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

{"title":"Remnant Preservation and Its Effects on Cyclops Lesions and Postoperative Knee Instability in Anterior Cruciate Ligament Reconstruction: A Propensity Score-Matched Study","authors":"","doi":"10.1016/j.jisako.2025.101008","DOIUrl":"10.1016/j.jisako.2025.101008","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 101008"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361400","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":"Survivorship and Clinical Outcomes of a Novel Personalized Metal Implant for the Treatment of Cartilage Lesions of the Knee","authors":"","doi":"10.1016/j.jisako.2025.101009","DOIUrl":"10.1016/j.jisako.2025.101009","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 101009"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361401","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":"Fractures In Oxford Unicompartmental Knee Arthroplasty Are Associated With A Decreased Medial Keel Cortex Distance Of The Tibial Implant – A Combined Clinical And Biomechanical Study","authors":"","doi":"10.1016/j.jisako.2025.101006","DOIUrl":"10.1016/j.jisako.2025.101006","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 101006"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361410","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":"Intertrochanteric derotational femoral osteotomy for pathological femoral anteversion without ligamentous instability. Technical note.","authors":"Vicente Sanchis-Alfonso, Erik Montesinos-Berry","doi":"10.1016/j.jisako.2025.100924","DOIUrl":"10.1016/j.jisako.2025.100924","url":null,"abstract":"<p><p>Pathological femoral anteversion is recognized as a cause of anterior knee pain. Derotational femoral osteotomy is a promising surgical intervention for anterior knee pain patients with excessive femoral anteversion. It is indicated in disabling anterior knee pain recalcitrant to conservative treatment with femoral anteversion >25° measured according to Murphy's method. However, robust evidence for a universal cutoff is lacking. It is contraindicated in patients with pathological femoral anteversion without clinical symptoms. Moreover, it is contraindicated for cosmetic reasons. This technical note describes our surgical technique of derotational osteotomy to correct pathological femoral anteversion. Femoral anteversion is problematic because it changes the direction of the quadriceps muscle. An intertrochanteric osteotomy allows a longer bone length for the thigh muscles to adjust to a new direction. The distal fragment of the femur is externally rotated until the correction desired in the preoperative planning is achieved. Good clinical outcomes and few complications have been reported with this surgical technique.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"100924"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609864","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":"Immune rejection of orthopedic tissue allograft scoping review: Are we missing a cause of graft/procedural failure? Current concepts","authors":"Grady H. Hofmann,&nbsp;Reem Sarsour,&nbsp;Willemijn van Deursen,&nbsp;Amin Alayleh,&nbsp;Nneoma Duru,&nbsp;Evans Whitaker,&nbsp;Kevin Shea","doi":"10.1016/j.jisako.2025.101002","DOIUrl":"10.1016/j.jisako.2025.101002","url":null,"abstract":"<div><div>Allograft transplants are commonly used in orthopedics. Unlike other transplanted tissues, orthopedic tissue allografts are not human leukocyte antigen (HLA)-matched. The clinical impact of the immune response to allografts is poorly understood. Recent experience with allograft failures and reactions to anterior cruciate ligaments (ACL), medial patellofemoral ligament (MPFL), osteochondral, and meniscus transplants raises concern. This scoping review examines the literature on immunologic rejection of orthopedic tissue allograft using PubMed, Embase, Web of Science, and Scopus for studies describing immune rejection of orthopedic tissue allografts in humans and animals. Four reviewers independently screened titles/abstracts based on these criteria. Full texts were screened independently by two reviewers for inclusion. Variables of interest included the species, graft type, and graft treatment. Our literature search yielded 1625 articles, with 78 meeting the inclusion criteria. Of these studies, 30 (38.5%) were in humans, 16 (20.5%) in rats, and 11 (14.1%) in dogs. The remaining 21 studies were in a combination of rabbit, primate, mice, sheep, and cat subjects. The orthopedic tissues in these studies included 23 osteochondral (29.5%), 16 bone (20.5%), 13 cartilage (16.7%), 6 bone-tendon-bone (7.7%), and 12 tendon/ligaments (15.4%) with 8 (10.2%) of the studies specifically in menisci. Methods used to reduce immune response include freezing, irrigation, and immunosuppressant administration. Recorded histological evidence of immune response included cell apoptosis, type II collagen increase, interleukins (IL) secretion, and increased lymphocytes/plasma cells in the synovial fluid. The pathways proposed were mismatched in cell-surface proteins as many studies conducted major histocompatibility complex (MHC) class I matching, which reduced the immune response. Despite histological evidence, including HLA sensitization after transplant signaling an immune response, clinical significance was not observed. Recent clinical experience of increased magnetic resonance imaging (MRI) signal response to orthopedic allografts, along with patient symptoms, has raised questions about rejection. Clinical rejection reports are limited in this review. This immune response to orthopedic allografts must be considered, and additional studies are needed to explore the relationship between rejection and clinical outcomes. This scoping review indicates that there is a range of human and animal studies demonstrating various immunologic response presentations and severities with different orthopedic tissue allografts.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101002"},"PeriodicalIF":3.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151163","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":"Use of custom three-dimensional printed models improves cam resection quality in arthroscopic treatment of femoral acetabular impingement syndrome","authors":"Malik Ali MD,&nbsp;Johnny Rayes MD,&nbsp;Maude Joannette-Bourguignon MD,&nbsp;Sara Sparavalo MASc,&nbsp;Jie Ma MES,&nbsp;Ivan Wong MD, FRCSC, MAcM, Dip. Sports Med.","doi":"10.1016/j.jisako.2025.101003","DOIUrl":"10.1016/j.jisako.2025.101003","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>To investigate whether the use of a three-dimensional (3D) printed model, compared to conventional imaging, resulted in better corrections of osseous deformities following femoral acetabular impingement syndrome (FAIS) hip arthroscopy by comparing radiographic outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent hip arthroscopy for FAIS between 2015 and 2019 was performed. Patients were sequentially allocated into the conventional or 3D model group. Radiographic plain films preoperatively and postoperatively assessed bony resection quality, measuring alpha angles and head-neck offset (HNO) ratios using 45° Dunn, frog-leg lateral, and anteroposterior views. <em>Good</em> resection was defined as an alpha angle &lt;55° and <em>poor</em> resection as an alpha angle ≥55°.</div></div><div><h3>Results</h3><div>One hundred forty-eight patients were included (n ​= ​86 in the conventional group and n ​= ​62 in the 3D model group). Compared to conventional imaging, the 3D model group had statistically significantly lower postoperative alpha angles on 45° Dunn (p ​= ​0.002) and frog-leg lateral views (p ​&lt; ​0.001). The change (preoperative to postoperative) in alpha angle was statistically significantly larger for the 3D model group, compared to conventional imaging, in 45° Dunn (p ​= ​0.003) and frog-leg lateral views (p ​= ​0.041). Compared to the conventional imaging group, the postoperative HNO ratio was statistically significantly higher in the 3D model group on 45° Dunn (p ​= ​0.001) and frog-leg lateral views (p ​&lt; ​0.001) and change in HNO ratio was statistically significantly larger for the 3D model group in both 45° Dunn (p ​= ​0.001) and frog-leg lateral views (p ​= ​0.026). When considering the <em>good</em> and <em>poor</em> resections separately for all three radiographic views, the 3D model group showed a statistically significantly higher number of <em>good</em> resections than the conventional imaging group (p ​&lt; ​0.001).</div></div><div><h3>Conclusions</h3><div>Arthroscopic FAIS treatment shows adequate resection using conventional surgical planning. The use of a 3D model facilitated better cam resection and permitted more patients to return to those within normal radiological values as measured by alpha angles and HNO ratios.</div></div><div><h3>Level of evidence</h3><div>III. (retrospective cohort).</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101003"},"PeriodicalIF":3.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151137","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":"Bony Bankart lesions exceeding 20% of glenoid width are common and show gender-based anatomical differences: A radiological study of 239 patients","authors":"Vladislavs Gordins M.D. ,&nbsp;Mikael Sansone M.D., Ph.D ,&nbsp;Louise Karlsson M.D. ,&nbsp;Neel Desai M.D., Ph.D ,&nbsp;Nicklas Olsson M.D., Ph.D","doi":"10.1016/j.jisako.2025.101001","DOIUrl":"10.1016/j.jisako.2025.101001","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Bony Bankart lesions are anterior glenoid rim fractures associated with anterior shoulder dislocation and can increase the risk of recurrent instability, particularly in cases of fragment resorption or malpositioned healing. Despite their clinical significance, few large-scale radiological studies have detailed the fragment characteristics, displacement patterns, and associated bipolar lesions. The objective of this study was to describe fragment morphology, displacement, and related shoulder parameters using computed tomography (CT) imaging.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 239 patients with isolated bony Bankart injuries identified via the Swedish Fracture Register between 2012 and 2019. All patients underwent CT imaging. Standardized linear measurement techniques were used to assess fragment size, displacement (inferior migration, diastasis, and step-off), Hill–Sachs lesion characteristics, glenoid version, and glenohumeral subluxation index.</div></div><div><h3>Results</h3><div>The mean bony Bankart fragment size was 6.5 ​mm, representing 21.8% of the glenoid width. While absolute fragment size was similar between sexes, it accounted for a significantly larger portion of the glenoid surface in females (p ​= ​0.008). Fragment displacement parameters showed no sex-based differences. Hill–Sachs lesions were present in 61% of patients and were significantly larger in males (p ​= ​0.007), though relative to humeral head diameter, differences were not significant. A consistent ratio of glenoid-to-humeral head diameter (∼66–67%) was observed across sexes.</div></div><div><h3>Conclusion</h3><div>Bony Bankart lesions frequently involve more than 20% of the anterior glenoid, particularly in female patients due to anatomical size differences. CT-based linear measurements provide valuable data for analyzing clinically significant critical bone loss in cases of bony Bankart injuries. The consistent glenoid-to-humeral head diameter ratio may aid surgical planning in shoulder reconstructive procedures.</div></div><div><h3>Level of evidence</h3><div>Level IV, diagnostic study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101001"},"PeriodicalIF":3.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132106","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":"Thai version of the Marx Activity Rating Scale: Cross-cultural adaptation and validation in patients with anterior cruciate ligament injury","authors":"Pakorn Chawanpaiboon MD ,&nbsp;Kongpob Reosanguanwong MD ,&nbsp;Wacharapol Tepa MSc ,&nbsp;Suchitphon Chanchoo MSc ,&nbsp;Pisit Lertwanich MD","doi":"10.1016/j.jisako.2025.101000","DOIUrl":"10.1016/j.jisako.2025.101000","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The Marx Activity Rating Scale (MARS) is a validated patient-reported outcome measure quantifying high-demand knee activity frequency in anterior cruciate ligament (ACL)–injured populations. The instrument consists of 4 domains: running, cutting, decelerating, and pivoting. This prospective validation study aimed to translate and cross-culturally adapt the MARS into Thai and evaluate its psychometric properties among ACL-injured patients.</div></div><div><h3>Methods</h3><div>Cross-cultural adaptation followed Beaton's established guidelines, including translation, synthesis, backward translation, expert committee review, and pretesting. Validation of the Thai version of the MARS used dual recall timeframes: MARS with a 1-year recall period (MARS_yr) and MARS with a 1-month recall period (MARS_mo). A total of 110 ACL-injured patients, aged 18–50 years with pre-injury Tegner Activity Scale (TAS) scores ≥4, completed questionnaires at the baseline and 2-week follow-up. Psychometric evaluation encompassed construct validity, internal consistency, test-retest reliability, measurement error, and floor/ceiling effects.</div></div><div><h3>Results</h3><div>Cross-cultural adaptation of the Thai version of the MARS was successfully completed. Construct validity of the instrument was demonstrated by correlations between the MARS and the TAS with corresponding timeframes (Spearman's correlation coefficient of 0.51–0.61). Internal consistency was excellent with Cronbach's α coefficients of 0.87 (MARS_yr) and 0.93 (MARS_mo). Test-retest reliability showed excellent intraclass correlation coefficients of 0.93 (MARS_yr) and 0.94 (MARS_mo). Notable floor effects (33.6% for MARS_mo) and ceiling effects (26.4% for MARS_yr) were observed.</div></div><div><h3>Conclusion</h3><div>The MARS was successfully cross-culturally adapted into the Thai version. It exhibits acceptable psychometric properties for quantifying physical activity in ACL-injured populations. Floor/ceiling effects necessitate complementary outcome measures for comprehensive functional assessment.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101000"},"PeriodicalIF":3.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087630","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":"Deep lateral femoral notch sign is associated with superficial medial collateral ligament tear in patients with anterior cruciate ligament injury","authors":"Jumpei Inoue MD ,&nbsp;Koji Nukuto MD, PhD ,&nbsp;Yunseo L. Park BS ,&nbsp;Kohei Kamada MD, PhD ,&nbsp;Karina Dias MD ,&nbsp;Ting Cong MD ,&nbsp;Volker Musahl MD","doi":"10.1016/j.jisako.2025.100999","DOIUrl":"10.1016/j.jisako.2025.100999","url":null,"abstract":"<div><h3>Objectives</h3><div>The deep lateral femoral notch sign, observed in some anterior cruciate ligament (ACL) injuries, may result from valgus-compressive forces and anterior tibial translation. Since combined ACL and medial collateral ligament (MCL) injuries often involve high valgus torque, we hypothesized an association between MCL tears and the presence of a deep lateral femoral notch sign.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of skeletally mature patients (≥14 years) who underwent primary ACL reconstruction (ACLR) and had preoperative MRIs within 3 weeks of injury. Patients were grouped by the presence of a deep lateral femoral notch sign (≥2 ​mm depth). Superficial and deep MCL tears were graded via MRI. Demographics and meniscus surgery data were collected. Univariable and multivariable analyses were used to identify factors associated with the deep lateral femoral notch sign (P ​&lt; ​.050).</div></div><div><h3>Results</h3><div>Among 590 included patients, 104 (17.6%) had a deep lateral femoral notch sign. Intra- and inter-observer reliability for notch depth and MCL grading showed near-perfect agreement (κ ​&gt; ​0.8). Multivariable analysis identified superficial MCL tear, younger age, and medial posterior tibial bone bruise as independent predictors of a deep lateral femoral notch sign (P ​&lt; ​.001 for all). When stratifying superficial MCL tears, 12.6% of grade 0/I cases and 34.6% of grade II/III cases had deep lateral femoral notch signs. The sign showed 34.6% sensitivity, 87.4% specificity, and an odds ratio of 3.68 (95% CI, 2.35–5.77) for predicting grade II/III superficial MCL tears.</div></div><div><h3>Conclusion</h3><div>In acute ACL injuries, the deep lateral femoral notch sign is associated with grade II/III superficial MCL tears, showing high specificity and a 3.7-fold increased risk. Its presence should prompt careful assessment of MCL-related instability to optimize patient outcomes.</div></div><div><h3>Level of evidence</h3><div>Level IV, retrospective cohort study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 100999"},"PeriodicalIF":3.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034393","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":"Surgical reconstruction techniques for irreparable subscapularis tears provide functional improvement but variable failure rates: A systematic review","authors":"Marc Daniel Bouchard MD ,&nbsp;Justin Gilbert MD ,&nbsp;Omar Haque MD ,&nbsp;Colin Kruse MD, MSc ,&nbsp;Bianca Giovanna Vescio MB BCh BAO ,&nbsp;Darshil Shah MBBS ,&nbsp;Moin Khan MD, MSc, FRCSC ,&nbsp;Bashar Alolabi MD, MSc, FRCSC","doi":"10.1016/j.jisako.2025.100998","DOIUrl":"10.1016/j.jisako.2025.100998","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Irreparable subscapularis tears can cause severe functional impairment and present significant clinical challenges. Current treatment options include tendon transfers (TTs), anterior capsular reconstruction, and reverse shoulder arthroplasty. Each approach has distinct biomechanical advantages and limitations, but there remains no consensus regarding the optimal treatment. This systematic review aimed to evaluate and compare clinical outcomes, failure rates, and complication profiles of surgical reconstruction techniques for irreparable subscapularis tears.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA guidelines. A comprehensive search was conducted in Embase, OVID Medline, and Emcare databases. Eligible studies included adults with irreparable subscapularis tears treated with surgical reconstruction (e.g., tendon transfers, graft augmentation, or anterior capsular reconstruction) and reporting clinical outcomes. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) score. A narrative synthesis was performed with descriptive statistics (frequencies, percentages, or weighted means with variability).</div></div><div><h3>Results</h3><div>Fourteen studies comprising 351 patients (355 shoulders) were included, with a mean age of 58.1 years (SD 9.5) and mean follow-up of 44.7 months (SD 54.4). Studied procedures included latissimus dorsi (LD) TT (6 studies, n ​= ​164), pectoralis major (PM) TT (5 studies, n ​= ​94), pectoralis minor (Pm) TT (1 study, n ​= ​74), and anterior capsular reconstruction (ACR; 2 studies, n ​= ​25). PM TT had the highest failure rate (13.0 ​%), followed by ACR (12.0 ​%), LD transfer (11.0 ​%), and Pm TT (1.4 ​%). Postoperative complications were most frequent after PM TT (12.8 ​%), while LD TT had a complication rate of 9.8 ​%. Patient-reported outcome measures improved across all groups, with the greatest Constant-Murley Score (CMS) improvement following LD TT (+33.0), the greatest Subjective Shoulder Value (SSV) improvement after PM TT (+38.6), and the largest Visual Analogue Scale (VAS) pain reduction following ACR (−5.0) and Pm transfer (−5.1).</div></div><div><h3>Conclusions</h3><div>Surgical reconstruction techniques for irreparable subscapularis tears provide improvements in pain and function, though failure and complication rates vary by procedure and appear worse with concomitant rotator cuff pathology. Further high-quality comparative studies are needed to refine patient selection and optimize surgical decision-making.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100998"},"PeriodicalIF":3.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016347","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}