Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Metal sensitivity in total joint arthroplasty: None of the current diagnostic tests are reliable, sensitive and specific enough to guide treatment decisions!","authors":"Umile Giuseppe Longo,&nbsp;Giovanni Intermesoli,&nbsp;Raffaele Di Tommaso,&nbsp;Alberto Lalli,&nbsp;Bruno Violante,&nbsp;Michael T. Hirschmann","doi":"10.1002/ksa.12706","DOIUrl":"10.1002/ksa.12706","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review was conducted to evaluate the current literature on metal hypersensitivity in patients undergoing joint arthroplasty. The aims of the study were to report diagnostic tools used to assess metal hypersensitivity and to report complications arising in patients who are hypersensitive to nickel or other metals performing joint arthroplasty. Given the potential impact on implant longevity and patient outcomes, understanding the clinical relevance of metal hypersensitivity is crucial for optimising surgical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review adheres to PRISMA guidelines and evaluates the variability in diagnostic approaches and the challenges in clinical management. Included in this review were studies involving patients sensitive to nickel or other metals undergoing joint arthroplasty. Eligibility criteria focused on commonly employed diagnostic tools and associated complications. A comprehensive literature search was conducted across Medline, EMBASE, Scopus, CINAHL, and CENTRAL databases. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tool for case series and the ROBINS-I tool for case-control studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four articles met the inclusion criteria and were included in this systematic review. A total of 4865 patients undergoing joint arthroplasty were selected. Diagnostic tools included patch testing, lymphocyte transformation test (LTT), and medical history assessment. Variability in time point of testing and diagnostic protocols was noted. Complications including joint pain, swelling, reduced range of motion, and implant failure were reported in 12 studies. Clinical outcomes varied widely: some studies showing no significant differences between hypersensitive and non-hypersensitive patients, while others reported increased pain and reduced joint function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a lack of a standardised protocol for diagnosing metal hypersensitivity, leading to uncertainty regarding test selection and timing. This inconsistency leads to variability in reported outcomes, with limited studies focusing on post-surgical hypersensitivity in patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, systematic review.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3269-3285"},"PeriodicalIF":5.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251954","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":"Persistent isokinetic knee flexion strength deficits at the time of return to sport are not associated with a second ACL injury","authors":"Axel Sundberg,&nbsp;Rebecca Hamrin Senorski,&nbsp;Johan Högberg,&nbsp;Ramana Piussi,&nbsp;Kristian Samuelsson,&nbsp;Roland Thomeé,&nbsp;Eric Hamrin Senorski","doi":"10.1002/ksa.12718","DOIUrl":"10.1002/ksa.12718","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the rate of a second anterior cruciate ligament (ACL) injury based on different levels of knee flexion strength limb symmetry index (LSI) at the time of return to sport (RTS) after ACL reconstruction with hamstring tendon autograft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data was extracted from a rehabilitation registry for patients aged 15–40 years, who participated in knee-strenuous sports pre-injury (Tegner ≥ 6) and underwent ACL reconstruction with hamstring tendon autograft. Isokinetic knee flexion strength was analysed and reported as LSI. Patients were categorised into three groups (≥90%, 80%–89.9% and &lt;80%) based on their LSI at reported time of RTS. Patients were followed for 2 years after ACL reconstruction to record a second ACL injury, and hazard ratios (HR) were calculated using a Cox proportional hazards model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 526 patients (48% female, mean age 22 ± 6) were included, with 51 (9.7%) second ACL injuries recorded within 2 years after ACL reconstruction. Among patients with LSI ≥ 90% (71%), 43 second ACL injuries (11.0%) occurred. The LSI 80%–89.9% group had 4 second ACL injuries (4.0%), and the LSI &lt; 80% group had four injuries (8.2%). Persistent knee flexion strength asymmetry did not significantly influence the hazard of a second ACL injury. The LSI 80%–89.9% group had a lower hazard (HR 0.34, confidence interval [CI]: 0.12–0.94), while the LSI &lt; 80% group showed no significant difference (HR 0.70, CI: 0.25–1.97) compared with the LSI ≥ 90% group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Persistent isokinetic concentric knee flexion strength asymmetry at RTS were not associated with a second ACL injury.</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":"33 8","pages":"2971-2983"},"PeriodicalIF":5.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12718","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251955","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":"Beyond the curve: The influence of cut-off selection methods on synovial biomarker interpretation for periprosthetic joint infection","authors":"Sujeesh Sebastian,&nbsp;Jochen G. Hofstaetter","doi":"10.1002/ksa.12716","DOIUrl":"10.1002/ksa.12716","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 10","pages":"3665-3667"},"PeriodicalIF":5.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251953","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":"Poor side-to-side symmetry limits the use of the contralateral limb as a reliable reference for guiding coronal positioning and alignment in total knee arthroplasty","authors":"Oriol Pujol,&nbsp;Pedro Hinarejos,&nbsp;Albert Pons,&nbsp;Ernest Famada,&nbsp;Angela Zumel,&nbsp;Juan Erquicia,&nbsp;Joan Leal-Blanquet","doi":"10.1002/ksa.12714","DOIUrl":"10.1002/ksa.12714","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess the symmetry of coronal alignment in the lower limbs of patients with knee osteoarthritis to evaluate whether the contralateral lower limb can serve as a reliable reference for guiding coronal positioning and alignment in total knee arthroplasty (TKA) surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a multicentric cross-sectional observational study. Preoperative full-leg weight-bearing radiographies from patients with knee osteoarthritis treated with a TKA between 2022 and 2024 were analyzed. Radiological parameters were measured in both lower limbs: medial proximal tibial angle, tibial mechanical angle (TMA), lateral distal femoral angle, femoral mechanical angle (FMA), hip–knee–ankle angle (HKA) and Kellgren–Lawrence. Lower limb coronal symmetry was assessed using the HKA, coronal plane alignment of the knee (CPAK) and phenotypes classifications. The relationship between concordance rates and osteoarthritis severity and symmetry was also analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-six patients were included. The operated-to-contralateral concordance for the HKA classification was 57%. It was higher when the operated knee was neutral (81%), compared to varus (58%) or valgus (27%). The CPAK concordance was 38%; it was similar across different CPAK types. The phenotype classification concordance was only 11%; 30% for the HKA parameter, 39% for FMA and 34% for TMA. There was no relationship between osteoarthritis severity or symmetry and coronal concordance rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with knee osteoarthritis have poor side-to-side symmetry in lower limb coronal alignment. The concordance rate was 56% for the HKA classification, 39% for the CPAK classification and 11% for the phenotype classification. Therefore, the contralateral lower limb may not be a reliable reference for guiding coronal positioning and alignment in TKA surgery.</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":"33 10","pages":"3621-3628"},"PeriodicalIF":5.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228410","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":"Artificial intelligence-assisted analysis of musculoskeletal imaging—A narrative review of the current state of machine learning models","authors":"Felix C. Oettl,&nbsp;Bálint Zsidai,&nbsp;Jacob F. Oeding,&nbsp;Michael T. Hirschmann,&nbsp;Robert Feldt,&nbsp;David Fendrich,&nbsp;Matthew J. Kraeutler,&nbsp;Philipp W. Winkler,&nbsp;Pawel Szaro,&nbsp;Kristian Samuelsson,&nbsp;ESSKA Artificial Intelligence Working Group","doi":"10.1002/ksa.12702","DOIUrl":"10.1002/ksa.12702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>The potential of Artificial intelligence (AI) is increasingly recognized in musculoskeletal radiology, offering solutions to challenges posed by increasing imaging volumes and fellowship trained radiologist shortages. The integration of AI is not intended to replace radiologists but to augment their capabilities, improving workflow efficiency and diagnostic accuracy. This narrative review examines the current landscape of AI applications in musculoskeletal imaging, focusing on both general-purpose multimodal models and specialized foundation models. AI has proven effective in musculoskeletal imaging, enhancing fracture detection, scoliosis assessment, and lower limb alignment analysis. In osteoarthritis, AI aids early detection by identifying subtle structural changes. AI-accelerated MRI reconstruction reduces scan times by up to 90% while maintaining diagnostic quality, improving efficiency and accessibility. Emerging multimodal models further integrate imaging with clinical data, advancing precision medicine. Technical challenges persist, particularly in addressing motion artifacts and anatomical complexity. Ethical considerations, including data privacy, algorithmic bias, and model transparency, remain crucial for responsible implementation. While challenges remain in clinical validation and implementation, the combination of broad and narrow AI models shows promise in advancing precision medicine and democratizing quality care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 8","pages":"3032-3038"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251952","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":"Evaluating DeepResearch and DeepThink in anterior cruciate ligament surgery patient education: ChatGPT-4o excels in comprehensiveness, DeepSeek R1 leads in clarity and readability of orthopaedic information","authors":"Onur Gültekin,&nbsp;Jumpei Inoue,&nbsp;Baris Yilmaz,&nbsp;Mehmet Halis Cerci,&nbsp;Bekir Eray Kilinc,&nbsp;Hüsnü Yilmaz,&nbsp;Robert Prill,&nbsp;Mahmut Enes Kayaalp","doi":"10.1002/ksa.12711","DOIUrl":"10.1002/ksa.12711","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study compares ChatGPT-4o, equipped with its &lt;i&gt;deep research&lt;/i&gt; feature, and DeepSeek R1, equipped with its &lt;i&gt;deepthink&lt;/i&gt; feature—both enabling real-time online data access—in generating responses to frequently asked questions (FAQs) about anterior cruciate ligament (ACL) surgery. The aim is to evaluate and compare their performance in terms of accuracy, clarity, completeness, consistency and readibility for evidence-based patient education.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A list of ten FAQs about ACL surgery was compiled after reviewing the Sports Medicine Fellowship Institution's webpages. These questions were posed to ChatGPT and DeepSeek in research-enabled modes. Orthopaedic sports surgeons evaluated the responses for accuracy, clarity, completeness, and consistency using a 4-point Likert scale. Inter-rater reliability of the evaluations was assessed using intraclass correlation coefficients (ICCs). In addition, a readability analysis was conducted using the Flesch–Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES) metrics via an established online calculator to objectively measure textual complexity. Paired &lt;i&gt;t&lt;/i&gt; tests were used to compare the mean scores of the two models for each criterion, with significance set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Both models demonstrated high accuracy (mean scores of 3.9/4) and consistency (4/4). Significant differences were observed in clarity and completeness: ChatGPT provided more comprehensive responses (mean completeness 4.0 vs. 3.2, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), while DeepSeek's answers were clearer and more accessible to laypersons (mean clarity 3.9 vs. 3.0, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). DeepSeek had lower FKGL (8.9 vs. 14.2, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and higher FRES (61.3 vs. 32.7, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), indicating greater ease of reading for a general audience. ICC analysis indicated substantial inter-rater agreement (composite ICC = 0.80).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;ChatGPT-4o, leveraging its &lt;i&gt;deep research&lt;/i&gt; feature, and DeepSeek R1, utilizing its &lt;i&gt;deepthink&lt;/i&gt; feature, both deliver high-quality, accurate information for ACL surgery patient education. While ChatGPT excels in comprehensiveness, DeepSeek outperforms in clarity and readability, suggesting that integrating the strengths of both models could optimize patient education outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 8","pages":"3025-3031"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12711","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228409","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 Forgotten Joint Score after total knee arthroplasty with a kinematic alignment-optimized femoral component matches total hip arthroplasty","authors":"Stephen M. Howell,&nbsp;Ahmed Zabiba,&nbsp;Alexander J. Nedopil,&nbsp;Maury L. Hull","doi":"10.1002/ksa.12712","DOIUrl":"10.1002/ksa.12712","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In kinematic alignment (KA) total knee arthroplasty (TKA), 50% of patients treated with a femoral component that has a 6° valgus prosthetic trochlear groove (PTG) show an abnormal quadriceps line of pull directed laterally to the groove. Lateral misalignment is reported to decrease the Forgotten Joint Score (FJS) by 17–24 points. Therefore, this study aimed to determine whether using a femoral component with a 20° valgus PTG, which minimizes the risk of lateral misalignment, can achieve a mean FJS that meets the 70-point threshold for a successful outcome in total hip arthroplasty (THA) and the mean value of 67 points for knees in the U.S. population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study analyzed the first 127 patients who underwent KA TKA with the 20° valgus KA-optimized femoral component. At a minimum 2-year follow-up, patients were sent an online survey to complete the FJS and Oxford Knee Score (OKS) to assess function and report instances of revision knee surgery. Ten of the 127 cases were excluded: two required revision surgery. Four patients did not complete the questionnaire but reported no reoperations. The families of two individuals who passed away provided the same response. Two patients could not be contacted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis focused on 117 KA TKAs, with a mean FJS of 75 points, 5 points higher than the 70-point threshold considered successful for THA and exceeding the normative value of 67 points for knees. The mean OKS was 43 points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Primary KA TKA with a 20° valgus PTG can achieve an FJS comparable to THA with high functionality, as shown by 70% and 25% of subjects receiving an excellent (48–42) or good (41–34) OKS.</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":"33 10","pages":"3646-3653"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12712","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228412","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":"Ten-year outcomes of hip arthroscopy for femoroacetabular impingement with osteoarthritis: Sustained functional benefits but high conversion to total hip arthroplasty","authors":"Sarantos Nikou,&nbsp;Carl Sandlund,&nbsp;Ida Lindman,&nbsp;Per-Erik Johansson,&nbsp;Axel Öhlin,&nbsp;Louise Karlsson,&nbsp;Mikael Sansone","doi":"10.1002/ksa.12709","DOIUrl":"10.1002/ksa.12709","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the long-term clinical and radiographic outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients with mild to moderate osteoarthritis (OA). The hypothesis is that patients with FAIS and mild to moderate OA would experience sustained improvements in iHOT-12 at 10-year follow-up, despite natural OA progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study included 75 patients (80 hips) with FAIS and radiographic signs of mild to moderate OA (Tönnis grade 1 or 2) who underwent hip arthroscopy between November 2011 and December 2012. The International Hip Outcome Tool (iHOT-12) was the primary outcome at a minimum of 10-year follow-up. Radiographic progression of OA using Tönnis classification and conversion to THA were recorded. Statistical analysis of patient-reported outcome measures (PROMs) was performed with Wilcoxon signed-rank test. Relative risk assessment (RR) for conversion to THA for Tönnis grade 1 and 2 was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 10-year follow-up, 26 patients (29 hips) had undergone THA, resulting in a hip survivorship of 59% while 41% of hips progressed to THA by 10 years. The mean time to THA was 7.1 years (±1.5). Patients with Tönnis grade 2 at baseline had a significantly higher risk of THA compared with Tönnis grade 1 (RR = 3.44, 95% CI: 1.81–6.55, <i>p</i> &lt; 0.001). Among non-THA patients, 79% reported satisfaction with surgery. The iHOT-12 score improved from 41.4 (±17.1) preoperatively to 71.0 (±26.7) at follow-up (<i>p</i> &lt; 0.001), with 67% of patients exceeding the minimal important change (MIC) threshold. Radiographic progression of Tönnis grade was observed in four hips.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hip arthroscopy in patients with FAIS and mild to moderate OA provides substantial long-term functional benefits for those patients not having to undergo THA. However, preoperative OA severity is a key predictor of THA conversion with nearly two-fifths of hips requiring THA within 10 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, case series.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 7","pages":"2655-2663"},"PeriodicalIF":5.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12709","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153302","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":"Cemented mobile-bearing medial unicompartmental knee arthroplasty provides long-term implant survival and sustained functional performance in young and active patients aged 60 or below","authors":"Kevin-Arno Koch,&nbsp;Michael Thapa,&nbsp;Johannes Weishorn,&nbsp;Mustafa Hariri,&nbsp;Benedict Lotz,&nbsp;Kevin Knappe,&nbsp;Tobias Reiner,&nbsp;Tilman Walker","doi":"10.1002/ksa.12703","DOIUrl":"10.1002/ksa.12703","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate long-term outcomes of cemented, mobile-bearing medial unicompartmental knee arthroplasty (UKA) in patients aged 60 or younger, focusing on implant survival, functional results, patient-reported outcome measures (PROMs), and radiographic findings over &gt;10 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-centre study included 119 knees (102 patients). Implant survival was evaluated using Kaplan–Meier analysis. PROMs included the Oxford Knee Score (OKS), American Knee Society Score (AKSS), UCLA Activity Score and Visual Analogue Scale (VAS). Assessments were performed preoperatively, at mid-term (2–10 years), and at long-term follow-up (&gt;10 years). OKS and AKSS were analysed in relation to Patient Acceptable Symptom State (PASS) thresholds. Radiographs were graded using the Kellgren–Lawrence classification to evaluate lateral osteoarthritis (LOA) progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The implant survival rate was 86.7% (95% CI: 78.5–91.9%) at 15 years, and 81.7% (95% CI: 71.4%–88.5%) at 17.5 years. Revision surgery was required in 18 knees (mean time to revision: 8.7 years), primarily due to progression of LOA. All PROMs improved significantly from baseline to the final follow-up (mean: 16 years; <i>p</i> &lt; 0.0001). Although minor functional declines occurred between mid- and long-term follow-ups, these were not statistically significant (<i>p</i> &gt; 0.05), except for functional AKSS. At the final assessment, 96% of patients exceeded the PASS threshold for OKS, 84% for AKSS objective, and 80% for AKSS functional scores. Radiographic LOA progression was frequent but did not significantly impair functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cemented mobile-bearing medial UKA in patients aged ≤60 years demonstrated high long-term implant survival and sustained functional benefit. Even in the presence of radiographic LOA progression, clinical outcomes remained excellent. UKA represents a durable and effective treatment for younger patients with isolated medial compartment osteoarthritis.</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":"33 9","pages":"3324-3332"},"PeriodicalIF":5.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145376","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":"Femoral varus deformity predominates in male Chinese osteoarthritis patients with geographic variability in functional knee phenotypes","authors":"Songlin Li,&nbsp;Jiaming He,&nbsp;Weibo Zheng,&nbsp;Xuezhou Li,&nbsp;Jie Yang,&nbsp;Zhe Li,&nbsp;Houyi Sun,&nbsp;Zhuang Miao,&nbsp;Wenwei Qian,&nbsp;Peilai Liu,&nbsp;Qunshan Lu","doi":"10.1002/ksa.12693","DOIUrl":"10.1002/ksa.12693","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aims of this study were to generalise the distribution and sex differences in functional knee phenotypes in a Chinese osteoarthritis (OA) population and to compare the distributions of functional knee phenotypes across geographic regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Knee phenotypes were evaluated according to Hirschmann's classification in 908 knees with OA, and the correlations among the hip–knee–ankle angle (HKA), femoral mechanical angle (FMA) and tibial mechanical angle (TMA) and their differences between the sexes were described. Studies reporting the distributions of functional knee phenotypes for arthritic knees were included to compare the variability in geographic distribution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average values (males, females) of the HKA (173.1 ± 5.4°, 174.0 ± 6.9°), FMA (90.5 ± 2.9°, 91.6 ± 3.5°), and TMA (85.7 ± 3.1°, 85.7 ± 3.6°) demonstrated that the Chinese OA population tended towards femoral and tibial varus deformities in both males and females. A total of 145 functional knee phenotypes were identified in all 908 knees, comprising 68 types in males and 136 types in females. The most common phenotypes were VAR_HKA6° + VAR_FMA3° + NEU_TMA0° (5.7%) for all knees, VAR_HKA3° + NEU_FMA0° + NEU_TMA0° (7.4%) for males and VAR_HKA6° + VAR_FMA3° + NEU_TMA0° (5.4%) for females. The incidence of femoral varus deformity was greater than that of tibial varus deformity in 48.4% of males and 36.5% of females, and the incidence of tibial varus deformity was greater than that of femoral varus deformity in 24.7% of males and 35.2% of females. Seven studies including 16,395 knees were identified. The main femoral and tibial phenotypes in different geographic regions were VAR_FMA3° and NEU_TMA0°, but their proportional distributions differed significantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sex differences in the functional knee phenotypes of OA patients in China were identified. Femoral varus deformity was more common than tibial varus deformity in males, whereas the difference was minimal in females. Moreover, functional knee phenotypes varied significantly across geographic regions.</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":"33 9","pages":"3310-3323"},"PeriodicalIF":5.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096815","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}