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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, ÖmerBackground: 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.Yayın Durable patellar stability and high patient‐reported success at minimum 5‐year follow‐up after isolated suture tape MPFL reconstruction(Wiley, 2026) Erden, Tunay; Ağır, Muzaffer; Kayaalp, Mahmut Enes; Toker, Berkin; Taşer, ÖmerPurpose: To evaluate the mid‐to‐ long‐term clinical and radiological out comes of isolated medial patellofemoral ligament reconstruction (MPFL‐R) using a high‐strength suture tape (HSST) construct in patients with recur rent patellar instability and no major osseous risk factors. Methods: Patients treated with isolated MPFL‐R using HSST and a single knotless femoral anchor between 2015 and 2021 were retrospectively re viewed. Inclusion criteria were recurrent lateral patellar instability (≥2 disloca tions or symptomatic subluxations) refractory to nonoperative treatment and a minimum postoperative follow‐up of 60 months. Patients requiring concomitant bony realignment or presenting with major anatomic risk factors (e.g., high grade trochlear dysplasia, severe patella alta, tibial tubercle–trochlear groove distance >20mm) were excluded. Clinical outcomes were assessed with the International Knee Documentation Committee (IKDC) subjective score, Kujala score and visual analogue scale (VAS) for pain. Patellar tilt was mea sured on axial magnetic resonance imaging (MRI). Postoperative instability events, complications and reoperations were recorded. Clinically meaningful improvements were assessed using minimal clinically important difference (MCID) and patient‐acceptable symptomatic state (PASS) thresholds. Kaplan Meier survival analysis was performed to estimate 5‐year survivorship free from redislocation (primary endpoint) and any postoperative instability (secondary endpoint). Postoperative instability was defined as clinically docu mented redislocation or symptomatic subluxation. Results: Eighty‐one patients (mean age 20.8 years; 31.4% female) were included. At a mean follow‐up of 79.4±14.3 months, one redislocation (1.2%) and two subluxations (2.5%) occurred. Five‐year survivorship free from redislocation was 98.8% (95% confidence interval [CI], 96.4%–100%), and survivorship free from any postoperative instability was 96.3% (95% CI, 92.2%–100%). All patient‐reported outcome measures improved signifi cantly from baseline to final follow‐up (all p<0.001). Ninety‐six percent of patients achieved the PASS threshold for IKDC (95% CI, 89.7%–98.7%), whereas PASS attainment for the Kujala score ranged from 74% to 86% depending on the applied cut‐off. Radiologically, patellar tilt improved substantially on MRI (p<0.001). Postoperative complications were infrequent and manageable, including five cases of arthrofibrosis (requiring manipulation under anaesthesia), one deep infection (treated with arthro scopic debridement) and three cases of implant‐related bursitis at the femoral fixation site. Conclusion: Isolated MPFL reconstruction using an HSST construct pro vided durable patellar stability and significant functional improvement at a minimum 5‐year follow‐up. This technique represents a reliable mid‐to long‐term option for isolated MPFL‐R in appropriately selected patients, especially when graft harvest morbidity and patellar bone preservation are concerns.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, ÖmerObjective: 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.Yayın Increased residual anterior knee laxity at one year is associated with a dose‐dependent increase in graft re‐rupture risk following hamstring autograft ACL reconstruction in athletes(Wiley, 2026) Erden, Tunay; Ağır, Muzaffer; Kayaalp, Mahmut Enes; Toker, Berkin; Taşer, ÖmerPurpose: Residual anterior knee laxity following anterior cruciate ligament reconstruction (ACLR) has been associated with inferior subjective out comes and an increased risk of revision surgery; however, its prognostic value for predicting subsequent graft re‐rupture remains unclear. This study aimed to assess the association between KT‐1000–measured 1‐year post operative anterior knee laxity and graft re‐rupture after ACLR. We hy pothesised that increased residual anterior knee laxity at 1 year post operatively would be associated with a higher risk of graft re‐rupture in a dose‐dependent manner. Methods: This retrospective cohort study included 1011 amateur and pro fessional athletes who underwent primary ACLR with hamstring tendon autograft (HTA) between 2005 and 2024 by a single surgeon using a standardised surgical technique. Patients undergoing revision ACLR, mul tiligament reconstruction, or any lateral extra‐articular augmentation pro cedure were excluded. Anterior knee laxity was quantified using the KT 1000 arthrometer at a mean of 12.1±1.3 months post‐operatively. A landmark time‐to‐event design was applied, with follow‐up starting from the KT‐1000 assessment to minimise immortal time bias and to focus on anterior knee laxity after biological graft maturation. The primary exposure was KT‐1000 side‐to‐side difference (SSD), analysed as both a continuous variable and using clinically relevant thresholds (<3mm, 3–5mm, and >5mm). Associations between post‐operative laxity and graft re‐rupture, adjusting for demographic, surgical, and activity‐related factors were assessed using a multivariable Cox proportional hazards model. Secondary analyses evaluated the relationship between KT‐1000 laxity, return‐to‐play status, and post‐operative activity level. Results: Patients who experienced graft re‐rupture had significantly greater post‐operative KT‐1000 SSD compared with those without re‐rupture (3.5 ± 1.3mm vs. 2.1±0.9mm; p<0.001). Increased KT‐1000 SSD was independently associated with higher graft re‐rupture risk (adjusted hazard ratio, 2.97 per 1‐mm increase; 95% confidence interval [CI], 2.5–3.5). Higher laxity categories were associated with progressively increased re‐rupture risk with adjusted hazard ratios of 1.76 (95% CI, 1.3–2.3; p<0.001) for 3–5mm and 8.85 (95% CI, 4.7–16.4; p<0.001) for >5mm compared with <3mm. Post‐operative 1‐year KT‐1000 anterior knee laxity was not significantly associated with return‐to‐play status (odds ratio, 0.84 per 1‐mm increase; 95% CI, 0.6–1.1; p=0.28), but was modestly associ ated with lower post‐operative Tegner activity level (p<0.001). Conclusion: KT‐1000–measured post‐operative anterior knee laxity at 1 year post‐operatively was independently associated with the risk of sub sequent graft re‐rupture after HTA ACLR in athletic patients. These findings suggest that residual laxity may serve as a useful risk stratification tool, rather than a deterministic predictor of failure, and should be interpreted in the context of overall clinical and biomechanical assessment. Level of Evidence: Level III.
