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

{"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":"Preoperative osteoarthritis severity influences quality of life trajectories following hip arthroscopy in individuals with femoroacetabular impingement syndrome","authors":"Carson Halliwell ,&nbsp;Rebecca Moyer ,&nbsp;Ivan Wong","doi":"10.1016/j.jisako.2025.101044","DOIUrl":"10.1016/j.jisako.2025.101044","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Femoroacetabular impingement syndrome (FAIS), a known contributor to hip osteoarthritis, is frequently treated through hip arthroscopy. However, the impact of preoperative hip osteoarthritis severity on quality of life (QoL) post-surgery remains unclear. This study tested the hypothesis that individuals with moderate-to-severe hip osteoarthritis would show smaller QoL improvement over two years compared to those without or mild hip osteoarthritis.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 259 patients diagnosed with FAIS were included from a single orthopaedic clinic. Participants were categorized based on hip osteoarthritis severity using the Kellgren and Lawrence grade (KLG), with 147 classified as having no hip osteoarthritis (KLG ​= ​0), 77 with mild osteoarthritis (KLG ​= ​1), and 36 with moderate-to-severe osteoarthritis (KLG≥2 (72 ​% KLG ​= ​2, 25 ​% KLG ​= ​3, 3 ​% KLG ​= ​4)). QoL was assessed pre-operatively and at multiple post-operative time points using the 33-item International Hip Outcome Tool (iHOT-33). Linear mixed effects modelling assessed QoL changes over two years.</div></div><div><h3>Results</h3><div>All groups, regardless of hip osteoarthritis severity, demonstrated statistically significant improvements in iHOT-33 scores over two years postoperatively (p ​&lt; ​0.001, d ​= ​0.20–0.79). Patients without hip osteoarthritis (β ​= ​0.32, 95%CI: 0.01:0.64, p ​= ​0.049) and those with mild osteoarthritis (β ​= ​0.28, 95%CI: 0.04:0.52, p ​= ​0.031) showed steady improvements in QoL. Conversely, those with moderate-to-severe osteoarthritis exhibited more limited QoL improvement (β ​= ​0.05, 95%CI: −0.14:0.23, p ​= ​0.452).</div></div><div><h3>Conclusions</h3><div>Pre-operative hip osteoarthritis severity influenced postoperative QoL outcomes following hip arthroscopy in individuals with FAIS. Individuals without or with mild hip osteoarthritis experienced more consistent QoL improvements over two years compared to those with moderate-to-severe osteoarthritis. These findings highlight the importance of tailoring treatment strategies and managing patient expectations based on hip osteoarthritis severity.</div></div><div><h3>Level of evidence</h3><div>Level III (Observational Studies).</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101044"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640747","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":"Biological augmentation reduces failure rates but does not improve functional outcomes after acute patellar tendon repair","authors":"Rodrigo Olivieri ,&nbsp;Tomas Pineda ,&nbsp;Tania Rojas ,&nbsp;Javiera Álvarez ,&nbsp;José Laso ,&nbsp;Nicolás Franulic ,&nbsp;Jose Tomas Muñoz ,&nbsp;Jon Karlsson","doi":"10.1016/j.jisako.2025.101045","DOIUrl":"10.1016/j.jisako.2025.101045","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Acute patellar tendon rupture (PTR) is a rare but disabling injury, and repair failure remains a major concern despite advances in surgical techniques. Biological augmentation has been proposed to reinforce repair, but its clinical benefits remain uncertain. The aim of this study was to compare functional outcomes between isolated repair and biological augmentation for acute PTR and to assess differences in failure and complication rates at a minimum follow-up of two years.</div></div><div><h3>Methods</h3><div>This retrospective study included 39 knees treated surgically for acute PTR between 2015 and 2023 ​at a single center. Patients were divided into two groups based on surgical technique: isolated repair or repair with biological augmentation using autograft or allograft tissue. Functional outcomes were assessed using Kujala and Lysholm scores. Patellar height was evaluated on standardized lateral radiographs using the Caton-Deschamps index (CDI) and Insall-Salvati index (ISI). Postoperative complications and surgical failures were recorded. Patients with surgical failure were excluded from the functional and radiological analyses.</div></div><div><h3>Results</h3><div>The final cohort consisted of 36 patients (39 knees) with a follow-up rate of 82%. The mean follow-up duration was 62.4 ​± ​26.2 months (range: 24–110). Kujala and Lysholm scores were comparable between groups, with no statistically significant differences (Kujala score: 92.9 ​± ​7.9 vs. 93.8 ​± ​9.8, p ​= ​0.636; Lysholm score: 93.8 ​± ​5.7 vs. 93.5 ​± ​13.5, p ​= ​0.053). Patellar height was statistically significantly greater in the isolated repair group (CDI: 1.01 ​± ​0.23 vs. 0.86 ​± ​0.10, p ​= ​0.045; ISI: 1.17 ​± ​0.21 vs. 0.98 ​± ​0.17, p ​= ​0.020). All surgical failures occurred in the isolated repair group (5/23, 21.7%), while no failures occurred in the augmentation group (p ​= ​0.046). Postoperative complications were infrequent and similar between groups.</div></div><div><h3>Conclusion</h3><div>At a minimum of two years’ follow-up, biological augmentation did not improve functional outcomes compared with isolated repair but was associated with a lower rate of surgical failure and significantly lower patellar height, without an increased risk of complications. These results suggest that biological augmentation may be preferred over isolated repair when the primary goal is to reduce failure rates.</div></div><div><h3>Level of evidence</h3><div>this was a level III, retrospective cohort study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101045"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640715","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}

{"title":"Increased risk of postoperative complications in non-alcoholic cirrhosis versus non-alcoholic fatty liver disease following total knee arthroplasty: A national matched cohort study","authors":"Jared Sasaki ,&nbsp;Catherine Hand ,&nbsp;Camden Bohn ,&nbsp;Morgan Angotti ,&nbsp;Daniel Shinn ,&nbsp;Nicholas Lemme ,&nbsp;Brian Forsythe","doi":"10.1016/j.jisako.2025.101051","DOIUrl":"10.1016/j.jisako.2025.101051","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The growing obesity epidemic has led to a sharp rise in non-alcoholic fatty liver disease (NAFLD), now the most common chronic liver disease in the U.S. As both obesity and NAFLD are strongly associated with knee osteoarthritis, orthopedic surgeons are increasingly encountering these patients in need of total knee arthroplasty (TKA). While cirrhosis is a known risk factor for poor postoperative outcomes, the independent impact of NAFLD on TKA remains unclear. The objective of this study was to compare postoperative complication rates in patients with NAFLD versus non-alcoholic cirrhosis (NAC) undergoing TKA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort study was conducted using the Mariner database (PearlDiver Technologies), which includes administrative claims from over 151 million patients in the United States. A total of 1,767,399 patients undergoing primary TKA between 2010 and 2020 were identified. After filtering for continuous enrollment, first-instance procedures, and liver disease coding, patients with NAFLD were identified using ICD-9/10 codes and matched 1:1 via propensity score matching to NAC patients based on age, sex, Charlson Comorbidity Index, and key comorbidities. Postoperative complications were analyzed at 90 days and 1 year using multivariable logistic regression, adjusting for demographic and clinical covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The final matched cohorts included 14,866 patients (7,433 per group). NAFLD patients exhibited a lower overall complication burden at both time points (90-day: 14.4% vs. 17.1%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 25.9% vs. 29.8%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). Compared to matched NAC patients, patients with NAFLD had statistically significant lower rates of periprosthetic joint infection (90-day: 1.7% vs. 2.3%, &lt;em&gt;p&lt;/em&gt; = 0.004; 1-year: 2.6% vs. 4.0%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), pulmonary embolism (90-day: 0.04% vs. 0.4%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 0.1% vs. 0.5%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), hematoma (90-day: 0.3% vs. 0.8%, &lt;em&gt;p&lt;/em&gt; = 0.001; 1-year: 0.5% vs. 1.2%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), acute kidney injury (90-day: 2.8% vs. 3.6%, p = 0.007; 1-year: 5.6% vs. 6.8%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), transfusion (90-day: 0.7% vs. 2.9%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 1.3% vs. 3.9%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), and reoperation (90-day: 1.2% vs. 1.9%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 1-year: 2.2% vs. 3.6%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). Otherwise, NAFLD patients demonstrated statistically significant higher rates of manipulation under anesthesia (MUA) and readmission at both 90 days and 1 year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Despite high metabolic comorbidity prevalence, NAFLD patients experienced fewer postoperative complications following TKA than matched NAC patients. These findings suggest that non-cirrhotic NAFLD may have lower perioperative risk than NAC and should not be considered as strong a contraindication to TKA. Future studies incorporating fibrosis staging and ","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101051"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752271","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}