Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"The Spanish Version of the Western Ontario Meniscal Evaluation Tool Is a Reliable, Valid, Precise, and Highly Responsive Instrument for Patients With Meniscal Pathology at a Minimum 6-Month Follow-Up.","authors":"Miguel Angel Palacios-Flores, Maximiliano Ibañez, Zichun Liu Wang, Nicola Pizza, Raul Torres-Claramunt, Simone Perelli, Joan Carles Monllau","doi":"10.1002/ars2.70131","DOIUrl":"https://doi.org/10.1002/ars2.70131","url":null,"abstract":"<p><strong>Purpose: </strong>To translate, culturally adapt, and validate the Western Ontario Meniscal Evaluation Tool (WOMET) into Peninsular Spanish and to evaluate its psychometric properties (reliability, validity, precision, and responsiveness) in patients undergoing knee arthroscopy for meniscal pathology.</p><p><strong>Methods: </strong>This retrospective study with prospectively collected data (from July to December 2025) followed international guidelines for cross-cultural adaptation (forward-backward translation, expert committee review, and pilot testing in 30 patients). The Spanish WOMET and Knee Injury and Osteoarthritis Outcome Score-4 were assessed electronically at baseline (T0), retest (T1, 2 weeks later), and 3 (T2) and 6 (T3) months postoperatively (a minimum 6-month follow-up). Reliability was assessed with intraclass correlation coefficient; internal consistency with Cronbach's <i>α</i> and McDonald's <i>ω</i>; convergent validity with Spearman <i>ρ</i> against Knee Injury and Osteoarthritis Outcome Score-4; precision with standard error of measurement and minimal detectable change at 95% confidence level; and responsiveness with standardized response mean.</p><p><strong>Results: </strong>Seventy-one patients (67.7% men; median age 47 years, interquartile range 18-60) with a mean follow-up of 6.1 months (range: 5.7-6.8) were evaluated. Test-retest reliability was excellent (total WOMET intraclass correlation coefficient = 0.96, 95% confidence interval 0.94-0.97). Internal consistency was high (<i>α</i> = 0.90, <i>ω</i> = 0.92). Convergent validity with Knee Injury and Osteoarthritis Outcome Score-4 was strong (<i>ρ</i> = 0.90, <i>P</i> < .001). Precision was good (standard error of measurement = 2.78, minimal detectable change at 95% confidence level = 7.68). Responsiveness was substantial (standardized response mean = 2.71 at 3 months and 2.56 at 6 months; <i>P</i> < .001), exceeding values reported for most other language versions.</p><p><strong>Conclusions: </strong>The Spanish version of the WOMET questionnaire is a reliable, valid, precise, and highly responsive instrument for assessing clinical outcomes in patients with meniscal pathology treated surgically in Spanish-speaking patients. Its brevity (16 items), specificity, and excellent patient acceptability make it an ideal tool for routine clinical practice and research.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70131"},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149274230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeons in North America and Asia-Pacific Adopt Various Practices Regarding Surgical Indications, Graft Selection, and Imaging Assessment in Pediatric Patients With Patellofemoral Instability.","authors":"Seth Ian Sim, Bo Xiang Bryan Neo, Daniel Green, James Hoi Po Hui, Zhou Zhilin","doi":"10.1002/ars2.70097","DOIUrl":"https://doi.org/10.1002/ars2.70097","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize and compare current practice patterns in the evaluation and management of pediatric patellofemoral instability (PFI) between Asia-Pacific and North American surgeons.</p><p><strong>Methods: </strong>A comprehensive survey developed by the Paediatric Research in Sports Medicine Society Patellofemoral Instability Research Interest Group assessed surgeon practices across evaluation, imaging, indications, and surgical techniques for pediatric patients with PFI. The survey was distributed to Asia-Pacific Paediatric Research in Sports Medicine members from 2024 to 2025 and compared against previously published North American data from 2018 to 2019. Responses were analyzed to compare regional practices.</p><p><strong>Results: </strong>A total of 127 subjects were included. Fifty-six Asia-Pacific orthopaedic surgeons and 56 North American orthopaedic surgeons managing pediatric PFI completed the survey. Most (89%) indicated surgery for large, symptomatic osteochondral fragments, with 90% routinely performing concomitant medial patellofemoral ligament reconstruction. Marked regional variation was seen in graft selection: hamstring autograft predominated in Asia-Pacific (78% vs 23%, <i>P</i> < .001), whereas allograft was preferred in North America (59% vs 14%, <i>P</i> < .001). Fixation strategies in skeletally immature patients also differed, with Asia-Pacific surgeons more often using suture anchors at both the patella (75% vs 54%, <i>P</i> = .004) and femoral insertion (59% vs 26%, <i>P</i> < .001). Computed tomography use for rotational profiling (85% vs 7%) and tibial tubercle assessment (84% vs 2%) was markedly higher in Asia-Pacific. Patella-stabilizing braces (73% vs 30%) and longer immobilization were also more common regionally.</p><p><strong>Conclusions: </strong>Significant regional variation exists in the management of pediatric PFI, particularly in graft choice, fixation technique, and imaging use.</p><p><strong>Clinical relevance: </strong>There is no universal consensus on the surgical management of PFI, and variation in practice may influence patient selection, surgical strategy, and outcomes. By characterizing similarities and differences in practice among Paediatric Research in Sports Medicine surgeons across geographic regions, this study identifies key areas of variability that can inform future research and guide the development of evidence-based standards to improve consistency and quality of care worldwide.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70097"},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149274175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcomes and Factors Influencing Partial-Thickness Articular-Sided Rotator Cuff Tear Transtendinous Repairs.","authors":"Roger V Ostrander, Mark Callanan, James R Andrews, Adam W Anz, Steve E Jordan, Jessi Truett, Ben Sherman","doi":"10.1002/ars2.70090","DOIUrl":"https://doi.org/10.1002/ars2.70090","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate patient-reported outcomes of the transtendinous repair technique for partial-thickness articular-sided tendon avulsions (PASTA) using patient-acceptable symptomatic state (PASS) thresholds.</p><p><strong>Methods: </strong>Chart reviews included patients who underwent a transtendinous arthroscopic rotator cuff repair by a single surgeon for a high-grade PASTA from January 2007 to December 2020. Inclusion criteria included patients 18 years or older who underwent surgery to repair a partial-thickness articular-sided rotator cuff tear. Exclusion criteria included previous ipsilateral arthroscopic shoulder procedures, rheumatoid arthritis, and severe glenohumeral arthritis. Patient-reported outcome data, including Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons (ASES), and visual analog scale, were retrospectively collected, as well as demographic data. These values were compared with a previously reported PASS threshold.</p><p><strong>Results: </strong>Eighty-four patients with a mean follow-up of 6.8 (standard deviation [SD] = 3.6) years were included in the study. All patients underwent arthroscopic rotator cuff repair for a high-grade PASTA tear. The mean ASES index score was 90.11 (SD = 12.79) at follow-up year (mean = 6.8, SD = 3.6), with 58 out of 84 (69%) patients meeting the PASS threshold. Seventy-five out of 84 (89%) participants reached the PASS threshold for the Single Assessment Numeric Evaluation assessment, with a mean score of 94.18 (SD = 7.49) at follow-up year. The mean visual analog scale was 1.24 (SD = 1.9) at follow-up year. Fifty-eight of 85 participants (68%) met PASS standards for both the ASES and Single Assessment Numeric Evaluation assessments.Achieving PASS in ASES was not significantly predicted by age, sex, athletic status, number of prior procedures, or lifestyle risk factors. However, participants classified as laborers showed a notable trend toward a lower likelihood of achieving PASS, suggesting that higher physical workload may negatively impact performance outcomes. Similarly, those with systemic disease tended to have reduced probability of achieving PASS.</p><p><strong>Conclusions: </strong>When clinically indicated, partial-thickness articular-sided rotator cuff tears can be reliably repaired via a transtendinous technique with demonstrated postoperative Patient Reported Outcomes Measures averages consistent with previously reported literature. Laborers, a Workers' Compensation claim, and history of gout all showed significantly worse Patient Reported Outcomes Measures after PASTA repairs.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70090"},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149274256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Anterior Cruciate Ligament Repair With Suture Augmentation Provides Good to Excellent Midterm Functional Outcomes Despite Clinically Relevant Revision Rates.","authors":"Anna Patricia Egert, Kristian Nikolaus Schneider, Georg Gosheger, Jan Christoph Theil, Jan Frederic Weller, Alexander Klug, Georg Ahlbäumer","doi":"10.1002/ars2.70128","DOIUrl":"https://doi.org/10.1002/ars2.70128","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate midterm functional outcomes after anterior cruciate ligament (ACL) repair with suture augmentation and to determine whether concomitant injuries influence patient-reported outcomes.</p><p><strong>Methods: </strong>This retrospective single-center cohort study included patients undergoing arthroscopic ACL repair with suture augmentation between January 2017 and March 2019. Eligible patients had proximal ACL tears (Sherman type I-II) with adequate tissue quality at a minimum 6-year follow-up. Patient-reported outcome measures included the International Knee Documentation Committee, Lysholm score, Tegner activity score, and forgotten joint score. Multivariate regression analysis was performed to identify predictors of postoperative outcomes. Clinically meaningful improvement was assessed using the minimal clinically important difference.</p><p><strong>Results: </strong>Of 93 patients, 80 (86%) were available for follow-up. Thirteen patients (16.3%) underwent revision surgery, all consisting of ACL reconstruction, at a median time of 35 months (interquartile range [IQR] 8-49) and were excluded, leaving 67 patients for evaluation. At a median follow-up of 79 months (IQR 75-97), median International Knee Documentation Committee was 94 (IQR 71-100); Lysholm score, 92 (IQR 74-100); and forgotten joint score, 86 (IQR 65-94). Median Tegner activity score decreased from 7 (IQR 4-10) preinjury to 6 (IQR 4-9) postoperatively (<i>P</i> = .03), remaining within the minimal clinically important difference in 74.6% of patients. Concomitant meniscal (n = 41) and ligamentous injuries (n = 63) were addressed intraoperatively and did not significantly affect patient-reported outcome measures. Delayed surgery was the only independent predictor of lower postoperative Tegner activity scores (<i>β</i> = -0.79, <i>P</i> = .025).</p><p><strong>Conclusions: </strong>Arthroscopic ACL repair with suture augmentation achieved good to excellent midterm functional outcomes in a 6-year follow-up, with 74.6% of patients maintaining activity levels within the minimal clinically important difference threshold. However, the revision rate of 16.3% remains clinically relevant. Concomitant ligamentous and meniscal lesions of low severity did not result in inferior patient-reported outcomes in this cohort.</p><p><strong>Level of evidence: </strong>Level IV, retrospective therapeutic case series.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70128"},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149274259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Lateral Tibial Plateau Translation Correlates With Pivot-Shift Severity in Anterior Cruciate Ligament-Deficient Knees.","authors":"Horacio Rivarola, Camilo Helito, Cristian Collazo, Marcos Palanconi, Marcos Meninato, Carlos Peñaherrera-Carrillo, Alejandro Barros Castro, Bautista Rivarola, Francisco Endara Urresta","doi":"10.1002/ars2.70113","DOIUrl":"https://doi.org/10.1002/ars2.70113","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify arthroscopic lateral tibial plateau (LTP) translation in anterior cruciate ligament (ACL)-deficient knees using a standardized intraoperative protocol and to evaluate its association with pivot-shift grade and lateral tibial slope, including its ability to discriminate high-grade pivot-shift.</p><p><strong>Methods: </strong>Patients aged 18 to 45 years with an isolated ACL rupture confirmed by clinical examination, magnetic resonance imaging, and arthroscopy who met the predefined eligibility criteria and had arthroscopic video of adequate quality for measurement underwent standardized arthroscopic assessment of LTP translation. Arthroscopic LTP translation was quantified from standardized high-definition arthroscopic video recordings using a calibrated probe during valgus and internal rotation stress at 30° of knee flexion. Measurements were independently repeated by 2 observers. Associations with preoperative pivot-shift grade and lateral tibial slope were assessed. Diagnostic performance was evaluated using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Sixty patients (38 men, 22 women; mean age 29.8 ± 6.7 years) were included in the final analysis. Mean arthroscopic LTP translation was 4.6 ± 1.7 mm (range, 2-8 mm). Reproducibility was excellent (intraclass correlation coefficient intra = 0.91; inter = 0.89). LTP translation strongly correlated with pivot-shift grade (<i>r</i> = 0.72, <i>P</i> < .001) and moderately with lateral tibial slope (<i>r</i> = 0.51, <i>P</i> = .003). Receiver operating characteristic analysis showed an area under the curve of 0.85 (95% confidence interval, 0.77-0.93). A threshold of >5 mm yielded 82% sensitivity and 78% specificity for detecting high-grade pivot-shift.</p><p><strong>Conclusions: </strong>Arthroscopic quantification of LTP translation is a reproducible and clinically relevant method for objectively assessing rotational instability in ACL-deficient knees. Arthroscopic quantification of LTP translation showed excellent inter- and intraobserver reliability and was strongly associated with preoperative pivot-shift grade. A translation threshold greater than 5 mm showed good discriminative performance for identifying high-grade pivot-shift.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70113"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149274196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Surgical Repair of Proximal Hamstring Tears Results in High Rates of Hamstring Strength Recovery and Return to Preinjury Activity.","authors":"Mohammad Mesfer Alzahrani, Brendon Swift, Zaid A Alzaid, Abdulhamid Alyousef, Michael Pickell, Geoffrey P Wilkin, Steven R Papp, Allan S Liew","doi":"10.1002/ars2.70150","DOIUrl":"https://doi.org/10.1002/ars2.70150","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical and patient-reported outcomes after open operative management of proximal hamstring ruptures.</p><p><strong>Methods: </strong>Retrospective chart review was completed for patients who underwent open surgical repair of a proximal hamstring rupture at a single academic center (The Ottawa Hospital) with a minimum of 1-year follow-up between June 2017 and August 2022. Demographic, injury, and surgical data were collected. Patient-reported outcomes, including the Lower Extremity Function Score and International Hip Outcome Tool, at final follow-up were collected and analyzed for all patients.</p><p><strong>Results: </strong>A total of 41 patients (58.5% men) with a mean age of 49.5 ± 11.7 years (range: 20-70 years old) with a mean follow-up of 46.8 ± 17.6 months (range 13-74 months) were included in the study. The most common mechanism of injury (31.7%) was a fall while skating or skiing. A 3-tendon injury was the most common pattern (82.9%), with the majority being retracted at least 6 cm (51.2%). Postoperative complications were observed in 12.2% of patients and included sensory nerve injury, repair failure, and postoperative admission for intractable pain. Most patients regained full hamstring strength (87.8%) and returned to preinjury activity levels (70.7%), with a mean follow-up of 46.8 months. Patient-reported outcomes at final follow-up were excellent, as 87.8% of the patients scored >90 on Lower Extremity Function Score and 82.9% scored >90 on International Hip Outcome Tool.</p><p><strong>Conclusions: </strong>In this study, patients who underwent open surgical repair of proximal hamstring tendon avulsion had high rates of hamstring strength recovery and return to preinjury activity, with favorable patient-reported outcomes and low complication rates.</p><p><strong>Level of evidence: </strong>Level IV, therapeutic retrospective study.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70150"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Predicts Failure of Nonoperative Treatment in Degenerative Posterosuperior Rotator Cuff Tears.","authors":"Santiago Gabardo, Natalia Martínez-Catalán, José María Belmonte Martínez, Gregorio Bernabé García, José Manuel García Carrasco, Cristina Delgado, María Valencia-Mora, Gonzalo Luengo-Alonso, Emilio Calvo","doi":"10.1002/ars2.70124","DOIUrl":"10.1002/ars2.70124","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an artificial intelligence-based algorithm to predict success of nonoperative treatment in degenerative posterosuperior tears and to identify the most influential features.</p><p><strong>Methods: </strong>Patients with degenerative rotator cuff tears initially treated nonoperatively were enrolled prospectively from January 2022 to November 2024. Exclusion criteria included age >75 years; <24 months of follow-up; massive, traumatic, and partial tears; arthritic changes (Hamada >2); and severe fatty degeneration (Goutallier >2). All patients followed a standardized physiotherapy protocol and could choose surgery if symptoms persisted; failure was defined as opting for surgery. Collected variables included demographics, comorbidities (diabetes, dyslipidemia, hypertension, hypothyroidism, and smoking), magnetic resonance imaging tear characteristics (size; International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine classification; associated cuff involvement; and biceps pathology), corticosteroid injection history, and functional scores (American Shoulder and Elbow Surgeons score, Subjective Shoulder Value, and the visual analog scale). First, a standard statistical analysis between groups was performed. Later, the dataset was split into a train (80%) and test (20%), and a random forest algorithm model was developed. Finally, SHapley Additive exPlanations values were computed to assess feature importance.</p><p><strong>Results: </strong>Of the 412 patients enrolled, 347 patients met the inclusion criteria. After 24 months, 66 (19%) patients opted for surgery. Mean follow-up was 30.4 months (range, 24-32). Compared with the successful nonoperative treatment group, patients who failed treatment were younger (58.5 vs 64.6 years, <i>P</i> = .001) and had higher body mass index (28.8 vs 27.2, <i>P</i> = .016), greater subscapularis involvement (13.5% vs 3%, <i>P</i> = .042), higher visual analog scale scores (7.7 vs 7.2, <i>P</i> = .018), lower Subjective Shoulder Value (30.9 vs 38.9, <i>P</i> = .003), and lower American Shoulder and Elbow Surgeons scores (40.6 vs 47.1, <i>P</i> = .001). The model achieved an area under the curve of 84%, predicting success rate of the nonoperative treatment with 94% sensitivity, 62% specificity, 89% positive predictive value, and 77% negative predictive value. The most influential variables for the model were age, tear size, and pretreatment functional scores.</p><p><strong>Conclusions: </strong>The artificial intelligence-based algorithm accurately predicted nonoperative treatment outcomes in degenerative posterosuperior rotator cuff tears (area under the curve 0.84, sensitivity 94%). Age, tear size, and function were the main predictors.</p><p><strong>Level of evidence: </strong>Level IV, prognostic retrospective case series.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70124"},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-Bundle Anterior Cruciate Ligament Reconstruction Provides Superior Short-to-Midterm Rotational Stability But Not Clinically Important Functional Gains Over Single-Bundle: A Systematic Review and Meta-analysis.","authors":"Manuel Alberto Gutierrez-Moreno, Luis Eduardo Arámbula-Torres, Ramon Alonso Prieto-Baeza, Carlos Leal-Contreras, Cristina Alejandra Fuentes-Flores, Edmundo Berumen-Nafarrate","doi":"10.1002/ars2.70102","DOIUrl":"10.1002/ars2.70102","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the biomechanical and functional outcomes between single-bundle and double-bundle (DB) anterior cruciate ligament reconstruction techniques using the most current evidence, stratified by follow-up duration.</p><p><strong>Methods: </strong>PubMed, Embase, and Cochrane databases were searched from 2013 to September 2025 for randomized controlled trials comparing single-bundle versus DB anterior cruciate ligament reconstruction with a minimum follow-up of 24 months. Primary outcomes included anterior tibial translation, rotational stability (pivot shift), and patient-reported outcomes (subjective International Knee Documentation Committee, Lysholm score). Secondary outcomes included return-to-sport and graft failure rate. Continuous outcomes were pooled using inverse-variance random-effects models (DerSimonian-Laird) and dichotomous outcomes using Mantel-Haenszel fixed-effect models, with stratification by follow-up duration (24-48 months vs >48 months). Heterogeneity was assessed using the <i>I</i> ² statistic.</p><p><strong>Results: </strong>Thirteen randomized controlled trials (1041 patients; 536 single-bundle, 505 DB; mean age 30.2 years; 68% men; follow-up 24-122 months) were included. At 24 to 48 months, DB reconstruction significantly reduced the risk of a positive pivot shift (risk ratio 0.60, 95% confidence interval [CI] 0.43-0.84, <i>P</i> = .003; number needed to treat = 10) and showed statistically higher subjective International Knee Documentation Committee (mean difference 5.88 points, 95% CI 0.44-11.33) and Lysholm (mean difference 7.47 points, 95% CI 0.06-14.88) scores; however, neither reached established minimal clinically important difference thresholds (11.5 and 8.9 points, respectively). Anterior tibial translation did not differ significantly between techniques (mean difference -0.34 mm, 95% CI -1.04 to 0.35, <i>P</i> = .327). No study reported sex-disaggregated outcomes or individual-level minimal clinically important difference attainment. Beyond 48 months, no significant differences were observed for any outcome.</p><p><strong>Conclusions: </strong>DB reconstruction shows statistically significant improvements in rotational stability and patient-reported functional scores at 24 to 48 months, but functional differences do not reach established minimal clinically important difference thresholds. No significant differences were observed beyond 48 months, a finding likely influenced by substantial study heterogeneity and graft selection. The current evidence does not support a universal clinical advantage for the DB technique; shared decision-making based on patient activity demands and surgeon experience remains essential.</p><p><strong>Level of evidence: </strong>Level I, systematic review and meta-analysis of randomized controlled trials.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70102"},"PeriodicalIF":0.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Mellitus Is Associated With Increased Risk for Subsequent Hip Arthroscopy After Index Hip Arthroscopy.","authors":"Nicholas J Morriss, Justin Harrington, Jacob Waldron, Brian Giordano","doi":"10.1002/ars2.70105","DOIUrl":"10.1002/ars2.70105","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether diabetes mellitus is associated with higher systemic and hip-specific complications and to evaluate reoperation rates after hip arthroscopy.</p><p><strong>Methods: </strong>Using the TriNetX Research Network and Current Procedural Terminology and International Classification of Diseases codes, we identified diabetic and nondiabetic patients aged 12 to 65 years who underwent hip arthroscopy between 2005 and 2025. Ninety-day systemic complications and 6-month, 1-year, and 3-year hip-specific outcomes were evaluated. Propensity score matching (1:1) was performed on 35 demographic and comorbidity variables. Risk analyses, Kaplan-Meier curves, and Cox proportional hazards models compared outcomes, with significance set at <i>α</i> = 0.05.</p><p><strong>Results: </strong>After matching, 1784 diabetic and 1784 nondiabetic patients were included. At 90 days, diabetes was associated with a higher hospital admission rate (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.16-2.87, <i>P</i> = .01). Diabetic patients had higher rates of subsequent hip arthroscopy at 1 year (OR 1.42, 95% CI 1.12-1.79, <i>P</i> = .004) and 3 years (OR 1.39, 95% CI 1.14-1.69, <i>P</i> = .001). Rates of arthroscopic irrigation and debridement were higher in patients with diabetes at 6 months (OR 1.81, 95% CI 1.09-3.00, <i>P</i> = .019), 1 year (OR 1.96, 95% CI 1.32-2.92, <i>P</i> = .001), and 3 years (OR 1.75, 95% CI 1.29-2.37, <i>P</i> < .001). Infection diagnoses were also higher among diabetic patients at 6 months (OR 1.64, 95% CI 1.06-2.52, <i>P</i> = .033) and 3 years (OR 1.70, 95% CI 1.24-2.33, <i>P</i> = .008).</p><p><strong>Conclusions: </strong>Diabetes was not associated with higher rates of most early systemic complications after hip arthroscopy, although hospital admissions were more common among patients with diabetes. Diabetes was associated with higher rates of subsequent hip arthroscopy procedures, arthroscopic irrigation and debridement, and infection diagnoses after index hip arthroscopy; however, these findings should be interpreted in the context of database limitations, including the inability to confirm laterality or ipsilateral revision status.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70105"},"PeriodicalIF":0.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging Does Not Accurately Estimate the Size of Glenoid Labrum Tears in Patients With Shoulder Instability.","authors":"Samuel K Gerak, Antonia S Caldwell, William A Crites, Cameron Crasto, Benjamin E Jevnikar, Ronak J Mahatme, Shawn A Moore, Susan E Braley, Brian M Grawe","doi":"10.1002/ars2.70125","DOIUrl":"10.1002/ars2.70125","url":null,"abstract":"<p><strong>Purpose: </strong>To compare magnetic resonance imaging (MRI)-based measurements of glenoid labral tears with intraoperative measurements.</p><p><strong>Methods: </strong>A retrospective review was performed of patients that underwent shoulder capsulorrhaphy between 2019 and 2024 at a single academic medical center. All patients with a single labrum tear, an MRI within 6 months of surgery, and historical tear measurements or measurable intraoperative photographs were included in the study. Glenoid labrum tear size was noted using the clockface convention described in \"hours.\" When clockface measurements were not reported on MRI reads, measurements were made by a radiologist. When clockface measurements were not reported in operative notes, measurements were made by an orthopaedic surgeon using intraoperative photographs. A paired <i>t</i> test was used to evaluate any difference between the MRI and intraoperative measurements.</p><p><strong>Results: </strong>Two hundred sixteen glenoid labral tears from 211 patients met inclusion criteria. Average age was 27.2 ± 11.8 years, 68.5% of patients were men, and 56.9% of glenoid labrum tears were right-sided. On average, MRI measurements exceeded intraoperative measurements (4.15 ± 2.90 hours vs 2.80 ± 1.59 hours) with an average difference of 1.36 ± 3.09 hours (95% confidence interval = 0.94-1.77, <i>P</i> < .001) and a correlation of 0.154 (<i>P</i> = .023). A greater difference in measurement was observed among men compared with women (1.64 vs 0.74 hours, <i>P</i> = .044).</p><p><strong>Conclusions: </strong>MRI overestimated glenoid labrum tear size compared with intraoperative measurements and differed substantially between the 2 modalities on a case-by-case basis, with men displaying a larger discrepancy in measurement difference than women. These findings indicate that MRI may be more appropriately used as a categorical tool for confirming the presence of glenoid labral tears, rather than as a precise measure of tear size.</p><p><strong>Level of evidence: </strong>Level III, retrospective diagnostic case series.</p>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":" ","pages":"e70125"},"PeriodicalIF":0.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}