A Greater Rate of Return to High-Impact Sports Favoring Unicompartmental Knee Arthroplasty Compared with Total Knee Arthroplasty: A Systematic Review with Meta-Analysis.

Several studies have demonstrated the importance of patient expectation management following surgery, as this is a crucial factor influencing postoperative outcomes. Informing patients on the likelihood on return to sport (RTS) following a knee arthroplasty is therefore important. This systematic review aimed to compare RTS rates and RTS rates per sport-impact level for primary total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), or patellofemoral knee arthroplasty (PFA).

Multiple Intrinsic and Extrinsic Factors Increase the Risk of Anterior Cruciate Ligament Injury in Skiers: A Systematic Review.

Purpose: To identify and synthesize risk factors associated with first-time, isolated anterior cruciate ligament (ACL) injuries in alpine skiers.

Methods: A comprehensive literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the study was registered in PROSPERO. Studies were included if they were original human research, discussed ACL injuries in skiers, and included first-time ACL injury data.

Insights Into Extension and Flexion Strength Recovery Following Posterior-Stabilized Total Knee Arthroplasty and Fixed-Bearing Unicompartmental Knee Arthroplasty: A 369-Case Prospective Cohort Study.

Background: Recovery of muscle strength following total knee arthroplasty (TKA) and medial unicompartmental knee arthroplasty (UKA) has been scarcely evaluated, yet it remains crucial for guiding rehabilitation. This study evaluated recovery of extension and flexion leg strength and patient-reported outcome measures (PROMs) following TKA and medial UKA.

Methods: A prospective study was performed among 369 patients (mean age 68 years [range, 51 to 81], 55.

Adding a Lateral Extra-articular Tenodesis Is Cost-Effective in Primary Anterior Cruciate Ligament Reconstruction: A Markov Analysis.

Purpose: To evaluate the cost-effectiveness of anterior cruciate ligament reconstruction (ACLR) with lateral extra-articular tenodesis (LET) augmentation in athletes with primary anterior cruciate ligament ruptures compared with ACLR alone.

Methods: A Markov chain Monte Carlo model evaluated the outcomes and costs of 1,000 athletes undergoing ACLR with LET (ACLR-LET, iliotibial band) compared with ACLR alone. Costs, utility values, graft failure rates, and transition probabilities were derived from existing literature.

Sagittal Slope-Reducing High Tibial Osteotomy Decreases Anterior Cruciate Ligament Force and Coupled Internal Tibial Rotation Under Pivoting Loads: A Computational Modeling Study.

Background: Sagittal-plane slope-reducing high tibial osteotomy (HTO) can reduce the risk of anterior cruciate ligament (ACL) injury in knees with a high posterior tibial slope. The biomechanical effect of slope-reducing HTO on tibiofemoral kinematics and force carried by the ACL remains less well understood.

Hypothesis: Decreased tibial slope will be associated with decreased ACL force, coupled internal tibial rotation (ITR), and anterior tibial translation (ATT) under both compressive and combined compressive and valgus loads.

Excellent early outcomes following lateral robotic-assisted unicompartmental knee arthroplasty.

Introduction: Lateral unicompartmental knee arthroplasty (UKA) has historically shown mixed results and there is limited contemporary literature on lateral robotic-assisted UKA (RA-UKA) outcomes. This study aimed to evaluate the short-term survivorship, clinical, and radiographic outcomes of lateral RA-UKA.

Methods: A retrospective review identified 138 lateral RA-UKAs performed from 2016 to 2022 at a single institution, with a study population of 58% women, a mean BMI of 27 kg/m, and a mean age of 62 years.

Distinct age-related modes of failure in cemented and cementless Oxford medial unicompartmental knee arthroplasty : results from 25,762 patients in the Dutch Arthroplasty Register.

Aims: The primary objective of this study was to compare short-term implant survival between cemented and cementless fixation for the mobile-bearing Oxford medial unicompartmental knee arthroplasty (UKA) across various age groups. The secondary objectives were to compare modes of failure and to evaluate patient-reported outcomes.

Methods: A total of 25,762 patients, comprising 8,022 cemented (31.

Inferior short-term survivorship and patient outcomes for cementless compared to hybrid fixation with a cemented femoral implant in a novel blade-anchored medial unicompartmental knee arthroplasty design: An analysis of 132 cases.

Purpose: For younger, more active patients, a cementless unicompartmental knee arthroplasty (UKA) might be more advantageous than cemented fixation. Therefore, this study aimed to compare implant survivorship and patient-reported outcome measures (PROMs) between cementless and hybrid fixation (cemented femur and cementless tibial fixation) in a novel tibial blade-anchored, medial UKA design.

Methods: Two surgeon's registries were reviewed for patients who underwent primary cementless or hybrid medial UKA for medial osteoarthritis between 2019 and 2022.

Diagnostic performance of deep learning for leg length measurements on radiographs in leg length discrepancy: A systematic review.

Purpose: To systematically review the literature regarding machine learning in leg length discrepancy (LLD) and to provide insight into the most relevant manuscripts on this topic in order to highlight the importance and future clinical implications of machine learning in the diagnosis and treatment of LLD.

Methods: A systematic electronic search was conducted using PubMed, OVID/Medline and Cochrane libraries in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Two observers independently screened the abstracts and titles of potential articles.

Compressive force and valgus torque are the predominant applied loads during the pivot shift exam: An in vitro study.

Purpose: Despite the clinical utility of the pivot shift exam, the requisite applied forces and torques to elicit a pivot shift remain unclear. The purposes of this study are (1) to identify the greatest forces and torques applied to the knee during the pivot shift exam and (2) to evaluate if the applied loads differ among experienced surgeons.

Methods: Three cadaveric hemipelvis-to-toe specimens (ages 53, 36 and 31 years; two males and one female) with no history of knee or hip injury were utilized.

Patient satisfaction following unicompartmental knee arthroplasty: Current concepts.

Unicompartmental knee arthroplasty (UKA) has gained progressive popularity in recent decades, currently comprising approximately 10% of knee arthroplasties in the United States. Nonetheless, UKA has not yet solidified its position as the superior treatment for isolated compartment osteoarthritis, as initially reported implant survivorship was subpar, leading to hesitation in its utilization and stricter patient indications compared to total knee arthroplasty. Patient satisfaction following knee arthroplasty has emerged as a critical metric to gauge patient acceptance and contentment with surgical interventions.

Segond Fractures Can Be Identified With Excellent Accuracy Utilizing Deep Learning on Anteroposterior Knee Radiographs.

Purpose: To develop a deep learning model for the detection of Segond fractures on anteroposterior (AP) knee radiographs and to compare model performance to that of trained human experts.

Methods: AP knee radiographs were retrieved from the Hospital for Special Surgery ACL Registry, which enrolled patients between 2009 and 2013. All images corresponded to patients who underwent anterior cruciate ligament reconstruction by 1 of 23 surgeons included in the registry data.

Team Approach: Neuromuscular Training for Primary and Secondary Prevention of Anterior Cruciate Ligament Injury.

Neuromuscular training is a method of performance optimization-typically combining plyometrics, balancing training, agility, and dynamic stabilization-predicated on improving the efficiency of fundamental movement patterns. Neuromuscular training has consistently been shown to reduce the risk of anterior cruciate ligament injury, particularly for athletes engaged in activities associated with noncontact knee injuries (i.e.

The Large Language Model ChatGPT-4 Exhibits Excellent Triage Capabilities and Diagnostic Performance for Patients Presenting With Various Causes of Knee Pain.

Purpose: To provide a proof-of-concept analysis of the appropriateness and performance of ChatGPT-4 to triage, synthesize differential diagnoses, and generate treatment plans concerning common presentations of knee pain.

Methods: Twenty knee complaints warranting triage and expanded scenarios were input into ChatGPT-4, with memory cleared prior to each new input to mitigate bias. For the 10 triage complaints, ChatGPT-4 was asked to generate a differential diagnosis that was graded for accuracy and suitability in comparison to a differential created by 2 orthopaedic sports medicine physicians.

Large variance in a lateral osteoarthritic population prior to and following lateral unicompartmental arthroplasty: An analysis of knee phenotypes.

Background: Disagreement exists on the optimal coronal alignment target for lateral unicompartmental knee arthroplasty (UKA). An improved understanding of the distribution of coronal alignment and joint line orientation in lateral osteoarthritis (OA) might prove beneficial. The aim of this study was to evaluate the pre- and postoperative Coronal Plane Alignment of the Knee (CPAK) distribution following lateral UKA and to evaluate the association between phenotypic variation and patient-reported outcome measures (PROMs).

Clinical Results of Primary Repair Versus Reconstruction of the Anterior Cruciate Ligament: A Systematic Review and Meta-analysis of Contemporary Trials.

Background: Primary anterior cruciate ligament (ACL) repair has gained renewed interest in select centers for patients with proximal or midsubstance ACL tears. Therefore, it is important to reassess contemporary clinical outcomes of ACL repair to determine whether a clinical benefit exists over the gold standard of ACL reconstruction (ACLR).

Purpose: To (1) perform a meta-analysis of comparative trials to determine whether differences in clinical outcomes and adverse events exist between ACL repair versus ACLR and (2) synthesize the midterm outcomes of available trials.

Preservation of prearthritic coronal knee phenotype and prearthritic coronal alignment yielded improved Kujala scores following ligament-guided medial unicompartmental knee arthroplasty.

Purpose: There is a lack of literature evaluating outcomes of the ligament-guided approach in medial unicompartmental knee arthroplasty (UKA). An improved comprehension of the distribution of coronal plane alignment of the knee (CPAK) phenotypes and sagittal tibial wear patterns and their associations with patient-reported outcome measures (PROMs) and implant survivorship could provide insights into its further application in daily practice.

Methods: A registry was reviewed for patients with a minimal 2-year follow-up who underwent robotic-assisted, ligament-guided, medial UKA between 2008 and 2016.

Robotic-arm-assisted lateral unicompartmental knee arthroplasty leads to high implant survival and patient satisfaction at mean 10-year follow-up.

Background: There is a lack of literature reporting on long-term outcomes following robotic-arm-assisted lateral unicompartmental knee arthroplasty (UKA). This study assessed the long-term survivorship, patient-reported satisfaction and pain scores following robotic-arm-assisted lateral UKA for lateral compartment osteoarthritis (OA).

Methods: A single surgeon's database was reviewed to identify all patients who underwent robotic-arm-assisted lateral UKA with a cemented, fixed-bearing prosthesis prior to May 2015.

Statistical shape analysis and computational modeling reveal novel relationships between tibiofemoral bony geometry and knee mechanics in young, female athletes.

Young female athletes participating in sports requiring rapid changes of direction are at heightened risk of suffering traumatic knee injury, especially noncontact rupture of the anterior cruciate ligament (ACL). Clinical studies have revealed that geometric features of the tibiofemoral joint are associated with increased risk of suffering noncontact ACL injury. However, the relationship between three-dimensional (3D) tibiofemoral geometry and knee mechanics in young female athletes is not well understood.

A practical guide to the development and deployment of deep learning models for the orthopaedic surgeon: Part III, focus on registry creation, diagnosis, and data privacy.

Deep learning is a subset of artificial intelligence (AI) with enormous potential to transform orthopaedic surgery. As has already become evident with the deployment of Large Language Models (LLMs) like ChatGPT (OpenAI Inc.), deep learning can rapidly enter clinical and surgical practices.

Independent data collectors decrease bias in the measurement of adherence to anterior cruciate ligament injury prevention programs.

Objectives: Studies on adherence to neuromuscular training (NMT) for anterior cruciate ligament (ACL) injury prevention are frequently biased due to the use of self-reporting by coaches or the athletes themselves. Few NMT studies use data collectors (aside from the athletes or the individuals administering the NMT program) to decrease bias when assessing the adherence of coaches and sports teams. We hypothesized that the use of a data collector who is independent of the team to evaluate adherence to NMT programs would be reliable.

Medical Imaging Applications Developed Using Artificial Intelligence Demonstrate High Internal Validity Yet Are Limited in Scope and Lack External Validation.

Purpose: To (1) review definitions and concepts necessary to interpret applications of deep learning (DL; a domain of artificial intelligence that leverages neural networks to make predictions on media inputs such as images) and (2) identify knowledge and translational gaps in the literature to provide insight into specific areas for improvement as adoption of this technology continues.

Methods: A comprehensive search of the literature was performed in December 2023 for articles regarding the use of DL in sports medicine. For each study, information regarding the joint of focus, specific anatomic structure/pathology to which DL was applied, imaging modality utilized, source of images used for model training and testing, data set size, model performance, and whether the DL model was externally validated was recorded.