Combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries with persistent grade II valgus (Fetto/Marshall classification) or anteromedial rotatory instability pose a significant risk to ACL graft integrity if treated in isolation. This single-stage procedure involves ACL reconstruction using a quadriceps tendon autograft combined with minimally invasive MCL augmentation using a pedicled gracilis tendon with preserved distal attachment. This gracilis-based approach addresses both superficial MCL and deep MCL stabilization in cases with valgus laxity at 20° to 30° of knee flexion. The present article outlines graft harvest, tunnel placement, graft routing, and fixation, emphasizing isometric reconstruction and graft protection. This combined procedure is believed to restore native knee biomechanics and to reduce ACL graft failure risk.

Rupturen der Quadrizepssehne sind seltene Verletzungen, die aufgrund ihrer komplexen Pathophysiologie und der begrenzten Evidenzlage jedoch erhebliche therapeutische Herausforderungen mit sich bringen. Eine sorgfältige Diagnostik und eine differenzierte Operationsplanung sind dabei von zentraler Bedeutung. Vor allem Rerupturen und chronische Läsionen sind häufig mit zusätzlichen herausfordernden Faktoren, wie einem höheren Patientenalter, relevanten Komorbiditäten, Retraktion des Sehnengewebes und einer Distalisierung der Patella, verbunden. Zu den therapeutischen Möglichkeiten zählen Rekonstruktionen mit oder ohne Vastus-Advancement, V‑Y-Sehnenverlängerungen sowie die Verwendung von Auto- oder Allografts. Eine individualisierte Therapie unter Beachtung möglicher Begleitkomorbiditäten und Risikofaktoren ist entscheidend für den Therapieerfolg.

Purpose:To identify current surgical strategies and objective criteria used for return to sport (RTS) clearance after primary isolated anterior cruciate ligament (ACL) reconstruction, based on a survey of knee surgery experts. Methods:An online survey was developed by the 'Knee Ligament' committee of the German-speaking Arthroscopy Society (AGA) and distributed to certified 'AGA Knee Experts' in November and December 2023. The final questionnaire consisted of 26 questions covering surgical strategies, postoperative evaluation, and RTS clearance after primary isolated ACL reconstruction. Participants were asked to rank objective RTS criteria, and weighted mean ranks were calculated to assess their relative importance (1 = most important, 8 = least important). Data were analysed descriptively to reflect current expert practices. Results:A total of 113 board-certified knee surgeons from Germany, Austria, and Switzerland participated in this survey. Hamstring tendon autografts were the preferred graft choice for primary isolated ACL reconstruction (87%), with over half of the respondents (58%) adapting graft selection based on the patient's activity level. RTS testing is routinely performed by 64% of participants. The most frequently used RTS tests are hop tests (93%), assessment of movement quality (59%), and postural stability (56%). The most important objective criteria for RTS clearance were time since ACL reconstruction (mean rank, 2.7), manual clinical examination (mean rank, 2.7), and RTS assessment tools (mean rank, 3.2). Concomitant surgical procedures such as cartilage treatment, meniscus repair, and osteotomies affect RTS clearance. Sport psychological assessment is rarely used (12%). Conclusion:This study found that knee experts prioritised time since surgery, clinical examination, and RTS assessment tools as the most important criteria for unrestricted RTS clearance after primary isolated ACL reconstruction. RTS clearance is affected by concomitant surgical procedures, whereas psychological assessment remains uncommon. Level of Evidence:Level V.

Quadriceps tendon ruptures are rare injuries but can pose significant challenges due to their complex pathology and limited evidence base. Meticulous diagnostics and a differentiated surgical planning are crucial for successful treatment. In particular, reruptures and chronic lesions are often associated with additional challenging factors, including advanced patient age, relevant comorbidities, tendon retraction and distal patellar displacement. Treatment options include tendon reconstruction with or without vastus muscle advancement, V-Y tendon lengthening and the use of autografts or allografts. An individualized treatment taking possible comorbidities and risk factors into account is decisive for the success of treatment.

Die Tuberositasosteotomie (TTO) ist ein wesentlicher Bestandteil der operativen Therapie patellofemoraler Instabilität. Die Indikation basiert auf der Analyse von TT-TG-Abstand („tibial tubercle – trochlear groove distance“; > 20 mm), Patella alta (CDI > 1,3), Patellamaltracking sowie fokalen distalen Knorpelschäden. Je nach Pathologie kommen unterschiedliche Verfahren zur Anwendung: medialisierende Verfahren (Elmslie-Trillat) bei erhöhtem TT-TG-Abstand, anteriorisierende (Maquet) zur Druckentlastung, anteromedialisierende (Fulkerson) bei kombinierter Instabilität und Knorpelschäden sowie distalisierende Verfahren bei Patella alta. Insgesamt zeigt die TTO sehr gute klinische Ergebnisse mit niedrigen Rezidivraten und geringen Komplikationen.

Abstract Purpose A higher posterior tibial slope (PTS) and malpositioning of bone tunnels are known risk factors for anterior cruciate ligament reconstruction (ACL reconstruction; ACLR) failure. However, it remains unclear whether these factors account for the mechanism of failure, whether traumatic or non‐traumatic. The purpose of this study was to analyze whether the ACL failure mechanism correlates with a higher PTS or non‐anatomical bone tunnels. It was hypothesized that a higher PTS and bone tunnel malposition are associated with non‐traumatic ACLR failure. Methods In this retrospective study, all ACLR failures between 2015 and 2023 treated surgically at a single institution were included. The following factors were evaluated: sex, age at the time of revision surgery, PTS, anatomical versus non‐anatomical tunnel placement, concomitant pathologies and fixation techniques. PTS was measured using the Dejour technique. Tibial and femoral tunnels were analyzed according to the method described by Stäubli and Rauschning, and Bernard et al., respectively. A logistic regression analysis was performed to evaluate the effect of each factor on the mechanism of graft failure (traumatic vs. non‐traumatic). Results Data from 143 of 144 available patients (99.3%) were included. There was no statistically significant difference in patient demographics between the two groups (p > 0.05). There was no statistically significant association between the PTS or tunnel malposition and non‐traumatic ACLR failure (p > 0.05). However, medial meniscus injuries were significantly more frequent in the non‐traumatic group (n = 53 [54.1%] vs. n = 16 [35.6%]; p = 0.034). The logistic regression showed no significant impact of any studied factor (p > 0.05) on the mechanism of ACLR failure. Conclusion Patients in our cohort with non‐traumatic ACLR failure did not demonstrate a higher PTS or a higher incidence of non‐anatomically positioned tibial or femoral tunnels compared with patients experiencing traumatic retears. However, non‐traumatic cases were associated with a higher prevalence of medial meniscus tears. Level of Evidence Level III, retrospective comparative study.

Purpose:Chronic patellofemoral instability (PFI) and pain are influenced by axial malalignment of the patellofemoral joint. Tibiofemoral rotation, defined as the rotation between femur and tibia knee, has shown to be correlated to PFI. This study aimed to determine whether tibiofemoral rotation is associated with anatomical risk factors for patellofemoral maltracking in patients with PFI. It was hypothesised that greater tibiofemoral rotation correlates with other predisposing factors for PFI. Methods:Eighty-five consecutive patients (mean age 22.6 ± 8.9 years; 58 female) with PFI underwent standardised bilateral knee MRI in 0° extension for rotational analysis. Tibiofemoral rotation was measured as the angle between the posterior femoral condylar tangent and posterior tibial plateau tangent on axial images. Ipsilateral and contralateral values along other anatomical patellofemoral risk factors were recorded. One-sample t-tests compared to the healthy contralateral side. Pearson correlations assessed associations between tibiofemoral rotation and anatomic risk factors for patellofemoral maltracking. Results:Mean ipsilateral tibiofemoral rotation was 6.9° ± 6.0° (range: -6.5° to 21.6°). Contralateral version averaged 6.4° ± 6.2° with no significant side difference. Absolute side-to-side difference was 3.7° ± 2.7°. Ipsilateral tibiofemoral rotation correlated with the tuberositas tibiae-trochlea groove (TT-TG) and medial posterior cruciate ligament distance (TT-PCL) (r = 0.37, p < 0.001, r = 0.43, p < 0.001), femoral torsion (r = -0.32, p = 0.003) and lateral trochlea inclination (r = -0.344, p = 0.001) whereas other patellofemoral risk factors showed no correlation. Conclusion:Tibiofemoral rotation showed a significant correlation with anatomical risk factors associated with lateral patellar maltracking in patients with PFI. Moreover, patients with PFI demonstrated a wide variability in tibiofemoral rotation. Consideration of tibiofemoral rotation may enhance anatomical assessment and aid clinical decision-making in patients with PFI. Level of Evidence:Level III.

PURPOSE:Posterolateral tibial plateau fractures (PLTFs) have been increasingly studied due to their association with soft tissue injuries around the knee. This prospective study aimed to determine whether the presence of PLTFs is associated with soft tissue injuries around the knee and correlates with an increased preoperative quantitative pivot shift (PS). It was hypothesized that the presence of PLTFs is associated with greater clinical and quantitative PS. METHODS:A prospective registry study was conducted, and patients who underwent primary unilateral anterior cruciate ligament (ACL) reconstruction at a single institution were included. The PS test was preoperatively performed in general anaesthesia and quantified using the PIVOT iPad application. The anterior translation of the lateral tibia plateau (ATLT) was measured in both the injured and uninjured knee, and the side-to-side difference was calculated. The PS test was additionally graded according to International Knee Documentation Committee (IKDC) criteria. PLTFs were classified according to Bernholt's classification. Injuries to the Kaplan fibres (KFs), anterolateral complex (ALC) and the menisci were evaluated on preoperative magnetic resonance imaging (MRI) scans. Student's t-test was used to compare means, and chi-square was used to test for correlations. Statistical significance was set to p < 0.05. RESULTS:A total of 142 patients with a mean age of 30.9 ± 11.7 years were included. PLTFs were present in 94 (66%) of patients. The presence of PLTFs was associated with concomitant injuries to the KF (p < 0.001), ALC (p < 0.001), medial and lateral meniscus (both p < 0.01). The presence or the severity of a PLTF did not increase the ATLT during quantitative PS or IKDC PS grading (n.s.). CONCLUSION:PLTFs are associated with concomitant injuries to the ALC and both menisci, indicating that they occur within a broader pattern of structural knee damage. However, these injuries do not appear to contribute to a greater preoperative PS. The presence of PLTFs should alert surgeons to the high probability of associated injuries. LEVEL OF EVIDENCE:Level III, diagnostic studies.

INTRODUCTION:The aim of this study was to establish a consensus-based classification of postoperative events following anterior cruciate ligament reconstruction (ACLR), clearly distinguishing no complication/normal clinical course, minor complication, major complication, and failure, using a structured Delphi methodology among international experts in anterior cruciate ligament (ACL) surgery. METHODS:A three-round modified Delphi process was conducted involving international high-volume ACL surgeons. An initial set of statements addressing potential postoperative events after ACLR was developed by a working group based on clinical expertise and contemporary literature. Panelists classified each statement as no complication/normal clinical course, minor complication, major complication, or failure. Consensus was predefined as ≥75% agreement within a single category. Statements reaching consensus were retained, whereas non-consensus statements were revised and re-evaluated in subsequent rounds. RESULTS:Thirty-nine experts completed the first and second Delphi rounds, and 30 (76.9%) completed the third round. The initial 52 statements were expanded to 67 in round two and refined to 46 in round three. Consensus was achieved for 14 statements (26.9%) in round one, 21 statements (31.3%) in round two, and 20 statements (43.5%) in round three. Overall, consensus was reached for 55 statements, forming the final classification framework. The panel clearly distinguished graft failure-defined as graft insufficiency or symptomatic instability-from major complications requiring surgical intervention or associated with substantial morbidity, and from minor complications or expected postoperative findings. Notably, traumatic graft rupture following a clearly documented new injury was not considered a postoperative complication. CONCLUSIONS:This international Delphi consensus establishes a standardized and clinically meaningful classification of postoperative events following ACLR. By clearly distinguishing no complication, minor complication, major complication, and failure, this framework provides a shared language that may improve consistency in outcome reporting, facilitate comparison across studies, and enhance the interpretability of clinical research and registry data. LEVEL OF EVIDENCE:V, expert consensus.

Abstract Background Refracture after implant removal in clavicle fractures is a relevant but insufficiently studied complication. Reported refracture rates vary due to small cohorts and heterogeneous populations. This study aims to determine the incidence of refracture following elective implant removal after confirmed fracture union and to identify potential demographic, clinical, and fracture-related risk factors. Methods A retrospective cohort of 575 adults who underwent implant removal after radiographically confirmed union between 2011 and 2024 was analyzed. Patients were assigned to a refracture (R) or non-refracture (NR) group. Demographics, fracture characteristics, treatment variables, and time intervals were analyzed. Results Refractures occurred in 21/575 patients (3.7%). No significant differences were observed between the R and NR groups regarding age, BMI, ASA classification, or tobacco use. The interval between initial fixation and implant removal was shorter in the refracture group but not statistically significant (18.8 ± 8.7 vs. 21.2 ± 18.5 months; p = 0.55). Most refractures occurred at the original fracture site (n = 19; 90.5%) and were mostly midshaft fractures (n = 18; 85.7%). Only the AO 15.2C fracture type showed a significant association with refracture (R: 11.1% vs. NR: 1.9%; p = 0.005). In time-to-event analysis, AO 15.2C fractures were independently associated with refracture (HR 6.70, 95% CI 1.49–30.12; p = 0.013). Refracture-free survival was 97.4% at 1 year and 96.2% at 10 years. Implant removal was most frequently performed due to patient preference (R: 66.7% vs. NR: 50%). Conclusion Refracture after clavicle implant removal is an uncommon yet clinically relevant complication. The overall refracture rate was 3.7% in the present study. Neither demographic variables nor implant retention time were significantly associated with refracture risk, whereas fracture morphology—specifically complex midshaft fractures (AO 15.2C)—was the only significant risk factor identified. Fracture morphology should therefore be a key consideration when deciding on elective implant removal. Further prospective research is needed to refine guidelines on optimal timing and patient selection.

INTRODUCTION:Posterior shoulder dislocation (PSD) is less common than anterior dislocation (ASD) but is increasingly recognized. Understanding the osseous characteristics of PSD is essential for guiding management. However, direct comparative radiographic analyses between PSD and ASD remain limited. The purpose of this study was to perform a matched-pair radiographic comparison of acromial, glenoidal, and (reverse) Hill-Sachs lesion morphology between patients with first-time traumatic PSD and ASD, and to identify osseous features that may predispose to posterior shoulder instability. METHODS:In this retrospective single-center study, 24 patients (24 shoulders) with cross-sectional imaging (computed tomography [CT] or magnetic resonance imaging [MRI]) following first-time traumatic PSD between 2011 and 2020 were included and matched 1:1 by sex, age, and laterality to 24 patients with first-time traumatic anterior shoulder dislocation. Two independent raters performed standardized radiological measurements on CT/MRI, assessing the following parameters: posterior acromial height (PAH), posterior acromial coverage (PAC), anterior acromial coverage (AAC), and total acromial coverage (TAC), acromial tilt (AT), glenoid bone loss (GBL, glenoid offset, glenoid retroversion, glenoid depth, scapular neck angle, defect size, width and depth of Hill-Sachs lesion (HSL)/reverse Hill-Sachs lesion (rHSL). RESULTS:PAH was greater in PSD than ASD (22.5 mm vs. 15.9 mm, p < 0.001). The PAC was lower in PSD (58.7° vs. 68.0°, p < 0.001), while AAC was higher (4.9° vs. -3.0°, p = 0.0015). No statistically significant difference was found for TAC. The AT was greater in PSD (65.5° vs. 55.2°, p < 0.001). The GBL was smaller in PSD than ASD (8.1% vs. 12.2%, p = 0.0073). Glenoid offset and neck angle showed no statistically significant differences. Retroversion was higher in PSD (8.0° vs. 3.3°, p < 0.001), and glenoid depth was greater (2.0 mm vs. 1.2 mm, p = 0.0053). The rHSL width was smaller in PSD than HSL width in ASD (13.0 mm vs. 17.0 mm, p = 0.037), while lesion depth and surface area did not differ. CONCLUSION:PSD is associated with distinct alterations in bony shoulder anatomy including a higher, flatter acromion resulting in reduced posterior containment of the humeral head, increased glenoid retroversion, less GBL, and deeper glenoid concavity compared with ASD. LEVEL OF EVIDENCE:Retrospective matched-pair cohort study, 3.

BACKGROUND:Assessment of bony parameters-such as glenoid version, glenoid concavity, and the bony shoulder stability ratio (BSSR)-has gained increasing attention after anterior shoulder dislocation, as they may contribute to persistent instability. Although computed tomography (CT) remains the gold standard for bony assessment, magnetic resonance imaging (MRI) is the primary imaging modality in many patients. Yet evidence comparing CT and MRI for these specific parameters remains limited. This study aimed to evaluate the agreement between MRI and CT in measuring glenoid version, glenoid concavity, and BSSR following anterior shoulder dislocation. We hypothesized that MRI provides measurements to those obtained with CT, demonstrating good agreement without clinically meaningful differences following anterior shoulder dislocation. METHODS:A retrospective case-series study was conducted at a Level I trauma center, screening patients who sustained anterior shoulder dislocation between 2011 and 2020. Glenoid version, glenoid depth, humeral head radius, and BSSR were measured using standardized multiplanar reconstructions by 2 independent raters. Interrater reliability was calculated using the intraclass correlation coefficient (ICC). Agreement between modalities was assessed using Student's t-tests, Pearson correlation coefficients, concordance correlation coefficients, and Bland-Altman analysis. RESULTS:Sixty-one patients (mean age, 45 ± 19 years; 75% male) met inclusion criteria. Inter-rater reliability was excellent for glenoid version (ICC, 0.92) and good for glenoid depth (ICC, 0.87) and humeral head radius (ICC, 0.82). No significant differences were observed between CT and MRI for glenoid version (3.7° ± 4.0° vs. 3.4° ± 3.7°; P = .10), glenoid depth (1.4 ± 0.7 mm vs. 1.3 ± 0.7 mm; P = .49), humeral head radius (23.1 ± 2.0 mm vs. 22.5 ± 4.9 mm; P = .33), or BSSR (34.8% ± 10.1% vs. 33.5% ± 11.2%; P = .34). Bland-Altman plots demonstrated good agreement, with MRI showing only minimal underestimation across parameters. CONCLUSION:MRI provides reliable measurements of glenoid version, glenoid concavity, and BSSR that closely align with CT following anterior shoulder dislocation. These findings support MRI as a viable modality for assessing key bony stability parameters, potentially reducing the need for supplemental CT in many clinical scenarios. Prospective studies are warranted to validate these results and explore their implications for surgical decision-making and recurrence risk stratification.

Die arthroskopische VKB-Refixation gewinnt zunehmend an Bedeutung. Die vorgestellte Technik zeigt die arthroskopische Refixation einer VKB-Ruptur an den femoralen, anatomischen Footprint und stellt bei indikationsgerechter Anwendung eine vielversprechende, ligamenterhaltende Therapieoption dar.

Background:The influence of acromial morphology on the severity of glenoid bone loss (GBL) and reverse Hill-Sachs lesions (rHSL) in patients with first-time traumatic posterior shoulder dislocations (PSD) remains unclear. Purpose/Hypothesis:The purpose of this study was to assess the relationship between glenoid and acromial morphology and the severity of bone lesions, posterior GBL, and rHSL, in patients with first-time posterior PSD. It was hypothesized that specific morphological parameters, including glenoid offset and depth, as well as posterior acromial height, correlate with the extent of GBL and rHSL. Study Design:Cross-sectional study; Level of evidence, 3. Methods:In this monocentric, retrospective study, 24 patients with first-time PSD treated at a level 1 trauma center between 2011 and 2020 were analyzed. Scapular and humeral morphology was assessed using computed tomography and magnetic resonance imaging. Key parameters included measurements of glenoid and humeral morphology and acromial position. The correlation between anatomic measurements was evaluated using Pearson and Spearman correlation coefficients. Statistical significance was set at P < .05. Results:A GBL was present in 66.7% of patients with 20.8% showing a GBL >10%, while 95.8% demonstrated an rHSL. Smaller glenoid offset correlated with a deeper rHSL (r = -0.455; P = .03). Higher acromial position (posterior acromial height) correlated with larger GBL (r = 0.611; P = .01). A deeper glenoid correlated with a larger rHSL surface area (r = 0.624; P = .001). Reduced total acromial coverage showed a moderate negative correlation with GBL (r = -0.520; P = .04), while posterior acromial coverage did not correlate significantly with GBL. Conclusion:A posterior GBL and an rHSL can often be detected after an initial traumatic PSD. A higher positioned acromion and reduced total acromial coverage were found to correlate with larger posterior GBL, while a deeper glenoid and smaller glenoid offset correlated with larger and deeper rHSL.

The posterolateral corner (PLC) of the knee is a biomechanically highly complex stabilization system whose lesions—alone or in combination with cruciate ligament injuries—lead to persistent varus and rotational instability. The clinical picture is subtle; up to 43% of injuries are missed initially. A lack of diagnosis or inadequate treatment can lead to gonarthrosis, increased stress on reconstructed cruciate ligaments, or functional impairment. This review article presents an evidence-based treatment algorithm and compares five established surgical procedures (refixation, Larson repair, Arciero technique, LaPrade technique, and popliteus bypass) with regard to technique, indication, advantages, and limitations. The goal is to support the clinical decision-making process for reconstructing posterolateral stability of the knee joint.

Shoulder dislocation is the most common major joint dislocation, with anterior dislocations accounting for 95

Introduction: Success of technically challenging hip arthroscopy for femoroacetabular impingement syndrome (FAIS) with demanding (steep) learning curve and increased risk of complications critically depends on optimal intraoperative visualization. Studies on optimization of surgeon-controllable parameters do not exist. Thus, impact of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pump pressure (Ppump), intraarticular pressure (Preal), and irrigation fluid flow rate (Flow) on visibility and typical intra-/postoperative complications (fluid extravasation, pain) was assessed, also in the context of arthrosis. Methods: Two hip arthroscopists (Expert/Advanced) evaluated visualization conditions (1-2 good/3-5 poor) at 10 typical surgical steps central/peripheral during supine FAIS arthroscopy (prospective consecutive monocentric single-surgeon cohort level 2 study, 211 patients). Influence of SBP, DBP, MAP, Ppump (inflow/outflow-system, DualWave Arthrex), Preal, Flow, arthrosis (Tönnis) on visualization, fluid extravasation (thigh circumference/swelling, linear regression) and pain (VAS, logistic regression) were analyzed. 11,403 perioperative measurements. Quantitative characteristics: Median and 1st/3rd quartile (Q1-Q3), Mann-Whitney U-test. Qualitative characteristics: Spearman’s rank correlation coefficient (ρ), 95% confidence interval = [CI]. ROC curves [95% CI]. A priori power analysis. Significance level α=0.05, Software R 4.2.2. Results: Cut-off values/discriminatory ability (AUC [95% CI]) for good visualization across all time points (p<0.001): SBP 104mmHg/AUC 0.89 [0.87-0.91], DBP 56mmHg/AUC 0.76 [0.72-0.80], MAP 78mmHg/AUC 0.85 [0.82-0.88], Ppump 47mmHg/AUC 0.58 [0.54-0.62], Preal 44mmHg/AUC 0.71 [0.68-0.75], Flow 199ml/min/AUC 0.71 [0.67-0.75]. Blood pressure visualization excellent (grade 1): 91(87-95)/50(46-54)/68(65-72) mmHg vs. poor (grade 5): 127(119-137)/70(65-79)/94(89-98) mmHg. Preal visualization excellent: 53(46-60) mmHg vs. poor: 39(27-52) mmHg. Strong correlation (p<0.001) between visualization and fluid extravasation (ρ 0.59 [0.50-0.67] and pain (ρ 0.60 [0.50-0.68]). Significant increase of complications (p<0.001) with higher SBP/MAP/Flow (fluid extravasation) and SBP/MAP (pain). SBP in fluid extravasation low 94(89-103) mmHg vs. high 106(98-115) mmHg. SBP in pain low 94(89-102) mmHg vs. moderate to high 105(96-113) mmHg. Strong association (p<0.005) between grade of arthrosis and visualization (OR 2.37 [1.30-4.38]), fluid extravasation (OR 2.54 [1.44-4.50]) and pain (OR 2.95 [1.67-5.28]). Mean Difference Preal/Ppump 12mmHg. Conclusion: Blood pressure (especially SBP) followed by Preal/Flow and by Ppump demonstrate significant influence on visualization at all stages of hip arthroscopy. Ideal cut-off values appear to be blood pressure 104/56/78mmHg, intraarticular pressure 44mmHg, flow 199ml/min, pump pressure 47mmHg. Good visualization and low blood pressure/flow significantly reduce complication rate. Arthrosis > Tönnis 1-2 is associated with reduced visualization and increased complications. Optimal parameters in hip arthroscopy should be prioritized for patient well-being, complication-free outcomes, outpatient feasibility, and shortening the learning curve. Intelligent interactive arthroscopy towers using such data may follow.

Sowohl der Verlust von Meniskusgewebe als auch eine koronare Achsfehlstellung gelten als Risikofaktoren für die Entwicklung und den Progress degenerativer Knorpelschäden bis hin zur Arthrose im Kniegelenk. Dieser negative synergistische Effekt sollte in der Diagnostik und in der Therapie von Patienten mit unikompartimentellen Schmerzen nach Meniskusverlust berücksichtigt werden. Während es für achskorrigierende Osteotomien bei Knorpelschäden und Arthrose sehr gute wissenschaftliche Evidenz gibt, ist der Nutzen bei isoliertem Meniskusverlust noch nicht gut belegt. Im vorliegenden Artikel sollen die grundlegende Problematik sowie die Herangehensweise bei Patienten mit residualen Schmerzen nach Meniskusverlust am praktischen Beispiel erläutert werden.