Knee最新文献

{"title":"Treatment options and outcomes for paediatric knee cartilage lesions: a systematic review","authors":"Matthew Bellamy ,&nbsp;Saleem Mastan ,&nbsp;Nicolas Nicolaou ,&nbsp;Matthew Hampton","doi":"10.1016/j.knee.2025.08.020","DOIUrl":"10.1016/j.knee.2025.08.020","url":null,"abstract":"<div><h3>Background</h3><div>Many treatments exist for paediatric knee cartilage lesions, without a clear consensus or gold standard. This systematic review analyses surgical approaches and assesses outcome evidence.</div></div><div><h3>Methods</h3><div>OVID Medline and EMBASE were searched to January 2025 using a customised strategy with MESH terms. Two reviewers independently screened studies on paediatric knee cartilage pathology (age &lt;18), including microfracture, autologous matrix-induced chondrogenesis (AMIC), autologous chondrocyte implantation (ACI), osteochondral allograft transplantation (OCA), osteochondral autograft transfer (OATS), or chondroplasty. Risk of bias assessment utilised ROB2 and MINORS. Analysis focused on outcome score improvements, with subgroup analysis by technique, age, location, failure rates, and lesion size.</div></div><div><h3>Results</h3><div>This review included 18 studies (12/18 case series) with 475 patients (56 % male). Most studies had high bias risk and low methodological quality. Follow-up ranged from 1 to 9.6 years. The medial femoral condyle (MFC) was the most common location (177 patients). OATS outperformed microfracture in radiographic repair and return-to-sport. OCA improved pain and function for larger defects and had the lowest failure rates. ACI consistently enhanced function, while microfracture was primarily used for smaller lesions. Internal fixation when added to concurrent procedures had mixed results, sometimes underperforming excision but showing some MRI-confirmed cartilage restoration. Smaller (&lt;2 cm) and MFC defects had better outcomes. Older adolescents more often received OCA or ACI.</div></div><div><h3>Conclusions</h3><div>ACI, OATS and OCA show the most promise for treating paediatric knee cartilage defects, but significant variability in techniques and outcomes remains. A gold standard is crucial to prevent long-term complications in this young population.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 298-310"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060376","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":"Contents contd","authors":"","doi":"10.1016/S0968-0160(25)00235-2","DOIUrl":"10.1016/S0968-0160(25)00235-2","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages IV-V"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060419","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":"masterclass_in_research","authors":"","doi":"10.1016/S0968-0160(25)00234-0","DOIUrl":"10.1016/S0968-0160(25)00234-0","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Page III"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060418","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":"Morphological changes observed on serial magnetic resonance imaging of repaired medial meniscal horizontal cleavage tears","authors":"Dong Hwan Lee ,&nbsp;Sung-Sahn Lee ,&nbsp;Dae-Hee Lee","doi":"10.1016/j.knee.2025.08.018","DOIUrl":"10.1016/j.knee.2025.08.018","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the healing rate and postoperative changes on serial magnetic resonance imaging (MRI) of horizontal cleavage tears (HCTs) repaired using outside-in vertical suture technique.</div></div><div><h3>Methods</h3><div>Thirty patients who underwent meniscal repair for HCTs between November 2019 and October 2022 were enrolled. Surgeries were performed using outside-in vertical sutures with a spinal needle and suture hook with two shuttle relays. The sagittal meniscal width (SMW) and sagittal meniscal height (SMH) were measured using MRI preoperatively, immediately postoperatively, and 2 years postoperatively.</div></div><div><h3>Results</h3><div>Compared with preoperative MRI, immediate postoperative MRI revealed decreased SMW and increased SMH, resulting in a trapezoidal shape. However, over time, the 2-year postoperative MRI showed increased width and decreased height compared with the immediate postoperative MRI, suggesting that this contributes to remodeling into a triangular shape.</div></div><div><h3>Conclusion</h3><div>The outside-in vertical suture technique for HCTs showed good clinical outcomes and successful healing of the repaired HCTs on serial postoperative MRI.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 267-276"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049045","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":"In vivo six degrees of freedom kinematics during step ascent in three total knee arthroplasty designs: A randomised clinical trial","authors":"Theresa Wallner ,&nbsp;Joseph T. Lynch ,&nbsp;Diana M. Perriman ,&nbsp;Jennie M. Scarvell ,&nbsp;Mark R. Pickering ,&nbsp;Catherine R. Galvin ,&nbsp;Paul N. Smith","doi":"10.1016/j.knee.2025.08.016","DOIUrl":"10.1016/j.knee.2025.08.016","url":null,"abstract":"<div><h3>Background</h3><div>Total knee replacement (TKR) is generally successful in alleviating joint pain, and restoring function, however, select patients experience continuing discomfort and unsatisfactory functional outcomes postoperatively. These deficits are particularly evident in highly demanding activities such as a step-up motion. The aim of this study was to compare the six degrees of freedom kinematics of three common TKR designs during step-up.</div></div><div><h3>Methods</h3><div>Sixty-eight participants were randomised to receive one of three TKR implants: cruciate-retaining fixed bearing (CR-FB), cruciate-retaining rotating platform (CR-RP) or posterior-stabilised fixed bearing (PS-FB). Participants performed a step-up task which was imaged via single-plane fluoroscopy at 12 and 24 months postoperatively. Implant models were registered to the fluoroscopy, generating kinematic data. Linear regression models were used to test the effect of implant design on kinematics during step-up.</div></div><div><h3>Results</h3><div>Fifty-four participants were included in the final analysis. Key kinematic findings were that the CR-FB designs started and remained more posterior on the tibia throughout step-up. Furthermore, CR-RP designs consistently demonstrated greater degrees of external femoral rotation. Interestingly, there were no differences in rotation or translation between designs.</div></div><div><h3>Conclusions</h3><div>The findings indicate that there may be kinematic advantages when selecting a particular implant design. However, the CR-FB design demonstrated unique kinematics which may favour a more efficient step-up. Further investigation of the relative biomechanical efficiency of the CR-FB implant would be an interesting next step in this research.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 256-266"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049046","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":"Clinical comparative evaluation of anterior cruciate ligament reconstruction supported by an orthopedic surgical simulation system","authors":"Song Li ,&nbsp;Xuewei Wen ,&nbsp;ZhiYue Zhang ,&nbsp;Yanlin Li ,&nbsp;Xiao Yang ,&nbsp;LiChao Zhang ,&nbsp;Shuo Li ,&nbsp;Tian Fu Jin ,&nbsp;GuangChao Chen ,&nbsp;ZiMing Gu ,&nbsp;YaTong Liao ,&nbsp;Fan Wang ,&nbsp;RunZe Li ,&nbsp;MinYuan Zhang ,&nbsp;FengYuan Guo ,&nbsp;Chuan He","doi":"10.1016/j.knee.2025.08.017","DOIUrl":"10.1016/j.knee.2025.08.017","url":null,"abstract":"<div><h3>Objective</h3><div>This study utilizes self-developed BioMxsf software to establish a virtual surgical system that assists in the surgical process of anterior cruciate ligament (ACL) reconstruction through a three-dimensional imaging model of the knee joint. Introducing these technical methods can provide insights and references to improve ACL reconstruction in clinical practice.</div></div><div><h3>Methods</h3><div>After scanning the knee joint data of patients and importing it into the BioMxsf software, a three-dimensional image model of the knee joint was created. A virtual surgical system was established to support the operational process of ACL reconstruction surgery. The ACL reconstruction surgery was performed on patients with the assistance of the virtual surgical system.</div></div><div><h3>Results</h3><div>The average surgical time for the BioMxsf simulation group (BSG) was 97.7 ± 8.5 min. In contrast, the surgical time for the conventional surgery group (CSG) was 107.4 ± 7.8 min, indicating a significant reduction in surgery duration (<em>P</em> ≤ 0.014, Chi-square test). In terms of functional scores, the CSG had a score of 81.4 ± 3.14. In contrast, the BSG scored 84.97 ± 3.97, demonstrating that patients in the BSG had better postoperative knee function than those in the CSG, with a statistically significant difference (<em>P</em> = 0.016). Although the functional scores reached statistical significance, they were below the reported minimal clinically important difference and are unlikely to be clinically meaningful.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the clinical feasibility of a virtual surgical system to assist ACL reconstruction. The virtual surgical system significantly reduced operative time and enhanced ACL reconstruction’s safety.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 244-255"},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027002","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 regarding: \"Re-evaluation of the Cartilage Safety of Low-Dose Tranexamic Acid\".","authors":"","doi":"10.1016/j.knee.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.knee.2025.08.004","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008684","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":"MRI templating for Oxford partial knee replacement femoral component – a novel sizing method","authors":"Brendon Newton ,&nbsp;Ben Waller ,&nbsp;Ritwik Kejriwal","doi":"10.1016/j.knee.2025.08.014","DOIUrl":"10.1016/j.knee.2025.08.014","url":null,"abstract":"<div><h3>Background</h3><div>Correct sizing of Oxford Medial Unicompartmental Knee Replacement (OUKR) femoral component can be challenging. Incorrect sizing can increase risk of bearing dislocation or revision. This study aimed to assess the accuracy of a simple but novel templating method in sizing the femoral component in OUKR.</div></div><div><h3>Methods</h3><div>A single surgeon retrospective study was performed reviewing all patients who underwent OUKR between April 2017 and May 2024 comparing those sized with the templating method with those sized by standard means. The method consisted of a circular fit over the posterior medial condyle of the femur on sagittal T2-weighted MRI sequence from which the component size was templated. Comparison between the groups was made by analyzing post operative radiographs for correct component sizing. Correctly sized components had a posterior condylar overhang of 0–4 mm. An interobserver reliability assessment of the templating method was conducted.</div></div><div><h3>Results</h3><div>121 OUKR met the selection criteria with 61 in the MRI templated group and 60 in the standard group. The MRI group was significantly more likely to have correctly sized femoral components than the standard group (72 % vs 54 %, <em>p</em> = 0.04). Average deviation from the correct size was also significantly lower in the MRI group (1.7 mm vs 2.3 mm, <em>p</em> = 0.01). Interobserver reliability was 75.9 % with Cohen’s Kappa 0.59 (<em>p</em> = 0.09).</div></div><div><h3>Conclusion</h3><div>Our novel preoperative MRI templating technique is a simple and useful tool that can improve sizing accuracy in UKR when compared with traditional intraoperative sizing methods.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 237-243"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924961","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":"Aseptic loosening in non-augmentable versus augmentable tibial baseplate total knee arthroplasty designs: a single-centre comparative 10-year outcomes study","authors":"Saskia Locke ,&nbsp;James Doonan ,&nbsp;Emma Bailey ,&nbsp;Emily Seymour-Jackson ,&nbsp;Nathan Campbell ,&nbsp;Mark J.G. Blyth ,&nbsp;Bryn G. Jones","doi":"10.1016/j.knee.2025.08.013","DOIUrl":"10.1016/j.knee.2025.08.013","url":null,"abstract":"<div><h3>Background</h3><div>Aseptic tibial loosening is a leading cause of revision in total knee arthroplasty (TKA). Previous work has highlighted concerns over the 5-year survivorship of a specific non-augmentable NexGen Legacy Posterior Stabilised (LPS) tibial baseplate. This study compares the long-term outcomes of augmentable versus non-augmentable tibial implants with a minimum 10-year follow-up.</div></div><div><h3>Methods</h3><div>A retrospective analysis identified patients undergoing primary cemented TKA between 2009 and 2014. Patients were categorised by tibial baseplate type (augmentable vs. non-augmentable). The primary outcome was aseptic loosening, assessed using Kaplan-Meier survival analysis. Secondary outcomes included overall revision rates and reasons for revision with a subgroup analysis by age and BMI.</div></div><div><h3>Results</h3><div>Among 1830 TKAs, revision rates were significantly higher in the non-augmentable group (6.4 % vs. 4.1 %; <em>p</em> = 0.036). Aseptic loosening was five times more common with non-augmentable implants (2.5 % vs. 0.7 %; <em>p</em> = 0.005). Kaplan-Meier analysis showed significantly reduced survivorship in the non-augmentable group due to aseptic loosening (<em>p</em> = 0.0012, HR = 0.262), with a marked decline after 100 months. Patients under 65 with higher BMI had greater risk, with aseptic loosening occurring in 9.1 % of those with BMI &gt; 40 kg/m².</div></div><div><h3>Conclusion</h3><div>Non-augmentable NexGen LPS tibial implants are associated with higher rates of aseptic tibial loosening at long-term follow-up when used in combination with a posterior stabilised NexGen femoral implant. Younger, high-BMI individuals are at particular risk. These findings support the need for further investigation into the mechanisms of implant failure, as well as a more granular approach to data reporting within large-scale registries to avoid camouflage by more successful implants of the same brand.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 228-236"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921386","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":"What’s new in artificial intelligence applications for knee surgery?","authors":"Marc Huttman (Academic Clinical Fellow),&nbsp;Vipin Asopa (Associate Editor),&nbsp;Caroline Hing (Editor-in-Chief)","doi":"10.1016/j.knee.2025.08.015","DOIUrl":"10.1016/j.knee.2025.08.015","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages A1-A2"},"PeriodicalIF":2.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979894","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}