Orthopaedic Journal of Sports Medicine

BACKGROUND: Identifying risk factors for an infection after anterior cruciate ligament reconstruction (ACLR) and following targeted preventive strategies can effectively reduce this potentially serious complication. PURPOSE: To perform a systematic review and meta-analysis to identify the risk factors for an infection after ACLR. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: The PubMed, Embase, and Web of Science databases were searched from inception to September 1, 2022, for prospective and retrospective studies investigating risk factors for any type of infection after ACLR...

BACKGROUND: Both partial- and full-thickness quadriceps tendon (QT) graft harvests are used for anterior cruciate ligament reconstruction (ACLR). PURPOSE: To evaluate the impact of QT graft harvest depth (full or partial thickness) on electromechanical delay (EMD), peak torque (PT), and rate of torque development (RTD) after ACLR. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 26 patients who underwent either partial-thickness (n = 14) or full-thickness (n = 12) autograft QT ACLR were recruited between June and November 2021 (>1 year before participation)...

BACKGROUND: Little League elbow, including humeral epicondylitis and osteochondritis dissecans, is a severe throwing injury in school-aged pitchers. Recent rule revisions have been implemented, and thus, prevention awareness may have increased. PURPOSE: To compare the incidence of elbow injury in 2011 from a previous study with that in 2021 and examine changes in the incidence and characteristics of players with elbow injuries. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...

BACKGROUND: Shoulder instability encompasses a spectrum of glenohumeral pathology ranging from subluxation to dislocation. While dislocation frequently leads to removal from play, athletes are often able to play through subluxation. Previous research on glenohumeral instability among athletes has largely focused on missed-time injuries, which has likely disproportionately excluded subluxation injuries and underestimated the overall incidence of shoulder instability. PURPOSE: To describe the epidemiology of shoulder instability injuries resulting in no missed time beyond the date of injury (non-missed time injuries) among athletes in the National Football League (NFL)...

BACKGROUND: There exists some controversy regarding whether patient age is a predictive factor for outcomes after high tibial osteotomy (HTO). PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate whether patient age affects clinical and radiological outcomes after medial open-wedge HTO (OWHTO) in a large population with a wider age range than previous studies. It was hypothesized that there would be no differences in outcomes when compared across age-groups...

BACKGROUND: Arthroscopic-assisted fixation of acute high-grade acromioclavicular (AC) joint dislocation has gained popularity in the last decade. Coracoclavicular (CC) fixation using the TightRope device is a less invasive technique. PURPOSE: To investigate CC ligament healing and functional outcomes after arthroscopic fixation using the TightRope device for acute AC joint disruption. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The study retrospectively analyzed the data of patients admitted for arthroscopic surgical treatment of acute AC joint injury using a single TightRope device...

BACKGROUND: Multiligament knee injuries involving the medial side are common. When performing surgical reconstruction, use of the medial hamstrings (HS) as grafts remains controversial in this setting. PURPOSE: To determine the role of the medial HS in stabilizing the valgus knee for different types of medial-sided knee injury. STUDY DESIGN: Controlled laboratory study. METHODS: A biomechanical study on 10 cadaveric knees was performed...

BACKGROUND: Glenohumeral dislocations often lead to glenoid bone loss and recurrent instability, warranting bony augmentation. While numerous biomechanical studies have investigated fixation methods to secure a graft to the glenoid, a review of available constructs has yet to be performed. PURPOSE: To synthesize the literature and compare the biomechanics of screw and suture button constructs for anterior glenoid bony augmentation. STUDY DESIGN: Systematic review...

BACKGROUND: There is concern for maintaining the integrity of the reflected head of the rectus femoris during arthroscopic hip joint access. Because of the proximity to the indirect head of the rectus femoris (IHRF), capsulotomy technique and capsular closure during routine hip arthroscopy may play a role in postoperative tendinitis. PURPOSE: To quantify the extent of injury sustained to the IHRF during interportal versus periportal capsulotomy for routine arthroscopic hip joint access...

BACKGROUND: Hip arthroscopy continues to advance and become increasingly commonly performed. With the evolution of techniques and instrumentation, labral repair rather than debridement has emerged as the treatment of choice for labral pathology. There remains a lack of data on long-term outcomes after labral repair. PURPOSE: To (1) evaluate long-term patient-reported outcomes of primary hip arthroscopy with labral repair for femoroacetabular impingement, (2) report achievement rates of Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID), and (3) investigate rates of reoperation and progression to total hip arthroplasty (THA)...

BACKGROUND: Developmental dysplasia of the hip (DDH) and trochlear dysplasia (TD) are distinct pathologies with several important features in common. In addition to shared risk factors, both forms of dysplasia cause abnormal joint kinematics and force transmission, predisposing patients to pain, injuries to cartilage and soft tissue stabilizers, and ultimately arthritis. PURPOSE: To evaluate for an association between hip dysplasia and TD in skeletally mature patients with symptomatic hip dysplasia...

BACKGROUND: Shoulder and elbow function is essential to basic basketball actions. Outside of anterior shoulder instability, injuries in these joints are not well characterized in National Basketball Association (NBA) players. PURPOSE: To describe the epidemiology and associated risk factors of shoulder and elbow injuries in NBA players and identify factors that influence player performance upon return to play. STUDY DESIGN: Descriptive epidemiology study...

BACKGROUND: Delayed anterior cruciate ligament (ACL) reconstruction has been associated with an increased risk of meniscal tears. However, studies comparing early versus delayed ACL reconstruction have not clearly demonstrated that meniscal tears diagnosed arthroscopically are new injuries as opposed to concomitant injuries sustained during ACL rupture. PURPOSE: To determine whether and how delay of ACL reconstruction is associated with risk of "new" meniscal tears (defined as those visualized arthroscopically that had not been detected on magnetic resonance imaging [MRI]) in adult and pediatric patients...

BACKGROUND: Several methods have been described to measure external rotation of the tibial tuberosity; all use femoral landmarks. PURPOSE: To develop reproducible tibial-based methods to measure external rotation of the tibial tuberosity in patients with patellar instability. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Included were magnetic resonance images of 61 patients with patellar instability and 61 age- and sex-matched healthy controls...

BACKGROUND: Children who participate in sports have reduced cardiovascular risk, obesity, and type 2 diabetes. However, sports participation also comes with an inherent risk of sports-related injuries. PURPOSE: To examine the efficacy of a school-based neuromuscular warm-up program (NWP) in reducing the risk of school sports injury (SSI) in children and the impact of different levels of compliance on the effectiveness of the program. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1...

BACKGROUND: In patients with osteochondral lesion, defects of the medial talus, or failed cartilage surgery, a periarticular osteotomy can unload the medial compartment. PURPOSE: To compare the effects of supramalleolar osteotomy (SMOT) versus sliding calcaneal osteotomy (SCO) for pressure redistribution and unloading of the medial ankle joint in normal, varus-aligned, and valgus-aligned distal tibiae. STUDY DESIGN: Controlled laboratory study...

BACKGROUND: Previous research suggests that estrogen plays a role in increased ligamentous laxity observed within the female population. Whereas many studies have sought to evaluate the impact of exogenous estrogen on anterior cruciate ligament injuries, research has not yet explored its impact on the medial patellofemoral ligament. Furthermore, less is known about the role of exogenous progesterone on ligamentous structures. PURPOSE: To determine whether women prescribed systemic estrogen (ethinyl estradiol) or progesterone (norgestimate or etonogestrel) hormonal contraceptives had an increased risk of undergoing reconstruction surgery for patellar instability compared with women without a prescription for systemic hormonal contraceptives...

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction (ACLR) is associated with postoperative pain and necessitates using perioperative nerve blocks and multimodal analgesic plans. PURPOSE: To assess postoperative pain and daily opioid use after ACL repair versus ACLR and to assess whether ACL repair could be performed successfully without using long-acting nerve blocks. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: All eligible patients who underwent ACL surgery between 2019 and 2022 were prospectively enrolled...

BACKGROUND: A knotless, tensionable primary anterior cruciate ligament (ACL) repair system preloaded with an internal brace has been released. Currently, there is no biomechanical data on the stabilization and gap formation behavior of the adjustable system when compared with fixed repairs in human ACL tissue. HYPOTHESIS: That knotless adjustable suture repair with an internal brace would provide overall higher construct stability and greater load share on the ACL with less gap formation compared with fixed repair...

BACKGROUND: Little is known about the stability of adjustable-loop devices (ALDs) for anterior cruciate ligament (ACL) reconstruction (ACLR). PURPOSE: To evaluate the stabilization behavior of 3 different types of ALDs for all-inside ACLR in a full-construct surgical technique-based manner. STUDY DESIGN: Controlled laboratory study. METHODS: The femoral and tibial devices of Ultrabutton (Smith & Nephew), Infinity (Conmed), and TightRope II (Arthrex) were applied to quadrupled bovine tendon grafts (n = 8 each) with tibial-sided traction applied (350 N) for graft tensioning in a simulated fully extended knee...