Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"The recovery trajectory of anterior cruciate ligament ruptures in randomised controlled trials: A systematic review and meta-analysis of operative and nonoperative treatments.","authors":"Ali Ridha, Siddarth Raj, Henry Searle, Imran Ahmed, Nicholas Smith, Andrew Metcalfe, Chetan Khatri","doi":"10.1002/ksa.12626","DOIUrl":"https://doi.org/10.1002/ksa.12626","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this research was to understand the trajectory of recovery following anterior cruciate ligament (ACL) reconstruction compared to nonoperative treatments.</p><p><strong>Methods: </strong>A systematic review and meta-analysis approach was used to evaluate randomised controlled trials (RCTs). A comprehensive search was conducted on databases including Medline, Embase, Web of Science and The Cochrane Central Register of Controlled Trials up until 18 May 2023. The study focused on full-text RCTs involving patients with partial or complete ACL tears. Included were studies focusing on patients undergoing ACL reconstruction or nonoperative care. The primary outcome was characterising the effects of treatments and tracking changes in International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) outcomes over time. The secondary outcome was characterising and tracking the changes of the knee injury and osteoarthritis outcome score subscales, ACL-quality-of-life questionnaire, Lysholm, Tegner and CKRS scores.</p><p><strong>Results: </strong>A total of 84 RCTs were included. The pooled standardised mean changes for the IKDC compared with baseline were: 2.0 (95% confidence interval [CI]: 0.3-3.6) at 3 months, 2.2 (95% CI: 0.9-3.6) at 6 months, 2.2 (95% CI: 0.8-3.6) at 12 months and 2.3 (95% CI: 1.3-3.4) at 24 months. Graphs illustrating IKDC scores over time further emphasise these findings, showing a sustained improvement over time to 12 months, with a plateauing of scores past this time point. Our secondary outcome patient-reported outcome measures (PROMs) also showed a similar pattern with scores plateauing at the 12-months mark.</p><p><strong>Conclusion: </strong>Our findings suggest that the IKDC score and other PROMs are effective for tracking recovery up to 12 months. Other PROMs show pain and daily activities generally recover within 6 months, and quality of life improves up to 12 months, but PROMs show minimal improvement beyond this period. This inconsistency with a return sport period indicates that PROMs may lack the sensitivity required to assess this aspect of recovery accurately.</p><p><strong>Level of evidence: </strong>Level I.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic analysis of the sternoclavicular, acromioclavicular and scapulothoracic joint demonstrates significant multiplanar alterations in acromioclavicular injuries with each consecutive ligamentous injury during movements of the shoulder girdle: A whole-cadaver study.","authors":"Thomas Braeckevelt, Ian Peeters, Tanneke Palmans, Lieven De Wilde, Alexander Van Tongel","doi":"10.1002/ksa.12621","DOIUrl":"https://doi.org/10.1002/ksa.12621","url":null,"abstract":"<p><strong>Purpose: </strong>In acromioclavicular (AC) joint injuries, the kinematical interplay between the AC ligament, coracoclavicular (CC) ligaments and deltotrapezial fascia (DTF) during motions of the shoulder complex is disturbed. This study assessed kinematic alterations of sternoclavicular (SC), scapulothoracic (ST) and AC joint motion during humerothoracic and ST movements in AC injuries.</p><p><strong>Methods: </strong>Shoulder girdle motion was evaluated in 14 cadaveric shoulders in 4 conditions, consisting of an intact state and AC injuries of increasing severity by sequentially sectioning the AC and CC ligaments and DTF. Joint motions were registered during humerothoracic elevation and protraction. An optical navigation system measured three-dimensional rotations and translations in the SC, ST and AC joints.</p><p><strong>Results: </strong>Sectioning of the AC ligament increased inferior and anterior AC translation with a concomitant increase of scapular protraction. The clavicle rotated to an overall more posteriorly rotated position. Sectioning of the CC ligaments increased lateral rotation and protraction of the scapula relative to the clavicle with a concomitant inferior translation of the acromion. Also, manifest overriding of the clavicle is noted due to instability in the superoinferior and anteroposterior axes. The clavicle rotated back to an overall more anteriorly rotated position, similar to the native condition. Sectioning of the DTF further increased protraction of the scapula relative to the clavicle, while a further medial translation of the acromion under the clavicle is observed.</p><p><strong>Conclusion: </strong>The AC ligament affects anteroposterior stability, while the CC ligaments disturb stability in a superoinferior and mediolateral direction. All ligaments influence clavicular axial rotation. The DTF exacerbates alterations caused by the CC ligaments. Multiplanar decoupling results in overriding of the clavicle observed after sectioning the CC ligaments. Each sectioned ligament significantly increases scapular protraction. These findings guide further advancements in (non)surgical treatment of AC injuries to restore optimal function.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee muscle strength and movement biomechanics in individuals with and without knee pain after anterior cruciate ligament reconstruction: A cross-sectional study.","authors":"Elisabeth Bandak, Lauri Stenroth, Will Bosch, Kasper Krommes, Johannes Iuel Berg, Henrik Aagaard, Micael Haugegaard, Per Hölmich, Henning Bliddal, Marius Henriksen, Tine Alkjær","doi":"10.1002/ksa.12630","DOIUrl":"https://doi.org/10.1002/ksa.12630","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior cruciate ligament injury increases the risk of knee osteoarthritis, possibly via early onset of knee pain and changes in musculoskeletal function. This study compared knee muscle strength and movement biomechanics during walking and forward lunge between individuals with and without knee pain after anterior cruciate ligament reconstruction.</p><p><strong>Methods: </strong>Cross-sectional study including participants at least 3 years post anterior cruciate ligament reconstruction, aged 18-40 at the time of surgery, and body mass index ≤30. Symptomatic participants were defined by a knee pain score (reconstructed knee) of ≥3 on a 0-10 scale during activities of daily living in the past week. Asymptomatic participants were defined by a pain score of 0. Maximal isometric quadriceps and hamstring muscle strength (Nm/kg) and 3D walking, and forward lunge movement biomechanics were measured.</p><p><strong>Results: </strong>A total of 122 participants (30% females) were included: 33 symptomatic and 89 asymptomatic (average age: 33.7, range 23.7-51.3 years). The average post-surgery time was 6 (range 3-10) years. The symptomatic group exhibited lower isometric quadriceps and hamstring strength with mean group differences (95% confidence interval [CI]) of 0.33 (0.10 to 0.56) Nm/kg and 0.19 (0.07 to 0.31) Nm/kg, respectively. There were no important group differences in the walking and forward lunge movement biomechanics.</p><p><strong>Conclusions: </strong>Symptomatic individuals with anterior cruciate ligament reconstruction demonstrated weaker knee muscles compared to their asymptomatic counterparts. The comparable walking and forward lunge biomechanics suggest that knee pain has no substantial impact on movement biomechanics up to 10 years post-surgery.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458592","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":"Routine-data-compatible quality indicators for the ambulatory care of osteoarthritis of the knee and hip: A systematic review.","authors":"Tobias Bock, Ronja Flemming, Philip Bammert, Rüdiger von Eisenhart-Rothe, Michael T Hirschmann, Leonie Sundmacher","doi":"10.1002/ksa.12614","DOIUrl":"https://doi.org/10.1002/ksa.12614","url":null,"abstract":"<p><strong>Purpose: </strong>Germany has high rates of total joint arthroplasty for osteoarthritis of the knee and hip. Ambulatory health interventions can affect the progression of these conditions and the need for total joint arthroplasty. Quality indicators and guideline recommendations facilitate the transparent measurement and demonstration of care quality. Therefore, a systematic literature review of quality indicators and guideline recommendations for ambulatory care of osteoarthritis of the knee and hip before total joint arthroplasty was conducted, focusing on those that could be quantified using routine data from German statutory health insurers.</p><p><strong>Methods: </strong>Five electronic databases for quality indicators and guidelines published between 2000 and 2021 related to the ambulatory management of osteoarthritis of the knee and hip before total joint arthroplasty were searched. Two reviewers independently selected and appraised the quality of the studies. To synthesise a routine-data-compatible set of quality indicators, similarities and differences among existing quality indicator sets and guideline recommendations were identified and resolved.</p><p><strong>Results: </strong>This systematic search yielded 10,841 potentially relevant records, leading to the identification of 20 sets of quality indicators and 35 guidelines with measures quantifiable using routine data. The present evidence synthesis produced 24 routine-data-compatible process quality indicators related to the type, order or frequency of musculoskeletal appointments, diagnostic imaging procedures, referrals to physical therapists and pharmaceutical prescriptions.</p><p><strong>Conclusion: </strong>The synthesised set of routine-data-compatible quality indicators can provide a resource-saving tool for offering individual feedback to physicians on the processes involved in the ambulatory management of osteoarthritis of the knee and hip. Engaging in interdisciplinary discussions on variations in quality indicator outcomes could contribute to improving interdisciplinary physician collaboration in ambulatory care for these conditions.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414481","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":"Knee laxity, joint hypermobility, femoral anteversion, hamstring extensibility and navicular drop as risk factors for non-contact ACL injury in female athletes: A 4.5-year prospective cohort study.","authors":"Kati Pasanen, Arttu Seppänen, Mari Leppänen, Kari Tokola, Timo Järvelä, Tommi Vasankari, Grethe Myklebust, Tron Krosshaug, Jari Parkkari","doi":"10.1002/ksa.12625","DOIUrl":"https://doi.org/10.1002/ksa.12625","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether six selected anatomical variables were associated with non-contact anterior cruciate ligament (ACL) injury in female team sport athletes.</p><p><strong>Methods: </strong>Two hundred eighty-seven female athletes (age 13-38 at baseline) from basketball, floorball, ice hockey and volleyball completed a baseline physical examination, including measurements of anterior-posterior (AP) knee laxity, knee hyperextension, generalized joint hypermobility, femoral anteversion, hamstring extensibility, and navicular drop. Athletes entered the study either in 2011, 2012 or 2013 and were followed up until the end of 2015. During the follow-up, all complete and magnetic resonance-verified ACL injuries were recorded.</p><p><strong>Results: </strong>Twenty-three non-contact ACL injuries were recorded. There were no significant differences in baseline physical examination variables between athletes who sustained ACL injuries and those who did not. However, a side-to-side difference in AP knee laxity greater than 2 mm was observed in 20% of the ACL injury group compared to 12% of the non-injured group, although this difference was not statistically significant.</p><p><strong>Conclusions: </strong>In this study, AP knee laxity, knee hyperextension, generalized joint hypermobility, femoral anteversion, hamstring extensibility and navicular drop were not associated with increased risk for non-contact ACL injury in female team sport athletes. This study was powered to detect moderate to strong risk associations; thus, smaller risk associations may not have been identified.</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":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408719","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":"Improved quadriceps efficiency with a medial pivot in comparison to a cruciate-retaining design in total knee arthroplasty.","authors":"Leandra Bauer, Thomas R Niethammer, Christoph Thorwächter, Matthias Woiczinski, Peter E Müller, Florian Simon, Boris M Holzapfel, Johanna-Maria Simon","doi":"10.1002/ksa.12624","DOIUrl":"https://doi.org/10.1002/ksa.12624","url":null,"abstract":"<p><strong>Purpose: </strong>The posterior cruciate-retaining (CR) design offers rotational freedom but risks abnormal kinematics and instability. The medial pivot (MP) design mimics native joint motion with a high-conformity medial and flat lateral interface. Within clinical studies, the MP design outclassed the CR design, but biomechanical studies are lacking. This study investigates the tibiofemoral and patellofemoral kinematics of both implant designs compared to native kinematics.</p><p><strong>Methods: </strong>Eight fresh-frozen cadaveric knee specimens underwent total knee arthroplasty using MP and CR designs. Testing was performed in a dynamic knee rig simulating active knee flexion (30-130°) under muscle load. Biomechanical assessments included tibial rotation, tibiofemoral translation, patellar tilt/shift, patellofemoral contact/pressure patterns and quadriceps force. Functional regressions were used to analyse the effects of the component designs on the native situation.</p><p><strong>Results: </strong>The MP design exhibited increased tibial rotation (130° flexion: MP 9.4° vs. CR 6.6°) and lateral anterior tibial translation during flexion (130° flexion: MP 25.8 mm vs. CR 22.6 mm). Both designs showed no significant differences in patellar tilt or shift and similar patellofemoral pressure (CR 3.2 MPa, MP 3.4 MPa) and contact patterns (CR 213.8 mm² vs. MP 230.4 mm²). The MP design required lower quadriceps force, particularly in deep flexion (NS 452.6 N, CR 407.8 N and MP 367.3 N).</p><p><strong>Conclusion: </strong>The MP design provides a more native-like knee kinematic profile than the CR design, with a more pronounced MP motion pattern and reduced quadriceps loading.</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":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414477","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":"DeepSeek versus ChatGPT: Multimodal artificial intelligence revolutionizing scientific discovery. From language editing to autonomous content generation—Redefining innovation in research and practice","authors":"Mahmut Enes Kayaalp,&nbsp;Robert Prill,&nbsp;Erdem Aras Sezgin,&nbsp;Ting Cong,&nbsp;Aleksandra Królikowska,&nbsp;Michael T. Hirschmann","doi":"10.1002/ksa.12628","DOIUrl":"10.1002/ksa.12628","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 5","pages":"1553-1556"},"PeriodicalIF":3.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12628","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399525","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":"Measuring osteotomy wedge angle is more important than measuring wedge height in open wedge osteotomies around the knee in preoperative planning","authors":"Julius Watrinet,&nbsp;Johannes Schlaich,&nbsp;Romed Vieider,&nbsp;Marco-Christopher Rupp,&nbsp;Julian Mehl,&nbsp;Sebastian Siebenlist,&nbsp;Armin Runer","doi":"10.1002/ksa.12609","DOIUrl":"10.1002/ksa.12609","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Preoperative planning for medial open wedge high tibial osteotomies (HTOs) and lateral open wedge distal femur osteotomies (DFOs) commonly uses wedge height to guide accurate correction. However, it is unclear if this parameter is influenced by intraoperative variations in osteotomy entry point or length. This study hypothesized that wedge angle remains constant during planning, while wedge height varies depending on hinge or entry points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Whole leg radiographs of 40 patients who underwent HTO or DFO (2018–2024) were analysed using digital planning software. For each HTO and DFO case, 27 and 21 osteotomy variants were created, respectively, by altering entry and hinge points, resulting in 960 simulations. Wedge angle, wedge height and osteotomy depth were measured for each variant. Correlations and regression analyses assessed the relationships among these variables, and a mathematical formula was developed to predict wedge height from wedge angle and osteotomy depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Wedge angle remained consistent across variants (mean deviation: 0.1 ± 0.1°), while wedge height showed variability (mean deviation: 0.7 ± 0.5 mm) influenced by entry and hinge points. Significant correlations were found between wedge height and opening angle (<i>R</i> = 0.83, <i>p</i> &lt; 0.001) and osteotomy depth (<i>R</i> = 0.60, <i>p</i> &lt; 0.001). Predicted wedge height closely matched actual values (<i>R</i> = 0.998, <i>p</i> &lt; 0.001), with minimal error (−0.01 ± 0.1°).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights that relying solely on wedge height for osteotomy planning in HTO and DFO is insufficient due to variations in entry and hinge points. The hinge angle proved to be the most reliable parameter. Intraoperative osteotomy depth measurements can help adjust wedge height for accurate limb alignment when deviations occur.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V, simulation study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 4","pages":"1443-1451"},"PeriodicalIF":3.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399478","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":"AKIRA: Deep learning tool for image standardization, implant detection and arthritis grading to establish a radiographic registry in patients with anterior cruciate ligament injuries.","authors":"Yining Lu, Linjun Yang, Kellen Mulford, Austin Grove, Ellie Kaji, Ayoosh Pareek, Bruce Levy, Cody C Wyles, Christopher L Camp, Aaron J Krych","doi":"10.1002/ksa.12618","DOIUrl":"https://doi.org/10.1002/ksa.12618","url":null,"abstract":"<p><strong>Purpose: </strong>Developing large-scale, standardized radiographic registries for anterior cruciate ligament (ACL) injuries with artificial intelligence (AI) tools can enhance personalized orthopaedics. We propose deploying Artificial Intelligence for Knee Imaging Registration and Analysis (AKIRA), a trio of deep learning (DL) algorithms, to automatically classify and annotate radiographs. We hypothesize that algorithms can efficiently organize radiographs based on laterality, projection, identify implants and classify osteoarthritis (OA) grade.</p><p><strong>Methods: </strong>A collection of 20,836 knee radiographs from all time points of treatment (mean orthopaedic follow-up 70.7 months; interquartile range [IQR]: 6.8-172 months) were aggregated from 1628 ACL-injured patients (median age 26 years [IQR: 19-42], 57% male). Three DL algorithms (EfficientNet, YOLO [You Only Look Once] and Residual Network) were employed. Radiograph laterality and projection (anterior-posterior [AP], lateral, sunrise, posterior-anterior, hip-knee-ankle and Camp-Coventry intercondylar [notch]) were labelled by a DL model. Manually provided labels of metal fixation implants were used to develop a DL object detection algorithm. The degree of OA, both as measured by specific Kellgren-Lawrence (KL) grades, as well as based on a binarized label of OA (defined as KL Grade ≥2), on standing AP radiographs were classified using a DL algorithm. Individual model performances were evaluated on a subset of images prior to the deployment of AKIRA to registry construction using all ACL radiographs.</p><p><strong>Results: </strong>The classification algorithms showed excellent performance in classifying radiographic laterality (F1 score: 0.962-0.975) and projection (F1 score: 0.941-1.0). The object detection algorithm achieved high precision-recall (area under the precision-recall curve: 0.695-0.992) for identifying various metal fixations. The KL classifier reached concordances of 0.39-0.40, improving to 0.81-0.82 for binary OA labels. Sequential deployment of AKIRA following internal validation processed and labelled all 20,836 images with the appropriate views, implants, and the presence of OA within 88 min.</p><p><strong>Conclusion: </strong>AKIRA effectively automated the classification and object detection in a large radiograph cohort of ACL injuries, creating an AI-enabled radiographic registry with comprehensive details on laterality, projection, implants and OA.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382654","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":"Comparison of double bundle semitendinosus technique and pedicled quadriceps technique in patellar instability.","authors":"Tayfun Özel, Semih Yaş, Hayati Hürol Türkoğlu, Asim Ahmadov, Muhammet Baybars Ataoğlu, Ulunay Kanatlı","doi":"10.1002/ksa.12619","DOIUrl":"https://doi.org/10.1002/ksa.12619","url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical and functional outcomes of medial patellofemoral ligament (MPFL) reconstruction using a minimally invasive pedicled quadriceps tendon (QT) or patella double tunnel technique with semitendinosus tendon (ST) graft in patients with recurrent patella dislocation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 51 patients who underwent MPFL reconstruction between 2014 and 2022, with a minimum 2-year post-operative follow-up. Patients were grouped as QT (n = 24) and ST (n = 27), alongside a control group of 24 healthy individuals. Kujala, Lysholm and Visual Analogue Scale (VAS) scores were evaluated. Isokinetic tests at 60° angular velocity were performed to calculate the limb symmetry index (LSI) and hamstring/quadriceps (H/Q) ratio.</p><p><strong>Results: </strong>No significant differences were found between groups regarding age, sex, body mass index, time to surgery, or number of dislocations (n.s). Mean Kujala (QT: 89.2 ± 8.9, ST: 85.4 ± 11.4), Lysholm (QT: 90.6 ± 9.4, ST: 87.9 ± 10.7), and VAS (QT: 0.83 ± 1.3, ST: 0.9 ± 1.1) scores showed no statistically significant differences between the groups (n.s). Extension LSI was significantly higher in QT (92.2 ± 10.0%) than ST (81.4 ± 16.4%, p = 0.024), as was flexion LSI (QT: 94.2 ± 10.9%, ST: 83.3 ± 17.5%, p < 0.01). H/Q ratios showed no significant differences between operated and non-operated sides (n.s). No redislocations or patellar fractures occurred. Apprehension signs were positive in two patients (7.4%) in ST and one patient (4.1%) in QT.</p><p><strong>Conclusion: </strong>MPFL reconstruction with both ST and pedicled QT grafts yields successful results in well-selected patient groups. Unlike ST, reconstruction with QT results in extension and flexion strength in the operated extremity that is closer to the non-operated side and to the healthy control group.</p><p><strong>Level of evidence: </strong>Level III, retrospective case-control study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382717","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}