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

{"title":"Robotic total knee arthroplasty: Have technological advances translated into clinical value?","authors":"Mehmet Süleyman Abul, Hüsnü Yılmaz, İbrahim Tuncay","doi":"10.1002/ksa.70627","DOIUrl":"https://doi.org/10.1002/ksa.70627","url":null,"abstract":"","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993643","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":"ACL injury mechanism in elite and recreational handball players.","authors":"Thomas Wagenblast Mayntzhusen, Kristoffer Weisskirchner Barfod, Frederik Flensted Andersen, Per Hölmich, Niels Christian Kaldau","doi":"10.1002/ksa.70595","DOIUrl":"https://doi.org/10.1002/ksa.70595","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior cruciate ligament (ACL) injuries are among the most severe knee injuries in handball, often resulting in surgical reconstruction and prolonged rehabilitation. Research on specific ACL injury mechanisms remains limited, though essential for prevention. The aim of this study was to investigate ACL injury mechanism in handball players.</p><p><strong>Methods: </strong>A registry-based study identified patients in the Danish National Patient Register with International Classification of Diseases (ICD) codes S835 (cruciate ligament lesion) and M235 (chronic knee instability) between 2000 and 2018. Players completed a questionnaire on ACL injury mechanism, and only handball-related cases were included.</p><p><strong>Results: </strong>Of 90,608 registry-identified patients invited to participate, 40,691 responded (45%); 26,627 reported an ACL injury, of whom 4540 reported sustaining the injury while playing handball. Most injuries were non-contact (55%), frequently occurring during pivoting actions (25%) and single-leg landings (11%). Female players reported significantly more non-contact injuries (p = 0.011). Indirect contact not involving the injured knee accounted for 31% of injuries. Players were in ball possession in 80% of cases, mainly while feinting (32%) or shooting (30%). Most ACL injuries (86.1%) occurred on the opponent's half of the court during offensive play, particularly between the opponent's goal-area and free-throw lines (38.1%). Back-line players accounted for 61% of ACL injuries. Male players reported more injuries during counterattacks (p < 0.001). Players aged 40 years or older had more injuries as goalkeepers compared with other positions (p < 0.001).</p><p><strong>Conclusion: </strong>Non-contact movements were the most common ACL injury mechanism in handball, followed by indirect contact not involving the injured knee. Injuries predominantly occurred during ball possession, particularly while feinting or shooting. Most injuries occurred during offence and among back-line players.</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":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984502","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":"Formal consensus on fast-track hip and knee arthroplasty: ESSKA/EKA, EHS and APAS recommendations for optimised recovery pathways in joint replacement surgeries.","authors":"Trifon Totlis, Nanne Kort, Remigio Kort, Nicolaas Cyrillus Budhiparama, Christian Carulli, Michael Clarius, Gloria Coden, Zakareya Gamie, Bruce Gomberg, Andrew Grant, Daniel Guenther, Fares Sami Haddad, Babar Kayani, Eustathios Kenanidis, Aleksandra Królikowska, David Liu, Imelda Lumban-Gaol, Luis Machado, Sumon Nandi, Daniel Pérez-Prieto, Robert Prill, Eric Smith, Reha Tandogan, Eleftherios Tsiridis, Rienk Van Beek","doi":"10.1002/ksa.70594","DOIUrl":"https://doi.org/10.1002/ksa.70594","url":null,"abstract":"<p><strong>Purpose: </strong>This international formal consensus aims to establish a unified, evidence-based approach to perioperative care by promoting the adoption of fast-track surgery or enhanced recovery after surgery (ERAS) protocols, informing healthcare professionals and administrators about optimal perioperative management of arthroplasty and facilitating broader implementation.</p><p><strong>Methods: </strong>A multidisciplinary panel of 106 experts contributed across a Steering Group (n = 22), a Rating Group (n = 35) and a Peer Review group (n = 49). The Steering Group developed 37 questions and corresponding statements based on the literature review and expert opinion. Statements were graded from A (high-level evidence) to D (expert opinion). An independent Rating Group evaluated each statement on a 1-9 Likert scale across two rounds using the Formal Consensus methodology. Statements were iteratively revised and finalised through consensus and joint discussion. The final document was assessed by an international Peer Review Group to ensure transnational applicability.</p><p><strong>Results: </strong>Out of 37 questions, a total of 63 statements were developed. Following a set of general statements outlining the principles and overall goals of fast-track total knee arthroplasty (TKA) and total hip arthroplasty (THA), the recommendations addressed and optimised the three key phases of perioperative care: preoperative, intraoperative and postoperative management. Of the 63 statements, 39 were graded A or B and 24 as C or D. Mean agreement scores ranged from 7.7 to 8.9. Overall, 56 statements were considered appropriate with strong agreement and 7 with relative agreement. The Peer Review Group supported the overall statements, providing feedback to clarify specific recommendations and to highlight regional differences in implementation, which were incorporated into the final document.</p><p><strong>Conclusions: </strong>This consensus endorses the adoption of structured fast-track or enhanced recovery programs as a patient-centred approach to perioperative care in total hip and knee arthroplasty. The aim is to improve the quality of care by reducing morbidity, optimising pain management, shortening hospital stay and enhancing patient satisfaction. While not intended to replace clinical judgement, it provides a pragmatic framework to guide decision-making, promote consistency and facilitate safe early mobilisation and discharge.</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":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984504","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":"Reframing knee injury and osteoarthritis outcome score-quality of life-defined 'subjective failure' after primary and revision posterior cruciate ligament reconstruction.","authors":"Xia Qu, Xinxiang Tang, Dujiang Yang, Bo Chen","doi":"10.1002/ksa.70610","DOIUrl":"https://doi.org/10.1002/ksa.70610","url":null,"abstract":"","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984532","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":"Increased medial posterior tibial slope is associated with greater postoperative anterior tibial translation over time after anterior cruciate ligament reconstruction.","authors":"Souvik Paul, Maher Ghandour, Christophe Jacquet, Kristian Kley, Fabio Sammartino, Matthieu Ollivier","doi":"10.1002/ksa.70597","DOIUrl":"https://doi.org/10.1002/ksa.70597","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the longitudinal relationship between medial posterior tibial slope (PTS) and postoperative anterior tibial translation (ATT) following anterior cruciate ligament reconstruction (ACLR), and to determine whether age, cartilage lesions and the use of lateral extra-articular tenodesis (LET) modify this relationship.</p><p><strong>Methods: </strong>We retrospectively analysed 319 patients who underwent primary ACLR with a semitendinosus autograft. Medial PTS was measured on long lateral radiographs (circle method) at 2 months and at final follow-up. ATT was assessed by Telos™ stress radiography in both knees preoperatively and at 2 months, 1 year and 2 years. Three measures were defined: the absolute ATT of the operated knee; the ATT side-to-side difference (ATT SSD; operated minus contralateral knee); and the change in this difference from the preoperative baseline (ΔATT SSD). Associations were tested with Pearson's/Kendall's correlation, group comparisons and multivariable regression; subgroups were defined by age, cartilage status and LET.</p><p><strong>Results: </strong>The absolute operated-knee ATT was 5.8 ± 3.5 mm preoperatively and 2.9 ± 2.3, 4.9 ± 2.8 and 6.8 ± 4.0 mm at 2 months, 1 year and 2 years, respectively. Medial PTS correlated positively but weakly with the ATT SSD at 1 year (r = 0.2, p = 0.001) and 2 years (r = 0.3, p < 0.001); at 2 months, the correlation was negative and non-significant (r = -0.5, p = 0.3). Medial PTS at 2 months and at final follow-up were independent predictors of the ATT SSD on multivariable regression (p < 0.01). Older age (r = 0.15, p = 0.009) and medial cartilage lesions (p = 0.008) were associated with greater postoperative laxity, whereas LET was associated with a lower 2-year ATT SSD (6.1 vs. 7.3 mm; p = 0.009). Meniscal and lateral cartilage lesions showed no significant association.</p><p><strong>Conclusion: </strong>Steeper medial PTS is associated with a progressive, though weak, increase in the ATT SSD following ACLR. LET attenuates this effect, whereas older age and medial cartilage lesions are associated with greater early laxity.</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":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984529","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":"Current concepts in isolated and combined injuries of the medial collateral ligament complex-Part I: Anatomy, biomechanics, clinical and radiological examination of the medial collateral ligament of the knee.","authors":"Armin Runer, Andrew Amis, Robert Smigielski, Elmar Herbst, Christoph Kittl, Guido Wierer, Nicolas Bouguennec, Riccardo Cristiani, Christian Hoser, Elisabeth Abermann, Lukas Willinger, Riccardo D'Ambrosi, Eric Hamrin Senorski, Alan Getgood, Volker Musahl, Simon Ball, Andy Williams, Gilbert Moatshe, Sebastian Siebenlist, Marc Strauss, Martin Lind, Mirco Herbort, Kristian Samuelsson, Christian Fink, James Robinson","doi":"10.1002/ksa.70588","DOIUrl":"https://doi.org/10.1002/ksa.70588","url":null,"abstract":"<p><p>Injuries involving the medial collateral ligament (MCL), or combined injuries to both the anterior cruciate ligament (ACL) and MCL, are common and present considerable diagnostic and therapeutic challenges. Better understanding of MCL anatomy and biomechanics, especially in combined ACL-MCL injuries, has driven the need for updated clinical examination and treatment approaches. The MCL complex comprises the superficial MCL (sMCL), deep MCL (dMCL), and the posteromedial complex (PMC), which includes the posterior oblique ligament (POL). Additional contributors to medial knee stability include the AMR and dynamic structures such as the semimembranosus, semitendinosus, and gracilis tendons. Biomechanically, the sMCL serves as the primary restraint against valgus loading and resists anterior tibial translation, particularly at higher degrees of knee flexion with external tibial rotation. The dMCL functions as a key stabiliser against external tibial rotation at low flexion angles and plays a significant role in anteromedial rotatory instability (AMRI), while the PMC/POL primarily limits internal tibial rotation. Accurate diagnosis requires an integrated approach, including thorough patient history, detailed physical examination, magnetic resonance imaging (MRI), and selective use of stress tests. Clinical assessment remains essential, as overreliance on imaging alone may misrepresent injury severity. Evaluation of medial-sided structures should be performed bilaterally and for each structure separately, based on their distinct biomechanical roles. The POL should be evaluated in full patient-specific knee extension. Assessment for AMRI should involve testing both valgus laxity at 20° of knee flexion, anteromedial drawer at 20° and anterior tibial translation at 90° with the tibia in neutral and then externally rotated. Findings of increased anterior tibial translation accompanied by excessive external tibial rotation relative to the contralateral side strongly indicate AMRI. This current concept article reviews the current literature and provides evidence-based recommendations to develop guidance and optimize treatment strategies for isolated MCL injuries and combined MCL-ACL injuries 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":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984507","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":"Youth athlete development and the burden of musculoskeletal injuries: Implications of early sport specialisation.","authors":"Alexandre Maricot, Camille Tooth, Christian Nührenbörger, Romain Seil","doi":"10.1002/ksa.70601","DOIUrl":"https://doi.org/10.1002/ksa.70601","url":null,"abstract":"<p><p>Youth sport participation has increased substantially over the past two decades, bringing well-documented physical, social and psychological benefits. However, this growth has been accompanied by a rising burden of musculoskeletal injuries among young athletes, with prevalence rates ranging from 34% to 65%. Overuse injuries account for up to 50% of all youth sport injuries, while severe injuries such as anterior cruciate ligament reconstructions have increased markedly over the past two decades. Early sport specialisation (ESS), defined as year-round, intensive, single-sport training that excludes other sports, has gained traction as a perceived pathway to elite performance. However, current evidence does not support ESS as a reliable predictor of long-term athletic success. The majority of successful senior athletes were not standouts as youths, and early performance is a poor forecaster of adult excellence. Evidence examining associations between ESS and injury risk remains limited and methodologically inconsistent. Definitions of ESS vary substantially, measurement tools incompletely capture the construct, and relatively few high-quality empirical studies are available. More importantly, ESS may be better viewed as a proxy for a broader constellation of interacting exposures, including cumulative training load, recovery practices, biological maturation, variety of movement experiences and psychosocial stressors, which are more plausible determinants of injury risk and athlete development. Rather than asking whether ESS is inherently harmful, a more informative question is which combinations of training, developmental and environmental factors best support both performance progression and long-term athlete health. Until these mechanisms are more clearly understood, a cautious, individualised and evidence-informed approach to youth athlete development is warranted.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984539","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":"Multidisciplinary perspectives on biologic augmentation in meniscal repair: Integrating surgical, radiological and rehabilitative insights.","authors":"Sabri Kerem Diril, Soner Koçak, Elif Ozyigit, Ayhan Akcali, Safak Ekinci","doi":"10.1002/ksa.70609","DOIUrl":"https://doi.org/10.1002/ksa.70609","url":null,"abstract":"","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984551","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 mechanism of injury's role in jump landing mechanics after anterior cruciate ligament reconstruction.","authors":"Haleigh M Hopper, Amelia S Bruce-Leicht, Joe M Hart, Xavier D Thompson","doi":"10.1002/ksa.70605","DOIUrl":"https://doi.org/10.1002/ksa.70605","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim of this study is to determine if there is a difference in post-rehabilitation Landing Error Scoring System (LESS) score between patients who injured their anterior cruciate ligament (ACL) through a contact or noncontact mechanism of injury (MOI). The secondary aim is to determine if there is a difference in demographics, strength, and patient-reported outcomes (PROs) between patients who injured their ACL through a contact or noncontact MOI.</p><p><strong>Methods: </strong>Patients were included from a larger observational laboratory study if they had undergone a primary, isolated, uncomplicated ACLR. Patients were excluded if they had a history of other lower extremity surgery, concomitant ligament injury, surgical complications, or any neurologic disorder.</p><p><strong>Results: </strong>One hundred and twenty-nine patients were included in this study (age: 21.4 ± 7.9, sex: 64 F/65 M, follow up: 8.1 ± 1.7 months). Ninety-one patients (70.5%) sustained a noncontact MOI, and 38 patients (29.5%) sustained a contact MOI. There was no difference in total LESS score (p = 0.930), frontal LESS score (p = 0.831) or sagittal LESS score (p = 0.980) between the contact and noncontact groups.</p><p><strong>Conclusion: </strong>There was no statistically significant difference in total LESS score, frontal LESS score, or sagittal LESS score between contact and noncontact MOI. A considerable proportion of participants demonstrated multiple landing errors, indicating that assessment and rehabilitation of landing mechanics may remain relevant during late-stage rehabilitation. There was no statistically significant difference between mechanism of initial ACL injury and strength or PROs. The decision to allow a patient to return to play is multifactorial and should occur after modifiable risk factors, including jump landing mechanics, have been properly mitigated during rehabilitation.</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":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984509","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 clinical purpose of the scientific anterior cruciate ligament network international classification of arthrogenic muscle inhibition.","authors":"Etienne Cavaignac, Alexandre Le Guen, Nicola A Maffiuletti, Bertrand Sonnery-Cottet","doi":"10.1002/ksa.70613","DOIUrl":"https://doi.org/10.1002/ksa.70613","url":null,"abstract":"","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984511","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}