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

{"title":"A shortened Knee Injury and Osteoarthritis Outcome Score (KOOS) is sufficient for measuring change in a cohort of patellofemoral instability patients","authors":"Kate E. Webster PhD ,&nbsp;Julie Agel MA ,&nbsp;Julian A. Feller MB, BS(Hons) ,&nbsp;Robert Magnussen MD ,&nbsp;Elizabeth A. Arendt MD","doi":"10.1016/j.jisako.2025.100899","DOIUrl":"10.1016/j.jisako.2025.100899","url":null,"abstract":"<div><h3>Introduction</h3><div>Various knee-related patient-reported outcome measures (PROMs) have been used for patients who undergo surgical treatment for patellofemoral instability. There has been limited evaluation of their suitability and no agreement about an optimal set of measures.</div></div><div><h3>Objectives</h3><div>To evaluate the Knee injury and Osteoarthritis Outcome Score (KOOS) and published shorter versions to determine their suitability for patients with patellofemoral instability.</div></div><div><h3>Methods</h3><div>The study cohort consisted of patients who underwent surgical stabilization with medial patellofemoral ligament reconstruction for recurrent lateral patellar dislocations. The full KOOS was administered preoperatively and the 6, 12, and 24 months postoperative. Four short form versions were calculated: KOOS-12, KOOS-Physical Function, KOOS-Joint Replacement, and KOOS-Global. Floor and ceiling effects were determined (threshold &gt;15%). Individual items were evaluated to identify where &gt;67% of patients had preoperative responses of “≥ moderate” (demonstrating item relevance). The standardized response mean (SRM) was calculated to assess responsiveness from baseline to each postoperative assessment time, as well as between postoperative assessments.</div></div><div><h3>Results</h3><div>289 patients completed the full KOOS at least once. No ceiling effects were present at any time point for the quality of life (QoL) or symptoms subscales, KOOS-12, or KOOS-global. Only 11 of the items passed the &gt;67% threshold for item relevance. These included all Sport/Recreation (SR) and QoL items, as well as one item (knee stiffness after sitting/resting later in the day) from the symptom subscale and one item (pain frequency) from the pain subscale. Given these individual item results, a two-subscale “composite” score was calculated that included the 9 items of the KOOS SR and QoL subscales (KOOS-SR ​+ ​QoL). Excellent responsiveness was seen for all preoperative to postoperative comparisons, especially the composite SR ​+ ​QoL measure (SRM &gt;1). Between 6- and 12-month assessments, the composite SR ​+ ​QoL score was also shown to be the most responsive measure.</div></div><div><h3>Conclusion</h3><div>The composite KOOS SR ​+ ​QoL score may be an improved option for measuring patient-related outcomes in this more active population, as it focuses on the most relevant constructs for this patient group. The full 42-item KOOS was shown to have limited applicability in this patient group.</div></div><div><h3>Level of evidence</h3><div>Level II.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100899"},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064843","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":"Nanofractures are inferior compared to other one-step treatments for chondral lesions in the patella: A controlled preclinical experiment in New Zealand rabbits","authors":"Juan Pablo Martinez-Cano ,&nbsp;Juliana Henao-Giraldo ,&nbsp;María Camila Gómez-Ayala ,&nbsp;Jacobo Triviño-Arias ,&nbsp;José Oscar Gutierrez-Montes","doi":"10.1016/j.jisako.2025.100897","DOIUrl":"10.1016/j.jisako.2025.100897","url":null,"abstract":"<div><h3>Introduction</h3><div>Patellofemoral chondral injuries pose a significant challenge due to their functional impact and potential progression to osteoarthritis. Bone marrow stimulation procedures, such as nanofractures and bone marrow aspirate (BMA), as well as use of autologous cartilage fragments (ACF), may enhance cartilage repair. This study aims to evaluate the efficacy of four one-step procedures plus a control group, for patellofemoral cartilage repair in an animal model.</div></div><div><h3>Methods</h3><div>A randomized preclinical trial was conducted in 20 New Zealand rabbits. A central chondral defect was created in the patella without affecting the subchondral bone. Knees were randomly assigned to five treatment groups: control, nanofractures, nanofractures-plus (fibrin glue), BMA and ACF. Histological assessment of defect filling and cartilage quality were performed using the International Cartilage Repair Society (ICRS) II score.</div></div><div><h3>Results</h3><div>All rabbits completed the follow-up period (20 weeks). The highest defect filling percentage was observed in the BMA group (61%, SD 36%), followed by nanofractures-plus (53%, SD 33%) and ACF (52%, SD 41%), followed by the control group (37%, SD 26%) and nanofractures (30%, SD 22%). Regarding tissue quality, the best mean ICRS II score was found in both nanofractures-plus (64.2%) and BMA (64.2%), followed by ACF (59.1%). Significant inferior cartilage quality was observed in nanofractures group when compared with other groups in certain items of ICRS II score.</div></div><div><h3>Conclusion</h3><div>All treatment strategies promoted some degree of cartilage regeneration; however, none achieved complete defect filling. The nanofractures group demonstrated the poorest outcomes in terms of subchondral bone and tissue integration; nanofractures-plus, BMA and ACF exhibited the greatest regenerative potential in terms of quality. BMA showed the highest defect filling. Given the limited regenerative capacity of these lesions and the high cost and limited accessibility of some treatments, exploring cost-effective alternatives is essential.</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":"13 ","pages":"Article 100897"},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054427","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":"Lateral opening wedge distal femoral osteotomy for symptomatic lateral compartment osteoarthritis: Survivorship and predictive factors at mean 10-year follow-up","authors":"Fabio Mancino ,&nbsp;Giacomo Dal Fabbro ,&nbsp;Kevin Qian ,&nbsp;David A. Parker","doi":"10.1016/j.jisako.2025.100898","DOIUrl":"10.1016/j.jisako.2025.100898","url":null,"abstract":"<div><h3>Introduction</h3><div>Lateral opening wedge distal femoral osteotomy (LOWDFO) is a reliable joint-preserving surgical procedure for isolated lateral compartment knee osteoarthritis (OA) and overload in valgus knees.</div><div>The aim of this study was to evaluate the long-term survivorship and clinical outcomes of patients undergoing LOWDFO, and to identify the factors associated with conversion to total knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>This was a retrospective study of prospectively collected patients who underwent LOWDFO for isolated lateral osteoarthritis and mechanical overload between 2003 and 2023. Clinical outcomes including the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Veterans RAND-12 (VR-12) Physical and Mental scores, and the International Knee Documentation Committee subjective evaluation form (IKDC) were collected and analyzed. Radiographic parameters included hip-knee-ankle angle (HKA) and lateral distal femoral angle (LDFA). Postoperative complications and further reoperations during the follow-up period were recorded. Survivorship was from conversion to TKA and investigated using Kaplan–Meier curve. Logistic regression was used to identify factors associated with conversion, and p values ​&lt; ​0.05 were considered significant.</div></div><div><h3>Results</h3><div>A total of 48 patients (56% males, mean age 36.5 ​± ​11.3 years) were included for analysis. The complication rate was 35.4%, and the reoperation rate was 29.2% at a mean 10.1 ​± ​4.9-year follow-up. Removal of metal hardware due to pain and/or discomfort was the main cause of reoperation in 20.8% of the patients. The cumulative rate of conversion to TKA at 5 years was 7.0%, 10 years 15.0% and 15 years 29%. Older age was significantly associated with an odd ratio (OR) of 1.16 (R²_N ​= ​0.31; 95% CI: 1.03 to 1.30). The survival analysis showed that patients &gt;45 years at the time of index surgery had an increased hazard ratio (HR) for conversion to TKA of 5.16 (95% CI: 1.32 to 10.10).</div></div><div><h3>Conclusion</h3><div>LOWDFO yields a 10-year cumulative survivorship of 85% in young patients with lateral compartment isolated knee OA and overload in valgus knees. Age at the time of index surgery is associated with an increased odds of conversion. Removal of metal hardware can affect one in five patients.</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":"12 ","pages":"Article 100898"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004902","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":"Preoperative computer tomography scans can accurately evaluate tibial bone mineral density for selecting bone fixation in total knee arthroplasty","authors":"Yoshinori Mikashima ,&nbsp;Hitoshi Imamura ,&nbsp;Koichiro Yano ,&nbsp;Katsunori Ikari ,&nbsp;Hiroshi Takagi ,&nbsp;Ken Okazaki","doi":"10.1016/j.jisako.2025.100894","DOIUrl":"10.1016/j.jisako.2025.100894","url":null,"abstract":"<div><h3>Introduction/objective</h3><div>The mechanical quality of bone at the proximal tibia is an important factor for the success of cementless total knee arthroplasty (TKA). The purpose of this study was to evaluate the relationship between preoperative bone mineral density (BMD) at the tibial resection level (tibial BMD) using computed tomography (CT) and intraoperative cancellous bone durability (ICBD) in TKA.</div></div><div><h3>Methods</h3><div>All consecutive cemented and cementless TKAs performed by a single surgeon between April 2024 and October 2024 were evaluated. All patients were examined preoperatively for tibial BMD via CT, hip BMD via dual-energy X-ray absorptiometry. A block of cancellous bone with a diameter of 10 ​mm and a height of 10 ​mm was harvested at the center of the tibia. The fixation method was selected intraoperatively according to the macroscopically evaluated bone quality. Using a pusher tension gauge and a metal measure, the force required to compress the harvested bone from 10 ​mm to 5 ​mm was measured and defined as ICBD. Pearson product-moment correlations were calculated to assess the relationships between tibial and hip BMD and ICBD.</div></div><div><h3>Results</h3><div>A consecutive series of 74 TKAs were included. There were 50 cementless fixations and 24 cemented fixations. Tibial BMD, hip BMD and mean ICBD were significantly greater in the cementless group than in the cemented group (tibial BMD: 70.3 ± 26.2 vs 37.5 ± 14.4, and hip BMD: 87.3 ± 11.8 vs 65.6 ± 10.5, ICBD: 85.6 ± 35.6 vs 49.8 ± 18.1, respectively, <em>P</em> &lt; 0.01). The cut-off value of tibial BMD indicating a cementless prosthesis was 46.4 HA/cm³. There was a very strong correlation between tibial BMD and ICBD (r = 0.88, <em>P</em> &lt; 0.01) and a strong correlation between hip BMD and ICBD(r = 0.62, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>This study is the first report to focus on the relationships between CT-based tibial BMD and the actual bone quality of the proximal tibia . Assessment of bone quality via CT is accurate, relatively simple, and potentially useful for determining whether cementless fixation in TKA is indicated. For cementless fixation, 46.4 HA/cm3 and 55.7 N were found as tibial BMD and ICBD cut-off values.</div></div><div><h3>Level of evidence</h3><div>Retrospective cohort study, Level Ⅳ.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100894"},"PeriodicalIF":2.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049933","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":"Pretibial abscess associated with instrumentation-specific infection after anterior cruciate ligament reconstruction: A case report","authors":"Xian Zhang ,&nbsp;Cong Qiao ,&nbsp;Jiang Zheng ,&nbsp;Bo Ren","doi":"10.1016/j.jisako.2025.100893","DOIUrl":"10.1016/j.jisako.2025.100893","url":null,"abstract":"<div><div>Pretibial abscess is a rare but serious complication after anterior cruciate ligament (ACL) reconstruction. We report six cases of pretibial abscesses from 364 ACL reconstructions at our center between January 2022 and June 2023. Patients presented with poor wound healing, sinus tract formation, and magnetic resonance imaging showed fluid accumulation and bone marrow edema in the tibial tunnel but no deep infection. Bacterial cultures identified <em>Pseudomonas aeruginosa</em> and <em>Burkholderia cepacia</em>. Further investigation found contamination in the hexagonal reamers used for screw implantation, which was likely the infection source. This report highlights the importance of investigating instrument-specific infections when infection rates unexpectedly rise.</div></div><div><h3>Level of evidence</h3><div>Level V.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100893"},"PeriodicalIF":2.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040091","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":"Is ChatGPT a more academic source than google searches for patient questions about hip arthroscopy? An analysis of the most frequently asked questions","authors":"Necati Bahadir Eravsar MD ,&nbsp;Mahmud Aydin MD ,&nbsp;Atahan Eryilmaz MD ,&nbsp;Cihangir Turemis MD ,&nbsp;Serkan Surucu MD ,&nbsp;Andrew E. Jimenez MD","doi":"10.1016/j.jisako.2025.100892","DOIUrl":"10.1016/j.jisako.2025.100892","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to compare the reliability and accuracy of responses provided to patients about hip arthroscopy (HA) by Chat Generative Pre-Trained Transformer (ChatGPT), an artificial intelligence (AI) and large language model (LLM) online program, with those obtained through a contemporary Google Search for frequently asked questions (FAQs) regarding HA.</div></div><div><h3>Methods</h3><div>“HA” was entered into Google Search and ChatGPT, and the 15 most common FAQs and the answers were determined. In Google Search, the FAQs were obtained from the “People also ask” section. ChatGPT was queried to provide the 15 most common FAQs and subsequent answers. The Rothwell system groups the questions under 10 subheadings. Responses of ChatGPT and Google Search engines were compared.</div></div><div><h3>Results</h3><div>Timeline of recovery (23.3%) and technical details (20%) were the most common categories of questions. ChatGPT produced significantly more data in the technical details category (33.3% vs. 6.6%; <em>p</em>-value ​= ​0.0455) than in the other categories. The most FAQs were academic in nature for both Google web search (46.6%) and ChatGPT (93.3%). ChatGPT provided significantly more academic references than Google web searches (93.3% vs. 46.6%). Conversely, Google web search cited more medical practice references (20% vs. 0%), single surgeon websites (26% vs. 0%), and government websites (6% vs. 0%) more frequently than ChatGPT.</div></div><div><h3>Conclusion</h3><div>ChatGPT performed similarly to Google searches for information about HA. Compared to Google, ChatGPT provided significantly more academic sources for its answers to patient questions.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100892"},"PeriodicalIF":2.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989594","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":"Statistical Shape Modeling to Compare Anatomical Differences in Individuals with Bilateral Symptomatic FAI","authors":"","doi":"10.1016/j.jisako.2025.100454","DOIUrl":"10.1016/j.jisako.2025.100454","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100454"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941651","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 Impact of Pain Tolerance and Grit on Patients with FAI Syndrome: A Prospective Study","authors":"","doi":"10.1016/j.jisako.2025.100487","DOIUrl":"10.1016/j.jisako.2025.100487","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100487"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941078","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":"Deep Learning-Based Ultrasonographic Imaging Diagnosis of Chronic Lateral Ankle Instability","authors":"","doi":"10.1016/j.jisako.2025.100411","DOIUrl":"10.1016/j.jisako.2025.100411","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100411"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941333","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":"Does Combined Polydeoxyribonucleotide Improve the Outcome of Extensor Muscle Strengthening Exercise with Extracorporeal Shockwave Therapy for Lateral Epicondylitis of Elbow?: A Randomized Controlled Trial","authors":"","doi":"10.1016/j.jisako.2025.100439","DOIUrl":"10.1016/j.jisako.2025.100439","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100439"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941563","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}