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Background and Objectives : Hypermobility of the lateral meniscus is typically associated with the posterior part of this structure, with occurrences in the anterior part rarely reported. However, a hypermobile anterior horn of the lateral meniscus can manifest clinical symptoms. This study aimed to increase awareness regarding hypermobility in the anterior horn of the lateral meniscus by presenting its clinical presentations, magnetic resonance imaging (MRI) findings, arthroscopic findings, treatment approaches, postoperative protocols, and clinical outcomes. Materials and Methods : A retrospective case-series involving patients diagnosed as having hypermobile anterior horn of the lateral meniscus through arthroscopy. The clinical presentations, preoperative image findings, arthroscopic findings, treatments, postoperative protocols, and clinical outcomes following meniscal stabilization were all reviewed. Results : A total of 17 patients (17 knees) with a mean age of 45.9 ± 18.4 years were analyzed. The mean follow-up period was 18.2 ± 7.6 months (range, 6-24 months). Primary symptoms included anterior lateral knee pain, tenderness in the lateral joint lines, and a locking sensation in six of the knees. MRI revealed hypodense lesions anterior to the meniscus, fluid accumulation, degenerative changes, and anterior horn deformities. Following meniscal stabilization, the Lysholm Knee Scoring Scale score increased from 65.8 ± 12.7 before surgery to 91.1 ± 9.6 at the final follow-up ( p < 0.001). All the analyzed knees achieved a full range of motion by the final follow-up, with no patient experiencing any complication or requiring reoperation. Conclusions : There is no specific sign or test that can be used to detect a hypermobile anterior horn of the lateral meniscus. A thorough arthroscopic examination is essential for diagnosing hypermobility in the anterior horn of the lateral meniscus. Arthroscopic meniscal stabilization yields favorable outcomes.

We report two rare cases of femoral neck fracture resulting from osteonecrosis of the femoral head (ONFH) that was undiagnosed at the patients' initial visits. The patient in the first case had sequential bilateral displaced femoral neck fractures. Because no osteonecrosis of the femoral head was visible on X-ray film and the data of liver function tests were normal, ONFH was not diagnosed. In addition, because the patient was a 55-year-old man with normal everyday functioning, closed reduction with cannulated screws was performed at both visits. Nine months later, he came to our outpatient department with bilateral hip pain; X-rays revealed nonunion and implant failure at both hips. The patient subsequently underwent bilateral total hip arthroplasty (THA) and had a satisfactory outcome at his 4-year follow-up. The patient in the second case had a left displaced femoral neck fracture after trivial trauma two months prior. ONFH was not diagnosed upon examination of X-ray findings. The patient was 52 years old with liver cirrhosis and had bipolar hemiarthroplasty performed because of a chronic displaced fracture and poor general condition. After 2 years, she began to have right hip pain. X-rays revealed massive necrosis and sclerosis of the femoral head. Computed tomography scans for ONFH staging revealed impending fracture lines at the subcapital site of the patient's previous left femoral neck fracture. Right THA was then performed, and the outcome was satisfactory.

Purpose: This meta-analysis was performed to compare outcomes among different types of graft for revision anterior cruciate ligament reconstruction (ACLR)., Methods: A comprehensive search from Embase, PubMed, and Cochrane Library was performed to identify relevant articles. Studies that conducted a comparative analysis on outcomes among different types of grafts were included. A meta-analysis was performed using Review Manager 5.4 software., Results: In total, 7 non-randomized studies with a minimum 1-year follow-up were included in analysis, and all studies compared outcomes between autograft and allograft. International Knee Documentation Committee subjective knee (IKDC) scores and side-to-side anterior laxity were not significantly different between autograft and allograft. Revision ACLR with allograft had a higher risk of failure than autograft at the final follow-up (OR=2.22, 95% CI=1.55-3.18). The rates of return to pre-injury type of sport and return to same and higher level of pre-injury sport were not significantly different between autograft and allograft., Conclusion: The outcomes of IKDC score, side-to-side anterior laxity, and rates of return to sport were not significantly different between autograft and allograft. Autografts provide a significantly lower risk of failure than allografts in revision ACLR., Level of Evidence: IV; meta-analysis., (Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Purpose: The present study aimed to propose a modified intra-articular transtendinous looped biceps tenodesis (mTLBT) using a suture anchor and to compare the functional outcomes and incidence of Popeye deformities between biceps tenotomy and mTLBT., Methods: Medical records of patients who underwent either tenotomy or mTLBT for the long head of the biceps tendon (LHBT) lesion between January 2016 and April 2021 were retrospectively reviewed. The inclusion criteria were patients aged 40-70 years with LHBT pathologies, such as superior labrum anterior to posterior (SLAP) lesions > type II, LHBT pulley system rupture with bicipital instability, and intra-articular LHBT tear. The exclusion criteria were full-thickness supraspinatus tears, frozen shoulder, shoulder fracture, and postoperative traumatic events that affected the operated shoulder. All patients were followed up for at least 1 year. Popeye deformity, bicipital cramping pain, visual analog scale (VAS) pain score, and functional outcome scores (University of California at Los Angeles [UCLA] and American Shoulder and Elbow Surgeons [ASES] scores) were recorded. Fisher's exact test and Chi-square test were used for categorical variables, whereas the Mann-Whitney U test was used for nonparametric variables., Results: The mTLBT and tenotomy groups included 15 and 40 patients, respectively. The incidence of Popeye deformity and biceps cramping pain in the tenotomy group (52.5% and 50%, respectively) was significantly higher than that in the mTLBT group (13.3% and 20%, respectively) (p = 0.009 and p = 0.045, respectively). The postoperative VAS, UCLA, and ASES scores were not significantly different between the two groups. One patient in the tenodesis group experienced metallic-anchor pullout., Conclusion: mTLBT is an arthroscopic intra-articular top of the groove tenodesis that can be performed completely in the intra-articular space and is especially suitable for patients with an intact or partially torn rotator cuff. This technique is reliable for treating biceps pathologies as it results in similar functional outcome scores, lesser biceps cramping pain, and less frequent Popeye deformity compared to biceps tenotomy., Level of Evidence: III., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Open-wedge high tibial osteotomy (OWHTO) is effective in treating medial compartment osteoarthritis. The association between body mass index (BMI) and outcomes following OWHTO is being debated. This study compared radiographic and clinical outcomes between patients with preoperative overweight, obesity, and normal BMI following OWHTO for medial compartment osteoarthritis. In total, 123 patients (123 knees) who underwent OWHTO for medial compartment osteoarthritis were enrolled and were divided into normal-BMI (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (>30 kg/m2) groups based on body mass index. The numeric rating scale for pain, mechanical tibiofemoral angle (mTFA), tibia tilting angle (TTA), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function were evaluated preoperatively and at postoperative follow-ups. The improvements of clinical and radiological outcomes in normal-BMI, overweight, and obese groups were not significantly different. The incidence of soft tissue irritation, wound infection, nonunion, and conversion to total knee arthroplasty were not significantly different between groups.The clinical and radiological outcomes in patients with preoperative overweight, obesity, and normal-BMI were not significantly different. Preoperative overweight and obesity thus has no effect on outcomes following OWHTO during the two years follow-up period. These findings cannot be generalized to patients with morbid obesity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Wu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This research proposes and tests an integrated model to explain how information overload influence vaccine skepticism and vaccination intention. In addition, this research investigates the effectiveness of using a celebrity endorsement strategy in promoting vaccination and compares its effectiveness with other endorsement types. A survey study (Study 1) was conducted to examine the mechanism underlying the impact of the COVID-19 vaccine information overload on vaccine skepticism that, subsequently, affects vaccination intention. It also examined the moderating role of celebrity endorsement trustworthiness. The results indicate that information overload positively influenced vaccine skepticism through cyberchondria and perceived risk of the vaccine, which subsequently reduces vaccination intention. The negative effect of vaccine skepticism on vaccination intention was weakened by the celebrity endorsement that was considered trustworthy. A follow-up experimental study (Study 2) was performed to compare the effectiveness of celebrity endorsement with other endorsement types (i.e., government official and medical expert endorsements). The results showed that the celebrity endorsement was more effective in mitigating the negative effect of vaccine skepticism on vaccination intention compared to government official and medical expert. The findings provide practical insights into how governments can minimize people's vaccine skeptical views and increase their vaccination intentions., (© 2021 Published by Elsevier Ltd.)

Objective: The objective of this study was to develop a new strategy for rapid diagnosis of the source of low back pain (LBP) for treatment with cooled radiofrequency ablation (RFA)., Materials: Patients suffering from facet joint (FJ) or sacroiliac joint (SIJ) pain for more than 3 months were included. Two methods, Technetium Tc99m methylene diphosphonate single photon emission tomography/computed tomography ( 99m Tc-MDP SPECT/CT) and a modified Fortin finger test were used to identify the source of LBP for treatment with cooled RFA. The visual analog scale (VAS) and Oswestry disability index (ODI) were used to assess the patients' pain levels and disabilities respectively. These two measures were recorded at baseline and 1-week, 1-month, 3-month, and 6-month follow-up visits., Results: A total of 40 patients with LBP were included in this study. Our results demonstrated that the patients with LBP identified by our new strategy had significant improvements in VAS or ODI score at 1-week to 6-month follow-up visits ( p < 0.001) after receiving cooled RFA. Similar results were also found in patients with FJ pain and those with FJ and SIJ pain respectively. Among all the patients, over 70% had greater than or equal to 50% reduction in VAS and ODI scores. No serious adverse events were observed after treatment., Conclusions: This new strategy could be successfully adopted for rapid diagnosis of the source of comprehensive LBP.

Purpose: To retrospectively assess the clinical outcomes of the patients with large to massive reparable RCTs treated by arthroscopic rotator cuff repair (ARCR) combined with modified superior capsule reconstruction (mSCR) using the long head of biceps tendon (LHBT) as reinforcement with a minimum of 2 years of follow-up., Methods: We retrospectively evaluated 40 patients with large to massive reparable RCTs who underwent ARCR and mSCR (group I) between February 2017 and June 2018 (18 patients) or underwent ARCR and tenotomy of LHBT performed at the insertion site (group II) between January 2015 and January 2017 (22 patients). The pain visual analog score (VAS) was assessed preoperatively and 1, 3, 6, 12, 24 months postoperatively. American Shoulder and Elbow Surgeons (ASES) scores, the University of California, Los Angeles (UCLA) shoulder rating scale, and active range of motion (AROM) were assessed before surgery and 6, 12, and 24 months after surgery. The integrity of the rotator cuff and mSCR was evaluated using magnetic resonance images at 12 months postoperatively., Results: After surgery, both groups had significantly improved in VAS, ASES, UCLA and AROM scores in the final follow-up. There were no significant between-group differences in the characteristics of the patients before surgery. Group I had improved pain relief at 1 month (P < .001) and at 3 months (P < .01) after surgery. For the AROM, group I (flexion, external rotation, internal rotation) demonstrated better improvement than group II 6 months after surgery (all P < .05) and better internal rotation 12 and 24 months after surgery (all P < .05). The mSCR survival rate was 94.4% (17/18). The retear rate of repaired rotator cuffs for groups I and II was 16.7% (3/18) and 40.9% (9/22), respectively, and the differences were significant (P < .046)., Conclusions: ARCR combined with mSCR using LHBT as reinforcement may lead to a lower retear rate and earlier functional recovery than conventional ARCR with tenotomy of LHBT for large to massive reparable RCTs., Level of Evidence: Level III, retrospective therapeutic comparative trial., (Copyright © 2021 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

In large or massive rotator cuff tears, successful repairs are difficult and complication rates are high, because the torn tendon is contracted and the superior capsule is disrupted. Recent studies have shown that superior capsule reconstruction (SCR) in massive irreparable rotator cuff tears results in better clinical scores and preserves stable glenohumeral stability without significant complications. In this article, we propose a simple, efficient SCR technique to reinforce the repair of large or massive rotator cuff tears. For this technique, the long head of the biceps tendon is used as a local autograft for the SCR, therefore eliminating comorbidities related to graft harvesting. The proximal part of the long head of the biceps tendon is transposed posteriorly and fixed onto the footprint as the SCR, which not only can maintain the stability of the glenohumeral joint, but also can preserve the vascular supply to help healing., (© 2019 by the Arthroscopy Association of North America. Published by Elsevier.)

Background: The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support., Objective: The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption., Methods: The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth., Results: The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use., Conclusion: The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.

Using the dual mediation hypothesis, this study investigates the role of interestingness (the power of attracting or holding one's attention) attitude towards the news, in the formation of Facebook Fan Page users' electronic word-of-mouth intentions. A total of 599 Facebook fan page users in Taiwan were recruited and structural equation modeling (SEM) was used to test the research hypotheses. The results show that both perceived news entertainment and informativeness positively influence interestingness attitude towards the news. Interestingness attitude towards the news subsequently influences hedonism and utilitarianism attitudes towards the Fan Page, which then influence eWOM intentions. Interestingness attitude towards the news plays a more important role than hedonism and utilitarianism attitudes in generating electronic word-of-mouth intentions. Based on the findings, the implications and future research suggestions are provided.

Electronic word of mouth (eWOM) has been an important factor influencing consumer purchase decisions. Using the ABC model of attitude, this study proposes a model to explain how eWOM affects online discussion forums. Specifically, we propose that platform (Web site reputation and source credibility) and customer (obtaining buying-related information and social orientation through information) factors influence purchase intentions via perceived positive eWOM review credibility, as well as product and Web site attitudes in an online community context. A total of 353 online discussion forum users in an online community (Fashion Guide) in Taiwan were recruited, and structural equation modeling (SEM) was used to test the research hypotheses. The results indicate that Web site reputation, source credibility, obtaining buying-related information, and social orientation through information positively influence perceived positive eWOM review credibility. In turn, perceived positive eWOM review credibility directly influences purchase intentions and also indirectly influences purchase intentions via product and Web site attitudes. Finally, we discuss the theoretical and managerial implications of the findings.

Vertebroplasty for osteoporotic thoracolumbar vertebral compression fractures usually results in complete and immediate cessation of pain symptoms. Occasionally the procedure does not relieve pain and further intervention is required. We herein report the case of a 62-year-old female with L2 and L3 vertebral compression fractures treated with vertebroplasty. Her symptoms did not improve and subsequent magnetic resonance imaging showed focal changes in the S1 and S2 vertebral bodies; bone scintigraphy showed the characteristic Honda sign of a sacral insufficiency fracture. Sacroplasty at S1 and S2 completely relieved the patient's back pain. If a vertebroplasty fails to relieve back pain immediately after the procedure as expected, surgeons should be aware of the possibility of a concomitant sacral insufficiency fracture.

Traumatic interposition of a rotator cuff tendon in the glenohumeral joint without recognizable glenohumeral dislocation is an unusual complication after shoulder trauma. Here we report the clinical and imaging presentations of a 17-year-old man with trapped rotator cuff tendons in the glenohumeral joint after a bicycle accident. The possible trauma mechanism is also discussed.