bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paper 34: Supratubercle Anterior Closing Wedge Osteotomy: No Change in Patellar Height, Compared to Decreased Height for Medial Opening Wedge Proximal Tibial Osteotomy, and Significant Decreases in Anterior Tibial Translation at Six Months Postoperatively
Authors: Tollefson Luke , Kennedy Nicholas , Banovetz Mark , Homan Morgan , Engebretsen Lars , Moatshe Gilbert , Wulf Corey , Larson Christopher , LaPrade Robert 
Published: August 2024

Objectives: The purpose of this study was to radiographically assess changes in 1) patellar height, 2) anterior tibial translation (ATT), and 3) posterior tibial slope following supratubercle ACW-PTO and to compare changes in patellar height to a cohort of medial opening proximal tibial osteotomies (MOW-PTO). Methods: Patients who underwent supratubercle ACW-PTO by a single surgeon from July 2019-February 2023 were included. Institutional Review Board approval was obtained for this study. Radiographic assessment at four time points (preoperative, postoperative day 1, 3 months and 6 months) of patellar height (via the Caton Dechamps and Insall Salvati ratios), posterior tibial slope, and anterior tibial translation of the lateral tibial plateau relative to the lateral femoral condyle was completed. A comparison cohort of patients undergoing MOW-PTO was included for comparison of patellar height. Results: Patellar height averages ( n=16) after ACW-PTO using the Caton-Deschamps ratio (Figure 1) demonstrated a significant increase in patellar height on postoperative day 1 ( p=0.004), but were not significantly different at 3 and 6 months postoperatively (Table 2). Conversely, averages of patellar height after MOW-PTO ( n=28) demonstrated no difference on postoperative day 1, but then was significantly decreased by 6 months postoperatively ( p=0.005) (Table 1). There was a significant difference between the closing and opening-wedge cohorts when comparing the difference in patellar height using the CD ratio between preoperative and 6 months ( p=0.011). Anterior tibial translation in the ACW-PTO cohort was significantly decreased by an average of 9.0 mm from preoperative to postoperative values ( p<<0.001) (Figure 2). Posterior tibial slope in the ACW-PTO cohort was significantly decreased by an average of 11.8° from preoperative to postoperative values ( p<<0.001). Conclusions: Supratubercle ACW-PTO performed for ACL failure in the setting of increased tibial slope did not induce significant changes in patellar height postoperatively. Furthermore, following ACW-PTO there was a significant decrease in anterior tibial translation and posterior tibial slope.
Paper 42: No Difference in Acromial Morphology in Primary versus Revision Posterior Shoulder Instability Patients
Authors: Keeling Laura , Arner Justin , Spaeder David , Bradley James 
Published: August 2024

Objectives: To evaluate differences in acromial morphology between patients undergoing primary and revision arthroscopic stabilization for posterior shoulder instability. Methods: A series of patients who underwent either primary or revision arthroscopic stabilization for posterior shoulder instability between 2001 and 2022 were identified. Primary and revision patients were matched based on age, gender, and sport (contact/throwing). Patient demographics were collected, and acromial morphology was evaluated in both groups using previously described MRI parameters including posterior acromial tilt (PAT), anterior acromial coverage (AAC), posterior acromial coverage (PAC), and posterior acromial height (PAH). Continuous variables were compared between groups using a two-tailed Student’s t-test. Results: Seventeen patients who underwent revision posterior shoulder stabilization during the study period were identified and matched to 17 patients who underwent primary posterior shoulder stabilization. Mean ages of the primary and revision patients at the time of initial surgery were 18.1 (±3.5; 13-27) and 18.6 (±4.3; 12-29), respectively (p = 0.66). Males comprised 35% of each group. Mean PAT in the primary and revision groups was 50.76° (±9.51) and 50.29° (± 7.47) (p = 0.88), while mean PAH was 13.34 mm (±6.50) and 15.25 mm (±4.75) (p = 0.35), respectively. Mean AAC in the primary and revision groups was 8.18° (±7.73) and 10.35° (±9.50) (p = 0.48), while mean PAC was 70.59° (±9.26) and 65.94° (±6.78) (p = 0.12), respectively. Conclusions: Measurements of acromial morphology including posterior height, tilt, and coverage were not significantly different in a case matched cohort of patients undergoing primary vs. revision arthroscopic posterior shoulder capsulolabral repair. Prior studies have demonstrated that a “higher and flatter” acromion may predispose patients to posterior shoulder instability; however, this does not appear to affect the risk of failure of arthroscopic posterior capsulolabral repair.
Poster 107: Arthroscopic Bankart Versus Open Latarjet: Short-To-Mid-Term Outcomes Of Recurrence And Complications in Patients With Recurrent Anterior Shoulder Dislocation
Authors: Ghayyad Kassem , Akbarzadeh Meysam , Mirghaderi Seyed Peyman , Salimi Maryam , Ebrahimzadeh Mohammad H. , Kachooei Amir 
Published: August 2024

Objectives: This retrospective comparative study aimed to compare the short to mid-term outcomes, including recurrence, complications, and patient-reported outcome measures (PROMs) of arthroscopic Bankart and open Latarjet procedures in patients with recurrent anterior shoulder instability. Methods: All patients with recurrent shoulder instability who underwent either arthroscopic Bankart or open Latarjet procedures between 2008 and 2020 with at least 1-year of follow-up were included in the study. Their surgery results and patient-reported outcome measures were assessed using the Oxford Shoulder Score (OSS) and Shoulder Pain and Disability Index (SPADI). Results: One-hundred thirty-three patients were analyzed in 2 groups: Latarjet (n = 67) and Bankart (n = 66). Before surgery, the 2 groups of patients were similar regarding surgery side, education level, occupation difficulty level, and smoking (P > 0.05). However, Latarjet patients were younger (32 ± 9 vs. 35 ± 9, P=0.04), had a higher proportion of male patients (95.5% vs. 81.8%, P=0.01), and had a significantly shorter follow-up period (3.2 ± 2.6 vs. 6.4 ± 3.0 years, P<0.001) than the Bankart group. There was no significant difference between the Latarjet and Bankart groups regarding the follow-up OSS score (37 ± 6 vs. 36 ± 9; P=0.94) and SPADI score (22 ± 14 and 24 ± 20, P=0.80). There was only 1 case (1.5%) of dislocation in the Latarjet group, but none in the Bankart group (P=1.0). Subluxation was observed in 5 patients (7.5%) of the Latarjet group and in 3 patients (4.5%) of the Bankart group (P=0.4). In the Bankart group, male patients had significantly superior OSS and SPADI scores compared with female patients, and follow-up time was significantly correlated with better OSS score (r=0.28) and better SPADI score (r=-0.28) (P<0.05). Latarjet group results showed that younger age was significantly associated with better OSS (r=-0.26) and better SPADI scores (r=0.25 (P<0.05). Conclusions: Our findings confirm that both Bankart and Latarjet are reliable techniques in short- to mid-term follow-up based on the bone loss cut off of 15%. Patients can be consulted regarding early arthroscopic intervention soon after the shoulder dislocation becomes recurrent in contrast to waiting too long to require a more extensive Latarjet procedure, albeit with comparable outcomes.
Poster 168: Early Surgery Provides Superior Cost-Effectiveness When Compared to Nonoperative Management for Partial Tears of the Ulnar Collateral Ligament in Baseball Pitchers
Authors: Oeding Jacob , Jurgensmeier Kevin , Boos Alexander , Krych Aaron , Okoroha Kelechi , Camp Christopher 
Published: August 2024

Objectives: Nonoperative management vs. early reconstruction for partial tears of the medial ulnar collateral ligament (MUCL) remains controversial, with the most common treatment options for partial tears consisting of rest, rehab, platelet rich plasma (PRP), and/or surgical intervention. However, whether the improved outcomes reported for treatments such as MUCL reconstruction (UCLR) or nonoperative management with a series of PRP injections justifies their increased upfront costs remains unknown. Thus, the purpose of this study was to compare the cost-effectiveness of an initial trial of physical therapy alone, an initial trial of physical therapy plus a series of PRP injections, and early UCLR to determine the preferred cost-effective treatment strategy for baseball pitchers with partial tears of the MUCL. Methods: A Markov Chain Monte Carlo probabilistic model was developed to evaluate the outcomes and costs of 1,000 simulated pitchers undergoing nonoperative management with and without PRP vs. early UCLR for partial MUCL tears. Utility values, RTP rates, and transition probabilities were derived from the published literature. Costs were determined based on the typical patient undergoing each treatment strategy at our institution. Outcome measures included costs, acquired playing-years (PYs), and the incremental cost-effectiveness ratio (ICER). Results: Mean total costs resulting from nonoperative management without PRP, nonoperative management with PRP, and early UCLR were $22,520, $24,800, and $43,992, respectively. On average, early UCLR produced an additional 4.0 PYs over the 10-year time horizon relative to nonoperative management, resulting in an ICER of $5,395/PY, which falls well below the $50,000 willingness-to-pay threshold (WTP). Overall, early UCLR was determined the preferred cost-effective strategy in 77.5% of pitchers included in the microsimulation model, with nonoperative management with PRP determined the preferred strategy in 15% of pitchers and nonoperative management alone in 7.5% of pitchers. Conclusions: Based on Monte Carlo microsimulation and probabilistic sensitivity analysis, early UCLR was demonstrated to be more cost-effective than an initial trial of nonoperative management for partial tears of the MUCL for the majority of high-level baseball pitchers. It is important to note that this model does not consider the unique experiences, goals, situations, career trajectory, and pitching horizons of individual patients, and thus a shared decision-making discussion should be conducted regarding optimal initial treatment for partial MUCL tears. This is particularly true as many athletes can successfully be treated non-operatively, which generally results in a quicker return to play when successful compared to surgery.
Poster 186: The Utility of Preoperative Hip Injection Response as a Predictor of 2-Year Postoperative Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement
Authors: Pepic Lejla , Markes Alexander , Sampson Hayden , Soriano Kylen , Wong Stephanie , Zhang Alan 
Published: August 2024

Objectives: The objective of this study is to determine whether response to preoperative lidocaine or corticosteroid intra-articular hip injections can predict 2-year postoperative outcomes in patients undergoing arthroscopic management of femoroacetabular impingement syndrome (FAIS). Methods: We performed a retrospective analysis of a prospective cohort consisting of patients who received a preoperative corticosteroid or lidocaine intra-articular hip injection and subsequently underwent hip arthroscopy for treatment of FAIS between 2014-2020. Patients were classified by injection received and labeled as “responders” if the injection provided pain relief. Lidocaine and corticosteroid cohorts were matched using 1:1 matching for age, BMI, and sex. Patient reported outcome (PRO) measurements including the Hip Disability and Osteoarthritis Outcome Score (HOOS), 12-item Short-Form Survey mental (SF-12 MCS) and physical component survey (SF-12 PCS), and visual analog scale (VAS) Pain were completed both preoperatively and 2-years postoperatively. Mean differences in preoperative and 2-year postoperative scores were calculated as was the percentage of patients achieving a mean clinically important difference (MCID). Floor and ceiling effects of PROs were also evaluated with 15% of patients achieving a maximum or minimum survey score deemed as significant. Results: Our cohort included 110 patients (55 lidocaine, 55 corticosteroid) with no significant differences in preoperative demographic variables (Table 1). Both cohorts demonstrated significant 2-year postoperative score improvements across all PROs, except SF-12 MCS, which was unchanged. Lidocaine non-responders demonstrated greater 2-year mean difference in all PROs, except for SF-12 MCS, when compared to lidocaine responders (Table 2). Lidocaine non-responders also achieved MCID at higher rates than responders in both HOOS Pain & VAS Pain (Table 3). There was no difference in percentage of patients achieving MCID or mean difference in PROs between corticosteroid responders and non-responders. Ceiling and floor effects were seen in 2-year postoperative PROs of a combined lidocaine & corticosteroid responder cohort. [Ceiling: HOOS ADL (34.6%) HOOS Pain (21.0%) HOOS Sport (28.4%); Floor: VAS Pain (34.6%)] Conclusions: Preoperative intra-articular hip injection response did not predict 2-year postoperative outcomes after hip arthroscopy for FAIS. Results from this study suggest that preoperative injection response should not be used in isolation to predict outcomes after arthroscopic treatment of FAIS.
Poster 207: Muscle Activation in Postoperative Ambulation Protocols Following Proximal Hamstring Tendon Repair
Authors: Athanasian Christian , Czerwonka Natalia , Reynolds Alan , Mather Richard C. , Christian Robert A. 
Published: August 2024

Objectives: Postoperative rehabilitation protocols for patients undergoing proximal hamstring tendon repair have not been explored extensively. There is no consensus regarding the optimal rehab protocol and bracing strategy to protect the surgical repair. Herein, we have tested for the optimal postoperative weight-bearing and bracing protocol utilizing novel transcutaneous electromyography (EMG) technology. Methods: Healthy volunteers without any history of hip or knee surgery were included in this study. Participants first walked a standardized distance with Myontec Mbody 3 shorts, and then completed the following over the same standardized distance with crutches: flat foot weightbearing (FFWB), FFWB with a Newport abduction hip brace restricting motion past 90 degrees of flexion, FFWB with an unlocked hinged-knee brace, hinged-knee brace locked in 90 degrees of flexion, hinged-knee brace locked in 60 degrees of flexion, and hinged-knee brace locked in 30 degrees of flexion. Each condition was tested on both right and left extremities. Ipsilateral and contralateral quadricep, hamstring, and gluteal group muscle activation were measured. Data from each trial were standardized with the walking trial muscle activation as the reference. Primary outcome measures were normalized cumulative muscle group activation and normalized maximal muscle group activation. Results: ANOVA testing across the different trials demonstrated a statistically significant difference between means of ipsilateral hamstring standardized cumulative muscle activation (p= 0.00128) and means of ipsilateral hamstring standardized peak muscle activation (p= 0.00231). Tukey test of Honestly Significant Differences demonstrated significant differences between hinged-knee brace locked at 90 degrees and hinged knee brace locked at 30 degrees (p=0.0399208), and hinged-knee brace locked at 90 degrees and FFWB with unlocked hinged-knee brace (p=0.0235594) for normalized cumulative muscle activation. Significant differences were noted for normalized peak muscle activation between hinged-knee brace locked at 60 degrees and FFWB (p=0.0188864), hinged-knee brace at locked at 60 degrees and FFWB with a hip brace restricting motion past 90 degrees of flexion (p=0.0314595), and hinged-knee brace at 60 degrees and FFWB with hinged-knee brace unlocked (p=0.0046806). Conclusions: Statistically significant differences were noted in cumulative muscle activation and peak muscle activation between trials involving FFWB (including no brace, a hip brace, and an unlocked knee brace) and trials involving hinged-knee braces locked in a high degree of flexion, with better outcomes trials involving FFWB. No significant differences were noted between FFWB trials involving no brace or the use of a brace. Postoperative bracing may not be necessary, with FFWB without the use of a brace appearing to be a viable option for patients. [Figure: see text][Figure: see text]
Poster 227: Prospective Clinical and Radiological Follow-Up Beyond 10 Years in Patients Undergoing Matrix-Induced Autologous Chondrocyte Implantation (MACI) in the Patellofemoral Joint
Authors: Ebert Jay , Klinken Sven , Wood David , Janes Greg 
Published: August 2024

Objectives: Matrix-induced autologous chondrocyte implantation (MACI) has demonstrated encouraging outcomes in the treatment of knee cartilage defects, though limited research is available on its longer-term (≥10 years) sustainability in the patellofemoral joint. This prospective study sought to present and report the clinical and radiological outcome beyond 10 years in a prospectively recruited cohort of patients undergoing MACI in the patellofemoral knee joint. Methods: The current study included 82 patients (patella = 41, trochlea = 41) assessed at ≥10 years following patellofemoral MACI. Patients were assessed preoperatively and at 2, 5 and ≥10 years via the Knee Injury and Osteoarthritis Outcome score (KOOS), the 36-item Short Form Health Survey (SF-36), the frequency (VAS-F) and severity (VAS-S) of knee pain, patient satisfaction, active knee range of motion (ROM) and peak isokinetic knee extensor and flexor torque. High-resolution magnetic resonance imaging (MRI) assessed pertinent measures of graft outcome as per the magnetic resonance observation of cartilage repair tissue (MOCART) system, as well as an overall MRI composite score. Results were analyzed according to the graft location (patella or trochlea). Results: While no statistically significant differences (p>0.05) were observed between those undergoing patella or trochlea MACI across the majority of demographic (age, weight, BMI), injury history (duration of symptoms) or surgery (defect size, prior procedures, requirement for concomitant patellofemoral re-alignment) variables, a significantly higher (p=0.013) proportion of males was seen in the trochlea MACI group. All patient-reported outcome measures significantly improved (p<0.05), with no differences observed between those undergoing patella or trochlea MACI. No group differences (p>0.05) were observed in active knee flexion or extension ROM between groups, though those undergoing patella (versus trochlea) MACI demonstrated significantly greater postoperative quadriceps (Figure 1) and hamstring strength limb symmetry indices. No statistically significant decline (p>0.05) was seen from 2 years to final follow-up in any MRI-based measure, with no MRI-based differences observed between patella (Figure 2) and trochlea (Figure 3) grafts. In the cohort assessed at ≥10 years post-surgery, 4 patients (patella n=2, trochlea n=2) demonstrated graft failure on MRI, though a further 3 patients (all trochlea) were omitted from ≥10-year review that had already progressed toward total knee arthroplasty. Conclusions: Good clinical scores, high levels of patient satisfaction and adequate graft survivorship were observed at ≥10 years following MACI to the patella or trochlea.
Poster 279: The Influence of Tibial Length on Posterior Tibial Slope Measurement: How Much Tibia Do We Need?
Authors: Garra Sharif , Li Zachary I. , Triana Jairo , Savage-Elliott Ian , Kanakamedala Ajay , Campbell Kirk A. , Alaia Michael J. , Strauss Eric J. , Jazrawi Laith M. 
Published: August 2024

Objectives: The purpose of this study was to determine whether significant differences exist when comparing posterior tibial slope (PTS) measurements using increasing lengths of the tibia to determine the anatomical axis. Methods: Patients with full-length weightbearing tibial radiographs were retrospectively identified from 2014-2022 at a single institution. Patients were excluded if there was any previous history of lower extremity fracture or osteotomy. The anatomical axis of the tibia was determined using the full length of tibial radiographs, and the “reference PTS” was measured using this axis. Using the same radiograph, the PTS was measured using four different anatomical axes at standardized tibial lengths. While the center of the proximal circle remained constant at 5-cm below the tibial plateau, the center of the distal circle was drawn at four points: a) overlapping circles; b) 10-cm distal to the tibial plateau; c) 15-cm distal to the tibial plateau; d) half the length of the tibia, measured from the tibial plateau to the tibial plafond. Bivariate correlation and frequency distribution analysis (measurements >2-degrees from reference PTS) were performed between the reference PTS and PTS measured at each of the four other lengths. Results: A total of 154 patients (39.8±17.4 years old, 44.2% male) were included in the final analysis. Measurements at each of the four tibial lengths were all significantly different from the reference PTS (p<0.001). The correlation strength improved with increasing tibial length (overlapping: R=0.681, 10-cm: R=0.821, 15-cm: R=0.937, and half-tibia: R=0.963). The number of PTS measurements >2-degree absolute difference from the reference PTS decreased with increasing tibial length (overlapping: 40.3%, 10-cm: 24.0%, 15-cm: 26.0%, and half-tibia: 18.8%). Conclusions: Assessment of PTS is dependent on the length of the tibia utilized to obtain the anatomical axis. Accuracy and precision of PTS measurements improved with increasing length of tibia used to determine the anatomical axis.