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

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Editorial Commentary: Anterior Cruciate Ligament Reconstruction Success Requires Additional Correction of Tibial Slope, Rotational Instability, and Meniscus Pathology: Meniscal Repair Failure Increases Knee Rotational Laxity.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-07 DOI: 10.1016/j.arthro.2025.03.001
Andrew S Bi, Jorge Chahla
{"title":"Editorial Commentary: Anterior Cruciate Ligament Reconstruction Success Requires Additional Correction of Tibial Slope, Rotational Instability, and Meniscus Pathology: Meniscal Repair Failure Increases Knee Rotational Laxity.","authors":"Andrew S Bi, Jorge Chahla","doi":"10.1016/j.arthro.2025.03.001","DOIUrl":"10.1016/j.arthro.2025.03.001","url":null,"abstract":"<p><p>The anterior cruciate ligament (ACL) and medial and lateral menisci are essential contributors of both anteroposterior and rotational knee stability. Multiple studies have shown both ACL-deficient knees lead to increased risk of meniscal injury, as well as multiple types of meniscal tears or deficiency leading to increased risk of ACL tear or ACL reconstruction (ACLR) failures. All amenable meniscal tears, such as red-red peripheral tears, radial tears, root tears, lateral meniscal oblique radial tears, and ramp lesions should be attempted to be repaired at time of ACLR. In addition, other contributors to rotational stability, such as collateral, posterolateral/posteromedial corner, anterolateral injuries, and excessive posterior tibial slope should be identified and addressed. Rotational stability should be part of every ACL surgeon's algorithm; in my practice, my preference for patients who will place high rotational stress on their knee is for bone-patellar tendon-bone autograft ACLR, aggressively repairing aforementioned meniscal pathology, and adding anterolateral extraarticular reconstructions when recurvatum/ligamentous laxity, increased posterior tibial slope, high-risk patients (e.g., young female athletes in pivoting sports), or high-grade pivot shift is present.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588251","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}
引用次数: 0
Sports Medicine Patient-Reported Outcomes Fail to Meet National Institutes of Health- and American Medical Association-Recommended Reading Levels.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-07 DOI: 10.1016/j.arthro.2025.02.029
Harjot Uppal, Daniel J Garcia, Matthew Kruchten, Matthew J Kraeutler, Andrew McGinniss, Arash Emami, Anthony J Scillia
{"title":"Sports Medicine Patient-Reported Outcomes Fail to Meet National Institutes of Health- and American Medical Association-Recommended Reading Levels.","authors":"Harjot Uppal, Daniel J Garcia, Matthew Kruchten, Matthew J Kraeutler, Andrew McGinniss, Arash Emami, Anthony J Scillia","doi":"10.1016/j.arthro.2025.02.029","DOIUrl":"10.1016/j.arthro.2025.02.029","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the readability of commonly used patient-reported outcome measures (PROMs) in the sports medicine literature to determine whether they meet the recommended reading levels set by the National Institutes of Health and the American Medical Association (AMA).</p><p><strong>Methods: </strong>A readability analysis was conducted on 26 PROMs commonly used in the sports medicine literature. The primary readability metrics used were the Flesch Reading Ease Score (FRES) and the Simple Measure of Gobbledygook (SMOG) Index. Readability scores were obtained using an online readability calculator and compared against National Institutes of Health and American Medical Association guidelines. An FRES of 80 or greater or an SMOG Index less than 7 was applied as a threshold for a sixth-grade reading level or lower.</p><p><strong>Results: </strong>The average FRES and SMOG Index for all PROMs were 65 ± 13 and 9 ± 1, respectively, indicating an eighth- to ninth-grade reading level. Four PROMs met the FRES and SMOG Index threshold for readability: 12-Item Short Form Survey, Pediatric Quality of Life Inventory, Numeric Pain Rating Scale, and Musculoskeletal Function Assessment. The Patient-Specific Functional Scale, Disablement in the Physically Active scale, Upper Extremity Functional Index, Low Back Outcome Score, and International Knee Documentation Committee questionnaire were among the least readable PROMs.</p><p><strong>Conclusions: </strong>Most sports medicine PROMs are written above the recommended sixth-grade reading level.</p><p><strong>Clinical relevance: </strong>Ensuring that sports medicine PROMs meet recommended readability standards may improve data accuracy and patient comprehension. By reducing literacy barriers, clinicians can obtain more reliable responses, better evaluate outcomes, and ultimately enhance patient care.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588265","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}
引用次数: 0
Medial Meniscus Posterior Root Repairs Performed With Modified Mason-Allen Locking Stitches Are Associated with Intact but Lax Repairs In A High Proportion of Cases Second Look Arthroscopy.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-06 DOI: 10.1016/j.arthro.2025.02.033
Kyu Sung Chung, Jin Seong Kim, Ui Jae Hwang, Seung Hun Baek, Hyun Soo Soh, Choong Hyeok Choi
{"title":"Medial Meniscus Posterior Root Repairs Performed With Modified Mason-Allen Locking Stitches Are Associated with Intact but Lax Repairs In A High Proportion of Cases Second Look Arthroscopy.","authors":"Kyu Sung Chung, Jin Seong Kim, Ui Jae Hwang, Seung Hun Baek, Hyun Soo Soh, Choong Hyeok Choi","doi":"10.1016/j.arthro.2025.02.033","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.033","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate meniscal healing results and clinical outcomes based on healing status after root repair using modified Mason-Allen stitches with a locking mechanism from second-look arthroscopy in medial meniscus posterior root tears (MMPRTs).</p><p><strong>Methods: </strong>Among patients who underwent root repair between 2018 and 2022, those who consented to undergo second-look arthroscopy 1 year after surgery were recruited. The healing condition of the repaired meniscus was evaluated based on 1) morphological continuity between the bone bed and meniscus (intact versus non-intact) and 2) meniscal laxity on bony attachment by probing (lax versus non-lax). Healing conditions were categorized as follows: intact and non-lax tissue (group 1), intact and lax tissue (group 2), and healing failures (group 3). Clinical scores (Lysholm, Western Ontario McMaster Osteoarthritis Index [WOMAC], and the Knee injury and Osteoarthritis Outcome Score [KOOS]) and radiological outcomes (Kellgren-Lawrence grade and medial joint space width) were evaluated preoperatively and at the final follow-up.</p><p><strong>Results: </strong>In total 34 patients (mean 58.2±6.1 years) were enrolled. In terms of healing conditions, intact root tissue and healing failure were observed in 33 (97%) and 1 (3%) patient, respectively. Among those with intact root tissue, 19 (56%) and 14 (41%) patients demonstrated non-lax tissue (group 1) and lax tissue (group 2) healing conditions, respectively. A significant improvement in clinical scores after surgery was noted in groups 1 and 2 but not in group 3. Regarding postoperative clinical scores, the minimal clinically important difference (MCID) for group 1 was as follows: Lysholm: 86.1±8.2 (MCID: 5.35), WOMAC: 12.8±6.6 (MCID: 4.55), and KOOS: 22.4±6.8 (MCID: 4.5). The group 1 outcomes were substantially better than those of group 2; the group 2 scores were as follows: Lysholm: 76.8±7.0 (MCID: 2.85), WOMAC: 21.0±8.3 (MCID: 4.75), and KOOS: 32.8±10.0 (MCID: 6.5). Radiographically, group 1 exhibited significantly less K-L grade progression and less medial joint space narrowing than group 2.</p><p><strong>Conclusion: </strong>Pullout repair utilizing modified Mason-Allen stitches demonstrated promising healing outcomes with a 97% intact root healing upon second-look arthroscopy. However, repairs that demonstrated laxity were associated with significantly worse PROMS, and higher rates of progression of osteoarthritis. Considering that 23% of the total patients refused second-look arthroscopy, the possibility of transfer bias should be considered.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588298","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}
引用次数: 0
Periacetabular Osteotomy with Concomitant Hip Arthroscopy Shows Comparable Outcomes Compared to Isolated Hip Arthroscopy with Capsular Plication in Borderline Dysplastic Hips: A Propensity-Matched Study.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-06 DOI: 10.1016/j.arthro.2025.02.032
Roger Quesada-Jimenez, Andrew R Schab, Meredith F Cohen, Benjamin D Kuhns, Ady H Kahana-Rojkind, Benjamin G Domb
{"title":"Periacetabular Osteotomy with Concomitant Hip Arthroscopy Shows Comparable Outcomes Compared to Isolated Hip Arthroscopy with Capsular Plication in Borderline Dysplastic Hips: A Propensity-Matched Study.","authors":"Roger Quesada-Jimenez, Andrew R Schab, Meredith F Cohen, Benjamin D Kuhns, Ady H Kahana-Rojkind, Benjamin G Domb","doi":"10.1016/j.arthro.2025.02.032","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.032","url":null,"abstract":"<p><strong>Purpose: </strong>To compare minimum 2-year outcomes of concomitant hip arthroscopy (HA) with periacetabular osteotomy (PAO) versus isolated HA with capsular plication in patients with borderline hip dysplasia (BHD).</p><p><strong>Methods: </strong>Data were retrospectively reviewed for patients who underwent surgery for femoroacetabular impingement in the setting of BHD between September 2008 and December 2021. Included patients had preoperative and minimum 2-year patient reported outcomes scores (PROs). Patients who underwent staged PAO and HA comprised the PAO group. Patients who underwent isolated HA with capsular plication comprised the HA group. Matching occurred in a 1:1 ratio based on age, sex, BMI, and Tonnis Grade.</p><p><strong>Results: </strong>74 hips were included. The HA group's mean postoperative values for the mHHS, NAHS, HOS-SSS, and VAS were, respectively: 90.32 ± 12.39, 89.46 ± 11.57, 81.47 ± 20.54, and 1.74 ± 1.89. These PRO values for the PAO group were: 90.69 ± 13.46, 91.59 ± 10.80, 82.20 ± 21.23, and 1.49 ± 1.94. The HA group met MCID for the mHHS (89.19%), NAHS (86.49%), and HOS-SSS (72.97%) at similar rates compared to the PAO group (89.19%, 86.49%, and 78.38%). Rates of achieving PASS in the HA group for these PROs were 86.49%, 72.97%, and 67.57%, while in the PAO group, rates were 86.49%, 78.38%, and 70.27%. Rates of achieving MOI in the HA group for these PROswere 81.1%, 75.68%, and 70.27%, while in the PAO group, rates were 75.68%, 75.68%, and 70.27%. 10.81% of the PAO group and 5.41% of the HA group experienced complications (p = 0.67).</p><p><strong>Conclusion: </strong>PAO with concomitant HA and isolated HA with capsular plication in the setting of BHD yielded favorable and comparable outcomes. A high percentage of patients in both HA and PAO groups reached clinically relevant thresholds, with similar rates of revision and conversion to arthroplasty at minimum 2-year follow-up.</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":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588306","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}
引用次数: 0
Lower Patient-Reported Outcomes After Isolated Anterior Cruciate Ligament Reconstruction Are Associated With Lower Muscle Strength Rather Than Graft Status During Second-Look Arthroscopic Evaluation.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-06 DOI: 10.1016/j.arthro.2025.02.031
Seo-Jun Lee, Jun-Gu Park, Seung-Beom Han, Ji-Hoon Bae, Ki-Mo Jang
{"title":"Lower Patient-Reported Outcomes After Isolated Anterior Cruciate Ligament Reconstruction Are Associated With Lower Muscle Strength Rather Than Graft Status During Second-Look Arthroscopic Evaluation.","authors":"Seo-Jun Lee, Jun-Gu Park, Seung-Beom Han, Ji-Hoon Bae, Ki-Mo Jang","doi":"10.1016/j.arthro.2025.02.031","DOIUrl":"10.1016/j.arthro.2025.02.031","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the relationship between patient-reported outcomes (PROs), objective graft status on second-look arthroscopy, and knee muscle strength during the early period after isolated primary anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Methods: </strong>Patients who underwent second-look arthroscopy at least 1 year after primary ACLR between 2012 and 2020 were retrospectively reviewed. Those who completed follow-up muscle strength tests and PRO measures were included in this study. Subjective clinical outcomes were assessed on the basis of patient-reported outcome measures using the Lysholm score preoperatively and during second-look arthroscopy. Objective graft status was assessed during second-look arthroscopy using a numeric scale system consisting of the following 4 subscales: tension, vascularity, synovialization, and continuity of the graft. The graft score (0-8) was determined by adding the points from each subscale (0-2). Muscle strength was measured using isokinetic dynamometry to assess peak torque, limb symmetry index for both the quadriceps and hamstrings and the ratio of the hamstring and quadriceps before second-look arthroscopy. Second-look arthroscopy patients included in analysis were those without concomitant meniscal or cartilage procedures. Multivariate logistic regression was used to identify factors associated with inferior PROs (Lysholm score ≤83).</p><p><strong>Results: </strong>A total of 82 patients were enrolled in this study. At an average follow-up of 22.4 ± 4.8 months, 25 patients (30.5%) scored less than 83 on the Lysholm scale. No significant differences were found in total graft status scores between groups with superior or inferior outcomes (6.9 ± 1.8 vs 7.1 ± 1.2, P = .573). However, the group with inferior PROs showed significantly lower peak torque in both hamstring and quadriceps (P = .001 and P < .001, respectively). Multivariate analysis indicated that older age and lower limb symmetry index for extension and flexion (<70% and 90%, respectively) were significantly correlated with inferior PROs (odds ratios: 1.08, 5.11, and 5.66; P = .014, .013, and .006, respectively).</p><p><strong>Conclusions: </strong>Early inferior subjective outcomes after ACLR were associated with delayed recovery of quadriceps and hamstring muscle strength compared to graft appearance and tension.</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":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588294","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}
引用次数: 0
Corticosteroid Injection up to 8 Weeks Before Anterior Cruciate Ligament Reconstruction Doubles the Incidence of Postoperative Infection.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-06 DOI: 10.1016/j.arthro.2025.02.027
Jared D Wainwright, Samuel S Gay, Adam Nguyen, William M Weiss, Joseph C Wenke
{"title":"Corticosteroid Injection up to 8 Weeks Before Anterior Cruciate Ligament Reconstruction Doubles the Incidence of Postoperative Infection.","authors":"Jared D Wainwright, Samuel S Gay, Adam Nguyen, William M Weiss, Joseph C Wenke","doi":"10.1016/j.arthro.2025.02.027","DOIUrl":"10.1016/j.arthro.2025.02.027","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether at least 1 corticosteroid injection (CSI) within 8 weeks before anterior cruciate ligament reconstruction (ACLR) increases the incidence of postoperative infection.</p><p><strong>Methods: </strong>A large globally federated research database (TriNetX) containing more than 200 million patient records was queried retrospectively for patients undergoing ACLR between October 1, 2010, and January 1, 2024, using diagnosis and procedure codes. A cohort of patients receiving CSI up to 8 weeks before ACLR were compared with a cohort of patients who did not receive a CSI before ACLR. One-to-one propensity score matching was performed on the basis of preoperative characteristics and comorbid diagnoses. Outcomes examined were incidence of postoperative infection at 90 days and 180 days. Postoperative infection was defined as a formal infection diagnosis or need for a washout surgery. Comparisons were performed using Pearson χ<sup>2</sup> tests.</p><p><strong>Results: </strong>After matching, 2,439 patients were analyzed in each cohort with matched preoperative characteristics and comorbid diagnoses. Patients receiving a CSI in the 8 weeks before ACLR had a 90-day infection rate of 1.2% (30/2,439) compared with a control group infection rate of 0.6% (14/2,439) represented as an odds ratio of 2.1 (95% confidence interval 1.1-4.0, P = .015). After 180 days, the infection rates grew to 1.3% (33/2,439) for patients receiving CSI and 0.6% (15/2,439) for the control group with an odds ratio of 2.2 (95% confidence interval 1.2-4.1, P = .009).</p><p><strong>Conclusions: </strong>CSIs given within 8 weeks of ACL-R approximately double the incidence of postoperative infection.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588253","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}
引用次数: 0
Hip Arthroscopy for Global Acetabular Overcoverage Demonstrates Favorable Patient-Reported Outcome Scores and Low to Moderate Rates of Revision and Conversion to Total Hip Arthroplasty: A Systematic Review.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-06 DOI: 10.1016/j.arthro.2025.02.028
Muzammil Akhtar, Mustafa Jundi, Sonia Aamer, Noorhan Amani, Malik Oda, Trevor Shelton, Dean Wang
{"title":"Hip Arthroscopy for Global Acetabular Overcoverage Demonstrates Favorable Patient-Reported Outcome Scores and Low to Moderate Rates of Revision and Conversion to Total Hip Arthroplasty: A Systematic Review.","authors":"Muzammil Akhtar, Mustafa Jundi, Sonia Aamer, Noorhan Amani, Malik Oda, Trevor Shelton, Dean Wang","doi":"10.1016/j.arthro.2025.02.028","DOIUrl":"10.1016/j.arthro.2025.02.028","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical outcomes of hip arthroscopy for patients with global acetabular overcoverage, as defined by a lateral center-edge angle (LCEA) >40° with coxa profunda, acetabular protrusio, and/or a negative Tönnis angle.</p><p><strong>Methods: </strong>A search following guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-analyses was performed in the PubMed, Embase, and Scopus databases in July 2024. Studies were included if they had a minimum 2-year follow-up and reported on outcomes of hip arthroscopy for patients with global acetabular overcoverage, which was defined as a LCEA >40° with coxa profunda, acetabular protrusio, and/or a negative Tönnis angle. The primary evaluated outcomes included patient-reported outcomes (PROs) and rates of revision and conversion to total hip arthroplasty (THA).</p><p><strong>Results: </strong>Eight studies comprising 369 hips (58.5% female; age range: 31.2-42.4 years; follow-up range, 24.0-73.2 months) with global acetabular overcoverage treated with arthroscopy were included. For labral management, 0-30% of patients underwent debridement, 65-100% underwent repair, and 0-100% underwent reconstruction. Femoroplasty and acetabuloplasty were performed in 73.3-100% and 94.7-100% of patients, respectively. Six studies reporting both preoperative and postoperative PROs reported significant improvements in all PROs. Rates of revision and conversion to THA ranged from 1.5 to 27.3% and from 1.8 to 13.6%, respectively. Of studies comparing outcomes between patients with global overcoverage versus normal coverage, there were no significant differences in any PROs (4/5 studies), revision rates (5/5 studies), and conversion to THA rates (3/5 studies).</p><p><strong>Conclusions: </strong>Hip arthroscopy for global acetabular overcoverage can allow patients to achieve significant improvements in PROs along with low to moderate rates of revision and conversion to THA that are comparable to patients with normal acetabular coverage LEVEL OF EVIDENCE: Level IV, a systematic review of Level III and Level IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588257","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}
引用次数: 0
Editorial Commentary: Lateral Femoral Notch Sign Is a Marker of Past Pivot Trauma Rather Than a Predictor of Future Anterior Cruciate Ligament Failure.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-05 DOI: 10.1016/j.arthro.2025.02.025
Rachit Saggar, Vikram A Mhaskar
{"title":"Editorial Commentary: Lateral Femoral Notch Sign Is a Marker of Past Pivot Trauma Rather Than a Predictor of Future Anterior Cruciate Ligament Failure.","authors":"Rachit Saggar, Vikram A Mhaskar","doi":"10.1016/j.arthro.2025.02.025","DOIUrl":"10.1016/j.arthro.2025.02.025","url":null,"abstract":"<p><p>Predicting anterior cruciate ligament (ACL) reconstruction failure remains a challenge, shaped by anatomic, biomechanical, surgical, and rehabilitation factors. The lateral femoral notch sign (LFNS), present in 6% to 52% of ACL injuries, is linked to lateral meniscal tears (40%-67%), steeper posterior tibial slope (2.7° higher), and cartilage degradation. However, despite its correlation with injury severity, the LFNS has limited value in predicting ACL graft failure or postoperative instability. Recent studies reinforce that the LFNS is a marker of past pivot trauma, not a predictor of future ACL failure. While a deeper LFNS (>2 mm) correlates with more severe initial injury, it does not influence long-term graft survival or knee stability. Research shows that the LFNS resolves over time in pediatric patients, fails to correlate with residual tibial laxity or rotational instability, and is associated with nonprogressive chondral lesions. In contrast, modifiable factors-such as achieving optimal tunnel positioning and effectively managing rotational instability-play a far more decisive role in determining ACL reconstruction success than static imaging markers such as LFNS. Ultimately, the LFNS is a historical remnant, not a clinical decision-making tool in ACL failure risk assessment. It reminds us that successful outcomes hinge on a comprehensive approach rather than isolated imaging findings. Such imaging signs show scars of battles lost but often do not predict the outcome of the war.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588275","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}
引用次数: 0
Editorial Commentary: Tranexamic Acid Does Not Improve Visualization During Hip Arthroscopy, But Other Techniques Do Help.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-03-04 DOI: 10.1016/j.arthro.2025.02.026
Derek Ochiai
{"title":"Editorial Commentary: Tranexamic Acid Does Not Improve Visualization During Hip Arthroscopy, But Other Techniques Do Help.","authors":"Derek Ochiai","doi":"10.1016/j.arthro.2025.02.026","DOIUrl":"10.1016/j.arthro.2025.02.026","url":null,"abstract":"<p><p>Visualization during hip arthroscopy can be challenging, particularly owing to a bloody arthroscopic image. Tranexamic acid is not effective in improving arthroscopic visualization, but techniques such as using epinephrine-impregnated irrigation fluid, administering controlled hypotensive anesthesia, and safely establishing a second outflow portal and using radiofrequency to control capsular bleeding are effective.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574698","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}
引用次数: 0
Corrigendum.
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-02-28 DOI: 10.1016/j.arthro.2025.02.006
{"title":"Corrigendum.","authors":"","doi":"10.1016/j.arthro.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.006","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525070","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}
引用次数: 0
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