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  • Küçük Resim
    Yayın
    Clinical outcomes following medial patellofemoral ligament reconstruction using ultra high-strength 2-mm-wide tape in non-elite athletes
    (Elsevier, 2025) Erden, Tunay; Ağır, Muzaffer; Ali, Jotyar; Çelik, Malik; Batar, Suat; Toprak, Ali; Toker, Berkin; Taşer, Ömer
    Background: The medial patellofemoral ligament (MPFL) reconstruction is commonly conducted using gracilis, semitendinosus, quadriceps or tensor fascia lata tendon autografts or allografts. This approach, however, can sometimes lead to complications or morbidity at the site from which the graft is harvested. This study reports the clinical outcomes of non-elite competitive athletes who undergone MPFL reconstruction using an ultrahigh strength 2-mm-wide tape. Patients and methods: This retrospective cohort study included 67 non-elite athletes with acute or recurrent lateral patellar instability who underwent surgical treatment between December 2015 and December 2020. Athletes who underwent tibial tubercle osteotomy due to severe patellofemoral arthritis or severe osteochondral damage (kissing lesions or >2.5cm2 ) (1), trochlear dysplasia (Dejour type D dysplasia) (5), open physis (19) and revison MPFL reconstruction (8), were excluded. The remaining 34 athletes were followed postoperatively for a mini mum of 48 months. Results: During the follow-up period, there was only one case and which was revised by adding Fulkerson Osteotomy. Two patients had limited range of motion and joint mobilization was performed under general anesthesia at the end of the second month. The International Knee documentation Committee (IKDC), Kujala, and visual analog scale (VAS) scores showed improvement postoperatively (p < 0.001). Moreover, the mean im provements in IKDC (≈+41), Kujala (≈+33), and VAS (≈− 3.8) scores exceeded the established minimal clini cally important difference (MCID) thresholds, indicating that the outcomes were not only statistically significant but also clinically meaningful for patients. When comparing the pre- and postoperative radiological measure ments, the mean tilt angle and mean congruence angle showed a significant decrease (p < 0.001) Conclusion: Suture tape may be a good alternative to autograft, as it does not cause donor site morbidity. However, its most important disadvantage is its higher cost. Level of evidence: IV; Retrospective case series.
  • Küçük Resim
    Yayın
    From surgery to sports career: The long-term fate of athletes with discoid meniscus
    (Lippincott Williams and Wilkins Ltd., 2025) Erden, Tunay; Ağır, Muzaffer; Ali, Jotyar; Toker, Berkin; Taşer, Ömer
    Objective: This study aimed to evaluate the long-term effectiveness of different surgical techniques for discoid meniscus in athletes. Design: This retrospective cohort study included 44 athletes (51 knees) who underwent arthroscopic surgery for symptomatic discoid meniscus between 1996 and 2019. Setting: The study was conducted at a tertiary-level sports medicine center. Patients: Athletes aged 15 to 35 years with symptomatic discoid meniscus confirmed by magnetic resonance imaging and requiring surgical treatment were included. Exclusion criteria were cartilage injuries (Outerbridge grades 3-4), concomitant ligament injuries requiring surgery, osteochondritis dissecans, and prior knee surgery. Interventions: Patients underwent arthroscopic partial, subtotal, or total meniscectomy, with or without meniscus repair. Main outcome measures: Functional outcomes were assessed using Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lysholm scores. Osteoarthritis progression was evaluated using the Kellgren-Lawrence classification. Return to sports time and total career duration were also recorded and compared between the surgical groups. Results: The mean follow-up was 13.5 ± 6.2 years (range: 5-27 years). At the final follow-up, 72% of the meniscus-preserving group (partial meniscectomy and repair) had KL grade 0 osteoarthritis, whereas 38% of the subtotal/total meniscectomy group developed KL grades 3 to 4 osteoarthritis (P < 0.001). All groups showed significant postoperative functional improvements (P < 0.001), but career duration and return to play time were significantly longer in the meniscus-preserving group (P = 0.004, P < 0.001, respectively). Conclusions: Subtotal/total meniscectomy significantly accelerates osteoarthritis progression. Meniscus-preserving techniques provide better long-term outcomes.
  • Kapalı Erişim
    Yayın
    Meniscal position after bucket-handle tear repair: A multiplanar MRI comparison of all-inside and inside-out techniques
    (Elsevier, 2026) Ağır, Muzaffer; Ali, Jotyar; Sarıkaş, Murat; Toker, Berkin; Tuncay, İbrahim; Taşer, Ömer; Erden, Tunay
    Hypothesis/purpose: To compare multiplanar meniscal position following all-inside and inside-out repair of bucket-handle tears using magnetic resonance imaging (MRI) and to evaluate the associa tion between meniscal shift and short-term clinical outcomes. Methods: A retrospective comparative study was performed on 83 patients who underwent arthro scopic repair of bucket-handle meniscal tears. Postoperative MRI was used to evaluate meniscal position in multiple planes by measuring coronal extrusion and sagittal anterior and posterior meniscal position relative to the tibial plateau borders. When available, postoperative measurements were additionally compared with MRI findings from contralateral asymptomatic knees as a patient-specific native refer ence. Clinical outcomes were evaluated using Lysholm, International Knee Documentation Committee (IKDC), and visual analogue scale (VAS) scores at final follow-up. Comparisons were made between all inside and inside-out repair techniques. Results: Eighty-three patients were included (45 medial, 38 lateral). In the medial meniscus, coronal position did not change significantly after repair in either technique, whereas posterior sagittal position increased by approximately 2 mm after repair regardless of repair technique (both p < 0.001). In the lateral meniscus, the meniscus shifted toward a more peripheral coronal position postoperatively in both techniques (both p < 0.001), while posterior sagittal position increased by approximately 5 mm and anterior sagittal position remained unchanged. Postoperative meniscal position was comparable between techniques and generally remained within contralateral native reference ranges. All clinical scores improved significantly without technique-dependent differences. Conclusion: All-inside and inside-out repair produced comparable coronal and sagittal meniscal posi tion at 1 year after bucket-handle repair and similar clinical improvements. Postoperative meniscal position generally remained within contralateral reference ranges regardless of repair technique. No technique-dependent differences in meniscal position or clinical outcomes were identified.