Freddie Mac (United States)

We are delighted to announce that Dr. Mahmut Enes Kayaalp will join the editorial leadership of Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) as Deputy Editor-in-Chief in 2026. His appointment strengthens our existing leadership team of Deputy Editors Giuseppe Milano, Elmar Herbst, and Volker Musahl, further enhancing KSSTA's ability to deliver clinically impactful, methodologically rigorous science to our global community. Dr. Kayaalp is an internationally trained orthopaedic surgeon and sports-medicine specialist with recognised expertise in knee biomechanics, ACL reconstruction, posterior tibial slope and slope-reducing osteotomies, and joint preservation. He is currently Associate Professor at the University of Health Sciences, Istanbul (Türkiye). His training spans Türkiye and Germany and includes competitive international fellowships supported by DAAD, ESSKA, AGA, and TÜBİTAK, culminating in a Sports Medicine Fellowship at the University of Pittsburgh, Department of Orthopaedic Surgery, and the UPMC Freddie Fu Sports Medicine Center. Scientifically, Dr. Kayaalp focuses on ACL biomechanics, tibial slope osteotomies, ligament reconstruction, as well as sensor-based motion analysis and applications of artificial intelligence in orthopaedics. He has authored 90+ publications (peer-reviewed articles and book chapters) and has been recognised with multiple international distinctions, including the 2025 ISAKOS Jan Gillquist Award (1st place), AOSSM Excellence in Research/Cabaud Finalist (2025), AOSSM Young Investigator Grant (co-investigator, 2023), and the ESSKA Best Poster Award (2022), alongside national awards such as the Best Oral Presentation at TUSYAD 2025. Dr. Kayaalp has contributed continuously to KSSTA's editorial work since 2017—first as a Reviewer, then as KSSTA's founding Web Editor (2019), and most recently as Associate Editor (2024). Beyond KSSTA, he serves as Co-Editor of Joint Diseases and Related Surgery (JDRS) and previously held an Editorial Board position at the Journal of Arthroplasty. He has completed 200+ manuscript reviews across leading journals, including KSSTA, JEO, AJSM, Arthroscopy, Journal of Arthroplasty, and JISAKOS. With his international training, robust scientific portfolio, and proven editorial leadership, Dr. Kayaalp brings rigour, innovation, and a global perspective to KSSTA. Together with Deputy Editors Giuseppe Milano, Elmar Herbst, and Volker Musahl, and our dedicated Editorial Board and reviewers worldwide, he will help drive KSSTA's mission: to advance excellence in knee surgery, sports traumatology, and arthroscopy—translating high-quality research into better decisions and better care for patients.

Lumbar degenerative disease and stenosis are increasingly prevalent with aging. Modern endoscopic lumbar decompression offers enhanced visualization, reduced tissue disruption, and lower morbidity compared with open surgery, with comparable clinical outcomes. Despite higher costs and a significant learning curve, endoscopy remains a valuable minimally invasive option for treating lumbar spine pathology.

The integration of artificial intelligence (AI), the rise of mega‐journals, and the manipulation of impact factors present challenges to scientific integrity. These trends threaten the core principles of objectivity, reproducibility, and transparency. This editorial highlights two categories of threats: (1) external pressures, such as AI misuse and metric‐driven publishing models, and (2) internal systemic flaws, including the ‘publish or perish’ culture and methodological fragility. Mega‐journals, characterized by high‐volume publishing and broad interdisciplinary scopes, improve accessibility and accelerate dissemination. However, the emphasis on publication volume might weaken the rigor of peer review. To navigate these challenges, the authors propose a balanced approach that harnesses innovation without compromising scientific integrity. Proposed solutions include mandating AI transparency through frameworks like CONSORT‐AI, and redefining impact metrics to emphasize reproducibility, mentorship, and societal impact alongside citations. Scientific journals should promote career opportunities less on publication quantity and more on quality. Global cooperation, via initiatives like the San Francisco Declaration on Research Assessment (DORA) and the Committee on Publication Ethics (COPE), is essential to standardize ethics and address resource disparities. This editorial proposes solutions for researchers, journals, and policymakers to realign academic incentives and uphold the ethical foundation of the science. By fostering transparency, accountability, and equity, the scientific community can preserve its ethical foundations while embracing transformative tools—ultimately advancing knowledge and serving society.Level of EvidenceLevel V.

This study examines how sports clubs in the Swiss cantons of Ticino and Vaud integrate ethical and social values into their governance by analysing their statutes. Sports clubs, as central actors in youth socialization, serve as key venues for the dissemination of values. The aim is to assess the extent to which these values are formalized, made explicit, and aligned with the Swiss Olympics’ Ethics Charter.A total of 190 statutes from clubs affiliated with various federations were analysed using a qualitative approach (MAXQDA). The coding framework was based on the values promoted by the International Olympic Committee (IOC), UNESCO, and Swiss Olympic.The results show that the promotion of sport (160 mentions) and team spirit (83 mentions) are the most frequent themes, while moral and ethical principles are less commonly cited (41 mentions). The complete absence of the verb “to transmit,” despite its centrality in the Ethics Charter, reveals a lack of formalization in how values are conveyed. Ticino clubs more frequently reference the Ethics Charter, whereas Vaud clubs place greater emphasis on fair play and anti-doping measures.These findings highlight a gap between the recognition of values and their practical implementation. To enhance the effective transmission of values to young athletes, it is necessary to harmonize the drafting of statutes, introduce training initiatives, and include monitoring mechanisms. Cette étude examine comment les clubs sportifs des cantons du Tessin et Vaud, en Suisse, intègrent les valeurs éthiques et sociales dans leur gouvernance, à travers l’analyse de leurs statuts. Les clubs sportifs, acteurs centraux de la socialisation des jeunes, constituent des lieux privilégiés de diffusion de valeurs. L’objectif est d’évaluer dans quelle mesure ces valeurs sont formalisées, explicitées et mises en lien avec la Charte d’éthique de Swiss Olympic.Au total, 190 statuts de clubs affiliés à différentes fédérations ont été analysés selon une approche qualitative (MAXQDA). La grille de codage s’appuie sur les valeurs sportives promues par le Comité International Olympique (CIO), l’UNESCO et Swiss Olympic.Les résultats montrent que la promotion du sport (160 mentions) et l’esprit d’équipe (83 mentions) sont les thèmes les plus fréquents, tandis que les principes moraux et éthiques apparaissent moins souvent (41 mentions). L’absence totale du verbe « transmettre », pourtant central dans la Charte d’éthique, souligne un manque de formalisation de la diffusion des valeurs. Le Tessin se distingue par un nombre plus élevé de références à la Charte d’éthique, alors que Vaud met davantage l’accent sur le Fair-Play et la lutte contre le dopage.Ces constats révèlent un décalage entre la reconnaissance des valeurs et leur mise en œuvre concrète. Pour renforcer la transmission effective des valeurs auprès des jeunes, il apparaît nécessaire d’harmoniser la rédaction des statuts, de prévoir des dispositifs de formation et d’intégrer des mécanismes d’évaluation.

BackgroundCoenzyme Q10 (CoQ-10) plays a vital role in cellular energy production and protection against oxidative stress. However, its absorption from orally administered forms is limited due to its poor water solubility and relatively large molecular weight. While co-ingesting CoQ-10 with a fatty meal can enhance absorption, this approach is not always practical. The aim of this study was to evaluate whether a liposomal formulation of CoQ-10 could improve its absorption compared with standard CoQ-10 without the need for the concurrent consumption of fatty foods.MethodsIn a randomized, double-blind, placebo-controlled, crossover study design, 7 men and 11 women (n = 18; age: 33.5 ± 6.4 years, height: 171.2 ± 8.1 cm, weight: 65.6 ± 8.8 kg) ingested a single dose of placebo (PLA), 100 mg of unformulated CoQ-10, or 100 mg of liposomal CoQ-10 (Lipo CoQ-10, LipoVantage®, Specnova, LLC, Tyson Corner, VA, USA). Venous blood samples were collected at 0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 h after ingestion and analyzed for plasma CoQ-10 concentrations.ResultsCoQ-10and Lipo CoQ-10 demonstrated significantly greater Cmax and AUC0-24 compared with placebo (p < 0.001). Additionally, Lipo CoQ-10 had significantly higher Cmax (+31.3%, p < 0.001) and AUC0-24 (+22.6%, p < 0.001) values as compared with CoQ-10. CoQ-10 formulations were well-tolerated, with no significant changes in safety markers (blood pressure, renal function, liver enzymes, and lipid profile; p > 0.05), indicating a favorable safety profile.ConclusionLiposomal delivery significantly enhances CoQ-10 absorption.Clinical trial registrationhttps://www.ctri.nic.in identifier CTRI/2024/04/066483.

The management of anterior cruciate ligament (ACL) ruptures is carried out differently in prevention, treatment and rehabilitation for athletes than for non‐athletes. However, different approaches to managing ACL ruptures are also discussed in different sports. This narrative review includes first time the current situation of ACL management in football by experiences from the practical routine as well as from scientific reports. No other sport shows such high number of literature reports and sufficient scientific evidence in the management of ACL ruptures like football and this article provides a football specific overview in prevention, treatment and return to sports strategies. These scientific reports underline the surgical treatment of ACL ruptures in football player and show a high sustainability and return to sports rate. However, reports from football show that despite good knowledge, the implementation of sustainable prevention and rehabilitation is difficult and needs improvement.Clinical Trial RegistrationConsidering that this manuscript is a narrative review, no clinical trial registration is neccesary.Level of EvidenceLevel V.

To provide a commentary on the indications and current state of anterior cruciate ligament (ACL) repair versus ACL reconstruction (ACLR), utilising a case-based discussion among a group of international Orthopaedic surgeons at the 2024 Freddie Fu Panther Sports Medicine Symposium. An electronically distributed survey was provided to participants of the 2024 Freddie Fu Panther Sports Medicine Symposium during the meeting with questions regarding their indications for a primary ACL repair and their views on rehabilitation, return to sport, and complications after ACL repair. Three cases were discussed, the results of the surveys were recorded, and a post-case discussion followed to reach a consensus during the case resolutions. Fifty-nine participants replied to the surveys during the symposium's 'Repair versus Reconstruction' session. For acute, complete, proximal ACL tears (modified Sherman classification I) in active patients older than 50 years, 34% of the participants would treat nonoperatively, 61% of the participants would treat with ACLR, and 5% of the participants would treat with primary ACL repair. For the same case in a 17-year-old patient, 3% of the participants would treat non-operatively, 90% of the participants would treat with ACLR, and 7% of the participants would treat with primary ACL repair. Bone-patellar tendon-bone autograft was most commonly selected for young patients (51%), while allografts were used in older patients (13.5%), and synthetic grafts were rarely considered. Consensus was achieved on ACLR as the standard of care for young patients (90%). Treatment choices in patients over 50 years were more variable (61% ACLR, 34% non-operative and 5% ACL repair). Based on the survey results, ACL repair remains a procedure with limited indications. Future clinical research is necessary to understand long-term clinical outcomes of ACL repair and to compare the clinical efficacy of ACL repair with ACLR or non-operative treatment. Level V.