Clinical Outcomes of Arthroscopic Surgeries for Shoulder and Knee Sports Injuries

Despite significant advancements in arthroscopic techniques for shoulder and knee sports injuries (e.g., anterior cruciate ligament reconstruction, meniscus repair, and rotator cuff repair), postoperative clinical outcomes and return-to-sport rates remain highly variable among individuals. This variability is likely influenced by a complex interplay of patient baseline characteristics, specific tear morphologies, individualized intraoperative surgical choices (e.g., mechanical augmentation strategies, remnant preservation), and post-operative rehabilitation.

This single-center, prospective observational cohort study is designed to systematically collect high-granularity clinical data from patients undergoing elective arthroscopic shoulder and knee surgeries. The study will construct a structured registry that integrates highly detailed intraoperative objective assessments with standardized Patient-Reported Outcome Measures (PROMs).

The primary objective is to evaluate the mid-to-long-term functional outcomes and utilize multivariable regression models to identify independent predictive factors for success or sub-optimal recovery. Additionally, the study involves the ethical collection of discarded intraoperative tissues (e.g., synovial fluid, degenerative tendon/cartilage fragments) and residual routine blood samples. This will establish a biobank to support future "clinical-basic" translational research exploring the microenvironment of tissue healing.

By establishing this comprehensive real-world database, the investigators aim to provide robust evidence to help resolve ongoing clinical controversies in sports medicine and ultimately optimize personalized surgical and rehabilitation protocols.

• Standard of Care Shoulder Arthroscopy (Procedure): Routine, minimally invasive arthroscopic surgical procedures tailored to the patient's specific shoulder pathology, followed by standard postoperative rehabilitation. This is strictly observational; no experimental procedures are introduced.
• Standard of Care Knee Arthroscopy (Procedure): Routine, minimally invasive arthroscopic surgical procedures tailored to the patient's specific knee pathology, followed by standard postoperative rehabilitation. This is strictly observational; no experimental procedures are introduced.

Primary outcomes

• Patient-Reported Outcome Measures (PROMs) for Joint Function [Preoperative baseline, 2 weeks, 1 month, 6 months, 1 year, and 2 years postoperatively.]: Validated questionnaires evaluate function, symptoms, and QoL based on the specific cohort. 1. Higher scores indicate better outcomes (better function / less symptoms): Score 0 to 100: IKDC, Pedi-IKDC, KOOS, ACL-RSI, WOMET, Kujala AKPS, BPII 2.0, ASES, Rowe score, and EQ-5D VAS. Score 0 to 48: OSIS (Oxford Shoulder Instability) and OSS (Oxford Shoulder). Score 0 to 10: Tegner Activity Scale (higher = higher activity level). Score 0 to 16: Marx Activity Scale (higher = higher activity level). 2. Lower scores indicate better outcomes (less pain / less disability): Score 0 to 10: VAS and NRS (for pain). Score 0 to 100: Quick-DASH (upper extremity disability).

Secondary outcomes

• Incidence of Postoperative Complications [From the date of surgery up to 2 years postoperatively.]: Tracking the occurrence rate of any adverse events related to the surgery, including but not limited to surgical site infection, deep vein thrombosis (DVT), severe joint stiffness requiring manipulation, and graft failure or re-rupture requiring revision surgery.
• Pain Intensity Assessed by Visual Analog Scale (VAS) [Preoperative baseline, 2 weeks, 1 month, 6 months, 1 year, and 2 years postoperatively.]: Assessment of joint pain at rest and during activity using a 10-point Visual Analog Scale, where 0 represents "no pain" and 10 represents "worst imaginable pain."

Sex: All, ages: 8 Years to 80 Years

Inclusion Criteria:

* Age >= 8 years.
* No gender restrictions.
* Definitive diagnosis of shoulder or knee sports injuries or related joint conditions.
* Scheduled to undergo elective, standard-of-care surgery at the study center (procedures include but are not limited to: arthroscopic meniscus repair/meniscectomy, cartilage repair, cruciate ligament reconstruction, high tibial osteotomy \[HTO\], unicompartmental knee arthroplasty \[UKA\], arthroscopic rotator cuff repair, shoulder stabilization, and shoulder arthroplasty).
* Clear consciousness, with the ability to read, understand, and communicate.
* Willing and able to comply with postoperative follow-up requirements.
* Voluntarily signed the written informed consent form.

Exclusion Criteria:

* Patients requiring emergency surgery due to acute, severe trauma (e.g., open fractures, polytrauma).
* Coexisting severe neurological or psychiatric diseases, or cognitive impairment that prevents understanding of the informed consent or cooperation with follow-up.
* Patients in an involuntary state (e.g., under coercion).
* Refusal to sign the informed consent form or refusal to participate in the study.
* Currently participating in other interventional clinical trials that may confound or affect the clinical outcomes of this study.

• Yan Xiong, Doctor, Study chair, Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
• Weijun Li, Master, Principal investigator, Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China