What’s New in Sports Medicine 2024

Key findings in sports medicine on topics such as rotator cuff repair, anterior cruciate ligament (ACL) reconstruction, and more are presented in the new JBJS Guest Editorial What’s New in Sports Medicine. Here, we highlight the 5 most compelling studies, as selected by co-author Cassandra A. Lee, MD. 

Shoulder

A clinical practice guideline consisting of 73 recommendations and 3 clinical decision algorithms was developed to aid in the diagnosis and management of rotator cuff disorders and to support the return to work of adult patients. An active rehabilitation program plus oral nonsteroidal anti-inflammatory drugs was favored over corticosteroid injections and opioids for initial nonoperative management. Recommendations for the use of advanced imaging for a suspected full-thickness rotator cuff tear, a traumatic event, or failure of nonoperative management were also provided, among other guidelines¹. 

In a systematic review and meta-analysis, arthroscopic Bankart repair with remplissage was compared with Bankart repair only or the Latarjet procedure with respect to return-to-sport rates, functional outcomes, and adverse events among athletes. Remplissage was associated with significantly higher odds of return to sport (odds ratio [OR], 2.71; p = 0.02) and significantly lower odds of recurrence (OR, 0.18; p < 0.001) and reoperation (OR, 0.17; p = 0.001) compared with the other surgical alternatives². 

Hip

A systematic review compared the outcomes, at a minimum 2-year follow-up, of patients with femoroacetabular impingement who underwent a capsulotomy either with capsular repair (249 hips) or without capsular repair (157 hips). The group with capsular repair showed greater improvement in patient-reported outcomes than the group with no repair. The rate of hip survivorship was also higher in the capsular repair group, although the rate of revision did not differ between the groups³. 

Knee

The STABILITY group reported the findings of their randomized clinical trial evaluating clinical outcomes in patients at a high risk for graft failure who underwent ACL reconstruction with or without a lateral extra-articular tenodesis (LET) augment. Patients who received the LET augment had a 67% relative reduction in the risk of graft rupture and a 38% relative reduction in the risk of clinical failure compared with those who did not receive the augment^4,5. 

The outcomes of adolescents with first-time patellar dislocation who underwent medial patellofemoral ligament (MPFL) reconstruction were compared with those of adolescents who underwent MPFL repair or who did not undergo treatment. Patients in the MPFL reconstruction cohort were 5 times less likely to experience recurrent instability and 8 times less likely to undergo a secondary procedure. They also returned to sport at a higher rate than patients in the other cohort (66.7% vs. 39.1%, respectively)⁶. 

What’s New in Sports Medicine is freely available at JBJS.org. 

What’s New by Subspecialty

Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org. 

Recent OrthoBuzz posts include: What’s New in Hand Surgery, What’s New in Pediatric Orthopaedics, and What’s New in Adult Reconstructive Knee Surgery. 

References 

1. Lafrance S, Charron M, Roy JS, Dyer JO, Frémont P, Dionne CE, Macdermid JC, Tousignant M, Rochette A, Doiron-Cadrin P, Lowry V, Bureau N, Lamontagne M, Sandman E, Coutu MF, Lavigne P, Desmeules F. Diagnosing, managing, and supporting return to work of adults with rotator cuff disorders: a clinical practice guideline. J Orthop Sports Phys Ther. 2022 Oct;52(10):647-64. 
2. Davis WH, DiPasquale JA, Patel RK, Sandler AB, Scanaliato JP, Dunn JC, Parnes N. Arthroscopic remplissage combined with Bankart repair results in a higher rate of return to sport in athletes compared with Bankart repair alone or the Latarjet procedure: a systematic review and meta-analysis. Am J Sports Med. 2023 Oct;51(12):3304-12. 
3. Carbone AD, Prabhavalkar O, Chishti Z, Curley AJ, Parsa A, Domb BG. Hip capsular repair results in improved patient-reported outcomes and survivorship: a systematic review of the literature. Arthroscopy. 2023 Feb;39(2):488-97. 
4. Getgood A, Bryant D, Firth A; Stability Group. The Stability study: a protocol for a multicenter randomized clinical trial comparing anterior cruciate ligament reconstruction with and without lateral extra-articular tenodesis in individuals who are at high risk of graft failure. BMC Musculoskelet Disord. 2019 May 15;20(1):216. 
5. Getgood AMJ, Bryant DM, Litchfield R, et al. Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial. Am J Sports Med. 2020;48(2):285-97.  
6. Gurusamy P, Pedowitz JM, Carroll AN, Johnson K, Chambers HG, Edmonds EW, Pennock AT. Medial patellofemoral ligament reconstruction for adolescents with acute first-time patellar dislocation with an associated loose body. Am J Sports Med. 2021 Jul;49(8):2159-64.