The American Journal of Sports Medicine最新文献

{"title":"Contemporary Arthroscopic Techniques May Improve the Outcomes of Revision Hip Arthroscopy: A Propensity-Matched Cohort Study.","authors":"Benjamin D Kuhns,Paras Shah,Krishi Rana,Benjamin G Domb","doi":"10.1177/03635465251405712","DOIUrl":"https://doi.org/10.1177/03635465251405712","url":null,"abstract":"BACKGROUNDPatient outcomes after revision hip arthroscopy are less favorable than those after primary procedures. Advancements in arthroscopic techniques including labral reconstruction and capsular plication have improved anatomic restoration of the suction seal and capsule. The effect of these techniques on outcomes remains unclear when compared with earlier techniques.PURPOSETo compare postoperative outcomes between patients undergoing modern revision (MR) hip arthroscopy techniques and those treated with older methods.STUDY DESIGNCohort study; Level of evidence, 3.METHODSA prospectively collected surgical database was reviewed for patients undergoing revision hip arthroscopy with a minimum 2-year follow-up. Patients were categorized into an older revision (OR) cohort or MR cohort based on available surgical techniques. Patients in the OR cohort did not have a capsular repair or labral reconstruction with the knotless pull-through technique, while all patients in the MR cohort had capsular closure or plication as well as labral restoration with either repair or modern reconstruction. A 1:1 age, sex, and body mass index propensity match was performed, and patient demographics along with pre- and postoperative radiographic data and outcomes were analyzed. The primary outcome was the rate of conversion to arthroplasty or revision arthroscopy at the 2-year time point. Secondary outcomes included patient-reported outcome scores (PROs) and achievement of clinically relevant outcome thresholds.RESULTSA total of 53 patients in the MR cohort were matched with 53 patients in the OR cohort. There were no significant preoperative demographic or radiographic differences between the 2 groups. Patients in the MR cohort had higher levels of acetabular chondral damage identified intraoperatively according to the Outerbridge and acetabular labrum articular disruption classifications (P < .01 for both). Patients in the MR cohort had significantly greater postoperative Hip Outcome Score Sports-Specific Subscale scores (62.8 ± 29.9 vs 53.0 ± 31.4; P = .03).CONCLUSIONPatients undergoing revision hip arthroscopy with modern techniques had greater postoperative PRO scores compared with revisions with older techniques. Notably, this improvement in outcomes was observed despite higher rates of cartilage damage identified intraoperatively in the modern group.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"390 1","pages":"3635465251405712"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcomes and Survivorship of Meniscal Allograft Transplantation: A Systematic Review With Minimum 10-Year Follow-up.","authors":"Jacob D Kodra,Surucu Serkan,Michael S Lee,Kevin Girardi,Ronak Mahatme,Rajiv Vasudevan,Louise Atadja,Mackenzie Norman,Jay Moran,Andrew E Jimenez","doi":"10.1177/03635465251405494","DOIUrl":"https://doi.org/10.1177/03635465251405494","url":null,"abstract":"BACKGROUNDMeniscal allograft transplantation (MAT) is an emerging treatment for patients with symptomatic meniscal deficiency.PURPOSETo systematically evaluate the long-term clinical outcomes and graft survivorship of MAT with a minimum follow-up of 10 years.STUDY DESIGNSystematic review and meta-analysis; Level of evidence, 4.METHODSA review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and registered on Prospero. The PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were queried in January 2025. Studies assessing MAT patient-reported or objective outcomes with ≥10 years of follow-up were included. Non-English-language studies, case reports, non-peer-reviewed articles, editorials, commentaries, and reviews were excluded. The Lysholm score, Tegner Activity Scale score, visual analog scale (VAS) for pain score, Knee injury and Osteoarthritis Outcome Score (KOOS), and graft survivorship were extracted for analysis. MAT failure was defined by individual studies based on clinical, surgical, and/or radiographic criteria.RESULTSThirteen studies, consisting of 619 patients and 632 MATs and performed from 1984 to 2012, met inclusion criteria. The mean patient age ranged from 24.5 to 43.5 years, with 47% to 87% males and a mean follow-up duration of 11.1 to 20.0 years. Fixation techniques included soft tissue (5 studies), bone plug (6 studies), and bone trough (4 studies). Statistically significant improvements were observed in the Lysholm score (7/9 studies), Tegner score (3/4 studies), VAS score (3/5 studies), and KOOS (1/1 studies). Two studies reported Patient Acceptable Symptom State rates ranging from 70.2% to 71% for Lysholm score and 58.5% to 82% for KOOS. Two studies also reported minimal clinically important difference rates, which ranged from 70.4% to 89.9% for the Lysholm score and 61% to 78.2% for the KOOS subscales. Ten-year MAT survival ranged from 45% to 100%. Most studies (5/9) demonstrated survivorship ≥73% at a minimum 10-year follow-up. MAT survival after ≥15 years ranged from 19% to 87%.CONCLUSIONMAT demonstrated favorable long-term clinical outcomes and variable graft survivorship beyond 10 years. Included studies varied based on graft type, fixation technique, and patient selection. Continued prospective, high-level studies are warranted to standardize surgical approaches, improve the durability of this joint-preserving intervention, and identify modifiable risk factors for inferior long-term outcomes.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"42 1","pages":"3635465251405494"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm Outcomes of Arthroscopic Treatment for Concomitant Painful External Hip Snapping and Femoroacetabular Impingement Syndrome: A Minimum 5-Year Follow-up Study.","authors":"Roger Quesada-Jimenez,Drashti Sikligar,Andrew R Schab,Ady H Kahana-Rojkind,Benjamin G Domb","doi":"10.1177/03635465251404480","DOIUrl":"https://doi.org/10.1177/03635465251404480","url":null,"abstract":"BACKGROUNDPainful external snapping hip (ESH) is estimated to affect 5% to 10% of the population. Hip arthroscopy treating ESH concomitantly with femoroacetabular impingement (FAI) has shown favorable short-term outcomes.PURPOSETo report midterm outcomes of hip arthroscopy that concomitantly treats FAI and ESH, with a secondary comparison of these results to benchmark a control group of hips with FAI without ESH.STUDY DESIGNCohort study; Level of evidence, 3.METHODSData were retrospectively analyzed for patients who underwent hip arthroscopy as treatment for FAI and iliotibial band (ITB) and gluteus maximus tendon release as treatment for painful ESH between 2008 and 2019. Patients were included if they had complete pre- and postoperative patient-reported outcomes (PROs) and visual analog scale (VAS) for pain scores with a minimum follow-up of 5 years or if they had a documented endpoint (revision surgery or conversion to arthroplasty) during the study period. Rates of revision surgery and conversion to total hip arthroplasty were included in the analysis. Patients were propensity matched to a benchmark control group of patients with FAI without ESH at a 1:4 ratio by sex, age at surgery, body mass index, acetabular Outerbridge grade, labral treatment, and capsular treatment.RESULTSA total of 215 hips (211 patients) were included in the study. The ESH study group showed significant improvements in all assessed PROs, with 98% of patients reporting resolution of painful external snapping at the latest follow-up, and no patient requiring revision hip arthroscopy secondary to a persistent external snapping. When compared with the benchmark control group, patients with ESH had similar preoperative outcomes for the modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score Sports-Specific Subscale, 12-item International Hip Outcome Tool score, and VAS score with equivalent magnitudes of improvement. Additionally, similar postoperative scores across all PROs and patient satisfaction were met. The minimal clinically important difference and Patient Acceptable Symptom State for all evaluated PROs were met at similar rates. Similar rates of complication revision hip arthroscopy and conversion to hip arthroplasty were observed between the groups.CONCLUSIONPrimary hip arthroscopy addressing FAI and painful ESH with ITB and gluteus maximus tendon release demonstrated significant improvement in all evaluated PROs, with 98% of patients reporting resolution of external snapping, and no revision surgery due to external snapping recurrence at the minimum 5-year follow-up. Functional outcomes and rates of clinically relevant threshold achievement were comparable to those of a propensity-matched benchmark control group with FAI without ESH.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"4 1","pages":"3635465251404480"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Augmentation in Rotator Cuff Repair Decreases the Risk of Retear: A Systematic Review and Meta-analysis.","authors":"Danielle Dagher,Darshil Shah,Colin Kruse,Hassaan Abdel Khalik,Usama Saleh,Abdul-Ilah Hachem,John M Tokish,Asheesh Bedi,Moin Khan","doi":"10.1177/03635465251400356","DOIUrl":"https://doi.org/10.1177/03635465251400356","url":null,"abstract":"BACKGROUNDRotator cuff tears are a common orthopaedic injury often resulting in shoulder pain and functional impairment. Despite the prevalence of rotator cuff tears, the incidence of retear after rotator cuff repair (RCR) remains high. There is growing interest in the use of structural augmentation in RCR to decrease retear rates and improve patient outcomes.PURPOSEThe purpose of this systematic review and meta-analysis was to compare the clinical and imaging outcomes of structural augmentation versus standard RCR in patients with full-thickness rotator cuff tears. The effectiveness of different augment subtypes was also assessed.STUDY DESIGNMeta-analysis; Level of evidence, 3.METHODSA comprehensive literature search was conducted in CENTRAL, Embase, and Medline from inception to November 13, 2024. Eligible studies included comparative trials evaluating structural augmentation in RCR for repairable full-thickness tears. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized controlled trials and the MINORS (Methodological Index for Non-randomized Studies) score for observational studies. Meta-analyses were performed via a random effects model, with subgroup analyses performed by study design and augment type.RESULTSTwenty-four studies (12 randomized controlled trials and 12 cohort studies) were included in this review, all of which evaluated biologic augments (xenograft, allograft, autograft). Structural augmentation significantly reduced the risk of retear by 35% as compared with standard RCR (risk ratio, 0.65; 95% CI, 0.48-0.89; P = .01). Retears were confirmed radiographically by magnetic resonance imaging or ultrasound. Subgroup analysis revealed the greatest reduction in retear rates with allograft augmentation (risk ratio, 0.34; 95% CI, 0.21-0.56). No significant differences were observed in patient-reported outcomes, including pain scores, American Shoulder and Elbow Surgeons scores, or Constant scores.CONCLUSIONStructural augmentation in RCR significantly reduces retear rates, particularly with allografts, but does not improve short-term patient-reported outcomes. Further research is needed to identify which patient and tear characteristics may influence the effectiveness of augmentation.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"22 1","pages":"3635465251400356"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcomes of Advanced Arthroscopic Techniques for Patients With Acetabular Retroversion Without Anteverting Periacetabular Osteotomy.","authors":"Benjamin G Domb,Megan E Flynn,Yasemin E Kingham,Jessica C Keane,Ady H Kahana-Rojkind,Roger Quesada-Jimenez","doi":"10.1177/03635465251405696","DOIUrl":"https://doi.org/10.1177/03635465251405696","url":null,"abstract":"BACKGROUNDAnterolateral acetabular overcoverage, also known as acetabular retroversion, can cause femoroacetabular impingement syndrome (FAIS). Various surgical options have been suggested for treatment, ranging from anteverting periacetabular osteotomy to isolated hip arthroscopy.PURPOSE/HYPOTHESISThe purpose of this study was, primarily, to analyze minimum 10-year outcomes of arthroscopic management of labral pathology in the setting of acetabular retroversion without dysplasia and, secondarily, to compare their outcomes to a propensity-matched group of nonretroverted patients. It was hypothesized that the outcomes of arthroscopic management would be comparable to those of the propensity-matched nonretroverted group and comparable to previously published outcomes of open treatment of acetabular retroversion.STUDY DESIGNCohort study; Level of evidence, 3.METHODSProspectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy for FAIS and labral tear treatment between June 2008 and December 2013 and had a minimum of 10-year follow-up data. Retroversion was determined based on the presence of an ischial spine sign, >20% crossover sign, and posterior wall sign. Propensity score matching was used to identify a control group without retroversion who were matched 1:1 with similar age, sex, body mass index, acetabular and femoral head Outerbridge grade, preoperative lateral center-edge angle, and labral treatment.RESULTSA total of 95 hips with acetabular retroversion were matched to a control group. The groups were equally matched in demographic variables. Significant improvements were seen in all patient-reported outcomes (PROs) collected in both groups, with a similar survivorship of 96% in both groups; 4 patients in each group converted to a total hip replacement. The acetabular retroversion cohort achieved similarly high rates of minimal clinically important difference and Patient Acceptable Symptom State and higher rates of substantial clinical benefit for modified Harris Hip Score compared with the control group (P = .04).CONCLUSIONPatients with acetabular retroversion who had FAIS and labral tears could be safely treated using advanced hip arthroscopic techniques without reverse (anteverting) periacetabular osteotomy in a high-volume surgeon's hands. Patients with acetabular retroversion demonstrated favorable PROs and low rates of revision arthroscopy and conversion to total hip arthroplasty at long-term follow-up, which was comparable with a propensity-matched control group without acetabular retroversion.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"269 1","pages":"3635465251405696"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermal Allograft Augmentation for Open Gluteus Medius Repair: A Case Series at 2-Year Follow-up.","authors":"Roger Quesada-Jimenez,Elizabeth J O'Brien,Elizabeth G Walsh,Ady H Kahana-Rojkind,Benjamin D Kuhns,Benjamin G Domb","doi":"10.1177/03635465251399214","DOIUrl":"https://doi.org/10.1177/03635465251399214","url":null,"abstract":"BACKGROUNDGluteus medius (GM) tears are a common cause of peritrochanteric regional pain and disability among middle-aged and older populations. While largely successful, when primary repair fails, it is often attributed to poor tendon quality. Dermal allograft augmentation offers a solution for this patient population by enhancing the biological and mechanical properties of the repair construct.PURPOSETo evaluate the outcomes of open isolated GM repair with dermal allograft augmentation at 2-year follow-up, with a sex-based subanalysis comparing clinical outcomes in male versus female patients.STUDY DESIGNCase series; Level of evidence, 4.METHODSProspectively collected data were retrospectively analyzed for all patients who underwent open GM repair with dermal allograft augmentation between June 2016 and April 2022. Included patients had complete preoperative and 2-year follow-up data for the following patient-reported outcome measures (PROMs): modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), International Hip Outcome Tool-12 (iHOT-12), visual analog scale for pain, and patient satisfaction; if complete 2-year follow-up data were not available, patients had a documented endpoint such as further surgery. Clinically relevant thresholds, complications, and secondary surgery were reported.RESULTSA total of 23 hips (18 female, 5 male) were included in this study. There were 17 primary procedures with dermal allograft augmentation (73.9%) and 6 revisions after prior GM repair without previous dermal allograft augmentation (26.1%). A significant improvement was observed on all evaluated PROMs, with 1 reoperation (4.4%) for a recurrent tear. A high percentage of patients achieved the minimal clinically important difference for the mHHS (86.4%), NAHS (81.8%), and iHOT-12 (72.7%). Moreover, 16 (72.7%) answered the patient acceptable symptom state anchor question positively. A sex-based subanalysis showed that female patients demonstrated a greater postoperative improvement on PROMs and a higher rate of achieving clinically relevant thresholds compared with male patients.CONCLUSIONPatients with extensive degenerative GM tears who underwent repair with dermal allograft augmentation had favorable outcomes with significant improvements on PROMs and low reoperation rates at short-term follow-up.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"59 1","pages":"3635465251399214"},"PeriodicalIF":0.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between Performance of Disease-Specific and Region-Specific Patient-Reported Outcome Measures in Adolescents After Patellofemoral Stabilization Surgery: Data From the JUPITER Cohort.","authors":"David Segal,Matthew W Veerkamp,Eric J Wall,Philip L Wilson,Daniel W Green,Benton E Heyworth,Natalie K Pahapill, ,Beth E Shubin Stein,Shital N Parikh,Robert A Magnussen,Jacquiline M Brady,Lauren H Redler,Henry B Ellis,Sabrina M Strickland,Dennis E Kramer,Adam B Yanke,Seth L Sherman,Caitlin C Chambers,Marc A Tompkins,Peter D Fabricant,Matthew D Milewski,Jason L Koh,Yi-Meng Yen,Jack Farr","doi":"10.1177/03635465251403568","DOIUrl":"https://doi.org/10.1177/03635465251403568","url":null,"abstract":"BACKGROUNDPatellofemoral instability (PFI) is common in adolescents and may require surgical treatment. Patient-reported outcome scores (PROs) are frequently used to evaluate outcomes after treatment. Commonly used PROs for PFI include disease-specific Banff Patellofemoral Instability Instrument 2.0 (BPII 2.0) and region-specific measures such as the Kujala Anterior Knee Pain Scale (Kujala), Pediatric International Knee Documentation Committee Subjective Knee Form (Pedi-IKDC), and Knee injury and Osteoarthritis Outcome Score (KOOS).HYPOTHESIS/PURPOSEThe study aimed to compare the performance of disease-specific and region-specific PROs in adolescents after PFI surgery, and to evaluate their sensitivity to change. It was hypothesized that disease-specific PROs would perform better than region-specific PROs.STUDY DESIGNCase series; Level of evidence, 4.METHODSThe JUPITER (Justifying Patellar Instability Treatment by Early Results) study database was used to evaluate PROs in 256 adolescents (263 knees) aged ≤18 years who underwent surgical treatment for PFI. Four commonly used PRO scores were analyzed at baseline and at least 1 year postoperatively. Statistical analysis included comparisons between pre- and postoperative scores, calculation of minimal clinically important difference (MCID), correlations among the 4 scores, and evaluation of their sensitivity to change, floor effects, and ceiling effects.RESULTSThe median age was 15 years. Isolated medial patellofemoral ligament reconstruction was the most common procedure. The mean BPII 2.0 scores were lower at baseline and postoperatively, and showed the most substantial change at 1-year follow-up. There was a moderate correlation between the BPII 2.0 and the Kujala, Pedi-IKDC, and KOOS scores, and a strong correlation among the latter 3 scores. All scores were more sensitive to change among those at the lower 50th percentile of baseline scores. The BPII 2.0 was the only PRO that did not exhibit ceiling effects at follow-up.CONCLUSIONWhen comparing the performance of disease-specific (BPII 2.0) and region-specific (Kujala, Pedi-IKDC, and KOOS) PROs, the BPII 2.0 was found to be the most sensitive to change after PFI surgery in adolescents, and the only scale that did not have a ceiling effect at baseline and 1-year follow-up. There was a moderate correlation-and thus limited interchangeability-between the BPII 2.0 and the Kujala, Pedi-IKDC, and KOOS scores, both at baseline and at 1-year follow-up, and a strong correlation among the latter 3 knee-specific PROs. The BPII 2.0 should be considered the PRO of choice when evaluating adolescent patients with PFI.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"42 1","pages":"3635465251403568"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a Residual Pivot Shift as the Indication to Perform a Lateral Extra-articular Tenodesis During ACL Reconstruction Using Autologous Hamstring Grafts Is Associated With Improved Surgical Outcomes: A Retrospective Review of 4755 Cases.","authors":"Mark Porter,Bruce Shadbolt","doi":"10.1177/03635465251399208","DOIUrl":"https://doi.org/10.1177/03635465251399208","url":null,"abstract":"BACKGROUNDThere is no consensus regarding the appropriate indications for the addition of lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction (ACLR).PURPOSETo determine if incomplete correction of the pivot shift during ACLR is an appropriate intraoperative indication to add the LET, in terms of clinical outcome.STUDY DESIGNCohort study; Level of evidence, 3.METHODSFrom January 2018, incomplete correction of the pivot shift relative to the contralateral knee was used as the indication to add LET to ACLR. Patients presenting before this date comprised group A and those after group B. Study criteria included first-ever ACL rupture, participating in pivoting sports, no other significant ligament injury, and surgery within 3 months of injury. Outcomes of interest were recurrent instability, meniscal tears, and patient-reported outcome measures (PROMs): Tegner activity score (TAS), Knee injury and Osteoarthritis Outcome Score subscales for sport and recreation (sport/rec) and knee-related quality of life, subjective International Knee Documentation Committee score, and Lysholm knee score. Statistical analysis was performed.RESULTSGroup A (2258 patients; 51% male) and group B (2497 patients; 58% male) were similar regarding age, body mass index, knee dominance, time to surgery, graft diameter, and preinjury TAS (P > .05). Group A had a lower male-to-female ratio (P < .05) and lower posterior tibial slope (P = .01). After 2 years, group A had a higher incidence of ACL rerupture than group B (101/2258 [4.5%] vs 75/2497 [3%]; P = .01), with a significant sex and group interaction (P = .04). Males in group A (4.4%) had a higher rate of recurrence than males in group B (2.4%) at 2 years (P = .03), while in females the rate of recurrence was similar (4.5% vs 3.8%; P = .42). Group A had a higher incidence of experiencing a subsequent ipsilateral meniscal tear (58/2258 [2.6%] vs 35/2497 [1.4%]; P = .02). All PROMs were similar (P > .05). Pivot-shift grade before surgery did not correlate with risk of recurrence (P = .991). Uncorrected residual pivot shift was associated with a higher ACL graft rupture rate (P < .001).CONCLUSIONUsing incomplete correction of the pivot shift during ACL surgery as the primary indication to perform LET is associated with lower rates of recurrent ACL rupture, and ipsilateral meniscal tears. Pivot-shift grade before surgery was not associated with risk of recurrence, while residual pivot shift after surgery was.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"19 1","pages":"3635465251399208"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synovial Fluid Biomarkers in the Contralateral Knee Predict Patient-Reported Outcomes After Injury at Long-term Follow-up","authors":"Emily Berzolla, Vishal Sundaram, Bradley A. Lezak, Nicole Rynecki Baker, Izabel Powers, Daniel J. Kaplan, Thorsten Kirsch, Eric J. Strauss","doi":"10.1177/03635465251401555","DOIUrl":"https://doi.org/10.1177/03635465251401555","url":null,"abstract":"Background: Inflammatory biomarkers in an injured knee have been shown to predict outcomes, yet the role of the subsequent systemic inflammatory response to injury remains poorly understood. Purpose: To investigate whether synovial fluid (SF) biomarkers from the contralateral uninjured knee could predict long-term patient-reported outcomes (PROs) for the operative knee in patients undergoing arthroscopic knee surgery. Study Design: Case series; Level of evidence, 4. Methods: This retrospective analysis included patients undergoing knee SF aspiration before arthroscopy with ≥8 years of follow-up. SF was aspirated from both the injured and healthy contralateral knees, and concentrations of 10 pro- and anti-inflammatory biomarkers were quantified. Patients completed visual analog scale (VAS) for pain score, Lysholm, Tegner, and Knee injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS) surveys preoperatively and at the final follow-up. Stepwise linear regression was performed to identify the most significant predictor(s) of PRO scores utilizing log-normalized contralateral biomarker concentration, age, body mass index, injury type, and Outerbridge grade as covariates. Concentrations from the contralateral knee were also compared with the injured knee to assess for correlations. Results: A total of 32 patients with a mean age 49.6 ± 12.3 years and follow-up of 10.0 ± 1.4 years were included. Elevated anti-inflammatory tissue inhibitor of metalloproteinase 1 (TIMP-1) in the contralateral knee was associated with improved VAS pain score ( <jats:italic toggle=\"yes\">P</jats:italic> = .002) and KOOS-PS ( <jats:italic toggle=\"yes\">P</jats:italic> &lt; .001) at long-term follow-up. Increased levels of contralateral pro-inflammatory matrix metalloproteinase 3 ( <jats:italic toggle=\"yes\">P</jats:italic> = .004) and regulated on activation normal T cell expressed and secreted ( <jats:italic toggle=\"yes\">P</jats:italic> = .035) were associated with worse KOOS-PS, while elevated interleukin 1 receptor antagonist was associated with worse VAS pain ( <jats:italic toggle=\"yes\">P</jats:italic> = .006), Lysholm ( <jats:italic toggle=\"yes\">P</jats:italic> = .005), and Tegner ( <jats:italic toggle=\"yes\">P</jats:italic> = .006) score at the final follow-up. Contralateral concentrations of monocyte chemotactic protein 1, macrophage inflammatory protein 1β, vascular endothelial growth factor, and TIMP-1 were correlated with levels in the operative knee but at significantly lower concentrations. Conclusion: SF biomarker levels in the contralateral uninjured knee at the time of arthroscopy were predictive of long-term outcomes for the operative knee. Increased levels of pro-inflammatory biomarkers were predictive of worse outcomes, while anti-inflammatory cytokines predicted improved scores. These results suggest that unilateral knee injury can result in a broader systemic inflammatory response that influences long-term outcomes in patients.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where Sex Matters for Perioperative and Postoperative Anterior Cruciate Ligament Reconstruction Outcomes: A Systematic Review of MOON Literature","authors":"Martina E. Hale, Michael S. Ramos, Riley A. O’Toole, Shelley Ivary, Kurt P. Spindler, Michael J. Scarcella","doi":"10.1177/03635465251386027","DOIUrl":"https://doi.org/10.1177/03635465251386027","url":null,"abstract":"Background: Females are 2 to 8 times more likely than males to sustain an initial anterior cruciate ligament (ACL) tear. However, after ACL reconstruction (ACLR), it remains less certain how males and females differ in other ACLR-related outcomes. Purpose: To summarize Multicenter Orthopaedic Outcomes Network (MOON) studies reporting on ACLR-related outcome differences between sexes. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic literature review based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted utilizing the Embase, MEDLINE, and Cochrane Library databases. Studies were included if they analyzed the MOON knee cohort and reported sex-specific outcomes for perioperative or postoperative primary ACLR outcomes. Results: This review included 28 studies. Six of 6 studies (100%) found no difference between sexes for graft tear at 2 and 6 years of follow-up. Three of 3 studies (100%) found no difference between sexes for contralateral native ACL tear at 2 and 6 years of follow-up. Six of 6 studies (100%) found that female sex correlated with worse Marx activity scores at 2, 6, and 10 years of follow-up. Three of 5 studies (60%) found female sex correlated with worse International Knee Documentation Committee (IKDC) scores at 6 and 10 years of follow-up. Conclusion: There was 100% agreement on the following: sex is not associated with differences in graft tear or contralateral native ACL tear at 2 and 6 postoperative years; female sex is associated with worse Marx activity scores at 2, 6, and 10 years; and female sex is associated with worse return-to-play percentages at 2 and 7 years. There was 60% agreement that female sex is associated with worse IKDC scores at 2 and 6 years.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"400 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955121","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}