Knee最新文献

{"title":"Application of Hertzian contact theory to predict cartilage overload in the osteoarthritic and anterior-cruciate-ligament-deficient knee: A biomechanical analysis","authors":"Carlos Peñaherrera-Carrillo ,&nbsp;Carlos Suarez-Ahedo ,&nbsp;Francisco Endara Urresta ,&nbsp;Alejandro Xavier Barros Castro ,&nbsp;Juan Pablo Alarcón Serrano","doi":"10.1016/j.knee.2025.104294","DOIUrl":"10.1016/j.knee.2025.104294","url":null,"abstract":"<div><h3>Background</h3><div>Altered tibiofemoral contact mechanics contribute to cartilage degeneration in knee osteoarthritis (OA) and anterior cruciate ligament (ACL) deficiency. Predicting focal cartilage overload is challenging due to biomechanical complexity. Hertzian contact theory, though simplified, provides a physically robust framework to estimate stress distributions from geometry and material properties.</div></div><div><h3>Objective</h3><div>To apply Hertzian theory to model tibiofemoral contact pressures and areas in healthy, osteoarthritic, and ACL-deficient knees, and assess its capability to identify patterns linked to cartilage degeneration.</div></div><div><h3>Methods</h3><div>A Hertzian-based model was built for three conditions using standardized cartilage properties (E = 10 MPa, ν = 0.45) and representative sagittal radii of curvature. A 700-N vertical load simulated single-leg stance. Peak contact pressure, contact area, and stress patterns were computed. Sensitivity analyses varied modulus, curvature, and load. Outputs were compared qualitatively with anatomical degeneration regions reported in imaging studies.</div></div><div><h3>Results</h3><div>Compared with the healthy model (3.21 MPa; 258.3 mm²), OA showed a 26.2 % higher peak pressure and 14.2 % smaller contact area; ACL deficiency showed a 33.3 % increase in peak pressure and 19.3 % reduction in area. OA overload localized medially, ACL deficiency shifted posteriorly. Geometry changes had greater influence on contact mechanics than stiffness or load changes.</div></div><div><h3>Conclusions</h3><div>Hertzian theory captures key biomechanical changes in OA and ACL deficiency, identifying clinically relevant overload zones. This simplified approach underscores the dominant role of joint geometry and supports practical biomechanical risk assessment.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104294"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901729","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":"Bacterial attachment and initial biofilm formation on the metal tibial tray and plastic spacer interfacing surfaces of total knee components: An in vitro scanning electron microscopy study","authors":"Amir Mafi ,&nbsp;Matthew Cabral ,&nbsp;Douglas Chonko ,&nbsp;Matthew Pigott ,&nbsp;Anne Sullivan ,&nbsp;Niraj Gupta ,&nbsp;David McComb ,&nbsp;Paul Stoodley","doi":"10.1016/j.knee.2025.10.014","DOIUrl":"10.1016/j.knee.2025.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic joint infection (PJI) is a challenging complication of total knee arthroplasty (TKA). Bacterial biofilm formation is strongly implicated in PJIs, and renders the bacteria tolerant of antibiotic therapy and innate immunity. However, there is little information on where biofilms may reside in the reconstructed joint. In previous mapping projects using an agar overlay ‘implant surface culture’ (ISC) method we found evidence that biofilm was forming in the gap between the polyethylene spacer and the tibial tray components explanted from TKA patients undergoing revision for PJI. We hypothesized that bacteria could enter this gap and attach to form biofilms on both plastic and metal interfacing surfaces.</div></div><div><h3>Methods</h3><div>We inoculated spacers and tibial tray components recovered from PJI patients that had been cleaned and reassembled with <em>Staphylococcus epidermidis</em>. We used scanning electron microscopy (SEM) to image the surfaces after an incubation of 3 days with daily media changes and analyzed the surface concentration of bacteria on flat surfaces and associated with surface features (slots, screw holes, ridges).</div></div><div><h3>Results</h3><div>Examination and quantification at multiple magnifications revealed a range from a sparse covering of bacteria on the flat areas to more extensive biofilms in monolayers and small aggregates around and within features in the tray. The polythene surfaces had three times more bacteria than the metal (<em>P</em> &lt; 0.05). In the four features measured there were six times more bacteria that were associated with adjacent flat surfaces, but this was not statistically significant (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Bacteria can attach and initiate biofilm formation in the metal–polyethylene gap on both surfaces and are most concentrated in association with surface features. The gap may provide a niche where biofilm could reside with protection from antibiotics as well as phagocytic cells and other components of host immunity, and even irrigation and debridement procedures in a partial exchange.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104260"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679795","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":"How do occupational demands affect return to work after total knee arthroplasty?","authors":"Anzar Sarfraz ,&nbsp;Sophia Antonioli ,&nbsp;Don H. Le ,&nbsp;Farouk Khury ,&nbsp;Joseph X. Robin ,&nbsp;Ran Schwarzkopf ,&nbsp;Armin Arshi ,&nbsp;Joshua C. Rozell","doi":"10.1016/j.knee.2025.11.010","DOIUrl":"10.1016/j.knee.2025.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Patients who undergo primary total knee arthroplasty (TKA) may return to work at variable times following surgery, the timeline for which is partly affected by the physical intensity of their occupation. The purpose of this study was to evaluate patient satisfaction and limitations when returning to work following TKA.</div></div><div><h3>Methods</h3><div>This retrospective review surveyed patients undergoing primary TKA between June 2011 and January 2022, with at least 1 year of follow up, regarding return to work. Of the 914 respondents, 507 (55.5 %) worked preoperatively and were stratified into high intensity (HI) (i.e., laborer, construction), standard intensity (SI) (i.e., walking, climbing stairs), or low intensity (LI) (i.e., sedentary desk jobs) groups. Baseline characteristics and survey responses were compared across groups. Among those who worked preoperatively, 35 (6.9 %), 213 (42 %), and 259 (51.1 %) were in the HI, SI, and LI groups, respectively.</div></div><div><h3>Results</h3><div>Of the 507 patients who worked prior to TKA, 447 (88.2 %) returned to work after surgery and 60 (11.8 %) did not. The HI group was comprised of more young males and more smokers than the SI and LI groups. In the LI group, 30 % returned within 1 month following surgery and an additional 44 % within 2 months. Similarly in the SI group, 11 % returned to work in less than 1 month with an additional 39 % returning within 2 months. In the HI group, 4 % returned within the first month and additional 42 % returned within 2 months. HI workers were more commonly hindered in their return (HI: 30.8 %, SI: 23.1 %, LI: 7.7 %), ‘moderately declined’ in their work ability (HI: 23.1 %, SI: 9.7 %, 3.0 %), and ‘very unsatisfied’ with their return (HI: 11.5 %, SI: 10.8 %, LI: 8.1 %).</div></div><div><h3>Conclusion</h3><div>TKA leads to improvements in work function and satisfaction across all intensity levels, but HI work is associated with longer recovery times and comparatively lower return-to-work satisfaction compared to SI and LI groups.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104284"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642745","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":"Shank motion analysis for quantifying knee gait deviations: Normative data at various walking speeds","authors":"Sophie Hameau ,&nbsp;Karim Jamal ,&nbsp;Charles Guignans ,&nbsp;Isabelle Bonan ,&nbsp;Sébastien Cordillet","doi":"10.1016/j.knee.2025.104293","DOIUrl":"10.1016/j.knee.2025.104293","url":null,"abstract":"<div><h3>Background</h3><div>Knee deviations in clinical gait analysis are often measured using joint angles and could be enhanced by incorporating additional indices such as shank angular velocity in addition to knee angular velocity, particularly in the context of knee extensor thrust. The aim of this study was to establish normative data for shank and knee angular velocities at various gait speeds and to perform clinical validation of these biomarkers.</div></div><div><h3>Methods</h3><div>A public dataset containing three-dimensional motion capture established on 50 healthy participants was used to calculate normative data of knee and shank angular velocities at five gait speeds (means, standard deviations and confidence intervals). Eleven hemiparetic persons walking with knee extensor thrust underwent three-dimensional gait analysis, during which minimum knee and shank angular velocities during stance phase were calculated.</div></div><div><h3>Results</h3><div>Hemiparetic persons walking with knee extensor thrust had significantly lower minimum knee and shank angular velocities than normative data at all gait speeds (<em>P</em> &lt; 0.001). In healthy persons, the minimum values for knee and shank angular velocities during stance phase or the values at foot-off, like most knee kinematics parameters, were correlated with gait speed (<em>r</em> = −0.83; <em>r</em> = 0.67; <em>r</em> ≥ 0.9; <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>This study provides normative data for knee and shank angular velocities at various gait speeds and demonstrates their usefulness for analysing knee deviations, notably the knee extensor thrust. This study underscores the impact of walking speed on gait patterns particularly on knee and shank angular velocities and underlines the need to compare data at the same gait speed for practice and future research.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104293"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913907","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 need for better quality studies: A systematic scoping review of current utility of artificial intelligence in orthopaedics and research gaps in the knee joint","authors":"Nadia Aghili ,&nbsp;Katie Hughes ,&nbsp;Kianoush Nazarpour ,&nbsp;Hamish Simpson ,&nbsp;Irene Yang","doi":"10.1016/j.knee.2025.10.022","DOIUrl":"10.1016/j.knee.2025.10.022","url":null,"abstract":"<div><h3>Background</h3><div>The application of artificial intelligence (AI) in orthopaedic research, particularly for knee conditions, is growing rapidly. While AI offers the potential to enhance the efficiency and precision of care, its role and impact remain underexplored. This systematic scoping review evaluates studies employing AI algorithms, including machine learning and deep learning, to support clinical decision making for knee diseases.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. MEDLINE, EMBASE, and ISI Web of Science were searched for English-language studies published between 2008 and 2025. Eligible studies involved adult patients and applied AI to diagnose knee conditions, predict outcomes, or support clinical processes. Extracted data included study demographics, targeted knee conditions, AI algorithms used, and their applications.</div></div><div><h3>Results</h3><div>From 2761 studies screened, 816 (30 %) were included after title and abstract screening. Among these, 66 % addressed diagnosis and 34 % focused on clinical prediction. Osteoarthritis was the most studied condition (71 %), followed by soft tissue damage (15 %). Deep learning was the most utilized AI method (43 %), followed by traditional machine learning (39 %). Among excluded studies, AI was indirectly applied in 21 %, primarily for identification (25 %), segmentation (42 %), and measurement (17 %).</div></div><div><h3>Conclusions</h3><div>Over the past 16 years, AI use in knee orthopaedic research has grown, yet only 30 % of studies directly addressed diagnostic or predictive applications. Challenges include limited reproducibility, generalizability, and clinical applicability of AI models. Future research should focus on improving reporting standards and exploring the application of AI in intra-operative, post-operative, and non-imaging use cases to enhance clinical utility.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104268"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582767","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":"Automatic detection of knee medial collateral ligament (MCL) tear from magnetic resonance imaging using deep neural network","authors":"Elahe Mirzakhani ,&nbsp;Mohammad Ayati Firoozabadi ,&nbsp;Mohammadreza Razzaghof ,&nbsp;Seyed Mohammad Javad Mortazavi ,&nbsp;Toktam Khatibi","doi":"10.1016/j.knee.2025.10.028","DOIUrl":"10.1016/j.knee.2025.10.028","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The medial collateral ligament (MCL) is a crucial structure supporting the stability of the knee joint. Although a clinical examination can detect an MCL tear, valgus stress radiography and magnetic resonance imaging (MRI) can confirm it. However, challenges persist in accurate MCL tear detection from MRI images, often leading to misdiagnosis and treatment delays. Therefore, proposing automatic methods for detecting MCL tears is necessary. To the best of the researcher’s knowledge, studies have yet to address this problem using deep neural networks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This study aims to detect medial collateral ligament (MCL) tears through knee MRI images. Our collected dataset includes coronal views of knee MRI images taken from patients in “Imam Khomeini Hospital, Tehran, Iran.” The dataset has 3575 knee MRI images from 60 patients, each with a resolution of 512 × 512 pixels. We employ the Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology to structure our approach, which includes three distinct scenarios utilizing deep learning models. In Scenario One, A custom Convolutional Neural Network (CNN) architecture is designed specifically for MCL tear detection. This model undergoes a meticulous fine-tuning process and is evaluated using a comprehensive knee MRI dataset. We adapt the hyperparameters of the CNN to accurate optimize its performance, ensuring classification of MCL tears. In the second scenario, we leverage a deep neural network pre-trained on the ImageNet dataset. The pre-trained VGG19 model is utilized, where we extract features from its layers and feed them into custom output layer to classify MCL tears using fine tuning. This approach allows us to assess the effectiveness of transfer learning in improving MCL tear detection. In the third scenario, we implement transfer learning using the VGG19 architecture. We apply transfer learning by freezing the early layers of the pre-trained VGG19 model and modifying its final layers. This innovative approach aims to enhance the model’s ability to accurately identify MCL tears by utilizing learned features from a large dataset.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;The experimental results demonstrate that the first scenario achieved an accuracy of 95 %. The second scenario outperformed the others, achieving an average accuracy of 98.3 %, an average loss of 0.07, and an area under the receiver operating characteristic (ROC) curve (AUC) of 1.00. In contrast, the third scenario attained an accuracy of 80 %.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;This study highlights the effectiveness of deep learning, particularly the pre-trained VGG19 model, in detecting MCL tears from knee MRI images with 98.3 % accuracy. By leveraging transfer learning, our approach mitigates data limitations, demonstrating the potential of automated diagnostic tools to improve accuracy and efficiency in clinical practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;d","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104274"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524895","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":"Lateral extra-articular tenodesis protects high-risk patients from the risk of re-rupture and improves patient-reported outcomes after primary anterior cruciate ligament repair: A retrospective cohort study with ≥2-year follow up","authors":"Alessandro Carrozzo ,&nbsp;Valerio Nasso ,&nbsp;Alessandro Annibaldi ,&nbsp;Gianluca Ciccarelli ,&nbsp;Pierfrancesco Orlandi ,&nbsp;Silvia Cardarelli ,&nbsp;Edoardo Monaco","doi":"10.1016/j.knee.2025.11.014","DOIUrl":"10.1016/j.knee.2025.11.014","url":null,"abstract":"<div><h3>Background</h3><div>Primary repair of proximal anterior cruciate ligament (ACL) tears is appealing, but the risk of re-rupture is a concern, particularly in young athletes. This study aimed to assess whether adding a lateral extra-articular tenodesis (LET) to an ACL repair procedure reduces the risk of failure and improves patient-reported outcomes in high-risk patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 39 consecutive patients treated within 14 days of injury (2018–2023) was reviewed. Nineteen patients underwent isolated ACL repair, while 20 patients received a combined repair plus a Coker–Arnold LET. The minimum follow up period was 24 months (mean ± standard deviation: 42.5 ± 11.8). Failure rates, return to sport, Rolimeter side-to-side laxity, and patient-reported outcome measures were compared.</div></div><div><h3>Results</h3><div>Failure rates were similar between the two groups (15.8 % vs. 10.0 %; <em>P</em> = 0.589), as well as for anterior laxity, IKDC and ACL-Return to Sport after Injury scores (<em>P</em> &gt; 0.05). Despite being younger, patients who underwent combined procedures achieved higher postoperative activity and better patient-reported outcomes: KOOS-Function: 94.6 vs. 86.1 (<em>P</em> = 0.007); KOOS-Sport: 83.5 vs. 70.8 (<em>P</em> = 0.020); KOOS-Total: 89.5 vs. 79.0 (<em>P</em> = 0.010); and FJS-12: 83.3 vs. 67.5 (<em>P</em> = 0.008). Return to sport was 74 % in the isolated ACL repair group and 85 % in the combined procedures group (<em>P</em> = 0.382).</div></div><div><h3>Conclusions</h3><div>The addition of a lateral extra-articular procedure to primary ACL repair in patients at a higher risk of re-rupture results in failure rates comparable to those of lower-risk, less active individuals and enhances functional recovery and activity levels.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104288"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679798","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":"Out with the old and in with the new?","authors":"","doi":"10.1016/j.knee.2026.104335","DOIUrl":"10.1016/j.knee.2026.104335","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104335"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038095","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":"How accurately do large language models answer patient questions on anterior cruciate ligament tears? A comparative study","authors":"Salim Youssef ,&nbsp;Anton Brehmer ,&nbsp;Peter Melcher ,&nbsp;Ralf Henkelmann ,&nbsp;Pierre Hepp ,&nbsp;Jan Theopold ,&nbsp;Maria Elze ,&nbsp;Yasmin Youssef ,&nbsp;Georg Osterhoff","doi":"10.1016/j.knee.2025.11.002","DOIUrl":"10.1016/j.knee.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Large language models (LLMs) are increasingly used in the medical sector, raising questions about their reliability for patient education. With more LLMs becoming publicly available, it remains unclear whether meaningful performance differences exist between them. This is particularly relevant for anterior cruciate ligament (ACL) injuries, which mainly affect young, active individuals, those most likely to seek health advice from AI. This study aimed to evaluate and directly compare the accuracy of five leading LLMs in answering common patient questions about ACL tears.</div></div><div><h3>Methods</h3><div>Fourteen commonly asked patient questions were identified in a systematic online search. Each question was submitted to five LLMs: ChatGPT-4, Gemini 2.0, Llama 3.1, DeepSeek-V3, and Grok3. Responses were assessed for accuracy by orthopedic consultants using a five-point Likert scale. Word count was recorded as a proxy for readability. Statistical analysis included ANOVA by Tukey’s HSD post hoc test.</div></div><div><h3>Results</h3><div>All models achieved mean accuracy scores ≥3 (mostly accurate). DeepSeek (3.61) and Grok (3.59) demonstrated significantly higher mean accuracies than Llama (3.25; <em>P</em> &lt; 0.05). ChatGPT and Gemini achieved mean scores of 3.48 and 3.52, respectively. Models generating longer responses, such as Grok and DeepSeek, tended to offer greater accuracy, whereas Llama produced the shortest and least accurate answers.</div></div><div><h3>Conclusions</h3><div>All tested LLMs show promise for patient education regarding ACL injuries, but notable performance differences exist. Model choice is therefore critical. While all responses were evaluated by clinical experts, the lack of guideline-based validation highlights the need for further studies assessing both accuracy and patient comprehension.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104276"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551934","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":"Meniscus repair: a review of techniques and long-term outcomes","authors":"Logan M. Good ,&nbsp;Emily L. Lu ,&nbsp;Eric M. Milliron ,&nbsp;Parker A. Cavendish ,&nbsp;Robert A. Duerr ,&nbsp;Christopher C. Kaeding ,&nbsp;David C. Flanigan ,&nbsp;Robert A. Magnussen","doi":"10.1016/j.knee.2025.11.015","DOIUrl":"10.1016/j.knee.2025.11.015","url":null,"abstract":"<div><h3>Background</h3><div>Advancements in technology and techniques have shaped meniscus repair outcomes, but long term results remain unclear. This review aims to comprehensively evaluate studies with a mean follow-up of greater than 10 years following inside-out, outside-in, all-inside, open, or pull-out repair techniques. In addition, this article will review the impact of concomitant anterior cruciate ligament (ACL) reconstruction on long-term meniscus repair outcomes and compare osteoarthritis risk of patients treated partial meniscectomy compared with meniscus repair. We hypothesize there is increased evidence of osteoarthritis following partial meniscectomy compared to all types of meniscal repair.</div></div><div><h3>Methods</h3><div>PubMed and EMBASE databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria included full-text English language, human patients with at least one outcome reported after meniscus repair, and publication before June 22, 2021. Exclusion criteria included mean follow up of less than 10 years, published before the year 2000, or significant concomitant procedures within the knee during meniscus repair.</div></div><div><h3>Results</h3><div>Inside-out, all-inside, <em>trans</em>-tibial pull-out, and open repair techniques of meniscal tears demonstrate clinical success and good long-term outcomes. Data regarding the impact of concomitant anterior cruciate ligament reconstruction on meniscus repair outcomes are conflicting. The risk of osteoarthritis is reduced in meniscal repair when compared with partial meniscectomy.</div></div><div><h3>Conclusion</h3><div>Outcomes of meniscus repair are favorable at 10 years post-operative regardless of technique. While the impact of concomitant ACL reconstruction on meniscus repair outcomes is unclear, meniscus repair is associated with decreased osteoarthritis risk compared to partial meniscectomy.</div><div>Level of evidence</div><div>IV; systematic review of level III-IV studies.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"58 ","pages":"Article 104289"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685778","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}