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

{"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}

{"title":"Complex knee injuries from bouldering: A case series","authors":"Jhulia Kawachi Cruz,&nbsp;Khim Yew Chew,&nbsp;Mok Ying Ren,&nbsp;Yee Han Dave Lee","doi":"10.1016/j.jisako.2025.100995","DOIUrl":"10.1016/j.jisako.2025.100995","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Bouldering, a dynamic climbing discipline performed without ropes, is associated with high-energy ground falls. While most existing climbing injury literature has focused on the upper extremities, our data indicated an increasing number of complex knee injuries related to bouldering. This review was conducted to characterize the injury patterns sustained from ground falls during bouldering, and to compare the relative burden of these injuries with those sustained in other high-participation sports.</div></div><div><h3>Methods</h3><div>A retrospective case series was performed, including climbers who presented with knee injuries from ground falls during bouldering between March 2022 and October 2024. Patient demographics, injury mechanisms, ligamentous and meniscal pathology, as well as osseous or chondral damage were collected. The injuries were stratified by sex, age group, and injury complexity, including multiligament injury, meniscus tears, and osseous or chondral involvement. The bouldering-related injuries were then compared to institutional data from soccer and basketball, the two most common causes of sports-related knee injuries requiring surgery at the institution’s sports center.</div></div><div><h3>Results</h3><div>Nineteen patients were included, with a mean age of 27 ​± ​5.1 years. Of these, 15 (78.9 ​%) sustained combined anterior cruciate ligament and meniscus injuries. Surgical intervention was performed in 18 (94.7 ​%) patients. Multiligament knee injuries occurred in 4 (21.2 ​%) bouldering cases, accounting for 20 ​% of all multiligament knee injuries treated during the study period. Meniscus root tears were identified in 4 (21.1 ​%) bouldering cases, representing 22 ​% of all surgically treated meniscus root tears. Bone contusions consistent with pivot-shift patterns were observed in 52.6 ​% of patients, with cartilage fissuring and sulcus terminalis impaction in 10.5 ​% each. Compared to soccer and basketball, bouldering demonstrated a relatively higher proportion of complex knee injuries, despite lower participation volumes.</div></div><div><h3>Conclusion</h3><div>Ground falls during bouldering ground falls have been associated with a high proportion of complex knee injuries, including multiligament knee injuries, meniscus root tears, and injuries to both menisci. These injury patterns are believed to result from high-energy axial and rotational loading, and suggest the need for increased awareness, preventive strategies, and rehabilitation programs tailored to the sport.</div></div><div><h3>Level of evidence</h3><div>Level 4, Case series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100995"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972679","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":"Fractures In Oxford Unicompartmental Knee Arthroplasty Are Associated With A Decreased Medial Keel Cortex Distance Of The Tibial Implant – A Combined Clinical And Biomechanical Study","authors":"","doi":"10.1016/j.jisako.2025.101006","DOIUrl":"10.1016/j.jisako.2025.101006","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 101006"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361410","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":"Assessing the current medicolegal landscape in orthopedic sports medicine surgery—patient-centered communication and multidisciplinary approaches matter: A consensus statement","authors":"Zachary J. Herman ,&nbsp;Camila Grandberg ,&nbsp;Abigail N. Boduch ,&nbsp;Stephen J. Rabuck ,&nbsp;Bryson P. Lesniak ,&nbsp;Jonathan D. Hughes ,&nbsp;James J. Irrgang ,&nbsp;Michael K. Feeney ,&nbsp;MaCalus V. Hogan ,&nbsp;Volker Musahl","doi":"10.1016/j.jisako.2025.100993","DOIUrl":"10.1016/j.jisako.2025.100993","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>While the opportunity to provide medical care for elite-level professional and collegiate athletes is an honor and privilege, it does not come without a unique set of challenges. The team physician role continues to evolve and insights on today’s climate of team physicians’ care of elite athletes globally may be enlightening. As such, the purpose of this review is to provide a synopsis of the meeting’s key points and present the results of the survey to better delineate the effect of the medicolegal risk involved in the care of elite athletes.</div></div><div><h3>Methods</h3><div>An international and multidisciplinary group of experts on anterior cruciate ligament injury and sports medicine was chosen to participate on a panel at the 2024 Freddie Fu Panther Sports Medicine Symposium held at the University of Pittsburgh, Pittsburgh, Pennsylvania, USA, on June 6, 2024. The international panel included orthopaedic surgeons, primary care physicians, and scientists and focused on the medicolegal climate of sports medicine. Throughout the duration of the panel, a live questionnaire was provided to the audience, which included practitioners from 17 countries and 5 continents. The survey consisted of eight “yes/no” questions.</div></div><div><h3>Results</h3><div>Several themes emerged from the discussion, including differing medicolegal consequences based on geographic location, changes to documentation in response to litigation risk, and increases in personal stressors to physicians. Of the eight statements administered to the audience during the panel discussion, only three had greater than 50 ​% agreement. These statements included changes to practice based on the medicolegal climate and the effects of defensive practice on physicians and patients alike.</div></div><div><h3>Conclusion</h3><div>The risk of litigation in orthopaedic sports medicine surgery varies greatly based on the geographic location of the practice and is perceived to affect both patient care and providers alike. As the assessment of medical professional liability risk arising from the care of elite athletes continues to evolve, discussion among physicians, athletes, agents, and teams/clubs should be patient-centered, multidisciplinary, and undertaken with absolute professionalism, strong communication, and thorough documentation.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100993"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849304","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":"Deepening the subchondral insufficiency fracture and osteonecrosis of the knee dilemma: Time for a new classification: Current concepts","authors":"Pierangelo Za ,&nbsp;Luca Ambrosio ,&nbsp;Sebastiano Vasta ,&nbsp;Augusto Ferrini ,&nbsp;Saseendar Shanmugasundaram ,&nbsp;Biagio Zampogna ,&nbsp;Rocco Papalia","doi":"10.1016/j.jisako.2025.100922","DOIUrl":"10.1016/j.jisako.2025.100922","url":null,"abstract":"<div><div>Knee osteonecrosis (ON), often subclassified as spontaneous ON of the knee, secondary ON, and post-arthroscopic ON of the knee, is a common disorder often associated with suboptimal outcomes. Magnetic resonance imaging is the current gold standard for diagnosis, revealing bone marrow edema and subchondral fracture lines. Therapeutic methods range from conservative treatments, such as partial weight-bearing, pharmaceutical interventions, and physical therapy, to surgical procedures in cases of advanced joint collapse. Available evidence from histological studies consistently shows the absence of bone necrosis, highlighting microfractures and bone remodeling as central features of these lesions. Therefore, the appropriateness of this terminology has recently been questioned, with knee ON being more accurately reinterpreted as subchondral insufficiency fracture of the knee (SIFK). This clinical dilemma stems from longstanding misclassification that has led to diagnostic confusion and inconsistent treatment approaches. Despite this progress, several unresolved issues persist. The precise biomechanical and biological factors that initiate SIFK remain unclear, and the optimal timing for intervention is still debated. In addition, long-term outcomes of both nonoperative and operative treatments have yet to be definitively established. Addressing these gaps requires comprehensive clinical trials and advanced imaging studies that correlate histological findings with patient outcomes. This evolving understanding calls for a reclassification of knee ON lesions, aiming to enhance diagnostic accuracy and inform more effective, targeted treatment strategies.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100922"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620832","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":"Return to sports and recreational activities after patellofemoral arthroplasty: A systematic review","authors":"José Arteaga MD, MSc ,&nbsp;Eduardo Poblete MD ,&nbsp;Fernando Martin MD ,&nbsp;Gabriel Domecq MD ,&nbsp;David Figueroa MD, Prof.","doi":"10.1016/j.jisako.2025.100925","DOIUrl":"10.1016/j.jisako.2025.100925","url":null,"abstract":"<div><h3>Importance</h3><div>Patellofemoral arthroplasty (PFA) is an established treatment for isolated patellofemoral osteoarthritis. However, evidence regarding postoperative activity levels and return to sport (RTS) remains limited.</div></div><div><h3>Objective</h3><div>The objective of this study was to evaluate RTS and recreational activity rates following PFA, identify factors influencing these outcomes, and report associated complications.</div></div><div><h3>Evidence review</h3><div>A systematic search was conducted in June 2024 across PubMed, EMBASE, ScienceDirect, and Scopus databases, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included variations of “patellofemoral arthroplasty,” “physical activity,” and “return to sport.” Studies were included if they reported RTS outcomes following PFA. Studies lacking RTS data or isolated PFA results were excluded. From 492 records, 7 studies met the inclusion criteria.</div></div><div><h3>Findings</h3><div>Seven studies (2 prospective and 5 retrospective) comprising 265 patients (281 knees; 64.6% women; mean age: 48.9 years) were included, with a mean follow-up of up to 5.3 years. RTS definitions varied, with reported rates ranging from 64.7% to 91%. Low-impact sports were more commonly resumed, and 58.6% of patients returned to sport within six months. Among those who returned, 74.8% reached or exceeded their preoperative activity level. Postoperative pain improved (visual analog scale scores decreased from 6.3 to 2.7), although up to 38.6% of patients reported pain limiting activity. Conversion to total knee arthroplasty occurred in 6.3% to 13% of cases, and reoperation rates ranged from 10.4% to 25%. Limitations included inconsistent RTS definitions, heterogeneous outcome reporting, and use of non-standardized questionnaires.</div></div><div><h3>Conclusions</h3><div>RTS and recreational activity after PFA can be resumed by most patients, especially low-impact activities. Pain management should be actively addressed. High-quality studies with standardized RTS definitions are needed to evaluate the long-term impact of activity on implant survival.</div></div><div><h3>Relevance</h3><div>RTS after PFA is safe and achievable. A personalized approach is essential to optimize RTS and manage patient expectations.</div></div><div><h3>Evidence level</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100925"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601793","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}