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

{"title":"Revision anterior cruciate ligament reconstruction in patients with high-grade anterolateral knee instability combined with modified Lemaire tenodesis using soft anchor fixation: Clinical and radiographic outcomes at two-year follow-up","authors":"Jacopo Conteduca ,&nbsp;Alessandro Carrozzo ,&nbsp;Marco Giaracuni ,&nbsp;Paolo Pichierri ,&nbsp;Damiano Longo ,&nbsp;Giuseppe Rollo","doi":"10.1016/j.jisako.2025.100938","DOIUrl":"10.1016/j.jisako.2025.100938","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>In recent years, the number of primary anterior cruciate ligament reconstructions (ACLRs) has increased, accompanied by an increase in revision anterior cruciate ligament reconstructions (RACLRs). Residual anterolateral knee instability has been identified as a major contributor to graft failure. Consequently, lateral extra-articular procedures (LEAPs), particularly modified Lemaire tenodesis, have gained interest in the management of high-grade anterolateral rotational instability in RACLR. The aim of this study was to evaluate the clinical outcomes of patients undergoing combined RACLR and modified Lemaire tenodesis with soft anchor fixation. The hypothesis was that this fixation could lead to good results in terms of clinical outcomes at a minimum follow-up of two years.</div></div><div><h3>Methods</h3><div>A retrospective review of consecutive patients with failed primary ACLR and high-grade anterolateral rotational instability (side-to-side difference &gt;5 ​mm, pivot shift ≥2+) was performed. All patients underwent an outside-in femoral tunnel technique for doubled semitendinosus and gracilis tendon ACLR, and a 2.6-mm knotless suture anchor was used for Lemaire fixation. Postoperative rehabilitation allowed for immediate weight bearing and progressive range of motion. Patients were evaluated clinically and radiographically at 3 and 6 weeks and at 3, 6, 12, and 24 months. Outcome measures included Lachman and pivot-shift tests, Rolimeter measurements, Tegner Activity Scale, Lysholm score, and subjective and objective International Knee Documentation Committee (IKDC) scores. Also, radiographic analysis was performed at the last follow-up.</div></div><div><h3>Results</h3><div>The final population comprised 15 patients. At a minimum of 2 years’ follow-up, one patient (6.6%) experienced graft failure. Most patients (10/15) achieved normal (Grade A) IKDC objective scores, with significant improvements in side-to-side differences and patient-reported outcomes. No intraoperative tunnel convergence was observed, and no additional hardware removal or reoperation was required.</div></div><div><h3>Conclusions</h3><div>A combined RACLR with modified Lemaire extra-articular tenodesis using soft anchor fixation provided favorable clinical and radiographic results in patients with high-grade anterolateral rotatory knee instability without significant complications.</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":"14 ","pages":"Article 100938"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785556","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":"Surgical reconstruction techniques for irreparable subscapularis tears provide functional improvement but variable failure rates: A systematic review","authors":"Marc Daniel Bouchard MD ,&nbsp;Justin Gilbert MD ,&nbsp;Omar Haque MD ,&nbsp;Colin Kruse MD, MSc ,&nbsp;Bianca Giovanna Vescio MB BCh BAO ,&nbsp;Darshil Shah MBBS ,&nbsp;Moin Khan MD, MSc, FRCSC ,&nbsp;Bashar Alolabi MD, MSc, FRCSC","doi":"10.1016/j.jisako.2025.100998","DOIUrl":"10.1016/j.jisako.2025.100998","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Irreparable subscapularis tears can cause severe functional impairment and present significant clinical challenges. Current treatment options include tendon transfers (TTs), anterior capsular reconstruction, and reverse shoulder arthroplasty. Each approach has distinct biomechanical advantages and limitations, but there remains no consensus regarding the optimal treatment. This systematic review aimed to evaluate and compare clinical outcomes, failure rates, and complication profiles of surgical reconstruction techniques for irreparable subscapularis tears.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA guidelines. A comprehensive search was conducted in Embase, OVID Medline, and Emcare databases. Eligible studies included adults with irreparable subscapularis tears treated with surgical reconstruction (e.g., tendon transfers, graft augmentation, or anterior capsular reconstruction) and reporting clinical outcomes. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) score. A narrative synthesis was performed with descriptive statistics (frequencies, percentages, or weighted means with variability).</div></div><div><h3>Results</h3><div>Fourteen studies comprising 351 patients (355 shoulders) were included, with a mean age of 58.1 years (SD 9.5) and mean follow-up of 44.7 months (SD 54.4). Studied procedures included latissimus dorsi (LD) TT (6 studies, n ​= ​164), pectoralis major (PM) TT (5 studies, n ​= ​94), pectoralis minor (Pm) TT (1 study, n ​= ​74), and anterior capsular reconstruction (ACR; 2 studies, n ​= ​25). PM TT had the highest failure rate (13.0 ​%), followed by ACR (12.0 ​%), LD transfer (11.0 ​%), and Pm TT (1.4 ​%). Postoperative complications were most frequent after PM TT (12.8 ​%), while LD TT had a complication rate of 9.8 ​%. Patient-reported outcome measures improved across all groups, with the greatest Constant-Murley Score (CMS) improvement following LD TT (+33.0), the greatest Subjective Shoulder Value (SSV) improvement after PM TT (+38.6), and the largest Visual Analogue Scale (VAS) pain reduction following ACR (−5.0) and Pm transfer (−5.1).</div></div><div><h3>Conclusions</h3><div>Surgical reconstruction techniques for irreparable subscapularis tears provide improvements in pain and function, though failure and complication rates vary by procedure and appear worse with concomitant rotator cuff pathology. Further high-quality comparative studies are needed to refine patient selection and optimize surgical decision-making.</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":"14 ","pages":"Article 100998"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparable clinical outcomes after conversion total knee arthroplasty following high tibial osteotomy and primary total knee arthroplasty: A matched cohort study","authors":"Ignacio Fernández Z,&nbsp;Myles Coolican","doi":"10.1016/j.jisako.2025.100931","DOIUrl":"10.1016/j.jisako.2025.100931","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Knee osteoarthritis (OA) leads to pain and functional decline. While total knee arthroplasty (TKA) is a definitive treatment, high tibial osteotomy (HTO) offers a joint-preserving alternative for younger patients with malalignment. However, patients with HTO may eventually require conversion to TKA. This study aimed to compare clinical, functional, and patient-reported outcome measures (PROMs) of patients undergoing TKA after a prior medial opening wedge HTO to a matched cohort who had a primary TKA, with follow-up at ≥12 months.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from The Knee Institute, Sydney, Australia. Patients converted from HTO to TKA were matched 1:1 to primary TKA patients based on age, sex, surgeon, body mass index, medial compartment OA, and approximate year of surgery. Inclusion criteria were TKA between 2011 and 2023, prior HTO in the same knee, both procedures by one of three fellowship-trained orthopaedic surgeons; and ≥ one year of follow-up. Data collected included the Oxford Knee Score (OKS), the Veterans RAND 12-Item Health Survey (VR-12), range of motion (ROM), hospital stay, and the Caton–Deschamps index (CDI). Fifty-one converted TKA patients were matched. Statistical analysis used paired t-tests, Mann–Whitney U, chi-square, and Fisher’s exact tests.</div></div><div><h3>Results</h3><div>Both groups showed statistically significant postoperative improvements in the OKS and the VR-12 physical scores (p ​&lt; ​0.01), with no statistically significant difference between groups. ROM improved in both groups; flexion was slightly higher in the primary TKA group but not statistically significant. Patella baja was more frequent in the HTO-to TKA group; however, this was not statistically significant (p ​= ​0.054). Both groups had a median hospital stay of 5 days; however, the HTO-to-TKA group demonstrated a statistically significant distribution shift toward longer stays.</div></div><div><h3>Conclusion</h3><div>Conversion from HTO to TKA yields comparable clinical and functional outcomes to primary TKA. These findings emphasize the effectiveness of TKA after HTO and the importance of careful preoperative planning in this patient population.</div></div><div><h3>Level of Evidence</h3><div>3.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100931"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754661","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":"Factors associated with treatment failure after hip arthroscopic surgery for the patient with femoroacetabular impingement secondary to Legg-Calvé-Perthes disease","authors":"Takahiro Negayama ,&nbsp;Haruki Nishimura ,&nbsp;Yoichi Murata ,&nbsp;Keisuke Nakayama ,&nbsp;Shinichiro Takada ,&nbsp;Hirotaka Nakashima ,&nbsp;Hokuto Fukuda ,&nbsp;Akinori Sakai ,&nbsp;Soshi Uchida","doi":"10.1016/j.jisako.2025.100937","DOIUrl":"10.1016/j.jisako.2025.100937","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Legg-Calvé-Perthes disease (LCPD) leads to complex hip deformities that often result in femoroacetabular impingement (FAI). While traditional open surgeries have been used to address these deformities, hip arthroscopy has emerged as a minimally invasive alternative. However, the factors determining successful outcomes in arthroscopic management of LCPD-related FAI remain poorly defined. The aim of this study was to compare clinical outcomes between successful and failed cases following hip arthroscopic surgery for FAI secondary to LCPD and identify factors associated with treatment failure to optimize patient selection.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who underwent hip arthroscopy for FAI secondary to LCPD from 2011 to 2023. Patients with less than 2-year follow-up or incomplete records were excluded. Treatment failure was defined as requiring revision surgery, experiencing complications, or failing to achieve both the minimal clinically important difference (9.1 points) and Patient-Acceptable Symptom State threshold (72 points) on the modified Harris Hip Score. We evaluated patient characteristics, clinical outcomes, radiographic measurements including lateral center-edge angle (LCEA) and vertical-center-anterior angle (VCAA), preoperative radiographic severity using Tönnis grade, lateral pillar classification, and Stulberg grade and compared these factors between success and failure groups.</div></div><div><h3>Results</h3><div>The study included 15 hips in 14 patients. Nine hips achieved successful outcomes, while six hips were considered failures. The failure group was statistically significantly older (35.5 years versus 20.3 years, P ​= ​0.047) with decreased acetabular coverage, showing smaller LCEA (19.3° versus 30.2°, P ​= ​0.046) and VCAA (14.7° versus 33.3°, P ​= ​0.033). The failure group demonstrated higher frequencies of preoperative Tönnis grade ≥2, lateral pillar classification ​≥B, and Stulberg grade ≥4, indicating more severe degenerative changes and deformity. No statistically significant differences were observed in gender distribution or duration of symptoms between the groups.</div></div><div><h3>Conclusion</h3><div>Forty percent of patients experienced treatment failure after hip arthroscopic surgery for FAI secondary to LCPD. Advanced age, decreased acetabular coverage, and severe preoperative radiographic changes were associated with treatment failure. These findings suggest careful patient selection based on these factors is crucial for successful arthroscopic treatment in this patient population.</div></div><div><h3>Level of Evidence</h3><div>Level III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100937"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776396","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":"Single stage anatomic posterolateral corner reconstruction with modified LaPrade technique, combined with arthroscopic posterior cruciate ligament reconstruction with tibia nail in situ—A current technique","authors":"N. Nizaj DNB(Ortho), MRCS (Glasgow) ,&nbsp;Jimmy Joseph Meleppuram MS (Ortho), FAASM ,&nbsp;Hamdi Nizar Ahamed MS (Ortho), FAASM ,&nbsp;T. Ajayakumar D'Ortho, MS (Ortho) ,&nbsp;Ayyappan V. Nair D'Ortho, DNB(Ortho) ,&nbsp;Azad Sait D'Ortho, MS (Ortho) ,&nbsp;Prince Shanavas Khan D'Ortho, MS (Ortho)","doi":"10.1016/j.jisako.2025.100996","DOIUrl":"10.1016/j.jisako.2025.100996","url":null,"abstract":"<div><div>The posterolateral corner (PLC) of the knee is a key anatomical structure which provides varus and rotational stability to the knee joint. Injuries to the PLC pose a great challenge for orthopedic surgeons due to their complex nature. PLC injuries rarely occur in isolation, with up to 95% being associated with ligament tears. Surgical reconstruction is indicated in Grade III injuries, defined clinically as &gt;10 ​mm lateral opening on varus stress and &gt;10° external rotation on the dial test, supported by MRI magnetic resonance imaging findings.</div><div>Several techniques have been described for PLC reconstruction; however, the classic anatomic reconstruction described by LaPrade remains the gold standard, traditionally performed using an Achilles tendon allograft. In this video technique, we describe a modified LaPrade technique using peroneus longus and hamstring tendon autografts for PLC and posterior cruciate ligament (PCL) reconstruction, respectively, in a patient having tibia nail in situ for Type IIIb open fracture shaft of tibia. The peroneus longus tendon is fashioned into a Y-shaped construct and must be at least 250 ​mm long to perform this technique. The graft passage and fixation sequence are the reverse of the LaPrade technique. This method ensures anatomic fixation, independent tensioning, and secure fixation of each segment, thereby restoring the normal biomechanics of the knee.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100996"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972656","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":"Open figure-of-8 configuration for traumatic posterior sternoclavicular joint dislocation of the shoulder: A novel technique","authors":"Mirko Poli ,&nbsp;Matteo Messori ,&nbsp;Federico Bove ,&nbsp;Valerio Moretti ,&nbsp;Joil Ramazzotti ,&nbsp;Alberto Nicolò Bergamini ,&nbsp;Giuseppe Mazzone ,&nbsp;Marco Reda ,&nbsp;Arash Astaneh ,&nbsp;Capitani Dario ,&nbsp;Massimo Domenico Torre ,&nbsp;Filippo Familiari ,&nbsp;Paolo Capitani","doi":"10.1016/j.jisako.2025.100933","DOIUrl":"10.1016/j.jisako.2025.100933","url":null,"abstract":"<div><div>Posterior dislocation of the sternoclavicular joint (SCJ) is a rare clinical condition requiring surgical management. Various surgical techniques have been described in the literature, but those involving bone tunnels carry an increased risk of residual instability and iatrogenic fractures. We present a novel surgical technique for the management of both acute and chronic posterior SCJ dislocations, based on a figure-of-eight configuration with autograft, which ensures joint stability while preserving its natural mobility. Furthermore, the use of a single clavicular tunnel oriented orthogonally to two sternal tunnels creates a highly stable three-dimensional construct and reduce iatrogenic fractures.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100933"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765624","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":"Midterm clinical outcomes and risk factor for conversion to total hip arthroplasty after arthroscopic treatment for femoroacetabular impingement syndrome in individuals over 40 years of age","authors":"Hirotaka Nakashima MD, PhD ,&nbsp;Yoichi Murata MD, PhD ,&nbsp;Shinichiro Takada MD, PhD ,&nbsp;Keisuke Nakayama MD, PhD ,&nbsp;Haruki Nishimura MD, PhD ,&nbsp;Hokuto Fukuda MD ,&nbsp;Akinori Sakai MD, PhD ,&nbsp;Soshi Uchida MD, PhD","doi":"10.1016/j.jisako.2025.100929","DOIUrl":"10.1016/j.jisako.2025.100929","url":null,"abstract":"<div><h3>Introduction</h3><div>The clinical outcomes of hip arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) in the older population are good, with a relatively high conversion rate of total hip arthroplasty (THA). However, the risk factors for conversion to THA in patients over 40 years of age are unclear. The purpose of this study was to review the midterm clinical outcomes after hip arthroscopic treatment for FAIS in patients over 40 years of age and to reveal the risk factors for conversion to THA.</div></div><div><h3>Methods</h3><div>Patients with FAIS who underwent primary hip arthroscopic treatment from March 2009 to December 2015 were retrospectively reviewed. Patient-reported outcome scores (PROs) and conversion to THA were assessed. To identify the predictors of conversion to THA, the non-THA and THA groups were compared via univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>Among 172 patients, 98 met the inclusion criteria, and 70 patients (34 males and 36 females) were followed for more than 5 years. The mean age at surgery was 53.6 ​± ​9.8 years, and the mean body mass index was 23.3 ​± ​2.9 ​kg/m². Sixteen patients (22.9%) were converted to THA at a mean of 47.3 ​± ​38.1 months after surgery. The lateral center-edge angle in the non-THA group was significantly greater than that in the THA group (p ​= ​0.040). The proportion of microfracture in the THA group was significantly greater than that in the non-THA group (p ​&lt; ​0.001). The Cox hazard model revealed that microfracture was a predictor of conversion to THA (hazard ratio 5.405, 95% CI: 1.876–15.384; p ​= ​0.002). The PROs in the non-THA group significantly improved after surgery.</div></div><div><h3>Conclusion</h3><div>The risk factor for conversion to THA was cartilage damage needed for microfracture. The rate of conversion to THA after primary hip arthroscopic treatment for FAIS in individuals over 40 years of age was 22.9% at a minimum 5-year follow-up.</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":"14 ","pages":"Article 100929"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676010","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":"Robotic total knee arthroplasty with functional alignment yields comparable outcomes across age and gender groups","authors":"Christos Koutserimpas ,&nbsp;Luca Andriollo ,&nbsp;Pietro Gregori ,&nbsp;Elvire Servien ,&nbsp;Cécile Batailler ,&nbsp;Sébastien Lustig","doi":"10.1016/j.jisako.2025.100930","DOIUrl":"10.1016/j.jisako.2025.100930","url":null,"abstract":"<div><h3>Objectives</h3><div>Age and gender can influence total knee arthroplasty (TKA) outcomes, complications, and revision rates. Functional alignment (FA), a personalized approach guided by robotic systems, has emerged as a strategy to optimize outcomes by addressing patient-specific anatomy and laxities. However, limited evidence exists regarding the influence of age and gender on outcomes of FA-guided robotic-assisted TKA.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated 353 patients who underwent robotic-assisted TKA guided by FA principles with a minimum of 2 years of follow-up. Patients were divided into groups based on age (≥75 years vs. &lt;75 years) and gender (males vs. females). Outcomes assessed included functional scores [Knee Society Score (KSS) and Forgotten Joint Score (FJS)], complications, and revision rates. Coronal alignment was evaluated using preoperative and postoperative full-length weight-bearing X-rays and the data from the robotic system.</div></div><div><h3>Results</h3><div>Preoperative clinical and radiographic evaluations showed no statistically significant differences between age groups. Females had more valgus preoperative alignment compared to males. Postoperatively, functional outcomes (KSS and FJS) and coronal alignment were comparable across all groups, with the only exception being the female group, which reported statistically significant higher FJS scores (P ​= ​0.02) despite similar KSS scores. Complication and revision rates did not differ in a statistically significant manner between groups.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that robotic-assisted TKA guided by FA yields comparable outcomes, complication rates, and revision rates across gender and age groups. These findings suggest that FA may help reduce demographic disparities by providing consistent outcomes across diverse patient populations.</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":"14 ","pages":"Article 100930"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733663","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":"Posterior fan-like extension of the anterior cruciate ligament femoral insertion increases ligament failure strength","authors":"Ryo Kanto ,&nbsp;Michael P. Smolinski ,&nbsp;Aly M. Fayed ,&nbsp;Monica A. Linde ,&nbsp;Volker Musahl ,&nbsp;Freddie H. Fu ,&nbsp;Patrick Smolinski","doi":"10.1016/j.jisako.2025.100939","DOIUrl":"10.1016/j.jisako.2025.100939","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The purpose of this study was to examine the role of the posterior fan-like extension (PFLE) region of the anterior cruciate ligament (ACL) on ligament failure load. It was hypothesized that transection of the PFLE region would reduce the ACL load-carrying capacity.</div></div><div><h3>Methods</h3><div>With institutional approval, fifteen fresh-frozen human cadaveric knees were divided into two age-matched groups: intact ACL femoral insertion (ACL intact group, n ​= ​8) and the cut ACL fan-like extension (PFLE-cut group, n ​= ​7). In the PFLE-cut group, the border between the mid-substance insertion and the PFLE was identified at 90° of knee flexion, and the border was cut. All specimens were dissected down to the ACL and placed in an axial testing machine at 15° of flexion, and anterior tibial loading was applied until ACL failure.</div></div><div><h3>Results</h3><div>The failure (peak) load of the ACL intact group was 910.1 ​± ​473.3 ​N, which was significantly greater (<em>P</em> ​&lt; ​0.05) than the failure load of the PFLE-cut group (409.5 ​± ​219.7 ​N). The displacement at the failure load of the ACL intact group was 21.7 ​± ​5.5 ​mm, which was significantly greater (<em>P</em> ​&lt; ​0.05) than the 14.5 ​± ​4.9 ​mm failure load displacement of the PFLE-cut group.</div></div><div><h3>Conclusion</h3><div>Transection of the PFLE region of the ACL femoral footprint significantly reduced the failure load of the ligament under anterior tibial loading at 15° of flexion. The morphology of the ACL at the femoral insertion significantly affects the failure strength of the ligament. If ACL reconstruction grafts could be constructed to more closely mimic this geometry, they could potentially have increased failure strengths and reduce failure rates.</div></div><div><h3>Level of Evidence</h3><div>Not applicable.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100939"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812540","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":"Outcomes of surgically treated traumatic neuromas of cutaneous nerves as complications of ankle arthroscopy: A 5-year follow-up","authors":"Yuxin Yan MS ,&nbsp;Yunfeng Chu BMed ,&nbsp;Xintao Zhang M.D ,&nbsp;Ying Shan Ph.D ,&nbsp;Sumeng Chen MS ,&nbsp;Yanling Wei MS ,&nbsp;Jingting Yan MPH ,&nbsp;Lu Bai M.D","doi":"10.1016/j.jisako.2025.100932","DOIUrl":"10.1016/j.jisako.2025.100932","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the long term result of traumatic neuromas as complications of ankle arthroscopy treated by neuroma resection.</div></div><div><h3>Methods</h3><div>Twenty-five patients diagnosed with traumatic neuroma as complications of ankle arthroscopy were included. The standard procedure of microsurgical neuroma resection and nerve release was performed in all patients. Outcomes comparison was evaluated at 3 months, 1 year, 2 years and 5 years postoperatively. Sensory function was assessed using the British Medical Research Council (BMRC) scale. Visual analog scale (VAS) was used to evaluate pain relief. The diameter of the affected nerve was measured by ultrasound.</div></div><div><h3>Results</h3><div>A total of 4 (16%) patients experienced neuroma recurrence during the 5-year follow-up. In nonrecurrence cases, sensory function improvement was observed at 3 months (<em>P</em> ​&lt; ​0.0001) and 2 years (<em>P</em> ​= ​0.003). There was no further statistically significant improvement to 5 years, by which time 11 patients (52.4%) had above partial recovery of sensory function (S3+, S4). The VAS pain score was 4 (3–4) preoperatively and 2 (1–2) at 3 months (Z ​= ​−4.347, <em>P</em> ​&lt; ​0.0001), which continued to improve, and patients got pain relief during the 2–5 years postoperative [2–5 years, 1 (0–1)]. The mean nerve diameter decreased at 3 months [preoperative, 20 (18.5–22); 3 months, 11 (9–12); Z ​= ​−6.082, <em>P</em> ​&lt; ​0.0001]. We did not observe a statistically significant increase of nerve diameter during the rest of follow-up time [5 years, 10 (9–11); Z ​= ​−0.765, <em>P</em> ​= ​0.451].</div></div><div><h3>Conclusion</h3><div>Microsurgical resection was effective for traumatic neuromas of ankle cutaneous nerves. Patients experienced pain relief and partial recovery of nerve function. Most sensory recovery occurred during the first 3 months and continued to 2 years. However, neuroma recurrence was also observed in some cases.</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":"14 ","pages":"Article 100932"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733662","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}