American Journal of Sports Medicine最新文献

{"title":"Influence of Platelet Concentration on the Clinical Outcome of Platelet-Rich Plasma Injections in Knee Osteoarthritis: Response.","authors":"Angelo Boffa, Luca De Marziani, Luca Andriolo, Alessandro Di Martino, Iacopo Romandini, Stefano Zaffagnini, Filardo Giuseppe","doi":"10.1177/03635465251342994","DOIUrl":"https://doi.org/10.1177/03635465251342994","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"53 8","pages":"NP15-NP16"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Articular Cartilage Repair With Stratified Zonal Chondrocyte Implantation.","authors":"Yingnan Wu, Steven Bak Siew Wong, Xiafei Ren, Ching Ann Tee, Jamie Ho, Vinitha Denslin, Afizah Hassan, Yi Wei Justin Koh, Eng Hin Lee, Jongyoon Han, James Hoi Po Hui, Zheng Yang","doi":"10.1177/03635465251343288","DOIUrl":"10.1177/03635465251343288","url":null,"abstract":"<p><strong>Background: </strong>The zonal organization of articular cartilage is critical for the biphasic mechanical properties of the tissue. Current treatments for articular cartilage have yet to regenerate this zonal architecture, compromising the functional efficacy of the repaired tissue, which could account for tissue failure in the long term. Autologous chondrocyte implantation (ACI) still suffers from inconsistent efficacy and a long recovery period stemming from implantation of a heterogeneous chondrocyte mixture.</p><p><strong>Hypothesis: </strong>Stratified implantation of zonal chondrocytes would facilitate the recapitulation of articular cartilage zonal properties and improve the repair efficacy of ACI treatment.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Autologous chondrocytes extracted from porcine articular cartilage were subjected to dynamic microcarrier expansion followed by size-based segregation using a spiral microfluidic device for the enrichment of zonal chondrocytes. Zonal chondrocytes were implanted into a chondral defect as a bilayered hydrogel construct consisting of superficial zone chondrocytes overlaying middle/deep zone chondrocytes (n = 6). Twelve months after implantation, the repair efficacy was compared against implantation of full-thickness cartilage-derived heterogeneous chondrocytes expanded on tissue culture plates (n = 5) or microcarriers (n = 6).</p><p><strong>Results: </strong>Quantitative assessment of the repair tissues, including gross morphology, histological analysis, micro-computed tomography (micro<i>-</i>CT), compression modulus, and surface lubrication analysis, at 12 months demonstrated statistically significant improvement in cartilage and subchondral bone repair with zonal chondrocyte bilayered implantation. Magnetic resonance imaging (MRI) T2 mapping indicated progressive improvement in graft maturation as early as 3 months, reaching normalcy at 9 months.</p><p><strong>Conclusion: </strong>This study demonstrates that with appropriate expansion and isolation of zonal chondrocytes, stratified zonal chondrocyte implantation is able to facilitate restoration of articular cartilage zonal architecture and significantly enhance the functional repair as compared with current ACI treatment.</p><p><strong>Clinical relevance: </strong>With appropriate expansion and enrichment of zonal chondrocytes, stratified zonal chondrocyte implantation could represent a significant advancement over current ACI-based cartilage repair, with the potential to support quicker and better recovery.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"2094-2106"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar Rate of Return to Sport and Reoperation but Higher Rate of Recurrent Instability in Contact Versus Noncontact Athletes After Primary Arthroscopic Anterior Bankart Repair: A Systematic Review and Meta-analysis.","authors":"Jayson Saleet, Kevin A Hao, Khalid Al-Hourani, Alexander J Ment, Ross A Clarke, Patrick Nian, Emily J Curry, Hussein Abdul-Rassoul, Antonio Cusano, Robert L Parisien, Xinning Li","doi":"10.1177/03635465251328974","DOIUrl":"https://doi.org/10.1177/03635465251328974","url":null,"abstract":"<p><strong>Background: </strong>Anterior shoulder instability (ASI) is often seen in both contact and noncontact athletes, and the arthroscopic Bankart repair (ABR) procedure is among the most utilized procedures to treat patients with this condition. There is a lack of large studies comparing the return to sport (RTS), outcome, and recurrence rates after ABR in contact and noncontact athletes.</p><p><strong>Purpose: </strong>To understand the differences in postoperative RTS, outcomes, and complications in contact and noncontact athletes after primary ABR for ASI.</p><p><strong>Study design: </strong>Systematic review and meta-analysis; Level of evidence, 4.</p><p><strong>Methods: </strong>A systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included studies reported primary ABR without remplissage to treat ASI in athletes with a 1-year minimum follow-up. Random-effects meta-analysis was performed to compare outcomes.</p><p><strong>Results: </strong>Of the 1575 screened studies, 31 studies (2387 shoulders) were included. The mean age was 23.3 years (range, 13-50 years; SD, 2.97 years), 89% of the athletes were male, and the mean follow-up was 55.1 months (range, 12-107 months; SD, 22.8 months). Contact and noncontact athletes had similar rates of RTS (79% [95% CI, 63%-89%] and 91% [95% CI, 82%-96%], respectively; P = .079) and return to preinjury level (71% [95% CI, 56%-82%] and 79% [95% CI, 73%-85%], respectively; P = .201). Contact and noncontact athletes also demonstrated similar rates of revision surgery (6% [95% CI, 3%-13%] and 4% [95% CI, 3%-7%], respectively; P = .334). Contact athletes, however, exhibited a significantly higher rate of recurrent instability than noncontact athletes (17% [95% CI, 10%-27%] vs 8% [95% CI, 6%-12%]; P = .023).</p><p><strong>Conclusion: </strong>Compared with noncontact athletes, contact athletes demonstrate similar rates of RTS, return to preinjury level of play, and need for revision surgery but a higher rate of recurrent instability after primary ABR for ASI.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"3635465251328974"},"PeriodicalIF":4.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Sports Medicine: What Is It, and Why Should We Care?","authors":"Miho Jean Tanaka","doi":"10.1177/03635465251342798","DOIUrl":"https://doi.org/10.1177/03635465251342798","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"53 7","pages":"1551-1553"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Lack of Joint Line Tenderness Is Consistent With a Healed Meniscus, But Positive Clinical Examination Findings and MRI Scans Are Inconsistent in Identifying Failure After Meniscal Repair: A Systematic Review and Subgroup Meta-analysis.","authors":"Jon H Schoenecker, Luke V Tollefson, Rafat H Solaiman, Jill K Monson, Morgan D Homan, Grant J Dornan, Nicholas I Kennedy, Erik Ronnblad, Robert F LaPrade","doi":"10.1177/03635465241295709","DOIUrl":"10.1177/03635465241295709","url":null,"abstract":"<p><strong>Background: </strong>The number of meniscal repairs being completed each year is increasing; however, the optimal, cost-effective postoperative assessment to determine the success or failure of a meniscal repair is not well known.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this systematic review was to identify the clinical examination testing that correlates with objective magnetic resonance imaging (MRI) or second-look arthroscopy (SLA) findings to determine an optimal clinical workup for assessing postoperative meniscal repair healing. It was hypothesized that specific clinical tests would correlate with meniscal repairs that did not heal.</p><p><strong>Study design: </strong>Systematic review and meta-analysis; Level of evidence, 4.</p><p><strong>Methods: </strong>This systematic review included all clinical studies investigating meniscal repairs, meniscal repair outcomes, and meniscal healing with clinical findings, MRI, and/or SLA, published in a peer-reviewed journal and with full English text available. All included studies were evaluated for bias using the Methodological Index for Non-Randomized Studies (MINORS). The clinical tests included those using \"Barrett's criteria,\" with the assessment of effusion, joint line tenderness, locking, McMurray testing, and radiographs. This parameter has also been abbreviated to \"modified Barrett's criteria\" to include only joint line tenderness, effusion, and McMurray testing.</p><p><strong>Results: </strong>No significant correlations were found between clinical tests and MRI or SLA. A subgroup meta-analysis between Barrett's and non-Barrett's studies reported no significant subgroup differences (χ₁² = 0.24; <i>P</i> = .62). A meta-analysis of diagnostic accuracy using a group of 7 studies that reported on true-positive, true-negative, false-positive, and false-negative data for SLA demonstrated that only a lack of joint line tenderness had a high specificity for a healed meniscal repair, with a log diagnostic odds ratio of 2.62 (95% CI, 0.47-4.76).</p><p><strong>Conclusion: </strong>This study found no significant correlation with any specific clinical test for meniscal repair healing status using postoperative MRI and/or SLA findings. However, it was found that no healing (when compared with complete or incomplete healing) on MRI and joint line tenderness should be considered when assessing the status of postoperative meniscal repair healing. In addition, a subgroup meta-analysis found that a lack of joint line tenderness was highly correlated with a healed meniscal repair.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"1750-1760"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the Minimal Clinically Important Improvement, Substantial Clinical Benefit, and Patient Acceptable Symptom State for the iHOT-12, HOOS, and HOOS_global in the Nonoperative Management of Nonarthritic Hip-Related Pain.","authors":"Abby L Cheng, Christopher M Radlicz, Madeline M Pashos, Julia B Huecker, Karen Steger-May, Heidi Prather, John C Clohisy, Marcie Harris-Hayes","doi":"10.1177/03635465251325466","DOIUrl":"10.1177/03635465251325466","url":null,"abstract":"<p><strong>Background: </strong>Score cutoffs of clinically important outcome values such as the minimal clinically important improvement (MCII), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS) are population and treatment specific. In patients with nonarthritic hip-related pain, numerous score cutoffs have been calculated for use after surgical treatment, but they have not been established for patients who pursue nonoperative care.</p><p><strong>Purpose: </strong>To determine the MCII, SCB, and PASS score cutoffs for the 12-item International Hip Outcome Tool (iHOT-12), the Hip Disability and Osteoarthritis Outcome Score (HOOS), and an 8-item abbreviated version of the HOOS (HOOS_global) among patients with nonarthritic hip-related pain who were managed nonoperatively.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 4.</p><p><strong>Methods: </strong>The cohort included 15- to 40-year-old patients who were diagnosed with nonarthritic hip-related pain by a surgical or nonsurgical orthopaedic clinician and were advised to pursue nonoperative management at the time of evaluation. At baseline and 12-month follow-up, patients completed the iHOT-12, HOOS, and HOOS_global. Receiver operating characteristic curves were used to generate MCII, SCB, and PASS score cutoffs using an anchor-based approach as well as score changes between baseline and 12 months. The anchor question for the MCII and SCB utilized a 9-item global rating of change scale. The anchor question for the PASS was as follows (\"yes\"/\"no\" response): \"Taking into account all the activities you have during your daily life, your level of pain, and also your functional impairment, do you consider that your current state is satisfactory?\"</p><p><strong>Results: </strong>Among 61 patients (mean age, 28 ± 8 years; 50 [82%] female), for the iHOT-12, the MCII score cutoff was 14, the SCB score cutoff was 18, and the PASS score cutoff was 63. For the HOOS subscales, the MCII score cutoffs ranged from 4 (Activities of Daily Living) to 13 (Sport and Recreation), the SCB score cutoffs ranged from 10 (Symptoms and Activities of Daily Living) to 25 (Quality of Life), and the PASS score cutoffs ranged from 50 (Quality of Life) to 87 (Activities of Daily Living). For the HOOS_global, the MCII score cutoff was 5, the SCB score cutoff was 12, and the PASS score cutoff was 65. The models mostly had good responsiveness (area under the curve = 0.73-0.94).</p><p><strong>Conclusion: </strong>These clinically important outcome values can assist clinicians and researchers with interpreting patients' clinical change during nonoperative treatment for nonarthritic hip-related pain.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"1486-1493"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Measurement of Anteriorization After Tibial Tubercle Osteotomy.","authors":"Nathan H Varady, Nicolas Pascual-Leone, Ava G Neijna, Andreas H Gomoll, Sabrina M Strickland","doi":"10.1177/03635465251328634","DOIUrl":"10.1177/03635465251328634","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest in sagittal plane malalignment as a risk factor for patellofemoral chondral wear and, correspondingly, as an important measure to correct when performing certain tibial tubercle osteotomy (TTO) procedures. However, a radiographic method to measure anteriorization after TTO has not been described.</p><p><strong>Purpose: </strong>To develop and validate a radiographic method of measuring anteriorization after TTO.</p><p><strong>Study design: </strong>Cross-sectional study (diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>Patients treated by 2 high-volume sports medicine surgeons at a single institution who underwent a TTO from 2015 to 2023 with available pre- and postoperative radiographic and magnetic resonance imaging (MRI) scans were identified. Approximately 10 mm and 0 mm of operative anteriorization were targeted for the anteromedializing and straight distalizing TTOs, respectively. Two methods to assess anteriorization after TTO on lateral knee radiographs were developed, using the preoperative to postoperative difference in distance between the anterior-most aspect of the tibial tubercle and either the center of the tibial shaft or the anterior tibial plateau. To validate the radiographic techniques, intraclass correlation coefficients (ICCs) were calculated between each method of radiographic measurement and the gold standard MRI measurement (preoperative to postoperative difference in sagittal tibial tubercle-trochlear groove distance).</p><p><strong>Results: </strong>There were 70 patients (52 [74%] women) with a mean age of 31.5 ± 9.2 years. The mean anteriorization amount among the 57 anteriorizing TTOs was 4.9 ± 2.5 mm on the x-ray (XR) shaft technique, 4.6 ± 2.6 mm on the XR plateau technique, and 5.3 ± 2.7 mm on MRI (<i>P</i> = .35). The mean anteriorization amount among the 13 straight distalizing TTOs was 0.1 ± 2.5 mm on the XR shaft technique, -0.3 ± 2.2 mm on the XR plateau technique, and 0.6 ± 2.6 mm on MRI (<i>P</i> = .66). There was excellent agreement with MRI for both the XR shaft (ICC, 0.89) and XR plateau (ICC, 0.82) techniques. Interrater reliability was excellent for both techniques (ICC, 0.94-0.95).</p><p><strong>Conclusion: </strong>Anteriorization after TTO can be measured using routine pre- and postoperative radiographs. Additionally, the amount of anteriorization achieved with modern anteromedializing TTO techniques was less than that traditionally targeted. Moving forward, surgeons can assess the amount of anteriorization achieved during TTO on standard radiographs, while researchers may investigate the potential role of anteriorization on postoperative outcomes.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"1409-1416"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tendon Tissue Regeneration With Cell Orientation Using an Injectable Alginate-Cell Cross-linked Gel.","authors":"Jun Yamaguchi, Kentaro Homan, Tomohiro Onodera, Masatake Matsuoka, Shoutaro Arakawa, Natsumi Ueda, Shiho Sawada, Nana Kawate, Takayuki Nonoyama, Yoshinori Katsuyama, Koji Nagahama, Mitsuru Saito, Norimasa Iwasaki","doi":"10.1177/03635465251325498","DOIUrl":"10.1177/03635465251325498","url":null,"abstract":"<p><strong>Background: </strong>Tendons have a limited blood supply and form inferior scar tissue during repair, which increases the risk of reruptures, causes complications, and limits regenerative capacity. Current methods to repair injured tendon tissue use solid scaffolds, which carry the risk of contamination (infections) and require open surgery for transplantation.</p><p><strong>Hypothesis: </strong>Alginate-cell cross-linked gels, which can be applied by a percutaneous injection and transmit mechanical stress to cells via direct cell interaction, could induce tendon tissue regeneration.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A cross-linked gel was prepared to suspend azide-modified mesenchymal stromal cells (MSCs) in a dibenzocyclooctyne-modified branched alginic acid solution. The cross-linked gel was cultured in a bioreactor. In vivo, the Achilles tendon defects of 104 Lewis rats were injected with saline (control group), alginate gel alone (alginate group), alginate gel with MSCs (MSC group), and cross-linked gel (cross-link group). At 2 and 4 weeks postoperatively, histological and biochemical evaluations were performed. The biomechanical properties of repaired tissue were assessed at 4 weeks.</p><p><strong>Results: </strong>In the bioreactor culture, the cell orientation in the cross-linked gel was parallel to the direction of tension. Histological analysis of the cross-link group showed significantly more repaired tendon tissue and improved collagen fiber orientation compared with the alginate group or MSC group. The biomechanical properties of the cross-link group included higher stiffness.</p><p><strong>Conclusion: </strong>The cross-linked gel was injectable at the injury site and was able to induce tissue regeneration with cell-oriented adaptability to the mechanical environment of tissue defects.</p><p><strong>Clinical relevance: </strong>Intercellular cross-linking technology holds the potential for clinical application as a minimally invasive therapeutic approach that can contribute to the qualitative improvement of tendon tissue regeneration.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"1336-1346"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Inferential Investigation Into Countermovement Jump Determinants of Ulnar Collateral Ligament Injuries in Collegiate Baseball Pitchers.","authors":"Mu Qiao, Ryan L Crotin, David J Szymanski","doi":"10.1177/03635465251322913","DOIUrl":"10.1177/03635465251322913","url":null,"abstract":"<p><strong>Background: </strong>Countermovement jump (CMJ) analyses can predict ulnar collateral ligament (UCL) injuries in professional baseball pitchers, yet a biomechanical determinant linking CMJ analytics to UCL sprains is unknown.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to evaluate CMJ parameters in collegiate pitchers with high and low elbow varus torque (EVT) and investigate multilinear regression relationships between CMJ and EVT kinetics. It was hypothesized that pitchers with greater EVT would have greater CMJ measures, and CMJ kinetics would explain the variance in EVT kinetics.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>Analyses of 19 Division I collegiate baseball pitchers (age, 19.9 ± 1.5 years; body height, 1.87 ± 0.08 m; body mass, 90.0 ± 13.4 kg) were performed with integrated ball release speed, 3-dimensional motion capture, and ground reaction force (GRF) technology. A 1-way between-participant analysis of variance was used to compare CMJ and ball velocity metrics, while Pearson correlations (<i>r</i>) were used to evaluate the association between EVT and CMJ kinetic variables. An alpha level of .05 indicated statistical significance for all tests that included effect size calculations (η²) for mean differences.</p><p><strong>Results: </strong>The EVT rate of torque development (EVTRTD) was significantly greater in pitchers with a higher EVT (high EVT: 605 ± 74 vs low EVT: 353 ± 103 N·m·s^-1; <i>P</i> < .001; η² = 0.41). CMJ data were similar between groups, yet correlation models indicated that changes in peak CMJ GRF (<i>r</i> = 0.60, <i>P</i> < .001) and power (<i>r</i> = 0.53, <i>P</i> < .05) can explain variance in EVTRTD.</p><p><strong>Conclusion: </strong>Compared with absolute EVT, CMJ kinetics were more associated with the rate of EVT in collegiate pitchers.</p><p><strong>Clinical relevance: </strong>Therefore, as it relates to injury surveillance, identifying pitchers who display increases in peak GRF, concentric impulse, and peak CMJ power may provide early detection in protecting athletes from elbow valgus overload.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"1202-1209"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Tibial Tubercle-Trochlear Groove Distance and Sulcus Angle Are Associated With Patellar Osteochondritis Dissecans in Pediatric Patients.","authors":"Emilie Lijesen, Akshitha Adhiyaman, Olivia C Tracey, Joshua T Bram, Nnaoma M Oji, Danielle E Chipman, Shae K Simpson, Douglas N Mintz, Peter D Fabricant, Daniel W Green","doi":"10.1177/03635465251320117","DOIUrl":"10.1177/03635465251320117","url":null,"abstract":"<p><strong>Background: </strong>Osteochondritis dissecans (OCD) lesions in the knee are most commonly found in the medial femoral condyle (MFC). However, a paucity of literature has explored the characteristics or morphology of patellar OCD lesions.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to analyze patellar tracking and patellofemoral measurements of pediatric patients with patellar OCD compared with patients with MFC OCD. It was hypothesized that the patients with patellar OCD would demonstrate an increased bony sulcus angle, cartilaginous sulcus angle, and tibial tubercle-trochlear groove (TT-TG) distance compared with patients with MFC OCD.</p><p><strong>Study design: </strong>Case series; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients aged ≤18 years diagnosed with either a patellar or MFC OCD lesion at a single tertiary care hospital between January 2016 and May 2023 were analyzed. Patients with a history of patellar instability were excluded. The Caton-Deschamps index, cartilaginous bony height, trochlear depth, patellar tilt, lateral patellar displacement, cartilaginous sulcus angle, bony sulcus angle, and TT-TG distance were assessed on magnetic resonance imaging (MRI). Patients were matched 1:2 based on sex and chronological age within 2 years between the patellar and MFC OCD groups.</p><p><strong>Results: </strong>A total of 40 extremities in 34 patients with patellar OCD were matched to 80 extremities in 73 patients with MFC OCD. The mean age at the time of MRI was 14.1 ± 2.3 years, and 23% were female. Compared with patients with MFC OCD, patients with patellar OCD had a significantly greater TT-TG distance (11.55 ± 4.15 vs 13.35 ± 4.07 mm, respectively; <i>P</i> = .03). The cartilaginous sulcus angle (150.63°± 7.20° vs 128.09°± 14.07°, respectively; <i>P</i> < .001) and bony sulcus angle (144.70°± 7.78° vs 137.37°± 9.62°, respectively; <i>P</i> < .001) were higher in the patellar OCD group compared with the MFC OCD group. Of patients with patellar OCD, 40% had a TT-TG distance >15 mm, and of patients with MFC OCD, 20% had a TT-TG distance >15 mm. The patellar OCD group had 3.7 times the risk of having a patellar dislocation compared with the MFC OCD group.</p><p><strong>Conclusion: </strong>An increased TT-TG distance and sulcus angle were associated with patellar OCD in pediatric patients. Patients with abnormal patellofemoral morphology who undergo treatment for a patellar OCD lesion may subsequently develop a patellar dislocation; in this study, patients with patellar OCD without a history of patellar dislocations demonstrated a nearly 4-fold higher dislocation rate compared with an age- and sex-matched group of patients with MFC OCD.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"1112-1118"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}