Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Synthetic augmentation in ACL reconstruction may reduce re-rupture rates and increase return-to-sport rates: A systematic review and meta-analysis.","authors":"Yufei Jiang, Seyran Naghdi, Nick Smith, Toby Smith, Andrew Metcalfe, Hema Mistry","doi":"10.1002/ksa.12680","DOIUrl":"https://doi.org/10.1002/ksa.12680","url":null,"abstract":"<p><strong>Purpose: </strong>Synthetic augmentation (SA) in anterior cruciate ligament reconstruction (ACLR) aims to enhance graft durability, but its benefits remain unclear. To evaluate whether SA in ACLR improves return-to-sport (RTS) rates, reduces graft failure, enhances patient-reported outcomes (PROs) and varies in effectiveness across materials and techniques.</p><p><strong>Methods: </strong>A systematic search of five databases was conducted until February 2025. Comparative studies were pooled using Hedges' random-effects meta-analysis with subgroup analysis based on materials and publication year. Non-comparative studies were analysed narratively. Risk of bias was assessed using the Risk of Bias in Non-randomised Studies of Interventions and the Cochrane risk-of-bias tools for randomised studies. Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence.</p><p><strong>Results: </strong>Forty-seven studies were included (n = 4289): 7 randomised and 40 non-randomised studies (21 comparative; 19 non-comparative). SA systems included InternalBrace (FiberTape, 16 studies), Ligament Augmentation and Reconstruction System (polyester, 5), Ligament Augmentation Device (polyethylene, 18) and other materials (8). GRADE assessment showed moderate-certainty evidence for improved mid-term RTS rate from eight studies (odds ratio [OR]: 1.58; 95% confidence interval (CI): 1.12-2.22; N = 716; I² = 0%; p = 0.01). Internal brace showed a reduction in re-rupture rates in the long-term (OR: 0.17, 95% CI: 0.04-0.64; N = 218; I² = 0%; p = 0.01); however, pooled analysis of all techniques showed no statistically significant difference. Contemporary studies showed a better return to sport rates with SA. PROs showed no clinically meaningful differences. Non-comparative studies showed low graft failure rates (<8.7% for InternalBrace; <16.4% for other SA), high RTS rates (>90% for InternalBrace; >56.7% for other SA) and satisfactory PROs.</p><p><strong>Conclusions: </strong>SA, particularly InternalBrace, may improve RTS rates and reduce re-rupture risk, though PROs remain inconclusive. Findings are limited by a moderate-to-serious risk of bias, emphasising the need for high-quality research.</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":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031355","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 structured framework for standardized 3D leg alignment analysis: An international Delphi consensus study","authors":"Quinten W. T. Veerman,&nbsp;Gabriëlle J. M. Tuijthof,&nbsp;Nico Verdonschot,&nbsp;Reinoud W. Brouwer,&nbsp;Peter Verdonk,&nbsp;Annemieke van Haver,&nbsp;Hugo C. van der Veen,&nbsp;Peter A. J. Pijpker,&nbsp;Judith olde Heuvel,&nbsp;Roy A. G. Hoogeslag,&nbsp;the 3D Leg Alignment Consensus Expert Group","doi":"10.1002/ksa.12676","DOIUrl":"10.1002/ksa.12676","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To reach consensus among international experts on a structured framework for standardized 3D leg alignment analysis based on 3D bone models, ensuring consistency and improving clinical applicability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Delphi study was performed in four rounds. Rounds 1 and 2 involved a steering and rating group that developed statements based on principles preserving the 3D complexity of anatomical structures, identified through a systematic review. These statements encompassed approaches for deriving joint centres and joint orientations, and defining coordinate systems using 3D bone models. In Rounds 3 and 4, a panel of 35 international experts, including clinicians (54%) and engineers (46%), with participants from Europe (80%), Oceania (9%), Asia (6%), and the Americas (6%), evaluated these statements. Consensus was defined as ≥80% agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Rounds 1 and 2 resulted in 31 statements to be included in the survey. Of these, 26 achieved consensus in Round 3, with the five remaining statements refined and reaching consensus in Round 4. Experts agreed on utilising all available relevant surface data to define joint centres, joint orientations, and individual femoral and tibial coordinate systems alongside a combined leg coordinate system, and adopting central 3D axes for femoral version and tibial torsion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This international Delphi consensus study provides a structured framework for a standardized 3D leg alignment analysis based on 3D bone models. This framework aims to enhance clinical applicability for preoperative planning and execution of uni- and multiplanar correction osteotomies around the knee, reduce the methodological variability in 3D leg alignment analysis literature, and improve cross-study comparability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"2276-2292"},"PeriodicalIF":5.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016022","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":"Wearable technology identifies differences in change of direction kinetics and kinematics in soccer players with a history of anterior cruciate ligament reconstruction.","authors":"Joao Belleboni Marques, Vasileios Sideris, Rodney Whiteley, Paul James Read, Matheus Machado Gomes, Paulo Roberto Pereira Santiago","doi":"10.1002/ksa.12679","DOIUrl":"https://doi.org/10.1002/ksa.12679","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates change of direction (COD) performance and biomechanics using wearable technology in athletes with a history of anterior cruciate ligament reconstruction (ACL-R) compared to healthy controls.</p><p><strong>Methods: </strong>A within and between subjects' cross-sectional design was used. The sagittal plane kinematics of the hip, knee, and ankle during 90° side-step cutting were measured with inertial measurement units, while the vertical force was recorded with insoles in the players' boots. Twenty-six professional soccer players participated (mean age 22.7 ± 3.7 years, height 177.8 ± 5.1 cm, weight 69.4 ± 8.5 kg). Sixteen players were healthy controls, and 10 were in a full-time ACL-R rehabilitation programme, assessed 9 months post-surgery. Mixed model analysis and statistical parametric mapping were used to compare COD completion time, kinetics, and kinematics between limbs (involved vs. uninvolved) and groups (ACL-R vs. controls) during the penultimate and final foot contacts.</p><p><strong>Results: </strong>No significant differences in COD completion time were found between limbs (p = 0.52, d = 0.22) or groups (p = 0.65, d = 0.51). However, during the penultimate foot contact, the involved limb exhibited greater ankle dorsiflexion compared to the uninvolved and controls from 48% to 100% of stance (p = 0.002, d = 0.94-1.86), with lower vertical force production (p > 0.05, d = 0.81-0.95). During the plant step, lower knee flexion angles were noted compared to the uninvolved limb and controls from 2% to 69% of stance (p = 0.011, d = 1.26-1.31).</p><p><strong>Conclusion: </strong>The findings suggest that soccer players with ACL-R can restore COD completion time at the time to return to sport. However, they used compensatory movement strategies on the involved side to achieve similar performance, and this must be considered from a rehabilitation standpoint.</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":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023298","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":"Wearable health technology finds improvements in daily physical activity levels following total knee arthroplasty: A prospective study","authors":"Kevin A. Wu,&nbsp;David N. Kugelman,&nbsp;Rahul K. Goel,&nbsp;Eric S. Dilbone,&nbsp;Devika Shenoy,&nbsp;Sean P. Ryan,&nbsp;Samuel S. Wellman,&nbsp;Michael P. Bolognesi,&nbsp;Thorsten M. Seyler","doi":"10.1002/ksa.12675","DOIUrl":"10.1002/ksa.12675","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Wearable technologies, like the Apple Watch, offer new possibilities for collecting objective data on physical activity post-operatively following total knee arthroplasty (TKA). This study aims to describe changes in daily physical activity levels using objective metrics over different time points following TKA.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study analyzed data from a prospective cohort of 152 patients undergoing a unilateral TKA. Patients wore an Apple Watch and used a digital care management application for data collection. Step count, steadiness, standing duration, gait speed and performance on a 6-min walk test were collected from Apple HealthKit at multiple time points: pre-operative, 6 weeks post-operatively, 6 months post-operatively and 12 months post-operatively. Statistical analyses were performed using R software, including descriptive statistics and paired &lt;i&gt;t&lt;/i&gt; tests to compare outcomes at different time points post-operatively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants demonstrated significant improvements in daily physical activity levels over the course of 12 months post-operative. At 6 months post-operative, participants showed the highest average daily step count (mean ± SD: 5293 ± 236 steps; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), with improvements persisting at 12 months post-operative (5180 ± 260 steps; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) compared to preoperative values. Gait speed increased from 0.88 ± 0.01 m/s preoperatively to 1.01 ± 0.01 m/s (&lt;i&gt;p&lt;/i&gt; = 0.006) at 12 months post-operative. Standing hours increased from 9.99 ± 0.30 to 11.47 ± 0.31 h at 6 months post-operative and persisted. Steadiness and the estimated 6-minute walk test showed recovery trends, though variability remained at 12 months post-operative, suggesting the need for additional longitudinal assessment&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study provides one of the first longitudinal analyses of post-operative functional recovery using Apple HealthKit, offering continuous real-world gait and activity tracking beyond traditional patient-reported measures. These findings highlight the value of wearable technology in monitoring post-operative activity and offering insights into TKA recovery patterns. The study suggests a critical recovery window at 6 months post-operative and emphasizes the need for ongoing support to maintain improvements. The integration of wearable technology in post-operative monitoring offers a promising approach to tracking patient progress and optimizing functional outcomes following TKA.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 ","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3218-3227"},"PeriodicalIF":5.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The projected economic burden and complications of revision hip and knee arthroplasties: Insights from national registry studies","authors":"Patrick Sadoghi,&nbsp;Amir Koutp,&nbsp;Daniel Perez Prieto,&nbsp;Martin Clauss,&nbsp;M. Enes Kayaalp,&nbsp;Michael T. Hirschmann","doi":"10.1002/ksa.12678","DOIUrl":"10.1002/ksa.12678","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>The rising volume of primary hip and knee arthroplasties has led to a parallel increase in revision surgeries, creating significant clinical and economic challenges for healthcare systems worldwide. This study synthesizes national arthroplasty registry data to evaluate trends in revision aetiology, associated costs and regional disparities. While advancements in prosthetic design have reduced aseptic loosening rates (declining to 35.1% for hips and 18.3% for knees), septic complications now account for a growing proportion of revision cases, rising to 18.2% for hips and 21.6% for knees. Additionally, instability and malalignment persist at 15.9% and 14.1%, respectively. Revision procedures are 76% more costly than primary surgeries, with two-stage septic revisions incurring costs of up to $37,297 per case. Beyond direct surgical costs, prolonged recovery and productivity loss contribute to a broader economic impact. Regional variations, such as higher periprosthetic fracture rates in England and Wales, highlight inconsistencies in data reporting and healthcare practices. Addressing these challenges requires standardized infection definitions, enhanced registry collaboration and investment in infection prevention strategies. The role of referral centres in improving outcomes and reducing costs through multidisciplinary care is increasingly recognized. By integrating evidence-based infection management protocols and leveraging emerging technologies, the orthopaedic community can optimize patient outcomes and reduce the financial burden of revising arthroplasties.</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":"3211-3217"},"PeriodicalIF":5.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001112","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":"No difference in 5-year survivorship between cemented versus cementless total knee arthroplasty in a cohort of 5266 patients using a deep-dish mobile bearing implant","authors":"Ophélie Manchec,&nbsp;Emilie Bérard,&nbsp;Regis Pailhé,&nbsp;Sébastien Lustig,&nbsp;Etienne Cavaignac","doi":"10.1002/ksa.12668","DOIUrl":"10.1002/ksa.12668","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The best fixation method for total knee arthroplasty (TKA) remains controversial. The aim of this study is to compare the effect of cemented and cementless fixation on prosthesis survivorship. Our primary hypothesis is that there is no difference in survivorship between cemented and cementless TKA. Our secondary hypothesis is that there is no difference in aseptic revisions and functional outcomes between cemented and cementless TKA at mid-term follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicentre retrospective study was done using data collected prospectively in a large cohort. The same deep-dish mobile bearing design was used for both cemented and cementless TKA. Patients were divided into two groups according to the fixation method. The survival rate between cemented and cementless TKA was compared. Functional outcomes were collected preoperatively and at the 5-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 5266 primary TKA included, 4549 were cementless, and 717 were cemented. At 5 years, there was no significant difference between the survivorship of the cementless (98.7% [95% confidence interval, CI: 98.2–99.1]) and cemented TKA (97.6%, [95% CI: 94.1–99.1]) (<i>p</i> = 0.468). There was no significant difference in the surgery-free survival at 5 years between cementless (95.8% [95% CI: 94.9–96.5]) and cemented TKA (95.5% [95% CI: 92.1–97.5]) (<i>p</i> = 0.508) as well as in aseptic revision: cementless (96.9% [95% CI: 96.2–97.5]) and cemented TKA (97.5 [95% CI: 95.5–98.6]) (<i>p</i> = 0.355). There was no significant difference in the functional outcomes at 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was no observed difference in survivorship between cemented and cementless TKA at 5 years in this cohort of 5266 patients. Additionally, rates of reoperation and aseptic revision were similar across both fixation methods, and clinical outcomes did not differ significantly. Therefore, it may be suggested that cementless fixation is a safe option for primary TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3194-3204"},"PeriodicalIF":5.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803332","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":"First validated automated scoring system using the diagnostic arthroscopy skill score (DASS 2.0) for assessing proficiency in virtual reality arthroscopy.","authors":"Hermann Anetzberger, Andreas Kugler, Michael Mohr, Florian Haasters, Stephan Reppenhagen, Roland Becker","doi":"10.1002/ksa.12670","DOIUrl":"https://doi.org/10.1002/ksa.12670","url":null,"abstract":"<p><strong>Purpose: </strong>Proficiency-based simulator training is a promising approach for learning the complex motor skills required for arthroscopy. However, its implementation requires an objective assessment tool to assess residents' arthroscopic skills. To address this need, an automated diagnostic arthroscopy skill score (DASS) was developed and validated as a replacement for manual scoring.</p><p><strong>Methods: </strong>An automated measurement system of arthroscopic skills was developed, replacing the manual assessment parameters of the DASS with objective measurement criteria. Data from arthroscopies performed by 20 experts were used to establish threshold values for scoring. To validate the new method, 125 videos of residents were recorded and evaluated by five raters. The results of the automated evaluation were then compared with those of established manual assessment. To assess the reliability of the manual evaluation, the intraclass correlation coefficient (ICC) and minimum detectable change (MDC) were calculated. Methodological agreement was evaluated using linear least squares regression and the Bland-Altman method.</p><p><strong>Results: </strong>A good to excellent level of reliability was found among the five raters (ICC for DASS_part1 = 0.89, 95% confidence interval [CI] = 0.84-0.92). The calculated MDC was 5.0 points. High methodological agreement was found between the manual and automated evaluations of the DASS. The 95% CI for the slope of the regression line included 1, and the 95% CI for the intercept included 0. According to the Bland-Altman method, the mean difference between manual and automated evaluations was 4.1 ± 5.4 points, and the scattering of the measurement differences was uniformly distributed, regardless of the total score.</p><p><strong>Conclusions: </strong>Automated DASS measurement is a valid and reliable tool for assessing arthroscopic skills. Its advantages, such as rater independence, precise and objective measurements, and immediate evaluation, make it a powerful tool for evaluating arthroscopic performance during simulation training.</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":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803202","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":"Deconstructing the age-washout phenomenon in ACL-R failure: A short survey of anatomical, physiological and genetic risk factors for ACL reinjury","authors":"Bálint Zsidai,&nbsp;Ramana Piussi,&nbsp;Philipp W. Winkler,&nbsp;Armin Runer,&nbsp;Pedro Diniz,&nbsp;Riccardo Cristiani,&nbsp;Eric Hamrin Senorski,&nbsp;Volker Musahl,&nbsp;Michael T. Hirschmann,&nbsp;Romain Seil,&nbsp;Kristian Samuelsson","doi":"10.1002/ksa.12669","DOIUrl":"10.1002/ksa.12669","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"1943-1947"},"PeriodicalIF":5.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12669","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811566","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":"Return to physical activity after revision total knee arthroplasty: Comparative insights with primary procedure","authors":"Louis-Paul Maugard,&nbsp;Constant Foissey,&nbsp;Cécile Batailler,&nbsp;Sebastien Lustig,&nbsp;Elvire Servien","doi":"10.1002/ksa.12638","DOIUrl":"10.1002/ksa.12638","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>While the return to physical activity (RTPA) after primary total knee arthroplasty (TKA) is well-documented, research on RTPA after revision TKA remains limited. This retrospective study aimed to evaluate the resumption of physical activity following revision TKA by comparing outcomes with a control group of primary TKA patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 110 revision TKA patients were matched 1:1 with 521 primary TKA patients with a minimum of 2 years of follow-up. Data collected included whether or not they had returned to physical activities, as well as the type of activity and time after surgery, pre- and post-operative University of California and Los Angeles Activity Scale (UCLA) and Forgotten Joint Score (FJS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-five and four tenths per cent of revision TKA patients returned to physical activities, with a mean delay of 8.9 months. The most common activities were walking (64.5%), biking (19.1%) and swimming (16.4%). Preoperative UCLA was the only significant predictor of RTPA. Comparatively, there were no significant differences in RTPA rates between primary TKA and revision TKA groups (72.7% vs. 65.4%, n.s), but primary TKA patients returned to activity sooner (6.3 vs. 8.9 months, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study showed that while RTPA is achievable after revision TKA in the same proportion as after primary TKA, it occurs later. These findings underline the importance of managing patient expectations regarding physical activity recovery following revision TKA.</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 7","pages":"2537-2544"},"PeriodicalIF":5.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780306","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, U or zigzag? Athletes with ACL reconstruction follow three major psychological patterns: Results from a retrospective evaluation of a local ACL register.","authors":"Lynn Kelders, Nicky van Melick, Tristan Warren, Rob Bogie","doi":"10.1002/ksa.12664","DOIUrl":"https://doi.org/10.1002/ksa.12664","url":null,"abstract":"<p><strong>Purpose: </strong>Emotional responses during anterior cruciate ligament (ACL) rehabilitation are described as a 'linear' or 'U-shaped' pattern, indicating not all athletes exhibit the same emotional pattern. Therefore, this study aimed to (1) identify emotional patterns during the early- and mid-stage phases of rehabilitation after ACL reconstruction (ACLR), and (2) investigate differences in patient-specific characteristics among these patterns.</p><p><strong>Methods: </strong>Patients completed the Photographic Series of Sports Activities for Anterior Cruciate Ligament Reconstruction (PHOSA-ACLR), and Dutch language short Anterior Cruciate Ligament Return to Sport after Injury scale (short ACL-RSI-NL) preoperatively and 6 weeks, 3 months and 6 months postoperatively. Cluster analysis was conducted to identify groups with similar emotional score patterns over time. Changes in scores between consecutive time points (deltas) were calculated for clustering, after which the optimal number of clusters was determined, and K-means clustering was performed.</p><p><strong>Results: </strong>One hundred and twenty-eight patients completed both surveys at all time points. Patients displayed an 'A-shaped', 'U-shaped' or 'zigzag' pattern. Patients with an A-shaped PHOSA-ACLR pattern were significantly younger than patients with a zigzag pattern (p = 0.01). Recreational athletes who are not in competition less often followed an A-shaped short ACL-RSI-NL pattern (p < 0.002). Patients with an A-shaped short ACL-RSI-NL pattern had significantly higher preoperative scores than patients with a U-shaped (p < 0.001) or zigzag pattern (p < 0.003). Patients with a U-shaped short ACL-RSI-NL pattern had lower scores at six months postoperatively than those with A-shaped or zigzag patterns.</p><p><strong>Conclusions: </strong>Patients' emotions before and after ACLR follow three patterns: 'A-shaped', 'U-shaped', or 'zigzag'. These patterns are significantly related to age (PHOSA-ACLR) and level of sport involvement and preoperative readiness to RTS (short ACL-RSI-NL).</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":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772627","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}