Knee Surgery & Related Research最新文献

{"title":"Correction to: Botulinum toxin injections as a salvage therapy is beneficial for management of patellofemoral pain syndrome.","authors":"Yuval Kesary, Vivek Singh, Tal Frenkel-Rutenberg, Arie Greenberg, Shmuel Dekel, Ran Schwarzkopf, Nimrod Snir","doi":"10.1186/s43019-022-00131-9","DOIUrl":"https://doi.org/10.1186/s43019-022-00131-9","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8809028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39878607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Past, present, and future of cartilage restoration: from localized defect to arthritis.","authors":"Dong Hwan Lee, Seok Jung Kim, Seon Ae Kim, Gang-Ik Ju","doi":"10.1186/s43019-022-00132-8","DOIUrl":"10.1186/s43019-022-00132-8","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis, one of the most common joint diseases, is characterized by the loss of joint function due to articular cartilage destruction. Herein, we review current and previous research involving the clinical applications of arthritis therapy and suggest potential therapeutic options for osteoarthritis in the future.</p><p><strong>Past, present, and future treatment: </strong>The arthroscopic cartilage regeneration procedure or realignment osteotomy has been performed as a joint-conserving procedure in cases where conservative treatment for damaged articular cartilage and early osteoarthritis failed. If cartilage regeneration is ineffective or if the joint damage progresses, arthroplasty is the main treatment option. The need for biological arthritis treatment has expanded as the healthy lifespan of the global population has increased. Accordingly, minimally invasive surgical treatment has been developed for the treatment of damaged cartilage and early osteoarthritis. However, patients generally prefer to avoid all types of surgery, including minimally invasive surgery. Therefore, in the future, the treatment of osteoarthritis will likely involve injection or medication.</p><p><strong>Conclusion: </strong>Currently, arthritis management primarily involves the surgical application of therapeutic agents to the joints. However, nonsurgical or prophylactic methods are expected to become mainstream arthritis therapies in the future.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39868047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait deviations of patients with ruptured anterior cruciate ligament: a cross-sectional gait analysis study on male patients.","authors":"Jay Hoon Park,&nbsp;Min-Ho Choi,&nbsp;Joonhee Lee,&nbsp;Hyuk-Soo Han,&nbsp;Myung Chul Lee,&nbsp;Du Hyun Ro","doi":"10.1186/s43019-021-00128-w","DOIUrl":"https://doi.org/10.1186/s43019-021-00128-w","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Notching is less, if femoral component sagittal positioning is planned perpendicular to distal femur anterior cortex axis, in navigated TKA.","authors":"Raj Kanna,&nbsp;Chandramohan Ravichandran,&nbsp;Gautam M Shetty","doi":"10.1186/s43019-021-00129-9","DOIUrl":"https://doi.org/10.1186/s43019-021-00129-9","url":null,"abstract":"<p><strong>Purpose: </strong>In navigated TKA, the risk of notching is high if femoral component sagittal positioning is planned perpendicular to the sagittal mechanical axis of femur (SMX). We intended to determine if, by opting to place the femoral component perpendicular to distal femur anterior cortex axis (DCX), notching can be reduced in navigated TKA.</p><p><strong>Methods: </strong>We studied 171 patients who underwent simultaneous bilateral computer-assisted TKA. Femoral component sagittal positioning was planned perpendicular to SMX in one knee (Femur Anterior Bowing Registration Disabled, i.e. FBRD group) and perpendicular to DCX in the opposite knee (Femur Anterior Bowing Registration Enabled, i.e. FBRE group). Incidence and depth of notching were recorded in both groups. For FBRE knees, distal anterior cortex angle (DCA), which is the angle between SMX and DCX, was calculated by the computer.</p><p><strong>Results: </strong>Incidence and mean depth of notching was less (p = 0.0007 and 0.009) in FBRE versus FBRD group, i.e. 7% versus 19.9% and 0.98 mm versus 1.53 mm, respectively. Notching was very high (61.8%) in FBRD limbs when the anterior bowing was severe (DCA > 3°) in the contralateral (FBRE) limbs.</p><p><strong>Conclusion: </strong>Notching was less when femoral component sagittal positioning was planned perpendicular to DCX, in navigated TKA.</p><p><strong>Level of evidence: </strong>Therapeutic level II.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of imageless navigation to quantify cutting error in total knee arthroplasty.","authors":"Ran Schwarzkopf,&nbsp;Morteza Meftah,&nbsp;Scott E Marwin,&nbsp;Michelle A Zabat,&nbsp;Jeffrey M Muir,&nbsp;Iain R Lamb","doi":"10.1186/s43019-021-00125-z","DOIUrl":"https://doi.org/10.1186/s43019-021-00125-z","url":null,"abstract":"<p><strong>Purpose: </strong>Navigated total knee arthroplasty (TKA) improves implant alignment by providing feedback on resection parameters based on femoral and tibial cutting guide positions. However, saw blade thickness, deflection, and cutting guide motion may lead to final bone cuts differing from planned resections, potentially contributing to suboptimal component alignment. We used an imageless navigation device to intraoperatively quantify the magnitude of error between planned and actual resections, hypothesizing final bone cuts will differ from planned alignment.</p><p><strong>Materials and methods: </strong>A retrospective study including 60 consecutive patients undergoing primary TKA using a novel imageless navigation device was conducted. Device measurements of resection parameters were obtained via attachment of optical trackers to femoral and tibial cutting guides prior to resection. Following resection, optical trackers were placed directly on the bone cut surface and measurements were recorded. Cutting guide and bone resection measurements of both femoral and tibial varus/valgus, femoral flexion, tibial slope angles, and both femoral and tibial medial and lateral resection depths were compared using a Student's t-test.</p><p><strong>Results: </strong>Femoral cutting guide position differed from the actual cut by an average 0.6 ± 0.5° (p = 0.85) in the varus/valgus angle and 1.0 ± 1.0° (p = 0.003) in the flexion/extension angle. The difference between planned and actual cut measurements for medial and lateral femoral resection depth was 1.1 ± 1.1 mm (p = 0.32) and 1.2 ± 1.0 mm (p = 0.067), respectively. Planned cut measurements based on tibial guide position differed from the actual cut by an average of 0.9 ± 0.8° (p = 0.63) in the varus/valgus angle and 1.1 ± 1.0° (p = 0.95) in slope angle. Measurement of medial and lateral tibial resection depth differed by an average of 0.1 ± 1.8 mm (p = 0.78) and 0.2 ± 2.1 mm (p = 0.85), respectively.</p><p><strong>Conclusions: </strong>Significant discrepancies between planned and actual femoral bone resection were demonstrated for flexion/extension angle, likely the result of cutting error. Our data highlights the importance of cut verification postresection to confirm planned resections are achieved, and suggests imageless navigation may be a source of feedback that would allow surgeons to intraoperatively adjust resections to achieve optimal implant alignment.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective randomized study of arthroscopic ACL reconstruction with adjustable- versus fixed-loop device for femoral side fixation.","authors":"Naiyer Asif,&nbsp;Mohammad Jesan Khan,&nbsp;K P Haris,&nbsp;Shah Waliullah,&nbsp;Anubhav Sharma,&nbsp;Danish Firoz","doi":"10.1186/s43019-021-00124-0","DOIUrl":"https://doi.org/10.1186/s43019-021-00124-0","url":null,"abstract":"<p><strong>Purpose: </strong>Suspensory devices are extensively used in the management of anterior cruciate ligament (ACL) tear. They include fixed- and adjustable-loop devices. There are only a few studies comparing the efficacy of these two devices in the available literature. Therefore, the aim of this study is to compare clinical outcomes between the adjustable-loop device (group I) and fixed-loop device (group II).</p><p><strong>Materials and methods: </strong>This was a prospective randomized study. Both groups were equivalent in demographic, preoperative, and intraoperative variables. Twenty-three patients underwent femoral side graft fixation with adjustable-loop and 20 with fixed-loop devices. Four patients were lost to follow-up. Assessment of clinical outcome was done with International Knee Documentation Committee (IKDC) score, Lysholm score, and knee stability tests (Lachman test and pivot shift test). Patient evaluation was performed preoperatively and finally postoperatively 2 years after surgery.</p><p><strong>Results: </strong>Postoperative IKDC scores of group I and II were 91.9 ± 3.6 and 91.5 ± 3.6, respectively, and Lysholm scores were 91.0 ± 3.6 and 91.4 ± 3.5, respectively, after 2 years; however, the difference in the outcomes was statistically insignificant (p > 0.05). Twenty patients (87%) in group I and 17 patients (85%) in group II had a negative Lachman test (p = 0.8). Twenty-two patients (95.7%) in group I and 19 patients (95%) in group II had a negative pivot shift test (p = 0.9).</p><p><strong>Conclusion: </strong>ACL reconstruction with fixed- and adjustable-loop suspensory devices for graft fixation gives equivalent and satisfactory clinical results.</p><p><strong>Level of evidence: </strong>1.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An increasing trend of posterior cruciate ligament reconstruction in South Korea: epidemiologic analysis using Korean National Health Insurance System Database.","authors":"Kyu Sung Chung","doi":"10.1186/s43019-021-00126-y","DOIUrl":"https://doi.org/10.1186/s43019-021-00126-y","url":null,"abstract":"<p><strong>Background: </strong>The posterior cruciate ligament is crucial for posterior stability of the knee joint, and, as well as anterior cruciate ligament reconstruction, posterior cruciate ligament reconstruction (PCLR) has attracted interest in orthopedic literature. A few studies have investigated epidemiologic data of PCLR in Western countries. However, there has been no report on the epidemiological pattern of PCLR in the Asian population, including South Korea. Therefore, this study investigated the incidence and trends of PCLR in South Korea using the Korean National Health Insurance (NHI) System Database.</p><p><strong>Methods: </strong>The data was collected by the Korean Health Insurance Review and Assessment Service (HIRA) from 2008 to 2016 in South Korea. Patients with a record of cruciate ligament reconstruction and PCLR were allocated from the database. An analysis of the total number and incidence per 100,000 people/year of PCLR procedures and other epidemiologic parameters was conducted according to sex and age.</p><p><strong>Results: </strong>The incidence of PCLR procedures rose from 2.3 to 2.6 per 100,000 people (from 1101 to 1299 total cases; 13% increase) between 2008 and 2016: from 3.8 to 4.0 (from 901 to 1000) in males, and from 0.8 to 1.2 (from 200 to 299) in females. PCLR was performed more frequently in males than in females, however, the rate of increase was higher in females than males. The incidence of PCLR over 9  years was highest in patients in their 20s, followed by patients in their 40s and 30s.</p><p><strong>Conclusion: </strong>The incidence of PCLR procedures increased by 13% over 9 years in South Korea. PCLR was performed approximately three times more in men than in women. The incidence of PCLR was highest in patients in their 20s, followed by those in their 40s. The current study will enhance our understanding of the epidemiology of PCLR.</p><p><strong>Study design: </strong>Descriptive Epidemiology Study.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriate determination of the surgical transepicondylar axis can be achieved following distal femur resection in navigation-assisted total knee arthroplasty.","authors":"Sang Jun Song,&nbsp;Hyun Woo Lee,&nbsp;Kang Il Kim,&nbsp;Cheol Hee Park","doi":"10.1186/s43019-021-00123-1","DOIUrl":"https://doi.org/10.1186/s43019-021-00123-1","url":null,"abstract":"<p><strong>Background: </strong>Many surgeons have determined the surgical transepicondylar axis (sTEA) after distal femur resection in total knee arthroplasty (TKA). However, in most navigation systems, the registration of the sTEA precedes the distal femur resection. This sequential difference can influence the accuracy of intraoperative determination for sTEA when considering the proximal location of the anatomical references for sTEA and the arthritic environment. We compared the accuracy and precision in determinations of the sTEA between before and after distal femur resection during navigation-assisted TKA.</p><p><strong>Methods: </strong>Ninety TKAs with Attune posterior-stabilized prostheses were performed under imageless navigation. The sTEA was registered before distal femur resection, then reassessed and adjusted after distal resection. The femoral component was implanted finally according to the sTEA determined after distal femur resection. Computed tomography (CT) was performed postoperatively to analyze the true sTEA (the line connecting the tip of the lateral femoral epicondyle to the lowest point of the medial femoral epicondylar sulcus on axial CT images) and femoral component rotation (FCR) axis. The FCR angle after distal femur resection (FCRA-aR) was defined as the angle between the FCR axis and true sTEA on CT images. The FCR angle before distal resection (FCRA-bR) could be presumed to be the value of FCRA-aR minus the difference between the intraoperatively determined sTEAs before and after distal resection as indicated by the navigation system. It was considered that the FCRA-bR or FCRA-aR represented the differences between the sTEA determined before or after distal femur resection and the true sTEA, respectively.</p><p><strong>Results: </strong>The FCRA-bR was -1.3 ± 2.4° and FCRA-aR was 0.3 ± 1.7° (p < 0.001). The range of FCRA-bR was from -6.6° to 4.1° and that of FCRA-aR was from -2.7° to 3.3°. The proportion of appropriate FCRA (≤ ±3°) was significantly higher after distal femur resection than that before resection (91.1% versus 70%; p < 0.001).</p><p><strong>Conclusions: </strong>The FCR was more appropriate when the sTEA was determined after distal femur resection than before resection in navigation-assisted TKA. The reassessment and adjusted registration of sTEA after distal femur resection could improve the rotational alignment of the femoral component in navigation-assisted TKA.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39875169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative FJS-12 scores for the knee in an Asian population: a cross-sectional study.","authors":"Jia Ying Lee,&nbsp;Wai Weng Yeo,&nbsp;Zi Yang Chia,&nbsp;Paul Chang","doi":"10.1186/s43019-021-00122-2","DOIUrl":"https://doi.org/10.1186/s43019-021-00122-2","url":null,"abstract":"<p><strong>Background: </strong>The Forgotten Joint Score is a patient-reported outcome measure validated in assessing patients post knee arthroplasty, anterior cruciate ligament (ACL) reconstruction surgery and patellar dislocation. A previous study had established the normative scores of a population in the USA but included knees with pathology. The aim of our study is to obtain normative Forgotten Joint Scores in young Asian adults without any pre-existing knee pathologies to increase the interpretability of the Forgotten Joint Score-12 (FJS-12) score.</p><p><strong>Methods: </strong>We conducted a cross-sectional study across young healthy Asian adults via electronic platforms. Participants who had sought either Western medical consultation, physiotherapy or traditional medical therapies were excluded. Demographic data, occupation, type of sport played, and FJS-12 scores were collected. Scores were stratified into subgroups and analysed.</p><p><strong>Results: </strong>There were 172 participants who met our inclusion criteria for this study. The average age of participants in our study was 28.1 ± 10.5 years (range 14-70 years), with 83 (47.7%) participants falling into the ages 21-25 years. Average body mass index (BMI) was 21.9 ± 3.3 kg/m² (range 14.7-36.3 kg/m²). The average FJS-12 score was 62.8 ± 25.6. The median FJS-12 was 63.5 with a range of 4.2-100. Nine participants (5.2%) scored the maximum score possible, and 56 (32.6%) participants scored below the midpoint score of 50. The percentiles for each subgroup of participants were tabulated and reported. Notably, males aged 46-70 years old scored the highest average FJS-12 score of 73.4 ± 5.5, and females aged 31-45 years old scored the lowest FJS-12 score of 57.1 ± 25.1. Females scored lower than males, although the difference was not statistically significant (p = 0.157). There were no significant correlations between BMI, age, or type of sport played with FJS-12; however, interestingly, we observed that women reported similar FJS-12 scores across all age groups, while men reported better scores with increasing age.Interestingly, we observed that women reported similar FJS-12 scores across all age groups, while men reported better scores with increasing age.  CONCLUSION: Having normative values provides opportunities for benchmarking and comparing individuals against age- and gender-matched peers in the general population. Knowledge of normative values for FJS-12 scores would aid evaluating and tracking progress in patients recovering from injuries or undergoing post-surgery rehabilitation. This would help clinicians  determine if they return to 'normal' post intervention.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39843175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum toxin injections as salvage therapy is beneficial for management of patellofemoral pain syndrome.","authors":"Yuval Kesary, Vivek Singh, Tal Frenkel-Rutenberg, Arie Greenberg, Shmuel Dekel, Ran Schwarzkopf, Nimrod Snir","doi":"10.1186/s43019-021-00121-3","DOIUrl":"10.1186/s43019-021-00121-3","url":null,"abstract":"<p><strong>Purpose: </strong>Patellofemoral pain syndrome (PFPS) is a common pathology usually presenting with anterior or retropatellar pain. It is associated with a relative imbalance between the vastus medialis oblique (VMO) and the vastus lateralis (VL) muscles. This can lead to considerable morbidity and reduced quality of life (QOL). This study aims to assess the long-term functional outcome of PFPS treated with VL muscle botulinum toxin A (BoNT-A) injection.</p><p><strong>Materials and methods: </strong>A retrospective review was performed on 26 consecutive patients (31 knees) with a mean age of 50.1 years (± 19.7 years) who were treated with BoNT-A injections to the VL muscle followed by physiotherapy between 2008 and 2015. Pre- and post-treatment pain levels (numerical rating scale, NRS), QOL (SF-6D), and functional scores (Kujala and Lysholm questionnaires) were measured. Demographics, physical therapy compliance, previous surgeries, perioperative complications, and patient satisfaction levels were collected.</p><p><strong>Results: </strong>The mean follow-up time was 58.8 ± 36.4 months. There were significant improvements in all the examined domains. The average pain score (NRS) decreased from 7.6 to 3.2 (P < 0.01), and the Kujala, Lysholm, and SF-6D scores improved from 58.9 to 82.7 (P < 0.001), 56.2 to 83.2 (P < 0.001), and 0.6 to 0.8 (P < 0.001), respectively. Similar delta improvement was achieved irrespective of gender, age, compliance to post-treatment physical therapy, or coexisting osteoarthritis. Patients who presented with a worse pre-treatment clinical status achieved greater improvement. Prior to BoNT-A intervention, 16 patients (18 knees) were scheduled for surgery, of whom 12 (75%, 13 knees) did not require further surgical intervention at the last follow-up.</p><p><strong>Conclusions: </strong>A single intervention of BoNT-A injections to the VL muscle combined with physiotherapy is beneficial for the treatment of patients with persistent PFPS.</p><p><strong>Level iii evidence: </strong>Retrospective cohort study.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}