Knee最新文献

{"title":"Response to : Letter to the editor on “Aseptic loosening of the option stemmed tibial tray in the Zimmer NexGen LPS total knee arthroplasty system”","authors":"","doi":"10.1016/j.knee.2024.10.005","DOIUrl":"10.1016/j.knee.2024.10.005","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 306-307"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513602","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":"Excellent early outcomes following lateral robotic-assisted unicompartmental knee arthroplasty","authors":"Colin C. Neitzke,&nbsp;Jeffrey A. O’Donnell,&nbsp;Claude J. Regis,&nbsp;Pravjit Bhatti,&nbsp;Yu-Fen Chiu,&nbsp;Andrew D. Pearle,&nbsp;David J. Mayman,&nbsp;Brian P. Chalmers","doi":"10.1016/j.knee.2025.02.011","DOIUrl":"10.1016/j.knee.2025.02.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Lateral unicompartmental knee arthroplasty (UKA) has historically shown mixed results and there is limited contemporary literature on lateral robotic-assisted UKA (RA-UKA) outcomes. This study aimed to evaluate the short-term survivorship, clinical, and radiographic outcomes of lateral RA-UKA.</div></div><div><h3>Methods</h3><div>A retrospective review identified 138 lateral RA-UKAs performed from 2016 to 2022 at a single institution, with a study population of 58% women, a mean BMI of 27 kg/m², and a mean age of 62 years. The mean follow-up was two years. Kaplan-Meier analysis assessed survivorship free from all-cause reoperation and revision. A radiographic review evaluated component positioning, aseptic loosening, and osteoarthritis progression.</div></div><div><h3>Results</h3><div>The one- and two-year survivorship free from all-cause revision was 100% (95% confidence interval [CI]: 100 to 100%). The one- and two-year survivorship free from all-cause reoperation was 97% (95% CI: 91 to 99%) and 96% (95% CI: 90 to 98%), respectively. There were six (4%) reoperations, most commonly for arthroscopic lysis/removal of scar tissue, synovitis, and osteophyte. The mean anatomic tibiofemoral angle decreased from 9.7° to 5.9° valgus. At the latest follow-up, 11 (8%) knees showed radiographic osteoarthritis progression. From preoperatively to two years postoperatively, the mean Knee Injury and Osteoarthritis Outcome Score for Joint Replacement increased from 56 to 82 (<em>P</em> &lt; 0.0001), and the mean visual analog scale for pain decreased from 53 to 18 (<em>P</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>Short-term follow-up of contemporary lateral RA-UKA demonstrated high survivorship free from all-cause reoperation (96%) and revision (100%). Patients had significant improvements in PROMs, and a minority had osteoarthritis progression.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 50-57"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520917","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":"Can the combination of kinematics and electromyography enhance the identification of individuals with patellofemoral pain?","authors":"Tadeu Aldrovando Brihy de Albuquerque ,&nbsp;Cintia Lopes Ferreira ,&nbsp;Fabiano Politti ,&nbsp;Cintia Elord Júlio ,&nbsp;Gabor József Barton ,&nbsp;Paulo Roberto Garcia Lucareli","doi":"10.1016/j.knee.2025.02.010","DOIUrl":"10.1016/j.knee.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Patellofemoral pain (PFP) affects many women’s movement function and quality of life. PFP is related to changes in muscle activity and movement patterns during functional tasks. This study aimed to determine whether the combined analysis of kinematics and electromyography data enhances the ability to discriminate between women with and without PFP, compared with the independent analysis of kinematics and electromyography.</div></div><div><h3>Methods</h3><div>Thirty-seven women with PFP and 34 unimpaired controls were evaluated for kinematics and electromyography during the lateral step-down (LSD) task. For three-dimensional kinematics, movements in the sagittal, frontal, and transverse planes of the trunk, pelvis, hip, knee, and foot were assessed. For electromyography, filtered, rectified, and smoothed signals from the adductor longus, gluteus medius, vastus lateralis and medialis, rectus femoris, biceps femoris, medial gastrocnemius and tibialis anterior muscles were used. The artificial neural network-based movement deviation profile (MDP) was used to analyse kinematics, electromyography and kinematics combined with electromyography. A MANOVA of MDP_mean Z-scores was used to compare the groups, considering <em>P &lt;</em> 0.05.</div></div><div><h3>Results</h3><div>Multivariate analysis showed group interaction. There was a significant difference between groups in the Z-score for kinematics. However, no significant differences were observed between groups for electromyography and kinematics combined with electromyography.</div></div><div><h3>Conclusion</h3><div>Women with PFP exhibit altered movement patterns during the LSD task but no change in the MDP of muscular activity. Using the MDP, which can combine kinematic and electromyography variables from different segments and muscles, kinematics was the most influential in distinguishing between women with and without PFP.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 90-98"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520916","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 letter to the editor by Dr. Liu Aifeng et al.","authors":"","doi":"10.1016/j.knee.2024.12.018","DOIUrl":"10.1016/j.knee.2024.12.018","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 310-311"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973461","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":"Letter to the editor: Validity of wearable sensors for total knee arthroplasty (TKA) rehabilitation: A study in younger and older healthy Participants. Knee. 2024 Oct; 24:51:292–302","authors":"Neimeng Gu,&nbsp;Dongdong Cao,&nbsp;Aifeng Liu","doi":"10.1016/j.knee.2024.12.017","DOIUrl":"10.1016/j.knee.2024.12.017","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 308-309"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967450","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":"National trends in knee arthroplasty and risk factors for revision surgery: A nationwide population-based cohort study in South Korea","authors":"Sung-Sahn Lee ,&nbsp;Eun Kyo Ha ,&nbsp;Ju Hee Kim ,&nbsp;Ha Na Yoo ,&nbsp;Man Yong Han ,&nbsp;Soonchul Lee","doi":"10.1016/j.knee.2025.02.015","DOIUrl":"10.1016/j.knee.2025.02.015","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to examine surgical trends in knee arthroplasty over past 18 years and identify the factors associated with risk of revision surgeries following total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) in South Korea.</div></div><div><h3>Methods</h3><div>This study was conducted using National Health Insurance Service – National Sample Cohort database, approximately 1 million individuals from 2002 to 2019. We analyzed general trends and procedural rates of knee arthroplasty, stratified by age, location of residence, and hospital size. Additionally, we investigated the risk factors of knee arthroplasty failure in UKA and TKA.</div></div><div><h3>Results</h3><div>The average age of the 15,395 individuals who underwent UKA (<em>n</em> = 664) or TKA (<em>n</em> = 14,731) was 69.8 years (standard deviation 7.2), and 77.3% were women. In TKA, occurrence increased by approximately 4.9 times from 2002 to 2010 and by 1.5 times 2010 onward. In contrast, the number of UKA procedures did not increase until 2008, after which it increased 6.1-fold by 2019. An increasing trend in TKA procedures was observed among individuals aged 70–79 and &gt;80 years, whereas the UKA procedural rates increased across all age groups. The revision rate was higher in UKA than that in TKA (13.7% vs. 2.8%). The risk factors were younger age, diabetes mellitus for TKA, and osteoporosis for UKA.</div></div><div><h3>Conclusion</h3><div>Unlike that of TKA, procedural rate increment of UKA occurred in younger people recently and featured a considerably higher revision rate. Given that UKA has a higher revision rate and different risk factors than TKA, monitoring should be tailored specifically for each procedure.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 111-121"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527165","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":"The impact of high-heel shoes on knee joint space width in healthy young females: A real-time ultrasound study","authors":"Congcong Cai ,&nbsp;Nurul Adliah Gazali ,&nbsp;Daniel Sheng Rong Ker ,&nbsp;Muhammad Amirul Hazim Bin Mohamad Helmy ,&nbsp;Sin Jie Tan ,&nbsp;Bao Xuan Teo","doi":"10.1016/j.knee.2025.02.002","DOIUrl":"10.1016/j.knee.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Wearing high heel shoes is thought to increase the risk of knee osteoarthritis in females by altering knee joint alignment and increasing muscle activation. However, direct measurements of knee joint space width using ultrasound have been limited. This study aimed to investigate the effects of 8-cm high-heel shoes on knee joint articular space in healthy young females during standing.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 30 healthy females (age 22 ± 1.3 years). Participants’ knee medial, lateral and patellofemoral joint space width were measured using an ultrasound imaging device in both barefoot and high-heel shoes conditions. A general linear model was used to compare the impact of high-heel shoes on knee joint articular space with adjusted covariates of demographic and lower limb physical measurement data.</div></div><div><h3>Results</h3><div>Significant reductions in lateral joint space width were observed in both the dominant and non-dominant knees when wearing high-heel shoes compared with barefoot (mean difference: dominant side = 1.63 ± 3.91 mm, non-dominant side = 2.34 ± 2.65 mm, <em>P</em> = 0.008). No significant changes were detected in medial and patellofemoral joint space width.</div></div><div><h3>Conclusion</h3><div>Wearing 8-cm high-heel shoes significantly reduces the lateral joint space width of the knee in healthy young females during standing, suggesting increased lateral knee joint stress. The current study underscores the importance of including standing as a test component when measuring joint space changes in future studies and clinical practice to comprehensively evaluate the effects of high-heel usage on knee joint biomechanics.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 19-27"},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520898","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":"Managing class imbalance in the training of a large language model to predict patient selection for total knee arthroplasty: Results from the Artificial intelligence to Revolutionise the patient Care pathway in Hip and knEe aRthroplastY (ARCHERY) project","authors":"Luke Farrow,&nbsp;Lesley Anderson,&nbsp;Mingjun Zhong","doi":"10.1016/j.knee.2025.02.007","DOIUrl":"10.1016/j.knee.2025.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>This study set out to test the efficacy of different techniques used to manage to class imbalance, a type of data bias, in application of a large language model (LLM) to predict patient selection for total knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>This study utilised data from the Artificial Intelligence to Revolutionise the Patient Care Pathway in Hip and Knee Arthroplasty (ARCHERY) project (ISRCTN18398037). Data included the pre-operative radiology reports of patients referred to secondary care for knee-related complaints from within the North of Scotland. A clinically based LLM (GatorTron) was trained regarding prediction of selection for TKA. Three methods for managing class imbalance were assessed: a standard model, use of class weighting, and majority class undersampling.</div></div><div><h3>Results</h3><div>A total of 7707 individual knee radiology reports were included (dated from 2015 to 2022). The mean text length was 74 words (range 26–275). Only 910/7707 (11.8%) patients underwent TKA surgery (the designated ‘minority class’). Class weighting technique performed better for minority class discrimination and calibration compared with the other two techniques (Recall 0.61/AUROC 0.73 for class weighting compared with 0.54/0.70 and 0.59/0.72 for the standard model and majority class undersampling, respectively. There was also significant data loss for majority class undersampling when compared with class-weighting.</div></div><div><h3>Conclusion</h3><div>Use of class-weighting appears to provide the optimal method of training a an LLM to perform analytical tasks on free-text clinical information in the face of significant data bias (‘class imbalance’). Such knowledge is an important consideration in the development of high-performance clinical AI models within Trauma and Orthopaedics.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512675","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":"Artificial intelligence and machine learning in knee arthroplasty","authors":"Hugo C. Rodriguez ,&nbsp;Brandon D. Rust ,&nbsp;Martin W Roche ,&nbsp;Ashim Gupta","doi":"10.1016/j.knee.2025.02.014","DOIUrl":"10.1016/j.knee.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) and its subset, machine learning (ML), have significantly impacted clinical medicine, particularly in knee arthroplasty (KA). These technologies utilize algorithms for tasks such as predictive analytics and image recognition, improving preoperative planning, intraoperative navigation, and postoperative complication anticipation. This systematic review presents AI-driven tools’ clinical implications in total and unicompartmental KA, focusing on enhancing patient outcomes and operational efficiency.</div></div><div><h3>Methods</h3><div>A systematic search was conducted across multiple databases including Cochrane Central Register of Controlled Trials, Embase, OVID Medline, PubMed, and Web of Science, following the PRISMA guidelines for studies published in the English language till March 2024. Inclusion criteria targeted adult human models without geographical restrictions, specifically related to total or unicompartmental KA.</div></div><div><h3>Results</h3><div>A total of 153 relevant studies were identified, covering various aspects of ML application for KA. Topics of studies included imaging modalities (<em>n</em> = 28), postoperative primary KA complications (<em>n</em> = 26), inpatient status (length of stay, readmissions, and cost) (<em>n</em> = 24), implant configuration (<em>n</em> = 14), revision (<em>n</em> = 12), patient-reported outcome measures (PROMs) (<em>n</em> = 11), function (<em>n</em> = 11), procedural communication (<em>n</em> = 8), total knee arthroplasty/unicompartmental knee arthroplasty prediction (<em>n</em> = 6), outpatient status (<em>n</em> = 4), perioperative efficiency (<em>n</em> = 4), patient satisfaction (<em>n</em> = 3), opioid usage (<em>n</em> = 3). A total of 66 ML models were described, with 48.7% of studies using multiple approaches.</div></div><div><h3>Conclusion</h3><div>This review assesses ML applications in knee arthroplasty, highlighting their potential to improve patient outcomes. While current algorithms and AI show promise, our findings suggest areas for enhancement in predictive performance before widespread clinical adoption.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 28-49"},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520895","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":"A deep learning and statistical shape modeling-based method for assessing intercondylar notch volume in anterior cruciate ligament reconstruction","authors":"Anna Ghidotti ,&nbsp;Daniele Regazzoni ,&nbsp;Miri Weiss Cohen ,&nbsp;Caterina Rizzi ,&nbsp;Vincenzo Condello","doi":"10.1016/j.knee.2025.02.009","DOIUrl":"10.1016/j.knee.2025.02.009","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament (ACL) reconstruction is a widely performed procedure for ACL injury, but there are several factors which may lead to re-rupture or clinical failure. An intercondylar notch (or fossa) that is narrower may increase the likelihood of injury. Traditional two-dimensional assessments are limited, and three-dimensional (3D) volume analysis may offer more detailed insights. This study employs deep learning and statistical shape modeling (SSM) to enhance 3D modeling of the intercondylar notch, aiming to gain a deeper understanding of this complex 3D anatomical region.</div></div><div><h3>Methods</h3><div>A methodology was developed to generate accurate 3D models of the intercondylar fossa within seconds. The variability of the intercondylar notch in ACL-injured samples was analyzed using SSM techniques, focusing on its principal components. Additionally, gender differences in notch volume were examined using <em>t</em>-tests.</div></div><div><h3>Results</h3><div>The best deep learning method for automatic segmentation of the notch was SegResNet, which achieved a Dice similarity coefficient of over 0.88 and a Hausdorff distance of 0.73 mm. The small volume-related relative error (0.06) illustrates the goodness of the result. Three principal components accounted for 72.59% of the variation, including notch volume, shape, width, and height. Females had statistically significant smaller notch compared with males with ACL injury (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>By examining notch volume and its variability in ACL-injured patients, it is possible to understand the complex anatomy of the intercondylar notch and tailor ACL reconstructions accordingly.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 71-80"},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520896","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}