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

{"title":"Computer Navigation-Assisted Osteochondroplasty May Improve Accuracy of Resection Planning With Limited Outcome Differences Compared With Freehand Hip Arthroscopic Technique in Patients With Femoroacetabular Impingement Syndrome","authors":"Masayoshi Saito M.D., Ph.D. ,&nbsp;Shota Higashihira M.D., Ph.D. ,&nbsp;Yohei Yukizawa M.D., Ph.D. ,&nbsp;Hyonmin Choe M.D., Ph.D. ,&nbsp;Hiroyuki Ike M.D., Ph.D. ,&nbsp;Ken Kumagai M.D., Ph.D. ,&nbsp;Yutaka Inaba M.D., Ph.D. ,&nbsp;Naomi Kobayashi","doi":"10.1016/j.arthro.2025.07.048","DOIUrl":"10.1016/j.arthro.2025.07.048","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the achievement of the preoperative plan and clinical outcomes in patients with cam- or combined-type femoroacetabular impingement syndrome undergoing computer navigation-assisted arthroscopic osteochondroplasty compared with freehand techniques.</div></div><div><h3>Methods</h3><div>This retrospective study included patients treated between 2020 and 2024 who met the following criteria: (1) primary hip arthroscopic surgery for cam- or combined-type femoroacetabular impingement syndrome, (2) availability of pre- and postoperative computed tomography imaging, and (3) minimum 12-month follow-up. Patients were divided into a navigation-assisted group and a freehand group. In the navigation group, a computed tomography−based system was used, enabling real-time tracking of the abrader burr during resection. Achievement of the preoperative plan was assessed by comparing postoperative 3-dimensional range of motion simulations to preoperative targets at 90°, 70°, and 45° of hip flexion. Clinical outcomes included the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS).</div></div><div><h3>Results</h3><div>Fifty-five hips were included (25 in the navigation-assisted group and 30 in the freehand group). Mean follow-up was 14.7 ± 4.4 months (range, 12-25 months) in the navigation group and 31.3 ± 11.2 months (range, 12-58 months) in the freehand group. The navigation group had greater achievement rates of the preoperative range of motion plan at 90° (92.0% vs 46.7%, P &lt; .001) and 70° (80.0% vs 50.0%, <em>P</em> = .027). At 1 year, NAHS was greater in the navigation group (88.6 ± 9.2 vs 79.8 ± 18.9, <em>P</em> = .037), with more patients achieving the minimal clinically important difference (76.0% vs 46.7%, <em>P</em> = .032). There were no significant differences in mHHS, revision arthroscopy, or conversion to total hip arthroplasty.</div></div><div><h3>Conclusions</h3><div>Computer navigation-assisted osteochondroplasty may improve the accuracy of cam resection and contribute to better short-term outcomes such as the NAHS at 1 year. However, clinical benefits over freehand technique were limited in other measures such as mHHS, revision, or conversion rates.</div></div><div><h3>Level of Evidence</h3><div>Level Ⅲ, retrospective comparative study.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5151-5163.e1"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093045","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":"Cover Image & Video Link","authors":"","doi":"10.1016/S0749-8063(25)00672-3","DOIUrl":"10.1016/S0749-8063(25)00672-3","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Page A18"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718865","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":"Platelet-Rich Plasma and Its Analogs Do Not Clinically Improve Functional Outcomes 1 Year After Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Randomized Controlled Trials","authors":"Paulo Vitor Pereira Pinho M.D. ,&nbsp;Maria L.R. Defante ,&nbsp;Gustavo Miranda Oliveira ,&nbsp;Joaquim Fernandes Fagundes Júnior M.D.","doi":"10.1016/j.arthro.2025.06.031","DOIUrl":"10.1016/j.arthro.2025.06.031","url":null,"abstract":"<div><h3>Purpose</h3><div>To perform a meta-analysis of randomized controlled trials with a minimum 12-month follow-up to determine whether platelet-rich plasma (PRP) improves postoperative functional outcomes after anterior cruciate ligament reconstruction (ACLR).</div></div><div><h3>Methods</h3><div>The MEDLINE, Embase, and Cochrane databases were evaluated for studies involving the use of PRP or its analogs in ACLR. Only randomized controlled trials with a follow-up period of 12 months or more that presented only PRP as an intervention were selected. Statistical analysis was performed using R software (version 4.4.1), and heterogeneity was assessed using the <em>I</em>² statistic.</div></div><div><h3>Results</h3><div>We included 502 patients who underwent ACLR from 9 studies; 251 of these patients were treated with PRP. The mean age ranged from 27.7 to 34.5 years, and the studies reported the participation of 109 female patients. The use of PRP in ACLR resulted in a statistically significant improvement in the International Knee Documentation Committee (IKDC) score after 12 months (mean difference, 2.05; 95% confidence interval, 0.25-3.85; <em>P</em> = .03; <em>I</em>² = 27%). However, there was no statistical significance based on the minimal clinically important difference. No statistically significant differences were found for the Tegner and Lysholm scores at 12 months.</div></div><div><h3>Conclusions</h3><div>This meta-analysis evaluated the effects of PRP and its analogs in ACLR. Functional outcomes were compared after 12 months in both the PRP-enhanced group and the inactive control group. Although the IKDC score showed a statistically significant improvement (<em>P</em> &lt; .05), the Lysholm and Tegner scores did not show significant differences. The statistical difference in the IKDC score, however, did not translate into a clinically significant difference based on the minimal clinically important difference. These findings suggest that although some functional benefits may be observed within the first year after surgery, overall recovery remains variable.</div></div><div><h3>Level of Evidence</h3><div>Level II, meta-analysis of Level I and II studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5292-5300.e4"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568149","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":"Remnant Preservation Improves 10-Year Graft Survival and Rotational Stability in Anatomic Single-Bundle Hamstring Anterior Cruciate Ligament Reconstruction","authors":"Kyoung Ho Yoon M.D., Ph.D. ,&nbsp;Bo Seung Bae M.D. ,&nbsp;Seung Jae Lee M.D. ,&nbsp;Dae Keun Suh M.D., Ph.D.","doi":"10.1016/j.arthro.2025.07.031","DOIUrl":"10.1016/j.arthro.2025.07.031","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare clinical outcomes and survival rates of isolated anterior cruciate ligament reconstruction (ACLR) with versus without remnant preservation using hamstring autografts at a minimum 10-year follow-up.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed unilateral isolated ACLRs with hamstring autografts performed between 2005 and 2012. Inclusion criteria were primary anterior cruciate ligament rupture, single-bundle 4-strand hamstring autograft, and a minimum 10-year follow-up. Cases of multiligament injury, allograft use, or revision surgery were excluded. At arthroscopy, knees were assigned to remnant-preserved ACLR (RP-ACLR) when a continuous stump thicker than 50% of the native bundle was retained; otherwise, they were assigned to non-remnant ACLR (NR-ACLR). The Tegner score, Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Lachman and pivot-shift tests, coronal alignment, and graft failures were evaluated. The minimal clinically important difference defined responder status. Kaplan-Meier and standard parametric or nonparametric tests were performed to compare groups, with <em>P</em> &lt; .05 defined as statistically significant.</div></div><div><h3>Results</h3><div>This study enrolled 91 patients (51 RP-ACLR and 40 NR-ACLR) with a mean follow-up period of 164.1 ± 38.4 months (157.2 ± 30.4 months vs 172.9 ± 45.5 months, <em>P</em> = .126). Baseline age, sex, and body mass index were comparable. The 10-year survival rate was higher in the RP-ACLR group (92.5% vs 83.0%, <em>P</em> = .040). Failures occurred in 5 of 51 RP-ACLR patients (9.8%) and 11 of 40 NR-ACLR patients (27.5%, <em>P</em> = .050). Grade 3 pivot shift was observed in 3 RP-ACLR and 8 NR-ACLR patients (<em>P</em> = .009), and overall pivot shift grades favored RP-ACLR patients (<em>P</em> = .040). The Tegner score (<em>P</em> = .794), Lysholm score (<em>P</em> = .551), IKDC score (<em>P</em> = .136), Lachman test (<em>P</em> = .695), weight-bearing line ratio (<em>P</em> = .407), and mechanical axis (<em>P</em> = .202) showed no differences. The minimal clinically important difference responder rates were comparable for the IKDC score (100% in each group), Lysholm score (100% in each group), and Tegner score (7.8% in the RP-ACLR group vs 7.5% in the NR-ACLR group).</div></div><div><h3>Conclusions</h3><div>Remnant preservation in isolated primary anatomic ACLR using hamstring autografts provides higher 10-year graft survival and superior rotational stability compared with non-remnant ACLR, with no significant differences in patient-reported outcomes, knee stability tests, coronal alignment, osteoarthritis progression, or the proportion of patients achieving clinically important improvement.</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 5278-5287"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765827","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":"Establishing the Minimum Clinically Important Difference, Patient Acceptable Symptomatic State, and Substantial Clinical Benefit After Isolated Medial Patellofemoral Ligament Reconstruction","authors":"Tristan J. Elias M.D. ,&nbsp;Erik Haneberg B.S. ,&nbsp;Daniel J. Kaplan M.D. ,&nbsp;Andrew Phillips M.D. ,&nbsp;Divesh Sachdev M.H.A., B.S. ,&nbsp;Nikhil Verma M.D. ,&nbsp;Jorge Chahla M.D., Ph.D. ,&nbsp;Brian Forsythe M.D. ,&nbsp;Brian J. Cole M.D., M.B.A. ,&nbsp;Adam B. Yanke M.D., Ph.D.","doi":"10.1016/j.arthro.2025.07.029","DOIUrl":"10.1016/j.arthro.2025.07.029","url":null,"abstract":"<div><h3>Purpose</h3><div>To establish the minimum clinically important difference (MCID), patient acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) for the Kujala score in patients who underwent isolated Medial patellofemoral ligament reconstruction (MPFLR) for patellar instability with a minimum 23 month follow-up.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used a prospectively maintained database of patients undergoing primary MPFLR between April 2016 and June 2021. Patients with concomitant procedures, such as osteotomy, trochleoplasty, meniscus repair, other ligamentous reconstruction, and cartilage transplantation, were excluded. Kujala scores were recorded at baseline and minimum of 23 months postoperatively. Anchor-based and distribution-based methods were used to calculate the MCID, SCB, and PASS.</div></div><div><h3>Results</h3><div>A total of 107 patients (109 knees; 21.5 ± 9.1 years old, 26.0 ± 6.7, 68.2% female, 61.5% left side) with a minimum of 23 months follow-up patient-reported outcome measures were included in the final analysis. The Kujala score threshold for achieving the MCID was defined as an increase of 10.0 on the basis of the distribution-method calculations and 12.0 using anchor-based analysis. The SCB was defined as an increase of 25.5. The PASS was defined as achieving a minimum of 23 month Kujala score of 78.5. These results are comparable with scores seen at 6 months and 1 year. The MCID was calculated to be 86% sensitive and 64% specific; SCB was found to be 67% sensitive and 100% specific; and PASS was found to be 85% sensitive and 80% specific. The rates of achieving the MCID, SCB, and PASS at a minimum of 23 months were 89% (distribution)/84% (anchor), 58%, and 78%, respectively.</div></div><div><h3>Conclusions</h3><div>This study established thresholds for the MCID, SCB, and PASS at a minimum of 23 months after isolated MPFLR. The distribution-based MCID corresponded with an improvement in Kujala score or 10.0 as compared with the anchor-based method of 12.0. The value for achieving a SCB was 25.5. An absolute Kujala score of 78.5 was determined to be the threshold for patient satisfaction 23 months postoperatively.</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 5268-5275"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765824","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":"Revision Hip Arthroscopy Yields Inferior Patient Reported Outcome Measures and Patient Acceptable Symptomatic State Along with Higher Total Hip Arthroplasty Conversion Compared to the Primary Setting at a Minimum 2-Year Follow-Up","authors":"Juan Bernardo Villarreal-Espinosa M.D. ,&nbsp;Fernando Gómez-Verdejo M.D. ,&nbsp;Michael J. Murray B.S. ,&nbsp;Kyleen Jan M.D. ,&nbsp;Amelia Hummel M.D. ,&nbsp;Melissa Carpenter B.S. ,&nbsp;Udit Dave B.S. ,&nbsp;Cameron Gerhold B.S. ,&nbsp;Felipe Casanova M.D. ,&nbsp;Kristen I. Barton M.D., Ph.D. ,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.arthro.2025.07.014","DOIUrl":"10.1016/j.arthro.2025.07.014","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare functional and patient-reported outcomes between primary and revision hip arthroscopy.</div></div><div><h3>Methods</h3><div>A systematic search was conducted using 3 databases (PubMed, EMBASE, CINAHL) from inception to October 2024, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Only comparative clinical studies evaluating primary versus revision hip arthroscopy with minimum 2-year follow-up were included. Evaluated outcomes included patient-reported outcome measures, reoperation/total hip arthroplasty conversion rates, and patient-acceptable symptomatic state (PASS)/minimal clinically important difference (MCID) achievement rates.</div></div><div><h3>Results</h3><div>Nine studies were retrieved for analysis. In total, 2,128 and 723 patients (2,230 and 737 hips) were included in the primary and revision setting, respectively. Femoroacetabular impingement and labral-related procedures were reported in all patients. At a minimum 2-year follow-up, Hip Outcome Score Activities of Daily Living and Sports Subsection scores ranged from 77 to 87.4 and 57 to 91.7 in the primary and from 77.6 to 80.4 and 54.4 to 65.3 in the revision groups, respectively. Moreover, modified Hip Harris Score and International Hip Outcome Tool 12 scores presented lower ranges in the revision setting, upon comparison with the primary cohort (72.2-81 vs 80-96 and 59.4-63.7 vs 71.9-91.5, respectively). Furthermore, revision/repeat revision ranged from 0-12.5% in the primary and 0-14.2% in the revision cohort. Conversion to total hip arthroplasty varied from 0 to 12.6% in the primary and from 0 to 27.5% in the revision arm. PASS threshold achievement rates were higher in the primary hip arthroscopy group in 3 of the 4 studies that reported them (55.8-71.1% vs 29.4-80.6%).</div></div><div><h3>Conclusions</h3><div>Patients undergoing revision hip arthroscopy achieve inferior functional outcomes, reflected in patient reported outcome measures and PASS achievement rates, compared to the primary setting. No apparent revision or repeat revision arthroscopy differences were observed; however, the revision cohort trended toward higher total hip arthroplasty conversions. These results support our hypothesis regarding inferior outcomes and higher conversion rates in revision cases.</div></div><div><h3>Level of Evidence</h3><div>III, systematic review of Level II-III studies</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5378-5390"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719214","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":"Platelet-Rich Plasma Is More Effective Than Hyaluronic Acid Injections for Osteoarthritis of the Knee: A Meta-analysis Based on Randomized, Double-Blinded, Controlled Clinical Trials","authors":"Yun-feng Li ,&nbsp;Huan-huan Xing B.A. ,&nbsp;Chuan-kun Wei ,&nbsp;Yu-tian Chen ,&nbsp;Ya-qi Sun ,&nbsp;Fu-lin Liu ,&nbsp;Yu-han Wu ,&nbsp;Wei Yang Ph.D.","doi":"10.1016/j.arthro.2025.06.033","DOIUrl":"10.1016/j.arthro.2025.06.033","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the difference in clinical efficacy of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in the treatment of knee osteoarthritis (KOA).</div></div><div><h3>Methods</h3><div>This study conducted a comprehensive search of the Cochrane Library, Web of Science, PubMed, CNKI, Wanfang Data, and VIP databases. Eligible studies underwent rigorous quality assessment using the Cochrane Handbook 8.2 Risk of Bias 2 criteria. A meta-analysis of efficacy-related indicators was performed using RevMan 5.4 software.</div></div><div><h3>Results</h3><div>Fifteen double-blind randomized controlled trials comprising 1,632 patients with KOA ranging from I to III on the Kellgren-Lawrence grading scale were included. Meta-analysis revealed that the PRP group exhibited significantly lower Western Ontario and McMaster Universities Osteoarthritis Index pain scores and total scores from baseline compared to the HA group at 12 months (MD = –1.14; 95% CI, –2.09 to –0.20; <em>P</em> = .02; MD = –7.33; 95% CI, –12.81 to –1.85; <em>P</em> = .009, respectively), both of which reached the minimal clinically important difference. Visual analog scale scores were also significantly reduced in the PRP group at 12 months (mean difference [MD] = –0.35; 95% CI, –0.59 to –0.10; <em>P</em> = .005, respectively). Improved International Knee Documentation Committee scores were observed in the PRP group at 1 month (MD = 3.13; 95% CI, 1.34-4.93; <em>P</em> = .0006, respectively).</div></div><div><h3>Conclusions</h3><div>After 12 months, there were statistically significant differences in Western Ontario and McMaster Universities Osteoarthritis Index pain and total scores, as well as minimal clinically important differences, with PRP being superior to HA in the treatment of KOA.</div></div><div><h3>Level of Evidence</h3><div>Level Ⅱ, meta-analysis of Level Ⅰ and Ⅱ studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5304-5318"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669048","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: Remnant-Preserving Anterior Cruciate Ligament Reconstruction Shows Long-Term Advantages, but Patient Selection, Characterization of Remnant Tissue, and Efficacy in Patients at Risk of Postoperative Knee Instability Are Areas for Future Investigation","authors":"Jay Moran M.D.,&nbsp;Etienne Cavaignac M.D., Ph.D.,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.arthro.2025.08.014","DOIUrl":"10.1016/j.arthro.2025.08.014","url":null,"abstract":"<div><div>Remnant preservation is one specific anterior cruciate ligament (ACL) reconstruction technique that has been explored to improve outcomes and involves retaining, as opposed to debriding, the “remnant” or native ACL tibial stump at the time of reconstruction. The ACL remnant tissue contains important mechanoreceptors and nerve endings, and preservation of this tissue is thought to enhance biological healing within the bone tunnels, graft ligamentization, maturation, synovialization, and proprioception, as well as reduce the risk of tunnel enlargement. Remnant preservation may also offer several technical advantages such as creation of a biological sleeve for the graft and improved anatomic graft placement. The indications for remnant preservation remain unclear, but greater than 50% thickness of remaining remnant tissue is our recommended threshold for preservation. Although long-term clinical studies are currently lacking, multiple short- and mid-term follow-up studies have suggested that remnant-preserving techniques can offer significantly superior pivot-shift outcomes and anterior knee stability, in addition to lower graft rerupture rates. Ultimately, remnant-preserving ACL reconstructions are exciting techniques that appear to offer a variety of benefits, but patient selection and indications, standardized characterization of the remnant tissue, and assessment of the long-term efficacy in patients at risk of residual postoperative rotational knee instability are still areas for future investigation.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5288-5291"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979681","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":"Minimal Hip Flexion Increase During Gait After Femoroacetabular Impingement Surgery: A Systematic Review and Meta-analysis of Pre- and Postoperative 3-Dimensional Motion Analysis","authors":"Talissa O. Generoso M.D. ,&nbsp;Felipe F. Gonzalez M.D., M.Sc. ,&nbsp;Alexandre R.M. Pelegrinelli P.T., Ph.D. ,&nbsp;Lucas V. Pallone M.D. ,&nbsp;Renato Locks M.D. ,&nbsp;Eliane C. Guadagnin Ph.D. ,&nbsp;Jorge Chahla M.D., Ph.D. ,&nbsp;Jonathan A. Gustafson Ph.D. ,&nbsp;Leonardo Metsavaht M.D., Ph.D. ,&nbsp;Gustavo Leporace P.T., Ph.D.","doi":"10.1016/j.arthro.2025.07.015","DOIUrl":"10.1016/j.arthro.2025.07.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of surgical treatment on gait biomechanics in patients with femoroacetabular impingement syndrome (FAIS).</div></div><div><h3>Methods</h3><div>A comprehensive search of 6 databases (from inception to 2024) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (CRD4202347397). Studies using 3-dimensional motion analysis to examine gait kinematics and/or kinetics in patients with FAIS before and after hip surgery were included. Studies analyzing data from patients with FAIS who had undergone surgery but lacked baseline presurgical data from the same patients or compared patients to controls without evaluating both pre- and postsurgical biomechanics were excluded. Qualitative and quantitative analyses were performed.</div></div><div><h3>Results</h3><div>Thirteen studies were reviewed qualitatively, and 12 were included in the meta-analysis, encompassing 279 presurgical and 268 postsurgical patients. Motion analysis was conducted 6 to 24.2 months postoperatively. Meta-analysis showed a statistically significant improvement of 1.3° in peak hip flexion angle during the gait cycle, although this may have limited clinical relevance. Other kinematic and kinetic parameters did not show significant differences. The quality of the studies was moderate or high.</div></div><div><h3>Conclusions</h3><div>This study showed a statistically significant increase in peak hip flexion and abduction angle throughout the gait cycle after surgery, although these changes were clinically negligible. The lack of significant changes in other kinematic and kinetic parameters indicates that factors beyond bone deformities may influence outcomes. These findings highlight the multifactorial nature of FAIS and suggest gait analysis alone may not fully capture postoperative biomechanical adaptations.</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 5391-5409.e30"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796181","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: Concomitant Osteotomy and Meniscus Centralization Should Be Considered in Selected Patients Undergoing Medial Meniscus Posterior Root Repair","authors":"Adnan Saithna M.D., F.A.A.N.A. (Associate Editor)","doi":"10.1016/j.arthro.2025.08.022","DOIUrl":"10.1016/j.arthro.2025.08.022","url":null,"abstract":"<div><div>Medial meniscus posterior root tears (MMPRTs) are associated with severe biomechanical consequences (loss of hoop force transmission) that are broadly equivalent to a total meniscectomy. The resultant increase in contact pressures predisposes to high rates of advanced medial compartment arthritis at long-term follow-up. Repair of MMPRTs is associated with significantly better outcomes than partial meniscectomy or nonoperative treatment (including improved patient-reported outcome measures and delay or even avoidance of arthroplasty). However, some patients may benefit from the addition of concomitant procedures (including osteotomy and meniscus centralization) to improve clinical outcomes and mitigate modifiable risk factors for failure of MMPRT repair. Although high-quality comparative studies are lacking, this strategy is supported by biomechanical data, clinical studies (including second-look arthroscopy data), and international consensus group statements.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5227-5229"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014436","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}