Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Open Biceps Tenodesis and Tenotomy Have Low 30-Day Postoperative Complication Rates","authors":"Sarah Whitaker B.A. ,&nbsp;Sarah Cole B.A. ,&nbsp;Maria Peri B.S. ,&nbsp;James Satalich M.D. ,&nbsp;Conor O’Neill M.D. ,&nbsp;Alexander Vap M.D.","doi":"10.1016/j.asmr.2024.100928","DOIUrl":"10.1016/j.asmr.2024.100928","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare 30-day postoperative rates of adverse events, particularly infection rates, between open biceps tenodesis and biceps tenotomy.</p></div><div><h3>Methods</h3><p>The American College of Surgeons National Surgical Quality Improvement Program was filtered using <em>Current Procedural Terminology</em> codes to identify patients undergoing open biceps tenodesis and tenotomy from 2010 to 2021. Patients were divided into cohorts based on procedure type. Propensity score matching was used to account for confounding variables. Statistical analyses were conducted to compare 30-day postoperative outcomes between cohorts, as well as to evaluate secondary risk factors for complications.</p></div><div><h3>Results</h3><p>Overall, 12,367 patients were included in the study with 11,417 undergoing open biceps tenodesis and 950 undergoing biceps tenotomy. After matching, 1,900 patients were included in the final analysis. The rate of outpatient procedures in the tenodesis cohort was significantly higher than in the tenotomy cohort. Rates of any adverse event (AAE), sepsis, pneumonia, reoperation, and extended length of stay (LOS) were significantly higher in the tenotomy cohort compared with the tenodesis cohort. There was no difference in infection rates or wound dehiscence between the 2 groups. After multivariable analysis, increasing age, longer operative time, and history of bleeding disorders were associated with significantly higher odds of developing AAE.</p></div><div><h3>Conclusions</h3><p>In this study, we found that tenotomy and open tenodesis are both safe options for treatment of biceps pathology. The overall rate of developing AAE and the rate of postoperative sepsis were higher in the tenotomy cohort. In addition, rates of postoperative infection and wound dehiscence did not vary between the 2 groups. Small differences were additionally observed in rates of pneumonia, return to the operating room, and extended LOS, and these rates were higher in the tenotomy cohort.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective comparative study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100928"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000464/pdfft?md5=0b156ecaeb705f575831e7d62f978f80&pid=1-s2.0-S2666061X24000464-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eighty-One Percent of Unrepaired Interportal Capsulotomies Showed Healed Capsules on Magnetic Resonance Imaging 5 Years After Primary Hip Arthroscopy","authors":"Onur Hapa M.D. ,&nbsp;Selahaddin Aydemir M.D ,&nbsp;Asli Irmak Akdogan M.D ,&nbsp;Mustafa Celtik M.D ,&nbsp;Ozgur Aydin M.D ,&nbsp;Batuhan Gocer M.D ,&nbsp;Onur Gursan M.D","doi":"10.1016/j.asmr.2024.100943","DOIUrl":"10.1016/j.asmr.2024.100943","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether unrepaired interportal capsulotomy presents with capsular defect on magnetic resonance imaging (MRI) 5 years after primary hip arthroscopy and to determine its effect on functional results and findings of osteoarthritis on radiographs or MRI scans.</p></div><div><h3>Methods</h3><p>Patients with femoroacetabular impingement (without arthritis or dysplasia) were retrospectively reviewed after arthroscopic labral repair or debridement and femoroplasty through interportal capsulotomy without closure. Patients were assessed preoperatively and at a minimum of 5 years postoperatively using patient-reported outcomes (Hip Outcome Score–Activities of Daily Living scale, modified Harris Hip Score, and visual analog scale pain score), radiographic measures, and MRI scans.</p></div><div><h3>Results</h3><p>Forty patients (42 hips) were deemed eligible for the study and were evaluated. Of the hips, 81% had healed capsules, whereas 8 (19%) had capsular defects on the latest MRI scan. There were 3 hips with subchondral edema in the defect group compared with 1 in the healed-capsule group (<em>P</em> = .01) on the latest MRI scan, which was not present on preoperative MRI (still positive on multivariate analysis when the preoperative alpha angle was also taken into consideration). Functional results did not differ between the groups (<em>P</em> &gt; .05).</p></div><div><h3>Conclusions</h3><p>In this study, 81% of interportal capsulotomies healed without repair at 5 years after primary hip arthroscopy.</p></div><div><h3>Clinical Relevance</h3><p>Understanding the prevalence and implications of unhealed capsulotomies could encourage surgeons to be meticulous in capsular closure.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100943"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000610/pdfft?md5=3768006f6948a9a0d2b81bd149da89d9&pid=1-s2.0-S2666061X24000610-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Flow in the Meniscus Can Be Visualized Arthroscopically Using an Intravenous Indocyanine Green Solution Diluted 10× in a Pig Model","authors":"Tamiko Kamimura M.D., Ph.D.","doi":"10.1016/j.asmr.2024.100932","DOIUrl":"10.1016/j.asmr.2024.100932","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the optimal indocyanine green (ICG) dose required for assessing vascularity in the meniscus using ICG fluorescence-guided knee arthroscopy in a pig model.</p></div><div><h3>Methods</h3><p>A 3-month-old Japanese esculent female pig was used in this study. Intravenous injections of ICG (25 mg) were administered with 2.0 mL of 5×, 10×, 100×, and 1,000× diluted solutions. An additional experiment was conducted to assess the microvasculature within the meniscus considering the results of the optimal dilution setting. A radial tear was purposely induced in the middle-to-posterior section of the medial meniscus to observe vascularity in the cross-sectioned meniscus; the optimal ICG dilution was administered.</p></div><div><h3>Results</h3><p>No fluorescence was detected in the meniscus with solutions diluted by 1,000× and 100×. Fluorescence was visualized at the anterior portion of the synovium and the anterior cruciate ligament using ICG diluted by 10×. Diluting ICG by 5×, contrast enhancement was too intense for observation. Therefore, the 10× diluted solution was considered the optimal setting for knee arthroscopy and observation of the radial tear. No fluorescence was observed in the cross section of the medial meniscus. Arterial hemorrhage was observed by stimulating the fluorescence-dyed synovium adjacent to the tear site. Through the additional waiting time after stimulating the tear site, the hemorrhage inside the meniscus became more intense.</p></div><div><h3>Conclusions</h3><p>The optimal dilution and dose setting of ICG for knee arthroscopy was 10× in a 2.0-mL intravenous injection. The meniscus showed no active blood flow, even in the red-red zone. This finding might support the notion that blood flow cannot be initiated, without synovial stimulation, even in vascular areas.</p></div><div><h3>Clinical Relevance</h3><p>This study could determine an ICG solution suitable for ICG fluorescence-guided knee arthroscopy. This finding could be valuable in future research focusing on case-specific meniscal vascularization under arthroscopy, particularly applying these findings to human meniscal treatment.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100932"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000506/pdfft?md5=072200b5b9eccfb2f436f8594ef3cf97&pid=1-s2.0-S2666061X24000506-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140405115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Autograft With Lateral Compartment Meniscectomy or Chondroplasty Does Not Lead to Decreased Return to Sport and Activity Compared With No Lateral Pathology","authors":"Sean Hazzard P.A., M.B.A.,&nbsp;Saoirse Connolly B.S.,&nbsp;Brendan Fitzgerald B.S.,&nbsp;Peter Asnis M.D.","doi":"10.1016/j.asmr.2024.100910","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100910","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the influence of lateral meniscal and cartilage pathology on the outcome after anterior cruciate ligament (ACL) reconstruction in patients who participate in pivoting sports.</p></div><div><h3>Methods</h3><p>Using a single-surgeon patient registry, patients undergoing an anterior cruciate ligament reconstruction (ACLR) using bone–patellar tendon–bone autograft were evaluated with minimum 2-year patient reported outcomes evaluated using Marx, Tegner, Lysholm, and International Knee Documentation Committee scales. Patients were divided into 3 groups: isolated ACL surgery, ACLR with a partial lateral meniscectomy, or a ACLR with partial lateral meniscectomy and lateral compartment chondroplasty.</p></div><div><h3>Results</h3><p>A total of 98 patients met inclusion criteria. Using the isolated ACL reconstruction group as a control, we found that Marx scores were greater in patients who additionally underwent a partial lateral meniscectomy at 1 year (<em>P</em> = .016). There were no significant differences between the ACL-only group and the ACL with partial lateral meniscectomy and chondroplasty group. Within the partial meniscectomy cohort comparing the patients with red-white zone tears with the patients with white-white zone tear, we found there were no significant differences when compared with the ACL-only control. There were no significant differences appreciated between groups using the International Knee Documentation Committee, Lysholm, and Tegner scales.</p></div><div><h3>Conclusions</h3><p>ACL reconstruction using bone–patellar tendon–bone autograft with anteromedial portal drilling technique does not have any significant short-term (2-year outcome) differences in return to activity and patient-reported outcomes compared with if patients additionally have a partial lateral meniscectomy and/or lateral compartment chondroplasty. Additional partial lateral meniscectomy showed significantly greater Marx scores at 1 and 2 years’ postoperatively.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100910"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000282/pdfft?md5=588ff7456a47f300daf11f39c50406b1&pid=1-s2.0-S2666061X24000282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excellent Clinical Outcomes and Rapid Return to Activity Following In-Office Needle Tendoscopy for Chronic Achilles Tendinopathy","authors":"James J. Butler Mb.Ch.B. ,&nbsp;Grace W. Randall B.S. ,&nbsp;Lauren Schoof M.D. ,&nbsp;Mackenzie Roof M.D. ,&nbsp;Matthew B. Weiss B.S. ,&nbsp;Arianna L. Gianakos D.O. ,&nbsp;John G. Kennedy M.D., M.Ch., M.MSc., F.F.S.E.M., F.R.C.S. (Orth)","doi":"10.1016/j.asmr.2024.100937","DOIUrl":"10.1016/j.asmr.2024.100937","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess outcomes following Achilles in-office needle tendoscopy (IONT) for the treatment of chronic Achilles tendinopathy (cAT) at a minimum 12-month follow-up.</p></div><div><h3>Methods</h3><p>A retrospective case series was conducted to evaluate patients who underwent Achilles IONT for cAT between January 2019 and December 2022. Inclusion criteria were patients ≥18 years of age and clinical history, physical history, and magnetic resonance imaging findings consistent with cAT who did not respond to a minimum of 3 months of conservative management for which each patient underwent Achilles IONT and had a minimum 12-month follow-up. Clinical outcomes were evaluated using the Victorian Institute of Sport Assessment–Achilles and visual analog scale scores. Patient satisfaction was measured at the final follow-up visit with a 5-point Likert scale.</p></div><div><h3>Results</h3><p>Twelve patients (13 Achilles) with a mean age of 50.9 ± 14.6 years were included in the study. The mean follow-up time was 26.3 ± 6.3 months. The mean Victorian Institute of Sport Assessment–Achilles scores improved from a preoperative score of 35.6 ± 5.9 to a postoperative score of 83.6 ± 14.1 (<em>P</em> &lt; .001). The mean visual analog scale score improved from a preoperative score of 6.6 ± 1.0 to a postoperative score of 1.3 ± 1.7 (<em>P</em> &lt; .001). There were 10 patients (83.3%) who participated in sports activities before the IONT procedure. Within this group, 9 patients (90.0%) returned to play at a mean time of 5.9 ± 2.6 weeks. The mean time to return to work was 4.2 ± 1.2 days. Patients reported an overall positive IONT experience with a mean rating scale of 4.5 ± 0.9.</p></div><div><h3>Conclusions</h3><p>This retrospective review demonstrated that Achilles IONT for the treatment of cAT results in significant improvements in subjective clinical outcomes and a low complication rate together with high patient satisfaction scores at short-term follow-up.</p></div><div><h3>Level of Evidence</h3><p>Level IV, therapeutic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100937"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000555/pdfft?md5=53e9b5cc7d1b31efd2a5a97b2d128735&pid=1-s2.0-S2666061X24000555-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open and Percutaneous Approaches Have Similar Biomechanical Results for Primary Midsubstance Achilles Tendon Repair: A Meta-analysis","authors":"Jonathan Lawson M.S. ,&nbsp;Rae Tarapore M.D. ,&nbsp;Sean Sequeira M.D. ,&nbsp;Casey Imbergamo M.D. ,&nbsp;Mitchell Tarka M.D. ,&nbsp;Gregory Guyton M.D. ,&nbsp;Walter Hembree M.D. ,&nbsp;Heath Gould M.D.","doi":"10.1016/j.asmr.2024.100924","DOIUrl":"10.1016/j.asmr.2024.100924","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the biomechanical properties of open versus percutaneous Achilles tendon repair.</p></div><div><h3>Methods</h3><p>A systematic review of original research articles was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To qualify for study inclusion, articles were required to be published in English, use a laboratory design using either human or animal tissue, and directly compare the biomechanical properties of open Achilles repair using a Krackow or Kessler technique with percutaneous repair using either a locking or nonlocking suture construct. The biomechanical outcomes evaluated were displacement (millimeters) and load to failure (Newtons).</p></div><div><h3>Results</h3><p>Twelve studies met inclusion criteria, including 234 specimens (open: 97, percutaneous locking: 73; percutaneous nonlocking: 64) that underwent primary midsubstance Achilles tendon repair. Pooled analysis demonstrated no statistically significant difference in displacement (<em>P</em> = .240) or load to failure (<em>P</em> = .912) between the open and percutaneous techniques. Among the percutaneous approaches, there was no difference in displacement (<em>P</em> = .109) between the locking and nonlocking tendon repair systems.</p></div><div><h3>Conclusions</h3><p>The results of this study suggest that both open and percutaneous techniques are biomechanically viable approaches for primary midsubstance Achilles tendon repair.</p></div><div><h3>Clinical Relevance</h3><p>In clinical studies, similar rerupture rates have been observed after open or percutaneous Achilles tendon repair. It may be beneficial for surgeons to understand whether biomechanical differences exist between these repair techniques.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100924"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000427/pdfft?md5=54bcc0af3c3f4241142b6c396918101d&pid=1-s2.0-S2666061X24000427-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Use of Twitter by Orthopaedic Sports Medicine Journals Can Result in Increased Impact Factor","authors":"Katina Kartalias M.D., M.S. ,&nbsp;Tessa R. Lavorgna B.S. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Mary K. Mulcahey M.D. ,&nbsp;Christopher J. Tucker M.D.","doi":"10.1016/j.asmr.2024.100931","DOIUrl":"10.1016/j.asmr.2024.100931","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine whether activity on Twitter was correlated with increasing impact factor (IF) among 6 orthopaedic sports medicine journals.</p></div><div><h3>Methods</h3><p>Twitonomy software was used to collect account activity for the <em>American Journal of Sports Medicine</em>; <em>Arthroscopy: The Journal of Arthroscopic and Related Surgery; Knee Surgery, Sports Traumatology, Arthroscopy</em>; <em>Journal of Shoulder and Elbow Surgery</em>; <em>Orthopaedic Journal of Sports Medicine</em>; and <em>Sports Health</em>. Data from 2000 to 2020 were collected. Each journal’s annual IF score was collected via <span>scijournal.org</span><svg><path></path></svg>. A multivariate regression model was used to predict the influence of different Twitter metrics on IF from 2012 to 2019. The journal name, number of tweets, and interaction of the two were used to predict IF. Additionally, Pearson correlation was used to assess correlations between Twitter account metrics and IF.</p></div><div><h3>Results</h3><p>Over the study period, all IFs increased, with the exception of that for <em>American Journal of Sports Medicine</em>. The effect size between number of tweets and IF was not the same for each journal. For every additional tweet, <em>American Journal of Sports Medicine</em> increased its IF by 0.001 (<em>P</em> = .18). <em>Sports Health</em> and <em>Orthopaedic Journal of Sports Medicine</em> increased their IF by 0.01 (<em>P</em> = .002) and 0.022 (<em>P</em> &lt; .001), respectively. <em>Knee Surgery, Sports Traumatology, Arthroscopy</em> would expect a decrease in its IF by 0.004 (<em>P</em> = .55) and <em>Journal of Shoulder and Elbow Surgery</em> and <em>Arthroscopy</em> would increase its IF by 0.002 (<em>P</em> = .71) and 0.001 (<em>P</em> = .99), but this was not significant. There was a statistically significant positive correlation between annual tweets and IF across all journals.</p></div><div><h3>Conclusions</h3><p>Markers of Twitter account activity, specifically the number of annual tweets, were predictive of an increase in IF among the orthopedic sports medicine journals included in this study.</p></div><div><h3>Clinical Relevance</h3><p>The findings of this study may allow orthopaedic sports medicine journals to make more effective, targeted, and productive use of their social media accounts to reach a broader audience, increase their influence, and increase the IF of their journal.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100931"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X2400049X/pdfft?md5=32d9c023af3ad9b2712eae00dc8427a3&pid=1-s2.0-S2666061X2400049X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140401958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Posterior Capsular Release Improves Range of Motion and Outcomes for Flexion Contracture After Anterior Cruciate Ligament Reconstruction in Athletes","authors":"Joseph C. Brinkman M.D. ,&nbsp;Jose M. Iturregui M.D. ,&nbsp;M. Lane Moore B.S., M.B.A. ,&nbsp;Jack Haglin M.D. ,&nbsp;Adam Thompson B.S. ,&nbsp;Justin Makovicka M.D. ,&nbsp;Kostas J. Economopoulos M.D.","doi":"10.1016/j.asmr.2024.100914","DOIUrl":"10.1016/j.asmr.2024.100914","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess outcomes of arthroscopic posterior capsular release among athletes for loss of terminal extension following anterior cruciate ligament (ACL) reconstruction.</p></div><div><h3>Methods</h3><p>A retrospective review of prospectively collected data was performed for patients undergoing arthroscopic posterior capsular release for knee extension loss following ACL reconstruction between January 2014 and December 2019. Procedure indications included extension loss greater than 10° at least 3 months after ACL reconstruction that was refractory to physical therapy. Patients were included if they were involved in either high school or college athletics, had complete outcomes of interest, and had at least 2 years of follow-up. Prospectively collected outcomes included preoperative and postoperative measurement of knee extension, International Knee Documentation Committee score, Lysholm score, return to sport data, and complications.</p></div><div><h3>Results</h3><p>Eighteen athletes with minimum 2 years of follow-up who underwent posterior capsular release following ACL reconstruction performed by a single surgeon were included in the analysis. Patients underwent surgery at an average of 16 weeks after ACL reconstruction. Knee extension improved an average of 13.8° at 2 years’ follow-up (prerelease mean extension deficit 15.1°, postrelease mean extension deficit 1.3°, <em>P</em> &lt; .005). Improvements in the International Knee Documentation Committee score averaged 21.7 at 6 months and 35.0 at 24 months, both of which were statistically significant (<em>P</em> &lt; .001). Similarly, differences in Lysholm included a significant improvement of 23.0 and 34.2 at 6 months and 2 years, respectively (<em>P</em> &lt; .001). In total, 77.8% returned to sport at an average of 9.8 months from their primary ACL surgery and 6.5 months following posterior capsular release surgery. No infections or neurovascular complications were observed. One patient required secondary release to achieve adequate extension.</p></div><div><h3>Conclusions</h3><p>For athletes with persistent knee extension loss after ACL reconstruction, knee extension was significantly improved at 2 years following arthroscopic posterior capsular release. Substantial improvements in patient-reported outcomes also were seen. In addition, subjects demonstrated a high rate of return to sport and return to preinjury performance levels.</p></div><div><h3>Level of Evidence</h3><p>Level IV, therapeutic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100914"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000324/pdfft?md5=438acbe143f2e0ec5da2af0a53311e55&pid=1-s2.0-S2666061X24000324-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizations of Capsule Closure in Hip Arthroscopy Are Infrequently and Incompletely Reported: A Systematic Review","authors":"John J. Heifner M.D. ,&nbsp;Leah M. Keller D.O. ,&nbsp;Gagan Grewal M.D. ,&nbsp;Ty A. Davis D.O. ,&nbsp;Jonathan Brutti B.S. ,&nbsp;Jan Pieter Hommen M.D.","doi":"10.1016/j.asmr.2023.100820","DOIUrl":"10.1016/j.asmr.2023.100820","url":null,"abstract":"<div><h3>Purpose</h3><p>To review the recent literature to provide an updated characterization of capsule closure techniques in hip arthroscopy and to determine if the characteristics of closure impacted clinical outcomes.</p></div><div><h3>Methods</h3><p>In keeping with the Preferred Reporting in Systematic Reviews and Meta Analyses (PRISMA) guidelines, a systematic review was performed with the following eligibility criteria: patients over 18 years of age who underwent primary hip arthroscopy with reporting of patient reported outcome measures or revision/failure, and a sufficiently detailed description of capsule closure. The GRADE framework evaluated study quality, and ROBINS-I evaluated the risk of bias.</p></div><div><h3>Results</h3><p>Across 18 studies (N = 3277) an interportal capsulotomy was reported in 12 studies (1972/3277) cases, and a T-type capsulotomy was reported in six studies (1305/3277) cases). Six studies reported using #2 suture. Nonabsorbable suture was reported in six studies, and absorbable suture in six studies. The rate of failure was 10.5% across five studies (N = 1133) and the rate of revision was 4.4% across 13 studies (N = 2957).</p></div><div><h3>Conclusions</h3><p>Capsule closure is commonly performed with #2 high strength suture—the T-type using two to three sutures in the vertical limb and two to three in the transverse limb, and the interportal type using two to three sutures. Compared to earlier reports, there is a trend for increased utilization of T-type capsulotomy. Although there is a growing body of investigations into the efficacy of routine capsule closure following hip arthroscopy, our results demonstrate infrequent and inconsistent reporting of capsule closure characteristics.</p></div><div><h3>Level of Evidence</h3><p>Level IV, systematic review of Level I-IV studies.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100820"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X23001712/pdfft?md5=0a49ea839ee5ddaf9ff51f3e249201fa&pid=1-s2.0-S2666061X23001712-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Mass Index Between 15 and 30 Does Not Influence Patient-Reported Outcomes After Anterior Cruciate Ligament Surgery Using a 10-mm-Diameter Bone-Tendon-Bone Graft","authors":"Mia Adler Lustig B.S. ,&nbsp;Sean Hazzard P.A., M.B.A. ,&nbsp;Brendan Fitzgerald B.S. ,&nbsp;Nasir Stovall B.S. ,&nbsp;Peter Asnis M.D.","doi":"10.1016/j.asmr.2024.100925","DOIUrl":"10.1016/j.asmr.2024.100925","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the relation between body mass index (BMI) and outcomes after anterior cruciate ligament reconstruction (ACLR) using 10-mm-diameter bone–patellar tendon–bone grafts.</p></div><div><h3>Methods</h3><p>In this retrospective study, the Surgical Outcome System was used to measure patient-reported outcomes before and after ACLR between 2015 and 2019. The inclusion criteria consisted on patients undergoing primary ACLR performed by the senior surgeon, with recorded age of 15 years or older and BMI of 15.0 to 30. The exclusion criteria included revisions, concomitant procedures, age younger than 15 years, and unknown BMI. Patients were divided into cohorts to evaluate the Marx Activity Rating Scale (MARS), Tegner, International Knee Documentation Committee (IKDC), and Lysholm scores at various time points from injury to 2 years postoperatively.</p></div><div><h3>Results</h3><p>A total of 137 patients (100 male and 37 female patients) with an average age of 33 years (95% confidence interval, 30.6-35.4 years) and average BMI of 23.58 (95% confidence interval, 23.1-24.0) were divided into those with a BMI of 15 to 23.4 (group A, n = 69) and those with a BMI of 23.5 to 30 (group B, n = 68). A significant difference in MARS scores was found between the BMI groups before treatment, with mean scores of 11.55 (group A) and 9.41 (group B) (<em>P</em> = .011), and Tegner scores showed significance at 2 years, with scores of 6.45 and 5.41 for groups A and B, respectively (<em>P</em> = .009). Daily function scores were all insignificant. Female patients exhibited no significant differences across any patient-reported outcome measures or time points. Contrarily, male patients showed a significant difference in pretreatment MARS scores (14.30 in group A vs 9.96 in group B, <em>P</em> = .011). Additionally, scores at 2 years depicted Tegner values of 7.40 in group A versus 5.30 in group B (<em>P</em> = .012) and IKDC values of 96.92 in group A versus 90.47 in group B (<em>P</em> = .048). All results for female and male patients aged 30 years or younger indicated no significance.</p></div><div><h3>Conclusions</h3><p>Regardless of patient age or sex, BMI is not significantly associated with patient-reported outcomes after ACLR using 10-mm-diameter bone–patellar tendon–bone grafts.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100925"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000439/pdfft?md5=8c6d8a803bfdb38e0591978d4d62214d&pid=1-s2.0-S2666061X24000439-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}