Journal of Knee Surgery最新文献

{"title":"Robotically-Assisted Medial Reduction Osteotomy: A Technique Based on the Pythagorean Theorem.","authors":"Olivia Bono, James V Bono","doi":"10.1055/a-2664-7508","DOIUrl":"https://doi.org/10.1055/a-2664-7508","url":null,"abstract":"<p><strong>Introduction: </strong>Varus deformity can present a significant challenge for limb alignment correction and balancing in total knee arthroplasty (TKA). One technique to address these challenges is a medial reduction osteotomy. This article describes utilization of a robotic platform to perform a safe and accurate medial subtraction osteotomy prior to balancing and bony resections. Deformity correction can be predicted by the Pythagorean Theorem.</p><p><strong>Materials and methods: </strong>CT-based robotic systems can be used to perform medial reduction osteotomy of the tibia in the setting of significant varus deformity in patients undergoing TKA. Prior to balancing and bony cuts, the tibial component is downsized \"virtually\" from the planned size. Through lateralization of the component, the excess medial bone can be mapped via tracking of the registration probe and removed. The amount of medial tibial bone resected determines the amount of laxity that will be created when the tibia is reduced under the femur when implants are placed. Following this, soft tissue tensioning, planning, bony resections, and trialing can progress as normal for a robotic total knee.</p><p><strong>Results: </strong>Through the described technique, the authors have been able to predict the amount of coronal plane correction based on the size of the osteotomized fragment using the Pythagorean Theorem.</p><p><strong>Conclusion: </strong>Robotic guidance of a medial subtraction osteotomy provides a safe and predictable means of varus correction. This is beneficial in that it can be performed with great accuracy and prior to any further balancing maneuvers or bony cuts.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Primary Femoral Bone Tunnel Position on Postoperative Outcomes and Femoral Bone Tunnel Creation in Revision ACL Reconstruction.","authors":"Kazumi Goto, Eisaburo Honda, Shin Sameshima, Miyu Inagawa, Koji Matsuo, Junki Shiota, Hitoshi Takagi, Takaki Sanada","doi":"10.1055/a-2664-7701","DOIUrl":"https://doi.org/10.1055/a-2664-7701","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of primary femoral tunnel position on rerupture rates following revision anterior cruciate ligament reconstruction (ACLR) remains unclear. This study aimed to explore whether the anatomical placement of the primary femoral tunnel affects rerupture risk, tunnel positioning at revision surgery, and postoperative clinical outcomes.</p><p><strong>Methods: </strong>Among 165 patients who underwent revision ACLR at our institution between 2018 and 2022, 78 cases with a minimum of two years of follow-up were included. The primary femoral tunnel position was evaluated using Bernard and Hertel's quadrant method on 3D CT scans. Patients were categorized into Group A (anatomical position) and Group N (non-anatomical position). Rerupture rate, tunnel position at revision ACLR, and clinical outcomes were compared between the groups. Subgroup analyses were conducted based on primary surgical technique (single-bundle vs. double-bundle). Additionally, multivariate logistic regression analysis was performed to identify independent predictors of rerupture.</p><p><strong>Results: </strong>Rerupture occurred in 3 of 39 cases (7.7%) in Group A and 6 of 39 cases (15.4%) in Group N (p = 0.48). There were no significant differences in age, sex, height, weight, sports type, or posterior tibial slope. Anatomical tunnel placement at revision was achieved in 94.9% of Group A and 79.5% of Group N (p = 0.087). No significant differences in Knee Injury and Osteoarthritis Outcome Score or Anterior Cruciate Ligament-Return to Sport after Injury scale were observed at two years postoperatively. Subgroup analysis based on primary surgical technique (single-bundle vs. double-bundle) revealed no significant differences in rerupture rates or femoral tunnel positioning at revision. Multivariate logistic regression identified anatomical tunnel placement during the revision surgery as the only independent protective factor against rerupture (odds ratio, 0.145; 95% CI, 0.022-0.951; p = 0.044).</p><p><strong>Conclusion: </strong>Anatomical tunnel placement during primary ACLR appears to be a key factor associated with a reduced risk of rerupture following revision ACLR. These exploratory findings underscore the importance of accurate tunnel positioning and should be interpreted cautiously due to limited sample size.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734468","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":"Newer versus older implant systems from a single manufacturer and cause-specific revision risk following primary total knee arthroplasty.","authors":"Matthew Kelly, Heather Prentice, Brian Fasig, Dhiren Sheth, Nithin Reddy, Monti Khatod, Elizabeth Paxton","doi":"10.1055/a-2664-7627","DOIUrl":"https://doi.org/10.1055/a-2664-7627","url":null,"abstract":"<p><strong>Background: </strong>Novel implant systems have design modifications that seek to improve total knee arthroplasty (TKA) survivorship. We evaluated overall and cause-specific revision risk for a newer generation implant system compared to its predecessor from the same manufacturer.</p><p><strong>Methods: </strong>We conducted a cohort study using data from the United States-based Kaiser Permanente Total Joint Replacement Registry. Adult patients who underwent primary, fully cemented, fixed bearing TKA for osteoarthritis between 2009 to 2022 were identified. Only two implant systems from the manufacturer were included: the newer generation (n=22,287) and the older generation (n=37,105). Multivariable Cox regression was used to evaluate overall and cause-specific aseptic revision risk.</p><p><strong>Results: </strong>In the adjusted analyses, no difference in risk was observed for the newer compared to older generation system in the first 4-years follow-up (HR=0.94, 95% CI=0.74-1.19); however, a higher risk was observed after 4-years follow-up (HR=2.09, 95% CI=1.41-3.08). This higher risk was due to loosening (within 4-years: HR=0.90, 95% CI=0.59-1.37; after 4-years: HR=2.88, 95% CI=1.84-4.51); no differences were observed for other revision reasons. When considering constructs utilizing different trays of the newer generation system, the higher risk of revision for loosening was observed only when the first iteration of the tray was used (HR=1.94, 95% CI=1.37-2.77); no difference was observed for constructs utilizing the subsequent iterations of the tray, which underwent design changes, when compared to the older generation TKA system (HR=0.45, 95% CI=0.20-1.01).</p><p><strong>Conclusions: </strong>We found no survivorship advantage with a newer TKA design compared to a preceding design from the same manufacturer. The higher risk of revision for loosening in the newer generation constructs was limited to those utilizing the first tray iteration, which is now discontinued by the manufacturer. The higher revision risk was not observed with subsequent iterations of the newer generation construct relative to the older generation.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734466","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":"Anterior Cruciate Ligament Injuries in National Football League Players from 2012 to 2022: A Descriptive Epidemiology Study.","authors":"Ashwin R Garlapaty, Rown Parola, Morgan C Kluge, Quin P Blankenship, Abdoulie Njai, James T Stannard, Caleb J Bischoff, James L Cook, Steven F DeFroda, Clayton W Nuelle","doi":"10.1055/a-2652-2567","DOIUrl":"10.1055/a-2652-2567","url":null,"abstract":"<p><p>There is a high incidence of anterior cruciate ligament (ACL) tears in National Football League (NFL) players. There is a relative paucity of long-term data characterizing the effects of artificial versus natural playing surfaces on ACL tear incidence. A comprehensive search of publicly available data identified any NFL player who sustained an ACL injury from 2012 to 2022. The publicly available databases allowed for characterization of playing surface, player position, timing of injury in season, mechanism of injury, and player's age. Incidence of ACL injuries by playing surface, player position, and position group relative to all other positions or position groups were compared by chi-squared test. Correlates of in-game ACL injury were determined by stepwise multivariate logistic regression. There were 520 NFL players who experienced an ACL tear between seasons 2012-2013 and 2022-2023. There was no significant difference in incidence of ACL tears on artificial turf versus natural playing surfaces (265 versus 255, <i>p</i> = 0.670). Wide receivers (<i>p</i> = 0.027) were associated with a significantly higher incidence of ACL tears compared with other positions. Receivers (wide receivers and tight ends) (<i>p</i> = 0.007) were associated with significantly higher incidence of ACL tears compared with other position groups, while specialists (punters, kickers, and long snappers) (<i>p</i> < 0.001) were associated with significantly lower incidence of ACL tears compared with other position groups. No significant difference between mechanism of injury between playing surfaces was found (<i>p</i> = 0.765). More ACL tears occurred before week 9 than on or after week 9 in-season, and the proportion of ACL tears occurring during a game (67%) was significantly higher than those occurring during practice. There was no statistically significant difference in incidence of ACL tears in NFL players from the 2012-2013 to 2022-2023 seasons based on playing surface (artificial versus natural). Wide receivers had a significantly higher incidence of ACL tears compared with other positions and tears were more common during games and before week 9 in-season.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610064","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":"Medicaid-Insured Patients Exhibit Similar Improvements in Knee Range of Motion Compared to Commercially Insured Patients Despite Inferior Access to Physical Therapy Following ACL Reconstruction.","authors":"Eric V Neufeld, John M Tarazi, Catherine Wickes, Brandon J Klein, Melissa A Colleluori, Randy M Cohn, Andrew D Goodwillie","doi":"10.1055/a-2640-3314","DOIUrl":"https://doi.org/10.1055/a-2640-3314","url":null,"abstract":"<p><p>Insurance status has been shown to impact clinical outcomes after several orthopaedic procedures. Current evidence examining the role of insurance provider on outcomes following anterior cruciate ligament (ACL) reconstruction is limited. Therefore, the purpose of this investigation was to explore the effect that insurance carrier had on physical therapy (PT) access, knee range of motion (ROM), and Knee Outcome Survey (KOS) scores. A retrospective cohort study identified patients who underwent ACL reconstruction at an academic health system from January 1, 2019 to December 31, 2021. Patients were partitioned into two cohorts based on their insurance provider: Managed care (MC) or commercial (COM). Outcomes recorded change in knee active range of motion (AROM), passive ROM (PROM), KOS score, and reason for conclusion of PT. Univariate and multivariate analyses were performed by chi-squared tests, Welch's <i>t</i>-tests, as well as multivariable logistic and linear regression with Bonferroni corrections applied to control the family-wise error rate. The study cohort included 149 patients who underwent ACL reconstruction and completed rehabilitation within affiliated PT locations. The MC cohort experienced a longer time until the first PT visit, shorter duration of PT, fewer total PT visits as well as insurance-authorized visits, and a smaller maximum number of visits per patient's benefit. However, there was no difference between cohorts in the number of visits divided over the treatment duration or the number of visits attended over the total number authorized. Both the groups displayed statistically similar improvements in AROM, PROM, and KOS in addition to comparable reasons for concluding PT. Furthermore, regression demonstrated that no insurance parameter predicted changes in AROM, PROM, KOS, or reason for concluding PT. MC-provided patients who underwent ACL reconstruction had inferior access to PT compared with those insured by COM. However, MC and COM yielded a similar percentage utilization of authorized PT visits and number of insurance denials leading to early PT termination. Both the cohorts also demonstrated similar improvements in AROM, PROM, and KOS.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643927","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 of Isokinetic Strength Deficits and Subjective Complaints in Patients with Knee Osteoarthritis Scheduled for Total Knee Arthroplasty.","authors":"Anna Gerg, Felix Greimel, Jan Reinhard, Tobias Kappenschneider, Stefano Pagano, Günther Maderbacher, Florian Zeman, Joachim Grifka, Julia Schiegl","doi":"10.1055/a-2631-4611","DOIUrl":"https://doi.org/10.1055/a-2631-4611","url":null,"abstract":"<p><p>This study investigated isokinetic muscle strength deficits in patients with advanced knee osteoarthritis (KOA) scheduled for total knee arthroplasty (TKA) to explore the relationship between objective strength measures and subjective symptoms such as pain and functional limitations. By analyzing muscle function using isokinetic dynamometry, the study aimed to provide insights into how strength deficits relate to patient-reported outcomes and whether these assessments could inform surgical decision-making. A total of 52 patients (mean age: 66.96 years, 53.85% female) with advanced KOA awaiting TKA were included. Isokinetic muscle strength of the knee, measured in peak torque (Newton-meters), work (Joules), and power (Watts), was assessed bilaterally before surgery using a Biodex dynamometer at angular velocities of 180 degrees/s and 60 degrees/s. Subjective symptoms were evaluated using standardized assessments, including the Numeric Rating Scale (NRS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Short Form-12 (SF-12), Hospital Anxiety and Depression Scale (HADS-D), and EuroQol 5-Dimension 3-Level questionnaire. Findings revealed a significant strength deficit on the affected side scheduled for surgery (<i>p</i> < 0.050). However, correlations between isokinetic knee parameters and symptom scores were weak (|r| ≤0.5), suggesting that subjective complaints do not necessarily align with objective strength measurements. Notably, isokinetic parameters were significantly intercorrelated (<i>p</i> < 0.050). These results indicate that isokinetic dynamometry effectively quantifies muscle strength differences in KOA patients, yet its findings should be considered alongside clinical assessments and patient-reported symptoms to form a comprehensive evaluation of disease severity and surgical necessity.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601979","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":"Revision of Unicompartmental Knee Arthroplasty Results in Outcomes Similar to those of Primary Total Knee Arthroplasty and Superior to those of Revision Total Knee Arthroplasty.","authors":"Chiara Ursino, Nicola Ursino, Amit Meena, Luca Maria Sconfienza, Riccardo D'Ambrosi","doi":"10.1055/a-2638-9842","DOIUrl":"10.1055/a-2638-9842","url":null,"abstract":"<p><p>The main aim of this study was to analyze whether revision of medial unicompartmental knee arthroplasty (rUKA) has better clinical outcomes than primary total knee arthroplasty (TKA) or revision of total knee arthroplasty (rTKA). The study reference group (rUKA) was identified and matched with two control groups: primary TKA and revision rTKA. Patients were matched according to five preoperative factors: follow-up (minimum of 60 months), age, sex, body mass index (BMI), and operation side at a ratio of 1:1:1. The Knee Society score (KSS) and the forgotten joint score (FJS) were used for the clinical assessment. The pain was measured via the visual analog scale (VAS) for pain. The following complications were also recorded: postoperative anemia, infection, and revision surgeries. Forty-five patients were included in each group. The three groups did not differ in terms of age, sex, operation side, BMI, or follow-up (<i>p</i> > 0.05). At the final follow-up, the rTKA group had lower values than did the rUKA and TKA groups in terms of the KSS (rUKA = 95; TKA = 100; rTKA = 87.5) and FJS (rUKA = 95; TKA = 100; rTKA = 90; <i>p</i> < 0.05). For the KSS, no difference was found between the rUKA and TKA groups (<i>p</i> > 0.05). Regarding pain, the rTKA group had a lower value than the TKA group did (<i>p</i> = 0.001; rUKA = 3; TKA = 2; rTKA = 3), whereas in terms of FJS, there was also a difference between the rUKA and TKA groups (<i>p</i> = 0.038). The rates of complications in terms of postoperative anemia and aseptic loosening were similar among the three groups (<i>p</i> > 0.05). Revised UKA has comparable clinical and patient-reported outcomes to those of primary TKA and better outcomes than those of revised TKA, whereas medical complications of revised UKA are similar to those of primary TKA. These findings serve to inform discussions with patients requiring revision of a UKA regarding clinical outcomes and complications following this procedure. The level of evidence is a level III match cohort study.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327465","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":"Why Are Patients Without Identifiable Etiology of Failure Dissatisfied Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Chiranjit De, Muhammad Tahir, Todd Pierce, Prashant Awasthi, Paul C Fonseca","doi":"10.1055/a-2638-9613","DOIUrl":"https://doi.org/10.1055/a-2638-9613","url":null,"abstract":"<p><p>Patient satisfaction following primary total knee arthroplasty (TKA) is of great importance to practitioners, and as many as one in five patients report postoperative dissatisfaction. The purpose of this study was to assess patient-specific factors that may have a correlation with being unsatisfied following primary TKA. A comprehensive literature review of four electronic databases was considered for inclusion in this meta-analysis. Upon review, 12 studies were included for analysis. Patient-specific factors for dissatisfaction without failure etiology were evaluated. The final cohort consisted of 27,496 patients who underwent primary TKA, and 2,815 (10.2%) were dissatisfied with their TKA. There was an association found between dissatisfaction and mild osteoarthritis (relative ratio [RR]: 1.86; 95% confidence interval [CI]: 1.41-2.45; <i>p</i> = 0.0001), female gender (RR: 1.06; 95% CI: 1.02-1.10; <i>p</i> = 0.004), and a diagnosis of depression and/or anxiety (RR: 1.46; 95% CI: 1.30-1.64; <i>p</i> = 0.0001). There was substantial heterogeneity among the studies. Those who may be at higher risk for dissatisfaction include those with mild arthritis, female gender, and depression/anxiety. Future research should focus on the role of any preoperative interventions and possible surgery-specific factors that may increase the chances of patient satisfaction.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592701","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":"Does Lateral Extraarticular Tenodesis Lead to Poor Patellofemoral Outcome in ACL Revision on Professional Soccer Players? A Minimum 3-Year, Clinical Radiographic Retrospective Study.","authors":"Mattia Alessio-Mazzola, Antonio Russo, Sean Ahmadi, Giacomo Placella, Lamberto Felli, Vincenzo Salini","doi":"10.1055/a-2640-3249","DOIUrl":"10.1055/a-2640-3249","url":null,"abstract":"<p><p>Lateral extra-articular tenodesis (LET) is indicated to decrease the pivot shift and to restore rotational control in anterior cruciate ligament (ACL) surgery. However, there are still concerns regarding the patellofemoral joint, as with increased tension on the iliotibial band, there is a hypothetical increase of lateralizing forces on the lateral patellar surface. To compare clinical and radiographic patellofemoral outcomes of professional soccer players who underwent LET and ACL revision with a control group of professional soccer players who underwent primary ACL reconstruction. Retrospective comparative study. Inclusion criteria were professional or elite soccer players with failed ACL reconstruction who underwent ACL revision and LET for anterior laxity >5 mm and a pivot-shift test >2. Exclusion criteria were a two-stage procedure, injuries to the contralateral knee, multi-ligament injuries, and patients with less than 3 years of follow-up. The control group was selected as standard ACL reconstruction with autograft in elite or professional soccer players. All included patients were assessed with a Tegner Lysholm, IKDC, and Kujala score. Patients recalled for radiographic patellofemoral assessment with bilateral skyline Merchant view which was compared with the contralateral unaffected knee. Sixty-four consecutive patients (30 in the study group and 34 in the control group) treated from 2015 to 2018 have been included in the study. All patients had a minimum 3-year follow-up, and the mean follow-up was 4.9 ± 2.8 (range: 3-7) years. Overall, patients demonstrated significant improvement in measured outcome measures from baseline to final follow-up. There were no significant differences between groups in Kujala, Tegner and Lysholm, and IKDC scores (<i>p</i> > 0.05). In the study group, no significant differences in lateral patellar tilt (<i>p</i> > 0.05) between treated and unaffected knees were found. LET represents a reliable solution to increase anteroposterior and rotational stability in revision ACL reconstruction with severe pivot shift. Clinical and radiographical results showed favorable patellofemoral outcomes, with clinical scores comparable to primary surgery and no significant patellar lateralization and degenerative changes.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337162","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":"Partial Meniscectomy or Physical Therapy in Degenerative Meniscus Tears: A Retrospective Cohort Study with 2-Year Follow-Up.","authors":"Yusuf Altuntas, Ismail Tuter, Raffi Armagan, Rodi Ertogrul, Muharrem Kanar, Güngör Alibakan, Osman T Eren","doi":"10.1055/a-2640-3369","DOIUrl":"10.1055/a-2640-3369","url":null,"abstract":"<p><p>Degenerative meniscal injuries are a common occurrence in orthopedic practice. However, there is currently no consensus regarding the optimal treatment algorithm and the efficacy of different treatment modalities. Therefore, this study aimed to analyze the clinical reflections of arthroscopic partial meniscectomy (APM) and physical therapy (PT) methods, as well as the potential development of osteoarthritis (OA) following treatment. The study group comprised patients diagnosed with degenerative meniscal tears who were treated with either conservative or APM methods at a center between March 2021 and January 2022. The radiographs of these patients prior to the commencement of treatment were classified according to the Kelgren-Lawrence system, and clinical and pain scores were recorded. Following a 2-year period of treatment, the radiographs and scores at the conclusion of the third, 12th, and 24th months were analyzed. Among 213 patients followed up with a diagnosis of degenerative meniscal damage, at the 3-month follow-up, the APM group demonstrated significantly better pain relief and functional outcomes compared with the PT group, with notable improvements in WOMAC (between score difference: -15.96; 95% confidence interval [CI]: -17.08 to -14.83), Lysholm (23.43; 95% CI: 22.15-24.71), and VAS (-6.98; 95% CI: -7.25 to -6.71) scores (<i>p</i> < 0.001). However, by the 12th and 24th months, both groups showed comparable long-term improvements. Radiographic assessments over 2 years revealed no significant differences in OA progression. These findings suggest that APM provides superior short-term benefits, but both APM and PT are equally effective in the long-term management of degenerative meniscus tears. A comparison of the APM and PT groups revealed that patients under 50 years of age who underwent APM demonstrated superior outcomes in terms of pain and functional scores at the 3-month follow-up. At the 2-year mark, the efficacy of the treatment methods was established, yet no significant differences were observed in their capacity to prevent OA.The level of evidence is III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337163","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}