Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Time-course changes in lower limb strength, vertical jump metrics and their relationship with patient reported outcomes following anterior cruciate ligament reconstruction","authors":"Benjamin Dutaillis, Tyler Collings, Philip Bellinger, Ryan G. Timmins, Morgan D. Williams, Mathew N. Bourne","doi":"10.1002/ksa.12694","DOIUrl":"10.1002/ksa.12694","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To (1) investigate how lower limb strength, vertical jump metrics, and patient reported outcome measures (PROMs) change in the initial 3- to 12-months of recovery following ACLR; and (2) explore which strength and vertical jump metrics best differentiate between lower and higher Knee Osteoarthritis Outcome Score (KOOS) and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty recreationally active athletes undergoing unilateral primary ACLR underwent field-based assessments of knee flexion and extension strength, hip adduction and abduction strength, and double and single leg countermovement (CMJ) and drop vertical jump (DVJ) kinetics at 3-, 6-, 9- and 12-months following surgery. The KOOS and ACL-RSI were also completed. Mixed models were used to investigate how measures of lower limb strength, vertical jump metrics and PROMs change across the first 12-months of rehabilitation. Mixed model decision trees were used to determine which strength and vertical jump measures best discriminated between lower and higher PROMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vertical jump height and reactive strength index (RSI) improved significantly over time (<i>p</i> < 0.001), with reductions in contraction and contact times (<i>p</i> < 0.05). Isometric knee extension and eccentric knee flexion strength increased significantly (<i>p</i> < 0.001), as did KOOS and ACL-RSI scores (<i>p</i> < 0.001). Surgically reconstructed limbs displayed deficits in most vertical jump and strength measures compared to the uninjured contralateral limb, although deficits reduced over time with between limb asymmetry deceasing in 70% of these variables (<i>p</i> range: 0.05 to <0.001). Single leg CMJ jump height < 8.4 cm best discriminated between lower and higher ACL-RSI scores (<i>r</i><sup>2</sup> = 0.67, <i>d</i> = 0.8), whilst knee extension peak force asymmetry < 38.3% best discriminated between lower and higher KOOS scores (<i>r</i><sup>2</sup> = −0.78, <i>d</i> = 0.9) across the time-course of rehabilitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most measures of lower limb strength and vertical jump metrics change in both the ACLR and uninjured contralateral limbs across the first 12-months of recovery following primary ACLR. A strong relationship was found between measures of lower limb strength and vertical jump performance with PROMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 ","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 7","pages":"2684-2699"},"PeriodicalIF":5.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12694","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989397","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":"Periprosthetic fractures of the tibia in knee arthroplasty have a high risk of treatment failure: A systematic review","authors":"Georgios Kalifis,&nbsp;Theodorakys Marin Fermin,&nbsp;Angelo V. Vasiliadis,&nbsp;Georgios Tsinaslanidis,&nbsp;Christopher Gee,&nbsp;Michael Hantes","doi":"10.1002/ksa.12692","DOIUrl":"10.1002/ksa.12692","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Tibial periprosthetic fractures (PPF) are rare but potentially devastating complications following knee arthroplasty. Despite the increasing number of knee replacements worldwide, there is limited data in the literature regarding these injuries. This systematic review aimed to add up-to-date, evidence-based data on tibial PPF that may lead to a more standardised approach and improved outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, Virtual Health Library and Cochrane Library databases was performed in accordance with PRISMA guidelines, including studies published from January 2015 to January 2025. Studies were eligible if they reported tibial PPF in knee arthroplasty with at least three patients, describing the treatment approach and follow-up. Data extracted included patient demographics, fracture classification, treatment method, outcomes and methodological quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies met the inclusion criteria, including 473 patients with a mean age of 67.6 ± 2.5 years. Felix classification was used for 172 patients, Type 3 being the most common (48%). Overall union rate was 87%. While 29% of fractures were managed conservatively, 71% underwent operative management, with open reduction and internal fixation (ORIF) being the most common at 55%. The complication rate was 38%, with infection being the most common standing at 13%. The secondary intervention rate was 28%, most commonly due to failure of initial management and soft-tissue-related complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tibial PPF is a rare but demanding complication of knee arthroplasty, associated with high complication (38%) and reoperation (28%) rates. Optimisation of surgical techniques is crucial to prevent iatrogenic fractures. Provided that the implant is stable, fracture fixation is effective following the appropriate principles depending on the personality of the fracture. Revision TKA may also be effective as a first-line option. Considering the scarce evidence in the literature and the high volume of worldwide knee arthroplasties performed, further high-quality studies are crucial to improve outcomes.</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":"3228-3239"},"PeriodicalIF":5.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028870","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":"Data beats dogma—Valgus knees are not associated with a hypoplastic lateral femoral condyle: A CT-based analysis from a high-volume institution","authors":"Fabio Mancino,&nbsp;Joshua G. Twiggs,&nbsp;Ishaan Jagota,&nbsp;Brett A. Fritsch","doi":"10.1002/ksa.12688","DOIUrl":"10.1002/ksa.12688","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Observations following the mechanical alignment principle have led to the concept that the lateral femoral condyle (LFC) is hypoplastic in valgus knee. This study aimed to investigate if this assumption is correct—the hypothesis was that there is no relationship between the radius of curvature of the LFC and coronal alignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective study of prospectively collected patients who underwent primary robotic TKA between 2021 and 2023. Segmentation of the preoperative computerised tomography scan was performed to obtain a three-dimensional model of the knee. A semi-automated algorithm was used to create a circle of best fit to obtain the radius of each femoral condyle. The size of the condyles was expressed as the lateral-to-medial (L2M) condylar radii ratio. Patients were stratified based on hip–knee–ankle (HKA) angle and L2M ratio, and the association with the alignment was analysed. Distal and posterior offset were investigated and analysed. Significance was for <i>p</i> values &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 498 consecutive knees were investigated. The mean HKA was 4.1 ± 5.4° varus. The mean L2M condylar ratio was 0.95 in patients with neutral alignment, 0.98 in varus alignment and 0.96 in valgus alignment. The L2M ratio was &lt;1 in all alignment groups, with no significant differences between varus and valgus. The knees with a hypoplastic LFC (L2M ratio &lt;0.9) showed a similar HKA distribution to those with L2M &gt; 0.9. No differences in posterior offset of the LFC were noted between valgus, neutral and varus knees. The lateral distal offset was greater in valgus than neutral knees (27.1 ± 2.7 mm vs. 25.9 ± 2.9 mm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The LFC is on average smaller than the MFC regardless of the coronal alignment, with no correlation with the HKA. These findings add evidence against the concept of a hypoplastic LFC in valgus knees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3240-3249"},"PeriodicalIF":5.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042338","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":"Current practice of biologic augmentation techniques to enhance the healing of meniscal repairs: A collaborative survey within the Meniscus International Network (MenIN) Study Group.","authors":"James Robinson, Iain R Murray, Gilbert Moatshe, Jorge Chahla, Luke V Tollefson, David A Parker, Filippo Familiari, Robert F LaPrade, Nicholas N DePhillipo","doi":"10.1002/ksa.12685","DOIUrl":"https://doi.org/10.1002/ksa.12685","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate practices and preferences among expert sports knee surgeons regarding biologic augmentation techniques in meniscal repair.</p><p><strong>Methods: </strong>A 12-question multiple-choice survey was distributed to the Meniscus International Network (MenIN) Study Group. It covered biologic augmentation techniques for various meniscal tear types, both in isolation and with anterior cruciate ligament reconstruction (ACLR). Eight options were assessed: no augmentation, trephination, rasping, marrow venting, fibrin clot, platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC) and meniscal wrapping. Surgeons could select multiple techniques per scenario.</p><p><strong>Results: </strong>Forty-two surgeons participated: 42% from Europe, 18% from North America, 10% from Latin America, 21% from Asia and 9% from Africa/Oceania. For isolated meniscal tears (excluding meniscal root tears), 90% of surgeons used at least one biologic augmentation technique. For meniscal tears associated with ACLR, 66% of surgeons used at least one biologic augmentation technique. The most utilized techniques were rasping (19%-69%), trephination (7%-43%), and marrow venting (0%-74%). PRP (2%-19%), BMAC (0%-14%) and meniscal wrapping (0%-10%) were least used. Biologic augmentation was most frequent for isolated radial (93%), isolated bucket-handle (86%), isolated vertical (86%) and isolated horizontal tears (98% for younger patients, 86% for degenerative tears). ACLR-associated repairs had lower augmentation rates, and meniscal root tears showed the highest percentage of non-augmented repairs. Over 50% of surgeons use a single augmentation technique, while 20% use two techniques depending on tear type. Overall, 33.3% (n = 14) of surgeons reported utilizing PRP and/or BMAC for meniscal repair augmentation, with the highest use observed in South America (12%) based on geographic usage.</p><p><strong>Conclusions: </strong>This survey provides insights into current meniscal repair practices among expert orthopaedic sports medicine surgeons. The findings reveal variability in approaches based on tear patterns and associated procedures, with a general preference for simpler mechanical augmentation techniques over more advanced biologics. For isolated meniscal tears (excluding meniscal root tears), 90% of surgeons in this cohort report using one or more biological augmentation techniques.</p><p><strong>Level of evidence: </strong>Level V expert opinion.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033001","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":"Large variability in minimal clinically important difference, substantial clinical benefit and patient acceptable symptom state values among literature investigating patellar stabilization surgery: A systematic review.","authors":"Ahmed Bilgasem, Prushoth Vivekanantha, Lauren Gyemi, Zackariyah Hassan, David Slawaska-Eng, Amit Meena, Shahbaz Malik, Darren de Sa","doi":"10.1002/ksa.12684","DOIUrl":"https://doi.org/10.1002/ksa.12684","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate minimal clinically important difference (MCID), substantial clinical benefit (SCB), patient acceptable symptom state (PASS) values for patient-reported outcome measures (PROMs) after patellar stabilization surgery for patellar instability. Secondary outcomes included to describe methods to calculate clinically significant outcomes (CSOs), and to report on the achievement of these metrics.</p><p><strong>Methods: </strong>On 31 July 2024, three databases were searched. Information on whether studies calculated MCID, SCB or PASS values or used previously established values was recorded. Data on study characteristics, CSO values, and the method of MCID quantification (e.g., distribution vs. anchor) were extracted.</p><p><strong>Results: </strong>A total of 17 articles with 1447 patients (1462 knees) were included. A total of 18 unique outcome measures were reported. Six out of 15 (40%), 2 out of 5 (40%), and zero studies used prior established values for MCID, SCB and PASS, respectively. MCID ranged widely (e.g., International Knee Documentation Committee [IKDC]: 5.6-20.5; Kujala Anterior Knee Pain Scale: 5.38-11.9 and Lysholm: 5.6-11.1). Fourteen out of 15 utilized a distribution-based method to calculate MCID, with only one study using an anchor-based method. SCB values ranged widely as well (e.g.</p><p><strong>, ikdc: </strong>14.5-23.6; Knee Osteoarthritis and Outcome Score [KOOS] symptoms: 4.2-14.2 and KOOS activities of daily living [ADLs]: 6.5-25.7). Large variability was found among percentages of patients that achieved MCID values (e.g.</p><p><strong>, ikdc: </strong>28%-98.6%, Kujala: 38%-100%, Lysholm: 44%-98.4% and Tegner: 84%-95%).</p><p><strong>Conclusion: </strong>The significant heterogeneity in reported thresholds for MCID, SCB and PASS across studies highlights critical challenges in interpreting results after patellar stabilization surgery, specifically regarding what constitutes a clinically relevant outcome. MCID was the most commonly reported metric and calculated predominantly with distribution-based methods, with over half of the studies using previously established thresholds. PASS and SCB were widely underreported as well, suggesting a need for studies investigating patellar stabilization to prioritize the calculation of all three metrics, using anchor-based techniques.</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":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969725","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":"Prehabilitation prior to anterior cruciate ligament reconstruction is a safe and effective intervention for short- to long-term benefits: A systematic review.","authors":"Alexander Zakharia, Kailai Zhang, Fares Al-Katanani, Preksha Rathod, Abhilash Uddandam, Jeffrey Kay, Ben Murphy, Dan Ogborn, Darren de Sa","doi":"10.1002/ksa.12631","DOIUrl":"https://doi.org/10.1002/ksa.12631","url":null,"abstract":"<p><strong>Purpose: </strong>Comprehensively explore current practices in preoperative rehabilitation (prehabilitation) for anterior cruciate ligament reconstruction (ACLR) and assess corresponding clinical outcomes and complication rates.</p><p><strong>Methods: </strong>A systematic search of EMBASE, MEDLINE, Cochrane and PubMed was conducted from inception to 1 November 2024. All studies reporting outcomes and/or complications following prehabilitation and ACLR were included. Screening and data abstraction were designed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Revised Assessment of Multiple Systematic Reviews guidelines.</p><p><strong>Results: </strong>Thirty-six studies with 2326 patients undergoing prehabilitation and ACLR were included. Weighted averages of all clinical outcomes met or surpassed patient acceptable symptom state (PASS) thresholds and return to sports (RTS) criteria. There were no preoperative complications following prehabilitation. Major post-operative complications included graft failure (4.6%), contralateral ACL rupture (1.0%), surgical site infection (0.6%), deep infection (0.4%), non-ACL ligament injury (0.5%), reoperation for hardware removal (0.3%), muscle rupture (0.1%), patellar subluxation (0.1%) and patellar rupture (0.1%).</p><p><strong>Conclusion: </strong>Current prehabilitation practices for ACLR emphasize impairment resolution, ROM restoration, and neuromuscular exercises. Safety of current practices is supported by the absence of preoperative complications and similar post-operative complication rates compared to patients undergoing standard care. Clinical outcomes of patients undergoing prehabilitation were shown to meet and surpass PASS thresholds and RTS criteria, expedite post-operative recovery, and maintain functional improvements up to 10 years post-operation, suggesting that prehabilitation is a safe and effective intervention yielding short- to long-term benefits. There is a need for further high-quality randomized controlled trials and large prospective cohort studies comparing the effect of prehabilitation on post-operative outcomes, reporting specific exercise details and protocol progression.</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":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974949","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 single root repair and centralisation tunnel best restores tibiofemoral contact mechanics and extrusion following a medial meniscus posterior root tear: An in vitro biomechanical study.","authors":"Khalis Boksh, Duncan E T Shepherd, Daniel M Espino, Christos Plakogiannis, Arijit Ghosh, Randeep Aujla, Michael E Hantes, Tarek Boutefnouchet","doi":"10.1002/ksa.12683","DOIUrl":"https://doi.org/10.1002/ksa.12683","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate what tunnel combination, with respect to anatomical transtibial pull-through root repair (ATPR) and transtibial centralisation (TTC), best restores tibiofemoral contact mechanics and meniscal extrusion following a medial meniscus posterior root tear (MMPRT).</p><p><strong>Methods: </strong>Meniscal extrusion and contact mechanics were measured using two-dimensional imaging and pressure films in 10 porcine knee joints. The posterior root was tested under six states: (1) intact; (2) MMPRT; (3) one tunnel ATPR and one tunnel TTC (1-ATPR + 1-TTC); (4) two tunnel ATPR and one tunnel TTC (2-ATPR + 1-TTC); (5) 1-ATPR + 2-TTC; and (6) 2-ATPR + 2-TTC. The testing protocol loaded knees with 200-N axial compression at 4 flexion angles (30°, 45°, 60° and 90°). At each angle and state, meniscal extrusion was measured as the difference in its position under load to that of the unloaded condition in the intact state. Contact area and pressure were recorded for all states at all angles and were analysed using a MATLAB programme.</p><p><strong>Results: </strong>MME was significantly reduced with both the 1-ATPR + 2-TTC and 2-ATPR + 2-TTC tunnels in comparison to the 1-ATPR + 1-TTC and 2-ATPR + 1-TTC tunnels at 60° and 90° (p < 0.05). The intact meniscus and 1-ATPR + 1-TTC technique had higher contact area at 60° (p = 0.01 and 0.04, respectively) and lower contact pressure at 90° (p = 0.01 and 0.04, respectively) compared to the 2-ATPR + 2-TTC technique. Otherwise, all tunnel combinations were similar to one another for contact mechanics and restored the loading profile to that of an intact meniscus (p > 0.05).</p><p><strong>Conclusion: </strong>When there are concerns of extrusion following a MMPRT, a combination of one centralisation and one root repair tunnel may provide better biomechanical properties compared to the addition of extra tunnels.</p><p><strong>Level of evidence: </strong>Not applicable (laboratory study).</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979059","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":"Indications and contraindications to platelet-rich plasma injections in musculoskeletal diseases in case of infectious, oncological and haematological comorbidities: A 2025 formal consensus from the GRIIP (International Research Group on Platelet Injections)","authors":"Florent Eymard,&nbsp;Karine Louati,&nbsp;Éric Noel,&nbsp;Redouane Abouqal,&nbsp;Philippe Adam,&nbsp;Fadoua Allali,&nbsp;Gabriel Antherieu,&nbsp;Jo Caers,&nbsp;Fabrice Cognasse,&nbsp;Hervé Collado,&nbsp;Christelle Darrieutort-Laffite,&nbsp;Corinne Frère,&nbsp;Alain Frey,&nbsp;Mathilde Gavillet,&nbsp;Vincent Gremeaux,&nbsp;Mael Heiblig,&nbsp;Guy Jerusalem,&nbsp;Charlotte Joly,&nbsp;Jean-François Kaux,&nbsp;Martin Lamontagne,&nbsp;Mathieu Leclerc,&nbsp;Philippe Léonard,&nbsp;Raphaël Lepeule,&nbsp;Daniel Lopez-Trabada-Ataz,&nbsp;Jérémy Magalon,&nbsp;Fabrice Michel,&nbsp;Paul Ornetti,&nbsp;Cécile Oury,&nbsp;Elvire Pons-Tostivint,&nbsp;Fernando Real,&nbsp;Ghislaine Robert,&nbsp;Mikel Sanchez,&nbsp;Alain Silvestre,&nbsp;Hervé Bard","doi":"10.1002/ksa.12682","DOIUrl":"10.1002/ksa.12682","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Platelet-rich plasma (PRP) could be a vector for certain diseases, and its composition may vary by pathologic condition. The main comorbidities that could affect PRP composition are infectious, oncologic and haematologic. In addition to potential alteration of clinical response, these pathologies could have a significant impact on the local tolerance of PRP as well as a risk of disease dissemination to the injection site. To date, there are few specific recommendations related to these comorbidities to guide clinicians. Therefore, the International Research Group on Platelet Injections (GRIIP) supported a consensus project to develop these recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the ‘recommendations by formal consensus’ methodology, a steering committee performed a literature review and drafted an initial set of recommendations. They were evaluated by an international rating group (15 specialists in musculoskeletal [MSK] diseases, five haematologists, four oncologists, three infectiologists and four scientists specialising in platelet physiology). From this rating, the first set of recommendations was discussed in a plenary meeting and then modified by the steering committee. Finally, four overarching principles and 23 recommendations were re-evaluated by the rating group. Recommendations were classified as appropriate or not, with strong or relative agreement, or uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From the 23 recommendations, 10 concerned infectious diseases (viral and bacterial infections; dialysis; immunosuppressive drugs; dental care…), five oncologic diseases (local tumour; cured, active or in remission cancer…) and eight haematologic diseases (cytopenia; cured, active or stabilised cured hemopathy; monoclonal gammopathy…). All were considered appropriate by the experts (median = 9; range = 8–9), with strong or relative agreement. Due to the paucity of literature data, the recommendations are mainly based on expert opinion (Grade D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This consensus project provides four overarching principles and 23 recommendations related to contraindications of PRP injections in case of infectious, oncologic or hematologic diseases, validated by an international expert group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"2293-2306"},"PeriodicalIF":5.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032402","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":"Prevention of ACL injury is better than repair or reconstruction—Implementing the ESSKA-ESMA ‘Prevention for All’ ACL programme","authors":"Robert Prill,&nbsp;Joseph Janosky,&nbsp;Lisa Bode,&nbsp;Nicky van Melick,&nbsp;Francesco Della Villa,&nbsp;Roland Becker,&nbsp;Jon Karlsson,&nbsp;Rimtautas Gudas,&nbsp;Alli Gokeler,&nbsp;Henrique Jones,&nbsp;Romain Seil,&nbsp;Philippe Tscholl,&nbsp;Thomas Patt","doi":"10.1002/ksa.12681","DOIUrl":"10.1002/ksa.12681","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"1954-1958"},"PeriodicalIF":5.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979133","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":"Off-season beach handball participation lowers injury incidence among handball players—A cross-sectional survey on 641 athletes","authors":"Hannes Degenhardt,&nbsp;Maximilian Hinz,&nbsp;Benjamin D. Kleim,&nbsp;Marco-Christopher Rupp,&nbsp;Alexander-Stephan Henze,&nbsp;Sebastian Siebenlist,&nbsp;Romed P. Vieider,&nbsp;Yannick J. Ehmann","doi":"10.1002/ksa.12677","DOIUrl":"10.1002/ksa.12677","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess the effect of beach handball training during the indoor handball off-season on the incidence of indoor handball injuries over three seasons. It was hypothesised that off-season beach handball training would be associated with a lower injury incidence in indoor handball season.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey of indoor handball athletes was distributed between 04-06/2023. Athletes' demographics, activity level, beach handball training during indoor handball off-season, indoor handball injuries in the previous three years, injury mechanisms and time to return to sport were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 641 athletes (22 years [interquartile range [IQR]: 19–26]; 62.1% female) from 36 different countries were included. 50.1% (<i>n</i> = 321) played beach handball in the off-season. The majority of athletes (92.7%, <i>n</i> = 594) played at a competitive (70.0%, <i>n</i> = 449) or a semi-professional (22.6%, <i>n</i> = 145) level. During the three-year period, 374 athletes (58.4%) reported a total of 501 injuries during indoor handball (incidence rate: 260.5 per 1000 athletes and year). The lower (66.1%) and upper extremity (26.3%) were the most frequently injured body parts. Overall, 87.0% (<i>n</i> = 436) of all athletes returned to indoor handball after injury. If participated in beach handball, a lower incidence of indoor handball injuries (odds ratio 0.60; [95% CI 0.42–0.87]; <i>p</i> = 0.006) and a lower injury rate in beach-and-indoor handball athletes was observed (225.3 vs. 295.8 injuries per 1000 athletes and year, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participation in beach handball during indoor handball off-season was associated with a significantly lower injury incidence during indoor handball. Beach handball may serve as a preventative training method to reduce injuries during breaks between indoor handball seasons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective comparative study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"2307-2316"},"PeriodicalIF":5.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12677","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969726","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}