Knee最新文献

{"title":"Inferior short-term survivorship and patient outcomes for cementless compared to hybrid fixation with a cemented femoral implant in a novel blade-anchored medial unicompartmental knee arthroplasty design: An analysis of 132 cases","authors":"Roderick J.M. Vossen ,&nbsp;Lindsey V. Ruderman ,&nbsp;Jonathan Spaan ,&nbsp;Tarik Bayoumi ,&nbsp;Edwin Su ,&nbsp;Andrew D. Pearle","doi":"10.1016/j.knee.2024.11.008","DOIUrl":"10.1016/j.knee.2024.11.008","url":null,"abstract":"<div><h3>Purpose</h3><div>For younger, more active patients, a cementless unicompartmental knee arthroplasty (UKA) might be more advantageous than cemented fixation. Therefore, this study aimed to compare implant survivorship and patient-reported outcome measures (PROMs) between cementless and hybrid fixation (cemented femur and cementless tibial fixation) in a novel tibial blade-anchored, medial UKA design.</div></div><div><h3>Methods</h3><div>Two surgeon’s registries were reviewed for patients who underwent primary cementless or hybrid medial UKA for medial osteoarthritis between 2019 and 2022. Patients were included if implant survivorship and one-year postoperative PROMs (UCLA-activity score, Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), pain (VAS) and satisfaction) were registered. Variables were compared using independent two-sample t-tests or the Chi-square test. Survival rates were determined using the Kaplan-Meier models and compared using the Log-rank test.</div></div><div><h3>Results</h3><div>A total of 132 knees were included (cementless 58.3%; cemented 41.7%; mean follow-up 3.1 ± 0.6 years). Three-year all-cause revision survival rate was significantly superior for the hybrid fixation (hybrid: 100%; cementless 88.5%[84.7%–92.3%], p = 0.026). However, the difference in three-year conversion rate to total knee arthroplasty (TKA) did not reach statistical significance. The one-year postoperative OKS (hybrid: 42.9 ± 4.8; cementless: 39.8 ± 6.4, p = 0.003) and KOOS-JR (hybrid:81.5 ± 13.7; cementless: 74.4 ± 12.1, p = 0.002) were significantly superior for the hybrid fixation. Three-year conversion rate to TKA and two-year postoperative PROMs did not significantly differ.</div></div><div><h3>Conclusion</h3><div>The cementless medial UKA demonstrated a significantly inferior short-term all-cause survival rate and inferior postoperative one-year OKS and KOOS-JR compared to the hybrid medial UKA design with a cemented femoral component.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 220-229"},"PeriodicalIF":1.6,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748168","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":"Translation, cross-cultural adaptation, and clinimetric properties evaluation of the Danish version of the Anterior Cruciate Ligament – Return to Sport after Injury scale (ACL-RSI)","authors":"Andreas Bjerregaard ,&nbsp;Esben Kjeldgaard ,&nbsp;Kasper Nordahl Wøbbe ,&nbsp;Cecilie Køllner Olsen ,&nbsp;Kristoffer W Barfod ,&nbsp;Vasileios Korakakis","doi":"10.1016/j.knee.2024.11.001","DOIUrl":"10.1016/j.knee.2024.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To translate and cross-cultural adapt the Anterior Cruciate Ligament–Return To Sport After Injury (ACL-RSI) questionnaire into Danish (ACL-RSI-DK) and evaluate the psychometric properties with the purpose to identify the psychological readiness on returning to sport (RTS).</div></div><div><h3>Methods</h3><div>The ACL-RSI-DK followed a six-step translation and cultural-adaptation process. Statistical analysis included correlation for construct validity of the ACL-R-DK with the Lysholm, KOOS and K-SES. Moreover, we assessed reliability using Cronbach’s alpha and ICC and used Bland Atman methods to assess bias between test and re-test. An exploratory factor-analysis was used for the dimensionality of ACL-RSI-DK.</div></div><div><h3>Results</h3><div>102 Danish individuals (Female 49%, age 27.7 ± 7.3 years), 51.2 (±15.5) weeks post-op from anterior cruciate ligament reconstruction (ACLR) were included. The ACL-RSI-DK showed excellent internal consistency (Cronbach’s alpha 0.957) and test–retest reliability (ICC = 0.96), with no floor or ceiling effects. The Bland Atman analysis showed no systematic bias. The mean score was 48 ± 23 out of 100 points. The SEM was calculated to be 5/10 points and the MDC₉₅ was 13/100. The construct validity evaluation presented strong correlation between ACL-RSI-DK, K-SES (ρ = 0.63) and KOOS-Sport (ρ = −0.63), whereas a moderate correlation was found with Lysholm (ρ = 0.48) and KOOS (ρ = −0.58) and its subscales KOOS-Symptoms (ρ = −0.27), KOOS-Pain (ρ = −0.43), KOOS-ADL (ρ = −0.47) and KOOS-QoL (ρ = −0.59. ACL-RSI-DK was found to be an unidimensional scale with a total variance explained of 68.5%.</div></div><div><h3>Conclusion</h3><div>The ACL-RSI was successfully translated and cross-cultural adapted into Danish and displayed good psychometric properties. The ACL-RSI-DK is a valid and reliable tool to investigate the psychological readiness on RTS.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 203-211"},"PeriodicalIF":1.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748047","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":"Association between distal tibial rotation and clinical outcomes of medial open-wedge high tibial osteotomy","authors":"Chang-Wan Kim,&nbsp;Chang-Rack Lee,&nbsp;Yong-Uk Kwon,&nbsp;Soo-Hwan Jung,&nbsp;Hyun-Seung Lee","doi":"10.1016/j.knee.2024.11.009","DOIUrl":"10.1016/j.knee.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to evaluate the association between changes in knee joint geometry after medial open-wedge high tibial osteotomy (MOWHTO) and clinical outcomes.</div></div><div><h3>Methods</h3><div>This was a retrospective study of patients who underwent MOWHTO (101 knees) at our hospital between January 2015 and February 2022 and who were followed up for &gt; 2 years. Radiological and functional outcomes were compared between those who were satisfied with surgery (satisfaction group) and patients who were dissatisfied with surgery (dissatisfaction group). Multiple regression analysis was performed to analyze factors affecting the radiological parameters that significantly differed between the two groups.</div></div><div><h3>Results</h3><div>The average follow up period was 38.0 ± 15.4 months. There were no significant differences regarding demographic characteristics and preoperative radiological parameters between the satisfaction and dissatisfaction groups. There was a significant intergroup difference with respect to postoperative distal tibial rotation and change in distal tibial rotation (13.5 ± 4.8° and 9.5 ± 4.3°, respectively; <em>P</em> &lt; 0.001). The difference in tibial rotation before and after surgery was 4.3 ± 2.3° and 1.7 ± 1.8° in the dissatisfaction and satisfaction groups (<em>P</em> &lt; 0.001) Multiple regression analysis showed that the correction angle affected the distal tibial rotation in MOWHTO (<em>R²</em> = 0.079, ß = 0.165, <em>P</em> = 0.038).</div></div><div><h3>Conclusions</h3><div>In MOWHTO, an increase in distal tibial rotation was associated with patient dissatisfaction. Because the increase in distal tibial rotation is associated with a large correction angle, excessive distal tibial rotation should be avoided when MOWHTO requires a large correction angle.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 195-202"},"PeriodicalIF":1.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748167","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":"Quantifying performance and joint kinematics in functional tasks crucial for anterior cruciate ligament rehabilitation using smartphone video and pose detection","authors":"Nicolas Lambricht ,&nbsp;Alexandre Englebert ,&nbsp;Laurent Pitance ,&nbsp;Paul Fisette ,&nbsp;Christine Detrembleur","doi":"10.1016/j.knee.2024.11.006","DOIUrl":"10.1016/j.knee.2024.11.006","url":null,"abstract":"<div><h3>Background</h3><div>The assessment of performance during functional tasks and the quality of movement execution are crucial metrics in the rehabilitation of patients with anterior cruciate ligament (ACL) injuries. While measuring performance is feasible in clinical practice, quantifying joint kinematics poses greater challenges. The aim of this study was to investigate whether smartphone video, using deep neural networks for human pose detection, can enable the clinicians not only to measure performance in functional tasks but also to assess joint kinematics.</div></div><div><h3>Methods</h3><div>Twelve healthy participants performed the forward reach of the Star Excursion Balance Test 10 times, along with 10 repetitions of forward jumps and vertical jumps, with simultaneous motion capture via a marker-based reference system and a smartphone. OpenPifPaf was utilized for markerless detection of anatomical landmarks in video recordings. The OpenPifPaf coordinates were scaled using anthropometric data of the thigh, and task performance and joint kinematics were computed for both the marker-based and markerless systems.</div></div><div><h3>Results</h3><div>Comparing results for marker-based and markerless systems revealed similar joint angles, with mean root mean square errors of 2.8° for the knee, 3.1° for the hip, and 3.9° for the ankle. Excellent agreement was observed for clinically pertinent parameters, i.e., the performance, the peak knee flexion, and the knee range of motion (intraclass correlation coefficient &gt; 0.97).</div></div><div><h3>Conclusion</h3><div>The results underscore the feasibility of using markerless methods based on OpenPifPaf for assessing performance and joint kinematics in functional tasks crucial for ACL patients’ rehabilitation. The simplicity of this approach makes it suitable for integration into clinical practice.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 171-178"},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720561","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":"SPECT-CT may aid in determining which side of a revision stemmed implant problematic total knee replacement is loose when planning revision surgery","authors":"Daniel Hill,&nbsp;Patrick Rogers,&nbsp;Jonathan Phillips,&nbsp;Ben Waterson,&nbsp;Andrew D. Toms","doi":"10.1016/j.knee.2024.10.016","DOIUrl":"10.1016/j.knee.2024.10.016","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate SPECT-CT in the diagnosis of single component aseptic loosening in patients with a problematic cemented stemmed TKR (Total Knee Replacement).</div></div><div><h3>Methods</h3><div>SPECT-CT was performed where aseptic loosening was suspected but was not clear on plain radiography. Demographics, suspected diagnosis and intention to revise were collected prospectively before and after SPECT-CT.</div></div><div><h3>Results</h3><div>30 patients were investigated. 43% (95% CI: 0.5–0.9) had clear evidence of loosening on SPECT-CT. In 23% (95% CI: 0.1–0.4) intention to perform revision surgery following SPECT-CT changed (7/30) (<em>p</em> = 0.0004, standard error = 42.1, <em>z</em> = 3.5).</div><div>Intentions to perform revision surgery according to the radiologist’s overall summary were:</div><div>Normal SPECT-CT – 0% (95% CI: 0.0–0.8) intention to revise (0/2).</div><div>Possibly abnormal SPECT-CT – 13% (95% CI: 0.0–0.4) intention to revise (2/15).</div><div>Definitely abnormal SPECT-CT – 77% (95% CI: 0.5–0.9) intention to revise (10/13).</div><div>We report that SPECT-CT had a test sensitivity of 90.9% (95% CI: 0.6–1.0), a specificity of 100% (95% CI: 0.9–1.0), a positive predictive value of 100% and a negative predictive value of 97.7%.</div><div>In 70% (95% CI: 0.3–0.9) of cases where revision surgery was performed for aseptic loosening SPECT-CT provided information that guided pre-operative planning with regards single component or both component revision surgery (7/10).</div></div><div><h3>CONCLUSION</h3><div>When positive SPECT-CT was useful in determining single component revision. A normal SPECT-CT may have a negative predictive value; however, overall half of our series had a possibly abnormal or equivocal investigation.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 179-194"},"PeriodicalIF":1.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699978","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 third gap – The forgotten space in total knee arthroplasty","authors":"William Brown ,&nbsp;Nicola Gallagher ,&nbsp;Dai Roberts ,&nbsp;Richard Napier ,&nbsp;David Barrett ,&nbsp;David Beverland","doi":"10.1016/j.knee.2024.10.011","DOIUrl":"10.1016/j.knee.2024.10.011","url":null,"abstract":"<div><h3>Aims</h3><div>Total Knee Arthroplasty (TKA) aims to leave the proximal flange of the femoral component flush with the femoral cortex. Manually, the requisite plane is found using the anterior femoral cortex or the intramedullary canal, whereas navigation uses hip and knee centre. Presently, no system prioritises restoration of the third space or native trochlear groove height (TGH) and there is a deficiency of published data on the variation of TGH with respect to the anterior cortex. This study aims to address this deficit. Hypothetically, restoration of the third space occurs when trochlear component depth equals TGH.</div></div><div><h3>Materials and Methods</h3><div>Relative to the posterior femoral axis the height of the anterior femoral cortex is higher laterally than centrally. For simplicity, this study reports MRI measurements of TGH relative to the centre in 110 normal subjects.</div></div><div><h3>Results</h3><div>TGH varied from the anterior femoral cortex by a mean of 2.32 mm (standard deviation, SD 1.77 mm, range −1.50 mm to 6.80 mm). If a femoral component trochlear depth of 2.2 mm is assumed, then 24.5% would be either over- or understuffed by more than 2 mm.</div></div><div><h3>Conclusion</h3><div>There is significant variation in TGH relative to the anterior femoral cortex. Assuming a femoral component trochlear depth of 2.2 mm, approximately one quarter of patients (24.5%) will be over- or understuffed by more than 2 mm. Variation in femoral component flexion and extension combined with whether or not it is left proud or notched will add further variation. Failure to restore the third space is likely to contribute to unsatisfactory results following TKA. Future surgical workflows should address this.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 164-170"},"PeriodicalIF":1.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700571","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":"Non-steroidal anti-inflammatory drugs influence cartilage healing","authors":"Asma Sajjad Khawaja ,&nbsp;Maria Zafar ,&nbsp;Rana Muhammad Zeeshan ,&nbsp;Muhammad Saad Ilyas ,&nbsp;Amer Aziz ,&nbsp;Uruj Zehra","doi":"10.1016/j.knee.2024.10.021","DOIUrl":"10.1016/j.knee.2024.10.021","url":null,"abstract":"<div><h3>Background</h3><div>Retrograde intramedullary nailing is commonly performed to stabilize distal femoral shaft fractures which may lead to iatrogenic injuries of the knee articular cartilage. The limited regenerative capability of cartilage may further be hindered by intake of non-steroidal anti-inflammatory drugs (NSAIDs) which are usually advised for injuries of the musculoskeletal system. The current study was designed to evaluate the histological changes in the femoral articular cartilage of knee joint after retrograde femoral nailing of rats.</div></div><div><h3>Methods</h3><div>Retrograde intramedullary nailing was performed in 36 adult male Wistar rats, divided into three groups of 12 each. Groups 1 and 2 were given nonselective and selective COX 2 inhibitors, respectively, while the third group was taken as control. Half of the animals from each group were sacrificed at the second week, and remainder on the seventh week, and samples of the femoral articular cartilage were assessed for cartilage regeneration according to the modified Mankin scoring on histology while BMP-2 expression was evaluated on immunohistochemistry.</div></div><div><h3>Results</h3><div>Mean modified Mankin scores for cartilage degradation were increased in animals taking NSAIDs at the second and seventh weeks of healing (<em>P</em> = 0.02, <em>P</em> &lt; 0.001 respectively). There was a significant decrease in chondrocytes at the second week (<em>P</em> = 0.001), along with the loss of proteoglycan content in these animals at both time points (<em>P</em> = 0.001). The BMP-2 expression was significantly enhanced in the control group at the second (<em>P</em> = 0.001) and seventh weeks (<em>P</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>The results reveal that intake of NSAIDs hinders the process of cartilage healing by reducing the number of chondrocytes and loss of proteoglycan content and decreased expression of BMP-2.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 121-130"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693786","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":"Three-dimensional models demonstrate differences in correction depending on femoral derotational osteotomy site and may enhance the planning and precision in femoral derotational osteotomy – An observational study in eight femora and two surgeons","authors":"Caterina Chiappe ,&nbsp;Alejandro Roselló-Añón ,&nbsp;Vicente Sanchis-Alfonso ,&nbsp;Joan Carles Monllau ,&nbsp;Julio Domenech-Fernández","doi":"10.1016/j.knee.2024.10.023","DOIUrl":"10.1016/j.knee.2024.10.023","url":null,"abstract":"<div><h3>Background</h3><div>Increased femoral anteversion (FAV) is crucial in the genesis of anterior knee pain (AKP) and a femoral derotational osteotomy (FDO) has demonstrated good clinical results. It remains unclear at what level of the femur the osteotomy should be performed. Resulting degrees of FAV measured by Murphy’s method do not always correspond to the degrees that had been planned after an FDO. The hypothesis of this study is that the femur rotation axis and the osteotomy rotation axis do not coincide. Three-dimensional (3D) technology is used to objectify the discrepancy between these two axes and to find solutions so that the two axes can coincide. The objective is to demonstrate the reliability and reproducibility of the 3D technique for osteotomy adjustment through an intraobserver and interobserver study.</div></div><div><h3>Methods</h3><div>Images of eight computed tomography scans of the femur, corresponding to seven patients with a diagnosis of AKP and increased FAV, were selected. Two surgeons performed the FAV measurement and simulation of FDO on 3D biomodels. The femoral osteotomies were defined at three levels, at 10°, 20°, 30°. To determine interobserver agreement, measurements were performed independently by two surgeons. To evaluate intraobserver differences each surgeon repeated all measurements after 15 days.</div></div><div><h3>Results</h3><div>Interobserver and intraobserver agreement: intraclass correlation coefficient 0.930 (95% confidence interval (CI) 0.799–0.975) and 0.986 (95% CI 0.959–0.995). Significant differences between the resulting values were observed when the osteotomy was performed at the intertrochanteric level.</div></div><div><h3>Conclusions</h3><div>The misalignment of the axes results in hypocorrection when the osteotomy is intertrochanteric. This phenomenon is not observed when the osteotomy is diaphyseal or supracondylar.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 131-138"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693891","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":"Biomechanical differences of Asian knee osteoarthritis patients during standing and walking using statistical parametric mapping: A cross-sectional study","authors":"Yi Hu ,&nbsp;Phillis Teng ,&nbsp;Tsung-Lin Wu ,&nbsp;Ross Clark ,&nbsp;Yong-Hao Pua ,&nbsp;Oliver Roberts ,&nbsp;Jia Wei Yong ,&nbsp;Amr Alhossary ,&nbsp;Lek Syn Lim ,&nbsp;Desmond Y.R. Chong ,&nbsp;Wei Tech Ang ,&nbsp;Bryan Yijia Tan","doi":"10.1016/j.knee.2024.10.022","DOIUrl":"10.1016/j.knee.2024.10.022","url":null,"abstract":"<div><h3>Background</h3><div>Biomechanics of knee osteoarthritis (KOA) patients have been extensively studied using motion capture systems, but less have explored standing knee joint angles with the walking parameters, particularly in Asians. We aim to determine gait biomechanical differences between healthy and KOA participants in an Asian population using One-dimensional Statistical Parametric Mapping (SPM1D) and explore if they are associated with standing joint angles.</div></div><div><h3>Methods</h3><div>A total of 20 KOA and 24 healthy stood upright and walked 10 m at self-selected speeds. The standing angles, walking kinematic and kinetic parameters of the ankle, knee, hip and trunk were analysed. Lower limb muscle excitation was measured via electromyography. SPM1D was used to compare the healthy group with the KOA group, and for further subgroup analysis.</div></div><div><h3>Results</h3><div>The all KOA group had significantly greater standing knee flexion angles (KFA) (<em>p</em> &lt; 0.001), standing ankle dorsiflexion angles (ADA) (<em>p</em> &lt; 0.001), walking KFA during terminal stance (<em>p</em> = 0.001) and terminal swing (<em>p</em> = 0.02) and walking ADA during terminal stance (<em>p</em> = 0.02) and mid-swing to terminal swing (<em>p</em> = 0.001). Knee adduction moment (<em>p</em> = 0.04) and knee flexion moment (<em>p</em> = 0.03) were higher in severe KOA. A positive correlation was found between standing KFA and initial KFA (<em>R</em>² = 0.579), and mean walking KFA (<em>R</em>² = 0.801) in the KOA group.</div></div><div><h3>Conclusion</h3><div>The increase in standing KFA was associated with an increase in walking KFA in the KOA group. Static joint angles remain as an essential parameter, although further studies need to be carried out to determine if the increase in standing joint angles can be recommended as an adjunctive measure during gait analysis of KOA using motion capture.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 155-163"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693778","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":"Patients submitted to re-revision ACL reconstruction present more knee laxity, more complications, and a higher failure rate than patients submitted to the first revision ACL reconstruction","authors":"Camilo Partezani Helito ,&nbsp;Andre Giardino Moreira da Silva ,&nbsp;Riccardo Cristiani ,&nbsp;Anders Stålman ,&nbsp;Vitor Barion Castro de Pádua ,&nbsp;Riccardo Gomes Gobbi ,&nbsp;José Ricardo Pécora","doi":"10.1016/j.knee.2024.11.004","DOIUrl":"10.1016/j.knee.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Few comparative studies have evaluated patients who underwent two revision anterior cruciate ligament reconstruction (ACLR) and patients who underwent one revision ACLR, and many of them have a short postoperative follow-up and a relatively small number of patients. The objective of this study is to evaluate the functional results, complications, and failure rates of patients who underwent one revision ACLR and patients who underwent two revision ACLRs.</div></div><div><h3>Methods</h3><div>This is a retrospective study comparing patients who underwent one revision ACLR (Group 1) with patients who underwent a re-revision ACLR (Group 2). Baseline demographic variables, operative data and post-operative data were evaluated.</div></div><div><h3>Results</h3><div>Among the 266 patients included, 226 were from Group 1 and 40 from Group 2. Patients in Group 2 had greater rotatory laxity and were more often subjected to associated osteotomy at the time of revision surgery. Postoperatively, patients from Group 2 reported poorer subjective IKDC score and showed greater knee laxity measured with the KT-1000 arthrometer, although both probably not clinically relevant. The complication rate was high in both groups, with a higher incidence in Group 2. Reconstruction failures were also higher in Group 2 (20% vs. 8.8%, <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Patients from Group 2 underwent a higher rate of associated osteotomy procedures, present higher complication rates and a higher failure rate compared with patients from Group 1. However, the functional scores (Lysholm and IKDC score) and the physical examination (KT-1000 and pivot-shift) did not show clinically relevant differences between the groups.</div></div><div><h3>Level of Evidence</h3><div>III, retrospective comparative therapeutic trial.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 147-154"},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693811","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}