Knee最新文献

{"title":"New-onset anxiety and depression after anterior cruciate ligament reconstruction: A national database study of incidence, risk-factors, and outcomes","authors":"Andrea H. Johnson,&nbsp;David C. Lutati,&nbsp;Jacob Z. Offer,&nbsp;Jane C. Brennan,&nbsp;Benjamin M. Petre,&nbsp;James J. York,&nbsp;Daniel E. Redziniak,&nbsp;Justin J. Turcotte","doi":"10.1016/j.knee.2025.05.005","DOIUrl":"10.1016/j.knee.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>Prior studies evaluating the mental-health burden of recovery from anterior cruciate ligament reconstruction (ACLR) have focused primarily on athletes. The purpose of this study is to evaluate rates of new-onset anxiety and depression (NOAD) after ACLR and identify risk factors in the broad population of ACLR patients.</div></div><div><h3>Methods</h3><div>A retrospective review of the PearlDiver national database was performed. All patients included had no prior diagnosis of depression or anxiety prior to undergoing ACLR and had ≥1-year follow-up. The primary outcome was development of NOAD within 1-year postoperatively. Multivariate regression was used to assess predictors of NOAD; clinical outcomes were compared between patients with and without NOAD.</div></div><div><h3>Results</h3><div>Of the 20,442 ACLR patients included, 1,284 (6.3%) were diagnosed with NOAD within 1-year postoperatively. Men (OR: 0.63, <em>p</em> &lt; 0.001) and patients from the southern US (OR: 0.81, <em>p</em> = 0.007) had lower rates of NOAD. Conversely, older patients (OR: 1.02, <em>p</em> &lt; 0.001), patients with alcohol disorders (OR: 2.19, <em>p</em> &lt; 0.001), anemia (OR: 1.26, <em>p</em> = 0.008), headaches/migraines (OR: 1.60, <em>p</em> &lt; 0.001), obesity (OR: 1.38; <em>p</em> &lt; 0.001), sleep apnea (OR: 1.40, <em>p</em> &lt; 0.001), tobacco use (OR: 2.15, <em>p</em> &lt; 0.001), and preoperative opioid use (OR: 1.23, <em>p</em> = 0.001) had higher rates of NOAD. Postoperatively, patients with NOAD had higher rates of 90-day readmission (1.1% vs. 0.3%; <em>p</em> &lt; 0.001), higher rates of opioid use at 1-year (30.7% vs. 20.4%; <em>p</em> &lt; 0.001), and higher rates of additional knee surgery at 2-years (5.4% vs. 3.2%; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The current study highlights risk factors for NOAD after ACLR that may be used to identify at-risk populations. The development of targeted multidisciplinary interventions may improve outcomes for these patients.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 29-40"},"PeriodicalIF":1.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099214","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":"Developing and validating a machine learning model to predict chronic pain following total knee arthroplasty","authors":"Ziliang Cheng ,&nbsp;Jingjing Li ,&nbsp;Weishan Wu ,&nbsp;Jiguang Yin ,&nbsp;Xiangpeng Wang","doi":"10.1016/j.knee.2025.05.011","DOIUrl":"10.1016/j.knee.2025.05.011","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to compare the performance of various machine learning algorithms in predicting chronic pain after total knee arthroplasty (CPSP).</div></div><div><h3>Methods</h3><div>Patients with CPSP after total knee arthroplasty at the same medical center between January 1, 2021, and January 1, 2023, were selected for this study. A retrospective cohort design was employed to collect samples, which were then randomly divided into a training set and a test set in a 7:3 ratio. Valid high-risk factors were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) method. Subsequently, five predictive models were constructed and evaluated based on machine learning (ML) algorithms, including Decision Tree (DT), Light Gradient Boosting Machine (LGBM), Support Vector Machine (SVM), Random Forest (RF), and Extreme Gradient Boosting (XGBoost). In the test dataset, the model’s performance was evaluated using metrics including accuracy, precision, recall, specificity, F1-score, Brier score, and area under the curve (AUC). The Brier score helped identify the most suitable model, and SHAP values were explained to analyze the key factors affecting the predictions.</div></div><div><h3>Results</h3><div>This study enrolled 785 patients who underwent total knee arthroplasty, with 549 in the training − set and 236 in the test − set. The overall CPSP incidence was 39.6%. Nine high − risk factors were identified: hospital stay length, albumin levels, acute postoperative pain status (APSP), non-operative pain status, pain catastrophizing, osteoporosis, preoperative operative-area pain score, education level, and rehabilitation site. The AUC values were: DT(0.877), LGBM(0.914), SVM(0.890), RF(0.918), and XGBoost(0.898). The Brier scores were: DT (0.123), LGBM (0.119), SVM (0.126), RF (0.111), and XGBoost (0.124). These findings suggest that the RF model had the best performance.</div></div><div><h3>Conclusion</h3><div>The incidence of CPSP in TKA patients is high, which has a significant adverse effect on body function and needs to be paid attention to. Nine risk factors have been identified. RF model can effectively identify CPSP patients, which is helpful for clinical medical staff to early identify and intervene in high-risk patients.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 52-65"},"PeriodicalIF":1.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099127","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":"Evaluation of the healing effect of kappa-carrageenan combined with dental pulp stem cell-derived exosomes on induced knee osteoarthritis in male rats","authors":"Maryam Jalahi ,&nbsp;Sina Shahijani ,&nbsp;Azadeh Jalahi ,&nbsp;Mohammad Hosseini ,&nbsp;Mohammad Farzam ,&nbsp;Amir Reza Dehghanian ,&nbsp;Fatemeh Akbarizadeh ,&nbsp;Sara Varzandian ,&nbsp;Nader Tanideh","doi":"10.1016/j.knee.2025.04.020","DOIUrl":"10.1016/j.knee.2025.04.020","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis (OA) is a degenerative joint disease that causes pain and reduces quality of life. Exosomes, dental pulp stem cells, and kappa carrageenan are arising as potential therapies for enhancing cartilage regeneration.</div></div><div><h3>Objective</h3><div>The aim of this study is to evaluate the combined therapeutic effects of exosomes, dental pulp stem cells, and kappa carrageenan in reducing osteoarthritis severity.</div></div><div><h3>Materials and methods</h3><div>Fifty-four male Sprague Dawley rats (10-wk-old, 200 ± 20 gr) were divided into nine groups. Human dental pulp stem cells (HDPSCs) were isolated from healthy third Molars of human teeth and cultured. Osteoarthritis was induced by anterior cruciate ligament transection. Treatments included intra-articular injections of kappa carrageenan, exosomes, HDPSCs, or their combinations. Ten weeks after treatment, knee joints were obtained and prepared for histopathological evaluation. Radiological evaluations were performed with CBCT imaging. A p-value of less than 0.05 is considered statistically significant.</div></div><div><h3>Results</h3><div>The group treated with Exosomes, Carrageenan, HDPSCs (ECD group) showed the most substantial reduction in Total Radiology and Osteophyte scores (<em>p</em> &lt; 0.0001 and <em>p</em> = 0.0003, respectively).</div><div>The exosome with HDPSCs group also showed significant improvements (<em>p</em> = 0.0002 and <em>p</em> = 0.0005). Histopathological analysis showed that the ECD group had significantly better cartilage integrity, matrix structure, and cell viability (<em>p</em> = 0.0225, <em>p</em> = 0.0002, and <em>p</em> = 0.0009). In Masson’s Trichrome and Safranin O staining, the ECD, ED, and EC-treated groups demonstrated improved matrix quality with better collagen alignment.</div></div><div><h3>Conclusions</h3><div>The intraarticular injection of the combination of exosomes, carrageenan, and HDPSCs significantly improved both the radiological and histopathological results in an osteoarthritis model.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 11-21"},"PeriodicalIF":1.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089552","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":"Extended oral antibiotic prophylaxis and PJI-free survivorship after primary total knee arthroplasty","authors":"Andrew A. Fuqua ,&nbsp;Jacob A. Worden ,&nbsp;Ayomide M. Ayeni ,&nbsp;Kyle E. Bundschuh ,&nbsp;Ajay Premkumar ,&nbsp;Jacob M. Wilson","doi":"10.1016/j.knee.2025.04.005","DOIUrl":"10.1016/j.knee.2025.04.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent evidence has emerged supporting the use of extended oral antibiotic (EOA) prophylaxis after primary total knee replacement (TKA) to reduce periprosthetic joint infection (PJI) in high-risk patients. However, much of the evidence stems from single-institution series with limited sample sizes. This study aimed to explore the impact of EOA on complications and infection-free survivorship in a large cohort of patients after primary TKA.</div></div><div><h3>Methods</h3><div>A large national database was used to identify patients undergoing primary TKA from 2015 to 2022. Patients receiving 7–14 days of EOA were identified. Propensity-score matching, based on patient comorbidities, was used to match patients who received EOA and to control patients who did not. Three cohorts were created: any-risk, high-risk, and standard-risk. Complications at 90-days were assessed with univariate analysis and survivorship free of PJI to 2 years was analyzed with the Kaplan-Meier method and cox regression.</div></div><div><h3>Results</h3><div>We identified 5,701 patients who received EOA: 3,628 (64%) with high-risk comorbidities and 2,073 (36%) standard risk. There were no significant reduction in hazard of PJI at 90-days (any-risk: HR: 1.65, 95% CI: 0.90–3.04, <em>P</em> = 0.11; high-risk: HR: 1.37, 95% CI: 0.69–2.70, <em>P</em> = 0.4; standard-risk: HR: 1.51, 95% CI: 0.53–4.26, <em>P</em> = 0.4), 1 year (<em>P</em> &gt; 0.07), or 2 years (any-risk: HR: 1.42, 95% CI: 0.98–2.05, <em>P</em> = 0.065; high-risk: HR: 1.14, 95% CI: 0.76–1.73, <em>P</em> = 0.5; standard-risk: HR: 1.51, 95% CI: 0.76–2.98, <em>P</em> = 0.2) with EOA administration.</div></div><div><h3>Discussion</h3><div>EOA prophylaxis was not associated with improved PJI-free survivorship at any measured time point following primary TKA in either high-risk or standard-risk risk patients. Given the observed widespread use of EOA, our study highlights the need for further investigation to delineate what specific populations may benefit from EOA prophylaxis.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072520","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":"Good results with low failure rate and high patients’ satisfaction after selective bundle anterior cruciate ligament (ACL) reconstruction for partial tears at average 14-years follow-up","authors":"Nicola Pizza ,&nbsp;Pietro Conte ,&nbsp;Marco Concha ,&nbsp;Francisco J. Simón-Sánchez ,&nbsp;Maximiliano Ibañez ,&nbsp;Raul Torres Claramunt ,&nbsp;Alexandros Sartidis ,&nbsp;Michael Hantes ,&nbsp;Simone Perelli ,&nbsp;Joan Carles Monllau","doi":"10.1016/j.knee.2025.04.015","DOIUrl":"10.1016/j.knee.2025.04.015","url":null,"abstract":"<div><h3>Purpose</h3><div>Aim of this study was to report the long-term outcomes of a cohort of patients treated with a selective bundle ACL reconstruction of a partial tear evaluating functional results as well as failure and satisfaction rates. The hypothesis was that good clinical results, high satisfaction and low failure rates could be obtained.</div></div><div><h3>Methods</h3><div>Patients treated with selective bundle ACL reconstruction between September 2008 and September 2011 were included. Functional assessment was performed with the objective International Knee Documentation Committee (IKDC) ligament evaluation form, the Lysholm knee scale and the Tegner activity level scale.</div></div><div><h3>Results</h3><div>Fifty-two patients were available for follow up. The average follow-up period was 14 years (13–16). Twenty-two had anteromedial bundle tears and 30 had posterolateral bundle tears. On average, a significant improvement was obtained from pre-surgery to last follow-up for Lysholm (pre-surg 64.1 ± 5.1; last follow-up 95.8 ± 6.2; p &lt; 0.001) and subjective IKDC (pre-surg 56.5 ± 7.5; last-follow-up 91.6 ± 9.8; p &lt; 0.001) scores. 3 patients underwent ACL revision surgery in the first-year post-surgery and 3 patients reported subjective instability accounting for a cumulative failure rate of 11.5% (6/52) and 7.7% of dissatisfied patients (4/52).</div></div><div><h3>Conclusion</h3><div>Selective bundle ACL reconstruction for partial ACL tears enable good to excellent results with high satisfaction (92.3%) and low revision rates (5.7%) at long-term follow-up (minimum 13 years, mean 14 years).</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 161-167"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924420","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 role of chitosan in tissue healing after primary repair of quadriceps tendon ruptures: Experimental animal model","authors":"Tevfik Çatal ,&nbsp;Alkan Bayrak ,&nbsp;Ahmet Çanlıoğlu ,&nbsp;Başar Burak Çakmur ,&nbsp;Murat Tıngır ,&nbsp;Alev Kural ,&nbsp;Ahmet Gülçubuk ,&nbsp;Gülay Yüzbaşıoğlu Öztürk ,&nbsp;Cemal Kural ,&nbsp;Altuğ Duramaz","doi":"10.1016/j.knee.2025.04.018","DOIUrl":"10.1016/j.knee.2025.04.018","url":null,"abstract":"<div><h3>Aim</h3><div>To expedite the healing of tendons by introducing chitosan to the repaired tendon site.</div></div><div><h3>Methods</h3><div>Thirty-six adult, male Wistar Albino rats (300–450 g) were randomly divided into three groups. A full-thickness quadriceps injury model was created in the right hind leg of all animals. The first group did not undergo any intervention (control group). In the second group, primary repair was performed following injury (primary suturing (PS) group). In the third group, primary repair was performed, and 50 mg chitosan was administered via injection at the repair site (PS+Chitosan group). Tail venous blood samples were collected from all rats on days 0, 3, 7 and 14. On days 14 and 28, four subjects from each group were sacrificed for histopathologic evaluation. On day 28, four subjects from each group were sacrificed for biomechanical investigation.</div></div><div><h3>Results</h3><div>The mean total value of the PS+Chitosan group on day 28 was lower than the mean total value of the control group on days 14 and 28 (<em>P</em> = 0.004). The mean IL-1β value on day 14 was higher in the PS group compared with the other groups (<em>P</em> &lt; 0.001). The mean TGF-β value on day 14 was lower in the PS+Chitosan group compared with the other groups (<em>P</em> &lt; 0.001). The average maximal tensile resistance in the monitor group was 1.51 N/mm². Although statistically significant results were not found, the PS+Chitosan group exhibited biomechanical values that were most similar to those of the intact tendon, while the control group displayed the most divergent results.</div></div><div><h3>Conclusion</h3><div>Chitosan application accelerates tendon healing after repair in quadriceps tendon injuries in our rat model. Chitosan affects different pathways and enhances tendon healing as observed in our study.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 193-205"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918507","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":"Five key ultrasound findings associated with medial meniscus posterior root tear","authors":"Manase Nishimura ,&nbsp;Yasushi Takata ,&nbsp;Yosuke Shima ,&nbsp;Kenichi Goshima ,&nbsp;Kengo Shimozaki ,&nbsp;Mitsuhiro Kimura ,&nbsp;Naoki Takemoto ,&nbsp;Kentaro Fujita ,&nbsp;Satoru Demura ,&nbsp;Junsuke Nakase","doi":"10.1016/j.knee.2025.04.021","DOIUrl":"10.1016/j.knee.2025.04.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Medial meniscus posterior root tear (MMPRT) is a critical condition leading to knee osteoarthritis. Although MRI is the standard diagnostic tool, its availability and cost can be limiting. This study aimed to identify characteristic ultrasound (US) findings of MMPRT and determine the criteria for recommending MRI.</div></div><div><h3>Methods</h3><div>This multicenter prospective study included 100 patients (101 knees, mean age 58.3 ± 11.2 years, 58 males and 42 females) with medial knee joint pain. All patients underwent US and MRI evaluations. US findings included joint effusion, synovial hypertrophy, and medial meniscus extrusion (MME) in the supine, 90° flexion, and standing positions. Color Doppler evaluation of Doppler signals (DSs) in the bursa and through the femur and tibia were performed. Statistical analysis compared US findings between MMPRT and non-MMPRT groups.</div></div><div><h3>Results</h3><div>The MMPRT group showed significantly higher rates of joint effusion (<em>p</em> = 0.028) and increased MME in all positions (<em>p</em> &lt; 0.001). MME changed from 0° to 90° knee flexion (<em>p</em> = 0.003). Color Doppler evaluations revealed DSs through the femur (<em>p</em> = 0.008) and tibia (<em>p</em> = 0.013). Horizontal meniscal tears were more frequent in the non-MMPRT group (<em>p</em> &lt; 0.001). For three or more positive parameters, sensitivity and specificity were 80% and 82.7%, respectively.</div></div><div><h3>Conclusion</h3><div>Five key US findings—joint effusion, increased MME, smaller MME change in knee flexion, fewer horizontal meniscal tears, and increased DSs through the femur and tibia—are characteristic of MMPRT. These suggest that US can effectively identify patients requiring MRI, facilitating early management.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 186-192"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918509","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":"Is medial soft tissue laxity more important than lateral laxity after total knee arthroplasty?","authors":"Hideki Mizu-uchi ,&nbsp;Shojiro Ishibashi ,&nbsp;Shinya Kawahara ,&nbsp;Takuro Yara ,&nbsp;Yasuharu Nakashima ,&nbsp;Darryl D. D’Lima","doi":"10.1016/j.knee.2025.04.016","DOIUrl":"10.1016/j.knee.2025.04.016","url":null,"abstract":"<div><h3>Background</h3><div>The optimal range of soft tissue balance that consistently leads to better patient outcomes has yet to be identified in total knee arthroplasty. This study aimed to analyze the effect of soft tissue tightness on Knee Society Score by grouping patients by extent of medial or lateral laxity and mediolateral balance.</div></div><div><h3>Methods</h3><div>Varus and valgus laxity were measured using stress radiographs for 95 varus-deformed osteoarthritis knees (82 patients). The joint line angle and the joint gap were calculated using digital measurement software and computer-aided design models of the implants. We divided patients based on medial and lateral joint gaps into three groups: tight (&lt;3 mm), intermediate (3–6 mm), and loose (&gt;6 mm).</div></div><div><h3>Results</h3><div>Postoperative joint line angles averaged 5.1 (1.8)° for varus stress and −4.6 (2.1)° for valgus stress. Medial joint gaps under valgus stress were 3.5 (1.6) mm and lateral joint gaps under varus stress were 3.9 (1.4) mm. The intermediate medial laxity group had the highest knee scores, and satisfaction scores in particular were significantly better than the two other groups. Patients with intermediate lateral laxity achieved significantly greater postoperative flexion compared with that in the two other groups. There were no significant differences in Knee Society Scores or range of motion among the patients grouped by mediolateral balance.</div></div><div><h3>Conclusions</h3><div>Achieving intermediate medial laxity is more impactful than equal mediolateral balance for better postoperative outcome. Clinically undetectable medial tightness may be more common without an accurate ligament balancer during the surgery.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 206-213"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918429","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":"Optimal cut-off scores of performance-based tests of physical function to discriminate disease severity in patients with knee osteoarthritis","authors":"Gulsah Ozsoy ,&nbsp;Muhammed Ihsan Kodak ,&nbsp;Caner Kararti ,&nbsp;Fatih Ozyurt ,&nbsp;Seyde Busra Kodak ,&nbsp;Basak Cigdem Karacay ,&nbsp;Ismail Ozsoy","doi":"10.1016/j.knee.2025.04.019","DOIUrl":"10.1016/j.knee.2025.04.019","url":null,"abstract":"<div><h3>Background</h3><div>A set of physical tests representing typical activities relevant to persons with knee osteoarthritis (KOA) is recommended by the Osteoarthritis Research Society International (OARSI). The objective of this study was to designate the cut-off values for OARSI-recommended performance-based tests to better discriminate disease severity in patients with KOA.</div></div><div><h3>Methods</h3><div>As recommended by the OARSI, we conducted the 30-s chair stand test (30-s CST), 40-m fast-paced walk test (40-m FPWT), stair climb test (SCT), 6-min walk test (6MWT), and timed up and go test (TUG). To investigate the discriminative power of the performance test scores using the Kellgren–Lawrence (K-L) grading system, receiver operating characteristic (ROC) curve analysis was performed. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess self-administered health status.</div></div><div><h3>Results</h3><div>Forty-eight patients with bilateral KOA were included this study. The area under the curves for four of the five performance tests (30-s CST, six-step SCT, 40-m FPWT, and TUG) had acceptable discrimination (0.753–0.793), while the 6MWT had excellent discrimination (0.860). The stepwise multiple regression analysis demonstrated that 6MWT and 30-s CST were significant and independent determinants of WOMAC score, explaining 48% of the variance (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The OARSI performance tests can discriminate disease severity in individuals with KOA. The 6MWT has the highest level of discriminative validity among all. In addition, despite the correlation between all five tests and the WOMAC score, 6MWT and 30-s CST are independent and significant determinants of the WOMAC.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 179-185"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918508","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":"Cortical activity during the first 4 months after anterior cruciate ligament reconstruction while performing an active knee joint position sense test: A pilot study","authors":"Daniela Nyffenegger ,&nbsp;Heiner Baur ,&nbsp;Philipp Henle ,&nbsp;Aglaja Busch","doi":"10.1016/j.knee.2025.04.017","DOIUrl":"10.1016/j.knee.2025.04.017","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament (ACL) rupture is thought to alter the way in which the brain receives and processes information, affecting body movements. Although alterations in brain activity after ACL rupture have been described, these are limited to time points more than 6 months after rupture. Therefore, this pilot study aims to investigate cortical activity during an active knee joint position sense (JPS) test within the first 4 months after ACL reconstruction.</div></div><div><h3>Methods</h3><div>Twelve participants with ACL reconstruction (nine males; age 25.3 ± 6.4 years; height 173.6 ± 8.0 cm; mass 71.1 ± 9.1 kg) and 12 matched healthy controls (nine males; age 28.8 ± 9.7 years; height 174.5 ± 9.7 cm; mass 72.7 ± 12.7 kg) performed an active knee JPS test in an open kinetic chain with a starting angle of 90° knee flexion and a target angle of 50°. Absolute angular error was measured with an electrogoniometer. Cortical activity was simultaneously recorded with dry electroencephalography. Participants with ACL reconstruction were measured at 5–8 weeks postoperative (M1) and 12–16 weeks postoperative (M2), the control group once. Power spectra for the frequencies, theta (4.75–6.75 Hz), alpha-1 (7.0–9.5 Hz) and alpha-2 (9.75–12.5 Hz) for frontal, central and parietal regions of interest were calculated.</div></div><div><h3>Results</h3><div>Participants with ACL reconstruction exhibited significantly higher central theta power during JPS testing with their uninvolved leg at M1 compared with M2 (adjusted <em>P</em> = 0.01; rank epsilon squared = 0.39). No other comparisons yielded statistically significant differences.</div></div><div><h3>Conclusions</h3><div>The results cautiously support current evidence on cortical alterations following ACL reconstruction. A larger sample size and more measurement time points may provide further insight into possible alterations in the early postoperative period.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"55 ","pages":"Pages 168-178"},"PeriodicalIF":1.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911949","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}