Journal of Knee Surgery最新文献

{"title":"Clinical Outcomes of Patients with Osteochondral Defects Secondary to Patella Dislocation: A Comparative Study.","authors":"John P Scanlon, Michael Finsterwald, Alistair Mayne, Satyen Gohil, Jay R Ebert, Aloysius Ng, Ashik Amlani, Jacobus H Otto, Peter D'Alessandro","doi":"10.1055/a-2756-0275","DOIUrl":"10.1055/a-2756-0275","url":null,"abstract":"<p><strong>Abstract: </strong>Osteochondral injuries secondary to patella dislocation are common and represent a significant complication of patellar instability. Despite the frequency of this injury, there are no published studies comparing outcomes between patients undergoing isolated medial patellofemoral ligament (MPFL) reconstruction for patellar instability versus patients undergoing MPFL reconstruction combined with procedures to address associated osteochondral defects. To evaluate differences in patient-reported outcome measures (PROMs), complications and revision rates between patients requiring MPFL reconstruction with osteochondral defects versus patients requiring MPFL reconstruction without osteochondral defects. A retrospective review of all patients undergoing MPFL reconstruction for patellar instability between April 2019 and March 2023 was performed. Patients were grouped into those requiring MPFL reconstruction combined with a procedure to address a concomitant osteochondral defect and those who underwent isolated MPFL reconstruction. Preoperative magnetic resonance imaging was used to assess anatomical risk factors for patella instability. At follow-up Lysholm, IKDC, KOOS-PF, satisfaction, and return to sport were evaluated. The study included 44 knees (18 and 26 for the osteochondral defect and isolated MPFL groups, respectively), with a mean age of 21.8 years and a mean follow-up of 23.1 months. The osteochondral defect group had a lower Insall-Salvati ratio (<i>p</i> = 0.03). At follow-up, the osteochondral defect group had lower Lysholm and Kujala scores (<i>p</i> = 0.01 and 0.002). Overall, 66.7% and 88.5% of participants in the osteochondral defect group and isolated MPFL groups, respectively, responded as being very satisfied with the results of surgery (<i>p</i> = 0.13). The return to play rate was 10.0% and 61.9% in the osteochondral defect and isolated MPFL groups, respectively (<i>p</i> = 0.009). Patients with osteochondral defects occurring secondary to patella dislocation had lower Insall-Salvati ratios and lower postoperative PROMs at follow-up. These findings highlight the significant impact of osteochondral injuries on patient outcomes in patients undergoing patellar stabilization surgery.</p><p><strong>Abstract: </strong>LEVEL OF EVIDENCE:  Cohort study; Level of evidence, 3.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"329-334"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641721","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":"Testosterone Replacement Therapy Is Associated with Extensor Mechanism Disruption after Total Knee Arthroplasty.","authors":"José Ayala-Ortiz, Sean Taylor, Hassan Ghomrawi, Farzam Farahani, Chase Hobbs, Gerald McGwin, Scott Mabry","doi":"10.1055/a-2741-1195","DOIUrl":"10.1055/a-2741-1195","url":null,"abstract":"<p><strong>Abstract: </strong>Use of testosterone replacement therapy (TRT) has increased significantly in the last few years and has been linked to tendon ruptures after a number of orthopedic procedures. Knee extensor mechanism disruption (EMD) after total knee arthroplasty (TKA) leads to significant morbidity and a decline in patients' quality of life. However, its association with TRT use remains unclear. We aimed to determine the association between TRT and the risk of EMD in patients undergoing primary TKA. This retrospective cohort study utilized the Merative MarketScan database to identify adults aged ≥ 18 years who underwent primary TKA between 2015 and 2022, with a minimum follow-up of 3 years. Knee EMD, defined as ruptures of the quadriceps tendon, patellar tendon, or fractures of the patella, was identified using ICD-10 (International Classification of Diseases, Tenth Revision) codes. TRT use was defined as patients filling prescriptions for at least 3 months before the index surgery. Multivariable logistic regression was employed to determine the independent risk of TRT on risk of EMD. Among 34,911 patients, 1,711 (4.9%) were on TRT, and 166 (0.48%) were identified with knee EMD. More than half of the cohort were aged 40 to 59 years (57.3%, <i>n</i> = 20,018) and female (59.6%, <i>n</i> = 20,820). Preoperative TRT was associated with more than twice the likelihood of developing knee EMD (odds ratio [OR]: 2.38, 95% confidence interval [CI]: 1.39-4.09; <i>p</i> = 0.002). In sex-stratified analyses, the association was observed in males (OR: 3.00, 95% CI: 1.64-5.49; <i>p</i> = 0.0002) but not in females (OR: 1.10, 95% CI: 0.27-4.46). Other significant risk factors included smoking (OR: 1.46, 95% CI: 1.02-2.08; <i>p</i> = 0.038), postoperative fluoroquinolone use (OR: 1.58, 95% CI: 1.06-2.36; <i>p</i> = 0.024), and female sex (OR: 1.44, 95% CI: 1.03-2.01; <i>p</i> = 0.034). Preoperative TRT was identified as the most important risk factor for developing knee EMD after TKA. These findings underscore the importance of recognizing and addressing this risk factor and counseling patients on its potential risks on postoperative outcomes.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"317-321"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507652","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 Progressive Balance Training on Lower Limb Recovery after Anterior Cruciate Ligament Reconstruction plus Meniscus Repair: A Prospective Study.","authors":"Shan Zheng, Pengcheng Li","doi":"10.1055/a-2741-1637","DOIUrl":"10.1055/a-2741-1637","url":null,"abstract":"<p><strong>Abstract: </strong>We aimed to evaluate the effect of progressive balance training on lower limb recovery following anterior cruciate ligament (ACL) reconstruction plus meniscus repair. A total of 106 patients undergoing ACL reconstruction plus meniscal repair between March 2022 and March 2024 were recruited and assigned into a control group (<i>n</i> = 53, non-individualized rehabilitation training) and a study group (<i>n</i> = 53, progressive balance training) using a random number table. The indicators related to knee joint proprioception, knee joint function, and lower limb motor function were compared before intervention and after 12 weeks of intervention. After 12 weeks of intervention, the active range of motion and Lysholm scores of the knee joint rose in both groups compared with those before intervention, and they were higher in the study group (<i>p</i> < 0.05). After 8 and 12 weeks of intervention, the anterior, posterolateral, and posteromedial reach distances were longer in the study group than in the control group (<i>p</i> < 0.05). After 12 weeks of intervention, the Fugl-Meyer assessment of lower extremity scores, Holden walking function scores, and 10-m walk test speed all increased in both groups compared with those before intervention, especially in the study group (<i>p</i> < 0.05). Progressive balance training leads to clinically meaningful improvements in knee joint proprioception and lower limb balance function in patients undergoing ACL reconstruction plus meniscal repair. The observed increase in Lysholm scores exceeds the established minimal clinically important difference threshold of 25 points, indicating significant functional gains. The improvements in Y-balance test performance suggest a reduced risk of injury.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"296-302"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716273","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":"Assessment of Swelling, Function and Pain Following Tourniquet Use in Total Knee Arthroplasty.","authors":"Moritz Wagner, Richard A Lindtner, Martin Eichinger, Franz Endstrasser, Hannes Schönthaler, Florian Pedross, Alexander Brunner","doi":"10.1055/a-2865-2700","DOIUrl":"https://doi.org/10.1055/a-2865-2700","url":null,"abstract":"<p><strong>Background: </strong>Tourniquet is frequently used during total knee arthroplasty (TKA), however it's use is associated with increased pain, reduced function and increased swelling in the early postoperative period.</p><p><strong>Questions/purposes: </strong>This study aims to evaluate the effects of tourniquet application on swelling, pain, knee function and patient reported outcome.</p><p><strong>Methods: </strong>This non-randomized single-center observational clinical trial included 84 primary TKAs, with assessment of tourniquet duration (minutes) and tourniquet pressure (mmHg). Swelling was quantitatively assessed through multiple circumferential measurements of the leg. Secondary outcome included pain intensity, knee flexion, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Outcome was measured at multiple time points before TKA until six weeks after TKA.</p><p><strong>Results: </strong>Overall swelling was less at five days (3.9 l ± 0.75 l vs. 4.7 l ± 1.0 l; p=0.004) with low tourniquet pressure. The level of pain after surgery was lower in the tourniquet cementation group both at two days (2.9 ± 2.1 vs. 4.7 ± 2.5, p=0.01) and at five days (2.7 ± 2.1 vs. 4.2 ± 2.5, p=0.02) after surgery. Active knee flexion at five days after surgery was less with longer tourniquet application (65.4 ± 16.4 vs. 74.4 ± 16.7, p=0.04).</p><p><strong>Conclusion: </strong>We recommend keeping tourniquet cuff pressure around the thigh below 300 mmHg to reduce swelling of the whole leg in the early postoperative period after TKA. Tourniquet duration should be kept as low as possible, ideally only during the cementation period, resulting in clinically relevant decreased postoperative pain and increased postoperative knee range of motion. In cases that require higher tourniquet pressures or longer duration of tourniquet, complete recovery from all negative effects can be expected at six weeks following TKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822557","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":"Epidemiology and Classification of Distal Femoral Periprosthetic Fractures Following Total Knee Arthroplasty.","authors":"Maximillian Phillip Ganz, James Germano, Giles R Scuderi","doi":"10.1055/a-2865-1934","DOIUrl":"https://doi.org/10.1055/a-2865-1934","url":null,"abstract":"<p><p>Distal femoral periprosthetic fractures (DFPF) are an increasingly prevalent complication following total knee arthroplasty (TKA), representing a significant challenge to the orthopedic community. As the volume of primary and revision TKA continues to rise globally, a clear understanding of the epidemiological landscape and standardized classification is paramount for appropriate treatment, clinical communication, and research. This review provides a focused analysis of the current epidemiological propensities of DFPF, identifying the specific patient populations and temporal trends that define these injuries. Identifying, reporting, and treating DFPF requires standardized nomenclature to classify these injuries. Currently, multiple classification systems are utilized. Each system demonstrates individual strengths and weakness from simple descriptive models to management-oriented frameworks. By focusing on the relationship between fracture location, implant stability, and bone stock, these systems provide algorithmic workflow for the surgical decision-making process between internal fixation construct type or the need for revision arthroplasty. As the incidence of these complex fractures continues to rise, the integration of epidemiological data with reliable classification remains essential for optimizing surgical outcomes and developing effective preventative strategies.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822541","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 the quantitative value of the pivot shift test using a navigation system in anterior cruciate ligament-injured knees.","authors":"Atsuo Nakamae, Akinori Nekomoto, Kyohei Nakata, Naofumi Hashiguchi, Junya Tsukisaka, Koji Takeda, Nobuo Adachi","doi":"10.1055/a-2865-3249","DOIUrl":"https://doi.org/10.1055/a-2865-3249","url":null,"abstract":"<p><p>This study aimed to identify factors associated with greater quantitative pivot shift in anterior cruciate ligament (ACL)-injured knees by quantitatively assessing the pivot shift under anaesthesia using a navigation system prior to ACL reconstruction. A total of 114 patients (66 males and 48 females) who underwent ACL reconstruction were included. Prior to reconstruction, the pivot shift test was performed under anaesthesia and measured using a navigation system. The maximum difference in the anterior-posterior position of the tibia during knee flexion-extension without stress and during the pivot shift test-termed peak coupled anterior tibial translation (peak c-ATT)-was recorded as the quantitative value. Multiple regression analysis was used to determine factors associated with the quantitative pivot shift value, with nine independent variables: sex, age, preoperative side-to-side difference in anterior knee laxity, time from injury to surgery, presence of medial and lateral meniscus injuries, knee extension angle, femorotibial angle, and pre-injury Tegner activity score. Among the 114 participants, 80 (70.2%) had normal lateral menisci and 34 (29.8%) had damaged lateral menisci. Multiple linear regression identified three variables significantly associated with greater quantitative pivot shift: time from injury to surgery (standardized partial regression coefficient (β) = 0.38, p = 0.000), knee extension angle (β = 0.29, p = 0.001), and presence of lateral meniscus injury (β = 0.29, p = 0.001). Other variables-including age, sex, anterior laxity, medial meniscus injury, femorotibial angle, and Tegner score-did not reach statistical significance. Three factors- prolonged time from injury to surgery, knee hyperextension, and lateral meniscus injury-were significantly associated with greater quantitative pivot shift in ACL-injured knees. The strongest predictor was the time elapsed between injury and surgery.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786501","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":"Trimming the Fat: Does GLP-1 Receptor Agonist Therapy Impact Clinical and Functional Results After Tibial Plateau Fracture Fixation?","authors":"Amelia R Goldstein, Alexander M Lashgari, Philipp Leucht, Abhishek Ganta, Sanjit R Konda, Kenneth A Egol","doi":"10.1055/a-2851-0573","DOIUrl":"10.1055/a-2851-0573","url":null,"abstract":"<p><strong>Abstract: </strong>This study evaluated the impact of prolonged glucagon-like peptide-1 (GLP-1) receptor agonist use on postoperative outcomes, including radiographic posttraumatic osteoarthritis (PTOA), fracture nonunion, and final knee range of motion (ROM)-following operative management of tibial plateau fractures across multiple body mass index (BMI) strata. A retrospective cohort study was conducted at an urban academic institution, including patients who underwent surgical fixation for tibial plateau fractures between 2016 and 2024, with a ≥ 6 months follow-up. The GLP-1 cohort consisted of patients with documented long-term GLP-1 use pre- and postoperatively. GLP-1 users (Group A, <i>n</i> = 24) were compared with three non-GLP-1 cohorts stratified by BMI: Group B (BMI: 18.5-25, <i>n</i> = 150), Group C (BMI: 25-30, <i>n</i> = 150), and Group D (BMI ≥ 30, <i>n</i> = 100). Outcomes included Kellgren-Lawrence osteoarthritis grade, postreduction fracture angulation, articular step-off, Charlson Comorbidity Index (CCI), fracture complications (infection, nonunion, PTOA, revision surgery), and final knee flexion ROM. Statistical analyses used SPSS Statistics version 29.0 (IBM Corp., Armonk, New York, United States) with analysis of variance and chi-square tests. Mean follow-up was 28.83 months. Baseline age, CCI, fracture angulation, and step-off were comparable between groups. Preinjury osteoarthritis severity was higher in Group A (0.96 ± 0.88) than in Groups B (0.68 ± 0.86), C (0.54 ± 0.75), and D (0.78 ± 0.74; <i>p</i> < 0.001). Radiographic PTOA incidence was highest in Group D (32%, <i>p</i> < 0.01), while Group A rates were comparable to Groups B and C (<i>p</i> is approximately 0.62). Final knee flexion ROM differed significantly (<i>p</i> < 0.01), with Group D showing the lowest mobility (119.08 ± 16.47 degrees). Nonunion rates were significantly higher in Group A (<i>p</i> < 0.01). Among obese patients, GLP-1 receptor agonist use was associated with a lower incidence of PTOA and preserved knee ROM compared with untreated obese individuals, with outcomes similar to nonobese patients. However, GLP-1 use was also linked to increased nonunion rates. These findings suggest that while GLP-1 therapy may mitigate obesity-related joint degeneration, it may also challenge fracture healing.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692502","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":"Impact of Internet+ Rehabilitation on Arthroscopic Treatment Outcomes for Knee Meniscal Injuries and Factors Influencing Knee Osteoarthritis.","authors":"Lina Qiu, Huadi Yuan, Luping Tang","doi":"10.1055/a-2835-3645","DOIUrl":"https://doi.org/10.1055/a-2835-3645","url":null,"abstract":"<p><strong>Abstract: </strong>This study aimed to assess the effectiveness of Internet+ rehabilitation in arthroscopic treatment for knee meniscal injuries and its influence on knee osteoarthritis (KOA) factors.</p><p><strong>Abstract: </strong>A cohort of 120 patients with meniscal injuries undergoing arthroscopic treatment in the Orthopedics Department between January 2021 and December 2022 was randomly assigned to either a control group or a study group using a randomization table. The control group underwent self-rehabilitation at home, while the study group received Internet-enhanced rehabilitation. Patient compliance with rehabilitation exercises, knee joint functionality, and long-term KOA outcomes were compared between the groups. KOA status was evaluated using the Kellgren-Lawrence (K-L) grading system, categorizing grades 0 to 2 as KOA negative and grades 3 to 5 as KOA positive, to investigate factors impacting KOA.</p><p><strong>Abstract: </strong>The study group demonstrated significantly higher compliance rates and Lysholm scores compared with the control group. K-L grades were notably lower in the study group, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were significantly reduced in the study group as well. The KOA-positive subgroup exhibited significantly older age and longer preoperative durations than the KOA-negative subgroup, with a notably higher proportion of Internet+ rehabilitation intervention in the study group than in the control group. Multifactorial logistic regression analysis identified advanced age and prolonged preoperative duration as risk factors for KOA, while Internet-enhanced rehabilitation intervention emerged as a protective factor against KOA.</p><p><strong>Abstract: </strong>The integration of Internet+ rehabilitation in arthroscopic treatment for knee meniscal injuries substantially enhances treatment compliance and improves joint functionality. During a 12-month follow-up, internet-enhanced rehabilitation was associated with a lower occurrence and severity of KOA. Furthermore, advanced age and an extended preoperative duration represented independent risk factors for KOA, while Internet+ rehabilitation was independently associated with a reduced odds of KOA in multivariate analysis.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786459","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":"Clinical Outcomes and Cartilage Regeneration Using Osteochondral Autograft Transfer System and Medial Open-Wedge High Tibial Osteotomy in Patients with Osteochondral Defects.","authors":"Bushu Harna, Shivali Arya, Dinesh Sandal","doi":"10.1055/a-2851-1032","DOIUrl":"10.1055/a-2851-1032","url":null,"abstract":"<p><strong>Abstract: </strong>Osteochondral defects of the medial femoral condyle, particularly in varus-aligned knees, pose significant clinical challenges due to the risk of progression to osteoarthritis. Osteochondral autograft transplantation (OATS) restores the cartilage-subchondral unit, while medial open-wedge high tibial osteotomy (MOWHTO) addresses malalignment. This study evaluates clinical, radiological, and survivorship outcomes following combined OATS and MOWHTO supplemented with platelet-rich plasma in patients with symptomatic medial femoral condyle defects. A prospective observational study was conducted on 13 patients (15 knees) treated with combined OATS and MOWHTO. Inclusion criteria included symptomatic full-thickness osteochondral defects (>1 cm²), varus malalignment (>3 degrees), and failure of conservative management. Pre- and postoperative assessments included Knee Society Score (KSS), visual analog scale (VAS), range of motion (ROM), radiographs, and magnetic resonance imaging (MRI). Follow-up was a minimum of 2 years. Statistical analyses were performed using paired <i>t</i>-tests and Kaplan-Meier survival analysis. The mean age was 36.7 years. The mean defect size was 2.1 cm² with an average preoperative varus of 5.4 degrees. Significant improvements were seen in KSS (knee: 48.3-90.4; function: 42.6-88.7), VAS (7.2-1.8), and ROM (96-122 degrees), all <i>p</i> < 0.05. MRI at 24 months showed excellent graft integration (mean MOCART score: 89.6). Mechanical alignment was corrected to a mean of 62.3% lateral. One minor complication was noted, and no cases required revision or conversion to arthroplasty. Overall survivorship was 96.7%. Combined OATS and MOWHTO is a safe, effective solution for young, active patients with focal cartilage defects and varus malalignment, offering substantial clinical and radiological improvements. Longer-term studies are warranted.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655249","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 Column Involvement in AO/OTA 41B3 Lateral Split-Depression Tibial Plateau Fractures Leads to Worse Outcomes.","authors":"Matthew T Kingery, Alexa R Deemer, Shiv Lamba, Utkarsh Anil, Abhishek Ganta, Kenneth A Egol, Sanjit R Konda","doi":"10.1055/a-2851-0681","DOIUrl":"https://doi.org/10.1055/a-2851-0681","url":null,"abstract":"<p><strong>Abstract: </strong>The purpose of this study was to compare outcomes in patients who sustained isolated lateral column tibial plateau fractures and combined lateral and posterolateral column tibial plateau fractures (AO/OTA 41B3 lateral split-depression fractures). Fractures were classified according to the three-column classification system of tibial plateau fractures. The primary outcome was the difference in Short Musculoskeletal Function Assessment (SMFA) function index at 12 months postoperatively between patients with lateral column plateau fractures and patients with combined lateral and posterolateral column plateau fractures. Seventy-eight patients were included (mean age: 48.8 ± 14.1 years). Thirty-two patients (41.0%) were in the isolated lateral column group (L), and 46 patients (59.0%) were in the lateral column plus posterolateral column group (L + PL). At 1 year following injury and fixation, the L + PL group demonstrated significantly worse SMFA function index than the L group (19.1 ± 17.7 vs. 9.1 ± 12.5, <i>p</i> = 0.005). Similarly, the L + PL group was significantly more bothered by the sequelae of their injury compared to the L group at 1 year based on the SMFA bothersome index (20.7 ± 23.7 vs. 8.6 ± 12.3, <i>p</i> = 0.005). Patients with combined lateral and posterolateral column tibial plateau fractures demonstrate worse outcomes compared to isolated lateral column fractures 1 year after fixation. The study provides level III evidence.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786504","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}