Journal of Knee Surgery最新文献

{"title":"Smart Knee Implants and Functional Outcome for Total Knee Arthroplasty.","authors":"Adam M Gordon, Lohith Vatti, Michael A Mont","doi":"10.1055/a-2550-2187","DOIUrl":"10.1055/a-2550-2187","url":null,"abstract":"<p><p>Smart knee implants integrate advanced sensor-based technologies, forming a unique technology-embedded total knee arthroplasty (TKA) implant. Such implants introduce the ability to capture new elements of patient-related data for use in the context of recovery in real time including subjective reported outcomes and objective outcomes related to range of motion, and gait parameters. This technology allows for real-time data capture and patient-specific insights, creating opportunities to optimize postoperative care. This brief narrative review discusses the foundations and origin of technology-embedded implants, beginning with research-related roots relating to the derivation of fundamental knee joint force measurements. Analyzing the current market of implants, the present review investigates the technological capacities of modern designs including form and function. Further discussed is an evaluation of smart knee implant effectiveness, focusing on its impact on recovery outcomes such as patient-reported outcome measures (PROMs), functional improvement, gait patterns, and patient adherence/satisfaction. Smart implants represent a significant technological advancement in personalized care, leveraging real-time data including joint motion, alignment, and patient motion to assist surgeons in optimizing rehabilitation protocols. These implants provide insights into recovery progression postoperatively, with the potential for early identification of at-risk individuals. Preliminary studies demonstrate favorable patient outcomes and satisfaction, although further research is necessary to establish the long-term benefits and efficacy of smart knee implants.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"397-402"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558473","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-Reported Outcome Measure Collection for TKA: What Surgeons Need to Know.","authors":"Matthew T Geiselmann, Mathew J Whittaker, Giles R Scuderi","doi":"10.1055/a-2542-7534","DOIUrl":"10.1055/a-2542-7534","url":null,"abstract":"<p><p>As the population ages and the prevalence of knee osteoarthritis increases, total knee arthroplasty (TKA) is expected to grow in demand. Traditionally, the success of TKA has been measured through clinical assessments, imaging, and the incidence of postoperative complications. Over the past decade, patient-reported outcome measures (PROMs) have become crucial in evaluating clinical outcomes. PROMs are soon to be tied to financial incentives in value-based payment programs as a measure of the quality of care provided. Centers for Medicare and Medicaid Services (CMS) has implemented a nationwide policy to enhance and standardize the collection of PROMs for those undergoing total joint arthroplasty. The policy is titled Patient Reported Outcome based Performance Measure or \"PRO-PM.\" This requires mandatory reporting in 2025, and by 2028, hospital payment evaluations will incorporate this data. CMS will require hospitals to achieve at least 50% postoperative PROM collection rates to qualify for full annual payment in 2028. Providers are incentivized to improve scores on PROMs, such as pain levels and physical function after procedures, as higher PROM scores often correlate with better reimbursement rates under these programs. Recent advancements in interactive technology, including mobile apps and telemedicine platforms, have enabled the collection of PROMs from patients without requiring or prior to a clinic visit. Looking ahead, the mandatory PROM reporting requirements set by the CMS highlight the urgency of adopting scalable, technology-driven solutions. Literature suggests women, individuals with lower socioeconomic status, lower educational attainment, and non-English speakers have significantly lower PROM response rates. While these mandates aim to standardize care quality, they also risk exacerbating disparities if underserved populations face barriers to participation. Equity-focused strategies, alongside continued investment in technology, will be critical to achieving widespread adoption and maximizing the benefits of PROMs in TKA care. Ultimately, the integration of electronic and adaptive PROM systems has the potential to transform the TKA landscape, offering a model for leveraging technology to enhance patient engagement, optimize care delivery, and improve outcomes across diverse populations.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"376-380"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469660","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":"Functional Assessment of Meniscus Extrusion, Excursion, and Hoop Strain under Clinically Relevant Loaded Range of Motion Conditions in Meniscus-Intact and Meniscus Root-Deficient Knees using a Novel Biomechanical Model.","authors":"Clayton W Nuelle, Ashwin R Garlapaty, Will Bezold, Joseph Anderson, James L Cook","doi":"10.1055/a-2555-1998","DOIUrl":"10.1055/a-2555-1998","url":null,"abstract":"<p><p>The knee is meniscus-dependent, relying on the tissue's biomechanical properties to maintain joint health and function. Meniscus dysfunction has primarily been assessed by measuring tibiofemoral articular contact areas and pressures, which entail important limitations. Meniscus extrusion, excursion, and hoop strain are dynamic measures of meniscal function, which have potential advantages for clinically applicable biomechanical testing of meniscus. The objective of this study was to quantify meniscus extrusion, excursion, and hoop strain under clinically relevant loading and motion conditions in meniscus-intact and meniscus-deficient cadaveric knees using a novel model. Cadaveric knees (<i>n</i> = 8) were dynamically tested through a functional range of motion under 30 N of compressive load in a robotic testing system to determine meniscus translations at full extension and 30, 60, 90, and 100 degrees of flexion through 10 cycles. For meniscus-intact and meniscus-deficient (posterior meniscus root release) states, measurements for medial and lateral meniscus excursion, extrusion, and hoop strain were determined by calculating respective translations of fiducial tracking markers and were compared for statistically significant differences. In the meniscus-intact state, medial and lateral meniscus extrusion, excursion, and hoop strain metrics corresponded well to previously reported measurements, suggesting that this model has translational validity for assessing functional kinematics for clinical application. For both medial and lateral menisci, posterior root release was associated with significantly more meniscus extrusion and significantly less maximum meniscus hoop strain compared with the meniscus-intact status. For meniscus excursion, medial root release showed significant differences from the intact status only at a knee flexion angle of 100 degrees, whereas lateral root release differed significantly from the intact status at 60 and 90 degrees of knee flexion. Taken together, this study verifies that this model can effectively quantify meniscus extrusion, excursion, and hoop strain under clinically relevant loading and motion conditions in meniscus-intact and meniscus-deficient knees for use in preclinical studies aimed at assessing the severity of meniscus deficiency, as well as surgical interventions and postoperative management strategies intended to optimize meniscus preservation.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"469-476"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606828","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":"Varus Producing Distal Femur Osteotomy Alters Radiographic Measurements Related to Patellofemoral Instability: A Cadaver Study.","authors":"Elizabeth C Bond, Grant Cochran, Clark H Bulleit, Emily Poehlein, Cynthia L Green, Jocelyn R Wittstein","doi":"10.1055/a-2542-2639","DOIUrl":"10.1055/a-2542-2639","url":null,"abstract":"<p><p>Varus-producing distal femoral osteotomy (DFO) is an established procedure to correct genu valgum in patients with osteoarthritis and gait abnormalities. DFO has also been proposed for the treatment of patellar instability in patients with valgus alignment. However, it is not known how DFO affects parameters associated with patellar instability. This study evaluated radiographic changes after DFO with variable degrees of correction on six cadaveric knees, with the hypothesis that improving mechanical alignment would improve radiographic parameters related to patellar instability. Controlled laboratory is the study design. Six lower-limb cadaveric specimens were obtained after approval by the Institutional Review Board. A lateral opening wedge DFO was performed on each specimen with correction blocks of 6, 10, and 14 mm. The mechanical axis, tibiofemoral angle (mTFA), distal femoral angle (mDFA), Caton Deschamps index (CDI), insall salvati index (ISI), tibial tubercle to trochlear groove distance (TT-TG), and patellofemoral congruence angle (PFCA) were measured on computed tomography (CT) scans at baseline and after each correction block. At baseline, a mean varus alignment of the limbs was observed (mTFA: 2.7 ± 2.8 degrees, mDFA: 87.6 ± 1.0 degrees). The baseline patellar height was normal (CDI: 0.9 ± 0.2, ISI: 1.0 ± 0.1). Statistically significant decreases in mechanical axis and TT-TG distance and increases in mDFA and mFTA were found with increasing block size. The TT-TG distance was decreased by -1.6 mm (95% confidence interval [CI]: -2.27 to -0.86), -3.8 mm (95% CI: -4.8 to -2.8), and -4.0 mm (95% CI: -5.4 to -2.7) with a 6, 10, and 14 mm block, respectively. No differences were observed in patellar height when measured with CDI or ISI after any block size. In a cadaveric model, DFO significantly affects the mechanical axis and TT-TG distance. Specifically, this study found a mean decrease in TT-TG of -3.8 mm when performing a 10 mm opening wedge osteotomy. No changes in patellar height were observed.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"463-468"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469692","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":"Rehabilitation at Home with Interactive Technology Following Total Knee Arthroplasty.","authors":"Adam M Gordon, Rajan Sharma, Michael A Mont","doi":"10.1055/a-2534-1546","DOIUrl":"10.1055/a-2534-1546","url":null,"abstract":"<p><p>Smartphone applications and wearable devices have shown promising outcomes to augment in-person postoperative total knee arthroplasty rehabilitation. Advantages of these technologies include patient-specific, real-time feedback, and motivation that can be integrated into newer rehabilitation protocols. These technologies can be utilized in the home setting with patient-directed therapy. This brief narrative review discusses the current utilization of smartphone applications and sensors for the postoperative rehabilitation period following total knee arthroplasty. This review will discuss how they are utilized for home-based rehabilitation and the outcomes of patients who utilize them. This review specifically focuses on recovery outcomes such as adherence/satisfaction, functional improvement, and gait patterns. Outcomes are primarily descriptive, with <i>p</i>-values noted where appropriate. This review highlights the growing evidence supporting the use of smartphone applications and wearable sensors as valuable tools in the rehabilitation process following total knee arthroplasty. Both technologies have been shown to enhance patient adherence, improve functional outcomes, mitigate pain, and provide valuable data for healthcare providers and patients. Importantly, the integration of these technologies, such as the combination of smartphone apps with wearable devices, can help improve patient outcomes when utilized in a home-based rehabilitation setting. Smartphone applications and wearable devices offer enhancements in postoperative rehabilitation following total knee arthroplasty. Despite being in their infancy, randomized trials have validated their effectiveness and utility in this context. Improved adherence to postoperative care plans emerged as a recurrent findings.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"403-406"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366408","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":"Internet-Based Patient Portals Increase Patient Connectivity Following Total Knee Arthroplasty.","authors":"James P Henry, Pierre Tamer, Giles R Scuderi","doi":"10.1055/a-2542-7427","DOIUrl":"10.1055/a-2542-7427","url":null,"abstract":"<p><p>Many healthcare-related processes have undergone substantial transformation by the internet since the turn of the century. This technological revolution has fostered a fundamental shift from medical paternalism to patient autonomy and empowerment via a \"patient-centric approach.\" Patient portals, or internet-enabled access to an electronic medical record, permit patients to access, manage, and share their health-related information. Patient connectivity following total knee arthroplasty (TKA) has the potential to positively influence overall outcomes, patient experience, and satisfaction. To understand current trends in patient portal usage, modalities of connectivity, and the implications following TKA. A systematic literature review was performed by searching PubMed and Google Scholar. Articles specific to portal usage and connectivity after TKA or total joint arthroplasty were subsequently identified for further review. Patient portals and internet-based digital connectivity platforms enable physicians, team members, and patients to communicate in the perioperative period both directly and indirectly. Communication can be through web-based patient portals, messaging services/apps, preprogrammed alerts (e.g., mobile applications or wearable devices), audio mediums, or videoconferencing. The spectrum and utilization of available patient engagement platforms continues to expand as the importance and implications of patient engagement and connectivity continue to be elucidated. Connectivity through patient portals or other mediums will continue to have an expanding role in all aspects of orthopedic surgery, patient care, and engagement. This includes preoperative education, postoperative rehabilitation, patient care, and, perhaps most importantly, collection of outcome measures. The level of evidence is V (expert opinion).</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"386-392"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765480","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":"Block or No-Block? Regional Anesthesia and Return-to-Sport Outcomes in Quadriceps Tendon Autograft ACL Reconstruction.","authors":"Seth M Borchard, Richard J VanTienderen, Nicholas J Pitcher, Elle M McCormick, Robert W Westermann","doi":"10.1055/a-2542-2526","DOIUrl":"10.1055/a-2542-2526","url":null,"abstract":"<p><p>This research aimed to compare return-to-sport (RTS) muscle strength testing in athletes 6 months following a quadriceps tendon (QT) autograft anterior cruciate ligament (ACL) reconstruction performed with or without a nerve block. Retrospective analysis of RTS strength testing in competitive or recreational athletes who had a QT ACL reconstruction at a Midwest academic referral center. There were 182 participants ranging from 12 to 29 years of age with a mean age of 16.9 years old. Patients were stratified into two groups based on whether they received an intraoperative nerve (adductor canal) block. Relevant tests performed during RTS testing included isokinetic quadriceps and hamstring strength (ISOK) in addition to limb symmetry and self-reported psychological readiness. Most patients underwent multiple RTS tests; for this study, we used the data from their initial test typically performed in the 6-month postoperative timeframe. Forty-three patients had an intraoperative nerve block, while 139 did not have a block. There were no observed statistically significant differences in quadriceps or hamstring strength when comparing the median scores of the nerve block and no-block groups across the major quantitative categories of isokinetic muscle strength, limb symmetry, tuck jump errors, or psychological readiness to return to sport. There was evidence of a relationship between increased graft thickness and decreased isokinetic quadriceps strength at both 60 and 300 deg/s in addition to lower self-reported confidence in readiness to RTS. No significant differences in functional strength testing or psychological readiness at 6 months were seen in ACL reconstruction involving QT grafts based on block status. There was evidence of a relationship between increased QT autograft thickness and decreased functional outcomes at 6 months. This research strengthens the case for leveraging an adductor canal block in QT ACL reconstruction involving young athletes as an effective tool for pain management without compromising muscle strength or RTS readiness. The level of evidence is III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"457-462"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765478","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":"Prediction of the Serial Alignment Change after Opening-Wedge High Tibial Osteotomy Based on Coronal Plane Alignment of the Knee Using Machine Learning Algorithm.","authors":"Joon Hee Cho, Hee Seung Nam, Seong Yun Park, Jade Pei Yuik Ho, Yong Seuk Lee","doi":"10.1055/a-2525-4622","DOIUrl":"10.1055/a-2525-4622","url":null,"abstract":"<p><p>Categorization of alignment into phenotypes can be useful for predicting and analyzing postoperative alignment changes after opening-wedge high tibial osteotomy (OWHTO). The purposes of this study were to (1) develop a machine learning model for the predicting the Coronal Plane Alignment of the Knee (CPAK) phenotypes of final alignment after OWHTO, and (2) analyze predictive factors for final alignment phenotypes. Data were retrospectively collected from 163 knees that underwent OWHTO between March 2014 and December 2019. Each data were assessed at three time points: preoperatively, at 3 months postoperatively, and the final follow-up. Constitutional alignment was also evaluated. Machine learning models were developed using two independent feature sets consisting of serial radiologic parameters and CPAK phenotypes. The area under the receiver-operating characteristic curve (AUC) was used as a primary metric to determine the best model. To evaluate the feature importance, Shapley additive explanation (SHAP) analysis was also performed on the best model. Multilayer perceptron (MLP) was the best prediction model, with the highest AUC of 0.867 based on radiologic parameters and 0.783 based on CPAK phenotypes. Joint line obliquity (JLO) at 3 months postoperatively was the most important factor among the radiologic parameters for predicting the final CPAK phenotypes. The features of constitutional and preoperative alignments also contributed, although the features of alignments at 3 months postoperatively were the highest contributing predictors. In conclusion, the developed machine learning models of the MLP showed excellent performance in predicting the final CPAK phenotypes after OWHTO. Postoperative JLO was the most important radiologic parameter for predicting the final alignment. The combination of features of the constitutional, preoperative, and postoperative periods enabled high accuracy and performance in predicting the final alignment.A retrospective cohort study with the level of evidence as level III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"422-431"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053980","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":"Radiological Characteristics of the Knee in Young Patients with Medial Meniscus Horizontal Tears.","authors":"Takuya Naraoka, Hikaru Soneda, Runa Hori, So Morioka, Yukihiro Matsuyama","doi":"10.1055/a-2525-4711","DOIUrl":"10.1055/a-2525-4711","url":null,"abstract":"<p><p>We aimed to assess medial meniscal (MM) healing and horizontal tear (HT) repair in the knees of young patients.We enrolled 37 knees of 35 patients (mean age: 28.0 ± 10.2 years) with isolated meniscal repair that were divided into three groups: MM HT group (HT group, <i>n</i> = 15), MM tear except for HT group (MM group, <i>n</i> = 11), and lateral meniscus (LM) tear except for discoid meniscus group (LM group, <i>n</i> = 11). The anatomical lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA), and posterior tibial slope were measured on preoperative radiographs. Magnetic resonance imaging was performed at 3, 6, and 12 months postsurgery. Clinical outcomes were evaluated using Lysholm and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 24 months postsurgery.aLDFA values were significantly lower in the HT and MM groups than in the LM group (<i>p</i> = 0.007). The MPTA was significantly lower in the HT group than in the MM and LM groups (<i>p</i> = 0.000). There were no differences in meniscal healing among the three groups at any time point after surgery (<i>p</i> = 0.376, 0.830, and 0.523, respectively). The KOOS subscale scores, symptom, pain, sports and recreation, and quality of life in the HT group were significantly lower than those in the LM group (<i>p</i> = 0.021, 0.033, 0.035, and 0.041, respectively).Young patients with MM HT have small aLDFA and MPTA values. Although the healing rate of HT postrepair was comparable to other types of MM or LM tears up to 1 year postrepair, clinical outcomes (KOOS) of repaired HTs were inferior to those of LM tears 2 years postrepair.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"415-421"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053982","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":"Weekend versus Weekday Procedures for Total Knee Arthroplasty.","authors":"Tiffany Lee, David Momtaz, Youssef Khalafallah, Alexandra Mclennan, Abdullah Ghali, Philip Ghobrial, Roberto Gonzalez, Ali Seifi, Khaled Saleh","doi":"10.1055/a-2555-1791","DOIUrl":"10.1055/a-2555-1791","url":null,"abstract":"<p><p>This study compares the outcomes of elective total knee arthroplasty (TKA) on a weekday versus the weekend. Patients undergoing elective TKA from 2016 to 2020 were identified using the Healthcare Cost and Utilization Project database. Demographics and hospital-related outcomes including length of stay (LOS), total charges, pain, wound disruption, implant infection, and mortality, were collected. Perioperative outcomes were assessed from each patient's concurrent diagnoses. Multivariable analysis was performed. A total of 586,285 patients who underwent elective TKA were identified, of which 2,199 (0.37%) were performed on the weekend. Patients undergoing weekend TKA were slightly older (68.055 ± 9.882 vs. 66.699 ± 9.454, <i>p</i> < 0.001), and had a statistically significant predilection toward Asians, Hispanics, and Blacks (<i>p</i> < 0.001). No significant difference was present in gender, obesity, or preoperative conditions. Weekend TKA patients had increased odds of prolonged LOS (odds ratio [OR]: 1.154 for LOS ≥3 days, <i>p</i> = 0.002) and higher total charges (OR: 1.328, <i>p</i> < 0.001), along with higher odds of uncontrolled pain (OR: 1.257, <i>p</i> = 0.001) and implant infection (OR: 1.418, <i>p</i> = 0.004). No significant differences in wound disruption or mortality were found. Our findings indicate an association between weekend TKA and increased pain, implant infection, LOS, and cost, validating the presence of a weekend effect on TKA. Future research is needed to clarify the underlying causes of this association and feasible ways to mitigate its impact.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"477-484"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007702","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}