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

{"title":"The Pittsburgh Instability Tool Score Predicts Outcomes After Arthroscopic Anterior Shoulder Stabilization in Patients With Subcritical Bone Loss.","authors":"Shaquille Charles, Stephen Marcaccio, Ryan T Lin, Stephanie Boden, Ehab M Nazzal, Jonathan D Hughes, Adam Popchak, Bryson P Lesniak, Albert Lin","doi":"10.1016/j.arthro.2025.04.023","DOIUrl":"10.1016/j.arthro.2025.04.023","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate rates of recurrent anterior glenohumeral instability among patients with \"on-track\" Hill-Sachs lesions who underwent either arthroscopic Bankart repair (ABR) alone or arthroscopic Bankart repair with remplissage augmentation (ABR+R) and develop a risk assessment tool for recurrent anterior glenohumeral instability as well as evaluate the role of remplissage augmentation for on-track shoulders to predict outcomes after arthroscopic stabilization.</p><p><strong>Methods: </strong>We retrospectively reviewed prospectively collected data of patients aged 14 to 40 years who underwent ABR or ABR+R between 2013 and 2021. Chart review was performed to gather patient-specific risk factors such as patient age, gender, sport-specific participation, number of preoperative dislocations, and shoulder laxity, whereas imaging measurements were used to gather glenoid bone loss and distance-to-dislocation. Recurrent anterior glenohumeral instability was defined as recurrent dislocation and/or subjective subluxation postoperatively. Exclusion criteria included revision procedure, less than 2-year follow-up, presence of an \"off-track\" Hill-Sachs lesion, documented connective tissue disorder, concomitant rotator cuff tear, missing data, or the presence of glenoid bone loss >20%. Multivariate hazard ratio estimates were used to create a risk assessment tool and correlated with patient-specific risk via postestimation analysis.</p><p><strong>Results: </strong>A total of 170 patients were included for analysis (ABR: 116, ABR+R: 54) with an average age of 21.5 ± 6.2 years and an average follow-up of 5.1 years (2.0-9.0 years). Near-track lesions (\"on-track\" lesions with a distance-to-dislocation value less than 10 mm), presence of hyperlaxity, younger age, 2+ preoperative recurrent instability episodes, contact sport athlete status, and increasing glenoid bone loss were independent risk factors for ABR failure on the basis of a final multivariate model predicting postoperative failure. Furthermore, patients undergoing ABR alone had a greater risk of recurrent instability than those undergoing ABR+R. From the final multivariate model using these prognostic factors, the hazard ratios were used to create the Pittsburgh Instability Tool (PIT) and was subsequently used to create risk-stratifying subgroups: low-risk (0-3), moderate-risk (4-8), high-risk (9-13), extreme-risk (14+). Remplissage augmentation lowered the PIT score by 8 points. Recurrent instability rates range from 2.2% among low-risk groups to 51.3% among extreme-risk groups.</p><p><strong>Conclusions: </strong>The current study indicates that arthroscopic Bankart repair with remplissage augmentation can lower the rate of recurrent instability in patients with high-risk \"on-track\" lesions. Surgeons can use the PIT tool to identify suitable candidates who may or may not benefit from arthroscopic Bankart repair with or without remplissage augmentation by computing PIT scores f","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144414","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":"Complications of Platelet-Rich Plasma Injection for Knee Osteoarthritis Are Similar to Those of Corticosteroids and Hyaluronic Acid but Are Significantly Greater Than Those of Placebo Injections: A Meta-analysis of Randomized Controlled Trials.","authors":"Stephen P Fucaloro, Jack Bragg, Makeda Berhane, Meghan Mulvey, Laura Krivicich, Thomas Zink, Matthew Salzler","doi":"10.1016/j.arthro.2025.05.018","DOIUrl":"10.1016/j.arthro.2025.05.018","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate complications of platelet-rich plasma (PRP) injections for knee osteoarthritis (OA) compared with other injected substances including hyaluronic acid (HA), corticosteroids, and placebo saline solution.</p><p><strong>Methods: </strong>The PubMed, Embase, Web of Science, and Cochrane databases were searched to identify randomized controlled trials (RCTs) comparing PRP with another injectable treatment for knee OA with documented complications. Studies not mentioning complications or using PRP during surgery were excluded. Complications were pooled to determine the overall complication rate and the number needed to harm (NNH). Subgroup analyses were performed for studies comparing PRP with HA, corticosteroids, and placebo saline solution using DerSimonian-Laird random-effects models displaying odds ratios (ORs).</p><p><strong>Results: </strong>Twenty-four RCTs were identified, with 2,751 total patients, 1,318 of whom received PRP injections. A total of 246 complications occurred in the PRP group versus 131 in the comparison cohort (18.66% vs 9.14%, P < .01). The NNH was 11. Subgroup analysis showed no difference in the odds of complications when PRP was compared with HA (OR = 1.33, P = .22, I² = 0.0%) and corticosteroids (OR = 3.07, P = .35, I² = 63.49%) but showed significantly more complications when compared with placebo (OR = 4.88, P < .01, I² = 0.00%). Only 1 patient reported severe pain; all other complications were described as moderate or mild and self-limiting.</p><p><strong>Conclusions: </strong>The use of PRP for knee OA is not innocuous, with a significantly higher rate of complications compared with placebo. However, most complications were reported as mild to moderate, and the odds of complications are similar to those of HA or corticosteroid injections. Compared with all other injectables, the NNH for PRP is 11, which is important for physicians to consider prior to PRP therapy.</p><p><strong>Level of evidence: </strong>Level II, meta-analysis of Level I and II RCTs.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133204","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":"Male Sex, Younger Age, Lower Body Mass Index, Athletes, Shorter Time From Injury to Surgery, and Non-contact Injury Are Associated With Achieving the Thresholds for Substantial Clinical Benefit for Patient-Reported Outcome Measures After Primary Anterior Cruciate Ligament Reconstruction.","authors":"Zhi-Yu Zhang, Wei-Li Shi, Yong Ma, Xi Gong, Ping Liu, Jia-Ning Wang, Xin Zhang, Hong-Jie Huang, Cheng Wang, Jian-Quan Wang","doi":"10.1016/j.arthro.2025.05.016","DOIUrl":"10.1016/j.arthro.2025.05.016","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the thresholds for substantial clinical benefit (SCB) for patient-reported outcome measures (PROMs) and to identify potential factors associated with achieving the SCB thresholds after primary anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Methods: </strong>Patients who underwent primary single-bundle ACLR using hamstring tendon autografts at our institute were included. The collected PROMs included the visual analog scale for pain, Tegner Activity Scale (Tegner score), modified Lysholm Knee Scoring Scale (Lysholm score), and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form (IKDC score). The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined based on patient responses to an anchor question. Multivariable logistic regression analyses were performed to identify factors associated with achieving the SCB thresholds.</p><p><strong>Results: </strong>A total of 382 patients with a minimum 4-year follow-up were included in this study. The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined to be 2 and 1.5, respectively, for the visual analog scale pain score; 3 and 3.5, respectively, for the Tegner score; 24.2 and 81.5, respectively, for the Lysholm score; and 27.2 and 77.6, respectively, for the IKDC score. Male sex (P = .0050 for raw postoperative score), younger age (P = .0249 for score improvement, P = .0075 for raw postoperative score), athletes (P = .0001 for score improvement), and non-contact injury (P = .0034 for raw postoperative score) were associated with increased odds of achieving the SCB threshold for the Tegner score. Higher body mass index was associated with decreased odds of achieving the SCB thresholds for both the raw postoperative Lysholm score (P = .0009) and Lysholm score improvement (P = .0036). A longer time from injury to surgery was associated with decreased odds of achieving the SCB threshold for IKDC score improvement (P = .0006).</p><p><strong>Conclusions: </strong>The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined after primary ACLR. Male sex, younger age, lower body mass index, athletes, shorter time from injury to surgery, and non-contact injury were associated with increased odds of achieving the SCB thresholds.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133234","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":"Patch Augmentation in the Treatment of Partial-Thickness Rotator Cuff Tears Facilitates Tendon Healing and Improves Patient Outcomes: A Systematic Review.","authors":"Ryne Jenkins, Nwe Oo Mon, Charles Ruotolo","doi":"10.1016/j.arthro.2025.05.014","DOIUrl":"10.1016/j.arthro.2025.05.014","url":null,"abstract":"<p><strong>Purpose: </strong>To assess outcomes and complications of patch augmentation in the treatment of partial-thickness rotator cuff tears (PTRCTs).</p><p><strong>Methods: </strong>A systematic review was conducted identifying studies assessing outcomes after surgical treatment of PTRCT with patch augmentation and 6-month follow-up. Clinical studies with full-text manuscripts were identified using Embase, PubMed, Web of Science, and Cochrane databases between January 1980 and December 2023. Postoperative tendon thickness on magnetic resonance imaging was assessed as well as complications and reoperation rates. Forest plots and 95% confidence intervals were generated from mean differences (MD) in pre-post outcome data.</p><p><strong>Results: </strong>Seven studies met study criteria, and only 1 study had a control group (1 Level III, 6 Level IV). In total, 514 patients were enrolled; 482 used a bioinductive collagen patch. Of those, 446 (93%) underwent debridement and 36 (7%) underwent take down and repair. Thirty-two patients served as a control without augmentation; however, only complications were assessed. In total, 14 (44%) underwent debridement alone and 18 (56%) underwent take down and repair. American Shoulder and Elbow Surgeons (ASES) shoulder scores improved with an MD of 16.9 to 41.3 in patients undergoing augmentation. The ASES shoulder function score improved with MD of 8.2 to 12.0. The ASES shoulder pain score improved with a MD of 3.5 to 4.4. A total of 83% to 93% of patients met a minimum clinically important difference (MCID) in ASES scores at 1 year, and 100% of patients with intermediate grade tears and 79.0% with high-grade tears met an MCID at 2 years. Tendon thickness increased, ranging from 0.8 to 2.0 mm. Postoperative complication rates varied, ranging from 3% to 25%, and reoperation rates ranging from 0% to 19%. Reported complications varied; however, stiffness/adhesive capsulitis was the most prevalent complication, occurring in 0% to 25% of patients.</p><p><strong>Conclusions: </strong>Augmentation was associated with increased tendon thickness and improved functional scores, with 79% to 100% of patients meeting a MCID in outcome scores.</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":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133238","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":"Perioperative Leukocyte-Poor Platelet-Rich Plasma Associated With Reduced Risk of Retear After Arthroscopic Rotator Cuff Repairs: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Samuel Hovland, Vraj Amin, Jason Liu, Matthew Aceto, Vonda Wright","doi":"10.1016/j.arthro.2025.05.015","DOIUrl":"10.1016/j.arthro.2025.05.015","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a systematic review and meta-analysis of randomized controlled trials in the literature to ascertain the clinical efficacy of leukocyte-poor platelet-rich plasma (LP-PRP) in arthroscopic rotator cuff repair.</p><p><strong>Methods: </strong>A through literature search was performed from databases such as PubMed, SCOPUS, Embase, Cochrane Library, and Google Scholar using key words. Eligible studies were randomized controlled trials with Level I or II evidence, an ≥80% follow-up rate, at least 12 months of follow-up, use of LP-PRP in arthroscopic rotator cuff repair, and report of postoperative outcomes.</p><p><strong>Results: </strong>Our literature search yielded 9 randomized controlled trials consisting of 743 patients, with 380 patients receiving LP-PRP and 363 patients receiving a control or placebo. Postoperative outcomes analyzed were rotator cuff retear rates, visual analog scale (VAS) pain scores, American Shoulder and Elbow Surgeons (ASES) scores, University of California Los Angeles (UCLA) scores, and Constant scores. Retear rates were significantly lower in the LP-PRP treated group compared with controls (risk ratio 0.54; confidence interval [CI] 0.41-0.71; P < .00001), VAS pain scores were significantly lower in the LP-PRP treated group compared with controls (mean difference [MD] -0.12; CI -0.24 to -0.01; P < .04), ASES scores were significantly greater in the LP-PRP-treated group compared with controls (MD 1.88; CI 0.46-3.31; P < .01), Constant scores were significantly greater in the LP-PRP-treated group compared with controls (MD 2.58; CI 1.28-3.89; P < .0001), and UCLA scores were significantly greater in the LP-PRP-treated group compared with controls (MD 1.16; CI 0.17-2.16; P < .02). Retear rates showed a relative risk reduction of about 46% in patients who received LP-PRP compared with controls, and although VAS Pain Scores, ASES Scores, Constant Scores, and UCLA Scores all were significantly improved, these clinical outcomes scores did not meet the minimal clinical important difference established within the literature.</p><p><strong>Conclusions: </strong>Administration of LP-PRP is associated with significantly reduced postoperative retear rates at minimum 12 months follow-up compared with a saline injection control group. However, its use did not show clinically meaningful effects on postoperative pain or patient-reported outcomes, highlighting its primary benefit as enhancing structural healing.</p><p><strong>Level of evidence: </strong>Level I and II, systematic review and meta-analysis.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133241","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: Open Distal Tibial Allograft With Screw Fixation for Distal Tibial Allograft Glenoid Reconstruction in Patients With Shoulder Instability May Result in Lower Recurrence Rates Than Button Fixation.","authors":"Phob Ganokroj, Nate Dickinson, Matthew T Provencher","doi":"10.1016/j.arthro.2025.05.013","DOIUrl":"10.1016/j.arthro.2025.05.013","url":null,"abstract":"<p><p>The glenoid rim is altered in up to 90% of shoulders with recurrent instability. Distal tibial allograft, an option for anatomic glenoid reconstruction (AGR), has excellent midterm outcomes and low recurrence and resorption rates using open or arthroscopic technique. Optimal graft position in both the medial-lateral and vertical axes, adequate fixation, and restoration of soft-tissue balance is the key to successful outcomes. Regarding fixation methods, metal screw fixation is a standard for AGR with free bone block or Latarjet procedure. The main disadvantage of screw fixation is hardware prominence and irritation to surrounding bone and soft tissue (6.5%), the leading cause of revision surgery. Button fixation may mitigate hardware complications but lead to greater graft malposition, resorption, and recurrence rates. The authors used an open approach with screw fixation for AGR with distal tibial allograft and restoration of the capsulolabral complex to reduce recurrent instability after surgery.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103259","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: Researchers Should Determine Study-Specific Thresholds for Substantial Clinical Benefit and Patient Acceptable Symptomatic State: Previous Reported Threshold Values May Not Apply.","authors":"Mark P Cote, Brandon J Allen, Srish S Chenna, Rachel L Poutre","doi":"10.1016/j.arthro.2025.05.012","DOIUrl":"10.1016/j.arthro.2025.05.012","url":null,"abstract":"<p><p>Patient-reported outcome measures capture a patient's health throughout the care process, but the scores do not provide direct information on whether there has been substantial improvement or whether the patient is satisfied with his or her current state of health. In contrast, metrics such as the substantial clinical benefit and patient acceptable symptomatic state are clinically relevant threshold scores that correspond to improvement and satisfaction. Various studies report varied thresholds because of differing anchor questions (used to establish improvement or satisfaction), lengths of follow-up, sample sizes, and patient demographic characteristics. This is unsurprising considering varied patient expectations, values, and goals, as well as surgeon practice patterns, setting, and interpersonal skills, that may influence patient perception. Such complexities will produce variation in threshold values from study to study, even studies using similar anchor questions, lengths of follow-up, and sample sizes. Thus, thresholds reported in the past literature may not well apply to current and future research, and researchers should determine study-specific thresholds, ideally by asking the patient whether he or she is substantially improved and/or satisfied, that is, asking 2\"anchor questions.\" To fully appreciate metrics such as the substantial clinical benefit and patient acceptable symptomatic state, they need to be viewed as distributions of values.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086924","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: Precise Categorization of Ligament Injuries in Knee Dislocations and Multiple Ligament Knee Injury Shows Potential for Improved Awareness of Neurovascular Injury and Patient Prognosis.","authors":"Michael J Medvecky","doi":"10.1016/j.arthro.2025.05.011","DOIUrl":"10.1016/j.arthro.2025.05.011","url":null,"abstract":"<p><p>Modifications to the Schenck Classification of knee dislocation and the newly described Anatomic Multiple Ligament Knee Injury Classification have improved our ability to classify complex knee ligament injuries more precisely. There is recent evidence that a distinct injury risk profile exists between the dislocated knee and the nondislocated but multiple ligament injured knee. Separation of injury patterns into the 2 distinct classifications allows researchers to stratify by these newer modifications and shows potential for assisting in patient prognosis. Comparative studies among the differing injury patterns are the next steps in furthering our knowledge of this potentially limb-threatening injury.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086922","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: Measure Labral Height Using Magnetic Resonance Imaging Prior to Hip Arthroscopy: A Diminutive Labrum Should Be Reconstructed With a Graft to Restore the Suction Seal.","authors":"Thomas Youm","doi":"10.1016/j.arthro.2025.05.009","DOIUrl":"10.1016/j.arthro.2025.05.009","url":null,"abstract":"<p><p>The acetabular labrum deepens the hip socket and provides a suction seal to the femoral head. Anatomic restoration of the suction seal is the goal of hip labral repair. Labral debridement outcomes are inferior to labral repair because this suction seal is disrupted. Labral height, surface area, and volume contribute to the suction seal and are important to consider in order to restore hip stability. Labral height should be measured on magnetic resonance imaging before arthroscopy. If the labrum is insufficient, surgeons should plan labral augmentation and reconstruction using a graft. Labral reconstruction can lead to successful outcomes in cases of short labral height or hypoplastic labrum by restoring the suction seal.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082270","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":"Partial Meniscectomy Increases Risk of Anterior Cruciate Ligament Revision Surgery Compared With Meniscus Repair in Patients With Concurrent Meniscus and Anterior Cruciate Ligament Tears After Anterior Cruciate Ligament Reconstruction.","authors":"Abhinav R Balu, Avani Chopra, Augustus Demanes, Peter C Shen, Rithvik R Balu, Michael Terry, Vehniah K Tjong","doi":"10.1016/j.arthro.2025.05.006","DOIUrl":"10.1016/j.arthro.2025.05.006","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the rates of revision anterior cruciate ligament (ACL) reconstruction, meniscal reoperation, and total knee arthroplasty associated with partial meniscectomy and meniscal repair performed at the time of index ACL reconstruction in patients with concurrent meniscus and ACL tears.</p><p><strong>Methods: </strong>The TriNetX database was queried for patients undergoing ACL reconstruction after January 1, 2000, with minimum 1-year clinical follow up. Inclusion criteria for this study were patients who had partial meniscectomy, meniscal repair, or isolated ACL reconstruction without meniscus injury. Statistical analyses were performed using Python with significance thresholds of P < .05.</p><p><strong>Results: </strong>A total of 39,126 patients were followed for an average of 5.02 years. Patients undergoing meniscal repair were less likely to experience revision ACL reconstruction compared with those undergoing partial meniscectomy (relative risk [RR] 0.78, confidence interval [CI] 0.71-0.85, P < .001). Meniscus reoperation occurred significantly more in patients undergoing meniscal repair (RR 1.26, CI 1.17-1.35, P < .001) than those undergoing partial meniscectomy. Regarding total knee arthroplasty, partial meniscectomy carried a more than 6-fold increased risk compared with isolated ACL reconstruction (RR 6.4, CI 2.49-16.42, P < .001).</p><p><strong>Conclusions: </strong>In patients with ACL injury, ACL reconstruction, and concurrent meniscus tear, those patients treated with meniscus repair were less likely to undergo revision surgery. In these patients, medial meniscal injuries were associated with ACL revision than lateral meniscal injury regardless of the method of treatment. When meniscus repair is performed, this is associated with lower rate of future total knee arthroplasty.</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":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082282","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}