Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology最新文献_第2页

The incidence of arthrogenic muscle inhibition in acute knee injuries: a prospective cohort study in a tertiary acute knee unit 急性膝关节损伤中关节源性肌肉抑制的发生率：一项三级急性膝关节单元的前瞻性队列研究

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-10-01 Epub Date: 2025-10-13 DOI: 10.1016/j.asmart.2025.08.005

M.J. Kennedy , C.S. Leung , T.C.F. Soh , H. Sitton-Kent , H.J. Thomson , O. Hill , T. Nunn , O. Bailey , G.P. Hopper , R. Bhattacharyya

Background

Arthrogenic Muscle Inhibition (AMI) is not well recognised and is therefore underdiagnosed. Improved understanding of AMI would allow improved patient treatment pathways and rehabilitation after acute knee injuries. The primary aim of this study was to evaluate the incidence of AMI in acute knee injuries. The secondary aim was to evaluate correlation between AMI and type of underlying knee injury.

Methods

This was a prospective cohort study. All patients reviewed by the acute knee service in a tertiary referral centre between January 01, 2023 and April 30, 2023 were included (n = 97). The patients were diagnosed with AMI by a fellowship trained orthopaedic consultant knee surgeon. The incidence was evaluated with descriptive statistics and logistic regression analysis performed to ascertain association of AMI with the underlying acute knee injury diagnosis.

Results

Of the 97 patients reviewed, 12 were excluded due to a mechanical block to extension on MRI imaging. Twenty-seven (31.8 %) of the 85 eligible patients were diagnosed with AMI. Nine of the twenty-seven patients (52 %) presenting with AMI had resolution of symptoms at the index clinic appointment with directed physical therapy. Patients with AMI were 6 times (OR 6.3, 95 % CI 1.48) more likely to have a diagnosis of patellofemoral (PFJ) dislocation (p = 0.013) than those with bone bruising or minor sprain. Other associations of AMI which did not reach statistical significance were meniscal tear (OR 4.2, 95 % CI 0.4) and ACL rupture (OR 3.5, 95 % CI 0.72).

Conclusions

AMI is common in acute knee injuries, affecting nearly a third of all patients reviewed. Patients with AMI were more likely to have an underlying diagnosis of PFJ dislocation than any other acute knee injury diagnosis, and was the only statistically significant association. Correct diagnosis and instituting immediate treatment can resolve >50 % cases at the index clinic appointment. Treatment workflows incorporating early review and management could result in improved patient outcome and expedited recovery from AMI.

背景：致癌性肌肉抑制（AMI）尚未得到很好的认识，因此诊断不足。提高对急性心肌梗死的认识将有助于改善患者的治疗途径和急性膝关节损伤后的康复。本研究的主要目的是评估急性膝关节损伤中AMI的发生率。第二个目的是评估AMI与潜在膝关节损伤类型之间的相关性。方法前瞻性队列研究。纳入了2023年1月1日至2023年4月30日在三级转诊中心接受急性膝关节服务的所有患者（n = 97）。患者被一名训练有素的骨科顾问膝关节外科医生诊断为急性心肌梗死。发生率通过描述性统计和逻辑回归分析进行评估，以确定AMI与潜在的急性膝关节损伤诊断的关系。结果97例患者中，12例因MRI表现为机械阻滞而被排除。85例符合条件的患者中有27例（31.8%）被诊断为AMI。27例急性心肌梗死患者中有9例（52%）在门诊预约时接受了定向物理治疗，症状得到缓解。AMI患者诊断为髌骨股骨（PFJ）脱位的可能性是骨挫伤或轻微扭伤患者的6倍（OR 6.3, 95% CI 1.48）（p = 0.013）。其他与AMI的相关性没有达到统计学意义的是半月板撕裂（OR 4.2, 95% CI 0.4）和ACL破裂（OR 3.5, 95% CI 0.72）。结论sami在急性膝关节损伤中很常见，近三分之一的患者受其影响。AMI患者更有可能诊断为PFJ脱位，而不是其他急性膝关节损伤，这是唯一有统计学意义的关联。正确的诊断和及时的治疗可以解决50%的病例在索引门诊预约。纳入早期审查和管理的治疗工作流程可以改善患者的预后并加速AMI的恢复。

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引用次数: 0

Objective postoperative knee stability after 1-stage and 2-stage revision anterior cruciate ligament reconstruction 目的探讨一期和二期前交叉韧带重建术后膝关节稳定性

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-10-01 Epub Date: 2025-09-03 DOI: 10.1016/j.asmart.2025.08.008

Ryohei Uchida , Yukiyoshi Toritsuka , Tomohiko Matsuo , Masashi Kusano , Takayuki Tsuda , Wataru Ando

Background

Revision anterior cruciate ligament reconstruction (ACLR) procedures are performed either as 1-stage or 2-stage surgeries. But there has been no report of comparison in postoperative knee stability between 1-stage and 2-stage Revision ACLR. Therefore, the present study aimed to compare postoperative anterior stability after 1-stage and 2-stage surgeries.

Methods

Objective anterior knee laxity was evaluated by knee arthrometer at 12+ months postoperatively among 35 patients who underwent revision ACLR.

Results

19 patients (Group 1: nine males and 10 females, mean age 26.4 ± 11.0 years) underwent 1-stage revision ACLR and 16 patients (12 males and four females, mean age 32.3 ± 10.6 years) underwent 2-stage revision ACLR with staged revision ACLR at six months after iliac bone grafting for large bone defects. At the final follow-up period (23 ± 9 months after 1-stage surgery and 21 ± 9 months after 2-stage surgery), procedures in two patients (10.5 %) after 1-stage surgery and one patient (6.7 %) after 2-stage surgery were found to have failed. KT side-to-side differences in anterior laxity at manual maximum force were 0.9 ± 1.1 mm and 0.9 ± 1.3 mm after 1- and 2-stage surgeries, respectively, with 94 % of patients after 1-stage surgery and 80 % of patients after 2-stage surgery showing anterior laxity values between −1 and 2 mm. We found no significant technique-dependent difference in objective anterior knee laxity between 1-stage and 2-stage revision ACLR.

Conclusions

After a minimum of 12 months of follow-up, patients who underwent 1-stage and 2-stage revision ACLR acquired sufficient knee stability regardless of surgical technique, showing no other significant differences.

背景：前交叉韧带重建（ACLR）手术分为一期或二期手术。但目前还没有一期和二期ACLR翻修术后膝关节稳定性比较的报道。因此，本研究旨在比较一期和二期手术后的术后前路稳定性。方法目的对35例行改良ACLR患者术后12个月用膝关节计评估膝关节前松度。结果1组19例（男9例，女10例，平均年龄26.4±11.0岁）行一期ACLR修复术；16例（男12例，女4例，平均年龄32.3±10.6岁）行2期ACLR修复术，大骨缺损髂骨移植术后6个月行分期ACLR修复术。在最后随访期（一期手术后23±9个月，二期手术后21±9个月），2例（10.5%）一期手术后手术失败，1例（6.7%）二期手术后手术失败。一期手术和二期手术后，手最大力度下前路松弛度的KT侧对侧差异分别为0.9±1.1 mm和0.9±1.3 mm，其中94%的一期手术患者和80%的二期手术患者前路松弛度值在- 1 ~ 2mm之间。我们发现一期和二期ACLR翻修术在客观前膝关节松弛度方面没有明显的技术依赖差异。结论经过至少12个月的随访，无论手术技术如何，接受一期和二期ACLR翻修的患者获得了足够的膝关节稳定性，没有其他显著差异。

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引用次数: 0

Arthroscopic outside-in “two-needle suture” technique for anterior horn tears of the lateral meniscus 关节镜内外“双针缝合”技术治疗外侧半月板前角撕裂

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-10-01 Epub Date: 2025-09-06 DOI: 10.1016/j.asmart.2025.08.003

Zheyue Zhu , Qiao Liu , Ying Ge , Wenbin Liang , Han Xue , Guangwei Wu , Ruochen Li , Chen Zhang , Rui Ma

Background

The outside-in suture technique is regarded as a practical method for treating anterior horn tears of the lateral meniscus (LM). The conventional outside-in technique often requires a lumbar puncture needle or specialized instruments (Meniscus Mender II). In this study, we employed a relatively novel and practical outside-in “two-needle suture” technique for anterior horn of meniscus repair. This method is simple and does not require any specialized instruments.

Objective

The aim of this study is to report the use of the arthroscopic outside-in “two-needle suture” technique for repairing anterior horn tears of the LM and to evaluate its therapeutic effect to provide a foundation for the clinical management of anterior horn injuries of the LM.

Methods

From March 2019 to August 2023, 21 patients with anterior horn tears of the LM were treated at our orthopedic center using the “two-needle suture” technique. We recorded the operation times, tear classifications, Lysholm scores, IKDC scores, and Tegner scores preoperatively and postoperatively and analyzed the functional scores using paired t tests. Additionally, the Barrett criterion was employed to evaluate the healing status of the meniscus.

Results

In the “two-needle suture” method, only 20 mL hollow needles are used for suturing, with two needles advanced into the joint cavity from the superior and inferior surfaces of the meniscus. The first needle pulled the suture thread through the preset suture loop of the second needle, and then the suture thread was knotted outside the joint capsule. In our study, the follow-up period was 12.38 ± 1.83 months, and the operative time was 32.95 ± 11.89 min. Compared with the preoperative values, significant improvements in the Lysholm, IKDC, and Tegner scores were observed at the final follow-up (p < 0.05). According to the Barrett criterion, the clinical healing rate of the meniscus was 90.48 %. In addition, no complications or risks were observed.

Conclusion

The arthroscopic “two-needle suture” technique for anterior horn tears of the LM was simple, fast and safe, with a high rate of clinical healing. This technique is useful and a valuable reference for the clinical management of anterior horn injuries of the LM.

背景外向内缝合技术被认为是治疗外侧半月板前角撕裂的一种实用方法。传统的由外而内的技术通常需要腰椎穿刺针或专门的器械（半月板修补器II）。在这项研究中，我们采用了一种相对新颖实用的由外而内的“双针缝合”技术来修复半月板前角。这种方法简单，不需要任何专门的仪器。目的报道关节镜下由外向内“双针缝合”技术修复LM前角撕裂并评价其治疗效果，为LM前角损伤的临床治疗提供依据。方法2019年3月至2023年8月，在我院骨科中心采用“双针缝合”技术治疗21例LM前角撕裂。术前、术后记录手术次数、撕裂分类、Lysholm评分、IKDC评分、Tegner评分，并采用配对t检验分析功能评分。此外，采用Barrett标准评估半月板的愈合情况。结果“两针缝合”法仅使用20 mL空心针进行缝合，两根针分别从半月板上、下表面进入关节腔。第一针将缝合线穿过第二针预设的缝合环，然后将缝合线在关节囊外打结。本研究随访时间12.38±1.83个月，手术时间32.95±11.89 min。与术前相比，最终随访时Lysholm、IKDC和Tegner评分均有显著改善（p < 0.05）。按照Barrett标准，半月板临床治愈率为90.48%。此外，未观察到并发症或危险。结论关节镜下“双针缝合”治疗LM前角撕裂术简单、快速、安全，临床治愈率高。该技术对LM前角损伤的临床治疗具有重要的参考价值。

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引用次数: 0

Comparison of the healing rate with meniscal repair concomitant with anterior cruciate ligament reconstruction and isolated meniscal repair based on magnetic resonance imaging signal intensity 基于磁共振成像信号强度的半月板修复联合前交叉韧带重建与孤立半月板修复的愈合率比较

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-10-01 Epub Date: 2025-10-17 DOI: 10.1016/j.asmart.2025.09.004

Yongun Cho , Jin Hwan Ahn

Purpose

The purpose of this study was to compare the healing rate of meniscal repair concomitant with anterior cruciate ligament (ACL) reconstruction and isolated meniscal repair based on Intrameniscal signal intensity (IMSI).

Methods

A total of 368 patients who underwent meniscus repair between March 2011 and July 2017 by an experienced single surgeon were enrolled. 228 patients were divided into the meniscus repair concomitant with ACL reconstruction (group A, n = 171) and isolated meniscal repair group (group B, n = 57). Magnetic resonance imaging (MRI) was performed preoperatively and 12 months postoperatively, measurements were conducted from the most prominent slice of meniscal tear (PSMT). IMSI of the PSMT was measured with the free line region-of-interest (ROI) tool in a picture archiving and communication system.

Results

Except for time of accident, no significant differences were found in terms of age, body mass index, posterior slope angle, or varus angle between two groups. There were statistically significant differences of post-operative adjusted mean IMSI of patients between the two groups using ANCOVA. The corrected postoperative adjusted mean IMSI in the coronal view of group A was an estimated mean (SD) of 1.44(0.08), and in group B was an estimated mean (SD) of 2.55(0.15). All the P-values were less than 0.05, which was the same compared with MRI values for healed meniscus.

Conclusions

IMSI is a simple and conventional parameter for the assessment of meniscal healing. The healing rate of meniscal repair concomitant with ACL reconstruction compared with isolated meniscal repair using IMSI was similar to that of MRI reading. Thus, concomitant ACL reconstruction significantly improves the healing process of meniscus.

Level of evidence and study design

Case control study.

目的比较基于半月板信号强度（IMSI）的前交叉韧带（ACL）重建半月板修复术与单侧半月板修复术的愈合情况。方法选取2011年3月至2017年7月间由一位经验丰富的外科医生行半月板修复术的368例患者。228例患者分为半月板修复合并ACL重建组（A组，n = 171）和孤立半月板修复组（B组，n = 57）。术前和术后12个月进行磁共振成像（MRI），测量半月板撕裂最突出切片（PSMT）。利用自由线感兴趣区域（ROI）工具在图像存档和通信系统中测量了PSMT的IMSI。结果两组患者除发生事故时间外，在年龄、体重指数、后斜角、内翻角等方面均无显著差异。两组患者经ANCOVA校正后平均IMSI比较，差异有统计学意义。A组冠状面矫正术后调整平均IMSI估计平均值（SD）为1.44(0.08)，B组估计平均值（SD）为2.55（0.15）。p值均小于0.05，与半月板愈合的MRI值相同。结论simsi是评价半月板愈合的一种简便、常规的指标。半月板修复合并前交叉韧带重建与单侧半月板IMSI修复的愈合率与MRI读数相似。因此，合并前交叉韧带重建可显著改善半月板的愈合过程。证据水平和研究设计：病例对照研究。

{"title":"Comparison of the healing rate with meniscal repair concomitant with anterior cruciate ligament reconstruction and isolated meniscal repair based on magnetic resonance imaging signal intensity","authors":"Yongun Cho , Jin Hwan Ahn","doi":"10.1016/j.asmart.2025.09.004","DOIUrl":"10.1016/j.asmart.2025.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to compare the healing rate of meniscal repair concomitant with anterior cruciate ligament (ACL) reconstruction and isolated meniscal repair based on Intrameniscal signal intensity (IMSI).</div></div><div><h3>Methods</h3><div>A total of 368 patients who underwent meniscus repair between March 2011 and July 2017 by an experienced single surgeon were enrolled. 228 patients were divided into the meniscus repair concomitant with ACL reconstruction (group A, n = 171) and isolated meniscal repair group (group B, n = 57). Magnetic resonance imaging (MRI) was performed preoperatively and 12 months postoperatively, measurements were conducted from the most prominent slice of meniscal tear (PSMT). IMSI of the PSMT was measured with the free line region-of-interest (ROI) tool in a picture archiving and communication system.</div></div><div><h3>Results</h3><div>Except for time of accident, no significant differences were found in terms of age, body mass index, posterior slope angle, or varus angle between two groups. There were statistically significant differences of post-operative adjusted mean IMSI of patients between the two groups using ANCOVA. The corrected postoperative adjusted mean IMSI in the coronal view of group A was an estimated mean (SD) of 1.44(0.08), and in group B was an estimated mean (SD) of 2.55(0.15). All the P-values were less than 0.05, which was the same compared with MRI values for healed meniscus.</div></div><div><h3>Conclusions</h3><div>IMSI is a simple and conventional parameter for the assessment of meniscal healing. The healing rate of meniscal repair concomitant with ACL reconstruction compared with isolated meniscal repair using IMSI was similar to that of MRI reading. Thus, concomitant ACL reconstruction significantly improves the healing process of meniscus.</div></div><div><h3>Level of evidence and study design</h3><div>Case control study.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 74-80"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319890","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

Electromyographic comparison of infraspinatus, anterior, and posterior deltoid fibres during belly press exercise and triceps overactivity 腹压运动和三头肌过度活动时冈下肌、三角肌前、后纤维的肌电图比较

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-10-01 Epub Date: 2025-09-04 DOI: 10.1016/j.asmart.2025.08.004

Yoshifumi Nanba , Tatsuyuki Ohta , Teruhiko Takata

Background/objective

The Belly Press Exercise (BPE) is a key clinical tool, but its efficacy is dependent on proper execution. This study aimed to clarify the muscle activation patterns that differentiate a proper BPE from an inappropriate pattern characterized by compensatory shoulder extension. We hypothesized that an appropriate pattern would involve greater posterior deltoid activation for stabilization, while the inappropriate pattern would show increased triceps brachii activity.

Methods

Surface electromyography was used to record the activity of the infraspinatus, anterior deltoid, posterior deltoid, and long head of the triceps brachii in 15 healthy male participants. The sample size was based on prior similar investigations (e.g., [13, 19]). Muscle activation was compared between two conditions: an appropriate pattern (isolated internal rotation) and an inappropriate pattern (internal rotation with 10° of shoulder extension) under three different load conditions (2, 5, and 10 % of body weight).

Results

Posterior deltoid activity was significantly higher in the appropriate pattern across all load conditions. In contrast, triceps brachii activity was significantly higher in the inappropriate pattern, particularly under the 5 % and 10 % load conditions. No significant differences were observed for the anterior deltoid or infraspinatus between patterns.

Conclusion

The posterior deltoid acts as a key stabilizer during a proper BPE, while overactivity of the long head of the triceps brachii is a clear indicator of compensatory shoulder extension. These findings provide clinicians with evidence-based markers for monitoring BPE form to ensure its therapeutic efficacy and safety.

背景/目的腹压练习（BPE）是一种重要的临床工具，但其效果取决于正确的执行。本研究旨在阐明区分适当的BPE和以代偿性肩部伸展为特征的不适当的BPE的肌肉激活模式。我们假设一个合适的模式将包括更大的后三角肌激活来稳定，而不合适的模式将显示肱三头肌活动增加。方法采用表面肌电记录15例健康男性冈下肌、三角肌前肌、三角肌后肌和肱三头肌长头肌的活动。样本量基于先前的类似调查（例如，[13,19]）。在三种不同的负荷条件下（体重的2%、5%和10%），比较了两种情况下的肌肉激活情况：适当的模式（孤立的内旋）和不适当的模式（内旋加肩部伸展10°）。结果在所有负载条件下，在适当的模式下，后验三角肌活动明显更高。相反，肱三头肌活动在不适当的模式下明显更高，特别是在5%和10%的负荷条件下。三角肌前肌和冈下肌在不同类型间无显著差异。结论后三角肌在适当的肩关节伸展中起着关键的稳定作用，而肱三头肌长头过度活动是代偿性肩部伸展的明确指标。这些发现为临床医生提供了监测BPE形式的循证标记物，以确保其治疗效果和安全性。

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引用次数: 0

Increased posterior tibial slope leads to increased risk of graft rupture in anterior cruciate reconstruction: a retrospective matched case-control study 胫骨后坡增加导致前十字骨重建中移植物破裂的风险增加：一项回顾性匹配病例对照研究

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-10-01 Epub Date: 2025-10-29 DOI: 10.1016/j.asmart.2025.10.001

Wing-Leong Chan , Keith Hay-Man Wan , Eugene Pak-Lin Ng , Christine Yuen-Shan Lai , Richard Hin-Lun Lee , Kevin Kwun-Hung Wong , Kam-Kwong Wong

Purpose

To investigate influence of an increased posterior tibial slope (PTS) on anterior cruciate ligament (ACL) reconstruction graft failure amongst ethnic Chinese in local subjects.

Methods

A total of number of 477 patients who had primary ACL reconstruction done from January 2008 to December 2021 were retrospectively reviewed. Ethnic Chinese patient graft size >7 mm using Hamstring graft by single bundle technique were included. Patients with age more than 50 years old, known medical comorbidities on graft rupture such as diabetes, renal failure, previous contralateral ACL injury, previous ACL revision surgery, concomitant multi-ligamental injuries, high energy trauma such as road traffic accident, contact sport injury were excluded. Included patient with graft rupture and revision surgery done will be matched and compared with those without graft rupture after primary surgery. PTS of both groups of patients will be measured on their true lateral knee X-Ray before their primary ACL reconstruction. Data of both groups (age, sex ratio, graft size, PTS angle) will be compared through Fisher exact test, t-Test and logistic regression.

Results

The incidence rate on ACL revision in our local ethnic Chinese patient was around 4.6 % (22 cases). 25 revision cases were matched with 125 control cases, with no statistically significant difference on sex ratio, age at primary operation, graft size among both groups. PTS of revision patient group had significantly higher PTS angle than control group (95 % confident interval, 10.7° vs 8.6°; P < 0.01). Logistic regression showed PTS as a significant factor affecting graft rupture outcome. Odd ratios of graft rupture due to increased PTS were 2.3 (P < 0.01), with increased risk when PTS ≥11.6° shown in logistic regression.

Conclusions

High PTS (>11.6°) will lead to increased ACL graft rupture risk and revision surgery amongst ethnic Chinese in Hong Kong. Patients with high PTS noted in pre-operative status should have their operation planned carefully and may require additional procedure such as slope-correcting operation and lateral augmentation to reduce risk of graft rupture.

Level of evidence

Level III, retrospective comparative study.

目的探讨华人胫骨后斜度（PTS）增高对前交叉韧带（ACL）重建失败的影响。方法回顾性分析2008年1月至2021年12月间行原发性ACL重建的477例患者。采用单束技术移植大小为7 mm的华人患者。排除年龄在50岁以上、已知的植骨破裂合并症如糖尿病、肾衰竭、既往对侧ACL损伤、既往ACL翻修手术、合并多韧带损伤、道路交通事故、接触性运动损伤等高能创伤的患者。在初次手术后进行移植物破裂和翻修手术的患者将与未发生移植物破裂的患者进行匹配和比较。两组患者的PTS将在初次ACL重建前在其真侧膝x线片上进行测量。两组数据（年龄、性别比、移植物大小、PTS角度）通过Fisher精确检验、t检验和logistic回归进行比较。结果本区华人患者ACL翻修的发生率为4.6%（22例）。25例翻修手术与125例对照，两组在性别比例、初次手术年龄、移植物大小方面差异无统计学意义。翻修组PTS角度明显高于对照组（95%可信区间，10.7°vs 8.6°；P < 0.01）。Logistic回归分析显示PTS是影响移植物破裂结局的重要因素。经logistic回归分析，PTS升高导致移植物破裂的奇比为2.3 (P < 0.01), PTS≥11.6°时风险增加。结论高PTS （>11.6°）会增加香港华人前交叉韧带移植破裂和翻修手术的风险。术前注意到高PTS的患者应仔细计划手术，并可能需要额外的手术，如斜面矫正手术和外侧增强手术，以减少移植物破裂的风险。证据等级：III级，回顾性比较研究。

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引用次数: 0

Prevalence of os acromiale in Japanese population: Comparison between patients with shoulder pain and asymptomatic subjects 肩峰性肌痛在日本人群中的患病率：肩痛患者与无症状患者的比较

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.1016/j.asmart.2025.09.002

Shinji Kawaguchi , Shoji Fukuta , Jun Kawamata , Koichi Sairyo

Background

Os acromiale, a condition in which the acromial apophysis fails to fuse, and its prevalence varies across ethnic groups. Although higher rates have been reported in African and Caucasian populations, data are scarce for Asian populations, particularly for Japanese individuals. This study aimed to determine the prevalence of os acromiale in a Japanese population and its association with rotator cuff-related symptoms.

Methods

We retrospectively identified 2221 shoulders of 1411 Japanese subjects aged over 25 years who underwent computed tomography (CT) of the shoulder at our institution between September 2010 and March 2023. The shoulders were divided into an asymptomatic group, which included 1386 shoulders of 693 patients with no documented history of shoulder pain who underwent chest CT for non-orthopedic reasons, and a symptomatic group, which included 836 shoulders of 800 patients who underwent arthroscopic surgery for rotator cuff tears or tendinopathy. Os acromiale was identified using three-dimensional CT and classified by location.

Results

Os acromiale was identified in 16 shoulders (0.72 %), 10 of which were classified as pre-acromial and 6 as meso-acromial. The prevalence was significantly higher in the symptomatic group than in the asymptomatic group (1.56 % vs 0.22 %, p = 0.002). No significant difference was observed according to sex or laterality.

Conclusion

The prevalence of os acromiale in Japanese was 0.72 %. The prevalence of this condition is markedly lower in this population than in African and Caucasian populations. However, its significantly higher occurrence in symptomatic patients suggests a potential role in shoulder pain associated with rotator cuff lesions. These results emphasize the importance of recognizing os acromiale as a possible anatomical contributor to shoulder symptoms in clinical practice.

肩峰性畸形是指肩峰突不能融合的一种疾病，其患病率在不同的民族中有所不同。虽然非洲和高加索人群的发病率较高，但亚洲人群，特别是日本人的数据很少。本研究旨在确定肩峰性骨质疏松症在日本人群中的患病率及其与肩袖相关症状的关系。方法回顾性分析了1411名年龄在25岁以上的日本受试者的2221个肩部，这些受试者于2010年9月至2023年3月在我们的机构接受了肩部计算机断层扫描（CT）。肩关节被分为无症状组，包括1386个肩关节，693名无肩关节疼痛病史的患者，因非骨科原因接受胸部CT检查；有症状组，包括800名因肩袖撕裂或肌腱病变接受关节镜手术的836个肩关节。采用三维CT对肩峰进行定位和分类。结果16例（0.72%）出现肩峰，其中10例为前肩峰，6例为中肩峰。有症状组的患病率明显高于无症状组（1.56% vs 0.22%, p = 0.002）。根据性别或侧边，没有观察到显着差异。结论日本人肩峰性骨质疏松症患病率为0.72%。这种情况的患病率明显低于非洲和高加索人群。然而，在有症状的患者中，其发生率明显较高，这表明它可能与肩袖病变相关的肩痛有关。这些结果强调了在临床实践中认识到肩峰肌作为肩部症状可能的解剖学因素的重要性。

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引用次数: 0

Does hip bone morphology differ depending on the presence of cam lesions in borderline developmental dysplasia of the hip? 髋部骨形态是否会因髋部边缘发育不良的cam病变而有所不同？

IF 1.5 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-07-01 Epub Date: 2025-07-03 DOI: 10.1016/j.asmart.2025.06.001

Yuichi Kuroda, Tomoyuki Kamenaga, Shotaro Araki, Masanori Tsubosaka, Naoki Nakano, Tomoyuki Matsumoto, Shinya Hayashi, Ryosuke Kuroda

Background

The purpose of this study was to divide patients with borderline developmental dysplasia of the hip (BDDH) into two groups according to the presence of Cam lesions, and compare radiographs related to bone morphology between them.

Methods

We retrospectively analyzed consecutive patients with BDDH who underwent hip arthroscopy (HA) or periacetabular osteotomy (PAO) at our institution between October 2013 and October 2019. The patients were classified into two groups according to the presence of Cam lesions. Radiographic measurements including lateral center-edge angle (LCEA), acetabular roof obliquity (ARO), cliff sign, femoral epiphyseal acetabular roof (FEAR) index, vertical center anterior angle (VCA), and Sourcil Index were compared between the two groups. The cutoff values were calculated using a receiver operating characteristic curve.

Results

Sixty-nine hips were analyzed in this study (Cam+: 34, Cam-: 35). The ARO and FEAR index were significantly higher in the Cam-group (P < 0.001, P < 0.001). The LCEA, VCA, and Sourcil Index was significantly lower in the Cam-group than that in the Cam + group (P < 0.001, P < 0.001, P < 0.001). The cutoff values were 21.0° for LCEA, 15.1° for the ARO, 22.5° for the VCA angle, −2.2° for the FEAR index, and 49.5° for the Sourcil Index.

Conclusion

Patients with BDDH exhibited significant differences in bone morphology depending on the presence of Cam lesions. Moreover, those without Cam lesions displayed similarities to patients with DDH.

本研究的目的是将髋关节交界性发育不良（BDDH）患者根据是否存在Cam病变分为两组，并比较两组患者的骨形态学相关x线片。方法回顾性分析2013年10月至2019年10月在我院接受髋关节镜（HA）或髋臼周围截骨术（PAO）治疗的连续BDDH患者。根据有无Cam病变将患者分为两组。比较两组患者的影像学指标，包括髋臼顶外侧中心边缘角（LCEA）、髋臼顶倾角（ARO）、悬崖征、股骨骺髋臼顶（FEAR）指数、垂直中心前角（VCA）和源指数。利用接收机工作特性曲线计算截止值。结果本研究共分析69例髋关节（Cam+: 34, Cam-: 35）。cam组的ARO和FEAR指数显著高于对照组(P <；0.001, P <；0.001)。Cam-组的LCEA、VCA和Sourcil Index显著低于Cam +组(P <；0.001, P <；0.001, P <；0.001)。LCEA的截止值为21.0°，ARO为15.1°，VCA角为22.5°，FEAR指数为- 2.2°，Sourcil指数为49.5°。结论BDDH患者的骨形态随Cam病变的存在而有显著差异。此外，没有Cam病变的患者与DDH患者表现相似。

{"title":"Does hip bone morphology differ depending on the presence of cam lesions in borderline developmental dysplasia of the hip?","authors":"Yuichi Kuroda, Tomoyuki Kamenaga, Shotaro Araki, Masanori Tsubosaka, Naoki Nakano, Tomoyuki Matsumoto, Shinya Hayashi, Ryosuke Kuroda","doi":"10.1016/j.asmart.2025.06.001","DOIUrl":"10.1016/j.asmart.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to divide patients with borderline developmental dysplasia of the hip (BDDH) into two groups according to the presence of Cam lesions, and compare radiographs related to bone morphology between them.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed consecutive patients with BDDH who underwent hip arthroscopy (HA) or periacetabular osteotomy (PAO) at our institution between October 2013 and October 2019. The patients were classified into two groups according to the presence of Cam lesions. Radiographic measurements including lateral center-edge angle (LCEA), acetabular roof obliquity (ARO), cliff sign, femoral epiphyseal acetabular roof (FEAR) index, vertical center anterior angle (VCA), and Sourcil Index were compared between the two groups. The cutoff values were calculated using a receiver operating characteristic curve.</div></div><div><h3>Results</h3><div>Sixty-nine hips were analyzed in this study (Cam+: 34, Cam-: 35). The ARO and FEAR index were significantly higher in the Cam-group (P < 0.001, P < 0.001). The LCEA, VCA, and Sourcil Index was significantly lower in the Cam-group than that in the Cam + group (P < 0.001, P < 0.001, P < 0.001). The cutoff values were 21.0° for LCEA, 15.1° for the ARO, 22.5° for the VCA angle, −2.2° for the FEAR index, and 49.5° for the Sourcil Index.</div></div><div><h3>Conclusion</h3><div>Patients with BDDH exhibited significant differences in bone morphology depending on the presence of Cam lesions. Moreover, those without Cam lesions displayed similarities to patients with DDH.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"41 ","pages":"Pages 14-19"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535885","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

Hyperuricemia predicts adverse clinical outcomes after arthroscopic microfracture of osteochondral lesions of the talus 高尿酸血症预测关节镜下距骨软骨病变微骨折后的不良临床结果

IF 1.5 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-07-01 Epub Date: 2025-06-25 DOI: 10.1016/j.asmart.2025.04.004

Yuanqiang Li , Zhenyu Wang , Guo Zheng , Lin Ma , Xin Xin Li , Yan Liang , Xinyu Xie , Xiaolin Zhang , Chengsong Yuan , Wan Chen

Purpose

To investigate the correlation of serum uric acid levels with the clinical outcomes of arthroscopic microfracture in osteochondral lesions of the talus (OLTs) and determine the cut-off point for predicting outcomes.

Methods

A total of 134 OLTs patients who underwent arthroscopic microfracture from November 2008 to June 2019 were included: 42 in the hyperuricemia group (≥ 420 μmol/L) and 92 in the non-hyperuricemia group (< 420 μmol/L). Clinical characteristics recorded and analyzed included Visual Analog Scale (VAS score), American Orthopaedic Foot & Ankle Society score (AOFAS), and 36-Item Short Form Health Survey score (SF-36). Logistic regression identified risk factors, and Receiver Operating Characteristic Curves (ROC) determined the serum uric acid cut-off value for predicting outcomes, which was prospectively validated.

Results

Significant improvement were observed in postoperative range of motion score, VAS score, AOFAS score, and SF-36 score across all patients (P < 0.05). However, the VAS score for the non-hyperuricemia group was lower; In contrast, the AOFAS and SF-36 scores were higher than the hyperuricemia group during the last visit (P < 0.05). Multivariate analysis identified age, serum uric acid, osteochondral defect size, and urate deposition as independent risk factors for clinical outcomes, and the cut-off value for the serum uric acid American Orthopaedic Foot & Ankle Society score 445 μmol/L with sensitivity and specificity of 87.25 % and 81.25 %, respectively. Additionally, the derivation set demonstrated a sensitivity of 85.71 % and specificity of 83.33 % in predicting poor outcomes.

Conclusion

Hyperuricemia predicts adverse clinical outcomes after arthroscopic microfracture of osteochondral lesions of the talus, strict postoperative drop uric acid treatment, especially hyperuricemia OLTs serum uric acid levels ≥ 445μmol/L.

Level of evidence

Level IV, case series.

目的探讨血清尿酸水平与关节镜下距骨软骨病变（OLTs）微骨折临床预后的相关性，并确定预测预后的截断点。方法收集2008年11月至2019年6月接受关节镜微骨折治疗的OLTs患者134例：高尿酸血症组42例（≥420 μmol/L），非高尿酸血症组92例(<；420μmol / L)。记录和分析临床特征包括视觉模拟量表（VAS）、American Orthopaedic Foot；踝关节社会评分（AOFAS）和36项简短健康调查评分（SF-36）。Logistic回归确定了危险因素，受试者工作特征曲线（ROC）确定了预测预后的血清尿酸临界值，并对其进行了前瞻性验证。结果所有患者术后活动范围评分、VAS评分、AOFAS评分和SF-36评分均有显著改善(P <；0.05)。然而，非高尿酸血症组VAS评分较低；相比之下，AOFAS和SF-36评分在最后一次访问时高于高尿酸血症组(P <；0.05)。多因素分析发现，年龄、血清尿酸、骨软骨缺损大小和尿酸沉积是影响临床结果的独立危险因素，血清尿酸的临界值为美国骨科足；踝关节社会评分为445 μmol/L，敏感性87.25%，特异性81.25%。此外，衍生集在预测不良预后方面的敏感性为85.71%，特异性为83.33%。结论高尿酸血症预示着关节镜下距骨软骨病变微骨折后的不良临床结局，术后应严格降尿酸治疗，尤其是高尿酸血症患者血清尿酸水平≥445μmol/L。证据等级：IV级，案例系列。

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引用次数: 0

IF 1.5 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-07-01 Epub Date: 2025-07-04 DOI: 10.1016/j.asmart.2025.06.002

Yoshihiro Ishida , Yasushi Takata , Tatsuya Ishikawa , Mitsuhiro Kimura , Naoki Takemoto , Manase Nishimura , Noriyuki Ozaki , Satoru Demura , Junsuke Nakase

Background

The quadriceps tendon (QT) has recently gained attention as a graft tendon for anterior cruciate ligament (ACL) reconstruction due to its high strength from a larger ultrastructural collagen fibril diameter in children than that of the semitendinosus tendon. While QT collagen fibril diameter increases with growth, changes in older adults remain unclear. This study investigated age-related changes in QT collagen fibril diameter.

Methods

Twenty-four patients who had undergone ACL reconstruction using the QT or other knee surgeries were included. QT tissues collected during surgery were analyzed using transmission electron microscopy. Collagen fibril diameter was measured in four groups: Immature (11–13 years), Young (15–17 years), Adult (21–50 years), and Older (61–81 years). The average fibril diameter was calculated for each sample. At least four slides (one slide = one digital electron micrographs of the ultrathin section) were evaluated for each specimen, with at least 200 collagen fibrils on each slide. The average number of collagen fibrils measured per specimen was 812 ± 10. Data of the four groups were analyzed using one-way analysis of variance and Tukey's test.

Results

The mean collagen fibril diameters were 89.7 ± 14.4, 94.8 ± 16.4, 107.2 ± 12.1, and 73.0 ± 9.7 nm in the Immature, Young, Adult, and Older groups, respectively. Although no significant difference was observed between the Immature and Young groups, fibril diameter was significantly larger in the Adult group than in the Young group and significantly smaller in the Older group than in the other groups.

Conclusions

The average QT collagen fibril diameter increased with growth but was lower in the Older group, suggesting a decrease with aging.

背景近来，股四头肌肌腱（QT）作为前交叉韧带（ACL）重建的移植肌腱受到了关注，因为在儿童中，其超微结构胶原纤维直径比半腱肌腱大，强度高。虽然QT胶原原纤维直径随着生长而增加，但老年人的变化尚不清楚。本研究探讨QT胶原纤维直径的年龄相关性变化。方法选取24例采用QT或其他膝关节手术进行前交叉韧带重建的患者。术中收集的QT组织用透射电镜进行分析。测量胶原纤维直径分为四组：未成熟（11-13岁）、年轻（15-17岁）、成年（21-50岁）和老年（61-81岁）。计算每个样品的平均纤维直径。每个标本至少评估四张载玻片（一张载玻片=一张超薄切片的数码电子显微图），每张载玻片上至少有200个胶原原纤维。每个标本测得的平均胶原原纤维数为812±10。四组资料采用单因素方差分析和Tukey检验进行分析。结果未成熟组、青壮年组、成年组和老年组胶原原纤维平均直径分别为89.7±14.4 nm、94.8±16.4 nm、107.2±12.1 nm和73.0±9.7 nm。虽然未成熟组和幼龄组之间没有显著差异，但成虫组的纤维直径明显大于幼龄组，而幼龄组的纤维直径明显小于其他组。结论QT胶原纤维平均直径随年龄增长而增加，但在老年组呈下降趋势，提示QT胶原纤维平均直径随年龄增长而降低。

{"title":"Age-related changes in the quadriceps tendon: Collagen fibril diameter decreases with aging","authors":"Yoshihiro Ishida , Yasushi Takata , Tatsuya Ishikawa , Mitsuhiro Kimura , Naoki Takemoto , Manase Nishimura , Noriyuki Ozaki , Satoru Demura , Junsuke Nakase","doi":"10.1016/j.asmart.2025.06.002","DOIUrl":"10.1016/j.asmart.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>The quadriceps tendon (QT) has recently gained attention as a graft tendon for anterior cruciate ligament (ACL) reconstruction due to its high strength from a larger ultrastructural collagen fibril diameter in children than that of the semitendinosus tendon. While QT collagen fibril diameter increases with growth, changes in older adults remain unclear. This study investigated age-related changes in QT collagen fibril diameter.</div></div><div><h3>Methods</h3><div>Twenty-four patients who had undergone ACL reconstruction using the QT or other knee surgeries were included. QT tissues collected during surgery were analyzed using transmission electron microscopy. Collagen fibril diameter was measured in four groups: Immature (11–13 years), Young (15–17 years), Adult (21–50 years), and Older (61–81 years). The average fibril diameter was calculated for each sample. At least four slides (one slide = one digital electron micrographs of the ultrathin section) were evaluated for each specimen, with at least 200 collagen fibrils on each slide. The average number of collagen fibrils measured per specimen was 812 ± 10. Data of the four groups were analyzed using one-way analysis of variance and Tukey's test.</div></div><div><h3>Results</h3><div>The mean collagen fibril diameters were 89.7 ± 14.4, 94.8 ± 16.4, 107.2 ± 12.1, and 73.0 ± 9.7 nm in the Immature, Young, Adult, and Older groups, respectively. Although no significant difference was observed between the Immature and Young groups, fibril diameter was significantly larger in the Adult group than in the Young group and significantly smaller in the Older group than in the other groups.</div></div><div><h3>Conclusions</h3><div>The average QT collagen fibril diameter increased with growth but was lower in the Older group, suggesting a decrease with aging.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"41 ","pages":"Pages 20-25"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549529","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