Orthopedic Surgery

ACI improves 10-year knee function versus alternative cartilage surgery after failed prior treatment

In this 10-year randomized trial, 390 adults with symptomatic knee cartilage defects after failed surgery received either ACI or alternative cartilage procedures. ACI produced a significantly higher Lysholm score at 10 years, with a mean difference of 7.3 points (95% CI 2.5–12.1). Treatment failure rates at 10 years were similar between ACI and alternatives (29% vs 25%; HR 1.04, 95% CI 0.69–1.6). Prior marrow stimulation did not impair ACI outcomes, whereas it was associated with worse function in the alternative-treatment group. 1

Arthroscopic Bankart repair outperforms immobilization for first-time anterior shoulder dislocation

This network meta-analysis included 19 randomized trials of first-time anterior shoulder dislocation without significant bone loss. Arthroscopic Bankart repair had the highest P score for preventing redislocation (0.9994), clearly outperforming internal- and external-rotation immobilization. Bankart repair also reduced subluxation episodes and residual instability sensations compared with conservative immobilization strategies. External-rotation immobilization was inferior to arthroscopic Bankart and did not show a clear advantage over internal-rotation immobilization. 2

SPORT precision micro-drilling accelerates early recovery versus talar microfracture

In this randomized trial, 56 patients with osteochondral lesions of the talus received either standard microfracture or SPORT precision micro-drilling. Both groups improved significantly in pain and function over 24 months. At 3 and 6 months, SPORT yielded superior clinical outcomes, including 44.6% and 32.2% greater FAAM-Sports improvement, respectively (P ≤ 0.001). More SPORT patients met FAAM-Sports MCID at 3 and 6 months, and SPORT had higher MOCART scores at all time points (P ≤ 0.002). 3