This systematic review and meta-analysis aimed to assess the efficacy of prolotherapy compared to control or placebo-based treatments. Methods: A comprehensive search of PubMed, Ovid, and Scopus was conducted up to April 2025. Inclusion criteria encompassed clinical studies comparing prolotherapy with control or placebo treatments and evaluating outcomes such as pain, function, and range of motion. Results: Eight studies involving 431 participants met the inclusion criteria. Patient-reported outcomes, including pain visual analog scale and Shoulder Pain and Disability Index, showed no statistically significant differences between prolotherapy and controls. Prolotherapy demonstrated a small but statistically significant improvement in shoulder abduction (mean difference, 7.08°; 95% CI, 2.49°–11.66°). Other range of motion measures, such as forward flexion, internal rotation, and external rotation, showed no significant differences. Radiographic outcomes, including tendon thickness and elasticity, suggested potential structural benefits but did not consistently translate to clinical improvements. Conclusions: Prolotherapy is not superior to control treatments for rotator cuff tendinopathy. While it offers minor gains in shoulder abduction, its clinical benefits are limited. Level of evidence: III.

Background: The medial meniscus posterior root tear is a common cause of knee osteoarthritis, often misdiagnosed. Surgical repair aims to restore knee biomechanics, with evolving techniques focusing on direct fixation. The objective of this study was to evaluate the clinical and radiographic outcomes of arthroscopic soft suture anchor repair, without utilizing the posterior portal technique, for medial meniscus posterior root tears over a 2-year follow-up period. Methods: This is a retrospective study involving 32 patients, including 13 men and 19 women, with a mean age of 57 years and follow-up of 2 years. All tears were classified as LaPrade type 2 medial meniscus posterior root tears. The paired t-test was used to compare the International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm score, as well as meniscus extrusion between preoperative and postoperative states. The Wilcoxon signed-rank test was utilized to compare the KellgrenLawrence (KL) grades. Healing rates were assessed on magnetic resonance imaging (MRI). Results: MRI revealed complete healing in 17 out of 32 knees (53.1%), partial healing in 12 knees (37.5%), and signs of retear in 3 knees (9.4%). At final follow-up, the mean IKDC and Lysholm scores were 57.4 ± 10.3 and 84.8 ± 11.3, respectively, showing significant improvement from preoperative values (p < 0.001). There was also a significant reduction in medial meniscus extrusion postoperatively, decreasing from 4.1 ± 0.8 mm preoperatively to 3.6 ± 0.9 mm postoperatively (p = 0.002). Additionally, KL grades did not progress significantly during the 2-year follow-up period, as evidenced by median KL grades of 2 both preoperatively and postoperatively (p = 0.072). Conclusions Arthroscopic repair of medial meniscus posterior root tears using a soft suture anchor without a posterior portal yielded a high healing rate in MRI and favorable patient-reported outcomes in short-term follow-up duration.

Background: The medial meniscus posterior root tear is a common cause of knee osteoarthritis, often misdiagnosed. Surgical repair aims to restore knee biomechanics, with evolving techniques focusing on direct fixation. The objective of this study was to evaluate the clinical and radiographic outcomes of arthroscopic soft suture anchor repair, without utilizing the posterior portal technique, for medial meniscus posterior root tears over a 2-year follow-up period. Methods: This is a retrospective study involving 32 patients, including 13 men and 19 women, with a mean age of 57 years and follow-up of 2 years. All tears were classified as LaPrade type 2 medial meniscus posterior root tears. The paired t-test was used to compare the International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm score, as well as meniscus extrusion between preoperative and postoperative states. The Wilcoxon signed-rank test was utilized to compare the KellgrenLawrence (KL) grades. Healing rates were assessed on magnetic resonance imaging (MRI). Results: MRI revealed complete healing in 17 out of 32 knees (53.1%), partial healing in 12 knees (37.5%), and signs of retear in 3 knees (9.4%). At final follow-up, the mean IKDC and Lysholm scores were 57.4 ± 10.3 and 84.8 ± 11.3, respectively, showing significant improvement from preoperative values (p < 0.001). There was also a significant reduction in medial meniscus extrusion postoperatively, decreasing from 4.1 ± 0.8 mm preoperatively to 3.6 ± 0.9 mm postoperatively (p = 0.002). Additionally, KL grades did not progress significantly during the 2-year follow-up period, as evidenced by median KL grades of 2 both preoperatively and postoperatively (p = 0.072). Conclusions Arthroscopic repair of medial meniscus posterior root tears using a soft suture anchor without a posterior portal yielded a high healing rate in MRI and favorable patient-reported outcomes in short-term follow-up duration.

Background: The medial meniscus posterior root tear is a common cause of knee osteoarthritis, often misdiagnosed. Surgical repair aims to restore knee biomechanics, with evolving techniques focusing on direct fixation. The objective of this study was to evaluate the clinical and radiographic outcomes of arthroscopic soft suture anchor repair, without utilizing the posterior portal technique, for medial meniscus posterior root tears over a 2-year follow-up period. Methods: This is a retrospective study involving 32 patients, including 13 men and 19 women, with a mean age of 57 years and follow-up of 2 years. All tears were classified as LaPrade type 2 medial meniscus posterior root tears. The paired t-test was used to compare the International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm score, as well as meniscus extrusion between preoperative and postoperative states. The Wilcoxon signed-rank test was utilized to compare the KellgrenLawrence (KL) grades. Healing rates were assessed on magnetic resonance imaging (MRI). Results: MRI revealed complete healing in 17 out of 32 knees (53.1%), partial healing in 12 knees (37.5%), and signs of retear in 3 knees (9.4%). At final follow-up, the mean IKDC and Lysholm scores were 57.4 ± 10.3 and 84.8 ± 11.3, respectively, showing significant improvement from preoperative values (p < 0.001). There was also a significant reduction in medial meniscus extrusion postoperatively, decreasing from 4.1 ± 0.8 mm preoperatively to 3.6 ± 0.9 mm postoperatively (p = 0.002). Additionally, KL grades did not progress significantly during the 2-year follow-up period, as evidenced by median KL grades of 2 both preoperatively and postoperatively (p = 0.072). Conclusions Arthroscopic repair of medial meniscus posterior root tears using a soft suture anchor without a posterior portal yielded a high healing rate in MRI and favorable patient-reported outcomes in short-term follow-up duration.

Background: The hamstring autograft can be harvested using various skin incisions, such as vertical, transverse, and oblique incisions, and from different localizations, including anteromedial and posteromedial harvest sites. The aim of this study was to compare studies on the anteromedial and posteromedial approaches for hamstring autograft harvest in terms of clinical outcomes, saphenous nerve injury, infection, operative time, graft length, incision length, range of motion, and patient satisfaction. Methods: Following the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a search was conducted in PubMed and Scopus, focusing on studies comparing anteromedial and posterior approaches for hamstring harvest. This study was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42023450249). Methodological quality was evaluated using the Modified Coleman Methodology Score. Odds ratios (ORs) and mean differences (MDs) quantified dichotomous and continuous outcomes, respectively. Results: Five articles, involving 405 knees, underwent analysis. Four studies were level 3 evidence, while 1 was level 1. The anteromedial hamstring harvest showed higher rates of saphenous nerve injury (OR, 9.77; 95% confidence interval [CI], 2.19–43.65; p = 0.003) and longer operative times, with an MD of about 13 minutes (MD, 13.33; 95% CI, 0.68–25.97; p = 0.04), compared to the posteromedial approach. The anteromedial method yielded a longer semitendinosus graft, with an MD of about 17 mm (MD, 17.57;95% CI, 7.17–27.98; p = 0.0009). However, no significant differences existed in range of motion, flexion contracture, unintentional graft harvest, infection rates, and patient-reported outcomes. Notably, the posteromedial group reported higher cosmetic satisfaction, with 92% being very satisfied, compared to the anteromedial group with 80% (p = 0.005). However, overall satisfaction levels were similar between the 2 groups (p = 0.35), with a very satisfied rate of 72% for the anteromedial group and 78% for the posteromedial group. Conclusions The anteromedial hamstring harvest showed greater saphenous nerve injury and longer operative times compared to the posteromedial approach, along with a longer graft. However, no significant differences were observed in the range of motion, flexion contracture, graft harvest, infection, or patient outcomes.

Background: The medial meniscus posterior root tear is a common cause of knee osteoarthritis, often misdiagnosed. Surgical repair aims to restore knee biomechanics, with evolving techniques focusing on direct fixation. The objective of this study was to evaluate the clinical and radiographic outcomes of arthroscopic soft suture anchor repair, without utilizing the posterior portal technique, for medial meniscus posterior root tears over a 2-year follow-up period. Methods: This is a retrospective study involving 32 patients, including 13 men and 19 women, with a mean age of 57 years and follow-up of 2 years. All tears were classified as LaPrade type 2 medial meniscus posterior root tears. The paired t-test was used to compare the International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm score, as well as meniscus extrusion between preoperative and postoperative states. The Wilcoxon signed-rank test was utilized to compare the KellgrenLawrence (KL) grades. Healing rates were assessed on magnetic resonance imaging (MRI). Results: MRI revealed complete healing in 17 out of 32 knees (53.1%), partial healing in 12 knees (37.5%), and signs of retear in 3 knees (9.4%). At final follow-up, the mean IKDC and Lysholm scores were 57.4 ± 10.3 and 84.8 ± 11.3, respectively, showing significant improvement from preoperative values (p < 0.001). There was also a significant reduction in medial meniscus extrusion postoperatively, decreasing from 4.1 ± 0.8 mm preoperatively to 3.6 ± 0.9 mm postoperatively (p = 0.002). Additionally, KL grades did not progress significantly during the 2-year follow-up period, as evidenced by median KL grades of 2 both preoperatively and postoperatively (p = 0.072). Conclusions Arthroscopic repair of medial meniscus posterior root tears using a soft suture anchor without a posterior portal yielded a high healing rate in MRI and favorable patient-reported outcomes in short-term follow-up duration.

Background: The Latarjet procedure is a common procedure for treating critical glenoid bone loss in anterior shoulder instability.Implants such as the screw and cortical button are widely used. The aim of this study was to compare studies on screw versus button fixation techniques in the Bristow-Latarjet procedure for anterior shoulder instability in terms of clinical outcomes, union rates, and complications. Methods: The PubMed, Scopus, and Embase databases were searched to find comparative studies that reported outcomes of using screw versus button fixation in the Bristow-Latarjet procedure following the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Studies that directly compared the screw and button fixation techniques and provided postoperative patient-reported outcomes, union rates, or complications were included. The Methodology Index for NonRandomized Research (MINORS) criteria were used to assess the quality of the included studies. Odds ratios (ORs) were calculated for dichotomous outcomes whereas mean differences were calculated for continuous outcomes. Results: Five articles included a total of 877 shoulders. All five studies had level 3 evidence. There was no statistically significant difference between the two techniques using the Walch-Duplay score, visual analog scale for pain, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, range of motion, and graft union rates. However, the button fixation technique had statistically significantly higher recurrence rates than the screw fixation technique (OR, 0.24; 95% confidence interval, 0.10–0.58; p = 0.001). Conclusions The screw fixation technique had statistically significantly lower recurrence rates than the button fixation technique. However, there was no significant difference between screw and button fixation techniques regarding postoperative patient-reported outcomes, range of motion, graft union rates, nerve injury rates, infection rates, and reoperation rates.