American Journal of Sports Medicine




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Bony Remodeling of Adolescent Displaced Clavicle Fractures: A FACTS Study

Andrew T. Pennock, * MD , Tracey P. Bastrom, MA, Kelly E. Boutelle, BS, Alyssa N. Carroll, MPH, Eric W. Edmonds, MD, Jeffrey J. Nepple, MD, Samuel G. Polinsky, BA, David D. Spence, MD, Crystal Perkins, MD, Samuel C. Willimon, MD, FACTS Study Group, and Benton E. Heyworth, MD

doi : 10.1177/03635465231152884

Volume 51 Issue 4, March 2023

Bony remodeling of displaced clavicle fractures in adolescents remains poorly understood.

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Arthroscopic Bankart Repair for Adolescent Anterior Shoulder Instability: Clinical and Imaging Predictors of Revision Surgery and Recurrent Subjective Instability

Anthony C. Egger, * MD, S. Clifton Willimon, * MD, Michael T. Busch, * MD, Sam Broida, * BS, and Crystal A. Perkins,*y MD

doi : 10.1177/03635465231151250

Multiple clinical and radiologic risk factors for recurrent instability after arthroscopic Bankart repair have been described. Humeral bone loss has gained more recent attention, particularly with respect to “off-track� lesions and increased rates of recurrent instability and revision surgery.

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Disagreement Between the Accepted Best-Fit Circle Method to Calculate Bone Loss Between Injured and Uninjured Shoulders

Woo-Sung Do, * MD, Joo-Hyung Kim, * MD, Joon-Ryul Lim, * MD, PhD, Tae-Hwan Yoon, * MD, PhD, and Yong-Min Chun, *y MD, PhD

doi : 10.1177/03635465221149743

No study has evaluated whether best-fit circles based on glenoids with defects accurately represent normal inferior glenoids before injury.

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Predictors of Return to Work Following Primary Arthroscopic Rotator Cuff Repair: An Analysis of 1502 Cases

Ryan S. Ting, * Ron Rosenthal, * MD, Yaerhim Shin,* Mina Shenouda, * BMedSci, Hilal S. A. Al-Housni, * MD, Patrick H. Lam, * MD, PhD, and George A. C. Murrell, *y MD, Dphil

doi : 10.1177/03635465231152479

It is undetermined which factors predict return to work after arthroscopic rotator cuff repair.

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A Knitted PET Patch Enhances the Maturation of Regenerated Tendons in Bridging Reconstruction of Massive Rotator Cuff Tears in a Rabbit Model

Yuting Zhong, * MD , Wenhe Jin, * MD, Han Gao, * MD, Luyi Sun,* MD, Peng Wang, * MD, Jian Zhang,* MD, Michael Tim Yun Ong,y MD, Fu Sai Chuen Bruma,y MD, PhD, Shiyi Chen, * MD, PhD, and Jun Chen, *z PhD

doi : 10.1177/03635465231152186

Although nondegradable synthetic grafts for bridging reconstruction of massive rotator cuff tears (MRCTs) have shown satisfactory clinical outcomes, their function and details on graft-tendon healing and enthesis regeneration have not been fully studied.

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Early Postoperative MRI Evaluation of a Fascia Lata Autograft With and Without Polypropylene Mesh Augmentation After Superior Capsular Reconstruction

Hui Ben, * MD, Erica Kholinne,y MD, PhD, Chu Hui Zeng,z MMed, Sang-Pil So, * MD, Jun-Bum Lee, * MD, PhD, Yucheng Sun,§ MD, PhD, Kyoung-Hwan Koh, * MD, PhD , and In-Ho Jeon, * || MD, PhD

doi : 10.1177/03635465231151927

Recently, a polypropylene mesh has been introduced and reported to improve clinical outcomes after superior capsular reconstruction (SCR) using a fascia lata autograft (FLA). However, mesh-related events such as a foreign body response may trigger inflammation, which might affect graft healing and remodeling.

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Clinical Outcomes After Ulnar Collateral Ligament Reconstructions With Concomitant Ulnar Nerve Transposition in Overhead Athletes: A Matched Cohort Analysis

Jeffrey C. Lynch, *y DO , Emma E. Johnson,z BS, Michael C. Ciccotti,z MD, Brandon J. Erickson,z MD, Christopher C. Dodson,z MD, Steven B. Cohen,z MD, and Michael G. Ciccotti,z MD

doi : 10.1177/03635465231152890

Injury of the ulnar collateral ligament (UCL) has become increasingly common, particularly in overhead athletes. There is no consensus on management of the ulnar nerve in UCL reconstruction (UCLR) in patients with preoperative ulnar nerve symptoms, as literature supports both not decompressing the nerve as well as ulnar nerve transposition (UNT).

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Effect of High School Showcase Exposures and Timing of Ulnar Collateral Ligament Tear on Professional Baseball Careers in Elite Pitchers

John P. Kriz, * Steven DeFroda,y MD, ME, Steven J. Staffa,z MS, and Peter K. Kriz, §|| MD

doi : 10.1177/03635465221150509

Showcase participation has been considered a risk factor for elbow injuries. It remains unclear whether high school (HS) showcase volume negatively affects pitchers’ career paths.

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Effects of Contralateral Trunk Tilt on Shoulder and Elbow Injury Risk and Pitching Biomechanics in Professional Baseball Pitchers

Rafael F. Escamilla, *yz PhD, PT, CSCS, FACSM, Jonathan S. Slowik, § PhD, and Glenn S. Fleisig, § PhD

doi : 10.1177/03635465231151940

Baseball pitchers employ various contralateral trunk tilt (CTT) positions when pitching depending on if they have an overhand, three-quarter, or sidearm delivery. There are no known studies that have examined how pitching biomechanics are significantly different in professional pitchers with varying amounts of CTT, which may provide insight into shoulder and elbow injury risk among pitchers with different CTT.

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The Associations Between Quadriceps Tendon Graft Thickness and Isokinetic Performance

Michael I. Letter, *y PhD, PA-C, Rosalia L. Parrino,y MS, Will Adams,y DC, Zachary Ripic,y PhD, Michael G. Baraga, * MD, Lee D. Kaplan, * MD, Tanner Harrah,z DO, Julien Tremblay, § BS, Dylan Luxenburg, § BS, Joseph Conti,y and Joseph F. Signorile,y{ PhD

doi : 10.1177/03635465231152899

Anterior cruciate ligament reconstruction (ACLR) using the quadriceps tendon is an increasingly popular technique. Both partial-thickness quadriceps tendon (PT-Q) and full-thickness quadriceps tendon (FT-Q) graft depths are employed.

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Determination of Standard Values for Knee Version in a Healthy Population

Felix Huettner, *y MD, Christoph Lutter,yz MD, PhD , Constantin Zuehlke, § MD, Mauricio Kfuri, || MD, PhD, Thomas Tischer,y{ MD, PhD , and Joerg Harrer, * # MD

doi : 10.1177/03635465231152475

Different measures are used to describe relevant anatomic variations that can result in patellofemoral instability and disorders. Knee version, the relative rotational alignment between the femur and tibia in the axial plane at the level of the knee, may have a decisive effect on the kinematics of the patellofemoral joint. However, data regarding the values of knee version are currently lacking.

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Aragonite-Based Scaffold Versus Microfracture and Debridement for the Treatment of Knee Chondral and Osteochondral Lesions: Results of a Multicenter Randomized Controlled Trial

Nir Altschuler, * MSc, Kenneth R. Zaslav,y MD, Berardo Di Matteo,z§|| MD, PhD, Seth L. Sherman,{ MD, Andreas H. Gomoll, # MD, Scott A. Hacker, ** MD, MS, Peter Verdonk,yy MD, PhD, Oliver Dulic,zz MD, PhD, Jenel M. Patrascu, §§ MD, PhD, Andrew S. Levy, || || MD, Dror Robinson,{{ MD, PhD, and Elizaveta Kon,z§ MD

doi : 10.1177/03635465231151252

Lesions of the articular cartilage, with or without involvement of the subchondral bone, are a common cause of pain and dysfunction in the knee. Although several treatment options have been developed, the majority of previous clinical trials examined patients with isolated or focal midsized defects, which rarely represent the condition found in the general population. Rather, cartilage lesions are often associated with the presence of mild to moderate osteoarthritic changes.

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Effect of Anterolateral Ligament Status and Inherent Knee Anatomy on Anterior Tibial Subluxation of the Lateral Compartment After Acute Anterior Cruciate Ligament Injury: A Cohort Study Based on MRI Analysis

Tong Zheng, * MD, Guanyang Song, * MD, Chao Wang,y MD, Yue Li, * MD, Zhijun Zhang, * MD, Yanwei Cao, * MD, Zheng Feng, * MD, Menglinqian Di, * MS, and Hui Zhang, *z MD

doi : 10.1177/03635465231151694

Anterior tibial subluxation (ATS) of the lateral compartment entails a pathological tibiofemoral alignment in knees with anterior cruciate ligament (ACL) injury. Causes of increased ATS after an acute ACL injury are not clear, but soft tissue abnormalities and bony variations of the knee are potential causes.

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Higher Association of Pelvis-Knee-Ankle Angle Compared With Hip-Knee-Ankle Angle With Knee Adduction Moment and Patient-Reported Outcomes After High Tibial Osteotomy

Koji Iwasaki, *y MD, PhD, Yasumitsu Ohkoshi,z MD, PhD, Yoshiaki Hosokawa, § MD, PhD, Shuya Chida,|| PT, MSc, Kengo Ukishiro, || PT, MSc, Kensaku Kawakami,{ PhD, Sho’ji Suzuki, # PhD, Tatsunori Maeda,z MD, PhD, Tomohiro Onodera, § MD, PhD, Eiji Kondo, ** MD, PhD, and Norimasa Iwasaki, § MD, PhD

doi : 10.1177/03635465221150513

High tibial osteotomy (HTO) reduces the load distribution of the medial compartment by modifying leg alignment. Knee adduction moment (KAM), a surrogate measure of dynamic loading in the knee joint, decreases after HTO. However, leg alignment does not fully account for KAM.

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Diagnostic Accuracy of Conventional Ankle CT Scan With External Rotation and Dorsiflexion in Patients With Acute Isolated Syndesmotic Instability

Joa ̃ o Carlos Rodrigues, *yz MD, PhD , Adham do Amaral e Castro,y§ MD, PhD , Laercio Alberto Rosemberg,yz MD, PhD, Cesar de Cesar Netto, || MD, PhD, and Alexandre Leme Godoy-Santos,{# MD, PhD

doi : 10.1177/03635465231153144

Syndesmotic injury in an athletic population is associated with a prolonged ankle disability after an ankle sprain and often requires a longer recovery than a lateral collateral ligament injury. Although several imaging tests are available, diagnosing syndesmotic instability remains challenging.

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Effect of Posterior Malleolar Fixation on Syndesmotic Stability

Ingrid Kvello Stake, *yz§ MD, Anna R. Bryniarski,z BS, Alex W. Brady,z MS, Jon W. Miles,z MSc, Grant J. Dornan,z MS , Jan Erik Madsen, §|| MD, PhD, C. Thomas Haytmanek,z{ MD, Elisabeth Ellingsen Husebye, || MD, PhD, and Thomas O. Clanton,z{ MD

doi : 10.1177/03635465231151448

Transsyndesmotic fixation with suture buttons (SBs), posterior malleolar fixation with screws, and anterior inferior tibiofibular ligament (AITFL) augmentation using suture tape (ST) have all been suggested as potential treatments in the setting of a posterior malleolar fracture (PMF). However, there is no consensus on the optimal treatment for PMFs.

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Two Novel Clinical Tests for the Diagnosis of Hip Labral Tears

Farshad Adib, * MD, Jacob Hartline,y MD, J. Skye Donovan,z PT, PhD, Kourosh Kalachi,y BS, Pegah Dehghan, § MD, and Derek Ochiai, * || MD

doi : 10.1177/03635465221149748

There are few well-studied clinical tests for the diagnosis of hip labral tears. As the differential diagnosis for hip pain is broad, accurate clinical examination is important in guiding advanced imaging and identifying patients who may benefit from surgical management.

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Limited External Rotation and Hip Extension Due to Posterior Extra-articular Ischiofemoral Hip Impingement in Female Patients With Increased Femoral Anteversion: Implications for Sports, Sexual, and Daily Activities

Adam Boschung, * MD, Tiziano Antioco,y MD, Simon D. Steppacher,z MD, Moritz Tannast, * MD, Eduardo N. Novais, § MD, Young-Jo Kim, § MD, and Till Dominic Lerch, §||{ MD, PhD

doi : 10.1177/03635465231153624

Posterior femoroacetabular impingement (FAI) is poorly understood. Patients with increased femoral anteversion (FV) exhibit posterior hip pain.

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Tissue Regrowth and Its Vascularization Through Bone Marrow Stimulation: Microfracture at the Acetabular Rim for Irreparable Labral Tear in a Porcine Model

Tiao Su, * MD, Yunong Ao, * MD, Liu Yang, *y MD, and Guang-xing Chen, *y MD

doi : 10.1177/03635465231151226

The treatment of irreparable acetabular labral tear remains a great challenge. Whether fibrocartilage-like tissue can regrow with sufficient volume to fill the labral defect area through bone marrow stimulation remains unknown.

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Exploring the Mechanism of Microfracture in the Treatment of Porcine Full-Thickness Cartilage Defect

Hui Li, *y Zihao He, *y Wenjing Li,z Jiaying Yao, § Cheng Lyu,z Yanan Du,z Dan Xing, *y|| MD, PhD, and Jianhao Lin,*y|| MD, PhD

doi : 10.1177/03635465231153630

Microfracture has the most extensive clinical application because of its advantages of a single operation, unified process, and low operation cost. Because research on the repair mechanism of microfractures in the treatment of cartilage defects is not in-depth, this study aimed to elucidate the mechanism.

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T Helper 17–Like Regulatory T Cells in Equine Synovial Fluid Are Associated With Disease Severity of Naturally Occurring Posttraumatic Osteoarthritis

aura E. Keller, * PhD, Elia D. Tait Wojno,y PhD, Laila Begum, * PhD, and Lisa A. Fortier, *z DVM, PhD, DACVS

doi : 10.1177/03635465231153588

Infiltration of cluster of differentiation (CD) 3+ (CD3+) T cells into the synovium and synovial fluid occurs in most patients with posttraumatic osteoarthritis. During disease progression, proinflammatory T helper 17 cells and anti-inflammatory regulatory T cells infiltrate the joint in response to inflammation.

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Using an Affordable Motion Capture System to Evaluate the Prognostic Value of Drop Vertical Jump Parameters for Noncontact ACL Injury

Jason Corban,* HBSc, MDCM , Nicolaos Karatzas,y MSc , Kevin Y. Zhao,yz Athanasios Babouras, § BSc , Stephane Bergeron, §|| MPH, MDCM, Thomas Fevens,{ PhD, Hassan Rivaz, # PhD, and Paul A. Martineau, * §# **yy HBSc, MDCM, ABOS, SCOSM

doi : 10.1177/03635465231151686

Knee kinematic parameters during a drop vertical jump (DVJ) have been demonstrated to be associated with increased risk of noncontact anterior cruciate ligament (ACL) injury. However, standard motion analysis systems are not practical for routine screening. Affordable and practical motion sensor alternatives exist but require further validation in the context of ACL injury risk assessment.

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The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods

Marco Franceschini, * MD, Angelo Boffa, *y MD , Elettra Pignotti,z Luca Andriolo, * MD , Stefano Zaffagnini, * MD, Prof., and Giuseppe Filardo,z MD, PhD, MBA, Prof.

doi : 10.1177/03635465231152484

The minimal clinically important difference (MCID) for patient-reported outcome measures (PROMs) expresses both the extent of the improvement and the value that patients place on it. MCID use is becoming increasingly widespread to understand the clinical efficacy of a given treatment, define guidelines for clinical practice, and properly interpret trial results. However, there is still large heterogeneity in the different calculation methods.

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How Does Platelet-Rich Plasma Compare Clinically to Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review and Meta-analysis

Lauro Augusto Veloso Costa, * MD, MSc, Ma � rio Lenza, * MD, PhD, James J. Irrgang,y PT, PhD, Freddie H. Fu,y MD, PhD, and Ma � rio Ferretti, *z MD, PhD

doi : 10.1177/03635465211062243

There has been an increase in interest in the use of biological therapies in orthopaedic conditions such as knee osteoarthritis. Platelet-rich plasma (PRP) is one of these therapies, but it still lacks consistent results.

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Core Muscle Injury: Evaluation and Treatment in the Athlete

Julianne M. Forlizzi, * MD , Mark B. Ward, * BS, James Whalen,y ATC, Thomas H. Wuerz, * MD, and Thomas J. Gill IV, *z§ MD

doi : 10.1177/03635465211063890

Pain in the groin region, where the abdominal musculature attaches to the pubis, is referred to as a “sports hernia,�“athletic pubalgia,� or “core muscle injury� and has become a topic of increased interest due to its challenging diagnosis.

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Outcomes of Arthroscopic Decompression of the Anterior Inferior Iliac Spine: A Systematic Review and Meta-analysis

Andrew L. Schaver, * BS, Steven M. Leary,y BS, Jacob L. Henrichsen, * MD, Christopher M. Larson,z MD, and Robert W. Westermann, * § MD

doi : 10.1177/03635465211062903

Anterior inferior iliac spine (AIIS) impingement has been increasingly recognized as a source of extra-articular impingement and hip pain. However, no aggregate data analysis of patient outcomes after AIIS decompression has been performed.

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Early and Delayed Surgery for Isolated ACL and Multiligamentous Knee Injuries Have Equivalent Results: A Systematic Review and Meta-analysis

Harmen D. Vermeijden, *yz MD, Xiuyi A. Yang, * MS, Maarten V. Rademakers,y MD, PhD, Gino M.M.J. Kerkhoffs,z§|| MD, PhD, Jelle P. van der List, *yz MD , and Gregory S. DiFelice, *{ MD

doi : 10.1177/03635465211069356

Early surgery for acute ligamentous injuries has recently shown good clinical and functional outcomes.

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