Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA最新文献

{"title":"A novel knee implant for total knee arthroplasty meets expectations at 10 years. First long-term follow-up report of clinical outcomes and survivorship.","authors":"Alice Montagna, Marina Marescalchi, Virginia Cinelli, Rudy Sangaletti, Luca Andriollo, Francesco Benazzo, Stefano Marco Paolo Rossi","doi":"10.1002/ksa.70037","DOIUrl":"https://doi.org/10.1002/ksa.70037","url":null,"abstract":"<p><strong>Purpose: </strong>Achieving a \"forgotten knee\" after total knee arthroplasty (TKA) remains a primary goal in modern knee replacement surgery. Anatomic implant designs aim to replicate native knee anatomy and kinematics, potentially improving patient satisfaction and functional outcomes. This study evaluates the long-term clinical outcome and survivorship of the Persona Knee System at a minimum follow-up of 10 years.</p><p><strong>Methods: </strong>116 TKAs performed using the Persona Posterior Stabilised (PS) Knee System (Zimmer Biomet, Warsaw, Indiana, USA) between 2013 and 2014 at a high-volume orthopaedic centre were prospectively followed and retrospectively analysed. Clinical outcomes were assessed using patient-reported outcome measures (PROMs), including the Forgotten Joint Score-12 (FJS-12), Oxford Knee Score (OKS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Implant survivorship was determined using Kaplan-Meier analysis, and complication rates were recorded.</p><p><strong>Results: </strong>At a mean follow-up of 11.1 years, 116 knees were available for analysis. Patients were assessed clinically and radiographically at 1, 3 and 6 months postoperatively, and then annually, with a mean follow-up of 11.1 years. The mean FJS-12 was 69.52 (SD 12.21, range 15-88), indicating a high level of joint awareness reduction. The OKS and WOMAC scores significantly improved postoperatively, with mean final values of 38.63 (SD 7.99, range 7-48) and 25.29 (SD 16.97, range 4-91), respectively. Radiological analysis demonstrated accurate and stable implant positioning, with no progressive radiolucent lines in non-revised cases. Kaplan-Meier survival analysis showed a 95.7% (SD 1.9%) implant survival rate. The revision rate was 4.3%, with aseptic loosening and persistent painful prosthesis as the primary causes.</p><p><strong>Conclusion: </strong>The anatomic design of the Persona Knee System provides excellent long-term clinical outcomes, high patient satisfaction, and sustained implant durability. Future research should further investigate patient-specific factors and surgical refinements to optimise long-term outcomes in TKA.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematically aligned total knee arthroplasty is as effective in severe varus deformities as in mild deformities.","authors":"Mohammad M Sarzaeem, Mohammad Movahedinia, Hamidreza J Kouhsari, Farzad A Omrani, Mohammad M Omidian, Stephen M Howell","doi":"10.1002/ksa.70019","DOIUrl":"https://doi.org/10.1002/ksa.70019","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares the clinical outcomes and radiological measures of kinematic alignment total knee arthroplasty (KA-TKA) in patients with severe knee deformities to those with mild varus.</p><p><strong>Methods: </strong>This retrospective cohort study included 145 patients with <10° varus malalignment and 145 patients with >10° varus. All cases underwent KA-TKA performed by a single surgeon using the same techniques between 2015 and 2022. The following variables were compared between groups: (1) demographic data, (2) clinical assessments including ROM, pre- and postoperative Oxford knee score (OKS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as well as postoperative knee society score (KSS) and forgotten joint score (FJS) and (3) radiographic parameters including femoral mechanical angle (FMA), tibial mechanical angle (TMA) and hip-knee-ankle (HKA). All postoperative data were collected after 2-9 years of follow-up (median: 6 years).</p><p><strong>Results: </strong>Preoperative parameters, including age, sex, height, weight, body mass index (BMI) and side of operation, were not significantly different between groups. Preoperative WOMAC and Oxford knee score (OKS) scores were significantly worse in the severe group (p < 0.001). However, both scores improved significantly more in the severe varus knees postoperatively. Postoperative KSS (mild: 87.31 ± 14.35 vs. severe: 83.79 ± 24.82, p = 0.93) and FJS (mild: 91.83 ± 8.09 vs. severe: 91.38 ± 12.16, p = 0.23) did not show significant differences. Though pre- and postoperative ROMs were significantly lower in the severe group (p < 0.001), they improved significantly in both groups without significant difference (p = 0.16). Preoperative HKA was 173.85 ± 1.79 degrees in the mild group and 159.83 ± 7.59 degrees in the severe group (p < 0.001). There was also a significant difference in preoperative FMA (p < 0.001) and TMA (p = 0.003) between groups. KA-TKA corrected HKA (13.44 ± 5.78 vs. 3.92 ± 2.36) and TMA (6.19 ± 5.41 vs. 2.10 ± 3.26) significantly more in patients with severe varus knee (p < 0.001).</p><p><strong>Conclusion: </strong>KA-TKA enhances clinical outcomes in individuals with severe knee varus to a degree comparable to those with mild varus. This technique achieves a more profound correction of HKA alignment in severe cases than in mild cases. KA-TKA may be a viable approach, but further prospective comparative studies are needed, especially in patients with severe deformities.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The number of prior knee arthroscopies is associated with an incremental increase in risk of revision in a subsequent total knee arthroplasty.","authors":"Julius Tetens Hald, Anders Odgaard, Michael Mørk Petersen, Anders El-Galaly","doi":"10.1002/ksa.70038","DOIUrl":"https://doi.org/10.1002/ksa.70038","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to estimate the relative risk of revision for total knee arthroplasty (TKA) with prior knee arthroplasties compared to TKAs in knees without prior surgery. In addition, this study aimed to assess if there was a dose-response relationship between the number of prior knee arthroscopies and the risk of TKA revision.</p><p><strong>Methods: </strong>A retrospective observational study of three Danish Health Registries. All primary TKAs performed in Denmark from 1998 to 2021 were identified. Knee arthroscopies prior to primary arthroplasty were identified for these knees. The patients were grouped by whether they had an arthroscopy prior to the TKA or not. Kaplan-Meier analysis and Cox regression analysis was used to estimate implant survival and hazard ratio (HR) for revision.</p><p><strong>Results: </strong>The study included 96,781 primary TKAs without prior surgery (de novo TKA) and 15,042 primary TKAs that had had one or more arthroscopies as only prior surgery. After adjusting for age, sex, and Charlson Comorbidity Index (CCI) the HR for revision was 1.38 (95% confidence interval [CI] 1.29-1.47, p < 0.001) for knees with prior arthroscopy compared to knees without prior arthroscopy. After adjusting for age, sex, and CCI each additional arthroscopy increased the HR for revision of 1.27 (95% CI 1.21-1.33, p < 0.001) in a dose-response manner.</p><p><strong>Conclusion: </strong>Previous knee arthroscopies increase the risk of revision following primary TKA. More importantly, each additional knee arthroscopy increased the risk by 27%. Although the exact mechanism behind the observation is unknown, this is important information for both surgeons and patients when considering treatment options for knees affected by degenerative conditions.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postless vs. traditional hip arthroscopy: A multilevel meta-analysis of current evidence on efficacy and safety.","authors":"Nikolai Ramadanov, Maximilian Voss, Jonathan Lettner, Robert Hable, Robert Prill, Roland Becker, Vanessa Twardy, Ingo J Banke","doi":"10.1002/ksa.70048","DOIUrl":"https://doi.org/10.1002/ksa.70048","url":null,"abstract":"<p><strong>Purpose: </strong>To date, no meta-analysis has systematically compared postless and post-assisted hip arthroscopy (HAS). This underscores the need for a structured synthesis of current evidence. To address this gap, a multilevel meta-analysis was conducted to systematically compare outcomes and complication rates of HAS performed with and without a perineal post.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, Epistemonikos, and CENTRAL was completed on 20 July 2025. A frequentist multilevel meta-analysis with random-effects modelling and Hartung-Knapp adjustment was conducted. Outcomes were summarised as pooled mean differences and proportions with 95% confidence intervals.</p><p><strong>Results: </strong>Eight primary studies including 1880 hips were analysed. The pooled nerve injury rate was higher in the traditional HAS group (7%; 95% confidence interval [CI]: 0.01-0.36) compared to the postless group (3%; 95% CI: 0.00-0.20), with a significant subgroup difference (F  =  10.81; p < 0.01). Mean traction time was longer in the traditional group (58.5 min) than in the postless group (52.2 min), also with a significant difference (F =  32.96; df = 1.50; p < 0.01). Other subgroup comparisons showed no significant differences.</p><p><strong>Conclusion: </strong>While trends suggest potential advantages of postless hip arthroscopy in certain outcomes, the evidence remains limited by study heterogeneity and design. These results support its growing clinical use, though further prospective comparative studies are needed to strengthen the evidence base.</p><p><strong>Level of evidence: </strong>Level II, systematic review and meta-analysis.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic alignment preserves the mid-flexion trochlear line orientation in total knee arthroplasty: A prospective analysis from the FP-UCBM Knee Study Group.","authors":"Stefano Campi, Giancarlo Giurazza, Edoardo Franceschetti, Marco Edoardo Cardinale, Andrea Tanzilli, Pietro Gregori, Michele Paciotti, Biagio Zampogna, Umile Giuseppe Longo, Rocco Papalia","doi":"10.1002/ksa.12810","DOIUrl":"10.1002/ksa.12810","url":null,"abstract":"<p><strong>Purpose: </strong>Kinematic alignment (KA) in total knee arthroplasty (TKA) aims to restore the patient's native joint anatomy by resurfacing the distal and posterior femoral condyles. However, the trochlear anatomy is often overlooked, raising concerns about potential relative internal rotation of the femoral component. The aim of this study was to define the 𠄈mid-flexion trochlear line' (MTL) and assess its orientation relative to the posterior condylar line, hypothesising a parallelism between the two.</p><p><strong>Methods: </strong>A total of 158 knees (145 patients) undergoing KA TKA were prospectively analysed, after excluding post-traumatic osteoarthritis, cases with trochlear dysplasia, and femoral component flexion >5°. The anterior chamfer cut was conducted with a posterior referencing guide and the most prominent points of the medial and lateral trochlear facets-defining the MTL-were measured with a caliper. The MTL orientation relative to the posterior condylar line was calculated as the difference between the medial and lateral trochlear facets, with the two lines considered parallel for differences of 0 ± 1 mm. Two one-sided tests was implemented to assess equivalence between the two lines within a ±1 mm threshold. Correlations with coronal plane parameters (hip-knee-ankle angle [HKA], medial proximal tibial angle [MPTA] and lateral distal femoral angle [LDFA]) were assessed with Pearson's correlation coefficient. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>The mean difference between the medial and lateral trochlear facets was 0.1 ± 1.40 mm, with 81.7% of cases falling within the 0 ± 1 mm range, indicating parallelism between the posterior condylar line and the mid-flexion trochlear line (p  =  0.709). No significant correlations were observed between MTL orientation and HKA, MPTA or LDFA.</p><p><strong>Conclusions: </strong>Referencing the posterior condylar line accurately restores MTL orientation in the vast majority of patients, irrespective of coronal plane parameters. These findings support the biomechanical rationale of kinematic alignment, dispelling concerns about femoral component internal rotation.</p><p><strong>Level of evidence: </strong>Level IV, prospective observational study.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No differences in functional and clinical outcomes after rehabilitation between modified kinematic and mechanical alignment in total knee arthroplasty: A randomized controlled trial.","authors":"Leandra Bauer, Frank Layher, Julia Kirschberg, Markus Heinecke, Matthias Woiczinski, Georg Matziolis","doi":"10.1002/ksa.70004","DOIUrl":"10.1002/ksa.70004","url":null,"abstract":"<p><strong>Purpose: </strong>Despite advancements in total knee arthroplasty (TKA), patient dissatisfaction remains notably high (15%-25%). This dissatisfaction will be multifactorial, one of which may be the alignment of the components. Kinematic alignment (KA), aimed at restoring pre-arthritic knee anatomy, is proposed as a promising alternative to mechanical alignment (MA), potentially offering better functional outcomes and improved gait characteristics.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted involving 100 patients undergoing primary TKA. Patients were randomized into two groups (KA vs. MA) using a navigation-assisted surgical approach, with follow-ups conducted at 1 year post-operatively. Outcomes assessed included patient-reported outcome measures (Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale and Forgotten Joint Score), radiological alignment and comprehensive gait analysis (kinematics, kinetics and spatio-temporal parameters).</p><p><strong>Results: </strong>Navigation analyses indicated significant post-operative alignment differences, with KA showing significantly more varus tibial (KA: 2.2 ± 2.8° vs. MA: 0.3 ± 0.6°, p < 0.001) and more valgus femoral cuts (KA: -0.7 ± 2.9° vs. MA: 0.3 ± 0.8°, p = 0.02) compared to MA. However, these differences did not translate into significant clinical or functional differences between groups in patient-related outcome measures, gait kinematics, kinetics, or spatio-temporal parameters at the 1-year mark. Both alignment techniques showed similar deviations from healthy gait patterns, particularly reduced knee flexion (mean ROM healthy 57.3°, KA 48.6°, MA 47.8°), and knee valgus during walking (mean maximal valgus healthy 15.2°, KA 10.5°, MA 9.5°). Notably, KA required fewer intraoperative soft tissue releases, suggesting procedural simplicity.</p><p><strong>Conclusion: </strong>This study found no significant differences in clinical or functional outcomes between KA and MA despite distinct radiological alignment outcomes after 1-year follow-up. Both approaches yield comparable patient satisfaction and functional performance 1 year post-operatively. KA offers procedural advantages, specifically reduced soft tissue interventions.</p><p><strong>Level of evidence: </strong>Level I.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The trajectory of patient-reported outcomes after hip preservation surgery: A National Registry Study.","authors":"Junya Yoshitani, Seper Ekhtiari, Ajay Malviya, Vikas Khanduja","doi":"10.1002/ksa.12771","DOIUrl":"10.1002/ksa.12771","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the trajectory of postoperative patient-reported outcomes after hip preservation surgery is essential. This study aims to analyse patient-reported outcome trajectories up to 2 years post-surgery using the UK's national hip preservation registry and to examine the influence of potential confounders.</p><p><strong>Methods: </strong>Patients who underwent hip arthroscopy or periacetabular osteotomy with preoperative International Hip Outcome Tool-12 (iHOT-12) scores and at least two follow-up measurements at 6 months, 1 year, or 2 years were included from the UK Non-Arthroplasty Hip Registry. iHOT-12 score trajectories were analysed, and Latent Growth Curve Modelling was used to identify predictors of these trajectories.</p><p><strong>Results: </strong>Overall 9845 patients were included in this study. 7081 patients underwent a hip arthroscopy, and 1327 patients underwent a periacetabular osteotomy. For hip arthroscopy, there were significant improvements in the iHOT-12 scores from baseline to 6 months, but no significant change from 6 months to 1 year. However, there was a decrease in the minimal clinically important difference from 1 to 2 year. For periacetabular osteotomy, there were significant improvements in the iHOT-12 scores from baseline to 6 months, but no significant change from 6 months to 1 year, and from 1 to 2 years. Latent Growth Curve Modelling showed that body mass index (BMI) and sex had a significant impact on pre-operative iHOT-12 scores, while age and sex significantly influenced the recovery slope.</p><p><strong>Conclusions: </strong>Patients who underwent hip preservation surgery exhibited significant improvement in iHOT-12 scores, surpassing the minimal clinically important difference at 6 months postoperatively. This improvement plateaued by 2 years, with a slight decline in scores between 1 and 2 years following hip arthroscopy, though the decrease remained within the clinically meaningful range. BMI, age and sex influenced score trajectories, highlighting the importance of setting patient expectations pre-operatively.</p><p><strong>Trial registration: </strong>The UK's Non-Arthroplasty Hip Registry https://www.nahr.co.uk/.</p><p><strong>Levels of evidence: </strong>Level III.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed reconstruction is associated with higher rates of medial meniscus and chondral injury following ACL injury: A New Zealand ACL Registry Study.","authors":"Richard Rahardja, Hamish Love, Mark G Clatworthy, Simon W Young","doi":"10.1002/ksa.70002","DOIUrl":"https://doi.org/10.1002/ksa.70002","url":null,"abstract":"<p><strong>Purpose: </strong>Early reconstruction for anterior cruciate ligament (ACL) rupture may be controversial, with some clinicians opting for a trial of non-operative management first. The impact of delayed surgery on outcomes is unclear, but it may be associated with an increase in secondary intra-articular pathology involving the menisci and cartilage. This study aimed to analyze the association between the timing of surgery and outcomes, including revision ACL reconstruction, concomitant meniscal and chondral injuries.</p><p><strong>Methods: </strong>Prospective data recorded in the New Zealand ACL Registry were analyzed. Primary ACL reconstructions performed between April 2014 and December 2022 were included. Timing of surgery was categorized into five groups: ≤6 weeks, 6 weeks to 3 months, 3-6 months, 6-12 months and >12 months. Revision rates and incidence of concomitant meniscal and chondral injury were compared between the five groups of surgical timing.</p><p><strong>Results: </strong>A total of 15,586 primary ACL reconstructions were analyzed, of which 1263 were performed within 6 weeks (8%), 3718 between 6 weeks to 3 months (24%), 5129 between 3 and 6 months (33%), 3223 between 6 and 12 months (21%) and 2253 more than 12 months (14%). The incidence of medial meniscal tears was greatest when surgery was delayed 6-12 months (40%, adjusted odds ratio [aOR] = 1.1, p = 0.01) and more than 12 months after injury (53%, aOR = 2.0, p < 0.001). Delayed surgery more than 3 months was associated with an increasing incidence of chondral injury (aOR > 1.3, p < 0.001). Revision rates were lowest in patients who underwent delayed surgery more than 12 months after injury (adjusted hazard ratio [HR] = 0.6, p < 0.001), but differences in activity levels, age, sex and graft choice were noted.</p><p><strong>Conclusion: </strong>Delayed ACL reconstruction is associated with a greater incidence of concomitant medial meniscal and chondral injury and should be considered when trialling non-operative management for ACL rupture.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sport-specific differences in ACL injury, treatment and return to sports: Football.","authors":"Werner Krutsch, Dominik Szymski, Johannes Rüther, Volker Musahl, Alberto Grassi, Thomas Tischer, Markus Gesslein","doi":"10.1002/ksa.12803","DOIUrl":"https://doi.org/10.1002/ksa.12803","url":null,"abstract":"<p><p>The management of anterior cruciate ligament (ACL) ruptures is carried out differently in prevention, treatment and rehabilitation for athletes than for non-athletes. However, different approaches to managing ACL ruptures are also discussed in different sports. This narrative review includes first time the current situation of ACL management in football by experiences from the practical routine as well as from scientific reports. No other sport shows such high number of literature reports and sufficient scientific evidence in the management of ACL ruptures like football and this article provides a football specific overview in prevention, treatment and return to sports strategies. These scientific reports underline the surgical treatment of ACL ruptures in football player and show a high sustainability and return to sports rate. However, reports from football show that despite good knowledge, the implementation of sustainable prevention and rehabilitation is difficult and needs improvement. CLINICAL TRIAL REGISTRATION: Considering that this manuscript is a narrative review, no clinical trial registration is neccesary. LEVEL OF EVIDENCE: Level V.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infratuberosity osteotomies require greater wedge resection and result in increased cortical mismatch compared to supratuberosity: A morphometric study supporting individualized planning in posterior tibial slope correction.","authors":"M Enes Kayaalp, Husnu Yilmaz, Jumpei Inoue, Camila Grandberg, Jonathan D Hughes, Volker Musahl","doi":"10.1002/ksa.70003","DOIUrl":"https://doi.org/10.1002/ksa.70003","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior tibial slope (PTS) reducing anterior closing wedge osteotomies are increasingly used to address the elevated risk of anterior cruciate ligament (ACL) graft failure in patients with increased PTS. This study evaluates the wedge height required at two osteotomy levels-supratuberosity and infratuberosity-for equivalent PTS correction and examines its relationship with tibial anatomy.</p><p><strong>Methods: </strong>Fifty patients undergoing multiple revision ACL reconstruction (ACL-R) with PTS ≥ 12° were retrospectively analyzed using standardized lateral knee radiographs. Simulated osteotomies at supratuberosity and infratuberosity levels were performed using MATLAB. Wedge thickness per degree, anterior cortical step-off, defined as the mismatch or offset between the anterior cortices of the proximal and distal tibial fragments following wedge removal, and tibial anterior-posterior width were measured. Correlations were assessed using Pearson's r. Model fit was evaluated with the coefficient of determination (R²), standard error of the estimate and root mean square error. Levene's test compared residual variance. A p value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean PTS was 14.6 ± 2.5°. Infratuberosity osteotomies required 1.2 ± 0.2 mm per degree correction versus 1 ± 0.1 mm for supratuberosity (p < 0.01). Cortical step-off was greater at the infratuberosity than the supratuberosity level (4.4 ± 1.6 mm vs. 1.8 ± 1.3 mm, respectively, p < 0.01). Tibial width strongly predicted wedge thickness at the supratuberosity level (r = 0.83, R² = 0.69), and moderately at the infratuberosity level (r = 0.66, R² = 0.48). Residual variance was not significantly different (p = 0.147).</p><p><strong>Conclusion: </strong>Infratuberosity anterior closing wedge osteotomy (ACWO) requires significantly greater wedge resection and leads to a larger mismatch at the anterior tibial cortex compared to supratuberosity ACWO for the same amount of PTS correction. Considerable variability existed regarding tibial morphology at both levels. These results highlight the importance of patient-specific, anatomy-based planning when performing ACWO in the setting of revision ACL-R.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}