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

{"title":"Quality-of-life outcomes and osteoarthritis development at 10-years after anterior cruciate ligament reconstruction: A large randomized clinical trial comparing patellar tendon, hamstring tendon and double-bundle grafts.","authors":"Nicholas Mohtadi, Denise Chan, Dana Hunter, Pablo Bertiche, Hana Marmura, Dianne Bryant","doi":"10.1016/j.jisako.2026.101220","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101220","url":null,"abstract":"<p><strong>Introduction: </strong>This large randomized clinical trial compared disease-specific quality-of-life, clinical and radiographic outcomes 10-years following Anterior Cruciate Ligament (ACL) reconstruction with patellar tendon (PT), single-bundle (HT; quadruple-stranded semitendinosis-gracilis/tendons), or double-bundle (DB; 2-stranded semitendinosis and 2-stranded gracilis tendon) hamstring tendon constructs.</p><p><strong>Methods: </strong>Three-hundred-and-thirty ACL deficient patients (183 males; 14-50 years) were randomized to PT (n=110, mean 28.7 years), single-bundle HT (n=110, mean 28.5 years), or double-bundle DB, (n=110, mean 28.3 years). An independent assessor and patients were blinded to treatment allocation up to 2-years. Outcomes were assessed at Baseline, 2-, 5- and 10-years post-operatively.</p><p><strong>Primary outcome: </strong>ACL Quality-of-Life (ACL-QOL) score.</p><p><strong>Secondary outcomes: </strong>pivot shift, kneeling pain, International Knee Documentation Committee (IKDC) scores, Tegner Activity Level, traumatic re-injuries and contralateral ACL tears. A blinded assessor graded each knee compartment using the International Knee Documentation Committee (IKDC) radiographic scale.</p><p><strong>Results: </strong>Two-hundred-and-eighty-seven patients (87%) completed 10-year follow-up (mean 10.2 1.2 years). Mean ACL-QOL scores increased over time for all groups (p<0.001), with no statistically significant difference at 10-years (PT=76.4 21.0 (95%CI 72.1-80.7); HT=77.7 20.5 (95%CI 73.4-81.9); DB=77.3 21.5 (95%CI 73.0-81.7); p=0.912). Fewer traumatic re-injuries occurred with PT grafts (PT=8%; HT=22%; DB=21%, p=0.023). No statistically significant differences for contralateral ACL tears (PT=13%; HT=13%; DB=10%; p=0.801), kneeling pain (PT=6%; HT=4%; DB=7%; p=0.637), Normal/Nearly Normal IKDC Objective scores (PT=73%; HT=68%; DB=72%; p=0.724) or the remaining secondary outcomes. Pivot shift grade ≥2 was less likely with a PT reconstruction (PT=18%; HT=25%; DB=24%; p=0.584). Forty-five percent of patients had radiographic OA at 10-year follow-up (medial=17%; lateral=29%; patellofemoral=6%). ACL-QOL scores were statistically significantly lower for patients with medial (69.3 3.2) and lateral OA (72.8 2.4). The PT group had more lateral OA (PT=42%, HT=23%, DB=23%; p=0.010), but no statistically significant differences in medial (PT=14%, HT=12%, DB=24%, p=0.094) or patellofemoral OA (PT=5%, HT=7%, DB=8%, p=0.782). Contributors of medial OA included baseline age, medial meniscectomy, chondral damage and subsequent secondary surgery. Contributors of lateral OA included PT graft, valgus alignment and lateral meniscectomy. ConclusionsACL reconstructive surgery consistently improves quality-of-life, with most patients remaining highly active at 10 years. ACL-QOL scores were lower for patients with medial and lateral OA. More traumatic re-injuries occurred with HT and DB reconstructions. PT reconstructions were more likely ","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101220"},"PeriodicalIF":3.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008999","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":"Total knee arthroplasty outcomes in older patients are still clinically beneficial: the impact of age on recovery and satisfaction in total knee arthroplasty patients.","authors":"Tess L Y Tsoi, Harbeer Ahedi, David A Parker","doi":"10.1016/j.jisako.2026.101210","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101210","url":null,"abstract":"<p><strong>Introduction: </strong>Total knee arthroplasty (TKA) improves pain and function in osteoarthritis patients, but recovery varies with age. TKA patients average at 68.7 years old, but with wide variation, the impact of age on outcomes remains unclear. This study investigated the impact of age on recovery after TKA to provide guidelines for TKA in different age groups.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent TKA between 2018 to mid-2023 and had 1 year post-operative patient-reported outcome measures (PROMs) data. Patients completed the Oxford Knee Score (OKS), Forgotten Joint Score (FJS), VR-12 Mental Component Score (MCS) and Physical Component Score (PCS) pre-operative and 1 year post-operative. Patient Medical Care Satisfaction, Knee Normality Score, and Visual Analogue Scale (VAS) (0-100) were recorded 3 months and 1 year post-operative. Data were analyzed and adjusted for sex, body mass index (BMI), range of motion (ROM), implant type, surgeon volume, and joint alignment.</p><p><strong>Results: </strong>Of the 1,723 participants (mean age 69.4 years, 50.7% males, average BMI 30 kg/m²), pre-operative PROMs were higher with age [OKS (p<0.001), FJS (p<0.001), MCS (p<0.001)]. At 3 months post-operative, older patients had lower Patient Medical Care Satisfaction (p=0.005) and Knee Normality Score (p=0.008) and higher VAS (p=0.001). At 1 year, older age was linked to lower OKS (p=0.002), PCS (p<0.001), and Patient Medical Care Satisfaction (p=0.02). After adjusting for covariates, OKS (p<0.0001), PCS (p<0.0001), and FJS (p=0.006) were statistically significant. ANCOVA modelling predicted cumulative difference in adjusted score between the youngest and oldest patients to exceed published minimal clinically important difference (MCID) thresholds for FJS and VR-12 PCS, but oldest age groups still experienced meaningful improvement in PROMs between pre- and post-operative, meeting all MCIDs.</p><p><strong>Conclusion: </strong>Older age is linked to better pre-operative PROMs, but worse outcomes after surgery. These results highlight the relationship between age and recovery following TKA, indicating worse improvements in knee function for older patients. However, all post-operative PROMs in older age groups still met MCIDs, thus showing the substantial impact of TKAs in patients of all ages.</p><p><strong>Level of evidence: </strong>Level IV retrospective study using historical controls or having more than one negative criterion.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101210"},"PeriodicalIF":3.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841486","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":"Arthroscopic shoulder anchorless biceps tenodesis: a novel intracapsular technique","authors":"Evans Few MD,&nbsp;Michael Mullen MD,&nbsp;Magnolia Livingston BA,&nbsp;Jonathan Willard MD,&nbsp;Joseph Laurent MS,&nbsp;Ian Savage-Elliott MD","doi":"10.1016/j.jisako.2026.101168","DOIUrl":"10.1016/j.jisako.2026.101168","url":null,"abstract":"<div><div>Pathology of the long head of the biceps tendon (LHBT) is a common source of anterior shoulder pain and is frequently encountered during arthroscopic shoulder surgery. Although biceps tenodesis is widely performed, many existing techniques rely on implants that increase cost and may be associated with bone- or fixation-related complications. This paper describes a novel arthroscopic intracapsular soft-tissue biceps tenodesis technique emphasizing efficiency, reproducibility, and implant minimization.</div><div>The LHBT is pierced percutaneously using a spinal needle approximately 1 cm proximal and lateral to the anterior portal with the patient in the lateral decubitus position. A simple 1.8-mm nonabsorbable suture is passed through the needle and retrieved arthroscopically through the anterior portal. The suture limb that was advanced through the needle is then retrieved from the subacromial space through the anterior portal with a probe thus leaving both limbs of the suture exiting through the anterior portal. A sliding arthroscopic knot is then tied in a blind fashion through the incision of the anterior portal thereby securing the biceps to the capsule in the rotator interval above the superior border of the subscapularis. This technique provides stable fixation while preserving the native length–tension relationship of the biceps and avoids interference screws or humeral drilling.</div><div>This technique may represent an efficient, cost-effective option for arthroscopic biceps tenodesis, particularly when performed in conjunction with other shoulder procedures. Further comparative studies with larger cohorts and longer follow-up are warranted.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"19 ","pages":"Article 101168"},"PeriodicalIF":3.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical decision-making algorithm for posterolateral corner injuries of the knee: Development and internal validation","authors":"Horacio Rivarola MD,&nbsp;Cristian Collazo MD,&nbsp;Marcos Palanconi MD,&nbsp;Marcos Meninato MD,&nbsp;Carlos Peñaherrera-Carrillo MD,&nbsp;Alejandro Barros Castro MD,&nbsp;Francisco Endara Urresta MD","doi":"10.1016/j.jisako.2026.101170","DOIUrl":"10.1016/j.jisako.2026.101170","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Posterolateral corner (PLC) injuries of the knee remain a complex and heterogeneous clinical entity, with substantial variability in surgical management and no widely accepted criteria to guide treatment selection. The purpose of this study was to develop and internally validate a clinically applicable decision-making algorithm for PLC injuries and to evaluate the outcomes of a minimally invasive reconstruction strategy in a consecutive cohort of patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort of 120 patients undergoing surgical treatment for PLC injuries, including both isolated PLC reconstructions and combined ligament procedures (ACL and/or PCL), was analyzed. Baseline demographic, clinical, radiographic, and intraoperative variables were collected. The primary outcome was defined as a successful clinical outcome at final follow-up, including absence of revision surgery, restoration of clinical stability, and functional improvement. Predictors of outcome were identified using multivariable logistic regression. Internal validation was performed using bootstrap resampling (1000 iterations). Model performance was assessed using discrimination (area under the curve [AUC]) and calibration analysis. A simplified clinical score and decision-making algorithm were derived from the final model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;At a mean follow-up of 24.8 ± 6.3 months, 92 patients (76.7%) achieved a successful clinical outcome. Independent preoperative predictors of unsuccessful outcome included varus laxity &gt;4 mm on stress radiographs (odds ratio [OR]: 3.12; p = 0.005), a positive dial test at 90° of knee flexion (OR: 2.67; p = 0.018), and combined ligamentous injury involving the posterior cruciate ligament (OR: 2.94; p = 0.010). The final model demonstrated good discrimination (area under the curve [AUC]: 0.81; 95% confidence interval [CI]: 0.73–0.89), with a bootstrap-corrected AUC of 0.78 and good calibration (slope 0.94). The derived clinical algorithm, based on a weighted score including varus laxity &gt;4 mm, dial test positivity at 90°, and PCL-associated injury, stratified patients into low-, intermediate-, and high-risk categories, supporting tailored selection of minimally invasive versus anatomic reconstruction strategies. Each variable was assigned points according to its regression coefficient, allowing classification into three groups based on cumulative score: low risk (0–1 points), intermediate risk (2–3 points), and high risk (≥4 points).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;A clinically applicable and internally validated algorithm can effectively guide surgical decision-making in PLC injuries of the knee. By integrating key clinical and radiographic variables, this model enables safe selection of minimally invasive reconstruction in appropriately selected patients while preserving the indication for anatomic techniques in complex instability patterns.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"19 ","pages":"Article 101170"},"PeriodicalIF":3.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically meaningful thresholds for the Thai Kujala score in patellofemoral pain syndrome: Minimal clinically important improvement and patient acceptable symptom state","authors":"Adinun Apivatgaroon,&nbsp;Panit Tungbanjerdsook,&nbsp;Bancha Chernchujit,&nbsp;Prakasit Sanguanjit","doi":"10.1016/j.jisako.2026.101169","DOIUrl":"10.1016/j.jisako.2026.101169","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The Kujala score is a patient-reported outcome questionnaire used to evaluate symptoms and functional limitations in patellofemoral pain syndrome (PFPS). The Kujala score has been translated and adapted into many languages, including Thai; however, no studies have investigated the minimal clinically important improvement (MCII) and patient acceptable symptom state (PASS) for the Thai version of the Kujala score. This study aimed to evaluate the MCII and PASS of the Thai Kujala score and to identify factors associated with changes in Kujala scores.</div></div><div><h3>Methods</h3><div>A prospective cohort study of 47 patients diagnosed with PFPS was conducted at Thammasat University Hospital. Patients completed the Kujala score, International Knee Documentation Committee score (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline, 1 month, and 3 months. Anchor-based and distribution-based methods were used to calculate MCII and PASS. Regression analysis was performed to identify factors associated with changes in Kujala scores.</div></div><div><h3>Results</h3><div>The MCII threshold for the Thai Kujala score was identified as ≥3.5 points, with an area under the curve (AUC) of 0.771 (95% confidence interval [CI]: 0.643-0.899, p = 0.002). The PASS threshold was a score of 72, with an AUC of 0.708 (95% CI: 0.561-0.855, Youden index = 0.310). The Kujala score demonstrated a strong correlation with the IKDC (Spearman's ρ = 0.701, p &lt; 0.001) and a moderate correlation with the KOOS (Spearman's ρ = 0.401, p = 0.002). No demographic variables (age, sex, body mass index, or exercise status) were associated with changes in Kujala scores in multivariate analysis.</div></div><div><h3>Conclusion</h3><div>An improvement of ≥3.5 points in the Thai Kujala score reflects the MCII, while a score of 72 represents the PASS in patients with PFPS. Therefore, the Thai Kujala score shows strong correlation with the IKDC and the KOOS score. The Thai Kujala score can be used reliably as a patient-centered outcome measure in both clinical practice and research settings.</div></div><div><h3>Level of Evidence</h3><div>Level II, diagnostic study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"19 ","pages":"Article 101169"},"PeriodicalIF":3.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic anterior glenohumeral microinstability in nonathletic patients satisfactory short-term outcomes of a case-control study of concurrent intra-articular soft arthroscopic Latarjet technique and suture-anchor capsular plication","authors":"Amr Abdel-Mordy Kandeel MD","doi":"10.1016/j.jisako.2026.101167","DOIUrl":"10.1016/j.jisako.2026.101167","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction/Objectives&lt;/h3&gt;&lt;div&gt;Arthroscopic management of post-traumatic anterior glenohumeral micro-instability, in the non-athletes, has not yet been thoroughly investigated. The current study compared the outcomes of antero-inferior capsulo-labral repair for the management of anterior glenohumeral microinstability (following a single-event trauma in the nonathletes) versus those of Bankart repair for the management of recurrent anterior gleno-humeral dislocation/macro-instability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Conducted between March 2018 and February 2024, this case–control study included 62 patients allocated according to the managed pathology into 2 groups. Group A included 21 nonathletes with anterior glenohumeral microinstability (following single-event trauma) managed with suture-anchor antero-inferior capsulo-labral repair coupled with the intra-articular soft arthroscopic Latarjet technique (in-SALT), including soft-tissue biceps tenodesis to the upper subscapularis. Whereas group B, on the other hand, included 41 nonathletes with recurrent anterior glenohumeral dislocation/macroinstability (i.e. type-V superior labrum anterior to posterior [SLAP] lesion) managed with suture-anchor Bankart repair coupled with in-SALT. Outcome measurements included the 2-year postoperative visual analog scale (VAS) score; range of forward flexion (FF) and external rotation (ER) at 90°-abduction; and the American Shoulder and Elbow Surgeons (ASES) and Rowe scores.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There were no intergroup statistically significant differences in baseline patient characteristics. The mean age of the patients was 26.8 ± 7.0 in group A and 26.6 ± 6.8 in group B. Other than 1 female patient in each group, all included patients were male. Except for range of motion in group A, patients in both groups had significant postoperative improvement in all outcome measurements (P &lt; 0.05 for all). Both groups showed comparable postoperative outcomes in terms of the VAS score (1.0 ± 0.8 vs 1.1 ± 0.9; &lt;em&gt;P&lt;/em&gt; = 0.607), FF (173.8° ± 7.4° vs 172.2° ± 5.2°; &lt;em&gt;P&lt;/em&gt; = 0.324), ER at 90°-abduction (83.3° ± 7.3° vs 80.7° ± 6.1°; &lt;em&gt;P&lt;/em&gt; = 0.142), ASES score (91.5 ± 4.4 vs 92.1 ± 3.0; &lt;em&gt;P&lt;/em&gt; = 0.582); Rowe score (89.8 ± 4.0 vs 88.2 ± 5.8; &lt;em&gt;P&lt;/em&gt; = 0.264), and instability persistence/recurrence (4.8% vs 2.4%; &lt;em&gt;P&lt;/em&gt; = 0.624), respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Anterior glenohumeral micro-instability following a single-event trauma in nonathletes could be successfully managed (in a way similar to that of type-V SLAP lesion of the recurrent anterior glenohumeral dislocation/macroinstability) via in-SALT-augmented suture-anchor antero-inferior capsulo-labral repair with comparable outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Trial Registration&lt;/h3&gt;&lt;div&gt;The study was approved by the Institutional Committee of Scientific Research and Ethics (IRB: 2/2023 ORTH 30-3).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level of evidence&lt;/h3&gt;&lt;div&gt;III.&lt;/d","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"19 ","pages":"Article 101167"},"PeriodicalIF":3.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two surgical stabilization strategies for irreducible proximal tibiofibular joint dislocations: case report","authors":"Fernando Coutin Moreno,&nbsp;Ruben Dario Arias Perez,&nbsp;Miguel Ángel Cano González,&nbsp;Julian Alexander Rubiano Jaramillo,&nbsp;Miguel Ángel Duque Zapata","doi":"10.1016/j.jisako.2026.101173","DOIUrl":"10.1016/j.jisako.2026.101173","url":null,"abstract":"<div><div>Proximal tibiofibular joint (PTFJ) dislocation is a rare and frequently underdiagnosed injury that may occur following both sports-related trauma and high-energy mechanisms. Irreducible dislocations represent a particular challenge because they often reflect complex injury patterns requiring surgical management. We report two cases of irreducible PTFJ dislocation with distinct displacement patterns: an anterolateral dislocation following a sports injury and a posteromedial dislocation associated with high-energy trauma and common fibular nerve palsy. In both cases, closed reduction was unsuccessful, necessitating open reduction. Surgical stabilization was tailored to the specific injury characteristics and intraoperative findings, using suture anchor-based ligament repair in the anterolateral dislocation and adjustable cortical button fixation in the posteromedial dislocation. The latter case additionally required repair of associated posterolateral soft-tissue injuries. At 12-month follow-up, both patients demonstrated maintenance of reduction, restoration of joint stability, substantial functional improvement, and no persistent neurological deficits or recurrent instability. These cases highlight the importance of recognizing irreducible PTFJ dislocations and addressing associated lesions when closed reduction fails. Rather than supporting a single fixation method, they illustrate a pattern-based surgical approach in which satisfactory short-term outcomes were achieved through anatomic reduction, restoration of soft-tissue stability, and protection of the common fibular nerve.</div></div><div><h3>Level of evidence</h3><div>Level V.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"19 ","pages":"Article 101173"},"PeriodicalIF":3.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holding the line: Ethics and surgical decision-making in an era of financial pressure in health care systems around the globe","authors":"Romain Seil,&nbsp;Elmar Herbst,&nbsp;Giuseppe Milano,&nbsp;Volker Musahl,&nbsp;Robert Prill,&nbsp;M. Enes Kayaalp,&nbsp;Natalie Mengis,&nbsp;Olufemi R. Ayeni,&nbsp;Michael T. Hirschmann","doi":"10.1016/j.jisako.2026.101137","DOIUrl":"10.1016/j.jisako.2026.101137","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"19 ","pages":"Article 101137"},"PeriodicalIF":3.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From structural prediction to surgical decision-making: methodological considerations on the Rotator Cuff Healing Index - A Letter to the Editor.","authors":"Jorge Rojas Lievano, Juan David Lacouture","doi":"10.1016/j.jisako.2026.101144","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101144","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101144"},"PeriodicalIF":3.3,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983668","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":"CRITICAL IMPLICATIONS OF FEMALE BONE METABOLISM IN ORTHOPEDICS: STATE OF THE ART.","authors":"Suzanne Hecht, Jocelyn Wittstein, Yuka Kimura, Claudia Arias","doi":"10.1016/j.jisako.2026.101133","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101133","url":null,"abstract":"<p><p>Female bone metabolism is a dynamic and tightly regulated process that plays a pivotal role in musculoskeletal health and orthopedic outcomes across the lifespan. Bone remodeling depends on the balance between osteoblastic bone formation and osteoclastic bone resorption and is strongly influenced by hormonal status, nutrition, genetics, physical activity, and systemic disease. In women, this balance is profoundly affected by reproductive and aging-related transitions, including adolescence, pregnancy and lactation, perimenopause, menopause, and postmenopause. Maximal peak bone mass is typically achieved by late adolescence or early adulthood and is a major determinant of future fracture risk. Inadequate nutrition, low energy availability, and insufficient weight-bearing activity during this critical period can compromise bone strength. In female athletes, Relative Energy Deficiency in Sport (REDs), formerly described as the Female Athlete Triad, is characterized by low energy availability (LEA), reproductive hormone suppression, and impaired bone health, substantially increasing the risk of bone stress injuries (BSI) and potentially leading to long-term deficits in bone mineral density (BMD). Hormones, particularly estrogen and progesterone, are central regulators of female bone metabolism. Estrogen deficiency-most notably during the menopausal transition-leads to accelerated bone loss, deterioration of bone microarchitecture, and a marked increase in osteoporotic fracture risk. Early or surgical menopause, aromatase inhibitor therapy, and chemotherapy-induced ovarian insufficiency further heighten this risk. Menopausal hormone therapy has demonstrated efficacy in preventing bone loss and reducing fracture incidence when appropriately prescribed. Adequate intake of key nutrients, including calcium, vitamin D, magnesium, and vitamin K, along with anti-inflammatory dietary patterns, is essential for maintaining bone integrity, optimizing fracture healing, and supporting surgical outcomes. Bone health is a critical determinant of success in orthopedic procedures such as fracture fixation, joint arthroplasty, and rotator cuff repair, as low bone mineral density (LMD) is associated with implant failure, delayed union, and revision surgery. This state-of-the-art review integrates current evidence on female bone metabolism, highlighting its relevance to sports injuries and orthopedic practice. It underscores the importance of early identification of at-risk patients, comprehensive bone health assessment, and individualized preventive and therapeutic strategies to improve musculoskeletal outcomes in women.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101133"},"PeriodicalIF":3.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864632","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}