Orthopedic Surgery Research Updates

In 142 primary ACL reconstruction patients, posterolateral tibial plateau fractures (PLTFs) were present in 66% and were significantly associated with injuries to Kaplan fibres, the anterolateral complex, and both menisci, but PLTF presence or severity did not correlate with greater quantitative or clinical pivot shift. PLTFs thus signal broader structural knee damage and should alert surgeons to likely concomitant injuries.

In 2,748 primary ACL reconstructions, the proportion of meniscal repairs rose from 18.0% to 30.2% (2015–2019 vs 2020–2023) while resections decreased, yet two-year meniscal reoperation rates and patient-reported outcomes were similar between periods; combined medial+lateral procedures had higher reoperation rates. Multivariable analysis showed lower odds of reoperation in 2020–2023, supporting increased meniscal preservation without increased short-term reoperation.

This systematic review of 24 studies (10,394 radiographs) found that quantitative minimum joint space width (mJSW) measurements have higher inter- and intra-observer reliability (mean ICC ~0.82) than Kellgren-Lawrence grading (mean kappa ~0.72); reliability improved with expert or AI raters, semiflexed PA/Rosenberg views, and atlas training, supporting use of mJSW alongside KL grading.