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

{"title":"Patients with previous anterior cruciate ligament reconstruction achieve equally good outcomes after total knee arthroplasty: A Swedish registry-based study of 7755 patients.","authors":"Ioannis Syrikas, Ioannis Karikis, Neel Desai, Georgios Tsikandylakis","doi":"10.1002/ksa.70240","DOIUrl":"10.1002/ksa.70240","url":null,"abstract":"<p><strong>Purpose: </strong>Patients who have undergone anterior cruciate ligament reconstruction (ACLR) may later require total knee arthroplasty (TKA) due to osteoarthritis (OA). The impact of previous ACLR on patient-reported outcomes (PROs) after TKA remains uncertain. This study compared PROs 1 year after TKA between patients with knee OA with a history of ACLR (group of patients who underwent total knee arthroplasty after anterior cruciate ligament reconstruction [ACLROA]) and those without prior major surgery on the operated knee (controls).</p><p><strong>Methods: </strong>The Swedish Arthroplasty and Knee Ligament Registers were linked. ACLROA cases were matched 1:2 to controls by age, sex, BMI, ASA score, implant type and surgery time period. Preoperative and 1-year postoperative patient-reported outcome measures (PROMs) included five-point Likert scales for satisfaction and pain, knee injury and Osteoarthritis Outcome Score, 12-item short form (KOOS-12), and EuroQol 5-dimensions, 3-level version (EQ-5D-3L).</p><p><strong>Results: </strong>Cohort sizes varied for the analysis of PROMs: satisfaction was compared between 998 ACLROA patients and 1996 controls, pain between 441 and 882, KOOS-12 between 595 and 1190, and EQ-5D-3L between 551 and 1102, respectively. At 1 year postoperatively, satisfaction scores differed significantly (p = 0.016), with a higher proportion of ACLROA patients reporting being 'very satisfied' (53% vs. 49%), although pain scores did not differ (p = 0.263). The mean KOOS-12 total score was 59 ± 16 points for ACLROA patients and 58 ± 16 for the controls (p = 0.22). The mean EQ-5D-3L index was 0.89 ± 0.11 for ACLROA patients and 0.88 ± 0.11 for the controls (p = 0.019).</p><p><strong>Conclusions: </strong>Prior ACLR did not compromise early PROs after subsequent TKA. Satisfaction, pain relief, knee function and HRQoL were comparable between groups. Although some differences reached statistical significance, they did not exceed established thresholds for clinical relevance. Prior ACLR should therefore not be considered a negative prognostic factor regarding PROs during preoperative counselling for 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":"3377-3386"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms and situational patterns of anterior cruciate ligament injuries in professional women's football (soccer): A systematic video analysis across 25 leagues (2022-2024).","authors":"Wyatt Hampstead, Ric Lovell, Matthew Whalan, Lionel Chia, Joshua Bonney, Bradley Wakefield, Vanessa Crespin, Evangelos Pappas","doi":"10.1002/ksa.70528","DOIUrl":"10.1002/ksa.70528","url":null,"abstract":"<p><strong>Purposes: </strong>To identify and describe the biomechanical characteristics and football-specific contextual factors associated with anterior cruciate ligament (ACL) injuries in professional women's football.</p><p><strong>Methods: </strong>A media-based prospective cross-sectional study identified 247 ACL injuries across international matches and 25 national women's leagues (tiers 3-5) between 2022 and 2024 using a validated media-based surveillance approach. Video footage was available for 127 injuries and analysed by three reviewers using Quality Appraisal for Sports Injury Video Analysis Study (QA-SIVA) informed protocols and frame-by-frame analysis. Situational variables included player action (e.g., pressing, tackling, landing, kicking), contact mechanism, match status, positional role, playing surface, competition, pitch location and time of injury.</p><p><strong>Results: </strong>Most injuries (67%) occurred within the first 45 min and during defensive play (65%). Mechanisms were non-contact (49%), indirect contact (41%) and direct contact (10%). Frequent scenarios included pressing/tackling (53%), being tackled (15%), regaining balance after kicking (7%) and landing from a jump (5%). Among the biomechanical subsample (57 frontal/transverse and 46 sagittal cases), commonly observed patterns during pressing or tackling included ~50° hip flexion, ~25° knee flexion, a neutral trunk position (~0°), hip abduction (66%) and knee valgus (54%).</p><p><strong>Conclusions: </strong>ACL injuries in professional women's football frequently occurred during defensive actions early in matches. Within the biomechanical subsample, these injuries commonly involved limited lower-limb flexion and valgus knee alignment, although findings should be interpreted cautiously due to the limited sample size. Together, these findings provide descriptive insight into common injury scenarios in professional women's football and may help inform future prevention strategies and targeted biomechanical research.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"3441-3458"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar tibial and femoral component fixation of mobile-bearing and fixed-bearing lateral unicompartmental knee arthroplasty: A radiostereometry study with 5-year follow-up.","authors":"Andreas Bidstrup Hovmark, Emil Toft Petersen, Jonathan Hugo Jürgens-Lahnstein, Tobias Dahl Vind, Søren Rytter, Claus Fink Jepsen, Maiken Stilling","doi":"10.1002/ksa.70238","DOIUrl":"10.1002/ksa.70238","url":null,"abstract":"<p><strong>Purpose: </strong>To compare tibial and femoral component fixation of lateral unicompartmental knee arthroplasty (UKA) with mobile-bearing (MB) and fixed-bearing (FB) designs up to 5 years follow-up. The primary outcome was mean tibial component maximal total point motion (MTPM) at 1-year follow-up.</p><p><strong>Methods: </strong>The Oxford lateral domed UKA (n = 14) and the Oxford Fixed Lateral UKA (n = 13) were inserted in 27 patients with posterolateral unicompartmental knee osteoarthritis. Tibial implants were cemented, while femoral implants were either cemented (n = 17) or cementless (n = 10). At baseline, 1-, 2-, and 5-year follow-up, radiostereometry (RSA) imaging, Oxford Knee Score (OKS) and EQ-5D-5L quality of life score were collected. A newly updated 1-year migration threshold was used to determine 15-year revision-risk with migration above 0.4 mm termed 'at-risk'.</p><p><strong>Results: </strong>At 1-year follow-up, tibial implant MTPM was 0.47 mm (confidence interval [CI]: 0.32; 0.62) for MB UKA and 0.52 mm (CI: 0.36; 0.68) for FB UKA. Femoral implant MTPM was 0.56 mm (CI: 0.34; 0.79) for MB UKA and 0.54 mm (CI: 0.30; 0.77) for FB UKA. Migration patterns were similar between cemented and cementless femoral components. No differences in tibial implant MTPM were found between groups at follow-up, with a mean difference of -0.06 (CI: -0.28; 0.15) at 2-year and -0.06 (CI: -0.31; 0.18) at 5-year follow-up. Further, 16/25 (MB: 7/13, FB: 9/12) implants were in the \"at-risk\" group for 15-year revision. Both groups demonstrated clinically relevant improvements in OKS and European quality of life score (EQ-5D-5L), no differences between FB and MB were found.</p><p><strong>Conclusion: </strong>The MB and FB tibial components had similar good fixation and clinical improvement until 5 years of follow-up. MTPM migration for both tibial groups was in the 'at risk' group for revision based on the newly established 1-year migration threshold, but showed no measurable migration after the 1-year follow-up.</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":"3387-3398"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional alignment in robotic total knee arthroplasty provides favourable outcomes and minimal early revisions: A systematic review and meta-analysis.","authors":"Vasileios Giovanoulis, Angelo V Vasiliadis, Luca Andriollo, Pietro Gregori, Konstantinos Dretakis, Christos Koutserimpas, Sébastien Lustig","doi":"10.1002/ksa.70226","DOIUrl":"10.1002/ksa.70226","url":null,"abstract":"<p><strong>Purpose: </strong>Functional alignment (FA) has emerged as a personalised alignment strategy in total knee arthroplasty (TKA), enabled by robotic-assisted technology. Although early clinical results are encouraging, evidence remains heterogeneous and long-term safety is uncertain. This systematic review aimed to evaluate functional outcomes, and early revision risk of robotic-assisted TKA performed under FA principles with a minimum follow-up of 2 years.</p><p><strong>Methods: </strong>This review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251134340). PubMed/MEDLINE and Scopus were searched up to August 2025. Eligible studies included adult patients undergoing robotic-assisted primary TKA with FA, reporting outcomes at ≥2 years' follow-up. Data on demographics, robotic system, implant type, patient-reported outcome measures (PROMs), range of motion (ROM), complications, and revision rates were extracted. Risk of bias was assessed using ROB 2 and ROBINS-I. A random-effects single-arm meta-analysis of pooled proportions was performed for early aseptic revision risk.</p><p><strong>Results: </strong>Twenty studies (5155 TKAs) were included, with a weighted mean follow-up of 2.5 years. All procedures were performed using the image-based robotic system. Postoperative PROMs were consistently high: Knee Society Score (KSS) Knee 92.4-94.5, KSS Function 91.4-93.4, and FJS 74.8-77.5. Kujala scores indicated minimal anterior knee pain (88.1-93.2). ROM improved from a mean preoperative flexion of 119.3° to 123°-124.8°. Complications were infrequent, most commonly stiffness requiring manipulation under anaesthesia. Across all cohorts, 18 aseptic revisions were reported (pooled proportion 0.35%, 95% CI 0.23-0.55). The single-arm meta-analysis of pooled proportions showed a negligible pooled early revision risk (rounded to 0.00; 95% CI 0.00-0.01; I² = 0%). Outcomes were comparable across age, gender, fixation type, and implant constraint, although obese patients accounted for all mechanical failures.</p><p><strong>Conclusion: </strong>Robotic-assisted TKA performed under FA principles yields favourable short- to mid-term functional outcomes and a low rate of early aseptic revision.</p><p><strong>Level of evidence: </strong>Level III, systematic review and meta-analysis.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"3362-3376"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There is no standardised measurement approach for medial proximal tibial angle after unicompartmental knee arthroplasty: A systematic review.","authors":"Sina Hajiaghajani, Ali Soltani Farsani, Sina Aminizadeh, Mohammad Poursalehian, Abtin Alvand, Seyed Mohammad Javad Mortazavi","doi":"10.1002/ksa.70204","DOIUrl":"10.1002/ksa.70204","url":null,"abstract":"<p><strong>Purpose: </strong>Unicompartmental knee arthroplasty (UKA) is increasingly used for isolated knee osteoarthritis. The medial proximal tibial angle (MPTA) is important for describing tibial alignment. However, MPTA measurement after UKA is challenging because one tibial compartment is prosthetic. This systematic review evaluated the measurement of MPTA after UKA, summarised methodological variability, and assessed the quality and reliability of the reported methods.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Scopus were searched. Eligible original studies reported radiographic MPTA measurement techniques in patients who underwent UKA. Two reviewers independently screened, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. Due to methodological heterogeneity, a qualitative narrative synthesis was conducted.</p><p><strong>Results: </strong>Twenty-three studies met the inclusion criteria, encompassing 4,075 patients and one cadaveric study with 26 specimens. Measurement reporting was heterogeneous and often incomplete: 12 studies did not specify their MPTA technique. Among the described approaches, three standard methods emerged: (1) using the tibial component coronal angle (TCA) as a proxy for MPTA, (2) connecting the proximal medial point of the prosthesis to a lateral native tibial landmark (medial-to-lateral joint line), and (3) the Cartier-type angle. Reliability reporting was limited: only six studies reported both inter- and intra-observer reliability with specific statistical measures, three reported inter-observer reliability only, three stated dual assessors without metrics, and eleven reported no reliability data.</p><p><strong>Conclusions: </strong>There is no standardised and validated method for MPTA measurement after UKA. Heterogeneity in landmarks and reliability reporting undermines the comparability of results across studies. A standardised and validated measurement approach for MPTA after UKA is urgently needed.</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":"3322-3332"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pie-crusting the medial collateral ligament is a safe and effective technique for improving visualisation and access in arthroscopic meniscal surgery: A systematic review.","authors":"Satyavenkata Kotipalli, Benjamin Blackman, Prushoth Vivekanantha, Marc Daniel Bouchard, Amit Meena, Shahbaz Malik, Darren de Sa","doi":"10.1002/ksa.70103","DOIUrl":"10.1002/ksa.70103","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the safety, effectiveness, and postoperative outcomes of medial collateral ligament (MCL) pie-crusting (PC) in arthroscopic meniscus surgery.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with PRISMA guidelines. Three databases (PubMed, EMBASE and MEDLINE) were searched from inception to 21 January 2025, for studies evaluating the use of MCL PC during arthroscopic meniscus or anterior cruciate ligament (ACL) surgery. Data on patient demographics, medial joint space measurements, postoperative instability, patient reported outcome measures (PROMs), and complications were extracted.</p><p><strong>Results: </strong>Fifteen studies comprising 1009 patients were included, with 723 undergoing PC. PC significantly increased medial joint space width by a mean of 5.7 mm intraoperatively (p < 0.05), with no residual laxity reported at mean final follow-up of 16.5 months. The most common complications of PC were transient medial knee pain (12.7%) and ecchymosis (12.9%). There were five reports of saphenous nerve irritation (0.8%), all resolved by final follow-up of 31.6 months. In contrast, iatrogenic chondral injury was reported in 9.0% of patients undergoing meniscal repair without PC.</p><p><strong>Conclusion: </strong>MCL PC is a safe and effective technique to improve visualisation and outcomes in arthroscopic meniscus surgery. It is associated with improved joint access and low complication rates without long-term instability. While current evidence supports its use, further high-quality, long-term comparative studies are needed to validate its safety and efficacy, as this study primarily used retrospective data without long-term follow-up.</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":"3298-3313"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive lateral femoral condyle lengthening in total knee arthroplasty produces dose-dependent increases in patellofemoral joint loading and alters patellar tracking.","authors":"Jobe Shatrov, Mounir Boudali, Koki Abe, David Parker, William Walter, Elizabeth Clarke","doi":"10.1002/ksa.70552","DOIUrl":"https://doi.org/10.1002/ksa.70552","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the biomechanical effects of progressive lateral femoral condyle lengthening on patellofemoral joint (PFJ) kinematics and kinetics following total knee arthroplasty (TKA), and to determine whether lateral condyle distalisation produces measurable, dose-dependent alterations in PFJ loading and patellar tracking.</p><p><strong>Methods: </strong>Eight fresh-frozen cadaveric knees were implanted with a cruciate-retaining TKA and tested in four states: Native (unresurfaced), Neutral (resurfaced to native thickness), medium (+2.5 mm distalisation) and Maximum (+4.5 mm distalisation). PFJ kinematics were recorded during passive flexion and simulated stair descent using optical tracking. PFJ kinetics were measured using calibrated thin-film pressure sensors (Neutral, Medium, Maximum).</p><p><strong>Results: </strong>Progressive lateral condyle distalisation produced a significant, dose-dependent increase in PFJ reaction force during both passive flexion (Neutral: 55.98 ± 32.33 N; Maximum: 76.30 ± 46.19 N; p = 0.006) and stair descent (Neutral: 42.19 ± 28.84 N; Maximum: 55.72 ± 28.02 N; p = 0.006). Medial and lateral facet loads increased with distalisation. Kinematically, significant increases in anterior patellar translation and external rotation were observed in all resurfaced conditions compared with the native state (p < 0.05, Holm-corrected). Medial-lateral translation, superior-inferior translation, patellar flexion and valgus-varus rotation were not significantly affected.</p><p><strong>Conclusion: </strong>Lateral femoral condyle lengthening in TKA increases PFJ reaction forces and alters patellar tracking in a dose-dependent manner. These findings highlight lateral condyle distalisation as a modifiable surgical factor with important implications for femoral component preparation and alignment philosophy in TKA.</p><p><strong>Level of evidence: </strong>Level IV, controlled laboratory study.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842792","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":"Medial meniscus posterior root repair with concomitant centralization does not demonstrate superior reduction of meniscal extrusion or improved clinical outcomes compared with isolated repair: A systematic review and meta-analysis.","authors":"Angelo V Vasiliadis, Nifon K Gkekas, Alexandros Maris, Nicholas Colyvas, Michael Hantes","doi":"10.1002/ksa.70583","DOIUrl":"https://doi.org/10.1002/ksa.70583","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether the addition of a meniscal centralization procedure to medial meniscus posterior root (MMPR) repair improves medial meniscus extrusion (MME) and patient-reported outcomes compared with isolated MMPR repair.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Cochrane CENTRAL and Scopus were searched from inception to 28 February 2026. Comparative studies evaluating isolated MMPR repair versus MMPR repair combined with centralization procedure (including transtibial pull-out repair, posteromedial pull-out repair with all-inside sutures and anchor-based techniques) and reporting radiographic extrusion measured by magnetic resonance imaging and/or patient-reported outcomes were included. Effect estimates were calculated using change scores. Mean differences (MDs) were used for extrusion, and standardized mean differences (SMDs) were used for patient-reported outcomes. Heterogeneity was assessed using the I² statistic, and pooled estimates were generated using a random-effects model.</p><p><strong>Results: </strong>Six comparative studies (one randomized controlled trial [RCT] and five retrospective cohort studies) comprising 309 patients (167 isolated repair; 142 centralization repair) with a mean follow-up period of 11.2 months (range, 3-26.8 months) were included. Participants were predominantly female, with mean age of 50.3-66.4 years, body mass index of 22.5-29 kg/m² and Kellgren-Lawrence ≤ 2. The overall pooled analysis demonstrated no significant difference in MME reduction between centralization and isolated repair (MD 0.4 mm; 95% confidence interval [CI] -0.34 to 1.22; p = 0.27; I²= 89%). Although post-operative MME was lower in the centralization group (3.3 vs. 3.8 mm), the absolute difference between groups was only 0.6 mm, suggesting limited clinical relevance. No significant differences were observed between groups in Lysholm (p = 0.93), International Knee Documentation Committee (p = 0.13) or visual analogue scale pain scores (p = 0.10). Reporting of complications was inconsistent, with no conversions to total knee arthroplasty during follow-up.</p><p><strong>Conclusions: </strong>The addition of a meniscal centralization to MMPR repair does not demonstrate a consistent reduction in meniscal extrusion or improvement in patient-reported outcomes compared with isolated MMPR repair. Given the heterogeneity of the current evidence and the predominance of non-randomized studies, further high-quality RCTs are required to clarify its clinical value.</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":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835847","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":"Get it moving: Return to activity and sport following primary total knee arthroplasty is not associated with increased adverse events.","authors":"George M Avram, Gian Luigi Canata, Aleksandra Królikowska, Michael T Hirschmann, Roland Becker, Robert Prill","doi":"10.1002/ksa.70586","DOIUrl":"https://doi.org/10.1002/ksa.70586","url":null,"abstract":"<p><p>Return to sport (RTS) after total knee arthroplasty (TKA) is an increasingly important patient expectation, yet current recommendations remain heterogeneous. This editorial summarises contemporary evidence on RTS after TKA, highlighting patient selection, biomechanical considerations, surgical technique, implant technology and rehabilitation. Current evidence supports an individualised approach based on preoperative activity level, sporting experience and the demands of each sport. Despite this approach, no evidence-based recommendations are currently available. Low-impact activities can be recommended to most patients, whereas selected individuals may safely resume higher-impact sports following structured rehabilitation and appropriate counselling. Importantly, current evidence has not demonstrated a definitive increase in implant-related complications associated with RTS after TKA.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835902","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":"Patient-reported acceptable symptom state does not reflect quadriceps symmetry 1 year after ACL reconstruction.","authors":"Tomas Pineda, Nathan H Varady, David Mazy, Christophe Jacquet, Julien Druel, Matthieu Ollivier","doi":"10.1002/ksa.70584","DOIUrl":"https://doi.org/10.1002/ksa.70584","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the agreement between achievement of the validated patient acceptable symptom state (PASS) thresholds for Knee injury and Osteoarthritis Outcome Score (KOOS) Sport and KOOS Quality of Life (QoL) and isokinetic quadriceps limb symmetry index (LSI) ≥ 90% in a prospective cohort undergoing primary anterior cruciate ligament reconstruction (ACLR), and to determine whether this agreement was modified by autograft type.</p><p><strong>Methods: </strong>Ninety consecutive patients undergoing primary ACLR with systematic anterolateral augmentation were prospectively allocated to three autograft groups in cohorts of 30: rectus femoris (RF), quadriceps tendon (QT) and hamstrings (HS). At 12 months postoperatively, all patients underwent concentric isokinetic testing at 60°/s and completed the KOOS Sport and Recreation and KOOS QoL subscales. Concordance between PASS achievement (KOOS Sport ≥75; KOOS QoL ≥62.5) and quadriceps LSI ≥ 90% was analysed using Cohen's kappa with bootstrap 95% confidence intervals and McNemar exact test.</p><p><strong>Results: </strong>Agreement between PASS achievement and isokinetic quadriceps symmetry was absent: KOOS Sport versus LSI κ = 0.060 (95% confidence interval [CI] -0.071 to 0.191; McNemar p < 0.001); KOOS QoL versus LSI κ = 0.030 (95% CI -0.062 to 0.122; McNemar p < 0.001). Forty-two patients (46.7%) met the KOOS Sport PASS threshold while showing LSI < 90%, compared with only five patients who achieved quadriceps LSI ≥ 90% without meeting the KOOS Sport PASS threshold. Among patients who reached the KOOS Sport PASS threshold, 76% had concurrent quadriceps LSI scores below 90%. The pattern was consistent across the three autograft groups (RF 50%, QT 47%, HS 43%; χ² p = 0.875).</p><p><strong>Conclusion: </strong>PASS achievement and isokinetic quadriceps symmetry capture distinct dimensions of recovery 1 year after ACLR. The two assessments diverged in approximately half of the cohort, and this discordance was independent of autograft type. Patient-reported and objective measures should be regarded as complementary rather than interchangeable, and a satisfactory PROM result alone should not be taken as evidence of restored quadriceps symmetry.</p><p><strong>Level of evidence: </strong>Level II, prospective comparative study.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835861","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}