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

{"title":"Rebound Pain After Arthroscopic Cuff Repair With Interscalene Brachial Plexus Block Anesthesia Is Reduced by Surgeon-Administered Multimodal Shoulder Injections: A Prospective Randomized Controlled Trial","authors":"Ki-Bong Park M.D. ,&nbsp;Hyun-Oh Cho M.D ,&nbsp;Min Seok Kim M.D. ,&nbsp;Young Dae Jeon M.D.","doi":"10.1016/j.arthro.2024.07.029","DOIUrl":"10.1016/j.arthro.2024.07.029","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the effects of additional multimodal shoulder injections on postoperative rebound pain in patients undergoing arthroscopic rotator cuff repair (ASRCR) under interscalene brachial plexus block (ISBPB) anesthesia.</div></div><div><h3>Methods</h3><div>A single-blind randomized controlled trial was conducted with 67 patients between April and December 2023. Patients undergoing ASRCR who received ISBPB anesthesia, rather than general anesthesia, with a minimum follow-up period of 48 hours were included. The injection group received 40 mL of 0.75% ropivacaine, 20 mg morphine, 1:200,000 epinephrine, and saline solution, totaling 100 mL. After surgery, the injection was administered to the subacromial space (50 mL) with blind suprascapular nerve block (25 mL) and blind axillary nerve block (25 mL). Control subjects received 100 mL of saline solution. Intravenous patient-controlled analgesia (IV-PCA) was used as adjuvant analgesia for all patients. The primary outcome was evaluated using the visual analog scale (VAS) pain score at 12 hours after surgery, with secondary outcomes of the incidence of rebound pain and VAS pain scores at 0, 2, 4, 8, 24, 36, and 48 hours postoperatively. Fentanyl in the IV-PCA and rescue analgesic amounts, complications, and patient satisfaction were recorded.</div></div><div><h3>Results</h3><div>Sixty-seven patients (32 in the injection group, 35 in the control group) with a mean age of 61.1 ± 9.0 years were included. The primary outcome assessment, VAS pain score at 12 hours, significantly favored the injection group (2.7 ± 0.93 vs 4.1 ± 1.70, <em>P</em> &lt; .001). The incidence of rebound pain was 18.8% and 65.7% in the injection and control groups, respectively (18.8% vs 65.7%, <em>P</em> &lt; .001). The injection group reported better VAS pain scores at 24, 36, and 48 hours and lower fentanyl use over the 48-hour postoperative period (<em>P</em> = .014). The use of rescue analgesics was similar between groups, and no complications were associated with multimodal shoulder injections. Satisfaction levels were similar in both groups.</div></div><div><h3>Conclusions</h3><div>The present study found that patients who underwent multimodal shoulder injections during ASRCR under ISBPB anesthesia had significantly lower VAS pain scores at 12 hours postoperatively and reduced incidence of rebound pain compared with the control group. Pain levels were consistently lower from 12 to 48 hours postoperatively. Additionally, the injection group had reduced opioid consumption within the first 48 hours postoperatively, with no complications observed.</div></div><div><h3>Level of Evidence</h3><div>Level I, randomized controlled trial</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1291-1298"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918145","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":"Repair of Isolated Subscapularis Tears With Concurrent Biceps Tenodesis Using a Single Anchor Results in Satisfactory Clinical Outcomes: Minimum 2-Year Follow-Up","authors":"Ethem Burak Oklaz M.D. ,&nbsp;Asim Ahmadov M.D. ,&nbsp;Furkan Aral M.D. ,&nbsp;Muhammed Furkan Tosun M.D. ,&nbsp;İnci Hazal Ayas M.S. ,&nbsp;Ulunay Kanatli M.D.","doi":"10.1016/j.arthro.2024.07.026","DOIUrl":"10.1016/j.arthro.2024.07.026","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the clinical outcomes of patients treated with isolated subscapularis tear repair and biceps tenodesis using a single anchor.</div></div><div><h3>Methods</h3><div>Patients diagnosed with subscapularis tear and who underwent arthroscopic surgery by a single surgeon between February 2017 and January 2022 were evaluated retrospectively. Inclusion criteria were patients who underwent repair of isolated subscapularis tear along with tenodesis for long head of the biceps tendon pathologies such as SLAP lesion, instability, partial tear, or tenosynovitis, with a minimum follow-up of 24 months. Assessment included active and passive range of motion, single-assessment numeric evaluation (SANE), visual analog scale (VAS), Constant-Murley score (CMS), and specific subscapularis and biceps tests. Improvements were analyzed using minimum clinically important difference (MCID) values.</div></div><div><h3>Results</h3><div>A total of 20 patients were included. The mean age was 48.5 ± 7 years, and the follow-up period was 43.1 ± 12.7 months. Significant improvements were observed at the final follow-up in active forward flexion, active abduction, active internal rotation, as well as VAS, SANE, and CMS (<em>P</em> &lt; .001). The MCID analysis showed that 100% of patients met the MCID for CMS, 90% for SANE, and 100% for VAS.</div></div><div><h3>Conclusions</h3><div>In the presence of an isolated subscapularis tear associated with long head of the biceps tendon pathologies, favorable clinical outcomes could be achieved by performing both tear repair and biceps tenodesis with a double-loaded single anchor. Most patients (&gt;90%) achieved the MCID for the CMS, SANE, and VAS, indicating significant clinical improvement and satisfactory patient outcomes.</div></div><div><h3>Level of Evidence</h3><div>Level IV, case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1268-1276"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918147","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":"Artificial Intelligence in Commercial Industry: Serving the End-to-End Patient Experience Across the Digital Ecosystem","authors":"Michael J. Ormond M.Sc. ,&nbsp;Eric H. Garling Ph.D. ,&nbsp;Joshua J. Woo B.A. ,&nbsp;Ishan T. Modi B.S. ,&nbsp;Kyle N. Kunze M.D. ,&nbsp;Prem N. Ramkumar M.D., M.B.A.","doi":"10.1016/j.arthro.2025.01.064","DOIUrl":"10.1016/j.arthro.2025.01.064","url":null,"abstract":"<div><h3>Abstract</h3><div>The purpose of this article is to evaluate the application of artificial intelligence (AI) from the perspective of the orthopaedic industry with respect to the specific opportunities offered by AI. It is clear that AI has the potential to impact the entire continuum of musculoskeletal and orthopaedic care. The following areas may experience improvements from integrating AI into surgical applications: surgical trainees can learn more easily at lower costs in extended reality simulations; physicians can receive support in decision-making and case planning; efficiencies can be driven with improved case management and hospital episodes; performing surgery, which until recently was the only element industry engaged with, can benefit from intraoperative AI-derived inputs; and postoperative care can be tailored to the individual patient and their circumstances. AI delivers the potential for industry to offer valuable augments to patient experience and enhanced surgical insights along the digital episode of care. However, the true value is in considering not just how AI can be applied in each silo but also across the patient’s entire continuum of care. This opportunity was first opened with the advent of robotics. The data derived from the robotic systems have added something akin to a black box flight recorder to the operation, which now offers 2 critical outcomes for industry. First, together we can now start to stitch preoperative elements like demographics, morphological phenotyping, and pathology that can be integrated with intraoperative elements to produce surgical plans and on-the-fly anatomic data like ligament tension. Second, postoperative elements such as recovery protocols and outcomes can be considered through the lens of the intraoperative experience. In forming this bridge, AI can accelerate the development of a truly integrated digital ecosystem, facilitating a shift from providing implants to providing patient experience pathways.</div></div><div><h3>Level of Evidence</h3><div>Level V, expert opinion.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1683-1690"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460805","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: Varus Recurrence After Medial Opening-Wedge High Tibial Osteotomy","authors":"Seth L. Sherman M.D. ,&nbsp;Robert M. Putko M.D.","doi":"10.1016/j.arthro.2024.08.042","DOIUrl":"10.1016/j.arthro.2024.08.042","url":null,"abstract":"<div><div>Medial opening-wedge high tibial osteotomy (MOWHTO) is a powerful tool in the surgical armamentarium to correct varus malalignment in patients with symptomatic medial compartment disease. This procedure has demonstrated proven results and long-term survivorship. Complications include cortical hinge fracture, symptomatic hardware, infection, delayed or nonunion, and nerve injury. Varus recurrence is a known complication after MOWHTO. Risk factors are multifactorial and thought to include degree of alignment correction, extent of meniscus and cartilage pathology, and effectiveness of soft-tissue balancing. Medial meniscus extrusion has been implicated in meniscus dysfunction and progression of degenerative joint disease. It is a recognized issue after meniscus-preserving and transplant procedures that may have long-term sequela. This loss of hoop stress can lead to increased contact pressure, putting the diseased compartment at further risk. Although it is certainly possible that extrusion matters for varus recurrence after MOWHTO, its role must be considered in the context of multiple other confounding factors.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1530-1531"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Reply to “Human- Versus ChatGPT-Generated Abstracts: Some Concerns and Suggestions”","authors":"Ryan D. Stadler B.S.,&nbsp;Suleiman Y. Sudah M.D.,&nbsp;Mariano E. Menendez M.D.","doi":"10.1016/j.arthro.2024.09.052","DOIUrl":"10.1016/j.arthro.2024.09.052","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1244-1245"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407242","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":"No Differences in 2-Year Reoperation Rates for Meniscus Allograft Transplant With Concomitant Cartilage Restoration or Osteotomy: A National Database Study","authors":"Anna L. Park M.Phil. ,&nbsp;Brian T. Feeley M.D. ,&nbsp;Alan L. Zhang M.D. ,&nbsp;C. Benjamin Ma M.D. ,&nbsp;Drew A. Lansdown M.D.","doi":"10.1016/j.arthro.2024.06.022","DOIUrl":"10.1016/j.arthro.2024.06.022","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate reoperation rates after meniscus allograft transplant (MAT), comparing rates with and without concomitant articular cartilage and osteotomy procedures using a national insurance claims database.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of patients who underwent MAT from 2010 to 2021 with a minimum 2-year follow-up using the PearlDiver database. Using Current Procedural Terminology and International Classification of Diseases codes, we identified patients who underwent concomitant procedures including chondroplasty or microfracture, cartilage restoration defined as osteochondral graft or autologous chondrocyte implantation (ACI), or osteotomy. Univariate logistic regressions identified risk factors for reoperation. Reoperations were classified as knee arthroplasty, interventional procedures, or diagnostic or debridement procedures.</div></div><div><h3>Results</h3><div>The study included 750 patients with an average age of 29.6 years (interquartile range: 21.0-36.8) and average follow-up time was 5.41 years (SD: 2.51). Ninety-day, 2-year, and all-time reoperation rates were 1.33%, 14.4%, and 27.6%, respectively. MAT with cartilage restoration was associated with increased reoperation rate at 90 days (odds ratio: 4.88; 95% confidence interval: 1.38-19.27; <em>P</em> = .015); however, there was no significant difference in reoperation rates at 2 years or to the end of follow-up. ACI had increased reoperation rates at 90 days (odds ratio: 6.95; 95% confidence interval: 1.45-25.96; <em>P</em> = .006), with no difference in reoperation rates 2 years postoperatively or to the end of follow-up. Osteochondral autograft and allograft were not associated with increased reoperation rates.</div></div><div><h3>Conclusions</h3><div>In our cohort, 14.4% of patients had a reoperation within 2 years of MAT. Nearly 1 in 4 patients undergoing MAT had concomitant cartilage restoration, showing that it is commonly performed on patients with articular cartilage damage. Concomitant osteochondral autograft, osteochondral allograft, chondroplasty, microfracture, and osteotomy were not associated with any significant difference in reoperation rates. ACI was associated with increased reoperation rates at 90 days, but not later.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective cohort study.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1451-1458.e2"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447664","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":"High Tibial Osteotomy With Medial Meniscal Posterior Root Tear Reconstruction Yields Improved Radiographic and Functional Outcomes and Healing Rates Compared With Osteotomy Alone","authors":"Min Lan M.D. ,&nbsp;Hongbo Li M.D. ,&nbsp;Wentao Dong M.A. ,&nbsp;Si Nie M.A. ,&nbsp;Xingen Liao M.D. ,&nbsp;Jiayu Huang M.A.","doi":"10.1016/j.arthro.2024.06.039","DOIUrl":"10.1016/j.arthro.2024.06.039","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare preoperative and postoperative clinical and radiologic outcomes between patients undergoing high tibial osteotomy (HTO) with medial meniscal posterior root tear (MMPRT) reconstruction using gracilis tendon graft and those undergoing HTO without MMPRT reconstruction.</div></div><div><h3>Methods</h3><div>Patients with MMPRTs who underwent HTO between January 2018 and December 2021 with minimum 2-year follow-up were included. All patients were divided into 2 groups based on whether they underwent meniscal root reconstruction with tendon graft: HTO alone (33 cases) and HTO with MMPRT reconstruction (21 cases). Clinical evaluation included the Lysholm score, International Knee Documentation Committee (IKDC) score, and visual analog scale (VAS) score. Functional recovery and radiologic outcomes of the knees were evaluated at the latest follow-up. Meniscal root healing rates and medial meniscal extrusion according to a second magnetic resonance imaging reading were compared between the 2 groups at the latest follow-up.</div></div><div><h3>Results</h3><div>The results showed statistically significant improvements in the postoperative Lysholm score, IKDC score, and VAS score in both groups at the latest follow-up (<em>P</em> &lt; .001). Analysis of the minimal clinically important difference for postoperative outcomes revealed that the percentage of patients who reached the minimal clinically important difference threshold was 100% for the Lysholm score, 100% for the IKDC score, and 100% for the VAS score in the HTO–MMPRT reconstruction group. In comparison, the percentages were 87.9% for the Lysholm score, 90.9% for the IKDC score, and 100% for the VAS score in the HTO-alone group. Additionally, compared with the HTO-alone group, the HTO–MMPRT reconstruction group using gracilis tendon graft showed significantly improved meniscal root healing rates (complete healing, 85.7% vs 45.4% [95% confidence interval, 0.003-0.007]; <em>P</em> = .001) and functional recovery (<em>P</em> &lt; .005) at the final follow-up. Additionally, the HTO–MMPRT reconstruction group showed significantly more improvement in the Kellgren-Lawrence grade (10 of 21 knees vs 6 of 33 knees with improved Kellgren-Lawrence grade, <em>P</em> = .033) and medial meniscal extrusion (2.1 ± 1.0 mm vs 3.1 ± 1.6 mm [95% confidence interval, 0.3-1.7 mm]; <em>P</em> = .007) compared with the HTO-alone group.</div></div><div><h3>Conclusions</h3><div>HTO with reconstruction of the meniscal root using a tendon graft resulted in improved radiographic and patient-reported outcomes, as well as improved healing rates, compared with HTO alone.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective case-series comparison.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1485-1492"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635949","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":"Gap Volume Based on Computed Tomography Measurement Is a Strong Risk Factor for Delayed Gap Healing After Open-Wedge High Tibial Osteotomy","authors":"Sayako Sakai M.D. ,&nbsp;Shinichi Kuriyama M.D., Ph.D. ,&nbsp;Yugo Morita M.D., Ph.D. ,&nbsp;Kohei Nishitani M.D., Ph.D. ,&nbsp;Shinichiro Nakamura M.D., Ph.D. ,&nbsp;Takenori Akiyama M.D., Ph.D. ,&nbsp;Shuichi Matsuda M.D., Ph.D.","doi":"10.1016/j.arthro.2024.07.015","DOIUrl":"10.1016/j.arthro.2024.07.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify factors that affect delayed gap healing after open-wedge high tibial osteotomy (OWHTO) and to determine whether large gap volume is a predictor of delayed gap healing.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed biplane OWHTO performed between 2019 and 2023 for knee osteoarthritis or osteonecrosis. The minimum follow-up period was 1 year. Delayed gap healing was defined when the medial half of the osteotomy gap area had not reached the consolidation phase by 6 months after surgery based on anteroposterior knee radiographs. Gap volume was calculated from computed tomography images. Logistic regression was performed using body height, smoking, correction angle, hinge fracture, flange thickness, and gap volume. A gap volume cutoff value for delayed gap healing was determined with receiver operating characteristic curve analysis. Gap volume was predicted with multiple linear regression.</div></div><div><h3>Results</h3><div>There were 80 knees in 71 patients (36 men and 44 women). The mean gap volume was 7.6 cm³. Gap healing rates at 3, 6, 9, and 12 months after surgery were 26%, 65%, 89%, and 100%, respectively. There were 25 knees with delayed gap healing. Male sex was not a significant risk factor when adjusted for body height. Multivariate logistic regression revealed that only larger gap volume was a significant risk factor (odds ratio, 1.45; <em>P</em> = .006). The gap volume cutoff value was 7.6 cm³, with an area under the curve of 0.74. Tall body height and a large correction angle (both <em>P</em> &lt; .001) were associated with a significantly larger gap volume (<em>R</em>² = 0.73).</div></div><div><h3>Conclusions</h3><div>Large gap volume is the most important risk factor for delayed gap healing after OWHTO. Gap volume can be predicted based on body height and correction angle. When OWHTO with substantial correction is planned for tall men, surgeons should be aware of possibly delayed gap healing.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case-control study.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1474-1484"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790050","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: Long Term Results of Hip Arthroscopy for Femoroacetabular Impingement Are Similar Between Male and Female Patients, So Let’s Not Use Sex as an Excuse","authors":"Derek H. Ochiai M.D. (Editorial Board)","doi":"10.1016/j.arthro.2024.08.001","DOIUrl":"10.1016/j.arthro.2024.08.001","url":null,"abstract":"<div><div>Female patients improve equally to male patients with femoroacetabular impingement syndrome arthroscopy, which includes labral repair and capsular closure. The equivalence in improvement may be related to routine capsular closure in all patients. Female patients have a greater incidence of generalized joint hypermobility, which can be mitigated with capsular closure and treated with capsular plication. The shift from dogma to clinical certainty is achieved by long-term outcome tracking.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1358-1359"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918142","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: Arthroscopic Bone Grafting Using Suspensory Fixation for Anterior Glenohumeral Fixation With Bone Loss May Supersede the Latarjet Procedure Using Coracoid Transfer","authors":"Stephen C. Weber M.D. (Editorial Board)","doi":"10.1016/j.arthro.2024.09.004","DOIUrl":"10.1016/j.arthro.2024.09.004","url":null,"abstract":"<div><div>The Latarjet procedure, including coracoid transfer, is indicated for anterior glenohumeral instability and significant bone loss. However, even in experienced hands, the Latarjet procedure is associated with potential complications including neurovascular injury, graft resorption leading to painful or broken hardware and secondary subscapularis damage, prominent hardware, and graft nonunion. An adjustable suture button technique may minimize hardware complications and show low rates of nonunion and resorption. (Perhaps, overly rigid fixation of the coracoid using screws contributes to the resorption.) Coracoid transfer may be avoided using various graft sources including iliac crest bone graft. Despite loss of the “sling effect” provided by coracoid and conjoined tendon transfer, the procedure shows good outcomes with low recurrent instability rates in indicated patients. Although technically complex, bone grafting and suspensory fixation may be performed arthroscopically. Time will tell if this technique may supersede the Latarjet procedure.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1335-1336"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156715","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}