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

{"title":"Experts Achieve Consensus on a Majority of Statements Regarding Ethics, Transparency, Regulation, and Best Practices for the Use of Orthobiologics","authors":"Ron Gilat M.D. ,&nbsp;Sarah A. Muth B.A. ,&nbsp;Eoghan T. Hurley M.B., M.Ch., Ph.D. ,&nbsp;Allen A. Yazdi B.S. ,&nbsp;Chloe H. Franzia B.S. ,&nbsp;Scott A. Rodeo M.D. ,&nbsp;Shane A. Shapiro M.D. ,&nbsp;Rachel M. Frank M.D. ,&nbsp;Brian J. Cole M.D., M.B.A. ,&nbsp;the Biologic Association Member Organization Representatives","doi":"10.1016/j.arthro.2025.01.062","DOIUrl":"10.1016/j.arthro.2025.01.062","url":null,"abstract":"<div><h3>Purpose</h3><div>To establish consensus statements via a modified Delphi process about ethics, transparency, regulation, and best practices for the use of orthobiologics in clinical practice for musculoskeletal pathology.</div></div><div><h3>Methods</h3><div>A consensus process on the regulation of orthobiologics at the provider level was conducted using a modified Delphi technique. Twenty orthopaedic surgeons, sports medicine physicians, or basic scientists participated. Each participant was a Biologic Association member organization representative and asked to participate because of their active interest in the field of orthobiologics. Levels of consensus were delineated according to the number of votes for each statement: no consensus, &lt;80%; consensus, 80% to 89%; strong consensus, 90% to 99%; unanimous, 100%.</div></div><div><h3>Results</h3><div>The 26 consensus statements on orthobiologics resulted in 14 achieving unanimous consensus, 8 achieving strong consensus, 3 achieving consensus, and 1 did not achieve consensus. Overall, 85% of the statements reached either a unanimous or strong consensus. Of the statements regarding communication and transparency, 9 reached unanimous consensus, including information to convey and helpful tools to describe current orthobiologics, persistent misinformation, use of the word “stem cells,” “off-label” use, and problems with the present regulatory environment. Five statements discussing the regulation of novel orthobiologics achieved unanimous consensus. These statements highlighted research regulation, safety, and suggested improvements to regulatory issues. The statement that did not achieve any consensus was on the regulatory processes that should be in place by an institution providing novel orthobiologic treatments. No statement reached a unanimous agreement on cost or ethical considerations.</div></div><div><h3>Conclusions</h3><div>This study successfully identified key consensus statements emphasizing the importance of ethics, transparency, and regulation in the use of orthobiologics, with 85% of statements reaching unanimous or strong consensus. These findings underscore the need for standardized communication, improved regulatory frameworks, and enhanced safety measures while highlighting persistent challenges in addressing cost and ethical considerations.</div></div><div><h3>Level of Evidence</h3><div>Level V, expert opinion.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3611-3621"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411693","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":"Patients Requiring Revision Surgery After Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome Show a Small Reduction of Postoperative Labral Size: A Propensity-Matched Controlled Study","authors":"Yichuan Zhu M.D. ,&nbsp;Rui Sun M.D. ,&nbsp;Tong Zuo M.D. ,&nbsp;Xinzhi He M.D. ,&nbsp;Guanying Gao M.D. ,&nbsp;Yan Xu M.D.","doi":"10.1016/j.arthro.2025.01.065","DOIUrl":"10.1016/j.arthro.2025.01.065","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the changes in labral size after primary hip arthroscopy between patients requiring revision surgery and those did not.</div></div><div><h3>Methods</h3><div><span>Data collected between August 2016 and September 2021 were retrospectively reviewed. Patients diagnosed with femoroacetabular impingement syndrome and undergoing primary and revision hip arthroscopy at our institute were included in the revision group. Exclusion criteria were Tönnis grade &gt;1, concomitant hip conditions, and incomplete magnetic resonance imaging (MRI) data. Patients who did not undergo revision surgery or conversion to </span>total hip arthroplasty at minimum 2-year follow-up were matched in a 1:2 ratio and included in the control group. The labral size (width and height at 11:30, 1:30, and 3:00) on MRI (noncontrast, 3.0 T) before and after 12 months of primary surgery was compared.</div></div><div><h3>Results</h3><div>Twenty-one patients were included in the revision group, and 42 patients were matched in the control group. In the revision group, significant reduction in labral width and height at 11:30 and 1:30, and labral width at 3:00 was observed at 12 months after primary hip arthroscopy (all with <em>P</em> &lt; .05), whereas the control group did not show significant difference of changes in labral size (all with <em>P</em> &gt; .05). Smaller postoperative labral width at 1:30 and 3:00 was observed in the revision group compared with the control group (all with <em>P</em> &lt; .05). The revision group presented with greater reduction of labral width at all 3 positions and labral height at 1:30 compared with the control group (all with <em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Patients requiring revision surgery after primary hip arthroscopy for femoroacetabular impingement syndrome presented with smaller postoperative labral size (less than 1 mm difference) and greater reduction of labral size (at or less than 1mm difference) on MRI 12 months after primary surgery compared with those patients that did not require later revision surgery.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective case control.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3569-3576.e2"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473222","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: Female Athletes Have Unique Anterior Cruciate Ligament Injury Recovery Timelines: The Need for Better Research on Women’s ACL Reconstruction","authors":"Kate E. Webster Ph.D.","doi":"10.1016/j.arthro.2025.04.030","DOIUrl":"10.1016/j.arthro.2025.04.030","url":null,"abstract":"<div><div>Historically, anterior cruciate ligament reconstruction research has favored male participants, leaving gaps in understanding female-specific experiences. Recent efforts have begun to address this by focusing on female cohorts. Female patients generally face slower recovery trajectories, which are influenced by an interplay of biological factors and lifestyle choices. This underscores the need for women-only studies to clarify how these factors uniquely shape recovery as mixed-sex research often obscures critical differences.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3460-3461"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053540","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":"Quadratus Lumborum Block Provides Similar or Reduced Postoperative Pain and Opioid Consumption Compared to Control Following Hip Arthroscopy: A Systematic Review","authors":"Muzammil Akhtar B.S. ,&nbsp;Mustafa Jundi B.S. ,&nbsp;Iqbal Khan B.S. ,&nbsp;Sonia Aamer B.S. ,&nbsp;Anand Dhaliwal M.D. ,&nbsp;Lillian Jundi M.D. ,&nbsp;Trevor Shelton M.D., M.S.","doi":"10.1016/j.arthro.2025.01.041","DOIUrl":"10.1016/j.arthro.2025.01.041","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether the quadratus lumborum (QL) block is associated with reduced postoperative pain<span> and opioid consumption in patients undergoing hip arthroscopy.</span></div></div><div><h3>Methods</h3><div>A search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed in PubMed, Embase, Scopus, and Cochrane Library databases to identify comparative studies of patients undergoing the QL block before hip arthroscopy. The primary outcomes of interest included postoperative pain and opioid consumption.</div></div><div><h3>Results</h3><div>Eight studies (5 randomized, 3 nonrandomized) with 274 patients receiving the QL block were included. Control groups included no block (3 studies), sham block (2 studies), pericapsular injection of anesthetic (1 study), lumbar plexus block (1 study), and femoral nerve/fascia iliaca block (1 study). In 1 randomized and 2 nonrandomized studies, the pain scores were significantly lower, at all postoperative time points, in the QL block versus sham, no block, and femoral nerve/fascia iliaca control groups. The same 3 studies reported significantly less opioid consumption in the QL group at all measured postoperative time points. The remaining 5 studies reported mostly no significant differences in pain scores and opioid consumption at multiple postoperative time points. In no study did the QL block group have significantly more pain or opioid consumption relative to the control groups.</div></div><div><h3>Conclusions</h3><div>Compared to a variety of control groups, the QL block provides similar or reduced postoperative pain and opioid consumption in patients undergoing hip arthroscopy.</div></div><div><h3>Level of Evidence</h3><div>Level III, systematic review of Level I and III studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3789-3800"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366853","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":"Both Arthroscopically Assisted Suture Button and Hook Plate Are Effective in Treating Acute High-grade Acromioclavicular Joint Dislocation: A Systematic Review","authors":"Junbo Liang M.D. ,&nbsp;Dawei Han M.M. ,&nbsp;Xiaofang Ying M.S. ,&nbsp;Cong Chen M.M. ,&nbsp;Hua Luo M.M.","doi":"10.1016/j.arthro.2025.03.035","DOIUrl":"10.1016/j.arthro.2025.03.035","url":null,"abstract":"<div><h3>Purpose</h3><div>To conduct a systematic review<span> of clinical studies comparing the clinical outcomes of arthroscopically assisted suture button (AASB) and hook plate (HP) in the treatment of acute high-grade acromioclavicular joint (ACJ) dislocation to determine which technique provides superior clinical benefits.</span></div></div><div><h3>Methods</h3><div>Two independent researchers conducted literature searches on the basis of Preferred Reporting Items from Systematic Reviews and Meta-analyses guidelines. PubMed, EMBASE, and the Cochrane Library were searched for studies that compared AASB and HP in treating acute high-grade (grade Ⅲ and greater) ACJ dislocation. Inclusion criteria included clinical studies that compared AASB and HP for acute Rockwood type III or greater dislocations with evaluations of functional outcomes (Constant score [CS], pain score, American Shoulder and Elbow Surgeons score, Disabilities of the Arm, Shoulder and Hand). Studies were excluded if they were case reports, reviews, or had missing data, revision procedures, or had loss to follow-up &gt;20%. The methodologic quality of the included studies was assessed on the basis of Newcastle-Ottawa scale.</div></div><div><h3>Results</h3><div><span>In this systematic review, 14 studies with 782 participants were included, all of which were classified as Level III-IV evidence. The analysis of 12 studies showed that the AASB group (81.9-95.31) had only slightly greater postoperative CS compared with the HP group (77.5-92.38), with 9 studies reporting significant improvements, whereas 3 studies found no significant difference compared with the HP group. For pain outcomes, 4 studies showed lower pain score in the AASB group, whereas the rest found no significant difference; the visual analog scale scores ranged from 0.3 to 3.61 in the AASB group and 0.5 to 4.9 in the HP group. Operation time was generally longer in the AASB group (AASB: 48.3-89.39 minutes; HP: 40.77-76.5 minutes). Complication rates were similar (AASB: 0%-50%; HP: 0%-36.36%), with only 1 study reporting a greater incidence in the AASB group. </span>Minimal clinically important difference analysis from 3 studies showed clinically significant improvements in CS with AASB, but no significant difference between AASB and HP for pain outcomes.</div></div><div><h3>Conclusions</h3><div>AASB shows comparable outcomes to HP for acute high-grade ACJ dislocations, with similar ranges in clinical scores and complication rates. Although AASB shows some advantages in functional outcomes, the differences between the 2 methods are minimal, suggesting that both approaches are effective and safe.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level Ⅲ-IV studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3733-3747.e1"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782108","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: Postoperative Capsulolabral Adhesions May Contribute to the Need for Revision Hip Arthroscopy After Adequate Bony Resection in Patients With Femoroacetabular Impingement","authors":"Elizabeth J. Scott M.D. (Editorial Board)","doi":"10.1016/j.arthro.2025.04.016","DOIUrl":"10.1016/j.arthro.2025.04.016","url":null,"abstract":"<div><div>Recent research shows a small but statistically significant reduction in hip labral size in hips requiring revision after primary arthroscopy for femoroacetabular impingement syndrome. What drives this divergence in healing? Rather than fixating on differences measured in millimeters, let’s focus on labral healing resulting in the need for revision independent of residual impingement. A hypothesis is that capsulolabral adhesions, a dynamic and 3-dimensional problem, may play a role. As bony correction techniques have improved, attention must shift to the complex and undercharacterized processes of soft-tissue healing. Routine assessment and reporting of adhesions in revision femoroacetabular impingement studies are essential to our understanding of labral mechanics, failure patterns, and postoperative care.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3577-3578"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023117","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: Lateral Extra-articular Augmentations in Anterior Cruciate Ligament Reconstruction Reduce Anterior Cruciate Ligament Graft Failure and Secondary Meniscectomy and Are Indicated for Anterior Cruciate Ligament Primary and Revision Reconstruction","authors":"Camilo Partezani Helito M.D., Ph.D. (Editorial Board),&nbsp;Andre Giardino Moreira da Silva M.D.","doi":"10.1016/j.arthro.2025.04.018","DOIUrl":"10.1016/j.arthro.2025.04.018","url":null,"abstract":"<div><div>In the past decade, increasing evidence supports knee lateral extra-articular tenodesis or anterolateral ligament reconstruction for anterolateral rotational instability in patients requiring anterior cruciate ligament (ACL) reconstruction. Extra-articular augmentation reduces the risk of ACL graft failure, particularly in high-risk populations. Recent research shows a 3-fold lower risk of failure and a lower rate of secondary meniscectomy. Indications include revision ACL reconstruction, pivoting sports participation, high-grade pivot shift, hyperlaxity or knee hyperextension, anterolateral complex injury on imaging evaluation, chronic ACL tear, meniscus repair, increased anterior translation (&gt;7 mm), and posterior tibial slope &gt;12°. We perform extra-articular procedures for every patient at high risk for rerupture, which currently accounts for more than 90% of our primary ACL reconstruction cases. Lateral extra-articular procedures may also be a viable option for treating patients who have undergone isolated ACL reconstruction and have symptomatic minor instabilities and an intact ACL graft.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3435-3438"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041312","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":"Arthroscopy’s Third Annual Musculoskeletal Biologics Special Issue Highlights Orthobiologics Having Current Impact and Future Promise","authors":"Michael J. Rossi M.D., M.S. (Editor-in-Chief),&nbsp;Elizabeth Matzkin M.D. (Deputy Editor)","doi":"10.1016/j.arthro.2025.05.030","DOIUrl":"10.1016/j.arthro.2025.05.030","url":null,"abstract":"<div><div><em>Arthroscopy</em>’s Third Annual Musculoskeletal Biologics Special Issue delivers the most nascent scientific research and techniques from selected top publications and authors. These articles, published in our family of journals, feature a mix of infographics, basic science, clinical research, systematic reviews and meta-analyses, and technical notes with video content. We congratulate the selected authors for their inclusion in this Special Issue and continue the Call for Papers to promote and publish orthobiologic research in musculoskeletal medicine.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3277-3280"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250996","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":"Minimal Hip Flexion Increase During Gait After Femoroacetabular Impingement Surgery: A Systematic Review and Meta-Analysis of Pre- and Postoperative 3-Dimensional Motion Analysis.","authors":"Talissa O Generoso, Felipe F Gonzalez, Alexandre R M Pelegrinelli, Lucas V Pallone, Renato Locks, Eliane C Guadagnin, Jorge Chahla, Jonathan A Gustafson, Leonardo Metsavaht, Gustavo Leporace","doi":"10.1016/j.arthro.2025.07.015","DOIUrl":"10.1016/j.arthro.2025.07.015","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of surgical treatment on gait biomechanics in patients with femoroacetabular impingement syndrome (FAIS).</p><p><strong>Methods: </strong>A comprehensive search of 6 databases (from inception to 2024) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (CRD4202347397). Studies using 3-dimensional motion analysis to examine gait kinematics and/or kinetics in patients with FAIS before and after hip surgery were included. Studies analyzing data from patients with FAIS who had undergone surgery but lacked baseline presurgical data from the same patients or compared patients to controls without evaluating both pre- and postsurgical biomechanics were excluded. Qualitative and quantitative analyses were performed.</p><p><strong>Results: </strong>Thirteen studies were reviewed qualitatively, and 12 were included in the meta-analysis, encompassing 279 presurgical and 268 postsurgical patients. Motion analysis was conducted 6 to 24.2 months postoperatively. Meta-analysis showed a statistically significant improvement of 1.3° in peak hip flexion angle during the gait cycle, although this may have limited clinical relevance. Other kinematic and kinetic parameters did not show significant differences. The quality of the studies was moderate or high.</p><p><strong>Conclusions: </strong>This study showed a statistically significant increase in peak hip flexion and abduction angle throughout the gait cycle after surgery, although these changes were clinically negligible. The lack of significant changes in other kinematic and kinetic parameters indicates that factors beyond bone deformities may influence outcomes. These findings highlight the multifactorial nature of FAIS and suggest gait analysis alone may not fully capture postoperative biomechanical adaptations.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level I to IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796181","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: Remnant-Preserving Anterior Cruciate Ligament Reconstruction Shows Long-Term Advantages, but Patient Selection, Characterization of Remnant Tissue, and Efficacy in Patients at Risk of Postoperative Knee Instability Are Areas for Future Investigation.","authors":"Jay Moran, Etienne Cavaignac, Jorge Chahla","doi":"10.1016/j.arthro.2025.08.014","DOIUrl":"10.1016/j.arthro.2025.08.014","url":null,"abstract":"<p><p>Remnant preservation is one specific anterior cruciate ligament (ACL) reconstruction technique that has been explored to improve outcomes and involves retaining, as opposed to debriding, the \"remnant\" or native ACL tibial stump at the time of reconstruction. The ACL remnant tissue contains important mechanoreceptors and nerve endings, and preservation of this tissue is thought to enhance biological healing within the bone tunnels, graft ligamentization, maturation, synovialization, and proprioception, as well as reduce the risk of tunnel enlargement. Remnant preservation may also offer several technical advantages such as creation of a biological sleeve for the graft and improved anatomic graft placement. The indications for remnant preservation remain unclear, but greater than 50% thickness of remaining remnant tissue is our recommended threshold for preservation. Although long-term clinical studies are currently lacking, multiple short- and mid-term follow-up studies have suggested that remnant-preserving techniques can offer significantly superior pivot-shift outcomes and anterior knee stability, in addition to lower graft rerupture rates. Ultimately, remnant-preserving ACL reconstructions are exciting techniques that appear to offer a variety of benefits, but patient selection and indications, standardized characterization of the remnant tissue, and assessment of the long-term efficacy in patients at risk of residual postoperative rotational knee instability are still areas for future investigation.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979681","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}