Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Meniscal hypermobility does not impair functional outcomes after anterior cruciate ligament reconstruction: A retrospective cohort study","authors":"Horacio Rivarola MD ,&nbsp;Cristian Collazo MD ,&nbsp;Marcos Palanconi MD ,&nbsp;Marcos Meninato MD ,&nbsp;Pablo Ramos Guarderas MD ,&nbsp;Gonzalo Arteaga MD ,&nbsp;Medardo Vargas MD ,&nbsp;Francisco Endara Urresta MD ,&nbsp;Carlos Peñaherrera-Carrillo MD ,&nbsp;Alejandro Barros Castro MD","doi":"10.1016/j.jisako.2025.101056","DOIUrl":"10.1016/j.jisako.2025.101056","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Meniscal hypermobility (MH), particularly hypermobile lateral meniscus (HLM), is increasingly recognized as a contributor to knee instability in the setting of anterior cruciate ligament (ACL) rupture. However, its influence on functional outcomes after ACL reconstruction remains unclear. This study aimed to determine whether MH affects clinical recovery and to evaluate the effectiveness of simultaneous ACL reconstruction and Forkel’s single-tunnel meniscal root repair.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted including 375 patients selected from 1200 ACL reconstructions performed between 2018 and 2023. Patients were allocated into two groups: the case group (n = 159), with ACL rupture and intraoperatively confirmed HLM, and control group (n = 216), with isolated ACL rupture. All patients underwent ACL reconstruction with a modified transtibial hamstring technique; in the case group, a concomitant posterior lateral meniscal root (PLMR) repair was performed using the Forkel single-tunnel method. Functional outcomes were assessed with the International Knee Documentation Committee (IKDC) subjective score preoperatively and at 3, 6, and 12 months. Clinical symptoms (posterolateral pain, hyperflexion pain, and subjective instability) were also recorded. Statistical significance was set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Both groups demonstrated significant improvement in IKDC scores over time (<em>p</em> &lt; 0.001). In the case group, scores increased from 60.0 ± 7.8 preoperatively to 93.0 ± 4.5 at 12 months, while the control group improved from 60.1 ± 8.1 to 92.0 ± 4.8. No statistically significant differences were observed between groups at any time point (3 months, p = 0.26; 6 months, p = 0.44; 12 months, p = 0.28). Preoperatively, the case group showed a higher prevalence of posterolateral pain (68 % vs. 20 %, <em>p</em> &lt; 0.001) and hyperflexion pain (72 % vs. 35 %, <em>p</em> &lt; 0.001). At 12 months, symptoms had resolved in &gt;80% of patients across both groups, with no differences between cohorts (posterolateral pain, <em>p</em> = 0.21; instability, <em>p</em> = 0.33).</div></div><div><h3>Conclusion</h3><div>MH does not compromise functional recovery when addressed during ACL reconstruction using the Forkel single-tunnel technique. This approach provides an anatomically sound, reproducible, and clinically effective option for treating combined ACL and meniscal pathology.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101056"},"PeriodicalIF":3.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a scale to assess risk-taking intentions during return to sport following anterior cruciate ligament reconstruction.","authors":"Amélie Labrousse, Emmanuel Reboursière, Marion Remilly, Romain Roulland, Guillaume Mergenthaler, Christophe Hulet, Joffrey Drigny","doi":"10.1016/j.jisako.2025.101052","DOIUrl":"https://doi.org/10.1016/j.jisako.2025.101052","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Psychological factors influence return-to-sport (RTS) decisions after anterior cruciate ligament reconstruction (ACLR). While existing tools measure fear and confidence, none specifically capture athletes' risk-taking tolerance and intentions. This study proposes the development and validation of a scale assessing Risk-taking Intentions and Sport Engagement after ACLR (RISE-ACL scale).</p><p><strong>Methods: </strong>Scale development consisted of deductive (literature review) and inductive (expert panel) methods. Eleven experts generated and rated relevant items to be included in the consensus RISE-ACL scale. Content validity was established through expert agreement. For scale validation, 162 ACLR participants, 4-24 months postoperatively (median age 26.5 years; 65% male), completed the newly developed RISE-ACL scale. Criterion validity used a self-rated risk-tolerance scale (0-100%). Construct validity was examined through correlations with the Anterior Cruciate Ligament - Return to Sport after Injury (ACL-RSI) scale and clinical/demographic variables, followed by multivariate modeling. Exploratory factor analysis (principal axis factoring) identified factor structure, and principal component analysis (PCA) explored a short form. Reliability was assessed via Cronbach's alpha and test-retest intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Scale development aimed to a 16-item RISE-ACL scale with good content validity (mean agreement 86%), face validity feasibility (mean completion time = 2:05). Criterion validity against the self-rated risk-tolerance scale (0-100%) was moderate and statistically significant (ρ = 0.348, p < 0.001). Construct validity analyses showed that in multivariate modeling, only ACL-RSI remained a statistically significant independent predictor of RISE-ACL scores (Wald χ² = 6.36, p = 0.012). Factor analysis yielded three interpretable factors (1) External Pressure, (2) Internal Pressure/Defiance, and (3) Urgency-explaining 47.72% of variance. Factor 3 correlated most with self-perceived risk-taking (ρ = 0.340), and Factor 2 most negatively with ACL-RSI (ρ = -0.166). Reliability showed good internal consistency (Cronbach's α = 0.84) and test-retest reliability (ICC = 0.84). A 6-item short form was proposed, showing a strong correlation with the total score (ρ = 0.891).</p><p><strong>Conclusion: </strong>The RISE-ACL is a 16-item self-administered scale designed to assess patients' risk-taking intentions during return to sport after ACLR. Validation demonstrated it is a reliable and valid tool, supporting shared decision-making to enhance RTS quality.</p><p><strong>Clinical trial registration: </strong>NCT06748066 LEVEL OF EVIDENCE: II.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101052"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical calcific tendinitis involving teres minor which affects overhead movement: A case report","authors":"Sawarin Voravitvet,&nbsp;Puttinan Pingpitayakul,&nbsp;Pinprapha Boonhyad,&nbsp;Phob Ganokroj","doi":"10.1016/j.jisako.2025.101055","DOIUrl":"10.1016/j.jisako.2025.101055","url":null,"abstract":"<div><div>Calcific tendinitis is a common cause of shoulder pain, with the supraspinatus tendon being most frequently affected. In contrast, involvement of the teres minor tendon is exceptionally rare.</div><div>We report an unusual case of a 55-year-old woman experiencing persistent left shoulder pain for six months, exacerbated by overhead activities. Clinical examination revealed point tenderness over the posterolateral shoulder and restricted abduction and external rotation. Imaging identified a 1.8 cm calcification within the teres minor tendon.</div><div>Given the unresponsiveness to nonoperative treatments, arthroscopic removal of the calcifications and teres minor tendon repair were performed, resulting in pain-free motion and a return to overhead activities. Postoperative magnetic resonance imaging (MRI) confirmed tendon integrity and the absence of calcification recurrence.</div><div>This case highlights the importance of considering atypical presentations of calcific tendinitis, particularly in the context of isolated posterior shoulder pain. Recognition of this rare tendon involvement is essential to avoid misdiagnosis and to guide appropriate surgical planning when conservative measures fail. Furthermore, this report demonstrates that arthroscopic intervention including targeted debridement and teres minor tendon repair can yield excellent clinical outcomes even with unusual presentation. Raising awareness of such rare cases may support earlier diagnosis and tailored treatment, ultimately improving patient outcomes.</div></div><div><h3>Level of evidence</h3><div>Level V, Case report.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101055"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Good clinical outcome of nonoperatively treated low grade medial collateral ligament injuries combined with primary anterior cruciate ligament reconstruction","authors":"Ji Hoon Bae,&nbsp;Ppuri Bak,&nbsp;Jeongho Son","doi":"10.1016/j.jisako.2025.101054","DOIUrl":"10.1016/j.jisako.2025.101054","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to determine whether functional outcomes differ between patients undergoing an anterior cruciate ligament (ACL) reconstruction with a concomitant, nonoperatively treated grade I and II medial collateral ligament (MCL) injury (ACL + MCL group) and those undergoing an isolated ACL reconstruction (ACL group).</div></div><div><h3>Methods</h3><div>A total of 153 patients (34 ACL + MCL group, 119 ACL group, mean age: 28.6 years) who were available for a 2-year follow-up without re-injuries or requiring revision were included in this study. Preoperative magnetic resonance imaging was used to diagnose the MCL injury and a grade of MCL laxity was evaluated by physical examination. Patient-reported outcomes (the Lysholm score, the Tegner activity score, the International Knee Documentation Committee subjective knee form score [IKDC 2000], the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI), and return to pre-injury level of sports activity at 2 years after ACL reconstruction were compared between the two groups. Statistical significance was set at a p-value &lt;0.05.</div></div><div><h3>Results</h3><div>At the 2-year follow-up, no statistically significant differences of Lysholm score (84.7 vs 83.2; p = 0.740), Tegner activity score (6.2 vs 6.3; p = 0.829), IKDC 2000 subjective score (77.1 vs 78.9; p = 0.572), KOOS symptom (81 vs 78.5; p = 0.454); pain (90.1 vs 93.6, p = 0.513), daily living (96.4 vs 94.5; p = 0.172), sports and recreation (80.5 vs 77.2; p = 0.352), quality of life (39.2 vs 43.1; p = 0.172), ACL-RSI emotion (53.4 vs 53.7; p = 0.953); confidence (63 vs 63.1; p = 0.970); risk (55.6 vs 52.5; p = 0.565) and ACL-RSI total (58.5 vs 57; p = 0.679) were observed. There were no statistically significant differences of rates of return to pre-injury level of sports activity (44% vs 29%, p = 0.092).</div></div><div><h3>Conclusion</h3><div>Similar patient-reported, functional, and return-to-sport outcomes were found for nonoperatively treated grade I and II MCL injuries combined with ACL reconstruction compared to those of isolated ACL reconstruction at the 2-year follow-up.</div></div><div><h3>Level of evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101054"},"PeriodicalIF":3.3,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric validation and cultural adaptation of the Persian version of international knee documentation committee subjective knee form (IKDC-SF) across diverse knee pathologies","authors":"Fardis Vosoughi MD ,&nbsp;Kamran Shirbache MD ,&nbsp;Pooya Vahedi ,&nbsp;Amirhossein Razavi ,&nbsp;Amir R. Entezari ,&nbsp;Philippe Neyret MD ,&nbsp;Amir Kasaeian PhD ,&nbsp;Iman M. Oskouie MD","doi":"10.1016/j.jisako.2025.101053","DOIUrl":"10.1016/j.jisako.2025.101053","url":null,"abstract":"<div><h3>Background</h3><div>Knee injuries and degenerative knee disorders meaningfully impact quality of life and physical function. Reliable patient-reported outcome measures (PROMs) are essential for evaluating treatment outcomes. The International Knee Documentation Committee Subjective Knee Form (IKDC-SF) is widely used for this purpose, but a Persian version applicable to all types of knee injuries is lacking.</div></div><div><h3>Methods</h3><div>This cross-sectional validation study included 149 Persian-speaking patients aged 18–75 years, including osteoarthritis (OA) and ligament/meniscus injuries, who were consecutively referred to the clinic. The IKDC-SF was culturally adapted using a standardized forward–backward translation process in accordance with international guidelines. A pilot study was conducted to evaluate the clarity and cultural relevance of the translated items. Participants completed the Persian IKDC-SF (P-IKDC-SF), the Persian Lysholm Knee Score (P-LKS), and the Persian version of the Medical Outcomes Study 36-Item Short Form Survey (P-SF-36) to assess reliability and construct validity. Subgroup analyses were conducted to evaluate psychometric performance across OA and ligament/meniscus groups, along with estimates of the minimal detectable change (MDC).</div></div><div><h3>Results</h3><div>The P-IKDC-SF demonstrated good internal consistency (Cronbach's alpha = 0.827) and excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.910; 95% confidence interval [CI] = 0.878–0.934). Strong construct validity was confirmed with a high correlation to the P-LKS (r = 0.857) and the P-SF-36 physical component (r = 0.753). The MDC for individual change was 10.45 in OA and 17.79 in ligament/meniscus injuries, supporting interpretability for clinical use. Minimal floor and ceiling effects were observed, and Bland–Altman analysis showed good test-retest agreement.</div></div><div><h3>CONCLUSION</h3><div>The P-IKDC-SF is a valid, reliable, and interpretable instrument for assessing knee function and symptoms among the Persian-speaking population with both degenerative and sports injuries of the knee. Its strong psychometric performance across subgroups and clinically meaningful change thresholds supports its use in both clinical and research settings.</div></div><div><h3>Level</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101053"},"PeriodicalIF":3.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee arthrofixation with modular nail as salvage for periprosthetic infection: Evaluation of quality of life and implant survival","authors":"Alejo M. Gonzalez Fantini,&nbsp;Hernan G. Sanchez Mele,&nbsp;Julian Costantini,&nbsp;Lisandro Carbo,&nbsp;Juan F. Astoul Bonorino,&nbsp;Tomás I. Nicolino","doi":"10.1016/j.jisako.2025.101050","DOIUrl":"10.1016/j.jisako.2025.101050","url":null,"abstract":"<div><h3>Introduction</h3><div>Periprosthetic joint infection (PJI) is a complication that can lead to severe bone defects, a lack of soft tissue coverage, and poor infection control. Knee arthrofixation, using modular intramedullary nails and a cement block as a spacer, is a salvage procedure for these situations, serving as an alternative to limb amputation.</div><div>The primary objective of this study was to evaluate the postoperative quality of life of patients undergoing knee arthrofixation with modular intramedullary nails. Secondary objectives included assessing implant survival, complication rates, and the rate of infection cure.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted on 34 patients treated with knee arthrofixation using an intramedullary nail as a definitive treatment for periprosthetic infection between 2015 and 2023 at a single institution. The minimum follow-up period was one year. In addition to the initial evaluation of clinical characteristics, patients' quality of life was assessed using the Oxford Knee Score (OKS). Implant survival, complications, and the proportion of patients who achieved infection cure according to Laffer's criteria were also analyzed.</div></div><div><h3>Results</h3><div>At the one-year follow-up after surgery, a moderate-to-good quality of life score of 32, standard deviation (SD) 12, was reported, with an implant survival rate of 77%, 95% confidence interval (CI) 56–88%, according to Kaplan–Meier estimates. The number of previous surgeries before arthrofixation was 9. Soft tissue flap coverage was required in 46.4% of cases. A modular intramedullary nail was used as the implant of choice in 88.2% of cases. Except for one case, all patients presented with a severe AORI 3 bone defect. Following reconstruction, the average limb length discrepancy was 28 mm. A 35% complication rate was recorded, including six amputations, three nail replacements due to persistent infection, and three implant fractures. The most frequently identified primary pathogen was methicillin-sensitive <em>Staphylococcus aureus</em>. The infection cure rate in this series was 56.5%.</div></div><div><h3>Conclusion</h3><div>Knee arthrofixation is a feasible limb-salvage strategy for recurrent periprosthetic infections, though our series showed increased reinfection rates and lower implant survival compared with previous reports.</div></div><div><h3>Evidence level</h3><div>IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101050"},"PeriodicalIF":3.3,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of postoperative complications in non-alcoholic cirrhosis versus non-alcoholic fatty liver disease following total knee arthroplasty: A national matched cohort study","authors":"Jared Sasaki ,&nbsp;Catherine Hand ,&nbsp;Camden Bohn ,&nbsp;Morgan Angotti ,&nbsp;Daniel Shinn ,&nbsp;Nicholas Lemme ,&nbsp;Brian Forsythe","doi":"10.1016/j.jisako.2025.101051","DOIUrl":"10.1016/j.jisako.2025.101051","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The growing obesity epidemic has led to a sharp rise in non-alcoholic fatty liver disease (NAFLD), now the most common chronic liver disease in the U.S. As both obesity and NAFLD are strongly associated with knee osteoarthritis, orthopedic surgeons are increasingly encountering these patients in need of total knee arthroplasty (TKA). While cirrhosis is a known risk factor for poor postoperative outcomes, the independent impact of NAFLD on TKA remains unclear. The objective of this study was to compare postoperative complication rates in patients with NAFLD versus non-alcoholic cirrhosis (NAC) undergoing TKA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort study was conducted using the Mariner database (PearlDiver Technologies), which includes administrative claims from over 151 million patients in the United States. A total of 1,767,399 patients undergoing primary TKA between 2010 and 2020 were identified. After filtering for continuous enrollment, first-instance procedures, and liver disease coding, patients with NAFLD were identified using ICD-9/10 codes and matched 1:1 via propensity score matching to NAC patients based on age, sex, Charlson Comorbidity Index, and key comorbidities. Postoperative complications were analyzed at 90 days and 1 year using multivariable logistic regression, adjusting for demographic and clinical covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The final matched cohorts included 14,866 patients (7,433 per group). NAFLD patients exhibited a lower overall complication burden at both time points (90-day: 14.4% vs. 17.1%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 25.9% vs. 29.8%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). Compared to matched NAC patients, patients with NAFLD had statistically significant lower rates of periprosthetic joint infection (90-day: 1.7% vs. 2.3%, &lt;em&gt;p&lt;/em&gt; = 0.004; 1-year: 2.6% vs. 4.0%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), pulmonary embolism (90-day: 0.04% vs. 0.4%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 0.1% vs. 0.5%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), hematoma (90-day: 0.3% vs. 0.8%, &lt;em&gt;p&lt;/em&gt; = 0.001; 1-year: 0.5% vs. 1.2%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), acute kidney injury (90-day: 2.8% vs. 3.6%, p = 0.007; 1-year: 5.6% vs. 6.8%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), transfusion (90-day: 0.7% vs. 2.9%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 1.3% vs. 3.9%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), and reoperation (90-day: 1.2% vs. 1.9%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 2.2% vs. 3.6%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). Otherwise, NAFLD patients demonstrated statistically significant higher rates of manipulation under anesthesia (MUA) and readmission at both 90 days and 1 year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Despite high metabolic comorbidity prevalence, NAFLD patients experienced fewer postoperative complications following TKA than matched NAC patients. These findings suggest that non-cirrhotic NAFLD may have lower perioperative risk than NAC and should not be considered as strong a contraindication to TKA. Future studies incorporating fibrosis staging and ","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101051"},"PeriodicalIF":3.3,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infratuberositary derotational tibial osteotomy for anterior knee pain in patients with pathological external tibial torsion: A novel technique","authors":"Vicente Sanchis-Alfonso MD, PhD ,&nbsp;Erik Montesinos-Berry MD, PhD ,&nbsp;Fermín Ordoño-Dominguez MD, PhD","doi":"10.1016/j.jisako.2025.101047","DOIUrl":"10.1016/j.jisako.2025.101047","url":null,"abstract":"<div><div>Pathological external tibial torsion is recognized as a cause of anterior knee pain. Derotational tibial osteotomy is a promising surgical intervention for anterior knee pain in patients with excessive external tibial torsion. It is indicated in disabling anterior knee pain recalcitrant to an appropriate conservative treatment with external tibial torsion &gt;35°. However, there is currently no strong evidence supporting specific torsion angles as a standalone indication for surgery. It is contraindicated in patients with pathological external tibial torsion without clinical symptoms or for cosmetic reasons. This technical note describes our surgical technique of derotational osteotomy to correct pathological external tibial torsion in patients with a normally positioned tibial tuberosity. When there is an excess of external tibial torsion and the foot is placed in a forward direction during gait, the knee joint is pointed inward, and this increases the Q angle and thereby the lateral quadriceps vector. When we internally rotate the distal tibial fragment of the osteotomy to the pre-planned correction, the knee faces forward when the foot points forward during gait, thereby correcting the excessive lateral quadriceps vector by reducing the Q angle. Good clinical outcomes and few complications have been reported with this surgical technique.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101047"},"PeriodicalIF":3.3,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combine anterior cruciate ligament reconstruction and unicompartmental knee arthroplasty with image-based robotic surgery: A current surgical technique","authors":"Luca Andriollo ,&nbsp;Cécile Batailler ,&nbsp;Pietro Gregori ,&nbsp;Guillaume Mesnard ,&nbsp;Thomas Neri ,&nbsp;Elvire Servien ,&nbsp;Sébastien Lustig","doi":"10.1016/j.jisako.2025.101046","DOIUrl":"10.1016/j.jisako.2025.101046","url":null,"abstract":"<div><div>Unicompartmental knee arthroplasty (UKA) is a widely recognized treatment for isolated compartment osteoarthritis (OA). The absence of an intact anterior cruciate ligament (ACL), however, has traditionally been considered a contraindication due to its critical role in maintaining knee stability and joint kinematics. This article aims to provide a detailed description of the surgical technique for UKA with simultaneous ACL reconstruction. It offers a practical guide for surgeons interested in adopting this approach for young, active patients with ACL-deficient and medial or lateral compartment OA, utilizing an image-based robotic platform for both preoperative and intraoperative planning. Indications and contraindications for the combined treatment are also reported. This technique, described through intraoperative images and video, represents a promising, joint-preserving alternative to total knee arthroplasty for appropriately selected patients. This step-by-step approach allows for the assessment of congruence between the bone tunnels and the prosthetic components, enabling personalized implant positioning.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101046"},"PeriodicalIF":3.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopically confirmed cartilage degeneration in the lateral tibial plateau over two years following anterior cruciate ligament and meniscus injury: A retrospective study","authors":"Akira Tsujii ,&nbsp;Yasukazu Yonetani ,&nbsp;Kazutaka Kinugasa ,&nbsp;Tomohiko Matsuo ,&nbsp;Seira Sato ,&nbsp;Tomoki Ohori ,&nbsp;Takashi Kanamoto ,&nbsp;Hiroyuki Tanaka ,&nbsp;Seiji Okada ,&nbsp;Ken Nakata ,&nbsp;Masayuki Hamada","doi":"10.1016/j.jisako.2025.101049","DOIUrl":"10.1016/j.jisako.2025.101049","url":null,"abstract":"<div><h3>Objectives</h3><div>Articular cartilage injuries are frequently associated with anterior cruciate ligament (ACL) injuries and may lead to early knee osteoarthritis (OA) if left untreated. Although ACL and meniscus injuries are commonly treated simultaneously, cartilage injuries are often left in situ. This study aimed to evaluate the progression of the cartilage injury in the lateral compartment following ACL reconstruction (ACLR) combined with lateral meniscus (LM) repairs.</div></div><div><h3>Methods</h3><div>A retrospective review of ACL and LM injuries was conducted in patients who underwent ACLR and meniscus repair. Patients were categorized into three groups: radial/flap tears (group R), longitudinal tears (group L), and controls without LM injuries (group C). Articular cartilage status in the lateral compartment was assessed by arthroscopic grading according to the International Cartilage Repair Society classification at the primary surgery and at second-look arthroscopy. Clinical assessments (pain, range of motion, swelling, and Lachman test) and radiographic and magnetic resonance imaging (MRI) findings were also evaluated.</div></div><div><h3>Results</h3><div>ACLR restored knee stability in 92 patients (34, 28, and 30 in groups R, L, and C, respectively). No statistically significant differences were identified in the demographics or preoperative bone bruises on MRI among the groups. However, cartilage injury in the lateral tibial plateau progressed arthroscopically in groups R and L. In addition, marginal osteophyte formation was significantly frequent in group R. Logistic regression analysis further revealed that a higher body mass index and the presence of a meniscus injury were independently associated with the progression of cartilage injury.</div></div><div><h3>Conclusion</h3><div>Cartilage damage may progress even after ACLR and meniscus repair, potentially increasing the risk of future OA. Cartilage injury progressed in patients with an elevated body mass index and the presence of a meniscus injury.</div></div><div><h3>Level of evidence</h3><div>Level III – Retrospective cohort study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101049"},"PeriodicalIF":3.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}