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.

Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity.

Background: A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown.

Use of Patient-Reported Outcome Measures in Lower Extremity Research.

Background: A large number of patient reported outcome measures (PROMs) have been developed for specific lower extremity orthopaedic pathologies. However, a consensus as to which PROMs are recommended for use in evaluating treatment outcomes for patients with hip, knee, ankle and/or foot pathology based on the strength of their psychometric properties is lacking.

Objective: To identify PROMs that are recommended in systematic reviews (SRs) for those with orthopaedic hip, knee, foot, and ankle pathologies or surgeries and identify if these PROMs are used in the literature.

Generalised joint hypermobility leads to increased odds of sustaining a second ACL injury within 12 months of return to sport after ACL reconstruction.

Objectives: To determine the 12-month risk of a second anterior cruciate ligament (ACL) injury in a population of patients with and without generalised joint hypermobility (GJH) who return to sports (RTS) at competition level after ACL reconstruction (ACL-R).

Methods: Data were extracted from a rehabilitation-specific registry for 16-50-year-old patients treated with ACL-R between 2014 and 2019. Demographics, outcome data and the incidence of a second ACL injury within 12 months of RTS, defined as a new ipsilateral or contralateral ACL, were compared between patients with and without GJH.

Distance to Dislocation and Recurrent Shoulder Dislocation After Arthroscopic Bankart Repair: Rethinking the Glenoid Track Concept.

Background: The "distance to dislocation" (DTD) calculation has been proposed as 1 method to predict the risk of recurrent dislocation after arthroscopic Bankart repair for an "on-track" shoulder. Rates of recurrent dislocation at specific DTD values are unknown.

Hypothesis: Among patients with "on-track" shoulder lesions who underwent primary arthroscopic Bankart repair, the rate of recurrent dislocation would increase as DTD values decrease.

Rehabilitation Guidelines for Use Following a Periacetabular Osteotomy (PAO): A North American Based Delphi Consensus.

Background: Treatment of acetabular dysplasia with a periacetabular osteotomy (PAO) has been shown to improve long term outcomes and is considered the gold standard in the setting of symptomatic hip dysplasia in patients younger than 35 years of age. Post-operative rehabilitation following a PAO plays an important role in helping patients return to their prior level of function and reduce the impact of strength deficits that may persist. Currently, there is a paucity of research supporting post-operative rehabilitation guidelines.

Relationship of Average Outcomes Scores and Change in Status Requires Further Interpretation Between 1 and 2 Years Following Hip Arthroscopy.

Background: Previous studies have demonstrated a clinically impactful change in patients between 1 and 2 years after hip arthroscopy. Assessment of differences in patient-specific factors between patients who remain the same and those who change (ie, either improve or decline) could provide valuable outcome information for orthopaedic surgeons treating those patients.

Purpose: To identify patients who experienced change in functional status between 1 and 2 years after hip arthroscopy for femoroacetabular impingement syndrome and assess differences in patient-specific factors between those who improved, remained the same, or declined in functional status.

Greater proportion of patients report an acceptable symptom state after ACL reconstruction compared with non-surgical treatment: a 10-year follow-up from the Swedish National Knee Ligament Registry.

Objectives: To compare the proportion of patients with anterior cruciate ligament (ACL) injury reporting an acceptable symptom state, between non-surgical and surgical treatment during a 10-year follow-up.

Methods: Data were extracted from the Swedish National Knee Ligament Registry. Exceeding the Patient Acceptable Symptom State (PASS) for the Knee injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome.

A comparison of 6-month outcomes between periacetabular osteotomy with concomitant hip arthroscopy to isolated hip arthroscopy for femoroacetabular impingement.

Purpose: To compare early outcomes of periacetabular osteotomy (PAO) with concomitant hip arthroscopy to isolated hip arthroscopy for femoroacetabular impingement (FAI) and chondrolabral pathology using patient-reported outcomes measurement information system (PROMIS).

Materials And Methods: Consecutive patients scheduled for PAO with concomitant hip arthroscopy (PAO + HA) or isolated hip arthroscopy (HA) between the ages of 15 and 30 years old were prospectively included in the study. Based on power analysis, subjects were recruited until there were 22 subjects in the PAO + HA group.

The Single Leg Squat Test: A "Top-Down" or "Bottom-Up" Functional Performance Test?

Background: Medial knee deviation (MKD) during the single leg squat test (SLST) is a common clinical finding that is often attributed to impairments of proximal muscular structures. Investigations into the relationship between MKD and the foot and ankle complex have provided conflicting results, which may impact clinicians' interpretation of the SLST.

Purpose: The purpose of this study was to compare ankle dorsiflexion range of motion (ROM) and foot posture in subjects that perform the SLST with MKD (fail) versus without MKD (pass).

On-Track Lesions with a Small Distance to Dislocation Are Associated with Failure After Arthroscopic Anterior Shoulder Stabilization.

Background: Off-track lesions are strongly associated with failure after arthroscopic Bankart repair. However, on-track lesions with a small distance-to-dislocation (DTD) value, or "near-track lesions," also may be at risk for failure. The purpose of the present study was to determine the association of DTD with failure after arthroscopic Bankart repair.

Anatomic single- and double-bundle ACL reconstruction both restore dynamic knee function: a randomized clinical trial-part II: knee kinematics.

Purpose: Compare side-to-side differences for knee kinematics between anatomic single-bundle (SB) and anatomic double-bundle (DB) ACLR during downhill running at 6 and 24 months post ACLR using high-accuracy dynamic stereo X-ray imaging. It was hypothesized that anatomic DB ACLR would better restore tibio-femoral kinematics compared to SB ACLR, based on comparison to the contralateral, uninjured knee.

Methods: Active individuals between 14 and 50 years of age that presented within 12 months of injury were eligible to participate.

Achievement of Meaningful Clinical Outcomes Is Unaffected by Capsulotomy Type During Arthroscopic Treatment of Femoroacetabular Impingement Syndrome: Results From the Multicenter Arthroscopic Study of the Hip (MASH) Study Group.

Background: Capsule management has emerged as an important topic in the field of hip arthroscopy. The 2 most popular techniques are interportal capsulotomy and T-type capsulotomy, but few studies have compared outcomes between these 2 techniques.

Purpose: To compare 2-year (±2 months) patient-reported outcomes (PROs) between patients who underwent interportal versus T-type capsulotomy during arthroscopic labral repair for femoroacetabular impingement syndrome (FAIS).

Patient-Reported Outcome Measures and Clinically Important Outcome Values in Hip Arthroscopy: A Systematic Review.

Background: Defining success in hip arthroscopy through patient-reported outcome measures (PROMs) is complicated by the wide range of available questionnaires and overwhelming amount of information on how to interpret scores. The minimal clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) are collectively known as clinically important outcome values (CIOVs). These CIOVs provide benchmarks for meaningful improvement.

Reliability and validity of a return to sports testing battery for the shoulder.

Objective: To determine the validity, intra- and inter-rater, and absolute reliability of a return to sport testing battery for the shoulder in a healthy cohort.

Design: Cross-sectional design. All participants completed a battery of strength (isokinetic, isometric, and repetition to failure) and functional assessments on two occasions.

Arthroscopic classification of intra-articular hip pathology demonstrates at best moderate interrater reliability.

Purpose: The purpose of this study was to report several novel classification systems for intra-articular lesions observed during hip arthroscopy, and to quantify the interrater reliability of both these novel systems and existing classifications of intra-articular lesions when tested by a group of high-volume hip arthroscopists.

Methods: Five hip arthroscopists deliberated over shortcomings in current classification systems and developed several novel grading systems with particular effort made to capture factors important to the treatment and outcomes of hip arthroscopy for labral injury. A video learning module describing the classifications was then developed from the video archive of surgeries performed by the senior author and reviewed by study participants.

A tiered system using substantial clinical benefit and patient acceptable symptomatic state scores to evaluate 2-year outcomes of hip arthroscopy with the Hip Outcome Score.

There is no information to define variations in hip arthroscopy outcomes at 2-year follow-up using the Hip Outcome Score (HOS). To offer a tiered system using HOS absolute substantial clinical benefit (SCB) and patient acceptable symptomatic state (PASS) scores for 2-year hip arthroscopy outcome assessment. This was a retrospective review of patients having hip arthroscopy for femoroacetabular impingement and/or chondrolabral pathology.

Defining Variations in Outcomes of Hip Arthroscopy for Femoroacetabular Impingement Using the 12-Item International Hip Outcome Tool (iHOT-12).

Background: As health care moves toward a value-based payment system, it will be important that patient-reported outcome measures (PROMs) define variations in outcome over a follow-up period that allows a patient to achieve maximal improvement. Although there is evidence to support the use of PROMs to assess postoperative outcomes after hip arthroscopy, there is limited information available to assess for variations in outcome at a 2-year follow-up interval.

Purpose: To identify substantial clinical benefit (SCB) and patient acceptable symptom state (PASS) cutoff scores for the 12-item International Hip Outcome Tool (iHOT-12) that define patient status across a spectrum of potential outcomes after hip arthroscopy at a 2-year follow-up interval.

Unique Substantial Clinical Benefit Values for the 12-Item International Hip Outcome Tool Based on Preoperative Level of Function.

Purpose: To define unique substantial clinical benefit (SCB) values for improvement on the 12-item International Hip Outcome Tool (iHOT-12) based on a preoperative self-rating of function in patients undergoing hip arthroscopy for intra-articular pathology.

Methods: This was a retrospective review of prospective collected data on patients having hip arthroscopy for labral and chondral pathology and femoroacetabular impingement. On preoperative assessment and 1-year (+/-1 month) follow-up, subjects completed the iHOT-12 and a self-categorical rating of function ("severely abnormal," "abnormal," "nearly normal," or "normal").

CLINICAL RELEVANCE of the LIGAMENTUM TERES: A LITERATURE REVIEW.

Background: The ligamentum teres (LT) continues to be a structure of debate and interest. Previously thought of as a vestigial structure, an awareness of LT pathology and its potential importance has increased with the expansion of hip arthroscopy.

Purpose: To provide a comprehensive literature synthesis on the LT and provide clinicians with the most current research regarding the LT and its anatomical features, functional relevance, prevalence of injury, risk factors for injury, clinical presentation, and treatment for pathology.

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review.

Objective: To systematically review and evaluate the efficacy and complication profile of prolotherapy using hyperosmolar dextrose solution injection for rotator cuff tendinopathy.

Literature Survey: MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (from inception to 1 July, 2019).

Methodology: A comprehensive search was completed to identify randomized controlled trials addressing prolotherapy using hyperosmolar dextrose solution for rotator cuff tendinopathy.

LENGTH CHANGE OF THE ILIOFEMORAL LIGAMENT DURING TESTS FOR ANTERIOR MICROINSTABILITY OF THE HIP JOINT: A CADAVERIC VALIDITY STUDY.

Purpose/background: There is little information to support the use of clinical tests to assess for microinstability of the hip joint. The purpose of this study was to use a string model to describe and compare length changes of the iliofemoral ligament in the test positions commonly used to assess hip ligament laxity.

Methods: Twelve hip joints from nine cadavers (4 male; 5 female) with lifespans of 57-84 years of age were studied.

Impact of Platelet-Rich Plasma Use on Pain in Orthopaedic Surgery: A Systematic Review and Meta-analysis.

Context: Amid extensive debate, evidence surrounding the use of platelet-rich plasma (PRP) for musculoskeletal injuries has rapidly proliferated, and an overall assessment of efficacy of PRP across orthopaedic indications is required.

Objectives: (1) Does PRP improve patient-reported pain in musculoskeletal conditions? and (2) Do PRP characteristics influence its treatment effect?

Data Sources: MEDLINE, EMBASE, Cochrane, CINAHL, SPORTDiscus, and Web of Science libraries were searched through February 8, 2017. Additional studies were identified from reviews, trial registries, and recent conferences.