Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Very warm welcome to our new Associate Editors Dr. Ayoosh Pareek, Dr. Cécile Batailler and Dr. Choon Chiet Hong.","authors":"Michael T Hirschmann, Elmar Herbst, Giuseppe Milano, Volker Musahl","doi":"10.1002/ksa.12591","DOIUrl":"https://doi.org/10.1002/ksa.12591","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 3","pages":"800-801"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502018","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":"Mean distraction force applied in tension-controlled ligament-balanced total knee arthroplasty: A systematic review and meta-analysis.","authors":"Roland Becker, Maximilan Voss, Jonathan Lettner, Robert Hable, Mahmut Enes Kayaalp, Reha Tandogan, Pier Indelli, Nikolai Ramadanov","doi":"10.1002/ksa.12629","DOIUrl":"https://doi.org/10.1002/ksa.12629","url":null,"abstract":"<p><strong>Background: </strong>Proper tension of the collateral ligaments is the key to success in total knee arthroplasty (TKA). The study aimed to identify the distraction force for the medial and lateral femorotibial compartments in tension-controlled ligament-balanced TKA at 0° and 90° of knee flexion.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed up to 31 December 2024 to identify studies that reported exact values of the distraction force applied in tension-controlled ligament-balanced TKA. Mean distraction force at 0° and 90° of knee flexion were calculated for the native knee, cadaver knee, and computer model/artificial knee groups. Differences between groups were calculated using Kruskal-Wallis and Mann-Whitney U tests, with p ≤ 0.05 considered significant. A frequentist meta-analysis of subgroup analysis between native and cadaver knee studies was performed using a random effects model with inverse variance and the Sidik-Jonkman heterogeneity estimator with Hartung-Knapp adjustment to calculate participant age and sex.</p><p><strong>Results: </strong>Out of 116 included primary studies involved, a total of 6869 participants had distraction force measurements during TKA. The mean distraction force was 149.9 N (35.0-320.0 N) at 0° knee extension and 139.5 N (14.7-244.7 N) at 90° of flexion. Using the Kruskal-Wallis test or the Mann-Whitney U test, there were no significant differences in distraction force between native knee, cadaver knee, computer model/artificial knee studies at extension (p = 0.2480 and p = 0.1130) and at 90° of knee flexion (p = 0.8439 and p = 0.6241).</p><p><strong>Conclusion: </strong>This meta-analysis is the first to quantify distraction force in TKA, providing essential reference values of 149.9 N at 0° extension and 139.5 N at 90° flexion. These findings offer valuable guidelines for intraoperative soft tissue management during TKA procedures. The consistency of distraction force across different experimental models suggests that these values are broadly applicable. However, it remains unclear whether a more personalized distraction force should be considered for gap preparation.</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":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515883","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":"Digital twin systems for musculoskeletal applications: A current concepts review.","authors":"Pedro Diniz, Bernd Grimm, Frederic Garcia, Jennifer Fayad, Christophe Ley, Caroline Mouton, Jacob F Oeding, Michael T Hirschmann, Kristian Samuelsson, Romain Seil","doi":"10.1002/ksa.12627","DOIUrl":"https://doi.org/10.1002/ksa.12627","url":null,"abstract":"<p><p>Digital twin (DT) systems, which involve creating virtual replicas of physical objects or systems, have the potential to transform healthcare by offering personalised and predictive models that grant deeper insight into a patient's condition. This review explores current concepts in DT systems for musculoskeletal (MSK) applications through an overview of the key components, technologies, clinical uses, challenges, and future directions that define this rapidly growing field. DT systems leverage computational models such as multibody dynamics and finite element analysis to simulate the mechanical behaviour of MSK structures, while integration with wearable technologies allows real-time monitoring and feedback, facilitating preventive measures, and adaptive care strategies. Early applications of DT systems to MSK include optimising the monitoring of exercise and rehabilitation, analysing joint mechanics for personalised surgical techniques, and predicting post-operative outcomes. While still under development, these advancements promise to revolutionise MSK care by improving surgical planning, reducing complications, and personalising patient rehabilitation strategies. Integrating advanced machine learning algorithms can enhance the predictive abilities of DTs and provide a better understanding of disease processes through explainable artificial intelligence (AI). Despite their potential, DT systems face significant challenges. These include integrating multi-modal data, modelling ageing and damage, efficiently using computational resources and developing clinically accurate and impactful models. Addressing these challenges will require multidisciplinary collaboration. Furthermore, guaranteeing patient privacy and protection against bias is extremely important, as is navigating regulatory requirements for clinical adoption. DT systems present a significant opportunity to improve patient care, made possible by recent technological advancements in several fields, including wearable sensors, computational modelling of biological structures, and AI. As these technologies continue to mature and their integration is streamlined, DT systems may fast-track medical innovation, ushering in a new era of rapid improvement of treatment outcomes and broadening the scope of preventive medicine. Level of Evidence: Level V.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483406","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":"Landmarks to guide femoral insertion in lateral patellofemoral ligament reconstruction: An in vivo assessment of isometry.","authors":"Miriam R Boot, Sebastiaan A W van de Groes, Esther Tanck, Dennis Janssen","doi":"10.1002/ksa.12635","DOIUrl":"https://doi.org/10.1002/ksa.12635","url":null,"abstract":"<p><strong>Purpose: </strong>Lateral patellofemoral ligament (LPFL) reconstruction addresses medial patellar instability, but uncertainty regarding the optimal femoral attachment site may affect isometry and increase complication rates. This study aimed to establish landmarks for the femoral attachment of the LPFL graft based on in vivo isometry during active knee extension.</p><p><strong>Methods: </strong>Dynamic computed tomography scans of 104 knees from 58 healthy participants were employed to examine flexion-extension movements. Length changes were assessed in approximately 1335 virtual LPFL graft fibres, which extended from the proximal one third of the patellar height to attachments across the femoral condyle. Four methods were evaluated for achieving (near-)isometric LPFL graft behaviour: three radiographic methods (R1-R3) and one anatomic method (A). Method R1 positioned the femoral attachment at a lateral equivalent of Schöttle's point, Method R2 at the centre of the trochlear groove arc, Method R3 at the centre of the lateral trochlear ridge arc and Method A at a point relative to the lateral epicondyle.</p><p><strong>Results: </strong>Median length changes during extension were 7.7 mm (Method R1), 3.4 mm (Method R2), 2.7 mm (Method R3) and 3.0 mm (Method A). Method R3 demonstrated significantly smaller length changes compared to Methods R1 (p < 0.001) and R2 (p < 0.01), while Method A yielded smaller changes than Method R1 (p < 0.001). Notably, Method R1 resulted in continuous LPFL graft tightening throughout knee motion, whereas Methods R2, R3 and A showed initial tightening until 20° flexion, followed by slackening and near-isometric behaviour.</p><p><strong>Conclusion: </strong>Femoral graft attachment is best determined at the centre of the lateral trochlear ridge arc (Method R3) or 15.1 mm anterior and 3.4 mm proximal to the lateral epicondyle (Method A). These guidelines help improve surgical precision and minimize complications in LPFL reconstructions.</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":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483420","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":"Satisfactory 10-year survivorship of medial opening wedge high tibial osteotomy for isolated medial compartment osteoarthritis and varus alignment: An analysis from a high-volume institution.","authors":"Cristian A Brito Ayet, Fabio Mancino, Yoong P Lim, Kevin Qian, George Jacob, David A Parker","doi":"10.1002/ksa.12633","DOIUrl":"https://doi.org/10.1002/ksa.12633","url":null,"abstract":"<p><strong>Purpose: </strong>Medial opening wedge high tibial osteotomy (MOWHTO) is a reliable joint-preserving surgical procedure for isolated medial compartment knee osteoarthritis (OA) and overload. The aim of this study was to evaluate the long-term survivorship and clinical outcomes of patients undergoing MOWHTO and to identify the risk factors associated with an increased risk of failure.</p><p><strong>Methods: </strong>This was a retrospective study of prospectively collected patients who underwent MOWHTO for isolated medial OA and overload between 2002 and 2023. Clinical outcomes were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity score. Radiographic analysis included hip-knee-ankle (HKA) angle and medial proximal tibial angle (MPTA). Survivorship was intended from conversion to total knee arthroplasty (TKA). Logistic regression was used to identify risk factors, and p values < 0.05 were considered significant.</p><p><strong>Results: </strong>Four hundred thirty-one patients who underwent MOWHTO were included for analysis. Males were 82.5%, and the mean age was 49.1 ± 8.0 years. The KOOS increased in any subsection at mean 5.7 ± 4.5 years of follow-up (p < 0.001). Complication rate was 35.9% and reoperation rate was 25.5% at mean 9.6 years of follow-up. Removal of metal hardware due to pain and/or discomfort was the main cause of reoperation in 22% of the patients. The cumulative rate of conversion to TKA at 5 years was 2.2%, at 10 years 17.8% and at 15 years 37.1%. Age (odds ratio [OR]: 1.05, p = 0.017), wedge thickness (OR: 1.08, p = 0.015), medial femoral condyle OA (OR: 3.41, p = 0.029), medial tibial plateau OA (OR: 2.04, p = 0.044), post-operative HKA (OR: 1.25, p = 0.031) and post-operative MPTA (OR: 1.26, p = 0.04) were associated with an increased risk of failure.</p><p><strong>Conclusion: </strong>MOWHTO yields satisfactory 10-year survivorship in patients with medial compartment isolated knee OA and overload. Age, preoperative stage of OA, cartilage wear and post-operative alignment are relevant patient-related risk factors for reduced survivorship.</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":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458600","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":"Symptoms predict total knee arthroplasty more than osteoarthritis severity: A multivariable analysis of more than 7500 knees.","authors":"Luca Bianco Prevot, Alessandro Bensa, Giuseppe Peretti, Giuseppe Filardo","doi":"10.1002/ksa.12623","DOIUrl":"https://doi.org/10.1002/ksa.12623","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple clinical factors may concur to determine the clinical trajectory leading towards total knee arthroplasty (TKA) in patients affected by knee osteoarthritis (OA). The aim of this study was to identify the main factors influencing progression to TKA in a large population of knee OA patients.</p><p><strong>Methods: </strong>A total of 7552 knees were selected from the Osteoarthritis Initiative (OAI) multicentre database. The data collected included demographic data, Kellgren-Lawrence (KL) grade, the presence of knee swelling, the frequency of swelling, visual analogue scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and the number of knees requiring TKA. The baseline data were collected as reported by the OAI database, and patients were followed up at 12, 24, 36, 48, 60, 72, 84 and 96 months, documenting whether they underwent TKA during this period.</p><p><strong>Results: </strong>A multivariable analysis was performed to identify factors independently influencing progression to TKA. At 96 months, 7.1% of knees underwent TKA. The progression to TKA correlated with age (p < 0.001), KL grade (p < 0.001), swelling frequency (p < 0.001), knee swelling (p < 0.001), VAS (p = 0.003) and KOOS (p < 0.001). Knees with KL Grades 3 and 4 had the same risk of undergoing this procedure, while the need for TKA was able to be predicted based on WOMAC pain (p = 0.035, hazard ratio [HR] = 0.864), VAS (p = 0.008, HR = 1.131) and KOOS (p = 0.02, HR = 0.966).</p><p><strong>Conclusions: </strong>This study revealed that several factors influenced progression to TKA, including age, KL grade, knee swelling, VAS pain and KOOS. However, there was no statistically significant difference between KL 3 and KL 4 in predicting the disease trajectory, and patients' clinical symptoms, as quantified by WOMAC pain subscale, VAS and KOOS, had a greater influence on progression to TKA than knee KL OA severity.</p><p><strong>Level of evidence: </strong>Level IIb.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458604","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":"Deep medial collateral ligament plays a stabilising role under degenerative medial meniscus root tears.","authors":"Luis Fernando Z Funchal, Leonardo Galibern, Rafael Ortiz, Diego C Astur, Moises Cohen, Carlos R Roesler, Eduardo A Fancello","doi":"10.1002/ksa.12610","DOIUrl":"https://doi.org/10.1002/ksa.12610","url":null,"abstract":"<p><strong>Purpose: </strong>Several posterior medial meniscal root (PMMR) repair techniques have been developed to restore the load-bearing function of the meniscus and reduce extrusion. The medial meniscotibial ligament (MMTL) has been shown to play a significant role in meniscal stability. This study evaluates the stabilising function of the MMTL by directly influencing the force exerted on the PMMR during weight-bearing and valgus motion of the knee. Our aim is to investigate whether loss of MMTL integrity is a determining factor in PMMR subluxation.</p><p><strong>Methods: </strong>Using a 3D model of the knee with parameters from experimental studies, compressive and valgus loading scenarios were simulated using the finite element method to analyse the mechanical response of different knee structures. To investigate the correlation between the integrity of the MMTL and the force acting on the PMMR, different degrees and types of injuries to both structures were modelled for comparison with the healthy joint, providing insights into their importance in preventing or correcting extrusion.</p><p><strong>Results: </strong>During compressive loading, tears in the MMTL and PMMR result in a 5.8% and 30.9% increase in meniscal extrusion, respectively, while a combined injury results in a 43.9% increase, indicating that the MMTL provides a secondary constraint against extrusion. Moreover, the importance of the MMTL in restraining extrusion becomes more pronounced as the PMMR weakens, as is typical in degenerative tears. Finally, during valgus motion, the MMTL prevents separation of the meniscus from the tibial plateau and reduces strain/stress on the PMMR.</p><p><strong>Conclusion: </strong>The integrity of the MMTL plays a crucial role in reducing meniscal extrusion and PMMR overload, particularly when the root is affected by degenerative tears. Therefore, surgical repair of the MMTL can improve meniscal function, potentially reducing the risk of osteoarthritis and should be considered as a better treatment strategy for PMMR tears.</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":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458587","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":"Management of first-time patellar dislocation: The ESSKA 2024 formal consensus-Part 1.","authors":"Lars Blønd, Marie Askenberger, Joanna Stephen, Ramazan Akmeşe, Peter Balcarek, Rene El Attal, Vasileios Chouliaras, Paolo Ferrua, Joan Minguell Monart, Geert Pagenstert, Petri Sillanpää, Manuel Vieira Da Silva, Jacek Walawski, Philippe Beaufils, Florian Dirisamer","doi":"10.1002/ksa.12620","DOIUrl":"https://doi.org/10.1002/ksa.12620","url":null,"abstract":"<p><strong>Purpose: </strong>To provide recommendations for the treatment of patients with first-time patellar dislocation (FTPD). Part I focused on clinical presentation, symptoms, diagnosis, evaluation and imaging.</p><p><strong>Methods: </strong>Fifty-four orthopaedic surgeons and one physiotherapist from 20 countries across Europe were involved in the consensus, which was the FTPD. The consensus was performed according to the European Society for Sports Traumatology, Knee Surgery and Arthroscopy consensus methodology. The steering group designed the questions and prepared the statements based on the experience of the experts and the evidence in the literature. The statements were evaluated by the ratings of the peer-review groups before a final consensus was released.</p><p><strong>Results: </strong>The consensus consists of 32 questions and statements, 13 of which will be reviewed in Part 1 of the review. There is an inverse correlation between the intensity of trauma leading to FTPD and the underlying pathoanatomic risk factors, meaning that low trauma intensity usually indicates more severe underlying abnormalities. In addition to the clinical investigation, patient age, family history, bilateral symptoms of instability and injury mechanism should be evaluated. However, reliance can be placed not only on clinical examination but also on magnetic resonance imaging scans as soon as possible, which are considered mandatory for evaluating predisposing factors such as trochlear dysplasia and patella alta and for detecting osteochondral lesions, with the exception of asymptomatic patients. Importantly, it must be recognized that in addition to recurrent instability, which affects approximately 25% of patients, a variety of symptoms are experienced by 50% of patients, such as pain, swelling, giving way, functional and psychological limitations, and a reduction in sports participation, all of which reduce their quality of life. The complications after medial patellofemoral ligament reconstruction in patients with FTPD have not yet been established; however, we know from cohorts of heterogeneous patients that the most common complications are patellofemoral pain, a reduced range of motion and patellar fracture. In total, there were 13 statements that were all accepted and achieved, 6 with strong agreements and 7 with relative agreements. The general median agreement was 8 (range 7-9). None were graded A, two were graded B, seven were graded C and 4 were graded D.</p><p><strong>Conclusion: </strong>In relation to the management of patients with first-time patellar luxation, we have worked with 13 questions and based on these we have achieved consensus on 13 statements.</p><p><strong>Level of evidence: </strong>Level I, consensus.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458597","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":"The recovery trajectory of anterior cruciate ligament ruptures in randomised controlled trials: A systematic review and meta-analysis of operative and nonoperative treatments.","authors":"Ali Ridha, Siddarth Raj, Henry Searle, Imran Ahmed, Nicholas Smith, Andrew Metcalfe, Chetan Khatri","doi":"10.1002/ksa.12626","DOIUrl":"https://doi.org/10.1002/ksa.12626","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this research was to understand the trajectory of recovery following anterior cruciate ligament (ACL) reconstruction compared to nonoperative treatments.</p><p><strong>Methods: </strong>A systematic review and meta-analysis approach was used to evaluate randomised controlled trials (RCTs). A comprehensive search was conducted on databases including Medline, Embase, Web of Science and The Cochrane Central Register of Controlled Trials up until 18 May 2023. The study focused on full-text RCTs involving patients with partial or complete ACL tears. Included were studies focusing on patients undergoing ACL reconstruction or nonoperative care. The primary outcome was characterising the effects of treatments and tracking changes in International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) outcomes over time. The secondary outcome was characterising and tracking the changes of the knee injury and osteoarthritis outcome score subscales, ACL-quality-of-life questionnaire, Lysholm, Tegner and CKRS scores.</p><p><strong>Results: </strong>A total of 84 RCTs were included. The pooled standardised mean changes for the IKDC compared with baseline were: 2.0 (95% confidence interval [CI]: 0.3-3.6) at 3 months, 2.2 (95% CI: 0.9-3.6) at 6 months, 2.2 (95% CI: 0.8-3.6) at 12 months and 2.3 (95% CI: 1.3-3.4) at 24 months. Graphs illustrating IKDC scores over time further emphasise these findings, showing a sustained improvement over time to 12 months, with a plateauing of scores past this time point. Our secondary outcome patient-reported outcome measures (PROMs) also showed a similar pattern with scores plateauing at the 12-months mark.</p><p><strong>Conclusion: </strong>Our findings suggest that the IKDC score and other PROMs are effective for tracking recovery up to 12 months. Other PROMs show pain and daily activities generally recover within 6 months, and quality of life improves up to 12 months, but PROMs show minimal improvement beyond this period. This inconsistency with a return sport period indicates that PROMs may lack the sensitivity required to assess this aspect of recovery accurately.</p><p><strong>Level of evidence: </strong>Level I.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458605","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":"Kinematic analysis of the sternoclavicular, acromioclavicular and scapulothoracic joint demonstrates significant multiplanar alterations in acromioclavicular injuries with each consecutive ligamentous injury during movements of the shoulder girdle: A whole-cadaver study.","authors":"Thomas Braeckevelt, Ian Peeters, Tanneke Palmans, Lieven De Wilde, Alexander Van Tongel","doi":"10.1002/ksa.12621","DOIUrl":"https://doi.org/10.1002/ksa.12621","url":null,"abstract":"<p><strong>Purpose: </strong>In acromioclavicular (AC) joint injuries, the kinematical interplay between the AC ligament, coracoclavicular (CC) ligaments and deltotrapezial fascia (DTF) during motions of the shoulder complex is disturbed. This study assessed kinematic alterations of sternoclavicular (SC), scapulothoracic (ST) and AC joint motion during humerothoracic and ST movements in AC injuries.</p><p><strong>Methods: </strong>Shoulder girdle motion was evaluated in 14 cadaveric shoulders in 4 conditions, consisting of an intact state and AC injuries of increasing severity by sequentially sectioning the AC and CC ligaments and DTF. Joint motions were registered during humerothoracic elevation and protraction. An optical navigation system measured three-dimensional rotations and translations in the SC, ST and AC joints.</p><p><strong>Results: </strong>Sectioning of the AC ligament increased inferior and anterior AC translation with a concomitant increase of scapular protraction. The clavicle rotated to an overall more posteriorly rotated position. Sectioning of the CC ligaments increased lateral rotation and protraction of the scapula relative to the clavicle with a concomitant inferior translation of the acromion. Also, manifest overriding of the clavicle is noted due to instability in the superoinferior and anteroposterior axes. The clavicle rotated back to an overall more anteriorly rotated position, similar to the native condition. Sectioning of the DTF further increased protraction of the scapula relative to the clavicle, while a further medial translation of the acromion under the clavicle is observed.</p><p><strong>Conclusion: </strong>The AC ligament affects anteroposterior stability, while the CC ligaments disturb stability in a superoinferior and mediolateral direction. All ligaments influence clavicular axial rotation. The DTF exacerbates alterations caused by the CC ligaments. Multiplanar decoupling results in overriding of the clavicle observed after sectioning the CC ligaments. Each sectioned ligament significantly increases scapular protraction. These findings guide further advancements in (non)surgical treatment of AC injuries to restore optimal function.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458589","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}