Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Seven-Tesla Magnetic Resonance Imaging Has Increased Sensitivity but Decreased Specificity in Diagnosing Cartilage Defects in the Knee Compared With 1.5- and 3-Tesla Magnetic Resonance Imaging","authors":"Andrew George M.D. ,&nbsp;Karen L. Hernandez B.S. ,&nbsp;Bradley Lambert Ph.D. ,&nbsp;Haley M. Goble M.H.A. ,&nbsp;Nakul Gupta M.D. ,&nbsp;Patrick C. McCulloch M.D.","doi":"10.1016/j.asmr.2025.101255","DOIUrl":"10.1016/j.asmr.2025.101255","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the accuracy of 7-Tesla (T) magnetic resonance imaging (MRI) compared with standard-of-care (SOC) 1.5- or 3-T MRI in detecting and grading cartilage defects in the knee.</div></div><div><h3>Methods</h3><div>Participants who already underwent SOC MRI at 1.5- or 3-T and provided consent were scheduled for 7-T MRI prior to arthroscopy for all indications except revision surgery. SOC and 7-T MRI scans were independently reviewed in randomized order by 2 blinded musculoskeletal radiologists using a modified Outerbridge classification system for defect grading. Image quality (sharpness, contrast, artifact, noise) was also rated. At the time of arthroscopy, each articular surface was then graded by the surgeon, who was blinded to the 7-T MRI scans. Using arthroscopy as the gold standard, we calculated the sensitivity and specificity of SOC MRI and 7-T MRI, as well as inter-rater reliability.</div></div><div><h3>Results</h3><div>A total of 81 patients—41 female patients (aged 45 ± 14 years) and 40 male patients (aged 40 ± 14 years)—were enrolled. The average time between SOC and 7-T MRI was 69 days, and the average time between 7-T MRI and surgery was 6 days. Sharpness, contrast, and noise ratings were all significantly improved with 7-T MRI compared with SOC MRI (<em>P</em> &lt; .05). Seven-Tesla MRI had higher sensitivity but lower specificity in detecting cartilage defects for all 6 articular surfaces (patella, trochlea, lateral femoral condyle, medial femoral condyle, lateral tibial plateau, and medial tibial plateau) when using arthroscopy as the gold standard. Intraoperative cartilage grading was significantly closer to 7-T grading compared with SOC grading for 2 of 6 surfaces (<em>P</em> &lt; .05). Seven-Tesla MRI had reduced coefficient-of-variation values for 1 articular surface (medial femoral condyle) compared with 3-T MRI (<em>P</em> = .036). There were no significant differences in other coefficient-of-variation measures or interobserver reliability with 7-T MRI compared with SOC MRI.</div></div><div><h3>Conclusions</h3><div>Seven-Tesla MRI showed improved imaging quality metrics and increased sensitivity but decreased specificity in diagnosing cartilage defects in the knee compared with SOC 1.5- and 3-T MRI using arthroscopy as the gold standard.</div></div><div><h3>Level of Evidence</h3><div>Level II, prospective comparative diagnostic accuracy study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101255"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Delay Increases the Incidence of Ramp Lesions and Bucket-Handle Tears in Anterior Cruciate Ligament Injuries","authors":"Dong Hwi Kim M.D., Ph.D. ,&nbsp;Do Kyung Lee M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101298","DOIUrl":"10.1016/j.asmr.2025.101298","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the correlation between surgical delay and the incidence of ramp lesions by performing meticulous arthroscopic evaluation of the posterior compartment in patients undergoing anterior cruciate ligament (ACL) reconstruction.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients who underwent primary ACL reconstruction between July 2015 and January 2023. To minimize underdiagnosis of ramp lesions, all patients received comprehensive arthroscopic evaluation of the posterior compartment via intercondylar notch view and posteromedial or posterolateral portals. Meniscal tears were classified on the basis of Cooper’s system, and radial and longitudinal tear components were analyzed separately. Patients were categorized into 3 groups according to time from injury to surgery: group 1 (&lt;6 weeks), group 2 (6 weeks–6 months), and group 3 (&gt;6 months). Incidence and tear patterns were compared among groups.</div></div><div><h3>Results</h3><div>A total of 201 patients were included in the study. The overall incidence of meniscal tears was lowest in group 2 (50%) compared with group 1 (73%; <em>P</em> = .02) and increased again in group 3 (75%; <em>P</em> = .04 vs group 2). Ramp lesions were significantly more common in group 3 than in group 2 (52.8% vs 23.1%; <em>P</em> = .02). Medial bucket-handle tears also increased significantly in group 3 (22.2%) compared to group 1 (2.9%) and group 2 (0%) (<em>P</em> &lt; .01 and <em>P</em> = .02, respectively).</div></div><div><h3>Conclusions</h3><div>A surgical delay of more than 6 months was associated with a higher incidence of medial ramp lesions, which can progress to bucket-handle tears in ACL-deficient knees. Early surgical intervention should be considered in ACL ruptures accompanied by rotational instability to prevent progression of medial meniscal pathology.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101298"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients Perceive Anterior Cruciate Ligament Reconstruction More Positively With Quadriceps Autograft Than With Patellar Tendon Autograft","authors":"Shankar S. Thiru B.S. ,&nbsp;Nicholas E. Aksu M.D. ,&nbsp;Gregorio Baek B.S. ,&nbsp;Stephen S. Rossettie M.D. ,&nbsp;Gabriel I. Onor Jr. M.D. ,&nbsp;Parth Sharma B.S. ,&nbsp;Daniel J. Kaplan M.D. ,&nbsp;Edward S. Chang M.D. ,&nbsp;William F. Postma M.D.","doi":"10.1016/j.asmr.2025.101296","DOIUrl":"10.1016/j.asmr.2025.101296","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze patient sentiment, experience, and perception differences between anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon autograft (QTG) and ACLR with bone-tendon-bone autograft (BTB).</div></div><div><h3>Methods</h3><div>Publicly accessible social media posts from 2012 to 2024 regarding ACLR were identified using a systematic keyword search strategy across major platforms. Posts containing information on patient experiences with QTG and BTB were extracted. First-order themes, sub-themes, and sentiment scores were assigned to each post by 2 independent reviewers. In addition, post characteristics such as platform of distribution, publication date, time after surgery, and sex of poster were recorded. Both inter-rater and intrarater reliability was assessed. Disagreements were settled with consensus discussions between the 2 raters. Descriptive statistics were used to summarize post characteristics, whereas χ² and one-way analysis of variance tests were used to compare outcomes between the two graft types.</div></div><div><h3>Results</h3><div>We analyzed 531 posts pertaining to QTG and 507 posts pertaining to BTB. QTG posts were more often positive (61.7%) than BTB posts (42.6%), with fewer negative posts (8.9% vs 18.9%, <em>P</em> &lt; .001). For both graft types, common first-order themes were functional outcomes (QTG, 50.6%; BTB, 45.2%), pain management (QTG, 40.8%; BTB, 48.5%), and recovery milestones (QTG, 51.5%; BTB, 39.1%). BTB posts more frequently referenced “scar formation” as a donor-site concern (<em>P</em> &lt; .001). Thematic trends varied over time. Among QTG posts, discussion of recovery milestones increased from 34.9% in the early postoperative period (0-2 weeks) to 57.9% at more than 2 years. In contrast, this theme decreased among BTB posts over the same time frame (from 43.9% to 33.3%). Pain management themes declined over time for QTG posts (from 55.3% to 36.8%) but remained consistently high for BTB posts (from 54.4% to 47.7%).</div></div><div><h3>Conclusions</h3><div>Social media posts regarding QTG were more positive in nature when compared with posts on patellar tendon autograft. Common discussion topics within the publicly available, online orthopaedic patient community were also identified, including functional outcomes, pain management, and recovery milestones.</div></div><div><h3>Clinical Relevance</h3><div>Social media can reflect patient sentiment regarding surgical options for ACLR. This study can therefore inform surgeons so that they can have more effective discussions with patients regarding autograft options.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101296"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Presence of Mechanoreceptors and Cortical Connections Support a Proprioceptive Role for Knee Plicae","authors":"Cihangir Turemis Ph.D., M.D. ,&nbsp;Ilker Senses M.D. ,&nbsp;Mehmet Erduran M.D. ,&nbsp;I. Halit Pinar M.D.","doi":"10.1016/j.asmr.2025.101219","DOIUrl":"10.1016/j.asmr.2025.101219","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine histologically and electrophysiologically whether the plicae have a proprioceptive function.</div></div><div><h3>Methods</h3><div>Tissue samples were obtained from 36 plicae in 29 knees (including 7 bilateral cases). The samples included 20 suprapatellar, 10 medial patellar, and 6 infrapatellar plicae. Kim and Choe’s classification was used to describe the patterns of the plicae.</div></div><div><h3>Results</h3><div>Twenty-nine patients who underwent knee arthroscopy were included in the study. Of these, 14 knees were on the left side and 15 on the right. The patients’ ages ranged from 12 to 78 years (mean age, 42 years). Golgi tendon organs (type III) were the most frequently observed mechanoreceptors. No free nerve endings (type IV) were identified in any of the plicae. Electrical stimulation of 4 plicae and 2 anterior cruciate ligaments was performed, and accurate, expected responses were obtained.</div></div><div><h3>Conclusions</h3><div>Histologic and neurophysiologic findings have shown the presence of mechanoreceptors in the knee plicae. Following the identification of these mechanoreceptors, the establishment of a neural connection between the plicae and the cerebral cortex suggests that the plicae are functional structures involved in proprioception. However, free nerve endings were evaluated in limited numbers and could not be shown.</div></div><div><h3>Clinical Relevance</h3><div>Plicae in the knee are considered rudimentary structures with the potential to become pathological. However, the plicae may not be useless structures but may improve the proprioceptive ability of the knee.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellar Osteochondral Allograft Transplantation Yields Clinically Meaningful Improvement in 2-Year Patient-Reported Outcomes","authors":"Nathaniel M. Tchangou B.S. ,&nbsp;Christopher A. Schneble M.D. ,&nbsp;Randal Timothy Kreulen M.D. ,&nbsp;Andres Perez M.D. ,&nbsp;Rioke M. Diejomaoh B.S. ,&nbsp;Fotios P. Tjoumakaris M.D. ,&nbsp;Kevin B. Freedman M.D. ,&nbsp;Bradford S. Tucker M.D.","doi":"10.1016/j.asmr.2025.101257","DOIUrl":"10.1016/j.asmr.2025.101257","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To assess the outcomes of patellar osteochondral allograft (OCA) transplantation and access the effect of preoperative indications and patient characteristics on outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Primary patellar OCA transplantation cases were retrospectively identified from a single surgeon from August 2017 and August 2021, all using grafts preserved with the Missouri Osteochondral Allograft Preservation technique. Patients with less than 2 years of follow-up were excluded. Variables collected included demographics, previous surgical and concomitant procedures, primary pathology and indications, graft size and location, range of motion, Magnetic Resonance Observation of Cartilage Repair Tissue 2.0 scores, patient-reported outcome measures, and reoperations. Primary pathology and unipolar versus bipolar grafting subgroups were analyzed. Preoperative and postoperative comparison was analyzed via paired sample &lt;em&gt;t&lt;/em&gt; tests. Subgroups were compared using independent &lt;em&gt;t&lt;/em&gt; tests for nonpaired continuous variables, with χ&lt;sup&gt;2&lt;/sup&gt; and Fisher exact tests used for categorical data. Statistical significance was set at &lt;em&gt;P&lt;/em&gt; &lt; .05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-eight cases (16 unipolar patellar OCA transplantation, 12 bipolar transplantation) met both inclusion and exclusion criteria, with a mean age of 31.0 ± 10.3 years, a mean body mass index of 30.0 ± 5.6, and a mean follow-up of 3.6 ± 1.4 years (range 2.3-5.8 years). Eighteen knees presented with lateral patellar instability, 9 with patellofemoral (PF) chondrosis, and 1 with juvenile osteochondritis dissecans. Three knees (10.7%) in total were converted to total knee arthroplasty, all of which occurred in the setting of PF chondrosis. OCA transplantation improved International Knee Documentation Committee (IKDC; 36.6-71.9; &lt;em&gt;P&lt;/em&gt; &lt; .001), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (49.8-77.5; &lt;em&gt;P&lt;/em&gt; = .001), Short-Form 12 Physical Health Survey (33.5-45.3; &lt;em&gt;P&lt;/em&gt; = .002), and Veterans RAND 12 Physical Health Survey (34.5-49.6; &lt;em&gt;P&lt;/em&gt; &lt; .001) scores at 2-years. The IKDC, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, Short-Form 12 Physical Health Survey, and Veterans RAND 12 Physical Health Survey thresholds (0-100) and percentages for achieving minimal clinically important difference were 18.75 (70.6%), 18.76 (73.5%), 11.90 (73.5%), and 13.56 (61.8%), respectively. Age and body mass index had strong negative correlations with IKDC scores in knees with PF chondrosis (r = −0.903; &lt;em&gt;P&lt;/em&gt; &lt; .01 and r = −0.875; &lt;em&gt;P&lt;/em&gt; = .010 respectively). Bipolar transplantation for “kissing” lesions had larger improvements in IKDC scores than unipolar cases (+54.6 vs +24.1; &lt;em&gt;P&lt;/em&gt; = .007).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Patellar OCA transplantation resulted in overall improvement in PROs with an 11% rate of conversion to total knee arthroplasty at 2-years fol","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101257"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant Tibial Tubercle Osteotomy Decreases Odds of Revision Patellofemoral Cartilage Restorative or Palliative Surgery After Autologous Chondrocyte Implantation for Patellofemoral Cartilage Disorders","authors":"Alexander R. Markes M.D.,&nbsp;Kyla Petrie M.D.,&nbsp;Alan L. Zhang M.D.,&nbsp;C. Benjamin Ma M.D.,&nbsp;Brian T. Feeley M.D.,&nbsp;Drew A. Lansdown M.D.","doi":"10.1016/j.asmr.2025.101286","DOIUrl":"10.1016/j.asmr.2025.101286","url":null,"abstract":"<div><h3>Purpose</h3><div>To utilize a large nationwide database to evaluate the need for revision patellofemoral cartilage restorative or palliative surgery after an index cartilage restoration procedure with and without concomitant tibial tubercle osteotomy (TTO) for patellofemoral cartilage injury.</div></div><div><h3>Methods</h3><div>The PearlDiver Mariner Database was queried for all patients who underwent osteochondral allograft transplantation (OCA), osteochondral autograft transfer (OAT), or autologous cartilage implantation (ACI) or chondroplasty of the patellofemoral joint between 2016 and 2021 using laterality-specific International Classification of Diseases, Tenth Revision and Current Procedural Terminology codes. The 5-year revision patellofemoral cartilage restorative or palliative surgery was evaluated via χ² analysis. Multivariable logistic regression was used to evaluate the association between 5-year revision patellofemoral cartilage restorative or palliative surgery and index cartilage restorative surgery with and without concomitant TTO.</div></div><div><h3>Results</h3><div>In total, 502 patients were identified who underwent patellofemoral cartilage restorative surgery, and 61,354 patients underwent patellofemoral cartilage palliative surgery. ACI accounted for nearly half of all patellofemoral cartilage restoration procedures and increased 32% in utilization. Patients who underwent ACI were on average 4 years younger and were more likely to receive a concomitant TTO than those who underwent OCA or OAT. Patients who underwent chondroplasty were older and less likely to undergo revision cartilage restoration. The 5-year revision rates were respectively 16.6%, 13.8%, and 12.7% for ACI, OAT, and OCA, although less than 3% accounted for revision cartilage restoration. Isolated ACI had the highest odds for revision (odds ratio, 10.13; <em>P</em> &lt; .001), although the addition of TTO attenuated those odds, with concomitant TTO and ACI having the lowest odds of revision of any procedure (odds ratio, 1.75; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Concomitant TTO with ACI for patellofemoral cartilage disorders is associated with lower odds of revision patellofemoral cartilage restorative or palliative surgery than ACI without TTO when compared to other cartilage restoration procedures.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101286"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fossa-Foveolar Mismatch Is Highest in Dysplastic Hips and During External Rotation","authors":"Vera M. Stetzelberger M.D. ,&nbsp;Cem Cek M.Sc. ,&nbsp;Jannine T. Segessenmann M.Sc. ,&nbsp;Vlad Popa M.D. ,&nbsp;Corinne A. Zurmuehle M.D. ,&nbsp;Joseph M. Schwab M.D. ,&nbsp;Moritz Tannast M.D.","doi":"10.1016/j.asmr.2025.101288","DOIUrl":"10.1016/j.asmr.2025.101288","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify which hip pathomorphologies and motions are associated with a high fossa-foveolar mismatch (FFM) index.</div></div><div><h3>Methods</h3><div>Three-dimensional models of hips with femoroacetabular impingement syndrome or developmental dysplasia of the hip (DDH) and control hips were analyzed. Simulations of the physiological range of motion and impingement tests were performed using validated collision detection software. The FFM index—the proportion of the fovea tracking outside the acetabular fossa—was calculated for each motion.</div></div><div><h3>Results</h3><div>A total of 183 hips with femoroacetabular impingement syndrome and 22 control hips were included. DDH hips showed the highest FFM index (median 0.4), followed by hips with excessive femoral version (median 0.3). Controls had the lowest values (median 0.2). External rotation had the highest FFM in all groups. Motions such as flexion, extension, and abduction had the lowest FFM values.</div></div><div><h3>Conclusions</h3><div>DDH and excessive femoral version were linked to increased FFM, while hips from the control group presented the lowest mismatch. From all analyzed motions, the highest FFM was found in external rotation in all groups.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101288"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Use and Pain Decrease Between Days 3 and 7 After Quadriceps Tendon Anterior Cruciate Ligament Reconstruction in Adolescents","authors":"Christopher J. DeFrancesco M.D. ,&nbsp;Morgan Swanson B.A. ,&nbsp;Brendan A. Williams M.D. ,&nbsp;Vineet M. Desai M.D. ,&nbsp;Richa Gandhi B.A. ,&nbsp;Divya Talwar Ph.D. ,&nbsp;Theodore J. Ganley M.D.","doi":"10.1016/j.asmr.2025.101289","DOIUrl":"10.1016/j.asmr.2025.101289","url":null,"abstract":"<div><h3>Purpose</h3><div>To detail pain levels and opioid consumption in the week following quadriceps tendon autograft (QT) anterior cruciate ligament (ACL) reconstruction among adolescents.</div></div><div><h3>Methods</h3><div>Adolescents (&lt;19 years) undergoing ACL reconstruction with QT using an all-inside technique were enrolled at the time of surgery. All underwent general anesthesia with femoral and sciatic nerve blocks. A subset had an indwelling femoral nerve catheter until postoperative day (POD) 2. Numeric Rating Scale pain level (scale 0-10) and opioid use at defined intervals (4 PM to 12 AM the evening of surgery, 12 AM to 8 AM on POD1, 8 AM to 4 PM on POD1, POD3, and POD7) were recorded via surveys. Patients who did not return at least half of their pain surveys were excluded, and all had a minimum of POD3 follow-up. Pain levels were summarized, and pairwise comparisons between the subgroups with and without femoral nerve catheters were done. Univariate tests were performed to evaluate the association between recorded variables and outcomes of POD3 opioid use or POD3 pain ≥5.</div></div><div><h3>Results</h3><div>Fifty-eight patients were included. A median of 15 tablets of 5 mg of oxycodone were prescribed. On POD3, 26.8% of patients reported pain ≥5, and 26.8% reported opioid use. On POD7, 5.5% of patients reported pain ≥5, and 3.6% reported opioid use. In total, 35.2% never reported opioid use. Patients with indwelling femoral nerve catheters had lower opioid consumption during the 12 AM to 8 AM timeframe the night after surgery (0% vs 37.8%, <em>P</em> = .006), despite similar pain scores in this time frame (median 3/10 vs 4/10, <em>P</em> = .153). Only 1 opioid refill was required.</div></div><div><h3>Conclusions</h3><div>In adolescents, moderate pain may persist for 3 days after ACL reconstruction with QT, even with regional blocks. However, both substantial pain and opioid use are uncommon at POD7.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101289"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Inferior Capsular Thickness on Magnetic Resonance Imaging Is Associated With Adhesive Capsulitis of the Hip","authors":"Deepak V. Chona M.D. ,&nbsp;Galvin J. Loughran M.D. ,&nbsp;James Yoon M.D. ,&nbsp;Kingsley Oladeji M.D. ,&nbsp;Alan D. Workman M.D. ,&nbsp;Robert D. Boutin M.D. ,&nbsp;Marc R. Safran M.D.","doi":"10.1016/j.asmr.2025.101291","DOIUrl":"10.1016/j.asmr.2025.101291","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate magnetic resonance imaging (MRI) findings associated with adhesive capsulitis of the hip and identify differences in capsular thickness between patients with the diagnosis and controls matched by age, sex, and body mass index (BMI).</div></div><div><h3>Methods</h3><div>Consecutive patients with the diagnosis of adhesive capsulitis of the hip were identified and included for retrospective chart review and compared with an equal number of age, sex, and BMI-matched controls. Patients were excluded if they had prior hip surgery or did not have an MRI or magnetic resonance arthrography (MRA) obtained at our institution to allow for calibrated measurement. Quantitative data were collected on capsular thickness in 4 locations (anterior, posterior, superior, inferior) and MRA filling ratios. Nonquantitative data were collected regarding the presence or absence of labral tears.</div></div><div><h3>Results</h3><div>Fourteen patients were included along with 14 controls. Patients with adhesive capsulitis have significantly thicker inferior capsules compared with controls (3.43 vs 2.50 mm; <em>P</em> = .014). Anterior (3.93 vs 3.86 mm; <em>P</em> = .923), posterior (3.57 vs 3.14 mm; <em>P</em> = .362), and superior (5.29 vs 3.57 mm; <em>P</em> = .156) capsular thickness, as well as filling ratios, did not differ in a statistically significant manner. Categorical evaluation of labral tearing did not demonstrate statistically significant differences.</div></div><div><h3>Conclusions</h3><div>Adhesive capsulitis of the hip is associated with thicker inferior joint capsules compared to age, sex, and BMI-matched controls. No differences were found in the thickness of anterior, posterior, or superior joint capsules.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective diagnostic case-control.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101291"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Delay Beyond Three Months for Primary Anterior Cruciate Ligament Reconstruction Does not Increase Risk of Medial Meniscal Ramp Lesions or Lateral Root Tears","authors":"Sandra Wan MBBS,&nbsp;W P Yau MBBS, FRSCSEd, FRCSEd (Ortho), FHKCOS, FHKAM","doi":"10.1016/j.asmr.2025.101292","DOIUrl":"10.1016/j.asmr.2025.101292","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the percentages of full-thickness meniscal tears per anterior cruciate ligament reconstruction (ACLR) at the time of primary ACLR and the contributions of individual tear patterns, specifically ramp lesions and root tears, to the overall prevalence of tears.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study included patients from 2007 to 2021. The inclusion criteria were patients who underwent primary ACLR. Patients were excluded if they had suffered from multiligamentous injuries, were skeletally immature, or had missing information regarding the outcomes. The outcomes included the presence of full-thickness meniscal tears detected during arthroscopy, the tear pattern according to the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine classification, and the time between injury and ACLR. Follow-up data were not collected.</div></div><div><h3>Results</h3><div>Among 731 patients, 606 were male, and 125 were female. The mean age was 28 ± 8 years, with an average time between injury and surgery of 539 ± 988 days. The primary causes of injury were soccer (38%) and basketball (32%). Medial meniscal (MM) tears occurred in 43.7% knees, while lateral meniscal (LM) tears occurred in 47.5% of patients. Ramp lesions accounted for 46.9% of all MM tears, and root tears accounted for 15.8% of all LM tears. As the time from injury to ACLR increased, MM tears significantly increased (<em>P</em> &lt; .001). However, the time between injury and ACLR was not able to discriminate between the presence or absence of lateral meniscus tears (<em>P</em> = 0.84), ramp lesions (<em>P</em> = .06), or root tears (<em>P</em> = .16).</div></div><div><h3>Conclusions</h3><div>Aside from the initial 3 months postinjury, the percentage of medial meniscal tears per ACLR steadily increases with increasing time elapsed from injury to surgery, whereas the percentage of lateral meniscal tears per ACLR remains unchanged. Increased surgical delay is not associated with a higher chance of ramp lesions or lateral meniscus root tears observed at the time of primary ACLR.</div></div><div><h3>Level of Evidence</h3><div>Level III: Retrospective cross-sectional study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101292"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}