Background:During a windmill softball pitch, the throwing shoulder experiences forces greater than the pitcher’s body weight. Various kinematic, kinetic, and performance factors have been related to shoulder forces and torques in softball pitchers, and softball research has examined clinical screening measures such as range of motion, muscular strength, and/or neuromuscular control. However, no studies

Background:Asymmetric landing kinetics 6 months after anterior cruciate ligament reconstruction (ACLR) are associated with higher risk of second anterior cruciate ligament injury. Little is known about landing kinetics after ACLR with an all–soft tissue quadriceps tendon (QT) autograft despite its increasingly common use in young, active patients.Purpose/Hypothesis:The purpose of this study was to

Background:Clinical studies have shown that the open Latarjet procedure (OLP) has lower recurrence rates than the isolated arthroscopic Bankart (IAB) procedure for recurrent anterior shoulder instability, but no long-term comparative studies exist for IAB in patients without bone loss.Purpose/Hypothesis:This study aimed to compare the outcomes of IAB in selected patients without bone loss versus OLP

Background:The number of meniscal repairs being completed each year is increasing; however, the optimal, cost-effective postoperative assessment to determine the success or failure of a meniscal repair is not well known.Purpose/Hypothesis:The purpose of this systematic review was to identify the clinical examination testing that correlates with objective magnetic resonance imaging (MRI) or second-look

Background:Anterior cruciate ligament reconstruction (ACLR) often involves harvesting a bone–patellar tendon–bone (BPTB) autograft. How graft harvest affects tendon strain across the 3 distinct regions (medial, lateral, and central) is not known.Purpose:To (1) quantify strain in the 3 regions of the patellar tendon during 60% of maximum voluntary isometric contraction (MVIC) in 90° of knee flexion

Background:There is growing evidence that medial meniscotibial ligament (MTL) deficiency and medial meniscus extrusion may precede the development of some medial meniscus posterior root (MMPR) tears. However, no study has investigated the biomechanical consequences of MTL deficiency on the MMPR.Hypothesis:(1) MTL deficiency leads to increased medial meniscus extrusion, (2) increased medial meniscus

Background:Elbow injuries are prevalent among professional baseball pitchers as nearly 25% undergo ulnar collateral ligament reconstruction. Pitch type, ball velocity, and spin rate have been previously hypothesized to influence elbow varus torque and subsequent risk of injury, but existing research is inconclusive.Purpose:To examine elbow varus torque, cumulative torque, and loading rate within professional

Background:Anterior glenoid bone defects significantly influence surgical outcomes in shoulder instability cases. Various measurement methods based on 3-dimensional computed tomography (3D-CT) have been developed. Recently, the simple linear formula method, which establishes a correlation between glenoid height and width, has emerged as a promising technique.Purpose:This study aimed to assess the differences

Background:A bone stress injury (BSI) is a common overuse injury in collegiate athletes, particularly cross-country and track and field runners. Limited work describes the seasonality of BSIs or the differences in rates and anatomic locations of BSIs in collegiate runners.Purpose:To describe seasonally related trends in anatomic locations of BSIs in National Collegiate Athletic Association (NCAA) Division

Background:Ruptures of the distal biceps tendon (DBT) can affect the range of motion and strength of the elbow, raising concerns for patients seeking to restore normal function and engage in their regular activities, particularly returning to previous levels of sport participation.Purpose:To characterize and assess the rate and timing of return to sport (RTS) after DBT repair.Study Design:Systematic

Background:Views surrounding acromioplasty at the time of arthroscopic rotator cuff repair (RCR) have shifted dramatically over time. In recent years, various studies have argued against acromioplasty, citing equivocal functional outcomes after arthroscopic RCR with or without acromioplasty.Purpose:To assess the statistical fragility of functional outcomes after arthroscopic RCR with and without acromioplasty

Background:Anterior cruciate ligament (ACL) tears are frequent injuries in athletes that often require surgical reconstruction so that patients may return to their previous levels of performance. While existing data on patient-reported outcomes are similar between bone–patellar tendon–bone (BTB) and hamstring tendon (HT) autografts, the literature regarding return to sport (RTS), return to previous

Background:The individual variation in on-snow performance outcomes after anterior cruciate ligament (ACL) reconstruction (ACLR) in elite alpine ski racers has not been reported and may be influenced by specific injury characteristics.Purpose:To report the performance statistics of elite ski racers before and after ACLR and to identify surgical and athlete-specific factors that may be associated with

Background:Sex has been associated with different pathologic characteristics in painful hips undergoing hip arthroscopic surgery.Purpose:To compare minimum 10-year patient-reported outcomes (PROs) and survivorship in patients who underwent primary hip arthroscopic surgery for femoroacetabular impingement syndrome and labral tears according to sex.Study Design:Cohort study; Level of evidence, 3.Methods:Data

Background:Residual interlimb deficits after anterior cruciate ligament reconstruction (ACLR) can lead to functional maladaptation and increase the risk of reinjury. The tuck jump assessment (TJA) may offer a more effective evaluation of ACLR status as compared with traditional tasks owing to increased risk of altered landing mechanics, asymmetrical landing, and increased knee valgus attributed to

Background:Anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET) has been used more frequently in conjunction with anterior cruciate ligament reconstruction (ACLR) in recent years. However, there are still concerns that these procedures may lead to complications such as overconstraint of the lateral compartment, stiffness, infections, tunnel convergence, and other

Background:Critical analysis of studies with high level of evidence has relied on the significance set by the reported P values. However, this strategy steers readers toward categorical interpretation of the data; therefore, a more comprehensive approach of data analysis is warranted. The continuous fragility index (CFI) allows for frailty interpretation of any given study's continuous outcome results

Background:Limited biomechanical evidence exists describing how horizontal meniscus tears (HMTs), meniscal repair (MR), and meniscectomy alter the knee's biomechanical environment.Purpose:To evaluate changes in knee contact mechanics following HMTs, MR, and meniscectomy.Study Design:Systematic review; Level of evidence, 5.Methods:PubMed, EMBASE, and CINAHL databases were systematically searched for

Background:Despite the effectiveness of remplissage in reducing instability recurrence, debate remains about the loss of external rotation (ER) after this procedure.Purpose:To compare the loss of ER after primary isolated arthroscopic Bankart repair alone (BR), Bankart with remplissage (REMP), and Latarjet (LAT) procedures.Study Design:Meta-analysis; Level of evidence, 3.Methods:A literature search

Background:Surgical options for septic arthritis include open arthrotomy or an arthroscopic procedure. The optimal surgical technique remains a matter of debate as acceptable results have been reported for both.Purpose:To evaluate the efficacy of arthroscopy versus arthrotomy for the treatment of septic arthritis in large and intermediate-sized joints.Study Design:Systematic review; Level of evidence

Background:Arthroscopic labral repair of the hip is successfully performed with increasing frequency using either knotless or knotted suture anchors, each with its own risks and benefits.Purpose:To examine biomechanical and clinical outcomes for labral repair of the hip based on the use of knotted or knotless suture anchors.Study Design:Systematic review; Level of evidence, 4.Methods:A search was performed

Background:Distal triceps tendon injuries are relatively rare injuries, often occurring in highly active patients with physically demanding jobs or lifestyles. Information on return to work, sport, and activity is essential for patient education and counseling after a distal triceps tendon rupture.Purpose:To determine the rates of return to work, sport, and sport-related activity after distal triceps

Background:The surgical management of bursal-sided partial-thickness rotator cuff tendon tears is controversial. The 2 methods used are in situ repair (ISR), preserving the contingent of intact articular tendon fiber, or tear completion before repair (TCBR) according to the operating surgeon's usual technique. No study with sufficient power has demonstrated a superior technique.Hypothesis:The 2 techniques

Background:Continued advancements in cartilage surgery and an accumulating body of evidence warrants a contemporary synthesis of return to sport (RTS) outcomes to provide updated prognostic data and to better understand treatment response.Purpose:To perform an updated systematic review of RTS in athletes after knee cartilage restoration surgery.Study Design:Systematic review; Level of evidence, 4.Methods:PubMed

Background:Orthopaedic surgeons play a critical role in ensuring the health and safety of professional athletes. Despite the privilege of treating elite athletes, there exists great financial exposure to individual physicians in the event of a malpractice lawsuit.Hypothesis/Purpose:The purpose of this study was to evaluate and model malpractice liability exposure of the sports medicine surgeon caring

Background:Osteochondral allograft transplantation (OCA) is well established as a viable chondral restoration procedure for the treatment of symptomatic, focal chondral defects of the knee. The efficacy of secondary OCA in the setting of failed index cartilage repair or restoration is poorly understood.Purpose:To evaluate radiographic and clinical outcomes, failures, and reoperations after OCA after

Background:In 2014, Costello and colleagues published a sentinel paper spotlighting the large disparity of female versus male representation within sports science and sports medicine (SSSM) research.Purpose:To (1) revisit the method published by Costello et al a decade later to evaluate female representation and (2) ascertain whether study designs account for menstrual status.Study Design:Systematic

Background:The Latarjet and other bony augmentation procedures are commonly used to treat anterior shoulder instability in the setting of significant glenoid bone loss. Although several fixation strategies have been reported, the biomechanical strength of these techniques remains poorly understood.Purpose:To perform a systematic review of the biomechanical strength of glenoid bony augmentation procedures

Background:The regenerative potential of mesenchymal stromal cells (MSCs) has sparked interest in their use for knee osteoarthritis. Concurrently, there have been investigations on how data in scientific journals are reported and how they may influence readers’ interpretations, or “spin bias.” These studies are at risk for bias, given the limited number of patients and inconsistent blinding or controls

Background:Treatment of stable osteochondritis dissecans (OCD) lesions of the knee in young patients poses the challenge of abstaining from competitive sports for months. Outcomes relevant to this patient population additionally include successful return to sport (RTS), return to the same level of sport, and the time needed to achieve both.Purpose:To evaluate the adolescent population for RTS outcomes

Background:While risk factors for recurrent instability (RI) after arthroscopic Bankart repair (ABR) for anterior glenohumeral instability (aGHI) have been well established in adult populations, there is much less evidence in pediatric and adolescent patients, despite being the most affected epidemiologic subpopulation.Purpose:To identify the clinical, demographic, radiologic, and operative risk factors

Background:A growing body of evidence surrounds secondary meniscal and cartilage pathology after delay to anterior cruciate ligament (ACL) reconstruction (ACLR). Many of these studies focus on or include an adult population.Purpose:To elucidate the prevalence of secondary meniscal and chondral pathology with delay to ACLR in the adolescent population as well as examine the influence of sex, skeletal

Background:Meniscal injuries that fail to heal instigate catabolic changes in the knee's microenvironment, posing a high risk for developing posttraumatic osteoarthritis (PTOA). Previous research has suggested that human cartilage–derived progenitor cells (hCPCs) can stimulate meniscal repair in a manner that depends on stromal cell–derived factor 1 (SDF-1) pathway activity.Hypothesis:Overexpressing

Background:Medial patellofemoral ligament reconstruction (MPFLR) is an excellent surgical option for patients with recurrent patellar instability. This technique has demonstrated significant improvements in patient-reported outcomes, high rates of return to sport, and low rates of failure. However, there is debate regarding the use of isolated MPFLR in the setting of concomitant pathoanatomic features

Background:The use of quadriceps tendon (QT) autograft for anterior cruciate ligament (ACL) reconstruction has been increasing since 2014. Studies have shown that QT is comparable to hamstring tendon (HT) and bone–patellar tendon–bone (BTB) autografts in terms of outcomes, although QT autograft has lower rates of donor site morbidity. Systematic reviews and meta-analyses have been previously conducted

Background:Loss of motion and arthrofibrosis after anterior cruciate ligament (ACL) reconstruction (ACLR) can be devastating complications for athletes. The cellular and molecular pathogenesis of arthrofibrosis is poorly understood, limiting prevention and treatment options. Synovial inflammation may contribute to post-ACLR arthrofibrosis.Hypothesis:Higher synovial immune cell infiltration and inflammatory/catabolic

Background:Surgical reconstruction is the standard treatment for injuries to the posterolateral corner (PLC) of the knee and can be performed using either a fibular-based or combined tibiofibular-based technique. Although some comparative studies have been performed, there is no consensus regarding the reconstructive approach that confers optimal biomechanical properties of the PLC.Purpose:To perform

Background:Mental health is a contributing factor to the overall well-being of patients, and the 2-question Patient Health Questionnaire (PHQ-2) and 9-question Patient Health Questionnaire (PHQ-9) are reliable in-clinic tools to assess depression and self-harm. The prevalence of adolescents with depression symptoms within a pediatric orthopaedic sports clinic has not been assessed.Hypothesis:That rates

Background:A lateral extra-articular tenodesis (LET) is increasingly being utilized to augment an anterior cruciate ligament reconstruction because it has been shown to reduce the risk of postreconstruction graft failure or recurrent rotatory instability. Various femoral fixation techniques are available, including the use of an interference screw, staple, or suture anchor.Purpose:To determine and

Background:Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery.Purpose:To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain.Study Design:Systematic review and meta-analysis; Level of evidence, 1.Methods:PubMed, Cochrane

Background:Failure of primary cartilage restoration procedures of the knee that proceed to necessitating revision cartilage procedures represent a challenging clinical scenario with variable outcomes reported in previous literature.Purpose:To perform a systematic review and meta-analysis of clinical outcomes and adverse events after revision cartilage restoration procedures of the knee for failed primary

Background:Peripheral nerve blocks (PNBs) are frequently utilized as a regional anesthetic in pediatric orthopaedic surgery for postoperative pain control and reduced time to discharge; however, short- and long-term complications after these procedures are variably reported.Purpose:To identify the frequency of long-term complications in pediatric patients who received regional anesthesia for a lower

Background:Selective androgen receptor modulators (SARMs) are small-molecule compounds that exert agonist and antagonist effects on androgen receptors in a tissue-specific fashion. Because of their performance-enhancing implications, SARMs are increasingly abused by athletes. To date, SARMs have no Food and Drug Administration approved use, and recent case reports associate the use of SARMs with deleterious

Background:Knee injuries resulting in purely cartilaginous defects are rare, and controversy remains regarding the reliability of chondral-only fixation.Purpose:To systematically review the literature for fixation methods and outcomes after primary fixation of chondral-only defects within the knee.Study Design:Systematic review; Level of evidence, 5.Methods:A literature search was conducted following

Background:Mismatch between osteochondral allograft (OCA) donor and recipient sex has been shown to negatively affect outcomes. This study accounts for additional donor variables and clinically relevant outcomes.Purpose:To evaluate whether donor sex, age, donor-recipient sex mismatch, and duration of graft storage affect clinical outcomes and failure rates after knee OCA transplantation.Study Design:Cohort

Background:Studies are still limited on the isolated effect of retear after arthroscopic rotator cuff repair (ARCR) on functional outcomes after the midterm period.Purpose:To assess the effect of retear at midterm follow-up after ARCR and to identify factors associated with the need for revision surgery.Study Design:Cohort study; Level of evidence, 3.Methods:A retrospective review was conducted on

Background:Many studies have examined the prevalence of acetabular version (AV) and femoral version (FV) abnormalities and their effect on patient-reported outcomes (PROs) after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), but few have explored the prevalence and influence of combined version (CV) abnormalities.Purpose:To (1) describe the distribution of AV, FV, and CV in the largest

Background:Patellar instability is frequently encountered by orthopaedic surgeons. One of the major risk factors of this condition is underlying trochlear dysplasia (TD). Recent trends have indicated the use of multiple procedures to correct patellar instability under these conditions. Medial patellofemoral ligament reconstruction (MPFLR) and trochleoplasty (TP) are surgical strategies that have demonstrated

Background:Failure, persistent knee instability, and reinjury rates after anterior cruciate ligament (ACL) reconstruction are still concerns. Biomechanical investigations have highlighted the role of the anterolateral ligament (ALL) as a crucial knee stabilizer, and clinical outcomes after combined ACL and ALL reconstruction appear to indicate the success of the procedure.Purpose:To compare the functional

Background:While allografts are commonly used for anterior cruciate ligament reconstruction (ACLR), evidence to guide specific allograft selection is lacking.Purpose:To compare clinical and graft failure rates after ACLR using soft tissue–only allografts and bone–soft tissue allografts in adults.Study Design:Systematic review and meta-analysis; Level of evidence, 4.Methods:English-language studies

Background:There is a lack of evidence and continuous debate on whether femoral tunnel displacement substantially influences the clinical efficacy of medial patellofemoral ligament reconstruction (MPFL-R) in addressing recurrent patellar dislocation.Purpose:To investigate possible associations between inaccurate femoral tunnel placement during MPFL-R and clinical outcomes, with a specific focus on

Background:The Minimum Information for Studies Evaluating Biologics in Orthopedics (MIBO) guidelines were developed in May 2017 to encourage improved reporting standards, promote increased transparency and reproducibility, and enhance clinical evaluation capabilities. The MIBO guidelines consist of 23 checklist items considered necessary to critically appraise clinical studies evaluating platelet-rich

Background:Tobacco use is a known modifiable risk factor for postoperative complications and revision surgery after anterior cruciate ligament reconstruction (ACLR). Previous studies focus on tobacco as a broad categorization of traditional smoking, smokeless tobacco, and other forms of nicotine use. It is unclear if differences in the type of nicotine used lead to similar adverse outcomes after ACLR

Background:Anterior cruciate ligament (ACL) stress techniques—including single-leg stress radiographs, Telos, and KT-1000 arthrometer—are highly accessible and can provide additional diagnostic information to assess ACL and ACL graft integrity. The degree of anterior tibial translation (ATT) may be useful in guiding treatment when a diagnosis on magnetic resonance imaging is not conclusive or for judging

Background:Microfragmented adipose tissue has been proposed for intra-articular treatment of knee osteoarthritis. There are little data comparing the outcomes of treatment between microfragmented adipose tissue and other biological treatments.Purpose:To perform a systematic review and meta-analysis comparing microfragmented aspirated fat injections to other orthobiologics, hyaluronic acid, and corticosteroid

Background:Platelet-rich plasma (PRP) has emerged as a promising therapeutic intervention for knee osteoarthritis (OA), attracting substantial clinical and research attention. However, the clinical relevance of the treatment benefit remains controversial.Purpose:To evaluate the effectiveness of PRP compared with placebo in patients with knee OA in terms of minimal clinically important difference (MCID)

Background:Superior labral tears are common shoulder injuries among athletes, and for athletes undergoing surgical intervention, one of the main priorities is to return to preinjury levels of activity in a timely manner. However, the literature surrounding return to play after superior labral repair presents inconsistent results, with limited studies evaluating the timing of return to play.Purpose:To

Background:Arthroscopic repair with the biceps rerouting (BR) technique has been determined to lead to promising clinical and biomechanical outcomes for treating large-to-massive rotator cuff tears (LMRCTs). However, the in vivo effects of BR on glenohumeral kinematics during functional shoulder movements have not been fully elucidated.Purpose:To investigate whether BR provides a better restoration

Background:Traditional superior capsular reconstruction (SCR) with biceps tendon transposition (TB) alone for irreparable massive rotator cuff tears (IMRCTs) has demonstrated a high retear rate, highlighting the need for alternative approaches. Therefore, SCR using a peroneus longus tendon graft (PLG) combined with TB (PLG-TB) should be clinically studied.Purpose:To compare the clinical and radiological

Background:For patients with osteoporosis and rotator cuff tears, there is still no consensus on current treatment methods. The material, structure, and number of anchors have important effects on the repair outcome.Purpose:To investigate the use of chitosan quaternary ammonium salt–coated nickel-titanium memory alloy (NTMA) anchors to treat rotator cuff injury in shoulders with osteoporosis in a rabbit