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

{"title":"Redefining the concept of patellofemoral stuffing in total knee arthroplasty","authors":"Jobe Shatrov ,&nbsp;Benoit Coulin ,&nbsp;Cécile Batailler ,&nbsp;Elvire Servien ,&nbsp;Angela Brivio ,&nbsp;David Barrett ,&nbsp;Bill Walter ,&nbsp;Sebastien Lustig","doi":"10.1016/j.jisako.2024.100364","DOIUrl":"10.1016/j.jisako.2024.100364","url":null,"abstract":"<div><h3>Introduction</h3><div>Balancing the patellofemoral joint (PFJ) in total knee arthroplasty (TKA) involves avoiding over-stuffing. The purpose of this study was to assess how often a strategy of recreating the anterior space of the trochlea (full extension) led to the trochlea depth being recreated in both mid-flexion (30–40°) and deep flexion (80–90°).</div></div><div><h3>Methods</h3><div>One hundred and twenty two consecutive patients undergoing robotic-assisted TKA had femoral components placed according to functional alignment principals and were assessed. The femoral component was sized and positioned in order to ensure that the anterior flange was within 2 ​mm of the native anatomy, corresponding to a patella position of full extension (0° flexion).</div><div>Trochlea depth restoration in 3 positions along the floor of the trochlea groove was compared and measured. The trochlea was defined as balanced if the prosthesis was within 2 ​mm of the native anatomy. Patients were divided into over-stuffed (prosthesis &gt;2 ​mm above the native anatomy) or under-stuffed (prosthesis &gt;2 ​mm beneath the native anatomy).</div></div><div><h3>Results</h3><div>All patients 122/122 (100%) had a balanced trochlea in full extension. In total 54 TKA were over or under-stuffed at either mid-flexion or deep flexion. In mid-flexion, 3/122 (2.5%) trochlea were over-stuffed and 39/122 (32%) trochlea were under-stuffed. In deep flexion, 25/122 (20.5%) of trochlea’s were overstuffed and 30/122 (24.6%) were under-stuffed. In mid-flexion, balanced trochlea components were more externally rotated relative to the posterior condylar axis compared to unbalanced components (2.35° external rotation vs 1.21°, <em>p=0.004</em>). There were no other significant differences observed between the balanced and unbalanced trochlea groups in mid or deep flexion.</div></div><div><h3>Conclusion</h3><div>Over 40% of TKA over or under-stuff the trochlea in deeper flexion despite the anterior flange being positioned within 2 ​mm of the native anatomy in full extension. The rate of over or under-stuffing in mid and deep flexion was similar (&gt;40%); however, in mid-flexion, under-stuffing of the native trochlea was more common. The concept of PFJ over or under-stuffing in TKA needs to be redefined to consider the full arc of flexion of the trochlea groove, and the biomechanical and clinical consequences of under-stuffing the trochlea investigated further.</div></div><div><h3>Evidence</h3><div>Level IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100364"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep quality improves after total knee arthroplasty: Addressing early disturbance and risk factors","authors":"Nirali Mehta,&nbsp;Parag Sancheti,&nbsp;Ashok Shyam,&nbsp;Kailash Patil,&nbsp;Sunny Gugale,&nbsp;Nisar Obaid,&nbsp;Yogesh Sisodia,&nbsp;Sahil Sanghavi","doi":"10.1016/j.jisako.2024.100373","DOIUrl":"10.1016/j.jisako.2024.100373","url":null,"abstract":"<div><h3>Objectives</h3><div>Sleep is an important determinant of quality of life. Sleep disturbance is concomitant with end-stage knee osteoarthritis for which total knee arthroplasty (TKA) is the most commonly done procedure. However, literature on this topic is lacking in terms of the impact of sleep quality on patient satisfaction after arthroplasty, especially the adverse associations of surgery on sleep quality. Improvement in sleep quality may be a necessary prerequisite for any effective rehabilitation program. In our study we aim to assess the changes in sleep quality after TKA, and how it affects patient satisfaction of TKA and other quality-of-life indicators, postoperatively.</div></div><div><h3>Methods</h3><div>Over a period of two years, 104 patients undergoing primary total knee arthroplasty were assessed prospectively using the Pittsburgh Sleep Quality Index (PSQI), Knee Society Score (KSS), Oxford Knee Score (OKS); preoperatively and postoperatively at 3 months, 6 months, and 1 year. Obesity and diabetes status were also included in the analyses.</div></div><div><h3>Results</h3><div>Preoperatively, most patients exhibited poor sleep quality (mean PSQI score 9.23 (Standard deviation (SD) ​= ​3.03), which subsequently improved after surgery. Immediately after surgery, there was an initial worsening in the PSQI scores until 6 weeks (12.58 (SD ​= ​3.59)). However, at 1 year, there was a statistically significant improvement to a mean of 5.69 (SD ​= ​1.91). The mean Visual Analogue Scale (VAS) score showed a statistically significant decrease from 7.26 (SD ​= ​1.90) pre-operatively to 1.80 (SD ​= ​1.37) at 1 year postoperatively (p ​&lt; ​0.001). The mean OKS showed a statistically significant increase from preoperative 18.15 to 33.81 at 1 year and the composite KSS increased from 36.22 preoperative to 87.09 at 1 year (p ​&lt; ​0.001). Improvement in sleep was observed for 61% of non-obese patients while obese patients did not observe any improvement in sleep. Only 8% of diabetics showed improved sleep compared to 55% of non-diabetics.</div></div><div><h3>Conclusions</h3><div>We observed an overall improvement in sleep quality after total knee arthroplasty. However, there was an initial stage of sleep disturbance immediately postoperatively. Obesity and diabetes may lower the chances of achieving optimal improvements in both functional and sleep outcomes.</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":"10 ","pages":"Article 100373"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency ablation of terminal sensory articular nerves before arthroscopic rotator cuff repair surgery improved early postoperative functional outcomes: A pilot study with 3 ​months follow-up","authors":"Marvin Thepsoparn ,&nbsp;Arunthip Luechoowong ,&nbsp;Thanathep Tanpowpong ,&nbsp;Danaithep Limskul","doi":"10.1016/j.jisako.2024.100379","DOIUrl":"10.1016/j.jisako.2024.100379","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic shoulder pain caused by a rotator cuff tear is commonly treated with arthroscopic rotator cuff repair surgery (ARCR). However, ARCR may be associated with moderate-to-severe postoperative pain, and poorly controlled pain can result in delayed functional recovery and the development of frozen shoulder. Terminal sensory articular nerve radiofrequency ablation (RFA) has been shown to be clinically effective in patients with severe refractory shoulder pain from multiple etiologies. We aimed to investigate whether preoperative RFA would improve the postoperative pain and functional outcomes after ARCR.</div></div><div><h3>Methods</h3><div>In this prospective pilot study, participants were randomized to receive fluoroscopic-guided terminal sensory articular nerve-cooled RFA (CRFA) (supraspinatus nerve, axillary nerve, lateral pectoral nerve) 1–5 days prior to elective ARCR as an intervention group compared to ARCR without prior RFA as a control group. Constant score (CS), American Shoulder and Elbow Surgeon score (ASES), and pain numerical rating score (NRS) were assessed at 1, 2, 3, 4, 5, and 6 weeks and 3 months following ARCR.</div></div><div><h3>Results</h3><div>Twenty-one participants were enrolled in this study, including 11 in the control group and 10 in the cooled RFA group. The cooled RFA group showed statistically significantly better CS and ASES both at 6 weeks and 3 months. The two groups showed no differences in pain outcomes at all time points. No intervention-related complications were noted.</div></div><div><h3>Conclusion</h3><div>Cooled RFA of the terminal sensory articular branches of the supraspinatus, axillary, and lateral pectoral nerves performed 1–5 days prior to elective ARCR as part of a multimodal postoperative pain management regimen can improve functional outcomes as early as 6 weeks.</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":"10 ","pages":"Article 100379"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low rate of growth disturbance after posterior cruciate ligament reconstruction or repair in skeletally immature patients: A systematic review","authors":"Riccardo D'Ambrosi ,&nbsp;Luca Farinelli ,&nbsp;Srinivas B.S. Kambhampati ,&nbsp;Luca M. Sconfienza ,&nbsp;Salvatore Gitto ,&nbsp;Elisabeth Abermann ,&nbsp;Christian Fink","doi":"10.1016/j.jisako.2024.100378","DOIUrl":"10.1016/j.jisako.2024.100378","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Importance&lt;/h3&gt;&lt;div&gt;The management of posterior cruciate ligament (PCL) injuries in children is complex and varies depending on the specific nature of the injury. Avulsions of the PCL can often be addressed with proximal or distal repair, whereas intrasubstance tears and cases with persistent instability generally require more extensive reconstruction. Despite the prevalence of such cases, the literature is predominantly composed of case reports, indicating a lack of comprehensive research in this area.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;The purpose of this systematic review was to analyze growth disturbance in skeletally immature patients after PCL reconstruction or repair.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence review&lt;/h3&gt;&lt;div&gt;A systematic review was conducted on the basis of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The following search terms were used in the title, abstract, and keyword fields: “PCL” or “posterior cruciate ligament” AND “children” or “open physis” or “immature.” The main outcome data extracted from the studies was to assess growth disturbance at a minimum 1-year follow-up after surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 34 patients, from 17 articles, were included of which 30 (88.24%) were male and 4 (11.76%) female. Mean age at surgery was 10.18 ​± ​2.88 years. The mean interval from injury to surgery was 178.9 ​± ​288.04 days. Average follow-up duration was 50.64 ​± ​22.69 months. Six studies reported on PCL reconstructions using various grafts, including autologous allografts (hamstring or tibialis anterioris), Achilles tendon allografts with bone plugs, and parental donated hamstrings allografts. Only one study reported the use of internal brace to repair PCL, whereas in all the other studies, a repair of the PCL was performed with fixation of the bone fragment (to the femur or tibia) using screws or suture. Growth disturbances (≥10 ​mm) were reported in 2 of the 13 (15.38%) patients who underwent PCL, whereas in PCL, repair was noted in 2 of the 21 patients (9.52%) (p ​= ​0.63). Only 1 patient belonging to PCL reconstruction reported a slight increase in the valgus alignment of the operated knee compared to the contralateral knee, representing medial overgrowth at the distal femur (p ​= ​0.33).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;There is scarce literature on the risk of growth disturbance in skeletally immature patients after PCL reconstruction or repair. Nevertheless, PCL reconstruction in children indicates a low risk of growth disturbance, in particular for length leg-length discrepancy (&lt;15%) in the mid- to long-term follow-up, and a low rate of angular deviations (&lt;8%). This surgery remains a major challenge for orthopedic surgeons, and many unknowns remain regarding ideal grafts, technique, and time for surgery to prevent growth disturbance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level of evidence&lt;/h3&gt;&lt;div&gt;Systematic review of Level IV.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Registration&lt;/","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100378"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When disaster strikes: Conversion of unicompartmental knee arthroplasty to total knee arthroplasty☆","authors":"Joicemar Tarouco Amaro ,&nbsp;Diego Costa Astur ,&nbsp;Camila Cohen Kaleka ,&nbsp;Pedro Debieux ,&nbsp;José Ricardo Dantas Moura Costa ,&nbsp;Gustavo Montibeller da Silva ,&nbsp;Nilton Gomes Oliveira Filho ,&nbsp;Moisés Cohen","doi":"10.1016/j.jisako.2024.100341","DOIUrl":"10.1016/j.jisako.2024.100341","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the causes of failure in unicompartmental knee arthroplasty (UKA), types of implants used in the revision, evaluate the need to use tibial stems, metal block augmentations, and bone grafts during conversion to total knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>In a 10-year retrospective analysis, focussing on cases of UKA failure, our study aimed to categorise early and late failures, determine the primary failure modes and assess the utilisation of bone augmentations and grafts during conversion to TKA. We evaluated patient data, diagnoses, procedure intervals, and follow-up periods to provide a comprehensive understanding of the conversion process.</div></div><div><h3>Results</h3><div>During the past decade, 301 UKA procedures were performed, with 36 knees (11.96%) requiring conversion to TKA. Patient ages averaged 64.3 years, with varied diagnoses, including osteoarthritis and avascular necrosis. The most common failure mode was component loosening or sinking (52.78%), followed by progression of arthritis (25%). Of the 31 cases with mobile-bearing UKA, 9 (29.03%) developed instability and displacement of the polyethylene. Of the 36 cases converted from UKA to TKA, in 31 (86.11%) a revision tibial component with a tibial stem was used. Metal block augmentation was performed in 19 knees (52,78%). All revised UKAs were converted to cemented TKA, with a focus on addressing tibial side issues, which constituted 72.22% of the revisions.</div></div><div><h3>Conclusion</h3><div>This study highlights the challenges associated with UKA failure, particularly early failures linked to displaced bearings. Converting from UKA to TKA presents technical hurdles, including rod alignment and utilisation. Management of proximal tibial defects with metal block augmentation proving to be a viable approach. The use of modular metal augmentation simplifies the reconstruction process. Although the study has limitations, it contributes valuable information about the complexities of knee arthroplasty conversion.</div></div><div><h3>Level of evidence</h3><div>Therapeutic study, level IV (case series).</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100341"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellofemoral joint including patellar instability part 3 (Patellofemoral cartilage treatment): State of the art","authors":"Betina B. Hinckel ,&nbsp;Pietro Conte ,&nbsp;Justin T. Smith ,&nbsp;Norimasa Nakamura ,&nbsp;Elizaveta Kon","doi":"10.1016/j.jisako.2024.100366","DOIUrl":"10.1016/j.jisako.2024.100366","url":null,"abstract":"<div><div>Cartilage lesions around the knee are common injuries in the orthopedic practice. The spontaneous healing capacity of the articular cartilage is limited, and therefore surgical intervention may be necessary. The goal is to improve patients’ symptoms, articular functionality, and potentially delay the progression of knee osteoarthritis. Extensive knowledge is available regarding the efficacy of cartilage restoration procedures for tibiofemoral chondral and osteochondral lesions; however, evidence on patellofemoral surgery remains more limited and controversial. The complex biomechanics and morphology of the patellofemoral joint represents a challenge in the setting of knee cartilage surgery and, as a result, inferior outcomes have been reported when compared to treatment of condylar lesions. Furthermore, patellofemoral cartilage restoration can be combined with procedures such as a tibial tuberosity osteotomy and/or other realigning osteotomies when pathological deformities are present. Finally, when the aforementioned strategies fail or when severe osteoarthritis develops, and preservation procedures are contraindicated, arthroplasty and other options can be considered. This <em>State of the Art</em> review aims to critically examine the current concepts of conservative and surgical treatment of patellofemoral cartilage lesions, reporting the latest clinical evidence and describing potential future perspectives in this field.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100366"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data is the new gold","authors":"C. Niek van Dijk","doi":"10.1016/j.jisako.2024.100333","DOIUrl":"10.1016/j.jisako.2024.100333","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100333"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to sport at the pre-injury level following anterior cruciate ligament reconstruction is influenced by patients' perceived knee status and psychological readiness, and does not correlate with functional ability","authors":"Claudio Legnani ,&nbsp;Matteo Del Re ,&nbsp;Giuseppe M. Peretti ,&nbsp;Vittorio Macchi ,&nbsp;Enrico Borgo ,&nbsp;Alberto Ventura","doi":"10.1016/j.jisako.2024.100369","DOIUrl":"10.1016/j.jisako.2024.100369","url":null,"abstract":"<div><h3>Objectives</h3><div>The purposes of this study were to (1) prospectively evaluate clinical and functional outcomes of athletes following anterior cruciate ligament (ACL) reconstruction up to 12 months after surgery, (2) to identify the correlations between functional and subjective tests, and (3) to determine which factors influence patients’ capability to resume sports at pre-injury level.</div></div><div><h3>Methods</h3><div>Patients who underwent ACL reconstruction using doubled autologous hamstring graft were prospectively assessed pre-operatively, 6, and 12 months after surgery using International Knee Documentation Committee (IKDC) Subjective Knee Form, Tegner activity level, and ACL–Return to Sport after Injury (ACL-RSI) scale. Jumping ability was instrumentally assessed using a test battery including bipodalic squat jump (SJ), bipodalic countermovement jump (CMJ), monopodalic CMJ, and monopodalic side-hop test.</div></div><div><h3>Results</h3><div>Thirty-three patients were available for clinical evaluation at 12-months follow-up. Average age was 34.0 years (SD 11.5, range 19–50). Male/female ratio was 31:2. Mean overall IKDC, and ACL-RSI scores increased from 52.5 to 47.1 preoperatively, to 89.9 (SD: 12.2, range 36.8–100) and 81.3 (SD 21.7, range 10–98.3), respectively at last follow-up (p ​&lt; ​0.001). Monopodalic jump tests showed improvements at 12-month evaluation compared to 6-month follow-up (p ​&lt; ​0.01). No statistically significant correlation was reported for ACL-RSI and jump limb symmetry index (LSI) (p ​= ​0.08 vs. CMJ; p ​= ​0.07 vs. side-hop test). No differences were observed in terms of jump LSI between patients who returned to pre-injury activity level and those who did not (p ​= ​0.11 for CMJ, p ​= ​0.09 for side-hop test). A significantly higher IKDC score at 6 months was observed in patients who did not return to pre-injury levels (p ​= ​0.009). Patients who did not return to pre-injury activity reported lower ACL-RSI scores at 12-months follow-up (p ​= ​0.007).</div></div><div><h3>Conclusions</h3><div>One year after ACL reconstruction, an improvement in jumping ability was observed, while a persistence of lower limbs asymmetries when performing jump tests was noted at 6-months follow-up. The ability to perform vertical jumps was not influenced by psychological outcomes 12 months following surgery. Higher values of subjective knee score and psychological readiness weakly correlated to return to sport at preinjury level, while no correlation was reported concerning jumping performance.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100369"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor site morbidity is higher when comparing bone–tendon–bone vs 4-strand semitendinosus/gracilis & all-inside 4-strand semitendinosus for anterior cruciate ligament reconstruction","authors":"Orlando Branco Simões ,&nbsp;João Pedro Oliveira ,&nbsp;Rui Lemos ,&nbsp;José Carlos Noronha","doi":"10.1016/j.jisako.2025.100394","DOIUrl":"10.1016/j.jisako.2025.100394","url":null,"abstract":"<div><h3>Objectives</h3><div>To study pain and sensory alterations of 75 (three cohorts of 25 patients) patients that underwent different anterior cruciate ligament reconstruction (ACLR) techniques. The cohorts were divided in the bone–patellar tendon–bone (BTB) autograft, the quadruple strand semitendinosus/gracilis (4ST/G) autograft and the all-inside quadruple strand semitendinosus autograft cohort.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study to evaluate pain and sensory alterations after surgery. All these patients followed a similar rehabilitation protocol, being 2 years the minimal follow-up time. Pain was characterized by duration and anatomical location and sensory deficits were evaluated concerning duration and affected area. Patients also scored on three different subjective tests: knee walking test (KWT); Lysholm knee scoring scale (LKSS), and International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and were divided according to its Tegner activity level scale (TALS).</div></div><div><h3>Results</h3><div>The mean anterior knee pain (AKP) duration amongst the three cohorts was 1.8 ​± ​4.5 months and was smaller in the 4ST/G cohort. The majority of patients of the BTB cohort located pain on the patellar tendon, while patients in the 4ST/G and all-inside cohorts referred that it was diffuse. At 15 days’ post-surgery, hypoesthesia was reported by 56 ​% patients and was higher on the BTB cohort and lower in the all-inside cohort. At 2-year follow-up, the all-inside cohort had no patients with hypoesthesia. In the BTB cohort, the sensitive alterations were only located on the area innervated by the infra-patellar branch of the saphenous nerve (IPBSN). The 4ST/G cohort located the hypoesthesia in the area innervated by the IPBSN and in the area of the lateral sural cutaneous nerve (LSCN). The all-inside group located the sensitive alterations mostly in the LSCN. The KWT was painful in BTB and 4ST/G patients and reported 0 ​% for the all-inside cohort. No statistic significant relevance was found for the IKDC-SKF and LKSS.</div></div><div><h3>Conclusions</h3><div>All cohorts referred pain and sensitive alterations. Using BTB autograft for ACLR seems to condition a higher number of anterior knee pain and hypoesthesia on medium postoperative follow-up and KWT was more often reported. The 4ST/G group had the smallest duration of AKP. The all-inside cohort showed, globally, a lower number of complaints and a shorter time of symptom persistence, namely in terms of sensory deficits.</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":"11 ","pages":"Article 100394"},"PeriodicalIF":2.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to ‘Letter to Editor’","authors":"K.N. Subramanian,&nbsp;Saseendar Shanmugasundaram,&nbsp;K.S. Jeash Narayan","doi":"10.1016/j.jisako.2025.100392","DOIUrl":"10.1016/j.jisako.2025.100392","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100392"},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}