Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Collaboration is our most powerful resistance in an increasingly fragmented world: Science is the light that reveals the unity beneath our differences","authors":"Mahmut Enes Kayaalp, Annunziato Amendola, Olufemi R. Ayeni, Roland Becker, Berte Boe, Nicolaas C. Budhiparama, Jeffrey R. Dugas, Tahir Durmus, João Espregueira-Mendes, Michael Hantes, Elmar Herbst, Jon Karlsson, Li Ke, Christoph Lutter, Thomas Neri, Daniel Perez-Prieto, Robert Prill, Bruce Reider, Mo Saffarini, Marc R. Safran, Erdem Aras Sezgin, Daniel C. Wascher, Stefano Zaffagnini, Michael T. Hirschmann","doi":"10.1002/ksa.70193","DOIUrl":"10.1002/ksa.70193","url":null,"abstract":"<p>In a world increasingly defined by fragmentation and alienation across nations, disciplines, and diverse political and ideological divides, science remains a key universal bridge for humanity. It speaks not by denying difference, but by engaging in a pursuit of shared truths. At its heart, the spirit of scientific collaboration is a quiet but profound call for unity that emphasizes collaboration and respect for the movement of ideas and experiments forward. Cultural differences and divergent opinions do not have to lead to limitations in our scientific work. Collaboration and mutual respect are the keys to successful enquiry.</p><p>True discovery does not occur in isolation, but is rather a result of collaboration, rooted in curiosity, humility, honesty and collective striving. Across cultures and generations, this shared endeavour affirms our interconnectedness. In times of social uncertainty and division, science, sports and art can all create and reinforce frameworks for solidarity. Collaboration is not merely a strategy for discovery; it is a philosophy of belonging and a necessary resistance to disconnectedness, not only now, but also in the future.</p><p>As the world grows more complex and interconnected, paradoxically, we often find ourselves drifting further apart. Social, cultural, political and ideological divides quietly shape our realities, often in ways we do not fully recognize or even understand. This fragmentation is exacerbated by the rapid spread of misinformation, the rise of echo chambers, and persistent economic and technological disparities that deepen societal rifts. Yet amid the current geopolitical turbulence, science remains a quiet bridge, linking minds, institutions and nations across vast distances in the pursuit of shared knowledge. This editorial is a joint reflection on the deeper purpose of science: to keep searching for truth as a lasting goal, not only for new discoveries, but also to protect and grow an environment where trust, open discussion and shared learning can thrive.</p><p>Science cares not for your origin; it values your desire to know and understand. It is universal in its approach: empirical, reproducible, and open to change. It speaks through data and evidence, not ideology or dogma. Every piece of knowledge, every data point, is a testament to human curiosity. Whether a discovery is made in a small hospital or a world-renowned institution, the findings resonate globally. Science is not bound by geography; its truths belong to everyone.</p><p>This capacity to transcend borders has made science a rare constant in an uncertain world. As Louis Pasteur wrote, ‘Science knows no country because knowledge belongs to humanity’. Pasteur's work, rooted in 19th-century France, continues to save lives in every corner of the world [<span>3</span>]. For him, it was never about national pride; it was about shared well-being and health [<span>5</span>].</p><p>There are modern examples that confirm this timeless ","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1190-1197"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined medial collateral ligament and posterior oblique ligament reconstruction demonstrates favourable patient-reported outcomes and medial knee stability in Grade III injuries: A systematic review","authors":"Ayomide Michael Ade-Conde,&nbsp;Michelle Cruickshank,&nbsp;Marc Daniel Bouchard,&nbsp;Prushoth Vivekanantha,&nbsp;Meshal Alomari,&nbsp;Darren de SA,&nbsp;Jeffrey Kay","doi":"10.1002/ksa.70344","DOIUrl":"10.1002/ksa.70344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess clinical and functional outcomes of combined medial collateral ligament and posterior oblique ligament (MCL–POL) reconstruction in isolated and multiligamentous Grade III medial knee injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted according to PRISMA and Cochrane guidelines. MEDLINE, EMBASE and CENTRAL were searched to 13 August 2025. Studies were eligible if they included patients undergoing combined MCL–POL reconstruction for acute or chronic medial knee instability and reported clinical, functional or radiographic outcomes. Studies involving MCL or POL repair, advancement or non-reconstructive procedures were excluded. Data on patient characteristics, surgical technique, patient-reported outcome measures (PROMs), valgus stability, return to sport and complications were extracted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve studies met the inclusion criteria, involving 350 patients (61.7% female). Mean age was 33.1 ± 4.4 years (range: 27.4–45.6), with mean follow-up of 41.5 ± 13.5 months (range: 12–86). Mean postoperative Lysholm, subjective International Knee Documentation Committee and Tegner scores were 86.0 (range: 74.8–93.4), 76.3 (range: 66.4–87.8) and 4.9 (range: 3.5–7), respectively, with post-operative values exceeding established minimal clinically important difference (MCID) thresholds where applicable. Return to recreational or high-level sport ranged from 64% to 91%. Valgus opening on stress radiographs decreased from 7.5 to 1.2 mm, and 88% of knees were graded as ‘normal’ or ‘nearly normal’ on the IKDC objective scale. The overall complication rate in 327 patients was 20.2%, most commonly arthrofibrosis (5.8%) and superficial infection (4.6%). MCL–POL graft failure was uncommon (1.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This systematic review suggests that MCL–POL reconstruction for Grade III MCL injuries in isolated and multiligamentous injury patterns may provide reliable short to mid-term clinical and functional outcomes, with greater medial stability than previously reported and acceptable safety profile. However, a lack of standardization and consensus in surgical technique remains, and future prospective studies are needed to determine the comparative efficacy of different techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1292-1309"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of anterior cruciate ligament reconstruction with and without lateral extra-articular tenodesis: A meta-analysis","authors":"Yi Zhang,&nbsp;Sharon Si Heng Tan,&nbsp;Andrew Kean Seng Lim,&nbsp;James Hoi Po Hui","doi":"10.1002/ksa.12726","DOIUrl":"10.1002/ksa.12726","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Rotational instability, post-operative high-grade pivot shifts and graft re-rupture are areas of debate in anterior cruciate ligament reconstruction (ACLR). Lateral extra-articular tenodesis (LET) techniques can control rotational laxity and reduce re-rupture by strengthening the anterolateral knee. Over-constraint and early-onset osteoarthritis are documented sequelae. This review compares the clinical, functional and patient-reported outcomes of ACLR with and without LET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies on the comparative outcomes of ACLR with and without LET were identified. All clinical, functional and patient-reported outcomes were extracted. The quality of each study was assessed. Random-effects model was then used to obtain pooled estimates of procedural differences for each outcome if they were reported by three or more studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies and 3225 patients were included. ACR with LET conferred statistically significant better laxity reduction through KT1000 testing with pooled RR estimate of 0.83 (95% confidence interval [CI], 0.73–0.95) and a better side-side comparison of anterior tibial translation with pooled WMD estimate of 0.61 (95% CI, 0.22–0.99). LET further lowered rates of graft failure/re-rupture with a pooled RR estimate of 0.93 (95% CI, 0.90–0.95). There was no significant difference in time taken for return to sports with a pooled WMD estimate of 0.00 (95% CI, −1.80 −1.80) or in subjective patient-reported outcome measures such as IKDC subjective score with a pooled WMD estimate of −0.75 (95% CI, −2.18 to 0.68), Lysholm score with a pooled WMD estimate of −1.73 (95% CI, −4.12 to 0.67), or Tegner activity index with a pooled WMD estimate of −0.55 (95% CI, −1.11 to 0.02). Osteoarthritic data was not assessed in this review due to the lack of data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LET addition confers better clinical outcomes over isolated ACLR. However, there is no significant difference between functional outcomes regarding returning to sports or subjective patient-reported outcome measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>Level II.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1271-1291"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278118","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":"Excellent functional outcome and satisfactory revision rates of two-staged bicompartmental knee arthroplasty for disease progression following unicompartmental knee arthroplasty","authors":"Conradin Schweizer,&nbsp;Wenzel Waldstein,&nbsp;Valentin Rühle,&nbsp;Niels Urban,&nbsp;Tatjana Krug,&nbsp;Joachim Herre,&nbsp;Peter R. Aldinger,&nbsp;Christian Merle","doi":"10.1002/ksa.70040","DOIUrl":"10.1002/ksa.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Disease progression in the untreated compartment is the leading cause for reoperation following unicompartmental knee arthroplasty (UKA). A less-invasive alternative to total knee arthroplasty (TKA) conversion is the addition of a second UKA. The study assessed survival, functional, and radiological outcomes after two-staged bicompartmental UKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was performed on 102 knees (98 patients, mean age 73.7 years) who received an additional medial (<i>n</i> = 29) or lateral UKA (<i>n</i> = 73) between 2016 and 2025 with a minimum follow-up of 1 year. Primary outcomes were cumulative revision rates for (1) any reoperation and (2) implant revision. Functional outcomes included the Oxford Knee Score (OKS) and UCLA (University of California, Los Angeles) Activity Score. Radiographic assessment included measurement of the hip-knee-ankle angle (HKAA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean follow-up was 4.0 years (SD 2.1). At 9 years, cumulative survival rate was 84.3% (95% CI: 0.763–0.923) for any reoperation and 89.3% (95% CI: 0.822–0.964) for implant revision. There were nine implant revisions (8.8%), most commonly due to medial mobile-bearing dislocation (44.4%). In 50%, implant revision to TKA was performed using primary non-modular components. Mean postoperative OKS and UCLA scores were 40.4 (SD 8.0) and 5.5 (SD 1.7), respectively. Medial osteonecrosis (ON) following primary lateral UKA accounted for 38% (11/29) of all indications for an additional medial UKA, and was associated with greater HKAA correction following prior lateral UKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Two-staged bicompartmental UKA is a viable less-invasive alternative to TKA conversion for patients with disease progression or ON after primary UKA. This approach demonstrates excellent mid-term functional outcomes and satisfactory implant survivorship, providing valuable evidence to support its role as a contemporary revision option Fixed-bearing implants for additional medial UKA are advised to eliminate the risk of bearing dislocations. In the absence of major complications, conversion to non-modular TKA components is feasible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1336-1345"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071644","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":"Incidence of meniscal tears in skeletally immature patients with anterior cruciate ligament (ACL) rupture: Medial tears are more common in patients closer to skeletal maturity while lateral tears in those with more remaining growth","authors":"Alberto Grassi,&nbsp;Emre Anil Ozbek,&nbsp;Yuta Nakanishi,&nbsp;Kyle Borque,&nbsp;Luca Ambrosini,&nbsp;Stefano Zaffagnini","doi":"10.1002/ksa.12729","DOIUrl":"10.1002/ksa.12729","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To report the prevalence of meniscal tears observed in patients with open physis and anterior cruciate ligament (ACL) rupture and to examine the relationship between meniscus tears and remaining growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Skeletally immature patients who underwent ACL reconstruction between June 2022 and June 2024 in a single institute were included. Patients were considered skeletally immature if the pre-operative knee magnetic resonance imaging (MRI) revealed an open physis. MRI was used to determine the bone age of the patients, and the patients were divided into two groups as &gt;1-year and &lt;1-year remaining growth. Independent sample t-test was used to compare the continuous variables with normal distribution, while the Mann–Whitney <i>U</i> test was used in the case of non-normal distribution. Fisher exact test to compare dichotomous categorical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 57 skeletally immature patients (77% male), with a mean age of 14.8 ± 1.4 years, underwent ACL reconstruction during the study period. A total of 61 meniscal tears were found in 58 patients, resulting in 84% of patients having at least one meniscus tear. Lateral meniscus (65%) tears were observed most frequently during arthroscopy. Moreover, longitudinal tears (23%) were found to be the most common lateral meniscus pathology and Ramp lesion (35%) was found to be the most common medial meniscus pathology. A significantly higher prevalence of meniscal tears was reported in patients with &gt;1-year of remaining growth (<i>p</i> = 0.0162). While medial meniscus tears are more common (52% vs. 18%; <i>p</i> = 0.0195) in patients with ≤1-year remaining growth, lateral meniscus tears are more common in patients with &gt;1-year remaining growth (88% vs. 55%; <i>p</i> = 0.0179).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Medial meniscus tears were more present in patients close to skeletal maturity while lateral tears were more common in patients with higher remaining growth. Considering the high number of false negatives of meniscal tears in preoperative MRI, high suspicion for specific tears should be used taking into account also the patient's remaining growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1209-1220"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304321","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 novel knee implant for total knee arthroplasty meets expectations at 10 years. First long-term follow-up report of clinical outcomes and survivorship","authors":"Alice Montagna,&nbsp;Marina Marescalchi,&nbsp;Virginia Cinelli,&nbsp;Rudy Sangaletti,&nbsp;Luca Andriollo,&nbsp;Francesco Benazzo,&nbsp;Stefano Marco Paolo Rossi","doi":"10.1002/ksa.70037","DOIUrl":"10.1002/ksa.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Achieving a “forgotten knee” after total knee arthroplasty (TKA) remains a primary goal in modern knee replacement surgery. Anatomic implant designs aim to replicate native knee anatomy and kinematics, potentially improving patient satisfaction and functional outcomes. This study evaluates the long-term clinical outcome and survivorship of the Persona Knee System at a minimum follow-up of 10 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>116 TKAs performed using the Persona Posterior Stabilised (PS) Knee System (Zimmer Biomet, Warsaw, Indiana, USA) between 2013 and 2014 at a high-volume orthopaedic centre were prospectively followed and retrospectively analysed. Clinical outcomes were assessed using patient-reported outcome measures (PROMs), including the Forgotten Joint Score-12 (FJS-12), Oxford Knee Score (OKS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Implant survivorship was determined using Kaplan-Meier analysis, and complication rates were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At a mean follow-up of 11.1 years, 116 knees were available for analysis. Patients were assessed clinically and radiographically at 1, 3 and 6 months postoperatively, and then annually, with a mean follow-up of 11.1 years. The mean FJS-12 was 69.52 (SD 12.21, range 15–88), indicating a high level of joint awareness reduction. The OKS and WOMAC scores significantly improved postoperatively, with mean final values of 38.63 (SD 7.99, range 7–48) and 25.29 (SD 16.97, range 4–91), respectively. Radiological analysis demonstrated accurate and stable implant positioning, with no progressive radiolucent lines in non-revised cases. Kaplan–Meier survival analysis showed a 95.7% (SD 1.9%) implant survival rate. The revision rate was 4.3%, with aseptic loosening and persistent painful prosthesis as the primary causes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The anatomic design of the Persona Knee System provides excellent long-term clinical outcomes, high patient satisfaction, and sustained implant durability. Future research should further investigate patient-specific factors and surgical refinements to optimise long-term outcomes in TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1318-1326"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescence risk factors for meniscus and ligamentous knee injuries in adulthood: A longitudinal study","authors":"Matias Vaajala,&nbsp;Alisa Teuho,&nbsp;Rasmus Liukkonen,&nbsp;Ville Ponkilainen,&nbsp;Arja Rimpelä,&nbsp;Leena K. Koivusilta,&nbsp;Ville M. Mattila","doi":"10.1002/ksa.12752","DOIUrl":"10.1002/ksa.12752","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Our aim is to investigate the influence of adolescent health-related behaviours on the occurrence of meniscus and ligament injuries in a large cohort of Finnish adolescents with an average 27-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The baseline data were surveys conducted biannually from 1981 to 1997, and these were individually linked to outcomes, as well as meniscus and ligamentous knee injuries obtained from the Care Register for Health Care. A total of 47,747 participants were included. Of these, 22,020 were male and 25,727 were female. A Cox regression model was used to analyze the associations between exposure variables in adolescence (physical activity in sports clubs, other physical activity, overweight, smoking, monthly drunkenness, presence of chronic disease, family socioeconomic status) and the risk for knee injuries. Adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) were computed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean follow-up time among the participants was 26.8 years (standard deviation [SD]: 4.1 years). A total of 1163 (2.4%) persons suffered a meniscus injury, and 1831 (3.8%) suffered a ligament injury. High physical activity in sports clubs (aHR: 2.02, CI: 1.85–2.21), overweight (aHR: 1.37, CI: 1.12–1.68), monthly drunkenness (aHR: 1.37, CI: 1.19–1.57) and presence of chronic disease (aHR 1.30, CI 1.08–1.56) increased the risk for meniscus injuries. Similarly, high (aHR: 1.72, CI: 1.60–1.84) physical activity in sports clubs, overweight (aHR: 1.26, CI 1.07–1.47), monthly drunkenness (aHR: 1.26, CI 1.13–1.41) and presence of chronic disease (aHR: 1.36, CI: 1.17–1.57) increased the risk for ligament injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Frequent physical activity in sports clubs presented a higher risk for meniscus and knee ligament injuries in individuals under 40, compared to degenerative factors such as being overweight or smoking. Interventions focusing on the suitable load level among adolescents with frequent and high-intensity physical activity, in addition to efforts to reduce negative habits should be prioritized to lower the knee injury risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1245-1256"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The number of prior knee arthroscopies is associated with an incremental increase in risk of revision in a subsequent total knee arthroplasty","authors":"Julius Tetens Hald,&nbsp;Anders Odgaard,&nbsp;Michael Mørk Petersen,&nbsp;Anders El-Galaly","doi":"10.1002/ksa.70038","DOIUrl":"10.1002/ksa.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to estimate the relative risk of revision for total knee arthroplasty (TKA) with prior knee arthroplasties compared to TKAs in knees without prior surgery. In addition, this study aimed to assess if there was a dose-response relationship between the number of prior knee arthroscopies and the risk of TKA revision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study of three Danish Health Registries. All primary TKAs performed in Denmark from 1998 to 2021 were identified. Knee arthroscopies prior to primary arthroplasty were identified for these knees. The patients were grouped by whether they had an arthroscopy prior to the TKA or not. Kaplan–Meier analysis and Cox regression analysis was used to estimate implant survival and hazard ratio (HR) for revision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 96,781 primary TKAs without prior surgery (de novo TKA) and 15,042 primary TKAs that had had one or more arthroscopies as only prior surgery. After adjusting for age, sex, and Charlson Comorbidity Index (CCI) the HR for revision was 1.38 (95% confidence interval [CI] 1.29–1.47, <i>p</i> &lt; 0.001) for knees with prior arthroscopy compared to knees without prior arthroscopy. After adjusting for age, sex, and CCI each additional arthroscopy increased the HR for revision of 1.27 (95% CI 1.21–1.33, <i>p</i> &lt; 0.001) in a dose-response manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Previous knee arthroscopies increase the risk of revision following primary TKA. More importantly, each additional knee arthroscopy increased the risk by 27%. Although the exact mechanism behind the observation is unknown, this is important information for both surgeons and patients when considering treatment options for knees affected by degenerative conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective comparative study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1327-1335"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic partial meniscectomy outcomes are comparable in patients with synovitis treated by synovectomy and those without synovitis","authors":"Kyle G. Williams,&nbsp;Evangelia P. Constantine,&nbsp;Kaitlyn E. Whitney,&nbsp;Carson L. Keeter,&nbsp;Ankit Hirpara,&nbsp;Sydney A. Fry,&nbsp;Martin Boublik,&nbsp;Rachel Frank,&nbsp;James W. Genuario,&nbsp;Braden K. Mayer,&nbsp;Eric C. McCarty,&nbsp;Thomas J. Noonan,&nbsp;Jason L. Dragoo","doi":"10.1002/ksa.70202","DOIUrl":"10.1002/ksa.70202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine whether patients undergoing arthroscopic partial meniscectomy (APM) with synovitis treated by synovectomy exhibit similar outcomes to those without synovitis after 24-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 181 patients who underwent primary APM at a single institution between 2018 and 2022 were included: 87 without synovitis and 94 with synovitis treated via synovectomy involving at least two compartments. Synovitis extent was assessed intraoperatively by the surgeon. Nine Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, including three derived from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), were collected preoperatively and at 24 months postoperatively. Patient demographics, surgical details, preoperative Kellgren–Lawrence (KL) osteoarthritis (OA) grade and intraoperative outerbridge chondral scores were compared between cohorts. ‘Failures’ underwent subsequent ipsilateral knee surgery during follow-up. ‘Responders’ reached the minimal clinically important difference (MCID) by 24 months. Time-to-response analysis using Cox regression compared the time to achieve MCID between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant differences in demographics between the cohorts including age, body mass index, sex, smoking status and number of comorbidities. The treated synovitis group demonstrated greater preoperative OA severity (median KL: 2 vs. 1.5; <i>p</i> = 0.013) and intraoperative chondral degeneration (median global outerbridge: 2 vs. 1; <i>p</i> &lt; 0.001). All nine KOOS subscales improved between baseline and 24-month follow-up (all <i>p</i> &lt; 0.001). At 24 months, all KOOS subscales were similar between groups (all <i>p</i> &gt; 0.05), except WOMAC Stiffness, which was higher in the treated snifters group (24.9 vs. 17.9; <i>p</i> = 0.025). Time-to-response analysis showed no difference in time to MCID achievement (374 vs. 362 days; <i>p</i> = 0.727), and failure rates were also similar (7.4% vs. 11.5%; <i>p</i> = 0.498).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite greater OA severity and chondral degeneration, snifters treated with synovectomy in patients undergoing APM did not result in worse KOOS scores, delayed clinical response or increased risk of subsequent ipsilateral knee surgery compared to APM without synovitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 4","pages":"1234-1244"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145553113","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":"Lower body mass index, higher Beighton score, complete anterior cruciate ligament tear, concomitant injuries to medial collateral ligament, anterolateral complex and meniscus especially posterior horn are risk factors for preoperative high-grade pivot shift under anaesthesia of patients with anterior cruciate ligament injury: A systematic review and meta-analysis","authors":"Wenbin Bai,&nbsp;Weili Shi,&nbsp;Chenzhao Xu,&nbsp;Zhiyu Zhang,&nbsp;Yitian Gao,&nbsp;Jinpeng Yao,&nbsp;Sirui Tang,&nbsp;Xi Gong,&nbsp;Qingyang Meng,&nbsp;Cheng Wang","doi":"10.1002/ksa.12747","DOIUrl":"10.1002/ksa.12747","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To perform a systematic review and meta-analysis on the incidence rate and risk factors for high-grade pivot shift in patients with anterior cruciate ligament (ACL) injury. It was hypothesised that the risk factors associated with high-grade pivot shift can be successfully identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pubmed, Scopus, Embase and Web of Science databases were systematically searched from inception to March 22, 2025, to identify relevant studies. Comparative studies reporting risk factors for high-grade pivot shift were included in this analysis. A random-effects model was utilised to assess the pooled effect and identify risk factors significantly associated with high-grade pivot shift.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 16 studies investigating risk factors for high-grade pivot shift (nine defined as grade ≥II and seven defined as grade III) involving 6051 patients were included in this analysis. The overall pooled incidence rate of high-grade pivot shift was 55.8% (95% confidence interval [CI]: 40.1%, 71.5%) for grade ≥II pivot shift and 23.0% (95% CI: 15.8%, 30.3%) for grade III pivot shift. Lower body mass index (BMI; mean difference [MD], −0.42), higher Beighton score (odds ratio [OR], 1.15), complete ACL tear (OR, 6.23), and concomitant injuries to medial collateral ligament (MCL; OR, 2.86), anterolateral complex (ALC; OR, 6.66), lateral meniscus (OR, 1.62), lateral meniscus posterior horn (OR, 2.39), medial meniscus (OR, 1.32) and medial meniscus posterior horn (OR, 1.75) were identified as risk factors for high-grade pivot shift in patients with ACL injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lower BMI, higher Beighton score, complete ACL tear, concomitant injuries to MCL, ALC, lateral meniscus, lateral meniscus posterior horn, medial meniscus and medial meniscus posterior horn were significantly associated with an increase of risk for high-grade pivot shift in patients with ACL injury. Clinicians are supposed to pay more attention to these risk factors to effectively identify patients with potential rotational instability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 3","pages":"855-872"},"PeriodicalIF":5.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661766","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}