γδ T cells are situated at barrier sites and guard the body from infection and damage. However, little is known about their roles outside of host defense in nonbarrier tissues. Here, we characterize a highly enriched tissue-resident population of γδ T cells in adipose tissue that regulate age-dependent regulatory T cell (T) expansion and control core body temperature in response to environmental fluctuations. Mechanistically, innate PLZF γδ T cells produced tumor necrosis factor and interleukin (IL) 17 A and determined PDGFRα and Pdpn stromal-cell production of IL-33 in adipose tissue. Mice lacking γδ T cells or IL-17A exhibited decreases in both ST2 T cells and IL-33 abundance in visceral adipose tissue. Remarkably, these mice also lacked the ability to regulate core body temperature at thermoneutrality and after cold challenge. Together, these findings uncover important physiological roles for resident γδ T cells in adipose tissue immune homeostasis and body-temperature control.
Background: Popularization of systematic reviews has been met with controversy because of concerns that the primary literature for certain topics may not be suited for systematic review and meta-analysis. Purpose: To assess the rate of publication of systematic reviews based on their level of evidence (LOE) in influential orthopaedic sports medicine journals and commonly studied topics in sports medicine. Study Design: Systematic review. Methods: An electronic search was performed using the PubMed database of studies published from January 2010 to December 2020. The advanced search function was used to identify systematic reviews from the Journal of Shoulder and Elbow Surgery ( JSES), American Journal of Sports Medicine ( AJSM), Arthroscopy, British Journal of Sports Medicine ( BJSM), Journal of Bone and Joint Surgery–American Volume ( JBJS), and Sports Medicine ( SM Auckland), as well as reviews of the most common areas of sports medicine research, including rotator cuff repair (RCR), shoulder instability (SI), anterior cruciate ligament reconstruction (ACLR), and meniscal repair. The LOE was assigned to each included study according to the Oxford Centre for Evidence-Based Medicine. Studies were grouped as LOE 1-2, LOE 3-5, and nonclinical systematic reviews. A negative binomial regression was used to determine the changes in publication rate over time. Results: A total of 2162 systematic reviews were included in this study. From 2010 to 2020, the rate of publication of LOE 3-5 systematic reviews increased significantly among most of the surveyed journals ( AJSM, P < .0001; Arthroscopy, P = .01; BJSM, P < .0001; JSES, P < .0001; SM Auckland, P < .0001), with the exception of JBJS ( P = .57). The rate of publication of LOE 1-2 systematic reviews increased in AJSM ( P < .0001), Arthroscopy ( P = .02), BJSM ( P < .0001), and SM Auckland ( P < .0001); however, no significant changes were seen in JBJS ( P = .08) or JSES ( P = .15). The publication rate of LOE 3-5 systematic reviews increased for all sports medicine topics surveyed (meniscal repair, P < .0001; RCR, P < .0001; SI, P < .0001; ACLR, P < .0001). However, the publication rate of LOE 1-2 studies only increased for RCR ( P = .0003) and ACLR ( P < .0001). Conclusion: The rate of publication of LOE 3-5 systematic reviews exponentially increased in orthopaedic sports medicine journals over the past decade, outpacing the publication rate of LOE 1-2 systematic reviews.
In the version of this article initially published, a source of funding was not included in the Acknowledgements section. That section should include the following: P.J.M.O. was supported by EU FP7 PREPARE project 602525. The error has been corrected in the HTML and PDF version of the article.
Background: Studies have demonstrated that pediatric patients have an increased risk of failure with allograft anterior cruciate ligament reconstruction (ACLR); however, there is no study investigating whether allograft ACLR may be safe in older adolescent patients who are not returning to competitive pivoting sports (ie, low risk). The purpose of this study was to assess outcomes for low-risk older adolescents selected for allograft ACLR. Methods: We performed a retrospective chart review of patients younger than 18 years who received a bone-patellar-tendon-bone allograft or autograft ACLR by a single orthopaedic surgeon from 2012 to 2020. Patients were offered allograft ACLR if they did not intend to return to pivoting sports for 1 year. The autograft cohort was matched 1:1 based on age, sex, and follow-up. Patients were excluded for skeletal immaturity, multiligamentous injury, prior ipsilateral ACLR, or concomitant realignment procedure. Patients were contacted to obtain patient-reported outcomes at ≥2 years follow-up, including single assessment numerical evaluation, surgery satisfaction, pain scores, Tegner Activity Scale, and the Lysholm Knee Scoring Scale. Parametric and nonparametric tests were used as appropriate. Results: Of the 68 allografts, 40 (59%) met inclusion and 28 (70%) were contacted. Among the 456 autografts, 40 (8.7%) were matched and 26 (65%) were contacted. Two allograft patients (2/40; 5%) failed at a median (interquartile range) follow-up of 36 (12, 60) months. There were 0/40 failures in the autograft cohort and 13/456 (2.9%) among the overall autografts; neither were significantly different from the allograft failure rate (both P > 0.05). Two (5.0%) patients in the autograft cohort required manipulation under anesthesia and arthroscopic lysis of adhesions. There were no significant differences between cohorts for single assessment numerical evaluation, Lysholm, Tegner, pain, and satisfaction scores (all P > 0.05). Conclusions: Although ACL allograft failure rates remain nearly two times higher than autograft failure rates in older adolescents, our study suggests that careful patient selection can potentially bring this failure rate down to an acceptable level. Level of Evidence: Level III; retrospective matched cohort study.
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