Knee最新文献

{"title":"Unveiling knee morphology with SHAP: shaping personalized medicine through explainable AI","authors":"Berke Cansiz ,&nbsp;Serdar Arslan ,&nbsp;Muhammet Zeki Gültekin ,&nbsp;Gorkem Serbes","doi":"10.1016/j.knee.2025.06.012","DOIUrl":"10.1016/j.knee.2025.06.012","url":null,"abstract":"<div><h3>Purpose:</h3><div>This study aims to enhance personalized medical assessments and the early detection of knee-related pathologies by examining the relationship between knee morphology and demographic factors such as age, gender, and body mass index. Additionally, gender-specific reference values for knee morphological features will be determined using explainable artificial intelligence (XAI).</div></div><div><h3>Methods:</h3><div>A retrospective analysis was conducted on the MRI data of 500 healthy knees aged 20–40 years. The study included various knee morphological features such as Distal Femoral Width (DFW), Lateral Femoral Condyler Width (LFCW), Intercondylar Femoral Width (IFW), Anterior Cruciate Ligament Width (ACLW), and Anterior Cruciate Ligament Length (ACLL). Machine learning models, including Decision Trees, Random Forests, Light Gradient Boosting, Multilayer Perceptron, and Support Vector Machines, were employed to predict gender based on these features. The SHapley Additive exPlanation was used to analyze feature importance.</div></div><div><h3>Results:</h3><div>The learning models demonstrated high classification performance, with 83.2% (±5.15) for classification of clusters based on morphological feature and 88.06% (±4.8) for gender classification. These results validated that the strong correlation between knee morphology and gender.</div></div><div><h3>Conclusion:</h3><div>The study found that DFW is the most significant feature for gender prediction, with values below 78–79 mm range indicating females and values above this range indicating males. LFCW, IFW, ACLW, and ACLL also showed significant gender-based differences. The findings establish gender-specific reference values for knee morphological features, highlighting the impact of gender on knee morphology. These reference values can improve the accuracy of diagnoses and treatment plans tailored to each gender, enhancing personalized medical care.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 415-430"},"PeriodicalIF":1.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556807","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 preventive effects of neuromuscular training on lower extremity sports injuries in adolescent and young athletes: a systematic review and meta-analysis","authors":"Yuda LI ,&nbsp;Weidong ZHU","doi":"10.1016/j.knee.2025.06.008","DOIUrl":"10.1016/j.knee.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents and young athletes who frequently engage in sports face a high risk of lower extremity injuries. Neuromuscular training (NMT) has been shown to effectively reduce sports-related injury incidence in this population. However, the intervention efficacy of NMT varies under the influence of different factors. This meta-analysis aimed to determine the preventive effects of NMT on various types of lower extremity injuries and investigate the impact of five moderating factors—Age, Sex, Training Duration, Training Frequency, and Intervention Period—on NMT program quality.</div></div><div><h3>Methods</h3><div>A systematic search of Web of Science, PubMed, Scopus, Cochrane Library, and PEDro databases was conducted in November 2024 using the search strategy: <em>(Neuromuscular Training OR NMT) AND (Sport Injury OR Injury Prevention)</em>. Eligible studies met the following criteria: 1) evaluated NMT programs; 2) reported clear mean age or age range of participants; 3) employed a randomized controlled trial (RCTs) design; 4) provided detailed raw data; and 5) included comprehensive injury data. Two reviewers independently extracted data and assessed study quality. Meta-analyses were performed to pool rate ratios (RRs) for lower extremity injuries and analyze the effects of moderating factors.</div></div><div><h3>Results</h3><div>Data from 24 included studies demonstrated that NMT reduced the overall risk of lower extremity injuries by 27 % (0.73, 95 % CI 0.67–0.79). Subgroup analyses by injury type yielded the following RRs: mixed lower extremity injuries (0.72, 95 % CI 0.63–0.83), knee injuries (0.72, 95 % CI 0.62–0.84), and ankle injuries (0.73, 95 % CI 0.63–0.84). Comprehensive moderator analyses revealed that NMT programs exhibited optimal preventive effects for knee injuries, males, and adolescents aged 12–18 years. Regarding training dosage, the greatest risk reduction was observed with programs involving 20–30 min per session, 1–2 sessions per week, and an intervention period exceeding 6 months.</div></div><div><h3>Conclusion</h3><div>NMT programs involving 20–30 min per session, 1–2 weekly sessions, and an intervention period of ≥ 6 months are most effective in preventing knee injuries among male adolescents aged 12–18 years.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 373-385"},"PeriodicalIF":1.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556803","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":"Assessment of joint laxity following total knee arthroplasty: A comparison of tensioner device, navigation, and robot evaluation","authors":"Hiroshi Inui,&nbsp;Haruhiko Nakamura,&nbsp;Ryota Takei,&nbsp;Masaki Uchida,&nbsp;Kei Satou,&nbsp;Tetsu Yamashita,&nbsp;Risa Matsumoto,&nbsp;Kazuo Saita","doi":"10.1016/j.knee.2025.06.020","DOIUrl":"10.1016/j.knee.2025.06.020","url":null,"abstract":"<div><h3>Background</h3><div>Appropriate soft-tissue balance is essential for total knee arthroplasty (TKA). Widely used techniques to evaluate soft-tissue balance are measuring the joint gap using tensioner devices, the robot and the navigation. We compared soft-tissue balance evaluated using tensioner, navigation, and robot tools.</div></div><div><h3>Methods</h3><div>81 patients who underwent bi-cruciate stabilized (BCS) TKA were included. 41 patients were performed using the navigation (Group N) and 40 patients were performed using the robot (Group R). After the final implantation, the joint laxities were measured using tensioner device (JLT) and navigation (JLN) in group N and measured using tensioner device and robot (JLR) in group R. The evaluations were performed at a flexion of 10°, 30°, 60° and 90°. Joint laxities evaluated by the different tools were compared in both groups.</div></div><div><h3>Results</h3><div>No significant between-group differences were observed for JLTs at each flexion angle in both compartments. The JLTs of were larger than JLNs at 90°. The JLTs were larger than JLRs at 30°, 60°and 90°. At a knee flexion angle of 60°, the difference between JLTs and JLRs were larger than that between JLTs and JLNs. The JLTs were smaller than JLNs at 60°and 90°in the lateral compartment.</div></div><div><h3>Conclusion</h3><div>Joint laxities evaluated using the tensioner device with a distraction force of 80 N for both compartments were similar to those evaluated with the robot and the navigation in extension position. However joint laxities evaluated using the tensioner device were larger than those evaluated with robot and the navigation in flexion position.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 397-406"},"PeriodicalIF":1.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556806","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":"Current management of Tenosynovial Giant Cell Tumours of the knee in the United Kingdom","authors":"Thomas R W Ward ,&nbsp;Robert U Ashford ,&nbsp;Nicholas C Eastley","doi":"10.1016/j.knee.2025.06.006","DOIUrl":"10.1016/j.knee.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Tenosynovial Giant Cell Tumours (TGCTs) are a group of rare, benign, mesenchymal tumours involving synovium, bursae or tendon sheaths. There are two subtypes of TGCT (nodular (nTGCT) and diffuse (dTGCT)) and the current guidelines on the management of both is limited.</div></div><div><h3>Methods</h3><div>A questionnaire was distributed to members of the British Orthopaedic Oncology Society to investigate members’ management of primary and recurrent TGCT. Respondents were questioned on their chosen radiological investigations, use of biopsy, surgical and oncological management and follow up. Descriptive analysis of the qualitative data was performed through data coding.</div></div><div><h3>Results</h3><div>Eighteen responses were received from orthopaedic consultants subspecialising in sarcoma surgery. One was excluded due to practice outside of the United Kingdom (UK). Magnetic Resonance Imaging (MRI) was unanimously the primary investigation of choice. Biopsy rates varied depending on extent of disease, imaging appearances and MDT input.</div><div>Most surgeons manage primary and recurrent nodular and diffuse TGCT with an open excision. When surgery is performed by a knee or soft-tissue knee surgeon, excisions were more likely to be performed arthroscopically. A staged resection was most commonly performed for dTGCT.</div><div>Indications for additional therapies in dTGCT varied between units. Follow up regimens also varied, although unsurprisingly diffuse and recurrent disease were reviewed with increased frequency for a longer duration.</div></div><div><h3>Discussion</h3><div>TGCT is a rare, complex disease that encompasses a range of phenotypes. Despite a recent global consensus meeting, our data shows that TGCT is still investigated, managed, and followed up with great variability across the UK.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 407-414"},"PeriodicalIF":1.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556804","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 anterior intermeniscal ligament in types of bucket-handle tear with using magnetic resonance ımaging","authors":"Ali Koç ,&nbsp;Turgut Tursem Tokmak ,&nbsp;Özgür Karabıyık ,&nbsp;Tuba Uçarkuş","doi":"10.1016/j.knee.2025.06.001","DOIUrl":"10.1016/j.knee.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Anterior intermeniscal ligament (AIML) has a beneficial influence on knee biomechanics, contributing to shock-absorbing function of the menisci and to the transmission of circumferential hoop stresses in the knee. Investigation of the relationship between meniscal bucket-handle tears and the AIML may help to elucidate AIML function. The aim of this study was to determine AIML according to anatomical insertions in groups composed of central and peripheral type bucket-handle tear cases.</div></div><div><h3>Methods</h3><div>In total 104 cases with bucket-handle tear were re-evaluated with magnetic reonance imaging (MRI) for AIML and tear pattern. AIMLs were grouped according to the classification of Nelson and LaPrade. Two groups of bucket-handle tear cases were recorded according to the tear pattern as central or peripheral according to the Cooper classification. Chi-squared analysis and Fisher’s exact test were used for correlation and significance analysis between AIML subtypes and the two types of bucket-handle tear.</div></div><div><h3>Results</h3><div>No significant correlation was found between the AIML and the groups consisting of different patterns of bucket-handle tear (<em>P</em> = 0.063). Peripheral zone tears were found in 53 (51%) patients, whereas central zone tears were found in 51 (49%) patients. AIML was absent in 51 patients. Type I AIML was present in 21, type II in 24, and type III in eight patients.</div></div><div><h3>Conclusions</h3><div>The distribution of AIML in different patterns of bucket-handle tear cases was not statistically significant and did not differ from the normal ratios specified in the literature.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 366-372"},"PeriodicalIF":1.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter Regarding “Diagnostic Accuracy of ChatGPT-4 in Orthopedic Oncology: A Comparative Study with Residents”","authors":"","doi":"10.1016/j.knee.2025.06.003","DOIUrl":"10.1016/j.knee.2025.06.003","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 661-662"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531298","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":"Letter to the editor regarding “Closing the tendon defect does not affect tendon length and patellar height after bone-patellar tendon-bone ACL reconstruction: A retrospective study using radiographs”","authors":"Renu Sah,&nbsp;Ankita Mathur","doi":"10.1016/j.knee.2025.06.002","DOIUrl":"10.1016/j.knee.2025.06.002","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 657-658"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512813","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":"Bone–patellar tendon–bone allografts are safe and effective grafts for anterior cruciate ligament one-stage revision: A consecutive series of 38 patients with at least 2 years of follow up","authors":"Marco Turati ,&nbsp;Filippo Maria Anghilieri ,&nbsp;Marco Crippa ,&nbsp;Massimiliano Piatti ,&nbsp;Luca Rigamonti ,&nbsp;Elena Tassistro ,&nbsp;Sabrina Trapletti ,&nbsp;Marco Bigoni","doi":"10.1016/j.knee.2025.05.034","DOIUrl":"10.1016/j.knee.2025.05.034","url":null,"abstract":"<div><h3>Background</h3><div>Rupture of the anterior cruciate ligament is one of the most common injuries in sports. Although primary reconstruction is a successful procedure, failure is reported to occur in up to 13% of patients. In patients who complain of instability, revision surgery should be proposed and discussed with patients. The issue arising in this setting is the graft choice, being limited from the grafts used in primary surgery.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled 38 consecutive patients who had undergone ACL one-stage revision with bone–patellar tendon–bone (BPTB) allografts from a single center with at least 2 years of follow up. The clinical evaluation was based on PROMs In addition, we recorded the rate of allograft re-rupture and post-surgical complications.</div></div><div><h3>Results</h3><div>Our series showed good PROMs at a minimum of 2 years follow up. Median IKDC, Lysholm, and Simple Knee Value were 82.8, 85.5, and 77.5, respectively. For the Tegner Activity Scale we recorded a median value of 8.0 before injury and 6.0 after surgery. Timing for return-to-play was between 6 and 9 months for 19 patients (54.3%). Regarding post-surgery complications, we recorded an overall rate of 15.79%, with however minor entity (Clavien–Dindo grade I). Allografts re-rupture rate was 10.5%.</div></div><div><h3>Conclusion</h3><div>BPTB allografts in one-stage ACL revision enabled patients to return to sports and to a good quality of life after the final follow up. Moreover, this type of graft has been shown to be a safe choice, being burdened by a low rate of post-surgical complications and re-rupture risk.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 354-365"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491674","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":"Modified Judet quadricepsplasty leads to enhanced knee function in patients with post-traumatic stiffness: a case series of 19 consecutive patients at 10 years mean follow-up","authors":"Alberto Fogacci ,&nbsp;Vito Gaetano Rinaldi ,&nbsp;Iacopo Sassoli ,&nbsp;Antongiulio Favero ,&nbsp;Stefano Di Paolo ,&nbsp;Margherita Bonaiuti ,&nbsp;Giulio Maria Marcheggiani Muccioli ,&nbsp;Stefano Zaffagnini","doi":"10.1016/j.knee.2025.05.021","DOIUrl":"10.1016/j.knee.2025.05.021","url":null,"abstract":"<div><h3>Aims</h3><div>Knee stiffness is common condition after high energy trauma, surgeries, leading to severe functional limitation in normal daily activities. Purpose is reporting clinical outcomes and detect complications at mean follow-up of 10 years after modified Judet quadriceplasty.</div></div><div><h3>Methods</h3><div>Retrospective observational single center study was conducted, evaluating a 19 patients sample affected by post traumatic knee stiffness who underwent modified Judet quadricepsplasty from January 2008 to June 2023. Procedures were performed by same expert surgical team, patients followed same perioperative protocol. Patients were clinically evaluated using Judet criteria for final range of motion and five score (KOOS, WOMAC, Tegner-Lysholm, HSS KS, EQ-5D). Demographic characteristic, clinical history, pre intra and post operative knee flexion and possible complications by computerized medical records were detected.</div></div><div><h3>Results</h3><div>Average definitive flexion was 100.7° (range 35°-140°) and flexion gain was 50.4° (range 5–100°). According to Judet’s criteria, the result obtained by 10 patients could be classified as excellent (52.6%), 7 as good (36.8%), 1 as fair (5.3%) and at last in 1 as poor (5.3%). An extension lag was observed in 47% of cases, with 8.8° average value (range 2–20°); only 10.5% showed significant deficit (greater than 10°). There were four cases that required new arthromyolysis, four cases of perioperative complications and two long-term complications, mostly due to infection.</div></div><div><h3>Conclusion</h3><div>Modified Judet quadricepsplasty is effective in improving knee function and mobility in patients with post-traumatic stiffness, resulting in a less aggressive invasive technique. Despite some risks, especially in severe cases, it remains a valuable surgical option when conservative treatments fail.</div><div>Level of evidence: Level IV retrospective case series.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 332-353"},"PeriodicalIF":1.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364955","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":"Re: “Diagnostic accuracy of ChatGPT-4 in orthopedic oncology: a comparative study with residents”","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.knee.2025.06.005","DOIUrl":"10.1016/j.knee.2025.06.005","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"56 ","pages":"Pages 659-660"},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487244","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}