The American Journal of Sports Medicine最新文献

{"title":"Midterm Outcomes of Primary Hip Arthroscopy in Athletes Older Than Age 40: A Propensity-Matched Controlled Study.","authors":"Andrew R Schab,Tyler R McCarroll,Elizabeth G Walsh,Ady H Kahana-Rojkind,Roger Quesada-Jimenez,Benjamin G Domb","doi":"10.1177/03635465251407118","DOIUrl":"https://doi.org/10.1177/03635465251407118","url":null,"abstract":"BACKGROUNDMaster athletes (MAs), or athletes older than age 40 years, make up a patient population whose midterm outcomes after primary hip arthroscopy are largely unstudied.PURPOSETo report minimum 5-year outcomes of MAs after primary hip arthroscopy and compare their results to a matched nonathlete (NA) control group.STUDY DESIGNCohort study; Level of evidence, 3.METHODSData were collected between February 2008 and April 2019 and reviewed for all patients who underwent primary hip arthroscopy. Patients were excluded if they were younger than age 40 years and had previous ipsilateral hip pathology, dysplasia (lateral center-edge angle <18°), Tönnis grade >1, or workers' compensation claims. Patients included in the MA cohort reported participation in sports within 1 year before surgery and had a 5-year minimum follow-up. MAs were matched to NAs in a 1:1 ratio based on age, sex, body mass index, and acetabular Outerbridge grade. Patient characteristics, radiographic measurements, intraoperative findings, surgical procedures performed, and patient-reported outcomes (PROs) were compared between the groups. Additionally, rates of meeting clinically relevant thresholds and secondary procedures were compared.RESULTSA total of 118 hips were included in the study, with 59 hips per group. The groups showed comparable demographics, intraoperative findings, and labral procedures. The MA group had higher preoperative and postoperative values for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score, and Hip Outcome Score Sport-Specific Subscale (HOS-SSS) (P < .05). MAs met the Patient Acceptable Symptom State and maximum outcome improvement for all evaluated PROs at higher rates. Additionally, the study group met the minimal clinical important difference for the mHHS and HOS-SSS at higher rates when compared with the control group (P < .05). MAs underwent secondary arthroscopy at similar rates to the NAs (1.59% vs 5.08%; P > .05) and had higher arthroplasty-free survivorship (94.92% vs 71.19%; P < .01).CONCLUSIONWhen compared with a propensity-matched control group of NA patients, MAs had better preoperative and postoperative PRO scores. However, the magnitudes of improvement in PROs were comparable between the groups. Furthermore, MAs met clinically meaningful thresholds at higher rates and had higher arthroplasty-free survivorship when compared with the NA group.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"183 1","pages":"3635465251407118"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005321","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":"Return to Sport After Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis: A Systematic Review and Clinical Recommendations.","authors":"Joseph E Nassar,Lama A Ammar,Mohammad Daher,Trevor L Toavs,Manjot Singh,Michael J Farias,Bassel G Diebo,Alan H Daniels","doi":"10.1177/03635465251390546","DOIUrl":"https://doi.org/10.1177/03635465251390546","url":null,"abstract":"BACKGROUNDReturn to sport (RTS) after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) is a critical patient-centered outcome, yet evidence-based guidelines remain limited. This systematic review synthesizes existing literature on RTS after PSF treatment in AIS to inform clinical practice.PURPOSETo evaluate the timing, rates of RTS, and factors influencing RTS outcomes after PSF for AIS and provide recommendations for clinical practice.STUDY DESIGNSystematic review; Level of evidence, 4.METHODSA systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the PubMed, Embase, Cochrane Library, and Google Scholar databases from inception to February 24, 2025. Studies evaluating RTS after PSF for AIS were included. Data extracted included patient characteristics, curve characteristics, surgical details, RTS outcomes, and patient-reported outcome measures.RESULTSOf 1569 identified articles, 11 studies (722 patients) were included. The mean age of patients was 15.2 ± 2.8 years, and the mean maximum Cobb angle was 58.3°± 14.8°. Patients generally resumed sports between 8 and 12 months postoperatively. RTS delays were frequently associated with older patient age, greater curve severity, longer spinal fusions, more distal fusion levels, and psychosocial factors including fear of injury, anxiety, physical deconditioning, and reduced spinal flexibility. Additionally, some patients transitioned from competitive or contact sports to noncompetitive or noncontact sports postoperatively due to these factors or conservative surgeon recommendations.CONCLUSIONMost patients with AIS successfully returned to sport within 1 year after PSF, although timing and performance levels varied significantly based on individual patient characteristics. Age, spinal curve severity, surgical extent, and psychological readiness considerably influenced RTS outcomes. Clear and individualized clinical guidelines addressing these factors are necessary to optimize RTS outcomes for patients with AIS undergoing PSF. Based on this systematic review, specific phased recommendations have been proposed to guide clinical practice and rehabilitation protocols for athletes with AIS.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"38 1","pages":"3635465251390546"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994835","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":"Intraoperative Zoledronic Acid for Arthroscopic Rotator Cuff Repair: Short-Term Results From a Prospective, Randomized, Placebo-Controlled Phase II Trial.","authors":"Jakob E Schanda,Roman Ullrich,Sandra Boesmueller,Rainer Mittermayr,Thomas Bruell,Michael Hexel,Philipp R Heuberer,Gebhard Woisetschlaeger,Ortrun M Neuper,Heinz Redl,Johannes Grillari,Christian Fialka","doi":"10.1177/03635465251399167","DOIUrl":"https://doi.org/10.1177/03635465251399167","url":null,"abstract":"BACKGROUNDDespite technical innovations and surgical improvements, retear rates after arthroscopic rotator cuff (RC) repair remain high. Preclinical studies demonstrated improved outcomes using bisphosphonates after RC repair.PURPOSE/HYPOTHESISThe purpose of this monocentric, prospective, randomized, placebo-controlled, triple-blinded phase II trial was to investigate retears in patients without osteoporosis undergoing arthroscopic RC repair with a systemic single-dose zoledronic acid. It was hypothesized that zoledronic acid would reduce retears after RC repair.STUDY DESIGNRandomized controlled trial; Level of evidence, 1.METHODSA total of 80 patients were intraoperatively randomized to the zoledronic acid group (n = 40) or the control group (n = 40). All patients underwent magnetic resonance imaging 6 months after surgery. Range of motion, abduction strength, Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), and Visual Analog Scale (VAS) for pain were assessed preoperatively as well as 3 and 6 months after arthroscopic RC repair.RESULTSAt 6 months, retears were significantly lower (P = .001) in the zoledronic acid group (n = 6; 15%) compared with the control group (n = 14; 35%). The risk of a RC retear with an additional zoledronic acid treatment (RR, 0.43 [95% CI, 0.16; 0.98]) was significantly lower compared with that of the control group (OR, 0.328; 95% CI, 0.111-0.969; P = .044). Postoperative fatty muscle infiltration of the supraspinatus was significantly lower in the zoledronic acid group compared with the control group (P < .001). Clinical and functional outcomes significantly improved in the 2 study groups 3 and 6 months postoperatively, with better outcomes for abduction (P = .002), forward flexion (P = .002), external rotation (P = .001), CMS (P < .001), ASES score (P < .001), SSV (P < .001), and VAS for pain (P < .001) in the zoledronic acid group at the final follow-up.CONCLUSIONAn intraoperative systemic single-dose zoledronic acid reduced retears after arthroscopic RC repair. Zoledronic acid is a safe, easy-to-apply, and cost-effective augmentation technique for patients undergoing arthroscopic RC repair.REGISTRATIONNCT05677152 (ClinicalTrials.gov identifier).","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"124 1","pages":"3635465251399167"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994801","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":"Effect of Subacromial Bursa Augmentation on Self-Reported and Magnetic Resonance Imaging Outcomes in Arthroscopic Rotator Cuff Repair: A Prospective, Blinded Randomized Clinical Trial.","authors":"James M Gregory,Ashley Z Smith,Payam Zandiyeh","doi":"10.1177/03635465251407328","DOIUrl":"https://doi.org/10.1177/03635465251407328","url":null,"abstract":"BACKGROUNDRotator cuff repair (RCR) failure remains a persistent clinical challenge despite advances in surgical techniques. Although the subacromial bursa-historically excised during repair-is recognized for its regenerative potential due to its rich population of connective tissue progenitor cells, high-quality clinical evidence supporting its utility as an autologous biological adjunct remains lacking.HYPOTHESISSubacromial bursa augmentation during arthroscopic RCR improves patient-reported outcomes and magnetic resonance imaging (MRI)-based tendon healing compared with standard repair.STUDY DESIGNRandomized controlled trial; Level of evidence, 2.METHODSA total of 67 patients undergoing primary arthroscopic repair for full- or near-full-thickness supraspinatus tears were randomized to receive either standard repair (control; n = 34) or repair with minced subacromial bursa reimplantation (cases; n = 33). All patients underwent identical surgical repair constructs. Patient-reported outcomes (American Shoulder and Elbow Surgeons [ASES], Simple Shoulder Test [SST], and PROMIS [Patient-Reported Outcomes Measurement Information System] Upper Extremity and Global scores) were collected at baseline and at multiple intervals up to 24 months. MRI was used to evaluate tendon integrity (Sugaya classification) and supraspinatus tendon thickness at a minimum of 6 months postoperatively. Generalized estimating equations and chi-square tests were used for longitudinal and categorical comparisons.RESULTSPatient-reported outcomes improved significantly over time in both the control and augmentation groups. While no statistically significant between-group differences were observed overall, the bursa augmentation group demonstrated a higher Global score at 6 months (P = .047). Across other time points, outcomes, including PROMIS, ASES, SST, and Global ratings, did not show significant differences. MRI analysis at 6 months reflected a similar pattern, and no significant differences were detected. A smaller proportion of patients in the augmentation group exhibited high-grade Sugaya types (3-5: 28% vs 39% in the control group), and retear dimensions were generally smaller.CONCLUSIONIn this randomized clinical trial, subacromial bursa augmentation did not improve tendon healing or clinical outcomes after arthroscopic RCR. These results clearly reject the initial hypothesis that bursal augmentation enhances the healing of repair. While the procedure appeared safe and feasible, the absence of measurable benefit indicates that its routine clinical use cannot be supported at this time.REGISTRATIONNCT04634084 (ClinicalTrials.gov identifier).","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"29 1","pages":"3635465251407328"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994802","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":"Contemporary Arthroscopic Techniques May Improve the Outcomes of Revision Hip Arthroscopy: A Propensity-Matched Cohort Study.","authors":"Benjamin D Kuhns,Paras Shah,Krishi Rana,Benjamin G Domb","doi":"10.1177/03635465251405712","DOIUrl":"https://doi.org/10.1177/03635465251405712","url":null,"abstract":"BACKGROUNDPatient outcomes after revision hip arthroscopy are less favorable than those after primary procedures. Advancements in arthroscopic techniques including labral reconstruction and capsular plication have improved anatomic restoration of the suction seal and capsule. The effect of these techniques on outcomes remains unclear when compared with earlier techniques.PURPOSETo compare postoperative outcomes between patients undergoing modern revision (MR) hip arthroscopy techniques and those treated with older methods.STUDY DESIGNCohort study; Level of evidence, 3.METHODSA prospectively collected surgical database was reviewed for patients undergoing revision hip arthroscopy with a minimum 2-year follow-up. Patients were categorized into an older revision (OR) cohort or MR cohort based on available surgical techniques. Patients in the OR cohort did not have a capsular repair or labral reconstruction with the knotless pull-through technique, while all patients in the MR cohort had capsular closure or plication as well as labral restoration with either repair or modern reconstruction. A 1:1 age, sex, and body mass index propensity match was performed, and patient demographics along with pre- and postoperative radiographic data and outcomes were analyzed. The primary outcome was the rate of conversion to arthroplasty or revision arthroscopy at the 2-year time point. Secondary outcomes included patient-reported outcome scores (PROs) and achievement of clinically relevant outcome thresholds.RESULTSA total of 53 patients in the MR cohort were matched with 53 patients in the OR cohort. There were no significant preoperative demographic or radiographic differences between the 2 groups. Patients in the MR cohort had higher levels of acetabular chondral damage identified intraoperatively according to the Outerbridge and acetabular labrum articular disruption classifications (P < .01 for both). Patients in the MR cohort had significantly greater postoperative Hip Outcome Score Sports-Specific Subscale scores (62.8 ± 29.9 vs 53.0 ± 31.4; P = .03).CONCLUSIONPatients undergoing revision hip arthroscopy with modern techniques had greater postoperative PRO scores compared with revisions with older techniques. Notably, this improvement in outcomes was observed despite higher rates of cartilage damage identified intraoperatively in the modern group.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"390 1","pages":"3635465251405712"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994832","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":"Long-term Outcomes and Survivorship of Meniscal Allograft Transplantation: A Systematic Review With Minimum 10-Year Follow-up.","authors":"Jacob D Kodra,Surucu Serkan,Michael S Lee,Kevin Girardi,Ronak Mahatme,Rajiv Vasudevan,Louise Atadja,Mackenzie Norman,Jay Moran,Andrew E Jimenez","doi":"10.1177/03635465251405494","DOIUrl":"https://doi.org/10.1177/03635465251405494","url":null,"abstract":"BACKGROUNDMeniscal allograft transplantation (MAT) is an emerging treatment for patients with symptomatic meniscal deficiency.PURPOSETo systematically evaluate the long-term clinical outcomes and graft survivorship of MAT with a minimum follow-up of 10 years.STUDY DESIGNSystematic review and meta-analysis; Level of evidence, 4.METHODSA review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and registered on Prospero. The PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were queried in January 2025. Studies assessing MAT patient-reported or objective outcomes with ≥10 years of follow-up were included. Non-English-language studies, case reports, non-peer-reviewed articles, editorials, commentaries, and reviews were excluded. The Lysholm score, Tegner Activity Scale score, visual analog scale (VAS) for pain score, Knee injury and Osteoarthritis Outcome Score (KOOS), and graft survivorship were extracted for analysis. MAT failure was defined by individual studies based on clinical, surgical, and/or radiographic criteria.RESULTSThirteen studies, consisting of 619 patients and 632 MATs and performed from 1984 to 2012, met inclusion criteria. The mean patient age ranged from 24.5 to 43.5 years, with 47% to 87% males and a mean follow-up duration of 11.1 to 20.0 years. Fixation techniques included soft tissue (5 studies), bone plug (6 studies), and bone trough (4 studies). Statistically significant improvements were observed in the Lysholm score (7/9 studies), Tegner score (3/4 studies), VAS score (3/5 studies), and KOOS (1/1 studies). Two studies reported Patient Acceptable Symptom State rates ranging from 70.2% to 71% for Lysholm score and 58.5% to 82% for KOOS. Two studies also reported minimal clinically important difference rates, which ranged from 70.4% to 89.9% for the Lysholm score and 61% to 78.2% for the KOOS subscales. Ten-year MAT survival ranged from 45% to 100%. Most studies (5/9) demonstrated survivorship ≥73% at a minimum 10-year follow-up. MAT survival after ≥15 years ranged from 19% to 87%.CONCLUSIONMAT demonstrated favorable long-term clinical outcomes and variable graft survivorship beyond 10 years. Included studies varied based on graft type, fixation technique, and patient selection. Continued prospective, high-level studies are warranted to standardize surgical approaches, improve the durability of this joint-preserving intervention, and identify modifiable risk factors for inferior long-term outcomes.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"42 1","pages":"3635465251405494"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994834","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":"Midterm Outcomes of Arthroscopic Treatment for Concomitant Painful External Hip Snapping and Femoroacetabular Impingement Syndrome: A Minimum 5-Year Follow-up Study.","authors":"Roger Quesada-Jimenez,Drashti Sikligar,Andrew R Schab,Ady H Kahana-Rojkind,Benjamin G Domb","doi":"10.1177/03635465251404480","DOIUrl":"https://doi.org/10.1177/03635465251404480","url":null,"abstract":"BACKGROUNDPainful external snapping hip (ESH) is estimated to affect 5% to 10% of the population. Hip arthroscopy treating ESH concomitantly with femoroacetabular impingement (FAI) has shown favorable short-term outcomes.PURPOSETo report midterm outcomes of hip arthroscopy that concomitantly treats FAI and ESH, with a secondary comparison of these results to benchmark a control group of hips with FAI without ESH.STUDY DESIGNCohort study; Level of evidence, 3.METHODSData were retrospectively analyzed for patients who underwent hip arthroscopy as treatment for FAI and iliotibial band (ITB) and gluteus maximus tendon release as treatment for painful ESH between 2008 and 2019. Patients were included if they had complete pre- and postoperative patient-reported outcomes (PROs) and visual analog scale (VAS) for pain scores with a minimum follow-up of 5 years or if they had a documented endpoint (revision surgery or conversion to arthroplasty) during the study period. Rates of revision surgery and conversion to total hip arthroplasty were included in the analysis. Patients were propensity matched to a benchmark control group of patients with FAI without ESH at a 1:4 ratio by sex, age at surgery, body mass index, acetabular Outerbridge grade, labral treatment, and capsular treatment.RESULTSA total of 215 hips (211 patients) were included in the study. The ESH study group showed significant improvements in all assessed PROs, with 98% of patients reporting resolution of painful external snapping at the latest follow-up, and no patient requiring revision hip arthroscopy secondary to a persistent external snapping. When compared with the benchmark control group, patients with ESH had similar preoperative outcomes for the modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score Sports-Specific Subscale, 12-item International Hip Outcome Tool score, and VAS score with equivalent magnitudes of improvement. Additionally, similar postoperative scores across all PROs and patient satisfaction were met. The minimal clinically important difference and Patient Acceptable Symptom State for all evaluated PROs were met at similar rates. Similar rates of complication revision hip arthroscopy and conversion to hip arthroplasty were observed between the groups.CONCLUSIONPrimary hip arthroscopy addressing FAI and painful ESH with ITB and gluteus maximus tendon release demonstrated significant improvement in all evaluated PROs, with 98% of patients reporting resolution of external snapping, and no revision surgery due to external snapping recurrence at the minimum 5-year follow-up. Functional outcomes and rates of clinically relevant threshold achievement were comparable to those of a propensity-matched benchmark control group with FAI without ESH.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"4 1","pages":"3635465251404480"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994831","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":"Structural Augmentation in Rotator Cuff Repair Decreases the Risk of Retear: A Systematic Review and Meta-analysis.","authors":"Danielle Dagher,Darshil Shah,Colin Kruse,Hassaan Abdel Khalik,Usama Saleh,Abdul-Ilah Hachem,John M Tokish,Asheesh Bedi,Moin Khan","doi":"10.1177/03635465251400356","DOIUrl":"https://doi.org/10.1177/03635465251400356","url":null,"abstract":"BACKGROUNDRotator cuff tears are a common orthopaedic injury often resulting in shoulder pain and functional impairment. Despite the prevalence of rotator cuff tears, the incidence of retear after rotator cuff repair (RCR) remains high. There is growing interest in the use of structural augmentation in RCR to decrease retear rates and improve patient outcomes.PURPOSEThe purpose of this systematic review and meta-analysis was to compare the clinical and imaging outcomes of structural augmentation versus standard RCR in patients with full-thickness rotator cuff tears. The effectiveness of different augment subtypes was also assessed.STUDY DESIGNMeta-analysis; Level of evidence, 3.METHODSA comprehensive literature search was conducted in CENTRAL, Embase, and Medline from inception to November 13, 2024. Eligible studies included comparative trials evaluating structural augmentation in RCR for repairable full-thickness tears. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized controlled trials and the MINORS (Methodological Index for Non-randomized Studies) score for observational studies. Meta-analyses were performed via a random effects model, with subgroup analyses performed by study design and augment type.RESULTSTwenty-four studies (12 randomized controlled trials and 12 cohort studies) were included in this review, all of which evaluated biologic augments (xenograft, allograft, autograft). Structural augmentation significantly reduced the risk of retear by 35% as compared with standard RCR (risk ratio, 0.65; 95% CI, 0.48-0.89; P = .01). Retears were confirmed radiographically by magnetic resonance imaging or ultrasound. Subgroup analysis revealed the greatest reduction in retear rates with allograft augmentation (risk ratio, 0.34; 95% CI, 0.21-0.56). No significant differences were observed in patient-reported outcomes, including pain scores, American Shoulder and Elbow Surgeons scores, or Constant scores.CONCLUSIONStructural augmentation in RCR significantly reduces retear rates, particularly with allografts, but does not improve short-term patient-reported outcomes. Further research is needed to identify which patient and tear characteristics may influence the effectiveness of augmentation.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"22 1","pages":"3635465251400356"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994830","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":"Long-term Outcomes of Advanced Arthroscopic Techniques for Patients With Acetabular Retroversion Without Anteverting Periacetabular Osteotomy.","authors":"Benjamin G Domb,Megan E Flynn,Yasemin E Kingham,Jessica C Keane,Ady H Kahana-Rojkind,Roger Quesada-Jimenez","doi":"10.1177/03635465251405696","DOIUrl":"https://doi.org/10.1177/03635465251405696","url":null,"abstract":"BACKGROUNDAnterolateral acetabular overcoverage, also known as acetabular retroversion, can cause femoroacetabular impingement syndrome (FAIS). Various surgical options have been suggested for treatment, ranging from anteverting periacetabular osteotomy to isolated hip arthroscopy.PURPOSE/HYPOTHESISThe purpose of this study was, primarily, to analyze minimum 10-year outcomes of arthroscopic management of labral pathology in the setting of acetabular retroversion without dysplasia and, secondarily, to compare their outcomes to a propensity-matched group of nonretroverted patients. It was hypothesized that the outcomes of arthroscopic management would be comparable to those of the propensity-matched nonretroverted group and comparable to previously published outcomes of open treatment of acetabular retroversion.STUDY DESIGNCohort study; Level of evidence, 3.METHODSProspectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy for FAIS and labral tear treatment between June 2008 and December 2013 and had a minimum of 10-year follow-up data. Retroversion was determined based on the presence of an ischial spine sign, >20% crossover sign, and posterior wall sign. Propensity score matching was used to identify a control group without retroversion who were matched 1:1 with similar age, sex, body mass index, acetabular and femoral head Outerbridge grade, preoperative lateral center-edge angle, and labral treatment.RESULTSA total of 95 hips with acetabular retroversion were matched to a control group. The groups were equally matched in demographic variables. Significant improvements were seen in all patient-reported outcomes (PROs) collected in both groups, with a similar survivorship of 96% in both groups; 4 patients in each group converted to a total hip replacement. The acetabular retroversion cohort achieved similarly high rates of minimal clinically important difference and Patient Acceptable Symptom State and higher rates of substantial clinical benefit for modified Harris Hip Score compared with the control group (P = .04).CONCLUSIONPatients with acetabular retroversion who had FAIS and labral tears could be safely treated using advanced hip arthroscopic techniques without reverse (anteverting) periacetabular osteotomy in a high-volume surgeon's hands. Patients with acetabular retroversion demonstrated favorable PROs and low rates of revision arthroscopy and conversion to total hip arthroplasty at long-term follow-up, which was comparable with a propensity-matched control group without acetabular retroversion.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"269 1","pages":"3635465251405696"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994833","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":"Dermal Allograft Augmentation for Open Gluteus Medius Repair: A Case Series at 2-Year Follow-up.","authors":"Roger Quesada-Jimenez,Elizabeth J O'Brien,Elizabeth G Walsh,Ady H Kahana-Rojkind,Benjamin D Kuhns,Benjamin G Domb","doi":"10.1177/03635465251399214","DOIUrl":"https://doi.org/10.1177/03635465251399214","url":null,"abstract":"BACKGROUNDGluteus medius (GM) tears are a common cause of peritrochanteric regional pain and disability among middle-aged and older populations. While largely successful, when primary repair fails, it is often attributed to poor tendon quality. Dermal allograft augmentation offers a solution for this patient population by enhancing the biological and mechanical properties of the repair construct.PURPOSETo evaluate the outcomes of open isolated GM repair with dermal allograft augmentation at 2-year follow-up, with a sex-based subanalysis comparing clinical outcomes in male versus female patients.STUDY DESIGNCase series; Level of evidence, 4.METHODSProspectively collected data were retrospectively analyzed for all patients who underwent open GM repair with dermal allograft augmentation between June 2016 and April 2022. Included patients had complete preoperative and 2-year follow-up data for the following patient-reported outcome measures (PROMs): modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), International Hip Outcome Tool-12 (iHOT-12), visual analog scale for pain, and patient satisfaction; if complete 2-year follow-up data were not available, patients had a documented endpoint such as further surgery. Clinically relevant thresholds, complications, and secondary surgery were reported.RESULTSA total of 23 hips (18 female, 5 male) were included in this study. There were 17 primary procedures with dermal allograft augmentation (73.9%) and 6 revisions after prior GM repair without previous dermal allograft augmentation (26.1%). A significant improvement was observed on all evaluated PROMs, with 1 reoperation (4.4%) for a recurrent tear. A high percentage of patients achieved the minimal clinically important difference for the mHHS (86.4%), NAHS (81.8%), and iHOT-12 (72.7%). Moreover, 16 (72.7%) answered the patient acceptable symptom state anchor question positively. A sex-based subanalysis showed that female patients demonstrated a greater postoperative improvement on PROMs and a higher rate of achieving clinically relevant thresholds compared with male patients.CONCLUSIONPatients with extensive degenerative GM tears who underwent repair with dermal allograft augmentation had favorable outcomes with significant improvements on PROMs and low reoperation rates at short-term follow-up.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"59 1","pages":"3635465251399214"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994902","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}