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

{"title":"Acceptable outcomes for isolated medial patellofemoral ligament reconstruction despite using higher thresholds for patella alta and regardless the value of tibial tubercle-trochlear groove distance and the degree of trochlear dysplasia—An international multicenter study","authors":"Julian A. Feller , Robert A. Magnussen , Petri Sillanpää , Ryosuke Kuroda , Marc A. Tompkins , Raimundo Vial , Julie Agel , Elizabeth A. Arendt","doi":"10.1016/j.jisako.2025.101028","DOIUrl":"10.1016/j.jisako.2025.101028","url":null,"abstract":"<div><h3>Introduction</h3><div>When planning surgery for treatment of recurrent patellar instability, one of the questions of interest is how far the indications for an isolated medial patellofemoral ligament (MPFL) reconstruction can be extended. This international multicenter study followed the outcomes of patients undergoing isolated MPFL reconstruction using higher thresholds for patella alta and tibial tubercle-trochlear groove (TT-TG) distance imaging measurements than in the current literature and in common practice algorithms.</div></div><div><h3>Methods</h3><div>One hundred ninety-nine patients from five countries (USA, Australia, Finland, Japan and Chile) were enrolled. All underwent an isolated MPFL reconstruction. The decision to perform additional stabilization surgery such as a tibial tubercle osteotomy was left to the discretion of the individual surgeon. Patients having additional bony surgery were not included. The guiding principle was a TT-TG distance up to 24 ​mm on magnetic resonance imaging (MRI) and a Caton–Deschamps index (CDI) or Insall–Salvati index (ISI) up to 1.4 were not considered to be an automatic indication for a tibial tubercle osteotomy. Patient-reported outcome measures (PROMs; Norwich Patellar Instability, Marx Activity, and the Knee injury and Osteoarthritis Outcome Score (KOOS) uality of ife scores) were recorded preoperatively and the same PROMS and reinjury (patellar re-dislocation) were recorded at 1 and 2 years, postoperatively.</div></div><div><h3>Results</h3><div>Sixty-six percent of patients were female and the mean age at surgery was 21 (standard deviation [SD]: 7.4) years. The CDI ranged from 0.7 to 1.7 with a mean of 1.1 (SD: 0.15); 7 ​% patients had a CDI of 1.4 or more. The ISI ranged from 0.7 to 1.9 with a mean of 1.3 (SD: 0.21); 44 ​% patients had an ISI ≥1.4. The TT-TG distance ranged from 4.0 to 29.0 ​mm (mean: 15 ​mm, SD: 4.4 ​mm); 3 ​% patients had a TT-TG distance ≥24 ​mm. Fourteen percent had no trochlear dysplasia, while 51 ​% had Dejour type A dysplasia; the remaining 35 ​% had types B to D dysplasia. Fourteen percent of patients had a J-sign on the affected side. The re-dislocation rate was 2 ​% at 2 years. There were more re-dislocations when the CDI was ≥1.4 compared to when it was <1.4 (p ​= ​0.04). There were no differences in re-dislocation rates based on an ISI threshold of ≥1.4, a TT-TG distance threshold of ≥24 ​mm, or on the grade of trochlear dysplasia (Dejour B, C, or D).</div></div><div><h3>Conclusion</h3><div>Based on the data of this case series, isolated MPFL reconstruction in the setting of increased thresholds for patella alta height and regardless of the value of TT-TG distance and the degree of trochlear dysplasia resulted in a low overall rate of patellar re-dislocation. This finding supports the concept of using higher threshold values for patella alta and TT-TG distance than previously suggested when deciding what surgical intervention is appropriate for a pati","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101028"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427065","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":"Bony Bankart lesions exceeding 20% of glenoid width are common and show gender-based anatomical differences: A radiological study of 239 patients","authors":"Vladislavs Gordins M.D. ,&nbsp;Mikael Sansone M.D., Ph.D ,&nbsp;Louise Karlsson M.D. ,&nbsp;Neel Desai M.D., Ph.D ,&nbsp;Nicklas Olsson M.D., Ph.D","doi":"10.1016/j.jisako.2025.101001","DOIUrl":"10.1016/j.jisako.2025.101001","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Bony Bankart lesions are anterior glenoid rim fractures associated with anterior shoulder dislocation and can increase the risk of recurrent instability, particularly in cases of fragment resorption or malpositioned healing. Despite their clinical significance, few large-scale radiological studies have detailed the fragment characteristics, displacement patterns, and associated bipolar lesions. The objective of this study was to describe fragment morphology, displacement, and related shoulder parameters using computed tomography (CT) imaging.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 239 patients with isolated bony Bankart injuries identified via the Swedish Fracture Register between 2012 and 2019. All patients underwent CT imaging. Standardized linear measurement techniques were used to assess fragment size, displacement (inferior migration, diastasis, and step-off), Hill–Sachs lesion characteristics, glenoid version, and glenohumeral subluxation index.</div></div><div><h3>Results</h3><div>The mean bony Bankart fragment size was 6.5 ​mm, representing 21.8% of the glenoid width. While absolute fragment size was similar between sexes, it accounted for a significantly larger portion of the glenoid surface in females (p ​= ​0.008). Fragment displacement parameters showed no sex-based differences. Hill–Sachs lesions were present in 61% of patients and were significantly larger in males (p ​= ​0.007), though relative to humeral head diameter, differences were not significant. A consistent ratio of glenoid-to-humeral head diameter (∼66–67%) was observed across sexes.</div></div><div><h3>Conclusion</h3><div>Bony Bankart lesions frequently involve more than 20% of the anterior glenoid, particularly in female patients due to anatomical size differences. CT-based linear measurements provide valuable data for analyzing clinically significant critical bone loss in cases of bony Bankart injuries. The consistent glenoid-to-humeral head diameter ratio may aid surgical planning in shoulder reconstructive procedures.</div></div><div><h3>Level of evidence</h3><div>Level IV, diagnostic study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101001"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132106","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":"Anterior cruciate ligament injury is rarely the last dance for professional basketball players: High return to play with longer recovery times. A systematic review and meta-analysis","authors":"Riccardo D'Ambrosi MD ,&nbsp;Derya Akbaba MD ,&nbsp;Alessandro Carrozzo MD ,&nbsp;Lorenzo Tagliabue MD ,&nbsp;Luca M. Sconfienza MD ,&nbsp;Elmar Herbst MD PhD ,&nbsp;Elisabeth Abermann MD ,&nbsp;Christian Fink MD","doi":"10.1016/j.jisako.2025.101023","DOIUrl":"10.1016/j.jisako.2025.101023","url":null,"abstract":"<div><h3>Importance</h3><div>Anterior cruciate ligament (ACL) injuries are considered one of the most serious setbacks for professional basketball players. While return to play (RTP) is commonly achieved in other sports, the impact of ACL reconstruction (ACLR) on RTP rate, timing, and re-rupture in elite basketball remains unclear.</div></div><div><h3>Aim</h3><div>To evaluate the rate, timing, and level of RTP, as well as re-rupture rates, in professional basketball players following ACL reconstruction, and to assess whether these outcomes have changed over time. We hypothesized that while overall RTP rates would remain high, time to RTP may have increased over the past decade, reflecting evolving rehabilitation protocols and return to sport criteria.</div></div><div><h3>Evidence review</h3><div>A comprehensive search of PubMed, Embase, and Cochrane Library was performed (last updated July 2025) following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Studies were included if they reported RTP outcomes in skeletally mature professional basketball players after primary ACLR. Four distinct outcome measures were extracted and documented: RTP, time to RTP, level of RTP, and ACL re-rupture. Meta-regression was performed based on the publication period (before 2016, 2016-2020, after 2020).</div></div><div><h3>Findings</h3><div>Eight studies were included. The pooled RTP rate was 86.8% (95% confidence interval [CI], 79.5-92.8%), with 97.2% (95% CI, 86.9-100.0%) of players returning to their pre-injury level. The mean time to RTP was 367 days (95% CI, 357-376), increasing significantly in recent years (p ​= ​0.012). The overall ACL re-rupture rate was 1.8% (95% CI, 0.2-4.6%). No significant differences were observed in RTP or re-rupture rates across time periods, but a progressive increase in time to RTP was noted.</div></div><div><h3>Conclusion</h3><div>Professional basketball players achieve high rates of RTP after ACLR, with most returning to their pre-injury level. Re-rupture rates are low; however, time to RTP has increased in recent years, likely reflecting more conservative, criteria-based rehabilitation strategies. ACL injury is no longer a career-ending event in elite basketball but a longer and more complex recovery may be required.</div></div><div><h3>Level of Evidence</h3><div>Level IV.</div></div><div><h3>Registration</h3><div>PROSPERO Registry (CRD420251113289).</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101023"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356403","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":"Thai version of the Marx Activity Rating Scale: Cross-cultural adaptation and validation in patients with anterior cruciate ligament injury","authors":"Pakorn Chawanpaiboon MD ,&nbsp;Kongpob Reosanguanwong MD ,&nbsp;Wacharapol Tepa MSc ,&nbsp;Suchitphon Chanchoo MSc ,&nbsp;Pisit Lertwanich MD","doi":"10.1016/j.jisako.2025.101000","DOIUrl":"10.1016/j.jisako.2025.101000","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The Marx Activity Rating Scale (MARS) is a validated patient-reported outcome measure quantifying high-demand knee activity frequency in anterior cruciate ligament (ACL)–injured populations. The instrument consists of 4 domains: running, cutting, decelerating, and pivoting. This prospective validation study aimed to translate and cross-culturally adapt the MARS into Thai and evaluate its psychometric properties among ACL-injured patients.</div></div><div><h3>Methods</h3><div>Cross-cultural adaptation followed Beaton's established guidelines, including translation, synthesis, backward translation, expert committee review, and pretesting. Validation of the Thai version of the MARS used dual recall timeframes: MARS with a 1-year recall period (MARS_yr) and MARS with a 1-month recall period (MARS_mo). A total of 110 ACL-injured patients, aged 18–50 years with pre-injury Tegner Activity Scale (TAS) scores ≥4, completed questionnaires at the baseline and 2-week follow-up. Psychometric evaluation encompassed construct validity, internal consistency, test-retest reliability, measurement error, and floor/ceiling effects.</div></div><div><h3>Results</h3><div>Cross-cultural adaptation of the Thai version of the MARS was successfully completed. Construct validity of the instrument was demonstrated by correlations between the MARS and the TAS with corresponding timeframes (Spearman's correlation coefficient of 0.51–0.61). Internal consistency was excellent with Cronbach's α coefficients of 0.87 (MARS_yr) and 0.93 (MARS_mo). Test-retest reliability showed excellent intraclass correlation coefficients of 0.93 (MARS_yr) and 0.94 (MARS_mo). Notable floor effects (33.6% for MARS_mo) and ceiling effects (26.4% for MARS_yr) were observed.</div></div><div><h3>Conclusion</h3><div>The MARS was successfully cross-culturally adapted into the Thai version. It exhibits acceptable psychometric properties for quantifying physical activity in ACL-injured populations. Floor/ceiling effects necessitate complementary outcome measures for comprehensive functional assessment.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101000"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087630","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":"Anterior cruciate ligament surgeons frequently modify their approach when treating patients with knee hyperextension or ligamentous hyperlaxity: Results from an international survey of ISAKOS members","authors":"Camilo Partezani Helito MD, PhD ,&nbsp;Andre Giardino Moreira da Silva MD ,&nbsp;Seth Lawrence Sherman MD ,&nbsp;Brett A. Fritsch MBBS BSc(Med), FRACS, FAOrthA ,&nbsp;Riccardo Cristiani MD, PhD ,&nbsp;Juan Miguel Del Castillo MD ,&nbsp;Adnan Saithna MD, FAANA ,&nbsp;ISAKOS Young Professionals Task Force","doi":"10.1016/j.jisako.2025.101021","DOIUrl":"10.1016/j.jisako.2025.101021","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients with ligamentous hyperlaxity or knee hyperextension seem to be at a higher risk of failure following anterior cruciate ligament (ACL) reconstruction. The objective of this study was to better understand global practices for the treatment of ACL injuries in patients with knee hyperextension and ligamentous hyperlaxity among knee and sports medicine surgeons worldwide.</div></div><div><h3>Methods</h3><div>A survey invitation was sent to members of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) who were identified as knee and sports surgeons. The survey consisted of a total of 25 questions, covering topics related to preoperative assessment, surgical technique, and postoperative management of patients with knee hyperextension. Survey responses were tabulated and reported using descriptive statistics.</div></div><div><h3>Results</h3><div>In total, 427 responses to the survey were obtained from ISAKOS members. All continents participated, with the largest number of responses coming from Latin America (36.8 ​%). 75.4 ​% of respondents believe that patients with knee hyperextension tend to have more ACL tears, and 90.4 ​% believe that those who undergo ACL reconstruction have higher rates of reconstruction failure. Regarding surgical technique and graft type, 66.7 ​% of respondents modify their approach when treating patients with knee hyperextension. 82.7 ​% of respondents do not change the position of the bone tunnels, while 12.9 ​% reported placing the tibial tunnel more posteriorly. The most used grafts are hamstrings (38.4 ​%) and bone-patellar tendon-bone (BTB) (37.2 ​%). Allografts are preferred by only 5.9 ​% of respondents, and 75.9 ​% of surgeons are not concerned about using autografts, even in cases of suspected collagen disorders. 89.5 ​% of respondents believe adding an extra-articular procedure could minimize failure risk. The most used extra-articular procedure is lateral extra-articular tenodesis (LET) (63.9 ​%).</div></div><div><h3>Conclusion</h3><div>ACL surgeons across diverse regions, demographics, experience levels, and surgical volumes tend to modify their approach for patients with knee hyperextension or ligamentous hyperlaxity. Hamstring and BTB grafts are most commonly used, with the vast majority not changing tunnel positioning. Most fix the graft at 20–30° of knee flexion and believe that lateral augmentations reduce failure rates in this population, with LET being the preferred technique.</div></div><div><h3>Level of evidence</h3><div>Level V, expert opinion study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101021"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370425","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":"Acute calcific periarthritis of the first metatarsophalangeal joint in young female patient: A case report","authors":"Roman Liang Pruski ,&nbsp;Michael Tyler DiPaolo ,&nbsp;Fares Zulfikar Noor Uddin","doi":"10.1016/j.jisako.2025.101019","DOIUrl":"10.1016/j.jisako.2025.101019","url":null,"abstract":"<div><div>Acute calcific periarthritis (ACP) is a rare condition when observed in the lower extremities, particularly in younger demographics. We outline and discuss the identification, treatment, and management of ACP in the foot of a 19-year-old female student who presented with severe atraumatic right foot pain in the first metatarsophalangeal (MTP) joint. Clinical examination and imaging confirmed acute calcific periarthritis of the first MTP joint, demonstrating periarticular calcification at the medial aspect, with joint aspiration negative for urate and calcium pyrophosphate crystals. A corticosteroid injection was administered, and Patient-Reported American Orthopaedic Foot and Ankle Society (PR-AOFAS) scores were taken prior to the injection, and at 3 months, 6 months, and 1 year post injection. The PR-AOFAS scores of 62/100 preinjection and 0/100 at 3 months, 6 months, and 1 year post injection demonstrated complete symptom resolution and patient satisfaction with the treatment, demonstrating the effectiveness of corticosteroid injections in the management of ACP. The use of corticosteroid injection is a treatment option that can resolve symptoms and allow patients to return to normal function, while PR-AOFAS scoring is a useful approach to understanding the effectiveness of this treatment modality by demonstrating patient-reported satisfaction.</div></div><div><h3>Level of Evidence</h3><div>Level 4, Case Report.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101019"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303923","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 graft size predicts anterior cruciate ligament re-tear after hamstring reconstruction: A minimum 2-year follow-up in a high-volume center","authors":"Fabio Mancino ,&nbsp;Simon L.E. Walgrave ,&nbsp;Sam C. Parker ,&nbsp;David A. Parker","doi":"10.1016/j.jisako.2025.101027","DOIUrl":"10.1016/j.jisako.2025.101027","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>This study aimed to investigate variables associated with increased odds of anterior cruciate ligament (ACL) re-tear and re-operation after anterior cruciate ligament reconstruction (ACLR) using hamstring autograft. We hypothesized that a proximal and/or distal graft diameter smaller than 8.5 ​mm would be associated with higher odds of re-tear.</div></div><div><h3>Materials and methods</h3><div>Patients who underwent primary ACLR between 2019 and 2022 were prospectively followed and retrospectively analyzed. Patients were excluded in cases of multi-ligament knee injury, bilateral ACLR, or age under 18 years. ACL re-tear was assessed at a minimum follow-up of 24 months (mean: 42 months, range: 24–60 months). Baseline characteristics, as well as intraoperative and postoperative data, were collected. Clinical outcomes and knee laxity were assessed 12 months postoperatively. Univariate logistic regression was performed to identify associations with re-tear and re-operation. P values ​&lt;0.05 were considered statistically significant.</div></div><div><h3>Results</h3><div>Overall, 255 patients were included, with a mean age of 30.3 ​± ​10.6 years. A hamstring graft was used in all cases. Intraoperative meniscal treatment was performed in 47.1% of cases (121 knees) and lateral extra-articular tenodesis in 15% (37 of 255 knees). The re-tear rate was 7.1% (18 knees). A proximal graft size &lt;8.5 ​mm was statistically significantly associated with ACL re-tear (odds ratio [OR]: 3.1, p ​= ​0.023). Male gender and graft size showed a statistically significant interaction effect with ACL re-tear (p ​= ​0.016).</div><div>In total, 30 patients (12%) underwent re-operation at a mean follow-up of 42 months (range: 24–60 months). A medial meniscal (MM) tear was associated with increased odds of re-operation (OR: 2.8, p ​= ​0.010). The re-operation rate was higher in cases of MM repair (27%) than in cases of MM debridement (5%, p ​= ​0.040). Lateral meniscal tears were not associated with an increased re-operation rate (p ​= ​0.496).</div></div><div><h3>Conclusions</h3><div>A proximal graft diameter &lt;8.5 ​mm in hamstring autograft ACLR is associated with increased odds of re-tear, particularly in young, active male patients. Meniscal tears are associated with higher odds of subsequent surgery on the same knee, especially following MM repair.</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":"15 ","pages":"Article 101027"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427104","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":"Editorial: A message of thanks to the JISAKOS community","authors":"","doi":"10.1016/j.jisako.2025.101031","DOIUrl":"10.1016/j.jisako.2025.101031","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101031"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525718","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":"Treatment of multiple chondral/osteochondral lesions in the knee of a juvenile athlete: A case report with literature review","authors":"Daniel P. Leal MD ,&nbsp;Victor Mores MD ,&nbsp;Bruno B. Varone MD ,&nbsp;Riccardo G. Gobbi MD, PhD ,&nbsp;Luís E.P. Tirico MD, PhD","doi":"10.1016/j.jisako.2025.100928","DOIUrl":"10.1016/j.jisako.2025.100928","url":null,"abstract":"<div><div>Chondral and osteochondral lesions in the knee, particularly in juvenile athletes, pose significant challenges due to their impact on joint functionality and the complexity of treatment. This case report describes the management of a 14-year-old soccer athlete with osteochondritis dissecans of the lateral femoral condyle and a subsequent grade IV chondral lesion in the femoral trochlea. The initial treatment with fresh osteochondral transplantation resulted in osteointegration, pain resolution, and restored functionality. During rehabilitation, a secondary trochlear lesion developed and was treated with a combination of micro-fragmented autologous adipose tissue and a collagen membrane. The patient showed significant improvements in functional scores (Internation Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala, and Lysholm) and magnetic resonance imaging–confirmed cartilage regeneration and returned to sports-specific training. These findings highlight the potential of regenerative techniques for cartilage repair in young athletes. Further research is needed to validate these results in larger cohorts with extended follow-ups.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 100928"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330244","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":"Immune rejection of orthopedic tissue allograft scoping review: Are we missing a cause of graft/procedural failure? Current concepts","authors":"Grady H. Hofmann,&nbsp;Reem Sarsour,&nbsp;Willemijn van Deursen,&nbsp;Amin Alayleh,&nbsp;Nneoma Duru,&nbsp;Evans Whitaker,&nbsp;Kevin Shea","doi":"10.1016/j.jisako.2025.101002","DOIUrl":"10.1016/j.jisako.2025.101002","url":null,"abstract":"<div><div>Allograft transplants are commonly used in orthopedics. Unlike other transplanted tissues, orthopedic tissue allografts are not human leukocyte antigen (HLA)-matched. The clinical impact of the immune response to allografts is poorly understood. Recent experience with allograft failures and reactions to anterior cruciate ligaments (ACL), medial patellofemoral ligament (MPFL), osteochondral, and meniscus transplants raises concern. This scoping review examines the literature on immunologic rejection of orthopedic tissue allograft using PubMed, Embase, Web of Science, and Scopus for studies describing immune rejection of orthopedic tissue allografts in humans and animals. Four reviewers independently screened titles/abstracts based on these criteria. Full texts were screened independently by two reviewers for inclusion. Variables of interest included the species, graft type, and graft treatment. Our literature search yielded 1625 articles, with 78 meeting the inclusion criteria. Of these studies, 30 (38.5%) were in humans, 16 (20.5%) in rats, and 11 (14.1%) in dogs. The remaining 21 studies were in a combination of rabbit, primate, mice, sheep, and cat subjects. The orthopedic tissues in these studies included 23 osteochondral (29.5%), 16 bone (20.5%), 13 cartilage (16.7%), 6 bone-tendon-bone (7.7%), and 12 tendon/ligaments (15.4%) with 8 (10.2%) of the studies specifically in menisci. Methods used to reduce immune response include freezing, irrigation, and immunosuppressant administration. Recorded histological evidence of immune response included cell apoptosis, type II collagen increase, interleukins (IL) secretion, and increased lymphocytes/plasma cells in the synovial fluid. The pathways proposed were mismatched in cell-surface proteins as many studies conducted major histocompatibility complex (MHC) class I matching, which reduced the immune response. Despite histological evidence, including HLA sensitization after transplant signaling an immune response, clinical significance was not observed. Recent clinical experience of increased magnetic resonance imaging (MRI) signal response to orthopedic allografts, along with patient symptoms, has raised questions about rejection. Clinical rejection reports are limited in this review. This immune response to orthopedic allografts must be considered, and additional studies are needed to explore the relationship between rejection and clinical outcomes. This scoping review indicates that there is a range of human and animal studies demonstrating various immunologic response presentations and severities with different orthopedic tissue allografts.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 101002"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151163","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}