Sport-related concussion prevention strategies in collision sports are a primary interest for sporting organizations and policy makers. After-market soft-shell padding purports to augment the protective capabilities of standard football helmets and to reduce head impact severity. We compared head impact kinematics [peak linear acceleration (PLA) and peak rotational acceleration (PRA)] in athletes wearing Guardian Cap soft-shell padding to teammates without soft-shell padding. Ten Division I college football players were enrolled [soft-shell padding (SHELL) included four defensive linemen and one tight end; non-soft-shell (CONTROL) included two offensive linemen, two defensive linemen, and one tight end]. Participants wore helmets equipped with the Head Impact Telemetry System to quantify PLA (g) and PRA (rad/s²) during 14 practices. Two-way ANOVAs were conducted to compare log-transformed PLA and PRA between groups across helmet location and gameplay characteristics. In total, 968 video-confirmed head impacts between SHELL (n = 421) and CONTROL (n = 547) were analyzed. We observed a Group x Stance interaction for PRA (F_1,963 = 7.21; p = 0.007) indicating greater PRA by SHELL during 2-point stance and lower PRA during 3- or 4-point stances compared to CONTROL. There were no between-group main effects. Protective soft-shell padding did not reduce head impact kinematic outcomes among college football athletes.

As tissue engineering and regenerative medicine (TERM) continues to revolutionize medicine and surgery, there is also growing interest in applying these advancements to foot and ankle surgery. The purpose of this article is to provide a comprehensive review of the types of gel scaffolds and templates, their applications in foot and ankle surgery, the challenges with current utilization, and the future directions of TERM in foot and ankle surgery. With multiple compelling scaffold prospects across the numerous natural, synthetic, and hybrid polymers currently utilized in TERM, promising results have been described in the treatment of osteoarthritis (OA) and osteochondral lesions (OCLs). However, concerns with material biocompatibility, structural integrity, feasibility during surgery, and degradation still exist and limit the extent of utilization. As researchers continue to develop enhanced polymers and formulations that address current issues, there are many opportunities to increase applications across foot and ankle surgery.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for managing type 2 diabetes mellitus (T2DM) and obesity due to their proven metabolic benefits. However, their impact on musculoskeletal conditions, particularly in non-weight-bearing joints such as the shoulder joint, remains unclear. This study aimed to determine whether GLP-1RA use was associated with the development of shoulder pathologies (glenohumeral osteoarthritis, adhesive capsulitis, atraumatic rotator cuff tears, and shoulder fractures) over a 5-year period. A retrospective cohort study was performed using the TriNetX research database. Adult patients prescribed GLP-1RAs between 2017 and 2019 were identified and stratified into 3 cohorts based on obesity (body mass index ≥30) and T2DM status: (1) obese T2DM, (2) nonobese T2DM, and (3) nonobese non-T2DM. Within each group, GLP-1RA users were 1:1 propensity score matched to nonusers. Primary outcomes (glenohumeral osteoarthritis, adhesive capsulitis, atraumatic rotator cuff tears, and shoulder fractures) were evaluated over a 5-year period, and secondary outcomes (hemoglobin A1c and body mass index) were assessed over a 2-year period. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to compare incidence between GLP-1RA users and nonusers. At 5-year follow-up, GLP-1RA use was associated with higher incidence rates of glenohumeral osteoarthritis, adhesive capsulitis, and atraumatic rotator cuff tears across all subgroups as compared to nonusers. The highest increased risk was observed for adhesive capsulitis, particularly in the obese nondiabetic subgroup (HR: 2.465; 95% CI [3.173-1.916]). Shoulder fracture incidence was lower among GLP-1RA users with both obesity and T2DM (HR: 0.903; 95% CI [0.827-0.987]) but did not differ significantly in patients with obesity without T2DM or in nonobese patients with diabetes. GLP-1RA therapy was associated with an increased incidence of certain shoulder pathologies, most notably adhesive capsulitis, suggesting GLP-1RAs may have adverse musculoskeletal effects in the shoulder joint. These findings highlight the need for future prospective studies to confirm these associations.

Background: Traumatic anterior shoulder instability (ASI) is common among young, active patients, with a progression to glenohumeral osteoarthritis (OA) in up to 55% of patients. Surgical stabilization procedures are routinely offered to patients; however, the long-term risk of the development and severity of OA after these interventions remains unclear because of the overlap with injury mechanics. Purpose: To evaluate the incidence and severity of radiographic OA after surgical treatment for traumatic ASI. Study Design: Systematic review; Level of evidence, 4. Methods: This PROSPERO-registered systematic review and meta-analysis was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was performed on February 12, 2025, in MEDLINE via PubMed, CINAHL, Embase, CENTRAL and SPORTDiscus, covering publications from 2004 to 2025. Data extracted included the rate of progression to OA (graded in accordance with the Samilson-Prieto or Buscayret classification), incidence of recurrent dislocations, and Rowe score at final follow-up. Cohort characteristics were summarized with weighted means, and data were presented as pooled proportion estimates with 95% confidence intervals (CIs), calculated via meta-analysis of binomial (OA progression, recurrent dislocation) and continuous (Rowe score) variables. Results: A total of 34 studies with a minimum 5-year follow-up comprising 2375 patients and 2403 shoulders were included, and 1962 of these shoulders had follow-up radiographs at a mean follow-up time of 139.0 months. The overall pooled rate of progression to radiographically diagnosed OA was 40.7% (95% CI, 32.6%-49.2%); rates of progression to grade ≥II and grade III OA were estimated to be 10.5% (95% CI, 6.9%-15.6%) and 2.3% (95% CI, 1.1%-4.7%), respectively. The pooled rate of OA at final follow-up based on a surgical intervention was 47.2% (95% CI, 32.0%-63.0%) for arthroscopic Bankart repair, 46.8% (95% CI, 36.6%-57.2%) for open Bankart repair, and 30.3% (95% CI, 20.0%-43.0%) for the Latarjet procedure. The overall pooled rate of recurrent instability was 10.4% (95% CI, 7.7%-13.9%), and the overall pooled Rowe score at final follow-up was 88.2 (95% CI, 86.1-90.3). Conclusion: The progression to radiographic OA occurred in a significant number of patients after surgical treatment for traumatic ASI at long-term follow-up. Although radiographic OA was common, severe degeneration was relatively rare, and functional outcomes remained favorable. These findings provide clinicians with pooled long-term data that can support evidence-based patient counseling, inform surgical planning, and guide future interventional trials.