Previous studies have demonstrated improvements in quality of life (QoL) following temporomandibular joint (TMJ) surgery for patients with temporomandibular disorders (TMDs). The aim of this study was to identify factors associated with postoperative improvement in QoL after TMJ surgery. This prospective longitudinal study observed patients with TMDs who underwent TMJ surgery at a German tertiary referral centre over a 10-year period. Predictor variables were categorised as demographic, clinical, operative and postoperative factors. The primary outcome was postoperative improvement in QoL. Appropriate statistical analyses were performed, with significance set at P ≤ 0.05. A total of 61 patients (mean age 40.9 years, range 15-74 years) were included, 68.9% of whom were female. Overall, 82.0% of patients reported an improved QoL following surgery. No significant associations were identified between QoL improvement and age, sex, preoperative diagnosis, surgical procedure or postoperative functional improvement. All patients reported postoperative pain relief; therefore, the association between pain relief and QoL improvement could not be statistically tested because there was no variability in the pain-relief variable. Descriptive analyses indicated that higher proportions of patients experienced QoL improvement following arthroplasty and total TMJ replacement than following arthroscopy with arthrocentesis. These findings suggest that postoperative QoL improvement was common after TMJ surgery, whereas the small subgroup sizes and absence of variability in postoperative pain relief limited the identification of independent predictors.

Confidence is an important part of psychological recovery after anterior cruciate ligament reconstruction, but what it means to have confidence in the knee may differ between athletes. Persistent lack of knee confidence is associated with poorer outcomes but may reflect a range of concerns, including reinjury, knee function, and sporting performance. Understanding what is driving a lack of knee confidence may help us identify how best to address it during rehabilitation.

Patella alta remains among the most critical anatomical risk factors for recurrent patellofemoral instability and failure of patellar stabilization surgery. The Caton-Deschamps index references the patella to the tibia by measuring the position of the patella relative to the anterosuperior margin of the tibial plateau. In contrast, the patellotrochlear index references the patella to the femoral trochlea by quantifying the proportion of patellar articular cartilage that shows sagittal overlap with trochlear cartilage on magnetic resonance imaging. Under normal trochlear morphology, these measurements closely covary, but they diverge in the presence of abnormal morphology. In high-grade trochlear dysplasia, the proximal trochlea is elongated, flattened, and often convex beneath a supratrochlear spur. The patella overlaps an expanded cartilage surface that provides minimal osseous constraint. Contact does not equate to containment. Therefore, a reference-range patellotrochlear index alone is insufficient to exclude a dysplastic knee from consideration for distalizing tibial tubercle osteotomy. Neither index correlates with the instability resolution angle obtained during examination under anesthesia, indicating that static imaging parameters do not fully capture dynamic patellofemoral containment. We must stop letting single 2-dimensional cutoffs dictate complex, 3-dimensional surgical decisions.

Does the size of a Hill-Sachs lesion (HSL) matter? Since its original description in 1940, understanding of the HSL's contribution to recurrent shoulder instability has evolved from a binary engaging/nonengaging framework under the glenoid track concept to more nuanced concepts of bipolar bone loss on a continuum. Although much attention has been centered on glenoid bone loss, the contribution of an HSL and, perhaps more importantly, the distance to dislocation of the HSL have gained increasing attention. How to evaluate at-risk patients with chronic shoulder instability and multiple, recurrent instability events remains problematic, especially when their shoulder fits a classic on-track, nonengaging biomechanical profile. Do patients with chronic and recurrent instability events have worse, larger, or more medialized HSL? Should we do more than isolated arthroscopic Bankart repair in these patients? The paradigm appears to shift along with the location of the HSL.

Background and Objectives: Traditional open anterior cruciate ligament transection (ACLT) surgical models performed through arthrotomy may introduce capsular trauma and postoperative inflammatory responses that can interfere with the interpretation of post-traumatic osteoarthritis (OA). This study aimed to evaluate the feasibility of a minimally invasive, arthroscopic ACLT rabbit model performed entirely under arthroscopic visualization, without arthrotomy, using a 2.4-mm arthroscope and 2.5-mm shaver, and to provide preliminary structural, histological, synovial, and systemic biochemical characterization of the model for future therapeutic testing. Materials and Methods: Bilateral arthroscopic ACLT was performed in three skeletally mature New Zealand rabbits, followed by a supervised 12-week exercise protocol. Joint degeneration was evaluated macroscopically and histopathologically using the standardized Pritzker-Osteoarthritis Research Society International (OARSI) grading system. Collagen matrix remodeling was assessed via Picrosirius Red staining. Local intra-articular catabolism was quantified via Enzyme-Linked Immunosorbent Assay (ELISA) for matrix metallopeptidase 13 (MMP-13) and interleukin-1β (IL-1β) from synovial fluid. Systemic oxidative stress, including lipid peroxidation biomarkers, malondialdehyde (MDA), and nitric oxide (NO), was evaluated in serum. Results: The arthroscopic approach induced osteoarthritic changes, with severity varying across the cohort. Histopathology revealed vertical matrix fissures and disruption of the normal columnar chondrocyte organization, yielding a median comprehensive Pritzker-OARSI score of 6 (range 6-10), with horizontal degradation restricted to stage 2. Synovial fluid analysis demonstrated measurable concentrations of MMP-13 (188.77 ± 93.87 ng/mL) and IL-1β (174.93 ± 95.51 pg/mL). Furthermore, serum oxidative stress parameters at the 12-week endpoint included lipid peroxidation (MDA: 1.01 ± 0.03 nmol/mL) and NO levels (82.72 ± 0.32 µmol/L), presented descriptively in the absence of a comparator group. Conclusions: This study establishes the first multifaceted pathological baseline of a minimally invasive arthroscopic ACLT rabbit model before therapeutic intervention. The arthroscopic ACLT model produced structural cartilage degeneration alongside measurable intra-articular catabolic and systemic oxidative stress changes, establishing a baseline phenotype and a starting point for future therapeutic studies.

Scapholunate (SL) instability is the most common form of carpal instability, and if untreated, it may progress through dorsal intercalated segment instability to scapholunate advanced collapse. Contemporary understanding emphasizes a dual stabilizing system in which the SL interosseous ligament (SLIL) acts as the intrinsic primary restraint, reinforced by extrinsic "critical" secondary stabilizers; isolated SLIL division does not by itself produce static malalignment until these secondary restraints are also compromised. Against this background, wrist arthroscopy has become a widely used reference standard for diagnosis and grading, allowing for graded assessment through the Geissler and the more granular European Wrist Arthroscopy Society (EWAS) classifications, while dry arthroscopy has reduced fluid-related morbidity and facilitated combined arthroscopic and mini-open procedures. Treatment has correspondingly shifted from open reconstruction toward arthroscopic and arthroscopic-assisted repair, capsulodesis, and ligamentoplasty, which are intended to preserve native capsuloligamentous structures and may offer potential advantages in limiting capsular disruption and postoperative stiffness. This narrative review synthesizes the literature identified through a selective search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (final search 13 June 2026). The evidence consists mainly of small observational series and technique reports. The review stages the injury by arthroscopic grade (EWAS/Geissler) and organizing techniques by the target ligament(s), from partial and dynamic injuries through complete, reducible, and advanced deformities. We align each technique with the corresponding pattern of intrinsic and extrinsic ligament injury to clarify indications, summarize reported outcomes, and propose a stage-based conceptual treatment framework rather than a validated, evidence-based guideline. Current evidence derives largely from small, heterogeneous case series with variable classifications and outcome measures, underscoring the need for standardized staging and comparative studies.

Background/Objectives: Femoroacetabular impingement (FAI) is a common cause of hip pain and functional limitation in young and active patients. Conventional hip arthroscopy commonly requires traction and central-compartment access, which may contribute to traction-related neuropraxia and access-related chondrolabral injury. This study evaluated clinical outcomes after traction-free only peripheral hip arthroscopy (OPHA) for cam-type FAI with associated labral pathology. Methods: This retrospective cohort study included consecutive patients who underwent OPHA between November 2016 and May 2022 and had complete paired preoperative and postoperative outcome data. Outcomes included the visual analog scale (VAS) pain score, Hip Outcome Score activities of daily living subscale (HOS-ADL), Hip Outcome Score sport subscale (HOS-Sport), International Hip Outcome Tool-12 (iHOT-12), and Tegner activity score. Labral status was categorized as intact, repaired, or debrided. Paired outcomes were analyzed with the Wilcoxon signed-rank test. Results: Sixty-six patients were included (mean age, 38.9 ± 10.8 years; 34 female). The mean postoperative follow-up was 5.7 years (range, 3.7-9.2 years). Labral status was intact in 32 patients, repaired in 23, and debrided in 11. Secondary intervention occurred in eight patients. In the overall cohort, VAS improved from 7.0 ± 0.6 to 3.2 ± 2.5 (p < 0.001), HOS-ADL from 59.1 ± 1.9 to 79.2 ± 17.5 (p < 0.001), HOS-Sport from 45.1 ± 2.1 to 67.6 ± 21.3 (p < 0.001), and iHOT-12 from 48.3 ± 1.8 to 72.2 ± 19.4 (p < 0.001). The Tegner activity score decreased from 5.2 ± 0.7 to 4.3 ± 1.4 (p < 0.001). Conclusions: Traction-free OPHA was associated with improvements in pain and hip-specific functional outcomes in selected patients with cam-type FAI and allowed individualized labral management without routine central-compartment distraction. The retrospective design and retrospective reconstruction of baseline PROMs in a subset of patients should be considered when interpreting the magnitude of the observed improvement.