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

{"title":"Medial Meniscus Root Tears: Anatomy, Repair Options, and Outcomes","authors":"Cameron Gerhold B.S.,&nbsp;Udit Dave B.S.,&nbsp;Andrew S. Bi M.D.,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.arthro.2025.01.005","DOIUrl":"10.1016/j.arthro.2025.01.005","url":null,"abstract":"<div><h3>Abstract</h3><div>Meniscal root tears are defined as complete avulsions of the meniscus at the site of tibial attachment or meniscal tears within 1 cm of the meniscotibial attachment sites. This injury often is seen in individuals older than the age of 50 years who have a sedentary lifestyle and can lead to the progression of osteoarthritis if not treated properly; in contrast, a traumatic etiology may be observed in younger individuals. Recent literature has defined the association between medial meniscal root tears and meniscal extrusion, defined by &gt;2 mm of overhang of the medial meniscus over the medial border of the tibial plateau. Surgical repair often is indicated for unstable meniscal root tears, as these injuries are functionally equivalent to a total meniscectomy because of a complete loss of circumferential fibers and hoop stresses. There are 2 main repair techniques: transtibial pullout and suture anchor repairs. Repair using the transtibial pullout technique involves drilling a tunnel from the anterior proximal tibia to the anatomic insertion site of the meniscal root. Sutures are then passed through the medial root, retrieved through the tunnel, and secured with a cortical button or suture anchor on the anterior tibial cortex. Suture anchor repairs either involve passing sutures through the meniscal root and into a suture anchor at the footprint. A supplemental centralization technique is a new advancement designed to reduce meniscal extrusion and involves fixation of the meniscal body with a suture anchor at the peripheral medial plateau. Medial meniscal root repair is associated with improved patient-reported outcomes and a reduced rate of knee replacement.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 4","pages":"Pages 871-873"},"PeriodicalIF":4.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642974","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":"Tranexamic Acid Has A Limited Role in Improving Visual Clarity and Pain in Arthroscopic Shoulder Surgery: A Systematic Review and Meta-Analysis.","authors":"Danielle Dagher, Imad Kashir, Osman Mahboob, Nasser Al-Turki, Moin Khan","doi":"10.1016/j.arthro.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.03.009","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this systematic review was to evaluate the effects of tranexamic acid (TXA) compared to placebo or other comparators with regard to visual clarity, pain, total operative time, and volume of blood loss in patients undergoing arthroscopic shoulder surgery.</p><p><strong>Methods: </strong>CENTRAL, EMBASE, and MEDLINE were searched from inception until January 4th, 2025. Study selection and data extraction were carried out in duplicate. Randomized controlled trials that compared TXA versus placebo or another comparator in patients undergoing arthroscopic shoulder surgery were included. All outcomes were assessed in duplicate for risk of bias (RoB) using the RoB-2 tool and for certainty of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. Results were pooled in a meta-analysis using a random-effects model when appropriate or were synthesized narratively when data could not be pooled.</p><p><strong>Results: </strong>Overall, 12 randomized controlled trials involving 1009 patients were included. The pooled estimate for visual clarity shows a slight increase in visual clarity (Standardized Mean Difference 0.64 [0.05, 1.24]). The pooled estimate for pain shows a mean difference of a reduction of pain by 0.38 points in the TXA group on a visual analog scale of 0 to 10 (0 = no pain) (Mean Difference -0.38 [-0.76, 0.00]).</p><p><strong>Conclusions: </strong>There is moderate-certainty evidence suggesting that TXA likely results in a slight increase in visual clarity. The evidence also suggests that TXA has little to no difference in pain, operative time, and volume of blood loss.</p><p><strong>Level of evidence: </strong>Level I, systematic review of Level I studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665442","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":"Cover Image & Video Link","authors":"","doi":"10.1016/S0749-8063(25)00091-X","DOIUrl":"10.1016/S0749-8063(25)00091-X","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 4","pages":"Page A18"},"PeriodicalIF":4.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643120","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":"Unlike Modifiable Factors, Non-Modifiable Risks Factors For ACL Injury Including Lateral Femoral Condyle Ratio (LFCR) and Index (LFCI) Have Low Clinical Relevance.","authors":"Drew W Nute","doi":"10.1016/j.arthro.2025.03.021","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.03.021","url":null,"abstract":"<p><p>Risk factor mitigation is of the utmost concern in prevention of primary ACL injuries. Known anatomic risks for ACL injury include varus deformity of the knee, increased posterior tibial slope, decreased femoral notch width, and more recently increased lateral femoral condyle ratio (LFCR) and decreased lateral femoral condyle index (LFCI). While some authors recommend knee osteotomy in the revision setting to correct deformities of the proximal tibia, osteotomy to decrease posterior femoral condyle depth is not described, to my knowledge, though lateral extra-articular tenodesis (LET) in cases of increased LFCR during revision ACL reconstruction has been recommended. Increased posterior femoral condyle depth as measured by the LFCR is non-modifiable, and therefore lacks clinical use in the prevention of primary ACL injuries. Providers should focus on modifiable factors such as quadriceps strength, core strengthening, and altered landing mechanics in the prevention of primary ACL injury.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651948","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":"Orthopaedic Musculoskeletal Biologics Research Impacts Patient Care: The 3rd Annual Journal of Arthroscopy Orthobiologics Virtual Special Issue.","authors":"Jared P Sachs, Yusuf N Mufti, Brian J Cole","doi":"10.1016/j.arthro.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.03.005","url":null,"abstract":"<p><p>Orthobiologics represent a rapidly advancing field of research in musculoskeletal care, providing novel therapies to modify symptoms and potentially augment tissue regeneration when used in the clinical or operative setting. These treatments are derived from autologous cells, tissues, and blood components, yielding bioactive elements that may promote healing, reduce symptoms and be associated with improved patient outcomes. Biologic therapies such as platelet-rich plasma, bone marrow aspirate concentrate, adipose-derived products, and amniotic allograft tissues have demonstrated favorable clinical outcomes. The Journal of Arthroscopy and its companion journals are committed to advancing the field by publishing high-quality, peer-reviewed orthobiologics research. This anthology of articles showcases significant recent advancements in musculoskeletal orthobiologics research.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639702","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":"Increased Lateral Posterior Tibial Slope is Associated with a Higher Rate of Lateral Meniscal Injury in Acute Noncontact Anterior Cruciate Ligament Ruptures.","authors":"Ryan R Thacher, Julia Retzky, Janet Hsu, Paley G Arnone, Joseph T Nguyen, Harry G Greditzer, Danyal H Nawabi, Robert G Marx","doi":"10.1016/j.arthro.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.03.011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The purpose of this study was to determine whether there was an association between increasing posterior tibial slope and meniscal tears in a group of patients with isolated, noncontact and acute ACL ruptures from a large ACL registry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Our institution's ACL Registry was consulted to identify patients between the age of 18 and 45 who underwent primary ACL reconstruction between Jan 2019 and July 2022 for acute, noncontact ACL rupture. Patients with pre-existing meniscal pathology, chronic ACL reconstructions, revisions, and multi-ligament knee injuries were excluded. Preoperative MRIs were used to measure lateral and medial posterior tibial slope. Meniscal injuries seen during arthroscopy were recorded based on operative reports. Independent cohorts were created based on the presence or absence of a meniscal tear. Two-tailed student's t tests were used to compare average medial and lateral posterior tibial slopes between groups. Separate analyses were performed for the presence of isolated lateral meniscal tears, isolated medial meniscal tears and both medial and lateral meniscal tears. Multivariable logistic regression models were generated to evaluate other potential risk factors for each tear outcome, including age, gender and BMI. Receiver Operating Characteristic (ROC) curve analysis was conducted to explore the potential of identifying an optimal threshold for predicting the presence of a meniscal tear based on lateral posterior tibial slope.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;1056 patients ultimately met inclusion criteria. There were 498 (47%) patients with any meniscal tear, 346 (33%) patients with lateral meniscus tears, 245 (23%) patients with medial meniscus tears and 93 (9%) patients with both medial and lateral tears. The average lateral and medial posterior tibial slopes were 5.5° (-4.2° to 13.4°) and 5.7° (0° to 15.7°), respectively. Increased lateral tibial slope was associated with a statistically significant increase in rate of any meniscal tear (aOR: 1.10, 95% CI: 1.04-1.16, p&lt;0.001) and lateral meniscal tear, specifically (aOR: 1.11, 95%CI: 1.04-1.18, p&lt;0.001). In regression analysis, male sex and BMI≥35 were found to increase the risk of all meniscal tear types. With a ROC curve analysis identifying LPTS threshold values that resulted AUC ranges from 0.55 to 0.57, we were unable to identify an optimal threshold for posterior tibial slope in predicting meniscal tears.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this single institution registry-based study, increasing lateral posterior tibial slope was associated with a higher rate of meniscus injury in acute ACL ruptures whereas medial tibial slope demonstrated no correlation. No optimal threshold of posterior slope could be identified above which the odds of a meniscal tear were significantly elevated. Regression analysis identified BMI&gt;35 and male sex as independent risk factors for meniscal tear in this select population.","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639701","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":"Author Reply to \"Regarding 'One-Year Follow-Up Does Not Determine Rotator Cuff Repair Long-Term Outcome'\".","authors":"Michaela E Corvi, Eoghan T Hurley, Tom R Doyle, Samuel G Lorentz, John J Corvi, Jonathan F Dickens, Oke Anakwenze, Christopher S Klifto","doi":"10.1016/j.arthro.2025.02.037","DOIUrl":"10.1016/j.arthro.2025.02.037","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630931","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":"Obese Patients Have Inferior 10-Year Patient-Reported Outcomes and Higher Rates of Conversion to Total Hip Arthroplasty After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.","authors":"Emily Berzolla, Nicole D Rynecki, Griffith G Gosnell, Allison M Morgan, Daniel Kaplan, Thomas Youm","doi":"10.1016/j.arthro.2025.03.012","DOIUrl":"10.1016/j.arthro.2025.03.012","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate patient-reported outcomes (PROs) and survivorship in obese patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) at 10-year follow-up.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients who underwent arthroscopy for FAIS from 2011 to 2013. Patients were assessed at baseline, 1 month, 6 months, 1 year, 2 years, 5 years, and 10 years using the modified Harris hip score (mHHS) and nonarthritic hip score (NAHS). Patients were categorized on the basis of BMI into normal, overweight, and obese cohorts. Minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) were calculated for both PROs. Improvements from baseline were analyzed, and differences between groups were evaluated while controlling for age. Survival to revision surgery was assessed with Kaplan-Meier survival curves.</p><p><strong>Results: </strong>144 patients (65.2% female) with a mean age of 38.8 ± 13.0 years and an average follow-up of 11.6 (range: 10.0-13.8) years were included, and categorized into normal weight (59.7%), overweight (26.4%), and obese (13.9%). All groups showed significant improvement in PROs at 10 years compared to baseline (P = .007). Obese patients had lower postoperative scores (mHHS: 72.8 vs 90.1; P = .009; NAHS: 68.4 vs 88.6; P = .003) and improvement in scores from baseline (mHHS: 23.4 vs 37.7; P = .013; NAHS: 18.4 vs 40.0; P = .004) at 10-year follow-up, as well as lower achievement of mHHS PASS (60.0% vs 87.2%; P = .015), NAHS PASS (50.0% vs 89.5%; P < .001) and NAHS MCID (70.0% vs 93.0%; P = .008). Obese patients also had a higher rate of conversion to THA (17.4% vs 3.3%; P = .012). The overall complication rate was 4.2% compared to 10% in the obese group, with obese patients experiencing a superficial infection more frequently (P = .002).</p><p><strong>Conclusions: </strong>Although obese patients still have significantly improved outcomes compared to baseline, at 10-year follow-up they have inferior outcomes compared to nonobese patients and higher rates of conversion to THA.</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":4.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631075","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":"Author reply to «Postoperative Immobilization Strategies Following Arthroscopic Rotator Cuff Repair: A Clinical and Sociological Perspective. ».","authors":"Florian Schönweger, Francesco Marbach, Pietro Feltri, Stamen Roumenov Milev, Giuseppe Filardo, Christian Candrian","doi":"10.1016/j.arthro.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.03.016","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630935","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":"Letter to the Editor Regarding \"One-Year Follow-up is Sufficient Time for Patient-Reported Outcomes following Rotator Cuff Repair: A Systematic Review and Meta-analysis\".","authors":"Shubham Kumar, Nosaibah Razaqi, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.arthro.2025.02.036","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.036","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631072","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}