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

{"title":"Persistent isokinetic knee flexion strength deficits at the time of return to sport are not associated with a second ACL injury.","authors":"Axel Sundberg, Rebecca Hamrin Senorski, Johan Högberg, Ramana Piussi, Kristian Samuelsson, Roland Thomeé, Eric Hamrin Senorski","doi":"10.1002/ksa.12718","DOIUrl":"https://doi.org/10.1002/ksa.12718","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the rate of a second anterior cruciate ligament (ACL) injury based on different levels of knee flexion strength limb symmetry index (LSI) at the time of return to sport (RTS) after ACL reconstruction with hamstring tendon autograft.</p><p><strong>Methods: </strong>Data was extracted from a rehabilitation registry for patients aged 15-40 years, who participated in knee-strenuous sports pre-injury (Tegner ≥ 6) and underwent ACL reconstruction with hamstring tendon autograft. Isokinetic knee flexion strength was analysed and reported as LSI. Patients were categorised into three groups (≥90%, 80%-89.9% and <80%) based on their LSI at reported time of RTS. Patients were followed for 2 years after ACL reconstruction to record a second ACL injury, and hazard ratios (HR) were calculated using a Cox proportional hazards model.</p><p><strong>Results: </strong>A total of 526 patients (48% female, mean age 22 ± 6) were included, with 51 (9.7%) second ACL injuries recorded within 2 years after ACL reconstruction. Among patients with LSI ≥ 90% (71%), 43 second ACL injuries (11.0%) occurred. The LSI 80%-89.9% group had 4 second ACL injuries (4.0%), and the LSI < 80% group had four injuries (8.2%). Persistent knee flexion strength asymmetry did not significantly influence the hazard of a second ACL injury. The LSI 80%-89.9% group had a lower hazard (HR 0.34, confidence interval [CI]: 0.12-0.94), while the LSI < 80% group showed no significant difference (HR 0.70, CI: 0.25-1.97) compared with the LSI ≥ 90% group.</p><p><strong>Conclusion: </strong>Persistent isokinetic concentric knee flexion strength asymmetry at RTS were not associated with a second ACL injury.</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":0.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251955","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":"Arthroscopic repair for acute anterior cruciate ligament rupture results in higher failure rates and greater residual knee laxity compared to reconstruction if performed more than 3 weeks after injury: A systematic review and meta-analysis.","authors":"Ghuna Arioharjo Utoyo, Yudi Mulyana Hidayat, Agus Hadian Rahim, Hermin Aminah Usman, Tatacipta Dirgantara, Nobuo Adachi, Calvin Calvin","doi":"10.1002/ksa.12715","DOIUrl":"https://doi.org/10.1002/ksa.12715","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the failure rates, complications and patient-reported outcome measures (PROMs) between arthroscopic anterior cruciate ligament (ACL) repair and reconstruction (ACLR) for acute ACL rupture.</p><p><strong>Methods: </strong>A search was conducted on MEDLINE, ScienceDirect, Scopus and Cochrane Library. Clinical studies reporting failure rates, complications or PROMs between ACL repair and ACLR with a minimum of 2-year follow-up period were included. The complications evaluated were residual knee laxity, subsequent secondary meniscus injury, scar-related complications, other knee-related complications and hardware removal rates. The PROMs evaluated were the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner score, Lysholm score and ACL-Return to Sport after Injury (ACL-RSI) scale. Subgroup analyses were conducted to evaluate the influence of repair techniques and surgical timing.</p><p><strong>Results: </strong>Fourteen studies were included, with 565 patients in the ACL repair group and 684 patients in the ACLR group. The meta-analysis demonstrated that ACL repair results in a significantly higher failure rate (p = 0.006) and greater residual knee laxity (p < 0.0001) compared to ACLR. No significant differences were found in subsequent secondary meniscus injury, scar-related complications, other knee-related complications and hardware removal rates. In terms of PROMs, ACL repair demonstrated higher IKDC and Lysholm scores, comparable KOOS and Tegner score, but a significantly lower ACL-RSI scores (p = 0.02) compared to ACLR. Subgroup analysis by surgical timing indicated that repairs performed with an interval of ≤3 weeks produce similar failure rates (p = 0.33) but exhibit greater residual laxity (p = 0.006) compared to ACLR, whereas those >3 weeks showed both significantly higher failure rates (p = 0.01) and greater residual laxity (p = 0.001).</p><p><strong>Conclusion: </strong>Arthroscopic repair performed more than 3 weeks after the initial injury was associated with a higher failure rate and greater residual laxity compared to ACLR.</p><p><strong>Level of evidence: </strong>Level III, meta-analysis.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228407","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":"Poor side-to-side symmetry limits the use of the contralateral limb as a reliable reference for guiding coronal positioning and alignment in total knee arthroplasty.","authors":"Oriol Pujol, Pedro Hinarejos, Albert Pons, Ernest Famada, Angela Zumel, Juan Erquicia, Joan Leal-Blanquet","doi":"10.1002/ksa.12714","DOIUrl":"https://doi.org/10.1002/ksa.12714","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the symmetry of coronal alignment in the lower limbs of patients with knee osteoarthritis to evaluate whether the contralateral lower limb can serve as a reliable reference for guiding coronal positioning and alignment in total knee arthroplasty (TKA) surgery.</p><p><strong>Methods: </strong>This is a multicentric cross-sectional observational study. Preoperative full-leg weight-bearing radiographies from patients with knee osteoarthritis treated with a TKA between 2022 and 2024 were analyzed. Radiological parameters were measured in both lower limbs: medial proximal tibial angle, tibial mechanical angle (TMA), lateral distal femoral angle, femoral mechanical angle (FMA), hip-knee-ankle angle (HKA) and Kellgren-Lawrence. Lower limb coronal symmetry was assessed using the HKA, coronal plane alignment of the knee (CPAK) and phenotypes classifications. The relationship between concordance rates and osteoarthritis severity and symmetry was also analyzed.</p><p><strong>Results: </strong>Seventy-six patients were included. The operated-to-contralateral concordance for the HKA classification was 57%. It was higher when the operated knee was neutral (81%), compared to varus (58%) or valgus (27%). The CPAK concordance was 38%; it was similar across different CPAK types. The phenotype classification concordance was only 11%; 30% for the HKA parameter, 39% for FMA and 34% for TMA. There was no relationship between osteoarthritis severity or symmetry and coronal concordance rates.</p><p><strong>Conclusions: </strong>Patients with knee osteoarthritis have poor side-to-side symmetry in lower limb coronal alignment. The concordance rate was 56% for the HKA classification, 39% for the CPAK classification and 11% for the phenotype classification. Therefore, the contralateral lower limb may not be a reliable reference for guiding coronal positioning and alignment in TKA surgery.</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":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228410","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":"Artificial intelligence-assisted analysis of musculoskeletal imaging-A narrative review of the current state of machine learning models.","authors":"Felix C Oettl, Bálint Zsidai, Jacob F Oeding, Michael T Hirschmann, Robert Feldt, David Fendrich, Matthew J Kraeutler, Philipp W Winkler, Pawel Szaro, Kristian Samuelsson","doi":"10.1002/ksa.12702","DOIUrl":"https://doi.org/10.1002/ksa.12702","url":null,"abstract":"","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251952","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":"Evaluating DeepResearch and DeepThink in anterior cruciate ligament surgery patient education: ChatGPT-4o excels in comprehensiveness, DeepSeek R1 leads in clarity and readability of orthopaedic information.","authors":"Onur Gültekin, Jumpei Inoue, Baris Yilmaz, Mehmet Halis Cerci, Bekir Eray Kilinc, Hüsnü Yilmaz, Robert Prill, Mahmut Enes Kayaalp","doi":"10.1002/ksa.12711","DOIUrl":"https://doi.org/10.1002/ksa.12711","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares ChatGPT-4o, equipped with its deep research feature, and DeepSeek R1, equipped with its deepthink feature-both enabling real-time online data access-in generating responses to frequently asked questions (FAQs) about anterior cruciate ligament (ACL) surgery. The aim is to evaluate and compare their performance in terms of accuracy, clarity, completeness, consistency and readibility for evidence-based patient education.</p><p><strong>Methods: </strong>A list of ten FAQs about ACL surgery was compiled after reviewing the Sports Medicine Fellowship Institution's webpages. These questions were posed to ChatGPT and DeepSeek in research-enabled modes. Orthopaedic sports surgeons evaluated the responses for accuracy, clarity, completeness, and consistency using a 4-point Likert scale. Inter-rater reliability of the evaluations was assessed using intraclass correlation coefficients (ICCs). In addition, a readability analysis was conducted using the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES) metrics via an established online calculator to objectively measure textual complexity. Paired t tests were used to compare the mean scores of the two models for each criterion, with significance set at p < 0.05.</p><p><strong>Results: </strong>Both models demonstrated high accuracy (mean scores of 3.9/4) and consistency (4/4). Significant differences were observed in clarity and completeness: ChatGPT provided more comprehensive responses (mean completeness 4.0 vs. 3.2, p < 0.001), while DeepSeek's answers were clearer and more accessible to laypersons (mean clarity 3.9 vs. 3.0, p < 0.001). DeepSeek had lower FKGL (8.9 vs. 14.2, p < 0.001) and higher FRES (61.3 vs. 32.7, p < 0.001), indicating greater ease of reading for a general audience. ICC analysis indicated substantial inter-rater agreement (composite ICC = 0.80).</p><p><strong>Conclusion: </strong>ChatGPT-4o, leveraging its deep research feature, and DeepSeek R1, utilizing its deepthink feature, both deliver high-quality, accurate information for ACL surgery patient education. While ChatGPT excels in comprehensiveness, DeepSeek outperforms in clarity and readability, suggesting that integrating the strengths of both models could optimize patient education outcomes.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228409","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":"Cognitive-behavioural physical therapy improves psychological readiness for return to sport, knee function, and resilience in patients after anterior cruciate ligament reconstruction: A randomised controlled trial.","authors":"Jian-Ning Sun, Rui-Song Wang, Qun-Ya Zheng, Yun-Ru Ma, Peng Chen","doi":"10.1002/ksa.12687","DOIUrl":"https://doi.org/10.1002/ksa.12687","url":null,"abstract":"<p><strong>Purpose: </strong>Psychological preparation prior to the return to sport (RTS) has a significant impact on knee function following anterior cruciate ligament reconstruction (ACLR). The objective of this study was to evaluate the efficacy of a cognitive-behavioural-based physical therapy (CBPT) program in enhancing patients' psychological well-being, psychological preparation for RTS and knee function.</p><p><strong>Methods: </strong>A randomised parallel-group controlled trial was conducted. Seventy-two patients awaiting ACLR were randomly assigned to the CBPT or control group. The evaluation comprised the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI), Lysholm score, Knee Self-Efficacy Scale (K-SES), Tampa Scale for Kinesiophobia (TSK), Brief Resilience Scale (BRS) and locus of control (LOC). These were measured preoperatively and at 6, 12 and 24 weeks postoperatively.</p><p><strong>Results: </strong>Sixty-one subjects were finally included, 29 in the CBPT and 32 in the control group. At the 6th, 12th, and 24th postoperative weeks, the CBPT group had significantly higher ACL-RSI scores (66.4 vs. 62.2, 73.7 vs. 67.8, 85.1 vs. 80.1; p = 0.035, 0.012, 0.032, respectively), K-SES future scores (7.1 vs. 5.6, 7.9 vs. 6.8, 8.2 vs. 7.3; p = 0.002, 0.028, 0.047, respectively), and BRS scores (3.6 vs. 3.2, 4.1 vs. 3.7, 5.0 vs. 4.3; p = 0.025, 0.029, <0.001, respectively) compared to the control group. Lysholm scores were better in the CBPT group at Weeks 12 and 24 (73.7 vs. 65.3, 83.2 vs. 72.2; p = 0.038, <0.001, respectively), and the Week 24 mean difference exceeded the minimal clinically important difference (MCID) (10.0). No significant differences were found in TSK, K-SES present and LOC scores.</p><p><strong>Conclusion: </strong>CBPT-based psychological interventions facilitate enhanced psychological preparation for RTS, improved knee function and elevated confidence and resilience for future rehabilitation in patients who have undergone ACLR.</p><p><strong>Level of evidence: </strong>Level I, randomised controlled trial.</p><p><strong>Clinical trial registration: </strong>ChiCTR2400087631.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228408","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 addition of lateral extra-articular augmentation procedures to bone-tendon-bone or quadriceps autograft anterior cruciate ligament reconstruction does not negatively affect physical or psychological readiness for return to sport at 6 and 9 months.","authors":"Christopher M LaPrade, E Grant Carey, Kennedy K Gachigi, Matthew Erbe, Chris Gabriel, Jonathan C Riboh","doi":"10.1002/ksa.12710","DOIUrl":"https://doi.org/10.1002/ksa.12710","url":null,"abstract":"<p><strong>Purpose: </strong>The addition of lateral extra-articular augmentation procedures (LEAP) to anterior cruciate ligament reconstruction (ACLR) reduces graft failure rates in hamstring ACLR. However, their effects on return-to-sport (RTS) testing are not well understood in the setting of quadriceps (Quad) or bone-tendon-bone (BTB) autograft ACLR. The purpose was to evaluate the effects of adding LEAP to Quad or BTB autograft ACLR in young athletes, with respect to formal RTS testing outcomes. We hypothesized that the addition of LEAP to Quad or BTB ACLR would result in non-inferior outcomes as compared to isolated ACLR.</p><p><strong>Methods: </strong>A retrospective case-control analysis was performed of prospectively collected data from 93 patients under the age of 25 undergoing Quad or BTB ACLR from a single surgeon between 2021 and 2023. A control group of isolated ACLR was compared to the study group of ACLR/LEAP (either anterolateral ligament reconstruction [ALLR] or lateral extra-articular tenodesis [LET]). All patients underwent standardized RTS testing at 6 and 9 months post-surgery. The study was powered based on a priori power analysis to assess non-inferiority of the ACL/LEAP group.</p><p><strong>Results: </strong>There were 51 patients (54.8%) in the isolated ACLR group and 42 (45.2%) in the ACLR/LEAP group. The ACL/LEAP group was non-inferior to the isolated ACLR group for the limb symmetry index (LSI) and passing rates for each of the 6- and 9-month RTS tests, as well as psychological readiness, as measured by Anterior Cruciate Ligament-Return to Sport after Injury. There was no significant difference in overall pass rate between the control and ACL/LEAP groups (33% vs. 45.2%, respectively, p = 0.273) at 9 months. Subgroup analysis showed no differences in any outcome variables at 6 or 9 months between ACL/ALLR and ACL/LET.</p><p><strong>Conclusions: </strong>This study confirmed our hypothesis that the addition of LEAP to Quad or BTB ACLR is non-inferior to isolated ACLR in terms of RTS testing and psychological readiness for sport at 6 and 9 months post-operatively.</p><p><strong>Level of evidence: </strong>Level III, case-control study.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228411","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 Forgotten Joint Score after total knee arthroplasty with a kinematic alignment-optimized femoral component matches total hip arthroplasty.","authors":"Stephen M Howell, Ahmed Zabiba, Alexander J Nedopil, Maury L Hull","doi":"10.1002/ksa.12712","DOIUrl":"https://doi.org/10.1002/ksa.12712","url":null,"abstract":"<p><strong>Purpose: </strong>In kinematic alignment (KA) total knee arthroplasty (TKA), 50% of patients treated with a femoral component that has a 6° valgus prosthetic trochlear groove (PTG) show an abnormal quadriceps line of pull directed laterally to the groove. Lateral misalignment is reported to decrease the Forgotten Joint Score (FJS) by 17-24 points. Therefore, this study aimed to determine whether using a femoral component with a 20° valgus PTG, which minimizes the risk of lateral misalignment, can achieve a mean FJS that meets the 70-point threshold for a successful outcome in total hip arthroplasty (THA) and the mean value of 67 points for knees in the U.S.</p><p><strong>Population: </strong></p><p><strong>Methods: </strong>The study analyzed the first 127 patients who underwent KA TKA with the 20° valgus KA-optimized femoral component. At a minimum 2-year follow-up, patients were sent an online survey to complete the FJS and Oxford Knee Score (OKS) to assess function and report instances of revision knee surgery. Ten of the 127 cases were excluded: two required revision surgery. Four patients did not complete the questionnaire but reported no reoperations. The families of two individuals who passed away provided the same response. Two patients could not be contacted.</p><p><strong>Results: </strong>The analysis focused on 117 KA TKAs, with a mean FJS of 75 points, 5 points higher than the 70-point threshold considered successful for THA and exceeding the normative value of 67 points for knees. The mean OKS was 43 points.</p><p><strong>Conclusion: </strong>Primary KA TKA with a 20° valgus PTG can achieve an FJS comparable to THA with high functionality, as shown by 70% and 25% of subjects receiving an excellent (48-42) or good (41-34) OKS.</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":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228412","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":"Ten-year outcomes of hip arthroscopy for femoroacetabular impingement with osteoarthritis: Sustained functional benefits but high conversion to total hip arthroplasty.","authors":"Sarantos Nikou, Carl Sandlund, Ida Lindman, Per-Erik Johansson, Axel Öhlin, Louise Karlsson, Mikael Sansone","doi":"10.1002/ksa.12709","DOIUrl":"https://doi.org/10.1002/ksa.12709","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term clinical and radiographic outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients with mild to moderate osteoarthritis (OA). The hypothesis is that patients with FAIS and mild to moderate OA would experience sustained improvements in iHOT-12 at 10-year follow-up, despite natural OA progression.</p><p><strong>Methods: </strong>This prospective cohort study included 75 patients (80 hips) with FAIS and radiographic signs of mild to moderate OA (Tönnis grade 1 or 2) who underwent hip arthroscopy between November 2011 and December 2012. The International Hip Outcome Tool (iHOT-12) was the primary outcome at a minimum of 10-year follow-up. Radiographic progression of OA using Tönnis classification and conversion to THA were recorded. Statistical analysis of patient-reported outcome measures (PROMs) was performed with Wilcoxon signed-rank test. Relative risk assessment (RR) for conversion to THA for Tönnis grade 1 and 2 was reported.</p><p><strong>Results: </strong>At 10-year follow-up, 26 patients (29 hips) had undergone THA, resulting in a hip survivorship of 59% while 41% of hips progressed to THA by 10 years. The mean time to THA was 7.1 years (±1.5). Patients with Tönnis grade 2 at baseline had a significantly higher risk of THA compared with Tönnis grade 1 (RR = 3.44, 95% CI: 1.81-6.55, p < 0.001). Among non-THA patients, 79% reported satisfaction with surgery. The iHOT-12 score improved from 41.4 (±17.1) preoperatively to 71.0 (±26.7) at follow-up (p < 0.001), with 67% of patients exceeding the minimal important change (MIC) threshold. Radiographic progression of Tönnis grade was observed in four hips.</p><p><strong>Conclusion: </strong>Hip arthroscopy in patients with FAIS and mild to moderate OA provides substantial long-term functional benefits for those patients not having to undergo THA. However, preoperative OA severity is a key predictor of THA conversion with nearly two-fifths of hips requiring THA within 10 years.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153302","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":"Cemented mobile-bearing medial unicompartmental knee arthroplasty provides long-term implant survival and sustained functional performance in young and active patients aged 60 or below.","authors":"Kevin-Arno Koch, Michael Thapa, Johannes Weishorn, Mustafa Hariri, Benedict Lotz, Kevin Knappe, Tobias Reiner, Tilman Walker","doi":"10.1002/ksa.12703","DOIUrl":"https://doi.org/10.1002/ksa.12703","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long-term outcomes of cemented, mobile-bearing medial unicompartmental knee arthroplasty (UKA) in patients aged 60 or younger, focusing on implant survival, functional results, patient-reported outcome measures (PROMs), and radiographic findings over >10 years.</p><p><strong>Methods: </strong>This retrospective single-centre study included 119 knees (102 patients). Implant survival was evaluated using Kaplan-Meier analysis. PROMs included the Oxford Knee Score (OKS), American Knee Society Score (AKSS), UCLA Activity Score and Visual Analogue Scale (VAS). Assessments were performed preoperatively, at mid-term (2-10 years), and at long-term follow-up (>10 years). OKS and AKSS were analysed in relation to Patient Acceptable Symptom State (PASS) thresholds. Radiographs were graded using the Kellgren-Lawrence classification to evaluate lateral osteoarthritis (LOA) progression.</p><p><strong>Results: </strong>The implant survival rate was 86.7% (95% CI: 78.5-91.9%) at 15 years, and 81.7% (95% CI: 71.4%-88.5%) at 17.5 years. Revision surgery was required in 18 knees (mean time to revision: 8.7 years), primarily due to progression of LOA. All PROMs improved significantly from baseline to the final follow-up (mean: 16 years; p < 0.0001). Although minor functional declines occurred between mid- and long-term follow-ups, these were not statistically significant (p > 0.05), except for functional AKSS. At the final assessment, 96% of patients exceeded the PASS threshold for OKS, 84% for AKSS objective, and 80% for AKSS functional scores. Radiographic LOA progression was frequent but did not significantly impair functional outcomes.</p><p><strong>Conclusions: </strong>Cemented mobile-bearing medial UKA in patients aged ≤60 years demonstrated high long-term implant survival and sustained functional benefit. Even in the presence of radiographic LOA progression, clinical outcomes remained excellent. UKA represents a durable and effective treatment for younger patients with isolated medial compartment osteoarthritis.</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":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145376","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}