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Spin is Prevalent in Abstracts of Systematic Reviews and Meta-analyses of Anterolateral Ligament Reconstruction and Lateral Extra-Articular Tenodesis
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101031
Pranit Kumaran B.S. , Jacob L. Kotlier B.A. , Amir Fathi B.S. , Eric H. Lin B.A. , Frank A. Petrigliano M.D. , Joseph N. Liu M.D.

Purpose

To analyze the incidence of spin in the abstracts of systematic reviews and meta-analyses investigating anterolateral ligament augmentation or lateral extra-articular tenodesis as treatment for anterior cruciate ligament injuries.

Method

Studies were identified using the Preferred Reporting Items for Systematic Reviews and Meta Analysis guidelines searching PubMed, Web of Science, and Scopus in November 2023. The abstracts were graded for the incidence of the 15 most common types of spin, and full texts were reviewed for AMSTAR 2 classification. General demographics were identified, including study title, author, journal of publication, year of publication, level of evidence, study design, and funding. Fisher’s exact test was used to compare study metrics.

Results

Twenty-two studies met final inclusion criteria. Thirteen studies were related to LET, and 12 were related to ALL with three relevant to both. At least 4 forms of spin were observed in the studies with a maximum of 11 observed. Spin type 9 (“Conclusion claims the beneficial effect of the experimental treatment despite reporting bias.”) was the overall most reported across all studies with 21 out of 22 studies reporting it. There was a significant correlation between the incidence of spin type 10 (“Authors hide or do not present any conflict of interest.”) with lower Level of Evidence (P = .002). There is also a significant association with spin type 3 (“Selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention.”) with the “very low” category of AMSTAR 2 confidence (p = 0.034).

Conclusions

Spin is highly prevalent in abstracts of systematic reviews and meta-analyses investigating anterolateral ligament augmentation and lateral extra-articular tenodesis reconstruction.

Level of Evidence

Level IV, systematic review of Level III-IV studies.
{"title":"Spin is Prevalent in Abstracts of Systematic Reviews and Meta-analyses of Anterolateral Ligament Reconstruction and Lateral Extra-Articular Tenodesis","authors":"Pranit Kumaran B.S. ,&nbsp;Jacob L. Kotlier B.A. ,&nbsp;Amir Fathi B.S. ,&nbsp;Eric H. Lin B.A. ,&nbsp;Frank A. Petrigliano M.D. ,&nbsp;Joseph N. Liu M.D.","doi":"10.1016/j.asmr.2024.101031","DOIUrl":"10.1016/j.asmr.2024.101031","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the incidence of spin in the abstracts of systematic reviews and meta-analyses investigating anterolateral ligament augmentation or lateral extra-articular tenodesis as treatment for anterior cruciate ligament injuries.</div></div><div><h3>Method</h3><div>Studies were identified using the Preferred Reporting Items for Systematic Reviews and Meta Analysis guidelines searching PubMed, Web of Science, and Scopus in November 2023. The abstracts were graded for the incidence of the 15 most common types of spin, and full texts were reviewed for AMSTAR 2 classification. General demographics were identified, including study title, author, journal of publication, year of publication, level of evidence, study design, and funding. Fisher’s exact test was used to compare study metrics.</div></div><div><h3>Results</h3><div>Twenty-two studies met final inclusion criteria. Thirteen studies were related to LET, and 12 were related to ALL with three relevant to both. At least 4 forms of spin were observed in the studies with a maximum of 11 observed. Spin type 9 (“Conclusion claims the beneficial effect of the experimental treatment despite reporting bias.”) was the overall most reported across all studies with 21 out of 22 studies reporting it. There was a significant correlation between the incidence of spin type 10 (“Authors hide or do not present any conflict of interest.”) with lower Level of Evidence (<em>P</em> = .002). There is also a significant association with spin type 3 (“Selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention.”) with the “very low” category of AMSTAR 2 confidence (<em>p</em> = 0.034).</div></div><div><h3>Conclusions</h3><div>Spin is highly prevalent in abstracts of systematic reviews and meta-analyses investigating anterolateral ligament augmentation and lateral extra-articular tenodesis reconstruction.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III-IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101031"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386635","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
Superficial Medial Collateral Ligament Transection Sufficiently Increases Joint Space Width for Medial Meniscal Procedures During Medial Open-Wedge High Tibial Osteotomy
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101008
Eiji Sasaki M.D., Ph.D., Takahiro Tsushima M.D., Ph.D., Yuka Kimura M.D., Ph.D., Yukiko Sakamoto M.D., Ph.D., Shizuka Sasaki M.D., Ph.D., Daisuke Chiba M.D., Ph.D., Yasuyuki Ishibashi M.D., Ph.D.

Purpose

To investigate the changes in minimum joint space width (mJSW) caused by superficial medial collateral ligament (sMCL) transection during open-wedge high tibial osteotomy (OWHTO).

Methods

This study included consecutive patients with a diagnosis of medial unicompartmental knee osteoarthritis who were scheduled for OWHTO between September 2020 and August 2022. Intraoperative fluoroscopic evaluations of mJSW were performed under neutral, valgus stress, and varus stress positions in knee extension and 20° of flexion before sMCL transection, after transection, and after plate fixation. Changes in mJSW and increases in valgus stress were calculated and compared using analysis of variance. Linear regression analysis was performed to investigate the related factors for increased mJSW after transection.

Results

We included 44 knees in 43 patients in the final statistical analysis. The maximum mJSW occurred during valgus stress after sMCL transection at 20° of flexion and returned to baseline after plate fixation. Under the valgus stress condition, mean mJSW before transection was 5.1 ± 0.9 mm in extension and 5.5 ± 1.1 mm at 20° of flexion. It increased significantly after transection to 7.8 ± 1.4 mm (P < .001) and 9.2 ± 2.1 mm (P < .001), respectively. Regression analysis showed that increased mJSW after transection in extension positively correlated with the knee extension angle (P = .032). Overall, mJSW increased with sMCL transection regardless of the preoperative condition.

Conclusions

Transection of the sMCL in OWHTO effectively enlarged the mJSW to 9.2 mm, which was 3.8 mm greater than that before transection, facilitating medial meniscal procedures. After plate fixation, the mJSW returned to pre-transection levels.

Level of Evidence

Level Ⅳ, therapeutic case series.
{"title":"Superficial Medial Collateral Ligament Transection Sufficiently Increases Joint Space Width for Medial Meniscal Procedures During Medial Open-Wedge High Tibial Osteotomy","authors":"Eiji Sasaki M.D., Ph.D.,&nbsp;Takahiro Tsushima M.D., Ph.D.,&nbsp;Yuka Kimura M.D., Ph.D.,&nbsp;Yukiko Sakamoto M.D., Ph.D.,&nbsp;Shizuka Sasaki M.D., Ph.D.,&nbsp;Daisuke Chiba M.D., Ph.D.,&nbsp;Yasuyuki Ishibashi M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101008","DOIUrl":"10.1016/j.asmr.2024.101008","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the changes in minimum joint space width (mJSW) caused by superficial medial collateral ligament (sMCL) transection during open-wedge high tibial osteotomy (OWHTO).</div></div><div><h3>Methods</h3><div>This study included consecutive patients with a diagnosis of medial unicompartmental knee osteoarthritis who were scheduled for OWHTO between September 2020 and August 2022. Intraoperative fluoroscopic evaluations of mJSW were performed under neutral, valgus stress, and varus stress positions in knee extension and 20° of flexion before sMCL transection, after transection, and after plate fixation. Changes in mJSW and increases in valgus stress were calculated and compared using analysis of variance. Linear regression analysis was performed to investigate the related factors for increased mJSW after transection.</div></div><div><h3>Results</h3><div>We included 44 knees in 43 patients in the final statistical analysis. The maximum mJSW occurred during valgus stress after sMCL transection at 20° of flexion and returned to baseline after plate fixation. Under the valgus stress condition, mean mJSW before transection was 5.1 ± 0.9 mm in extension and 5.5 ± 1.1 mm at 20° of flexion. It increased significantly after transection to 7.8 ± 1.4 mm (<em>P</em> &lt; .001) and 9.2 ± 2.1 mm (<em>P</em> &lt; .001), respectively. Regression analysis showed that increased mJSW after transection in extension positively correlated with the knee extension angle (<em>P</em> = .032). Overall, mJSW increased with sMCL transection regardless of the preoperative condition.</div></div><div><h3>Conclusions</h3><div>Transection of the sMCL in OWHTO effectively enlarged the mJSW to 9.2 mm, which was 3.8 mm greater than that before transection, facilitating medial meniscal procedures. After plate fixation, the mJSW returned to pre-transection levels.</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 1","pages":"Article 101008"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386712","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
The Measurement of the Lateral Center-Edge Angle Is Underestimated on Radiographs Compared With 3-Dimensional Computed Tomography
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101005
Julio Nerys-Figueroa B.S. , Ady H. Kahana-Rojkind M.D. , Ali Parsa M.D. , David Maldonado M.D. , Roger Quesada-Jimenez M.D. , Benjamin G. Domb M.D.

Purpose

To determine if there is a significant difference using femoral heads (FHs) as an anatomic horizon when measuring the lateral center-edge angle (LCEA) compared to floor, acetabular teardrops, and ischial tuberosities (ITs) and to determine their accuracy by comparing to a computed tomography (CT) scan with commercially available software.

Methods

Between June 2019 and May 2020, patients with preoperative supine anteroposterior pelvis radiographs and CT scans were included and retrospectively analyzed. The LCEA was measured on all preoperative supine anteroposterior pelvis radiographs 4 times per hip, using the 4 methods. The 4 anatomic horizons used to measure LCEA were compared to each other to determine statistically significant difference. The LCEA measured in the CT scan at the 12-o’clock position was used to compare and determine radiographs’ LCEA accuracy.

Results

Ninety-six patients (100 hips) met the inclusion criteria. Sixty-two were women (65%), and the mean age was 35.2 ± 15 years. The mean value for LCEA in CT was 32.2 and 31.1 for the 4 anatomic horizons on x-ray (P < .001). The lowest mean difference between CT scan and x-ray was obtained using the FHs (2.3 ± 2.4). Less mean difference was obtained between FHs and ITs (1.0 ± 0.8).

Conclusions

In this study, radiographic measurements underestimated LCEA compared with those from CT scans. Using the FHs as an anatomic horizon on radiographs was a more accurate method to measure LCEA than using acetabular teardrops, ITs, or floor. While this difference is statistically significant, it is not likely to be clinically significant.

Clinical Relevance

Assessment of acetabular coverage is an essential aspect of diagnosing and managing hip pathologies. One of the methods used for this is the LCEA measurement, which is based on a radiographic analysis of the hip joint. It is important to compare the measurements using different horizons and increasingly sophisticated imaging modalities to provide the most accurate information to guide clinical decision making.
{"title":"The Measurement of the Lateral Center-Edge Angle Is Underestimated on Radiographs Compared With 3-Dimensional Computed Tomography","authors":"Julio Nerys-Figueroa B.S. ,&nbsp;Ady H. Kahana-Rojkind M.D. ,&nbsp;Ali Parsa M.D. ,&nbsp;David Maldonado M.D. ,&nbsp;Roger Quesada-Jimenez M.D. ,&nbsp;Benjamin G. Domb M.D.","doi":"10.1016/j.asmr.2024.101005","DOIUrl":"10.1016/j.asmr.2024.101005","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if there is a significant difference using femoral heads (FHs) as an anatomic horizon when measuring the lateral center-edge angle (LCEA) compared to floor, acetabular teardrops, and ischial tuberosities (ITs) and to determine their accuracy by comparing to a computed tomography (CT) scan with commercially available software.</div></div><div><h3>Methods</h3><div>Between June 2019 and May 2020, patients with preoperative supine anteroposterior pelvis radiographs and CT scans were included and retrospectively analyzed. The LCEA was measured on all preoperative supine anteroposterior pelvis radiographs 4 times per hip, using the 4 methods. The 4 anatomic horizons used to measure LCEA were compared to each other to determine statistically significant difference. The LCEA measured in the CT scan at the 12-o’clock position was used to compare and determine radiographs’ LCEA accuracy.</div></div><div><h3>Results</h3><div>Ninety-six patients (100 hips) met the inclusion criteria. Sixty-two were women (65%), and the mean age was 35.2 ± 15 years. The mean value for LCEA in CT was 32.2 and 31.1 for the 4 anatomic horizons on x-ray (<em>P</em> &lt; .001). The lowest mean difference between CT scan and x-ray was obtained using the FHs (2.3 ± 2.4). Less mean difference was obtained between FHs and ITs (1.0 ± 0.8).</div></div><div><h3>Conclusions</h3><div>In this study, radiographic measurements underestimated LCEA compared with those from CT scans. Using the FHs as an anatomic horizon on radiographs was a more accurate method to measure LCEA than using acetabular teardrops, ITs, or floor. While this difference is statistically significant, it is not likely to be clinically significant.</div></div><div><h3>Clinical Relevance</h3><div>Assessment of acetabular coverage is an essential aspect of diagnosing and managing hip pathologies. One of the methods used for this is the LCEA measurement, which is based on a radiographic analysis of the hip joint. It is important to compare the measurements using different horizons and increasingly sophisticated imaging modalities to provide the most accurate information to guide clinical decision making.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101005"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386775","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
Both Single- and Double-anchor Remplissage Techniques Restore Native Stability in a Cadaveric Model of Hill-Sachs Lesions in Anterior Shoulder Instability
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101003
Patrick J. Morrissey M.D., Edward J. Testa M.D., Matthew Quinn M.D., Elaine He B.S., Rohit Badida B.S., Joseph Cusano M.D., Brett D. Owens M.D.

Purpose

To determine the most effective number and location of fixation points for remplissage of Hill-Sachs lesions (HSL) in a cadaveric model of anterior shoulder instability.

Methods

Eleven fresh-frozen cadaveric shoulder specimens were tested. A robot device tested resistance to anterior translation of the humeral head. Eleven shoulder conditions were tested: (1) intact, (2) 15% HSL, (3) 15% HSL with 1 central, (4) 15% HSL with 2 central, (5) 15% HSL with 1 medial, (6) 15% HSL with 2 medial, (7) 30% HSL, (8) 30% HSL with 1 central, (9) 30% HSL with 2 central, (10) 30% HSL with 1 medial, and (11) 30% HSL with 2 medial.

Results

All remplissage techniques tested restored peak resistance to at least equal that of the intact shoulder condition. In the small Hill-Sachs condition, the mean peak resistance for 1 central, 2 central, 1 medial, and 2 medial fixation was 41.5, 52.3, 45.1, and 54.8, respectively. In the large Hill-Sachs condition, the mean peak resistance was 41.7, 59.9, 42.6, and 64.43, respectively. Two fixation points provided more resistance than one in both the medial (P < .01) and central (P < .01) locations. When comparing fixation location, however, there was not a significant difference between 1 central and 1 medial (P > .05) or 2 central to 2 medial (P > .05) in either the large or small HSL.

Conclusions

All remplissage techniques were able to successfully restore mean peak resistance to anterior translation to the native condition in this cadaveric model. There was not a difference in resistance force between medial wall and central placement for either the single- or double-fixation configurations.

Clinical Relevance

This study suggests that one anchor placed either medially or centrally will restore native stability in remplissage for anterior shoulder instability.
{"title":"Both Single- and Double-anchor Remplissage Techniques Restore Native Stability in a Cadaveric Model of Hill-Sachs Lesions in Anterior Shoulder Instability","authors":"Patrick J. Morrissey M.D.,&nbsp;Edward J. Testa M.D.,&nbsp;Matthew Quinn M.D.,&nbsp;Elaine He B.S.,&nbsp;Rohit Badida B.S.,&nbsp;Joseph Cusano M.D.,&nbsp;Brett D. Owens M.D.","doi":"10.1016/j.asmr.2024.101003","DOIUrl":"10.1016/j.asmr.2024.101003","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the most effective number and location of fixation points for remplissage of Hill-Sachs lesions (HSL) in a cadaveric model of anterior shoulder instability.</div></div><div><h3>Methods</h3><div>Eleven fresh-frozen cadaveric shoulder specimens were tested. A robot device tested resistance to anterior translation of the humeral head. Eleven shoulder conditions were tested: (1) intact, (2) 15% HSL, (3) 15% HSL with 1 central, (4) 15% HSL with 2 central, (5) 15% HSL with 1 medial, (6) 15% HSL with 2 medial, (7) 30% HSL, (8) 30% HSL with 1 central, (9) 30% HSL with 2 central, (10) 30% HSL with 1 medial, and (11) 30% HSL with 2 medial.</div></div><div><h3>Results</h3><div>All remplissage techniques tested restored peak resistance to at least equal that of the intact shoulder condition. In the small Hill-Sachs condition, the mean peak resistance for 1 central, 2 central, 1 medial, and 2 medial fixation was 41.5, 52.3, 45.1, and 54.8, respectively. In the large Hill-Sachs condition, the mean peak resistance was 41.7, 59.9, 42.6, and 64.43, respectively. Two fixation points provided more resistance than one in both the medial (<em>P</em> &lt; .01) and central (<em>P</em> &lt; .01) locations. When comparing fixation location, however, there was not a significant difference between 1 central and 1 medial (<em>P</em> &gt; .05) or 2 central to 2 medial (<em>P</em> &gt; .05) in either the large or small HSL.</div></div><div><h3>Conclusions</h3><div>All remplissage techniques were able to successfully restore mean peak resistance to anterior translation to the native condition in this cadaveric model. There was not a difference in resistance force between medial wall and central placement for either the single- or double-fixation configurations.</div></div><div><h3>Clinical Relevance</h3><div>This study suggests that one anchor placed either medially or centrally will restore native stability in remplissage for anterior shoulder instability.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101003"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386468","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
Forty-Two Percent of Patients Undergoing Arthroscopic Shoulder Surgery Are Using Psychotropic Medications
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101030
Michael R. Cesarek M.S. , Nicholas O. Gerard III M.S. , Brianna N. Griswold B.S. , Mia V. Rumps M.S. , Michael J. O’Brien M.D. , Felix H. Savoie III M.D. , Mary K. Mulcahey M.D.

Purpose

To determine the prevalence of psychotropic medication use in patients undergoing shoulder arthroscopy at a single institution and to identify the most common medications and classes of drugs being taken in this specific patient population.

Methods

We conducted a retrospective chart review of patients treated by 3 fellowship-trained orthopaedic sports medicine and shoulder surgeons between 2019 and 2021. All patients who underwent shoulder arthroscopy during this period were included. The following data were collected: age, sex, laterality of surgery, prior surgical procedures on the operated shoulder, specific surgery performed, and use of psychotropic medications. Drug categories included anticonvulsants, antidepressants/anxiolytics, sedative hypnotics, stimulants, antipsychotics, and multiple psychotropic drugs. Psychotropic medications were included if they were listed as being taken at any time in the patient’s chart (“taking”) within a 6-month window prior to surgery.

Results

Of the 1,279 patients (828 male and 451 female patients) whose charts were reviewed, 534 (41.8%) were prescribed at least 1 psychotropic. Of the 453 patients treated in 2021, 201 (44.4%) were taking at least 1 psychotropic. Similarly, 152 of the 397 patients treated in 2020 (38.2%) and 181 of the 429 patients treated in 2019 (42.2%) were found to be taking at least 1 psychotropic. Among the 1,279 patients included, 282 of 828 male patients (34.1%) were prescribed psychotropic drugs compared with 252 of 451 female patients (55.9%, P = .001). From 2019 to 2021, 137 of the patients using psychotropic drugs (25%) were prescribed anticonvulsants/mood stabilizers; 105 (19%), antidepressants; 75 (14%), sedative hypnotics; 23 (4%), stimulants; 4 (1%), antipsychotics; and 190 (35%), multiple psychotropics. From 2019 to 2021, the rate of antidepressant/anxiolytic and/or sedative hypnotic prescription psychotropic drug use increased from 28% to 30.5% (P = .42).

Conclusions

This study showed that a large portion of patients undergoing shoulder arthroscopy were taking psychotropic medications. Furthermore, we found that female patients had significantly higher utilization of these medications compared with male patients.

Clinical Relevance

Understanding the prevalence of these medications in orthopaedic patients is essential for surgeons to take into consideration to limit preoperative, intraoperative, and postoperative complications, as well as optimize patient outcomes.
{"title":"Forty-Two Percent of Patients Undergoing Arthroscopic Shoulder Surgery Are Using Psychotropic Medications","authors":"Michael R. Cesarek M.S. ,&nbsp;Nicholas O. Gerard III M.S. ,&nbsp;Brianna N. Griswold B.S. ,&nbsp;Mia V. Rumps M.S. ,&nbsp;Michael J. O’Brien M.D. ,&nbsp;Felix H. Savoie III M.D. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2024.101030","DOIUrl":"10.1016/j.asmr.2024.101030","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prevalence of psychotropic medication use in patients undergoing shoulder arthroscopy at a single institution and to identify the most common medications and classes of drugs being taken in this specific patient population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review of patients treated by 3 fellowship-trained orthopaedic sports medicine and shoulder surgeons between 2019 and 2021. All patients who underwent shoulder arthroscopy during this period were included. The following data were collected: age, sex, laterality of surgery, prior surgical procedures on the operated shoulder, specific surgery performed, and use of psychotropic medications. Drug categories included anticonvulsants, antidepressants/anxiolytics, sedative hypnotics, stimulants, antipsychotics, and multiple psychotropic drugs. Psychotropic medications were included if they were listed as being taken at any time in the patient’s chart (“taking”) within a 6-month window prior to surgery.</div></div><div><h3>Results</h3><div>Of the 1,279 patients (828 male and 451 female patients) whose charts were reviewed, 534 (41.8%) were prescribed at least 1 psychotropic. Of the 453 patients treated in 2021, 201 (44.4%) were taking at least 1 psychotropic. Similarly, 152 of the 397 patients treated in 2020 (38.2%) and 181 of the 429 patients treated in 2019 (42.2%) were found to be taking at least 1 psychotropic. Among the 1,279 patients included, 282 of 828 male patients (34.1%) were prescribed psychotropic drugs compared with 252 of 451 female patients (55.9%, <em>P</em> = .001). From 2019 to 2021, 137 of the patients using psychotropic drugs (25%) were prescribed anticonvulsants/mood stabilizers; 105 (19%), antidepressants; 75 (14%), sedative hypnotics; 23 (4%), stimulants; 4 (1%), antipsychotics; and 190 (35%), multiple psychotropics. From 2019 to 2021, the rate of antidepressant/anxiolytic and/or sedative hypnotic prescription psychotropic drug use increased from 28% to 30.5% (<em>P</em> = .42).</div></div><div><h3>Conclusions</h3><div>This study showed that a large portion of patients undergoing shoulder arthroscopy were taking psychotropic medications. Furthermore, we found that female patients had significantly higher utilization of these medications compared with male patients.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the prevalence of these medications in orthopaedic patients is essential for surgeons to take into consideration to limit preoperative, intraoperative, and postoperative complications, as well as optimize patient outcomes.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101030"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386530","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
Multidisciplinary Team Discussions and the Inclusion of Individualized Patient Factors May Improve Informed Consent in Sports Medicine
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101007
John Grossi B.S. , Lexi Garber B.S. , Brandon Klein D.O., M.B.A. , Lucas Bartlett D.O. , Adam D. Bitterman D.O. , Randy M. Cohn M.D. , Nicholas A. Sgaglione M.D.
Informed consent allows for the maintenance of patient autonomy and is essential in establishing trusting relationships between physicians and their patients. This process involves thorough discussion of the risks and alternatives, as well as the short- and long-term outcomes, of proposed treatment options. Inadequacies with informed consent can lead to inferior patient outcomes and may be subject to severe legal consequences. Individualized discussions are warranted to address the questions of these patients, whether it be the high-level athlete or the weekend warrior. This review highlights factors, identifies barriers, and proposes potential solutions to improve informed consent within orthopaedic sports medicine.
{"title":"Multidisciplinary Team Discussions and the Inclusion of Individualized Patient Factors May Improve Informed Consent in Sports Medicine","authors":"John Grossi B.S. ,&nbsp;Lexi Garber B.S. ,&nbsp;Brandon Klein D.O., M.B.A. ,&nbsp;Lucas Bartlett D.O. ,&nbsp;Adam D. Bitterman D.O. ,&nbsp;Randy M. Cohn M.D. ,&nbsp;Nicholas A. Sgaglione M.D.","doi":"10.1016/j.asmr.2024.101007","DOIUrl":"10.1016/j.asmr.2024.101007","url":null,"abstract":"<div><div>Informed consent allows for the maintenance of patient autonomy and is essential in establishing trusting relationships between physicians and their patients. This process involves thorough discussion of the risks and alternatives, as well as the short- and long-term outcomes, of proposed treatment options. Inadequacies with informed consent can lead to inferior patient outcomes and may be subject to severe legal consequences. Individualized discussions are warranted to address the questions of these patients, whether it be the high-level athlete or the weekend warrior. This review highlights factors, identifies barriers, and proposes potential solutions to improve informed consent within orthopaedic sports medicine.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101007"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386531","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
Twenty-Year Analysis of Surfing Head and Neck Injuries Presenting to United States Emergency Departments Showed a Decrease in Overall Injuries Despite Steady Concussion Rates
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101014
Eli M. Snyder B.S. , Elizabeth A. Rooks B.A. , Kyle K. Obana M.D. , Spencer K.Y. Chang M.D. , Christopher S. Ahmad M.D. , Charles A. Popkin M.D. , David P. Trofa M.D.

Purpose

To analyze the etiology, diagnosis, and incidence of head and neck (HN) injuries among ocean surfers.

Methods

The National Electronic Injury Surveillance System database was queried for surfing HN injuries presenting to United States emergency departments (EDs) between January 2003 and December 2022. Date of presentation, age, sex, race, injured body part, injury diagnosis, and disposition, as well as a brief injury narrative, were included in the data. National estimates (NEs) were calculated using the associated statistical weight of the reporting hospital.

Results

A total of 1,359 surfing-related HN injuries (NE, 90,872) were included in this study. The average age at presentation was 29.2 ± 13.8 years (range, 3 to 81 years). The most commonly specified mechanisms of injury were impact with board (NE, 48,360 [53%]) and impact with ocean floor (NE, 8,690 [10%]). Concussions represented 5% of surfing HN injuries and occurred at a higher rate (8%) in the age group younger than 20 years. There were statistically significant decreases in overall HN injuries (P < .01) (coefficient, –270; 95% confidence interval [CI], –355 to –206), lacerations (P < .01) (coefficient, –208; 95% CI, –258 to –158), and impact-with-board injuries (P < .01) (coefficient, –177; 95% CI, –327 to –117) presenting to United States EDs from 2003 to 2022.

Conclusions

Although surfing HN injury ED presentations decreased from 2003 to 2022, the rate of surfing-related concussions presenting to EDs remained steady. Concussions therefore remain a significant concern in surfing, especially among surfers under 20 years of age.

Clinical Relevance

As the sport of surfing has increased in popularity, it is important to understand the range of surfing injuries seen in EDs. HN injuries, especially concussions, should be thoroughly investigated to better understand the risks of ocean surfing, to advise athletes, and to develop effective injury prevention strategies.
{"title":"Twenty-Year Analysis of Surfing Head and Neck Injuries Presenting to United States Emergency Departments Showed a Decrease in Overall Injuries Despite Steady Concussion Rates","authors":"Eli M. Snyder B.S. ,&nbsp;Elizabeth A. Rooks B.A. ,&nbsp;Kyle K. Obana M.D. ,&nbsp;Spencer K.Y. Chang M.D. ,&nbsp;Christopher S. Ahmad M.D. ,&nbsp;Charles A. Popkin M.D. ,&nbsp;David P. Trofa M.D.","doi":"10.1016/j.asmr.2024.101014","DOIUrl":"10.1016/j.asmr.2024.101014","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the etiology, diagnosis, and incidence of head and neck (HN) injuries among ocean surfers.</div></div><div><h3>Methods</h3><div>The National Electronic Injury Surveillance System database was queried for surfing HN injuries presenting to United States emergency departments (EDs) between January 2003 and December 2022. Date of presentation, age, sex, race, injured body part, injury diagnosis, and disposition, as well as a brief injury narrative, were included in the data. National estimates (NEs) were calculated using the associated statistical weight of the reporting hospital.</div></div><div><h3>Results</h3><div>A total of 1,359 surfing-related HN injuries (NE, 90,872) were included in this study. The average age at presentation was 29.2 ± 13.8 years (range, 3 to 81 years). The most commonly specified mechanisms of injury were impact with board (NE, 48,360 [53%]) and impact with ocean floor (NE, 8,690 [10%]). Concussions represented 5% of surfing HN injuries and occurred at a higher rate (8%) in the age group younger than 20 years. There were statistically significant decreases in overall HN injuries (<em>P</em> &lt; .01) (coefficient, –270; 95% confidence interval [CI], –355 to –206), lacerations (<em>P</em> &lt; .01) (coefficient, –208; 95% CI, –258 to –158), and impact-with-board injuries (<em>P</em> &lt; .01) (coefficient, –177; 95% CI, –327 to –117) presenting to United States EDs from 2003 to 2022.</div></div><div><h3>Conclusions</h3><div>Although surfing HN injury ED presentations decreased from 2003 to 2022, the rate of surfing-related concussions presenting to EDs remained steady. Concussions therefore remain a significant concern in surfing, especially among surfers under 20 years of age.</div></div><div><h3>Clinical Relevance</h3><div>As the sport of surfing has increased in popularity, it is important to understand the range of surfing injuries seen in EDs. HN injuries, especially concussions, should be thoroughly investigated to better understand the risks of ocean surfing, to advise athletes, and to develop effective injury prevention strategies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101014"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386548","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
Anterior Capsulectomy Through Humeral Fenestration in Arthroscopic Arthrolysis for Elbow Stiffness Is Safe and Effective
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101029
Clémence Lemaître , Antoine Senioris M.D. , Fabrice Duparc M.D., Ph.D.

Purpose

To evaluate arc of motion and complications following transhumeral anterior capsulectomy through a purely posterior approach with the Outerbridge-Kashiwagi procedure in treating elbow stiffness.

Methods

Patients who were treated for elbow stiffness between April 2003 and February 2023 were retrospectively identified. The inclusion criteria were an extension/flexion arc deficit of at least 30° and treatment with arthroscopic arthrolysis through posterior and posterolateral portals with humeral fenestration. Elbow joint range of motion and the Mayo Elbow Performance Score were assessed preoperatively, intraoperatively, at 6 weeks, and at final follow-up. The follow-up ended when the elbow became asymptomatic again or when the recovery was considered stable. Postoperative complications were recorded.

Results

A total of 30 patients (23 men/7 women; 31 elbows; 1 bilateral/29 unilateral) were included. Mean follow-up was 11.1 months (1-64). Mean joint amplitudes intraoperatively increased in all areas of mobility, including extension/flexion from 86° to 132.6° (P = .001) and pronation/supination from 163.9° to 179.7° (P = .025). At the longest follow-up, mean joint amplitude was increased from 86° to 118.9° (P = .002) in extension/flexion and from 136.9° to 173.9° (P = .022) in pronation/supination. The mean deficit was reduced from 54° to 21.1° (P = .001) in extension/flexion and from 16.1° to 6.1° (P = .006) in pronation/supination. The mean gain in the extension/flexion arc was 31.5° and 10° for the pronation/supination arc. Loss in flexion/extension was limited (mean: 14.2°, extreme: 50°). The study showed no neurologic complications.

Conclusions

Arthroscopic arthrolysis of a stiff elbow using a purely posterior approach with anterior capsulectomy via the Outerbridge-Kashiwagi procedure was safe and effective. Clinical results showed improvement in joint range of motion in flexion/extension and pronation/supination, both intraoperatively and postoperatively, with no postoperative neurologic complications.

Level of Evidence

Level IV, therapeutic case series.
{"title":"Anterior Capsulectomy Through Humeral Fenestration in Arthroscopic Arthrolysis for Elbow Stiffness Is Safe and Effective","authors":"Clémence Lemaître ,&nbsp;Antoine Senioris M.D. ,&nbsp;Fabrice Duparc M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101029","DOIUrl":"10.1016/j.asmr.2024.101029","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate arc of motion and complications following transhumeral anterior capsulectomy through a purely posterior approach with the Outerbridge-Kashiwagi procedure in treating elbow stiffness.</div></div><div><h3>Methods</h3><div>Patients who were treated for elbow stiffness between April 2003 and February 2023 were retrospectively identified. The inclusion criteria were an extension/flexion arc deficit of at least 30° and treatment with arthroscopic arthrolysis through posterior and posterolateral portals with humeral fenestration. Elbow joint range of motion and the Mayo Elbow Performance Score were assessed preoperatively, intraoperatively, at 6 weeks, and at final follow-up. The follow-up ended when the elbow became asymptomatic again or when the recovery was considered stable. Postoperative complications were recorded.</div></div><div><h3>Results</h3><div>A total of 30 patients (23 men/7 women; 31 elbows; 1 bilateral/29 unilateral) were included. Mean follow-up was 11.1 months (1-64). Mean joint amplitudes intraoperatively increased in all areas of mobility, including extension/flexion from 86° to 132.6° (<em>P</em> = .001) and pronation/supination from 163.9° to 179.7° (<em>P</em> = .025). At the longest follow-up, mean joint amplitude was increased from 86° to 118.9° (<em>P</em> = .002) in extension/flexion and from 136.9° to 173.9° (<em>P</em> = .022) in pronation/supination. The mean deficit was reduced from 54° to 21.1° (<em>P</em> = .001) in extension/flexion and from 16.1° to 6.1° (<em>P</em> = .006) in pronation/supination. The mean gain in the extension/flexion arc was 31.5° and 10° for the pronation/supination arc. Loss in flexion/extension was limited (mean: 14.2°, extreme: 50°). The study showed no neurologic complications.</div></div><div><h3>Conclusions</h3><div>Arthroscopic arthrolysis of a stiff elbow using a purely posterior approach with anterior capsulectomy via the Outerbridge-Kashiwagi procedure was safe and effective. Clinical results showed improvement in joint range of motion in flexion/extension and pronation/supination, both intraoperatively and postoperatively, with no postoperative neurologic complications.</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 1","pages":"Article 101029"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386774","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
Rotator Cuff Repairs Using Double-Row Modified Mason-Allen Stitches Resulted in Superior Clinical Outcomes at 2-Year Follow-Up Compared to the Double-Row Suture-Bridge Technique: A Case-Control Matching Study
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.100997
W.P. Yau M.B.B.S., F.R.C.S.Ed., F.R.C.S.Ed. (Ortho), F.H.K.C.O.S., F.H.K.A.M. (Orthopaedic Surgery)

Purpose

To compare the clinical outcomes of rotator cuff repair using a double-row modified Mason-Allen stitch (DR-MA) with those repaired with a double-row suture bridge (DR-SB).

Methods

A retrospective case-control matching study was conducted to compare the results of patients who received complete supraspinatus tendon repair using a DR-MA configuration and a DR-SB pattern between 2009 and 2020. Exact matching was performed for patients with intact rotator cuff repair at postoperative magnetic resonance imaging. The matching criteria included sex, workers’ compensation, smoking status, hyperlipidemia, size and retraction of tear, and acromioplasty. Clinical outcomes, including visual analog scale (VAS), American Shoulder and Elbow Surgeon (ASES) score, and active shoulder forward flexion (FF), were documented at the 2-year follow-up. The percentage of patients who achieved minimum clinically important difference (MCID) was reported.

Results

A total of 64 patients, including 28 men and 36 women, were matched, and the 2-year follow-up rate was 100%. All patients received postoperative magnetic resonance imaging at 19 ± 11 months. Significant improvement in all clinical outcomes was observed, regardless of the repair pattern (P < .001). The 2-year VAS was better in the DR-MA group compared to the DR-SB group (1.5 ± 2.0 and 2.9 ± 2.6, respectively; P = .009). At the 2-year follow-up, 91%, 90%, and 63% of patients in the DR-MA group achieved MCID in VAS, ASES, and FF, respectively. There was no difference in the proportion of patients achieving MCID between the 2 treatment arms. However, a more substantial improvement in VAS (P = .008), ASES (P = .014), and FF (P = .039) between preoperation and the 2-year follow-up was noted in the DR-MA group.

Conclusions

No clinical differences in pain or function were found between DR-MA and DR-SB despite small and statistically significant differences in favor of DR-MA.

Level of Evidence

Level III, retrospective cohort study.
{"title":"Rotator Cuff Repairs Using Double-Row Modified Mason-Allen Stitches Resulted in Superior Clinical Outcomes at 2-Year Follow-Up Compared to the Double-Row Suture-Bridge Technique: A Case-Control Matching Study","authors":"W.P. Yau M.B.B.S., F.R.C.S.Ed., F.R.C.S.Ed. (Ortho), F.H.K.C.O.S., F.H.K.A.M. (Orthopaedic Surgery)","doi":"10.1016/j.asmr.2024.100997","DOIUrl":"10.1016/j.asmr.2024.100997","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the clinical outcomes of rotator cuff repair using a double-row modified Mason-Allen stitch (DR-MA) with those repaired with a double-row suture bridge (DR-SB).</div></div><div><h3>Methods</h3><div>A retrospective case-control matching study was conducted to compare the results of patients who received complete supraspinatus tendon repair using a DR-MA configuration and a DR-SB pattern between 2009 and 2020. Exact matching was performed for patients with intact rotator cuff repair at postoperative magnetic resonance imaging. The matching criteria included sex, workers’ compensation, smoking status, hyperlipidemia, size and retraction of tear, and acromioplasty. Clinical outcomes, including visual analog scale (VAS), American Shoulder and Elbow Surgeon (ASES) score, and active shoulder forward flexion (FF), were documented at the 2-year follow-up. The percentage of patients who achieved minimum clinically important difference (MCID) was reported.</div></div><div><h3>Results</h3><div>A total of 64 patients, including 28 men and 36 women, were matched, and the 2-year follow-up rate was 100%. All patients received postoperative magnetic resonance imaging at 19 ± 11 months. Significant improvement in all clinical outcomes was observed, regardless of the repair pattern (<em>P</em> &lt; .001). The 2-year VAS was better in the DR-MA group compared to the DR-SB group (1.5 ± 2.0 and 2.9 ± 2.6, respectively; <em>P</em> = .009). At the 2-year follow-up, 91%, 90%, and 63% of patients in the DR-MA group achieved MCID in VAS, ASES, and FF, respectively. There was no difference in the proportion of patients achieving MCID between the 2 treatment arms. However, a more substantial improvement in VAS (<em>P</em> = .008), ASES (<em>P</em> = .014), and FF (<em>P</em> = .039) between preoperation and the 2-year follow-up was noted in the DR-MA group.</div></div><div><h3>Conclusions</h3><div>No clinical differences in pain or function were found between DR-MA and DR-SB despite small and statistically significant differences in favor of DR-MA.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 100997"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386467","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
Cadaveric Specimens Used in Studies Evaluating Bone Loss in Anterior Shoulder Instability Are Not Representative of the Affected Patient Population: A Systematic Review
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.100996
Amin Karimi M.D., Anya Singh-Varma B.S., Rajiv P. Reddy M.D., Matthew P. Kolevar M.D., Albert Lin M.D.

Purpose

To examine the age, sex, and site of evaluated bone loss in specimens used in cadaveric studies assessing the role of bone loss in anterior shoulder instability and to evaluate whether these studies evaluate glenoid and humeral bone loss separately or as a combined biomechanical problem.

Methods

Embase, MEDLINE, Scopus, Web of Sciences, Google Scholar, and Cochrane databases were queried electronically in April 2023 for cadaveric studies examining the relationship between anatomic structures and recurrent anterior shoulder instability. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Studies were excluded if they evaluated the role of soft tissue structures in anterior shoulder stability or assessed anterior bony reconstruction methods to create a stable shoulder and those with fewer than 5 specimens. The following search terms were used: cadaver(s), corpse(s), shoulder dislocation(s), glenohumeral dislocation(s), glenohumeral subluxation(s), glenoid (cavity), and humeral head. Data collected included the age, sex, and site of evaluated bone loss in cadaveric specimens. Studies were categorized based on the anatomic structure that was examined in connection with recurrent anterior shoulder instability: proximal humerus bone defects, glenoid bone defects, and combined bone defects.

Results

Eighteen articles were included in the review, which evaluated 244 cadavers. The sex of 74 cadavers (30.3%) was recorded as male, 50 (20.4%) as female, and 120 (49.1%) were not reported. The mean age of the cadavers was 61.1 ± 15.9 years. Most of the investigations (55.5%) were conducted in the United States. Ten studies looked at the relationship between anterior shoulder instability and glenoid bony structure, 3 assessed the effect of Hill-Sachs lesion size, and only 5 (27.7%) investigated the impact of bipolar bone defects.

Conclusions

The ages of cadavers utilized in biomechanical studies assessing the relationship of glenoid and humeral bone loss to anterior shoulder instability are different from the age range of patients who present with this clinical problem. Males were more frequently studied, and most of these biomechanical studies were conducted in the United States. In addition, few studies evaluate the relationship between anterior shoulder instability and bone loss as a bipolar structural defect.

Clinical Relevance

It is important to understand how closely study specimens match the patient population with the condition being investigated. This study will provide information about the cadaveric specimens used in studies evaluating bone loss in anterior shoulder instability.
{"title":"Cadaveric Specimens Used in Studies Evaluating Bone Loss in Anterior Shoulder Instability Are Not Representative of the Affected Patient Population: A Systematic Review","authors":"Amin Karimi M.D.,&nbsp;Anya Singh-Varma B.S.,&nbsp;Rajiv P. Reddy M.D.,&nbsp;Matthew P. Kolevar M.D.,&nbsp;Albert Lin M.D.","doi":"10.1016/j.asmr.2024.100996","DOIUrl":"10.1016/j.asmr.2024.100996","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the age, sex, and site of evaluated bone loss in specimens used in cadaveric studies assessing the role of bone loss in anterior shoulder instability and to evaluate whether these studies evaluate glenoid and humeral bone loss separately or as a combined biomechanical problem.</div></div><div><h3>Methods</h3><div>Embase, MEDLINE, Scopus, Web of Sciences, Google Scholar, and Cochrane databases were queried electronically in April 2023 for cadaveric studies examining the relationship between anatomic structures and recurrent anterior shoulder instability. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Studies were excluded if they evaluated the role of soft tissue structures in anterior shoulder stability or assessed anterior bony reconstruction methods to create a stable shoulder and those with fewer than 5 specimens. The following search terms were used: cadaver(s), corpse(s), shoulder dislocation(s), glenohumeral dislocation(s), glenohumeral subluxation(s), glenoid (cavity), and humeral head. Data collected included the age, sex, and site of evaluated bone loss in cadaveric specimens. Studies were categorized based on the anatomic structure that was examined in connection with recurrent anterior shoulder instability: proximal humerus bone defects, glenoid bone defects, and combined bone defects.</div></div><div><h3>Results</h3><div>Eighteen articles were included in the review, which evaluated 244 cadavers. The sex of 74 cadavers (30.3%) was recorded as male, 50 (20.4%) as female, and 120 (49.1%) were not reported. The mean age of the cadavers was 61.1 ± 15.9 years. Most of the investigations (55.5%) were conducted in the United States. Ten studies looked at the relationship between anterior shoulder instability and glenoid bony structure, 3 assessed the effect of Hill-Sachs lesion size, and only 5 (27.7%) investigated the impact of bipolar bone defects.</div></div><div><h3>Conclusions</h3><div>The ages of cadavers utilized in biomechanical studies assessing the relationship of glenoid and humeral bone loss to anterior shoulder instability are different from the age range of patients who present with this clinical problem. Males were more frequently studied, and most of these biomechanical studies were conducted in the United States. In addition, few studies evaluate the relationship between anterior shoulder instability and bone loss as a bipolar structural defect.</div></div><div><h3>Clinical Relevance</h3><div>It is important to understand how closely study specimens match the patient population with the condition being investigated. This study will provide information about the cadaveric specimens used in studies evaluating bone loss in anterior shoulder instability.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 100996"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386550","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
期刊
Arthroscopy Sports Medicine and Rehabilitation
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