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In Patients With Bilateral Rotator Cuff Tear, Staged Surgery is Superior to Simultaneous Surgery: A Systematic Review
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101033
Gaston Davis B.S. , Usman Zareef B.A. , Andres Perez B.A. , Ryan W. Paul B.S. , Daniel Givner B.S. , Brandon J. Erickson M.D. , Kevin B. Freedman M.D. , Steven B. Cohen M.D. , Fotios P. Tjoumakaris M.D.

Purpose

To compare revision rates and functional outcomes between patients who underwent staged versus simultaneous bilateral rotator cuff repair (RCR).

Methods

This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with no institutional review board approval or funding required. The PubMed, SportDiscus, and Ovid Medline databases were queried to identify original research studies evaluating preoperative characteristics and postoperative outcomes of staged or simultaneous RCR. The following search algorithm was used: ((Bilateral) OR (simultaneous) OR (Staged)) AND (rotator cuff repair). Demographics including the number of male and female patients, age, type of surgical intervention, time between staged surgery, and surgical indication were collected. Variables of interest included pre- and postoperative shoulder pain and functional scores, as well as retear, reoperation, revision, complications, and their rates of occurrence.

Results

Overall, 594 studies were screened, and 8 studies were included in this systematic review. In total, 11,188 patients (97.5%) underwent staged repair and 286 (2.5%) underwent simultaneous repair. Delaying staged surgery by more than 2 years also had decreased surgical complications such as conversion to reverse total shoulder arthroplasty, postoperative infection, venous thromboembolism, and emergency department visits when compared with simultaneous RCR (P ≤ .031) and earlier staging (less than 3 months) (P ≤ .015). In addition, one study found staged RCR had better patient-reported outcome measures (University of California-Los Angeles, Constant, and American Shoulder and Elbow Surgeons scores; P < .001) when staged greater than 9 months apart.

Conclusions

Staged RCR has superior functional outcomes, decreased surgical complications, as well as lower revision rates than simultaneous RCR.

Level of Evidence

Level IV, systematic review of Level II-IV studies.
{"title":"In Patients With Bilateral Rotator Cuff Tear, Staged Surgery is Superior to Simultaneous Surgery: A Systematic Review","authors":"Gaston Davis B.S. ,&nbsp;Usman Zareef B.A. ,&nbsp;Andres Perez B.A. ,&nbsp;Ryan W. Paul B.S. ,&nbsp;Daniel Givner B.S. ,&nbsp;Brandon J. Erickson M.D. ,&nbsp;Kevin B. Freedman M.D. ,&nbsp;Steven B. Cohen M.D. ,&nbsp;Fotios P. Tjoumakaris M.D.","doi":"10.1016/j.asmr.2024.101033","DOIUrl":"10.1016/j.asmr.2024.101033","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare revision rates and functional outcomes between patients who underwent staged versus simultaneous bilateral rotator cuff repair (RCR).</div></div><div><h3>Methods</h3><div>This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with no institutional review board approval or funding required. The PubMed, SportDiscus, and Ovid Medline databases were queried to identify original research studies evaluating preoperative characteristics and postoperative outcomes of staged or simultaneous RCR. The following search algorithm was used: ((Bilateral) OR (simultaneous) OR (Staged)) AND (rotator cuff repair). Demographics including the number of male and female patients, age, type of surgical intervention, time between staged surgery, and surgical indication were collected. Variables of interest included pre- and postoperative shoulder pain and functional scores, as well as retear, reoperation, revision, complications, and their rates of occurrence.</div></div><div><h3>Results</h3><div>Overall, 594 studies were screened, and 8 studies were included in this systematic review. In total, 11,188 patients (97.5%) underwent staged repair and 286 (2.5%) underwent simultaneous repair. Delaying staged surgery by more than 2 years also had decreased surgical complications such as conversion to reverse total shoulder arthroplasty, postoperative infection, venous thromboembolism, and emergency department visits when compared with simultaneous RCR (<em>P</em> ≤ .031) and earlier staging (less than 3 months) (<em>P</em> ≤ .015). In addition, one study found staged RCR had better patient-reported outcome measures (University of California-Los Angeles, Constant, and American Shoulder and Elbow Surgeons scores; <em>P</em> &lt; .001) when staged greater than 9 months apart.</div></div><div><h3>Conclusions</h3><div>Staged RCR has superior functional outcomes, decreased surgical complications, as well as lower revision rates than simultaneous RCR.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level II-IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101033"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386633","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
Lateral Meniscal Oblique Radial Tears Were Observed Concomitantly With Anterior Cruciate Ligament Tears in 6% of Pediatric Patients Undergoing Anterior Cruciate Ligament Reconstruction
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101012
John F. Burke M.D., Emma L. Klosterman M.D., Adam J. Tagliero M.D., Neil P. Blanchard M.D., Royce Le B.S., Antonio Almario B.S., David R. Diduch M.D.

Purpose

To identify the incidence of lateral meniscal oblique radial tears (LMORTs) concomitant with anterior cruciate ligament (ACL) tears in pediatric patients undergoing ACL reconstruction.

Methods

A single-center retrospective cohort design was used to analyze all patients 18 years and younger undergoing ACL reconstruction between July 2017 and February 2023. Operative notes and intraoperative arthroscopic photos were analyzed to determine the incidence of LMORTs. Two independent observers reviewed the images and reached agreement on LMORT incidence and classification of each tear. Demographic, clinical, and outcomes data were collected and analyzed.

Results

Lateral meniscal oblique radial tears were identified in 19 of 310 (6.13%) adolescent and pediatric ACL reconstruction cases. Of these patients, 68.4% were male. All but one patient had signs of lateral meniscus injury on preoperative magnetic resonance imaging. Of the LMORT patients, 7 (37%) had a type 1 tear, 1 (5%) had a type 2 tear, 7 (37%) had a type 3 tear, and 4 (21%) had a type 4 tear.

Conclusions

Lateral meniscal oblique radial tears were observed concomitantly with ACL tears in 6% of pediatric patients undergoing ACL reconstruction.

Clinical Relevance

Awareness and recognition of LMORTs is important as the treatment paradigm for LMORT injuries continues to evolve.
{"title":"Lateral Meniscal Oblique Radial Tears Were Observed Concomitantly With Anterior Cruciate Ligament Tears in 6% of Pediatric Patients Undergoing Anterior Cruciate Ligament Reconstruction","authors":"John F. Burke M.D.,&nbsp;Emma L. Klosterman M.D.,&nbsp;Adam J. Tagliero M.D.,&nbsp;Neil P. Blanchard M.D.,&nbsp;Royce Le B.S.,&nbsp;Antonio Almario B.S.,&nbsp;David R. Diduch M.D.","doi":"10.1016/j.asmr.2024.101012","DOIUrl":"10.1016/j.asmr.2024.101012","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify the incidence of lateral meniscal oblique radial tears (LMORTs) concomitant with anterior cruciate ligament (ACL) tears in pediatric patients undergoing ACL reconstruction.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort design was used to analyze all patients 18 years and younger undergoing ACL reconstruction between July 2017 and February 2023. Operative notes and intraoperative arthroscopic photos were analyzed to determine the incidence of LMORTs. Two independent observers reviewed the images and reached agreement on LMORT incidence and classification of each tear. Demographic, clinical, and outcomes data were collected and analyzed.</div></div><div><h3>Results</h3><div>Lateral meniscal oblique radial tears were identified in 19 of 310 (6.13%) adolescent and pediatric ACL reconstruction cases. Of these patients, 68.4% were male. All but one patient had signs of lateral meniscus injury on preoperative magnetic resonance imaging. Of the LMORT patients, 7 (37%) had a type 1 tear, 1 (5%) had a type 2 tear, 7 (37%) had a type 3 tear, and 4 (21%) had a type 4 tear.</div></div><div><h3>Conclusions</h3><div>Lateral meniscal oblique radial tears were observed concomitantly with ACL tears in 6% of pediatric patients undergoing ACL reconstruction.</div></div><div><h3>Clinical Relevance</h3><div>Awareness and recognition of LMORTs is important as the treatment paradigm for LMORT injuries continues to evolve.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101012"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386715","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
Patients with Frozen-Phase Frozen Shoulder Demonstrated Improvement of Pain and Mobility of Forward Elevation and Internal Rotation After a Single Glenohumeral Injection of Corticosteroids
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101025
Wei-Hsuan Wang , Poyu Chen Ph.D. , Louis Yi Lu M.D. , Cheng-Pang Yang M.D. , Joe Chih-Hao Chiu M.D., Ph.D.

Purpose

To investigate the improvement in frozen-phase frozen shoulder (FS) patients’ pain and shoulder mobility, including passive forward elevation (FE), external rotation (ER), and internal rotation (IR), after 2 consecutive intra-articular corticosteroid (IACS) injections.

Methods

This retrospective cohort study was performed from July 2020 to November 2023. All patients with frozen-phase FS received 2 ultrasound-guided IACS injections at 6-week intervals. FE, ER, IR, and visual analog scale scores were measured at each follow-up consultation with a 6-week interval.

Results

A total of 134 patients finished the study. There were varying degrees of change in pain relief and range-of-motion improvement between each IACS injection. FE and IR improved significantly between the first and second injections (P = 5.2 × 1024 and 1.1 × 1021, respectively), whereas ER only improved significantly after the second injection (P < .05). The pain level improved both after the first injection and after the second injection (both p < .001).

Conclusions

Patients with frozen-phase FS show improved pain, FE mobility, and IR mobility after a single IACS injection. However, a second IACS injection provides similar therapeutic effects and significantly improves ER mobility.

Level of Evidence

Level III, retrospective cohort study.
{"title":"Patients with Frozen-Phase Frozen Shoulder Demonstrated Improvement of Pain and Mobility of Forward Elevation and Internal Rotation After a Single Glenohumeral Injection of Corticosteroids","authors":"Wei-Hsuan Wang ,&nbsp;Poyu Chen Ph.D. ,&nbsp;Louis Yi Lu M.D. ,&nbsp;Cheng-Pang Yang M.D. ,&nbsp;Joe Chih-Hao Chiu M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101025","DOIUrl":"10.1016/j.asmr.2024.101025","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the improvement in frozen-phase frozen shoulder (FS) patients’ pain and shoulder mobility, including passive forward elevation (FE), external rotation (ER), and internal rotation (IR), after 2 consecutive intra-articular corticosteroid (IACS) injections.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was performed from July 2020 to November 2023. All patients with frozen-phase FS received 2 ultrasound-guided IACS injections at 6-week intervals. FE, ER, IR, and visual analog scale scores were measured at each follow-up consultation with a 6-week interval.</div></div><div><h3>Results</h3><div>A total of 134 patients finished the study. There were varying degrees of change in pain relief and range-of-motion improvement between each IACS injection. FE and IR improved significantly between the first and second injections (<em>P</em> = 5.2 × 10<sup>−</sup><sup>24</sup> and 1.1 × 10<sup>−</sup><sup>21</sup>, respectively), whereas ER only improved significantly after the second injection (<em>P</em> &lt; .05). The pain level improved both after the first injection and after the second injection (both <em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Patients with frozen-phase FS show improved pain, FE mobility, and IR mobility after a single IACS injection. However, a second IACS injection provides similar therapeutic effects and significantly improves ER mobility.</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 101025"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386716","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
Larger Zona Orbicularis Size on Magnetic Resonance Imaging Is Not Associated With Increased Resistance to Axial Distraction of the Hip Joint
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.100989
Allan K. Metz M.D. , Joseph Featherall M.D. , Ameen Z. Khalil M.S. , Reece M. Rosenthal B.S. , Collin D.R. Hunter B.S. , Daniel C. Lewis M.D. , Stephen K. Aoki M.D.

Purpose

To evaluate the relation between zona orbicularis (ZO) thickness on magnetic resonance imaging and distractibility of the hip in patients undergoing hip arthroscopy.

Methods

We conducted a retrospective review of primary hip arthroscopy patients treated for femoroacetabular impingement syndrome from December 2021 to September 2022. Prior to arthroscopy, hips were subjected to 100 lb of force (lbf) with fluoroscopic images taken to calculate joint space and overall distraction distance. The ZO was measured on coronal sequences of preoperative magnetic resonance imaging or magnetic resonance arthrography. Multivariable linear regression was performed and controlled for age, sex, body mass index, and lateral center-edge angle.

Results

Sixty-eight patients were included in the final analysis. The mean age was 34.5 ± 12.4 years. The mean joint space at 100-lbf axial traction was 11.0 ± 3.8 mm, and the mean distraction distance was 6.6 ± 3.7 mm. The mean ZO size was 3.2 ± 1.0 mm. Linear regression showed no relation between ZO size and joint space at 100 lbf (β = –0.109, R = 0.107, P = .842). The results of our linear regression analysis also showed no significant association between ZO size and overall distraction distance (β = –0.15, R = 0.108, P = .977).

Conclusions

The results of this study show no significant association between ZO size and resistance to axial traction at the hip joint.

Clinical Relevance

Our results suggest that the resistance to axial traction on the hip from the ZO is conferred by its overall integrity and presence—and is not dependent on its size—and that, likely, deviations in other soft-tissue restraints contribute to the spectrum of hip stability experienced by patients.
{"title":"Larger Zona Orbicularis Size on Magnetic Resonance Imaging Is Not Associated With Increased Resistance to Axial Distraction of the Hip Joint","authors":"Allan K. Metz M.D. ,&nbsp;Joseph Featherall M.D. ,&nbsp;Ameen Z. Khalil M.S. ,&nbsp;Reece M. Rosenthal B.S. ,&nbsp;Collin D.R. Hunter B.S. ,&nbsp;Daniel C. Lewis M.D. ,&nbsp;Stephen K. Aoki M.D.","doi":"10.1016/j.asmr.2024.100989","DOIUrl":"10.1016/j.asmr.2024.100989","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the relation between zona orbicularis (ZO) thickness on magnetic resonance imaging and distractibility of the hip in patients undergoing hip arthroscopy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of primary hip arthroscopy patients treated for femoroacetabular impingement syndrome from December 2021 to September 2022. Prior to arthroscopy, hips were subjected to 100 lb of force (lbf) with fluoroscopic images taken to calculate joint space and overall distraction distance. The ZO was measured on coronal sequences of preoperative magnetic resonance imaging or magnetic resonance arthrography. Multivariable linear regression was performed and controlled for age, sex, body mass index, and lateral center-edge angle.</div></div><div><h3>Results</h3><div>Sixty-eight patients were included in the final analysis. The mean age was 34.5 ± 12.4 years. The mean joint space at 100-lbf axial traction was 11.0 ± 3.8 mm, and the mean distraction distance was 6.6 ± 3.7 mm. The mean ZO size was 3.2 ± 1.0 mm. Linear regression showed no relation between ZO size and joint space at 100 lbf (β = –0.109, <em>R</em> = 0.107, <em>P</em> = .842). The results of our linear regression analysis also showed no significant association between ZO size and overall distraction distance (β = –0.15, <em>R</em> = 0.108, <em>P</em> = .977).</div></div><div><h3>Conclusions</h3><div>The results of this study show no significant association between ZO size and resistance to axial traction at the hip joint.</div></div><div><h3>Clinical Relevance</h3><div>Our results suggest that the resistance to axial traction on the hip from the ZO is conferred by its overall integrity and presence—and is not dependent on its size—and that, likely, deviations in other soft-tissue restraints contribute to the spectrum of hip stability experienced by patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 100989"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386630","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
Low Rates of 30-Day Postoperative Complications After Meniscal Allograft Transplantation: A Retrospective Study Using the National Surgical Quality Improvement Program Database
Q3 Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.asmr.2024.101015
Sarah Whitaker B.A. , Conor O’Neill M.D. , James Satalich M.D. , Omar Protzuk M.D. , Carl Edge M.D. , Eoghan Hurley M.B., M.Ch., Ph.D. , Annunziato Amendola M.D. , Alexander Vap M.D.

Purpose

To determine the short-term (30-day) postoperative complication rates in patients undergoing meniscus allograft transplantation (MAT).

Methods

The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who had undergone MAT from 2014 to 2021 using Current Procedural Terminology codes. Patients were excluded if they did not have sufficient demographic data, namely those without data for age, sex, body mass index, preoperative functional status, American Society of Anesthesiologists classification, operative time, and length of hospital stay. Postoperative complications within 30 days were identified, and rates of complications were examined as the primary outcome of this study. As a secondary outcome, multivariate logistic regression was used to identify risk factors associated with the 30-day incidence of postoperative complications. Subgroup analysis was performed to analyze differences in postoperative outcomes after isolated MAT versus MAT with concomitant ligament reconstruction/repair, cartilage preservation, or realignment osteotomy.

Results

A total of 396 meniscal transplants were identified, with mean age of 35.2 ± 14.9, mean body mass index of 29.6 ± 6.7, mean length of stay of 0.5 ± 1.8 days. Eleven patients experienced any adverse event. Specific complications included surgical-site infections (5), deep-vein thrombosis (1), urinary tract infection (3), and return to the operating room (2). On subgroup analysis, there was no significant difference between any adverse event rates in patients undergoing MAT with concomitant procedures compared with patients undergoing isolated MAT (7 vs 4, P = .5).

Conclusions

Patients who underwent MAT had an overall complication rate of 2.8% in the short-term postoperative period (≤30 days). Patients undergoing MAT with concomitant ligament reconstruction/repair, cartilage preservation, and realignment osteotomy had similar rates of all postoperative complications when compared with patients undergoing isolated MAT.

Level of Evidence

Level IV, therapeutic case series.
{"title":"Low Rates of 30-Day Postoperative Complications After Meniscal Allograft Transplantation: A Retrospective Study Using the National Surgical Quality Improvement Program Database","authors":"Sarah Whitaker B.A. ,&nbsp;Conor O’Neill M.D. ,&nbsp;James Satalich M.D. ,&nbsp;Omar Protzuk M.D. ,&nbsp;Carl Edge M.D. ,&nbsp;Eoghan Hurley M.B., M.Ch., Ph.D. ,&nbsp;Annunziato Amendola M.D. ,&nbsp;Alexander Vap M.D.","doi":"10.1016/j.asmr.2024.101015","DOIUrl":"10.1016/j.asmr.2024.101015","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the short-term (30-day) postoperative complication rates in patients undergoing meniscus allograft transplantation (MAT).</div></div><div><h3>Methods</h3><div>The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who had undergone MAT from 2014 to 2021 using Current Procedural Terminology codes. Patients were excluded if they did not have sufficient demographic data, namely those without data for age, sex, body mass index, preoperative functional status, American Society of Anesthesiologists classification, operative time, and length of hospital stay. Postoperative complications within 30 days were identified, and rates of complications were examined as the primary outcome of this study. As a secondary outcome, multivariate logistic regression was used to identify risk factors associated with the 30-day incidence of postoperative complications. Subgroup analysis was performed to analyze differences in postoperative outcomes after isolated MAT versus MAT with concomitant ligament reconstruction/repair, cartilage preservation, or realignment osteotomy.</div></div><div><h3>Results</h3><div>A total of 396 meniscal transplants were identified, with mean age of 35.2 ± 14.9, mean body mass index of 29.6 ± 6.7, mean length of stay of 0.5 ± 1.8 days. Eleven patients experienced any adverse event. Specific complications included surgical-site infections (5), deep-vein thrombosis (1), urinary tract infection (3), and return to the operating room (2). On subgroup analysis, there was no significant difference between any adverse event rates in patients undergoing MAT with concomitant procedures compared with patients undergoing isolated MAT (7 vs 4, <em>P</em> = .5).</div></div><div><h3>Conclusions</h3><div>Patients who underwent MAT had an overall complication rate of 2.8% in the short-term postoperative period (≤30 days). Patients undergoing MAT with concomitant ligament reconstruction/repair, cartilage preservation, and realignment osteotomy had similar rates of all postoperative complications when compared with patients undergoing isolated MAT.</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 101015"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386717","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
Male National Basketball Association G-League and Collegiate Basketball Athletes Have a High Prevalence of Radiographic Ankle Abnormalities NBA G 联盟和大学篮球队的男性运动员踝关节放射学异常的患病率很高
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.asmr.2024.100980
Krishna Mandalia B.S. , Ryan Harrington M.D. , Albert Mousad B.S. , Bryan Jenkin B.S. , Katharine Ives B.S. , Sarav Shah M.D.

Purpose

To characterize radiographic foot/ankle bony abnormalities in elite-level, asymptomatic male basketball athletes and to investigate the association between anthropometric (age, height, weight) or sport-specific characteristics (total exposures, player position, pregame ankle taping) and the prevalence of abnormal radiographic findings in asymptomatic basketball athletes.

Methods

Elite-level basketball players who underwent routine, preseason static radiographic imaging, including anteroposterior, lateral, and mortise views of the ankle were included. Radiographs were collected from asymptomatic athletes participating in preseason history and physical with negative anterior drawer/talar tilt test. Radiographs were evaluated by a musculoskeletal radiologist and board-certified orthopaedic surgeon; kappa statistics were used to evaluate agreement.

Results

Fifty-four basketball players (34 collegiate, 20 professional; mean age 21.5 years) were included, totaling 5,148 player exposures from 2017 to 2019. In total, 106 ankles presented with radiographic findings (98.15%). The most prevalent radiographic finding was pes planus (47.22%), followed by degenerative joint disease (DJD; 33.33%), talonavicular sclerosis (28.70%), prominent stieda process (25.93%), os trigonum (20.93%), os subfibulare (11.11%), pes cavus (5.56%), subtalar coalition (2.78%), and cavovarus (0.93%). Height ≥80 inches was significantly associated with talonavicular sclerosis and Kellgren-Lawrence 1 changes.

Conclusions

This study showed a strong association between height and talonavicular sclerosis and DJD, as well as a relatively high prevalence of pes planus and DJD in asymptomatic collegiate and professional basketball players.

Level of Evidence

Level II; Cross-sectional study.
{"title":"Male National Basketball Association G-League and Collegiate Basketball Athletes Have a High Prevalence of Radiographic Ankle Abnormalities","authors":"Krishna Mandalia B.S. ,&nbsp;Ryan Harrington M.D. ,&nbsp;Albert Mousad B.S. ,&nbsp;Bryan Jenkin B.S. ,&nbsp;Katharine Ives B.S. ,&nbsp;Sarav Shah M.D.","doi":"10.1016/j.asmr.2024.100980","DOIUrl":"10.1016/j.asmr.2024.100980","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize radiographic foot/ankle bony abnormalities in elite-level, asymptomatic male basketball athletes and to investigate the association between anthropometric (age, height, weight) or sport-specific characteristics (total exposures, player position, pregame ankle taping) and the prevalence of abnormal radiographic findings in asymptomatic basketball athletes.</div></div><div><h3>Methods</h3><div>Elite-level basketball players who underwent routine, preseason static radiographic imaging, including anteroposterior, lateral, and mortise views of the ankle were included. Radiographs were collected from asymptomatic athletes participating in preseason history and physical with negative anterior drawer/talar tilt test. Radiographs were evaluated by a musculoskeletal radiologist and board-certified orthopaedic surgeon; kappa statistics were used to evaluate agreement.</div></div><div><h3>Results</h3><div>Fifty-four basketball players (34 collegiate, 20 professional; mean age 21.5 years) were included, totaling 5,148 player exposures from 2017 to 2019. In total, 106 ankles presented with radiographic findings (98.15%). The most prevalent radiographic finding was pes planus (47.22%), followed by degenerative joint disease (DJD; 33.33%), talonavicular sclerosis (28.70%), prominent stieda process (25.93%), os trigonum (20.93%), os subfibulare (11.11%), pes cavus (5.56%), subtalar coalition (2.78%), and cavovarus (0.93%). Height ≥80 inches was significantly associated with talonavicular sclerosis and Kellgren-Lawrence 1 changes.</div></div><div><h3>Conclusions</h3><div>This study showed a strong association between height and talonavicular sclerosis and DJD, as well as a relatively high prevalence of pes planus and DJD in asymptomatic collegiate and professional basketball players.</div></div><div><h3>Level of Evidence</h3><div>Level II; Cross-sectional study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 6","pages":"Article 100980"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841701","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
Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Osteotomy Has a Lower Risk of Recurrent Instability Requiring Revision Stabilization at 2 Years Than Either Procedure Alone 髌股内侧韧带重建术联合胫骨结节截骨术在2年内需要翻修稳定的复发性不稳定风险较单独手术低。
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.asmr.2024.100994
Alexander R. Markes M.D., Ramesh B. Ghanta M.D., Alan L. Zhang M.D., C.Benjamin Ma M.D., Brian T. Feeley M.D., Drew A. Lansdown M.D.

Purpose

To use a large nationwide administrative database to directly compare usage, complications, and need for revision stabilization surgery after medial patellofemoral ligament reconstruction (MPLFR), tibial tubercle osteotomy (TTO), and combined MPFLR and TTO (MPFLRTTO).

Methods

The PearlDiver Mariner database was queried for all reported cases of MPLFR, TTO, and combined MPFLRTTO performed between 2010 and 2020 using Current Procedural Terminology codes. Subsets from those cohorts with laterality-specific International Classification of Diseases, Tenth Revision, codes for patellar instability were used to evaluate 2-year incidence of infection, stiffness, fracture, and revision stabilization with MPFLR and/or TTO. Multiple linear regression and χ2 analysis were used to analyze incidence trends and to compare complication rates.

Results

A total of 70,070 patients were identified. MPFLR was found to be the most common procedure (73.1%), followed by TTO (19.2%) and then MPFLRTTO (7.6%). MPLFR was observed to have the lowest overall complication rate (5.4%), whereas both TTO (7.5%) and MPFLRTTO (7.1%) had greater complication rates (P < .001). MPFLR had the greatest rate of revision stabilization surgery at 3.7% compared with TTO at 2.7% and MPFLRTTO, which carried the lowest risk for revision at 2.4% (P < .001).

Conclusions

Isolated MPFLR is the most common modality used for patellar instability, with increasing prevalence and the lowest 2-year complication rate. Isolated TTO was unchanged in its use and had the greatest overall complication rate. Combined MPFLRTTO increased the overall complication rate but had a lower 2-year rate of recurrent instability requiring revision than MPFLR alone.

Level of Evidence

Level III, retrospective cohort study.
目的:利用一个全国性的大型管理数据库,直接比较内侧髌股韧带重建术(MPLFR)、胫骨结节截骨术(TTO)和MPFLR联合TTO (MPFLRTTO)后翻修稳定手术的使用、并发症和需求。方法:使用现行程序术语代码查询PearlDiver Mariner数据库中2010年至2020年间所有报告的MPLFR、TTO和联合MPFLRTTO病例。来自这些具有侧侧特异性国际疾病分类第十版髌骨不稳定代码的队列的亚群被用于评估2年感染、僵硬、骨折的发生率,以及MPFLR和/或TTO的翻修稳定性。采用多元线性回归和χ2分析发病率趋势,比较并发症发生率。结果:共发现70,070例患者。MPFLR是最常见的手术(73.1%),其次是TTO(19.2%)和MPFLRTTO(7.6%)。观察到MPLFR的总并发症发生率最低(5.4%),而TTO(7.5%)和MPFLRTTO(7.1%)的并发症发生率更高(P < 0.001)。MPFLR的翻修稳定手术率最高,为3.7%,而TTO为2.7%,MPFLRTTO的翻修稳定手术风险最低,为2.4% (P < 0.001)。结论:孤立性MPFLR是治疗髌骨不稳最常见的方式,其发病率不断上升,2年并发症发生率最低。孤立性TTO的使用没有变化,其总并发症发生率最高。联合MPFLRTTO增加了总体并发症发生率,但与单独MPFLR相比,2年内复发性不稳定需要翻修的发生率较低。证据等级:III级,回顾性队列研究。
{"title":"Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Osteotomy Has a Lower Risk of Recurrent Instability Requiring Revision Stabilization at 2 Years Than Either Procedure Alone","authors":"Alexander R. Markes M.D.,&nbsp;Ramesh B. Ghanta 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.2024.100994","DOIUrl":"10.1016/j.asmr.2024.100994","url":null,"abstract":"<div><h3>Purpose</h3><div>To use a large nationwide administrative database to directly compare usage, complications, and need for revision stabilization surgery after medial patellofemoral ligament reconstruction (MPLFR), tibial tubercle osteotomy (TTO), and combined MPFLR and TTO (MPFLRTTO).</div></div><div><h3>Methods</h3><div>The PearlDiver Mariner database was queried for all reported cases of MPLFR, TTO, and combined MPFLRTTO performed between 2010 and 2020 using Current Procedural Terminology codes. Subsets from those cohorts with laterality-specific <em>International Classification of Diseases</em>, <em>Tenth Revision</em>, codes for patellar instability were used to evaluate 2-year incidence of infection, stiffness, fracture, and revision stabilization with MPFLR and/or TTO. Multiple linear regression and χ<sup>2</sup> analysis were used to analyze incidence trends and to compare complication rates.</div></div><div><h3>Results</h3><div>A total of 70,070 patients were identified. MPFLR was found to be the most common procedure (73.1%), followed by TTO (19.2%) and then MPFLRTTO (7.6%). MPLFR was observed to have the lowest overall complication rate (5.4%), whereas both TTO (7.5%) and MPFLRTTO (7.1%) had greater complication rates (<em>P</em> &lt; .001). MPFLR had the greatest rate of revision stabilization surgery at 3.7% compared with TTO at 2.7% and MPFLRTTO, which carried the lowest risk for revision at 2.4% (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Isolated MPFLR is the most common modality used for patellar instability, with increasing prevalence and the lowest 2-year complication rate. Isolated TTO was unchanged in its use and had the greatest overall complication rate. Combined MPFLRTTO increased the overall complication rate but had a lower 2-year rate of recurrent instability requiring revision than MPFLR alone.</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":"6 6","pages":"Article 100994"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955986","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
Interleukin-6 and Interleukin-8 Gene Expressions Differ Between Male and Female Patients at Time of Hip Arthroscopy for Femoroacetabular Impingement Syndrome 白细胞介素-6和白细胞介素-8基因表达在股骨髋臼撞击综合征患者髋关节镜检查时的男女差异
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.asmr.2024.100985
Andrea M. Spiker M.D. , Joshua A. Choe Ph.D. , Elizabeth H.G. Turner M.D. , Ray Vanderby Ph.D. , William L. Murphy Ph.D. , Connie S. Chamberlain Ph.D.

Purpose

To identify key molecular components within the femoroacetabular impingement hip and compare the findings between male and female patients across varying age groups.

Methods

All patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) without hip dysplasia were included. During hip arthroscopy, performed at University of Wisconsin Health, loose articular cartilage, excess synovium, damaged labral tissue, and minimal adipose tissue were debrided only as needed for visualization and tissue repair purposes and collected. Tissue was processed and used for quantitative polymerase chain reaction (qPCR). Genes were selected for qPCR on the basis of their associated function in inflammation and/or extracellular matrix remodeling during the progression of osteoarthritis.

Results

A total of 91 male (M) and female (F) patients 15 to 58 years old were included in the study. qPCR results indicated that Interleukin-6 (P < .05, 95% confidence interval [CI] 0.047-0.083 F, 0.070-0.12 M) and Interleukin-8 (P = .04, 95% CI 0.059-0.10 F, 0.082-0.18 M) were significantly greater in male patients compared with female patients regardless of age, and IL6 (P = .02, 95% CI [0.026-0.070] F, [0.067-0.17] M), Interleukin-1ß (P < .01 95% CI [0.013-0.063] F, [0.073-0.25] M), and Matrix metalloproteinase-13 (P = .047, 95% CI [0.0051-0.017] F, [0.0084-0.052] M) were significantly greater in male patients younger than 20 years old compared with female patients younger than 20 years old.

Conclusions

In patients with FAIS, there are significant differences between male and female patients in the biomarkers present in the affected hip at the time of surgery. Male patients have greater levels of IL6 and IL8 and male patients younger than 20 years of age have greater levels of IL1β, IL6, and MMP13 compared with age-matched female patients.

Clinical Relevance

A better understanding of the molecular markers present during varying stages of FAIS and in patients of different ages will help characterize the pathologic process behind FAIS. This may also help define future methods of targeted treatment and prevention of disease progression.
目的:确定股髋臼撞击髋关节内的关键分子成分,并比较不同年龄组男性和女性患者的发现。方法:所有接受髋关节镜检查的无髋关节发育不良的股髋臼撞击综合征(FAIS)患者。在威斯康星健康大学进行的髋关节镜检查中,疏松的关节软骨、多余的滑膜、受损的唇部组织和少量的脂肪组织仅在可视化和组织修复需要时进行清理并收集。组织处理后用于定量聚合酶链反应(qPCR)。根据骨关节炎进展过程中炎症和/或细胞外基质重塑的相关功能,选择基因进行qPCR。结果:共纳入15 ~ 58岁的男(M)、女(F)患者91例。qPCR结果显示,无论年龄大小,男性患者白细胞介素-6 (P < 0.05, 95%可信区间[CI] 0.047 ~ 0.083 F, 0.070 ~ 0.12 M)和白细胞介素-8 (P = 0.04, 95% CI 0.059 ~ 0.10 F, 0.082 ~ 0.18 M)均显著高于女性患者,il -6 (P = 0.02, 95% CI [0.026 ~ 0.070] F, [0.067 ~ 0.17] M)、白细胞介素-1ß (P < 0.01, 95% CI [0.013 ~ 0.063] F, [0.073 ~ 0.25] M)和基质金属蛋白酶-13 (P = 0.047, 95% CI [0.0051 ~ 0.017] F,[0.0084-0.052] M),年龄在20岁以下的男性患者与年龄在20岁以下的女性患者相比显著增高。结论:在FAIS患者中,手术时受影响髋关节的生物标志物在男性和女性患者之间存在显著差异。男性患者的il - 6和il - 8水平高于同龄女性患者,年龄小于20岁的男性患者的il - 1β、il - 6和MMP13水平高于同龄女性患者。临床意义:更好地了解FAIS不同阶段和不同年龄患者的分子标志物将有助于表征FAIS背后的病理过程。这也可能有助于确定未来的靶向治疗和预防疾病进展的方法。
{"title":"Interleukin-6 and Interleukin-8 Gene Expressions Differ Between Male and Female Patients at Time of Hip Arthroscopy for Femoroacetabular Impingement Syndrome","authors":"Andrea M. Spiker M.D. ,&nbsp;Joshua A. Choe Ph.D. ,&nbsp;Elizabeth H.G. Turner M.D. ,&nbsp;Ray Vanderby Ph.D. ,&nbsp;William L. Murphy Ph.D. ,&nbsp;Connie S. Chamberlain Ph.D.","doi":"10.1016/j.asmr.2024.100985","DOIUrl":"10.1016/j.asmr.2024.100985","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify key molecular components within the femoroacetabular impingement hip and compare the findings between male and female patients across varying age groups.</div></div><div><h3>Methods</h3><div>All patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) without hip dysplasia were included. During hip arthroscopy, performed at University of Wisconsin Health, loose articular cartilage, excess synovium, damaged labral tissue, and minimal adipose tissue were debrided only as needed for visualization and tissue repair purposes and collected. Tissue was processed and used for quantitative polymerase chain reaction (qPCR). Genes were selected for qPCR on the basis of their associated function in inflammation and/or extracellular matrix remodeling during the progression of osteoarthritis.</div></div><div><h3>Results</h3><div>A total of 91 male (M) and female (F) patients 15 to 58 years old were included in the study. qPCR results indicated that Interleukin-6 (<em>P</em> &lt; .05, 95% confidence interval [CI] 0.047-0.083 F, 0.070-0.12 M) and Interleukin-8 (<em>P</em> = .04, 95% CI 0.059-0.10 F, 0.082-0.18 M) were significantly greater in male patients compared with female patients regardless of age, and <em>IL6</em> (<em>P</em> = .02, 95% CI [0.026-0.070] F, [0.067-0.17] M), Interleukin-1ß (<em>P</em> &lt; .01 95% CI [0.013-0.063] F, [0.073-0.25] M), and Matrix metalloproteinase-13 (<em>P</em> = .047, 95% CI [0.0051-0.017] F, [0.0084-0.052] M) were significantly greater in male patients younger than 20 years old compared with female patients younger than 20 years old.</div></div><div><h3>Conclusions</h3><div>In patients with FAIS, there are significant differences between male and female patients in the biomarkers present in the affected hip at the time of surgery. Male patients have greater levels of <em>IL6</em> and <em>IL8</em> and male patients younger than 20 years of age have greater levels of <em>IL1β</em>, <em>IL6</em>, and <em>MMP13</em> compared with age-matched female patients.</div></div><div><h3>Clinical Relevance</h3><div>A better understanding of the molecular markers present during varying stages of FAIS and in patients of different ages will help characterize the pathologic process behind FAIS. This may also help define future methods of targeted treatment and prevention of disease progression.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 6","pages":"Article 100985"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956090","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
Pediatric Snowboarding-Related Concussions and Musculoskeletal Injuries Decreased From 2012 to 2022 从2012年到2022年,儿童单板滑雪相关脑震荡和肌肉骨骼损伤减少。
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.asmr.2024.100990
Kyle K. Obana M.D. , Avanish Yendluri B.S. , Mininder S. Kocher M.D., M.P.H. , Theodore J. Ganley M.D. , David P. Trofa M.D. , Robert L. Parisien M.D.

Purpose

To analyze mechanisms, diagnoses, and incidence of youth snowboarding-related injuries presenting to US emergency departments.

Methods

Data from the National Electronic Injury Surveillance System were analyzed for pediatric snowboarding injuries (≤18 years old) from 2012 to 2022. Data were collected for mechanism of injury, diagnosis, location of injury, and disposition. National estimates (NEs) were calculated using the statistical sample weight of the corresponding hospital assigned by the National Electronic Injury Surveillance System. Linear regressions were used to analyze injuries over time.

Results

In total, 3,036 (NEs = 120,140) pediatric snowboarding injuries were included in this study. Average age was 14.0 ± 2.7 years. The most common mechanism of injury was impact with the ground (NEs = 97,120, 80.8%). The most injured body parts were 719 wrists (NEs = 115,505, 96.1%), 580 heads (NEs = 22,258, 18.5%), and 381 shoulders (NEs = 17,269, 14.4%). The most common diagnoses were fractures (NEs = 48,886, 40.7%), strains/sprains (NEs = 22,948, 19.1%), and concussions (NEs = 12,553, 10.4%). Fractures primarily involved the wrist (NEs = 18,122, 37.1%), lower arm (NEs = 12,348, 25.3%), and shoulder (NEs = 9,073, 18.6%). From 2012 to 2022, there were average decreases of 1,051 overall injuries per year (P < .01), 299 fractures per year (P = .04), 298 strains/sprains per year (P < .01), and 143 concussions per year (P < .01). There were average decreases of 784 impact with ground injuries per year (P < .01), 161 not specified injuries per year (P < .01), and 42 impact with inanimate object injuries per year (P = .03) from 2012 to 2022.

Conclusions

Pediatric snowboarding injuries demonstrated a large decline from 2012 to 2022. Fractures are the most common diagnosis, primarily affecting the wrist and shoulder. The head was the second most injured body part, and concussions were the third most common diagnosis.

Clinical Relevance

This study highlights decreasing injuries despite growing popularity of snowboarding, bringing to light the importance of protective equipment, on-site injury management, and implementation of clinics at resort bases.
目的:分析美国急诊科青少年单板滑雪相关损伤的发病机制、诊断和发生率。方法:分析2012 - 2022年美国国家电子伤害监测系统(National Electronic Injury Surveillance System)的儿童单板滑雪损伤(≤18岁)数据。收集损伤机制、诊断、损伤部位和处理的数据。使用国家电子伤害监测系统分配的相应医院的统计样本权重计算国家估计值(NEs)。使用线性回归分析随时间变化的损伤。结果:本研究共纳入3,036例(NEs = 120,140)例儿童单板滑雪损伤。平均年龄14.0±2.7岁。最常见的损伤机制是撞击地面(NEs = 97,120, 80.8%)。其中手腕719例(115,505例,占96.1%),头部580例(22258例,占18.5%),肩部381例(17,269例,占14.4%)。最常见的诊断为骨折(NEs = 48,886, 40.7%),拉伤/扭伤(NEs = 22,948, 19.1%)和脑震荡(NEs = 12,5553, 10.4%)。骨折主要累及腕部(ne = 18,122, 37.1%)、下臂(ne = 12,348, 25.3%)和肩部(ne = 9,073, 18.6%)。2012 - 2022年,平均每年减少损伤1051例(P < 0.01),骨折299例(P = 0.04),拉伤/扭伤298例(P < 0.01),脑震荡143例(P < 0.01)。2012 - 2022年平均每年减少地面撞击伤784例(P < 0.01),每年减少非特定撞击伤161例(P < 0.01),每年减少无生命物体撞击伤42例(P = 0.03)。结论:从2012年到2022年,儿童单板滑雪损伤呈大幅下降趋势。骨折是最常见的诊断,主要影响手腕和肩膀。头部是第二大受伤的身体部位,脑震荡是第三大最常见的诊断。临床相关性:本研究强调了在滑雪板日益普及的情况下伤害的减少,揭示了防护设备、现场伤害管理和度假村基地诊所实施的重要性。
{"title":"Pediatric Snowboarding-Related Concussions and Musculoskeletal Injuries Decreased From 2012 to 2022","authors":"Kyle K. Obana M.D. ,&nbsp;Avanish Yendluri B.S. ,&nbsp;Mininder S. Kocher M.D., M.P.H. ,&nbsp;Theodore J. Ganley M.D. ,&nbsp;David P. Trofa M.D. ,&nbsp;Robert L. Parisien M.D.","doi":"10.1016/j.asmr.2024.100990","DOIUrl":"10.1016/j.asmr.2024.100990","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze mechanisms, diagnoses, and incidence of youth snowboarding-related injuries presenting to US emergency departments.</div></div><div><h3>Methods</h3><div>Data from the National Electronic Injury Surveillance System were analyzed for pediatric snowboarding injuries (≤18 years old) from 2012 to 2022. Data were collected for mechanism of injury, diagnosis, location of injury, and disposition. National estimates (NEs) were calculated using the statistical sample weight of the corresponding hospital assigned by the National Electronic Injury Surveillance System. Linear regressions were used to analyze injuries over time.</div></div><div><h3>Results</h3><div>In total, 3,036 (NEs = 120,140) pediatric snowboarding injuries were included in this study. Average age was 14.0 ± 2.7 years. The most common mechanism of injury was impact with the ground (NEs = 97,120, 80.8%). The most injured body parts were 719 wrists (NEs = 115,505, 96.1%), 580 heads (NEs = 22,258, 18.5%), and 381 shoulders (NEs = 17,269, 14.4%). The most common diagnoses were fractures (NEs = 48,886, 40.7%), strains/sprains (NEs = 22,948, 19.1%), and concussions (NEs = 12,553, 10.4%). Fractures primarily involved the wrist (NEs = 18,122, 37.1%), lower arm (NEs = 12,348, 25.3%), and shoulder (NEs = 9,073, 18.6%). From 2012 to 2022, there were average decreases of 1,051 overall injuries per year (<em>P</em> &lt; .01), 299 fractures per year (<em>P</em> = .04), 298 strains/sprains per year (<em>P</em> &lt; .01), and 143 concussions per year (<em>P</em> &lt; .01). There were average decreases of 784 impact with ground injuries per year (<em>P</em> &lt; .01), 161 not specified injuries per year (<em>P</em> &lt; .01), and 42 impact with inanimate object injuries per year (<em>P</em> = .03) from 2012 to 2022.</div></div><div><h3>Conclusions</h3><div>Pediatric snowboarding injuries demonstrated a large decline from 2012 to 2022. Fractures are the most common diagnosis, primarily affecting the wrist and shoulder. The head was the second most injured body part, and concussions were the third most common diagnosis.</div></div><div><h3>Clinical Relevance</h3><div>This study highlights decreasing injuries despite growing popularity of snowboarding, bringing to light the importance of protective equipment, on-site injury management, and implementation of clinics at resort bases.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 6","pages":"Article 100990"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956092","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
Simulated Cam Morphology of the Hip Changes Sacroiliac Motion During Hip Motion and Loading in a Cadaveric Model 模拟髋关节凸轮形态改变髋关节运动和负载时的骶髂运动
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.asmr.2024.100977
Mason E. Uvodich M.D., Alex W. Hooke M.A., Zachary V. Braig M.D., Micah J. Nieboer M.D., Evan M. Dugdale M.D., William W. Cross M.D., Aaron J. Krych M.D., Mario Hevesi M.D., Ph.D.

Purpose

To determine the relationship between cam morphology of the hip and ipsilateral sacroiliac motion compared to the native hip in a cadaveric model.

Methods

A simulated cam state was created using a 3-dimensional printed cam secured to the head-neck junction of 5 cadaveric hips. Hips were studied using a computed tomography–based optic metrology system and a 6 degree-of-freedom robot to exert an internal rotation torque at 3 different torque levels (6 N-m, 12 N-m, 18 N-m). Outcomes included translational and rotational movement about 3 axes and composite (total) translational motion at the ipsilateral sacroiliac (SI) joint. Statistical analysis included a linear mixed model regression with repeated measures.

Results

The presence of a simulated cam was associated with medial motion in the coronal plane (P = .03) and posterior motion in the sagittal plane (P < .01) but not composite motion (P = .37). Motion in the axial plane was in an inferior direction (P = .08). Cam morphology significantly changed rotation in the sagittal plane (P < .01) but not in the coronal (P = .63) or axial plane (P = .18). Composite motion was related to the amount of torque applied to the hip (P < .01). The amount of torque applied to the hip was related to rotation in the coronal plane (P < .01), axial plane (P < .01), and sagittal plane (P < .01) with increased effects as torque increased. Torque was not associated with translation movement in any of the anatomic planes.

Conclusions

The presence of simulated cam morphology is associated with motion in a more medial, inferior, and posterior direction at the ipsilateral SI joint relative to a native state. Increasing torque affects the magnitude of translation, but not its direction, which in this study is primarily influenced by cam morphology.

Clinical Relevance

This biomechanical connection between cam-type femoroacetabular impingement syndrome and the ipsilateral SI joint provides insight into SI joint dysfunction in patients with femoroacetabular impingement syndrome.
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Arthroscopy Sports Medicine and Rehabilitation
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