Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"In functionally aligned total knee arthroplasty, femoral component rotation follows the transepicondylar axis to achieve flexion balance","authors":"Joss Moore,&nbsp;Victor A. Van de Graaf,&nbsp;Jil A. Wood,&nbsp;Darren B. Chen,&nbsp;Samuel J. MacDessi","doi":"10.1002/ksa.12590","DOIUrl":"10.1002/ksa.12590","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In functionally aligned (FA) total knee arthroplasty (TKA), femoral component rotation (FCR) is personalised to optimise flexion gap balance. As axial malalignment has been attributed to patellofemoral complications, this study assessed FA FCR in relation to the surgical transepicondylar axis (TEA) and early implant survivorship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed 446 robotic-assisted primary TKAs in 393 patients using FA with preresection gap balancing. Femoral and tibial coronal resection boundaries were 6° valgus to 3° varus and 6° varus to 3° valgus, respectively. The TEA and posterior condylar axis (PCA) were identified on preoperative computed tomographic scans. Intraoperatively, FCR was initially set parallel to the PCA, then rotated to achieve flexion balance within 6° boundaries to the TEA. The primary outcome was the mean angular difference between the TEA and final FCR and the proportion of patients with FCR within 2°, 4° and 6° from the TEA. Secondary outcomes included all-cause revisions for the robotic-assisted TKAs in this series from our in-house database and a national joint replacement registry at a mean of 3.3 years postoperatively (range 2.2–5.5).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean FCR was 0.0° (SD 2.1°) relative to the TEA and 1.8° (SD 1.4°) externally rotated to the PCA. Final FCR was within 2° in 74.9%, within 4° in 97.3% and within 6° in 99.6% of patients relative to the TEA. There were seven postoperative procedures (1.6%) within the study period: two reoperations (0.5%) for early arthrotomy failure requiring repair (both exhibiting FCR within 1° to the TEA) and three revisions (0.7%) for deep surgical site infection (one after early traumatic arthrotomy failure, one revision for instability and one manipulation for stiffness).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In FA TKA, femoral components more closely align to the TEA than the PCA to achieve a balanced flexion gap. In conjunction with a low incidence of revision surgeries, this suggests the FA technique does not result in significant patellofemoral complications.</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":"1784-1791"},"PeriodicalIF":3.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007918","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":"Stress radiography of medial knee instability provides a reliable correlation with the severity of injury and medial joint space opening-A robotic biomechanical cadaveric study.","authors":"Thorben Briese, Matthias Holz, Christian Peez, Michael J Raschke, Adrian Deichsel, Elmar Herbst, Mirco Herbort, Christoph Kittl","doi":"10.1002/ksa.12594","DOIUrl":"https://doi.org/10.1002/ksa.12594","url":null,"abstract":"<p><strong>Purpose: </strong>The medial collateral ligament (MCL), and posterior oblique ligament (POL) are the primary valgus stabilisers of the knee, and clinical examinations in grading valgus instability can be inherently subjective. Stress radiography of medial-sided knee injuries provides objective diagnosis and was analysed in this study. We hypothesised that (1) medial joint space opening would increase cutting the superficial MCL (sMCL), POL and anterior cruciate ligament (ACL); (2) isolated deep MCL (dMCL) injury would not increase medial joint space opening; (3) medial joint space opening would increase at higher flexion angles.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Ten human cadaveric knees were dissected, preserving ligamentous structures, muscles and fascia. The femur was secured, and the tibia was attached to the six-degree-of-freedom robot. A 10 Nm valgus torque was applied at 0°-45° of flexion and anterior-posterior (a.p.) radiographs were taken. Sequential sectioning was performed on the dMCL, sMCL, POL and ACL. Medial joint space opening was measured on a.p. radiographs (midpoint technique). Statistical analysis was conducted using a mixed model with post hoc correction (p < 0.05). Intra- and interobserver reliability was assessed by calculating the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Medial joint space opening significantly increased with cutting state (p < 0.0001) and flexion angle (p < 0.0001). Although isolated dMCL injury did not significantly increase medial joint space opening, sMCL resection gradually increased joint space opening 3.2 ± 1.9 to 6.9 ± 2.7 mm (p = 0.039) between 0° and 45° knee flexion. Following POL deficiency, medial joint space opening further increased 6.4 ± 2.7 to 11.4 ± 6.2 mm between 0° and 45° knee flexion (p = 0.0035). A combined injury (dMCL/sMCL/POL/ACL) increased medial joint space opening 12.0 ± 4.9 to 21.8 ± 7.9 mm (p < 0.0001) between 0° and 45° knee flexion, compared to the intact state. The intraobserver ICC was 0.995 and the interobserver ICC was 0.955 showing excellent intra- and interobserver reliability.</p><p><strong>Conclusion: </strong>Deficiency of the medial stabilisers of the knee increased medial joint space opening in stress radiography, whereas isolated dMCL deficiency did not significantly affect valgus gapping. This study demonstrated a good concordance between valgus stress radiography and clinical scores (International Knee Documentation Committee and Hughston). Our findings support performing valgus stress tests at 0° and at least 20° of flexion.</p><p><strong>Level of evidence: </strong>There is no level of evidence as this study was an experimental laboratory study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007949","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":"Heterogeneity in the use of osseous risk factors and limited use of relevant patient-reported outcome measurements in studies investigating treatment of patellar dislocation: A scoping review.","authors":"Ebrahim Rahdi, Catarina Anna Evelina Malmberg, Adam Witten, Tue Smith Jørgensen, Rafal Yahya, Lars Blønd, Per Hölmich, Kristoffer Weisskirchner Barfod","doi":"10.1002/ksa.12581","DOIUrl":"https://doi.org/10.1002/ksa.12581","url":null,"abstract":"<p><strong>Purpose: </strong>The treatment of patellar dislocation is tailored based on the presence or absence of osseous risk factors. The purpose of this scoping review was to investigate whether existing research addresses patient differences by mapping the use of osseous risk factors and patient-reported outcome measures (PROMs) in studies investigating the treatment of patellar dislocation.</p><p><strong>Methods: </strong>This study was a scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Studies published between 1 January 2013 and 3 April 2023 were included if they investigated the treatment of patellar dislocation and registered osseous risk factor(s). Case series with fewer than 10 patients, reviews and meta-analyses were excluded.</p><p><strong>Results: </strong>A total of 8923 records were identified, of which 1007 articles underwent full-text screening, and 300 met the inclusion criteria. A twofold increase in articles investigating patellar dislocation treatment was observed between the years 2013 and 2022. This review identified 176 osseous risk factors and 56 PROMs. Among the included articles, 131 (44%) utilized osseous risk factors as in- or exclusion criteria, and 26 (9%) employed a PROM specifically developed for patellar instability evaluation. The most frequently investigated treatment was medial patellofemoral ligament reconstruction (231 articles, 77%), followed by tibial tubercle osteotomies (87 articles, 29%).</p><p><strong>Conclusion: </strong>There is considerable heterogeneity among studies investigating the treatment of patellar dislocation. Less than half of studies define the patient population according to osseous risk factors, and only 1 in 10 studies use a PROM designed for patellar dislocation. This complicates the evaluation of treatment effects in relation to osseous risk factors.</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":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007917","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":"Preventing burnout in orthopaedic surgeons: The power of research engagement","authors":"Thomas Nau,&nbsp;Michael T. Hirschmann","doi":"10.1002/ksa.12595","DOIUrl":"10.1002/ksa.12595","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 4","pages":"1163-1167"},"PeriodicalIF":3.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007869","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":"Slope changing osteotomies in the knee: Time to go Infra","authors":"Matthieu Ollivier,&nbsp;Romain Seil,&nbsp;Kristian Kley,&nbsp;Michael T. Hirschmann","doi":"10.1002/ksa.12589","DOIUrl":"10.1002/ksa.12589","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 4","pages":"1174-1177"},"PeriodicalIF":3.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007948","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":"Functional alignment in robotic-assisted total knee arthroplasty for valgus deformity achieves safe coronal alignment and excellent short-term outcomes.","authors":"Pietro Gregori, Christos Koutserimpas, Vasileios Giovanoulis, Cécile Batailler, Elvire Servien, Sébastien Lustig","doi":"10.1002/ksa.12585","DOIUrl":"https://doi.org/10.1002/ksa.12585","url":null,"abstract":"<p><strong>Purpose: </strong>Functional alignment (FA) in total knee arthroplasty (TKA) prioritizes soft tissue balancing and anatomical restoration without systematic correction to neutral alignment. Most studies have focused on varus deformity, with little evidence available about FA in valgus deformity. The hypothesis of the present study was that FA in robotic-assisted TKA for valgus deformity would demonstrate correction of the coronal alignment and yield satisfactory short-term outcomes.</p><p><strong>Methods: </strong>This retrospective study included 58 patients with valgus coronal alignment (hip-knee-angle [HKA] ≥ 183°) who underwent robotic-assisted TKA using the FA technique with a minimum of 1-year follow-up. Outcomes were assessed through the Knee Society Score (KSS), Oxford Knee Score (OKS), Forgotten Joint Score (FJS) and radiographic measurements of alignment and phenotypes. Complication and revision rates were also analyzed.</p><p><strong>Results: </strong>The cohort included 39 females and 19 males with a median age of 70. Post-operatively, 86.2% of cases achieved coronal alignment within the safe zone (HKA 177-183°). Significant improvements were observed in KSS (part 1: 69.5-95, part 2: 65-94, p < 0.001), while OKS and FJS exhibited optimal outcomes. Two complications were recorded: one aseptic loosening (1.7%) and one early infection (1.7%). Kaplan-Meier survival analysis indicated favourable implant survivorship at a median follow-up of 18 months.</p><p><strong>Conclusion: </strong>FA in image-based robotic TKA is a safe and effective approach for patients with valgus deformity. This procedure resulted in a modest correction of the coronal alignment, where no soft tissue releases were needed. The majority of the cases fell within the target coronal alignment boundaries by only accommodating the individual laxities, suggesting the aim of FA to restore each knee's pre-pathological alignment.</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":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007914","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":"Very warm welcome to our new Associate Editors Dr. Ayoosh Pareek, Dr. Cécile Batailler and Dr. Choon Chiet Hong","authors":"Michael T. Hirschmann,&nbsp;Elmar Herbst,&nbsp;Giuseppe Milano,&nbsp;Volker Musahl","doi":"10.1002/ksa.12591","DOIUrl":"10.1002/ksa.12591","url":null,"abstract":"","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 3","pages":"800-801"},"PeriodicalIF":3.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007950","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 preinjury pivoting sports after anterior cruciate ligament reconstruction is different between males and females, as are the patient-reported reasons.","authors":"Jay R Ebert, Liza Kneebone, Peter Edwards, Ross Radic, Peter D'Alessandro","doi":"10.1002/ksa.12588","DOIUrl":"https://doi.org/10.1002/ksa.12588","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR), differences based on sex and concomitant meniscal repair, and identify reasons why patients do not RTS.</p><p><strong>Methods: </strong>Overall, 232 patients undergoing ACLR, with or without concomitant meniscal repair, that were actively participating in pivoting sports at the time of injury, were prospectively recruited. At 2 years, return to preinjury pivoting sport was investigated and, if they had returned, whether they felt their performance was at (or better) or below preinjury status. Specific reasons for not returning were identified. RTS rates and reasons for not returning were compared based on sex and meniscal repair.</p><p><strong>Results: </strong>Overall, 140 patients (60.3%) had returned to their preinjury pivoting sport, of which 98 (70.0%) felt they were performing at (or beyond) preinjury status. While a significantly greater (p = 0.024) percentage of males (66.9%) versus females (52.4%) had returned to pivoting sports by 2 years, no differences (p = 0.708) were seen based on concomitant meniscal repair. Overall, 92 patients (39.7%) had not RTS, with primary reasons being loss of interest (21.7%), too busy due to their work and/or family environment (22.8%), or fear of reinjury or lacking confidence (17.4%). Other less-reported reasons included ongoing knee issues (6.5%) or not feeling physically ready (5.4%).</p><p><strong>Conclusions: </strong>This study outlined specific reasons why community-level patients do not RTS, with RTS status (and reasons for not returning to preinjury pivoting sports) differing between males and females, with the latter returning at a significantly lower rate overall.</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":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007872","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":"Lumbopelvic hyperlordosis is linked to higher femoral head coverage, lower femoral anteversion and younger age at periacetabular osteotomy","authors":"Maximilian Fischer,&nbsp;Lars Nonnenmacher,&nbsp;Andreas Nitsch,&nbsp;Matthias R. Mühler,&nbsp;Alexander Möller,&nbsp;Andre Hofer,&nbsp;Georgi I. Wassilew","doi":"10.1002/ksa.12587","DOIUrl":"10.1002/ksa.12587","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The dynamic alignment of the lumbar spine, pelvis and femur is increasingly studied in hip preservation surgery. However, the interaction between lumbopelvic alignment, acetabular and femoral morphology and its influence on patients' preoperative symptom burden remains poorly understood. The aim of this study was to evaluate whether lumbopelvic malalignment affects osseous hip morphology and exacerbates preoperative patient-reported joint functionality in patients undergoing periacetabular osteotomy (PAO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred thirteen patients were prospectively enroled in this single-centre study. Sagittal lumbopelvic radiographs were used to divide the patients in accordance with their lumbopelvic alignment (pelvic incidence [PI]–lumbar lordosis [LL] mismatch) into a balanced (PI–LL: 10° and 10°/<i>n</i> = 60) and unbalanced alignment (PI–LL: &lt;10° and &gt;10°/<i>n</i> = 53) group. Intergroup analyses were performed for acetabular and femoral morphology as well as various patient-reported outcome measures (PROMs) scores (modified Harris-Hip, Hip Osteoarthritis Outcome, International Hip Outcome tool-12 and University of California Los Angeles activity scale).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with concomitant unbalanced lumbopelvic alignment due to hyperlordosis showed higher femoral head coverage and lower femoral anteversion (lateral centre-edge angle 20.2° vs. 15.8°, <i>p</i> = 0.012/anterior wall index 0.47 vs. 0.36, <i>p</i> = 0.001/acetabular inclination 10.2° vs. 13.6°, <i>p</i> = 0.008/Femoral anteversion 21.3° vs. 28.2°, <i>p</i> = 0.041). Furthermore, these patients were significantly younger at the time of PAO (28.7 vs. 32.4 years, <i>p</i> = 0.020), even when there were no intergroup differences in all analyzed PROMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Concomitant lumbopelvic deformity affecting the hip joint morphology could aggravate clinical symptoms leading to earlier presentation in patients undergoing PAO. Thus, the lumbopelvic balance needs to be carefully evaluated in clinical decision-making in PAO patients and future research should focus on long-term outcomes of patients with concomitant unbalanced lumbopelvic alignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, prognostic study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 4","pages":"1515-1523"},"PeriodicalIF":3.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007868","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":"Clinical SANTI classification of arthrogenic muscle inhibition has an excellent inter-rater and intra-rater reliability in preoperative and post-operative anterior cruciate ligament rupture.","authors":"Alexandre Le Guen, Emilie Bérard, Hasnae Ben-Roummane, Kévin Lacaze, Thomas Richaud, Bertrand Sonnery-Cottet, Etienne Cavaignac","doi":"10.1002/ksa.12586","DOIUrl":"10.1002/ksa.12586","url":null,"abstract":"<p><strong>Purpose: </strong>Arthrogenic muscle inhibition (AMI) is a reflexive shutdown of the quadriceps muscles following a knee injury or surgery that presents with or without hamstring contracture. This complication can be classified according to the SANTI classification, but the reproducibility of this clinical classification has not yet been demonstrated.</p><p><strong>Methods: </strong>This single-centre longitudinal observational study included 140 patients who were within 6 weeks of an ACL rupture. The presence of AMI was assessed separately and blindly during the preoperative consultation and at 3 weeks post-operative by an Orthopaedic Surgeon, an Orthopaedic Resident, a Sports Medicine Physician and a Physiotherapist. AMI was also assessed a second time by the physiotherapist, 10 days after the first assessment, before and after reconstruction surgery, in order to measure intra-rater reliability. The inter-rater and intra-rater reliability of the AMI classification was determined by calculating the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Agreement for the AMI classification between different examiners was excellent pre-operatively (ICC = 0.99 [95% confidence interval, CI: 0.99-0.99]) and post-operatively (ICC = 0.98 [95% CI: 0.98-0.99]). Agreement in the AMI classification, when determined repeatedly by the same assessor (physiotherapist), was excellent pre-operatively (ICC = 0.92 [95% CI: 0.89-0.94]) and post-operatively (ICC = 0.98 [95% CI: 0.97-0.99]).</p><p><strong>Conclusion: </strong>Excellent intra-rater and inter-rater reliability of the AMI classification system was found in patients with recent ACL rupture and post-operatively.</p><p><strong>Level of evidence: </strong>Level II, diagnostic study prospective cohort study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007856","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}