Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"The majority of elite and professional athletes return to the preinjury level of activity after anterior cruciate ligament reconstruction: A systematic review and meta-analysis","authors":"Riccardo D'Ambrosi,&nbsp;Andrea Marchetti,&nbsp;Luca Farinelli,&nbsp;Amit Meena,&nbsp;Piero Franco,&nbsp;Luca Maria Sconfienza,&nbsp;Riccardo Cristiani,&nbsp;Elmar Herbst,&nbsp;Christoph Kittl,&nbsp;Mirco Herbort,&nbsp;Elisabeth Abermann,&nbsp;Christian Fink","doi":"10.1002/ksa.70020","DOIUrl":"10.1002/ksa.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare return to play (RTP), time to RTP, level of RTP, and anterior cruciate ligament (ACL) graft failure among elite and professional athletes from different sports after anterior cruciate ligament reconstruction (ACLR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PubMed, Embase and Cochrane Library databases were searched to identify potentially relevant research articles that analysed RTP, time to RTP, level of RTP, and graft failure rate in elite and professional athletes after ACLR. An elite or professional athlete was defined as one who participates in national- or international-level competitions in professional or amateur sports—including academy players aged 15 years or over.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 49 studies met the inclusion criteria. Eleven different sports and 4463 knees were included in the final analysis. The pooled data revealed an RTP rate of 85.8% (95% confidence interval [CI] 82.8–88.5]. A lower RTP was observed in Australian football (67.8% [95% CI 54.1–80.1]; <i>p</i> &lt; 0.001) and football (73.0% [95% CI 65.9–79.5]; <i>p</i> &lt; 0.001) than in soccer (92.8% [95% CI 89.3–95.7]). Almost 90% of the athletes returned to their preinjury level. The meta-analysis revealed no difference (<i>p</i> &gt; 0.05) in the level of RTP rate among the different studies, ranging from 79.0% (soccer) to 97.3% (basketball). The pooled mean time to RTP was 292 days (95% CI 268–316 days). The pooled ACL graft failure rate was estimated to be 7.0% for athletes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Following ACLR, more than 85% of elite and professional athletes returned to play and almost 90% returned to their preinjury level, with a graft failure rate of 7.0% and a mean return to play at 292 days. Athletes and their treating physicians can utilise these findings to set reasonable expectations for their return to competition after ACLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV systematic review and meta-analysis</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 7","pages":"2370-2391"},"PeriodicalIF":5.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986484","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":"Prospective randomised controlled trial comparing PLLA and PLDLA/HA/β-TCP interference screws in anterior cruciate ligament reconstruction: CT scans, MRI and clinical outcomes","authors":"Christian Coppola,&nbsp;Raul Mayr,&nbsp;Rene El Attal,&nbsp;Vinzenz Smekal,&nbsp;Gerald Degenhart,&nbsp;Christof Kranewitter,&nbsp;Josef Fritz,&nbsp;Christian Koidl","doi":"10.1002/ksa.70024","DOIUrl":"10.1002/ksa.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Modifying interference screw composition may ensure better osteoconductive properties in order to reduce tunnel enlargement after anterior cruciate ligament (ACL) reconstruction. The primary and secondary purposes were to evaluate tunnel and screw volume changes in poly-<span>L</span>-lactide acid (PLLA) and poly-<span>D</span>-lactic acid + hydroxyapatite + β-tricalcium phosphate (PLDLA+) screws. The tertiary purpose was to compare patient reported- and functional outcomes between PLLA and PLDLA+ group. It was hypothesised that PLLA group would show more tunnel enlargement and a lower rate of resorption than PLDLA+ group with similar clinical results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were treated with ACL reconstruction using hamstring autograft with femoral and tibial interference screw fixation (PLLA or PLDLA+). Tunnel volume changes were assessed after 0, 24 and 36 months on computed tomography (CT) scans. Screw volume changes were analysed after 0, 3, 6, 12, 24 and 36 months on magnetic resonance imaging (MRI). Patient reported outcome scores (PROMS) and knee laxity were analysed after 12 and 36 months. Data were evaluated using analysis of variance (ANOVA) with Bonferroni correction. Significance was set at &lt;0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Femoral/tibial tunnel volume enlarged 10.7 ± 46.6%/3.8 ± 14.4% (PLLA, <i>n</i> = 9) and 2.6 ± 30.8%/19.0 ± 20.5% (PLDLA +, <i>n</i> = 13) after 36 months on CT scans (<i>p</i> = 0.063/<i>p</i> = 0.070). Using MRI scans, femoral/tibial screw volume decreased −53.8 ± 6.9%/−48.8 ± 9% (PLLA) and −88.2 ± 8.9%/−80.6 ± 3.4% (PLDLA+) (<i>p</i> ≤ 0.001/<i>p</i> ≤ 0.001). No difference was found between the two groups (PLLA, <i>n</i> = 17; PLDLA+, <i>n</i> = 19) in PROMS and knee laxity (n.s. and/or minimal clinically important difference (MCID) not reached).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tunnel volumes remained slightly enlarged, screw degradation was significantly higher in the PLDLA+ group while clinical outcomes led to good short-term results. Comparable tunnel enlargement for both screws can be expected in revision ACL reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I randomised controlled trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 7","pages":"2408-2417"},"PeriodicalIF":5.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025183","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":"Lean management in total knee arthroplasty: A model for efficiency and value-based care","authors":"Patrick Sadoghi,&nbsp;Maximilian Budin,&nbsp;Elmar Herbst,&nbsp;Giuseppe Milano,&nbsp;Volker Musahl,&nbsp;Michael T. Hirschmann","doi":"10.1002/ksa.70294","DOIUrl":"10.1002/ksa.70294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>With rising procedure volumes, cost pressures, and shorter hospital stays, the application of Lean management principles offer substantial promise for the pathway of total knee arthroplasty (TKA). This editorial outlines how Lean and Lean Six Sigma methodologies can be applied to TKA—covering pre-operative pathway standardisation, intra-operative workflow optimisation, implant and instrument logistics, and post-operative care. Evidence shows that process redesign can reduce length of stay, time in the operating room, cancellations, and wasted resources. Key success factors, barriers, future directions and limitations are highlighted, with particular relevance for high-volume arthroplasty centres and revision scenarios. The concept is positioned as a model for clinical innovation in arthroplasty services, aligning with the ambitions of value-based care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 7","pages":"2325-2329"},"PeriodicalIF":5.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000448","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":"Slope reducing osteotomy: The emerging gap between indication, safety and proportionality","authors":"Tomas Pineda,&nbsp;Romain Seil,&nbsp;Bertrand Sonnery-Cottet,&nbsp;David H. Dejour,&nbsp;Michael T. Hirschmann,&nbsp;Matthieu Ollivier","doi":"10.1002/ksa.70488","DOIUrl":"10.1002/ksa.70488","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Slope-reducing osteotomy (SRO) has emerged as a valuable risk-mitigation tool in the management of anterior cruciate ligament (ACL) injuries, particularly in high-risk patients and in revision settings. However, its rapid adoption has outpaced the evidence defining when, how and in whom it should be performed, raising important questions regarding proportionality, technical demand and patient selection. This editorial argues that SRO should be guided by integrated, individualised risk stratification rather than isolated numerical thresholds, and that clinical judgement and surgical experience remain the essential safeguards for its safe and effective application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 7","pages":"2334-2339"},"PeriodicalIF":5.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255566","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":"Artificial anterolateral ligament reconstruction provides similar knee kinematics as compared to an autologous reconstruction and a lateral extra-articular tenodesis","authors":"Hua Ying,&nbsp;Xianghui Li,&nbsp;Gai Yao,&nbsp;Yuning Su,&nbsp;Xiangjun Hu,&nbsp;Rongshan Cheng,&nbsp;Tsung-Yuan Tsai,&nbsp;Zimin Wang","doi":"10.1002/ksa.12811","DOIUrl":"10.1002/ksa.12811","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We biomechanically compared three anterolateral procedures (artificial-anterolateral ligament [ALL] reconstruction, autologous-ALL reconstruction and lateral extra-articular tenodesis [LET]) in knees with anterior cruciate ligament (ACL) and anterolateral complex (ALC) injuries when combined with nonanatomic artificial ACL reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight cadaveric knees were tested robotically at time-zero: (1) intact, (2) ACL + ALC deficient, (3) ACL reconstruction + artificial-ALL reconstruction, (4) ACL reconstruction + autologous-ALL reconstruction, (5) ACL reconstruction+LET. Each state was tested under 3 loads: (1) a 89N anterior tibial (AT) loading to test AT translation (ATT) at full extension (FE), 30°, 60° and 90°, (2) a 5N·m internal rotation (IR) tibial torque to test tibial IR at FE, 15°, 30° and 45°, (3) a simulated pivot-shift test consisting of a combined 5 N·m IR tibial torque and 7 N·m valgus load to test ATT and IR at FE, 15°, 30° and 45°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ACL + ALC deficiency impaired anteroposterior and rotational knee stability across all conditions. Under 89 N AT loading, the anterior instability was fully restored by ACL reconstruction + artificial-ALL reconstruction (n.s.) and partially by ACL reconstruction + autologous-ALL reconstruction and ACL reconstruction + LET, with significant differences from the intact state at 30° (<i>p</i> = 0.019) and 60° (<i>p</i> = 0.011) in the ACL reconstruction + autologous-ALL reconstruction state and at 30° (<i>p</i> = 0.032) and 60° (<i>p</i> = 0.018) in the ACL reconstruction+LET state. Under 5 N·m IR tibial torque, the internal rotational instability was fully restored by ACL reconstruction+artificial-ALL reconstruction and ACL reconstruction + LET (n.s.) and partially by ACL reconstruction + autologous-ALL reconstruction, with significant differences from the intact state at FE (<i>p</i> = 0.044) and 15° (<i>p</i> = 0.049). During simulated pivot-shift testing, all three procedures fully restored native kinematics with no significant differences observed (n.s.).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Artificial-ALL reconstruction, autologous-ALL reconstruction, and LET similarly restored native knee kinematics in ACL + ALC deficient knees when combined with artificial ACL reconstruction at time-zero.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V laboratory study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 7","pages":"2359-2369"},"PeriodicalIF":5.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736580","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":"Improving anterior cruciate ligament reconstruction outcomes using a unified return-to-sport communication framework","authors":"John Nyland,&nbsp;Robert Prill,&nbsp;Jarod Richards,&nbsp;Robin Martin","doi":"10.1002/ksa.70276","DOIUrl":"10.1002/ksa.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>The poor outcomes for many athletes who attempt to return to sports at high-performance levels post-anterior cruciate ligament (ACL) reconstruction are concerning. Unless the surgeon and rehabilitation team communicate using a shared language from a common return-to-sport plan problem-solving and decision-making perspective, treatment outcomes have a high failure risk. Development and use of a shared language, such as that provided by the International Classification of Functioning, Disability and Health (ICF) framework is recommended. This editorial discusses the need for the surgeon and rehabilitation team to better appreciate differing viewpoints, be active listeners and display professional empathy. In addition to time and physical performance impairment-based evaluations, greater consideration for athlete sex, age, socioeconomic and sociocultural personal and environmental factors may improve outcomes. Long-term outcome success through the achievement of sustainable, high-performance levels and decreased re-injury rates is more likely to occur when all unique factors that may adversely influence individual athlete recovery have been identified and effectively managed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 7","pages":"2319-2324"},"PeriodicalIF":5.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000419","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":"Dynamic computed tomography assessment of patellofemoral and tibiofemoral kinematics before and after total knee arthroplasty: A pilot study","authors":"Miriam R. Boot,&nbsp;Sebastiaan A. W. van de Groes,&nbsp;Esther Tanck,&nbsp;Dennis Janssen","doi":"10.1002/ksa.70076","DOIUrl":"10.1002/ksa.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To develop and evaluate the clinical feasibility of a dynamic computed tomography (CT) protocol for assessing patellofemoral (PF) and tibiofemoral (TF) kinematics before and after total knee arthroplasty (TKA), and to quantify postoperative kinematic changes in a pilot study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective single-centre study, patients with primary osteoarthritis scheduled for cemented TKA underwent dynamic CT scans preoperatively and at 1-year follow-up during active flexion-extension-flexion. Preoperatively, the femur, tibia and patella were segmented using a neural network. Postoperatively, computer-aided design (CAD) implant models were aligned to CT data to determine relative implant-bone orientation. Due to metal artefacts, preoperative patella meshes were manually aligned to postoperative scans by four raters, and averaged for analysis. Anatomical coordinate systems were applied to quantify patellar flexion, tilt, proximal tip rotation, mediolateral translation and femoral condyle anterior-posterior translation. Descriptive statistics were reported, and interoperator agreement for patellar registration was assessed using intraclass correlation coefficients (ICCs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten patients (mean age, 65 ± 8 years; 6 men) were analysed across a shared flexion range of 14°–55°. Postoperatively, the patella showed increased flexion (median difference: 0.9°–3.9°), medial proximal tip rotation (median difference: 1.5°–6.0°), lateral tilt (median difference: 2.7°–5.5°), and lateral shift (median difference: −1.5 to −2.8 mm). The medial and lateral femoral condyles translated 2–4 mm anterior-posteriorly during knee flexion. Interoperator agreement for patellar registration ranged from good to excellent across all parameters (ICC = 0.85–1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pilot study demonstrates that dynamic CT enables in vivo assessment of PF and TF kinematics before and after TKA. The protocol quantified postoperative kinematic changes and demonstrated potential as research tool. Further automation is needed to investigate relationships between these kinematic patterns and patient outcomes in larger-scale studies.</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":"34 6","pages":"2087-2095"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188249","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":"Longitudinal correlation between X-ray and MRI findings in medial compartment knee osteoarthritis: Insights into early cartilage loss and structural changes","authors":"Do Weon Lee,&nbsp;Ji-Sahn Kim,&nbsp;Hyuk-Soo Han,&nbsp;Du Hyun Ro","doi":"10.1002/ksa.70016","DOIUrl":"10.1002/ksa.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Knee osteoarthritis (OA) is a common joint disorder assessed using radiographic (X-ray) and magnetic resonance imaging (MRI). While X-rays are accessible, MRI provides detailed insights into meniscus and cartilage. Few studies have evaluated the correlation between X-ray and MRI findings in knee OA longitudinally. This study addresses this gap by investigating their relationship over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Multicenter Osteoarthritis Study (MOST) dataset, a public, longitudinal cohort study focusing on knee OA in older adults, was used. The analysis included 3710 knees with medial compartment OA from different follow-ups over the course of 7 years. X-ray findings were compared with MRI findings, encompassing cartilage, meniscal and bone pathologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the central compartment, knee OA progression began with cartilage loss, followed by meniscal and bone pathology, while in the posterior compartment, meniscal changes preceded cartilage and bone lesions. Cartilage loss in the central femur was the earliest event, even in Kellgren–Lawrence grade 0 knees, preceding X-ray changes. Tibial osteophytes developed first on X-ray, followed by joint space narrowing and femoral osteophytes. Longitudinal regression identified meniscal extrusion, cartilage loss and meniscal tear as significant predictors of OA progression (<i>p</i> &lt; 0.001), with meniscal extrusion being the strongest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Knee OA progression differs by compartment, with cartilage loss initiating changes centrally and meniscal pathology leading posteriorly. Tibial osteophytes appear early on X-ray. Meniscal extrusion is the strongest predictor of OA progression, highlighting the importance of MRI in identifying early changes and guiding personalised management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"2047-2056"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986443","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":"Three in every four systematic reviews and meta-analyses on concomitant anterior cruciate ligament reconstruction and anterolateral complex procedures present at least one type of spin in the abstract","authors":"Adela Gottardi,&nbsp;Kieran Chalmers,&nbsp;Prushoth Vivekanantha,&nbsp;Jeffrey Kay,&nbsp;Mikael Sansone,&nbsp;Darren de SA","doi":"10.1002/ksa.12787","DOIUrl":"10.1002/ksa.12787","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Spin is a form of bias that misrepresents research findings, potentially influencing clinical decisions and patient care. This meta-research study evaluates the prevalence and types of spin in abstracts of systematic reviews and meta-analyses comparing anterior cruciate ligament reconstruction (ACLR) with and without lateral extra-articular tenodesis (LET) and anterolateral ligament reconstruction (ALLR). A secondary aim is to assess review quality per AMSTAR-2 criteria and associations between spin and review characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, EMBASE and MEDLINE[Ovid] in May 2024 identified eligible reviews. Two reviewers independently assessed the nine most severe types of spin and methodological quality using AMSTAR-2. Review characteristics, including publication year, total citations, average yearly citations and journal impact factor, were analyzed for associations with spin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 24 included reviews, 75% (18/24) contained at least one form of spin, with Type 3 spin, ‘Selective reporting or overemphasis on efficacy outcomes favoring the experimental intervention’, being the most common (62.5%, 15/24). Reviews with spin had a significantly more recent median publication year (<i>p</i> = 0.011), while those without spin had significantly higher total citation counts (<i>p</i> = 0.021). No significant differences were observed in average yearly citations or impact factors between groups. Reviews with three or more types of spin were published more recently than those with fewer (<i>p</i> = 0.007), with no significant differences in total citations, average yearly citations or impact factor. Most reviews (91.7%) were rated as critically low-quality using AMSTAR-2, with substantial inter-reviewer agreement (<i>κ</i> = 0.839).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Spin is highly prevalent in systematic reviews and meta-analyses evaluating ACLR with and without LET or ALLR, particularly in recent publications. Given that many reviews exhibit critically low methodological quality, efforts should focus on strengthening adherence to reporting standards and reducing spin to ensure the publication of unbiased evidence that informs clinical practice.</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":"34 6","pages":"1986-1999"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12787","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621749","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":"Impairment in quality of life with different sport orthopaedic musculoskeletal injuries—A comprehensive analysis of the German arthroscopy register","authors":"Dominik Szymski,&nbsp;Christoph Lutter,&nbsp;Sina Graeber,&nbsp;Alexander-Stephan Henze,&nbsp;Maximilian Hinz,&nbsp;Anja Hirschmueller,&nbsp;Thomas Niethammer,&nbsp;Ralf Mueller Rath,&nbsp;Thomas Tischer","doi":"10.1002/ksa.70205","DOIUrl":"10.1002/ksa.70205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to identify the impairment of quality of life (QoL) for different sport orthopaedic injuries prior to surgery in Germany and build a baseline dataset for these injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the German arthroscopy registry (DART) between November 2017 and January 2025 were used. EuroQol five-dimension questionnaire (EQ) value and EQ-visual analogue scale (EQ-VAS) were analysed for shoulder, hip, knee and ankle injuries. The EQ index value was calculated using a time-trade-off value set for Germany. One-way analysis of variance (ANOVA) and standardised mean differences (SMD) were calculated to assess between-group effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 9432 patients from the DART were included, predominantly with knee (75.5%) and shoulder (19.1%) pathologies. The highest EQ value was observed in shoulder patients (mean = 0.744 ± 0.22), while the lowest was reported in ankle patients (mean = 0.692 ± 0.26). EQ-VAS scores were highest in ankle (mean = 66.30 ± 22.1) and lowest in hip patients (mean = 62.41 ± 19.9). One-way ANOVA revealed significant differences between joint groups (<i>p</i> &lt; 0.001). Subgroup analysis showed the highest EQ value in meniscus lesions with future resection (0.806 ± 0.17) and ACL re-rupture (0.785 ± 0.21), while patella instability (0.633 ± 0.28) and posterior cruciate ligament (PCL) rupture (0.641 ± 0.27) showed the lowest. EQ-VAS was highest for meniscus lesions with future resection (71.03 ± 19.8) and rotator cuff tear without biceps tendon pathology (68.20 ± 20.8), and lowest for PCL rupture (62.45 ± 18.4) and femoroacetabular impingement (62.20 ± 20.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sport orthopaedic injuries cause a marked reduction in QoL, especially prior to surgical treatment. These findings highlight the need for greater integration of QoL assessment and mental health support in orthopaedic care and research to ensure more holistic, patient-centred treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II prognostic prospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"2067-2077"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145553052","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}