The edition · Orthopaedics
A steep tibial slope matters most in the youngest ACL patients
In 581 hamstring ACL reconstructions, each degree of slope raised rerupture odds similarly at every age, but absolute risk at 15° fell from 37% at 18 to 4% at 45. Also: psychiatric comorbidity and hip arthroscopy failure, and graft choice in combined ACL-MCL injury.
The edition in brief
A French cohort of 581 primary hamstring ACL reconstructions followed for at least six years found posterior tibial slope raised rerupture odds by 28% per degree and each year of age lowered them by 9%, with no interaction between the two. The absolute picture differed sharply: at a 15° slope, modelled rerupture risk was 36.6% at 18 and 3.9% at 45, and risk fell below 10% only after about 35. Slope measurement and any decision about slope-reducing osteotomy or added procedures should therefore be weighed against age. In 243 patients with hip arthroscopy for femoroacetabular impingement followed for ten years, those with a psychiatric diagnosis failed more often (23.3% vs 5.3%) and improved less. In a French registry of 489 ACL reconstructions, non-hamstring grafts were associated with higher IKDC scores, and MCL injury status did not significantly change that association. The pearl covers timing of antibiotic prophylaxis before arthroplasty.
Anxiety and depression linked to hip arthroscopy failure at ten years
Screen for anxiety and depression before hip arthroscopy and counsel affected patients about a higher long-term failure rate.
ACL graft choice with a concomitant MCL injury
Weigh graft choice in combined ACL-MCL injury on the same grounds as isolated ACL tears; MCL status did not clearly change the picture.
Kinesio tape alone did not clearly help plantar fasciitis
Treat kinesio tape as an optional extra in plantar fasciitis, not a treatment in its own right.
Give arthroplasty prophylaxis within the hour before incision
Time arthroplasty prophylaxis to finish within the hour before incision and before the tourniquet goes up.
Tibial slope and age together set ACL rerupture risk
Combine tibial slope with age when counselling about ACL rerupture, because the same slope carries very different absolute risk at 18 and at 45.
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