Knee最新文献

{"title":"Metaphyseal sleeves for revision total knee arthroplasty for patients with bone cement allergy and minimal bone loss: a case series","authors":"Juan Segura-Nuez ,&nbsp;Julián Carlos Segura-Nuez ,&nbsp;María Belén Castaño-Doste ,&nbsp;Adrián Roche-Albero ,&nbsp;Carlos Martín-Hernández","doi":"10.1016/j.knee.2025.08.009","DOIUrl":"10.1016/j.knee.2025.08.009","url":null,"abstract":"<div><h3>Background</h3><div>When evaluating persistent knee inflammation following total knee arthroplasty (TKA), hypersensitivity to implant components should be considered once other causes have been excluded. Revision total knee arthroplasty (rTKA) in patients with bone cement hypersensitivity presents a unique challenge.</div></div><div><h3>Method</h3><div>This study reports on four patients with clinical failure of TKA, three with confirmed allergy to polymethyl methacrylate (PMMA) and one to benzoyl peroxide, as demonstrated by skin patch testing. All patients underwent rTKA using metaphyseal sleeves. In three cases, diaphyseal stems were also used.</div></div><div><h3>Results</h3><div>After a mean follow-up of 71.2 months, all patients experienced symptomatic improvement, with a mean increase in range of motion (ROM) of 12.5 degrees. There was a mean increase of 16, 75 points in Knee Society Score. None required additional surgery.</div></div><div><h3>Conclusion</h3><div>In patients undergoing revision TKA due to confirmed allergy to bone cement and minimal bone loss, the use of metaphyseal sleeves—alone or in combination with stems—provides a viable cementless fixation strategy with promising mid-term outcomes.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 147-155"},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879796","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":"Combined high tibial osteotomy and osteochondral autograft transplantation for medial osteoarthritis with concomitant lateral femoral condyle cartilage lesions: A retrospective study","authors":"Shuzo Takazawa ,&nbsp;Yuki Kato ,&nbsp;Ken Ichikawa ,&nbsp;Takuya Okada ,&nbsp;Shin Yamada ,&nbsp;Hiroshi Ohuchi","doi":"10.1016/j.knee.2025.07.017","DOIUrl":"10.1016/j.knee.2025.07.017","url":null,"abstract":"<div><h3>Background</h3><div>Open-wedge high tibial osteotomy (OWHTO) is traditionally avoided in varus knees with medial osteoarthritis when accompanied by concomitant lateral femoral condyle (LFC) cartilage lesions, due to concerns about overloading the lateral compartment. This study aimed to evaluate the clinical outcomes of OWHTO combined with osteochondral autograft transplantation (OAT) in patients with such bicompartmental involvement.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 30 patients (30 knees) with varus knee osteoarthritis and LFC cartilage lesions who underwent OWHTO with concomitant OAT between January 2015 and December 2020. Radiographic assessments included the %mechanical axis (%MA) , hip–knee–ankle (HKA) angle, and joint line convergence angle (JLCA). Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales. Second-look arthroscopy evaluated cartilage repair at 12 months postoperatively.</div></div><div><h3>Results</h3><div>All radiographic parameters significantly improved postoperatively. The mean %MA changed from 36 % preoperatively to 66 % postoperatively (<em>P</em> &lt; 0.001). The HKA angle corrected from −7.2° to 1.6° (<em>P</em> &lt; 0.001). KOOS subscale scores for pain, symptoms, activities of daily living, sports and recreation, and quality of life all significantly improved (<em>P</em> &lt; 0.001). Second-look arthroscopy revealed cartilage repair classified as ICRS-CRA Grade 1 or 2 in the majority of cases.</div></div><div><h3>Conclusion</h3><div>Combining OWHTO with OAT was associated with significant clinical and radiographic improvements in patients with medial osteoarthritis accompanied by concomitant LFC cartilage lesions. This joint-preserving approach may offer a treatment option for selected patients with bicompartmental cartilage involvement, although further studies are needed to assess long-term outcomes.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 129-137"},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879695","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":"Nitrided titanium alloy component enhances detection of small bone defects after total knee arthroplasty","authors":"Sho Masuda ,&nbsp;Yukihide Minoda ,&nbsp;Yohei Ohyama ,&nbsp;Ryo Sugama ,&nbsp;Yoichi Ohta ,&nbsp;Hidetomi Terai","doi":"10.1016/j.knee.2025.07.014","DOIUrl":"10.1016/j.knee.2025.07.014","url":null,"abstract":"<div><h3>Background</h3><div>This study compared the accuracy of various imaging modalities in detecting small bone defects simulating radiolucent lines (RLLs) around femoral components made of nitrided titanium alloy (Ti-6Al-4V) versus cobalt–chromium (Co–Cr) alloy.</div></div><div><h3>Methods</h3><div>Eight femoral components (four nitrided titanium alloy and four Co–Cr alloy) were implanted into pig femurs. Two total knee arthroplasty (TKA) models were fabricated for each component: normal and RLL TKA models. Fluoroscopically guided plain radiography, tomosynthesis, computed tomography (CT), and magnetic resonance imaging (MRI) were performed. Thirty orthopaedic surgeons independently assessed the images to determine the presence or absence of bone defects. Sensitivity, specificity, and accuracy were compared between materials and imaging modalities.</div></div><div><h3>Results</h3><div>The accuracy of detecting bone defects was significantly higher in nitrided titanium alloy components than in Co–Cr alloy components using fluoroscopically guided plain radiography (66.7 % vs. 53.3 %, <em>P</em> = 0.048), tomosynthesis (87.5 % vs. 63.3 %, <em>P</em> &lt; 0.001), and CT (100 % vs. 61.7 %, <em>P</em> &lt; 0.001). MRI showed no significant difference (52.5 % vs. 55.8 %, <em>P</em> = 0.698). Furthermore, for nitrided titanium alloy components, the accuracy of detecting bone defects around the femoral components using CT was 100 %.</div></div><div><h3>Conclusions</h3><div>Small bone defects simulating RLLs were more easily detected around nitrided titanium alloy femoral components than around Co–Cr alloy components. Nitrided titanium alloy femoral components may offer an advantage by enabling earlier detection of loosening and potentially reducing the need for complex revision surgery. These findings may serve as one of several factors for surgeons to consider when selecting implant materials for TKA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 138-146"},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879795","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 anterior knee laxity measurements recorded by manual versus mechanical arthrometers in ACL reconstruction patients at return to sport","authors":"Alexander H. Fischbach ,&nbsp;Gregory D. Myer ,&nbsp;Kim D. Barber-Foss ,&nbsp;Nathan D. Schilaty ,&nbsp;Alexandra N. Sheldon ,&nbsp;Christopher V. Nagelli ,&nbsp;April L. McPherson ,&nbsp;Aaron J. Krych ,&nbsp;Nathaniel A. Bates","doi":"10.1016/j.knee.2025.08.006","DOIUrl":"10.1016/j.knee.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Arthrometers are devices used to evaluate knee laxity by quantifying anterior tibiofemoral displacement. The purpose of this study was to assess the congruence of tibiofemoral displacement measurements between manual and mechanical knee arthrometers in anterior cruciate ligament reconstructed (ACLR) patients.</div></div><div><h3>Methods</h3><div>This investigation evaluated 44 limbs in 22 subjects who underwent ACLR. All subjects were cleared for return to sport prior to enrollment. Participants underwent manual and mechanical arthrometer assessments of anterior knee laxity in the same visit. Both involved and uninvolved limbs were assessed. The magnitude of raw knee laxity measurements between arthrometers, inter-device associations, and rank-order significance of limb measurements were assessed. The impact of different post-operative training protocols on device measurements was also evaluated.</div></div><div><h3>Results</h3><div>Mean tibiofemoral displacement measurements for involved and uninvolved limbs were comparable for the mechanical arthrometer at 134 N and manual arthrometer at 89 N (<em>P</em> = 0.33), however, mean displacement values varied significantly between the two arthrometers at 134 N (<em>P</em> &lt; 0.01). Overall, significant associations between mechanical and manual arthrometer measurements were not observed. Rank order trended toward lower difference when comparing Side and Device (<em>P</em> &gt; 0.06). Consilience between mechanical and manual arthrometers was not observed in this investigation.</div></div><div><h3>Conclusions</h3><div>Multi-center studies or literature syntheses that incorporate more than one type of arthrometer should focus on reporting delta values as the present data demonstrated no significant repeated measures deltas between-devices.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 100-109"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867102","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":"Growth disturbance in paediatric anterior cruciate ligament reconstruction","authors":"Franck Accadbled ,&nbsp;Marco Crippa ,&nbsp;Marco Turati","doi":"10.1016/j.knee.2025.07.016","DOIUrl":"10.1016/j.knee.2025.07.016","url":null,"abstract":"<div><div>Anterior cruciate ligament (ACL) reconstruction in skeletally immature patients represents a significant challenge due to the risk of growth disturbance, including limb length discrepancy (LLD) and angular deformity (AD). Although rare, the consequences of such complications can be substantial. Contributing factors include inadequate clinical and radiological preoperative assessment and insufficient postoperative monitoring.</div></div><div><h3>Methods</h3><div>This review synthesizes the current understanding of growth disturbances after paediatric ACL reconstruction, examining their incidence, pathophysiology, and technical considerations. Growth anomalies, categorized as arrest (type A), overgrowth (type B), or tethering effect (type C), arise from physeal damage, periosteal disruption, or tunnel malposition, during autograft harvesting, bone tunnels placement or graft fixation.</div></div><div><h3>Results</h3><div>Surgical technique is crucial, with disturbances reported across transphyseal, all-epiphyseal, and extraosseous reconstructions, regardless of whether bone or soft tissue grafts are used. Meta-analyses indicate low overall rates of LLD and AD; however, reporting is complicated by heterogeneous definitions and follow up protocols.</div><div>Conclusions.</div><div>No single technique has demonstrated superiority in preventing growth disturbances, and most complications correlate with technical errors rather than the approach itself. Accurate assessment of growth potential – utilizing bone age, clinical markers, and radiographic tools – is paramount for surgical planning. Postoperative surveillance with clinical and full-length standing radiographs of the lower limbs is strongly recommended until skeletal maturity. While most growth disturbances are subclinical or self-limiting, significant anomalies may necessitate observation, guided growth procedures, or corrective osteotomy. Until high-level comparative studies are available, meticulous surgical technique and vigilant follow up are essential to minimize complications in this vulnerable population.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 60-67"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867003","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":"Unveiling the sensory architecture of the medial collateral ligament epiligament: A morphological study with clinical relevance","authors":"Nikola Stamenov ,&nbsp;Lyubomir Gaydarski ,&nbsp;R. Shane Tubbs ,&nbsp;Joe Iwanaga ,&nbsp;Maria Piagkou ,&nbsp;Svetoslav A. Slavchev ,&nbsp;Pavel Rashev ,&nbsp;Julian Ananiev ,&nbsp;Boycho Landzhov ,&nbsp;Georgi P. Georgiev","doi":"10.1016/j.knee.2025.07.019","DOIUrl":"10.1016/j.knee.2025.07.019","url":null,"abstract":"<div><h3>Background</h3><div>This cadaveric descriptive study was aimed at evaluation of the nerve fibers and mechanoreceptors of the epiligament of the medial collateral ligament (MCL) of the human knee – their distribution, density and potential clinical implications.</div></div><div><h3>Methods</h3><div>Tissue samples were obtained from 12 fresh cadavers, and 5-μm sections corresponding to the proximal, mid, and distal portions of the epiligament were stained with hematoxylin and eosin, Luxol fast blue/Cresyl violet, and antibodies against S100B and myelin basic protein. ANOVA and post hoc Tukey tests were used to assess the differences in density distributions of the neural elements in the different portions of the epiligament.</div></div><div><h3>Results</h3><div>The proximal region of the epiligament exhibited the highest density of both myelinated and unmyelinated nerve fibers and Meissner’s corpuscles, followed by the distal region, while the mid-portion, despite a lower density, contained larger-caliber nerve fibers –suggesting that primary nerve branches enter through the mid-region and subsequently branch into smaller fibers towards the proximal and distal areas.</div></div><div><h3>Conclusions</h3><div>This investigation is the first to document the presence of Meissner’s corpuscles within the epiligament of the MCL, thereby expanding our understanding of ligament mechanoreception. These findings underscore the pivotal role of the epiligament in mediating mechanoreception, nociception, proprioception, and blood flow regulation, and highlight its potential impact on ligament regeneration and post-surgical outcomes. Overall, our study advances the current knowledge of MCL innervation and lays the groundwork for future research into its therapeutic implications in knee joint biomechanics and ligament healing.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 110-119"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867100","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":"Meniscus extrusion and lower leg alignment predict the distribution of subchondral bone density across the knee joint","authors":"Koji Iwasaki ,&nbsp;Taku Ebata ,&nbsp;Tomoya Sato ,&nbsp;Yoshiaki Hosokawa ,&nbsp;Masanari Hamasaki ,&nbsp;Dai Sato ,&nbsp;Masatake Matsuoka ,&nbsp;Tomohiro Onodera ,&nbsp;Eiji Kondo ,&nbsp;Norimasa Iwasaki","doi":"10.1016/j.knee.2025.07.020","DOIUrl":"10.1016/j.knee.2025.07.020","url":null,"abstract":"<div><h3>Background</h3><div>Stress distribution is the pattern of mechanical load distribution, particularly between the medial and lateral compartments. Lower leg alignment and the meniscus play an important role in this distribution. CT-osteoabsorptiometry estimates stress distribution by analyzing the distribution pattern of subchondral bone density. This study aimed to explore the extent to which lower limb alignment and meniscal extrusion can explain the distribution of subchondral bone density.</div></div><div><h3>Methods</h3><div>This was a retrospective study including 92 patients (73 with osteoarthritis (OA) and 19 without OA). Lower limb alignment, meniscus-extrusion ratio (MER), and subchondral bone density were assessed using CT-osteoabsorptiometry. High-density areas (HDA) on the articular surface were quantitatively analyzed.</div></div><div><h3>Results</h3><div>Hip-knee-ankle (HKA) angle, medial MER (MMER), lateral MER (LMER), and medial compartment HDA to total HDA ratio (medial ratio) were −4.3°, 46.8 %, 20.4 %, and 70.0 %, respectively. Multiple regression analysis revealed that HKA, MMER, and LMER were significant variables. The adjusted R2 of HKA, MMER, and LMER for the medial ratio was 0.80. The standardized coefficients for HKA, MMER, and LMER were −0.30, 0.40, and −0.41, respectively.</div></div><div><h3>Conclusions</h3><div>Lower leg alignment and meniscus extrusion explain 80% of the variance in the distribution of subchondral bone density. These findings indicate that both factors can account for approximately 80% of the estimated stress distribution as assessed by CT-osteoabsorptiometry. The distribution of subchondral bone density estimated by HKA and meniscus extrusion was useful for diagnosing and treating knee osteoarthritis.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 68-76"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867101","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":"Prospective, randomized study comparing clinical outcomes when reconstructing ACL with either semitendinosus autograft or the Jewel synthetic standalone device in two separate patient cohorts","authors":"Maciej Kentel ,&nbsp;Sebastian Krupa ,&nbsp;Paweł Reichert ,&nbsp;Krzysztof Korolczuk ,&nbsp;Monika Kentel ,&nbsp;Kacper Kentel ,&nbsp;Maciej Daszkiewicz","doi":"10.1016/j.knee.2025.07.024","DOIUrl":"10.1016/j.knee.2025.07.024","url":null,"abstract":"<div><h3>Aim of the study</h3><div>This prospective study aimed to compare the clinical outcomes of ACL reconstruction using either a JewelACL synthetic ligament or a Semitendinosus (ST) autograft, with a minimum follow-up period of 2 years.</div></div><div><h3>Patients and methods</h3><div>This study enrolled 50 sports-active patients with anteromedial bundle injuries for primary standalone ACL reconstruction. In group I (20 patients with a BMI of 24.36 ± 2.32, and a mean age of 40.65 ± 11.43) the Jewel ACL synthetic graft was implemented, while in group II (30 patients with a BMI of 24.82 ± 3.25, and a mean age of 35.57 ± 7.18) the ST autograft was used, both with the same surgical technique. Pre- and postoperative assessments included ROM, Lachman, Pivot Shift, KT 1000, IKDC 2000, Cincinnati, Lysholm, Tegner scores, and time to return to sport.</div></div><div><h3>Results</h3><div>There was no statistical difference between the JewelACL and ST groups in ROM or scores. The JewelACL group returned earlier to participation at 2.6 months and to sports at 4.65 months, compared to 5.2 and 10.87 months for the ST group. On the day of surgery, 25 % of the JewelACL group and 37 % of the ST group had positive Pivot Shift tests. At 24 months, all JewelACL patients had negative results, while 10 % of the ST group remained positive. Three cases of hematoma at the donor site were noted in the ST group but none in the JewelACL group.</div></div><div><h3>Conclusions</h3><div>ACL reconstruction with both the ST autograft and JewelACL synthetic ligament provided similarly positive outcomes across nearly all measured scores. The JewelACL technique allows for a faster return to training and sports activities. In contrast, the ST group experienced donor site complications after harvesting, leading to delayed healing and a slower rehabilitation process.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 84-99"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867103","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":"GLP-1 agonists are protective against postoperative complications following total knee arthroplasty","authors":"Rachel Ranson ,&nbsp;Philip M. Parel ,&nbsp;Julia Kirkland ,&nbsp;Jackson W. Durbin ,&nbsp;Jordan C. Villa ,&nbsp;Robert Sterling","doi":"10.1016/j.knee.2025.08.007","DOIUrl":"10.1016/j.knee.2025.08.007","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 receptor agonists (GLP1RAs) have gained prominence for managing type 2 diabetes mellitus and obesity. Their impact in orthopedic surgery, particularly total knee arthroplasty (TKA), remains underexplored. Thus, this study aimed to investigate the influence of GLP1RAs on 90-day medical complications and 2-year surgical outcomes following TKA.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was performed using a national all-payer claims database. Patients who underwent primary TKA were stratified into two groups: patients who received a GLP1RA within 6 months prior to surgery (GLP-1 cohort) and patients who did not have a GLP1RA history. Outcomes included the incidence of 90-day readmission and medical complications, and 2-year surgical complications. Univariate and multivariable regression analysis was conducted to compare outcomes.</div></div><div><h3>Results</h3><div>Patients in the GLP-1 cohort exhibited a lower 90-day readmission rate (OR: 0.77; <em>P</em> &lt; 0.001) and fewer medical complications such as arrhythmia (OR: 0.78), death (OR: 0.24), and deep vein thrombosis (OR: 0.70) compared to the control (<em>P</em> &lt; 0.05 for all). However, they experienced a higher odds of acute renal failure (OR: 1.16; <em>P</em> = 0.001). No significant differences were observed in 2-year surgical outcomes.</div></div><div><h3>Conclusion</h3><div>GLP1RAs use is associated with a reduced incidence of certain 90-day medical complications following TKA. We believe that this is likely due to their effects on weight loss and glycemic control. However, they are associated with an increased risk of acute renal failure. GLP1RAs do not appear to influence long-term surgical outcomes, suggesting their benefits are primarily confined to the early postoperative period.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 77-83"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867104","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":"Association of autophagy-related proteins in serum and synovial fluid with the severity of knee osteoarthritis","authors":"Hamza Malik Okuyan ,&nbsp;Serdar Dogan ,&nbsp;Hazal Fatma Erdoğan ,&nbsp;Aydıner Kalacı","doi":"10.1016/j.knee.2025.07.022","DOIUrl":"10.1016/j.knee.2025.07.022","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis (OA) is a highly prevalent painful joint disease that significantly reduces the quality of life and causes physical disability. Recently, autophagy has gained significant attention due to its role in the pathogenesis of OA. However, there is no study examining the role of autophagy-related proteins (ATGs) in the serum and synovial fluid (SF) of OA patients. Here, we aim to investigate the relationship of ATGs with the radiographic findings and symptomatic severity of knee OA.</div></div><div><h3>Methods</h3><div>We enrolled 43 OA patients and 37 patients with other knee joint disorders (non-OA knee disease) in the study. The radiographic grading and symptomatic severity of OA were evaluated using the Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores and the Kellgren-Lawrence (KL) classification, respectively. ATGs, including BECN1, LC3A and ATG3 were measured with an enzyme-linked immunosorbent assay.</div></div><div><h3>Results</h3><div>BECN1 expressions in the OA group were higher than in the non-OA knee disease group (<em>p</em> &lt; 0.05). The SF LC3A and SF ATG3 expressions in OA were markedly elevated compared to the non-OA knee disease group (<em>p</em> &lt; 0.05). SF LC3A and SF ATG3 expressions in grade 4 OA patients were higher than in grade 3 OA patients (<em>p</em> &lt; 0.05). Moreover, SF ATG3 was significantly correlated with the severity of OA symptoms. We found that the area under the ROC curve for serum BECN1, SF BECN1, SF LC3A, and SF ATG3 was 0.6908, 0.6496, 0.6681, and 0.7034, respectively (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>We report that ATGs might indicate potential diagnostic value and are closely associated with the severity and progression of OA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"57 ","pages":"Pages 37-46"},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828608","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}