American Journal of Sports Medicine最新文献

{"title":"Association Between Global Overcoverage and Long-term Survivorship, Chondrolabral Junction Breakdown, and Reduced Joint Space Width: Minimum 8-Year Follow-up.","authors":"Jonathan S Lee, Stephen M Gillinov, Bilal S Siddiq, Kieran S Dowley, Michael C Dean, Nathan J Cherian, Christopher T Eberlin, Michael P Kucharik, Scott D Martin","doi":"10.1177/03635465251317738","DOIUrl":"10.1177/03635465251317738","url":null,"abstract":"<p><strong>Background: </strong>Although previous literature has established the association between femoroacetabular impingement and progressive hip osteoarthritis, there exists a paucity of studies investigating the effects of global acetabular overcoverage on chondral wear and long-term outcomes.</p><p><strong>Purpose: </strong>To compare baseline joint space width (JSW), intraoperative findings, long-term total hip arthroplasty (THA)-free survivorship, patient-reported outcome measures (PROMs), pain levels, and patient satisfaction in patients who underwent hip arthroscopy with global overcoverage (GO) to a matched-control (MC) cohort.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>In this retrospective analysis, the authors queried patients who underwent hip arthroscopy for acetabular labral tears secondary to femoroacetabular impingement. Patients with complete PROMs at a minimum 8-year follow-up, the presence of coxa profunda as indicated by an acetabular wall projecting medial to the ilioischial line, and a lateral center-edge angle >40° were matched 1:1 by sex, age, body mass index, Tönnis grade, and labral treatment to a MC cohort of patients who had normal acetabular coverage. Baseline radiographic and intraoperative findings were compared between cohorts. Collected outcomes include the modified Harris Hip Score, Nonarthritic Hip Score, Lower Extremity Functional Scale score, Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Specific Subscale, 33-item International Hip Outcome Tool score, pain levels, patient satisfaction, and conversion to THA.</p><p><strong>Results: </strong>In total, 38 patients with GO were 1:1 matched to a MC cohort. The GO cohort had significantly decreased baseline JSW at 50° (<i>P</i> = .002) and greater chondrolabral junction breakdown (<i>P</i> = .037). The GO and MC cohorts achieved similar outcomes for all 6 PROMs, rates of conversion to THA, pain levels, and patient satisfaction. Kaplan-Meier survival analysis demonstrated that the patients experienced a similar overall 18-year THA-free survival rate (GO: 71.1% vs MC: 84.2%; <i>P</i> = .101). To isolate the long-term effects of GO on hip arthroscopy outcomes, 6- to 18-year THA-free survivorship was examined, revealing that the GO cohort (-13.1%) experienced a significantly greater decrease compared with the MC cohort (-5.3%) (<i>P</i> = .008).</p><p><strong>Conclusion: </strong>Patients with GO had significantly lower baseline ipsilateral JSW at 50° and greater intraoperative severity of chondrolabral junction breakdown. Furthermore, the GO cohort experienced a significantly greater decrease in long-term THA-free survivorship 6 to 18 years after hip arthroscopy.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"900-910"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460806","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":"To Fix or Rebuild.","authors":"Brett D Owens","doi":"10.1177/03635465251318658","DOIUrl":"https://doi.org/10.1177/03635465251318658","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"53 3","pages":"523-524"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532217","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":"Trochlear Morphological Changes in Skeletally Immature Patients Across Consecutive MRI Studies.","authors":"Kevin J Orellana, Julianna Lee, Daniel Yang, David Kell, Jie Nguyen, J Todd Lawrence, Brendan A Williams","doi":"10.1177/03635465241312168","DOIUrl":"10.1177/03635465241312168","url":null,"abstract":"<p><strong>Background: </strong>Trochlear dysplasia is a consistent risk factor for recurrent patellofemoral instability (PFI), but there is limited understanding of how the trochlea develops during growth. The aim of this study was to evaluate serial magnetic resonance imaging (MRI) studies performed in skeletally immature patients with and without PFI to characterize changes in trochlear anatomy over time.</p><p><strong>Hypothesis: </strong>PFI leads to progressive worsening of trochlear dysplasia over time.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted on pediatric patients (<18 years of age) with and without a diagnosis of PFI who had multiple ipsilateral MRI studies of the knee at least 6 months apart. Inclusion criteria were patients with open distal femoral physes at the initial MRI study and no intervening surgery between MRI studies. All patients with PFI were included, and 30 patients without PFI were identified for comparison. MRI scans were retrospectively reviewed to evaluate trochlear morphology using the Dejour and Oswestry-Bristol classifications and to measure the sulcus angle, trochlear depth index, medial condylar trochlear offset, and lateral trochlear inclination (LTI). Univariate and bivariate statistics were performed to evaluate differences in morphology between MRI studies and between groups.</p><p><strong>Results: </strong>A total of 128 patients were identified (98 in the PFI group, 30 in the non-PFI group) with a mean age of 12.3 ± 2.4 years and mean time between MRI studies of 2.3 ± 1.5 years (range, 0.5-6.5 years). Among patients with PFI, rates of moderate to severe (Dejour grades B-D and Oswestry-Bristol classification flat or convex) trochlear dysplasia increased from the initial to most recent imaging study (67% vs 89%; <i>P</i> < .001), and statistically significantly more dysplastic LTI and sulcus angle were observed on follow-up (<i>P</i> < .05). Among the non-PFI group, the percentage of patients with normal trochlear morphology increased from 53% to 87% (<i>P</i> < .001), and less dysplastic measures of trochlear depth index, LTI, and sulcus angle were seen on follow-up imaging (<i>P</i> < .05). When comparing rates of change, trochlear metrics changed toward a more shallow and dysplastic direction in the PFI cohort and toward a deeper and less dysplastic direction in the non-PFI group.</p><p><strong>Conclusion: </strong>Skeletally immature patients with untreated PFI have trochlear dysplasia that progressively worsens over time. Conversely, those without PFI have trochlear characteristics that appear to normalize with growth.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"690-698"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030321","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":"The Predicted Position of the Knee Near the Time of ACL Rupture Is Similar Between 2 Commonly Observed Patterns of Bone Bruising on MRI: Response.","authors":"Sophia Y Kim-Wang, Charles E Spritzer, Jefferson R Bercaw, Kwadwo Owusu-Akyaw, James A Coppock, Adam P Goode, Jocelyn R Wittstein, Louis E DeFrate","doi":"10.1177/03635465241311246","DOIUrl":"https://doi.org/10.1177/03635465241311246","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"53 3","pages":"NP7-NP13"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532214","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":"Comparison of Revision and Primary Osteochondral Allograft Transplantation at Midterm Follow-up: Patient Reported Outcomes, Survivorship, and Reoperation Rates.","authors":"Zachary D Meeker, Derrick M Knapik, Kyle R Wagner, Ron Gilat, Eric J Cotter, Allen A Yazdi, Alexander C Weissman, Nolan B Condron, Adam B Yanke, Brian J Cole","doi":"10.1177/03635465251316475","DOIUrl":"10.1177/03635465251316475","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Previous studies have observed promising short-term outcomes after revision osteochondral allograft (OCA) transplantation. However, few studies have examined midterm outcomes after revision OCA transplantation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To examine midterm outcomes after revision OCA transplantation of the femoral condyle and evaluate reoperation and survivorship compared with a matched cohort of patients who underwent primary OCA transplantation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review of prospectively collected data identified patients undergoing revision OCA transplantation to the femoral condyle between 1999 and 2018 (minimum 5-year follow-up). A 1:2 cohort of patients who underwent revision OCA transplantation to patients who underwent primary OCA transplantation, matched by defect size, age, sex, and body mass index, was created. Patient-reported outcome measures and the incidence of reoperations or graft failures were collected. Failure was defined as subchondral collapse of the OCA transplantation as confirmed via second-look arthroscopy, revision OCA transplantation, or conversion to knee arthroplasty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifteen patients who underwent revision OCA transplantation were matched to 30 patients who underwent primary OCA transplantation. The mean follow-up in the revision OCA transplantation group was 9.3 ± 3.0 years (range, 5.1-14.7 years), with a mean age of 31.4 ± 10.0 years (range, 19.9-52.7 years) and a mean body mass index of 25.9 ± 3.4 (range, 20.8-30.4). Revision OCA transplantation was performed to the lateral condyle in 53% of cases (8/15). A concomitant procedure was performed in 73% of patients (11/15), most commonly involving meniscal allograft transplantation (73% [8/11]), followed by realignment osteotomy (27% [3/11]). The Patient Acceptable Symptom State was achieved by a majority of patients who underwent revision OCA transplantation for all patient-reported outcome measures examined (International Knee Documentation Committee, 70%; Lysholm, 83%; Knee injury and Osteoarthritis Outcome Score [KOOS] Pain, 100%; KOOS Symptoms, 70%, KOOS Sport, 90%; KOOS Activities of Daily Living, 80%; KOOS Quality of Life, 80%), and there was no difference in the proportion of patients the Patient Acceptable Symptom State when compared with those undergoing primary OCA transplantation (&lt;i&gt;P&lt;/i&gt;≥ .070) (see Table 3). Eight patients (53%) underwent revision OCA transplantation reoperation at a mean time of 3.9 ± 3.7 years (range, 0.6-11.2 years). Failures were observed in 20% (3/15) of patients who underwent revision OCA transplantation at a mean of 4.3 ± 1.9 years (range, 1.7-6.4 years). Graft survivorship free from reoperation (&lt;i&gt;P&lt;/i&gt; = .905; revision 53% [8/15], primary 43% [13/30]) and failure (&lt;i&gt;P&lt;/i&gt; = .577; revision 13% [2/15], primary 20% [6/30]) was not significantly different betwe","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"863-870"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460740","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":"Microfragmented Adipose Tissue Has No Advantage Over Platelet-Rich Plasma and Bone Marrow Aspirate Injections for Symptomatic Knee Osteoarthritis: A Systematic Review and Meta-analysis.","authors":"Erik Hohmann, Natalie Keough, Rachel M Frank, Scott A Rodeo","doi":"10.1177/03635465241249940","DOIUrl":"10.1177/03635465241249940","url":null,"abstract":"<p><strong>Background: </strong>Microfragmented adipose tissue has been proposed for intra-articular treatment of knee osteoarthritis. There are little data comparing the outcomes of treatment between microfragmented adipose tissue and other biological treatments.</p><p><strong>Purpose: </strong>To perform a systematic review and meta-analysis comparing microfragmented aspirated fat injections to other orthobiologics, hyaluronic acid, and corticosteroid injections for symptomatic knee osteoarthritis.</p><p><strong>Study design: </strong>Systematic review and meta-analysis; Level of evidence, 2.</p><p><strong>Methods: </strong>A systematic review of the literature was performed to identify pertinent publications in the MEDLINE, Embase, Scopus, and Google Scholar databases, including all level 1 to 3 studies from 2000 to 2023. Validated knee scores (visual analog scale [VAS] for pain, Knee injury and Osteoarthritis Outcome Score [KOOS], Lysholm, International Knee Documentation Committee) were included as outcome measures. Risk of bias was assessed using Cochrane tools. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the quality of the body of evidence and the modified Coleman Methodology Score was used to assess study quality. Heterogeneity was assessed using χ² and <i>I</i>² statistics.</p><p><strong>Results: </strong>Five studies were included in the analysis. One study had a high risk of bias; 4 studies had some risk of bias. The overall study quality was fair, and the certainty of evidence was low. The pooled estimate for VAS scores did not demonstrate significant differences at 3, 6, and 12 months. The pooled estimate for the KOOS Pain, Symptoms, Activities of Daily Living, Sport and Recreation, and Quality of Life subscales did not demonstrate significant differences at 3, 6, and 12 months.</p><p><strong>Conclusion: </strong>The results of this systematic review and meta-analysis demonstrated that there were no statistically significant differences for both the clinical outcomes and pain scores between microfragmented adipose tissue and other orthobiologics for the treatment of knee osteoarthritis. However, modest study quality, some risk of bias, and low certainty of evidence reduce external validity, and these results must be viewed with some caution.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"988-998"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923968","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":"The Clinical Significance of Using PASS Thresholds When Administering Patient-Reported Outcome Instruments After Anterior Cruciate Ligament Reconstruction.","authors":"Julian Mobley, Devin K Kelly, Bradley J Lauck, Gabrielle M DelBiondo, Xavier D Thompson, Joe M Hart, Amelia S Bruce Leicht","doi":"10.1177/03635465241298917","DOIUrl":"10.1177/03635465241298917","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patient-reported outcome (PROs) instruments of knee function quality of life are routinely administered to patients after anterior cruciate ligament reconstruction (ACLR). The Patient Acceptable Symptom State (PASS), an evidence-based threshold defining perceived outcomes, may be a useful indicator of strength and functional performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare strength and functional performance between patients recovering from ACLR who did and did not meet PASS thresholds on associated PROs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cross-sectional study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 223 patients who had undergone ACLR (106 women, 117 men; 7.62 ± 1.71 months after ACLR) completed isokinetic knee extensor and flexor strength at 90 deg/s, hop performance (single-limb hop for distance [SLHD], triple hop for distance [THD], 6-m timed hop [6MH]), and PROs (International Knee Documentation Committee Subjective Form [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], and Anterior Cruciate Ligament Return to Sport After Injury [ACL-RSI]) assessments in a controlled laboratory setting at an academic institution. Independent-samples &lt;i&gt;t&lt;/i&gt; tests compared strength and hop measures between patients who did and did not achieve a PASS on the PROs. Limb symmetry index (LSI) was calculated as (ACLR Limb ÷ Contralateral Limb) × 100%. Strength and hop performance LSI outcomes were converted into indicator variables, categorized as either a \"pass\" or \"fail\" based on the operational definition of having an LSI value ≥90%. Chi-square tests compared strength and hop LSI PASS status measures to PRO PASS status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients who achieved IKDC&lt;sub&gt;PASS&lt;/sub&gt; were significantly stronger and had more symmetric limbs than those who did not achieve IKDC&lt;sub&gt;PASS&lt;/sub&gt;. Values for IKDC&lt;sub&gt;PASS&lt;/sub&gt; were as follows: knee extension ACLR limb 1.72 ± 0.47 N·m/kg, contralateral limb 2.40 ± 0.45 N·m/kg, LSI 71.64% ± 15.23%; knee flexion ACLR limb 1.04 ± 0.29 N·m/kg, contralateral limb 1.05 ± 0.26 N·m/kg, LSI 99.12% ± 17.22%. Values for IKDC&lt;sub&gt;FAIL&lt;/sub&gt; were knee extension ACLR limb 1.47 ± 0.52 N·m/kg, contralateral limb 2.25 ± 0.47 N·m/kg, LSI 64.66% ± 17.07%; knee flexion ACLR limb 0.88 ± 0.28 N·m/kg, contralateral limb 0.97 ± 0.28 N·m/kg, LSI 90.46% ± 17.41%. Effect sizes ranged from small to moderate (&lt;i&gt;P&lt;/i&gt; &lt; .001; &lt;i&gt;d&lt;/i&gt; = 0.3-0.55). IKDC&lt;sub&gt;PASS&lt;/sub&gt; status was significantly associated with an LSI ≥90% for knee flexion peak torque (χ&lt;sup&gt;2&lt;/sup&gt; = 9.66; &lt;i&gt;P&lt;/i&gt; = .002), SLHD (χ&lt;sup&gt;2&lt;/sup&gt; = 9.61; &lt;i&gt;P&lt;/i&gt; = .002), and THD (χ&lt;sup&gt;2&lt;/sup&gt; = 3.97; &lt;i&gt;P&lt;/i&gt; = .02), with a moderate effect size (&lt;i&gt;P&lt;/i&gt; &lt; .05; &lt;i&gt;d&lt;/i&gt; = 0.41-0.73). Significant relationships were found with KOOS&lt;sub&gt;PASS&lt;/sub&gt; (Pain, Activities of Daily Living [ADL], and Sport) and LSI ≥90% for peak knee flexion torque with a moderate effect size (Pain and ADL, &lt;i&gt;P&lt;/i&gt; &lt; .001; Sp","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"299-307"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916144","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":"Reconstruction of the Superior Capsule Using Peroneus Longus Tendon Graft Combined With Transposition of Biceps Tendon for Irreparable Massive Rotator Cuff Tears.","authors":"Yi Zhou, Ling Chen, Fan Bai, Xiaolong Yang, Weili Fu","doi":"10.1177/03635465241303153","DOIUrl":"10.1177/03635465241303153","url":null,"abstract":"<p><strong>Background: </strong>Traditional superior capsular reconstruction (SCR) with biceps tendon transposition (TB) alone for irreparable massive rotator cuff tears (IMRCTs) has demonstrated a high retear rate, highlighting the need for alternative approaches. Therefore, SCR using a peroneus longus tendon graft (PLG) combined with TB (PLG-TB) should be clinically studied.</p><p><strong>Purpose: </strong>To compare the clinical and radiological outcomes of SCR using the PLG-TB technique versus the TB technique alone for IMRCT.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Between February 2017 and March 2022, 94 patients were diagnosed with IMRCT; 45 patients underwent SCR using the TB technique (group 1), and 49 patients underwent SCR using the PLG-TB technique (group 2). The choice of technique was based on tendon damage severity and patient preference. After a minimum follow-up period of 2 years, postoperative clinical outcomes were compared using the American Shoulder and Elbow Surgeons (ASES); University of California, Los Angeles (UCLA); Constant; and visual analog scale (VAS) for pain scores as well as the shoulder range of motion. The integrity of tendons, acromiohumeral distance, and retear was evaluated through magnetic resonance imaging (MRI).</p><p><strong>Results: </strong>The mean follow-up times were 35.2 ± 4.2 months for group 1 and 34.1 ± 3.2 months for group 2. There was a significant improvement observed in all clinical outcomes in both groups from the baseline preoperative evaluations to the final follow-up assessments (<i>P</i> = .001 for ASES score, UCLA score, Constant score, VAS score, forward flexion, abduction, and external rotation). Shoulder abduction in group 2 showed statistically significant mean improvements at the postoperative 3-month, 6-month, and final follow-ups compared with group 1 (3 months: 105.17°± 7.13° vs 89.34°± 7.34° [<i>P</i> = .001]; 6 months: 138.14°± 9.12° vs 107.35°± 8.54° [<i>P</i> = .001]; final follow-up: 157.35°± 8.11° vs 135.31°± 7.01° [<i>P</i> = .001]). The tendon integrity at the final follow-up (Sugaya MRI grades 1/2/3/4/5) was significantly better in group 2 (30/6/6/4/3) compared with group 1 (11/13/5/6/10) (<i>P</i> = .014). Additionally, the tendon retear rate was lower in group 2 (7/49; 14.29%) than in group 1 (16/45, 35.56%) (<i>P</i> = .015).</p><p><strong>Conclusion: </strong>Both surgical techniques led to acceptable clinical outcomes in patients with IMRCT. However, using the PLG-TB technique for SCR was associated with lower retear rates and enhanced abduction function outcomes compared with the TB technique for SCR.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"437-446"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923977","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":"Evaluation of a Depression Screening Program in Pediatric Orthopaedic Sports Clinics: Identifying At-Risk Adolescents.","authors":"Reinaldo E Colon-Morillo, Katina Kartalias, Tracey P Bryan, Eric W Edmonds","doi":"10.1177/03635465241307207","DOIUrl":"10.1177/03635465241307207","url":null,"abstract":"<p><strong>Background: </strong>Mental health is a contributing factor to the overall well-being of patients, and the 2-question Patient Health Questionnaire (PHQ-2) and 9-question Patient Health Questionnaire (PHQ-9) are reliable in-clinic tools to assess depression and self-harm. The prevalence of adolescents with depression symptoms within a pediatric orthopaedic sports clinic has not been assessed.</p><p><strong>Hypothesis: </strong>That rates of depression and risk of self-harm would vary based on presenting pathology among adolescents sustaining a sports-related injury.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A query of the institutional electronic medical record was performed to identify all patients aged 12 to 21 years who were administered the PHQ-2 or PHQ-9 over a 2.3-year period within pediatric orthopaedic sports clinics. The rate of a positive screen prompting administration of PHQ-9 (PHQ-2 score ≥3), rate of depression risk (PHQ-9 score ≥10), and rate of patients indicating self-harm (affirmative score on question 9) were evaluated. Patients were placed into 4 broad diagnostic categories: knee instability, knee other, shoulder pathology, or other sports-related injuries. Multivariate binary logistic regression was performed to identify available patient and diagnosis predictors of self-harm risk.</p><p><strong>Results: </strong>A total of 3298 patients were screened in pediatric orthopaedic sports clinics from 2018 to 2021. The overall positive screen rate (PHQ-2) was 4.2% (n = 138), the depression risk rate (PHQ-9) was 1.9% (n = 63), and the self-harm rate was 0.9% (n = 29). Self-harm showed a significant difference, with shoulder and knee instability having the highest rate. Black/African American race (OR, 3.8; 95% CI, 1.3-11; <i>P</i> = .02), female sex (OR, 3.0; 95% CI, 1.3-6.9; <i>P</i> = .01), public/government insurance (OR, 2.2; 95% CI, 1.03-4.8; <i>P</i> = .041), shoulder pathology (OR, 3.4; 95% CI, 1.3-9.4; <i>P</i> = .016), and knee instability diagnosis (OR, 2.8; 95% CI, 1.2-6.5; <i>P</i> = .02) were associated with an increased risk of self-harm.</p><p><strong>Conclusion: </strong>This study demonstrated a 2% rate of depression risk and a 1% rate of self-harm risk in adolescents treated within pediatric orthopaedic sports clinics. Race, sex, and public/government insurance were found to be predictive factors. Knowledge of risk factors can help increase awareness and recognition of potential mental health conditions that may need to be addressed during treatment for adolescents with sports-related injuries. The authors recommend that adolescents >12 years of age complete this quick assessment at the start of their orthopaedic sports clinic encounter.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"463-468"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933656","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":"No Difference in External Rotation Loss After Isolated Bankart Repair, Remplissage, or Latarjet: A Systematic Review and Meta-analysis.","authors":"Diego Gonzalez-Morgado, Javier Ardebol, Matthew B Noble, Lisa A Galasso, Mariano E Menendez, Patrick J Denard","doi":"10.1177/03635465241241825","DOIUrl":"10.1177/03635465241241825","url":null,"abstract":"<p><strong>Background: </strong>Despite the effectiveness of remplissage in reducing instability recurrence, debate remains about the loss of external rotation (ER) after this procedure.</p><p><strong>Purpose: </strong>To compare the loss of ER after primary isolated arthroscopic Bankart repair alone (BR), Bankart with remplissage (REMP), and Latarjet (LAT) procedures.</p><p><strong>Study design: </strong>Meta-analysis; Level of evidence, 3.</p><p><strong>Methods: </strong>A literature search of 4 databases was conducted to identify comparative studies reporting ER after BR, REMP, or LAT. ER loss with the arm at side was collected, along with postoperative Rowe score, return to previous sport level, instability recurrence, reintervention, and noninstability complications. Dichotomous variables were assessed using odds ratios with 95% CIs, and continuous variables were analyzed using mean differences (MDs) with 95% CIs. A random-effects meta-analysis was used for continuous outcomes and dichotomous outcomes.</p><p><strong>Results: </strong>In total, 27 studies were included, consisting of 2100 patients: 824 in BR, 378 in REMP, and 898 in LAT groups. The mean ER loss was 6.8°± 11° after BR, 9.3°± 12.6° after REMP, and 0.8°± 20.4° after LAT. Comparing REMP and BR, the MD was 5.9° (<i>P</i> = .13); between REMP and LAT, the MD was 9.6° (<i>P</i> = .17). For Rowe scores, the MD was 3.46 (<i>P</i> = .49) between REMP and BR and 0.24 (<i>P</i> = .9) between REMP and LAT. Odds ratios for return to previous sport level were 1.08 (<i>P</i> = .84) for REMP versus BR and 1.62 (<i>P</i> = .09) for REMP versus LAT. Regarding instability recurrence, the odds ratio was 6.67 (<i>P</i> = .04) for REMP versus BR and 1.43 (<i>P</i> = .48) for REMP versus LAT. The odds ratio for reoperation for BR was 7.69 (<i>P</i> = .05) compared with REMP, and the odds ratio for complications for LAT was 6.25 (<i>P</i> = .02) compared with REMP.</p><p><strong>Conclusion: </strong>Remplissage reduces instability recurrence compared with isolated Bankart repair without any statistically significant difference in postoperative ER deficit. Remplissage may reduce the risk of reoperation compared with Latarjet with no difference in postoperative ER deficit or recurrence.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"493-500"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967391","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}