The American journal of sports medicine
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Studies on midterm outcomes of the arthroscopic treatment of femoroacetabular impingement (FAI) and labral tears with mild osteoarthritis (OA) are limited. ⋯ The arthroscopic treatment of FAI and labral tears in patients with Tönnis grade 1 had good results at 5-year follow-up. After controlling for other variables using a matched-pair comparison, patients with Tönnis grade 1 had similar, durable improvements to those with Tönnis grade 0. While strict surgical indications and appropriate expectations are recommended for patients with mild OA, Tönnis grade 1 alone should not be considered a contraindication to hip arthroscopic surgery.
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In the knee joint, predisposition for patellar instability can be assessed by an abnormal Insall-Salvati index, tibial tuberosity-trochlear groove (TTTG) distance, and abnormal shape of patella and trochlea. Given the complex anatomic features of the knee joint with varying positions of the patella during motion, the presence of a single or even a combination of these factors does not inevitably result in patellar instability. After trocheoplasty in patients with trochlear dysplasia, assessment of trochlear cartilage and subchondral bone is limited due to postoperative artifacts. Identification of presence of edema in the patellar cartilage may be helpful to identify patellar instability before and after surgery in these patients. ⋯ Patellar cartilage at the lateral facet of the patella can be assessed after trochleoplasty despite postoperative artifacts in the trochlea. A decrease of patellar edema seems to be associated with improved femoropatellar articulation. Moreover, patellar edema may be used as a functional criterion of patellofemoral instability. This would provide additional information compared to morphologic criteria which just describe predisposing factors for femoropatellar instability.
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Injuries to the latissimus dorsi and teres major muscles, while rare, are debilitating. They are seen in a variety of sports, although disproportionately in the throwing shoulder of baseball pitchers. There have been 25 case reports and 2 case series published on the nonoperative and operative management of these injuries. ⋯ Return-to-play timing, shoulder strength, and healing on magnetic resonance imaging are variable. No standard of care currently exists for the treatment of latissimus dorsi or teres major injuries. If treating a patient with an injury to either muscle, the clinician should be familiar with accumulated experience as reported in the published literature.
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Comparative Study
Performance-Based Outcomes After Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ Between Sports.
Excellent outcomes have been reported for anterior cruciate ligament (ACL) reconstruction (ACLR) in professional athletes in a number of different sports. However, no study has directly compared these outcomes between sports. ⋯ The data indicate that NFL athletes fare the worst after ACLR with the lowest survival rate, shortest postoperative career length, and sustained decreases in performance. NHL athletes fare the best with the highest rates of RTP, highest survival rates, longest postoperative career lengths, and no significant changes in performance. The unique physical demand that each sport requires is likely one of the explanations for these differences in outcomes.
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It remains unknown how variations in body mass index (BMI) influence outcomes after primary hip arthroscopic surgery with capsular plication for femoroacetabular impingement (FAI). ⋯ In the current cohort, there were multiple potential confounding variables, and while some clinical differences were observed initially (higher HOS-ADL, HOS-Sports, and mHHS scores for normal BMI patients than overweight and obese patients at 2 years postoperatively; lower satisfaction scores for obese patients than normal BMI patients; and lower improvement in VAS pain scores for overweight, obese, and morbidly obese patients when compared with normal BMI patients), after multivariate analysis, no associations were observed between BMI and clinical outcomes after hip arthroscopic surgery with capsular plication for FAI.