Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Beyond the coronal plane in robotic total knee arthroplasty—Part 1: Variations in tibial slope and distal femoral flexion do not affect outcomes","authors":"Luca Andriollo,&nbsp;Christos Koutserimpas,&nbsp;Pietro Gregori,&nbsp;Elvire Servien,&nbsp;Cécile Batailler,&nbsp;Sébastien Lustig","doi":"10.1002/ksa.12658","DOIUrl":"10.1002/ksa.12658","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Robotic-assisted total knee arthroplasty (TKA) and new alignment principles are transforming traditional implant positioning, not only in the coronal plane but also in the sagittal and axial planes. The impact of differences between a patient's native tibial slope (TS) and distal femoral flexion (DFF) compared to the final implant positioning remains unclear. This study aims to evaluate whether variations in TS (ΔTS) and DFF (ΔDFF) play a role in clinical outcomes and implant survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analysed patients who underwent robotic-assisted TKA following functional alignment (FA) principles between March 2021 and January 2023. A total of 310 patients were included. Preoperative and postoperative data, including radiographic and robotic measurements, were collected. Clinical outcomes (KSS, FJS-12 and AKPS), range of motion (ROM), complication rates, and implant survival were compared between groups at a minimum of 2 years follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the final follow-up (mean 2.93 ± 0.62 years), no significant differences were found in clinical scores or ROM between groups with different ΔTS or ΔDFF values. Complication rates and implant survival (99%) were also similar. However, patients with ΔTS &gt; 5° had a slightly increased femoral valgus alignment, while those with ΔDFF ≤ 5° had lower preoperative ROM, with the femoral implant positioned in varus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Variations between native and implant TS and DFF in robotic-assisted TKA do not negatively impact functional outcomes or implant survival. A personalised sagittal alignment approach within the concept of FA represents a progression to a functional knee positioning based on three dimensions. Further research is needed to explore the long-term effects of sagittal alignment on TKA performance.</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":"2928-2938"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700537","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":"Very low dislocation rate and good clinical outcome after Bereiter trochleoplasty and additional procedures following the Copenhagen patella-femoral instability algorithm: One- and two-years outcomes from a consecutive cohort of 368 cases.","authors":"Christian Dippmann, Volkert Siersm, Simone Rechter, Kristoffer W Barfod, Peter Lavard","doi":"10.1002/ksa.12663","DOIUrl":"https://doi.org/10.1002/ksa.12663","url":null,"abstract":"<p><strong>Purpose: </strong>Patello-femoral instability (PFI) is often caused by predisposing factors, with trochlea dysplasia (TD) as the most prominent. Untreated patellar instability leads to impaired function and an increased risk of patellofemoral osteoarthritis. Since 2009 patients with PFI have been treated according to the Copenhagen PFI algorithm, where underlying osseous predisposing factors are addressed. The aim of this study was to report the two-year outcome after Bereiter trochleoplasty (TP) for high grade TD in a cohort of 368 consecutive patients treated according to the Copenhagen PFI algorithm from 2011 to 2021.</p><p><strong>Methods: </strong>This was a register study evaluating a consecutive cohort of patients with high grade TD undergoing Bereiter trochleoplasty and additional procedures following the Copenhagen PFI algorithm. Outcomes were the Kujala score, the Knee Osteoarthritis Outcome Score (KOOS) and the Lysholm score collected preoperatively and after 1 and 2 years.</p><p><strong>Results: </strong>From January 2011 to September 2021, 368 Bereiter TPs were performed on 346 patients (99 males, 225 females and 44 bilateral surgeries). Four knees (1.1%) experienced a re-dislocation. There were statistically significant (p < 0.0001) and clinically relevant improvements in all patients reported outcome measure (PROM)-scores 1 and 2 years after surgery. Over 2 years Kujala score improved mean (95% confidence interval) 18.7 (16.5-20.9), KOOS QoL 31.0 (28.0-34.0) and Lysholm score 20.0 (17.1-22.9).</p><p><strong>Conclusions: </strong>Patients with high grade TD treated with Bereiter TP and additional procedures according to the Copenhagen PFI algorithm showed low re-dislocation rate and statistically significant and clinically relevant improvement in patient reported outcome 1 and 2 years after treatment.</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":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700550","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 new preclinical sheep model of medial meniscus anterior root repair: Part 2—Surgical strategy, technical considerations, pearls and pitfalls","authors":"Matthias Brockmeyer,&nbsp;Wei Liu,&nbsp;Marta Carretero-Hernández,&nbsp;Yin Zhang,&nbsp;Henning Madry","doi":"10.1002/ksa.12636","DOIUrl":"10.1002/ksa.12636","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To address a gap in translational research by developing a preclinical sheep model of medial meniscus anterior root (MAR) repair in vivo and to compare probabilities of potential pitfalls and difficulties with humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Preoperative planning and surgical procedures applied to patients were adapted to adult sheep. Eight healthy, skeletally mature, female Merino ewes between 2 and 4 years of age underwent a mini-open medial parapatellar approach to both stifle joints without luxating the patella. Next, the MAR was transected in 16 knees (8 sheep) resulting in a subtype 2A tear according to the LaPrade classification, followed by a transtibial pull-out repair through a 3.2 mm diameter bone tunnel with a reinforced Mason–Allen suture and non-absorbable suture material. Animals were followed until 21 days after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The surgery time per knee ranged between 30 and 50 min (mean, 40.0 ± 7.8 min). The surgical technique was safe without intra- or post-operative complications. Solid repair is most likely if the following surgical principles are respected: (1) Selection of the MAR and the open technique allow for elegant tunnel positioning and less post-operative loading stress due to the normal extension deficit of sheep; (2) careful preparation of the MAR is mandatory; (3) considering the oval shape of the MAR attachment (MARA) results in anatomic tunnel placement; (4) robust suture placement and configuration avoids suture cut out. The probabilities of potential pitfalls and difficulties differ from the human situation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A clinically adapted MAR repair model in adult sheep was developed following its complete transection close to the MARA, followed by an open transtibial pull-out repair. The surgical technique was safe without intra- or short-term post-operative complications. This model may be suitable to study the biomechanics and pathophysiology of meniscal root injuries and their repair.</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 7","pages":"2487-2497"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700531","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":"Tibial implant varus >3° does not adversely affect outcomes or revision rates in functionally aligned image-based robotic total knee arthroplasty in a minimum of 2-year follow-up","authors":"Christos Koutserimpas,&nbsp;Riccardo Garibaldi,&nbsp;Flora Olivier,&nbsp;Elvire Servien,&nbsp;Cécile Batailler,&nbsp;Sébastien Lustig","doi":"10.1002/ksa.12659","DOIUrl":"10.1002/ksa.12659","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Functional alignment (FA) aims to restore knee kinematics by balancing laxities and adapting implant positioning. This study evaluates safety and outcomes of &gt;3° varus tibial positioning in patients with varus deformity undergoing robotic-assisted total knee arthroplasty (TKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 337 patients with varus deformity undergoing robotic-assisted TKA with FA principles with a minimum of 2-year follow-up. Patients were divided into two groups based on tibial varus positioning: ≤3° varus: Group A and &gt;3° varus: Group B. Preoperative and postoperative coronal alignment, implant positioning, and outcomes were assessed using the Knee Society Score (KSS) and the Forgotten Joint Score (FJS) at final follow-up. The primary outcome was implants' survivorship, and secondary outcomes included complication rates and functional scores. Statistical analyses included Mann–Whitney and Chi-square tests for group comparisons, Kaplan–Meier survival analysis for implant survivorship, and multivariate regression for key covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Implant survivorship was 99.4% in Group B over a median follow-up of 30 months, with one revision due to aseptic loosening and 100% in Group A (<i>p</i> = 0.36). The overall complication rates were 12.7% in Group A and 10.2% in B (<i>p</i> = 0.48). The median KSS-knee and function scores were 94.5 and 90 in Group A and 94 and 90 in B (<i>p</i> = 0.88 and 0.8, respectively). The final FJS was 82 in Group A and 84 in B (<i>p</i> = 0.8). No significant differences were observed in postoperative knee range of motion between the two groups. Multivariate regression analysis showed that none of the included covariates were statistically significant predictors of implant failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FA in robotic-assisted TKA with tibial positioning &gt;3° varus seems to be safe and reliable in patients with varus deformity, demonstrating similar revision rates, implant survivorship, and outcomes compared to the ≤3° tibial varus group.</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":"2917-2927"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700472","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 new preclinical sheep model of medial meniscus anterior root repair: Part 1—Quantitative morphology and relationships to adjacent structures","authors":"Wei Liu,&nbsp;Marta Carretero-Hernández,&nbsp;Yin Zhang,&nbsp;Magali Cucchiarini,&nbsp;Matthias Brockmeyer,&nbsp;Henning Madry","doi":"10.1002/ksa.12656","DOIUrl":"10.1002/ksa.12656","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To analyse the quantitative morphology of the menisci, their roots and relations with a focus on the medial meniscus anterior root (MAR) as a basis for a preclinical model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data was obtained from 24 tibial plateaus of skeletally mature, female Merino ewes. The MAR attachment (MARA) was scanned with micro-computed tomography and stained with hematoxylin and eosin. Data of relevant anatomical structures was subjected to principal component analysis (PCA) and Spearman correlations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The osteo-ligamentous junction of the MARA represents a classical enthesis with a type-I insertion into the cortical bone. The medial tibial plateau was of a significantly smaller area than lateral. Its sagittal length was significantly longer than lateral. The widths of the MAR and lateral meniscus anterior root (LAR) were approximately half of both anterior horn widths. The MAR was significantly wider than the LAR. The medial meniscus body, posterior horn and medial posterior root were significantly thinner than lateral. PCA and cluster analysis revealed a striking, significant distinction between the structures of the medial and lateral tibial plateau. The sagittal length of the articular cartilage of both tibial plateaus correlated with the primary axis length of both menisci. The maximum width of the articular cartilage of both plateaus correlated with the area of both menisci. Significant correlations also existed between the length of the MAR and the total width of the tibia plateau and between the size of the MARA and the coronal distance to the medial tibial eminence (MTE), to the tibial tuberosity and the sagittal distance to the MTE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ovine MAR may be appropriate for repair approaches because of its morphological similarities to the human situation. The substantial differences between the medial and lateral tibial plateau have to be respected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 7","pages":"2470-2486"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12656","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700532","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":"Similar outcomes between gracilis-reinforced ITB and HT with modified Lemaire technique in combined ACL reconstruction with lateral tenodesis: A propensity score-matched analysis.","authors":"Alexandre Sabaté Ferris, Maxime Bayon, Guillaume David, Marie-Camille Bohand, Romain Rousseau","doi":"10.1002/ksa.12650","DOIUrl":"https://doi.org/10.1002/ksa.12650","url":null,"abstract":"<p><strong>Purpose: </strong>While both iliotibial band graft augmented by gracilis tendon (ITB + G) and hamstring autograft with modified Lemaire lateral extra-articular tenodesis (STG + LET) are established techniques for addressing rotatory instability in anterior cruciate ligament reconstruction, no direct comparison exists between these approaches. The purpose of this study was to provide the first direct comparison between these two surgical techniques regarding graft survival, functional outcomes and return to sport.</p><p><strong>Methods: </strong>This single-centre, single-surgeon retrospective study analyzed 56 patients (28 per group) after 1:1 propensity score matching based on age, gender and Tegner activity scale. Primary end point was failure (graft retear or secondary meniscal lesion). Secondary outcomes included the International Knee Documentation Committee (IKDC), anterior cruciate ligament-return to sport after surgery (ACL-RSI) scores, and return to sport rate. Kaplan-Meier survival analysis and between-group comparisons were performed using appropriate statistical tests.</p><p><strong>Results: </strong>At mean follow-up of 53.3 ± 6.4 months, failure-free survival rates at 24 months were 85.7% (95% confidence interval [CI]: 66.3-94.4) for STG + LET and 89.3% (95% CI: 70.4-96.4) for ITB + G (p = 0.664). Graft retear rate was 7.1% (STG + LET: 3.6%, ITB + G: 10.7%). Secondary meniscal injuries occurred equally (14.3%) in both groups. Return-to-sport rate was 89.3% at mean of 9.6 ± 3.9 months. Mean IKDC scores were 87.5 ± 11.4 for STG + LET and 83.6 ± 16.3 for ITB + G, with 73.7% achieving Patient Acceptable Symptom State criteria. ACL-RSI scores were similar between groups (STG + LET: 74.2 ± 24.3 and ITB + G: 73.5 ± 26.8).</p><p><strong>Conclusion: </strong>No significant differences were found between ITB + G and STG + LET techniques regarding failure rates, return to sport and functional outcomes. Both techniques achieved satisfactory results in this cohort, with similar complication profiles. This comparison provides valuable clinical guidance, supporting surgical decision-making based on surgeon experience.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676986","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":"Restoring native posterior tibial slope within 4° leads to better clinical outcomes after cruciate-retaining robot-assisted total knee arthroplasty with functional alignment","authors":"Young Tak Cho,&nbsp;Ho Jung Jung,&nbsp;Joong Il Kim","doi":"10.1002/ksa.12649","DOIUrl":"10.1002/ksa.12649","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The impact of posterior tibial slope (PTS) on clinical outcomes after robot-assisted total knee arthroplasty (RTKA) with functional alignment (FA) remains unclear. This study aimed to evaluate the effect of PTS on clinical outcomes following RTKA with FA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospectively collected database was retrospectively reviewed for patients who underwent primary cruciate-retaining RTKA (CR-RTKA) with FA using the MAKO robotic system, with a minimum 1-year follow-up. Knees were categorized into two groups: the small change (SC) group (<i>n</i> = 47) with a small PTS change (&lt;4°) and the large change (LC) group (<i>n</i> = 53) with a large PTS change (≥4°). PTS change was defined as differences between pre- and post-operative PTS values. At the 1-year follow-up, clinical outcomes including Knee Society Score (KSS), Western Ontario and McMaster University Index (WOMAC), Forgotten Joint Score-12 (FJS-12) and post-operative complications were compared between groups. A multiple linear regression analysis was conducted to identify independent factors influencing post-operative WOMAC scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The SC group demonstrated significantly better post-operative clinical outcomes than the LC group (KSS-functional score: 85.63 ± 13.00 vs. 77.08 ± 18.39, <i>p</i> = 0.026; WOMAC: 10.46 ± 5.36 vs. 16.98 ± 10.69, <i>p</i> &lt; 0.001; FJS-12: 75.94 ± 21.96 vs. 61.37 ± 26.61, <i>p</i> = 0.019). In multivariate regression analysis, PTS change was identified as an independent factor correlated with the post-operative WOMAC score (<i>β</i>: 0.842, <i>p</i> = 0.001). No post-operative complications were observed in either group during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Restoring the native PTS within 4° leads to better clinical outcomes following CR-RTKA with FA without post-operative complications for up to 1 year. Therefore, efforts to restore the native PTS are critical for achieving optimal short-term clinical outcomes after CR-RTKA with FA.</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 7","pages":"2592-2604"},"PeriodicalIF":5.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676979","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 traditional orthopaedic data analysis: AI, multimodal models and continuous monitoring","authors":"Felix C. Oettl,&nbsp;Bálint Zsidai,&nbsp;Jacob F. Oeding,&nbsp;Michael T. Hirschmann,&nbsp;Robert Feldt,&nbsp;Thomas Tischer,&nbsp;Kristian Samuelsson,&nbsp;ESSKA Artificial Intelligence Working Group","doi":"10.1002/ksa.12657","DOIUrl":"10.1002/ksa.12657","url":null,"abstract":"<p>Multimodal artificial intelligence (AI) has the potential to revolutionise healthcare by enabling the simultaneous processing and integration of various data types, including medical imaging, electronic health records, genomic information and real-time data. This review explores the current applications and future potential of multimodal AI across healthcare, with a particular focus on orthopaedic surgery. In presurgical planning, multimodal AI has demonstrated significant improvements in diagnostic accuracy and risk prediction, with studies reporting an Area under the receiving operator curve presenting good to excellent performance across various orthopaedic conditions. Intraoperative applications leverage advanced imaging and tracking technologies to enhance surgical precision, while postoperative care has been advanced through continuous patient monitoring and early detection of complications. Despite these advances, significant challenges remain in data integration, standardisation, and privacy protection. Technical solutions such as federated learning (allowing decentralisation of models) and edge computing (allowing data analysis to happen on site or closer to site instead of multipurpose datacenters) are being developed to address these concerns while maintaining compliance with regulatory frameworks. As this field continues to evolve, the integration of multimodal AI promises to advance personalised medicine, improve patient outcomes, and transform healthcare delivery through more comprehensive and nuanced analysis of patient data.</p><p><b>Level of Evidence:</b> Level V.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 6","pages":"2269-2275"},"PeriodicalIF":5.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676975","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":"Correction to “Posterior knee arthroscopy facilitates the safe and effective all‑inside repair of locked bucket‑handle medial meniscal tear using a suture hook technique”","authors":"","doi":"10.1002/ksa.12617","DOIUrl":"10.1002/ksa.12617","url":null,"abstract":"<p>Keyhani, S., Soleymanha, M., Verdonk, R. et al. (2022) Posterior knee arthroscopy facilitates the safe and effective all‑inside repair of locked bucket‑handle medial meniscal tear using a suture hook technique. <i>Knee Surgery, Sports Traumatology, Arthroscopy</i>, 30(4), 1311–1315. https://esskajournals.onlinelibrary.wiley.com/doi/10.1007/s00167-021-06576-x.</p><p>Mohammadreza Abbasian has been added as a co-author of the above cited article.</p><p>We apologize for this error.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649546","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":"Age not a primary risk factor for ACL injury-A comprehensive review of ACL injury and reinjury risk factors confounded by young patient age.","authors":"Bálint Zsidai, Ramana Piussi, Philipp W Winkler, Armin Runer, Pedro Diniz, Riccardo Cristiani, Eric Hamrin Senorski, Volker Musahl, Michael T Hirschmann, Romain Seil, Kristian Samuelsson","doi":"10.1002/ksa.12646","DOIUrl":"https://doi.org/10.1002/ksa.12646","url":null,"abstract":"<p><p>Revision surgery after anterior cruciate ligament reconstruction (ACL-R) is hypothesized to be the result of an interplay between factors associated with the anatomy, physiological characteristics and environment of the patient. The multifactorial nature of revision ACL-R risk is difficult to quantify, and evidence regarding the independent roles of potentially important variables is inconsistent throughout the literature. Young patient age is often cited as one of the most prominent risk factors for reinjury after ACL-R. However, the association between a non-modifiable variable such as patient age and revision ACL-R risk is likely to be a spurious correlation due to the confounding effect of more important variables. From the perspective of healthcare professionals aiming to mitigate revision ACL-R risk through targeted interventions, awareness of factors like generalized joint hypermobility, bone morphology, muscle strength imbalances, and genetic factors is critical for the individualized risk assessment of patients with ACL injury. The aim of this current concepts article is to raise awareness of the essential anatomical, physiological, and activity-related risk factors associated with ACL injury and reinjury risk that are likely captured and confounded by patient age. LEVEL OF EVIDENCE: Level V.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657620","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}