Most patients indicated for high tibial osteotomy (HTO) often have medial meniscus extrusion (MME), which is associated with the progression of knee osteoarthritis. However, limited research has discussed the changes in MME before and after HTO. This study aimed to compare preoperative and postoperative MME, assess the amount of change in MME (ΔMME), and identify factors influencing MME and ΔMME in open wedge (OW) and closed wedge (CW) HTO.
Methods
This retrospective study analyzed 82 knees that underwent HTO between 2018 and 2022. Among them, 50 knees were treated with OWHTO and 32 knees were treated with CWHTO. Computed tomography was used to evaluate preoperative and postoperative MME. Radiographic parameters included the hip-knee-ankle (HKA) angle, femorotibial angle (FTA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTSA), joint line convergence angle (JLCA), and joint space height (JSH). Joint laxity was calculated as the difference between supine and standing JLCA. Preoperative MME, postoperative MME and ΔMME were compared between the OWHTO (O group) and CWHTO (C group). ΔMME and its associations with perioperative variables were assessed using univariate and multivariate analyses.
Results
The mean postoperative MME (5.71 ± 1.63 mm) was significantly larger than the mean preoperative MME (5.16 ± 1.84 mm) in the O group (P = 0.002), while there was no significant difference between preoperative MME (5.71 ± 2.02 mm) and postoperative MME (5.32 ± 1.86 mm) in the C group (P = 0.239). ΔMME in the C group was significantly smaller than that in the O group (P < 0.001). In the O group,ΔMME negatively correlated with age (R = −0.377, P = 0.007) and positively with joint laxity (R = 0.309, P = 0.029). No factors correlated with ΔMME in the C group.
Conclusion
MME increased after OWHTO but was maintained or reduced after CWHTO. From the perspective of MME, CWHTO might be preferable to OWHTO.
{"title":"Closed wedge high tibial osteotomy can reduce medial meniscus extrusion in comparison with open wedge high tibial osteotomy","authors":"Akinori Nekomoto , Goki Kamei , Masakazu Ishikawa , Kyohei Nakata , Shunya Tsuji , Naofumi Hashiguchi , Atsuo Nakamae , Nobuo Adachi","doi":"10.1016/j.asmart.2025.12.001","DOIUrl":"10.1016/j.asmart.2025.12.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Most patients indicated for high tibial osteotomy (HTO) often have medial meniscus extrusion (MME), which is associated with the progression of knee osteoarthritis. However, limited research has discussed the changes in MME before and after HTO. This study aimed to compare preoperative and postoperative MME, assess the amount of change in MME (ΔMME), and identify factors influencing MME and ΔMME in open wedge (OW) and closed wedge (CW) HTO.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 82 knees that underwent HTO between 2018 and 2022. Among them, 50 knees were treated with OWHTO and 32 knees were treated with CWHTO. Computed tomography was used to evaluate preoperative and postoperative MME. Radiographic parameters included the hip-knee-ankle (HKA) angle, femorotibial angle (FTA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTSA), joint line convergence angle (JLCA), and joint space height (JSH). Joint laxity was calculated as the difference between supine and standing JLCA. Preoperative MME, postoperative MME and ΔMME were compared between the OWHTO (O group) and CWHTO (C group). ΔMME and its associations with perioperative variables were assessed using univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>The mean postoperative MME (5.71 ± 1.63 mm) was significantly larger than the mean preoperative MME (5.16 ± 1.84 mm) in the O group (P = 0.002), while there was no significant difference between preoperative MME (5.71 ± 2.02 mm) and postoperative MME (5.32 ± 1.86 mm) in the C group (P = 0.239). ΔMME in the C group was significantly smaller than that in the O group (P < 0.001). In the O group,ΔMME negatively correlated with age (R = −0.377, P = 0.007) and positively with joint laxity (R = 0.309, P = 0.029). No factors correlated with ΔMME in the C group.</div></div><div><h3>Conclusion</h3><div>MME increased after OWHTO but was maintained or reduced after CWHTO. From the perspective of MME, CWHTO might be preferable to OWHTO.</div></div><div><h3>Level of evidence</h3><div>III (Retrospective cohort study).</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"43 ","pages":"Pages 1-6"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081548","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}
<div><h3>Background</h3><div>Long-toss throwing is a common practice in baseball for arm strengthening, arm recovery, and as part of an interval throwing program after elbow surgery. However, the effect of long-toss throwing on the throwing elbow remains controversial, with limited studies. Different long-toss techniques, such as using a crow-hop and varying the throw trajectory, may influence elbow stress and injury risk. This study investigated the association between long-toss distance, technique, and subjective elbow symptoms and clinical findings among high school baseball pitchers.</div></div><div><h3>Objective</h3><div>The objective of this study was to determine whether subjective elbow symptoms and clinical findings were associated with long-toss throwing techniques in high school baseball pitchers. We hypothesized that longer distances and specific techniques correlate with a higher incidence of elbow symptoms and clinical findings on physical examination and ultrasound.</div></div><div><h3>Methods</h3><div>One hundred eighty-two high school baseball pitchers from 49 schools participated in the study. After excluding two players who did not routinely use long-toss, 180 pitchers (mean age 16.2 ± 0.6 years, mean baseball experience 8.1 ± 1.8 years) completed a thorough history, physical examination, and elbow ultrasound examination. The history collected demographical data, elbow pain within the past year, and long-toss techniques (distance, use of crow-hop, and throw trajectory). Physical examination assessed medial, lateral, and posterior-sided elbow tenderness, moving valgus stress test, and extension stress tests. Ultrasound examination evaluated for abnormalities of the medial epicondyle, ulnar collateral ligament (UCL), and coronoid. Statistical analyses assessed the relationship between long-toss, positive clinical findings, and subjective elbow symptoms.</div></div><div><h3>Results</h3><div>The mean long-toss distance was 67.0 m, with 75 m being the most common distance. Among the pitchers, 75 % used a crow-hop, and 58 % used a “not on a line” trajectory. Sixty-six pitchers (37 %) reported elbow pain within the past year. The mean long-toss distance was significantly longer for pitchers using a crow-hop, 68.8 m and a “not on a line” trajectory, 72.8 m compared to those not using these techniques, 61.8 m (<em>p</em> = 0.006) and 59.1 m (<em>p</em> < 0.001). Longer distances were associated with positive moving valgus stress tests (<em>p</em> = 0.041, cut-off = 82.8 m, Odds ratio (OR) = 3.4) and UCL abnormalities on ultrasound (<em>p</em> = 0.019, cut-off = 65.0 m, OR = 4.6). The use of a crow-hop was significantly associated with elbow pain within the past year (42 % vs. 20 %, adjusted <em>p</em> = 0.018, adjusted OR = 2.8), and a “not on a line” trajectory was linked to higher UCL abnormalities (14 % vs. 1 %, adjusted <em>p</em> = 0.039, adjusted OR = 10.7).</div></div><div><h3>Conclusions</h3><div>This study demonstrates a sig
{"title":"Effect of long-toss throwing on elbow injuries in high school baseball pitchers","authors":"Masataka Minami , Yoshikazu Kida , Okihiro Onishi , Shota Hoshika , Hiroyuki Sugaya , Kenji Takahashi , Michael T. Freehill","doi":"10.1016/j.asmart.2025.09.001","DOIUrl":"10.1016/j.asmart.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Long-toss throwing is a common practice in baseball for arm strengthening, arm recovery, and as part of an interval throwing program after elbow surgery. However, the effect of long-toss throwing on the throwing elbow remains controversial, with limited studies. Different long-toss techniques, such as using a crow-hop and varying the throw trajectory, may influence elbow stress and injury risk. This study investigated the association between long-toss distance, technique, and subjective elbow symptoms and clinical findings among high school baseball pitchers.</div></div><div><h3>Objective</h3><div>The objective of this study was to determine whether subjective elbow symptoms and clinical findings were associated with long-toss throwing techniques in high school baseball pitchers. We hypothesized that longer distances and specific techniques correlate with a higher incidence of elbow symptoms and clinical findings on physical examination and ultrasound.</div></div><div><h3>Methods</h3><div>One hundred eighty-two high school baseball pitchers from 49 schools participated in the study. After excluding two players who did not routinely use long-toss, 180 pitchers (mean age 16.2 ± 0.6 years, mean baseball experience 8.1 ± 1.8 years) completed a thorough history, physical examination, and elbow ultrasound examination. The history collected demographical data, elbow pain within the past year, and long-toss techniques (distance, use of crow-hop, and throw trajectory). Physical examination assessed medial, lateral, and posterior-sided elbow tenderness, moving valgus stress test, and extension stress tests. Ultrasound examination evaluated for abnormalities of the medial epicondyle, ulnar collateral ligament (UCL), and coronoid. Statistical analyses assessed the relationship between long-toss, positive clinical findings, and subjective elbow symptoms.</div></div><div><h3>Results</h3><div>The mean long-toss distance was 67.0 m, with 75 m being the most common distance. Among the pitchers, 75 % used a crow-hop, and 58 % used a “not on a line” trajectory. Sixty-six pitchers (37 %) reported elbow pain within the past year. The mean long-toss distance was significantly longer for pitchers using a crow-hop, 68.8 m and a “not on a line” trajectory, 72.8 m compared to those not using these techniques, 61.8 m (<em>p</em> = 0.006) and 59.1 m (<em>p</em> < 0.001). Longer distances were associated with positive moving valgus stress tests (<em>p</em> = 0.041, cut-off = 82.8 m, Odds ratio (OR) = 3.4) and UCL abnormalities on ultrasound (<em>p</em> = 0.019, cut-off = 65.0 m, OR = 4.6). The use of a crow-hop was significantly associated with elbow pain within the past year (42 % vs. 20 %, adjusted <em>p</em> = 0.018, adjusted OR = 2.8), and a “not on a line” trajectory was linked to higher UCL abnormalities (14 % vs. 1 %, adjusted <em>p</em> = 0.039, adjusted OR = 10.7).</div></div><div><h3>Conclusions</h3><div>This study demonstrates a sig","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 90-95"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464865","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}
Recently, the quadriceps tendon (QT) has gained attention as a graft material for anterior cruciate ligament (ACL) reconstruction. However, no study has yet evaluated the maturation process of the reconstructed ACL using QT grafts. Magnetic resonance imaging (MRI)-Ultra Short Echo time (UTE) T2∗ mapping is a precise technique for quantifying tissue states in tendons and ligaments. This study aimed to prospectively observe trends in UTE-T2∗ values for the intra-articular and intra-osseous regions of the reconstructed ACL from 6 to 12 months following ACL reconstruction using MRI-UTE-T2∗ mapping and to assess graft maturation of the reconstructed ACL with QT grafts.
Methods
This study enrolled 10 patients (five males and five females). For each patient, UTE-T2∗ values were measured at 6, 9, and 12 months postoperatively. A two-way mixed ANOVA was performed with time (6, 9, and 12 months) as a within-subjects factor and location (intra-articular, tibial intra-osseous, and femoral intra-osseous) as a between-subjects factor.
Results
A significant main effect of time was observed (F (2,54) = 38.162, p < 0.001), with UTE-T2∗ values decreasing as postoperative time progressed. Additionally, a significant main effect of measurement location was identified (F (2,27) = 95.853, p < 0.001), with intra-articular UTE-T2∗ values being significantly higher than those in the tibial and femoral intra-osseous regions (p < 0.001).
Conclusion
Quantitative assessment using MRI-UTE-T2∗ mapping following ACL reconstruction with QT grafts demonstrated that graft maturation progressed more rapidly in the intra-osseous region compared to the intra-articular region.
{"title":"Quantitative assessment of graft maturation after anterior cruciate ligament reconstruction using quadriceps tendon: Insights from ultra short echo time T2∗ mapping","authors":"Naoki Takemoto , Yasushi Takata , Miho Okuda , Yoshihiro Ishida , Manase Nishimura , Kentaro Fujita , Mikino Saito , Satoru Demura , Junsuke Nakase","doi":"10.1016/j.asmart.2025.09.003","DOIUrl":"10.1016/j.asmart.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Recently, the quadriceps tendon (QT) has gained attention as a graft material for anterior cruciate ligament (ACL) reconstruction. However, no study has yet evaluated the maturation process of the reconstructed ACL using QT grafts. Magnetic resonance imaging (MRI)-Ultra Short Echo time (UTE) T2∗ mapping is a precise technique for quantifying tissue states in tendons and ligaments. This study aimed to prospectively observe trends in UTE-T2∗ values for the intra-articular and intra-osseous regions of the reconstructed ACL from 6 to 12 months following ACL reconstruction using MRI-UTE-T2∗ mapping and to assess graft maturation of the reconstructed ACL with QT grafts.</div></div><div><h3>Methods</h3><div>This study enrolled 10 patients (five males and five females). For each patient, UTE-T2∗ values were measured at 6, 9, and 12 months postoperatively. A two-way mixed ANOVA was performed with time (6, 9, and 12 months) as a within-subjects factor and location (intra-articular, tibial intra-osseous, and femoral intra-osseous) as a between-subjects factor.</div></div><div><h3>Results</h3><div>A significant main effect of time was observed (F (2,54) = 38.162, p < 0.001), with UTE-T2∗ values decreasing as postoperative time progressed. Additionally, a significant main effect of measurement location was identified (F (2,27) = 95.853, p < 0.001), with intra-articular UTE-T2∗ values being significantly higher than those in the tibial and femoral intra-osseous regions (p < 0.001).</div></div><div><h3>Conclusion</h3><div>Quantitative assessment using MRI-UTE-T2∗ mapping following ACL reconstruction with QT grafts demonstrated that graft maturation progressed more rapidly in the intra-osseous region compared to the intra-articular region.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 68-73"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319894","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}
Pub Date : 2025-10-01DOI: 10.1016/j.asmart.2025.08.005
M.J. Kennedy , C.S. Leung , T.C.F. Soh , H. Sitton-Kent , H.J. Thomson , O. Hill , T. Nunn , O. Bailey , G.P. Hopper , R. Bhattacharyya
Background
Arthrogenic Muscle Inhibition (AMI) is not well recognised and is therefore underdiagnosed. Improved understanding of AMI would allow improved patient treatment pathways and rehabilitation after acute knee injuries. The primary aim of this study was to evaluate the incidence of AMI in acute knee injuries. The secondary aim was to evaluate correlation between AMI and type of underlying knee injury.
Methods
This was a prospective cohort study. All patients reviewed by the acute knee service in a tertiary referral centre between January 01, 2023 and April 30, 2023 were included (n = 97). The patients were diagnosed with AMI by a fellowship trained orthopaedic consultant knee surgeon. The incidence was evaluated with descriptive statistics and logistic regression analysis performed to ascertain association of AMI with the underlying acute knee injury diagnosis.
Results
Of the 97 patients reviewed, 12 were excluded due to a mechanical block to extension on MRI imaging. Twenty-seven (31.8 %) of the 85 eligible patients were diagnosed with AMI. Nine of the twenty-seven patients (52 %) presenting with AMI had resolution of symptoms at the index clinic appointment with directed physical therapy. Patients with AMI were 6 times (OR 6.3, 95 % CI 1.48) more likely to have a diagnosis of patellofemoral (PFJ) dislocation (p = 0.013) than those with bone bruising or minor sprain. Other associations of AMI which did not reach statistical significance were meniscal tear (OR 4.2, 95 % CI 0.4) and ACL rupture (OR 3.5, 95 % CI 0.72).
Conclusions
AMI is common in acute knee injuries, affecting nearly a third of all patients reviewed. Patients with AMI were more likely to have an underlying diagnosis of PFJ dislocation than any other acute knee injury diagnosis, and was the only statistically significant association. Correct diagnosis and instituting immediate treatment can resolve >50 % cases at the index clinic appointment. Treatment workflows incorporating early review and management could result in improved patient outcome and expedited recovery from AMI.
背景：致癌性肌肉抑制（AMI）尚未得到很好的认识，因此诊断不足。提高对急性心肌梗死的认识将有助于改善患者的治疗途径和急性膝关节损伤后的康复。本研究的主要目的是评估急性膝关节损伤中AMI的发生率。第二个目的是评估AMI与潜在膝关节损伤类型之间的相关性。方法前瞻性队列研究。纳入了2023年1月1日至2023年4月30日在三级转诊中心接受急性膝关节服务的所有患者（n = 97）。患者被一名训练有素的骨科顾问膝关节外科医生诊断为急性心肌梗死。发生率通过描述性统计和逻辑回归分析进行评估，以确定AMI与潜在的急性膝关节损伤诊断的关系。结果97例患者中，12例因MRI表现为机械阻滞而被排除。85例符合条件的患者中有27例（31.8%）被诊断为AMI。27例急性心肌梗死患者中有9例（52%）在门诊预约时接受了定向物理治疗，症状得到缓解。AMI患者诊断为髌骨股骨（PFJ）脱位的可能性是骨挫伤或轻微扭伤患者的6倍（OR 6.3, 95% CI 1.48） （p = 0.013）。其他与AMI的相关性没有达到统计学意义的是半月板撕裂（OR 4.2, 95% CI 0.4）和ACL破裂（OR 3.5, 95% CI 0.72）。结论sami在急性膝关节损伤中很常见，近三分之一的患者受其影响。AMI患者更有可能诊断为PFJ脱位，而不是其他急性膝关节损伤，这是唯一有统计学意义的关联。正确的诊断和及时的治疗可以解决50%的病例在索引门诊预约。纳入早期审查和管理的治疗工作流程可以改善患者的预后并加速AMI的恢复。
{"title":"The incidence of arthrogenic muscle inhibition in acute knee injuries: a prospective cohort study in a tertiary acute knee unit","authors":"M.J. Kennedy , C.S. Leung , T.C.F. Soh , H. Sitton-Kent , H.J. Thomson , O. Hill , T. Nunn , O. Bailey , G.P. Hopper , R. Bhattacharyya","doi":"10.1016/j.asmart.2025.08.005","DOIUrl":"10.1016/j.asmart.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Arthrogenic Muscle Inhibition (AMI) is not well recognised and is therefore underdiagnosed. Improved understanding of AMI would allow improved patient treatment pathways and rehabilitation after acute knee injuries. The primary aim of this study was to evaluate the incidence of AMI in acute knee injuries. The secondary aim was to evaluate correlation between AMI and type of underlying knee injury.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study. All patients reviewed by the acute knee service in a tertiary referral centre between January 01, 2023 and April 30, 2023 were included (n = 97). The patients were diagnosed with AMI by a fellowship trained orthopaedic consultant knee surgeon. The incidence was evaluated with descriptive statistics and logistic regression analysis performed to ascertain association of AMI with the underlying acute knee injury diagnosis.</div></div><div><h3>Results</h3><div>Of the 97 patients reviewed, 12 were excluded due to a mechanical block to extension on MRI imaging. Twenty-seven (31.8 %) of the 85 eligible patients were diagnosed with AMI. Nine of the twenty-seven patients (52 %) presenting with AMI had resolution of symptoms at the index clinic appointment with directed physical therapy. Patients with AMI were 6 times (OR 6.3, 95 % CI 1.48) more likely to have a diagnosis of patellofemoral (PFJ) dislocation (p = 0.013) than those with bone bruising or minor sprain. Other associations of AMI which did not reach statistical significance were meniscal tear (OR 4.2, 95 % CI 0.4) and ACL rupture (OR 3.5, 95 % CI 0.72).</div></div><div><h3>Conclusions</h3><div>AMI is common in acute knee injuries, affecting nearly a third of all patients reviewed. Patients with AMI were more likely to have an underlying diagnosis of PFJ dislocation than any other acute knee injury diagnosis, and was the only statistically significant association. Correct diagnosis and instituting immediate treatment can resolve >50 % cases at the index clinic appointment. Treatment workflows incorporating early review and management could result in improved patient outcome and expedited recovery from AMI.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 62-67"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319873","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}
Pub Date : 2025-10-01DOI: 10.1016/j.asmart.2025.09.004
Yongun Cho , Jin Hwan Ahn
Purpose
The purpose of this study was to compare the healing rate of meniscal repair concomitant with anterior cruciate ligament (ACL) reconstruction and isolated meniscal repair based on Intrameniscal signal intensity (IMSI).
Methods
A total of 368 patients who underwent meniscus repair between March 2011 and July 2017 by an experienced single surgeon were enrolled. 228 patients were divided into the meniscus repair concomitant with ACL reconstruction (group A, n = 171) and isolated meniscal repair group (group B, n = 57). Magnetic resonance imaging (MRI) was performed preoperatively and 12 months postoperatively, measurements were conducted from the most prominent slice of meniscal tear (PSMT). IMSI of the PSMT was measured with the free line region-of-interest (ROI) tool in a picture archiving and communication system.
Results
Except for time of accident, no significant differences were found in terms of age, body mass index, posterior slope angle, or varus angle between two groups. There were statistically significant differences of post-operative adjusted mean IMSI of patients between the two groups using ANCOVA. The corrected postoperative adjusted mean IMSI in the coronal view of group A was an estimated mean (SD) of 1.44(0.08), and in group B was an estimated mean (SD) of 2.55(0.15). All the P-values were less than 0.05, which was the same compared with MRI values for healed meniscus.
Conclusions
IMSI is a simple and conventional parameter for the assessment of meniscal healing. The healing rate of meniscal repair concomitant with ACL reconstruction compared with isolated meniscal repair using IMSI was similar to that of MRI reading. Thus, concomitant ACL reconstruction significantly improves the healing process of meniscus.
{"title":"Comparison of the healing rate with meniscal repair concomitant with anterior cruciate ligament reconstruction and isolated meniscal repair based on magnetic resonance imaging signal intensity","authors":"Yongun Cho , Jin Hwan Ahn","doi":"10.1016/j.asmart.2025.09.004","DOIUrl":"10.1016/j.asmart.2025.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to compare the healing rate of meniscal repair concomitant with anterior cruciate ligament (ACL) reconstruction and isolated meniscal repair based on Intrameniscal signal intensity (IMSI).</div></div><div><h3>Methods</h3><div>A total of 368 patients who underwent meniscus repair between March 2011 and July 2017 by an experienced single surgeon were enrolled. 228 patients were divided into the meniscus repair concomitant with ACL reconstruction (group A, n = 171) and isolated meniscal repair group (group B, n = 57). Magnetic resonance imaging (MRI) was performed preoperatively and 12 months postoperatively, measurements were conducted from the most prominent slice of meniscal tear (PSMT). IMSI of the PSMT was measured with the free line region-of-interest (ROI) tool in a picture archiving and communication system.</div></div><div><h3>Results</h3><div>Except for time of accident, no significant differences were found in terms of age, body mass index, posterior slope angle, or varus angle between two groups. There were statistically significant differences of post-operative adjusted mean IMSI of patients between the two groups using ANCOVA. The corrected postoperative adjusted mean IMSI in the coronal view of group A was an estimated mean (SD) of 1.44(0.08), and in group B was an estimated mean (SD) of 2.55(0.15). All the P-values were less than 0.05, which was the same compared with MRI values for healed meniscus.</div></div><div><h3>Conclusions</h3><div>IMSI is a simple and conventional parameter for the assessment of meniscal healing. The healing rate of meniscal repair concomitant with ACL reconstruction compared with isolated meniscal repair using IMSI was similar to that of MRI reading. Thus, concomitant ACL reconstruction significantly improves the healing process of meniscus.</div></div><div><h3>Level of evidence and study design</h3><div>Case control study.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 74-80"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319890","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}
Pub Date : 2025-10-01DOI: 10.1016/j.asmart.2025.10.001
Wing-Leong Chan , Keith Hay-Man Wan , Eugene Pak-Lin Ng , Christine Yuen-Shan Lai , Richard Hin-Lun Lee , Kevin Kwun-Hung Wong , Kam-Kwong Wong
Purpose
To investigate influence of an increased posterior tibial slope (PTS) on anterior cruciate ligament (ACL) reconstruction graft failure amongst ethnic Chinese in local subjects.
Methods
A total of number of 477 patients who had primary ACL reconstruction done from January 2008 to December 2021 were retrospectively reviewed. Ethnic Chinese patient graft size >7 mm using Hamstring graft by single bundle technique were included. Patients with age more than 50 years old, known medical comorbidities on graft rupture such as diabetes, renal failure, previous contralateral ACL injury, previous ACL revision surgery, concomitant multi-ligamental injuries, high energy trauma such as road traffic accident, contact sport injury were excluded. Included patient with graft rupture and revision surgery done will be matched and compared with those without graft rupture after primary surgery. PTS of both groups of patients will be measured on their true lateral knee X-Ray before their primary ACL reconstruction. Data of both groups (age, sex ratio, graft size, PTS angle) will be compared through Fisher exact test, t-Test and logistic regression.
Results
The incidence rate on ACL revision in our local ethnic Chinese patient was around 4.6 % (22 cases). 25 revision cases were matched with 125 control cases, with no statistically significant difference on sex ratio, age at primary operation, graft size among both groups. PTS of revision patient group had significantly higher PTS angle than control group (95 % confident interval, 10.7° vs 8.6°; P < 0.01). Logistic regression showed PTS as a significant factor affecting graft rupture outcome. Odd ratios of graft rupture due to increased PTS were 2.3 (P < 0.01), with increased risk when PTS ≥11.6° shown in logistic regression.
Conclusions
High PTS (>11.6°) will lead to increased ACL graft rupture risk and revision surgery amongst ethnic Chinese in Hong Kong. Patients with high PTS noted in pre-operative status should have their operation planned carefully and may require additional procedure such as slope-correcting operation and lateral augmentation to reduce risk of graft rupture.
{"title":"Increased posterior tibial slope leads to increased risk of graft rupture in anterior cruciate reconstruction: a retrospective matched case-control study","authors":"Wing-Leong Chan , Keith Hay-Man Wan , Eugene Pak-Lin Ng , Christine Yuen-Shan Lai , Richard Hin-Lun Lee , Kevin Kwun-Hung Wong , Kam-Kwong Wong","doi":"10.1016/j.asmart.2025.10.001","DOIUrl":"10.1016/j.asmart.2025.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate influence of an increased posterior tibial slope (PTS) on anterior cruciate ligament (ACL) reconstruction graft failure amongst ethnic Chinese in local subjects.</div></div><div><h3>Methods</h3><div>A total of number of 477 patients who had primary ACL reconstruction done from January 2008 to December 2021 were retrospectively reviewed. Ethnic Chinese patient graft size >7 mm using Hamstring graft by single bundle technique were included. Patients with age more than 50 years old, known medical comorbidities on graft rupture such as diabetes, renal failure, previous contralateral ACL injury, previous ACL revision surgery, concomitant multi-ligamental injuries, high energy trauma such as road traffic accident, contact sport injury were excluded. Included patient with graft rupture and revision surgery done will be matched and compared with those without graft rupture after primary surgery. PTS of both groups of patients will be measured on their true lateral knee X-Ray before their primary ACL reconstruction. Data of both groups (age, sex ratio, graft size, PTS angle) will be compared through Fisher exact test, <em>t</em>-Test and logistic regression.</div></div><div><h3>Results</h3><div>The incidence rate on ACL revision in our local ethnic Chinese patient was around 4.6 % (22 cases). 25 revision cases were matched with 125 control cases, with no statistically significant difference on sex ratio, age at primary operation, graft size among both groups. PTS of revision patient group had significantly higher PTS angle than control group (95 % confident interval, 10.7° vs 8.6°; P < 0.01). Logistic regression showed PTS as a significant factor affecting graft rupture outcome. Odd ratios of graft rupture due to increased PTS were 2.3 (P < 0.01), with increased risk when PTS ≥11.6° shown in logistic regression.</div></div><div><h3>Conclusions</h3><div>High PTS (>11.6°) will lead to increased ACL graft rupture risk and revision surgery amongst ethnic Chinese in Hong Kong. Patients with high PTS noted in pre-operative status should have their operation planned carefully and may require additional procedure such as slope-correcting operation and lateral augmentation to reduce risk of graft rupture.</div></div><div><h3>Level of evidence</h3><div>Level III, retrospective comparative study.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 81-85"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415515","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}
Os acromiale, a condition in which the acromial apophysis fails to fuse, and its prevalence varies across ethnic groups. Although higher rates have been reported in African and Caucasian populations, data are scarce for Asian populations, particularly for Japanese individuals. This study aimed to determine the prevalence of os acromiale in a Japanese population and its association with rotator cuff-related symptoms.
Methods
We retrospectively identified 2221 shoulders of 1411 Japanese subjects aged over 25 years who underwent computed tomography (CT) of the shoulder at our institution between September 2010 and March 2023. The shoulders were divided into an asymptomatic group, which included 1386 shoulders of 693 patients with no documented history of shoulder pain who underwent chest CT for non-orthopedic reasons, and a symptomatic group, which included 836 shoulders of 800 patients who underwent arthroscopic surgery for rotator cuff tears or tendinopathy. Os acromiale was identified using three-dimensional CT and classified by location.
Results
Os acromiale was identified in 16 shoulders (0.72 %), 10 of which were classified as pre-acromial and 6 as meso-acromial. The prevalence was significantly higher in the symptomatic group than in the asymptomatic group (1.56 % vs 0.22 %, p = 0.002). No significant difference was observed according to sex or laterality.
Conclusion
The prevalence of os acromiale in Japanese was 0.72 %. The prevalence of this condition is markedly lower in this population than in African and Caucasian populations. However, its significantly higher occurrence in symptomatic patients suggests a potential role in shoulder pain associated with rotator cuff lesions. These results emphasize the importance of recognizing os acromiale as a possible anatomical contributor to shoulder symptoms in clinical practice.
肩峰性畸形是指肩峰突不能融合的一种疾病，其患病率在不同的民族中有所不同。虽然非洲和高加索人群的发病率较高，但亚洲人群，特别是日本人的数据很少。本研究旨在确定肩峰性骨质疏松症在日本人群中的患病率及其与肩袖相关症状的关系。方法回顾性分析了1411名年龄在25岁以上的日本受试者的2221个肩部，这些受试者于2010年9月至2023年3月在我们的机构接受了肩部计算机断层扫描（CT）。肩关节被分为无症状组，包括1386个肩关节，693名无肩关节疼痛病史的患者，因非骨科原因接受胸部CT检查；有症状组，包括800名因肩袖撕裂或肌腱病变接受关节镜手术的836个肩关节。采用三维CT对肩峰进行定位和分类。结果16例（0.72%）出现肩峰，其中10例为前肩峰，6例为中肩峰。有症状组的患病率明显高于无症状组（1.56% vs 0.22%, p = 0.002）。根据性别或侧边，没有观察到显着差异。结论日本人肩峰性骨质疏松症患病率为0.72%。这种情况的患病率明显低于非洲和高加索人群。然而，在有症状的患者中，其发生率明显较高，这表明它可能与肩袖病变相关的肩痛有关。这些结果强调了在临床实践中认识到肩峰肌作为肩部症状可能的解剖学因素的重要性。
{"title":"Prevalence of os acromiale in Japanese population: Comparison between patients with shoulder pain and asymptomatic subjects","authors":"Shinji Kawaguchi , Shoji Fukuta , Jun Kawamata , Koichi Sairyo","doi":"10.1016/j.asmart.2025.09.002","DOIUrl":"10.1016/j.asmart.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Os acromiale, a condition in which the acromial apophysis fails to fuse, and its prevalence varies across ethnic groups. Although higher rates have been reported in African and Caucasian populations, data are scarce for Asian populations, particularly for Japanese individuals. This study aimed to determine the prevalence of os acromiale in a Japanese population and its association with rotator cuff-related symptoms.</div></div><div><h3>Methods</h3><div>We retrospectively identified 2221 shoulders of 1411 Japanese subjects aged over 25 years who underwent computed tomography (CT) of the shoulder at our institution between September 2010 and March 2023. The shoulders were divided into an asymptomatic group, which included 1386 shoulders of 693 patients with no documented history of shoulder pain who underwent chest CT for non-orthopedic reasons, and a symptomatic group, which included 836 shoulders of 800 patients who underwent arthroscopic surgery for rotator cuff tears or tendinopathy. Os acromiale was identified using three-dimensional CT and classified by location.</div></div><div><h3>Results</h3><div>Os acromiale was identified in 16 shoulders (0.72 %), 10 of which were classified as pre-acromial and 6 as meso-acromial. The prevalence was significantly higher in the symptomatic group than in the asymptomatic group (1.56 % vs 0.22 %, p = 0.002). No significant difference was observed according to sex or laterality.</div></div><div><h3>Conclusion</h3><div>The prevalence of os acromiale in Japanese was 0.72 %. The prevalence of this condition is markedly lower in this population than in African and Caucasian populations. However, its significantly higher occurrence in symptomatic patients suggests a potential role in shoulder pain associated with rotator cuff lesions. These results emphasize the importance of recognizing os acromiale as a possible anatomical contributor to shoulder symptoms in clinical practice.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 86-89"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415516","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}
Pub Date : 2025-09-23DOI: 10.1016/j.asmart.2025.08.001
Seong Hun Kim , Seung Joo Kim , Jae-Hoo Lee
Background/objective
In young patients with massive irreparable rotator cuff tears (MRCTs), superior capsular reconstruction (SCR) is a viable surgical treatment option, whereas SCR and reverse shoulder arthroplasty (RSA) are reliable treatments for irreparable MRCTs in patients aged >65 years. This study aimed to compare the outcomes of arthroscopic SCR and RSA in patients with MRCTs without arthritis aged ≥65.
Methods
This retrospective comparative study included 202 patients ≥65 years old with irreparable MRCTs who had undergone either SCR using a 3–4 mm single-layer human acellular dermal matrix or RSA between January 2017 and December 2021. All patients underwent at least 2 years of postoperative follow-up. Propensity score matching was performed based on age, sex, dominant-arm involvement, follow-up duration, body mass index, pseudoparalysis, bone mineral density, global fatty degeneration index, and rotator cuff tear size. A total of 44 matched patients (22 with SCR and 22 with RSA) were included in the analysis. Clinical outcomes were assessed using the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, Constant score, Single Assessment Numeric Evaluation (SANE), and active range of motion (ROM). Postoperative radiological evaluations were performed to assess healing failure.
Results
No significant differences were observed in the preoperative demographic data, clinical outcomes, or active ROM between the SCR and RSA groups. At the final follow-up, significant improvements in pain, ROM, and functional outcomes were observed in both groups. However, the SCR group had significantly higher ASES scores (88.6 ± 7.5 vs. 81.0 ± 12.0; p = 0.02), Constant scores (72.4 ± 8.9 vs. 65.0 ± 7.0; p < 0.01), and SANE scores (87.2 ± 8.4 vs. 81.2 ± 6.8; p = 0.01) than the RSA group. Postoperative active ROM was also superior in the SCR group for forward flexion (157.7 ± 21.2° vs. 141.2 ± 16.0°; p < 0.01) and internal rotation (8.1 ± 1.4 vs. 9.5 ± 2.0; p = 0.01) compared with the RSA group. Healing failure occurred in 6 patients in the SCR group (27.3 %).
Conclusion
SCR and RSA resulted in reliable improvements 2 years post-surgery in patients aged >65 years without glenohumeral joint arthritis. However, SCR provided superior outcomes in terms of forward flexion, internal rotation, and functional scores. These results suggest SCR as a more effective treatment option than RSA for irreparable MRCT in this population.
{"title":"Comparison of clinical outcomes of superior capsular reconstruction and reverse shoulder arthroplasty for irreparable rotator cuff tears in patients aged 65 and older: A propensity score-matched study","authors":"Seong Hun Kim , Seung Joo Kim , Jae-Hoo Lee","doi":"10.1016/j.asmart.2025.08.001","DOIUrl":"10.1016/j.asmart.2025.08.001","url":null,"abstract":"<div><h3>Background/objective</h3><div>In young patients with massive irreparable rotator cuff tears (MRCTs), superior capsular reconstruction (SCR) is a viable surgical treatment option, whereas SCR and reverse shoulder arthroplasty (RSA) are reliable treatments for irreparable MRCTs in patients aged >65 years. This study aimed to compare the outcomes of arthroscopic SCR and RSA in patients with MRCTs without arthritis aged ≥65.</div></div><div><h3>Methods</h3><div>This retrospective comparative study included 202 patients ≥65 years old with irreparable MRCTs who had undergone either SCR using a 3–4 mm single-layer human acellular dermal matrix or RSA between January 2017 and December 2021. All patients underwent at least 2 years of postoperative follow-up. Propensity score matching was performed based on age, sex, dominant-arm involvement, follow-up duration, body mass index, pseudoparalysis, bone mineral density, global fatty degeneration index, and rotator cuff tear size. A total of 44 matched patients (22 with SCR and 22 with RSA) were included in the analysis. Clinical outcomes were assessed using the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, Constant score, Single Assessment Numeric Evaluation (SANE), and active range of motion (ROM). Postoperative radiological evaluations were performed to assess healing failure.</div></div><div><h3>Results</h3><div>No significant differences were observed in the preoperative demographic data, clinical outcomes, or active ROM between the SCR and RSA groups. At the final follow-up, significant improvements in pain, ROM, and functional outcomes were observed in both groups. However, the SCR group had significantly higher ASES scores (88.6 ± 7.5 vs. 81.0 ± 12.0; <em>p</em> = 0.02), Constant scores (72.4 ± 8.9 vs. 65.0 ± 7.0; <em>p</em> < 0.01), and SANE scores (87.2 ± 8.4 vs. 81.2 ± 6.8; <em>p</em> = 0.01) than the RSA group. Postoperative active ROM was also superior in the SCR group for forward flexion (157.7 ± 21.2° vs. 141.2 ± 16.0°; <em>p</em> < 0.01) and internal rotation (8.1 ± 1.4 vs. 9.5 ± 2.0; <em>p</em> = 0.01) compared with the RSA group. Healing failure occurred in 6 patients in the SCR group (27.3 %).</div></div><div><h3>Conclusion</h3><div>SCR and RSA resulted in reliable improvements 2 years post-surgery in patients aged >65 years without glenohumeral joint arthritis. However, SCR provided superior outcomes in terms of forward flexion, internal rotation, and functional scores. These results suggest SCR as a more effective treatment option than RSA for irreparable MRCT in this population.</div></div><div><h3>Level of evidence</h3><div>Level III, Retrospective comparative study.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 54-61"},"PeriodicalIF":1.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117716","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}
Pub Date : 2025-09-09DOI: 10.1016/j.asmart.2025.08.002
Yen-Wei Huang , Pu-Kuang Wang , Shen-Wu Hung , Yu-Pin Chen , Wei-chun Chang , Yi-Jie Kuo , Tai-Yuan Chuang
Purpose
This study compared the clinical efficacy of T-shaped biceps tenotomy (release of the long head of the biceps tendon with a portion of the superior labrum) with that of conventional cylinder-shaped biceps tenotomy (without the labrum) in patients with reparable rotator cuff tears and concomitant lesions of the long head of the biceps tendon.
Methods
Among patients who underwent arthroscopic repair of rotator cuff tears and concomitant lesions of the long head of the biceps tendon, 89 patients aged ≥65 years who were treated with T-shaped biceps tenotomy (group T; n = 46) or conventional cylinder-shaped biceps tenotomy (group C; n = 43) were evaluated. The presence of a Popeye deformity, severity of cramping pain, elbow flexion strength, and forearm supination strength were recorded. The anatomic status of the biceps stump was assessed through ultrasonography. Anatomic failure was considered when the biceps tendon was not identified in the intertubercular groove.
Results
Overall, 86 patients (45 in group T and 41 in group C) were monitored for more than 2 years. Their postoperative functional scores were significantly better than their preoperative scores (P < 0.03) and did not differ significantly between the two groups. Three patients (6.7 %) in group T and nine (22.0 %) in group C had a Popeye deformity (P = 0.036). Ultrasonography revealed anatomic failure in five patients (11.1 %) in group T and 13 (31.7 %) in group C (P = 0.021). Postoperative cramping pain and elbow flexion strength were evaluated, showing no significant differences between groups.
Conclusions
For treating concomitant LHBT lesions in patients with rotator cuff tears, T-shaped tenotomy involving a portion of the superior labrum is an acceptable alternative to conventional cylinder-shaped tenotomy not involving the labrum. T-shaped tenotomy is associated with similar functional outcome and lower occurrence rates of a postoperative Popeye deformity than conventional cylinder-shaped tenotomy.
{"title":"Arthroscopic T-shaped biceps tenotomy decreased risk of Popeye deformity compared to traditional biceps tenotomy","authors":"Yen-Wei Huang , Pu-Kuang Wang , Shen-Wu Hung , Yu-Pin Chen , Wei-chun Chang , Yi-Jie Kuo , Tai-Yuan Chuang","doi":"10.1016/j.asmart.2025.08.002","DOIUrl":"10.1016/j.asmart.2025.08.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared the clinical efficacy of T-shaped biceps tenotomy (release of the long head of the biceps tendon with a portion of the superior labrum) with that of conventional cylinder-shaped biceps tenotomy (without the labrum) in patients with reparable rotator cuff tears and concomitant lesions of the long head of the biceps tendon.</div></div><div><h3>Methods</h3><div>Among patients who underwent arthroscopic repair of rotator cuff tears and concomitant lesions of the long head of the biceps tendon, 89 patients aged ≥65 years who were treated with T-shaped biceps tenotomy (group T; n = 46) or conventional cylinder-shaped biceps tenotomy (group C; n = 43) were evaluated. The presence of a Popeye deformity, severity of cramping pain, elbow flexion strength, and forearm supination strength were recorded. The anatomic status of the biceps stump was assessed through ultrasonography. Anatomic failure was considered when the biceps tendon was not identified in the intertubercular groove.</div></div><div><h3>Results</h3><div>Overall, 86 patients (45 in group T and 41 in group C) were monitored for more than 2 years. Their postoperative functional scores were significantly better than their preoperative scores (<em>P</em> < 0.03) and did not differ significantly between the two groups. Three patients (6.7 %) in group T and nine (22.0 %) in group C had a Popeye deformity (<em>P</em> = 0.036). Ultrasonography revealed anatomic failure in five patients (11.1 %) in group T and 13 (31.7 %) in group C (<em>P</em> = 0.021). Postoperative cramping pain and elbow flexion strength were evaluated, showing no significant differences between groups.</div></div><div><h3>Conclusions</h3><div>For treating concomitant LHBT lesions in patients with rotator cuff tears, T-shaped tenotomy involving a portion of the superior labrum is an acceptable alternative to conventional cylinder-shaped tenotomy not involving the labrum. T-shaped tenotomy is associated with similar functional outcome and lower occurrence rates of a postoperative Popeye deformity than conventional cylinder-shaped tenotomy.</div></div><div><h3>Level of evidence</h3><div>Level III, retrospective comparative study.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 47-53"},"PeriodicalIF":1.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018871","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}
Pub Date : 2025-09-06DOI: 10.1016/j.asmart.2025.08.003
Zheyue Zhu , Qiao Liu , Ying Ge , Wenbin Liang , Han Xue , Guangwei Wu , Ruochen Li , Chen Zhang , Rui Ma
Background
The outside-in suture technique is regarded as a practical method for treating anterior horn tears of the lateral meniscus (LM). The conventional outside-in technique often requires a lumbar puncture needle or specialized instruments (Meniscus Mender II). In this study, we employed a relatively novel and practical outside-in “two-needle suture” technique for anterior horn of meniscus repair. This method is simple and does not require any specialized instruments.
Objective
The aim of this study is to report the use of the arthroscopic outside-in “two-needle suture” technique for repairing anterior horn tears of the LM and to evaluate its therapeutic effect to provide a foundation for the clinical management of anterior horn injuries of the LM.
Methods
From March 2019 to August 2023, 21 patients with anterior horn tears of the LM were treated at our orthopedic center using the “two-needle suture” technique. We recorded the operation times, tear classifications, Lysholm scores, IKDC scores, and Tegner scores preoperatively and postoperatively and analyzed the functional scores using paired t tests. Additionally, the Barrett criterion was employed to evaluate the healing status of the meniscus.
Results
In the “two-needle suture” method, only 20 mL hollow needles are used for suturing, with two needles advanced into the joint cavity from the superior and inferior surfaces of the meniscus. The first needle pulled the suture thread through the preset suture loop of the second needle, and then the suture thread was knotted outside the joint capsule. In our study, the follow-up period was 12.38 ± 1.83 months, and the operative time was 32.95 ± 11.89 min. Compared with the preoperative values, significant improvements in the Lysholm, IKDC, and Tegner scores were observed at the final follow-up (p < 0.05). According to the Barrett criterion, the clinical healing rate of the meniscus was 90.48 %. In addition, no complications or risks were observed.
Conclusion
The arthroscopic “two-needle suture” technique for anterior horn tears of the LM was simple, fast and safe, with a high rate of clinical healing. This technique is useful and a valuable reference for the clinical management of anterior horn injuries of the LM.
{"title":"Arthroscopic outside-in “two-needle suture” technique for anterior horn tears of the lateral meniscus","authors":"Zheyue Zhu , Qiao Liu , Ying Ge , Wenbin Liang , Han Xue , Guangwei Wu , Ruochen Li , Chen Zhang , Rui Ma","doi":"10.1016/j.asmart.2025.08.003","DOIUrl":"10.1016/j.asmart.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>The outside-in suture technique is regarded as a practical method for treating anterior horn tears of the lateral meniscus (LM). The conventional outside-in technique often requires a lumbar puncture needle or specialized instruments (Meniscus Mender II). In this study, we employed a relatively novel and practical outside-in “two-needle suture” technique for anterior horn of meniscus repair. This method is simple and does not require any specialized instruments.</div></div><div><h3>Objective</h3><div>The aim of this study is to report the use of the arthroscopic outside-in “two-needle suture” technique for repairing anterior horn tears of the LM and to evaluate its therapeutic effect to provide a foundation for the clinical management of anterior horn injuries of the LM.</div></div><div><h3>Methods</h3><div>From March 2019 to August 2023, 21 patients with anterior horn tears of the LM were treated at our orthopedic center using the “two-needle suture” technique. We recorded the operation times, tear classifications, Lysholm scores, IKDC scores, and Tegner scores preoperatively and postoperatively and analyzed the functional scores using paired t tests. Additionally, the Barrett criterion was employed to evaluate the healing status of the meniscus.</div></div><div><h3>Results</h3><div>In the “two-needle suture” method, only 20 mL hollow needles are used for suturing, with two needles advanced into the joint cavity from the superior and inferior surfaces of the meniscus. The first needle pulled the suture thread through the preset suture loop of the second needle, and then the suture thread was knotted outside the joint capsule. In our study, the follow-up period was 12.38 ± 1.83 months, and the operative time was 32.95 ± 11.89 min. Compared with the preoperative values, significant improvements in the Lysholm, IKDC, and Tegner scores were observed at the final follow-up (p < 0.05). According to the Barrett criterion, the clinical healing rate of the meniscus was 90.48 %. In addition, no complications or risks were observed.</div></div><div><h3>Conclusion</h3><div>The arthroscopic “two-needle suture” technique for anterior horn tears of the LM was simple, fast and safe, with a high rate of clinical healing. This technique is useful and a valuable reference for the clinical management of anterior horn injuries of the LM.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 40-46"},"PeriodicalIF":1.4,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004030","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}
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