Shoulder and Elbow Recent Publications

This study examined how often patients who underwent hip arthroscopy for femoroacetabular impingement (FAI)—a condition where abnormal bone shape causes hip pain and joint damage—required conversion to total hip arthroplasty (THA) within two years of the procedure. Using a large U.S. commercial insurance database, researchers analyzed data from over 11,000 patients treated between 2011 and 2016, applying logistic regression and survivorship analysis to identify risk factors for early surgical failure. The study found that 7% of patients converted to THA within two years, and that older age, pre-existing osteoarthritis, joint inflammation, a history of opioid use, and smoking were all independently associated with a significantly higher risk of requiring THA. Notably, the rate of hip arthroscopy nearly doubled over the study period, reflecting growing adoption of the procedure despite these risks. These findings suggest that surgeons should carefully counsel higher-risk patients—particularly older individuals or those with degenerative joint disease and certain lifestyle factors—about realistic expectations before proceeding with hip arthroscopy for FAI.

This study aimed to develop and validate a physical examination test — called the Pull-Out Test — to help identify hip microinstability (HMI), a condition where the hip joint is excessively loose without full dislocation. Researchers studied 100 patients scheduled for hip arthroscopy, dividing them into two groups based on established instability assessments: 32 with HMI and 68 without. The Pull-Out Test was performed by applying gentle traction to the leg and measuring how far the femoral head separated from the hip socket, with a distance of 1.3 cm or greater used as the threshold for identifying instability. The test demonstrated strong diagnostic accuracy, with a sensitivity of 91% and specificity of 96%, meaning it was reliable at both detecting true cases of instability and ruling out those without it. These findings suggest the Pull-Out Test is a simple, effective clinical tool that could improve pre-surgical diagnosis of hip microinstability and help guide treatment decisions for patients with labral tears.

This study investigated whether 3D surface scanning could objectively track physical changes in the knee following anterior cruciate ligament (ACL) reconstruction surgery. Thirty patients underwent 3D surface scans of their knee at five time points: before surgery and at 2, 6, 12, and 26 weeks after surgery, alongside standard questionnaires measuring knee function. The scans revealed significant swelling around the kneecap (patella) immediately after surgery, which gradually returned to normal levels, while noticeable muscle loss in the quadriceps region became measurable by 12 weeks but largely recovered by six months. Swelling in the patella region was also meaningfully linked to how well patients reported their knee was functioning during recovery. These findings suggest that 3D surface scanning is a practical and precise tool for monitoring post-surgical recovery, potentially allowing clinicians to better track healing progress and tailor rehabilitation programs for ACL patients.

This study investigated whether the Microsoft Kinect™, a low-cost, markerless motion capture camera, could accurately measure knee movements associated with ACL injury risk and return-to-sport readiness. Researchers compared the Kinect™ to a gold-standard 3D motion capture system by having 20 healthy participants perform dynamic lower-body exercises, including single-leg hops and box jumps, while both systems simultaneously recorded knee angles. The results showed notable differences between the two systems, with angle measurements differing by roughly 4 to 10 degrees on average and intraclass correlation coefficients ranging from 0.553 to 0.759, indicating only moderate-to-poor agreement. These discrepancies suggest that the Kinect™ cannot reliably capture the precise knee mechanics needed to evaluate ACL injury risk or determine when an athlete is safely ready to return to sport. While affordable motion capture tools are highly desirable in clinical settings, this study highlights that the Microsoft Kinect™ lacks the accuracy required for making these critical assessments.

This systematic review and meta-analysis investigated whether the phases of the menstrual cycle influence anterior knee laxity and the risk of anterior cruciate ligament (ACL) tears in women, since women experience ACL injuries at higher rates than men. Researchers analyzed 28 studies drawn from nearly 1,300 search results, including 19 studies on knee laxity (573 subjects) and 9 studies on ACL tear rates (2,519 subjects). Results showed that knee laxity was greatest during the ovulatory phase compared to the follicular phase, while ACL tear risk was actually lower during the luteal phase relative to the follicular and ovulatory phases combined. Notably, the phases with the greatest knee laxity did not correspond to the phases with the highest ACL injury risk, suggesting that hormonal influences on ACL tears are not simply explained by changes in joint looseness. While these findings challenge a straightforward hormone-laxity-injury connection, the authors caution that differences in study design and methodology limit firm conclusions, highlighting the need for more standardized research in this area.