bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 142: Location of Shoulder Glenoid Labral Tears: A Study of 1763 Consecutive Patients
Authors: Nammour Michael , Mohr Damaris , Arner Justin , Bradley James 
Published: August 2024

Objectives: To examine the location of surgically repaired labral tears by a single surgeon over a consecutive 23-year period. Methods: A total of 1763 consecutive patients who underwent arthroscopic or open shoulder labral repair by a single sports medicine fellowship trained orthopedic surgeon were retrospectively reviewed between April 2000 and April 2023. Current procedural terminology codes were utilized to identify patients which included 29806, 29807, 29822, and 29823. Exclusion criteria included isolated shoulder manipulation or glenohumeral joint or labral debridement which did not include repair. Intraoperative glenoid labral tears observed were categorized into 6 broad categories which included (1) anterior labral tears, (2) posterior labral tears, (3) superior labral anterior to posterior (SLAP) type 2 tears (a, b, or c), (2) SLAP type 5 tears, (3) SLAP type 8 tears, or circumferential tears (combined SLAP, anterior and posterior labral tear). Shoulders diagnosed with multiple tear patterns (ie anterior and posterior) were also noted. Results: During the 23-year period, 1763 patients underwent arthroscopic or open labral repair which included 1295 male patients and 468 female patients, ranging from ages 12 to 70, with a mean age of 23.2 and median age of 19. Overall, 28.4% of tears involved the anterior labrum, 64.9% involved the posterior labrum, and 59.7% involved the superior labrum. Regarding isolated tears, 9.25% were isolated anterior labral tears, 19.7% were isolated posterior labral tears, 11.4% involved the anterior and posterior labrum, 22.2% were isolated SLAP type 2 tears, 3.63% were isolated SLAP type 5 tears, and 29.7% were isolated SLAP type 8 tears, and 4.01% were circumferential tears. Conclusions: In contrast to historic ideology, posterior shoulder labral tearing was more common than anterior in a large consecutive series of 1763 patients who underwent surgical repair. This highlights the importance of posterior labral pathology which sometimes may be overlooked due to more vague complaints, including pain and loss of function, being most common.
Poster 196: Comparison of Short-Term Outcomes Following Hip Arthroscopy With Labral Repair Versus Labral Augmentation
Authors: Fasulo Sydney , Marder Ryan , Nadeau Nicolas , Richards Sean , Nugent Robert , Dave Neil , Maguire James , Kraeutler Matthew , Scillia Anthony 
Published: August 2024

Objectives: The treatment of labral pathology during hip arthroscopy has evolved over the last decade or more. Recently, the use of labral augmentation or reconstruction with allograft for the treatment of irreparable or tissue-deficient labral pathology has demonstrated favorable outcomes. The purpose of this study was to compare the clinical outcomes of patients undergoing hip arthroscopy with labral repair (LR) versus labral augmentation (LA). Methods: A prospective, single-surgeon cohort study was performed on all patients undergoing hip arthroscopy with LR or LA between September 2019 and April 2022. For patients with labral deficiency or a hypotrophic labrum, labral augmentation was performed by addition of iliotibial band allograft to a segment of the repair construct. An electronic survey of patient-reported outcome measures (PROMs) was completed by each patient at a minimum of 1-year postoperatively. PROMs included a visual analog scale (VAS) for pain, University of California - Los Angeles (UCLA) Activity Scale, modified Harris Hip Score (mHHS), Hip Outcome Score-Sport (HOS-Sport), and a Single Assessment Numeric Evaluation (SANE). Results: Seventy-nine patients were reached for follow-up (52 LR, 27 LA). No differences were found between the LR and LA groups in terms of age at surgery (34 ± 13 vs 38 ± 13 years, p = 0.15), sex (52% vs 74% female, p = 0.09), or body mass index (26 ± 7 vs 24 ± 5 kg/m2, p = 0.22). Due to a more recent adoption of the LA technique to the senior surgeon’s practice, there was a significantly longer time to follow-up in the LR group (LR: 26 ± 8 months, LA: 20 ± 7 months, p < 0.001). There was a significantly higher HOS-Sport (80.7 ± 21 vs 67.9 ± 33, p=0.04) and SANE (86.7 ± 16 vs 74.4 ± 29, p = 0.02) in the LR group. However, there were no significant differences between groups in other postoperative PROMs including VAS (2.1 ± 2.1 vs 3.0 ± 2.8, p = 0.10), UCLA Activity Scale (7.8 ± 2 vs 7.3 ± 3, p = 0.35), and mHHS (78.6 ± 13 vs 72.5 ± 17, p = 0.09). Conclusions: Our study identified mixed short-term functional outcomes when comparing the use of labral augmentation to labral repair in a young and active population. With the evolution of hip arthroscopy and advancements in surgical technique, our study does support the cautious use of labral augmentation when indicated. Larger studies are warranted to corroborate these findings.
Poster 198: Patient Satisfaction 2 Years After Hip Arthroscopy for Femoroacetabular Impingement Syndrome Predicts 10-Year Outcomes
Authors: Wright-Chisem Joshua , Alvero Alexander , Vogel Michael , Nho Shane 
Published: August 2024

Objectives: To evaluate if patient satisfaction 2 years after primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) predicts 10-year minimum patient-reported outcomes (PROs), clinically significant outcomes, and survivorship. Methods: Patients who underwent primary hip arthroscopy for FAIS between June 2012 and December 2012 with minimum 10-year follow-up were identified. Patients were partitioned into High Satisfaction and Low Satisfaction groups based on their achievement of Patient Acceptable Symptom State (PASS) for visual analog scale for satisfaction (VAS-Satisfaction) at 2 years postoperatively using a previously defined PASS threshold for VAS-Satisfaction. Ten-year minimum PRO scores were then compared between the groups, including Hip Outcome Score – Activities of Daily Living (HOS-ADL) subscale and Hip Outcome Score – Sport Specific (HOS-SS) subscale, modified Harris Hip Score (mHHS), visual analog scale for pain (VAS-P) subscale, and VAS-Satisfaction. Achievement of 10-year PASS for HOS-ADL, HOS-SS, mHHS, VAS-P, and VAS-Satisfaction were compared between groups. Kaplan-Meier survival analysis was used to compare reoperation-free survivorship between groups. Results: Of the 120 consecutive eligible patients, 85 were included (70.8% compliance) with an average age of 34.0 ± 12.8 years, 60.9% female, and an average BMI of 25.4 ± 4.6 kg/m2. Fifty-six patients achieved PASS for VAS-Satisfaction at 2 years postoperatively, and 29 did not. No significant demographic differences were observed between groups (p ≥ 0.357). At 10-year follow up, the High Satisfaction group demonstrated significantly greater HOS-ADL, HOS-SS, mHHS, VAS-P, and VAS-Satisfaction scores (p ≤ 0.031, for all) and significantly greater PASS achievement for all PROs (p ≤ 0.015, for all). Kaplan-Meier survival analysis demonstrated significantly greater reoperation-free survivorship for the High Satisfaction group (p < 0.001) with a significantly lower rate of reoperation (1.8% vs. 24.1%, p = 0.002). Conclusions: Patients who achieved PASS for VAS-Satisfaction 2 years after hip arthroscopy for FAIS showed superior 10-year minimum patient-reported outcomes, higher achievement of 10-year PASS, and a lower reoperation rate compared to those who did not achieve PASS for VAS-Satisfaction at 2 years.
Poster 272: Age-Based Differences in Characteristics of Pediatric Discoid Lateral Meniscus
Authors: Niu Emily , Sheasley Jennifer , Gopalan Maya , Gupta Apeksha , Carsen Sasha , Stinson Zachary , Finlayson Craig , Nault Marie-Lyne , Lee Rushyuan J. , Haus Brian , Green Daniel W. , Schlechter John , Heyworth Benton E. , Beck Jennifer , Nguyen Jie , Schmale Gregory A. 
Published: August 2024

Objectives: Discoid lateral meniscus (DLM) in pediatric patients presents across a broad age range. It is unknown whether clinical presentation and DLM morphology differ between age groups. This study investigates age-based differences in DLM characteristics from a multi-center retrospective database of DLM. We hypothesize that there are predictable differences in presentation and DLM morphology between age groups. Methods: This retrospective study included surgically treated DLM patients between January 2000 and March 2020 from 9 centers in North America. Patients’ demographic and clinical characteristics were collected. Statistical analysis was performed to compare characteristics of DLM between age groups: < 7, 7-10, 11-13, 14-16, and ≥ 17 years. Kruskal-Wallis test and Chi-square or Fisher Exact test were used to compare age groups for continuous and categorical variables, respectively. Statistical significance was defined as p-value < 0.05. Results: 868 patients with mean age 12 years (range: 1-22 years) were included for analysis. More patients were female (57%) than male, especially in the younger age groups. The proportion of patients in each age group: <7 years (7.6%), 7-10 years (25.8%), 11-13 years (28.2%), 14-16 years (25.2%), ≥17 years (13.1%). Patients <7 years had significantly longer duration from initial presentation to surgery (median 214 days vs ≥17 years 28.5 days; p<0.05). Among patients <7 years, over 40% presented with a complaint of either “snapping” or “clunking.” Meanwhile, patients aged ≥17 years more commonly presented with complaints of swelling (33%) and locking (44%) [Figure1]. Incidence of discoid meniscus tear was highest among patients ≥17 years (80.7%), and lowest among <7 years (56.1%). Among patients with tear (N=648), patients ≥17 years were significantly more likely to have radial and parrot beak tears compared to other age groups (radial 18.5%, parrot beak 7.6%; Table 1). Patients 13 and under were more likely to have stiffness on exam (18%-25%) compared to patients 14 years and older (10%-13%; p<0.05). During surgery, patients 13 years and younger were more likely than older patients to have instability of the meniscus (41%-48% vs 26%-30%; p<0.05) and meniscus repair (46%-48% vs 32%-33%; p<0.05). Conclusions: Younger patients tend to present with “clunking” DLM and do not typically proceed acutely to surgery. They are more likely to have preoperative stiffness and instability, and more likely to undergo meniscus repair. Older patients are more likely to have a tear, and receive more acute treatment, though repair Is less frequent. These age-based differences in presentation and characteristics of DLM are important in counseling these patients and treatment decision-making.
Poster 289: Impact of Graft Selection on Clinical Outcomes following Isolated MPFL Reconstruction in Adolescent and Young Adult Athletes
Authors: Tisano Breann , Quinn Michael , Warner Tyler , Kramer Dennis E. , Yen Yi-Meng , Kocher Mininder S. , Heyworth Benton E. 
Published: August 2024

Objectives: Patellofemoral instability (PFI) commonly requires surgical intervention in adolescent and young adult athletes. However, the clinical impact of graft selection, which may vary amongst surgeons, has not been well studied. The purpose of this study was therefore to compare clinical outcomes, including recurrent instability reoperations and complications, of medial patellofemoral ligament reconstruction (MPFLR), based on graft type. Methods: Electronic medical records of patients who underwent primary MPFLR surgery for PFI over a 10-year period between 2010 and 2019 at a single center were retrospectively reviewed. Collected data included demographic, clinical, and radiologic parameters of instability and post-operative clinical outcomes. Exclusion criteria included concomitant extensor realignment procedures (tibial tubercle osteotomy, patellar tendon transfer procedures) and factors that would alter routine surgical indications or technical approaches, such as fixed or syndromic PFI, osteochondral shear fractures undergoing fixation or >1 cm in diameter, and prior ipsilateral knee surgery. Results: One-hundred and one patients (average age 15.2 years, 63% female), underwent primary isolated MPFLR with an average follow up time of 2.87 years. There were no significant differences in demographic and radiographic parameters between autograft and allograft, other than more semitendinosus grafts, increased number of pre-op dislocation events, and higher sulcus angle in autograft (Table 1). The autograft group had a higher rate of recurrent instability (41% vs 14%, p = 0.01) but no significant difference in return to sport, complications, and reoperations (Table 2). Reoperations for recurrent instability were performed in 9% of all patients (Table 3). Subgroup analysis of allograft tendon type demonstrated more dislocations and recurrent instability in gracilis than semitendinosus, though these differences were not statistically significant, and there was no difference in recurrent instability surgery or complications (Table 4). Conclusions: In adolescent and young adult athletes undergoing isolated primary MPFLR for PFI, allograft may be associated with decreased rates of recurrent instability compared to autograft. While trends towards higher recurrent instability were detected with gracilis allograft, compared to semitendinosus allograft, the precise role of allograft tendon type would benefit from future studies with larger sample size to better elucidate its impact on clinical outcomes.
Poster 291: Entry Point-Transition Point Angle as a Novel 3-Dimensional Metric of Patellar Instability
Authors: Park Nancy , Sieberer Johannes , Rancu Albert L. , Manafzadeh Armita , McDonald Curtis , Yu Kristin , Wiznia Daniel , Fulkerson John P. 
Published: August 2024

Objectives: Three-dimensional (3D) modeling has increasing utility in identifying differences in trochlear morphology in patients with patellar instability when compared to historical 2-dimensional (2D) attempts. Distortions in the proximal medial ridges of trochleas are a distinguishing feature of trochlear dysplasia. Recently, the entry-point to transition-point (EP-TP) angle was established as a novel 3D metric to quantify degree of dysplasia, as it captures the tracking of the patella within the trochlea. However, previous attempts relied on 3D prints, which are not widely accessible. The purpose of this study is to validate this new measurement and compare differences between patients with patellar instability and the general population. Methods: Forty-three patients with recurrent patellar dislocations who were treated by a single surgeon between January 2020 and July 2023 were included. The study received an institutional review board exemption. Individuals from the New Mexico Decedent Image Database with no history of patellar instability or patellofemoral pain were used to obtain computed tomography (CT) images from the general population. Stereolithography (STL) models of distal femurs in 3D were generated from CT images using ScanIP. Minimum and maximum principal curvature maps were taken as screenshots from maps generated in MeshLab. Two people independently conducted measurements using a custom measuring tool displaying anteroposterior views and curvature maps of the distal femur. The measurers were asked to locate the medial and lateral ridges, transition point, and apex of the trochlea groove for each femur. A Mann–Whitney U test was performed to evaluate whether the recurrent dislocators had higher EP-TP values. P values below 0.01 were regarded as significant. Interclass correlation for both raters (ICC (1, k), reliability of values within this study) and single rater (ICC (1,1), reliability of measurement within clinical practice) and the 95% CI thereof, was computed for the 2 independent measurements. Results: A total of 100 femurs were measured, including 43 recurrent dislocators and 57 population femurs. The recurrent dislocator cohort had a mean EP-TP of 40.9° with a standard deviation of 16.4°. The general population cohort had a mean EP-TP of 11.3° with a standard deviation of 12.3°. EP-TP for dislocators and general population was significantly different. (p < 0.001). ICC (1, k) was 0.81 with a 95%-confidence interval of 0.72 to 0.87. ICC (1,1) was 0.69 with a 95% CI of 0.57 to 0.78. Conclusions: EP-TP angle is a novel metric that helps quantify trochlear dysplasia, which can help clinicians better understand patellar instability. In this study, we validate EP-TP angle by showing that EP-TP angle was significantly different between femurs of recurrent dislocators and the general population.
Poster 297: Clinical Outcomes and Return to Sports After Revision ACL Reconstruction With Lateral Extraarticular Tenodesis: Comparison to A Control Group of ACL Reconstruction Only at a Minimum 2-Year Follow-Up
Authors: Gould Heath P. , Eliasberg Claire D. , Adamec Dakota , James Evan W. , Marx Robert G. , Allen Answorth A. , Cordasco Frank A. , Nwachukwu Benedict U. , Nawabi Danyal H. 
Published: August 2024

Objectives: Lateral extraarticular tenodesis (LET) has been shown to decrease failure rate in settings of revision anterior cruciate ligament (ACL) reconstruction in young, high-demand patients. However, there is a paucity of literature comparing clinical outcomes and return to sports after patients who undergo revision ACL reconstruction LET compared to those without LET (control group). Methods: All patients who underwent revision ACL reconstruction with and without LET between January 2018 and February 2020 were queried at our institutional registry. The LET group was compared to the control group (revision ACL reconstruction without LET) were followed for a minimum of 24 months postsurgery to evaluate patients reported outcome measures, satisfaction, return to sports, rate of reoperation, and psychological readiness for return to sports (using the ACL-Return to Sport After Injury Scale, ACL-RSI). Results: A total of 81 patients with a mean follow-up of 2.75 years were included. The LET group contained 37 patients (76% female) with a mean age of 26.6 years and body mass index (BMI) of 23.5 kg/m^2 compared to 44 patients (80% female) with mean age of 28.2 years and BMI of 26.9 kg/m^2. There were no significant differences between the LET and control groups with respect to mean postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (47.7 vs 48.3, p = 0.46) and PROMIS Mobility scales (53.3 vs 52.9, p = 0.97). In addition, there were no differences in postoperative International Knee Documentation Committee (78.9 vs 78.3, p=0.45), Marx (7.9 vs 7.2, p = 0.64), or Single Assessment Numeric Evaluation (73.1 vs 74.2, p = 0.38) scores. The same held true with regards to postoperative ACL-RSI scores between the groups (43.3 vs 50.1, p = 0.38). Return to play rates after revision ACL were similar in the LET group compared to the control group (55% vs 45%, p = 0.40) with similar confidence to play their pre-injury sport (scale out of 100, 58.2 vs 56.2, p = 0.82). Lastly, overall reoperation rates were similar between the groups with the LET group having a rate of 21.2% compared to 19.4% for the control group. When isolated for revision due to graft tear, the LET group had a re-revision rate of 13.5% compared to 6.8% in the control group (p = 0.31). Conclusions: Satisfaction and patient reported outcome scores after revision ACL reconstruction are good with or without LET. While both groups have similar rates of return to play and reoperation at greater than 2- year follow-up, these results suggest the addition of LET may provide similar outcomes in high-risk patients when compared to isolated revision ACL reconstruction.
Poster 312: Prospective and Randomized Evaluation of Three Different Anterior Cruciate Ligament (ACL) Reconstruction Techniques Including a Lateral Extra-Articular Tenodesis (LET): A Clinical and Radiographic Evaluation at Minimum 20 Years Follow-Up
Authors: Lucidi Gian Andrea , Agostinone Piero , Grassi Alberto , Viotto Marianna , Serra Margherita , Dal Fabbro Giacomo , Di Paolo Stefano , Zaffagnini Stefano 
Published: August 2024

Objectives: Modern lateral extra-articular tenodesis (LET) has shown promising results at short term follow-up but there is a lack of studies investigating the incidence of complication and lateral osteoarthritis (OA) at long-term. The aim of the study was to compare in terms of failure rates, clinical outcomes and OA incidence three different ACL reconstruction techniques including hamstring single-bundle (HS group), patellar tendon (BTB) and hamstring over-the-top with LET (LET group). Methods: Seventy-five patients were randomized to receive one of the three ACL reconstruction techniques. At the last follow-up, patients reported outcomes (PROMs), complication and reoperation were collected for every patient. An objective clinical evaluation was performed including anteroposterior laxity measurement (KT-1000) and pivot shift quantification (PS, triaxial-accelerometer). Clinical failures were considered patients with evidence of graft rupture or those with KT-1000 side-to-side > 5mm or with PS side-to-side > >1mm/s2. A radiographic evaluation was performed to assess the incidence of tibiofemoral and patellar OA. Results: Final analysis was conducted on 61 patients (81.3%) at an average 23.0 ± 1.1 years follow-up, 38 patients completed the clinical and radiological evaluation. The LET group showed a higher Tegner score compared to the BTB (p=0.026), mean of 4.41 (up to 7) against 3.47 (up to 5). No difference was identified in the other clinical scores among the three groups (p>0.05). Revision rate and clinical failure were respectively 15.8% and 57.1% for the BTB group, 4.6% and 38.5% for the HS group and 4.6% and 18.8% for the LET group (P= 0.09 to 0.8, ns). No difference in the quantitative evaluation of the Pivot Shift were reported, while AP side-to-side difference was lower in the BTB group compared to the HS group (mean -0.1mm vs. +1.5mm). Finally, the BTB group showed a higher rate of patellofemoral OA compared to the other two groups (p=0,009) while the incidence of lateral OA was not increased in the LET group compared to the other techniques (p=0.50). Conclusions: Satisfactory clinical outcomes after ACL reconstruction at long-term follow-up could be achieved with different modern surgical techniques. However, the BTB graft was associated with increased incidence of patellofemoral OA when compared with the other techniques. Finally, LET was associated with increased sport participation and similar rate of lateral OA compared to other techniques at long-term follow-up.