SICOT-J最新文献

{"title":"Sequential Workflow for Integrated Biological Repair in Combined Four-Graft Knee Reconstruction.","authors":"Eliseo Javier Firman","doi":"10.1051/sicotj/2026044","DOIUrl":"https://doi.org/10.1051/sicotj/2026044","url":null,"abstract":"<p><strong>Objective: </strong>To describe a structured technical-conceptual workflow for comprehensive biological knee reconstruction, focusing on the coordinated integration of four independent allografts - femoral osteochondral, tibial osteochondral, meniscal, and anterior cruciate ligament (ACL) - performed in a single operative setting.</p><p><strong>Background: </strong>Multicompartmental failure involving bipolar osteochondral defects, meniscal deficiency, and ligamentous instability represents one of the most challenging scenarios in joint preservation surgery. Although individual reconstructive techniques are well documented, current literature lacks a widely accepted consensus regarding their simultaneous execution. In this context, three-dimensional preoperative planning and structured sequencing logic are critical for preventing tunnel convergence and preserving the biological viability of the grafts. Methodological Framework Description: A structured reconstructive strategy is proposed to optimize surgical exposure and avoid spatial conflicts and graft interference. The workflow begins with a systematic arthroscopic mapping followed by a wide arthrotomy, adhering to a \"surface restoration-to-stabilization\" logic, consisting of: (1) customized femoral osteochondral shell allograft transplantation; (2) tibial osteochondral transplantation using a cylindrical plug technique; (3) medial meniscal allograft transplantation with dovetail bone fixation; and (4) anatomic ACL reconstruction using a soft tissue tendon allograft. This specific sequencing allows stabilizing elements to be adapted to the already restored articular anatomy, minimizing tunnel convergence and protecting soft-tissue grafts from aggressive osseous surgical maneuvers.</p><p><strong>Clinical relevance: </strong>This technical-conceptual work provides a structured roadmap to support surgical decision-making in highly complex reconstructive cases. By systematizing operative sequencing and the management of technical interferences, the proposed workflow enables a reproducible biological reconstruction strategy aimed at restoring articular homeostasis in young and active patients within a single surgical procedure.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"47"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799379","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 versus mechanical alignment in robotic primary total knee arthroplasty: A meta-analysis.","authors":"Youssef Jamaleddine, Ralph Maroun, Chahine Assi, Alfred Khoury, Pascal Kouyoumdjian","doi":"10.1051/sicotj/2026061","DOIUrl":"10.1051/sicotj/2026061","url":null,"abstract":"<p><strong>Introduction: </strong>Functional alignment (FA) has emerged as a robot-enabled, patient-specific strategy in total knee arthroplasty (TKA), aiming to individualize component positioning and knee balance within predefined safety limits. However, whether robotic FA provides clinically meaningful advantages over robotic mechanical alignment (MA) remains uncertain. This meta-analysis compared robotic FA versus robotic MA in primary TKA.</p><p><strong>Methods: </strong>Medline, the Cochrane Library, and Google Scholar were searched from inception to December 29, 2025, for comparative studies evaluating FA versus MA in robotic primary TKA. Outcomes included additional soft-tissue release, reported knee motion, Forgotten Joint Score-12 (FJS-12), 1-year functional score improvement using Oxford Knee Score or converted Western Ontario and McMaster Universities Osteoarthritis Index scores, and operative duration. Continuous outcomes were pooled as mean differences (MDs), and dichotomous outcomes as odds ratios (ORs).</p><p><strong>Results: </strong>Six studies including 645 TKAs were included. MA was associated with higher odds of requiring additional soft-tissue release compared with FA (OR = 5.38; 95% CI: 2.71 to 10.69; P < 0.00001). FA showed greater early improvement in reported knee motion at ≤6 weeks (MD = -4.64°; 95% CI: -7.07 to -2.21; P = 0.0002), but this difference was no longer significant at 6 months (MD = -1.13°; 95% CI: -8.24 to 5.98; P = 0.76). FJS-12 scores were similar at 3 months but favored FA at 6 months (MD = -10.74; 95% CI: -13.65 to -7.83; P < 0.00001), although this did not reach the established threshold for clinical importance. Functional score improvement at 1 year was similar between groups. Operative time statistically favored FA, although the difference was small.</p><p><strong>Conclusion: </strong>Robotic FA was associated with fewer soft-tissue releases and greater early improvement in reported knee motion, but these early advantages did not translate into superior functional improvement by 1 year. Longer-term standardized comparative studies are required.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"50"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876181","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":"Arthroscopically occult meniscotibial instability persists despite systematic transcondylar assessment: Incidence and associated factors during ACL reconstruction.","authors":"Tsuneari Takahashi, Takumi Matsumoto","doi":"10.1051/sicotj/2026067","DOIUrl":"10.1051/sicotj/2026067","url":null,"abstract":"<p><strong>Introduction: </strong>Medial meniscus ramp lesions are recognized contributors to knee instability in anterior cruciate ligament (ACL)-injured knees. However, some knees may demonstrate functional instability at the meniscotibial attachment without visible structural disruption on arthroscopic inspection. The purpose of this study was to determine the incidence of probe-detected meniscotibial instability in knees without a visible ramp lesion on transcondylar inspection and to identify associated factors.</p><p><strong>Methods: </strong>Patients who underwent primary ACL reconstruction between January 2021 and January 2026 were retrospectively reviewed. The ramp region was evaluated using a standardized transcondylar view, followed by systematic probing. Meniscotibial instability was defined as abnormal mobility of the posterior horn of the medial meniscus at the meniscotibial attachment in the absence of visible structural disruption. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed.</p><p><strong>Results: </strong>Of 171 patients, 113 met eligibility criteria. Forty-three had visible ramp lesions, leaving 70 for analysis. Meniscotibial instability was identified in 29 of 70 patients (41.4%). Preoperative side-to-side difference (SSD) in anterior tibial translation (OR, 1.81; P = 0.0024) and reduced ramp vascularity (OR, 3.36; P = 0.047) were independently associated with instability. An SSD cutoff of 5.0 mm showed acceptable discrimination (AUC, 0.734).</p><p><strong>Conclusion: </strong>Meniscotibial instability may be present despite normal arthroscopic appearance of the ramp region and is associated with increased preoperative instability. Systematic probing is essential to identify this occult functional abnormality.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"57"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026363","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":"Reflections on SICOT-J Volume 11 (2025).","authors":"Raju Vaishya, Sébastien Lustig, Andreas F Mavrogenis, Vikas Khanduja","doi":"10.1051/sicotj/2026006","DOIUrl":"10.1051/sicotj/2026006","url":null,"abstract":"<p><p>Volume 11 (2025) of SICOT-J showcases high-quality global orthopaedic research spanning spine, trauma, arthroplasty, sports, and perioperative care. Through impactful original studies, reviews, and editorials, the volume reinforces evidence-based practice, surgical innovation, and multidisciplinary approaches to contemporary musculoskeletal challenges worldwide.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"E2"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785095","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":"Lateral approach in robotic total knee arthroplasty for valgus knees: A step-by-step technique.","authors":"Luca Andriollo, Pietro Gregori, Christos Koutserimpas, Elvire Servien, Cécile Batailler, Pascal Kouyoumdjian, Sébastien Lustig","doi":"10.1051/sicotj/2025017","DOIUrl":"10.1051/sicotj/2025017","url":null,"abstract":"<p><p>Total knee arthroplasty (TKA) in valgus knee deformities presents unique challenges, including alignment, soft tissue balance, and implant positioning. The lateral approach offers advantages over the traditional medial approach by improving direct access, patellar tracking, and soft tissue preservation. Robotic-assisted TKA enhances precision, ligament balancing, and patient-specific alignment strategies, such as functional knee positioning (FKP). This study describes a surgical technique integrating the lateral approach with robotic-assisted TKA using FKP principles. The technique is based on an image-based robotic system, ensuring accurate preoperative planning, intraoperative adjustments, and optimized prosthetic placement. Key intraoperative steps, including bone resection strategies, soft tissue balancing, and trial component evaluations, are detailed. The lateral robotic approach with FKP was found to be effective and reproducible, allowing for precise implant alignment and optimized soft tissue balance in valgus knees. This method minimizes the need for extensive lateral releases, preserves vascularity, and ensures postoperative stability. The combination of the lateral approach, robotic-assisted TKA, and FKP represents a promising strategy for valgus knee deformities. Further long-term studies are needed to validate the durability and functional benefits of this technique.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"20"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722077","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 concepts in total knee arthroplasty: Rotating hinge prostheses.","authors":"Tiffany Carol Oliver, Babar Kayani, Tianyi David Luo, Hugo Humphries, Fares Sami Haddad","doi":"10.1051/sicotj/2025010","DOIUrl":"10.1051/sicotj/2025010","url":null,"abstract":"<p><p>This narrative review evaluates the purpose and functionality of rotating hinged total knee arthroplasty (RHTKA). The main indications for an RHTKA are poor bone stock, soft tissue compromise, gross instability, and periprosthetic fractures. Studies have shown that an RHTKA may be used in both the primary and revision scenarios to improve the range of motion and functional outcomes. Radiostereometric analysis has shown that some RHTKA designs are associated with early femoral component micromotion, but this has not translated to increased failure or revision rates. Implant survivorship with a modern RHTKA is comparable to a condylar-constrained TKA at mid-term follow-up. The most common complications associated with RHTKA are aseptic loosening, periprosthetic joint infection, stiffness and periprosthetic fractures.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"18"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664970","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":"Save the Patella.","authors":"Angelo V Vasiliadis, Vasileios Giovanoulis, Dimitrios Chytas, George Noussios","doi":"10.1051/sicotj/2025004","DOIUrl":"10.1051/sicotj/2025004","url":null,"abstract":"","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"10"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469498","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":"Relationship between the location of the popliteal artery and the tibial osteotomy plane in patients with medial and lateral unicompartmental knee arthroplasty: A retrospective analysis of preoperative magnetic resonance imaging and intraoperative findings.","authors":"Tatsuya Kubo, Tsuneari Takahashi, Yuya Kimura, Takashi Ajiki, Eri Yasuda, Katsushi Takeshita","doi":"10.1051/sicotj/2024058","DOIUrl":"10.1051/sicotj/2024058","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the location of the popliteal artery (PA) is relative to the tibial osteotomy plane in patients with medial and lateral unicompartmental knee osteoarthritis (KOA) undergoing UKA.</p><p><strong>Methods: </strong>Preoperative MRI and postoperative radiographs obtained from 50 patients with unicompartmental KOA who underwent fixed-bearing UKA were analyzed. The amount of tibial resection was determined from the surgical records, and a line was drawn parallel to the tibial posterior tilt angle on the sagittal MR image to create a virtual tibial cut line. The tibial resection width measured from the anteroposterior image of the postoperative radiograph was projected onto the transverse plane containing the intersection between the virtual tibial cut line and the posterior tibial cortex, after which a line was drawn parallel to the medial or lateral intercondylar ridge. We then determined whether the PA was within an extension of the osteotomy area. The shortest distance (Distance 1) between the posterior tibial cortex and the PA within the osteotomy area was measured. In addition, the shortest distance between the line extending the osteotomy posteriorly and the PA was measured (Distance 2).</p><p><strong>Results: </strong>The medial UKA (group M) and lateral UKA (group L) group comprised 41 and 9 cases. The percentage of PA located behind the osteotomy plane was significantly higher in group L than in group M [6/9 knees (66.7%) vs. 2/41 knees (4.9%); P < 0.001]. The distance 1 was 12.6 (4.3) mm in group M and 7.9 (3.7) mm in group L (P = 0.004). The distance2 was 11.1 (4.9) mm in group M and 2.6 (3.5) mm in group L (P < 0.001).</p><p><strong>Conclusion: </strong>During lateral UKA, the PA was often located behind the tibial osteotomy plane and close to the posterior tibial cortex. Nearly 5% of medial UKAs, the artery was located behind the osteotomy plane.</p><p><strong>Level of evidence: </strong>Retrospective comparative LEVEL III study.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"1"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972731","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":"Posteromedial varus fatigue fragment (PVFF) in severe varus knee osteoarthritis phenotype: incidence, surgical implications, and management.","authors":"Vaibhav Bagaria, Anjali Tiwari","doi":"10.1051/sicotj/2025038","DOIUrl":"10.1051/sicotj/2025038","url":null,"abstract":"<p><strong>Purpose: </strong>Severe varus knee osteoarthritis (OA) alters weight-bearing mechanics, leading to progressive stress concentration on the posteromedial tibial plateau. In select cases, this results in the development of a Posteromedial Varus Fatigue Fragment (PVFF), a chronic stress-related fracture that remains ununited and influences knee stability, surgical planning, and implant selection. This study aims to evaluate the incidence, radiographic detectability, and intraoperative significance of PVFF in patients undergoing total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted of 856 consecutive TKA cases performed by a single surgeon. Preoperative radiographs, intraoperative findings, and surgical modifications were assessed to determine the incidence and implications of PVFF. Correlation with varus severity and absence of ACL was done.</p><p><strong>Results: </strong>PVFF was detected intraoperatively in 17 of 856 cases (1.99%), but only 9 (53%) were visible on pre-op imaging.\" All PVFF cases exhibited varus alignment exceeding 15° and complete ACL deficiency. Intraoperatively, fragment removal resulted in an increased medial flexion gap, impacting gap balancing and necessitating adjustments in implant selection, including the use of tibial stems or augments in select cases.</p><p><strong>Conclusion: </strong>PVFF is an underrecognized structural lesion for precision in severe varus knee OA, affecting tibial fixation, load distribution, and medial knee stability. Its presence requires careful intraoperative assessment, as fragment removal can alter gap balancing. Improved preoperative recognition and surgical planning are essential to optimize TKA outcomes in patients. Further prospective studies and biomechanical analyses are needed to better understand PVFF's long-term clinical implications and refine surgical strategies.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"42"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700031","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":"Venous thromboembolism prophylaxis after anterior cruciate ligament reconstruction: retrospective case-control study.","authors":"Hatem B Afana, Shine Ashokan, Thomas Nau","doi":"10.1051/sicotj/2025032","DOIUrl":"10.1051/sicotj/2025032","url":null,"abstract":"<p><strong>Introduction: </strong>Venous thromboembolism (VTE) is a rare but potentially serious complication following anterior cruciate ligament reconstruction (ACLR). There is no guideline for the routine use of anticoagulants post-ACLR surgery.</p><p><strong>Methods: </strong>This retrospective case-control study reviewed 199 patients who underwent ACLR between February 2020 and November 2024. Two groups were compared: Group A (n = 113) received no pharmacological prophylaxis, while Group B (n = 86) received low-molecular-weight heparin (LMWH) for 2 weeks postoperatively. The incidence of symptomatic VTE, postoperative bleeding, and related complications was evaluated.</p><p><strong>Results: </strong>No symptomatic VTE or bleeding complications were observed in either group. There was no statistically significant difference between the groups in terms of age, BMI, smoking, comorbidities, and postoperative weight bearing. There was a significant difference in surgical duration, graft type, and meniscal procedure.</p><p><strong>Discussion: </strong>Our findings support a risk-stratified approach rather than universal pharmacologic prophylaxis in ACLR patients.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"38"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650830","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}