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

{"title":"Combined high tibial osteotomy and root repair improves patient-reported outcomes in medial meniscus posterior root tears: A systematic review and meta-analysis","authors":"Ayomide Michael Ade-Conde MD(c) ,&nbsp;Michelle Cruickshank MD(c) ,&nbsp;Marc Daniel Bouchard MD ,&nbsp;Prushoth Vivekanantha MD ,&nbsp;Amit Meena MBBS MS DNB ,&nbsp;Shahbaz S. Malik BSc (Hons), MB BCh, MSc (Orth Engin), LLM, FRCS (Tr&Orth) ,&nbsp;Darren de SA MD MBA FRCSC","doi":"10.1016/j.jisako.2025.101035","DOIUrl":"10.1016/j.jisako.2025.101035","url":null,"abstract":"<div><h3>Importance</h3><div>High tibial osteotomy (HTO) is a well-established joint-preserving surgery for varus knees with medial compartment overload. There is a growing interest in combining HTO with meniscal root repair (HTO-MRR) to address both the varus malalignment and the meniscal deficiency caused by medial meniscus posterior root tears (MMPRTs).</div></div><div><h3>Aim</h3><div>This systematic review and meta-analysis aimed to synthesise current evidence on the clinical, radiographic, and arthroscopic outcomes following HTO-MRR for isolated MMPRTs. Where available, comparative data with HTO alone were analysed as a secondary objective.</div></div><div><h3>Evidence review</h3><div>MEDLINE, EMBASE, and CINAHL were searched from inception to June 5, 2025 for studies on HTO-MRR for isolated MMPRTs. Data from comparative studies with HTO alone were pooled using random-effects models. Outcomes included patient-reported outcomes (PROMs), range of motion, radiographic parameters, and healing rates.</div></div><div><h3>Findings</h3><div>Thirteen studies, comprising 725 patients with degenerative MMPRTs (67% female), met the inclusion criteria. Of these, 459 underwent HTO-MRR and 266 underwent HTO alone. The mean age was 54 ​± ​9 years (range, 41–65) and a mean follow-up of 25 months (range, 15–66). The baseline varus angles in HTO-MRR patients ranged from 3.3° ​± ​1.2°–6.9° ​± ​2.5°. Weighted means for postoperative Lysholm, Hospital for Special Surgery (HSS), and International Knee Documentation Committee (IKDC) scores were 86 (range, 78–95), 85 (range, 81–85), and 68 (range, 50–81), respectively. The minimal clinically important difference (MCID) thresholds of 8.9, 5.4, and 12.5 for these PROMs, respectively, were exceeded. There was a statistically significant improvement in HSS (standardised mean difference [SMD]: 0.59; 95% CI 0.34–0.84; I² ​= ​0%; p ​&lt; ​0.01) and IKDC scores (SMD: 0.31; 95% CI 0.01–0.61; I² ​= ​0%; p ​= ​0.04) in HTO-MRR versus HTO alone. Complete meniscal healing rates following HTO-MRR ranged from 13% to 60%, with a weighted mean of 33%. Radiographic parameters, including Kellgren–Lawrence grade, meniscal extrusion, and joint space width, showed no statistically significant between-group differences (all p ​&gt; ​0.05).</div></div><div><h3>Conclusion and Relevance</h3><div>HTO-MRR demonstrated improved HSS and IKDC scores compared to HTO alone in isolated MMPRTs. While no short-to mid-term differences in osteoarthritic progression were observed, the current level of evidence remains low, and the potential joint-preserving benefits of HTO-MRR warrant investigation in long-term prospective studies.</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":"16 ","pages":"Article 101035"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565750","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 resection of navicular osteoid osteoma: A case report","authors":"Maxime Rarchaert MD ,&nbsp;Thais Dutra Vieira MD ,&nbsp;Ronny Lopes MD","doi":"10.1016/j.jisako.2025.101041","DOIUrl":"10.1016/j.jisako.2025.101041","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>This is the second navicular osteoid osteoma (OO) reported in the English literature and the first case of navicular OO treated by lateral arthroscopy of the sinus tarsi.</div></div><div><h3>Case presentation</h3><div>The patient was a 32-year-old man who complained of chronic foot pain linked to an OO observed on computed tomography scan, magnetic resonance imaging, and scintigraphy. Endoscopic surgery was proposed after the failure of radiofrequency ablation, allowing total excision of the lesion. No complications were reported, and there was no residual pain at the 16-month follow-up.</div></div><div><h3>Discussion</h3><div>Most reported cases of OOs in the foot and ankle were located in the talar neck and distal tibia. The success rate of arthroscopic excision was 96%. Arthroscopic excision of OO by lateral approach represents a safe and effective alternative to radiofrequency ablation.</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":"16 ","pages":"Article 101041"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589256","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":"Clinical outcomes of arthroscopic hip labral reconstruction versus repair in the primary setting: A systematic review and meta-analysis","authors":"Muzammil Akhtar ,&nbsp;Daniel Razick ,&nbsp;Anand Dhaliwal ,&nbsp;Kory Pasko ,&nbsp;Trevor Shelton ,&nbsp;Andrew Jimenez ,&nbsp;Dean Wang","doi":"10.1016/j.jisako.2025.101058","DOIUrl":"10.1016/j.jisako.2025.101058","url":null,"abstract":"<div><h3>Importance</h3><div>Advancements in understanding the acetabular labrum's role in hip biomechanics have emphasized preserving its native anatomy. However, severe labral pathology may make labral repair unfeasible in certain cases.</div></div><div><h3>Aim or objective</h3><div>The primary aim of the present study is to review existing literature comparing clinical outcomes of arthroscopic hip labral reconstruction versus repair in the primary setting.</div></div><div><h3>Evidence review</h3><div>A search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed in PubMed, Embase, and Scopus to identify studies comparing clinical outcomes of arthroscopic hip labral reconstruction versus repair for the treatment of labral tears in the primary setting. Meta-analyses comparing patient-reported outcomes (PROs), achievement of a minimal clinically important difference (MCID) or patient acceptable symptomatic state (PASS), and revision or conversion to total hip arthroplasty (THA) were performed using a random-effects model. A P-value &lt;0.05 was statistically significant.</div></div><div><h3>Results</h3><div>Six studies (level of evidence 3) with 429 hips undergoing reconstruction and 1278 undergoing repair were included. Indications for reconstruction in the primary setting based on authors’ preferences included nonviable or inadequate size of remaining labrum for repair, labral calcification, &gt;8 mm or &lt;2–3 mm of labral tissue, complex or extensive tear, labral hypotrophy or hypertrophy, tears with severe (or moderate in patients &gt;40 years old) intrasubstance damage, labral ossification, and segmental defects. All studies reported statistically significantly more severe labral and cartilage pathology in the reconstruction group compared to the repair group. The results of the meta-analysis are as follows: No statistically significant difference between labral repair and reconstruction in PROs, odds of achieving an MCID or PASS for the modified Harris Hip Score and International Hip Outcome Tool, and risk of revision (P &gt; 0.05). However, the risk of conversion to THA was statistically significantly higher in the reconstruction group compared to the repair group (P &lt; 0.001).</div></div><div><h3>Conclusions and relevance</h3><div>While PROs, achievement of clinically significant outcomes, and risk of revision were not statistically significantly different for primary labral reconstruction versus repair, the risk of conversion to THA was found to be statistically significantly higher for patients undergoing primary labral reconstruction, although this may be related to increased severity of labral/cartilage pathology in patients undergoing labral reconstruction.</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":"16 ","pages":"Article 101058"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850917","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":"Osteochondral knee joint lesion treated with an aragonite-based scaffold. 12-year follow-up of the world's first implantation: Case report","authors":"Matej Drobnič MD, PhD ,&nbsp;Elizaveta Kon MD, PhD ,&nbsp;Dror Robinson MD, PhD ,&nbsp;Matic Kolar MD, PhD ,&nbsp;Nir Altschuler MSc","doi":"10.1016/j.jisako.2025.101040","DOIUrl":"10.1016/j.jisako.2025.101040","url":null,"abstract":"<div><div>Articular surface lesions, which include chondral and osteochondral defects, are debilitating and favor the development of osteoarthritis. The long-term follow-up of the world's first case of implantation of an aragonite-based scaffold (Agili-C™, from CartiHeal) in a chronic post-traumatic osteochondral knee joint lesion (International Cartilage Repair Society (ICRS) grade IV, size 2 ​cm²) was presented. Over a decade after implantation, the treatment results remained stable, the patient was fully satisfied, and was able to resume his preinjury activities. Despite the partial meniscectomy of the medial meniscus, the degenerative process was successfully contained, with only subtle osteophytes and mild narrowing of the medial compartment. In addition, radiologic monitoring of the restored bone and cartilage tissue showed successful and durable results.</div></div><div><h3>Study design</h3><div><strong>Case-report (level of evidence: V</strong>).</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101040"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565709","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":"Efficacy of single intra-articular 2% sodium hyaluronate versus corticosteroid injection in isolated patellofemoral osteoarthritis: A double-blind, randomized controlled trial","authors":"Korawish Mekariya MD ,&nbsp;Pratchaya Manop MD ,&nbsp;Bancha Chernchujit MD","doi":"10.1016/j.jisako.2025.101038","DOIUrl":"10.1016/j.jisako.2025.101038","url":null,"abstract":"<div><h3>Introduction/objective</h3><div>Patellofemoral osteoarthritis (PFOA) is unicompartmental arthritis with a hallmark of anterior knee pain, disturbing quality of life. Unlike tibiofemoral osteoarthritis, there is still a lack of evidence regarding intra-articular injection for isolated PFOA patients. This study aims to evaluate the efficacy of intra-articular hyaluronic acid (HA) in comparison to corticosteroid (CS) injections for pain reduction and improvement in knee function in isolated PFOA patients.</div></div><div><h3>Methods</h3><div>This was a prospective, double-blind, randomized controlled trial. Patients with isolated PFOA based on clinical and radiographic features were randomized 1:1 to receive a single-shot, 2 ​ml intra-articular 2% sodium hyaluronate plus 0.5% mannitol or a 2 ​ml solution comprising 1 ​ml of 40 ​mg triamcinolone acetonide and 1% lidocaine. The visual analog scale (VAS) for anterior knee pain, Kujala score, pain during injection, and adverse events were assessed during a 6-month follow-up.</div></div><div><h3>Results</h3><div>A total of 60 patients were included. Both groups demonstrated statistically significant improvements in VAS pain and Kujala scores from 48 ​h post-injection to 6 months compared to baseline (p ​&lt; ​0.05). At the 6-month follow-up, there were no significant between-group differences in VAS pain (mean difference [95% CI]: −4.46 [-11.2, 2.28]; p ​= ​0.270) or Kujala scores (2.56 [-4.08, 9.2]; p ​= ​0.45). However, at 48 ​h, 72 ​h, and 1 week post-injection, the CS group reported statistically significantly greater pain relief compared to the HA group (mean differences: 10.33, 9.67, and 7.67; p ​= ​0.002, 0.003, and 0.013, respectively). No significant differences were observed in pain during injection or adverse events.</div></div><div><h3>Conclusion</h3><div>Intra-articular HA and CS injections provide comparable pain reduction and functional score improvement at 6-month follow-up in patients with PFOA, with better pain relief in the first week for the CS group. Intra-articular HA may be an alternative to CS, with equivalent results but without increasing the risk of chondrotoxicity and cartilage volume loss, especially in isolated PFOA patients whose tibiofemoral compartment cartilage is relatively preserved.</div></div><div><h3>Clinical Trial Registration</h3><div>TCTR20200709009.</div></div><div><h3>Level of Evidence</h3><div>Level I.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101038"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542536","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":"Meniscal hypermobility does not impair functional outcomes after anterior cruciate ligament reconstruction: A retrospective cohort study","authors":"Horacio Rivarola MD ,&nbsp;Cristian Collazo MD ,&nbsp;Marcos Palanconi MD ,&nbsp;Marcos Meninato MD ,&nbsp;Pablo Ramos Guarderas MD ,&nbsp;Gonzalo Arteaga MD ,&nbsp;Medardo Vargas MD ,&nbsp;Francisco Endara Urresta MD ,&nbsp;Carlos Peñaherrera-Carrillo MD ,&nbsp;Alejandro Barros Castro MD","doi":"10.1016/j.jisako.2025.101056","DOIUrl":"10.1016/j.jisako.2025.101056","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Meniscal hypermobility (MH), particularly hypermobile lateral meniscus (HLM), is increasingly recognized as a contributor to knee instability in the setting of anterior cruciate ligament (ACL) rupture. However, its influence on functional outcomes after ACL reconstruction remains unclear. This study aimed to determine whether MH affects clinical recovery and to evaluate the effectiveness of simultaneous ACL reconstruction and Forkel’s single-tunnel meniscal root repair.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted including 375 patients selected from 1200 ACL reconstructions performed between 2018 and 2023. Patients were allocated into two groups: the case group (n = 159), with ACL rupture and intraoperatively confirmed HLM, and control group (n = 216), with isolated ACL rupture. All patients underwent ACL reconstruction with a modified transtibial hamstring technique; in the case group, a concomitant posterior lateral meniscal root (PLMR) repair was performed using the Forkel single-tunnel method. Functional outcomes were assessed with the International Knee Documentation Committee (IKDC) subjective score preoperatively and at 3, 6, and 12 months. Clinical symptoms (posterolateral pain, hyperflexion pain, and subjective instability) were also recorded. Statistical significance was set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Both groups demonstrated significant improvement in IKDC scores over time (<em>p</em> &lt; 0.001). In the case group, scores increased from 60.0 ± 7.8 preoperatively to 93.0 ± 4.5 at 12 months, while the control group improved from 60.1 ± 8.1 to 92.0 ± 4.8. No statistically significant differences were observed between groups at any time point (3 months, p = 0.26; 6 months, p = 0.44; 12 months, p = 0.28). Preoperatively, the case group showed a higher prevalence of posterolateral pain (68 % vs. 20 %, <em>p</em> &lt; 0.001) and hyperflexion pain (72 % vs. 35 %, <em>p</em> &lt; 0.001). At 12 months, symptoms had resolved in &gt;80% of patients across both groups, with no differences between cohorts (posterolateral pain, <em>p</em> = 0.21; instability, <em>p</em> = 0.33).</div></div><div><h3>Conclusion</h3><div>MH does not compromise functional recovery when addressed during ACL reconstruction using the Forkel single-tunnel technique. This approach provides an anatomically sound, reproducible, and clinically effective option for treating combined ACL and meniscal pathology.</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":"16 ","pages":"Article 101056"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811579","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":"Supporting pregnancy and parental leave within orthopedics","authors":"Kristen I. Barton,&nbsp;Pascale Thibaudeau,&nbsp;Laurie A. Hiemstra","doi":"10.1016/j.jisako.2025.101029","DOIUrl":"10.1016/j.jisako.2025.101029","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101029"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432425","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":"Breaking down tibial tuberosity to trochlear groove distance into two components to enable patient-specific treatment strategies","authors":"Johannes M. Sieberer ,&nbsp;Nancy Park ,&nbsp;Shelby Desroches ,&nbsp;Kelsey Brennan ,&nbsp;Albert Rancu ,&nbsp;Brooke McGinley ,&nbsp;Armita R. Manafzadeh ,&nbsp;Neil A. Segal ,&nbsp;David Felson ,&nbsp;Steven M. Tommasini ,&nbsp;Daniel H. Wiznia ,&nbsp;John P. Fulkerson","doi":"10.1016/j.jisako.2025.101025","DOIUrl":"10.1016/j.jisako.2025.101025","url":null,"abstract":"<div><h3>Objective</h3><div>Tibial tuberosity to trochlear groove (TT-TG) distance serves as one of the main metrics for patellofemoral instability (PFI) surgical decision-making. The purpose of this study is to split TT-TG into translational (caused by bony morphology) and rotational (external tibiofemoral rotation) components, elucidate how those two components relate to each other, and determine how the components differ between recurrent PFI patients and controls.</div></div><div><h3>Methods</h3><div>Computed tomography (CT) scans of PFI patients with at least two reported dislocation events, seen by our institution's orthopedic department, were retrospectively acquired. Control CT scans were acquired from the Multicenter Osteoarthritis Study (MOST). Three-dimensional (3D) landmarks were placed on the distal femora and the proximal tibias. TT-TG, its rotational and translational components, and tibiofemoral rotation were algorithmically calculated from these landmarks. The two cohorts' means were compared using Mann–Whitney U-tests. Pearson coefficients were used to evaluate the correlation between the TT-TG components. The reliability of the measurements was evaluated with intraclass correlation coefficients (ICCs). The minimal sample size for a power level of 0.80 was calculated with an <em>a priori</em> sample size calculation.</div></div><div><h3>Results</h3><div>A total of 26 PFI (sex parity; age: 24.6 ​± ​10.0 years) and 294 control knees (sex parity; age: 52.6 ​± ​7.0 years) were analyzed. Statistically significant differences for TT-TG (18.7 ​± ​4.8 vs. 12.0 ​± ​3.4 ​mm, p ​&lt; ​0.001), rotational (5.3 ​± ​2.5 vs. 1.0 ​± ​2.5 ​mm, p ​&lt; ​0.001) and translational (13.4 ​± ​3.7 vs. 11.0 ​± ​3.1 ​mm, p ​= ​0.002) components of TT-TG, and tibiofemoral rotation (10.7 ​± ​4.7 vs. 1.9 ​± ​4.7°, p ​&lt; ​0.001) were found. No significant correlation between the components of TT-TG was found (p ​= ​0.14, r² ​= ​0.29). Predictive ICCs for the four measurements ranged from 0.82 to 0.99.</div></div><div><h3>Conclusion</h3><div>TT-TG can be split into (1) a translational component, primarily dependent on bony morphology, and (2) a rotational component, caused by external tibiofemoral rotation, both of which can lead to an elevated TT-TG measurement independently of each other. The rotational component is the primary factor for differences observed between PFI patients and controls but might vary between consequential patient scans. Our findings emphasize the importance of personalized treatment strategies tailored to individual patient profiles in treating patellar instability and will aid in more accurately targeted selection of surgical methods addressing either or both translational or rotational components of TT-TG.</div></div><div><h3>Level of evidence</h3><div>III Case-Control study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101025"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423175","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":"Two-year clinical outcome of ultrasound-guided repair of the anterior talofibular ligament with or without Gould augmentation: A case series","authors":"Takuya Okada ,&nbsp;Soichi Hattori ,&nbsp;Kentaro Onishi ,&nbsp;Ken Ichikawa ,&nbsp;Shuzo Takazawa ,&nbsp;Shin Yamada ,&nbsp;Yuki Kato ,&nbsp;MaCalus V. Hogan ,&nbsp;Hiroshi Ohuchi","doi":"10.1016/j.jisako.2025.101043","DOIUrl":"10.1016/j.jisako.2025.101043","url":null,"abstract":"<div><h3>Introduction</h3><div>Building on the prior work, the authors have shown that ultrasound-guided anterior talofibular ligament (ATFL) repair with augmentation enables precise anchor placement, restores ankle stability in cadaveric models, and improves six-month clinical outcomes. The objective of the current study is to assess the mid-term clinical outcomes of this procedure over a two-year period.</div></div><div><h3>Methods</h3><div>The authors treated patients with chronic lateral ankle instability using intraoperative ultrasound–guided ATFL repair, with or without Gould augmentation, followed by a standardized postoperative rehabilitation protocol. After excluding 21 patients with concomitant injuries that could affect clinical outcomes and 8 patients who were lost to follow-up, 20 patients (10 athletes and 10 nonathletes) were included in the study. The following outcome scores were measured at baseline and at two years postoperatively: (1) numerical rating scale (NRS) for pain, (2) foot and ankle outcome score (FAOS), (3) Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale, and (4) self-administered foot evaluation questionnaire sports (SAFE-Q Sports) score.</div></div><div><h3>Results</h3><div>All four clinical outcome measures improved statistically significantly at two years (all p ​&lt; ​0.001). Values are reported as median interquartile range (IQR); effect sizes as standardized mean differences (SMD). Median NRS decreased from 4.0 (2.0–5.0) at baseline to 0.0 (0.0–1.0) at two years (Wilcoxon signed-rank test, p ​&lt; ​0.001; SMD ​= ​1.545). FAOS increased from 76.5 (66.2–80.3) to 99.5 (96.5–100.0) (p ​&lt; ​0.001; SMD ​= ​2.046). JSSF scale increased from 59.5 (44.0–67.0) to 100.0 (90.0–100.0) (p ​&lt; ​0.001; SMD ​= ​2.834). Among athletes with available data, SAFE-Q Sports score increased from 38.8 (21.5–51.0) to 99.0 (96.7–99.9) at two years (p ​&lt; ​0.001; SMD ​= ​3.262). Ten athletes returned to sports at their pre-injury level by six months. Complications were limited to one case of superficial peroneal nerve irritation, which resolved within six months. One patient underwent revision surgery at two years.</div></div><div><h3>Conclusion</h3><div>For chronic lateral ankle instability, ultrasound-guided ATFL repair—with or without augmentation—produced statistically significant improvements at two years (all p ​&lt; ​0.001).</div></div><div><h3>Evidence level</h3><div>Ⅳ</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101043"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The classic from Shelbourne and Nitz (1990) on accelerated rehabilitation after anterior cruciate ligament reconstruction","authors":"W.M. Nabulyato,&nbsp;B. Gompels,&nbsp;A. O'Neill,&nbsp;T. McMeniman,&nbsp;P.T. Myers","doi":"10.1016/j.jisako.2025.101032","DOIUrl":"10.1016/j.jisako.2025.101032","url":null,"abstract":"<div><div>This review provides a contemporary analysis of the seminal study \"Accelerated Rehabilitation After Anterior Cruciate Ligament Reconstruction\" by Shelbourne and Nitz (1990), initially published in the <em>American Journal of Sports Medicine</em>. This retrospective, single-surgeon cohort study compared two postoperative anterior cruciate ligament reconstruction (ACLR) patient groups, both treated using a modified Jones technique. Group I followed a traditional rehabilitation protocol involving immobilization and phased progression, while Group II underwent an accelerated rehabilitation program with early knee motion, weight-bearing, and functional recovery.</div><div>The study demonstrated superior outcomes in the accelerated group, including significantly faster knee extension recovery, quicker return of quadriceps strength by 10 weeks, greater KT-1000 stability measurements, lower complication and reoperation rates, and improved patient compliance and satisfaction. These findings led to a paradigm shift in ACL rehabilitation, challenging the necessity of prolonged immobilization and conservative progression. The study's impact continues to influence modern individualized rehabilitation protocols to optimize patient outcomes.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101032"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472281","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}