bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 116: When do Patients Return to Sports? Arthroscopic Anatomic Glenoid Reconstruction Versus Bankart Repair
Authors: Ojaghi Reza , Remedios Sarah , Wong Ivan 
Published: August 2024

Objectives: Participation in contact or collision sports is a known risk factor for shoulder instability. Recurrent instability is a barrier to return to same level of athletic activities following surgical intervention. Previous literature has described that approximately 50% to 90% of patients return to sports following stabilization procedures. However, it is currently unknown the rate and timing of return to sports after Arthroscopic Anatomic Glenoid Reconstruction (AAGR). This study aimed to determine the rate of return and the time to return to sports of patients’ who underwent AAGR compared to a Bankart, alone. Methods: This is a subcohort of 100 patients who consented to a randomized controlled trial and were randomized for AAGR or Bankart procedure (1:1 ratio). The subgroup consists of individuals at a minimum 2-year follow up and participate in a sport at either the recreational or competitive level. A descriptive analysis was completed on the percentage of patients that returned to their preinjury sport, as well as when they returned and compared between groups. Descriptive reporting on why patients did not return was included. Results: Age, follow up, sex, and sport level were all statistically similar between the 2 groups. The rate to return was significantly larger for patients in the AAGR group (78%) compared with the Bankart group (60%). For those who did return to sports, time to return was not significantly different between the AAGR group (9.48 ± 4.2 months) and Bankart group (10.2 ± 6.2 months). For those who did not return in the Bankart group, redislocation was the greatest factor (38%). In the AAGR group, prioritizing work and life (30%) and lack of confidence (30%) were the top reasons for not returning. Conclusions: AAGR demonstrated superior rate of return to sports compared to those who underwent a Bankart repair. Patients in the Bankart group did not return due to redislocation events, whereas individuals in AAGR did not return due to a lack of confidence or prioritizing their work and life. These results can aid in setting realistic expectations for patients undergoing AAGR and can help guide discussions around postoperative rehabilitation.
Poster 119: Outcomes of Shoulder Instability Surgery in Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 5 years Mean Follow Up
Authors: Camp Christopher , Marigi Erick , Lamba Abhinav , Boos Alexander , Wang Allen , Okoroha Kelechi , Barlow Jonathan , Krych Aaron , Meta Fabien 
Published: August 2024

Objectives: Wrestling is a physically demanding sport with young athletes prone to traumatic shoulder instability (SI). However, there is a paucity of data evaluating the results of shoulder instability surgery (SIS) in this cohort of athletes. The purpose of this study is to assess reoperation rates, patient-reported outcomes (PRO), and return to wrestling (RTW) following SIS in a cohort of competitive wrestlers. Methods: All competitive wrestlers with a history of SI and subsequent surgery at a single institution between 1996 and 2020 were identified. All directions of SI (anterior SI [ASI], posterior SI [PSI], and traumatic multidirectional SI [TMDI]) were analyzed. Exclusion criteria included revision SIS and less than 2 years of clinical follow-up. Patients were contacted for determination of reinjury rates, return to wrestling (RTW), and Western Ontario Shoulder Instability index (WOSI) scores. Results: Ultimately, 104 wrestlers were included at a mean follow-up of 5.2 years (range, 2.0 – 22.0). Fifty-eight (55.8%) wrestlers presented for evaluation after a single SI event while 46 (44.2%) sustained multiple events prior to presentation. ASI was the most common direction (n = 79; 76.0%) followed by PSI (n = 14; 13.4%), and TMDI (n = 11; 10.6%). Surgical treatment was most commonly an arthroscopic soft tissue stabilization (n = 88; 84.6%), followed by an open soft tissue repair (n = 13; 12.5%) and open bony augmentation (n = 3; 2.9%) (Table 1). RTW occurred in 57.3% of wrestlers at a mean of 9.8 ± 9.6 months. Recurrent instability was the most common complication in 18 (17.3%) wrestlers. Revision SIS was performed in 15 (14.6%) wrestlers (Table 2). Across the entire cohort, Kaplan-Meier survivorship free from recurrent instability (Figure 1) and revision surgery (Figure 2) was 91.4% and 98.1% at 1 year, 90.4% and 92.5% at 2 years, 71.9% and 70.7% at 5 years, and 71.9% and 66.5% at 10 years, respectively. Pre-operative recurrent instability was an independent risk factor for post-operative recurrent instability (Hazard ratio [HR], 3.8; 95% confidence interval [CI], 1.33 – 11.03; P = .012). Conclusions: Anterior shoulder instability was the most common direction among competitive wrestlers presenting for SIS. Wrestlers with multiple dislocations prior to initial clinical presentation were 3.8 times more likely to experience post-operative recurrent instability.
Poster 137: Psychological Readiness has Stronger Relationship with Patient Reported Return to Normal than Traditional Measures of Strength and Western Ontario Shoulder Instability Index
Authors: Meyer Alex , Twomey-Kozak John , Hurley Eoghan , Udoh Imoh , Briggs Damon , Lau Brian 
Published: August 2024

Objectives: Literature is scarce regarding the influence of psychological readiness on return-to-play (RTP) after shoulder instability surgery. The shoulder instability-Return to Sport after Injury (SIRSI) score is a tool designed to predict whether patients are psychologically ready to return to sports after glenohumeral stabilization surgery. The objective of this study is to correlate SIRSI, and traditional measures including strength testing and Western Ontario Shoulder Instability Index (WOSI) survey with patient’s self-reported Single Assessment Numeric Evaluation (SANE) score during rehabilitation and at the time of RTP. Methods: All patients who participated in athletics who underwent arthroscopic labral repair for shoulder instability from June 2021 to December 2022 with a fellowship trained orthopaedic surgeon were eligible to participate. SIRSI and WOSI scores and strength testing (Biodex testing) were administered at 4 months postoperatively and every 2 months until clearance based on functional testing battery (>90% limb symmetry, strength, rate of force development, shoulder stability and endurance). Pearson Correlation coefficients were calculated for survey metrics between SANE with SIRSI, WOSI, and strength testing at final follow up. Strength of correlation coefficients was reported as very strong >0.80, strong (0.60-0.79), moderate (0.40-0.59), weak (0.20-0.39), and very weak (0.00-0.19). Results: Overall, 22 patients who cleared objective functional testing criteria and completed appropriate surveys at return to sport. There was a mean age of 19.8 years (range 11-44 years), with 12 males and 10 females, and the mean follow up was 11 months (6-24 months). The mean final SANE scores at these time points were 79.12 (25-100). Pearson correlation between SANE and SIRSI, WOSI at time of return-to-play was 0.92, and 0.67 respectively. The correlation coefficients for strength testing at varying positions including closed kinetic chain upper extremity stability test, posterior shoulder endurance test LSI, and peak force in Y, T, I positions LSI were weak to moderate (0.20-0.59). Conclusions: The SIRSI had a stronger correlation than WOSI to patients self-reported return to baseline (SANE scores). This finding highlights the importance of psychological readiness in return to sport compared to traditional measures of strength testing and WOSI scores. SIRSI should be incorporated into functional test batteries for shoulder instability.
Poster 232: Clinical Outcomes of Medial Meniscus Allograft Transplantation (MAT) with or without High Tibial Osteotomy (HTO): A Case-Control Study up to 8 Years of Follow-up
Authors: Grassi Alberto , Lucidi Gian Andrea , Di Paolo Stefano , Altovino Emanuele , Agostinone Piero , Dal Fabbro Giacomo , Romandini Iacopo , Filardo Giuseppe , Zaffagnini Stefano 
Published: August 2024

Objectives: The purpose of this study was to compare the survival rates and clinical outcomes of patients who received medial MAT+HTO (MAT+HTO group) with a control group undergoing isolated medial MAT (MAT group), to define if a surgically corrected varus malignment may affect patient’s outcomes and the survivorship of MAT over time. The hypothesis was that there is no difference between the two groups and, therefore, a concomitant realignment procedure can be a valid treatment to restore the limb axis. Methods: A total of  110 patients underwent arthroscopic MAT with soft tissue technique: 55 underwent medial MAT and HTO (age 41.3 ± 10.4; 9 females) and 55 controls receiving isolated medial MAT were included after fuzzy case-control matching on demographics. Survival analysis was performed using the Kaplan–Meier curve with surgical failure, clinical failure (Lysholm score<65), and reoperations as endpoints. Subjective clinical scores (Lysholm, Tegner Activity Scale, KOOS, and VAS) were collected preoperatively and at final follow-up. Results: The mean follow-up time was 5.4 ± 3.4 years (up to 8 years). All outcomes significantly improved at the last follow-up (p<0.001). No differences were identified between MAT and MAT + HTO groups preoperatively and at the last follow-up (p>0.05). At final follow-up, 8/55 (14.5%) of the MAT+HTO patients and 9/55 (16.4%) of the MAT patients had a Lysholm <65 (p>0.05). Overall, 90% of the patients declared they would repeat the surgery regardless of the combined procedure. Surgical failure was identified in 6/110 patients (5.5%): 5/55 (9.1%) in the MAT+HTO group and 1/55 (1.8%) in the MAT group (p>0.05). Clinical failure was identified in 19/110 patients (17.3%): 11/55 (20%) in the MAT+HTO group and 8/55 (14.5%) in the MAT group (p>0.05). A significantly lower survivorship from surgical failure was identified in the MAT + HTO group (Hazard Ratio=5.1, p=0.049), while no differences in survivorship from reoperation and clinical failure were identified (p>0.05). Conclusions: Patients with varus malalignment and medial meniscus deficiency who are treated with combined medial MAT and HTO showed satisfactory clinical results at a mid-term follow-up, and thus malalignment represents only a relative contraindication for MAT.
Poster 290: Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age
Authors: Stone Kevin , Walgenbach Ann W. , Slatter Shadera , Turek Thomas J. , Ferguson-Dryden Caroline , Dicker Marie , Miltenberger Emma , Cowles Haley , Liu Vivian , Wu Stephanie , Vessal Mani 
Published: August 2024

Objectives: This study evaluates the utility of meniscus allografts in combination with other procedures to delay knee arthroplasty in patients older than 50 years of age previously advised to have a joint arthroplasty. The reason this study is important is because a 10-year delay in knee arthroplasty has been shown to reduce the lifetime revision rate. It was hypothesized that as opposed to debridement or meniscectomy alone, these subjects would benefit from a meniscus transplant in terms of improved knee symptoms, function, and delay of arthroplasty. Methods: One-hundred eight meniscus allograft transplants (MATs) using the arthroscopic 3-tunnel technique between 1997 and 2019 in patients over 50 were reviewed. Eighty-six of 108 (79.6%) patients met eligibility for this case series report. Inclusion criteria were patients recommended a knee arthroplasty with pain and preservation of some joint space by standing anterior-posterior and posterior-anterior flexion x-ray. Exclusion criteria were defined as lack of joint space, failure to comply with rehabilitation protocol or complete questionnaires. International Knee Documentation Committee and visual analog scale scores were obtained longitudinally. Time from meniscus transplantation to arthroplasty was measured with failure defined as allograft revision or excision, progression to arthroplasty, or same or increased pain. Results: Over the follow-up range of 2 to 25 years, 41 of 86 (47.6%) patients progressed to arthroplasty at a mean of 8.6 years. At the time of reporting, 41 of 86 (47.6%) patients had intact meniscus transplants. In subjects with intact meniscus allografts, significant improvements (p < 0.05) were observed in pain and function. These improvements were sustained through ten years post-operatively, which correlated to a mean of 65.8 years of age. Conclusions: Meniscus allografts in combination with other arthroscopic knee treatments delay arthroplasty and improve symptoms of pain and function in a population over 50 who are otherwise candidates for knee arthroplasty. Limitations include the lack of a control population and the difficulty separating the relative contribution of concomitant procedures from meniscus transplantation alone to the clinical benefit observed. [Figure: see text][Figure: see text]
Poster 300: Patellar Cartilage Width and Facet Measurements Associated With Improved Patellar Osteochondral Allograft Matching
Authors: Huddleston Hailey , Credille Kevin T. , Cregar William M. , Christian David , Trasolini Nicholas A. , Inoue Nozomu , Cole Brian J. , Yanke Adam B. 
Published: August 2024

Objectives: Few studies have investigated how to best select a donor patella for ideal surface matching when performing a patellar osteochondral allograft (OCA) transplantation. Prior studies have suggested that certain anatomic factors, such as degree of donor patellar dysplasia may play a role. Patella OCA sizing is currently based on tibial width, but other anatomic factors may improve OCA topography matching. The purpose was to investigate how donor and recipient anatomical variables influence patella OCA topography mismatch and articular step-off. Methods: In silico point-cloud models were generated from CT images of 16 patella specimens. Virtual donor allografts were implanted (diameter of 18.0 mm or 22.5 mm) in virtual defects on medial, central, and lateral articular surfaces (Figure 1). Topographical mismatch and step-off were calculated. Linear regression analysis was used to identify anatomic variables influencing these factors. Results: Overall, surface incongruity was largely unaffected by anatomic variables. For 22.5mm medial defects, medial facet length, cartilage width, and medial facet percent were significantly associated with step-off (p < 0.05). For lateral defects (both 22.5 mm and 18.0 mm), lateral facet length, cartilage width, and lateral facet percent had greater effects on articular step-off than tibial width. For 18.0mm medial defects and central defects, tibial width demonstrated a small effect on step-off (Table 1). Cartilage width and tibial width, as well as lateral length and lateral percent were significantly correlated with each other (p = 0.019) (Figure 2). Conclusions: For noncentral defects, articular step-off was strongly influenced by differences in medial or lateral facet length and percent and cartilage width. Tibial width, the current standard for allograft matching, only modestly influenced step-off for central, 18.0 mm medial, and 22.5mm lateral lesions. Since tibial width highly correlated with cartilage width, using cartilage width as a surrogate for tibial width may improve patellar osteochondral surface topography matching as it is a strong predictor of articular step off for non-central lesions. Medial and lateral facet length should also be considered for topography matching of lateral lesions and 22.5 mm medial lesions as they were the strongest overall correlates with articular step-off.
Poster 307: Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: 6-Year Follow up Results from the MARS Cohort
Authors: Fox Jake , Huston Laura , Wright Rick 
Published: August 2024

Objectives: Meniscal preservation has been demonstrated to contribute to long term knee health and has been a successful intervention in the isolated and ACL reconstructed patient. The long-term results of meniscus repair in the setting of revision ACL reconstruction have yet to be documented. The purpose of this study is to report the incidence of meniscal repair failures at 6-year follow-up in a cohort of patients who underwent concurrent revision ACL reconstruction and meniscal repair. Methods: All revision ACL reconstructions with concomitant meniscal repair cases from a multicenter group between 2006 and 2011 were selected. Six-year follow-up was obtained by both phone and email to determine whether any subsequent surgery had occurred to either knee since their initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify pathologic condition and treatment. Results: In total, 221 patients from 1234 revision ACL reconstructions underwent concurrent meniscal repairs (18% of the cohort). There were 238 repairs performed:  173 medial and 65 lateral. The vast majority of these repairs (n=181; 76%) were performed with an all-inside technique. Baseline patient and surgical characteristics of this group are reported (Tables 1, 2). Six-year surgical follow-up was obtained on 77% (171/221) of the cohort. Overall, the meniscal repair failure rate defined as reoperation was 13% (31/235) at 6 years. Of the 31 failures, 28 were medial (24 all-inside, 4 inside-out; 16% failure rate) and 3 were lateral (2 all-inside, 1 inside-out; 4.6% failure rate; Table 2). Three medial failures were treated in conjunction with a subsequent repeat revision reconstruction. The mean (SD) time to failure for the medial repairs was 2.6 (1.7) years, while the time to failure for the lateral repairs was 1.6 (1.8) years. Medial tears underwent reoperation for failure at a statistically significant higher rate than lateral tears (16% versus 4.6%; p<0.001). Conclusions: Meniscus repair in the revision ACL setting is a successful treatment option when clinically indicated with low failure rates. At 6-year follow-up, overall meniscal failure rate as defined by reoperation was 13% in this revision cohort. Failure rates for medial tears (16%) were higher than for lateral tears (4.6%), which aligns with previous studies both in the revision and primary setting.
Poster 353: Impact of Meniscus and Cartilage Treatment on Return to Sport Following Anterior Cruciate Ligament (ACL) Reconstruction
Authors: McCormick Elle , Maly Connor , Duchman Kyle , An Qiang , Leary Steven , Wolf Brian , Westermann Robert 
Published: August 2024

Background: Anterior cruciate ligament (ACL) tears are a common injury in athletes. ACL tears often occur with other injuries, including cartilaginous injuries. There is a lack of research regarding cartilage treatment on return to sport (RTS) following ACL reconstruction. Purpose: To evaluate the impact of meniscus and/or cartilage (meniscus-cartilage) treatment on return to sport (RTS) rates and time to return to sport following ACL reconstruction with hamstring tendon (HT), patellar tendon (BPTB), and quadriceps tendon (QT) grafts. Methods: Competitive and recreational athletes between the ages of 13-24 who had an ACL reconstruction between 2010-2022 were included. Activity level, sport, graft type, cartilage treatment, RTS testing result data, and time to RTS were collected. Chi-square statistics and Wilcoxon rank sum tests were used, and statistical significance was set to p<0.05. Results: There were 855 total patients with 354 HT, 361 BPTB, and 140 QT grafts of which 275 did not have meniscus-cartilage treatment and 580 received meniscus-cartilage treatment. Females comprised 52% of ACL reconstructions without meniscus-cartilage treatment and 42% of ACL reconstructions with meniscus-cartilage treatment. The median age was 18 and 17 for those receiving meniscus-cartilage treatment and those without treatment, respectively. Median time to RTS was 27.86 weeks for 151 patients without meniscus-cartilage treatment and 30.49 weeks for 299 patients receiving meniscus cartilage-treatment (p=0.0253). The median 6-meter timed hop ratio was 1.01 for 21 athletes with meniscus-cartilage treatment and 0.965 for 12 athletes without meniscus-cartilage treatment (p=0.0492). Median isokinetic quadriceps testing at 300 degrees per second was 85% of the contralateral leg for 170 athletes with meniscus-cartilage treatment and 85% for 67 athletes without meniscus-cartilage treatment (p=0.7181). Return to previous level of play occurred in 91/104 (87.5%) of those without meniscus-cartilage treatment and 196/220 (89%) of those with meniscus-cartilage treatment (p=0.6742). ACL and non-ACL reinjuries occurred in 18% (49/272) of those without and 20% (118/577) of those with meniscus-cartilage treatment (p=0.4047). Conclusions: Time to clearance to return to sport occurred more quickly in those without meniscus-cartilage treatment. Six-meter timed hop testing results were superior in those receiving meniscus-cartilage treatment. This study will aid orthopaedic surgeons and their athletes while addressing common concomitant injuries during ACL reconstruction.