Knee最新文献

{"title":"Does the posterior tibial slope in caliper-verified unrestricted kinematically aligned TKA using manual instruments match the slope in the contralateral healthy knee and improve function?","authors":"Alexander J. Nedopil ,&nbsp;Stefano Ghiradelli ,&nbsp;S.M. Howell ,&nbsp;M.L. Hull","doi":"10.1016/j.knee.2024.11.022","DOIUrl":"10.1016/j.knee.2024.11.022","url":null,"abstract":"<div><h3>Purpose</h3><div>Unrestricted kinematically aligned total knee arthroplasty (unKA TKA) strives to restore the pre-arthritic posterior tibial slope (PTS), however consistency of achieving this alignment target is unknown. The present study determined the proportion of subjects with differences in PTS less than 2° from the target and the improvement in patient-reported function after unKA TKA.</div></div><div><h3>Methods</h3><div>A review of 562 postoperative scanograms identified 99 patients (51 female) with a unKA TKA in one limb, a contralateral healthy limb, and a postoperative axial CT scan. All patients were treated with a primary unKA TKA performed with mechanical instruments where the alignment target was setting the PTS to match that of the medial compartment of the contralateral healthy knee. The PTS of the TKA and the healthy medial tibial plateau were measured and the difference determined. The patient-reported Oxford Knee Score (OKS) measured pre- and post-operative function.</div></div><div><h3>Results</h3><div>The proportion of subjects within a tolerance interval of ±2° of the contralateral healthy knee at 95% confidence was 85%. The median OKS improved from 20 points preoperatively to 47 points (range 18–48) at 15 months postoperatively. Greater differences of the PTS from healthy were unrelated to poorer Oxford Knee Scores.</div></div><div><h3>Conclusion</h3><div>Unrestricted KA TKA using manual instruments with caliper verification of resection thickness restored a high percentage of patients within a clinically acceptable tolerance of the posterior tibial slope of the contralateral healthy knee. The median postoperative OKS indicated clinically important improvement in patient-reported function.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 62-68"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820190","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":"Patellar tendon lateral deviation angle: a new computed tomography scan measurement for evaluation of patellar instability","authors":"Zhu Dai ,&nbsp;Jian Li ,&nbsp;Juan Tan ,&nbsp;Zhijun Yang ,&nbsp;Zhihao Gong","doi":"10.1016/j.knee.2024.11.011","DOIUrl":"10.1016/j.knee.2024.11.011","url":null,"abstract":"<div><h3>Background</h3><div>The tibial tuberosity–trochlear groove (TT-TG) distance is an important reference for the evaluation of patellar instability. However, measurement of the TT-TG distance has disadvantages with relatively low reproducibility. This study aimed to investigate the reliability of patellar tendon lateral deviation angle (PTLD-A) measured on a single computed tomography (CT) slice and the clinical significance for predicting patellar instability.</div></div><div><h3>Methods</h3><div>Seventy-eight knees with recurrent patellar dislocation were included as the study group, and 76 normal knees in the control group. The PTLD-A and the TT-TG distance were measured on CT images, inter- and intra-observer reproducibility were assessed, and correlation was analyzed, and compared between the groups. The predictive value of both measurements for patellar instability was examined using the receiver operating characteristic curve, and the cut-off value was predicted using the Youden index.</div></div><div><h3>Results</h3><div>Inter- and intra-observer reproducibility of PTLD-A was better than TT-TG distance in both groups as well as across all extents of trochlear types. The correlation between the two measurements was strong (r = 0.756, <em>P</em> &lt; 0.001). Notably, both measurements were significantly higher in the study group than in the control group (<em>P</em> &lt; 0.05). PTLD-A showed high predictive value for patellar instability, whereas TT-TG distance showed medium predictive value. A PTLD-A value of ≥ 13.7° was the threshold for diagnosis of patellar instability.</div></div><div><h3>Conclusion</h3><div>PTLD-A measured on a single computed tomography slice of the distal femoral trochlear groove is more reliable than TT-TG distance for prediction of patellar instability. A PTLD-A ≥ 13.7° predicts patellar instability.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 35-41"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820203","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":"Total knee arthroplasty improves energy conversion efficiency during walking in patients with knee osteoarthritis","authors":"Ruido Ida ,&nbsp;Gen Kuroyanagi ,&nbsp;Yoshino Ueki ,&nbsp;Satona Murakami ,&nbsp;Takayuki Shiraki ,&nbsp;Daiki Shimotori ,&nbsp;Hideki Okamoto ,&nbsp;Kunio Yamada","doi":"10.1016/j.knee.2024.11.020","DOIUrl":"10.1016/j.knee.2024.11.020","url":null,"abstract":"<div><h3>Background</h3><div>Energy conversion efficiency of human gait can be evaluated by calculating the ratio of conversion of mechanical energy from vertical motion to horizontal motion of the center of gravity through the movement of the joints. Osteoarthritis (OA) of the knee joint impairs this energy conversion efficiency. Total knee arthroplasty is the standard treatment for knee OA. However, its effect on energy conversion efficiency is unclear. In this study, we investigated how energy conversion efficiency changed in the gait of patients with knee OA before and after surgery.</div></div><div><h3>Methods</h3><div>Twelve patients with unilateral knee OA who underwent total knee arthroplasty were included. Ground walking was measured using a motion capture system (VICON®) before and 6 months after surgery. We calculated potential and kinetic energy from the coordinate change of the center of mass to obtain energy conversion efficiency. Other gait parameters such as gait speed, vertical movement distance of the body center, step length, hip joint angle, and trailing and leading limb angles were assessed.</div></div><div><h3>Results</h3><div>Energy conversion efficiency on the operated side significantly improved from 41.4 ± 12.2% to 57.5 ± 9.2% 6 months after surgery. Other gait parameters on the operated side were significantly improved after surgery compared with before surgery. Step length on the operated and the non-operated sides and trailing limb angles on the non-operated side before surgery correlated to energy conversion efficiency, while at 6 months after surgery, gait speed and step length on the non-operated side correlated to energy conversion efficiency.</div></div><div><h3>Conclusion</h3><div>Energy conversion efficiency was strongly improved postoperatively in patients with knee OA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 42-48"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820206","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":"Sartorius muscle transfer for chronic quadriceps tendon rupture: A prospective study","authors":"Andrea Pintore ,&nbsp;Ernesto Pintore ,&nbsp;Giovanni Asparago ,&nbsp;Emanuela Marsilio ,&nbsp;Ernesto Torsiello ,&nbsp;Olimpio Galasso","doi":"10.1016/j.knee.2024.11.023","DOIUrl":"10.1016/j.knee.2024.11.023","url":null,"abstract":"<div><h3>Background</h3><div>Quadriceps tendon rupture (QTR) is an uncommon injury. In chronic QTR there may be a large defect and direct repair is not possible with sutures or transosseous anchors. There is no gold standard surgical procedure for the treatment of chronic QTR. We propose a novel technique in which the quadriceps tendon (QT) is reconstructed using a transfer of ipsilateral sartorius tendon.</div></div><div><h3>Methods</h3><div>Between January 2002 and April 2020, 19 patients undergoing sartorius muscle transfer for chronic QTR were prospectively recruited. The Knee Society Score (KSS), range of motion (ROM), and Medical Research Council (MRC) Scale for QT muscle strength were collected preoperatively and at a minimum of 2 years follow up.</div></div><div><h3>Results</h3><div>The mean age of our cohort was 53.4 ± 9.8 years with a female patient count of 12 (54%). The mean body mass index recorded was 28.5 ± 3.2 kg/m² (range 23–30). At the mean follow up of 53.4 ± 28.1 months the mean KSS was 90.9 ± 6.3 (range 80–100) (<em>P</em> &lt; 0.05), the mean ROM was 119.5 ± 9.9° for flexion (range 100–130) (<em>P</em> &lt; 0.05) and the mean extension lag was 3.8 ± 5.1° (range 0–15) (<em>P</em> &lt; 0.05). The mean MRC scale was 4.5 ± 0.7 (range 3–5) (<em>P</em> &lt; 0.05). The most frequent complication was QT hypotrophy; it was noted in 14 patients.</div></div><div><h3>Conclusion</h3><div>Satisfactory clinical outcomes of ipsilateral sartorius muscle transfer for chronic QTR can be expected a mean of 4.4 years after surgery.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 79-85"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823004","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":"Optimal arithmetic hip–knee–ankle angle for performing prearthritic/kinematic alignment in unicompartmental knee arthroplasty","authors":"Kyota Ishibashi ,&nbsp;Eiji Sasaki ,&nbsp;Shohei Yamauchi ,&nbsp;Kento Ota ,&nbsp;Ryo Tomita ,&nbsp;Hikaru Kristi Ishibashi ,&nbsp;Hironori Otsuka ,&nbsp;Yasuyuki Ishibashi","doi":"10.1016/j.knee.2024.11.013","DOIUrl":"10.1016/j.knee.2024.11.013","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate whether arithmetic hip–knee–ankle angle (aHKA) can be a surrogate for valgus stress radiography (VSR). Furthermore, we investigated the optimal cutoff values for preoperative radiographic parameters, thereby validating the appropriate inclusion criteria for prearthritic/kinematic unicompartmental knee arthroplasty (prearthritic-UKA).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 123 patients who underwent medial UKA. We measured the HKA on VSR, termed sHKA. The aHKA was calculated by subtracting the lateral distal femoral angle from the medial proximal tibial angle. Prearthritic-UKA was defined as a postoperative HKA angle within 3° of the aHKA. We divided the patients into the prearthritic-UKA and non-prearthritic-UKA groups. To assess whether the aHKA serves as a surrogate for VSR, Spearman’s rank correlations were performed among the radiographic parameters. These radiographic parameters calculated the proper criteria for prearthritic-UKA using receiver operating characteristic (ROC) curve analysis and logistic regression analysis.</div></div><div><h3>Results</h3><div>Overall, 59 patients were classified into the prearthritic-UKA group. The aHKA was larger than the sHKA and exhibited no significant correlation with the sHKA. ROC analysis revealed that the cutoff values of aHKA for detecting overcorrected UKA (i.e., postoperative HKA – aHKA &gt;3°) was −5.0°. Similarly, the cutoff values for detecting undercorrected UKA (i.e., postoperative HKA – aHKA &lt;−3°) were −3°. Logistic regression analysis revealed that the aHKA was significantly associated with prearthritic-UKA.</div></div><div><h3>Conclusion</h3><div>The aHKA was not identified as a surrogate for the sHKA. Comprehensive preoperative radiographic assessment, including both aHKA and VSR, is crucial for optimizing UKA outcomes and minimizing risks of misalignment.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 1-9"},"PeriodicalIF":1.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792346","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":"Does a medial congruent bearing in total knee arthroplasty compromise fixation? A randomized controlled trial","authors":"Kristian R.L. Mortensen ,&nbsp;Lina Holm Ingelsrud ,&nbsp;Omar Muharemovic ,&nbsp;Kirill Gromov ,&nbsp;Anders Troelsen","doi":"10.1016/j.knee.2024.11.015","DOIUrl":"10.1016/j.knee.2024.11.015","url":null,"abstract":"<div><h3>Background</h3><div>Medially congruent (MC) bearings aim at promoting medial pivoting after total knee arthroplasty (TKA), as the congruency provides further constraint for the medial femoral compartment. However, this design difference could alter intra-articular force distribution, potentially compromising fixation of the tibia implant. The aim of this study was to compare migration, measured with radiostereometric analysis (RSA), of an MC to a more traditional cruciate retaining (CR) TKA system. Secondary aims were to compare patient-perceived treatment outcome and number of complications between the treatment groups.</div></div><div><h3>Methods</h3><div>Sixty patients undergoing TKA were randomized to an MC or CR bearing and had follow up visits after 3 months, 1 and 2 years. Primary outcome was tibia implant migration, measured by maximal total point motion (MTPM) with model-based RSA, 2 years post-surgery. Secondary outcomes were tibia MTPM, change in patient-reported outcome measurements (PROMs) and number of complications registered at all follow up visits.</div></div><div><h3>Results</h3><div>Primary outcome was available for 52 patients (27 MC patients, 25 CR patients). We found no difference in tibia MTPM between the MC and CR groups 2 years post-surgery. Median (interquartile range) MTPM was 0.60 (0.39–0.97) mm and 0.48 (0.32–0.78) mm in the MC and CR group, respectively (<em>P</em> = 0.167). There were no between-group differences in improvement in PROMs and no between-group differences in number of complications.</div></div><div><h3>Conclusion</h3><div>We found no compromising of tibia implant fixation in TKA by choosing an MC bearing, when compared with a CR bearing. PROMs and complication rates suggest comparable treatment results with both types of bearings in TKA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 19-27"},"PeriodicalIF":1.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792296","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":"Analysis of microvascular density and collagen structure of the medial meniscotibial ligament of the knee: Immunohistochemical study with CD31 and histology with Picrosirius red","authors":"Amanda Progenio dos Santos ,&nbsp;Jonatas Brito de Alencar Neto ,&nbsp;Pedro Henrique Marques Amorim ,&nbsp;Paulo Goberlânio de Barros Silva ,&nbsp;Maria Luzete Costa Cavalcante","doi":"10.1016/j.knee.2024.11.016","DOIUrl":"10.1016/j.knee.2024.11.016","url":null,"abstract":"<div><h3>Background</h3><div>The aim of the present study was to describe the structure of the collagen matrix and the microvascularization of the medial meniscotibial ligament (MMTL), in order to contribute to the refinement of the surgical technique for repairing these structures and consequently lead to a reduction in the risk of anterior cruciate ligament re-rupture.</div></div><div><h3>Methods</h3><div>Twelve MMTLs were obtained from deceased organ donors. The ligaments were initially analyzed macroscopically and evaluated histologically using hematoxylin and eosin staining. The evaluation of the collagen matrix was carried out using the Picrosirius red staining method under a polarized light microscope. Immunohistochemical study using monoclonal antibodies against CD31 was used to evaluate microvascularization.</div></div><div><h3>Results</h3><div>The MMTL was identified in 100% of the dissections. The hematoxylin and eosin-stained histological sections exhibited oriented and parallel collagen fibers, with low cellularity in its intrasubstance portion and increase in cellularity close to the meniscal insertion. Quantitative analysis of the collagen matrix showed a ratio of type I to type III collagen of 3.86 (±3.07). The average microvascular density in the intrasubstance portion was 33.71 ± 8.7 vessels/mm² and in the meniscal insertion portion it was 74.14 ± 23.85 vessels/mm².</div></div><div><h3>Conclusion</h3><div>The MMTL is a structure with a predominance of Type I collagen in relation to Type III collagen and high microvascular density in the region of meniscal insertion. These findings suggest that the healing potential of MMTL, regarding ramp injuries, is high because these injuries occur in the meniscal insertion area.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 10-18"},"PeriodicalIF":1.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793135","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 outcome and complications after simultaneous bilateral medial opening-wedge high tibial osteotomy","authors":"Kyung Wook Nha ,&nbsp;Hyung Suh Kim ,&nbsp;Jong Min Kim ,&nbsp;Tulyapruek Tawonsawatruk ,&nbsp;Sang-Gyun Kim","doi":"10.1016/j.knee.2024.11.012","DOIUrl":"10.1016/j.knee.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>The literature provides limited evidence regarding postoperative outcomes and complications following simultaneous bilateral medial opening-wedge high tibial osteotomy (MOWHTO). This study aimed to investigate the clinical outcomes and complications associated with simultaneous bilateral MOWHTO.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated 72 knees from 36 patients (mean age, 58.6 ± 8.2 years) who underwent simultaneous bilateral MOWHTOs between December 2011 and January 2021. Locking compression plates were used for simultaneous bilateral MOWHTOs. The Oxford Knee Score (OKS) was used to assess clinical outcomes at the last follow up. Complications (lateral hinge fracture (LHF), nonunion, and loss of correction) were evaluated using postoperative serial plain radiography and computed tomography (CT).</div></div><div><h3>Results</h3><div>At the last follow up (range, 2.0–11.1 years), the mean OKS for the 72 knees was 36.8 ± 10.4. According to the OKS, 42 knees (58.3%) scored ’excellent’, 16 (22.2%) scored ‘good’, eight (11.1%) scored ‘moderate’, and six (8.3%) scored ‘poor’. LHFs occurred in 11 of the 72 knees (15.3%). Among these, five LHFs were identified on postoperative plain radiographs and CT scans (acute LHFs), whereas six fractures were identified only on follow up plain radiographs (delayed LHFs). Loss of correction occurred in one patient with delayed LHFs. The patient required an additional surgical treatment to achieve bone healing at the osteotomy site.</div></div><div><h3>Conclusion</h3><div>Simultaneous bilateral MOWHTO is a viable treatment option for patients with bilateral medial osteoarthritis of the knee joint. Serial plain radiographs at short-term intervals are recommended to detect delayed LHFs and prevent complications such as fixation failure and loss of correction.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 230-237"},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758981","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":"Budgets, costs and deprivation","authors":"Caroline Hing (Editor-in-chief),&nbsp;Oday Al-Dadah (Editor-in-chief)","doi":"10.1016/j.knee.2024.11.010","DOIUrl":"10.1016/j.knee.2024.11.010","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages A1-A2"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645180","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":"Machine learning is better than surgeons at assessing unicompartmental knee replacement radiographs","authors":"S Jack Tu ,&nbsp;Sara Kendrick ,&nbsp;Karthik Saravanan ,&nbsp;Christopher Dodd ,&nbsp;David W Murray ,&nbsp;Stephen J Mellon","doi":"10.1016/j.knee.2024.11.007","DOIUrl":"10.1016/j.knee.2024.11.007","url":null,"abstract":"<div><h3><strong>Background:</strong></h3><div>Poor results occasionally occur after unicompartmental knee replacement (UKR). It is often difficult, even for experienced surgeons, to determine why patients have poor outcomes from radiographs. The aim was to compare the ability of experienced surgeons and machine learning to predict whether patients had poor or excellent outcomes from radiographs.</div></div><div><h3><strong>Methods:</strong></h3><div>924 one-year anterior-posterior radiographs post-UKR were used to train a machine learning model (ResNet50v2) with a transfer learning approach based on their one-year Oxford Knee Score categories. Two experienced surgeons and the model assessed and categorised 70 radiographs (14 Poor scores; 56 Excellent scores) not used for training according to their expected outcome.</div></div><div><h3><strong>Results:</strong></h3><div>The ResNet50v2 model correctly identified 71% (n = 10) of the patients with a poor score and 46 (82%) of those with an excellent score. In contrast, one surgeon could not identify patients with Poor scores (0%) and the other identified one (7%). Both misidentified 3 of those with Excellent scores. The model visualisation method suggested that estimated classifications were made from image features around the implants.</div></div><div><h3><strong>Conclusion:</strong></h3><div>The results suggest that there are radiographical features that relate to poor outcomes, which the surgeons are unaware of. Those the model did not identify may have an extra-articular cause for their poor outcome. Further analysis to identify the features associated with poor outcomes could potentially suggest ways that indications or techniques could be improved so as to decrease the incidence of poor results.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 212-219"},"PeriodicalIF":1.6,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748211","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}