Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Higher hospital volume reduces early failure rates in single-stage revision TKR for infection: An analysis of the United Kingdom National Joint Registry and National Administrative Databases.","authors":"Alexander H Matthews, William K Gray, Jonathan P Evans, Ruth Knight, Jonathan T Evans, Sarah E Lamb, Tim Briggs, Andrew Porteous, Shiraz A Sabah, Abtin Alvand, Andrew Price, Andrew D Toms","doi":"10.1002/ksa.12578","DOIUrl":"https://doi.org/10.1002/ksa.12578","url":null,"abstract":"<p><strong>Purpose: </strong>Revision knee replacement (RevKR) for infection is rare but increasing. It is hypothesised that higher hospital volume reduces adverse outcomes. The aim was to estimate the association of surgical unit volume with outcomes following first, single-stage RevKR for infection.</p><p><strong>Methods: </strong>This population-based cohort study merged data from the United Kingdom National Joint Registry, Hospital Episode Statistics, National Patient Reported Outcome Measures and the Civil Registrations of Death. Patients undergoing procedures between 1 January 2009 and 30 June 2019 were included. Early outcomes were chosen to reflect the quality of the surgical provision and included re-revision at 2 years, mortality, serious medical complications, length of stay and patient-reported outcome measures (PROMs). Adjusted fixed effect multivariable regression models were used to examine the association between surgical unit mean annual caseload and the risk of adverse outcomes.</p><p><strong>Results: </strong>A total of 1477 patients underwent first-time single-stage RevKRs for infection across 267 surgical units and 716 surgeons. Following adjustment for age, gender, American Society of Anaesthesiologists grade, surgeon volume, year of surgery and operation funder and modelling surgical unit volume with restricted cubic spline, a greater mean annual volume was associated with a lower risk of re-revision at 2 years. The odds of re-revision in hospitals performing fewer than or equal to 12 cases per year was 2.53 (95% confidence interval = 1.50-4.31) times more likely than hospitals performing three to four cases per month. Annual variation in surgical unit volume was not associated with mortality and serious medical complications within 90 days. Only 99 out of 1477 (7%) of patients had linked PROMs which precluded subsequent analysis.</p><p><strong>Conclusion: </strong>Overall, higher volume surgical units had lower rates of early re-revision following the first RevKR for infection. We were unable to provide recommended specific volume thresholds for units; however, the probability of re-revision appears to be lowest in the highest volume units.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study of prospectively collected data.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983726","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":"Patients with jumping sign exhibit rotational and bony structural abnormalities consistent with high-grade J-sign in recurrent patellar dislocation.","authors":"Daofeng Wang, Yang Liu, Jianzhong Sun, Qizhen Fu, Chengcheng Lv, Tian Yue, Zhengjie Tang, Zhijun Zhang, Hui Zhang","doi":"10.1002/ksa.12584","DOIUrl":"https://doi.org/10.1002/ksa.12584","url":null,"abstract":"<p><strong>Purpose: </strong>To propose a new sign of patellar maltracking in recurrent patellar dislocation (RPD) and compare the differences in lower limb rotational and bony structural abnormalities among the different signs.</p><p><strong>Patients and methods: </strong>A retrospective study included 279 patients (mean age: 22 years; female: 81%) who underwent primary surgery for RPD over the past 4 years was performed. The patients were grouped based on the characteristics of patellar tracking: low-, moderate- and high-grade J-sign. Patients were further divided into 'jumping' and 'gliding' subgroups based on whether the patella exhibited a 'jumping' sign during flexion-extension motion. All patients received bilateral standard hip-knee-ankle CT scans. The rotational and bony structural parameters of affected knees were measured, and the differences in these variables among the groups were described and analyzed. Reliability analysis was performed to test the consistency of J-sign grading and measurements.</p><p><strong>Results: </strong>There were 92, 100 and 87 patients in the low-, moderate- and high-grade J-sign, respectively. The overall incidence of the jumping sign is 37%. The incidence of the 'Jumping sign' in the high-grade J-sign was significantly higher than in the other two groups (82% vs. 32% vs. 0, p < 0.001). Compared to those with the gliding sign, patients with the jumping sign have higher proportions of increased femoral anteversion (40.8% vs. 24.4%, p = 0.004), excessive knee torsion (61.2% vs. 15.3%, p < 0.001), trochlear dysplasia (95.1% vs. 69.3%, p < 0.001), pronounced supratrochlear spur (73.1% vs. 32.3%, p < 0.001), increased tibial tuberosity-trochlear groove distance (68% vs. 43.3%, p < 0.001), flatter lateral trochlear inclination (81.3% vs. 27.5%, p < 0.001) and excessive sulcus angle (68.7% vs. 35.3%, p = 0.003). No significant morphological differences were found in various bony structural parameters between knees with jumping sign and high-grade J-sign (all p > 0.05). The inter-observer reliability kappa values were 0.65 for the quadrant classification and 0.83 for the new patellar sign.</p><p><strong>Conclusion: </strong>In RPD patients, the rotational and bony structural abnormalities in the jumping sign are highly consistent with the high-grade J sign. This finding may assist the surgeon and their patients in making informed decisions about further imaging tests and osteotomy procedures in the treatment of RPD.</p><p><strong>Level of evidence: </strong>Level IV, cross-sectional study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971523","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":"Embracing the opportunities of 2025: Shaping the future of KSSTA","authors":"Michael T. Hirschmann,&nbsp;Elmar Herbst,&nbsp;Giuseppe Milano,&nbsp;Volker Musahl","doi":"10.1002/ksa.12573","DOIUrl":"10.1002/ksa.12573","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 1","pages":"7-12"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950785","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":"Young age and return to play increase the likelihood of subsequent ACL reconstruction in football players: Data from the Swedish National Knee Ligament Registry.","authors":"Anne Fältström, Magnus Forssblad, Alexander Sandon","doi":"10.1002/ksa.12580","DOIUrl":"https://doi.org/10.1002/ksa.12580","url":null,"abstract":"<p><strong>Purpose: </strong>To compare football players who have undergone one anterior cruciate ligament (ACL) reconstruction (ACLR) with those who have undergone a subsequent ACLR (revision or contralateral) regarding (1) demographics, (2) football-related factors and (3) injury-specific data.</p><p><strong>Methods: </strong>Players who voluntarily completed a football-specific questionnaire available at the Swedish National Knee Ligament Registry website between April 2017 and September 2020 at the time of their primary ACL injury were included in the study. The questionnaire covered demographics, football-related activities and injury-specific factors. Subsequent ACLR registrations within 4 years of the primary ACLR were identified in December 2023. Data on game participation post-primary ACLR were retrieved from the Swedish Football Association's administrative system in September 2022.</p><p><strong>Results: </strong>A total of 992 football players (66% men) were included, of whom 99 (10%) were registered for subsequent ACLRs. Univariable analysis showed that the following factors significantly increased the odds of a subsequent ACLR: female sex, younger age, a lower weight and body mass index, fewer years played, use of knee control exercises during warm-up, more likely to plan a return to football, more game participation registered following the primary ACLR, and shorter time between injury and ACLR. Multivariable logistic regression analysis indicated that the odds of undergoing subsequent ACLR decreased significantly with each additional year of age (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.83‒0.92, p < 0.01). Players using knee control exercises during warm-up (OR, 1.71; 95% CI, 1.08‒2.72, p = 0.02), planning to return to football (OR, 2.74; 95% CI, 1.27‒5.91, p = 0.01), and participating in games after primary ACLR (OR, 1.81; 95% CI, 1.13‒2.91, p = 0.01) increased the odds of undergoing a subsequent ACLR.</p><p><strong>Conclusions: </strong>Younger age and returning to play after an ACLR significantly increase the likelihood of undergoing a subsequent ACLR in football players.</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":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950784","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":"Meniscal forces and knee kinematics are affected by tibial slope modifying high tibial osteotomy.","authors":"Philipp W Winkler, Calvin K Chan, Sene K Polamalu, Gian Andrea Lucidi, Nyaluma N Wagala, Jonathan D Hughes, Richard E Debski, Volker Musahl","doi":"10.1002/ksa.12577","DOIUrl":"https://doi.org/10.1002/ksa.12577","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the effect of increasing the posterior tibial slope (PTS) on knee kinematics and the resultant medial and lateral meniscal forces.</p><p><strong>Methods: </strong>In this controlled laboratory study, a 6 degrees of freedom (DOF) robotic testing system was used to apply external loading conditions to seven fresh-frozen human cadaveric knees: (1) 200-N axial compressive load, (2) 5-N m internal tibial +10-N m valgus torque and (3) 5-N m external tibial + 10-N m varus torque. Knee kinematics and the resultant medial and lateral meniscal forces were acquired for two PTS states: (1) native PTS and (2) increased PTS. Resultant forces in the medial and lateral meniscus were calculated using the principle of superposition.</p><p><strong>Results: </strong>In response to 5-N m external tibial + 10-N m varus torque, significantly more internal tibial rotation was observed after increasing PTS at 60° (p = 0.0156) and 90° (p = 0.0156) flexion. Increasing PTS caused significantly more medial tibial translation from 30° to 90° flexion in response to 5-N m internal tibial + 10-N m valgus torque. In response to 5-N m external tibial + 10-N m varus torque, the resultant force in the medial meniscus at 60° flexion decreased significantly after increasing PTS (32.8%, p = 0.016). Resultant forces in the lateral meniscus decreased significantly after increasing PTS at 30° (34.5%; p = 0.016) and 90° (29.7%; p = 0.031) flexion in response to 5-N m internal tibial + 10-N m valgus torque.</p><p><strong>Conclusion: </strong>Increasing PTS in a native knee with intact cruciate ligaments affected 6 DOF knee kinematics and decreased resultant forces in the medial and lateral meniscus by up to 35% in response to combined rotatory loads. Therefore, increasing PTS during high tibial osteotomy in a knee with intact cruciate ligaments does not increase the force carried by the entire meniscus at time zero.</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":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932236","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":"Multiple secondary stabiliser injuries increase rotational instability in anterior cruciate ligament-deficient knees.","authors":"Jiro Kato, Hiroaki Fukushima, Abe Kensaku, Syunta Hanaki, Kyohei Ota, Yusuke Kawanishi, Makoto Kobayashi, Masahito Yoshida, Tetsuya Takenaga, Yohei Kawaguchi, Gen Kuroyanagi, Hiroaki Sakai, Hideki Murakami, Masahiro Nozaki","doi":"10.1002/ksa.12565","DOIUrl":"https://doi.org/10.1002/ksa.12565","url":null,"abstract":"<p><strong>Purpose: </strong>Medial meniscus ramp lesions (MMRLs), lateral meniscus posterior root tears (LMPRTs), and anterolateral complex injuries (ALCIs) are major secondary stabiliser injuries associated with anterior cruciate ligament (ACL) injuries. This study aimed to investigate the effect of the number of secondary stabiliser injuries on knee instability in ACL injuries.</p><p><strong>Methods: </strong>Patients who underwent primary ACL reconstruction between January 2017 and May 2023 were enroled in this study. Exclusion criteria encompassed patients with other ligament injuries, a history of contralateral knee injury, hyperextension, flexion contracture and meniscus injuries other than MMRL or LMPRT. Ultimately, 158 patients (mean age: 25.3 years; 81 males and 77 females) were included in this study, and the presence of MMRL, LMPRT and ALCI was investigated. Patients were categorised into four groups based on the number of ACL and secondary stabiliser injuries: single (isolated ACL injury), dual, triad and tetrad. Subsequently, the groups were compared regarding pivot shift grade, quantitative rotational instability measured using an inertial sensor, and anterior tibial translation (ATT).</p><p><strong>Results: </strong>Secondary stabiliser injuries identified included ALCI 85 (53.8%), MMRL 58 (36.7%) and LMPRT 23 (14.6%). The distribution of patients in the single, dual, triad and tetrad groups was 45 (28.5%), 68 (43.0%), 37 (23.4%) and 8 (5.1%), respectively. High-grade pivot shifts were observed in 33.3% (15 out of 45) of the single group, 63.2% (43 out of 68) of the dual group, 67.6% (25 out of 37) of the triad group, and 100% (8 out of 8) of the tetrad group. Quantitative evaluations using the inertial sensor revealed significantly lower acceleration in the isolated ACL injury group compared to the other groups (p < 0.05). No significant difference was observed in ATT measurements (n.s.).</p><p><strong>Conclusion: </strong>The combination of secondary stabiliser injuries led to higher instability. Therefore, it is important to carefully diagnose these injuries and devise appropriate treatment plans, particularly in cases of high knee instability.</p><p><strong>Level of evidence: </strong>Level III diagnostic.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932158","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":"Characteristics of eligible patients with knee osteoarthritis accepting versus declining participation in a randomised trial investigating the effect of weight loss versus knee arthroplasty to explore generalisability: A cross-sectional study.","authors":"Saber Muthanna Aljuboori, Robin Christensen, Marius Henriksen, Henning Bliddal, Anders Troelsen, Mikael Boesen, Asbjørn Seenithamby Poulsen, Camilla Toft Nielsen, Kristine Ifigenia Bunyoz, Søren Overgaard","doi":"10.1002/ksa.12546","DOIUrl":"https://doi.org/10.1002/ksa.12546","url":null,"abstract":"<p><strong>Background: </strong>The INtensive diet versus Knee Arthroplasty (INKA) trial is a randomised trial assessing weight loss as an alternative to knee arthroplasty (KA) in obese patients with severe knee osteoarthritis (OA) awaiting KA (NCT05172843). The external validity of the INKA trial may be hampered if the patients who participate differ from those who decline participation.</p><p><strong>Objective: </strong>To compare baseline characteristics between patients who enrol in the INKA trial and those who decline participation (i.e., non-INKA [nINKA] group).</p><p><strong>Methods: </strong>We applied a cross-sectional study design, collecting and comparing baseline characteristics among all patients eligible for enrolment in the INKA trial from two clinics in Copenhagen. Imbalance between accepting (INKA) and declining (nINKA) groups was assessed using standardised differences (StdDs). We were prespecified that StdD values < 0.20 would indicate a clinically insignificant imbalance between groups, whereas values > 0.80 indicate incomparability.</p><p><strong>Results: </strong>Of the 913 patients scheduled for KA, 888 were screened for INKA trial eligibility. Of the 217 eligible patients, 92 (42%) were enroled in the INKA trial, while 37 (17%) participated in the nINKA cross-sectional sample only. Patients enroled in INKA had on average a less severe Oxford knee score (OKS) of 22.0 (standard deviation = 6.7) compared to declining participants in nINKA with 18.6 (7.2), corresponding to an StdD of 0.50, and an absolute difference of 3.45 (95% confidence interval = 0.64-6.26, p = 0.017). A consistent similar pattern was noted across all secondary patient-reported outcomes applied in the INKA trial.</p><p><strong>Conclusions: </strong>We observed discrepancies in patient-reported outcomes, with those who declined enrolment reporting more severe symptoms. These differences, however, were below the minimally important difference between groups for OKS, which is set to 4.84 points.</p><p><strong>Level of evidence: </strong>Level II-III cross-sectional study in a randomised control trial.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932234","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":"Sport-specific differences in ACL injury, treatment and return to sports: Basketball.","authors":"Baris Kocaoglu, Tahir Koray Yozgatli, Thomas Tischer, Julio Calleja-Gonzalez, Francesco Cuzzolin, Asheesh Bedi, Romain Seil","doi":"10.1002/ksa.12575","DOIUrl":"10.1002/ksa.12575","url":null,"abstract":"<p><p>Basketball is an intense, fast-paced game that is physically, highly demanding. Certain aspects of the game, such as the quick pivoting and cutting movements, predispose the players to serious knee injuries, including anterior cruciate ligament (ACL) tears. While an ACL tear can be a devastating condition for players, multidisciplinary management of the injury can provide the players with a reasonable chance to return to play at the pre-injury level. This article aims to review the general principles and guidelines for the management of ACL injury in basketball players. The diagnosis, surgical treatment, rehabilitation and return to sports are discussed from European and North American perspectives. With a comprehensive and multidisciplinary approach to this condition, medical professionals can provide injured basketball players with a favourable prognosis for returning to play at the pre-injury level. To return to normal life and basketball after ACL reconstruction, the proposed approach includes (1) the selection of the appropriate surgical graft and technique, (2) maintaining a healthy and persistent mental state during rehabilitation, and (3) following a scientific rehabilitation programme based on personalized recovery. LEVEL OF EVIDENCE: Level V.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922014","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":"High satisfaction and low conversion rate to total hip arthroplasty after hip arthroscopy for femoroacetabular impingement syndrome and risk factors affecting survival at long-term follow-up.","authors":"Erdal Uzun, Josep Ferrer, Xavi Lizano, Joan Cabello, Sarper Gürsu, Marc Tey Pons","doi":"10.1002/ksa.12563","DOIUrl":"https://doi.org/10.1002/ksa.12563","url":null,"abstract":"<p><strong>Purpose: </strong>Studies evaluating the long-term survival rate, patient satisfaction, and conversion to total hip arthroplasty (THA) are limited. The aim of this study was to evaluate satisfaction and hip survival at a minimum 10-year follow-up in patients following hip arthroscopy for femoroacetabular impingement syndrome (FAIS).</p><p><strong>Methods: </strong>A total of 164 patients underwent hip arthroscopy for FAIS between 2007 and 2012; of these, 76 (49 men and 27 women; mean age, 40.7 ± 11.2 years; range, 15-69 years) patients could be clinically examined or reached by phone or email and included in the study. Prospectively collected data of these patients who followed for a minimum of 10 years were retrospectively analysed. Patients who had previous trauma or surgery on the hip or were younger than 15 years were excluded. Of the 76 patients, 37 (48.7%) had mixed type, where 29 (38.2%) had cam and 10 (13.2%) had pincer type FAIS. Patient demographics, Tonnis grade for osteoarthritis and intraoperative findings were reviewed. Outcome measures of interest included reoperations (re-arthroscopy, conversion to THA), patient satisfaction, ability to return to sports, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Harris Hip Score (mHHS) and some possible factors associated with conversion to THA.</p><p><strong>Results: </strong>The mean follow-up was 12.4 ± 1.8 (10-16 years). Twenty-one per cent required conversion to THA, with a mean time requiring THA of 4.8 ± 1.7 years (2-8 years). Mean age of the patients requiring THA was 47.8 ± 8.2 years. Two (2.6%) patients required re-arthroscopy. Fifty-eight (76.3%) patients did not undergo any revision surgery or other treatments. Forty-seven (61.8%) patients were completely satisfied with the results, where 5 (6.6%) patients were very satisfied and 4 (5.3%) patients were satisfied. Overall satisfaction rate was 73.7%. Mean postoperative mHHS score was 76.5 ± 15.5 and the mean WOMAC score was 84.0 ± 16.0. Return-to-sports rate was 85%, and the return to the old sport level was 67.1%. Age over 40 years (p = 0.004), a Tonnis Grade >1 (p < 0.001) and a full-thickness acetabular chondral lesion (p = 0.001) were identified as factors for failure and conversion to THA.</p><p><strong>Conclusions: </strong>Hip arthroscopy for FAIS resulted in high satisfaction of patients who did not eventually require THA. Higher rates of conversion to THA were seen in older patients, patients treated with higher Tonnis grade and full-thickness acetabular chondral lesions.</p><p><strong>Level of evidence: </strong>IV, Case Series.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922013","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 flat posterior cruciate ligament reconstruction restores native knee kinematics, comparable to a double-bundle reconstruction-A biomechanical robotic investigation.","authors":"Adrian Deichsel, Florian Gellhaus, Christian Peez, Michael J Raschke, Moritz Martinovic, Elmar Herbst, Mirco Herbort, Christian Fink, Christoph Kittl","doi":"10.1002/ksa.12572","DOIUrl":"https://doi.org/10.1002/ksa.12572","url":null,"abstract":"<p><strong>Purpose: </strong>To biomechanically evaluate a flat posterior cruciate ligament (PCL) reconstruction utilizing rectangular femoral bone tunnels.</p><p><strong>Methods: </strong>Eight fresh-frozen human knee specimens were tested in a six-degrees-of-freedom robotic test setup. In each testing step, a force-controlled test protocol was performed, including 89 N posterior tibial translation (PTT) in neutral, internal and external rotation, from 0 to 90° of flexion. After determining the native knee kinematics, the PCL was cut. Subsequently, a flat PCL reconstruction (PCLR) with a rectangular bone tunnel was performed, utilizing a quadriceps tendon autograft with a patellar bone block. After filling the bone tunnel, a single-bundle PCLR without and with femoral interference screw fixation, as well as a double-bundle reconstruction, was performed. Statistical analysis was performed using mixed linear models.</p><p><strong>Results: </strong>Cutting of the PCL led to significant (p ≤ .05) increases in PTT, from 0 to 90° of flexion, up to 10.7 mm, in comparison to the native state. After flat reconstruction and double-bundle reconstruction, no significant difference was found between the native and reconstructed state (p ≥ .05). The single-bundle PCLR without interference screw showed significantly increased PTT in comparison to the native state in 30° (mean difference [MD] 3.3 mm; 95% confidence interval [CI] 1.3 - 5.2 mm; p < .001), 60° (MD 4.4 mm; 95% CI 2.5-6.4 mm; p < .001) and 90° of flexion (MD 4.0 mm; 95% CI 2.1-6.0 mm; p < .001). The single-bundle PCLR with additional interference screw showed significantly increased PTT in comparison to the native state only in 30° (MD 1.9 mm; 95% CI 0.05-3.8 mm; p = .01).</p><p><strong>Conclusion: </strong>Both a flat and a double-bundle PCLR were able to restore the native knee kinematics in all tested flexion angles. A single-bundle reconstruction was not able to fully restore native kinematics, with only small residual anteroposterior instability.</p><p><strong>Level of evidence: </strong>Not applicable (an experimental laboratory study).</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909862","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}