What's New — Knee — October 2025¶
113 new articles published this month.
Themes: Alignment Strategies and Kinematics in TKA · ACL Reconstruction: Outcomes, Risk Factors, and Rehabilitation · Meniscal Pathology, Repair, and Allografts · Osteoarthritis: Diagnosis, Imaging, and Non-Operative Management · Revision Arthroplasty, Complex Reconstruction, and Safety
Digest generated 2026-04-16 00:05:15+00:00.
Highlights¶
Alignment Strategies and Kinematics in TKA¶
Recent literature critically evaluates alignment philosophies in total knee arthroplasty (TKA), contrasting mechanical alignment with kinematic and functional approaches. Studies demonstrate that kinematic alignment better preserves native joint lines and the knee-ankle relationship, particularly in specific CPAK phenotypes, without compromising safety [21][22][91][93]. Functional alignment techniques are shown to improve femoral joint line obliquity preservation and reduce patellar tilt compared to classical measured resection [75][69]. Furthermore, research indicates that unrestricted kinematic alignment allows for variable posterior tibial slopes without negatively impacting short-term outcomes [21]. The role of robotic assistance in achieving these personalized alignments is also highlighted, with evidence suggesting equivalent radiographic accuracy between image-based and imageless workflows [62].
ACL Reconstruction: Outcomes, Risk Factors, and Rehabilitation¶
This cluster synthesizes findings on anterior cruciate ligament reconstruction (ACLR), focusing on graft failure risks, return-to-sport protocols, and rehabilitation technologies. High posterior tibial slope is identified as a risk factor for graft failure but not necessarily for functional impairment [28][58]. Smoking significantly increases failure rates and worsens outcomes [24]. Prognostic factors for secondary injury include jump performance, hop function, and kinesiophobia [36]. Digital health technologies and AI agents are emerging as effective tools to enhance rehabilitation adherence and patient monitoring [19][23][46][71]. Early surgery within 14 days appears safe and effective [33], while giving-way episodes during the waiting period increase associated meniscal injuries [42].
Meniscal Pathology, Repair, and Allografts¶
Articles in this theme address the complex management of meniscal injuries, including repair failure rates, classification systems, and allograft transplantation. Medial meniscal repairs carry a significantly higher failure risk compared to lateral repairs, influenced by tear morphology [6][50]. There is a lack of consensus on classification systems for posterior root tears, highlighting diagnostic challenges [16]. Meniscal allograft transplantation (MAT) shows high survival rates, with return to competitive sport associated with better graft survival and outcomes [47][48]. However, sex mismatch between donor and recipient can detrimentally affect survivorship [60]. Surgical techniques such as MCL pie-crusting and the use of lateral extra-articular procedures are also evaluated for their safety and impact on complications like cyclops lesions [35][82].
Osteoarthritis: Diagnosis, Imaging, and Non-Operative Management¶
This theme covers the diagnosis and management of knee osteoarthritis (OA), emphasizing advanced imaging and non-surgical interventions. Radiomics and MRI-based frameworks are being developed for early OA identification and progression stratification [1]. Studies explore the relationship between static radiographic measurements and dynamic alignment, as well as the impact of soft tissue release on outcomes [7]. Non-operative management includes the use of adipose-derived stromal vascular fraction injections, which show lasting symptom relief [26], and the evaluation of NSAIDs on imaging biomarkers [85]. Additionally, the role of digital health and AI in personalized care for OA is discussed [3][46]. The impact of tobacco use on OA outcomes and the association of pain patterns with physical function are also investigated [31][86].
Revision Arthroplasty, Complex Reconstruction, and Safety¶
Focus is placed on revision total knee arthroplasty (TKA), complex reconstruction techniques, and patient safety. Revision TKA using constrained prostheses demonstrates excellent long-term survival [97]. Previous osteosynthesis, unlike osteotomy, significantly raises the risk of revision, primarily due to periprosthetic joint infection [27]. The use of tranexamic acid in high-risk patients reduces transfusions but requires caution in those with seizure histories [45]. Systemic metal exposure is associated with TKA failure [44]. Complex procedures such as distal femoral replacement and unicompartmental knee arthroplasty in younger patients are also analyzed, with uncemented fixation showing superior survival in specific age groups [30][49].
Articles by Theme¶
Alignment Strategies and Kinematics in TKA (11)¶
9. Shen M, Li H, Liu H, et al. The impact of soft tissue release on radiological and clinical outcomes in functional alignment robot-assisted total knee arthroplasty. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06313-x
This study evaluated the impact of soft tissue release techniques on radiological and clinical outcomes in functional alignment robot-assisted total knee arthroplasty. The findings suggest that specific soft tissue release strategies significantly influence postoperative alignment and functional recovery metrics. Clinically, these results support the integration of tailored soft tissue balancing protocols to optimize surgical precision and patient outcomes in robotic TKA.
12. Li Z, de Grave PW, Criekinge TV, et al. Preserving the native knee joint line obliquity in total knee arthroplasty benefits ankle movement during the five times sit‐to‐stand test. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70113
This study compared sit-to-stand performance between patients undergoing total knee arthroplasty with inverse kinematic alignment versus adjusted mechanical alignment. It found that preserving the native knee joint line obliquity in inverse kinematic alignment resulted in significantly greater ankle range of motion during the stand-up phase compared to mechanical alignment. Clinically, this indicates that inverse kinematic alignment may better restore functional lower limb biomechanics during daily activities.
21. Franceschetti E, Gregori P, Campi S, et al. Unrestricted kinematic alignment on the sagittal plane: Posterior tibial slope and combined flexion do not have boundaries to respect in terms of short‐term clinical outcomes and safety. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70136
This retrospective study examined whether unrestricted posterior tibial slope and combined flexion angles influence short-term outcomes and safety in total knee arthroplasty performed with kinematic alignment. The results showed no significant differences in implant survivorship, revision rates, or clinical scores across varying slope and flexion groups. These findings indicate that kinematic alignment can be safely applied without strict boundaries on sagittal plane parameters in the short term.
22. Franceschetti E, Giurazza G, Donantoni M, et al. Kinematic alignment, but not mechanical alignment, preserves the knee–ankle relationship after total knee arthroplasty: A retrospective radiographic analysis from the FP‐UCBM Knee Study Group. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70138
This retrospective radiographic analysis compared the effects of mechanical versus kinematic alignment on the knee-ankle relationship following total knee arthroplasty. The study found that kinematic alignment preserved the native ankle alignment, whereas mechanical alignment induced significant alterations in ankle-specific parameters. This suggests that kinematic alignment is superior for maintaining the natural biomechanics of the entire lower limb chain post-surgery.
62. Narkbunnam R, Chorunchan Y, Chareancholvanich K, et al. Imageless and image‐based robotic‐assisted total knee arthroplasty achieve equivalent radiographic accuracy: A randomised controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70123
A randomized controlled trial compared the radiographic accuracy of image-based versus imageless robotic-assisted total knee arthroplasty using the ROSA system. Both techniques achieved equivalent radiographic accuracy with no significant differences in alignment parameters or functional outcomes. Surgeons can choose either workflow based on preference or availability without compromising accuracy.
69. Le Guen A, Marmor S, Le Strat V, et al. Personalized alignment in total knee arthroplasty reduces patellar tilt: A retrospective study. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70097
This retrospective study assessed the incidence of postoperative patellar tilt greater than 5 degrees following total knee arthroplasty using personalized alignment techniques and identified associated risk factors. The study found that while personalized alignment is beneficial, a significant number of patients still experienced excessive patellar tilt, which is linked to inferior clinical outcomes. These results highlight the need for surgeons to carefully monitor specific preoperative and intraoperative factors to prevent patellar maltracking even when using advanced alignment methods.
75. Pujol O, Hinarejos P, Pons A, et al. Functional alignment improves femoral joint line obliquity preservation in comparison with the classical measured resection technique. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70092
This multicenter study compared femoral component positioning in total knee arthroplasty between classical measured resection and robotic-assisted functional alignment using preoperative CT data. The findings demonstrated that functional alignment significantly improves the preservation of femoral joint line obliquity compared to the mechanical alignment technique. This supports the adoption of functional alignment strategies to better restore native knee kinematics during surgery.
91. Franceschetti E, Giurazza G, Campi S, et al. Unrestricted kinematic alignment in varus total knee arthroplasty outperforms mechanical alignment in CPAK I phenotype, but yields comparable outcomes in CPAK IV: A retrospective analysis from the FP‐UCBM Knee Study Group. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70084
This retrospective analysis compared clinical outcomes of unrestricted kinematic alignment versus mechanical alignment in varus total knee arthroplasty across different CPAK phenotypes. The study found that kinematic alignment yielded superior outcomes specifically in CPAK I phenotype patients, while results were comparable to mechanical alignment in CPAK IV patients. These findings suggest that alignment strategy should be tailored to the patient's specific joint line obliquity phenotype to maximize functional recovery.
93. Manara JR, Whitehouse SL, Marley M, et al. The influence of native Coronal Plane Alignment Knee phenotype on two-year outcomes of functionally aligned robot-assisted total knee arthroplasty. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2023-1071.r3
This study assessed two-year outcomes of functionally aligned robot-assisted total knee arthroplasty and evaluated the influence of native CPAK phenotypes on results. The research demonstrated significant improvements in patient-reported outcomes, with no significant differences in outcome changes across different native CPAK phenotypes. Additionally, the procedure largely preserved the native CPAK phenotype, suggesting functional alignment effectively maintains individual knee kinematics.
94. Hannon CP, Schwabe MT, King J, et al. Does robotic assistance influence recovery after total knee arthroplasty?. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2024-0989.r2
This prospective study compared early recovery metrics between robotically-assisted and manual total knee arthroplasty using daily remote patient monitoring. Results showed that robotic assistance significantly reduced postoperative pain and opioid consumption in the first week compared to manual techniques. These findings suggest that robotic assistance may facilitate faster early recovery and reduced analgesic requirements following TKA.
108. Koutserimpas C, Andriollo L, Gregori P, et al. Robotic total knee arthroplasty with functional alignment yields comparable outcomes across age and gender groups. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100930
This study assesses the outcomes of robotic total knee arthroplasty utilizing functional alignment across different age and gender demographics. The results demonstrate that this robotic technique yields comparable clinical outcomes regardless of patient age or sex. This suggests that functional alignment with robotics is a versatile and effective approach suitable for a broad patient population.
ACL Reconstruction: Outcomes, Risk Factors, and Rehabilitation (19)¶
4. Wackerle AM, Joreitz R, Sprague A, et al. Freddie Fu Panther Symposium Expert Group 2024: Rehabilitation and return to sport after anterior cruciate ligament reconstruction Part 2: Concepts and emerging technology in return to sport. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70110
An international expert group convened to establish a comprehensive framework for optimizing rehabilitation and return-to-sport protocols following anterior cruciate ligament reconstruction. The summary addresses the lack of consensus on milestones and highlights emerging technologies and interdisciplinary approaches to reduce secondary injury rates. This work aims to bridge the gap between research findings and clinical application for athletes.
15. Tayfur B, Johnson AK, Palmieri‐Smith RM. Compromised quadriceps and hamstring force control, not maximal strength, is associated with gait biomechanics at 9 months following anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70129
This study examined the relationship between quadriceps and hamstring force control and gait biomechanics nine months after anterior cruciate ligament reconstruction. It found that compromised force control, rather than maximal strength deficits, was significantly associated with altered gait patterns in the reconstructed limb. These findings highlight the importance of targeting neuromuscular control and force variability in rehabilitation protocols to restore normal gait mechanics.
19. Sun Q, Yin H, Guan L, et al. Effectiveness of digital health technologies in postoperative rehabilitation following anterior cruciate ligament reconstruction: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70134
This systematic review and meta-analysis of 16 randomized controlled trials evaluated the impact of digital health technologies on rehabilitation following anterior cruciate ligament reconstruction. The analysis demonstrated that digital interventions significantly improved rehabilitation adherence, reduced pain, and enhanced proprioception, muscle strength, and walking ability compared to standard care. These findings support the integration of digital health tools into postoperative protocols to optimize patient recovery and functional outcomes.
23. Fricke L, Petersen W, Häner M, et al. Digital rehabilitation after anterior cruciate ligament reconstruction—A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70141
This systematic review analyzed seven studies involving digital rehabilitation applications for patients undergoing anterior cruciate ligament reconstruction. The review concluded that digital interventions are at least as effective as standard physiotherapy, with some studies reporting superior outcomes in patient-reported measures, muscle strength, and range of motion. The findings support the use of digital tools to enhance patient engagement and adherence during the rehabilitation process.
24. Rinne JS, Vossen RJM, ten Noever de Brauw GV, et al. Tobacco's toll: Comparable anterior cruciate ligament graft failure rates and inferior functional outcomes in smokers compared to non‐smokers: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70146
This systematic review and meta-analysis of over 92,000 patients investigated the impact of smoking on anterior cruciate ligament reconstruction outcomes. The results indicated that smokers have significantly higher reoperation rates and inferior functional outcomes compared to non-smokers, despite similar graft failure rates in the limited comparative data. These findings underscore the critical importance of smoking cessation counseling to improve surgical success and long-term recovery in ACLR patients.
28. Souvik P, Ghandour M, Siret E, et al. High posterior tibial slope increases graft failure risk but does not impair functional outcomes after primary ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70154
Précis unavailable.
33. Carrozzo A, Ciccarelli G, Monaco E, et al. Early anterior cruciate ligament reconstruction within 14 days is safe and effective: Favourable clinical outcomes in 203 consecutive patients with a minimum 2‐year follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70099
This retrospective study evaluated 203 patients undergoing anterior cruciate ligament reconstruction (ACLR) within 14 days of injury to assess safety and efficacy. The findings demonstrated a low graft rupture rate of 1.9% and favorable clinical outcomes at a mean follow-up of 53.4 months, supporting the hypothesis that early surgery is safe. Clinically, these results suggest that performing ACLR within two weeks of injury is a viable strategy that does not significantly increase complication risks compared to delayed procedures.
36. Niederer D, Keller M, Petersen W, et al. Jump performance and hop function, kinesiophobia and return to sports are important prognostic factors for a subsequent injury after an anterior cruciate ligament reconstruction: A 2‐year follow‐up cohort study. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70104
This 2-year cohort study investigated prognostic factors for subsequent ACL injuries in 148 patients following primary reconstruction. Key findings identified jump performance, hop function, kinesiophobia, and return to sports status as significant predictors, with a model achieving 83.3% sensitivity for detecting subsequent injury risk. These results suggest that rehabilitation protocols should prioritize objective functional testing and psychological assessment to better identify patients at high risk for re-injury.
39. Edwards P, Blackah N, Radic R, et al. Vertical jump asymmetries from 6 to 9 months following anterior cruciate ligament reconstruction with hamstring tendon autograft in non‐elite athletes. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70112
Précis unavailable.
40. Koca F, von Essen C, Senorski EH, et al. Age, sex and graft choice are associated with the achievement of a patient acceptable symptom state five years after primary ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70116
Précis unavailable.
42. Sakamoto T, Watanabe S, Hayashi N, et al. Giving‐way episodes during preoperative waiting period increase associated injury in anterior cruciate ligament injury: A multicentre observational study. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70118
This multicentre study investigated the impact of preoperative giving-way episodes on the severity of associated intra-articular injuries in patients awaiting ACL reconstruction. The results demonstrated that patients experiencing two or more giving-way episodes during the waiting period had a significantly higher incidence of medial meniscus tears and other associated injuries compared to those with fewer episodes. These findings suggest that minimizing instability episodes prior to surgery may reduce the extent of secondary damage and improve surgical outcomes.
43. Sülek Y, Demirhan A, Altuntaş Y, et al. Anatomical risk mapping in ACL reconstruction: Radiological predictors of graft rerupture. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70119
This study compared anatomical parameters between patients who experienced ACL graft rerupture and matched controls to identify radiological predictors of failure. Significant differences were found in tibial tunnel angle and anteroposterior position, with specific anatomical configurations correlating with higher rerupture rates. Identifying these anatomical risk factors preoperatively could assist surgeons in optimizing graft placement and tunnel positioning to enhance long-term stability.
58. Dracic A, Zeravica D, Becirbegovic S, et al. Steep tibial slope correlates with inferior patient‑reported knee function independent of tunnel widening. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70096
Researchers compared revision and primary ACL reconstructions to determine if posterior tibial slope influences graft failure and patient outcomes. They found that a steeper tibial slope significantly correlates with graft failure and inferior patient-reported function, independent of bone tunnel widening. This suggests that preoperative slope assessment is critical for predicting outcomes and guiding surgical strategy.
73. Oronowicz J, Malinovskiy V, Bumberger A, et al. ACL injuries in elite alpine skiing reliably allow athletes to return to competition and perform at or above their pre‐injury level. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70090
This retrospective study analyzed World Cup results of 48 elite alpine skiers who sustained ACL injuries to determine if reconstruction limits post-injury performance. The key finding was that 97.9% of athletes returned to competition, with the majority performing at or above their pre-injury levels. Clinically, this suggests that ACL reconstruction in elite skiers does not preclude a return to peak professional performance.
80. Castellanos Dolk D, Sarakatsianos V, Wörner T, et al. Semitendinosus vs quadriceps tendon autograft in anterior cruciate ligament reconstruction (SEQUAR): protocol for a prospective randomized controlled trial. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09183-w
This research assessed the intra-rater and inter-rater reliability of a novel arthrometer designed to measure anterior tibial translation in healthy subjects. The device demonstrated high reliability across different raters, indicating consistent measurement capabilities. This validates the new arthrometer as a reliable tool for objective assessment of knee laxity in clinical and research settings.
82. Voskuijl T, Webster KE, Whitehead TS, et al. The addition of a lateral extra‐articular procedure to a primary anterior cruciate ligament reconstruction is associated with an increased rate of further surgery for cyclops lesions and restricted range of motion. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70089
Researchers analyzed a cohort of 1,076 young patients to assess whether adding a lateral extra-articular procedure (LEAP) to primary ACL reconstruction increases reoperation rates for cyclops lesions or restricted motion. The study found that the addition of LEAP was significantly associated with a higher rate of reoperation for these specific complications compared to ACL reconstruction alone. This indicates that while LEAP may reduce graft failure, it introduces a trade-off of increased risk for postoperative stiffness and cyclops lesions requiring further surgery.
90. Landfald IC, LaPrade RF, Olewnik Ł. Kaplan fibres of the knee revisited: Anatomical variants, MRI identification and surgical implications for ACL reconstruction and rotational instability. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70078
This narrative review synthesizes anatomical, radiological, and biomechanical data to redefine the role of Kaplan fibres in knee stability and their association with the pivot shift phenomenon. Key findings indicate that these fibres possess a bipartite architecture and are frequently disrupted in ACL tears, potentially explaining residual rotational laxity after reconstruction. Clinically, high-resolution MRI protocols are recommended for identification, and surgeons should consider addressing these structures to optimize rotational stability outcomes.
107. Conteduca J, Longo D, Carrozzo A, et al. Combining anterolateral ligament with anterior cruciate ligament reconstruction improves kinesiophobia and pivot shift reducing reoperation rate when stable lateral meniscal tears are left in situ. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100926
This study investigates the impact of combining anterolateral ligament reconstruction with anterior cruciate ligament reconstruction in patients with stable lateral meniscal tears. The key finding indicates that this combined approach significantly reduces kinesiophobia and pivot shift while lowering reoperation rates. Clinically, this supports a more comprehensive reconstruction strategy to improve stability and psychological recovery in complex knee injuries.
112. Lutz C, Mancino F, Parker DA. Twelve-month magnetic resonance imaging after anterior cruciate ligament reconstruction can identify risk factors for subsequent graft rupture and used to guide the return to sport. Results from a high-volume institution. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100994
This study analyzes twelve-month postoperative magnetic resonance imaging findings to identify risk factors for anterior cruciate ligament graft rupture. The results show that specific MRI characteristics can predict subsequent failure and guide return-to-sport decisions. Clinically, this supports the use of routine 12-month imaging as a tool for risk stratification and personalized rehabilitation planning.
Meniscal Pathology, Repair, and Allografts (10)¶
6. von Essen C, Cristiani R, Rizvanovic D, et al. Impact of tear morphology and meniscal laterality on repair failure in stable knees: Medial repairs show over twofold risk. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70166
A retrospective cohort study of 1,008 patients found that medial meniscal repairs in stable knees have a significantly higher failure rate compared to lateral repairs, with medial longitudinal tears showing the highest risk. The analysis identified tear morphology and laterality as critical predictors of repair failure, with medial repairs carrying over twice the risk of failure. These findings suggest that surgeons should exercise heightened caution and consider alternative treatments for medial tears.
16. Palco M, Giuca G, Familiari F, et al. Reliable labels, uncertain meaning: Classifications for medial meniscus posterior root tears lack consensus and arthroscopy‐anchored accuracy. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70130
A systematic review evaluated the consensus and diagnostic accuracy of various classification systems for medial meniscus posterior root tears. The review revealed a lack of standardized classifications and inconsistent reliability across different imaging modalities, with only one study providing arthroscopy-validated accuracy. This underscores the urgent need for harmonized classification criteria to improve diagnostic consistency and treatment planning for these injuries.
35. Kotipalli S, Blackman B, Vivekanantha P, et al. Pie‐crusting the medial collateral ligament is a safe and effective technique for improving visualisation and access in arthroscopic meniscal surgery: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70103
A systematic review of 15 studies assessed the safety and effectiveness of medial collateral ligament pie-crusting to improve visualization during arthroscopic meniscal surgery. The technique significantly increased medial joint space width without causing residual laxity, though transient pain and minor complications like ecchymosis were observed. The clinical implication is that pie-crusting is a safe and effective adjunctive maneuver to enhance surgical access, provided patients are counseled on the risk of transient symptoms.
47. Ahmed I, Khatri C, Davidescu A, et al. Returning to competitive sport after meniscal allograft transplant is associated with sustained graft survival and improved patient‐reported outcomes. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70137
This study compared outcomes in patients who returned to competitive sport versus those who did not following meniscal allograft transplantation. Patients who resumed competitive sport demonstrated superior graft survival rates and significantly better patient-reported outcomes at 10 years compared to non-returners. These findings suggest that returning to competitive sport after MAT is not only safe but may be associated with enhanced long-term graft durability and functional recovery.
48. Jackson GR, Stannard JP, Nuelle CW, et al. Fresh meniscus allograft transplantation using a double‐bone‐plug technique results in an overall high (>90%) 2‐to‐7‐year functional survival rate. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70140
This single-institution study analyzed failure rates and mechanisms in patients undergoing fresh meniscus allograft transplantation using a double-bone-plug technique. The results showed an overall functional survival rate exceeding 90% at 2 to 7 years, with failure mechanisms including joint disease progression and graft extrusion. Identifying these failure patterns allows for the optimization of surgical techniques and patient selection to further improve long-term outcomes.
50. Christensen BB, Hansen CH, El‐Galaly A, et al. One‐third of meniscal repairs undergo reoperation within five years: Incidence and predictors in a retrospective study of 2390 cases. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70144
Researchers analyzed a large cohort of 2,390 meniscal repairs to determine the five-year incidence of reoperation and identify associated risk factors. They found that approximately one-third of repairs required reoperation within five years, with smoking showing a trend toward increased failure risk while other factors like age and BMI were not significant. These findings highlight the high failure rate of meniscal repairs and suggest that smoking cessation may be a critical modifiable factor for improving surgical outcomes.
60. Lucidi GA, Balboni G, Di Paolo S, et al. Deleterious effect of sex mismatch between donor and recipient after meniscus allograft transplantation. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70106
The study investigated how donor-recipient demographic mismatches, specifically sex, affect the survivorship of meniscal allograft transplantation. It identified a deleterious effect where sex mismatch between donor and recipient significantly reduces graft longevity. Clinicians should consider matching donor and recipient sex to optimize graft survival rates.
77. Çeliksöz AH, Çağlar C, Akçaalan S, et al. No clinical differences between outside-in and all-inside techniques in medial meniscus repair: emphasizing Minimal Clinically Important Difference (MCID) -based outcomes. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09145-2
This study compared clinical outcomes between outside-in and all-inside techniques for medial meniscus repair, specifically analyzing results based on the Minimal Clinically Important Difference. The analysis found no statistically significant clinical differences between the two surgical approaches. Clinicians can therefore select either technique based on surgeon preference or specific defect characteristics without compromising patient outcomes.
78. Jin X, Wu X, Mao Y, et al. Radiographic evaluation of key anatomical markers in discoid lateral meniscus: a systematic review and meta-analysis. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09175-w
A systematic review and meta-analysis were conducted to evaluate radiographic markers used for diagnosing discoid lateral meniscus. The study synthesized data to identify the most reliable imaging criteria for accurate diagnosis of this anatomical variant. These findings provide standardized radiographic benchmarks to assist clinicians in diagnosing discoid meniscus and planning appropriate interventions.
83. Yu C, Zhao W, Liu K, et al. Stability characteristics of medial meniscus tear in mild varus knee: a finite element analysis. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09046-4
Using finite element analysis on subject-specific models, this study investigated how mild varus alignment influences stress distribution and healing potential in medial meniscus tears. Results demonstrated that peak contact pressure in the medial compartment increases linearly with the degree of varus angulation, exacerbating stress on both radial and longitudinal tears. These findings suggest that varus alignment significantly compromises the healing environment of meniscal tears, highlighting the need to address alignment in treatment planning.
Osteoarthritis: Diagnosis, Imaging, and Non-Operative Management (14)¶
1. Fu J, Mu L, Dong D, et al. An MRI-based radiomics framework for early identification and progression stratification in knee osteoarthritis: data from the osteoarthritis initiative. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09234-2
Researchers developed an MRI-based radiomics framework to identify and stratify the progression of knee osteoarthritis using data from the Osteoarthritis Initiative. The study demonstrates that this approach can effectively distinguish early disease stages and predict progression trajectories. This method offers a potential tool for early intervention and personalized management strategies in clinical practice.
3. Pasqualini I, Piuzzi NS. 2025 Kappa Delta Young Investigator Award: Optimizing Hip and Knee Arthroplasty Outcomes Through a PROMs-Based Personalized Approach. Journal of the American Academy of Orthopaedic Surgeons 2025. doi:10.5435/jaaos-d-25-00977
The authors advocate for integrating Patient-Reported Outcome Measures (PROMs) into a personalized medicine framework to optimize total joint arthroplasty outcomes and align with value-based healthcare models. Key findings indicate that comprehensive, multimodal PROM collection with one-year follow-up provides clinically meaningful data for quality improvement while reducing costs. The study emphasizes using specific metrics like minimal clinically important difference to interpret surgical effectiveness accurately.
7. Paul J, Imhoff FB, Heitner AH, et al. Static radiographic measurements accurately reflect dynamic knee alignment in medial compartment osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70171
This prospective study investigated the relationship between static radiographic measurements and dynamic knee alignment in patients with medial compartment osteoarthritis. Results indicated that static hip-knee-ankle angles accurately reflect dynamic alignment, and the presence of varus thrust is significantly associated with larger alignment angles. These findings support the use of static radiographs as a reliable proxy for dynamic assessment in preoperative planning.
10. Khadour FA, Khadour YA, Alharbi NSK. Synergistic effects of low-intensity pulsed ultrasound and extracorporeal shock wave therapy in knee osteoarthritis: clinical outcomes and biochemical mechanisms. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06384-w
Researchers investigated the synergistic effects of combining low-intensity pulsed ultrasound with extracorporeal shock wave therapy for treating knee osteoarthritis. The study demonstrated that this combined approach yields superior clinical improvements and favorable biochemical changes compared to monotherapies. These findings imply that multimodal non-invasive treatments could serve as a more effective conservative management strategy for knee osteoarthritis.
11. Kong H, Gao J, Lin J, et al. Association between knee stiffness and MRI-detected lesions: data from the osteoarthritis initiative (OAI). BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09242-2
Using data from the Osteoarthritis Initiative, this study analyzed the association between knee stiffness and specific lesions detected via MRI. The analysis revealed a significant correlation between restricted knee motion and particular structural abnormalities identified on imaging. This suggests that MRI-detected lesions may serve as valuable biomarkers for assessing the mechanical causes of stiffness in osteoarthritis patients.
26. Mangiavini L, Rossi N, Giorgino R, et al. Autologous minimally manipulated adipose‐derived stromal vascular fraction in knee osteoarthritis: Lasting symptom relief and imaging evidence from a 12‐month prospective study. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70149
This retrospective study investigated the impact of high posterior tibial slope (PTS) on graft survival and functional outcomes following primary ACL reconstruction with hamstring autografts. While a PTS of 12° or greater was associated with a significantly higher risk of graft failure, it did not negatively affect patient-reported outcomes or objective stability measures at two years. These findings suggest that while high PTS is a risk factor for graft rupture, it does not necessarily compromise the functional success of the reconstruction.
31. Peng H, Cai Q, Liu D, et al. Self-reported physical activity and risk of primary knee replacement for osteoarthritis: a competing risks cohort analysis. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09254-y
This competing risks cohort analysis investigated the association between self-reported physical activity levels and the risk of undergoing primary knee replacement for osteoarthritis. The study aimed to determine if higher physical activity serves as a protective factor or a risk factor for end-stage knee osteoarthritis requiring surgical intervention. The findings will inform public health guidelines regarding physical activity recommendations for preventing severe knee osteoarthritis progression.
55. Beyaz S, Yayli SB, Kılıç K. From variability to consistency: building a Kellgren-Lawrence gonarthrosis dataset. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06057-8
Précis unavailable.
63. Kang H, Kim G, Lim S, et al. CT-derived proximal tibial bone density imbalance is associated with knee osteoarthritis. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06302-0
This study examined the relationship between CT-derived proximal tibial bone density imbalance and the presence of knee osteoarthritis. It found that significant bone density imbalance in the proximal tibia is associated with knee osteoarthritis. This suggests that bone density distribution may play a role in osteoarthritis pathogenesis and could serve as a diagnostic marker.
65. Severyns M, Zot F, Vendeuvre T, et al. Biomechanical analysis of medial tibial cartilage by 7T magnetic resonance imaging and digital volume correlation: a preliminary study of variations caused meniscus ramp lesions. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06326-6
This preliminary study utilized 7T MRI and digital volume correlation to perform a biomechanical analysis of medial tibial cartilage in the presence of meniscus ramp lesions. The research identified specific variations in cartilage biomechanics caused by these lesions, providing new insights into the mechanical environment of the knee joint. These findings may inform future surgical strategies and rehabilitation protocols aimed at mitigating cartilage damage associated with meniscus injuries.
85. Kreutzinger V, Ziegeler K, Luitjens J, et al. Limited effects of non-steroidal anti-inflammatory drugs (NSAIDs) on imaging outcomes in osteoarthritis: observational data from the osteoarthritis initiative (OAI). BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09172-z
This observational study utilized data from the Osteoarthritis Initiative to evaluate the impact of new NSAID use on synovitis and structural cartilage damage over four years. The results indicated that NSAID use had limited effects on imaging biomarkers, showing no significant association with reduced synovitis or slowed structural cartilage damage compared to non-users. These findings suggest that while NSAIDs provide symptomatic relief, they may not alter the underlying disease progression or structural degeneration in knee osteoarthritis.
86. Li S, Li G, Zou J, et al. Association of different pain patterns with physical function in participants with knee osteoarthritis: data from the osteoarthritis initiative. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06146-8
This study analyzed data from the Osteoarthritis Initiative to explore the relationship between distinct pain patterns and physical function in knee osteoarthritis patients. Although the abstract is unavailable, the research likely identifies specific pain phenotypes that correlate with varying degrees of functional impairment. Understanding these associations could help clinicians tailor pain management strategies to improve physical function based on individual pain profiles.
103. Xu P, Xu C, Zhang Y, et al. Altered subchondral bone mineral density in painful knee osteoarthritis without cysts: a comparative analysis of lateral and medial regions. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09177-8
This study performed a comparative analysis of subchondral bone mineral density in painful knee osteoarthritis patients without cysts, focusing on differences between lateral and medial regions. The research identified specific alterations in bone density patterns associated with pain in the absence of radiographic cysts. These insights may help refine the understanding of pain mechanisms in osteoarthritis and inform targeted therapeutic strategies.
104. Za P, Ambrosio L, Vasta S, et al. Deepening the subchondral insufficiency fracture and osteonecrosis of the knee dilemma: Time for a new classification: Current concepts. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100922
This current concepts article addresses the diagnostic and classification challenges surrounding subchondral insufficiency fractures and osteonecrosis of the knee. The authors propose a new classification system to better delineate these conditions and guide clinical decision-making. Adopting this new framework aims to standardize diagnosis and improve treatment outcomes for these complex knee pathologies.
Revision Arthroplasty, Complex Reconstruction, and Safety (9)¶
8. Lei C, Huang W, Mei L, et al. Hinged total knee arthroplasty in two female patients with type 1 diabetes-associated charcot neuroarthropathy: case reports and a review of the literature series. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09262-y
Précis unavailable.
27. Wagener N, Wu Y, Grimberg A, et al. Prior osteosynthesis—unlike osteotomy—raises revision risk after total knee arthroplasty, predominantly via periprosthetic infection. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70153
Using German registry data, this study compared revision risks after total knee arthroplasty (TKA) in patients with prior osteosynthesis versus those with prior osteotomy. The analysis found that prior osteosynthesis significantly increased the risk of all-cause revision and periprosthetic joint infection, whereas prior osteotomy showed no increased risk compared to controls. Clinicians should recognize that the type of prior surgery critically influences TKA outcomes, with osteosynthesis posing a substantially higher risk of failure primarily due to infection.
30. Bok A, Bolam SM, Hooper GJ, et al. Uncemented Oxford mobile‐bearing unicompartmental knee arthroplasty demonstrates superior long‐term implant survival compared to cemented fixation in patients under 60 years. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70163
This multicentre study compared long-term survivorship of cemented versus uncemented Oxford mobile-bearing unicompartmental knee arthroplasty (UKA) across different age groups. In patients under 60 years, uncemented fixation demonstrated significantly superior 10- and 15-year implant survival rates compared to cemented fixation, while no difference was observed in older cohorts. These results support the use of uncemented fixation for younger patients undergoing UKA to enhance long-term implant durability.
44. Flindt A, Huesker K, Volk G, et al. Knee arthroplasty failure is associated with significant systemic multimetal exposure. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70122
This research quantified systemic metal levels in patients undergoing revision total knee arthroplasty compared to arthroplasty-naïve controls to assess metal exposure. Patients with failed implants exhibited significantly elevated systemic levels of cobalt, chromium, molybdenum, titanium, niobium, and zirconium, with levels varying based on implant constraint. These results highlight the potential for significant systemic multimetal exposure in revision cases, warranting further investigation into long-term biological implications.
45. Porto JR, Lavu MS, Hecht CJ, et al. Tranexamic acid lowers transfusions and readmissions in high‐risk total knee arthroplasty patients, but neurologic risks remain in patients with seizures or visual disturbances. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70124
This large-scale retrospective analysis evaluated the safety and efficacy of tranexamic acid in high-risk TKA patients with various comorbidities. While tranexamic acid significantly reduced transfusion rates, readmissions, and revisions across multiple risk groups without increasing thromboembolic events, it was associated with potential neurologic risks in patients with a history of seizures or visual disturbances. Clinicians should weigh the benefits of reduced bleeding against the specific neurologic risks when considering tranexamic acid for these high-risk subgroups.
49. Innocenti B. Cemented fixation improves bone stress and stability in distal femoral replacement. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70143
This study utilized finite element modeling to compare bone stress and implant micromotion between cemented and press-fit fixation methods in distal femoral replacement. The findings demonstrated that cemented fixation significantly reduces bone stress and enhances implant stability compared to press-fit configurations. Clinically, these results support the preference for cemented fixation to optimize load transfer and longevity in distal femoral replacement procedures.
95. Lisacek-Kiosoglous AB, Fontalis A, Powling AS, et al. Radiological and clinical outcomes of cementless versus cemented implants in total knee arthroplasty. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2024-1358.r1
This systematic review and meta-analysis evaluated the clinical and radiological outcomes of contemporary cementless versus cemented total knee arthroplasty implants. The analysis found no significant difference in survival rates between the two groups overall, though cementless implants showed superior survival in patients under 60 years old up to 14 years postoperatively. These results support the use of cementless designs, particularly for younger, active patients.
97. Yapp LZ, Scott CEH, Baxendale-Smith L, et al. Revision total knee arthroplasty using a fully cemented single-radius condylar constrained prosthesis has excellent ten-year survival and improvements in outcome measures. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2024-1619.r1
This retrospective study evaluated the long-term outcomes of 358 revision total knee arthroplasties using a fully cemented single-radius condylar constrained prosthesis with a median follow-up of 9.8 years. The key finding was an excellent ten-year survival rate accompanied by significant improvements in patient-reported outcome measures. Clinically, this supports the use of this specific prosthesis as a reliable option for complex revision knee cases.
109. Fernández Z I, Coolican M. Comparable clinical outcomes after conversion total knee arthroplasty following high tibial osteotomy and primary total knee arthroplasty: A matched cohort study. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100931
This matched cohort study compares clinical outcomes between conversion total knee arthroplasty after high tibial osteotomy and primary total knee arthroplasty. The research finds that clinical results are comparable between the two surgical pathways. These findings imply that conversion surgery following failed osteotomy can achieve success rates similar to primary procedures, aiding surgical decision-making.
Other articles this month¶
2. Knapik DM, Smith MV, Matava MJ, et al. Management of Posterior Cruciate Ligament Injury: A Concise Overview of Current Indications, Techniques, and Outcomes. Journal of the American Academy of Orthopaedic Surgeons 2025. doi:10.5435/jaaos-d-25-00500
This review evaluates current literature on posterior cruciate ligament (PCL) injuries, addressing controversies regarding surgical versus nonsurgical management and optimal reconstruction techniques. It highlights the importance of considering concomitant injuries, posterior tibial slope, and patient-specific factors like age to improve outcomes. The article serves as a guide for clinicians navigating complex decision-making in PCL injury treatment.
5. Pavan N, Segat F, Pellicciari L, et al. Development of the Italian version of the Anterior Cruciate Ligament Quality of Life (ACL‐QoL): A validity and reliability study. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70133
This study successfully translated and validated the Italian version of the Anterior Cruciate Ligament Quality of Life (ACL-QoL) questionnaire for assessing patients with ACL injuries. The instrument demonstrated good to excellent reliability and adequate internal consistency, supporting its use for both surgical and nonsurgical management contexts. The validated tool enables clinicians to accurately measure quality of life outcomes in Italian-speaking populations.
13. Simon J, Niethammer TR, Thorwächter C, et al. Retention or sacrifice of posterior cruciate ligament has no effect on in vitro kinematics in medial pivot total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70121
An in vitro study assessed whether retaining or sacrificing the posterior cruciate ligament affects kinematics in medial pivot total knee arthroplasty designs. The results showed no significant difference in knee kinematics between retained and resected posterior cruciate ligament groups, as both deviated similarly from native knee motion. This suggests that posterior cruciate ligament status may not be a critical determinant of biomechanical function in medial pivot TKA, potentially simplifying surgical decision-making.
14. El Kayali MKD, Bürck LV, Fahy S, et al. Abduction and adduction malpositioned lateral radiographs cannot be used for proper assessment of the posterior tibial slope. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70127
This retrospective analysis compared posterior tibial slope measurements on properly positioned lateral radiographs versus those with abduction or adduction malpositioning. The study found that malpositioning significantly alters measured slope values, potentially leading to incorrect surgical classifications and inappropriate osteotomy decisions. Clinicians must ensure strict radiographic positioning to avoid diagnostic errors that could compromise surgical planning.
17. Carrozzo A, Torre G, Gousopoulos L, et al. Identification of hidden lesions of the popliteal hiatus through a systematic clinical, MRI and arthroscopic assessment. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70131
This prospective study established a systematic clinical, MRI, and arthroscopic protocol to evaluate the popliteal hiatus, revealing that 38% of patients had pathological findings and 20.9% had structures that were not visible during arthroscopy. The findings highlight the high prevalence of occult lesions in this region that are often missed by standard assessments. Clinically, this supports the adoption of a dedicated, multi-modal evaluation strategy to improve the detection and management of posterolateral knee pathologies.
18. Pineda T, Sewpaul Y, Morin V, et al. The rectus femoris tendon demonstrates comparable ultimate stress to the patellar tendon: A paired biomechanical study. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70132
This biomechanical study compared the strength of paired rectus femoris and patellar tendon grafts, finding no significant difference in ultimate stress between the two tissues. However, rectus femoris grafts demonstrated significantly lower load-to-failure values and greater elongation compared to patellar tendons. These results suggest that while rectus femoris tissue has comparable tensile strength, its lower failure load and higher elasticity may influence graft selection and surgical planning for knee reconstruction.
20. Franceschetti E, Giurazza G, Del Monaco A, et al. Posterior tibial slope varies across functional tibial phenotypes but not CPAK categories: A radiographic analysis from the FP‐UCBM Knee Study Group. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70135
This radiographic study investigated the relationship between posterior tibial slope and various tibial phenotypes, finding no significant correlation between slope and CPAK categories or coronal alignment parameters. However, posterior tibial slope was found to vary significantly across different functional tibial phenotypes. This suggests that while sagittal and coronal planes are largely independent regarding standard classification systems, functional phenotypes may better capture the interplay between these anatomical planes.
25. Zimmermann F, Balcarek P, Giesinger JM, et al. Age‐ and sex‐specific reference values for the Banff Patella Instability Instrument (BPII 2.0) in the German population based on 1309 participants. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70148
This study established age- and sex-specific reference values for the Banff Patella Instability Instrument (BPII 2.0) in the German general population using data from 1,309 participants. Key findings revealed that males and individuals aged 14–30 years reported significantly higher BPII 2.0 scores compared to females and older adults. These reference values provide clinicians with essential benchmarks to better interpret patient-reported outcomes and assess disease-specific quality of life in patellar instability cases.
29. Buckthorpe M, Paolo SD, Grassi A, et al. Timing of ACL injuries during elite male football (soccer) matches—Impact of player position, substitutes, contact mechanisms, possession status and situational pattern: An analysis of 369 ACL injuries. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70161
This analysis of 369 ACL injuries in elite male football players examined injury timing relative to match minutes, player position, and situational factors. The study identified specific high-risk periods and patterns, such as increased injury rates during the final 15 minutes of matches and in specific game phases involving possession changes. Understanding these temporal and situational risk factors can help coaches and medical staff implement targeted prevention strategies during critical moments of play.
32. Lin Q, Li Z, Li M, et al. Effects of postoperative knee bracing on knee function and stability after anterior cruciate ligament reconstruction: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70098
A systematic review and meta-analysis of 11 studies involving 785 patients assessed the clinical benefits of postoperative knee bracing following anterior cruciate ligament reconstruction (ACLR). The analysis found no significant differences in knee function scores, pain levels, muscle strength, or joint stability between patients who used braces and those who did not. Consequently, routine postoperative bracing may not be necessary for improving recovery outcomes after ACLR.
34. Mabrouk A, Risebury M, Mumith A, et al. Medial opening wedge high tibial osteotomy yields comparable outcome across all Kellgren–Lawrence osteoarthritis grades. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70100
Researchers analyzed 1,170 medial opening wedge high tibial osteotomies to determine if radiographic osteoarthritis severity impacts clinical outcomes and survivorship. The study found that patient-reported outcomes and survivorship were comparable across all Kellgren–Lawrence grades, indicating that OA severity does not negatively influence the success of the procedure. This implies that surgeons can confidently offer this osteotomy to patients with varying degrees of radiographic osteoarthritis severity without compromising long-term results.
37. Rucinski K, Stannard JP, Nuelle CW, et al. Lower 3‐ and 6‐month postoperative patient‐reported outcome measures are associated with treatment failure 2 years following osteochondral allograft transplantation in the knee. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70105
This study evaluated whether early postoperative patient-reported outcome measures (PROMs) could predict treatment failure two years after osteochondral allograft transplantation. Lower PROM scores at 3 and 6 months were significantly associated with treatment failure, defined as conversion to total knee arthroplasty or revision surgery. Clinically, early PROM assessments serve as a valuable predictive tool to identify patients at risk of poor long-term outcomes who may require closer monitoring or alternative interventions.
38. Masuda S, Minoda Y, Ueyama H, et al. Medial‐pivot design total knee arthroplasty provides higher post‐operative patient satisfaction than posterior‐stabilized design under mechanical alignment. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70111
Précis unavailable.
41. Yang X, Tian W, Yuan M, et al. Lateral meniscal tear, medial femoral and tibial condyles bone bruise, posterolateral tibial plateau fracture, and lateral collateral ligament injury are correlated with Segond fracture associated with anterior cruciate ligament injury. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70117
This retrospective study compared concomitant injuries in ACL-injured patients with and without Segond fractures to identify risk factors and injury patterns. Key findings revealed that lateral meniscal tears, bone bruises on the lateral femoral and tibial condyles, posterolateral tibial plateau fractures, and lateral collateral ligament injuries are significantly correlated with Segond fractures. Clinically, the presence of a Segond fracture should prompt a thorough evaluation for these specific associated injuries to guide comprehensive surgical planning.
46. Oettl FC, Pruneski JA, Zsidai B, et al. Small language models: The big play for agentic artificial intelligence in orthopaedics. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70126
This editorial argues for a strategic shift from resource-intensive Large Language Models to Small Language Models for specialized orthopaedic applications. It posits that SLMs offer a more efficient, cost-effective, and adaptable solution for narrow clinical tasks like surgical assistance and administrative automation. The authors emphasize that rigorous validation and robust evaluation benchmarks are essential to ensure the safe and trustworthy integration of these models into clinical practice.
51. Oettl FC, Pruneski JA, Zsidai B, et al. Is orthopaedics entering the age of generative AI?—A narrative review of current applications challenges and future directions. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70145
This narrative review examines the transition from discriminative to generative AI in orthopaedics, highlighting its potential to revolutionize clinical workflows, surgical planning, and patient communication. Although current evidence is limited, the authors argue that generative AI offers unique benefits in spatial reasoning and procedural simulation for this imaging-heavy specialty. The article calls for further research to integrate these tools effectively while maintaining clinical excellence and ethical standards.
52. Kono K, Inui H, Kage T, et al. Efficacy of functional alignment in total knee arthroplasty in restoring in vivo cruciate ligament forces and knee kinematics compared with mechanical alignment. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70151
This study compared in vivo cruciate ligament forces and knee kinematics between mechanically aligned and functionally aligned total knee arthroplasties during squatting. Results indicated that both alignment methods altered native kinematics compared to normal knees, with specific differences in femoral rotation and ligament tension patterns observed between the two techniques. These findings suggest that while functional alignment aims to restore native mechanics, it does not fully replicate normal ligament forces, necessitating careful patient selection and surgical technique.
53. Pichler L, Girolamo LD, Arendt E, et al. Sustaining momentum in gender equity: Lessons from the women in European Society of Sports Traumatology, Knee Surgery and Arthroscopy initiative. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70157
This study evaluated the efficacy of fresh-frozen porcine knee models as a training tool for orthopaedic residents performing arthroscopic procedures. Residents demonstrated significant improvements in task completion, speed, and skill assessment scores after training on these models, with consistent gains across all experience levels. The findings support the integration of fresh-frozen porcine models into residency curricula to enhance arthroscopic skill acquisition before clinical practice.
54. Zeng H, Zeng H, Dai Z, et al. Effect analysis of transosseous wire fixation for patella fractures: therapeutic efficacy. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09228-0
Précis unavailable.
56. Hanaki S, Fukushima H, Abe K, et al. Significant improvement in arthroscopic skills of orthopaedic residents using fresh‐frozen porcine knee models. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70125
Précis unavailable.
57. Boer BC, Veerman QWT, Brouwer RW, et al. Proximal anatomical axes show bidirectional variability: Accurate tibial slope requires mechanical axis measurement. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70093
This study evaluated whether proximal anatomical axes can reliably substitute for the mechanical tibial axis when measuring posterior tibial slope. Although correlations were strong, agreement was poor with significant bidirectional variability, indicating that anatomical axes are inaccurate proxies. Clinically, mechanical axis measurement is required for precise tibial slope assessment to avoid errors in surgical planning.
59. Mylonas T, Raoulis V, Konstantinou E, et al. Satisfactory midterm clinical results and low incidence of patellofemoral arthritis after MPFL reconstruction for patellar instability, in patients with low‐grade trochlear dysplasia. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70101
This retrospective study assessed the long-term clinical results and incidence of patellofemoral arthritis following isolated MPFL reconstruction in young patients with low-grade trochlear dysplasia. The procedure yielded satisfactory midterm clinical scores and a low rate of subsequent arthritis development. These findings support MPFL reconstruction as a viable treatment option for this specific patient population.
61. Lima Y, Özçakar L, Köyağasıoğlu O, et al. Official match time underestimates injury incidence in football and beach soccer compared with futsal. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70114
This study compared injury incidence rates in football, beach soccer, and futsal using official match time versus total exposure time. It found that relying solely on official match time underestimates injury incidence in football and beach soccer compared to futsal. Accurate injury surveillance requires using total exposure time rather than just official match duration.
64. Pei Z, Tian A, Zhang B, et al. Network meta-analysis of high tibial osteotomy combined with different bone defect filler materials for medial compartment knee osteoarthritis. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06306-w
A network meta-analysis evaluated the clinical and radiographic outcomes of high tibial osteotomy combined with various bone defect filler materials for medial compartment knee osteoarthritis. The analysis compared different fillers to identify the most effective materials for enhancing recovery and structural support. These findings help refine treatment strategies by identifying optimal bone graft substitutes for this procedure.
66. Razi M, Soleimani M, Dadgostar H, et al. Higher graft failure rates following primary ACL reconstruction and conservative MCL treatment compared to simultaneous primary ACL and MCL reconstruction: a retrospective cohort study. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06334-6
This retrospective cohort study compared graft failure rates in patients undergoing primary ACL reconstruction with either conservative MCL treatment or simultaneous MCL reconstruction. The key finding revealed significantly higher graft failure rates in the group treated with conservative MCL management compared to those receiving simultaneous reconstruction. Clinically, this suggests that simultaneous MCL reconstruction should be strongly considered for patients with concomitant ACL and MCL injuries to improve graft survival.
67. Yao J, Wu Y, Xu L, et al. Targeting CD14 to Inhibit Macrophage Senescence and Regulate the Microenvironment for Enhanced Tendon-Bone Healing. The American Journal of Sports Medicine 2025. doi:10.1177/03635465251383161
This laboratory study investigated the role of macrophage senescence in the tendon-bone interface and evaluated the therapeutic potential of targeting CD14 to enhance healing in a murine ACLR model. The researchers found that inhibiting CD14 reduced macrophage senescence, improved the microenvironment, and significantly enhanced tendon-bone healing outcomes. This suggests that CD14-targeted pharmacological agents could serve as a novel postoperative therapy to optimize healing after ACL reconstruction.
68. Wang L, Feng S, Zhao Z, et al. Comparative diagnostic accuracy of next‐generation sequencing in different specimen types for periprosthetic joint infection: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70095
This systematic review and meta-analysis compared the diagnostic accuracy of next-generation sequencing (NGS) across synovial fluid, periprosthetic tissue, and implant sonicate fluid for detecting periprosthetic joint infection. The results indicated that all three specimen types demonstrated high and comparable pooled sensitivities, with sonicate fluid showing a slightly higher sensitivity of 0.89. Clinically, this supports the use of NGS on various specimen types as a reliable diagnostic tool, though sonicate fluid may offer a marginal advantage in sensitivity.
70. Jarstad J, Albert J, Sköldenberg O, et al. Primary knee arthroplasty in Sweden: A nationwide analysis of all‐cause 30‐day mortality and impact of age and ASA‐class. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70102
This nationwide observational study analyzed all-cause mortality rates following primary knee arthroplasty in Sweden between 2017 and 2021 to assess the impact of age and ASA class. The findings revealed an extremely low 30-day mortality rate of 0.045%, with advanced age and higher ASA classification being the primary predictors of increased mortality risk. These data provide current, reassuring benchmarks for patient counseling regarding the safety of knee arthroplasty in the Swedish population.
71. Oettl FC, Pruneski J, Zsidai B, et al. Artificial intelligence agents in orthopaedics: Concepts, capabilities and the road ahead. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70109
This review introduces the concept of AI agents in orthopaedics, distinguishing them from traditional narrow AI by their ability to autonomously manage complex, multistep patient journeys. The authors outline potential applications ranging from perioperative workflow optimization to intelligent physician support, while also addressing significant implementation and ethical challenges. Understanding these advanced systems is presented as essential for orthopaedic surgeons to leverage future technological advancements for improved efficiency and patient outcomes.
72. Moon H, Kim S, Choi C, et al. MOCART 2.0 score of 60 or greater measured at 1 year post‐operatively predicts favourable clinical outcomes after surgical repair of tibiofemoral cartilage lesions. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70086
This retrospective study evaluated the correlation between the 1-year postoperative MOCART 2.0 score and patient-reported outcome measures following surgical repair of tibiofemoral cartilage lesions. The analysis determined that a MOCART 2.0 score of 60 or greater serves as a significant threshold for predicting favorable clinical outcomes and substantial clinical benefit. This finding establishes a quantitative radiographic benchmark that surgeons can use to prognosticate patient recovery and satisfaction after cartilage repair procedures.
74. Oehme S, Bartek B, Callsen J, et al. Spheroid‐based matrix‐induced autologous chondrocyte implantation combined with autologous bone grafting restores physiological cartilage and subchondral bone properties in osteochondral knee defects ‐ An MRI‐based analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70091
Researchers evaluated 28 patients with osteochondral knee defects treated using spheroid-based matrix-induced autologous chondrocyte implantation combined with autologous bone grafting. MRI analysis revealed restored physiological cartilage and subchondral bone properties, which correlated with improved patient-reported outcome measures. These results indicate that this combined surgical approach effectively restores both structural integrity and clinical function in complex knee defects.
76. Mao Z, Li K, Zhang Z, et al. Application of saphenous nerve infrapatellar branch protection technique in total knee arthroplasty. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09099-5
This article describes a specific surgical technique designed to protect the infrapatellar branch of the saphenous nerve during total knee arthroplasty. The method aims to reduce the incidence of postoperative numbness and neuroma formation associated with nerve injury. Implementing this protection technique is clinically relevant for improving sensory outcomes and patient comfort following knee replacement.
79. Li J, Zhang J, Li W, et al. Intra-rater and inter-rater reliability of a new arthrometer for measuring anterior tibial translation in healthy subjects. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09209-3
This protocol outlines a prospective randomized controlled trial comparing quadriceps tendon autografts with semitendinosus tendon autografts in athletes undergoing primary ACL reconstruction. The study aims to determine if the quadriceps tendon offers superior biomechanical stability or lower donor site morbidity in this specific population. The results will guide graft selection strategies for high-level athletes seeking optimal return to pivoting sports.
81. Veizi E, Caria C, Koutserimpas C, et al. Lateral prosthetic trochlear angle deviation is common and clinically safe after robotic functionally aligned total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70087
This retrospective study evaluated 237 patients to determine if lateral deviation of the prosthetic trochlear angle from the quadriceps vector affects outcomes in robotic functionally aligned total knee arthroplasty. The findings revealed that while lateral deviation is common (mean 3.8°), it does not correlate with patient-reported outcomes, which remained excellent. Clinically, this suggests that minor lateral prosthetic trochlear angle deviations are safe and do not compromise functional results in this surgical context.
84. Plangsiri K, Chotiwatanadilok B, Chaiyakit P, et al. Postural coronal alignment shift after total knee arthroplasty diminishes with age and becomes negligible in elderly patients. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70085
This cross-sectional study examined 113 TKA patients to determine if age moderates the shift in coronal alignment between supine and standing positions. The analysis revealed that younger patients exhibit a standing varus drift of 2–3°, whereas this postural shift diminishes with age and becomes statistically negligible in patients aged 60 and older. Clinically, this implies that preoperative planning for alignment correction should account for age-related differences in postural alignment shifts to avoid overcorrection in elderly patients.
87. Zhu J, Xia Z, Min J, et al. Non-linear association between surgical duration and length of hospital stay in primary unilateral total knee arthroplasty: a secondary analysis based on a retrospective cohort study in Singapore. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06267-0
A secondary analysis of 2,394 primary unilateral TKA patients in Singapore investigated the relationship between surgical duration and length of hospital stay. The study identified a non-linear association where length of stay increases substantially only after surgical duration exceeds 115 minutes, with anemia and ASA scores further modulating this effect. Clinically, this suggests that optimizing surgical efficiency below the 115-minute threshold may be more effective for reducing hospital stays than addressing minor delays beyond this point.
88. Pakdel FK, Pakdel AK, Norasteh AA. Cross-cultural adaptation and validation of the 12-item short forms of the knee injury and osteoarthritis outcome score (KOOS-12) to Persian language. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06301-1
This study describes the cross-cultural adaptation and validation of the 12-item KOOS short form into the Persian language for use in Iranian populations. The process likely involved translation, back-translation, and psychometric testing to ensure the tool's reliability and validity for assessing knee injury and osteoarthritis outcomes in Persian speakers. This validated instrument will facilitate more accurate clinical assessments and research comparisons in Persian-speaking regions.
89. zheng Y, zhang X, Niu Y, et al. A new CT-based classification system for posterior cruciate ligament tibial avulsion fractures: a nationwide multicenter study. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09025-9
This nationwide multicenter study developed a new CT-based classification system for posterior cruciate ligament tibial avulsion fractures to improve diagnostic precision. The research establishes a standardized framework for categorizing fracture patterns based on computed tomography imaging. This system aims to guide surgical decision-making and improve prognostic accuracy for this specific injury type.
92. Mitchell BC, Shea KG, Ganley TJ, et al. Juvenile Knee Osteochondritis Dissecans. Arthroscopy 2025. doi:10.1016/j.arthro.2025.07.021
This article reviews the etiology, presentation, and management of juvenile osteochondritis dissecans, emphasizing that clinical and radiographic markers of lesion stability dictate treatment selection. Key findings highlight that older age, effusion, and range of motion loss are significant risk factors for instability, necessitating advanced imaging like MRI for accurate assessment. Early identification of instability is crucial to prevent lesion disruption and subsequent premature osteoarthritis.
96. Gille J, Reiss E, Anders† S, et al. Patients aged 50 to 69 years show comparable outcomes with those aged under 50 years following autologous matrix-induced chondrogenesis for the repair of focal chondral defects in the knee. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2024-1397.r2
This study compared long-term outcomes of autologous matrix-induced chondrogenesis for focal chondral defects between patients aged 50 to 69 and those under 50. The findings revealed no significant difference in Lysholm scores or pain levels between the two age cohorts despite the age disparity. This suggests that patient age alone should not be a limiting factor for considering AMIC in patients up to 69 years of age.
98. Klinger CE, Nguyen JT, Mintz DN, et al. Diagnostic accuracy of knee CT Hounsfield units for osteopenia and osteoporosis. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2024-1703.r1
This study assessed the diagnostic accuracy of regional knee CT Hounsfield units for detecting osteopenia and osteoporosis compared to DXA scans in 126 patients. Results indicated that specific trabecular bone regions on knee CT could serve as a viable screening tool for bone density assessment. This finding suggests that knee CT scans could be leveraged to identify osteoporosis in patients who undergo imaging for other reasons, potentially reducing the need for separate DXA scans.
99. French JMR, Deere K, Sayers A, et al. Trends in day-case hip and knee replacement in England. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2025-0066.r1
This national cohort study analyzed trends in day-case hip and knee replacements in England between 2010 and 2022 using linked registry and hospital data. The proportion of day-case procedures increased significantly from 0.3% to over 1% for both hip and knee replacements, with the majority of these cases occurring after 2019. These results indicate a growing adoption of day-case pathways for joint arthroplasty, reflecting evolving surgical efficiency and patient selection criteria.
100. Park J, Kim DH, Chang CB. Efficacy of direct adductor canal block in pain control and sparing opioid consumption after total knee arthroplasty: a randomized controlled trial. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09087-9
This randomized controlled trial compared the efficacy of direct adductor canal block combined with periarticular injection versus periarticular injection alone in 78 patients undergoing total knee arthroplasty. The group receiving the direct block demonstrated significantly reduced opioid consumption and effective pain control without major adverse events. This suggests that intraoperative direct adductor canal block is a safe and effective strategy for enhancing postoperative analgesia and facilitating opioid-sparing protocols.
101. Hu J, Huang X. Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial fractures: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09162-1
This systematic review and meta-analysis compared suprapatellar and infrapatellar intramedullary nailing techniques for tibial fractures based on randomized controlled trials. The analysis aimed to determine differences in clinical outcomes, such as alignment, union rates, and complication profiles between the two approaches. The findings will guide surgeons in selecting the optimal nailing entry point to improve fracture management outcomes.
102. Chen J, Zhong X, Zhai Y, et al. Clinical prediction models for postoperative blood transfusion after total knee arthroplasty: a systematic review and meta-analysis. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09164-z
This systematic review and meta-analysis evaluated existing clinical prediction models designed to estimate the risk of postoperative blood transfusion following total knee arthroplasty. The study synthesized data to identify the most accurate and reliable models for preoperative risk stratification. These findings support the implementation of validated prediction tools to optimize blood management and reduce unnecessary transfusions in TKA patients.
105. Sanchis-Alfonso V, Montesinos-Berry E. Intertrochanteric derotational femoral osteotomy for pathological femoral anteversion without ligamentous instability. Technical note. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100924
This technical note describes a surgical technique for intertrochanteric derotational femoral osteotomy to correct pathological femoral anteversion in the absence of ligamentous instability. The procedure aims to restore normal femoral rotation and joint mechanics through precise osteotomy and fixation. It provides a specific operative strategy for managing rotational deformities where soft tissue stability is preserved.
106. Arteaga J, Poblete E, Martin F, et al. Return to sports and recreational activities after patellofemoral arthroplasty: A systematic review. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100925
This systematic review evaluates the rates and patterns of return to sports and recreational activities following patellofemoral arthroplasty. The analysis synthesizes existing literature to determine functional outcomes and activity levels post-surgery. The findings offer evidence-based benchmarks for patient counseling regarding postoperative rehabilitation and activity resumption.
110. Kanto R, Smolinski MP, Fayed AM, et al. Posterior fan-like extension of the anterior cruciate ligament femoral insertion increases ligament failure strength. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100939
This biomechanical study examines how a posterior fan-like extension of the anterior cruciate ligament femoral insertion affects ligament failure strength. The key finding reveals that this specific anatomical variation significantly increases the ligament's resistance to failure. This insight enhances understanding of ACL anatomy and may influence surgical graft placement techniques to optimize biomechanical strength.
111. Herman ZJ, Grandberg C, Boduch AN, et al. Assessing the current medicolegal landscape in orthopedic sports medicine surgery—patient-centered communication and multidisciplinary approaches matter: A consensus statement. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100993
This consensus statement outlines the current medicolegal landscape in orthopedic sports medicine, emphasizing the importance of patient-centered communication and multidisciplinary care. It identifies key strategies to mitigate legal risks and improve patient safety through collaborative approaches. The document serves as a guideline for surgeons to navigate legal challenges while maintaining high standards of care.
113. Nizaj N, Meleppuram JJ, Ahamed HN, et al. Single stage anatomic posterolateral corner reconstruction with modified LaPrade technique, combined with arthroscopic posterior cruciate ligament reconstruction with tibia nail in situ—A current technique. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100996
This article describes a surgical technique combining single-stage anatomic posterolateral corner reconstruction using a modified LaPrade method with arthroscopic posterior cruciate ligament reconstruction utilizing a tibia nail in situ. The key finding is the successful integration of these two procedures into a unified, minimally invasive approach for complex knee instability. The clinical implication is that this combined technique offers a viable, standardized option for surgeons to address multi-ligament knee injuries with improved stability and reduced operative time.