Femoroacetabular impingement (FAIS) is a common cause of hip pain and performance limitation in athletes. Hip arthroscopy is the gold standard of treatment in professional American football athletes, with numerous studies demonstrating favorable outcomes and high return-to-sport (RTS) rates. However, limited outcomes data exists in collegiate athletes and fewer still in high school athletes. The purpose of this study was to evaluate long-term patient-reported outcomes (PROs), RTS rates, and predictors of outcomes following hip arthroscopy for symptomatic FAIS in high school and collegiate football athletes. A retrospective cohort study was performed which included high-school and collegiate football athletes who underwent hip arthroscopy for symptomatic FAIS. Outcomes were assessed using the modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (IHOT-12), and Hip Outcomes Score-Sport Specific Subscale (HOS-Sport). Data regarding return to preinjury sport were also collected. Pre-operative radiographic data, including alpha angle, lateral center edge angle, and Tönnis grade, were collected. This cohort had a mean post-operative follow up of 6.3 years, with mean PRO scores of 82.2 on the mHHS, 84.6 on the iHOT-12, and 88.3 on the HOS-Sport. PASS thresholds were achieved by 69
To investigate changes in MRI-measured Caton–Deschamps index (CDI) at mid- to long-term follow-up following groove-deepening trochleoplasty (TP) combined with medial patellofemoral ligament reconstruction (MPFLR) and to compare these changes between single-bundle quadriceps tendon graft (QTG) and double-bundle hamstring tendon graft (HTG) reconstruction. Seventeen patients who had undergone TP with concomitant MPFLR were analyzed retrospectively. Patellar height was assessed preoperatively and postoperatively on sagittal magnetic resonance images by three independent observers using the CDI. Preoperative and postoperative CDI values were compared using a paired t-test. CDI changes were compared between single-bundle QTG (n = 9) and double-bundle HTG (n = 8) reconstruction using an independent-samples t-test. Interobserver reliability was assessed using the intraclass correlation coefficient (ICC). The mean CDI decreased significantly from 1.06 ± 0.13 preoperatively to 0.95 ± 0.15 postoperatively (Δ = −0.10 ± 0.07; P < 0.001). Significant postoperative reductions in CDI were observed in both subgroups (QTG: P = 0.002; HTG: P = 0.004), with no significant difference in CDI change between the groups (P = 0.77). Interobserver reliability was good for single measurements and excellent for measurements averaged across the three observers. Combined trochleoplasty and MPFL reconstruction was associated with a significant postoperative reduction in MRI-measured CDI at mid- to long-term follow-up, with an average decrease of − 0.10. Whether this finding reflects true anatomical patellar distalization cannot be determined from the present study.
One of the complications of COVID-19 infection is avascular necrosis of the femoral head. To date, various studies have reported a wide range of osteonecrosis of the femoral head in patients with COVID-19. The previous systematic review included only 14 studies. So, this systematic review aims to update the findings of these studies. Databases such as PubMed, Scopus, EMBASE, PsycINFO, Web of Science, and Google Scholar were systematically searched by two independent researchers on April 1st, 2024. A literature search revealed 1229 records, 161 full-texts were evaluated, and finally, 55 studies remained for systematic review. Fifty-five studies were included in this systematic review. Four studies were cross-sectional studies, six were retrospective studies, and the remaining (45studies) were case reports or case-series studies. Totally, 864 cases were included. Except for 12 studies, 43 studies reported the administration of steroid therapy in included cases. The most common underlying conditions were hypertension, followed by diabetes. In 274 (31.7
Kinematic alignment (KA) in total knee arthroplasty (TKA) of the varus knee shows promising clinical outcomes by preserving individual joint anatomy. However, it remains unknown whether this results in knee joint kinematics that more closely resemble the native baseline condition than mechanical alignment (MA). Therefore, this study evaluated the direct influence of KA versus MA on tibiofemoral and patellofemoral kinematics and contact biomechanics in the varus knee during a standardized dynamic muscle-loaded squat. Seven fresh-frozen human cadaveric knee specimens with constitutional varus (-1.4° to -8.3°) were tested in a dynamic knee rig (30° to 130° flexion) under muscle-controlled loading. Kinematics, retropatellar contact area, peak pressure, and quadriceps force were continuously recorded across three successive states within the same specimen: native, KA TKA, and MA TKA using a medial-pivot implant design. Statistical analysis was performed using one-dimensional statistical parametric mapping, including non-parametric SnPM1D ANOVA and pairwise SnPM{F} tests for kinematics, and paired-samples SPM{t} tests for contact mechanics and quadriceps force. Between alignment techniques (KA vs. MA), no statistically significant differences emerged regarding kinematics and patellofemoral biomechanics following Holm-Bonferroni correction (all padj > 0.05). Descriptively, KA displayed a trend toward unphysiological anterior femoral translation in deep flexion (100°–120°, p = 0.028; padj = 0.084) and persistent patellar medialization (delta of up to 5 mm) compared to MA, though these did not retain statistical significance post-adjustment. Both TKA techniques significantly reduced patellar contact area (padj < 0.01), illustrating a general TKA effect rather than an alignment-specific difference. KA was not shown to restore native knee kinematics or patellofemoral mechanics more closely than MA. Descriptive kinematic variations suggest that KA does not automatically optimize functional joint mechanics when using standard implant geometries.
Reported rates of loss of reduction in nonoperatively treated distal radius fractures (DRF) range from 17 to 71
