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

{"title":"Increased Meniscal Extrusion at 1 Year After Surgery Is Associated With a Lower Likelihood of Substantial Mid-Term Patient-Perceived Improvement After Medial Meniscal Root Tear Repair","authors":"Hyun-Soo Moon M.D., Ph.D. ,&nbsp;Min Jung M.D., Ph.D. ,&nbsp;Chong-Hyuk Choi M.D., Ph.D. ,&nbsp;Kwangho Chung M.D. ,&nbsp;Se-Han Jung M.D. ,&nbsp;Junwoo Byun M.D. ,&nbsp;Hyeongwon Ham M.D. ,&nbsp;Sung-Hwan Kim M.D., Ph.D.","doi":"10.1016/j.arthro.2025.04.058","DOIUrl":"10.1016/j.arthro.2025.04.058","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze factors influencing achievement of mid-term substantial clinical improvement after surgical repair of medial meniscal root tears (MMRTs).</div></div><div><h3>Methods</h3><div>Patients who underwent arthroscopic pullout repair of MMRTs between 2010 and 2018 with minimum 5-year follow-up were reviewed. Patients were classified into 2 groups based on achieving substantial clinical improvement at 5 years using published substantial clinical benefit (SCB) values: Group 1 showed improvement beyond the SCB thresholds in both the International Knee Documentation Committee subjective score and Lysholm score<span>, whereas group 2 did not reach the SCB threshold for one or both scores. Additionally, secondary grouping was performed using minimal clinically important difference (MCID) values based on the same criteria as SCB grouping. Comparative analyses were performed for both groupings, followed by regression analyses to identify factors influencing achievement of clinical improvement. In particular, SCB-based regression analyses were performed using multiple models with adjusted SCB thresholds.</span></div></div><div><h3>Results</h3><div>Of 64 patients, 22 (34.4%) achieved SCB-level improvement and 36 (56.3%) achieved MCID-level improvement at 5 years postoperatively. Age, postoperative medial meniscal extrusion (MME) at 1 year, and preoperative-to-postoperative difference in MME were significantly higher in group 2 patients than in group 1 patients (<em>P</em> = .005, <em>P</em> = .013, and <em>P</em> = .047, respectively). Group 2 also exhibited higher Kellgren-Lawrence grades and greater progression of Kellgren-Lawrence grades at 5 years postoperatively (<em>P</em> = .003 and <em>P</em> = .015, respectively). Subsequently, perioperative variables showing differences in between-group comparisons were included in the SCB-based regression analyses, with postoperative MME consistently identified across all models as a factor influencing the achievement of mid-term clinical improvement after surgical repair of MMRTs (<em>P</em> = .015, <em>P</em> = .034, and <em>P</em> = .014 in models 1, 2, and 3, respectively). The analysis based on secondary grouping using MCID values showed consistent results.</div></div><div><h3>Conclusions</h3><div>The number of patients who perceived substantial clinical improvement 5 years after surgical repair of MMRTs was relatively small. Notably, increased MME at 1 year postoperatively was associated with a lower likelihood of achieving patient-perceived substantial clinical improvement at 5 years.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective prognostic case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5181-5190.e2"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175573","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":"Isolated Subacromial Balloon Spacer Implantation for Massive Irreparable Rotator Cuff Tears Is Associated With Improvement in Pain and Function at a Minimum 1-Year Follow-Up","authors":"Mohamad Y. Fares M.D., M.Sc.,&nbsp;Peter Boufadel M.D.,&nbsp;Jonathan Koa B.Sc.,&nbsp;Jaspal Singh M.D.,&nbsp;Joseph A. Abboud M.D.","doi":"10.1016/j.arthro.2025.06.009","DOIUrl":"10.1016/j.arthro.2025.06.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy of isolated subacromial balloon spacer implantation in patients with massive irreparable rotator cuff tears (MIRCTs), as evidenced by changes in patient-reported outcomes and range-of-motion values.</div></div><div><h3>Methods</h3><div>A retrospective review of prospectively collected data was conducted for patients with MIRCTs who underwent subacromial balloon spacer implantation alone without any concomitant procedures, with a minimum 1-year follow-up. Patient demographics and preoperative magnetic resonance imaging findings were recorded. Outcomes included the American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) pain score, active forward elevation, complications, and reoperations.</div></div><div><h3>Results</h3><div>A total of 34 patients (18 women, 16 men) were included. The mean age was 65.9 years, and the mean follow-up period was 15.9 months. On preoperative magnetic resonance imaging, the mean posterosuperior rotator cuff tear size was 3.57 cm, mean retraction size was 3.7 cm, 71% were Goutailler grade III/IV, and 94% had none or minimal osteoarthritis. There were no complications, and 2 patients (5.9%) underwent conversion to reverse shoulder arthroplasty. Significant improvements were observed in mean forward elevation (136.6 <span><math><mrow><mo>°</mo></mrow></math></span> to 150.4 <span><math><mrow><mo>°</mo></mrow></math></span>, <em>P</em> = .009), ASES scores (39.5 to 76.1, <em>P</em> &lt; .001), and VAS scores (6.1 to 2.1, <em>P</em> &lt; .001) at final follow-up. At the final follow-up, 90.3% of patients reached the minimal clinically important difference for ASES scores, and 87.1% reached the minimal clinically important difference for VAS scores.</div></div><div><h3>Conclusions</h3><div>Isolated subacromial balloon spacer implantation is an effective treatment option for patients with MIRCTs, evident by the significant improvements in forward elevation and high rates of clinically meaningful ASES and VAS scores at a minimum 1-year follow-up.</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 5005-5012"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340721","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":"Hip Arthroscopy With Labral Repair and Capsular Closure in Patients With Joint Hypermobility Does Not Result in Inferior Outcomes Compared With Patients Without Joint Hypermobility","authors":"Joseph J. Ruzbarsky M.D. ,&nbsp;Spencer M. Comfort M.D. ,&nbsp;Trevor J. Shelton M.D. ,&nbsp;Joan C. Rutledge B.S. ,&nbsp;Nicholas A. Felan B.A. ,&nbsp;Karen K. Briggs M.P.H. ,&nbsp;Grant J. Dornan M.S. ,&nbsp;Marc J. Philippon M.D.","doi":"10.1016/j.arthro.2025.06.007","DOIUrl":"10.1016/j.arthro.2025.06.007","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare patient-reported outcomes between patients with and without joint hypermobility after primary hip arthroscopy with labral repair for femoroacetabular impingement syndrome.</div></div><div><h3>Methods</h3><div>Patients undergoing primary hip arthroscopy with labral repair for femoroacetabular impingement syndrome between January 2016 and December 2018 were identified. Exclusion criteria included prior ipsilateral hip surgery or a center-edge angle less than 20°. At minimum 2-year follow-up, the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport (HOS-Sport), modified Harris Hip Score (mHHS), 12-Item Short Form (SF-12) Physical Component Score, SF-12 Mental Component Score, Western Ontario and McMaster Universities Osteoarthritis Index, minimal clinically important difference (MCID), patient acceptable symptom state (PASS), Tegner Activity Scale score, and satisfaction rating were compared between the hypermobility (HM) group (Beighton score ≥ 5) and non-hypermobility (NHM) group (Beighton score &lt; 5).</div></div><div><h3>Results</h3><div>A total of 221 patients met the inclusion criteria, with 218 (98.6%) completing the minimum follow-up. The HM group included 24 patients with a mean follow-up period of 4.18 ± 1.3 years, and the NHM group comprised 194 patients with a mean follow-up period of 5.21 ± 1.65 years. There were no significant differences in mean postoperative HOS-ADL (92 ± 12 vs 87 ± 19), HOS-Sport (81 ± 24 vs 77 ± 29), mHHS (87 ± 14 vs 87 ± 13), SF-12 Physical Component Score (53 ± 8 vs 49 ± 12), SF-12 Mental Component Score (54 ± 7 vs 54 ± 9), or Western Ontario and McMaster Universities Osteoarthritis Index (9 ± 11 vs 10 ± 12) between the NHM and HM groups (<em>P</em> &gt; .05). The NHM group attained the MCID for the HOS-ADL at a higher rate (<em>P</em> = .04). No difference in PASS attainment for the HOS-ADL or in PASS or MCID attainment for the HOS-Sport or mHHS was observed (<em>P</em> &gt; .05). The median satisfaction rating was 8.50 (range, 1-10) in the HM group and 10 (range, 1-10) in the NHM group.</div></div><div><h3>Conclusions</h3><div>At minimum 2-year follow-up, patient-reported outcomes, reoperation rates, and total hip arthroplasty rates were similar between patients with Beighton scores of less than 5 and those with scores of 5 or more undergoing hip arthroscopy with labral repair and capsular plication.</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 5075-5080"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340720","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":"Greater Return to Sport and Lower Recurrences With the Latarjet Procedure Versus Bankart Repair Without Remplissage in Martial Art Contact Athletes With Glenohumeral Instability and Glenoid Bone Loss Less Than 20%","authors":"Luciano A. Rossi Ph.D. ,&nbsp;Rodrigo Brandariz M.D. ,&nbsp;Ignacio Pasqualini M.D. ,&nbsp;Oguz Turan M.S. ,&nbsp;Catalina Larrague M.D. ,&nbsp;Ignacio Tanoira Ph.D. ,&nbsp;Maximiliano Ranalletta Ph.D.","doi":"10.1016/j.arthro.2025.07.026","DOIUrl":"10.1016/j.arthro.2025.07.026","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To compare return to sport, functional outcomes, and complications between the arthroscopic Bankart repair without remplissage and the Latarjet procedure in competitive martial arts (MA) athletes with glenohumeral instability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Between January 2008 and February 2021, competitive MA athletes with anterior shoulder instability were operated in our institution. The first group of patients were operated on with the arthroscopic isolated Bankart procedure and the other with an open Latarjet procedure. Return to sports, range of motion, the Rowe score, the visual analog scale, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes using the minimal clinically important difference for Rowe and the patient acceptable symptomatic state (PASS) for the Rowe and ASOSS score. Recurrences, reoperations, and complications also were evaluated with a minimum follow-up of 36 months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The mean follow-up was 68.7 months (range, 36-96 months) and the mean age was 24.2 years (range, 16-33 years). Ninety-two percent of patients were able to return to sports, 88% at their preinjury level of play. Sixty-one percent of patients in the Bankart group and 81% in the Latarjet group returned to compete at the same level (&lt;em&gt;P&lt;/em&gt; = .021). No significant difference in functional scores and shoulder range of motion were found between the groups. In addition, the percentage of patients who surpassed the PASS threshold was similar. For the Bankart group, 92% achieved the PASS for Rowe scores and 85% for ASOSS scores. In the Latarjet group, the corresponding percentages were 88% and 81%. Nine recurrences and 7 reoperations were recorded. The rate of recurrences was 25% (7/28) in the Bankart group and 6% (2/32) in the Latarjet group (&lt;em&gt;P&lt;/em&gt; = .01). The rate of reoperations was 18% (5/28) in the Bankart group and 6% (2/32) in the Latarjet group (&lt;em&gt;P&lt;/em&gt; = .07). The rate of complications was 7% (2/28) in the Bankart group and 13% (4/32) in the Latarjet group (&lt;em&gt;P&lt;/em&gt; = .14). these included biceps tendinitis and subacromial bursitis in the Bankart group (both resolved with conservative management), asymptomatic graft nonconsolidation in 3 patients who underwent Latarjet and resumed sports, and 1 patient who underwent Latarjet who developed a hematoma successfully treated with sling immobilization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In competitive MA athletes with glenohumeral instability and a glenoid bone loss &lt;20%, both, the arthroscopic Bankart repair and the Latarjet procedure, produced excellent functional outcomes with most athletes returning to sports. However, the Bankart repair without remplissage was associated with a greater rate of recurrences and reoperations, as well as lower rates of return to the same level of competition than the Latarjet procedure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level of Evidence&lt;/h3&gt;&lt;div&gt;Level III, retr","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5038-5045"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765825","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":"Ranges of Return to Sport Outcomes Following Anterior Shoulder Instability Surgery Are Influenced by Procedure, Athletic Level, and Follow-Up Duration: A Systematic Review","authors":"Josiah Valk D.O. ,&nbsp;Viraj Deshpande B.S. ,&nbsp;Hunter Hitchens B.S. ,&nbsp;Coen Zediker B.S. ,&nbsp;Evan Simpson B.S. ,&nbsp;Kevin Parvaresh M.D. ,&nbsp;Hafiz Kassam M.D.","doi":"10.1016/j.arthro.2025.07.032","DOIUrl":"10.1016/j.arthro.2025.07.032","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate and qualitatively synthesize studies performed in the past decade that report return to sport (RTS) after anterior shoulder instability surgery and identify study, patient, and surgical characteristics that reduce heterogeneity in RTS outcomes, to help guide surgeons and patients in collaborative decision-making and set appropriate expectations of postoperative athletic performance.</div></div><div><h3>Methods</h3><div>A systematic review of PubMed, Embase, and Web of Science databases was conducted for all studies published between January 2015 and March 2025 reporting RTS or return to preinjury level (RTPL) following surgical treatment for anterior shoulder instability. Exclusion criteria included non-English studies, studies reporting less than a 2-year follow-up, and studies reporting any shoulder instability other than anterior, including atraumatic instability. The risk of bias was assessed, and data were extracted. Heterogeneity in procedure-specific RTS outcomes was qualitatively assessed through subgroup analyses of study, patient, and surgical characteristics.</div></div><div><h3>Results</h3><div>A total of 123 studies encompassing 10,992 athletes were included. Across 9,581 patients, RTS rates ranged from 50% to 100%, and RTPL ranged from 19.4% to 100%. RTS was most consistent following open iliac crest (100%) and open Bankart repair (91.6%-100%), while wider ranges were observed after arthroscopic Bankart (50%-100%) and open Latarjet (50%-100%). RTPL exhibited rates of 100% after open iliac crest and 19.4% to 97.1% after open Latarjet. Female athletes had higher and more consistent RTS (91.4%-100%) and RTPL (74.1%-76.9%) compared to males (RTS, 73.9%-100%; RTPL, 39.4%-97.1%). Ranges of RTS and RTPL narrowed in studies with a prospective design (RTS, 87%-98%; RTPL, 38%-97%), revision procedures (RTS, 77.9%-100%; RTPL, 42.9%-95.4%), and among elite athletes (RTS, 81.8%-100%). Patients with &gt;20% glenoid bone loss exhibited narrower RTPL (78.3%-95.4%) than those with &lt;20% (70%-100%). Sport type, athlete level, and bone defect tracking status further influenced RTS variability.</div></div><div><h3>Conclusions</h3><div>Anterior shoulder stabilization procedures lead to high, though varied, reported RTS and return to preinjury rates across all studied cohorts. Ranges of RTS rates are influenced by procedure type, clinical follow-up duration, athletic level, and revision surgery status.</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 5343-5363.e60"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765826","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":"Shoulder Superior Capsular Reconstruction Using Xenograft Shows No Deterioration in Functional Improvement at 5-Year Follow-Up","authors":"Anton Ulstrup M.D., FEBOT,&nbsp;Michael Reinhold M.D.,&nbsp;Charlotte Stenqvist M.D.","doi":"10.1016/j.arthro.2025.07.020","DOIUrl":"10.1016/j.arthro.2025.07.020","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine functional outcomes and radiographic shoulder findings at mid-term after superior capsular reconstruction for irreparable rotator cuff ruptures using a porcine dermal graft.</div></div><div><h3>Methods</h3><div>Clinical results for patients not older than 70 years of age with a chronic irreparable superior or posterosuperior tendon defect, which included either a total defect of the supraspinatus tendon or a larger defect, including both the supraspinatus and infraspinatus tendons, treated with a xenograft superior capsular reconstruction technique during a 5-year period between October 2015 and January 2020. Patients were evaluated using the Constant score and Western Ontario Rotator Cuff (WORC) index over a minimum 5-year follow-up. All operated shoulders had magnetic resonance imaging of the injured shoulder after 1 year and after 5 years or later with a qualitative radiographic evaluation of graft integrity. Preoperative x-rays and x-rays at mid-term were classified according to the Hamada classification.</div></div><div><h3>Results</h3><div>Twenty-three patients were operated on. Twenty-one patients completed a mid-term follow-up (range, 60-101 months; mean, 71 months). Mean age was 57 years at the time of surgery. No correlation was found between functional outcome scores, graft durability, and Hamada grade. There was no correlation between functional outcome and any progression of radiographic rotator cuff arthropathy. Patients with a single-tendon defect or patients with no prior rotator cuff operation had better outcomes than patients with a 2-tendon defect and patients with a prior operation. At final follow-up for 21 patients, the mean Constant score improved from an average of 26 points to 68 points (<em>P</em> &lt; .001). The mean WORC index increased from a percentage average of 29% to 76% (<em>P</em> &lt; .001). Twenty-one of 21 patients exceeded recognized minimal clinically important difference (MCID) levels for their Constant scores, and 20 of 21 patients exceeded MCID levels for their WORC indices. At mid-term follow-up, no further complications in terms of graft tears, infections, or revisions were registered. The clinical failure rate was 1 patient out of 21.</div></div><div><h3>Conclusions</h3><div>At the time of completed mid-term follow-up, a substantial number of patients (95%) achieved the MCID for the Constant scores and WORC indices, with no deterioration in functional improvement. No correlations between functional outcomes and radiographic shoulder findings at mid-term were identified.</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 5027-5035"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755193","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":"Hip Arthroscopy for Femoroacetabular Impingement Syndrome and Labral Tears in Competitive Soccer Players Shows Significant Functional Improvement and High Return-to-Sport Rates at Mid-Term Follow-Up","authors":"Roger Quesada-Jimenez M.D. ,&nbsp;Matthew J. Strok B.A. ,&nbsp;Andrew R. Schab B.S. ,&nbsp;Nils Becker M.D. ,&nbsp;Ady H. Kahana-Rojkind M.D. ,&nbsp;Benjamin G. Domb M.D.","doi":"10.1016/j.arthro.2025.07.012","DOIUrl":"10.1016/j.arthro.2025.07.012","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the outcomes and return-to-sport rates of hip arthroscopy as treatment for femoroacetabular impingement syndrome (FAIS) and labral tears in competitive soccer players at mid-term follow-up, with a subanalysis of return to sport based on sex and competitive level.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data of all patients who underwent hip arthroscopy as treatment for FAIS between February 2008 and January 2019. Included patients reported competitive soccer participation and completed preoperative and minimum 5-year postoperative questionnaires for at least one of several patient-reported outcomes—modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12), and visual analog scale for pain—or underwent documented revision surgery or conversion to arthroplasty. An overall return-to-sport analysis was conducted, with a subanalysis considering preoperative competitive level and sex.</div></div><div><h3>Results</h3><div>A total of 65 patients (74 hips) were included. Patients experienced improvements in the mHHS (67.0 to 90.4), NAHS (65.4 to 89.1), HOS-SSS (42.5 to 82.1), and iHOT-12 score (37.7 to 81.3) (<em>P</em> &lt; .01 for all). Patients reached the minimal clinically important difference for the mHHS, NAHS, HOS-SSS, and iHOT-12 score at rates of 81.7%, 78.9%, 83.8%, and 92.6%, respectively. Patients met the patient acceptable symptom state for the mHHS, NAHS, HOS-SSS, and iHOT-12 score at rates of 76.1%, 76.1%, 65.7%, and 68.5%, respectively. Of the 54 patients who attempted to return to soccer at any time point, 47 (87.0%) were successful. Of these 47 patients, 32 (68.1%) continued playing soccer at 5 years postoperatively. No differences were observed when comparing return-to-soccer rates by sex or competitive level.</div></div><div><h3>Conclusions</h3><div>Hip arthroscopy for FAIS and labral treatment in soccer players resulted in significant improvements in functional outcomes, with a high percentage of patients achieving important clinical thresholds. There was a high rate of return to soccer, enabling a substantial number of patients to continue playing at a minimum 5-year follow-up.</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 5096-5104"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719212","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":"The Presence or Absence of Cartilage Regeneration Following Medial Open-Wedge High Tibial Osteotomy Does Not Predict Long-Term Outcomes","authors":"Kang-Il Kim M.D., Ph.D. ,&nbsp;Sang-Hak Lee M.D., Ph.D. ,&nbsp;Jun-Ho Kim M.D., Ph.D.","doi":"10.1016/j.arthro.2025.07.004","DOIUrl":"10.1016/j.arthro.2025.07.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess whether the patients who showed mature cartilage regeneration in the medial compartment in a second-look arthroscopy have better clinical and radiologic long-term outcomes and survivorship compared to immature cartilage regeneration following medial open-wedge high tibial osteotomy (MOWHTO).</div></div><div><h3>Methods</h3><div>Patients who underwent MOWHTO using a medial locked plate system were retrospectively reviewed between February 2008 and December 2012. All included patients had no concomitant cartilage-restoring procedures, underwent second-look arthroscopy at 2 years postoperatively, and were followed for at least 10 years. Based on arthroscopic findings in the medial femoral condyle, patients were classified into mature and immature cartilage regeneration groups. Clinical outcomes, including the primary outcome of the total Western Ontario and McMaster Universities Osteoarthritis Index score, were compared between the groups using patient-reported outcome measures. The minimal clinically important difference (MCID) was assessed to determine clinical significance. Radiologic progression of osteoarthritis was evaluated using serial changes in the Kellgren-Lawrence grade, and survivorship, defined as conversion to arthroplasty, was analyzed using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>A total of 83 consecutive knees were included, with 34 in the mature group and 49 in the immature group. The mean follow-up period was 12.1 years (range, 10-15.2 years). No significant differences were observed in clinical outcomes or the proportion of patients achieving the MCID on the Western Ontario and McMaster Universities Osteoarthritis Index scale (MCID 9.1; group M 93.9% vs group I 97.9%, <em>P</em> = .564). Radiologic progression showed a trend of progressing more slowly in the mature group than in the immature group without significance at the latest follow-up (<em>P</em> = .113). The 10-year survival rate was 100% in the mature group and 95.6% in the immature group (<em>P</em> = .099).</div></div><div><h3>Conclusions</h3><div>The presence or absence of cartilage regeneration in the medial compartment does not predict better long-term outcomes, including radiologic progression, the achievement of MCID in clinical outcomes, or survivorship following MOWHTO.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective comparative case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5230-5242.e1"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651305","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 Tibial Slope Measurement With the Axis Estimate Method Is Not Inferior to the Established Proximal Anatomic Axis Method, and Both Differ From Cortical-Based Measurements","authors":"Michael B. DiCosmo M.D. ,&nbsp;Alyssa M. DiCosmo M.D. ,&nbsp;Michael J. DeSarno M.S. ,&nbsp;Matthew G. Geeslin M.D. ,&nbsp;Andrew G. Geeslin M.D.","doi":"10.1016/j.arthro.2025.06.036","DOIUrl":"10.1016/j.arthro.2025.06.036","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether simpler alternative methods, using a tangential line along the (1) posterior tibial cortex (posterior cortical reference [PCR]), (2) anterior tibial cortex (anterior cortical reference [ACR]), and (3) axis estimate (AE), can yield posterior tibial slope (PTS) measurements comparable in reliability and reproducibility to the proximal anatomic axis (PAA) method.</div></div><div><h3>Methods</h3><div>This was a retrospective review of patients aged 18 to 40 years who underwent lateral knee radiographs, followed by magnetic resonance imaging scans within 30 days for pain and suspected internal derangement (between January 2018 and January 2022). Lateral radiographs were required to include at least 10 cm of the tibia distal to the joint line. Patients were grouped as follows based on magnetic resonance imaging findings: anterior cruciate ligament tear, posterior cruciate ligament tear, or no cruciate ligament tear. Each measurement was performed by 2 independent raters. Inter-method, inter-rater, and intrarater reliability was assessed using the intraclass correlation coefficient (ICC).</div></div><div><h3>Results</h3><div>A total of 155 patients met the study criteria: 73 with no cruciate ligament tears, 70 with anterior cruciate ligament tears, and 12 with posterior cruciate ligament tears. Compared with the PAA method, the AE method showed no difference (10.3°, <em>P</em> = .09), whereas the ACR method (11.7°, <em>P</em> &lt; .0001) and PCR method (7.5°, <em>P</em> &lt; .0001) differed significantly from the PAA method. All methods had moderate reliability (ICCs, 0.5-0.74). The inter-method ICC was excellent for AE and PAA (ICC, 0.87) and was lowest for PAA and PCR (ICC, 0.47).</div></div><div><h3>Conclusions</h3><div>The reliability of the AE method was not significantly different from that of the established standard PAA method; thus, it may serve as a suitable substitute in the clinical setting. The ACR and PCR methods were significantly different from the PAA method. Although the PAA and PCR methods had similar inter-rater reliability, the PCR method may underestimate PTS and therefore may not be interchangeable with the PAA method.</div></div><div><h3>Clinical Relevance</h3><div>The PAA method requires several steps to measure PTS, which can be time-consuming and prone to variability. A simpler and equally reliable method such as the AE method may increase utilization and maintain performance.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5205-5213"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602326","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: Beyond the Numbers: Why Return to Sport After Hip Arthroscopy Is Not Always What It Seems","authors":"Niv Marom M.D.","doi":"10.1016/j.arthro.2025.08.015","DOIUrl":"10.1016/j.arthro.2025.08.015","url":null,"abstract":"<div><div>Hip arthroscopy has been shown to consistently result in significant improvements in pain, function, and quality of life for athletes diagnosed with femoroacetabular impingement syndrome. This outcome is similarly observed in studies focusing specifically on soccer players, a group notably associated with femoroacetabular impingement syndrome because of the physical demands of the sport. Although most athletes return to their sport, interpreting return-to-sport (RTS) data requires caution. Definitions vary widely, used tools and methods to measure RTS are poor and too generalized, performance levels and metrics often are overlooked, and additional important factors contributing to RTS, such as psychological readiness, are frequently ignored. Reported RTS rates may therefore not reflect sustained performance at a preinjury level. Moreover, failure to RTS may not always directly suggest athletes’ dissatisfaction from surgery. These nuances matter. Moving forward, RTS reporting should evolve to capture the quality of return, integrating validated definitions, performance metrics, and transparency about limitations. In addition, we should acknowledge that in some cases reporting on less-favorable RTS data after a surgical intervention does mean it is not successful. Only by doing so can the orthopaedic community provide athletes with accurate, realistic guidance about outcomes after hip-preservation surgery. The critical message is that hip arthroscopy reliably improves pain and function, but RTS is not always what it seems.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 12","pages":"Pages 5105-5107"},"PeriodicalIF":5.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979614","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}