Journal of ISAKOS

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Journal of ISAKOS

Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine is a leading journal for high-quality orthopaedic reviews.
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Launched February 2016, Journal of ISAKOS is an official journal of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine. Publishing high-quality State of the Art and systematic reviews, this new journal synthesizes current research in orthopaedic sports medicine to provide a comprehensive reference for diagnosing and treating patients. Learn more at jisakos.bmj.com and follow us on twitter

06/03/2026

Local extensor fascia septum autograft may offer a promising soft-tissue option for restoring lateral elbow stability in competitive athletes with chronic posterolateral rotatory instability.

In this multicenter case series, 38 athletes underwent LUCL reconstruction using a local extensor fascia septum autograft. At a mean follow-up of 36.7 months, patients showed significant improvements in pain and functional scores, with 33 of 38 returning to their previous level of sport.

🔗 https://www.jisakos.com/article/S2059-7754(26)00011-8/fulltext

05/29/2026

How do surgeons actually decide when—and how—to operate on SLAP lesions?

New in : A case-vignette study of 126 orthopaedic surgeons found that the decision to operate is driven by clinical factors, but the choice of technique varies considerably.

🔑 Key findings:

• Surgery least likely without prior failed nonoperative treatment (OR = 0.07)

• SLAP type III/IV, overhead pain, and high activity level favoured operative management

• Tenodesis/tenotomy preferred over repair in older or less active patients

• Lesion type and surgeon expertise did not influence choice of surgical technique

🔗 https://www.jisakos.com/article/S2059-7754(26)00023-4/fulltext

05/26/2026

Should young athletes with juvenile osteochondritis dissecans wait for conservative treatment to work—or is early fixation the better option?

New in : Early arthroscopic fixation with bioabsorbable pins achieved 100% MRI consolidation and a 100% return-to-sport rate in 32 skeletally immature athletes.

🔑 Key findings:

• 100% lesion consolidation confirmed on MRI at 6 months

• IKDC improved from 72.1 to 94.7 (p < 0.001), exceeding MCID thresholds

• All patients returned to pre-injury sport level at mean 6.2 months

• No reoperations, implant complications, or degenerative changes at mean 6.8-year follow-up

🔗 https://www.jisakos.com/article/S2059-7754(25)00648-0/fulltext

05/21/2026

When patellofemoral arthroplasty fails due to instability, does conversion to TKA have to be the answer?

New in : A combined joint-preserving approach—MPFL reconstruction, tibial tubercle osteotomy, and VMO advancement—successfully restored stability and function without revision to TKA, with a proposed decision-making algorithm for similar cases.

🔑 Key findings:

• Kujala score improved from 54 to 78 and IKDC from 38 to 69 at 3 months

• No recurrent instability, complications, or implant-related problems

• Combined soft-tissue, bony, and dynamic stabilisation avoided conversion to TKA

• Algorithm proposed to guide decision-making in PFA failure due to instability

🔗 https://www.jisakos.com/article/S2059-7754(25)00681-9/fulltext

05/19/2026

Does knee alignment phenotype in patients from India with osteoarthritis differ from other populations—and does it affect TKA outcomes?

New in : In 947 OA knees, varus alignment was near-universal (88.2%) and neutral phenotypes were absent entirely—findings with direct implications for surgical planning.

🔑 Key findings:

• CPAK Type I (varus + apex-distal joint line) predominated at 78.7% of knees

• Neutral alignment phenotypes absent in advanced knee OA in this cohort

• Robotic-assisted TKA with functional alignment restored native alignment in most cases

• KOOS improved from 50.7 to 89.1 at 6 months (p < 0.05)

🔗 https://www.jisakos.com/article/S2059-7754(26)00011-8/fulltext

05/16/2026

Does intraoperative lateral meniscal root injury during ACL reconstruction lead to meniscal extrusion?

New in : In 102 patients, lateral meniscal anterior root injury alone was not a significant driver of postoperative lateral meniscal extrusion—but concomitant meniscal tears and surgical technique were.

🔑 Key findings:

• LMAR injury alone was not significantly associated with postoperative LME

• Concomitant lateral meniscal tear was an independent predictor of greater LME (p < 0.001)

• Single-bundle technique associated with higher LMAR injury rate vs double-bundle (27.3% vs 5.7%)

• Lateral tibial tunnel position correlated with LMAR injury rate

🔗 https://www.jisakos.com/article/S2059-7754(26)00004-0/fulltext

05/14/2026

Can MRI replace X-ray for measuring patellar height in children with patellofemoral instability?

New in : In 252 pediatric knees, the Caton–Deschamps Index showed only fair agreement between MRI and X-ray when classifying patella alta—with disagreement in 1 in 5 cases.

🔑 Key findings:

• MRI and X-ray CDI values were similar on average, but disagreed on patella alta classification in 21% of cases

• Agreement was only fair (kappa = 0.50)—not sufficient for interchangeable use

• Younger age independently associated with higher disagreement between modalities

• Caution advised when using MRI-derived CDI in younger pediatric patients

🔗 https://www.jisakos.com/article/S2059-7754(26)00015-5/fulltext

05/12/2026

Are patients actually able to understand what ChatGPT tells them about ACL surgery?

New in : ChatGPT 5.0 information on ACLR requires a college-level reading ability—significantly harder to understand than the AAOS OrthoInfo website.

🔑 Key findings:

• ChatGPT 5.0 average reading grade level: 12.9 vs 10.2 for AAOS (p < 0.01)

• ChatGPT reading ease score: 38.1 ("difficult") vs 56.9 ("fairly difficult") for AAOS

• Neither source meets the recommended 8th-grade reading level for patient education

• ChatGPT 5.0 showed no readability improvement over ChatGPT 3.5

🔗 https://www.jisakos.com/article/S2059-7754(26)00021-0/fulltext

05/09/2026

Does delaying PCL reconstruction increase the risk of intraarticular injury? New in : A registry-based study of 210 patients found no significant association between surgical timing and prevalence of meniscal or cartilage injury at the time of PCL-R.

🔑 Key findings:

• 50% of patients had intraarticular injuries at time of surgery—regardless of timing

• No association between delay to surgery and injury prevalence (OR = 1.01, p = 0.19)

• Findings held across all knee compartments

• Registry data do not support the hypothesis that delayed PCL-R increases intraarticular injury burden

🔗 https://www.jisakos.com/article/S2059-7754(26)00006-4/fulltext

05/07/2026

New in : The first matched-pair radiographic comparison of bony morphology between posterior and anterior shoulder dislocations reveals key structural differences that may predispose to posterior instability.

🔑 Key findings:

• Higher, flatter acromion in PSD — reducing posterior containment of the humeral head

• Greater glenoid retroversion (8.0° vs 3.3°) and deeper glenoid concavity in PSD

• Smaller glenoid bone loss in PSD vs ASD (8.1% vs 12.2%)

• Distinct osseous profile supports tailored assessment and management of PSD

🔗 https://www.jisakos.com/article/S2059-7754(26)00007-6/fulltext

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