Journal of Knee Surgery最新文献

{"title":"Dalí Sign: Characterization and Case Series of Patellar Bony Shell Morphological Changes after Two-Stage Revision for Periprosthetic Joint Infection.","authors":"Alexandra L Hohmann, Cristian A DeSimone, Jessica H Leipman, Yale A Fillingham, Jess H Lonner","doi":"10.1055/a-2559-5268","DOIUrl":"https://doi.org/10.1055/a-2559-5268","url":null,"abstract":"<p><strong>Introduction: </strong>The fate of the patella in two-stage revision total knee arthroplasty (TKA) for periprosthetic joint infection (PJI) in which the patella is left as a bony shell is poorly described. The purpose of this case series is to describe a phenomenon we name the Dalí Sign, which is characterized by elongation and curvature of the patella around the lateral edge of the femoral component occasionally observed in patients undergoing two-stage revision without reimplantation of the patellar component.</p><p><strong>Materials: </strong>Our institutional surgical database was queried for patients who were treated with two-stage revision arthroplasty for PJI. All available sequential skyline patellar radiographs were viewed from immediately prior to first stage explantation to latest image at final outpatient follow up at our institution and assessed for the above mentioned morphological changes.</p><p><strong>Methods: </strong>Included patients underwent a two-stage revision surgery for PJI at our institution, had a patellar component removed during the first stage of their treatment which included implant explantation and insertion of temporary antibiotic spacers, did not have the patellar component reimplanted during their second stage revision surgery, and demonstrated radiographic patellar morphological changes at final follow up. Patient demographic, surgical, and outcome data were recorded.</p><p><strong>Results: </strong>Our review identified six patients meeting these criteria. Mean follow up after second stage surgery was 12 months (range, 2 to 21 months). At final follow-up, three patients were walking without pain, one patient was exercising to tolerance, one patient was walking with pain, and one was using a wheelchair or a walker for mobility.</p><p><strong>Conclusion: </strong>In this case series, we characterize the Dalí Sign, the elongation and curvature of the patellar bony shell over the femoral component after two-stage revision for PJI. Further comparative cohort studies are necessary to identify the incidence and risk factors for the development of this morphological change and to compare outcomes of patients with and without the Dalí Sign when left with a bony shell after staged revision TKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651541","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":"Risk Factors and Thresholds for Minimal Clinically Important Difference in Worsening after Unicompartmental Knee Arthroplasty.","authors":"Perry Lim, Marcos Gonzalez, Hany Bedair, Christopher M Melnic","doi":"10.1055/a-2555-1941","DOIUrl":"https://doi.org/10.1055/a-2555-1941","url":null,"abstract":"<p><strong>Background: </strong>The rising demand for unicompartmental knee arthroplasty (UKA) in the United States has led to high one-year patient satisfaction rates. However, some patients experience substantial declines in patient-reported outcome measures (PROMs) post-operatively, which we refer to as \"Minimal Clinically Importance Difference for Worsening \" (MCID-W). We sought to define MCID-W values for specific PROMs and identify risk factors associated with PROMIS Physical Function Short Form 10a (PROMIS PF-10a) declines after UKA.</p><p><strong>Methods: </strong>We conducted a retrospective study of 760 patients undergoing UKA at our institution between 2016 and 2023. Preoperative and postoperative PROMIS PF-10a, PROMIS Global Physical, and Knee injury and Osteoarthritis Outcome Score-Physical Function Short-form (KOOS-PS) scores were collected. Patients were stratified upon reaching Minimal Clinically Importance Difference for Improvement (MCID-I), MCID-W, or \"no significant change\" (score between MCID-W and MCID-I). MCID-W and MCID-I values were determined using a distribution-based method. Logistic regression was performed to identify risk factors for scoring below MCID-W.</p><p><strong>Results: </strong>We established the following MCID-I and MCID-W thresholds: PROMIS PF-10a (+3.00 and -1.64), KOOS-PS (+6.25 and -3.42), and PROMIS Global-Physical (+2.72 and -1.55). Bivariate analysis revealed differences in terms revision (P=0.02), reoperation (P=0.03), postoperative complications (P=0.002), deep venous thrombosis (DVT) (P<.001), and pneumonia (P=0.01) between cohorts. Body mass index >35 (odds ratio [OR]=2.49), postoperative complications (OR=5.09), pneumonia (OR=22.39), DVT (OR=9.27), and pre-operative PROMIS PF-10a scores (OR=1.07) were risk factors for scoring below the MCID-W threshold, whereas age > 80 (OR=2.89) and pre-operative PROMIS PF-10a scores (OR=1.05) were risk factors for failing to achieve MCID-I.</p><p><strong>Conclusion: </strong>Our study established MCID-W values for pivotal PROMs after primary UKAs. We found that 8.8% of patients scored below MCID-W, highlighting the need to improve patient selection and perioperative care in UKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606834","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":"Functional Assessment of Meniscus Extrusion, Excursion and Hoop Strain UnderClinicallyRelevantLoadedRangeofMotionConditions inMeniscus-IntactandMeniscusRoot-DeficientKneesUsingaNovelBiomechanicalModel.","authors":"Clayton W Nuelle, Ashwin Garlapaty, Will A Bezold, Joseph Anderson, James L Cook","doi":"10.1055/a-2555-1998","DOIUrl":"https://doi.org/10.1055/a-2555-1998","url":null,"abstract":"<p><p>The knee is meniscus-dependent, relying on the tissue's biomechanical properties to maintain joint health and function. Meniscus dysfunction has primarily been assessed by measuring tibiofemoral articular contact areas and pressures, which entail important limitations. Meniscus extrusion, excursion, and hoop strain are dynamic measures of meniscal function, which have potential advantages for clinically applicable biomechanical testing of meniscus. The objective of this study was to quantify meniscus extrusion, excursion, and hoop strain under clinically relevant loading and motion conditions in meniscus-intact and meniscus-deficient cadaveric knees using a novel model. Cadaveric knees (n=8) were dynamically tested through a functional range of motion under 30 N of compressive load in a robotic testing system to determine meniscus translations at full extension and 30^○, 60^○, 90^○, and 100^○ of flexion through 10 cycles. For meniscus-intact and meniscus-deficient (posterior meniscus root release) states, measurements for medial and lateral meniscus excursion, extrusion, and hoop strain were determined by calculating respective translations of fiducial tracking markers, and were compared for statistically significant differences. In the meniscus-intact state, medial and lateral meniscus extrusion, excursion, and hoop strain metrics corresponded well to previously reported measurements, suggesting that this model has translational validity for assessing functional kinematics for clinical application. For both medial and lateral menisci, posterior root release was associated with significantly more meniscus extrusion and significantly less maximum meniscus hoop strain compared to the meniscus-intact status. For meniscus excursion, medial root release showed significant differences from the intact status only at a knee flexion angle of 100^○, while lateral root release differed significantly from the intact status at 60^○ and 90^○ of knee flexion. Taken together, this study verifies that this model can effectively quantify meniscus extrusion, excursion, and hoop strain under clinically relevant loading and motion conditions in meniscus-intact and meniscus-deficient knees for use in preclinical studies aimed at assessing the severity of meniscus deficiency, as well as surgical interventions and postoperative management strategies intended to optimize meniscus preservation.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606828","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":"Correlation between anthropometric parameters and anterior cruciate ligament, hamstring tendon, and posterior horn of medial and lateral meniscus sizes.","authors":"Waleed Albishi, Sarah Aljasser, Mamdouh Almalki, Faten Almohideb, Faisal Alwahabi","doi":"10.1055/a-2555-1879","DOIUrl":"https://doi.org/10.1055/a-2555-1879","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) reconstruction is commonly performed in orthopedic surgery. Hamstring autografts are frequently used as a graft option for the ACL; however, a clear consensus on optimal graft size is lacking.</p><p><strong>Hypothesis/purpose: </strong>Here we aimed to determine the mean ACL, hamstring tendon, and posterior horn meniscal sizes in a Saudi population to determine whether correlations exist between anthropometric data and the widths of the ACL, hamstring tendons (specifically the gracilis and semitendinosus tendons), and medial and lateral meniscal posterior horns.</p><p><strong>Study design: </strong>cross-sectional study Methods: This study examined 705 knee magnetic resonance images to obtain the following data: proximal origin width, mid-fiber width, distal insertion widths and lengths (in millimeters), semitendinosus and gracilis widths (mm), and posterior horn widths of the bilateral menisci (mm). Anthropometric data included age, sex, weight, height, and body mass index.</p><p><strong>Results: </strong>The mean ± standard deviation proximal, mid-fiber, and distal ACL attachment widths were 8.46 ± 2.48, 9.98 ± 2.46, and 13.57 ± 2.75 mm, respectively. The mean ACL length was 30.89 ± 4.57 mm, while the mean semitendinosus and gracilis widths were 4.50 ± 1.05 and 3.39 mm, respectively. The mean medial and lateral meniscus posterior horn widths were 14.10 ± 2.77 and 9.32 ±1.35 mm, respectively. Height and weight were significantly positively correlated with ACL width and length (P < .010) and semitendinosus and gracilis tendon (P < .010) and posterior horn menisci (P < .010) widths.</p><p><strong>Conclusion: </strong>The mean ACL width and length, hamstring tendon (gracilis and semitendinosus) width, and posterior horn width of both menisci were positively correlated with an individual's height and weight.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606860","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":"Utilization of Smartphone Technology and Wearable Technology Following TKA.","authors":"Adam M Gordon, Awais Hussain, Michael A Mont","doi":"10.1055/a-2525-4672","DOIUrl":"10.1055/a-2525-4672","url":null,"abstract":"<p><p>The widespread adoption of smartphones and wearable technology has introduced innovative approaches in health care, particularly in postoperative rehabilitation. These technologies hold significant promise for improving recovery following lower extremity arthroplasty, especially total knee arthroplasty (TKA). Despite growing interest, the evidence on their effectiveness and long-term impact remains variable.This narrative review evaluates the utilization of smartphone applications, wearable devices, and their combined use in postoperative recovery after TKA. Key studies assessing adherence, functional outcomes, patient satisfaction, and health care utilization were analyzed to synthesize insights into their effectiveness compared to traditional rehabilitation approaches.Smartphone applications have demonstrated improvements in adherence to rehabilitation plans, pain management, and functional outcomes. For instance, interventions using text-based prompts or interactive platforms enhanced physical activity, reduced narcotic use, and improved patient-reported outcomes such as PROM adherence and range of motion (ROM). Similarly, wearable devices provided accurate feedback on activity levels and step counts, promoting early mobility and strength recovery. Combined approaches leveraging both technologies further enhanced adherence, functional recovery, and patient engagement while reducing health care utilization.The integration of smartphone and wearable technologies in TKA rehabilitation shows potential for improving recovery outcomes. While findings generally indicate noninferiority or superiority to conventional methods, limitations exist in standardization, data accuracy, and long-term benefits. Future research should focus on refining these technologies, establishing standardized guidelines, and evaluating their cost-effectiveness in diverse populations. Smartphone and wearable technologies represent safe and effective tools for enhancing postoperative outcomes in TKA patients. Their integration into clinical practice could optimize rehabilitation protocols, improve patient engagement, and potentially reduce health care costs.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053984","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":"Planning Assistance Freeware for Surgical Management of the Multiple Ligament Knee Injury: From Historical to Modern Surgical Procedures.","authors":"Maxime Guerot, Baptiste Boukebous, Lucas Chanteux, Haroun Bouhali, Marc-Antoine Rousseau, Cédric Maillot","doi":"10.1055/a-2509-3322","DOIUrl":"https://doi.org/10.1055/a-2509-3322","url":null,"abstract":"<p><p>Anatomical knowledge and identification of multiple ligament knee injuries have considerably evolved during the last decade. Consecutively, a trend for anatomical reconstruction of these injuries emerged. These procedures are challenging and require precise planning. Moreover, the planning itself is made difficult by the variety of techniques, whose descriptions are scattered throughout the literature. The objective is to reference and categorize the different ligament reconstruction techniques to provide free planning assistance software using a standardized graphic chart.The search for ligament reconstruction techniques on nine different databases produced 1,536 articles. After reviewing for relevance, the authors included the full papers of the remaining 306 articles. From the reference lists of the selected articles reviewed, 96 studies describing original techniques were retrieved. Techniques were extracted, drawn following the same graphics chart, and classified into conceptual categories.After selection, 10, 4, 28, 28, and 26 articles described anterior cruciate ligament, posterior cruciate ligament, posteromedial corner, posterolateral corner, and anterolateral corner procedures for reconstruction, respectively. Early techniques often used tenodesis while nowadays various grafts are fixed to isometric points or anatomic landmarks. An interactive tool was created. It allows the visualization of selected reconstructions on axial, frontal, and sagittal representations of the knee. Tunnel position, preferred transplant type, and fixation mode are represented. The freeware is available at: https://apps.medecine.u-paris.fr/multilig/.The techniques described for the reconstruction of an isolated ligament or corner cannot always be extrapolated for multiple ligament knee injuries treatment. Bone stock and tunnel convergence are two main concerns to consider during planning. Sometimes, it could be necessary to sacrifice a potentially biomechanically superior approach if simpler reconstructions provide equivalent knee kinematics. Surgical options are multiple and scattered throughout the literature. Our study provides an open-source and clinician-accessible research tool for multiple ligament injuries planification using a standardized graphic chart.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574403","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":"Radiological Characteristics of the Knee in Young Patients with Medial Meniscus Horizontal Tears.","authors":"Takuya Naraoka, Hikaru Soneda, Runa Hori, So Morioka, Yukihiro Matsuyama","doi":"10.1055/a-2525-4711","DOIUrl":"10.1055/a-2525-4711","url":null,"abstract":"<p><p>We aimed to assess medial meniscal (MM) healing and horizontal tear (HT) repair in the knees of young patients.We enrolled 37 knees of 35 patients (mean age: 28.0 ± 10.2 years) with isolated meniscal repair that were divided into three groups: MM HT group (HT group, <i>n</i> = 15), MM tear except for HT group (MM group, <i>n</i> = 11), and lateral meniscus (LM) tear except for discoid meniscus group (LM group, <i>n</i> = 11). The anatomical lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA), and posterior tibial slope were measured on preoperative radiographs. Magnetic resonance imaging was performed at 3, 6, and 12 months postsurgery. Clinical outcomes were evaluated using Lysholm and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 24 months postsurgery.aLDFA values were significantly lower in the HT and MM groups than in the LM group (<i>p</i> = 0.007). The MPTA was significantly lower in the HT group than in the MM and LM groups (<i>p</i> = 0.000). There were no differences in meniscal healing among the three groups at any time point after surgery (<i>p</i> = 0.376, 0.830, and 0.523, respectively). The KOOS subscale scores, symptom, pain, sports and recreation, and quality of life in the HT group were significantly lower than those in the LM group (<i>p</i> = 0.021, 0.033, 0.035, and 0.041, respectively).Young patients with MM HT have small aLDFA and MPTA values. Although the healing rate of HT postrepair was comparable to other types of MM or LM tears up to 1 year postrepair, clinical outcomes (KOOS) of repaired HTs were inferior to those of LM tears 2 years postrepair.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053982","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":"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":"https://doi.org/10.1055/a-2550-2187","url":null,"abstract":"<p><strong>Introduction: </strong>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 post-operative care.</p><p><strong>Methods: </strong>This brief narrative review discusses the foundations & 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.</p><p><strong>Conclusion: </strong>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":"2025-03-04","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":"No Difference in Postoperative Complications between Simultaneous and Staged, Bilateral Unicompartmental Knee Arthroplasty.","authors":"Enrico M Forlenza, Joseph Serino Iii, Daniel Shinn, Tad L Gerlinger, Craig J Della Valle, Denis Nam","doi":"10.1055/a-2451-1194","DOIUrl":"10.1055/a-2451-1194","url":null,"abstract":"<p><p>The optimal timing of contralateral surgery following unicompartmental knee arthroplasty (UKA) remains unknown. Therefore, the objective of this study was to examine the differences in postoperative complications in patients undergoing unilateral, simultaneous, and staged bilateral UKA.The PearlDiver administrative claims database was queried for patients undergoing UKA between 2015 and 2020. Patients undergoing unilateral UKA were matched in a 1:1 fashion with patients undergoing simultaneous bilateral UKA, staged bilateral UKA within 1 to 90 days, and staged bilateral UKA within 91 to 365 days based on age, gender, Elixhauser Comorbidity Index (ECI), obesity, diabetes, and smoking status. Univariate and multivariate analyses were performed to examine the impact of timing of bilateral procedures on 90-day postoperative complications relative to patients who underwent unilateral UKA. Outcomes were considered significant at <i>p</i> < 0.05.A total of 9,638 patients undergoing UKA were included in the final analysis, of which 5,672 (58.9%) were unilateral, 396 (4.1%) were simultaneous bilateral, 1,496 (15.5%) were staged bilateral between 1 and 90 days, and 2,074 (21.5%) were staged bilateral between 91 and 365 days. Univariate analysis identified no significant differences in complications between matched groups except for an increased incidence of wound dehiscence among patients who underwent simultaneous bilateral UKA (2.1% vs. 0.0%, <i>p</i> = 0.040) compared with unilateral UKA. However, multivariate analysis demonstrated that simultaneous or staged bilateral UKA at either time point did not increase the risk of any postoperative complication relative to unilateral surgery.Bilateral UKA can be performed either simultaneous or in a staged fashion without increasing the risk of 90-day complications relative to unilateral UKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"201-206"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510976","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 Tibial Tunnel Size Relative to the Proximal Tibia Affects the Tibial Tunnel Widening in Anatomical Anterior Cruciate Ligament Reconstruction.","authors":"Ryo Murakami, Shuji Taketomi, Ryota Yamagami, Kenichi Kono, Kohei Kawaguchi, Tomofumi Kage, Takahiro Arakawa, Takashi Kobayashi, Sakae Tanaka","doi":"10.1055/s-0044-1792021","DOIUrl":"10.1055/s-0044-1792021","url":null,"abstract":"<p><p>The impact of the bone tunnel size relative to body size on clinical results in anterior cruciate ligament (ACL) reconstruction remains unclear. This study aimed to assess the morphological alteration of the tibial tunnel aperture and relationship between the tibial tunnel size relative to the proximal tibia among the tibial tunnel widening (TW) and clinical results following ACL reconstruction. This study comprised 131 patients who had undergone anatomical ACL reconstruction utilizing bone-patellar tendon-bone autografts. The morphology and enlargement of the tibial tunnel were examined via three-dimensional computed tomography 1 week and 1 year postoperatively. The anteroposterior (AP) and mediolateral (ML) positions were determined as a percentage relative to the proximal AP and ML tibial dimensions, respectively. Clinical assessment was conducted 2 years postoperatively. The association between the primary tibial tunnel size among TW and clinical outcomes was examined. The tibial tunnel significantly migrated posterolaterally. The ML diameter significantly widened; however, the AP diameter did not exhibit widening. AP widening was associated with the AP diameter of the primary tibial tunnel (<i>r</i> = -0.482, <i>p</i> < 0.01), and ML widening correlated with the ML diameter of that tunnel (<i>r</i> = -0.478, <i>p</i> < 0.01). However, there was no significant correlation observed between the primary tibial tunnel size and clinical outcomes. The tibial tunnel migrated and enlarged laterally in the ML plane, but did not enlarge in the AP plane. The primary tibial tunnel diameter relative to the proximal tibia negatively correlated with the tibial TW in the AP and ML planes. Level of evidence: level IV.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"163-169"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576662","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}