Journal of Knee Surgery最新文献

{"title":"Initial Outcomes of Single versus Multiple-Plug Osteochondral Allograft Transplantation for Osteochondral Defects of the Knee: A Matched Cohort Analysis.","authors":"Julia S Retzky, Francesca R Coxe, Brittany Ammerman, Ava G Neijna, Paige Hinkley, Andreas H Gomoll, Sabrina M Strickland","doi":"10.1055/a-2368-4253","DOIUrl":"10.1055/a-2368-4253","url":null,"abstract":"<p><p>Although several prior studies have described the outcomes of osteochondral allograft (OCA) transplantation for single osteochondral lesions, there is a paucity of comparative data on outcomes of single versus multiple OCA transplants. We aimed to describe the initial outcomes of single-plug versus multiple-plug knee OCA transplants at a minimum of 1 year of follow-up. We hypothesized that there would be no difference in patient-reported outcome measures (PROMs) between patients undergoing single-plug and multiple-plug OCA transplants at a minimum of 1 year of follow-up. We retrospectively reviewed the prospectively collected data of patients undergoing OCA transplantation for large (>2 cm²) osteochondral defects of the knee. Thirty patients who underwent multiple-plug (2 + ) OCA transplants (either single surface using the snowman technique or multi-surface) were 1:1 age, sex, and body mass index (BMI) matched with 30 patients who underwent single-plug OCA transplants. PROMs, including the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores, were obtained both preoperatively and at a minimum of 1 year postoperatively. Failure was defined as a revision OCA or conversion to unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). The cohort comprised 30 females (31 affected left knees), with an average age of 37 ± 10.3 years and median follow-up of 2.0 years (interquartile range: 1.7-2.5 years). There was a significant increase in PROMs from the preoperative to the postoperative period for the entire cohort and the single-plug versus multiple-plug subgroups (<i>p</i> < 0.01). There was no difference between the groups with respect to the percentage of patients who achieved the minimal clinically important difference (MCID) for each PROM (<i>p</i> > 0.05). There were two failures, both in the single-plug group, with a mean time to failure of 3.5 years. There was no difference in the initial outcomes between patients undergoing single-plug versus multiple-plug OCA transplant at the short-term follow-up. LEVEL OF EVIDENCE::  Level IV, case series.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"902-909"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635069","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 Patients Based on Their Self-Selected Discharge Pathway after Total Knee Arthroplasty at an Ambulatory Surgical Center.","authors":"Allison Palmsten, Amy L Haynes, Jaclyn M Ryan, Gavin T Pittman, Der-Chen T Huang, Michael Obermeier, Terese L Chmielewski","doi":"10.1055/a-2344-4993","DOIUrl":"10.1055/a-2344-4993","url":null,"abstract":"<p><p>Outpatient total knee arthroplasty (TKA) is being performed more frequently in ambulatory surgical centers (ASCs) to decrease the cost of care. Discharge pathways include 23-hour observation (OBSERVATION) or same-day discharge home (HOME), which differ in postoperative medical supervision. Few studies allow patients to self-select their discharge pathway. This study compared patient variables between self-selected OBSERVATION or HOME discharge after TKA at an ASC. We hypothesized that age, sex, and distance lived from the ASC would differ between discharge pathways. Clinical and patient-reported outcomes were explored.A chart review identified 130 patients with TKA at an ASC between November 2017 and December 2019. Patients self-selected OBSERVATION or HOME during a preoperative physician visit. Patient variables obtained from the electronic medical record were age, sex, race/ethnicity, marital status, body mass index, diabetic status, American Society of Anesthesiologists (ASA) class, distance lived from the ASC, anesthesia type, procedure time, and time in the postanesthesia recovery unit. Clinical outcomes (knee range of motion, infection rate, and reoperation rate) and patient-reported outcomes (Knee Injury and Osteoarthritis Outcome Score, Joint Replacement [KOOS, JR]; Oxford Knee Score [OKS]) were collected at either 6 or 12 weeks postsurgery. Variables were compared between groups.Pathway selection was <i>n</i> = 70 OBSERVATION and <i>n</i> = 60 HOME, and all patients completed their self-selected discharge pathway. Age and proportion of females were significantly higher in OBSERVATION than in HOME (61.3 ± 3.5 vs. 58.5 ± 5.4 years, 85.7 vs. 65.0%, respectively; <i>p</i> < 0.05). Distance lived from the ASC tended to be greater in OBSERVATION than HOME (22.1 ± 24.6 vs. 15.3 ± 10.1 miles, <i>p</i> = 0.056). Across groups, clinical outcomes were favorable (i.e., >88% met the 6-week knee flexion milestone, 1.9% infection rate, and 3.1% manipulation under anesthesia), and the preoperative to 12-week postoperative change in KOOS, JR and OKS scores met the minimal clinically important difference.Older age, female sex, and farther distance lived from the ASC may influence patients to select OBSERVATION over HOME discharge following TKA at an ASC. No robust differences were found in early outcomes.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"887-893"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318664","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":"An Advanced Knee Simulator Model Can Reproducibly Be Used for Ligament Balancing Training during Total Knee Arthroplasty.","authors":"Scott Logan, Sean B Sequeira, Seth A Jerabek, Arthur L Malkani, Ormond M Mahoney, James P Crutcher, Michael A Mont, Ahmad Faizan","doi":"10.1055/a-2343-2346","DOIUrl":"10.1055/a-2343-2346","url":null,"abstract":"<p><p>A critical and difficult aspect of total knee arthroplasty (TKA) is ligamentous balancing for which cadavers and models have played a large role in the education and training of new arthroplasty surgeons, although they both have several shortcomings including cost, scarcity, and dissimilarity to in vivo ligament properties. An advanced knee simulator (AKS) model based on computed tomography (CT) scans was developed in the setting of these challenges with cadavers and previous models. In this study, we compared the ligament balancing between AKS and human cadaveric knees to assess the validity of using the AKS for ligament balancing training during TKA. A CT scan of a TKA patient with varus deformity was used to design the AKS model with modular components, using three-dimensional printing. Three fellowship-trained arthroplasty surgeons used technology-assisted TKA procedure to plan and balance three cadaver knees and the AKS model. Medial and lateral laxity data were captured using manual varus and valgus stress assessments for cadavers and the model in an extension pose (10 degrees of flexion from terminal extension) and between 90 and 95 degrees for flexion. After preresection assessments, surgeons planned a balanced cruciate-retaining TKA. Following bony cuts and trialing, extension and flexion ligament laxity values were recorded in a similar manner. Descriptive statistics and Student's <i>t-</i>tests were performed to compare the cadavers and model with a <i>p</i>-value set at 0.05. Preresection medial/lateral laxity data for both extension and flexion were plotted and showed that the highest standard deviation (SD) for the cadavers was 0.67 mm, whereas the highest SD for the AKS was 1.25 mm. A similar plot for trialing demonstrated that the highest SD for the cadavers was 0.6 mm, whereas the highest SD for the AKS was 0.61 mm. The AKS trialing data were highly reproducible when compared with cadaveric data, demonstrating the value of the AKS model as a tool to teach ligament balancing for TKA and for future research endeavors.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"873-878"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312088","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 the Cost-Effectiveness and Safety between Staged Bilateral Total Knee Arthroplasty and Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Cohort Study between 2001 and 2022.","authors":"Omar W K Tsui, Ping-Keung Chan, Amy Cheung, Vincent W K Chan, Michelle H Luk, Man-Hong Cheung, Lawrence C M Lau, Thomas K C Leung, Henry Fu, Kwong-Yuen Chiu","doi":"10.1055/a-2368-4516","DOIUrl":"10.1055/a-2368-4516","url":null,"abstract":"<p><p>A substantial proportion of Hong Kong's aging population suffers from osteoarthritis in both knees. Bilateral total knee arthroplasty (BTKA) is a surgical option for addressing this condition and can be performed via two approaches: simultaneous BTKA (SimBTKA) and staged BTKA (StaBTKA). We compared the cost-effectiveness and safety of these two methods in our institution. We retrospectively reviewed 2,372 patients (SimBTKA, 772; StaBTKA, 1,600; females, 1,780; males, 592; mean age at SimBTKA, 70.4 ± 7.99 years; mean age at StaBTKA, 66.4 ± 7.50 years; <i>p</i> < 0.001) who underwent BTKA in our institution from 2001 to 2022. Patients were categorized according to the surgical approach. Patients undergoing BTKA in our institution were included. Particularly for SimBTKA, patients were assessed by anesthetists to be medically fit before undergoing the procedure according to their age, American Society of Anesthesiologists status, and osteoarthritis severity. The primary outcome was the length of stay (LOS) after surgery. The secondary outcomes were the 30-day unintended readmission, intensive care unit (ICU) admission, and death. SimBTKA had a shorter mean total LOS (acute hospital + rehabilitation center; SimBTKA, 13.09 days; StaBTKA, 18.12 days; <i>p</i> < 0.001) and mean LOS in acute hospital (SimBTKA, 7.70 days; StaBTKA, 10.42 days; <i>p</i> < 0.001). However, no significant difference was found in the mean LOS in rehabilitation centers (SimBTKA, 5.47 days; StaBTKA, 6.32 days; <i>p</i> > 0.05) between the two approaches. The 30-day unintended readmission rate was lower in SimBTKA (SimBTKA, 2.07%; StaBTKA, 3.30%; odds ratio [OR] = 1.60; <i>p</i> > 0.05) but statistically insignificant. SimBTKA was less costly than StaBTKA by US$ 8,422.22 per patient. No significant differences in ICU admission and death rates were found (<i>p</i> > 0.05) between the two groups. SimBTKA had a shorter LOS and lower cost than StaBTKA and comparable complication rates. Therefore, SimBTKA should be indicated in medically stable patients.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"916-923"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635068","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":"Biomechanical Effects of Stem Extension of Tibial Components for Medial Tibial Bone Defects in Total Knee Arthroplasty: A Finite Element Study.","authors":"Hyuck Min Kwon, Hyoung-Taek Hong, Inuk Kim, Byung Woo Cho, Yong-Gon Koh, Kwan Kyu Park, Kyoung-Tak Kang","doi":"10.1055/a-2344-5084","DOIUrl":"10.1055/a-2344-5084","url":null,"abstract":"<p><p>The aim of this study was to investigate the biomechanical effects of stem extension with a medial tibial bone defect in primary total knee arthroplasty (TKA) on load distribution and stress in the proximal tibia using finite element (FE) analysis.FE simulations were performed on the tibia bone to evaluate the stress and strain on the tibia bone and bone cement. This was done to investigate the stress shielding effect, stability of the tibia plate, and the biomechanical effects in TKA models with various medial defects and different stem length models.The results demonstrated that in the bone defect model, the longer the stem, the lower the average von Mises stress on the cortical and trabecular bones. In particular, as the bone defect increased, the average von Mises stress on cortical and trabecular bones increased. The average increase in stress according to the size of the bone defect was smaller in the long stem than in the short stem. The maximal principal strain on the trabecular bone occurred mainly at the contact point on the distal end of the stem of the tibial implant. When a short stem was applied, the maximal principal strain on the trabecular bone was approximately 8% and 20% smaller than when a long stem was applied or when no stem was applied, respectively.The findings suggest that a short stem extension of the tibial component could help achieve excellent biomechanical results when performing TKA with a medial tibial bone defect.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"879-886"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318663","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":"Characterization and Potential Relevance of Randomized Controlled Trial Patient Populations in Revision Total Joint Arthroplasty: A Systematic Review.","authors":"Jonathan S Yu, Vidushi Tripathi, Patrick Magahis, Michael Ast, Peter Sculco, Ajay Premkumar","doi":"10.1055/a-2428-1058","DOIUrl":"10.1055/a-2428-1058","url":null,"abstract":"<p><p>Randomized controlled trial (RCT) studies in revision total joint arthroplasty (rTJA) are essential to investigate the effectiveness of interventions. However, there has been limited research investigating how patient cohorts comprising rTJA RCT samples resemble the U.S. patient population undergoing rTJA in terms of demographic and clinical characteristics. Thus, the purpose of this systematic review was to compare the patient characteristics of rTJA RCT cohorts with the characteristics of national patient database cohorts. RCT studies for rTJA were aggregated. Patient demographics in this group were compared against Healthcare Cost and Utilization Project-National Inpatient Sample (NIS) and American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) patient cohorts. Forty-six RCTs met inclusion criteria. There were 3,780 total patients across 46 RCTs. The average age of patients in the rTJA RCT cohort was 66.4 ± 9.4 while in the NIS cohort was 67.3 ± 11.1 (<i>d</i> = 0.08, effect size = small). The average body mass index (BMI) of the rTJA RCT cohort was 31.1 ± 5.7 while the NSQIP cohort was 31.7 ± 8.3 (<i>d</i> = 0.08, effect size = small). For rTJA, effect sizes for age, BMI, sex, ethnicity, smoking, and diabetes were all small or very small.Overall, the rTJA RCT patient cohort does not differ significantly compared with the general patient population undergoing rTJA. Differences in demographic and clinical characteristics between the rTJA RCT cohort and database cohorts were minimal to small, indicating that these differences are unlikely to impact clinical outcomes.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367098","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 Impact of Anterior Cruciate Ligament Tear on Player Performance and Longevity in La Liga League Soccer Players.","authors":"Abdullah N Ghali, Philip Ghobrial, David A Momtaz, Hari N Krishnakumar, Rishi K Gonuguntla, Yousef Salem, Amir AlSaidi, Katherine C Bartush, David M Heath","doi":"10.1055/s-0044-1791985","DOIUrl":"https://doi.org/10.1055/s-0044-1791985","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) rupture is among the most studied sports injuries. We investigate the impact of ACL reconstruction (ACLR) on performance and longevity in La Liga to elucidate performance parameters impacted after surgery in professional soccer players and variables impacting return-to-play (RTP).Demographic and performance data for La Liga players with ACLR between 1993 and 2020 were collected three seasons before and after injury and compared with two healthy controls. Analysis was conducted between and within ACLR and control groups. Pearson's correlation coefficients and a multiple linear regression model analyzed relationships between demographic variables and RTP.After exclusion, 23 professional soccer players were identified for the ACLR group. One year after index, ACLR had lower goals, shots on-target, assists, pass percentage, tackles, tackle success percentage, blocks, and clearances compared with control (<i>p</i> < 0.05). Two years after index, ACLR had lower assists, pass percentage, and tackle success percentage than control (<i>p</i> < 0.05). Three years after index, ACLR had fewer matches and blocks versus control (<i>p</i> < 0.05). Pearson's correlation showed a positive correlation between experience and RTP (<i>p</i> = 0.001). Multiple linear regression found RTP to increase 32.66 days for each additional year of experience (<i>p</i> < 0.001).With performance metrics showing significant decreases up to 2 years post-ACLR but largely recovering within 3 years of RTP, results support that soccer players undergoing ACLR eventually recover to preinjury levels of play. Players should be counseled on initial declines in performance metrics the first few years after RTP.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Difference in Postoperative Complications Between Simultaneous and Staged, Bilateral Unicompartmental Knee Arthroplasty.","authors":"Enrico M Forlenza, Joseph Serino, Daniel Shinn, Tad Gerlinger, Craig Della Valle, Denis Nam","doi":"10.1055/a-2451-1194","DOIUrl":"https://doi.org/10.1055/a-2451-1194","url":null,"abstract":"<p><p>Background The optimal timing of contralateral surgery following unicompartmental knee arthroplasty (UKA) remains unknown. Therefore, the objective of this study was to examine the differences in postoperative complications in patients undergoing unilateral, simultaneous and staged bilateral UKA. Methods The PearlDiver administrative claims database was queried for patients undergoing UKA between 2015-2020. Patients undergoing unilateral UKA were matched in a 1:1 fashion based on age, gender, Elixhauser Comorbidity Index (ECI), obesity, diabetes and smoking status to patients undergoing simultaneous bilateral UKA, bilateral UKA staged 1-90 days and bilateral UKA staged 91-365 days. Univariate and multivariate analyses were performed to examine the impact of timing of bilateral procedures on 90-day postoperative complications relative to patients who underwent unilateral UKA. Outcomes were considered significant at p<0.05. Results A total of 9,638 patients undergoing UKA were included in the final analysis, of which 5,672 (58.9%) were unilateral, 396 (4.1%) were simultaneous bilateral, 1,496 (15.5%) were bilateral staged between 1-90 days and 2,074 (21.5%) were bilateral staged between 91-365 days. Univariate analysis identified no significant differences in complications between matched groups except for an increased incidence of wound dehiscence amongst patients who underwent simultaneous bilateral UKA (2.1% vs. 0.0%, p=0.040) compared to unilateral UKA. However, multivariate analysis demonstrated that simultaneous or staged bilateral UKA at either time point did not increase the risk of any postoperative complication relative to unilateral surgery. Conclusion Bilateral UKA can be performed simultaneously or in a staged fashion without increasing the risk of 90-day complications relative to unilateral UKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint Injection or Aspiration before Total Knee Arthroplasty: Does it Increase the Risk of Periprosthetic Joint Infection?","authors":"Darren Nin, Ya-Wen Chen, Carl Talmo, Brian Hollenbeck, David Mattingly, Yoav Zvi, Ruijia Niu, David Chang, Eric L Smith","doi":"10.1055/a-2451-8845","DOIUrl":"https://doi.org/10.1055/a-2451-8845","url":null,"abstract":"<p><p>Background Injections are a common preoperative treatment for patients who eventually undergo total knee arthroplasty (TKA). However, recent studies have shown a relationship between preoperative injections and adverse outcomes following surgery. The purpose of this study was to characterize the type of intra-articular procedure patients receive in the acute period prior to surgery and determine their association with postoperative periprosthetic joint infection (PJI) Methods An observational cohort study was conducted using the Merative MarketScan databases. Patients who underwent primary TKA between April 1, 2019, and July 4, 2021, were included in the study. Patients were grouped according to the type of intra-articular procedure they received in the 90-day period prior to TKA: (i) intra-articular hyaluronic (IA-HA), (ii) intra-articular corticosteroid (IA-CS), (iii) aspiration, and (iv) no drug injections or aspirations. The primary outcome was the postoperative 180-day PJI rate. Results 43,219 patients were included in the study. 11.8% of patients were found to have received at least one injection or aspiration in the 90 days prior to their TKA. The most common injection performed was IA-CS (78.3%), followed by aspiration (13.0%) and IA-HA (8.7%). No image guidance was performed for 92.3% of injections, with most being administered between 61-90 days before surgery (93.6%). 180-day PJI rates were similar between patients with and without injections (OR 1.11, p=.569). Neither drug type nor image guidance had an effect on overall postoperative PJI rate. Conclusion Injections performed prior to TKA do not increase the risk of developing postoperative.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510975","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 Allograft Reconstruction in Females Can Produce Outcomes Comparable to Those of Autografts in Male Counterparts.","authors":"Sung Bae Park, Yong Seuk Lee","doi":"10.1055/a-2451-6685","DOIUrl":"https://doi.org/10.1055/a-2451-6685","url":null,"abstract":"<p><strong>Introduction: </strong>There are unique anatomic and geometric risk factors that contribute to higher injury rates of the anterior cruciate ligament (ACL) in women. Allografts are an important alternative option for female patients.</p><p><strong>Materials & methods: </strong>Patients who underwent primary ACL reconstruction were retrospectively evaluated. The case group comprised female patients with ACL allograft reconstruction, and the control group comprised male patients with ACL reconstruction. Functional and clinical evaluations were based on the pre- and postoperative Cybex test, Lysholm score, International Knee Documentation Committee subjective and objective measurement criteria, and Tegner Activity Scale questionnaires. Radiological comparisons were performed using the femorotibial angle (FTA), posterior tibial slope (PTS), and intercondylar notch width (INW). The roof inclination angle (RIA) was assessed using magnetic resonance imaging.</p><p><strong>Results: </strong>The two groups [female (44) and male (88)] had an average follow-up period of 57.9±19.3 months and average ages of 36.5±10.9 and 35.2±11.7 years, respectively. Functional and clinical outcomes showed no differences between the groups, except that the return to the pre-injury activity level was higher in the female group (95% vs. 77%, P<0.001). The female group showed larger FTA and PTS and smaller INW and RIA than those of the male group (P<0.001, 0.008, <0.001 and 0.035, respectively).</p><p><strong>Conclusion: </strong>Female ACL allograft reconstruction showed comparable outcomes to those of their male counterparts, and the return to pre-injury activity levels was significantly higher in women. However, women showed lower activity levels and were more vulnerable to geometric risk factors than their male counterparts.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510974","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}