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

{"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}

{"title":"Knee Joint Line Obliquity Continues to Regress Beyond 1 Year and Stabilizes at 3 Years After Open Wedge High Tibial Osteotomy Without Correlation to Clinical Outcome.","authors":"Ju-Ho Song, Bum-Sik Lee, Jong-Min Kim, Seong-Il Bin","doi":"10.1016/j.arthro.2025.06.005","DOIUrl":"10.1016/j.arthro.2025.06.005","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate midterm serial postoperative changes in the knee and adjacent joints, with a focus on the knee joint obliquity (KJLO).</p><p><strong>Methods: </strong>Patients undergoing open wedge high tibial osteotomy between January 2011 and December 2018 were retrospectively reviewed. Those with a follow-up duration of ≥5 years and serial long-standing hip-to-ankle radiographs were included. KJLO and joint line convergence angle were measured at the knee joint. The influence of the hip joint was assessed using the hip abduction angle (HAA), and the influence of the ankle joint was evaluated using the ankle joint line obliquity (AJLO) and the tibiotalar angle. Serial changes in the radiographic parameters (preoperatively and 3 months, 1 year, 3 years, and 5 years postoperatively) were analyzed using repeated-measures correlation. Clinical outcomes were evaluated using the Knee Society objective and functional scores.</p><p><strong>Results: </strong>A total of 105 knees were followed up for 90.2 ± 27.2 months (range, 60-151 months). KJLO increased from -0.7° ± 0.2° (mean ± standard error) preoperatively to 2.5° ± 0.3° at 3 months postoperatively and to 3.0° ± 0.2° at 1 year postoperatively (P = .026, vs 3 months postoperatively) but subsequently decreased to 2.9° ± 0.2° at 3 years postoperatively (P < .001, vs 1 year postoperatively) and to 2.7° ± 0.3° at 5 years postoperatively, with no significant difference between the 3- and 5-year values (P = .609, vs 3 years postoperatively). Similarly, HAA increased until 1 year postoperatively (P < .001, vs 3 months postoperatively) and then decreased significantly until 5 years postoperatively (P < .001, vs 1 year postoperatively). However, AJLO showed a significant decrease between 3 months and 1 year postoperatively (P < .001), with no further significant changes observed between 1 and 5 years postoperatively (P = .225). According to the repeated-measures correlation, the factors significantly correlating with changes in KJLO were HAA (P < .001), AJLO (P < .001), and joint line convergence angle (P = .028). Five-year postoperative KJLO did not have significant correlations with the Knee Society objective (P = .845) and functional (P = .361) scores.</p><p><strong>Conclusions: </strong>KJLO increased after open wedge high tibial osteotomy and began to decrease from 1 year postoperatively, with no significant difference observed between 3 and 5 years. This change did not correlate with clinical outcomes. HAA showed a similar pattern, increasing until 1 year and then continuing to decrease significantly throughout the midterm follow-up. AJLO showed a significant decrease within the first postoperative year, with no further changes thereafter.</p><p><strong>Level of evidence: </strong>Level III, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340722","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":"Rates of Return to Sport After Surgical Management of Multiligament Knee Injuries Are Higher Than Previously Described yet Highly Heterogeneous: A Systematic Review.","authors":"Joshua Dworsky-Fried, Satyavenkata Kotipalli, Prushoth Vivekanantha, Meshal Alomari, Sachin Tapasvi, Gilbert Moatshe, Ryan Martin, Darren de Sa","doi":"10.1016/j.arthro.2025.06.006","DOIUrl":"10.1016/j.arthro.2025.06.006","url":null,"abstract":"<p><strong>Purpose: </strong>To provide an updated overview of return to sport (RTS) and return to work (RTW) after surgical management of multiligament knee injuries (MLKIs).</p><p><strong>Methods: </strong>A search was conducted across the MEDLINE, Embase, and PubMed databases from inception to August 26, 2024. Studies published after 2018 that reported on rates of RTS or RTW after multiligament knee reconstruction were included. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed, and a quality assessment was performed using the Methodological Index for Non-randomized Studies (MINORS) criteria. Data on study characteristics, demographic characteristics, and surgical details were extracted. Rates of RTS or RTW at the same level or at any level of participation were recorded. Random-effects models were used to generate forest plots.</p><p><strong>Results: </strong>Fifteen studies reported on RTS, with rates ranging from 41.2% to 100% when investigating RTS at any level. Thirteen studies reported rates of return to preinjury level, ranging from 5.9% to 100%. RTS rates at any level and preinjury level had higher ceilings than shown in a prior systematic review. Time taken to RTS ranged from 6.7 to 24.9 months. Twelve studies reported on RTW at any capacity, with rates ranging from 41% to 100%. Seven studies reported rates of RTW at preinjury capacity, ranging from 39.3% to 100%. For both RTS and RTW outcomes, high heterogeneities precluded pooled estimates. Time taken to RTW ranged from 2.4 to 24.8 months. Substantially lower RTW rates were associated with multi-trauma dislocations and sedentary occupations.</p><p><strong>Conclusions: </strong>Rates of RTS at any level and preinjury level ranged from 41.2% to 100% and 5.9% to 100%, respectively, with corresponding heterogeneity values of 91% and 83%. These rates have higher ceilings than reported in a previous systematic review. Currently, there is insufficient evidence to recommend one surgical approach over another.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III and IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340723","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":"Adding a Lateral Extra-articular Tenodesis Is Cost-Effective in Primary Anterior Cruciate Ligament Reconstruction: A Markov Analysis.","authors":"Nathan H Varady, Jacob F Oeding, Paul M Inclan, Anil S Ranawat, Sabrina M Strickland, Andrew D Pearle, Scott A Rodeo, Riley J Williams","doi":"10.1016/j.arthro.2025.06.004","DOIUrl":"10.1016/j.arthro.2025.06.004","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the cost-effectiveness of anterior cruciate ligament reconstruction (ACLR) with lateral extra-articular tenodesis (LET) augmentation in athletes with primary anterior cruciate ligament ruptures compared with ACLR alone.</p><p><strong>Methods: </strong>A Markov chain Monte Carlo model evaluated the outcomes and costs of 1,000 athletes undergoing ACLR with LET (ACLR-LET, iliotibial band) compared with ACLR alone. Costs, utility values, graft failure rates, and transition probabilities were derived from existing literature. Targeted meta-analysis of failure rates and patient-reported outcomes from randomized controlled trials comparing ACLR versus ACLR-LET was performed. Model outcomes included costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio. Given varying definitions of \"high risk,\" sensitivity analyses assessed the cost-effectiveness of ACLR-LET across a range of theoretical failure rates.</p><p><strong>Results: </strong>Meta-analysis of 1,072 patients (530 ACLR-LET and 542 ACLR patients) showed a graft failure rate of 5.1% (95% confidence interval [CI], 2.9%-8.8%) for ACLR-LET compared with 11.2% (95% CI, 7.0%-17.6%) for ACLR alone (relative risk, 0.39; 95% CI, 0.27-0.57; P < .001). Across a 5-year horizon, the mean total cost of ACLR alone was $68,605 ± $9,472 compared with $56,217 ± $7,349 for ACLR-LET. ACLR-LET yielded 1.88 ± 0.30 QALYs compared with 1.54 ± 0.30 QALYs for ACLR alone, and ACLR-LET was the preferred treatment in 98.1% of patients in the microsimulation model. In sensitivity analyses, ACLR-LET remained more cost-effective assuming an ACLR-LET failure rate up to 11.3% or an ACLR-alone failure rate down to 4.8%.</p><p><strong>Conclusions: </strong>LET augmentation is cost-effective in athletes undergoing primary ACLR. The results of this Monte Carlo microsimulation suggest that ACLR-LET yields both superior outcomes and lower overall costs compared with ACLR alone. By use of sensitivity analysis, we found that only small improvements in graft failure rates were required for LET augmentation to be the favored treatment, suggesting that LET may be a cost-effective treatment option even when used beyond the athletes at highest-risk of graft rupture LEVEL OF EVIDENCE: Level II, economic and decision analysis.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340704","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":"Comparable Graft Failure Rates and Outcome in Superior Capsular Reconstruction Yet Faster Pain Relief Using Dermal Allograft and Faster Motion Recovery Using Tensor Fascia Lata Autograft.","authors":"Wael Mohammed Alzahrani, Hyojune Kim, In-Ho Jeon, Kyoung Hwan Koh","doi":"10.1016/j.arthro.2025.06.008","DOIUrl":"10.1016/j.arthro.2025.06.008","url":null,"abstract":"<p><strong>Purpose: </strong>To directly compare clinical outcomes of superior capsular reconstruction (SCR) using dermal allografts (DAs) and tensor fascia latae (TFL) autografts and determine independent factors associated with patient satisfaction and graft failure.</p><p><strong>Methods: </strong>This retrospective study was conducted between June 2013 and November 2021. Patients who underwent SCR using DA or TFL were included. Inclusion criteria included irreparable rotator cuff tears, a minimum 12-month follow-up, and age older than 50 years. Clinical outcomes were evaluated preoperatively and at 6 months, 1 year, and final follow-up. Logistic regression analysis was performed to identify independent factors associated with graft failure and patient satisfaction. Trend analysis was conducted to evaluate changes in outcomes over time.</p><p><strong>Results: </strong>Of initially eligible patients, 16.7% (8/48) from the DA group and 17.1% (7/41) from the TFL group were excluded due to loss to follow-up, resulting in a total of 74 patients analyzed. The average follow-up duration was 34.6 months (range, 23.8-66.0 months) in the DA group and 33.8 months (range, 12.0-60.0 months) in the TFL group. The overall graft failure rate was 35.0% in the DA group and 32.4% in the TFL group (P = .810). Logistic regression revealed older age, use of DA, and reduced postoperative acromiohumeral distance as significant predictors of graft failure. Graft failure, specifically at the greater tuberosity site, was strongly associated with lower patient satisfaction (odds ratio, 0.007; 95% confidence interval, 0.000-0.124; P = .001). The TFL group showed faster recovery of range of motion, while the DA experienced more rapid pain relief.</p><p><strong>Conclusions: </strong>This study showed that graft failure at the greater tuberosity significantly influenced patient dissatisfaction following SCR. Both graft types (DA and TFL) showed similar graft failure rates and clinical outcomes. However, the DA group experienced faster pain relief, whereas the TFL group had earlier recovery of shoulder range of motion.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340719","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":"Allograft AC joint reconstruction provides long-term benefit for high grade injuries in the active population, but may not be necessary for all patients.","authors":"Dustin Volkmer","doi":"10.1016/j.arthro.2025.06.003","DOIUrl":"10.1016/j.arthro.2025.06.003","url":null,"abstract":"<p><p>Acromioclavicular (AC) joint separations are a challenging injury to treat, since some patients do very well with conservative treatment while others (particularly those with high demand activity requirements) develop debilitating symptoms and require surgical intervention. Surgical treatment for AC joint separations has traditionally carried high risk of complications, most notably loss of reduction and recurrent instability. The advancement of arthroscopic techniques has allowed for less invasive options with good functional outcomes, although the risk of recurrent instability still remains. Type V injuries have traditionally been an indication for surgery in most cases, but recent evidence has suggested equivalent outcomes between conservative and surgical treatment for these injuries. Although arthroscopic allograft AC joint reconstruction can provide excellent patient outcomes, the jury is still out on whether surgery is necessary for all type V AC joint injuries, and it is important to provide patients individualized counseling and treatment while adhering to the classic medical principle of \"first, do no harm.\"</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340705","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":"Hip Arthroscopy with Labral Repair and Capsular Closure in Patients with Joint Hypermobility does not Result in Inferior Outcomes Compared to Patients without Joint Hypermobility.","authors":"Joseph J Ruzbarsky, Spencer M Comfort, Trevor J Shelton, Joan C Rutledge, Nicholas A Felan, Karen K Briggs, Grant J Dornan, Marc J Philippon","doi":"10.1016/j.arthro.2025.06.007","DOIUrl":"10.1016/j.arthro.2025.06.007","url":null,"abstract":"<p><strong>Purpose: </strong>To compare patient-reported outcomes (PROs) between patients with and without joint hypermobility following primary hip arthroscopy with labral repair for femoroacetabular impingement syndrome (FAIS).</p><p><strong>Methods: </strong>Patients undergoing primary hip arthroscopy with labral repair for FAIS between January 2016 and December 2018 were identified. Exclusion criteria included prior ipsilateral hip surgery or center edge angle <20°. At minimum 2-year follow up, Hip Outcome Score (HOS) Activities of Daily Living (HOS-ADL) and Sport (HOS-Sport), modified Harris Hip Score (mHHS), 12-Item Short Form (SF-12) Physical and Mental Component Scores (PCS, MCS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), minimal clinically important difference (MCID), patient acceptable symptom states (PASS), Tegner Activity Scale, and satisfaction, were compared between hypermobility (HM) (Beighton score >5) and non-hypermobility (NHM) (Beighton score <5) groups.</p><p><strong>Results: </strong>A total of 221 patients met the criteria, with 218 (98.6%) completing minimum follow-up. The HM group included 24 patients with mean follow-up of 4.18 ± 1.3 years, and the NHM group had 186 patients with mean follow-up of 5.21 ± 1.65 years. There were no significant differences in mean postoperative HOS-ADL (92±12 vs 87±19), HOS-Sport (81±24 vs 77±29), mHHS (87±14 vs 87±13), SF-12 PCS (53±8 vs 49±12), SF-12 MCS (54 ± 7 vs 54± 9), or WOMAC (9±11 vs 10±12) scores between NHM and HM groups, respectively (P>0.05). The NHM group attained MCID for HOS-ADL at a higher rate (P=0.04). No difference in PASS attainment for HOS-ADL or in PASS/MCID attainment for HOS-Sport or mHHS was observed (P>0.05). Median satisfaction was 8.50 (Range: 1-10) for HM and 10 (Range: 1-10) for NHM.</p><p><strong>Conclusion: </strong>At minimum 2-year follow-up, PROs, reoperation, and THA rates were similar between patients with Beighton scores <5 and >5 undergoing hip arthroscopy with labral repair and capsular plication.</p><p><strong>Level of evidence: </strong>Retrospective Comparative Case Series, III.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340720","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":"Isolated Subacromial Balloon Spacer Implantation for Massive Irreparable Rotator Cuff Tears Is Associated with Improvement In Pain and Function at Minimum One Year Follow-Up.","authors":"Mohamad Y Fares, Peter Boufadel, Jonathan Koa, Jaspal Singh, Joseph A Abboud","doi":"10.1016/j.arthro.2025.06.009","DOIUrl":"10.1016/j.arthro.2025.06.009","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the efficacy of isolated subacromial balloon spacer implantation in patients with MIRCTs, as evidenced by changes in patient reported outcomes and range of motion values.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data was conducted for MIRCT patients who underwent subacromial balloon spacer implantation alone without any concomitant procedures, with a minimum follow-up of one year. Patient demographics and preoperative MRI findings were recorded. Outcomes included the American Shoulder and Elbow Surgeon (ASES) score, Visual Analogue Scale (VAS) pain score, active forward elevation, as well as complications and reoperations.</p><p><strong>Results: </strong>A total of 34 patients (18 female, 16 male) were included. The mean age was 65.9 years and the mean follow-up period was 15.9 months. On preoperative MRI, the mean posterosuperior rotator cuff tear size was 3.57 cm, mean retraction size was 3.7 cm, 71% were Goutailler grade III/IV, and 94% had none or minimal osteoarthritis. There were no complications, and two patients (5.9%) underwent conversion to reverse shoulder arthroplasty. Significant improvements were observed in mean forward elevation (136.6° to 150.4°, p=0.009), ASES scores (39.5 to 76.1, p<0.001) and VAS score (6.1 to 2.1, p<0.001) at final follow up. At final follow-up, 90.3% of patients reached minimal clinically important difference(MCID) for ASES scores and and 87.1% reached MCID for VAS scores.</p><p><strong>Conclusion: </strong>Isolated subacromial balloon spacer implantation is an effective treatment option for patients with MIRCTs evident by the significant improvements in forward elevation, and high rates of clinically meaningful ASES and VAS scores at minimum one year follow-up.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340721","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: Conversion to Arthroscopy Is Twice the Cost of Rehabilitation and More Costly Than Early Arthroscopy.","authors":"Mark A Glover, Eoghan T Hurley","doi":"10.1016/j.arthro.2025.06.002","DOIUrl":"10.1016/j.arthro.2025.06.002","url":null,"abstract":"<p><p>First-time anterior shoulder dislocations pose a surgical indication challenge for orthopaedic surgeons. Despite ample evidence suggesting a reduction in secondary instability, improved patient-reported and quality-of-life outcomes, and improved satisfaction for patients undergoing early arthroscopic management, conservative management is a common choice for these patients. Recent literature has identified that conversion to arthroscopic management for patients with first-time anterior shoulder instability was twice the out-of-pocket expense of conservative management and more expensive, on average, than primary management with arthroscopy. Although insignificant, the increased cost of arthroscopic conversion for these patients likely reflects global costs to both patients and the health care system. As such, in the context of time spent away from sport or work, redislocation rate, patient-reported outcomes, and future surgery, aggressive, early surgical management of high-risk patients is imperative.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337215","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}