DSpace Community:

Effect of intra-articular tibial tunnel aperture positioning on the clinical outcomes after repair of medial meniscus posterior root tear with pull-out repair technique

2026-08-01T00:00:00Z

Title: Effect of intra-articular tibial tunnel aperture positioning on the clinical outcomes after repair of medial meniscus posterior root tear with pull-out repair technique Authors: Byun, Junwoo; Kim, Sung-Hwan; Chung, Kwangho; Moon, Hyun-Soo; Jung, Se-Han; Yoon, Seung-Ho; Jung, Min Abstract: Background: The impact of tibial tunnel aperture position on outcomes after medial meniscus posterior root (MMPR) repair with a transtibial pull-out technique remains unclear. This study evaluated the association between intra-articular tibial tunnel aperture position and postoperative outcomes after transtibial pull-out MMPR repair using intra-articular assessment. Methods: Patients who underwent arthroscopic MMPR repair between March 2010 and February 2022 were retrospectively reviewed. The tibial tunnel aperture was classified relative to the MMPR footprint midpoint as anterior (Group A; 28 patients) or posterior (Group P; 30 patients). PROMs (VAS, Lysholm score, International Knee Documentation Committee subjective score, and KOOS) and radiologic outcomes (changes in joint space width and Kellgren-Lawrence (K-L) grade progression) were evaluated at >= 2-year follow up. Results: Postoperative outcomes did not differ significantly between groups. However, Group A showed higher rates of K-L grade progression (67.8% vs. 36.7%; P = 0.031) and greater medial joint space narrowing (0.9 mm (interquartile range 0.4-1.4) vs. 0.3 mm (interquartile range 0.0-0.6), P = 0.001) than Group P. Joint space narrowing demonstrated a significant positive correlation with the normalized anteroposterior distance of the tibial tunnel aperture (r = 0.459; P < 0.001),indicating that more anterior tunnels were associated with greater joint space loss. Conclusion: Anterior placement of the intra-articular tibial tunnel aperture was associated with unfavorable radiologic outcomes, including joint space narrowing and progression of the K-L grade. Notably, the normalized anteroposterior distance of the MMPR footprint to the center of the tibial tunnel aperture showed a significant correlation with joint space narrowing, (c) 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Anterior cruciate ligament reconstruction achieved noninferior patient reported outcome measures while residual rotational instability depends on anterolateral ligament femoral tunnel position: A matched analysis

2026-06-01T00:00:00Z

Title: Anterior cruciate ligament reconstruction achieved noninferior patient reported outcome measures while residual rotational instability depends on anterolateral ligament femoral tunnel position: A matched analysis Authors: Byun, Junwoo; Jung, Min; Chung, Kwangho; Moon, Hyun-Soo; Jung, Se-Han; Kim, Sung-Hwan Abstract: Background: The efficacy of anterolateral ligament (ALL) reconstruction in low-demand patients remains unclear. Therefore, we aimed to analyse the outcomes of ALL reconstruction with anterior cruciate ligament (ACL) reconstruction in low-demand patients. Methods: Patients who underwent arthroscopic ACL reconstruction using the transportal technique between March 2010 and December 2022 with a minimum 2-year follow-up were retrospectively reviewed. Patients with preoperative high-grade pivot shifts (grades 2 and 3) were classified into two groups based on whether ALL reconstruction was performed. Matched cohort analysis, including noninferiority analyses for subjective and objective outcomes, was performed. Additionally, a subgroup analysis of postoperative outcomes was performed based on the position of the anterolateral ligament-femoral tunnel. Results: Twenty-nine patients were included in each group. No significant differences were found in the preoperative or postoperative variables. Patient-reported outcome measures (PROMs) met the noninferiority trial criteria, whereas the residual pivot shift did not. Subgroup analysis comparing results according to the femoral tunnel of the ALL resulted in a significantly higher proportion of patients with a residual pivot shift when the femoral tunnel was positioned anterior to the lateral epicondyle compared to posterior placement (P = 0.035 and 0.021 at 1 and 2 years postoperatively). Conclusions: ACL reconstruction without ALL reconstruction was noninferior for PROMs. However, residual rotational instability was affected by the ALL femoral tunnel position, which favours femoral tunnel posterior to the lateral epicondyle. Therefore, routine addition of ALL reconstruction in low-demand patients may not be necessary, and greater emphasis should be placed on precise ALL femoral tunnel positioning. (c) 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Bone Bridge Effect for the Treatment of Acute Osteoporotic Vertebral Compression Fractures: A Multistrategic Approach Using an Anabolic Agent

2026-06-01T00:00:00Z

Title: Bone Bridge Effect for the Treatment of Acute Osteoporotic Vertebral Compression Fractures: A Multistrategic Approach Using an Anabolic Agent Authors: Yoon, Ja-Yeong; Kim, Sung-Min; Moon, Seong-Hwan; Kim, Hak-Sun; Suk, Kyung-Soo; Park, Si-Young; Kwon, Ji-Won; Lee, Byung Ho Abstract: Purpose: To determine the bone bridge effect (BBE) and compare treatment outcomes of different osteoporosis medications in patients with lumbar osteoporotic vertebral compression fractures (OVCF). Materials and Methods: This study followed 264 patients with lumbar OVCFs undergoing conservative treatment for more than 12 months. Patients were divided into four groups based on medication: denosumab monotherapy (group D), teriparatide and denosumab combination (group TDco), sequential romosozumab followed by denosumab (group RDse), and bisphosphonate mono-therapy (group B). Changes in bone mineral density (BMD), radiological parameters including BBE, and visual analog scale (VAS) scores were compared from injury to 1 year post-injury. Results: The 1-year BBE incidence was highest in groups treated with anabolic agents: group RDse (56.3%) and group TDco (51.8%). These rates were significantly higher than in group D (28.6%) and group B (21.1%). The annual BMD increase was significantly greater in group TDco (1.04) compared to the other groups (RDse: 0.63; D: 0.55; B: 0.35). VAS scores decreased significantly by the 3-month mark in anabolic agent groups and in patients with confirmed BBE, indicating rapid pain relief. Multivariate logistic regression analysis confirmed that anabolic agent groups (TDco and RDse) were significant independent predictors of BBE formation (odds ratio 2.717 and 3.472, respectively), even after adjusting for confounding variables such as initial BMD. Conclusion: Anabolic agents appeared to be associated with more BBE formation, greater BMD gains, and faster pain reduction compared to anti-resorptive agents. Therefore, treatment strategies using anabolic agents, such as those in groups TDco and RDse, maybe important considerations for treating patients with OVCFs.

Comparison of Outcomes after Minimally Invasive Transverse Distal Metatarsal Osteotomy (MITO) and Proximal Phalangeal Osteotomy for Hallux Valgus With and Without Rheumatoid Arthritis: A Matched Cohort Study

2026-05-01T00:00:00Z

Title: Comparison of Outcomes after Minimally Invasive Transverse Distal Metatarsal Osteotomy (MITO) and Proximal Phalangeal Osteotomy for Hallux Valgus With and Without Rheumatoid Arthritis: A Matched Cohort Study Authors: Yoon, Yeo Kwon; Shim, Dong Woo; Kim, Jeong Hoon; Han, Seung Hwan; Lee, Jin Woo; Park, Kwang Hwan Abstract: Background: There is an increasing role for joint-preserving surgery in hallux valgus (HV) management among patients with rheumatoid arthritis (RA). We compared radiologic and clinical outcomes after minimally invasive transverse distal metatarsal osteotomy (MITO) and a complete proximal phalangeal osteotomy for HV correction in patients with and without RA. Methods: This retrospective cohort study included 16 RA patients (21 feet) who underwent MITO between July 2018 and June 2023 with a minimum follow-up of 24 months. In total, 53 non-RA patients (63 feet) were matched by propensity score matching (1:3 ratio) after consideration of age, sex, body mass index, follow-up duration, preoperative hallux valgus angle (HVA), first-second intermetatarsal angle (1-2 IMA), and tibial sesamoid position (TSP). Radiologic evaluation included HVA, 1-2 IMA, and TSP measurements. Clinical outcomes were assessed using visual analog scale (VAS) pain scores, Foot and Ankle Outcome Scores, and Medical Outcomes Study Short Form Health Survey-36 physical component summary scores. Results: The matched cohorts consisted entirely of female patients, with a mean age of 63.7 years in the RA group and 63.3 years in the non-RA group. The mean follow-up duration was 38.1 months (range, 24-85 months). All radiologic parameters significantly improved at the last follow-up (all P < .001). Postoperative mean HVA, 1-2 IMA, and TSP were 4.9 degrees, 3.9 degrees, and 3, respectively, in the RA group and 7.0 degrees, 5.2 degrees, and 3, respectively, in the non-RA group; with the numbers available, no significant difference could be detected. Similarly, no significant difference could be detected in the final functional scores, and VAS met the predefined noninferiority margin. Likewise, no significant difference could be detected in total complications (P = 1.000) or reoperation rates (P = .184). Conclusion: MITO combined with a complete proximal phalangeal osteotomy yielded favorable radiographic improvements and noninferior pain relief in RA patients compared with non-RA patients. Our findings indicate that MITO with proximal phalangeal osteotomy may be a safe and effective minimally invasive joint-preserving surgical option for HV correction in RA patients without advanced first metatarsophalangeal joint destruction.