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

{"title":"Greater Deltoid Coverage on Pre-Operative MRI Correlates with Improved Early Functional Outcomes after Reverse Shoulder Arthroplasty.","authors":"Hannah M Lie, Wen Qiang Lee, Denny Tt Lie","doi":"10.1016/j.jisako.2025.100912","DOIUrl":"https://doi.org/10.1016/j.jisako.2025.100912","url":null,"abstract":"<p><strong>Introduction: </strong>Reverse shoulder arthroplasty (RSA) translates deltoid contraction into abduction and rotational forces, allowing the deltoid to replace the function of the deficient rotator cuff. While RSA is classically contraindicated in patients with deltoid deficiency, there is no consensus in the literature as to the importance of the deltoid muscle in predicting clinical outcomes. Therefore, the extent or arc of the deltoid wrapped around the humeral head, and the thickness of the deltoid muscle at specific intervals are investigated as possible predictors of post-RSA outcomes in this study.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data was performed in a tertiary institution. Patients who had undergone a reverse shoulder arthroplasty from 2011 to 2021 were included. Pre- and post-operative radiographic measurements of deltoid wrap arc anteriorly and posteriorly, as well as thickness at 45-degree intervals were taken. These were correlated with forward flexion and abduction range of motion (ROM) and clinical scores pre-operatively and at 3, 6 months, 1 and 2-year post-operatively. A statistical significance of p<0.05 was taken.</p><p><strong>Results: </strong>Forty-five cases from forty-one patients were included. From the plane of the native glenoid, the deltoid arc ranges at an average of 21.5˚ anteriorly to 168˚ posteriorly. The thickness of the deltoid at 45˚ was correlated with greater flexion and abduction ROM at the 6-month mark (p=0.037 and p=0.014 respectively). Greater deltoid thickness at 45^o was also correlated with better early functional outcomes (Constant, University of California-Los Angeles and Oxford scores) at 6-months (p=0.007, p=0.004 and p=0.031 respectively). No correlation was found with late functional outcomes at 2-years.</p><p><strong>Conclusion: </strong>Patients who undergo RSA with a greater pre-operative deltoid thickness, especially at 45˚ from the anterior, are associated with better forward flexion and abduction ROM, as well as improved functional outcomes 6 months post-operatively. There may be value in prehabilitation to improve early post-operation outcomes.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"100912"},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250093","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":"From data to decisions: The evolution and impact of hip preservation registries","authors":"Ryan McWilliams ,&nbsp;Ajay Malviya ,&nbsp;Vikas Khanduja","doi":"10.1016/j.jisako.2025.100911","DOIUrl":"10.1016/j.jisako.2025.100911","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100911"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188158","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":"Assessment and Surgical Correction of Posterior Tibial Slope in Revision Anterior Cruciate Ligament Surgery: An International Expert Delphi Consensus Statement.","authors":"Anja M Wackerle, Stephen Marcaccio, Nicholas Apseloff, Alan Getgood, Volker Musahl, Sachin Tapasvi","doi":"10.1016/j.jisako.2025.100900","DOIUrl":"https://doi.org/10.1016/j.jisako.2025.100900","url":null,"abstract":"<p><strong>Purpose: </strong>The aim was to provide international guidelines to enhance decision-making regarding the definition and evaluation of increased posterior tibial slope (PTS) and the role of anterior closing wedge high tibial osteotomy (ACWHTO) in the setting of revision anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Methods: </strong>This guideline is based on responses from 46 international orthopedic surgeons with expert experience in knee pathologies and osteotomy. Based on a literature review, each expert drafted and commented on a set of core statements. The provided comments were blinded and discussed within the working group to refine the statements. In a subsequent round of surveys, all experts discussed with the final 32 statements. Consensus was achieved when at least 80% of survey respondents fully agreed.</p><p><strong>Results: </strong>With respect to ACWHTO for PTS reduction, there was consensus achieved for using the medial plateau as a measurement for PTS measuring, aiming for PTS correction of 5 - 7 degrees, individualizing osteotomy wedge thickness, and performing ACWHTO and revision ACLR in a single stage. There was no consensus on the type of radiographs to be used, a cut-off value for increased PTS, an absolute indication for ACWHTO the osteotomy technique, nor type of fixation. The International consensus statements aim to bridge the gap between research and clinical application to enhance clinicians' decision-making in revision ACLR management and to focus future areas of required research.</p><p><strong>Conclusion: </strong>The literature review confirmed a paucity of evidence to guide clinicians in the diagnosis and surgical management of increased PTS. An agreement could be achieved for 25/32 statements (78%) on the definition and assessment of PTS, indication, planning, surgical decision-making, and peri- and postoperative management for ACWHTO. While no consensus could be achieved for the definition of a cut-off value for pathological PTS, consensus was reached for a variety of statements on diagnostic and surgical aspects.</p><p><strong>Level of evidence: </strong>V, expert opinion.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"100900"},"PeriodicalIF":2.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209806","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":"Satisfactory functional outcomes and low recurrence rates at a mean 10-year follow-up after combined staged synovectomy and external radiotherapy for diffuse pigmented villonodular synovitis of the knee","authors":"Fahmy Samir Fahmy MD,&nbsp;Mohamed ElAttar MD,&nbsp;Ahmed Hatem Farhan MD,&nbsp;Sami Ibrahim Sadek MD,&nbsp;Mahmoud Abdo Mahmoud MD,&nbsp;Hossam Fathi Mahmoud MD","doi":"10.1016/j.jisako.2025.100907","DOIUrl":"10.1016/j.jisako.2025.100907","url":null,"abstract":"<div><h3>Introduction</h3><div>Diffuse pigmented villonodular synovitis (PVNS) of the knee is a locally destructive lesion that tends to recur following surgical synovectomy. This study aims to evaluate the long-term functional outcomes and recurrence rates of combined staged synovectomy and external radiotherapy in managing diffuse PVNS of the knee.</div></div><div><h3>Methods</h3><div>The data of twenty-three patients who had a diffuse PVNS of the knee between June 2011 and September 2017 were retrospectively collected. The patients underwent combined staged anterior arthroscopic and open posterior synovectomy followed by low-dose external radiotherapy (average 3000 ​cGy). Functional outcomes were assessed preoperatively and at the final follow-up using the International Knee Documentation Committee (IKDC) score, Musculoskeletal Tumor Society (MSTS) score, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, and SF-36 score, along with the knee motion measurements. Statistical analysis evaluated the changes in functional scores and recurrence rates, with a p-value &lt; 0.05 as the cut-off level of significance.</div></div><div><h3>Results</h3><div>The mean follow-up time was 121.1 ​± ​20.2 months, with a minimum of 85 months. At the final follow-up, the mean range of motion (ROM) improved from 84.1 ​± ​16.2° to 110.4 ​± ​9.7°. The WOMAC score increased significantly from 44.5 ​± ​5.1 to 81.5 ​± ​6.3 (p ​&lt; ​0.00001). The IKDC score improved from 43.7 ​± ​8.1 to 79.1 ​± ​7.4 (p ​&lt; ​0.00001), MSTS scores from 6.7 ​± ​2.1 to 20.3 ​± ​5.7 (p ​&lt; ​0.00001), and SF-36 scores from 28.6 ​± ​7.4 to 77.4 ​± ​11.5 (p ​&lt; ​0.00001). Two recurrent cases were documented at the last follow-up visit (8.6%), with a minor complication rate of 21.7%.</div></div><div><h3>Conclusion</h3><div>Combined staged synovectomy and external radiotherapy is an effective treatment for diffuse PVNS of the knee. It has demonstrated significant functional improvement and low recurrence rates over extended follow-up periods, supporting its role as a durable and reliable treatment strategy.</div></div><div><h3>Level of evidence</h3><div>Level IV, retrospective cohort.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100907"},"PeriodicalIF":2.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152203","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":"The sport function subscale of the Copenhagen Hip and Groin Outcome Score could not be an indicator of postural balance in soccer players with groin pain","authors":"Fatma Chaari ,&nbsp;Nicolas Peyrot ,&nbsp;Sébastien Boyas ,&nbsp;Abderrahmane Rahmani ,&nbsp;Haithem Rebai ,&nbsp;Sonia Sahli","doi":"10.1016/j.jisako.2025.100906","DOIUrl":"10.1016/j.jisako.2025.100906","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the association between the Copenhagen Hip and Groin Outcome Score (HAGOS) related to sport and recreation (Sport/Rec) and static and dynamic postural balance in soccer players with groin pain. We hypothesized that better postural balance outcomes would correlate with higher HAGOS Sport/Rec scores in these players.</div></div><div><h3>Methods</h3><div>Eighty-four soccer players with groin pain from seven soccer teams volunteered to take part in the study. An investigator collected static (stabilometric platform) and dynamic (Y-Balance Test (Y-BT)) postural balance, and patient-reported outcome measures (HAGOS) in the research laboratory. To investigate the association between the postural balance outcomes and the HAGOS Sport/Rec scores, Spearman’s correlation coefficient (<em>r</em>) was used.</div></div><div><h3>Results</h3><div>The included participants presented the following demographic information: age: 21.56 ​yrs (2.22), height: 1.78 ​m (0.06), body mass: 75.10 ​kg (8.41), body mass index: 23.80 ​km/m² (2.50). The HAGOS Sport/Rec scores showed a small significant positive correlation with the posteromedial reach distance for the Y-BT on both injured (<em>r</em> ​= ​0.21, p ​= ​0.04) and non-injured (<em>r</em> ​= ​0.22, p ​= ​0.04) limbs. However, no significant associations (p ​&gt; ​0.05) were found between these scores and the other Y-BT outcomes or with the static bipedal and unipedal postural balance findings.</div></div><div><h3>Conclusion</h3><div>Overall, the findings of the present study showed only small positive correlations between the posteromedial direction of the Y-BT and the HAGOS Sport/Rec scores. Given the observed small magnitude of correlations and the non-significant associations between the HAGOS Sport/Rec scores and the rest of the Y-BT outcomes or static postural balance outcomes, it appears that Sport/Rec may not serve as a comprehensive indicator for postural balance outcomes. Therefore, coaches and clinicians should consider combining postural balance assessments with the HAGOS Sport/Rec scores to comprehensively tailor their interventions to address both the subjective and objective functional aspects of groin pain in soccer players.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100906"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143898","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":"Proximal fibular osteotomy in conjunction with supramalleolar osteotomy in concurrent management of ankle and knee osteoarthritis: A case series","authors":"Ramesh Radhakrishnan MBBS(Spore), MRCS (Eng),&nbsp;Akshay Padki MBBCh BAO (Ire), MRCS (Ire),&nbsp;Rui Xiang Toh MBBS (Spore), MRCS (Edin), MMed (Orth), FRCSEd (Orth),&nbsp;Kae Sian Tay MBBS (S'pore), MMed (Ortho), MRCSEd, FRCSEd (Ortho),&nbsp;Kong Hwee Lee MBBS (Spore), MRCS (Edin), MMed (Ortho), FRCS (Edin),&nbsp;Nicholas Eng Meng Yeo MBBS (Spore), MRCS (Edin), MMed (Ortho), FRCS (Edin), FAMS","doi":"10.1016/j.jisako.2025.100895","DOIUrl":"10.1016/j.jisako.2025.100895","url":null,"abstract":"<div><div>Management of ankle osteoarthritis (OA) remains a challenge due to its profound impact on pain, function, and quality of life. Supramalleolar osteotomy (SMO) is a joint-preserving procedure that addresses malalignment and redistributes joint loads, while proximal fibular osteotomy (PFO) targets varus deformities and lateral instability. This study explores the outcomes of combining SMO and PFO to treat concurrent ipsilateral ankle and knee OA, providing a comprehensive approach to lower limb pathology.</div><div>We report two cases of patients with symptomatic ankle and knee OA managed using a combined surgical strategy. Both patients underwent preoperative clinical evaluations, radiographic assessments, and standardized rehabilitation protocols postoperatively. Surgical procedures included ankle arthroscopic debridement, microfracture, SMO, PFO, and lateral ligament reconstruction as required.</div><div>Postoperative outcomes demonstrated improvements in alignment, pain, and function. Patient-reported outcome measures showed marked improvements 6 months postoperatively, with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores increasing from 40 to 67 in one patient and from 69 to 94 in the other. Pain scores on the visual analog scale (VAS) showed substantial reductions in both cases, and quality of life domains assessed via the RAND 36-item health survey (RAND 36) questionnaire, including physical function and vitality, demonstrated marked gains. Radiographic analysis confirmed effective realignment and increased joint space, with improvements in key angles such as the tibial anterior surface (TAS) angle and talar tilt (TT).</div><div>These cases highlight the synergistic effect of SMO and PFO in managing complex ipsilateral lower limb OA. Radiographic and patient-reported outcomes demonstrated improved alignment, pain relief, and functionality. SMO addressed varus malalignment in the ankle, while PFO facilitated medial opening and enhanced correction of TT. Additionally, combining these techniques reduced mechanical stress on the medial knee compartment.</div><div>This dual approach shows some promise as a joint-preserving alternative for patients with moderate to severe ipsilateral ankle and knee OA. However, meticulous preoperative planning and patient selection remain essential to optimize outcomes. Further studies with larger cohorts and long-term follow-up are needed to validate these findings and refine surgical indications.</div></div><div><h3>Level of evidence</h3><div>Level V, Case report.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100895"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081217","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":"Comparable clinical outcomes between patients aged over and under 60 ​years undergoing medial meniscus posterior root repair using a soft suture anchor technique: A preliminary retrospective cohort study","authors":"Napatpong Thamrongskulsiri ,&nbsp;Chitapoom Choentrakool ,&nbsp;Thanathep Tanpowpong ,&nbsp;Somsak Kuptniratsaikul ,&nbsp;Danaithep Limskul ,&nbsp;Thun Itthipanichpong","doi":"10.1016/j.jisako.2025.100896","DOIUrl":"10.1016/j.jisako.2025.100896","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate whether functional outcome scores in patients over 60 years of age improve after arthroscopic medial meniscus posterior root repair using a soft suture anchor. Additionally, it aimed to compare postoperative outcomes between patients over 60 years and those under 60 years of age.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of 30 patients who underwent medial meniscus posterior root repair between June 2019 and February 2023. The patients were divided into two groups (≥60 years, n ​= ​15; &lt;60 years, n ​= ​15). Outcomes were assessed using the International Knee Documentation Committee (IKDC) and Lysholm scores at two years, along with MRI-based meniscus healing and radiographic osteoarthritis progression.</div></div><div><h3>Results</h3><div>Both age groups demonstrated statistically significant improvement in functional scores at two years. In the ≥60 years age group, IKDC improved from 31.9 ​± ​8.8 to 61.5 ​± ​11.3 (<em>P</em> ​&lt; ​0.001) and Lysholm from 49.1 ​± ​14.9 to 87.6 ​± ​10.5 (<em>P</em> ​&lt; ​0.001). In the &lt;60 years group, IKDC improved from 35.7 ​± ​10.4 to 54.3 ​± ​8.1 (<em>P</em> ​&lt; ​0.001) and Lysholm from 52.1 ​± ​19.3 to 82.0 ​± ​12.4 (<em>P</em> ​&lt; ​0.001). No statistically significant differences were observed between the groups for functional scores, meniscal healing (<em>P</em> ​= ​0.352) or osteoarthritis progression (<em>P</em> ​= ​0.762).</div></div><div><h3>Conclusions</h3><div>The patients aged ≥60 years who underwent arthroscopic medial meniscus posterior root repair using a soft suture anchor demonstrated functional improvements comparable to younger patients. Age alone should not be a contraindication for this procedure, though long-term follow-up is warranted to assess osteoarthritis progression.</div></div><div><h3>Level of Evidence</h3><div>Level III—retrospective cohort study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100896"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081216","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":"Tibial shaft fracture with knee and proximal tibiofibular dislocation: Case report","authors":"Cristian Camilo Fajardo Cantillo ,&nbsp;Oriana Pérez Gibson,&nbsp;Daniel Gaitan Vargas","doi":"10.1016/j.jisako.2025.100902","DOIUrl":"10.1016/j.jisako.2025.100902","url":null,"abstract":"<div><div>Tibial shaft fractures are the most common type of long bone fracture, frequently associated with high-energy traumas such as traffic accidents, which carry a high mortality rate in Colombia. The combination of an open tibial shaft fracture with knee and proximal tibiofibular joint dislocation is extremely rare. The presented case involves these injuries, which were managed surgically in a single-stage with a follow-up of six months and good functional outcomes. Intramedullary nailing of the tibia was performed using an extra-articular, extra-synovial, semi-extended technique, which optimized tibial alignment for reduction and mitigated one of the common complications of intramedullary nailing: anterior knee pain. The proximal tibiofibular dislocation was reduced and stabilized using two screws, followed by a bucket-handle suture of the lateral meniscus, single-bundle posterior cruciate ligament (PCL), and anterior cruciate ligament (ACL) reconstructions. This injury combination has not been previously reported, highlighting its clinical and academic relevance in advancing medical knowledge and serving as a reference for similar cases. Furthermore, this case underscores the importance of a well-structured management approach for victims of high-energy trauma and the necessity for surgeons to be adept at addressing multifaceted surgical challenges. Finally, it emphasizes the benefits of a single-stage surgical approach in facilitating early rehabilitation and optimizing outcomes.</div></div><div><h3>Level of evidence</h3><div>V.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100902"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081218","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":"Quadriceps muscle strength of adolescents recovers faster than those of adults after anterior cruciate ligament reconstruction using hamstring graft","authors":"Marc Dauty ,&nbsp;Loïc Geffroy ,&nbsp;Antoine Chalopin ,&nbsp;Pierre Menu ,&nbsp;Jérôme Grondin ,&nbsp;Thomas Hirardot ,&nbsp;Vincent Crenn ,&nbsp;Alban Fouasson-Chailloux","doi":"10.1016/j.jisako.2025.100901","DOIUrl":"10.1016/j.jisako.2025.100901","url":null,"abstract":"<div><h3>Objectives</h3><div>Knee muscle strength recovery after anterior cruciate ligament reconstruction is usually evaluated using isokinetic limb symmetry index to help take the decision to allow return to the previous sport. However, the role of age on knee strength recovery is not well known. So, we aimed to compare the isokinetic knee muscle strength recovery according to age at 4 and 7 months after anterior cruciate ligament reconstruction using hamstring graft.</div></div><div><h3>Methods</h3><div>From a historical cohort (2018-2023) of patients who completed isokinetic monitoring at 4 and 7 months after anterior cruciate ligament reconstruction using hamstring graft, two groups were compared according to age: ≤19 and ​&gt; ​20 years old. The quadriceps and hamstring limb symmetry indexes were studied as the main parameters. A multivariate analysis was realized to assess the weight of potential inter-subject explanatory parameters on knee strength evolution.</div></div><div><h3>Results</h3><div>Two hundred fifty-three adolescents were compared with 247 adults. The adolescent quadriceps symmetry index at 60°/s was significantly higher than that of adults (79% vs 72% and 88% vs 82% at 4 and 7 months of follow-up, respectively). The hamstring symmetry index was not statistically significantly different. No inter-subject explanatory parameters were found after the multivariate analysis.</div></div><div><h3>Conclusion</h3><div>Knee strength recovers faster in adolescents than in adults after anterior cruciate ligament reconstruction using hamstring graft. This result should be carefully considered because adolescents could be exposed to return to sport too early, while the risk of graft rupture is still high, if strength cutoff is only considered.</div></div><div><h3>Level evidence</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100901"},"PeriodicalIF":2.7,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038565","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 shortened Knee Injury and Osteoarthritis Outcome Score (KOOS) is sufficient for measuring change in a cohort of patellofemoral instability patients","authors":"Kate E. Webster PhD ,&nbsp;Julie Agel MA ,&nbsp;Julian A. Feller MB, BS(Hons) ,&nbsp;Robert Magnussen MD ,&nbsp;Elizabeth A. Arendt MD","doi":"10.1016/j.jisako.2025.100899","DOIUrl":"10.1016/j.jisako.2025.100899","url":null,"abstract":"<div><h3>Introduction</h3><div>Various knee-related patient-reported outcome measures (PROMs) have been used for patients who undergo surgical treatment for patellofemoral instability. There has been limited evaluation of their suitability and no agreement about an optimal set of measures.</div></div><div><h3>Objectives</h3><div>To evaluate the Knee injury and Osteoarthritis Outcome Score (KOOS) and published shorter versions to determine their suitability for patients with patellofemoral instability.</div></div><div><h3>Methods</h3><div>The study cohort consisted of patients who underwent surgical stabilization with medial patellofemoral ligament reconstruction for recurrent lateral patellar dislocations. The full KOOS was administered preoperatively and the 6, 12, and 24 months postoperative. Four short form versions were calculated: KOOS-12, KOOS-Physical Function, KOOS-Joint Replacement, and KOOS-Global. Floor and ceiling effects were determined (threshold &gt;15%). Individual items were evaluated to identify where &gt;67% of patients had preoperative responses of “≥ moderate” (demonstrating item relevance). The standardized response mean (SRM) was calculated to assess responsiveness from baseline to each postoperative assessment time, as well as between postoperative assessments.</div></div><div><h3>Results</h3><div>289 patients completed the full KOOS at least once. No ceiling effects were present at any time point for the quality of life (QoL) or symptoms subscales, KOOS-12, or KOOS-global. Only 11 of the items passed the &gt;67% threshold for item relevance. These included all Sport/Recreation (SR) and QoL items, as well as one item (knee stiffness after sitting/resting later in the day) from the symptom subscale and one item (pain frequency) from the pain subscale. Given these individual item results, a two-subscale “composite” score was calculated that included the 9 items of the KOOS SR and QoL subscales (KOOS-SR ​+ ​QoL). Excellent responsiveness was seen for all preoperative to postoperative comparisons, especially the composite SR ​+ ​QoL measure (SRM &gt;1). Between 6- and 12-month assessments, the composite SR ​+ ​QoL score was also shown to be the most responsive measure.</div></div><div><h3>Conclusion</h3><div>The composite KOOS SR ​+ ​QoL score may be an improved option for measuring patient-related outcomes in this more active population, as it focuses on the most relevant constructs for this patient group. The full 42-item KOOS was shown to have limited applicability in this patient group.</div></div><div><h3>Level of evidence</h3><div>Level II.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100899"},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064843","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}