Bridging continents, elevating evidence: The special joint issue of the Indian Arthroscopy Society and European Society for Knee Surgery, Sports Traumatology, and Arthroscopy on arthroscopic surgery and sports medicine

The convergence of the Indian Arthroscopy Society (IAS) and the European Society for Knee Surgery, Sports Traumatology, and Arthroscopy (ESSKA) in this special issue of the Journal of Arthroscopic Surgery and Sports Medicine (JASSM) marks a landmark moment for our field. For the 1^st time, two vibrant arthroscopic communities, representing the rapidly growing clinical volume and innovation from the Indian subcontinent alongside the rigorous, multi-center European tradition, have pooled their intellectual resources to deliver a single, high-impact volume. The result is not merely a collection of papers but also a panoramic snapshot of where arthroscopy and sports medicine stand in 2026: Evidence-driven, patient-centered, and relentlessly focused on returning athletes and active individuals to their highest level of function.

At the heart of this issue lies the anterior cruciate ligament, still the most studied yet most debated structure in knee surgery. Desouza, et al.^[1,2] present two powerful meta-analyses: One demonstrating that lateral extra-articular tenodesis with femoral fixation meaningfully improves graft survival and another confirming the equivalence (with subtle advantages) of quadriceps versus hamstring autografts in primary reconstruction. These are complemented by Pichler, et al. comprehensive review^[3] on posterior tibial slope as a determinant of instability and graft failure, offering clear measurement protocols, risk-stratification algorithms, and surgical decision trees. When read together, these three papers move the needle from “which graft?” to “which patient-specific anatomic and biomechanical profile demands which combined procedure?”

Equally timely is the rehabilitation debate. Heinz, et al. systematic review and meta-analysis of randomized trials establishes that accelerated protocols deliver superior patient-reported outcome measures without compromising knee stability.^[4] In an era when elite Indian footballers (analyzed by Sivaraman, et al.)^[5] and other high-performance athletes are under pressure to return faster than ever, this evidence provides both surgeons and physiotherapists with confidence to push boundaries safely.

High tibial osteotomy (HTO) continues its renaissance as a joint-preserving cornerstone. Tripathy, et al. tracks temporal trends in the Forgotten joint score after HTO and unicompartmental knee arthroplasty,^[6] while Sinharoy, et al.^[7] demonstrate that higher correction angles increase hinge fractures yet do not worsen short-term outcomes. These data will help surgeons in resource-constrained as well as high-volume settings calibrate their correction targets with greater confidence.

Meniscal and extra-articular pathologies receive focused attention. Joshi, et al. validation of the modified Akmese’s test for posterior horn medial meniscus root tears,^[8] Kambhampati, et al. exhaustive review of popliteus tendon disorders,^[9] and Singhi, et al.^[10] update on changing trends in posterior cruciate ligament avulsion fixation together close important knowledge gaps that are frequently encountered but seldom synthesized in one place.

Shoulder instability and rotator-cuff pathology are not overlooked. Singh, et al. work on Bankart variants^[11] and Ghosh, et al.^[12] correlation of magnetic resonance imaging healing with clinical outcomes at 12 months reminds us that arthroscopic decision-making in the shoulder remains as nuanced as ever. The learning-curve scoping review by Kumar, et al.^[13] across knee, shoulder, and hip procedures offers practical guidance for fellowship directors and young surgeons navigating the steep ascent of minimally invasive mastery.

Two papers deserve special mention for their broader perspective. Vaishya, et al.^[14] bibliometric analysis of sports injury research in India from 2001 to 2025 documents an exponential rise in both quantity and quality of publications – an achievement that should make every Indian arthroscopic surgeon proud. At the same time, international voices enrich the dialogue: Vasiliadis, et al.^[15] technical report on mini-open core decompression with platelet-rich plasma for femoral-head bone-marrow edema and Tripathy, et al.^[16] management algorithm for chondromalacia patellae in elite athletes illustrates that the best ideas transcend geography. Additionally, Komar, et al. contributed a randomised pilot trial examining the effect of blood flow restriction training on knee joint position sense in healthy recreationally active adults, offering early insights into its potential influence on proprioception.^[17]

Collectively, these contributions demonstrate the following emerging truths in our specialty:

• High-quality systematic reviews and meta-analyses are no longer optional, but they are the new standard for clinical decision-making

• The Indian experience, with its unique mix of high-volume trauma, elite athletic demands, and economic pragmatism, is generating solutions that are globally relevant

• Collaboration across societies accelerates the translation of research into safer, faster, and more durable outcomes for our patients.

We express our profound gratitude to Prof. S. Arumugam (President, IAS), Dr. Thomas Patt (President, ESMA/ESSKA), and Dr. Rajeev Raman (Secretary, IAS) for their exemplary leadership and unwavering commitment that made this special joint issue possible. Their visionary initiative in establishing this historic collaboration between the IAS and ESSKA has bridged two continents, fostered an exceptional exchange of expertise, and elevated the global discourse in arthroscopy and sports medicine. The IAS–ESSKA partnership that produced this issue is therefore more than symbolic. It is a model for the future: Open, inclusive, and uncompromisingly evidence-based. We are confident that every reader will find actionable insights that will improve daily practice.

On behalf of the editorial board of JASSM, we extend our deepest gratitude to every contributing author, reviewer, and the leadership of both societies for this outstanding scientific offering. We invite the global arthroscopy community to read, debate, apply, and build upon the work presented here. The next frontier is already visible on these pages; the only question is how quickly we will reach it together!!!