SICOT-J最新文献

{"title":"Chondrosarcoma arising from long-standing Dysplasia Epiphysealis Hemimelica of the proximal humerus: A case report.","authors":"Nikolaos A Stavropoulos, Dimitra P Papagelopoulos, Olympia Papakonstantinou, Penelope Korkolopoulou, Eleftheria Lakiotaki, Panayiotis J Papagelopoulos","doi":"10.1051/sicotj/2025057","DOIUrl":"10.1051/sicotj/2025057","url":null,"abstract":"<p><p>Dysplasia Epiphysealis Hemimelica (DEH), or Trevor's disease, is a rare, nonhereditary skeletal disorder involving abnormal cartilaginous overgrowth of the epiphysis. To our knowledge, malignant transformation has not been previously documented. We report a unique case of chondrosarcoma arising from a DEH lesion in the proximal humerus nearly 30 years after the initial diagnosis. The patient was treated with wide resection and reconstruction using a proximal humeral replacement with a reverse-constrained total shoulder arthroplasty. This case highlights the need for long-term follow-up in patients with DEH, especially when new symptoms suggest possible malignant transformation.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"5"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114521","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":"Glucagon-like peptide-1 receptor agonists in orthopaedics.","authors":"Andreas F Mavrogenis, Pavlos Altsitzioglou, Sotirios Pililis, Athanasios D Anastasilakis, Symeon Tournis, Polyzois Makras, Theodosis Saranteas, Sebastien Lustig","doi":"10.1051/sicotj/2025067","DOIUrl":"10.1051/sicotj/2025067","url":null,"abstract":"<p><p>Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RA) help people control blood glucose and lose weight. They may also help with bone metabolism, healing fractures, keeping joints healthy, and recovering after surgery. There is growing amount of evidence of their ability to modulate the activity of osteoblasts and osteoclasts, affect inflammatory pathways, and interact with neuroprotective and psychological systems. Although the growing importance of GLP-1 receptor agonists in orthopaedics marks a major shift in how metabolic medicines affect musculoskeletal health, current knowledge is still basic and lacks information on long-term results, safety, and how well different treatments work compared to one another. This paper summarizes the existing evidence on the effects of GLP-1RA drugs on bone metabolism and healing, and discusses their role in current orthopaedics.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"E1"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366303","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":"Variations in Acetabular Offset Between the Preoperative Plan (mediCAD^®) and Postoperative Radiographic Measurements: an overlooked source of error that affects restoration of global offset after THA.","authors":"Anatole Matray, Clément Cazemajou, Tanguy Vendeuvre, Pierre Pries, Guillaume Anthony Odri, Mathieu Severyns","doi":"10.1051/sicotj/2026050","DOIUrl":"10.1051/sicotj/2026050","url":null,"abstract":"<p><strong>Introduction: </strong>Restoring the offset after THA is positively correlated with good functional outcomes and patient satisfaction. Preoperative planning is now an essential tool for optimizing this restoration. Nevertheless, recent studies have focused mainly on the femoral offset, at the expense of the acetabular offset. Our hypothesis was that the variations in global offset after THA are mainly due to variations in acetabular offset relative to its initially planned value.</p><p><strong>Methods: </strong>This retrospective study involved 104 patients who had undergone primary anterior THA with two-dimensional preoperative planning between January 2023 and November 2024. The planned preoperative radiographs and the postoperative radiographs were analyzed independently by two attending orthopeadic surgeons who measured the global, acetabular, and femoral offsets. The intra-rater and inter-rater agreement was determined. The differences between the planned implant sizes and the size actually implanted were also determined.</p><p><strong>Results: </strong>In the end, 43 patients met all the pre and postoperative radiographic criteria and were included in the analysis. There was a correlation between the variation in acetabular offset and the variations in global offset (r = 0.74, p < 0.0001) and between the variation in femoral offset and the variations in global offset (r = 0.68, p < 0.0001). Using multiple linear regression, the coefficients of regression for the variation in the acetabular offset and femoral offset were 1.00, indicating an equal contribution (50%) to variations in global offset.</p><p><strong>Conclusion: </strong>Variations in the positioning of the acetabular cup are an important factor in the variations in global offset after THA. The postoperative variations in acetabular and femoral offsets contribute equally to changes in the global offset. Clinically, this means that practitioners should focus more on implanting the acetabular component.</p><p><strong>Registration: </strong>IRB approval N° 22727513.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"46"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686353","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":"Custom 3D-printed implants for severe acetabular bone loss in revision total hip arthroplasty: A review of current advances and future directions.","authors":"Ashish Singh, Purushotam Kumar, Sudhir Shankar Mane, Himanshu Swarnkar, Kanukuntla Kalyan, Akash Chandrashekar Gundalli, Lokesh Goyal, Jithin M Vipin, Rabindra Narain Singh","doi":"10.1051/sicotj/2026062","DOIUrl":"10.1051/sicotj/2026062","url":null,"abstract":"<p><p>Massive acetabular bone loss in revision total hip arthroplasty (rTHA) presents a major reconstructive challenge, particularly in Paprosky type III defects and pelvic discontinuity. Conventional reconstructive strategies, including biologic grafting, porous metal augments, and cup-cage constructs, may not adequately address complex three-dimensional (3D) defect morphology or achieve durable fixation in severe bone loss. This narrative review summarises current reconstruction strategies, with particular emphasis on the evolution, biomechanical principles, clinical outcomes, and future directions of custom 3D-printed acetabular implants. A literature search of PubMed, Google Scholar, and Embase (via Ovid) identified relevant clinical studies, systematic reviews, and registry analyses addressing reconstruction of severe acetabular defects using custom 3D-printed acetabular implants. Current evidence demonstrates favourable short- to intermediate-term clinical and radiographic outcomes, with reported implant survivorship of 95.8% at 3-6 years and 95% at 10 years in selected series. Compared with conventional modular reconstruction, custom 3D-printed acetabular implants improve conformity to complex defects, facilitate restoration of the hip centre of rotation, and optimise implant-bone contact and fixation. Reported complications are generally of lower rates comparatively, with postoperative dislocation, periprosthetic joint infection, and sciatic nerve palsy being the most frequently described adverse events, although the available evidence remains largely limited to retrospective case series with heterogeneous implant designs and relatively short follow-up. Two institutional cases are presented as illustrative examples of CT-based planning, custom implant manufacture, and surgical application in severe Paprosky type III acetabular defects. Custom 3D-printed acetabular implants represent an important advancement when conventional biologic and modular reconstruction techniques are insufficient. Future developments in artificial intelligence-assisted planning, robotic guidance, and sensor-enabled implants may further improve implant design, surgical precision, and postoperative monitoring; however, prospective comparative studies with longer follow-up are required to establish long-term durability and comparative effectiveness.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"63"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138701","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":"Revision of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty Using the CORI^TM Imageless System: A Step-By-Step Surgical Technique.","authors":"Dan Croitor, Régis Pailhé, Alexandre Le Guen, Ali Alayane, Étienne Cavaignac, Alessandro Carrozzo","doi":"10.1051/sicotj/2026045","DOIUrl":"10.1051/sicotj/2026045","url":null,"abstract":"<p><p>Conversion of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) is technically demanding due to altered anatomy, asymmetric bone loss, and soft-tissue imbalance, often necessitating stems or augments. Robotic-assisted TKA may enhance the accuracy of bone resection and ligament balancing, potentially facilitating bone preservation in this complex setting. This article describes a step-by-step surgical technique for imageless robotic-assisted conversion of a failed medial UKA to TKA using the CORI™ system in a case of early aseptic loosening. The workflow is based on intraoperative surface mapping and dynamic kinematic assessment. The knee is initially registered as a native joint to capture global alignment and soft-tissue behavior, followed by additional reference point acquisition after implant removal to accurately quantify bone loss. This strategy enables patient-specific planning of femoral and tibial resections, real-time adjustment of component positioning, and controlled gap balancing throughout the range of motion. The principal innovation of this technique is the dual-stage imageless robotic workflow, combining pre-explant native kinematic registration with post-explant defect mapping and iterative re-planning. In the presented case, conversion was successfully achieved without the use of stems or augments. Imageless robotic-assisted UKA-to-TKA conversion using this technique appears feasible and reproducible. By combining native kinematic mapping with quantitative defect assessment, this workflow may facilitate accurate implant positioning, controlled gap balancing, and bone-preserving reconstruction in selected cases.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"65"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138680","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":"Current classification systems in slipped capital femoral epiphysis: Clinical relevance, limitations, and future directions.","authors":"Clevio Desouza, Vishnu Senthil Kumar, Aravinth Thamizholi, Karthik Loganathan, Nawin Suriya Arunachalam, Ramachandran Umapathy, Pradeep Pandian Kumaramurugan","doi":"10.1051/sicotj/2026083","DOIUrl":"10.1051/sicotj/2026083","url":null,"abstract":"<p><p>Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder and remains a significant cause of pain, gait disturbance, proximal femoral deformity, and early degenerative hip disease. Accurate classification of SCFE is essential for diagnosis, prognostication, treatment planning, and communication among orthopedic surgeons. Over the past several decades, multiple classification systems have been proposed based on symptom duration, physeal stability, radiographic severity, and deformity morphology. However, substantial variability exists regarding their reliability, prognostic value, and clinical applicability. This review provides a comprehensive overview of the currently available classification systems in SCFE, including temporal, Loder, Southwick, Wilson, epiphyseal tubercle (Maranho), MRI-based, and three-dimensional/statistical shape modeling classifications. Particular emphasis is placed on their historical evolution, clinical relevance, prognostic implications, limitations, and emerging role in modern hip preservation strategies. Among existing systems, the Loder classification remains the most clinically influential because of its strong association with avascular necrosis risk, while the Southwick classification continues to play a central role in quantifying deformity severity and guiding surgical decision-making. Emerging imaging-based and three-dimensional classifications have improved understanding of the rotational and multiplanar nature of SCFE and may facilitate earlier diagnosis, improved deformity characterization, and individualized treatment planning. Nevertheless, no single classification system comprehensively integrates physeal stability, deformity severity, vascular compromise, cartilage injury, and long-term functional prognosis. Current SCFE classification systems remain valuable tools in contemporary clinical practice; however, important limitations persist regarding reproducibility, prognostic accuracy, and integration with modern biomechanical concepts. Future classification frameworks may benefit from a multidomain approach integrating physeal stability, deformity morphology, vascular and biological status, cartilage involvement, and patient-specific prognostic factors, with prospective multicentre validation required before clinical adoption.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"74"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196405","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":"Functional positioning in robotic lateral unicompartmental knee arthroplasty: a step-by-step technique.","authors":"Luca Andriollo, Giovan Giuseppe Mazzella, Filippo Leggieri, Elvire Servien, Cécile Batailler, Sébastien Henri Michel Lustig","doi":"10.1051/sicotj/2025055","DOIUrl":"10.1051/sicotj/2025055","url":null,"abstract":"<p><p>Lateral unicompartmental knee arthroplasty (UKA) represents 1-2% of knee replacement procedures, yet offers distinct advantages including reduced surgical burden, bone stock preservation, and faster functional recovery. However, lateral UKA presents unique technical difficulties due to the surgical complexity of the lateral compartment. Recent advances in image-based robotic systems have demonstrated improved accuracy in implant positioning and promoted more individualized surgical strategies. This article presents a step-by-step surgical technique for lateral UKA using Functional Positioning (FP) principles in combination with an image-based robotic system. The technique ensures precise preoperative planning based on CT imaging, real-time intraoperative kinematic evaluation, and accurate component placement tailored to individual patient anatomy. The key steps of this surgical technique include comprehensive preoperative planning with 3D anatomical modeling, intraoperative kinematic evaluation following osteophyte removal, achieving centered femorotibial contact points throughout the full range of motion with precise lateral laxity gap boundaries, and cartilage mapping to ensure optimal component positioning and avoid overstuffing. FP addresses the characteristic posterior cartilage wear pattern of valgus knees while preserving pre-arthritic coronal alignment and avoiding varus overcorrection. This systematic approach demonstrates reproducible surgical steps that may translate into improved long-term outcomes and implant survivorship for lateral UKA procedures.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"8"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144099","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":"Accuracy and functional outcomes of robot-assisted total knee arthroplasty combined with inverse kinematic alignment: a 500-case cohort study.","authors":"Bryan Bertot, Arnaud Royet, Alban Stordeur, Frédéric Farizon, Pierre-Henri Vermorel, Rémi Philippot","doi":"10.1051/sicotj/2026043","DOIUrl":"10.1051/sicotj/2026043","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted techniques combined with inverse kinematic alignment in knee arthroplasty allow for improved intraoperative management of lower limb alignment, particularly regarding the Hip-Knee-Ankle (HKA) angle. Postoperative HKA outliers, associated with mechanical and functional complications, may be reduced. Our study aims at determining the incidence rate of HKA outliers at 12 months postoperatively in patients who underwent Robot-Assisted Total Knee Arthroplasty (RA-TKA). Secondary objectives were to evaluate functional outcomes, postoperative HKA deviation, and complication rates at 12 months.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including all RA-TKA procedures performed in our center between 2020 and 2022. The arthroplasty technique was assisted by the Stryker MAKO™ robotic system combined with inverse kinematic alignment. Patients underwent clinical follow-up for 12 months, enabling the collection of radiological, clinical, and functional data. An HKA outlier was defined as a deviation greater than 3° at 12 months compared to the target HKA obtained immediately postoperatively, measured by the Stryker MAKO™ system.</p><p><strong>Results: </strong>The cohort included 500 arthroplasties, of which 487 provided complete data. The outlier rate obtained with RA-TKA was 2.05%. The mean difference between immediate postoperative HKA (HKA-D0) and HKA at 12 months (HKA-M12) was 1.3° (SD ± 1.2°). At follow-up, mean functional scores were 214 (SD ± 31) for KSS-2011 and 82 (SD ± 14) for KOOS. Mean range of flexion was 127° (SD ± 11°). Regarding safety outcomes, 1.2% of patients experienced sepsis, and 2.3% developed joint stiffness requiring mobilization under general anesthesia.</p><p><strong>Conclusions: </strong>This large cohort study demonstrates a low incidence of HKA outliers (only 2.05%) at 12 months postoperatively. Functional scores and range of motion indicate good recovery. Although this observational and non-comparative study does not allow definitive conclusions, the findings provide encouraging insights into alignment and functional outcomes following the combination of robot-assisted surgery and inverse kinematic alignment.</p><p><strong>Level of evidence: </strong>III. Retrospective Cohort.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"44"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608343","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":"Cost reduction associated with telemedicine evaluation of low-risk orthopedic assessment: A cost-minimization analysis.","authors":"Noel Oizerovici Foni, Daniel Tavares Malheiro, Kauê Capellato Junqueira Parreira, Tarso Augusto Duenhas Accorsi, Flavio Tocci Moreira, Karen Francine Köhler, Carlos Henrique Sartorato Pedrotti, Nelson Wolosker","doi":"10.1051/sicotj/2026039","DOIUrl":"10.1051/sicotj/2026039","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the growing adoption of teleorthopedics, predominantly targeting low-complexity cases, the cost-minimization potential of this approach remains insufficiently characterized.</p><p><strong>Methods: </strong>The study employed a cost-minimization analysis to compare telemedicine triage against conventional in-person care for orthopedic patients in a private hospital in São Paulo, Brazil. The analysis focused on cost as the primary outcome, assuming clinical equivalence between interventions. The perspective was hospital-based, considering operational expenses in the emergency department. Data were derived from historical cost records using absorption costing. A decision tree model was developed using TreeAge Pro 2024, and a sensitivity analysis was conducted to evaluate cost variations. Results adhered to CHEERS guidelines and ISPOR economic reporting standards.</p><p><strong>Results: </strong>The economic analysis revealed an average cost reduction of 48% (US$ 130.00) associated with teleorthopedics, with sensitivity analysis indicating potential 22 savings ranging from 25% (US$ 72.00) to 54% (US$ 146.00). The financial benefit was most pronounced in clinical pathways without diagnostic testing, with a 0.78 probability of cost savings compared to standard care. The consultation duration and telemedicine operational costs are the most influential factors in the cost-benefit outcome.</p><p><strong>Conclusion: </strong>Teleorthopedics demonstrates substantial cost-saving potential, particularly in scenarios without diagnostic testing. Consultation duration and operational costs emerge as key economic drivers.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"43"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13405415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608329","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":"Single-stage total knee arthroplasty revision with extensor mechanism allograft: surgical technique.","authors":"Yasmine Salese, Gerald Delfosse, Cécile Batailler, Elvire Servien, Sébastien Lustig","doi":"10.1051/sicotj/2026014","DOIUrl":"10.1051/sicotj/2026014","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic rupture of the extensor mechanism is a serious complication that could occur in the context of revision total knee arthroplasty (TKA). Performing combined extensor mechanism allograft reconstruction and revision TKA as a single-stage procedure requires precise surgical technique.</p><p><strong>Technique: </strong>Allograft size and quality were assessed preoperatively. A tibial tubercle osteotomy (TTO) was performed prior to revision TKA. After implantation of the definitive prosthesis, the TTO was fixed to the tibia using screws. The quadriceps tendon was sutured to the allograft using the Pulvertaft weave technique with the knee in full extension. Native patellar retinacula and prepatellar fascia were preserved to optimize graft coverage. Postoperatively, patients were immobilized in full extension for three months before starting progressive mobilization.</p><p><strong>Results: </strong>From January 2017 to April 2024, 20 patients underwent a single-stage revision TKA with total extensor mechanism allograft and were followed for a minimum of one year. Range of motion was recovered at follow-up. Five patients (25%) had failures attributed to the allograft.</p><p><strong>Conclusion: </strong>Single-stage TKA revision combined with extensor mechanism allograft, in the context of multiply operated knees, requires meticulous stepwise execution, including secure tibial fixation, precise graft tensioning, and preservation of native soft tissue coverage, to optimize outcomes in this high-risk setting.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"26"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934431","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}