The American Journal of Sports Medicine最新文献

{"title":"Synovial Fluid Biomarkers in the Contralateral Knee Predict Patient-Reported Outcomes After Injury at Long-term Follow-up","authors":"Emily Berzolla, Vishal Sundaram, Bradley A. Lezak, Nicole Rynecki Baker, Izabel Powers, Daniel J. Kaplan, Thorsten Kirsch, Eric J. Strauss","doi":"10.1177/03635465251401555","DOIUrl":"https://doi.org/10.1177/03635465251401555","url":null,"abstract":"Background: Inflammatory biomarkers in an injured knee have been shown to predict outcomes, yet the role of the subsequent systemic inflammatory response to injury remains poorly understood. Purpose: To investigate whether synovial fluid (SF) biomarkers from the contralateral uninjured knee could predict long-term patient-reported outcomes (PROs) for the operative knee in patients undergoing arthroscopic knee surgery. Study Design: Case series; Level of evidence, 4. Methods: This retrospective analysis included patients undergoing knee SF aspiration before arthroscopy with ≥8 years of follow-up. SF was aspirated from both the injured and healthy contralateral knees, and concentrations of 10 pro- and anti-inflammatory biomarkers were quantified. Patients completed visual analog scale (VAS) for pain score, Lysholm, Tegner, and Knee injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS) surveys preoperatively and at the final follow-up. Stepwise linear regression was performed to identify the most significant predictor(s) of PRO scores utilizing log-normalized contralateral biomarker concentration, age, body mass index, injury type, and Outerbridge grade as covariates. Concentrations from the contralateral knee were also compared with the injured knee to assess for correlations. Results: A total of 32 patients with a mean age 49.6 ± 12.3 years and follow-up of 10.0 ± 1.4 years were included. Elevated anti-inflammatory tissue inhibitor of metalloproteinase 1 (TIMP-1) in the contralateral knee was associated with improved VAS pain score ( <jats:italic toggle=\"yes\">P</jats:italic> = .002) and KOOS-PS ( <jats:italic toggle=\"yes\">P</jats:italic> &lt; .001) at long-term follow-up. Increased levels of contralateral pro-inflammatory matrix metalloproteinase 3 ( <jats:italic toggle=\"yes\">P</jats:italic> = .004) and regulated on activation normal T cell expressed and secreted ( <jats:italic toggle=\"yes\">P</jats:italic> = .035) were associated with worse KOOS-PS, while elevated interleukin 1 receptor antagonist was associated with worse VAS pain ( <jats:italic toggle=\"yes\">P</jats:italic> = .006), Lysholm ( <jats:italic toggle=\"yes\">P</jats:italic> = .005), and Tegner ( <jats:italic toggle=\"yes\">P</jats:italic> = .006) score at the final follow-up. Contralateral concentrations of monocyte chemotactic protein 1, macrophage inflammatory protein 1β, vascular endothelial growth factor, and TIMP-1 were correlated with levels in the operative knee but at significantly lower concentrations. Conclusion: SF biomarker levels in the contralateral uninjured knee at the time of arthroscopy were predictive of long-term outcomes for the operative knee. Increased levels of pro-inflammatory biomarkers were predictive of worse outcomes, while anti-inflammatory cytokines predicted improved scores. These results suggest that unilateral knee injury can result in a broader systemic inflammatory response that influences long-term outcomes in patients.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955124","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}

{"title":"Where Sex Matters for Perioperative and Postoperative Anterior Cruciate Ligament Reconstruction Outcomes: A Systematic Review of MOON Literature","authors":"Martina E. Hale, Michael S. Ramos, Riley A. O’Toole, Shelley Ivary, Kurt P. Spindler, Michael J. Scarcella","doi":"10.1177/03635465251386027","DOIUrl":"https://doi.org/10.1177/03635465251386027","url":null,"abstract":"Background: Females are 2 to 8 times more likely than males to sustain an initial anterior cruciate ligament (ACL) tear. However, after ACL reconstruction (ACLR), it remains less certain how males and females differ in other ACLR-related outcomes. Purpose: To summarize Multicenter Orthopaedic Outcomes Network (MOON) studies reporting on ACLR-related outcome differences between sexes. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic literature review based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted utilizing the Embase, MEDLINE, and Cochrane Library databases. Studies were included if they analyzed the MOON knee cohort and reported sex-specific outcomes for perioperative or postoperative primary ACLR outcomes. Results: This review included 28 studies. Six of 6 studies (100%) found no difference between sexes for graft tear at 2 and 6 years of follow-up. Three of 3 studies (100%) found no difference between sexes for contralateral native ACL tear at 2 and 6 years of follow-up. Six of 6 studies (100%) found that female sex correlated with worse Marx activity scores at 2, 6, and 10 years of follow-up. Three of 5 studies (60%) found female sex correlated with worse International Knee Documentation Committee (IKDC) scores at 6 and 10 years of follow-up. Conclusion: There was 100% agreement on the following: sex is not associated with differences in graft tear or contralateral native ACL tear at 2 and 6 postoperative years; female sex is associated with worse Marx activity scores at 2, 6, and 10 years; and female sex is associated with worse return-to-play percentages at 2 and 7 years. There was 60% agreement that female sex is associated with worse IKDC scores at 2 and 6 years.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"400 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955121","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}

{"title":"Toward an Integrated Perspective Regarding Clinically Significant Labral Injuries in Overhead Throwing Athletes: Form Follows Function","authors":"W. Ben Kibler, Aaron D. Sciascia","doi":"10.1177/03635465251390549","DOIUrl":"https://doi.org/10.1177/03635465251390549","url":null,"abstract":"Inconsistent outcomes of treatment of labral injuries in the overhead athlete suggest that deficiencies exist in the current knowledge about the roles of the labrum in overhead throwing athletes. These may include inadequate knowledge of labral anatomy and optimum glenohumeral joint (GHJ) mechanics, inadequate knowledge of the pathoanatomy and pathomechanics that create the clinical dysfunction and symptoms, or use of nonanatomic surgical techniques. These deficiencies suggest that a different perspective regarding labral anatomy and GHJ mechanics may provide a basis for examination and guidance for further scholarship and treatment. This perspective is based on the principle of form follows function, which states that the form, the shape or structure of an object, should be based on its intended function, or purpose, and can be utilized to address these deficiencies. It integrates anatomy/form and mechanics/function to provide more effective knowledge and resources for evaluation and treatment. Based on this perspective, this clinical commentary will review and discuss the mechanical function of the GHJ—to optimize task-specific ball-and-socket kinematics, concavity/compression, and dynamic GHJ stability in the overhead throwing athlete; the form of the glenoid labrum, its 3-component mechanical anatomy, and associated biceps tendon–labral complex, which exists to achieve that function; and the demonstrated alterations to the form that result in alteration of function. Alterations to the form, representing various types of labral injury, produce mechanical consequences in GHJ kinematics and contact pressures that can be associated with clinical symptoms and dysfunction. Surgical techniques that address restoring and optimizing the form by re-creating the 3-component mechanical anatomy have been demonstrated to restore the joint kinematics and contact pressures to the intact state. This perspective also provides implications regarding evaluation techniques and treatment guidelines and may serve to provide insights into the development of more effective techniques for restoration of the form that can optimize the function.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955120","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}

{"title":"Preoperative Nonopioid Analgesia Reduces Postoperative Opioid Consumption After Arthroscopic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials","authors":"Joshua Dworsky-Fried, Ryley Fowler, Prushoth Vivekanantha, Dan Cohen, Nicole Simunovic, Darren de SA, Olufemi R. Ayeni","doi":"10.1177/03635465251396164","DOIUrl":"https://doi.org/10.1177/03635465251396164","url":null,"abstract":"Background: Orthopaedic surgeons frequently overprescribe opioids after arthroscopic surgery. Previous research has shown reductions in postoperative opioid consumption and pain scores with multimodal nonopioid analgesics. However, the clinical effect of preoperative analgesic strategies has not been fully uncovered. Purpose: To assess the outcomes of arthroscopic surgery associated with preoperative treatment with nonopioid medications. Study Design: Systematic review and meta-analysis; Level of evidence, 1. Methods: Three online databases (PubMed, MEDLINE, Embase) were searched on December 12, 2024, to identify randomized controlled trials investigating the effect of preoperative intervention on pain management following arthroscopic surgery. Extracted data included patient demographics, surgery type, analgesic protocols (ie, type, dosing, timing), adverse effects, postoperative opioid consumption, and pain scores. Postoperative opioid consumption was standardized and converted to oral morphine equivalents. Pain scores were assessed using the visual analog scale (VAS). Weighted means and meta-analyses were conducted to compare postoperative outcomes. Subgroup analyses were performed by analgesic class (COX-2 inhibitors, gabapentin) and surgery type. The quality of studies was assessed with the Risk of Bias 2 tool. Results: A total of 22 studies were included in this review. The overall pooled mean reduction in postoperative opioid consumption with any preoperative medication type was 4.3 mg of oral morphine equivalents (95% CI, –6.1 to –2.5; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; &lt; .001; &lt;jats:italic toggle=\"yes\"&gt;I&lt;/jats:italic&gt; &lt;jats:sup&gt;2&lt;/jats:sup&gt; = 96%) at 24 hours. The pooled mean reduction associated with preoperative COX-2 administration and gabapentin was 4.2 mg (95% CI, –7.9 to –0.5; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .03; &lt;jats:italic toggle=\"yes\"&gt;I&lt;/jats:italic&gt; &lt;jats:sup&gt;2&lt;/jats:sup&gt; = 93%) and 6.3 mg (95% CI, –9.6 to –3.0; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; &lt; .001; &lt;jats:italic toggle=\"yes\"&gt;I&lt;/jats:italic&gt; &lt;jats:sup&gt;2&lt;/jats:sup&gt; = 90%) at 24 hours, respectively. Preoperative COX-2 inhibitors also yielded a statistically significant VAS pain reduction of 0.3 cm (95% CI, –0.5 to –0.02; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .04). Patients undergoing anterior cruciate ligament reconstruction had higher postoperative opioid consumption as compared with general knee or shoulder arthroscopies. Conclusion: This systematic review demonstrated that preoperative treatment with nonopioid medications, particularly COX-2 inhibitors and gabapentin, is associated with statistically significant reductions in postoperative opioid consumption after arthroscopic surgery. Despite statistically significant findings, observed reductions in postoperative opioid consumption and VAS pain scores may not represent clinically meaningful improvements. The current available literature is highly heterogeneous, indicating the need f","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"243 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955122","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}

{"title":"No Significant Difference in Return-to-Sport Rates Between Anterior Cruciate Ligament Reconstruction With Lateral Extra-Articular Tenodesis and Isolated Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Viraj A Deshpande,Abhay Mathur,Isabel Barnett,Jordan Frausto,Patrick Saunders,David S Gazzaniga,Kevin C Parvaresh","doi":"10.1177/03635465251386013","DOIUrl":"https://doi.org/10.1177/03635465251386013","url":null,"abstract":"BACKGROUNDAlthough anterior cruciate ligament (ACL) reconstruction (ACLR) remains the standard to treat ACL ruptures, athletes remain at higher risk of graft rerupture. Concomitant lateral extra-articular tenodesis (LET) has gained popularity by improving rotatory stability, yet no synthesis of expected return-to-sport (RTS) rates in athletes undergoing ACLR with LET (ACLR+LET) exists.PURPOSESTo synthesize RTS outcomes in athletes undergoing ACLR+LET and compare RTS rates, patient-reported outcome measures, and adverse event rates between isolated ACLR (iACLR) and ACLR+LET in the athletic population.STUDY DESIGNSystematic review and meta-analysis; Level of evidence 4.METHODSStudies reporting RTS after primary single-bundle iACLR and ACLR+LET using an iliotibial band autograft at a minimum 12-month clinical follow-up were included. Primary outcomes were RTS and return to previous level (RTPL), while secondary outcomes were patient-reported outcomes and adverse events. Study quality was assessed using the Cochrane Risk of Bias 2 and Methodological Index for Non-Randomized Studies tools, while RTS criteria were assessed using the Return to Play Quality of Evidence tool. Meta-analyses and sensitivity analyses were performed using R with the \"Metafor\" package.RESULTSFourteen studies were included, encompassing 1791 patients (38% female; mean age, 23.5 ± 8.5 years); 840 patients (709 athletes) underwent iACLR and 951 patients (901 athletes) underwent ACLR+LET. Grafts, surgical techniques, and rehabilitation protocols varied, and athletes participated in a variety of competitive and noncompetitive sports. Patients with iACLR reported a mean overall RTS rate of 88.2% ± 1.8% (344/390) and mean RTPL rate of 79% ± 16.2% (264/334), while patients with ACLR+LET reported a mean RTS rate of 88.2% ± 10.4% (591/670) and RTPL rate of 76.9% ± 16.5% (333/433). RTS did not significantly differ between the iACLR and ACLR+LET groups (OR, 0.84; 95% CI, 0.55-1.27; I2 = 0%; P = .41), nor did RTPL (OR, 1.20; 95% CI, 0.78-1.84; I2 0%; P = .40). Patients with ACLR+LET reported superior side-to-side laxity and flexion differential (both P < .001) and reduced graft rerupture risk (OR, 0.31; 95% CI, 0.17-0.57; I2 = 0%; P < .001).CONCLUSIONThere is no significant difference in RTS rates between the iACLR and ACLR+LET groups. However, ACLR+LET is associated with superior rotational stability and significantly lower graft rupture risk in an athletic population, supporting its use in high-risk patients where durability is critical.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"3 1","pages":"3635465251386013"},"PeriodicalIF":0.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949668","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}

{"title":"Anterior Cruciate Ligament Reconstruction With a Quadriceps Tendon Autograft in Female Patients Shows Equivalent Graft Failure But Lower Activity Scores and Slower Quadriceps Strength Recovery Compared With Male Patients: A Systematic Review and Meta-analysis.","authors":"Anirudh Sharma,Muaaz Tahir,Osama Aweid,Tarek Boutefnouchet,Tamer Sweed,Amit Meena,Darren L de Sa,Rachel M Frank,Peter D'Alessandro,Shahbaz S Malik","doi":"10.1177/03635465251376649","DOIUrl":"https://doi.org/10.1177/03635465251376649","url":null,"abstract":"BACKGROUNDThe use of a quadriceps tendon (QT) autograft has gained popularity in recent years, and it has been called the \"graft of the future.\" However, there is limited evidence of its sex-specific outcomes in female patients.PURPOSETo assess the outcomes of anterior cruciate ligament reconstruction (ACLR) with a QT autograft specifically in female patients and to elucidate any differences in sex-specific outcomes compared with male patients.STUDY DESIGNSystematic review; Level of evidence, 2.METHODSThis systematic review was conducted in accordance with PRISMA guidelines using 4 online databases for a review of the literature. Studies using a QT autograft for ACLR but not reporting female-specific outcomes were excluded. Outcomes assessed included patient-reported outcomes, objective functional outcomes, and complications. A meta-analysis was performed in which data allowed for a comparison of outcomes with male patients.RESULTSThere were 9 studies included in this review, with a total of 714 female knees (mean age, 23.0 years) that underwent ACLR with a QT autograft. No difference was observed in the pooled graft failure rate between male and female patients at ≥24 months (8.8% vs 7.4%, respectively; P = .50). Female patients had lower Tegner scores at 24 months (P = .0007) and a lower quadriceps strength limb symmetry index at 6 months (P < .0001). No significant difference was seen in the side-to-side difference in instrumented laxity measurements at 6 months (P = .44) or in Lysholm scores at 24 months (P = .52). The mean extension loss in female patients was 0.07° (range, -0.22° to 0.58°) at 24 months. The return-to-sport rate in female patients ranged from 71.4% to 82.7%.CONCLUSIONEvidence from currently available literature suggests that there is no difference in graft failure rates between the sexes after ACLR with a QT autograft. Additionally, female patients have lower activity scores and slower quadriceps recovery compared with male patients.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"24 1","pages":"3635465251376649"},"PeriodicalIF":0.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949669","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}

{"title":"Risk Factors for Knee Osteoarthritis After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Lei Zhang,Tianhao Xu,Qianjiang Xiong,Yunan Hu,Lei Fan,Weili Fu","doi":"10.1177/03635465251380285","DOIUrl":"https://doi.org/10.1177/03635465251380285","url":null,"abstract":"BACKGROUNDThe incidence of knee osteoarthritis (KOA) after anterior cruciate ligament (ACL) reconstruction (ACLR) is high, posing significant challenges to long-term joint health and overall quality of life. Identifying and understanding the risk factors associated with postoperative KOA are crucial for improving surgical outcomes and guiding preventive strategies.PURPOSETo perform a systematic review and meta-analysis to investigate the risk factors for KOA after ACLR.STUDY DESIGNSystematic review; Level of evidence, 4.METHODSA systematic review with meta-analysis was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. There were 3 databases (PubMed, Embase, and Web of Science) searched from inception to September 2024. All prospective and retrospective studies investigating the risk factors for KOA after ACLR were considered. The odds ratio (OR) or weighted mean difference (WMD) was calculated for potential risk factors if ≥2 studies assessed the same risk factor. Variables that could not be subjected to a meta-analysis were qualitatively analyzed.RESULTSA total of 39 studies met the inclusion criteria, with a combined sample size of 46,545, and 35 studies were subjected to a meta-analysis. The incidence of KOA after ACLR ranged from 2.34% to 100.00%, with a mean incidence of 8.29%. Overall, 9 factors were associated with an increase in the risk of KOA after ACLR: older age (WMD, 3.30 [95% CI, 2.33-4.28]), male sex (OR, 1.41 [95% CI, 1.14-1.74]), a higher body mass index (WMD, 1.31 [95% CI, 0.34-2.27]), bone-patellar tendon-bone autografts (OR, 1.66 [95% CI, 1.11-2.50]), a longer interval between ACL injury and surgery (WMD, 1.09 [95% CI, 0.55-1.63]), meniscectomy (OR, 2.42 [95% CI, 2.01-2.91]), meniscal injuries (OR, 3.35 [95% CI, 2.06-5.45]), additional injuries (OR, 3.65 [95% CI, 1.74-7.68]), and chondral lesions at the time of ACLR (OR, 2.15 [95% CI, 1.43-3.24]).CONCLUSIONOlder age, male sex, a higher body mass index, bone-patellar tendon-bone autografts, meniscectomy, a longer interval between ACL injury and surgery, and concomitant other injuries (meniscal or chondral) may increase the risk of KOA after ACLR. An increased awareness of relevant risk factors and targeted preventive strategies for modifiable risk factors can effectively reduce the incidence of KOA after ACLR.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"94 1","pages":"3635465251380285"},"PeriodicalIF":0.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949667","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}

{"title":"Arthroscopic Primary Labral Reconstruction in the Hip: Minimum 10-Year Outcomes With a Nested Propensity-Matched Control","authors":"Benjamin G. Domb, Drashti Sikligar, Andrew R. Schab, Roger Quesada-Jimenez, Tyler R. McCarroll, Ady H. Kahana-Rojkind","doi":"10.1177/03635465251392196","DOIUrl":"https://doi.org/10.1177/03635465251392196","url":null,"abstract":"Background: Labral reconstruction demonstrates promising short- and midterm benefits for irreparable labral tears, but long-term outcomes remain understudied. Purpose: To evaluate minimum 10-year patient-reported outcomes (PROs) of primary arthroscopic labral reconstruction compared with a propensity-matched control group. Study Design: Cohort study; Level of evidence, 2. Methods: Data were prospectively collected for all patients who underwent primary arthroscopic labral reconstruction with allograft as treatment for femoroacetabular impingement and labral tears. Patients included had preoperative and 10-year minimum postoperative data for PROs. Patients were propensity-matched to a control group that had undergone primary labral repair in a 1:3 ratio based on age, sex, body mass index, and acetabular Outerbridge grade. Patient characteristics and PROs were reported and compared between the groups. Rates of meeting clinically relevant thresholds, secondary arthroscopy, and survivorship were also compared. Results: A total of 22 hips (22 patients) of 27 eligible hips (81%) that underwent primary labral reconstruction (RECON) were matched to 66 hips (63 patients) that underwent primary repair (REPAIR). Both groups had similar preoperative and postoperative scores for all PROs ( <jats:italic toggle=\"yes\">P</jats:italic> &gt; .05). The RECON group met the substantial clinical benefit for the Non-Arthritic Hip Score at a lower rate than the REPAIR group ( <jats:italic toggle=\"yes\">P</jats:italic> &lt; .05). The RECON group underwent secondary arthroscopy at similar rates to the REPAIR group (13.6% vs 10.6%; <jats:italic toggle=\"yes\">P</jats:italic> &gt; .05) and had similar rates of survivorship (90.9% vs 81.8%; <jats:italic toggle=\"yes\">P</jats:italic> &gt; .05). Conclusion: Primary labral reconstruction demonstrated favorable outcomes at a minimum 10-year follow-up. When compared with a propensity-matched control group that underwent primary labral repair, both groups achieved similar postoperative PRO scores. Additionally, they met clinically meaningful thresholds and underwent secondary procedures at comparable rates.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949866","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}

{"title":"Distal Radius Allograft for Posterior Glenoid Bone Loss: A Cadaveric Graft Matching Study and Biomechanical Study.","authors":"Edward J Testa,Ryan T Fallon,Rohit Badida,Michael J Kutschke,Jonathan Liu,Stephen E Marcaccio,John D Milner,Brett D Owens","doi":"10.1177/03635465251400313","DOIUrl":"https://doi.org/10.1177/03635465251400313","url":null,"abstract":"BACKGROUNDPosterior glenoid reconstruction for shoulder instability is commonly performed with distal tibia allograft (DTA), but with variable results. Recent evidence shows that distal radius allograft (DRA) has a radius of curvature (ROC) that more closely matches that of the glenoid.HYPOTHESISDRA would more closely match the posterior glenoid than DTA in ROC and bone mineral density (BMD), and DRA would have superior biomechanical characteristics in a posterior instability model.STUDY DESIGNControlled laboratory study.METHODSTen cadaveric shoulders, ankles, and wrists underwent computed tomography scans. ROC and BMD for the glenoid, DRA, and DTA were measured. Biomechanical analysis was performed for each shoulder by translating the humerus 10 mm posterior-inferiorly relative to the glenoid and recording the maximum force (N) required and lateral displacement (mm) of the humeral head. Five conditions were tested for each shoulder: intact, posterior capsulolabral tear, 30% glenoid bone loss, DRA, and DTA.RESULTSTen shoulders were tested (mean age, 58.1 years [SD, 5.9 years]). The mean anterior-posterior ROC was 31.1 mm (SD, 6.9 mm) for the glenoid, compared to 14.0 mm (SD, 1.9 mm; P < .0001) for DRA, and 68.2 mm (SD, 29.1 mm; P < .0001) for DTA. The mean superior-inferior ROC was 30.2 mm (SD, 3.7 mm) for the glenoid, compared to 30.7 mm (SD, 3.2 mm; P = .901) for DRA, and 23.5 mm (SD, 5.4 mm, P < .001) for DTA. For biomechanical testing, DRA demonstrated increased resistance to force compared with the instability and bone loss states (42.1 N [SD, 14.3 N] vs capsulolabral tear 21.5 N [SD, 17.9 N; P = .002] and bone loss 14.3 N [SD, 7.8 N; P < .001], respectively). However, DRA showed no significant difference in force resistance when compared with DTA (36.3 N [SD, 9.3 N]; P = .362).CONCLUSIONThe native glenoid ROC and BMD are more comparable with DRA than DTA. The DRA restores posterior forces comparable to those of the native glenoid and did not result in significantly greater resistance forces when compared with DTA.CLINICAL RELEVANCEThese anatomic data support DRA use in posterior glenoid reconstruction.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"48 1","pages":"3635465251400313"},"PeriodicalIF":0.0,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949672","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}

{"title":"Surgical Stabilization for Recurrent Shoulder Instability Using Distal Tibial Allograft: Open Technique With Fresh Allograft Versus Arthroscopic Technique With Frozen Allograft, a Cohort Study.","authors":"Ivan Wong,Marco Adriani,Sarah Remedios,Phob Ganokroj,Nate J Dickinson,Annalise M Peebles,Ryan J Whalen,Stephanie K Eble,Justin W Arner,Toufic R Jildeh,Liam A Peebles,Anthony A Romeo,Matthew T Provencher","doi":"10.1177/03635465251399165","DOIUrl":"https://doi.org/10.1177/03635465251399165","url":null,"abstract":"BACKGROUNDThe distal tibial allograft (DTA) procedure has been described as an effective treatment option for reconstruction of glenoid bone deficiency in the setting of recurrent anterior shoulder instability; however, no comparative data between an arthroscopic or open DTA approach are available.PURPOSETo compare the clinical and radiographic outcomes of patients who underwent open fresh versus arthroscopic frozen DTA stabilization procedures.STUDY DESIGNCohort study; Level of evidence, 4.METHODSA retrospective review was performed of consecutive patients with a minimum of 5% anterior glenoid bone loss (GBL) associated with recurrent anterior shoulder instability who underwent stabilization with either open fresh or arthroscopic frozen DTA glenoid reconstruction and had a minimum 2-year follow-up. Consecutive patients undergoing arthroscopic frozen DTA were matched in a 1-to-1 format to patients undergoing open fresh DTA by age, body mass index, and number of previous shoulder operations. Patients were evaluated postoperatively in terms of the Western Ontario Shoulder Instability Index (WOSI) score, pain relief, and episodes of recurrent instability. All patients also underwent postoperative imaging evaluation with computed tomography (CT) in which graft incorporation and allograft angle were measured.RESULTSA total of 100 patients (50 open fresh DTA, 50 arthroscopic frozen DTA) with a median ± IQR age of 32.0 ± 6.7 and 27.9 ± 15.9 years, respectively, were analyzed at minimum 2-year follow-up. The open fresh DTA group had significantly more male patients than the arthroscopic frozen DTA group (98% vs 70%, respectively; P < .01), and patients in the open fresh DTA group had significantly greater GBL defects (25% ± 6% vs 21% ± 11%, respectively; P < .01). Both groups demonstrated significantly improved WOSI scores (P < .05) and had similar clinical outcomes regarding improvement postoperatively (P = .61), pain relief (P = .09), and recurrence rates (P = .31). Only 1 case of recurrent instability was noted, which occurred in the open fresh DTA cohort. Analysis of CT data at a mean of 15 months postoperatively showed no significant difference between open fresh versus arthroscopic frozen DTA groups.CONCLUSIONOpen fresh and arthroscopic frozen DTA for anatomic glenoid reconstruction in patients with recurrent anterior shoulder instability resulted in a clinically stable joint with comparable outcomes and excellent healing rates. Additional long-term studies are needed to determine whether the surgical technique and type of allograft used influence clinical outcomes and whether these results are maintained over time.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"9 1","pages":"3635465251399165"},"PeriodicalIF":0.0,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949671","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}