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Background: Kinematic parameters predictive of pitch velocity have been evaluated in adolescent and collegiate baseball pitchers; however, they have not been established for high school or professional pitchers., Purpose: To create multiregression models using anthropometric and kinematics features most predictive for pitch velocity in high school and professional pitchers and compare them with prior multiregression models evaluating other playing levels., Study Design: Descriptive laboratory study., Methods: High school (n = 59) and professional (n = 337) baseball pitchers threw 8 to 12 fastballs while being evaluated with 3-dimensional motion capture (480 Hz). Using anthropometric and kinematic variables, multiregression models for pitch velocity were created for each group. A systematic review was conducted to determine previous studies that established kinematic models for ball velocity in youth, high school, and collegiate pitchers., Results: Leg length was predictive of pitch velocity for high school and professional pitchers ( P < .001 for both). When compared with previously established models for pitch velocity, almost all groups were distinct from one another when assessing age ( P maximum < .001), weight ( P max = .0095), and pitch velocity ( P max < .001). Stride length was a significant predictor for the youth/high school pitchers, as well as the current study's high school and professional pitchers ( P < .001 for all). Maximal shoulder external rotation (collegiate: P = .001; professional: P < .001) and maximal elbow extension velocity (high school/collegiate: P = .024; collegiate: P < .001; professional: P = .006) were shared predictors for the collegiate and current study's professional group multiregression models. Trunk flexion at ball release was a commonly shared predictor in the youth/high school ( P = .04), high school/collegiate ( P = .003), collegiate ( P < .001), and the current study's professional group ( P < .001)., Conclusion: Youth, high school, collegiate, and professional pitchers had unique, predictive kinematic and anthropometric features predictive of pitch velocity. Leg length, stride length, trunk flexion at ball release, and maximal shoulder external rotation were predictive features that were shared between playing levels., Clinical Relevance: Coaches, clinicians, scouts, and pitchers can consider both the unique and the shared predictive features at each playing level when attempting to maximize pitch velocity., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: A.N. has received grant support from Arthrex, education payments from Arthrex and SeaPearl, and hospitality payments from Zimmer Biomet and Stryker. M.C.C. has received grant support from Arthrex and DJO. J.J.R. has received grant support from Arthrex and hospitality payments from Smith+Nephew. J.S.D. has received education payments from Gotham Surgical; consulting fees from Arthrex, KCI, and Trice Medical; nonconsulting fees from Arthrex; and royalties from Arthrex and Linvatec. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2024.)

Background: While an association between femoroacetabular impingement (FAI) and osteoarthritis (OA) has been reported, the mechanistic differences and transition between the 2 conditions is not fully understood. In FAI, cartilage lesions at the femoral head-neck junction can sometimes be visualized during hip arthroscopy., Purpose/hypothesis: The purpose of this study was to describe a unique dimpled pattern of superficial fissured cartilage lesions on the femoral head-neck junction at impingement site in patients with FAI syndrome (FAIS) and to evaluate the clinical, histological, and genetic phenotype of this cartilage. We hypothesized that the cartilage lesions may indicate risk for, or predict occurrence of, OA., Study Design: Controlled laboratory study., Methods: Six hips (6 patients; mean age, 34.2 ± 12.9 years; range, 19-54 years) with dimpled or fissured cartilage were included among patients who underwent hip arthroscopy for treatment of FAIS from October 2020 through December 2021. This affected cartilage (dimple-pattern group) and normal cartilage (control group) on the femoral head-neck junction were collected from the same patients and evaluated for histological quantification by Mankin scores and expression of proteins related to cartilage degeneration (eg, matrix metalloproteinase [MMP]-1, MMP-2, MMP-3, MMP-10, and MMP-12, tissue inhibitor of metalloproteinase [TIMP]-1 and TMP-2, aggrecan neopepitope CS846, and hyaluronic acid [HA]) with the use of Milliplex Multiplex Assays., Results: All 6 hips were of the mixed FAI subtype. Preoperatively, 4 of 6 hips had Tönnis grade 1 radiographic changes, which was associated with greater femoral head chondral damage visualized intraoperatively. Mankin scores for the normal cartilage group and the dimple-pattern group were 0.67 ± 0.82 and 3.3 ± 0.82, respectively. Dimple pattern fissured cartilage showed a significant increase in Mankin score ( P = .031) and a significant increase in protein expression of CS846 ( P = .031) compared with normal cartilage. There were no significant differences in MMPs, TIMPs, or HA levels between the 2 groups., Conclusion: The dimple pattern fissured cartilage, compared to normal cartilage, showed histologically significant cartilage degeneration and a significant increase in protein expression of CS846, a biomarker for early OA., Clinical Relevance: This lesion serves as helpful visual indicator of early degeneration of the cartilage of femoral head-neck junction caused by FAIS., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: C.S.B. has received royalties from Iota Biosciences for a United States patent (041263). J.H. has received royalties from Cook Myosite. M.J.P. has received education payments from Smith & Nephew, Conmed, Linvatec, Ossur, Arthrex, Siemens Medical Solutions; consulting fees from Smith & Nephew, MIS, Olatec, and NICE Recovery Systems; nonconsulting fees from Smith & Nephew, MIS, Olatec, NICE Recovery Systems, and Synthes; royalties from Linvatec, Smith & Nephew, Arthrosurface, Bledsoe, Conmed, DJO, Slack, and Elsevier; and holds shares in Arthrosurface, MJP Innovations, Vail Valley Surgery Center, Vail MSO Holdings, MIS, EFFRx, Olatec, Arthrex, Manna Tree Partners, Stryker, Trimble, 3M, Bristol Myers, Squibb, Pfizer, AbbVie, and Johnson & Johnson. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Vail Health Hospital (ref No. v7 092321)., (© The Author(s) 2024.)

Background: Throwing arm kinetics differ in pitchers at varying arm slot (AS) positions (frontal-plane arm position at ball release relative to the vertical axis)., Purpose: To determine how kinematic and kinetic values differ between professional and high school pitchers with varying AS positions, and whether these differences are similarly observed in both populations., Methods: High school (n = 130) and professional (n = 288) pitchers threw 8 to 12 fastballs under 3-dimensional motion capture technology. Pitchers in each cohort were subdivided based on mean AS position at ball release: AS 1 (least degree of AS: most overhand throwing styles), AS 2 (intermediate degree of AS: three-quarter throwing styles), or AS 3 (greatest degree of AS: most sidearm throwing styles). Kinetic and kinematic parameters were compared between groups., Study Design: Controlled laboratory study., Results: High school pitchers had a more overhand AS at ball release (50° ± 11°) compared with professional pitchers (58° ± 14°) ( P < .001). In both cohorts, AS 1 pitchers had significantly greater shoulder abduction (high school, P <0.001; professional, P <0.0001) and lateral trunk flexion (high school, P < 0.001; professional, P <0.0001) at ball release compared with AS 3 pitchers. Professional pitchers with an AS 3 position had significantly delayed timing of maximum upper trunk angular velocity compared with AS 1 pitchers (64% ± 7% vs 57% ± 7% of pitch time, respectively; P < .0001). A significant positive correlation between AS and elbow flexion torque was found in high school pitchers ( P = .002; β = 0.28), and a significant negative correlation between AS and elbow varus torque ( P < .001; β = -0.22) and shoulder internal rotation torque ( P < .001; β = -0.20) was noted in professional pitchers., Conclusion: AS position was related to shoulder abduction and trunk lateral tilt. Professional and high school pitchers with varying AS positions did not experience similar changes in throwing arm kinetics., Clinical Relevance: In professional pitchers, the earlier onset of maximum upper trunk angular velocity with overhand throwing style may reflect inappropriate pelvis-trunk timing separation, a parameter implicated in upper extremity injury, and the negative correlation between AS and elbow varus and shoulder internal rotation torque suggests that both excessive and minimal AS positions have negative implications., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: J.J.R. has received hospitality payments from Smith & Nephew. M.C.C. has received education payments from Liberty Surgical. J.S.D. has received education payments from Gotham Surgical; consulting fees from Arthrex, Merck Sharp & Dohme, and Trice Medical; nonconsulting fees from Arthrex; and royalties from Arthrex and Linvatec. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2023.)

Background: The prevalence of findings on shoulder magnetic resonance imaging (MRI) is high in asymptomatic athletes of overhead sports., Purpose/hypothesis: The purpose of this study was to determine the prevalence of atypical findings on MRI in shoulders of asymptomatic, elite-level climbers and to evaluate the association of these findings with clinical examination results. It was hypothesized that glenoid labrum, long head of the biceps tendon, and articular cartilage pathology would be present in >50% of asymptomatic athletes., Study Design: Cross-sectional study; Level of evidence, 3., Methods: A total of 50 elite climbers (age range, 20-60 years) without any symptoms of shoulder pain underwent bilateral shoulder examinations in addition to dedicated bilateral shoulder 3-T † MRI. Physical examinations were performed by orthopaedic sports medicine surgeons, while MRI scans were interpreted by 2 blinded board-certified radiologists to determine the prevalence of abnormalities of the articular cartilage, glenoid labrum, biceps tendon, rotator cuff, and acromioclavicular joint., Results: MRI evidence of tendinosis of the rotator cuff, subacromial bursitis, and long head of the biceps tendonitis was exceptionally common, at 80%, 79%, and 73%, respectively. Labral pathology was present in 69% of shoulders, with discrete labral tears identified in 56%. Articular cartilage changes were also common, with humeral pathology present in 57% of shoulders and glenoid pathology in 19% of shoulders. Climbers with labral tears identified in this study had significantly increased forward elevation compared with those without labral tears in both active ( P = .026) and passive ( P = .022) motion., Conclusion: The overall prevalence of intra-articular shoulder pathology detected by MRI in asymptomatic climbers was 80%, with 57% demonstrating varying degrees of glenohumeral articular cartilage damage. This high rate of arthritis differs significantly from prior published reports of other overhead sports athletes., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: M.N.S. has received education payments from Southern Edge Orthopaedics. C.P.H. has received consulting fees from Smith & Nephew. T.R.H. has received hospitality payments from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2022.)

Background: The therapeutic efficacy of orthobiologic therapies for rotator cuff repair is difficult to evaluate owing to reporting inconsistences. In response, the Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines were developed to ensure standard reporting on orthobiologic therapies., Purpose: To systematically review clinical studies evaluating platelet-rich plasma (PRP) for full-thickness rotator cuff repair and adherence to MIBO guidelines., Study Design: Scoping review; Level of evidence, 4., Methods: A search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, EMBASE, and the Cochrane Library databases. Inclusion criteria were clinical studies reporting on rotator cuff tears (≥1 cm) surgically repaired with PRP. Patient demographics, biologic intervention, and adherence to the MIBO guidelines were systematically reviewed., Results: A total of 19 studies (1005 patients) were included in this review. Across all studies, 58.5% of the MIBO checklist items for PRP were reported. Out of 47 checklist items, 19 were reported in over 85% of studies, whereas 22 were reported in less than half of studies. Details of whole-blood processing and characteristics, as well as PRP processing and characteristics, were reported inconsistently, and no study provided adequate information to enable the precise replication of preparation protocols for PRP., Conclusion: This systematic review highlights the current reporting deficiencies within the scientific literature of important variables for evaluating PRP for full-thickness rotator cuff repair. There was widespread variability among published studies that evaluate PRP for this application and, more specifically, studies were limited by inconsistent universal reporting of whole-blood and PRP processing and postprocessing characteristics. To improve our understanding of biologic efficacy and to promote repeatability, stricter adherence to the MIBO guidelines is necessary. We propose that the checklist limitations be addressed and that modification of the MIBO guidelines be considered to improve the reporting of individual components within certain categories., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: J.J.R. has received financial support from ProofPoint Biologics and hospitality payments from Smith & Nephew. P.J.M. has received financial support from ProofPoint Biologics, royalties from Arthrex, Medbridge, and Springer; consulting fees from Arthrex; research support from Arthrex, Ossur, Siemens, VuMedi, and Smith & Nephew; and hospitality payments from Arthrosurface, Gemini Mountain Medical, Stryker, and Sanofi-Aventis; and holds stock in Vu Medi. J.H. has received financial support from ProofPoint Biologics and royalties from CookMyosite. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2021.)