Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Postoperative Reverse Shoulder Arthroplasty Angle Is Not Correlated with Patient-Reported Outcomes or Range of Motion","authors":"Noah E. DiNapoli B.S. ,&nbsp;Nichole M. Perry M.D. ,&nbsp;James A. Rhead B.S. ,&nbsp;Edward C. Beck M.D. ,&nbsp;Nicholas A. Trasolini M.D. ,&nbsp;Benjamin R. Graves M.D. ,&nbsp;Brian R. Waterman M.D. ,&nbsp;Alan W. Reynolds M.D.","doi":"10.1016/j.asmr.2025.101250","DOIUrl":"10.1016/j.asmr.2025.101250","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether postoperative reverse shoulder arthroplasty (RSA) angle as a continuous variable is correlated with postoperative patient-reported outcome measures (PROMs) or range of motion (ROM) for patients undergoing RSA with modern implants.</div></div><div><h3>Methods</h3><div>A retrospective review was performed to measure preoperative and postoperative RSA angle using radiographs for patients with a minimum 2-year follow-up undergoing primary RSA at a single academic center between 2015 and 2022. PROMs including American Shoulder and Elbow Surgeon (ASES), visual analog scale (VAS), and Single Assessment Numeric Evaluation (SANE) scores were collected. External rotation, internal rotation, and forward flexion ROM measurements were also recorded. Pearson and Spearman correlation analyses were performed to determine whether there were any linear or monotonic relationships between postoperative RSA angle and the other variables.</div></div><div><h3>Results</h3><div>A total of 142 patients were included with an average follow-up of 3.3 ± 1.3 years. The average RSA angle was 19.3° ± 9.1° preoperatively and 4.3° ± 7.1° postoperatively. No significant relationship between postoperative RSA angle and PROMs was found: ASES (<em>r</em> = –0.01, <em>P</em> = .87), VAS (<em>r</em> = 0.01, <em>P</em> = .85), and SANE (<em>r</em> = 0.04, <em>P</em> = .67). Patients showed varying degrees of improvement in PROMs, as indicated by rates of achieving the minimal clinically important difference: ASES: 77.3%; VAS: 92.0%; SANE: 66.7%. Final ROM also showed no statistically significant association with postoperative RSA angle: external rotation (<em>r</em> = 0.05, <em>P</em> = .59), internal rotation (<em>r</em> = 0.03, <em>P</em> = .74), and forward flexion (<em>r</em> = –0.08, <em>P</em> = .59). Patients with a higher postoperative RSA angle had a higher preoperative RSA angle (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Postoperative RSA angle was not correlated with differences in postoperative PROMs, including ASES, VAS, and SANE, or with differences in postoperative ROM. Inclination of postoperative RSA angle, particularly without significant outliers, may not be detrimental to patient outcomes.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101250"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478823","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}

{"title":"Long Head Biceps Tendon Angle Shows the Highest Sensitivity and Long Head Biceps Tendon-Groove Distance the Highest Specificity for the Diagnosis of Biceps Pulley Lesions Using Conventional Magnetic Resonance Imaging","authors":"Javier Ardebol M.D., M.B.A. ,&nbsp;Roger Erosa-Villarreal M.D. ,&nbsp;Edwin Valencia-Ramón M.D. ,&nbsp;Alejandro López-Villers M.D. ,&nbsp;Guillermo Franco-del Río M.D. ,&nbsp;Patrick J. Denard M.D. ,&nbsp;Frank Martetschläger M.D. ,&nbsp;Juan Cosme-Labarthe M.D. ,&nbsp;Alexandre Lädermann M.D. ,&nbsp;Juan Pablo Muñoz M.D. ,&nbsp;Alberto Guevara-Alvarez M.D.","doi":"10.1016/j.asmr.2025.101253","DOIUrl":"10.1016/j.asmr.2025.101253","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the diagnostic performance and inter-rater agreement for magnetic resonance imaging (MRI) signs of long head biceps tendon (LHBT) instability and overall, using conventional MRI for the diagnosis of biceps pulley lesions.</div></div><div><h3>Methods</h3><div>In this retrospective analysis, conventional MRIs were reviewed by 5 assessors for the presence or absence of biceps pulley lesions and 6 specific MRI signs. Diagnostic performance of pulley lesion and sign detection using MRI was tested using arthroscopy as the reference standard. Interobserver agreement was measured with Kappa statistics and diagnostic performance with sensitivity, specificity, negative and positive predictive values overall and for radiologists and surgeons.</div></div><div><h3>Results</h3><div>A total of 60 MRIs, 30 with biceps pully lesions and 30 without, were included. Overall, diagnostic performance metrics for MRI included a sensitivity of 81%, specificity of 79%, positive predictive value of 80%, and negative predictive value of 80%. Interobserver reliability analysis revealed moderate agreement overall, with a global kappa value of 0.59. LHBT angle showed the highest sensitivity (84%) and LHBT-groove distance showed the greatest specificity (98%). Both radiologists and surgeons reported similar diagnostic accuracy through MRI.</div></div><div><h3>Conclusions</h3><div>Overall, conventional MRI had an acceptable diagnostic performance, with sensitivity, specificity, and predictive values of approximately 80%. Among the evaluated signs, the LHBT angle had the highest sensitivity, whereas the LHBT-groove distance showed the greatest specificity. Interobserver reliability was moderate overall, though some observer pairs achieved substantial agreement. However, there was variability across diagnostic signs.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101253"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478846","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}

{"title":"High Patient Satisfaction With Gluteus Maximus Transfer for Abductor Insufficiency Despite Persistent Trendelenburg Gait","authors":"Katherine L. Esser B.S.,&nbsp;Michelle Shen M.D.,&nbsp;Larry Chen B.S.,&nbsp;Griffith G. Gosnell M.S.,&nbsp;Emily Berzolla B.S.,&nbsp;Guillem Gonzalez-Lomas M.D.,&nbsp;Robert Meislin M.D.,&nbsp;Thomas Youm M.D.","doi":"10.1016/j.asmr.2025.101224","DOIUrl":"10.1016/j.asmr.2025.101224","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate short-term clinical and patient reported outcomes after gluteus maximus/tensor fascia lata (GM/TFL) transfer for abductor insufficiency.</div></div><div><h3>Methods</h3><div>This was a retrospective case series. Inclusion criteria were patients who underwent GM/TFL for chronic abductor insufficiency from 2017 to 2024 at a single institution with a minimum follow-up of 6 months and at least 1 recorded postoperative visit. Demographic, clinical, and outcome data were collected, including hip range of motion, abduction strength, presence of Trendelenburg gait, postoperative rehabilitation details, complications, and patient-reported outcomes. Statistical comparisons of pre- and postoperative objective measures were performed using the Wilcoxon signed-rank test.</div></div><div><h3>Results</h3><div>Ten patients (8 female, 2 male) with a mean age of 65.8 ± 11.2 years were included. Mean follow-up was 2.3 years (0.7-7.8). Postoperatively, range of motion and abduction strength showed no significant changes (<em>P</em> &gt; .05), and Trendelenburg gait persisted in 80% of patients. However, patient-reported outcome scores were strong, with a mean postoperative modified Harris Hip Score of 76.5 ± 22.4 and Non-Arthritic Hip Score of 74.1 ± 21.7. Patient satisfaction was high, with 100% of patients indicating they would undergo the procedure again. Three patients experienced complications (30%), including 2 patients who had persistent pain and seroma formation, and a patient who had a recurrent hematoma.</div></div><div><h3>Conclusions</h3><div>GM/TFL transfer does not consistently improve hip strength or gait mechanics; however, it provides pain relief and improved quality of life, as evidenced by high patient satisfaction and favorable modified Harris Hip Score outcomes. Three patients experienced complications (30%), including two patients who had persistent pain and seroma formation, and a patient who had a recurrent hematoma.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101224"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478851","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}

{"title":"General Anesthesia Using Laryngeal Mask Airway Ventilation With Low-Dose Neuromuscular Blockade Is Safe and Effective for Patients Undergoing Hip Arthroscopy","authors":"Justin T. Jabara M.D. ,&nbsp;Jillian H. Neuner B.A. ,&nbsp;Akash Vasanthan M.S. ,&nbsp;Pedram Aleshi M.D. ,&nbsp;Sakura Kinjo M.D. ,&nbsp;Stephanie E. Wong M.D. ,&nbsp;Alan L. Zhang M.D.","doi":"10.1016/j.asmr.2025.101218","DOIUrl":"10.1016/j.asmr.2025.101218","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate safety and efficacy of a general anesthesia protocol using laryngeal mask airway (LMA) ventilation without endotracheal intubation (ETT) in the setting of a low dosage of neuromuscular blockade (NMBA) for patients undergoing hip arthroscopy.</div></div><div><h3>Methods</h3><div>Patients who underwent hip arthroscopy for femoroacetabular impingement syndrome at a single institution from 2014 to 2024 were retrospectively analyzed. Those who underwent hip arthroscopy for non-femoroacetabular impingement syndrome indications and those with a concomitant periacetabular osteotomy were excluded. General anesthesia was administered with propofol and sevoflurane, with LMA ventilation. A low-dose (10-50 mg) NMBA agent (rocuronium) was given before hip distraction. The primary outcome of interest was pulmonary aspiration. Secondary outcomes of interest included conversion to ETT and operating room time.</div></div><div><h3>Results</h3><div>This study included 1,169 cases (49.8% female) with mean age 37.8 years (± 11.0) and body mass index 24.4 (± 3.9). In total, 64.0% were American Society of Anesthesiologists (ASA) class I, 34.8% class II, and 1.2% class III. In 24 cases, patients underwent ETT without attempting LMA as a result of preoperative aspiration risk factors. Of the 1,145 cases that underwent LMA with NMBA, mean dose of rocuronium given was 20.4 mg, and no patients experienced pulmonary aspiration or anesthesia complications. Twenty-one cases (1.8%) required conversion to ETT as the result of poor LMA fit or ventilation leakage. ASA class was not associated with LMA-to-ETT conversion (<em>P</em> = .77). Mean airway manipulation time was 6.0 minutes (± 6.4), mean procedure duration was 100.3 minutes (± 48.7), and mean procedure end to airway removal time- 5.0 minutes (± 5.0). No surgical complications related to hip distraction or traction force occurred.</div></div><div><h3>Conclusions</h3><div>Administration of general anesthesia using LMA ventilation with a low dosage of neuromuscular blockade is safe and effective for patients undergoing hip arthroscopy. The rate of conversion to endotracheal intubation was low and showed no association with ASA classification.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101218"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478980","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}

{"title":"Aragonite-Based Scaffolds Are Effective Osteochondral Graft Substitutes for Osteochondral Defects of the Knee: A Systematic Review","authors":"Jonathan D. McKeeman M.D.,&nbsp;Neil Jain M.D.,&nbsp;Nigel Wang M.D.,&nbsp;Ajay C. Kanakamedala M.D.","doi":"10.1016/j.asmr.2025.101215","DOIUrl":"10.1016/j.asmr.2025.101215","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the outcomes and complication profiles after the implantation of aragonite-based scaffold osteochondral substitutes for the treatment of osteochondral lesions of the knee.</div></div><div><h3>Methods</h3><div>Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we completed a comprehensive search of the PubMed, Embase, and Medline databases in January 2025 to obtain studies reporting on outcomes after implantation of an aragonite-based scaffold in patients with osteochondral defects of the knee. Clinical studies were assessed for patient-reported outcome measures, failure rates, and magnetic resonance imaging findings. Risk-of-bias assessment was performed and the Methodological Index for Non-randomized Studies (MINORS) criteria were applied to appraise study quality.</div></div><div><h3>Results</h3><div>Five studies were included for data analysis. In total, 526 patients with a mean age of 39.1 years (range, 31.6-42.0 years) were followed up for an average of 30.5 months (range, 12-78 months). Four studies evaluating Knee Injury and Osteoarthritis Outcome Scores reported mean improvements of 16.1 to 41.0 from preoperatively to final follow-up. Three studies reported improvements of 23.1 to 43 in International Knee Documentation Committee Subjective Knee Form scores. Failure, defined as any secondary intervention on the index knee, occurred in 0% to 13.6% of cases, and these rates were significantly lower than those for microfracture and arthroscopic debridement. Tapered scaffolds had lower failure rates than cylindrical designs (0% vs 8%-10.5%).</div></div><div><h3>Conclusions</h3><div>Aragonite-based scaffolds in the treatment of osteochondral lesions of the knee show improved patient-reported outcomes and low failure rates at mean follow-up durations ranging from 12 to 78 months.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I and IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101215"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478987","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}

{"title":"Large Language Models Show Comparable Response Performance but Vary in Readability Regarding Patient Questions on Hip Arthroscopy","authors":"Jeffrey S. Mun B.A. ,&nbsp;Srish S. Chenna B.S.E. ,&nbsp;Rachel L. Poutre B.A. ,&nbsp;Brandon J. Allen B.A. ,&nbsp;Stephen M. Gillinov M.D. ,&nbsp;Frederick Mun M.D. ,&nbsp;James R. Satalich M.D. ,&nbsp;Richard M. Wilk M.D. ,&nbsp;Scott D. Martin M.D.","doi":"10.1016/j.asmr.2025.101229","DOIUrl":"10.1016/j.asmr.2025.101229","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the quality of large language model (LLM) responses to frequently asked questions regarding hip arthroscopy, assess the incorrect response rate of LLMs, and compare the readability among different LLM outputs.</div></div><div><h3>Methods</h3><div>Three LLMs, including OpenAI Chat Generative Pre-Trained Transformer (ChatGPT) 3.5, Microsoft Co-Pilot, and Google Gemini, were each queried with 10 frequently asked questions regarding hip arthroscopy. Two high-volume hip arthroscopists graded the responses on a 4-point Likert scale (1 = excellent, requiring no clarification; 2 = satisfactory, requiring minimal clarification; 3 = satisfactory, requiring moderate clarification; and 4 = unsatisfactory, requiring substantial clarification). Additionally, the 2 graders ranked the responses from the 3 different LLMs for each of the 10 questions on a 3-point Likert scale (1 = best, 2 = intermediate, 3 = worst). Readability was assessed using the Flesch-Kincaid Grade Level and Flesch Reading Ease metrics.</div></div><div><h3>Results</h3><div>Commonly used LLMs performed on a similar level of response accuracy and adequacy (mean ± SD: ChatGPT: 3.0 ± 1.0 vs Microsoft: 2.9 ± 1.1 vs Gemini: 2.6 ± 1.1, <em>P</em> = .481). Reviewers had no preference for one LLM’s responses over another (mean ± SD: ChatGPT: 2.0 ± 0.8 vs Microsoft: 2.1 ± 0.9 vs Gemini: 2.0 ± 0.8, <em>P</em> = .931). The overall incorrect response rate among LLMs was 20%. ChatGPT responses were at a significantly worse reading level compared to Gemini and Microsoft outputs (Flesch-Kincaid Grade Level mean ± SD: ChatGPT: 11.0 ± 2.2 grade reading level vs Microsoft: 8.6 ± 2.3 vs Gemini: 6.6 ± 2.2, <em>P</em> = .003; Flesch Reading Ease mean ± SD: ChatGPT: 36.6 ± 19.0 vs Microsoft: 57.7 ± 13.3 vs Gemini: 65.0 ± 4.7, <em>P</em> = .001).</div></div><div><h3>Conclusions</h3><div>Hip arthroscopists find LLM outputs on patient questions regarding hip arthroscopy satisfactory but requiring moderate clarification and show no preference for one LLM’s responses over another. LLMs produce a substantial number of incorrect responses. ChatGPT outputs had a significantly worse reading level compared to those of Microsoft and Gemini.</div></div><div><h3>Clinical Relevance</h3><div>This study provides insights into the accuracy and readability of LLM-generated responses to commonly asked questions about hip arthroscopy. As patients increasingly turn to artificial intelligence tools for health information, understanding the quality and potential risks of misinformation becomes essential.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101229"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478850","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}

{"title":"Augmenting an Allograft for Anterior Cruciate Ligament Reconstruction With a Collagen Matrix and Bone Marrow Aspirate Concentrate Injection Appears Safe and Produces Favorable Clinical Outcomes at 2-Year Follow-Up","authors":"Steve E. Jordan M.D. ,&nbsp;Adam W. Anz M.D. ,&nbsp;Roger V. Ostrander III M.D. ,&nbsp;Eric A. Branch M.D. ,&nbsp;Thomas S. Denney Ph.D. ,&nbsp;Achraf Cohen Ph.D. ,&nbsp;Jessi Truett Ed.D., B.C.B.A. ,&nbsp;James R. Andrews M.D.","doi":"10.1016/j.asmr.2025.101209","DOIUrl":"10.1016/j.asmr.2025.101209","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate clinical outcomes of augmenting an anterior cruciate ligament (ACL) allograft with an amnion matrix wrap and injecting bone marrow aspirate concentrate (BMAC).</div></div><div><h3>Methods</h3><div>We enrolled 10 ACL reconstruction patients aged 22-60 years with hamstring allografts wrapped with an amnion collagen matrix and injected with BMAC in this prospective case series. Participants completed physical therapy and reported outcomes for 2 years. Postoperative magnetic resonance imaging scans were mapped/processed at 3, 6, 9, and 12 months, yielding mean transverse relations time constant (T2∗) and volume values for grafts and bone tunnel integration.</div></div><div><h3>Results</h3><div>We assessed the longitudinal outcomes of allograft augmentation using descriptive statistics and confidence intervals, showing significant increases in average Knee Injury and Osteoarthritis Outcome Score (KOOS₅) and Single Assessment Numerical Evaluation (SANE) scores (KOOS₅: Baseline-24 months [m] = 64.2-84.8, 95% confidence interval [CI] 9.14-32.56, SANE: Baseline-24m = 33.8-87.9, 95% CI 38.71-64.87). Average Veterans RAND 12 Item Health Survey (VR-12) Physical scores significantly increased from baseline to 24 months postoperation (Baseline-24m = 35.1-49.6, 95% CI 8.25-20.30). Average visual analog scale for pain scores significantly decreased from baseline at all time points except 2 weeks postoperation (baseline-2 weeks = 2.7-3.6, 95% CI −0.19 to 2.07) starting at 6 weeks postoperation (baseline-6 weeks = 2.7-1.3, 95% CI −2.52 to −0.26) and remained significantly lower than baseline to 24 months postoperation (baseline-24m = 2.7-0.6, 95% CI− 3.27 to −0.85). Average Max Activity Scale scores were significantly decreased from baseline starting at 12 months postoperation (baseline-12m = 6.3-2.7, 95% CI −6.32 to −0.88) but returned to baseline levels at 24-months postoperation (Baseline-24m = 6.3-5.8, 95% CI −4.45 to 1.45). There were no significant differences in VR-12 mental component scores or magnetic resonance imaging measures. No infections nor reconstruction failures occurred after 2 years.</div></div><div><h3>Conclusions</h3><div>This case series demonstrated augmenting hamstring allograft ACL reconstruction with an amnion collagen matrix and injecting BMAC appeared to be safe, and clinical outcomes were favorable up to 2 years postoperation despite having no quantifiable effect on graft maturation.</div></div><div><h3>Level of Evidence</h3><div>Level IV, therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101209"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478917","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}

{"title":"Pickleball-Related Geriatric Fractures and Pediatric Equipment-Related Injuries Are Increasing in Emergency Departments Across the United States","authors":"Philip M. Lee B.S. ,&nbsp;Ryan Nishi B.S. ,&nbsp;Kyle K. Obana M.D. ,&nbsp;Sean M. Chan M.D. ,&nbsp;Jae K. You M.D. ,&nbsp;Jennifer M. Weiss M.D. ,&nbsp;William N. Levine M.D. ,&nbsp;David P. Trofa M.D.","doi":"10.1016/j.asmr.2025.101228","DOIUrl":"10.1016/j.asmr.2025.101228","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the epidemiology, prevalence, and mechanism of injury of pickleball-related injuries in patients presenting to emergency departments in the United States.</div></div><div><h3>Methods</h3><div>Data between 2004 and 2023 from the National Electronic Injury Surveillance System were analyzed for racquetball-related injuries. The data set was screened for pickleball-related injuries using keywords. Data included body part, diagnosis, mechanism of injury, and disposition. Calculations used corresponding hospital sample weights for national estimates (NEs). Patients were divided into the following age groups: pediatric (&lt;18 years), 19 to 39 years, 40 to 59 years, and 60 years or older.</div></div><div><h3>Results</h3><div>A total of 1,714 injuries (NE, 99,816 [98.8%]) were included. The most commonly injured body locations were the upper trunk (n = 232) (NE, 14,884 [13.5%]), head (n = 226) (NE, 12,990 [13.2%]), and knee (n = 188) (NE, 10,700 [10.9%]). The most identified final diagnoses were fracture (n = 493) (NE, 27,493 [28.7%]), sprain/strain (n = 423) (NE, 25,237 [24.7%]), internal organ damage (n = 168) (NE, 10,050 [9.8%]), and contusion (n = 163) (NE, 9,573 [9.5%]). The most identified mechanisms of injury were impact with the floor (n = 856) (NE, 50,797 [49.9%]), exertional cardiovascular event (n = 244) (NE, 15,796 [14.2%]), and non-contact movement (n = 222) (NE, 12,936 [13.0%]). Pediatric patients had the highest proportion of head injuries (NE, 222 [16.9%]) and injuries from equipment (NE, 634 [32.2%]). The group aged 60 years or older had the highest proportion of wrist injuries (NE, 10,302 [13.0%]), fractures (NE, 17,802 [32.8%]), and injuries cause by impact with the floor (NE, 43,592 [56.1%]). Additionally, this group had the highest proportion of upper trunk injuries (NE, 12,947 [15.4%]) and exertional chest pain (NE, 13,789 [16.2%]).</div></div><div><h3>Conclusions</h3><div>Pickleball injuries most frequently involved the upper trunk, head, and knee, with fractures and sprains/strains being the most common diagnoses. Nearly half of all pickleball injuries resulted from impacts with the floor. Pediatric patients had a higher proportion of head injuries and equipment-related trauma, whereas older adults (≥60 years) were more prone to wrist and upper trunk injuries, fractures, and exertional chest pain.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective epidemiologic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101228"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478976","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}

{"title":"Current Classification Systems for Knee Ligament Injuries Are Limited to Ligament Involvement and Do Not Consider Injury Mechanism or Sequence of Injury: A Scoping Review","authors":"Jelle P. van der List M.D., Ph.D., M.B.A. ,&nbsp;Roy A.G. Hoogeslag M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101207","DOIUrl":"10.1016/j.asmr.2025.101207","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically assess published classification systems for knee ligament injuries and to propose a comprehensive, multiplanar, sequential knee ligament classification system that improves upon those in the published literature.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. PubMed, Embase, and Cochrane were searched from inception to January 2025 for studies reporting knee classification systems. Inclusion criteria consisted of studies reporting knee classification systems and English language. Exclusion criteria consisted of classifications only describing specific type of knee injuries (e.g., only anterior cruciate ligament injuries). The characteristics of each classification system were recorded and analyzed descriptively. A classification system was proposed that addresses the weaknesses of the existing systems.</div></div><div><h3>Results</h3><div>A total of 6 classification systems were identified in 8 studies in the literature and were published between 1975 and 2009. Existing classification systems were strong in correlating type of injuries with rotatory ligamentous laxity and physical examination findings but were lacking assessment of knee position during injury, discussion of sequence of injuries, involvement of bone marrow edema (except one study), and lack of correlation with knee dislocations. No clinical validation was performed. A knee classification system was created that included sequence of injuries, correlation with knee dislocation and injury mechanism, and bone marrow edema.</div></div><div><h3>Conclusions</h3><div>Knee injury classification systems lack comprehensive consideration of injury mechanism, sequence of injury, bone marrow edema, meniscus and chondral damage, involved ligaments, rotatory instability, and correlation with knee dislocation. The sequence of injury to these structures could be relevant to understanding injury mechanism and treatment, but requires validation.</div></div><div><h3>Level of Evidence</h3><div>Level V, systematic review of level IV-V studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101207"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478982","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}

{"title":"Concomitant Hip Arthroscopy Is Associated With Improved Outcomes of Core Decompression for Osteonecrosis of the Femoral Head: A Systematic Review","authors":"Ady H. Kahana-Rojkind M.D. ,&nbsp;Paras P. Shah B.A. ,&nbsp;Krishi Rana B.A. ,&nbsp;Nils Becker M.D. ,&nbsp;Roger Quesada-Jimenez M.D. ,&nbsp;Benjamin G. Domb M.D.","doi":"10.1016/j.asmr.2025.101225","DOIUrl":"10.1016/j.asmr.2025.101225","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effectiveness of core decompression (CD) with concomitant arthroscopic treatment of intra-articular pathologies for improving outcomes for patients with osteonecrosis of the femoral head (ONFH) and intra-articular pathology and to compare results with patients undergoing isolated CD.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted using PubMed, MEDLINE, and Cochrane Library databases through July 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing CD with and without hip arthroscopy (HA) were included, provided they reported patient-reported outcomes (PROs), survivorship, or total hip arthroplasty (THA) conversion rates. Studies were excluded if HA was solely diagnostic. Quality was assessed using Methodological Index for Non-Randomized Studies and Risk Of Bias In Non-randomised Studies - of Interventions. Data extracted included demographics, surgical techniques, PROs, and THA-free survivorship.</div></div><div><h3>Results</h3><div>Six studies (4 Level III, 2 Level IV) met the inclusion criteria, comprising 632 hips with mean ages ranging from 35.5 to 41.1 years. All studies reported pre- and postoperative Harris Hip Score, and one included visual analog scale pain scores. Patients undergoing CD with HA had significantly greater postoperative Harris Hip Score (71.41-93.33) and improved THA-free survivorship compared with CD alone. Three of four comparative studies showed significantly lower THA conversion rates and femoral head collapse in the HA group. However, no study directly showed that HA improved bone healing.</div></div><div><h3>Conclusions</h3><div>CD with HA results in better PROs and femoral head survivorship compared with CD alone, likely because of intra-articular pathology treatment and improved joint function. Core decompression with concomitant hip arthroscopy to address intra-articular pathology should be considered for pre-collapse ONFH.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III and IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101225"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145479048","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}