Knee最新文献

{"title":"Application of machine learning in the context of reoperation, outcome and management after ACL reconstruction – A systematic review","authors":"Julius Michael Wolfgart ,&nbsp;Ulf Krister Hofmann ,&nbsp;Maximilian Praster ,&nbsp;Marina Danalache ,&nbsp;Filipo Migliorini ,&nbsp;Martina Feierabend","doi":"10.1016/j.knee.2025.02.032","DOIUrl":"10.1016/j.knee.2025.02.032","url":null,"abstract":"<div><h3>Introduction</h3><div>Machine learning-based tools are becoming increasingly popular in clinical practice. They offer new possibilities but are also limited in their reliability and accuracy.</div></div><div><h3>Objectives</h3><div>The present systematic review updates and discusses the existing literature regarding machine learning algorithm-based tools to predict outcome and management in patients after ACL reconstruction.</div></div><div><h3>Method</h3><div>PubMed was searched for articles containing machine learning algorithms related to anterior cruciate ligament reconstruction and its outcome and management. No additional filters or time constraints were used. All eligible studies were accessed by hand.</div></div><div><h3>Results</h3><div>After screening of 115 articles, 15 were included. Six studies evaluated predictors for reoperation after ACL surgery. Four studies investigated the clinical outcome prediction after ACL reconstruction including prediction of secondary meniscus tear and secondary knee osteoarthritis. Single topics addressed in patients with ACL reconstruction were costs, opioid use, the need for a femoral nerve block, short term complications, hospital admission, and reduction of the burden to complete the Knee Osteoarthritis and Outcome score questionnaire. Predictive power was very heterogeneous, depending on the specific research question and parameters included.</div></div><div><h3>Conclusion</h3><div>New machine-learning tools offer interesting insights into variables affecting the target outcome and general management of patients with ACL reconstruction. While present machine-learning based prediction models seem to outperform previous existing benchmark regression models, their predictive ability often is still too low to base individual decision making on them. With the rapid progress observed over the last few years, it is conceivable that this might change, however, in the foreseeable future.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 301-315"},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643502","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":"Dynamic ultrasound-based determination of the optimal knee position for pullout fixation of medial meniscus posterior root tears","authors":"Haruhiko Nakamura,&nbsp;Atsuto Hoshikawa,&nbsp;Kei Sato,&nbsp;Ryota Takei,&nbsp;Risa Matsumoto,&nbsp;Hiroshi Inui,&nbsp;Kazuo Saita","doi":"10.1016/j.knee.2025.02.029","DOIUrl":"10.1016/j.knee.2025.02.029","url":null,"abstract":"<div><h3>Purpose</h3><div>A larger medial meniscus extrusion (MME) predicts a poorer prognosis after arthroscopic pullout fixation for medial meniscus posterior root tears (MMPRT). However, the optimal knee position in surgery for MMPRT to reduce MME is unclear. We evaluated the MME at various knee positions used for medial fixation.</div></div><div><h3>Methods</h3><div>We enrolled 20 patients who underwent MMPRT repair and performed ultrasonography preoperatively under anaesthesia, before fixation (both with or without traction), and post-fixation. MMEs were measured in positions A, B, C, and D (supine with the leg dropped from the bed with the knee flexed; valgus stress knee; figure-of-four; and supine with the injured knee flexed over the bed, respectively) at different time points and compared. Surgical fixation was performed in Position B.</div></div><div><h3>Results</h3><div>The preoperative mean MMEs at positions A, B, C, and D were 1.5, 1.4, 5.8, and 3.6 mm, respectively, and MMEs at A and B were significantly smaller than those at C and D, whereas the MME at C was significantly larger than that at D. The intraoperative mean MMEs, at positions B and C, before traction, with traction, and post-fixation were 1.2 and 5.5 mm, 0.7 and 4.3 mm, and 0.9 and 2.3 mm, respectively.</div></div><div><h3>Conclusion</h3><div>During MMPRT repair, MMEs increased in the figure-of-four position, but decreased with pullout fixation in the valgus stress knee position. Therefore, the valgus stress knee position is suitable for pullout fixation in MMPRT repair.</div></div><div><h3>Level of Evidence</h3><div>IV.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 275-281"},"PeriodicalIF":1.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of pre-operative co-morbidities on pain and function outcomes at 1 year after primary total knee arthroplasty","authors":"Sean D. Scattergood ,&nbsp;Vincent Cheng ,&nbsp;Vikki Wylde ,&nbsp;Ashley W. Blom ,&nbsp;Michael R. Whitehouse ,&nbsp;Erik Lenguerrand","doi":"10.1016/j.knee.2025.02.031","DOIUrl":"10.1016/j.knee.2025.02.031","url":null,"abstract":"<div><h3>Introduction</h3><div>Multimorbidity has been found to be associated with more pain and poorer function following total knee arthroplasty (TKA). We describe the relationship between both the total number of pre-operative co-morbidities, and individual co-morbidities, with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 12 months after TKR.</div></div><div><h3>Methods</h3><div>We performed a secondary analysis on 290 participants from the Arthroplasty Pain Experience (APEX) trial, with seventeen imputations by Chained Equations. Using multivariable adjusted linear regression models, we analysed the relationship between total number of pre-operative co-morbidities, followed by individual co-morbidities, with WOMAC score at 12 months after randomisation.</div></div><div><h3>Results</h3><div>Patients with ≥ 5 co-morbidities have worse outcomes compared to patients with 3 co-morbidities, scoring −9.6 points for function (95% CI −15.3 to −3.8), and −9.8 points for pain (95%CI −15.9 to −3.8). Patients reported worse pain with osteoporosis (−7.8 95%CI −14.1 to −1.6), peripheral vascular disease (−17.8 95%CI −34 to −1.8), depression (−9.8 95%CI −18.1 to −1.4), anxiety (−9.7 95%CI −18 to −1.4) or degenerative disc disease (−7.5 95%CI −13.3 to −1.7). Worse function was associated with osteoporosis (−7.1 95%CI −12.9 to −1.4), diabetes mellitus (−9.1 95%CI −15.6 to −2.6), anxiety (−8.1 95%CI −16 to −0.2) and degenerative disc disease (−8.6 95%CI −14.1 to −3.2).</div></div><div><h3>Conclusion</h3><div>Pre-operative multimorbidity is associated with worse outcomes after TKA. Patients with pre-operative osteoporosis, anxiety and degenerative disc disease had worse pain and function at 12-months. Surgeons may use these results during discussion with patients about their potential outcome after TKA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 263-274"},"PeriodicalIF":1.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helix meniscus − A novel anatomical discovery","authors":"Tetsuhiro Hagino ,&nbsp;Ryosuke Koizumi ,&nbsp;Tetsuo Hagino ,&nbsp;Satoshi Ochiai ,&nbsp;Naoto Furuya ,&nbsp;Masanori Wako ,&nbsp;Hirotaka Haro","doi":"10.1016/j.knee.2025.02.030","DOIUrl":"10.1016/j.knee.2025.02.030","url":null,"abstract":"<div><div>Many anatomical variations of the meniscus have been reported. In this report, we present a case of a novel pattern of meniscal morphology showing a helix structure. A 14-year-old boy presented with knee pain without an apparent cause. Arthroscopic surgery was performed, revealing a helical-shaped meniscus on the lateral side, without injury or degeneration. Partial meniscectomy resulted in symptom improvement. A helix meniscus is very rare and should be recognized as a novel anatomical variant. While arthroscopic meniscectomy improved symptoms, careful consideration is needed when determining surgical indications, as long-term effects remain unknown.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 240-243"},"PeriodicalIF":1.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619851","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":"Patients aged 80 years and older have an equal improvement in joint-specific outcome health related quality of life and level of satisfaction when compared to those aged 65–75 years old undergoing knee arthroplasty","authors":"Gregory Hodgson ,&nbsp;Samantha Jones ,&nbsp;Jad Wehbe ,&nbsp;Irrum Afzal ,&nbsp;Nick D Clement ,&nbsp;Deiary F Kader","doi":"10.1016/j.knee.2025.02.017","DOIUrl":"10.1016/j.knee.2025.02.017","url":null,"abstract":"<div><h3>Aims</h3><div>To assess functional outcomes, health-related quality-of-life (HRQoL), and satisfaction at 1-year following knee arthroplasty (KA) in patients aged ≥80 compared to those aged 65–75-years when adjusting for confounding factors.</div></div><div><h3>Methods</h3><div>A single-centre retrospective cohort study was performed using data from 2010 to 2020. Demographic data, length of stay (LOS), preoperative and 1-year postoperative EuroQol (EQ-5D and EQ-VAS), Oxford Knee Score (OKS) and Outcome Satisfaction (OS) were recorded. Patients aged ≥80 were compared to a control group aged 65–75-years. Regression analyses were performed to assess the independent association of age group after adjusting for confounding factors.</div></div><div><h3>Results</h3><div>Compared to the 65–75-year group (<em>n</em> = 7525) the ≥80-year group (<em>n</em> = 2966) had greater comorbidity (<em>p</em> &lt; 0.001), worse preoperative OKS (<em>p</em> &lt; 0.001) and EQ-VAS (<em>p</em> = 0.012). Postoperatively both groups had clinically and statistically significant (<em>p</em> &lt; 0.001) improvements in OKS, EQ-5D and EQ-VAS. There was no difference in improvement in OKS (mean difference (<em>p</em> = 0.081) or OS (<em>p</em> = 0.203) between the groups. However, the ≥80-year group had less of an improvement in EQ-5D (<em>p</em> = 0.047) and EQ-VAS (<em>p</em> = 0.007), but these were not clinically meaningful. However, when adjusting for confounding variables there were no differences in improvement in OKS (<em>p</em> = 0.372), EQ-5D (<em>p</em> = 0.703), and EQ-VAS (<em>p</em> = 0.283), or OS (<em>p</em> = 0.829) between the groups. The ≥80-year group was independently associated with a longer LOS (95% CI 0.3–0.8, <em>p</em> &lt; 0.001) when adjusting for confounding factors.</div></div><div><h3>Conclusions</h3><div>Patients ≥80-years had clinically significant improvements in joint-specific outcome and HRQoL and OS equal to those aged 65–75-years following KA. The ≥80 group had a longer mean LOS of half a day.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 209-216"},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619849","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":"Medial meniscus extrusion is associated with acute cartilage deformation after mechanical loading during treadmill walking in older adults","authors":"Shogo Okada ,&nbsp;Masashi Taniguchi ,&nbsp;Masahide Yagi ,&nbsp;Yoshiki Motomura ,&nbsp;Sayaka Okada ,&nbsp;Kaede Nakazato ,&nbsp;Yoshihiro Fukumoto ,&nbsp;Kenta Iwane ,&nbsp;Masashi Kobayashi ,&nbsp;Kyoseki Kanemitsu ,&nbsp;Noriaki Ichihashi","doi":"10.1016/j.knee.2025.02.021","DOIUrl":"10.1016/j.knee.2025.02.021","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate whether the worsening of meniscus function caused by medial meniscus extrusion (MME) was associated with acute cartilage deformation in the medial femur after mechanical loading, which changes depending on the contact force on the cartilage.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of our previous study investigating acute cartilage deformation after mechanical loading in older women. Fifty-six women, aged ≥50 years, participated in the previous study, 48 of whom (age: 70.3 ± 7.6 years) participated in the meniscus assessment and were included in this analysis. MME was assessed using ultrasonographic B-mode images acquired in the standing position. Acute cartilage deformation was assessed based on the reduction in cartilage thickness after 15 min of treadmill walking. The mechanical cumulative loading was calculated by multiplying the time integrals of the positive values of the knee adduction moment, as assessed by motion analysis with the number of steps taken during treadmill walking. Paired <em>t</em>-tests were performed to compare cartilage thickness in pre- and post-walking. In addition, multiple linear regression analysis was performed to investigate whether MME was associated with acute cartilage deformation after walking.</div></div><div><h3>Results</h3><div>Significant cartilage deformation occurred after treadmill walking (pre-walking: 1.6 ± 0.3 mm, post-walking: 1.5 ± 0.3 mm, <em>P</em> &lt; 0.001, effect size (r) = 0.760). MME was associated with the amount of acute cartilage deformation after walking, independent of cumulative mechanical loading or cartilage condition (unstandardized regression coefficient B = 0.013, 95% confidence interval: 0.001–0.025, <em>P</em> = 0.033, effect size (R²) = 0.144).</div></div><div><h3>Conclusion</h3><div>Greater MME is associated with increased acute cartilage deformation after mechanical loading.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 192-198"},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620550","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":"Patellar tilt calculation utilizing artificial intelligence on CT knee imaging","authors":"Johannes Sieberer ,&nbsp;Albert Rancu ,&nbsp;Nancy Park ,&nbsp;Shelby Desroches ,&nbsp;Armita R. Manafzadeh ,&nbsp;Steven Tommasini ,&nbsp;Daniel H. Wiznia ,&nbsp;John Fulkerson","doi":"10.1016/j.knee.2025.02.019","DOIUrl":"10.1016/j.knee.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>In the diagnosis of patellar instability, three-dimensional (3D) imaging enables measurement of a wide range of metrics. However, measuring these metrics can be time-consuming and prone to error due to conducting 2D measurements on 3D objects. This study aims to measure patellar tilt in 3D and automate it by utilizing a commercial AI algorithm for landmark placement.</div></div><div><h3>Methods</h3><div>CT-scans of 30 patients with at least two dislocation events and 30 controls without patellofemoral disease were acquired. Patellar tilt was measured using three different methods: the established method, and by calculating the angle between 3D-landmarks placed by either a human rater or an AI algorithm. Correlations between the three measurements were calculated using interclass correlation coefficients, and differences with a Kruskal-Wallis test. Significant differences of means between patients and controls were calculated using Mann-Whitney U tests. Significance was assumed at 0.05 adjusted with the Bonferroni method.</div></div><div><h3>Results</h3><div>No significant differences (overall: <em>p</em> = 0.10, patients: 0.51, controls: 0.79) between methods were found. Predicted ICC between the methods ranged from 0.86 to 0.90 with a 95% confidence interval of 0.77–0.94. Differences between patients and controls were significant (<em>p</em> &lt; 0.001) for all three methods.</div></div><div><h3>Conclusion</h3><div>The study offers an alternative 3D approach for calculating patellar tilt comparable to traditional, manual measurements. Furthermore, this analysis offers evidence that a commercially available software can identify the necessary anatomical landmarks for patellar tilt calculation, offering a potential pathway to increased automation of surgical decision-making metrics.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 217-221"},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620571","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":"Structural equation model of knee pain in individuals with knee osteoarthritis-associated knee pain, based on functional capacity, kinesiophobia, muscle thickness, and joint position sense","authors":"Prasert Sakulsriprasert ,&nbsp;Tipwadee Bunprajun ,&nbsp;Ninwisan Hengsomboon ,&nbsp;Pichaya Hengsomboon ,&nbsp;Pavinee Harutaichun ,&nbsp;Chompunoot Suwanasri ,&nbsp;Pinyada Warathanagasame ,&nbsp;Chutiporn Thammajaree ,&nbsp;Akenarin Chocknakawaro ,&nbsp;Nattapa Ariyakitsakul","doi":"10.1016/j.knee.2025.02.024","DOIUrl":"10.1016/j.knee.2025.02.024","url":null,"abstract":"<div><h3>Background</h3><div>There are several clinical parameters that contribute to knee osteoarthritis (KOA)-associated knee pain and/or its progression such as kinesiophobia, functional capacity, muscle thickness, and joint position sense. The relationship between knee pain and those aforementioned clinical parameters is needed for clear understanding. Therefore, this study constructed the structural equation model of knee pain with the variables of kinesiophobia, functional capacity, muscle thickness, and joint position sense in individuals with KOA-associated knee pain.</div></div><div><h3>Methods</h3><div>We examined 200 individuals (74% female) with KOA-associated knee pain. Kinesiophobia, functional capacity test, quadriceps and hamstring muscle thickness, and knee joint position sense in flexion and extension were obtained and served as latent variables to investigate causal relationships with knee pain through structural equation modeling.</div></div><div><h3>Results</h3><div>All latent variables were fit for the structural model with excellent statistical parameters. The squared multiple correlations’ estimate for the model was 0.928. In particular, kinesiophobia, functional capacity test, and hamstring muscle thickness had significant associations with knee pain.</div></div><div><h3>Conclusion</h3><div>Knee pain was associated with kinesiophobia, functional capacity, quadriceps and hamstring muscle thickness, and knee joint position sense. Although this relationship does not establish causality, the findings underscore the importance of adopting an integrated approach when designing preventive interventions or therapeutic strategies for managing knee pain.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 199-208"},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to editor: Correction of injury rate calculation in anterior cruciate ligament ruptures in Spanish soccer first division: An epidemiological retrospective study.","authors":"David Ortiz-Sánchez, Alfredo Bravo-Sánchez, Javier Abián-Vicén","doi":"10.1016/j.knee.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.knee.2025.02.023","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626836","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":"Commentary on \"Bone Patella Bone allografts show superior outcomes in revision ACL reconstruction: A systematic review and meta-analysis\".","authors":"Shubham Kumar, Ahmad Neyazi, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.knee.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.knee.2025.02.020","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626851","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}