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

{"title":"Transtibial Centralization Using Peripheral Stabilization Suture Reduces Medial Meniscus Extrusion and Varus Progression 1 Year After Medial Meniscus Posterior Root Tear Repair.","authors":"Shogo Hashimoto, Takeshi Shimada, Ryota Takase, Hibiki Kakiage, Takashi Ohsawa, Hirotaka Chikuda","doi":"10.1002/arj.70198","DOIUrl":"https://doi.org/10.1002/arj.70198","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical and structural effects of adding peripheral stabilization suture (PSS), an additional transtibial pullout centralization technique, to conventional transtibial pullout repair for medial meniscus posterior root tears (MMPRTs).</p><p><strong>Methods: </strong>A retrospective review was conducted of patients who underwent MMPRT repair between April 2019 and March 2024 with at least 1 year follow-up. Patients were divided into conventional pullout repair and pullout repair combined with PSS. Medial meniscus extrusion (MME) was evaluated by magnetic resonance imaging (MRI) preoperatively and at 1 year postoperatively. Radiographic parameters including hip-knee-ankle angle (HKA), mechanical axis (%MA), and Kellgren-Lawrence (KL) grade were assessed. Patient-reported outcome measures (PROMs) were also collected. Minimal clinically important difference (MCID) for MME was calculated, and the proportion of patients exceeding this threshold was compared between groups.</p><p><strong>Results: </strong>Thirty-five patients were included. At 1 year postoperatively, the PSS group showed significantly less MME (5.3 mm vs. 3.2 mm; P < .001), fewer cases of varus alignment progression (12 vs. 5; P = .018), and less radiographic KL classification progression (11 vs. 5; P = .044) compared to the conventional group. The %MA remained unchanged in the PSS group but significantly shifted medially in the conventional group. PROMs improved significantly in both groups, with no significant differences between them. MCID analysis showed that the rate of clinically meaningful worsening of MME was significantly higher in the conventional group than in the PSS group (15/17 [88.2%] vs 4/18 [22.2%], P < .001).</p><p><strong>Conclusions: </strong>The addition of PSS to conventional pullout repair for MMPRT effectively reduced postoperative MME and suppressed the progression of varus alignment and osteoarthritic changes at 1 year postoperatively, while both groups showed significant but comparable improvements in PROMs.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</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":"147823627","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: Is Standard Repair Enough for Posterior Medial Meniscus Root Tears? Early Promise of Meniscus Centralization.","authors":"Mina Entessari, Alan W Reynolds","doi":"10.1002/arj.70212","DOIUrl":"https://doi.org/10.1002/arj.70212","url":null,"abstract":"<p><p>Posterior medial meniscal root tears and meniscal extrusion have come under increasing focus in recent years, with management that prevents or delays advancing degenerative changes in the medial compartment being the ultimate goal. Although meniscal root repair can restore meniscal function and slow degeneration, it does not eliminate osteoarthritis progression, with conversion to total knee arthroplasty reported as high as 33%. Augmenting posterior medial meniscal root repair with centralization techniques appears to reduce short-term postoperative extrusion and may mitigate early radiographic progression of osteoarthritis, in addition to its biomechanical superiority. It is certainly a worthy focal point of study, and an increasingly proven surgical technique to support the at-risk medial compartment.</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":"147823629","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: Capsule-Sparing Hip Arthroscopy: Preserving Stability Without Compromising Outcomes.","authors":"Alan L Zhang","doi":"10.1002/arj.70206","DOIUrl":"https://doi.org/10.1002/arj.70206","url":null,"abstract":"<p><p>Capsule-sparing techniques in hip arthroscopy including periportal and puncture capsulotomy aim to minimize disruption of the iliofemoral ligament while maintaining adequate visualization and treatment of intra-articular pathology. By limiting iatrogenic injury to the capsule, these approaches may offer advantages such as reduced scar tissue or adhesions, avoidance of need for capsular closure, and potentially faster recovery. Concerns remain regarding technical difficulty of these techniques and the ability to adequately visualize and maneuver in all cases. Current evidence suggests that capsule-sparing techniques can achieve comparable patient-reported outcomes to traditional interportal or T-capsulotomy techniques with capsule closure. Capsular management should therefore be individualized to the patient as well as the surgeon, balancing preservation of native anatomy with proper surgical exposure and efficiency.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823695","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 Database Studies in Orthopaedics and Sports Medicine Have Inherent Limitations and Biases That Must be Acknowledged and Managed.","authors":"George C Balazs, Matthew Salzler, Michal J Rossi","doi":"10.1002/arj.70268","DOIUrl":"https://doi.org/10.1002/arj.70268","url":null,"abstract":"<p><p>An increasing number of orthopaedic and sports medicine research studies use large databases of electronic health records and claim data aggregated from multiple health systems and corporations. While these databases benefit from study populations far larger than any single institution, they create additional risks of bias that may not exist in traditional orthopaedic clinical research designs. Researchers need to consider how the health data is transformed (\"harmonized\") into research data, how much data is missing, whether the length of follow-up within the database is disclosed, and whether the quality of the data input is uniform across contributing institutions. In some cases, these data may not be disclosed, especially for databases maintained by private for-profit entities. It remains unclear whether the perceived benefits of these databases truly outweigh concerns about transparency and bias, which need to be acknowledged and managed when presenting the data-supported conclusions.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823661","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":"Periportal and Puncture Capsulotomy Techniques Have Similar Outcomes to Traditional Capsulotomies With Closure in Hip Arthroscopy: A Systematic Review and Meta-analysis of 2-Year Outcomes.","authors":"Brandon J Allen, Jeffrey S Mun, Srish S Chenna, Rachel L Poutre, Kieran S Dowley, Stephen M Gillinov, Bilal S Siddiq, Nathan J Cherian, Chris T Eberlin, Scott D Martin","doi":"10.1002/arj.70207","DOIUrl":"https://doi.org/10.1002/arj.70207","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically evaluate capsulotomy techniques through patient-reported outcome measures, rates of revision arthroscopy, conversion to total hip arthroplasty, and achievement of clinically meaningful outcomes.</p><p><strong>Methods: </strong>PubMed, Scopus, and Embase databases were queried in June 2024 for studies that could be used to compare capsular management strategies primarily via patient-reported outcome measures at a minimum 2-year follow-up. Inclusion criteria consisted of patients who underwent primary hip arthroscopy for the treatment of femoroacetabular impingement, minimum 2-year follow-up, and reported capsulotomy type. Based on the capsular management technique performed, groups were defined as interportal capsulotomy with closure, T-capsulotomy with complete closure, periportal capsulotomy, or puncture capsulotomy. Heterogeneity was adjusted for using metaregression models.</p><p><strong>Results: </strong>Of the 1322 unique studies identified in our search, 8 studies (1961 hips) were included. The combined puncture capsulotomy and periportal capsulotomy group (mean difference range, 21.30-32.56) performed similarly to interportal capsulotomy with closure (mean difference range, 18.33-32.00) and T-capsulotomy with complete closure (mean difference range, 20.70-23.30) groups in modified Harris Hip Score (P = .274). This continued when evaluating revision and total hip arthroplasty rates (proportion range, 0.0-0.05 and 0.0-0.01, respectively). Metaregression adjustments found baseline modified Harris Hip Score significantly influences mean differences (adjusted mean difference, -0.53 [-0.83, -0.23], P = .0006). When considering the achievement rates of minimal clinically important difference, all capsulotomy methods were similar for modified Harris Hip Score; however, minimal clinically important difference thresholds had a significant influence of -0.46 (95% confidence interval, [-0.54, -0.39], P < .0001) based on a metaregression model.</p><p><strong>Conclusions: </strong>Periportal and puncture capsulotomy techniques did not yield statistically different outcomes compared with traditional capsulotomy techniques that use capsular closure at 2-year follow-up.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level II to IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789867","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: Repair of Proximal Hamstring Injuries Leads to Good Outcomes in Most Patients, but Higher Level of Evidence Suggests We Might Not Need to Repair Them All in the First Place.","authors":"Jelle P van der List","doi":"10.1002/arj.70169","DOIUrl":"https://doi.org/10.1002/arj.70169","url":null,"abstract":"<p><p>Hamstring injuries are common injuries in recreational and professional athletes. Treatment of these injuries depends on various factors, including age, activity level, type of sport, and tear location such as proximal, myotendinous, muscle, or distal injuries. Proximal hamstring avulsion injuries are a different type of injury and symptoms can consist of cramping, pain, weakness, or even sciatic nerve symptoms. Over the last decade, Level III and IV retrospective cohort studies and case series have suggested an increasing role for operative repair, using either an open, endoscopic, or combined (\"scopen\") approach. More recently, studies have focused on ideal selection criteria for open repair and assessed factors such as age, retraction, activity level, partial versus complete tears, timing, failure of physical therapy, and whether the semimembranosus, semitendinosus, biceps femoris, or combination with conjoined tendon are involved. Overall, outcomes following surgical reattachment are encouraging and patient satisfaction is high with return to sports rates ranging between 60% and 100%. Emerging prospective cohort studies and randomized controlled trials with low crossover rates suggest that nonoperative treatment might lead to equivalent results to operative treatment, so a thorough discussion with patients on both treatments is important for these injuries.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789785","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: Dermal Allograft Is an Ideal Augmentation for Rotator Cuff Repairs at Risk for Failure.","authors":"Albert Lin, Dan Cohen, Camila Grandberg","doi":"10.1002/arj.70194","DOIUrl":"https://doi.org/10.1002/arj.70194","url":null,"abstract":"<p><p>Rotator cuff repair outcomes remain inconsistent, with high retear rates, attributed to multiple risk factors including narrow acromiohumeral distance, elevated critical shoulder angle, larger tear dimensions, fatty infiltration, increased retraction of the torn tendons, and advanced patient age (>63-70 years). Since its introduction, the Rotator Cuff Healing Index, which has been externally validated, is a useful tool for systematic risk stratification that can help guide clinical decision-making, though it should complement rather than supersede surgical judgment.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789839","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":"Open Proximal Hamstring Repair Yields Comparable Outcomes in Patients Older and Younger Than 60 Years.","authors":"Isabelle C Bote, Peter J Georgakas, Evan A Glass, Sophie M Nemec, Suzanne L Miller","doi":"10.1002/arj.70168","DOIUrl":"https://doi.org/10.1002/arj.70168","url":null,"abstract":"<p><strong>Purpose: </strong>To compare patient-reported outcome measures (PROMs) and return-to-sport rates following proximal hamstring repair between patients older than versus younger than 60.</p><p><strong>Methods: </strong>A retrospective study was conducted with patients who have undergone proximal hamstring repair between October 2021 and February 2023. Patients with acute or chronic, partial, or complete proximal hamstring tears who underwent open surgical repair, completed preoperative and postoperative PROMS, and had a minimum follow-up of 24 months were included. PROMs included: Perth Hamstring Assessment Tool (PHAT); Lower Extremity Functional Scale (LEFS); Hip Outcome Score (HOS), including the Activities of Daily Living (ADL) and Sports subscales; and 12-Item Short Forms Survey Questionnaire (SF-12). Patients were stratified into 2 cohorts depending on age at time of surgery: those under versus those 60 years and older (U-60 and O-60, respectively). Univariate analysis was performed to compare cohort demographics and clinical outcomes.</p><p><strong>Results: </strong>Fifty-five of the 59 eligible patients met the inclusion requirements of the study. The U-60 cohort included 36 patients with a mean age of 49.3 (21.8-58.6) years and the O-60 cohort included 19 patients with a mean age of 66 (60.0-75.0) years. The mean follow-up time was 23.3 ± 0.44 months for the O-60 group and 23.4 ± 0.50 months for the U-60 group (P = .664). There were no significant differences between the O-60 and U-60 postoperative PROM scores (LEFS P = .346, HOS-ADL P = .389, HOS-Sports P = .648, PHAT P = .123, SF-12 mental component score P = .943, SF-12 physical component score P = .680). There were no significant differences between groups after disaggregating by sex (females: LEFS P = .273, HOS-ADL P = .278, HOS-Sports P = .963, PHAT P = .146; Males: LEFS P = .536, HOS-ADL P = .099, HOS-Sports P = .693, PHAT P = .446). There were no significant differences in achievement of cohort-specific minimal clinically important difference between the O-60 and U-60 groups for LEFS (P = .345), HOS-ADL (P = .067), HOS-Sports (P = .219), or PHAT (P = .426). These differences remained nonsignificant after disaggregating the data by sex. Forty-seven patients (85%) completed 2-year follow-up return-to-sport surveys. In the O-60 group, 100% (12/12) patients returned to sports, compared with 82.9% of patients (29/35) in the U-60 group (P = .315).</p><p><strong>Conclusions: </strong>Proximal hamstring repair is a viable treatment option for the aging population and provides similar postoperative functional outcomes compared with younger patients.</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":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789898","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":"Patch Augmentation Using Acellular Dermal Matrix During Arthroscopic Rotator Cuff Repair Reduces Retear Rates in High-Risk Patients With Rotator Cuff Healing Index 7 or Higher.","authors":"Jae Soo Kim, Su Cheol Kim, Jong Hun Park, Hyun Gon Kim, Seung Jin Yoo, Sang Min Lee, Jae Chul Yoo","doi":"10.1002/arj.70187","DOIUrl":"https://doi.org/10.1002/arj.70187","url":null,"abstract":"<p><strong>Purpose: </strong>To compare retear rates and short-term clinical outcomes between arthroscopic rotator cuff repair (ARCR) and ARCR with patch augmentation (PA) using acellular dermal matrix allograft according to the Rotator Cuff Healing Index (RoHI), in order to identify appropriate indications for PA.</p><p><strong>Methods: </strong>This retrospective study included patients aged 50 years or older who underwent primary ARCR between 2017 and 2023, with a minimum follow-up of 12 months. Patients were stratified according to the RoHI score and categorized into ARCR alone (ARCR) and ARCR with PA groups. The receiver operating characteristic curve analysis was performed to assess the predictive performance of the RoHI for retears in the ARCR group. Cumulative retear rates and clinical outcomes, including active range of motion, American Shoulder and Elbow Surgeons, and Constant score were compared between groups across RoHI score thresholds.</p><p><strong>Results: </strong>A total of 738 patients were included (ARCR group, n = 659; PA group, n = 79). In the ARCR group, the RoHI showed fair predictive performance (area under the curve, 0.774; 95% confidence interval, 0.719-0.828), with an optimal cutoff score of 7. Among patients with RoHI score ≥7, cumulative retear rate was significantly lower in the PA group than in the ARCR group (21.6% vs 36.6%, P = .048), and this difference remained significant among female patients (8.3% vs 28.3%, P = .015). However, there were no significant differences in range of motion and clinical outcomes (PA vs ARCR; 72.7 ± 10.7 vs 70.4 ± 13.3 for American Shoulder and Elbow Surgeons score; 59.6 ± 10.9 vs 61.7 ± 10.8 for Constant score) between groups at a mean follow-up of 18.9 ± 5.6 (range, 12-24) months. The proportion of patients achieving the minimal clinically important difference for American Shoulder and Elbow Surgeons (PA vs ARCR; 72.1% vs 57.9%) and Constant score (39.5% vs 49.6%) was also comparable between the groups.</p><p><strong>Conclusions: </strong>A marked increase in the retear rate was observed from a RoHI score of 7 or higher, and in these high-risk patients, patch augmentation using acellular dermal matrix allograft effectively reduced the retear rate regardless of sex, although short-term clinical outcomes were comparable to those of ARCR alone.</p><p><strong>Level of evidence: </strong>Level III, retrospective case-control study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789929","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":"Chronicity of Anterior Cruciate Ligament Injury Does Not Adversely Affect the Clinical Outcomes of Primary Repair in Appropriately Selected Patients.","authors":"Maximilian M Mueller, Sebastian Conner-Rilk, Kyle N Kunze, Fidelius von Rehlingen-Prinz, Gabriel C Goodhart, Fabian M Tomanek, Robert J O'Brien, Jelle P van der List, Gregory S DiFelice","doi":"10.1002/arj.70193","DOIUrl":"https://doi.org/10.1002/arj.70193","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the association between surgical delay, anterior cruciate ligament (ACL) tissue quality, failure rates, and clinical outcomes at a minimum 2-year follow-up after arthroscopic ACL primary repair (ACLPR).</p><p><strong>Methods: </strong>Consecutive patients with complete, proximal (type I/II) ACL tears who underwent arthroscopic ACLPR and had a minimum 2-year follow-up were included. Surgical delay was stratified into 3 categories: acute (≤21 days), subacute (22-90 days), and chronic (>90 days). Intraoperative tissue quality was assessed according to synovial sheath integrity (grade 1, completely intact; grade 2, >50% intact; grade 3, <50% intact) and rupture pattern (1-bundle, 2-bundle, and complex tear). Failure was defined as instrumented laxity >3 mm anterior tibial translation side-to-side difference, pivot shift grade ≥2, and/or subjective instability. Clinical and patient-reported outcomes were compared and Patient Acceptable Symptom State thresholds established.</p><p><strong>Results: </strong>Between 2008 and 2021, 276 of 298 (loss to follow-up, 7.4%) patients (mean age, 39.7 ± 10.7 years; females, 50.3%) who underwent ACLPR with a follow-up of 2.9 ± 1.0 years (2.0-6.5 years) met the inclusion criteria. Sixty-eight (24.6%) ACLPR were acute, 152 (50.1%) subacute, and 56 (20.3%) chronic. Surgical delay was not significantly correlated with worse tissue quality (grade 2, P = .79; grade 3, P = .06) or increased failure risk (P = .57). ACLPR failure occurred in 28 patients (10.1%), with no significant differences among groups (acute, 10.2%; subacute, 11.2%; chronic, 7.1%; P = .76). Reoperation rates (P = .62) and anterior tibial translation side-to-side difference (P = .90), as well as patient-reported outcomes (all P > .28) and Patient Acceptable Symptom State threshold achievements (overall: International Knee Documentation Committee, 84.7%; Lysholm, 83.3%; Forgotten Joint Score-12, 87.3%; and ACL-Return to Sport after Injury, 88.5%) were comparable across groups (all P > .05).</p><p><strong>Conclusions: </strong>Injury chronicity did not adversely affect failure rates or clinical outcomes at minimum 2-year follow-up after ACLPR. Therefore, in the case of a proximal tear location and sufficient tissue quality, surgical delay alone should not be considered a contraindication for ACLPR.</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":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789335","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}