Journal of Knee Surgery最新文献

{"title":"Efficacy and Safety of High Tibial Osteotomy Combined with Mesenchymal Stem Cells for Knee Osteoarthritis: A Systematic Review and Meta-Analysis.","authors":"Wenbin Zhang, Yulin Ma, Feilong Lu, Wanqiang Liang, Chen Chen, Chaoran Huang, Lei Duan, Jing Li","doi":"10.1055/a-2939-2546","DOIUrl":"https://doi.org/10.1055/a-2939-2546","url":null,"abstract":"<p><strong>Abstract: </strong>This study aimed to systematically review the clinical efficacy of high tibial osteotomy (HTO) combined with mesenchymal stem cells (MSCs) in the treatment of knee osteoarthritis (KOA) and to provide an updated summary of current evidence and identify gaps in knowledge to inform future research directions. The study design is systematic review and meta-analysis. Level of evidence is 3. We searched for clinical controlled studies on the treatment of KOA with HTO combined with MSCs published before May 2026 in databases such as PubMed, Web of Science, the Cochrane Library, and Embase. The literature that met the inclusion criteria was carefully screened, a quality evaluation was conducted, the data information from the literature was extracted, and the data were input into Review Manager 5.4 for meta-analysis. A total of 12 studies involving 714 patients were included. The results of the analysis indicated that the use of HTO combined with MSCs significantly improved the Lysholm score, International Knee Documentation Committee (IKDC) score, Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, International Cartilage Repair Society (ICRS), Koshino score, and Hospital for Special Surgery (HSS) score. In terms of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the results of the HTO combined with MSCs group were significantly lower. There was no significant difference between the two groups in terms of the visual analog scale (VAS) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), or mechanical axis. No serious adverse events related to stem cell therapy were observed in the included studies. In the treatment of KOA, HTO combined with MSCs appears to be a promising and safe therapeutic strategy. However, owing to the limited number of high-quality RCTs and clinical heterogeneity across studies, current evidence is insufficient to recommend this combination as the standard of care. More robust, properly designed RCTs are needed to confirm its superiority over HTO alone.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819853","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":"Care Setting and State-level Predictors of Unicompartmental Knee Arthroplasty Price Variation Across the United States.","authors":"Bradley Quinn Fox, Lindsey V Ruderman, Katherine M Kutzer, Kevin A Wu, Matthew K Stein, Thorsten M Seyler","doi":"10.1055/a-2939-2278","DOIUrl":"10.1055/a-2939-2278","url":null,"abstract":"<p><strong>Abstract: </strong>Unicompartmental knee arthroplasty (UKA) is a cost-conscious, minimally invasive surgical option for patients with isolated compartment disease. Because UKA is an increasingly common and outpatient procedure, it serves as a model for evaluating the effects of hospital price transparency legislation. This study investigated the association between state-level policy and socioeconomic factors on hospital-reported UKA pricing. This cross-sectional analysis included hospital-reported gross charges for UKA (CPT 27446) from the Turquoise Health database across the 50 states in the United States. Multivariable linear regression assessed associations between UKA price and state partisanship (0-5 scale: Democrat to Republican), Certificate of Need (CON) laws, Medicaid expansion, and care setting (inpatient or outpatient). A secondary analysis of North Carolina hospitals assessed the influence of Area Deprivation Index and urbanization on within-state price variation. Among 141,541 reported UKA prices from 2,522 facilities, lower gross charges were associated with states with Republican affiliation (β = $286.9; <i>p</i> < 0.0001), presence of CON laws (β = - $799.8, <i>p</i> < 0.0001), and outpatient settings (β = - $386.0, <i>p</i> < 0.0001). Medicaid expansion was associated with increased pricing (β = +$468.3, <i>p</i> < 0.0001). In North Carolina, hospitals in high ADI counties listed significantly lower prices (β = - $2,727.4, <i>p</i> = 0.014); urban location was not significant. Gross charges for UKA vary by state policy environment and care setting. Lower prices were observed in states with Republican leaning, CON laws, high-deprivation regions, and outpatient settings, whereas higher prices were associated with Medicaid expansion. These findings highlight the complex role of policy in shaping equitable access to affordable orthopedic care.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800149","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":"Postoperative Outcomes Following High Tibial Osteotomy in Patients Over 55 Years of Age: A Systematic Review.","authors":"Siddhant Bhat, Daniel C Touhey, S Ryan Pierson, Matthew V Smith, Derrick M Knapik","doi":"10.1055/a-2939-2700","DOIUrl":"https://doi.org/10.1055/a-2939-2700","url":null,"abstract":"<p><strong>Abstract: </strong>To systematically review the literature to better understand outcomes and complications following high tibial osteotomy (HTO) in patients aged ≥55 years, a population in which HTO remains controversial, with advanced age suggested to be a negative predictor of outcomes. PubMed, Embase, Cochrane, and Scopus databases were searched from inception to April 2026 to identify studies reporting outcomes following HTO in patients aged ≥55 years. Studies reporting operative approach, complications, reoperations, and radiographic and/or patient-reported outcomes were included. Twenty-four studies comprising 21,261 patients (weighted mean age 64.7 years [range, 55-86]; 74% male) undergoing HTO were identified, with a weighted mean follow-up of 57.5 months (range, 10.0-132.2). Preoperatively, 57.0% (<i>n</i> = 362/635) of patients had Kellgren-Lawrence (K-L) grade 3 changes, followed by grade 2 (28.0%, <i>n</i> = 178/635) and grade 4 (14.2%, <i>n</i> = 90/635). Opening-wedge HTO was performed in 87.5% (<i>n</i> = 1,115/1,275) of cases reporting surgical approach, while 12.5% (<i>n</i> = 160/1,275) underwent a closed-wedge procedure. Concomitant diagnostic arthroscopy and/or debridement were performed in 95.4% (<i>n</i> = 433/454) of patients reporting concomitant procedures, with meniscectomy and osteochondral autograft transplantation performed in 54.4 and 9.7% of cases, respectively. At final follow-up, conversion to knee arthroplasty was reported in a subset of patients, with a pooled rate of 8.6% (<i>n</i> = 53/619). Post-surgical complications were reported in 2.3% (<i>n</i> = 471/20,777) of patients among studies reporting complications, including infection (0.9%) and lateral hinge fracture (0.3%). Radiographically, the weighted mean femorotibial angle decreased from 179.6 to 171.7 degrees, while mean tibial slope increased from 9.7 to 10.0 degrees. Mean visual analog scale scores decreased from 6.0 to 3.0, while mean Lysholm and Japanese Orthopaedic Association Knee scores improved from 57.4 to 78.0 and 67.5 to 90.2, respectively. HTO in patients aged ≥55 years is most commonly performed for symptomatic medial compartment chondrosis, primarily K-L grade 3, using an open-wedge approach. Low complication rates and improvements in alignment, knee function, and patient-reported outcomes were reported.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814566","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":"Targeted Fat Pad Excision during Arthroscopy Improves Early Pain Outcomes in Obese Knee Osteoarthritis Patients.","authors":"Xun Xu, Zhengming Zhu, Shijie Wang, Rende Ning, Libing Cai","doi":"10.1055/a-2886-7700","DOIUrl":"https://doi.org/10.1055/a-2886-7700","url":null,"abstract":"<p><strong>Abstract: </strong>Knee osteoarthritis (KOA) is a chronic degenerative joint disease characterized by cartilage degradation, resulting in knee pain, restricted mobility, and potential functional disability. This study evaluates postoperative knee pain and joint function recovery in early- to mid-stage KOA patients following arthroscopic debridement combined with partial infrapatellar fat pad (IPFP) resection and identifies factors influencing treatment outcomes. We retrospectively analyzed 82 KOA patients who underwent surgery between October 2023 and June 2024. Forty-one patients received arthroscopic debridement alone (control group), while 41 underwent additional partial IPFP resection (observation group). Resected IPFP tissues were histopathologically examined for inflammation, fibrosis, and other pathological changes. Pain was assessed using the visual analogue scale (VAS), and knee function was evaluated with the Oxford Knee Score (OKS) and range of motion (ROM) at 3, 6, and 12 months postoperatively. Patients were categorized as improved or nonimproved based on clinical outcomes. Pearson correlation analysis was performed to identify factors associated with treatment response. No significant differences in baseline characteristics were observed between the groups (<i>p</i> > 0.05). Histopathological analysis of IPFP tissues revealed increased inflammatory infiltration, fibrosis, neovascularization, and elevated expression of pain-related proteins in diseased samples. At 12 months, the observation group demonstrated significantly greater improvements in VAS, OKS, and ROM compared to the control group. Furthermore, higher body mass index and Kellgren-Lawrence grade were positively correlated with better outcomes in the observation group (<i>r</i> = 0.356 and 0.333, respectively). The study provides level II evidence.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800213","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":"Outcomes of Same-Day Discharge Total Knee Arthroplasty in a Specialized Ambulatory Surgery Center: Satisfied and Safe.","authors":"Joseph M Schwab, Thomas Bradbury, Mary Jane McConnell, Sophia Ghegan, Mason Stephenson, Alex Bradham, George Guild","doi":"10.1055/a-2796-8229","DOIUrl":"10.1055/a-2796-8229","url":null,"abstract":"<p><strong>Abstract: </strong>Despite the overall success and widespread utilization of total knee arthroplasty (TKA), studies on inpatient TKA show that an average of 10% of patients are unsatisfied with their outcomes. Patient satisfaction with modern outpatient TKA care pathways in the ambulatory surgery center (ASC) is not well studied. We therefore asked the following questions: (1) What is the prevalence of patient satisfaction and dissatisfaction following outpatient TKA in an ASC? (2) How do preoperative and postoperative patient-reported outcome measures, pain scores, and preparedness for surgery compare between satisfied and nonsatisfied patients? (3) Do radiographic factors such as Kellgren-Lawrence grade, posterior tibial slope, tibiofemoral angle, or postoperative flexion of the femoral component differ between satisfied and nonsatisfied patients? We retrospectively reviewed 678 patients undergoing primary unilateral TKA from 2022 to 2023 at a single ASC. Demographics, baseline function, surgical variables, complications, patient-reported outcomes, and patient satisfaction were recorded. Analysis of the difference between the satisfied and nonsatisfied groups was performed. Based on our criteria, 92.5% (<i>n</i> = 627) of patients were either \"satisfied\" or \"very satisfied,\" whereas 7.5% (<i>n</i> = 51) of patients were \"neutral,\" \"dissatisfied,\" or \"very dissatisfied.\" Body mass index, age, sex, and preoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement were not associated with postoperative dissatisfaction. Low Veterans Rand 12-Item Health Survey Mental Component Summary (VR-12 MCS), and lower preoperative \"preparedness for surgery\" scores were associated with nonsatisfaction. Patient satisfaction following TKA in an ASC was 92.5% in our cohort. Pain relief, functional improvement, patient expectations, and psychosocial factors were associated with satisfaction. Addressing these factors with perioperative care pathways that include enhanced pain management, personalized patient education, and attention to psychosocial and cultural factors may further improve satisfaction rates.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"534-539"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208175","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":"Osteophyte Bony Balancing in Robotic Total Knee Arthroplasty: A Surgical Technique and Predictive Algorithm for Soft Tissue Laxity.","authors":"Olivia J Bono, James V Bono","doi":"10.1055/a-2796-8119","DOIUrl":"10.1055/a-2796-8119","url":null,"abstract":"<p><strong>Abstract: </strong>The removal of osteophytes during total knee arthroplasty (TKA) results in reduced soft tissue tension, which may result in joint laxity. Thus, for gap balancing, a surgeon may try to predict the effect of osteophyte removal on the resulting flexion and extension gap before any bone cuts are made and before those osteophytes are removed. Posterior osteophytes, however, are relatively inaccessible, since their removal can be done only after posterior bone cuts are made on the femur. Any laxity created by posterior osteophyte removal cannot be corrected by adjusting bone cuts because they have already been made. The authors have developed a predictive algorithm for use in robotic TKA, which anticipates the effect of osteophyte removal, allowing adjustment in bony resection before any bone cuts are made. The cross-sectional area of the posterior femoral osteophytes is measured on the sagittal plane of the preoperative computed axial tomography (CAT) scan. The authors' method of osteophyte correction is to make changes to the tibial cut based on the size and shape of the posterior osteophytes, as they believe the laxity created by osteophyte removal effects both extension and flexion. The amount and specific location of bony resection are then determined based on the size and location (posteromedial vs. posterolateral) of the osteophytes. Through the described technique, the authors have found that the amount of laxity created by osteophyte removal correlates directly to the dimension of the osteophyte over which the soft tissue extends. The size and shape of initially inaccessible posterior osteophytes, determined using CAT scan-based imaging, were used to create a predictive bony balancing algorithm, designed to be incorporated with the surgeon's preferred bony balancing technique. Our predictive algorithm anticipates the laxity created by osteophyte removal prior to their removal and can be used to alter bone resection parameters and/or implant parameters (e.g., thickness of a tibial liner) to accommodate the increased laxity, allowing for the conservation of bone and correction of deformity.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"510-515"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087643","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 Use of Technology Affect Manipulation Under Anesthesia Rates in Total Knee Arthroplasty?","authors":"Theodor Di Pauli von Treuheim, Filippo Romanelli, Muhammad Haider, Jonathan Katzman, Matthew S Hepinstall, Ran Schwarzkopf, Joshua Rozell","doi":"10.1055/a-2796-7827","DOIUrl":"10.1055/a-2796-7827","url":null,"abstract":"<p><strong>Abstract: </strong>Arthrofibrosis can be a major source of dissatisfaction for patients undergoing total knee arthroplasty (TKA). Manipulation under anesthesia (MUA) may be offered to improve motion in selected cases. Advancements in computer-navigated and robotic-assisted technology have been championed to improve component positioning with fewer soft tissue releases. We sought to investigate whether these technologies impact MUA rates. An institutional retrospective review was conducted on 18,815 patients who underwent a primary, elective, unilateral TKA between January 2010 and December 2022. Patients were stratified into conventional (<i>n</i> = 12,659), computer-navigated (<i>n</i> = 4,071), or robotic-assisted TKA (<i>n</i> = 2,085) cohorts. Patient demographics and implant data, including mode of fixation and level of constraint (cruciate-retaining [CR] vs. posterior-stabilized) were collected. MUA rates were the primary outcome. Data were analyzed using analysis of variance with Tukey post hoc testing and multivariate logistic regression analysis. We report a 1.7% overall MUA rate, with a rate of 1.6% for conventional and 1.5% for navigated TKA, which were significantly lower than robotic-assisted TKA at 3.2% (<i>p</i> < 0.001). However, on multivariate analysis, there was no difference in MUA rates for navigated and robotic-assisted when compared with conventional techniques. Cementless and hybrid fixation and CR implant designs were higher with robotic-assisted compared with conventional and navigated TKA. Multivariate regression revealed that TKA with fully cementless (odds ratio [OR]: 1.80 [95% confidence interval [CI]: 1.16-2.78]; <i>p</i> = 0.008) or hybrid fixation (OR: 2.92 [95% CI: 1.77-4.81]; <i>p</i> < 0.001) increased the risk for future MUA. Constraint also significantly influenced MUA rates, with CR designs yielding higher MUA rates (OR: 1.51 [95% CI: 1.16-1.96]; <i>p</i> = 0.002). When controlling for confounding factors, navigated and robotic-assisted TKA generated comparable odds for MUA when compared with conventional techniques. However, robotic-assisted TKA were more likely to utilize cementless or hybrid fixation and CR implant constraint, each of which were independently associated with increased odds of MUA. These operative factors should be considered when risk-stratifying and counseling patients on the likelihood of MUA.</p><p><strong>Abstract: </strong>LEVEL OF EVIDENCE:  Level III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"547-553"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221775","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":"Intraoperative Assessment of Kinematics Using Robotic-Assisted Total Knee Arthroplasty Is Reliable: A Cadaver-Based Study.","authors":"Emily Hampp, Azhar A Ali, Nicole Szabo, Kevin Abbruzzese, Sarah Shi, Sébastien Lustig, Fares S Haddad, Ormonde Mahoney, Chase W Smitterberg, Michael A Mont, Robert C Marchand","doi":"10.1055/a-2796-8502","DOIUrl":"10.1055/a-2796-8502","url":null,"abstract":"<p><strong>Abstract: </strong>Computed tomography-based robotic-arm-assisted total knee arthroplasty (RATKA) enables three-dimensional surgical planning and intraoperative adjustment of implant positioning based on ligament laxity. Stability and kinematic assessments may offer enhanced insight into multiplanar knee laxity, but their reproducibility remains underexplored. This study evaluated the reliability of intraoperative knee kinematic (dynamic), sagittal and transverse stability assessments in a cadaver setting under different support conditions. Cruciate-retaining RATKA was performed on five fresh-frozen cadaver knees by three experienced surgeons. Medial and lateral anteroposterior translation (MAP, LAP) and internal-external rotation (IE) were measured at 10, 45, and 90 degrees of flexion before and after component implantation. Dynamic assessments across the full range of motion were used to calculate the average medial contact position (AMCP) and medial pivot ratio (MPR). Inter- and intra-rater reliability were determined using intraclass correlation coefficients (ICC: poor < 0.4, good 0.4 to 0.74, and excellent ≥ 0.75). Analyses compared a leg-holder-only condition with all surgeons, including manual support. Intra- and inter-rater reliability across all surgeons was generally good to excellent. For intact knees, reliability ranged from ICC 0.52 to 0.84 for MAP, 0.44 to 0.57 for LAP, and 0.48 to 0.62 for IE. With components, reliability remained good to excellent for MAP, LAP, and IE (ICC 0.47 to 0.80). Dynamic AMCP assessments demonstrated excellent inter-rater reliability (ICC 0.84 to 0.93), while MPR showed good reliability (ICC 0.57). The leg holder reduced variance for MAP/LAP and IE, maintaining error within two mm or 5 degrees, respectively. Intra-rater reliability was consistently excellent across nearly all measures (ICC 0.69 to 0.99). Intraoperative stability and kinematic assessments during RATKA are reproducible, particularly for AMCP. The leg holder generally improved consistently across observers and reduced variance. These findings support the reliability of robotic-assisted intraoperative stability and kinematic measures for evaluating knee function and guiding surgical planning.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"503-509"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132492","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":"Five-Year Functional Outcomes and Gait Analysis Following Anterior Cruciate Ligament Reconstruction with Peroneus Longus Tendon Autograft.","authors":"Antony Nguyen, Dan Carter, Mehr Vather, Michael Le, David Sutton, Kelly Macgroarty","doi":"10.1055/a-2796-8372","DOIUrl":"10.1055/a-2796-8372","url":null,"abstract":"<p><strong>Abstract: </strong>The peroneus longus tendon (PLT) is an increasingly used autograft for anterior cruciate ligament reconstruction (ACLR). Several studies have reported donor site morbidity, gait, muscle strength, and long-term safety. This study provides additional 5-year outcome data, including pedorthist-led gait and foot posture assessment. This study aimed to evaluate 5-year gait symmetry, foot posture, and patient-reported outcomes following ACLR using a PLT autograft. Seventeen patients underwent assessment 5 years after ACLR with PLT autograft. Pedorthist-led gait analysis using pressure-mapping technology measured stance time, midfoot force, center-of-pressure (COP) excursion, and gait force differential. Foot posture was classified as planus, cavus, or neutral. Patient-reported outcomes included the Foot and Ankle Disability Index (FADI) and Tegner Activity Scale. The pedorthist, blinded to the operative side, attempted to identify the reconstructed limb. Statistical analysis used paired <i>t</i>-tests, Spearman correlation, and chi-square testing. At 5 years, no significant differences were detected in stance time, midfoot force, or COP excursion between operated and non-operated limbs. Gait force differentials were similar (<i>p</i> = 0.75). Foot posture was not associated with the operated side (<i>p</i> = 0.183), and FADI scores did not differ by foot type. The pedorthist correctly identified the operative limb in 23.5% of cases. PLT harvest was not associated with detectable differences in gait symmetry or arch morphology at 5 years. Findings are consistent with a favorable biomechanical profile; however, the small sample size, lack of preoperative baseline data, and the absence of a control group limit the strength of these inferences. Larger, controlled studies are needed to confirm long-term safety. The level of evidence was IV-retrospective case series with prospective biomechanical follow-up.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"528-533"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158390","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 Consensus on the Role of Component Rotation in Postoperative Outcomes After Total Knee Arthroplasty: A Systematic Review.","authors":"Stefan Gelderman, Hans Peter van Jonbergen, Ellie Landman, Ydo Kleinlugtenbelt","doi":"10.1055/a-2796-8647","DOIUrl":"10.1055/a-2796-8647","url":null,"abstract":"<p><strong>Abstract: </strong>Up to 20% of patients report dissatisfaction after total knee arthroplasty (TKA), often due to unexplained long-term pain. Component malrotation has been proposed as a contributing factor. This systematic review aimed to evaluate the association between component malrotation and patient-reported outcome measures (PROMs). A systematic search was conducted in PubMed/Medline, Embase, and the Cochrane Library. Studies assessing the effect of femoral, tibial, combined rotation, or rotational mismatch on PROMs were included. Methodological quality was assessed using the Joanna Briggs Institute manual, and evidence levels were assigned based on the Oxford Levels of Evidence. A total of 22 studies involving 1,943 patients met the inclusion criteria. No consistent association was found between component rotation, whether femoral, tibial, combined, or mismatch, and PROMs. There is no clear consensus on the impact of component malrotation on PROMs. However, combined malrotation and rotational mismatch may influence outcomes more than isolated femoral or tibial rotation. Further, high-quality, Level 1 studies are needed to define optimal rotational alignment in TKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"521-527"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183305","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}