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

{"title":"Knee Brace Application Does Not Affect Thigh Muscle Strength and Knee Range of Motion After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Po-Han Chen, Sung Huang Laurent Tsai, Cheng-Pang Yang, Hao-Che Tang, Joe Chih-Hao Chiu, Yi-Sheng Chan, Chieh-An Chuang","doi":"10.1016/j.arthro.2025.07.042","DOIUrl":"10.1016/j.arthro.2025.07.042","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of rehabilitative knee bracing on thigh muscle strength, knee mobility, subjective and objective performance, knee stability, and functional test outcomes following anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with INPLASY, we included randomized controlled trials and cohort studies comparing knee bracing versus no bracing after ACL reconstruction. Outcome measures were collected preoperatively and at defined study intervals of each study. Primary outcomes were thigh muscle strength and knee mobility, while secondary outcomes included International Knee Documentation Committee score, Tegner score, Lysholm score, visual analog scale for pain, knee anterior laxity, and the 1-legged hop test. Data were collected from multiple databases and analyzed using Comprehensive Meta-Analysis software, with bias assessed via the Cochrane Risk of Bias 2.0 tool and the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Fourteen studies with 1,199 patients were included, with follow-up ranging from 2 weeks to 4 years. Knee bracing showed no significant effect on isokinetic flexion (standardized mean difference [SMD] = -0.027; P = .935; 4 studies) or extension torque (SMD = -0.007; P = .980; 4 studies) within 2 years, flexion range of motion within 3 months (SMD = -0.001; P = .997; 4 studies), or extension deficits within 3 months (SMD = 0.355; P = .334; 3 studies) and 2 years (SMD = -0.439; P = .132; 3 studies). Secondary outcomes also showed no significant group differences.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis demonstrated that rehabilitative bracing after ACL reconstruction did not result in significant differences in thigh muscle strength or knee range of motion compared to nonbracing protocols. On the other hand, no significant differences were observed between the brace and nonbrace groups in terms of stability and functional outcomes.</p><p><strong>Level of evidence: </strong>Level III, systematic review and meta-analysis of Level I-III studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056339","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":"Virtual Reality and Augmented Reality Are Uniquely Suited to Hip Arthroscopy Education and Reveal Adequate Face, Content, and Construct Validity: A Systematic Review With Expert Commentary.","authors":"Prushoth Vivekanantha, Derek H Ochiai, Satyavenkata Kotipalli, Andrew Duong, Nicole Simunovic, Antonio J Andrade, Olufemi R Ayeni","doi":"10.1016/j.arthro.2025.07.039","DOIUrl":"10.1016/j.arthro.2025.07.039","url":null,"abstract":"<p><strong>Purpose: </strong>To (1) summarize the current literature regarding virtual reality (VR)/augmented reality (AR) as it pertains to efficacy in hip arthroscopy training, (2) compare the VR/AR performance of experienced and less experienced hip arthroscopists, and (3) assess the suitability of VR/AR for hip arthroscopy education by assessing various elements of validity.</p><p><strong>Methods: </strong>Three databases were searched on February 9, 2025, for studies investigating VR/AR simulation in hip arthroscopy training. Descriptive statistics were used to report participant details, simulation specifics, and validity (e.g., face, construct, and content).</p><p><strong>Results: </strong>Nine studies comprising 218 participants were included, 37 (16.9%) being considered experienced. Most studies (7 of 9, 77.8%) were analyses of 1 session, with 2 studies comparing progress during sessions over time. Five studies investigated face validity; the majority of participants (>70%) in each of these studies found that simulators were realistic in all elements apart from tactile feedback. Eight studies evaluated construct validity. Three of four studies (75%) found statistically lower amounts of iatrogenic tissue damage in the experienced group (P ≤ .002). Three of four studies (75%) found that the experienced group had shorter completion times (P ≤ .03) than the non-experienced group. One study reported lower iatrogenic damage (P < .0001) and completion times (P < .001) with repeated sessions in non-experienced learners.</p><p><strong>Conclusions: </strong>VR/AR simulation training for hip arthroscopy reveals good face, content, and construct validity. Generally, VR/AR simulations were rated by users as realistic in most elements apart from tactile feel. Participants, particularly junior learners, improved in minimizing iatrogenic tissue damage, decreasing completion time, and minimizing excess travel with the scope. More experienced hip arthroscopists generally outperformed non-experienced participants in the majority of performance metrics and scores.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level I, II, and IV studies, plus Level V, expert opinion.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056272","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":"High-Dose Statins Preserve Tendon-Bone Interface Healing Without Adversely Affecting Fatty Infiltration in a Rotator Cuff Repair Rat Model.","authors":"Jong Pil Yoon, Sung-Jin Park, Dong-Hyun Kim, Jun-Young Kim, Chul-Hyun Cho, Hyun Joo Lee, Seok Won Chung","doi":"10.1016/j.arthro.2025.07.043","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.07.043","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of high-dose atorvastatin (hATZ) on histological and biomechanical tendon-bone interface (TBI) healing and fatty infiltration following rotator cuff (RC) repair in a rat model.</p><p><strong>Methods: </strong>Twenty Sprague-Dawley rats underwent RC repair surgery on both shoulders, after which hATZ was administered orally for four weeks postoperatively. The effects of hATZ on TBI healing were assessed macroscopically, histologically, and biomechanically. Fatty infiltration was evaluated using Oil Red O staining and immunohistochemical analysis of gene marker expressions. Expression levels of muscle RING-finger protein-1 (MuRF-1) and muscle atrophy F-box protein (Atrogin-1), markers of muscle atrophy, and peroxisome proliferator-activated receptor gamma (PPAR-γ) and CCAAT/enhancer-binding protein alpha (C/EBP-α), transcription factors involved in adipogenesis, were assessed by quantitative real-time polymerase chain reaction to evaluate molecular changes related to muscle degeneration. Biomechanical tendon healing was measured using a universal testing machine, and histological analysis was performed using H&E, and Masson's trichrome staining.</p><p><strong>Results: </strong>At 4 weeks postoperatively, systemic administration of hATZ did not negatively affect TBI healing following rotator cuff repair. Fatty infiltration analysis showed no significant difference between the hATZ group (3322.16 ± 1117.59 μm²) and the control group (3946.94 ± 1843.96 μm²) (P = .415). However, immunohistochemical analysis revealed that hATZ significantly inhibited the expression of MuRF-1 (P < .001), a key regulator of muscle atrophy, while the expression levels of Atrogin-1 (P = .803), PPAR-γ (P = .200), and C/EBP-α (P = .909) remained unchanged. Histological analysis confirmed no significant differences in collagen density (P = .142) or arrangement (P = .164) between the groups, and biomechanical testing demonstrated comparable ultimate strength (P = .398) and load-to-failure (P = .464).</p><p><strong>Conclusion: </strong>High-dose atorvastatin did not impair histological and biomechanical healing of the TBI in a rat model of RC repair. It also did not accelerate fatty infiltration of the muscle and led to a significant downregulation of the muscle atrophy-related marker MuRF-1.</p><p><strong>Clinical relevance: </strong>This study demonstrates that hATZ does not negatively affect TBI healing or muscle recovery following RC repair, supporting its continued use in patients requiring long-term statin therapy.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056280","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 Is Superior to Conservative Options in Preventing Recurrence of First-Time Anterior Shoulder Dislocation in Adolescents and Adults Under 40 Years of Age: A Systematic Review and Network Meta-analysis.","authors":"Hongfu Jin, Guoxu Zhang, Sijie Chen, Yao Tong, Wenze Shao, Tao Li, Yizhou Huang, Jian Li, Xin Tang","doi":"10.1016/j.arthro.2025.07.044","DOIUrl":"10.1016/j.arthro.2025.07.044","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effectiveness of multiple treatments for first-time anterior shoulder dislocation in adolescents and young adults under 40 years of age.</p><p><strong>Methods: </strong>A systematic review and network meta-analysis of randomized controlled trials were conducted to compare 5 treatments for first-time anterior shoulder dislocation: arthroscopic Bankart repair, open Bankart repair, arthroscopic lavage, internal rotation immobilization, and external rotation immobilization. The primary outcome was recurrent instability, with secondary outcomes including functional scores, return to normal activities and sports, and patient satisfaction.</p><p><strong>Results: </strong>A total of 10 randomized controlled trials were identified in the review, of which 8 involving 439 participants (mean age range: 20.0-25.3 years; maximum age 39 years) were included in the network meta-analysis. Surgical treatments, especially arthroscopic Bankart repair, exhibited lower recurrence risk, significantly outperforming external rotation immobilization (risk ratio [RR] = 0.15; 95% confidence interval [CI], 0.03-0.73) and internal rotation immobilization (RR = 0.14; 95% CI, 0.04-0.40). Arthroscopic Bankart repair showed no statistically significant difference in risk of recurrent instability when compared to open Bankart repair (RR = 4.19; 95% CI, 0.32-212.92) or when compared to arthroscopic lavage (RR = 0.3; 95% CI, 0.07-1.15). Both external rotation and internal rotation immobilization had the poorest outcomes, with no significant difference between them (RR = 0.91; 95% CI, 0.28-2.96). Surgical treatments were also associated with better functional outcomes, higher patient satisfaction, and higher rates of return to normal activities and sports.</p><p><strong>Conclusions: </strong>Surgical treatments are more effective than conservative options in preventing recurrent instability in adolescents and young adults under 40 years of age with first-time anterior shoulder dislocation. Arthroscopic Bankart repair has comparable efficacy in preventing the recurrence of open Bankart repair. Both external rotation and internal rotation immobilization had the poorest outcomes in terms of reducing recurrence instability rates, with no significant difference between them.</p><p><strong>Level of evidence: </strong>Level I, systematic review and network meta-analysis of Level I studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056262","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 Postoperative Opioid Prescription Refills Have Similar Long-Term Clinical Outcomes to Those Not Requiring Refills After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.","authors":"Andrew Bi, Eric Y Hu, Jesus E Cervantes, Kyleen Jan, Shane J Nho","doi":"10.1016/j.arthro.2025.07.041","DOIUrl":"10.1016/j.arthro.2025.07.041","url":null,"abstract":"<p><strong>Purpose: </strong>To identify long-term patient-reported outcomes (PROs), achievement of clinically significant outcomes, and reoperation rates after primary hip arthroscopy for femoroacetabular impingement between patients requesting at least 1 postoperative opioid refill after hip arthroscopy and patients not requesting a refill.</p><p><strong>Methods: </strong>Patients who underwent hip arthroscopy between January 2012 and October 2014 with minimum 10-year follow-up were included. Patients who had received at least 1 opioid refill were propensity matched 1:1 to patients who did not receive a refill, controlling for age, sex, and body mass index (BMI). Patients completed PROs including the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale, modified Harris Hip Score, and visual analog scale scores for pain and satisfaction. Clinically significant outcomes obtained at 10-year follow-up included the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). A Kaplan-Meier analysis was performed to evaluate survivorship between cohorts.</p><p><strong>Results: </strong>Seventy-four patients who received opioid refills (age, 35.1 ± 11.7 years; 67.6% female sex; BMI, 26.3 ± 5.8) were successfully matched to 74 patients who did not receive a refill (age, 36.9 ± 11.1 years; 68.9% female sex; BMI, 26.1 ± 5.4). There were no significant differences in patient demographic characteristics. Refill group patients showed worse scores for preoperative Hip Outcome Score-Activities of Daily Living; preoperative, 1-year postoperative, and 5-year postoperative modified Harris Hip Score; and 1-year postoperative Hip Outcome Score-Sports Subscale. All other PROs at each time point were not significantly different. Maximum observable improvement did not differ between groups. Groups did not differ in 10-year MCID achievement (98.1 vs 94.0) or PASS achievement (75.9 vs 81.1). Time-dependent survivorship was similar between groups. Male and female opioid who received refills had similar 10-year outcomes and reoperation rates.</p><p><strong>Conclusions: </strong>After primary hip arthroscopy, patients who require opioid refills have significantly worse PROs at short- and mid-term follow-up, with no differences in PROs, achievement of the MCID or PASS, and reoperation rates at long-term follow-up.</p><p><strong>Level of evidence: </strong>Level III, retrospective, comparative case-control series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056264","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: Posterior Shoulder Instability in Athletes: Durable Recovery May Be Achievable With Arthroscopic Management.","authors":"Jeffrey Kay, Olufemi R Ayeni","doi":"10.1016/j.arthro.2025.09.003","DOIUrl":"10.1016/j.arthro.2025.09.003","url":null,"abstract":"<p><p>Posterior shoulder instability, once considered rare, is increasingly recognized in young and athletic populations. Arthroscopic stabilization techniques have shown favorable outcomes with improvements in pain, function, and return to sport. Although most available evidence has been limited to short-term follow-up, emerging data suggest that arthroscopic management offers durable protection against recurrent instability and sustained athletic participation. The challenge remains in accurate diagnosis and patient selection, but advances in surgical technique and rehabilitation continue to refine outcomes. Posterior shoulder instability should no longer be viewed as an uncommon or unpredictable entity; rather, with modern arthroscopic management, it represents a condition where reliable and lasting recovery may be achievable.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042276","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: Lower-Leg Alignment Changes After Opening-Wedge Tibial Osteotomy: The Third Law of Motion and the Future of the Tibial Osteotomy.","authors":"Mark G Siegel","doi":"10.1016/j.arthro.2025.09.004","DOIUrl":"10.1016/j.arthro.2025.09.004","url":null,"abstract":"<p><p>Opening-wedge tibial osteotomies have an effect on the entire lower limb with resultant changes in alignment to the ankle and hip. These changes are not static given that there is a small but measurable change in the knee joint line obliquity over 5 years. Secondary compensation occurs in the ankle for the first postoperative year, with measured changes in the hip abduction angle over 5 years. These changes, along with the effects of the opening-wedge tibial osteotomy on a future arthroplasty, provide added information that must be considered when planning tibial realignment surgery for arthritis.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042279","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":"Rethinking Standards for Minimum Short-Term Follow-Up Duration for Clinical Outcome in Orthopaedic and Sports Medicine Studies.","authors":"Adnan Saithna, Matthew Salzler, Elizabeth Matzkin, Michael J Rossi","doi":"10.1016/j.arthro.2025.08.019","DOIUrl":"10.1016/j.arthro.2025.08.019","url":null,"abstract":"<p><p>A 2-year minimum follow-up period has generally been preferred in orthopaedic studies. This minimum standard aids comparisons across the literature and helps to ensure methodologic rigor. However, in some situations, these minimum durations are not required to answer specific research questions and strictly enforcing these requirements poses unnecessary barriers to research by adding cost and complexity, increasing the risk of loss to follow-up and potentially restricting early dissemination of clinically important findings. There can be situations when variability in these minimum time frames might be appropriate, depending on the research question, diagnosis, treatment, and primary outcome measure. Therefore, we encourage authors to include a statement in their manuscript justifying their chosen follow-up period. In many cases, this may default to the established minimum standard. However, we include examples of procedures (rotator cuff repair, shoulder stabilization, superior capsule reconstruction, shoulder arthroplasty, anterior cruciate ligament reconstruction, partial meniscectomy, meniscus repair, platelet-rich plasma injection, microfracture for osteochondral lesions of the talus, and arthroscopic hip preservation surgery) in which the literature has shown when clinical outcomes plateau. In some cases, this confirms the need to adhere to the established minimum follow-up of 2 years, but in other scenarios, clinical outcomes plateau much earlier. Therefore, authors evaluating patient-reported outcome measures may justify shorter durations of minimum follow-up in some settings.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034834","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: Research on Clinically Important Differences Has Value but Over-reliance on Thresholds May Obscure the Complexity of Patient-Perceived Improvement.","authors":"Mark P Cote, Jeffrey S Mun, Paradis Saathoff","doi":"10.1016/j.arthro.2025.09.002","DOIUrl":"10.1016/j.arthro.2025.09.002","url":null,"abstract":"<p><p>Efforts to determine the relationship between patient-reported outcome measures (PROMs) and patient-reported improvement have largely been focused on determining threshold values to classify patients as having experienced a certain amount of improvement or satisfaction. Although these metrics aid in understanding the extent to which specific PROM scores associated with improvement vary across studies, they are imperfect thresholds sensitive to the practice and setting in which they are estimated. Even when applied to the patients who contributed to their estimation, thresholds misclassify patients. The misclassification is often exacerbated when threshold values are used outside the setting in which they were derived owing to differences in patient expectations, settings, and practice patterns, among others. The growing amount of research reporting thresholds for various measures and patient populations in the orthopaedic and sports medicine literature provides the opportunity to evaluate the consistency between PROM scores and patient-reported improvement and satisfaction across different settings. Although this is valuable, over-reliance on thresholds to determine substantial improvement or satisfaction will obscure the complexity and nuance of patient-perceived improvement.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024871","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: Concomitant Osteotomy and Meniscus Centralization Should Be Considered in Selected Patients Undergoing Medial Meniscus Posterior Root Repair.","authors":"Adnan Saithna","doi":"10.1016/j.arthro.2025.08.022","DOIUrl":"10.1016/j.arthro.2025.08.022","url":null,"abstract":"<p><p>Medial meniscus posterior root tears (MMPRTs) are associated with severe biomechanical consequences (loss of hoop force transmission) that are broadly equivalent to a total meniscectomy. The resultant increase in contact pressures predisposes to high rates of advanced medial compartment arthritis at long-term follow-up. Repair of MMPRTs is associated with significantly better outcomes than partial meniscectomy or nonoperative treatment (including improved patient-reported outcome measures and delay or even avoidance of arthroplasty). However, some patients may benefit from the addition of concomitant procedures (including osteotomy and meniscus centralization) to improve clinical outcomes and mitigate modifiable risk factors for failure of MMPRT repair. Although high-quality comparative studies are lacking, this strategy is supported by biomechanical data, clinical studies (including second-look arthroscopy data), and international consensus group statements.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014436","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}