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

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 : 2025-09-06 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

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 : 2025-09-04 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

Comparison of a patient-specific instrument and conventional high tibial Osteotomy: Accuracy of correction target and prevention of posterior tibial slope change 患者专用器械与传统胫骨高位截骨术的比较：矫正目标的准确性及胫骨后坡改变的预防

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-09-03 DOI: 10.1016/j.asmart.2025.08.006

Joo Hyung Han , Min Jung , Kwangho Chung , Sungjun Kim , Min Ho Lee , Chong-Hyuk Choi , Sung-Hwan Kim

Background

High tibial osteotomy (HTO) is crucial for managing medial compartmental knee osteoarthritis. Precision in achieving the medial proximal tibial angle (MPTA) correction and maintenance of posterior tibial slope (PTS) is essential for clinical success. This study aims to compare the use of 3D-printed patient-specific instruments (PSI) to conventional HTO to achieve precise MPTA correction and maintenance of PTS, aiming to enhance surgical outcomes in HTO patients.

Methods

Among 104 patients who underwent HTO between September 2018 and July 2021, 60 met the inclusion criteria and were categorized into a PSI group (30 cases) and conventional method group (30 cases). Radiological outcomes included estimated and postoperative MPTA values, along with preoperative and postoperative PTS measurements.

Results

Within the conventional HTO group, significant differences were noted between the estimated and postoperative MPTA values (94.3° ± 2.4° vs. 93.5° ± 2.5°, P = 0.023), as well as between the preoperative and postoperative PTS values (8.8° ± 3.2° vs. 7.9° ± 3.5°, P = 0.033). Conversely, the PSI group did not exhibit any significant differences in these values.

Conclusion

This study indicated that the use of PSI-guided HTO could provide enhanced accuracy in achieving the target MPTA and improve the prevention of PTS changes.

背景：胫骨高位截骨术（HTO）对于治疗内侧室性膝骨关节炎至关重要。精确实现胫骨内侧近端角（MPTA）矫正和维持胫骨后坡（PTS）是临床成功的关键。本研究旨在比较3d打印患者专用器械（PSI）与传统HTO的使用，以实现精确的MPTA矫正和维持PTS，旨在提高HTO患者的手术效果。方法2018年9月至2021年7月104例HTO患者中，60例符合纳入标准，分为PSI组（30例）和常规方法组（30例）。放射学结果包括估计和术后MPTA值，以及术前和术后PTS测量。结果在常规HTO组中，估计的MPTA值与术后的MPTA值（94.3°±2.4°vs 93.5°±2.5°，P = 0.023）以及术前和术后的PTS值（8.8°±3.2°vs 7.9°±3.5°，P = 0.033）之间存在显著差异。相反，PSI组在这些值上没有表现出任何显著差异。结论使用psi引导下的HTO可以提高MPTA目标的准确性，提高PTS改变的预防效果。

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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 : 2025-09-03 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

Hip internal rotation restriction and heel raise mechanics as risk factors for Jones fractures in youth football players 髋关节内旋限制和足跟抬高力学是青少年足球运动员琼斯骨折的危险因素

IF 1.4 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-08-21 DOI: 10.1016/j.asmart.2025.08.007

Tomoki Koyama , Yoshitomo Saita , Tomohiko Tateishi , Tomokazu Tanita , Hiroki Ukita , Toshiro Shima , Nobuyuki Itaya , Haruki Yaguchi , Nanako Yamamoto , Yu Mori , Toshimi Aizawa , Masashi Nagao

Background

Jones fractures, stress fractures at the proximal metaphyseal-diaphyseal junction of the fifth metatarsal, are common in sports that involve repetitive jumping and turning, particularly football (i.e., soccer). The incidence among Japanese football players is higher than in Europe, with a high refracture rate, particularly in conservatively managed cases. Although surgical treatment is preferred for athletes, limited data exist on risk factors in youth players. This study aimed to investigate the prevalence and risk factors for Jones fractures among high-level Japanese high school football players through medical examinations.

Methods

Medical examinations were conducted during the 2024 tournament involving 20 top-level high school teams (567 players). Ultrasound and X-ray imaging identified fractures, and players underwent various physical tests, including hip internal rotation (HIR) and weight-bearing position during a single heel raise (SHR). A questionnaire collected demographic data and fracture histories. Statistical analyses, including the Wilcoxon signed-rank test and Mann-Whitney U test, were conducted to determine associations with fracture risk.

Results

Of 232 male players (40.9 % of all), 18 (7.8 %) tested positive on ultrasound, seven (3.0 %) had confirmed fractures on radiography, and 11 reported a history of Jones fractures. Players with restricted HIR <30° and lateral weight-bearing during SHR showed a significantly higher fracture risk (Crude Odds Ratio: 3.74, p = 0.01). Additional lateral weight bearing during SHR increased the risk (Crude Odds Ratio, 4.02; p = 0.007).

Conclusion

Restricted HIR and lateral weight-bearing during SHR were identified as risk factors for Jones fractures in youth football players. Recognizing these factors may enable targeted preventive measures to reduce injury risk in high-level athletes.

jones骨折是发生在第五跖骨干骺端-干骺端交界处的应力性骨折，常见于重复性跳跃和转身的运动，尤其是足球。日本足球运动员的发病率高于欧洲，再骨折率很高，特别是在保守治疗的病例中。虽然手术治疗是运动员的首选，但关于青少年运动员的危险因素的数据有限。本研究旨在透过医学检查，探讨日本高水平高中足球运动员琼斯骨折的发生率及危险因素。方法对20支高水平高中代表队（567名运动员）参加的2024年比赛进行体格检查。超声和x射线成像确定了骨折，球员们进行了各种身体测试，包括髋关节内旋（HIR）和单脚跟抬高（SHR）时的负重位置。调查问卷收集了人口统计数据和骨折病史。统计分析包括Wilcoxon sign -rank检验和Mann-Whitney U检验，以确定与骨折风险的关联。结果232名男性球员（40.9%）中，18人（7.8%）超声检查呈阳性，7人（3.0%）x线片证实骨折，11人有琼斯骨折史。在SHR期间，HIR受限和侧位负重受限的运动员骨折风险明显更高（粗优势比：3.74,p = 0.01）。SHR期间额外的侧向负重增加了风险（粗优势比，4.02;p = 0.007）。结论青少年足球运动员Jones骨折发生的危险因素为SHR过程中受限的HIR和侧位负重。认识到这些因素可以使有针对性的预防措施减少高水平运动员的受伤风险。

{"title":"Hip internal rotation restriction and heel raise mechanics as risk factors for Jones fractures in youth football players","authors":"Tomoki Koyama , Yoshitomo Saita , Tomohiko Tateishi , Tomokazu Tanita , Hiroki Ukita , Toshiro Shima , Nobuyuki Itaya , Haruki Yaguchi , Nanako Yamamoto , Yu Mori , Toshimi Aizawa , Masashi Nagao","doi":"10.1016/j.asmart.2025.08.007","DOIUrl":"10.1016/j.asmart.2025.08.007","url":null,"abstract":"<div><h3>Background</h3><div>Jones fractures, stress fractures at the proximal metaphyseal-diaphyseal junction of the fifth metatarsal, are common in sports that involve repetitive jumping and turning, particularly football (i.e., soccer). The incidence among Japanese football players is higher than in Europe, with a high refracture rate, particularly in conservatively managed cases. Although surgical treatment is preferred for athletes, limited data exist on risk factors in youth players. This study aimed to investigate the prevalence and risk factors for Jones fractures among high-level Japanese high school football players through medical examinations.</div></div><div><h3>Methods</h3><div>Medical examinations were conducted during the 2024 tournament involving 20 top-level high school teams (567 players). Ultrasound and X-ray imaging identified fractures, and players underwent various physical tests, including hip internal rotation (HIR) and weight-bearing position during a single heel raise (SHR). A questionnaire collected demographic data and fracture histories. Statistical analyses, including the Wilcoxon signed-rank test and Mann-Whitney <em>U</em> test, were conducted to determine associations with fracture risk.</div></div><div><h3>Results</h3><div>Of 232 male players (40.9 % of all), 18 (7.8 %) tested positive on ultrasound, seven (3.0 %) had confirmed fractures on radiography, and 11 reported a history of Jones fractures. Players with restricted HIR <30° and lateral weight-bearing during SHR showed a significantly higher fracture risk (Crude Odds Ratio: 3.74, p = 0.01). Additional lateral weight bearing during SHR increased the risk (Crude Odds Ratio, 4.02; p = 0.007).</div></div><div><h3>Conclusion</h3><div>Restricted HIR and lateral weight-bearing during SHR were identified as risk factors for Jones fractures in youth football players. Recognizing these factors may enable targeted preventive measures to reduce injury risk in high-level athletes.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 15-20"},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879024","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

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 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

IF 1.5 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-07-01 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。

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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 : 2025-06-25 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

Clinical outcomes following anatomic double-bundle ACL reconstruction in skeletally mature adolescent patients: Comparison to single-bundle procedure 骨骼成熟的青少年患者解剖双束前交叉韧带重建的临床结果：与单束手术的比较

IF 1.5 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-06-04 DOI: 10.1016/j.asmart.2025.04.006

Kanto Nagai , Takehiko Matsushita , Shurong Zhang , Yuichi Hoshino , Yuta Nakanishi , Daisuke Araki , Kyohei Nishida , Ryosuke Kuroda

Background

The present study was aimed to compare the clinical outcomes following double-bundle (DB) ACL reconstruction (ACLR) with the outcomes following single-bundle (SB) ACLR in skeletally mature teenagers.

Methods

A total of 113 skeletally mature teenagers with unilateral ACL injury, who underwent primary ACLR using hamstring autograft with minimum 2 years follow-up, were included. This included 82 DB ACLR (median 16.0 [interquartile range (IQR), 2.0] year-old, male/female: 21/61) and 31 SB ACLR (17.0 [2.0] year-old, male/female: 6/25). At the final follow-up (3.6 [1.9] years), IKDC Subjective Knee Form (IKDC-SKF), Tegner activity scale, the side-to-side difference (SSD) in anterior tibial translation using KT arthrometer were obtained. The rate of residual pivot-shift test, graft rupture rate and contralateral ACL injury rate were also assessed.

Results

The rate of residual pivot-shift test was significantly lower in DB group than SB group (12.0 % vs 33.3 %, P = 0.02). Postoperative Tegner activity scale was significantly greater in DB group (7 [2]) than SB group (4 [4], P = 0.002). No significant differences were observed between two groups in IKDC-SKF (96.6 [10.0] in DB group, 97.7 [9.0] in SB group) and SSD in anterior tibial translation (1.5 [2.0] mm in DB group, 2.0 [2.0] mm in SB group). Graft rupture occurred in seven patients in DB group (8.5 %), and one patient in SB group (3.3 %). Contralateral ACL injury occurred in four patients in DB group (4.9 %), and two patients in SB group (6.5 %). No significant differences were observed between two groups in graft rupture and the contralateral ACL injury rates.

Conclusion

Clinical outcomes following DB ACLR were similar to SB ACLR, but the pivot-shift phenomenon appeared to be better controlled in DB ACLR than SB ACLR. Thus, to better restore rotatory knee stability, DB ACLR may be recommended in the skeletally mature teenagers.

Level of evidence

III.

本研究旨在比较骨骼成熟青少年双束（DB） ACL重建（ACLR）和单束（SB） ACLR的临床结果。方法对113例单侧前交叉韧带损伤的骨骼发育成熟的青少年，采用自体腘绳肌腱移植术行原发性前交叉韧带修复，随访至少2年。其中DB ACLR 82例（中位数16.0[四分位间距（IQR）， 2.0]岁，男/女：21/61），SB ACLR 31例（17.0[2.0]岁，男/女：6/25）。在最终随访（3.6[1.9]年）时，获得IKDC主观膝关节形态（IKDC- skf）、Tegner活动量表、KT关节计胫骨前平移的侧侧向差（SSD）。同时评估残端枢轴移位率、移植物破裂率和对侧ACL损伤率。结果DB组残余枢轴偏移率显著低于SB组（12.0% vs 33.3%, P = 0.02）。DB组术后Tegner活动量表（7[2]）显著高于SB组（4 [2],P = 0.002）。两组间IKDC-SKF （DB组96.6 [10.0]，SB组97.7[9.0]）和SSD胫骨前平移（DB组1.5 [2.0]mm， SB组2.0 [2.0]mm）差异无统计学意义。DB组7例（8.5%），SB组1例（3.3%）。DB组对侧前交叉韧带损伤4例（4.9%），SB组2例（6.5%）。两组间移植物断裂及对侧ACL损伤发生率无显著差异。结论DB ACLR的临床结果与SB ACLR相似，但DB ACLR的枢轴移位现象比SB ACLR得到更好的控制。因此，为了更好地恢复旋转膝关节的稳定性，推荐在骨骼成熟的青少年中使用DB ACLR。证据水平ii。

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引用次数: 0

Comparative meta-analysis of TightRope vs. hook plate for acromioclavicular joint dislocation 钢丝与钩钢板治疗肩锁关节脱位的比较meta分析

IF 1.5 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology

Pub Date : 2025-05-10 DOI: 10.1016/j.asmart.2025.04.001

Manuel Alejandro Villagrán-Luján , Alejandro Alarcon-Mendoza , Edgar Azael Perez-Gutierrez , Manuel Alberto Gutierrez-Moreno , Nadia Karina Portillo-Ortiz , Edmundo Berumen-Nafarrate

Objective

This study aims to compare the clinical and radiographic outcomes of the tight-rope system versus internal fixation with a hook plate for treating grade III-VI acute acromioclavicular dislocation.

Methods

Relevant studies were identified by searching PubMed, Cochrane, and Google Scholar, from January 2017 to December 2023. The primary focus of the study revolved around evaluating various factors such as the Constant Score, University of California Los Angeles (UCLA) Shoulder Score, Visual Analogue Scale (VAS), coracoclavicular distance (CCD), and incidences of complications. The analysis involved determining the weighted mean difference (WMD) along with its corresponding 95 % confidence intervals (95 % CIs), or risk ratios (RR) with 95 % CIs to quantify the collected data.

Results

Eight studies comprising 484 participants were included. Significant differences were observed in the Constant-Murley score between groups. However, no disparities were found in UCLA scores, VAS scores, or CCD improvement. Subgroup analyses also yielded consistent results.

Conclusions

Both treatment modalities demonstrated similar clinical and radiographic efficacy in alleviating pain, enhancing acromioclavicular joint function, and correcting coracoclavicular distance. Nevertheless, the TightRope system exhibited additional advantages, including reduced reoperation rates and lower risk of subacromial distal clavicle osteolysis.

目的本研究旨在比较钢丝绳系统与钩钢板内固定治疗III-VI级急性肩锁关节脱位的临床和影像学结果。方法检索PubMed、Cochrane和谷歌Scholar，检索时间为2017年1月至2023年12月。该研究的主要重点是评估各种因素，如恒定评分、加州大学洛杉矶分校（UCLA）肩部评分、视觉模拟量表（VAS）、喙锁骨距离（CCD）和并发症发生率。分析包括确定加权平均差（WMD）及其相应的95%置信区间（95% ci），或95% ci的风险比（RR），以量化收集到的数据。结果共纳入8项研究，484名受试者。各组之间的Constant-Murley评分差异有统计学意义。然而，在UCLA评分、VAS评分或CCD改善方面没有发现差异。亚组分析也得出了一致的结果。结论两种治疗方式在缓解疼痛、增强肩锁关节功能、矫正喙锁关节距离方面具有相似的临床和影像学疗效。然而，TightRope系统显示出额外的优势，包括降低再手术率和降低肩峰下锁骨远端骨溶解的风险。

{"title":"Comparative meta-analysis of TightRope vs. hook plate for acromioclavicular joint dislocation","authors":"Manuel Alejandro Villagrán-Luján , Alejandro Alarcon-Mendoza , Edgar Azael Perez-Gutierrez , Manuel Alberto Gutierrez-Moreno , Nadia Karina Portillo-Ortiz , Edmundo Berumen-Nafarrate","doi":"10.1016/j.asmart.2025.04.001","DOIUrl":"10.1016/j.asmart.2025.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to compare the clinical and radiographic outcomes of the tight-rope system versus internal fixation with a hook plate for treating grade III-VI acute acromioclavicular dislocation.</div></div><div><h3>Methods</h3><div>Relevant studies were identified by searching PubMed, Cochrane, and Google Scholar, from January 2017 to December 2023. The primary focus of the study revolved around evaluating various factors such as the Constant Score, University of California Los Angeles (UCLA) Shoulder Score, Visual Analogue Scale (VAS), coracoclavicular distance (CCD), and incidences of complications. The analysis involved determining the weighted mean difference (WMD) along with its corresponding 95 % confidence intervals (95 % CIs), or risk ratios (RR) with 95 % CIs to quantify the collected data.</div></div><div><h3>Results</h3><div>Eight studies comprising 484 participants were included. Significant differences were observed in the Constant-Murley score between groups. However, no disparities were found in UCLA scores, VAS scores, or CCD improvement. Subgroup analyses also yielded consistent results.</div></div><div><h3>Conclusions</h3><div>Both treatment modalities demonstrated similar clinical and radiographic efficacy in alleviating pain, enhancing acromioclavicular joint function, and correcting coracoclavicular distance. Nevertheless, the TightRope system exhibited additional advantages, including reduced reoperation rates and lower risk of subacromial distal clavicle osteolysis.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 8-14"},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929445","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