Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Complex knee injuries from bouldering: A case series","authors":"Jhulia Kawachi Cruz,&nbsp;Khim Yew Chew,&nbsp;Mok Ying Ren,&nbsp;Yee Han Dave Lee","doi":"10.1016/j.jisako.2025.100995","DOIUrl":"10.1016/j.jisako.2025.100995","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Bouldering, a dynamic climbing discipline performed without ropes, is associated with high-energy ground falls. While most existing climbing injury literature has focused on the upper extremities, our data indicated an increasing number of complex knee injuries related to bouldering. This review was conducted to characterize the injury patterns sustained from ground falls during bouldering, and to compare the relative burden of these injuries with those sustained in other high-participation sports.</div></div><div><h3>Methods</h3><div>A retrospective case series was performed, including climbers who presented with knee injuries from ground falls during bouldering between March 2022 and October 2024. Patient demographics, injury mechanisms, ligamentous and meniscal pathology, as well as osseous or chondral damage were collected. The injuries were stratified by sex, age group, and injury complexity, including multiligament injury, meniscus tears, and osseous or chondral involvement. The bouldering-related injuries were then compared to institutional data from soccer and basketball, the two most common causes of sports-related knee injuries requiring surgery at the institution’s sports center.</div></div><div><h3>Results</h3><div>Nineteen patients were included, with a mean age of 27 ​± ​5.1 years. Of these, 15 (78.9 ​%) sustained combined anterior cruciate ligament and meniscus injuries. Surgical intervention was performed in 18 (94.7 ​%) patients. Multiligament knee injuries occurred in 4 (21.2 ​%) bouldering cases, accounting for 20 ​% of all multiligament knee injuries treated during the study period. Meniscus root tears were identified in 4 (21.1 ​%) bouldering cases, representing 22 ​% of all surgically treated meniscus root tears. Bone contusions consistent with pivot-shift patterns were observed in 52.6 ​% of patients, with cartilage fissuring and sulcus terminalis impaction in 10.5 ​% each. Compared to soccer and basketball, bouldering demonstrated a relatively higher proportion of complex knee injuries, despite lower participation volumes.</div></div><div><h3>Conclusion</h3><div>Ground falls during bouldering ground falls have been associated with a high proportion of complex knee injuries, including multiligament knee injuries, meniscus root tears, and injuries to both menisci. These injury patterns are believed to result from high-energy axial and rotational loading, and suggest the need for increased awareness, preventive strategies, and rehabilitation programs tailored to the sport.</div></div><div><h3>Level of evidence</h3><div>Level 4, Case series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100995"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractures In Oxford Unicompartmental Knee Arthroplasty Are Associated With A Decreased Medial Keel Cortex Distance Of The Tibial Implant – A Combined Clinical And Biomechanical Study","authors":"","doi":"10.1016/j.jisako.2025.101006","DOIUrl":"10.1016/j.jisako.2025.101006","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 101006"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the current medicolegal landscape in orthopedic sports medicine surgery—patient-centered communication and multidisciplinary approaches matter: A consensus statement","authors":"Zachary J. Herman ,&nbsp;Camila Grandberg ,&nbsp;Abigail N. Boduch ,&nbsp;Stephen J. Rabuck ,&nbsp;Bryson P. Lesniak ,&nbsp;Jonathan D. Hughes ,&nbsp;James J. Irrgang ,&nbsp;Michael K. Feeney ,&nbsp;MaCalus V. Hogan ,&nbsp;Volker Musahl","doi":"10.1016/j.jisako.2025.100993","DOIUrl":"10.1016/j.jisako.2025.100993","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>While the opportunity to provide medical care for elite-level professional and collegiate athletes is an honor and privilege, it does not come without a unique set of challenges. The team physician role continues to evolve and insights on today’s climate of team physicians’ care of elite athletes globally may be enlightening. As such, the purpose of this review is to provide a synopsis of the meeting’s key points and present the results of the survey to better delineate the effect of the medicolegal risk involved in the care of elite athletes.</div></div><div><h3>Methods</h3><div>An international and multidisciplinary group of experts on anterior cruciate ligament injury and sports medicine was chosen to participate on a panel at the 2024 Freddie Fu Panther Sports Medicine Symposium held at the University of Pittsburgh, Pittsburgh, Pennsylvania, USA, on June 6, 2024. The international panel included orthopaedic surgeons, primary care physicians, and scientists and focused on the medicolegal climate of sports medicine. Throughout the duration of the panel, a live questionnaire was provided to the audience, which included practitioners from 17 countries and 5 continents. The survey consisted of eight “yes/no” questions.</div></div><div><h3>Results</h3><div>Several themes emerged from the discussion, including differing medicolegal consequences based on geographic location, changes to documentation in response to litigation risk, and increases in personal stressors to physicians. Of the eight statements administered to the audience during the panel discussion, only three had greater than 50 ​% agreement. These statements included changes to practice based on the medicolegal climate and the effects of defensive practice on physicians and patients alike.</div></div><div><h3>Conclusion</h3><div>The risk of litigation in orthopaedic sports medicine surgery varies greatly based on the geographic location of the practice and is perceived to affect both patient care and providers alike. As the assessment of medical professional liability risk arising from the care of elite athletes continues to evolve, discussion among physicians, athletes, agents, and teams/clubs should be patient-centered, multidisciplinary, and undertaken with absolute professionalism, strong communication, and thorough documentation.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100993"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deepening the subchondral insufficiency fracture and osteonecrosis of the knee dilemma: Time for a new classification: Current concepts","authors":"Pierangelo Za ,&nbsp;Luca Ambrosio ,&nbsp;Sebastiano Vasta ,&nbsp;Augusto Ferrini ,&nbsp;Saseendar Shanmugasundaram ,&nbsp;Biagio Zampogna ,&nbsp;Rocco Papalia","doi":"10.1016/j.jisako.2025.100922","DOIUrl":"10.1016/j.jisako.2025.100922","url":null,"abstract":"<div><div>Knee osteonecrosis (ON), often subclassified as spontaneous ON of the knee, secondary ON, and post-arthroscopic ON of the knee, is a common disorder often associated with suboptimal outcomes. Magnetic resonance imaging is the current gold standard for diagnosis, revealing bone marrow edema and subchondral fracture lines. Therapeutic methods range from conservative treatments, such as partial weight-bearing, pharmaceutical interventions, and physical therapy, to surgical procedures in cases of advanced joint collapse. Available evidence from histological studies consistently shows the absence of bone necrosis, highlighting microfractures and bone remodeling as central features of these lesions. Therefore, the appropriateness of this terminology has recently been questioned, with knee ON being more accurately reinterpreted as subchondral insufficiency fracture of the knee (SIFK). This clinical dilemma stems from longstanding misclassification that has led to diagnostic confusion and inconsistent treatment approaches. Despite this progress, several unresolved issues persist. The precise biomechanical and biological factors that initiate SIFK remain unclear, and the optimal timing for intervention is still debated. In addition, long-term outcomes of both nonoperative and operative treatments have yet to be definitively established. Addressing these gaps requires comprehensive clinical trials and advanced imaging studies that correlate histological findings with patient outcomes. This evolving understanding calls for a reclassification of knee ON lesions, aiming to enhance diagnostic accuracy and inform more effective, targeted treatment strategies.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100922"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to sports and recreational activities after patellofemoral arthroplasty: A systematic review","authors":"José Arteaga MD, MSc ,&nbsp;Eduardo Poblete MD ,&nbsp;Fernando Martin MD ,&nbsp;Gabriel Domecq MD ,&nbsp;David Figueroa MD, Prof.","doi":"10.1016/j.jisako.2025.100925","DOIUrl":"10.1016/j.jisako.2025.100925","url":null,"abstract":"<div><h3>Importance</h3><div>Patellofemoral arthroplasty (PFA) is an established treatment for isolated patellofemoral osteoarthritis. However, evidence regarding postoperative activity levels and return to sport (RTS) remains limited.</div></div><div><h3>Objective</h3><div>The objective of this study was to evaluate RTS and recreational activity rates following PFA, identify factors influencing these outcomes, and report associated complications.</div></div><div><h3>Evidence review</h3><div>A systematic search was conducted in June 2024 across PubMed, EMBASE, ScienceDirect, and Scopus databases, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included variations of “patellofemoral arthroplasty,” “physical activity,” and “return to sport.” Studies were included if they reported RTS outcomes following PFA. Studies lacking RTS data or isolated PFA results were excluded. From 492 records, 7 studies met the inclusion criteria.</div></div><div><h3>Findings</h3><div>Seven studies (2 prospective and 5 retrospective) comprising 265 patients (281 knees; 64.6% women; mean age: 48.9 years) were included, with a mean follow-up of up to 5.3 years. RTS definitions varied, with reported rates ranging from 64.7% to 91%. Low-impact sports were more commonly resumed, and 58.6% of patients returned to sport within six months. Among those who returned, 74.8% reached or exceeded their preoperative activity level. Postoperative pain improved (visual analog scale scores decreased from 6.3 to 2.7), although up to 38.6% of patients reported pain limiting activity. Conversion to total knee arthroplasty occurred in 6.3% to 13% of cases, and reoperation rates ranged from 10.4% to 25%. Limitations included inconsistent RTS definitions, heterogeneous outcome reporting, and use of non-standardized questionnaires.</div></div><div><h3>Conclusions</h3><div>RTS and recreational activity after PFA can be resumed by most patients, especially low-impact activities. Pain management should be actively addressed. High-quality studies with standardized RTS definitions are needed to evaluate the long-term impact of activity on implant survival.</div></div><div><h3>Relevance</h3><div>RTS after PFA is safe and achievable. A personalized approach is essential to optimize RTS and manage patient expectations.</div></div><div><h3>Evidence level</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100925"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of body mass index on robotic-assisted total knee arthroplasty outcomes: A retrospective cohort analysis","authors":"Waldo Gonzalez Duque ,&nbsp;Rafael Calvo Rodriguez ,&nbsp;David Figueroa Poblete ,&nbsp;Jorge Isla Villanueva ,&nbsp;Daniela Landea Caroca ,&nbsp;Camila Tapia Castillo","doi":"10.1016/j.jisako.2025.100927","DOIUrl":"10.1016/j.jisako.2025.100927","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is a growing global health concern and a known risk factor in total knee arthroplasty (TKA). With an increasing number of obese patients requiring TKA, it is essential to understand how obesity influences clinical outcomes and complication rates. The objective of this study is to investigate the impact of obesity on clinical outcomes and complications in patients undergoing robotic-assisted TKA (RA-TKA).</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 216 patients aged ≥18 years who underwent RA-TKA between 2019 and 2023, with a minimum postoperative follow-up of one year. Patients were stratified into three body mass index (BMI) categories: &lt;25, 25–29, and ≥30 ​kg/m². Demographic, intraoperative, and postoperative variables—including tourniquet use and time, implant type, hospital stay, and complications—were compared. Statistical analysis was performed (p &lt; 0.05).</div></div><div><h3>Results</h3><div>Two hundred sixteen patients (91.5% follow-up rate) were evaluated at a mean of 34 months, postoperatively. No statistically significantly difference was found among the BMI groups in terms of age, sex, use of tourniquet, hospital stay, or use of stem implants. A statistically significant difference was observed only in the group of BMI &lt;25 ​kg/m² regarding arthrofibrosis. When patients were grouped as a BMI &lt;35 vs a BMI ​≥ ​35 ​kg/m², a higher complication rate was noted in the ≥35 ​kg/m² group (18.2% versus 7.2%), though the difference was not statistically significant (p ​= ​0.09).</div></div><div><h3>Conclusions</h3><div>This study found that the difference was not statistically significant in the overall rate of postoperative complications among patients with obesity undergoing RA-TKA. However, a nonsignificant trend toward a higher complication rate was observed in patients with severe obesity (BMI ≥35 ​kg/m²). Interestingly, a statistically significant increase in arthrofibrosis was found in patients with BMI &lt;25 ​kg/m², a finding that contrasts with the current literature.</div></div><div><h3>Level of Evidence</h3><div>Level III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100927"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-month magnetic resonance imaging after anterior cruciate ligament reconstruction can identify risk factors for subsequent graft rupture and used to guide the return to sport. Results from a high-volume institution","authors":"Christian Lutz ,&nbsp;Fabio Mancino ,&nbsp;David A. Parker","doi":"10.1016/j.jisako.2025.100994","DOIUrl":"10.1016/j.jisako.2025.100994","url":null,"abstract":"<div><h3>Introduction</h3><div>Retear after anterior cruciate ligament reconstruction (ACLR) has been reported between 6% and 31% of cases, resulting in worse outcomes and increased risk of post-traumatic osteoarthritis. This study investigated whether postoperative magnetic resonance imaging (MRI) assessment, clinical outcomes, and return-to-sport test findings can help identify patients at higher risk of early graft retear.</div></div><div><h3>Methods</h3><div>Retrospective analysis of 430 patients who underwent primary ACLR using hamstring autograft between 2017 and 2022, with a minimum follow-up of 12 months. Baseline characteristics, intraoperative, and postoperative information were collected. Graft signal, tunnel widening and positioning were assessed through a 12-month MRI. Patients who experienced early graft retear were compared with a matched cohort with a ratio of 1:4. Continuous variables were compared. Logistic regression and analysis of variance were used to identify risk factors and association with retear. p values ​&lt; ​0.05 were considered significant.</div></div><div><h3>Results</h3><div>Of the 346 patients who met the inclusion/exclusion criteria, 19 experienced a graft rupture (5.4 ​%) after the 12-months follow-up. Of those, six patients were excluded due to missing postoperative 1-year MRI. Overall, 13 patients were included in the retear group and compared with 50 matched patients. The mean follow-up was 23.6 ​± ​4.2 months (range, 18–36 months). The 12-month MRI showed a greater signal-to-noise quotient (SNQ) in case of retear (2.93 vs 2.02; p ​= ​0.029). The analysis of variance showed a positive interaction between graft signal and retear (analysis of variance [ANOVA], p ​= ​0.028). Tunnel positioning was comparable between the groups, and not associated with retear. Similarly, tibial and femoral tunnel widening were comparable between the two groups and not associated with graft retear (ANOVA, p ​= ​0.733 and p ​= ​0.190). A greater proportion of patients had an anterior knee laxity &gt;2 ​mm at one year in the retear group (83.3% vs 38.8 ​%, p ​= ​0.058). However, mean laxity was comparable (2.55 ​mm vs 1.35 ​mm; p ​= ​0.189). No differences were noted for clinical scores and return-to-sport testing.</div></div><div><h3>Conclusion</h3><div>Higher graft signal on MRI at 12 months, indicating poorer graft healing, is associated with early anterior cruciate ligament retear. Resonance imaging after ACLR could be used to guide the follow-up management. Further research is required to confirm these preliminary findings.</div></div><div><h3>Level of evidence Ⅲ</h3><div>Retrospective comparative study.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"14 ","pages":"Article 100994"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intertrochanteric derotational femoral osteotomy for pathological femoral anteversion without ligamentous instability. Technical note.","authors":"Vicente Sanchis-Alfonso, Erik Montesinos-Berry","doi":"10.1016/j.jisako.2025.100924","DOIUrl":"10.1016/j.jisako.2025.100924","url":null,"abstract":"<p><p>Pathological femoral anteversion is recognized as a cause of anterior knee pain. Derotational femoral osteotomy is a promising surgical intervention for anterior knee pain patients with excessive femoral anteversion. It is indicated in disabling anterior knee pain recalcitrant to conservative treatment with femoral anteversion >25° measured according to Murphy's method. However, robust evidence for a universal cutoff is lacking. It is contraindicated in patients with pathological femoral anteversion without clinical symptoms. Moreover, it is contraindicated for cosmetic reasons. This technical note describes our surgical technique of derotational osteotomy to correct pathological femoral anteversion. Femoral anteversion is problematic because it changes the direction of the quadriceps muscle. An intertrochanteric osteotomy allows a longer bone length for the thigh muscles to adjust to a new direction. The distal fragment of the femur is externally rotated until the correction desired in the preoperative planning is achieved. Good clinical outcomes and few complications have been reported with this surgical technique.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"100924"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EDITORIAL: Celebrating the inaugural year of the global JISAKOS Excellence in Authorship Program","authors":"Nicole Simunovic ,&nbsp;Vikas Khanduja ,&nbsp;Olufemi R. Ayeni","doi":"10.1016/j.jisako.2025.100919","DOIUrl":"10.1016/j.jisako.2025.100919","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100919"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted total knee arthroplasty leads to a higher proportion of better Kujala score and global patient-reported outcomes measurements compared to conventional surgery after a minimum of two years of follow-up","authors":"Jaime Duboy ,&nbsp;Roberto Negrin ,&nbsp;Julio Soto ,&nbsp;Maximiliano Hormazabal ,&nbsp;Gaspar Rojas ,&nbsp;Nicolas Jabes ,&nbsp;Maximiliano Barahona","doi":"10.1016/j.jisako.2025.100923","DOIUrl":"10.1016/j.jisako.2025.100923","url":null,"abstract":"<div><h3>Introduction</h3><div>Total knee arthroplasty (TKA) is a widely adopted surgical intervention for individuals with severe knee osteoarthritis. The integration of robotic assistance in TKA (R-TKA) has been proposed to enhance surgical precision and patient outcomes. Specifically, R-TKA has demonstrated enhanced consistency in radiological outcomes. However, consistent improvements in clinical results remains to be proven, as existing reports are heterogeneous, necessitating further investigation. This study compares patient-reported outcome measurements (PROMs) for TKA performed with conventional (C-TKA) versus R-TKA. Specifically, it evaluates the frequency of patients achieving Patient Acceptable Symptom State (PASS), Threshold for Improved Satisfaction (TIS), and Threshold for Improved Failure (TIF) for Western Ontario and McMaster Universities Arthritis Index (WOMAC), Kujala, and Knee Injury and Osteoarthritis Outcome Score quality of life (KOOS-QoL) questionnaires.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using institutional data from 2016 to 2021, involving 149 TKA cases (41 ​R-TKA, 108 ​C-TKA) with a minimum follow-up of two years. Patients completed validated PROMs, including WOMAC, Kujala, and KOOS-QoL. Propensity score matching adjusted for variables including age, sex, surgeon, side, and patellar resurfacing. The primary outcome was the proportion of patients surpassing PASS and TIS thresholds for WOMAC pain, WOMAC function, Kujala and KOOS-QoL.</div></div><div><h3>Results</h3><div>A total of 117 patients were contacted. Patients who underwent R-TKA showed a significantly higher proportion of favorable outcomes compared to those with C-TKA. Specifically, 30% more patients in the R-TKA group surpassed the Kujala threshold (95% CI: 18%-45%; 1–β ​= ​0.97), and 29% more met all thresholds simultaneously, indicating a successful TKA (95% CI: 13%-45%; 1–β ​= ​0.84); both were associated with moderate to large effect sizes. Although differences in PASS achievement for WOMAC pain (+5%), WOMAC function (+6%), and KOOS-QoL favored R-TKA and reached statistical significance, the study lacked sufficient statistical power to confirm these findings with high confidence.</div></div><div><h3>Conclusions</h3><div>Compared to C-TKA, R-TKA achieves a significantly higher proportion of patients with Kujala scores of 70 or above, as well as a higher proportion of patients meeting all targeted PROM thresholds at the two-year follow-up. These findings underscore the potential for R-TKA to optimize outcomes.</div></div><div><h3>Level of evidence</h3><div>Clinical study, Level III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"13 ","pages":"Article 100923"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}