Journal of Knee Surgery最新文献

{"title":"Journey Bicruciate Stabilised Total Knee Replacement-A Survival Analysis of a Full Single Hospital Cohort of Implants at a Minimum of 10 Years.","authors":"Darren Myatt, Alasdair J A Santini, Joanne Banks, John S Davidson, Andrew Phillipson, Joanne Yorke, Jill Pope","doi":"10.1055/a-2908-2576","DOIUrl":"10.1055/a-2908-2576","url":null,"abstract":"<p><strong>Abstract: </strong>The original <i>Journey BCS</i> total knee arthroplasty (Smith and Nephew, Watford, United Kingdom) is a bicruciate-stabilized (BCS) total knee arthroplasty. Dislocations and anterior knee pain led to the introduction of the <i>Journey II</i> system in 2013. We reviewed the 10-year survival in our institution. All <i>Journey BCS</i> total knee replacements were included. The study period was from November 2010 to July 2013. Microsoft Excel was used. The primary outcome was 10-year survival using life tables; end points were re-operation for any reason; revision excluding dislocation-related issues; revision excluding secondary patella resurfacing; aseptic loosening; and a worst-case scenario. Secondary outcomes were 10-year Oxford and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores. A total of 275 <i>Journey BCS</i> total knee replacements were undertaken. Mean follow-up of 10.3 years with 192 remaining. All cause revision at 10-years was 82.75% (95% CI: 87.14-77.34), excluding dislocation and patellar resurfacing 10-year survival was 95.03% (95% CI: 97.15-92.59), 10-year aseptic loosening survival rate was 97.72% (95% CI: 99.00-95.08) and 10-year worst case scenario was 82.70% (95% CI: 87.12-77.24). The mean 10-year Oxford score was 29.5, and WOMAC was 34.5. Ten-year survival shows a all cause survival rate of 82.75%. Predominant early failures were secondary patellar resurfacing and dislocations. A concerning late mode of failure in peg fracture has been identified, and further research is required.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406409","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":"A Comparative Analysis of Lower Extremity Deformity Correction: Two-dimensional versus Three-dimensional Computed Tomography.","authors":"Andrew Dobitsch, Ryan C Palmer, Avinash Iyer, Parul Sharma, Mckenzie Culler, Sahil S Telang, Ryan Freshman, Nathanael D Heckmann, George F Rick Hatch Iii","doi":"10.1055/a-2908-1958","DOIUrl":"10.1055/a-2908-1958","url":null,"abstract":"<p><strong>Abstract: </strong>Preoperative planning for high tibial, distal femoral, and tibial tubercle osteotomies has traditionally relied on cross-sectional two-dimensional (2D) images obtained from computed tomography (CT) scans. However, recent studies have underscored the potential advantages of three-dimensional (3D) reconstruction in preoperative planning. The present study aims to compare lower extremity alignment parameters obtained using 2D and 3D measurement techniques before peri-articular osteotomies used to treat patellofemoral disorders. All lower extremity osteotomies performed between 2022 and 2024 at our institution were retrospectively identified. Eligible patients received both 2D and 3D CT measurements prior to surgical intervention. For both imaging modalities, tibial tuberosity-trochlear groove (TT-TG), tibial torsion, and Caton-Deschamps (CD) index measurements were obtained. Paired <i>t</i>-tests were used to assess discrepancies between radiographic measurements obtained from 2D and 3D reconstruction. Statistical significance was defined as <i>p</i> ≤ 0.05. In total, 52 patients (66.0% female) with a mean age of 31.1 ± 9.0 years were identified. Median 2D and 3D measurements were similar for TT-TG distance (16.0 vs. 16.3 mm) and CD index (1.1 vs. 1.2), while median tibial torsion was greater on 2D compared with 3D imaging (27.0 degrees vs. 22.7 degrees). The average absolute difference between modalities were 3.1 mm for TT-TG distance (interquartile range [IQR]: 1.0-5.0), 5.6 degrees for tibial torsion (IQR: 1.0-7.5 degrees), and 0.16 for CD index (IQR: 0.05-0.22). Statistically significant differences in tibial torsion measurements highlight potential limitations of 2D CT measurements in capturing 3D complexity. These findings suggest that 3D preoperative planning leads to improved accuracy in postoperative multi-planar alignment goals. Further research is needed to evaluate the clinical implications of these differences and to refine imaging protocols for preoperative planning.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406466","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":"Knee Bracing after Medial Patellofemoral Ligament Reconstruction: A Systematic Review of Protocols and Postoperative Outcomes.","authors":"Margaret G Grossman, Rebecca Luft, Elizabeth Huggins, Jackson Paras, Mitchell J Christiansen, Mary Mulcahey","doi":"10.1055/a-2908-2717","DOIUrl":"10.1055/a-2908-2717","url":null,"abstract":"<p><strong>Abstract: </strong>Medial patellofemoral ligament reconstruction (MPFLr) is the most common procedure performed for recurrent patellar instability. Although the benefits of MPFLr are well-established, postoperative bracing protocols remain highly variable and poorly characterized in the current literature. The purpose of this study was to evaluate the use of bracing by sports medicine surgeons for patients following MPFLr. Randomized controlled trials, prospective, and retrospective studies of patellar instability treated with MPFLr were identified across three databases: EMBASE (Elsevier), Medline (OVID), and SportDiscus with Full Text (EBSCOHost). Study quality was assessed using established risk of bias tools; several studies demonstrated moderate risk of bias due to nonrandom selection of intervention groups and variability in rehabilitation. Data collected included functional outcomes and rates of redislocation or subluxation. Of 521 studies identified, 112 duplicates were removed. Abstracts of 409 studies were reviewed, with 348 excluded for relevance. Full-text review of 61 studies yielded seven meeting inclusion criteria, all of which included postoperative rehabilitation protocols. Five studies (71.4%) used knee braces postoperatively, and two (28.6%) compared postoperative bracing to no bracing. Four studies (57.1%) reported using a hinged knee brace and two (28.6%) used a knee immobilizer. Six of seven studies (85.7%) braced patients for up to 6 weeks postoperatively. Postoperative instability events were reported in six studies (85.7%), collectively encompassing 650 knees. Bracing was applied to 533 knees, of which 25 (4.7%) experienced at least one instability event, compared with 1 of 117 nonbraced knees (0.9%). There was no statistically significant difference in instability events between groups (χ² [1, <i>N</i> = 650] = 3.68, <i>p</i> = 0.055). Most sports medicine surgeons brace patients for up to 6 weeks following MPFLr. Bracing protocols are widely variable, and current studies exhibit marked heterogeneity in reporting of postoperative outcomes. Further research is needed to determine the optimal postoperative rehabilitation protocol, including the use of a hinged knee brace, following MPFLr.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406441","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":"Long-Term Follow-up of Total Knee Arthroplasty Following Previous Ligament Reconstruction Surgery in Men: Does Implant Survival, Modes of Failure, and Patient-Reported Outcome Measures Differ?","authors":"Wayne Hoskins, Charles A Gusho, Kelly G Vince, Chris Frampton, Simon Young","doi":"10.1055/a-2908-2235","DOIUrl":"https://doi.org/10.1055/a-2908-2235","url":null,"abstract":"<p><strong>Abstract: </strong>Few studies assess the impact of prior knee surgery on long-term total knee arthroplasty (TKA) outcomes. This study investigates the effect of prior ligament reconstruction on TKA revision rates, modes of failure, and patient-reported outcome measures (PROMs). All males undergoing primary TKA from January 1999 to July 2024 from the New Zealand Joint Replacement Registry were included, with a median follow-up of 7.2 years. Patients with previous knee ligament reconstruction were compared with those without. The primary outcome was all-cause revision with results stratified by age. Secondary outcome measures were modes of failure and 6-month and 5-year Oxford Knee Scores (OKS). Age, sex, American Society of Anesthesiologists (ASA) score, body mass index, fixation, bearing, patella resurfacing, and surgery year were examined as potential confounders. Revision rates with 95% confidence intervals (CI) were calculated using Poisson approximation. Multivariate Cox proportional hazards assessed the independent relationship between ligament reconstruction and revision. A total of 73,355 TKAs were performed; 1,440 (2.0%) with previous ligament reconstruction surgery and 71,915 (98.0%) without. Patients with previous ligament reconstruction were younger (58.7 [8.7] vs. 68.3 [8.8] years) and had lower ASA scores, less cemented fixation, more posterior-stabilized bearings, and more patella resurfacing (all <i>p</i> < 0.001). The unadjusted risk of revision was higher in those with previous ligament reconstruction (hazard ratio [HR]: 1.90 [95% CI: 1.54-2.35], <i>p</i> < 0.001) with 15-year cumulative percent revision (CPR) 12.9 versus 6.1%. This difference was more profound in younger patients (age < 40: 15-year CPR 33.3 vs. 10.0%; age 40-54: 15-year CPR 16.6 vs. 11.8%). Adjusted multivariate analysis showed a nonstatistical difference in revision risk (HR: 1.25 [95% CI: 0.99-1.59], <i>p</i> = 0.064). No statistical differences for modes of failure and no clinically significant differences in 6-month nor 5-year OKS were seen. In men with previous knee ligament reconstruction surgery undergoing TKA, revision risk appeared higher, particularly in younger patients, but the difference was attenuated and no longer statistically significant after adjustment for confounders, especially in younger patients, but PROMs remain similar.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457423","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":"Lateral Extra-Articular Tenodesis Was Not Associated with Improved Mid-Term Outcomes After Primary BPTB ACL Reconstruction in Amateur Soccer Players: A Prospective Comparative Cohort Study.","authors":"Iván José Bitar, Damián Gabriel Bustos, Lucas Daniel Marangoni, Luciano Pezzutti, Santiago Luis Iglesias, Lucía Belén Bitar, Juan Valentín Rivera Bacile","doi":"10.1055/a-2908-2103","DOIUrl":"10.1055/a-2908-2103","url":null,"abstract":"<p><strong>Abstract: </strong>To compare clinical and functional outcomes in competitive amateur soccer players undergoing isolated bone-patellar tendon-bone (BPTB) anterior cruciate ligament reconstruction (ACLR) versus BPTB ACLR combined with lateral extra-articular tenodesis (LET) using a modified Lemaire technique. In this prospective, nonrandomized comparative cohort study, 165 athletes treated between 2017 and 2020 were enrolled; 150 (91%) completed a minimum 5-year follow-up. Surgical technique was selected according to the surgeon's evolving practice. Seventy-four underwent isolated BPTB ACLR, and 76 underwent BPTB ACLR + LET. Primary outcomes were International Knee Documentation Committee (IKDC), Lysholm, Tegner, graft failure (rerupture or symptomatic objective instability), and reoperations. Secondary outcomes were stability, return to sport (RTS), radiographic osteoarthritis, and range of motion. IKDC minimal clinically important difference (MCID)/ patient acceptable symptom state (PASS) and Lysholm PASS (≥85 points) were recorded. Both groups showed significant improvements in patient-reported outcome measures (PROMs) from baseline (<i>p</i> < 0.001). At final follow-up, no between-group differences were found for IKDC (mean difference, 2.4; <i>p</i> = 0.14), Lysholm score (2.9; <i>p</i> = 0.07), or Tegner activity level (0.5; <i>p</i> = 0.11). IKDC MCID and PASS rates were similarly high between groups (88.5% vs. 90.1% and 84.2% vs. 86.0%, respectively), as were Lysholm PASS rates (67.6% vs. 80.3%). Graft failure rates were low and comparable (5.3% vs. 4.1%; <i>p</i> = 0.72), as were reoperation rates (9.4% vs. 10.5%; <i>p</i> = 0.81). Knee stability improved in both groups, with comparable final side-to-side differences of approximately 2 mm. Return to competitive amateur soccer was achieved by 82.4% of patients in the BPTB group and 80.2% in the BPTB + LET group. Radiographic osteoarthritis was observed in 17.1 and 25.8% of patients (<i>p</i> = 0.24). In competitive amateur soccer players, adding LET to primary BPTB ACLR was not associated with superior PROMs, knee stability, or RTS at mid-term follow-up. Both procedures showed similarly low graft-failure and reoperation rates and comparable functional recovery. The study provides level II evidence, a nonrandomized comparative study.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399699","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":"Arthrofibrosis After Total Knee Arthroplasty Managed with Manipulation Under Anesthesia.","authors":"Lawrence Jajou, Giles R Scuderi","doi":"10.1055/a-2779-0459","DOIUrl":"10.1055/a-2779-0459","url":null,"abstract":"<p><strong>Abstract: </strong>Arthrofibrosis after total knee arthroplasty (TKA) is the result of excessive scar formation because of the inflammatory insult of surgery. This formation can lead to significant loss of range of motion, pain, and functional deficits requiring further treatment. Although much has been researched on arthrofibrosis, it continues to lack definitive diagnostic testing. This has led to an array of approaches and treatments to relieve patients of this complication. In response to the inflammatory insult caused by TKA, arthrofibrosis occurs because of an overactivation and proliferation of myofibroblasts. This leads to an abundant deposition of type I collagen and scar tissue formation. This general cascade has been found to be associated with multiple signaling pathways involving primarily transforming growth factor-beta. Additionally, there is a multifactorial component of risk factors and comorbidities, which contribute to the formation of arthrofibrosis. Arthrofibrosis is diagnosed as both a clinical diagnosis and a diagnosis of exclusion. Using the patient's history, clinical examination, and diagnostic testing to rule out other etiologies, one can obtain the diagnosis of arthrofibrosis. While stiffness is an umbrella term that is commonly used interchangeably with arthrofibrosis, it is imperative to use the diagnostic testing to systematically rule out other causes of stiffness. There is no definitive imaging, biopsy, or biomarker test specific for arthrofibrosis currently, which makes obtaining a definitive diagnosis difficult. Nonoperative and operative treatment options are available for the treatment of arthrofibrosis. Most conservative approaches begin with physical therapy, appropriate pain management, and oral anti-inflammatory medication. Treatment options rise in invasiveness with manipulation under anesthesia, arthroscopic lysis of adhesions, open lysis of adhesions, and ultimately revision TKA. This review will focus on the role of manipulation under anesthesia in the setting of arthrofibrosis.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"428-433"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866144","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":"Management of Arthrofibrosis After Total Knee Arthroplasty: Insights and Future Directions.","authors":"Amir H Hoveidaei, Chase W Smitterberg, Monica Misch, Reza Katanbaf, James Nace, Ronald E Delanois, Michael A Mont","doi":"10.1055/a-2741-1796","DOIUrl":"10.1055/a-2741-1796","url":null,"abstract":"<p><strong>Abstract: </strong>Arthrofibrosis is a debilitating complication following total knee arthroplasty (TKA), affecting 3 to 13% of primary TKA patients and leading to 10% of revision surgeries. This review evaluates the current management strategies for arthrofibrosis, answering key questions on treatment modalities: (1) nonsurgical interventions, (2) arthroscopic and open surgical approaches, (3) revision procedures, and (4) adjunct and emerging therapies. Nonsurgical treatments, including aggressive physical therapy and continuous passive motion devices, show some improvements in range of motion (ROM), but long-term efficacy remains uncertain. Arthroscopic lysis of adhesions improves knee flexion by 26.7 to 51.2 degrees, with a mean final flexion of 100 to 103 degrees, but carries higher infection and revision risks. Open arthrolysis provides ROM improvements up to 43.4 degrees, with higher morbidity and complications. Revision TKA yields better functional outcomes, with mean flexion improvements of 15 to 25 degrees, but 43% of patients require further care. Emerging therapies, such as low-dose irradiation and pharmacologic agents like celecoxib and dexamethasone, show promise but require further validation. Despite advancements, gaps in high-quality data and standardized protocols persist, underscoring the need for more prospective trials.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"409-412"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507614","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":"Increased Time from Onset of Symptoms to Revision Anterior Cruciate Ligament Reconstruction is Associated with More Intra-Articular Pathology.","authors":"George Durisek, Bryce Dzubara, Zachary Burnett, Ryan H Barnes, David C Flanigan, Parker Cavendish, Eric Milliron, Robert A Duerr, Christopher C Kaeding, Robert A Magnussen","doi":"10.1055/a-2778-8916","DOIUrl":"10.1055/a-2778-8916","url":null,"abstract":"<p><strong>Abstract: </strong>This cohort study aimed to identify whether time greater than 3 months between the onset of new symptoms of instability after primary anterior cruciate ligament (ACL) reconstruction (ACLR) and subsequent revision ACLR influences outcomes of revision surgery. We hypothesized greater than 3 months from onset of symptoms to revision ACLR is associated with increased intra-articular damage and poorer outcomes following revision ACLR. A retrospective chart review was conducted to identify patients who underwent revision ACLR at a large tertiary referral institution between 2008 and 2019. Demographic, surgical, and postsurgical data were collected. Patients who underwent revision ACLR within 3 months of documented graft symptomology were defined as the Early Revision group, and patients who underwent revision ACLR at or greater than 3 months after onset of graft symptomology were defined as the Late Revision group. Demographic data, intraoperative findings, subsequent graft failure, and patient-reported outcomes were compared between the groups. A total of 74 patients met inclusion criteria. Patients in the Late Revision group were more likely to have cartilage damage in the patella, trochlea, medial tibial plateau, lateral femoral condyle, and lateral tibial plateau. Patients in the Late Revision group were also more likely to have concomitant lateral meniscus tears. Medial meniscus tears identified at time of surgery in this group were also less likely to be deemed repairable. No significant differences were noted in postoperative Knee Injury and Osteoarthritis Outcome Scores, Marx Activity scores, or ACL graft retear risk based on the time from injury to surgery. Undergoing revision ACLR more than 3 months after graft tear is associated with more severe articular cartilage damage, more frequent lateral meniscus pathology, and a greater incidence of irreparable medial meniscus tears. No significant differences in patient-reported outcomes or revision graft failure risk were observed.</p><p><strong>Abstract: </strong>LEVEL OF EVIDENCE:  III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"440-445"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893390","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":"Medial Patellofemoral Ligament Reconstruction with Quadriceps Tendon Autograft and Double Bundle Semitendinosus Tendon Autograft: A Retrospective Comparative Study.","authors":"Ozan Altun, Yilmaz Ergisi, Uygar Dasar, Ulas Can Kolac, Erdi Ozdemir","doi":"10.1055/a-2796-8441","DOIUrl":"10.1055/a-2796-8441","url":null,"abstract":"<p><strong>Abstract: </strong>Patellar dislocations often result in damage to the medial patellofemoral ligament (MPFL), a key stabilizer preventing lateral patellar translation. Various reconstruction techniques, including semitendinosus (ST) and quadriceps tendon (QT) autografts, have been developed to restore stability, with QT emerging as a promising option due to lower risk of complications. We aimed to compare the functional outcomes of patients who underwent MPFL reconstruction using double bundle ST autograft and those who underwent reconstruction using partial QT autograft. Patients who underwent MPFL reconstruction at our institution between January 2018 and January 2023 were retrospectively reviewed. The inclusion criteria were patients with a history of at least two patellar dislocations, a follow-up period of more than 24 months, positive preoperative patellar apprehension, traumatic dislocations, and no prior surgical history on the same knee. Two groups were formed based on the used graft type for reconstruction: a partial QT and ST groups. At the final follow-up, visual analog scale (VAS), Kujala patellofemoral pain score, Lysholm knee score, Tegner activity index, IKDC score, and Crosby-Insall grading system parameters were evaluated. A total of 40 patients (23 QT, 17 ST) were included. Based on the Crosby-Insall grading system, the QT group had 17 excellent, 5 good, and 1 poor result, while the ST group had 8 excellent, 7 good, and 2 poor results (<i>p</i> = 0.215). Mean scores for QT versus ST were as follows: Kujala 91.4 ± 7.1 versus 88.4 ± 10.0 (<i>p</i> = 0.401), Lysholm 92.8 ± 7.5 versus 90.2 ± 10.4 (<i>p</i> = 0.464), IKDC 91.3 ± 6.1 versus 87.5 ± 12.1 (<i>p</i> = 0.725), Tegner 6.8 ± 1.2 versus 6.4 ± 1.5 (<i>p</i> = 0.516), and VAS 0.2 ± 0.5 versus 0.4 ± 1.0 (<i>p</i> = 0.935). The functional outcomes of reconstruction techniques using double bundle ST and partial QT autografts were both successful. Given the potential complications of ST technique, we believe partial QT could be a good alternative in MPFL reconstruction. LEVEL OF EVIDENCE: was retrospective cohort study, level 3.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"490-496"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132653","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":"Assessing Application of the Multicenter Orthopaedic Outcome Network Calculator to Include Quadriceps Tendon Autografts and Older Patients.","authors":"Chase Erganian, Kylee Rucinski, Clayton W Nuelle, James P Stannard, Richard Ma, Steven DeFroda, James L Cook","doi":"10.1055/a-2780-1216","DOIUrl":"10.1055/a-2780-1216","url":null,"abstract":"<p><strong>Abstract: </strong>Anterior cruciate ligament reconstruction (ACLR) is a known risk factor for ipsilateral and contralateral anterior cruciate ligament (ACL) tear, influenced by patient age, activity level, and graft choice. The Multicenter Orthopaedic Outcome Network (MOON) calculator predicts risks post-ACLR, aiding in graft selection and prognosis. The MOON calculator is only validated for those patients under 22 years of age and with patellar bone-tendon-bone (BTB) or hamstring tendon graft options, restricting its applicability. This study assessed the MOON calculator's accuracy in a more diverse patient population, including quadriceps tendon (QT) recipients and patients > 22. With institutional review board approval, registry data were reviewed for patients with primary ACLR at our institution over the past 10 years. Patient information was entered into the MOON calculator, adjusting ages over the calculator's maximum to \"22 years\" for entry. Patients with QT grafts were entered as BTB. MOON retear and contralateral tear risk predictions were recorded. True outcomes were extracted from medical records. A Brier score of <0.25 was chosen a priori as indicative of acceptable model calibration. An area under the curve (AUC) threshold of 0.70 was determined to indicate acceptable discrimination. A total of 78 patients (49 ≤22 years, 29 23+ years), fulfilled inclusion criteria for analyses. A total of 64 patients received QT grafts (82.1%) and 14 received BTB (17.9%). There were three ACL retears, two QT (3.1%), and one BTB (7.1%) patients. MOON predicted a retear rate of 8.3% for the combined BTB + QT graft group. Brier and receiver operating characteristic curve results suggest poor model calibration, but good discrimination-QT Brier score: 0.89, AUC 0.782, and BTB Brier score: 0.84, AUC 0.846. Analysis restricted to those >22years-QT Brier: 0.84, AUC 0.525, showed poor accuracy and poor outcome discrimination. BTB Brier score: 0.81, AUC 0.778, demonstrated acceptable discrimination. The MOON calculator was not effective in predicting ipsilateral ACL retear risk with the inclusion of patients >22 years and QT grafts. Validating the MOON calculator for a broader age range and QT grafts could enhance its clinical applicability.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"485-489"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879251","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}