Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"External femoral rotation of 2 degrees is associated with the lowest stuffing rates around the femur in functionally aligned TKA.","authors":"Alexander Maslaris, Eustathios Kenanidis, Nikolaos Mylonakis, Zakareya Gamie, Abtin Alvand, William F Jackson, Andrew J Price, Eleftherios Tsiridis","doi":"10.1002/ksa.12662","DOIUrl":"https://doi.org/10.1002/ksa.12662","url":null,"abstract":"<p><strong>Purpose: </strong>Modifying femoral morphology after total knee arthroplasty (TKA) poses a potential risk for ligament-imbalances and patella mal-tracking. The purpose of this study was primarily to quantify TKA-induced stuffing around the femur and secondarily assess the effect of femoral rotation (FR) on trochlear and condylar anatomy-changes.</p><p><strong>Methods: </strong>Knee anatomy-modification was quantified in 69 robotic-assisted TKAs utilising tibia-based functional alignment (FA). Caliper-measurements were performed on the medial (Med), central (Ctr), and lateral (Lat) sides of the following resection planes: anterior trochlea (AT), oblique trochlea (OT), distal condyles (DC), posterior condyles (PC) and tibia (TIB). The same caliper-measurements were performed on the femoral components used to calculate bone-implant differences and analyse possible patterns of postoperative trochlear anatomy-modifications (TAM) and condylar anatomy-modifications (CAM). Over- or understuffing analysis for different FRs and regression analysis were conducted to assess the effect of FR on CAM and TAM.</p><p><strong>Results: </strong>TAM results were Lat-AT -3.2 mm ([95% confidence interval [CI]: -3.71 to -2.63], p < 0.001), Ctr-AT 0.7 mm ([95%CI: 0.22-1.32], p = 0.02), and Ctr-OT -1.7 mm ([95%CI: -1.85 to -0.93], p < 0.001) with stuffing > 2 mm in 60.9%, 39.1%, and 39.1%, respectively. CAM results were Med-DC -3.6 mm ([95%CI: -4.14 to -3.05], p < 0.001) and Lat-PC 3.0 mm ([95%CI: 2.48-3.38], p > 0.001) with stuffing > 2 mm in 78.3% and 63.8%. FR (3.8 ± 2.6°, range: -1.6° to 8.5°) affected mostly the anterior (r = -0.40, p < 0.001) and posterior (r = 0.71, p < 0.001) aspects of the knee but hardly the OT plane (r = 0.06, p = 0.624) and the trochlear groove to its full range of flexion (r = 0.21, p = 0.17). External FR 2° was associated with the lowest incidence of femoral stuffing > 2 mm and ≥ 4 mm.</p><p><strong>Conclusions: </strong>FA-typical modification-pattern was a TAM with lateral facet understuffing, and CAM with medial distal understuffing and lateral posterior overstuffing. Trochlear groove height was non-significantly affected by FR. FA with the current off-the-shelf implant induces the lowest stuffing rates when set in 2° external femoral rotation.</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":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730695","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 patient acceptable symptomatic state for commonly used outcome scores 10 years after matrix-associated autologous chondrocyte implantation.","authors":"Kevin-Arno Koch, Raphael Trefzer, Mustafa Hariri, Paul Mick, Tilman Walker, Stefanos Tsitlakidis, Johannes Weishorn","doi":"10.1002/ksa.12661","DOIUrl":"https://doi.org/10.1002/ksa.12661","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the Patient Acceptable Symptomatic State (PASS) thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), Lysholm and EuroQol 5 Dimensions (EQ-5D) scores and to identify predictors of PASS at 10 years after matrix-associated autologous chondrocyte implantation (M-ACI).</p><p><strong>Methods: </strong>Patients who underwent M-ACI for chondral defects of the knee between 2011 and 2015 were prospectively evaluated. KOOS, IKDC, Lysholm and EQ-5D scores and anchor-based questions were assessed at baseline and at least 10 years post-operatively. PASS thresholds were determined using receiver operating characteristic (ROC) curve analyses. Multivariable binomial regression analysis was performed to determine the effect of sex, body mass index (BMI), articular cartilage maturation status and the presence of more than one previous knee surgery on the likelihood of achieving PASS.</p><p><strong>Results: </strong>A total of 112 patients who met the inclusion criteria were evaluated at a mean of 11.3 ± 1.2 years post-operatively, with a mean age of 29.2 ± 11.0 years. The PASS thresholds for the aforementioned PROMs at 10 years were 61.9 for KOOS (Symptoms 51.8, Pain 79.2, Activities of Daily Living 87.5, Sport 57.5 and Quality of Life 59.4), 59.7 for IKDC, 61.5 for Lysholm and 82.5 for EQ-5D. The ROC curve showed good to excellent predictive value with an area under the curve (AUC) of 0.76-0.84. Male gender (odds ratio [OR] = 3.1; p = 0.016) and BMI between 20 and 29 (OR = 3.9; p = 0.004) had a positive predictive value for achieving PASS at long-term follow-up.</p><p><strong>Conclusions: </strong>The present study determined long-term PASS thresholds for KOOS, IKDC, Lysholm and EQ-5D scores in patients undergoing M-ACI for cartilage repair at the knee. Male gender and a BMI of 20-29 were positive predictors of the likelihood of achieving PASS at 10 years. The identified PASS thresholds are critical for assessing clinical outcomes, evaluating procedural efficacy for regulatory considerations, and planning sample sizes for prospective, controlled studies.</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":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730696","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":"Biologic augmentation of meniscus repair: A scoping review.","authors":"Jonathan T Super, Robert F LaPrade, James Robinson, David A Parker, Nicholas DePhillipo, Gilbert Moatshe, Philippe Beaufils, Iain R Murray","doi":"10.1002/ksa.12634","DOIUrl":"https://doi.org/10.1002/ksa.12634","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to carry out a scoping review to investigate the use of biologic augmentation strategies for arthroscopic meniscal repair.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and Arksey and O'Malley frameworks were followed. The studies were obtained and screened, with inclusion criteria comprising clinical studies evaluating the biologic augmentation of arthroscopic meniscal repair, systematic reviews, opinion pieces, and consensus statements. Studies involving any biologic therapy were included and were not limited to geographical location, participant age group, or sex. Data were extracted and presented as a descriptive analysis and thematic summary.</p><p><strong>Results: </strong>A total of 1135 studies were initially identified, and 125 met the inclusion criteria for this scoping review. Sixty-six (52.8%) of these studies were published in the last 5 years, and 50.4% (63) originated from the United States. Most of the evidence was either Level IV or V (87 articles, 69.6%). The most frequently studied biological augmentation technique was the use of platelet-rich plasma (58 articles, 46.4%).</p><p><strong>Conclusion: </strong>There is diverse use of biologic therapies for the augmentation of meniscal repairs without the presence of high-quality evidence to clearly define indications and usage. Further research priorities include defining which meniscal tear types and locations might benefit from specific biologic augmentation techniques, as well as outcome measures and diagnostic modalities to detect the success of these interventions.</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":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719985","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 vein thrombosis, age and body mass index are significant risk factors for arthrofibrosis following total knee arthroplasty.","authors":"Maximilian Budin, T David Luo, Thorsten Gehrke, Mustafa Citak","doi":"10.1002/ksa.12665","DOIUrl":"https://doi.org/10.1002/ksa.12665","url":null,"abstract":"<p><strong>Purpose: </strong>Arthrofibrosis is a significant complication that occurs in 3.7%-10% of total knee arthroplasty (TKA) cases, causing pain and limiting the range of motion. Addressing arthrofibrosis poses a considerable challenge, given its intricate and time-consuming treatment. The aim of this study was to identify patient-related risk factors that contribute to the formation of arthrofibrosis following primary TKA.</p><p><strong>Methods: </strong>This retrospective case-control study encompassed 1033 cases in which arthrofibrosis was identified as a cause for failure following primary TKA between 1996 and 2021. These patients were compared to a cohort of 39,572 patients from the same time frame who did not undergo any revision following primary TKA, with a minimum follow-up of 3 years. Both bivariate analysis and binary logistic regression analysis, adjusting for age, gender, body mass index (BMI) and age-adjusted Charlson comorbidity index (CCI) were conducted. The odds ratio (OR) and 95% confidence interval (CI) were presented.</p><p><strong>Results: </strong>Patients with arthrofibrosis were significantly younger (p < 0.001), had lower BMIs (p = 0.044) and exhibited significantly lower CCI scores (p < 0.001). No significant difference in gender was observed between patients with and without arthrofibrosis. Binary logistic regression indicated that a deep vein thrombosis (DVT) following primary TKA (p < 0.001; OR = 2.21; 95% CI = 1.64-2.98) was linked to an increased risk, while rheumatoid arthritis (RA) (p = 0.016; OR = 0.25; 95% CI = 0.08-0.77) was associated with a decreased risk for developing arthrofibrosis following primary TKA.</p><p><strong>Conclusions: </strong>In conclusion, a DVT following primary TKA increased the risk of arthrofibrosis after primary TKA, while RA decreased it. Patients with arthrofibrosis tended to be younger, have a lower BMI, and have fewer comorbidities, with no gender differences observed. Preventing DVT is crucial, and TKA should be approached cautiously in young, thin patients with few comorbidities.</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":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719990","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":"Beyond the coronal plane in robotic total knee arthroplasty-Part 2: Combined flexion does not affect outcomes.","authors":"Luca Andriollo, Pietro Gregori, Christos Koutserimpas, Elvire Servien, Cécile Batailler, Sébastien Lustig","doi":"10.1002/ksa.12660","DOIUrl":"https://doi.org/10.1002/ksa.12660","url":null,"abstract":"<p><strong>Purpose: </strong>Personalized alignment in total knee arthroplasty (TKA) is becoming increasingly widespread, driven in part by advancements in robotic-assisted surgery. However, true personalization must extend beyond the coronal plane to include sagittal and axial planes. This study investigates the impact of combined flexion (CF) of the femoral and tibial components in robotic-assisted TKA within functional alignment (FA), also analyzing its variation (ΔCF) from native anatomy and its correlation with functional outcomes and complications.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 310 patients who underwent primary TKA using an image-based robotic system between March 2021 and January 2023. CF was calculated based on tibial slope (TS) and distal femoral flexion (DFF). Patients were stratified into groups based on CF (≤7.5° vs. >7.5°) and CF variation (ΔCF < -3, -3 to 3 and >3). Clinical scores, radiographic parameters and complication rates were analyzed.</p><p><strong>Results: </strong>Patients with CF ≤ 7.5° had lower preoperative maximum flexion values (p = 0.005). No significant differences in complication rates or clinical outcomes were observed between groups. ΔCF were associated with post-operative coronal alignment changes (mechanical hip-knee-ankle angle and medial proximal tibial angle) but did not impact patient-reported outcomes. Additionally, subgroup analysis revealed that ΔCF were not linked to differences in implant survival, revision rates or mechanical failure.</p><p><strong>Conclusions: </strong>Although CF influences knee biomechanics, its direct impact on clinical outcomes remains unclear. It is evident that a personalized approach to sagittal alignment can be an integral component of functional knee positioning.</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":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719982","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":"Beyond the coronal plane in robotic total knee arthroplasty-Part 1: Variations in tibial slope and distal femoral flexion do not affect outcomes.","authors":"Luca Andriollo, Christos Koutserimpas, Pietro Gregori, Elvire Servien, Cécile Batailler, Sébastien Lustig","doi":"10.1002/ksa.12658","DOIUrl":"https://doi.org/10.1002/ksa.12658","url":null,"abstract":"<p><strong>Purpose: </strong>Robotic-assisted total knee arthroplasty (TKA) and new alignment principles are transforming traditional implant positioning, not only in the coronal plane but also in the sagittal and axial planes. The impact of differences between a patient's native tibial slope (TS) and distal femoral flexion (DFF) compared to the final implant positioning remains unclear. This study aims to evaluate whether variations in TS (ΔTS) and DFF (ΔDFF) play a role in clinical outcomes and implant survival.</p><p><strong>Methods: </strong>This retrospective study analysed patients who underwent robotic-assisted TKA following functional alignment (FA) principles between March 2021 and January 2023. A total of 310 patients were included. Preoperative and postoperative data, including radiographic and robotic measurements, were collected. Clinical outcomes (KSS, FJS-12 and AKPS), range of motion (ROM), complication rates, and implant survival were compared between groups at a minimum of 2 years follow-up.</p><p><strong>Results: </strong>At the final follow-up (mean 2.93 ± 0.62 years), no significant differences were found in clinical scores or ROM between groups with different ΔTS or ΔDFF values. Complication rates and implant survival (99%) were also similar. However, patients with ΔTS > 5° had a slightly increased femoral valgus alignment, while those with ΔDFF ≤ 5° had lower preoperative ROM, with the femoral implant positioned in varus.</p><p><strong>Conclusions: </strong>Variations between native and implant TS and DFF in robotic-assisted TKA do not negatively impact functional outcomes or implant survival. A personalised sagittal alignment approach within the concept of FA represents a progression to a functional knee positioning based on three dimensions. Further research is needed to explore the long-term effects of sagittal alignment on TKA performance.</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":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700537","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":"Very low dislocation rate and good clinical outcome after Bereiter trochleoplasty and additional procedures following the Copenhagen patella-femoral instability algorithm: One- and two-years outcomes from a consecutive cohort of 368 cases.","authors":"Christian Dippmann, Volkert Siersm, Simone Rechter, Kristoffer W Barfod, Peter Lavard","doi":"10.1002/ksa.12663","DOIUrl":"https://doi.org/10.1002/ksa.12663","url":null,"abstract":"<p><strong>Purpose: </strong>Patello-femoral instability (PFI) is often caused by predisposing factors, with trochlea dysplasia (TD) as the most prominent. Untreated patellar instability leads to impaired function and an increased risk of patellofemoral osteoarthritis. Since 2009 patients with PFI have been treated according to the Copenhagen PFI algorithm, where underlying osseous predisposing factors are addressed. The aim of this study was to report the two-year outcome after Bereiter trochleoplasty (TP) for high grade TD in a cohort of 368 consecutive patients treated according to the Copenhagen PFI algorithm from 2011 to 2021.</p><p><strong>Methods: </strong>This was a register study evaluating a consecutive cohort of patients with high grade TD undergoing Bereiter trochleoplasty and additional procedures following the Copenhagen PFI algorithm. Outcomes were the Kujala score, the Knee Osteoarthritis Outcome Score (KOOS) and the Lysholm score collected preoperatively and after 1 and 2 years.</p><p><strong>Results: </strong>From January 2011 to September 2021, 368 Bereiter TPs were performed on 346 patients (99 males, 225 females and 44 bilateral surgeries). Four knees (1.1%) experienced a re-dislocation. There were statistically significant (p < 0.0001) and clinically relevant improvements in all patients reported outcome measure (PROM)-scores 1 and 2 years after surgery. Over 2 years Kujala score improved mean (95% confidence interval) 18.7 (16.5-20.9), KOOS QoL 31.0 (28.0-34.0) and Lysholm score 20.0 (17.1-22.9).</p><p><strong>Conclusions: </strong>Patients with high grade TD treated with Bereiter TP and additional procedures according to the Copenhagen PFI algorithm showed low re-dislocation rate and statistically significant and clinically relevant improvement in patient reported outcome 1 and 2 years after treatment.</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":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700550","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 new preclinical sheep model of medial meniscus anterior root repair. Part 2. Surgical strategy, technical considerations, pearls and pitfalls.","authors":"Matthias Brockmeyer, Wei Liu, Marta Carretero-Hernández, Yin Zhang, Henning Madry","doi":"10.1002/ksa.12636","DOIUrl":"https://doi.org/10.1002/ksa.12636","url":null,"abstract":"<p><strong>Purpose: </strong>To address a gap in translational research by developing a preclinical sheep model of medial meniscus anterior root (MAR) repair in vivo and to compare probabilities of potential pitfalls and difficulties with humans.</p><p><strong>Methods: </strong>Preoperative planning and surgical procedures applied to patients were adapted to adult sheep. Eight healthy, skeletally mature, female Merino ewes between 2 and 4 years of age underwent a mini-open medial parapatellar approach to both stifle joints without luxating the patella. Next, the MAR was transected in 16 knees (8 sheep) resulting in a subtype 2A tear according to the LaPrade classification, followed by a transtibial pull-out repair through a 3.2 mm diameter bone tunnel with a reinforced Mason-Allen suture and non-absorbable suture material. Animals were followed until 21 days after surgery.</p><p><strong>Results: </strong>The surgery time per knee ranged between 30 and 50 min (mean, 40.0 ± 7.8 min). The surgical technique was safe without intra- or post-operative complications. Solid repair is most likely if the following surgical principles are respected: (1) Selection of the MAR and the open technique allow for elegant tunnel positioning and less post-operative loading stress due to the normal extension deficit of sheep; (2) careful preparation of the MAR is mandatory; (3) considering the oval shape of the MAR attachment (MARA) results in anatomic tunnel placement; (4) robust suture placement and configuration avoids suture cut out. The probabilities of potential pitfalls and difficulties differ from the human situation.</p><p><strong>Conclusion: </strong>A clinically adapted MAR repair model in adult sheep was developed following its complete transection close to the MARA, followed by an open transtibial pull-out repair. The surgical technique was safe without intra- or short-term post-operative complications. This model may be suitable to study the biomechanics and pathophysiology of meniscal root injuries and their repair.</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":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700531","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":"Tibial implant varus >3° does not adversely affect outcomes or revision rates in functionally aligned image-based robotic total knee arthroplasty in a minimum of 2-year follow-up.","authors":"Christos Koutserimpas, Riccardo Garibaldi, Flora Olivier, Elvire Servien, Cécile Batailler, Sébastien Lustig","doi":"10.1002/ksa.12659","DOIUrl":"https://doi.org/10.1002/ksa.12659","url":null,"abstract":"<p><strong>Purpose: </strong>Functional alignment (FA) aims to restore knee kinematics by balancing laxities and adapting implant positioning. This study evaluates safety and outcomes of >3° varus tibial positioning in patients with varus deformity undergoing robotic-assisted total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This retrospective study included 337 patients with varus deformity undergoing robotic-assisted TKA with FA principles with a minimum of 2-year follow-up. Patients were divided into two groups based on tibial varus positioning: ≤3° varus: Group A and >3° varus: Group B. Preoperative and postoperative coronal alignment, implant positioning, and outcomes were assessed using the Knee Society Score (KSS) and the Forgotten Joint Score (FJS) at final follow-up. The primary outcome was implants' survivorship, and secondary outcomes included complication rates and functional scores. Statistical analyses included Mann-Whitney and Chi-square tests for group comparisons, Kaplan-Meier survival analysis for implant survivorship, and multivariate regression for key covariates.</p><p><strong>Results: </strong>Implant survivorship was 99.4% in Group B over a median follow-up of 30 months, with one revision due to aseptic loosening and 100% in Group A (p = 0.36). The overall complication rates were 12.7% in Group A and 10.2% in B (p = 0.48). The median KSS-knee and function scores were 94.5 and 90 in Group A and 94 and 90 in B (p = 0.88 and 0.8, respectively). The final FJS was 82 in Group A and 84 in B (p = 0.8). No significant differences were observed in postoperative knee range of motion between the two groups. Multivariate regression analysis showed that none of the included covariates were statistically significant predictors of implant failure.</p><p><strong>Conclusion: </strong>FA in robotic-assisted TKA with tibial positioning >3° varus seems to be safe and reliable in patients with varus deformity, demonstrating similar revision rates, implant survivorship, and outcomes compared to the ≤3° tibial varus group.</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":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700472","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 new preclinical sheep model of medial meniscus anterior root repair: Part 1-Quantitative morphology and relationships to adjacent structures.","authors":"Wei Liu, Marta Carretero-Hernández, Yin Zhang, Magali Cucchiarini, Matthias Brockmeyer, Henning Madry","doi":"10.1002/ksa.12656","DOIUrl":"https://doi.org/10.1002/ksa.12656","url":null,"abstract":"<p><strong>Purpose: </strong>To analyse the quantitative morphology of the menisci, their roots and relations with a focus on the medial meniscus anterior root (MAR) as a basis for a preclinical model.</p><p><strong>Methods: </strong>Data was obtained from 24 tibial plateaus of skeletally mature, female Merino ewes. The MAR attachment (MARA) was scanned with micro-computed tomography and stained with hematoxylin and eosin. Data of relevant anatomical structures was subjected to principal component analysis (PCA) and Spearman correlations.</p><p><strong>Results: </strong>The osteo-ligamentous junction of the MARA represents a classical enthesis with a type-I insertion into the cortical bone. The medial tibial plateau was of a significantly smaller area than lateral. Its sagittal length was significantly longer than lateral. The widths of the MAR and lateral meniscus anterior root (LAR) were approximately half of both anterior horn widths. The MAR was significantly wider than the LAR. The medial meniscus body, posterior horn and medial posterior root were significantly thinner than lateral. PCA and cluster analysis revealed a striking, significant distinction between the structures of the medial and lateral tibial plateau. The sagittal length of the articular cartilage of both tibial plateaus correlated with the primary axis length of both menisci. The maximum width of the articular cartilage of both plateaus correlated with the area of both menisci. Significant correlations also existed between the length of the MAR and the total width of the tibia plateau and between the size of the MARA and the coronal distance to the medial tibial eminence (MTE), to the tibial tuberosity and the sagittal distance to the MTE.</p><p><strong>Conclusion: </strong>The ovine MAR may be appropriate for repair approaches because of its morphological similarities to the human situation. The substantial differences between the medial and lateral tibial plateau have to be respected.</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":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700532","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}