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

{"title":"Repair of Labral Tears in a Cadaveric Model Normalizes Acetabular Contact Pressure Distribution and Restores Dynamic Hip Motion.","authors":"Patrick Birmingham, Hayden P Baker, Andrew J Straszewski, Mark Bowers, Matthew Carpenter, Mei Wang","doi":"10.1002/arj.70524","DOIUrl":"10.1002/arj.70524","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate cadaveric hip biomechanics in the intact, torn, and repaired labral states.</p><p><strong>Methods: </strong>Eight fresh-frozen cadaveric hips underwent 250 N of axial load on a material testing load frame. Contact pressures and areas were measured with a Tekscan sensor inserted into the acetabular wall. Measurements were divided into anterior (3 o'clock), superior (1 o'clock), and posterior (9 o'clock) acetabular regions. A motion capture system tracked the 3-dimensional hip motion. Peak contact stress, contact area, and dynamic motion were compared across conditions: (1) intact, (2) simulated labral tear from 11 to 2 o'clock, and (3) labral repair with 5 suture anchors, using repeated measures 2-factor analysis of variance.</p><p><strong>Results: </strong>Labral condition significantly influenced joint mechanics. Tears increased superior peak contact stress by 27%, whereas repair reduced it by 45% compared with intact (P < .05). The total contact area decreased by 21% with tear and was restored within 10% of intact values after repair. Regional differences were also observed, with superior contact area increasing from 42% to 53% of the total contact area after tear (P = .03) and decreasing to 46% after repair. Dynamic analysis showed a 20% decrease in relative abduction with tear (0.96° vs 1.20°), which returned to 98% of intact (1.17°) after repair.</p><p><strong>Conclusions: </strong>Labral tears result in a proportional increase in contact pressure distribution and contact area in the superior acetabulum, correlating with a decreased femoral head abduction moment under a simulated axial load. Labral repair normalizes these biomechanics toward the intact state, which may more evenly distribute force across the acetabulum and restore dynamic hip motion.</p><p><strong>Clinical relevance: </strong>Restoration of labral integrity may re-establish native biomechanics, supporting improved joint function after repair.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2530-2535"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914409","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":"Platelet-Rich Plasma Provides Small but Superior Short-term Pain Relief and Functional Improvement Compared With Hyaluronic Acid for the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis.","authors":"Chenguang Zhong, Kunhao Wang, Xing Hu, Lingyue Yuan, Wenbo Wang","doi":"10.1002/arj.70520","DOIUrl":"10.1002/arj.70520","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in knee osteoarthritis and to identify preparation and application-related factors influencing outcomes.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020, this study was registered in the International Prospective Register of Systematic Reviews. PubMed, Embase, and Cochrane Library were searched to August 2025. Randomized controlled trials comparing intra-articular PRP and HA in knee osteoarthritis were included. Primary outcomes were pain and function scores (visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score, and International Knee Documentation Committee). Risk of bias was assessed with Cochrane RoB 1.0. Standardized mean differences with 95% confidence interval were pooled; subgroup and metaregression analyses explored platelet concentration, leukocyte enrichment, activation, and injection frequency.</p><p><strong>Results: </strong>Twenty-one randomized controlled trials (1790 patients) were analyzed. At 3 and 6 months, PRP showed no significant advantage over HA in visual analog scale scores. At 12 months, however, PRP significantly reduced pain compared with HA (Standardized mean difference 0.76, P = .016). Western Ontario and McMaster Universities Osteoarthritis Index improvements favored PRP at all time points (P ≤ .001). No significant differences were observed in Knee Injury and Osteoarthritis Outcome Score or International Knee Documentation Committee. Subgroup analyses revealed that high-concentration, leukocyte-rich, and activated PRP were associated with superior outcomes at 12-month follow-up, whereas injection frequency showed no consistent effect. Metaregression confirmed platelet concentration as a positive predictor of treatment efficacy at 12 months.</p><p><strong>Conclusions: </strong>Based on the available evidence with follow-up up to 12 months, PRP was associated with small but statistically significant improvements in pain (visual analog scale) and Western Ontario and McMaster Universities Osteoarthritis Index scores compared with HA in patients with knee osteoarthritis, whereas no significant differences were observed in International Knee Documentation Committee or Knee Injury and Osteoarthritis Outcome Score outcomes. Subgroup and metaregression analyses suggested that platelet concentration, leukocyte content, and activation status may be associated with variability in treatment effects, although substantial heterogeneity and risk of bias were present across studies. These findings should be interpreted cautiously and reflect short-term to 12-month outcomes only.</p><p><strong>Level of evidence: </strong>Level II, systematic review and meta-analysis of Level I and II studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2779-2797"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978718","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 Time Is More Predictive of Suture Contamination During Arthroscopic Rotator Cuff Repair Compared With Skin-Preparation Method: A Prospective Randomized Study on Male Patients.","authors":"Hideki Kamijo, Keisuke Matsuki, Norimasa Takahashi, Shota Hoshika, Tomoyuki Matsuba, Tomoshige Tamaki","doi":"10.1002/arj.70467","DOIUrl":"10.1002/arj.70467","url":null,"abstract":"<p><strong>Purpose: </strong>To compare 3 antiseptics and to identify factors associated with suture contamination during arthroscopic rotator cuff repair.</p><p><strong>Methods: </strong>One hundred fifty male patients scheduled for rotator cuff repair between July 2021 and October 2022 were enrolled. Patients were randomly assigned to 1 of 3 antiseptics groups: povidone-iodine (P), alcohol-containing povidone-iodine (AP), and olanexidine gluconate (O). To minimize variability in surgical duration, surgeons were categorized into 3 groups (A, shortest; B, intermediate; C, longest) based on their preliminary average surgical time, and 1 of 3 antiseptics was randomly assigned to each group. Sutures cut after the last medial knot tying were cultured for a maximum of 3 weeks. The positive rates of Cutibacterium acnes and miscellaneous bacteria were compared between antiseptics and surgeon groups. Repair integrity was evaluated via postoperative magnetic resonance imaging, and its relation with contamination was assessed.</p><p><strong>Results: </strong>C. acnes was detected in 92 shoulders (61%) and miscellaneous bacteria in 34 shoulders (23%), with coagulase-negative Staphylococcus predominating. There were no significant differences in the C. acnes-positive rates between the antiseptics groups. The contamination rate for any bacteria was significantly lower in AP than in O. Logistic regression analysis showed that O had a higher risk of any bacterial contamination than AP (odds ratio, 3.82; P = .013). Shorter surgical and suture exposure times were associated with lower contamination rates. No relation was found between contamination and retear.</p><p><strong>Conclusions: </strong>C. acnes was the most commonly detected bacterium in suture contamination during arthroscopic rotator cuff repairs. There was no difference in the efficacy of the 3 disinfectants in preventing C. acnes contamination; however, the overall bacterial contamination rate was significantly higher in olanexidine compared with alcohol-containing povidone-iodine. Shorter surgical and suture exposure times were associated with a lower incidence of suture contamination.</p><p><strong>Level of evidence: </strong>Level I, prospective randomized study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2408-2416"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610358","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":"Serial Magnetic Resonance Imaging Analysis Reveals Acetabular Labral Volume Decreases After Labral Reconstruction and Returns to Native Size.","authors":"Yichuan Zhu, Zhuohan Cao, Guanying Gao, Yan Xu","doi":"10.1002/arj.70334","DOIUrl":"10.1002/arj.70334","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the consecutive changes in labral size and signal-to-noise ratio (SNR) on magnetic resonance imaging after labral reconstruction and to determine factors including patient characteristics and graft diameter associated with postoperative labral size and their effect on clinical outcomes.</p><p><strong>Methods: </strong>Data between October 2021 and December 2023 were reviewed. Patients diagnosed with femoroacetabular impingement syndrome and who underwent hip arthroscopy for labral reconstruction (irreparable nondiminutive labrum) were included. Exclusion criteria were incomplete magnetic resonance imaging data and concomitant hip conditions. The cross-sectional area of the labral size at 11:30, 1:30, and 3:00 o'clock positions and SNR at 11:30 position was measured on magnetic resonance imaging at preoperative, immediate postoperative, 3/6/12-month postoperative timepoint. Visual analog pain scale (VAS), modified Harris Hip Score, and 12-component International Hip Outcome Tool were collected preoperatively and at follow-up. The achievement of a minimal clinically important difference was calculated.</p><p><strong>Results: </strong>Twenty patients were included. The labral size significantly decreased at postoperative 3 months (11:30, P = .007; 1:30, P < .001; 3:00, P = .018), 6 months (11:30, P < .001; 1:30, P < .001; 3:00, P = .018), and 12 months (11:30, P < .001; 1:30, P < .001; 3:00, P = .012) compared to the immediate postoperative value and returned to its preoperative native size at 6 months (3:00, P = .310) and 12 months (11:30, P = .778, 1:30, P = .500). The SNR presented a significant increase at all postoperative timepoints (3 months, P = .004; 6 months, P = .001; and 12 months, P < .001) compared with the immediate postoperative value and returned to its preoperative level at 6 months (P = .215) and 12 months (P = .370). Graft diameter was positively correlated with 12-month postoperative labral size at both 11:30 and 1:30 positions. Graft diameter was positively associated with VAS improvement. A total of 85%, 90%, and 80% of patients achieved a minimal clinically important difference of VAS, modified Harris Hip Score, and 12-component International Hip Outcome Tool, respectively. The cutoff value of graft diameter predicting the achievement of a minimal clinically important difference of VAS was 5.5 mm.</p><p><strong>Conclusions: </strong>In patients with a nondiminutive native labrum preoperatively, the reconstructed labral size gradually decreased and returned to its preoperative native size by 6 to 12 months. The SNR of reconstructed labrum gradually increased and returned to its preoperative level by 6 to 12 months. Larger graft diameter was associated with greater 12-month postoperative labral size and reduction of pain.</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":"2539-2547"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159161","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: Platelet-Rich Plasma Improves Arthroscopic Rotator Cuff Repair Outcomes but Not as Much as We Would Like.","authors":"Josef K Eichinger","doi":"10.1002/arj.70672","DOIUrl":"10.1002/arj.70672","url":null,"abstract":"<p><p>Biologic optimization of rotator cuff tears is perhaps the next frontier for improving outcomes after arthroscopic repair. A lack of clarity regarding multiple variables when it comes to platelet-rich plasma formulation and application limits the usefulness of these products. Recent literature helps provide clarity. Optimization of platelet-rich plasma with leukocyte-poor formulations while maximizing platelet concentration, along with intratendinous insertion, appears to be the best practice for improving retear rates and patient-reported outcomes. Although the improvements are not clinically substantial, we now have a pathway to attain meaningful clinical results with biologic augmentation.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2777-2778"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118533","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":"Progressive Thinning of Autologous Fascia Lata Graft Is Associated With Graft Retear After Superior Capsular Reconstruction: A 5-Year Magnetic Resonance Imaging Study.","authors":"Chang Hee Baek, Chaemoon Lim, Jung Gon Kim, Bo Taek Kim, Seung Hoon Li, Seung Jin Kim, Kush Shyamlal Mukhi, Luis Alfredo Miranda","doi":"10.1002/arj.70497","DOIUrl":"10.1002/arj.70497","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate serial changes on magnetic resonance imaging (MRI) in superior capsular reconstruction grafts classified as healed according to the Sugaya classification over a 5-year follow-up period, with graft thickness as the primary outcome, and to evaluate humeral head migration (HHM), clinical outcomes, the longitudinal correlation between MRI-based graft changes and clinical outcomes, and the diagnostic accuracy of MRI using magnetic resonance arthrography (MRA).</p><p><strong>Methods: </strong>This retrospective comparative study reviewed patients with massive irreparable rotator cuff tears who underwent superior capsular reconstruction between January 2017 and December 2019 and had a minimum follow-up of 5 years. Patients with concomitant tendon transfer, nonfascia lata grafts, or incomplete follow-up were excluded. The patients were divided into 2 groups (graft intact or graft retear group) according to the Sugaya classification of MRI. MRI was performed at 1 week, 6 months, and 1, 2, and 5 years postoperatively to assess changes in graft thickness and HHM. Clinical outcomes were evaluated using the visual analog scale, Constant score, American Shoulder and Elbow Surgeons score, forward elevation, and external rotation, both preoperatively and at the same postoperative intervals. MRA was performed in patients with persistent symptoms despite an intact-appearing graft on conventional MRI to further assess graft integrity and validate MRI findings.</p><p><strong>Results: </strong>A total of 58 patients were included in this study, of whom 33 were categorized into the graft retear group and 25 into the graft intact group. In the graft intact group, the graft thickness at the humeral attachment, midsubstance, and glenoid attachment progressively decreased over time, with a significant reduction observed at 5 years compared with 1 week postoperatively. HHM significantly increased beginning at 1 year and continued to rise through the 5-year follow-up. Linear mixed-effects analysis showed a significant association between greater graft thickness and better outcomes in the visual analog scale (β = -0.45), American Shoulder and Elbow Surgeons score (β = 3.48), forward elevation (β = 6.06), and external rotation (β = 3.07). Among 10 patients who underwent MRA because of persistent symptoms, 8 (80.0%) were found to have a graft retear despite MRI-based classification as intact.</p><p><strong>Conclusions: </strong>Graft thinning and superior HHM were observed on MRI despite apparent graft integrity, and these findings were associated with worse clinical outcomes. MRA showed a high incidence of graft retears in these cases.</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":"2457-2469"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868093","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":"Concomitant Procedures Around Cartilage Restoration Surgery Is Associated With Improved Outcomes and Decreased Failure Rates: A Systematic Review.","authors":"Lucy E Meyer, Mikhail A Bethell, Eoghan T Hurley, Juan Bernardo Villarreal-Espinosa, Seth L Sherman, Annunziato Amendola, Alison P Toth","doi":"10.1002/arj.70415","DOIUrl":"10.1002/arj.70415","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the current literature to determine the impact of concomitant alignment or meniscal surgery on outcomes in patients undergoing cartilage restoration surgery.</p><p><strong>Methods: </strong>A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines utilizing a comprehensive search of MEDLINE, EMBASE, and The Cochrane Library databases. Studies were included if they reported clinical outcomes of cartilage restoration with concomitant osteotomy or meniscal allograft transplantation performed. Data extraction included functional outcomes, failure rates, and International Cartilage Repair Society/Magnetic Resonance Observation of Cartilage Repair Tissue scores.</p><p><strong>Results: </strong>A total of 40 studies, comprising 1783 knees, were included. Patients undergoing cartilage restoration with concomitant osteotomy had a lower range of failure rates (0.0%-10.5%) compared with cartilage restoration alone (0%-41.7%). Similarly, cartilage repair with meniscal allograft transplantation had increased Lysholm and International Knee Documentation Committee scores from preoperative ranges of 41.9-70.6 and 32.9-45.5 to 63.6-88.0 and 55.3-76.0, respectively. The failure rates for cartilage restoration with concomitant meniscal allograft transplantation (range: 14.0-15.2) were comparable to cartilage restoration alone (range: 12.1-14.0). Additionally, the mean heterogeneity within the included studies ranged from 0% to 98%.</p><p><strong>Conclusions: </strong>Available evidence suggests that osteotomy and meniscal allograft transplantation can be performed concomitantly with cartilage restoration without adversely affecting overall outcomes. These procedures may be particularly relevant for patients with malalignment or meniscal deficiency, where mechanical factors contribute to disease progression.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level II, III, and IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2802-2814"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498509","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: The Suture Staple Technique Is Viable for Endoscopic Gluteus Medius Repair, but Its Superiority to Traditional Configurations Remains Unclear.","authors":"Daniel J Kaplan","doi":"10.1002/arj.70569","DOIUrl":"10.1002/arj.70569","url":null,"abstract":"<p><p>Gluteal tendon tears are typically degenerative and often only partial. For patients who fail nonoperative management, endoscopic repair is a reasonable option. Traditionally, a knotted side-to-side suture repair technique has been used, though this can be technically demanding and leave knot stacks adjacent to the trochanteric bursa. Using a suture staple technique may increase the tendon-footprint contact area and avoids the knot stacks. Although the biomechanics seem theoretically in favor of the staple technique, this has yet to be proven. Clinically, the techniques are likely comparable, though more research is needed on several fronts before a determination can be made.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2528-2529"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860535","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: Platelet-Rich Plasma Outlasts Hyaluronic Acid for Knee Osteoarthritis, but the Product, Not the Acronym, Is the Prescription.","authors":"Jakob Ackermann, Matthew T Kao, Lee R Friedman, Alexis Sassower, Katia Chiampas, Brian J Cole","doi":"10.1002/arj.70588","DOIUrl":"10.1002/arj.70588","url":null,"abstract":"<p><p>Intra-articular platelet-rich plasma (PRP) is among the most frequently administered orthobiologic treatments for symptomatic knee osteoarthritis. PRP is not a single intervention. Preparations differ in platelet concentration, total platelet dose, leukocyte and erythrocyte content, injection volume, activation method, and injection interval, such that 2 products sharing the acronym may constitute fundamentally different biologic treatments. The randomized literature supports a small symptomatic advantage of PRP over hyaluronic acid in mild-to-moderate disease. That advantage appears to emerge at 12 months rather than early and is best framed as symptom modification rather than cartilage regeneration. Whether any particular formulation drives the effect is far less certain. Reported associations between platelet concentration, leukocyte enrichment, activation status, and outcome are biologically plausible, yet they are typically carried by small and heavily overlapping sets of trials in which these variables cannot be separated from one another. Platelet concentration is furthermore not equivalent to platelet dose, which is the product of concentration and injection volume. Until absolute dose, leukocyte composition, activation, and final volume are consistently reported, comparisons of high versus low concentration remain uninterpretable. In our practice, PRP and hyaluronic acid are increasingly combined for a theoretical synergistic impact because viscosupplementation and biologic signaling address distinct components of the osteoarthritic joint. Standardized product characterization, dose-defined randomized trials, responder-based outcomes, and improved patient selection are warranted. The acronym is not the prescription; the product is.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2798-2801"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978682","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: Chekhov's Unloaded Gun-The Fate of a Knee Cartilage Biopsy Taken in the First Act.","authors":"Tzadok Yona, Ron Gilat","doi":"10.1002/arj.70501","DOIUrl":"10.1002/arj.70501","url":null,"abstract":"<p><p>Matrix-induced autologous chondrocyte implantation is a well-established, staged cartilage repair procedure. However, historical data suggests that most patients undergoing the initial index biopsy procedure do not proceed to definitive implantation. Although various predictors for conversion have been proposed, including body mass index, lesion size, defect grade, and surgical history, significant discrepancies persist across the literature. Accurately predicting which patients will convert is critical for 2 primary reasons: first, to minimize unnecessary iatrogenic cartilage damage from nonused biopsies, and second, to mitigate health care waste and optimize resource allocation. Currently, precisely identifying the patient cohorts most likely to undergo implantation remains a clinical challenge, underscoring the need for large-scale consensus data to guide patient counseling and surgical decision-making.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":"2672-2673"},"PeriodicalIF":6.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860252","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}