Journal of Knee Surgery最新文献

{"title":"Revision Total Knee Arthroplasty for Arthrofibrosis.","authors":"Rolanda Willacy, Giles R Scuderi","doi":"10.1055/a-2778-9096","DOIUrl":"10.1055/a-2778-9096","url":null,"abstract":"<p><strong>Abstract: </strong>Arthrofibrosis is a common issue that can occur after a primary total knee arthroplasty (TKA) and is a significant cause of patient dissatisfaction. As the annual incidence of TKA in the United States rises, the prevalence of arthrofibrosis will rise. The prevalence of this outcome has been reported between 1.3 and 5.3%. The range of values is attributed to the varying quantitative thresholds of flexion and/or extension loss used to define arthrofibrosis. This causes a significant burden on the healthcare system, with a reported 27.5% of the 90-day readmissions after TKA due to arthrofibrosis. This can lead to debilitating results for the affected patients with pain, abnormal gait, fatigue, and difficulty rising from the seated position. The definition of stiffness has changed over the years. This underscores the increasing expectations that both surgeons and patients have for total knee replacements. Management of arthrofibrosis includes both nonoperative and operative modalities. The treatment algorithm includes physical therapy and manipulation under anesthesia (MUA). Physical therapy is most used, while revision arthroplasty is typically reserved as a last resort.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"423-427"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087682","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":"Return to Sport Following ACL Repair: A Systematic Review.","authors":"Cooper Williams, Antonio Da Costa, Aghdas Movassaghi, Het Chavda, Vani Sabesan","doi":"10.1055/a-2779-0367","DOIUrl":"10.1055/a-2779-0367","url":null,"abstract":"<p><strong>Abstract: </strong>Anterior cruciate ligament (ACL) injuries are among the most common sports-related knee injuries, affecting athletes across varying levels of competition. ACL repair procedures have become a popular treatment option to repair these lesions. There is a need for a comprehensive analysis of recent studies among a growing body of literature to better understand return to sport (RTS), return to previous level (RPL), and timing of RTS following these procedures. A systematic review was performed using the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A literature search of PubMed, Embase, Scopus, and SPORTDiscus databases was performed on October 11, 2024. Two independent reviewers screened 2,098 articles. The inclusion criteria included studies from 2000 to the present, a minimum of 12-month follow-up, level of evidence (LOE) I to IV, English language, and reported outcomes after ACL repair procedures with RTS data. Data were stratified by ACL repair technique for subgroup analysis. RTS, RPL, and RTS timing were reported as ranges to reflect study variability. The 16 studies included 614 athletes with RTS rates ranging from 36% to 100%. Seven studies report RPL encompassing 342 athletes with RPL rates ranging from 60% to 81%. The average time for athletes to RTS ranged from 5.9 to 11.9 months. ACL repair with bone marrow stimulation achieved RTS rates ranging from 78% to 92%. Primary repair techniques demonstrated RTS rates from 67% to 100%, while primary repair with internal brace techniques demonstrated RTS rates ranging from 36% to 100%. RTS rates following the Bridge-Enhanced ACL Repair (BEAR) technique were only reported in one study, and reported an RTS rate at 88%. The majority of patients undergoing ACL repair RTS, with a majority also returning to preinjury levels between 4 and 11.9 months postsurgery. ACL repair techniques are a viable treatment option in the correct patient population.</p><p><strong>Abstract: </strong>LOE is IV; systematic review of level IV studies.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"447-454"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844434","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":"Effect of Cyanoacrylate Skin Adhesive on Outcomes Following Total Knee Arthroplasty: A Prospective Evaluation.","authors":"Gabriel Furey, Juan D Lizcano, Cordero Mccall, Matthew Austin, Chad A Krueger, James J Purtill","doi":"10.1055/a-2796-8586","DOIUrl":"10.1055/a-2796-8586","url":null,"abstract":"<p><strong>Abstract: </strong>Achieving proper skin closure after total knee arthroplasty (TKA) is crucial for minimizing complications, as the surrounding skin is under significant tension during the early postoperative period. Cyanoacrylate, or skin adhesive, supplements subcuticular suture closure, providing a secure, watertight seal while lowering infection risk. This study compared wound healing, complications, and patient-reported outcomes between suture closure and suture plus adhesive. A total of 167 patients undergoing primary TKA were enrolled in a prospective single-blinded protocol change study at a single institution from August 2023 to September 2024. Patients had their wound closed with subcuticular 3-0 Monocryl suture (<i>n</i> = 69) or suture plus cyanoacrylate adhesive (S + C) (<i>n</i> = 98), alternating techniques every 3 months. Scar healing was assessed through photographic review at 1 month, evaluating scabbing and scar length. Wound complications, stiffness, and readmission rates were recorded. Patient satisfaction was measured at 6 months using the Patient and Observer Scar Assessment Scale (POSAS) score. Bivariate analyses evaluated differences between groups. Wound complications occurred at a similar rate between suture (11.6%) and S + C (14.3%; <i>p</i> = 0.784). Stiffness was reported in 6.6% of patients (8.7% suture vs. 5.1% S + C; <i>p</i> = 0.365). A 90-day readmission occurred in 3.6% (4.4% suture vs. 3.1% S + C; <i>p</i> = 0.692). Scar healing assessments showed 19.1% of patients had more than two scabs, with a higher frequency in S + C (24.2%) than sutures (12.5%; <i>p</i> = 0.193). The mean scar length was slightly longer in S + C (15.0 vs. 14.5 cm; <i>p</i> = 0.148). No cosmetic differences were noted between groups according to the mean POSAS score (5.0 ± 4.18 sutures vs. 5.1 ± 5.57 S + C; <i>p</i> = 0.641). Both sutures and cyanoacrylate adhesive demonstrated comparable clinical and patient-reported outcomes following TKA. The cyanoacrylate adhesive group had a slightly higher rate of minor wound healing concerns. Both closure methods are viable options, and the choice of technique can be left to the surgeon.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"497-502"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132444","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":"How Successful are Meniscus Repair All-Inside Implants during Deployment?","authors":"Emma L Flanigan, Sonu Bae, Tyler Barker, David C Flanigan","doi":"10.1055/a-2886-8226","DOIUrl":"10.1055/a-2886-8226","url":null,"abstract":"<p><strong>Abstract: </strong>The purpose of this study was to determine the percentage of implants successfully deployed during arthroscopic all-inside meniscal repair. A data query of meniscus repair (Current Procedural Terminology [CPT] codes: 29882 and 29883) procedures was performed at a single institution. The query was limited to include procedures performed between June 1, 2020, and June 1, 2023. Multiple different manufacturer implants were used by five sports medicine fellowship-trained orthopaedic surgeons. The number of implants successfully used and the number of implants wasted due to intraoperative failure during meniscal repair were found on EPIC and documented for each procedure. The success rate of meniscal implants was determined by dividing the number of implants wasted by the total number of implants used. The query identified 1,026 patients who underwent meniscus repair. From this cohort, 3,867 total meniscal implants were utilized for an average of 3.77 implants per case. Overall, all-inside meniscus repair was found to have a low implant failure or waste rate (1.03% [<i>n</i> = 40]). The highest failure rates were found with JuggerStitch Curved (9.38%), NOVOSTITCH Cartridge 0 Suture (2.44%), and TRUESPAN 12 Degrees (2.11%) implants. The most important finding was that the overall failure rate of meniscal implants is low. Implants with higher waste rates should be addressed by the industry and considered by surgeons when selecting surgical implants. These preliminary findings establish the necessity to further examine the implant failure rate and the associated costs of meniscus repair.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212942","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":"Age and Racial Disparities in Manipulation Rates Following Total Knee Arthroplasty: An 11-Year Review.","authors":"Sean Rodriguez, Ethan J Mickelson, Michael M Decker, John C Neilson, Ryan D Conrardy, Kai Yang, Dylan Wiese, John F Nettrour","doi":"10.1055/a-2886-7765","DOIUrl":"https://doi.org/10.1055/a-2886-7765","url":null,"abstract":"<p><strong>Abstract: </strong>Manipulation under anesthesia (MUA) is a recognized intervention for early postoperative stiffness following total knee arthroplasty (TKA). Although a restricted preoperative range of motion is a known risk factor for postoperative stiffness, the impact of many patient-related factors remains unclear. To our knowledge, no previous investigations have directly evaluated the effect of employment status on MUA incidence. Similarly, the impact of marital status/social support and the presence of language barriers remains incompletely assessed. The primary aim of this investigation was to evaluate how such patient-related parameters may impact MUA incidence following primary TKA. We performed a retrospective review of a prospectively gathered multicenter institutional database from July 1, 2012, through December 3, 2023, comprising cases from 23 surgeons at seven surgical sites. Patients undergoing a primary TKA with subsequent MUA within 16 weeks of the index procedure were included. Demographic variables, employment and marital status, primary language, and Area Deprivation Index (ADI) were collected. Variances in MUA frequency were then identified using two-sample <i>t</i>-tests for continuous data and Pearson's chi-square tests for categorical data. To model MUA risk and eliminate potential confounding, multivariate and matched case-control logistic regression analyses were performed. Statistical significance was defined as <i>p</i> < 0.05. Among 6,110 primary TKA patients, 265 (4.3%) underwent MUA within 16 weeks. The MUA cohort was significantly younger than the non-MUA cohort (median age: 67 years vs. 73 years, <i>p</i> < 0.001). Self-identification as Black or African American was associated with an increased incidence of MUA (10.3% vs. 4.3% overall, <i>p</i> < 0.001). Gender, marital status, employment status (except \"disabled\"), other racial designations, primary language, and ADI did not significantly impact MUA incidence. Younger age and Black/African American race were independently associated with significantly higher rates of MUA following TKA. Further investigation is warranted. These results may help guide physician and patient postoperative expectations and support resource allocation to promote successful outcomes for all patients undergoing knee replacement.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279423","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":"Factors affecting Union Rates following Fixation of Osteochondritis Dissecans of the Knees: A Systematic Review and Meta-Analysis.","authors":"Si Heng Sharon Tan, Chen Xi Kasia Chua, Wilson Wei Yang Tham, Shant Qinxiang Sin, Andrew Kean Seng Lim, James Hoipo Hui","doi":"10.1055/a-2886-8159","DOIUrl":"https://doi.org/10.1055/a-2886-8159","url":null,"abstract":"<p><strong>Abstract: </strong>The current systematic review and meta-analysis aims to evaluate the factors that affect union rates following fixation of osteochondritis dissecans of the knees. The systematic review was conducted using the keywords \"knee\" and \"osteochondritis dissecans\" or \"osteochondral lesion\" via a search through PubMed and Cochrane Library. All original human studies that reported on factors affecting union rates following fixation of osteochondritis dissecans of the knees were included. Nineteen studies with 512 knees were included. The union rates following surgical fixation of osteochondritis dissecans was 88% (95% confidence interval [CI]: 85-91%). Stability of the osteochondritis dissecans intraoperatively was the most important factor in affecting the union rates (pooled relative risk: 1.20; 95% CI: 1.07-1.36). No other risk factors, including skeletal maturity, gender of patients, location of osteochondritis dissecans, size of osteochondritis dissecans, open versus arthroscopic surgery, and number of fixation devices used affected the union rates following surgical fixation of osteochondritis dissecans. Surgical fixation of osteochondritis dissecans provided good union rates in majority of the patients, and stability of the osteochondritis dissecans intraoperatively was the most important factor in affecting the union rates.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279428","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":"Repeated Knee Flexion Maneuvers after Wound Closure Improve Early but not Long-Term Knee Flexion Following Simultaneous Bilateral Total Knee Arthroplasty: A Double-Blinded Randomized Controlled Trial.","authors":"Chatchapol Ongkosit, Noraworn Jirattikanwong, Phichayut Phinyo, Atthakorn Jarusriwanna","doi":"10.1055/a-2886-8101","DOIUrl":"10.1055/a-2886-8101","url":null,"abstract":"<p><strong>Abstract: </strong>Restoring knee joint range of motion is a key objective after total knee arthroplasty (TKA), as it strongly influences functional outcomes. This study evaluated the efficacy of repeated knee flexion maneuvers performed after wound closure on clinical outcomes following one-stage simultaneous bilateral TKA. In this prospective, double-blinded, randomized controlled trial, 46 patients (92 knees) were randomized to determine the intervention side, which involved 15 repetitions of deep knee flexion and full extension after wound closure. The contralateral knee served as the control. Outcomes included active knee flexion angles, extension lag (EL), and pain intensity measured by the visual analog scale (VAS). Active knee flexion angles were significantly greater in the intervention group on postoperative day 1 (mean difference of 6.9 degrees, 95% confidence interval [CI]: 3.8-10.0, <i>p</i> < 0.001), day 2 (mean difference of 4.8 degrees, 95% CI: 1.7-8.0, <i>p</i> = 0.003), day 3 (mean difference of 6.3 degrees, 95% CI: 3.1-9.4, <i>p</i> < 0.001), and at 2 weeks (mean difference of 5.4 degrees, 95% CI: 2.3-8.6, <i>p</i> < 0.001). The EL was lower in the intervention knee, with statistical significance observed on postoperative day 1. VAS pain scores were also significantly lower in the intervention knee at 2 weeks postoperatively, although the difference remained below the clinically meaningful threshold. Repeated knee flexion maneuvers after wound closure improved active knee flexion during the first 2 weeks after TKA. However, these differences did not persist beyond the early postoperative period, and final knee flexion outcomes were similar between groups. This study was registered in the Thai Clinical Trials Registry database (no. TCTR20230314002).</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151943","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":"Cooled Radiofrequency Ablation of the Genicular Nerve for the Treatment of Chronic Knee Pain Following Total Knee Arthroplasty: An Observational Study.","authors":"Alexander Rabinovich, Steven Phillips, Darryl Yardley, Naveen Mathew, David Dick","doi":"10.1055/a-2886-8396","DOIUrl":"https://doi.org/10.1055/a-2886-8396","url":null,"abstract":"<p><strong>Abstract: </strong>Radiofrequency ablation (RFA) has been shown to be effective in relieving pain in patients with osteoarthritis of the knee. There is a paucity of literature on the effectiveness of RFA in patients with persistent pain following total knee arthroplasty. A prospective observational trial of 20 patients with pain lasting greater than 12 months following a total knee arthroplasty. Patients were treated with a single session of cooled RFA to the genicular nerves under ultrasound guidance. Outcome measures were the numeric rating scale (NRS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and patient perceived effect. Patients were followed at 13, 26, and 52 weeks following treatment. Patients showed a significant improvement in NRS pain at 13 (median: 4, interquartile range [IQR]: 3.5), 26 (median: 3, IQR: 4.5), and 52 (median: 5, IQR: 5.5) weeks when compared with baseline (median: 8, IQR: 1.75; <i>p</i> < 0.05). Patients also demonstrated significant improvements in WOMAC pain, function, and overall scores from 13 to 52 weeks and WOMAC stiffness from 26 to 52 weeks (<i>p</i> < 0.05). This study found that cooled RFA led to decreases in patient-reported pain and increases in patient-reported function through 12 months. Future studies should look to evaluate cooled RFA against a control group and provide longer follow-up to determine the total duration of effect.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228789","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":"Comparison of Knee Extensor Mechanism, Function, and Flexion Range of Motion Between Obese and Nonobese Patients After Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Follow-up Study.","authors":"Serkan Bakırhan, Ertan Şahinoğlu, Bayram Ünver, Vasfi Karatosun","doi":"10.1055/a-2886-8345","DOIUrl":"https://doi.org/10.1055/a-2886-8345","url":null,"abstract":"<p><strong>Abstract: </strong>Conflicting findings exist regarding the association between obesity and functionality after total knee arthroplasty (TKA). We aimed to compare knee extensor mechanism function, knee function, and knee flexion range of motion between obese and nonobese patients who underwent simultaneous bilateral TKA. A total of 153 patients were divided into two groups as the obese (<i>N</i> = 99) and nonobese (<i>N</i> = 54) groups. The groups were compared for knee extensor mechanism function (chair-rise test), knee function (Hospital for Special Surgery [HSS] knee score), and knee flexion range of motion. The follow-up period was 2 years. In the chair-rise test, no statistically significant group-by-time interaction (χ2 (5) = 1.29, <i>p</i> = 0.93) or main effect of group (χ2 (1) = 0.02, <i>p</i> = 0.90) was found. For the HSS knee score, neither the group-by-time interaction (<i>F</i> (5, 728.17) = 0.17, <i>p</i> = 0.97) nor the main effect of group (<i>F</i> (1, 146.79) = 2.21, <i>p</i> = 0.14) was statistically significant. Regarding knee flexion range of motion, the group-by-time interaction was not statistically significant (<i>F</i> (5, 728.01) = 0.10, <i>p</i> = 0.99), whereas the main effect of group was statistically significant (<i>F</i> (1, 146.81) = 4.19, <i>p</i> = 0.04), with the obese group exhibiting lower knee flexion range of motion than the nonobese group. Obese and nonobese patients show similar improvements in knee extensor mechanism function, knee function, and knee flexion range of motion during the 2 years following simultaneous bilateral TKA. Obese patients have lower knee flexion range of motion compared with nonobese patients over the 2-year period after TKA. At the end of 2 years after TKA, both obese and nonobese patients achieve satisfactory results in all outcomes.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228867","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":"Tibial-Sided Suspension Fixation increases Risk of Cyclops Lesion following Anterior Cruciate Ligament Reconstruction.","authors":"Brian K Hansen, Evan P Sandefur, Alexander R Garcia, Devon R Pekas, Nicholas J Peterman, Darren T Hackley, John R Tuttle","doi":"10.1055/a-2886-8022","DOIUrl":"10.1055/a-2886-8022","url":null,"abstract":"<p><strong>Abstract: </strong>Cyclops lesions are a common postoperative complication that occurs in up to 47% of patients after anterior cruciate ligament reconstruction (ACLR), often resulting in painful extension loss. While risk factors for cyclops lesions have been identified, the influence of graft fixation technique on the development of symptomatic cyclops lesions remains unknown. A retrospective cohort study was conducted on 1,245 patients who underwent primary ACLR between January 1, 2015 and December 31, 2021. Patient demographics, pre-/postoperative metrics, graft type, and fixation methods were collected. The primary outcome was development of symptomatic cyclops lesions, confirmed by clinical exam and magnetic resonance imaging or surgical debridement. Statistical analysis included Kaplan-Meier survival analysis and mixed-effects logistic regression to determine predictors of lesion development. All-suspension fixation showed a significantly higher cyclops lesion rate (12.34%) compared with the other methods (4.2%, <i>p</i> < 0.01) and was the strongest predictor of cyclops lesion development (odds ratio [OR]: 9.208, 95% CI [1.773, 47.836]). Female sex and Black race were also significant predictors. Graft type did not significantly affect lesion risk in multivariable analysis. The all-suspension tibial-sided fixation technique significantly increases the risk of symptomatic cyclops lesion development, independent of graft type, or patient-specific factors. Biomechanical factors such as sagittal plane micro-motion and local tissue response may contribute to this increased risk. Recognition of fixation-related risk may inform surgical decision-making and postoperative management.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158464","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}