A morphometric study of posterior tibial slope differences by sex and ethnicity in a South African population.

Purpose: Posterior tibial slope (PTS) influences knee kinetics and kinematics. The purpose of this study was to investigate morphology and variation within a sample of the black and white male and female population.

Method: 480 randomly selected lateral knee radiographs were included.

Microfragmented Adipose Tissue Has No Advantage Over Platelet-Rich Plasma and Bone Marrow Aspirate Injections for Symptomatic Knee Osteoarthritis: A Systematic Review and Meta-analysis.

Background: Microfragmented adipose tissue has been proposed for intra-articular treatment of knee osteoarthritis. There are little data comparing the outcomes of treatment between microfragmented adipose tissue and other biological treatments.

Purpose: To perform a systematic review and meta-analysis comparing microfragmented aspirated fat injections to other orthobiologics, hyaluronic acid, and corticosteroid injections for symptomatic knee osteoarthritis.

The Knee Anterolateral Ligament is Present in 82% of North Americans and 65% of Europeans but Only in 46% of Asian Studies: A Systematic Review of Frequency and Anatomy.

Purpose: To perform an updated systematic review on the prevalence and morphological characteristics of the anterolateral ligament (ALL) in human cadaveric specimens.

Methods: Medline, Embase, Scopus, and Google Scholar were searched for studies from 2012 to 2024 describing morphology. Study quality was assessed using the Critical Appraisal Skills Programme checklist and Quality Appraisal for Cadaveric Studies scale.

Anterior and coracoid base tunnel location combined with single -or double clavicular tunnel techniques using double-button fixation for coracoclavicular ligament reconstruction both restore horizontal stability. A biomechanical cadaver study.

Background: The placement of clavicle tunnels in coracoclavicular ligament reconstruction is well established, but the optimal position of the coracoid tunnel remains unclear. This study aimed to investigate how the coracoid tunnel's position affects horizontal stability during coracoclavicular ligament reconstruction using a double-button technique.

Methods: Fifteen fresh frozen shoulder cadaver specimens were tested under various conditions: intact coracoclavicular ligaments, disrupted ligaments, and reconstructions with a single coracoid and clavicle tunnel or double clavicle tunnels.

Severity and outcome of a first episode of idiopathic acute pancreatitis is not more severe than pancreatitis of other etiologies.

Background: With respect to severity and outcome of an index episode of idiopathic acute pancreatitis the current literature reports conflicting retrospective results. One reason might be the retrospective study design precluding in depth analysis resulting in mixed etiologies and combination of index episode versus recurrent idiopathic acute pancreatitis.

Methods: In this retrospective monocentric cohort study, we retrieved all patients with a first acute pancreatitis episode treated between 2005 and 2021 at the LMU University Hospital from our clinical information system based on the respective ICD-10 codes.

Editorial Commentary: A Delphi Expert Consensus Provides Clarity on Diagnosis, Treatment, Rehabilitation, and Return-to-Sports for Posterior Shoulder Instability.

Posterior shoulder instability (PSI) is an uncommon condition, accounting for 2% to 12% of shoulder instability cases. However, PSI might be more common and possibly accounts for up to 24% of all young, active patients treated for shoulder instability. The etiology of PSI is complex and multifactorial, making accurate diagnosis, classification, and treatment challenging.

Use of the FallAkte Plus System as an IT Infrastructure for the North Rhine-Westphalian General Practice Research Network: Mixed Methods Usability Study.

Background: Primary care research networks can generate important information in the setting where most patients are seen and treated. However, this requires a suitable IT infrastructure (ITI), which the North Rhine-Westphalian general practice research network is looking to implement.

Objective: This mixed methods research study aims to evaluate (study 1) requirements for an ITI and (study 2) the usability of an IT solution already available on the market, the FallAkte Plus (FA+) system for the North Rhine-Westphalian general practice research network, which comprises 8 primary care university institutes in Germany's largest state.

The four seasons of pancreatitis - Etiology of acute pancreatitis during the course of the year.

Background/objectives: Whether seasonality is a factor that influences the incidence of acute pancreatitis (AP) is an under-investigated area. If seasonal incidence peaks can be detected, specifically with regard to biliary pancreatitis, has so far been answered in contradictory ways in the literature.

Methods: All AP cases from two tertiary German referral centers were identified between 2016 and 2022 based on ICD-10 discharge codes.

Severity of Gallstone-, Sludge-, or Microlithiasis-Induced Pancreatitis-All of the Same?

Background/aim: Severity of microlithiasis- and sludge-induced pancreatitis in comparison to gallstone-induced pancreatitis has never been studied for a lack of definition.

Materials And Methods: In this retrospective cohort study, 263 patients with acute biliary pancreatitis treated at a tertiary care center from 2005 to 2021 were stratified according to the recent consensus definition for microlithiasis and sludge. The gallstone-pancreatitis cohort was compared to microlithiasis, sludge, and suspected stone passage pancreatitis cohorts in terms of pancreatitis outcome, liver function, and endosonography/endoscopic retrograde cholangiopancreatography results using one-way analysis of variance and χ 2 test.

Editorial Commentary: High-Platelet-Dose Platelet-Rich Plasma May Be the Nonoperative Treatment of Choice for Knee Osteoarthritis.

Knee osteoarthritis (OA) affects 30% of individuals older than 60 and 40% older than 70 years old. The incidence of radiologic knee OA is 373 per 10,000 person-years, but symptomatic knee OA registers at a considerably lower rate of 50 per 10,000 person-years. For symptomatic cases that are not candidates for surgical intervention, various treatment options include exercise, weight loss, pharmacologic management, bracing, physical therapy, oral supplementation, and intra-articular injection with corticosteroids, hyaluronic acid, or orthobiologics such as platelet-rich plasma (PRP).

Third-party fecal microbiota transplantation for high-risk treatment-naïve acute GVHD of the lower GI tract.

Disruption of the intestinal microbiome is observed with acute graft-versus-host disease (GVHD) of the lower gastrointestinal (LGI) tract, and fecal microbiota transplantation (FMT) has successfully cured steroid-refractory cases. In this open-label, single-arm, pilot study, third-party, single-donor FMT was administered in combination with systemic corticosteroids to participants with high-risk acute LGI GVHD, with a focus on treatment-naïve cases. Participants were scheduled to receive 1 induction dose (15 capsules per day for 2 consecutive days), followed by 3 weekly maintenance doses, consisting of 15 capsules per dose.

Micro-Fragmented Adipose Tissue Demonstrates Comparable Clinical Efficacy to Other Orthobiologic Injections in Treating Symptomatic Knee Osteoarthritis: A Systematic Review of Level I to IV Clinical Studies.

Purpose: To perform a systematic review of clinical outcomes in patients who underwent treatment with micro-fragmented aspirated tissue for symptoms of knee osteoarthritis.

Methods: Medline, Embase, Scopus, and Google Scholar were screened for studies from 2000 to 2023. Risk of bias (ROB) was assessed using the Cochrane Collaboration's tools and the Risk Of Bias In Non-randomised Studies-of Interventions tool.

Editorial Commentary: Hip Arthroscopy Benefits Patients With Tönnis Grade 0 or 1 Hip Arthritis and Is Not Recommended for Grade 3: Optimal Treatment of Femoroacetabular Impingement Syndrome for Grade 2 Arthritis May Be Determined by Age and Body Mass Index.

Femoroacetabular impingement syndrome (FAIS) is a possible cause of early osteoarthritis, and restoration of normal anatomy can potentially prevent future major cartilage damage. Symptomatic cam lesions can lead to debonding of articular cartilage, resulting in superolateral cartilage lesions in 93% of patients. Patients with pincer lesions often exhibit cartilage lesions in the anterior and superolateral glenoid rim.

Editorial Commentary: Recurrence Rates Following Arthroscopic Bankart Repair Differ Among Contact and Collision Sports and Are Higher in Collision Sports.

Collision and contact sports athletes are at higher risk of shoulder dislocations. In collision sports such as boxing, ice hockey, rugby, football, and various martial arts, the athlete purposely hits or collides with other athletes or objects with substantial force, whereas in contact sports such as basketball, field hockey, wrestling, and soccer, the athlete makes regular contact with other athletes but with substantially less force. Return-to-sports rates following arthroscopic shoulder stabilization are above 90%.

Editorial Commentary: Platelet-Rich Plasma for Musculoskeletal Conditions Is Supported by a Large Number of Clinical Studies, Particularly for Knee Osteoarthritis.

Platelet-rich plasma (PRP) represents a biological treatment for various musculoskeletal conditions. Over the past 20 years, publications regarding the treatment of orthopaedic conditions with PRP have shown a 4-fold increase. Several systematic reviews and meta-analyses have demonstrated that PRP is effective and often superior to other treatment modalities.

Cadaveric Biomechanical Laboratory Research Can Be Quantitatively Scored for Quality With the Biomechanics Objective Basic Science Quality Assessment Tool: The BOBQAT Score.

Purpose: To develop a quality appraisal tool for the assessment of cadaveric biomechanical laboratory and other basic science biomechanical studies.

Methods: For item identification and development, a systematic review of the literature was performed. The content validity index (CVI) was used either to include or exclude items.

Machine learning-based decision tool for selecting patients with idiopathic acute pancreatitis for endosonography to exclude a biliary aetiology.

Background: Biliary microlithiasis/sludge is detected in approximately 30% of patients with idiopathic acute pancreatitis (IAP). As recurrent biliary pancreatitis can be prevented, the underlying aetiology of IAP should be established.

Aim: To develop a machine learning (ML) based decision tool for the use of endosonography (EUS) in pancreatitis patients to detect sludge and microlithiasis.

Prevalence of Comorbid Factors in Patients With Recurrent Clostridioides difficile Infection in ECOSPOR III, a Randomized Trial of an Oral Microbiota-Based Therapeutic.

Background: Although comorbidities are risk factors for recurrent Clostridioides difficile infection (rCDI), many clinical trials exclude patients with medical conditions such as malignancy or immunosuppression. In a phase 3, double-blind, placebo-controlled, randomized trial (ECOSPOR III), fecal microbiota spores, live (VOWST, Seres Therapeutics; hereafter "VOS," formerly SER-109), an oral microbiota therapeutic, significantly reduced the risk of rCDI at week 8. We evaluated the efficacy of VOS compared with placebo in patients with comorbidities and other risk factors for rCDI.

Return to Sports Following Sports-Related Concussion in Collision Sports: An Expert Consensus Statement Using the Modified Delphi Technique.

Purpose: To perform a Delphi consensus for return to sports (RTS) following sports-related concussion (SRC).

Methods: Open-ended questions in rounds 1 and 2 were answered. The results of the first 2 rounds were used to develop a Likert-style questionnaire for round 3.

On-Field and Pitch-Side (Sideline) Assessment of Sports Concussion in Collision Sports: An Expert Consensus Statement Using the Modified Delphi Technique.

Purpose: To perform a Delphi consensus for on-field and pitch-side assessment of sports-related concussion (SRC).

Methods: Open-ended questions in rounds 1 and 2 were answered. The results of the first 2 rounds were used to develop a Likert-style questionnaire for round 3.

Editorial Commentary: Autologous and Synthetic Bone Fillers for Medial Open-Wedge High Tibial Osteotomy Have No Effect on Clinical Outcomes But Autologous Graft Promotes Complete Bony Union.

In contrast to closed-wedge high tibial osteotomy, medial based open-wedge high tibial osteotomy produces gaps of various sizes. Synthetic bone void fillers are an attractive option to close these gaps, potentially increase bone union, decrease time to union, and improve clinical outcomes. Autologous bone grafts are the accepted standard and result in reliable and reproducible outcomes.

Corticosteroid injections for the treatment of lateral epicondylitis are superior to platelet-rich plasma at 1 month but platelet-rich plasma is more effective at 6 months: an updated systematic review and meta-analysis of level 1 and 2 studies.

Background: The purpose of this study was to perform a systematic review and meta-analysis of studies comparing local injections of either platelet-rich plasma (PRP) or corticosteroid for the treatment of lateral elbow epicondylitis.

Methods: A systematic review of MEDLINE, Embase, Scopus, and Google Scholar was performed, and all level 1 and 2 randomized studies from 2000 to 2022 were included. Clinical symptoms, patient perceived outcomes, and pain were assessed by the DASH (disabilities of the arm, shoulder and hand questionnaire) and pain by the visual analog scale (VAS).

Transcoracoid Drilling for Coracoclavicular Ligament Reconstructions in Patients With Acromioclavicular Joint Dislocations Result in Eccentric Tunnels.

Purpose: To determine the location of coracoid inferior tunnel exit with superior-based tunnel drilling and coracoid superior tunnel exit with inferior-based tunnel drilling.

Methods: Fifty-two cadaveric embalmed shoulders (mean age 79 years, range 58-96 years) were used. A transcoracoid tunnel was drilled at the center of the base.

Editorial Commentary: Diagnosis, Treatment, Rehabilitation and Return to Sport After Ulnar Collateral Ligament Injury: Agreement Does not Equal Consensus.

Tommy John surgical reconstruction for ulnar collateral ligament injuries was first described by Frank Jobe in 1974. Although he estimated the chance for successful return very low, John, famous baseball pitcher, was able to return to play for another 14 years. Modern techniques and better understanding of anatomy and biomechanics have now resulted in a return-to-play rate of more than 80%.