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

{"title":"Should I add orthobiologics to my knee osteotomy practice? A systematic review","authors":"Amit Meena , Riccardo D’Ambrosi , Luca Farinelli , Manish Attri , Ahmed Mabrouk , Norimasa Nakamura , Matthieu Ollivier , Sachin Tapasvi","doi":"10.1016/j.jisako.2024.06.001","DOIUrl":"10.1016/j.jisako.2024.06.001","url":null,"abstract":"<div><h3>Importance</h3><div>Orthobiologics has seen a renaissance over the last decade as an adjunct therapy during osteotomy due to the limited inherent regenerative potential of damaged intraarticular tissues.</div></div><div><h3>Aim or objective</h3><div>This systematic review aims to present the latest evidence regarding using orthobiologics with simultaneous high tibial osteotomy (HTO) for knee osteoarthritis. The results of this study may guide surgeons to improve their clinical results and clear the air regarding confusion over whether or not to add orthobiologics to HTO in clinical practice backed by scientific evidence.</div></div><div><h3>Evidence review</h3><div>According to PRISMA guidelines a systematic search for relevant literature was performed in the PubMed (MEDLINE), Scopus, EMBASE, and Cochrane Library databases of all studies published in English from January 1990 to May 2023. The following search terms were entered into the title, abstract, and keyword fields: “knee” or “osteotomy” AND “valgus” or “varus” AND “regenerative medicine” or “PRP” or “mesenchymal stem cells” or “stem cells” or “BMAC” or “bone marrow” or “growth factors” or “umbilical cord blood-derived mesenchymal stem cell” or “stromal vascular fraction”. The AMSTAR-2 checklist was used to confirm the quality of the systematic review. Randomised controlled trials (RCTs), prospective and retrospective comparative cohort studies, case-control studies, and case series were included. Studies that reported clinical outcomes in patients treated with knee osteotomy for varus/valgus knee with concomitant adjunction of regenerative treatment [Platelet-rich plasma (PRP), Adipose-derived stem cells (ADSC), Human Umbilical Cord Blood-Derived (HUCBD), Mesenchymal Stem Cells (MSC), bone marrow aspirate concentrate (BMAC), stromal vascular fraction (SVF)] were included. The outcome measures extracted from the studies were the KOOS score, Lysholm score, Subjective IKDC, WOMAC Score, KSS, Tegner, HSS, radiographic tibiofemoral angle, posterior tibial slope and complications. The current systematic review is registered in the PROSPERO Registry (CRD42023439379).</div></div><div><h3>Findings</h3><div>Osteotomy for unicompartmental arthritis with adjunction of orthobiologics such as PRP, ADSC, HVCBD, MSC, BMAC, and SVF presents a consistent statistically significant clinical improvement compared to preoperative scores regardless of the treatment modality used and there were no notable complications associated with the use of these novel agents.</div></div><div><h3>Conclusions and relevance</h3><div>Orthobiologics and knee osteotomies could improve outcomes in patients with knee osteoarthritis desiring Knee preservation surgeries. However, only a few studies are available on the topic to conclude anything with certainty, the patients included in the studies could not be disintegrated based on the grade of osteoarthritis (OA), type, dosage and frequency of administration of orthobiolog","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100282"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-articular injection of a cross-linked hyaluronic acid combined with triamcinolone hexacetonide improves pain at six months in patients with mild to moderate hip osteoarthritis: A prospective observational study","authors":"The Prospective Evaluation of the Cingal™ Injection for Hip Osteoarthritis (ECHO) Investigators","doi":"10.1016/j.jisako.2024.100363","DOIUrl":"10.1016/j.jisako.2024.100363","url":null,"abstract":"<div><h3>Objectives</h3><div>Joint-preserving interventions, such as intra-articular viscosupplementation injections, are evolving and requiring efficacy and safety evaluations through an evidence-based approach. The objective of this study was to assess the use of a hyaluronic acid and corticosteroid-based injection (Cingal™; Anika Therapeutics, Bedford, MA, USA) in improving pain and functional outcomes for patients aged between 40 and 65 with mild to moderate hip osteoarthritis (OA) six months post-injection.</div></div><div><h3>Methods</h3><div>This prospective observational study included 100 patients receiving a single ultrasound-guided intra-articular injection of Cingal™. Eligible patients seen in participating orthopaedic, physiatry and sports medicine clinics were evaluated at baseline, one-month, and six-month follow-up. The primary outcome was patient-reported hip pain (Visual Analogue Scale, VAS) at six months post-injection. Secondary outcomes included hip function (Hip Disability and Osteoarthritis Outcome Score, HOOS), quality of life (Short-Form 12, SF-12), pain medication use, range of motion (ROM), physical activity (activity tracker), and adverse events.</div></div><div><h3>Results</h3><div>Ninety-six patients received the injection; 91 had complete data for primary outcome analysis. Statistically significant improvements were observed in VAS (p ​&lt; ​0.001), HOOS (p ​&lt; ​0.001), and SF-12 scores (Physical Component Summary, p ​= ​0.005; Mental Component Summary, p ​= ​0.022) from baseline to six months post-injection. Pain medication use decreased from 50.0% to 34.0% (p ​= ​0.035). No statistically significant change was observed in ROM or activity level. Adverse events were reported in 9.5% of patients: five (5.3%) experienced hip pain for less than seven days, one for more than seven days but less than one month, and three (3.2%) underwent hip arthroplasty.</div></div><div><h3>Conclusion</h3><div>Patients receiving an ultrasound-guided Cingal™ injection for hip OA reported statistically significantly reduced hip pain, improved function and quality of life, and reduced pain medication use at six months. The most common adverse event was transient hip pain.</div></div><div><h3>Level of Evidence</h3><div>Prospective observational study, Level III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100363"},"PeriodicalIF":2.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ligamentous ankle injuries in relation to the morphology of the incisura fibularis: A systematic review","authors":"Louise Wittouck ,&nbsp;Ruben Vermeir ,&nbsp;Matthias Peiffer ,&nbsp;Wouter Huysse ,&nbsp;Lauren Pringels ,&nbsp;Nicolò Martinelli ,&nbsp;Emmanuel Audenaert ,&nbsp;Arne Burssens","doi":"10.1016/j.jisako.2024.100361","DOIUrl":"10.1016/j.jisako.2024.100361","url":null,"abstract":"<div><h3>Importance</h3><div>Ligamentous ankle lesions are among the most frequent sports injuries. One of the key intrinsic stabilizers of the ankle joint is the incisura fibularis (IF), as it interlocks the distal tibia and fibula. Despite an abundant amount of studies related to ligamentous ankle injuries, scant attention has been given to the specific role of the IF morphology.</div></div><div><h3>Objective</h3><div>We systematically reviewed all literature focused on the relation between ligamentous ankle lesions and IF morphology.</div></div><div><h3>Evidence review</h3><div>A systematic literature search was conducted on PubMed, Embase, and Web of Science according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021282862). In general, search terms were related to ankle and syndesmosis trauma/instability in combination with morphology parameters of the IF. Studies categorizable as original research (randomized controlled trial or observational) were included. Studies concerning degenerative ankle disease and cadavers were excluded.</div></div><div><h3>Findings</h3><div>Thirteen studies were confirmed eligible and consisted of a prospective cohort (<em>n</em> ​= ​1), retrospective comparative (<em>n</em> ​= ​10), and observational (<em>n</em> ​= ​2) study design. Several studies have found an increased number of ankle ligament injuries and a higher incidence of chronic ankle instability in association with a shallow IF depth. In addition, statistically significant differences in incisura height and angle were also noted: a shorter incisura and more obtuse angle were more present in patients with ankle ligament injuries.</div></div><div><h3>Conclusion and relevance</h3><div>Most studies found distinct characteristics of the IF morphology associated with ligamentous ankle lesions, potentially due to lower osseous resistance against tibiofibular displacement. However, not all studies could identify this association and presented a heterogeneous methodological quality. Therefore, further prospective studies are warranted to clarify the relationship between the IF morphology and ligamentous ankle injuries.</div></div><div><h3>Lever of evidence</h3><div>Level III, systematic review.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"10 ","pages":"Article 100361"},"PeriodicalIF":2.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute compartment syndrome of the leg following peroneus longus tendon graft harvesting: a case report","authors":"Andre Giardino Moreira da Silva ,&nbsp;Adriano Marques de Almeida ,&nbsp;Camilo Partezani Helito ,&nbsp;André Pedrinelli","doi":"10.1016/j.jisako.2024.100360","DOIUrl":"10.1016/j.jisako.2024.100360","url":null,"abstract":"<div><div>Acute compartment syndrome is a rare donor-site complication of peroneus longus tendon graft harvesting. A case of leg compartment syndrome following peroneus longus tendon harvest for a revision anterior cruciate ligament reconstruction is described. Symptoms began on the first day after surgery, including intense pain in the lateral aspect of the leg and dorsum of the foot and motor and sensory deficits of the common peroneal nerve. Emergency decompressive fasciotomy was necessary. The patient presented a complete resolution of symptoms and neurological deficit 24 days after surgery. Surgeons harvesting this graft should keep in mind the possibility of this complication in case of unusual pain in the early postoperative period so that they can quickly diagnose and treat this threatening condition.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100360"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MCL pie crusting for concomitant medial meniscal surgery does not appear to adversely influence primary ACL reconstruction functional outcomes","authors":"Ayman Gabr ,&nbsp;James Robinson","doi":"10.1016/j.jisako.2024.100359","DOIUrl":"10.1016/j.jisako.2024.100359","url":null,"abstract":"<div><h3>Objectives</h3><div>Medial collateral ligament “pie-crusting” (MCLPC), selective release of the superficial MCL, has been shown to improve the arthroscopic access to the posterior horn of the medial meniscus without adversely affecting the outcomes of isolated meniscal surgery. However, whether MCL PC, to address concomitant meniscal lesions during anterior cruciate ligament reconstruction (ACLR) surgery, adversely affects ACLR outcomes is unknown. The aim of this study was to assess whether patients who had undergone MCLPC at the time of ACLR had similar post outcomes to patients undergoing isolated ACLR.</div></div><div><h3>Methods</h3><div>55 consecutive patients (33 male and 22 female), with minimum 2-year follow-up, who had undergone MCLPC with concomitant primary ACLR (PC group) were retrospectively matched on the basis of age, sex and follow-up with 55 patients who underwent isolated primary ACLR. Post-operative outcome measures (PROMs) included the Knee injury and Osteoarthritis Outcome Score, the International Knee Documentation Committee score, Tegner activity score, the EuroQol five-dimension health questionnaire and EuroQol visual analogue scale.</div></div><div><h3>Results</h3><div>The two groups’ median postoperative EQ 5D-VAS, EQ 5D-index and Tegner scores were similar. The difference between pre-operative and post-operative KOOS scores was similar for the two group for all subscales except the ADL subscale which was higher in the MCLPC group (24, IQR ​= ​6–32) than in the isolated ACLR group (5, IQR ​= ​0–9.74). The median post op IKDC score was 84 in the MCLPC group and compared with 90 in the isolated ACLR group. However, the difference between pre-operative and post-operative IKDC scores was higher in patients in the MCLPC group (40, IQR ​= ​25–49) than in the isolated ACLR group (32, IQR ​= ​19.6–46.8).</div></div><div><h3>Conclusions</h3><div>MCLPC, performed at the time of ACLR does not appear to adversely affect the functional post-operative outcomes.</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":"9 6","pages":"Article 100359"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oblique or short incisions reduce the risk of saphenous nerve damage during hamstrings harvesting: A model for mapping nerve pathways at the harvest site","authors":"Pierre-Henri Vermorel ,&nbsp;Alban Stordeur ,&nbsp;Sylvain Grange ,&nbsp;Antonio Klasan ,&nbsp;Rémi Philippot ,&nbsp;Thomas Neri","doi":"10.1016/j.jisako.2024.100358","DOIUrl":"10.1016/j.jisako.2024.100358","url":null,"abstract":"<div><h3>Introduction</h3><div>Hamstring autografts are frequently used for ligament reconstruction surgery. Between 12% and 84% of patients report hypoesthesia or dysaesthesia secondary to injury of the saphenous nerve or one of its branches after hamstring harvesting. Type of incision (orientation and length) is subject of much regarding limiting the risk of nerve damage. A cadaveric study was performed to determine which type of incision limits the risk of injury to the saphenous nerve or one of its branches, based on an anatomic model for mapping nerve pathways at the harvest site.</div></div><div><h3>Methods</h3><div>An anatomical study was performed on 20 knees from 12 embalmed bodies. Distance between saphenous nerve branches and 4 points of interest along the tibial crest was measured. Based on these measurements, a digital model of the saphenous nerve and its branches was created. A model of three common types of incision (vertical, horizontal and oblique) was overlaid. Each incision was modeled for three lengths (2, 3, and 4 ​cm). Percentage of collision between nerve course model and incision model was then calculated to determine the risk of nerve damage for each type of incision. Based on the nerve course model, a ‘low-collision-risk’ safe zone was identified.</div></div><div><h3>Results</h3><div>Nerve damage risk after an oblique incision was significantly lower than for a horizontal or vertical incision, for incision lengths of 3 and 4 ​cm (p ​&lt; ​0.05). For a specific incision orientation, the length of the incision did not affect the risk of nerve damage. A trapezoidal space close to the tibial crest and distal to the anterior tibial tuberosity appears to reduce risk of nerve damage.</div></div><div><h3>Conclusion</h3><div>This cadaveric study suggests that during hamstring harvesting, incisions shorter than 2 ​cm reduce the risk of saphenous nerve's branches injuries. For incisions longer than 2 ​cm, using an oblique incision may reduce the risk compared to vertical or horizontal incisions.</div></div><div><h3>Level of evidence</h3><div>Level of evidence not applicable: Laboratory experiments.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100358"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in lateral extra-articular augmentation use and surgical technique with anterior cruciate ligament reconstruction from 2016 to 2023, an ACL study group survey","authors":"Ian Hollyer ,&nbsp;Connor Sholtis ,&nbsp;Galvin Loughran ,&nbsp;Yazdan Raji ,&nbsp;Muzammil Akhtar ,&nbsp;Patrick A. Smith ,&nbsp;Volker Musahl ,&nbsp;Peter C.M. Verdonk ,&nbsp;Bertrand Sonnery-Cottet ,&nbsp;Alan Getgood ,&nbsp;Seth L. Sherman ,&nbsp;ACL Study Group","doi":"10.1016/j.jisako.2024.100356","DOIUrl":"10.1016/j.jisako.2024.100356","url":null,"abstract":"<div><h3>Purpose</h3><div>To survey the ACL study group (ACLSG) members to determine the current practice patterns surrounding the use and methodology of lateral extra-articular procedures (LEAPs), including anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET) during ACL reconstruction (ACLR).</div></div><div><h3>Methods</h3><div>A web-based questionnaire was distributed to members of the ACLSG during the 2016, 2018, 2020, and 2023 biennial meetings. Questions explored the indications and techniques when incorporating LEAPs in ACLR.</div></div><div><h3>Results</h3><div>Analysis of survey responses found that the reported use of LEAPs in both primary and revision ACLR increased between 2016 and 2023 and that surgeons were using lateral augmentation more frequently over time. Surgical techniques were stable across survey years, with most surgeons using iliotibial band (ITB) autograft attached at Gerdy's tubercle, passed under the lateral collateral ligament (LCL), and anchored proximal/posterior to the lateral femoral epicondyle.</div></div><div><h3>Conclusion</h3><div>Survey responses demonstrate that LEAPs are becoming more common among ACL surgeons in the ACL SG, with the modified Lemaire LET being the predominant technique. This aligns with recent clinical studies showing improved outcomes and reduced risk of failure in ACLR with lateral augmentation compared to ACLR alone.</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":"9 6","pages":"Article 100356"},"PeriodicalIF":2.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial center of rotation and 90-degree lateral laxity improve patient-reported outcomes in posterior cruciate retaining total knee arthroplasty","authors":"Takahiro Tsushima ,&nbsp;Eiji Sasaki ,&nbsp;Shizuka Sasaki ,&nbsp;Kazuki Oishi ,&nbsp;Yuka Kimura ,&nbsp;Yukiko Sakamoto ,&nbsp;Eiichi Tsuda ,&nbsp;Yasuyuki Ishibashi","doi":"10.1016/j.jisako.2024.100357","DOIUrl":"10.1016/j.jisako.2024.100357","url":null,"abstract":"<div><h3>Objectives</h3><div>Physiologic knee kinematics is crucial for successful total knee arthroplasty (TKA) but are often not replicated. Using a medial stabilizing technique (MST) minimizes bone resection but results in lateral laxity. This study aimed to investigate the effects of lateral laxity on knee kinematics and symptoms after TKA.</div></div><div><h3>Methods</h3><div>Mobile-bearing cruciate-retaining MST-TKA was performed on 40 knees using a navigation system. In the kinematic analysis, the anteroposterior (AP) translations of the medial femoral condyle (MFC) and lateral femoral condyle (LFC), femoral rotation angles, and medial and lateral component gaps were recorded every 0.1 ​s. These data were extracted from the software from 0° to 120° flexion in 10° increments. Kinematics was classified as the medial center of rotation (MCR) or non-MCR between 0° to 90° of flexion. Lateral laxity was calculated by subtracting the medial component gap from the lateral component gap. The final follow-up Knee Injury and Osteoarthritis Outcome Scores (KOOS) were evaluated. The relationships between the pre- and post-operative kinematics and between postoperative lateral laxity and kinematics were assessed using Spearman's correlation coefficients. Finally, the correlation between postoperative lateral laxity and KOOS symptoms was evaluated using linear regression analysis.</div></div><div><h3>Results</h3><div>Preoperative kinematics, including AP translation of the MFC and LFC and femoral rotation, correlated with postoperative kinematics (all P ​&lt; ​0.001). Additionally, postoperative lateral laxity correlated with postoperative AP translation of the MFC, LFC, and femoral rotation (all P ​&lt; ​0.001). Furthermore, the receiver operating characteristic analysis indicated a cutoff value of 0.9 ​mm on postoperative lateral laxity at 90° flexion for postoperative MCR (P ​&lt; ​0.001). Postoperative lateral laxity at 90° flexion was significantly correlated with KOOS symptoms (β ​= ​0.465, P ​= ​0.025).</div></div><div><h3>Conclusion</h3><div>Preoperative kinematics and postoperative lateral laxity correlated with postoperative kinematics after MST-TKA. Postoperative lateral laxity greater than 0.9 ​mm at 90° flexion was associated with physiological kinematic motion, leading to fewer knee symptoms in the PROMs. The key to successful TKA was considered to be keeping the asymmetric gap balance with physiological lateral laxity, rather than the conventional symmetrical gap balance.</div></div><div><h3>Level of Evidence Level III</h3><div>Retrospective study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100357"},"PeriodicalIF":2.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented suture pull-out with suture-button(triple fixation) yields less radiological residual laxity than suture pull-out technique-for Arthroscopic reduction and internal fixation of posterior cruciate ligament avulsion fractures.","authors":"Rajagopalakrishnan Ramakanth, Sundararajan Silvampatti Ramasamy, Sameer Muhammed, Terence D Souza, Palaniswamy Arumugam, Shanmuganathan Rajasekaran","doi":"10.1016/j.jisako.2024.100354","DOIUrl":"https://doi.org/10.1016/j.jisako.2024.100354","url":null,"abstract":"<p><strong>Objectives: </strong>Among numerous arthroscopic reduction and internal fixation (ARIF) techniques for displaced posterior cruciate ligament (PCL) avulsions, residual posterior laxity and non-unions are under reported and the optimal technique is still unclear. The objective of our study is to differentiate the outcomes of arthroscopic suture pull-out(SPO) versus augmented suture pull-out(ASPO) using suture button for acute displaced tibial PCL avulsion fractures.</p><p><strong>Methods: </strong>Retrospective study of ARIF for displaced tibial PCL avulsion operated between 2015 to 2021.. Chronologically, initial group of patients had underwent SPO(Group I), while the later underwent ASPO(Group II). Assessment included-functional scores (IKDC(International Knee Documentation Committee),Lysholm and KOOS scores(Knee Injury and Osteoarthritis outcome score)), and radiological assessment (union and posterior tibial displacement (PTD)). Student's unpaired t test and Cohen's term d for Effect size was used to compare the groups. Intraclass-correlation-coefficient for assessing inter-observer-reliability.</p><p><strong>Results: </strong>64 patients-Group I(n=32),Group II(n=32) were compared. |Mean duration of surgery was 48.06 (±9.52) and 54.3 (± 6.97) in group I and II respectively (p=0.004(s)). At mean follow-up of 39.7months(SD-10.6) in Group I and 35.6months(SD-6.6) in Group II, there was a statistically significant improvement in postoperative-IKDC, Lysholm and KOOS scores(p< 0.001). However, there was no significant difference between the two groups with respect to functional outcomes (P >0.05). Effect size(Cohen's-d) was 0.47(medium for IKDC), 0.78(large for Lysholms), 0.05 (small for KOOS), 1.46 (large for PTD). Mean PTD measuring the residual posterior laxity was greater in Group I (7.25 mm)(SD-1.9) than Group II (4.5mm)(SD-2.1) and was statistically significant(P=0.001). There were two non-unions (6.6%) and one popliteal artery injury in Group I.</p><p><strong>Conclusions: </strong>Both ASPO and SPO techniques result in comparable functional outcomes for ARIF of PCL avulsion fractures. However, augmented SPO with a suture button provides triple fixation and additional compression during ARIF of PCL avulsion fractures to mitigate residual posterior laxity on follow-up.</p><p><strong>Level of evidence: </strong>Level III Retrospective cohort study.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"100354"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548098","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: Demystifying unicompartmental knee arthroplasty","authors":"Daniel C. Wascher","doi":"10.1016/j.jisako.2024.100351","DOIUrl":"10.1016/j.jisako.2024.100351","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100351"},"PeriodicalIF":2.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}