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

{"title":"The quiet revolution in anterior cruciate ligament grafting: An international survey of current global practices in quadriceps tendon use","authors":"Riccardo D'Ambrosi MD (Prof) ,&nbsp;Volker Musahl MD ,&nbsp;Danko Dan Milinkovic MD ,&nbsp;Christian Fink MD (Prof) ,&nbsp;International Quadriceps Tendon Interest Group","doi":"10.1016/j.jisako.2025.101060","DOIUrl":"10.1016/j.jisako.2025.101060","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the current practices, techniques, and opinions regarding the use of the quadriceps tendon (QT) in anterior cruciate ligament reconstruction (ACLR) among knee surgeons worldwide.</div></div><div><h3>Methods</h3><div>A 25-question web-based, anonymous survey was conducted between July 1 and August 15, 2025, and distributed electronically to members of the ACL Study Group, Herodicus Society, and Magellan Society. The questionnaire explored demographics, graft choice, surgical technique, fixation methods, postoperative management, and perceived complications related to QT use. Data were analyzed descriptively.</div></div><div><h3>Results</h3><div>A total of 137 surgeons completed the survey (response rate: 16%), representing more than 30 countries. Respondents had a mean age of 55 ± 11 years (range: 36–88) and reported performing an average of 160 ± 170 ACL reconstructions per year (range: 0–1500). The QT was reported to be used in 27% of primary ACL reconstructions, with an average usage of 42% in revision cases. Over the past five years, QT use increased by approximately 15%. The most commonly reported reasons for selecting QT included its use in revision settings, reduced donor site morbidity, and limitations related to prior grafts. Partial-thickness harvest was preferred by 62% of respondents, and 63% used a soft-tissue-only graft. Adjustable buttons and interference screws were the most frequent methods for femoral and tibial fixation, respectively. Most surgeons (83%) did not alter rehabilitation protocols when using QT, and 71% did not perceive an increased risk of cyclops lesions.</div></div><div><h3>Conclusions</h3><div>This international survey provides valuable insights into current practices and evolving approaches regarding quadriceps tendon use in ACL reconstruction among knee surgeons. While QT usage has increased and is commonly employed in revision settings, there remains variability in harvesting technique, fixation strategy, and perceived indications. These findings underscore the need for further comparative clinical studies and efforts toward standardization of QT-based ACL reconstruction techniques.</div></div><div><h3>Level of evidence</h3><div>International Survey, Level IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101060"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949363","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":"Predicted healing rates do not correlate with patient outcomes following rotator cuff repair—A minimum 2-year follow-up","authors":"Jonathan Chan BSc, MBChB,&nbsp;Ritwik Kejriwal BHB, MBChB, FRACS PGDipSportsMed","doi":"10.1016/j.jisako.2025.101026","DOIUrl":"10.1016/j.jisako.2025.101026","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>The Rotator Cuff Healing Index (RoHI) predicts healing rates following rotator cuff repair based on patient- and tear-specific risk factors and has subsequently been suggested as a means of predicting which high-risk patients might benefit from the use of repair augmentation. However, the correlation between predicted healing rates and functional outcomes is unclear. The aim of this study was to evaluate the relationship between predicted healing rates based on the RoHI and patient-reported outcomes (PROMs) at minimum 2-years following rotator cuff repair.</div></div><div><h3>Methods</h3><div>Patients undergoing superior rotator cuff repair, supraspinatus with or without concurrent infraspinatus repair, by a single surgeon between 2019 and 2022 with a minimum 2-year follow-up were included. Modified RoHI scores were retrospectively calculated using preoperative imaging. Patients were divided into four groups based on RoHI scores (≤4, 5–6, 7–9, and ≥10) and into two groups for further analysis (RoHI &lt;7 and RoHI ≥7). PROMs [the American Shoulder and Elbow Surgeons score (ASES) and the University of California Los Angeles (UCLA) score] were compared preoperatively and at 2 years postoperatively. Statistical significance was set at p ​&lt; ​0.05.</div></div><div><h3>Results</h3><div>A total of 94 patients met the inclusion criteria. All groups demonstrated significant improvements in the ASES and the UCLA scores from preoperative to 2-year follow-up, RoHI &lt;4 group ASES 33.58 to 87.88 (p ​&lt; ​0.0001), UCLA score 15.45 to 32.26 (p ​&lt; ​0.0001); RoHI 5–6 group ASES 45.88 to 93.29 (p ​&lt; ​0.0001), UCLA score 16.06 to 22.12 (p ​&lt; ​0.0001); RoHI 7–9 group ASES score 34.00 to 87.00 (p ​&lt; ​0.0001), UCLA score 15.277 to 31.53 (p ​&lt; ​0.0001); RoHI ≥10 group ASES score 41.00 to 90.00 (p ​= ​0.0014), UCLA score 13.50 to 33.17 (p ​= ​0.0004). Mean 2-year PROMs were not statistically different across all RoHI groups. Likewise, patients in the RoHI &lt;7 and RoHI ≥7 groups demonstrated no statistical difference in outcomes at 2 years (ASES, p ​= ​0.68; UCLA, p ​= ​0.56).</div></div><div><h3>Conclusion</h3><div>Patients achieve similar and significant improvements in PROMs at 2 years following rotator cuff repair without augmentation regardless of predicted healing rates.</div></div><div><h3>Level of evidence</h3><div>Retrospective series; level of evidence, 4.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101026"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432450","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":"Rockwood type VI acromioclavicular joint dislocations: A systematic review","authors":"Eduard Van Eecke MD ,&nbsp;Edward Mattelaer MD ,&nbsp;Wouter Schroven MD ,&nbsp;Sophie Uittenbogaard MD ,&nbsp;Chantal den Haan BSc ,&nbsp;Michel P.J. van den Bekerom MD, PhD","doi":"10.1016/j.jisako.2025.101042","DOIUrl":"10.1016/j.jisako.2025.101042","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Importance&lt;/h3&gt;&lt;div&gt;Rockwood (RW) type VI acromioclavicular (AC) dislocations are exceptionally rare injuries, often associated with high-energy trauma and polytrauma. Limited evidence exists regarding their optimal management and long-term outcomes, making it crucial to synthesize available data to guide clinical decision-making.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim/objective&lt;/h3&gt;&lt;div&gt;This study aims to systematically review existing literature on patient demographics, mechanisms of injury, treatment strategies, functional and radiographic outcomes, and complications of reported cases of RW type VI acromioclavicular (AC) injuries.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence review&lt;/h3&gt;&lt;div&gt;A comprehensive literature search was conducted in multiple databases on February 5, 2025. Eligible studies included retrospective and prospective reports of patients with RW type VI AC dislocations. Case reports and case series were considered, given the rarity of the condition. Data extracted included demographics, mechanism of injury, treatment methods, functional outcomes, radiographic results, and complications. Due to the limited number of cases and heterogeneity of reporting, a qualitative synthesis was performed without formal meta-analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Twenty-four patients were identified across 20 case reports and 2 case series. Among them, 10 were classified as RW type VIa (subacromial) and 14 as type VIb (subcoracoid). The predominant mechanism of injury was motor vehicle accidents. Surgical intervention was the treatment of choice in 91.7% of cases, with techniques including K-wire fixation and coracoclavicular ligament repair. Two patients with type VIa dislocations experienced spontaneous reduction without surgical intervention. At follow-up, 21 of 24 patients regained full range of motion and reported pain-free function, accompanied by satisfactory radiographic findings. The overall complication rate was 8.3%, comprising persistent pain and muscle atrophy. No cases of recurrent dislocation or infection were reported. Hardware removal was performed in 45.8% of patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;RW type VI AC dislocations remain exceedingly rare, with only 24 cases reported to date. Subclassification into type VIa and VIb may assist orthopedic surgeons in tailoring management strategies due to differences in associated injury patterns. While the majority of cases are surgically managed, no single treatment approach demonstrates clear superiority. Overall outcomes appear favorable regardless of intervention, with high rates of return to function and low complication rates. Awareness of this injury pattern is essential to prevent missed diagnoses in the acute trauma setting. Future high-quality, multicenter studies are necessary to establish evidence-based treatment recommendations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level of evidence&lt;/h3&gt;&lt;div&gt;V. Systematic reviews and meta-analyses are assigned a level of evidence equivalent to the lowest l","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101042"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589228","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":"Knee arthrofixation with modular nail as salvage for periprosthetic infection: Evaluation of quality of life and implant survival","authors":"Alejo M. Gonzalez Fantini,&nbsp;Hernan G. Sanchez Mele,&nbsp;Julian Costantini,&nbsp;Lisandro Carbo,&nbsp;Juan F. Astoul Bonorino,&nbsp;Tomás I. Nicolino","doi":"10.1016/j.jisako.2025.101050","DOIUrl":"10.1016/j.jisako.2025.101050","url":null,"abstract":"<div><h3>Introduction</h3><div>Periprosthetic joint infection (PJI) is a complication that can lead to severe bone defects, a lack of soft tissue coverage, and poor infection control. Knee arthrofixation, using modular intramedullary nails and a cement block as a spacer, is a salvage procedure for these situations, serving as an alternative to limb amputation.</div><div>The primary objective of this study was to evaluate the postoperative quality of life of patients undergoing knee arthrofixation with modular intramedullary nails. Secondary objectives included assessing implant survival, complication rates, and the rate of infection cure.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted on 34 patients treated with knee arthrofixation using an intramedullary nail as a definitive treatment for periprosthetic infection between 2015 and 2023 at a single institution. The minimum follow-up period was one year. In addition to the initial evaluation of clinical characteristics, patients' quality of life was assessed using the Oxford Knee Score (OKS). Implant survival, complications, and the proportion of patients who achieved infection cure according to Laffer's criteria were also analyzed.</div></div><div><h3>Results</h3><div>At the one-year follow-up after surgery, a moderate-to-good quality of life score of 32, standard deviation (SD) 12, was reported, with an implant survival rate of 77%, 95% confidence interval (CI) 56–88%, according to Kaplan–Meier estimates. The number of previous surgeries before arthrofixation was 9. Soft tissue flap coverage was required in 46.4% of cases. A modular intramedullary nail was used as the implant of choice in 88.2% of cases. Except for one case, all patients presented with a severe AORI 3 bone defect. Following reconstruction, the average limb length discrepancy was 28 mm. A 35% complication rate was recorded, including six amputations, three nail replacements due to persistent infection, and three implant fractures. The most frequently identified primary pathogen was methicillin-sensitive <em>Staphylococcus aureus</em>. The infection cure rate in this series was 56.5%.</div></div><div><h3>Conclusion</h3><div>Knee arthrofixation is a feasible limb-salvage strategy for recurrent periprosthetic infections, though our series showed increased reinfection rates and lower implant survival compared with previous reports.</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 101050"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757929","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":"Psychometric validation and cultural adaptation of the Persian version of international knee documentation committee subjective knee form (IKDC-SF) across diverse knee pathologies","authors":"Fardis Vosoughi MD ,&nbsp;Kamran Shirbache MD ,&nbsp;Pooya Vahedi ,&nbsp;Amirhossein Razavi ,&nbsp;Amir R. Entezari ,&nbsp;Philippe Neyret MD ,&nbsp;Amir Kasaeian PhD ,&nbsp;Iman M. Oskouie MD","doi":"10.1016/j.jisako.2025.101053","DOIUrl":"10.1016/j.jisako.2025.101053","url":null,"abstract":"<div><h3>Background</h3><div>Knee injuries and degenerative knee disorders meaningfully impact quality of life and physical function. Reliable patient-reported outcome measures (PROMs) are essential for evaluating treatment outcomes. The International Knee Documentation Committee Subjective Knee Form (IKDC-SF) is widely used for this purpose, but a Persian version applicable to all types of knee injuries is lacking.</div></div><div><h3>Methods</h3><div>This cross-sectional validation study included 149 Persian-speaking patients aged 18–75 years, including osteoarthritis (OA) and ligament/meniscus injuries, who were consecutively referred to the clinic. The IKDC-SF was culturally adapted using a standardized forward–backward translation process in accordance with international guidelines. A pilot study was conducted to evaluate the clarity and cultural relevance of the translated items. Participants completed the Persian IKDC-SF (P-IKDC-SF), the Persian Lysholm Knee Score (P-LKS), and the Persian version of the Medical Outcomes Study 36-Item Short Form Survey (P-SF-36) to assess reliability and construct validity. Subgroup analyses were conducted to evaluate psychometric performance across OA and ligament/meniscus groups, along with estimates of the minimal detectable change (MDC).</div></div><div><h3>Results</h3><div>The P-IKDC-SF demonstrated good internal consistency (Cronbach's alpha = 0.827) and excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.910; 95% confidence interval [CI] = 0.878–0.934). Strong construct validity was confirmed with a high correlation to the P-LKS (r = 0.857) and the P-SF-36 physical component (r = 0.753). The MDC for individual change was 10.45 in OA and 17.79 in ligament/meniscus injuries, supporting interpretability for clinical use. Minimal floor and ceiling effects were observed, and Bland–Altman analysis showed good test-retest agreement.</div></div><div><h3>CONCLUSION</h3><div>The P-IKDC-SF is a valid, reliable, and interpretable instrument for assessing knee function and symptoms among the Persian-speaking population with both degenerative and sports injuries of the knee. Its strong psychometric performance across subgroups and clinically meaningful change thresholds supports its use in both clinical and research settings.</div></div><div><h3>Level</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101053"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783127","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":"Infratuberositary derotational tibial osteotomy for anterior knee pain in patients with pathological external tibial torsion: A novel technique","authors":"Vicente Sanchis-Alfonso MD, PhD ,&nbsp;Erik Montesinos-Berry MD, PhD ,&nbsp;Fermín Ordoño-Dominguez MD, PhD","doi":"10.1016/j.jisako.2025.101047","DOIUrl":"10.1016/j.jisako.2025.101047","url":null,"abstract":"<div><div>Pathological external tibial torsion is recognized as a cause of anterior knee pain. Derotational tibial osteotomy is a promising surgical intervention for anterior knee pain in patients with excessive external tibial torsion. It is indicated in disabling anterior knee pain recalcitrant to an appropriate conservative treatment with external tibial torsion &gt;35°. However, there is currently no strong evidence supporting specific torsion angles as a standalone indication for surgery. It is contraindicated in patients with pathological external tibial torsion without clinical symptoms or for cosmetic reasons. This technical note describes our surgical technique of derotational osteotomy to correct pathological external tibial torsion in patients with a normally positioned tibial tuberosity. When there is an excess of external tibial torsion and the foot is placed in a forward direction during gait, the knee joint is pointed inward, and this increases the Q angle and thereby the lateral quadriceps vector. When we internally rotate the distal tibial fragment of the osteotomy to the pre-planned correction, the knee faces forward when the foot points forward during gait, thereby correcting the excessive lateral quadriceps vector by reducing the Q angle. Good clinical outcomes and few complications have been reported with this surgical technique.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101047"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709587","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":"Safe and reproducible knee posterolateral portal development using an arthroscopic inside-out technique: A technical note and retrospective case series of current technique","authors":"Philippe Beauchamp-Chalifour ,&nbsp;Michael Leslie ,&nbsp;Brett Lavender ,&nbsp;David Longino ,&nbsp;Prism Schneider ,&nbsp;Ryan Martin","doi":"10.1016/j.jisako.2025.101057","DOIUrl":"10.1016/j.jisako.2025.101057","url":null,"abstract":"<div><div>There have been many variations of knee arthroscopy posterolateral portal establishment techniques, yet few reports of associated complications. The objective of this study was to describe a standardized inside-out posterolateral portal development technique and to report data on its safety. We conducted a retrospective case series of adult patients who underwent knee posterior arthroscopy using a modified inside-out posterolateral portal development from January 1, 2019, to December 1, 2024. Neurovascular complications were defined as injury to either the popliteal artery, or popliteal vein, or fibular nerve injury with motor function deficit. Other complications were also recorded. A total of 221 patients were included. Most patients underwent knee arthroscopy surgery for posterior cruciate ligament (PCL) reconstruction (N = 141, 64 %). Other indications included meniscal ramp repair (N = 45, 20 %), posterior pigmented villonodular synovitis resection (N = 19, 9 %), and posterior capsular release for arthrofibrosis (N = 11, 5 %). There were no neurovascular complications recorded in this cohort; however, there were six other complications (N = 6, 2.7 %). The most common other complication was a superficial portal site infection (N = 4, 1.8 %). All portal superficial infections occurred at the posteromedial portal, and none occurred at the posterolateral portal. Establishment of the posterolateral portal using an inside-out technique is safe and resulted in no injury to either the popliteus artery or vein, or fibular nerve.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101057"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878961","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":"Good clinical outcome of nonoperatively treated low grade medial collateral ligament injuries combined with primary anterior cruciate ligament reconstruction","authors":"Ji Hoon Bae,&nbsp;Ppuri Bak,&nbsp;Jeongho Son","doi":"10.1016/j.jisako.2025.101054","DOIUrl":"10.1016/j.jisako.2025.101054","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to determine whether functional outcomes differ between patients undergoing an anterior cruciate ligament (ACL) reconstruction with a concomitant, nonoperatively treated grade I and II medial collateral ligament (MCL) injury (ACL + MCL group) and those undergoing an isolated ACL reconstruction (ACL group).</div></div><div><h3>Methods</h3><div>A total of 153 patients (34 ACL + MCL group, 119 ACL group, mean age: 28.6 years) who were available for a 2-year follow-up without re-injuries or requiring revision were included in this study. Preoperative magnetic resonance imaging was used to diagnose the MCL injury and a grade of MCL laxity was evaluated by physical examination. Patient-reported outcomes (the Lysholm score, the Tegner activity score, the International Knee Documentation Committee subjective knee form score [IKDC 2000], the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI), and return to pre-injury level of sports activity at 2 years after ACL reconstruction were compared between the two groups. Statistical significance was set at a p-value &lt;0.05.</div></div><div><h3>Results</h3><div>At the 2-year follow-up, no statistically significant differences of Lysholm score (84.7 vs 83.2; p = 0.740), Tegner activity score (6.2 vs 6.3; p = 0.829), IKDC 2000 subjective score (77.1 vs 78.9; p = 0.572), KOOS symptom (81 vs 78.5; p = 0.454); pain (90.1 vs 93.6, p = 0.513), daily living (96.4 vs 94.5; p = 0.172), sports and recreation (80.5 vs 77.2; p = 0.352), quality of life (39.2 vs 43.1; p = 0.172), ACL-RSI emotion (53.4 vs 53.7; p = 0.953); confidence (63 vs 63.1; p = 0.970); risk (55.6 vs 52.5; p = 0.565) and ACL-RSI total (58.5 vs 57; p = 0.679) were observed. There were no statistically significant differences of rates of return to pre-injury level of sports activity (44% vs 29%, p = 0.092).</div></div><div><h3>Conclusion</h3><div>Similar patient-reported, functional, and return-to-sport outcomes were found for nonoperatively treated grade I and II MCL injuries combined with ACL reconstruction compared to those of isolated ACL reconstruction at the 2-year follow-up.</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":"16 ","pages":"Article 101054"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795057","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":"25-Year trends in anterior cruciate ligament reconstruction: Results from the biennial ACL Study Group survey from 1998 to 2023","authors":"Grant G. Schroeder MD ,&nbsp;Ian Hollyer MD ,&nbsp;Yazdan Raji MD ,&nbsp;Muzammil Akhtar BS ,&nbsp;Christopher C. Kaeding MD ,&nbsp;Tim Spalding FRCS(Orth) ,&nbsp;Ryosuke Kuroda MD, PhD ,&nbsp;Seth L. Sherman MD ,&nbsp;ACL Study Group","doi":"10.1016/j.jisako.2025.101039","DOIUrl":"10.1016/j.jisako.2025.101039","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Anterior cruciate ligament reconstruction (ACLR) has been a highly active area in orthopaedic research in the past several decades, which has been associated with changing surgical practices. The purpose of this study is to present survey data over 25 years from members of the ACL Study Group (ACL SG) and to evaluate trends in expert opinion over time.</div></div><div><h3>Methods</h3><div>From 1998 to 2023, an electronic questionnaire was distributed to members of the ACL SG every two years. The questions explore ACLR topics including graft preferences, tunnel drilling techniques, graft fixation techniques, role for ACL repair, meniscal repair aggressiveness, return to sport timelines, and osteoarthritis risk as it relates to ACLR.</div></div><div><h3>Results</h3><div>Between 1998 and 2023, preferences for graft choice for primary ACLR showed a trend toward decreasing bone-patellar tendon-bone (BTB) autograft usage, increasing hamstring autograft usage, low allograft usage, and a recent rise in quadriceps autograft usage. For revision ACLR, hamstring autograft usage initially predominated but sharply declined in 2016, concurrent with a sharp rise in BTB autograft use and a steadier rise in quadriceps autograft usage. Anteromedial femoral tunnel drilling technique showed a dominant and increasing utilization, antegrade full-tunnel tibial drilling consistently predominated, metallic interference screw use has declined with a rise in cortical suspensory constructs for femoral fixation, and absorbable interference screws use for tibial fixation has been the most common technique. There has been a trend of increasing aggressiveness for concurrent extra-articular augmentation and meniscus repair over time, and a recent trend toward 9-month return to cutting sport timelines compared to 6 months.</div></div><div><h3>Conclusion</h3><div>This study reveals trends in opinions and preferences of the ACL SG over the past 25 years, which dynamically both drive and respond to important scientific evidence in ACLR.</div></div><div><h3>Level of evidence</h3><div>Level V, Expert Opinion.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101039"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582671","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":"Dynamic knee valgus as a predictor of graft rerupture after anterior cruciate ligament reconstruction: Influence of sex and graft type","authors":"Waldo Gonzalez ,&nbsp;Juan Pablo Riquelme ,&nbsp;Diego Barba ,&nbsp;Daniela Erskine ,&nbsp;Rodrigo Venegas ,&nbsp;Rafael Calvo ,&nbsp;David Figueroa","doi":"10.1016/j.jisako.2025.101034","DOIUrl":"10.1016/j.jisako.2025.101034","url":null,"abstract":"<div><h3>Introduction</h3><div>Dynamic knee valgus has been identified as a potential risk factor for anterior cruciate ligament (ACL) injury, but its role in predicting graft failure or contralateral rupture after anterior cruciate ligament reconstruction (ACLR) remains unclear. The purpose of this study was to evaluate dynamic valgus (DV) as a predictor of graft re-rupture and contralateral ACL injury following ACLR, and to explore whether graft type influences this association.</div></div><div><h3>Methods</h3><div>Prospective cohort study was conducted patients who underwent primary ACLR between 2020 and 2024. Patients with multiligament injuries, osteotomies, or revision surgeries were excluded. DV was measured during a standardized return-to-sport (RTS) drop jump test. Logistic regression was performed to assess associations with graft rerupture and contralateral ACL injury, adjusting for age, sex, body mass index (BMI), and graft type. Receiver operating characteristic (ROC) analysis was used to evaluated discriminative ability.</div></div><div><h3>Results</h3><div>A total of 137 patients completed follow-up at a mean of 3.0 ​± ​1.2 years. Most patients were male (75.9%), with a mean age of 26.7 years. Ten patients (7.3%) sustained a graft re-rupture and nine (6.6%) a contralateral rupture. The DV was an independent predictor of graft rerupture (adjusted odds ratio [aOR]: 1.07; 95% confidence interval [CI]: 1.001–1.15). In sex-stratified analyses, this association was statistically significant only among men (aOR: 1.13; 95% CI: 1.02–1.24), with an area under the curve (AUC) of 0.76. A threshold between 18° and 20° yielded a balanced sensitivity and specificity of 71% and 73%, respectively. No statistically significant differences in DV were observed across graft types.</div></div><div><h3>Conclusion</h3><div>DV is an independent predictor of graft rerupture after ACLR, particularly among men, where valgus angles above 18–20° markedly increase the risk of failure. These findings support the integration of DV assessment into postoperative follow-up to identify high-risk patients and to inform graft selection and rehabilitation strategies.</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 101034"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530974","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}