Arthroscopy-The Journal of Arthroscopic and Related Surgery最新文献

{"title":"Establishing a Sustainable Artificial Intelligence Infrastructure for Health Care Systems Part II: Consideration of Key Regulatory and Bioethical Barriers to Implementation.","authors":"Kyle N Kunze, Ashis Barad","doi":"10.1002/arj.70231","DOIUrl":"https://doi.org/10.1002/arj.70231","url":null,"abstract":"<p><p>Establishing an artificial intelligence (AI) infrastructure is contingent upon processes being conducted within structured regulatory frameworks that adhere to existing best practices. Institutional policies should include the development of an AI governance body with the goals of proactively monitoring deployed AI solutions for deviations in performance, responsibly scaling them, mitigating potential biases, and ensuring the fundamental principles of transparency and accountability are followed. Specific regulatory considerations include ensuring compliance with Food and Drug Administration regulations as well as ensuring data privacy and Health Insurance Portability and Accountability Act compliance. Implementation challenges that must be considered include workflow integration of AI solutions, user acceptance and trust, initiating a change in hospital culture toward embracing new technology, and building a sustainable technical foundation for maintenance and continuous learning. Emphasizing these considerations is essential to fostering compliant and responsible use of AI that maximizes value and quality of care delivered across a health care system. Likewise, a top-down focus on ethics surrounding responsible use of AI, measures toward the reduction in bias, and emphasizing explainability of AI decision-making will be critical for sustainable and trustworthy integration of systems-wide AI solutions. LEVEL OF EVIDENCE: Level V, expert opinion.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large to Massive Rotator Cuff Tears With Only Partial Repair Possible Treated With Human Dermal Allograft Results in Lower Retear Rates and Improved Function Compared With Matched Group Without Augmentation.","authors":"Seong Hun Kim, Ji Young Yoon","doi":"10.1002/arj.70122","DOIUrl":"https://doi.org/10.1002/arj.70122","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical and radiologic outcomes of incomplete rotator cuff repair with and without human dermal allograft patch in patients with large to massive rotator cuff tears.</p><p><strong>Methods: </strong>A retrospective analysis was performed on patients who underwent arthroscopic rotator cuff repair with footprint medialization between March 2013 and September 2022, with a minimum 2-year follow-up for clinical outcomes. Patients were included if they had a full-thickness rotator cuff tear measuring ≥3.0 cm and underwent incomplete repair due to excessive tension after medialization. Propensity score matching (1-to-1) was performed between the patch augmentation and incomplete repair-only groups by preoperative variables, including tear size, chronicity, and tendon quality. Clinical outcomes were assessed via visual analog scale for pain, American Shoulder and Elbow Surgeons score, Constant score, and Single Assessment Numeric Evaluation score, along with active range of motion. Structural integrity was evaluated using magnetic resonance imaging at 6 months, ultrasonography at 1 year, and at final follow-up.</p><p><strong>Results: </strong>Among 1129 patients, 174 met the inclusion criteria: 43 received human dermal allograft patch augmentation, and 131 underwent incomplete repair. Propensity score matching produced 36 matched pairs for analysis. At final follow-up, the patch augmentation group had significantly better outcomes, including lower visual analog scale for pain score (0.6 ± 0.9 vs 1.2 ± 1.3, P = .035), and higher American Shoulder and Elbow Surgeons (93.3 ± 4.5 vs 89.0 ± 6.6, P = .002), Constant (89.8 ± 4.9 vs 86.6 ± 7.3, P = .031), and Single Assessment Numeric Evaluation scores (90.6 ± 6.8 vs 84.7 ± 8.4, P = .002). Furthermore, 83.3% of the patch group and 77.8% of the control group achieved the minimal clinically important difference of 9.1 for the American Shoulder and Elbow Surgeons score. Both groups showed significant range of motion improvement with no intergroup difference. Magnetic resonance imaging at 6 months showed healing failure in 8.3% of the patch augmentation group versus 27.8% in the incomplete repair group (P = .063). At the final follow-up, retear rates reached 33.3% in the incomplete repair group but remained at 8.3% with patch augmentation (P = .009).</p><p><strong>Conclusions: </strong>Human dermal allograft patch augmentation in patients with large to massive rotator cuff tears led to lower retear rates and superior clinical outcomes compared with incomplete repair alone.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative case-control study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Treatment Shows Noninferior Outcomes to Open Treatment for Native Glenohumeral Septic Arthritis: A Systematic Review.","authors":"Rachel Sze Jen Goh, Bryan Chong, Sean Kean Ann Phua, Sean Wei Loong Ho","doi":"10.1002/arj.70173","DOIUrl":"https://doi.org/10.1002/arj.70173","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of arthroscopic versus open treatment of native glenohumeral septic arthritis (not including prosthetic joint infections), both in terms of reinfection rates and postoperative functional outcomes.</p><p><strong>Methods: </strong>PubMed and Embase/Medline were searched from date of inception to July 26, 2025, for articles comparing arthroscopic versus open treatment of native glenohumeral septic arthritis. Cohort studies reporting outcomes of both arthroscopic and open treatment for glenohumeral septic arthritis were included. A meta-analysis comparing the primary outcome between using arthroscopy and arthrotomy for glenohumeral septic arthritis was not performed due to low level of evidence of included comparative studies. The primary outcome of interest in this study was reoperation or reinfection rates. Secondary outcomes analyzed included mortality rate, length of hospital stay, 30-day all-cause complications, cost, and functional outcomes.</p><p><strong>Results: </strong>Nine articles comprising 10,352 patients with glenohumeral septic arthritis were included, including 4250 patients in the arthroscopic treatment arm (mean age 63.2 ± 16.3 years) and 6102 patients in the open treatment arm (mean age 60.9 ± 18.7 years). Notably, reinfection rates showed considerable heterogeneity, particularly in the arthroscopic group, with reinfection rates ranging from 7.46% to 75.0% compared with the narrower range of 12.6% to 22.2% in the open treatment group. Thirty-day all-cause complication rates ranged from 15.7% to 47.5% in patients undergoing arthroscopic treatment versus 22.6% to 50.5% in patients undergoing open treatment. In the arthroscopic treatment group, mortality rates ranged from 2.09% to 4.76%, while mortality rates in the open treatment arm were between 3.47% and 7.0%.</p><p><strong>Conclusions: </strong>Current evidence comparing arthroscopic versus open treatment of glenohumeral septic arthritis shows mixed results with substantial heterogeneity in reinfection rates. While arthroscopic treatment showed lower 30-day all-cause complications and blood transfusion requirements, the wide variation in outcomes prevents definitive conclusions about treatment superiority.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III and IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip Arthroscopy in Femoroacetabular Impingement Syndrome With Versus Without Low Back Pain and Lumbar Spine Pathology Shows Comparable Outcomes at Minimum 5-Year Follow-Up.","authors":"Xin Niu, Zongping Xie","doi":"10.1002/arj.70191","DOIUrl":"https://doi.org/10.1002/arj.70191","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the patient-reported outcome measures (PROMs) of hip arthroscopy (HA) in patients with concomitant low back pain and lumbar spine pathology (LSP) compared with those without back concerns at a minimum of 5 year follow-up and determine the prevalence of low back pain (LBP) and LSP in Asian patients with femoroacetabular impingement syndrome (FAIS).</p><p><strong>Methods: </strong>Patients with FAIS, who underwent primary HA for FAIS with labral repair by a single surgeon between July 2017 and October 2019 with minimum 5-year follow-up, were identified. Patients were placed into 3 groups based on presence of preoperative LBP and LSP. These groups included: group LBP (with LBP), group Both (with LBP and LSP), and group None (neither diagnosis). The presence of concomitant LSP was identified using preoperative imaging with a pathologic lumbar spine diagnosis. All patients included in the study were asked to complete the Harris Hip Score (HHS) and Visual Analog Scale (VAS). All patients enrolled in the study were asked to fill out this survey preoperatively, at 3 months postoperatively, and latest follow-up. Satisfaction ratings were collected. Patient-reported outcomes (PROs) were compared between groups, postoperative with preoperative, along with revision arthroscopy, and conversion to total hip arthroplasty (THA).</p><p><strong>Results: </strong>The groups were similar in age (46.2 ± 14.4 years, 46.0 ± 15.5 vs 43.9 ± 13.8, P = .16), sex (55.4% female, 58.2% vs 55.4%,P = .91), and body mass index (23.4 ± 2.2 kg/m², 23.6 ± 2.5 vs 23.1 ± 2.2, P = .93). Comparing HHS and VAS between groups, no significant differences were observed preoperatively and at 5-year follow-up (P ≥ 0.057). Postoperative PROs significantly improved compared with preoperative PROs in all groups at 5-year follow-up (P < .0001). The LBP, Both, and None groups showed comparable rates of any patient acceptable symptomatic state (PASS) (89.1%, 88.1% vs 90.1%, P = .86) at 5-year follow-up. No significant differences in the rates of revision or THA conversion were identified between groups (P = .45). The prevalence of LBP and LSP was 28.9% and 11.5% in the cohort, respectively.</p><p><strong>Conclusions: </strong>The patients with LBP and/or LSP undergoing HA achieved comparable PROs, achievement of PASS, and reoperation-free survivorship to patients with isolated FAIS at minimum 5-year follow-up. The prevalence of LBP and LSP was 28.9% and 11.5% in Asian patients with FAIS, respectively.</p><p><strong>Level of evidence: </strong>Level III, retrospective therapeutic comparative case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Pubic Symphysectomy for Refractory Osteitis Pubis Provides Positive Functional Outcomes and High Return-to-Sport Rate at a Minimum 2-Year Follow-Up.","authors":"Roger Quesada-Jimenez, Ady H Kahana-Rojkind, Elizabeth G Walsh, Benjamin G Domb","doi":"10.1002/arj.70075","DOIUrl":"https://doi.org/10.1002/arj.70075","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcomes of endoscopic pubic symphysectomy as a treatment for refractory osteitis pubis with a minimum 2-year follow-up, and to present a return-to-sport (RTS) subanalysis of this patient population.</p><p><strong>Methods: </strong>Prospectively collected data were retrospectively analyzed for patients who underwent endoscopic pubic symphysectomy as treatment for osteitis pubis between May 2012 and September 2021. Included patients had completed preoperative and a minimum of 2-year postoperative questionnaires for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports-Specific Subscale, International Hip Outcome Tool (iHOT-12), visual analog scale, and patient satisfaction. The minimal clinically important difference was calculated for the mentioned patient-reported outcomes and included in the analysis. For the subanalysis, sport participation was defined as participation within 1 year of surgery, and RTS rates were calculated for the overall cohort and for the subset of patients who attempted to return postoperatively.</p><p><strong>Results: </strong>A total of 14 (93.3%) out of 15 patients were included in the study. All patients experienced symptom relief with a significant improvement in mHHS (P < .05), NAHS (P < .05), iHOT-12 (P < .01), and a high patient satisfaction rate with a mean satisfaction of 8.5 ± 2.7. A high percentage of patients reached the calculated minimal clinically important difference for mHHS, NAHS, Hip Outcome Score-Sports-Specific Subscale, and iHOT-12. Twelve patients (85.7%) reported sports participation. The overall RTS rate was 75%. Of the 9 patients who attempted to return, all (100%) successfully resumed sport within 1 year postoperatively, while 3 (25%) patients chose not to attempt RTS due to a desire to prevent symptoms.</p><p><strong>Conclusions: </strong>Endoscopic pubic symphysectomy for refractory cases of osteitis pubis yielded significant improvement in mHHS, NAHS, iHOT-12, and a high patient satisfaction, reaching clinical important thresholds at a high rate at a minimum 2-year follow-up. All patients who attempted to return to sport were able to return to sport participation within 1 year of the surgery.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nontobacco Nicotine Dependence Is Associated With Perioperative Complications and Repeat Surgery After Arthroscopic Rotator Cuff Repair.","authors":"Samuel A Florentino, Alexander N Berk, Logan M Good, Jeremy M Adelstein, Robert J Wetzel, George Ochenjele, Joshua K Napora","doi":"10.1002/arj.70189","DOIUrl":"https://doi.org/10.1002/arj.70189","url":null,"abstract":"<p><strong>Purpose: </strong>To compare perioperative complications and revision surgery rates between following primary rotator cuff repair among patients with nontobacco nicotine dependence (NTND), no nicotine dependence, and traditional tobacco-related nicotine dependence.</p><p><strong>Methods: </strong>A large database was used to identify patients who underwent primary arthroscopic rotator cuff repair from 2003 to 2023 with a minimum of 2-year follow-up. Patients with NTND, traditional tobacco, and non-nicotine use were matched 1:1. Postoperative complications within 90 days and outcomes at 2 and 5 years were compared. Multivariable logistic regression was used to control for confounders.</p><p><strong>Results: </strong>A total of 6345 NTND patients were matched with 13,398 traditional tobacco users and 80,360 controls. NTND patients had higher 90-day odds of myocardial infarction (odds ratio [OR] 3.817, 95% confidence interval [CI] 1.900-7.668), stroke (OR 2.511, 95% CI 1.452-4.343), pneumonia (OR 1.908, 95% CI 1.225-2.974), emergency department utilization (OR 1.248, 95% CI 1.063-1.464), and hospitalizations (OR 1.659, 95% CI 1.225-2.247) versus nonusers. Compared with tobacco, NTND had lower odds of emergency department visits (OR 0.696, 95% CI 0.607-0.797) and hospitalizations (OR 0.562, 95% CI 0.445-0.709). At 2 years, NTND showed increased odds of subsequent cuff repair (OR 5.836, 95% CI 4.284-7.949) and manipulation under anesthesia or debridement (OR 1.819, 95% CI 1.436-2.304) versus controls. Risks remained significant at 5 years. Compared with tobacco, NTND had significantly higher odds of these procedures at 2 and 5 years. No differences were seen in adhesive capsulitis or total shoulder arthroplasty.</p><p><strong>Conclusions: </strong>NTND is associated with increased perioperative complications and secondary manipulation under anesthesia arthroscopic debridement, or arthroscopic rotator cuff repair following primary arthroscopic rotator cuff repair compared with traditional tobacco users and non-nicotine controls.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance to Axial Traction Decreases Over Time Following Repaired Periportal Capsulotomies During Hip Arthroscopy.","authors":"Benjamin T Johnson, Zoe D Trutner, Allan K Metz, Richard N Puzzitiello, William L Johns, Joseph Featherall, Stephen K Aoki","doi":"10.1002/arj.70192","DOIUrl":"https://doi.org/10.1002/arj.70192","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if distraction distance changes on an axial traction examination between the time zero capsular repair state and a later follow-up traction examination in patients with staged bilateral hip arthroscopies for femoroacetabular impingement syndrome.</p><p><strong>Methods: </strong>Patients between September 2022 and February 2025 who underwent staged, primary bilateral hip arthroscopies for femoroacetabular impingement syndrome with a closed periportal capsulotomy were included. Patients were excluded if they had prior hip surgery or had acetabular pathology beyond a labral tear. Fluoroscopic images were obtained at 0 and 100 pounds of axial traction force (lbf) at multiple time points: preinstrumentation, postcapsulotomy, postcapsular repair, and at follow-up during contralateral hip surgery. Linear regression assessed the change in distraction distance over time between time zero repair and the follow-up distraction distance, whereas logistic regression evaluated factors associated with substantial distraction increase, defined by the minimal detectable change.</p><p><strong>Results: </strong>Forty-one patients (41 hips, mean age 25.7 ± 11.4 years, 66% female) were included. Mean lateral center edge angle was 28.5 ± 5.0° and mean alpha angle was 59.7 ± 7.4°. Mean time between surgeries was 248 ± 191 days [range 43-833]. Compared with the native state, a repaired periportal showed greater resistance to axial traction at 100 lbf (8.50 ± 2.35 mm vs 6.37 ± 2.67 mm; P = .01). Regression analysis showed a significant relationship between time since surgery and increase in distractibility (β = 0.003, 95% confidence interval [0.001-0.006], P = .01). Logistic regression identified female sex (β = 1.74, 95% confidence interval [1.02-31.9], P = .04) as a predictor of a substantial postoperative increases in distractibility (minimal detectable change ≥1.2 mm).</p><p><strong>Conclusions: </strong>A repaired periportal capsulotomy shows increased resistance to axial traction compared with the native state at time zero; however, this resistance progressively decreases over time and returns to the native state on follow-up testing.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: Refractory Osteitis Pubis Appears to Respond Favorably to Endoscopic Pubic Symphysectomy.","authors":"Vivek Jha","doi":"10.1002/arj.70104","DOIUrl":"https://doi.org/10.1002/arj.70104","url":null,"abstract":"<p><p>Osteitis pubis is an important cause of pain in athletes which may be severe enough to prevent participation in sports. While the majority of patients respond to conservative measures, approximately 5% to 10% do require surgery. A variety of surgical options exist ranging from total symphysectomy to arthrodesis. Recent advancements in arthroscopy have allowed arthroscopists to explore endoscopic symphysectomy as a surgical management. Endoscopic pubic symphysectomy does appear to allow for adequate resection and resolution of symptoms with minimal complications and without causing instability. Preliminary good short term results have been reported using this technique. In addition to being less invasive and retaining efficacy, endoscopic pubic symphysectomy can be concomitantly performed with arthroscopic procedures for coexistent conditions like femoroacetabular impingement syndrome, adductor, and rectus abdominis pathologies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: Hip Capsular Healing Is Dynamic-What Axial Traction Reveals After Periportal Repair.","authors":"David R Maldonado","doi":"10.1002/arj.70203","DOIUrl":"https://doi.org/10.1002/arj.70203","url":null,"abstract":"<p><p>Capsular management has become a central focus in hip arthroscopy over the past decade, reflecting our evolving understanding of hip stability and soft-tissue preservation. The conversation has appropriately expanded beyond the binary question of repair versus nonrepair to include how the capsulotomy itself is performed and how much iatrogenic disruption is created in the first place. In my practice, there has been a deliberate shift toward techniques that minimize capsular violation, allow for reliable repair, and aim to leave no lasting footprint of surgical access. The hip capsule is not an inert structure but a living tissue with biologic capacity to heal, remodel, and adapt over time. As such, capsular healing should be viewed as a dynamic process rather than a static, time-zero endpoint. Appreciating this temporal behavior is essential when interpreting biomechanical data, counseling patients, and refining postoperative rehabilitation strategies. Continued efforts to align surgical technique with capsular biology will ultimately define the next phase of hip arthroscopy.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: Tobacco or Not-All Nicotine Products Negatively Impact Rotator Cuff Surgery.","authors":"Justin J Ernat","doi":"10.1002/arj.70199","DOIUrl":"https://doi.org/10.1002/arj.70199","url":null,"abstract":"<p><p>Rotator cuff repair is one of the most common elective orthopaedic surgeries performed; however, failure rates have been reported to range from 10% to 94% depending on the tear characteristics and other patient risk factors. One of the most common risk factors for failure is tobacco use. However, despite decreasing rates of tobacco use in recent years, the use of nontobacco-based nicotine products has become more commonplace, particularly in younger populations. The impact of these newer nicotine delivery products on orthopaedic surgery has been a topic of recent interest but minimally explored in the realm of rotator cuff surgery. It is imperative that our knowledge of risk factors for surgical complications evolves linearly with the socioeconomic and lifestyle factors that impact our public health sector.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}