Search Results (416)

Background/Objectives: Chronic spontaneous urticaria (CSU) is a heterogeneous immune-mediated condition involving multiple inflammatory pathways. The clinical utility of platelet-activating factor (PAF) as a biomarker in CSU remains insufficiently defined. This study aimed to evaluate plasma PAF levels in patients with CSU and to investigate their associations with clinical characteristics, disease activity, and laboratory and immunological parameters. Methods: This cross-sectional study included 205 adult patients diagnosed with CSU between January 2016 and May 2023. Clinical data, patient-reported outcome measures (PROMs), and extensive laboratory parameters were collected. Plasma PAF levels were measured using ELISA in 171 patients. Associations were analyzed using appropriate statistical methods. Results: The cohort was predominantly female (77.6%), with a mean age of 42.6 ± 15.3 years. Most patients had uncontrolled disease (76.9%). The median Urticaria Activity Score over 7 days (UAS7) score was 14, corresponding to mild disease activity. PAF levels differed significantly across clinical subgroups. Higher PAF levels were observed in patients with angioedema (alone or in combination with urticaria) compared to those with urticaria alone (p = 0.002), and in patients with predominantly nocturnal and early morning symptoms (p = 0.018). No associations were found between PAF levels and disease activity scores or treatment response. PAF levels showed positive correlations with age, age at symptom onset, IgM, IgG anti-IgE, HSP70, and the CD4/CD8 ratio (all p < 0.05). Conclusions: Plasma PAF levels are associated with specific clinical phenotypes, circadian symptom patterns, and selected immunological markers in CSU, suggesting that PAF may serve as a marker of underlying biological heterogeneity and immune activation. However, the present cross-sectional findings do not establish clinical utility, prognostic significance, or predictive relevance for treatment response, and these aspects require further longitudinal investigation. Full article

Background/Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory condition that significantly impairs health-related quality of life (HRQoL), particularly sleep quality. Beyond mechanical nasal obstruction, type 2 cytokines (IL-4, IL-13) are thought to directly disrupt sleep architecture. Dupilumab, an IL-4Rα antagonist, is approved for severe CRSwNP, but its specific effect on sleep quality remains under investigation. This systematic review aims to evaluate the impact of dupilumab on sleep quality in patients with severe, uncontrolled CRSwNP. Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Google Scholar, and Web of Science up to June 2026. We included adult studies (≥1 month of dupilumab 300 mg every 15 days) reporting sleep outcomes using validated tools (Epworth Sleepiness Scale [ESS], Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], or the SNOT-22 sleep domain). Risk of bias was assessed using ROBINS-I and RoB 2 tools. Results: Seven studies (n = 2164 patients) met inclusion criteria. Across observational and post hoc RCT analyses, dupilumab consistently improved the SNOT-22 sleep domain (mean reduction up to −7.02 points at 24 weeks; p < 0.001), PSQI, ESS, and ISI scores. One study reported a decrease in poor global sleep quality from 88.9% at baseline to 5.7% at 12 months. However, most observational studies had a serious risk of bias due to unaddressed confounding and lack of blinding. No polysomnographic data were reported. Conclusions: Dupilumab was associated with significant improvements in patient-reported sleep quality in CRSwNP patients across seven included studies. However, the evidence is limited by the absence of objective sleep measures, the serious risk of bias in most observational studies, and the lack of comparative head-to-head data. High-quality randomized controlled trials with prespecified sleep endpoints and polysomnographic assessments are needed before definitive conclusions can be drawn. Full article

Background/Objectives: SPINEHealthie is a smartphone-based application enabling remote patient monitoring, care delivery and standardized collection of patient-reported outcome measures (PROMs). This registry-based analysis evaluates patient satisfaction with the platform across a large, heterogeneous spine surgery cohort. Methods: A total of 1729 thoracolumbar spine surgery cases were eligible for analysis. Among these, 881 (50.9%) completed the in-app feedback survey and constituted the primary feedback cohort. The global app experience was categorized as “Very Good” or “Poor”. Clinical outcomes, i.e., the Visual Analogue Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) were assessed at baseline and in the postoperative period; Δ denotes the change from baseline to two weeks postoperation. Results: Among feedback responders, 800 patients (90.8%) rated their app experience as “Very Good”, while 80.8% of 639 patients with surgical outcome data reported that the surgery met their expectations. However, app experience and surgical outcome expectations were assessed using different items at different postoperative time points. Among patients whose surgery did not meet expectations, 84.6% rated their app experience as “Very Good”. Patients with a “Very Good” app-experience rating demonstrated significantly greater improvement in back pain (ΔVAS Back pain 2.94 vs. 2.13, p = 0.027), leg pain (ΔVAS Leg pain 3.16 vs. 2.14, p = 0.019) and disability (ΔODI 11.00 vs. 2.41, p < 0.001). In the primary model, older age, shorter follow-up duration and smaller ODI improvement were associated with an unfavorable app experience; only the association with age remained consistent across sensitivity analyses. Conclusions: Among feedback responders, SPINEHealthie was associated with a high proportion of favorable global app-experience ratings. Favorable app-experience ratings remained high, even among patients with unmet surgical expectations or failure to achieve the exploratory two-week ODI-improvement threshold, suggesting that perceived platform value is not solely explained by surgical outcome. Older patients and those with limited functional recovery were identified as subgroups that may benefit from targeted onboarding and engagement strategies. Full article

Background and Objectives: This study evaluated whether exploratory spinopelvic compensation patterns are associated with 12-month patient-reported recovery after total knee arthroplasty (TKA), with explicit separation between baseline-only prediction and contemporaneous association-based risk stratification. Materials and Methods: This retrospective single-center cohort included 700 complete cases selected from 723 primary TKA records after 23 exclusions for incomplete key radiographic alignment data and/or unavailable 12-month patient-reported outcome measures (PROMs). The primary endpoint was a strict composite MCID-based endpoint, defined as failure to achieve the prespecified minimal clinically important difference (MCID) for either the Oxford Knee Score (OKS) or WOMAC at 12 months. OKS- and WOMAC-specific MCID failures were reported as component sensitivity outcomes. K-means clustering was used to define exploratory compensation patterns rather than validated preoperative phenotypes. Predictor timing was separated into a baseline-only model and a contemporaneous model that additionally used 12-month alignment-change variables. Results: The strict composite MCID endpoint occurred in 537/700 patients (76.7%). Exploratory patterns showed increasing endpoint prevalence: Pattern A, 153/215 (71.2%); Pattern B, 195/258 (75.6%); and Pattern C, 189/227 (83.3%). The baseline-only ridge logistic model showed moderate discrimination (out-of-fold AUC 0.715, 95% CI 0.670–0.758). The contemporaneous model showed higher internal discrimination (out-of-fold AUC 0.864, 95% CI 0.834–0.894), but it included alignment changes measured in the same follow-up window as the outcome. Conclusions: Baseline-only prediction was modest, whereas stronger model performance was observed only in a contemporaneous association model. The exploratory patterns should not be interpreted as stable clinical phenotypes or used for individual-level decisions without external validation. Full article

The introduction of robotic-assisted total hip arthroplasty (THA) has had significant effects over and above the more accurate component position it delivers. Diagnosis and templating are improved as a result of the planning CT scan. Complex cases involving abnormal anatomy are simplified surgically by a single ream for the acetabular component and feedback for hip length and offset for the femoral component. The learning curve for surgeons relates primarily to operative time rather than complications. Once planned, robotic systems may reduce variability in component positioning between surgeons with differing levels of experience. Patient Reported Outcome Measures (PROMs) will need to be supplemented with gait lab data and functional tests to prove the added value of robotic-assisted THA. As robotic-assisted surgery (RAS) becomes increasingly reliant on imaging systems and digital workflows, operating theatres face greater complexity in technology integration and intraoperative coordination. Emerging evidence links spatial organisation, equipment positioning, and workflow to operative efficiency, intraoperative safety, and surgical performance. This paper provides an evidence-informed narrative perspective on how advances in robotic-assisted THA are influencing the spatial and functional requirements of operating theatres, thereby affecting clinical performance. As surgical practice advances, there is a need to move towards future-proofed design strategies informed by clinical performance and systems-based evidence. This includes a greater focus on flexibility and integrated digital infrastructure to support evolving technologies, changing team dynamics, and increasing procedural demands. Operating theatres must therefore evolve to enable effective integration of RAS in THA, and support improved patient safety and clinical outcomes. Full article

Background and Objectives: The wrist is one of the most common sites of rheumatic disease. Based on the graded deformities of Larsen et al., surgery has been adapted to minimize harm while maximizing benefit to the individual. This study aims to survey the institutional experience, describing functional outcomes and patient satisfaction across several surgical approaches, without formal statistical comparison. Materials and Methods: The studies and results presented here are from one center specialized in rheumaorthopedic surgery and reflect the above concepts. The studies cover a broad spectrum of surgical techniques, which were categorized according to the Larsen stages of wrist destruction. All studies were retrospective or retrospective-like, and follow-up data were analyzed collectively. The primary endpoints were functional outcome scales and patient satisfaction, supplemented by pain relief, as well as strength and range of motion. The assessment utilized, amongst others, the QuickDASH, FFbH and Clayton score, as well as appropriate patient-reported measures such as ADL and SF-36. Radiological follow-ups were classified according to the Larsen–Dale–Eek classification; for endoprostheses/arthrodesis, carpal height was determined according to Youme. Results: Significant improvements in the Clayton score (consistently greater postoperatively than preoperatively) are evident for several procedures, particularly MPW^® (+37 points) and APW^® (+28 points). Postoperative reductions in VAS pain scores are marked for most procedures, e.g., MPW^® from 7 to 1.8. The revision rates for most procedures are around 10–13% during the follow-up periods. In addition, the tendon and soft tissue functions of the hand(s) play critical roles in these PROMs. Conclusions: The studies present the results and limitations of surgical treatment for rheumatic wrists in the prebiological era. The results of individual studies need to be examined more closely to better assess the potential and limitations of surgery for patients. Full article

Background: Management of post-extraction sockets with buccal dehiscence in the esthetic zone remains clinically challenging, particularly when immediate implant placement is indicated. Conventional approaches often rely on guided bone regeneration (GBR) with biomaterials, which may increase surgical complexity and morbidity. This case report evaluates the clinical and radiographic outcomes of a fully autologous approach combining leukocyte- and platelet-rich fibrin (L-PRF) and connective tissue graft (CTG) in conjunction with immediate implant placement. Methods: A 50-year-old healthy patient presenting with a fractured maxillary lateral incisor and buccal bone dehiscence underwent atraumatic extraction, immediate implant placement, and simultaneous site management using L-PRF membranes and CTG. Clinical and radiographic evaluations were performed at baseline (T0) and after 12 months (T1). Cone-beam computed tomography (CBCT) was used to assess horizontal bone thickness (HBT) at multiple apico-coronal levels and vertical evaluation parameters, including nasal floor–crest distance (NF–AC). Clinical outcomes included probing pocket depth (PPD), keratinized tissue width (KT), gingival thickness (GT) and patient-reported outcome measures (PROMs). Results: Radiographic analysis demonstrated increased HBT at all levels (+1.4 mm at 9 mm, +3.1 mm at 12 mm, +3.2 mm at 15 mm, and +2.6 mm at 18 mm). NF-AC showed a marked increase (+2.7 mm) and substantial reduction in the buccal dehiscence defect. Clinically, KT increased by +2.0 mm and GT by +1.8 mm. Healing was uneventful, with minimal postoperative discomfort and high patient satisfaction. Conclusions: Within the limitations of a single case report, the combined use of L-PRF and CTG with immediate implant placement was associated with favorable clinical and radiographic outcomes. These preliminary findings suggest that a fully autologous, biologically driven approach may represent a potential alveolar ridge preservation strategy and a biomaterial-sparing alternative to conventional GBR in carefully selected cases. Further controlled studies are required to confirm these observations and define the indications and limitations of this approach. Full article

Background/Objectives: The purpose of this study was to evaluate the outcomes of meniscal suture repair in patients over 50 years of age with a minimum follow-up of 6 months, following failure of at least 6 months of conservative treatment. Methods: We retrospectively reviewed patients older than 50 years treated between 1 January 2017 and 30 June 2023 at the Orthopaedics and Traumatology Division of ASST Papa Giovanni XXIII (Bergamo, Italy) who underwent meniscal repair after failed conservative management. Patients underwent clinical, radiological and functional assessments. Meniscal healing was evaluated by MRI at 6 months postoperatively. Patient-reported outcome measures (PROMs), including KOOS, IKDC, Lysholm and Tegner Activity Scale, were collected preoperatively and at final follow-up. Results: Eleven patients were included, with a mean age of 53.4 ± 4.1 years (range, 50–64). Nine patients had lateral meniscus tears, and two had medial meniscus tears. At a mean follow-up of 22.0 ± 16.8 months (range, 6–66), significant improvements were observed in KOOS, IKDC and Lysholm scores (p < 0.05), with mean postoperative values of 95.4 ± 5.1, 87.5 ± 8.3 and 97.1 ± 3.5, respectively. All patients returned to their pre-injury activity level according to the Tegner scale. One complete failure and one partial failure were observed, both in patients with medial meniscus tears. Conclusions: In this small cohort, arthroscopic meniscal repair in patients over 50 years of age was associated with significant improvements in clinical and functional outcomes, with a failure rate of 18.2%. These findings suggest that meniscal repair may be a viable joint-preserving option in carefully selected middle-aged patients, particularly in lateral meniscus lesions. However, results should be interpreted cautiously given the limited sample size and retrospective design. Full article

Sarcoidosis is a multisystem disease characterised by a heterogeneous clinical presentation and variable disease course. Despite low mortality, the burden of sarcoidosis extends beyond organ involvement, with many patients reporting significant impairment in quality of life (QoL). Fatigue, chronic cough, and small fibre neuropathy (SFN) are among the most prevalent and debilitating symptoms reported by patients, often demonstrating poor correlation with conventional markers of disease activity and frequently persisting despite apparent disease control. This review examines the impact of sarcoidosis on QoL and highlights the limitations of traditional assessment tools, including imaging and pulmonary function testing, in capturing the full extent of disease burden. The role of patient-reported outcome measures (PROMs) is discussed, including generic instruments and sarcoidosis-specific tools such as the King’s Sarcoidosis Questionnaire (KSQ), Sarcoidosis Health Questionnaire (SHQ), and Sarcoidosis Assessment Tool (SAT), alongside symptom-specific measures targeting fatigue, neuropathic symptoms, and cough. Current and emerging management strategies aimed at improving QoL are reviewed, including immunosuppressive therapies, biologic agents, and non-pharmacological interventions. Despite increasing recognition of QoL as a key outcome, its integration into clinical trials remains inconsistent. Incorporating PROMs into routine clinical practice and research is essential to enable comprehensive assessment and support patient-centred care. Greater emphasis on QoL outcomes may improve therapeutic decision-making and overall disease management in sarcoidosis. Full article

Background/Objectives: Atrial fibrillation (AF) imposes a substantial long-term clinical and healthcare system burden, recurrent hospitalizations, impaired quality of life, and increasing long-term healthcare costs. Although patient-reported outcome measures (PROMs) are increasingly used in AF research and clinical practice, their broader role in healthcare delivery, implementation, and system-level decision-making remains insufficiently defined. Existing assessment strategies frequently prioritize symptom burden while underrepresenting cognitive, emotional, social, and functional dimensions of AF-related impairment. This narrative implementation review examines the current role of PROMs in AF management from a healthcare system and implementation perspective. Methods: Literature addressing AF-specific and generic PROM instruments, implementation strategies, health system integration, value-based care, and digital health approaches was reviewed and synthesized across PubMed, Scopus, and Google Scholar. Particular emphasis was placed on implementation barriers, workflow integration, evidence strength, and challenges encountered across diverse healthcare settings. Results: Current PROM frameworks incompletely capture several important dimensions of AF burden, including cognitive dysfunction, sleep disturbance, emotional distress, social participation, sexual health, and productivity loss. Beyond conventional symptom assessment, PROMs may support longitudinal patient monitoring, treatment evaluation, shared decision-making, and patient-centred care. Emerging evidence also suggests potential roles in outpatient prioritization, healthcare quality assessment, and value-based healthcare initiatives, although prospective AF-specific implementation studies remain limited. Mapping PROM applications to the 2024 ESC AF-CARE pathway demonstrates the strongest alignment with the Evaluation and Reducing symptoms domains while supporting patient engagement, comorbidity management, and individualized care planning. Implementation remains constrained by clinician workload, questionnaire fatigue, limited interoperability, heterogeneous digital infrastructure, and variability in organizational resources, with these challenges potentially being more pronounced in smaller or resource-limited healthcare systems. Conclusions: PROM integration in AF care may provide opportunities to strengthen patient-centered management and improve healthcare system responsiveness beyond conventional rhythm- and symptom-focused approaches. Successful implementation may require careful adaptation to local healthcare infrastructure, workflow feasibility, and long-term sustainability. Future developments involving digital platforms, wearable technologies, and artificial intelligence-assisted interpretation may further expand the clinical and operational relevance of PROM-guided AF care. Full article

Background/Objectives: Cochlear implant (CI) candidacy has expanded beyond traditional bilateral hearing loss (HL) to include single-sided deafness (SSD) and asymmetric hearing loss (AHL), yet baseline differences in speech recognition and patient-reported outcome measures (PROMs) between these groups—bilateral HL, SSD, and AHL—remain poorly characterized. The objective of this study was to characterize and compare preoperative speech recognition performance and PROMs between traditional bilateral HL and SSD/AHL CI candidates, and to examine associations between preoperative word recognition scores and PROMs across the full cohort. Methods: Sixty-eight adults (mean age 71.6 years, SD 7.4) undergoing preoperative CI evaluation were enrolled (31 bilateral HL, 12 SSD, and 25 AHL). Consonant–Nucleus–Consonant (CNC) word recognition and AzBio sentence recognition were assessed for both the ear-to-be-implanted (CI ear) and the contralateral ear. The following PROMs were evaluated: the Speech, Spatial and Qualities of Hearing Scale (SSQ-12); Cochlear Implant Quality of Life–35 (CIQOL-35); Patient Health Questionnaire-2 (PHQ-2); Tinnitus Handicap Inventory (THI); and the Instrumental Activities of Daily Living (IADL). Group comparisons used Mann–Whitney U tests and t-tests. CNC, SSQ-Mean, and CIQOL-Global associations were assessed using multivariable linear regression analysis. Results: Preoperative CI-ear speech recognition did not differ between the bilateral HL and SSD/AHL groups. SSD/AHL candidates had significantly higher contralateral-ear speech recognition performance, better SSQ-12 scores across all domains, and higher CIQOL-35 Global, Communication, Entertainment, and Environment scores compared to bilateral HL candidates. However, the CIQOL-35 Emotional, Listening Effort, and Social domains, PHQ-2, THI, and IADL did not differ significantly between the bilateral HL and SSD/AHL groups. Across our entire sample of candidates, CI-ear CNC scores were not significantly associated with preoperative SSQ-Mean or CIQOL-Global scores, while contralateral-ear CNC scores showed moderate, significant associations with both measures. Conclusions: Traditional bilateral and SSD/AHL CI candidates exhibit distinct preoperative PROM profiles (namely, the SSQ-12 and CIQOL-35) despite having no significant differences in CI-ear speech recognition. Contralateral-ear CNC scores—but not CI-ear scores—were significantly associated with the SSQ-Mean and CIQOL-Global, suggesting that contralateral-ear CNC scores may offer relevant insight into CI candidates’ functional hearing. These findings support population-specific counseling and highlight the complementary value of PROMs and audiometric data in CI candidacy evaluations. Full article

Background/Objectives: Chronic home oxygen therapy—long-term oxygen therapy (LTOT)—improves survival and quality of life in chronic respiratory failure when used ≥15 h/day, but adherence is frequently suboptimal and specific patient-reported outcome measures (PROMs) are scarce. To develop, validate and apply a specific PROM for patients on LTOT. Methods: A prospective observational cohort study was conducted at San Juan de Alicante University Hospital (April 2024–December 2025) following a four-stage process: conceptual framework definition and expert workshop, content validation and item reduction, cognitive interviews with pilot reliability testing (n = 25), and field application to 120 consecutive chronic LTOT users. The LTOT-PROM was designed to capture the patient-perceived impact attributable to LTOT during the previous 4 weeks. Internal consistency was assessed with Cronbach’s α and test–retest reproducibility with the intraclass correlation coefficient (ICC). Results: The final instrument comprises 15 scored items in two dimensions—Daily Activity (9 items) and Adverse Effects (6 items)—plus one ambulatory-only mobility item excluded from the total score. Cronbach’s α was 0.814 (95% CI 0.681–0.906) for Daily Activity, 0.743 (95% CI 0.548–0.872) for Adverse Effects and 0.808 (95% CI 0.677–0.902) for the total scale; total ICC(A,1) was 0.890 (95% CI 0.767–0.950). Among the 120 patients (62 men, 58 women; mean age 78 ± 13 years; mean therapy duration 40 ± 32 months), 68% reported reduced effort for daily activities, 66% reported a reduction in dyspnoea and 67% reported improved self-confidence; 49% reported morning airway dryness and 7% abandoned the equipment due to nasal dryness or rhinitis. Conclusions: The LTOT-PROM is a brief, reliable and reproducible oxygen-specific instrument for assessing the recent patient-perceived impact of LTOT in routine clinical practice. Further studies should evaluate structural validity, external validity and the relationship between LTOT-PROM scores and objective adherence measures. The construct was predefined as the patient-perceived impact attributable to LTOT during a standardised 4-week recall window, and cognitive interviews confirmed that respondents interpreted the items as experienced benefit/burden during that period rather than as week-to-week symptom change. Full article

Background/Objectives: Treatment for laryngeal cancer often impacts voice, swallowing, communication, and quality of life. Patient-reported outcome measures (PROMs) are increasingly used to evaluate survivorship, but their application and connection with objective functional measures vary widely. The objective was to explore how PROMs are used in laryngeal cancer research, identify the functional areas they assess, analyze their link with objective clinical outcomes, and identify methodological gaps in current studies. Methods: This scoping review followed PRISMA-ScR guidelines. Searches were conducted in PubMed/MEDLINE, Scopus, and Web of Science from their start until April 2026. Included studies involved adults with laryngeal cancer reporting PROMs and/or objective functional outcomes. Data on study features, PROM tools, evaluated domains, and how PROMs relate to objective outcomes were extracted and summarized descriptively. Results: Ninety-five studies with 10,807 participants were included. Most were observational (84.2%) and conducted at a single center (72.6%). Voice-related outcomes were the most common (86.3%), followed by psychological (72.6%) and swallowing outcomes (65.3%). Less frequently assessed were nutritional (22.1%) and supportive care domains (41.1%). The Voice Handicap Index family was the most used PROM group (30.5%). Over half the studies reported PROMs and objective measures separately without statistical integration (51.6%), while only 13.7% performed analytical integration, and none used predictive multivariable models. Significant variation existed in PROM choices, assessed domains, and integration approaches. Conclusions: PROM use in laryngeal cancer survivorship research is heterogeneous and predominantly focused on voice-related outcomes. Limited analytical integration with objective measures hampers a comprehensive understanding of recovery. There is a need for standardized, multidimensional assessment frameworks that include functional, nutritional, psychosocial, and objective outcomes to effectively support patient-centered survivorship care and rehabilitation planning. Full article

Background/Objectives: This investigation was performed because corticosteroid injections are commonly used for symptomatic relief in patients with meniscal deficiency, yet their effect on graft survivorship and postoperative outcomes following meniscal allograft transplantation (MAT) remains poorly understood, with limited literature specifically addressing this topic. The aim of this study is to evaluate whether preoperative intra-articular corticosteroid injections (ICS) are associated with reoperation after MAT. Secondary aims included comparing reoperation-free survival, patient-reported outcome measures (PROMs), and patient acceptable symptom state (PASS) achievement. Methods: A retrospective review of 130 adults undergoing meniscal allograft transplantation (MAT) between 2011 and 2023 was performed. Patients with documented corticosteroid injection (CSI) status and ≥2 years of follow-up were included. Exclusion criteria included prior meniscal allograft transplantation, receipt of non-corticosteroid injections (e.g., hyaluronic acid or platelet-rich plasma), concomitant osteotomy procedures, multi-ligament knee reconstruction or inadequate follow-up. Propensity score matching (2:1 no steroid: steroid) based on age, sex, body mass index, fixation technique, operative compartment, and concomitant procedures yielded 54 matched patients (35 no steroid, 19 steroid). The primary outcome was ipsilateral knee reoperation, categorized as major reoperation (revision MAT, anterior cruciate ligament reconstruction, osteochondral allograft transplantation, conversion to total knee arthroplasty, meniscectomy and meniscus repair). Minor reoperations included irrigation and debridement, lysis of adhesions or manipulation under anesthesia, hardware removal, chondroplasty, and synovectomy. Reoperation-free survival was assessed using Kaplan–Meier analysis. PROMs and PASS were compared using adjusted regression models. Statistical significance was set at p < 0.05. Results: Baseline characteristics and follow-up were comparable between groups (7.6 ± 3.5 vs. 6.6 ± 3.2 years; p = 0.30). Overall reoperation occurred in 37.1% of patients in the no-steroid group and 31.6% in the steroid group (p = 0.771). Major reoperation rates were similar (17.1% vs. 15.8%; p = 1.000. There was no significant difference in minor reoperations between groups (20.0% vs. 10.5%; p = 0.468). Kaplan–Meier analysis demonstrated no difference in reoperation-free survival (p = 0.903), with comparable survival at the 1-, 2-, and 5-year time points. No individual subtypes differed significantly between groups. PROMs and PASS achievement were also similar, with no statistically significant differences observed. Conclusions: Preoperative corticosteroid injection was not associated with increased reoperation risk, inferior reoperation-free survival, or worse patient-reported outcomes following meniscal allograft transplantation. However, given the study’s limited power, lack of detailed injection characteristics, and the use of a heterogeneous complication outcome, these findings should be interpreted cautiously, as further investigation is warranted. Full article

Background/Objectives: This updated systematic review and meta-analysis provide a focused synthesis of contemporary evidence on clinical outcomes reported after the Latarjet procedure and Free Bone Block (FBB) techniques for anterior shoulder instability, focusing on recurrence, patient-reported outcome measures (PROMs), return to sport, complications, and osteoarthritis progression. Given that most available studies report single-procedure cohorts, between-technique comparisons were interpreted in the context of indirect evidence and study-level heterogeneity. Methods: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. The updated search included studies published from 2019 to May 2024 and was integrated with 70 studies from the previous review that were re-screened according to the same eligibility criteria. Eligible studies reported outcomes for the Latarjet or FBB procedure, with a minimum 2-year follow-up and at least five patients in the relevant treatment cohort. Risk of bias was assessed using the RoB 2 and MINORS tools. Outcomes were synthesized using random-effects meta-analysis. Pooled estimates were calculated separately for each procedure, and between-technique contrasts were treated as exploratory and descriptive when appropriate. Heterogeneity was assessed using I². Results: Ninety-eight studies with 6043 patients and 6071 shoulders were included: 72 on Latarjet, 23 on FBB, and 3 direct comparative studies. Both procedures were associated with low recurrence rates, improved PROMs, and comparable return-to-sport rates. Recurrence was 7% for Latarjet and 5% for FBB. Return to sport was 66% after Latarjet and 65% after FBB. Complication rates were 5% for Latarjet and 8% for FBB, while osteoarthritis progression was 12% and 9%, respectively. PROMs improved after both techniques, although differences between procedures should be interpreted cautiously because of the indirect nature of most comparisons and substantial heterogeneity across studies. Conclusions: Both Latarjet and FBB procedures were associated with generally favorable outcomes for anterior shoulder instability with bone loss in the included studies. The available evidence suggests broadly comparable clinical outcomes, with possible differences in complication profile, recurrence pattern, and osteoarthritis progression. However, these findings should be interpreted considering differences in patient characteristics, follow-up duration, surgical technique, graft type, and outcome definitions across studies. Current evidence does not allow definitive conclusions regarding the superiority of one technique over the other, but it provides useful descriptive outcome profiles to inform clinical decision-making and guide future direct comparative research. Full article