Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"No difference in 5-year survivorship between cemented versus cementless total knee arthroplasty in a cohort of 5266 patients using a deep-dish mobile bearing implant.","authors":"Ophélie Manchec, Emilie Bérard, Regis Pailhé, Sébastien Lustig, Etienne Cavaignac","doi":"10.1002/ksa.12668","DOIUrl":"https://doi.org/10.1002/ksa.12668","url":null,"abstract":"<p><strong>Purpose: </strong>The best fixation method for total knee arthroplasty (TKA) remains controversial. The aim of this study is to compare the effect of cemented and cementless fixation on prosthesis survivorship. Our primary hypothesis is that there is no difference in survivorship between cemented and cementless TKA. Our secondary hypothesis is that there is no difference in aseptic revisions and functional outcomes between cemented and cementless TKA at mid-term follow-up.</p><p><strong>Methods: </strong>A multicentre retrospective study was done using data collected prospectively in a large cohort. The same deep-dish mobile bearing design was used for both cemented and cementless TKA. Patients were divided into two groups according to the fixation method. The survival rate between cemented and cementless TKA was compared. Functional outcomes were collected preoperatively and at the 5-year follow-up.</p><p><strong>Results: </strong>Of the 5266 primary TKA included, 4549 were cementless, and 717 were cemented. At 5 years, there was no significant difference between the survivorship of the cementless (98.7% [95% confidence interval, CI: 98.2-99.1]) and cemented TKA (97.6%, [95% CI: 94.1-99.1]) (p = 0.468). There was no significant difference in the surgery-free survival at 5 years between cementless (95.8% [95% CI: 94.9-96.5]) and cemented TKA (95.5% [95% CI: 92.1-97.5]) (p = 0.508) as well as in aseptic revision: cementless (96.9% [95% CI: 96.2-97.5]) and cemented TKA (97.5 [95% CI: 95.5-98.6]) (p = 0.355). There was no significant difference in the functional outcomes at 5 years.</p><p><strong>Conclusion: </strong>There was no observed difference in survivorship between cemented and cementless TKA at 5 years in this cohort of 5266 patients. Additionally, rates of reoperation and aseptic revision were similar across both fixation methods, and clinical outcomes did not differ significantly. Therefore, it may be suggested that cementless fixation is a safe option for primary TKA.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First validated automated scoring system using the diagnostic arthroscopy skill score (DASS 2.0) for assessing proficiency in virtual reality arthroscopy.","authors":"Hermann Anetzberger, Andreas Kugler, Michael Mohr, Florian Haasters, Stephan Reppenhagen, Roland Becker","doi":"10.1002/ksa.12670","DOIUrl":"https://doi.org/10.1002/ksa.12670","url":null,"abstract":"<p><strong>Purpose: </strong>Proficiency-based simulator training is a promising approach for learning the complex motor skills required for arthroscopy. However, its implementation requires an objective assessment tool to assess residents' arthroscopic skills. To address this need, an automated diagnostic arthroscopy skill score (DASS) was developed and validated as a replacement for manual scoring.</p><p><strong>Methods: </strong>An automated measurement system of arthroscopic skills was developed, replacing the manual assessment parameters of the DASS with objective measurement criteria. Data from arthroscopies performed by 20 experts were used to establish threshold values for scoring. To validate the new method, 125 videos of residents were recorded and evaluated by five raters. The results of the automated evaluation were then compared with those of established manual assessment. To assess the reliability of the manual evaluation, the intraclass correlation coefficient (ICC) and minimum detectable change (MDC) were calculated. Methodological agreement was evaluated using linear least squares regression and the Bland-Altman method.</p><p><strong>Results: </strong>A good to excellent level of reliability was found among the five raters (ICC for DASS_part1 = 0.89, 95% confidence interval [CI] = 0.84-0.92). The calculated MDC was 5.0 points. High methodological agreement was found between the manual and automated evaluations of the DASS. The 95% CI for the slope of the regression line included 1, and the 95% CI for the intercept included 0. According to the Bland-Altman method, the mean difference between manual and automated evaluations was 4.1 ± 5.4 points, and the scattering of the measurement differences was uniformly distributed, regardless of the total score.</p><p><strong>Conclusions: </strong>Automated DASS measurement is a valid and reliable tool for assessing arthroscopic skills. Its advantages, such as rater independence, precise and objective measurements, and immediate evaluation, make it a powerful tool for evaluating arthroscopic performance during simulation training.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deconstructing the age-washout phenomenon in ACL-R failure: A short survey of anatomical, physiological and genetic risk factors for ACL reinjury.","authors":"Bálint Zsidai, Ramana Piussi, Philipp W Winkler, Armin Runer, Pedro Diniz, Riccardo Cristiani, Eric Hamrin Senorski, Volker Musahl, Michael T Hirschmann, Romain Seil, Kristian Samuelsson","doi":"10.1002/ksa.12669","DOIUrl":"https://doi.org/10.1002/ksa.12669","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to physical activity after revision total knee arthroplasty: Comparative insights with primary procedure.","authors":"Louis-Paul Maugard, Constant Foissey, Cécile Batailler, Sebastien Lustig, Elvire Servien","doi":"10.1002/ksa.12638","DOIUrl":"https://doi.org/10.1002/ksa.12638","url":null,"abstract":"<p><strong>Introduction: </strong>While the return to physical activity (RTPA) after primary total knee arthroplasty (TKA) is well-documented, research on RTPA after revision TKA remains limited. This retrospective study aimed to evaluate the resumption of physical activity following revision TKA by comparing outcomes with a control group of primary TKA patients.</p><p><strong>Methods: </strong>A total of 110 revision TKA patients were matched 1:1 with 521 primary TKA patients with a minimum of 2 years of follow-up. Data collected included whether or not they had returned to physical activities, as well as the type of activity and time after surgery, pre- and post-operative University of California and Los Angeles Activity Scale (UCLA) and Forgotten Joint Score (FJS).</p><p><strong>Results: </strong>Sixty-five and four tenths per cent of revision TKA patients returned to physical activities, with a mean delay of 8.9 months. The most common activities were walking (64.5%), biking (19.1%) and swimming (16.4%). Preoperative UCLA was the only significant predictor of RTPA. Comparatively, there were no significant differences in RTPA rates between primary TKA and revision TKA groups (72.7% vs. 65.4%, n.s), but primary TKA patients returned to activity sooner (6.3 vs. 8.9 months, p < 0.001).</p><p><strong>Conclusion: </strong>This study showed that while RTPA is achievable after revision TKA in the same proportion as after primary TKA, it occurs later. These findings underline the importance of managing patient expectations regarding physical activity recovery following revision TKA.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A, U or zigzag? Athletes with ACL reconstruction follow three major psychological patterns: Results from a retrospective evaluation of a local ACL register.","authors":"Lynn Kelders, Nicky van Melick, Tristan Warren, Rob Bogie","doi":"10.1002/ksa.12664","DOIUrl":"https://doi.org/10.1002/ksa.12664","url":null,"abstract":"<p><strong>Purpose: </strong>Emotional responses during anterior cruciate ligament (ACL) rehabilitation are described as a 'linear' or 'U-shaped' pattern, indicating not all athletes exhibit the same emotional pattern. Therefore, this study aimed to (1) identify emotional patterns during the early- and mid-stage phases of rehabilitation after ACL reconstruction (ACLR), and (2) investigate differences in patient-specific characteristics among these patterns.</p><p><strong>Methods: </strong>Patients completed the Photographic Series of Sports Activities for Anterior Cruciate Ligament Reconstruction (PHOSA-ACLR), and Dutch language short Anterior Cruciate Ligament Return to Sport after Injury scale (short ACL-RSI-NL) preoperatively and 6 weeks, 3 months and 6 months postoperatively. Cluster analysis was conducted to identify groups with similar emotional score patterns over time. Changes in scores between consecutive time points (deltas) were calculated for clustering, after which the optimal number of clusters was determined, and K-means clustering was performed.</p><p><strong>Results: </strong>One hundred and twenty-eight patients completed both surveys at all time points. Patients displayed an 'A-shaped', 'U-shaped' or 'zigzag' pattern. Patients with an A-shaped PHOSA-ACLR pattern were significantly younger than patients with a zigzag pattern (p = 0.01). Recreational athletes who are not in competition less often followed an A-shaped short ACL-RSI-NL pattern (p < 0.002). Patients with an A-shaped short ACL-RSI-NL pattern had significantly higher preoperative scores than patients with a U-shaped (p < 0.001) or zigzag pattern (p < 0.003). Patients with a U-shaped short ACL-RSI-NL pattern had lower scores at six months postoperatively than those with A-shaped or zigzag patterns.</p><p><strong>Conclusions: </strong>Patients' emotions before and after ACLR follow three patterns: 'A-shaped', 'U-shaped', or 'zigzag'. These patterns are significantly related to age (PHOSA-ACLR) and level of sport involvement and preoperative readiness to RTS (short ACL-RSI-NL).</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation guidelines after autograft anterior cruciate ligament reconstruction need more graft-specific exercise recommendations-A scoping review.","authors":"Kristín Briem, Mette Kreutzfeldt Zebis, Bjarki Þór Haraldsson, Jesper Bencke, Linda Fernandes","doi":"10.1002/ksa.12666","DOIUrl":"https://doi.org/10.1002/ksa.12666","url":null,"abstract":"<p><strong>Purpose: </strong>Autografts for anterior cruciate ligament reconstruction (ACLR) are primarily harvested from the quadriceps, patellar, and semitendinosus tendons. The purpose of this scoping review was to describe available recommendations for exercise-based rehabilitation following primary ACLR with a quadriceps tendon (QT), semitendinosus tendon (ST), or bone-patellar-tendon-bone (BPTB) autograft and determine whether these recommendations included graft-specific clinical practice guidelines (CPGs).</p><p><strong>Methods: </strong>A search was conducted via three electronic databases, using variations of three main strings: 'anterior cruciate ligament reconstruction', 'rehabilitation' and 'guideline'. To be considered eligible, publications had to be published between 2014 and 2024, target patients 16 or older, and include exercise-based recommendations for rehabilitation after primary ACLR using QT, BPTB or ST autografts. Identified papers were screened for title, abstract and full text in accordance with a pre-registered protocol, with specific inclusion and exclusion criteria. Charting of data found within eligible publications was done according to their overall exercise-based content, as well as any graft-specific considerations.</p><p><strong>Results: </strong>A total of 1083 publications were imported for screening, but after the removal of duplicates and subsequent screening of titles, abstracts and 98 full texts, 17 remained for inclusion. The timeline and implementation of different exercise modalities involving knee joint loading varied during the earliest phases of rehabilitation. Sixteen papers included one or more graft-specific considerations, the majority of which focused on protecting the graft and/or considerations relating to the BPTB harvest site. Few focused on the ST or QT harvest sites, and only one publication provided guidelines that considered all three autografts.</p><p><strong>Conclusion: </strong>CPGs providing exercise recommendations and post-surgical considerations for all three autograft types are needed. These would provide a comprehensive and valuable resource for clinicians to plan rehabilitation for patients who have undergone ACLR, mindful of graft choice and surgical procedure.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semitendinosus tendons in physically immature patients have a lower type I collagen content.","authors":"Yushin Mizuno, Yasushi Takata, Kazuaki Yoshioka, Naoki Takemoto, Manase Nishimura, Kentaro Fujita, Takuya Sengoku, Sakae Miyagi, Satoru Demura, Junsuke Nakase","doi":"10.1002/ksa.12673","DOIUrl":"https://doi.org/10.1002/ksa.12673","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the collagen composition of the semitendinosus and quadriceps tendons at different levels of physical maturity.</p><p><strong>Methods: </strong>Tissue samples were collected from 70 patients who underwent anterior cruciate ligament or medial patellofemoral ligament reconstruction using the semitendinosus or quadriceps tendon. The samples were immunostained to identify type I and type III collagen. Confocal microscopy and image analysis software were used to determine the percentage composition of collagen types (type I + type III, 100%). Patients were categorized into three groups based on age and epiphyseal patency: immature (<20 years, >1.5 mm), young (<20 years, <1.5 mm) and adult (>20 years). The Mann-Whitney U test was used to analyze differences between the immature and other groups in the semitendinosus tendon group. The percentage of collagen content in the semitendinosus and quadriceps tendons was evaluated based on the patient's maturity level.</p><p><strong>Results: </strong>The median type I collagen content in the semitendinosus tendon was 54.2% (40.9-75.4), 98.9% (81.0-99.6) and 97.0% (40.0-100.0) in the immature (n = 6), young (n = 8) and adult (n = 18) groups, respectively. For the quadriceps tendon, the values were 98.4% (68.9-100.0), 89.1% (68.6-98.9) and 85.6% (72.3-99.6) in the immature (n = 11), young (n = 14) and adult (n = 13) groups, respectively. The semitendinosus tendon in the immature group had significantly lower type I collagen content than in the young and adult groups. Additionally, in the immature group, type I collagen content was significantly lower in the semitendinosus tendon than in the quadriceps tendon.</p><p><strong>Conclusions: </strong>A comparison of collagen composition between the semitendinosus and quadriceps tendons, based on patient maturity level, revealed that the semitendinosus tendon in immature patients had a lower percentage of type I collagen than in mature patients and lower than the quadriceps tendon.</p><p><strong>Level of evidence: </strong>Not applicable.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision rates and progression to shoulder arthroplasty after arthroscopic repair of massive rotator cuff tears.","authors":"Umile Giuseppe Longo, Alberto Lalli, Benedetta Bandini, Alice Piccolomini, Nathan S Ullman, Andrea Vaiano, Pieter D'Hooghe","doi":"10.1002/ksa.12651","DOIUrl":"https://doi.org/10.1002/ksa.12651","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this systematic review was to assess the rate of progression to reverse total shoulder arthroplasty (RTSA) and to other interventions as revision surgeries after an arthroscopic repair of a massive rotator cuff tear (MRCT). Additionally, the review aimed at defining the best arthroscopic approach for the treatment of MRCTs in terms of failure and revision rates.</p><p><strong>Methods: </strong>The purpose of this systematic review and meta-analysis was to evaluate the rates of progression to reverse total shoulder arthroplasty in patients who underwent primary arthroscopic repair of an MRCT with different arthroscopic procedures. A meta-analysis was performed to compare the rate of progression to revision surgery and reverse total shoulder arthroplasty.</p><p><strong>Results: </strong>Eighteen articles were included in the qualitative synthesis and 14 articles were included in the meta-analysis. Overall, 934 patients and 950 shoulders were involved in the review. Seven-hundred and thirty patients and 735 shoulders were included in the meta-analysis. The proportion of revisions to reverse total shoulder arthroplasty was 0.9%, 3.3% and 0.1% for complete repair, partial repair and superior capsular reconstruction, respectively. No statistically significant differences were found across the groups in terms of progression to reverse total shoulder arthroplasty (n.s.). The average proportions of revisions to interventions different than reverse total shoulder arthroplasty. were 0.9% for complete repair, 2.0% for partial repair and 2.0% for superior capsular reconstruction again, no statistically relevant difference was found among the groups (n.s.).</p><p><strong>Conclusions: </strong>The current review finds no statistically significant differences in the progression to reverse total shoulder arthroplasty or other revision procedures among partial repair, complete repair and superior capsular reconstruction for massive irreparable rotator cuff tears. It is crucial to understand the long-term outcomes of different surgical techniques for massive rotator cuff tears, particularly regarding failure rates and progression to further procedures.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting terminology: The transition from 'functional alignment' to 'functional knee positioning'.","authors":"Christos Koutserimpas, Luca Andriollo, Pietro Gregori, Francesco Zambianchi, Eleftherios Tsiridis, Fabio Catani, Sébastien Lustig","doi":"10.1002/ksa.12667","DOIUrl":"https://doi.org/10.1002/ksa.12667","url":null,"abstract":"<p><p>Functional alignment (FA), now proposed to be termed Functional Knee Positioning (FKPos), is a modern, patient-specific approach to total knee arthroplasty (TKA) that emphasises a three-dimensional (3D) methodology. This approach integrates 3D bony anatomy, mediolateral laxities in extension and flexion, and anterior compartment geometry and laxity to achieve personalised implant positioning and has evolved thanks to the development of advanced surgical aids, such as robotics. The term \"Functional Alignment\" inadequately captures the 3D nature of the technique, which leverages robotic systems to dynamically optimise patello-femoral (PF) and tibio-femoral (TF) soft tissue balance while preserving the native ligamentous structure, often referred to as the knee's 'DNA'. FKPos highlights the biomechanical decoupling of the PF and TF joints, ensuring proper PF and TF kinematics and addressing unique anatomical and alignment variations. Clinical outcomes for FKPos have demonstrated improved functional recovery, patient satisfaction and reduced complications compared to traditional alignment methods. Adopting the term FKPos more accurately represents the holistic and personalised nature of this innovative surgical approach to TKA.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unworn cartilage in total knee arthroplasty strongly deviates from 2 mm: MRI, robotic-assisted and ruler assessment.","authors":"Antonio Klasan, Victoria Anelli-Monti, Alexander Johannes Nedopil","doi":"10.1002/ksa.12671","DOIUrl":"https://doi.org/10.1002/ksa.12671","url":null,"abstract":"<p><strong>Background: </strong>Kinematic alignment (KA) in total knee arthroplasty (TKA) aims to resurface the articular surface of the pre-arthritic knee. One cornerstone of KA TKA and the basis for conventional instrumentation (CI) is a 2 mm cartilage thickness of the healthy distal femur. This study of image-based (CT) robotic-assisted surgery (RAS) TKA determined (1) the difference in measuring cartilage thickness using preoperative MRI, the RAS registration probe and MRI and (2) the percentage of knees with a <1.5 or >2.5 mm thickness of the unworn cartilage.</p><p><strong>Methods: </strong>Forty-two patients undergoing a TKA using an image-based RAS were included. Preoperative long-leg radiographs provided the limb phenotype. The two zones of interest for cartilage thickness were the distal unworn (DU) and posterior unworn (PU) condyle. The preoperative MRI provided cartilage thickness values for both zones. Intraoperatively, the surgeon identified the zones without cartilage wear (healthy cartilage) and measured the distance between the cartilage and bone with the RAS registration probe. After resecting the condyles, a ruler was provided to measure the cartilage thickness reference.</p><p><strong>Results: </strong>Mean patient age was 68.2 ± 4.1 years, and gender was evenly distributed. According to the phenotype classification, there were 8 NEU_HKA0°, 13 VAR_HKA3°, 9 VAR_HKA6°, 5 VAR_HKA9°, 4 VAL_HKA3°, 2 VAL_HKA6° and 1 VAL_HKA9° patient. The difference between measurement techniques was not statistically significant for both zones (DU p = 0.960, PU p = 0.267). In seven patients (16.7%), the DU cartilage thickness was >2.5 mm measured with any of the three techniques, and up to 50% of patients had unworn cartilage thickness <1.5 mm, depending on the zone and measurement technique.</p><p><strong>Conclusion: </strong>There is a significant variation of unworn cartilage thickness from the assumed 2 mm, with a significant proportion (up to 67.7%) having >2.5 or <1.5 mm. If KA is applied, additional preoperative or intraoperative measurements might provide valuable information to avoid the risk of femoral component malposition.</p><p><strong>Level of evidence: </strong>Level II, diagnostic study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}