Pub Date : 2024-12-17eCollection Date: 2025-01-01DOI: 10.1016/j.asmart.2024.12.001
Joshua Yeuk Shun Tran, Rex Wang-Fung Mak, Kevin Ki-Wai Ho, Jonathan Patrick Ng, Cham Kit Wong, Gloria Yan-Ting Lam, Tsz Lung Choi, Michael Tim-Yun Ong, Patrick Shu-Hang Yung
This technical note explores the novel use of an imageless robotic surgical system for simultaneous unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament reconstruction (ACLR). Knee osteoarthritis (OA) and anterior cruciate ligament (ACL) insufficiency are common conditions that traditionally require separate management. The integration of robotic assistance offers enhanced precision in surgical procedures, addressing both medial compartment OA and ACL insufficiency in a single operation. We present a case involving a 47-year-old patient with medial compartment osteoarthritis and complete ACL rupture. The patient underwent a simultaneous robotic-assisted UKA and ACLR using the CORI Surgical System (Smith&Nephew, London, UK). This approach enables accurate tibial tunnel placement and precise soft tissue balancing. The robotic system facilitates real-time gap assessment and balancing, reducing the risk of over- or under-constraint during ACL graft tensioning. The procedure was performed with a standard medial parapatellar approach. Key steps included hamstring autograft harvesting, femoral and tibial tunnel creation, and robotic-assisted implant positioning. Post-operative rehabilitation allowed full weight-bearing by the third week. This case represents the first reported instance of using an imageless robotic system for simultaneous UKA and ACLR, highlighting its potential to standardize and improve results in complex knee surgeries. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
{"title":"Novel application of an imageless robotic system in simultaneous unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction.","authors":"Joshua Yeuk Shun Tran, Rex Wang-Fung Mak, Kevin Ki-Wai Ho, Jonathan Patrick Ng, Cham Kit Wong, Gloria Yan-Ting Lam, Tsz Lung Choi, Michael Tim-Yun Ong, Patrick Shu-Hang Yung","doi":"10.1016/j.asmart.2024.12.001","DOIUrl":"10.1016/j.asmart.2024.12.001","url":null,"abstract":"<p><p>This technical note explores the novel use of an imageless robotic surgical system for simultaneous unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament reconstruction (ACLR). Knee osteoarthritis (OA) and anterior cruciate ligament (ACL) insufficiency are common conditions that traditionally require separate management. The integration of robotic assistance offers enhanced precision in surgical procedures, addressing both medial compartment OA and ACL insufficiency in a single operation. We present a case involving a 47-year-old patient with medial compartment osteoarthritis and complete ACL rupture. The patient underwent a simultaneous robotic-assisted UKA and ACLR using the CORI Surgical System (Smith&Nephew, London, UK). This approach enables accurate tibial tunnel placement and precise soft tissue balancing. The robotic system facilitates real-time gap assessment and balancing, reducing the risk of over- or under-constraint during ACL graft tensioning. The procedure was performed with a standard medial parapatellar approach. Key steps included hamstring autograft harvesting, femoral and tibial tunnel creation, and robotic-assisted implant positioning. Post-operative rehabilitation allowed full weight-bearing by the third week. This case represents the first reported instance of using an imageless robotic system for simultaneous UKA and ACLR, highlighting its potential to standardize and improve results in complex knee surgeries. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"37-40"},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-16eCollection Date: 2025-01-01DOI: 10.1016/j.asmart.2024.11.001
Le Yu, Shanshan Zheng, Yushi Chen, Xiao'ao Xue, Zikun Wang, JiaYan Cheng, Yang Sun, He Wang, Yinghui Hua
Background: Persistent maladaptive changes of corticospinal tract (CST) and quadriceps strength deficits exist in patients with anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate the relationships between the structural alterations of CST and quadriceps muscle strength deficits in patients with ACLR.
Methods: Twenty-nine participants who had undergone unilateral ACLR (29 males; age = 32.61 ± 6.72 years) were enrolled in a cross-sectional investigation. We chose CST as a region of interest and performed diffusion tensor imaging (DTI) that measured the microstructure of white matter tracts. Maximal voluntary isometric quadriceps muscle strength was assessed using a hand-held dynamometer. Simple and partial correlation analyses were performed between the DTI outcomes and quadriceps muscle strength deficits in patients with ACLR before and after controlling for age, sex, BMI, Tegner activity score, and graft type. Sub-group analyses were also performed to investigate the relationships between the DTI outcomes of CST structure and quadriceps muscle strength deficits according to the graft type before and after controlling for age, sex, BMI, and Tegner activity score.
Results: Lower limb symmetry index (LSI) of quadriceps muscle strength was associated with a higher ratio of radial diffusivity (RD, r = -0.379, p = 0.042) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score and graft type. In subgroup analyses of ACLR patients with hamstring autografts, we found that higher injured quadriceps muscle strength was associated with higher axial diffusivity (AD, r = 0.616, p = 0.033) of CST structure and lower LSI of quadriceps muscle strength was associated with higher ratio of mean diffusivity (MD, r = -0.682, p = 0.014) and RD (r = -0.759, p = 0.004) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score.
Conclusion: Decreased integrity (higher ratio of RD) of CST microstructure in ACLR patients was significantly associated with lower quadriceps limb symmetry index, which hinted that quadriceps muscle strength deficits of injured side may be a demyelinating process of CST microstructure in ACLR.
背景：前交叉韧带重建（ACLR）患者存在持续的皮质脊髓束（CST）不适应变化和股四头肌力量缺陷。本研究旨在探讨ACLR患者CST结构改变与股四头肌力量不足之间的关系。方法：29例接受单侧ACLR的患者(男性29例；年龄= 32.61±6.72岁)，纳入横断面调查。我们选择CST作为感兴趣的区域，并进行扩散张量成像（DTI），测量白质束的微观结构。最大自愿等长四头肌力量评估使用手持式测功机。在控制年龄、性别、BMI、Tegner活动评分和移植物类型前后，对ACLR患者DTI结果与股四头肌力量缺陷进行简单和部分相关分析。在控制年龄、性别、BMI和Tegner活动评分前后，我们还进行了亚组分析，根据移植物类型调查CST结构DTI结果与股四头肌力量缺陷之间的关系。结果：在控制年龄、BMI、Tegner活动评分和移植物类型后，ACLR患者下肢四头肌力量对称性指数（LSI）与损伤半球皮质脊髓束桡骨弥散度比值（RD, r = -0.379, p = 0.042）高于非损伤半球。ACLR肌腱缺损患者群分析,我们发现受伤的股四头肌肌肉力量与高轴向扩散系数(广告,r = 0.616, p = 0.033)春秋国旅的结构和较低的LSI的股四头肌肌肉力量更高比例的意思是扩散系数(医学博士,r = -0.682, p = 0.014)和RD (r = -0.759, p = 0.004)在受伤的半球皮质脊髓束的non-injured半球ACLR患者在控制了年龄,BMI， Tegner活动评分。结论：ACLR患者CST微结构完整性降低（RD比值升高）与下四头肌肢体对称指数显著相关，提示损伤侧四头肌肌力缺失可能是ACLR CST微结构脱髓鞘过程。
{"title":"Neural structural alterations correlates of quadriceps muscle strength deficits in patients after anterior cruciate ligament reconstruction.","authors":"Le Yu, Shanshan Zheng, Yushi Chen, Xiao'ao Xue, Zikun Wang, JiaYan Cheng, Yang Sun, He Wang, Yinghui Hua","doi":"10.1016/j.asmart.2024.11.001","DOIUrl":"10.1016/j.asmart.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Persistent maladaptive changes of corticospinal tract (CST) and quadriceps strength deficits exist in patients with anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate the relationships between the structural alterations of CST and quadriceps muscle strength deficits in patients with ACLR.</p><p><strong>Methods: </strong>Twenty-nine participants who had undergone unilateral ACLR (29 males; age = 32.61 ± 6.72 years) were enrolled in a cross-sectional investigation. We chose CST as a region of interest and performed diffusion tensor imaging (DTI) that measured the microstructure of white matter tracts. Maximal voluntary isometric quadriceps muscle strength was assessed using a hand-held dynamometer. Simple and partial correlation analyses were performed between the DTI outcomes and quadriceps muscle strength deficits in patients with ACLR before and after controlling for age, sex, BMI, Tegner activity score, and graft type. Sub-group analyses were also performed to investigate the relationships between the DTI outcomes of CST structure and quadriceps muscle strength deficits according to the graft type before and after controlling for age, sex, BMI, and Tegner activity score.</p><p><strong>Results: </strong>Lower limb symmetry index (LSI) of quadriceps muscle strength was associated with a higher ratio of radial diffusivity (RD, r = -0.379, p = 0.042) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score and graft type. In subgroup analyses of ACLR patients with hamstring autografts, we found that higher injured quadriceps muscle strength was associated with higher axial diffusivity (AD, r = 0.616, p = 0.033) of CST structure and lower LSI of quadriceps muscle strength was associated with higher ratio of mean diffusivity (MD, r = -0.682, p = 0.014) and RD (r = -0.759, p = 0.004) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score.</p><p><strong>Conclusion: </strong>Decreased integrity (higher ratio of RD) of CST microstructure in ACLR patients was significantly associated with lower quadriceps limb symmetry index, which hinted that quadriceps muscle strength deficits of injured side may be a demyelinating process of CST microstructure in ACLR.</p>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"30-36"},"PeriodicalIF":1.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-28DOI: 10.1016/j.asmart.2024.10.002
Yuting Zhong , Chengxuan Yu , Sijia Feng , Han Gao , Luyi Sun , Yunxia Li , Shiyi Chen , Jun Chen
Purpose
To use a finite element method to construct a patch-bridge repair model for massive rotator cuff tears (MRCTs) and investigate the effects of different suture methods and knot numbers on postoperative biomechanics.
Methods
A finite element model based on intact glenohumeral joint data was used for a biomechanical study. A full-thickness defect and retraction model of the supraspinatus tendon simulated MRCTs. Patch, suture, and anchor models were constructed, and the Marlow method was used to assign the material properties. Three suturing models were established: 1-knot simple, 1-knot mattress, and 2-knot mattress. The ultimate failure load, failure mode, stress distribution of each structure, and other biomechanical results of the different models were calculated and compared.
Results
The ultimate failure load of the 1-knot mattress suture (71.3 N) was 5.6 % greater than that of the 1-knot simple suture (67.5 N), while that (81.5 N) of the 2-knot mattress was 14.3 % greater than that of the 1-knot mattress. The stress distribution on the patch and supraspinatus tendon was concentrated on suture perforation. Failure of the bridging reconstruction mainly occurred at the suture perforation of the patch, and the damage forms included cutting-through and isthmus pull-out.
Conclusion
A finite element model for the patch-bridging reconstruction of MRCTs was established, and patch-bridging restored the mechanical integrity of the rotator cuff. The 2-knot mattress suture was optimal for patch-bridging reconstruction of MRCTs.
{"title":"Optimal suturing techniques in patch-bridging reconstruction for massive rotator cuff tears: A finite element analysis","authors":"Yuting Zhong , Chengxuan Yu , Sijia Feng , Han Gao , Luyi Sun , Yunxia Li , Shiyi Chen , Jun Chen","doi":"10.1016/j.asmart.2024.10.002","DOIUrl":"10.1016/j.asmart.2024.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To use a finite element method to construct a patch-bridge repair model for massive rotator cuff tears (MRCTs) and investigate the effects of different suture methods and knot numbers on postoperative biomechanics.</div></div><div><h3>Methods</h3><div>A finite element model based on intact glenohumeral joint data was used for a biomechanical study. A full-thickness defect and retraction model of the supraspinatus tendon simulated MRCTs. Patch, suture, and anchor models were constructed, and the Marlow method was used to assign the material properties. Three suturing models were established: 1-knot simple, 1-knot mattress, and 2-knot mattress. The ultimate failure load, failure mode, stress distribution of each structure, and other biomechanical results of the different models were calculated and compared.</div></div><div><h3>Results</h3><div>The ultimate failure load of the 1-knot mattress suture (71.3 N) was 5.6 % greater than that of the 1-knot simple suture (67.5 N), while that (81.5 N) of the 2-knot mattress was 14.3 % greater than that of the 1-knot mattress. The stress distribution on the patch and supraspinatus tendon was concentrated on suture perforation. Failure of the bridging reconstruction mainly occurred at the suture perforation of the patch, and the damage forms included cutting-through and isthmus pull-out.</div></div><div><h3>Conclusion</h3><div>A finite element model for the patch-bridging reconstruction of MRCTs was established, and patch-bridging restored the mechanical integrity of the rotator cuff. The 2-knot mattress suture was optimal for patch-bridging reconstruction of MRCTs.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 22-29"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bursal-side supraspinatus tendon tears are a common form of rotator cuff injury, often associated with acromial impingement and other extrinsic factors. Existing anatomical parameters, such as the lateral acromion angle, acromial index, and critical shoulder angle, have been studied in relation to rotator cuff tears; however, reliable indicators specific to the risk of bursal-side supraspinatus tears remain lacking. The acromioclavicular (AC) angle, which reflects the angular relationship between the acromion and clavicle, may offer a new predictive marker for this specific pathology.
Methods
In this retrospective case-control study, patients presenting with shoulder pain between January 2016 and February 2020 were reviewed. Group 1 included patients with isolated bursal-side supraspinatus tendon tears confirmed by arthroscopy, while Group 2 consisted of age- and gender-matched controls without rotator cuff pathology. The AC angle was measured using both X-ray and MRI. Diagnostic performance was assessed through Receiver Operating Characteristic (ROC) curve analysis, identifying the optimal cut-point with Youden's index. Reliability was measured using the Intraclass Correlation Coefficient (ICC) for both intra- and inter-rater reliability.
Results
The ROC analysis determined an optimal AC angle cut-point of ≤160°. X-ray measurements showed moderate diagnostic value (AUC 0.60, sensitivity 67.2 %, specificity 51.7 %), while MRI measurements demonstrated good diagnostic performance (AUC 0.79, sensitivity 84.5 %, specificity 70.7 %). X-ray yielded high sensitivity but low specificity, suggesting its utility as an initial screening tool, whereas MRI provided improved diagnostic accuracy. Reliability assessments indicated high intra- and inter-rater reliability for AC angle measurements across both imaging modalities (ICC >0.80).
Conclusion
The AC angle, particularly when measured on MRI, may serve as a valuable diagnostic marker for identifying isolated bursal-side supraspinatus tendon tears. While X-ray can be utilized as an accessible screening tool, combining it with clinical assessments and MRI is recommended for greater diagnostic precision. Further multi-center, prospective studies are warranted to confirm the clinical utility of the AC angle in predicting rotator cuff pathology.
{"title":"Predicting bursal-side supraspinatus tendon tears with the acromioclavicular angle","authors":"Nadhaporn Saengpetch , Jaturong Bamrungchaowkasem , Niyata Chitrapazt , Pinkawas Kongmalai","doi":"10.1016/j.asmart.2024.11.003","DOIUrl":"10.1016/j.asmart.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Bursal-side supraspinatus tendon tears are a common form of rotator cuff injury, often associated with acromial impingement and other extrinsic factors. Existing anatomical parameters, such as the lateral acromion angle, acromial index, and critical shoulder angle, have been studied in relation to rotator cuff tears; however, reliable indicators specific to the risk of bursal-side supraspinatus tears remain lacking. The acromioclavicular (AC) angle, which reflects the angular relationship between the acromion and clavicle, may offer a new predictive marker for this specific pathology.</div></div><div><h3>Methods</h3><div>In this retrospective case-control study, patients presenting with shoulder pain between January 2016 and February 2020 were reviewed. Group 1 included patients with isolated bursal-side supraspinatus tendon tears confirmed by arthroscopy, while Group 2 consisted of age- and gender-matched controls without rotator cuff pathology. The AC angle was measured using both X-ray and MRI. Diagnostic performance was assessed through Receiver Operating Characteristic (ROC) curve analysis, identifying the optimal cut-point with Youden's index. Reliability was measured using the Intraclass Correlation Coefficient (ICC) for both intra- and inter-rater reliability.</div></div><div><h3>Results</h3><div>The ROC analysis determined an optimal AC angle cut-point of ≤160°. X-ray measurements showed moderate diagnostic value (AUC 0.60, sensitivity 67.2 %, specificity 51.7 %), while MRI measurements demonstrated good diagnostic performance (AUC 0.79, sensitivity 84.5 %, specificity 70.7 %). X-ray yielded high sensitivity but low specificity, suggesting its utility as an initial screening tool, whereas MRI provided improved diagnostic accuracy. Reliability assessments indicated high intra- and inter-rater reliability for AC angle measurements across both imaging modalities (ICC >0.80).</div></div><div><h3>Conclusion</h3><div>The AC angle, particularly when measured on MRI, may serve as a valuable diagnostic marker for identifying isolated bursal-side supraspinatus tendon tears. While X-ray can be utilized as an accessible screening tool, combining it with clinical assessments and MRI is recommended for greater diagnostic precision. Further multi-center, prospective studies are warranted to confirm the clinical utility of the AC angle in predicting rotator cuff pathology.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 15-21"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are reports indicating that between 10 and 38.5 % of patients with chronic lateral ankle instability (CLAI) have an os subfibulare. In cases where CLAI accompanied by os subfibulare is resistant to conservative treatment, surgery may be necessary; however, there is no consensus on the most appropriate surgical method. We report outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare at our hospital, followed for over 2 years post-operatively.
Methods
We reviewed 33 patients (39 ankles) whom underwent arthroscopic lateral ankle ligament repair (ALLR) for CLAI and followed for at least 2 years post-operatively between November 2015 and May 2020. Patients were classified into two groups: a group with os subfibulare (ossicle group) and a group without os subfibulare (non-ossicle group), based on the presence of an os subfibulare on pre-operative plain radiographs. ALLR surgeries were performed without resection of the os subfibulare in ossicle group. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) scale and the Self-administered Foot Evaluation Questionnaire (SAFE-Q). In addition, the bone-union rate was evaluated by using plain computer tomography in the ossicle group.
Results
There were significant improvements in the mean total JSSF scale scores from pre-operative to post-operative measurements in both the ossicle and non-ossicle groups. The mean scores for pain and related symptoms, foot function and activities of daily living, social functioning, shoe-related, and general health and well-being subscales of the SAFE-Q also showed significant improvements in both groups. There were no significant differences between the post-operative ossicle and non-ossicle groups regarding the JSSF scale scores or the SAFE-Q subscale scores. In the ossicle group, the bone-union rate was 14.3 % (2 of 14 ankles), but no symptom recurrence was observed.
Conclusion
The 2 years outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare revealed good results and no symptom recurrence.
{"title":"Clinical outcomes over 2 years following arthroscopic ankle lateral ligament repair with os subfibulare","authors":"Shohei Sano, Noriyuki Kanzaki, Kiminari Kataoka, Koji Nukuto, Tetsuya Yamamoto, Yuta Nakanishi, Kyohei Nishida, Kanto Nagai, Yuichi Hoshino, Takehiko Matsushita, Ryosuke Kuroda","doi":"10.1016/j.asmart.2024.11.002","DOIUrl":"10.1016/j.asmart.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>There are reports indicating that between 10 and 38.5 % of patients with chronic lateral ankle instability (CLAI) have an os subfibulare. In cases where CLAI accompanied by os subfibulare is resistant to conservative treatment, surgery may be necessary; however, there is no consensus on the most appropriate surgical method. We report outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare at our hospital, followed for over 2 years post-operatively.</div></div><div><h3>Methods</h3><div>We reviewed 33 patients (39 ankles) whom underwent arthroscopic lateral ankle ligament repair (ALLR) for CLAI and followed for at least 2 years post-operatively between November 2015 and May 2020. Patients were classified into two groups: a group with os subfibulare (ossicle group) and a group without os subfibulare (non-ossicle group), based on the presence of an os subfibulare on pre-operative plain radiographs. ALLR surgeries were performed without resection of the os subfibulare in ossicle group. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) scale and the Self-administered Foot Evaluation Questionnaire (SAFE-Q). In addition, the bone-union rate was evaluated by using plain computer tomography in the ossicle group.</div></div><div><h3>Results</h3><div>There were significant improvements in the mean total JSSF scale scores from pre-operative to post-operative measurements in both the ossicle and non-ossicle groups. The mean scores for pain and related symptoms, foot function and activities of daily living, social functioning, shoe-related, and general health and well-being subscales of the SAFE-Q also showed significant improvements in both groups. There were no significant differences between the post-operative ossicle and non-ossicle groups regarding the JSSF scale scores or the SAFE-Q subscale scores. In the ossicle group, the bone-union rate was 14.3 % (2 of 14 ankles), but no symptom recurrence was observed.</div></div><div><h3>Conclusion</h3><div>The 2 years outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare revealed good results and no symptom recurrence.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 9-14"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare the initial postoperative stability of opening-wedge high tibial osteotomy (HTO) and opening-wedge distal tuberosity osteotomy (DTO) and investigate the factors that influence initial stability.
Methods
Patients with the same operative indications who underwent HTO (n = 51) and DTO (n = 55) were included. Demographic and preoperative radiographic data (weight-bearing line percentage [%WBL], femoral-tibial angle [FTA], medial proximal tibial angle [MPTA], posterior tibial slope and correction angle), and postoperative computed tomography (CT) scan data (initial postoperative stability [12 weeks postoperative], and hinge fracture [1 and 12 weeks postoperatively], and hinge length, flange thickness, flange length, axial flange osteotomy angle, sagittal flange osteotomy angle [1 week postoperatively]) were statistically analyzed. As a subgroup analysis, HTO and DTO patients were divided into Stable and Unstable groups respectively based on postoperative CT at 12 weeks; demographic and radiological data were compared.
Results
Patients with DTO was significantly younger (median [range]; 59 [22, 73] vs 64 [45, 75], P = 0.02) and had a smaller preoperative deformity (%WBL: median [range]; 28.9 [12.8, 46.0] vs 24.3 [4.9, 44.3], P < 0.01, FTA: median [range]; 179.0 [173.0, 183.0] vs 180.0 [172.5, 186.2], P < 0.01, MPTA: median [range]; 84.0 [79.0, 87.1] vs 83.0 [78.2, 86.5], P = 0.04) and smaller correction angles (median [range]; 9 [6, 12] vs 10 [7, 15], P < 0.01). Postoperative CT data showed that DTO was associated with significantly more unstable cases (stable/unstable: 31/24 vs. 39/12, P = 0.02) and hinge fractures (none/1/2/3: 24/25/3/3 vs. 36/12/1/2, P < 0.01) and shorter hinge (median [range]; 27.8 [14.7, 43.4] vs 32.6 [22.5, 44.0], P < 0.01) than HTO. The Unstable DTO group had significantly shorter hinges (median [range]; 23.2 [14.7, 33.9] vs 31.1 [15.2, 43.4], P < 0.01) and thicker flanges (median [range]: 15.2 [9.0, 24.8] vs. 11.0 [6.8, 13.8], P < 0.01) than the stable group. The other data were not significantly different between the two groups.
Conclusion
DTO resulted in less initial postoperative stability than HTO. The risk factors for initial instability in DTO were a short hinge and thick flange.
{"title":"Is there a difference in bony stability at three months postoperatively between opening-wedge high tibial osteotomy and opening-wedge distal tuberosity osteotomy?","authors":"Suguru Koyama , Keiji Tensho , Kazushige Yoshida , Hiroki Shimodaira , Daiki Kumaki , Yusuke Maezumi , Hiroshi Horiuchi , Jun Takahashi","doi":"10.1016/j.asmart.2024.10.001","DOIUrl":"10.1016/j.asmart.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the initial postoperative stability of opening-wedge high tibial osteotomy (HTO) and opening-wedge distal tuberosity osteotomy (DTO) and investigate the factors that influence initial stability.</div></div><div><h3>Methods</h3><div>Patients with the same operative indications who underwent HTO (n = 51) and DTO (n = 55) were included. Demographic and preoperative radiographic data (weight-bearing line percentage [%WBL], femoral-tibial angle [FTA], medial proximal tibial angle [MPTA], posterior tibial slope and correction angle), and postoperative computed tomography (CT) scan data (initial postoperative stability [12 weeks postoperative], and hinge fracture [1 and 12 weeks postoperatively], and hinge length, flange thickness, flange length, axial flange osteotomy angle, sagittal flange osteotomy angle [1 week postoperatively]) were statistically analyzed. As a subgroup analysis, HTO and DTO patients were divided into Stable and Unstable groups respectively based on postoperative CT at 12 weeks; demographic and radiological data were compared.</div></div><div><h3>Results</h3><div>Patients with DTO was significantly younger (median [range]; 59 [22, 73] vs 64 [45, 75], P = 0.02) and had a smaller preoperative deformity (%WBL: median [range]; 28.9 [12.8, 46.0] vs 24.3 [4.9, 44.3], P < 0.01, FTA: median [range]; 179.0 [173.0, 183.0] vs 180.0 [172.5, 186.2], P < 0.01, MPTA: median [range]; 84.0 [79.0, 87.1] vs 83.0 [78.2, 86.5], P = 0.04) and smaller correction angles (median [range]; 9 [6, 12] vs 10 [7, 15], P < 0.01). Postoperative CT data showed that DTO was associated with significantly more unstable cases (stable/unstable: 31/24 vs. 39/12, P = 0.02) and hinge fractures (none/1/2/3: 24/25/3/3 vs. 36/12/1/2, P < 0.01) and shorter hinge (median [range]; 27.8 [14.7, 43.4] vs 32.6 [22.5, 44.0], P < 0.01) than HTO. The Unstable DTO group had significantly shorter hinges (median [range]; 23.2 [14.7, 33.9] vs 31.1 [15.2, 43.4], P < 0.01) and thicker flanges (median [range]: 15.2 [9.0, 24.8] vs. 11.0 [6.8, 13.8], P < 0.01) than the stable group. The other data were not significantly different between the two groups.</div></div><div><h3>Conclusion</h3><div>DTO resulted in less initial postoperative stability than HTO. The risk factors for initial instability in DTO were a short hinge and thick flange.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.asmart.2024.09.004
Yang Wu , Hong Shao , Mingru Huang , Junru Lu , Li Cao , Yunxia Li , Shurong Zhang , Yunshen Ge
Background
The long-term effects of extracorporeal shockwave therapy (ESWT) on rotator cuff repair are unknown.
Objectives
To investigate the functional outcomes and structural changes of ESWT at 3-year follow-up after rotator cuff repair.
Methods
A randomized clinical trial was conducted, including patients who underwent rotator cuff repair. The patients were assigned to two groups based on whether they underwent radial ESWT 3 months postoperatively. The ESWT Group received 5 weeks of rehabilitation and ESWT weekly, whereas the CONTROL Group received only rehabilitation. Visual analog scale (VAS) pain score and functional scores were analyzed at 3 months (baseline), 6 months, and 3 years follow-up. In addition, MRI and ultrasonography were used to assess tendon maturation, integrity, tendon quality, acromiohumeral distance (AHD), and muscle fatty infiltration.
Results
Finally, 32 participants completed all the assessments. At the final follow-up, 2 patients in the ESWT Group (16.5 %) versus one patient in the CONTROL Group (6.25 %) had rotator cuff failure (P = 0.176). The ESWT treatment showed similar clinical outcomes in VAS-pain score, functional scores, tendon quality, AHD, and muscle fatty infiltration versus the CONTROL Group (Ps > 0.05). MRI analysis indicated improved tendon healing after ESWT treatment at both 6-month (P = 0.036) and 3-year follow-up (P = 0.028).
Conclusion
Early intervention with radial ESWT sustained long-term effects on the healing of the repaired rotator cuff and similar functional outcomes at long-term follow-up compared with standard rehabilitation.
{"title":"Early intervention of extracorporeal shockwave therapy sustained positive long-term effect on rotator cuff healing: A randomized controlled trial with 3-year follow-up","authors":"Yang Wu , Hong Shao , Mingru Huang , Junru Lu , Li Cao , Yunxia Li , Shurong Zhang , Yunshen Ge","doi":"10.1016/j.asmart.2024.09.004","DOIUrl":"10.1016/j.asmart.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>The long-term effects of extracorporeal shockwave therapy (ESWT) on rotator cuff repair are unknown.</div></div><div><h3>Objectives</h3><div>To investigate the functional outcomes and structural changes of ESWT at 3-year follow-up after rotator cuff repair.</div></div><div><h3>Methods</h3><div>A randomized clinical trial was conducted, including patients who underwent rotator cuff repair. The patients were assigned to two groups based on whether they underwent radial ESWT 3 months postoperatively. The ESWT Group received 5 weeks of rehabilitation and ESWT weekly, whereas the CONTROL Group received only rehabilitation. Visual analog scale (VAS) pain score and functional scores were analyzed at 3 months (baseline), 6 months, and 3 years follow-up. In addition, MRI and ultrasonography were used to assess tendon maturation, integrity, tendon quality, acromiohumeral distance (AHD), and muscle fatty infiltration.</div></div><div><h3>Results</h3><div>Finally, 32 participants completed all the assessments. At the final follow-up, 2 patients in the ESWT Group (16.5 %) versus one patient in the CONTROL Group (6.25 %) had rotator cuff failure (P = 0.176). The ESWT treatment showed similar clinical outcomes in VAS-pain score, functional scores, tendon quality, AHD, and muscle fatty infiltration versus the CONTROL Group (Ps > 0.05). MRI analysis indicated improved tendon healing after ESWT treatment at both 6-month (P = 0.036) and 3-year follow-up (P = 0.028).</div></div><div><h3>Conclusion</h3><div>Early intervention with radial ESWT sustained long-term effects on the healing of the repaired rotator cuff and similar functional outcomes at long-term follow-up compared with standard rehabilitation.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"38 ","pages":"Pages 49-55"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Platelet-rich-plasma (PRP) is rapidly spreading as a conservative treatment option for knee osteoarthritis (KOA), however, its therapeutic efficacy is controversial. This study aimed to investigate the factors affecting the therapeutic effect of intra-articular PRP therapy for KOA in patients who received multiple PRP injections (PRP-I).
Methods
This is a historical cohort study included 1057 knees of 701 patients who received PRP-I during KOA treatment from 2018 to 2020. The difference in visual analog scale (VAS) scores before and after PRP-I was defined as the amount of change in VAS (ΔVAS). A linear mixed-effects model was employed with ΔVAS as a random effect and age, sex, BMI, KL classification, pre-treatment VAS, treatment duration, and the number of PRP injections as fixed effects. Evaluations using the Kellgren-Lawrence (KL) classification were added.
Results
Age, KL grade, and VAS score before treatment and after three, four, and five PRP-I were significantly associated with ΔVAS score. According to KL grade, age was significantly associated with ΔVAS score in the KL grade 4 group. VAS score before treatment was significantly associated with ΔVAS score, regardless of KL grade. Three-time PRP-I were significantly associated with ΔVAS in the KL-grade 1 and 2 groups. For KL grade 4, two or more PRP-I were significantly associated with the high efficacy.
Conclusions
Age, pain before treatment, KL grade and number of injections were associated with pain reduction after intra-articular PRP-I for KOA treatment. Pain reduction can be expected after PRP-I when patients are younger or experience severe pain before treatment. Three-time PRP-I are recommended to reduce pain in early-stage KOA and more than three times in advanced-stage KOA.
{"title":"Factors affecting the therapeutic effects of multiple intra-articular injections of platelet-rich-plasma for knee osteoarthritis","authors":"Kohei Kamada , Takehiko Matsushita , Takahiro Yamashita , Tomoyuki Matsumoto , Hideki Iwaguro , Ryosuke Kuroda , Satoshi Sobajima","doi":"10.1016/j.asmart.2024.09.006","DOIUrl":"10.1016/j.asmart.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Platelet-rich-plasma (PRP) is rapidly spreading as a conservative treatment option for knee osteoarthritis (KOA), however, its therapeutic efficacy is controversial. This study aimed to investigate the factors affecting the therapeutic effect of intra-articular PRP therapy for KOA in patients who received multiple PRP injections (PRP-I).</div></div><div><h3>Methods</h3><div>This is a historical cohort study included 1057 knees of 701 patients who received PRP-I during KOA treatment from 2018 to 2020. The difference in visual analog scale (VAS) scores before and after PRP-I was defined as the amount of change in VAS (ΔVAS). A linear mixed-effects model was employed with ΔVAS as a random effect and age, sex, BMI, KL classification, pre-treatment VAS, treatment duration, and the number of PRP injections as fixed effects. Evaluations using the Kellgren-Lawrence (KL) classification were added.</div></div><div><h3>Results</h3><div>Age, KL grade, and VAS score before treatment and after three, four, and five PRP-I were significantly associated with ΔVAS score. According to KL grade, age was significantly associated with ΔVAS score in the KL grade 4 group. VAS score before treatment was significantly associated with ΔVAS score, regardless of KL grade. Three-time PRP-I were significantly associated with ΔVAS in the KL-grade 1 and 2 groups. For KL grade 4, two or more PRP-I were significantly associated with the high efficacy.</div></div><div><h3>Conclusions</h3><div>Age, pain before treatment, KL grade and number of injections were associated with pain reduction after intra-articular PRP-I for KOA treatment. Pain reduction can be expected after PRP-I when patients are younger or experience severe pain before treatment. Three-time PRP-I are recommended to reduce pain in early-stage KOA and more than three times in advanced-stage KOA.</div></div><div><h3>Trial registration</h3><div>Retrospectively registration.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"38 ","pages":"Pages 43-48"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In order to do arthroscopic surgery on medial meniscus injuries, there must be enough joint space and good visibility for instrumentation. There is a possibility of iatrogenic cartilage damage if the medial joint space is reduced. Therefore, a medial collateral ligament (MCL) releasing procedure may be necessary for the majority of individuals with medial knee tightness. The MCL residual laxity after pie-crusting release during arthroscopic medial meniscus repair in medial knee tightness were studied in this study.
Methods
Between July 2022 and June 2023, fourteen patients (4 male, 10 female) underwent medial meniscus surgery with pie-crusting release of the superficial MCL. Mean age was 50 ± 10 years (range, 35–63 years). Medial meniscal lesions were meniscus root tear in 10 cases (71.5 %), longitudinal tear in 2 (14.5 %), horizontal tear in 1 (7 %) and radial tear in 1 (7 %). Preoperatively, valgus stress radiographs were obtained. During surgery if arthroscopic exploration revealed medial joint space narrowing after applying valgus force with the knee in 20 degrees of flexion, pie-crusting MCL release was performed. At the 3-month follow-up, valgus stress radiographs were obtained. Residual MCL laxity was assessed by comparing preoperative and 3-month follow-up medial joint space width measurements.
Result
At the 3-month follow-up, no significant increase in the medial joint space width on valgus stress radiograph was observed in comparison to the preoperative. The medial joint space width on valgus stress radiograph was 7.42 ± 1.16 mm preoperatively and 7.47 ± 1.15 mm at 3-month postoperatively (p value = 0.914). All patients had no intraoperative iatrogenic cartilage injury and no saphenous nerve injury after operation.
Conclusions
The magic point pie-crusting MCL release is a reliable and useful procedure to arthroscopic surgery in patients with medial meniscal injury and medial knee tightness. Furthermore, percutaneous pie-crusting MCL release had no effect on residual valgus laxity at the last follow-up.
{"title":"The residual laxity of medial collateral ligament after magic point pie crusting MCL released in arthroscopic management of medial meniscus","authors":"Pinij Srisuwanporn , Suriya Laksawut , Jiradeth Tanulugpairoj , Yottawee Chinakarn , Phichit Khunvejvaidya , Banchong Thantong","doi":"10.1016/j.asmart.2024.09.001","DOIUrl":"10.1016/j.asmart.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>In order to do arthroscopic surgery on medial meniscus injuries, there must be enough joint space and good visibility for instrumentation. There is a possibility of iatrogenic cartilage damage if the medial joint space is reduced. Therefore, a medial collateral ligament (MCL) releasing procedure may be necessary for the majority of individuals with medial knee tightness. The MCL residual laxity after pie-crusting release during arthroscopic medial meniscus repair in medial knee tightness were studied in this study.</div></div><div><h3>Methods</h3><div>Between July 2022 and June 2023, fourteen patients (4 male, 10 female) underwent medial meniscus surgery with pie-crusting release of the superficial MCL. Mean age was 50 ± 10 years (range, 35–63 years). Medial meniscal lesions were meniscus root tear in 10 cases (71.5 %), longitudinal tear in 2 (14.5 %), horizontal tear in 1 (7 %) and radial tear in 1 (7 %). Preoperatively, valgus stress radiographs were obtained. During surgery if arthroscopic exploration revealed medial joint space narrowing after applying valgus force with the knee in 20 degrees of flexion, pie-crusting MCL release was performed. At the 3-month follow-up, valgus stress radiographs were obtained. Residual MCL laxity was assessed by comparing preoperative and 3-month follow-up medial joint space width measurements.</div></div><div><h3>Result</h3><div>At the 3-month follow-up, no significant increase in the medial joint space width on valgus stress radiograph was observed in comparison to the preoperative. The medial joint space width on valgus stress radiograph was 7.42 ± 1.16 mm preoperatively and 7.47 ± 1.15 mm at 3-month postoperatively (<em>p</em> value = 0.914). All patients had no intraoperative iatrogenic cartilage injury and no saphenous nerve injury after operation.</div></div><div><h3>Conclusions</h3><div>The magic point pie-crusting MCL release is a reliable and useful procedure to arthroscopic surgery in patients with medial meniscal injury and medial knee tightness. Furthermore, percutaneous pie-crusting MCL release had no effect on residual valgus laxity at the last follow-up.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"38 ","pages":"Pages 36-42"},"PeriodicalIF":1.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The main surgical treatment for medial meniscus posterior root tear (MMPRT) has shifted from meniscectomy to meniscus repair; however, there is no clear consensus regarding the optimal postoperative management strategy after MMPRT repair. This study aimed to perform a comparative analysis of patients who received conventional rehabilitation or fast rehabilitation following MMPRT repair.
Methods
The current retrospective cohort study compared clinical, radiological, and arthroscopic outcomes after conventional rehabilitation (group A, January 2020 to April 2020, 24 patients) with those after fast rehabilitation (group B, May 2020 to August 2020, 24 patients) in patients who underwent pullout repair for MMPRT. Partial weight-bearing and range of motion exercises were allowed 2 weeks postoperatively in group A and 1 week postoperatively in group B. In patients with an average weight of approximately 60 kg, full weight bearing was allowed 4 weeks postoperatively in group A and 3 weeks postoperatively in group B.
Results
At 12 months postoperatively, the clinical scores, including International Knee Documentation Committee and Japanese Knee Injury and Osteoarthritis Outcome Score, significantly improved in both groups (p < 0.01). Although meniscus healing was achieved in both groups, medial meniscus extrusion significantly progressed by 0.9 mm in group A and 0.8 mm in group B (p < 0.01, compared with preoperative extrusion). There were no significant differences in clinical scores, arthroscopic meniscal healing status, or medial meniscus extrusion progression on magnetic resonance images between the groups.
Conclusion
A fast rehabilitation protocol can be safely implemented without compromising patient outcomes after pullout repair for MMPRT.
{"title":"Fast rehabilitation does not worsen clinical, radiological, and arthroscopic outcomes after medial meniscus posterior root repair: A retrospective comparative study","authors":"Masanori Tamura , Takayuki Furumatsu , Yusuke Yokoyama , Yuki Okazaki , Koki Kawada , Toshifumi Ozaki","doi":"10.1016/j.asmart.2024.09.003","DOIUrl":"10.1016/j.asmart.2024.09.003","url":null,"abstract":"<div><h3>Background/Objective</h3><div>The main surgical treatment for medial meniscus posterior root tear (MMPRT) has shifted from meniscectomy to meniscus repair; however, there is no clear consensus regarding the optimal postoperative management strategy after MMPRT repair. This study aimed to perform a comparative analysis of patients who received conventional rehabilitation or fast rehabilitation following MMPRT repair.</div></div><div><h3>Methods</h3><div>The current retrospective cohort study compared clinical, radiological, and arthroscopic outcomes after conventional rehabilitation (group A, January 2020 to April 2020, 24 patients) with those after fast rehabilitation (group B, May 2020 to August 2020, 24 patients) in patients who underwent pullout repair for MMPRT. Partial weight-bearing and range of motion exercises were allowed 2 weeks postoperatively in group A and 1 week postoperatively in group B. In patients with an average weight of approximately 60 kg, full weight bearing was allowed 4 weeks postoperatively in group A and 3 weeks postoperatively in group B.</div></div><div><h3>Results</h3><div>At 12 months postoperatively, the clinical scores, including International Knee Documentation Committee and Japanese Knee Injury and Osteoarthritis Outcome Score, significantly improved in both groups (p < 0.01). Although meniscus healing was achieved in both groups, medial meniscus extrusion significantly progressed by 0.9 mm in group A and 0.8 mm in group B (p < 0.01, compared with preoperative extrusion). There were no significant differences in clinical scores, arthroscopic meniscal healing status, or medial meniscus extrusion progression on magnetic resonance images between the groups.</div></div><div><h3>Conclusion</h3><div>A fast rehabilitation protocol can be safely implemented without compromising patient outcomes after pullout repair for MMPRT.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"38 ","pages":"Pages 29-35"},"PeriodicalIF":1.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000220/pdfft?md5=0d1d3caf8f4a1cd6c37f226b9a53e49b&pid=1-s2.0-S2214687324000220-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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