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

{"title":"Offset correction via the Hueter approach effectively eliminates the pistol grip deformity in dysplastic hips undergoing periacetabular osteotomy","authors":"Sufian S. Ahmad,&nbsp;Marco Haertlé,&nbsp;Quentin Karisch,&nbsp;Henning Windhagen,&nbsp;Justus Stamp","doi":"10.1016/j.jisako.2025.101012","DOIUrl":"10.1016/j.jisako.2025.101012","url":null,"abstract":"<div><h3>Objectives</h3><div>Large posterolateral CAM deformities represent a technically challenging entity due to the posterior location of the asphericity at the head–neck junction. The aim of this study was to determine whether access to the posterior CAM is improved in patients with concomitant hip dysplasia via a Hueter approach. It was hypothesized that an arthrotomy prior to periacetabular osteotomy (PAO) via the Hueter approach would allow for the elimination of the pistol-grip deformity in dysplastic hips.</div></div><div><h3>Methods</h3><div>A single-surgeon series of 342 PAOs performed between June 2023 and May 2025 was retrospectively assessed. Seventeen hips with dysplasia and a concomitant pistol-grip deformity were identified. Preoperative and postoperative measures of global femoral-head coverage (lateral center-edge angle, acetabular index, extrusion index, anterior and posterior wall indices) and femoral offset (anteroposterior and axial α-angles) were collected. The elimination of the pistol-grip deformity was confirmed independently by two observers. A matched cohort of isolated-PAO hips served to compare surgical time.</div></div><div><h3>Results</h3><div>There were only 17 (4.97%) dysplastic hips undergoing PAO with a concomitant pistol-grip deformity, indicating that this is a rather rare combination of pathologies. Of these, 11 (64.71%) were male. The femoral offset correction performed via the Hueter approach effectively restored a physiological offset as shown by a statistical significant reduction in the α-angle on anteroposterior (88.51 ​± ​13.17° to 60.86 ​± ​16.24°, p ​&lt; ​0.0001) and axial (82.49 ​± ​10.37° to 51.31 ​± ​11.21°, p ​&lt; ​0.0001) radiographs. The pistol-grip deformity was completely eliminated in all 17 hips. The combined procedure of PAO and femoral offset correction required statistical significantly more surgical time than isolated PAO (101.06 ​± ​21.34 ​min vs. 56.06 ​± ​16.75 ​min; p ​&lt; ​0.0001).</div></div><div><h3>Conclusions</h3><div>These findings demonstrate that, in dysplastic hips, excellent access to the posterolateral CAM lesion characteristic of the pistol-grip deformity can be achieved. The posterior CAM deformity can be corrected through an arthrotomy via the Hueter approach, making use of the acetabular undercoverage to correct the posterior CAM, prior to performing the reorientation to correct dysplasia.</div></div><div><h3>Level of Evidence</h3><div>Level IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101012"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281369","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":"Multiligament knee surgical planning checklist: Introducing a conceptual shift in the reporting of surgical management protocols with mid-term outcomes","authors":"Iftach Hetsroni MD ,&nbsp;Shanny Gur MD ,&nbsp;Mischa van Stee BPT ,&nbsp;Gideon Mann MD ,&nbsp;Nissim Ohana MD","doi":"10.1016/j.jisako.2025.101064","DOIUrl":"10.1016/j.jisako.2025.101064","url":null,"abstract":"<div><h3>Background</h3><div>Multiligament knee trauma is a heterogenous and exceptionally challenging area of knee-preserving surgery. Currently, there is a lack in reporting standards of treatment protocols and outcomes. The aim of this study is to present a novel way for reporting multiligament injury management protocols with their outcomes which could become a basis for future standardization.</div></div><div><h3>Methods</h3><div>To address acute multiligament knee injury management, a lesion-specific surgical planning checklist was developed. Patients managed according to the checklist were evaluated at 4.5- to 10-year follow-up incorporating reported and disease-specific outcome scores alongside knee function measures. Descriptive statistics included means with standard deviations and medians with ranges. Tegner activity level at follow-up was compared to before the injury. Statistical significance threshold was set at 0.05.</div></div><div><h3>Results</h3><div>Of 25 patients with multiligament injured knees treated between 2013 and 2020, the checklist was applicable to 17, which were managed early (i.e., within 3 weeks), of whom 15 were managed in accordance with the checklist items. Of these, 12 were evaluated at mid-term (12/15 = 80% follow-up rate). The follow-up International Knee Documentation Committee –subjective score was 75 ± 14, the Knee injury and Osteoarthritis Outcome Score-symptoms was 74 ± 17, KOOS-activities of daily living was 85 ± 15, KOOS-sports was 60 ± 28, the multiligament quality of life questionnaire–physical impairment score was 31 ± 20, and jump–squat performance was found symmetric in 75%. Tegner activity level was inferior compared to before the injury (median 4 vs. 7, <em>p</em> = 0.02). No infections, iatrogenic neurovascular injuries, or thromboembolic events were encountered in any of the 25 patients.</div></div><div><h3>Conclusion</h3><div>A lesion-specific 20-item checklist designed for surgical planning in acute multiligament knee trauma clearly defines the surgical protocol, facilitates the preparations for surgery, and is associated with favorable mid-term outcomes. Nevertheless, a multicenter collaboration is still required in order to transform this reporting method into a validated global registry system.</div></div><div><h3>Level of evidence</h3><div>4, Case series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101064"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935494","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":"Arthroscopically confirmed cartilage degeneration in the lateral tibial plateau over two years following anterior cruciate ligament and meniscus injury: A retrospective study","authors":"Akira Tsujii ,&nbsp;Yasukazu Yonetani ,&nbsp;Kazutaka Kinugasa ,&nbsp;Tomohiko Matsuo ,&nbsp;Seira Sato ,&nbsp;Tomoki Ohori ,&nbsp;Takashi Kanamoto ,&nbsp;Hiroyuki Tanaka ,&nbsp;Seiji Okada ,&nbsp;Ken Nakata ,&nbsp;Masayuki Hamada","doi":"10.1016/j.jisako.2025.101049","DOIUrl":"10.1016/j.jisako.2025.101049","url":null,"abstract":"<div><h3>Objectives</h3><div>Articular cartilage injuries are frequently associated with anterior cruciate ligament (ACL) injuries and may lead to early knee osteoarthritis (OA) if left untreated. Although ACL and meniscus injuries are commonly treated simultaneously, cartilage injuries are often left in situ. This study aimed to evaluate the progression of the cartilage injury in the lateral compartment following ACL reconstruction (ACLR) combined with lateral meniscus (LM) repairs.</div></div><div><h3>Methods</h3><div>A retrospective review of ACL and LM injuries was conducted in patients who underwent ACLR and meniscus repair. Patients were categorized into three groups: radial/flap tears (group R), longitudinal tears (group L), and controls without LM injuries (group C). Articular cartilage status in the lateral compartment was assessed by arthroscopic grading according to the International Cartilage Repair Society classification at the primary surgery and at second-look arthroscopy. Clinical assessments (pain, range of motion, swelling, and Lachman test) and radiographic and magnetic resonance imaging (MRI) findings were also evaluated.</div></div><div><h3>Results</h3><div>ACLR restored knee stability in 92 patients (34, 28, and 30 in groups R, L, and C, respectively). No statistically significant differences were identified in the demographics or preoperative bone bruises on MRI among the groups. However, cartilage injury in the lateral tibial plateau progressed arthroscopically in groups R and L. In addition, marginal osteophyte formation was significantly frequent in group R. Logistic regression analysis further revealed that a higher body mass index and the presence of a meniscus injury were independently associated with the progression of cartilage injury.</div></div><div><h3>Conclusion</h3><div>Cartilage damage may progress even after ACLR and meniscus repair, potentially increasing the risk of future OA. Cartilage injury progressed in patients with an elevated body mass index and the presence of a meniscus injury.</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 101049"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688415","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":"Combine anterior cruciate ligament reconstruction and unicompartmental knee arthroplasty with image-based robotic surgery: A current surgical technique","authors":"Luca Andriollo ,&nbsp;Cécile Batailler ,&nbsp;Pietro Gregori ,&nbsp;Guillaume Mesnard ,&nbsp;Thomas Neri ,&nbsp;Elvire Servien ,&nbsp;Sébastien Lustig","doi":"10.1016/j.jisako.2025.101046","DOIUrl":"10.1016/j.jisako.2025.101046","url":null,"abstract":"<div><div>Unicompartmental knee arthroplasty (UKA) is a widely recognized treatment for isolated compartment osteoarthritis (OA). The absence of an intact anterior cruciate ligament (ACL), however, has traditionally been considered a contraindication due to its critical role in maintaining knee stability and joint kinematics. This article aims to provide a detailed description of the surgical technique for UKA with simultaneous ACL reconstruction. It offers a practical guide for surgeons interested in adopting this approach for young, active patients with ACL-deficient and medial or lateral compartment OA, utilizing an image-based robotic platform for both preoperative and intraoperative planning. Indications and contraindications for the combined treatment are also reported. This technique, described through intraoperative images and video, represents a promising, joint-preserving alternative to total knee arthroplasty for appropriately selected patients. This step-by-step approach allows for the assessment of congruence between the bone tunnels and the prosthetic components, enabling personalized implant positioning.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101046"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696520","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":"Incidence and risk factors of loss of motion following anterior cruciate ligament reconstruction: a systematic review and meta-analysis","authors":"Alyssa A. Federico ,&nbsp;Reva Y. Qiu ,&nbsp;Golpira Elmi Assadzadeh ,&nbsp;Nicholas G. Mohtadi","doi":"10.1016/j.jisako.2025.101036","DOIUrl":"10.1016/j.jisako.2025.101036","url":null,"abstract":"<div><h3>Importance</h3><div>The anterior cruciate ligament (ACL) is the most commonly injured ligament of the knee, with most patients undergoing surgical reconstruction. Of these patients, 6.5–27.6% require a second operation to treat loss of motion, which can cause substantial delays in patient recovery and return to sport. Currently, there is a paucity of comprehensive data regarding loss of motion following anterior cruciate ligament reconstruction (ACLR) surgery, resulting in variable measures of incidence and uncertainty about risk factors.</div></div><div><h3>Objective</h3><div>The primary objective of this study is to identify the incidence and risk factors for repeat surgical intervention for loss of motion following primary ACLR.</div></div><div><h3>Evidence review</h3><div>Two independent reviewers conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The EMBASE, MEDLINE, and PubMed databases were searched, along with the reference lists of included articles and related systematic reviews. Studies were included if they met the following criteria: (1) included adult patients with primary ACL ruptures treated surgically, (2) had a follow-up period of at least 3 months postoperative, (3) provided an objective definition of stiffness, arthrofibrosis, or cyclops lesions, and (4) reported the incidence and/or risk factors for loss of motion. A random-effects meta-analysis was conducted to estimate the pooled incidence of loss of motion across studies.</div></div><div><h3>Findings</h3><div>A total of 48 studies were included in the final analysis. Of these studies, 46 reported the incidence of loss of motion requiring surgery, with a mean pooled incidence of 4% (95% CI: 3–5 ​%). The incidence decreased over time from 10% (95% CI: 7–13%) in 1991–1999 to 4% (95% CI: 3–5%) in 2000–2023. There were 29 studies that reported statistically significant risk factors for loss of motion requiring surgery. The most common risk factors were female sex, acute repair, concomitant meniscus repair, delayed postoperative range of motion, and preoperative range of motion deficit.</div></div><div><h3>Conclusion</h3><div>The incidence of loss of motion requiring surgery after ACLR is 4%, with a variety of risk factors related to the patient, injury, surgery, and recovery. The incidence has decreased over time, but arthrofibrosis remains a devastating surgical complication that is important to discuss with patients.</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 101036"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534852","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":"Recurrent yoke fracture in rotating-hinge total knee arthroplasty: A case report and literature review","authors":"Victoria L'Hourre MD ,&nbsp;Antoine Desseaux MD ,&nbsp;Thomas Williams MD ,&nbsp;Agathe Yvinou MD MSc","doi":"10.1016/j.jisako.2025.101033","DOIUrl":"10.1016/j.jisako.2025.101033","url":null,"abstract":"<div><div>Rotating-hinge total knee arthroplasty is a valuable option in complex primary and revision procedures, Rotating-hinge total knee arthroplasty is commonly used in complex primary and revision procedures when severe ligamentous deficiency, bone loss, or instability precludes the use of less constrained implants. Although modern hinge designs aim to reduce mechanical complications, structural failure of the polyethylene insert and its metal-reinforced yoke remains a rare but serious event, often requiring further revision.</div><div>We report the case of a 62-year-old man who underwent revision total knee arthroplasty with a rotating-hinge prosthesis for a distal femoral periprosthetic fracture. Initial postoperative recovery was satisfactory. Two years later, he presented with sudden knee pain and swelling, and imaging revealed a fracture of the hinge insert keel with associated femoral component loosening. Intraoperative findings confirmed a fracture involving both the polyethylene and the metal reinforcement. Synovectomy and isolated insert exchange were performed, and cultures grew Staphylococcus aureus and Corynebacterium striatum, leading to chronic suppressive antibiotic therapy.</div><div>One year later, a second identical hinge insert fracture occurred despite infection control. Revision surgery with upsizing of the femoral component and a thicker polyethylene insert was performed. Intraoperative cultures were negative. At 12-month follow-up, the patient demonstrated stable implant positioning and satisfactory joint motion, with return to prior activity levels.</div><div>This case highlights the biomechanical vulnerability of the cone–cylinder junction of the hinge insert under cyclic loading, particularly when postoperative soft-tissue tension and flexion-extension balance are suboptimal. Isolated insert exchange alone may not sufficiently address the underlying mechanical stresses. Strategic upsizing of the femoral component can restore joint line height, improve the extensor lever arm, and reduce distraction forces transmitted through the hinge.</div><div>Early recognition of instability and consideration of mechanical contributors during revision planning may reduce recurrence risk.</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":"16 ","pages":"Article 101033"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490564","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":"Atypical calcific tendinitis involving teres minor which affects overhead movement: A case report","authors":"Sawarin Voravitvet,&nbsp;Puttinan Pingpitayakul,&nbsp;Pinprapha Boonhyad,&nbsp;Phob Ganokroj","doi":"10.1016/j.jisako.2025.101055","DOIUrl":"10.1016/j.jisako.2025.101055","url":null,"abstract":"<div><div>Calcific tendinitis is a common cause of shoulder pain, with the supraspinatus tendon being most frequently affected. In contrast, involvement of the teres minor tendon is exceptionally rare.</div><div>We report an unusual case of a 55-year-old woman experiencing persistent left shoulder pain for six months, exacerbated by overhead activities. Clinical examination revealed point tenderness over the posterolateral shoulder and restricted abduction and external rotation. Imaging identified a 1.8 cm calcification within the teres minor tendon.</div><div>Given the unresponsiveness to nonoperative treatments, arthroscopic removal of the calcifications and teres minor tendon repair were performed, resulting in pain-free motion and a return to overhead activities. Postoperative magnetic resonance imaging (MRI) confirmed tendon integrity and the absence of calcification recurrence.</div><div>This case highlights the importance of considering atypical presentations of calcific tendinitis, particularly in the context of isolated posterior shoulder pain. Recognition of this rare tendon involvement is essential to avoid misdiagnosis and to guide appropriate surgical planning when conservative measures fail. Furthermore, this report demonstrates that arthroscopic intervention including targeted debridement and teres minor tendon repair can yield excellent clinical outcomes even with unusual presentation. Raising awareness of such rare cases may support earlier diagnosis and tailored treatment, ultimately improving patient outcomes.</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":"16 ","pages":"Article 101055"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral extra-articular tenodesis reduces graft failure without affecting functional outcomes after revision anterior cruciate ligament reconstruction: A retrospective comparative study with 6-year follow-up","authors":"Waldo Gonzalez ,&nbsp;Jorge Isla ,&nbsp;Alfredo Sandoval ,&nbsp;Francisco Figueroa ,&nbsp;Minerva Itriago ,&nbsp;David Figueroa","doi":"10.1016/j.jisako.2025.101048","DOIUrl":"10.1016/j.jisako.2025.101048","url":null,"abstract":"<div><h3>Introduction</h3><div>Revision anterior cruciate ligament reconstruction (ACLR) is associated with a substantially higher risk of anterior cruciate ligament (ACL) graft failure than primary ACLR. Lateral extra-articular tenodesis (LET) has gained increasing attention as an adjunctive procedure to enhance rotatory stability and potentially reduce the rate of ACL graft failure. The purpose of this study was to compare clinical and functional outcomes between patients undergoing isolated revision ACLR and those undergoing revision ACLR with concomitant LET. We hypothesized that the addition of LET would reduce the incidence of ACL graft failure without compromising functional outcomes or return-to-sport rates.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included skeletally mature patients who underwent first-time revision ACLR with a minimum follow-up of four years. Patients were divided into two groups according to surgical technique: isolated revision ACLR (n ​= ​58) and revision ACLR with LET (n ​= ​65). ACL graft failure was defined as clinically confirmed graft rupture based on a positive pivot-shift or Lachman test, magnetic resonance imaging, or the need for further revision ACLR. Demographic characteristics, surgical details, and patient-reported outcomes (International Knee Documentation Committee [IKDC] and Tegner activity scale) were compared between groups.</div></div><div><h3>Results</h3><div>A total of 123 patients were analyzed (mean age: 27.1 ​± ​8.0 years) with a mean follow-up of 6.0 years (range: 4.5–7.3 years). Functional outcomes were comparable between groups (IKDC score: 80.4 ​± ​9.2 vs 84.1 ​± ​8.8; p ​= ​0.86; Tegner score: 6.6 ​± ​1.3 vs 6.7 ​± ​1.2; p ​= ​0.92). ACL graft failure occurred in 11 patients (18.3%) in the isolated revision ACLR group and in 2 patients (3.3%) in the revision ACLR with LET group (p ​= ​0.03; odds ratio: 0.15; 95% confidence interval: 0.03–0.72). Sixty percent of all patients (74/123) returned to sport, including 50 (40.6%) who reached their preinjury level, with no statistically significant differences between groups (p ​= ​0.41).</div></div><div><h3>Conclusion</h3><div>The addition of an LET to revision ACLR significantly reduced the rate of ACL graft failure without adversely affecting functional recovery or return-to-sport rates. This procedure may serve as a valuable adjunct for selected high-risk patients undergoing revision ACLR.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"16 ","pages":"Article 101048"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649655","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":"Survivorship, return to sport, and biokinetic risk factors in total knee arthroplasty for young patients: current concepts.","authors":"Felipe F Gonzalez, Lucas Pallone, Jorge Chahla, Jonathan Gustafson, Gustavo Leporace, Leonardo Metsavaht","doi":"10.1016/j.jisako.2025.101061","DOIUrl":"https://doi.org/10.1016/j.jisako.2025.101061","url":null,"abstract":"<p><p>Total knee arthroplasty (TKA) is a successful treatment for knee osteoarthritis, with up to 92% implant survival at 20 years. This success has led to its increased use in younger patients (under 55), who benefit from early pain relief and improved quality of life, but face higher revision risks due to prolonged implant exposure, higher activity levels, and mechanical loading over time. Biokinetic stresses from sports and other high-demand activities are a critical yet often overlooked factor, as decades of repetitive loading may influence long-term outcomes. This narrative review summarizes recent evidence from English-language consensus statements and systematic reviews on implant survivorship, revision risk factors, sports participation, and biomechanical considerations in younger TKA patients. Implant survivorship rates in younger patients are 52.1% to 65.3% after 40 years. Higher revision rates are linked to varus alignment, increased posterior tibial slope, thinner polyethylene inserts, and fewer comorbidities. Low-impact sports like cycling and swimming are encouraged post-TKA, while high-impact sports should be approached cautiously. Biokinetic risk factors, such as altered gait patterns (e.g., stiff-knee gait, dynamic valgus, and increased flexion moment), warrant both preoperative and postoperative motion analysis and may be particularly important in younger patients, given their longer duration of implant use. In summary, young patients undergoing TKA can generally expect excellent implant survivorship, functional outcomes, and satisfaction. Specific risk factors for revision in this population require careful attention. Although current evidence does not link sports participation to increased revision rates or implant wear in the short to mid-term, the combination of long-term implant use and increased mechanical loading during activities represents an important frontier and ongoing challenge in the field. LEVEL OF EVIDENCE: Not Applicable [Current Concepts Review].</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"101061"},"PeriodicalIF":3.3,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893341","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":"Favorable outcomes after all-inside repair of complete lateral meniscus oblique radial tears in patients undergoing anterior cruciate ligament reconstruction: A case-series study","authors":"Periklis Giannakis ,&nbsp;Blake C. Meza MD ,&nbsp;Sophia T. Zhuang BA ,&nbsp;Robert G. Marx MD","doi":"10.1016/j.jisako.2025.101024","DOIUrl":"10.1016/j.jisako.2025.101024","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the outcomes of repairing lateral meniscus oblique radial tears of the posterior horn (LMORT) that are complete and originate &gt;1 ​cm from the posterior root (type 4), during anterior cruciate ligament reconstruction (ACLR) at a minimum of 2 years of follow-up.</div></div><div><h3>Methods</h3><div>In this case series (March 2018–March 2023), we included adults undergoing primary ACLR with type 4 LMORT all-inside repair and complete ≥2-year postoperative complication data. We assessed change from baseline and minimal clinically important difference (MCID) rate for the Patient Reported Outcome Measures Information System Pain Interference (PROMIS-PI) and Mobility (PROMIS-MO), International Knee Documentation Committee Subjective Knee Form (IKDC), Activity Rating Scale (ARS) and Single Assessment Numeric Evaluation (SANE). Return-to-sport (RTS), same-level RTS and complication (retear of lateral meniscus, reoperation, ACLR graft failure, infection, contralateral knee surgery) rates were reported. When available, we evaluated second-look arthroscopy and postoperative magnetic resonance imaging (MRI) findings.</div></div><div><h3>Results</h3><div>In 16 cases (median follow-up; 37.3 [29.1–65.3] months), improvement was noted in median PROMIS-PI (60.3 [57.7–65.8] vs 43.0 [39.0–48.9]; p ​&lt; ​0.001), PROMIS-MO (38.5 [33.5–40.8] vs 61.1 [54.0–66.8]; p ​&lt; ​0.001), IKDC (42.0 [23.5–48.0] vs 91.4 [82.8–96.6]; p ​&lt; ​0.001) and SANE (25.0 [10.0–38.3] vs 89.0 [80.0–95.0]; p ​= ​0.002). No statistically significant differences were observed for ARS (16.0 [13.0–16.0] vs 12.0 [8.0–14.5] p ​= ​0.099). MCID rates were 85.7 ​%, 92.9 ​%, 100 ​%, 57.1 ​% and 78.6 ​% for PROMIS-PI, PROMIS-MO, IKDC, ARS and SANE, respectively. RTS and same-level RTS rates were 12/14 (85.7 ​%) and 8/14 (57.1 ​%), respectively. Three (18.8 ​%) patients underwent ipsilateral knee reoperations; none for lateral meniscus retears. There was one (6.3 ​%) contralateral knee operation. Complete LMORT repair healing was observed on available second-look arthroscopies and MRIs.</div></div><div><h3>Conclusions</h3><div>Our study of patients with type 4 LMORT repair during ACLR supports the limited existing evidence by demonstrating statistically significant improvement in patient-reported outcome measures, low complication rates and satisfactory healing patterns. Our findings should further encourage all-inside repair of type 4 LMORTs during ACLR, as it results in high RTS and substantial same-level RTS.</div></div><div><h3>Level of evidence</h3><div>IV. Case-series. Clinical study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101024"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525719","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}