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

{"title":"Arthroscopic remnant preservation anterior cruciate ligament reconstruction using quadrupled semitendinosus autograft with internal brace: A current technique","authors":"Jai Thilak,&nbsp;Johncy Panicker","doi":"10.1016/j.jisako.2025.100918","DOIUrl":"10.1016/j.jisako.2025.100918","url":null,"abstract":"<div><div>We present our arthroscopic technique for anterior cruciate ligament reconstruction (ACLR) using autogenous semitendinosus tendon graft with an internal brace (IB). Single-bundle ACLR with remnant preservation of the torn anterior cruciate ligament (ACL) stump and internal bracing is our preference to recreate the anatomic ACL, thereby providing anteroposterior stability in all patients with no considerable contraindications. We achieve suspensory fixation of the graft with an adjustable loop with a built-in IB consisting of a cortical button that anchors the proximal end of the graft to the femoral outer cortex. The tibial end of the graft with FiberWire sutures is anchored on the proximal tibia through an external attachable button system, onto which the IB is also tightened. The advantages of remnant preservation include accelerated graft revascularisation and remodeling, enhanced proprioception, reduced bone tunnel enlargement, and enhanced objective knee stability, and the IB protects the new ACL during rehabilitation, acting as a secondary stabilizer after the ligament is healed. Our technique helps to minimize the use of additional implants for anchoring IB and ensures cost-effectiveness.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100918"},"PeriodicalIF":2.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498265","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 Sparta Science force plate is reliable in assessment of recovery following anterior cruciate ligament reconstruction","authors":"W.T. Wilson ,&nbsp;J.A. Feller ,&nbsp;H.J. Klemm ,&nbsp;L.M. Batty ,&nbsp;J.C. Kirby ,&nbsp;K.E. Webster","doi":"10.1016/j.jisako.2025.100917","DOIUrl":"10.1016/j.jisako.2025.100917","url":null,"abstract":"<div><h3>Introduction</h3><div>The Sparta Science force plate provides kinetic information derived from movements such as vertical jump and balance tests. It has primarily been utilized to assess fitness amongst athletic and military populations. The outputs from this system may be useful in the assessment of return to sport (RTS) readiness following anterior cruciate ligament (ACL) reconstruction. The aim of this study was to determine the reliability of the Sparta Science metrics in ACL reconstruction patients and to compare these results with the healthy population data provided by the Sparta system.</div></div><div><h3>Methods</h3><div>Primary ACL reconstruction patients were recruited to undergo testing at 9 months postoperatively, excluding those with a history of ipsilateral or contralateral knee injury, or concomitant multiligament knee injury requiring surgery. Testing included knee laxity assessment, hop tests, isokinetic strength testing using a dynamometer, and then kinetic measures using the Sparta force plate. The force plate assessed double- and single-leg vertical jump and balance tasks, with each test performed twice after a 5-min rest. Metrics analyzed were jump height and Sparta-derived jump profiles and balance scores. Sparta-derived t-scores were used to compare against the population average for each test. Intraclass correlation coefficients (ICCs) were calculated to determine relative reliability.</div></div><div><h3>Results</h3><div>There were 74 patients, 44 (60%) males, mean age 25(±9) years, with mean pre-injury Marx scale 13.1(±3.4). The Sparta Science metrics showed moderate to excellent reliability for double-leg (ICC: 0.75-0.97) and single-leg vertical jump (ICC: 0.81-0.95), as well as balance assessments (ICC: 0.71-0.81). Patients scored lower than the healthy population norms for vertical jump tests but greater for balance tests. The jump test scores were significantly correlated with hop tests and quadriceps and hamstring strength.</div></div><div><h3>Conclusion</h3><div>The Sparta Science force plate is reliable when assessing patients after ACL reconstruction with ICCs showing moderate to excellent reliability. We identified kinetic deficiencies in vertical jump test performance and the results correlate with other return to sport testing methods. This demonstrates the Sparta system’s potential as a reliable option to augment traditional testing methods.</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":"13 ","pages":"Article 100917"},"PeriodicalIF":2.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340402","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":"Anteromedial structures, including the joint capsule sleeve and the deep collateral ligament, serve as a stabilizer and contribute to midflexion stability in cruciate ligament-deficient knees: A cadaveric study","authors":"Takashi Tsuda ,&nbsp;Kazunori Hino ,&nbsp;Tatsuhiko Kutsuna ,&nbsp;Kunihiko Watamori ,&nbsp;Tomofumi Kinoshita ,&nbsp;Yusuke Horita ,&nbsp;Masaki Takao","doi":"10.1016/j.jisako.2025.100913","DOIUrl":"10.1016/j.jisako.2025.100913","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The specific contributions of the soft tissue attachments along the tibial rim remain poorly understood, while the importance of medial stability in the knee joint has been widely emphasized. This study aimed to evaluate the effect of releasing individual anteromedial stabilizers by replicating the soft tissue release typically performed in total knee arthroplasty.</div></div><div><h3>Methods</h3><div>Eight cadaveric knees were evaluated. Passive stress in each direction with six degrees of freedom was applied to the knees under image-free navigation monitoring. Measurements were taken following the sequential release of soft tissue structures: normal; anterior and posterior cruciate ligament resection; removal of the medial meniscus with 1 ​cm of anteromedial meniscotibial ligament release; 3 ​cm of anteromedial joint capsule release; and tibial attachment release of the deep collateral ligament. The entire section was performed sequentially on the identical cadaver knee.</div></div><div><h3>Results</h3><div>Anterior translation exhibited a statistically significant increase following dissection of the medial meniscus and 1 ​cm of the meniscotibial ligament at an intermediate flexion angle compared with the previous section. External laxity statistically significantly increased following dissection of the medial meniscus and 1 ​cm of the meniscotibial ligament overall flexion angle. Moreover, further external rotational laxity was observed following 3-cm anteromedial joint capsule release and subsequent deep collateral ligament release throughout an extensive flexion angle. Due to the dissection of each medial structure, gradual increases in external rotation laxity were observed in all sections, with statistically significant differences. Following deep collateral ligament dissection, laxity in each of the six degrees of freedom increased by approximately 20-30 ​% compared with the values observed after anterior and posterior cruciate ligament dissection.</div></div><div><h3>Conclusion</h3><div>Structures attaching to the anteromedial rim of the tibia serve as critical secondary stabilizers during midflexion in cruciate-deficient knees, with the anteromedial joint capsule sleeve and deep medial collateral ligament contributing to rotational stability despite the presence of an intact superficial medial collateral ligament.</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":"13 ","pages":"Article 100913"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486293","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":"Greater deltoid coverage on preoperative MRI correlates with improved early functional outcomes after reverse shoulder arthroplasty","authors":"Hannah M. Lie ,&nbsp;Wen Qiang Lee ,&nbsp;Denny TT. Lie","doi":"10.1016/j.jisako.2025.100912","DOIUrl":"10.1016/j.jisako.2025.100912","url":null,"abstract":"<div><h3>Introduction</h3><div>Reverse shoulder arthroplasty (RSA) translates deltoid contraction into abduction and rotational forces, allowing the deltoid to replace the function of the deficient rotator cuff. While RSA is classically contraindicated in patients with deltoid deficiency, there is no consensus in the literature as to the importance of the deltoid muscle in predicting clinical outcomes. Therefore, the extent or arc of the deltoid wrapped around the humeral head and the thickness of the deltoid muscle at specific intervals are investigated as possible predictors of post-RSA outcomes in this study.</div></div><div><h3>Methods</h3><div>A retrospective review of prospectively collected data was performed in a tertiary institution. Patients who had undergone a reverse shoulder arthroplasty from 2011 to 2021 were included. Preoperative and postoperative radiographic measurements of deltoid wrap arc anteriorly and posteriorly, as well as thickness at 45-degree intervals, were taken. These were correlated with forward flexion and abduction range of motion (ROM) and clinical scores preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. A statistical significance of p ​&lt; ​0.05 was taken.</div></div><div><h3>Results</h3><div>Forty-five cases from forty-one patients were included. From the plane of the native glenoid, the deltoid arc ranges at an average from 21.5° anteriorly to 168° posteriorly. The thickness of the deltoid at 45° was correlated with greater flexion and abduction ROM at the 6-month mark (p ​= ​0.037 and p ​= ​0.014, respectively). Greater deltoid thickness at 45° was also correlated with better early functional outcomes (the Constant, the University of California–Los Angeles, and the Oxford scores) at 6 months (p ​= ​0.007, p ​= ​0.004 and p ​= ​0.031, respectively). No correlation was found with late functional outcomes at 2 years</div></div><div><h3>Conclusion</h3><div>Patients who undergo RSA with a greater pre-operative deltoid thickness, especially at 45° from the anterior, are associated with better forward flexion and abduction ROM, as well as improved functional outcomes 6 months post-operatively. There may be value in prehabilitation to improve early postoperation outcomes.</div></div><div><h3>Level of Evidence</h3><div>3.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100912"},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250093","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":"From data to decisions: The evolution and impact of hip preservation registries","authors":"Ryan McWilliams ,&nbsp;Ajay Malviya ,&nbsp;Vikas Khanduja","doi":"10.1016/j.jisako.2025.100911","DOIUrl":"10.1016/j.jisako.2025.100911","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100911"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188158","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":"Assessment and surgical correction of posterior tibial slope in revision anterior cruciate ligament surgery: An international expert Delphi consensus statement","authors":"Anja M. Wackerle ,&nbsp;Stephen Marcaccio ,&nbsp;Nicholas Apseloff ,&nbsp;Alan Getgood ,&nbsp;Volker Musahl ,&nbsp;Sachin Tapasvi","doi":"10.1016/j.jisako.2025.100900","DOIUrl":"10.1016/j.jisako.2025.100900","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim was to provide international guidelines to enhance decision-making regarding the definition and evaluation of increased posterior tibial slope (PTS) and the role of anterior closing wedge high tibial osteotomy (ACWHTO) in the setting of revision anterior cruciate ligament reconstruction (ACLR).</div></div><div><h3>Methods</h3><div>This guideline is based on responses from 46 international orthopaedic surgeons with expert experience in knee pathologies and osteotomy. Based on a literature review, each expert drafted and commented on a set of core statements. The provided comments were blinded and discussed within the working group to refine the statements. In a subsequent round of surveys, all experts discussed with the final 32 statements. Consensus was achieved when at least 80 ​% of survey respondents fully agreed.</div></div><div><h3>Results</h3><div>With respect to ACWHTO for PTS reduction, there was consensus achieved for using the medial plateau as a measurement for PTS measuring, aiming for PTS correction of 5–7°, individualizing osteotomy wedge thickness, and performing ACWHTO and revision ACLR in a single stage. There was no consensus on the type of radiographs to be used, a cut-off value for increased PTS, an absolute indication for ACWHTO the osteotomy technique, nor type of fixation. The International consensus statements aim to bridge the gap between research and clinical application to enhance clinicians’ decision-making in revision ACLR management and to focus future areas of required research.</div></div><div><h3>Conclusion</h3><div>The literature review confirmed a paucity of evidence to guide clinicians in the diagnosis and surgical management of increased PTS. An agreement could be achieved for 25/32 statements (78 ​%) on the definition and assessment of PTS, indication, planning, surgical decision-making, and peri- and postoperative management for ACWHTO. While no consensus could be achieved for the definition of a cut-off value for pathological PTS, consensus was reached for a variety of statements on diagnostic and surgical aspects.</div></div><div><h3>Level of Evidence</h3><div>V, expert opinion.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100900"},"PeriodicalIF":2.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209806","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":"Satisfactory functional outcomes and low recurrence rates at a mean 10-year follow-up after combined staged synovectomy and external radiotherapy for diffuse pigmented villonodular synovitis of the knee","authors":"Fahmy Samir Fahmy MD,&nbsp;Mohamed ElAttar MD,&nbsp;Ahmed Hatem Farhan MD,&nbsp;Sami Ibrahim Sadek MD,&nbsp;Mahmoud Abdo Mahmoud MD,&nbsp;Hossam Fathi Mahmoud MD","doi":"10.1016/j.jisako.2025.100907","DOIUrl":"10.1016/j.jisako.2025.100907","url":null,"abstract":"<div><h3>Introduction</h3><div>Diffuse pigmented villonodular synovitis (PVNS) of the knee is a locally destructive lesion that tends to recur following surgical synovectomy. This study aims to evaluate the long-term functional outcomes and recurrence rates of combined staged synovectomy and external radiotherapy in managing diffuse PVNS of the knee.</div></div><div><h3>Methods</h3><div>The data of twenty-three patients who had a diffuse PVNS of the knee between June 2011 and September 2017 were retrospectively collected. The patients underwent combined staged anterior arthroscopic and open posterior synovectomy followed by low-dose external radiotherapy (average 3000 ​cGy). Functional outcomes were assessed preoperatively and at the final follow-up using the International Knee Documentation Committee (IKDC) score, Musculoskeletal Tumor Society (MSTS) score, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, and SF-36 score, along with the knee motion measurements. Statistical analysis evaluated the changes in functional scores and recurrence rates, with a p-value &lt; 0.05 as the cut-off level of significance.</div></div><div><h3>Results</h3><div>The mean follow-up time was 121.1 ​± ​20.2 months, with a minimum of 85 months. At the final follow-up, the mean range of motion (ROM) improved from 84.1 ​± ​16.2° to 110.4 ​± ​9.7°. The WOMAC score increased significantly from 44.5 ​± ​5.1 to 81.5 ​± ​6.3 (p ​&lt; ​0.00001). The IKDC score improved from 43.7 ​± ​8.1 to 79.1 ​± ​7.4 (p ​&lt; ​0.00001), MSTS scores from 6.7 ​± ​2.1 to 20.3 ​± ​5.7 (p ​&lt; ​0.00001), and SF-36 scores from 28.6 ​± ​7.4 to 77.4 ​± ​11.5 (p ​&lt; ​0.00001). Two recurrent cases were documented at the last follow-up visit (8.6%), with a minor complication rate of 21.7%.</div></div><div><h3>Conclusion</h3><div>Combined staged synovectomy and external radiotherapy is an effective treatment for diffuse PVNS of the knee. It has demonstrated significant functional improvement and low recurrence rates over extended follow-up periods, supporting its role as a durable and reliable treatment strategy.</div></div><div><h3>Level of evidence</h3><div>Level IV, retrospective cohort.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100907"},"PeriodicalIF":2.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152203","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 sport function subscale of the Copenhagen Hip and Groin Outcome Score could not be an indicator of postural balance in soccer players with groin pain","authors":"Fatma Chaari ,&nbsp;Nicolas Peyrot ,&nbsp;Sébastien Boyas ,&nbsp;Abderrahmane Rahmani ,&nbsp;Haithem Rebai ,&nbsp;Sonia Sahli","doi":"10.1016/j.jisako.2025.100906","DOIUrl":"10.1016/j.jisako.2025.100906","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the association between the Copenhagen Hip and Groin Outcome Score (HAGOS) related to sport and recreation (Sport/Rec) and static and dynamic postural balance in soccer players with groin pain. We hypothesized that better postural balance outcomes would correlate with higher HAGOS Sport/Rec scores in these players.</div></div><div><h3>Methods</h3><div>Eighty-four soccer players with groin pain from seven soccer teams volunteered to take part in the study. An investigator collected static (stabilometric platform) and dynamic (Y-Balance Test (Y-BT)) postural balance, and patient-reported outcome measures (HAGOS) in the research laboratory. To investigate the association between the postural balance outcomes and the HAGOS Sport/Rec scores, Spearman’s correlation coefficient (<em>r</em>) was used.</div></div><div><h3>Results</h3><div>The included participants presented the following demographic information: age: 21.56 ​yrs (2.22), height: 1.78 ​m (0.06), body mass: 75.10 ​kg (8.41), body mass index: 23.80 ​km/m² (2.50). The HAGOS Sport/Rec scores showed a small significant positive correlation with the posteromedial reach distance for the Y-BT on both injured (<em>r</em> ​= ​0.21, p ​= ​0.04) and non-injured (<em>r</em> ​= ​0.22, p ​= ​0.04) limbs. However, no significant associations (p ​&gt; ​0.05) were found between these scores and the other Y-BT outcomes or with the static bipedal and unipedal postural balance findings.</div></div><div><h3>Conclusion</h3><div>Overall, the findings of the present study showed only small positive correlations between the posteromedial direction of the Y-BT and the HAGOS Sport/Rec scores. Given the observed small magnitude of correlations and the non-significant associations between the HAGOS Sport/Rec scores and the rest of the Y-BT outcomes or static postural balance outcomes, it appears that Sport/Rec may not serve as a comprehensive indicator for postural balance outcomes. Therefore, coaches and clinicians should consider combining postural balance assessments with the HAGOS Sport/Rec scores to comprehensively tailor their interventions to address both the subjective and objective functional aspects of groin pain in soccer players.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100906"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143898","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":"Proximal fibular osteotomy in conjunction with supramalleolar osteotomy in concurrent management of ankle and knee osteoarthritis: A case series","authors":"Ramesh Radhakrishnan MBBS(Spore), MRCS (Eng),&nbsp;Akshay Padki MBBCh BAO (Ire), MRCS (Ire),&nbsp;Rui Xiang Toh MBBS (Spore), MRCS (Edin), MMed (Orth), FRCSEd (Orth),&nbsp;Kae Sian Tay MBBS (S'pore), MMed (Ortho), MRCSEd, FRCSEd (Ortho),&nbsp;Kong Hwee Lee MBBS (Spore), MRCS (Edin), MMed (Ortho), FRCS (Edin),&nbsp;Nicholas Eng Meng Yeo MBBS (Spore), MRCS (Edin), MMed (Ortho), FRCS (Edin), FAMS","doi":"10.1016/j.jisako.2025.100895","DOIUrl":"10.1016/j.jisako.2025.100895","url":null,"abstract":"<div><div>Management of ankle osteoarthritis (OA) remains a challenge due to its profound impact on pain, function, and quality of life. Supramalleolar osteotomy (SMO) is a joint-preserving procedure that addresses malalignment and redistributes joint loads, while proximal fibular osteotomy (PFO) targets varus deformities and lateral instability. This study explores the outcomes of combining SMO and PFO to treat concurrent ipsilateral ankle and knee OA, providing a comprehensive approach to lower limb pathology.</div><div>We report two cases of patients with symptomatic ankle and knee OA managed using a combined surgical strategy. Both patients underwent preoperative clinical evaluations, radiographic assessments, and standardized rehabilitation protocols postoperatively. Surgical procedures included ankle arthroscopic debridement, microfracture, SMO, PFO, and lateral ligament reconstruction as required.</div><div>Postoperative outcomes demonstrated improvements in alignment, pain, and function. Patient-reported outcome measures showed marked improvements 6 months postoperatively, with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores increasing from 40 to 67 in one patient and from 69 to 94 in the other. Pain scores on the visual analog scale (VAS) showed substantial reductions in both cases, and quality of life domains assessed via the RAND 36-item health survey (RAND 36) questionnaire, including physical function and vitality, demonstrated marked gains. Radiographic analysis confirmed effective realignment and increased joint space, with improvements in key angles such as the tibial anterior surface (TAS) angle and talar tilt (TT).</div><div>These cases highlight the synergistic effect of SMO and PFO in managing complex ipsilateral lower limb OA. Radiographic and patient-reported outcomes demonstrated improved alignment, pain relief, and functionality. SMO addressed varus malalignment in the ankle, while PFO facilitated medial opening and enhanced correction of TT. Additionally, combining these techniques reduced mechanical stress on the medial knee compartment.</div><div>This dual approach shows some promise as a joint-preserving alternative for patients with moderate to severe ipsilateral ankle and knee OA. However, meticulous preoperative planning and patient selection remain essential to optimize outcomes. Further studies with larger cohorts and long-term follow-up are needed to validate these findings and refine surgical indications.</div></div><div><h3>Level of evidence</h3><div>Level V, Case report.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100895"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081217","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":"Comparable clinical outcomes between patients aged over and under 60 ​years undergoing medial meniscus posterior root repair using a soft suture anchor technique: A preliminary retrospective cohort study","authors":"Napatpong Thamrongskulsiri ,&nbsp;Chitapoom Choentrakool ,&nbsp;Thanathep Tanpowpong ,&nbsp;Somsak Kuptniratsaikul ,&nbsp;Danaithep Limskul ,&nbsp;Thun Itthipanichpong","doi":"10.1016/j.jisako.2025.100896","DOIUrl":"10.1016/j.jisako.2025.100896","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate whether functional outcome scores in patients over 60 years of age improve after arthroscopic medial meniscus posterior root repair using a soft suture anchor. Additionally, it aimed to compare postoperative outcomes between patients over 60 years and those under 60 years of age.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of 30 patients who underwent medial meniscus posterior root repair between June 2019 and February 2023. The patients were divided into two groups (≥60 years, n ​= ​15; &lt;60 years, n ​= ​15). Outcomes were assessed using the International Knee Documentation Committee (IKDC) and Lysholm scores at two years, along with MRI-based meniscus healing and radiographic osteoarthritis progression.</div></div><div><h3>Results</h3><div>Both age groups demonstrated statistically significant improvement in functional scores at two years. In the ≥60 years age group, IKDC improved from 31.9 ​± ​8.8 to 61.5 ​± ​11.3 (<em>P</em> ​&lt; ​0.001) and Lysholm from 49.1 ​± ​14.9 to 87.6 ​± ​10.5 (<em>P</em> ​&lt; ​0.001). In the &lt;60 years group, IKDC improved from 35.7 ​± ​10.4 to 54.3 ​± ​8.1 (<em>P</em> ​&lt; ​0.001) and Lysholm from 52.1 ​± ​19.3 to 82.0 ​± ​12.4 (<em>P</em> ​&lt; ​0.001). No statistically significant differences were observed between the groups for functional scores, meniscal healing (<em>P</em> ​= ​0.352) or osteoarthritis progression (<em>P</em> ​= ​0.762).</div></div><div><h3>Conclusions</h3><div>The patients aged ≥60 years who underwent arthroscopic medial meniscus posterior root repair using a soft suture anchor demonstrated functional improvements comparable to younger patients. Age alone should not be a contraindication for this procedure, though long-term follow-up is warranted to assess osteoarthritis progression.</div></div><div><h3>Level of Evidence</h3><div>Level III—retrospective cohort study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"12 ","pages":"Article 100896"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081216","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}