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

{"title":"Kellgren-Lawrence Versus Outerbridge Classifications: Shedding Light on the Weak Correlation to Reaffirm the Value of Knee Clinical Examination.","authors":"Francesco Pegreffi, Maria Tiziana Di Leo, Giuseppe Gianluca Costa, Marco Sapienza, Gianluca Testa, Vito Pavone, Vincenzo Cristian Francavilla, Raoul Saggini, Arcangelo Russo","doi":"10.1016/j.arthro.2025.05.036","DOIUrl":"10.1016/j.arthro.2025.05.036","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303697","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: The Anterolateral Ligament Is Only Part of the Puzzle of Anterolateral Corner Injury in Anterior Cruciate Ligament Disruption and Reconstruction.","authors":"Wybren A van der Wal, Jelle P van der List","doi":"10.1016/j.arthro.2025.06.001","DOIUrl":"10.1016/j.arthro.2025.06.001","url":null,"abstract":"<p><p>Over the past decade, there has been an increased awareness of the role of the anterolateral corner (ALC) in the setting of anterior cruciate ligament (ACL) injury and ACL reconstruction. Although several studies have debated the existence, exact anatomy, and function of the ALC, the role in clinical practice is well recognized. Biomechanical studies have assessed the role of the anterolateral ligament (ALL), superficial and deep Kaplan fiber layers of the iliotibial band, the anterolateral capsule with the ALL, and the capsulo-osseous layer within the ALC. Furthermore, both biomechanical and clinical studies support the role of either ALL reconstruction or lateral extra-articular tenodesis, such as the modified Lemaire or Arnold-Coker modification of the McIntosh technique in the setting of ACL reconstruction. Not only have many randomized controlled trials shown decreased failure or rerupture rates with adding these procedures, but they also show minimal complication rates, equivalent to superior patient-reported outcome measures and decreased presence of persisting rotatory instability or positive pivot shift. These developments have caused a major shift in the treatment of young patients with ACL injuries, especially those who have ligamentous laxity, hyperextension, involvement in pivoting sports, or contralateral injuries. The next steps should focus on which patients require ALC procedures, the role of ALC procedures with hamstring versus quadriceps or bone-patellar tendon-bone autograft, and the development of post-traumatic osteoarthritis.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287166","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":"AANA Annual Meeting 2025 Delivers History and Innovation in the Nation's Capital.","authors":"Elizabeth Matzkin, Michael J Rossi","doi":"10.1016/j.arthro.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.05.019","url":null,"abstract":"<p><p>The 2025 AANA Annual Meeting delivered a robust program featuring cutting-edge instructional course lectures, case-based debates, innovation spotlights, and original research presentations. The multidisciplinary scope-from shoulder and knee to hip, elbow, foot, and ankle-ensured relevance for arthroscopists at every stage of practice. We look forward to seeing you in the Valley of the Sun, Phoenix, Arizona, May 14-16, 2026, for AANA26.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276784","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":"A Mechanistic Classification for Superior Labral Injuries Guides Operative Management.","authors":"Eoghan T Hurley, Dean C Taylor, John Twomey-Kozak, Samuel G Lorentz, Bryan S Crook, Zoe W Hinton, Alex M Meyer, Jay M Levin, Lucy E Meyer, Tom R Doyle, Kendall E Bradley, Brian C Lau, Tally Lassiter, Jocelyn R Wittstein, Christopher S Klifto, Jonathan F Dickens, Alison P Toth","doi":"10.1016/j.arthro.2025.03.059","DOIUrl":"10.1016/j.arthro.2025.03.059","url":null,"abstract":"<p><p>The purpose of this article is to provide a clinically oriented classification system for superior labral injuries based on etiology, pathoanatomy, and associated biceps-labrum anchor complex injuries. The proposed classification system is based primarily on the mechanism of superior labral injuries as an ABCD classification (A, acute trauma; B, Bankart extension from instability; C, chronic repetitive overhead activity; and D, degenerative). The recognition of the cause is paramount to appropriately treating these patients, especially when considering operative treatment. Traumatic injuries include compressive loads, axial traction, or torsional loading and can also be secondary to shoulder instability events. Chronic overuse-related superior labral injuries typically occur with repetitive overhead activities, most commonly throwing mechanisms in athletes. Degenerative changes to the superior labrum are related to normal aging processes and are often identified during evaluation and management of other conditions (e.g., rotator cuff tears). Superior labral anatomic variants may also be present that may alter labral loading. Nonoperative management is often an appropriate and effective initial treatment for superior labral injuries, unless there are obvious pathologic changes altering the mechanics of the glenohumeral joint (large labral flap tears, bucket handle tears, etc.) or other associated injuries (traumatic rotator cuff tears, fractures, etc.). Surgical treatment principles include (1) preserving normal mobility of the superior labrum/biceps tendon complex; (2) when detached, repairing the normally fixed inferior labrum anteriorly and posteriorly; (3) considering biceps tenotomy or tenodesis when pathologic changes extend into the long head of the biceps tendon; and (4) considering individual patient factors in each case. In addition to these general principles, the classification guides operative treatment. LEVEL OF EVIDENCE: Level V, expert opinion.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276783","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":"Bone Marrow Aspirate Concentrate May Decrease Reoperation in Osteochondral Allograft Transplantation: A Prospective, Randomized, Double-Blind Investigation.","authors":"Adam B Yanke, Navya Dandu, Blake M Bodendorfer, Nicholas A Trasolini, Mario Hevesi, Tristan J Elias, Erik Haneberg, Reem Y Darwish, Athan Zavras, Brian Forsythe, Brian J Cole","doi":"10.1016/j.arthro.2025.05.024","DOIUrl":"10.1016/j.arthro.2025.05.024","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a prospective, double-blind, randomized controlled trial to assess differences in integration and patient-reported outcomes metrics (PROMs) of osteochondral allograft transplantation with and without bone marrow aspirate concentrate (BMAC) augmentation.</p><p><strong>Methods: </strong>Patients (n = 36) undergoing osteochondral allograft transplantation of the knee were consented and enrolled in this prospective study. They were randomized to either iliac crest BMAC or sham incision groups and blinded to their allocation. Computerized tomography (CT) scans of the knee were obtained at 6 months postoperatively after the index transplantation and graded by the semiquantitative assessment CT osteochondral allograft system. PROMs, including the International Knee Documentation Committee and Knee injury and Osteoarthritis Outcome Score-Joint Replacement, were obtained at 6 months, 1 year, and 2 years postoperatively.</p><p><strong>Results: </strong>On 6-month postoperative CT scans, patients receiving BMAC-treated grafts were more likely to have small cystic changes (P = .01), with an associated trend toward reduction in large cyst formation (P = .06), but equal osseous integration, graft signal density, and presence of discernible clefts and intra-articular fragments. The BMAC group was less likely to undergo subsequent surgery for graft debridement or revision (5.3% vs 35.3%; P = .02). There were no significant differences in PROMs between the 2 groups preoperatively or postoperatively at 6 months, 1 year, or 2 years. Patients receiving BMAC trended toward a higher rate of achievement of Knee Documentation Committee and Knee injury and Osteoarthritis Outcome Score-Joint Replacement minimal clinically important difference (88% vs 55%; P = .076).</p><p><strong>Conclusions: </strong>Patients receiving BMAC-treated grafts were more likely to have small cystic changes and were less likely to undergo subsequent surgery for persistent or new symptoms after the index procedure. No difference in postoperative PROMs was shown at the 6-month, 1-year, and 2-year follow-ups between the 2 groups.</p><p><strong>Level of evidence: </strong>Level I, prospective, randomized controlled trial.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250997","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":"Regarding \"The Primary Risk Factors for Season-Ending Injuries in Professional Basketball Are Minutes Played Per Game and Later Season Games\".","authors":"Wiemi Douoguih, John DiFiori, Travis Maak, Jennifer Russell, Asheesh Bedi, Barnett Frank, Brian Cole, Peter Meisel","doi":"10.1016/j.arthro.2025.05.031","DOIUrl":"10.1016/j.arthro.2025.05.031","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251001","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":"Arthroscopy's Third Annual Musculoskeletal Biologics Special Issue Highlights Orthobiologics Having Current Impact and Future Promise.","authors":"Michael J Rossi, Elizabeth Matzkin","doi":"10.1016/j.arthro.2025.05.030","DOIUrl":"10.1016/j.arthro.2025.05.030","url":null,"abstract":"<p><p>Arthroscopy's Third Annual Musculoskeletal Biologics Special Issue delivers the most nascent scientific research and techniques from selected top publications and authors. These articles, published in our family of journals, feature a mix of infographics, basic science, clinical research, systematic reviews and meta-analyses, and technical notes with video content. We congratulate the selected authors for their inclusion in this Special Issue and continue the Call for Papers to promote and publish orthobiologic research in musculoskeletal medicine.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250996","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":"Intravenous Tranexamic Acid Is Marginally Inferior to Epinephrine Irrigation for Visual Clarity During Arthroscopic Rotator Cuff Repair: A Double-Blind, Randomized Controlled Trial.","authors":"Son Quang Tran, Thun Itthipanichpong, Danaithep Limskul, Napatpong Thamrongskulsiri, Thanathep Tanpowpong","doi":"10.1016/j.arthro.2025.05.034","DOIUrl":"10.1016/j.arthro.2025.05.034","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of intravenous tranexamic acid (TXA) versus epinephrine (EPN)-diluted irrigation on visual clarity, surgical outcomes, and safety during arthroscopic rotator cuff repair.</p><p><strong>Methods: </strong>This study randomized 82 patients (aged 64.9 ± 9.6 years) diagnosed with rotator cuff tears, allocated 1:1 into the TXA and EPN groups. The TXA group received a preoperative intravenous infusion of TXA (15 mg/kg) over 15 minutes with normal saline irrigation, while the EPN group received irrigation with 0.33 mg/L EPN in normal saline without intravenous TXA. Both patients and surgeons were blinded to the interventions. Visual clarity was assessed by surgeons using a numeric rating scale (0-10). Secondary outcomes included operative time, irrigation fluid volume, pump pressure, perioperative hemodynamic parameters, postoperative pain and swelling, and adverse events.</p><p><strong>Results: </strong>The EPN group showed higher visual clarity scores than the TXA group, with a mean difference of 1.41 (95% confidence interval [CI], 0.55-2.28; P = .002) on a 0 to 10 scale. In contrast, the TXA group exhibited a significantly higher proportion of cases requiring increased pump pressure during surgery compared to the EPN group, with an absolute difference of 34.1% and an odds ratio of 4.4 (95% CI, 1.5-12.7; P = .002). The average pump pressure was also higher in the TXA group than in the EPN group (mean difference, 3.2 mm Hg, 95% CI, 1.36-5.04; P = .001). No serious adverse events were observed.</p><p><strong>Conclusions: </strong>Intravenous TXA was marginally less effective than EPN irrigation in bleeding control during arthroscopic rotator cuff repair and showed less improvement in visual clarity, with no severe adverse events observed.</p><p><strong>Level of evidence: </strong>Level I, randomized controlled trial.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251000","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":"Response to Douoguih et al.'s Letter to the Editor.","authors":"Sanjit Menon, Landon Morikawa, Sailesh Tummala, Skye Buckner-Petty, Anikar Chhabra","doi":"10.1016/j.arthro.2025.05.032","DOIUrl":"10.1016/j.arthro.2025.05.032","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251002","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":"Early Surgical Stabilization Is a Positive Predictor Whereas Dominant Extremity Involvement and Off-Track Lesions Are Negative Predictors in Arthroscopic Repair of Bony Bankart Lesions With Glenoid Bone Loss <25.","authors":"Muhammed Furkan Tosun, Ethem Burak Oklaz, Asim Ahmadov, Cem Ismail Gungor, Mehmet Ali Tokgoz, Ibrahim Kaya, Mustafa Melik Can, Ulunay Kanatli","doi":"10.1016/j.arthro.2025.05.035","DOIUrl":"10.1016/j.arthro.2025.05.035","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the minimal clinically important difference (MCID), significant clinical benefit (SCB), and patient acceptable symptomatic status (PASS) in patients who underwent arthroscopic repair of bony Bankart lesions and to analyze the effect of patient characteristics on these parameters.</p><p><strong>Methods: </strong>This retrospective case series included patients who underwent shoulder arthroscopy for bony Bankart lesions by a single surgeon between 2015 and 2022. Inclusion criteria were patients with <25% glenoid bone defect and a minimum follow-up of 24 months. Assessment included Rowe, American Shoulder and Elbow Surgeons (ASES), SANE (Single Assessment Numeric Evaluation), and visual analog scale (VAS) scores. Patients who met the MCID, SCB, and PASS thresholds for Rowe, ASES, SANE, and VAS were determined. Regression analysis was used to determine the factors affecting thresholds achievement.</p><p><strong>Results: </strong>A total of 76 patients (mean age 32.2 ± 12.3 years; mean follow-up 57.5 ± 25.4) were included in the study. MCID, PASS, and SCB thresholds were calculated, respectively, for Rowe (9.9, 77.5, 32.5), ASES (9.7, 76.5, 36.5), SANE (11, 82.5, 27.5), and VAS (1.04, 3.5, 5.5). The rates of patients achieving MCID, PASS, and SCB were determined, respectively, Rowe (97%, 84%, 80%), ASES (98%, 79%, 71%), SANE (94%, 77%, 72%), and VAS (96%, 83%, 74%). Increased odds of achieving PASS and SCB were associated with early presentation. Reduced odds of achieving PASS and SCB were associated with dominant extremity involvement and off-track lesions.</p><p><strong>Conclusions: </strong>The current study revealed that early surgical stabilization was a positive predictor for achieving clinically significant outcomes, whereas dominant extremity involvement and off-track lesions were negative predictors.</p><p><strong>Level of evidence: </strong>Level IV, therapeutic study, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250998","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}