Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Arthroscopic subscapularis augmentation of the classic Bankart repair leads to satisfactory clinical and functional mid-term outcomes in patients with recurrent anterior shoulder instability and less than a subcritical glenoid bone loss.","authors":"Emmanouil Brilakis, Nikolaos Platon Sachinis, Stefania Kokkineli, Ioannis Pantekidis, Prodromos Natsaridis, George Gatos, Emmanouil Antonogiannakis","doi":"10.1002/ksa.12483","DOIUrl":"https://doi.org/10.1002/ksa.12483","url":null,"abstract":"<p><strong>Purpose: </strong>The long-term failure rate of the arthroscopic Bankart repair may reach unacceptable values, raising the need to augment this classic procedure. Arthroscopic subscapularis augmentation is the tenodesis of the upper part of the subscapularis tendon to the anterior glenoid rim. The aim of the study was to evaluate the mid-term clinical and functional outcomes of patients operated with arthroscopic subscapularis augmentation of the classic Bankart repair due to recurrent anterior shoulder instability.</p><p><strong>Methods: </strong>This is a retrospective single-centre case series study with prospectively collected data. All patients suffered from recurrent anterior shoulder instability and had glenoid bone loss less than 13.5% of the inferior glenoid diameter (subcritical glenoid bone loss). Patients with greater anterior glenoid bone defect, engaging Hill-Sachs lesions, multidirectional instability or subscapularis insufficiency were excluded. Postoperatively, all patients were evaluated for recurrence and apprehension. The patient's shoulder range of motion and functional scores were recorded.</p><p><strong>Results: </strong>The final study cohort included 34 patients with a mean age of 29.3 ± 10.2 years. The mean follow-up period was 42.4 ± 10.7 months (range, 24-62 months). Two out of 34 patients (5.8%) experienced a re-dislocation postoperatively, while one additional patient had a subjective feeling of apprehension. External rotation at the last follow-up was lower compared to preoperative values or the healthy side, but only one patient had restrictions in his sporting activities. The functional scores were significantly increased compared to the preoperative values. Twenty-two out of 26 patients (84.6%) returned to the same level of sporting activities, and 30/34 patients (88.2%) were highly satisfied with the results.</p><p><strong>Conclusion: </strong>Arthroscopic subscapularis augmentation of the classic Bankart repair reduces the dislocation recurrence rate and leads to satisfactory clinical and functional mid-term outcomes in patients with recurrent anterior shoulder instability and less than a subcritical glenoid bone loss.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349291","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":"Methodology and development of a machine learning probability calculator: Data heterogeneity limits ability to predict recurrence after arthroscopic Bankart repair.","authors":"Sanne H van Spanning, Lukas P E Verweij, Laurent A M Hendrickx, Laurens J H Allaart, George S Athwal, Thibault Lafosse, Laurent Lafosse, Job N Doornberg, Jacobien H F Oosterhoff, Michel P J van den Bekerom, Geert Alexander Buijze","doi":"10.1002/ksa.12443","DOIUrl":"https://doi.org/10.1002/ksa.12443","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to develop and train a machine learning (ML) algorithm to create a clinical decision support tool (i.e., ML-driven probability calculator) to be used in clinical practice to estimate recurrence rates following an arthroscopic Bankart repair (ABR).</p><p><strong>Methods: </strong>Data from 14 previously published studies were collected. Inclusion criteria were (1) patients treated with ABR without remplissage for traumatic anterior shoulder instability and (2) a minimum of 2 years follow-up. Risk factors associated with recurrence were identified using bivariate logistic regression analysis. Subsequently, four ML algorithms were developed and internally validated. The predictive performance was assessed using discrimination, calibration and the Brier score.</p><p><strong>Results: </strong>In total, 5591 patients underwent ABR with a recurrence rate of 15.4% (n = 862). Age <35 years, participation in contact and collision sports, bony Bankart lesions and full-thickness rotator cuff tears increased the risk of recurrence (all p < 0.05). A single shoulder dislocation (compared to multiple dislocations) lowered the risk of recurrence (p < 0.05). Due to the unavailability of certain variables in some patients, a portion of the patient data had to be excluded before pooling the data set to create the algorithm. A total of 797 patients were included providing information on risk factors associated with recurrence. The discrimination (area under the receiver operating curve) ranged between 0.54 and 0.57 for prediction of recurrence.</p><p><strong>Conclusion: </strong>ML was not able to predict the recurrence following ABR with the current available predictors. Despite a global coordinated effort, the heterogeneity of clinical data limited the predictive capabilities of the algorithm, emphasizing the need for standardized data collection methods in future studies.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349315","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":"Late (≥60 years old) and middle adulthood (40-59 years old) patients achieve similar improvement in patient-reported outcomes following ACL reconstruction.","authors":"Nicholas B Pohl, Patrick Fitzgerald, Parker L Brush, Daniel J Fletcher, Joshua Hornstein","doi":"10.1002/ksa.12491","DOIUrl":"https://doi.org/10.1002/ksa.12491","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the range of motion (ROM), surgical outcomes, and patient-reported outcome measures (PROMs) following anterior cruciate ligament (ACL) reconstruction outcomes in patients 60 years or older at the time of surgery to 40- to 59-year-old patients.</p><p><strong>Methods: </strong>In this retrospective cohort study from 2015 to 2022, a 3:1 propensity match was performed to match late adulthood patients (≥60 years old) undergoing ACL reconstruction with middle adulthood (40-59 years old) ACL reconstruction patients. Patients were matched based on sex, ACL graft utilized and concomitant procedures performed during ACL reconstruction. Statistical analysis compared demographics, preoperative injury management, surgical outcomes, PROMs, and minimal clinical important difference (MCID) and substantial clinical benefit (SCB) achievement rates for all ACL reconstruction patients included.</p><p><strong>Results: </strong>Twenty late adulthood and 60 middle adulthood patients who underwent ACL reconstruction were included in the final cohort. Patients who were 60 years or older experienced no difference in reoperation rate (n.s.), incidence of retears (n.s.) or ROM (n.s.) at 1 year post-operatively. There were also no differences in International Knee Documentation Committee (ΔIKDC) (31.3 ± 19.1 vs. 34.2 ± 18.2, n.s.) or ΔPCS-12 (12.4 ± 9.8 vs. 12.9 ± 10.8, n.s.) scores at 1 year post-operatively. Furthermore, the younger and older patient cohorts demonstrated similar rates of achieving the MCID (80.0% vs. 83.3%, n.s.) and SCB (50.0% vs. 61.7%, n.s.) scores for IKDC.</p><p><strong>Conclusion: </strong>Patients 60 years or older and 40- to 59-year-old patients demonstrated similar outcomes after undergoing ACL reconstruction with allograft. This study concludes that ACL reconstruction in late adulthood can still be a successful treatment option and should allow surgeons to feel more comfortable when performing indicated surgical intervention for older patients who experience an ACL tear.</p><p><strong>Level of evidence: </strong>Level III, Therapeutic III, retrospective cohort study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349312","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":"Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty.","authors":"Kazandra M Rodriguez, Chandramouli Krishnan, Riann M Palmieri-Smith","doi":"10.1002/ksa.12480","DOIUrl":"https://doi.org/10.1002/ksa.12480","url":null,"abstract":"<p><strong>Purpose: </strong>The primary purpose of this randomized, cross-sectional study was to determine whether operant conditioning of motor evoked torque (MEP_TORQUE) in individuals with total knee arthroplasty (TKA) increases quadriceps MEP_TORQUE responses within a single session and induces acute corticospinal adaptations by producing sustained increases in MEP_TORQUE after training. A secondary purpose was to determine if these changes were affected by the stimulus intensity and number of training trials.</p><p><strong>Methods: </strong>Thirty participants were block-randomized into one of three groups based on the participant's active motor threshold (100%, 120%, and 140%) to evaluate the effect of stimulus intensity. Participants received three blocks of conditioning trials (COND), where they trained to increase their MEP_TORQUE. Control (CTRL) transcranial magnetic stimulation pulses were provided before and after each COND block to establish baseline corticospinal excitability and to evaluate the effect of the number of training trials. Two MEP_TORQUE recruitment curves were collected to evaluate the effect of up-conditioning on acute corticospinal adaptations.</p><p><strong>Results: </strong>TKA participants were able to successfully increase their MEP_TORQUE in a single session (F_3,81 = 10.719, p < 0.001) and induce acute corticospinal adaptations (F_1,27 = 20.029, p < 0.001), indicating sustained increases in quadriceps corticospinal excitability due to operant conditioning. While the stimulus intensity used during training did not affect the ability to increase MEP_TORQUE (F_2,26 = 0.021, n.s.) or its associated acute adaptations (F_2,27 = 0.935, n.s.), the number of training trials significantly influenced these outcomes (F_3,81 = 10.719, p < 0.001; F_3,81 = 4.379, p = 0.007, respectively).</p><p><strong>Conclusion: </strong>Operant conditioning is a feasible approach for improving quadriceps corticospinal excitability following TKA. While any of the three stimulus intensities evaluated in this study may be used in future operant conditioning interventions, using a low or moderate stimulus intensity and 150 training trials are recommended to improve treatment efficiency and patient adherence.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349322","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":"Specific fibre areas in the femoral footprint of the posterior cruciate ligament act as a major contributor in resisting posterior tibial displacement: A biomechanical robotic investigation.","authors":"Adrian Deichsel, Thorben Briese, Wenke Liu, Michael J Raschke, Alina Albert, Christian Peez, Andreas Weiler, Christoph Kittl","doi":"10.1002/ksa.12486","DOIUrl":"https://doi.org/10.1002/ksa.12486","url":null,"abstract":"<p><strong>Purpose: </strong>Similar to the anterior cruciate ligament, the femoral footprint of the posterior cruciate ligament (PCL) is composed of different fibre areas, possibly having distinct biomechanical functions. The aim of this study was to determine the role of different fibre areas of the femoral footprint of the PCL in restraining posterior tibial translation (PTT).</p><p><strong>Methods: </strong>A sequential cutting study was performed on eight fresh-frozen human knee specimens, utilizing a six-degrees-of-freedom robotic test setup. The femoral attachment of the PCL was divided into 15 areas, which were sequentially cut from the bone in a randomized sequence. After determining the native knee kinematics, a displacement-controlled protocol was performed replaying the native motion, while constantly measuring the force. The reduction of the restraining force presented the percentage contribution of each cut, according to the principle of superposition.</p><p><strong>Results: </strong>The PCL was found to contribute 29 ± 16% in 0°, 51 ± 24% in 30°, 60 ± 22% in 60° and 55 ± 18% in 90°, to restricting a PTT. The fibre areas contributing the most were located at the proximal border of the PCL footprint, away from the cartilage, and directly adjacent to the medial intercondylar ridge (p < 0.05). Of these, one fibre area showed the highest contribution at all flexion angles. This area was located at the posterior half of the medial intercondylar ridge. No clear assignment of the areas to either the anterolateral or posteromedial bundle was possible.</p><p><strong>Conclusion: </strong>An area towards the proximal and posterior part of the femoral PCL footprint was found to significantly restrain a posterior tibial force. Based on the data of this testing setup, a PCL graft positioned at the identified area may best mimic the part of the native PCL, which bears the most load in resisting a PTT force.</p><p><strong>Level of evidence: </strong>No evidence level (laboratory study).</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349325","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":"Chronic pain at 1-year following knee arthroplasty is associated with a worse joint-specific function and health-related quality of life.","authors":"Nick D Clement, Samantha Jones, Irrum Afzal, Deiary F Kader","doi":"10.1002/ksa.12455","DOIUrl":"https://doi.org/10.1002/ksa.12455","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to identify independent variables associated with chronic pain (CP) at 1 year following knee arthroplasty (KA) and whether this influenced functional outcomes.</p><p><strong>Methods: </strong>This retrospective study was conducted over a 2-year period and included 2588 patients with completed Oxford knee score (OKS) and EuroQol (EQ)-five domains (5D) preoperatively and at 1 and 2 years postoperatively. The OKS pain component score was used to define patients with CP (≤14 points). The mean age was 70.0 (range 34-94) years and there were 1553 (60.0%) females.</p><p><strong>Results: </strong>There were 322 (12.4%) patients with CP at 1 year. A worse preoperative EQ-5D (p = 0.025), EQ-visual analogue scale (VAS) (p = 0.005) and OKS questions relating to washing (p = 0.010), limping (p = 0.007), kneeling (p = 0.003) and night pain (p = 0.004) were independently associated with risk of CP. However, the preoperative OKS (area under the curve [AUC]: 72.0, p < 0.001) and EQ-5D score (AUC: 70.1, p < 0.001) were the most reliable predictors, with threshold values of <18-points and <0.300 being predictive of CP, respectively. Of those with CP at 1 year, 231 were followed up at 2 years, of which 92 (39.8%) had resolution of their CP. A worse response to OKS question 11 (ability to shop) and EQ-5D (p = 0.028) at 1 year was independently associated with persistent CP. Patients with CP had significantly (p < 0.001) worse OKS, EQ-5D and EQ-VAS at 1 year compared to those without. However, for those that had resolution of their CP at 2 years, their outcomes were clinically equal to those that did not have CP at 1 year.</p><p><strong>Conclusion: </strong>One in eight patients had CP at 1 year following surgery, which was associated with clinically worse knee-specific outcomes and quality of life. However, by 2 years, two in five patients had resolution of their CP and had functional outcomes clinically equal to those without CP at 1 year. The risk factors identified could be used to inform patients of their risk for CP and the potential for resolution.</p><p><strong>Level of evidence: </strong>Level III retrospective study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349308","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":"Effect of tibia-first, restricted functional alignment technique on gap width changes, and component positioning in robotic arm-assisted total knee arthroplasty.","authors":"Hong Y Yang, Jae H Cheon, Sung J Kang, Jong K Seon","doi":"10.1002/ksa.12487","DOIUrl":"https://doi.org/10.1002/ksa.12487","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to quantitatively assess the predictability of post-resection gap dimensions and the attainment of balanced gaps using robotic arm-assisted total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This retrospective cohort study included 100 consecutive patients who underwent robotic arm-assisted TKA for knee osteoarthritis using a restricted functional alignment (FA) technique. Tibial cuts were performed based on preoperative tibial anatomy within predefined boundaries, followed by femoral component adjustments according to tensioned soft tissues to optimise gap balance. The primary outcome was the proportion of balanced gaps, defined as differential laxities of ≤2 mm, across extension, flexion, lateral, and medial gap measurements. Ligament balancing in lateral and medial compartments was assessed using a robotic system at 10° and 90° flexion to evaluate if restricted FA facilitated a balanced knee. Secondary outcomes included implant alignment, resection depth, and patient-reported outcome measures (PROMs).</p><p><strong>Results: </strong>Significant increases in both lateral and medial gaps at 10° and 90° flexion were observed following tibial and femoral bone resections (p < 0.001). At extension, average gap changes were 0.9 mm (lateral) and 1.6 mm (medial) after tibial cuts, and 0.5 mm (lateral) and 1.2 mm (medial) after femoral cuts. At 90° flexion, changes were 0.3 mm (lateral) and 1.7 mm (medial) following tibial cuts, and 1.0 mm (lateral) and 1.4 mm (medial) after femoral cuts. Despite these variations, the tibia-first, gap-balancing technique achieved overall balance in 98% of gap measurements. The tibial component was placed at an average of 2.1° varus, while the femoral component was positioned at 0.3° varus and 1.3° external rotation relative to the surgical transepicondylar axis. Significant improvements in PROMs were noted between preoperative and one-year postoperative evaluations (all p < 0.05).</p><p><strong>Conclusions: </strong>The tibia-first, restricted FA technique achieved a well-balanced knee in 98% of cases, despite inconsistent gap increments observed between initial assessments and post-resection.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349310","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":"Lateral meniscus posterior root repairs show superior healing, reduced meniscal extrusion and improved clinical outcomes compared to medial meniscus posterior root repairs: A systematic review.","authors":"Lika Dzidzishvili, Gloria Pedemonte-Parramón, Ester Garcia-Oltra, Vicente López, José A Hernández-Hermoso","doi":"10.1002/ksa.12478","DOIUrl":"https://doi.org/10.1002/ksa.12478","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review and summarize the available literature on (1) postoperative healing rates, meniscal extrusion (ME) and clinical outcomes following lateral (LMPRR) versus medial (MMPRR) root repair and (2) potential correlations between residual ME and healing outcomes.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using the Scopus, PubMed and Embase databases. Clinical studies evaluating healing status on second-look arthroscopy and magnetic resonance imaging (MRI) after LMPRR and MMPRR were included. Study quality was assessed using the Methodological Index for Non-Randomized Studies criteria and the modified Coleman Methodology Score.</p><p><strong>Results: </strong>Twenty-three studies comprising 871 patients with LMPRR (n = 406) and MMPRR (n = 465) were included. Overall, 223 (54.9% of total) and 149 (32.04% of total) patients underwent second-look arthroscopy in the LMPRR and MMPRR groups, respectively. Complete root healing was observed in 190 (85.2%) patients in the LMPRR group versus 78 (52.3%) in the MMPRR group (p < 0.001). There were six (2.7%) failed repairs in the LMPRR group compared to 21 (14.09%) in the MMPRR group (p < 0.001). On postoperative MRI, 109 (75.7%) root repairs were healed in the LMPRR group compared to 192 (53.3%) in the MMPRR group (p < 0.001). Failure rates were lower after all-inside and transtibial pullout repairs in the LMPRR group but higher in the MMPRR group, with no significant mean difference between preoperative and postoperative ME in the MMPRR group (p = 0.95). Significantly better clinical outcomes were observed in the LMPRR group compared to the MMPRR group. A greater degree of postoperative ME was associated with lower healing rates (R = -0.78, p < 0.0005). Postoperative ME did not influence clinical outcomes (R = 0.28, p = 0.29).</p><p><strong>Conclusions: </strong>Lateral meniscus posterior root repairs showed higher healing rates compared to MMPRR on both second-look arthroscopy and postoperative MRI. Meniscal extrusion decreased after LMPRR but not after MMPRR. Greater residual ME correlated inversely with healing rates, as more extrusion was associated with lower healing. Postoperative clinical improvement did not affect ME or healing status.</p><p><strong>Study design: </strong>Systematic review of level III and IV studies.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349313","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":"Lost in quantity: The urgent need for more quality in orthopaedic research","authors":"Stefano Zaffagnini,&nbsp;Piero Agostinone","doi":"10.1002/ksa.12488","DOIUrl":"10.1002/ksa.12488","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308029","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 transepicondylar distance is a reliable and easily measured parameter for estimating femoral cartilage surface area using MRI.","authors":"Tayfun Yilmaz, Markus Siegel, Elham Taghizadeh, Andreas Fuchs, Philipp Niemeyer, Hagen Schmal, Kaywan Izadpanah","doi":"10.1002/ksa.12482","DOIUrl":"https://doi.org/10.1002/ksa.12482","url":null,"abstract":"<p><strong>Purpose: </strong>Different cartilage repair techniques are widely used to regenerate cartilage, such as autologous chondrocyte implantation (ACI), osteochondral autograft transfer, microfracturing and minced cartilage. Defect size is a key parameter for selecting the best procedure to repair cartilage. However, the defect's size is not related to the patient's total cartilage surface. This is because assessing the femoral cartilage surface area is time-consuming and therefore unsuitable in the daily clinical routine. It has been proposed that the femur's total cartilage area correlates positively with the transepicondylar distance (TEA).</p><p><strong>Methods: </strong>The knees of 40 subjects were analysed. Their average age was 30.1 ± 8.6 years. Twenty-four female and 16 male subjects were examined. Their mean body height was 176.2 ± 8.8 cm. MRI scans were performed via 3-Tesla MRI. These data were postprocessed and quantified using the browser-based, customizable SATORI platform (Fraunhofer MEVIS). This software computed the femoral cartilage surface area (FeCA), the patella cartilage surface area (PCA), the TEA and the patella length.</p><p><strong>Results: </strong>Body height reveals a good correlation (r = 0.722, p < 0.001) with the distal femur's cartilage area surface. However, regression analysis shows only moderate dependence (R²: 0.514). A very good correlation (r = 0.830, p < 0.001) was observed between the TEA distance and the total cartilage surface area of the distal femur. The regression analysis yields a good value (R²: 0.684). The cranio-caudal length of the patella was chosen as a suitably measurable two-dimensional parameter for correlation analysis with the patella's total cartilage surface area. Those results yield a poor correlation (r = 0.577, p < 0.001) between the two parameters, and regression analysis reveals a low value (R²: 0.384).</p><p><strong>Conclusion: </strong>The TEA is a reliable parameter for estimating the femur's cartilage area using MRI. A simple determination of this parameter allows the estimation of the femur's total cartilage area as well as the surface-corrected defect size (SCDS) in daily routine.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308030","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}