Knee最新文献

{"title":"Elevated risks of pneumonia, cognitive dysfunction, and cerebrovascular disorder in super-elderly knee arthroplasty patients: insights from a nationwide Japanese database","authors":"Yu Mori ,&nbsp;Kunio Tarasawa ,&nbsp;Hidetatsu Tanaka ,&nbsp;Masayuki Kamimura ,&nbsp;Kento Harada ,&nbsp;Naoko Mori ,&nbsp;Kiyohide Fushimi ,&nbsp;Toshimi Aizawa ,&nbsp;Kenji Fujimori","doi":"10.1016/j.knee.2026.104351","DOIUrl":"10.1016/j.knee.2026.104351","url":null,"abstract":"<div><h3>Introduction</h3><div>Knee arthroplasty is an effective treatment option for managing advanced osteoarthritis and rheumatoid arthritis, even in elderly patients. However, super-elderly patients face increased risks of postoperative complications such as in-hospital mortality, deep vein thrombosis, pneumonia, cerebrovascular events, and cognitive dysfunction. This study aims to analyze postoperative complications in super-elderly patients (aged 85 years and older) and elderly patients (aged 70–84 years) who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) using Japan’s nationwide DPC database. The analysis was conducted after adjusting for confounding factors through propensity score matching.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 200,925 patients who underwent TKA or UKA between 2016 and 2023. After propensity score matching (1:1) based on age, sex, body mass index, surgical method, and comorbidities, 21,117 patients were included in each group. Postoperative complications, including in-hospital mortality, deep vein thrombosis, pneumonia, cerebrovascular events, and cognitive dysfunction, were analyzed. Multivariate logistic regression identified independent risk factors for postoperative complications.</div></div><div><h3>Results</h3><div>The super-elderly group exhibited higher odds ratios for pneumonia (2.227, 95% CI: 1.494–3.319), cerebrovascular events (1.720, 95% CI: 1.305–2.266), and cognitive dysfunction (1.767, 95% CI: 1.485–2.103). They also had more extended hospital stays and higher blood transfusion requirements. However, no significant differences were observed for deep vein thrombosis, pulmonary embolism, or in-hospital mortality.</div></div><div><h3>Conclusion</h3><div>Super-elderly patients exhibit increased risks for certain complications, though not for mortality. When clinically appropriate, performing knee arthroplasty before the age of 85 may help reduce these risks.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104351"},"PeriodicalIF":2.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of Agilium Freestep ankle–foot orthosis on the kinetic and kinematic parameters of gait in patients with knee osteoarthritis","authors":"Mahsa Kavyani Boroujeni ,&nbsp;Mohammad Taghi Karimi ,&nbsp;Masoud Rafiaei ,&nbsp;Hossein Akbari Aghdam","doi":"10.1016/j.knee.2026.104353","DOIUrl":"10.1016/j.knee.2026.104353","url":null,"abstract":"<div><h3>Background</h3><div>There are several orthotic treatment options for knee osteoarthritis. Ankle–foot orthosis (AFO) is a new approach in this regard; it is designed to reduce knee joint loading and consequently reduce the joint cartilage degeneration process. Previous studies considered the knee adduction moment as a surrogate marker for knee joint loading and knee joint contact force was not measured precisely. Moreover, the effect of this orthosis on joint kinematic and ground reaction force was not evaluated in previous studies. Thus, the aim of this study was to evaluate the gait kinetic parameters including joint moment and joint contact force and kinematic parameters of patients with medial knee compartment osteoarthritis using AFO.</div></div><div><h3>Methods</h3><div>Ten women with knee osteoarthritis participated in this study. Patients were assessed in two conditions: walking with and without AFO (Agilium Freestep®, Ottobock, Duderstadt, Germany). Thirty-six reflective markers were attached on lower limb anatomical landmarks of patients and a motion analysis system and a Kistler force plate were used to monitor the markers’ motion and collect the forces applied on the legs, respectively. OpenSim software was used to measure knee joint kinematic, moments and estimate knee joint contact force.</div></div><div><h3>Results</h3><div>The current study showed that immediately after wearing AFO, stride length significantly decreased (1.141 ± 0.103 vs. 1.101 ± 0.095 m, <em>P</em> = 0.02). Moreover, the second peak of vertical ground reaction force decreased significantly (1.034 ± 0.035 vs. 1.013 ± 0.030, <em>P</em> = 0.02). Immediately after wearing the AFO, no statistically significant changes were observed in the knee joint contact force components or in the ankle and knee ranges of motion.</div></div><div><h3>Conclusion</h3><div>No statistically significant difference was observed immediately after wearing Agilium AFO regarding its effect on reducing knee joint contact force and sagittal knee moment. It is important to note that due to the small sample size and the short-term nature of this study, the generalizability of these findings is limited. Further research with larger cohorts and longer follow up periods is recommended to clarify and confirm these preliminary findings. However, therapists could consider recommending this AFO for osteoarthritic knee patients to potentially decrease knee joint loading, especially for those who cannot tolerate knee orthoses.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104353"},"PeriodicalIF":2.0,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and validity of the Persian knee Self-Efficacy Scale in patients with knee injuries: a cross-sectional validation study","authors":"Bahram Sheikhi ,&nbsp;Pouya Rabiei ,&nbsp;Amir Letafatkar ,&nbsp;Malihe Hadadnezhad ,&nbsp;Hadi Akbari","doi":"10.1016/j.knee.2026.104326","DOIUrl":"10.1016/j.knee.2026.104326","url":null,"abstract":"<div><h3>Purpose</h3><div>The Knee Self-Efficacy Scale (K-SES) is widely used to assess patients’ confidence after knee injury, but no validated Persian version exists, limiting its use in Persian-speaking populations. This study aimed to translate, adapt, and evaluate the psychometric properties of the Persian-language versions of the K-SES (K-SES-Persian).</div></div><div><h3>Methods</h3><div>One hundred and six Persian patients with knee injuries were recruited from orthopedic and physiotherapy centers. Construct validity was examined using confirmatory factor analysis and Pearson correlations. Reliability was assessed by Cronbach’s alpha and intraclass correlation coefficients (ICC). Convergent validity was tested with the Oxford Knee Score (OKS) and Knee outcome survey activities for daily living (KOS-ADL). Test-retest reliability was assessed in 53 patients after 7–8 days.</div></div><div><h3>Results</h3><div>The K-SES-Persian showed excellent internal consistency for total score (α = 0.965). An excellent internal consistency (α = 0.953) was shown for present score and good internal consistency (α = 0.898) for the future score. The factor loading for each item was greater than 0.70. The K-SES-Persian showed significant correlations with the OKS (<em>r</em> = 0.37, 95% CI: 0.19–0.53, <em>p</em> &lt; 0.001) and the KOS-ADL (<em>r</em> = 0.33, 95% CI: 0.15–0.49, <em>p</em> = 0.001). A significant but weak correlation was found between the OKS and KOS-ADL (<em>r</em> = 0.219 <em>p</em> = 0.024), indicating limited consistency between the comparator measures used for evaluating the convergent validity of the K-SES-Persian. No floor or ceiling effects were observed.</div></div><div><h3>Conclusions</h3><div>The K-SES-Persian was successfully adapted and demonstrated sound psychometric properties, including construct validity, internal consistency, and test–retest reliability, with internal consistency varying across subscales, supporting its use among Persian-speaking patients with knee injuries.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104326"},"PeriodicalIF":2.0,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic findings and intra-articular anomalies in congenital cruciate ligament deficiency","authors":"Sheba Z. Basheer ,&nbsp;Tariq A. Kwaees ,&nbsp;Paul Haslam,&nbsp;Fazal M. Ali,&nbsp;Nicolas Nicolaou","doi":"10.1016/j.knee.2026.104349","DOIUrl":"10.1016/j.knee.2026.104349","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to evaluate the arthroscopic findings of patients undergoing surgery for congenital cruciate ligament deficiency. Specifically, it investigates the frequency and types of intra-articular meniscal and ligament abnormalities associated with this rare condition, which often presents with knee instability in conjunction with longitudinal limb deficiency.</div></div><div><h3>Methods</h3><div>This prospective case series included 53 knees from 51 patients undergoing surgery for congenital cruciate ligament deficiency over a seven year period at a single tertiary centre. Patient demographics, clinical findings, imaging and surgical outcomes were documented. Preoperative MRI scans were used to assess intra-articular anatomy and arthroscopic findings were recorded, focusing on osseous and meniscal morphology as well as ligament anomalies.</div></div><div><h3>Results</h3><div>Among the 53 knees, 61% were associated with congenital longitudinal limb deficiencies, primarily fibular hemimelia. The ACL was deficient in all cases, while the PCL was also absent or underdeveloped in seven knees. Meniscal abnormalities were found in 42 knees (79.25%), including atypical shape, abnormal attachments and hypertrophied meniscofemoral ligaments that seemed to have a role in constraining sagittal instability.</div></div><div><h3>Conclusion</h3><div>Congenital cruciate ligament deficiency presents complex intra-articular anomalies, notably in ligament and meniscal structure. Hypertrophied meniscofemoral ligaments often provide compensatory stability, which can be disrupted by trivial trauma. Arthroscopic assessment is critical in planning reconstruction, especially given the atypical anatomy in these patients.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104349"},"PeriodicalIF":2.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liposomal bupivacaine reduced postoperative analgesia in patients undergoing knee arthroplasty","authors":"Jad Mansour ,&nbsp;Mohammad Daher ,&nbsp;Matthew Nakouzi ,&nbsp;Jonathan Liu ,&nbsp;Michel Estephan ,&nbsp;Amer Sebaaly ,&nbsp;Alan H. Daniels ,&nbsp;Mouhanad M. El-Othmani","doi":"10.1016/j.knee.2026.104346","DOIUrl":"10.1016/j.knee.2026.104346","url":null,"abstract":"<div><h3>Background</h3><div>Liposomal bupivacaine (LB), a sustained-release formulation, is designed to prolong regional analgesia, and has been investigated as a solution for perioperative pain management. This meta-analysis of randomized controlled trials (RCTs) assessed the benefits of LB in patients undergoing knee arthroplasty.</div></div><div><h3>Methods</h3><div>Following the PRISMA guidelines, PubMed, Cochrane, and Google Scholar were accessed and explored until November 2025. The extracted data consisted of the risk of nausea/vomiting (N/V), length of stay (LOS), and postoperative pain and opioid consumption at 1, 2, and 3 days postoperatively.</div></div><div><h3>Results</h3><div>Six RCTs were included, consisting of 311 in the LB group and 318 in the control group. There was no difference between the two groups in N/V or LOS. However, patients receiving LB had less pain compared with patients receiving ropivacaine at 1 day postoperatively (standardized mean difference = −0.69, <em>P</em> = 0.03), and less pain compared with the control groups as a whole 2 days postoperatively (standardized mean difference = −0.44, <em>P</em> &lt; 0.001). Opioid consumption was lower in the LB group compared with the group receiving standard bupivacaine at 1, 2, and 3 days postoperatively (mean difference = −11.52 morphine milligram equivalents (MME), mean difference = −9.02 MME, mean difference = −4.58 MME, <em>P</em> &lt; 0.001 respectively). Similarly, Opioid consumption was lower in the LB group compared with the control group as a whole at 2 and 3 days postoperatively (mean difference = −7.01 MME, <em>P</em> = 0.02; mean difference = −4.59 MME, <em>P</em> &lt; 0.001, respectively).</div></div><div><h3>Conclusion</h3><div>LB reduces postoperative pain and opioid consumption after knee arthroplasty with no increased risk of N/V.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104346"},"PeriodicalIF":2.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cemented metal-on-polyethylene spacers have similar cost profiles with lower complications rates compared to molded all-cement articulating spacers for treatment of knee periprosthetic joint infection","authors":"Angel X Xiao ,&nbsp;Ramesh B Ghanta ,&nbsp;Alejandro S. Cazzulino ,&nbsp;Kelechi Nwachuku ,&nbsp;Erdan Kayupov ,&nbsp;Erik N. Hansen","doi":"10.1016/j.knee.2026.104347","DOIUrl":"10.1016/j.knee.2026.104347","url":null,"abstract":"<div><h3>Background</h3><div>All-cement spacers or metal-on-polyethylene (MoP) spacers are types of articulating spacers used in two-stage treatment of total knee arthroplasty (TKA) periprosthetic joint infection (PJI). While MoP spacers have improved durability and versatility, there is concern that use of primary arthroplasty components as a temporary spacer is not cost-effective. We investigated the cost of MoP versus molded all-cement articulating spacers for the treatment of TKA PJI.</div></div><div><h3>Methods</h3><div>A retrospective review of primary TKA PJIs treated with articulating spacers between 2013 and 2020 was performed. Primary TKA implants were used for MoP spacers and molds were used to create all-cement spacers. Supply, implant, and surgical encounter costs were reviewed. Total cost and complications were reviewed.</div></div><div><h3>Results</h3><div>Thirty-two molded all-cement and 17 MoP spacers were included. There was no difference between all-cement and MoP spacer Stage 1 cost ($4184 vs $4365), Stage 2 cost ($20,026 vs $20,441) or total cost ($24,210 vs $24,614). Moreover, spacer cost accounted for 17% of total cost. 3 patients in the all-cement group had mechanical complications requiring additional surgery.<!--> <!-->The MoP group had a shorter length of stay (LOS) after stage 2 (2.06 vs 4.16 days). Spacer choice did not affect stage 1 LOS, discharge disposition, operating room time, or reinfection rate.</div></div><div><h3>Conclusion</h3><div>MoP spacers have similar cost profiles, but lower incidence of complications compared to molded all-cement articulating spacers for two-stage exchange in treatment of TKA PJI. More than 80% of the surgical implant and supply cost is incurred during Stage 2 regardless of the spacer construct utilized.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104347"},"PeriodicalIF":2.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterolateral skin incision for total knee arthroplasty is associated with lower prevalence of postoperative hypoesthesia at 1-year: a meta-analysis of randomised trials","authors":"Omar E.S. Mostafa ,&nbsp;Eden E.S. Mostafa ,&nbsp;Tahir Khaleeq ,&nbsp;Osama Aweid ,&nbsp;Loiy Alkhatib ,&nbsp;Amit Meena ,&nbsp;Bolarinwa Akinola ,&nbsp;Usman Ahmed ,&nbsp;Shahbaz S. Malik","doi":"10.1016/j.knee.2026.104345","DOIUrl":"10.1016/j.knee.2026.104345","url":null,"abstract":"<div><h3>Background</h3><div>A meta-analysis of randomised trials was conducted to compare clinical and functional outcomes between the standard anteromedial or midline skin incision and unconventional anterolateral incision for total knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>This study was registered prospectively on the INPLASY database. Literature search was performed on 14th December 2024 in accordance with PRISMA. Only randomised controlled trials (RCTs) comparing anterolateral incision (ALI) versus standard (midline or anteromedial) incision (SI) were included and quality-assessed. Outcomes at 1 year postoperatively were prevalence of numbness, surface area of skin numbness, degrees of knee flexion, Visual Analogue Scale (VAS), Forgotten Joint Score (FJS) and Knee Injury and Osteoarthritis Outcome Score (KOOS).</div></div><div><h3>Results</h3><div>Eight RCTs totalling 609 patients (ALI 276 vs. SI 333) were included. Mean age, BMI and proportion of male patients were comparable between the two groups. There was no baseline difference between the two groups for the incision length or operative duration. Statistical difference was observed for two outcomes favouring the ALI group: prevalence of hypoesthesia (OR 0.36, CI 0.17–0.77, <em>P</em> = 0.008) and surface area of numbness (SMD −1.04, CI −1.80 to −0.28, <em>P</em> = 0.007). No significant difference was observed in KOOS (SMD 0.16, CI – 0.07 to revman 0.38, <em>P</em> = 0.17), FJS (SMD −0.14, CI −0.39 to 0.12, <em>P</em> = 0.30) and VAS (SMD −0.10, CI −0.39 to 0.20, <em>P</em> = 0.51).</div></div><div><h3>Conclusion</h3><div>An anterolateral incision to TKA results in a lower rate and smaller surface area of numbness at 1-year, with no difference in patient-reported outcome measures.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104345"},"PeriodicalIF":2.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in knee osteoarthritis imaging and total knee arthroplasty: advances, challenges, and segmentation methods – A review","authors":"Ahsan Humayun ,&nbsp;Mustafain Rehman ,&nbsp;Muhammad Zainulabideen","doi":"10.1016/j.knee.2026.104327","DOIUrl":"10.1016/j.knee.2026.104327","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (KOA) is one of the most prevalent degenerative joint diseases and a significant cause of disability. Total Knee Arthroplasty (TKA) is the standard treatment for advanced cases, but its success depends on accurate imaging, precise preoperative planning, and intraoperative execution. Imaging modalities such as radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound are widely used in TKA workflows. Still, they are often limited by anatomical variability, image artifacts, and poor soft tissue contrast.</div></div><div><h3>Methods</h3><div>This review surveys automated segmentation and analysis approaches for knee imaging, covering classical methods including region-, boundary-, atlas-, and model-based techniques, as well as recent artificial intelligence (AI)-driven approaches, particularly deep learning models. Their capabilities, limitations, and clinical relevance in TKA planning and evaluation are discussed.</div></div><div><h3>Results</h3><div>Classical segmentation methods provide foundational tools but often exhibit limited generalization and robustness in heterogeneous clinical datasets. AI-based methods, particularly deep learning, enable automated feature extraction, improved segmentation accuracy, and enhanced classification and outcome prediction. These methods address many limitations of traditional approaches, although their dependence on large annotated datasets and variability in imaging protocols remains a significant challenge.</div></div><div><h3>Conclusion</h3><div>This review presents a comprehensive overview of knee anatomy, imaging modalities, and segmentation techniques relevant to TKA. Comparing classical and AI-based approaches highlights their strengths, limitations, and persistent challenges, while also identifying opportunities for integrating AI into clinical workflows to achieve more precise, reliable, and patient-specific knee arthroplasties.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104327"},"PeriodicalIF":2.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported opioid dependency and reasons for use 12 months following knee arthroplasty: a prospective observational study","authors":"Mette J. Hansen ,&nbsp;Mette Garval ,&nbsp;Jeppe Lange ,&nbsp;Charlotte Runge ,&nbsp;Søren T. Skou ,&nbsp;Nicolai K. Kristensen","doi":"10.1016/j.knee.2026.104325","DOIUrl":"10.1016/j.knee.2026.104325","url":null,"abstract":"<div><h3>Background</h3><div>Opioids are prescribed to alleviate pain after knee arthroplasty. However, prolonged postoperative opioid use may complicate recovery and potentially increase the risk of persistent use. This study explores opioid use following fast-track knee arthroplasty.</div></div><div><h3>Method</h3><div>This prospective, single-center, observational study included patients scheduled for fast-track knee arthroplasty. A total of 1195 patients were included, of whom 996 underwent total knee arthroplasty (TKA) and 199 medial unicompartmental knee arthroplasty (mUKA). Participants completed a study-specific questionnaire on opioid use before surgery and at 3- and 12-month follow-up (FU).</div><div>Patient-reported data at 12-month FU were available for 797 TKA (80%) and 160 mUKA (80%).</div><div>Participants were categorized based on preoperative opioid use. The primary outcome was patient-reported opioid use at 12-month FU. Reasons for opioid use were also registered.</div></div><div><h3>Results</h3><div>At 12-month FU, 3% (95% confidence interval (CI) 2–4; 24 patients) of TKA patients reported daily opioid use attributed to prosthetic knee joint pain; the proportion was higher among patients with preoperative daily opioid use (17%, CI 10–26, 17 patients) compared to those without preoperative use (1%, CI 0.2–1.5, 4 patients). 1 mUKA patient (0.6%, CI 0–3) reported daily opioid use attributed to prosthetic knee joint pain at 12-month FU.</div></div><div><h3>Conclusion</h3><div>Persistent daily opioid use due to pain in the prosthetic knee joint was rare 12 months after fast-track TKA and mUKA. Patients with preoperative daily opioid use had a markedly higher risk of continued use compared to those without prior opioid use.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104325"},"PeriodicalIF":2.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm clinical outcomes and survivorship of a next generation revision knee system in complex primary and revision total knee arthroplasty","authors":"Nicholas B. Frisch ,&nbsp;Paul Edwards ,&nbsp;Michael Bloomfield ,&nbsp;Roberta E. Redfern ,&nbsp;Nicholas Brown ,&nbsp;John Dundon","doi":"10.1016/j.knee.2026.104328","DOIUrl":"10.1016/j.knee.2026.104328","url":null,"abstract":"<div><h3>Background</h3><div>The burden of revision total knee arthroplasty (TKA) is expected to continue to grow with the increase in the number of primary procedures performed each year. The purpose of this study was to evaluate the early clinical outcomes of a novel revision knee system for use in revision and complex primary TKA.</div></div><div><h3>Methods</h3><div>Multicenter prospective observational cohort study of 185 patients undergoing revision TKA (rTKA) or complex primary TKA with a next generation revision knee system. Patients were separated into cohorts based on indication and combination of components. 2-year implant survivorship was examined. Clinical outcomes including Knee Society Knee Scores (KS-KS), Knee Injury and Osteoarthritis Outcomes – Joint Replacement (KOOS JR) and pain scores were compared by indication and component combinations.</div></div><div><h3>Results</h3><div>Most patients underwent TKA for aseptic revision (89.7%); implant survivorship at 2 years was 97.2% (95%CI 93.5–98.8) considering all indications; 97.0% (95%CI 93.0–98.7) in revision cases only. KS-KS scores improved significantly in all cohorts, with overall mean increase of 40.8 ± 22.9 points (<em>p</em> &lt; 0.001). KOOS JR scores improved by 27.0 ± 20.3 (<em>p</em> &lt; 0.001); pain reduction demonstrated overall mean of 3.5 ± 3.4 points (<em>p</em> &lt; 0.001). Subgroup analysis of fixation method revealed no difference in KS-KS scores in uncemented approach (80.5 ± 16.4 vs 84.7 ± 14.0, <em>p</em> = 0.06)</div></div><div><h3>Conclusion</h3><div>This revision implant system demonstrated high survival and improvement in functional outcomes after 2 years, in both the complex primary and revision TKA setting. Further study is warranted to monitor long-term results.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"60 ","pages":"Article 104328"},"PeriodicalIF":2.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}