The American Journal of Sports Medicine最新文献

{"title":"Return to Sport After Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Varun Gopinatth,Daniel C Touhey,Edward M Barksdale,Derrick M Knapik","doi":"10.1177/03635465251405493","DOIUrl":"https://doi.org/10.1177/03635465251405493","url":null,"abstract":"BACKGROUNDRevision anterior cruciate ligament (ACL) reconstruction (ACLR) is a well-established procedure to restore knee stability and improve function after a failed primary ACLR. In active individuals, patient, injury, and operative variables influencing successful return to sport (RTS) after revision ACLR remain poorly understood.PURPOSETo evaluate RTS outcomes in patients undergoing revision ACLR.STUDY DESIGNMeta-analysis, Level of evidence, 4Methods:A systematic review was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was conducted by querying 5 databases from inception through January 2025 to identify studies reporting on RTS outcomes in athletes undergoing revision ACLR. Meta-analysis was performed using random-effects models at 95% confidence intervals, with odds ratios used for comparative studies.RESULTSA total of 52 studies, consisting of 3814 patients, met inclusion criteria. The mean patient age was 27.6 ± 8.4 years, with 66.3% (2340/3532) of the patients being male. Soccer was the most commonly reported sport (24.6%; 390/1584), followed by basketball (17.6%; 278/1584) and football (7.8%; 124/1584). The overall pooled RTS rate was 77.8% (95% CI, 0.732-0.824), with the RTS rate to the previous level of competition being 48.2% (95% CI, 0.410-0.553). The weighted mean time to RTS was 9.3 ± 2.7 months. Patients undergoing revision ACLR with the addition of a lateral extra-articular procedure (LEAP) had a significantly higher RTS rate (90.6% vs 74.9%; P < .00001), while greater articular cartilage damage was associated with less successful RTS (OR, 0.214; 95% CI, 0.078-0.584). The mean postoperative Anterior Cruciate Ligament Return to Sport after Injury score was 61.2 ± 24.1 (n = 535). The most commonly reported reason for failure to RTS or RTS at a lower competition level was fear of reinjury (28.0%; 142/508), followed by knee pain (12.0%; 61/508) and persistent instability (7.3%; 37/508).CONCLUSIONThe overall RTS rate after revision ACLR was 77.8%, with 48.2% returning to the previous level of competition. The addition of a LEAP led to improved RTS rates. Fear of reinjury was reported as the most commonly reported barrier to successful RTS.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"69 1","pages":"3635465251405493"},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021673","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":"The Effect of Lateral Extra-articular Tenodesis Femoral Fixation Methods on Graft Failure Rates in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Matthew Charles Johnson,Ameer Tabbaa,Jesse Galina,Hardik Dabas,Orry Erez,Jorge Chahla,Andrew Pearle,Ron Gilat","doi":"10.1177/03635465251405495","DOIUrl":"https://doi.org/10.1177/03635465251405495","url":null,"abstract":"BACKGROUNDAnterior cruciate ligament reconstruction augmented with modified-Lemaire lateral extra-articular tenodesis (ACLR+LET) improves rotational stability of the knee in patients with a moderate to high risk of graft failure. Early biomechanical data suggest divergent pullout strengths among various LET fixation methods, but their clinical significance remains to be determined.PURPOSETo evaluate graft rupture rates in ACLR+LET compared with ACLR alone, stratified by the method of LET femoral fixation.STUDY DESIGNSystematic review and meta-analysis; Level of evidence, 3.METHODSA systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. A comprehensive search was conducted across PubMed, Embase, Scopus, and CENTRAL for studies that referenced Lateral Extra-articular Tenodesis and Modified Lemaire. A meta-analysis was performed with a significance threshold of .05.RESULTSA total of 1199 studies were screened, and 17 met the final inclusion criteria. Across these studies, 2527 patients who underwent ACLR were analyzed; 1254 underwent ACLR with LET augmentation. LET augmentation significantly reduced graft rupture rates compared with ACLR alone (odds ratio [OR], 2.90 [95% CI, 1.89-4.46]). Among ACLR+LET subgroups, anchor fixation demonstrated the greatest reduction in graft failure (OR, 4.93; P < .001), followed by staple fixation (OR, 3.04; P < .001). Other fixation methods-including button, suture, and screw-showed potential benefit, but individual results were not statistically significant (P > .05). Further analysis revealed that LET significantly reduced graft failure in primary ACLR (OR, 3.44; P = .00). LET-specific hardware removal was rare (0.82% [95% CI, 0.07%-2.10%]), with the highest rates seen in staple fixation, followed by anchor, and no events reported in the button and screw groups (1.58% vs 1.10% vs 0% vs 0%; P = .702).CONCLUSIONACLR+LET significantly reduces the risk of primary graft failure compared with ACLR alone. Among LET femoral fixation methods, anchor and staple fixation demonstrate the lowest ACL graft failure rates, with similar hardware removal rates.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"86 1","pages":"3635465251405495"},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021628","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":"The Long-term Radiographic Fate of the Chronically ACL-Deficient Knee: A Systematic Review and Meta-analysis of Matched Cohort Studies.","authors":"Ajay Shah,Kosaran Gumarathas,Paul Marks,Robert G Marx,Alexander Kiss,David Wasserstein","doi":"10.1177/03635465251405438","DOIUrl":"https://doi.org/10.1177/03635465251405438","url":null,"abstract":"BACKGROUNDDetermining the long-term risk of arthritis in patients with anterior cruciate ligament (ACL) injury treated nonoperatively versus those who undergo ACL reconstruction (ACLR) remains an important and unanswered question for patients and surgeons.PURPOSE(1) To define the cumulative arthritis rate and severity after nonsurgical management of ACL injury-the chronically ACL-deficient (ACLD) knee; (2) to compare rates and severity of arthritis in patients who have ACLD knee with similar patients who underwent ACLR; and (3) to identify clinically relevant risk factors for arthritis.STUDY DESIGNSystematic review; Level of evidence, 3.METHODSThree databases (Medline, Embase, PubMed) were searched for primary studies examining radiographic outcomes in patients with chronic ACL deficiency (>12 months of ACL deficiency). Studies with a matched ACLR control group were included. Quality assessment was performed with the MINORS (Methodological Index for Nonrandomized Studies) tool. Arthritis prevalence over time was plotted and modeled to best-fit using the Akaike information criterion. Data were extracted for meta-analysis for the primary outcome of osteoarthritis. The cumulative odds ratio of prognostic factors was calculated where appropriate.RESULTSNineteen full-text studies met inclusion criteria (11 matched cohort studies comparing ACLD and ACLR) including 1432 patients with a mean 11.1 years of follow-up after injury. The methodological quality of included studies was moderate. The pooled rate of radiographic arthritis in ACLD patients was 37.8%; the rate of moderate to severe arthritis was 18.1% (compared with 35.2% and 12.8% in patients with ACLR, respectively, and 5.0% in the nonoperated knee). An increase in the rate of arthritis was observed, accelerating sharply at 10 years after injury. ACLR and ACLD knees had similar prevalence of mild arthritis (P = .60), irrespective of activity level. Joint degeneration was significantly accelerated by meniscectomy in ACLD patients in most studies.CONCLUSIONPatients with a chronically ACLD knee may be at an increased predisposition for developing moderate to severe arthritis but not mild arthritis compared with matched patients who undergo ACLR. Meniscectomy is a key predictor of worsened severity of osteoarthritis.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"47 1","pages":"3635465251405438"},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021679","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":"Outcomes of Hip Arthroscopy in Patients With Acetabular Cysts: A Multicenter Matched Controlled Study From the MASH Study Group.","authors":"Dean K Matsuda,Andrew B Wolff,Shane Nho,John J Christoforetti,John P Salvo,RobRoy L Martin,Ryan McGovern,Richard J Silk,Allysa Ishimoto,Brandon Ko,Dominic Carreira","doi":"10.1177/03635465251405731","DOIUrl":"https://doi.org/10.1177/03635465251405731","url":null,"abstract":"BACKGROUNDSome studies have reported more severe chondral pathology and less successful hip arthroscopic outcomes in patients with acetabular subchondral cysts.PURPOSE/HYPOTHESISThe purpose of this study was to report multicenter arthroscopic outcomes of patients with and without acetabular bone cysts. It was hypothesized that patients with acetabular cysts would demonstrate inferior outcomes at minimum 2-year follow-up compared with patients without acetabular cysts.STUDY DESIGNCohort study; Level of evidence, 3.METHODSA multicenter matched-pair study was performed across 6 medical centers with data from a large prospectively collected database. Inclusion criteria were adult patients who had undergone primary unilateral hip arthroscopy for femoroacetabular impingement syndrome (FAIS). The study group was defined by the presence of a superolateral acetabular subchondral cyst on preoperative imaging. A control group was matched on age; sex; body mass index (BMI); lateral center-edge angle (LCEA); alpha angle; arthroscopic treatments of femoroplasty, acetabuloplasty, and labral treatment (ie, repair, reconstruction, or debridement); Beck chondral grade; and minimum 2-year outcomes using visual analog scale (VAS) for pain, International Hip Outcome Tool-12 (iHOT-12), minimal clinically important difference (MCID), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS).RESULTSThe study included 82 patients, of whom 41 composed the study group and 41 served as matched control patients. The study group had a mean age of 42.16 ± 11.26 years with 48.78% women and a mean BMI of 26.51 ± 4.31 kg/m2. Mean LCEA was 33.55°± 6.30°, and mean alpha angle was 70.22°± 9.71°. Mean Beck chondral grade was 2.59 ± 1.27 in the study group and 2.70 ± 0.95 in the matched control group (P = .72). Two-year mean postoperative iHOT-12 scores for the study and control groups were 69.49 ± 24.51 and 73.24 ± 25.16, respectively (P = .38), whereas mean postoperative VAS scores for pain were 18.84 ± 18.17 and 20.74 ± 21.39, respectively (P = .70). The study group reached MCID in 82.93%, SCB in 58.54%, and PASS in 65.85% and were similar to those of the control group.CONCLUSIONPatients undergoing arthroscopic surgery for FAIS with acetabular cysts had similarly successful outcomes as patients without acetabular cysts. Acetabular subchondral cysts may not be a contraindication to hip arthroscopy in patients with FAIS who would otherwise be indicated for this surgery.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"123 1","pages":"3635465251405731"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005265","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":"Prediction of Contralateral Patellar Instability After Ipsilateral Medial Patellofemoral Ligament Reconstruction.","authors":"Ali Asma,Samir Sharrak,Marcus A Shelby,Matthew Veerkamp,Shital N Parikh","doi":"10.1177/03635465251401561","DOIUrl":"https://doi.org/10.1177/03635465251401561","url":null,"abstract":"BACKGROUNDAbout 10% to 16% of patients with patellar instability have bilateral involvement. The risk factors for future contralateral patellar instability in patients who have ipsilateral patellar instability are not known. Knowledge related to the possibility of future contralateral patellar instability would be helpful, as previous studies have shown suboptimal outcomes and increased complication rates in patients with bilateral patellar instability.PURPOSEThe purpose of the current study was to identify the risk factors for future contralateral patellar instability and develop a prediction model for contralateral patellar instability.STUDY DESIGNCase series; Level of evidence, 4.METHODSUsing a hospital-based surgery database from 2012 to 2022, all patients who underwent medial patellofemoral ligament (MPFL) reconstruction were identified. Age, sex, skeletal maturity, body mass index, generalized joint hypermobility (defined as a Beighton score ≥5), and first-time versus recurrent ipsilateral patellar dislocation were noted. There were 4 anatomic risk factors-trochlear depth, Caton-Deschamps index, tibial tubercle-trochlear groove distance, and patellar tilt-assessed on magnetic resonance imaging of the ipsilateral knee. Multivariable backward conditional logistic regression analysis was performed to identify the risk factors for contralateral patellar instability. A simplified prediction model for contralateral patellar instability was developed based on the number of risk factors.RESULTSDuring the study period, 380 knees in 293 patients underwent MPFL reconstruction and formed the study cohort. The mean age at surgery was 14.7 ± 2.7 years. 243 ipsilateral knees (63.9%) were female, and 168 (44.2%) were skeletally immature. 83 knees (21.8%) had a first-time dislocation, while 297 (78.2%) had a recurrent dislocation. Of these 380 knees, 130 (34.2%) had future contralateral patellar instability. On multivariable regression analysis, skeletal immaturity (odds ratio [OR], 1.90 [95% CI, 1.20-3.00]), generalized joint hypermobility (OR, 2.80 [95% CI, 1.50-5.10]), recurrent patellar instability in the ipsilateral knee (OR, 2.00 [95% CI, 1.10-3.70]), trochlear dysplasia in the ipsilateral knee (OR, 1.90 [95% CI, 1.05-3.40]), and patella alta in the ipsilateral knee (OR, 1.80 [95% CI, 0.96-3.30]) comprised the final model to predict contralateral patellar instability. As per the prediction model, the risk of future contralateral patellar instability was 9.2% if there was no risk factor present and 77.8% if all 5 risk factors were present.CONCLUSIONSkeletal immaturity, recurrent patellar instability in the involved knee, generalized joint hypermobility (Beighton score ≥5), trochlear dysplasia in the involved knee, and patella alta in the involved knee could help to predict contralateral patellar instability.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"48 1","pages":"3635465251401561"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005267","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":"Perception of Pain and Function Among Athletes and Parents: A PROMIS Dyad Study.","authors":"Corinna C Franklin,Emily Nice,Kevin Moran, , ,Eric Heidel,Jeremy Bauer","doi":"10.1177/03635465251407113","DOIUrl":"https://doi.org/10.1177/03635465251407113","url":null,"abstract":"BACKGROUNDAthletes can be profoundly impacted by their environment and support system. For young, injured athletes, parents may wield significant influence over their treatment and recovery, yet may hold divergent perceptions of the athletes' condition.HYPOTHESISWhen using the Patient-Reported Outcomes Measurement Information System (PROMIS) metrics, parents and athletes will have differing perceptions about how the athletes are affected by their injury.STUDY DESIGNCohort study; Level of evidence, 3.METHODSThis study was approved by our institutional review board. In our clinics, each child (age, 8-17 years) routinely takes a series of PROMIS questionnaires. For study purposes, at 1 sports clinic visit per child, we had an accompanying parent independently complete the same PROMIS metrics on the child's behalf. We then formed dyads from each athlete/parent response and used these dyads for analysis to quantify differences in their understanding. Generalized estimating equations were used to analyze differences between members of the dyads (correlated data).RESULTSThe total number of dyads examined was 387. There were 201 female athletes, 186 male athletes, 302 female parents, and 85 male parents. The mean age of both male and female athletes was 14 years. Across all dyads, parents rated pain interference as worse than patients did, by a mean of 5 points (mean score, 50.03 vs 45.46, respectively; P < .001). Significant differences were also noted in peer relationships, mobility, and upper-extremity PROMIS domains. In all domains, parents rated the patients as doing worse than the athletes did themselves. When examined by sport, parents of athletes in football, soccer, gymnastics, and basketball rated pain interference as worse. Parents of athletes treated both operatively and nonoperatively rated pain interference as higher, and parents of both sexes rated pain interference as higher.CONCLUSIONParents of injured athletes perceive their children to be more affected by pain than the athletes themselves. Parents also perceive injured athletes to have worse function across all domains than the athletes themselves do.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"29 1","pages":"3635465251407113"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005263","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":"Anterior Cruciate Ligament Reconstruction With Hamstring Autografts and Suture Tape Augmentation Results in Lower Failure Rates While Maintaining Functional Outcomes and Complication Rates Similar to Nonaugmented Techniques: A Systematic Review and Meta-analysis.","authors":"Rodrigo Bernstein Conde,André Richard da Silva Oliveira Filho,Elcio Machinski,Vinícius Furtado da Cruz,Bruno Butturi Varone,Riccardo Gomes Gobbi,Camilo Partezani Helito,Andre Giardino Moreira da Silva,Daniel Peixoto Leal","doi":"10.1177/03635465251400346","DOIUrl":"https://doi.org/10.1177/03635465251400346","url":null,"abstract":"BACKGROUNDAnterior cruciate ligament reconstruction with suture augmentation (ACLR-SA) has been explored for its potential to provide additional graft protection.PURPOSETo compare failure rates, complications, patient-reported outcomes, and return to sport between ACLR-SA and nonaugmented ACLR.STUDY DESIGNSystematic review and meta-analysis; Level of evidence, 2.METHODSRandomized controlled trials and quasi-experimental studies were included if they provided data on population (patients with anterior cruciate ligament tear), intervention (ACLR-SA regardless of SA material and graft type), comparator (nonaugmented ACLR), and outcomes (failure, arthrofibrosis and cyclops, subsequent meniscal surgery, hardware removal, Lysholm and International Knee Documentation Committee scores, and/or return to sport).RESULTSEleven articles (1179 patients) were included. ACLR performed with hamstring autograft augmented with FiberTape reduced failure rates as compared with nonaugmented ACLR (3.1% vs 8.5%; odds ratio [OR], 2.86; 95% CI, 1.03-7.90; P = .043; I2 = 0%). In addition, the 2 techniques showed no differences in arthrofibrosis/cyclops (OR, 0.94; 95% CI, 0.26-3.33; P = .919; I2 = 0%), subsequent meniscal surgery (OR, 1.05; 95% CI, 0.32-3.44; P = .942; I2 = 0%), International Knee Documentation Committee score (mean difference, -1.20; 95% CI, -3.06 to 0.06; P = .206; I2 = 0%), and Lysholm score (mean difference, -0.96; 95% CI, -4.53 to 2.61; P = .597; I2 = 65%). When the FiberWire was utilized for hamstring autograft suture augmentation, no significant differences in failure rates were observed between groups. The pooled synthesis for all graft and augmentation combinations showed that ACLR-SA was associated with an increased return to preinjury activity level (72.5% vs 54.0%; OR, 0.44; 95% CI, 0.21-0.91; P = .027; I2 = 0%).CONCLUSIONAvailable evidence supports the use of suture tape augmentation in ACLRs performed with hamstring autografts, as it reduces failure rates while maintaining equivalent complication rates and patient-reported outcomes as compared with nonaugmented ACLR.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"101 1","pages":"3635465251400346"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005264","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 of 3 Forms of Clinically Available Hydroxyapatite Artificial Bone for Use in Biphasic Implants With Synovial Mesenchymal Stem Cell-Derived Tissue-Engineered Constructs for Osteochondral Repair.","authors":"Kazunori Shimomura,Seido Yarimitsu,George Jacob,Taro Akimori,Masato Nakamura,Wataru Ando,David A Hart,Hiromichi Fujie,Seiji Okada,Norimasa Nakamura","doi":"10.1177/03635465251407260","DOIUrl":"https://doi.org/10.1177/03635465251407260","url":null,"abstract":"BACKGROUNDOsteochondral injuries, involving damage to both cartilage and subchondral bone, require a biphasic regenerative approach. A previous study demonstrated that a biphasic implant, composed of a hydroxyapatite (HA) block for the bone layer and a scaffold-free synovial mesenchymal stem cell-derived tissue-engineered construct (TEC) for the cartilage layer, successfully repaired osteochondral defects in a rabbit model. To facilitate less invasive surgical application, the authors investigated alternative HA forms including granules and paste for use in the subchondral component for the biphasic implant.HYPOTHESISBiphasic implants composed of TEC combined with either HA granules or HA paste would potentially achieve successful osteochondral repair, comparable to that of a conventional HA block-based implant.STUDY DESIGNControlled laboratory study.METHODSBilateral osteochondral defects (5 mm in diameter and 6 mm in depth) were created in the femoral grooves of rabbits and treated with a TEC combined with 1 of 3 HA forms: block, granules, or paste. Histological and biomechanical analyses were performed at 4, 8, and 24 weeks postimplantation (5 per group per time point).RESULTSThe TEC/HA block group achieved complete osteochondral repair with stable maturation, and the repaired tissue demonstrated biomechanical properties comparable to native tissue at 24 weeks postimplantation. In contrast, the TEC/HA granule group showed early signs of repair that progressively deteriorated, resulting in significantly inferior structural and mechanical properties. The TEC/HA paste group supported subchondral bone repair but resulted in incomplete cartilage formation at 24 weeks postimplantation.CONCLUSIONThe TEC/HA block implant showed superior histological and biomechanical outcomes compared with other HA forms. Therefore, further optimization of granular or paste formulation is required to possibly enhance the potential for arthroscopic or minimally invasive delivery of a biphasic implant.CLINICAL RELEVANCEThis study highlights the potential of biphasic implants combining clinically available TEC and HA artificial bone for osteochondral repair. The biphasic implant can be easily prepared intraoperatively without specialized fabrication. Long-term observations revealed distinct repair patterns for each HA form, which may assist surgeons in selecting the optimal HA artificial bone form for effective and durable subchondral bone repair in osteochondral regeneration.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"275 1","pages":"3635465251407260"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005268","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":"Outcomes of Simultaneous Bilateral, Staged Bilateral, and Unilateral Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Systematic Review and Meta-analysis.","authors":"Napatpong Thamrongskulsiri,Jacob T Morgan,Felipe Casanova,Tomas F Vega,Alireza Mirahmadi,Jorge Chahla","doi":"10.1177/03635465251409347","DOIUrl":"https://doi.org/10.1177/03635465251409347","url":null,"abstract":"BACKGROUNDFemoroacetabular impingement (FAI) is a common cause of hip pain, often treated with arthroscopy. The optimal approach among unilateral, staged bilateral, and simultaneous bilateral procedures remains unclear due to limited comparative data.PURPOSETo compare clinical outcomes and complication rates among simultaneous bilateral, staged bilateral, and unilateral hip arthroscopy in patients with FAI syndrome.STUDY DESIGNSystematic review and Meta-analysis; Level of evidence, 3.METHODSA systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scopus, and Ovid MEDLINE databases were searched through April 2025. Eligible comparative studies included patients with FAI undergoing hip arthroscopy via unilateral, simultaneous bilateral, or staged bilateral approaches and reported outcomes such as patient-reported scores, complications, and revision or conversion to total hip arthroplasty (THA).RESULTSNine studies with a total of 4040 hips were included. All surgical approaches showed significant improvements in pain and functional outcome scores. There were no statistically significant differences in postoperative visual analog scale score, Modified Harris Hip Score, Non-Arthritic Hip Score, International Hip Outcome Tool-12 score, rates of revision surgery, or conversion to THA among the 3 groups. Meta-analyses confirmed similar outcomes between staged and unilateral groups. Although 1 study reported a lower THA conversion rate in the simultaneous group, findings were inconsistent across the literature.CONCLUSIONSimultaneous bilateral, staged bilateral, and unilateral hip arthroscopy offer comparable short- to midterm outcomes and complication rates in FAI patients. Simultaneous bilateral arthroscopy may represent a safe and efficient option for appropriately selected patients. Surgical approaches should be individualized based on patient symptoms, goals, and risk profile.REGISTRATIONPROSPERO (CRD420251039957).","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"194 1","pages":"3635465251409347"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005312","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":"Arthroscopic Posterior Bankart Repair: Risk Factors for Recurrence of Instability.","authors":"Valeria Vismara,Pascal Boileau","doi":"10.1177/03635465251403499","DOIUrl":"https://doi.org/10.1177/03635465251403499","url":null,"abstract":"BACKGROUNDThe high rates of failures and reoperations (up to 50%) after arthroscopic posterior Bankart repair (APBR) remain a concern.PURPOSETo evaluate mid- to long-term follow-up outcomes of APBR in patients with unidirectional, recurrent posterior shoulder instability and to identify risk factors for failure.STUDY DESIGNCase series; Level of evidence, 4.METHODSA single-center, retrospective study was conducted that included all consecutive athletes with unidirectional recurrent posterior shoulder instability operated on between 2006 and 2022. Patients with voluntary instability or previous failed instability repair were excluded. The posterior labrum was reattached using a minimum of 4 suture anchors, and a posteroinferior capsular shift was systematically performed. The mean follow-up was 11 years (range, 2-18 years). At final follow-up, the investigators evaluated persistent pain, apprehension, recurrence of instability (recurrent episode of either true dislocation or subluxation), range of motion, return to sport, and satisfaction. Revision surgeries and reoperations were also recorded.RESULTSThe study included 44 athletes (45 shoulders). Patients were predominantly males (96%) and had a mean age of 28 years at surgery, and half (51%) practiced a contact or collision sport. Recurrence of posterior instability occurred in 22% (10/45): 2 patients sustained frank posterior dislocations, 6 reported recurrent subluxations, and 2 had a single episode of subluxation. Of the 10 patients with recurrence of instability, only 2 were reoperated (revision rate 4%); the 8 remaining patients declined any additional surgery. The presence of posterior glenoid bone erosion (9 patients) was associated with a higher risk of postoperative recurrent dislocation or subluxation (P = .024). By contrast, the presence of a posterior glenoid fracture (6 patients) was not a risk factor for postoperative recurrence of instability. Other potential prognostic factors (young age, contact sport, voluntary instability that became involuntary, or reproducible instability) were not found to be significant in the present series. At 1-year follow-up, 75% returned to the same level of sports.CONCLUSIONIn patients with recurrent posterior instability, the presence of posterior glenoid erosion was the main risk factor for failure after APBR. By contrast, a posterior bony Bankart lesion did not represent a contraindication to arthroscopic stabilization using suture anchor fixation.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"87 1","pages":"3635465251403499"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005216","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}