bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players
Authors: Kida Yoshikazu , Takatsuji Kenta , Sukenari Tsuyoshi , Furukawa Ryuhei , Minami Masataka , Morihara Toru , Takahashi Kenji , Kotoura Yoshihiro 
Published: July 2022

Objectives: The goals of treatment of osteochondritis dissecans of the humeral capitellum (OCD) are morphological healing and early return to sports and these are often contradictive. The purpose of this study was to evaluate our conservative treatment of OCD and establish the appropriate treatment. Methods: We retrospectively reviewed 206 patients with OCD who were treated conservatively at first visit our hospital and affiliated institutions from 2009 to 2019. Exclusion criteria were loss and less than 1 year follow-up. Mean age was 12.1 years (8-15). All patients were advised to stop or limit throwing and underwent physical therapy. Depending on the stage and healing process, at least, after waiting for the lateral wall of the capitellum to heal throwing was permitted to resume. Age at first visited, OCD Stage (Ⅰ; radiolucent area, Ⅱ; nondisplaced fragmentation, Ⅲ; loose body), clinical result (complete healing, partial healing, surgery required), and when to return to play were evaluated statistically. Results: A total of 193 patients were enrolled. There were 115 patients that were stageⅠ with a mean age of 11.2 years, 63 patients that were stageⅡ with a mean age of 13.2 years, and 15 patients that were stageⅢ with a mean age of 14.1 years (Table 1), and these differences were statistically significant (p<0.01). Collectively, complete healing was observed in 70.4%, partial healing in 17.4%, surgery in 12.2% of stageⅠ, complete healing in 50.8%, partial healing in 12.7%, surgery in 36.5% of stageⅡ, and complete healing in 0%, partial healing in 26.7%, surgery in 73.3% of stageⅢ (Fig 1). Of the 47 patients who underwent surgery, arthroscopic debridement for OCD lesions was selected for 79%, osteochondral autograft transplantation was selected for 16%, and fixation was selected for 4% (Fig 2). The mean period of return to play was 8.6 months; < 6 months was 42%, 6 months- 1 year was 39%, 1 year-1.5 year was 16%, and 1.5%< was 3%. Conclusions: In this study, OCD lesions likely to heal when the OCD stage were early. Even if surgery was needed after failed conservative treatment, most of the patients were treated by arthroscopic debridement which was a relatively minimally invasive procedure. Conservative treatment of OCD was successful when the treatment is begun in early stage of the disease. UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/e5e18779-1cc0-4cc6-814b-a97204c6da85/1/file.pdf
Paper 43: Long-term Outcomes of an All-Arthroscopic Matrix-Assisted Autologous Chondrocyte Transplantation Technique
Authors: Ibarra Clemente , Olivos-Meza Anell , Velasquillo Cristina , Barbosa Fernando , Ramirez-Carrera Myriam , Villalobos-Cordova Felix , Madrazo-Ibarra Antonio 
Published: July 2022

Objectives: To evaluate the long-term clinical and magnetic resonance imaging outcomes of patients treated with an all-arthroscopic matrix-assisted autologous chondrocyte transplantation (MACT) technique for articular cartilage lesions of the knee. Methods: A total of 63 patients (21 women, 42 men) with a mean age of 35 ± 9.2 years, were treated with an all-arthroscopic MACT technique for articular cartilage lesions of the knee. Patients were prospectively evaluated preoperatively and after 2, 5, and 10 years of the surgery using multiple clinical scores: Lysholm, Tegner, International Knee Documentation Committee (IKDC), and the Knee injury and Osteoarthritis Outcome Score (KOOS); as well as with magnetic resonance imaging (MRI) T2-mapping at the same time points. Failure was defined as a reoperation because of symptoms caused by the primary repaired defect or a patient improvement of <10 points in the IKDC subjective score between the preoperative value and the final follow-up value. Results: Patients showed statistically significant clinical improvement in all PROM scores at 2, 5, and 10 years postoperative (PO) compared to their preoperative status. MRI T2-Mapping values of the repaired tissue decreased from 59.0 ± 14.6 ms preoperatively to 44.4 ± 15.6 ms at 10 years PO (P= 0.008), showing no statistical differences compared to the native cartilage values (39.1 ± 4.0 ms, P= 0.398). A surgical failure rate of 1.5% was documented, which was increased to 33% when clinical failures were also considered. Among all the analyzed factors linked to the likelihood of failure, lesions >4cm2 were the only ones to show statistical significance (P= 0.024). Conclusions: Patients treated with this arthroscopic MACT technique showed good and long-lasting clinical outcomes, as well as close to native cartilage characteristics on MRI T2-mapping. A limited number of failures were observed at 10 years PO, with most failures being in the first two years after treatment. Big chondral lesions (>4cm2) were found to have a greater likelihood of failing. UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/9e2d9f3a-b8a0-4921-9952-144a0de7acd7/1/Base_Px_AMECI_-_Clinica_2.pdf UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/e39a94d5-bbc5-4e27-8493-786a2237cef3/1/Patient-Reported_Outcome_Measures_1.pdf UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/aba360a2-961d-4b2e-a4fa-1049626e23d3/1/MRI_T2-Mapping_2.pdf UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/d9c78782-8a61-446f-b0e7-24873b631a5a/1/kaplan_meier.pdf
Paper 44: Does femoral osteoplasty enhance clinical outcomes and survivorship of FAI surgery at long-term follow-up beyond fifteen years?
Authors: Parilla Frank , Garrido Cecilia Pascual , Ince Deniz , Pashos Gail , Clohisy John , Nepple Jeffrey 
Published: July 2022

Objectives: Cam-type femoroacetabular impingement (FAI) is now well-established as a risk factor for intra-articular damage (labrum and articular cartilage) and secondary osteoarthritis. Long-term studies of FAI surgery are critical in understanding clinical outcomes, refining surgical treatments and predicting osteoarthritis progression. Nevertheless, studies beyond 15 years are uncommon. Although femoral osteoplasty is now common practice in treating cam FAI, long-term data supportive of this procedure and its ability to alter the natural history of FAI are not available. The purpose of this study was to analyze the long-term clinical outcomes and survivorship of symptomatic FAI treatment by arthroscopic correction of labral pathology alone or in combination with femoral osteoplasty (structural FAI correction). Methods: A retrospective comparative study was performed on two consecutive, longitudinal cohorts of patients with isolated cam-type FAI that underwent surgical treatment of labral pathology either with femoral osteoplasty (HSLO group, 23 hips) or without femoral osteoplasty (HS group, 17 hips). These cohorts were captured immediately prior to and after implementation of femoral osteoplasty into our practice and have been previously reported on at mean 2-year followup. The current study investigated clinical outcomes and survivorship at minimum 15-year followup. Patients with pincer or combined cam-pincer morphologies were excluded. Clinical outcomes were measured with the modified Harris hip score (mHHS). Kaplan-Meier survival was assessed for THA-free and reoperation-free survivorship. Results: The HSLO group included 23 hips followed for a mean of 16.0 ±0.6 years, and the HS group 17 hips followed for 19.7 ±1.2. The HSLO group had a significantly higher final mHHS (82.7 vs. 64.7, p=0.002) and mHHS improvement (18.4 vs. 6.1, p=0.02) compared to the HS group. The rate of THA conversion (22% vs. 59%, P=0.02) and overall reoperation (22% vs. 70%, P=0.003) were significantly lower in the HSLO group. THA conversion occurred at a mean of 5.8 ±2.5 years postoperatively in the HSLO group, and 7.1 ±4.0 years in the HS group. The HSLO group had significantly greater 15-year THA-free survivorship (78% vs 41%, p=0.02) and reoperation-free survivorship (78% vs. 29%, p=0.003) by Kaplan-Meier analysis. Conclusions: This study demonstrates better long-term clinical outcomes and survivorship with combined arthroscopy and femoral osteoplasty compared to arthroscopy alone. These long-term data strongly support the current practice of femoral osteoplasty in patients with cam FAI morphologies and suggest that this treatment alters the natural history of FAI. [Figure: see text]
Paper 46: Comparing Midterm Outcomes of High-Level Athletes Versus Nonathletes Undergoing Primary Hip Arthroscopy: A Propensity Matched Comparison with Minimum 5-year Follow-Up *ACCEPTED TO AJSM*
Authors: Jimenez Andrew , Monahan Peter , Owens Jade , Lall Ajay , Domb Benjamin , Maldonado David 
Published: July 2022

Objectives: (1) To report mid-term outcomes of HLA following primary hip arthroscopy and (2) to compare their results to a propensity-matched cohort of NA patients. Methods: Data were prospectively collected and retrospectively reviewed from February 2008 to November 2015 for HLA (professional, college, or high school) who underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS). HLA were included if they had preoperative, minimum 2-year, and minimum 5-year follow-up data for the Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score Sports-Specific Subscale (HOS-SSS). Radiographic and intraoperative findings, surgical procedures, patient-reported outcome scores (PROs), the patient acceptable symptomatic state (PASS), the minimal clinically important difference (MCID) and the return to play were reported. The HLA study group was propensity-matched to a control group of NA patients for comparison. Results: A total 65 HLA (67 hips) were included in the final analysis with mean follow-up time of 74.6 ± 16.7 months. HLA showed significant improvement in all PROs recorded, achieved high rates of MCID and PASS for mHHS (74.6% and 79.4% respectively) and HOS-SSS (67.7% and 66.1% respectively), and returned to sport at high rates (80.4%). When compared to the propensity-matched NA control group, HLA reported higher baseline but comparable postoperative scores for the mHHS and NAHS. HLA patients achieved MCID and PASS for mHHS at similar rates as NA patients, but they achieved PASS for HOS-SSS at higher rates which trended toward statistical significance (66.1% vs 48.4%; P = .07). NA underwent revision arthroscopic surgery at similar rates compared to HLA patients (14.9% vs 9.0%; P = .424). Conclusions: Primary hip arthroscopy results in favorable mid-term outcomes in HLA. When compared to a propensity-matched NA control group, HLA demonstrated a tendency toward higher rates of achieving PASS for HOS-SSS but similar arthroscopic revision rates at minimum 5-year follow-up. [Figure: see text][Figure: see text][Table: see text]
Paper 48: Elite Female Athletes Demonstrate Greater Improvement in Patient Reported Outcome Scores and Equal Rate of Return to Sport Compared to Elite Male Athletes After Hip Arthroscopy: A Sex-Based Comparison in Professional and Collegiate Athletes *ACCEPTED TO AJSM*
Authors: Domb Benjamin , Glein Rachel , Miecznikowski Kara , Maldonado David , MD,MS Ajay Lall , Jimenez Andrew 
Published: July 2022

Objectives: (1) To report minimum 2-year patient reported outcome scores (PROs) and return to sport for elite female athletes undergoing hip arthroscopy for femoroacetabular impingement (FAI) and (2) to compare clinical results with a matched control group of elite male athletes. Methods: Data on all consecutive female athletes who underwent primary hip arthroscopy performed by the senior author (X.X.X.) between March 2009 and July 2018 were collected. Patients were considered eligible if they underwent hip arthroscopy for labral tears or FAI and participated in collegiate or professional athletics within 1 year of surgery. Minimum 2-year PROs were collected for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and RTS status. The percentage of patients achieving minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were also recorded. These patients were then matched to elite male athletes for comparison. Results: Seventy-three female athlete hips were included with a mean follow-up of 65.1 ± 27.9 months. They demonstrated significant improvement from preoperative to latest follow-up for mHHS, NAHS, HOS-SSS, and VAS (P < .05). When outcomes were compared to a control group of male athletes, female athletes demonstrated lower preoperative scores, similar postoperative scores, and significantly greater magnitude of improvement (delta value) for mHHS, NAHS, and VAS. Female athletes also achieved MCID at higher rates than male athletes for HOS-SSS (85.1% vs 70.0%, P = .035) and NAHS (79.1% vs 62.9%, P = .037). RTS rates were similar between the two groups (Females: 67.1%, Males: 67.1%, P > 0.999). Conclusions: Elite female athletes undergoing primary hip arthroscopy for FAI demonstrated significant improvement in PROs and high rates of return to play, which were similar to a matched group of male athletes. Female athletes exhibited greater improvement in PROs (mHHS, NAHS, VAS) and achieved MCID (HOS-SSS, NAHS) at higher rates when compared to a control cohort of male athletes. [Figure: see text][Figure: see text][Table: see text]
Paper 52: Sex-Based Differences in Outcomes After MPFL Reconstruction
Authors: Hurley Eoghan , Bi Andrew , Mojica Edward , Campbell Kirk , Strauss Eric , Markus Danielle 
Published: July 2022

Objectives: The purpose of the current study was to investigate whether pain, function, satisfaction, or return to play (RTP) differ between sexes post-operatively in those undergoing MPFL reconstruction for symptomatic patellar instability. Methods: A retrospective review of patients who underwent an MPFL reconstruction for symptomatic patellar instability was performed. Kujala score, Visual Analogue Scale (VAS), patient satisfaction, willingness to undergo surgery again, revisions, return to play (RTP) and MPFL-RSI score were evaluated. Clinical outcomes were compared between male and female patients. A p value of <0.05 was considered to be statistically significant. Results: Our study included 141 knees that underwent MPFLR, and the patient population was 69.5% female. Post-operatively, the mean VAS score at rest was 1.0 ± 1.7 in male patients and 1.6 ± 2.1 in female patients (p= 0.0963). The mean Kujala score was 88.8 ± 13.3 and 83.5 ± 16.1 for male and female patients respectively (p=0.1062). Overall, there was a significant difference in RTP, with male patients returning at higher rates (58.1% vs 33.3%, p = 0.0479). The mean VAS score during activity was significantly lower in male patients at 1.8 compared to female patients at 3 (p=0.016). MPFL-RSI-score was also significantly worse in female patients (69.5 vs 55.6, p = 0.0098). While female patients had slightly higher rates of recurrent subjective instability (14.3% vs 11.7%) and re-dislocation (2% vs 0%), the difference was not statistically significant (p = 0.6731 and 0.3490, respectively). Female patients demonstrated higher rates of additional surgery at long term follow up, though this difference was also not statistically significant (12.2% vs 4.6%, p = 0.1674). Conclusions: Female patients had worse clinical outcomes than males undergoing MPFLR for patellar instability, with significantly lower rates of RTP, VAS score during sport and MPFL-RSI scores with a trend towards lower Kujala score and VAS score.
Paper 61: Surgical Management of Distal Clavicle Fractures in Skeletally Immature Athletes
Authors: Jasty Naveen , Heyworth Benton 
Published: July 2022

Objectives: The objective of this study was to characterize distal clavicle fractures in a cohort of pediatric and adolescent athletes who underwent operative treatment at a single, tertiary-care pediatric center, including surgical techniques used and resultant clinical outcomes. Methods: A retrospective review was performed of all clavicle fractures extending to the level of the corococlavicular ligaments or more lateral, which were treated operatively at a single tertiary-care pediatric hospital between the years of 2005-2020. Patients >19 years-old or those with pathological fractures were excluded. Radiographic fracture characteristics, surgical techniques, time to radiographic healing, return to sports, and complications were analyzed. Results: Fifty-two patients were identified, with mean age 13.8 ± 2.2 years. The majority of fractures were classified as Nenopoulus type IIB (transverse, displaced; 42.3%) or type IIIB (oblique, displaced; 26.9%), though type IIA (transverse, minor displacement; 3.8%), IV (comminuted; 11.6%) , and V (AC dislocation; 15.4%) patterns were also observed. Primary direction of displacement was posterior in 90% of cases and superior in 10%. Plate fixation was performed in 53.8% of surgeries, with locking plate (26.9%) and hook plate (17.3%) most frequent. Suture-based fixation was performed in 32.7% of cases (Figure 1). Rate of implant removal was 66% after plate fixation, the majority of which (72.2%) were planned at the time of primary fixation. Total complication rate, including unplanned removal of implant, was higher in the plate fixation group (25%) than in the suture-based fixation group (11.2%). Time to radiographic healing was not significantly different between plate and suture-based constructs (2.9 vs. 2.9 months, p = 0.96) though patients with suture-based constructs returned to sport faster (2.5 vs. 3.6 months, p = 0.014). Conclusions: Posteriorly displaced fractures comprised the vast majority of surgically-treated distal clavicle fractures in pediatric and adolescent athletes. When chosen in the appropriate patient, based on age and fracture pattern, suture-only constructs can lead to similar time to radiographic healing and faster return to sports compared to plate-based constructs, with significantly reduced need for removal of hardware. These data provide a foundation for future comparative research to further elucidate precise surgical indications and optimal treatment approaches in this population. [Table: see text]
Paper 63: Remodeling of Adolescent Displaced Clavicle Fractures: A FACTS Study
Authors: Bae Donald , Boutelle Kelly , Busch Michael , Carroll Alyssa , Edmonds Eric , Ellis Henry , Hergott Katelyn , Kocher Mininder , Li G. Ying , Nepple Jeffrey , Pandya Nirav , Perkins Crystal , Polinsky Samuel , Sabatini Coleen , Spence David , Willimon Samuel , Wilson Philip , Heyworth Benton , Pennock Andrew 
Published: July 2022

Objectives: The phenomenon of bony remodeling of healed displaced clavicle midshaft fractures in adolescents remains poorly understood. The purpose of the current study was to evaluate and quantify clavicle remodeling in a large population of adolescents with completely displaced fractures treated non-operatively to understand the factors that may influence this process. Methods: Patients were identified from the database(s) of a multi-center study group investigating the functional outcomes of adolescent clavicle fractures. Patients between the ages of 10 and 19 years with completely displaced mid-diaphyseal clavicle fractures that were treated non-operatively who had further imaging of the affected clavicle at a minimum of 9 months from initial injury were included. Radiographic measurements were performed on the injury and final follow-up films. Fracture remodeling was subjectively classified as ‘complete/near-complete’, ‘moderate’, or ‘minimal’ (Figure 1) and subsequently analyzed quantitively and qualitatively to determine factors associated with deformity correction. Results: Ninety-eight patients (mean age of 14.4±2.2 years) were analyzed at a mean radiographic follow-up of 3.4± 2.3 years. Fracture shortening, superior displacement, and angulation significantly improved during the follow-up period by 59%, 61%, and 30% respectively (p<0.001). Fracture remodeling was found to be associated with follow-up time; those with longer follow-up time demonstrate more remodeling (p<0.001). Ninety-two percent of patients <14 years and 79% of patients ³14 years-old at time of injury with a minimum follow-up of four years underwent complete/near-complete remodeling. Conclusions: Significant clavicle remodeling occurs in adolescent patients with displaced fractures, including older adolescents and particularly when followed for longer time intervals. This finding may help explain why symptomatic malunions are so infrequently observed in adolescent patients, even in severely displaced fractures.
Paper 79: Increasing Shoulder Osteoarthritis Severity (SOAS) Score Predicts Lower PROMIS-UE Score Following Rotator Cuff Repair
Authors: Davies Michael , Kucirek Natalie , Motamedi Daria , Ma C. Benjamin , Feeley Brian , Lansdown Drew 
Published: July 2022

Objectives: Mild to moderate glenohumeral osteoarthritis (GHOA) is a common finding among patients who are evaluated for rotator cuff (RC) tears. However, the impact of pre-operative shoulder joint degeneration on patient-reported outcomes (PROs) following RC repair (RCR) is not well-established. Certain studies have reported a negative association between radiographic findings of glenohumeral osteoarthritis (GHOA) and RCR PROs, while other studies have found no substantial association. The purpose of this study was to apply the MRI-based Shoulder Osteoarthritis Severity (SOAS) score to the evaluation of patients undergoing RCR and determine the relationship between pre-operative shoulder pathology present on MRI with post-operative PROMIS-UE scores. We hypothesized that patients with higher pre-operative SOAS scores, indicating greater shoulder pathology, would have lower post-operative PROMIS-UE scores following RCR. Methods: Seventy-one MRIs corresponding to 71 patients were analyzed by two independent reviewers and scored using the SOAS criteria. Intraclass correlation coefficients were calculated for total SOAS score as well as for each sub-score. Spearman’s correlations were calculated between averaged SOAS scores, patient demographics, and PROMIS-UE scores. Linear regression analysis was performed between the independent variables of patient age, sex, BMI, and significant SOAS score components determined by univariate analysis with the dependent variable of PROMIS-UE score. Significance was defined as p<0.05. Results: The mean PROMIS-UE score of this cohort was 51.5 ± 7.5 (Table 1), while the average total SOAS score was 21.5 ± 8.4 (Table 2). There was a negative correlation between increasing total SOAS score and worsening post-operative PROMIS-UE score (r = -0.24, p = 0.04) (Table 3). Both cartilage wear (r = -0.33, p = 0.0045) and AC joint degeneration (r = -0.24, p = 0.048) individually demonstrated negative correlations with PROMIS-UE score (Table 3). SOAS cartilage score was an independent negative predictor of PROMIS-UE score in a multiple variable linear regression with patient age and sex (β = -1.05, p = 0.038) (Table 4). Conclusions: In this cohort of patients undergoing RCR, increasing pre-operative total SOAS score was predictive of lower post-operative PROMIS-UE scores. SOAS sub-scores with the strongest negative correlations with PROMIS-UE scores included cartilage wear and AC joint degeneration. Cartilage subscore was negatively correlated with PROMIS-UE scores independent of patient demographic factors in multivariate analysis. Pre-operative GH cartilage wear and AC joint degeneration may warrant particular attention and counseling in patients undergoing RCR. [Table: see text][Table: see text][Table: see text][Table: see text]