The American Journal of Sports Medicine最新文献

{"title":"Absolute Risk of Anterior Cruciate Ligament Graft Reruptures From the Posterior Tibial Slope Falls With Increasing Age: A Risk Stratification Analysis","authors":"Tomas Pineda, David Mazy, José Ramos-Rojas, Nicolas Cance, Michael J. Dan, Guillaume Demey, David H. Dejour","doi":"10.1177/03635465261479079","DOIUrl":"https://doi.org/10.1177/03635465261479079","url":null,"abstract":"Background: Posterior tibial slope (PTS) and young age are well-established independent predictors of an anterior cruciate ligament (ACL) graft rerupture. Although both factors have been studied individually, whether age changes the relative effect of PTS, its absolute clinical impact, or both has not been formally examined across the full age range of patients undergoing ACL reconstruction (ACLR). Purpose: To determine whether age modifies the relative or absolute rerupture risk associated with PTS after ACLR, and to identify age thresholds at which clinically relevant absolute risk levels are reached for given slope values. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort of 585 patients who underwent primary ACLR with hamstring tendon autografts was analyzed, comprising a low-risk group (isolated ACLR) and a high-risk group (ACLR with lateral extra-articular tenodesis), with a minimum follow-up of 6 years. The Firth penalized logistic regression was used to model the joint effects of PTS and age on graft reruptures in pooled and group-specific analyses. A PTS×age interaction term was evaluated via the likelihood ratio test to assess whether the relative effect of PTS differed across age strata. Predicted absolute rerupture probabilities were derived from additive models, and age thresholds below which the risk fell under predefined clinically relevant levels (5% and 10%) were estimated for PTS values of 12° and 15°, with stability assessed by bootstrap resampling (1000 iterations). Results: After excluding 4 patients with missing covariate values, 581 patients were included in the final sample (low risk: n = 431; high risk: n = 150). In the pooled cohort (n = 581; 38 reruptures), PTS was independently associated with reruptures (odds ratio per degree, 1.28 [95% CI, 1.10-1.47]; <jats:italic toggle=\"yes\">P</jats:italic> = .001), and increasing age was independently protective (odds ratio per year, 0.91 [95% CI, 0.87-0.95]; <jats:italic toggle=\"yes\">P</jats:italic> &lt; .001). No statistically significant PTS×age interaction was identified in any analysis (pooled cohort: <jats:italic toggle=\"yes\">P</jats:italic> = .685), indicating that the relative effect of each degree of PTS remained approximately stable across ages. However, the predicted absolute rerupture risk decreased markedly with increasing age. In the pooled cohort, a patient with a PTS of 15° had an estimated rerupture probability of 36.6% at age 18 years versus 3.9% at age 45 years. Age thresholds at which the predicted risk fell below 10% were approximately 27 years for a PTS of 12° and approximately 35 years for a PTS of 15°. Conclusion: Age modulated the absolute, but not the relative, risk associated with PTS after ACLR. Younger patients with elevated slope values had the highest absolute rerupture risk, reinforcing the clinical value of integrating age into preoperative slope-based risk stratification.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"163 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898903","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":"The Lark-Loop Technique for Onlay Biceps Tenodesis: A Biomechanical, Histological, and Radiological Study in a Rabbit Model","authors":"Min Zhou,Xinhao Li,Jinming Zhang,Xinghao Deng,Zhuo Wang,Jingyi Hou,Yan Yan,Yi Long,Rui Yang","doi":"10.1177/03635465261469680","DOIUrl":"https://doi.org/10.1177/03635465261469680","url":null,"abstract":"Background: Arthroscopic cortical surface tenodesis has been established as an effective technique for managing lesions of the long head of the biceps tendon (LHBT). However, traditional suture techniques frequently provide insufficient initial mechanical strength, which may contribute to tenodesis failure. To address this limitation, the Lark-Loop suture technique was developed. Purpose: To compare the biomechanical, histological, and radiological outcomes of Lasso-Loop, Lark-Loop, and Krackow suture techniques for cortical surface tenodesis of the LHBT in a rabbit model. Study Design: Controlled laboratory study. Methods: A total of 75 New Zealand White rabbits underwent bilateral proximal biceps tenodesis using a cortical surface fixation model. Animals were randomly assigned to 1 of 3 groups: (1) Lasso-Loop suture (control group; n = 25), (2) Lark-Loop suture (experimental group; n = 25), and (3) Krackow suture (positive control group; n = 25). At 4, 8, and 12 weeks postoperatively, 21 rabbits from each group (n = 63 total) were sacrificed for evaluation: 3 rabbits per group were used for magnetic resonance imaging and histological analysis, and 4 rabbits per group for micro–computed tomography and biomechanical testing. An additional 12 rabbits (4 per group) were used for initial biomechanical testing at week 0. One-way analysis of variance and Bonferroni post hoc correction were used to assess between-group differences. A P value &lt;.05 was considered statistically significant. Results: Macroscopically, complete healing at the tenodesis site was observed in all groups at 12 weeks. The Lark-Loop group demonstrated significantly improved signal-to-noise quotient values, mechanical strength, new bone formation, and histological tendon-bone integration compared with the Lasso-Loop group at all time points. No significant differences were observed between the Lark-Loop and Krackow groups. Conclusion: This study demonstrated that all 3 suture techniques achieved effective tendon-bone healing in a rabbit model. The Lark-Loop technique provided enhanced biomechanical properties and histological healing compared with the Lasso-Loop technique, and comparable outcomes to the Krackow stitch. Clinical Relevance: The findings suggest that the Lark-Loop technique may serve as a viable arthroscopic alternative for LHBT tenodesis in clinical practice, potentially enhancing tendon-bone healing and reducing failure rates.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"176 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893711","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":"Biomechanical Effect of Medial Collateral Ligament Repair With and Without Suture Augmentation on Knee Laxity and Anterior Cruciate Ligament Force","authors":"Fidelius von Rehlingen-Prinz, David Z. Shamritsky, Sebastian Rilk, Kyle N. Kunze, Maximilian M. Mueller, Bryce Demopoulos, Carl W. Imhauser, Gregory S. DiFelice","doi":"10.1177/03635465261476766","DOIUrl":"https://doi.org/10.1177/03635465261476766","url":null,"abstract":"Background: The medial collateral ligament (MCL) is the most frequently injured knee ligament. MCL repair is a surgical technique intended to acutely reduce medial side laxity that can be performed in isolation or combined with suture augmentation (SA). Purpose: To assess the effect of MCL repair with and without SA on (1) valgus laxity and anteromedial rotational laxity and (2) force carried by the anterior cruciate ligament (ACL) and (3) to quantify load-sharing between the MCL repair and SA components. Study Design: Controlled laboratory study. Methods: Seven cadaveric knees were tested using a 6 degrees of freedom robotic manipulator in 4 states: (1) intact, (2) MCL cut, (3) isolated MCL repair, and (4) MCL repair combined with SA. Valgus laxity and anteromedial rotational laxity were measured at 0°, 15°, 30°, and 90° of flexion. In situ ACL force and forces carried by the MCL repair components were assessed at peak valgus moment using principle of superposition. Results: Valgus laxity after isolated MCL repair was greater than the intact state at all flexion angles &gt;0° ( <jats:italic toggle=\"yes\">P</jats:italic> ≤ .01). The addition of SA to MCL repair significantly reduced valgus laxity at 15° and 30° of flexion only ( <jats:italic toggle=\"yes\">P</jats:italic> ≤ .02). Anteromedial rotational laxity after both MCL repairs was greater than the intact state at 90° of flexion ( <jats:italic toggle=\"yes\">P</jats:italic> &lt; .01), whereas no differences were detected at 0° and 30°. For both MCL repairs, ACL force was less than in the MCL cut state and did not differ from the intact state. In situ forces carried by the repair and SA components did not differ for the MCL repair combined with SA. Conclusion: Both MCL repair with and without SA reduced ACL force relative to the MCL cut state. Addition of SA to MCL repair resulted in less residual valgus laxity but not less anteromedial rotational laxity. Clinical Relevance: These findings suggest that MCL repair may reduce medial side laxity and partially offload the ACL relative to the MCL cut state. This is particularly important for treatment of combined ACL and MCL injuries, where the protection of the ACL graft or repair is most important immediately after surgery.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858823","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":"Effect of Multiple Centralization Sutures on Meniscal Extrusion and Contact Pressures in a Cadaveric Model of Medial Meniscus Root Repair","authors":"Mathias Andersen, Luke V. Tollefson, Jacob Ngobi, Mitchell R. Carlson, Christopher M. LaPrade, Bjørge Fladberg, Frede Frihagen, Eivind Inderhaug, Robert F. LaPrade","doi":"10.1177/03635465261475396","DOIUrl":"https://doi.org/10.1177/03635465261475396","url":null,"abstract":"Background: Adding a centralization suture (CS) during repair of a posterior medial meniscus root (PMMR) tear may decrease meniscal extrusion and osteoarthritis progression. However, the number and optimal placement of CSs remain unclear. Hypothesis: Increasing numbers and changing localization of CSs would not influence the degree of postoperative extrusion or joint contact pressures. Study Design: Controlled laboratory study. Methods: Meniscal extrusion and tibiofemoral contact pressures were assessed using a 3-dimensional motion capture system and pressure sensors in 9 human cadaveric knees. A nonanatomic root repair was created to simulate persistent meniscal extrusion after a PMMR repair. Each knee was tested under 10 conditions: (1) intact, (2) PMMR tear, (3) root repair, (4) CS at the posterior border of the medial collateral ligament (MCL) (CS1), (5) CS midway between CS 1 and CS 3 (CS2), (6) CS at the midpoint between the MCL and posterior root attachment (CS3), and (7-10) combinations of these CSs (all CSs were in addition to the root repair). Analysis of variance testing was used for analyses of pressure data and extrusion measurements. Results: There was no significant difference in medial contact pressure between the intact state and the states with root repair in combination with any CS configuration ( <jats:italic toggle=\"yes\">P</jats:italic> &gt; .05). Contact pressures were reduced compared to the root repair state for CS1 alone at 0° ( <jats:italic toggle=\"yes\">P</jats:italic> = .014); the combination of CS2 and CS3 at 0°, 60°, and 120° ( <jats:italic toggle=\"yes\">P</jats:italic> ≤ .038); and the combination of all 3 CSs at 0°, 30°, and 60° of flexion ( <jats:italic toggle=\"yes\">P</jats:italic> ≤ .037). Extrusion was reduced compared to the root repair state for CS1 alone at 60° ( <jats:italic toggle=\"yes\">P</jats:italic> = .043) and all 3 CSs combined at 90° of flexion ( <jats:italic toggle=\"yes\">P</jats:italic> &lt; .009). Conclusion: A single CS placed at the posterior border of the MCL decreased medial contact pressures at 0° and reduced extrusion at 60° of flexion. The combined use of 2 CSs placed at the posteromedial meniscus junction reduced contact pressures across multiple flexion angles (0°, 60°, and 120°). The combination of 3 CSs reduced contact pressures at 0°, 30°, and 60° and extrusion at 90°. Until clinical studies are conducted, the benefits of additional CSs should be weighed against time and cost. Clinical Relevance: These findings should guide surgeons on the optimal number and placement of CSs to minimize meniscal extrusion and restore medial compartment contact pressures.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836234","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":"Increased Posterior Tibial Slope and Lateral Extra-articular Tenodesis Are Independently Associated With Revision ACLR in a Young High-Risk Population","authors":"Wybren A. van der Wal, Tom M. de Groot, Lamba Tamana, Nikolaos Tsoulgkounidis, Jorick T. Veraart, Roy A.G. Hoogeslag, Henk van der Hoeven, Yde Engelsma, Roel J.H. Custers, Daniel B.F. Saris","doi":"10.1177/03635465261473931","DOIUrl":"https://doi.org/10.1177/03635465261473931","url":null,"abstract":"Background: Increased posterior tibial slope (PTS) has been associated with higher revision rates after anterior cruciate ligament reconstruction (ACLR). Whether the addition of lateral extra-articular tenodesis (LET) mitigates the risk associated with increased PTS is unclear. Purpose: To determine the prevalence of increased PTS (≥12°) in a young high-risk primary ACLR population and evaluate whether LET is associated with lower revision rates in patients with increased PTS. Study Design: Cohort study; Level of evidence, 3. Methods: This study included patients aged ≤25 years undergoing primary ACLR across 3 high-volume centers with ≥2 years between surgery and data collection. PTS was measured on lateral radiographs for medial and lateral plateaus. Primary analyses consisted of 4 prespecified multivariable logistic regression models with different PTS operationalizations as continuous predictors per 1° increase (medial PTS, lateral PTS, the maximum [PTSmax], and the lateral-medial difference), adjusted for patient and surgical covariates including graft type, with surgical center as a fixed effect. Secondary analyses used PTS dichotomized at 12°; revision rates were compared between isolated ACLR and ACLR with LET, with the treatment effect quantified as absolute risk reduction and number needed to treat. Results: A total of 780 patients were included; 84 (10.8%) underwent revision ACLR. Increased PTS (≥12°) was present in 28.2% of patients and more common in those requiring revision (38.6% vs 27.0%; <jats:italic toggle=\"yes\">P</jats:italic> = .03). In patients with PTSmax ≥12°, revision occurred in 21.0% without LET and 9.2% with LET (absolute risk reduction, 11.8% [95% CI, 2.3%-21.3%]; number needed to treat, 9); in patients with PTSmax &lt;12°, revision occurred in 13.2% without LET and 5.4% with LET (absolute risk reduction, 7.8% [95% CI, 3.0%-12.6%]; number needed to treat, 13). In the 4 prespecified multivariable models with PTS as a continuous predictor, LET was independently associated with substantially lower odds of revision ACLR (odds ratio [OR], 0.37; 95% CI, 0.22-0.62; <jats:italic toggle=\"yes\">P</jats:italic> &lt; .001). Lateral PTS (OR, 1.09 per 1° increase; 95% CI, 1.00-1.18; <jats:italic toggle=\"yes\">P</jats:italic> = .04) and PTSmax (OR, 1.09; 95% CI, 1.00-1.19; <jats:italic toggle=\"yes\">P</jats:italic> = .04) were independently associated with revision ACLR. The lateral-medial PTS difference was not associated with revision ACLR. Conclusion: In a young high-risk primary ACLR population, increased PTS was present in nearly 30% of patients. LET was associated with a lower risk of revision irrespective of PTS, while increased PTS was independently associated with revision ACLR.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768568","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":"Higher Rates of PASS and SCB After Arthroscopic Subspine Decompression Are Associated With a Positive Diagnostic AIIS Injection: A Propensity Score–Matched Cohort Study","authors":"Yu-Peng Duan, Fan Yang, Rong-Ge Liu, Hao Sun, Hongjie Huang, Yan Xu, Xiao-Dong Ju, Jian-Quan Wang","doi":"10.1177/03635465261464773","DOIUrl":"https://doi.org/10.1177/03635465261464773","url":null,"abstract":"Background: Hip arthroscopy effectively treats femoroacetabular impingement syndrome (FAIS), but persistent pain may be related to concomitant extra-articular pathology such as subspine impingement syndrome (SSI). Standard diagnosis of SSI often relies on 3-dimensional computed tomography (3D-CT) morphology (Hetsroni type II/III), although this morphology is common in individuals who are asymptomatic and correlates poorly with symptoms. Purpose: To compare minimum 2-year clinical outcomes after arthroscopic subspine decompression in patients with concurrent FAIS and type II/III anterior inferior iliac spine (AIIS) morphology, stratified by diagnostic method: 3D-CT morphology alone versus 3D-CT morphology plus a positive ultrasound-guided diagnostic injection. Study Design: Cohort study; Level of evidence, 3. Methods: This study included patients aged 18 to 55 years with type II/III AIIS morphology who underwent primary hip arthroscopy for FAIS and SSI between January 2021 and November 2023 and had minimum 2-year follow-up. Patients diagnosed by CT morphology alone (CT classification group) were propensity score matched 1:1 to patients with a positive ultrasound-guided AIIS injection (injection group), with 57 patients per group. Matching variables were age, sex, body mass index, lateral center-edge angle, alpha angle, Tönnis grade, and Beighton score. All patients underwent arthroscopic subspine decompression. Patient-reported outcomes and rates of achieving the minimal clinically important difference, Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) were compared. Results: Preoperative patient-reported outcome scores were similar between groups (all &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; &gt; .05). At minimum 2-year follow-up, the injection group had significantly better scores on the modified Harris Hip Score (90.8 vs 84.2), Hip Outcome Score–Activities of Daily Living (88.4 vs 82.4), Hip Outcome Score–Sports Subscale (71.9 vs 64.1), 12-item International Hip Outcome Tool (83.9 vs 76.1), and visual analog scale for pain (1.2 vs 2.0) (all &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; &lt; .001). Minimal clinically important difference rates were high in both groups, with higher rates in the injection group for modified Harris Hip Score (93% vs 77%; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .033) and Hip Outcome Score–Activities of Daily Living (91% vs 75%; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .042). PASS and SCB rates were significantly higher in the injection group across all patient-reported outcome measures (all &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; &lt; .05). Revision and complication rates were low and did not differ significantly between groups. Conclusion: Both groups improved significantly after arthroscopic subspine decompression. However, patients with a positive ultrasound-guided diagnostic AIIS injection achieved higher PASS and SCB rates than those selected by CT morphology alone, suggestin","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768571","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":"Minimum 5-Year Follow-up After Arthroscopic Latarjet: Outcomes and Complications","authors":"Tea Berge, Andrew M. Garratt, Gilbert Moatshe, Anna Grimsmo Øines, Ingvild Blich, Ragnhild Støen, Tom Clement Ludvigsen, Filip Vuletić, Berte Bøe","doi":"10.1177/03635465261475810","DOIUrl":"https://doi.org/10.1177/03635465261475810","url":null,"abstract":"Background: The Latarjet procedure is widely used for recurrent anterior shoulder instability with glenoid bone loss. Arthroscopic techniques are increasing; however, there is limited evidence for mid- to long-term outcomes. Purpose: To evaluate clinical outcomes, recurrence rates, and quality of life at a minimum of 5 years’ follow-up after undergoing the arthroscopic Latarjet procedure. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent the arthroscopic Latarjet procedure using double-screw fixation at Oslo University Hospital between 2014 and 2019 were prospectively registered. Descriptive data and Western Ontario Shoulder Instability Index (WOSI) scores were recorded preoperatively and at 1 and 5 years postoperatively. At 5 years, complications and health-related quality of life (HRQoL; EQ-5D-5L) were assessed. Results: Of 107 patients who underwent the arthroscopic Latarjet procedure, 93 cases met the inclusion criteria. After loss to follow-up, 85 cases were included. The median follow-up time was 5.2 years (range, 5.1-9.4 years). The median age at surgery was 27.8 years (range, 15.6-49.8 years), and 78 of 85 (92%) cases were male. Of the 85 cases, 56 (66%) had &gt;10 dislocations before surgery, and 36 (42%) were revision procedures. At the 5-year follow-up, 2 of 85 patients experienced recurrent dislocations, and 8 of 85 reported subluxations. The median WOSI score improved significantly from 51% (IQR, 29.1%-62.4%) preoperatively to 79% (IQR, 62.9%-91.4%) at 5 years ( <jats:italic toggle=\"yes\">P</jats:italic> &lt; .001). The median WOSI score at 1 year was 80% (IQR, 67%-88.4%), with no significant difference between the 1-year and 5-year scores ( <jats:italic toggle=\"yes\">P</jats:italic> = .69). The mean EQ-5D-5L index scores at 5 years were 0.889 ± 0.169 compared to 0.896 ± 0.177 for general population norms, with no significant difference ( <jats:italic toggle=\"yes\">P</jats:italic> = .77). Overall, 87% of patients reported satisfaction with the surgical outcome. Ten patients underwent reoperation due to complications. Conclusion: At a minimum 5-year follow-up, the arthroscopic Latarjet procedure resulted in significant improvement in WOSI score, low rates of recurrent dislocation, and high patient satisfaction. The WOSI score remained stable over 1 to 5 years. HRQoL, assessed using the EQ-5D-5L index, was comparable to age- and sex-matched general population norms at 5 years, supporting a satisfactory long-term impact on HRQoL.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768569","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":"The Association of Advanced Patellofemoral Chondrosis With Outcomes After Posterior Medial Meniscus Root Repair","authors":"Michelle Shen, Larry Chen, Benjamin Padon, Garret Ruff, Daniel J. Kaplan, Eric Strauss, Laith Jazrawi, Michael Alaia","doi":"10.1177/03635465261471374","DOIUrl":"https://doi.org/10.1177/03635465261471374","url":null,"abstract":"Background: Meniscus root repair has been shown to improve symptoms and protect against progressive knee arthritis by restoring more normal weightbearing force distribution. While advanced tibiofemoral chondrosis is known to negatively affect root repair outcomes, there is a paucity of literature describing the impact of concomitant patellofemoral chondrosis (PFC). Purpose: To evaluate outcomes of meniscus root repair in patients with and without advanced PFC. Study Design: Cohort study; Level of evidence, 3. Methods: This single-center retrospective study included patients who underwent isolated posterior medial meniscus root repair (PMMRR) between July 2013 and February 2023, with a minimum 2-year follow-up. Based on intraoperative arthroscopic findings, patients were stratified into 2 groups: those with PFC, defined as Outerbridge grade ≥3, and those without PFC (Outerbridge grade &lt; 3). Clinical outcomes, including meniscal retear, conversion to unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA), and revision meniscal surgery, were obtained through chart review. Patient-reported outcomes (PROs) were collected from patients without retear or revision meniscal surgery and who did not convert to UKA or TKA and included the Knee injury and Osteoarthritis Outcome Score–12 (KOOS-12), International Knee Documentation Committee (IKDC) subjective score, and return-to-sport status. Results: A total of 115 patients were included: 67 with PFC (mean age, 55.0 years; 82.1% female) and 48 non-PFC controls (mean age, 52.0 years; 66.7% female). The mean follow-up duration was 6.2 years for the PFC group and 5.7 years for the non-PFC group. At the final follow-up, there were no significant differences between groups in KOOS-12 Pain, Function in Daily Living, or Quality of Life subscales; IKDC scores; or return-to-sport rates (all <jats:italic toggle=\"yes\">P</jats:italic> &gt; .05). Rates of Patient Acceptable Symptom State, minimal clinically significant difference, and substantial clinical benefit achievement were also similar. Retear rates (11.9% for PFC and 8.3% for non-PFC) and revision meniscal surgery rates (1.5% for PFC and 4.2% for non-PFC) were similar between groups. However, the PFC group demonstrated a significantly higher rate of conversion to UKA or TKA compared with the non-PFC group (14.9% vs 2.1%; <jats:italic toggle=\"yes\">P</jats:italic> = .021). Conclusion: Patients with and without PFC at the time of PMMRR who did not experience a retear, undergo revision surgery, or convert to UKA or TKA had comparable PROs and clinically significant outcomes at the final follow-up. However, there was a significantly higher rate (almost 7-fold) of conversion to UKA or TKA in patients with PFC, suggesting that while short- to midterm functional outcomes may be preserved, advanced PFC may predispose patients to earlier progression of joint degeneration and need for arthroplasty.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768570","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":"IL-1β–Induced Inflammatory Transcriptome and TGF-β1 Attenuation of Chemokine Expression in ACL Remnant Fibroblasts","authors":"Lei Cai, Robert H. Brophy, Eric D. Tycksen, Muhammad Farooq Rai","doi":"10.1177/03635465261470174","DOIUrl":"https://doi.org/10.1177/03635465261470174","url":null,"abstract":"Background: The high incidence of posttraumatic osteoarthritis after anterior cruciate ligament (ACL) injury and reconstruction suggests that biological mechanisms beyond joint instability contribute to disease progression. After injury, ACL-resident cells are exposed to inflammatory mediators within the joint and may influence the local inflammatory microenvironment; however, their global transcriptomic responses to inflammatory stimuli remain underexplored. Hypothesis: Interleukin-1 beta (IL-1β) induces inflammatory transcriptomic responses in ACL remnant–derived (ACLr) fibroblasts, and transforming growth factor beta 1 (TGF-β1) attenuates these responses. Study Design: Descriptive laboratory study. Methods: Primary ACLr fibroblasts were isolated from ACL remnants (n = 10) collected at the time of knee surgery. Near-confluent cultures were treated with IL-1β (10 ng/mL) for 24 hours to model an inflammatory joint environment. Genome-wide transcriptional changes were assessed by RNA sequencing using an Illumina NovaSeq-6000, with selected targets confirmed by microfluidic digital polymerase chain reaction (PCR). To evaluate the effects of TGF-β1, ACLr fibroblasts pretreated with IL-1β were exposed to TGF-β1 (10 ng/mL) for 48 hours, and chemokine transcript levels were assessed using digital PCR. Results: IL-1β induced broad inflammatory transcriptional responses characterized by upregulation of chemokines ( &lt;jats:italic toggle=\"yes\"&gt;CXCL6&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;CXCL8&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;CXCL5&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;CCL20&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;CXCL1&lt;/jats:italic&gt; , and &lt;jats:italic toggle=\"yes\"&gt;CXCL3&lt;/jats:italic&gt; ), cytokines ( &lt;jats:italic toggle=\"yes\"&gt;IL33&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;IL1B&lt;/jats:italic&gt; , and &lt;jats:italic toggle=\"yes\"&gt;IL6&lt;/jats:italic&gt; ), and matrix-degrading enzymes ( &lt;jats:italic toggle=\"yes\"&gt;MMP3&lt;/jats:italic&gt; and &lt;jats:italic toggle=\"yes\"&gt;MMP12&lt;/jats:italic&gt; ), while suppressing extracellular matrix-associated genes ( &lt;jats:italic toggle=\"yes\"&gt;KRT14&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;COL21A1&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;POSTN&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;COL1A1&lt;/jats:italic&gt; , and &lt;jats:italic toggle=\"yes\"&gt;COL6A3&lt;/jats:italic&gt; ). Functional enrichment analysis demonstrated activation of immune and inflammatory responses, cytokine and chemokine signaling, and cell activation. TGF-β1 reduced the expression of all assessed IL-1β–induced chemokines, with reduction of up to 50%, with statistically significant suppression observed for 13 of the 16 chemokines. Concomitantly, TGF-β1 treatment reduced expression of &lt;jats:italic toggle=\"yes\"&gt;CEBPB&lt;/jats:italic&gt; , &lt;jats:italic toggle=\"yes\"&gt;NFKBIA&lt;/jats:italic&gt; , and &lt;jats:italic toggle=\"yes\"&gt;NFKBIZ&lt;/jats:italic&gt; , transcripts implicated in inflammatory gene regulation. Conclusion: ACLr fibroblasts mounted a robust inflammatory transcriptomic response to IL-1β, ","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148729135","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":"Changes in ACL T2* Metrics Over the Course of the Female Menstrual Cycle: A New Biomarker for the ACL Injury Risk?","authors":"Erin Argentieri, Tatum W. Hamilton, Matthew F. Koff, Kevin M. Koch, Hollis G. Potter","doi":"10.1177/03635465261470921","DOIUrl":"https://doi.org/10.1177/03635465261470921","url":null,"abstract":"Background: Sex-based disparities in the anterior cruciate ligament (ACL) injury risk may be partly explained by cyclic variations in sex hormones that drive systemic shifts in tissue osmoregulation. Ultrashort echo time (UTE) T2 <jats:sup>*</jats:sup> magnetic resonance imaging provides a noninvasive, quantitative means of evaluating the water content and collagen orientation in tissue. Hypothesis: Eumenorrheic female participants will exhibit significant ACL T2 <jats:sup>*</jats:sup> changes across the cycle, while anovulatory control participants will demonstrate no significant changes over time. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 25 women with no prior knee injuries were enrolled: 10 premenopausal, eumenorrheic participants and 15 anovulatory control participants (6 postmenopausal and 9 premenopausal using oral contraceptives). Bilateral knee magnetic resonance imaging was performed at 4 time points evenly spaced over 1 month, with the first visit within 24 hours of menses onset. Ovulation status was confirmed using commercially available ovulation predictor kits. Three-dimensional UTE sequences (11 echoes; 0.03-25 ms) were acquired to evaluate bicomponent ACL T2 <jats:sup>*</jats:sup> metrics. Linear mixed-effects models assessed temporal differences in long and short T2 <jats:sup>*</jats:sup> values, and the Cohen <jats:italic toggle=\"yes\">d</jats:italic> quantified effect size. Results: Eumenorrheic participants demonstrated significantly shorter preovulatory long T2 <jats:sup>*</jats:sup> values compared with postovulatory values (mean difference, 1.0 ms [95% CI, 0.2-1.9 ms]; <jats:italic toggle=\"yes\">P</jats:italic> = .015; Cohen <jats:italic toggle=\"yes\">d</jats:italic> = 0.51). No significant temporal differences were observed for any T2 <jats:sup>*</jats:sup> metric in anovulatory controls. Conclusion: Eumenorrheic female participants exhibited significant preovulatory to postovulatory changes in ACL T2 <jats:sup>*</jats:sup> metrics, while anovulatory controls demonstrated no significant changes over time. These findings suggest that ACL T2 <jats:sup>*</jats:sup> metrics are sensitive to cyclic fluctuations in female sex hormones across the menstrual cycle.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148728078","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}