Knee最新文献

{"title":"Functional activities and patient satisfaction after total knee arthroplasty for valgus knee are inferior to those for varus knee: A propensity-matched cohort study","authors":"Kohei Nishitani,&nbsp;Shinichi Kuriyama,&nbsp;Shinichiro Nakamura,&nbsp;Yugo (侑吾) Morita,&nbsp;Hiromu Ito,&nbsp;Shuichi Matsuda","doi":"10.1016/j.knee.2025.03.004","DOIUrl":"10.1016/j.knee.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to compare the clinical outcomes of total knee arthroplasty (TKA) for valgus and varus knees in a background-matched cohort.</div></div><div><h3>Method</h3><div>Preoperative and two years postoperative original and new Knee Society Scores (OKSS and 2011KSS, respectively) were obtained from patients who underwent primary TKA. Propensity score-matched cohorts were assessed for valgus and varus knees with malalignment ≥3°, ensuring parity in age, sex, primary diagnosis, body mass index, deviation from neutral alignment, surgical approach, patellar resurfacing, and implant type. Multiple linear regression analysis was performed on the 2011KSS Functional activities.</div></div><div><h3>Results</h3><div>Of the 1158 TKAs involving 122 valgus, 110 neutral, and 924 varus knees, propensity score matching yielded 106 valgus–varus knee pairs. Preoperatively, both groups exhibited similar scores, except for 2011KSS expectations. At two years, valgus knee showed inferior OKSS Function Score (valgus: 69.5 ± 26.7, varus: 79.6 ± 19.3, <em>P</em> = 0.005) and 2011KSS Functional activities (valgus: 57.8 ± 23.3, varus: 66.9 ± 20.4, <em>P</em> = 0.007) to varus knees. Valgus knees also showed inferior 2011KSS Satisfaction at two years (valgus: 25.1 ± 7.8, varus: 28.5 ± 7.8, <em>P</em> = 0.006). In the multiple linear regression analysis, older age, preoperative valgus deformity, rheumatoid arthritis, higher BMI, and lower functional scores were significant independent variables that predicted lower 2011KSS Functional activities (<em>R</em>² = 0.28).</div></div><div><h3>Conclusion</h3><div>Postoperative clinical scores related to function after TKA were inferior in valgus knees to varus knees in the background-matched comparison. Valgus knees carry the risk of limited postoperative function after TKA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 24-32"},"PeriodicalIF":1.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806847","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":"Therapeutic potential of microRNA in meniscal repair and regeneration","authors":"George Jacob ,&nbsp;Kazunori Shimomura ,&nbsp;Hiroto Hanai ,&nbsp;Taro Akimori ,&nbsp;Tomoki Ohori ,&nbsp;Akira Tsujii ,&nbsp;Yu Moriguchi ,&nbsp;Norimasa Nakamura","doi":"10.1016/j.knee.2025.03.002","DOIUrl":"10.1016/j.knee.2025.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Managing meniscal injuries is challenging due to the complex nature of the tissue and its limited healing capacity. MicroRNAs (miRNAs) are key regulators of cellular processes, making them promising candidates for therapeutic interventions aimed at enhancing meniscal repair. This study explores the potential role of miRNAs in meniscal healing.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in July 2024 using the PubMed (MEDLINE) and EMBASE databases, without any date restrictions. Relevant studies involving the use of miRNAs in meniscal injury or repair were identified, and a narrative review was performed.</div></div><div><h3>Results</h3><div>The search yielded three in-vitro studies and one animal study, with no clinical studies found. The identified studies suggest that miRNAs may enhance meniscal healing by promoting angiogenesis and reducing inflammation.</div></div><div><h3>Conclusions</h3><div>This review underscores the emerging potential of miRNA-based therapies for meniscal repair and regeneration. While progress has been made in understanding the mechanisms of action, several challenges remain before clinical application, including safety concerns, the need for standardized protocols, and the development of clinical-grade miRNA products.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 18-23"},"PeriodicalIF":1.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806848","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":"ChatGPT versus expert arthroplasty surgeons in total knee arthroplasty patient counseling","authors":"Jonathan Liu,&nbsp;Mohammad Daher,&nbsp;Jacob Laperche,&nbsp;Noah Gilreath,&nbsp;Edward J. Testa,&nbsp;Mouhanad M. El-Othamni,&nbsp;Thomas J. Barrett,&nbsp;Valentin Antoci Jr.","doi":"10.1016/j.knee.2025.03.005","DOIUrl":"10.1016/j.knee.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to assess the effectiveness of AI compared directly with expert arthroplasty surgeons regarding patient counseling for total knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>A set of 10 commonly asked generic and nonspecific, single-step patient questions were selected based on review of existing patient resources and expert consensus. Responses were then collected from ChatGPT-4.0 as well as five expert arthroplasty attendings at our institution. A, B, C, D, and E represent attending responses, while F represents the ChatGPT responses. The collected responses were then blinded and independently assessed by the same five arthroplasty surgeons using a five-point Likert scale in four performance areas including empathy, accuracy, completeness, and overall quality. Average scores for each question were determined.</div></div><div><h3>Results</h3><div>Set F, the ChatGPT answers scored significantly higher than sets A, B, and D in all categories. However, set F did not differ significantly from set C, and E in all the categories. The mean score for set D was above a mean of 4, above neutral, for all four categories. This was only the case for sets C and E.<!--> <!-->When the attendings scores were combined and compared with ChatGPT, the latter had higher ratings for empathy (4.4 vs. 3.5), accuracy (4.4 vs. 3.7), completeness (4.4 vs. 3.5), and overall quality (4.4 vs. 3.6) (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>A preliminary evaluation of ChatGPT-4.0 shows potential for large language AI models to serve as a supplementary resource of patients considering TKA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 12-17"},"PeriodicalIF":1.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791869","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":"Bidirectional barbed polydioxanone filament insertion in vastus medialis oblique muscle for knee osteoarthritis improvement","authors":"Sai-Won Kwon ,&nbsp;Sung-Woo Choi ,&nbsp;Byung-Hak Oh ,&nbsp;Chang-Hyun Kim ,&nbsp;Byung-Ryul Lee ,&nbsp;Hyoung-Ye Kim ,&nbsp;Mi-Ae Nam ,&nbsp;Kang-San Lee ,&nbsp;Dong-Woo Lee","doi":"10.1016/j.knee.2025.03.006","DOIUrl":"10.1016/j.knee.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Strengthening the quadriceps muscle in patients with knee osteoarthritis (OA) can effectively alleviate symptoms such as pain and swelling. However, the use of bidirectional barbed polydioxanone filament (BBPF) for this purpose remains underexplored. Therefore, this study aimed to evaluate the impact of a new muscle enhancement and support therapy (MEST) involving the insertion of a BBPF into the vastus medialis obliquus (VMO) to improve the symptoms of knee OA.</div></div><div><h3>Methods</h3><div>In a multicenter, randomized, double-blind study, we evaluated 131 patients over 40 with Kellgren–Lawrence grade II–III medial compartment knee OA. Of these, 88 received BBPF insertion into the VMO (MEST group), and 43 were in the control group. We compared pain levels (via a visual analog scale (VAS) during weight-bearing and walking), quadriceps muscle strength (IMCSQ), Patient Global Impression of Change (PGIC), and Clinical Global Impression of Change (CGIC), assessing outcomes before and after the procedure.</div></div><div><h3>Results</h3><div>At four and eight weeks post-procedure, the VAS scores during weight-bearing and walking were significantly lower in the MEST group compared to the control group (<em>P</em> = 0.001). The differences in the IMCSQ at four and eight weeks post-procedure were significantly higher in the MEST group (<em>P</em> = 0.001). The PGIC and CGIC scores improved significantly at four weeks post-procedure (<em>P</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>By reducing pain, improving function, and increasing muscle strength, MEST shows promise as a valuable addition to current treatment options. The biodegradable nature of the sutures suggests that repeat procedures may be beneficial, warranting further investigation to optimize this technique for wider clinical use.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777334","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":"Response to the letter regarding \"Bone Patella Bone allografts show superior outcomes in revision ACL reconstruction: A systematic review and meta-analysis\".","authors":"Kamrul Hasan, Yuvraj Chhabraa, Sarup Sarohaa, Raj Thakrar, Akash Patel","doi":"10.1016/j.knee.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.knee.2025.03.007","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789389","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":"Accuracy amidst errors: Evaluating a commercially available wearable sensor system and its associated calibration procedures for monitoring sagittal knee motion in patients undergoing total knee arthroplasty","authors":"Ryan M. Chapman ,&nbsp;Kelly B. Taylor ,&nbsp;Emily Kaczynski ,&nbsp;Shayan Khodabakhsh ,&nbsp;Skye Richards ,&nbsp;Jayson B. Hutchinson ,&nbsp;Robert C. Marchand","doi":"10.1016/j.knee.2025.03.001","DOIUrl":"10.1016/j.knee.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Commercially available wearable sensors monitoring knee range of motion (ROM) are gaining traction in orthopaedics, but few studies validate against optical motion capture (MOCAP) in total knee arthroplasty (TKA) patients. Furthermore, wearable calibration is essential for accurate measurements, yet few investigations evaluate calibration and ROM accuracy. This study assessed one commercial wearable sensor system’s calibration (goniometric versus MOCAP) and sagittal knee angle computation accuracy in TKA patients during activities.</div></div><div><h3>Methods</h3><div>Twenty TKA patients were recruited (5 lost to follow-up). Following a sensor tutorial (MotionSense, Stryker, Mahwah, NJ), participants self-applied sensors for pre-TKA data capture. TKA was then performed by one surgeon followed by identical post-TKA data captures. MOCAP and wearable sensor data were collected during activities. MOCAP sagittal knee angles (θ_MOCAP) were compared to two wearable sensor knee angles: 1) θ_CalGoni = goniometric calibration, 2) θ_CalMOCAP = MOCAP calibration. Two-way ANOVAs evaluated the impact of time (pre-TKA vs. post-TKA) and calibration type (goniometry vs. MOCAP) on calibration angles and wearable sensor error. Variance equality tests compared pre-TKA vs. post-TKA and goniometric vs. MOCAP calibration.</div></div><div><h3>Results</h3><div>No significant differences were noted pre-TKA vs. post-TKA. Calibration angles differed significantly with goniometry yielding significantly more error than MOCAP. MOCAP calibration reduced error below clinically acceptable levels (&lt;5°) during activities and with significantly less error variance.</div></div><div><h3>Conclusion</h3><div>MOCAP calibration significant improved accuracy of knee angle computations to acceptable levels (&lt;5°). Accordingly, these wearables are suitable for continuous knee ROM monitoring after calibrating with correct angles, Future studies should investigate specific activities and sensor misplacement on angle measurements.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 316-328"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747388","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":"Comparison of ultrasonography findings of patients with patellofemoral pain and healthy controls","authors":"Derya Karacif ,&nbsp;Onur Karacif ,&nbsp;Ayla Cagliyan Turk ,&nbsp;Handan Elif Nur Bayraktar","doi":"10.1016/j.knee.2025.03.003","DOIUrl":"10.1016/j.knee.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to compare knee ultrasonography findings in patients with Patellofemoral Pain (PFP) and healthy controls.</div></div><div><h3>Methods</h3><div>Our cross-sectional study included 54 participants, 27 patients with PFP and 27 healthy controls. Medial and lateral retinaculum thickness, trochlear cartilage thickness and patellofemoral distances were measured by ultrasonography In the PFP group, pain intensity at rest and during activity was assessed by Visual Analogue Scale (VAS, 0–10 cm), functional status was assessed by Kujala Patellofemoral Pain Scoring system. The quality of life of both groups was evaluated with the Short Form-36 (SF-36).</div></div><div><h3>Results</h3><div>The groups were similar in terms of age, gender, body mass index (BMI), marital status, educational level and dominant extremity. In the PFP group, medial and lateral retinaculum thickness, medial patellofemoral distance were found to be significantly higher (mean difference [MD]:1.08; 95% confidence interval [CI]:0.87–1.28, MD:0.80; 95%CI:0.59–1.01, MD:5.65; 95%CI:4.68–6.61, respectively), while medial and lateral cartilage thickness were found to be significantly lower than the control group (MD:1.32; 95%CI:1.0–1.64, MD:-1.56; 95%CI:-1.86--1.26, respectively). There was no significant difference in lateral patellofemoral distance between the two groups (<em>p</em> = 0.752). No statistically significant correlation was found between ultrasonography measurements and age, BMI, pain duration, Kujala score, VAS scores at rest and during activity and SF-36 subgroup scores in the PFP group.</div></div><div><h3>Conclusion</h3><div>In our study, medial retinaculum thickness, lateral retinaculum thickness and medial patellofemoral distance were statistically significantly higher and medial and lateral trochlear cartilage thickness were lower in the PFP group compared to the control group.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 329-339"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747279","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":"Synovial D-dimer is a novel and accurate test for diagnosis of chronic knee periprosthetic joint infection","authors":"Zirvecan Güneş ,&nbsp;Mehmet Kürşat Yılmaz ,&nbsp;Bahattin Kemah ,&nbsp;Ömür Çağlar ,&nbsp;Ahmet Mazhar Tokgözoğlu ,&nbsp;Javad Parvizi ,&nbsp;İbrahim Azboy ,&nbsp;Bülent Atilla","doi":"10.1016/j.knee.2025.02.027","DOIUrl":"10.1016/j.knee.2025.02.027","url":null,"abstract":"<div><h3>Background</h3><div>Despite numerous tests and guidelines, diagnosing periprosthetic joint infection (PJI) remains challenging. The study aimed to determine the value of synovial D-dimer, rather than serum, in diagnosing PJI.</div></div><div><h3>Methods</h3><div>This prospective study enrolled 17 patients with chronic knee PJI (the PJI group) and 52 with primary knee osteoarthritis (the control group). PJI was defined using the 2018 International Consensus Meeting Criteria. Synovial D-dimer, plasma D-dimer, serum erythrocyte sedimentation rate, and serum C-reactive protein levels were measured. Synovial fluid D-dimer levels were determined using an enzyme-linked fluorescence assay. The performance of each biomarker in diagnosing PJI was evaluated using receiver operating characteristic (ROC) curves.</div></div><div><h3>Results</h3><div>The median synovial D-dimer level was significantly higher in the PJI group at (927,095 ng/ml, IQR 566,882–1,215,066) than in the control group (20,954 ng/ml, IQR 10,350–46,493) (<em>P &lt;</em> 0.001). When the synovial D-dimer threshold value was determined to be 236,804 ng/ml, the sensitivity was 100% (CI 93.2–100%), and the specificity was 94.12% (95% CI 71.3–99.9). The area under the curve determined by ROC analysis was 0.992 (95% CI 0.992–1.000, <em>P &lt;</em> 0.0001).</div></div><div><h3>Conclusions</h3><div>Patients with chronic knee PJI have significantly high synovial D-dimer levels, demonstrating that an increase in fibrinolytic activity coexists with an infection-induced inflammatory response. Synovial D-dimer levels appear to be valuable biomarkers for diagnosing PJI. However, further studies are required to evaluate the role of this novel biomarker.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 282-290"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671682","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":"Restoration of anatomical knee phenotype is associated with improved postoperative clinical outcomes after total knee arthroplasty","authors":"Hong Yeol Yang,&nbsp;Jae Hyeok Cheon,&nbsp;Jae Yeon Hwang,&nbsp;Jong Keun Seon","doi":"10.1016/j.knee.2025.02.028","DOIUrl":"10.1016/j.knee.2025.02.028","url":null,"abstract":"<div><h3>Background</h3><div>A comprehensive assessment of knee phenotypes is crucial for optimizing surgical realignment strategies in total knee arthroplasty (TKA). This study aimed to investigate the relationship between the restoration of preoperative phenotypes, such as joint line orientation (JLO) and alignment, and clinical outcomes following TKA.</div></div><div><h3>Methods</h3><div>A retrospective review was performed on the records of 1052 primary osteoarthritic knees that underwent mechanically aligned (MA) TKA between March 2016 and October 2021. Patient-reported outcome measures (PROMs) were assessed preoperatively and at 2 years postoperatively. Patients were categorized according to the coronal plane alignment of the knee (CPAK) classification system, which incorporates the arithmetic hip–knee–ankle angle (aHKA) as an indicator of constitutional alignment and JLO. Clinical outcomes were compared between patients whose knee phenotype was maintained and those in whom it was not restored.</div></div><div><h3>Results</h3><div>Among osteoarthritic knees, the majority (59.4%) were classified as CPAK type I (varus aHKA, apex distal JLO) preoperatively. Using mechanical axis techniques, the native phenotype was restored in 127 (12.1%) of the 1052 cases. These patients demonstrated significantly better postoperative clinical outcomes, as measured by WOMAC function and Forgotten Joint Scores (FJS), compared with the non-restored group (<em>P</em> &lt; 0.05). When alignment was adjusted through detailed analyses of patients with maintained alignment between preoperative and latest follow up assessments, the significant differences in WOMAC function and FJS outcomes between restored JLO and non-restored JLO groups persisted (all <em>P</em> &lt; 0.05). No significant association was observed between the restoration of aHKA and clinical outcomes.</div></div><div><h3>Conclusion</h3><div>The restoration of the anatomical knee phenotype, particularly JLO, is associated with improved postoperative PROMs, notably in functional outcomes, following TKA. These findings underscore the clinical importance of prioritizing preoperative JLO for optimizing surgical outcomes, rather than focusing exclusively on overall limb alignment.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 291-300"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671681","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":"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}