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Future Technologies and Hip Arthroscopy: Recent Innovations in the Management of Hip Preservation Surgery 未来技术与髋关节镜:髋关节保留手术管理的最新创新
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1016/j.otsm.2025.151189
Lauren Heylmun BS , Brianna Rowe MS , Kelly Mardaus PA , James Genuario MS, MD , Michael Ellman MD
The field of hip preservation has undergone rapid technological transformation, driven by innovations that enhance diagnostic accuracy, surgical precision, and personalized care. This review explores recent advancements and future directions in hip preservation surgery. The topics covered in this review include preoperative and intraoperative tools at the forefront of innovation, including three-dimensional (3D) modeling and templating, machine learning (ML), artificial intelligence (AI), virtual reality (VR), and robotic-, computer- and AI- assisted surgery. 3D modeling techniques, both static and dynamic, allow for comprehensive visualization of hip morphology and simulation of joint kinematics. These advancements enable precise identification of impingement and instability patterns. Patient-specific 3D printed models and surgical templates are currently used to enhance preoperative planning, patient and trainee education, and surgical efficiency. ML and AI applications have demonstrated utility for automating several processes including radiographic analysis, risk stratification, and outcome assessment. VR simulation tools facilitate immersive, patient-specific surgical planning and skill development. These tools allow surgeons to rehearse procedures in a risk-free environment. Computer-assisted navigation and AI-driven platforms augment this technology by providing real-time feedback and enhanced accuracy. Further, robotic systems are a promising tool for precise boney resection and instrumentation placement. These technologies are shaping the future of hip preservation by enabling more accurate diagnosis, personalized treatment, and improved surgical outcomes. Ongoing research in these areas is essential for validating clinical utility, improving accessibility, and ensuring safe and effective integration into clinical and surgical workflows.
在提高诊断准确性、手术精度和个性化护理的创新的推动下,髋关节保存领域经历了快速的技术变革。本文综述了髋关节保存手术的最新进展和未来发展方向。本综述涵盖的主题包括创新前沿的术前和术中工具,包括三维(3D)建模和模板,机器学习(ML),人工智能(AI),虚拟现实(VR)以及机器人,计算机和人工智能辅助手术。三维建模技术,静态和动态,允许全面可视化的髋关节形态和模拟关节运动学。这些进步使得精确识别撞击和不稳定模式成为可能。目前,针对患者的3D打印模型和手术模板被用于加强术前计划、患者和受训者教育以及手术效率。机器学习和人工智能应用已经证明了自动化几个过程的实用性,包括放射分析、风险分层和结果评估。VR模拟工具促进沉浸式,患者特定的手术计划和技能发展。这些工具使外科医生能够在无风险的环境中演练手术。计算机辅助导航和人工智能驱动平台通过提供实时反馈和提高准确性来增强这项技术。此外,机器人系统是一个很有前途的工具,用于精确的骨切除和器械放置。这些技术通过实现更准确的诊断、个性化治疗和改善手术结果,正在塑造髋关节保存的未来。这些领域正在进行的研究对于验证临床效用、改善可及性以及确保安全有效地整合到临床和外科工作流程中至关重要。
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引用次数: 0
Management of Articular Cartilage Defects of the Foot and Ankle 足、踝关节软骨缺损的治疗
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1016/j.otsm.2025.151186
Eric I. Ferkel MD, Richard D. Ferkel MD, Connor M. Delman MD
Osteochondral lesions of the foot and ankle—most commonly involving the talus—pose significant diagnostic and therapeutic challenges in athletes due to high functional demands and the limited intrinsic healing capacity of articular cartilage. This review summarizes the epidemiology, pathophysiology, clinical evaluation, imaging modalities, and classification systems relevant to these injuries, with a focus on the talus, tibial plafond, and first metatarsophalangeal joint. Management strategies range from nonoperative care for stable lesions to surgical approaches aimed at restoring the structure and function of the joint surface. Surgical decision-making is guided by lesion size, morphology, location, chronicity, and associated pathology, with an emphasis on restoring joint congruity, preserving cartilage, and optimizing long-term outcomes. Special consideration is given to the athletic population, where timely return to pre-injury performance levels and career longevity are critical. Available evidence on return-to-sport rates, prognostic factors, and long-term durability is reviewed, providing an updated framework for treatment selection and patient counseling.
足部和踝关节的骨软骨病变——最常见的是涉及距骨——由于高功能要求和关节软骨有限的内在愈合能力,给运动员的诊断和治疗带来了重大挑战。本文综述了与这些损伤相关的流行病学、病理生理学、临床评价、成像方式和分类系统,重点是距骨、胫骨平台和第一跖趾关节。治疗策略范围从非手术治疗稳定病变到旨在恢复关节表面结构和功能的手术方法。手术决策是根据病变大小、形态、位置、慢性和相关病理来指导的,重点是恢复关节一致性、保留软骨和优化长期结果。特别考虑到运动人群,及时恢复到受伤前的表现水平和职业生涯寿命是至关重要的。本文回顾了有关恢复运动率、预后因素和长期持久性的现有证据,为治疗选择和患者咨询提供了一个更新的框架。
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引用次数: 0
Innovations in Cartilage Restoration and Joint Preservation of the Knee 膝关节软骨修复和关节保护的创新
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1016/j.otsm.2025.151185
Connor M. Delman , Claudia Ghisa , Nathan White , Evan E. Vellios
Knee preservation surgery has evolved significantly with the introduction of advanced techniques aimed at restoring joint surface integrity, relieving pain, and promoting functional recovery. As the treatment strategies continue to shift, it is imperative for cartilage surgeons to remain informed about the expanding array of surgical options. In addition to cartilage restoration, there is growing interest in meniscal preservation using synthetic implants and scaffold-based approaches. These emerging technologies must be rigorously assessed for safety, efficacy, and long-term outcomes prior to broader adoption. A thorough understanding of these innovations is critical as the field moves toward more personalized, biologically driven solutions for joint preservation.
随着旨在恢复关节表面完整性、缓解疼痛和促进功能恢复的先进技术的引入,膝关节保护手术有了显著的发展。随着治疗策略的不断变化,软骨外科医生必须了解不断扩大的手术选择。除了软骨修复,人们对半月板保存越来越感兴趣,使用合成植入物和支架为基础的方法。在广泛采用这些新兴技术之前,必须严格评估其安全性、有效性和长期结果。随着该领域朝着更加个性化、生物驱动的联合保护解决方案发展,对这些创新的透彻理解至关重要。
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引用次数: 0
Innovations in Rotator Cuff Repair 肩袖修复的创新
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1016/j.otsm.2025.151188
Andrew Tran MD , William J. Hill MD, MPH , Steve K. Kwak MD , SangDo Park MD , Theodore B. Shybut MD
Recent literature has identified biological and patient features that contribute to rotator cuff failure to heal, placing increased emphasis on optimizing the biology of healing, which is increasingly understood to correlate with functional outcomes following arthroscopic rotator cuff repair. Biomaterials for sutures and anchors are increasingly tailored to supporting biological tendon to bone healing and incorporation. Biologic augments such as platelet rich plasma (PRP), cell-based therapies, and bursal tissue autograft, and bioinductive implants are increasingly utilized, as are structural augments such as human dermal allografts and long head biceps tendon autografts. Increased attention has also come to the role of medical and nutritional optimization. A number of early stage or preclinical interventions have shown promise, suggesting future pharmaceutical interventions are on the horizon to further aid rotator cuff healing, but much work remains to be done to optimize their clinical applicability and implementation. Beyond the scope of this article are additional nonrepair reconstructive and salvage options such as tendon transfers, balloon arthroplasty, tuberoplasty, and reverse shoulder arthroplasty. The multifactorial nature of rotator cuff repair outcomes, including surgical, social/environmental, host factors, microenvironment of shoulder, systemic environment of host, rehabilitations, nutrition and patient optimization, will require shoulder surgeons to closely follow evolving literature, practice guidelines, and treatment strategies for rotator cuff tear patients.
最近的文献已经确定了导致肩袖无法愈合的生物学和患者特征,越来越强调优化愈合的生物学,这越来越多地被理解为与关节镜下肩袖修复后的功能结果相关。用于缝合和锚定的生物材料越来越适合于支持生物肌腱骨愈合和融合。诸如富血小板血浆(PRP)、细胞疗法、自体法氏囊组织移植和生物诱导植入等生物增强物的应用越来越多,结构增强物如人类真皮同种异体移植和自体长头二头肌腱移植也越来越多。医疗和营养优化的作用也受到越来越多的关注。许多早期或临床前干预措施已经显示出希望,这表明未来的药物干预措施将进一步帮助肩袖愈合,但仍有许多工作要做,以优化其临床适用性和实施。在本文的范围之外,还有一些非修复性重建和挽救性选择,如肌腱转移、球囊关节成形术、结节成形术和反向肩关节成形术。肩袖修复结果的多因素性质,包括手术、社会/环境、宿主因素、肩部微环境、宿主系统环境、康复、营养和患者优化,将要求肩外科医生密切关注不断发展的文献、实践指南和肩袖撕裂患者的治疗策略。
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引用次数: 0
Editorial Board (pick up from previous issue) 编辑委员会(选自上一期)
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1053/S1060-1872(25)00041-3
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引用次数: 0
Advances and Future Directions and Technologies in Orthobiologics 骨科的进展和未来方向与技术
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1016/j.otsm.2025.151190
Thomas Moran MD , Alyssa Althoff MD , Badr Squali BS , Jared P. Sachs MS , Daanish Sheikh BS , Sam Alfonsi MD , Yusuf N. Mufti BS , Brian J. Cole MD, MBA
Orthobiologics are a diverse class of biologically-derived materials utilized in the treatment of a wide range of musculoskeletal pathologies. Within sports medicine, these materials are becoming more frequently used both in clinical settings and in the operating room. Commonly included treatments include platelet rich plasma (PRP), concentrated bone marrow aspirate (cBMA), adipose-tissue derived therapy, and perinatal derived therapy. These materials promote tissue healing and regeneration through a variety of cellular mechanisms. Several emerging approaches for orthobiologic delivery and application, such as exosomes, induced pluripotent stem cells, and injectable cytokines and peptides, have also demonstrated promise. The efficacy of orthobiologics is heavily condition-dependent, with good evidence for substantial outcomes in some pathologies and limited effects in others. Current challenges within orthobiologics include a lack of standardized preparation, dosing, formulation, and nomenclature within the field. This is further complicated by a dynamic regulatory landscape. The future of orthobiologics will likely focus on standardizing research trials and data collection. More research is needed to firmly establish the uses, side effects, cost-effectiveness, and long-term outcomes of orthobiologics.
骨科是一种不同种类的生物衍生材料,用于治疗各种肌肉骨骼疾病。在运动医学中,这些材料越来越多地用于临床和手术室。常用的治疗方法包括富血小板血浆(PRP)、浓缩骨髓抽吸(cBMA)、脂肪组织源性治疗和围产期源性治疗。这些材料通过多种细胞机制促进组织愈合和再生。一些新兴的移植和应用方法,如外泌体、诱导多能干细胞和可注射的细胞因子和肽,也显示出了希望。骨科的疗效严重依赖于病情,有充分的证据表明,在某些病理中有实质性的结果,而在其他病理中效果有限。目前骨科面临的挑战包括在该领域缺乏标准化的制备、剂量、配方和命名。动态的监管环境使情况进一步复杂化。骨科的未来可能会集中在标准化的研究试验和数据收集上。需要更多的研究来确定骨科的用途、副作用、成本效益和长期结果。
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引用次数: 0
Table of Contents (pick up from previous issue w/updates) 目录(选自上一期的内容和更新)
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1053/S1060-1872(25)00040-1
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引用次数: 0
Introduction: Innovations in Orthopaedic Sports Medicine—Operative Techniques in Sports Medicine 导言:骨科运动医学的创新-运动医学的手术技术
IF 0.7 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-05-01 DOI: 10.1016/j.otsm.2025.151187
Eric Ferkel MD, Theodore Shybut MD
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引用次数: 0
Table of Contents (pick up from previous issue w/updates) 目录(选自上一期的内容和更新)
IF 0.4 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-03-01 DOI: 10.1053/S1060-1872(25)00013-9
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引用次数: 0
The Role of Growth Modulation in Young Patients With Coronal Malalignment and Associated Knee Pathology 生长调节在年轻冠状位失调和相关膝关节病理患者中的作用
IF 0.4 4区 医学 Q4 SPORT SCIENCES Pub Date : 2025-03-01 DOI: 10.1016/j.otsm.2025.151164
Emilie Lijesen , Joshua T. Bram , Ruth H. Jones , Shae K. Simpson , Daniel W. Green
Hemi-epiphysiodesis, or implant-mediated guided growth (IMGG), is a common and effective operation used to treat angular deformities about the knee in children with at least 2 years of skeletal growth remaining. There are several pathologies associated with coronal malalignment of the knee, including patellofemoral instability (PFI), osteochondritis dissecans (OCD), anterior cruciate ligament (ACL) tears, and meniscus injuries. In skeletally immature patients with PFI and genu valgum, simultaneous medial patellofemoral ligament reconstruction (MPFL) and IMGG has demonstrated successful outcomes with low rates of recurrent instability. Furthermore, young patients with OCD lesions can be treated with hemi-epiphysiodesis to unload the affected medial or lateral compartment of the knee. Finally, as genu valgum puts more stress on the ACL and lateral meniscus, IMGG may lead to improved outcomes after ACL reconstruction and lateral discoid meniscus saucerization.
膝关节半外翻矫正术(Hemi-epiphysiodesis)或植入物引导生长术(IMGG)是一种常见而有效的手术,用于治疗骨骼生长期至少还剩两年的儿童膝关节成角畸形。与膝关节冠状位错位相关的病症有多种,包括髌骨股骨不稳定(PFI)、骨软骨炎(OCD)、前交叉韧带(ACL)撕裂和半月板损伤。对于骨骼尚未发育成熟的髌股关节不稳定和膝外翻患者,同时进行髌股关节内侧韧带重建(MPFL)和IMGG的治疗效果显著,复发性不稳定的发生率较低。此外,对患有 OCD 病变的年轻患者,可采用半骺成形术来减轻受影响的膝关节内侧或外侧间室的负荷。最后,由于膝膝外翻会对前交叉韧带和外侧半月板造成更大的压力,IMGG可能会改善前交叉韧带重建和外侧盘状半月板切除术后的疗效。
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Operative Techniques in Sports Medicine
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