Citations

This cross-sectional study investigates rates of incident pericardial effusion or cardiac tamponade in patients receiving Bruton tyrosine kinase inhibitors.

Objective During open chondral defect preparation, audible debridement sound changes mark the transition from deep cartilage to the calcified cartilage layer. We developed a novel curette microphone to characterize these audio feature differences during arthroscopic defect preparation. Design A piezoelectric curette microphone was used to transmit and record debridement sound from 12 defect preparations (6 deep cartilage, 6 CCL) using human osteochondral allograft remnants. Live audio from the device was used to stop each debridement at the intended level, which was verified histologically. Spectrograms and power-spectral density plots were used to describe the audible transition from deep cartilage to CCL. We compared 22 audio features describing loudness, frequency, and complexity between the two tissue levels. Results Curette strokes against the deep cartilage were louder, higher frequency, and more acoustically complex than strokes against the CCL (p < 0.001). Cartilage debridement generated acoustically complex frequency bands above 2.5 kHz that diminished upon reaching the CCL. Debridement of the CCL produced a simpler audio profile that was predominant below 350 Hz. Conclusion The novel curette microphone presented here transmits high-fidelity debridement audio that can be used to accurately distinguish tissue depth based on the distinct audio profiles of the deep cartilage and CCL.

Purpose The purpose of this study was to identify risk factors and evaluate clinical outcomes associated with incidental left common iliac vein compression on CT imaging. Methods This is a retrospective study that reviewed venous-phase abdomen and pelvis CT scans to identify patients with incidental extrinsic compression of the left common iliac vein due to an overlying right common iliac artery. A total of 726 patients were included (364 females, 362 males; mean patient age: 61.9 ± 15.9 years). Board-certified radiologists reviewed all CT scans. Significant left iliac vein compression was defined as >50% luminal narrowing. Results Significant iliac vein compression was identified in 114 (15.7%) patients and was more common in females (19.5%) versus males (11.9%) ( p < 0.01). Patients with iliac vein compression >50% had significantly lower BMI than those without compression (24.8 ± 6.2 vs 28.7 ± 7.2 kg/m 2 , p < 0.01). Patients with incidental left iliac vein compression had a higher rate of prior left lower extremity DVT ( p = 0.02). Conclusion Incidental left common iliac vein compression was present in approximately 16% of patients and was more frequent among females. Compression was associated with lower BMI and more than twice the rate of ipsilateral DVT, despite no prior diagnosis of MTS. These findings suggest that incidental iliac vein compression could have more clinical significance than previously recognized.

Purpose To evaluate objective return‐to‐sport (RTS) outcomes and limb symmetry index (LSI) data after primary medial patellofemoral ligament reconstruction (MPFLR) in patients with patellar instability. Methods A systematic search of Scopus, PubMed, CINAHL, and Embase (2000‐2024) identified studies reporting RTS outcomes and LSI‐based performance testing in patients undergoing primary MPFLR. Clinical and observational studies reporting objective metrics such as isokinetic strength and hop testing were included. Results Six studies including 243 patients (64% women, mean age 19.4 years) undergoing primary MPFLR were included. Several studies included patients undergoing concomitant bone procedures (41%), such as tibial tubercle osteotomy or trochleoplasty. Objective RTS testing commonly included isokinetic strength (4 studies), hop testing (3 studies), and Y‐Balance testing (2 studies). Follow‐up testing ranged from 6 to 8 months postoperatively. Reported LSI values ranged from 83% to 94% for isokinetic flexion, 70% to 96% for isokinetic extension, 85% to 93% for single hop, and 90% to 97% for triple hop. Time to RTS ranged from 6.1 to 8.1 months across studies, with RTS rates from 85% to 100%. However, only 14% to 40% of patients met all study‐specific RTS criteria when reported. Testing protocols and thresholds varied across studies, contributing to heterogeneity in outcomes. Conclusions Few studies reporting RTS outcomes after MPFLR incorporate LSI measures as part of RTS assessment, and only a minority define explicit RTS criteria based on objective testing. Among studies that reported LSI, quadriceps strength frequently remained below 90% LSI at the time of RTS. Despite high reported RTS rates, substantial variability exists in RTS assessment after MPFLR. Level of Evidence Level IV, systematic review of Level III to IV studies.

Background: The limb symmetry index (LSI) is a measure comparing strength and functional movement between the surgical and nonsurgical limbs, used after anterior cruciate ligament reconstruction (ACLR) to guide rehabilitation and assess return-to-sport readiness. With increasing use of the quadriceps tendon autograft (QT-ACLR), limited data exist on whether the LSI score correlates with patient-reported outcome measures (PROMs). Hypothesis/Purpose: To evaluate the predictive value of postoperative strength and functional LSI tests at 3, 6, and 9 months for short-term PROMs, determine Patient Acceptable Symptom State (PASS) thresholds, and assess differences based on PASS achievement. It was hypothesized that quadriceps strength LSI score would more strongly predict 2-year PROMs than hamstring strength LSI score, and that higher 9-month isokinetic quadriceps LSI scores would be associated with higher International Knee Documentation Committee (IKDC) and Lysholm scores. Study Design: Case series; Level of evidence, 4. Methods: Patients undergoing primary QT-ACLR from 2021 to 2024 with LSI testing during rehabilitation (isometric and isokinetic lower extremity strength, Y-Balance, hop testing) and no revision or additional knee surgery were included. The LSI score was assessed at 3, 6, and 9 months, and PROMs, including Lysholm and IKDC scores, were collected at a mean follow-up of 2.0 ± 0.7 years. Multivariable linear regression was used to evaluate associations between LSI measures and PROMs after adjusting for age, sex, and body mass index (BMI). Receiver operating characteristic analysis was used to determine PASS thresholds. Results: A total of 100 knees in 100 patients (mean age, 25.3 ± 11.2 years; BMI, 25.9 ± 6.5 kg/m 2 ; 52% male) were included. Quadriceps and hamstring strength and functional performance progressively improved from 3 to 9 months, with the LSI score reaching 77% to 81% for quadriceps strength and 98% to 100% for hamstring strength by 9 months postoperatively. At a mean follow-up of 2.0 ± 0.7 years, the mean satisfaction score was 8.4 of 10, the Lysholm score was 90.7, and the IKDC score was 77.8. Linear regression, adjusted for age, sex, and BMI, demonstrated that 3-month isometric quadriceps LSI score had a strong effect on IKDC score, explaining substantial variance (β = 3.9; adjusted R 2 [Adj R 2 ] = 0.36; P < .03); 6-month isokinetic quadriceps and hamstrings showed moderate but significant effects (β = 2.9-3.7; Adj R 2 = 0.13-0.17; P < .05) on IKDC score; and 9-month fast quadriceps had a strong effect explaining substantial variance in Lysholm and IKDC scores (β = 3.9-4.7; Adj R 2 = 0.34-0.35; P ≤ .003). Lysholm and IKDC scores correlated with satisfaction and accurately discriminated PASS thresholds (area under the curve, 0.927-0.937; P < .001). Patients achieving the IKDC PASS demonstrated higher LSI scores across time points and all PROMs. Conclusion: After QT-ACLR, strength-associated LSIs were independently associated with PROMs at a mean 2-year follow-up, after adjusting for age, sex, and BMI. Early isometric quadriceps strength at 3 months predicted higher 2-year IKDC scores, with PASS achievers generally attaining a 60% to 70% LSI score by 3 months. Isokinetic quadriceps strength at 9 months predicted both IKDC and Lysholm scores. These findings highlight the importance of early quadriceps strength recovery and the value of LSI measures in predicting PROMs and informing early rehabilitation.