Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101293
Joshua T. Finerty B.S. , Nicholas R. Kossoff B.S. , Allison R. Garden B.S. , Joshua S. Everhart M.D., M.P.H.
Purpose
To determine whether patient-reported allergies (a proposed indirect measure of mental health) or direct measures of mental health are associated with preoperative symptom scores, as measured by the 12-item International Hip Outcome Tool (iHOT-12) in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome.
Methods
This retrospective study analyzed prospectively collected data from consecutive patients undergoing outpatient hip arthroscopy for femoroacetabular impingement syndrome by a single surgeon. Patients completed the iHOT-12 preoperatively. Number of allergies, medication classes with allergic reactions, and reaction types were documented. Mental health was assessed via pre-existing psychiatric diagnoses, EQ-5D-5L anxiety/depression score, and Mental Health Inventory-5 (MHI-5) score. Associations between mental health measures (including allergies) and iHOT-12 scores were determined using bivariate and multivariate regression with forward selection.
Results
Ninety-one patients were included (69.2% male, 30.8% female), with a mean age of 36.6 (±13.7) years. In bivariate analysis, mental health measures associated with lower iHOT-12 scores were number of allergies (−1.91 per allergy, SE = 0.62; P = .002), MHI-5 score (+0.87 per point, SE = 0.38; P = .03), EQ-5D-5L anxiety/depression score (−3.87 per point, SE = 1.71; P = .03), and nonphysiologically appropriate allergic reactions (−3.78 per reaction, SE = 1.72; P = .03). Independent predictors of iHOT-12 scores in multivariate analysis were number of allergies (−1.16 points per allergy, SE = 0.58; P = .04), EQ-5D-5L anxiety/depression score, (−3.68 per 1 point increase, SE = 1.51; P = .02), and UCLA activity score (2.83 per 1-point increase, SE = 0.71; P = .001).
Conclusions
Number of self-reported allergies is a simple, easily accessible measure that clinicians can use as a proxy measure of mental health that is predictive of patient-reported outcome measures prior to hip arthroscopy.
Level of Evidence
Level III, Retrospective cross-sectional.
目的通过12项国际髋关节结局工具（iHOT-12）对接受股髋臼撞击综合征髋关节镜检查的患者进行测量，确定患者报告的过敏（一种建议的间接心理健康指标）或直接心理健康指标是否与术前症状评分相关。方法回顾性分析同一外科医生门诊连续行股髋臼撞击综合征髋关节镜检查患者的前瞻性资料。患者术前完成iHOT-12测试。记录过敏的数量，过敏反应的药物类别和反应类型。通过预先存在的精神诊断、EQ-5D-5L焦虑/抑郁评分和心理健康量表-5 （MHI-5）评分来评估心理健康状况。心理健康指标（包括过敏）与iHOT-12评分之间的关系采用双变量和多变量回归和正向选择来确定。结果纳入患者91例（男性69.2%，女性30.8%），平均年龄36.6（±13.7）岁。在双变量分析中，与iHOT-12得分较低相关的心理健康指标为过敏次数（每个过敏- 1.91次，SE = 0.62; P = 0.002）、MHI-5评分（每分+0.87次，SE = 0.38; P = 0.03）、EQ-5D-5L焦虑/抑郁评分（每分- 3.87次，SE = 1.71; P = 0.03）和非生理上适当的过敏反应（每个反应- 3.78次，SE = 1.72; P = 0.03）。多变量分析中iHOT-12评分的独立预测因子为过敏次数（每个过敏- 1.16分，SE = 0.58; P = 0.04）、EQ-5D-5L焦虑/抑郁评分（每增加1分- 3.68分，SE = 1.51; P = 0.02）和UCLA活动评分（每增加1分2.83分，SE = 0.71; P = 0.001）。结论自我报告的过敏次数是一种简单、容易获得的测量方法，临床医生可以用它作为心理健康的替代测量方法，预测髋关节镜检查前患者报告的结果。证据等级：III级，回顾性横断面。
{"title":"Number of Patient-Reported Allergies and Other Mental Health Measures Correlate With Symptom Severity at Time of Hip Arthroscopy for Femoroacetabular Impingement Syndrome","authors":"Joshua T. Finerty B.S. , Nicholas R. Kossoff B.S. , Allison R. Garden B.S. , Joshua S. Everhart M.D., M.P.H.","doi":"10.1016/j.asmr.2025.101293","DOIUrl":"10.1016/j.asmr.2025.101293","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether patient-reported allergies (a proposed indirect measure of mental health) or direct measures of mental health are associated with preoperative symptom scores, as measured by the 12-item International Hip Outcome Tool (iHOT-12) in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed prospectively collected data from consecutive patients undergoing outpatient hip arthroscopy for femoroacetabular impingement syndrome by a single surgeon. Patients completed the iHOT-12 preoperatively. Number of allergies, medication classes with allergic reactions, and reaction types were documented. Mental health was assessed via pre-existing psychiatric diagnoses, EQ-5D-5L anxiety/depression score, and Mental Health Inventory-5 (MHI-5) score. Associations between mental health measures (including allergies) and iHOT-12 scores were determined using bivariate and multivariate regression with forward selection.</div></div><div><h3>Results</h3><div>Ninety-one patients were included (69.2% male, 30.8% female), with a mean age of 36.6 (±13.7) years. In bivariate analysis, mental health measures associated with lower iHOT-12 scores were number of allergies (−1.91 per allergy, SE = 0.62; <em>P</em> = .002), MHI-5 score (+0.87 per point, SE = 0.38; <em>P</em> = .03), EQ-5D-5L anxiety/depression score (−3.87 per point, SE = 1.71; <em>P</em> = .03), and nonphysiologically appropriate allergic reactions (−3.78 per reaction, SE = 1.72; <em>P</em> = .03). Independent predictors of iHOT-12 scores in multivariate analysis were number of allergies (−1.16 points per allergy, SE = 0.58; <em>P</em> = .04), EQ-5D-5L anxiety/depression score, (−3.68 per 1 point increase, SE = 1.51; <em>P</em> = .02), and UCLA activity score (2.83 per 1-point increase, SE = 0.71; <em>P</em> = .001).</div></div><div><h3>Conclusions</h3><div>Number of self-reported allergies is a simple, easily accessible measure that clinicians can use as a proxy measure of mental health that is predictive of patient-reported outcome measures prior to hip arthroscopy.</div></div><div><h3>Level of Evidence</h3><div>Level III, Retrospective cross-sectional.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101293"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Purpose</h3><div>To investigate the postoperative results of arthroscopic posterior Bankart repair for traumatic posterior shoulder instability in collision sports athletes and their clinical characteristics, including injury mechanism, symptoms, physical examination findings, and imaging features.</div></div><div><h3>Methods</h3><div>Between January 2011 and April 2022, a retrospective review was conducted of collision-sport athletes who underwent arthroscopic posterior Bankart repair for traumatic posterior shoulder instability at a single institution. The inclusion criteria were posterior instability caused by trauma, absence of generalized joint laxity, and arthroscopic posterior Bankart repair. All the patients had a minimum follow-up of 24 months. Patient demographics, injury mechanisms, imaging findings (evaluated using radiographs, computed tomography, and magnetic resonance imaging, including posterior labral tears, posterior glenoid bone loss, glenoid retroversion, and reverse Hill-Sachs lesions), return-to-play rates, recurrence, and postoperative shoulder pain and Rowe score were evaluated. Pre- and postoperative Rowe scores were compared using the Wilcoxon signed-rank test. A <em>P</em> value of < .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Of 517 shoulders operated on for instability, 21 (4.1%) had posterior instability. After excluding 8 cases, 17 shoulders from collision sports athletes were analyzed. The mean age of the athletes was 21.1 years. All patients had a positive posterior apprehension test, and 62% had a positive anterior apprehension test. Imaging revealed posterior glenoid bony defects in 85% of cases. The mean glenoid retroversion angle was 1.6° ± 3.6° as measured on axial computed tomography images. The mean follow-up period was 40.5 ± 22.9 months, and all patients returned to their preinjury level of sports activity at a mean of 6.5 ± 1.0 months postoperatively. At the time of injury, 6 patients experienced a posterior dislocation, one experienced a subluxation, and 6 reported only posterior shoulder pain. Before surgery, 7 patients had no history of complete dislocation, while 6 patients had recurrent dislocations (≥2 times). The mean interval from the first dislocation or symptom onset to surgery was 21.8 ± 20.8 months. The Rowe score improved significantly from 55 (range: 25-75) preoperatively to 95 (range: 50-100) postoperatively (<em>P</em> < .01). The minimum clinically important difference for the Rowe score was 13.4 points, and 92% of patients exceeded this threshold. However, one patient (8%) experienced redislocations, and 4 patients (31%) reported residual pain, with 3 of these cases involving glenoid cartilage lesions at the time of surgery. Although postoperative pain was more common in patients with cartilage lesions (60%) than in those without (13%), this difference did not reach statistical significance (<em>P</em> = .217).</div></div><div><h3>Co
{"title":"Favorable Outcomes After Arthroscopic Posterior Bankart Repair for Traumatic Posterior Shoulder Instability in Collision Athletes","authors":"Daisuke Yamashita M.D. , Atushi Tasaki M.D., Ph.D. , Takayuki Oishi M.D., Ph.D. , Taiki Nozaki M.D., Ph.D. , Shota Mashimo P.T., M.P.H. , Nobuto Kitamura M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101264","DOIUrl":"10.1016/j.asmr.2025.101264","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the postoperative results of arthroscopic posterior Bankart repair for traumatic posterior shoulder instability in collision sports athletes and their clinical characteristics, including injury mechanism, symptoms, physical examination findings, and imaging features.</div></div><div><h3>Methods</h3><div>Between January 2011 and April 2022, a retrospective review was conducted of collision-sport athletes who underwent arthroscopic posterior Bankart repair for traumatic posterior shoulder instability at a single institution. The inclusion criteria were posterior instability caused by trauma, absence of generalized joint laxity, and arthroscopic posterior Bankart repair. All the patients had a minimum follow-up of 24 months. Patient demographics, injury mechanisms, imaging findings (evaluated using radiographs, computed tomography, and magnetic resonance imaging, including posterior labral tears, posterior glenoid bone loss, glenoid retroversion, and reverse Hill-Sachs lesions), return-to-play rates, recurrence, and postoperative shoulder pain and Rowe score were evaluated. Pre- and postoperative Rowe scores were compared using the Wilcoxon signed-rank test. A <em>P</em> value of < .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Of 517 shoulders operated on for instability, 21 (4.1%) had posterior instability. After excluding 8 cases, 17 shoulders from collision sports athletes were analyzed. The mean age of the athletes was 21.1 years. All patients had a positive posterior apprehension test, and 62% had a positive anterior apprehension test. Imaging revealed posterior glenoid bony defects in 85% of cases. The mean glenoid retroversion angle was 1.6° ± 3.6° as measured on axial computed tomography images. The mean follow-up period was 40.5 ± 22.9 months, and all patients returned to their preinjury level of sports activity at a mean of 6.5 ± 1.0 months postoperatively. At the time of injury, 6 patients experienced a posterior dislocation, one experienced a subluxation, and 6 reported only posterior shoulder pain. Before surgery, 7 patients had no history of complete dislocation, while 6 patients had recurrent dislocations (≥2 times). The mean interval from the first dislocation or symptom onset to surgery was 21.8 ± 20.8 months. The Rowe score improved significantly from 55 (range: 25-75) preoperatively to 95 (range: 50-100) postoperatively (<em>P</em> < .01). The minimum clinically important difference for the Rowe score was 13.4 points, and 92% of patients exceeded this threshold. However, one patient (8%) experienced redislocations, and 4 patients (31%) reported residual pain, with 3 of these cases involving glenoid cartilage lesions at the time of surgery. Although postoperative pain was more common in patients with cartilage lesions (60%) than in those without (13%), this difference did not reach statistical significance (<em>P</em> = .217).</div></div><div><h3>Co","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101264"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101260
Evan A. Jacquez M.D. , Kyle P. Zielinski B.S. , John M. Etchart B.S. , Layla Dawit , Sarah L. Lucas M.D. , Gregory T. Perraut M.D. , Kyle W. Zittel M.D. , Stephen C. Saddler M.D. , Bryan W. Cunningham Ph.D.
Purpose
To evaluate the tensile strength of human cadaveric quadriceps tendon (QT) and bone–patellar tendon–bone (BTB) allografts augmented by intratendinous saline injection.
Methods
Thirty-three QT and 14 BTB allografts harvested from fresh-frozen human cadaveric knees were tested using a servohydraulic test system. One half of all grafts were injected with 2 mL of intratendinous 0.9% saline, acting as a substitute for PRP, whereas the other half were soaked in saline as a control. Tensile testing was then performed and the ultimate load at failure (N) was measured. Statistical analysis, including descriptive, analysis of variance, and post hoc Tukey analysis, was performed. A P value less than .05 was considered significant.
Results
The mean ultimate load at failure was not significantly different for treated QT grafts and control QT grafts (330 ± 179 N vs 291 ± 195 N, P = .94). The mean ultimate load at failure was also not significantly different for treated BTB grafts and control BTB specimens (553 ± 195 N vs 656 ± 242 N, P = .76).
Conclusions
Intratendinous normal saline injection compared with passive normal saline exposure was not associated with any significant differences in ultimate load at failure for quadriceps and patellar tendon allografts at time zero.
Clinical Relevance
Graft rupture is a feared complication of anterior cruciate ligament reconstruction. The current study may provide surgeons with added confidence that intratendinous therapeutic injections of nonviscous substances do not significantly impair the tensile strength of QT and BTB allografts used in ACL reconstruction at time zero.
目的评价肌腱内生理盐水注射增强人尸体股四头肌肌腱（QT）和骨-髌肌腱-骨（BTB）异体移植物的抗拉强度。方法采用伺服液压测试系统对33例QT移植体和14例BTB移植体进行检测。所有移植物的一半注射2ml的肌腱内0.9%生理盐水，作为PRP的替代品，而另一半则浸泡在生理盐水中作为对照。然后进行拉伸试验，并测量破坏时的极限载荷(N)。进行统计分析，包括描述性分析、方差分析和事后Tukey分析。P值小于。05被认为是显著的。结果QT移植组和对照组QT移植组失败时的平均极限负荷无显著差异（330±179 N vs 291±195 N, P = 0.94）。治疗BTB移植物和对照BTB标本失败时的平均极限负荷也无显著差异（553±195 N vs 656±242 N, P = 0.76）。结论与被动生理盐水暴露相比，腱束生理盐水注射在零时间内与股四头肌和髌骨肌腱移植失败时的极限负荷无显著差异。临床意义前交叉韧带重建术中，移植物断裂是一个令人恐惧的并发症。目前的研究可以为外科医生提供更多的信心，即在时间零时，阑尾内治疗性注射非粘性物质不会显著损害用于ACL重建的QT和BTB同种异体移植物的抗拉强度。
{"title":"Intratendinous Normal Saline Injection of Quadriceps and Patellar Tendon Allografts Does Not Reduce Mechanical Strength at Time Zero","authors":"Evan A. Jacquez M.D. , Kyle P. Zielinski B.S. , John M. Etchart B.S. , Layla Dawit , Sarah L. Lucas M.D. , Gregory T. Perraut M.D. , Kyle W. Zittel M.D. , Stephen C. Saddler M.D. , Bryan W. Cunningham Ph.D.","doi":"10.1016/j.asmr.2025.101260","DOIUrl":"10.1016/j.asmr.2025.101260","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the tensile strength of human cadaveric quadriceps tendon (QT) and bone–patellar tendon–bone (BTB) allografts augmented by intratendinous saline injection.</div></div><div><h3>Methods</h3><div>Thirty-three QT and 14 BTB allografts harvested from fresh-frozen human cadaveric knees were tested using a servohydraulic test system. One half of all grafts were injected with 2 mL of intratendinous 0.9% saline, acting as a substitute for PRP, whereas the other half were soaked in saline as a control. Tensile testing was then performed and the ultimate load at failure (N) was measured. Statistical analysis, including descriptive, analysis of variance, and post hoc Tukey analysis, was performed. A <em>P</em> value less than .05 was considered significant.</div></div><div><h3>Results</h3><div>The mean ultimate load at failure was not significantly different for treated QT grafts and control QT grafts (330 ± 179 N vs 291 ± 195 N, <em>P</em> = .94). The mean ultimate load at failure was also not significantly different for treated BTB grafts and control BTB specimens (553 ± 195 N vs 656 ± 242 N, <em>P</em> = .76).</div></div><div><h3>Conclusions</h3><div>Intratendinous normal saline injection compared with passive normal saline exposure was not associated with any significant differences in ultimate load at failure for quadriceps and patellar tendon allografts at time zero.</div></div><div><h3>Clinical Relevance</h3><div>Graft rupture is a feared complication of anterior cruciate ligament reconstruction. The current study may provide surgeons with added confidence that intratendinous therapeutic injections of nonviscous substances do not significantly impair the tensile strength of QT and BTB allografts used in ACL reconstruction at time zero.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101260"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101299
Romir P. Parmar B.S. , Sailesh V. Tummala M.D. , Sachin S. Pathuri B.S. , Jainam Shah B.S. , Jai Khurmi B.S. , Kostas J. Economopoulos M.D.
<div><h3>Purpose</h3><div>To compare clinical outcomes between augmented subchondral drilling (aSCD) and nonsubchondral drilling (NoSCD) techniques, both using a cartilage scaffold, in the treatment of isolated patellar cartilage lesions.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on patients who underwent surgical treatment for isolated patellar cartilage using either an aSCD technique (a subchondral drilling augmented with a particulated cartilage allograft scaffold or a flexible osteochondral allograft scaffold) or a NoSCD technique (a particulated juvenile articular cartilage scaffold or a flexible osteochondral allograft scaffold implanted without performing a subchondral drilling). Patients were included if they had a minimum 2-year follow-up and excluded if they underwent concomitant meniscal or ligamentous procedures. While tibial tubercle osteotomy (TTO) was commonly performed, it was not a strict inclusion criterion. All procedures were performed through arthrotomy with a standardized postoperative rehabilitation protocol. Clinical outcomes included International Knee Documentation Committee (IKDC) and Lysholm scores, reoperation rates, conversion to total knee arthroplasty, and complications.</div></div><div><h3>Results</h3><div>A total of 65 knees were included: 31 in the aSCD group and 34 in the NoSCD group, with a mean follow-up of 50.4 months (range, 24-88 months). In the aSCD group, particulated allograft cartilage hydrated with platelet-rich plasma was used in 80.7% of cases and flexible osteochondral allograft in 19.3%, while the NoSCD group was treated with Cartiform (Arthrex) in 70.6% and particulated juvenile articular cartilage in 29.4% of cases. TTO was performed in 87.0% of aSCD and 91.2% of NoSCD cases. Average defect sizes were 3.7 cm<sup>2</sup> (aSCD) and 4.0 cm<sup>2</sup> (NoSCD). At final follow-up, the NoSCD group had significantly better outcomes, with higher median IKDC scores (81.0 vs 74.0; <em>P</em> < .001) and median Lysholm scores (83.0 vs 77.0; <em>P</em> < .001). A significantly greater proportion of NoSCD patients exceeded the minimal clinically important difference for IKDC (100% vs 80.6%; <em>P</em> = .024) but not for Lysholm (97.1% vs 93.5%; <em>P</em> = .935) at final follow-up. In multivariable regression adjusting for scaffold type, TTO, and defect size, aSCD remained a significant independent predictor of lower final IKDC (β = –8.97; <em>P</em> = .001) and Lysholm (β = –12.71; <em>P</em> < .001) scores. The aSCD group had a significantly higher rate of repeat surgery (45.2% vs 14.7%; <em>P</em> = .015). There was no significant difference in conversion to total knee arthroplasty between groups (<em>P</em> = .432).</div></div><div><h3>Conclusions</h3><div>For the treatment of isolated patellar cartilage lesions, a nonsubchondral drilling technique with scaffolding was associated with improved patient-reported outcomes and fewer complications compared to
目的比较软骨支架增强软骨下钻孔（aSCD）和非软骨下钻孔（NoSCD）技术治疗离体髌骨软骨病变的临床效果。方法回顾性队列研究采用aSCD技术（软骨下钻孔加颗粒软骨异体移植支架或柔性骨软骨异体移植支架）或NoSCD技术（颗粒少年关节软骨支架或柔性骨软骨异体移植支架植入而不进行软骨下钻孔）对手术治疗分离髌骨软骨的患者进行了回顾性队列研究。如果患者进行了至少2年的随访，则将其纳入，如果患者同时进行了半月板或韧带手术，则将其排除在外。虽然胫骨结节截骨术（TTO）是常用的手术，但并没有一个严格的纳入标准。所有手术均通过关节切开术进行，并遵循标准化的术后康复方案。临床结果包括国际膝关节文献委员会（IKDC）和Lysholm评分、再手术率、转全膝关节置换术和并发症。结果共纳入65个膝关节：aSCD组31个，NoSCD组34个，平均随访50.4个月（范围24 ~ 88个月）。aSCD组采用富血小板血浆水合的颗粒状同种异体软骨移植治疗占80.7%，软性骨软骨移植治疗占19.3%，而NoSCD组采用Cartiform （Arthrex）治疗占70.6%，采用颗粒状少年关节软骨治疗占29.4%。aSCD和NoSCD的成功率分别为87.0%和91.2%。平均缺陷尺寸为3.7 cm2 （aSCD）和4.0 cm2 （NoSCD）。在最后的随访中，NoSCD组有明显更好的结果，IKDC中位评分（81.0比74.0;P < 0.001）和Lysholm中位评分（83.0比77.0;P < 0.001）更高。在最后的随访中，NoSCD患者的比例明显大于IKDC患者的最小临床重要差异（100% vs 80.6%, P = 0.024），但Lysholm患者的比例则没有（97.1% vs 93.5%, P = 0.935）。在调整支架类型、TTO和缺陷大小的多变量回归中，aSCD仍然是较低的最终IKDC （β = -8.97; P = .001）和Lysholm （β = -12.71; P < .001）评分的显著独立预测因子。aSCD组的重复手术率明显高于aSCD组（45.2% vs 14.7%; P = 0.015）。两组间转行全膝关节置换术的差异无统计学意义（P = .432）。结论：对于孤立性髌骨病变的治疗，与软骨下钻孔技术和支架相比，非软骨下钻孔技术与改善患者报告的结果和更少的并发症相关，尽管在转换率到全膝关节置换术方面没有差异。证据等级：III级，回顾性比较研究。
{"title":"Cartilage Scaffolds Implanted Without Subchondral Drilling Are Associated With Improved Outcomes and Fewer Complications Compared to Scaffolds Implanted With Subchondral Drilling in the Treatment of Isolated Patellar Cartilage Lesions","authors":"Romir P. Parmar B.S. , Sailesh V. Tummala M.D. , Sachin S. Pathuri B.S. , Jainam Shah B.S. , Jai Khurmi B.S. , Kostas J. Economopoulos M.D.","doi":"10.1016/j.asmr.2025.101299","DOIUrl":"10.1016/j.asmr.2025.101299","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare clinical outcomes between augmented subchondral drilling (aSCD) and nonsubchondral drilling (NoSCD) techniques, both using a cartilage scaffold, in the treatment of isolated patellar cartilage lesions.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on patients who underwent surgical treatment for isolated patellar cartilage using either an aSCD technique (a subchondral drilling augmented with a particulated cartilage allograft scaffold or a flexible osteochondral allograft scaffold) or a NoSCD technique (a particulated juvenile articular cartilage scaffold or a flexible osteochondral allograft scaffold implanted without performing a subchondral drilling). Patients were included if they had a minimum 2-year follow-up and excluded if they underwent concomitant meniscal or ligamentous procedures. While tibial tubercle osteotomy (TTO) was commonly performed, it was not a strict inclusion criterion. All procedures were performed through arthrotomy with a standardized postoperative rehabilitation protocol. Clinical outcomes included International Knee Documentation Committee (IKDC) and Lysholm scores, reoperation rates, conversion to total knee arthroplasty, and complications.</div></div><div><h3>Results</h3><div>A total of 65 knees were included: 31 in the aSCD group and 34 in the NoSCD group, with a mean follow-up of 50.4 months (range, 24-88 months). In the aSCD group, particulated allograft cartilage hydrated with platelet-rich plasma was used in 80.7% of cases and flexible osteochondral allograft in 19.3%, while the NoSCD group was treated with Cartiform (Arthrex) in 70.6% and particulated juvenile articular cartilage in 29.4% of cases. TTO was performed in 87.0% of aSCD and 91.2% of NoSCD cases. Average defect sizes were 3.7 cm<sup>2</sup> (aSCD) and 4.0 cm<sup>2</sup> (NoSCD). At final follow-up, the NoSCD group had significantly better outcomes, with higher median IKDC scores (81.0 vs 74.0; <em>P</em> < .001) and median Lysholm scores (83.0 vs 77.0; <em>P</em> < .001). A significantly greater proportion of NoSCD patients exceeded the minimal clinically important difference for IKDC (100% vs 80.6%; <em>P</em> = .024) but not for Lysholm (97.1% vs 93.5%; <em>P</em> = .935) at final follow-up. In multivariable regression adjusting for scaffold type, TTO, and defect size, aSCD remained a significant independent predictor of lower final IKDC (β = –8.97; <em>P</em> = .001) and Lysholm (β = –12.71; <em>P</em> < .001) scores. The aSCD group had a significantly higher rate of repeat surgery (45.2% vs 14.7%; <em>P</em> = .015). There was no significant difference in conversion to total knee arthroplasty between groups (<em>P</em> = .432).</div></div><div><h3>Conclusions</h3><div>For the treatment of isolated patellar cartilage lesions, a nonsubchondral drilling technique with scaffolding was associated with improved patient-reported outcomes and fewer complications compared to","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101299"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101220
Alexander Ziedas M.D. , Momin Nasir M.D. , Michael Dubé M.D. , Noah Elagamy M.D. , Julius Gumma B.S. , Philip Shaheen M.D. , Todd Frush M.D.
Purpose
To determine the return-to-sport (RTS) rate and time to RTS for National Collegiate Athletic Association (NCAA) football players and National Football League (NFL) players after suture-button fixation for the treatment of unstable tibiofibular syndesmotic injuries and to identify possible risk factors associated with a delay in RTS.
Methods
NCAA and NFL players who underwent suture-button fixation for an isolated syndesmotic ankle injury between 2017 and 2023 were evaluated. All player information and data were retrieved from publicly available internet sources. The following information was gathered on each player's career; NFL participation, number of seasons played before and after surgery, number of games played before and after surgery, and time between surgery and RTS. RTS was defined as the time until the first game after syndesmotic suture-button fixation.
Results
Seven NCAA and fourteen NFL players (21 ankles) were included. The mean age at surgery was 24.90 ± 4.66 years (range, 18-34 years). One hundred percent of patients were able to RTS at their level of sport. The mean time between surgery and the first game played was 139.4 ± 123.6 days (range, 12-427 days). Players played in 23.48 ± 21.9 games (range, 3-72 games) after surgery. NCAA players were able to RTS significantly earlier than NFL players (39.0 ± 20.4 days vs 189.6 ± 123.2 days, P = .005, with P < .05 denoting significance). There was no significant difference in workload after surgery for both NCAA and NFL players.
Conclusions
In this study, we found that athletes, regardless of whether they were NCAA or NFL players, were able to successfully return to their level of sport after ankle surgery. Whereas NCAA players returned to play significantly faster, both groups were able to achieve similar performance levels postoperatively in terms of the number of games played.
Level of Evidence
Level III, retrospective cohort study.
目的研究美国大学体育协会（NCAA）和美国国家橄榄球联盟（NFL）运动员在不稳定胫腓联合损伤的缝合-按钮固定治疗后的恢复运动（RTS）率和恢复运动时间，并确定延迟恢复运动的可能危险因素。方法对2017年至2023年间接受单发韧带联合踝关节损伤缝合-按钮固定的sncaa和NFL球员进行评估。所有球员的信息和数据都是从公开的互联网资源中获取的。以下是收集到的每个球员职业生涯的信息：参与NFL，手术前后打了多少赛季，手术前后打了多少场比赛，手术和RTS之间的时间间隔。RTS被定义为关节联合缝合-按钮固定后到第一场比赛的时间。结果NCAA 7例，NFL 14例（踝关节21例）。手术平均年龄24.90±4.66岁（18-34岁）。100%的病人都能达到他们的运动水平。手术至第一次比赛的平均时间为139.4±123.6天（范围12-427天）。术后比赛时间23.48±21.9场（范围3-72场）。NCAA球员能够进行RTS的时间明显早于NFL球员（39.0±20.4天vs 189.6±123.2天，P = 0.005, P <； 0.05表示有意义）。NCAA和NFL球员手术后的工作量没有显著差异。在这项研究中，我们发现运动员，无论是NCAA还是NFL球员，都能够在脚踝手术后成功地恢复到他们的运动水平。尽管NCAA球员恢复比赛的速度要快得多，但就比赛次数而言，两组球员在术后都能达到相似的表现水平。证据水平：III级，回顾性队列研究。
{"title":"Full Return to Sport in All Athletes After Suture-Button Fixation for Syndesmotic Injuries; However, Faster Recovery Was Seen in National Collegiate Athletic Association Football Players Compared with National Football League Players","authors":"Alexander Ziedas M.D. , Momin Nasir M.D. , Michael Dubé M.D. , Noah Elagamy M.D. , Julius Gumma B.S. , Philip Shaheen M.D. , Todd Frush M.D.","doi":"10.1016/j.asmr.2025.101220","DOIUrl":"10.1016/j.asmr.2025.101220","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the return-to-sport (RTS) rate and time to RTS for National Collegiate Athletic Association (NCAA) football players and National Football League (NFL) players after suture-button fixation for the treatment of unstable tibiofibular syndesmotic injuries and to identify possible risk factors associated with a delay in RTS.</div></div><div><h3>Methods</h3><div>NCAA and NFL players who underwent suture-button fixation for an isolated syndesmotic ankle injury between 2017 and 2023 were evaluated. All player information and data were retrieved from publicly available internet sources. The following information was gathered on each player's career; NFL participation, number of seasons played before and after surgery, number of games played before and after surgery, and time between surgery and RTS. RTS was defined as the time until the first game after syndesmotic suture-button fixation.</div></div><div><h3>Results</h3><div>Seven NCAA and fourteen NFL players (21 ankles) were included. The mean age at surgery was 24.90 ± 4.66 years (range, 18-34 years). One hundred percent of patients were able to RTS at their level of sport. The mean time between surgery and the first game played was 139.4 ± 123.6 days (range, 12-427 days). Players played in 23.48 ± 21.9 games (range, 3-72 games) after surgery. NCAA players were able to RTS significantly earlier than NFL players (39.0 ± 20.4 days vs 189.6 ± 123.2 days, <em>P</em> = .005, with <em>P</em> < .05 denoting significance). There was no significant difference in workload after surgery for both NCAA and NFL players.</div></div><div><h3>Conclusions</h3><div>In this study, we found that athletes, regardless of whether they were NCAA or NFL players, were able to successfully return to their level of sport after ankle surgery. Whereas NCAA players returned to play significantly faster, both groups were able to achieve similar performance levels postoperatively in terms of the number of games played.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101220"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101270
Ashley Treanor B.S. , Michelle Shimizu B.Sc. , Shreya M. Saraf M.S. , Mary K. Mulcahey M.D.
Purpose
To determine the level of involvement of orthopaedic sports medicine fellowships on social media, the type of content shared, and the overall level of engagement based on the type of content posted.
Methods
A web-based systematic approach identifying and analyzing the social media presence of the Accreditation Council for Graduate Medical Education–accredited orthopaedic sports medicine fellowship programs across 3 major platforms—Instagram, Facebook, and X—from the inception of each Instagram and X account to January 30, 2025, and from January 1, 2020, to January 30, 2025, for each Facebook account. Data on each program’s profile and posts were collected. The χ2 tests evaluated the variability of content posted between programs. Kruskal-Wallis tests of the mean likes/post/follower evaluated variability in engagement between program profiles.
Results
Of the 95 Accreditation Council for Graduate Medical Education–accredited orthopaedic sports medicine fellowship programs identified, 20 (21.1%) posted about their fellowship on Instagram, 13 (13.7%) on X, 9 (9.5%) on Facebook, and 5 (5.3%) on all 3 platforms. On average, Instagram profiles had 148.7 posts (range, 8-985), X profiles had 2,807.0 posts (range, 102-6,747), and Facebook profiles had 527.4 posts (range, 23-1,185). Non-fellowship-related content (national holidays, patient information) was the most common category across all platforms (mean of 103 posts on Instagram, 2,260 on X, and 489 on Facebook), with little variability between programs. Level of engagement did not statistically differ across any platform (Instagram, P = .457; X, P = .446; Facebook, P = .433).
Conclusions
Although Instagram was identified as the most favored platform, the overall social media presence of orthopaedic sports medicine fellowships across all platforms was limited. Content analysis revealed a predominant focus on posts unrelated to the program’s orthopaedic sports medicine fellowship.
Clinical Relevance
This study highlights the underutilized potential of social media in enhancing visibility, engagement, and communication for orthopaedic sports medicine fellowships.
目的确定骨科运动医学奖学金在社交媒体上的参与程度，分享的内容类型，以及基于发布内容类型的整体参与水平。方法采用基于网络的系统方法，识别和分析研究生医学教育认证委员会（Accreditation Council for Graduate Medical education）认可的骨科运动医学奖学金项目在Instagram、Facebook和X三个主要平台上的社交媒体存在情况，从每个Instagram和X账户成立到2025年1月30日，以及每个Facebook账户从2020年1月1日到2025年1月30日。收集了每个程序的个人资料和帖子的数据。χ2检验评估了节目间发布内容的可变性。Kruskal-Wallis的平均点赞/帖子/关注者测试评估了项目概况之间参与度的可变性。结果在95个研究生医学教育认证委员会认可的骨科运动医学奖学金项目中，20个（21.1%）在Instagram上发布了他们的奖学金，13个（13.7%）在X上发布，9个（9.5%）在Facebook上发布，5个（5.3%）在所有3个平台上发布。Instagram个人资料平均有148.7个帖子（范围8-985），X个人资料有2807.0个帖子（范围102- 6747），Facebook个人资料有527.4个帖子（范围23- 1185）。与奖学金无关的内容（国家假日、患者信息）是所有平台上最常见的类别（Instagram上平均有103个帖子，X上有2260个帖子，Facebook上有489个帖子），项目之间几乎没有变化。参与程度在任何平台上都没有统计学差异（Instagram, P = .457； X, P = .446; Facebook, P = .433）。尽管Instagram被认为是最受欢迎的平台，但所有平台上骨科运动医学奖学金的整体社交媒体存在度有限。内容分析显示，主要关注与该计划的骨科运动医学奖学金无关的帖子。临床相关性本研究强调了社会媒体在提高骨科运动医学奖学金的知名度、参与度和沟通方面的潜力未被充分利用。
{"title":"Current Orthopaedic Sports Medicine Fellowships Have a Limited Presence on Social Media","authors":"Ashley Treanor B.S. , Michelle Shimizu B.Sc. , Shreya M. Saraf M.S. , Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101270","DOIUrl":"10.1016/j.asmr.2025.101270","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the level of involvement of orthopaedic sports medicine fellowships on social media, the type of content shared, and the overall level of engagement based on the type of content posted.</div></div><div><h3>Methods</h3><div>A web-based systematic approach identifying and analyzing the social media presence of the Accreditation Council for Graduate Medical Education–accredited orthopaedic sports medicine fellowship programs across 3 major platforms—Instagram, Facebook, and X—from the inception of each Instagram and X account to January 30, 2025, and from January 1, 2020, to January 30, 2025, for each Facebook account. Data on each program’s profile and posts were collected. The χ<sup>2</sup> tests evaluated the variability of content posted between programs. Kruskal-Wallis tests of the mean likes/post/follower evaluated variability in engagement between program profiles.</div></div><div><h3>Results</h3><div>Of the 95 Accreditation Council for Graduate Medical Education–accredited orthopaedic sports medicine fellowship programs identified, 20 (21.1%) posted about their fellowship on Instagram, 13 (13.7%) on X, 9 (9.5%) on Facebook, and 5 (5.3%) on all 3 platforms. On average, Instagram profiles had 148.7 posts (range, 8-985), X profiles had 2,807.0 posts (range, 102-6,747), and Facebook profiles had 527.4 posts (range, 23-1,185). Non-fellowship-related content (national holidays, patient information) was the most common category across all platforms (mean of 103 posts on Instagram, 2,260 on X, and 489 on Facebook), with little variability between programs. Level of engagement did not statistically differ across any platform (Instagram, <em>P</em> = .457; X, <em>P</em> = .446; Facebook, <em>P</em> = .433).</div></div><div><h3>Conclusions</h3><div>Although Instagram was identified as the most favored platform, the overall social media presence of orthopaedic sports medicine fellowships across all platforms was limited. Content analysis revealed a predominant focus on posts unrelated to the program’s orthopaedic sports medicine fellowship.</div></div><div><h3>Clinical Relevance</h3><div>This study highlights the underutilized potential of social media in enhancing visibility, engagement, and communication for orthopaedic sports medicine fellowships.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101270"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101269
Jack Twomey-Kozak M.D., Mikhail A. Bethell M.S., Zoe Wiatt Hinton M.D., Samuel Lorentz M.D., Lucy Meyer M.D., Alex Meyer M.D., Eoghan Hurley M.D., Damon V. Briggs B.S., Kendall Bradley M.D., Jocelyn Wittstein M.D., Brian Lau M.D.
<div><h3>Purpose</h3><div>To systematically review and evaluate the diagnostic efficacy and predictive power of artificial intelligence (AI) models in detecting patellofemoral (PF) compartment pathology and to compare their performance against ground-truth human clinical experts when applicable.</div></div><div><h3>Methods</h3><div>In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, the PubMed, Ovid/MEDLINE, and Cochrane Library databases were searched from inception through May 2024 for studies on AI methods for diagnosing trochlear dysplasia, PF osteoarthritis, or PF instability and tracking abnormalities on cross-sectional imaging. AI model choice, knee pathology, input/output data, performance metrics (accuracy, area under the curve [AUC], precision-recall curve average precision, sensitivity, specificity, positive predictive value, and negative predictive value), sample sizes of datasets, image modalities, and limitations were recorded.</div></div><div><h3>Results</h3><div>Of 68 studies screened, 17 met the inclusion criteria. Ten studies investigated AI diagnostics for PF osteoarthritis; four, PF tracking and/or instability; and three, trochlear dysplasia. Various deep learning architectures and machine learning algorithms were used. Input data included computed tomography scans, magnetic resonance imaging scans, and radiographs. Output data included anatomic landmark identification and diagnostic predictions. AUC values ranged from 0.664 to 0.990, and accuracy ranged from 74% to 99%. Model performance was moderate to excellent, with AI models consistently surpassing traditional methods in processing times. Common limitations included small sample size, single-center datasets, limited generalizability, and bias due to imbalanced datasets.</div></div><div><h3>Conclusions</h3><div>AI models showed variable diagnostic performance in identifying PF pathologies and predicting disease progression, with reported AUCs ranging from 0.664 to 0.990 and accuracies between 74% and 99%. Although some studies suggested that AI outperformed traditional diagnostic methods such as interpretation by musculoskeletal radiologists, manual segmentation, or arthroscopy, the degree of superiority was inconsistent and influenced by significant heterogeneity in model architectures, imaging modalities, and reference standards. Given the broad scope of this review and variability across studies, caution is warranted in interpreting these findings, and specific clinical recommendations cannot be made at this time.</div></div><div><h3>Clinical Relevance</h3><div>AI-based diagnostic tools show promise in supporting the evaluation of PF joint pathologies by potentially improving efficiency and consistency in image interpretation. However, because of the heterogeneity in current models and study designs, the clinical applicability of these tools remains limited. Further refinement and external validation of AI algorithms are
{"title":"Artificial Intelligence Has Varied Diagnostic and Predictive Performance in Diagnosing Patellofemoral Osteoarthritis, Trochlear Dysplasia, and Patellofemoral Tracking Abnormalities: A Systematic Review","authors":"Jack Twomey-Kozak M.D., Mikhail A. Bethell M.S., Zoe Wiatt Hinton M.D., Samuel Lorentz M.D., Lucy Meyer M.D., Alex Meyer M.D., Eoghan Hurley M.D., Damon V. Briggs B.S., Kendall Bradley M.D., Jocelyn Wittstein M.D., Brian Lau M.D.","doi":"10.1016/j.asmr.2025.101269","DOIUrl":"10.1016/j.asmr.2025.101269","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically review and evaluate the diagnostic efficacy and predictive power of artificial intelligence (AI) models in detecting patellofemoral (PF) compartment pathology and to compare their performance against ground-truth human clinical experts when applicable.</div></div><div><h3>Methods</h3><div>In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, the PubMed, Ovid/MEDLINE, and Cochrane Library databases were searched from inception through May 2024 for studies on AI methods for diagnosing trochlear dysplasia, PF osteoarthritis, or PF instability and tracking abnormalities on cross-sectional imaging. AI model choice, knee pathology, input/output data, performance metrics (accuracy, area under the curve [AUC], precision-recall curve average precision, sensitivity, specificity, positive predictive value, and negative predictive value), sample sizes of datasets, image modalities, and limitations were recorded.</div></div><div><h3>Results</h3><div>Of 68 studies screened, 17 met the inclusion criteria. Ten studies investigated AI diagnostics for PF osteoarthritis; four, PF tracking and/or instability; and three, trochlear dysplasia. Various deep learning architectures and machine learning algorithms were used. Input data included computed tomography scans, magnetic resonance imaging scans, and radiographs. Output data included anatomic landmark identification and diagnostic predictions. AUC values ranged from 0.664 to 0.990, and accuracy ranged from 74% to 99%. Model performance was moderate to excellent, with AI models consistently surpassing traditional methods in processing times. Common limitations included small sample size, single-center datasets, limited generalizability, and bias due to imbalanced datasets.</div></div><div><h3>Conclusions</h3><div>AI models showed variable diagnostic performance in identifying PF pathologies and predicting disease progression, with reported AUCs ranging from 0.664 to 0.990 and accuracies between 74% and 99%. Although some studies suggested that AI outperformed traditional diagnostic methods such as interpretation by musculoskeletal radiologists, manual segmentation, or arthroscopy, the degree of superiority was inconsistent and influenced by significant heterogeneity in model architectures, imaging modalities, and reference standards. Given the broad scope of this review and variability across studies, caution is warranted in interpreting these findings, and specific clinical recommendations cannot be made at this time.</div></div><div><h3>Clinical Relevance</h3><div>AI-based diagnostic tools show promise in supporting the evaluation of PF joint pathologies by potentially improving efficiency and consistency in image interpretation. However, because of the heterogeneity in current models and study designs, the clinical applicability of these tools remains limited. Further refinement and external validation of AI algorithms are","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101269"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101258
Ady H. Kahana-Rojkind M.D. , Andrew R. Schab B.S. , Drashti Sikligar M.Eng. , Roger Quesada-Jimenez M.D. , Benjamin D. Kuhns M.D. , Benjamin G. Domb M.D.
Purpose
To evaluate midterm clinical outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients with inflammatory joint diseases (IJD) compared to a matched control group without IJD.
Methods
Data were prospectively collected on all hip arthroscopies performed between February 2008 and December 2018 at a single center. Patients diagnosed with IJD undergoing primary hip arthroscopy for FAIS with labral tears were included. Exclusion criteria were prior ipsilateral hip conditions (except IJD), hip dysplasia (lateral center-edge angle <18°), and Tönnis grade >1. Patients with a minimum 5-year follow-up were matched 1:3 to controls based on age, sex, body mass index, and Tönnis grade. Patient-reported outcomes (PROs), rates of achieving clinically relevant thresholds, and secondary procedures were compared between groups.
Results
A total of 27 hips (23 patients) with IJD were matched to 81 hips (79 patients) in the control group. At a minimum 5-year follow-up, both groups showed significant improvement in all PROs. However, the IJD group had lower postoperative PRO scores and fewer patients meeting patient acceptable symptom state for modified Harris Hip Score and Non-Arthritic Hip Score (29.6% vs 61.7% and 40.7% vs 64.2%). The IJD group had significantly higher odds of requiring a second hip surgery (odds ratio, 3.57; 95% confidence interval, 1.04-12.23; P = .042) and lower odds of maintaining arthroplasty-free survivorship (odds ratio, 0.14; 95% confidence interval, 0.04-0.56; P = .003).
Conclusions
Patients with IJD undergoing hip arthroscopy for FAIS experience significant improvement in PROs at midterm follow-up. However, they achieve clinically significant thresholds less frequently, exhibit increased revision arthroscopy rates, and have higher rates of conversion to total hip arthroplasty compared to the control group.
{"title":"Inferior Clinical Outcomes and Increased Conversion to Total Hip Arthroplasty Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome in Patients With Inflammatory Joint Disease: A Minimum 5-Year Matched Cohort Study","authors":"Ady H. Kahana-Rojkind M.D. , Andrew R. Schab B.S. , Drashti Sikligar M.Eng. , Roger Quesada-Jimenez M.D. , Benjamin D. Kuhns M.D. , Benjamin G. Domb M.D.","doi":"10.1016/j.asmr.2025.101258","DOIUrl":"10.1016/j.asmr.2025.101258","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate midterm clinical outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients with inflammatory joint diseases (IJD) compared to a matched control group without IJD.</div></div><div><h3>Methods</h3><div>Data were prospectively collected on all hip arthroscopies performed between February 2008 and December 2018 at a single center. Patients diagnosed with IJD undergoing primary hip arthroscopy for FAIS with labral tears were included. Exclusion criteria were prior ipsilateral hip conditions (except IJD), hip dysplasia (lateral center-edge angle <18°), and Tönnis grade >1. Patients with a minimum 5-year follow-up were matched 1:3 to controls based on age, sex, body mass index, and Tönnis grade. Patient-reported outcomes (PROs), rates of achieving clinically relevant thresholds, and secondary procedures were compared between groups.</div></div><div><h3>Results</h3><div>A total of 27 hips (23 patients) with IJD were matched to 81 hips (79 patients) in the control group. At a minimum 5-year follow-up, both groups showed significant improvement in all PROs. However, the IJD group had lower postoperative PRO scores and fewer patients meeting patient acceptable symptom state for modified Harris Hip Score and Non-Arthritic Hip Score (29.6% vs 61.7% and 40.7% vs 64.2%). The IJD group had significantly higher odds of requiring a second hip surgery (odds ratio, 3.57; 95% confidence interval, 1.04-12.23; <em>P</em> = .042) and lower odds of maintaining arthroplasty-free survivorship (odds ratio, 0.14; 95% confidence interval, 0.04-0.56; <em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Patients with IJD undergoing hip arthroscopy for FAIS experience significant improvement in PROs at midterm follow-up. However, they achieve clinically significant thresholds less frequently, exhibit increased revision arthroscopy rates, and have higher rates of conversion to total hip arthroplasty compared to the control group.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101258"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101266
Samuel I. Rosenberg M.D. , Elizabeth H. Merritt B.S. , Neeraj M. Patel M.D., M.P.H., M.B.S.
Purpose
To compare the rates and types of early complications in pediatric patients undergoing a 2-limb lateral extra-articular procedure (LEAP) alongside anterior cruciate ligament reconstruction (ACLR) versus ACLR alone.
Methods
The records of patients who underwent primary ACLR at a single tertiary children’s hospital were reviewed for this retrospective cohort study, excluding those with multiligament reconstructions, modified MacIntosh reconstructions, or less than 1-year follow-up. The 2-limb LEAP used a strip of iliotibial band autograft that remained attached at the Gerdy tubercle and was first fixed to the femur and then reflected distally and fixed to the tibia, resulting in 1 limb that was similar to the Lemaire tenodesis and another that reconstructed the anterolateral ligament. Demographic data, intraoperative findings and techniques, and postoperative complications were compared between patients who underwent ACLR with LEAP and those who underwent ACLR alone.
Results
A total of 268 patients with a mean follow-up period of 2.0 ± 0.8 years were included in the analysis, of whom 49 (18%) underwent a 2-limb LEAP with ACLR. Most of the patients who underwent LEAP (91.8%) received a quadriceps tendon autograft for ACLR, whereas those who underwent only ACLR had a more equal distribution of quadriceps (38.8%), patella (34.2%), and hamstring (26.9%) tendon autografts. The most common short-term complication was persistent pain (i.e., pain lasting >3 months), occurring in 4.1% of patients with LEAP and 5.9% of those with ACLR alone (P > .99). There was no difference in the proportion of patients with arthrofibrosis (10.2% of those with LEAP vs 9.6% of those with ACLR alone, P = .90), superficial wound infection (2.0% with LEAP vs 3.7% with ACLR alone, P > .99), or reoperation for any reason (32.6% with LEAP vs 36.5% with ACLR alone, P = .78). The rate of postoperative cosmetic concerns was significantly different (6.1% of patients with LEAP vs 0.5% of patients with ACLR, P = .02).
Conclusions
Children and adolescents undergoing a 2-limb LEAP with primary ACLR reported a higher rate of cosmetic concerns after surgery than those undergoing ACLR alone. However, the addition of the LEAP did not otherwise increase the risk of early postoperative complications at a minimum 1-year follow-up.
{"title":"Addition of a 2-Limb Lateral Extra-articular Procedure to Anterior Cruciate Ligament Reconstruction Does Not Increase Early Complications in Pediatric Patients at Minimum 1-Year Follow-Up","authors":"Samuel I. Rosenberg M.D. , Elizabeth H. Merritt B.S. , Neeraj M. Patel M.D., M.P.H., M.B.S.","doi":"10.1016/j.asmr.2025.101266","DOIUrl":"10.1016/j.asmr.2025.101266","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the rates and types of early complications in pediatric patients undergoing a 2-limb lateral extra-articular procedure (LEAP) alongside anterior cruciate ligament reconstruction (ACLR) versus ACLR alone.</div></div><div><h3>Methods</h3><div>The records of patients who underwent primary ACLR at a single tertiary children’s hospital were reviewed for this retrospective cohort study, excluding those with multiligament reconstructions, modified MacIntosh reconstructions, or less than 1-year follow-up. The 2-limb LEAP used a strip of iliotibial band autograft that remained attached at the Gerdy tubercle and was first fixed to the femur and then reflected distally and fixed to the tibia, resulting in 1 limb that was similar to the Lemaire tenodesis and another that reconstructed the anterolateral ligament. Demographic data, intraoperative findings and techniques, and postoperative complications were compared between patients who underwent ACLR with LEAP and those who underwent ACLR alone.</div></div><div><h3>Results</h3><div>A total of 268 patients with a mean follow-up period of 2.0 ± 0.8 years were included in the analysis, of whom 49 (18%) underwent a 2-limb LEAP with ACLR. Most of the patients who underwent LEAP (91.8%) received a quadriceps tendon autograft for ACLR, whereas those who underwent only ACLR had a more equal distribution of quadriceps (38.8%), patella (34.2%), and hamstring (26.9%) tendon autografts. The most common short-term complication was persistent pain (i.e., pain lasting >3 months), occurring in 4.1% of patients with LEAP and 5.9% of those with ACLR alone (<em>P</em> > .99). There was no difference in the proportion of patients with arthrofibrosis (10.2% of those with LEAP vs 9.6% of those with ACLR alone, <em>P</em> = .90), superficial wound infection (2.0% with LEAP vs 3.7% with ACLR alone, <em>P</em> > .99), or reoperation for any reason (32.6% with LEAP vs 36.5% with ACLR alone, <em>P</em> = .78). The rate of postoperative cosmetic concerns was significantly different (6.1% of patients with LEAP vs 0.5% of patients with ACLR, <em>P</em> = .02).</div></div><div><h3>Conclusions</h3><div>Children and adolescents undergoing a 2-limb LEAP with primary ACLR reported a higher rate of cosmetic concerns after surgery than those undergoing ACLR alone. However, the addition of the LEAP did not otherwise increase the risk of early postoperative complications at a minimum 1-year follow-up.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101266"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.asmr.2025.101261
Adam J. Tagliero M.D. , Brandon Cabarcas M.D. , Sanathan Iyer M.S. , Adam V. Daniel M.D. , John J. Kelly M.D. , Aaron J. Krych M.D. , Bruce A. Levy M.D.
Purpose
To compare clinical and functional outcomes (including range of motion, clinical laxity, reoperation/revision rates, and patient-reported outcome measures) of combined anterior cruciate ligament/posterior cruciate ligament reconstruction (ACLR/PCLR) with and without suture tape (ST) augmentation via a propensity-matched cohort analysis.
Methods
A retrospective review was performed to identify all patients who underwent simultaneous primary ACLR/PCLR between 2001 and 2022. A 1:1 propensity match was performed using patient sex, Schenck classification grade, age ±8 years, and body mass index ±10 to produce 2 cohorts: ACLR/PCLR with and without (control) ST augmentation. Clinical outcomes (visual analog scale [VAS], range of motion, Tegner activity scale, Lysholm score, and International Knee Documentation Committee subjective score) were analyzed.
Results
The propensity match produced a final cohort of 50 ACLR/PCLR patients: 25 with ST augmentation and 25 nonaugmented controls. Most patients had a KD3M injury (12 in each cohort), and no significant differences were noted in concomitant neurovascular, meniscal, or chondral injuries between the groups. Forty patients (80%) completed follow-up at a mean of 4.7 years for the ST cohort and 8.5 years for the control cohort (P > .05). Postoperative ST versus control values for outcome measures including VAS at rest (0.9 vs 1.5; P = .71), VAS with use (3.0 vs 2.2; P = .24), International Knee Documentation Committee (75.7 vs 76.3; P = .37), Lysholm (81.8 vs 77.6; P = .91), and Tegner activity (4.8 vs 5.4; P = .37) scores showed no differences (P > .05 for all). There were no differences in excessive postoperative clinical laxity between ST and control cohorts (ST n = 1 vs control n = 2, Lachman 2+, P = .140; ST n = 3 vs control n = 1, posterior drawer 2+, P = .122). The total number of patients who underwent reoperation was 7 of 25 (28%) for the ST cohort and 8 of 25 (32%) for the control cohort (P = .76).
Conclusions
Concomitant ACLR/PCLR utilizing ST augmentation showed similarly satisfactory postoperative clinical outcomes at a minimum 2-year follow-up compared to a matched cohort without ST. The use of an independent ST did not limit motion or increase the incidence of complications or revision surgery.
Level of Evidence
Level III, retrospective comparative case series.
目的通过倾向匹配的队列分析，比较有无缝合带增强的联合前交叉韧带/后交叉韧带重建（ACLR/PCLR）的临床和功能结果（包括活动范围、临床松弛度、再手术/翻修率和患者报告的结果测量）。方法回顾性分析2001 - 2022年间所有同时行原发性ACLR/PCLR的患者。根据患者性别、Schenck分类等级、年龄±8岁和体重指数±10进行1:1倾向匹配，产生2个队列：ACLR/PCLR伴ST增强和不伴ST增强（对照）。分析临床结果（视觉模拟量表[VAS]、活动范围、Tegner活动量表、Lysholm评分和国际膝关节文献委员会主观评分）。结果倾向匹配产生了50例ACLR/PCLR患者的最终队列：25例ST增强组和25例非ST增强组。大多数患者有KD3M损伤（每组12例），两组间合并的神经血管、半月板或软骨损伤无显著差异。40名患者（80%）完成了ST组平均4.7年的随访，对照组平均8.5年的随访（P > 0.05）。术后ST与对照组的结果测量值，包括静止时VAS评分（0.9 vs 1.5, P = 0.71）、使用时VAS评分（3.0 vs 2.2, P = 0.24）、国际膝关节文献委员会评分（75.7 vs 76.3, P = 0.37）、Lysholm评分（81.8 vs 77.6, P = 0.91）和Tegner活动评分（4.8 vs 5.4, P = 0.37）均无差异（P = 0.05）。ST组与对照组术后临床过度松弛无差异（ST组n = 1 vs对照组n = 2, Lachman 2+, P = 0.140； ST组n = 3 vs对照组n = 1，后抽屉2+，P = 0.122）。ST组25例患者中有7例（28%）再次手术，对照组25例患者中有8例（32%）再次手术（P = 0.76）。结论：在至少2年的随访中，与没有ST的匹配队列相比，采用ST增强术的ACLR/PCLR患者的术后临床结果同样令人满意。使用独立ST不会限制运动或增加并发症或翻修手术的发生率。证据等级：III级，回顾性比较病例系列。
{"title":"No Difference in Clinical Outcomes Between Concomitant Anterior and Posterior Cruciate Ligament Reconstruction With and Without Independent Suture Tape Augmentation","authors":"Adam J. Tagliero M.D. , Brandon Cabarcas M.D. , Sanathan Iyer M.S. , Adam V. Daniel M.D. , John J. Kelly M.D. , Aaron J. Krych M.D. , Bruce A. Levy M.D.","doi":"10.1016/j.asmr.2025.101261","DOIUrl":"10.1016/j.asmr.2025.101261","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare clinical and functional outcomes (including range of motion, clinical laxity, reoperation/revision rates, and patient-reported outcome measures) of combined anterior cruciate ligament/posterior cruciate ligament reconstruction (ACLR/PCLR) with and without suture tape (ST) augmentation via a propensity-matched cohort analysis.</div></div><div><h3>Methods</h3><div>A retrospective review was performed to identify all patients who underwent simultaneous primary ACLR/PCLR between 2001 and 2022. A 1:1 propensity match was performed using patient sex, Schenck classification grade, age ±8 years, and body mass index ±10 to produce 2 cohorts: ACLR/PCLR with and without (control) ST augmentation. Clinical outcomes (visual analog scale [VAS], range of motion, Tegner activity scale, Lysholm score, and International Knee Documentation Committee subjective score) were analyzed.</div></div><div><h3>Results</h3><div>The propensity match produced a final cohort of 50 ACLR/PCLR patients: 25 with ST augmentation and 25 nonaugmented controls. Most patients had a KD3M injury (12 in each cohort), and no significant differences were noted in concomitant neurovascular, meniscal, or chondral injuries between the groups. Forty patients (80%) completed follow-up at a mean of 4.7 years for the ST cohort and 8.5 years for the control cohort (<em>P</em> > .05). Postoperative ST versus control values for outcome measures including VAS at rest (0.9 vs 1.5; <em>P</em> = .71), VAS with use (3.0 vs 2.2; <em>P</em> = .24), International Knee Documentation Committee (75.7 vs 76.3; <em>P</em> = .37), Lysholm (81.8 vs 77.6; <em>P</em> = .91), and Tegner activity (4.8 vs 5.4; <em>P</em> = .37) scores showed no differences (<em>P</em> > .05 for all). There were no differences in excessive postoperative clinical laxity between ST and control cohorts (ST n = 1 vs control n = 2, Lachman 2+, <em>P</em> = .140; ST n = 3 vs control n = 1, posterior drawer 2+, <em>P</em> = .122). The total number of patients who underwent reoperation was 7 of 25 (28%) for the ST cohort and 8 of 25 (32%) for the control cohort (<em>P</em> = .76).</div></div><div><h3>Conclusions</h3><div>Concomitant ACLR/PCLR utilizing ST augmentation showed similarly satisfactory postoperative clinical outcomes at a minimum 2-year follow-up compared to a matched cohort without ST. The use of an independent ST did not limit motion or increase the incidence of complications or revision surgery.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101261"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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