Journal of Knee Surgery最新文献

{"title":"Does Resurfacing the Patella Increase the Risk of Extensor Mechanism Injury Within the First Two Years After Total Knee Arthroplasty?","authors":"David E DeMik,Juan David Lizcano,Emily Jimenez,Kyle Mullen,Jess H Lonner,Chad A Krueger","doi":"10.1055/a-2413-3876","DOIUrl":"https://doi.org/10.1055/a-2413-3876","url":null,"abstract":"Background Extensor mechanism injury (EMI) following total knee arthroplasty (TKA) is a potentially catastrophic complication and may lead to significant morbidity or need for revision reconstructive procedures. Patella resurfacing (PR), while commonly performed during TKA, reduces overall patella bone stock and may increase the risk of EMI after TKA. The purpose of this study was to assess if patellar resurfacing (PR) in elderly patients raises the risk for subsequent EMI. Methods The American Joint Replacement Registry (AJRR) was queried to identify Medicare patients ≥65 years old undergoing primary elective TKA for osteoarthritis between January 2012 and March 2020. Patient age, sex, and Charlson Comorbidity Index (CCI) were collected. Records were subsequently merged with Medicare claims records and evaluated for the occurrence of patella fracture, quadriceps tendon rupture, or patellar tendon rupture based on ICD-9/10 diagnosis codes within 2 years of TKA. Patients were stratified based on whether PR occurred or not (NR). Logistic regression was used to determine the association between PR and EMI. Results A total of 453,828 TKA were eligible for inclusion and 428,644 (94.45%) underwent PR. The incidence of PR decreased from 96.06% in 2012 to 92.35% in 2022 (p<0.001). Patients undergoing PR were more often female (60.93% vs 58.50%; p<0.001) and had a lower mean CCI (3.09 [1.10] vs. 3.16 [1.20]; p<0.001). Odds for EMI did not differ based on whether PR was performed (OR: 0.85 [0.65-1.11]; p=0.2246). Increasing age (OR: 1.06 [1.05-1.07], p<0.0001]) and CCI (OR: 1.06 [0.95-1.19], p=0.0009) were associated with EMI. Conclusions PR is commonly performed during TKA in the United States and was not found to increase odds for EMI within 2 years of TKA in patients ≥65 years old. Increased age and medical comorbidity were associated with higher odds for subsequent EMI.","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":"57 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205693","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":"Compartment Syndrome in Association with Tibial Plateau Fracture: Standardized Protocols Ensure Optimal Outcomes","authors":"Luke Schwartz, Rown Parola, Abhishek Ganta, Sanjit Konda, Steven Rivero, Kenneth A. Egol","doi":"10.1055/s-0044-1790282","DOIUrl":"https://doi.org/10.1055/s-0044-1790282","url":null,"abstract":"<p>The purpose of this study was to report on the treatment, results, and longer-term outcomes of patients who sustained a tibial plateau fracture with an associated leg compartment syndrome (CS). A total of 766 patients who sustained 766 tibial plateau fractures met inclusion criteria. Fourteen patients (1.8%) were diagnosed with CS in association with a tibial plateau fracture during their initial hospitalization, 13 at the time of presentation and 1 delayed. The treatment protocol consisted of initial external fixation and fasciotomy, followed by irrigation and debridement, and eventual closure. Fasciotomy cases included 2/14 (14.3%) single incision approaches and 12/14 (85.7%) dual incision approaches. Operative treatment of the tibial plateau fracture was performed at the time of final closure or once soft tissues were permitted. One case of CS that developed following definitive fixation was treated with fasciotomy and delayed primary closure after initial stabilization. Ten (71.4%) were available at 1-year follow-up. We compared these 10 cases to the patients with operative tibial plateau fractures without CS to assess for surgical, radiographic, clinical, and functional outcomes. We used a propensity match based on age, body mass index, sex, Charleson comorbidity index, and fracture type to reduce the presence of confounding biases. Standard statistical methods were employed. Those in the CS cohort were younger males (<i>p</i> < 0.05). At latest follow-up, function did not differ between those in the CS group compared with the non-CS cohort (<i>p</i> > 0.05). Clinically, knee flexion (130.7 vs. 126; <i>p</i> = 0.548), residual depression (0.5 vs. 0.2; <i>p</i> = 0.365), knee alignment (87.7 vs. 88.3; <i>p</i> = 0.470), and visual analog scale pain scores (3.0 vs. 2.4; <i>p</i> = 0.763) did not differ between the cohorts. Although infection was higher in the CS cohort, the overall complication rates did not differ between the CS patients and non-CS cohort (<i>p</i> > 0.05). Early identification and standardized treatment protocols for the management of CS that develops in association with a tibial plateau fracture lead to outcome scores that were not significantly different from patients who did not develop CS.</p> ","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":"61 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205694","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":"Initial Outcomes following Fresh Meniscus Allograft Transplantation in the Knee.","authors":"James L Cook, James P Stannard, Kylee J Rucinski, Clayton W Nuelle, Cory R Crecelius, Cristi R Cook, Richard Ma","doi":"10.1055/a-2389-9001","DOIUrl":"10.1055/a-2389-9001","url":null,"abstract":"<p><p>Based on recent evidence-based advances in meniscus allograft transplantation (MAT), fresh (viable) meniscus allografts have potential for mitigating key risk factors associated with MAT failure, and preclinical and clinical data have verified the safety of fresh meniscus allografts as well as possible efficacy advantages compared with fresh-frozen meniscus allografts. The objective of this study was to prospectively assess clinical outcomes for the initial cohort of patients undergoing MAT using fresh meniscus allografts at our center. Patients who were prospectively enrolled in a dedicated registry were included for analyses when they had undergone primary MAT using a fresh meniscus allograft for treatment of medial and/or lateral meniscus deficiency with at least 1-year follow-up data recorded. Forty-five patients with a mean final follow-up of 47.8 months (range = 12-90 months) were analyzed. The mean patient age was 30.7 years (range = 15-60 years), mean body mass index (BMI) was 29.7 kg/m² (range = 19-48 kg/m²), and 14 patients (31%) were females. In total, 28 medial, 13 lateral, and 4 combined medial and lateral MATs with 23 concurrent ligament reconstructions and 2 concurrent osteotomies were included. No local or systemic adverse events or complications related to MAT were reported for any patient in the study. Treatment success rate for all patients combined was 91.1% with three patients requiring MAT revision and one patient requiring arthroplasty. Treatment failures occurred 8 to 34 months after MAT and all involved the medial meniscus. None of the variables assessed were significantly different between treatment success and treatment failure cohorts. Taken together, the data suggest that the use of fresh (viable) meniscus allografts can be considered a safe and effective option for medial and lateral MAT. When transplanted using double bone plug suspensory fixation with meniscotibial ligament reconstruction, fresh MATs were associated with a 91% success rate, absence of local or systemic adverse events or complications, and statistically significant and clinically meaningful improvements in patient-reported measures of pain and function at a mean of 4 years postoperatively.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996693","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":"Enrollment in a Behavioral Health Program Positively Impacts 2-Year Cumulative Survival Rates in Osteochondral Allograft Transplant Patients.","authors":"Jonathan Williams, Kylee Rucinski, Renee Stucky, James P Stannard, Cory R Crecelius, Aaron M Stoker, Clayton W Nuelle, James L Cook","doi":"10.1055/s-0044-1790252","DOIUrl":"https://doi.org/10.1055/s-0044-1790252","url":null,"abstract":"<p><p>Emerging evidence suggests that patients' behavioral health may influence outcomes after osteochondral allograft transplantation (OCAT). A comprehensive behavioral health program (BHP) including preoperative screening and education, and postoperative counseling and support, led by a health behavior psychologist was implemented for patients considering OCAT. We hypothesized that patients undergoing knee OCAT and enrolled in the BHP would have a significantly higher 2-year graft survival rate than those not enrolled. Prospectively collected data for patients undergoing knee OCAT enrolled in the lifelong outcomes registry were analyzed. Based on the timing of implementation of a comprehensive BHP to provide preoperative screening and education followed by postoperative counseling and support, BHP and no-BHP cohorts were compared. Treatment failure was defined as the need for either OCAT revision surgery or knee arthroplasty. The Kaplan-Meier method using log-rank tests compared cumulative survival rates. Multivariable Cox regression analysis was used to determine the effects of confounding variables on the influence of BHP enrollment on graft survival. A total of 301 patients were analyzed (no-BHP = 220 and BHP = 81). At 2-year follow-up, a significantly lower cumulative graft survival rate was observed for patients not enrolled in the BHP (68.2 vs. 91.4%; <i>p</i> = 0.00347). Adjusting for sex, age, body mass index, tobacco use, tibiofemoral bipolar OCAT type surgery, and nonadherence, patients not enrolled in the BHP were 2.8 times more likely to experience OCAT treatment failure by 2 years after primary OCAT compared with patients in the BHP (95% confidence interval, 1.02-4.98; <i>p</i> = 0.01). A comprehensive BHP contributes to significant improvements in 2-year graft survival rates following OCAT in the knee. Preoperative mental and behavioral health screening and support for shared decision-making regarding treatment options, in conjunction with patient and caregiver education and assistance through integrated health care team engagement, are beneficial to patients pursuing complex joint preservation surgeries. Level of evidence is 2, prospective cohort study.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141522","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":"Computer Patient-Specific 3D Modeling and Custom-Made Guides for Revision ACL Surgery.","authors":"Armando Del Prete, Piero Franco, Matteo Innocenti, Fabrizio Matassi, Filippo Leggieri, Rosario Jr Sagliocco, Roberto Civinini","doi":"10.1055/a-2315-7873","DOIUrl":"10.1055/a-2315-7873","url":null,"abstract":"<p><p>Revision anterior cruciate ligament reconstruction (ACLR) is a challenging surgery occurring in 3 to 24% of primary reconstructions. A meticulous planning to study the precise size and location of both femoral and tibial bone tunnels is mandatory. The aim of the study was to evaluate the intra- and interoperator differences in the decision-making process between experienced surgeons after they were asked to make preoperative planning for ACL revision reconstruction with the use of both the computed tomography (CT) scan and a three-dimensional (3D)-printed model of the knee. Data collected from 23 consecutive patients undergoing revision of ACLR for graft failure at a single institute between September 2018 and February 2020 were prospectively reviewed. The double-blinded collected data were presented to three board-certificate attending surgeons. Surgeons were asked to decide whether to perform one-stage or two-stage revision ACLR based on the evaluation of the CT scan images and the 3D-printed custom-made models at two different rounds, T0 and T1, respectively, 7 days apart one from the other. Interoperator consensus following technical mistake was 52% at T0 and 56% at T1 using the CT scans, meanwhile concordance was 95% at T0 and 94% at T1 using the 3D models. Concordance between surgeons following new knee injury was 66% at T0 and 70% at T1 using CT scans, while concordance was 96% both at T0 and T1 using 3D models. Intraoperative variability using 3D models was extremely low: concordance at T0 and T1 was 98%. McNemar test showed a statistical significance in the use of 3D model for preoperative planning (<i>p</i> < 0.005). 3D-printed model reliability resulted to be higher compared with CT as intraoperator surgery technique selection was not modified throughout time from T0 to T1 (<i>p</i> < 0.005). The use of 3D-printed models had the most impact when evaluating femoral and tibial tunnels, resulting to be a useful instrument during preoperative planning of revision ACLR between attending surgeons with medium-high workflow.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"804-811"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856656","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":"Isolated, Proximal Tibiofibular Injuries in Athletic Patients: A Critical Analysis Review.","authors":"Derrick M Knapik, Varun Gopinatth, Garrett R Jackson, Robert F LaPrade, Jorge Chahla, Robert H Brophy, Matthew J Matava, Matthew V Smith","doi":"10.1055/a-2315-7691","DOIUrl":"10.1055/a-2315-7691","url":null,"abstract":"<p><p>While infrequently reported, isolated injuries to the proximal tibiofibular (TF) joint primarily occur in young, athletic patients participating in sporting activities requiring explosive, high-impact movements, increasing the risk for potential twisting injuries, especially across a hyperflexed knee. The proximal TF joint is stabilized by bony, muscular and ligamentous structures, including both the anterior and posterior proximal TF complexes, with the anterior complex providing more robust stability. Proximal TF injuries frequently involve anterior and lateral displacement of the proximal fibula relative to its native articulation with the tibia. Proper diagnosis is dependent on careful and meticulous history and physical examination, as missed injuries are common, leading to the potential for continued pain, weakness and disability, especially in athletic patients. While spontaneous joint reduction has been reported, injuries may require formal closed reduction, with irreducible and chronic injuries requiring open reduction and stabilization, with recent investigations reporting satisfactory outcomes following anatomic reconstruction of the proximal TF ligament.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"773-783"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872398","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":"Short-term Comparison of Survivorship and Functional Outcomes for Metaphyseal Cones with Short and Long Stems in Revision Total Knee Arthroplasty.","authors":"Nicolas S Piuzzi, Emily L Hampp, Sarah Shi, Manoshi Bhowmik-Stoker, Nickelas Huffman, Kevin M Denehy, David C Markel, Daniel D Li, Michael A Mont","doi":"10.1055/a-2315-7778","DOIUrl":"10.1055/a-2315-7778","url":null,"abstract":"<p><p>Printed porous titanium metaphyseal cones have become a mainstay for managing bone loss in revision total knee arthroplasty (rTKA). A short or long stem is routinely used when implanting a cone to augment fixation and offload stresses. This retrospective analysis compared the short-term survivorships and functional outcomes for use of a short or long stem with a metaphyseal cone.A total of 179 cases using metaphyseal cones and stems with median follow-up of 1.95 years (interquartile range, 1.00-2.14) were compared based on stem type. There were 55 cases with long stem(s) and 124 cases with short stem(s). Cases with both long and short stems were excluded. Demographics, Kaplan-Meier survivorships, and preoperative and 1-year postoperative patient-reported outcome measures (PROMs; 2011 Knee Society Score [KSS] objective knee score, function, and satisfaction scores; EuroQol five-dimension scale; and Short Form Survey Physical Component Summary and Mental Component Summary scores) were compared using <i>t</i>-tests with a significance level of α = 0.05. There were no significant differences in body mass index (mean ± standard deviation) or sex (men [%]) between the short and long stem cohorts (32.3 ± 5.3, 36.3% and 31.5 ± 5.5, 38.2%, respectively; <i>p</i> > 0.05). Patients who had short stems were younger (65.9 ± 8.8 vs. 69.0 ± 9.4, <i>p</i> = 0.0323).Revision-free survivorship for the femoral or tibial component was 100% for long stems and 98.2% for short stems at 1 and 2 years, respectively (log-rank <i>p</i> = 0.6330). The two revisions in the short group were for infection, thus the survivorship for aseptic loosening was 100% at 2 years for both cohorts. There were no significant differences in preoperative or postoperative PROMs.This study demonstrated that highly porous printed metaphyseal cones provided rTKA with excellent early survivorship and similar PROMs whether a short or long stem was used. Additional studies will be needed to discern longer term differences.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"765-772"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872259","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":"Patient Demographic Factors Impact KOOS JR Response Rates for Total Knee Arthroplasty Patients.","authors":"Yixuan Tong, Vinaya Rajahraman, Rajan Gupta, Ran Schwarzkopf, Joshua C Rozell","doi":"10.1055/s-0044-1787055","DOIUrl":"10.1055/s-0044-1787055","url":null,"abstract":"<p><p>The Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) is a validated patient-reported measure for assessing pain and function following total knee arthroplasty (TKA). This study investigates how patient demographic factors (i.e., age, sex, and race) correlate with KOOS JR response rates. This was a retrospective cohort study of adult, English-speaking patients who underwent primary TKA between 2017 and 2023 at an academic institution. KOOS JR completion status-complete or incomplete-was recorded within 90 days postoperatively. Standard statistical analyses were performed to assess KOOS JR completion against demographic factors. Among 2,883 total patients, 70.2% had complete and 29.8% had incomplete KOOS JR questionnaires. Complete status (all <i>p</i> < 0.01) was associated with patients aged 60 to 79 (71.8%), white race (77.6%), Medicare (81.7%), marriage (76.8%), and the highest income quartile (75.7%). Incomplete status (all <i>p</i> < 0.001) was associated with patients aged 18 to 59 (64.4%), Medicaid (82.4%), and lower income quartiles (41.6% first quartile, 36.8% third quartile). Multiple patient demographic factors may affect KOOS JR completion rates; patients who are older, white, and of higher socioeconomic status are more likely to participate. Addressing underrepresented groups is important to improve the utility and generalizability of the KOOS JR.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"784-788"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082003","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":"Specific Preoperative Factors Increase Manipulations under Anesthesia Following Primary TKA.","authors":"Anson G Bautista, Nicholas L Kolodychuk, Jeremy S Frederick, Michael B Held, H John Cooper, Roshan P Shah, Jeffrey A Geller","doi":"10.1055/a-2315-7955","DOIUrl":"10.1055/a-2315-7955","url":null,"abstract":"<p><p>Arthrofibrosis following primary total knee arthroplasty (TKA) can result in pain and limit postoperative range of motion (ROM), jeopardizing clinical outcomes and patient satisfaction. This study aims to identify preoperative risk factors associated with necessitating a manipulation under anesthesia (MUA) following primary TKA.We retrospectively reviewed 950 cases of consecutive primary TKAs performed at one institution by three arthroplasty surgeons between May 2017 and May 2019. Recorded preoperative variables included smoking status, race, preoperative ROM, presence of effusion or positive anterior drawer, and medical comorbidities. Demographic characteristics were compared with Student's <i>t</i>-tests or chi-square tests as appropriate. For each preoperative factor, we obtained an odds ratio (OR) for MUA risk using multivariate logistic regression.Twenty (2.3%) patients underwent MUA following their index primary TKA surgery. History of ipsilateral knee surgery (OR: 2.727, <i>p</i> = 0.047) and diagnosed hypertension (OR: 4.764, <i>p</i> = 0.016) were identified as risk factors associated with significantly increased risk of MUA. The greater the preoperative ROM, the higher likelihood needed of MUA (OR: 1.031, <i>p</i> = 0.034).Patients who had diagnosed hypertension or a history of prior ipsilateral knee surgery were associated with increased risk of necessitating an MUA following primary TKA. Additionally, a greater total arc of motion preoperatively increased the odds of needing MUA.Level III of evidence was present.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"789-795"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867068","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":"Relationship between Kinesiophobia and Dynamic Postural Stability after Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Study.","authors":"Derrick M Knapik, Aguri Kamitani, Matthew V Smith, John Motley, Amanda K Haas, Matthew J Matava, Rick W Wright, Robert H Brophy","doi":"10.1055/a-2315-8034","DOIUrl":"10.1055/a-2315-8034","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) injuries in young, active patients generally require ACL reconstruction (ACLR) to restore mechanical and postural stability. The fear of movement or reinjury (kinesiophobia) has become increasingly recognized in the post-ACLR population; however, the association between restoration of postural stability and kinesiophobia remains largely unknown. The purpose of this study was to investigate changes in mean Tampa Scale of Kinesiophobia-11 (TSK-11), dynamic motion analysis (DMA) scores, and time on the testing platform, as well as any correlation between TSK-11 and mean overall and individual translational and rotational DMA scores during the first 12 months following ACLR. Cohort study. Patients undergoing ACLR were prospectively enrolled and dynamic postural stability and kinesiophobia based on the TSK-11 were collected within 2 days prior to surgery and at 6 and 12 months following ACLR. Dynamic postural stability was quantified by calculating a DMA score, with score calculated in three translational (anterior/posterior [AP], up/down [UD], medial/lateral [ML]) and three rotational (left/right [LR], flexion/extension, and internal/external rotation) independent planes of motions. Correlations between DMA and TSK-11 scores at each time point were analyzed. A total of 25 patients meeting inclusion criteria were analyzed. Mean overall DMA and TSK-11 scores increased with each successive testing interval. At 6-month follow-up, a weakly positive association between TSK-11 and DMA scores was appreciated based on overall DMA, AP, UD, ML, and LR. At 12 months, a moderately positive correlation was appreciated between TSK-11 and the translational, but not rotational, planes of motion. Following ACLR, lower level of kinesiophobia were found to be moderately associated with improved dynamic stability, especially in the translation planes of motion.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"796-803"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870509","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}