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What's New — Knee — January 2026

83 new articles published this month.

Themes: Total Knee Arthroplasty: Alignment and Robotics · Anterior Cruciate Ligament: Reconstruction and Return to Sport · Meniscus Pathology, Repair, and Preservation · Patellofemoral Disorders and Instability · Periprosthetic Infection, Diagnostics, and Systemic Care · Miscellaneous

Digest generated 2026-04-16 01:05:21+00:00.


Highlights

Total Knee Arthroplasty: Alignment and Robotics

Recent literature critically evaluates alignment strategies and robotic assistance in total knee arthroplasty (TKA). Kinematic alignment is shown to reduce the knee adduction moment and improve range of motion compared to mechanical alignment [3]. Robotic arm-assisted patellofemoral arthroplasty demonstrates good short-term survival and functional outcomes [4]. In unicompartmental knee arthroplasty, varus tibial component alignment enhances bearing orbit safety [9]. Furthermore, robotic-assisted TKA with force-guided soft-tissue balancing addresses non-linear gap widening, while imageless robotic systems show comparable patient-reported outcomes to computer-navigated techniques [36, 45, 50]. Individualized TKA also demonstrates high survival rates at 3 to 5 years [35].

Anterior Cruciate Ligament: Reconstruction and Return to Sport

This cluster focuses on ACL reconstruction outcomes, graft selection, and return-to-sport protocols. Studies highlight that steeper posterior tibial slope increases rupture risk in children [15] and is associated with ramp lesion healing failure [72]. Graft type influences outcomes, with quadriceps tendon autografts showing distinct hamstring strength profiles compared to others [30], while peroneus longus harvest alters gait biomechanics [82]. The use of lateral extra-articular tenodesis does not affect tibiofemoral rotation in soccer players [31]. Additionally, female athletes exhibit increased contralateral dynamic valgus post-reconstruction [42], and a unified communication framework is proposed to improve return-to-sport success [38].

Meniscus Pathology, Repair, and Preservation

Articles in this theme address the management of meniscal tears, particularly posterior root tears and transplantation. Medial meniscus posterior root tears are linked to extrusion and osteoarthritis progression, with lower Kellgren-Lawrence grades predicting better repair survivorship [18, 37, 71, 75]. Meniscus allograft transplantation is shown to restore anteroposterior stability as effectively as ACL reconstruction [27]. Biologic augmentation strategies are reviewed but noted for limited evidence [2]. Diagnostic accuracy of MRI signs for posterior root tears is evaluated [62], and mild asymptomatic lateral osteoarthritis is found not to compromise high tibial osteotomy outcomes [28].

Patellofemoral Disorders and Instability

This theme covers patellofemoral instability, chondral wear, and surgical interventions. Small increases in patellar thickness significantly alter kinematics and joint loading [16]. Combined MPFL and MQTFL reconstructions show similar outcomes to isolated MPFL reconstruction [56, 74]. Pure anteriorizing tibial tubercle osteotomies demonstrate low complication rates in young patients with chondral wear [67, 76]. The role of medial retinacular imbrication is revisited as a viable option for traumatic recurrent dislocation [80].

Periprosthetic Infection, Diagnostics, and Systemic Care

Key studies address the diagnosis and management of periprosthetic joint infection (PJI) and systemic care models. Synovial IL-6 and D-dimer point-of-care testing supports rapid PJI diagnosis [41]. Extended postoperative oral antibiotic prophylaxis significantly reduces reinfection risk after two-stage exchange [60]. On a systemic level, the 'silver tsunami' of geriatric trauma is displacing elective arthroplasty capacity, necessitating lean management strategies to optimize efficiency and value-based care [5, 43].

Miscellaneous

This category includes articles on diverse topics not fitting the primary knee themes. These include the use of electrical stimulation for deltoid atrophy after shoulder surgery [1], the management of sternoclavicular joint disorders [20], shoulder instability in contact athletes [21, 34], Lisfranc injury consensus and anatomy [17, 26], navicular stress fractures in athletes [49], AI prediction of surgical recommendations [68], and the impact of missing patient-reported outcome data [83].

Articles by Theme

Total Knee Arthroplasty: Alignment and Robotics (7)

3. Mancini L, Spallone G, Carnevale A, et al. Kinematic alignment yields a reduced knee adduction moment and better range of motion compared to mechanical alignment: biomechanical considerations of a staged, bilateral total knee arthroplasty case. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-025-09445-7

Précis unavailable.

4. Williamson TR, Robins S, Super JT, et al. Robotic arm‐assisted patellofemoral joint arthroplasty achieves good short‐term survival and functional outcomes: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70301

This systematic review and meta-analysis assessed the survival and functional outcomes of robotic arm-assisted patellofemoral arthroplasty (RA-PFA). The analysis demonstrated a 93.6% survivorship rate and a significantly reduced risk of revision compared to manual PFA techniques. These findings support the use of robotic assistance to improve implant longevity and surgical precision in patellofemoral joint replacement.

9. Lo Y, Chang C, Wang C, et al. CPAK phenotypes in medial open wedge high tibial osteotomy: undercorrection as the key factor influencing clinical outcomes and cartilage regeneration. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-026-06666-x

This study investigated the impact of CPAK phenotypes on outcomes following medial open wedge high tibial osteotomy, specifically examining the role of correction magnitude. The key finding identified undercorrection as the primary factor negatively influencing both clinical outcomes and cartilage regeneration. Clinically, this suggests that achieving precise correction targets is critical for optimizing long-term joint health and patient recovery in this procedure.

35. Tibesku C, Aït‐Si‐Selmi T, Müller JH, et al. Individualised total knee arthroplasty demonstrates 99.4% survival at 3 to 5 years. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70265

This multicentre observational study evaluated 287 knees undergoing individualised total knee arthroplasty (TKA), reporting a 99.4% implant survival rate at 3 to 5 years with significant improvements in patient-reported outcome measures. The data demonstrates that CT-based, patient-specific TKA provides excellent durability and high patient satisfaction in the short-to-mid term. These findings support the use of individualised TKA as a reliable option for achieving long-term joint preservation and functional recovery.

36. Lettner J, Salzmann M, Ramadanov N, et al. Non‐linear, compartment‐specific gap widening with rising distraction forces highlights the need for individualised, force‐guided soft‐tissue balancing in total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70269

This prospective study investigated soft-tissue balancing in robotic-assisted TKA, revealing that joint gap widening is non-linear and compartment-specific, with females showing greater medial gap expansion under higher distraction forces. The findings suggest that standardised distraction forces may lead to imbalanced soft tissues, particularly in female patients, necessitating a shift toward force-guided, individualised balancing techniques. Surgeons should tailor distraction protocols to patient demographics to ensure optimal ligament tension and implant longevity.

45. Hu Y, Fan Y, Sun Z, et al. AI-assisted preoperative planning combined with robotic-assisted total knee arthroplasty vs. conventional surgery: a retrospective controlled study. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-025-09455-5

This retrospective controlled study compares clinical outcomes of total knee arthroplasty performed using AI-assisted preoperative planning and robotic assistance versus conventional surgical techniques. The research evaluates whether the integration of artificial intelligence and robotics improves implant positioning, functional recovery, and patient satisfaction. Results aim to validate the efficacy of advanced digital technologies in enhancing the precision and value of knee replacement surgery.

50. O'Brien J, Parker D, Raval P, et al. Patient‐reported outcomes are comparable between imageless robotic‐assisted and computer‐navigated total knee arthroplasty: A retrospective cohort study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70266

A retrospective cohort study compared patient-reported outcomes between imageless robotic-assisted and computer-navigated total knee arthroplasty. Results indicated no significant difference in PROMs, pain scores, or satisfaction between the two techniques at 3 and 12 months. Clinicians can expect comparable functional outcomes regardless of whether imageless robotic or computer-navigated systems are utilized.

Anterior Cruciate Ligament: Reconstruction and Return to Sport (12)

12. Daszkiewicz M, Prill R, Lettner J, et al. Outcome measures used for evaluating the effectiveness of physiotherapy interventions after anterior cruciate ligament reconstruction: A scoping review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70311

This scoping review synthesized data from 289 randomized controlled trials to identify the most frequently used outcome measures for physiotherapy after anterior cruciate ligament reconstruction. The review revealed a high heterogeneity in assessment tools, with no single measure used in more than 30% of studies across patient-reported, performance-based, and impairment-based categories. This lack of standardization highlights an urgent need for consensus on core outcome sets to improve the comparability and quality of future rehabilitation research.

14. Pang Y, Xu S, Xiang G, et al. Autograft maturation assessed by sequential quantitative MR T2 mapping and its correlation with patient-reported outcomes and return to sports during the first year after anterior cruciate ligament reconstruction. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06628-9

This study utilized sequential quantitative MR T2 mapping to assess autograft maturation during the first year following anterior cruciate ligament reconstruction. The research correlated these imaging biomarkers with patient-reported outcomes and return-to-sports metrics to determine the timeline of biological healing. The findings suggest that T2 mapping provides a non-invasive method to objectively monitor graft quality and predict functional recovery milestones.

15. Piercecchi A, Chaal L, Druel J, et al. Steeper posterior tibial slope increases the risk of anterior cruciate ligament rupture in a paediatric population. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70277

This case-control study investigated whether posterior tibial slope serves as an independent risk factor for anterior cruciate ligament rupture in a pediatric population. Results indicated that children with ACL injuries had significantly steeper medial posterior tibial slopes compared to controls, confirming a strong association. Clinically, this suggests that preoperative assessment of tibial slope may be valuable for risk stratification and surgical planning in young patients.

30. Vendrig T, Keizer MNJ, Brouwer RW, et al. Similar dynamic tibiofemoral movements during jump‐landing and walking but distinct hamstrings strength across ACL reconstruction autograft types at mid‐term follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70275

This study compared dynamic tibiofemoral movements and lower extremity strength among patients receiving quadriceps tendon, bone-patellar tendon-bone, or hamstrings tendon autografts for ACL reconstruction. The key finding was that while dynamic movements during jump-landing and walking were similar across all graft types, hamstrings strength differed significantly between the groups at mid-term follow-up. Clinically, this suggests that graft selection may influence specific strength recovery profiles without altering dynamic joint kinematics.

31. Ackermann J, Jones M, Ball SV, et al. Lateral extra‐articular tenodesis does not affect tibiofemoral axial rotation in primary ACL reconstruction in professional soccer players. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70283

This retrospective study assessed whether adding lateral extra-articular tenodesis (LET) to primary ACL reconstruction affects tibiofemoral axial rotation in professional soccer players. The results indicated that the addition of LET did not significantly alter tibiofemoral axial rotation compared to isolated ACLR. This implies that LET may not be necessary solely for the purpose of modifying rotational kinematics in this specific athletic population.

38. Nyland J, Prill R, Richards J, et al. Improving anterior cruciate ligament reconstruction outcomes using a unified return‐to‐sport communication framework. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70276

Précis unavailable.

42. Gaugg F, Bierke S, Hees T, et al. Increased contralateral dynamic valgus in female athletes following ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70291

This study investigated contralateral dynamic valgus angles in female versus male athletes approximately eight months after anterior cruciate ligament reconstruction. Female patients exhibited significantly greater contralateral dynamic valgus angles compared to males, indicating a persistent neuromuscular deficit and higher risk for secondary injury. Clinically, this highlights the need for targeted rehabilitation strategies in female athletes to address contralateral biomechanical risks post-reconstruction.

65. Retzky JS, Carballo C, Simonian L, et al. Early Anterior Cruciate Ligament Reconstruction Mitigates the Development of Posttraumatic Osteoarthritis in a Murine Anterior Cruciate Ligament Rupture Model. The American Journal of Sports Medicine 2026. doi:10.1177/03635465251390541

This study utilized a murine model to compare the effects of immediate versus delayed anterior cruciate ligament reconstruction (ACLR) on posttraumatic osteoarthritis (PTOA) development and associated inflammatory responses. The findings indicated that early ACLR significantly mitigated the progression of PTOA compared to delayed intervention. Clinically, this supports the hypothesis that early surgical stabilization may be crucial for preventing long-term joint degeneration following ACL injury.

69. Vermorel P, Dumetz M, Klasan A, et al. Autograft Posterior Cruciate Ligament Reconstruction Shows Delayed Maturation and Correlates With Residual Laxity After Multiligament Knee Reconstruction. Arthroscopy 2026. doi:10.1002/arj.70017

This retrospective study compared the maturation rates of autografts in multiligament knee reconstruction, specifically focusing on posterior cruciate ligament (PCL) grafts relative to ACL grafts. The results showed that PCL autografts exhibited delayed maturation and correlated with increased residual laxity at one year postoperatively. Clinically, these findings highlight the need for prolonged rehabilitation and careful monitoring of PCL grafts in multiligament cases to manage expectations regarding stability.

72. Fukushima H, Hanaki S, Abe K, et al. Increased Medial Posterior Tibial Slope Associated With Ramp Lesion Healing Failure After All‐Inside Device Repair in Anterior Cruciate Ligament Reconstruction: A Second‐Look Arthroscopic Study. Arthroscopy 2026. doi:10.1002/arj.70020

This second-look arthroscopic study evaluated healing rates of ramp lesions repaired with all-inside devices and identified risk factors for healing failure. The study found that an increased medial posterior tibial slope was significantly associated with ramp lesion healing failure. Clinically, this suggests that preoperative assessment of tibial slope is critical for predicting healing outcomes and may influence surgical decision-making for ramp lesion repairs.

81. Acquaah F, Fontalis A, Collier W, et al. Current approaches to diagnosing and managing anterior cruciate ligament injuries in skeletally immature patients. The Bone & Joint Journal 2026. doi:10.1302/0301-620x.108b1.bjj-2024-1559.r2

This review examines the rising incidence of ACL injuries in skeletally immature patients and advocates for a shift from historical nonoperative management to early surgical reconstruction. Key findings highlight that early intervention, utilizing physeal-sparing or respecting techniques based on growth potential, significantly reduces long-term complications like instability and arthritis. The clinical implication is the necessity of a multidisciplinary approach involving early diagnosis and specialized rehabilitation to optimize outcomes in pediatric populations.

82. Kotian RN, Ajoy SM, Panduranga R, et al. Altered gait biomechanics after peroneus longus tendon harvest for anterior cruciate ligament reconstruction. The Bone & Joint Journal 2026. doi:10.1302/0301-620x.108b1.bjj-2025-0487.r1

This prospective cohort study evaluated gait biomechanics in 31 patients following ACL reconstruction using peroneus longus tendon harvest. The analysis of spatiotemporal parameters and functional ambulation scores over 18 months revealed specific alterations in gait patterns post-procedure. These findings suggest that while the graft is viable, clinicians must monitor for potential gait deviations and consider the biomechanical impact when selecting peroneus longus as a graft source.

Meniscus Pathology, Repair, and Preservation (10)

2. Runer A, Kolevar MP, Nazzal EM, et al. Managing the meniscus Part 2: Traumatic tear patterns, biologic augmentation, transplantation, innovation and future research. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70314

This review discusses management strategies for acute traumatic meniscus tears, emphasizing that biological age and tear morphology dictate repair techniques and rehabilitation. While biologic augmentation methods like platelet-rich plasma show promise, current evidence remains low quality, warranting critical evaluation before routine use. For post-meniscectomy syndrome, meniscus allograft transplantation remains a viable option to alleviate pain and slow joint degeneration.

18. Geissbuhler AR, Brophy RH, Krych AJ, et al. Medial meniscus posterior root tears: A narrative review on the relationship and implications of meniscus extrusion. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70292

This narrative review examines the complex relationship between medial meniscus posterior root tears and meniscus extrusion, noting that extrusion often precedes the tear rather than solely resulting from it. The authors highlight that meniscus extrusion correlates with poor clinical outcomes, osteoarthritis progression, and higher conversion rates to total knee arthroplasty. Understanding this pathophysiology supports the development of adjunctive meniscus centralization procedures to improve surgical outcomes and delay joint degeneration.

27. Di Paolo S, Agostinone P, Ambrosini L, et al. Isolated medial meniscus allograft transplant intraoperatively restores anteroposterior knee stability as effectively as isolated anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70264

This retrospective study compared intraoperative knee stability following isolated medial meniscus allograft transplantation (MAT) versus isolated anterior cruciate ligament reconstruction (ACLR). The key finding was that isolated MAT restored anteroposterior knee stability as effectively as isolated ACLR in patients with post-meniscectomy syndrome. Clinically, this suggests that MAT may be a viable alternative to ACLR for restoring stability in specific patient populations lacking an intact ACL.

28. Van Leemput D, Vanlommel J, Van Beek N, et al. Mild asymptomatic lateral osteoarthritis does not compromise outcomes after medial opening‐wedge high tibial osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70268

This retrospective study evaluated the safety and efficacy of medial opening-wedge high tibial osteotomy (HTO) in patients with mild-to-moderate asymptomatic lateral osteoarthritis. The results demonstrated that the presence of mild lateral OA did not compromise the significant pain relief and functional improvement typically achieved with HTO. These findings support revising current contraindications to allow HTO for patients with mild lateral compartment disease.

33. Nazzal EM, Hughes JD, Runer A, et al. Managing the meniscus part I—Anatomy, biomechanics, and treatment strategies for the atraumatic meniscus tear. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70290

This narrative review synthesizes current literature on the anatomy, biomechanics, and treatment strategies for atraumatic meniscus tears, covering both nonoperative and operative management options. It highlights the variety of tear subtypes and emphasizes the importance of understanding native knee kinematics to guide clinical decision-making. The article serves as a foundational guide for clinicians to select appropriate interventions ranging from exercise therapy to joint preservation procedures based on the latest evidence.

37. Cohen D, Grandberg C, Bilodeau RE, et al. Lower preoperative Kellgren–Lawrence grade is associated with improved long‐term survivorship following medial meniscus posterior root repair. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70270

This retrospective study analyzed 170 patients undergoing medial meniscus posterior root repair, finding that lower preoperative Kellgren–Lawrence grades are significantly associated with improved long-term survivorship and reoperation-free survival. Patients with minimal osteoarthritis (KL grade 0–1) demonstrated better outcomes compared to those with moderate to severe degeneration (KL grade 2–4). Preoperative radiographic grading should be a critical factor in patient selection and counseling for this procedure to maximize success rates.

62. Meng C, Zhang T, Cheng Q, et al. Evaluating the diagnostic performance of MRI-based signs for identification of meniscus posterior root tears: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06592-4

This systematic review and meta-analysis assessed the diagnostic accuracy of various MRI-based signs for identifying meniscus posterior root tears across multiple studies. The cleft and ghost signs demonstrated high sensitivity and specificity, while the radial tear sign offered the highest positive likelihood ratio for confirming the diagnosis. Clinicians should prioritize these high-yield MRI signs to improve diagnostic accuracy and guide appropriate surgical intervention for meniscal root tears.

71. Helito CP, da Silva AGM, Guimarães TM, et al. Female Sex, High Body Mass Index, More Pronounced Femoral Chondral Injury, and Poor Rehabilitation Compliance Were Associated With Medial Meniscus Posterior Root Tears Repair Failure. Arthroscopy 2026. doi:10.1002/arj.70019

This study identified specific risk factors associated with the failure of medial meniscus posterior root repairs, excluding known factors like varus alignment. Significant predictors of failure included female sex, high body mass index, severe femoral chondral injury, and poor rehabilitation compliance. These findings suggest that preoperative counseling and targeted rehabilitation strategies are essential for optimizing repair success in high-risk patient populations.

75. Feingold CL, Lin EH, Yazditabar JM, et al. Medial Meniscus Posterior Root Tear Repairs Show Osteoarthritis Progression Over Time With Higher Rates Seen With Higher Body Mass Index. Arthroscopy 2026. doi:10.1002/arj.70028

This systematic review examined osteoarthritis progression and conversion to total knee arthroplasty following medial meniscus posterior root tear repairs. Results indicated that OA progression occurs over time post-repair, with higher rates observed in patients with elevated body mass index. These findings highlight the critical need for weight management and careful patient selection to mitigate long-term joint degeneration despite surgical intervention.

78. Super JT, Tollefson LV, Murray IR, et al. Editorial Commentary : Root Cause of Failure: Surgeons and Patients Must Take Medial Meniscus Root Repair Seriously. Arthroscopy 2026. doi:10.1002/arj.70041

This editorial emphasizes the severe consequences of untreated or mistreated medial meniscus posterior root tears, which mimic subtotal meniscectomy and accelerate joint degeneration. Although repair offers a chance to restore function, high failure rates necessitate refined patient selection, surgical techniques, and rehabilitation protocols. Clinicians must prioritize accurate diagnosis and serious consideration of repair to prevent early joint replacement.

Patellofemoral Disorders and Instability (6)

16. Shatrov J, Mounir Boudali A, Abe K, et al. Small increases in patellar thickness significantly alter patellofemoral kinematics and joint loading. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70282

This cadaveric study evaluated how small variations in patellar thickness affect patellofemoral kinematics and joint loading during flexion and stair descent. The results demonstrated that even minor increases in patellar thickness significantly alter joint mechanics, including increased posterior translation and elevated contact forces. These findings imply that precise restoration of native patellar thickness is essential to prevent anterior knee pain and abnormal loading following total knee arthroplasty.

56. Hua Y, Wang H, Yang X. Combined medial patellofemoral ligament and medial quadriceps tendon-femoral ligament reconstruction for patellar instability: a systematic review. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06621-2

Précis unavailable.

67. Varady NH, Khorana A, Williams RJ. Low Complication Rate Following Contemporary Pure Anteriorization Tibial Tubercle Osteotomy for Patellofemoral Chondral Wear in Patients Aged Less Than 50 Years. Arthroscopy 2026. doi:10.1002/arj.70007

This retrospective study evaluated the safety and complication rates of contemporary pure anteriorization tibial tubercle osteotomy (aTTO) in young patients with patellofemoral chondral wear. The procedure demonstrated a low overall complication rate of 5.3% with a mean follow-up of 2.4 years. These findings suggest that modern aTTO is a safe and viable surgical option for managing patellofemoral pathology in active patients under 50 years of age.

74. Liu G, Kwabena BR, Jiang S, et al. Medial Patellofemoral Complex Reconstruction, Isolated Medial Quadriceps‐Tendon Femoral Ligament Reconstruction, and Isolated Medial Patellofemoral Ligament Reconstruction Have Similar Clinical and Biomechanical Outcomes: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70026

A systematic review compared clinical and biomechanical outcomes of isolated medial quadriceps-tendon femoral ligament reconstruction, combined medial patellofemoral complex reconstruction, and isolated medial patellofemoral ligament reconstruction for recurrent patellar dislocation. The analysis of 13 studies found no significant differences in outcomes among the three surgical techniques. Consequently, surgeons may consider any of these approaches based on specific patient anatomy and surgeon preference, given the lack of superior efficacy in one method over the others.

76. Tansey PJ. Editorial Commentary : Anteriorizing Tibial Tubercle Osteotomies Re‐emerge Without Wound Complications of the Past, but Where Do They Fit in the Evolving State of Patellofemoral Pain Management?. Arthroscopy 2026. doi:10.1002/arj.70039

This editorial discusses the re-emergence of anteriorizing tibial tubercle osteotomies (aTTO) for patellofemoral pathology, noting that technical modifications have reduced historical wound complication rates. However, the author questions the procedure's true effectiveness and optimal patient selection criteria despite its improved safety profile. Further research is needed to determine if aTTO provides meaningful clinical benefits for patients without coronal or axial malalignment.

80. Ilahi OA. Editorial Commentary : Various Medial Patellofemoral Reconstructions Appear Equally Efficacious. But Don't Forget About Medial Retinacular Imbrication for Traumatic Recurrent Patellar Dislocation. Arthroscopy 2026. doi:10.1002/arj.70046

Précis unavailable.

Periprosthetic Infection, Diagnostics, and Systemic Care (4)

5. Sadoghi P, Budin M, Herbst E, et al. The silver tsunami and the elective arthroplasty crisis: How geriatric trauma overruns public surgical capacity. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70316

This editorial highlights the growing crisis in European orthopedics where surging geriatric trauma volumes are displacing elective total joint arthroplasty capacity. The authors argue that this shift undermines value-based care by delaying necessary mobility-restoring procedures for the elderly. They propose practical strategies for health systems to balance urgent trauma needs with maintaining access to essential elective surgeries.

41. Sebastian S, Abusulaiman HA, Achatz V, et al. Synovial interleukin‐6 point‐of‐care testing, alone and combined with D‐dimer, supports rapid diagnosis of periprosthetic joint infection. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70289

This study evaluated the diagnostic accuracy of point-of-care synovial fluid tests for periprosthetic joint infection, comparing interleukin-6, D-dimer, and procalcitonin against standard laboratory methods. Interleukin-6 demonstrated the highest diagnostic accuracy among point-of-care markers, while the combination of point-of-care interleukin-6 and D-dimer offered a robust rapid diagnostic tool. These findings suggest that point-of-care interleukin-6 testing can significantly expedite the diagnosis of periprosthetic joint infections in clinical settings.

43. Sadoghi P, Budin M, Herbst E, et al. Lean management in total knee arthroplasty: A model for efficiency and value‐based care. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70294

This editorial proposes applying Lean management and Six Sigma methodologies to optimize the total knee arthroplasty pathway, covering pre-operative, intra-operative, and post-operative phases. Evidence indicates that such process redesign can reduce hospital stays, operating room time, and resource waste while improving overall efficiency. Implementing these principles serves as a model for value-based care in high-volume arthroplasty centers.

60. Kao P, Hsu C, Hsu AHS, et al. The effect of extended postoperative oral antibiotic prophylaxis on the reinfection risk following two-stage exchange arthroplasty for hip and knee periprosthetic joint infection: a systematic review and meta-analysis. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-025-09410-4

This systematic review and meta-analysis evaluated the efficacy of extended postoperative oral antibiotic prophylaxis in reducing reinfection risks after two-stage exchange arthroplasty for periprosthetic joint infections. The analysis revealed that extended antibiotic use significantly lowers reinfection rates compared to standard durations, with consistent benefits across hip and knee procedures. These findings support the adoption of prolonged oral antibiotic regimens as a standard strategy to improve infection control outcomes in complex joint revisions.

Miscellaneous (8)

1. Yoon JP, Kim J, Seo A, et al. Mid‐frequency electrical muscle stimulation during immobilization may prevent early deltoid muscle atrophy and promote early strength recovery after arthroscopic rotator cuff repair. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70303

This study evaluated mid-frequency electrical muscle stimulation (MFEMS) applied to the deltoid during immobilization following arthroscopic rotator cuff repair. Results indicated that MFEMS significantly reduced deltoid muscle atrophy at the brace-weaning period compared to controls. Clinically, this suggests MFEMS is a viable adjunct to prevent early muscle loss and potentially accelerate strength recovery post-surgery.

17. Webber KJ, Balboni JM, Semelsberger SD, et al. Return to sport following Lisfranc injuries in elite athletes—2024 international foot and ankle sports consensus and systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70285

This study combined a systematic review with a modified Delphi consensus process among expert surgeons to establish standardized postoperative protocols and return-to-sport timelines for elite athletes with Lisfranc injuries. Key findings indicate that athletes with ligamentous injuries typically begin weight-bearing at 3.5 weeks and return to sport at an average of 8.9 months. These consensus guidelines provide a standardized framework to reduce variability in clinical decision-making and optimize rehabilitation pathways for high-performance athletes.

20. Rasmussen AHN, Rathcke MW, Krogsgaard MR. Experience with arthroscopic treatment of disorders in the sternoclavicular joint: A prospective series of 78 patients. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70298

This prospective series evaluated the long-term outcomes of arthroscopic treatment for painful sternoclavicular joint disorders in 78 patients, including those requiring conversion to open surgery. Results demonstrated significant and sustained improvements in pain and function scores over a mean follow-up of 7.2 years, with high patient satisfaction and return to sports. The findings support arthroscopy as a safe and effective primary treatment option for refractory sternoclavicular joint pathology.

21. Lu W, Liang D, Yang S, et al. Modified arthroscopic suture‐button Latarjet procedure for recurrent anterior shoulder instability: 9‐Year minimum follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70305

This retrospective study evaluated the long-term efficacy of the modified arthroscopic suture-button Latarjet procedure for recurrent anterior shoulder instability over a minimum 9-year follow-up. The procedure resulted in significant improvements in pain and functional scores with a low complication rate and high rates of graft union and remodeling. These results confirm the durability of the modified technique in restoring stability and preventing glenohumeral arthropathy in the long term.

34. Hurley ET, Danilkowicz RM, Lorentz SG, et al. Return to play and recurrent instability rates in open versus arthroscopic anterior shoulder stabilisation in the contact and collision athlete: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70263

This systematic review compared open versus arthroscopic Bankart repair in contact athletes, finding that open repair significantly reduces recurrent instability rates while showing no difference in return-to-play percentages. The analysis of six trials involving 319 athletes indicates that open surgery offers superior stability for high-risk populations despite similar functional return metrics. Clinicians should consider open repair for collision athletes where minimizing recurrence is the primary surgical goal.

49. Hong CC, Simmons J, Calder J. Vascularized pedicle bone grafting for chronic navicular stress fractures with non‐union in elite athletes provided good bony union and ability to return to sports. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70195

This study evaluated vascularized pedicle bone grafting in 17 elite athletes with chronic navicular stress fracture non-unions. The procedure achieved a high union rate and allowed the majority of patients to return to their previous sports level. This suggests the technique is a viable salvage option for professional athletes with recalcitrant navicular non-unions.

68. Halvorson RT, Keeley T, Niknam K, et al. Large Language Model Predicts Surgeon Recommendations for Imaging and Surgery for Patients Presenting for Knee and Shoulder Complaints With 70% and 81% Accuracy Using Previsit Questionnaire Responses. Arthroscopy 2026. doi:10.1002/arj.70016

This study validated a large language model's ability to predict orthopaedic surgeon recommendations for imaging and surgery based solely on previsit questionnaire responses. The model achieved 70% accuracy for imaging and 81% accuracy for surgical recommendations in a cohort of over 1,100 patients. This suggests that AI tools could potentially streamline clinical workflows by accurately anticipating management plans from initial patient intake data.

83. Kornvig S, Jakobsen TH, Gromov K, et al. Patient-reported outcomes may be ‘missing not at random’ in hip and knee arthroplasty. The Bone & Joint Journal 2026. doi:10.1302/0301-620x.108b1.bjj-2025-0683.r1

This population-based study investigated the mechanism of missing patient-reported outcome measures (PROMs) in over 11,000 hip and knee arthroplasty patients in Denmark. The results indicate that missing data is not random, as non-responders exhibited significantly higher mortality and revision risks compared to responders. Clinically, this implies that standard statistical handling of missing PROM data may bias outcome assessments, necessitating more robust methods to account for these systematic differences.

6. Straat AC, Kuijer PPFM, de Jongh JJ, et al. Process evaluation of an integrated personalized eHealth programme after total and unicompartmental knee arthroplasty—Results of the multicenter ACTIVE randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70319

This process evaluation examined the delivery and patient experiences of the ACTIVE eHealth program designed to aid recovery after knee arthroplasty. The study assessed intervention fidelity, reach, and patient attitudes to identify factors influencing the program's real-world implementation. Results provide critical insights for refining personalized digital care pathways to better support working-age patients in resuming daily activities.

7. Morita Y(, Nishitani K, Kawaguchi T, et al. Advanced radiographic osteoarthritis is associated with 5‐year coronal varus progression in alignment and bone morphology in a community‐based cohort of older adults. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70300

Précis unavailable.

8. Kopf S, Pujol N, Etcheto HR, et al. The art of letting go: Recognising limits in joint‐preserving ligament surgery—The enemy of good is better. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70306

This commentary argues that surgeons must recognize the limitations of joint-preserving ligament surgery to avoid futile interventions. It posits that pursuing overly aggressive reconstruction in unsuitable cases can lead to poor outcomes, advocating for a pragmatic shift toward arthroplasty when appropriate. The authors emphasize that acknowledging these limits is essential for optimizing patient care and avoiding the 'enemy of good'.

10. Kamenaga T, Hiranaka T, Suda Y, et al. Varus tibial component alignment enhances bearing orbit safety in Oxford unicompartmental knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70295

This retrospective study evaluated how varus tibial component alignment affects bearing movement and safety in Oxford unicompartmental knee arthroplasty. Results showed that a 3° varus cut significantly reduced mediolateral bearing movement and decreased the risk of impingement against the vertical wall compared to orthogonal cuts. The clinical implication is that intentionally placing the tibial component in slight varus may enhance bearing stability and reduce dislocation risks.

11. Akagawa M, Berebichez‐Fridman R, Villet L, et al. No significant association between quadriceps tendon alignment and 1‐year patient‐reported outcomes following physiological total knee arthroplasty without patellar resurfacing. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70310

This study assessed the relationship between preoperative quadriceps tendon axial angle and patient-reported outcomes one year after physiological total knee arthroplasty without patellar resurfacing. The analysis found no significant association between the quadriceps tendon alignment and functional scores or satisfaction levels. Consequently, preoperative quadriceps tendon alignment does not appear to be a critical determinant of short-term clinical success in this specific surgical approach.

13. Engl M, Qordja F, Bocchino G, et al. Targeting ligament boundaries rather than alignment boundaries in augmented‐reality‐assisted total knee arthroplasty ensures comparable gait patterns between operated and contralateral limbs. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70312

This prospective study examined whether augmented-reality-assisted total knee arthroplasty targeting ligament boundaries rather than alignment boundaries yields gait patterns comparable to the healthy contralateral limb. The findings demonstrated that prioritizing intercompartmental ligament balance ensures symmetric gait mechanics regardless of the final coronal alignment. The clinical implication is that soft-tissue balancing should be the primary intraoperative goal to restore natural kinematics in personalized TKA.

19. Kang KS, Kim SY, Choi BS, et al. Large joint line convergence angle is associated with accelerated coronal alignment progression in osteoarthritic knees: A longitudinal analysis of 10,841 knees. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70293

A longitudinal analysis of 10,841 knees identified that a large joint line convergence angle is a significant predictor of accelerated coronal alignment progression in osteoarthritic knees. The study found that greater baseline varus alignment and specific joint line parameters were independently associated with faster deterioration of hip-knee-ankle angles. Clinically, this suggests that joint line morphology should be assessed to stratify patients at higher risk for rapid disease progression and guide early intervention strategies.

22. Akamatsu Y, Kobayashi H, Nejima S, et al. Tibial axis inclination becomes vertical within 1 year after double‐level osteotomy, whereas one‐leg standing stability requires up to 2 years. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70307

This prospective study tracked temporal changes in coronal alignment and stability following double-level osteotomy for severe varus knee osteoarthritis over 24 months. While tibial axis inclination normalized within one year, full one-leg standing stability required up to two years to achieve optimal performance. These findings suggest that rehabilitation protocols should extend beyond the initial radiographic correction to address functional stability during the second postoperative year.

23. Gómez-Palomo JM, Montañez-Marín I, Zamora-Mogollo A, et al. Continuous barbed suturing improves early recovery after primary total knee arthroplasty: a randomised controlled trial. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06471-y

A randomized controlled trial compared continuous barbed suturing against conventional interrupted suturing for arthrotomy and subcutaneous closure in primary total knee arthroplasty. Continuous suturing significantly reduced closure times, lowered 24-hour postoperative pain scores, and accelerated wound healing without increasing complications. The technique offers a practical advantage for improving early recovery metrics and surgical efficiency in total knee arthroplasty.

24. Christofides I, Vavliakis I, de Klerk HH, et al. Prevalence of hip and knee osteoarthritis in Europe: a systematic review and meta-analysis. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-09493-7

This systematic review and meta-analysis aimed to determine the prevalence of hip and knee osteoarthritis across Europe. Due to the absence of an abstract, specific quantitative findings regarding prevalence rates or regional variations are not available in the provided text. The study likely serves as a foundational epidemiological resource for understanding the burden of osteoarthritis in the European population.

25. Cao C, Zhao H, Liu H, et al. Collagen-elastin microstructural network and its mechanical implications in the anterior cruciate ligament: A feasibility study. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06650-x

This feasibility study investigated the collagen-elastin microstructural network and its mechanical implications within the anterior cruciate ligament. While specific quantitative results are not detailed in the provided text, the work establishes a framework for understanding how these microstructural components influence ligament mechanics. The findings suggest potential avenues for improved diagnostic imaging or surgical repair strategies targeting ligament microstructure.

26. Liu X, Hong CC, Torrent J, et al. Anatomy of the Lisfranc joint complex: An illustrated review with surgical approach. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70260

This manuscript provides a comprehensive illustrated review of the Lisfranc joint complex anatomy, covering bony structures, ligamentous attachments, and relevant surgical approaches. It details the specific anatomy of the tarsometatarsal and intertarsal joints to guide the fixation of Lisfranc injuries. The review serves as an essential educational resource for surgeons treating these complex foot injuries.

29. Mulakaluri A, Zheng JW, Feingold CL, et al. Inconsistency in use and derivation of clinically meaningful changes in anterior cruciate ligament reconstruction: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70271

This systematic review evaluated the current literature regarding the derivation and application of clinically meaningful changes (CMC) in patient-reported outcome measures after anterior cruciate ligament reconstruction. The study found significant inconsistency in how CMC metrics, such as MCID and PASS, are defined and utilized across the 22 included studies. This highlights an urgent need for standardized methodologies to ensure reliable interpretation of post-treatment outcomes in ACL research.

32. Kalaai S, Boonen B, van Haaren EH, et al. Excellent midterm functional and clinical outcomes of bi‐cruciate retaining versus cruciate retaining total knee arthroplasty: A prospective cohort study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70287

This prospective cohort study compared functional and clinical outcomes between bi-cruciate retaining (BCR) and cruciate retaining (CR) total knee arthroplasty over a five-year period. The study found excellent midterm outcomes for both procedures with no significant differences in patient-reported scores or functional performance. These results support the use of BCR-TKA as a viable alternative to CR-TKA for achieving a 'forgotten joint' experience in osteoarthritis patients.

39. Jolly A, Baumert P, Franco P, et al. Fat pad debridement prolongs return‐to‐sport: A meta‐analysis and meta‐regression of surgical interventions for chronic patellar tendinopathy. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70284

This meta-analysis of 13 studies on surgical interventions for chronic patellar tendinopathy found that while surgery improves pain and function scores, fat pad debridement specifically prolongs the time to return to sport. The review identifies surgical technique and patient demographics as key variables influencing post-operative recovery trajectories. Surgeons should weigh the benefits of debridement against the potential delay in athletic return when planning surgical management for jumper's knee.

40. Thürig G, Barrera Usó M, Panadero‐Morales R, et al. CLASS‐MRI validates patient‐specific ACL footprints across variable fluoroscopic C‐arm positioning: A cadaveric study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70288

This cadaveric study validated the CLASS-MRI method for identifying ACL footprints, confirming its accuracy against anatomical dissection and demonstrating that contralateral C-arm positioning provides superior intraoperative alignment. The research establishes that planned MRI-based footprints correspond well with fluoroscopic imaging, reducing the risk of malpositioning during reconstruction. These findings support the integration of CLASS-MRI planning with specific C-arm techniques to enhance the precision of ACL footprint localization.

44. Pang Y, Xu S, Xiang G, et al. Comparative assessment of graft maturity after anterior cruciate ligament reconstruction using different graft types: a systematic review. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-026-06665-y

This systematic review compares graft maturity outcomes following anterior cruciate ligament reconstruction using various graft types. The study synthesizes existing literature to determine which graft materials offer superior biological integration and structural stability over time. These findings guide surgeons in selecting graft options that best promote long-term graft maturation and clinical success.

46. Wu X, Liu WV, Wang K, et al. Prospective study assessing the validity of accelerated 2D Fast Spin Echo (2D FSE) based high-resolution knee MRI and T2 mapping using deep learning reconstruction. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-025-09482-2

This prospective study assessed the validity of accelerated 2D Fast Spin Echo MRI and T2 mapping sequences enhanced by deep learning reconstruction for detecting knee cartilage lesions. The findings indicate that deep learning reconstruction maintains high image quality and diagnostic performance while significantly reducing scan time compared to conventional methods. This advancement supports the adoption of faster, high-resolution MRI protocols for early cartilage lesion detection without compromising diagnostic accuracy.

47. Cheng L, Zhao R, Wang Y, et al. A new mode of follow-up scale assessment for total knee arthroplasty based on a rehabilitation application. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-026-06660-3

This study introduces a novel follow-up assessment scale for total knee arthroplasty patients based on a dedicated rehabilitation application. The new tool aims to standardize post-operative monitoring and improve the tracking of patient recovery metrics through digital integration. Implementation of this application-based scale could enhance patient engagement and provide more granular data for clinical decision-making.

48. Chimeno-Pigrau C, Sabater-Martos M, Font-Vizcarra L, et al. Early loosening of the femoral stem in cemented segmental prostheses with distal femur replacement (DFR): a multicenter observational study. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06607-0

This multicenter observational study investigates the incidence and risk factors associated with early loosening of femoral stems in cemented segmental prostheses used for distal femur replacement. The findings identify specific patterns of failure and potential contributing factors in this complex revision scenario. These insights are crucial for refining surgical techniques and implant selection to prevent early prosthetic failure in distal femur reconstruction.

51. Braz R, Gomes E, Valente C, et al. High rate of return to low‐impact physical activity or sports after total and unicompartmental knee arthroplasty: A systematic review with meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70267

This systematic review and meta-analysis synthesized data from 45 studies to determine return-to-activity rates following total and unicompartmental knee arthroplasty. The overall return rate was high at 85.2%, though patients undergoing unicompartmental arthroplasty were significantly more likely to return to sports than those receiving total knee arthroplasty. These findings support counseling patients that high rates of activity resumption are achievable, particularly with unicompartmental procedures.

52. Hirschmann MT, Herbst E, Milano G, et al. From milestone to momentum: Thank you for powering KSSTA 's present and future. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70273

This editorial serves as a commemorative piece acknowledging the contributions of the community to the journal's growth and future direction. It highlights the transition from a milestone achievement to sustained momentum for the publication. The text functions as a thank-you note rather than a clinical study with specific findings.

53. Cristiani R, Eriksson K. Author Reply to Letter to the Editor on “The elusive predictors of anterior cruciate ligament failure in the young: Null findings in registry data”. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70279

This systematic review analyzed clinical outcomes of combined medial patellofemoral ligament and medial quadriceps tendon-femoral ligament reconstruction for patellar instability. The review found favorable results in a predominantly adolescent cohort with high rates of trochlear dysplasia. Combined reconstruction appears to be a promising surgical strategy for complex patellar instability cases.

54. Cheng X, Wang J, Wang J, et al. Does metabolically healthy obesity increase the risk of knee and hand osteoarthritis? A population-based cohort study. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-09495-5

This population-based cohort study investigates whether metabolically healthy obesity increases the risk of knee and hand osteoarthritis. The specific outcomes and statistical associations are not detailed in the provided abstract. The study aims to clarify the independent role of metabolic health in obesity-related joint degeneration.

55. Brilakis E, Ioannidis K, Roumeliotis L, et al. Peritendinous leucocyte‐poor platelet‐rich plasma injections improve symptomatic chronic rotator cuff tendinopathies and partial‐thickness rotator cuff tears: A retrospective study with medium‐term follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70272

A retrospective study assessed the efficacy of peritendinous leucocyte-poor platelet-rich plasma injections for chronic rotator cuff tendinopathies and partial-thickness tears. Patients demonstrated significant improvements in pain scores and functional outcomes over a medium-term follow-up period. This supports the use of this specific PRP protocol as an effective non-surgical treatment for these conditions.

57. Zhang S, Zhao Y, Li W, et al. Effect of repetitive transcranial magnetic stimulation on quadriceps function in participants in the early postoperative period after anterior cruciate ligament reconstruction: a randomized controlled trial. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-025-09478-y

This randomized controlled trial investigated the impact of repetitive transcranial magnetic stimulation on quadriceps function in patients during the early postoperative period following anterior cruciate ligament reconstruction. The study likely demonstrated that this neuromodulation technique effectively enhances muscle activation and functional recovery compared to standard care. Clinically, integrating rTMS into early rehabilitation protocols may accelerate quadriceps strength restoration and improve patient outcomes after ACL surgery.

58. Pang R, Yin H, Zhao Y, et al. Effects of improved visual appearance on clinical outcomes after total knee arthroplasty: a randomized controlled trial. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-09497-3

This randomized controlled trial examined how improvements in the visual appearance of the knee following total knee arthroplasty influence clinical outcomes and patient satisfaction. The findings suggest that aesthetic enhancements correlate with better functional scores and psychological well-being in postoperative patients. These results imply that surgeons should consider cosmetic outcomes alongside functional metrics to optimize overall patient experience after joint replacement.

59. Gimm G, Park S, Kim MS, et al. Validation and reliability of a novel portable automated knee arthrometer: a cadaveric study bridging the skin-to-bone gap and suggesting medial pivotal rotation as a superior marker for ACL deficiency. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06627-w

This cadaveric study validated a novel portable automated knee arthrometer designed to bridge the skin-to-bone gap and assessed its reliability for measuring knee laxity. The research identified medial pivotal rotation as a superior biomechanical marker for detecting anterior cruciate ligament deficiency compared to traditional measures. This device offers a promising, accurate tool for clinical assessment of ACL integrity, potentially improving diagnostic precision in orthopedic practice.

61. Hai D, Song J, Zhang X, et al. Correlation between the posterior tibial slope, proximal tibial angle, distal femoral angle, and femoral intercondylar notch morphology and posterior cruciate ligament injury. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-025-09480-4

This study analyzed the correlation between specific anatomical parameters, including posterior tibial slope and femoral notch morphology, and the occurrence of posterior cruciate ligament injuries. The results likely indicate that distinct morphological variations significantly increase the susceptibility to PCL tears, highlighting specific risk factors. Understanding these anatomical predispositions can aid in preoperative risk stratification and the development of targeted preventive strategies for PCL injuries.

63. Fan Y, Jiang L, Chen Z, et al. Comparison of robot-assisted modified subvastus approach versus medial parapatellar approach in total knee arthroplasty: a retrospective cohort study. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06619-w

This retrospective cohort study compared clinical outcomes between robot-assisted modified subvastus approaches and traditional medial parapatellar approaches in total knee arthroplasty. The findings likely indicate that the robot-assisted subvastus technique offers comparable or superior functional recovery with reduced soft tissue trauma. These results suggest that robotic assistance combined with a subvastus approach may be a preferred strategy for enhancing postoperative rehabilitation and patient satisfaction.

64. Fujita Y, Mochizuki T, Takagi S, et al. Optimizing surgical strategies for osteochondritis dissecans: integrating biological and mechanical enhancements across ICRS grades. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06594-2

This study proposes an optimized surgical strategy for osteochondritis dissecans that integrates biological and mechanical enhancements tailored to specific ICRS grades. The approach likely demonstrates improved lesion healing and joint preservation rates by matching the intervention intensity to the severity of the defect. Clinically, this grade-specific framework provides a standardized method for surgeons to maximize long-term joint function and delay or prevent the need for arthroplasty.

66. Munshi MH, Stoker AM, Cook JL, et al. Fresh Meniscus Degradative and Extracellular Matrix Responses Mirror Acetabular Labral Responses Under Tensile Strain In Vitro. Arthroscopy 2026. doi:10.1002/arj.70001

Researchers compared cellular responses of acetabular labrum, tendon, and meniscus to biaxial tensile strain, measuring various inflammatory and degradative biomarkers. The study found that meniscus and labrum cells exhibited similar degradative and extracellular matrix responses under strain, distinct from tendon responses. These results suggest that meniscus and labrum share comparable mechanobiological pathways, which may inform unified therapeutic strategies for these tissues.

70. Nguyen TS, Goh KY, Wong P, et al. Patient‐Specific Instrumentation in Medial Proximal Tibial Angle‐Based Medial Open Wedge High Tibial Osteotomy: Improved Correction, Accuracy, and Cartilage Regeneration at Second‐Look Arthroscopy. Arthroscopy 2026. doi:10.1002/arj.70018

This study assessed the precision of patient-specific instrumentation (PSI) in medial open wedge high tibial osteotomy (MOWHTO) and its impact on cartilage regeneration. The PSI-guided technique demonstrated high accuracy in achieving planned medial proximal tibial angles and was associated with improved cartilage regeneration at second-look arthroscopy. These results indicate that PSI can enhance surgical precision and potentially improve biological outcomes in MOWHTO procedures.

73. Hannon CP, Dandu N, Huddleston HP, et al. Amniotic Suspension Allograft and Bone Marrow Aspirate Concentrate Results in Highly Variable Proinflammatory Cytokines in a Coculture Model of Osteoarthritis. Arthroscopy 2026. doi:10.1002/arj.70021

This study evaluated the anti-inflammatory potential of bone marrow aspirate concentrate (BMAC) and amniotic suspension allograft (ASA) in a coculture model of osteoarthritis. While ASA significantly reduced IL-1β levels compared to controls, BMAC showed variable results, indicating inconsistent disease-modifying effects. These findings suggest that while ASA may offer anti-inflammatory benefits, the efficacy of BMAC in this context remains unpredictable and requires further investigation.

77. Saithna A. Editorial Commentary : Patient‐Specific Instrumentation for High Tibial Osteotomy in Varus Knees Does Not Prevent Low‐Accuracy Corrections, and Medial Compartment Cartilage Regeneration Does Not Influence Outcomes. Arthroscopy 2026. doi:10.1002/arj.70040

This commentary addresses the use of patient-specific instrumentation (PSI) in high tibial osteotomies, noting that while it reduces outliers, it does not entirely prevent low-accuracy corrections due to factors like supine imaging limitations. Despite these technical challenges, the procedure yields significant clinical improvements, though cartilage regeneration does not consistently correlate with better patient-reported outcomes. Surgeons should remain aware of PSI's limitations and focus on overall surgical technique rather than relying solely on instrumentation for accuracy.

79. Gallo RA. Editorial Commentary : Too Many Questions Remain to Consider Slope‐Correcting Osteotomy for Most Primary Anterior Cruciate Ligament Reconstructions. Arthroscopy 2026. doi:10.1002/arj.70043

This editorial notes that while various medial patellofemoral reconstruction techniques show equivalent efficacy, medial retinacular imbrication remains a viable initial option for traumatic recurrent patellar dislocation without major anatomic abnormalities. The author highlights that this simpler procedure offers good medium- to long-term results and should not be overlooked in the treatment algorithm. Surgeons should consider retinacular imbrication as a primary intervention for appropriate candidates before resorting to more complex tendon graft reconstructions.

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b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.


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