Arthroscopy-The Journal of Arthroscopic and Related Surgery最新文献

{"title":"Increased Pitch-Specific Velocity, Spin Rate, and Horizontal Movement Lead to Increased Odds of Undergoing Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers Using Baseball Savant Data","authors":"Maxwell Harrell B.S. ,&nbsp;Clay Rahaman B.A. ,&nbsp;Dev Dayal B.S. ,&nbsp;Patrick Elliott M.D. ,&nbsp;Caleb Berta B.S. ,&nbsp;Nathaniel Buchanan B.S. ,&nbsp;Eugene Brabston M.D. ,&nbsp;Thomas Evely D.O. ,&nbsp;Walter Smith M.D. ,&nbsp;Aaron Casp M.D. ,&nbsp;Amit Momaya M.D.","doi":"10.1016/j.arthro.2025.07.022","DOIUrl":"10.1016/j.arthro.2025.07.022","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate advanced pitch-specific metrics to uncover which are associated with pitchers undergoing ulnar collateral ligament reconstruction (UCLR).</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using Major League Baseball pitchers who underwent UCLR between 2017 and 2024. Preinjury pitch metrics, including velocity, spin rate, movement profiles, and pitch use, were collected from the public database Baseball Savant and compared with league averages. To be included, pitchers must have had pitching data recorded in the Baseball Savant public database. Pitchers were excluded from the study if no data were found in Baseball Savant. Mann-Whitney <em>U</em> tests and logistic regression models were used to assess statistical differences and identify significant predictors of undergoing UCLR.</div></div><div><h3>Results</h3><div>A total of 132 pitchers who underwent UCLR were analyzed against 6,001 league-average pitchers. Pitchers with UCLR displayed greater average velocities for 4-seamers (94.6 miles per hour [mph] vs 93.2 mph, Δ1.4), sinkers (94.4 mph vs 92.7 mph, Δ1.7), cutters (90.0 mph vs 88.6 mph, Δ1.4), sliders (85.5 mph vs 84.4 mph, Δ1.1), changeups (86.9 mph vs 85.3 mph, Δ1.6), and curveballs (79.7 mph vs 78.5 mph, Δ1.4) (<em>P</em> &lt; .001). Increased spin rate for 4-seamers (2,301.3 revolutions per minute [rpm] vs 2,253.2 rpm, Δ 48.1, <em>P</em> = .0004) and changeups (1810.8 rpm vs 1757.4 rpm, Δ 52.6, <em>P</em> = .04) also was noted. Decreased glove-side horizontal movement on cutters (1.3 inches vs 3.0 inches, Δ 1.7 inches, &lt;.0001) and increased arm-side movement of changeups (14.1 inches vs 13.2 inches, Δ0.9 inches, <em>P</em> = .01) significantly increased odds of UCLR. Increased sinker velocity (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.16-1.40), 4-seamer velocity (OR 1.27, 95% CI 1.18-1.37), changeup velocity (OR 1.20, 95% CI 1.12-1.28), and decreased glove-side cutter horizontal break (OR 0.64, 95% CI 0.54-0.77) increased a pitcher’s odds of undergoing UCLR.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that specific pitch characteristics, including increased velocity, increased spin rate, reduced glove-side horizontal movement of cutters, and increased arm-side horizontal movement of changeups, are associated with an increased likelihood of a pitcher undergoing UCLR.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5068-5074"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: There Are Limited Changes In Gait Biomechanics After Femoroacetabular Impingement Surgery: A Call for More Comprehensive Functional Testing","authors":"Jay Moran M.D.,&nbsp;Andrew E. Jimenez M.D. (Editorial Board)","doi":"10.1016/j.arthro.2025.08.007","DOIUrl":"10.1016/j.arthro.2025.08.007","url":null,"abstract":"<div><div>Biomechanical studies have reported that patients with femoroacetabular impingement syndrome (FAIS) exhibit altered walking patterns compared with control patients. The underlying mechanisms of these observed kinematic differences in FAIS patients are believed to be maladaptive and multifactorial in nature. Although arthroscopic hip techniques, surgical indications, and long-term postoperative outcomes for FAIS continue to rapidly evolve, the influence of surgical intervention on restoration of abnormal gait patterns in FAIS patients remains understudied. Recent biomechanical studies using 3-dimensional in vivo gait analysis techniques have reported minimal differences between presurgical and postsurgical gait in patients undergoing hip arthroscopy for the treatment of FAIS. The lack of postoperative gait improvement may be because normal gait rarely produces the ranges of motion that would result in impingement or may result from soft-tissue changes and/or gait alterations that are not improved with the treatment of FAIS alone. Motion analysis of FAIS patients performing more physically demanding tasks that are more likely to result in impingement, such as jumping, squatting, running, and/or landing, can potentially highlight differences that may not be identified from analyzing normal gait kinematics. In addition, longer follow-up time, stratification of outcomes based on sex, FAIS type (cam vs pincer vs combined), and the influence of microinstability are important considerations for future biomechanical investigation.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5410-5412"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: The Ideal Combination of Anterior Cruciate Ligament Reconstruction and Lateral Extra-articular Procedures Has Yet to Be Determined, But We Are Getting Closer","authors":"Matthias Brockmeyer M.D. (Editorial Board)","doi":"10.1016/j.arthro.2025.08.006","DOIUrl":"10.1016/j.arthro.2025.08.006","url":null,"abstract":"<div><div>In recent years, the addition of lateral extra-articular procedures (LEAPs) to primary and revision anterior cruciate ligament (ACL) reconstructions has been recommended in patients with appropriate indications. Possible indications for combined primary ACL reconstructions and LEAPs include a preoperative high-grade pivot shift, generalized ligamentous hyperlaxity, genu recurvatum, chronic injury (&gt;6 months), and young patients (&lt;25 years) who intend to return to high-demand sporting activities such as pivot or contact sports. Different LEAPs are described in the current literature. The combination of ACL reconstructions and LEAPs leads to decreased graft rupture and reoperation rates, improved graft survival, and increased knee stability. Nevertheless, the most promising combination of ACL graft and LEAP has yet to be determined.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5256-5257"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Hormonal Contraception Is Associated With a Greater Rate of Greater Trochanteric Pain Syndrome, Labral Tear, and Femoroacetabular Impingement Syndrome in Female Patients","authors":"Kira L. Smith M.D. ,&nbsp;Aakash K. Shah B.S. ,&nbsp;Robert J. Burkhart M.D. ,&nbsp;Jeremy M. Adelstein M.D. ,&nbsp;Andrew J. Moyal M.D. ,&nbsp;Bhargavi Maheshwer M.D. ,&nbsp;James E. Voos M.D. ,&nbsp;Michael J. Salata M.D.","doi":"10.1016/j.arthro.2025.07.017","DOIUrl":"10.1016/j.arthro.2025.07.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the association between various hormonal contraception (HC) formulations and pathology around the hip.</div></div><div><h3>Methods</h3><div>The TriNetX U.S Collaborative Network database was used to complete a retrospective review of female patients, aged 13 to 50 years old, who were on sex hormone modulation. The primary outcome assessed was the development of pathology around the hip occurring within 5 years of starting various forms of HC. The included pathologies were greater trochanteric pain syndrome (GTPS), labral tear, femoroacetabular impingement syndrome (FAIS), or any combination of those injuries. The categories of HC were a progestin-only cohort and a mixed estrogen-progestin cohort. Odds ratio (OR) with a 95% confidence interval (CI) was used to measure the association between exposure to HC and development of hip pathology. Statistical significance was set to <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>After 1:1 propensity matching, a total of 1,397,123 patients were included in the final analysis. Progestin-only hormonal contraceptives (HCs) were associated with a greater likelihood of developing GTPS (OR 1.93, <em>P</em> &lt; .001), labral tear (OR 1.75, <em>P</em> &lt; .001), FAIS (OR 1.63, <em>P</em> &lt; .001), or a form of combined hip pathology (OR 1.83, <em>P</em> &lt; .001) compared with the control group. The mixed-HCs also were associated with a greater likelihood of developing GTPS (OR 2.13, <em>P</em> &lt; .001), labral tear (OR 2.21, <em>P</em> &lt; .001), FAIS (OR 1.82, <em>P</em> &lt; .001), or a form of combined hip pathology (OR 2.10, <em>P</em> &lt; .001) compared with the control group.</div></div><div><h3>Conclusions</h3><div>There is an association between systemic HC and hip pathology 5 years after initiation of HC among female patients aged 13 to 50 years old. Both progestin-only HCs and mixed-HCs were associated with a greater likelihood of developing GTPS, labral tear, FAIS, or a form of combined hip pathology compared with their control groups.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case-control series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5118-5124"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery Stages After Multiligament Knee Reconstruction","authors":"Warren W. Nielsen M.D. ,&nbsp;Jill K. Monson P.T., O.C.S ,&nbsp;Robert F. LaPrade M.D., Ph.D. ,&nbsp;Andrew G. Geeslin M.D.","doi":"10.1016/j.arthro.2025.09.001","DOIUrl":"10.1016/j.arthro.2025.09.001","url":null,"abstract":"<div><div>Multiligament knee injuries are severe limb-threatening injuries involving a tear of two or more of the major knee ligaments including the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and fibular (lateral) collateral ligament/posterolateral corner. Anatomic reconstructions can help restore joint stability, which is complemented by a postoperative rehabilitation program to maximize knee function. The postoperative recovery will likely be extended compared with single-ligament procedures and usually involves robust precautions. However, it can be started the day after the reconstruction procedure to include initiation of knee motion. The goals are similar to those of single-ligament procedures including gradual recovery of motion, strength, and load capacity; as well as symptom control, restoration of cardiovascular fitness, and long-term joint protection. These are achieved through a protocolized rehabilitation program that involves four phases: recovery phase, transition phase, rebuild phase, and restore phase. Their goals and milestones are incremental to achieve optimal patient outcomes. With a team-based approach to protocolized recovery between the patient, surgeon, and rehabilitation team, patient function and return to activities can be maximized.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 4965-4967"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopically Assisted Acromioclavicular Joint Stabilization in Patients Aged ≥50 Years Results in a Low Rate of Clinical Failure, Favorable Outcomes, and High Return to Activity and Work","authors":"Marco-Christopher Rupp M.D. ,&nbsp;Lorenz Fritsch M.D. ,&nbsp;Lukas N. Muench M.D. ,&nbsp;Yannick Ahlheit cand. M.D. ,&nbsp;Yannick Ehmann M.D. ,&nbsp;Daniel Berthold M.D. ,&nbsp;Lucca Lacheta M.D. ,&nbsp;Sebastian Siebenlist M.D. ,&nbsp;Bastian Scheiderer M.D.","doi":"10.1016/j.arthro.2025.06.015","DOIUrl":"10.1016/j.arthro.2025.06.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate clinical outcomes as well as return to activity and work following an arthroscopically assisted suspensory fixation technique for acromioclavicular joint (ACJ) instability in patients aged ≥50 years and to compare these outcome parameters between surgery in the acute (≤3 weeks) and chronic setting of ACJ instability.</div></div><div><h3>Methods</h3><div>Patients aged ≥50 years who underwent arthroscopically assisted ACJ stabilization with a suspensory fixation between January 2011 and June 2020 were included. The American Shoulder and Elbow Surgeons score; Single Assessment Numerical Evaluation (SANE); the Disabilities of the Arm, Shoulder, and Hand score; and visual analog scale for pain were collected at a minimum of 24 months. Return to activity and return to work were evaluated by a questionnaire. Outcomes were compared between undergoing surgery for acute or chronic (≤3 weeks/&gt;3 weeks) ACJ instability.</div></div><div><h3>Results</h3><div>Of 55 eligible patients, 44 with a mean age of 59.9 ± 7.8 (50-76) years were included. At a minimum 37 months after surgery (mean, 74.8 ± 31.4; range, 37-142 months), patients reported an American Shoulder and Elbow Surgeons score of 89.4 ± 15.6 (38-100), SANE of 89.8 ± 13.9 (40-100), and Disabilities of the Arm, Shoulder, and Hand questionnaire score of 9.8 ± 13.3 (0-47.7), along with a visual analog scale for pain score of 0.9 ± 1.7 (0-7), with 73.3% of the patients reaching the patient acceptable symptom state. There was no revision for subsequent recurrent instability. Postoperatively, 87.2% of patients returned to athletic activity after 4.1 ± 2.3 (1-12) months, but to fewer disciplines (2.4 ± 1.2 vs 2.1 ± 1.4; <em>P</em> = .025). Of the patients, 97% returned to work at a mean of 7.3 ± 8.8 (0-40) weeks, with 90% reporting a similar or superior working ability. While the overall outcome was comparable in the chronic and the acute setting, patients in the chronic situation of ACJ instability reported a significantly inferior SANE compared to the contralateral shoulder (<em>P</em> = .024) and returned to fewer athletic disciplines (<em>P</em> = .007) compared to the acute situation.</div></div><div><h3>Conclusions</h3><div>Patients aged ≥50 years undergoing arthroscopically assisted ACJ stabilization experienced favorable clinical outcomes at mid-term follow-up, with high rates of return to athletic activity and work. Outcomes were comparable in patients undergoing surgery in acute and chronic situations.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case series</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5015-5024.e3"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Reconstruction After Anterior Cruciate Ligament Injury Is Associated With Reduced Odds of Future Total Knee Arthroplasty at Mid- to Long-Term Follow-Up","authors":"Verdinand C.B. Ruelos M.D. ,&nbsp;Sabrina M. Pescatore M.Sc. ,&nbsp;Patrick J. Tansey M.D. ,&nbsp;Robert W. Lindeman M.D. ,&nbsp;William M. Weiss M.D.","doi":"10.1016/j.arthro.2025.07.028","DOIUrl":"10.1016/j.arthro.2025.07.028","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether anterior cruciate ligament (ACL) reconstruction is associated with reduced odds of future total knee arthroplasty (TKA) among patients who sustain ACL injuries and to determine whether operative intervention is associated with reduced odds of future TKA among patients who sustain concomitant ACL and meniscus injuries.</div></div><div><h3>Methods</h3><div>Data were obtained from the TriNetX database to identify patients who were aged at least 30 years with ACL injuries between 2009 and 2019. Patients were divided into 2 groups: those who were treated with surgical ipsilateral ACL reconstruction and those who were treated nonoperatively. After propensity score matching for comorbidities, the 2 groups were followed up for ipsilateral TKA. The follow-up time was 5 to 15 years. Analyses were performed comparing odds of TKA after differing treatment options for concomitant ACL and meniscus injury. χ² Analysis and Kaplan-Meier survival analysis were performed to determine the association between treatment of ACL injury and future TKA. Odds ratios (ORs) were reported, with <em>P</em> &lt; .05 considered statistically significant.</div></div><div><h3>Results</h3><div>Our analysis included 11,683 patients. Of these patients, 5,829 were managed nonoperatively and 5,854 underwent ACL reconstruction. In the nonoperative group, 247 patients (4.2%) underwent TKA compared with 128 patients (2.2%) in the ACL reconstruction group (OR, 1.98; 95% confidence interval, 1.59-2.46; <em>P</em> &lt; .0001). In our concomitant ACL and meniscus injury analysis, 2,407 patients were managed nonoperatively and 2,411 patients underwent ACL reconstruction and meniscectomy. In the nonoperative group, 105 patients (4.4%) underwent TKA compared with 49 patients (2.0%) in the ACL reconstruction and meniscectomy group (OR, 2.20; 95% confidence interval, 1.56-3.10, <em>P</em> &lt; .0001).</div></div><div><h3>Conclusions</h3><div>Patients with ACL injuries treated with ACL reconstruction and patients with ACL and meniscus injuries treated with ACL reconstruction and meniscectomy are less likely to undergo TKA at mid- to long-term follow-up compared with patients treated nonoperatively.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective prognostic case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5258-5264.e1"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: Let’s Finally Agree That Anterior Cruciate Ligament Reconstruction Lowers the Risk of Total Knee Arthroplasty When Compared With Nonoperative Treatment","authors":"Adam V. Daniel M.D.,&nbsp;Genna P. Thompson M.D.,&nbsp;Bruce A. Levy M.D.","doi":"10.1016/j.arthro.2025.08.008","DOIUrl":"10.1016/j.arthro.2025.08.008","url":null,"abstract":"<div><div>The debate rages on whether anterior cruciate ligament (ACL) reconstruction can reduce the risk of the development of symptomatic osteoarthritis (OA)—and subsequent total knee arthroplasty—in ACL-injured knees. The decision to perform ACL reconstruction depends on many factors. Typically, we consider knee-specific factors and patient-specific factors that ultimately drive decision making. However, if we can show that ACL reconstruction can delay or even prevent the development of OA, then the risk of OA may be a factor to consider as well.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5265-5267"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality and Augmented Reality Are Uniquely Suited to Hip Arthroscopy Education and Reveal Adequate Face, Content, and Construct Validity: A Systematic Review With Expert Commentary","authors":"Prushoth Vivekanantha M.D. ,&nbsp;Derek H. Ochiai M.D. ,&nbsp;Satyavenkata Kotipalli B.M.Sc. ,&nbsp;Andrew Duong M.Sc. ,&nbsp;Nicole Simunovic M.Sc. ,&nbsp;Antonio J. Andrade M.Sc., F.R.C.S.(Tr&Orth) ,&nbsp;Olufemi R. Ayeni M.D., Ph.D., F.R.C.S.C.","doi":"10.1016/j.arthro.2025.07.039","DOIUrl":"10.1016/j.arthro.2025.07.039","url":null,"abstract":"<div><h3>Purpose</h3><div>To (1) summarize the current literature regarding virtual reality (VR)/augmented reality (AR) as it pertains to efficacy in hip arthroscopy training, (2) compare the VR/AR performance of experienced and less experienced hip arthroscopists, and (3) assess the suitability of VR/AR for hip arthroscopy education by assessing various elements of validity.</div></div><div><h3>Methods</h3><div>Three databases were searched on February 9, 2025, for studies investigating VR/AR simulation in hip arthroscopy training. Descriptive statistics were used to report participant details, simulation specifics, and validity (e.g., face, construct, and content).</div></div><div><h3>Results</h3><div>Nine studies comprising 218 participants were included, 37 (16.9%) being considered experienced. Most studies (7 of 9, 77.8%) were analyses of 1 session, with 2 studies comparing progress during sessions over time. Five studies investigated face validity; the majority of participants (&gt;70%) in each of these studies found that simulators were realistic in all elements apart from tactile feedback. Eight studies evaluated construct validity. Three of four studies (75%) found statistically lower amounts of iatrogenic tissue damage in the experienced group (<em>P</em> ≤ .002). Three of four studies (75%) found that the experienced group had shorter completion times (<em>P</em> ≤ .03) than the non-experienced group. One study reported lower iatrogenic damage (<em>P</em> &lt; .0001) and completion times (<em>P</em> &lt; .001) with repeated sessions in non-experienced learners.</div></div><div><h3>Conclusions</h3><div>VR/AR simulation training for hip arthroscopy reveals good face, content, and construct validity. Generally, VR/AR simulations were rated by users as realistic in most elements apart from tactile feel. Participants, particularly junior learners, improved in minimizing iatrogenic tissue damage, decreasing completion time, and minimizing excess travel with the scope. More experienced hip arthroscopists generally outperformed non-experienced participants in the majority of performance metrics and scores.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I, II, and IV studies, plus Level V, expert opinion.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5413-5436.e2"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male Sex, Younger Age, Lower Body Mass Index, Athletes, Shorter Time From Injury to Surgery, and Non-contact Injury Are Associated With Achieving the Thresholds for Substantial Clinical Benefit for Patient-Reported Outcome Measures After Primary Anterior Cruciate Ligament Reconstruction","authors":"Zhi-yu Zhang M.D.,&nbsp;Wei-li Shi M.D., Ph.D.,&nbsp;Yong Ma M.D.,&nbsp;Xi Gong M.D.,&nbsp;Ping Liu M.D.,&nbsp;Jia-ning Wang M.D.,&nbsp;Xin Zhang M.D., Ph.D.,&nbsp;Hong-jie Huang M.D.,&nbsp;Cheng Wang M.D.,&nbsp;Jian-quan Wang M.D.","doi":"10.1016/j.arthro.2025.05.016","DOIUrl":"10.1016/j.arthro.2025.05.016","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the thresholds for substantial clinical benefit (SCB) for patient-reported outcome measures (PROMs) and to identify potential factors associated with achieving the SCB thresholds after primary anterior cruciate ligament reconstruction (ACLR).</div></div><div><h3>Methods</h3><div><span>Patients who underwent primary single-bundle ACLR using hamstring tendon<span> autografts at our institute were included. The collected PROMs included the visual analog scale for pain, </span></span>Tegner Activity Scale<span> (Tegner score), modified Lysholm Knee Scoring Scale (Lysholm score), and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form (IKDC score). The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined based on patient responses to an anchor question. Multivariable logistic regression analyses were performed to identify factors associated with achieving the SCB thresholds.</span></div></div><div><h3>Results</h3><div>A total of 382 patients with a minimum 4-year follow-up were included in this study. The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined to be 2 and 1.5, respectively, for the visual analog scale pain score; 3 and 3.5, respectively, for the Tegner score; 24.2 and 81.5, respectively, for the Lysholm score; and 27.2 and 77.6, respectively, for the IKDC score. Male sex (<em>P</em> = .0050 for raw postoperative score), younger age (<em>P</em> = .0249 for score improvement, <em>P</em> = .0075 for raw postoperative score), athletes (<em>P</em><span> = .0001 for score improvement), and non-contact injury (</span><em>P</em><span> = .0034 for raw postoperative score) were associated with increased odds of achieving the SCB threshold for the Tegner score. Higher body mass index was associated with decreased odds of achieving the SCB thresholds for both the raw postoperative Lysholm score (</span><em>P</em> = .0009) and Lysholm score improvement (<em>P</em> = .0036). A longer time from injury to surgery was associated with decreased odds of achieving the SCB threshold for IKDC score improvement (<em>P</em> = .0006).</div></div><div><h3>Conclusions</h3><div>The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined after primary ACLR. Male sex, younger age, lower body mass index, athletes, shorter time from injury to surgery, and non-contact injury were associated with increased odds of achieving the SCB thresholds.</div></div><div><h3>Level of Evidence</h3><div>Level IV, case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5167-5177.e4"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}