Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"3D kinematics of noncontact and indirect contact ACL injuries in elite male football players.","authors":"Alice Ranzini, Cristiano Alessandro, Monica Nitri, Alessandro Pellegrini, Fabio Esposito, Francesco Della Villa, Matteo Zago","doi":"10.1002/ksa.12612","DOIUrl":"https://doi.org/10.1002/ksa.12612","url":null,"abstract":"<p><strong>Purpose: </strong>Our primary goal was to deepen the understanding of the mechanisms leading to anterior cruciate ligament (ACL) injuries by reconstructing the three-dimensional (3D) joint kinematics of ACL injuries that occurred in professional male football matches. In particular, we aimed to compare the time courses of trunk and injured limb joint angles between noncontact and indirect contact injury mechanisms.</p><p><strong>Methods: </strong>In this cross-sectional observational study, we analysed a total of 27 cases (18 noncontact, 9 indirect contact). Whole-body 3D kinematics preceding and during ACL injuries was reconstructed using the Model-Based Image-Matching technique, implemented in Blender. For each injury, television footage from multiple perspectives (≥2, nine frames per view) were used, and Euler's joint angles across all the anatomical planes were extracted. The joint angle time courses of both the trunk and the injured limb, comprising 12 waveforms in total, were compared between injury mechanisms and Statistical Parametric Mapping was used to detect significant clusters.</p><p><strong>Results: </strong>Compared to noncontact injuries, indirect contact cases showed a lower hip abduction (-16°, p = 0.003), knee internal rotation (~3°, p < 0.001) at the initial contact with the ground, and ankle dorsiflexion (~7°, p = 0.035) at instants before the initial ground contact. These differences resulted from the player's adaptation to the sudden (yet variable) mechanical perturbation due to the contact with the opponent.</p><p><strong>Conclusion: </strong>Mechanical interactions with other players impact segmental kinematics before and during ACL injuries in professional male football. These findings reinforce the importance of considering the sport-specificity of mechanisms in injury prevention.</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":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123179","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 predictability of post-operative knee joint line obliquity in high tibial osteotomy: A new radiographic parameter correcting for foot position.","authors":"M Mertens, N van Beek, T Claes, W J Vleugels, Y Nys, S Claes, S Bartholomeeusen","doi":"10.1002/ksa.12598","DOIUrl":"https://doi.org/10.1002/ksa.12598","url":null,"abstract":"<p><strong>Purpose: </strong>Joint line obliquity is crucial for the long-term success of a high tibial osteotomy (HTO), particularly when large corrections are made. The relationship between the size of correction and changes in joint line obliquity (KJLO) is complex, often leading to the preference for a double-level osteotomy to manage significant post-operative obliquity. We aim to improve the prediction of knee joint line orientation changes and correction size by examining the influence of foot position. The goal is to develop a linear model to predict post-operative KJLO, which could assist in determining whether a single- or double-level osteotomy is necessary to prevent excessive post-operative joint line obliquity.</p><p><strong>Methods: </strong>A retrospective radiographic analysis was conducted on patients who underwent HTO surgery between April 2016 and April 2017. Ninety-one patients were randomly selected for radiographic measurements on long-leg radiographs pre- and 3-month post-operative. A novel radiographic parameter was introduced to realign the foot of the operated side to the midline. The foot position relative to the midline was assessed by determining the angle formed when rotating the natural foot position onto the midline using the centre of the hip as a rotation point. The angle obtained by subtracting this from the KJLO results in a corrected KJLO for midline foot position (aKJLO).</p><p><strong>Results: </strong>Predictive model of differences between pre- and post-operative values of MPTA (ΔMPTA [medial proximal tibial angle]) and KJLO (ΔKJLO) was less predictive (0.185 [p < 0.001]) than ΔMPTA and ΔKJLO corrected for foot position, namely ΔaKJLO (0.688 [p < 0.001]). Adding more parameters did not significantly improve the linear model's predictions.</p><p><strong>Conclusion: </strong>Predictability of aKJLO could be significantly enhanced. With this new parameter, inter- and intra-variability of foot position is bypassed. A safe MPTA position of 91° can be presumed; however, inter-individual variability in limb adaptation following correction remains uncertain.</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":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080319","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":"Robotic-assisted partial knee surgery performances: A 10-year follow-up retrospective study.","authors":"Piergiuseppe Perazzini, Paolo Sembenini, Francesco Alberton, Andrea Cochetti, Bernardo Innocenti, Edoardo Bori","doi":"10.1002/ksa.12599","DOIUrl":"https://doi.org/10.1002/ksa.12599","url":null,"abstract":"<p><strong>Purpose: </strong>Robotic surgery has emerged as an advanced technique for facilitating knee prosthesis implantation, especially in cases requiring high precision. However, due to the recent introduction and implementation of this approach, long-term data on its outcomes remain limited in the literature. This study aims to assess implant survival, complications and reoperation rates resulting from robotic arm-assisted partial knee arthroplasties, with a long-term follow-up period.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 236 patients who underwent robotic arm-assisted partial knee arthroplasty, with a minimum follow-up of 10 years. Clinical outcomes were evaluated, focusing on implant survival, complications, reoperation rates, and overall patient satisfaction. The study primarily examined medial unicompartmental knee arthroplasty (UKA), with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS) Part 1 and KSS Function scores assessed preoperatively and at the last follow-up.</p><p><strong>Results: </strong>Among the 236 patients, 212 were available at the last follow-up; satisfaction rates were overall positive, with 210 patients reporting being 'satisfied' or 'very satisfied'. Both WOMAC score and KSS showed statistically significant improvement postoperatively, both globally and in UKA patients specifically.</p><p><strong>Conclusions: </strong>The study demonstrates excellent long-term satisfaction rates, improved clinical outcomes and implant survival with minimal surgical morbidity. These findings offer valuable insights into the effectiveness of robotic arm-assisted knee arthroplasty.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080331","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":"Lack of validated patient-reported outcome tools persists in paediatric and adolescent hip arthroscopy—A systematic review","authors":"Ayomide Michael Ade-Conde,&nbsp;Brendan Amoyaw,&nbsp;Yoan Bourgeault-Gagnon,&nbsp;Hassaan Abdel Khalik,&nbsp;Nicole Simunovic,&nbsp;Olufemi R. Ayeni","doi":"10.1002/ksa.12603","DOIUrl":"10.1002/ksa.12603","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review aimed to (1) identify commonly used patient-reported outcome (PRO) tools in paediatric hip arthroscopy and (2) assess whether the PROs used in this population have been formally validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two systematic searches of MEDLINE, Embase and CENTRAL, from inception to 31 March 2024 and 22 August 2024, respectively, followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The first search identified PRO instruments used in studies on hip arthroscopy in patients aged 19 and under. The second focused on the clinimetric properties of these tools in paediatric hip arthroscopy. PRO utilization was stratified by pathology, trends over time and publication type. Use of the Consensus-based Standards for the Selection of Health Measurement Instruments tool, and a descriptive analysis, were planned to assess the eligible clinimetric studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-seven studies were included, identifying 10 hip-specific and 5 nonspecific PROs. The second search did not identify any clinimetric studies on these tools used in paediatric patients. The most commonly reported hip-specific PRO were the modified Hip Harris Score (<i>n</i> = 48), the Hip Outcome Score–Sport-Specific Subscale (<i>n</i> = 25) and the Non-Arthritic Hip Score (<i>n</i> = 20). Hip arthroscopy was used to treat over seven different conditions, with femoroacetabular impingement being the most common (<i>n</i> = 41, 77%). Between 2005 and 2024, the variety of hip-specific PROs increased, with seven new ones introduced by 2019–2024. Additionally, this study found a relatively equal distribution of outcomes across presentation abstracts and manuscripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The key finding of this study is the ongoing lack of hip-specific PRO tools in the paediatric hip arthroscopy literature, with reliance on adult-derived instruments. The absence of clinimetric studies and heterogeneity in PRO use emphasises the need for standardized, paediatric-specific tools. Developing and validating such instruments should be prioritized to ensure accurate, age-appropriate outcome assessment and care.</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 5","pages":"1863-1873"},"PeriodicalIF":3.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066437","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":"High failure rate in meniscal repair when preceding anterior cruciate ligament reconstruction: An analysis of two-stage surgery for concomitant ACL injury and traumatic meniscus tear.","authors":"Adolfo López Personat, Riccardo Cristiani, Anders Stålman, Johan Wänman, Christoffer Von Essen","doi":"10.1002/ksa.12593","DOIUrl":"https://doi.org/10.1002/ksa.12593","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the failure rate, predictive factors associated with failure and clinical outcomes after a two-stage surgery; meniscus repair followed by subsequent anterior cruciate ligament (ACL) reconstruction (ACLR).</p><p><strong>Methods: </strong>Patients with a concomitant traumatic meniscus tear and ACL injury who underwent a two-stage surgery between January 2015 and January 2021 were identified. The primary outcome was meniscal repair failure, defined as a reoperation (re-repair or resection). A Cox-regression analysis was used in order to analyse factors associated with meniscal repair failure within 3 years after the primary surgery for a meniscal repair. Secondary outcomes were range of motion (ROM), anterior knee laxity and the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 1- and 2-year follow-up. The thresholds of patient acceptable symptom state (PASS), treatment failure (TF) and minimum important change (MIC) were applied to KOOS4 (mean score of the KOOS Pain, Symptoms, Sports/Rec and QoL subscales).</p><p><strong>Results: </strong>A total of 150 patients were included. The meniscal repair failure rate after 3 years was 36.7%. Failure of meniscal repair was significantly associated with a time interval >1 year between the meniscal repair to the ACLR (hazard ratio [HR] = 2.5; 95% confidence interval [CI] = 1.2-5.5; p < 0.01), medial meniscus repair (HR = 2.3; 95% CI = 1.6-3.4; P < 0.01), and female sex (HR = 1.42; 95% CI = 1.0-1.9; p = 0.01). The age of the patient was not associated with meniscal repair failure. At the 6-month follow-up, most patients (72.5%) showed less than 2 mm of knee laxity; four patients (6.7%) experienced loss of extension and four patients (1.7%) experienced loss of flexion. On the KOOS4, at the 2-year follow-up, PASS was achieved in 53.4%, TF occurred in 1.7%, and MIC was reached in 36.4% of patients.</p><p><strong>Conclusion: </strong>The meniscus repair failure rate after the staged procedure was 36.7% at 3 years. A longer time interval from meniscal repair to ACLR, medial meniscus repair, and female sex were associated with an increased risk of meniscal repair failure. Age was not associated with meniscal repair failure.</p><p><strong>Level of evidence: </strong>Level IV case series retrospective study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059728","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":"Welcoming Dr. Hany Bedair as an Associate Editor for KSSTA","authors":"Michael T. Hirschmann,&nbsp;Elmar Herbst,&nbsp;Giuseppe Milano,&nbsp;Volker Musahl","doi":"10.1002/ksa.12606","DOIUrl":"10.1002/ksa.12606","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 3","pages":"802"},"PeriodicalIF":3.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052459","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":"Combined use of cleft and truncated triangle signs helps improve the preoperative MRI diagnosis of lateral meniscus posterior root tears in patients with ACL injuries.","authors":"Aritoshi Yoshihara, Caroline Mouton, Renaud Siboni, Tomomasa Nakamura, Ichiro Sekiya, Hideyuki Koga, Romain Seil, Yusuke Nakagawa","doi":"10.1002/ksa.12597","DOIUrl":"https://doi.org/10.1002/ksa.12597","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate whether combining the analysis of different magnetic resonance imaging (MRI) signs enhances the diagnostic accuracy of lateral meniscus posterior root tears (LMPRTs) in patients with anterior cruciate ligament (ACL) injuries. We hypothesised that analysing the cleft, ghost and truncated triangle signs and lateral meniscus extrusion (LME) measurement together would improve the preoperative MRI-based diagnosis of LMPRTs.</p><p><strong>Methods: </strong>This retrospective study used prospectively collected registry data from two academic centres, including patients undergoing primary or revision ACL reconstruction (ACLR) and LMPRT repair. The control group included age- and sex-matched (1:1) patients undergoing ACLR without any lateral meniscus tears. LME (mm) and the presence of cleft, ghost and/or truncated triangle signs were evaluated using preoperative MRI.</p><p><strong>Results: </strong>In total, 252 patients (126 per group) were included. Individually, the cleft and truncated triangle signs achieved the highest sensitivity (60% and 62%, respectively) and accuracy (>89%). The presence of either sign increased sensitivity to 79% and enabled the correct classification of 93% of ACL injuries as having or not having an LMPRT, with high specificity (95%) and good positive predictive value (74%). This combination was considered the most efficient in reducing false positives and false negatives. The LME (cutoff value: 2.2 mm) and ghost sign had lower sensitivities (50% and 14%, respectively) and accuracies (83% and 87%) and were not part of the optimal combination.</p><p><strong>Conclusion: </strong>The cleft and/or truncated triangle signs on preoperative MRI reliably detected 79% of LMPRTs in this cohort, with high specificity (95%) and good positive predictive value (74%). This combination provides an effective method for achieving reasonable sensitivity while minimising false positives, aiding surgeons in preoperative diagnosis and planning for LMPRT repair.</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":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047038","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":"Return to competition after ACL reconstruction: Factors influencing rates and timing in Swedish football players.","authors":"Alexander Sandon, Joanna Kvist, Henrik Hedevik, Magnus Forssblad","doi":"10.1002/ksa.12579","DOIUrl":"https://doi.org/10.1002/ksa.12579","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the rate and timing for return to football league games after anterior cruciate ligament reconstruction (ACLR) in Swedish players, examining associations with sex, age, level, graft and additional ACL surgery.</p><p><strong>Method: </strong>Data from the Swedish National Knee Registry (SNKLR) and the Swedish Football Association's IT System (FOGIS) were used. The study cohort comprised 971 football players, 64% males, who underwent primary ACLR. Demographics, graft type and surgical information were extracted from the SNKLR and game participation from FOGIS. Follow-up for return to competition (RTC) was conducted for 36 months, while additional ACLR follow-up was 3-7 years. Statistical analyses, including Kaplan-Meier survival curves and relative risk calculations, were employed to assess factors influencing RTC rates and timing.</p><p><strong>Results: </strong>Out of 971 players analyzed, 53% RTC within 3 years with no difference between males and females, at a mean of 15 months (median 14 months) from surgery to the first game. Eleven (2%) players RTC < 6 months from ACLR, 62 (12%) 6-9 months, 125 (24%) 9-12 months and 331 (63%) >12 months. Patellar tendon (PT) grafts demonstrated superior performance, showing quicker returns and higher RTC rates (p = 0.005) compared to hamstring (hazard ratio [HR]: 0.63 [0.48-0.84]) and quadriceps tendon grafts (HR: 0.53 [0.30-0.93]). Players competing in higher divisions pre-injury experienced significantly swifter and higher RTC rates (p < 0.001). Ninety-five (10%) had a registered additional ACLR. Players who RTC did not exhibit a significantly higher rate of revision (35 [7%] vs. 25 [5%]). However, those who returned faced a heightened risk of contralateral ACLRs compared to those who did not RTC (32 [6%] vs. 4 [1%] RR 1.72 [1.59-1.96], p < 0.001).</p><p><strong>Conclusion: </strong>The study reveals that 53% of football players RTC after ACLR, predominantly after more than 12 months. The RTC was higher and faster in high-level players and those receiving a PT graft. The slow RTC may contribute to the relatively low rate of additional ACLRs.</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":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047041","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":"Improved outcomes of proximal hamstring avulsion surgery in patients both under and over 50 years, with greater gains in the younger group: A matched comparative study of the PHAS cohort","authors":"Nicolas Lefèvre,&nbsp;Mohamad K. Moussa,&nbsp;Pierre Alban Bouché,&nbsp;Eugénie Valentin,&nbsp;Antoine Gerometta,&nbsp;Frederic Khiami,&nbsp;Olivier Grimaud,&nbsp;Alain Meyer,&nbsp;Yoann Bohu,&nbsp;Alexandre Hardy","doi":"10.1002/ksa.12596","DOIUrl":"10.1002/ksa.12596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the functional outcomes of surgical treatment for proximal hamstring avulsion injuries in patients aged over 50 years and to compare the results across another matched group of patients under 50.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective analysis of prospectively collected data in a matched case-control design targeting patients with proximal hamstring avulsion injuries who underwent surgical treatment at a sports surgery referral centre. Patients over 50 years with complete avulsion or partial injury (&gt;2 cm retraction) were included. Two age groups were formed (18–50 and over 50), matched by the following variables: gender, rupture type (complete or partial), injury chronicity (chronic: more than 4 weeks from the injury or acute) and the preinjury Tegner score. The primary outcome was the Parisian Hamstring Avulsion Score (PHAS), with secondary outcomes, including the Tegner Activity Scale, University of California, Los Angeles (scale) (UCLA) scale, return to sport and complication rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 298 patients, with a mean age of 41.8 (7.2) years for the younger group and 58.0 (5.7) years for the older group. The follow-up duration in the younger group, 4.7 years (3.2), was slightly longer than that of the older group, 4.1 years (2.5), (<i>p</i> &lt; 0.001). At the last follow-up, significant improvements were observed in PHAS, UCLA and Tegner scores in both groups (<i>p</i> &lt; 0.001) compared to preoperative scores. The differential gain was higher in the younger group in all three scores (<i>p</i> &lt; 0.05). The rerupture rate was 8.1% in the younger group and 4.7% in the older group (<i>p</i> &gt; 0.05), with no significant differences in complication and return to sports rates (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows that surgical treatment of proximal hamstring avulsion injuries is associated with significant improvements in functional outcomes in both younger and older patients, with greater magnitude of improvements in younger patients. Complication rates were similar between the age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, Cohort Study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 5","pages":"1853-1862"},"PeriodicalIF":3.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023876","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":"No difference in ACL revision rates between hamstring and patellar tendon autograft in patients with ACL-R and a concurrent meniscal injury irrespective of meniscal treatment.","authors":"Johan Högberg, Lina Petersson, Bálint Zsidai, Alexandra Horvath, Riccardo Cristiani, Kristian Samuelsson, Eric Hamrin Senorski","doi":"10.1002/ksa.12592","DOIUrl":"https://doi.org/10.1002/ksa.12592","url":null,"abstract":"<p><strong>Purpose: </strong>The aims of this study were to compare (1) the rate of anterior cruciate ligament (ACL) revision and (2) subjective knee function using the Knee injury and Osteoarthritis Outcome Score (KOOS) between isolated ACL reconstruction (ACL-R) and ACL-R and concurrent meniscal injury, based on graft selection and meniscal treatment.</p><p><strong>Methods: </strong>Data from the Swedish National Knee Ligament Registry were extracted in November 2022 for patients who underwent primary ACL-R. Patients were divided into two main groups based on graft choice: hamstring tendon (HT) or patellar tendon (PT) autograft, with four meniscal sub-groups: no injury, resection, repair or left in situ. The primary outcome was the rate of ACL revision within 5 years of primary ACL-R, and the secondary outcome was subjective knee function measured with the mean KOOS subscale scores and the rate of patients achieving a patient-acceptable symptom state (PASS) at the 1-, 2- and 5-year follow-up.</p><p><strong>Results: </strong>The analysis of ACL revision was performed on 45,656 patients, and 7639 patients for the analysis of subjective knee function. The overall rate of ACL revision was 2.4% and 4.9% at 2 and 5 years, respectively. There were no differences in the rate of ACL revision within 5 years of primary surgery irrespective of graft choice or meniscal injury treatment. Patients with ACL-R and concurrent meniscal resection or meniscal injury left in situ achieved a PASS at the 1 (∆ = -11.3% to -29.5%), 2 (∆ = -12.7% to -40.3%) and 5-year (∆ = -12.0% to -30.6%) follow-up to a greater extent when receiving HT autograft compared to PT autograft.</p><p><strong>Conclusion: </strong>Graft selection was not associated with ACL revision in patients with ACL-R and concurrent meniscal injury, regardless of meniscal injury treatment. Superior subjective knee function was reported by patients who underwent ACL-R with HT autograft compared with PT autograft where the injured meniscus was resected or left in situ.</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":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023879","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}