Arthroscopy Sports Medicine and Rehabilitation最新文献_第7页

Hip Arthroscopy for Femoroacetabular Impingement Syndrome Reduces the Risk for Developing Hip Osteoarthritis: A Systematic Review 髋关节镜治疗股髋臼撞击综合征可降低患髋关节骨关节炎的风险：一项系统综述

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-10-01 DOI: 10.1016/j.asmr.2025.101256

Dylan Parry B.S. , Jaydeep Dhillon D.O. , Gabriel Embree B.S. , Matthew J. Kraeutler M.D.

Purpose

To perform a systematic review to directly compare hip arthroscopy and nonoperative treatment for femoroacetabular impingement syndrome (FAIS) with outcomes including the risk for developing hip osteoarthritis (OA) or undergoing total hip arthroplasty (THA) later in life.

Methods

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by searching PubMed, the Cochrane Library, and Embase to identify studies directly comparing hip arthroscopy and nonoperative treatment for FAIS. The search terms used were as follows: hip AND arthroscopy AND “femoroacetabular impingement” AND (osteoarthritis OR arthroplasty). Studies with a follow-up time <2 years were excluded. Outcomes measured were incidence rates for OA progression and THA conversion following treatment.

Results

Six studies (1 Level I, 2 Level II, 3 Level III) met inclusion criteria, with a total of 622 hips that underwent arthroscopy and 1,424 hips that underwent nonoperative treatment (control). Mean patient age ranged from 28.2 to 42.2 years in the arthroscopy group and 28.1 to 42.2 years in the control group. Mean follow-up ranged from 2.0 to 12.5 years. OA incidence rates ranged from 10.8% to 28.0% in the arthroscopy group and from 7.1% to 48.0% in the control group. Two studies found a significantly lower rate of OA in the arthroscopy group (P < .001 and P = .005), 1 study had less articular damage in the arthroscopy group at follow-up (P < .001), and 1 study showed a greater proportion of patients who progressed to Tönnis grade 3 changes in the arthroscopy group at follow-up (P < .001). THA conversion rates ranged from 0.9% to 7.0% in the arthroscopy group and from 0.0% to 10.5% in the control group. One study showed a significantly lower rate of conversion to THA in the arthroscopy group (P = .035).

Conclusions

There is some evidence that patients with FAIS who undergo hip arthroscopy may have a lower rate of progression of OA and conversion to THA compared to similar patients initially treated nonoperatively.

Level of Evidence

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

目的对股骨髋臼撞击综合征（FAIS）的髋关节镜和非手术治疗进行系统回顾，比较其预后，包括发生髋关节骨关节炎（OA）或在以后的生活中进行全髋关节置换术（THA）的风险。方法通过检索PubMed、Cochrane图书馆和Embase，根据系统评价和荟萃分析指南的首选报告项目进行系统评价，找出直接比较髋关节镜和非手术治疗FAIS的研究。使用的搜索词如下：髋关节和关节镜检查和“股髋臼撞击”和（骨关节炎或关节成形术）。随访时间为2年的研究被排除在外。测量的结果是治疗后OA进展和THA转化的发生率。结果6项研究（1项I级，2项II级，3项III级）符合纳入标准，共有622个髋关节接受了关节镜检查，1424个髋关节接受了非手术治疗（对照组）。关节镜组患者平均年龄28.2 ~ 42.2岁，对照组患者平均年龄28.1 ~ 42.2岁。平均随访时间为2.0年至12.5年。关节镜组OA发病率为10.8% ~ 28.0%，对照组为7.1% ~ 48.0%。两项研究发现关节镜组骨性关节炎发生率显著降低（P <； 0.001和P = 0.005）， 1项研究发现关节镜组随访时关节损伤较少（P < 0.001）， 1项研究显示关节镜组随访时进展为Tönnis 3级病变的患者比例更高（P < 0.001）。关节镜组THA转换率为0.9% ~ 7.0%，对照组为0.0% ~ 10.5%。一项研究显示关节镜组转化为THA的比率明显较低（P = 0.035）。结论：有证据表明，与最初非手术治疗的类似患者相比，接受髋关节镜治疗的FAIS患者的OA进展和THA转化率可能较低。证据水平：III级，对I-III级研究的系统评价。

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引用次数: 0

Arthroscopic Repair of Distal Triceps Tendon Rupture Provides Excellent Functional Outcomes With Minimal Complications 关节镜下修复远端三头肌腱断裂提供了良好的功能效果和最小的并发症

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101164

Felix H. Savoie M.D., Nolan M. Reinhart M.D., Jackson P. Tate M.D., Taylor M. Troutman M.D., Sara M. Yuter B.S., William F. Sherman M.D., M.B.A.

Purpose

To report the outcomes of patients who underwent arthroscopic distal triceps tendon repair using double-row anatomic footprint repair with suture anchors.

Methods

This was a retrospective review of patients who underwent arthroscopic triceps tendon repair between 2012 and 2022 performed by a single surgeon. The inclusion criteria included a full-thickness tear of the distal triceps tendon confirmed by magnetic resonance imaging and repaired arthroscopically. The exclusion criteria included patients with documented follow-up of less than 24 months for whom postoperative outcome measures were lacking, as well as tear size of less than 50% of the width of the tendon. The primary outcome measures were retear rates and reoperation rates. Secondary outcomes included change in pain score (visual analog scale), postoperative functional score (Mayo Elbow Performance Score), postoperative Single Assessment Numeric Evaluation score, manual muscle testing, and rate of perioperative wound complications.

Results

A total of 16 patients (age range, 37-80 years) were included. All patients had an intact triceps tendon on ultrasound at a mean follow-up of 79.3 months (range, 24.6-149.1 months). The mean preoperative visual analog scale pain score decreased from 4 to 0, ranging from 0 to 6 preoperatively (P < .001). The postoperative Mayo Elbow Performance Score averaged 100, indicating no functional limitations. The mean Single Assessment Numeric Evaluation score were 98, ranging from 90 to 100. No major perioperative wound complications, retears, or reoperations were reported. Muscle strength was graded as equal to the opposite side on manual strength testing.

Conclusions

In this study, we found that arthroscopic triceps tendon repair is safe and effective, with excellent pain relief, excellent functional scores, minimal complications, and the ability to address concomitant elbow pathologies.

Level of Evidence

Level IV, therapeutic case series.

目的报道关节镜下应用缝合锚钉双排解剖脚印修复肱三头远端肌腱的疗效。方法回顾性分析2012年至2022年间由同一位外科医生进行关节镜肱三头肌肌腱修复的患者。纳入标准包括经磁共振成像证实并经关节镜修复的三头肌腱远端全层撕裂。排除标准包括随访时间少于24个月且缺乏术后结果测量的患者，以及撕裂大小小于肌腱宽度的50%的患者。主要观察指标为复发率和再手术率。次要结果包括疼痛评分（视觉模拟量表）、术后功能评分（Mayo肘关节功能评分）、术后单一评估数值评估评分、人工肌肉测试和围手术期伤口并发症发生率的变化。结果共纳入16例患者，年龄37 ~ 80岁。在平均79.3个月（24.6-149.1个月）的超声检查中，所有患者的三头肌肌腱均完好无损。术前视觉模拟量表疼痛平均评分从4分降至0分，术前评分从0分降至6分（P < .001）。术后Mayo肘关节功能评分平均为100分，无功能限制。单次评估的平均数值评估得分为98分，范围从90到100分。无重大围手术期伤口并发症、撕裂或再手术报道。在手工力量测试中，肌肉力量被分级为与对面相等。结论在本研究中，我们发现关节镜下肱三头肌肌腱修复术安全有效，具有良好的疼痛缓解，良好的功能评分，最小的并发症，并且能够解决伴随的肘部病变。证据水平：IV级，治疗性病例系列。

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引用次数: 0

Resizing and Reshaping Anterior Cruciate Ligament Stump Tissue Does Not Compromise Cell Viability, and Infiltration Into Patellar Tendon Grafts Does Not Compromise Tensile Properties 前交叉韧带残端组织的大小调整和重塑不影响细胞活力，髌骨肌腱移植物的浸润不影响拉伸性能

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101201

Juliana Heimur D.O. , Mark Callanan M.D. , Jessi Truett Ed.D., B.C.B.A. , Achraf Cohen Ph.D. , Murilo Basso B.E. , Nick Carssow , Adam W. Anz M.D.

Purpose

To determine whether a technique to process anterior cruciate ligament (ACL) stump tissue for needle infiltration into tendon grafts for ACL reconstruction would affect the viability of the cells within the tissue or the tensile properties of infiltrated grafts.

Methods

ACL stump and Hoffa fat pad tissue was harvested from 13 ACL reconstruction patients and processed. Harvesting involved a standard arthroscopic shaver and an inline suction device. Processing involved 3 steps, 2 syringes, and 3 syringe transfer devices of decreasing size. After processing, tissue could pass through a needle for infiltration into ACL reconstruction tendon grafts. Tissue analysis was performed at each serial step of the processing technique and included cell counts and viability testing. Tensile testing involved 15 matched-pair cadaveric knees, from which bone–patellar tendon–bone (BPTB) grafts, stump tissue, and fat pad tissue were harvested. Harvested and processed tissue was infiltrated into BPTB grafts, and tensile biomechanical testing was performed.

Results

Unprocessed tissue showed average cell viability (ACV) of 72.8% during cell viability testing. After step 1 of the process, ACV was 66.4%; after step 2, ACV was 73.1%; and after step 3, ACV was 67.1%. There was no significant difference in cell viability between processing steps (P = .528). When un-infiltrated control grafts were compared with infiltrated grafts, expected significant differences were found for weight (6.55 ± 1.51 g vs 8.91 ± 0.98 g, P < .001), width (9.53 ± 1.35 mm vs 13.74 ± 2.04 mm, P < .001), thickness (5.2 ± 1.26 mm vs 10.78 ± 2.11 mm, P < .001), and Young’s modulus (94.55 ± 47.19 MPa vs 28.57 ± 16.37 MPa, P < .001). There were no significant differences in tensile failure load (536.65 ± 168.00 N vs 509.55 ± 139.31 N, P = .49), deformation at failure (9.34 ± 2.96 mm vs 9.28 ± 3.21 mm, P = .91), or stiffness (97.04 ± 32.34 N/mm vs 86.82 ± 24.37 N/mm, P = .11) between the groups.

Conclusions

A technique to process remnant ACL and fat pad tissue for infiltration does not affect the viability of cells within the tissue. Infiltration of tissue into BPTB graft increases overall volume and mass and does not significantly alter the graft’s tensile load to failure when compared with matched controls.

Clinical Relevance

Evaluation of the biomechanical properties of a graft injected with minimally manipulated biologic material obtained at the time of harvest may provide laboratory data on the procedure's safety and viability as a direct delivery method for ACL grafts. These data could contribute to future studies involving clinical application during ACL reconstruction.

目的探讨前交叉韧带（ACL）残端组织处理方法针刺入肌腱移植物重建前交叉韧带，是否会影响组织内细胞活力及浸润移植物的拉伸性能。方法收集13例前交叉韧带重建患者的前交叉韧带残端和Hoffa脂肪垫组织进行处理。采集包括一个标准的关节镜刮刀和一个内嵌吸装置。处理涉及3个步骤，2个注射器和3个注射器转移装置的尺寸递减。处理后的组织可以通过针浸润到ACL重建肌腱移植物中。在处理技术的每个系列步骤中进行组织分析，包括细胞计数和活力测试。拉伸试验涉及15对配对的尸体膝盖，从中获取骨-髌骨肌腱-骨（BPTB）移植物、残肢组织和脂肪垫组织。采集和处理的组织浸润到BPTB移植物中，并进行拉伸生物力学测试。结果细胞活力检测显示，处理后的组织平均细胞活力（ACV）为72.8%。经过步骤1处理，ACV为66.4%；步骤2后，ACV为73.1%；步骤3后ACV为67.1%。不同处理步骤间细胞活力无显著差异（P = .528）。未浸润对照移植物与浸润对照移植物相比，在重量（6.55±1.51 g vs 8.91±0.98 g, P < .001）、宽度（9.53±1.35 mm vs 13.74±2.04 mm, P < .001）、厚度（5.2±1.26 mm vs 10.78±2.11 mm, P < .001）和杨氏模量（94.55±47.19 MPa vs 28.57±16.37 MPa, P < .001）方面存在显著差异。拉伸破坏载荷（536.65±168.00 N vs 509.55±139.31 N, P = 0.49）、破坏变形（9.34±2.96 mm vs 9.28±3.21 mm, P = 0.91）、刚度（97.04±32.34 N/mm vs 86.82±24.37 N/mm, P = 0.11）组间差异均无统计学意义。结论人工前交叉韧带残馀组织和脂肪垫组织浸润处理不影响组织内细胞活力。与对照组相比，组织浸润到BPTB移植物中会增加移植物的总体体积和质量，并且不会显著改变移植物的拉伸负荷而导致失败。临床意义：在收获时，用最小操作的生物材料注射移植物，对其生物力学特性进行评估，可以为该程序的安全性和作为ACL移植物直接传递方法的可行性提供实验室数据。这些数据可以为未来ACL重建的临床应用研究做出贡献。

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引用次数: 0

Current Research Regarding the Latarjet Procedure Is Focused on Technical Refinements, Fixation Alternatives, and Individualized Surgical Planning 目前关于Latarjet手术的研究主要集中在技术改进、固定选择和个体化手术计划上

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101160

Jingyue Su M.D. , Pengyu Xiang M.D. , Chenhao Jia M.D. , Jiali Ma M.D. , Zhiyun Li M.D. , Jian Xu M.D., Ph.D. , Shengwu Yang M.D. , Chunwu Zhang M.D. , Wei Lu M.D. , Zhenhan Deng M.D., Ph.D.

Purpose

To evaluate the literature regarding the Latarjet procedure to identify clinical practices and current areas of research focus.

Methods

Publications related to the Latarjet procedure in English, published between 1985 and 2024, were retrieved from the Web of Science Core Collection. Document types, including corrections, meeting abstracts, early access articles, and biographical items, were excluded from the analysis. The study employed CiteSpace, VOSviewer, R-Bibliometrix, and GraphPad Prism for data analysis. Evaluated metrics encompassed publication/citation trends, country/institution contributions, author impact, keyword co-occurrence patterns, thematic evolution across the study period.

Results

Among 1,133 publications, annual output surged post-2010, peaking in 2021. The United States and France dominated contributions, while Arthroscopy and Journal of Shoulder and Elbow Surgery were the leading journals. Provencher and Hurley were prolific authors, while Burkhart had the most cited papers. Keyword analysis revealed shifting priorities; “sport,” “return,” “fixation,” “epidemiology,” “remplissage,” and “glenoid bone loss” were the new keyword bursts in recent years and are still popular today. “Adolescent” and “congruent arc Latarjet technique” were new terms that had only emerged in the past 2 years.

Conclusions

The Latarjet procedure remains the standard treatment for anterior instability, with research increasingly focused on technical refinements, fixation alternatives, and individualized surgical planning.

Clinical Relevance

By identifying areas of research focus, this study may guide future advancements in the Latarjet procedure, ultimately improving the surgical management of shoulder dislocation.

目的评价Latarjet手术的相关文献，以确定临床实践和当前的研究重点。方法从Web of Science Core Collection检索1985 ~ 2024年间发表的与Latarjet手术相关的英文出版物。文件类型，包括更正、会议摘要、早期访问文章和传记项目，被排除在分析之外。本研究采用CiteSpace、VOSviewer、R-Bibliometrix和GraphPad Prism进行数据分析。评估指标包括出版/引用趋势、国家/机构贡献、作者影响力、关键词共现模式、研究期间的主题演变。结果在1133篇论文中，2010年后的年产出大幅增长，并在2021年达到顶峰。美国和法国占主导地位，而《关节镜》和《肩肘外科杂志》是主要期刊。普罗文彻和赫尔利都是多产的作者，而伯克哈特的论文被引用次数最多。关键词分析显示优先级变化；“运动”、“回归”、“固定”、“流行病学”、“康复”和“关节骨丢失”是近年来爆发的新关键词，至今仍很流行。“青春期”和“同弧拉塔捷技术”是近两年才出现的新术语。结论Latarjet手术仍然是治疗前路不稳的标准方法，研究越来越关注技术改进、固定选择和个体化手术计划。通过确定研究重点领域，本研究可能指导Latarjet手术的未来发展，最终改善肩关节脱位的外科治疗。

{"title":"Current Research Regarding the Latarjet Procedure Is Focused on Technical Refinements, Fixation Alternatives, and Individualized Surgical Planning","authors":"Jingyue Su M.D. , Pengyu Xiang M.D. , Chenhao Jia M.D. , Jiali Ma M.D. , Zhiyun Li M.D. , Jian Xu M.D., Ph.D. , Shengwu Yang M.D. , Chunwu Zhang M.D. , Wei Lu M.D. , Zhenhan Deng M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101160","DOIUrl":"10.1016/j.asmr.2025.101160","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the literature regarding the Latarjet procedure to identify clinical practices and current areas of research focus.</div></div><div><h3>Methods</h3><div>Publications related to the Latarjet procedure in English, published between 1985 and 2024, were retrieved from the Web of Science Core Collection. Document types, including corrections, meeting abstracts, early access articles, and biographical items, were excluded from the analysis. The study employed CiteSpace, VOSviewer, R-Bibliometrix, and GraphPad Prism for data analysis. Evaluated metrics encompassed publication/citation trends, country/institution contributions, author impact, keyword co-occurrence patterns, thematic evolution across the study period.</div></div><div><h3>Results</h3><div>Among 1,133 publications, annual output surged post-2010, peaking in 2021. The United States and France dominated contributions, while <em>Arthroscopy</em> and <em>Journal of Shoulder and Elbow Surgery</em> were the leading journals. Provencher and Hurley were prolific authors, while Burkhart had the most cited papers. Keyword analysis revealed shifting priorities; “sport,” “return,” “fixation,” “epidemiology,” “remplissage,” and “glenoid bone loss” were the new keyword bursts in recent years and are still popular today. “Adolescent” and “congruent arc Latarjet technique” were new terms that had only emerged in the past 2 years.</div></div><div><h3>Conclusions</h3><div>The Latarjet procedure remains the standard treatment for anterior instability, with research increasingly focused on technical refinements, fixation alternatives, and individualized surgical planning.</div></div><div><h3>Clinical Relevance</h3><div>By identifying areas of research focus, this study may guide future advancements in the Latarjet procedure, ultimately improving the surgical management of shoulder dislocation.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101160"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934136","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}

引用次数: 0

Three or More Revision Hip Arthroscopy Surgeries Is More Common in Female Patients and High-Grade Acetabular Chondral Lesions Lead to Increased Risk of Failure 三次或三次以上髋关节镜翻修手术在女性患者中更为常见，髋臼软骨高度病变导致手术失败的风险增加

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101166

Joseph J. Ruzbarsky M.D. , Spencer M. Comfort M.D. , Vera M. Stetzelberger M.D. , Justin J. Ernat M.D. , Nicholas A. Felan B.A. , Grant J. Dornan M.S. , Marc J. Philippon M.D.

Purpose

To characterize risk factors for patients who underwent multiple-revision hip arthroscopies and report survivorship at a minimum 2 years after hip arthroscopy.

Methods

Patients aged 18-65 years who underwent revision hip arthroscopy between January 2011 and September 2018 with ≥2-year follow-up were included. Exclusion criteria were age <18 or >65 years at time of surgery, center-edge angle <20°, previous ipsilateral periacetabular osteotomy, or refusal to participate. Procedures were categorized as first (R1), second (R2), or third or more (R3+) revisions. Demographics, preoperative radiographic measurements, baseline patient-reported outcomes (PROs), intraoperative findings, and survivorship were compared across groups and between those requiring further surgery or total hip arthroplasty (THA) and those who did not. Survivorship was defined as re-revision and arthroplasty-free survival. PROs included modified Harris Hip Score, Hip Outcome Score – Activities Daily Living, HOS-Sport, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form Physical and Mental Component Scores (12-Item Short Form Physical Component Score/Mental Component Score).

Results

A total of 284 hips (246 patients) met inclusion criteria, with mean follow-up of 4.3 ± 2.1 years. Female sex (52% vs 63% vs 78%, P = .03), primary hip arthroscopy at an outside institution (62% vs 78% vs 96%, P < .001), smaller alpha angle (64° vs 56° vs 50°, P < .001), and worse baseline PROs (modified Harris Hip Score, Hip Outcome Score – Activities Daily Living, HOS-Sport, Western Ontario and McMaster Universities Osteoarthritis Index; P = .05, P = .01, P < .001, P = .01) were associated with more previous revisions. Failure incidence did not differ between groups (P = .29), but the hazard ratio for further surgery or THA was greater for R3+ versus R1 (hazard ratio 2.4, 95% confidence interval 1.04-5.38, P = .04).

Conclusions

At a minimum 2-year follow-up, more prior revisions were associated with female sex, lower baseline PROs, capsular deficiency, and greater failure risk. Patients with lower nondysplastic lateral center-edge angles, severe acetabular cartilage damage, or ≥3 revisions had elevated risk for re-revision or THA.

Level of Evidence

Level IV, therapeutic case series.

目的分析多次髋关节镜翻修患者的危险因素，并报告髋关节镜术后至少2年的生存率。方法纳入2011年1月至2018年9月期间接受髋关节镜翻修术的18-65岁患者，随访≥2年。排除标准为手术时年龄18岁或65岁，中心边缘角20°，既往同侧髋臼周围截骨，或拒绝参加。程序被分类为第一次（R1），第二次（R2）或第三次或更多次（R3+）修订。人口统计学、术前x线测量、基线患者报告结果（PROs）、术中发现和生存率在组间以及需要进一步手术或全髋关节置换术（THA）和不需要手术的患者之间进行比较。生存期定义为重新翻修和无关节置换术生存期。PROs包括改良Harris髋关节评分、髋关节结果评分-日常生活活动、HOS-Sport、西安大略和麦克马斯特大学骨关节炎指数，以及简短的身心成分评分（12项简短的身体成分评分/精神成分评分）。结果284髋（246例）符合纳入标准，平均随访4.3±2.1年。女性（52% vs 63% vs 78%, P = 0.03）、在外部机构进行首次髋关节镜检查（62% vs 78% vs 96%, P < 0.001）、较小的α角（64°vs 56°vs 50°，P < 0.001）以及较差的基线PROs（修改后的Harris髋关节评分、髋关节结局评分-日常生活活动、HOS-Sport、西安大略和麦克马斯特大学骨关节炎指数；P = 0.05, P = 0.01, P < 001, P = 0.01）与更多的先前修订相关。失败发生率组间无差异（P = 0.29），但R3+组进一步手术或THA的风险比高于R1组（风险比2.4,95%可信区间1.04-5.38,P = 0.04）。结论：在至少2年的随访中，女性性别、较低的基线PROs、囊膜缺陷和更大的失败风险与更多的先前翻修相关。非发育不良的外侧中缘角较低、严重髋臼软骨损伤或翻修≥3次的患者再次翻修或THA的风险增加。证据水平：IV级，治疗性病例系列。

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引用次数: 0

Thigh Muscle Volume Remains Decreased on 3-Dimensional Magnetic Resonance Imaging at Minimum of 5 Years After Patellar Tendon but not Allograft Anterior Cruciate Ligament Reconstruction 髌腱重建后至少5年的三维磁共振成像显示大腿肌肉体积仍然减少，而不是同种异体前交叉韧带重建

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101191

Collin D.R. Hunter B.S., Natalya McNamara M.D., Reece M. Rosenthal, Joseph Featherall M.D., Patrick Greis M.D., Travis G. Maak M.D., Stephen K. Aoki M.D., Justin J. Ernat M.D.

Purpose

To evaluate thigh muscle volume differences in patients undergoing anterior cruciate ligament reconstruction (ACLR) with either allograft tissue or bone−patellar tendon−bone (BPTB) autografts, using 3-dimensional magnetic resonance imaging (MRI) modeling.

Methods

This is a retrospective, single-center study of patients undergoing primary ACLR with either ipsilateral BPTB autograft or allograft tissue. Inclusion criteria were age 18-45 years, 5 to 8 years of follow-up, and body mass index <30. Patients were excluded if they had multiligamentous knee injuries, surgical treatment of meniscus tears (repair or reconstruction), and any subsequent knee procedures after the index ACLR. 3D MRI of the bilateral thighs was performed and images were rendered with 3D modeling software and the total thigh, anterior-, posterior-, and medial-thigh compartment musculature were individually segmented and the volumes were calculated. Data were evaluated using a t test, and muscle volumes were standardized as a percentage of the corresponding nonoperative extremity and then tested in comparison with the alternative graft type.

Results

Ten allograft and 10 patients with BPTB were included. Patients with allograft were older at surgery (mean age 34.6 vs 23.4 years (P < .001) and at study MRI (mean age 40.9 vs 29.7 years; P < .001). Allografts showed no differences in total thigh or compartmental muscle volumes between the operative and nonoperative limbs. BPTB showed a statistically significant reduction in total thigh volume on the operative side (103 cm³, 97.0%, P = .013), whereas compartment volumes remained similar between limbs. Percentage changes in volume comparing injured with contralateral thigh volume was not significantly different between graft type groups.

Conclusions

No significant side-to-side differences were found in individual thigh compartments or total volume after allograft ACLR. BPTB ACLR has a modest effect (∼3%) on long-term total thigh muscle volume.

Level of Evidence

Level III, retrospective cohort study.

目的利用三维磁共振成像（MRI）模型，评价同种异体组织或自体骨-髌腱-骨（BPTB）移植行前交叉韧带重建（ACLR）患者大腿肌肉体积的差异。方法：这是一项回顾性的单中心研究，研究对象是接受原发性ACLR的同侧BPTB自体移植或同种异体移植组织患者。纳入标准为年龄18-45岁，随访5 - 8年，体重指数30。如果患者有膝关节多韧带损伤，手术治疗半月板撕裂（修复或重建），以及指数ACLR后的任何后续膝关节手术，则排除患者。对双侧大腿进行三维MRI扫描，用三维建模软件绘制图像，分别对大腿、大腿前侧、后侧和大腿内侧隔室肌肉组织进行分割并计算体积。使用t检验对数据进行评估，并将肌肉体积标准化为相应非手术肢体的百分比，然后与替代移植物类型进行比较。结果10例BPTB患者均接受同种异体移植。同种异体移植患者在手术时年龄较大(平均年龄34.6岁比23.4岁（P < 0.001），在研究MRI时年龄较大（平均年龄40.9岁比29.7岁；P < 0.001）。同种异体移植物在手术和非手术肢体之间的总大腿或室间肌体积没有差异。BPTB患者手术侧大腿总容积减少（103 cm3, 97.0%, P = 0.013），而四肢间室容积保持相似。不同移植物类型组间对侧大腿体积百分率变化无显著性差异。结论同种异体ACLR移植后各股间室及总容积均无显著差异。BPTB ACLR对长期总大腿肌肉容量有适度的影响（约3%）。证据水平：III级，回顾性队列研究。

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引用次数: 0

Sociodemographic Variables Are Rarely Reported in Studies Investigating Ulnar Collateral Ligament Reconstruction: A Systematic Review 调查尺侧副韧带重建的研究很少报道社会人口学变量：系统回顾

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101189

Erin L. Brown B.A. , Kenneth T. Nguyen B.S. , Won-Kwem W. Kim B.S. , Shreya M. Saraf M.S. , Mary K. Mulcahey M.D.

Purpose

To evaluate the reporting of sociodemographic variables in studies related to ulnar collateral ligament (UCL) reconstruction.

Methods

A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Scopus were searched on April 9, 2024, using the terms “medial ulnar collateral ligament reconstruction,” “ulnar collateral ligament reconstruction,” “ulnar collateral ligament surgery,” or “Tommy John Surgery.” Studies were included if they were randomized controlled trials, case control studies, cross-sectional studies, cohort studies, and case series in English. The presence of sociodemographic variables, including sex or gender and age, as well as the presence of sociodemographic variables, including race, ethnicity, insurance status, income, housing status, work status, and level of education were collected. Descriptive statistics and χ² tests or Fisher exact tests were used for analysis.

Results

The initial database search yielded 1,504 studies, with 831 duplicates removed and an additional 598 studies excluded after title and abstract screening. Of the remaining 75 studies, 31 were excluded after full-text screening, leaving 44 studies for inclusion, all published between 2006 and 2024. Among these, sociodemographic variables (e.g., race: 0/44, ethnicity: 0/44, insurance status: 0/44, level of education: 10/44, income: 0/44, work status: 12/44) were reported significantly less frequently than demographic factors such as age (42/44; 95.5%), and sex or gender (24/44; 54.5%; P < 0.05). There was no significant difference in reporting of any sociodemographic variables among included journals (P = .83) or by year of publication (P = .67).

Conclusions

This systematic review highlights a critical lack in the reporting of sociodemographic variables within studies examining UCL reconstruction, with a significantly greater rate of reporting of demographic factors, such as age and sex or gender, compared with sociodemographic variables like race and ethnicity.

Level of Evidence

Level IV, systematic review of level II-IV studies.

目的评价尺侧副韧带（UCL）重建相关研究中社会人口学变量的报告。方法根据系统评价和荟萃分析指南的首选报告项目进行系统评价。在2024年4月9日检索PubMed、Embase和Scopus，检索词为“内侧尺侧副韧带重建”、“尺侧副韧带重建”、“尺侧副韧带手术”或“汤米·约翰手术”。纳入随机对照试验、病例对照研究、横断面研究、队列研究和英文病例系列研究。收集社会人口变量的存在，包括性别或性别和年龄，以及社会人口变量的存在，包括种族、民族、保险状况、收入、住房状况、工作状况和教育水平。采用描述性统计、χ2检验或Fisher精确检验进行分析。最初的数据库检索产生了1504项研究，在标题和摘要筛选后，删除了831项重复研究，另外排除了598项研究。在剩下的75项研究中，31项在全文筛选后被排除，剩下44项研究被纳入，这些研究均发表于2006年至2024年之间。其中，社会人口学变量（如种族：0/44，民族：0/44，保险状况：0/44，教育水平：10/44，收入：0/44，工作状况：12/44）的报告频率明显低于人口统计学因素，如年龄（42/44;95.5%）和性别或性别（24/44;54.5%;P < 0.05）。在纳入的期刊（P = 0.83）或出版年份（P = 0.67）中，任何社会人口学变量的报告没有显著差异。本系统综述强调了在检查UCL重建的研究中严重缺乏对社会人口变量的报告，与种族和民族等社会人口变量相比，年龄、性别或性别等人口因素的报告率要高得多。证据水平：IV级，II-IV级研究的系统评价。

{"title":"Sociodemographic Variables Are Rarely Reported in Studies Investigating Ulnar Collateral Ligament Reconstruction: A Systematic Review","authors":"Erin L. Brown B.A. , Kenneth T. Nguyen B.S. , Won-Kwem W. Kim B.S. , Shreya M. Saraf M.S. , Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101189","DOIUrl":"10.1016/j.asmr.2025.101189","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the reporting of sociodemographic variables in studies related to ulnar collateral ligament (UCL) reconstruction.</div></div><div><h3>Methods</h3><div>A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Scopus were searched on April 9, 2024, using the terms “medial ulnar collateral ligament reconstruction,” “ulnar collateral ligament reconstruction,” “ulnar collateral ligament surgery,” or “Tommy John Surgery.” Studies were included if they were randomized controlled trials, case control studies, cross-sectional studies, cohort studies, and case series in English. The presence of sociodemographic variables, including sex or gender and age, as well as the presence of sociodemographic variables, including race, ethnicity, insurance status, income, housing status, work status, and level of education were collected. Descriptive statistics and χ<sup>2</sup> tests or Fisher exact tests were used for analysis.</div></div><div><h3>Results</h3><div>The initial database search yielded 1,504 studies, with 831 duplicates removed and an additional 598 studies excluded after title and abstract screening. Of the remaining 75 studies, 31 were excluded after full-text screening, leaving 44 studies for inclusion, all published between 2006 and 2024. Among these, sociodemographic variables (e.g., race: 0/44, ethnicity: 0/44, insurance status: 0/44, level of education: 10/44, income: 0/44, work status: 12/44) were reported significantly less frequently than demographic factors such as age (42/44; 95.5%), and sex or gender (24/44; 54.5%; <em>P</em> < 0.05). There was no significant difference in reporting of any sociodemographic variables among included journals (<em>P</em> = .83) or by year of publication (<em>P</em> = .67).</div></div><div><h3>Conclusions</h3><div>This systematic review highlights a critical lack in the reporting of sociodemographic variables within studies examining UCL reconstruction, with a significantly greater rate of reporting of demographic factors, such as age and sex or gender, compared with sociodemographic variables like race and ethnicity.</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 4","pages":"Article 101189"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934137","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}

引用次数: 0

Patient Online Ratings of Sports Medicine Surgeons Most Commonly Relate to Bedside Manner and Communication 患者对运动医学外科医生的在线评分通常与床边态度和沟通有关

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101202

Shea E. Randall B.A. , Klea Gjonaj M.S. , Raheyma N. Siddiqui B.A. , Julia Mansour B.S. , Siddharth Mehrotra B.S. , Shreya M. Saraf M.S. , Mary K. Mulcahey M.D.

Purpose

To determine whether online ratings of sports medicine surgeons are more heavily influenced by clinical or nonclinical factors and to determine whether gender and geographic region influence surgeon reviews.

Methods

A list of 102 sports medicine surgeons who were members of the American Academy of Orthopaedic Surgeons was randomly generated. Each surgeon was searched on the Healthgrades and Google Reviews websites, and every 1- and 5-star review for each surgeon since 2022 was compiled. The comments within these reviews were subsequently classified as clinical and nonclinical based on predetermined categories.

Results

Surgeons averaged 25 five-star reviews (range, 0-119) and 1 one-star review (range, 0-7) from Healthgrades and Google Reviews. Among 5-star reviews, the most common positive comments were related to bedside manner (n = 1,336; 56%), communication (n = 1,216; 50.9%), and treatment success (n = 453; 19%). The most common negative comments among 1-star reviews were related to communication (n = 59; 46.8%), bedside manner (n = 57; 45.2%), and appointment efficiency/scheduling (n = 38; 30.2%). Overall, both 1- and 5-star reviews contained a higher proportion of nonclinical comments than clinical comments. Female sports medicine surgeons had a higher proportion of clinical comments in their 1-star reviews (28 of 58, 48.3%) compared with their male counterparts (58 of 202, 28.7%) (P = .01).

Conclusions

Most 5- and 1-star reviews of sports medicine surgeons complimented or critiqued nonclinical aspects of patient care. Among both 5- and 1-star reviews, the most common comments related to communication and bedside manner. Thus, sports medicine surgeons can improve patient satisfaction by focusing on overall demeanor and communication skills.

Clinical Relevance

These findings offer valuable insights into patient satisfaction and guide efforts to improve patient experiences and outcomes within orthopaedic sports medicine.

目的确定临床或非临床因素对运动医学外科医生的在线评分的影响更大，并确定性别和地理区域是否影响外科医生的评价。方法随机抽取102名美国骨科学会会员的运动医学外科医生。每位外科医生都在Healthgrades和谷歌Reviews网站上进行了搜索，并编译了自2022年以来每位外科医生的所有1星和5星评论。这些综述中的评论随后根据预先确定的类别分为临床和非临床。结果外科医生在健康等级和谷歌评价中平均获得25个五星评价（范围0-119）和1个一星评价（范围0-7）。在5星评价中，最常见的正面评价与床边态度（n = 1336; 56%）、沟通（n = 1216; 50.9%）和治疗成功（n = 453; 19%）有关。一星评价中最常见的差评与沟通（n = 59, 46.8%）、对病人态度（n = 57, 45.2%）和预约效率/安排（n = 38, 30.2%）有关。总体而言，1星和5星评价包含的非临床评论比临床评论的比例更高。女性运动医学外科医生在1星评价中的临床评论比例（58分之28,48.3%）高于男性同行（202分之58,28.7%）（P = 0.01）。结论：大多数运动医学外科医生的5星和1星评价赞扬或批评了患者护理的非临床方面。在5星和1星的评论中，最常见的评论与沟通和对病人的态度有关。因此，运动医学外科医生可以通过关注整体举止和沟通技巧来提高患者满意度。临床相关性这些发现对患者满意度提供了有价值的见解，并指导了骨科运动医学中改善患者体验和结果的努力。

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引用次数: 0

Major League Baseball Pitchers Experienced Increased Flexor Tendon and Forearm Injuries 2 Years After Pitch Clock Implementation 美国职业棒球大联盟投手在使用投球钟2年后，屈肌腱和前臂损伤增加

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101171

Troy B. Puga D.O., M.B.A., M.P.H. , McKenna W. Box M.D. , Winston Scambler B.S. , Hans Drawbert M.S., M.D. , John T. Riehl M.D.

Purpose

To evaluate the incidence of pitcher injuries 2 years after implementation of the Major League Baseball (MLB) pitch clock.

Methods

Injury data were collected for the 2021, 2022, 2023, and 2024 MLB seasons using the fangraphs.com injury database. The incidence rate ratio was calculated to compare the injury rate for the 2024 season with that for each of the 2021, 2022, and 2023 seasons. Data were pooled for the pre- and post-pitch clock seasons and were compared in similar fashion to the individual seasons using the incidence rate ratio. The z test for proportions was used to determine significance.

Results

The 2024 MLB season, with 366 overall injuries, showed a decrease in the overall number of injuries compared with the 2021 season, which had 467 overall injuries (P < .001), and the 2022 season, which had 461 overall injuries (P < .001). The 2024 season, with 61 lower-extremity injuries, showed a decrease in the number of lower-extremity injuries compared with the 2021 season, which had 104 lower-extremity injuries (P = .001), and the 2022 season, which had 87 lower-extremity injuries (P = .03). The 2024 season, with 55 torso injuries, showed a decrease in the number of torso injuries compared with the 2022 season, which had 75 torso injuries (P = .04). The 2024 season, which had 62 flexor tendon/forearm injuries, revealed a statistically significant rise in flexor tendon/forearm injuries compared with the 2021 season, with 37 injuries (P = .01); the 2022 season, with 33 injuries (P = .005); and the 2023 season, with 36 injuries (P = .02). There was no statistically significant difference in the number of ulnar collateral ligament operations when the 2024 MLB season (n = 34) was compared with the 2021 season (n = 20), 2022 season (n = 30), and 2023 season (n = 27). When the pre-and post-pitch clock pooled data were compared, there was a significant decrease in overall injuries (P < .001) and lower-extremity injuries (P = .004). This comparison also revealed a significant increase in flexor tendon/forearm injuries (P = .04).

Conclusions

Two years after the implementation of the MLB pitch clock, there was a decrease in the incidence of overall injury rates and lower-extremity injuries. There remained no associated increase in ulnar collateral ligament operations 2 years after implementation. However, the pre- versus post-pitch clock comparison showed a rise in flexor tendon and forearm injuries in the 2024 season.

Level of Evidence

Level III, retrospective cohort study.

目的评估美国职业棒球大联盟（MLB）投球钟实施2年后投手受伤的发生率。方法使用fangraphs.com伤病数据库收集2021、2022、2023和2024赛季MLB的伤病数据。发病率比的计算是为了比较2024赛季与2021、2022和2023赛季的伤病率。收集了球场时钟前后赛季的数据，并使用发病率比以类似的方式与单个赛季进行比较。采用比例的z检验来确定显著性。结果美国职业棒球大联盟（MLB） 2024赛季总受伤人数为366人，与2021赛季总受伤人数467人（P < 0.001）和2022赛季总受伤人数461人（P < 0.001）相比，总受伤人数有所减少。与2021赛季的104例下肢受伤（P = 0.001）和2022赛季的87例下肢受伤（P = 0.03）相比，2024赛季的下肢受伤人数为61例，下肢受伤人数有所减少。2024赛季有55人躯干受伤，与2022赛季的75人躯干受伤相比，躯干受伤的数量有所减少（P = 0.04）。2024赛季，有62例屈肌腱/前臂损伤，与2021赛季的37例相比，有统计学意义的屈肌腱/前臂损伤增加（P = 0.01）；2022赛季，33人受伤（P = 0.005）；2023赛季，36人受伤（P = 0.02）。与2021赛季（n = 20）、2022赛季（n = 30）、2023赛季（n = 27）相比，2024赛季（n = 34）尺侧副韧带手术次数无统计学差异。当比较前后的数据时，总体损伤（P < 0.001）和下肢损伤（P = 0.004）显著减少。该比较还显示屈肌腱/前臂损伤显著增加（P = 0.04）。结论美国职业棒球大联盟投球钟实施两年后，整体损伤率和下肢损伤发生率均有所下降。术后2年尺侧副韧带手术未见相关增加。然而，前后对比显示，2024赛季屈肌腱和前臂损伤增加。证据水平：III级，回顾性队列研究。

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引用次数: 0

The COVID-19 Pandemic Did Not Have a Negative Impact on Psychological Readiness to Return to Sport 6 Months After Anterior Cruciate Ligament Reconstruction COVID-19大流行对前交叉韧带重建后6个月重返运动的心理准备没有负面影响

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation

Pub Date : 2025-08-01 DOI: 10.1016/j.asmr.2025.101174

Adam Nasreddine M.D. , Aditi S. Majumdar M.D. , Rohit Siddabattula B.A. , Matthew D. Milewski M.D. , Emma C. Gossman B.S. , Ryan P. Coene M.S. , Danielle L. Cook M.A. , Mininder S. Kocher M.D., M.P.H. , Dennis E. Kramer M.D. , Lyle J. Micheli M.D. , Yi-Meng Yen M.D., Ph.D. , Melissa A. Christino M.D.

Purpose

To compare 6-month postoperative levels of psychological readiness to return to sport (RTS) in patients who underwent anterior cruciate ligament reconstruction (ACLR) before and during the COVID-19 pandemic.

Methods

Patients between 8 and 35 years of age were enrolled 6 months post primary ACLR at an academic sports medicine practice from December 2018 to May 2021 and categorized into pre-COVID-19 and COVID-19 groups. Demographics and outcomes scores, including ACL-Return to Sport after Injury Scale, Patient-Reported Outcomes Measurement Information System Psychological Stress Experiences, International Knee Documentation Committee Score (IKDC), Pediatric Functional Activity Brief Scale, and physician RTS clearance were compared. χ², Student t tests, and linear regression were performed. A matched analysis between groups was completed, controlling for age, sex, and graft type.

Results

A total of 231 patients were included (89 male, 142 female, average age 16.9 years), with 76% (176/231) in the pre-COVID-19 group and 24% (55/231) in the COVID-19 group. No significant differences in age and sex were noted between cohorts. A significant difference in time from surgery to enrollment was seen in the COVID-19 group compared to the pre-COVID-19 group (7.1 vs 6.2 months, P < .001). In the matched analysis cohort (n = 126, 37/126 COVID-19 group), the COVID-19 group received RTS clearance earlier than the pre-COVID-19 group (6.9 months vs 8.8 months, P < .001). Six-month ACL-RSI scores showed no significant differences between groups (63.8 pre-COVID-19 vs 67.0 COVID-19, P = .42), with both groups scoring low. There were no significant differences between matched groups in Patient-Reported Outcomes Measurement Information System Psychological Stress Experiences (P = .37), IKDC (P = .43), Pedi-IKDC (P = .35), and Pedi-Function Activity Brief Scale (P = .74).

Conclusions

Young patients showed similar levels of psychological readiness to RTS at 6 months after ACLR before and during the COVID-19 pandemic. Patient-reported outcome scores were comparable between groups, suggesting minimal COVID-19 pandemic impact on perceptions of recovery. Psychological readiness may not be fully optimized at 6 months post-ACLR, and young patients may benefit from additional time and rehabilitation.

Level of Evidence

Level III, retrospective cohort analysis of prospectively collected data.

目的比较2019冠状病毒病（COVID-19）大流行前后行前交叉韧带重建（ACLR）患者术后6个月重返运动的心理准备水平。方法于2018年12月至2021年5月在一家学术运动医学实践中心招募原发性ACLR后6个月的8至35岁患者，并将其分为COVID-19前组和COVID-19组。比较人口统计学和结局评分，包括损伤后恢复运动量表、患者报告的结果测量信息系统心理应激经历、国际膝关节文献委员会评分（IKDC）、儿科功能活动简要量表和医生RTS清除率。χ2、Student t检验，并进行线性回归。在控制年龄、性别和移植物类型的情况下，完成了组间的匹配分析。结果共纳入231例患者，其中男性89例，女性142例，平均年龄16.9岁，其中新冠肺炎前期组占76%(176/231)，新冠肺炎组占24%（55/231）。队列之间的年龄和性别没有显著差异。与COVID-19前组相比，COVID-19组从手术到入组的时间有显著差异（7.1个月vs 6.2个月，P < 0.001）。在匹配分析队列（n = 126, 37/126 COVID-19组）中，COVID-19组比COVID-19前组更早获得RTS清除（6.9个月vs 8.8个月，P < 0.001）。6个月的ACL-RSI评分在两组间无显著差异（新冠病毒前63.8 vs新冠病毒前67.0,P = 0.42），两组评分均较低。配对组在患者报告结果测量信息系统心理应激经历（P = 0.37）、IKDC （P = 0.43）、pedii -IKDC （P = 0.35）和pedii -功能活动简短量表（P = 0.74）方面无显著差异。结论年轻患者在ACLR后6个月对RTS的心理准备水平与COVID-19大流行前和期间相似。患者报告的结果评分在两组之间具有可比性，表明COVID-19大流行对康复认知的影响最小。心理准备在aclr后6个月可能不会完全优化，年轻患者可能会从额外的时间和康复中受益。证据水平：III级，前瞻性收集数据的回顾性队列分析。

{"title":"The COVID-19 Pandemic Did Not Have a Negative Impact on Psychological Readiness to Return to Sport 6 Months After Anterior Cruciate Ligament Reconstruction","authors":"Adam Nasreddine M.D. , Aditi S. Majumdar M.D. , Rohit Siddabattula B.A. , Matthew D. Milewski M.D. , Emma C. Gossman B.S. , Ryan P. Coene M.S. , Danielle L. Cook M.A. , Mininder S. Kocher M.D., M.P.H. , Dennis E. Kramer M.D. , Lyle J. Micheli M.D. , Yi-Meng Yen M.D., Ph.D. , Melissa A. Christino M.D.","doi":"10.1016/j.asmr.2025.101174","DOIUrl":"10.1016/j.asmr.2025.101174","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare 6-month postoperative levels of psychological readiness to return to sport (RTS) in patients who underwent anterior cruciate ligament reconstruction (ACLR) before and during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Patients between 8 and 35 years of age were enrolled 6 months post primary ACLR at an academic sports medicine practice from December 2018 to May 2021 and categorized into pre-COVID-19 and COVID-19 groups. Demographics and outcomes scores, including ACL-Return to Sport after Injury Scale, Patient-Reported Outcomes Measurement Information System Psychological Stress Experiences, International Knee Documentation Committee Score (IKDC), Pediatric Functional Activity Brief Scale, and physician RTS clearance were compared. χ<sup>2</sup>, Student <em>t</em> tests, and linear regression were performed. A matched analysis between groups was completed, controlling for age, sex, and graft type.</div></div><div><h3>Results</h3><div>A total of 231 patients were included (89 male, 142 female, average age 16.9 years), with 76% (176/231) in the pre-COVID-19 group and 24% (55/231) in the COVID-19 group. No significant differences in age and sex were noted between cohorts. A significant difference in time from surgery to enrollment was seen in the COVID-19 group compared to the pre-COVID-19 group (7.1 vs 6.2 months, <em>P</em> < .001). In the matched analysis cohort (n = 126, 37/126 COVID-19 group), the COVID-19 group received RTS clearance earlier than the pre-COVID-19 group (6.9 months vs 8.8 months, <em>P</em> < .001). Six-month ACL-RSI scores showed no significant differences between groups (63.8 pre-COVID-19 vs 67.0 COVID-19, <em>P</em> = .42), with both groups scoring low. There were no significant differences between matched groups in Patient-Reported Outcomes Measurement Information System Psychological Stress Experiences (<em>P</em> = .37), IKDC (<em>P</em> = .43), Pedi-IKDC (<em>P</em> = .35), and Pedi-Function Activity Brief Scale (<em>P</em> = .74).</div></div><div><h3>Conclusions</h3><div>Young patients showed similar levels of psychological readiness to RTS at 6 months after ACLR before and during the COVID-19 pandemic. Patient-reported outcome scores were comparable between groups, suggesting minimal COVID-19 pandemic impact on perceptions of recovery. Psychological readiness may not be fully optimized at 6 months post-ACLR, and young patients may benefit from additional time and rehabilitation.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort analysis of prospectively collected data.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101174"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934130","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}

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