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

{"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}

{"title":"Steven F. DeFroda, M.D., M.E., Associate Editor, Arthroscopy Techniques","authors":"Michael J. Rossi M.D., M.S. (Editor-in-Chief)","doi":"10.1016/j.arthro.2025.04.012","DOIUrl":"10.1016/j.arthro.2025.04.012","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page 2168"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329961","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":"Derek H. Ochiai, M.D., Associate Editor, Arthroscopy Techniques","authors":"Michael J. Rossi M.D., M.S. (Editor-in-Chief)","doi":"10.1016/j.arthro.2025.04.022","DOIUrl":"10.1016/j.arthro.2025.04.022","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page 2168"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329962","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":"Adhesive Capsulitis of the Shoulder","authors":"Joseph P. Mullen B.S.,&nbsp;Tyler M. Hauer M.D.,&nbsp;Emily N. Lau M.D.,&nbsp;Albert Lin M.D.","doi":"10.1016/j.arthro.2025.03.027","DOIUrl":"10.1016/j.arthro.2025.03.027","url":null,"abstract":"<div><div>Adhesive capsulitis is characterized by limited range of motion (ROM) due to adhesions within the glenohumeral joint capsule. The pathophysiology is suspected to involve an inflammatory reaction progressing to fibrotic contracture. Active fibroblastic proliferation can be found on histologic analysis, with some transformation to myofibroblasts, ultimately creating collagen in the form of a thick band. Clinically, adhesive capsulitis is classified into phases: freezing, frozen, and thawing. Risk factors include diabetes, hyperthyroidism, prior fractures, shoulder and cervical spine surgery, and radiation therapy. The condition affects 2% to 5% of individuals, with higher rates in women. While plain radiographs are often unremarkable, magnetic resonance imaging may reveal a thickened capsule, synovial hypertrophy, and joint capsule edema. Nonsurgical treatment focuses on pain relief and restoring ROM and includes physical therapy (PT), oral anti-inflammatory medications, corticosteroid injections, extracorporeal shock wave therapy, and ultrasonography-guided hydrodistention. Early corticosteroid injections are associated with shortened symptom duration and improved functional scores. Both a rotator interval approach, compared with a posterior approach, and lower dosages (10 mg vs 40 mg) of corticosteroid may lead to better pain relief and functional improvement. Ultrasound-guided hydrodilatation with hyaluronic acid combined with PT has also shown superior outcomes compared with PT alone. For patients with diabetes, extracorporeal shock wave therapy avoids potential metabolic complications from steroids. Adhesive capsulitis is self-limiting, with most patients achieving symptom resolution without surgery. Surgical intervention, typically considered after 9 to 12 months of failed nonsurgical management, includes arthroscopic capsular release, manipulation under anesthesia (MUA), or both. Both approaches are efficacious, with improved pain, ROM, and functional scores. Although MUA may be more cost-effective, arthroscopy allows direct visualization and treatment of pathology while reducing the risk of complications from MUA, such as fracture, dislocation, or nerve injury. Postoperative protocols emphasize early PT supplemented by multimodal pain management to maintain and improve ROM.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Pages 2176-2178"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329963","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 and Complications of Lateral Extra-Articular Procedures in the ACL reconstructed Knee: Part II of An International Consensus Statement.","authors":"Bertrand Sonnery-Cottet, Alessandro Carrozzo, Adnan Saithna, Edoardo Monaco, Thais Dutra Vieira, Volker Musahl, Alan Getgood, Camilo Partezani Helito","doi":"10.1016/j.arthro.2025.06.013","DOIUrl":"10.1016/j.arthro.2025.06.013","url":null,"abstract":"<p><strong>Purpose: </strong>To establish international expert consensus on surgical techniques, complications, and rehabilitation protocols for lateral extra-articular procedures (LEAPs) performed adjunctively with anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>Fifty-five knee surgeons from 17 countries on five continents completed a three-round modified Delphi process. In the final round, 16 statements on LEAP techniques and complications were scored on a 5-point Likert scale; ≥75 % \"agree/strongly agree\" constituted consensus. When appropriate, strength of recommendation was graded. Statements lacking support were revised until consensus or abandonment.</p><p><strong>Results: </strong>Six statements achieved unanimous consensus (100 %), two strong consensus (90-99.9 %), and three consensus (75-89.9 %); four were removed. Key technical recommendations were: (1) in iliotibial-band (ITB) procedures, the graft strip should pass beneath the lateral collateral ligament (LCL); (2) an anatomic technique is mandatory for anterolateral ligament reconstruction (ALLR); and (3) no single LEAP is clinically superior to another. Unanimous agreement indicated that modern LEAPs do not increase lateral-compartment osteoarthritis risk, carry a low complication rate, and do not necessitate changes to rehabilitation or return-to-play timelines.</p><p><strong>Conclusions: </strong>Consensus defined core surgical principles and confirmed the safety of adding LEAPs to ACL reconstruction. When an ITB graft is used, it should be routed deep to the LCL and fixed between 0° and 60° of knee flexion under low tension. For ALLR, femoral fixation should be in full extension at a posterior-proximal point relative to the lateral epicondyle. Although no single LEAP proved superiority, adherence to these principles permits safe, effective surgery without altering standard rehabilitation or return-to-sport protocols and without increasing osteoarthritis risk.</p><p><strong>Level of evidence: </strong>Level V, Expert consensus.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369572","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":"Indications for Lateral Extra-Articular Procedures in the ACL Reconstructed Knee: Part I of An International Consensus Statement.","authors":"Bertrand Sonnery-Cottet, Alessandro Carrozzo, Adnan Saithna, Edoardo Monaco, Thais Dutra Vieira, Volker Musahl, Alan Getgood, Camilo Partezani Helito","doi":"10.1016/j.arthro.2025.06.012","DOIUrl":"10.1016/j.arthro.2025.06.012","url":null,"abstract":"<p><strong>Purpose: </strong>To define expert consensus on if and how lateral extra-articular procedures (LEAPs) should accompany anterior cruciate ligament (ACL) reconstruction to optimise outcomes in ACL-deficient knees.</p><p><strong>Methods: </strong>Fifty-five knee surgeons from 17 countries on five continents completed a three-round modified Delphi process. Twenty-one statements on patient selection for combined ACL reconstruction (ACLR) + LEAPs were graded on 5-point Likert scales; ≥75 % \"agree/strongly agree\" signified consensus. Strength of recommendation was ranked, and statements failing threshold were revised or discarded after discussion.</p><p><strong>Results: </strong>One statement achieved unanimous agreement (100 %): it's strongly reccomendend to add a LEAP for active patients ≤25 years receiving hamstring-autograft ACLR to reduce graft failure. Strong consensus (≥90 %) supported LEAPs in primary ACLR when grade-3 pivot shift (97.9 %), knee hyperextension (97.9 %), skeletally immature status (79.5 %), revision ACLR (91.5 %), return to pivoting sports (93.2 %), active patients ≤25 years using non-hamstring grafts (90.7 %), grade-3 Lachman test (90 %), and when multiple relative risk factors coexist (statement #36, 97.1 %). Consensus (75-89.9 %) favoured LEAPs for chronic symptomatic ACL deficiency (86.1 %), posterior tibial slope >12° (85.7 %), and a history of contralateral ACL injury (88.9 %). Eight statements did not reach consensus regarding small-diameter autografts, female athletes, imaging signs of anterolateral injury (e.g., Segond fracture, lateral femoral-notch sign), and concomitant meniscal procedures. One statement on LEAPs with primary ACL repair was withdrawn because the project focused on reconstruction.</p><p><strong>Conclusions: </strong>International experts strongly recommend adding a LEAP in young active patients undergoing hamstring-autograft ACLR and in cases of high-grade rotational or anterior laxity, knee hyperextension, revision surgery, or returning to pivoting sports. Unresolved issues include small graft size, female athletes, imaging-findings of rotational instability, and concurrent meniscal procedures, highlighting priorities for future research.</p><p><strong>Level of evidence: </strong>Level V, Expert opinion.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369571","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)00380-9","DOIUrl":"10.1016/S0749-8063(25)00380-9","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page A20"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329958","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":"Kyle N. Kunze, M.D., Associate Editor","authors":"Michael J. Rossi M.D., M.S. (Editor-in-Chief)","doi":"10.1016/j.arthro.2025.03.056","DOIUrl":"10.1016/j.arthro.2025.03.056","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 7","pages":"Page 2167"},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329960","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: Combined Transosseous and Capsular Repair for Triangular Fibrocartilage Complex Tears With Distal Radioulnar Joint Instability-A Step Toward Comprehensive Joint Stabilization.","authors":"Julia A V Nuelle","doi":"10.1016/j.arthro.2025.06.014","DOIUrl":"10.1016/j.arthro.2025.06.014","url":null,"abstract":"<p><p>Triangular fibrocartilage complex (TFCC) tears involving the foveal attachment are a known cause of distal radioulnar joint instability. While transosseous repair of the deep TFCC fibers is a widely accepted technique for restoring distal radioulnar joint instability, persistent instability remains a clinical challenge in a subset of patients. Combining transosseous repair with volar and dorsal capsular repair is an important technique to consider when treating Atzei Class 2 TFCC tears. This evolving approach reflects a more comprehensive appreciation of the TFCC as a complex stabilizing unit, rather than an isolated ligamentous structure.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369570","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}