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What's New — Knee — February 2026

75 new articles published this month.

Themes: ACL Reconstruction: Grafts, Techniques, and Outcomes · Meniscal Pathology, Repair, and Biomechanics · Arthroplasty Alignment, Robotics, and Infection · Artificial Intelligence and Digital Health in Orthopaedics · Multiligament Injuries and Soft Tissue Reconstruction

Digest generated 2026-04-16 01:20:38+00:00.

Highlights

ACL Reconstruction: Grafts, Techniques, and Outcomes

Recent literature extensively evaluates anterior cruciate ligament reconstruction (ACLR) strategies, focusing on graft selection, surgical adjuncts, and rehabilitation. Quadriceps tendon autografts demonstrate non-inferiority to bone-patellar tendon-bone and hamstring grafts regarding patient-reported outcomes at two years [3], though hamstring harvest may leave residual strength deficits unrelated to tendon regeneration [14]. The role of lateral extra-articular tenodesis (LET) is refined, with deep LET showing superior rotational stability compared to superficial techniques in high-risk patients [7]. Furthermore, graft diameter, rather than type, predicts success in single-stage revision ACLR [21]. Rehabilitation protocols are also scrutinized, with evidence suggesting that postoperative bracing may limit extension recovery [45] and that mental skills training is feasible for young athletes [11].

Meniscal Pathology, Repair, and Biomechanics

Studies on meniscal management highlight the nuanced relationship between meniscal treatment and long-term joint health. Registry data indicates that meniscal repair does not significantly reduce cartilage damage compared to resection in ACL-reconstructed knees [2]. Biomechanical investigations provide critical technical guidance, suggesting suture interval spacing should be ≤7 mm to prevent gap formation [48]. Clinical outcomes for ramp lesions appear independent of specific subtypes or stability [38], while meniscal hypermobility does not negatively impact functional scores post-ACLR [73]. Additionally, the combination of high tibial osteotomy with meniscal root repair offers improved outcomes for medial meniscus posterior root tears [62], and sport type significantly influences the topography of associated meniscal injuries [15].

Arthroplasty Alignment, Robotics, and Infection

Total knee arthroplasty (TKA) research focuses on alignment philosophies, robotic assistance, and infection management. Kinematically aligned TKA with a fixed 2 mm adjustment for cartilage loss does not compromise outcomes [34], whereas static native tibial alignment optimizes whole-body gait kinematics compared to adjusted mechanical alignment [22]. Robotic assistance in revision TKA offers planning benefits but introduces complexity regarding bony defects [31]. Infection management sees a shift toward standardized debridement, antibiotics, and implant retention (DAIR) protocols [18], with single-stage revision proving viable even for fistulized infections [56]. High tibial osteotomy continues to demonstrate long-term survivorship and favorable force redistribution [16, 36].

Artificial Intelligence and Digital Health in Orthopaedics

The integration of artificial intelligence (AI) into orthopaedic practice is a rapidly evolving theme, with mixed results regarding clinical utility. While AI-generated medical documentation significantly underperforms human clinicians in critical dimensions [1], advanced large language models with deep research capabilities show improved concordance with clinical guidelines [52]. AI also demonstrates promise in early detection, with deep learning models identifying movement signatures of knee osteoarthritis up to five years before diagnosis [33]. However, AI-generated patient information on shoulder instability remains suboptimal in completeness, though newer models like DeepSeek outperform ChatGPT [40]. These findings underscore the need for rigorous validation before widespread clinical adoption [32].

Multiligament Injuries and Soft Tissue Reconstruction

Management of complex soft tissue injuries extends beyond the knee, addressing multiligament instability and shoulder/ankle pathologies. Combined medial collateral and posterior oblique ligament reconstruction yields favorable outcomes for Grade III medial knee injuries [26]. In the shoulder, anatomical factors like humeral retroversion and posterior glenohumeral distance are linked to throwing pain [29], and consensus guidelines now exist for age-specific management of anterior instability [30]. Ankle instability research indicates that calcaneofibular ligament rupture negatively affects Broström-Gould outcomes [23], while suture tape augmentation accelerates return to sport without compromising clinical scores [51]. Lisfranc injuries in elite athletes also require specialized consensus-based surgical strategies [49].

Articles by Theme

ACL Reconstruction: Grafts, Techniques, and Outcomes (6)

3. Boer BC, Brouwer RW, olde Heuvel J, et al. Quadriceps tendon autograft is not inferior to bone‐patellar tendon‐bone or hamstring autograft in anterior cruciate ligament reconstruction in terms of subjective patient‐reported outcomes: Two‐year results of a multicenter randomised controlled study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70354

Précis unavailable.

7. Şahbat Y, Altay N, Kocaoğlu B, et al. Deep lateral extra‐articular tenodesis (LET) is associated with improved tibial internal rotational stability and favourable patient‐reported outcomes compared with superficial LET in high‐grade pivot‐shift male patients undergoing quadrupled hamstring autograft ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70372

A randomized study compared deep versus superficial lateral extra-articular tenodesis (LET) in high-grade pivot-shift patients, finding that deep LET provided superior tibial internal rotational stability and better patient-reported outcomes. The results contradicted the hypothesis that superficial LET would be comparable, showing clear biomechanical and clinical advantages for the deep technique. Clinically, deep LET is recommended over superficial LET for high-risk patients requiring enhanced rotational control.

11. Gossman EC, Christino MA, Roberts KL, et al. Feasibility of mental skills training during rehabilitation after anterior cruciate ligament reconstruction in young athletes. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70324

This prospective study assessed the feasibility of implementing mental skills training (MST) for young athletes during rehabilitation after ACL reconstruction. It demonstrated high feasibility with 96% session attendance and 83% completion rates among participants. The results indicate that integrating MST into post-operative care is practical and may help address psychological barriers to return to sport.

14. Choudhary A, Gahlot N, Banerjee S, et al. Hamstring muscle strength recovery remains incomplete at 2 years after harvest for ACL reconstruction and does not correlate with radiological tendon regeneration at 6 months: A prospective study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70346

This prospective study examined hamstring strength recovery and tendon regeneration two years after ACL reconstruction using hamstring autografts. It found that hamstring strength recovery remains incomplete at two years and does not correlate with the degree of radiological tendon regeneration observed at six months. These results suggest that functional recovery is independent of structural tendon healing, necessitating targeted strength rehabilitation.

21. Altun O, Ergişi Y, Karabacak M, et al. Graft diameter, not graft type, predicts outcomes in single‐stage revision ACL reconstruction: A comparison of peroneus longus and contralateral hamstring autografts. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70355

Précis unavailable.

45. Schoepp C, Tennler J, Dudda M, et al. Running into deficits: Post‐operative bracing limits knee extension recovery 6 months after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70317

This randomized controlled trial investigated the impact of postoperative bracing on knee kinematics following anterior cruciate ligament reconstruction with hamstring autografts. The study found that patients using a brace for six weeks exhibited significant deficits in knee extension during running and jumping tasks at six months compared to the brace-free group. These findings imply that routine postoperative bracing may hinder dynamic functional recovery and should be reconsidered in rehabilitation protocols.

Meniscal Pathology, Repair, and Biomechanics (6)

2. Sandon A, Agostinone P, Romandini I, et al. Similar cartilage outcomes after meniscal repair and resection in anterior cruciate ligament‐reconstructed knees: A registry‐based second‐look arthroscopy study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70369

A registry-based study of 2,845 patients compared meniscal repair versus resection during ACL reconstruction, revealing no statistically significant difference in the development of new cartilage lesions at revision surgery. The key finding demonstrates that both treatment approaches yield similar cartilage outcomes in the medial and lateral compartments. This implies that the choice between repair and resection may be guided by other factors, such as meniscal stability or patient age, rather than cartilage preservation alone.

15. Marzouki I, Graveleau N, Morvan A, et al. Influence of sport type on the risk and topography of meniscal injuries associated with anterior cruciate ligament rupture: An analysis of 4570 patients from the MERIscience cohort. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70347

This large-scale epidemiological study analyzed the influence of sport type on the risk and location of meniscal injuries associated with ACL ruptures. It revealed significant differences in meniscal injury prevalence and topography across pivot-contact, pivot non-contact, and non-pivot sports. Identifying these sport-specific patterns can help refine injury prevention strategies and optimize surgical management.

38. Riché L, D'Ambrosio A, Geageac C, et al. No influence of meniscal ramp lesion subtypes, stability and length on surgical repair outcomes: A 7–8 year follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70330

This retrospective study investigated whether the subtype, stability, or length of meniscal ramp lesions influences long-term outcomes following repair during ACL reconstruction. Over a 7–8 year follow-up, no significant association was found between these lesion characteristics and the rate of revision surgery or functional scores. The findings suggest that surgical repair outcomes for ramp lesions are robust regardless of specific lesion morphology, simplifying prognostic expectations for surgeons.

48. Runer A, Höger SA, Frantz J, et al. Suture Interval Spacing in Meniscal Repair—Aim for ≤7 mm: A Biomechanical Study: ISAKOS Albert Trillat Award 2025. The American Journal of Sports Medicine 2026. doi:10.1177/03635465251411932

This biomechanical study evaluated the effect of varying suture interval spacings on gap development and stiffness in vertical meniscal repairs using bovine menisci. The results indicated that spacing greater than 7 mm significantly increased gap formation and reduced construct stiffness under cyclic loading. Clinically, this supports a recommendation to maintain suture intervals of 7 mm or less to optimize the mechanical stability of meniscal repairs.

62. Ade-Conde AM, Cruickshank M, Bouchard MD, et al. Combined high tibial osteotomy and root repair improves patient-reported outcomes in medial meniscus posterior root tears: A systematic review and meta-analysis. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101035

This systematic review and meta-analysis identifies the incidence and specific risk factors associated with loss of motion following anterior cruciate ligament reconstruction. The findings highlight key variables, such as surgical technique and rehabilitation adherence, that influence postoperative range of motion. These insights enable surgeons to better counsel patients and tailor rehabilitation protocols to minimize stiffness.

73. Rivarola H, Collazo C, Palanconi M, et al. Meniscal hypermobility does not impair functional outcomes after anterior cruciate ligament reconstruction: A retrospective cohort study. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101056

This retrospective cohort study evaluated functional outcomes in patients undergoing anterior cruciate ligament reconstruction who presented with meniscal hypermobility. The key finding was that meniscal hypermobility did not negatively impact postoperative functional results. Clinically, this suggests that meniscal hypermobility alone should not be considered a contraindication or a primary factor for modifying surgical planning in ACL reconstruction.

Arthroplasty Alignment, Robotics, and Infection (6)

16. Grenno G, Valente G, Fabbro GD, et al. High tibial osteotomy leads to medial‐lateral redistribution of knee internal forces during walking and stair ambulation and improves patient‐reported outcomes. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70348

This study evaluated changes in knee contact forces and patient outcomes following open-wedge high tibial osteotomy for medial knee osteoarthritis. It found that the procedure successfully redistributed medial and lateral knee internal forces during walking and stair ambulation, leading to improved patient-reported outcomes. The results support the use of high tibial osteotomy to alter joint loading mechanics and alleviate symptoms.

18. Sánchez‐Rosenberg G, Bartsch A, Morgenstern M, et al. A standardized surgical technique for DAIR improves treatment success rates in acute periprosthetic knee infection. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70350

Researchers compared treatment success rates for acute periprosthetic knee infections between a non-standardized cohort and a cohort treated with a standardized surgical technique and multidisciplinary team support. The study found that the standardized approach significantly improved treatment success rates to 96% compared to the non-standardized group. This suggests that implementing standardized protocols and multidisciplinary collaboration is critical for optimizing outcomes in periprosthetic joint infection management.

22. Li Z, Winnock de Grave P, Van Criekinge T, et al. Static native tibial alignment in total knee arthroplasty optimises whole‐body gait kinematics. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70356

This study investigated the impact of static native tibial alignment versus adjusted mechanical alignment on whole-body gait kinematics in total knee arthroplasty patients. Patients treated with inverse kinematic alignment exhibited gait patterns more closely resembling healthy controls, whereas those with adjusted mechanical alignment showed persistent biomechanical deviations in the knee, hip, and pelvis. These findings support the use of kinematic alignment techniques to restore more natural gait mechanics and potentially improve long-term patient function.

31. Becker R, Ettinger M, Hirschmann MT, et al. Robotics in revision knee arthroplasty: Solution, support tool or new source of complexity?. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70337

This article discusses the application of robotic assistance in revision knee arthroplasty to address complex challenges like bony defects and component malposition. Robotic systems enhance surgical planning and execution by enabling precise three-dimensional component placement and accommodating revision-specific hardware. While offering improved accuracy, the technology also introduces new complexities that surgeons must navigate during revision procedures.

34. Nedopil AJ, Mamidi D, Howell SM, et al. A fixed 2 mm adjustment for worn distal femoral cartilage when the cartilage of the unworn compartment is ≥3 mm does not negatively affect outcome scores after kinematically aligned total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70320

Précis unavailable.

56. Barbaret A, Jacquet J, Wong P, et al. Single‐stage revision for chronic fistulized infected total knee arthroplasty achieves infection‐free survival comparable to non‐fistulized cases. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70328

This retrospective study evaluated infection-free survival in patients undergoing single-stage revision for chronic infected total knee arthroplasty with and without a sinus tract. The results demonstrated that the presence of a fistula did not significantly compromise infection-free survival compared to non-fistulized cases. These findings challenge the traditional contraindication for single-stage revision in fistulized infections, suggesting it may be a viable option in selected patients.

Artificial Intelligence and Digital Health in Orthopaedics (5)

1. Camathias C, Papp K, Betschart P, et al. Human medical documentation significantly outperforms ChatGPT‐4o in critical clinical dimensions: A blinded comparative assessment in paediatric orthopaedics. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70357

This blinded comparative study evaluated ChatGPT-4o against human documentation for paediatric orthopaedic histories, finding that human-generated summaries achieved significantly higher scores across multiple quality criteria. The key finding indicates that current AI models still lag behind human clinicians in capturing temporal, spatial, and symptom-specific details. Clinically, this suggests that AI should not yet replace human documentation in critical clinical settings without rigorous oversight.

32. Bouterse A, Pruneski JA, Oettl FC, et al. Artificial intelligence in orthopaedics: Enhanced examinations, ambient intelligence and the future of clinical practice. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70339

The authors review the transformative potential of artificial intelligence in orthopaedics, highlighting applications in enhanced examinations, ambient intelligence, and clinical workflow automation. AI tools are expected to streamline administrative tasks, improve diagnostic accuracy through data-driven insights, and personalize patient education. Although limitations exist, the integration of AI promises a symbiotic relationship that will optimize clinical decision-making and patient outcomes.

33. Smits Serena R, Hirschmann MT, Matziolis G, et al. Deep learning of wrist accelerometry from UK Biobank data identifies early movement signatures of knee osteoarthritis up to 5 years before diagnosis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70332

Researchers utilized a 1D convolutional neural network to analyze week-long wrist accelerometry data from the UK Biobank to detect early movement signatures of knee osteoarthritis. The model successfully distinguished healthy individuals from those with established or prodromal knee osteoarthritis, identifying at-risk patients up to five years before clinical diagnosis. This finding suggests that passive wearable monitoring combined with deep learning could enable early intervention strategies to delay or prevent the onset of symptomatic knee osteoarthritis.

40. Öğümsöğütlü E, Bozgeyik B, Huri G. Artificial intelligence‐generated patient information on shoulder instability remains suboptimal: DeepSeek outperforms ChatGPT in completeness of content while ChatGPT is more readable. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70335

This study compared the quality of patient information on shoulder instability generated by ChatGPT and DeepSeek, finding that neither model fully met JAMA transparency criteria. DeepSeek demonstrated superior completeness and DISCERN scores, whereas ChatGPT provided more readable content with a lower grade level. The results suggest that while AI can assist in generating medical information, current models require careful review and supplementation to ensure accuracy and accessibility for patients.

52. Şengül HB, Akın B, Kayaalp ME, et al. Deep research capabilities in GPT‐5 thinking and Gemini 2.5 Pro improve citation integrity and concordance with American Academy of Orthopaedic Surgeons anterior cruciate ligament and rotator cuff guidelines. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70315

Précis unavailable.

Multiligament Injuries and Soft Tissue Reconstruction (6)

23. Baudelle F, Vega J, Cordier G. CFL rupture is a negative prognostic factor for return to sport after endoscopic Broström‐Gould. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70358

The study assessed 5-year outcomes of endoscopic Broström-Gould repair for chronic lateral ankle instability, comparing patients with intact versus ruptured calcaneofibular ligaments. While patient satisfaction and functional scores were high in both groups, the presence of a concomitant CFL rupture was identified as a negative prognostic factor for return to sport. Surgeons should counsel patients with CFL rupture regarding potentially lower rates of return to high-level sports despite successful structural repair.

26. Ade‐Conde AM, Cruickshank M, Bouchard MD, et al. Combined medial collateral ligament and posterior oblique ligament reconstruction demonstrates favourable patient‐reported outcomes and medial knee stability in Grade III injuries: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70344

A systematic review evaluated the clinical and functional outcomes of combined medial collateral ligament and posterior oblique ligament reconstruction for Grade III medial knee injuries. The analysis of 350 patients demonstrated favorable patient-reported outcomes and restored medial stability with a mean follow-up of over four years. These findings support the efficacy of combined reconstruction as a viable surgical strategy for complex medial knee instability.

29. Takahashi M, Mutsuzaki H, Iwamoto K, et al. Shoulder morphology and throwing shoulder pain: Associations with humeral retroversion angle and posterior glenohumeral distance. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70334

Researchers examined the relationship between shoulder morphology and throwing pain in baseball players using MRI to measure humeral retroversion and posterior glenohumeral distance. The study found that a larger increase in posterior glenohumeral distance was significantly associated with a smaller difference in humeral retroversion angle in symptomatic athletes. These morphological changes may serve as key indicators for identifying throwing shoulder pain mechanisms.

30. Alentorn‐Geli E, Ângelo AC, Brilakis E, et al. Age‐ and time‐specific management of traumatic anterior shoulder instability: The 2024 ESSKA‐ESA formal consensus. Part 1: History taking, physical exam and imaging studies. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70336

The ESSKA-ESA formal consensus provides age- and time-specific guidelines for the history taking, physical examination, and imaging of traumatic anterior shoulder instability. The panel established high-agreement recommendations for diagnosing first-time and recurrent dislocations across adolescent, young adult, and older adult populations. These guidelines aim to standardize clinical decision-making and improve diagnostic accuracy for general practitioners.

49. Balboni JM, Levine AR, Boggiano VJ, et al. Operative treatment of 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.70261

This study combined a systematic review of 16 studies with an international expert consensus to evaluate surgical strategies for Lisfranc injuries in elite athletes. The findings suggest that suture button fixation yields higher functional scores and fewer complications compared to open reduction internal fixation in unstable ligament injuries. These results provide evidence-based recommendations to optimize recovery and return-to-play outcomes for high-level athletes.

51. Vermorel P, Vega J, Guelfi M. Suture tape augmentation in arthroscopic lateral ligament repair for chronic ankle instability yields similar clinical outcomes but faster return to sport compared to isolated repair. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70308

This retrospective cohort study compared isolated arthroscopic ligament repair with suture tape augmentation for chronic ankle instability in higher-risk patients. While both groups showed similar long-term clinical outcomes, the augmentation group achieved a significantly faster return to sport. The findings support the use of suture tape augmentation to expedite athletic recovery without compromising functional results.

4. Ackermann J, Jones M, Ball SV, et al. Static tibiofemoral rotation remains stable after ACL reconstruction and is associated with posterior tibial slope in professional soccer players. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70362

A retrospective review of professional soccer players assessed static tibiofemoral rotation after ACL reconstruction, finding that rotational alignment remains stable over time and is associated with posterior tibial slope. The study determined that lateral extra-articular tenodesis did not significantly alter these rotational parameters. These findings suggest that posterior tibial slope is a primary determinant of rotational alignment, which may inform surgical planning for high-demand athletes.

5. Terol‐Alcayde P, Martín‐Gorgojo V, Ferrando‐Meseguer E, et al. Superior capsular reconstruction using human acellular collagen matrix: A 2‐year follow‐up study in posterosuperior massive irreparable rotator cuff tears. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70364

This multicenter randomized controlled trial compared quadriceps tendon autografts to bone-patellar tendon-bone and hamstring tendon autografts for ACL reconstruction, finding that quadriceps tendon grafts were non-inferior regarding patient-reported outcomes at two years. The study showed no significant differences in functional scores, satisfaction, or adverse events among the three graft types. Clinically, quadriceps tendon is validated as a viable alternative graft option for primary ACL reconstruction.

6. Demiral MF, Çankaya BY, Paksoy AE, et al. Addition of platelet‐rich plasma to physiotherapy reduces tear volume and іmproves functional outcomes in articular‐sided partial supraspinatus tendon tears. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70370

This prospective randomized trial investigated the addition of platelet-rich plasma (PRP) to physiotherapy for articular-sided partial supraspinatus tears, finding that the PRP group experienced significantly greater reductions in tear volume and improved functional scores. The key finding highlights the structural and functional benefits of combining PRP injections with rehabilitation. This supports the use of PRP as an adjunctive therapy to enhance healing in partial-thickness rotator cuff tears.

8. Hirschmann MT, Herbst E, Prill R, et al. KSSTA leadership update: Welcoming Philipp Winkler as new Associate Editor for cartilage and meniscus. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70360

Précis unavailable.

9. Antonio K, Kohei K, Michael HT, et al. Narrative over numbers: How testimonial medicine erodes safe practice. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70363

This editorial critiques the shift from evidence-based medicine to testimonial and marketing-driven practices in orthopaedics, particularly in joint arthroplasty. It finds that commercial pressures and rebranding of established techniques without scientific validation threaten patient safety and scientific integrity. The authors argue that regulatory reforms are necessary to curb endorsement-driven decision-making and ensure responsible technology adoption.

10. Meyer O, Miranda F, Castro ADAE, et al. Composite tibial and meniscal angle ratios from both compartments on MRI are associated with anterior cruciate ligament rupture. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70321

This retrospective study evaluated the association between composite tibial and meniscal angle ratios on MRI and anterior cruciate ligament (ACL) rupture risk. It found that ACL rupture patients exhibited significantly greater lateral tibial slope, more negative lateral meniscal slope, and smaller lateral meniscal-bone angles compared to controls. These findings suggest that composite indices derived from these measurements can improve risk stratification for ACL injuries.

12. Cottmeyer DF, Chiu M, Maltusch K, et al. Towards optimized rehabilitation with regenerative therapy: A systematic review and meta‐analysis on the effects of cell‐based injections for knee osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70338

This systematic review and meta-analysis investigated the effects of intra-articular mesenchymal stem cell injections on pain and function in knee osteoarthritis. It found that MSC-based injections significantly improved subjective pain and function compared to controls, with benefits increasing over time. The study suggests that cell-based therapies are effective for managing knee OA, though further research is needed on objective functional measures.

13. Zhao B, Zhao W, Chen L, et al. Comparative effectiveness of neuromuscular, virtual reality, proprioceptive, blood flow restriction and conventional training after ACL reconstruction: A network meta‐analysis of randomized controlled trials. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70345

This network meta-analysis compared the effectiveness of various rehabilitation strategies, including neuromuscular, virtual reality, and blood flow restriction training, following ACL reconstruction. It identified specific training modalities that outperformed conventional rehabilitation in reducing quadriceps atrophy and improving functional outcomes. The findings provide evidence-based rankings to guide clinicians in selecting optimal post-operative rehabilitation protocols.

17. Muench LN, Gunenc AC, Rupp M, et al. Patient‐specific psychological characteristics and personality structure affect functional outcomes after surgical stabilization of acute and chronic acromioclavicular joint injuries. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70349

This study evaluated how psychological factors and personality traits influence functional outcomes in 142 patients undergoing acromioclavicular joint stabilization. Key findings indicated that specific psychological characteristics, such as kinesiophobia and self-efficacy, significantly correlate with postoperative functional scores and readiness to return to sport. Clinically, preoperative psychological screening is recommended to identify patients at risk for suboptimal recovery and to tailor rehabilitation strategies accordingly.

19. Kunze KN, Moews LD, Alfonsi S, et al. Hardware‐related symptoms are the most common complication after anterior closing wedge osteotomy performed with ACL reconstruction: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70351

A systematic review analyzed complications in 505 patients undergoing anterior closing wedge osteotomy combined with ACL reconstruction. The most frequent complication was symptomatic hardware, accounting for nearly half of all reported adverse events, with an overall complication rate of 9.7%. Surgeons should prioritize hardware management strategies and patient counseling regarding hardware removal to mitigate the most common risks associated with this combined procedure.

20. Uchio Y, Kuroda R, Niki Y, et al. Collagen‐membrane‐covered matrix‐associated chondrocyte implantation improves safety over periosteum‐covered MACI for large knee cartilage defects: A real‐world data analysis in the registry study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70352

This registry study compared the safety and effectiveness of collagen membrane-covered versus periosteum-covered matrix-associated chondrocyte implantation for large knee cartilage defects. Results demonstrated that the collagen membrane technique offered superior safety profiles with fewer adverse events while maintaining comparable functional outcomes to the periosteum method. Clinicians may prefer collagen membrane-covered implants for large defects to enhance patient safety without compromising therapeutic efficacy.

24. Couch BK, Pfeil AN, Hryc CF, et al. Alignment boundaries and soft tissue balancing goals are inconsistently reported in robotic‐assisted total knee arthroplasty studies: A narrative methodological review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70331

A narrative methodological review assessed the reporting quality of alignment boundaries and soft tissue balancing goals in 134 studies on robotic-assisted total knee arthroplasty. The analysis revealed inconsistent and often insufficient reporting of critical surgical parameters, hindering reproducibility and meaningful outcome comparisons across the literature. Standardized reporting guidelines are urgently needed to ensure transparency and facilitate valid comparisons of robotic TKA techniques.

25. Hansen CF, Krogsgaard MR, Lind M, et al. The KIDS‐KNEES‐ACL is a valid PROM for children and adolescents with an ACL injury; item reduction using Rasch analysis and confirmatory factor analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70343

An international Delphi study established expert consensus on the definitions, indications, and research priorities for biologic augmentation in meniscus repair. Experts agreed that augmentation should be defined as modifying the local healing environment and recommended selective use of low-cost strategies like trephination. This consensus provides a standardized framework for clinical decision-making and future research in meniscus healing.

27. Super JT, Murray IR, Tollefson LV, et al. Biologic augmentation strategies in meniscus repair: A Delphi study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70353

Précis unavailable.

28. Thönes JP, Geiger F, Osterloh J, et al. Correlation study: electrical impedance-based approximation of knee joint angle and extensor. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-09634-y

This study investigated the use of electrical impedance tomography (EIT) as a non-invasive method to approximate knee joint angle and extensor strength during muscle activation. Results showed that EIT signals effectively correlate with joint kinematics and torque levels, outperforming traditional dynamometry for daily monitoring. The findings suggest EIT has significant potential for portable, real-time assessment of muscle function in clinical and home settings.

35. Yang D, Yi M, Ye Z, et al. Beyond the registry: The multifactorial enigma of revision anterior cruciate ligament reconstruction in the young athlete. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70325

This letter critiques a registry study finding no link between perioperative variables and revision ACL reconstruction, arguing that the null result stems from registry limitations rather than a true absence of risk factors. The authors highlight that critical domains like biomechanical movement quality, limb symmetry, and psychological readiness are missing from standard datasets. Consequently, they advocate for integrating high-dimensional functional and psychological profiling into future research to better understand the multifactorial causes of graft failure.

36. Ge Y, Häner M, Borges JS, et al. Long‐term survivorship after medial open‐wedge high tibial osteotomy: A systematic review and single‐arm meta‐analysis with regional subgroup analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70326

A systematic review and meta-analysis evaluated the long-term survivorship of medial open-wedge high tibial osteotomy, finding a pooled 10-year non-conversion rate to knee arthroplasty of 86%. Subgroup analysis revealed higher survival rates in Asian studies (92%) compared to European studies (84%), though functional outcomes remained durable across regions. These results support the procedure as a viable long-term joint-preserving option for young patients with medial compartment osteoarthritis.

37. Kaldau NC, Barfod KW, Winther‐Jensen M, et al. ACL Denmark: A nationwide register‐questionnaire study from 2000 to 2018 reporting stable ACL incidence rates but rising rates of reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70329

A nationwide Danish study from 2000 to 2018 found that the overall incidence rate of adult ACL ruptures remained stable, while the rate of ACL reconstructions significantly increased over the same period. The data indicates a shift in clinical management where more patients are opting for surgical reconstruction despite constant injury rates, with a notable rise in incidence among females. This trend highlights evolving treatment preferences and potential disparities in surgical access or decision-making over two decades.

39. AlMasri A, Syan R, Dagher D, et al. The impact of randomized controlled trials on the management of anterior shoulder instability: A bibliometric and altmetrics analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70333

A bibliometric and altmetric analysis of 24 randomized controlled trials on anterior shoulder instability management assessed the scholarly and public impact of these studies. The analysis revealed moderate citation density and altmetric attention, with most research originating from Canada and showing variable impact factors. These results indicate that while RCTs provide essential evidence, their dissemination and influence on broader clinical practice and public discourse may be limited.

41. Apseloff NA, Taoufik T, Kaeding CC, et al. Postoperative weightbearing timing after distal femur osteotomy is not associated with rates of union or complications: a systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70340

This systematic review and meta-analysis evaluated outcomes of early versus delayed weightbearing following distal femoral osteotomy across 26 studies. The key finding was that weightbearing timing did not significantly affect union rates, complication rates, or patient-reported outcomes. Clinically, this supports the safety of early weightbearing protocols to potentially accelerate rehabilitation without compromising healing.

42. Hirschmann MT, Herbst E, Milano G, et al. Welcoming Dr. Mahmut Enes Kayaalp as Deputy Editor‐in‐Chief. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70341

This brief editorial announces the appointment of Dr. Mahmut Enes Kayaalp as the new Deputy Editor-in-Chief for the journal. No specific research findings or clinical implications are presented in this announcement. The text serves solely to inform the readership of the new editorial leadership.

43. Forquignon B, Drenck T, Krause M, et al. Impact of hamstring versus quadriceps tendon graft on thigh muscle strength and surface electromyography activity after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70342

This study compared quadriceps tendon and hamstring tendon autografts for anterior cruciate ligament reconstruction regarding muscle strength and electromyography activity. While overall limb symmetry was similar, the hamstring group showed reduced flexion strength and the quadriceps group showed reduced extension strength compared to preoperative baselines. Clinically, surgeons should anticipate specific strength deficits based on the graft choice, though functional symmetry remains comparable between the two techniques.

44. Villarreal‐Espinosa JB, Shalakhti O, Henriques M, et al. Sample size and follow‐up duration predict the robustness of findings in randomized controlled trials comparing anterior cruciate ligament reconstruction with or without lateral extra‐articular procedures: A fragility index meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70313

This fragility index meta-analysis assessed the statistical robustness of randomized controlled trials comparing isolated ACL reconstruction with and without lateral extra-articular procedures. The study found that sample size and follow-up duration were significant predictors of result robustness, with many trials showing low fragility indices. This suggests that future research requires larger sample sizes and longer follow-up periods to ensure the reliability of conclusions regarding lateral extra-articular procedures.

46. Yang D, Yang J, Wang G. 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.70278

This registry-based study investigated potential predictors of anterior cruciate ligament failure in young patients but reported null findings. No specific demographic or clinical factors were identified as significant predictors of failure within the analyzed dataset. The results suggest that current registry data may lack the granularity or specific variables needed to identify high-risk profiles for ACL failure in this population.

47. Yang DJ, Yang J, Wang G. The flat posterior cruciate ligament graft: Unresolved questions on biomechanical equivalence and clinical translation. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70280

This commentary discusses unresolved questions regarding the biomechanical equivalence and clinical translation of flat posterior cruciate ligament grafts. It highlights the need for further investigation to determine if these graft configurations offer comparable stability to traditional round grafts. Clinically, the lack of definitive evidence currently prevents a clear recommendation on the optimal graft shape for PCL reconstruction.

50. Dagher D, Mewhinney E, MacDonald P, et al. Management of first‐time shoulder dislocations: A survey of sport medicine physician perceptions. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70297

A global survey of 326 sport medicine physicians revealed that immobilization for 1–3 weeks followed by physical therapy remains the most common management strategy for first-time shoulder dislocations. The study highlights significant variability in treatment approaches and a reliance on individual experience rather than standardized guidelines. These findings underscore the need for clearer consensus on optimal initial management to reduce recurrence rates.

53. Kao C, Hashemi J, Slauterbeck J, et al. Machine learning model identifies tibial anatomical variables as potential risk factors for anterior cruciate ligament injury. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70322

Researchers developed and validated a machine learning model using MRI-derived tibial anatomical parameters to predict anterior cruciate ligament injury risk. The model identified specific tibial slope and depth variables as the most predictive features for distinguishing injured from uninjured subjects. This tool offers a potential objective method for pre-participation screening and risk stratification in athletes.

54. Winkler PW, Zsidai B, Narup E, et al. Inferior clinical outcomes and higher subjective treatment failure after revision compared to primary posterior cruciate ligament reconstruction: A propensity score‐matched analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70323

A propensity score-matched analysis of Scandinavian registry data compared outcomes between primary and revision posterior cruciate ligament reconstructions. The study found that revision surgeries resulted in inferior clinical scores and higher rates of subjective treatment failure compared to primary procedures. These results indicate that patients undergoing revision PCLR should be counseled regarding the elevated risk of suboptimal outcomes.

55. Vide J, Santos F, Dantas S, et al. A worldwide perspective on chronic Achilles tendon rupture: An ESSKA AFAS survey initiative. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70327

A worldwide survey of 667 orthopaedic surgeons identified significant variability in the evaluation and surgical management of chronic Achilles tendon ruptures. Despite the lack of clear guidelines, MRI is the dominant imaging modality, and gap size is the primary determinant for selecting surgical techniques. The findings highlight a global need for standardized protocols to improve consistency in treating this complex injury.

57. Zacher S, Lauberger J, Ates DM, et al. Evidence-based informed consent forms for total knee arthroplasty and anaesthesia: development and pilot study. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-026-06729-z

Researchers developed and pilot-tested an evidence-based informed consent form for total knee arthroplasty and anesthesia, alongside a clinician training program and patient knowledge assessment tool. The study found that iterative revisions based on patient feedback significantly improved the forms' acceptability, usability, and comprehensibility. This approach offers a practical framework for enhancing patient decision-making and legal compliance in orthopedic surgery.

58. Bouhali H, Da Silva Dias B, Chanteux L, et al. Anatomical medial and posteromedial ligamentoplasty for multiligament knee injury: an original technique using a pediculated autograft. Journal of Orthopaedic Surgery and Research 2026. doi:10.1186/s13018-025-06638-7

The article introduces a novel surgical technique utilizing a pediculated autograft for anatomical medial and posteromedial ligamentoplasty in multiligament knee injuries. This original method aims to restore native knee stability while preserving graft viability through its vascularized attachment. The technique provides a potential solution for complex ligament reconstructions where standard grafts may be insufficient.

59. Sieberer JM, Park N, Desroches S, et al. Breaking down tibial tuberosity to trochlear groove distance into two components to enable patient-specific treatment strategies. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101025

This study proposes decomposing the tibial tuberosity to trochlear groove distance into two distinct components to refine patient-specific treatment strategies for patellofemoral instability. By isolating these anatomical variables, clinicians can better tailor surgical interventions to individual biomechanical needs. This granular approach may improve surgical outcomes by addressing specific underlying causes of maltracking.

60. Nabulyato W, Gompels B, O'Neill A, et al. The classic from Shelbourne and Nitz (1990) on accelerated rehabilitation after anterior cruciate ligament reconstruction. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101032

This publication reprints and contextualizes the seminal 1990 work by Shelbourne and Nitz regarding accelerated rehabilitation protocols following anterior cruciate ligament reconstruction. The article highlights the historical shift toward early motion and weight-bearing, which has become a cornerstone of modern postoperative care. It serves as a foundational reference for current rehabilitation philosophies in ACL management.

61. L'Hourre V, Desseaux A, Williams T, et al. Recurrent yoke fracture in rotating-hinge total knee arthroplasty: A case report and literature review. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101033

This case report and literature review documents a rare recurrent yoke fracture occurring within a rotating-hinge total knee arthroplasty. The authors analyze the mechanical stresses and patient factors contributing to this specific failure mode. The findings underscore the need for heightened vigilance and potential design modifications in rotating-hinge implants to prevent catastrophic component failure.

63. Federico AA, Qiu RY, Assadzadeh GE, et al. Incidence and risk factors of loss of motion following anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101036

A double-blind, randomized controlled trial compares the efficacy of single intra-articular 2% sodium hyaluronate injections versus corticosteroids for isolated patellofemoral osteoarthritis. The study evaluates pain relief and functional improvement to determine the optimal injection therapy for this specific condition. Results will guide clinical decision-making regarding the choice between long-term lubrication and short-term anti-inflammatory treatment.

64. Mekariya K, Manop P, Chernchujit B. Efficacy of single intra-articular 2% sodium hyaluronate versus corticosteroid injection in isolated patellofemoral osteoarthritis: A double-blind, randomized controlled trial. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101038

Précis unavailable.

65. Schroeder GG, Hollyer I, Raji Y, et al. 25-Year trends in anterior cruciate ligament reconstruction: Results from the biennial ACL Study Group survey from 1998 to 2023. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101039

This study analyzed 25 years of surgical trends in anterior cruciate ligament reconstruction using biennial survey data from 1998 to 2023. Key findings indicate significant shifts in graft selection, surgical techniques, and rehabilitation protocols over the two-and-a-half decades. These trends highlight evolving standards of care that surgeons should consider when planning modern ACL reconstruction strategies.

66. Olivieri R, Pineda T, Rojas T, et al. Biological augmentation reduces failure rates but does not improve functional outcomes after acute patellar tendon repair. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101045

Researchers evaluated the impact of biological augmentation on failure rates and functional outcomes following acute patellar tendon repairs. The study found that while biological augmentation significantly reduced failure rates, it did not lead to improved functional outcomes compared to standard repair. Clinically, this suggests that biological agents may enhance structural stability but should not be expected to accelerate functional recovery.

67. Andriollo L, Batailler C, Gregori P, et al. Combine anterior cruciate ligament reconstruction and unicompartmental knee arthroplasty with image-based robotic surgery: A current surgical technique. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101046

This article describes a novel surgical technique combining anterior cruciate ligament reconstruction with unicompartmental knee arthroplasty using image-based robotic assistance. The technique aims to address both ligamentous instability and early osteoarthritis in a single procedure with enhanced precision. This approach offers a potential solution for complex knee pathologies where traditional staged procedures might be less optimal.

68. Sanchis-Alfonso V, Montesinos-Berry E, Ordoño-Dominguez F. Infratuberositary derotational tibial osteotomy for anterior knee pain in patients with pathological external tibial torsion: A novel technique. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101047

A novel infratuberositary derotational tibial osteotomy technique is presented to treat anterior knee pain in patients with pathological external tibial torsion. The procedure successfully realigns the patella by correcting the underlying rotational deformity of the tibia. This method provides a targeted surgical option for patients with specific torsional abnormalities who have not responded to conservative management.

69. Tsujii A, Yonetani Y, Kinugasa K, et al. Arthroscopically confirmed cartilage degeneration in the lateral tibial plateau over two years following anterior cruciate ligament and meniscus injury: A retrospective study. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101049

The study assessed the efficacy of knee arthrofixation with a modular nail as a salvage procedure for periprosthetic joint infections. Results demonstrated acceptable implant survival rates and significant improvements in patient quality of life. This technique represents a viable salvage option for managing complex periprosthetic infections when standard treatments fail.

70. Gonzalez Fantini AM, Sanchez Mele HG, Costantini J, et al. Knee arthrofixation with modular nail as salvage for periprosthetic infection: Evaluation of quality of life and implant survival. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101050

This research involved the psychometric validation and cultural adaptation of the Persian version of the IKDC-SF questionnaire for diverse knee pathologies. The adapted tool demonstrated high reliability and validity, making it suitable for clinical use in Persian-speaking populations. This adaptation facilitates more accurate assessment of patient-reported outcomes in this demographic.

71. Vosoughi F, Shirbache K, Vahedi P, et al. Psychometric validation and cultural adaptation of the Persian version of international knee documentation committee subjective knee form (IKDC-SF) across diverse knee pathologies. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101053

Précis unavailable.

72. Bae JH, Bak P, Son J. Good clinical outcome of nonoperatively treated low grade medial collateral ligament injuries combined with primary anterior cruciate ligament reconstruction. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101054

Précis unavailable.

74. Hetsroni I, Gur S, van Stee M, et al. Multiligament knee surgical planning checklist: Introducing a conceptual shift in the reporting of surgical management protocols with mid-term outcomes. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2025.101064

The authors introduced a conceptual shift in surgical management protocols by developing and validating a multiligament knee surgical planning checklist. This tool aims to standardize the reporting of complex surgical procedures and improve the consistency of mid-term outcome data. The clinical implication is that adopting such structured checklists can enhance surgical precision and facilitate more reliable comparative research in multiligament knee injuries.

75. Uslu M, Genc E, Bozdağ E, et al. Patellar tendon autografts outperform fascia lata in superior capsular reconstruction: a comparative histopathological and biomechanical study. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2025.05.015

This comparative study analyzed the histopathological and biomechanical properties of patellar tendon autografts versus fascia lata grafts for superior capsular reconstruction. Results demonstrated that patellar tendon autografts significantly outperformed fascia lata grafts in both tissue integration and mechanical strength. These findings support the preferential use of patellar tendon autografts to optimize structural integrity and long-term success in shoulder reconstruction procedures.

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