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

{"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}

{"title":"Arthroscopic Medial Meniscus Substitution Using Autologous Semitendinosus Tendon with Suture Tape Augmentation as an Alternative to Meniscal Allograft Transplantation: A Modified Technique.","authors":"Gabriel Antonio A Escueta, Chih-Hao Chiu, Cheng-Pang Yang, Karl Eriksson","doi":"10.1016/j.jisako.2026.101112","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101112","url":null,"abstract":"<p><p>Irreparable meniscal tears and complete loss of meniscal tissue can accelerate osteoarthritis by disrupting normal load transmission within the knee. Although meniscal allograft transplantation (MAT) is commonly used for the post-meniscectomy knee, its clinical application is limited by graft availability, sizing logistics, cost, and potential disease transmission. Autologous tendon substitution has therefore emerged as an accessible alternative. This technical note describes a reproducible arthroscopic technique for medial meniscal substitution using an autologous semitendinosus tendon (ST) graft reinforced with suture tape augmentation. The procedure combines anatomic tibial bone tunnel fixation of the anterior and posterior roots with hybrid peripheral suture fixation-employing all-inside sutures at the posterior root and outside-in sutures at the mid-body and anterior horn-to optimize graft containment and restore hoop tension. Surgical indications, key technical steps, and pearls to avoid common pitfalls are detailed. By addressing the logistical and economic limitations of allograft transplantation, this technique provides a cost-effective, universally available, and biologically compatible option for medial meniscal reconstruction. This approach aims to restore knee kinematics and may help delay degenerative joint changes in young, active patients.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101112"},"PeriodicalIF":3.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677450","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":"Preserving scientific integrity in academic publishing: Navigating artificial intelligence, journal policies, and the impact factor as a quality indicator","authors":"Mahmut Enes Kayaalp ,&nbsp;Stefano Zaffagnini ,&nbsp;Michael A. Mont ,&nbsp;Jon Karlsson ,&nbsp;Bruce Reider ,&nbsp;Olufemi Ayeni ,&nbsp;Thomas Heyse ,&nbsp;Henning Madry ,&nbsp;Elmar Herbst ,&nbsp;Giuseppe Milano ,&nbsp;Volker Musahl ,&nbsp;Roland Becker ,&nbsp;Michael T. Hirschmann","doi":"10.1016/j.jisako.2025.100940","DOIUrl":"10.1016/j.jisako.2025.100940","url":null,"abstract":"<div><div>The integration of artificial intelligence (AI), the rise of mega-journals, and the manipulation of impact factors present challenges to scientific integrity. These trends threaten the core principles of objectivity, reproducibility, and transparency. This editorial highlights two categories of threats: (1) external pressures, such as AI misuse and metric-driven publishing models, and (2) internal systemic flaws, including the <em>‘publish or perish’</em> culture and methodological fragility. Mega-journals, characterized by high-volume publishing and broad interdisciplinary scopes, improve accessibility and accelerate dissemination. However, the emphasis on publication volume might weaken the rigor of peer review. To navigate these challenges, the authors propose a balanced approach that harnesses innovation without compromising scientific integrity. Proposed solutions include mandating AI transparency through frameworks like CONSORT-AI, and redefining impact metrics to emphasize reproducibility, mentorship, and societal impact alongside citations. Scientific journals should promote career opportunities based less on publication quantity and more on quality. Global cooperation, via initiatives like the San Francisco Declaration on Research Assessment (DORA) and the Committee on Publication Ethics (COPE), is essential to standardize ethics and address resource disparities. This editorial proposes solutions for researchers, journals, and policymakers to realign academic incentives and uphold the ethical foundation of the science. By fostering transparency, accountability, and equity, the scientific community can preserve its ethical foundations while embracing transformative tools—ultimately advancing knowledge and serving society.</div></div><div><h3>For clinical trials</h3><div>n/a.</div></div><div><h3>Level of evidence</h3><div>V.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"17 ","pages":"Article 100940"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491924","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 sentinel sign of the biceps tendon as an arthroscopic indicator of supraspinatus tears","authors":"Geert Alexander Buijze MD ,&nbsp;Igor J. Shirinskiy MD ,&nbsp;Paul Commeil MD ,&nbsp;Pratheek Chikkalur MD ,&nbsp;Arno A. Macken MD ,&nbsp;Michel P.J. van den Bekerom Prof ,&nbsp;Laurent Lafosse MD ,&nbsp;Thibault Lafosse MD","doi":"10.1016/j.jisako.2026.101065","DOIUrl":"10.1016/j.jisako.2026.101065","url":null,"abstract":"<div><h3>Introduction</h3><div>Magnetic resonance imaging (MRI) is highly accurate for diagnosing full-thickness rotator cuff tears but inaccurate in detecting small anterosuperior cuff tears near the rotator interval. Expanding on the concepts of long head of biceps tendon (LHBT) instability and the anterior sentinel sign, the present study evaluated the posterior sentinel sign, a novel arthroscopic indicator of supraspinatus tears.</div></div><div><h3>Methods</h3><div>This monocentric prospective cohort study included patients undergoing arthroscopic repair of rotator cuff tears at a single institution. The integrity and stability of the LHBT were assessed intra-articularly for abrasion, delamination, or partial tears. Sentinel signs were classified as anterior or posterior based on their location on the LHBT. Rotator cuff tears were evaluated, and their correlation with sentinel signs was analyzed using the chi–squared test. To evaluate the diagnostic value of the sentinel signs, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated.</div></div><div><h3>Results</h3><div>This study included 69 patients. The posterior sentinel sign was observed in 21/39 patients with supraspinatus tears (53.8%) and in 1/30 patient without (3.3%), showing a significant association (X² = 19.9, p &lt; 0.001, Phi = 0.54). For detecting supraspinatus tears, the posterior sentinel sign had a sensitivity of 53.8% (95%CI: 38.6–68.4), specificity of 96.7% (83.3%-99.4), PPV of 95.5% (78.2–99.2), NPV of 61.7% (47.4%-74.2) and AUC of 0.79 (95%CI: 0.68–0.89). The anterior sentinel sign was present in 17/24 patients with subscapularis tears (70.8%) and absent in those without (0/45), showing a significant association (X² = 42.3, p &lt; 0.001, Phi = 0.78). For detecting subscapularis tears, it had a sensitivity of 70.8% (95%CI: 50.8–85.1), specificity of 100% (92.1–100), PPV of 100% (81.6–100), NPV of 86.5% (74.7–93.3) and AUC of 0.97 (95%CI: 0.87–0.99).</div></div><div><h3>Conclusions</h3><div>Expanding our evaluation of the previously reported arthroscopic LHBT sentinel sign with a more detailed description of location, two main types can be discriminated. The anterior sentinel sign, which is associated with subscapularis tears, and the posterior sentinel sign, which is associated with supraspinatus tears. The presence of a sentinel sign should prompt the clinician tosearch for (occult) anterosuperior rotator cuff tears.</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":"17 ","pages":"Article 101065"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935538","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":"Radial tears of the lateral meniscus reduce contact area by 70% and triple condylar stress: A physics-based finite element analysis","authors":"Horacio Rivarola MD (Orthopaedic Surgeon, Knee Surgery Specialist) ,&nbsp;Camilo Helito MD (Orthopaedic Surgeon, Knee Surgery Specialist) ,&nbsp;Cristian Collazo MD (Orthopaedic Surgeon, Knee Surgery Specialist) ,&nbsp;Marcos Palanconi MD (Orthopaedic Surgeon, Knee Surgery Specialist) ,&nbsp;Marcos Meninato MD (Orthopaedic Surgeon, Knee Surgery Specialist) ,&nbsp;Francisco Endara Urresta MD (Orthopaedic Surgeon) ,&nbsp;Carlos Peñaherrera-Carrillo MD (Orthopaedic Surgeon) ,&nbsp;Alejandro Barros Castro MD (Resident) (Traumatology and Orthopedics Resident) ,&nbsp;Bautista Rivarola MD (Physician)","doi":"10.1016/j.jisako.2026.101066","DOIUrl":"10.1016/j.jisako.2026.101066","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction/objectives&lt;/h3&gt;&lt;div&gt;Radial tears of the lateral meniscus disrupt the circumferential collagen fibers responsible for converting axial compression into hoop tension. Although their clinical impact is well recognized, the underlying physics of stress redistribution remains poorly quantified and rarely visualized. The objective of this study was to model and mechanically characterize how radial tears alter contact stress distribution using solid-mechanics principles and finite element analysis (FEA), and to determine whether anatomic repair restores hoop-stress continuity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A three-dimensional FEA model of a healthy knee was reconstructed from high-resolution 3-T magnetic resonance imaging (MRI). Four conditions were simulated under identical loading: intact meniscus, 50% partial radial tear, complete (100%) radial tear, and anatomic repair. A 1000-N axial load was applied with a friction coefficient of 0.02. Primary outcomes included femorotibial contact area, peak contact stress, and qualitative stress-flow continuity, assessed through vector and heat map trajectories. Model performance was validated against published cadaveric and computational benchmarks. Repeated measures analysis of variance (ANOVA) with Bonferroni correction was used to compare conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The intact meniscus demonstrated uniform stress distribution with a mean contact area of 110 ± 8 mm&lt;sup&gt;2&lt;/sup&gt; and peak stress of 1.2 ± 0.2 MPa.&lt;/div&gt;&lt;div&gt;A 50% radial tear reduced contact area to 80 ± 7 mm&lt;sup&gt;2&lt;/sup&gt; (−27%) and increased peak stress to 2.1 ± 0.3 MPa (p &lt; 0.001). A complete radial tear further decreased contact area to 35 ± 6 mm&lt;sup&gt;2&lt;/sup&gt; (−68%) and tripled peak stress to 3.3 ± 0.4 MPa (2.8-fold increase; p &lt; 0.001). Anatomic repair restored 86% of baseline contact area (95 ± 7 mm&lt;sup&gt;2&lt;/sup&gt;) and normalized peak stress to 1.4 ± 0.3 MPa (p = 0.04 vs. intact; ns for intact vs. repaired). Stress flow analysis showed complete collapse of circumferential tension after full tear, with restoration of hoop-stress continuity following repair. Correlation with experimental benchmarks was strong (r = 0.91).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study quantitatively demonstrates that a radial meniscal tear disrupts circumferential load transmission, converting uniform hoop tension into focal condylar overload according to the fundamental principle that stress equals force divided by area. Finite element analysis showed that loss of circumferential continuity reduces contact area by nearly seventy percent and triples peak stress, whereas anatomic repair restores stress flow and re-establishes near-normal load sharing. These findings provide a physics-based explanation for the mechanical collapse that follows radial tears and reinforce that successful meniscal repair must restore the biomechanics of the hoop.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level of evidence&lt;/h3&gt;&lt;div&gt;III – Experimental bi","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"17 ","pages":"Article 101066"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991097","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":"Transposition of the local extensor fascia for elbow lateral collateral ligament reconstruction: Results in a group of competitive athletes","authors":"Giuseppe Bardellini MD ,&nbsp;Angelo De Crescenzo MD ,&nbsp;Marco Filipponi MD ,&nbsp;Michele Di Mauro MD ,&nbsp;Federico Martinelli MD ,&nbsp;Andrea Celli MD ,&nbsp;Luigi Celli MD Prof","doi":"10.1016/j.jisako.2025.101059","DOIUrl":"10.1016/j.jisako.2025.101059","url":null,"abstract":"<div><h3>Introduction</h3><div>The lateral ulnar collateral ligament (LUCL) is a primary elbow stabilizer against posterolateral rotatory instability (PLRI). Direct repair is the treatment of choice in the acute setting, whereas reconstruction is the best option in patients with chronic PLRI. Several autograft/allograft solutions can be used to perform LUCL reconstruction, including a local extensor fascia septum autograft.</div></div><div><h3>Methods</h3><div>In this retrospective multicenter study, 38 patients (26 males and 12 females) with chronic PLRI of the elbow underwent LUCL reconstruction with a local extensor fascia septum autograft. Patients’ mean age at the time of surgery was 35.5 ± 9.6 years. The right elbow was involved in 29 cases and the left elbow in 9 cases. The dominant arm was involved in 23 (61%) patients. All patients were competitive athletes practicing different sports. Clinical assessments included range of motion and stability using the Mayo Elbow Performance Score (MEPS), the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, the visual analog scale (VAS), and the rate of return to sports. Radiographs were taken to evaluate joint congruency, heterotopic ossifications, and grade of osteoarthritis.</div></div><div><h3>Results</h3><div>At a mean follow-up of 36.7 ± 7.8 months, the range of motion in flexion and extension was comparable to preoperative values, whereas the postoperative MEPS, the QuickDASH score, and the VAS score showed statistically significant differences (p &lt; 0.001). Before the procedure, the MEPS was 76 ± 12.6, the QuickDASH score was 23 ± 5.6, and the VAS score during the activities was 5 ± 3. At the last follow-up, the MEPS was 97 ± 5.9 and the QuickDASH score was 1.3 ± 2.8; both showed a statistically significant improvement (p &lt; 0.001). The VAS score was 0.34 ± 0.67 and was also statistically significantly improved (p &lt; 0.001). The significant improvement in the functional scores enabled 33 of the 38 patients to return to their previous sports level.</div></div><div><h3>Conclusion</h3><div>The high rate of return to previous sports level of our cohort of athletes demonstrates that the local extensor fascia septum autograft is a viable LUCL reconstruction option for patients with chronic PLRI. Further prospective studies are needed to validate these encouraging results.</div></div><div><h3>Level of evidence</h3><div>Level IV, Case Series, Prognosis Studies.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"17 ","pages":"Article 101059"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991031","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":"Moderate Predictive Ability of Machine Learning for Achievement of Minimal Clinically Important Difference for the Pain and Healthy Utility Scores after Hip Arthroscopy: Analysis From the Femoroacetabular Impingement RandomiSed Controlled Trial (FIRST) and Embedded Prospective Cohort.","authors":"Prushoth Vivekanantha, Jeffrey Kay, Nicole Simunovic, Olufemi R Ayeni","doi":"10.1016/j.jisako.2026.101097","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101097","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>To predict achievement of the minimal clinically important difference (MCID) for the Visual Analogue Scale (VAS) and EuroQol-5D (EQ-5D) score at six and 12 months using both logistic regression and machine learning models.</p><p><strong>Methods: </strong>Data from the Femoroacetabular Impingement RandomiSed controlled Trial (FIRST) and its embedded prospective cohort was used. Predictive models were trained using demographic, radiographic, and intraoperative variables using a 70:30 training split. MCID was defined using a distribution-based method. Model discrimination was assessed using area under the curve (AUC), and calibration was evaluated via slope, intercept, and Brier scores. Models included logistic regression, LASSO, XGBoost, and Random Forest.</p><p><strong>Results: </strong>309 patients (mean±SD age 34.0±8.7 years, 37.7% female) were included. MCID for VAS and EQ-5D was 11.4 and 9.0, respectively. MCID achievement for VAS and EQ-5D was 70% and 72%, and 52.9% and 55.5% at six and 12 months, respectively. For VAS, at six months, XGBoost and logistic regression achieved AUCs of 0.653 and 0.623, respectively. At 12 months, logistic regression and LASSO achieved AUCs of 0.722 and 0.762, respectively. Key predictors for MCID achievement VAS at six or 12 months included increased baseline VAS, decreased Outerbridge grade, male sex, increased traction time, and presence of labral tears. Logistic regression and LASSO were the two strongest models at six and 12 months for EQ-5D, with AUCs of 0.817 and 0.745, respectively The most important predictor of achieving the MCID for both models was lower baseline EQ-5D scores.</p><p><strong>Conclusion: </strong>Logistic regression and machine learning demonstrated moderate ability (AUC∼0.6-0.8) to predict achievement of the MCID for VAS and EQ-5D at six and 12 months postoperatively. For VAS, XGBoost had the highest AUC at six months, while logistic regression and LASSO were superior at 12 months. Factors contributing to MCID achievement of VAS included higher preoperative VAS scores, younger age, male sex, lower Outerbridge grade, and increased traction time. For EQ-5D, logistic regression and LASSO achieved the highest predictive performance at six and 12-months. The strongest predictor of achievement of the MCID for EQ-5D was lower preoperative scores.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101097"},"PeriodicalIF":3.3,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468764","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 Treatment of Avulsion Fracture of the Posterior Cruciate Ligament from the Tibia: A Modified Surgical Technique and Case Series.","authors":"Xinxiao Chen, Yihong Cao, Zhongzheng Shi, Longxin An, Jie Zhao, Xiaojing Li, Yanbin Teng, Xuecheng Sun, Xiaoming Yang, Naibo Feng","doi":"10.1016/j.jisako.2026.101086","DOIUrl":"https://doi.org/10.1016/j.jisako.2026.101086","url":null,"abstract":"<p><strong>Objective: </strong>Avulsion fractures of the posterior cruciate ligament (PCL) at its tibial insertion present technical challenges and are critical for restoring knee stability and function. Traditional open surgery may cause extensive soft-tissue disruption and increase the risk of neurovascular injury. Arthroscopic fixation has become the preferred approach. This study describes a modified arthroscopic technique using steel wire and high-strength sutures for PCL tibial avulsion fixation and evaluates its clinical outcomes in a case series.</p><p><strong>Methods: </strong>The technique utilizes anteromedial, anterolateral, and posterolateral portals. With a tibial PCL guide, steel wire and high-strength sutures are passed through three tibial tunnels to achieve anatomical reduction and secure fixation of the avulsed fragment. We retrospectively reviewed 27 patients who underwent this procedure between January 2021 and August 2024. Pre- and postoperative assessments included knee range of motion (ROM), posterior tibial displacement measured with a KT-1000 arthrometer, Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score, and postoperative complications.</p><p><strong>Results: </strong>Satisfactory reduction and stable fixation were achieved in all cases. The follow-up duration ranged from 7 to 32 months (mean, 20 months). At the 3-month postoperative follow-up, all patients achieved knee flexion of at least 120°, with restoration of functional range of motion sufficient for activities of daily living. Radiographic evaluation demonstrated solid osseous union in all cases. At final follow-up, posterior drawer tests were negative. Mean ROM improved from 61.17 ± 9.32° preoperatively to 134.5 ± 4.5° postoperatively (P < 0.001). The Lysholm score increased from 48.48 ± 6.28 to 92.26 ± 3.13 (P < 0.001), IKDC score from 34.41 ± 5.16 to 90.44 ± 4.12 (P < 0.001), Tegner score from 1.5 ± 0.7 to 6.3 ± 0.9 (P < 0.001), and KT-1000 displacement decreased from 5.9 ± 0.63 mm to 1.1 ± 0.34 mm (P < 0.001).</p><p><strong>Conclusion: </strong>This modified arthroscopic fixation technique is safe, effective, and stable. It enables early rehabilitation, effectively restores knee stability, and supports rapid recovery of joint function. The method represents a practical and reliable option for treating PCL tibial insertion avulsion fractures and merits wider clinical adoption.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101086"},"PeriodicalIF":3.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221370","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}