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

{"title":"Hamstring Anterior Cruciate Ligament Reconstruction With Anterolateral Ligament Reconstruction Is Associated With Fewer Reoperations Than Bone−Patellar Tendon−Bone Plus Modified Lemaire Tenodesis—A Matched-Pair Analysis From the SANTI Study Group Database","authors":"Francesco Pettinari M.D. ,&nbsp;Alessandro Carrozzo M.D. ,&nbsp;Derrick Junhong Guo M.D. ,&nbsp;Marta Barosso M.D. ,&nbsp;Hervé Ouanezar M.D. ,&nbsp;Ali Alayane M.D. ,&nbsp;Ahmad Abed Ali M.D. ,&nbsp;Julien Chamoux M.D. ,&nbsp;Marc Barrera Uso M.D. ,&nbsp;Adnan Saithna M.D. ,&nbsp;Thais Dutra Vieira M.D. ,&nbsp;Bertrand Sonnery-Cottet M.D., Ph.D.","doi":"10.1016/j.arthro.2025.07.016","DOIUrl":"10.1016/j.arthro.2025.07.016","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare combined anterior cruciate ligament reconstruction (ACLR) with hamstring tendon (HT) + anterolateral ligament reconstruction (ALLR) and bone−patellar tendon−bone with modified Lemaire lateral extra-articular tenodesis (BPTB + LET).</div></div><div><h3>Methods</h3><div>Patients who underwent primary ACLR with BPTB + LET between January 2003 and December 2021 with a minimum follow-up of 2 years were propensity matched 1:4 with patients who underwent HT + ALLR during the same period. Graft rupture (defined as symptomatic graft rupture leading to revision surgery), reoperation rates (including any subsequent surgical intervention on the index knee), and postoperative side-to-side knee laxity were compared. Multivariable analysis using the Cox model was performed to examine the relationship between graft rupture, reinterventions, surgical procedure type, and all potential explanatory variables.</div></div><div><h3>Results</h3><div>The study included 365 patients: 73 in the BPTB + LET group and 292 in the HT + ALLR group, with a mean follow-up of 162.6 ± 70.4 months for the BPTB + LET and 74.1 ± 33.5 months for the HT + ALLR group. The HT + ALLR group had a significantly lower reoperation rate than the BPTB + LET group (10.6% vs 24.7%; <em>P</em> &lt; .0001). Graft rupture rates were not significantly different between the groups (3.4% in the HT + ALLR group vs 5.5% in the BPTB + LET group; <em>P</em> = .22). The BPTB + LET group had greater rates of secondary meniscal surgeries (12.3% vs 4.5%; <em>P</em> = .0006) and infections (4.1% vs 0.7%; <em>P</em> = .0075). Postoperative side-to-side knee laxity was comparable between groups (0.2 mm; <em>P</em> = .8495). Kaplan-Meier analysis demonstrated superior reoperation-free survival in the HT + ALLR group at all the time points. Multivariate Cox analysis confirmed that the BPTB + LET technique was independently associated with increased reoperation risk (hazard ratio 2.57; 95% confidence interval 1.15-5.74; <em>P</em> = .0209).</div></div><div><h3>Conclusions</h3><div>Primary ACLR using HT + ALLR was associated with significantly lower reoperation rates compared with BPTB + LET. Specifically, the BPTB + LET group had significantly increased reoperation rate because of secondary meniscal procedures and infections. There were no significant differences in graft rupture rates between the 2 groups.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative case-series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5245-5255"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719211","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}

{"title":"Editorial Commentary: Hormonal Contraception and Hip Pain: Clinical Insights and Association, not Causation","authors":"Mario Hevesi M.D., Ph.D.,&nbsp;Aaron J. Krych M.D.","doi":"10.1016/j.arthro.2025.08.011","DOIUrl":"10.1016/j.arthro.2025.08.011","url":null,"abstract":"<div><div>Scientific literature commonly aims to establish an association between exposures of interest— hormonal contraception in the case of the present study—and their dependent effects. As readers, studies confirming risk factors we suspected all along—or even those bringing new risk factors to light—are often stored away in our clinical minds as causation rather than association, regardless of how clearly their findings were presented. This is a bias we must be cognizant of given that some exposures of interest are nonmodifiable whereas others, while modifiable, should not necessarily be modified.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5125-5126"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979666","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}

{"title":"Arthroscopically Assisted Posterior Latissimus Dorsi and Teres Major Transfer Can Alleviate Pain and Improve Shoulder Function","authors":"Chang Hee Baek M.D. ,&nbsp;Bo Taek Kim M.D. ,&nbsp;Luis Alfredo Miranda M.D. ,&nbsp;Jung Gon Kim M.D. ,&nbsp;Chaemoon Lim M.D. ,&nbsp;Seung Jin Kim M.S. ,&nbsp;Jean Kany M.D.","doi":"10.1016/j.arthro.2025.07.046","DOIUrl":"10.1016/j.arthro.2025.07.046","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy of arthroscopically assisted latissimus dorsi–teres major (LD-TM) transfer in patients with posterosuperior irreparable rotator cuff tears (PSIRCTs) without glenohumeral arthritis.</div></div><div><h3>Methods</h3><div>This retrospective study reviewed patients from 2 centers who underwent arthroscopically assisted LD-TM transfer: center A (between June 2014 and June 2020) and center B (between October 2014 and December 2017). The inclusion criteria consisted of patients with PSIRCTs without glenohumeral arthritis and a minimum 2-year follow-up. The exclusion criteria were combined biceps superior capsular reconstruction, missing clinical data, or loss to follow-up. Patient outcomes were assessed using the visual analog scale score, range of motion (ROM), progression of arthritis, and various patient-reported measures, including the Simple Shoulder Test (SST) score, Subjective Shoulder Value (SSV), Activities of Daily Living That Require Active External Rotation (ADLER) score, and American Shoulder and Elbow Surgeons (ASES) score.</div></div><div><h3>Results</h3><div>After the exclusion of 15 patients, 96 patients (26 from center A and 70 from center B) were included. The mean age was 64.0 ± 9.4 years (range, 38-83 years), with a mean follow-up of 43.3 ± 18.3 months (range, 24-101 months). Significant improvements were observed in the SST score, SSV, ADLER score, and ASES score (<em>P</em> &lt; .001 for all). Significant ROM improvements were noted in forward elevation, abduction, and external rotation. Clinically meaningful improvements (minimal clinically important difference, calculated by 0.5 standard deviation method) were seen in 73.9% of patients for the SST score, 90.6% for the SSV, 73.5% for the ADLER score, and 79.1% for the ASES score. A total of 16 patients experienced retears, and 3 patients required conversion to reverse total shoulder arthroplasty because of persistent pain unresponsive to conservative treatment. No significant differences in outcomes or complication rates were observed between the 2 centers.</div></div><div><h3>Conclusions</h3><div>Arthroscopically assisted LD-TM transfer significantly relieved pain and improved functional outcomes in patients with PSIRCTs, as shown by significant improvements in pain scores, patient-reported outcome measures, and ROM. This study supports that arthroscopically assisted LD-TM transfer is an effective treatment option for managing PSIRCTs.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5058-5065"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092841","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}

{"title":"Editorial Commentary: Reconstructing the Surgical Indications for Acromioclavicular Joint Injuries: Age Is Just a Number","authors":"Joseph C. Brinkman M.D. (Editorial Board),&nbsp;Kyle N. Kunze M.D. (Associate Editor)","doi":"10.1016/j.arthro.2025.07.034","DOIUrl":"10.1016/j.arthro.2025.07.034","url":null,"abstract":"<div><div>Traditional age-based contraindications for orthopaedic surgery are increasingly being challenged by a growing demographic of older adults who maintain active, physically demanding lifestyles. Emerging data show that acromioclavicular joint reconstruction can offer meaningful benefit even in patients older than 50 years. These findings reflect a broader trend across orthopaedics that emphasizes physiological status, functional demands, and healing potential over chronological age. Although caution and appropriate patient selection remain crucial, the shift toward individualized, function-based decision making offers a more thoughtful and patient-centered approach to musculoskeletal care of an aging population.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5025-5026"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786016","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}

{"title":"Residual Structural Disease and New Labral Tears Are the Most Common Indications for Revision Hip Arthroscopy: A Systematic Review","authors":"Mahant Malempati B.S. ,&nbsp;Preston M. Terle M.D. ,&nbsp;Jaydeep Dhillon D.O. ,&nbsp;Matthew J. Kraeutler M.D.","doi":"10.1016/j.arthro.2025.07.024","DOIUrl":"10.1016/j.arthro.2025.07.024","url":null,"abstract":"<div><h3>Purpose</h3><div>To provide a summary of the available literature on the most common indications for revision hip arthroscopy (RHA).</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines by searching PubMed, Embase, and the Cochrane Library to identify English-language clinical studies reporting on indications for patients undergoing RHA from January 1, 2000, to April 1, 2025. The search terms used were as follows: hip AND arthroscopy AND (revision OR failure OR reoperation). The primary outcomes assessed were reasons for revision reported by each study. Other outcomes included revision procedures, radiographic measures, patient-reported outcomes, rates of conversion to total hip arthroplasty, and rates of subsequent RHA; additional data extracted included number of patients, sex or gender distribution, follow-up period, and time from index procedure.</div></div><div><h3>Results</h3><div>Eleven studies (1 Level I, 1 Level II, 6 Level III, and 3 Level IV) met the inclusion criteria, with a total of 1,242 hips. Patient age ranged from 24.2 to 38.0 years, with 12.3- to 63.9-month follow-up reported. The most common revision indications were unaddressed femoroacetabular impingement (744 hips), labral tears (667 hips), and capsulolabral adhesions (401 hips). Common revision procedures included femoroplasty (704 hips), acetabuloplasty (526 hips), labral repair (365 hips), and lysis of adhesions (321 hips). Among studies presenting preoperative and postoperative patient-reported outcomes, patients showed significant improvements in the modified Harris Hip Score, Hip Outcome Score–Activities of Daily Living, and Hip Outcome Score–Sports Subscale. Two studies reported achievement of the minimal clinically important difference in 65.5% to 69.8% of patients for the modified Harris Hip Score and 61.9% to 63.6% of patients for the Hip Outcome Score–Sports Subscale. Rates of subsequent RHA ranged from 3.9% to 13.1%, and rates of conversion to total hip arthroplasty ranged from 3.9% to 11.9%.</div></div><div><h3>Conclusions</h3><div>The most common indications for RHA include unaddressed femoroacetabular impingement and new labral tears. There are differing opinions on reporting capsulolabral adhesions as an indication. These findings suggest that revision is often necessitated by a combination of structural and soft-tissue abnormalities that may be under-recognized or inadequately addressed at the time of the primary procedure.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I to IV studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5437-5452.e2"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755192","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}

{"title":"Editorial Commentary: The Subacromial Balloon Spacer for Massive Irreparable Rotator Cuff Tears—A Valuable Tool, but Not a Blanket Solution","authors":"Ira Bachar-Avnieli M.D.,&nbsp;Philip J. Rosinsky M.D. (Associate Editor)","doi":"10.1016/j.arthro.2025.08.012","DOIUrl":"10.1016/j.arthro.2025.08.012","url":null,"abstract":"<div><div>The subacromial balloon spacer continues to gain attention as a minimally invasive option for the treatment of massive irreparable rotator cuff tears, yet its long-term role and optimal surgical context remain under debate. Recent clinical studies have highlighted the short-term improvements in pain and function but also raise important questions regarding concomitant procedures, patient selection, and rehabilitation protocols. While current evidence supports its role in short-term functional improvement and pain relief, individual patient factors and technical variability suggest that balloon implantation should remain a selective, not reflexive, intervention. As with many emerging techniques in shoulder surgery, enthusiasm must be paired with clinical judgment.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5013-5014"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979708","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}

{"title":"Editorial Commentary: Should Platelet-Rich Plasma Be the New Standard? Reframing Biologic Strategies for Knee Osteoarthritis","authors":"Carlos Suarez-Ahedo M.D., M.Sc. (Editorial Board)","doi":"10.1016/j.arthro.2025.07.035","DOIUrl":"10.1016/j.arthro.2025.07.035","url":null,"abstract":"<div><div>Knee osteoarthritis remains one of the most challenging conditions in nonoperative orthopaedics. While hyaluronic acid has long been established in our injectable algorithm, evidence is increasing that platelet-rich plasma (PRP) can offer superior and longer-lasting outcomes. Based on data emerging from high-quality, double-blinded, randomized trials, we may now recognize the superiority of PRP as an alternative to other biologic therapies as well. A reconsideration of the hierarchy of intra-articular treatments is necessary, and PRP should be placed at the top of the list.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5319-5320"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812703","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}

{"title":"Editorial Commentary: One Year Is Enough to Know the Short-Term Outcomes of Arthroscopic Rotator Cuff Repair, but What Happens to the Sugaya III Tendon After a Year?","authors":"Michael H. Amini M.D. (Editorial Board),&nbsp;Midhat Patel M.D.","doi":"10.1016/j.arthro.2025.08.003","DOIUrl":"10.1016/j.arthro.2025.08.003","url":null,"abstract":"<div><div>There has been a growing body of evidence that 1- and 2-year patient-reported outcomes (PROs) have little variance after many orthopaedic interventions, including lower extremity arthroplasty, shoulder arthroplasty, anterior cruciate ligament reconstruction, and, of course, rotator cuff repair. The upsides of this are huge: better ability to achieve high follow-up rates and faster iterative research progressing our field. This study shows an increase in the retear rate after , rotator cuff repair between 1 and 2 years, but in only 4% of patients. This corresponds roughly to the number of patients whose PROs decline between 1 and 2 years, but this is offset by a similar number of patients whose PROs improve during that time. Yet again, it seems that 1 year captures the outcome of a given cohort well. However, this study also honed in on the Sugaya III tendons, as this subgroup had 10 of 30 patients progress to Sugaya IV/V between 1 and 2 years, with a corresponding decrease in PROs. Although previous work has shown Sugaya III tendons to be more protective against the natural progression of arthritis, head migration, and fatty infiltration than IV/V tendons, patients with Sugaya III may not be immune to disease progression. As always, we must do better at getting the rotator cuff to heal.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 4976-4977"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862719","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}

{"title":"Surgical Treatment Is Superior to Conservative Options in Preventing Recurrence of First-Time Anterior Shoulder Dislocation in Adolescents and Adults Under 40 Years of Age: A Systematic Review and Network Meta-analysis","authors":"Hongfu Jin Ph.D.,&nbsp;Guoxu Zhang Ph.D.,&nbsp;Sijie Chen M.D.,&nbsp;Yao Tong Ph.D.,&nbsp;Wenze Shao Ph.D.,&nbsp;Tao Li Ph.D.,&nbsp;Yizhou Huang Ph.D.,&nbsp;Jian Li Ph.D.,&nbsp;Xin Tang Ph.D.","doi":"10.1016/j.arthro.2025.07.044","DOIUrl":"10.1016/j.arthro.2025.07.044","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the effectiveness of multiple treatments for first-time anterior shoulder dislocation in adolescents and young adults under 40 years of age.</div></div><div><h3>Methods</h3><div>A systematic review and network meta-analysis of randomized controlled trials were conducted to compare 5 treatments for first-time anterior shoulder dislocation: arthroscopic Bankart repair, open Bankart repair, arthroscopic lavage, internal rotation immobilization, and external rotation immobilization. The primary outcome was recurrent instability, with secondary outcomes including functional scores, return to normal activities and sports, and patient satisfaction.</div></div><div><h3>Results</h3><div>A total of 10 randomized controlled trials were identified in the review, of which 8 involving 439 participants (mean age range: 20.0-25.3 years; maximum age 39 years) were included in the network meta-analysis. Surgical treatments, especially arthroscopic Bankart repair, exhibited lower recurrence risk, significantly outperforming external rotation immobilization (risk ratio [RR] = 0.15; 95% confidence interval [CI], 0.03-0.73) and internal rotation immobilization (RR = 0.14; 95% CI, 0.04-0.40). Arthroscopic Bankart repair showed no statistically significant difference in risk of recurrent instability when compared to open Bankart repair (RR = 4.19; 95% CI, 0.32-212.92) or when compared to arthroscopic lavage (RR = 0.3; 95% CI, 0.07-1.15). Both external rotation and internal rotation immobilization had the poorest outcomes, with no significant difference between them (RR = 0.91; 95% CI, 0.28-2.96). Surgical treatments were also associated with better functional outcomes, higher patient satisfaction, and higher rates of return to normal activities and sports.</div></div><div><h3>Conclusions</h3><div>Surgical treatments are more effective than conservative options in preventing recurrent instability in adolescents and young adults under 40 years of age with first-time anterior shoulder dislocation. Arthroscopic Bankart repair has comparable efficacy in preventing the recurrence of open Bankart repair. Both external rotation and internal rotation immobilization had the poorest outcomes in terms of reducing recurrence instability rates, with no significant difference between them.</div></div><div><h3>Level of Evidence</h3><div>Level I, systematic review and network meta-analysis of Level I studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5364-5377.e4"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056262","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}

{"title":"Posterior Labral Repair With Capsular Plication Shows Enduring Mid-Term Outcomes and Return to Sports With Low Recurrence Rates","authors":"Ignacio Pasqualini M.D. ,&nbsp;Oguz Turan M.S. ,&nbsp;Catalina Larrague M.D. ,&nbsp;Ignacio Tanoira M.D., Ph.D. ,&nbsp;Maximiliano Ranalletta M.D., Ph.D. ,&nbsp;Luciano Rossi M.D., Ph.D.","doi":"10.1016/j.arthro.2025.07.040","DOIUrl":"10.1016/j.arthro.2025.07.040","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate mid-term (&gt;5-year) clinical outcomes, recurrence rates, and return to sports in a cohort of patients undergoing arthroscopic posterior labral repair and capsular plication.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of patients who underwent isolated posterior labral repairs with capsular plication for posterior shoulder instability with a minimum follow-up period of 8 years. We included patients who (1) underwent arthroscopic posterior labral repair and capsular plication as the index procedure, (2) had minimum 8-year follow-up, (3) were older than 18 years at the time of final follow-up, and (4) had complete patient-reported outcome measures at final follow-up. Clinical outcomes were assessed using the Rowe score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE) score at baseline, 1-year follow-up, and final follow-up. Recurrence rates, complications, and return to sports were also evaluated. The proportions of patients achieving the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were calculated for each outcome measure using established thresholds.</div></div><div><h3>Results</h3><div>Forty-seven patients met the inclusion criteria, with a mean age at surgery of 20.7 ± 4.1 years, and 87.2% were male patients. At a mean final follow-up of 10.2 years (range, 8.0-13.6 years), the mean Rowe, ASES, and SANE scores were 89.5 ± 13.0, 87.8 ± 12.8, and 83.8 ± 7.7, respectively, showing significant improvements from baseline. The MCID was achieved by 97.9% of patients for the Rowe score, 100% for the ASES score, and 85.1% for the SANE score. The PASS was achieved by 66% of patients for the Rowe score, 83% for the ASES score, and 68% for the SANE score. Three patients (6.4%) experienced recurrent instability, with a mean time to recurrence of 21.3 ± 1.5 months. Two patients underwent revision surgery. Most patients (91.5%) returned to sports, at an average time of 5.4 ± 1.0 months after surgery, with 78.7% returning at the same level as before the injury.</div></div><div><h3>Conclusions</h3><div>Arthroscopic repair for posterior shoulder instability yields favorable mid-term outcomes, with significant improvements in functional scores and a low recurrence rate at a mean follow-up of 10.6 years. A high proportion of patients achieved the MCID and PASS for all outcome measures, indicating clinically meaningful improvements in shoulder function and patient satisfaction. Most patients successfully returned to sports, with nearly 80% returning at their preinjury level. These findings support the durability and effectiveness of arthroscopic repair in managing posterior shoulder instability, helping patients maintain a high level of shoulder function and sports participation over an extended period.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5049-5055"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182385","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}