Disagreement Persists on Optimal Rehabilitation Goals and Timelines for Weight-Bearing Restriction, Knee Brace Use, and Return to Sports After Posterolateral Corner Reconstruction.

Purpose: To assess the variability of rehabilitation protocols for both isolated posterolateral corner (PLC) reconstructions and those with a concomitant anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL) reconstruction, to construct uniform rehabilitative protocol recommendations, and to propose rehabilitative outcome measures for future PLC-related clinical studies.

Methods: A Google search was conducted for online PLC reconstruction rehabilitation protocols, categorizing them into isolated PLC reconstructions or PLC with concomitant ACL/PCL reconstructions. Rehabilitative goals and timelines were described and agreement rates among protocols were calculated.

Injuries in Mixed Martial Arts After Adoption of the Unified Rules of MMA: A Systematic Review.

Background: The existing literature on injuries in mixed martial arts (MMA) is sparse and lacks a summarized review of injuries in the sport after the adoption of the new rule set in 2009.

Purpose: To assess the injury characteristics in terms of injury rates and types in MMA after the adoption of the Unified Rules of MMA (URM) by the Association of Boxing Commissions and compare them with preadoption trends.

Study Design: Systematic review; Level of evidence, 4.

Indications for Lateral Extra-articular Procedures in the Anterior Cruciate Ligament-Reconstructed Knee: Part I of an International Consensus Statement.

Purpose: To define expert consensus on whether and how lateral extra-articular procedures (LEAPs) should accompany anterior cruciate ligament (ACL) reconstruction to optimize outcomes in ACL-deficient knees.

Methods: Fifty-five knee surgeons from 17 countries on 5 continents completed a 3-round modified Delphi process. Twenty-one statements on patient selection for combined ACL reconstruction (ACLR) + LEAPs were graded on 5-point Likert scales; ≥75% "agree/strongly agree" signified consensus.

Rates of Return to Sport After Surgical Management of Multiligament Knee Injuries Are Higher Than Previously Described yet Highly Heterogeneous: A Systematic Review.

Purpose: To provide an updated overview of return to sport (RTS) and return to work (RTW) after surgical management of multiligament knee injuries (MLKIs).

Methods: A search was conducted across the MEDLINE, Embase, and PubMed databases from inception to August 26, 2024. Studies published after 2018 that reported on rates of RTS or RTW after multiligament knee reconstruction were included.

A Contemporary International Expert Consensus Statement on the Evaluation, Diagnosis, Treatment, and Rehabilitation of Injuries to the Posterolateral Corner of the Knee.

Purpose: To use a modified Delphi technique to generate an expert consensus statement on the evaluation, diagnosis, treatment, and rehabilitation of posterolateral corner (PLC) injuries of the knee.

Methods: A 5-individual working group developed a list of 62 statements regarding PLC injuries for use in a 3-round modified Delphi series. Ultimately, 40 statements were retained, and a 100% participation rate was observed in all rounds.

Current practice of biologic augmentation techniques to enhance the healing of meniscal repairs: A collaborative survey within the Meniscus International Network (MenIN) Study Group.

Purpose: To evaluate practices and preferences among expert sports knee surgeons regarding biologic augmentation techniques in meniscal repair.

Methods: A 12-question multiple-choice survey was distributed to the Meniscus International Network (MenIN) Study Group. It covered biologic augmentation techniques for various meniscal tear types, both in isolation and with anterior cruciate ligament reconstruction (ACLR).

Guidelines for Designing and Conducting Delphi Consensus Studies: An Expert Consensus Delphi Study.

Purpose: To conduct a Delphi project to develop guidelines for the design and execution of Delphi studies within medical and surgical specialties.

Methods: Open-ended questions in round 1 and open-ended and semi-open questions in round 2 were answered. The results of the first 2 rounds were used to develop a Likert-style questionnaire for round 3.

Biologic augmentation of meniscus repair: A scoping review.

Purpose: The aim of this study was to carry out a scoping review to investigate the use of biologic augmentation strategies for arthroscopic meniscal repair.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and Arksey and O'Malley frameworks were followed. The studies were obtained and screened, with inclusion criteria comprising clinical studies evaluating the biologic augmentation of arthroscopic meniscal repair, systematic reviews, opinion pieces, and consensus statements.

Exploring artificial intelligence in orthopaedics: A collaborative survey from the ISAKOS Young Professional Task Force.

Purpose: Through an analysis of findings from a survey about the use of artificial intelligence (AI) in orthopaedics, the aim of this study was to establish a scholarly foundation for the discourse on AI in orthopaedics and to elucidate key patterns, challenges and potential future trajectories for AI applications within the field.

Methods: The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Young Professionals Task Force developed a survey to collect feedback on issues related to the use of AI in the orthopaedic field. The survey included 26 questions.

Adequate Failure Loads for Modified Lemaire Lateral Extra-articular Tenodesis Are Achieved With an Interference Screw, Staple, and Suture Anchor: A Biomechanical Study of Structural Properties.

Background: A lateral extra-articular tenodesis (LET) is increasingly being utilized to augment an anterior cruciate ligament reconstruction because it has been shown to reduce the risk of postreconstruction graft failure or recurrent rotatory instability. Various femoral fixation techniques are available, including the use of an interference screw, staple, or suture anchor.

Purpose: To determine and compare the biomechanical properties of an LET graft when using an interference screw, staple, or suture anchor for the femoral fixation for a modified Lemaire LET.

Evaluation of Factors Associated With Short-term Failure After Primary Isolated PCL Reconstruction: A Study of Patients From the Swedish and Norwegian Knee Ligament Registries.

Background: The rate of subjective failure after isolated primary posterior cruciate ligament reconstruction (PCL-R) is relatively high, requiring an improved understanding of factors associated with inferior outcomes.

Purpose: To determine the association between patient and injury-related factors and total (surgical and clinical) failure at 2 years after PCL-R based on data from the Swedish National Knee Ligament Registry (SNKLR) and the Norwegian Knee Ligament Registry (NKLR).

Study Design: Cohort study; Level of evidence, 3.

Editorial Commentary: Grade III Medial Collateral Ligament Management Strategies in Patients Having Anterior Cruciate Ligament Reconstruction Vary Depending on Injury Pattern and Patient Factors.

Management strategies for grade III medial collateral ligament (MCL) tears in patients having anterior cruciate ligament reconstruction include repair, reconstruction, nonoperative management, and all of the aforementioned plus suture tape augmentation. Not all MCL injuries, even grade III injuries, are similar. Proximal MCL injuries have a good capacity to heal with nonoperative treatment, whereas distal MCL avulsions are thought to benefit from early surgery.

Patient-Reported Outcomes of Bicruciate Multiligament Versus Single Cruciate Multiligament Knee Injuries.

Background: Multiligament knee injuries (MLKIs) are heterogeneous, and bicruciate knee ligament injuries are considered a serious form of this injury. The current literature tends not to distinguish between single and bicruciate MLKI when reporting outcomes.

Purpose: To investigate patient-reported outcomes after surgical treatment of MLKI comparing single cruciate MLKI with bicruciate MLKI.

Strategies for Preventing Tunnel Convergence in Multiligament Knee Injury Reconstructions.

Background: Multiligament knee injuries (MLKIs) are complex and heterogeneous, often associated with concomitant injuries, and necessitates precise treatment strategies.

Preoperative Management: Effective preoperative management in MLKIs requires comprehensive evaluation, starting with a detailed patient history to identify the mechanisms of injury and prior treatments. Physical examination assesses for knee stability, while imaging techniques including magnetic resonance imaging (MRI) and radiographs detail ligament, cartilage, and meniscal injuries to identify all injured structures.

Diagnosis and Treatment Strategies of Meniscus Root Tears: A Scoping Review.

Background: Meniscus root tears comprise 10% to 21% of all meniscal tears. These tears alter knee biomechanics, elevating contact pressure, akin to a meniscectomy. Consequently, they are linked to advanced joint degeneration and cartilage damage in the affected compartment.

Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation.

Multiligament knee injuries (MLKIs) represent a broad spectrum of pathology with potentially devastating consequences. Currently, disagreement in the terminology, diagnosis and treatment of these injuries limits clinical care and research. This study aimed to develop consensus on the nomenclature, diagnosis, treatment and rehabilitation strategies for patients with MLKI, while identifying important research priorities for further study.

Pitch-Tracking Metrics as a Predictor of Future Shoulder and Elbow Injuries in Major League Baseball Pitchers: A Machine-Learning and Game-Theory Based Analysis.

Background: Understanding interactions between multiple risk factors for shoulder and elbow injuries in Major League Baseball (MLB) pitchers is important to identify potential avenues by which risk can be reduced while minimizing impact on player performance.

Purpose: To apply a novel game theory-based approach to develop a machine-learning model predictive of next-season shoulder and elbow injuries in MLB pitchers and use this model to understand interdependencies and interaction effects between the most important risk factors.

Study Design: Case-control study; Level of evidence, 3.

The gender and sex data gap in anterior cruciate ligament injuries in paediatric patients.

Anterior cruciate ligament (ACL) injury is a concerning problem in the paediatric population, impacting joint health and longevity. Moreover, ACL injury hampers physical activity, which is important for children's social network and general well-being. Recent data demonstrates a rise in paediatric ACL reconstructions, affecting both girls and boys.

Early Surgery for Partial Tears of the Ulnar Collateral Ligament May Be More Cost-Effective and Result in Longer Playing Careers Than Nonoperative Management for High-Level Baseball Pitchers: A Decision-Analytic Markov Model-Based Analysis.

Background: Nonoperative management versus early reconstruction for partial tears of the medial ulnar collateral ligament (MUCL) remains controversial, with the most common treatment options for partial tears consisting of rest, rehabilitation, platelet-rich plasma (PRP), and/or surgical intervention. However, whether the improved outcomes reported for treatments such as MUCL reconstruction (UCLR) or nonoperative management with a series of PRP injections justifies their increased upfront costs remains unknown.

Purpose: To compare the cost-effectiveness of an initial trial of physical therapy alone, an initial trial of physical therapy plus a series of PRP injections, and early UCLR to determine the preferred cost-effective treatment strategy for young, high-level baseball pitchers with partial tears of the MUCL and with aspirations to continue play at the next level (ie, collegiate and/or professional).

Supratubercle Anterior Closing Wedge Osteotomy: No Changes in Patellar Height and Significant Decreases in Anterior Tibial Translation at 6 Months Postoperatively.

Background: Because of the increased prevalence of revision anterior cruciate ligament (ACL) reconstruction, there has been a desire to understand the role of posterior tibial slope on increased anterior tibial translation and increased ACL graft forces. One potential concern in supratubercle anterior closing wedge proximal tibial osteotomy (ACW-PTO) for decreasing the posterior tibial slope is the risk of altering the patellar height.

Purpose: To radiographically assess changes in (1) patellar height, (2) anterior tibial translation, and (3) posterior tibial slope after supratubercle ACW-PTO.

Functional anterior cruciate ligament braces may have a role in select patient groups although there is presently limited evidence supporting or refuting their routine use: A scoping review of clinical practice guidelines and an updated bracing classification.

Purpose: The purpose of this study was to perform a scoping review of clinical practice guidelines (CPGs) concerning the use of functional anterior cruciate ligament (ACL) braces and to clarify the nomenclature for bracing relevant to ACL injury treatment in order to support prescribing clinicians.

Methods: A PubMed search for CPGs for the use of braces following ACL injury or reconstruction was performed. CPGs on the treatment of ACL injuries with sufficient attention to postoperative braces were included in this scoping review.

Meniscal extrusion consensus statement: A collaborative survey within the Meniscus International Network (MenIN) Study Group.

Purpose: The purpose of the present study was to perform a survey administered to members of the Meniscus International Network (MenIN) Study Group, seeking to delineate the most contentious aspects of meniscal extrusion classification and provide a foundation for new, more comprehensive definitions and treatments for these pathologies.

Methods: MenIN Study Group is a group of international experts treating and performing research on meniscus pathology and treatment. All MenIN Study Group members were asked to complete a survey aimed at establishing criteria for the optimal classification system for meniscal extrusion.

Rates of Subjective Failure After Both Isolated and Combined Posterior Cruciate Ligament Reconstruction: A Study From the Norwegian Knee Ligament Registry 2004-2021.

Background: Outcomes after posterior cruciate ligament (PCL) reconstruction (PCLR) have been reported to be inferior to those of anterior cruciate ligament reconstruction. Furthermore, combined ligament injuries have been reported to have inferior outcomes compared with isolated PCLR.

Purpose/hypothesis: The purpose of this study was to report on PCLR outcomes and failure rates and compare these outcomes between isolated PCLR and multiligament knee surgery involving the PCL.