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Between 2008 and 2022, Lower-Extremity Injuries Declined in Male Rugby Players, Whereas Noncontact Knee Injuries Showed No Decline in Female Rugby Players 2008 年至 2022 年间，男性橄榄球运动员的下肢损伤有所减少，而女性橄榄球运动员的非接触膝部损伤没有减少

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100967

Purpose

To assess the distribution and mechanisms of lower-extremity injuries among high school and college age rugby players presenting to U.S. emergency departments (EDs) from 2008 to 2022.

Methods

The National Electronic Injury Surveillance System was queried for lower-extremity rugby injuries (ages 14-23 years) from January 2008 to December 2022. Patient demographics, injury location, diagnosis, and disposition were extracted for each case. Linear regression analysis assessed differences over time. Injury distribution for male versus female players was evaluated using Pearson χ² analysis.

Results

An estimated 31,318 (845 National Electronic Injury Surveillance System cases) high school and college-age rugby players presented to U.S. EDs with a lower-extremity injury during the study period. Male players accounted for 66.9% of the injuries. Linear regression analysis revealed a significant decrease in the annual frequency of lower-extremity injuries presenting to U.S. EDs from 2008 to 2022 (P = .001). The most common injury mechanism was overwhelmingly a noncontact twisting motion (11,108, 35.5%) followed by a hit/collision (5,298, 16.9%). Strains/sprains were the most common diagnosis (17,243, 55.1%). Injuries most commonly occurred at the ankle (12,659, 40.4%) and knee (11,016, 35.2%). In a sex-specific linear regression analysis, there was a significant decrease in lower-extremity injuries sustained by male players (P = .001) but no significant decrease among female players (P = .112). Furthermore, χ² analysis revealed that female players sustained a significantly greater proportion of knee injuries secondary to twists (15.9% for female vs 9.0% for male players, P = .01).

Conclusions

Lower-extremity injuries are declining among high school and college-age male rugby players. However, there has not been a corresponding decrease among female rugby players. Furthermore, female players are disproportionately affected by noncontact twisting knee injuries.

Level of Evidence

Level III, retrospective comparative study.

目的评估 2008 年至 2022 年期间在美国急诊科（ED）就诊的高中和大学年龄段橄榄球运动员下肢损伤的分布情况和机制。方法对 2008 年 1 月至 2022 年 12 月期间的下肢橄榄球损伤（14-23 岁）查询全国电子损伤监测系统。提取了每个病例的患者人口统计学特征、受伤部位、诊断和处置情况。线性回归分析评估了不同时期的差异。结果在研究期间，约有 31,318 名（845 例全国电子伤害监测系统病例）高中和大学年龄段的橄榄球运动员因下肢受伤而前往美国急诊室就诊。男性球员占受伤人数的 66.9%。线性回归分析表明，从 2008 年到 2022 年，每年到美国急诊室就诊的下肢受伤病例明显减少（P = .001）。最常见的受伤机制绝大多数是非接触性扭转运动（11108 例，35.5%），其次是撞击/碰撞（5298 例，16.9%）。拉伤/扭伤是最常见的诊断结果（17243 例，55.1%）。最常见的受伤部位是踝关节（12659 人，40.4%）和膝关节（11016 人，35.2%）。在针对不同性别的线性回归分析中，男性球员的下肢受伤率显著下降（P = .001），但女性球员的下肢受伤率没有显著下降（P = .112）。此外，χ2 分析表明，女队员因扭转而造成的膝关节损伤比例明显更高（女队员为 15.9%，男队员为 9.0%，P = .01）。结论高中和大学年龄段的男性橄榄球运动员的下肢损伤正在减少，但女性橄榄球运动员的下肢损伤并没有相应减少。此外，女性球员受非接触性扭转膝关节损伤的影响尤为严重。

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引用次数: 0

Medial Patellofemoral Ligament Augmented With a Reinforced Bioinductive Implant Is Biomechanically Similar to the Native Medial Patellofemoral Ligament at Time Zero in a Cadaveric Model 在尸体模型中，使用增强型生物感应植入物增强的髌股内侧韧带 (MPFL) 在零时的生物力学特性与原生 MPFL 相似

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100975

Purpose

To biomechanically compare primary medial patellofemoral ligament (MPFL) repair (MPFLr) augmented with a reinforced bioinductive implant (RBI) to the native MPFL ligament and a semitendinosus (semi-T) MPFL reconstruction (MPFLR) at time zero.

Methods

Four fresh-frozen matched pair cadavers (8 knees) were used to biomechanically compare the native MPFL to augmented MPFLr (n = 4) and semi-T MPFLR (n = 4). The native MPFL (n = 8) was isolated, preserving the femoral and patellar attachments, and pulled to failure. The semi-T was harvested from 1 of the matched pairs and whipstitched, as was a 250-mm × 5-mm RBI. A standard double-bundle docking technique was utilized. The patella was potted and mechanically pulled parallel to the transverse axis until failure in both cohorts. Cyclic creep, load and displacement at failure, failure mode, and stiffness were recorded.

Results

Failure load was highest in the RBI with repair group (287 ± 130 N) compared to the native MPFL (219 ± 64 N) and the semi-T group (84 ± 29 N). No statistically significant difference in failure load between the RBI augmentation with repair group and the native ligament (P = .19) were found. The semi-T reconstruction group failed at the least amount of displacement (7.93 ± 3.4 mm) compared to the native MPFL (20.9 ± 9 mm) (P < .01) and the RBI with repair group (33.2 ± 17.7 mm) (P < .02). At 10 mm of displacement, the RBI group (8.3 ± 1.2 N/mm) demonstrated stiffness in the midrange compared to the native MPFL (14.1 ± 7.1 N/mm). Early anchor/tendon pullout failure on the patella side was noted in the semi-T group compared to the RBI group. One reconstruction was excluded from analysis due to poor bone quality.

Conclusions

No statistically significant difference was seen between the augmented MPFL repair and the native MPFL in load-to-failure testing. The augmented MPFL repair was observed to have biomechanical properties similar to the native MPFL. MPFLr with RBI augmentation provided consistent stiffness at clinically relevant displacement.

Clinical Relevance

Primary MPFL repair and reconstruction using the semi-T graft, while effective, are nevertheless imperfect procedures. MPFL repair has been shown to have higher instability recurrence rates, while the stiffness profile of MPFLR with semi-T is higher than the native MFPL and may lead to knee stiffness, loss of motion, or cartilage damage. The results of this time-zero biomechanical study indicate that the use of an RBI for augmentation of a primary MPFL repair may be a viable alternative to traditional MPFL repair or reconstruction using a semi-T graft.

目的比较使用增强型生物诱导植入物（RBI）增强的初级髌股内侧韧带（MPFL）修复术（MPFLr）与原生MPFL韧带和半腱肌（semi-T）MPFL重建术（MPFLR）在零时的生物力学效果。方法使用四具新鲜冷冻的配对尸体（8个膝盖），比较原生MPFL与增强型MPFLr（n = 4）和半腱肌MPFLR（n = 4）的生物力学效果。对原生 MPFL（n = 8）进行分离，保留股骨和髌骨附着处，并将其拉至失效。从其中一对匹配的患者身上取下半T型，然后鞭状缝合，并缝合一个250毫米×5毫米的RBI。采用标准的双束对接技术。在两个组群中，髌骨都被灌注并平行于横轴进行机械牵拉，直至失效。结果与原生 MPFL（219 ± 64 N）和半 T 组（84 ± 29 N）相比，带修复的 RBI 组的破坏载荷最高（287 ± 130 N）。在统计学上，RBI 增强修复组与原生韧带组的失败载荷没有明显差异（P = 0.19）。与原生 MPFL（20.9 ± 9 mm）（P <.01）和带修复的 RBI 组（33.2 ± 17.7 mm）（P <.02）相比，半 T 重建组在最小位移量（7.93 ± 3.4 mm）时失效。与原生 MPFL（14.1 ± 7.1 N/mm）相比，在 10 mm 位移时，RBI 组（8.3 ± 1.2 N/mm）显示出中等硬度。与 RBI 组相比，半 T 组的髌骨侧出现了早期锚/肌腱拉出失败。结论增强型 MPFL 修复与原生 MPFL 在负载-失效测试中没有明显的统计学差异。据观察，增强型 MPFL 修复的生物力学特性与原生 MPFL 相似。使用 RBI 增强的 MPFLr 在临床相关位移时具有一致的硬度。已证明 MPFL 修复术的不稳定性复发率较高，而使用半 T 的 MPFLR 的硬度曲线高于原生 MFPL，可能会导致膝关节僵硬、运动功能丧失或软骨损伤。这项零时生物力学研究结果表明，使用 RBI 增强初级 MPFL 修复可能是使用半 T 移植物进行传统 MPFL 修复或重建的可行替代方案。

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引用次数: 0

Graft Type and Diameter Are Predictors of Reinjury After Transphyseal Anterior Cruciate Ligament Reconstruction in Pediatric and Adolescent Patients 预测儿科和青少年患者经骺前十字韧带重建术后再次损伤的移植物类型和直径

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100964

Purpose

To report the rate of anterior cruciate ligament (ACL) graft failure by physis status (open, closing, closed) and to analyze which factors were associated with higher risk of ACL graft failure.

Methods

Patients younger than 18 years who underwent transphyseal ACL reconstruction (ACLR) between 2000 and 2018 at a single institution were reviewed at minimum 2 years after ACLR. Patient records were reviewed for anthropometrics, surgical techniques, and ACL graft failure. Patients were subsequently stratified based on physis status (open, closing, closed) and analyzed.

Results

A total of 272 patients (mean age of 15.4 ± 1.3 years) were assessed. The transtibial technique was used in 63.6% of cases. A hamstring autograft was used exclusively in the open physis group. A patellar tendon autograft was used in 65.9% of patients with a closing physis and 80.9% of patients with a closed physis. The overall graft failure rate was 13.2%, with a contralateral ACL injury rate of 11.0%. Kaplan-Maier analysis by physis status showed different injury free from ACL reinjury (P < .001). An open physis was associated with increased risk of ACL reinjury (hazard ratio, 5.2; P < .001) when compared to a closed physis. A closing physis presented a higher hazard ratio but was not statistically significant (hazard ratio, 2.6; P = .08). Hamstring graft type (P = .03) and lower graft diameter (P = .04) were significantly related to higher ACL reinjury after adjusting for physis status.

Conclusions

Transphyseal ACLR is a safe procedure in pediatric patients. The rate of reinjury was 13.2%. This rate decreases with skeletal maturity, use of patellar tendon autograft, and a larger graft diameter.

Level of Evidence

Level III, retrospective cohort study.

目的报告按韧带状态（开放、闭合、封闭）分类的前交叉韧带（ACL）移植物失败率，并分析哪些因素与前交叉韧带移植物失败的高风险相关。方法对 2000 年至 2018 年期间在一家机构接受经骨前交叉韧带重建术（ACLR）的 18 岁以下患者在 ACLR 术后至少 2 年进行复查。回顾了患者的人体测量学、手术技术和前交叉韧带移植失败的记录。随后根据假体状态（开放、闭合、封闭）对患者进行分层并进行分析。63.6%的病例采用了经胫骨技术。开放髋关节组仅使用了腘绳肌自体移植。65.9%的闭合髋关节患者和80.9%的闭合髋关节患者使用了髌腱自体移植物。总体移植失败率为13.2%，对侧前交叉韧带损伤率为11.0%。按韧带状态进行的 Kaplan-Maier 分析显示，前交叉韧带再损伤的免伤率存在差异（P < .001）。与闭合髋臼相比，开放髋臼增加了前交叉韧带再损伤的风险（危险比，5.2；P <.001）。闭合式髋关节的危险比更高，但无统计学意义（危险比为 2.6；P = .08）。腘绳肌移植物类型（P = .03）和较低的移植物直径（P = .04）与较高的前交叉韧带再损伤率有显著相关性（调整髋臼状态后）。再损伤率为13.2%。随着骨骼的成熟、髌腱自体移植物的使用以及移植物直径的增大，再损伤率会降低。

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引用次数: 0

Most Systematic Reviews and Meta-analyses Reporting Clinical Outcomes of the Remplissage Procedure Have at Least 1 Form of Spin 大多数报告再植手术临床结果的系统综述和荟萃分析至少有一种旋转形式

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100969

Purpose

To determine the prevalence of spin in systematic reviews (SRs) and meta-analyses of clinical studies of the remplissage procedure.

Methods

Two reviewers independently performed a literature search of the PubMed, Scopus, and Embase databases using the search term “remplissage” in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The full article of each included SR was assessed for the presence of the 15 most common types of spin. Methodologic quality was assessed using the second version of A Measurement Tool to Assess Systematic Reviews (AMSTAR 2).

Results

A total of 15 SRs (8 accompanied by meta-analyses; 6 Level III and 9 Level IV) were included. Overall, 13 SRs (86.7%) contained at least 1 form of spin, with 33 unique instances of spin recorded; the mean frequency was 2.2 ± 1.3 (range, 0-4). The most prevalent form of spin, present in 11 studies (73%), was type 9 (“conclusion claims the beneficial effect of the experimental treatment despite reporting bias”). There were 14 uses of spin classified as misleading reporting, 16 classified as misleading interpretation, and 3 classified as inappropriate extrapolation. The mean 5-year impact factor of the publishing journals was 4.4 ± 0.9 (range, 0-6.1), the mean number of citations per SR was 33.3 ± 24.9 (range, 0-55), and the mean number of citations per month since publication was 0.68 ± 0.44 (range, 0-1.48). According to the AMSTAR 2 assessment, confidence in the results of the SRs was rated as critically low for 20% of reviews, low for 33.3%, and moderate for 46.7%.

Conclusions

Most SRs of the remplissage procedure are affected by the presence of spin. Favorable reporting was observed in the absence of definite findings, as was minimization of drawbacks for certain populations.

Level of Evidence

Level IV, systematic review of Level III and IV studies.

目的确定再植手术临床研究的系统综述（SR）和荟萃分析中自旋的发生率。方法两位审稿人根据系统综述和荟萃分析首选报告项目（PRISMA）指南，使用检索词 "再植 "对 PubMed、Scopus 和 Embase 数据库进行了独立的文献检索。对每篇纳入的 SR 全文进行了评估，以确定是否存在 15 种最常见的旋转类型。结果共纳入了 15 篇系统综述（8 篇附有荟萃分析；6 篇三级，9 篇四级）。总体而言，13 篇 SR（86.7%）包含至少一种形式的自旋，记录了 33 个独特的自旋实例；平均频率为 2.2 ± 1.3（范围为 0-4）。最常见的自旋形式是第 9 种（"尽管存在报告偏差，但结论声称实验治疗具有有益效果"），共有 11 项研究（占 73%）采用了这种形式。有 14 项自旋被归类为误导性报告，16 项被归类为误导性解释，3 项被归类为不恰当的外推。发表期刊5年的平均影响因子为4.4±0.9（范围0-6.1），每篇SR的平均引用次数为33.3±24.9（范围0-55），发表后每月的平均引用次数为0.68±0.44（范围0-1.48）。根据 AMSTAR 2 评估，20% 的综述对再植手术结果的置信度为极低，33.3% 为低，46.7% 为中等。证据级别IV级，III级和IV级研究的系统综述。

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引用次数: 0

Concomitant Popliteomeniscal Fascicles Tears Are Found in 21% of Professional Soccer Players With Acute Anterior Cruciate Ligament Injuries 在 21% 急性前十字韧带损伤的职业足球运动员中发现了同时存在的腘绳肌撕裂

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100956

Purpose

To investigate the incidence of popliteomeniscal fascicles (PMF) tears in anterior cruciate ligament (ACL) rupture in professional soccer players, to describe arthroscopic and magnetic resonance imaging (MRI) findings and treatment of these lesions with clinical outcomes, and to evaluate the incidence of subsequent lateral meniscus tears and ACL reinjury.

Methods

ACL reconstructions on soccer players were retrospectively analyzed, and among them, a cohort of patients with PMFs tears was reviewed. The cohort was assessed with MRI examination, arthrometric testing, Lysholm score, and International Knee Documentation Committee score. The occurrence of subsequent lateral meniscus tears and ACL reinjury were evaluated.

Results

A total of 208 ACL reconstructions were identified. From these, 43 male and 3 female subjects with a mean age of 24 ± 4.2 years were included. Median time from injury to surgery was 5 days. Preoperative MRI showed a tear of posterior PMFs in 24 of 47 knees (51.1%). The mean preoperative arthrometric measured laxity was 4.3 ± 1.65 mm, and postoperatively 0.1 ± 1.1 mm. Preoperative Lysholm score and International Knee Documentation Committee score were, respectively, 50.4 ± 25.4 and 39.6 ± 5, and postoperatively 98 ± 2.4 and 73.6 ± 1.2. Mean time to return to play, at the same preoperative level for all patients, was 184 ± 41.7 days. One patient underwent ACL revision due to a reinjury 9 months after surgery, whereas no lateral meniscus tears occurred in the follow-up period.

Conclusions

PMF tears are found in approximately 20% of professional soccer players with acute ACL injuries. After ACL reconstruction and PMFs repair, outcomes including return to play are good, ACL retear is low, and recurrent lateral meniscus tears were not observed.

Level of Evidence

Level IV, therapeutic case series.

目的研究职业足球运动员前十字韧带（ACL）断裂时腘绳肌筋膜（PMF）撕裂的发生率，描述这些病变的关节镜和磁共振成像（MRI）检查结果和治疗方法以及临床疗效，并评估后续外侧半月板撕裂和 ACL 再损伤的发生率。通过核磁共振成像检查、关节测量、Lysholm评分和国际膝关节文献委员会评分对该组患者进行了评估。对随后发生的外侧半月板撕裂和前交叉韧带再损伤进行了评估。其中，男性 43 例，女性 3 例，平均年龄为 24 ± 4.2 岁。从受伤到手术的中位时间为 5 天。术前磁共振成像显示，47个膝关节中有24个（51.1%）后PMF撕裂。术前关节测量的平均松弛度为（4.3 ± 1.65）毫米，术后为（0.1 ± 1.1）毫米。术前Lysholm评分和国际膝关节文献委员会评分分别为（50.4 ± 25.4）和（39.6 ± 5），术后分别为（98 ± 2.4）和（73.6 ± 1.2）。所有患者恢复到术前水平的平均时间为 184 ± 41.7 天。一名患者在术后9个月因再次受伤而接受了前十字韧带翻修手术，而在随访期间没有发生外侧半月板撕裂。前交叉韧带重建和PMFs修复后，包括重返赛场在内的效果良好，前交叉韧带再撕裂率低，未发现复发性外侧半月板撕裂。

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引用次数: 0

The Top-20 Studies About Anterior Shoulder Instability From an Altmetric Analysis Had Higher Levels of Evidence Than Those From a Traditional Bibliometric Analysis Altmetric 分析得出的关于肩关节前方失稳的前 20 篇研究的证据等级高于传统文献计量分析得出的研究的证据等级

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100974

Purpose

To compare the characteristics of the top-20 studies about anterior shoulder instability according to the Altmetric Attention Score (AAS) with total citation counts.

Methods

Two separate searches were performed for articles related to anterior shoulder instability. The Altmetric search identified the top-20 articles according to AAS. A bibliometric search using Web of Science identified the top-20 most-cited articles. Altmetric criteria were applied to the bibliometric list and vice versa.

Results

The AAS from the Altmetric list ranged from 44 to 432. The highest AAS from the bibliometric search was 70. One study appeared in both lists. Most online mentions were from X (formerly Twitter). The geographical breakdown of X mentions saw 71 countries appearing in the Altmetric search versus 21 in the bibliometric search. The total citations in the bibliometric list ranged from 91 to 358 versus 0 to 121 for the Altmetric list. The Altmetric top-20 list contained 8 studies that were Level II or higher versus 3 in the bibliometric list.

Conclusions

The top-20 studies according to AAS or citation count are not the same. The top-20 studies by AAS are composed of studies at higher levels of evidence versus the top-20 studies when listed by citation count.

Clinical Relevance

Electronic searches are an important way to access information in the modern world. Different search options generate results according to different parameters and may generate different results for the same query. It is important to understand these differences so that users have a better understanding of where the most clinically useful information can be found, especially regarding medical conditions.

目的比较根据Altmetric关注度评分（AAS）排在前20位的肩关节前侧不稳定性研究的特点和总引用次数。方法对与肩关节前侧不稳定性相关的文章分别进行了两次检索。Altmetric 搜索根据 AAS 确定了排名前 20 的文章。使用Web of Science进行的文献计量学搜索确定了被引用次数最多的前20篇文章。结果Altmetric列表中的AAS从44到432不等。文献计量学搜索的最高 AAS 为 70。有一项研究同时出现在两个列表中。大多数在线提及来自 X（原 Twitter）。从 X 提及的地域分布来看，Altmetric 搜索中出现了 71 个国家，而文献计量学搜索中出现了 21 个国家。文献计量学列表中的总引用次数从 91 到 358 不等，而 Altmetric 列表中的总引用次数从 0 到 121 不等。Altmetric排名前20的研究中有8项为二级或二级以上，而文献计量学排名中只有3项。按AAS排序的前20名研究与按引用次数排序的前20名研究相比，前者的证据级别更高。不同的搜索选项会根据不同的参数生成不同的结果，而且同一查询可能会生成不同的结果。了解这些差异非常重要，这样用户就能更好地了解在哪里可以找到对临床最有用的信息，尤其是有关医疗条件的信息。

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引用次数: 0

Defensive Performance Declines in Ultimate Fighting Championship Fighters Following Anterior Cruciate Ligament Reconstruction 终极格斗冠军赛选手前十字韧带重建术后的防守表现下降

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100961

Purpose

To evaluate the impact anterior cruciate ligament reconstruction (ACLR) has on strike evasion rates, strike and landing rates, win percentage, and career longevity in Ultimate Fighting Championship (UFC) fighters.

Methods

UFC fighters who underwent ACLR from 1993 to 2022 were matched 2:1 with uninjured controls. The percentage of each injured fighter’s career that occurred before ACLR was deemed the “index percentage.” Injured fighter performance pre-/post-ACLR was compared with control metrics pre-/postindex percentage.

Results

Of the 82 patients with documented ACL injuries identified, 48 met the inclusion criteria. Of these, 27 returned for more than 2 fights and were paired with 54 controls. UFC fighters demonstrated return-to-sport rates of 81.25% and 56.25% for at least 1 and 2 fights, respectively. On average, it took 411.85 ± 174.73 (range, 165-879) days for fighters to return. All fighters had significantly lower evasion rates against total significant strikes, distance strikes, and head strikes, postindex (P < .05 for each). ACLR fighters had significantly lower submission attempts and evasion rates against clinch strikes, ground strikes, and total strikes, postindex (P < .05 for each). Controls had a significantly lower evasion rate against leg strikes, postindex. Both groups’ win percentages significantly declined (ACLR, P = .001; control, P = .012). No significant difference in total career fights was observed (P = .873).

Conclusions

In this study, we found that most UFC fighters who undergo ACLR return to sport for at least 1 fight; however, just over half return for at least 2 fights. There was not a significant difference in career length between fighters who returned to sport following ACLR for at least 2 fights and their controls. Defensive performance, but not offensive performance, declined significantly following ACLR. All fighters demonstrated significant declines in their win percentage as their career progressed, irrespective of ACLR.

Level of Evidence

Level III, retrospective comparative study.

目的评估前交叉韧带重建术（ACLR）对终极格斗锦标赛（UFC）格斗选手的攻击规避率、攻击和着地率、胜率以及职业寿命的影响。方法将 1993 年至 2022 年期间接受前交叉韧带重建术的 UFC 格斗选手与未受伤的对照组进行 2:1 配对。每名受伤拳手在 ACLR 之前的职业生涯百分比被视为 "指数百分比"。受伤拳手在 ACLR 之前/之后的表现与对照组在指数百分比之前/之后的指标进行了比较。其中 27 人重返赛场参加了两场以上的比赛，并与 54 名对照组选手配对。UFC 选手至少参加 1 场比赛和 2 场比赛的重返赛场率分别为 81.25% 和 56.25%。选手平均需要 411.85 ± 174.73 天（165-879 天不等）才能重返赛场。在指数后，所有拳手对总重大打击、远距离打击和头部打击的规避率都明显降低（P < .05）。ACLR 格斗者的降服尝试率以及对擒拿格斗、地面格斗和总格斗的规避率在指数发布后明显降低（P 均为 0.05）。对照组对腿部打击的规避率在指数后明显降低。两组的胜率都明显下降（ACLR，P = .001；对照组，P = .012）。结论在这项研究中，我们发现大多数接受前交叉韧带重建的 UFC 格斗运动员至少会重返赛场参加一场比赛；然而，仅有一半以上的运动员至少会重返赛场参加两场比赛。在接受前交叉韧带修复术后重返赛场至少参加 2 场比赛的拳手与对照组拳手在职业生涯长度上没有明显差异。前交叉韧带撕裂后，防守能力显著下降，但进攻能力并未下降。随着职业生涯的发展，所有拳手的胜率都有明显下降，与前交叉韧带损伤无关。

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引用次数: 0

ChatGPT and Google Provide Mostly Excellent or Satisfactory Responses to the Most Frequently Asked Patient Questions Related to Rotator Cuff Repair ChatGPT 和 Google 对患者最常问到的有关肩袖修复的问题提供了大部分优秀或满意的答复

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-10-01 DOI: 10.1016/j.asmr.2024.100963

Purpose

To assess the differences in frequently asked questions (FAQs) and responses related to rotator cuff surgery between Google and ChatGPT.

Methods

Both Google and ChatGPT (version 3.5) were queried for the top 10 FAQs using the search term “rotator cuff repair.” Questions were categorized according to Rothwell’s classification. In addition to questions and answers for each website, the source that the answer was pulled from was noted and assigned a category (academic, medical practice, etc). Responses were also graded as “excellent response not requiring clarification” (1), “satisfactory requiring minimal clarification” (2), “satisfactory requiring moderate clarification” (3), or “unsatisfactory requiring substantial clarification” (4).

Results

Overall, 30% of questions were similar between what Google and ChatGPT deemed to be the most FAQs. For questions from Google web search, most answers came from medical practices (40%). For ChatGPT, most answers were provided by academic sources (90%). For numerical questions, ChatGPT and Google provided similar responses for 30% of questions. For most of the questions, both Google and ChatGPT responses were either “excellent” or “satisfactory requiring minimal clarification.” Google had 1 response rated as satisfactory requiring moderate clarification, whereas ChatGPT had 2 responses rated as unsatisfactory.

Conclusions

Both Google and ChatGPT offer mostly excellent or satisfactory responses to the most FAQs regarding rotator cuff repair. However, ChatGPT may provide inaccurate or even fabricated answers and associated citations.

Clinical Relevance

In general, the quality of online medical content is low. As artificial intelligence develops and becomes more widely used, it is important to assess the quality of the information patients are receiving from this technology.

目的评估谷歌和 ChatGPT 之间有关肩袖手术的常见问题（FAQs）和回复的差异。方法使用搜索词 "肩袖修复 "查询谷歌和 ChatGPT（3.5 版）的前 10 个常见问题。问题按照罗斯威尔分类法进行分类。除了每个网站的问题和答案外，还注明了答案的来源并进行了分类（学术、医疗实践等）。回答也被分为 "不需要澄清的优秀回答"（1）、"需要少量澄清的满意回答"（2）、"需要适度澄清的满意回答"（3）或 "需要大量澄清的不满意回答"（4）。在谷歌网络搜索的问题中，大多数答案来自医疗机构（40%）。而在 ChatGPT 中，大多数答案来自学术界（90%）。对于数字问题，ChatGPT 和谷歌对 30% 的问题提供了相似的回答。对于大多数问题，Google 和 ChatGPT 的回答要么是 "优秀"，要么是 "满意，只需少量说明"。结论对于有关肩袖修复的大多数常见问题，Google 和 ChatGPT 都提供了大部分优秀或满意的回答。临床相关性一般来说，在线医疗内容的质量较低。随着人工智能的发展和广泛应用，评估患者从这项技术中获得的信息质量非常重要。

{"title":"ChatGPT and Google Provide Mostly Excellent or Satisfactory Responses to the Most Frequently Asked Patient Questions Related to Rotator Cuff Repair","authors":"","doi":"10.1016/j.asmr.2024.100963","DOIUrl":"10.1016/j.asmr.2024.100963","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the differences in frequently asked questions (FAQs) and responses related to rotator cuff surgery between Google and ChatGPT.</div></div><div><h3>Methods</h3><div>Both Google and ChatGPT (version 3.5) were queried for the top 10 FAQs using the search term “rotator cuff repair.” Questions were categorized according to Rothwell’s classification. In addition to questions and answers for each website, the source that the answer was pulled from was noted and assigned a category (academic, medical practice, etc). Responses were also graded as “excellent response not requiring clarification” (1), “satisfactory requiring minimal clarification” (2), “satisfactory requiring moderate clarification” (3), or “unsatisfactory requiring substantial clarification” (4).</div></div><div><h3>Results</h3><div>Overall, 30% of questions were similar between what Google and ChatGPT deemed to be the most FAQs. For questions from Google web search, most answers came from medical practices (40%). For ChatGPT, most answers were provided by academic sources (90%). For numerical questions, ChatGPT and Google provided similar responses for 30% of questions. For most of the questions, both Google and ChatGPT responses were either “excellent” or “satisfactory requiring minimal clarification.” Google had 1 response rated as satisfactory requiring moderate clarification, whereas ChatGPT had 2 responses rated as unsatisfactory.</div></div><div><h3>Conclusions</h3><div>Both Google and ChatGPT offer mostly excellent or satisfactory responses to the most FAQs regarding rotator cuff repair. However, ChatGPT may provide inaccurate or even fabricated answers and associated citations.</div></div><div><h3>Clinical Relevance</h3><div>In general, the quality of online medical content is low. As artificial intelligence develops and becomes more widely used, it is important to assess the quality of the information patients are receiving from this technology.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529086","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}

引用次数: 0

Tibial Tubercle Osteotomies Performed in an Outpatient Setting Have a Low Rate of Early Complications 在门诊环境下进行的胫骨结节截骨术早期并发症发生率较低

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-08-01 DOI: 10.1016/j.asmr.2024.100948

Purpose

To characterize the early postoperative complications following outpatient tibial tubercle osteotomy (TTO) to determine its safety in this setting.

Methods

Patients undergoing TTO by a single surgeon between July 2017 and August 2022 for patellar instability or patellofemoral chondromalacia and achieving a minimum of 3 months of clinical and radiographic follow-up were evaluated for inclusion. Although an inclusion criterion was a minimum follow-up of 3 months, if evidence of a healed osteotomy was observed sooner, final follow-up was accepted at 2 months. Patient demographics, perioperative risk factors, and incidence of complications were collected retrospectively. Categorical data were analyzed using χ² and Fisher exact tests. Continuous data were analyzed using 2-tailed t tests and Mann-Whitney U data for parametric and nonparametric data, respectively.

Results

A total of 195 knees in 167 patients met inclusion criteria, with a mean age of 24.7 ± 9.2 years and mean follow-up time of 10.9 months (range, 2-69 months). Fifty-one early postoperative complications occurred in 47 (24.1%) knees in 42 (25.1%) patients. Ten major and 41 minor complications occurred. Major complications were associated with older age (P = .015), smoking (P = .038), and smaller preoperative patellar tendon–lateral trochlear ridge distance (P = .012). Forty-four reoperations occurred in 42 (21.5%) knees in 37 (22.2%) patients. The most common reasons for reoperation included removal of symptomatic hardware (31 knees; 15.9%) and arthrofibrosis requiring lysis of adhesions and manipulation under anesthesia (8 knees; 4.1%). The mean time to reoperation was 13.0 months (range, 1-42 months). Smaller body mass index was associated with increased risk of reoperation (P = .002).

Conclusions

Outpatient TTO is safe when performed with the described technique, but the later development of minor complications is not infrequent following surgery. Patients should be counseled regarding a relatively high incidence of hardware irritation, arthrofibrosis, and eventual reoperation.

Level of Evidence

Level IV, case series.

目的探讨门诊胫骨结节截骨术（TTO）术后早期并发症的特点，以确定其在这种情况下的安全性。方法对2017年7月至2022年8月期间因髌骨不稳或髌骨软骨软化症而接受由单个外科医生实施的TTO手术，并进行至少3个月的临床和影像学随访的患者进行评估纳入。虽然纳入标准是至少随访 3 个月，但如果截骨愈合的证据在更早的时间内被观察到，则最终随访时间为 2 个月。对患者的人口统计学特征、围手术期风险因素和并发症发生率进行了回顾性收集。分类数据采用χ2和费舍尔精确检验进行分析。结果共有167名患者的195个膝关节符合纳入标准，平均年龄为（24.7±9.2）岁，平均随访时间为10.9个月（2-69个月）。42名（25.1%）患者的47个（24.1%）膝关节发生了51例早期术后并发症。其中10例为主要并发症，41例为轻微并发症。主要并发症与年龄较大（P = .015）、吸烟（P = .038）和术前髌腱与侧髁间距较小（P = .012）有关。42例（21.5%）膝关节再手术发生在37例（22.2%）患者身上。最常见的再手术原因包括切除有症状的硬件（31 个膝关节；15.9%）和需要在麻醉下溶解粘连并进行操作的关节纤维化（8 个膝关节；4.1%）。再次手术的平均时间为13.0个月（1-42个月）。较小的体重指数与再次手术的风险增加有关（P = .002）。结论门诊 TTO 采用所述技术是安全的，但术后出现轻微并发症的情况并不少见。应告知患者硬件刺激、关节纤维化和最终再次手术的发生率相对较高。

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引用次数: 0

The Use of Platelet-Rich Plasma Augmentation in Meniscus Repair Results in a Lower Failure Rate than in the Control Group: A Systematic Review From Meta-analysis 富血小板血浆扩增术在半月板修复中的疗效：荟萃分析的系统性综述

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2024-08-01 DOI: 10.1016/j.asmr.2024.100934

Purpose

To investigate the efficacy of platelet-rich plasma (PRP) as an augmentation in meniscus repair.

Methods

A comprehensive search of PubMed, Medline (via EBSCO), ProQuest, and ScienceDirect from January to February 2023 was conducted using the terms “meniscus repair,” “PRP,” and “meniscus tear.” Meta-analyses that investigated the rate of failure after meniscus repair were included. Studies before 2003, not in English, associated procedures during surgery, and animal studies were excluded. The included studies underwent quality appraisal and risk of bias assessment. Data were extracted from each study‘s text, figures, tables, and associated supplementary files and then analyzed qualitatively.

Results

The failure rate is lower in the PRP augmentation group compared with the group without augmentation, with a mean difference of 0.42, 0.50, and 0.43. Visual analog scale score was also found to be significantly lower in the treatment group, with a mean difference of 0.40, 0.76, and 6.69. However, only mean differences in Lysholm score in one of the included studies were found significant regarding functional outcomes, which can be found in the Xie et al. study with a mean difference of 3.06.

Conclusions

In this study, we found that meniscal repairs augmented with PRP have a lower failure rate.

Level of Evidence

Level IV, systematic review of Level III-IV studies.

目的研究富血小板血浆（PRP）作为半月板修复术的增强剂的疗效。方法使用 "半月板修复术"、"PRP "和 "半月板撕裂 "等术语对 2023 年 1 月至 2 月期间的 PubMed、Medline（通过 EBSCO）、ProQuest 和 ScienceDirect 进行了全面检索。研究半月板修复术后失败率的 Meta 分析也包括在内。2003年之前的研究、非英语研究、手术过程中的相关程序以及动物研究均被排除在外。对纳入的研究进行了质量评估和偏倚风险评估。从每项研究的正文、图、表和相关补充文件中提取数据，然后进行定性分析。结果PRP增强组的失败率低于未增强组，平均差异为0.42、0.50和0.43。治疗组的视觉模拟评分也明显降低，平均差异为 0.40、0.76 和 6.69。结论在本研究中，我们发现使用 PRP 增强半月板修复术的失败率较低。

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引用次数: 0