Defining the Cost of Arthroscopic Rotator Cuff Repair: A Multicenter, Time-Driven Activity-Based Costing and Cost Optimization Investigation.

Background: Rotator cuff repair (RCR) is a frequently performed outpatient orthopaedic surgery, with substantial financial implications for health-care systems. Time-driven activity-based costing (TDABC) is a method for nuanced cost analysis and is a valuable tool for strategic health-care decision-making. The aim of this study was to apply the TDABC methodology to RCR procedures to identify specific avenues to optimize cost-efficiency within the health-care system in 2 critical areas: (1) the reduction of variability in the episode duration, and (2) the standardization of suture anchor acquisition costs.

Early muscular training and immobilization in external rotation could reduce the recurrence rate in first-time shoulder dislocators among young rugby athletes.

Background: Among rugby players, anterior shoulder dislocation is challenging to treat during the in-season period. It often leads to recurrent shoulder instability and requires prolonged rest post-surgery. No studies have determined the effectiveness of immobilization, early muscle strength training, or both in preventing reinjury in this population.

Downregulation of the PI3K/AKT/mTOR/MMP-13 pathway for promoting interface healing via lubricating microspheres.

Interface friction impedes tissue healing and stimulates interface cells to produce matrix metalloproteinases (MMPs); however, the precise mechanisms underlying matrix degradation, and the formation of fibrous scars remain unclear. This research involved the development of interface lubricating microspheres that inhibit the PI3K/AKT/mTOR signaling pathway in tenocytes. This inhibition significantly decreased MMP-13 expression and increased COL-1 production, thereby facilitating interface repair and regeneration.

Subcutaneous injections of dextrose in musculoskeletal pain, a potential therapeutic intervention: scoping review.

Background: The aims of this review were to identify and to analyze the clinical studies that used subcutaneous injections of dextrose for treating musculoskeletal pain, in order to establish an overview.

Methods: A systematic search was carried out in scientific databases including Web of Science, Cochrane Central Register of Controlled Trials, PUBMED and other sources, up until March 2024. We included clinical studies that used subcutaneous injections of dextrose in the treatment of individuals with musculoskeletal pain associated with tendinopathies, enthesopathy, osteoarthritis, ligament sprains, muscle strains or bursitis of various locations.

External focus instruction using a soft paper balloon on muscle activation patterns in isometric hip abduction exercises: A comparative analysis with external resistance tools.

Background: This study investigates a novel isometric method utilizing an external focus instruction technique with a soft paper balloon. By emphasizing control to avoid crushing the balloon, this method promotes co-contraction of muscles without exerting pressure on the object. We aim to evaluate differences in muscle activation patterns during isometric hip abduction exercises between the paper balloon task and tasks using external resistance (hard plastic, non-elastic, and elastic bands), and further determine their influence on the contralateral side.

3D preoperative plan assisted total knee arthroplasty after knee arthrodesis with patella absence: a case report.

Purpose: The conversion of knee arthrodesis to total knee arthroplasty (TKA) is a challenging procedure. This article aims to report a case of fusion knee with patellar absence who was converted to TKA and has achieved good results.

Methods: The patient, a 23 years old Tibetan Buddhist monk, sustained a left knee joint injury at the age of 12 due to a car accident, leading to subsequent knee arthrodesis at 18 years old as a result of recurrent severe infections.

3D-printed biomimetic scaffolds loaded with ADSCs and BMP-2 for enhanced rotator cuff repair.

Rotator cuff tear repair poses significant challenges due to the complex gradient interface structure. In the face of disease-related disruptions in the tendon-bone interface (TBI), the strategy of constructing a biomimetic scaffold is a promising avenue. A novel 3D-printed rotator cuff scaffold loaded adipose stem cells (ADSCs), bone morphogenetic protein-2 (BMP-2), and collagen type I (COL I).

Bilateral patellar tendon repair with suture bridge augmentation: A case report.

We describe the case of a 37-year-old male who presented with simultaneous bilateral patellar tendon rupture without any associated risk factors. Additionally, this is the first reported use of the suture bridge technique with patellar and tibial suture anchors in repairing bilateral proximal patellar tendon rupture. At 12-month follow-up, the patient had normal alignment, no effusion, and symmetric quadriceps strength.

Light weights are as effective as heavy weights for muscle activation in the Hammerobics exercise.

Purpose: We previously reported that a Hammerobics exercise using weights can enhance trunk and lower extremity muscles, some studies suggested that training effects could also be expected without heavy weights. If the muscle activity induced by Hammerobics swinging with a 'light plastic ball' equals or surpasses that of the isometric static squat and synchronized squat with a heavy ball, this training approach could alleviate joint strain, fostering an exercise regimen universally accessible across generations, benefit for workouts sports and rehabilitation.

Methods: Fifteen healthy men participated in this study.

Identifying clinically meaningful subgroups following open reduction and internal fixation for proximal humerus fractures: a risk stratification analysis for mortality and 30-day complications using machine learning.

Background: Identification of prognostic variables for poor outcomes following open reduction internal fixation (ORIF) of displaced proximal humerus fractures have been limited to singular, linear factors and subjective clinical intuition. Machine learning (ML) has the capability to objectively segregate patients based on various outcome metrics and reports the connectivity of variables resulting in the optimal outcome. Therefore, the purpose of this study was to (1) use unsupervised ML to stratify patients to high-risk and low-risk clusters based on postoperative events, (2) compare the ML clusters to the American Society of Anesthesiologists (ASA) classification for assessment of risk, and (3) determine the variables that were associated with high-risk patients after proximal humerus ORIF.

Revision shoulder arthroplasty: predictors of subsequent revision surgery and economic burden amongst Medicare beneficiaries.

Background: Revision shoulder arthroplasty continues to add an increasing burden on patients and the healthcare system. This study aimed to delineate long-term shoulder arthroplasty revision incidence, quantify associated Medicare spending, and identify relevant predictors of both revision and spending.

Methods: The complete 2016-2022 (Q3) Medicare fee-for-service inpatient and outpatient claims data was analyzed.

Autonomic dysfunction as a possible cause of sudden cardiac death in swimming sports.

Introduction: Human diving reflex is a well-studied phenomenon. However, very little is known about the possible relationship between augmented diving reflex and autonomic dysfunction.

Methods: We retrospectively studied a group of four swimmers who underwent a diving reflex test as part of the examination due to symptoms related to autonomic dysfunction during swimming.

The association of the medial meniscus covering ratio with knee cartilage thickness at 15 medial compartment subregions as found by three-dimensional analysis using MRI.

Purpose: The correlation of cartilage thickness measured by three-dimensional (3D) magnetic resonance imaging (MRI) and the medial meniscal coverage ratio (MMCR), which presented pathology of the medial meniscus extrusion (MME) in 3D MRI, has not yet been elucidated. The study's purpose was to retrospectively verify whether the average cartilage thickness calculated by the automatic MRI 3D analysis system for each subregion was correlated with MMCR.

Methods: A total of 60 patients underwent medial meniscus repair or high tibial osteotomy to treat their medial knee osteoarthritis.

Utility of Machine Learning, Natural Language Processing, and Artificial Intelligence in Predicting Hospital Readmissions After Orthopaedic Surgery: A Systematic Review and Meta-Analysis.

Background: Numerous applications and strategies have been utilized to help assess the trends and patterns of readmissions after orthopaedic surgery in an attempt to extrapolate possible risk factors and causative agents. The aim of this work is to systematically summarize the available literature on the extent to which natural language processing, machine learning, and artificial intelligence (AI) can help improve the predictability of hospital readmissions after orthopaedic and spine surgeries.

Methods: This is a systematic review and meta-analysis.

Effect of diabetes on microvascular morphology and permeability of rat skeletal muscle: in vivo imaging using two-photon laser scanning microscopy.

This investigation evaluated the microvascular permeability and ultrastructure of skeletal muscle capillaries in the skeletal muscle of diabetic (DIA) rats using two-photon laser scanning microscopy (TPLSM) and transmission electron microscopy (TEM). Microvascular permeability was assessed in the tibialis anterior muscle of control (CON) and DIA (streptozocin) male Wistar rats ( = 20, 10-14 wk) by in vivo imaging using TPLSM after fluorescent dye intravenous infusion. Fluorescent dye leakage was quantified to determine microvascular permeability.

Exploring age-related changes in motor function: insights from the peak decline found in Koji Awareness screening test.

The KOJI AWARENESS (KA) screening test assesses motor function in humans. We aimed to analyze the correlation between age and KA screening scores and to identify the specific age at which a significant decline occurs. A total of 793 healthy participants (234 females) were interviewed for basic information on age and sex and completed the KA screening test.

Clinically most relevant psychometric properties of the Lower Extremity Functional Scale: a systematic review.

Purpose: To systematically review and summarize the literature on minimal detectable change (MDC) and minimal clinically important difference (MCID) values for the Lower Extremity Functional Scale (LEFS).

Methods: The databases that were searched included PubMed, Embase, Medline, and CINAHL, from database inception to August 2023. The inclusion criteria were studies that examined the MDC or MCID of the LEFS in various patient populations and languages.