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

{"title":"Editorial Commentary: Arthroscopic All-Inside Ligament Repair Is an Essential Technique and the Emerging Gold-Standard Treatment for Ankle Instability.","authors":"Jordi Vega","doi":"10.1016/j.arthro.2025.06.026","DOIUrl":"10.1016/j.arthro.2025.06.026","url":null,"abstract":"<p><p>Arthroscopic all-inside ligament repair is a minimally invasive procedure for the treatment of patients with chronic ankle instability. Excellent results have been obtained through this arthroscopic procedure. However, remnant tissue quality can be a limitation to ligament repair. During the procedure, it is necessary to decide whether the injured ligament is repairable. When ligament resorption occurs, ligamentoplasty is indicated. In the case of good or excellent remnant ligament quality, ligament repair is the technique of choice. However, when ligament quality is poor, the surgeon must decide whether to proceed with repair. Although a poor-quality ligament can be repaired with good results, the use of augmentation techniques to protect the ligament repair should be considered when remnant ligament quality is poor.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531236","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: Capsular Management in Arthroscopic Hip Surgery - What if Disruption of the Iliofemoral Ligament is Optional?","authors":"Brett Shore","doi":"10.1016/j.arthro.2025.06.024","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.024","url":null,"abstract":"<p><p>Postoperative iatrogenic hip instability is an increasingly recognized complication of arthroscopic hip surgery. Numerous publications have reported on the biomechanical importance of capsular preservation, as well as the clinical importance of proper capsular management. The majority of studies published in the literature report on the clinical benefits of capsular repair in order to best preserve native anatomy, but other strategies directed at minimizing capsular disruption are critical, given that capsular repair is technically challenging early in the learning curve, and even a well-repaired capsule can fail to heal or retear in the early postoperative period.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531239","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":"Comprehensive Management of Piriformis Syndrome with Endoscopic Release and Sciatic Neurolysis Provides Favorable Outcomes and Low Complication Rate.","authors":"Roger Quesada-Jimenez, Elizabeth G Walsh, Ady H Kahana-Rojkind, Andrew R Schab, Tyler R McCarroll, Benjamin G Domb","doi":"10.1016/j.arthro.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.023","url":null,"abstract":"<p><strong>Purpose: </strong>The study aims to evaluate the outcomes of endoscopic sciatic neurolysis and piriformis release as treatment for piriformis syndrome (PS) with a minimum 2-year follow-up. The secondary aim is to present a comprehensive approach to enhance diagnostic accuracy.</p><p><strong>Methods: </strong>Prospectively collected data was retrospectively analyzed for all patients who underwent endoscopic piriformis release and sciatic neurolysis as treatment for PS between 2010-2021. A diagnostic algorithm was employed for surgical indications throughout this time period. Included patients had completed pre-operative and minimum of 2-year postoperative questionnaires for the following patient reported outcome (PRO) measures: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analogue Scale (VAS) for pain and patient satisfaction. The minimal clinical important difference (MCID) was calculated for the mentioned PROs and included in the analysis.</p><p><strong>Results: </strong>A total of 18 patients with a mean follow-up time of 93.1 ± 38.2 months were included in the study. All patients experienced symptom relief postoperatively. Significant improvement was seen at latest follow-up compared to preoperative baseline for mHHS (p < 0.001), NAHS (p < 0.001), HOS-SSS (p = 0.019), and VAS (p < 0.001),as well as a high mean patient satisfaction of 8.3 ± 1.7. Furthermore, a high percentage of patients reached the calculated MCID for mHHS (83.3%), NAHS (77.8%), HOS-SSS (61.1%), and VAS (94.4%).</p><p><strong>Conclusion: </strong>Endoscopic release of the piriformis tendon and sciatic neurolysis have shown favorable outcomes, high patient satisfaction rates, and a high percentage of patients reaching clinically important thresholds, with a low rate of complications at a minimum 2-year follow-up.</p><p><strong>Level of evidence: </strong>Retrospective Case Series.; Level IV.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531237","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":"Diagnosed Mental Health Disorders Are Associated With Greater Rates of Postoperative Complications, Additional Procedures, and Lower Anterior Cruciate Ligament Tears and Revision Rates After Anterior Cruciate Ligament Reconstruction.","authors":"Ahad A Kesaria, Brady P Moore, Oluwatofe Alimi, William M Weiss","doi":"10.1016/j.arthro.2025.05.037","DOIUrl":"10.1016/j.arthro.2025.05.037","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the influence of diagnosed mental disorders on postoperative outcomes after arthroscopic anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>Using the TriNetX health network database, we evaluated postoperative complications and additional procedures of patients who underwent arthroscopic ACL reconstruction over a 20-year period. Patients with a documented mental health disorder (e.g., anxiety or depression) within 1 year preceding surgery were compared with patients without mental health disorders. The cohorts were propensity-matched for demographic and medical factors, including hypertension, type 2 diabetes, and obesity. Short- and long-term outcomes were evaluated within 90 days and 3 years postoperative, respectively. A χ² analysis was performed to compare outcomes between the 2 cohorts.</p><p><strong>Results: </strong>A total of 8,351 patients with diagnosed mental health disorders were propensity-score matched at a 1:1 ratio with 82,127 patients without diagnosed mental health disorders. Within 90 days postoperative, patients with diagnosed mental health disorders demonstrated significantly greater odds of postoperative infection (P = .0042), lower limb mononeuropathy (P = .025), acute postoperative pain (P < .0001), knee stiffness (P < .0001), and any emergency department visit (P <.0001). Within 3 years postoperative, these patients had significantly greater odds of opioid abuse (P = .0015), knee pain (P < .0001), patella fracture (P =.0008), and arthrocentesis/aspiration/injection (P = .0005) but significantly lower odds of ACL tear (P < .0001) and repeat ACL reconstruction (P = .0033).</p><p><strong>Conclusions: </strong>Diagnosed mental health disorders were associated with increased short- and long-term postoperative complications after ACL reconstruction but also demonstrated a potentially protective association with multiple postoperative outcomes, including decreased odds of additional ACL tears and reconstructions.</p><p><strong>Level of evidence: </strong>Level III, retrospective, comparative cohort study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531238","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":"Revision Hip Labral Reconstruction after Primary Repair Demonstrates Inferior Outcomes Compared to Matched Primary Reconstruction at Minimum 2-Year Follow-Up.","authors":"Ady H Kahana-Rojkind, Krishi Rana, Yasemin E Kingham, Onur Hapa, Roger Quesada-Jimenez, Benjamin G Domb","doi":"10.1016/j.arthro.2025.06.022","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.022","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare minimum 2-year patient-reported outcomes revision arthroscopic labral reconstruction following failed primary labral repair with those of matched primary labral reconstruction cases.</p><p><strong>Methods: </strong>Data from patients who underwent labral reconstruction between April 2010 and November 2024 were retrospectively reviewed. Inclusion criteria required revision hip arthroscopy with labral reconstruction and a minimum 2-year follow-up for PROs, including the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), patient satisfaction, and visual analog scale for pain (VAS). Exclusion criteria included Tonnis grade >1, pre-existing hip conditions, lateral central edge angle < 20, intraoperative gluteus medius repair, ongoing workers' compensation claims, and patients with microinstability who underwent remplissage or capsular reconstruction. Revision patients (n=75) were matched 1:1 with a benchmark control group of primary reconstruction patients (n=75).</p><p><strong>Results: </strong>At a minimum 2-year follow-up, both groups demonstrated significant improvement in all PROs (p < 0.001), with comparable rates of improvement (p > 0.05). However, the revision group showed inferior postoperative outcomes across all PROs (p < 0.01) and lower rates of achieving patient acceptable symptom state (PASS) compared to the control group.</p><p><strong>Conclusion: </strong>Both primary and revision labral reconstructions lead to significant clinical improvement. However, primary reconstruction achieves superior outcomes, with a higher percentage of patients reaching clinically meaningful thresholds.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531240","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: Collagen Patch Augmentation of Partial-Thickness Rotator Cuff Tears Appears to Increase Tendon Thickness With Few Complications, but Indications and Efficacy Remain Unclear.","authors":"Patrick J Tansey, Robert W Lindeman","doi":"10.1016/j.arthro.2025.06.019","DOIUrl":"10.1016/j.arthro.2025.06.019","url":null,"abstract":"<p><p>Partial-thickness rotator cuff tears disrupt the most structurally sound layers of collagen as tear thickness approaches 50% on either the articular or bursal side. Recent studies of cuff insertional dimensions suggest that a tear of just 3 mm may begin to compromise the most supportive zones. Partial-thickness tears can be effectively treated with debridement or a variety of reparative techniques. However, creating a more biomechanically favorable environment is not sufficient in all cases, given that up to 22% of patients who undergo repair experience tear progression and reoperation. Bioinductive bovine collagen patches represent a relatively recent approach to biologically augmenting cuff repairs. Collagen patches appear to increase mean tendon thickness at short-term follow-up, and complication profiles appear comparable to those of non-augmented tears, although surgeon vigilance for early postoperative stiffness is advised. Patients who undergo patch augmentation may show earlier functional outcome improvement with debridement versus take-down and repair. Ultimately, comparative studies with non-augmented control groups are necessary to better understand the contribution of patch augmentation to improved clinical outcomes. Equally important, consistent reporting and clear definitions of rotator cuff tear progression will be essential to determining whether biologic reinforcement can truly prevent long-term repeat injury.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512796","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":"Sports Medicine: A Path, A Profession, A Passion.","authors":"Alan S Curtis","doi":"10.1016/j.arthro.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.010","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509550","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":"Is \"Patch and Run\" The New Way to Address Partial Rotator Cuff Tears?","authors":"Avinesh Agarwalla, Joseph N Liu","doi":"10.1016/j.arthro.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.017","url":null,"abstract":"<p><p>Partial rotator cuff tears are managed non-operatively as a first-line treatment modality. When operative intervention is indicated, the appropriate technique has yet to be clearly elucidated. Operative management includes in-situ repair, tear completion with repair, and more recently, bioinductive collagen patch implantation. Although bioinductive collagen implants have a shorter recovery time with a less stringent rehabilitation protocol with significant improvements on magnetic resonance imaging, comparison of functional outcomes following isolated biologic patch augmentation to repair techniques is limited and demonstrates no difference.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509549","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: Bioinductive Collagen Implants Yield Improved Retear Rates Compared With Other Types of Collagen Implants, Yet Exact Reasons Are Still Unknown.","authors":"Hyungsuk Kim, Hyun Seok Song","doi":"10.1016/j.arthro.2025.06.018","DOIUrl":"10.1016/j.arthro.2025.06.018","url":null,"abstract":"<p><p>Biologic augmentation in arthroscopic rotator cuff repair has emerged as a key focus in the ongoing pursuit to enhance tendon healing and improve long-term outcomes. The recent randomized controlled trial of bovine bioinductive collagen implants in arthroscopic rotator cuff repair presents a significant reduction in retear rate. As biologic augmentation continues to evolve, future research should aim to define patient subgroups who are most likely to benefit from specific augmentation strategies, both biologically and economically. Moreover, we need an explanation as to what makes a bioinductive collagen implant produce better retear rate compared with other type of collagen implants.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509548","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":"Arthroscopic Acromioclavicular Joint Stabilization in Patients Aged ≥50 Years Results in a Low Rate of Clinical Failure, Favorable Outcomes and High Return to Activity and Work.","authors":"Marco-Christopher Rupp, Lorenz Fritsch, Lukas N Muench, Yannick Ahlheit, Yannick Ehmann, Daniel Berthold, Lucca Lacheta, Sebastian Siebenlist, Bastian Scheiderer","doi":"10.1016/j.arthro.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.06.015","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical outcomes as well as return-to-activity (RTA) and -work (RTW) following an arthroscopically-assisted suspensory fixation technique for ACJ instability in patients aged ≥50 years and to compare these outcome parameters between surgery in the acute (≤3 weeks) and chronic setting of ACJ instability.</p><p><strong>Methods: </strong>Patients aged ≥50 years who underwent arthroscopic ACJ stabilization via suspensory fixation between 01/2011 and 06/2020 were included. The American Shoulder and Elbow Surgeons (ASES), Single Assessment Numerical Evaluation (SANE), the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), visual analogue scale (VAS) for pain were collected at a minimum of 24 months. RTA and RTW were evaluated by a questionnaire. Outcomes were compared between undergoing surgery for acute or chronic (≤/>3 weeks) ACJ instability.</p><p><strong>Results: </strong>Of 55 eligible patients, 44 patients with a mean age of 59.9±7.8(50-76) years were included. At a minimum 37 months after surgery (mean, 74.8±31.4, range 37-142 months), patients reported an ASES of 89.4±15.6 (38-100), SANE of 89.8±13.9(40-100), and Quick-DASH of 9.8±13.3(0-47.7), along with a VAS pain score of 0.9±1.7(0-7); with 73.3% of the patients reaching the PASS. There was no revision for subsequent recurrent instability. Postoperatively, 87.2% of patients returned to athletic activity after 4.1±2.3(1-12) months, however to fewer disciplines (2.4±1.2 vs. 2.1±1.4 p=0.025). 97% of the patients returned to work at a mean of 7.3±8.8(0-40) weeks, with 90% reporting a similar or superior working ability. While the overall outcome was comparable in the chronic and the acute setting, patients in the chronic situation of ACJ instability reported significantly inferior SANE scores compared to the contralateral shoulder (p=0.024) and returned to fewer athletic disciplines (p=0.007) compared to the acute situation.</p><p><strong>Conclusion: </strong>Patients aged ≥50 years undergoing arthroscopic ACJ stabilization experienced favorable clinical outcomes at mid-term follow-up, with high rates of return to athletic activity and work. Outcomes were comparable in patients undergoing surgery in the acute and chronic situation.</p><p><strong>Level of evidence: </strong>Retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499459","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}