Pub Date : 2024-02-10DOI: 10.1016/j.asmr.2024.100891
Stephanie E. Wong M.D. , Kaitlyn R. Julian B.S. , Jocelyn G. Carpio B.S. , Alan L. Zhang M.D.
Purpose
To evaluate patient-reported outcomes and risk for rerupture after surgical treatment of proximal hamstring tendon ruptures using all-suture anchors and a unique postoperative bracing strategy.
Methods
A retrospective review of a prospectively collected database was conducted of patients undergoing proximal hamstring repair or reconstruction from 2020 to 2022 at a tertiary, academic institution. Patients were included if they reached minimum 1-year follow-up and completed postoperative patient-reported outcomes. The surgical protocol for proximal hamstring repairs included all-suture anchors placed either in an open or endoscopic fashion in the ischial tuberosity. After surgery, all patients underwent an accelerated rehabilitation protocol, including 6 weeks touchdown weight-bearing in a hinged knee brace locked in extension for ambulation, allowing passive knee flexion to 90° while seated. Descriptive statistics were used to analyze the data.
Results
Twenty-one patients were included (mean age 50.4 ± 9.5 years, body mass index 24.4 ± 3.5, 66.7% female). Lower Extremity Functional Scale score achieved postoperatively was 74.2 ± 7.5 (out of 80). Patients had minimal pain (mean visual analog scale pain score of 0.9 ± 1.2). 61.9% of patients were able to return to the same level of activity after based on Tegner score by 1 year. Postoperative Single Assessment Numeric Evaluation activity of daily living was 94.3 ± 8.3, and Single Assessment Numeric Evaluation Sports was 82.3 ± 19.0. Mean Short Form Survey (SF-12) postoperative scores were 51.6 ± 6.8 for SF-12 Physical Component Score and 53.9 ± 9.7 for Mental Component Score. 95.2% (20 of 21) patients were satisfied with their outcome. There were no reruptures, infections, or reoperations. One patient of 21 (4.8%) incurred a postoperative deep venous thrombosis, which was treated with therapeutic anticoagulation for 3 months.
Conclusions
All-suture anchors for proximal hamstring repair with a unique accelerated postoperative rehabilitation and bracing protocol result in good outcomes and patient satisfaction with minimal risk of complications.
{"title":"Proximal Hamstring Repair With All-Suture Anchors and an Accelerated Rehabilitation and Bracing Protocol Demonstrates Good Outcomes at 1-Year Follow-Up","authors":"Stephanie E. Wong M.D. , Kaitlyn R. Julian B.S. , Jocelyn G. Carpio B.S. , Alan L. Zhang M.D.","doi":"10.1016/j.asmr.2024.100891","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100891","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate patient-reported outcomes and risk for rerupture after surgical treatment of proximal hamstring tendon ruptures using all-suture anchors and a unique postoperative bracing strategy.</p></div><div><h3>Methods</h3><p>A retrospective review of a prospectively collected database was conducted of patients undergoing proximal hamstring repair or reconstruction from 2020 to 2022 at a tertiary, academic institution. Patients were included if they reached minimum 1-year follow-up and completed postoperative patient-reported outcomes. The surgical protocol for proximal hamstring repairs included all-suture anchors placed either in an open or endoscopic fashion in the ischial tuberosity. After surgery, all patients underwent an accelerated rehabilitation protocol, including 6 weeks touchdown weight-bearing in a hinged knee brace locked in extension for ambulation, allowing passive knee flexion to 90° while seated. Descriptive statistics were used to analyze the data.</p></div><div><h3>Results</h3><p>Twenty-one patients were included (mean age 50.4 ± 9.5 years, body mass index 24.4 ± 3.5, 66.7% female). Lower Extremity Functional Scale score achieved postoperatively was 74.2 ± 7.5 (out of 80). Patients had minimal pain (mean visual analog scale pain score of 0.9 ± 1.2). 61.9% of patients were able to return to the same level of activity after based on Tegner score by 1 year. Postoperative Single Assessment Numeric Evaluation activity of daily living was 94.3 ± 8.3, and Single Assessment Numeric Evaluation Sports was 82.3 ± 19.0. Mean Short Form Survey (SF-12) postoperative scores were 51.6 ± 6.8 for SF-12 Physical Component Score and 53.9 ± 9.7 for Mental Component Score. 95.2% (20 of 21) patients were satisfied with their outcome. There were no reruptures, infections, or reoperations. One patient of 21 (4.8%) incurred a postoperative deep venous thrombosis, which was treated with therapeutic anticoagulation for 3 months.</p></div><div><h3>Conclusions</h3><p>All-suture anchors for proximal hamstring repair with a unique accelerated postoperative rehabilitation and bracing protocol result in good outcomes and patient satisfaction with minimal risk of complications.</p></div><div><h3>Level of Evidence</h3><p>Level IV, case series, therapeutic.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100891"},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000099/pdfft?md5=2c8c0b8fe6e62bc3d5f1eb105af12fb8&pid=1-s2.0-S2666061X24000099-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718977","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}
Pub Date : 2024-02-09DOI: 10.1016/j.asmr.2023.100879
Sean W.L. Ho M.D. , Tiago Martinho M.D. , Arash Amiri M.D. , Jeanni Zbinden M.D. , Xue Ling Chong M.D. , Hugo Bothorel M.E. , Philippe Collin M.D. , Alexandre Lädermann M.D.
Purpose
To determine the clinical and radiologic outcomes after surgical repair of medial bursal-side Fosbury flop rotator cuff tears compared with traditional avulsion of tendinous attachments lesions.
Methods
A retrospective cohort study was performed. All patients who had undergone arthroscopic posterosuperior repair were recruited. Patients with previous shoulder rotator cuff surgery were excluded. Recruited patients were divided into 2 groups: one presenting Fosbury flop tears and the other presenting with standard avulsion lesions. Preoperative demographics such as age, gender, and arm dominance were recorded. Range of motion (ROM), visual analog scale (VAS) for pain and satisfaction, Constant score, Single Alpha-Numeric Evaluation score, and American Shoulder and Elbow Surgeons score were evaluated at 3 points in time: preoperatively, and at 6 months and minimum 1-year postoperatively. The healing of repaired cuffs was evaluated by ultrasound at 6 months.
Results
Two hundred thirty-six patients were recruited, with 27 (11.4%) Fosbury flop tears and 209 (88.6%) tendon avulsions. Although there was no significant difference in gender or arm dominance between the groups, Fosbury flop tears had significantly older patients (P < .05) with a mean age 61.6 years (standard deviation 9.0), compared with tendon avulsions with a mean age of 56.1 years (standard deviation 9.1). There was no significant difference in tendon retraction between the groups. Both groups demonstrated significant improvement in ROM, visual analog scale, American Shoulder and Elbow Surgeons, Single Alpha-Numeric Evaluation, and Constant score postoperatively at 6 months and minimum 1 year. The groups demonstrated no significant difference in the ROM and clinical scores. There was a nonsignificant difference in re-tear rate of 7.4% (2/27) in Fosbury flop tears compared with 2.8% (6/209) in tendon avulsions (P = .361).
Conclusions
Arthroscopic rotator cuff repair of medial bursal side Fosbury Flop rotator cuff tears results in favorable clinical and radiologic outcomes at 4 years after surgery. These outcomes are comparable with surgically repaired avulsion lesions, with an acceptable retear rate after arthroscopic repair.
Level of Evidence
Level III, retrospective comparative prognostic trial.
{"title":"Clinical and Radiologic Outcomes of Arthroscopic Rotator Cuff Repair in Medial Bursal-Side Fosbury Flop Tears Compared With Tendinous Avulsion Lesions","authors":"Sean W.L. Ho M.D. , Tiago Martinho M.D. , Arash Amiri M.D. , Jeanni Zbinden M.D. , Xue Ling Chong M.D. , Hugo Bothorel M.E. , Philippe Collin M.D. , Alexandre Lädermann M.D.","doi":"10.1016/j.asmr.2023.100879","DOIUrl":"https://doi.org/10.1016/j.asmr.2023.100879","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the clinical and radiologic outcomes after surgical repair of medial bursal-side Fosbury flop rotator cuff tears compared with traditional avulsion of tendinous attachments lesions.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was performed. All patients who had undergone arthroscopic posterosuperior repair were recruited. Patients with previous shoulder rotator cuff surgery were excluded. Recruited patients were divided into 2 groups: one presenting Fosbury flop tears and the other presenting with standard avulsion lesions. Preoperative demographics such as age, gender, and arm dominance were recorded. Range of motion (ROM), visual analog scale (VAS) for pain and satisfaction, Constant score, Single Alpha-Numeric Evaluation score, and American Shoulder and Elbow Surgeons score were evaluated at 3 points in time: preoperatively, and at 6 months and minimum 1-year postoperatively. The healing of repaired cuffs was evaluated by ultrasound at 6 months.</p></div><div><h3>Results</h3><p>Two hundred thirty-six patients were recruited, with 27 (11.4%) Fosbury flop tears and 209 (88.6%) tendon avulsions. Although there was no significant difference in gender or arm dominance between the groups, Fosbury flop tears had significantly older patients (<em>P</em> < .05) with a mean age 61.6 years (standard deviation 9.0), compared with tendon avulsions with a mean age of 56.1 years (standard deviation 9.1). There was no significant difference in tendon retraction between the groups. Both groups demonstrated significant improvement in ROM, visual analog scale, American Shoulder and Elbow Surgeons, Single Alpha-Numeric Evaluation, and Constant score postoperatively at 6 months and minimum 1 year. The groups demonstrated no significant difference in the ROM and clinical scores. There was a nonsignificant difference in re-tear rate of 7.4% (2/27) in Fosbury flop tears compared with 2.8% (6/209) in tendon avulsions (<em>P</em> = .361).</p></div><div><h3>Conclusions</h3><p>Arthroscopic rotator cuff repair of medial bursal side Fosbury Flop rotator cuff tears results in favorable clinical and radiologic outcomes at 4 years after surgery. These outcomes are comparable with surgically repaired avulsion lesions, with an acceptable retear rate after arthroscopic repair.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective comparative prognostic trial.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100879"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X23002304/pdfft?md5=f8052d4fda2282226acb43281604bcc4&pid=1-s2.0-S2666061X23002304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139714578","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}
Pub Date : 2024-02-09DOI: 10.1016/j.asmr.2024.100892
Hanmei Dong M.D. , Maihemuti Maimaitimin M.D. , Chenbo Jiao , Yuhao Liu , Guanying Gao M.D. , Tongchuan He M.D. Ph, D. , Yan Xu M.D.
Purpose
To determine the reliability of 3-dimensional (3D) reconstruction of computed tomography (CT) imaging in evaluating acetabular rim morphology or acetabular rim osteophyte (ARO) existence and to group patients with femoroacetabular impingement (FAI) by ARO extent on coronal sections of CT and further compare clinical differences among groups.
Methods
Patients who underwent primary hip arthroscopy for FAI by the same surgeon between August 2016 and December 2018 with minimum 2-year follow-up were enrolled. The ARO was evaluated both on the acetabular gross anatomy (AGA) and coronal sections of CT, for its position, width (unit: mm), area (unit: mm2), and CT value (unit: HU). Patients were divided into 4 groups based on the extent of ARO on coronal CT: group A (ARO anterior to 12 o’clock), group P (ARO posterior to 12 o’clock), group AP (ARO across 12 o’clock), and group N (no ARO). Inter- and intraobserver correlation was analyzed. Demographic data, FAI deformity indicators on imaging, quantitative measurements of ARO, and pre- and postoperative patient-reported outcomes were compared among groups.
Results
There were 229 patients (229 hips) enrolled in total, 122 male (53.3%) and 107 female (46.7%), with a mean age of 37.2 ± 10.2 years. The correlation between 2 observers for grouping ARO using AGA was positive but poor (Kendall Tau-b coefficient = 0.157, P = .008). Moderate correlation was found between grouping based on AGA and coronal CT by the same observer (Kendall Tau-b coefficient = 0.482, P = .000). The patients were divided into 4 groups: 84 patients (36.7%) in group N, 2 patients (0.9%) in group A, 69 patients (30.1%) in group P, and 74 patients (32.3%) in group AP. Group N was younger in age (35.4 ± 10.7 years) than group P (39.6 ± 10.2 years) (P = 0.012) and had a larger proportion of women (57.1%) than group AP (36.5%) (χ2 = 6.869, P = .032). There was a greater proportion of positive posterior wall sign in group P (52.2%) than 48.6% for group AP and 33.3% for group N (χ2 = 6.397, P = .041). Group N had 61 (72.6%) Tönnis grade 0 hips compared with 37 (50%) in group AP (P = .014). No statistical significance was found among groups in pre- and postoperative α angle, lateral center-edge angle, and patient-reported outcomes. The widths of ARO in group AP for the 3 marked points from anterior to posterior were 3.88 ± 1.86, 4.84 ± 2.72, and 6.66 ± 3.18, separately (P＜.001); 15.73 ± 21.46, 19.22 ± 18.86, and 29.96 ± 17.05 for area (P＜.01); and 652.67 ± 214.12, 677.10 ± 274.81, and 728.84 ± 232.39 for CT value (P＜.05). For the ARO posterior to 12 o’clock, the group AP showed a larger width (6.66 ± 3.18), area (29.96 ± 17.05), and CT value (728.84 ± 232.39) than group P of (4.70 ± 2.25), (20.15 ± 12.91), and (641.84 ± 183.33) (P＜.001).
{"title":"Three-Dimensional Reconstruction of Computed Tomography Imaging Is Not Reliable in Assessing Acetabular Rim Osteophytes or Acetabular Rim Pathology in Patients With Femoroacetabular Impingement","authors":"Hanmei Dong M.D. , Maihemuti Maimaitimin M.D. , Chenbo Jiao , Yuhao Liu , Guanying Gao M.D. , Tongchuan He M.D. Ph, D. , Yan Xu M.D.","doi":"10.1016/j.asmr.2024.100892","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100892","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the reliability of 3-dimensional (3D) reconstruction of computed tomography (CT) imaging in evaluating acetabular rim morphology or acetabular rim osteophyte (ARO) existence and to group patients with femoroacetabular impingement (FAI) by ARO extent on coronal sections of CT and further compare clinical differences among groups.</p></div><div><h3>Methods</h3><p>Patients who underwent primary hip arthroscopy for FAI by the same surgeon between August 2016 and December 2018 with minimum 2-year follow-up were enrolled. The ARO was evaluated both on the acetabular gross anatomy (AGA) and coronal sections of CT, for its position, width (unit: mm), area (unit: mm<sup>2</sup>), and CT value (unit: HU). Patients were divided into 4 groups based on the extent of ARO on coronal CT: group A (ARO anterior to 12 o’clock), group P (ARO posterior to 12 o’clock), group AP (ARO across 12 o’clock), and group N (no ARO). Inter- and intraobserver correlation was analyzed. Demographic data, FAI deformity indicators on imaging, quantitative measurements of ARO, and pre- and postoperative patient-reported outcomes were compared among groups.</p></div><div><h3>Results</h3><p>There were 229 patients (229 hips) enrolled in total, 122 male (53.3%) and 107 female (46.7%), with a mean age of 37.2 ± 10.2 years. The correlation between 2 observers for grouping ARO using AGA was positive but poor (Kendall Tau-b coefficient = 0.157, <em>P</em> = .008). Moderate correlation was found between grouping based on AGA and coronal CT by the same observer (Kendall Tau-b coefficient = 0.482, <em>P</em> = .000). The patients were divided into 4 groups: 84 patients (36.7%) in group N, 2 patients (0.9%) in group A, 69 patients (30.1%) in group P, and 74 patients (32.3%) in group AP. Group N was younger in age (35.4 ± 10.7 years) than group P (39.6 ± 10.2 years) (<em>P</em> = 0.012) and had a larger proportion of women (57.1%) than group AP (36.5%) (χ<sup>2</sup> = 6.869, <em>P</em> = .032). There was a greater proportion of positive posterior wall sign in group P (52.2%) than 48.6% for group AP and 33.3% for group N (χ<sup>2</sup> = 6.397, <em>P</em> = .041). Group N had 61 (72.6%) Tönnis grade 0 hips compared with 37 (50%) in group AP (<em>P</em> = .014). No statistical significance was found among groups in pre- and postoperative α angle, lateral center-edge angle, and patient-reported outcomes. The widths of ARO in group AP for the 3 marked points from anterior to posterior were 3.88 ± 1.86, 4.84 ± 2.72, and 6.66 ± 3.18, separately (<em>P</em>＜.001); 15.73 ± 21.46, 19.22 ± 18.86, and 29.96 ± 17.05 for area (<em>P</em>＜.01); and 652.67 ± 214.12, 677.10 ± 274.81, and 728.84 ± 232.39 for CT value (<em>P</em>＜.05). For the ARO posterior to 12 o’clock, the group AP showed a larger width (6.66 ± 3.18), area (29.96 ± 17.05), and CT value (728.84 ± 232.39) than group P of (4.70 ± 2.25), (20.15 ± 12.91), and (641.84 ± 183.33) (<em>P</em>＜.001).</p></div><div><","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100892"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000105/pdfft?md5=af9a44455e6f0803b785b08afeafc843&pid=1-s2.0-S2666061X24000105-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139714579","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}
Pub Date : 2024-02-08DOI: 10.1016/j.asmr.2024.100907
Mohamad Y. Fares M.D., M.Sc., Jonathan Koa B.Sc., Jaspal Singh M.D., Joseph A. Abboud M.D.
Purpose
To examine long-term patient-reported outcomes and range of motion in patients with massive irreparable rotator cuff tears (MIRCTs) who underwent subacromial balloon spacer implantation.
Methods
A retrospective review of all patients who underwent subacromial balloon placement procedure for MIRCTs at our institution was conducted. Patients with adequate preoperative and postoperative data, with at least 5 years of follow-up, were included in our study. Outcome measures were range of motion (forward elevation), American Shoulder and Elbow Surgeon (ASES) score, and visual analog scale (VAS) score. Independent t test was conducted to check for statistically significant differences between preoperative and postoperative outcome scores, with P < .05 deemed significant.
Results
Ten patients were identified: 4 were lost to follow-up beyond 2 years and were excluded. One was converted to an arthroplasty at the 1-year mark and was then lost to follow-up (conversion rate: 16.6%). Five patients had at least 5 years of follow-up after the balloon procedure and were involved in our case series analysis. Mean age was 63.1 years, and mean follow-up was 5.8 years (range, 5-7 years). Preoperatively, mean forward elevation was 110 degrees, mean ASES score was 40.68, and mean VAS score was 6.2. On follow-up, mean forward elevation was 163 degrees (P = .007), mean ASES score was 90.97 (P = .001), and mean VAS score was 0.9 (P = .004). All patients showed significant improvements in all outcome measures, and none had any significant complications.
Conclusions
In this study, we found that the use of a subacromial balloon spacer can lead to good outcomes at a minimum 5-year follow-up in patients with MIRCTs.
{"title":"The Insertion of a Subacromial Balloon Spacer Can Provide Symptom Relief and Functional Improvement at a Minimum 5-Year Follow-Up in Patients With Massive Irreparable Rotator Cuff Tears","authors":"Mohamad Y. Fares M.D., M.Sc., Jonathan Koa B.Sc., Jaspal Singh M.D., Joseph A. Abboud M.D.","doi":"10.1016/j.asmr.2024.100907","DOIUrl":"10.1016/j.asmr.2024.100907","url":null,"abstract":"<div><h3>Purpose</h3><p>To examine long-term patient-reported outcomes and range of motion in patients with massive irreparable rotator cuff tears (MIRCTs) who underwent subacromial balloon spacer implantation.</p></div><div><h3>Methods</h3><p>A retrospective review of all patients who underwent subacromial balloon placement procedure for MIRCTs at our institution was conducted. Patients with adequate preoperative and postoperative data, with at least 5 years of follow-up, were included in our study. Outcome measures were range of motion (forward elevation), American Shoulder and Elbow Surgeon (ASES) score, and visual analog scale (VAS) score. Independent <em>t</em> test was conducted to check for statistically significant differences between preoperative and postoperative outcome scores, with <em>P</em> < .05 deemed significant.</p></div><div><h3>Results</h3><p>Ten patients were identified: 4 were lost to follow-up beyond 2 years and were excluded. One was converted to an arthroplasty at the 1-year mark and was then lost to follow-up (conversion rate: 16.6%). Five patients had at least 5 years of follow-up after the balloon procedure and were involved in our case series analysis. Mean age was 63.1 years, and mean follow-up was 5.8 years (range, 5-7 years). Preoperatively, mean forward elevation was 110 degrees, mean ASES score was 40.68, and mean VAS score was 6.2. On follow-up, mean forward elevation was 163 degrees (<em>P</em> = .007), mean ASES score was 90.97 (<em>P</em> = .001), and mean VAS score was 0.9 (<em>P</em> = .004). All patients showed significant improvements in all outcome measures, and none had any significant complications.</p></div><div><h3>Conclusions</h3><p>In this study, we found that the use of a subacromial balloon spacer can lead to good outcomes at a minimum 5-year follow-up in patients with MIRCTs.</p></div><div><h3>Level of Evidence</h3><p>Level IV, therapeutic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100907"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000257/pdfft?md5=0677869f34c9864777accf7e29403dbc&pid=1-s2.0-S2666061X24000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139886549","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}
Pub Date : 2024-02-08DOI: 10.1016/j.asmr.2024.100884
Varun Singla M.D., Michael B. Banffy M.D.
Purpose
To report on operative and clinical outcomes in a series of shoulders treated with arthroscopic Latarjet performed in the lateral decubitus position.
Methods
Patients with shoulders that underwent arthroscopic Latarjet in the lateral decubitus position were identified. Data were retrospectively collected, including patient demographics, operative times, intra- and postoperative complications, and clinical and functional outcomes. Descriptive statistics were performed.
Results
Eighteen shoulders in 17 patients were included in the study with a mean follow-up of 14 ± 12.1 months (range, 4-39 months). The mean operative time for all procedures was 132.2 ± 18.0 minutes, and the mean operative time for the first half of the cohort was significantly longer than that of the second half (141.6 ± 14.2 minutes vs 122.8 ± 17.0 minutes, P = .02). There were no intraoperative complications, and no patients required a conversion to open surgery. One patient experienced a recurrent dislocation after a traumatic event but was able to be treated nonoperatively. Preoperative and postoperative patient-reported outcome measures (PROMs) were able to be collected on 8 of 18 patients (44.4%). Although all PROMs demonstrated improvements postoperatively, only the Single Assessment Numeric Evaluation score and American Shoulder and Elbow Surgeons Shoulder Index displayed a statistically significant increase (P < .05). Five of 8 (62.5%) shoulders demonstrated bony fusion on postoperative computed tomography scan. Of those eligible, 100% of patients returned to sport or felt that they could return if they wanted to.
Conclusions
The arthroscopic Latarjet is an effective procedure for managing glenohumeral instability and can safely be performed in the lateral decubitus position.
{"title":"Arthroscopic Coracoid Transfer in the Lateral Decubitus Position is Safe and Effective at Short-Term Follow-Up","authors":"Varun Singla M.D., Michael B. Banffy M.D.","doi":"10.1016/j.asmr.2024.100884","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100884","url":null,"abstract":"<div><h3>Purpose</h3><p>To report on operative and clinical outcomes in a series of shoulders treated with arthroscopic Latarjet performed in the lateral decubitus position.</p></div><div><h3>Methods</h3><p>Patients with shoulders that underwent arthroscopic Latarjet in the lateral decubitus position were identified. Data were retrospectively collected, including patient demographics, operative times, intra- and postoperative complications, and clinical and functional outcomes. Descriptive statistics were performed.</p></div><div><h3>Results</h3><p>Eighteen shoulders in 17 patients were included in the study with a mean follow-up of 14 ± 12.1 months (range, 4-39 months). The mean operative time for all procedures was 132.2 ± 18.0 minutes, and the mean operative time for the first half of the cohort was significantly longer than that of the second half (141.6 ± 14.2 minutes vs 122.8 ± 17.0 minutes, <em>P</em> = .02). There were no intraoperative complications, and no patients required a conversion to open surgery. One patient experienced a recurrent dislocation after a traumatic event but was able to be treated nonoperatively. Preoperative and postoperative patient-reported outcome measures (PROMs) were able to be collected on 8 of 18 patients (44.4%). Although all PROMs demonstrated improvements postoperatively, only the Single Assessment Numeric Evaluation score and American Shoulder and Elbow Surgeons Shoulder Index displayed a statistically significant increase (<em>P</em> < .05). Five of 8 (62.5%) shoulders demonstrated bony fusion on postoperative computed tomography scan. Of those eligible, 100% of patients returned to sport or felt that they could return if they wanted to.</p></div><div><h3>Conclusions</h3><p>The arthroscopic Latarjet is an effective procedure for managing glenohumeral instability and can safely be performed in the lateral decubitus position.</p></div><div><h3>Level of Evidence</h3><p>Level IV, therapeutic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100884"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000026/pdfft?md5=0a7d7e567a0a2c8b34ff80a16184f34c&pid=1-s2.0-S2666061X24000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139709898","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}
Pub Date : 2024-02-07DOI: 10.1016/j.asmr.2023.100882
Sean Hazzard P.A., M.B.A. , Blake Bacevich B.S. , Nicholas Perry M.D. , Varun Nukala B.S. , Peter Asnis M.D.
Purpose
To evaluate patient-reported outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction using allograft in patients 40 years of age or older divided by sex.
Methods
Patients age 40 years of age or older who underwent ACL reconstruction by the same surgeon using allograft via anteromedial portal technique were retrospectively identified. Patient-reported outcomes (International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score, Tegner, Lysholm, Marx, and Single Assessment Numeric Evaluation) were evaluated and recorded, and outcomes were analyzed by sex.
Results
In total, 159 patients undergoing primary ACL reconstruction were reviewed. Two-year outcomes were obtained. All patients noted improvement in patient-reported outcome measures. Male patients had overall greater postoperative patient-reported outcomes measures at all time points for IKDC, Tegner, Lysholm, Marx, and Single Assessment Numeric Evaluation scores; however, the only significant time points were IKDC 6 months (P = .016), 1 year (P = .012) and Marx 1 year (P = .007) and 2 year (P = .016). Knee Injury and Osteoarthritis Outcome Score scores similarly showed greater postoperative scores at all time points and statistical significance at 3 months (P = .002), 6 months (P = .033), and 1 year (P = .031).
Conclusions
ACL reconstruction in individuals older than the age of 40 years using allograft results in good outcomes compared with preoperative status. Patient-reported outcomes were similar between male and female patients regarding most patient-reported outcome measures.
{"title":"Anterior Cruciate Ligament Reconstruction Using Allograft in Adults Older Than the Age of 40 Years Shows Similar Patient-Reported Outcomes Between Male and Female Patients","authors":"Sean Hazzard P.A., M.B.A. , Blake Bacevich B.S. , Nicholas Perry M.D. , Varun Nukala B.S. , Peter Asnis M.D.","doi":"10.1016/j.asmr.2023.100882","DOIUrl":"https://doi.org/10.1016/j.asmr.2023.100882","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate patient-reported outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction using allograft in patients 40 years of age or older divided by sex.</p></div><div><h3>Methods</h3><p>Patients age 40 years of age or older who underwent ACL reconstruction by the same surgeon using allograft via anteromedial portal technique were retrospectively identified. Patient-reported outcomes (International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score, Tegner, Lysholm, Marx, and Single Assessment Numeric Evaluation) were evaluated and recorded, and outcomes were analyzed by sex.</p></div><div><h3>Results</h3><p>In total, 159 patients undergoing primary ACL reconstruction were reviewed. Two-year outcomes were obtained. All patients noted improvement in patient-reported outcome measures. Male patients had overall greater postoperative patient-reported outcomes measures at all time points for IKDC, Tegner, Lysholm, Marx, and Single Assessment Numeric Evaluation scores; however, the only significant time points were IKDC 6 months (<em>P</em> = .016), 1 year (<em>P</em> = .012) and Marx 1 year (<em>P</em> = .007) and 2 year (<em>P</em> = .016). Knee Injury and Osteoarthritis Outcome Score scores similarly showed greater postoperative scores at all time points and statistical significance at 3 months (<em>P</em> = .002), 6 months (<em>P</em> = .033), and 1 year (<em>P</em> = .031).</p></div><div><h3>Conclusions</h3><p>ACL reconstruction in individuals older than the age of 40 years using allograft results in good outcomes compared with preoperative status. Patient-reported outcomes were similar between male and female patients regarding most patient-reported outcome measures.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100882"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X2300233X/pdfft?md5=56b0e5cac896cbb0790f63033499dd24&pid=1-s2.0-S2666061X2300233X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139700054","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}
Pub Date : 2024-02-07DOI: 10.1016/j.asmr.2024.100888
Quinten W.T. Veerman M.Sc. , Romy M. ten Heggeler M.Sc. , prof. Gabriëlle J.M. Tuijthof , Feike de Graaff Ph.D. , René Fluit Ph.D. , Roy A.G. Hoogeslag M.D., Ph.D.
Purpose
To investigate the simultaneous effect of 3-dimensional (3D) hinge axis (HA) orientation on alignment parameters in all 3 anatomical planes in high tibial osteotomy.
Methods
A computed tomography–based 3D model of a human tibia/fibula was used to establish a 3D tibial coordinate system based on the tibial mechanical axis. In here, an HA was positioned and an opening-wedge high tibial osteotomy with a rotation angle of 10° over the HA was simulated. HA rotation in the axial plane ranged from 0° to 90° and HA tilt relative to the axial plane ranged from –20° to +20°. The study quantified the simultaneous effect of HA orientation on change of alignment parameters in all anatomical reference planes.
Results
HA rotation within the tibial axial plane between orientations perpendicular to the coronal and sagittal planes primarily affected both coronal and sagittal plane alignment, with an inverse relationship between these planes (range: 0°-9.7°); the effect of HA rotation on the change in axial plane alignment was maximally 0.9°. In contrast, HA tilt relative to the tibial axial plane primarily affected axial alignment (maximum change: 6.9°); the effect on change in both coronal and sagittal plane alignment was maximally 0.6°.
Conclusions
HA rotation in the tibial axial plane primarily affects sagittal and coronal plane alignment, and HA tilt relative to the tibial axial plane primarily affects axial plane alignment.
Clinical Relevance
Integrating 3D HA orientation in malalignment planning and correction offers the potential to minimize unintended corrections in nontargeted planes in uniplanar correction osteotomies and to facilitate intentional multiplanar correction with a single osteotomy.
目的研究三维（3D）铰链轴（HA）方向对高胫骨截骨术中所有 3 个解剖平面的对位参数的同时影响。方法使用基于计算机断层扫描的人体胫骨/腓骨三维模型，根据胫骨机械轴建立三维胫骨坐标系。在此模型中，对 HA 进行定位，并模拟在 HA 上旋转 10° 的开口楔形高胫骨截骨术。HA在轴向平面上的旋转角度从0°到90°不等，HA相对于轴向平面的倾斜角度从-20°到+20°不等。结果HA在胫骨轴向平面内垂直于冠状面和矢状面的方向之间的旋转主要影响冠状面和矢状面的对位，这两个平面之间呈反比关系（范围：0°-9.7°）；HA旋转对轴向平面对位变化的影响最大为0.9°。结论HA在胫骨轴向平面的旋转主要影响矢状面和冠状面的对线，而HA相对于胫骨轴向平面的倾斜主要影响轴向平面的对线（最大变化：6.9°）；对冠状面和矢状面对线变化的影响最大为0.6°。临床意义在错位规划和矫正中整合三维HA定位，可最大限度地减少单平面矫正截骨中非目标平面的意外矫正，并促进单次截骨的有意多平面矫正。
{"title":"Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy","authors":"Quinten W.T. Veerman M.Sc. , Romy M. ten Heggeler M.Sc. , prof. Gabriëlle J.M. Tuijthof , Feike de Graaff Ph.D. , René Fluit Ph.D. , Roy A.G. Hoogeslag M.D., Ph.D.","doi":"10.1016/j.asmr.2024.100888","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100888","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the simultaneous effect of 3-dimensional (3D) hinge axis (HA) orientation on alignment parameters in all 3 anatomical planes in high tibial osteotomy.</p></div><div><h3>Methods</h3><p>A computed tomography–based 3D model of a human tibia/fibula was used to establish a 3D tibial coordinate system based on the tibial mechanical axis. In here, an HA was positioned and an opening-wedge high tibial osteotomy with a rotation angle of 10° over the HA was simulated. HA rotation in the axial plane ranged from 0° to 90° and HA tilt relative to the axial plane ranged from –20° to +20°. The study quantified the simultaneous effect of HA orientation on change of alignment parameters in all anatomical reference planes.</p></div><div><h3>Results</h3><p>HA rotation within the tibial axial plane between orientations perpendicular to the coronal and sagittal planes primarily affected both coronal and sagittal plane alignment, with an inverse relationship between these planes (range: 0°-9.7°); the effect of HA rotation on the change in axial plane alignment was maximally 0.9°. In contrast, HA tilt relative to the tibial axial plane primarily affected axial alignment (maximum change: 6.9°); the effect on change in both coronal and sagittal plane alignment was maximally 0.6°.</p></div><div><h3>Conclusions</h3><p>HA rotation in the tibial axial plane primarily affects sagittal and coronal plane alignment, and HA tilt relative to the tibial axial plane primarily affects axial plane alignment.</p></div><div><h3>Clinical Relevance</h3><p>Integrating 3D HA orientation in malalignment planning and correction offers the potential to minimize unintended corrections in nontargeted planes in uniplanar correction osteotomies and to facilitate intentional multiplanar correction with a single osteotomy.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100888"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000063/pdfft?md5=b9d71471b4b302cded571ca7a9b890c2&pid=1-s2.0-S2666061X24000063-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139700053","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}
Pub Date : 2024-02-05DOI: 10.1016/j.asmr.2024.100889
Nata Parnes M.D. , Kyle J. Klahs D.O. , Alexis B. Sandler M.D. , Emily I. Wynkoop M.D. , Adam Goldman D.O. , Keith Fishbeck D.O. , Robert H. Rolf M.D. , John P. Scanaliato M.D.
Purpose
To evaluate the reliability of the “perfect-circle” methodology for measurement of glenoid bone loss with magnetic resonance imaging (MRI) in patients with posterior glenohumeral instability.
Methods
A prospective chart review was performed on patients who underwent isolated arthroscopic posterior labral repairs in our institution’s electronic medical records between January 1, 2021, and June 30, 2021. Inclusion criteria included isolated posterior shoulder instability with posterior labral repair and corroborated tears on MRI. A total of 9 raters, either sports or shoulder and elbow fellowship-trained orthopaedic surgeons, each evaluated the affected shoulder MRI scans twice, at over 2 weeks apart. Measurements followed the “perfect-circle” technique and included projected anterior-to-posterior (AP) glenoid diameter, amount of posterior bone loss, and percentage of posterior bone loss.
Results
Ten consecutive patients between the ages of 17 and 46 years with diagnosed posterior glenohumeral instability were selected. The average age was 28 ± 10 years, and 60% of patients were male. The patient’s dominant arm was affected in 40%, and 50% of cases involved the right shoulder. The average glenoid diameter was 29.62 ± 3.69 mm, and the average measured bone loss was 2.8 ± 1.74 mm. The average percent posterior glenoid bone loss was 9.41 ± 5.78%. The inter-rater reliability was poor for the AP diameter and for the posterior glenoid bone loss with intraclass correlation coefficients at 0.30 (0.12-0.62) and 0.22 (0.07-0.54) respectively. The intrarater reliability was poor for AP diameter and moderate for posterior glenoid bone loss, with intraclass correlation coefficients at 0.41 (0.22-0.57) and 0.50 (0.33-0.64), respectively.
Conclusions
Using the “perfect-circle” technique for evaluating posterior glenohumeral bone loss has poor-to-moderate inter- and intrarater reliability from MRI.
{"title":"The Perfect-Circle Technique Demonstrates Poor Inter-Rater Reliability in Measuring Posterior Glenoid Bone Loss on Magnetic Resonance Imaging","authors":"Nata Parnes M.D. , Kyle J. Klahs D.O. , Alexis B. Sandler M.D. , Emily I. Wynkoop M.D. , Adam Goldman D.O. , Keith Fishbeck D.O. , Robert H. Rolf M.D. , John P. Scanaliato M.D.","doi":"10.1016/j.asmr.2024.100889","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100889","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the reliability of the “perfect-circle” methodology for measurement of glenoid bone loss with magnetic resonance imaging (MRI) in patients with posterior glenohumeral instability.</p></div><div><h3>Methods</h3><p>A prospective chart review was performed on patients who underwent isolated arthroscopic posterior labral repairs in our institution’s electronic medical records between January 1, 2021, and June 30, 2021. Inclusion criteria included isolated posterior shoulder instability with posterior labral repair and corroborated tears on MRI. A total of 9 raters, either sports or shoulder and elbow fellowship-trained orthopaedic surgeons, each evaluated the affected shoulder MRI scans twice, at over 2 weeks apart. Measurements followed the “perfect-circle” technique and included projected anterior-to-posterior (AP) glenoid diameter, amount of posterior bone loss, and percentage of posterior bone loss.</p></div><div><h3>Results</h3><p>Ten consecutive patients between the ages of 17 and 46 years with diagnosed posterior glenohumeral instability were selected. The average age was 28 ± 10 years, and 60% of patients were male. The patient’s dominant arm was affected in 40%, and 50% of cases involved the right shoulder. The average glenoid diameter was 29.62 ± 3.69 mm, and the average measured bone loss was 2.8 ± 1.74 mm. The average percent posterior glenoid bone loss was 9.41 ± 5.78%. The inter-rater reliability was poor for the AP diameter and for the posterior glenoid bone loss with intraclass correlation coefficients at 0.30 (0.12-0.62) and 0.22 (0.07-0.54) respectively. The intrarater reliability was poor for AP diameter and moderate for posterior glenoid bone loss, with intraclass correlation coefficients at 0.41 (0.22-0.57) and 0.50 (0.33-0.64), respectively.</p></div><div><h3>Conclusions</h3><p>Using the “perfect-circle” technique for evaluating posterior glenohumeral bone loss has poor-to-moderate inter- and intrarater reliability from MRI.</p></div><div><h3>Level of Evidence</h3><p>Level IV, prospective diagnostic study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100889"},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000075/pdfft?md5=f4e2a94a2cdafb6ea0a19218c74a25a1&pid=1-s2.0-S2666061X24000075-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139694723","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}
Pub Date : 2024-02-05DOI: 10.1016/j.asmr.2024.100890
Timothy L. Waters B.A. , Evan M. Miller M.D. , Edward C. Beck M.D., M.P.H. , Danielle E. Rider M.D. , Brian R. Waterman M.D.
Purpose
To compare functional outcomes and failure rates between medial patellofemoral ligament (MPFL) reconstructions with and without lateral retinacular release (LRR) at minimum 1-year follow up.
Methods
A retrospective review identified consecutive patients from 2013 to 2019 at a single center who met all of the following inclusion criteria: at least 1 confirmed patellar dislocation, patellar tilt (evidenced by tight retinaculum on operative examination or patellar tilt on radiographs), underwent either MPFL reconstruction alone or combined with LRR, had available preoperative documentation and imaging, and were at least 1 year out of surgery. Patients were excluded if they had previous surgery to the ipsilateral limb or had any concomitant procedure performed. Demographics and preoperative imaging were evaluated. Failure rates and functional outcome scores were obtained including Kujala, Patient-Reported Outcomes Measurement Information System, International Knee Documentation Committee, Single Assessment Numeric Evaluation, and Knee injury and Osteoarthritis Outcome Scores. Clinical failure was defined as revision MPFL reconstruction on the affected knee or at least 1 instance of postoperative patellar dislocation.
Results
A total of 18 patients underwent isolated MPFL reconstruction (mean follow-up = 29.3 ± 8.3 months, range = 15.1-42.8 months), and 31 underwent MPFL reconstruction combined with LRR (mean follow up = 36.0 ± 11.3 months, range = 14.0-51.9 months). At final follow-up, there were no statistical differences between the isolated MPFL and MPFL combined with LRR cohorts for any of the functional outcome scores (P > .05 for all). At the time of final follow-up, no patients who underwent isolated MPFL and 19.3% (n = 6) or patients undergoing MPFL combined with LRR experienced clinical failure (P = .073), as defined by subsequent patellar dislocation or revision MPFL reconstruction. Of these, 2 patients underwent revision MPFL reconstructions with distal tubercle transfer for borderline abnormal TT:TG (i.e., >15 mm).
Conclusions
MPFL reconstruction surgery combined with LRR failed to demonstrate significantly different functional outcome scores and failure rates compared with isolated MPFL reconstruction at minimum 1-year follow up. In addition, there were no differences in rates of achieving MCID between both groups
{"title":"Adding Lateral Retinacular Release to Medial Patellofemoral Ligament Reconstruction Fails to Demonstrate Clinical Benefit Compared With Isolated Medial Patellofemoral Ligament Reconstruction","authors":"Timothy L. Waters B.A. , Evan M. Miller M.D. , Edward C. Beck M.D., M.P.H. , Danielle E. Rider M.D. , Brian R. Waterman M.D.","doi":"10.1016/j.asmr.2024.100890","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100890","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare functional outcomes and failure rates between medial patellofemoral ligament (MPFL) reconstructions with and without lateral retinacular release (LRR) at minimum 1-year follow up.</p></div><div><h3>Methods</h3><p>A retrospective review identified consecutive patients from 2013 to 2019 at a single center who met all of the following inclusion criteria: at least 1 confirmed patellar dislocation, patellar tilt (evidenced by tight retinaculum on operative examination or patellar tilt on radiographs), underwent either MPFL reconstruction alone or combined with LRR, had available preoperative documentation and imaging, and were at least 1 year out of surgery. Patients were excluded if they had previous surgery to the ipsilateral limb or had any concomitant procedure performed. Demographics and preoperative imaging were evaluated. Failure rates and functional outcome scores were obtained including Kujala, Patient-Reported Outcomes Measurement Information System, International Knee Documentation Committee, Single Assessment Numeric Evaluation, and Knee injury and Osteoarthritis Outcome Scores. Clinical failure was defined as revision MPFL reconstruction on the affected knee or at least 1 instance of postoperative patellar dislocation.</p></div><div><h3>Results</h3><p>A total of 18 patients underwent isolated MPFL reconstruction (mean follow-up = 29.3 ± 8.3 months, range = 15.1-42.8 months), and 31 underwent MPFL reconstruction combined with LRR (mean follow up = 36.0 ± 11.3 months, range = 14.0-51.9 months). At final follow-up, there were no statistical differences between the isolated MPFL and MPFL combined with LRR cohorts for any of the functional outcome scores (<em>P</em> > .05 for all). At the time of final follow-up, no patients who underwent isolated MPFL and 19.3% (n = 6) or patients undergoing MPFL combined with LRR experienced clinical failure (<em>P</em> = .073), as defined by subsequent patellar dislocation or revision MPFL reconstruction. Of these, 2 patients underwent revision MPFL reconstructions with distal tubercle transfer for borderline abnormal TT:TG (i.e., >15 mm).</p></div><div><h3>Conclusions</h3><p>MPFL reconstruction surgery combined with LRR failed to demonstrate significantly different functional outcome scores and failure rates compared with isolated MPFL reconstruction at minimum 1-year follow up. In addition, there were no differences in rates of achieving MCID between both groups</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100890"},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000087/pdfft?md5=11fed4883d2c06f0a8da019bdf5b43bb&pid=1-s2.0-S2666061X24000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139694724","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}
Pub Date : 2024-02-03DOI: 10.1016/j.asmr.2024.100905
Nata Parnes M.D. , Clare K. Green B.S. , Emily I. Wynkoop M.D. , Adam Goldman D.O. , Keith Fishbeck D.O. , Kyle J. Klahs D.O. , Robert H. Rolf M.D. , John P. Scanaliato M.D.
Purpose
To evaluate the reliability of the perfect circle methodology for measurement of glenoid bone loss in patients with anterior glenohumeral instability.
Methods
We performed a chart review of retrospectively collected patients who underwent isolated arthroscopic anterior labral repair between January 1 and June 30, 2021, using our institution’s electronic medical records. The inclusion criteria included isolated anterior shoulder instability with anterior labral repair and corroborated tears on magnetic resonance imaging. A total of 9 raters, either sports or shoulder and elbow fellowship-trained orthopaedic surgeons, each evaluated the affected shoulder magnetic resonance imaging scans twice, with a minimum of 2 weeks between measurements. Measurements followed the “perfect circle” technique and included projected anterior-to-posterior glenoid diameter, amount of posterior bone loss, and percentage of posterior bone loss. Intrarater reliability and inter-rater reliability were then determined by calculating intraclass correlation coefficients (ICCs).
Results
Ten consecutive patients meeting the selection criteria were chosen for inclusion in this analysis. Average estimated bone loss for the cohort was 2.45 mm, and the mean estimated glenoid diameter of the involved shoulder was 28.82 mm. The average percentage of bone loss measured 8.54%. The ICC for interobserver reliability was 0.55 for the perfect circle diameter and 0.17 for the anterior bone loss measurement (poorly to moderately reliable). The ICC for intraobserver reliability was 0.69 for the perfect circle diameter and 0.71 for anterior bone loss (moderately reliable).
Conclusions
The perfect circle technique for estimating anterior glenoid bone loss on magnetic resonance imaging was found to have moderate intrarater reliability; however, reliability between observers was found to be moderate to poor.
{"title":"The Perfect Circle Technique Shows Poor Inter-rater Reliability in Measuring Anterior Glenoid Bone Loss on Magnetic Resonance Imaging","authors":"Nata Parnes M.D. , Clare K. Green B.S. , Emily I. Wynkoop M.D. , Adam Goldman D.O. , Keith Fishbeck D.O. , Kyle J. Klahs D.O. , Robert H. Rolf M.D. , John P. Scanaliato M.D.","doi":"10.1016/j.asmr.2024.100905","DOIUrl":"10.1016/j.asmr.2024.100905","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the reliability of the perfect circle methodology for measurement of glenoid bone loss in patients with anterior glenohumeral instability.</p></div><div><h3>Methods</h3><p>We performed a chart review of retrospectively collected patients who underwent isolated arthroscopic anterior labral repair between January 1 and June 30, 2021, using our institution’s electronic medical records. The inclusion criteria included isolated anterior shoulder instability with anterior labral repair and corroborated tears on magnetic resonance imaging. A total of 9 raters, either sports or shoulder and elbow fellowship-trained orthopaedic surgeons, each evaluated the affected shoulder magnetic resonance imaging scans twice, with a minimum of 2 weeks between measurements. Measurements followed the “perfect circle” technique and included projected anterior-to-posterior glenoid diameter, amount of posterior bone loss, and percentage of posterior bone loss. Intrarater reliability and inter-rater reliability were then determined by calculating intraclass correlation coefficients (ICCs).</p></div><div><h3>Results</h3><p>Ten consecutive patients meeting the selection criteria were chosen for inclusion in this analysis. Average estimated bone loss for the cohort was 2.45 mm, and the mean estimated glenoid diameter of the involved shoulder was 28.82 mm. The average percentage of bone loss measured 8.54%. The ICC for interobserver reliability was 0.55 for the perfect circle diameter and 0.17 for the anterior bone loss measurement (poorly to moderately reliable). The ICC for intraobserver reliability was 0.69 for the perfect circle diameter and 0.71 for anterior bone loss (moderately reliable).</p></div><div><h3>Conclusions</h3><p>The perfect circle technique for estimating anterior glenoid bone loss on magnetic resonance imaging was found to have moderate intrarater reliability; however, reliability between observers was found to be moderate to poor.</p></div><div><h3>Level of Evidence</h3><p>Level IV, diagnostic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100905"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000233/pdfft?md5=ce6605d7c70898461737304c0d1a2f43&pid=1-s2.0-S2666061X24000233-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139887318","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号