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

{"title":"Response to: The aberrant anterior tibial artery should be respected and can be protected in high tibial osteotomy (HTO) surgery.","authors":"Philipp Schuster, Philipp Mayer, Jonathan Cornacchini, Michael Schlumberger, Janina Leiprecht, Philipp Minzlaff, Joerg Richter, Grégoire Micicoi","doi":"10.1002/ksa.70005","DOIUrl":"https://doi.org/10.1002/ksa.70005","url":null,"abstract":"","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986503","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 majority of elite and professional athletes return to the preinjury level of activity after ACL reconstruction: A systematic review and meta-analysis.","authors":"Riccardo D'Ambrosi, Andrea Marchetti, Luca Farinelli, Amit Meena, Piero Franco, Luca Maria Sconfienza, Riccardo Cristiani, Elmar Herbst, Christoph Kittl, Mirco Herbort, Elisabeth Abermann, Christian Fink","doi":"10.1002/ksa.70020","DOIUrl":"https://doi.org/10.1002/ksa.70020","url":null,"abstract":"<p><strong>Purpose: </strong>To compare return to play (RTP), time to RTP, level of RTP, and anterior cruciate ligament (ACL) graft failure among elite and professional athletes from different sports after anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Methods: </strong>The PubMed, Embase and Cochrane Library databases were searched to identify potentially relevant research articles that analysed RTP, time to RTP, level of RTP, and graft failure rate in elite and professional athletes after ACLR. An elite or professional athlete was defined as one who participates in national- or international-level competitions in professional or amateur sports-including academy players aged 15 years or over.</p><p><strong>Results: </strong>A total of 49 studies met the inclusion criteria. Eleven different sports and 4463 knees were included in the final analysis. The pooled data revealed an RTP rate of 85.8% (95% confidence interval [CI] 82.8-88.5]. A lower RTP was observed in Australian football (67.8% [95% CI 54.1-80.1]; p < 0.001) and football (73.0% [95% CI 65.9-79.5]; p < 0.001) than in soccer (92.8% [95% CI 89.3-95.7]). Almost 90% of the athletes returned to their preinjury level. The meta-analysis revealed no difference (p > 0.05) in the level of RTP rate among the different studies, ranging from 79.0% (soccer) to 97.3% (basketball). The pooled mean time to RTP was 292 days (95% CI 268-316 days). The pooled ACL graft failure rate was estimated to be 7.0% for athletes.</p><p><strong>Conclusions: </strong>Following ACLR, more than 85% of elite and professional athletes returned to play and almost 90% returned to their preinjury level, with a graft failure rate of 7.0% and a mean return to play at 292 days. Athletes and their treating physicians can utilise these findings to set reasonable expectations for their return to competition after ACLR.</p><p><strong>Study registration: </strong>CRD42025632248.</p><p><strong>Level of evidence: </strong>Systematic review and meta-analysis of level IV.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986484","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 difference in sudden-onset injury risk between artificial turf and natural grass for Finnish female elite-level footballers: A five-season study.","authors":"Ville Immonen, Iida Mustakoski, Ilari Kuitunen, Tommi Vasankari, Mari Leppänen","doi":"10.1002/ksa.70018","DOIUrl":"https://doi.org/10.1002/ksa.70018","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence on injury incidence on artificial turf for female footballers is conflicting. Some studies have found no difference in injury rates, while others have suggested increased knee injury risk. The aim of this study was to compare match injury incidences between artificial turf and natural grass in the Finnish female premier division of football.</p><p><strong>Methods: </strong>All teams in the Finnish female premier division of football were invited to participate in a five-season prospective cohort study, and eight to ten teams took part depending on the season. Injuries were reported by players in weekly questionnaires and categorised by anatomical region, recurrence, contact, severity, and playing position. Individual match exposure was tabled, and incidences per 1000 h of match exposure and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated for both surface types.</p><p><strong>Results: </strong>A total of 517 league matches (401 on artificial turf and 116 on natural grass) were played during the five-season follow-up. In that time, 237 sudden-onset injuries (184 on artificial turf and 53 on natural grass) were reported. The overall injury incidence rate was 19.6/1000 match hours on artificial turf and 19.3/1000 match hours on natural grass (IRR 1.0, 95% CI 0.7-1.4). No statistical difference was observed for risk in knee injuries or other subcategories.</p><p><strong>Conclusions: </strong>This study found no evidence of a difference in match injury risk between artificial turf and natural grass for elite level female footballers. Research with modern non-filler surfaces will be needed as pitches containing microplastic pollution are banned in the European Union.</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":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986488","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":"Successful return to sport following distal femoral osteotomy and lateral unicompartmental knee arthroplasty for isolated lateral knee osteoarthritis: A systematic review and meta-analysis.","authors":"Gaby V Ten Noever de Brauw, Lindsey V Ruderman, Roderick J M Vossen, Inger N Sierevelt, Jelle P van der List, Gino M M J Kerkhoffs, Hendrik A Zuiderbaan","doi":"10.1002/ksa.70009","DOIUrl":"https://doi.org/10.1002/ksa.70009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate: (i) return to sport (RTS) rates following distal femoral osteotomy (DFO) and lateral unicompartmental knee arthroplasty (UKA), including the likelihood of returning to pre-arthritic or higher levels of performance; (ii) participation in low-, intermediate- and high-impact sports pre- and postoperatively; and (iii) the ability of athletes to resume sporting activities at a professional or competitive level.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase and the Cochrane Library up to 17 June 2025. Studies were eligible if they focused on symptomatic lateral unicompartmental knee osteoarthritis as the primary indication and provided data on RTS outcomes. Outcomes of interest included RTS and return to performance (RTP) rates, sport participation categorized by impact level, return to play rates and sports-related patient-reported outcome measures. Random-effects models were utilized to evaluate RTS and RTP outcomes.</p><p><strong>Results: </strong>Nine non-comparative studies (256 patients) were included. Five on DFO (127 patients; mean age 40.1 ± 13.3 years; mean follow-up 90.4 ± 72.3 months) and four on lateral UKA (125 patients; mean age 58.0 ± 8.8 years; mean follow-up 39.1 ± 16.2 months). Most studies provided Level IV Evidence and moderate quality (Methodological Index for Non-Randomized Studies score: 8-10). Random effect models provided RTS rates of 89.7% (95% confidence interval [CI]: 76.9-95.8) for DFO and 92.4% (95% CI: 81.5-97.1) for lateral UKA. RTP rates were 62.7% (95% CI: 41.1-80.2) and 88.5% (95% CI: 75.1-95.1), respectively. High-impact sport participation decreased after lateral UKA (11.5% to 3.4%), while remaining relatively stable following DFO (32.8% to 28.0%). Competitive-level athletes achieved a 100% RTS rate following DFO.</p><p><strong>Conclusions: </strong>Both DFO and lateral UKA are associated with high rates of RTS. However, lateral UKA often leads to a transition from high-impact to lower-impact activities. Clinicians can leverage these findings to optimize patient counselling and align postoperative RTS expectations with functional outcomes.</p><p><strong>Level of evidence: </strong>Level IV, systematic review.</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":"144986428","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":"Anatomical reconstruction of coracoclavicular and acromioclavicular ligaments using an autologous tendon graft provides excellent outcomes in acute acromioclavicular joint dislocation.","authors":"Efstathios Konstantinou, Alexandros Koskiniotis, Nikolaos Stefanou, Antonios Koutalos, Efstratios Athanaselis, Michael Hantes, Socratis Varitimidis","doi":"10.1002/ksa.70051","DOIUrl":"https://doi.org/10.1002/ksa.70051","url":null,"abstract":"<p><strong>Purpose: </strong>Common surgical techniques for managing acute acromioclavicular (AC) injuries include reconstruction of the coracoclavicular (CC) ligaments using tendon grafts or high-strength artificial looping materials, as well as fixation with a hook plate. This study presents a thorough analysis of the outcomes of anatomical reconstruction of both the CC and AC ligaments using a single-strand semitendinosus tendon graft.</p><p><strong>Methods: </strong>All patients with acute AC joint dislocation who underwent anatomical reconstruction of the CC and AC ligaments between 2017 and 2022 were included in this retrospective analysis. Postoperative evaluation of clinical and functional outcomes was conducted using the Simple Shoulder Test, QuickDASH and Constant-Murley scores. Radiographic assessments were used to determine any loss of reduction.</p><p><strong>Results: </strong>The study included twelve male patients with a mean age of 37.8 years (range: 23-64). According to the Rockwood classification, three patients had Type III, three had Type IV, and six had Type V dislocations. All patients underwent anatomical reconstruction of the CC and AC ligaments. The most recent follow-up, with a mean duration of 31.8 months (range: 12-64 months), demonstrated excellent postoperative functional outcomes, with scores of 87 (SD = 4.1) for the Simple Shoulder Test, 2.9 (SD = 4.5) for QuickDASH and 89.7 (SD = 3.1) for the Constant-Murley score. Radiographic assessment showed a reduction in CC distance from a preoperative mean of 16.6-8.9 mm at final follow-up. Partial loss of reduction was noted in two patients; however, neither exhibited functional impairment or activity limitations that required surgical revision. Minor complications included wound dehiscence (one patient) and persistent numbness at the incision site (two patients).</p><p><strong>Conclusions: </strong>Reconstruction of the CC and AC ligaments using an autologous semitendinosus tendon graft for acute AC joint dislocation results in excellent clinical outcomes and satisfactory radiographic findings.</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":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986259","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":"Rehabilitation alone after ACL injury yields greater limb symmetry but lower knee related self-efficacy without limiting return to preinjury activity level.","authors":"Rebecca Hamrin Senorski, Ramana Piussi, Johan Högberg, Roland Thomeé, Kristian Samuelsson, Eric Hamrin Senorski","doi":"10.1002/ksa.70042","DOIUrl":"https://doi.org/10.1002/ksa.70042","url":null,"abstract":"<p><strong>Purpose: </strong>To compare patients treated with rehabilitation alone to those undergoing anterior cruciate ligament (ACL) reconstruction and rehabilitation with regard to recovery of muscle strength, return to knee-strenuous sport and patient-reported outcomes during the first 12 months of treatment.</p><p><strong>Methods: </strong>This study is a prospective cohort study, based on data from a rehabilitation registry, Project ACL, Gothenburg, Sweden. Included patients were ≥15 years with a primary ACL injury and had completed four follow-ups under first year of treatment. Patients were divided into two groups, depending on treatment choice (1) rehabilitation alone (rehabilitation group), or (2) rehabilitation with ACL reconstruction (ACLR group). Absolute and symmetrical isokinetic muscle strength and patient reported outcomes were assessed using a predefined schedule. Analyses were adjusted for age at time of injury. Subanalyses were performed separately on muscle strength for female and male patients. Clinical relevance was assessed with Cohen's d.</p><p><strong>Results: </strong>In total, 31 patients in the rehabilitation group and 359 patients in the ACLR group were included. The rehabilitation group reported significantly greater symmetrical strength at every follow-up, except 12-month follow-up for knee flexion, and better quality of life at 8 months. Female patients in the rehabilitation group were stronger in their injured limbs knee extension at 10-week, 4-month and 8-month follow-up as well as for the knee flexion at 10 weeks although no clinically relevant results. The ACLR group demonstrated significantly larger changes in limb symmetry from the 2- to 12-month follow-up, greater future knee self-efficacy at 10 weeks, 4- and 8-month follow-up, and higher level of physical activity compared with the rehabilitation group, both preinjury, and at the 8- and 12-month follow-ups.</p><p><strong>Conclusion: </strong>Patients treated with rehabilitation alone recovered greater limb symmetry, while patients treated with ACLR had greater change in limb symmetry between 2 and 12 months after treatment. Patients in the ACLR group had higher future knee-related self-efficacy and were active at a higher level of physical activity at 8 and 12 months after treatment.</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":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986510","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":"Comparable clinical outcomes in functionally aligned computer-assisted and image-based robotic assisted total knee arthroplasty.","authors":"Stefano Seracchioli, Francesco Zambianchi, Sebastiano Clemenza, Mattia Clò, Riccardo Cuoghi Costantini, Fabio Catani","doi":"10.1002/ksa.70023","DOIUrl":"https://doi.org/10.1002/ksa.70023","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the clinical outcomes differences and complications in two comparable groups of patients undergoing computer aided surgery (CAS) and robotic-assisted (RA) posterior stabilised (PS) total knee arthroplasty (TKA) following functional alignment (FA) principles with tibial pre-cut at a minimum of 4-year follow-up.</p><p><strong>Methods: </strong>This retrospective, monocentric and observational study included 94 consecutive patients undergoing PS TKA performed with CAS and RA-TKA following FA principles, between January 2017 and January 2020. Patients were followed with radiological and clinical assessment and evaluated with the Forgotten Joint Score-12 (FJS-12), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) and the 5-Level Likert Scale (5-LLS).</p><p><strong>Results: </strong>Out of 94 patients two were lost to follow-up and one deceased in the robotic branch, eight patients were lost to follow-up and two were deceased in the navigated branch. Hereby, a total of 84 patients (87 knees) with a mean age of 69.2 ± 8.4 years were considered. A total of 40 cases were included in the CAS group; 44 cases were included in the RA-TKA group. No revisions were performed in any of the two groups, resulting in an overall Kaplan-Meyer survivorship rate of 100% for both cohorts. At last follow-up, no statistically significant differences were recorded between CAS and RA-TKA relative to FJS-12, KOOS-JR and 5-LLS (FJS-12: 89.4 ± 9.5 vs 88.3 ± 13.4; KOOS-JR: 88.0 ± 10.2 vs 86.2 ± 11.5; 5-LLS 4.4 ± 1.7 vs 4.6 ± 2.1) respectively.</p><p><strong>Conclusions: </strong>No significant outcomes differences and complications were detected between patients undergoing PS-TKA performed with either CAS and RA at a minimum 4-year follow-up. TKA performed with a patient-specific FA technique and with a soft tissue-preserving approach, showed excellent results with both CAS and RA-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":"144986315","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":"Effects of landing instructions on Achilles tendon load: Emphasising hip flexion as the optimal strategy.","authors":"Yuta Koshino, Mina Samukawa, Tomoya Ishida, Harukazu Tohyama","doi":"10.1002/ksa.70006","DOIUrl":"https://doi.org/10.1002/ksa.70006","url":null,"abstract":"<p><strong>Purpose: </strong>Managing Achilles tendon (AT) load during dynamic activities is essential for preventing and rehabilitating Achilles tendinopathy. While various exercises have been studied, the impact of verbal instructions on landing mechanics remains unclear. This study aimed to identify instructional methods that effectively reduce AT load during drop vertical jumps (DVJs).</p><p><strong>Methods: </strong>Twenty-three healthy participants performed DVJs under five instructional conditions: (1) natural: no instruction; (2) posterior-centre of pressure (COP): shifting the COP posteriorly; (3) hip-flexion: increasing hip flexion; (4) knee-flexion: increasing knee flexion; and (5) quiet-landing: minimising landing sound. A three-dimensional motion analysis system recorded peak AT force, loading rate, joint angles, ground reaction force (GRF) and COP position. Data were analysed using the Friedman test, the Wilcoxon signed-rank test with Holm's correction and effect size (ES).</p><p><strong>Results: </strong>Peak AT force was significantly lower in hip-flexion and posterior-COP compared to natural (p < 0.001, ES = -0.87 and -0.82, respectively). Hip-flexion also showed lower AT force than the knee-flexion and quiet-landing (p < 0.01). Loading rates were lower in hip-flexion (ES = -0.73) and quiet-landing (ES = -0.64) than in natural (p < 0.01) but were higher in posterior-COP than hip-flexion (p = 0.042). Hip-flexion, knee-flexion and quiet-landing increased hip flexion (p < 0.001), while knee-flexion and quiet-landing increased knee flexion (p < 0.001) compared to natural. Posterior-COP resulted in decreased hip, knee and ankle flexion, increased vertical GRF and a more posterior COP position compared to the other conditions (p < 0.05). Vertical GRF was lower in hip-flexion, knee-flexion and quiet-landing than in natural (p < 0.005).</p><p><strong>Conclusions: </strong>Increasing hip flexion is the most effective strategy for reducing AT force during landing, and may aid in the prevention and rehabilitation of Achilles tendinopathy. Although a posterior COP shift lowers AT force, it increases AT loading rate and GRF, potentially elevating injury risk.</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":"144986232","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":"Boosting the clinical use of ground reaction forces in anterior cruciate ligament injury prevention: The 'CUTtheACL' study.","authors":"Stefano Di Paolo, Matthew Buckthorpe, Luca Pirli Capitani, Luca Ciampone, Alfredo Bravo-Sànchez, Margherita Mendicino, Filippo Tosarelli, Alberto Grassi, Stefano Zaffagnini, Francesco Della Villa","doi":"10.1002/ksa.70017","DOIUrl":"https://doi.org/10.1002/ksa.70017","url":null,"abstract":"<p><strong>Purpose: </strong>Ground reaction forces (GRF) data have been introduced to enhance the understanding of anterior cruciate ligament (ACL) injury pathomechanics. However, translating GRF information into daily clinical practice remains challenging for high-demanding movements such as cutting manoeuvres. This study aims to describe GRF of the 90° change of direction (COD) task, providing robust benchmark data and force-time curve description to enhance their use in clinical practice, particularly ACL injury prevention.</p><p><strong>Methods: </strong>One thousand and two healthy football (soccer) players (16.3 ± 2.8 years, 264 females) performed three preplanned 90° COD tasks per limb at maximum intensity, with the cutting foot contact performed on an artificial turf floor embedded force platform (AMTI), which collected GRF data (frequency: 1000 Hz). Peak GRF (impact and propulsion phases, and their ratio), ground contact time, rate of force acceptance (RFA), impulse were presented as absolute values and normalised to body weight (BW). Differences in kinetics metrics according to sex, level of play, limb dominance were determined via Student's t-test (p < 0.05). Multiple linear regression analyses determined the association between players' characteristics and kinetics.</p><p><strong>Results: </strong>Six thousand and eight valid attempts were included. Vertical GRF was 1516 ± 526 N (2.48 ± 0.79 N/BW) and occurred 32.6 ms after initial contact (10.4% of the cut stance). Vertical RFA was 95,200 ± 48,138 N/s (155.6 ± 75.5 N/s/BW). Male players had higher absolute and normalised GRFs and vertical RFA than females (p < 0.001). Elite players had smaller impulse: propulsion ratio than subelite players (p < 0.001). The regression showed limited variance of GRF metrics (adjusted-R² = 0.047-0.014, p < 0.001).</p><p><strong>Conclusion: </strong>Normative data and explanation of clinically relevant GRF features were provided. GRF features could enrich the understanding of players' COD movement quality and performances. Sports medical and performance practitioners may include the analysis of GRF during COD as part of athlete screening for participation, injury risk and return to play, potentially offering insights for ACL (re)injury risk mitigation.</p><p><strong>Level of evidence: </strong>Level IV, cohort study.</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":"144986240","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":"Various surgical techniques result in different outcomes for full extensor mechanism ruptures following total knee replacement: A systematic review by the European Knee Associates (ESSKA-EKA).","authors":"Bruno Violante, Riccardo Compagnoni, Artur Kroell, Michael Engl, Octav Russu, George Mihai Avram, Sarper Gursu, Elvire Servien, Francesco Puglia, Pietro Simone Randelli, Reha Tandogan, Michael T Hirschmann","doi":"10.1002/ksa.70015","DOIUrl":"https://doi.org/10.1002/ksa.70015","url":null,"abstract":"<p><strong>Purpose: </strong>Extensor mechanism (EM) ruptures after total knee arthroplasty (TKA) are rare but lead to substantial functional impairment and morbidity. Treatment remains challenging due to the diversity of surgical techniques and the limited number of comparative studies. The European Knee Associates (EKA) group conducted a systematic review to evaluate available treatments for EM rupture following primary TKA, assess outcomes such as extensor lag, patient-reported outcome measures (PROMs) and walking status, and to identify prevailing trends and complication rates.</p><p><strong>Methods: </strong>A systematic review was registered in PROSPERO (CRD42022341591) and conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis and Cochrane guidelines. PubMed/Medline and Scopus databases were searched for clinical studies published between 2014 and 2024 reporting outcomes after EM repair in TKA patients. Inclusion criteria encompassed retrospective and prospective studies in English or German. Studies on EM ruptures due to infection, revision TKA, or patellectomy were excluded. Data extraction included demographics, time-to-reconstruction, repair type, extensor lag, PROMs and walking status. Due to heterogeneity, a meta-analysis was not feasible, and results were descriptively reported.</p><p><strong>Results: </strong>A total of 32 studies comprising 893 EM rupture cases were included. The mean patient age was 66.8 years (standard deviation [SD] ± 7.4), with a mean body mass index of 34.5 (SD ± 6.2). Patellar tendon ruptures (39%) were the most frequent. Nine different surgical techniques were identified, including allografts, synthetic meshes, autografts and direct repairs. The overall complication rate was 16%, with autografts having the highest complication rate (38%). All repair techniques led to improvements in extensor lag and post-operative Knee Society Scores exceeding the minimal clinically important difference thresholds. However, walking status and PROMs were inconsistently reported.</p><p><strong>Conclusions: </strong>EM failure after TKA remains a complex complication with variable outcomes depending on treatment strategy. Standardization of surgical techniques and outcome measures, along with multicenter collaborations, is crucial to improve future patient care as the number of TKA procedures continues to rise.</p><p><strong>Level of evidence: </strong>Level III, systematic review of Level III studies.</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":"144986491","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}