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

{"title":"How much improvement in patient reported outcomes after isolated medial patellofemoral ligament reconstruction is associated with surgeon-defined satisfactory outcomes? A JUPITER study","authors":"Saral Patel MD ,&nbsp;Matthew W. Veerkamp BA ,&nbsp;Eric J. Wall MD ,&nbsp;Philip L. Wilson MD ,&nbsp;Daniel W. Green MD, MS, FAAP, FACS ,&nbsp;Benton E. Heyworth MD ,&nbsp;Natalie K. Pahapill BS ,&nbsp;Beth E. Shubin Stein MD ,&nbsp;Shital N. Parikh MD, FACS","doi":"10.1016/j.jisako.2025.100997","DOIUrl":"10.1016/j.jisako.2025.100997","url":null,"abstract":"<div><h3>Introduction</h3><div>The extent of change in Patient Reported Outcome Measures (PROMs) required to meet surgeon-defined satisfactory outcomes after isolated medial patellofemoral ligament reconstruction (MPFL-R) has not been reported. The primary aim of the study was to define the threshold value of maximal outcome improvement (MOI) in PROMs associated with surgeon-defined satisfactory postoperative outcomes. The secondary aim was to identify the most effective PROM in predicting these outcomes and to evaluate the factors associated with it.</div></div><div><h3>Methods</h3><div>This is a retrospective review of prospectively collected data as part of the JUPITER multi-center study. Receiver operating characteristic curves were calculated to determine threshold values for MOI for 4 commonly used PROMs - Banff Patella Instability Instrument (BPII 2.0), Pediatric International Knee Documentation Committee (Pedi-IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Kujala score - associated with surgeon-defined satisfactory outcomes. Multivariate analyses were performed to determine preoperative, intraoperative, and radiographic factors associated with satisfactory outcomes.</div></div><div><h3>Results</h3><div>284 patients were included in the analysis. 183 (66.9 ​%) patients achieved surgeon-defined satisfactory outcomes. For MOI, achieving an improvement in BPII 2.0 score greater than 65.86 ​% (Area under the curve (AUC): 0.75; CI: 068–0.80; p ​&lt; ​0.0001) and in the Kujala score greater than 85.18 ​% (AUC: 0.69; CI: 0.62–0.75; p ​&lt; ​0.0001) was associated with a satisfactory outcome. BPII 2.0 had the highest AUC while Kujala had the least AUC (p ​= ​0.04). Multiple logistic regression analysis showed that first-time dislocation or having 10 or more dislocations prior to surgery significantly decreased the odds of achieving satisfactory postoperative outcomes (OR 0.12, p ​= ​0.002). None of the radiographic parameters were associated with outcomes.</div></div><div><h3>Conclusion</h3><div>MOI serves as an important measure to gauge clinical success after isolated MPFL-R. The study sets MOI thresholds for four commonly used PROMs, thus correlating patient- and surgeon-defined satisfactory outcomes after isolated MPFL-R. BPII 2.0 had good discriminative ability while Kujala had the least. The study identifies that isolated MPFL-R after first-time dislocation or after 10 or more dislocations are associated with decreased odds of satisfactory outcomes.</div></div><div><h3>Level of evidence</h3><div>Level 4 retrospective review of prospectively collected data.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 100997"},"PeriodicalIF":3.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008479","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":"Single stage anatomic posterolateral corner reconstruction with modified LaPrade technique, combined with arthroscopic posterior cruciate ligament reconstruction with tibia nail in situ—A current technique","authors":"N. Nizaj DNB(Ortho), MRCS (Glasgow) ,&nbsp;Jimmy Joseph Meleppuram MS (Ortho), FAASM ,&nbsp;Hamdi Nizar Ahamed MS (Ortho), FAASM ,&nbsp;T. Ajayakumar D'Ortho, MS (Ortho) ,&nbsp;Ayyappan V. Nair D'Ortho, DNB(Ortho) ,&nbsp;Azad Sait D'Ortho, MS (Ortho) ,&nbsp;Prince Shanavas Khan D'Ortho, MS (Ortho)","doi":"10.1016/j.jisako.2025.100996","DOIUrl":"10.1016/j.jisako.2025.100996","url":null,"abstract":"<div><div>The posterolateral corner (PLC) of the knee is a key anatomical structure which provides varus and rotational stability to the knee joint. Injuries to the PLC pose a great challenge for orthopedic surgeons due to their complex nature. PLC injuries rarely occur in isolation, with up to 95% being associated with ligament tears. Surgical reconstruction is indicated in Grade III injuries, defined clinically as &gt;10 ​mm lateral opening on varus stress and &gt;10° external rotation on the dial test, supported by MRI magnetic resonance imaging findings.</div><div>Several techniques have been described for PLC reconstruction; however, the classic anatomic reconstruction described by LaPrade remains the gold standard, traditionally performed using an Achilles tendon allograft. In this video technique, we describe a modified LaPrade technique using peroneus longus and hamstring tendon autografts for PLC and posterior cruciate ligament (PCL) reconstruction, respectively, in a patient having tibia nail in situ for Type IIIb open fracture shaft of tibia. The peroneus longus tendon is fashioned into a Y-shaped construct and must be at least 250 ​mm long to perform this technique. The graft passage and fixation sequence are the reverse of the LaPrade technique. This method ensures anatomic fixation, independent tensioning, and secure fixation of each segment, thereby restoring the normal biomechanics of the knee.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100996"},"PeriodicalIF":3.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972656","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":"Complex knee injuries from bouldering: A case series","authors":"Jhulia Kawachi Cruz,&nbsp;Khim Yew Chew,&nbsp;Mok Ying Ren,&nbsp;Yee Han Dave Lee","doi":"10.1016/j.jisako.2025.100995","DOIUrl":"10.1016/j.jisako.2025.100995","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Bouldering, a dynamic climbing discipline performed without ropes, is associated with high-energy ground falls. While most existing climbing injury literature has focused on the upper extremities, our data indicated an increasing number of complex knee injuries related to bouldering. This review was conducted to characterize the injury patterns sustained from ground falls during bouldering, and to compare the relative burden of these injuries with those sustained in other high-participation sports.</div></div><div><h3>Methods</h3><div>A retrospective case series was performed, including climbers who presented with knee injuries from ground falls during bouldering between March 2022 and October 2024. Patient demographics, injury mechanisms, ligamentous and meniscal pathology, as well as osseous or chondral damage were collected. The injuries were stratified by sex, age group, and injury complexity, including multiligament injury, meniscus tears, and osseous or chondral involvement. The bouldering-related injuries were then compared to institutional data from soccer and basketball, the two most common causes of sports-related knee injuries requiring surgery at the institution’s sports center.</div></div><div><h3>Results</h3><div>Nineteen patients were included, with a mean age of 27 ​± ​5.1 years. Of these, 15 (78.9 ​%) sustained combined anterior cruciate ligament and meniscus injuries. Surgical intervention was performed in 18 (94.7 ​%) patients. Multiligament knee injuries occurred in 4 (21.2 ​%) bouldering cases, accounting for 20 ​% of all multiligament knee injuries treated during the study period. Meniscus root tears were identified in 4 (21.1 ​%) bouldering cases, representing 22 ​% of all surgically treated meniscus root tears. Bone contusions consistent with pivot-shift patterns were observed in 52.6 ​% of patients, with cartilage fissuring and sulcus terminalis impaction in 10.5 ​% each. Compared to soccer and basketball, bouldering demonstrated a relatively higher proportion of complex knee injuries, despite lower participation volumes.</div></div><div><h3>Conclusion</h3><div>Ground falls during bouldering ground falls have been associated with a high proportion of complex knee injuries, including multiligament knee injuries, meniscus root tears, and injuries to both menisci. These injury patterns are believed to result from high-energy axial and rotational loading, and suggest the need for increased awareness, preventive strategies, and rehabilitation programs tailored to the sport.</div></div><div><h3>Level of evidence</h3><div>Level 4, Case series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100995"},"PeriodicalIF":3.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972679","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":"Twelve-month magnetic resonance imaging after anterior cruciate ligament reconstruction can identify risk factors for subsequent graft rupture and used to guide the return to sport. Results from a high-volume institution","authors":"Christian Lutz ,&nbsp;Fabio Mancino ,&nbsp;David A. Parker","doi":"10.1016/j.jisako.2025.100994","DOIUrl":"10.1016/j.jisako.2025.100994","url":null,"abstract":"<div><h3>Introduction</h3><div>Retear after anterior cruciate ligament reconstruction (ACLR) has been reported between 6% and 31% of cases, resulting in worse outcomes and increased risk of post-traumatic osteoarthritis. This study investigated whether postoperative magnetic resonance imaging (MRI) assessment, clinical outcomes, and return-to-sport test findings can help identify patients at higher risk of early graft retear.</div></div><div><h3>Methods</h3><div>Retrospective analysis of 430 patients who underwent primary ACLR using hamstring autograft between 2017 and 2022, with a minimum follow-up of 12 months. Baseline characteristics, intraoperative, and postoperative information were collected. Graft signal, tunnel widening and positioning were assessed through a 12-month MRI. Patients who experienced early graft retear were compared with a matched cohort with a ratio of 1:4. Continuous variables were compared. Logistic regression and analysis of variance were used to identify risk factors and association with retear. p values ​&lt; ​0.05 were considered significant.</div></div><div><h3>Results</h3><div>Of the 346 patients who met the inclusion/exclusion criteria, 19 experienced a graft rupture (5.4 ​%) after the 12-months follow-up. Of those, six patients were excluded due to missing postoperative 1-year MRI. Overall, 13 patients were included in the retear group and compared with 50 matched patients. The mean follow-up was 23.6 ​± ​4.2 months (range, 18–36 months). The 12-month MRI showed a greater signal-to-noise quotient (SNQ) in case of retear (2.93 vs 2.02; p ​= ​0.029). The analysis of variance showed a positive interaction between graft signal and retear (analysis of variance [ANOVA], p ​= ​0.028). Tunnel positioning was comparable between the groups, and not associated with retear. Similarly, tibial and femoral tunnel widening were comparable between the two groups and not associated with graft retear (ANOVA, p ​= ​0.733 and p ​= ​0.190). A greater proportion of patients had an anterior knee laxity &gt;2 ​mm at one year in the retear group (83.3% vs 38.8 ​%, p ​= ​0.058). However, mean laxity was comparable (2.55 ​mm vs 1.35 ​mm; p ​= ​0.189). No differences were noted for clinical scores and return-to-sport testing.</div></div><div><h3>Conclusion</h3><div>Higher graft signal on MRI at 12 months, indicating poorer graft healing, is associated with early anterior cruciate ligament retear. Resonance imaging after ACLR could be used to guide the follow-up management. Further research is required to confirm these preliminary findings.</div></div><div><h3>Level of evidence Ⅲ</h3><div>Retrospective comparative study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100994"},"PeriodicalIF":3.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972686","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":"Assessing the current medicolegal landscape in orthopedic sports medicine surgery—patient-centered communication and multidisciplinary approaches matter: A consensus statement","authors":"Zachary J. Herman ,&nbsp;Camila Grandberg ,&nbsp;Abigail N. Boduch ,&nbsp;Stephen J. Rabuck ,&nbsp;Bryson P. Lesniak ,&nbsp;Jonathan D. Hughes ,&nbsp;James J. Irrgang ,&nbsp;Michael K. Feeney ,&nbsp;MaCalus V. Hogan ,&nbsp;Volker Musahl","doi":"10.1016/j.jisako.2025.100993","DOIUrl":"10.1016/j.jisako.2025.100993","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>While the opportunity to provide medical care for elite-level professional and collegiate athletes is an honor and privilege, it does not come without a unique set of challenges. The team physician role continues to evolve and insights on today’s climate of team physicians’ care of elite athletes globally may be enlightening. As such, the purpose of this review is to provide a synopsis of the meeting’s key points and present the results of the survey to better delineate the effect of the medicolegal risk involved in the care of elite athletes.</div></div><div><h3>Methods</h3><div>An international and multidisciplinary group of experts on anterior cruciate ligament injury and sports medicine was chosen to participate on a panel at the 2024 Freddie Fu Panther Sports Medicine Symposium held at the University of Pittsburgh, Pittsburgh, Pennsylvania, USA, on June 6, 2024. The international panel included orthopaedic surgeons, primary care physicians, and scientists and focused on the medicolegal climate of sports medicine. Throughout the duration of the panel, a live questionnaire was provided to the audience, which included practitioners from 17 countries and 5 continents. The survey consisted of eight “yes/no” questions.</div></div><div><h3>Results</h3><div>Several themes emerged from the discussion, including differing medicolegal consequences based on geographic location, changes to documentation in response to litigation risk, and increases in personal stressors to physicians. Of the eight statements administered to the audience during the panel discussion, only three had greater than 50 ​% agreement. These statements included changes to practice based on the medicolegal climate and the effects of defensive practice on physicians and patients alike.</div></div><div><h3>Conclusion</h3><div>The risk of litigation in orthopaedic sports medicine surgery varies greatly based on the geographic location of the practice and is perceived to affect both patient care and providers alike. As the assessment of medical professional liability risk arising from the care of elite athletes continues to evolve, discussion among physicians, athletes, agents, and teams/clubs should be patient-centered, multidisciplinary, and undertaken with absolute professionalism, strong communication, and thorough documentation.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100993"},"PeriodicalIF":3.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849304","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":"Posterior fan-like extension of the anterior cruciate ligament femoral insertion increases ligament failure strength","authors":"Ryo Kanto ,&nbsp;Michael P. Smolinski ,&nbsp;Aly M. Fayed ,&nbsp;Monica A. Linde ,&nbsp;Volker Musahl ,&nbsp;Freddie H. Fu ,&nbsp;Patrick Smolinski","doi":"10.1016/j.jisako.2025.100939","DOIUrl":"10.1016/j.jisako.2025.100939","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The purpose of this study was to examine the role of the posterior fan-like extension (PFLE) region of the anterior cruciate ligament (ACL) on ligament failure load. It was hypothesized that transection of the PFLE region would reduce the ACL load-carrying capacity.</div></div><div><h3>Methods</h3><div>With institutional approval, fifteen fresh-frozen human cadaveric knees were divided into two age-matched groups: intact ACL femoral insertion (ACL intact group, n ​= ​8) and the cut ACL fan-like extension (PFLE-cut group, n ​= ​7). In the PFLE-cut group, the border between the mid-substance insertion and the PFLE was identified at 90° of knee flexion, and the border was cut. All specimens were dissected down to the ACL and placed in an axial testing machine at 15° of flexion, and anterior tibial loading was applied until ACL failure.</div></div><div><h3>Results</h3><div>The failure (peak) load of the ACL intact group was 910.1 ​± ​473.3 ​N, which was significantly greater (<em>P</em> ​&lt; ​0.05) than the failure load of the PFLE-cut group (409.5 ​± ​219.7 ​N). The displacement at the failure load of the ACL intact group was 21.7 ​± ​5.5 ​mm, which was significantly greater (<em>P</em> ​&lt; ​0.05) than the 14.5 ​± ​4.9 ​mm failure load displacement of the PFLE-cut group.</div></div><div><h3>Conclusion</h3><div>Transection of the PFLE region of the ACL femoral footprint significantly reduced the failure load of the ligament under anterior tibial loading at 15° of flexion. The morphology of the ACL at the femoral insertion significantly affects the failure strength of the ligament. If ACL reconstruction grafts could be constructed to more closely mimic this geometry, they could potentially have increased failure strengths and reduce failure rates.</div></div><div><h3>Level of Evidence</h3><div>Not applicable.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100939"},"PeriodicalIF":3.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812540","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":"Revision anterior cruciate ligament reconstruction in patients with high-grade anterolateral knee instability combined with modified Lemaire tenodesis using soft anchor fixation: Clinical and radiographic outcomes at two-year follow-up","authors":"Jacopo Conteduca ,&nbsp;Alessandro Carrozzo ,&nbsp;Marco Giaracuni ,&nbsp;Paolo Pichierri ,&nbsp;Damiano Longo ,&nbsp;Giuseppe Rollo","doi":"10.1016/j.jisako.2025.100938","DOIUrl":"10.1016/j.jisako.2025.100938","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>In recent years, the number of primary anterior cruciate ligament reconstructions (ACLRs) has increased, accompanied by an increase in revision anterior cruciate ligament reconstructions (RACLRs). Residual anterolateral knee instability has been identified as a major contributor to graft failure. Consequently, lateral extra-articular procedures (LEAPs), particularly modified Lemaire tenodesis, have gained interest in the management of high-grade anterolateral rotational instability in RACLR. The aim of this study was to evaluate the clinical outcomes of patients undergoing combined RACLR and modified Lemaire tenodesis with soft anchor fixation. The hypothesis was that this fixation could lead to good results in terms of clinical outcomes at a minimum follow-up of two years.</div></div><div><h3>Methods</h3><div>A retrospective review of consecutive patients with failed primary ACLR and high-grade anterolateral rotational instability (side-to-side difference &gt;5 ​mm, pivot shift ≥2+) was performed. All patients underwent an outside-in femoral tunnel technique for doubled semitendinosus and gracilis tendon ACLR, and a 2.6-mm knotless suture anchor was used for Lemaire fixation. Postoperative rehabilitation allowed for immediate weight bearing and progressive range of motion. Patients were evaluated clinically and radiographically at 3 and 6 weeks and at 3, 6, 12, and 24 months. Outcome measures included Lachman and pivot-shift tests, Rolimeter measurements, Tegner Activity Scale, Lysholm score, and subjective and objective International Knee Documentation Committee (IKDC) scores. Also, radiographic analysis was performed at the last follow-up.</div></div><div><h3>Results</h3><div>The final population comprised 15 patients. At a minimum of 2 years’ follow-up, one patient (6.6%) experienced graft failure. Most patients (10/15) achieved normal (Grade A) IKDC objective scores, with significant improvements in side-to-side differences and patient-reported outcomes. No intraoperative tunnel convergence was observed, and no additional hardware removal or reoperation was required.</div></div><div><h3>Conclusions</h3><div>A combined RACLR with modified Lemaire extra-articular tenodesis using soft anchor fixation provided favorable clinical and radiographic results in patients with high-grade anterolateral rotatory knee instability without significant complications.</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 100938"},"PeriodicalIF":3.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785556","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":"Factors associated with treatment failure after hip arthroscopic surgery for the patient with femoroacetabular impingement secondary to Legg-Calvé-Perthes disease","authors":"Takahiro Negayama ,&nbsp;Haruki Nishimura ,&nbsp;Yoichi Murata ,&nbsp;Keisuke Nakayama ,&nbsp;Shinichiro Takada ,&nbsp;Hirotaka Nakashima ,&nbsp;Hokuto Fukuda ,&nbsp;Akinori Sakai ,&nbsp;Soshi Uchida","doi":"10.1016/j.jisako.2025.100937","DOIUrl":"10.1016/j.jisako.2025.100937","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Legg-Calvé-Perthes disease (LCPD) leads to complex hip deformities that often result in femoroacetabular impingement (FAI). While traditional open surgeries have been used to address these deformities, hip arthroscopy has emerged as a minimally invasive alternative. However, the factors determining successful outcomes in arthroscopic management of LCPD-related FAI remain poorly defined. The aim of this study was to compare clinical outcomes between successful and failed cases following hip arthroscopic surgery for FAI secondary to LCPD and identify factors associated with treatment failure to optimize patient selection.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who underwent hip arthroscopy for FAI secondary to LCPD from 2011 to 2023. Patients with less than 2-year follow-up or incomplete records were excluded. Treatment failure was defined as requiring revision surgery, experiencing complications, or failing to achieve both the minimal clinically important difference (9.1 points) and Patient-Acceptable Symptom State threshold (72 points) on the modified Harris Hip Score. We evaluated patient characteristics, clinical outcomes, radiographic measurements including lateral center-edge angle (LCEA) and vertical-center-anterior angle (VCAA), preoperative radiographic severity using Tönnis grade, lateral pillar classification, and Stulberg grade and compared these factors between success and failure groups.</div></div><div><h3>Results</h3><div>The study included 15 hips in 14 patients. Nine hips achieved successful outcomes, while six hips were considered failures. The failure group was statistically significantly older (35.5 years versus 20.3 years, P ​= ​0.047) with decreased acetabular coverage, showing smaller LCEA (19.3° versus 30.2°, P ​= ​0.046) and VCAA (14.7° versus 33.3°, P ​= ​0.033). The failure group demonstrated higher frequencies of preoperative Tönnis grade ≥2, lateral pillar classification ​≥B, and Stulberg grade ≥4, indicating more severe degenerative changes and deformity. No statistically significant differences were observed in gender distribution or duration of symptoms between the groups.</div></div><div><h3>Conclusion</h3><div>Forty percent of patients experienced treatment failure after hip arthroscopic surgery for FAI secondary to LCPD. Advanced age, decreased acetabular coverage, and severe preoperative radiographic changes were associated with treatment failure. These findings suggest careful patient selection based on these factors is crucial for successful arthroscopic treatment in this patient population.</div></div><div><h3>Level of Evidence</h3><div>Level III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100937"},"PeriodicalIF":3.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776396","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":"Open figure-of-8 configuration for traumatic posterior sternoclavicular joint dislocation of the shoulder: A novel technique","authors":"Mirko Poli ,&nbsp;Matteo Messori ,&nbsp;Federico Bove ,&nbsp;Valerio Moretti ,&nbsp;Joil Ramazzotti ,&nbsp;Alberto Nicolò Bergamini ,&nbsp;Giuseppe Mazzone ,&nbsp;Marco Reda ,&nbsp;Arash Astaneh ,&nbsp;Capitani Dario ,&nbsp;Massimo Domenico Torre ,&nbsp;Filippo Familiari ,&nbsp;Paolo Capitani","doi":"10.1016/j.jisako.2025.100933","DOIUrl":"10.1016/j.jisako.2025.100933","url":null,"abstract":"<div><div>Posterior dislocation of the sternoclavicular joint (SCJ) is a rare clinical condition requiring surgical management. Various surgical techniques have been described in the literature, but those involving bone tunnels carry an increased risk of residual instability and iatrogenic fractures. We present a novel surgical technique for the management of both acute and chronic posterior SCJ dislocations, based on a figure-of-eight configuration with autograft, which ensures joint stability while preserving its natural mobility. Furthermore, the use of a single clavicular tunnel oriented orthogonally to two sternal tunnels creates a highly stable three-dimensional construct and reduce iatrogenic fractures.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100933"},"PeriodicalIF":3.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765624","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":"Comparable clinical outcomes after conversion total knee arthroplasty following high tibial osteotomy and primary total knee arthroplasty: A matched cohort study","authors":"Ignacio Fernández Z,&nbsp;Myles Coolican","doi":"10.1016/j.jisako.2025.100931","DOIUrl":"10.1016/j.jisako.2025.100931","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Knee osteoarthritis (OA) leads to pain and functional decline. While total knee arthroplasty (TKA) is a definitive treatment, high tibial osteotomy (HTO) offers a joint-preserving alternative for younger patients with malalignment. However, patients with HTO may eventually require conversion to TKA. This study aimed to compare clinical, functional, and patient-reported outcome measures (PROMs) of patients undergoing TKA after a prior medial opening wedge HTO to a matched cohort who had a primary TKA, with follow-up at ≥12 months.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from The Knee Institute, Sydney, Australia. Patients converted from HTO to TKA were matched 1:1 to primary TKA patients based on age, sex, surgeon, body mass index, medial compartment OA, and approximate year of surgery. Inclusion criteria were TKA between 2011 and 2023, prior HTO in the same knee, both procedures by one of three fellowship-trained orthopaedic surgeons; and ≥ one year of follow-up. Data collected included the Oxford Knee Score (OKS), the Veterans RAND 12-Item Health Survey (VR-12), range of motion (ROM), hospital stay, and the Caton–Deschamps index (CDI). Fifty-one converted TKA patients were matched. Statistical analysis used paired t-tests, Mann–Whitney U, chi-square, and Fisher’s exact tests.</div></div><div><h3>Results</h3><div>Both groups showed statistically significant postoperative improvements in the OKS and the VR-12 physical scores (p ​&lt; ​0.01), with no statistically significant difference between groups. ROM improved in both groups; flexion was slightly higher in the primary TKA group but not statistically significant. Patella baja was more frequent in the HTO-to TKA group; however, this was not statistically significant (p ​= ​0.054). Both groups had a median hospital stay of 5 days; however, the HTO-to-TKA group demonstrated a statistically significant distribution shift toward longer stays.</div></div><div><h3>Conclusion</h3><div>Conversion from HTO to TKA yields comparable clinical and functional outcomes to primary TKA. These findings emphasize the effectiveness of TKA after HTO and the importance of careful preoperative planning in this patient population.</div></div><div><h3>Level of Evidence</h3><div>3.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100931"},"PeriodicalIF":3.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754661","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}