Mr Shahbaz Malik

ACL Reconstruction in Skeletally Immature Athletes: Current Concepts

ACL injury in skeletally immature patients remains a debatable topic in terms of its management, surgical choices and rehabilitation. The treatment preferences vary across the globe. Children are not little adults in terms of their physiology and anatomy. Hence, contemporary treatment inferred from the adult population does not give the same outcomes in pediatric patients. An in-depth study of specific challenges and difficulties is warranted to optimize the treatment strategies to cater to this group of patients. There is a paucity of literature giving long-term follow-up of ACLR in skeletally immature patients and no standardized guidelines are present for managing this group of patients. The authors have tried to summarize the current concepts for managing ACL injuries in skeletally immature patients through this article. Multiple lacunae and controversies exist in the knowledge regarding the optimum treatment of pediatric patients with ACL injuries who are comparatively more prone to ACL tears than their adult counterparts. Identifying the best mode of management of ACL tears in these skeletally immature patients is necessary.

Combined high tibial osteotomy and root repair improves patient-reported outcomes in medial meniscus posterior root tears: A systematic review and meta-analysis

High tibial osteotomy (HTO) is a well-established joint-preserving surgery for varus knees with medial compartment overload. There is a growing interest in combining HTO with meniscal root repair (HTO-MRR) to address both the varus malalignment and the meniscal deficiency caused by medial meniscus posterior root tears (MMPRTs). Aim This systematic review and meta-analysis aimed to synthesise current evidence on the clinical, radiographic, and arthroscopic outcomes following HTO-MRR for isolated MMPRTs. Where available, comparative data with HTO alone were analysed as a secondary objective.

High continuous fragility index values for randomised controlled trials investigating medial patellofemoral ligament reconstruction for patellar instability: A systematic review

Purpose To evaluate the statistical fragility of randomised controlled trials (RCTs) investigating medial patellofemoral ligament reconstruction (MPFLR) of patients with patellar instability. Conclusion This systematic review shows that while FI was low at a median of 1.0, consistent with RCTs in sports medicine, the other indicators of statistical fragility were relatively high, especially CFI (11.7). The level of fragility should be taken into account when assessing practical applicability of RCTs on patellar instability, in combination with other indicators of study rigour.