Knee最新文献

{"title":"Anatomical variability in the quadriceps tendon: structural layering and patellar insertion patterns","authors":"Hyun Jin Park ,&nbsp;Seong-Kyu Choi ,&nbsp;Hongtae Kim ,&nbsp;Mi‑Sun Hur","doi":"10.1016/j.knee.2025.09.004","DOIUrl":"10.1016/j.knee.2025.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>The quadriceps tendon is a complex anatomical structure that is crucially involved in knee stability and extension by transmitting forces from the quadriceps muscles to the patella. This study investigated anatomical variability in the quadriceps tendon of elderly Korean cadavers, focusing on the structural layering and muscle contributions at its patellar insertion.</div></div><div><h3>Methods</h3><div>Sixty-three quadriceps tendon specimens from 35 Korean cadavers were dissected to assess the composition and arrangement of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and vastus intermedius (VI).</div></div><div><h3>Results</h3><div>The quadriceps tendon configurations were categorized into four distinct types based on the pattern of muscle layering: Type 1, a trilaminar structure with the RF as the superficial layer, the VM and VL combined as the middle layer, and the VI as the deepest layer (8/20, 40 %); Type 2, a multilayered arrangement with RF insertions merging with the VM and VL (8/20, 40 %); Type 3, comprising the RF, VL, and VI, with no contribution from the VM (3/20, 15 %); and Type 4, consisting solely of the RF and VI (1/20, 5 %). In terms of tendon ratios, the combined vastus muscles (VM + VL) were 1–3 times larger than the RF and VI in 50 of 63 specimens, while 12 specimens displayed ratios as high as 4–6 times.</div></div><div><h3>Conclusion</h3><div>These data suggest that adjusted approaches that account for individual anatomical differences may improve outcomes in surgical procedures involving the knee.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 345-352"},"PeriodicalIF":2.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imageless robotic surgery and a personalized approach: optimizing TKA after ACL reconstruction","authors":"Luca Andriollo ,&nbsp;Aurelio Picchi ,&nbsp;Gerardo Demattia ,&nbsp;Marina Marescalchi ,&nbsp;Rudy Sangaletti ,&nbsp;Francesco Benazzo ,&nbsp;Stefano Marco Paolo Rossi","doi":"10.1016/j.knee.2025.09.007","DOIUrl":"10.1016/j.knee.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament reconstruction (ACLR) increases the risk of knee osteoarthritis (OA) and the need for total knee arthroplasty (TKA), with an increased rate of complications. The aim of this prospective study is to evaluate the role of imageless robotic surgery and a personalized approach in TKA after prior ACLR.</div></div><div><h3>Methods</h3><div>This prospective study involved 70 patients who underwent primary TKA: 35 with prior ACLR and 35 with primary OA. All surgeries were performed using an imageless robotic system. Demographic, intraoperative, and postoperative data were analyzed, including knee function (ROM, KSS, WOMAC), complications, and radiographic outcomes.</div></div><div><h3>Results</h3><div>Despite significantly lower preoperative values in the ACLR group for maximum flexion (p = 0.021), KSS-knee (p = 0.041), KSS-function (p = 0.032), WOMAC-stiffness (p = 0.017), and WOMAC-function (p = 0.035), postoperative outcomes were comparable between the two groups, except for a residual reduction in knee flexion in the ACLR group (114.41° vs 128.61°, p &lt; 0.001). Intraoperative adjustments were more frequent in the ACLR group, with a significantly higher rate of tibial recuts (20 % vs 2.8 %, p = 0.017). No major complications or revisions were reported at the three-year follow-up.</div></div><div><h3>Conclusions</h3><div>The use of imageless robotic surgery combined with a personalized approach can achieve comparable postoperative outcomes between patients undergoing TKA after ACLR and those with primary OA, while also reducing common issues associated with TKA in patients with a history of ACLR. The overall results indicate that robotic-assisted TKA is a safe and effective option for these patients.</div></div><div><h3>Level of evidence</h3><div>Level II.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 353-360"},"PeriodicalIF":2.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservation of posterior cruciate ligament in cruciate-retaining total knee arthroplasty with a cruciate-substituting insert does not affect postoperative clinical outcomes, including Forgotten Joint Score 12","authors":"Seiju Hayashi ,&nbsp;Kei Kato","doi":"10.1016/j.knee.2025.09.001","DOIUrl":"10.1016/j.knee.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>The <em>in vivo</em> function of the preserved posterior cruciate ligament (PCL) in cruciate-retaining (CR) total knee arthroplasty (TKA) is still ill-defined. This study aimed to investigate whether the preserved PCL itself affects postoperative clinical outcomes, including the Forgotten Joint Score 12 (FJS-12), in CR-TKA using matched prostheses and matched inserts.</div></div><div><h3>Methods</h3><div>We prospectively included 93 knees from 62 patients undergoing primary TKA for knee osteoarthritis using the Triathlon total knee system with a cruciate-substituting (CS) insert (CS-insert). The PCL was preserved in the CR-group, while it was sacrificed in the CS-group. Postoperative clinical outcome at the final follow-up (at least one year postoperatively), including FJS-12, radiologic parameters, and intraoperative influencing factors such as each component angle, posterior tibial slope, posterior condylar offset, joint gap, joint balance, and joint laxity were compared between the two groups.</div></div><div><h3>Results</h3><div>There were no significant differences between CR- and CS-groups in terms of preoperative patient characteristics, as well as intraoperative influencing factors. In addition, there were no significant differences between the two groups regarding postoperative extension (<em>p</em> = 0.14) and flexion (<em>p</em> = 0.41), Knee Injury and Osteoarthritis Outcome Score (69.4 ± 8.4 versus 72.9 ± 9.5, <em>p</em> = 0.07), and median FJS-12 score (75.0 (64.6–84.3) versus 82.0 (72.4–89.6), <em>p</em> = 0.16).</div></div><div><h3>Conclusions</h3><div>In CR-TKA, the preserved PCL itself does not affect postoperative clinical outcomes, including FJS-12.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 370-377"},"PeriodicalIF":2.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term outcomes of residual valgus alignment after total knee arthroplasty for valgus knee deformity: a minimum 10-year follow up","authors":"Sung-Sahn Lee ,&nbsp;Tae Woo Kim ,&nbsp;Motaz Doubi ,&nbsp;Young-Wan Moon","doi":"10.1016/j.knee.2025.09.002","DOIUrl":"10.1016/j.knee.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the impact of postoperative hip-knee-ankle (HKA) angle on clinical outcomes and survivorship in total knee arthroplasty (TKA) patients with valgus knee.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed TKAs performed for valgus knee deformity between January 2005 and February 2015. Patients were categorized into two groups based on postoperative HKA angle: neutrally aligned (0° ± 3°) and residual valgus groups (&gt;3°). Preoperative and postoperative clinical outcomes, including the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index and Knee Society Scores (KSSs), as well as radiographic parameters such as HKA angle and lateral distal femoral angle (LDFA), were compared between the groups. Survivorship analysis was also conducted.</div></div><div><h3>Results</h3><div>A total of 73 knees (64 patients) were included, with a mean follow-up period of 140.1 ± 14.4 months. Of these, 55 and 18 knees were classified as neutrally aligned and residual valgus group, respectively. The preoperative HKA angle and LDFA were significantly different between the two groups. Postoperative LDFA (88.6° ± 1.8° vs. 86.7° ± 1.7°, <em>P</em> &lt; 0.001) differed significantly. However, long-term WOMAC Index and KSSs were comparable. The cumulative survival rates were 96.4 % in the neutrally aligned group and 100 % in the residual valgus group, with no significant difference (<em>P</em> = 0.322).</div></div><div><h3>Conclusion</h3><div>The residual valgus group exhibited more severe preoperative femoral valgus. Primary cause of postoperative residual valgus was residual femoral valgus. Residual valgus alignment was not related to inferior long-term clinical outcomes and survival rates compared to neutrally aligned TKA for preoperative valgus deformity.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 335-344"},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower limb biomechanical differences in runners with long-duration and short-duration patellofemoral pain","authors":"Huijuan Shi ,&nbsp;Yuanyuan Yu ,&nbsp;Shuang Ren ,&nbsp;Shengxing Fu ,&nbsp;Hanjun Li ,&nbsp;Hui Liu","doi":"10.1016/j.knee.2025.09.003","DOIUrl":"10.1016/j.knee.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the biomechanical alterations in the lower limbs of runners with varying durations of patellofemoral pain (PFP) and provide a basis for the rehabilitation treatment of PFP.</div></div><div><h3>Methods</h3><div>We recruited 14 recreational runners with PFP lasting more than 12 months (long-duration group), 12 runners with PFP lasting less than 3 months (short-duration group), and 16 runners without PFP (control group). Landmark coordinates and ground reaction forces during running were collected. One-way ANOVA was performed to compare the lower limb biomechanics among the groups.</div></div><div><h3>Results</h3><div>Compared to the control group, the long-duration group demonstrated significantly greater peak knee external rotation angle (<em>p</em> = 0.010), knee abduction moment (<em>p</em> &lt; 0.001), hip abduction moment (<em>p</em> = 0.007), and ankle external rotation moment (<em>p</em> = 0.004). The short-duration group showed significantly greater peak ankle eversion angle (<em>p</em> = 0.004) and ankle dorsiflexion–plantarflexion range of motion (<em>p</em> = 0.003) compared to the controls. No significant differences were found in peak vertical impact ground reaction forces (<em>p</em> = 0.906) or peak patellofemoral joint stress (<em>p</em> = 0.150) during the landing phase between runners with PFP and controls.</div></div><div><h3>Conclusions</h3><div>Runners with long-duration PFP exhibited greater external knee rotation angles, knee and hip abduction moments during running, while runners with shorter PFP duration showed greater ankle eversion. These findings support the need for duration-specific rehabilitation strategies tailored to the distinct biomechanical characteristics associated with PFP symptom duration.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 361-369"},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of practice patellofemoral instability collaborative (EPPIC)","authors":"","doi":"10.1016/j.knee.2025.06.015","DOIUrl":"10.1016/j.knee.2025.06.015","url":null,"abstract":"<div><h3>Background</h3><div>The management of patellofemoral instability in the United Kingdom remains poorly standardised. Through the British Association for Surgery of the Knee trainee collaborative, we aimed to identify which procedures (and in which combination) were being used to surgically manage this common condition across the UK.</div></div><div><h3>Method</h3><div>A retrospective national audit was conducted via a trainee collaborative analysing local trust data between 1st January 2014 and 31st December 2019. Data from institutions registered for the EPPIC audit was compiled and analysed for degree of compliance against more recently published national guidelines.</div></div><div><h3>Results</h3><div>Fifty (<em>n</em> = 50) sites submitted data, totalling 3189 skeletally mature patients. The median age was 26.7 (SD 0.5) years and 63.3 % were female. An isolated lateral release was performed in 8 %, an isolated medial patellofemoral ligament reconstruction (MPFLR) was performed in 37 % of patients and proximal realignment surgery was conducted in 8 % of patients. Trochleoplasty was required in 11 % of patients, with combined MPFLR and tibial tubercle osteotomy (TTO) being undertaken in 22 % of patients. Combined MPFLR, TTO and trochleoplasty was undertaken in 3 % of patients.</div></div><div><h3>Conclusion</h3><div>This audit highlights the national variation in surgical treatment of a common orthopaedic presentation. Despite the lack of evidence, an isolated lateral release is still being performed. There remains a lack of standardisation within the UK in the management of recurrent patellar instability, highlighting the need for national consensus of appropriate surgical interventions.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 325-334"},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring BMP9 and integrin alpha 10 as novel chondrogenic markers in human bone marrow-derived mesenchymal stem cells, chondroprogenitors, and chondrocytes: an immunohistochemistry study","authors":"Mohana Priya ,&nbsp;Ayshath Ruksana C ,&nbsp;Christo Jeyaraj ,&nbsp;Archa Suresh ,&nbsp;Ganesh Parasuraman ,&nbsp;Grace Rebekah ,&nbsp;Elizabeth Vinod","doi":"10.1016/j.knee.2025.09.005","DOIUrl":"10.1016/j.knee.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Evaluating cartilage repair potential involves subjecting the cellular 3D pellets to chondrogenic differentiation and assessing their differentiation degree using immunohistochemical (IHC) studies. Collagen type II IHC staining stands as a key marker to evaluate mature chondrogenesis, but its non-uniform staining confounded by incomplete differentiation necessitates exploring alternative markers. This study explored the potential of BMP9 and Integrin Alpha 10 as novel early-stage chondrogenic markers in human bone marrow-derived mesenchymal stem cells (BM-MSCs), fibronectin assay derived chondroprogenitors (FAA-CPs), migratory chondroprogenitors (MCPs) and chondrocytes following differentiation.</div></div><div><h3>Methods</h3><div>Three human articular cartilage samples and bone marrow aspirate from osteoarthritis patients were collected to isolate the BM-MSCs, FAA-CPs, MCPs and chondrocytes. Following their molecular characterization, differentiation assays were conducted followed by their confirmatory staining and IHC for BMP9 and Integrin alpha10.</div></div><div><h3>Result</h3><div>IHC analysis collagen type II revealed positive with a non-uniform pattern of expression. The same sections subjected to integrin alpha 10 IHC analysis exhibited a greater proportion of uptake and a more uniform distribution throughout the differentiated pellet, addressing a key limitation observed with ECM and collagen staining techniques. The spatial homogeneity observed could be attributed to the functional relevance of integrin alpha 10, a Collagen type II receptor which mediates cell-matrix interactions and is specifically expressed in chondrocytes, further underscoring its potential as an alternative marker. However, BMP9 did not display robust staining.</div></div><div><h3>Conclusion</h3><div>Integrin alpha 10 may serve as a valuable alternative or complementary marker to collagen type II for assessing chondrogenic differentiation, offering a more consistent spatial distribution.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 311-324"},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of a novel portable tension-gauge dynamometer for isometric and isotonic seated knee extension strength measurement.","authors":"Katsumi Takeno, Victor L Katch, Grant E Norte, Christopher D Ingersoll","doi":"10.1016/j.knee.2025.07.013","DOIUrl":"10.1016/j.knee.2025.07.013","url":null,"abstract":"<p><strong>Background: </strong>Accessible measurements of multimodal strength are essential to clinical practice and outcome research. While isokinetic dynamometers are considered the gold standard for isometric and isokinetic strength measurement, their practical use is limited by the insufficiency to measure isotonic strength, high cost, and needs for extensive physical space. Establishing techniques to assess isotonic strength using a portable dynamometer may enhance performance evaluations. Our objective was to determine the validity and test-retest reliability of isometric and isotonic knee extension strength measurements using a novel portable tension-gauge dynamometer.</p><p><strong>Methods: </strong>Twenty recreationally active college-aged individuals participated. We recorded knee extension maximal voluntary isometric contraction (MVIC) force using both a tension-gauge dynamometer and an isokinetic dynamometer for validity and reliability. Peak isotonic knee extension force was recorded against external loads equivalent to 25 % and 30 % MVIC using the tension-gauge dynamometer for test-retest reliability during two sessions 7 days apart.</p><p><strong>Results: </strong>We observed a very high correlation in the MVICs obtained between devices (r = 0.98, p < 0.001, R² = 0.96).We observed good-to-excellent reliability for MVIC force (ICC_3,1 = 0.94 [0.86, 0.98], p = 0.01), good-to-excellent reliability for peak isotonic force against external load at 25 % MVIC (ICC_3,1 = 0.95 [0.87, 0.98], p < 0.001), and excellent reliability for peak isotonic force against external load at 30 % MVIC (ICC_3,1 = 0.97 [0.93, 0.99], p < 0.001).</p><p><strong>Conclusions: </strong>Valid and reliable force-based outcomes can be measured using a novel, tension-gauge dynamometer, which may provide relevant characteristics of muscle function for clinical and research uses.</p>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"646-656"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guided growth for paediatric knee pathology","authors":"Jason Hong ,&nbsp;Brian Loh","doi":"10.1016/j.knee.2025.08.019","DOIUrl":"10.1016/j.knee.2025.08.019","url":null,"abstract":"<div><div>Guided growth has fundamentally transformed paediatric knee surgery, offering a less invasive alternative to manage paediatric knee pathology and lower limb angular deformities.</div><div>A better understanding of the various guided growth techniques, growth plate mechanism and pathology has expanded the indications of physeal modulation to include coronal plane deformities, patellofemoral instability with genu valgum, osteochondritis dissecans with mechanical malalignment, ACL injuries with associated deformities, sequelae of paediatric meniscal pathology, and knee fixed flexion deformities.</div><div>This systematic review identifies and examines current applications, techniques, and outcomes of guided growth for paediatric knee pathology, while exploring future directions in this evolving field.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 277-291"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACL tears in female and male professional soccer players","authors":"Daniele Mazza ,&nbsp;Alessandro Carrozzo ,&nbsp;Alessandro Annibaldi ,&nbsp;Francesco De Carli ,&nbsp;Vincenzo Santoriello ,&nbsp;Paolo Zeppilli ,&nbsp;Angelo De Carli","doi":"10.1016/j.knee.2025.08.021","DOIUrl":"10.1016/j.knee.2025.08.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Women’s football has experienced significant growth, with approximately 16.6 million female players worldwide, emphasizing the need for research focused on injuries. Anterior cruciate ligament (ACL) ruptures are a major concern, particularly among elite players, and understanding differences of sex in injury incidence and recovery is crucial for developing effective prevention and rehabilitation strategies.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed ACL injuries in male and female players from the top five European leagues (Serie A, Premier League, Ligue 1, La Liga, and Bundesliga) during the 2022–2023. A total of 169 players (68 female, 101 male) who underwent ACL reconstruction were included. Data on age, body mass index (BMI), injury history, affected side, playing position, and return-to-play (RTP) outcomes were collected. Statistical analyses were performed using SPSS® software with a significance level of <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Female players had a significantly longer average RTP (300 days) compared to male players (248 days) (<em>P</em> &lt; 0.001). Furthermore, 8.8 % of female athletes did not return to play, while 20.7 % of male athletes failed to achieve RTP (<em>P</em> = 0.031). The defender position had the highest non-return rate (25 %).</div></div><div><h3>Conclusion</h3><div>This study highlights significant sex differences in ACL injury recovery in professional football. Professional female soccer players appear to require a longer rehabilitation period with a significant increase in return to play (RTP) compared to male soccer players, but with a lower risk of dropout (8.8 % vs 20.7 %). Further research and targeted interventions are essential to improve rehabilitation for female players.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 292-297"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}