Arthroscopy-The Journal of Arthroscopic and Related Surgery最新文献

Corrigendum to “No Significant Differences in Clinical Outcomes Were Observed Between Healed and Unhealed Hip Joint Capsules in Femoroacetabular Impingement Syndrome After Arthroscopy [Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 41, No 9 (September), 2025: pp 3540-3552.e2” “股骨髋臼撞击综合征关节镜术后愈合和未愈合髋关节胶囊的临床结果无显著差异”的更正[关节镜：《关节镜与相关外科杂志》，Vol 41, No 9 (September), 2025: pp 3540-3552.e2]

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.11.001

Lin-Yi Shen M.M. , Li Sun M.M. , Wei-Xing Li M.M. , Qian-Ru Li Ph.D. , Yi-Xin Wen M.M. , Yi-Wen Hu Ph.D. , Yang Sun Ph.D. , Ji-Wu Chen M.D., Ph.D. , Hong-Yun Li M.D., Ph.D.

引用次数: 0

Combined Hip Arthroscopy and Periacetabular Osteotomy Performed Under the Same Anesthesia Event Results in Significant Improvement in Outcomes at Short- and Medium-Term Follow-Up With Low Rates of Complications and Conversion to Total Hip Arthroplasty 在相同的麻醉事件下，联合髋关节镜和PAO在中短期随访中结果显著改善，并发症发生率低，转行全髋关节置换术。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.06.027

Spencer M. Comfort M.D. , Nicholas A. Felan B.A. , Mitchell S. Mologne B.S. , Marc J. Philippon Jr. B.A. , Marc J. Philippon M.D. , Joseph J. Ruzbarsky M.D.

Purpose

To summarize and evaluate the surgical technique, patient-reported outcomes (PROs), and complications of combined periacetabular osteotomy (PAO) and hip arthroscopy for the treatment of hip dysplasia and intra- and extra-articular hip pathology, respectively.

Methods

Clinical studies evaluating outcomes of simultaneous combined hip arthroscopy and PAO procedures performed under the same anesthesia event were identified in PubMed, Embase, and The Cochrane Library per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines up to October 10, 2024. PROs, complications, intraoperative procedures, radiographic parameters, and demographic factors were assessed. Study quality and bias were assessed using the modified Coleman score and Methodological Index for Non-Randomized Studies (MINORS). Studies assessing hip arthroscopy and PAO not performed under the same anesthesia event were excluded.

Results

Twelve studies with 730 hips (612 female and 118 male) were included, with average follow-up time ranging from 1.7 to 12.8 years. Eleven studies reported PROs, and all studies that compared postoperative and baseline outcomes reported a statistically significant improvement in modified Harris Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sport, and visual analog scale for pain postoperatively compared to baseline. The modified Harris Hip Score, visual analog scale for pain, and Non-Arthritic Hip Score ranged from 55 to 72 preoperatively to 82 to 90 postoperatively, 5.1 to 6 preoperatively to 1.9 to 3 postoperatively, and 57 to 61 preoperatively to 80 to 90 postoperatively, respectively. Minimal clinically important difference was reported in 4 studies and patient acceptable symptom state in 2 studies. Thirty-three hips (4.5%) experienced complications, and 8 hips (1%) converted to total hip arthroplasty. The median modified Coleman methodology score was 59 (Range: 43-65), and the median MINORS score was 12 (Range: 11-14) for noncomparative studies and 20.5 (Range: 19-22) for comparative studies.

Conclusions

Combined hip arthroscopy and PAO results in statistically significant improvement in PROs, low complication rates, and low conversion to arthroplasty at short- to medium-term follow-up.

Level of Evidence

Level IV, systematic review of Level III and IV studies.

目的：总结和评价髋臼周围截骨术（PAO）联合髋关节镜治疗髋关节发育不良和关节内、关节外病变的手术技术、患者报告的预后（PROs）和并发症。方法：根据PRISMA指南，截至2024年10月10日，在PubMed， Embase， the Cochrane Library中确定了评估相同麻醉事件下同时联合髋关节镜和PAO手术结果的临床研究。评估利弊、并发症、术中操作、影像学参数和人口统计学因素。采用改良Coleman评分和非随机研究的方法学指数（minor）评估研究质量和偏倚。评估髋关节镜和PAO未在相同麻醉事件下进行的研究被排除在外。结果：纳入了12项研究，涉及730髋（612名女性，118名男性），平均随访时间为1.7至12.8年。11项研究报告了PROs，所有比较术后和基线结果的研究报告，与基线相比，术后改良Harris髋关节评分（mHHS）、髋关节预后评分-日常生活活动（HOS-ADL）、髋关节预后评分-运动（HOS-Sport）和视觉模拟量表-疼痛（VAS-Pain）均有统计学显著改善。mHHS、VAS-Pain、NAHS分别为术前55-72 ~术后82-90、5.1-6 ~术后1.9-3、57-61 ~术后80-90。4项研究报告了MCID， 2项研究报告了PASS。33例髋关节（4.5%）出现并发症，8例髋关节（1%）转为全髋关节置换术。MCMS和MINSORS的中位数为59（范围：43 - 65），非比较研究的中位数为12（范围：11-14），比较研究的中位数为20.5（范围：19-22）。结论：在中短期随访中，联合髋关节镜和PAO对PROs的改善有统计学意义，并发症发生率低，转换率低。证据等级：IV（范围：III至IV）；系统的回顾。

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引用次数: 0

Female Athletes May Have a Greater Challenge in Returning to Sport After Contemporary Cartilage Procedures in the Knee: A Systematic Review and Meta-analysis 女性运动员在膝关节软骨手术后重返运动可能面临更大的挑战：一项系统回顾和荟萃分析。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.06.037

Andromahi Trivellas M.D. , Cooper Williams B.S. , Aaron D. Therien M.S., B.S. , Samantha Kaplan Ph.D. , Stephanie Hendren M.L.I.S. , Brian C. Lau M.D., M.P.H.

Purpose

To assess the current literature for differences in return-to-sport (RTS) rates between male and female athletes after common cartilage procedures in the knee including autologous chondrocyte implantation (ACI), matrix-induced autologous chondrocyte implantation (MACI), osteochondral autograft transplantation (OAT), and osteochondral allograft transplantation (OCA).

Methods

Electronic databases were searched from inception to November 2024. Two independent reviewers screened 2,482 articles. The inclusion criteria were studies published between 2004 and 2024, with level of evidence I to IV, reporting RTS data and sex-specific outcomes after OAT, MACI, ACI, or OCA of the knee, with a minimum 12-month follow-up. The main outcome was the difference in RTS rates between male and female athletes. RTS was defined as the percentage of athletes able to resume sport or military duty, as well as the percentage able to return to their preinjury level or full duty. A meta-analysis was conducted using the inverse variance method with a random-effects model to account for both within- and between-study variability to identify sex differences in RTS rates. Statistical analyses were conducted using R (version 2024.09.0+375).

Results

Twenty-two primary studies, encompassing 1,468 athletes who underwent OAT, MACI, ACI, or OCA, reported sex-specific outcomes. Fifteen of these reported no statistically significant differences in RTS rates between female and male athletes. Five studies reported better RTS rates in male athletes, and one reported a better RTS rate in female athletes. Only one study reported sex-specific differences in return to preinjury level. Meta-analysis identified RTS rates of 75% for male athletes and 56% for female athletes.

Conclusions

There is a paucity of available data on RTS based on sex after contemporary cartilage procedures for chondral injuries of the knee. Meta-analysis of available data suggests female athletes may have more difficulty with returning to sport than male athletes.

Level of Evidence

Level IV, systematic review of Level II and IV studies.

目的：本系统综述的目的是评估当前文献中男性和女性运动员在膝关节常见软骨手术后恢复运动（RTS）率的差异，包括自体软骨细胞植入（ACI）、基质诱导的自体软骨细胞植入（MACI）、自体骨软骨移植（OAT）和骨软骨同种异体移植（OCA）。方法：检索成立至2024年11月的电子数据库。两名独立审稿人筛选了2482篇文章。纳入标准为：2004年至今的研究，证据水平1-4，报告RTS数据和膝关节OAT、MACI、ACI或OCA后的性别特异性结果，至少随访12个月。主要观察指标为男女运动员RTS率的差异。RTS被定义为能够恢复运动或军事任务的百分比，以及能够恢复到受伤前水平（RPL）或全面任务的百分比。采用逆方差法和随机效应模型进行荟萃分析，以解释研究内部和研究之间的可变性，以确定RTS中的性别差异。使用R （Version 2024.09.0+375）进行统计分析。结果：22项包括1468名接受OAT、MACI、ACI或OCA治疗的运动员的初步研究报告了性别特异性结果。其中15个报告的RTS在女性和男性之间没有统计学上的显著差异。5项研究报告了男性RTS更好，1项研究报告了女性RTS更好。只有一项研究报告了RPL的特定性别差异。荟萃分析表明，男性的RTS率为75%，女性为56%。结论：在膝关节软骨损伤的当代软骨手术中，缺乏基于性别的RTS的可用数据。对现有数据的荟萃分析表明，女性在回归运动方面可能比男性更困难。

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引用次数: 0

Regarding “Single-Dose Intravenous Tranexamic Acid Does Not Increase Venous Thromboembolic Rate or Complication Rate During Hip Arthroscopy” 致编辑的信：单剂量静脉注射氨甲环酸不会增加髋关节镜下静脉血栓栓塞率或并发症发生率。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.08.005

Murat Yuncu M.D.

引用次数: 0

Editorial Commentary: Current Evidence Does Not Support Routine Augmentation of Anterior Cruciate Ligament Reconstruction With Platelet-Rich Plasma, but the Pursuit of Biologic Enhancements to Improve Anterior Cruciate Ligament Surgical Outcomes Should Continue 社论评论：目前的证据不支持常规的前交叉韧带重建增强富血小板血浆，但追求生物增强，以改善前交叉韧带手术结果应继续。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.08.021

Theodore B. Shybut M.D. (Editorial Board)

Platelet-rich plasma (PRP) has been used to augment anterior cruciate ligament (ACL) surgery, with studies reaching conflicting conclusions as to the extent of beneficial effects. Although most ACL surgeries I have performed have not been augmented, I have used PRP (and bone marrow concentrate) enough to conclude that my personal experience matches the literature finding of no significant difference in outcomes, and, at present does not support routine augmentation of ACL reconstruction with PRP. Instead, I believe the “crimson duvet” effect of reaming tunnels is a key source of cells and signals that promote healing and initiate graft incorporation. Our journals must continue to publish important “negative” outcome studies as we continue to pursue more substantially beneficial methods of biologically enhancing ACL surgery.

富血小板血浆（PRP）已被用于增强ACL手术，关于有益效果的程度，研究得出了相互矛盾的结论。虽然我进行的大多数ACL手术都没有增强，但我充分利用了PRP（和骨髓浓缩物），得出结论，我的个人经验与文献相符，结果没有显著差异，并且目前不支持常规增强ACL重建（ACLR）。相反，我认为“深红色羽绒被”效应是促进愈合和启动移植物结合的细胞和信号的关键来源。我们的期刊必须继续发表重要的“负面”结果研究，因为我们继续追求更有益的生物增强前交叉韧带手术方法。

引用次数: 0

Editorial Commentary: Research on Clinically Important Differences Has Value but Over-reliance on Thresholds May Obscure the Complexity of Patient-Perceived Improvement 临床重要差异的研究具有价值，但过度依赖阈值可能会模糊患者感知改善的复杂性。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.09.002

Mark P. Cote D.P.T., M.S.C.T.R., Deputy Editor, Statistics, Jeffrey S. Mun B.A., Paradis Saathoff B.A.

Efforts to determine the relationship between patient-reported outcome measures (PROMs) and patient-reported improvement have largely been focused on determining threshold values to classify patients as having experienced a certain amount of improvement or satisfaction. Although these metrics aid in understanding the extent to which specific PROM scores associated with improvement vary across studies, they are imperfect thresholds sensitive to the practice and setting in which they are estimated. Even when applied to the patients who contributed to their estimation, thresholds misclassify patients. The misclassification is often exacerbated when threshold values are used outside the setting in which they were derived owing to differences in patient expectations, settings, and practice patterns, among others. The growing amount of research reporting thresholds for various measures and patient populations in the orthopaedic and sports medicine literature provides the opportunity to evaluate the consistency between PROM scores and patient-reported improvement and satisfaction across different settings. Although this is valuable, over-reliance on thresholds to determine substantial improvement or satisfaction will obscure the complexity and nuance of patient-perceived improvement.

确定患者报告的结果测量（PROM）和患者报告的改善之间关系的努力主要集中在确定阈值，以将患者分类为经历了一定程度的改善或满意度。虽然这些指标有助于理解不同研究中与改善相关的特定PROM分数的差异程度，但它们是不完美的阈值，对其估计的实践和设置很敏感。甚至当应用于对他们的估计有贡献的患者时，阈值也错误地对患者进行了分类。由于患者期望、环境和实践模式等方面的差异，阈值在设定之外使用时，往往会加剧错误分类。在骨科和运动医学文献中，越来越多的研究报告了各种测量方法和患者群体的阈值，这为评估不同环境下PROM评分与患者报告的改善和满意度之间的一致性提供了机会。虽然这是有价值的，但过度依赖阈值来确定实质性改善或满意度会模糊患者感知改善的复杂性和细微差别。

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引用次数: 0

Knee Joint Line Obliquity Continues to Regress Beyond 1 Year and Stabilizes at 3 Years After Open Wedge High Tibial Osteotomy Without Correlation to Clinical Outcome 开楔高位胫骨截骨术后1年后膝关节线倾角继续退化，3年后稳定，与临床结果无关。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.06.005

Ju-Ho Song M.D., Ph.D., Bum-Sik Lee M.D., Ph.D., Jong-Min Kim M.D., Ph.D., Seong-Il Bin M.D., Ph.D.

Purpose

To evaluate midterm serial postoperative changes in the knee and adjacent joints, with a focus on the knee joint obliquity (KJLO).

Methods

Patients undergoing open wedge high tibial osteotomy between January 2011 and December 2018 were retrospectively reviewed. Those with a follow-up duration of ≥5 years and serial long-standing hip-to-ankle radiographs were included. KJLO and joint line convergence angle were measured at the knee joint. The influence of the hip joint was assessed using the hip abduction angle (HAA), and the influence of the ankle joint was evaluated using the ankle joint line obliquity (AJLO) and the tibiotalar angle. Serial changes in the radiographic parameters (preoperatively and 3 months, 1 year, 3 years, and 5 years postoperatively) were analyzed using repeated-measures correlation. Clinical outcomes were evaluated using the Knee Society objective and functional scores.

Results

A total of 105 knees were followed up for 90.2 ± 27.2 months (range, 60-151 months). KJLO increased from –0.7° ± 0.2° (mean ± standard error) preoperatively to 2.5° ± 0.3° at 3 months postoperatively and to 3.0° ± 0.2° at 1 year postoperatively (P = .026, vs 3 months postoperatively) but subsequently decreased to 2.9° ± 0.2° at 3 years postoperatively (P < .001, vs 1 year postoperatively) and to 2.7° ± 0.3° at 5 years postoperatively, with no significant difference between the 3- and 5-year values (P = .609, vs 3 years postoperatively). Similarly, HAA increased until 1 year postoperatively (P < .001, vs 3 months postoperatively) and then decreased significantly until 5 years postoperatively (P < .001, vs 1 year postoperatively). However, AJLO showed a significant decrease between 3 months and 1 year postoperatively (P < .001), with no further significant changes observed between 1 and 5 years postoperatively (P = .225). According to the repeated-measures correlation, the factors significantly correlating with changes in KJLO were HAA (P < .001), AJLO (P < .001), and joint line convergence angle (P = .028). Five-year postoperative KJLO did not have significant correlations with the Knee Society objective (P = .845) and functional (P = .361) scores.

Conclusions

KJLO increased after open wedge high tibial osteotomy and began to decrease from 1 year postoperatively, with no significant difference observed between 3 and 5 years. This change did not correlate with clinical outcomes. HAA showed a similar pattern, increasing until 1 year and then continuing to decrease significantly throughout the midterm follow-up. AJLO showed a significant decrease within the first postoperative year, with no further changes thereafter.

Level of Evidence

Level III, retrospective case series.

目的：评估膝关节及邻近关节术后中期系列变化，重点关注膝关节斜度（KJLO）。方法：回顾性分析2011年1月至2018年12月行开放楔形胫骨高位截骨术（OWHTO）的患者。随访时间≥5年并连续长期拍摄髋关节-踝关节x线片的患者纳入研究。测量膝关节处的KJLO和关节线收敛角（JLCA）。用髋关节外展角（HAA）评估髋关节的影响，用踝关节线倾角（AJLO）和胫距角（TAA）评估踝关节的影响。采用重复测量相关性分析影像学参数（术前、术后3个月、1年、3年和5年）的系列变化。临床结果采用膝关节协会客观评分和功能评分进行评估。结果：105个膝关节共随访90.2±27.2个月（范围60 ~ 151个月）。KJLO从术前的-0.7±0.2°（平均±标准误差）增加到术后3个月的2.5±0.3°和术后1年的3.0±0.2°（p=0.026，相对于术后3个月），但随后在术后3年下降到2.9±0.2°(p结论：OWHTO后KJLO增加，从术后1年开始下降，3年和5年之间无显著差异。这种变化与临床结果无关。HAA表现出类似的模式，在1年之前呈上升趋势，然后在中期随访期间继续显著下降。AJLO在术后一年内显著下降，此后无进一步变化。证据级别：III级，回顾性病例系列。

{"title":"Knee Joint Line Obliquity Continues to Regress Beyond 1 Year and Stabilizes at 3 Years After Open Wedge High Tibial Osteotomy Without Correlation to Clinical Outcome","authors":"Ju-Ho Song M.D., Ph.D., Bum-Sik Lee M.D., Ph.D., Jong-Min Kim M.D., Ph.D., Seong-Il Bin M.D., Ph.D.","doi":"10.1016/j.arthro.2025.06.005","DOIUrl":"10.1016/j.arthro.2025.06.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate midterm serial postoperative changes in the knee and adjacent joints, with a focus on the knee joint obliquity (KJLO).</div></div><div><h3>Methods</h3><div>Patients undergoing open wedge high tibial osteotomy between January 2011 and December 2018 were retrospectively reviewed. Those with a follow-up duration of ≥5 years and serial long-standing hip-to-ankle radiographs were included. KJLO and joint line convergence angle were measured at the knee joint. The influence of the hip joint was assessed using the hip abduction angle (HAA), and the influence of the ankle joint was evaluated using the ankle joint line obliquity (AJLO) and the tibiotalar angle. Serial changes in the radiographic parameters (preoperatively and 3 months, 1 year, 3 years, and 5 years postoperatively) were analyzed using repeated-measures correlation. Clinical outcomes were evaluated using the Knee Society objective and functional scores.</div></div><div><h3>Results</h3><div>A total of 105 knees were followed up for 90.2 ± 27.2 months (range, 60-151 months). KJLO increased from –0.7° ± 0.2° (mean ± standard error) preoperatively to 2.5° ± 0.3° at 3 months postoperatively and to 3.0° ± 0.2° at 1 year postoperatively (<em>P</em> = .026, vs 3 months postoperatively) but subsequently decreased to 2.9° ± 0.2° at 3 years postoperatively (<em>P</em> < .001, vs 1 year postoperatively) and to 2.7° ± 0.3° at 5 years postoperatively, with no significant difference between the 3- and 5-year values (<em>P</em> = .609, vs 3 years postoperatively). Similarly, HAA increased until 1 year postoperatively (<em>P</em> < .001, vs 3 months postoperatively) and then decreased significantly until 5 years postoperatively (<em>P</em> < .001, vs 1 year postoperatively). However, AJLO showed a significant decrease between 3 months and 1 year postoperatively (<em>P</em> < .001), with no further significant changes observed between 1 and 5 years postoperatively (<em>P</em> = .225). According to the repeated-measures correlation, the factors significantly correlating with changes in KJLO were HAA (<em>P</em> < .001), AJLO (<em>P</em> < .001), and joint line convergence angle (<em>P</em> = .028). Five-year postoperative KJLO did not have significant correlations with the Knee Society objective (<em>P</em> = .845) and functional (<em>P</em> = .361) scores.</div></div><div><h3>Conclusions</h3><div>KJLO increased after open wedge high tibial osteotomy and began to decrease from 1 year postoperatively, with no significant difference observed between 3 and 5 years. This change did not correlate with clinical outcomes. HAA showed a similar pattern, increasing until 1 year and then continuing to decrease significantly throughout the midterm follow-up. AJLO showed a significant decrease within the first postoperative year, with no further changes thereafter.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5193-5201"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combined Medial Meniscus Repair, Centralization, and High Tibial Osteotomy Are Associated With Improved Clinical, Radiological, and Arthroscopic Outcomes in Patients With Posterior Root Tears and Varus Alignment 联合内侧半月板修复、集中和胫骨高位截骨可改善后根撕裂和内翻对准患者的临床、放射学和关节镜预后。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.07.003

Yasumasa Tokumoto M.D. , Yusuke Nakagawa M.D., Ph.D. , Tomomasa Nakamura M.D., Ph.D. , Nobutake Ozeki M.D., Ph.D. , Takashi Hoshino M.D., Ph.D. , Ichiro Sekiya M.D., Ph.D. , Hideyuki Koga M.D., Ph.D.

Purpose

To evaluate the radiological, clinical, and arthroscopic outcomes following meniscal centralization combined with pullout repair and open-wedge high tibial osteotomy (OWHTO) in patients with medial meniscal posterior root tear and varus alignment.

Methods

We retrospectively analyzed patients who underwent OWHTO between 2017 and 2022, including those with medial meniscal posterior root tear and varus alignment who received meniscal centralization and transtibial pullout repair, with a minimum 2-year follow-up. Clinical and radiographic outcomes, including medial joint space width in the Rosenberg view, were evaluated. Second-look arthroscopy, performed at the time of plate removal (1 year after surgery) evaluated meniscal healing and cartilage status. Medial meniscus extrusion was classified at the initial surgery and second-look arthroscopy. The cohort-specific minimal clinically important difference (MCID) was calculated.

Results

Of the 48 eligible patients, 37 were available for follow-up and were included in the analysis, with a mean follow-up of 45.7 ± 12.0 months (range, 24-71 months). The flexion angle and all clinical scores were significantly improved. MCID was achieved in 92.9% of patients, according to the International Knee Documentation Committee, and in >80% of patients for all Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, except for the KOOS Sport. Medial joint space width increased from 2.7 ± 1.0 mm before surgery to 2.9 ± 1.0 mm at 2 years after surgery (P = .046). Complete meniscal healing was observed in 80.6%, with significant improvements in the International Cartilage Repair Society scores for medial femoral condyle and medial tibial plateau (P = .011, P = .006). Medial meniscus extrusion was improved in 83.3% of patients.

Conclusions

Combined with pullout repair, meniscal centralization and OWHTO significantly improved clinical, radiological, and arthroscopic outcomes at short-term follow-up, with a high proportion of patients achieving MCID thresholds in the Lysholm score, International Knee Documentation Committee subjective score, and KOOS subscales.

Level of Evidence

Level Ⅳ, retrospective case series.

目的：评估半月板集中联合拔出修复和开放楔形胫骨高位截骨术（OWHTO）治疗内侧半月板后根撕裂（MMPRT）和内翻对准患者的放射学、临床和关节镜结果。方法：我们回顾性分析了2017年至2022年期间接受OWHTO手术的患者，包括MMPRT和内翻对准并接受半月板集中和经胫骨拔出修复的患者，随访时间至少为2年。评估临床和影像学结果，包括Rosenberg视图中的内侧关节间隙宽度（mJSW）。在钢板取出时（手术后1年）进行二次关节镜检查，评估半月板愈合和软骨状态。内侧半月板挤压（MME）在初次手术和二次关节镜检查中被分类。计算队列特异性最小临床重要差异（MCID）。结果：48例符合条件的患者中，37例可随访，纳入分析，平均随访时间为45.7±12.0个月（范围：24-71个月）。屈曲角度及各项临床评分均有明显改善。根据国际膝关节文献委员会（IKDC）的数据，92.9%的患者达到了MCID，在所有膝关节损伤和骨关节炎结局评分（kos）亚量表中，除kos运动外，80%的患者达到了MCID。mJSW由术前的2.7±1.0 mm增加到术后2年的2.9±1.0 mm （p = 0.046）。半月板完全愈合率为80.6%，国际软骨修复学会股骨内侧髁和胫骨内侧平台评分显著提高（p = 0.011, p = 0.006）。83.3%的患者MME得到改善。结论：在短期随访中，联合拔出修复、半月板集中和OWHTO显著改善了临床、放射学和关节镜预后，在Lysholm评分、IKDC主观评分和kos亚量表中达到MCID阈值的患者比例很高。

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引用次数: 0

Editorial Commentary: Navigating the Cam: Balancing Precision, Cost, and Patient-Reported Outcomes for Computer-Assisted Femoral Resections 导航凸轮：平衡精度，成本和患者报告的计算机辅助股骨切除术的结果。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.08.026

Lauren H. Schoof M.D., Matthew J. Hartwell M.D. (Editorial Board)

Accurate correction of cam or combined deformities in femoroacetabular impingement syndrome is essential because under- and over-resection can lead to complications and inferior patient-reported outcomes. Yet, consistent visualization and complete resection remain challenging, with under-resection being a leading cause of revision surgery. Computer-assisted navigation in hip arthroscopy offers the potential to improve accuracy and reduce variability. Recent studies show improved adherence to preoperative plans, reduced residual impingement, and favorable short-term functional scores. However, long-term, patient-centered outcomes remain unknown, and there is limited evidence for improved clinical outcomes compared with traditional freehand fluoroscopic techniques. Drawbacks, including longer operative time and increased system cost, may limit efficiency and raise cost-effectiveness concerns. Larger, prospective studies with extended follow-up are needed to clarify the true clinical impact of computer-assisted navigation and identify the settings in which it may provide maximal benefit.

股骨髋臼撞击综合征（FAIS）的局部或联合畸形的精确矫正是必不可少的，因为切除不足和过度会导致并发症和患者报告的不良结果。然而，一致的可视化和完全切除仍然具有挑战性，未切除是翻修手术的主要原因。计算机辅助导航（CAN）在髋关节镜检查中提供了提高准确性和减少可变性的潜力。最近的研究表明，术前计划的依从性得到改善，残余撞击减少，短期功能评分良好。然而，以患者为中心的长期结果仍然未知，并且与传统的徒手透视技术相比，改善临床结果的证据有限。缺点，包括较长的操作时间和增加的系统成本，可能会限制效率和提高成本效益问题。需要更大规模的、前瞻性的长期随访研究来澄清CAN的真正临床影响，并确定它可能提供最大益处的环境。

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引用次数: 0

Editorial Commentary: Matrix-Associated Autologous Chondrocyte Implantation for Osteochondral Talar Lesions Is Promising yet Premature 编辑评论：基质相关的自体软骨细胞植入治疗距骨软骨病变是有希望的，但为时过早。

IF 5.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.arthro.2025.08.023

Nicola Maffulli M.D., Ph.D., F.R.C.P., F.R.C.S.(Orth) , Filippo Migliorini M.D., Ph.D., M.B.A., M.Sc.

Matrix-associated autologous chondrocyte implantation (MACI) has long been established as a viable option for focal cartilage defects in the knee. Its application in the ankle, however, remains controversial, with inconsistent evidence and substantial variation in outcomes. This commentary reflects on the current status of MACI for osteochondral lesions of the talus, highlighting methodologic weaknesses, uncertain clinical significance, and the need for robust comparative trials. The field needs higher-quality prospective research to generalize the use of MACI to focal cartilage lesions of the talus with the same confidence as in the knee.

基质相关自体软骨细胞植入（mACI）长期以来一直被认为是治疗膝关节局灶性软骨缺损的可行选择。然而，其在踝关节的应用仍然存在争议，证据不一致，结果也有很大差异。这篇评论反映了距骨软骨病变mACI的现状，强调了方法学上的弱点，不确定的临床意义，以及对强有力的比较试验的需要。该领域需要更高质量的前瞻性研究，以推广mACI在距骨局灶性软骨病变中的应用，同时对膝关节保持同样的信心。

引用次数: 0