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

{"title":"Steven F. DeFroda, M.D., M.E., Associate Editor, Arthroscopy Techniques","authors":"Michael J. Rossi M.D., M.S. (Editor-in-Chief)","doi":"10.1016/j.arthro.2025.04.012","DOIUrl":"10.1016/j.arthro.2025.04.012","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page 2168"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329961","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":"Derek H. Ochiai, M.D., Associate Editor, Arthroscopy Techniques","authors":"Michael J. Rossi M.D., M.S. (Editor-in-Chief)","doi":"10.1016/j.arthro.2025.04.022","DOIUrl":"10.1016/j.arthro.2025.04.022","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page 2168"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329962","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":"Adhesive Capsulitis of the Shoulder","authors":"Joseph P. Mullen B.S.,&nbsp;Tyler M. Hauer M.D.,&nbsp;Emily N. Lau M.D.,&nbsp;Albert Lin M.D.","doi":"10.1016/j.arthro.2025.03.027","DOIUrl":"10.1016/j.arthro.2025.03.027","url":null,"abstract":"<div><div>Adhesive capsulitis is characterized by limited range of motion (ROM) due to adhesions within the glenohumeral joint capsule. The pathophysiology is suspected to involve an inflammatory reaction progressing to fibrotic contracture. Active fibroblastic proliferation can be found on histologic analysis, with some transformation to myofibroblasts, ultimately creating collagen in the form of a thick band. Clinically, adhesive capsulitis is classified into phases: freezing, frozen, and thawing. Risk factors include diabetes, hyperthyroidism, prior fractures, shoulder and cervical spine surgery, and radiation therapy. The condition affects 2% to 5% of individuals, with higher rates in women. While plain radiographs are often unremarkable, magnetic resonance imaging may reveal a thickened capsule, synovial hypertrophy, and joint capsule edema. Nonsurgical treatment focuses on pain relief and restoring ROM and includes physical therapy (PT), oral anti-inflammatory medications, corticosteroid injections, extracorporeal shock wave therapy, and ultrasonography-guided hydrodistention. Early corticosteroid injections are associated with shortened symptom duration and improved functional scores. Both a rotator interval approach, compared with a posterior approach, and lower dosages (10 mg vs 40 mg) of corticosteroid may lead to better pain relief and functional improvement. Ultrasound-guided hydrodilatation with hyaluronic acid combined with PT has also shown superior outcomes compared with PT alone. For patients with diabetes, extracorporeal shock wave therapy avoids potential metabolic complications from steroids. Adhesive capsulitis is self-limiting, with most patients achieving symptom resolution without surgery. Surgical intervention, typically considered after 9 to 12 months of failed nonsurgical management, includes arthroscopic capsular release, manipulation under anesthesia (MUA), or both. Both approaches are efficacious, with improved pain, ROM, and functional scores. Although MUA may be more cost-effective, arthroscopy allows direct visualization and treatment of pathology while reducing the risk of complications from MUA, such as fracture, dislocation, or nerve injury. Postoperative protocols emphasize early PT supplemented by multimodal pain management to maintain and improve ROM.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Pages 2176-2178"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329963","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":"Surgical Treatment and Complications of Lateral Extra-Articular Procedures in the ACL reconstructed Knee: Part II of An International Consensus Statement.","authors":"Bertrand Sonnery-Cottet, Alessandro Carrozzo, Adnan Saithna, Edoardo Monaco, Thais Dutra Vieira, Volker Musahl, Alan Getgood, Camilo Partezani Helito","doi":"10.1016/j.arthro.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.013","url":null,"abstract":"<p><strong>Purpose: </strong>To establish international expert consensus on surgical techniques, complications, and rehabilitation protocols for lateral extra-articular procedures (LEAPs) performed adjunctively with anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>Fifty-five knee surgeons from 17 countries on five continents completed a three-round modified Delphi process. In the final round, 16 statements on LEAP techniques and complications were scored on a 5-point Likert scale; ≥75 % \"agree/strongly agree\" constituted consensus. When appropriate, strength of recommendation was graded. Statements lacking support were revised until consensus or abandonment.</p><p><strong>Results: </strong>Six statements achieved unanimous consensus (100 %), two strong consensus (90-99.9 %), and three consensus (75-89.9 %); four were removed. Key technical recommendations were: (1) in iliotibial-band (ITB) procedures, the graft strip should pass beneath the lateral collateral ligament (LCL); (2) an anatomic technique is mandatory for anterolateral ligament reconstruction (ALLR); and (3) no single LEAP is clinically superior to another. Unanimous agreement indicated that modern LEAPs do not increase lateral-compartment osteoarthritis risk, carry a low complication rate, and do not necessitate changes to rehabilitation or return-to-play timelines.</p><p><strong>Conclusions: </strong>Consensus defined core surgical principles and confirmed the safety of adding LEAPs to ACL reconstruction. When an ITB graft is used, it should be routed deep to the LCL and fixed between 0° and 60° of knee flexion under low tension. For ALLR, femoral fixation should be in full extension at a posterior-proximal point relative to the lateral epicondyle. Although no single LEAP proved superiority, adherence to these principles permits safe, effective surgery without altering standard rehabilitation or return-to-sport protocols and without increasing osteoarthritis risk.</p><p><strong>Level of evidence: </strong>Level V, Expert consensus.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369572","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":"Indications for Lateral Extra-Articular Procedures in the ACL Reconstructed Knee: Part I of An International Consensus Statement.","authors":"Bertrand Sonnery-Cottet, Alessandro Carrozzo, Adnan Saithna, Edoardo Monaco, Thais Dutra Vieira, Volker Musahl, Alan Getgood, Camilo Partezani Helito","doi":"10.1016/j.arthro.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.012","url":null,"abstract":"<p><strong>Purpose: </strong>To define expert consensus on if and how lateral extra-articular procedures (LEAPs) should accompany anterior cruciate ligament (ACL) reconstruction to optimise outcomes in ACL-deficient knees.</p><p><strong>Methods: </strong>Fifty-five knee surgeons from 17 countries on five continents completed a three-round modified Delphi process. Twenty-one statements on patient selection for combined ACL reconstruction (ACLR) + LEAPs were graded on 5-point Likert scales; ≥75 % \"agree/strongly agree\" signified consensus. Strength of recommendation was ranked, and statements failing threshold were revised or discarded after discussion.</p><p><strong>Results: </strong>One statement achieved unanimous agreement (100 %): it's strongly reccomendend to add a LEAP for active patients ≤25 years receiving hamstring-autograft ACLR to reduce graft failure. Strong consensus (≥90 %) supported LEAPs in primary ACLR when grade-3 pivot shift (97.9 %), knee hyperextension (97.9 %), skeletally immature status (79.5 %), revision ACLR (91.5 %), return to pivoting sports (93.2 %), active patients ≤25 years using non-hamstring grafts (90.7 %), grade-3 Lachman test (90 %), and when multiple relative risk factors coexist (statement #36, 97.1 %). Consensus (75-89.9 %) favoured LEAPs for chronic symptomatic ACL deficiency (86.1 %), posterior tibial slope >12° (85.7 %), and a history of contralateral ACL injury (88.9 %). Eight statements did not reach consensus regarding small-diameter autografts, female athletes, imaging signs of anterolateral injury (e.g., Segond fracture, lateral femoral-notch sign), and concomitant meniscal procedures. One statement on LEAPs with primary ACL repair was withdrawn because the project focused on reconstruction.</p><p><strong>Conclusions: </strong>International experts strongly recommend adding a LEAP in young active patients undergoing hamstring-autograft ACLR and in cases of high-grade rotational or anterior laxity, knee hyperextension, revision surgery, or returning to pivoting sports. Unresolved issues include small graft size, female athletes, imaging-findings of rotational instability, and concurrent meniscal procedures, highlighting priorities for future research.</p><p><strong>Level of evidence: </strong>Level V, Expert opinion.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369571","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":"Cover Image & Video Link","authors":"","doi":"10.1016/S0749-8063(25)00380-9","DOIUrl":"10.1016/S0749-8063(25)00380-9","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page A20"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329958","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":"Kyle N. Kunze, M.D., Associate Editor","authors":"Michael J. Rossi M.D., M.S. (Editor-in-Chief)","doi":"10.1016/j.arthro.2025.03.056","DOIUrl":"10.1016/j.arthro.2025.03.056","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page 2167"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329960","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":"Combined Transosseous and Capsular Repair for TFCC Tears with DRUJ Instability-A Step Toward Comprehensive Joint Stabilization.","authors":"Julia A V Nuelle","doi":"10.1016/j.arthro.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.014","url":null,"abstract":"<p><p>Triangular fibrocartilage complex (TFCC) tears involving the foveal attachment are a known cause of distal radioulnar joint (DRUJ) instability. While transosseous repair of the deep TFCC fibers is a widely accepted technique for restoring DRUJ instability, persistent instability remains a clinical challenge in a subset of patients. Combining transosseous repair with volar and dorsal capsular repair is an important technique to consider when treating Atzei Class 2 TFCC tears. This evolving approach reflects a more comprehensive appreciation of the TFCC as a complex stabilizing unit, rather than an isolated ligamentous structure.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369570","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":"Knee Joint Line Obliquity Continues to Regress Beyond 1 Year and Stabilizes at 3 Years After Open Wedge High Tibial Osteotomy Without Correlation to Clinical Outcome.","authors":"Ju-Ho Song, Bum-Sik Lee, Jong-Min Kim, Seong-Il Bin","doi":"10.1016/j.arthro.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.005","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate midterm serial postoperative changes in the knee and adjacent joints, with a focus on the knee joint obliquity (KJLO).</p><p><strong>Methods: </strong>Patients undergoing open wedge high tibial osteotomy (OWHTO) between January 2011 and December 2018 were retrospectively reviewed. Those with a follow-up duration of ≥5 years and serial long-standing hip-to-ankle radiographs were included. KJLO and joint line convergence angle (JLCA) were measured at the knee joint. The influence of the hip joint was assessed using the hip abduction angle (HAA), and the influence of the ankle joint was evaluated using the ankle joint line obliquity (AJLO) and the tibiotalar angle (TAA). Serial changes in the radiographic parameters (preoperative, 3-month, 1-year, 3-year, and 5-year postoperative) were analyzed using repeated measures correlation. Clinical outcomes were evaluated using the Knee Society objective and functional scores.</p><p><strong>Results: </strong>A total of 105 knees were followed up for 90.2 ± 27.2 months (range, 60-151 months). KJLO increased from -0.7 ± 0.2° (mean ± standard error) preoperatively to 2.5 ± 0.3° at 3 months postoperatively and to 3.0 ± 0.2° at 1 year postoperatively (p=0.026, vs. 3-month postoperative), but subsequently decreased to 2.9 ± 0.2° at 3 years postoperatively (p<0.001, vs. 1-year postoperative) and to 2.7 ± 0.3° at 5 years postoperatively, with no significant difference between the 3- and 5-year values (p=0.609, vs. 3-year postoperative). Similarly, HAA increased until 1 year postoperatively (p<0.001, vs. 3-month postoperative), and then decreased significantly until 5 years postoperatively (p<0.001, vs. 1-year postoperative). However, AJLO showed a significant decrease between 3 months and 1 year postoperatively (p<0.001), with no further significant changes observed between 1 and 5 years postoperatively (p=0.225). According to the repeated measures correlation, the factors significantly correlating with changes in KJLO were HAA (p<0.001), AJLO (p<0.001), and JLCA (p=0.028). Five-year postoperative KJLO did not have significant correlations with the Knee Society objective (p=0.845) and functional (p=0.361) scores.</p><p><strong>Conclusion: </strong>KJLO increased after OWHTO and began to decrease from 1 year postoperatively, with no significant difference observed between 3 and 5 years. This change did not correlate with clinical outcomes. HAA showed a similar pattern, increasing until 1 year and then continuing to decrease significantly throughout the midterm follow-up. AJLO showed a significant decrease within the first postoperative year, with no further changes thereafter.</p><p><strong>Level of evidence: </strong>Level III, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340722","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":"Rates of Return to Sport Following Surgical Management of Multi-ligament Knee Injuries Are Higher Than Previously Described Yet Highly Heterogeneous: A Systematic Review.","authors":"Joshua Dworsky-Fried, Satyavenkata Kotipalli, Prushoth Vivekanantha, Meshal Alomari, Sachin Tapasvi, Gilbert Moatshe, Ryan Martin, Darren de Sa","doi":"10.1016/j.arthro.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.006","url":null,"abstract":"<p><strong>Purpose: </strong>To provide an updated overview of return to sport (RTS) and return to work (RTW) following surgical management of multi-ligament knee injuries (MLKIs).</p><p><strong>Methods: </strong>A search was conducted across MEDLINE, Embase, and PubMed from inception to August 26th, 2024. Studies published after 2018 that reported on rates of RTS or RTW following multi-ligament knee reconstruction were included. PRISMA guidelines were followed, and a quality assessment was performed using the MINORS criteria. Data on study characteristics, demographics, and surgical details were extracted. Rates of RTS or RTW at the same or at any level of participation were recorded. Random effects models were used to generate forest plots.</p><p><strong>Results: </strong>Fifteen studies reported on RTS, with rates ranging from 41.2% to 100% when investigating RTS at any level. Thirteen studies reported rates of return to pre-injury level, ranging from 5.9% to 100%. RTS rates at any level and pre-injury level had higher ceilings than shown in a prior systematic review. Time taken to RTS ranged from 6.7 to 24.9 months. Twelve studies reported on RTW at any capacity, with rates ranging from 41% to 100%. Seven studies reported rates of RTW to pre-injury capacities, ranging from 39.3% to 100%. For both RTS and RTW outcomes, high heterogeneities precluded pooled estimates. Time taken to RTW ranged from 2.4 to 24.8 months. Substantially lower RTW rates were associated with multi-trauma dislocations and sedentary occupations.</p><p><strong>Conclusions: </strong>Rates of RTS at any level and pre-injury level ranged from 41.2% to 100% and 5.9% to 100% respectively, with corresponding heterogeneity values of 91% and 83%. These rates have higher ceilings than reported in previous systematic reviews. Currently, there is insufficient evidence to recommend one surgical approach over another. Future research should employ standardized RTS criteria, postoperative protocols and outcome measures to better help guide surgical decision-making.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340723","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}