Knee Surgery, Sports Traumatology, Arthroscopy最新文献

{"title":"Total knee arthroplasty: Have we made any strides over the last 50 years?","authors":"Augusto Ferrini,&nbsp;Mincong He,&nbsp;Kashif Anwar,&nbsp;Rocco Papalia,&nbsp;Ibrahim Tuncay,&nbsp;Javad Parvizi","doi":"10.1002/ksa.70073","DOIUrl":"10.1002/ksa.70073","url":null,"abstract":"<p>Total knee arthroplasty (TKA) is a successful surgical procedure for patients with disabling arthritis of the knee. However, persistent challenges such as patient dissatisfaction, discrepancies in functional recovery, and variability in long-term outcomes have necessitated ongoing innovations. This review explores the evolution of TKA, and advancements that this surgical procedure has witnessed over the past few decades. While no one can dispute the fact that TKA has undergone significant change from its rudimentary hinge style prosthesis made of ivory to a sophisticated and well-functioning prosthesis, some of these so-called advancements have been transient and others have adversely affected patient outcomes. We will critically evaluate some of these advancements and innovations to determine whether they have resulted in any improvements in patient outcomes and have stood the test of time.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"2078-2086"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188327","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":"Increased reoperation rates after meniscus repair compared to arthroscopic partial meniscectomy: Data from a comprehensive clinical cohort with up to 10 years follow-up","authors":"Fredrik Boric-Persson,&nbsp;Aleksandra Turkiewicz,&nbsp;Martin Englund,&nbsp;Paul Neuman","doi":"10.1002/ksa.12791","DOIUrl":"10.1002/ksa.12791","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the rates of knee reoperation and medical complications after meniscal repair versus partial meniscectomy (APM) up to 10 years after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients ≥ 15 years old operated for a meniscal tear with meniscus repair or partial meniscectomy at Scania University Hospital were included, between year 2010 and 2014. Information was retrieved from patient records until the year 2020. Rates of any reoperation, reoperation in same meniscus and medical complications were estimated. Differences were also estimated in the three outcomes in a subgroup aged 15–40 years using flexible parametric survival models adjusted for age, sex, knee laterality, tear type, medial/lateral, anterior cruciate ligament (ACL) status, osteoarthritis, body mass, height and smoking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Records identified 2098 patients (395 undergoing meniscal repair and 1703 partial meniscectomy) with 540 reoperations in 430 patients. The incidence rate of reoperation was 32/1000 person-years (95% confidence interval [CI] 29–35) and of reoperation in the same meniscus 19/1000 person-years (95% CI 17–21). There were 2.1% postoperative complications. In the age group 15-40 years, with only bucket-handle, longitudinal and horizontal tears, 341 patients had meniscal repair and 361 partial meniscectomy. The incidence rate of any reoperation was 105 (95% CI 90–122) per 1000 person-years in the meniscal repair group and 24 (95% CI 18–31) in the partial meniscectomy group. The adjusted hazard ratio of any reoperation comparing meniscal repair with partial meniscectomy was 4.3 (95% CI 3.1–6.0) and of reoperations in the same meniscus 17 (95% CI 9–31). 3.3% patients had postoperative complications (15 after meniscal repair and 14 after partial meniscectomy).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The risk of any knee reoperation after meniscal repair had a four-fold increase compared with partial meniscectomy, and for same meniscus reoperations about 17-fold. The rate of medical postoperative complications was low.</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":"1946-1959"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677132","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":"Increased contralateral dynamic valgus in female athletes following ACL reconstruction","authors":"Fredrik Gaugg,&nbsp;Sebastian Bierke,&nbsp;Tilman Hees,&nbsp;Kerstin Siemßen,&nbsp;Bernd Wolfarth,&nbsp;Wolf Petersen","doi":"10.1002/ksa.70291","DOIUrl":"10.1002/ksa.70291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Female athletes have a higher risk of anterior cruciate ligament (ACL) injury, which has been associated with neuromuscular deficits and dynamic valgus, while contralateral risk profiles after ACL reconstruction remain insufficiently characterized. The purpose of this study was to investigate whether female patients after ACL reconstruction exhibit greater contralateral valgus angles compared with male patients, indicating a higher risk profile for secondary ACL injury. It was hypothesized that dynamic valgus would be more pronounced in women than in men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this predefined subanalysis of a controlled laboratory study, 26 patients (17 male and 9 female) were analysed approximately eight months after primary ACL reconstruction with either semitendinosus or quadriceps tendon autograft. Isokinetic strength testing and three-dimensional (3D) motion capture analysis were performed. Participants executed vertical drop jumps and single-leg jumps for distance. The primary outcome was the maximal contralateral knee valgus angle; secondary outcomes included hip and knee flexion angles, valgus moments and hamstrings-to-quadriceps (H/Q) ratio. Mann–Whitney <i>U</i> test was used for testing between male and female patients after testing for parametric distribution using Shapiro–Wilk test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the vertical drop jump, females demonstrated a significantly larger median maximal valgus angle compared to males (−2.9° [valgus] [interquartile range, IQR (−9.8) to 2.0] vs. 6.7° [varus] [IQR (−0.2) to 8.5], <i>p</i> = 0.016). No significant sex-specific differences were observed in secondary kinematic parameters, single-leg jump performance or isokinetic strength measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Female patients exhibited greater contralateral dynamic valgus during drop jump landings after ACL reconstruction, suggesting sex-specific neuromuscular risk patterns. These findings support the need for individualized rehabilitation and prevention strategies with a focus on dynamic valgus in female athletes.</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":"2057-2066"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000446","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":"Adherence as the key to anterior cruciate ligament injury prevention programme success: From efficacy to effectiveness","authors":"Mahmut Enes Kayaalp,&nbsp;Haluk Celik,&nbsp;Marko Ostojic,&nbsp;Can Doruk Basa,&nbsp;Aleksandra Królikowska,&nbsp;Alper Kaya,&nbsp;Robert Prill","doi":"10.1002/ksa.70256","DOIUrl":"10.1002/ksa.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>High-quality anterior cruciate ligament (ACL) injury prevention programmes such as the FIFA 11+ and prevent injury and enhance performance warm-up have demonstrated strong efficacy in controlled trials, yet their real-world impact remains limited. The primary reason is not the design of these neuromuscular training protocols, but inadequate <i>adherence</i> by athletes and teams. Evidence consistently shows that only individuals with high adherence, typically ≥75% of prescribed sessions, achieve meaningful ACL injury risk reduction, whereas moderate or low adherence provides little benefit. In everyday sports settings, athletes struggle to follow prevention programmes due to time constraints, limited supervision, low motivation, and competing training priorities. These barriers result in poor fidelity, inconsistent use, and incomplete implementation across youth, amateur, and even elite sport. Understanding adherence as a multidimensional construct encompassing frequency, technique quality, and supervision is essential for bridging the gap between programme efficacy and real-world effectiveness. Enhancing coach buy-in, integrating exercises into regular practice, improving supervision, and leveraging digital tools may substantially increase adherence and translate proven protocols into meaningful injury prevention outcomes. Ultimately, closing the adherence gap is more important than discovering new exercises; changing athlete and coach behaviour is the key to achieving consistent, large-scale reductions in ACL injuries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"1935-1939"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implementation gap in anterior cruciate ligament prevention programs—From evidence to everyday practice","authors":"Robert Prill,&nbsp;Aleksandra Królikowska,&nbsp;Marko Ostoijc,&nbsp;M. Enes Kayaalp,&nbsp;Thomas Patt,&nbsp;Joseph Janosky,&nbsp;Craig Lockwood,&nbsp;Roland Becker","doi":"10.1002/ksa.70258","DOIUrl":"10.1002/ksa.70258","url":null,"abstract":"<p>Anterior cruciate ligament (ACL) injury remains one of the most impactful injuries in pivoting sports, with non-contact mechanisms accounting for the majority of cases and offering a clear target for prevention. Robust evidence—including multiple Level 1 meta-analyses—demonstrates that structured neuromuscular training (NMT) programs can reduce ACL injury rates by approximately 50%, particularly among youth and female athletes. Effective programs are multicomponent, integrate strength, plyometrics, agility, balance and movement-quality feedback, and require adequate training dose and in-season continuity. Despite this well-established evidence base, real-world implementation remains limited. Coaches and sports organisations frequently report barriers such as time constraints, competing performance priorities and low confidence in delivering prevention exercises. This disconnect reflects a broader implementation gap: while we know what works, we are not consistently doing it. Insights from implementation science, including JBI's phased models, facilitation strategies and context-driven frameworks, provide a roadmap for translating evidence into sustained practice. Reframing prevention as performance-enhancing movement training and embedding programs such as the ESSKA ‘Prevention for All’ initiative into coaching pathways and club standards are essential system-level strategies. The priority is no longer proving efficacy, but achieving widespread, high-fidelity implementation so that ACL prevention becomes a routine component of athlete preparation.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"1930-1934"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145867096","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":"Infratuberosity osteotomies require greater wedge resection and result in increased cortical mismatch compared to supratuberosity: A morphometric study supporting individualized planning in posterior tibial slope correction","authors":"M. Enes Kayaalp,&nbsp;Husnu Yilmaz,&nbsp;Jumpei Inoue,&nbsp;Camila Grandberg,&nbsp;Jonathan D. Hughes,&nbsp;Volker Musahl","doi":"10.1002/ksa.70003","DOIUrl":"10.1002/ksa.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Posterior tibial slope (PTS) reducing anterior closing wedge osteotomies are increasingly used to address the elevated risk of anterior cruciate ligament (ACL) graft failure in patients with increased PTS. This study evaluates the wedge height required at two osteotomy levels—supratuberosity and infratuberosity—for equivalent PTS correction and examines its relationship with tibial anatomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty patients undergoing multiple revision ACL reconstruction (ACL-R) with PTS ≥ 12° were retrospectively analyzed using standardized lateral knee radiographs. Simulated osteotomies at supratuberosity and infratuberosity levels were performed using MATLAB. Wedge thickness per degree, anterior cortical step-off, defined as the mismatch or offset between the anterior cortices of the proximal and distal tibial fragments following wedge removal, and tibial anterior–posterior width were measured. Correlations were assessed using Pearson's <i>r</i>. Model fit was evaluated with the coefficient of determination (<i>R</i>²), standard error of the estimate and root mean square error. Levene's test compared residual variance. A <i>p</i> value of &lt;0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean PTS was 14.6 ± 2.5°. Infratuberosity osteotomies required 1.2 ± 0.2 mm per degree correction versus 1 ± 0.1 mm for supratuberosity (<i>p</i> &lt; 0.01). Cortical step-off was greater at the infratuberosity than the supratuberosity level (4.4 ± 1.6 mm vs. 1.8 ± 1.3 mm, respectively, <i>p</i> &lt; 0.01). Tibial width strongly predicted wedge thickness at the supratuberosity level (<i>r</i> = 0.83, <i>R</i>² = 0.69), and moderately at the infratuberosity level (r = 0.66, <i>R</i>² = 0.48). Residual variance was not significantly different (<i>p</i> = 0.147).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Infratuberosity anterior closing wedge osteotomy (ACWO) requires significantly greater wedge resection and leads to a larger mismatch at the anterior tibial cortex compared to supratuberosity ACWO for the same amount of PTS correction. Considerable variability existed regarding tibial morphology at both levels. These results highlight the importance of patient-specific, anatomy-based planning when performing ACWO in the setting of revision ACL-R.</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":"2038-2046"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857398","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":"Sex differences and gender factors in anterior cruciate ligament injury prevention: A call for purpose-driven strategies","authors":"Aleksandra Królikowska,&nbsp;Robert Prill,&nbsp;Thomas Patt,&nbsp;Mahmut Enes Kayaalp,&nbsp;Marko Ostojic,&nbsp;Łukasz Oleksy","doi":"10.1002/ksa.70257","DOIUrl":"10.1002/ksa.70257","url":null,"abstract":"<p>Female athletes face a disproportionately high risk of anterior cruciate ligament (ACL) injuries, with patterns that vary by age and developmental stages, influenced by interactions among biological sex factors, anatomy, hormones, neuromuscular control and gendered sports environments shaped by social norms, organisational structures and unequal access to resources. Despite significant progress, most ACL injury prevention strategies still rely on male-derived evidence and are implemented in systems that neither recognise sex-linked physiology nor address gendered barriers to training, communication and support. Building on the substantial work of Female, woman and/or girl Athlete Injury pRevention (FAIR) consensus, a sex- and gender-responsive framework for ACL injury prevention that integrates biological mechanisms, neuromuscular priorities, contextual factors and communication considerations is proposed in this editorial. Ongoing gaps in surveillance, intervention design and reporting are highlighted; essential components for a purpose-driven ACL prevention framework are suggested; and equitable, context-sensitive implementation is advocated to reduce the ACL injury gap among female athletes worldwide.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"1940-1945"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.70257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145867101","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":"Older age, higher BMI, female sex and meniscal repair are predictors of inferior patient-reported outcomes 1 year after ACL reconstruction","authors":"Junya Tsukisaka,&nbsp;Atsuo Nakamae,&nbsp;Kazuhiro Tsukisaka,&nbsp;Ryo Shimizu,&nbsp;Yuki Yamanashi,&nbsp;Akinori Nekomoto,&nbsp;Kyohei Nakata,&nbsp;Nobuo Adachi","doi":"10.1002/ksa.12744","DOIUrl":"10.1002/ksa.12744","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To identify predictors of inferior patient-reported outcomes (PROs) 1 year after anterior cruciate ligament reconstruction (ACLR) and to examine whether these predictors differ by sex. We hypothesised that older age, female sex, and meniscectomy are associated with inferior PROs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a prospective cohort study involving 733 patients (396 males and 337 females) who underwent ACLR using autologous hamstring tendons. Participants were enroled in the Hiroshima Clinical ACL Research Project. Pre-operative assessments included demographic data, injury history, and scores from the five subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Additional assessments included the International Knee Documentation Committee (IKDC) subjective form, Lysholm score, and Tegner activity scale. Multivariable linear regression analysis was performed to identify predictors of KOOS subscale outcomes, including sex-specific subgroup analyses at 1 year postoperatively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Older age was a significant predictor of poorer KOOS outcomes across all subscales (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Higher body mass index (BMI) was also associated with inferior KOOS outcomes overall (&lt;i&gt;p&lt;/i&gt; = 0.000–0.012). Female sex was significantly associated with worse outcomes on the KOOS Symptom (&lt;i&gt;p&lt;/i&gt; = 0.003), Pain (&lt;i&gt;p&lt;/i&gt; = 0.001), ADL (&lt;i&gt;p&lt;/i&gt; = 0.002), and Sports/Recreation (&lt;i&gt;p&lt;/i&gt; = 0.001) subscales. In female patients, higher BMI was significantly associated with all KOOS subscales (&lt;i&gt;p&lt;/i&gt; = 0.000–0.007), while no such associations were observed in males. Medial meniscal repair was associated with significantly poorer KOOS Symptom (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), Sports/Recreation (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), and QOL (&lt;i&gt;p&lt;/i&gt; = 0.018) scores. Lateral meniscal repair was significantly associated with worse KOOS Sports/Recreation (&lt;i&gt;p&lt;/i&gt; = 0.003) and QOL (&lt;i&gt;p&lt;/i&gt; = 0.005) scores. Contrary to our hypothesis, meniscectomy was not a significant predictor (&lt;i&gt;p&lt;/i&gt; &gt; 0.05).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Older age, higher BMI, female sex, and meniscal repair were predictors of inferior PROs 1 year after ACLR. These findings underscore the importance of sex-specific preoperative counselling and postoperative management for patients at higher risk of suboptimal outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Level II.&lt;/p&gt;\u0000","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"1960-1969"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12744","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532837","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":"Arthroscopic minced cartilage implantation provides superior clinical and magnetic resonance imaging outcomes compared to microfracture in patellar cartilage defects","authors":"Frank Wein,&nbsp;Clément Ferri,&nbsp;Lisa Peduzzi,&nbsp;Arthur Barbaret,&nbsp;Paul Walbron","doi":"10.1002/ksa.12800","DOIUrl":"10.1002/ksa.12800","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare clinical and radiological outcomes of arthroscopic minced cartilage implantation (MCI) versus microfracture (MFx) in patients with patellar cartilage defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, single-centre cohort study was conducted on 46 patients treated between January 2021 and December 2022. Patients underwent either MCI (<i>n</i> = 26) or MFx (<i>n</i> = 20) with a minimum follow-up of 24 months (mean 35.7 ± 6.2). Magnetic resonance imaging (MRI) outcomes were assessed using the MOCART 2.0 Knee score by an independent blinded radiologist. Clinical outcomes included pain (visual analogue scale), function (self knee value), International Knee Documentation Committee, knee injury and osteoarthritis outcome score (KOOS) and patient acceptable symptom state (PASS)/minimal clinically important difference scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The MOCART 2.0 score was significantly higher in the MCI group (mean 86; 95% confidence interval [CI]: 83–92) compared to the MFx group (mean 66; 95% CI: 55–73) (<i>p</i> &lt; 0.001). MCI patients achieved significantly greater improvements across all clinical measures, notably in the KOOS sport subscore (+33.2 vs. +5.3 points). PASS was achieved in 100% of MCI patients versus 35% of MFx patients (<i>p</i> &lt; 0.001). No major complications or reoperations were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both MCI and MFx improved clinical and MRI outcomes in patellar cartilage defects after 2 years, but MCI demonstrated significantly superior results across all parameters. Arthroscopic MCI appears to be an effective, safe, single-stage alternative to MFx for treating focal patellar cartilage lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III retrospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 6","pages":"2000-2012"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677131","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":"Isolated meniscal repair, medial meniscus repair and older age increase failure risk after all-inside meniscal repair: A cohort study of 2264 patients","authors":"Christoffer von Essen,&nbsp;Riccardo Cristiani,&nbsp;Carolina Kekki,&nbsp;Dzan Rizvanovic,&nbsp;Anders Stålman","doi":"10.1002/ksa.12780","DOIUrl":"10.1002/ksa.12780","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the overall failure rate and assess factors influencing the failure of modern all-inside meniscal repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent all-inside meniscal repair at Capio Artro Clinic, Stockholm, Sweden, from January 2015 to June 2022, were identified. The primary outcome was the occurrence of failure of the repair, defined as reoperation and secondary partial or total meniscal resection within three years. Kaplan–Meier analysis was performed to assess meniscal repair survival, with multivariate Cox regression analysis to adjust for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2264 patients who underwent meniscal repairs were included (55.9% males, mean age of 27 years ±10). The meniscal repair failure rate for the entire cohort was 20.2% (457/2264). Older age (&gt;40 years) (<i>p</i> = 0.03), medial meniscus repair (<i>p</i> &lt; 0.001) and isolated meniscal repair (without concomitant anterior cruciate ligament reconstruction [ACLR]) (<i>p</i> &lt; 0.001) were associated with statistically significant increased failure rates. Multivariate Cox regression analysis revealed that failure after meniscal repair was statistically significant related to age &gt; 40 (hazard ratio [HR] 1.22; 95% confidence interval (CI) 1.03–1.56; <i>p</i> = 0.034), medial meniscus repair (HR 2.57; 95% CI 2.06–3.19; <i>p</i> &lt; 0.001) and isolated repairs (HR 2.63; 95% CI 2.17–3.19; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this large cohort study of more than 2000 patients, the overall failure rate of all-inside meniscal repair was 20.2%. Repair without concomitant ACLR, medial meniscal repair, and older age were associated with an increased hazard of failure. These findings underscore the clinical importance of recognising patient-specific risk factors for meniscal repair failure, as such knowledge can guide surgical decision-making and improve individualised treatment strategies to enhance long-term knee function.</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":"1977-1985"},"PeriodicalIF":5.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577565","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}