Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Adductor sling and anatomic femoral tunnel fixation both yield high postoperative functional scores after medial patellofemoral ligament reconstruction: A retrospective multicenter study.","authors":"Rodrigo Guiloff Krauss, José Tomás Arteaga Correa, Jorge Isla Villanueva, José Luis Prado García, Francisco Figueroa Berríos, Alex Vaisman Burucker, Rafael Calvo Rodriguez, David Figueroa Poblete","doi":"10.1016/j.jisako.2026.101225","DOIUrl":"10.1016/j.jisako.2026.101225","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Adductor sling (AS) and anatomic femoral tunnel (AFT) are femoral-side fixation options for medial patellofemoral ligament reconstruction (MPFLR), but direct comparative evidence remains limited. We hypothesized similar final Kujala scores and similar outcomes regarding redislocation, residual subjective instability, and subsequent ipsilateral knee surgery with both techniques.</p><p><strong>Methods: </strong>This retrospective multicenter comparative cohort included 84 knees in 78 skeletally mature patients who underwent MPFLR for recurrent lateral patellar instability between 2017 and 2024 (19 AS and 65 AFT cases). Exclusion criteria included previous ipsilateral surgery and concomitant trochleoplasty, corrective femoral osteotomy, or tibial osteotomy other than tibial tubercle osteotomy (TTO). The primary outcome was the final Kujala score. An exploratory parsimonious regression adjusted for age, sex, follow-up duration, and TTO; cluster-robust standard errors accounted for bilateral knees.</p><p><strong>Results: </strong>The final Kujala score, redislocation, and residual-instability outcomes were available for 80 knees (18 AS and 62 AFT cases). Median follow-up was 35.6 months after AS and 55.6 months after AFT (p < 0.001). Concomitant TTO was more frequent after AFT than AS fixation (66.2% versus 31.6%; p = 0.009). Median Kujala scores were 91.0 and 94.0, respectively, (difference: -3.0; 95% confidence interval [CI]: -8.5 to 2.5; p = 0.456). Redislocation occurred in 0 of 18 AS and 2 of 62 AFT knees (p = 1.000). Residual instability occurred in 6 of 18 (33.3%) and 13 of 62 (21.0%) cases, respectively (risk difference: 12.4%; 95% CI: -8.3% to 36.7%; p = 0.347). No subsequent procedures occurred after AS fixation; four occurred after AFT fixation, including two in the same patient for the same complication. In the parsimonious adjusted model, the mean difference for AS versus AFT was -5.31 points (95% CI: -12.61 to 1.99; p = 0.151).</p><p><strong>Conclusion: </strong>Both AS and AFT fixation yielded high postoperative functional scores and low redislocation rates. Neither analysis identified a clear between-technique difference in the final Kujala score. Patient-reported residual instability was more common after AS fixation, although the estimate was imprecise and based on a retrospective, nonstandardized assessment. Prospective studies with standardized indications and instability assessments should clarify which patient subgroups benefit from each technique.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101225"},"PeriodicalIF":3.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip arthroscopy with comprehensive capsular closure following longitudinal outside-in capsulotomy showed improved clinical outcomes in symptomatic borderline hip dysplasia: A retrospective study with minimum 2-year follow-up.","authors":"Shiyu Sha, Yi Liu, Haoling Li, Linyi Shen, Weixing Li, Wenguang Liu, Hongyun Li, Qingfeng Yin","doi":"10.1016/j.jisako.2026.101226","DOIUrl":"10.1016/j.jisako.2026.101226","url":null,"abstract":"<p><strong>Purpose: </strong>To introduce the comprehensive capsular closure technique following longitudinal outside-in capsulotomy (LOIC) and to evaluate its clinical outcomes in patients with symptomatic borderline hip dysplasia (BHD) at a minimum 2-year follow-up period.</p><p><strong>Methods: </strong>This retrospective study included patients (aged 18-60 years) with symptomatic BHD who underwent primary hip arthroscopy for labral tears using LOIC and the comprehensive capsular closure technique between January 2020 and June 2023. The comprehensive capsular closure technique includes proximal capsular augmentation with the indirect head of the rectus femoris, anatomical repair of the zona orbicularis, and mid-capsular plication. Outcomes were assessed using the 12-item International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Achievement rates for the minimal clinically important difference (MCID) and patient acceptable symptom status (PASS) were analyzed.</p><p><strong>Results: </strong>Thirty-six patients (36 hips) were included with a mean age of 37.5 ± 11.0 years and a mean follow-up of 3.7 ± 1.0 years. Intraoperatively, femoral head cartilage degeneration was observed in 63.9% of cases, and ligamentum teres tears in 77.8%. The median thickness of the middle part of the anterior capsule was 5 mm measured under arthroscopy. Improvements in iHOT-12 (45.2 ± 7.8 vs 79.5 ± 7.0), VAS (3.7 ± 1.0 vs 1.4 ± 0.8) and WOMAC (18.3 ± 8.4 vs 9.1 ± 3.7) were observed from preoperative to final follow-up (all p < 0.001). MCID achievement rates were 100% for iHOT-12, 91.7% for VAS, and 72.2% for WOMAC. PASS achievement rates were 88.9% for iHOT-12, 80.6% for VAS, and 58.3% for WOMAC. No severe complications occurred.</p><p><strong>Conclusions: </strong>Hip arthroscopy with comprehensive capsular closure following LOIC may represent a safe and effective technique for treating symptomatic BHD patients, with favorable clinical outcomes expected in the short- to mid-term follow-up.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101226"},"PeriodicalIF":3.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A diagnostic model integrating clinical, magnetic resonance imaging, and arthroscopic findings accurately identified hypermobile lateral meniscus: Development and internal validation.","authors":"Horacio Rivarola, Cristian Collazo, Marcos Palanconi, Marcos Meninato, Alejandro Barros Castro, Carlos Peñaherrera-Carrillo, Francisco Endara Urresta","doi":"10.1016/j.jisako.2026.101227","DOIUrl":"10.1016/j.jisako.2026.101227","url":null,"abstract":"<p><strong>Background: </strong>To develop and internally validate a diagnostic model for hypermobile lateral meniscus (HLM) integrating clinical symptoms, magnetic resonance imaging (MRI) findings, and dynamic arthroscopic assessment.</p><p><strong>Methods: </strong>A retrospective diagnostic model study was performed, including 100 consecutive patients evaluated for suspected lateral meniscal pathology at a tertiary knee surgery center. All patients underwent standardized clinical examination, preoperative MRI, and arthroscopic assessment of lateral meniscal mobility, which served as the reference standard. Candidate predictors were restricted to preoperative clinical and MRI variables, including intermittent locking, posterolateral McMurray test, meniscocapsular gap, and suspected meniscotibial discontinuity. Arthroscopic findings were used exclusively to establish the reference-standard diagnosis and were not entered into the diagnostic model. A penalized logistic regression model with least absolute shrinkage and selection operator (LASSO) selection was used to identify independent predictors and construct the Hypermobile Meniscus Index (HMI). Internal validation was performed using bootstrap resampling, and robustness was assessed with Monte Carlo simulation.</p><p><strong>Results: </strong>HLM was confirmed arthroscopically in 47% of patients. The final model included five independent predictors and demonstrated excellent discriminative performance, with an area under the receiver operating characteristic curve (AUC) of 0.84 (95% confidence interval [CI], 0.83-0.95). At the optimal cut-off (≥5 points), sensitivity was 81%, specificity 79.2%, positive predictive value 77.6%, and negative predictive value 82.4%. Calibration analysis showed good agreement between predicted and observed probabilities (calibration slope 0.94, intercept 0.03; and Brier score 0.13). Bootstrap validation yielded an optimism-corrected AUC of 0.82. Monte Carlo simulation confirmed stability of model performance across varying prevalence scenarios, with consistent sensitivity and specificity ranges.</p><p><strong>Conclusion: </strong>A diagnostic model combining clinical and MRI findings demonstrated internally validated performance for identifying HLM as defined by dynamic arthroscopy. The HMI provides a structured framework to improve preoperative recognition and guide targeted arthroscopic assessment in patients with mechanical lateral compartment symptoms and inconclusive imaging. External validation is required prior to routine clinical implementation.</p><p><strong>Level of evidence: </strong>Level III, diagnostic study.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101227"},"PeriodicalIF":3.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral extra-articular augmentation is associated with improved graft survival after revision anterior cruciate ligament reconstruction.","authors":"Cristian Collazo, Horacio Rivarola, Marcos Palanconi, Marcos Meninato, Carlos Peñaherrera-Carrillo, Alejandro Barros Castro, Francisco Endara Urresta","doi":"10.1016/j.jisako.2026.101224","DOIUrl":"10.1016/j.jisako.2026.101224","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Revision anterior cruciate ligament reconstruction (ACLR) remains associated with higher graft failure rates and greater residual rotational laxity than primary reconstruction. Although lateral extra-articular augmentation has been increasingly incorporated into revision surgery, evidence remains limited by confounding related to treatment allocation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To evaluate the association between lateral extra-articular augmentation and graft survival after first-time single-stage revision ACLR using propensity score-based inverse probability of treatment-weighting (IPTW), and to compare postoperative rotational laxity and patient-reported outcomes, with the direct comparison between lateral extra-articular tenodesis (LET) and anterolateral ligament (ALL) reconstruction considered exploratory. We hypothesized that lateral extra-articular augmentation would be associated with lower graft-failure risk and less residual rotational laxity than isolated revision ACLR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 364 consecutive patients undergoing first-time single-stage revision ACLR between January 2015 and December 2019 were screened at three high-volume knee centers. Sixty-four patients were excluded during eligibility assessment, leaving 300 eligible patients, all of whom were included in the final cohort. The observed treatment distribution was 100 isolated revision ACLRs, 100 revision ACLRs with LET, and 100 revision ACLRs with ALL reconstruction; these group sizes were not created by propensity-score matching, frequency matching, sampling, capping, or post hoc balancing. LET and ALL reconstruction were pooled as lateral extra-articular augmentation for the primary comparison. IPTW was used to improve balance in measured baseline characteristics. Secondary outcomes included residual pivot shift, instrumented anterior laxity, postoperative International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS) Sport scores, and return to preinjury sport.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During a mean follow-up of 5.8 ± 1.1 years, graft failure occurred in 20 of 100 patients (20.0%) after isolated revision ACLR and 19 of 200 patients (9.5%) after lateral extra-articular augmentation. Five-year weighted graft survival was 79.9% after isolated revision and 90.6% after augmentation. Lateral augmentation was associated with a lower risk of graft failure (IPTW-adjusted hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.28-0.74; P = 0.002). Residual pivot shift was observed in 34 of 200 patients (17.0%) after augmentation and 34 of 100 patients (34.0%) after isolated revision ACLR (weighted odds ratio [OR], 0.42; 95% CI, 0.25-0.71; P = 0.001). Mean instrumented anterior laxity was 2.60 ± 1.00 mm after isolated revision ACLR and 2.25 ± 0.85 mm after augmentation; the device-adjusted difference was -0.21 mm (95% CI, -0.38 to -0.04; P = 0.015) and was not considered","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101224"},"PeriodicalIF":3.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-term clinical outcomes of one and two patient-specific mini-implants for focal (osteo-)chondral lesions of the distal femur.","authors":"Malte Leo Rüter, Clemens Kösters, Daniel Aaron den Toom","doi":"10.1016/j.jisako.2026.101234","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101234","url":null,"abstract":"<p><strong>Objectives: </strong>Patient-specific mini-metal implants may represent a treatment option for middle-aged patients with focal (osteo-)chondral lesions of the distal femur when biological repair has failed or when other individual risk factors make biological repair unlikely to succeed. Both single-implant approaches for one and dual-implant approaches for two separate lesions in the same knee were investigated. This study evaluates the clinical performance of these implants for one or two lesions in one knee.</p><p><strong>Methods: </strong>This retrospective single-center study was conducted using prospectively collected data of consecutive patients treated with one or two implants (Episealer® Implant, Episurf, Stockholm, Sweden) with a mean follow-up of 38 months. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analogue Scale (VAS) for pain, adverse events, and conversions to unicompartmental or total knee arthroplasty were assessed.</p><p><strong>Results: </strong>Statistically significant improvements in all KOOS subscales and VAS pain score compared to the preoperative values were observed in both groups (one implant n = 45; two implants n = 48; all p < 0.001). KOOS Symptoms improved from 48.7 ± 17.9 to 74.3 ± 21.6 in the one-implant group and from 44.7 ± 15.0 to 66.0 ± 24.8 in the two-implant group. Similar improvements were observed across all remaining KOOS subscales. The comparison between the two groups revealed slightly better improvements for the one-implant group. Implant survival according to Kaplan-Meier analysis was 88.1% for the one-implant group (number at risk = 21) and 83.4% for the two-implant group (number at risk = 27) after 60 months.</p><p><strong>Conclusion: </strong>Patient-specific mini-metal implants may represent a viable treatment option for middle-aged patients when biological repair is not feasible. Within the limitations of this study, the findings suggest that this approach can be considered for patients with one as well as patients with two (osteo-)chondral lesions. An acceptable implant survival was observed, regardless of lesion count.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101234"},"PeriodicalIF":3.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee Morphometry in Asian and Western Populations: A Systematic Review and Meta-Analysis of Anterior Cruciate Ligament-Related Parameters.","authors":"Francis Fong Jia Yi, Wang Chen, James Hoi Po Hui, Lee Yee Han Dave","doi":"10.1016/j.jisako.2026.101233","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101233","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Intercondylar notch dimensions, anterior cruciate ligament (ACL) width, and posterior tibial slope (PTS) are recognized as important anatomical factors associated with ACL injury risk, and anatomical reference values for these parameters are derived predominantly from Western cohorts. Individual studies suggest that ACL-related knee morphology may vary across populations, but whether such differences are consistent between Asian and Western populations across commonly assessed magnetic resonance imaging (MRI)-measured parameters remains uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To determine whether MRI-measured knee morphology differs between geographically defined Asian and Western adult populations with radiologically intact ACLs across six prespecified parameters: femoral notch volume (FNV), notch width (NW), notch width index (NWI), medial tibial slope (MTS), lateral tibial slope (LTS), and ACL width.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) [CRD420261403854]. Four electronic databases were searched from inception to 11 June 2026 for MRI studies reporting eligible morphometric outcomes in adults with radiologically intact ACLs. Studies were classified as Asian or Western by country of cohort recruitment, reflecting geographic origin rather than verified individual ethnicity. Single-arm random-effects meta-analyses using restricted maximum likelihood estimation were pooled separately by cohort and compared using the Q test for subgroup differences. Meta-regression evaluated geographic cohort, measurement technique, mean age and sex composition as potential sources of between-study variation. Statistical significance was defined as two-sided p &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-one studies (2,463 knees; 15 Asian, 16 Western) were included. No statistically significant between-cohort differences were identified for FNV (7.26 versus 7.64 cm&lt;sup&gt;3&lt;/sup&gt;, p = 0.78), NW (20.13 versus 19.86 mm, p = 0.77), NWI (0.28 versus 0.24, p = 0.45), MTS (5.66° versus 6.04°, p = 0.67) or LTS (5.73° versus 6.24°, p = 0.53). ACL width also did not differ statistically significantly (5.20 versus 7.62 mm, p = 0.08). Heterogeneity, quantified using the I&lt;sup&gt;2&lt;/sup&gt; statistic, was substantial across all outcomes (I&lt;sup&gt;2&lt;/sup&gt; = 75-100%) and prediction intervals were wide and overlapping between cohorts. Geographic cohort was not a statistically significant moderator of any outcome (p = 0.09-0.82). Measurement technique was associated with LTS (p = 0.03), explaining 44% of the between-study variance (R&lt;sup&gt;2&lt;/sup&gt;), but with no other outcome (p = 0.28-0.89), whereas study-level sex composition was associated with NW (regression coefficient [β] = 6.48 mm, p = 0.02), FNV (β","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101233"},"PeriodicalIF":3.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Adaptation and Psychometric Validation of the Persian Version of the University of California Los Angeles Activity Scale in Patients Following Total Knee Arthroplasty.","authors":"Fardis Vosoughi, Golnaz Nikeghbali, Faryar Koolinia, Masoud Imani, Amirreza Entezari, Iman Menbari Oskouie","doi":"10.1016/j.jisako.2026.101232","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101232","url":null,"abstract":"<p><strong>Introduction: </strong>The University of California Los Angeles (UCLA) Activity Scale is a widely used score used to assess physical activity. No reliable Persian validation of the UCLA score in Total Knee Arthroplasty (TKA) patients exists. This study aims to translate, culturally adapt, and validate the Persian version of UCLA (p-UCLA) activity scale in TKA patients.</p><p><strong>Methods: </strong>Following the established cross-cultural guidelines, the UCLA activity scale was translated to Persian using forward-backward translation. A total of 104 TKA patients completed the p-UCLA, Oxford Knee Score (OKS), International Documentation Committee Subjective Form (IKDC-SF), and Forgotten Joint Score-12 (FJS-12). Construct validity was assessed using the Spearman Correlation coefficient, while reliability was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. Floor and ceiling effects were examined.</p><p><strong>Results: </strong>The p-UCLA showed excellent test-retest reliability (ICC = 0.98; P < 0.001). Construct validity was supported by moderate to strong correlation with OKS (r = 0.75-0-78; p < 0.001), IKDC-SF (r = 0.34-0.66; p < 0.001), and FJS-12 (r = 0.69; p < 0.001). No floor or ceiling effect were observed. Bland- Altman analysis showed minimal bias and high measurement stability.</p><p><strong>Conclusion: </strong>The p-UCLA activity scale is a reliable and valid instrument for assessing activity levels in Persian patients after TKA.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101232"},"PeriodicalIF":3.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Medial Posterior Tibial Slope Is Associated with Patellofemoral Cartilage Lesions: A Matched-Pair Case-Control Study.","authors":"Stephan Oehme, José Arteaga, Moses El-Kayali, Felix Wolf, Benjamin Bartek, Clemens Gwinner, Tobias Winkler, Tobias Jung, Danko Dan Milinkovic","doi":"10.1016/j.jisako.2026.101228","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101228","url":null,"abstract":"<p><strong>Objective: </strong>The medial posterior tibial slope (MPTS) is a key anatomical parameter influencing knee joint biomechanics and load distribution. This study aimed to analyze whether the MPTS is associated with cartilage lesions in different anatomical regions, including the medial and lateral femoral condyles, the trochlea and retropatellar surface.</p><p><strong>Methods: </strong>Between 09/2013 and 02/2024, 501 patients with cartilage lesions of the knee underwent matrix-induced autologous chondrocyte implantation (MACI) at a single-center university hospital. After applying the eligibility criteria, 280 patients were included. Each case was matched to matched controls by age and sex using a 1:1 matching design. MPTS was measured independently by three blinded raters using the Dejour method, and the mean value was used for analysis. Inter-rater reliability was assessed via intraclass correlation coefficient (ICC). Subgroup analysis was performed according to lesion location (medial/lateral femoral condyle, trochlea, retropatellar) using a many-to-one matching design. Linear mixed-effects regression models accounting for age, sex, and the matched-set structure were used as the primary analyses; unpaired t-tests with Cohen's d effect sizes served as sensitivity analyses. Adjusted mean differences and model-based standardized mean differences were reported with 95% confidence intervals (CI), and location-specific comparisons were adjusted for multiple testing.</p><p><strong>Results: </strong>The MACI group had a greater MPTS than matched controls (9.73° vs. 8.92°; adjusted mean difference, 0.80°; 95% CI 0.32 to 1.27; p < 0.01). Inter-rater reliability was excellent (ICC = 0.921). In the location-specific analyses, greater MPTS values were observed in patients with retropatellar lesions (n = 100 vs. 200; adjusted mean difference, 0.92°; 95% CI 0.05 to 1.80; adjusted p = 0.03) and trochlear lesions (n = 34 vs. 68; adjusted mean difference, 1.60°; 95% CI 0.11 to 3.10; adjusted p = 0.03). No statistically significant differences were identified for medial (n = 73 vs. 146; adjusted mean difference, 0.15°; 95% CI -0.87 to 1.17; adjusted p = 0.99) or lateral femoral condylar lesions (n = 36 vs. 72; adjusted mean difference, 1.01°; 95% CI -0.44 to 2.46; adjusted p = 0.29). The unadjusted sensitivity analyses yielded consistent conclusions.</p><p><strong>Conclusion: </strong>An increased MPTS was associated with cartilage lesions in the patellofemoral compartment, but not in the femoral condyles. This suggests a compartment-specific relationship between MPTS and cartilage lesions in the knee joint. However, their clinical relevance remains uncertain.</p><p><strong>Level of evidence: </strong>Retrospective matched case-control study, Level III.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101228"},"PeriodicalIF":3.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual meniscal extrusion was not associated with 2-year clinical outcomes after posterior lateral meniscus root repair in a cohort predominantly undergoing anterior cruciate ligament reconstruction.","authors":"Gustavo A Rincón, Camilo Martínez, Eiber Sanabria, David Marulanda, Jorge Quintero, Andrés Baquero, Edgar Muñoz","doi":"10.1016/j.jisako.2026.101229","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101229","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>The clinical significance of residual meniscal extrusion after posterior lateral meniscus root repair, particularly with concomitant anterior cruciate ligament (ACL) reconstruction, remains uncertain. This study evaluated longitudinal clinical and imaging outcomes after transtibial pull-out repair of traumatic posterior lateral meniscus root tears and examined whether residual extrusion was associated with the final Lysholm score or change from baseline at 2-year follow-up.</p><p><strong>Methods: </strong>Thirty patients with arthroscopically confirmed traumatic posterior lateral meniscus root tears underwent transtibial pull-out repair and completed 2-year follow-up; 28 underwent concomitant ACL reconstruction. Lysholm scores were obtained preoperatively and at 3, 6, 12, and 24 months. Residual extrusion was measured once on 1.5-tesla magnetic resonance imaging (MRI) at 24 months. Associations of extrusion with the postoperative score and score change were assessed using Spearman correlation. A sensitivity analysis was restricted to patients with concomitant ACL reconstruction.</p><p><strong>Results: </strong>The cohort included 8 women (26.7%) and 22 men (73.3%), with a mean age of 29.1 ± 6.2 years. The median Lysholm score increased progressively from 61 preoperatively to 71.5, 79, 89.5, and 95 at 3, 6, 12, and 24 months, respectively (Friedman χ²[4] = 120.0; p < 0.0001; Kendall W = 1.00). Twenty-nine patients (96.7%) reported returning to their preinjury recreational sport. Mean residual extrusion was 2.06 ± 0.51 mm. Extrusion was not statistically significantly associated with the 24-month Lysholm score (Spearman ρ = -0.13; 95% confidence interval, -0.48 to 0.25; p = 0.495) or change from baseline (ρ = 0.18; p = 0.340). Results were similar in the sensitivity analysis of the 28 patients with concomitant ACL reconstruction.</p><p><strong>Conclusion: </strong>In this small cohort, predominantly comprising patients treated with combined meniscal root repair and ACL reconstruction, Lysholm scores improved over 2 years. Within the limited observed extrusion range of 1.20 to 3.15 mm, no statistically significant association with clinical outcomes was demonstrated.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101229"},"PeriodicalIF":3.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes Following Stand-Alone Extracorporeal Shockwave Therapy Differ Between Bony and Soft Tissue Pathologies of the Foot and Ankle.","authors":"Warren P Austin, Rachit Saggar, Joseph P Mullen, Abdulganeey O Olawin, Soichi Hattori, Lauren K Lewis, MaCalus V Hogan","doi":"10.1016/j.jisako.2026.101221","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101221","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Extracorporeal Shockwave Therapy (ESWT) has emerged as a non-invasive option for treating musculoskeletal conditions. However, its effectiveness as a standalone treatment for certain foot and ankle pathologies needs further investigation. The purpose of this study is to evaluate ESWT's effectiveness as a primary intervention for bony versus soft tissue pathologies of the foot and ankle.</p><p><strong>Methods: </strong>A retrospective analysis identified patients who received three weekly ESWT sessions (2020-2024) from a single provider for foot and ankle pathology, using standardized parameters (10 mJ, 10 Hz, 1500 shockwaves). Outcome measures included Foot and Ankle Ability Measure (FAAM) scores, Visual Analog Scale (VAS) for pain, Patient-Reported Outcomes Measurement Information System (PROMIS) scores, Global Rating of Change (GRC), and Patient Acceptable Symptomatic State (PASS) values, all collected pre-treatment and at least 4 weeks post-treatment.</p><p><strong>Results: </strong>Eighty-five patients (52 females, 33 males; mean age 34.7±18.1 years) were stratified into bony (n=39) and soft tissue (n=46) pathology groups. Of the 42 patients with reported outcome measures (20 bony, 22 soft tissue), bony pathologies showed statistically significant improvements in FAAM ADL, FAAM Sports, PROMIS Physical and Mental Health, and VAS (all p<0.001). Soft tissue pathologies showed modest, non-statistically significant improvements. GRC scores indicated improvement in 95% of patients with bony pathology, compared to 52.4% for those with soft tissue. PASS thresholds were achieved by 35% of patients with bony pathology, compared to 14.3% for those with soft tissue conditions. Bony tissue pathologies were predominantly observed in athletes (87.2%), while soft tissue pathologies were more common in non-athletes (80.4%).</p><p><strong>Conclusion: </strong>In the short-term, ESWT provided noteable greater therapeutic benefit for bony tissue pathologies of the foot and ankle compared to soft tissue conditions.</p><p><strong>Level of evidence: </strong>Level III, Retrospective Cohort Study.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101221"},"PeriodicalIF":3.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}