Knee Surgery and Related Research最新文献

{"title":"Comparative analysis of revision causes between robotic-assisted and conventional manual unicompartmental knee arthroplasty: a systematic review and meta-analysis.","authors":"Pengyu Xiang, Hongfu Jin, Yiming Dai, Yixin Yang, Chenhao Jia, Lather Sagar, Jian Zhang, Yungang Wu, Chunwu Zhang, Shengwu Yang, Zhenhan Deng","doi":"10.1186/s43019-026-00311-x","DOIUrl":"10.1186/s43019-026-00311-x","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted unicompartmental knee arthroplasty (R-UKA) is an emerging procedure; however, its benefits over conventional manual unicompartmental knee arthroplasty (C-UKA) are controversial, especially the revision and failure rates, and existing studies failed to reach a consensus on this issue.</p><p><strong>Methods: </strong>The literature search was conducted on four databases (PubMed, Embase, Cochrane Library and Web of Science) from inception to 28 April 2025 according to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Eligibility criteria were studies that were written in English and reported any causes for a revision or failure subsequent to UKA with comparisons between R-UKA and C-UKA. The quality of each article was assessed using the Cochrane collaboration risk of bias tool or the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>A total of 15 studies incorporating 29,982 patients with 30,099 knees (22,290 in the C-UKA group and 7809 in the R-UKA group) were analyzed. Compared with R-UKA, C-UKA showed higher total revision rates (RR: 1.58; 95% CI: ~1.33-1.87; P < 0.00001; I² = 43%). Prosthesis loosening, infection, pain, and progression of disease were the main reasons for R-UKA revision, whereas for C-UKA revision, loosening, progression of disease, infection, and limb malalignment were the major causes. Loosening was the predominant reason in both groups across all follow-up periods; early revisions were also due to infection and disease progression. Within 2-5 years, the secondary reasons differed, being limb malalignment for C-UKA and pain for R-UKA.</p><p><strong>Conclusions: </strong>Compared with C-UKA, R-UKA may lower the risk of revision related to loosening, disease progression, and limb malalignment. Loosening remains the primary revision cause for both. Large-scale prospective trials with unified technical details are warranted to draw more rigorous conclusions in the future.</p><p><strong>Trial registration: </strong>PROSPERO CRD420251042604.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311049","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":"Effect of femoral component design and quadriceps load on patellofemoral kinematics after total knee arthroplasty: an in vitro cadaveric study.","authors":"Vera Maioli, Emanuele Diquattro, Michele Conconi, Francesco Castagnini, Francesco Traina, Nicola Sancisi, Luca Cristofolini","doi":"10.1186/s43019-026-00308-6","DOIUrl":"10.1186/s43019-026-00308-6","url":null,"abstract":"<p><strong>Purpose: </strong>Patellofemoral (PF) complications are a common cause of dissatisfaction and revision following total knee arthroplasty (TKA), often linked to altered kinematics and implant design. \"Patella-friendly\" femoral components with a wider, funnel-shaped trochlear groove may better restore native patellar motion. This study evaluated PF kinematics both before and after TKA performed using kinematic alignment, investigating the role of implant design and quadriceps loading.</p><p><strong>Methods: </strong>In total, 12 paired fresh-frozen cadaveric lower limbs were tested before and after TKA. Within each pair, one limb received a traditional medial pivot femoral component, while the contralateral limb received a \"patella-friendly\" medial pivot femoral component. Native and implanted knees were tested by flexing the knee under the action of an external load applied through the quadriceps tendon, varying its magnitudes (20, 160, 280N) and directions in the frontal (neutral,±6°, ±12°) and sagittal plane (neutral, +5° anterior). Motion was captured using an eight-camera optoelectronic system.</p><p><strong>Results: </strong>In the reference condition (20N, neutral direction), neither design showed statistical differences versus native (p > 0.05). However, the patella excursion in varus-valgus rotation was much higher in the specimens implanted with the traditional femoral component design (35.1° versus 14.6° native) than with the patella-friendly (20.5°). Differences between the designs emerged mainly with quadriceps load variations, especially frontal direction changes, which significantly affected patellar motion in both native and implanted knees (p < 0.05). Overall, the patella-friendly design better reproduced native kinematics under most conditions. However, with extreme medial loading (12°), three out of six specimens implanted with the patella-friendly femoral component were untestable owing to instability, and others exhibited high lateral displacement and trochlear dysplasia. In contrast, all traditional design implants remained stable, though with greater deviation from native kinematics.</p><p><strong>Conclusions: </strong>This study provides foundational insights into PF biomechanics before and after TKA with kinematic alignment. By analyzing the interplay between implant geometry and quadriceps loading direction, it emphasizes the importance of selecting femoral components on the basis of individual patient anatomy. Our findings suggest that patella-friendly femoral components-although capable of better reproducing native motion in some cases-may not be suitable for patients with medially directed quadriceps forces or severely varus morphotypes.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309903","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":"Shared decision-making and patient decision aids in knee osteoarthritis: a scoping review.","authors":"Ethan Wang, Amber Stefanski, Tsz King Donald Chow, Angela Spencer, Keniesha Thompson, Sheyna Gifford","doi":"10.1186/s43019-026-00310-y","DOIUrl":"10.1186/s43019-026-00310-y","url":null,"abstract":"<p><strong>Background: </strong>Shared decision-making is a collaborative approach that enables clinicians and patients to make informed treatment decisions that align with patient preferences. This study examined current practices of shared decision-making in managing knee osteoarthritis.</p><p><strong>Methods: </strong>A comprehensive search was conducted in Cochrane, CINAHL, ProQuest, Scopus, Ovid MEDLINE, and Web of Science databases through August 2025. EndNote 21 was utilized for de-duplication, and Rayyan was used for screening. Studies were analyzed for the use of patient decision aids, shared decision-making outcome measures, and barriers and factors impacting shared decision-making practices.</p><p><strong>Results: </strong>Of 4708 records screened, 69 studies were included for analysis, comprising 23 randomized controlled trials, 18 qualitative studies, 9 trial protocols, and 19 other observational designs. A total of 44 studies explicitly described the use of a patient decision aid. Reported outcome domains included decision quality, decisional conflict, satisfaction, regret, and patient-clinician communication. Commonly cited barriers to shared decision-making (SDM) implementation were limited clinician time, lack of awareness of patient decision aids (PDAs), and patient difficulty using digital tools.</p><p><strong>Conclusions: </strong>The included studies suggest that patient decision aids may be a valuable tool for management of knee osteoarthritis, with studies reporting improvements in patient engagement and informed decision-making. However, variability in shared decision-making implementation and inconsistency in outcome measures highlight the need for further research to evaluate the comparative effectiveness of decision aids in clinical practice.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277270","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":"Comparison of serum systemic inflammatory biomarkers in bone-milling robotic-assisted total knee arthroplasty and conventional total knee arthroplasty: a prospective randomized controlled trial.","authors":"Peeranut Jittangtrong, Natthapong Hongku, Satit Thiengwittayaporn","doi":"10.1186/s43019-026-00309-5","DOIUrl":"10.1186/s43019-026-00309-5","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted total knee arthroplasty (RA-TKA) aims to improve surgical accuracy and reduce soft-tissue trauma. The bone-milling technique may further decrease mechanical stress during bone preparation. This study primarily compared systemic inflammatory biomarkers between bone-milling RA-TKA and conventional TKA (C-TKA), with secondary assessments of perioperative parameters, radiographic alignment, and early postoperative outcomes.</p><p><strong>Methods: </strong>This prospective randomized controlled trial included 30 RA-TKAs and 30 C-TKAs performed between August 2023 and December 2024 in patients with Kellgren-Lawrence grade IV knee osteoarthritis. All RA-TKA procedures were conducted during the operating surgeon's early learning phase with the robotic platform. Serum interleukin (IL)-6, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), creatine kinase (CK), and lactate dehydrogenase (LDH) were measured preoperatively and at 6 h, 1 day, 3 days, 2 weeks, and 6 weeks postoperatively. Perioperative variables, radiographic alignment, and 6-week Knee Society Score (KSS) and visual analog scale (VAS) pain scores were compared.</p><p><strong>Results: </strong>Postoperative inflammatory biomarkers did not differ significantly between groups at any time point, and the corresponding effect sizes were small, indicating minimal biological differences. Estimated blood loss was comparable (p = 0.753). RA-TKA demonstrated significantly improved postoperative mechanical alignment (mechanical axis [MA] deviation: 0.3 ± 2.4° versus 2.8 ± 3.4°; p = 0.002) but required longer tourniquet times (121.4 ± 15.3 min versus 95.0 ± 13.3 min; p < 0.001). Early functional outcomes were similar, with no significant differences in KSS (p = 0.114) or VAS pain scores at 6 weeks (p = 0.508).</p><p><strong>Conclusions: </strong>Bone-milling RA-TKA did not reduce systemic inflammatory responses compared with C-TKA, with small effect sizes confirming minimal biological differences. However, it provided superior radiographic alignment, while perioperative parameters and early postoperative recovery remained comparable except for longer tourniquet time.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":"7"},"PeriodicalIF":4.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229301","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":"Return to sport after ACL reconstruction, meniscus and cartilage surgeries in professional soccer players: a systematic review and meta-analysis.","authors":"Riccardo D'Ambrosi, Jari Dahmen, Alessandro Carrozzo, Luca Maria Sconfienza, Christoph Kittl, Elmar Herbst, Christian Fink","doi":"10.1186/s43019-026-00304-w","DOIUrl":"10.1186/s43019-026-00304-w","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this systematic review and meta-analysis is to evaluate and compare the effects of anterior cruciate ligament reconstruction (ACLR), meniscal surgeries, and cartilage surgeries on return to sport (RTS) outcomes in professional soccer players.</p><p><strong>Materials and methods: </strong>The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic database search was performed to identify potentially relevant research articles. Four different outcome measures (age at surgery, return to sport, time to return to sport, level of return to sport) were extracted and meta-analyzed from all included studies and compared from three different groups (ACLR, cartilage surgeries, meniscus surgeries).</p><p><strong>Results: </strong>The pooled meta-analysis showed no difference in age at surgery among groups (p > 0.05). The overall pooled return-to-sport rate was 90% (95% CI 93.3-95.9), with no significant differences between ACL reconstruction, meniscus surgeries, and cartilage surgeries (p > 0.05) Patients treated for ACLR reported a longer time (p < 0.05) to return to sport (258.05 days; 95% CI 230.48-288.93) compared with meniscus (41.11 days; 95% CI 30.22-55.93) and cartilage surgeries (135.0 days; 95% CI 130.54-139.61). Furthermore, the pooled meta-analysis showed that athletes who underwent meniscus surgeries had a higher (p < 0.05) percentage of return to sport (100%: 95% CI 86.0-100.0) compared with ACLR (80.0%; 95% CI 67.5-90.3) and cartilage treatment (94.5%; 64.2-100.0).</p><p><strong>Conclusions: </strong>For professional soccer players, ACL reconstruction, meniscus surgeries, and cartilage surgeries demonstrated a favorable RTP rate of around 90%. Nevertheless, the analysis of the level of RTS and the time to RTS was constrained by limited evidence, precluding a more objective conclusion.</p><p><strong>Level of evidence: </strong>Meta-analysis of studies of Level IV.</p><p><strong>Study registration: </strong>PROSPERO Registry (CRD420251074362).</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":"6"},"PeriodicalIF":4.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229249","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":"Quadriceps muscle force magnitude and control in the knee scheduled for arthroplasty versus the contralateral knee: A cross-sectional study in patients with end-stage osteoarthritis.","authors":"Thiago Lemos, Yan R Razuck, Gustavo H Halmenschlager, Conrado T Laett, Sidney C Silva, Alan P Mozella, José C S Albarello","doi":"10.1186/s43019-026-00305-9","DOIUrl":"10.1186/s43019-026-00305-9","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a leading cause of musculoskeletal disability. Beyond the well-established impairment of reduced strength, deficits in force control (steadiness and complexity) may also influence functional performance. This cross-sectional study investigated quadriceps strength, force steadiness and complexity in patients with KOA and their associations with functional performance.</p><p><strong>Methods: </strong>A total of 48 patients scheduled for unilateral knee arthroplasty performed maximal voluntary isometric contraction in both limbs. A 2-s window from the trial containing the peak torque was used to compute quadriceps strength (average torque, AT), force steadiness (coefficient of variation, CV), and force complexity (sample entropy, SE; detrended fluctuation analysis alpha exponent). Functional performance was assessed via sitting-to-standing, single-leg stance, Timed Up and Go, and 30-s sit-to-stand tests. Comparisons between involved and contralateral limbs used analysis of variance (ANOVA) models, accounting for prior surgery in contralateral knees. Linear regression analyzed associations between functional performance and the lateral symmetry index (LSI) of AT and SE.</p><p><strong>Results: </strong>Results showed significant differences between limbs for AT (P < 0.001, η² = 0.074) and SE (P = 0.041, η² = 0.046), with the involved knee exhibiting lower strength and higher complexity. Regression revealed a positive association between sitting-to-standing and 30-s sit-to-stand performance and LSI-AT (βs are equal to -0.337 and 0.336, respectively; P < 0.027), but no other links were found.</p><p><strong>Conclusions: </strong>KOA is associated with between-limb asymmetries in quadriceps strength and force complexity, with the involved knee exhibiting deleterious alterations. Nonetheless, force complexity was not correlated with functional performance.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":"4"},"PeriodicalIF":4.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067201","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":"Patterns of meniscal tears in multiligament knee injuries with and without dislocation: a retrospective study from a Level I trauma center.","authors":"Luis Henrique Longo, Bruno Dada Gulini, Marcos Paulo Tercziany Vanzin, Fernando Martins Rosa, Luca Eiji Sohn Sato, Luis Antonio de Ridder Bauer","doi":"10.1186/s43019-026-00307-7","DOIUrl":"10.1186/s43019-026-00307-7","url":null,"abstract":"<p><strong>Background: </strong>Multiligament knee injuries (MLKI) are rare but severe, often associated with knee dislocation and carry a high risk of neurovascular complications. Although ligamentous reconstruction has been widely studied, there is limited evidence addressing the incidence and specific patterns of meniscal injuries in this setting.</p><p><strong>Methods: </strong>We retrospectively analyzed skeletally mature patients admitted to a Level I trauma center between January 2022 and December 2024 with MLKI, with or without knee dislocation. Demographics, trauma mechanism, ligamentous, and meniscal injury patterns were reviewed on the basis of magnetic resonance imaging (MRI) and surgical records. Meniscal tears were classified by location and morphology. Statistical analysis included Fisher's exact test, chi-square tests, and univariate logistic regression with significance set at p < 0.05.</p><p><strong>Results: </strong>A total of patients were included: 35 (63.6%) with knee dislocation and 20 (36.4%) without. Mean age was 36.8 ± 13.2 years, and 81.8% were male. Magnetic resonance imaging was performed at a mean of 28.1 ± 7.3 days after injury. High-energy trauma accounted for 69.1% of cases and was significantly associated with dislocation (p = 0.001). Medial meniscus tears in patients with dislocation were predominantly radial/complex/oblique (72.7% versus 0% in nondislocated, p = 0.004; OR not calculable due to perfect separation), while all nondislocated patients had longitudinal tears. Lateral meniscus tears showed a similar pattern, with radial/complex/oblique tears more frequent in dislocation (80.0% versus 20.0%, OR = 16.00, 95% CI 1.27-200.92, p = 0.031).</p><p><strong>Conclusions: </strong>Knee dislocations demonstrate distinct meniscal tear patterns compared with nondislocated MLKI, with radial and complex tears predominating in dislocated knees. Recognition of these differences may assist in accurate diagnosis and individualized surgical planning.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":"5"},"PeriodicalIF":4.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146066809","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":"Effects of axial malrotation on posterior tibial slope measurement: a digitally reconstructed radiograph study enabling automated quality assessment.","authors":"Jaeseok Park, Andreas Persson, R Kyle Martin, Eivind Inderhaug, Sung Eun Kim, Sangyoon Kim, Donghyuk Kwak, Du Hyun Ro","doi":"10.1186/s43019-026-00303-x","DOIUrl":"10.1186/s43019-026-00303-x","url":null,"abstract":"<p><strong>Background: </strong>Accurate measurement of posterior tibial slope (PTS) is highly sensitive to axial malrotation of the knee during acquisition, but its impact has not been systematically quantified across different anatomical variations. This simulation study aimed to quantify the effect of axial malrotation on PTS using digitally reconstructed radiographs (DRRs) and suggest a practical marker for filtering out low-quality images with excessive malrotation.</p><p><strong>Materials and methods: </strong>A total of 55 preoperative computed tomography (CT) scans from January 2021 to December 2024 in a single, tertiary hospital were retrospectively reviewed. DRRs were generated from those scans to simulate lateral knee radiographs with malrotation ranging from -12° to +12° relative to an anatomically aligned baseline. An artificial-intelligence (AI)-based tool automatically measured PTS on each DRR, with agreement evaluated using intraclass correlation coefficient (ICC). PCDR was calculated from femoral contours and analyzed for correlation with malrotation angles and resulting PTS measurement error.</p><p><strong>Results: </strong>AI-based PTS measurements on DRRs showed good agreement with expert annotations (ICC = 0.78, 95% CI 0.73-0.82). PTS increased linearly with internal rotation, with each 1° of rotation resulting in approximately 0.2° change in PTS (R² = 0.43, p < 0.01). Errors exceeded 1° when malrotation surpassed ±6°. PCDR was strongly correlated with malrotation angle (R² > 0.98, p < 0.001) and achieved fair discriminative performance as a binary classifier for > 1° PTS error [area under the receiver operating curve (AUROC) = 0.77].</p><p><strong>Conclusions: </strong>CT-derived DRRs combined with AI analysis showed that PTS measurement error proportionately increased with axial malrotation. Identifying and excluding radiographs with excessive rotation improves the reliability of slope-based assessments and supports more accurate surgical planning.</p><p><strong>Level of evidence: </strong>III, retrospective cohort study.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":"3"},"PeriodicalIF":4.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067519","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":"Patient selection and management for successful cementless total knee arthroplasty.","authors":"Byung Sun Choi, Min Jung, Byung Woo Cho, Jun Young Chung, Jeong Ku Ha, Hyuk-Soo Han","doi":"10.1186/s43019-026-00300-0","DOIUrl":"10.1186/s43019-026-00300-0","url":null,"abstract":"<p><p>Total knee arthroplasty (TKA) is a widely performed procedure for end-stage arthritis, with cemented fixation historically dominating owing to its immediate stability and ability to compensate for minor bone defects. However, concerns over the long-term durability of cemented implants, particularly in younger and more active patients, have renewed interest in cementless TKA as a viable alternative. Advances in implant design, including hydroxyapatite coatings and porous metal surfaces, have improved clinical outcomes, reducing early loosening and enhancing biological fixation. Proper patient selection is crucial for the success of cementless TKA. Studies suggest that younger patients, those with good bone quality, and even some elderly or obese individuals may benefit from cementless implants. While initial migration of the tibial component is more pronounced in cementless TKA, research indicates that this stabilizes over time without impacting long-term outcomes. In addition, pharmacologic interventions, such as bisphosphonates and teriparatide, may help enhance periprosthetic bone density and implant fixation. Despite promising results, challenges remain, particularly in patients with osteoporosis, rheumatoid arthritis, and smoking-related bone health issues. Further research is needed to refine selection criteria, optimize surgical techniques, and ensure long-term success. As next-generation cementless implants continue to evolve, ongoing studies will be essential in guiding patient management strategies for improved outcomes.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":"1"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030839","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":"Incidence and geographic mapping of meniscal tears in acute ACL injuries with meticulous posterior arthroscopic evaluation: longitudinal tears at the posterior menisco-capsular junction are the most common tear pattern in acute ACL injuries.","authors":"Dong Hwi Kim, Do Kyung Lee","doi":"10.1186/s43019-026-00301-z","DOIUrl":"10.1186/s43019-026-00301-z","url":null,"abstract":"<p><strong>Background: </strong>Meniscal injuries are commonly observed in acute anterior cruciate ligament (ACL) injuries, with varying reports on the incidence and location of meniscal tears. In particular, the incidence of posterior menisco-capsular tears may have been underestimated in previous literature owing to the technical challenges associated with posterior arthroscopic evaluation. This study aimed to determine the true incidence and location of posterior menisco-capsular junction tears in patients undergoing anterior cruciate ligament reconstruction (ACLR) up to 6 weeks of injury, hypothesizing a higher incidence than previously reported.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent primary ACLR between July 2015 and January 2023, including a total of 139 patients. Arthroscopic findings and surgical records were reviewed, and the posteromedial and posterolateral joint spaces were evaluated via intercondylar notch view with a 70-degree arthroscope or via a posteromedial/posterolateral portal as a viewing portal to confirm posterior menisco-capsular junctional tears in all patients. The Cooper's classification system was used to document tear locations, and radial and longitudinal tear components were analyzed.</p><p><strong>Results: </strong>Meniscal tears were observed in 104 patients (74.8%). Medial meniscus tears occurred in 63 patients (45.3%), while lateral meniscus tears were found in 78 patients (56.1%). Bilateral meniscus tears were identified in 37 patients (26.6%). Radial tears were predominantly observed in the lateral meniscus (22.3%), with a significant portion being lateral meniscus root tears (15.1%). Longitudinal tears, particularly at the menisco-capsular junction, were the most common tear pattern, occurring in 64.7% of patients.The most commonly involved tear sites were Zone A0 (39.6%) and Zone A1 (42.4%) in the medial meniscus, and Zone F0 (36.7%) and Zone F1 (38.1%) in the lateral meniscus.</p><p><strong>Conclusions: </strong>Longitudinal tears at the menisco-capsular junction are the most common tear pattern in acute ACL injuries, revealing a higher incidence than previously reported. In acute ACL injuries, Zones A0-A1 and F0-F1 should be meticulously evaluated using an intercondylar notch view with a 70-degree arthroscope or via a posteromedial/posterolateral portal as a viewing portal.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"38 1","pages":"2"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030873","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}