Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"No Difference in Ligament Discontinuity Versus Thickening on Magnetic Resonance Imaging When Evaluating Anterior Talofibular Ligament Injuries: A Systematic Review","authors":"Joshua Taylor B.S. ,&nbsp;Damon V. Briggs B.A. ,&nbsp;Albert T. Anastasio M.D. ,&nbsp;Julia E. Ralph B.A. ,&nbsp;Emily Poehlein M.B. ,&nbsp;Cynthia L. Green Ph.D. ,&nbsp;Stephanie Hendren M.L.I.S. ,&nbsp;Brian C. Lau M.D., M.P.H.","doi":"10.1016/j.asmr.2025.101194","DOIUrl":"10.1016/j.asmr.2025.101194","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically review the literature evaluating whether incorporating ligament thickening and increased signal intensity alongside ligament discontinuity on magnetic resonance imaging (MRI) improves diagnostic accuracy for anterior talofibular ligament (ATFL) injuries.</div></div><div><h3>Methods</h3><div>Two independent reviewers conducted a systematic literature search on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the MEDLINE, Embase, CINAHL Complete, and Scopus databases to find studies reporting MRI and ultrasound imaging findings after ATFL injuries. Statistical analyses were conducted via Review Manager, and a <em>P</em> value of &lt;.05 was statistically significant.</div></div><div><h3>Results</h3><div>In total, 15 studies met inclusion criteria, and 9 provided sufficient data for meta-analyses. MRI demonstrated high sensitivity and specificity for diagnosing ATFL injuries. There were greater diagnostic results for ligament thickening with increased signal intensity, but there was no statistically significant difference between diagnostic approaches on the basis solely of ligament discontinuity and the thickening with increased signal intensity. Pooled sensitivity ranged from 84.7% to 87.1%, whereas specificity ranged from 84.6% to 91.4%. Diagnostic odds ratios were consistently high across methods.</div></div><div><h3>Conclusions</h3><div>This study found that incorporating ligament thickening and increased signal intensity alongside ligament discontinuity on MRI does not significantly improve diagnostic accuracy.</div></div><div><h3>Level of Evidence</h3><div>Level III, systematic review of Level II and III studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101194"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478988","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":"Reporting Bias Is Highly Prevalent in Systematic Reviews and Meta-Analyses Related to Medial Patellofemoral Ligament Reconstruction","authors":"Kenneth T. Nguyen B.S. ,&nbsp;Erin L. Brown B.A. ,&nbsp;William C. Rittmeyer B.S. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Mia V. Rumps M.S. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101213","DOIUrl":"10.1016/j.asmr.2025.101213","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze reporting bias in the form of spin present in systematic reviews and meta-analyses related to medial patellofemoral ligament reconstruction (MPFLR).</div></div><div><h3>Methods</h3><div>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematic reviews were collected from PubMed, Web of Science, and Embase using the search “medial patellofemoral ligament reconstruction” or “MPFLR” AND “systematic review” OR “meta-analysis.” Abstracts were assessed for 15 common spin types. A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) was used to evaluate the quality of the studies. Characteristics such as Preferred Reporting Items for Systematic Reviews and Meta-Analyses adherence, publication year, and level of evidence were analyzed. Associations between these factors and spin presence or type were determined using statistical tests, including <em>t</em> tests, analysis of variance, Fisher tests, and Spearman rank coefficients.</div></div><div><h3>Results</h3><div>The initial database search identified 1,044 studies, of which a total of 57 studies were included. Spin was present in the abstract in 51 of 57 studies (89.5%). Each type of spin was observed in at least 1 study’s abstract with the exceptions of spin types 1, 7, 13, and 15. The 3 most common types were type 5 (48/57, 84.2%), followed by type 3 (32/57, 56.1%) and type 9 (30/57, 52.6%). Of the included studies, 91.2% received a critically low AMSTAR 2 confidence rating, and only 5.3% reported a conflict of interest. There was a statistically significant negative correlation between the numerical AMSTAR 2 rating and the presence of spin (<em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>Most systematic reviews on MPFLR received critically low AMSTAR 2 ratings, reflecting the poor quality of evidence in this area. Nearly 90% of abstracts exhibited at least 1 type of spin, with spin types 3, 5, and 9 being the most common, suggesting a tendency to overstate the efficacy of MPFLR for patellar instability.</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 5","pages":"Article 101213"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478986","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":"High Variability in Arthroscopic Fluid Use Among Surgeons and Joints for Common Orthopaedic Procedures","authors":"Andrew B. Rees M.D. ,&nbsp;Calvin C. Chandler M.D., M.B.A. ,&nbsp;V. V. N. Manohar Devarasetty M.D. ,&nbsp;Evan M. Polce M.D. ,&nbsp;Alex B. White M.D. ,&nbsp;Kennedy K. Gachigi M.S. ,&nbsp;Nady Hamid M.D.","doi":"10.1016/j.asmr.2025.101226","DOIUrl":"10.1016/j.asmr.2025.101226","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine arthroscopic fluid volume use patterns across common elective orthopaedic procedures, evaluate intersurgeon consistency in fluid use, and assess whether blood loss reduction adjuncts affect fluid consumption to generate actionable insights to guide surgeons in optimizing resource use, reducing waste, and improving efficiency during times of resource constraint.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis at a single outpatient surgery center of adult arthroscopic procedures was conducted. A representative sample of 500 arthroscopic cases of the shoulder, elbow, knee, and ankle performed by multiple surgeons were reviewed. A total of 449 cases met inclusion criteria. Analysis of fluid use relative to body area, Current Procedural Terminology codes, surgeon, and blood loss reduction adjuncts (tranexamic acid [TXA] and epinephrine) was performed using analysis of variance tests.</div></div><div><h3>Results</h3><div>Mean fluid volume was greatest in shoulder arthroscopy (16,582 ± 7,026 mL), followed by knee (8,677 ± 7,027 mL), elbow (6,489 ± 2,540 mL), and ankle procedures (3,534 ± 1,500 mL). Significant intersurgeon variation was observed (F = 19.61, <em>P</em> = .0001). Epinephrine was used in 58.8% of cases, with mean fluid volume of 11,571 ± 6,896 mL for local injection and 15,401 ± 8,610 mL for arthroscopic fluid administration. Cases without epinephrine averaged 7,676 ± 6,570 mL of fluid use. TXA was used in only 0.7% of cases. Neither epinephrine nor TXA showed significant reduction in fluid consumption (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Arthroscopic fluid use across anatomic regions was highly varied, with shoulder procedures requiring the greatest volumes. Surgeon-specific use patterns also varied considerably. The use of neither TXA nor epinephrine reduced fluid consumption, although this finding may reflect the small sample size and lack of standardized protocols rather than true ineffectiveness.</div></div><div><h3>Level of Evidence</h3><div>Level III, cross-sectional study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101226"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478921","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":"Complex Labral Tears Are Not Predicted by Number of Preoperative Dislocations nor Time From Injury to Surgery in Patients Receiving Arthroscopic Anterior or Posterior Labral Repairs","authors":"Brandon Wilde M.D.,&nbsp;Adrik Da Silva M.D.,&nbsp;Collin Hunter B.S.,&nbsp;Christopher Clinker M.D.,&nbsp;Natalya McNamara M.D.,&nbsp;Samuel Simister M.D., M.B.A.,&nbsp;Peter N. Chalmers M.D.,&nbsp;Justin J. Ernat M.D., M.H.A.","doi":"10.1016/j.asmr.2025.101252","DOIUrl":"10.1016/j.asmr.2025.101252","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether complex glenoid labral tears (i.e., those involving &gt;120°of the glenoid labrum) are related to demographics, injury patterns, and surgical procedures/timing in patients undergoing primary arthroscopic labral repair.</div></div><div><h3>Methods</h3><div>This retrospective chart review included patients with traumatic shoulder instability who underwent primary arthroscopic labral repair between 2012 and 2020. Patients with atraumatic multidirectional instability, clinical ligamentous laxity, or previous shoulder surgeries were excluded. Variables analyzed included age, sex, body mass index, contact sports participation, number of dislocations (&lt;1, 1, 2, &gt;2), direction of instability, labral tear size, time to surgery, number of anchors, and concomitant procedures. Complex labral tears involved &gt;120° of the glenoid rim. Cohorts of “simple” anterior or posterior tears (&lt;120°) were used for comparison. Statistical analyses used <em>t</em> tests, Mann-Whitney <em>U</em>, χ², and the Fisher exact tests with a significance level of 0.05 and Bonferroni correction at 0.002.</div></div><div><h3>Results</h3><div>In total, 477 patients (364 simple labral tear patients – 280 anterior and 84 posterior; 113 complex labral tear patients) met inclusion criteria (mean age: 27 years; range: 14-72 years). In all tear size groups, it was more common to have &gt;2 dislocations than ≤2 dislocations (120° = 48.6%, 240° = 40.4%, 360° = 83.3%), but these differences were not statistically significant (<em>P</em> = .067). Time from first injury/instability event to surgery (in months) was not a predictor of tear size (simple = 45 ± 70 months, complex = 38 ± 67 months). There was no statistical difference between tear size groups and patient demographics in sex, contact sport participation, tobacco use, instability direction (anterior versus posterior), body mass index, age, or association of concomitant procedures. The number of anchors used was the only variable found to correlate with tear size (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Complex glenoid labral tears did not correlate with the number of preoperative instability events, direction of instability, time to surgery, or previously cited factors such as contact sports or BMI in patients arthroscopically treated for shoulder instability.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative cohort.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101252"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478845","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":"No Difference in 10- to 14-Year Outcomes After Modified Transtibial Versus Anteromedial Portal Techniques in Anterior Cruciate Ligament Reconstruction","authors":"Guocheng Ding M.D. ,&nbsp;Haomin Li M.D. ,&nbsp;Fanfan Cai M.D. ,&nbsp;Zhixin Duan M.D. ,&nbsp;Jianquan Wang M.D. ,&nbsp;Chen Jiao M.D.","doi":"10.1016/j.asmr.2025.101173","DOIUrl":"10.1016/j.asmr.2025.101173","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To compare the long-term clinical and radiological outcomes of modified transtibial and anteromedial portal techniques in single-bundle anterior cruciate ligament (ACL) reconstruction to provide more comprehensive guidance for treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study included patients who underwent arthroscopic single-bundle ACL reconstruction with adequate follow-up between January 2010 and December 2014. Patients were grouped according to the surgical techniques used: those who underwent the modified transtibial technique (group 1) and those who underwent the anteromedial portal technique (group 2). Clinical assessments included the 2000 International Knee Documentation Committee subjective knee score, Lysholm knee score, Tegner activity scale, Hospital for Special Surgery Knee score, Lachman test, and pivot-shift test. Radiological evaluations assessed the femoral tunnel’s location and length, as well as the inclination angles in the coronal, sagittal, and axial planes through computed tomography scans, while the graft bending angle and ligament maturity were evaluated via magnetic resonance imaging.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 73 patients were included: 36 in group 1 and 37 in group 2. No clinically significant differences were observed between the 2 techniques in the International Knee Documentation Committee score (mean difference [MD], 2.7; 95% confidence interval [CI], –1.5 to 6.9; minimal clinically important difference [MCID], 13.8), Lysholm score (MD, –0.1; 95% CI, –5.0 to 4.8; MCID, 8.9), Tegner score (MD, 0.6; 95% CI, –0.3 to 1.5; MCID, 1), and Hospital for Special Surgery Knee score (MD, 3.0; 95% CI, 0.3 to 5.7; MCID, 5.4). However, significant differences were noted in the mean distances from the femoral tunnel center to the posterior condylar surface (36.77% ± 4.60% in group 1 vs 32.14% ± 5.21% in group 2; &lt;em&gt;P&lt;/em&gt; &lt; .001) and to the Blumensaat line (24.34% ± 4.36% vs 30.02% ± 6.44%; &lt;em&gt;P&lt;/em&gt; &lt; .001). The inclination angles of the femoral tunnel differed significantly between the 2 groups in the coronal plane (55.21° ± 6.10° vs 35.79° ± 8.79°; &lt;em&gt;P&lt;/em&gt; &lt; .001), sagittal plane (27.80° ± 8.26° vs 40.06° ± 9.29°; &lt;em&gt;P&lt;/em&gt; &lt; .001), and axial plane (43.21° ± 7.21° vs 31.21° ± 8.36°; &lt;em&gt;P&lt;/em&gt; &lt; .001). Compared with group 2, group 1 presented a significantly greater femoral tunnel length (38.63 ± 4.33 vs 33.97 ± 2.65; &lt;em&gt;P&lt;/em&gt; &lt; .001). Furthermore, the graft bending angle in group 1 was significantly smaller than that in group 2 (26.62° ± 7.49° vs 36.92° ± 5.92°; &lt;em&gt;P&lt;/em&gt; &lt; .001). There was no statistically significant difference in graft maturity between the 2 groups (5.32 ± 3.52 vs 4.82 ± 2.91; &lt;em&gt;P&lt;/em&gt; = .544).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The modified transtibial and anteromedial portal techniques for ACL reconstruction achieved comparable clinical outcomes. Despite some differences in femoral tunnel placement, there are n","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101173"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478914","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 Who Underwent Anterior Cruciate Ligament Reconstruction With an All Soft-Tissue Quadriceps Tendon Graft Had a Greater Return-to-Play Rate Than Patients Who Received a Quadriceps Tendon Bone Graft","authors":"William Woodhams B.A.,&nbsp;Doyle Ford B.S., M.B.A.,&nbsp;Jeremiah Hutson B.S.,&nbsp;Jacob Reisner D.O.,&nbsp;Kendall Hamilton M.D.,&nbsp;Travis Menge M.D.","doi":"10.1016/j.asmr.2025.101223","DOIUrl":"10.1016/j.asmr.2025.101223","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the outcomes after anterior cruciate ligament reconstruction (ACLR) with either a quadriceps tendon bone (QTB) graft or an all soft-tissue quadriceps tendon (ASTQT) graft and to compare QTB versus ASTQT graft options, including return to play, patient-reported outcome scores, and complication rates.</div></div><div><h3>Methods</h3><div>A systematic review was conducted by searching PubMed, Embase, SCOPUS, and Cochrane databases for studies published between 2003 and 2023, focusing on outcomes of quadriceps tendon autograft in ACLR.</div></div><div><h3>Results</h3><div>In total, 37 studies with a total of 39 cohorts (n = 2,647) met inclusion criteria. The studies included 22 cohorts (n = 1,825 patients) for QTB and 17 cohorts (n = 822 patients) for ASTQT. Patients who underwent ACLR with ASTQT graft had a greater rate of return to play compared with those with a QTB (84% to 90% vs 45%-85%). Between ASTQT and QTB graft constructs, International Knee Documentation Committee scores (77.4 to 94.8 vs 71.2 to 92), Lysholm scores (85-95.5 vs 86-96.1), Knee injury and Osteoarthritis Outcome Score-Pain (88.9-89.7 vs 90-90.7), return-to-play times (269.2-319.4 days vs 337.6 days), and revision rates (2.3%-12.8% vs 0%-2.9%) were similar.</div></div><div><h3>Conclusions</h3><div>Our analysis shows a greater return-to-play rate in patients who underwent ACLR with an ASTQT compared with QTB graft. No differences were found in patient-reported outcome scores or revision rates.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I-IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101223"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145479350","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":"Widely Available Large Language Models Are Not a Reliable Source to Address Medical Treatment Recommendations of Patients After a First-Time Anteroinferior Shoulder Dislocation","authors":"Elian Niklas Oudintsov,&nbsp;Soraya Bahlawane,&nbsp;Agahan Hayta M.D.,&nbsp;Cagman Seker M.D.,&nbsp;Doruk Akgun M.D.,&nbsp;David Alexander Back M.D.,&nbsp;Rony-Orijit Dey Hazra M.D.","doi":"10.1016/j.asmr.2025.101216","DOIUrl":"10.1016/j.asmr.2025.101216","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the ability of ChatGPT 3.5 to aid in the treatment planning process of first-time anteroinferior shoulder dislocation.</div></div><div><h3>Methods</h3><div>Forty fictional patient cases were created varying in 15 different characteristics, whose distribution was randomized. Six orthopaedic surgeons (3 residents and 3 specialists in shoulder surgery) were then asked to determine the best treatment option for these patient cases. Their answers were compared with the treatment recommendations proposed by ChatGPT in 2 different sessions on the basis of preselected literature. To counteract the wide dispersion of responses, tendencies towards nonoperative, open surgical, or arthroscopic treatment were subsequently defined. The results were then analyzed descriptively.</div></div><div><h3>Results</h3><div>The mean age of the fictional patients was 44 years (13-80 years), with 57.5% of the patients female. The agreement between the ChatGPT responses in the 2 sessions was 70.0%. In contrast, the 3 assistant physicians agreed with each other in 35% of all cases and the 3 specialists agreed in 32.5% of all cases. There was an exact match of 12.5% between the ChatGPT responses and all human assessments. In 65.0% of all cases, the physicians showed similar tendencies in their choice of therapy resulting in a 55.0% match between ChatGPT and the surgeons.</div></div><div><h3>Conclusions</h3><div>There was no clear consensus regarding the treatment for first-time anteroinferior dislocations of the shoulder, neither among physicians nor with ChatGPT 3.5. However, ChatGPT 3.5 and physicians showed similar tendencies regarding the treatment in over half of the cases. Because of the inconsistent responses of ChatGPT 3.5, it cannot yet be considered as reliable tool for therapy planning.</div></div><div><h3>Clinical Relevance</h3><div>ChatGPT 3.5, widely available and free of charge, is increasingly used in clinical settings. However, it’s crucial to highlight its limitations in treatment planning for pathologies, especially when there’s no clear consensus even among experienced surgeons.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101216"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478821","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":"Lower Trapezius Tendon Transfer Using Achilles Tendon Allograft Effectively Restores Function After Failed Superior Capsular Reconstruction","authors":"Bo Taek Kim M.D. ,&nbsp;Erick M. Marigi M.D. ,&nbsp;Chang Hee Baek M.D. ,&nbsp;Jung Gon Kim M.D. ,&nbsp;Chaemoon Lim M.D. ,&nbsp;Gyuna Baek M.S. ,&nbsp;Bassem T. Elhassan M.D.","doi":"10.1016/j.asmr.2025.101222","DOIUrl":"10.1016/j.asmr.2025.101222","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the clinical outcomes of lower trapezius tendon (LTT) transfer using an Achilles tendon allograft in patients with failed superior capsular reconstruction (SCR).</div></div><div><h3>Methods</h3><div>A retrospective therapeutic review was conducted on patients who underwent LTT transfer using an Achilles tendon allograft after SCR failure between January 2018 and May 2020. The inclusion criteria encompassed both structural and functional failures of SCR in patients with minimal glenohumeral arthritis and a minimum follow-up of 2 years. Exclusion criteria were insufficient clinical data or loss to follow-up. Clinical outcomes were assessed preoperatively and at final follow-up using the visual analog scale (VAS), subjective shoulder value (SSV), Constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM).</div></div><div><h3>Results</h3><div>Eighteen patients were included, with a mean follow-up of 42.5 months (range: 24-62 months). All outcome measures demonstrated statistically significant improvement: VAS scores improved from 5.9 ± 1.3 to 1.8 ± 1.4; SSV scores improved from 18.0 ± 9.1 to 61.4 ± 18.5; Constant score improved from 33.3 ± 5.3 to 65.5 ± 17.4; and ASES score improved from 38.5 ± 5.2 to 67.1 ± 17.7 (all <em>P</em> &lt; .001). On the basis of the minimal clinically important difference (MCID) using a 0.5 SD distribution-based method, clinically meaningful improvements were observed in 88.9% of patients for VAS and ASES scores, and 94.4% for Constant and SSV scores. ROM gains included forward elevation (73° to 120°), abduction (57° to 93°), and external rotation (−22° to 40°). At final follow-up, 77.8% of patients had resumed occupational activities, and 61.1% returned to sports. Four patients (22.2%) required conversion to reverse shoulder arthroplasty.</div></div><div><h3>Conclusions</h3><div>LTT transfer using an Achilles tendon allograft following failed SCR yields significant improvements in pain relief, functional outcomes, and ROM. LTT transfer using an Achilles tendon allograft following failed SCR may offer a potential treatment option, particularly in younger, active patients who seek to preserve native shoulder anatomy and function.</div></div><div><h3>Level of Evidence</h3><div>Level IV retrospective case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101222"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478822","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":"Twenty-Five Percent of Patients Undergoing Knee Arthroscopy Use Psychotropic Medications","authors":"Zachary Ramsey B.A. ,&nbsp;Victoria Ierulli M.S. ,&nbsp;Nicholas O. Gerard III M.D. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Wendell Heard M.D. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101251","DOIUrl":"10.1016/j.asmr.2025.101251","url":null,"abstract":"<div><h3>Purpose</h3><div>To estimate the prevalence of psychotropic medication (PTM) usage in patients undergoing knee arthroscopy and to identify knee pathologies associated with the use of PTMs.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted. Subjects were identified using the billing database at a single institution. All eligible patients treated by 2 fellowship-trained orthopaedic sports medicine surgeons between 2017 and 2021 were analyzed; patients were included if they were at least 12 years old and had at least 6 months of documented follow-up. The following characteristics were gathered: age, sex, surgery laterality, ipsilateral knee surgery history, knee pathology, and use of PTMs if listed in patient charts within 6 months prior to surgery.</div></div><div><h3>Results</h3><div>Records from 1,000 arthroscopic knee surgical procedures were examined (399 female and 601 male patients). From 2017 to 2021, 245 patients (24.5%) were prescribed at least 1 psychotropic drug. Female patients took PTM drugs at higher rates than male patients (odds ratio, 1.92; 95% confidence interval, 1.42-2.60; <em>P</em> &lt; .001). An examination of drug classes revealed 106 antidepressant prescriptions (35.2%), 77 sedative hypnotics (25.6%), 38 stimulants (12.6%), 6 antipsychotics (2.0%), and 74 anticonvulsants/mood stabilizers (24.6%). Patients taking PTMs had lower adjusted odds of presenting with anterior cruciate ligament injury compared with their peers not taking PTMs (adjusted odds ratio, 0.55; 95% confidence interval, 0.32-0.82; <em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>The rate of PTM usage among patients undergoing knee arthroscopy was 24.5% based on 5 years of records from 1 institution. Female patients had a higher frequency of PTM use compared with their male counterparts.</div></div><div><h3>Clinical Relevance</h3><div>PTM use is common among knee arthroscopy patients, with higher rates observed in female patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 5","pages":"Article 101251"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478915","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":"Osteochondral Autograft Transplantation Coupled With Platelet-Rich Plasma and Hyaluronic Acid Injections Can Yield Favorable Outcomes in Patients With Osteochondral Lesions of the Talus","authors":"George A. Rublev M.D. ,&nbsp;Nivedita Pant M.D. ,&nbsp;Mohamed Ahmed Mohamed M.D. ,&nbsp;Tamaz Tamazishvili M.D. ,&nbsp;Giorgi Khokhashvili M.D. ,&nbsp;Irakli Gogua M.D. ,&nbsp;Irakli Kartozia M.D. ,&nbsp;Giorgi Zimlitski M.D. ,&nbsp;George Loria M.D. ,&nbsp;Vazha Gaprindashvili M.D. ,&nbsp;Mikheil Zimlitski M.D. ,&nbsp;Levan Natchkebia M.D.","doi":"10.1016/j.asmr.2025.101206","DOIUrl":"10.1016/j.asmr.2025.101206","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the outcomes of patients who had osteochondral lesions of the talus treated with osteochondral allograft transplants combined with platelet-rich plasma (PRP) and hyaluronic acid (HA).</div></div><div><h3>Methods</h3><div>We aimed to investigate the outcomes of patients who underwent osteochondral autograft transplantation surgery (OATS) from 2015 to 2022. The inclusion criteria for patients to undergo OATS included a defect size greater than 5 mm and failure of conservative management. The preoperative and postoperative visual analog scale (VAS) and American Orthopaedic Foot &amp; Ankle Society (AOFAS) scores were recorded and subsequently analyzed using a paired <em>t</em> test. We also performed cohort-specific analyses that included the minimal clinically important difference, patient acceptable symptom state, and substantial clinical benefit. PRP injections were administered at 8 weeks postoperatively and were given every 2 weeks, for 3 total injections. HA was injected once every 6 months for the following 2 years. The minimum follow-up time was 2 years.</div></div><div><h3>Results</h3><div>At the 12-month follow-up, all 19 patients reported a mean increase in the VAS score of 33.40 (95% confidence interval, 30.9-35.8). The average age was 31 years, and there were 12 male and 7 female patients. Of the 19 patients, 17 reported no restriction of motion, whereas the other 2 patients reported some restriction of dorsiflexion. Ankle function based on the AOFAS scoring system showed good to excellent results in 18 of 19 cases (94%), with no long-term donor-site morbidity and a mean increase of 37.49 (95% confidence interval, 34.7-40). Hardware removal of lag screws was conducted at 12 months after initial surgery; all cases resulted in union of the malleolar osteotomy. The average follow-up time was 3 years.</div></div><div><h3>Conclusions</h3><div>Combining OATS with PRP-HA injections can yield promising results for patients with osteochondral lesions of the talus, showing significant improvement in VAS and AOFAS scores postoperatively.</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 5","pages":"Article 101206"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145478919","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}