Journal of Knee Surgery最新文献

{"title":"Radiographic Assessment of Total Knee Arthroplasty Alignment With and Without Accelerometer-Based Navigation at a Resident Training Institution.","authors":"Brett G Brazier, Christian B Allen, Daryl G Hilyard, Darshan S Shah, David E Vizurraga, Donald N Hope","doi":"10.1055/a-2481-8647","DOIUrl":"10.1055/a-2481-8647","url":null,"abstract":"<p><p>Malalignment and lack of surgeon experience are cited as risk factors for prosthetic failure and the need for subsequent revision surgery in total knee arthroplasty (TKA). Various conventional (CON) and computer-assisted surgical (CAS) methods have been developed to try and prevent malalignment and limit outliers. One of these methods is through an accelerometer-based CAS (aCAS), which intraoperatively helps determine the angulation and amount of resection necessary to restore alignment in TKA. The purpose of this study was to determine the number of TKA alignment outliers in TKAs performed both with CON and aCAS methods at a single training institution in cases that trainees were involved in. In this retrospective single-center study, radiographic analysis of 150 primary TKAs performed at our training institution was performed. The medial distal femoral angle (DFA), medial proximal tibial angle (PTA), and posterior slope angle (PSA) were evaluated on immediate postoperative radiographs of 75 aCAS and 75 CON knees. Outlier measurements were defined as DFA outside of 5 ± 3 degrees valgus, PTA > ± 3 degrees from neutral axis, and PSA outside 0 to 7 degrees for cruciate retaining and 0 to 5 degrees for posterior stabilized implants. Data was analyzed using chi-squared, analysis of variance, and Student's <i>t</i>-tests. There was no significant difference found between these two groups in the total number of outliers (8% aCAS vs. 9.8% CON, <i>p</i> = 0.508). Additionally, there was also no significant difference found for any of the radiographic measurements independently; DFA (8% vs. 8%, <i>p</i> = 1.00), PTA (4% vs. 9%, <i>p</i> = 0.184), and PSA (12% vs. 12%, <i>p</i> = 1.00), when comparing aCAS and CON TKAs. Primary TKAs performed at a single training institution demonstrated no significant difference between aCAS and CON methods in the total number of outliers or in the number of outliers for each postoperative radiographic measurement. This study would suggest that there is no advantage in limiting outliers when utilizing aCAS for TKAs at training institutions in cases that trainees are involved in. LEVEL OF EVIDENCE:  Level III Retrospective Cohort Study.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"224-228"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693816","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":"Efficacy of Amniotic Suspension Allografts in the Treatment of Knee Osteoarthritis: A Systematic Review.","authors":"Ayub Ansari, Mirza Baig, Yazan Tanbour, Kazi Syed, Yunus Ahmed, Bryan G Beutel","doi":"10.1055/s-0044-1801758","DOIUrl":"10.1055/s-0044-1801758","url":null,"abstract":"<p><p>Knee osteoarthritis significantly impacts mobility and quality of life. This condition is a leading cause of disability in aging populations, with total knee replacement commonly sought in advanced cases. Traditional nonoperative management strategies, including anti-inflammatories, corticosteroid injections, and hyaluronic acid, often provide limited relief, especially in severe cases. Recently, regenerative therapies such as amniotic suspension allografts (ASA) have emerged as promising alternatives due to their anti-inflammatory and regenerative properties, which may counteract the catabolic effects of osteoarthritis. This systematic review evaluated the efficacy and safety of ASA in reducing pain and improving function among knee osteoarthritis patients. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, a comprehensive search of PubMed and Embase databases initially identified 1,733 studies pertaining to ASA, of which 1,575 were screened, and 9 studies ultimately met the inclusion criteria for detailed analysis of ASA in the treatment of knee osteoarthritis. Data extraction and narrative synthesis focused on outcomes such as pain reduction and functional improvement using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as well as safety profiles. The results demonstrated notable improvements in pain scores following ASA treatment, as shown by studies reporting increases in KOOS pain scores over 6 months, which generally outperformed hyaluronic acid and saline treatments in pain reduction. Similarly, ASA treatment was associated with substantial improvements in physical function outcome scores, enhancing patients' ability to perform daily activities. Patient-reported outcomes also indicated higher quality of life and functional status, with most patients experiencing high levels of satisfaction. Additionally, ASA's safety profile was favorable, with adverse events primarily mild to moderate in nature, including a few transient events such as knee stiffness and myalgias. This systematic review highlights ASA as an effective therapeutic option for knee osteoarthritis, although further studies focusing on long-term radiographic outcomes and mechanisms of action are recommended to fully establish its benefits and optimize treatment protocols.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"229-236"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967018","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":"Internet-Based Patient Portals Increase Patient Connectivity Following Total Knee Arthroplasty.","authors":"James P Henry, Pierre Tamer, Giles R Suderi","doi":"10.1055/a-2542-7427","DOIUrl":"https://doi.org/10.1055/a-2542-7427","url":null,"abstract":"<p><p>Many healthcare-related processes have undergone substantial transformation by the internet since the turn of the century. This technological revolution has fostered a fundamental shift from medical paternalism to patient autonomy and empowerment via a \"patient-centric approach.\" Patient portals, or internet-enabled access to an electronic medical record, permit patients to access, manage, and share their health-related information. Patient connectivity following total knee arthroplasty (TKA) has the potential to positively influence overall outcomes, patient experience, and satisfaction. To understand current trends in patient portal usage, modalities of connectivity, and the implications following TKA. A systematic literature review was performed by searching PubMed and Google Scholar. Articles specific to portal usage and connectivity after TKA or total joint arthroplasty were subsequently identified for further review. Patient portals and internet-based digital connectivity platforms enable physicians, team members, and patients to communicate in the perioperative period both directly and indirectly. Communication can be through web-based patient portals, messaging services/apps, preprogrammed alerts (e.g., mobile applications or wearable devices), audio mediums, or videoconferencing. The spectrum and utilization of available patient engagement platforms continues to expand as the importance and implications of patient engagement and connectivity continue to be elucidated. Connectivity through patient portals or other mediums will continue to have an expanding role in all aspects of orthopedic surgery, patient care, and engagement. This includes preoperative education, postoperative rehabilitation, patient care, and, perhaps most importantly, collection of outcome measures. The level of evidence is V (expert opinion).</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":"143765480","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":"Rehabilitation at Home with Interactive Technology Following Total Knee Arthroplasty.","authors":"Adam M Gordon, Rajan Sharma, Michael A Mont","doi":"10.1055/a-2534-1546","DOIUrl":"10.1055/a-2534-1546","url":null,"abstract":"<p><p>Smartphone applications and wearable devices have shown promising outcomes to augment in-person postoperative total knee arthroplasty rehabilitation. Advantages of these technologies include patient-specific, real-time feedback, and motivation that can be integrated into newer rehabilitation protocols. These technologies can be utilized in the home setting with patient-directed therapy. This brief narrative review discusses the current utilization of smartphone applications and sensors for the postoperative rehabilitation period following total knee arthroplasty. This review will discuss how they are utilized for home-based rehabilitation and the outcomes of patients who utilize them. This review specifically focuses on recovery outcomes such as adherence/satisfaction, functional improvement, and gait patterns. Outcomes are primarily descriptive, with <i>p</i>-values noted where appropriate. This review highlights the growing evidence supporting the use of smartphone applications and wearable sensors as valuable tools in the rehabilitation process following total knee arthroplasty. Both technologies have been shown to enhance patient adherence, improve functional outcomes, mitigate pain, and provide valuable data for healthcare providers and patients. Importantly, the integration of these technologies, such as the combination of smartphone apps with wearable devices, can help improve patient outcomes when utilized in a home-based rehabilitation setting. Smartphone applications and wearable devices offer enhancements in postoperative rehabilitation following total knee arthroplasty. Despite being in their infancy, randomized trials have validated their effectiveness and utility in this context. Improved adherence to postoperative care plans emerged as a recurrent findings.</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":"143366408","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":"Block or No-Block? Regional Anesthesia and Return-to-Sport Outcomes in Quadriceps Tendon Autograft ACL Reconstruction.","authors":"Seth M Borchard, Richard J VanTienderen, Nicholas J Pitcher, Elle M McCormick, Robert W Westermann","doi":"10.1055/a-2542-2526","DOIUrl":"https://doi.org/10.1055/a-2542-2526","url":null,"abstract":"<p><p>This research aimed to compare return-to-sport (RTS) muscle strength testing in athletes 6 months following a quadriceps tendon (QT) autograft anterior cruciate ligament (ACL) reconstruction performed with or without a nerve block. Retrospective analysis of RTS strength testing in competitive or recreational athletes who had a QT ACL reconstruction at a Midwest academic referral center. There were 182 participants ranging from 12 to 29 years of age with a mean age of 16.9 years old. Patients were stratified into two groups based on whether they received an intraoperative nerve (adductor canal) block. Relevant tests performed during RTS testing included isokinetic quadriceps and hamstring strength (ISOK) in addition to limb symmetry and self-reported psychological readiness. Most patients underwent multiple RTS tests; for this study, we used the data from their initial test typically performed in the 6-month postoperative timeframe. Forty-three patients had an intraoperative nerve block, while 139 did not have a block. There were no observed statistically significant differences in quadriceps or hamstring strength when comparing the median scores of the nerve block and no-block groups across the major quantitative categories of isokinetic muscle strength, limb symmetry, tuck jump errors, or psychological readiness to return to sport. There was evidence of a relationship between increased graft thickness and decreased isokinetic quadriceps strength at both 60 and 300 deg/s in addition to lower self-reported confidence in readiness to RTS. No significant differences in functional strength testing or psychological readiness at 6 months were seen in ACL reconstruction involving QT grafts based on block status. There was evidence of a relationship between increased QT autograft thickness and decreased functional outcomes at 6 months. This research strengthens the case for leveraging an adductor canal block in QT ACL reconstruction involving young athletes as an effective tool for pain management without compromising muscle strength or RTS readiness. The level of evidence is III.</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":"143765478","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 Benefit of Combining Kinematic Alignment and a Medial Pivot Implant in Total Knee Arthroplasty, The KA-MP Knee: Why and How.","authors":"Robert N Steensen","doi":"10.1055/a-2544-4116","DOIUrl":"10.1055/a-2544-4116","url":null,"abstract":"<p><p>Kinematic alignment (KA) has emerged as an alternative alignment technique for total knee arthroplasty with the goal of duplicating the pre-arthritic joint surface. Medial pivot (MP) total knee implants duplicate the medial stability of the natural knee and recreate the medial rotational axis of the knee. Each has had favorable results. Combining the two, the KA-MP knee, creates a synergy and achieves better results than KA or MP alone.</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":"143505246","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 Resurfaced Patellar Thickness on Outcomes after Total Knee Arthroplasty.","authors":"Siddhartha Dandamudi, Viktor Tollemar, Jonathan Spaan, Ashwinee Manivannan, Brett R Levine","doi":"10.1055/a-2530-7953","DOIUrl":"10.1055/a-2530-7953","url":null,"abstract":"<p><p>Total knee arthroplasty (TKA) is the gold standard for the treatment of end-stage knee osteoarthritis. Patellar resurfacing is an optional step in the procedure and remains a controversial topic of discussion. This retrospective study aims to assess the impact of over-resecting and under-resecting the patella during resurfacing on patient-reported outcomes and range of motion (ROM) after surgery. Out of 475 patients who underwent TKA between August 2017 and November 2019 at a single center by a single surgeon, 438 (92.2%) were included in the analysis. Patients were split into three study groups based on reconstructed patellar thickness; normal resection (NR) was defined as within 2 mm native thickness, over-resected was defined as ≤ -2 mm, and under-resected (UR) was defined as ≥ 2 mm. Statistical analyses included chi-squared tests, mixed effect models, and Cox proportional hazards models. There were 364, 41, and 33 patients in the NR, OR, and UR groups, respectively. The cohort's mean age at the time of surgery was 67.1 ± 9.1 and had a mean length of follow-up of 2.1 ± 1.7 years with no difference among cohorts. Significant differences were found in gender (<i>p</i> < 0.001) and BMI (<i>p</i> = 0.0134) with UR having fewer males, OR having more males, and OR having lower BMI. At 6 months, the complete cohort ROM improved from 108.7 ± 14.4 to 111 ± 11 degrees, objective knee society score (KSS) increased from 15.4 ± 11.2 to 36.2 ± 12, functional KSS increase from 47.3 ± 18.9 to 65.6 ± 22.2, and knee injury and osteoarthritis outcome score increase from 46.1 ± 15 to 70.7 ± 15 with no significant differences among cohorts. There were no patellofemoral-related complications. This study supports that while it is important to restore the anatomy in the anterior compartment of the knee, minor changes in patellar thickness from patellar resurfacing likely have minimal impact on outcomes for patients. Further studies with a larger sample size are necessary to further validate these findings.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123923","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":"Additional Dose of Intravenous Dexamethasone Can Replace Patient-Controlled Analgesia in Pain Control after Total Knee Arthroplasty while Reducing Opioid Complications.","authors":"Jisu Park, Moon Jong Chang, Tae Woo Kim, Chong Bum Chang, Seung-Baik Kang","doi":"10.1055/a-2509-3502","DOIUrl":"10.1055/a-2509-3502","url":null,"abstract":"<p><p>The purpose of this study was to evaluate whether intravenous (IV) dexamethasone, within the current multimodal pain management protocol, (1) could maintain postoperative pain at a comparable level without IV patient-controlled analgesia (PCA), (2) could reduce opioids-related side effects, and (3) whether an additional dose of dexamethasone on postoperative day (POD) 2 would offer further pain-relieving effect without increasing the risk of complications. A total of 178 patients (182 knees) who underwent total knee arthroplasty for osteoarthritis were included in the study. The patients were divided into Dexa 2 & PCA and Dexa 3 & NoPCA groups. From operative day to POD 5, pain visual analogue score (VAS), rescue opioids consumption, episodes of postoperative nausea and vomiting (PONV), antiemetics usage, and side effects of opioids such as postoperative urinary retention (POUR) and constipation were checked. For safety, wound complication and infection were checked. There was no difference in pain VAS between the two groups during all six perioperative days. Rescue opioids consumption was lower in Dexa 2 & PCA group. Total dosage of used opioids for six perioperative days was lower in Dexa 3 & NoPCA group. Dexa 3 & NoPCA group had less PONV and POUR. There was a marked increase in pain VAS and the use of rescue opioids from POD 1 to POD 2 in the Dexa 2 & PCA. There were no wound problems or infections in either group. Under the current multimodal pain management protocol, comparable level of postoperative pain could be achieved by dexamethasone without the need of IV PCA. By not using IV PCA, overall opioid usage was reduced, which could lead to a lower frequency of PONV and POUR. While there is still room for further research on the duration and frequency of administering dexamethasone, additional administration on POD 2 is believed to provide additional pain management benefits compared with administering only until POD 1.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928491","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":"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":"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}