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

{"title":"Physical and Mental Health Scores Worsen Over Division I Collegiate Sports Season and Decline Further Following Mid-Season Injury or Illness.","authors":"Nathaniel E Zona, Michael A Hewitt, Shanthan Challa, Sara E Buckley, Marissa Holliday, Kenneth J Hunt","doi":"10.1016/j.jisako.2026.101128","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101128","url":null,"abstract":"<p><strong>Background/objectives: </strong>Collegiate athletes commonly report higher physical function and lower pain interference than the average population. However, limited information is available regarding how patient-reported outcome scores change across a sports season or following a mid-season injury or illness. It was hypothesized that collegiate athletes would report higher scores in Patient-Reported Outcomes Measurement Information System (PROMIS) physical, mental, and social health domains compared to the general population, and mid-season injury/illness would be associated with worsened post-season scores compared to pre-season.</p><p><strong>Methods: </strong>Collegiate athletes across all varsity sports from one Division I institution were surveyed pre-season and post-season in this prospective cohort study. Mid-season injury/illness was self-reported and defined as an event interrupting in-season participation. Pre- and post-season PROMIS Physical Function (PF), Pain Interference (PI), Ability to Participate in Social Roles and Activities (APSRA), and Depression (D) were collected. Change from pre-season was compared between non-injured/non-ill and injured/ill athletes with paired non-parametric tests.</p><p><strong>Results: </strong>A total of 211 athletes were included, consisting of 117 (55%) males and a similar distribution across collegiate year (26%, 28%, 22%, 23%, respectively). Team field sports including football (42%), female lacrosse (12%) and female soccer (9%) made up a majority of respondents. Pre-season PROMIS PF (59.9±7.8) and APSRA (60.1±7.1) scores were nearly one standard deviation higher than the US population T-score (50±10). PI (48.6±7.6) and Depression (45.5±8.4) were within typical range. Athletes sustaining a mid-season injury/illness reported worse post-season scores in PF (-3.9±9.0, p<0.001, r=0.396), PI (2.5±10.7, p=0.034, r=0.213), APSRA (-2.6±7.5, p=0.003, r=0.325), and Depression (1.9±7.5, p=0.011, r=0.276) compared to their pre-season. Non-injured/ill athletes also demonstrated mildly worsened scores in PF (-2.3±7.3, p<0.001, r=.312) and APSRA (-1.3±7.9, p=0.049, r=0.183) compared to their pre-season.</p><p><strong>Conclusions: </strong>Mid-season injury/illness was associated with worsened PROMIS scores across all measured physical and mental health domains. Athletes without an injury/illness also reported worsened PF and APSRA, indicating a potential impact from the sports season. However, the clinical significance of these score changes remains uncertain. The declines were modest and athlete-specific minimal clinically significant difference thresholds are needed to better define clinical significance in this population.</p><p><strong>Level of evidence: </strong>Level 2.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101128"},"PeriodicalIF":3.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857392","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":"Generative Artificial Intelligence as a Research Partner in Orthopaedics: State of the Art.","authors":"Ricardo Bastos, Américo Dias, Paulo Amado, Philippe Neyret, João Espregueira-Mendes, Sthefan Gabriel Berwanger","doi":"10.1016/j.jisako.2026.101126","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101126","url":null,"abstract":"<p><p>The integration of Artificial Intelligence (AI) into medicine has progressed from discriminative models to Generative AI (GenAI), which can synthesize novel content. For orthopaedic surgeons, scientific publication remains a vital marker of academic success but is often constrained by clinical workload. This review proposes a structured, practical framework to help orthopaedists effectively harness AI tools, transitioning from opaque, \"black box\" generation to grounded, verifiable research assistance through Retrieval-Augmented Generation (RAG). A PubMed search was conducted to explore the application of GenAI in the context of orthopaedic scientific research. An interactive review with experts in GenAI was also conducted, from which the proposed structure was developed. From this synthesis, a three-phase workflow is proposed: (1) Evidence selection using semantic discovery systems to identify and map relevant literature beyond keyword matching; (2) Data extraction and synthesis employing RAG-based systems to anchor AI responses to verified PDF sources, thereby minimizing hallucinations; and (3) Drafting and refining using Large Language Models (LLMs) for structured composition, linguistic clarity, and iterative manuscript improvement. The workflow integrates platform features to enhance efficiency, accuracy, and accessibility in orthopaedic research. When applied within a controlled, evidence-grounded environment, these systems can automate literature synthesis, expedite data extraction, and assist with scientific writing, while preserving authorial intent and accountability. However, challenges remain. Risks include algorithmic bias, \"hallucinations\", privacy concerns, and ethical issues related to authorship. Despite these limitations, AI represents a paradigm shift in orthopaedic scholarship, functioning as a cognitive exoskeleton that augments rather than replaces human expertise. With vigilant human oversight and adherence to journal ethics, orthopaedic surgeons can leverage AI to enhance research productivity, reproducibility, and quality while upholding the highest standards of scientific integrity.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101126"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821889","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":"Comparison of portable ultrasound and arthroscopy for assessing sagittal fibular translation for assessment of syndesmotic instability.","authors":"Noortje C Hagemeijer, Go Sato, Rohan Bhimani, Bart Lubberts, Mohamed A Elghazy, Inger N Sierevelt, Gregory Waryasz, Gino M M J Kerkhoffs, Christopher W DiGiovanni, Daniel Guss","doi":"10.1016/j.jisako.2026.101121","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101121","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate 1) whether portable ultrasonography can evaluate syndesmotic instability in the sagittal plane, and 2) how portable ultrasonound measurements compare to arthroscopic evaluation.</p><p><strong>Methods: </strong>Eight fresh, above-knee cadaveric specimens were used. The syndesmosis was evaluated with portable ultrasonound and arthroscopy in the intact state, and thereafter with progressive sectioning of, 1) anterior-inferior tibiofibular ligament (AITFL), 2) interosseous ligament (IOL), and 3) posterior-inferior tibiofibular ligament (PITFL). Sagittal plane translation was simulated with 50N and 100N of anterior to posterior (A to P) and posterior to anterior (P to A) directed force using a bone hook. Separately, a 50N manual force was applied to the fibular tip and measured with portable ultrasound to simulate a fibular \"shuck test\" performed in the clinical setting. Agreement between portable ultrasound and arthroscopic measurements of fibular translation was assessed using Bland-Altman analysis.</p><p><strong>Results: </strong>When all three syndesmotic ligaments were transected, there was a statistically significant increase in fibular motion in the sagittal plane when evaluated using portable ultrasonography with application of 50N of manual pressure and when applying a 100N hook test when measuring total sagittal plane motion (p=<0.001 and p=0.009). Arthroscopy demonstrated a statistically significant increased motion with a 100N hook test when measuring total sagittal plane motion (p<0.001). Bland-Altman analysis between 50N manual portable ultrasound and 100N hook arthroscopy showed a mean difference of -0.24 with 95% limits of agreement ranging from -1.58 to 1.10.</p><p><strong>Conclusions: </strong>Portable ultrasonound could detect increased fibular motion in the sagittal plane after progressive syndesmotic ligamentous injury and demonstrated acceptable agreement with arthroscopy. Portable ultrasonound also offers several advantages over arthroscopy, including availability, non-invasiveness, low cost, and affording contralateral comparison. The promise of this technique suggests it should be further explored as a potential future standard for the diagnostic assessment of occult syndesmotic instability in the sagittal plane.</p><p><strong>Level of evidence: </strong>Not Applicable, diagnostic cadaver study.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101121"},"PeriodicalIF":3.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783709","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":"Large opening width and low serum 25-hydroxyvitamin D status are associated with inferior 12-month radiographic gap healing after medial open-wedge distal tibial tuberosity osteotomy.","authors":"Hitoshi Suzuki, Takenori Akiyama, Manabu Tsukamoto, Tomoya Arashi, Kotaro Tokuda, Norimasa Nakamura, Akinori Sakai","doi":"10.1016/j.jisako.2026.101125","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101125","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Evidence regarding factors associated with radiographic gap healing (GH) after medial open-wedge distal tibial tuberosity osteotomy (MOWDTO) remains limited. This study aimed to identify patient-related and surgical factors associated with radiographic GH after MOWDTO.</p><p><strong>Methods: </strong>This retrospective observational study included 189 patients who underwent MOWDTO between January 2020 and December 2023. GH was evaluated on anteroposterior radiographs at 3 and 12 months postoperatively. Multiple linear regression analyses were performed for GH rate at each time point, and logistic regression analysis was performed for delayed GH at 12 months, defined as GH < 50%. Additional analyses included treatment-era adjustment, categorical and season-adjusted analyses of serum 25-hydroxyvitamin D [25(OH)D], and a sensitivity analysis using a stricter threshold of delayed GH.</p><p><strong>Results: </strong>The mean GH rate was 20.99 ± 9.44% at 3 months and 55.62 ± 19.89% at 12 months, and delayed GH at 12 months was observed in 72 of 189 patients (38.1%). At 3 months, older age and hinge fracture were independently associated with a lower GH rate. The apparent association between porous hydroxyapatite/collagen composite (HAp/Col) use and lower 3-month GH was attenuated and was no longer statistically significant after adjustment for treatment era. At 12 months, larger opening width was independently associated with a lower GH rate, whereas higher serum 25(OH)D concentration, porous HAp/Col use, and greater descending cut thickness were associated with a higher GH rate. In logistic regression analysis, larger opening width was associated with increased odds of delayed GH, whereas higher serum 25(OH)D concentration, porous HAp/Col use, and greater descending cut thickness were associated with lower odds of delayed GH. In the era-adjusted delayed-GH model, the association for porous HAp/Col use was attenuated and became borderline significant. No patient developed nonunion or required additional surgery during follow-up.</p><p><strong>Conclusion: </strong>Opening width, hinge fracture, descending cut thickness, porous HAp/Col use, and serum 25(OH)D level were associated with radiographic GH after MOWDTO, although the robustness of these associations differed across the additional analyses.</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":"101125"},"PeriodicalIF":3.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783730","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":"No Differences in Objective Knee Laxity Measurements or Patient Reported Outcome Measures Between Fixed and Adjustable Loop Suspensory Fixation in Anterior Cruciate Ligament Reconstruction: 1-Year Results from the GAP Study, A Prospective, Double-Blinded, Randomized Trial.","authors":"Simon G F Abram, Adam Nelson, Simon Middleton, Vipul Mandalia","doi":"10.1016/j.jisako.2026.101123","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101123","url":null,"abstract":"<p><strong>Introduction: </strong>Suspensory fixation is one of the most common graft fixation methods in anterior cruciate ligament (ACL) reconstruction and can be performed with either a fixed-loop device or adjustable-loop device. There has, however, been a paucity of comparative clinical data and a clear need for an adequately powered, double-blinded, randomized study. to determine whether there is any difference in objective knee laxity between these fixation methods. The GAP study was designed to address this need.</p><p><strong>Methods: </strong>In a single-centre, two-surgeon series, 164 patients were recruited and randomized to receive a hamstring autograft ACL reconstruction using either a fixed-loop or adjustable-loop femoral fixation (Stryker G-Lock or ProCinch, respectively). Patients and assessors were blinded. Knee laxity was the primary outcome measure and measurements were taken using the GNRB (Genourob, Laval, France) knee arthrometer set at 150N and 200N respectively. Measurements were taken from the operated leg and compared to the contralateral leg. Patient reported outcome measures (PROMs) were collected at baseline, 6 months and 12 months and a linear regression analysis was undertaken.</p><p><strong>Results: </strong>At 1-year, 121 patients (62% male; mean age 31, SD 9.8) had complete knee laxity assessments. Of these, 58 received the fixed-loop fixation and 63 the adjustable-loop device. At 150N, the operated-knee laxity in the fixed-loop group was 5.51mm (SD 1.40; 95% CI 5.14-5.87) versus 5.61mm (SD 1.39; 95% CI 5.26-5.96) in the adjustable-loop group (P=0.68). At 200N, the operated-knee laxity in the fixed-loop group was 6.94mm (SD 1.54; 95% CI 6.53-7.34) versus 7.02mm (SD 1.53; 95% CI 6.63-7.40) in the adjustable-loop group (P=0.77). There was no statistically significant difference in the between-knee laxity measurements or PROMs (Tegner Activity Score, International Knee Documentation Committee [IKDC] Subjective Knee Evaluation Form, Lysholm Score, or any of the Knee injury and Osteoarthritis Outcome Score [KOOS] domains) between the groups.</p><p><strong>Conclusion: </strong>The GAP study is the first to compare knee laxity measurements between these two graft fixation devices in a randomized and blinded study. No statistically significant differences were observed in absolute or relative (operated vs. non-operated) knee laxity measurements or PROMs. These important new findings should inform surgeons and patients when considering graft fixation choice in ACL reconstruction. This study also provides new reference data for the operated and non-operated knees of patients following hamstring autograft ACL reconstruction.</p><p><strong>Level of evidence: </strong>Level 1 prospective, double-blinded, randomized controlled trial.</p><p><strong>Trial registration: </strong>NCT03184922 (ClinicalTrials.gov).</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101123"},"PeriodicalIF":3.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783790","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":"Medial Patellotibial Ligament Reconstruction Concomitant with Medial Patellofemoral Ligament (MPFL) Reconstruction in Fixed and Obligatory Patellar Dislocation: A Consecutive Case Series.","authors":"Emilie Lijesen, Olivia C Tracey, Samuel A Beber, Giulia Beltrame, Josh T Bram, Sarah L Lu, Ariana I Matarangas, Akshitha Adhiyaman, Daniel W Green","doi":"10.1016/j.jisako.2026.101124","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101124","url":null,"abstract":"<p><strong>Introduction: </strong>Patellofemoral instability (PFI) is a common knee injury in the pediatric population, and medial patellofemoral ligament (MPFL) reconstruction is common surgery to minimize risk of chronic PFI. Medial patellotibial ligament (MPTL) reconstruction may be subsequently performed, providing more lateral stability to reduce rotational instability and tilt. Recent literature has described MPTL reconstruction in adults and nonpathologic pediatric patients, however little literature has discussed this procedure in pediatric patients with underlying abnormal patellofemoral morphology.</p><p><strong>Methods: </strong>All pediatric patients ≤ 21 years of age undergoing MPFL reconstruction with concomitant MPTL reconstruction from 1/2016-7/2025 were included. Patients' demographic information, dislocation type, surgical details, pre-operative radiographic parameters, and follow-up was recorded.</p><p><strong>Results: </strong>Sixteen extremities in 14 patients were included in this analysis. Mean age at time of surgery was 14.5 ± 3.6 years, and mean body mass index at time of surgery was 22.8 ± 7.8 kg/m². Ten patients reported a past medical history of genetic, syndromic conditions or hypermobility syndromes. Fixed patellar dislocations were present in 9/16 extremities, and obligatory patellar dislocations were present in 7/16 extremities. Postoperative follow-up averaged 25.0 ± 23.9 months. Preoperative radiographs revealed a mean mechanical axis deviation (MAD) of 6.4 ± 15.8 mm and a mean hip-knee-ankle (HKA) angle of 2.5 ± 5.4 degrees (where varus is represented by a negative value). Preoperative MRI revealed a mean TT-TG distance of 19.4 ± 11.2 mm and seven extremities demonstrated TT-TG distance >20 mm. All patients underwent simultaneous MPFL reconstruction. Only one patient displayed recurrent patellar dislocation post-operatively.</p><p><strong>Conclusion: </strong>MPTL reconstruction is a favorable adjunct procedure providing favorable outcomes in pediatric patients with PFI. This consecutive case series demonstrates that MPTL reconstruction is a favorable adjunct procedure for pediatric patients with underlying abnormal patellofemoral morphology.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101124"},"PeriodicalIF":3.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783742","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":"Morphological characteristics in non-traumatic osteochondral lesions of the talus: a radiographic study.","authors":"Yuki Suzuki, Yuta Kawae, Koji Iwasaki, Masatake Matsuoka, Ryosuke Hishimura, Masanari Hamasaki, Jun Onodera, Tomonori Yagi, Eiji Kondo, Norimasa Iwasaki, Tomohiro Onodera","doi":"10.1016/j.jisako.2026.101119","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101119","url":null,"abstract":"<p><strong>Introduction: </strong>Osteochondral lesions of the talus (OLT) are frequently associated with trauma; however, the severity and mechanism of injury vary widely, making it difficult to clarify predisposing morphological factors. In contrast, non-traumatic OLT cases may reflect intrinsic anatomical characteristics that contribute to lesion development independent of injury. This study aimed to identify the radiographic morphological features of the ankle in patients with non-traumatic OLT and to elucidate inherent structural factors associated with its occurrence.</p><p><strong>Methods: </strong>Fifteen ankles (8 males, 7 females) of medial OLT patients without a history of trauma or ankle instability (OLT group) and 15 healthy control ankles (7 males, 8 females) were included in the study. Radiological assessment was conducted using standing frontal and lateral views of ankle joint radiography. A cutoff value was determined based on receiver operating characteristic (ROC) curve analysis and decision criteria. Statistical significance was set at p <.05.</p><p><strong>Results: </strong>The OLT group exhibited statistically significantly larger tibial medial malleolus angle (TMM; p = .02, Cohen's d = 0.90), and transverse diameter of the tibia plafond (TTiP; p = .006, Cohen's d = 1.15), but a shorter vertical distance between the tibia plafond and the tip of the medial malleolus (VTiPMM; p = .02, Cohen's d = 0.92) compared to the control group. Additionally, the radius of the tibial plafond (RTiP; p = .01, Cohen's d = 1.27) and talar dome (RTaD: p = .014, Cohen's d = 0.88) were smaller in the OLT group, while the medial malleolar length showed no statistically significant difference. ROC curve and area under the curve analysis demonstrated moderate accuracy for four parameters: TTiP, TMM, VTiPMM, and RTiP. The optimal cutoff values for predicting OLT were: TTiP at 44.3 mm, TMM at 19.6°, VTiPMM at 23.4 mm, RTiP at 81.9 mm, and RTaD at 82.8 mm.</p><p><strong>Conclusion: </strong>Focusing on non-traumatic cases allowed us to identify intrinsic ankle morphology that predisposes to medial talar stress and OLT. These radiological parameters may aid in the diagnosis of non-traumatic OLT and enhance understanding of its pathophysiology.</p><p><strong>Level of evidence: </strong>Level 3 (case-control study).</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101119"},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783813","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":"Patellar Facet Maturation and Trochlear Depth in the Early Pediatric Age Group: A 3D Laser Scanning Analysis of Developmental Interplay.","authors":"Cassidy M Schultz, Henry B Ellis, Kevin G Shea, Aaron J Zynda, Charles W Wyatt, Theodore J Ganley, Yi-Meng Yen, Matthew R Schmitz, Marc Tompkins, J Javier Masquijo, Philip L Wilson","doi":"10.1016/j.jisako.2026.101118","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101118","url":null,"abstract":"<p><strong>Background: </strong>The progression and timing of patellar development have been minimally investigated, and the reciprocal influence of patellar and trochlear morphology remains poorly understood. A detailed characterization of age-related surface anatomy is essential to understand the developmental interplay between these structures. The objectives of this study were: (1) to characterize the geometric development of the patellar articular surface and its facets in relation to age, and (2) to define the age-based progression of soft-tissue footprints on the patella.</p><p><strong>Methods: </strong>Fifty-seven immature cadaveric knees (age 1 month to 11 years; 63% male) underwent standardized dissection by fellowship-trained orthopedic surgeons. A coordinate-measuring device with integrated laser scanning recorded 3D cartilaginous, bony, and soft tissue anatomy. Trochlear cartilage sulcus angles (SA) were analyzed at 30°, 60°, and 90° of flexion.</p><p><strong>Results: </strong>The average number of patellar facets increased significantly with age (p < 0.001). All specimens with a deep sulcus (SA <150°) demonstrated multiple medial and lateral facets. While the absolute dimensions of the quadriceps insertion (r = 0.69; p < 0.001), patellar tendon insertion (r = 0.65; p = 0.001), and medial patellofemoral ligament (MPFL) insertion (r = 0.45, p = 0.032) increased significantly with age, their proportional relationship to the total patellar cartilage surface area remained isometrically stable across all age groups (p > 0.05).</p><p><strong>Conclusions: </strong>Patellar facet complexity is an active developmental process emerging early and directly influenced by trochlear depth. Although soft tissue footprints expand in absolute size with age, they maintain a constant proportional relationship to the maturing articular surface. These findings provide normative data for patellar stabilization procedures in the early pediatric population.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101118"},"PeriodicalIF":3.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718353","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":"Nerve-Targeted Interventions Provide Meaningful Short-Term Pain and Functional Improvement in Refractory Hip Pain: A Systematic Review.","authors":"Helena Son, Agarsh Satheesh, Dan Cohen, Marc Daniel Bouchard, Eugene Maida, Alexander Markes, Raed Narvel, Craig S Mauro, Tyler M Hauer, Olufemi R Ayeni","doi":"10.1016/j.jisako.2026.101115","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101115","url":null,"abstract":"<p><strong>Importance: </strong>The management of chronic hip pain in patients not amenable to surgical treatment remains challenging. Increasing evidence suggests that targeted denervation may reduce hip pain by disrupting nociceptive input.</p><p><strong>Aim: </strong>To synthesize available evidence on patient-level outcomes following nerve-targeted interventions for hip pain; to summarize procedural techniques, patient selection criteria, and reported clinical outcomes associated with these interventions EVIDENCE REVIEW: A comprehensive search of MEDLINE, EMBASE, and PubMed was performed following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies reported pain-related or functional outcomes after nonpharmacological, nerve-targeted interventions for hip pain. Inter-reviewer agreement was assessed using the kappa (κ) statistic and study quality was appraised using Methodological Index for Non-Randomized Studies (MINORS) criteria. Descriptive statistics summarized study characteristics, patient demographics, procedural details, and outcomes.</p><p><strong>Findings: </strong>Ten studies (358 patients, 370 hips) were included (one level II, one level III, eight level IV studies). Eight studies evaluated radiofrequency ablation and two examined pericapsular alcohol neurolysis. Most interventions targeted the femoral and obturator nerves. Across studies, 60-80% of patients achieved >50% pain relief at 3-6 months, with some reporting sustained benefits to 12 months. Significant improvements were also observed in functional outcomes and reductions in opioid use were reported in some studies, although statistically significant reductions were demonstrated in only one study. Complications were rare and minor, limited to transient neuritis, hematomas, or sensory changes without lasting sequelae.</p><p><strong>Conclusion: </strong>and Relevance: Nerve-targeted interventions may provide meaningful short-term improvements in pain, function, and analgesic use in patients with refractory hip pain. These interventions may represent a potential therapeutic option in patients not amenable to surgical treatment or with persistent symptoms despite prior surgical management. However, the evidence base remains limited by heterogeneity and study design, highlighting the need for high-quality randomized controlled trials to establish optimal techniques and long-term effectiveness.</p><p><strong>Level of evidence: </strong>IV, systematic review of level II, III, and IV studies.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101115"},"PeriodicalIF":3.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692591","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 Unique Case of Compartment Syndrome of the Lower Leg Following Hip Arthroscopy: A Case Report.","authors":"Alexander Crowley, Michael Mullen, Carly Cignetti, Misty Suri, Brian Godshaw","doi":"10.1016/j.jisako.2026.101110","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101110","url":null,"abstract":"<p><p>Compartment syndrome is a serious condition typically arising from trauma, fracture, or vascular injuries, but it can also occur following surgery. Recognized by symptoms such as severe pain, swelling, and neurological deficits, prompt diagnosis and intervention are crucial to prevent long-term complications. Here, we present a rare occurrence of compartment syndrome in the leg following hip arthroscopy. A healthy 25-year-old male underwent revision hip arthroscopy for CAM resection and acetabular labral reconstruction. Post-operatively, the patient had progressively worsening pain and swelling in the lower leg, accompanied by sensory disturbances and weakness. Despite the procedure's minimal invasiveness, vigilant assessment and prompt intervention became imperative as clinical signs pointed towards the development of compartment syndrome. This case emphasizes that a high index of suspicion is necessary following routine operations when patients develop atypical or escalating symptoms, and early compartment pressure measurement should be considered. LEVEL OF EVIDENCE: V.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101110"},"PeriodicalIF":3.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677432","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}