Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Rehabilitation guidelines after autograft anterior cruciate ligament reconstruction need more graft-specific exercise recommendations-A scoping review.","authors":"Kristín Briem, Mette Kreutzfeldt Zebis, Bjarki Þór Haraldsson, Jesper Bencke, Linda Fernandes","doi":"10.1002/ksa.12666","DOIUrl":"https://doi.org/10.1002/ksa.12666","url":null,"abstract":"<p><strong>Purpose: </strong>Autografts for anterior cruciate ligament reconstruction (ACLR) are primarily harvested from the quadriceps, patellar, and semitendinosus tendons. The purpose of this scoping review was to describe available recommendations for exercise-based rehabilitation following primary ACLR with a quadriceps tendon (QT), semitendinosus tendon (ST), or bone-patellar-tendon-bone (BPTB) autograft and determine whether these recommendations included graft-specific clinical practice guidelines (CPGs).</p><p><strong>Methods: </strong>A search was conducted via three electronic databases, using variations of three main strings: 'anterior cruciate ligament reconstruction', 'rehabilitation' and 'guideline'. To be considered eligible, publications had to be published between 2014 and 2024, target patients 16 or older, and include exercise-based recommendations for rehabilitation after primary ACLR using QT, BPTB or ST autografts. Identified papers were screened for title, abstract and full text in accordance with a pre-registered protocol, with specific inclusion and exclusion criteria. Charting of data found within eligible publications was done according to their overall exercise-based content, as well as any graft-specific considerations.</p><p><strong>Results: </strong>A total of 1083 publications were imported for screening, but after the removal of duplicates and subsequent screening of titles, abstracts and 98 full texts, 17 remained for inclusion. The timeline and implementation of different exercise modalities involving knee joint loading varied during the earliest phases of rehabilitation. Sixteen papers included one or more graft-specific considerations, the majority of which focused on protecting the graft and/or considerations relating to the BPTB harvest site. Few focused on the ST or QT harvest sites, and only one publication provided guidelines that considered all three autografts.</p><p><strong>Conclusion: </strong>CPGs providing exercise recommendations and post-surgical considerations for all three autograft types are needed. These would provide a comprehensive and valuable resource for clinicians to plan rehabilitation for patients who have undergone ACLR, mindful of graft choice and surgical procedure.</p><p><strong>Level of evidence: </strong>Level V.</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":"143772631","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":"Semitendinosus tendons in physically immature patients have a lower type I collagen content.","authors":"Yushin Mizuno, Yasushi Takata, Kazuaki Yoshioka, Naoki Takemoto, Manase Nishimura, Kentaro Fujita, Takuya Sengoku, Sakae Miyagi, Satoru Demura, Junsuke Nakase","doi":"10.1002/ksa.12673","DOIUrl":"https://doi.org/10.1002/ksa.12673","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the collagen composition of the semitendinosus and quadriceps tendons at different levels of physical maturity.</p><p><strong>Methods: </strong>Tissue samples were collected from 70 patients who underwent anterior cruciate ligament or medial patellofemoral ligament reconstruction using the semitendinosus or quadriceps tendon. The samples were immunostained to identify type I and type III collagen. Confocal microscopy and image analysis software were used to determine the percentage composition of collagen types (type I + type III, 100%). Patients were categorized into three groups based on age and epiphyseal patency: immature (<20 years, >1.5 mm), young (<20 years, <1.5 mm) and adult (>20 years). The Mann-Whitney U test was used to analyze differences between the immature and other groups in the semitendinosus tendon group. The percentage of collagen content in the semitendinosus and quadriceps tendons was evaluated based on the patient's maturity level.</p><p><strong>Results: </strong>The median type I collagen content in the semitendinosus tendon was 54.2% (40.9-75.4), 98.9% (81.0-99.6) and 97.0% (40.0-100.0) in the immature (n = 6), young (n = 8) and adult (n = 18) groups, respectively. For the quadriceps tendon, the values were 98.4% (68.9-100.0), 89.1% (68.6-98.9) and 85.6% (72.3-99.6) in the immature (n = 11), young (n = 14) and adult (n = 13) groups, respectively. The semitendinosus tendon in the immature group had significantly lower type I collagen content than in the young and adult groups. Additionally, in the immature group, type I collagen content was significantly lower in the semitendinosus tendon than in the quadriceps tendon.</p><p><strong>Conclusions: </strong>A comparison of collagen composition between the semitendinosus and quadriceps tendons, based on patient maturity level, revealed that the semitendinosus tendon in immature patients had a lower percentage of type I collagen than in mature patients and lower than the quadriceps tendon.</p><p><strong>Level of evidence: </strong>Not applicable.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772635","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":"Revision rates and progression to shoulder arthroplasty after arthroscopic repair of massive rotator cuff tears","authors":"Umile Giuseppe Longo,&nbsp;Alberto Lalli,&nbsp;Benedetta Bandini,&nbsp;Alice Piccolomini,&nbsp;Nathan S. Ullman,&nbsp;Andrea Vaiano,&nbsp;Pieter D'Hooghe","doi":"10.1002/ksa.12651","DOIUrl":"10.1002/ksa.12651","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this systematic review was to assess the rate of progression to reverse total shoulder arthroplasty (RTSA) and to other interventions as revision surgeries after an arthroscopic repair of a massive rotator cuff tear (MRCT). Additionally, the review aimed at defining the best arthroscopic approach for the treatment of MRCTs in terms of failure and revision rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The purpose of this systematic review and meta-analysis was to evaluate the rates of progression to reverse total shoulder arthroplasty in patients who underwent primary arthroscopic repair of an MRCT with different arthroscopic procedures. A meta-analysis was performed to compare the rate of progression to revision surgery and reverse total shoulder arthroplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen articles were included in the qualitative synthesis and 14 articles were included in the meta-analysis. Overall, 934 patients and 950 shoulders were involved in the review. Seven-hundred and thirty patients and 735 shoulders were included in the meta-analysis. The proportion of revisions to reverse total shoulder arthroplasty was 0.9%, 3.3% and 0.1% for complete repair, partial repair and superior capsular reconstruction, respectively. No statistically significant differences were found across the groups in terms of progression to reverse total shoulder arthroplasty (n.s.). The average proportions of revisions to interventions different than reverse total shoulder arthroplasty. were 0.9% for complete repair, 2.0% for partial repair and 2.0% for superior capsular reconstruction again, no statistically relevant difference was found among the groups (n.s.).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current review finds no statistically significant differences in the progression to reverse total shoulder arthroplasty or other revision procedures among partial repair, complete repair and superior capsular reconstruction for massive irreparable rotator cuff tears. It is crucial to understand the long-term outcomes of different surgical techniques for massive rotator cuff tears, particularly regarding failure rates and progression to further procedures.</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 6","pages":"2255-2268"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753135","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":"Revisiting terminology: The transition from ‘functional alignment’ to ‘functional knee positioning’","authors":"Christos Koutserimpas,&nbsp;Luca Andriollo,&nbsp;Pietro Gregori,&nbsp;Francesco Zambianchi,&nbsp;Eleftherios Tsiridis,&nbsp;Fabio Catani,&nbsp;Sébastien Lustig","doi":"10.1002/ksa.12667","DOIUrl":"10.1002/ksa.12667","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"1948-1953"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12667","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753087","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":"Unworn cartilage in total knee arthroplasty strongly deviates from 2 mm: MRI, robotic-assisted and ruler assessment","authors":"Antonio Klasan,&nbsp;Victoria Anelli-Monti,&nbsp;Alexander Johannes Nedopil","doi":"10.1002/ksa.12671","DOIUrl":"10.1002/ksa.12671","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kinematic alignment (KA) in total knee arthroplasty (TKA) aims to resurface the articular surface of the pre-arthritic knee. One cornerstone of KA TKA and the basis for conventional instrumentation (CI) is a 2 mm cartilage thickness of the healthy distal femur. This study of image-based (CT) robotic-assisted surgery (RAS) TKA determined (1) the difference in measuring cartilage thickness using preoperative MRI, the RAS registration probe and MRI and (2) the percentage of knees with a &lt;1.5 or &gt;2.5 mm thickness of the unworn cartilage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-two patients undergoing a TKA using an image-based RAS were included. Preoperative long-leg radiographs provided the limb phenotype. The two zones of interest for cartilage thickness were the distal unworn (DU) and posterior unworn (PU) condyle. The preoperative MRI provided cartilage thickness values for both zones. Intraoperatively, the surgeon identified the zones without cartilage wear (healthy cartilage) and measured the distance between the cartilage and bone with the RAS registration probe. After resecting the condyles, a ruler was provided to measure the cartilage thickness reference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean patient age was 68.2 ± 4.1 years, and gender was evenly distributed. According to the phenotype classification, there were 8 NEU_HKA0°, 13 VAR_HKA3°, 9 VAR_HKA6°, 5 VAR_HKA9°, 4 VAL_HKA3°, 2 VAL_HKA6° and 1 VAL_HKA9° patient. The difference between measurement techniques was not statistically significant for both zones (DU <i>p</i> = 0.960, PU <i>p</i> = 0.267). In seven patients (16.7%), the DU cartilage thickness was &gt;2.5 mm measured with any of the three techniques, and up to 50% of patients had unworn cartilage thickness &lt;1.5 mm, depending on the zone and measurement technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a significant variation of unworn cartilage thickness from the assumed 2 mm, with a significant proportion (up to 67.7%) having &gt;2.5 or &lt;1.5 mm. If KA is applied, additional preoperative or intraoperative measurements might provide valuable information to avoid the risk of femoral component malposition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, diagnostic study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3205-3210"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12671","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753318","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":"External femoral rotation of 2 degrees is associated with the lowest stuffing rates around the femur in functionally aligned TKA","authors":"Alexander Maslaris,&nbsp;Eustathios Kenanidis,&nbsp;Nikolaos Mylonakis,&nbsp;Zakareya Gamie,&nbsp;Abtin Alvand,&nbsp;William F. Jackson,&nbsp;Andrew J. Price,&nbsp;Eleftherios Tsiridis","doi":"10.1002/ksa.12662","DOIUrl":"10.1002/ksa.12662","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;Modifying femoral morphology after total knee arthroplasty (TKA) poses a potential risk for ligament-imbalances and patella mal-tracking. The purpose of this study was primarily to quantify TKA-induced stuffing around the femur and secondarily assess the effect of femoral rotation (FR) on trochlear and condylar anatomy-changes.&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;Knee anatomy-modification was quantified in 69 robotic-assisted TKAs utilising tibia-based functional alignment (FA). Caliper-measurements were performed on the medial (Med), central (Ctr), and lateral (Lat) sides of the following resection planes: anterior trochlea (AT), oblique trochlea (OT), distal condyles (DC), posterior condyles (PC) and tibia (TIB). The same caliper-measurements were performed on the femoral components used to calculate bone-implant differences and analyse possible patterns of postoperative trochlear anatomy-modifications (TAM) and condylar anatomy-modifications (CAM). Over- or understuffing analysis for different FRs and regression analysis were conducted to assess the effect of FR on CAM and TAM.&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;TAM results were Lat-AT −3.2 mm ([95% confidence interval [CI]: −3.71 to −2.63], &lt;i&gt;p&lt;/i&gt; &lt; 0.001), Ctr-AT 0.7 mm ([95%CI: 0.22–1.32], &lt;i&gt;p&lt;/i&gt; = 0.02), and Ctr-OT −1.7 mm ([95%CI: −1.85 to −0.93], &lt;i&gt;p&lt;/i&gt; &lt; 0.001) with stuffing &gt; 2 mm in 60.9%, 39.1%, and 39.1%, respectively. CAM results were Med-DC −3.6 mm ([95%CI: −4.14 to −3.05], &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and Lat-PC 3.0 mm ([95%CI: 2.48–3.38], &lt;i&gt;p&lt;/i&gt; &gt; 0.001) with stuffing &gt; 2 mm in 78.3% and 63.8%. FR (3.8 ± 2.6°, range: −1.6° to 8.5°) affected mostly the anterior (&lt;i&gt;r&lt;/i&gt; = −0.40, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and posterior (&lt;i&gt;r&lt;/i&gt; = 0.71, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) aspects of the knee but hardly the OT plane (&lt;i&gt;r&lt;/i&gt; = 0.06, &lt;i&gt;p&lt;/i&gt; = 0.624) and the trochlear groove to its full range of flexion (&lt;i&gt;r&lt;/i&gt; = 0.21, &lt;i&gt;p&lt;/i&gt; = 0.17). External FR 2° was associated with the lowest incidence of femoral stuffing &gt; 2 mm and ≥ 4 mm.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;FA-typical modification-pattern was a TAM with lateral facet understuffing, and CAM with medial distal understuffing and lateral posterior overstuffing. Trochlear groove height was non-significantly affected by FR. FA with the current off-the-shelf implant induces the lowest stuffing rates when set in 2° external femoral rotation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 8","pages":"2957-2970"},"PeriodicalIF":5.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12662","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730695","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":"The patient acceptable symptomatic state for commonly used outcome scores 10 years after matrix-associated autologous chondrocyte implantation.","authors":"Kevin-Arno Koch, Raphael Trefzer, Mustafa Hariri, Paul Mick, Tilman Walker, Stefanos Tsitlakidis, Johannes Weishorn","doi":"10.1002/ksa.12661","DOIUrl":"https://doi.org/10.1002/ksa.12661","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the Patient Acceptable Symptomatic State (PASS) thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), Lysholm and EuroQol 5 Dimensions (EQ-5D) scores and to identify predictors of PASS at 10 years after matrix-associated autologous chondrocyte implantation (M-ACI).</p><p><strong>Methods: </strong>Patients who underwent M-ACI for chondral defects of the knee between 2011 and 2015 were prospectively evaluated. KOOS, IKDC, Lysholm and EQ-5D scores and anchor-based questions were assessed at baseline and at least 10 years post-operatively. PASS thresholds were determined using receiver operating characteristic (ROC) curve analyses. Multivariable binomial regression analysis was performed to determine the effect of sex, body mass index (BMI), articular cartilage maturation status and the presence of more than one previous knee surgery on the likelihood of achieving PASS.</p><p><strong>Results: </strong>A total of 112 patients who met the inclusion criteria were evaluated at a mean of 11.3 ± 1.2 years post-operatively, with a mean age of 29.2 ± 11.0 years. The PASS thresholds for the aforementioned PROMs at 10 years were 61.9 for KOOS (Symptoms 51.8, Pain 79.2, Activities of Daily Living 87.5, Sport 57.5 and Quality of Life 59.4), 59.7 for IKDC, 61.5 for Lysholm and 82.5 for EQ-5D. The ROC curve showed good to excellent predictive value with an area under the curve (AUC) of 0.76-0.84. Male gender (odds ratio [OR] = 3.1; p = 0.016) and BMI between 20 and 29 (OR = 3.9; p = 0.004) had a positive predictive value for achieving PASS at long-term follow-up.</p><p><strong>Conclusions: </strong>The present study determined long-term PASS thresholds for KOOS, IKDC, Lysholm and EQ-5D scores in patients undergoing M-ACI for cartilage repair at the knee. Male gender and a BMI of 20-29 were positive predictors of the likelihood of achieving PASS at 10 years. The identified PASS thresholds are critical for assessing clinical outcomes, evaluating procedural efficacy for regulatory considerations, and planning sample sizes for prospective, controlled studies.</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":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730696","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":"Biologic augmentation of meniscus repair: A scoping review.","authors":"Jonathan T Super, Robert F LaPrade, James Robinson, David A Parker, Nicholas DePhillipo, Gilbert Moatshe, Philippe Beaufils, Iain R Murray","doi":"10.1002/ksa.12634","DOIUrl":"https://doi.org/10.1002/ksa.12634","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to carry out a scoping review to investigate the use of biologic augmentation strategies for arthroscopic meniscal repair.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and Arksey and O'Malley frameworks were followed. The studies were obtained and screened, with inclusion criteria comprising clinical studies evaluating the biologic augmentation of arthroscopic meniscal repair, systematic reviews, opinion pieces, and consensus statements. Studies involving any biologic therapy were included and were not limited to geographical location, participant age group, or sex. Data were extracted and presented as a descriptive analysis and thematic summary.</p><p><strong>Results: </strong>A total of 1135 studies were initially identified, and 125 met the inclusion criteria for this scoping review. Sixty-six (52.8%) of these studies were published in the last 5 years, and 50.4% (63) originated from the United States. Most of the evidence was either Level IV or V (87 articles, 69.6%). The most frequently studied biological augmentation technique was the use of platelet-rich plasma (58 articles, 46.4%).</p><p><strong>Conclusion: </strong>There is diverse use of biologic therapies for the augmentation of meniscal repairs without the presence of high-quality evidence to clearly define indications and usage. Further research priorities include defining which meniscal tear types and locations might benefit from specific biologic augmentation techniques, as well as outcome measures and diagnostic modalities to detect the success of these interventions.</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":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719985","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":"Deep vein thrombosis, age and body mass index are significant risk factors for arthrofibrosis following total knee arthroplasty","authors":"Maximilian Budin,&nbsp;T. David Luo,&nbsp;Thorsten Gehrke,&nbsp;Mustafa Citak","doi":"10.1002/ksa.12665","DOIUrl":"10.1002/ksa.12665","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Arthrofibrosis is a significant complication that occurs in 3.7%–10% of total knee arthroplasty (TKA) cases, causing pain and limiting the range of motion. Addressing arthrofibrosis poses a considerable challenge, given its intricate and time-consuming treatment. The aim of this study was to identify patient-related risk factors that contribute to the formation of arthrofibrosis following primary TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective case–control study encompassed 1033 cases in which arthrofibrosis was identified as a cause for failure following primary TKA between 1996 and 2021. These patients were compared to a cohort of 39,572 patients from the same time frame who did not undergo any revision following primary TKA, with a minimum follow-up of 3 years. Both bivariate analysis and binary logistic regression analysis, adjusting for age, gender, body mass index (BMI) and age-adjusted Charlson comorbidity index (CCI) were conducted. The odds ratio (OR) and 95% confidence interval (CI) were presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with arthrofibrosis were significantly younger (<i>p</i> &lt; 0.001), had lower BMIs (<i>p</i> = 0.044) and exhibited significantly lower CCI scores (<i>p</i> &lt; 0.001). No significant difference in gender was observed between patients with and without arthrofibrosis. Binary logistic regression indicated that a deep vein thrombosis (DVT) following primary TKA (<i>p</i> &lt; 0.001; OR = 2.21; 95% CI = 1.64–2.98) was linked to an increased risk, while rheumatoid arthritis (RA) (p = 0.016; OR = 0.25; 95% CI = 0.08–0.77) was associated with a decreased risk for developing arthrofibrosis following primary TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, a DVT following primary TKA increased the risk of arthrofibrosis after primary TKA, while RA decreased it. Patients with arthrofibrosis tended to be younger, have a lower BMI, and have fewer comorbidities, with no gender differences observed. Preventing DVT is crucial, and TKA should be approached cautiously in young, thin patients with few comorbidities.</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 8","pages":"2950-2956"},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719990","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":"Beyond the coronal plane in robotic total knee arthroplasty—Part 2: Combined flexion does not affect outcomes","authors":"Luca Andriollo,&nbsp;Pietro Gregori,&nbsp;Christos Koutserimpas,&nbsp;Elvire Servien,&nbsp;Cécile Batailler,&nbsp;Sébastien Lustig","doi":"10.1002/ksa.12660","DOIUrl":"10.1002/ksa.12660","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Personalized alignment in total knee arthroplasty (TKA) is becoming increasingly widespread, driven in part by advancements in robotic-assisted surgery. However, true personalization must extend beyond the coronal plane to include sagittal and axial planes. This study investigates the impact of combined flexion (CF) of the femoral and tibial components in robotic-assisted TKA within functional alignment (FA), also analyzing its variation (ΔCF) from native anatomy and its correlation with functional outcomes and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on 310 patients who underwent primary TKA using an image-based robotic system between March 2021 and January 2023. CF was calculated based on tibial slope (TS) and distal femoral flexion (DFF). Patients were stratified into groups based on CF (≤7.5° vs. &gt;7.5°) and CF variation (ΔCF &lt; −3, −3 to 3 and &gt;3). Clinical scores, radiographic parameters and complication rates were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with CF ≤ 7.5° had lower preoperative maximum flexion values (<i>p</i> = 0.005). No significant differences in complication rates or clinical outcomes were observed between groups. ΔCF were associated with post-operative coronal alignment changes (mechanical hip–knee–ankle angle and medial proximal tibial angle) but did not impact patient-reported outcomes. Additionally, subgroup analysis revealed that ΔCF were not linked to differences in implant survival, revision rates or mechanical failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although CF influences knee biomechanics, its direct impact on clinical outcomes remains unclear. It is evident that a personalized approach to sagittal alignment can be an integral component of functional knee positioning.</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 8","pages":"2939-2949"},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719982","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}