Journal of Knee Surgery最新文献

{"title":"Smart Knee Implants and Functional Outcome for Total Knee Arthroplasty.","authors":"Adam M Gordon, Lohith Vatti, Michael A Mont","doi":"10.1055/a-2550-2187","DOIUrl":"10.1055/a-2550-2187","url":null,"abstract":"<p><p>Smart knee implants integrate advanced sensor-based technologies, forming a unique technology-embedded total knee arthroplasty (TKA) implant. Such implants introduce the ability to capture new elements of patient-related data for use in the context of recovery in real time including subjective reported outcomes and objective outcomes related to range of motion, and gait parameters. This technology allows for real-time data capture and patient-specific insights, creating opportunities to optimize postoperative care.This brief narrative review discusses the foundations and origin of technology-embedded implants, beginning with research-related roots relating to the derivation of fundamental knee joint force measurements. Analyzing the current market of implants, the present review investigates the technological capacities of modern designs including form and function. Further discussed is an evaluation of smart knee implant effectiveness, focusing on its impact on recovery outcomes such as patient-reported outcome measures (PROMs), functional improvement, gait patterns, and patient adherence/satisfaction.Smart implants represent a significant technological advancement in personalized care, leveraging real-time data including joint motion, alignment, and patient motion to assist surgeons in optimizing rehabilitation protocols. These implants provide insights into recovery progression postoperatively, with the potential for early identification of at-risk individuals. Preliminary studies demonstrate favorable patient outcomes and satisfaction, although further research is necessary to establish the long-term benefits and efficacy of smart knee implants.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Varus Producing Distal Femur Osteotomy Alters Radiographic Measurements Related to Patellofemoral Instability: A Cadaver Study.","authors":"Elizabeth C Bond, Grant Cochran, Clark H Bulleit, Emily Poehlein, Cynthia L Green, Jocelyn R Wittstein","doi":"10.1055/a-2542-2639","DOIUrl":"10.1055/a-2542-2639","url":null,"abstract":"<p><p>Varus-producing distal femoral osteotomy (DFO) is an established procedure to correct genu valgum in patients with osteoarthritis and gait abnormalities. DFO has also been proposed for the treatment of patellar instability in patients with valgus alignment. However, it is not known how DFO affects parameters associated with patellar instability. This study evaluated radiographic changes after DFO with variable degrees of correction on six cadaveric knees, with the hypothesis that improving mechanical alignment would improve radiographic parameters related to patellar instability. Controlled laboratory is the study design. Six lower-limb cadaveric specimens were obtained after approval by the Institutional Review Board. A lateral opening wedge DFO was performed on each specimen with correction blocks of 6, 10, and 14 mm. The mechanical axis, tibiofemoral angle (mTFA), distal femoral angle (mDFA), Caton Deschamps index (CDI), insall salvati index (ISI), tibial tubercle to trochlear groove distance (TT-TG), and patellofemoral congruence angle (PFCA) were measured on computed tomography (CT) scans at baseline and after each correction block. At baseline, a mean varus alignment of the limbs was observed (mTFA: 2.7 ± 2.8 degrees, mDFA: 87.6 ± 1.0 degrees). The baseline patellar height was normal (CDI: 0.9 ± 0.2, ISI: 1.0 ± 0.1). Statistically significant decreases in mechanical axis and TT-TG distance and increases in mDFA and mFTA were found with increasing block size. The TT-TG distance was decreased by -1.6 mm (95% confidence interval [CI]: -2.27 to -0.86), -3.8 mm (95% CI: -4.8 to -2.8), and -4.0 mm (95% CI: -5.4 to -2.7) with a 6, 10, and 14 mm block, respectively. No differences were observed in patellar height when measured with CDI or ISI after any block size. In a cadaveric model, DFO significantly affects the mechanical axis and TT-TG distance. Specifically, this study found a mean decrease in TT-TG of -3.8 mm when performing a 10 mm opening wedge osteotomy. No changes in patellar height were observed.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Knee Phenotypes Based on Coronal Plane Alignment of the Knee on Intraoperative Soft Tissue Balance and Clinical Outcomes: Comparison between Kinematically and Mechanically Aligned Total Knee Arthroplasty.","authors":"Shotaro Tachibana, Tomoyuki Matsumoto, Naoki Nakano, Masanori Tsubosaka, Tomoyuki Kamenaga, Yuichi Kuroda, Shinya Hayashi, Ryosuke Kuroda","doi":"10.1055/a-2542-2583","DOIUrl":"10.1055/a-2542-2583","url":null,"abstract":"<p><p>This study examined the impact of preoperative coronal plane alignment of the knee (CPAK) classification on intraoperative soft tissue balance and postoperative clinical outcomes in patients undergoing modified kinematically aligned (mKA) and mechanically aligned (MA) total knee arthroplasty (TKA). A total of 90 knees treated with mKA-TKA and 63 knees treated with MA-TKA were classified based on CPAK. After adjusting for confounding factors, intraoperative soft tissue balance, including varus/valgus balance and joint component gap, range of motion (ROM), and the 2011 Knee Society score (KSS), were compared 1 year postoperatively using one-way ANOVA. The analysis included 69 knees classified as type I and 18 type II in the mKA group, and 52 type I and 11 type II in the MA group. Varus balance at 30 and 60 degrees flexion was significantly larger in mKA type I and MA type I compared to mKA type II (<i>p</i> < 0.001, 0.005, <0.001, 0.008). At 90 degrees, mKA type I showed a larger varus balance than both MA type I and mKA type II (<i>p</i> = 0.008, 0.002), while at 120 degrees, mKA type I demonstrated a larger varus balance than MA type I (<i>p</i> < 0.001). The improved ROM in mKA type I was greater than in MA type I (<i>p</i> = 0.04). Improvement in the objective indicator of the 2011 KSS was better in mKA type I than in mKA type II, and patient satisfaction was significantly better in mKA type I compared to both mKA type II and MA type I (<i>p</i> = 0.01, <0.001, 0.03). mKA type I preserved lateral laxity in mid- and deep flexion compared to both mKA type II and MA type I, potentially contributing to improved ROM and clinical outcomes.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bedside-to-Bench-to-Bedside Journey to Advance Osteochondral Allograft Transplantation towards Biologic Joint Restoration.","authors":"James L Cook, James P Stannard, Aaron M Stoker, Kylee Rucinski, Brett D Crist, Cristi R Cook, Cory Crecelius, Chantelle C Bozynski, Keiichi Kuroki, Lisa A Royse, Renee Stucky, Clark T Hung, Matthew J Smith, Kyle M Schweser, Clayton W Nuelle, Steven DeFroda","doi":"10.1055/a-2506-2675","DOIUrl":"10.1055/a-2506-2675","url":null,"abstract":"<p><p>More than 70 million adults in the United States are impacted by osteoarthritis (OA). Symptomatic articular cartilage loss that progresses to debilitating OA is being diagnosed more frequently and earlier in life, such that a growing number of active patients are faced with life-altering health care decisions at increasingly younger ages. Joint replacement surgeries, in the form of various artificial arthroplasties, are reliable operations, especially for older (≥65 years), more sedentary patients with end-stage OA, but have major limitations for younger, more active patients. For younger adults and those who wish to remain highly active, artificial arthroplasties are associated with significantly higher levels of pain, complications, morbidity, dysfunction, and likelihood of revision. Unfortunately, non-surgical management strategies and surgical treatment options other than joint replacement are often not indicated and have not proven to be consistently successful for this large and growing population of patients. As such, these patients are often relegated to postpone surgery, take medications including opioids, profoundly alter their lifestyle, and live with pain and disability until artificial arthroplasty is more likely to meet their functional demands without high risk for early revision. As such, our research team set out to develop, test, and validate biologic joint restoration strategies that could provide consistently successful options for young and active patients with joint disorders who were not considered ideal candidates for artificial arthroplasty. In pursuit of this goal, we implemented a targeted bedside-to-bench-to-bedside translational approach to hypothesis-driven studies designed to address this major unmet need in orthopaedics by identifying and overcoming key clinical limitations and obstacles faced by health care teams and patients in realizing optimal outcomes after biologic joint restoration. The objective of this article is to condense more than two decades of rigorous patient-centered research aimed at optimizing osteochondral and meniscus allograft transplantation toward more consistently successful management of complex joint problems in young and active patients.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"256-271"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Adaptations of the Anterolateral Complex of the Knee and Associated Tissues: A Comparative Anatomical and Histological Analysis of Knees With and Without an Anterolateral Ligament.","authors":"Charles R Marchese, Benjamin Pautler, Makayla M Swancutt, Bryan G Beutel","doi":"10.1055/s-0044-1801749","DOIUrl":"10.1055/s-0044-1801749","url":null,"abstract":"<p><p>The anterolateral ligament (ALL) is considered a secondary stabilizer of internal rotation and, due to proximity to the lateral collateral ligament (LCL), it may contribute to anterolateral rotatory stability. This study characterized the anatomy of the ALL and associated tissues of the anterolateral complex (ALC) to determine if structural and histological compensatory adaptations exist in patients without an ALL. Forty-nine cadaveric knees were dissected from distal-to-proximal using established landmarks with the aid of internal rotation stress to localize the ALL (if present), LCL, iliotibial band (ITB), and anterolateral capsule. The width and thickness of ALL and LCL were measured with digital calipers at the origin, middle, and insertion, and cross-sectional areas were calculated. ALL and LCL length and ITB thickness were also obtained. Samples of each tissue were stained with hematoxylin and eosin and picrosirius red, and histological images were evaluated with ImageJ to quantify collagen density (mean gray value [mgv]) and quantity (percent coverage). Size measurements and collagen characteristics were compared between ALL-present and ALL-deficient knees. The ALL was identified in 63% of knees with mean cross-sectional areas of 8.9, 5.8, and 9.7 mm² at the origin, middle, and insertion, respectively. Mean collagen density of the ALL was 106.9 mgv on a scale of 0 (black) to 255 (white), and overall collagen quantity was 40.3%. Proximal LCL width (<i>p</i> = 0.04), distal LCL thickness (<i>p</i> = 0.03), and cross-sectional area (<i>p</i> = 0.01), and ITB thickness (<i>p</i> = 0.02) were significantly greater in ALL-deficient knees. A significantly higher collagen density was found within the LCL (<i>p</i> = 0.04), and higher overall quantity of collagen within the LCL (<i>p</i> < 0.01) and ITB (<i>p</i> < 0.01), of ALL-deficient knees. Gross anatomical and histological alterations exist in knees without an ALL compared with those with an ALL. These may reflect adaptations in the ALC and LCL that are present to compensate for the absence of the anterolateral rotatory stability afforded by the ALL.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"237-244"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Size-Up, Size-Down: Accuracy of Component Sizing with Computerized Tomography and Robotic-Assisted Total Knee Arthroplasty.","authors":"James P Henry, Brienne Paradis, Aleksandra Qilleri, Nadia Baichoo, Keith R Reinhardt, James D Slover, Jonathan R Danoff, James A Germano","doi":"10.1055/s-0044-1800976","DOIUrl":"10.1055/s-0044-1800976","url":null,"abstract":"<p><p>Templating prior to total knee arthroplasty (TKA) can help to improve surgical efficiency and potentially improve alignment and outcomes. The purpose of this article is to evaluate the ability of computed tomography (CT)-based preoperative templating to accurately predict implant sizes. A total of 724 Stryker MAKO robotic-assisted TKA cases were retrospectively evaluated from a prospectively collected database between January 2020 and October 2023. Cases were performed by one of three adult reconstruction fellowship-trained orthopaedic surgeons from a health system that includes an academic level one trauma center, an ambulatory surgery center, and a community hospital. Out of the 724 cases, 391 were preoperatively templated independently by the surgeon and the company representative (MAKO Product Specialist [MPS]). The remaining 333 cases were only templated prior to incision by the MPS. Final implant sizes of the tibial and femoral components were compared to preoperative templates. The MPS was able to preoperatively predict the final tibial and femoral implants within one size in 97.2 and 97.8% of cases, respectively. A surgeon and MPS combined preoperative templating increased accuracy to predict the final tibial and femoral implants within one size in 98.9 and 99.5% of cases, respectively. Height and weight were positively correlated with the final implant size (<i>p</i> < 0.001). Non-surgeons can reliably predict implanted components in CT-based preoperative templating in the majority of cases, which is further enhanced by surgeon review and adjustments. In no cases in our series were the final size components implanted greater than two sizes larger or smaller. Our findings suggest that there is opportunity to avoid waste by processing fewer trial implants and transporting fewer components. This would likely decrease overall case cost and improve efficiency in the operating room. Level of evidence: III (retrospective cohort).</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"217-223"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 10-Year Outcomes of Single- versus Double-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review.","authors":"Yang Ge, Ning Fan, Fangda Si, Lei Zang","doi":"10.1055/s-0044-1801756","DOIUrl":"10.1055/s-0044-1801756","url":null,"abstract":"<p><p>Single-bundle (SB) and double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) have been compared for years, and long-term outcomes of the two techniques remain inconclusive. We compared the 10-year outcomes of SB and DB reconstruction, in terms of subjective scores, knee stability, graft failure, and osteoarthritis (OA). We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for relevant studies, without restrictions on study design, language, or publication date. The risk of bias and methodological quality were assessed using the Cochrane risk of bias tools (RoB 2 and ROBINS-I) and the Modified Coleman Methodology Score (MCMS), respectively. Reconstructions scoring at least 8 on the Anatomic ACLR Scoring Checklist (AARSC) were considered anatomic. The results were narratively summarized and graphically represented using tables and forest plots. Our search included six studies (two randomized control trials [RCTs] and four cohort studies [CSs]), comprising 222 SB and 214 DB reconstruction patients, with an average follow-up of 11.4 years. Of these, four studies achieved a methodological rating of \"good\" or above. Bias risk was evaluated as \"some concerns\" in the RCTs and \"serious\" in the CSs. Six, four, four, and two studies reported on subjective scores, knee stability, graft failure, and OA, respectively. Except for one study that reported a higher Lysholm score (<i>p</i> = 0.007) in the DB group, no group differences in subjective scores were identified. According to one study, the DB group performed better on the Lachman test (<i>p</i> = 0.02) and the KT-2000 arthrometer (<i>p</i> = 0.024 and 0.034 for pulling and back pushing, respectively). Three studies revealed higher negative rates of the pivot shift test in the DB group. The incidence of graft failure and OA were not statistically significant between the SB and DB groups. The existing evidence does not conclusively determine whether DB reconstruction provides long-term advantages over SB reconstruction. Future research with larger sample sizes and higher levels of evidence is warranted.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"245-255"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Cruciate Ligament Revision Surgery: Outcomes, Failure Rates, and Complications: A Systematic Review of the Literature.","authors":"Riccardo D'Ambrosi, Alessandro Carrozzo, Fabrizio Di Feo, Edna Skopljak, Srinivas B S Kambhampati, Manish Attri, Amit Meena","doi":"10.1055/a-2542-2417","DOIUrl":"10.1055/a-2542-2417","url":null,"abstract":"<p><p>To synthesize and qualitatively assess the currently available evidence in the literature regarding the revision of posterior cruciate ligament (PCL) reconstruction. A systematic review was conducted on the basis of the preferred reporting items for systematic reviews and meta-analyses guidelines. The outcome data extracted from the studies were the Lysholm score, Orthopadische Arbeitsgruppe Knie (OAK) scoring system, KT-2000, International Knee Documentation Committee (IKDC) subjective and objective, radiological changes, rate of return to sports, complications, and failures and/or revision surgeries. The cohort consisted of 54 patients (42 [77.8%] men and 12 [22.2%] women), with a mean age of 33.14 ± 3.67 years (range: 17-48 years). The mean postoperative follow-up was 71.8 ± 45.32 months, whereas the mean time from primary surgery to revision was 41.7 ± 4.5 months. All studies reported a clinical improvement from preoperative to final follow-up in terms of the Lysholm, OAK, KT-2000, and IKDC scores (<i>p</i> < 0.05). Posterior displacement was significantly improved in all studies, demonstrating the stability of the knee. The mean posterior displacement ranged from a preoperative value of 10.68 ± 0.7 mm to a final value of 2.7 ± 0.2 mm (<i>p</i> < 0.05). A total of two (3.7%) failures were reported, and there were also eight (14.8%) revision surgeries. Studies on PCL reconstruction revisions have shown satisfactory clinical outcomes and a high level of knee stability, with minimal risk of new reruptures. However, the rate of returning to preinjury sports activity is relatively low. Whenever possible, it is recommended to perform the ligament revision in a single stage. The level of evidence is a systematic review of level IV.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Patient Monitoring after TKA-What Surgeons Need to Know.","authors":"Kevin C Chang, John P Stelmach, Giles R Scuderi","doi":"10.1055/a-2545-5121","DOIUrl":"10.1055/a-2545-5121","url":null,"abstract":"<p><p>Multiple new technologies have been introduced in recent years to allow for remote patient monitoring (RPM) after total knee arthroplasty. These tools allow for the recording and transmission of various types of data from the patient to the surgeon throughout a recovery course without necessitating an in-person office visit.RPM has the ability to improve patient outcomes and experience throughout the rehabilitation period by providing much more data on patient progress than has been available in the past. However, these technologies are available in many forms, and different formats provide different types of data that may be of variable utility depending on surgeon preference and training. In this article, we will review different forms of RPM, benefits associated with each, and recommendations for incorporating RPM into a knee arthroplasty practice.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Medial Meniscus Posterior Root Tears with Proximal Tibial Morphology and Knee Osteoarthritis.","authors":"Eren Çamur, Semra Duran","doi":"10.1055/a-2525-4565","DOIUrl":"https://doi.org/10.1055/a-2525-4565","url":null,"abstract":"<p><p>The meniscus is vital to knee function. Medial meniscus posterior root tear (MMPRT) causes a loss of hoop tension. This, in turn, reduces the meniscus's ability to transmit load. Thus, the higher pressure on the weight-bearing surface speeds up joint degeneration. proximal tibial morphology (PTM) describes the geometric structure of tibia near the knee joint and tibial plateau. Medial posterior tibial slope angle (MPTSA) has the most significant impact on knee biomechanics among PTM measurements. This study aims to investigate the relationship between PTM and MMPRT, and evaluate the association between medial meniscal extrusion amount (MMEA) and osteoarthritis (OA) in patients with MMPRT.This retrospective study analyzed knee magnetic resonance imaging (MRI) of 100 patients with MMPRT and 100 age, gender, side-matched controls. MPTSA, mediolateral length (MLL), medial anteroposterior width (MAW), and lateral anteroposterior width (LAW) were used to evaluate PTM. MMEA and tear gap (TG) correlation and their relationship with knee OA severity was assessed.MPTSA was significantly higher in MMPRT group compared with controls (<i>p</i> < 0.001). Moderate positive correlation was found between MMEA and OA severity (<i>R</i> ²= 0.445, <i>p</i> < 0.001). Cartilage loss was observed when MMEA exceeded 4 mm (sensitivity: 80.68%; specificity: 83.33%). MMEA increased by 1.10 mm for each 1 mm increase in TG.This groundbreaking study reveals that steeper medial tibial plateau is a significant risk factor for MMPRT. Strikingly, MMEA exceeding 4 mm serves as a critical threshold for cartilage loss which is the first finding of OA, potentially revolutionizing treatment decisions. These findings not only enhance our understanding of MMPRT pathomechanics but also provide crucial insights for early intervention strategies, potentially altering the course of OA progression in patients with MMPRT.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}