Pub Date : 2025-09-03DOI: 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.
{"title":"Comparison of a patient-specific instrument and conventional high tibial Osteotomy: Accuracy of correction target and prevention of posterior tibial slope change","authors":"Joo Hyung Han , Min Jung , Kwangho Chung , Sungjun Kim , Min Ho Lee , Chong-Hyuk Choi , Sung-Hwan Kim","doi":"10.1016/j.asmart.2025.08.006","DOIUrl":"10.1016/j.asmart.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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°, <em>P</em> = 0.023), as well as between the preoperative and postoperative PTS values (8.8° ± 3.2° vs. 7.9° ± 3.5°, <em>P</em> = 0.033). Conversely, the PSI group did not exhibit any significant differences in these values.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 28-35"},"PeriodicalIF":1.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932120","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}
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.
{"title":"Objective postoperative knee stability after 1-stage and 2-stage revision anterior cruciate ligament reconstruction","authors":"Ryohei Uchida , Yukiyoshi Toritsuka , Tomohiko Matsuo , Masashi Kusano , Takayuki Tsuda , Wataru Ando","doi":"10.1016/j.asmart.2025.08.008","DOIUrl":"10.1016/j.asmart.2025.08.008","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>Objective anterior knee laxity was evaluated by knee arthrometer at 12+ months postoperatively among 35 patients who underwent revision ACLR.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 21-27"},"PeriodicalIF":1.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932109","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}
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.
{"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}
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}
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.
{"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}
Pub Date : 2025-06-25DOI: 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.
{"title":"Hyperuricemia predicts adverse clinical outcomes after arthroscopic microfracture of osteochondral lesions of the talus","authors":"Yuanqiang Li , Zhenyu Wang , Guo Zheng , Lin Ma , Xin Xin Li , Yan Liang , Xinyu Xie , Xiaolin Zhang , Chengsong Yuan , Wan Chen","doi":"10.1016/j.asmart.2025.04.004","DOIUrl":"10.1016/j.asmart.2025.04.004","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Level of evidence</h3><div>Level IV, case series.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"41 ","pages":"Pages 6-13"},"PeriodicalIF":1.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470467","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}
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.
{"title":"Clinical outcomes following anatomic double-bundle ACL reconstruction in skeletally mature adolescent patients: Comparison to single-bundle procedure","authors":"Kanto Nagai , Takehiko Matsushita , Shurong Zhang , Yuichi Hoshino , Yuta Nakanishi , Daisuke Araki , Kyohei Nishida , Ryosuke Kuroda","doi":"10.1016/j.asmart.2025.04.006","DOIUrl":"10.1016/j.asmart.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"41 ","pages":"Pages 1-5"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205690","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}
Pub Date : 2025-05-10DOI: 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.
{"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}
Pub Date : 2025-05-05DOI: 10.1016/j.asmart.2025.04.005
Onur Engin , Ceren Durmaz Engin , Atilla Hikmet Çilengir , Berna Dirim Mete
Objective
To evaluate the performance of a code free deep learning (CFDL) application in diagnosing supraspinatus tendon pathologies on shoulder magnetic resonance imaging (MRI) images.
Design
This retrospective cross-sectional study included patients with supraspinatus MRI showing partial or full-thickness tears and tendinosis, with patients having normal findings as the control group. MRI images were processed in the LobeAI application using transfer learning with ResNet-50 V2 for model development. Models were built to differentiate each pathology from normal and full-thickness tears from partial tears.
Results
The ML models developed using the LobeAI application demonstrated the ability to differentiate between normal shoulder MRI images and partial tears, full-thickness tears, and tendinosis with sensitivities of 93.75 %, 100 %, and 100 %, respectively, and specificities of 43.75 %, 62.5 %, and 18.75 %. The model designed to classify partial vs. full-thickness tears achieved an accuracy of 34.38 %. The model incorporating all pathological images compared to normal MRI images exhibited an accuracy of 37.50 % and a weighted F1 score of 0.32.
Conclusion
The results of the study suggest that, although CFDL applications may be promising for the initial detection of supraspinatus pathologies, their current iteration has limitations that must be resolved before they can be reliably integrated into clinical practice.
{"title":"Detection and classification of supraspinatus pathologies on shoulder magnetic resonance images using a code-free deep learning application","authors":"Onur Engin , Ceren Durmaz Engin , Atilla Hikmet Çilengir , Berna Dirim Mete","doi":"10.1016/j.asmart.2025.04.005","DOIUrl":"10.1016/j.asmart.2025.04.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the performance of a code free deep learning (CFDL) application in diagnosing supraspinatus tendon pathologies on shoulder magnetic resonance imaging (MRI) images.</div></div><div><h3>Design</h3><div>This retrospective cross-sectional study included patients with supraspinatus MRI showing partial or full-thickness tears and tendinosis, with patients having normal findings as the control group. MRI images were processed in the LobeAI application using transfer learning with ResNet-50 V2 for model development. Models were built to differentiate each pathology from normal and full-thickness tears from partial tears.</div></div><div><h3>Results</h3><div>The ML models developed using the LobeAI application demonstrated the ability to differentiate between normal shoulder MRI images and partial tears, full-thickness tears, and tendinosis with sensitivities of 93.75 %, 100 %, and 100 %, respectively, and specificities of 43.75 %, 62.5 %, and 18.75 %. The model designed to classify partial vs. full-thickness tears achieved an accuracy of 34.38 %. The model incorporating all pathological images compared to normal MRI images exhibited an accuracy of 37.50 % and a weighted F1 score of 0.32.</div></div><div><h3>Conclusion</h3><div>The results of the study suggest that, although CFDL applications may be promising for the initial detection of supraspinatus pathologies, their current iteration has limitations that must be resolved before they can be reliably integrated into clinical practice.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 1-7"},"PeriodicalIF":1.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904355","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}
The femoral neck anteversion angle has been used as a surgical indicator for hip and patellofemoral joint disorders. However, the influence of limb position on femoral neck anteversion angle measurements during imaging remains unclear. Therefore, this study aimed to investigate the influence of limb position on femoral neck anteversion angle measurements.
Methods
Computed tomography images of 20 femurs from 10 patients were obtained. The angle between the line passing through the center of the femoral head and the center of the femoral neck and the tangential line of the femoral posterior condyles on axial slices was measured as the femoral neck anteversion angle. Raw femoral neck anteversion angle data was defined as the original femoral neck anteversion angle. The cutting direction of the axial plane was changed from −20° to 20° in 5° increments to simulate limb position changes for each of the following measurements: hip flexion/extension, abduction/adduction angles, and their combined directions. The femoral neck anteversion angle was measured under each condition, and the change in the angle was calculated. The correlation between hip angle and femoral neck anteversion angle change was analysed by Spearman's rank correlation coefficient.
Results
The mean original femoral neck anteversion angle was 17.6°. There was a strong negative correlation between hip flexion/extension change and femoral neck anteversion angle change (r = −0.96, p < 0.001). There was a weak correlation between hip adduction/abduction change and femoral neck anteversion angle change (r = 0.35, p < 0.001). The average maximum potential difference in femoral neck anteversion angle measurement combining flexion/extension and abduction/adduction was 21.0° ± 4.9°.
Conclusions
The femoral neck anteversion angle changed in association with changes in limb position, particularly with hip flexion and extension. Careful attention to limb position and conditions of the slice is needed to consistently evaluate the femoral neck anteversion angle.
背景：股骨颈前倾角已被用作髋关节和髌股关节疾病的外科指标。然而，在成像过程中，肢体位置对股骨颈前倾角测量的影响尚不清楚。因此，本研究旨在探讨肢体位置对股骨颈前倾角测量的影响。方法对10例患者的20根股骨进行计算机断层扫描。测量轴向片上穿过股骨头中心和股骨颈中心的线与股骨后髁切线之间的夹角为股骨颈前倾角。原始股骨颈前倾角数据定义为原始股骨颈前倾角。轴向平面的切割方向以5°的增量从- 20°变为20°，以模拟以下每个测量的肢体位置变化：髋关节屈伸、外展/内收角及其组合方向。测量各工况下股骨颈前倾角，计算其变化量。采用Spearman秩相关系数分析髋角与股骨颈前倾角变化的相关性。结果股骨颈前倾角平均为17.6°。髋屈伸变化与股骨颈前倾角度变化呈显著负相关(r = - 0.96, p <；0.001)。髋关节内收/外展变化与股骨颈前倾角变化相关性较弱(r = 0.35, p <；0.001)。股骨颈前倾角测量结合屈伸外展内收的平均最大电位差为21.0°±4.9°。结论股骨颈前倾角随肢体位置的变化而变化，尤其是髋屈伸。需要仔细注意肢体位置和切片条件，以一致地评估股骨颈前倾角。
{"title":"Influence of limb position on femoral neck anteversion angle measurement during computed tomography imaging","authors":"Rika Shigemoto, Takehiko Matsushita, Kyohei Nishida, Kanto Nagai, Yuta Nakanishi, Tetsuya Yamamoto, Tomoyuki Matsumoto, Noriyuki Kanzaki, Yuichi Hoshino, Ryosuke Kuroda","doi":"10.1016/j.asmart.2025.04.003","DOIUrl":"10.1016/j.asmart.2025.04.003","url":null,"abstract":"<div><h3>Background</h3><div>The femoral neck anteversion angle has been used as a surgical indicator for hip and patellofemoral joint disorders. However, the influence of limb position on femoral neck anteversion angle measurements during imaging remains unclear. Therefore, this study aimed to investigate the influence of limb position on femoral neck anteversion angle measurements.</div></div><div><h3>Methods</h3><div>Computed tomography images of 20 femurs from 10 patients were obtained. The angle between the line passing through the center of the femoral head and the center of the femoral neck and the tangential line of the femoral posterior condyles on axial slices was measured as the femoral neck anteversion angle. Raw femoral neck anteversion angle data was defined as the original femoral neck anteversion angle. The cutting direction of the axial plane was changed from −20° to 20° in 5° increments to simulate limb position changes for each of the following measurements: hip flexion/extension, abduction/adduction angles, and their combined directions. The femoral neck anteversion angle was measured under each condition, and the change in the angle was calculated. The correlation between hip angle and femoral neck anteversion angle change was analysed by Spearman's rank correlation coefficient.</div></div><div><h3>Results</h3><div>The mean original femoral neck anteversion angle was 17.6°. There was a strong negative correlation between hip flexion/extension change and femoral neck anteversion angle change (<em>r</em> = −0.96, p < 0.001). There was a weak correlation between hip adduction/abduction change and femoral neck anteversion angle change (<em>r</em> = 0.35, p < 0.001). The average maximum potential difference in femoral neck anteversion angle measurement combining flexion/extension and abduction/adduction was 21.0° ± 4.9°.</div></div><div><h3>Conclusions</h3><div>The femoral neck anteversion angle changed in association with changes in limb position, particularly with hip flexion and extension. Careful attention to limb position and conditions of the slice is needed to consistently evaluate the femoral neck anteversion angle.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 29-34"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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