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

{"title":"Twelve-month magnetic resonance imaging after anterior cruciate ligament reconstruction can identify risk factors for subsequent graft rupture and used to guide the return to sport. Results from a high-volume institution","authors":"Christian Lutz ,&nbsp;Fabio Mancino ,&nbsp;David A. Parker","doi":"10.1016/j.jisako.2025.100994","DOIUrl":"10.1016/j.jisako.2025.100994","url":null,"abstract":"<div><h3>Introduction</h3><div>Retear after anterior cruciate ligament reconstruction (ACLR) has been reported between 6% and 31% of cases, resulting in worse outcomes and increased risk of post-traumatic osteoarthritis. This study investigated whether postoperative magnetic resonance imaging (MRI) assessment, clinical outcomes, and return-to-sport test findings can help identify patients at higher risk of early graft retear.</div></div><div><h3>Methods</h3><div>Retrospective analysis of 430 patients who underwent primary ACLR using hamstring autograft between 2017 and 2022, with a minimum follow-up of 12 months. Baseline characteristics, intraoperative, and postoperative information were collected. Graft signal, tunnel widening and positioning were assessed through a 12-month MRI. Patients who experienced early graft retear were compared with a matched cohort with a ratio of 1:4. Continuous variables were compared. Logistic regression and analysis of variance were used to identify risk factors and association with retear. p values ​&lt; ​0.05 were considered significant.</div></div><div><h3>Results</h3><div>Of the 346 patients who met the inclusion/exclusion criteria, 19 experienced a graft rupture (5.4 ​%) after the 12-months follow-up. Of those, six patients were excluded due to missing postoperative 1-year MRI. Overall, 13 patients were included in the retear group and compared with 50 matched patients. The mean follow-up was 23.6 ​± ​4.2 months (range, 18–36 months). The 12-month MRI showed a greater signal-to-noise quotient (SNQ) in case of retear (2.93 vs 2.02; p ​= ​0.029). The analysis of variance showed a positive interaction between graft signal and retear (analysis of variance [ANOVA], p ​= ​0.028). Tunnel positioning was comparable between the groups, and not associated with retear. Similarly, tibial and femoral tunnel widening were comparable between the two groups and not associated with graft retear (ANOVA, p ​= ​0.733 and p ​= ​0.190). A greater proportion of patients had an anterior knee laxity &gt;2 ​mm at one year in the retear group (83.3% vs 38.8 ​%, p ​= ​0.058). However, mean laxity was comparable (2.55 ​mm vs 1.35 ​mm; p ​= ​0.189). No differences were noted for clinical scores and return-to-sport testing.</div></div><div><h3>Conclusion</h3><div>Higher graft signal on MRI at 12 months, indicating poorer graft healing, is associated with early anterior cruciate ligament retear. Resonance imaging after ACLR could be used to guide the follow-up management. Further research is required to confirm these preliminary findings.</div></div><div><h3>Level of evidence Ⅲ</h3><div>Retrospective comparative study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100994"},"PeriodicalIF":3.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972686","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":"Assessing the current medicolegal landscape in orthopedic sports medicine surgery—patient-centered communication and multidisciplinary approaches matter: A consensus statement","authors":"Zachary J. Herman ,&nbsp;Camila Grandberg ,&nbsp;Abigail N. Boduch ,&nbsp;Stephen J. Rabuck ,&nbsp;Bryson P. Lesniak ,&nbsp;Jonathan D. Hughes ,&nbsp;James J. Irrgang ,&nbsp;Michael K. Feeney ,&nbsp;MaCalus V. Hogan ,&nbsp;Volker Musahl","doi":"10.1016/j.jisako.2025.100993","DOIUrl":"10.1016/j.jisako.2025.100993","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>While the opportunity to provide medical care for elite-level professional and collegiate athletes is an honor and privilege, it does not come without a unique set of challenges. The team physician role continues to evolve and insights on today’s climate of team physicians’ care of elite athletes globally may be enlightening. As such, the purpose of this review is to provide a synopsis of the meeting’s key points and present the results of the survey to better delineate the effect of the medicolegal risk involved in the care of elite athletes.</div></div><div><h3>Methods</h3><div>An international and multidisciplinary group of experts on anterior cruciate ligament injury and sports medicine was chosen to participate on a panel at the 2024 Freddie Fu Panther Sports Medicine Symposium held at the University of Pittsburgh, Pittsburgh, Pennsylvania, USA, on June 6, 2024. The international panel included orthopaedic surgeons, primary care physicians, and scientists and focused on the medicolegal climate of sports medicine. Throughout the duration of the panel, a live questionnaire was provided to the audience, which included practitioners from 17 countries and 5 continents. The survey consisted of eight “yes/no” questions.</div></div><div><h3>Results</h3><div>Several themes emerged from the discussion, including differing medicolegal consequences based on geographic location, changes to documentation in response to litigation risk, and increases in personal stressors to physicians. Of the eight statements administered to the audience during the panel discussion, only three had greater than 50 ​% agreement. These statements included changes to practice based on the medicolegal climate and the effects of defensive practice on physicians and patients alike.</div></div><div><h3>Conclusion</h3><div>The risk of litigation in orthopaedic sports medicine surgery varies greatly based on the geographic location of the practice and is perceived to affect both patient care and providers alike. As the assessment of medical professional liability risk arising from the care of elite athletes continues to evolve, discussion among physicians, athletes, agents, and teams/clubs should be patient-centered, multidisciplinary, and undertaken with absolute professionalism, strong communication, and thorough documentation.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100993"},"PeriodicalIF":3.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849304","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":"Posterior fan-like extension of the anterior cruciate ligament femoral insertion increases ligament failure strength","authors":"Ryo Kanto ,&nbsp;Michael P. Smolinski ,&nbsp;Aly M. Fayed ,&nbsp;Monica A. Linde ,&nbsp;Volker Musahl ,&nbsp;Freddie H. Fu ,&nbsp;Patrick Smolinski","doi":"10.1016/j.jisako.2025.100939","DOIUrl":"10.1016/j.jisako.2025.100939","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The purpose of this study was to examine the role of the posterior fan-like extension (PFLE) region of the anterior cruciate ligament (ACL) on ligament failure load. It was hypothesized that transection of the PFLE region would reduce the ACL load-carrying capacity.</div></div><div><h3>Methods</h3><div>With institutional approval, fifteen fresh-frozen human cadaveric knees were divided into two age-matched groups: intact ACL femoral insertion (ACL intact group, n ​= ​8) and the cut ACL fan-like extension (PFLE-cut group, n ​= ​7). In the PFLE-cut group, the border between the mid-substance insertion and the PFLE was identified at 90° of knee flexion, and the border was cut. All specimens were dissected down to the ACL and placed in an axial testing machine at 15° of flexion, and anterior tibial loading was applied until ACL failure.</div></div><div><h3>Results</h3><div>The failure (peak) load of the ACL intact group was 910.1 ​± ​473.3 ​N, which was significantly greater (<em>P</em> ​&lt; ​0.05) than the failure load of the PFLE-cut group (409.5 ​± ​219.7 ​N). The displacement at the failure load of the ACL intact group was 21.7 ​± ​5.5 ​mm, which was significantly greater (<em>P</em> ​&lt; ​0.05) than the 14.5 ​± ​4.9 ​mm failure load displacement of the PFLE-cut group.</div></div><div><h3>Conclusion</h3><div>Transection of the PFLE region of the ACL femoral footprint significantly reduced the failure load of the ligament under anterior tibial loading at 15° of flexion. The morphology of the ACL at the femoral insertion significantly affects the failure strength of the ligament. If ACL reconstruction grafts could be constructed to more closely mimic this geometry, they could potentially have increased failure strengths and reduce failure rates.</div></div><div><h3>Level of Evidence</h3><div>Not applicable.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100939"},"PeriodicalIF":3.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812540","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":"Revision anterior cruciate ligament reconstruction in patients with high-grade anterolateral knee instability combined with modified Lemaire tenodesis using soft anchor fixation: Clinical and radiographic outcomes at two-year follow-up","authors":"Jacopo Conteduca ,&nbsp;Alessandro Carrozzo ,&nbsp;Marco Giaracuni ,&nbsp;Paolo Pichierri ,&nbsp;Damiano Longo ,&nbsp;Giuseppe Rollo","doi":"10.1016/j.jisako.2025.100938","DOIUrl":"10.1016/j.jisako.2025.100938","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>In recent years, the number of primary anterior cruciate ligament reconstructions (ACLRs) has increased, accompanied by an increase in revision anterior cruciate ligament reconstructions (RACLRs). Residual anterolateral knee instability has been identified as a major contributor to graft failure. Consequently, lateral extra-articular procedures (LEAPs), particularly modified Lemaire tenodesis, have gained interest in the management of high-grade anterolateral rotational instability in RACLR. The aim of this study was to evaluate the clinical outcomes of patients undergoing combined RACLR and modified Lemaire tenodesis with soft anchor fixation. The hypothesis was that this fixation could lead to good results in terms of clinical outcomes at a minimum follow-up of two years.</div></div><div><h3>Methods</h3><div>A retrospective review of consecutive patients with failed primary ACLR and high-grade anterolateral rotational instability (side-to-side difference &gt;5 ​mm, pivot shift ≥2+) was performed. All patients underwent an outside-in femoral tunnel technique for doubled semitendinosus and gracilis tendon ACLR, and a 2.6-mm knotless suture anchor was used for Lemaire fixation. Postoperative rehabilitation allowed for immediate weight bearing and progressive range of motion. Patients were evaluated clinically and radiographically at 3 and 6 weeks and at 3, 6, 12, and 24 months. Outcome measures included Lachman and pivot-shift tests, Rolimeter measurements, Tegner Activity Scale, Lysholm score, and subjective and objective International Knee Documentation Committee (IKDC) scores. Also, radiographic analysis was performed at the last follow-up.</div></div><div><h3>Results</h3><div>The final population comprised 15 patients. At a minimum of 2 years’ follow-up, one patient (6.6%) experienced graft failure. Most patients (10/15) achieved normal (Grade A) IKDC objective scores, with significant improvements in side-to-side differences and patient-reported outcomes. No intraoperative tunnel convergence was observed, and no additional hardware removal or reoperation was required.</div></div><div><h3>Conclusions</h3><div>A combined RACLR with modified Lemaire extra-articular tenodesis using soft anchor fixation provided favorable clinical and radiographic results in patients with high-grade anterolateral rotatory knee instability without significant complications.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100938"},"PeriodicalIF":3.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785556","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":"Factors associated with treatment failure after hip arthroscopic surgery for the patient with femoroacetabular impingement secondary to Legg-Calvé-Perthes disease","authors":"Takahiro Negayama ,&nbsp;Haruki Nishimura ,&nbsp;Yoichi Murata ,&nbsp;Keisuke Nakayama ,&nbsp;Shinichiro Takada ,&nbsp;Hirotaka Nakashima ,&nbsp;Hokuto Fukuda ,&nbsp;Akinori Sakai ,&nbsp;Soshi Uchida","doi":"10.1016/j.jisako.2025.100937","DOIUrl":"10.1016/j.jisako.2025.100937","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Legg-Calvé-Perthes disease (LCPD) leads to complex hip deformities that often result in femoroacetabular impingement (FAI). While traditional open surgeries have been used to address these deformities, hip arthroscopy has emerged as a minimally invasive alternative. However, the factors determining successful outcomes in arthroscopic management of LCPD-related FAI remain poorly defined. The aim of this study was to compare clinical outcomes between successful and failed cases following hip arthroscopic surgery for FAI secondary to LCPD and identify factors associated with treatment failure to optimize patient selection.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who underwent hip arthroscopy for FAI secondary to LCPD from 2011 to 2023. Patients with less than 2-year follow-up or incomplete records were excluded. Treatment failure was defined as requiring revision surgery, experiencing complications, or failing to achieve both the minimal clinically important difference (9.1 points) and Patient-Acceptable Symptom State threshold (72 points) on the modified Harris Hip Score. We evaluated patient characteristics, clinical outcomes, radiographic measurements including lateral center-edge angle (LCEA) and vertical-center-anterior angle (VCAA), preoperative radiographic severity using Tönnis grade, lateral pillar classification, and Stulberg grade and compared these factors between success and failure groups.</div></div><div><h3>Results</h3><div>The study included 15 hips in 14 patients. Nine hips achieved successful outcomes, while six hips were considered failures. The failure group was statistically significantly older (35.5 years versus 20.3 years, P ​= ​0.047) with decreased acetabular coverage, showing smaller LCEA (19.3° versus 30.2°, P ​= ​0.046) and VCAA (14.7° versus 33.3°, P ​= ​0.033). The failure group demonstrated higher frequencies of preoperative Tönnis grade ≥2, lateral pillar classification ​≥B, and Stulberg grade ≥4, indicating more severe degenerative changes and deformity. No statistically significant differences were observed in gender distribution or duration of symptoms between the groups.</div></div><div><h3>Conclusion</h3><div>Forty percent of patients experienced treatment failure after hip arthroscopic surgery for FAI secondary to LCPD. Advanced age, decreased acetabular coverage, and severe preoperative radiographic changes were associated with treatment failure. These findings suggest careful patient selection based on these factors is crucial for successful arthroscopic treatment in this patient population.</div></div><div><h3>Level of Evidence</h3><div>Level III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100937"},"PeriodicalIF":3.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776396","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":"Open figure-of-8 configuration for traumatic posterior sternoclavicular joint dislocation of the shoulder: A novel technique","authors":"Mirko Poli ,&nbsp;Matteo Messori ,&nbsp;Federico Bove ,&nbsp;Valerio Moretti ,&nbsp;Joil Ramazzotti ,&nbsp;Alberto Nicolò Bergamini ,&nbsp;Giuseppe Mazzone ,&nbsp;Marco Reda ,&nbsp;Arash Astaneh ,&nbsp;Capitani Dario ,&nbsp;Massimo Domenico Torre ,&nbsp;Filippo Familiari ,&nbsp;Paolo Capitani","doi":"10.1016/j.jisako.2025.100933","DOIUrl":"10.1016/j.jisako.2025.100933","url":null,"abstract":"<div><div>Posterior dislocation of the sternoclavicular joint (SCJ) is a rare clinical condition requiring surgical management. Various surgical techniques have been described in the literature, but those involving bone tunnels carry an increased risk of residual instability and iatrogenic fractures. We present a novel surgical technique for the management of both acute and chronic posterior SCJ dislocations, based on a figure-of-eight configuration with autograft, which ensures joint stability while preserving its natural mobility. Furthermore, the use of a single clavicular tunnel oriented orthogonally to two sternal tunnels creates a highly stable three-dimensional construct and reduce iatrogenic fractures.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100933"},"PeriodicalIF":3.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765624","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 after conversion total knee arthroplasty following high tibial osteotomy and primary total knee arthroplasty: A matched cohort study","authors":"Ignacio Fernández Z,&nbsp;Myles Coolican","doi":"10.1016/j.jisako.2025.100931","DOIUrl":"10.1016/j.jisako.2025.100931","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Knee osteoarthritis (OA) leads to pain and functional decline. While total knee arthroplasty (TKA) is a definitive treatment, high tibial osteotomy (HTO) offers a joint-preserving alternative for younger patients with malalignment. However, patients with HTO may eventually require conversion to TKA. This study aimed to compare clinical, functional, and patient-reported outcome measures (PROMs) of patients undergoing TKA after a prior medial opening wedge HTO to a matched cohort who had a primary TKA, with follow-up at ≥12 months.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from The Knee Institute, Sydney, Australia. Patients converted from HTO to TKA were matched 1:1 to primary TKA patients based on age, sex, surgeon, body mass index, medial compartment OA, and approximate year of surgery. Inclusion criteria were TKA between 2011 and 2023, prior HTO in the same knee, both procedures by one of three fellowship-trained orthopaedic surgeons; and ≥ one year of follow-up. Data collected included the Oxford Knee Score (OKS), the Veterans RAND 12-Item Health Survey (VR-12), range of motion (ROM), hospital stay, and the Caton–Deschamps index (CDI). Fifty-one converted TKA patients were matched. Statistical analysis used paired t-tests, Mann–Whitney U, chi-square, and Fisher’s exact tests.</div></div><div><h3>Results</h3><div>Both groups showed statistically significant postoperative improvements in the OKS and the VR-12 physical scores (p ​&lt; ​0.01), with no statistically significant difference between groups. ROM improved in both groups; flexion was slightly higher in the primary TKA group but not statistically significant. Patella baja was more frequent in the HTO-to TKA group; however, this was not statistically significant (p ​= ​0.054). Both groups had a median hospital stay of 5 days; however, the HTO-to-TKA group demonstrated a statistically significant distribution shift toward longer stays.</div></div><div><h3>Conclusion</h3><div>Conversion from HTO to TKA yields comparable clinical and functional outcomes to primary TKA. These findings emphasize the effectiveness of TKA after HTO and the importance of careful preoperative planning in this patient population.</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":"14 ","pages":"Article 100931"},"PeriodicalIF":3.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754661","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":"Robotic total knee arthroplasty with functional alignment yields comparable outcomes across age and gender groups","authors":"Christos Koutserimpas ,&nbsp;Luca Andriollo ,&nbsp;Pietro Gregori ,&nbsp;Elvire Servien ,&nbsp;Cécile Batailler ,&nbsp;Sébastien Lustig","doi":"10.1016/j.jisako.2025.100930","DOIUrl":"10.1016/j.jisako.2025.100930","url":null,"abstract":"<div><h3>Objectives</h3><div>Age and gender can influence total knee arthroplasty (TKA) outcomes, complications, and revision rates. Functional alignment (FA), a personalized approach guided by robotic systems, has emerged as a strategy to optimize outcomes by addressing patient-specific anatomy and laxities. However, limited evidence exists regarding the influence of age and gender on outcomes of FA-guided robotic-assisted TKA.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated 353 patients who underwent robotic-assisted TKA guided by FA principles with a minimum of 2 years of follow-up. Patients were divided into groups based on age (≥75 years vs. &lt;75 years) and gender (males vs. females). Outcomes assessed included functional scores [Knee Society Score (KSS) and Forgotten Joint Score (FJS)], complications, and revision rates. Coronal alignment was evaluated using preoperative and postoperative full-length weight-bearing X-rays and the data from the robotic system.</div></div><div><h3>Results</h3><div>Preoperative clinical and radiographic evaluations showed no statistically significant differences between age groups. Females had more valgus preoperative alignment compared to males. Postoperatively, functional outcomes (KSS and FJS) and coronal alignment were comparable across all groups, with the only exception being the female group, which reported statistically significant higher FJS scores (P ​= ​0.02) despite similar KSS scores. Complication and revision rates did not differ in a statistically significant manner between groups.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that robotic-assisted TKA guided by FA yields comparable outcomes, complication rates, and revision rates across gender and age groups. These findings suggest that FA may help reduce demographic disparities by providing consistent outcomes across diverse patient populations.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100930"},"PeriodicalIF":3.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733663","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":"Outcomes of surgically treated traumatic neuromas of cutaneous nerves as complications of ankle arthroscopy: A 5-year follow-up","authors":"Yuxin Yan MS ,&nbsp;Yunfeng Chu BMed ,&nbsp;Xintao Zhang M.D ,&nbsp;Ying Shan Ph.D ,&nbsp;Sumeng Chen MS ,&nbsp;Yanling Wei MS ,&nbsp;Jingting Yan MPH ,&nbsp;Lu Bai M.D","doi":"10.1016/j.jisako.2025.100932","DOIUrl":"10.1016/j.jisako.2025.100932","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the long term result of traumatic neuromas as complications of ankle arthroscopy treated by neuroma resection.</div></div><div><h3>Methods</h3><div>Twenty-five patients diagnosed with traumatic neuroma as complications of ankle arthroscopy were included. The standard procedure of microsurgical neuroma resection and nerve release was performed in all patients. Outcomes comparison was evaluated at 3 months, 1 year, 2 years and 5 years postoperatively. Sensory function was assessed using the British Medical Research Council (BMRC) scale. Visual analog scale (VAS) was used to evaluate pain relief. The diameter of the affected nerve was measured by ultrasound.</div></div><div><h3>Results</h3><div>A total of 4 (16%) patients experienced neuroma recurrence during the 5-year follow-up. In nonrecurrence cases, sensory function improvement was observed at 3 months (<em>P</em> ​&lt; ​0.0001) and 2 years (<em>P</em> ​= ​0.003). There was no further statistically significant improvement to 5 years, by which time 11 patients (52.4%) had above partial recovery of sensory function (S3+, S4). The VAS pain score was 4 (3–4) preoperatively and 2 (1–2) at 3 months (Z ​= ​−4.347, <em>P</em> ​&lt; ​0.0001), which continued to improve, and patients got pain relief during the 2–5 years postoperative [2–5 years, 1 (0–1)]. The mean nerve diameter decreased at 3 months [preoperative, 20 (18.5–22); 3 months, 11 (9–12); Z ​= ​−6.082, <em>P</em> ​&lt; ​0.0001]. We did not observe a statistically significant increase of nerve diameter during the rest of follow-up time [5 years, 10 (9–11); Z ​= ​−0.765, <em>P</em> ​= ​0.451].</div></div><div><h3>Conclusion</h3><div>Microsurgical resection was effective for traumatic neuromas of ankle cutaneous nerves. Patients experienced pain relief and partial recovery of nerve function. Most sensory recovery occurred during the first 3 months and continued to 2 years. However, neuroma recurrence was also observed in some cases.</div></div><div><h3>Level of evidence</h3><div>Ⅳ</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100932"},"PeriodicalIF":3.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733662","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":"Midterm clinical outcomes and risk factor for conversion to total hip arthroplasty after arthroscopic treatment for femoroacetabular impingement syndrome in individuals over 40 years of age","authors":"Hirotaka Nakashima MD, PhD ,&nbsp;Yoichi Murata MD, PhD ,&nbsp;Shinichiro Takada MD, PhD ,&nbsp;Keisuke Nakayama MD, PhD ,&nbsp;Haruki Nishimura MD, PhD ,&nbsp;Hokuto Fukuda MD ,&nbsp;Akinori Sakai MD, PhD ,&nbsp;Soshi Uchida MD, PhD","doi":"10.1016/j.jisako.2025.100929","DOIUrl":"10.1016/j.jisako.2025.100929","url":null,"abstract":"<div><h3>Introduction</h3><div>The clinical outcomes of hip arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) in the older population are good, with a relatively high conversion rate of total hip arthroplasty (THA). However, the risk factors for conversion to THA in patients over 40 years of age are unclear. The purpose of this study was to review the midterm clinical outcomes after hip arthroscopic treatment for FAIS in patients over 40 years of age and to reveal the risk factors for conversion to THA.</div></div><div><h3>Methods</h3><div>Patients with FAIS who underwent primary hip arthroscopic treatment from March 2009 to December 2015 were retrospectively reviewed. Patient-reported outcome scores (PROs) and conversion to THA were assessed. To identify the predictors of conversion to THA, the non-THA and THA groups were compared via univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>Among 172 patients, 98 met the inclusion criteria, and 70 patients (34 males and 36 females) were followed for more than 5 years. The mean age at surgery was 53.6 ​± ​9.8 years, and the mean body mass index was 23.3 ​± ​2.9 ​kg/m². Sixteen patients (22.9%) were converted to THA at a mean of 47.3 ​± ​38.1 months after surgery. The lateral center-edge angle in the non-THA group was significantly greater than that in the THA group (p ​= ​0.040). The proportion of microfracture in the THA group was significantly greater than that in the non-THA group (p ​&lt; ​0.001). The Cox hazard model revealed that microfracture was a predictor of conversion to THA (hazard ratio 5.405, 95% CI: 1.876–15.384; p ​= ​0.002). The PROs in the non-THA group significantly improved after surgery.</div></div><div><h3>Conclusion</h3><div>The risk factor for conversion to THA was cartilage damage needed for microfracture. The rate of conversion to THA after primary hip arthroscopic treatment for FAIS in individuals over 40 years of age was 22.9% at a minimum 5-year follow-up.</div></div><div><h3>Level of Evidence</h3><div>Ⅳ.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100929"},"PeriodicalIF":3.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676010","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}