Search Results (830)

Background: Recent evidence has suggested that patients undergoing anterior cruciate ligament (ACL) revision surgery tend to have a larger differential posterior tibial slope compared to healthy individuals. The impact of differential slope on patient reported clinical outcomes following revision ACL surgery remains unclear. Methods: Patients undergoing revision ACL surgery between 2019 and 2024 in our institution were eligible for inclusion. The primary outcome was the change in subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS) from preoperative to at least 1 year postoperative. Medial and lateral posterior tibial slopes were measured independently by four assessors on preoperative magnetic resonance imaging (MRI) scans. The correlation between change in KOOS and the mean differential posterior tibial slope (dPTS) was calculated by using Pearson’s correlation statistic. Results: Data from 31 revision ACL cases were analysed. There were statistically significant postoperative improvements in all five KOOS domains (Symptoms p = 0.036, Pain p = 0.004, Daily Living p = 0.002, Sport and Recreation p < 0.001, Quality of Life p < 0.001). There was a statistically significant correlation between mean differential slope and change in KOOS Symptoms (p = 0.007), Pain (p < 0.001), Sport and Recreation (p = 0.034), and Quality of Life (p = 0.010), but not with Daily Living (p = 0.070). Conclusions: In patients undergoing ACL revision reconstruction, greater differential posterior tibial slope is associated with poorer patient-reported outcomes. MRI-based assessment of dPTS demonstrated moderate single-rater and good average-rater interobserver reliability, potentially aiding in preoperative risk stratification and patient management. Full article

Background: Anterior cruciate ligament (ACL) injuries induce neurophysiological alterations that may persist after rehabilitation, affecting motor control and neuromuscular coordination. This study aimed to examine residual neuromuscular deficits in team-sport athletes who had undergone ACL reconstruction by assessing phase-specific force production, electromyographic (EMG) signal complexity, and inter-limb asymmetries. Methods: Thirteen competitive team-sport athletes (men: n = 5, 24.2 ± 2.9 years; women: n = 8, 21.5 ± 1.9 years) participated in this cross-sectional study. Force production and surface EMG activity of the vastus lateralis (VL) and biceps femoris (BF) were recorded during an iso-inertial squat. Force data were analyzed globally and according to the concentric (CON) and eccentric (ECC) phases. Inter-limb asymmetries were calculated, and linear analyses were applied to force and EMG variables, while EMG complexity was assessed using sample entropy (SampEn). Results: Significant inter-limb differences were observed during the ECC phase, with lower peak and mean force values in the ACL-reconstructed limb (ACLR; p < 0.05), whereas no statistically significant inter-limb differences were identified in the global or CON analyses. Conventional EMG measures showed no statistically significant inter-limb differences. VL SampEn values were descriptively lower in the ACLR than in the contralateral non-reconstructed limb (ACLN), but this difference did not reach statistical significance (p = 0.063; Hedges’ g = −0.67). Inter-limb asymmetries showed substantial inter-individual variability, particularly across movement phases. Athletes following ACL reconstruction exhibited residual deficits in eccentric force production, whereas conventional EMG activation did not differ significantly between limbs. Phase-specific force analysis may therefore identify residual ECC deficits that are not apparent in global or concentric analyses. Although nonlinear EMG metrics may provide complementary information on neuromuscular organization beyond that captured by conventional amplitude-based measures, the present SampEn findings should be considered exploratory and hypothesis-generating rather than evidence of a confirmed alteration in neuromuscular complexity. Larger, adequately powered studies incorporating robustness and sensitivity analyses are required to determine the relevance of entropy-based EMG measures following ACL reconstruction. Full article

Background/Objectives: Graft selection remains one of the main hot topics in anterior cruciate ligament (ACL) reconstruction. Despite significant advances in surgical techniques, graft-related factors continue to influence postoperative stability, graft survival, donor-site morbidity, and return-to-sport outcomes. Hamstring tendon (HT), bone–patellar tendon–bone (BPTB), and quadriceps tendon (QT) autografts currently represent the most widely utilized graft choices. Recently, isolated rectus femoris tendon (RFT) harvesting has emerged as a potential alternative, based on the concept of selective utilization of the superficial component of the QT, while preserving deeper structures of the extensor mechanism. Methods: A narrative review of the available literature in accordance with the principles of the Scale for the Assessment of Narrative Review Articles (SANRA) on RFT autografts for ACL reconstruction was performed, focusing on anatomical, biomechanical, technical, and clinical studies. Relevant evidence regarding graft morphology, harvesting techniques, biomechanical properties, and clinical outcomes in both primary and revision procedures was synthesized. Results: Initial evidence consists of anatomical and biomechanical investigations, as well as three clinical series (one primary, two revision reconstructions). Available data suggest favorable biomechanical characteristics, including adequate graft length, strength, and versatility, together with promising short-term clinical outcomes. Conclusions: Isolated RFT autografting represents a promising emerging option for ACL reconstruction. Preclinical and anatomical studies support the rationale for selective harvesting, and the currently available, albeit very limited, clinical data are encouraging. Higher-level prospective evidence is required to define its role in contemporary ACL surgery. Full article

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. Full article

Background: Psychological readiness, quantified by the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale, is one of the most consistent correlates of return-to-sport success following ACL reconstruction. Whether psychological readiness reflects an independent construct or is related to measured functional performance is not known. Purpose: To evaluate the associations between patient-perceived knee function and objective performance on a functional task, as quantified by traditional scoring, kinematics, and motion quality, and psychological readiness 9 to 12 months after ACL reconstruction. Methods: In this cross-sectional study, forty patients performed the Star Excursion Balance Test using a validated markerless motion capture system. Three biomechanical domains derived from that task (reach distance, lower-extremity kinematics, and a time-series motion quality index) were evaluated against psychological readiness, with patient-reported function (as measured by the Knee Injury and Osteoarthritis Outcomes Score [KOOS-12]) as a comparator. Associations were estimated using multivariable regression adjusted for age, sex, body mass index, and limb length. Relative contributions were evaluated with variance decomposition, and Bayes factors quantified the strength of evidence for or against each association. Results: Patient-perceived knee function was strongly associated with psychological readiness (standardized β = 0.58; 95% confidence interval, 0.29 to 0.87; BF₁₀ = 249), whereas no biomechanical domain derived from the functional task reached statistical significance (all |β| ≤ 0.34; all |r| ≤ 0.3). In the combined model (total R² = 0.463), variance decomposition attributed 89.3% of explained variance in psychological readiness to patient-perceived knee function, versus 6.9% for reach distances, 2.4% for motion quality, and 1.4% for lower extremity kinematics. Bayes factors favored the null for each biomechanical domain, but reached only anecdotal strength (BF₀₁, 1.3–2.8). Conclusion: In this cross-section, psychological readiness after ACL reconstruction more closely aligned with patient-perceived knee function than biomechanical performance on the SEBT, indicating that perceived function and biomechanical performance on certain tasks may be divergent at the time of return-to-sport clearance. These findings support the routine inclusion of patient-reported outcome measures alongside functional testing in multi-domain return-to-sport assessment. Full article

Background/Objectives: ACL injuries in skeletally immature patients present a unique surgical challenge, with ongoing debate regarding the optimal reconstruction technique relative to the open physis. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines, searching PubMed/MEDLINE, Cochrane Library, and Google Scholar. Twenty-two studies (n = 1036 patients; 598 physeal-sparing, 438 transphyseal) were included. The evidence base consisted predominantly of non-randomized retrospective studies. Patient-reported outcomes, return-to-sport rates, growth disturbances, graft failure, and reoperation rates were pooled using a random-effects model. Results: Pooled IKDC scores were 95.14 (95% CI: 93.81–96.50) for physeal-sparing and 96.17 (95% CI: 93.98–98.42) for transphyseal reconstruction, with no significant between-group difference (p = 0.436). Lysholm scores were 95.56 versus 93.04 (p = 0.075), and Tegner scores were 6.39 versus 7.08 (p = 0.366), respectively, with no statistically significant differences. KOOSs also showed no significant difference (96.19 vs. 96.00; p = 0.948). The pooled return-to-sport rate was higher following transphyseal reconstruction than physeal-sparing reconstruction (97.8% vs. 93.9%; p = 0.034). Growth disturbances were more frequently reported in the physeal-sparing group (5.1% vs. 1.4%; p = 0.008). Graft failure (5.8% vs. 8.4%; p = 0.144) and reoperation rates (13.5% vs. 13.8%; p = 0.906) were comparable between techniques. Conclusions: Both techniques yielded comparable functional outcomes across major PROMs. Transphyseal reconstruction was associated with a higher pooled return-to-sport rate in the included studies, whereas physeal-sparing reconstruction was associated with a higher incidence of reported growth disturbances. However, these findings should be interpreted cautiously given that the evidence base consisted predominantly of non-randomized retrospective studies and was subject to potential confounding and other sources of bias. Full article

Anterior cruciate ligament (ACL) reconstruction represents the current gold standard for restoring knee stability following ligament rupture, particularly in young and physically active individuals. The aim of this narrative review is to provide an updated overview of the biomechanical, biological, and clinical considerations underlying graft selection in ACL reconstruction, with particular emphasis on graft incorporation, fixation strategies, and postoperative outcomes. While surgical techniques and fixation devices have undergone substantial refinement, the optimal choice of graft remains a subject of ongoing debate. Traditionally, emphasis has been placed on the biomechanical characteristics of grafts, including tensile strength, stiffness, and resistance to cyclic loading. However, increasing attention has been directed toward biological factors that influence graft incorporation and clinical outcomes. The aim of this narrative review is to summarize the currently available literature regarding graft selection in ACL reconstruction by integrating biomechanical properties, biological graft incorporation, fixation strategies, and clinical outcomes. Particular emphasis is placed on the relationship between biomechanical performance and biological healing, as well as postoperative outcomes, in order to facilitate individualized graft selection in contemporary orthopedic practice. Full article

Background: Persistent quadriceps weakness is a common consequence of joint injury, particularly following anterior cruciate ligament (ACL) injury and reconstruction. While traditionally attributed to muscle atrophy and disuse, growing evidence suggests that neural mechanisms play a central role. Arthrogenic Muscle Inhibition (AMI) is a neurally mediated impairment in the ability to voluntarily activate periarticular musculature following joint injury, occurring within a broader neurophysiological response involving altered joint-related afferent input, spinal mechanisms, and supraspinal adaptations. Methods: A narrative review of the literature was conducted using PubMed and Scopus databases. Studies investigating the peripheral, spinal, and supraspinal mechanisms of AMI, as well as its clinical manifestations, assessment methods, and rehabilitation strategies, were reviewed. Experimental, observational, and neurophysiological studies focusing on ACL injury and related joint disorders were included. Results: Current evidence indicates that AMI is a multifactorial neurophysiological process involving altered afferent signaling, spinal reflex inhibition, and central nervous system adaptations. These mechanisms contribute to persistent quadriceps activation failure, impaired motor control, biomechanical asymmetries, and functional and biomechanical alterations that may persist during recovery. Neuroimaging and electrophysiological studies further demonstrate cortical reorganization and neuroplastic changes that may persist despite restoration of joint stability and muscle strength. Conclusions: AMI should be considered a multilevel sensorimotor dysfunction rather than an isolated muscular deficit. Recognition of its neurophysiological basis may improve rehabilitation strategies by promoting interventions that target both neural and muscular components of recovery. Full article

Magnetic resonance imaging (MRI) is universally recognized as the gold standard for evaluating anterior cruciate ligament (ACL) injuries. However, differentiating partial tears from complete ruptures using the standard sagittal plane remains a diagnostic challenge. The oblique coronal orientation of the ACL often leads to volume averaging artifacts and inaccurate interpretations. While axial imaging offers a favorable alternative, distal tears near the tibial attachment are frequently missed. This review synthesizes current concepts in the anatomical and radiological evaluation of the ACL and introduces the “Namaste sign,” a novel and proposed preliminary imaging marker observed on coronal MRI to help assess ACL integrity. Grounded in the distinct native double-bundle architecture of the ACL, the Namaste sign utilizes the coronal plane to evaluate the transverse relationship and physiological tension of the anteromedial and posterolateral bundles. In a normal knee, these bundles converge symmetrically from their distinct tibial footprints and maintain tight contact with the lateral femoral condyle, mimicking hands pressed together in a traditional “Namaste” gesture. This article details the anatomical basis of this sign, provides a systematic method for its identification, and illustrates how morphological variations such as “broken hands,” “absent hands,” “absent proximal hug,” or “separation of hands” may correspond to specific ACL lesions. As a preliminary conceptual marker, the Namaste sign is intended to serve as an educational adjunct to combined three-plane evaluation rather than a standalone diagnostic criterion. Notably, this sign is not applicable to postoperative ACL reconstructions. A preliminary pilot study of 50 cases utilizing thin-slice MRI (≤3 mm) demonstrated nearly 100% visibility of the sign, 98% diagnostic accuracy, and almost perfect inter-observer agreement between two radiologists with more than 10 years of experience (Cohen’s kappa = 0.92). However, future diagnostic studies with rigorous arthroscopic reference standards are required to establish its clinical performance and reliability in larger cohorts. Full article

Background: Anterior cruciate ligament reconstruction (ACLR) is the standard of care for ACL injuries, and graft choice may influence the recovery of function assessed with vertical jump tests. Objective: To evaluate the effect of graft type on vertical jump performance in adults after ACLR and to synthesise the differences between grafts. Material and Methods: This systematic review was conducted in accordance with the PRISMA 2020 and SWiM guidelines. The following databases were searched: Scopus, Web of Science, PubMed, MEDLINE and SPORTDiscus (EBSCOhost), up to 31 January 2026. Studies with an unambiguously defined graft type and objective jump tests (CMJ, SL CMJ/SL VJ, DVJ/DJ, SJ) were included. Risk of bias was assessed using the RoB 2, ROBINS-I, JBI and MINORS tools, and the certainty of evidence using the GRADE approach. Because of substantial clinical and methodological heterogeneity, a structured narrative synthesis was performed in accordance with the SWiM guidelines; no pooled analysis was undertaken. Results: Forty-seven studies (>3400 participants) were included. BPTB was associated with greater eccentric-phase asymmetry in the bilateral CMJ in the early/intermediate phase compared with HT, with equalisation after 9–12 months. QT provided jump height comparable to HT but a more favourable dynamic valgus profile. Autograft and allograft did not differ in jump performance. Deficits followed a biphasic course: normalisation of symmetry after approximately 2 years, with reduced height/power for up to 5 years. Conclusions: Forty-two of the studies (89.4%) were non-randomised, and the certainty of evidence was low for one clinical question and very low for all others. Studies comparing BPTB with HT showed an association suggesting greater eccentric-phase asymmetry in the bilateral CMJ in the early and intermediate phase after BPTB, but findings were inconsistent and two studies reported no difference. Evidence suggesting that these differences equalise after 9–12 months derives from between-study comparisons. Jump height did not differ between QT and HT; a single study of 26 patients reported smaller dynamic valgus after QT. Autograft and allograft did not differ in vertical jump performance. Registration: This review was registered in the PROSPERO database and is available under the number CRD420261386307. Full article

Background: Vascular endothelial growth factor (VEGF) has emerged as a potential therapeutic target in osteoarthritis (OA). Although several anti-VEGF agents are widely used in clinical practice, their comparative effects on osteoarthritic cartilage remain unclear. This study compared the histopathological effects of intra-articular bevacizumab, ranibizumab, and aflibercept in an experimental rat model of OA. Methods: Experimental OA was induced in 36 rats using anterior cruciate ligament transection. One month later, animals received two intra-articular injections of bevacizumab (2 mg/kg), ranibizumab (0.5 mg/kg), aflibercept (3.2 mg/kg), or saline at 3-week intervals. Histopathological evaluation was performed using the Osteoarthritis Research Society International (OARSI) grading and staging system by two blinded pathologists. The primary outcome was the total OARSI score. Group comparisons were performed using the Kruskal–Wallis test followed by Dunn–Holm post hoc analysis. Results: Three animals were lost during anesthesia and surgical induction of OA before treatment allocation, leaving 33 rats for analysis. Significant overall differences were observed among the groups for the primary outcome of total OARSI score (p = 0.026) and the secondary outcomes of OARSI grade (p = 0.042) and OARSI stage (p = 0.019). Ranibizumab demonstrated numerically lower OARSI grade and total scores than the control group, whereas both groups had the same median OARSI stage score. Bevacizumab showed numerically lower OARSI grade and total scores than the control group but a slightly higher median stage score. Pairwise analysis showed significantly lower OARSI stage and total OARSI scores in the ranibizumab group than in the aflibercept group, whereas no significant differences were observed between any treatment group and the control group after correction for multiple comparisons. Conclusions: Anti-VEGF agents demonstrated differential histopathological responses in experimental OA. Although no treatment significantly improved histopathological outcomes compared with the control group after adjustment for multiple comparisons, ranibizumab showed lower OARSI stage and total scores than aflibercept. These findings indicate that the evaluated anti-VEGF agents may not exert equivalent biological effects and warrant further investigation in adequately powered experimental studies. Full article

Background and Objectives: This study aimed to compare the clinical, functional, and graft-related outcomes of two tibial fixation constructs used in primary hamstring autograft anterior cruciate ligament reconstruction (ACLR): tibial cortical button fixation and bioabsorbable interference screw fixation reinforced with a U-shaped staple. Materials and Methods: This retrospective two-center comparative cohort study included 58 patients with isolated anterior cruciate ligament injuries who underwent primary ACLR and had a minimum postoperative follow-up of 12 months. Patients were classified into the cortical button group (n = 26) or the U-staple group (n = 32) according to the initial graft diameter, which strictly dictated the tibial fixation construct documented in the operative report. Both the semitendinosus and gracilis tendons were used in each group. A shorter quadrupled graft construct was prepared in the cortical button group, whereas a longer doubled graft construct was used in the U-staple group. Donor-site pain measured using the visual analog scale (VAS), graft diameter, International Knee Documentation Committee (IKDC) score, Lysholm score, knee range of motion (ROM), Lachman and pivot-shift findings, and graft failure were compared between the groups. Graft failure was defined as magnetic resonance imaging (MRI) evidence of graft discontinuity or insufficiency accompanied by grade 2–3 Lachman laxity or a positive pivot-shift test. Numerical variables were analyzed using the Mann–Whitney U test, whereas categorical variables were compared using the Pearson chi-square or Fisher’s exact test, as appropriate. Results: Donor-site pain was significantly higher in the cortical button group than in the U-staple group [median VAS score: 2.5 (2.0–4.0) vs. 2.0 (0–2.0), respectively; p = 0.007]. Graft diameter was also significantly greater in the cortical button group [10.0 mm (10.0–10.0) vs. 9.0 mm (8.0–9.0); p < 0.001]. In contrast, IKDC scores were significantly higher in the U-staple group [71.0 (51.5–78.0) vs. 60.0 (55.0–62.8); p = 0.017]. No significant differences were observed in Lysholm scores (p = 0.701), knee ROM (p = 0.508), positive pivot-shift findings (11.5% vs. 6.3%; p = 0.648), clinically relevant Lachman laxity (30.8% vs. 18.8%; p = 0.287), or graft failure rates (11.5% vs. 18.8%; p = 0.495). Conclusions: No significant between-group differences were observed in Lysholm scores, knee ROM, clinical stability, or graft failure rates after hamstring autograft ACLR. The U-staple group demonstrated lower donor-site pain and higher IKDC scores, whereas the cortical button group had larger graft diameters, likely reflecting the shorter quadrupled graft configuration. Overall, neither tibial fixation construct showed a consistent advantage across all clinical outcomes. Full article

Purpose: In a relatively new concept of individualised ACL reconstruction, the restoration or matching of the native ACL footprints at both the tibial and femoral insertions might be sufficient as a surgical objective. This study aimed to determine whether ACL graft size relative to the native ACL tibial footprint influences the rate of graft failure in a Singaporean Asian population. Methods: A retrospective study of all consecutive patients who underwent primary hamstring autograft ACL reconstruction over a 3-year period at a tertiary referral centre was performed. Baseline anthropometric data and native ACL tibial footprint area from pre-operative MRI scans were collected. Graft area was calculated based on the graft tunnel diameter. ACL graft failures were diagnosed clinically and confirmed radiologically. Multivariable analyses were performed using pre-specified variables based on the literature. Results: This cohort comprised 240 patients with a mean age of 24.4 years. There were a total of seven graft failures (2.92%), with two patients undergoing revision surgeries. There was no association between graft-to-footprint ratios and failure rates (71.9 vs. 80.2%, p = 0.386). There were no other significant predictors of graft failure. There was no statistically significant difference in graft failure rate between grafts <8 mm and ≥8 mm (p = 1.00). Gender, but not the graft-to-footprint ratio, was a significant predictor of graft size. Conclusions: No statistically significant association was identified between graft-to-footprint ratio and early graft failure. However, the low event rate and short-term follow-up limit definitive conclusions. Full article

Background and Objectives: Strength deficits are extremely common following anterior cruciate ligament reconstruction (ACLR). These deficits may be further impacted by concomitant meniscus repair during ACLR. However, there remains limited evidence investigating the effect of meniscus repair on lower-limb strength after ACLR, and particularly if there are between-sex differences in strength after ACLR with and without meniscus repair. Therefore, the purpose of this study was to investigate sex-specific differences in meniscus repair during ACLR on quadriceps and hamstring isometric strength. Methods: Eighty-five (37 females; 19.0 ± 6.6 years old) patient charts were retrospectively evaluated after undergoing ACLR. Variables documented included meniscal status, maximal isometric quadriceps and hamstring strength of the operative (OP) and non-operative (NOP) legs. Three separate 3-way [leg (OP vs. NOP) × sex (males vs. females) × meniscus repair status (yes vs. no)] mixed-factorial analyses of variance (ANOVA) assessed differences in quadriceps and hamstring strength, and the hamstring-to-quadriceps strength ratio (H:Q), at an alpha level of p ≤ 0.05. Results: For H:Q there was a sex by meniscus repair status interaction (p = 0.007). Females who underwent meniscus repair had lower H:Q (18.2%) than those without. Females without meniscus repair had a 20.3% greater H:Q than males without meniscus repair. Males had greater quadriceps strength than females (mean difference ± standard error; 0.58 ± 0.28 N∙kg⁻¹) and the NOP leg was stronger than OP for quadriceps (0.34 ± 0.08 N∙kg⁻¹) and hamstring (0.14 ± 0.04 N∙kg⁻¹) strength across sex. Conclusions: These findings suggest that the H:Q ratio differed according to sex and meniscus repair status. Further, there was a between-limb difference for strength in the quadriceps and hamstrings along with sex-related differences in strength. However, meniscus repair status did not influence raw strength values. Full article

Biodegradable magnesium (Mg)-based implants represent a paradigm shift in orthopedic biomaterials, offering temporary mechanical support, inherent osteogenic bioactivity, and elimination of hardware removal surgery. These properties are particularly attractive for sports orthopedic applications, including anterior cruciate ligament (ACL) reconstruction, rotator cuff repair, meniscal fixation, and osteochondral fragment refixation, where young, active patients demand rapid return to function and where permanent metallic hardware poses long-term risks of stress shielding, imaging artifact, and reoperation. Despite extensive preclinical evidence demonstrating that Mg-based interference screws promote fibrocartilaginous enthesis regeneration, attenuate peri-tunnel bone loss, and achieve biomechanical fixation comparable to titanium, no human clinical trial has yet evaluated Mg fixation devices for soft-tissue reconstruction in sports medicine. Meanwhile, clinical fracture fixation data from over 468 patients across multiple trials and a meta-analysis confirm complication rates equivalent to those of titanium. This narrative review synthesizes the current evidence on Mg alloy design, surface engineering strategies, preclinical sports medicine applications, clinical translation in fracture fixation, imaging compatibility, and the remaining barriers to clinical adoption in sports orthopedic surgery. By mapping the translational gap between promising animal data and the absence of clinical sports medicine trials, this review aims to guide future research priorities and accelerate the pathway toward clinical application of Mg-based devices in sports orthopedics. Full article