What's New — Knee — June 2026¶
136 new articles published this month.
Themes: ACL Reconstruction Techniques and Outcomes · Total Knee Arthroplasty Alignment and Technology · Periprosthetic Joint Infection and Revision Arthroplasty · Meniscal Pathology and Cartilage Restoration · Osteotomy and Biomechanical Phenotyping
Digest generated 2026-07-15 06:14:17+00:00.
Highlights¶
ACL Reconstruction Techniques and Outcomes¶
This month's literature extensively evaluates anterior cruciate ligament reconstruction strategies, focusing on graft selection, augmentation, and timing. Quadriceps tendon autografts demonstrate comparable stability and functional outcomes to bone-patellar tendon-bone grafts with potentially lower donor-site morbidity [22], [27], while attachment-sparing techniques may accelerate graft maturation [44]. The role of lateral extra-articular procedures remains contentious; while some data suggest increased arthrofibrosis risk [13], others indicate comparable outcomes in revision settings [40]. Timing of reconstruction influences secondary meniscus surgery rates [61], and biological augmentations like PRP or BMAC show no clinical benefit [39]. Furthermore, patient-specific factors such as hamstring graft size mismatch in athletes [28] and contralateral ACL rupture history [57] significantly impact revision risks.
Total Knee Arthroplasty Alignment and Technology¶
Advancements in total knee arthroplasty (TKA) emphasize personalized alignment and technological integration. Robotic-assisted systems facilitate functional and patient-specific alignment strategies, which may improve ligament balance compared to mechanical alignment [38], [102]. The impact of sagittal femoral morphology on robotic planning appears limited [12], while axial plane classifications help describe flexion-gap patterns [102]. Cementless fixation is gaining traction, with long-term data supporting its durability in younger patients [106] and registry trends showing increased utilization [116]. However, cement viscosity remains a critical factor in aseptic loosening risk [101]. Navigation systems, including portable accelerometer-based tools, show promise in improving radiological accuracy [127], though surgeon subspecialty training may influence complication rates more than technology alone [134].
Periprosthetic Joint Infection and Revision Arthroplasty¶
Management of periprosthetic joint infection (PJI) and complex revision arthroplasty continues to evolve with a focus on cost, safety, and surgical technique. Single-stage exchange for PJI offers cost advantages over two-stage procedures [41], while standardized protocols minimize kidney injury risks in two-stage revisions [96]. Imaging modalities for PJI diagnosis show moderate accuracy, highlighting the need for refined diagnostic criteria [68]. In revision TKA, stacked-cone constructs effectively address extensive bone loss [18], and the 'DFR downgrade' technique preserves bone stock in massive femoral defects [91]. Rotating-hinge implants improve motion in arthrofibrosis cases without increasing complications [109]. Additionally, transfusions in revision TKA are associated with higher VTE and infection risks [98], and obesity increases PJI risk and polymicrobial infection rates [6].
Meniscal Pathology and Cartilage Restoration¶
Recent studies address meniscal repair healing, rehabilitation, and cartilage restoration techniques. Posterior tibial slope influences medial meniscus posterior root tear healing, with steeper slopes associated with compromised outcomes [49]. Combined high tibial osteotomy and root repair may improve healing rates but does not consistently prevent osteoarthritis progression [29]. Rehabilitation protocols for root repairs vary, with systematic reviews characterizing current practices [48]. For cartilage defects, surface-based restoration strategies are tailored to lesion characteristics and subchondral bone status [59]. Novel autologous osteoperiosteal composites show promise in preclinical models for osteochondral regeneration [7], while basic research explores intrameniscal injections as a direct treatment modality [84].
Osteotomy and Biomechanical Phenotyping¶
Slope-reducing osteotomy (SRO) is gaining attention as a risk-mitigation tool for ACL-deficient knees, though evidence regarding indication and safety is still maturing [54]. Planning precision for tibial slope osteotomy can be optimized using osteotomy depth parameters [31]. Biomechanical phenotyping is emerging as a key concept, with static anterior tibial translation defining sagittal knee phenotypes that guide surgical decision-making [4], [23]. In TKA, laxity phenotyping based on bony anatomy and ligamentous status provides a framework for balancing strategies [24], while coronal alignment behavior across the range of motion correlates with constitutional alignment and soft-tissue balance [17].
Articles by Theme¶
ACL Reconstruction Techniques and Outcomes (11)¶
13. Varady NH, Parise S, Inclan PM, et al. Lateral Extra‐articular Procedure Augmentation Is Associated With an Increased Risk of Arthrofibrosis Following Anterior Cruciate Ligament Reconstruction. Arthroscopy 2026. doi:10.1002/arj.70335
Précis unavailable.
19. Tambosco V, de Oliveira Neto VE, Mosca A, et al. Anterior Cruciate Ligament Repair Shows Higher Failure Rate but Similar Functional Outcomes Compared With Reconstruction at 5 Years in Matched‐Pair Analysis. Arthroscopy 2026. doi:10.1002/arj.70394
This matched-pair analysis compared five-year outcomes of anterior cruciate ligament (ACL) repair versus reconstruction in a primary ACL cohort. The key finding was that while functional outcomes were similar, the repair group had a significantly higher failure rate, particularly in patients under 40 years old. Clinically, this suggests that ACL reconstruction remains the preferred option for younger, active patients due to lower failure rates, despite comparable long-term function.
21. Pruneski JA, Zsidai B, Öttl F, et al. Short-term Patient-Reported Outcomes After Primary Anterior Cruciate Ligament Reconstruction With and Without Lateral Extra-articular Tenodesis: A Matched-Cohort Analysis From the Swedish Knee Ligament Registry. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261456637
This registry-based matched-cohort study compared short-term patient-reported outcomes and failure rates between primary ACL reconstruction with and without lateral extra-articular tenodesis (LET). The key finding was that while LET reduces graft failure, it does not significantly improve short-term patient-reported outcomes or clinical failure rates compared to reconstruction alone. Clinically, this suggests that the routine addition of LET may not be necessary for improving short-term patient satisfaction in primary ACL reconstruction.
22. Eliasberg CD, Shamrock A, James EW, et al. Similar Outcomes but Significantly Different Donor Site Morbidity Profiles After Autograft Quadriceps and Bone–Patellar Tendon–Bone Anterior Cruciate Ligament Reconstruction. Arthroscopy 2026. doi:10.1002/arj.70271
This study compared donor site morbidity profiles between quadriceps tendon (QT) and bone-patellar tendon-bone (BPTB) autografts for anterior cruciate ligament reconstruction at two-year follow-up. The key finding was that while total morbidity scores were similar, QT grafts resulted in less kneeling pain and numbness but more quadriceps atrophy, particularly in females. Clinically, this highlights distinct morbidity trade-offs, suggesting QT may be preferable for patients prioritizing kneeling comfort, while BPTB may be better for those concerned about quadriceps strength.
27. Khalafallah MA, Hall OK, Elmenawy Z, et al. Quadriceps tendon autograft provides comparable stability and functional outcomes with lower donor‐site morbidity than bone–patellar tendon–bone: A systematic review and meta‐analysis of 15 randomized controlled trials with GRADE evidence. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70499
This systematic review and meta-analysis of 15 RCTs found that quadriceps tendon autografts provide comparable anterior stability and functional outcomes to bone-patellar tendon-bone grafts in primary ACL reconstruction. Additionally, QT grafts demonstrated lower donor-site morbidity compared to BPTB. These results support the use of quadriceps tendon autografts as a viable alternative to BPTB with potentially fewer complications.
28. Sandon A, Eriksson K, Forssblad M, et al. Anterior cruciate ligament revision risk is associated with mismatch between hamstring graft size and body size in football players. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70477
Précis unavailable.
39. Mokhtar AA, Gawish H, Abdelgawad A, et al. Biologically enhanced anterior cruciate ligament reconstruction: Platelet‐rich plasma or bone marrow aspirate concentrate does not lead to better clinical or radiological outcomes—A randomized controlled trial of 175 cases with 2 years of follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70484
This randomized controlled trial compared clinical and radiological outcomes of anterior cruciate ligament reconstruction augmented with platelet-rich plasma or bone marrow aspirate concentrate against a control group. The study found no significant differences in clinical outcomes, graft signal intensity, or patient-reported scores between the biological augmentation groups and the control group at two years. These results indicate that biological additives do not provide additional clinical or radiological benefits over standard anterior cruciate ligament reconstruction.
40. Mas V, Giardino A, Ripoll T, et al. Revision ACL reconstruction using a modified iliotibial band–allograft technique for combined ACL and lateral extra‐articular procedure achieves comparable outcomes to bone–patellar tendon–bone with modified Lemaire. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70496
This retrospective study compared clinical outcomes of revision anterior cruciate ligament reconstruction using a modified iliotibial band-allograft technique versus bone-patellar tendon-bone with lateral extra-articular tenodesis. The results showed comparable retear rates, stability, and functional scores between the two techniques at two-year follow-up. This suggests that the iliotibial band-allograft technique is a viable alternative that may avoid the morbidity associated with patellar tendon harvesting in revision surgery.
44. Sinha S, Arumugham KC, Singh DK, et al. ACL Reconstruction With Attachment-Sparing Hamstring Autograft Results in Earlier Graft Maturation and Better Short-Term Clinical Outcome in Comparison to Free Graft: A Randomized Controlled Trial. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261455046
This randomized controlled trial compared attachment-sparing hamstring autografts to free grafts for anterior cruciate ligament reconstruction, assessing graft maturation via MRI and clinical outcomes. The attachment-sparing technique resulted in earlier graft maturation and superior short-term clinical scores compared to the free graft technique. These findings support the use of attachment-sparing methods to enhance early graft healing and functional recovery.
57. Santamaria F, Culebras Almeida LA, Carrozzo A, et al. Contralateral ACL Rupture as an Indicator of Intrinsic Risk for Graft Failure After ACL Reconstruction: A Cohort Study of 7718 Patients From the SANTI Study Group. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261448200
This cohort study of 7,718 patients determined that a history of bilateral native ACL ruptures significantly increases the risk of graft failure after primary ACL reconstruction compared to unilateral injuries. The findings suggest that contralateral ACL rupture serves as a marker for intrinsic susceptibility to ligament injury, necessitating heightened surveillance or modified surgical strategies for these high-risk patients.
61. Wang L, Lu W, Liu G, et al. Early Anterior Cruciate Ligament Reconstruction Reduces Long‐Term Rates of Secondary Meniscus Surgery: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70408
This systematic review evaluated the impact of ACL reconstruction timing on secondary meniscus surgery, finding that early reconstruction reduces long-term risks of meniscal intervention in follow-ups exceeding five years. However, shorter-term studies showed no significant difference, indicating that the protective effect of early surgery on meniscal preservation becomes evident primarily in the long term.
Total Knee Arthroplasty Alignment and Technology (9)¶
12. Andriollo L, Lazzaro R, Alborghetti M, et al. Sagittal femoral morphology is not associated with robotic planning or soft‐tissue balance during robotic‐assisted total knee arthroplasty: An analysis from the Brescia Knee Research Group. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70504
This retrospective study analyzed whether sagittal femoral morphology influences robotic planning parameters and intraoperative soft-tissue balance during robotic-assisted total knee arthroplasty. The results indicated that sagittal morphological variations have limited impact on planning accuracy and soft-tissue laxity outcomes. This suggests that robotic systems can effectively manage diverse femoral anatomies without requiring significant adjustments to standard planning protocols based on sagittal shape.
17. Mylonakis N, Kenanidis E, Maslaris A, et al. Coronal alignment behaviour across the knee range of motion is associated with constitutional alignment and soft‐tissue balance: The REAL HKA classification. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70506
This study evaluated intraoperative coronal alignment across the knee range of motion during robotic-assisted total knee arthroplasty to define a composite REAL HKA phenotype. The key finding was that alignment behavior is significantly associated with constitutional alignment (CPAK) and soft-tissue balance (REAL classifications). Clinically, this suggests that preoperative constitutional and laxity assessments can predict intraoperative alignment stability, aiding in surgical planning.
38. Wierer G, Clatworthy M. Tibia‐first, gap‐balanced patient‐specific alignment in total knee arthroplasty achieves better ligament balance than mechanical, kinematic and functional alignment strategies. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70483
This prospective cohort study compared ligament balance outcomes across mechanical, kinematic, functional, and patient-specific alignment strategies in robotic-assisted total knee arthroplasty. The tibia-first, gap-balanced patient-specific alignment technique achieved superior ligament balance compared to the other three alignment strategies. This suggests that patient-specific alignment may offer a more optimal approach to achieving balanced knees during total knee arthroplasty.
101. Harris A, Donnelly PC, Jennings JM, et al. Cement Viscosity Is Associated With Aseptic Loosening After Primary Total Knee Arthroplasty: An Analysis of the American Joint Replacement Registry. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.029
This registry-based analysis examined the association between polymethylmethacrylate cement viscosity and the risk of aseptic loosening after primary total knee arthroplasty. The study found that medium- and high-viscosity cements were associated with significantly higher rates of revision for aseptic loosening compared to low-viscosity cement. Clinicians should consider using low-viscosity cement to potentially reduce the risk of aseptic loosening in primary TKA.
102. Yu M, Hu M, Liu T, et al. Axial Plane Alignment of the Knee (APAK): A Bony-Based Framework for Describing Flexion-Plane Knee Phenotypes and Its Association With Intraoperative Flexion-Gap Patterns. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.035
This study introduced the Axial Plane Alignment of the Knee (APAK) classification to describe flexion-plane knee phenotypes and evaluated its association with intraoperative flexion-gap patterns. The findings demonstrated that APAK phenotypes correlate with specific flexion-gap patterns and differences between mechanical and functional alignment approaches. This framework may assist surgeons in predicting and managing flexion gaps during total knee arthroplasty.
106. Nielsen AW, Bloebaum RD, Hofmann AA. 30-Year Outcomes of a Cementless Total Knee Arthroplasty System in Patients Under 50 Years Old. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.030
This study evaluated the 30-year clinical and radiographic outcomes of a cementless total knee arthroplasty system in patients under 50, demonstrating sustained improvements in Knee Society Scores and implant survivorship. These findings support the long-term durability of cementless fixation in younger, active populations when specific surgical techniques like anatomic resection and bone slurry application are utilized.
116. Hilow H, Tanenbaum J, Zaniletti I, et al. United States Trends in Utilization and One-Year Revision Risk of Cementless Total Knee Arthroplasty: An Analysis of American Joint Replacement Registry Data. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.050
This international survey assessed current practice patterns, controversies, and management approaches for Cyclops syndrome following anterior cruciate ligament reconstruction. The authors identified significant variability in treatment strategies among surgeons and proposed a standardized management algorithm based on survey consensus. This algorithm aims to reduce practice variation and improve clinical decision-making for patients experiencing arthrofibrosis after ACL reconstruction.
127. Tang Z, Yuan M, Jiang L, et al. A Meta-Analysis Comparing Accelerometer-Based Portable Navigation Systems and Traditional Techniques in Total Knee Arthroplasty: Assessment of Radiological and Clinical Outcomes. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.060
Précis unavailable.
134. Brady TT, Bera SR, Paul BR, et al. A New Perspective On Manual Versus Technology-Assisted Total Knee Arthroplasty: Complications Stratified by Surgeon Subspecialty Designation. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.057
This study compared complications between technology-assisted and manual total knee arthroplasty, stratified by surgeon subspecialty, finding that technology-assisted procedures performed by adult reconstruction surgeons resulted in significantly lower rates of aseptic loosening and malalignment. The benefits of technology assistance were most pronounced when performed by fellowship-trained adult reconstruction specialists rather than other orthopaedic subspecialties. These results suggest that surgeon expertise is a critical modifier of outcomes when utilizing technology-assisted surgical techniques.
Periprosthetic Joint Infection and Revision Arthroplasty (9)¶
6. Aljuboori SM, Jimenez‐Solem E, Calum H, et al. Patients with obesity have a higher risk of periprosthetic joint infection and more frequent polymicrobial infections after knee arthroplasty: A nationwide register‐based study from Denmark. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70513
This nationwide register-based study compared periprosthetic joint infection (PJI) risks and microbial profiles in patients with and without obesity undergoing knee arthroplasty. Patients with obesity had a higher risk of PJI revision and more frequent polymicrobial infections compared to non-obese patients. These findings highlight the need for enhanced infection prevention strategies and careful microbial monitoring in obese patients undergoing joint replacement.
18. Kumaran P, Telang SS, Culler M, et al. Stacked-Cone Constructs for Extensive Tibial and/or Femoral Bone Loss in Complex Primary and Revision TKA. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00165
This multicenter retrospective study assessed the five-year outcomes of stacked metaphyseal cone constructs used to manage extensive bone loss in complex primary and revision total knee arthroplasty. The key finding was a 91.7% survivorship free from construct revision for aseptic loosening, though all-cause reoperation rates were higher. This indicates that stacked cones are a viable option for addressing severe bone loss, although patients should be counseled on the risk of reoperation.
41. Lam AD, Sutton RM, Lizcano JD, et al. Facility Cost Differences Between Single-stage and Two-stage Exchange for Chronic Periprosthetic Joint Infection: A Time-driven Activity-based Costing Analysis. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01024
This study utilized time-driven activity-based costing to compare facility expenses for single-stage versus two-stage exchange revisions in chronic periprosthetic joint infection. Single-stage revision total knee arthroplasty demonstrated lower personnel costs compared to the combined costs of two hospital admissions required for two-stage exchange. These findings suggest that single-stage procedures may offer a more cost-effective facility-level option for selected patients.
68. Abedi AA, Tarabichi S, Glaudemans AWJM, et al. Imaging modalities demonstrate moderate and heterogeneous diagnostic accuracy for periprosthetic joint infection: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70423
Précis unavailable.
91. Chalmers BP, Afzal S, Bhatti P, et al. The “Distal Femoral Replacement Downgrade”: Technique of Using Bicondylar Femoral Cones with a Hinge Total Knee Arthroplasty Revision in Patients Who Have Massive Distal Femoral Bone Loss as an Alternative. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.076
This retrospective review analyzed outcomes of a bone-preserving 'DFR downgrade' technique using bicondylar femoral cones with hinge implants in 20 patients with massive distal femoral bone loss. The technique demonstrated acceptable survivorship and clinical outcomes, offering a viable alternative to traditional distal femoral replacements. This approach may help preserve bone stock and reduce risks associated with extensive bone resection in complex revision TKAs.
96. Epley R, Stoops TK, Deckard ER, et al. Kidney Injury and Mortality Are Minimal Following Two-Stage Treatment of Periprosthetic Joint Infection. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.027
This retrospective review evaluated kidney function and mortality in 138 patients undergoing two-stage treatment for periprosthetic joint infection using a standardized protocol with aggressive fluid resuscitation and antibiotic management. The incidence of acute kidney injury was low (9.4%), and mortality was minimal, contradicting claims of significant nephrotoxicity. The study supports the safety of the two-stage approach when managed with optimized perioperative protocols.
98. Telang SS, Kumaran P, Lim MA, et al. Transfusions are Associated with an Elevated Risk of Venous Thromboembolism and Periprosthetic Joint Infection following Revision Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.051
This study evaluated the risk of venous thromboembolism and periprosthetic joint infection in patients undergoing revision total knee arthroplasty who received blood transfusions compared to non-transfused controls. The analysis revealed that transfusions are associated with an elevated risk of both VTE and infectious complications in this population. These findings suggest that transfusion avoidance strategies should be prioritized in revision knee surgery to mitigate adverse outcomes.
109. Ruelos VC, Jayarajan NA, Shi JL, et al. Rotating-Hinge Revision Total Knee Arthroplasty for Arthrofibrosis Improves Motion Without Increasing Complications: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.041
This systematic review and meta-analysis demonstrated that rotating-hinge revision total knee arthroplasty significantly improves range of motion in patients with arthrofibrosis without increasing complication rates compared to non-hinged constructs. Clinically, this supports the use of rotating-hinge implants as a safe and effective option for restoring mobility in stiff knees requiring revision surgery.
136. Javidmehr S, Ramezanpour MR, Vaziri AS, et al. Total Knee and Hip Arthroplasty in Patients Who Had Prior Septic Arthritis: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.056
This systematic review and meta-analysis assessed the risk of periprosthetic joint infection following total knee and hip arthroplasty in patients with a history of septic arthritis, finding a pooled infection rate of 2.6%. The risk was higher for total knee arthroplasty compared to total hip arthroplasty, and two-stage procedures did not significantly reduce infection rates compared to single-stage approaches in this population. Surgeons should counsel patients with prior septic arthritis about these infection risks, noting that procedural strategy may not mitigate them as effectively as previously assumed.
Meniscal Pathology and Cartilage Restoration (7)¶
3. von Essen C, Kekki C, Rizvanovic D, et al. High failure rate after all‐inside revision meniscal repair: Female sex and absence of ACL reconstruction increase risk. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70503
This retrospective cohort study analyzed failure rates and risk factors for all-inside revision meniscal repair in 108 patients with persistent symptoms. The study identified a high overall failure rate of 50%, with female sex and the absence of concomitant anterior cruciate ligament reconstruction significantly increasing the risk of failure. Clinicians should consider these risk factors when counseling patients about the prognosis of revision meniscal surgery.
7. Yao L, Zhu S, Wu Y, et al. A Novel Autologous Osteoperiosteal Composite for Osteochondral Regeneration. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261456227
This controlled laboratory study evaluated the efficacy of an autologous inverted subchondral bone-periosteum composite graft for osteochondral reconstruction in a rabbit model. The composite graft demonstrated superior osteochondral regeneration compared to microfracture and untreated controls. This novel autologous approach shows promise for improving repair quality in osteochondral defects, warranting further clinical investigation.
29. Dzidzishvili L, Gerhold C, Poulson TA, et al. Combined High Tibial Osteotomy and Medial Meniscus Posterior Root Repair May Improve Root Healing Without Consistent Reduction in Meniscal Extrusion or Osteoarthritis Progression: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70393
Précis unavailable.
48. Tageldein MM, Alhamdah Y, Bouchard MD, et al. Postoperative rehabilitation after transtibial pullout repair of medial meniscus posterior root tears: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70491
This systematic review and meta-analysis characterized rehabilitation protocols following transtibial pullout repair for medial meniscus posterior root tears and evaluated their impact on patient-reported outcomes. The analysis demonstrated substantial improvements in knee function scores post-operatively, though specific rehabilitation parameters showed variable associations with longitudinal outcomes. These results provide evidence-based insights into optimizing postoperative care for this specific meniscal injury.
49. Kim JS, Hwang UJ, Park SH, et al. Impact of the Posterior Tibial Slope on Medial Meniscus Posterior Root Tear Healing Based on Second-Look Arthroscopy. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261451725
This study investigated the influence of posterior tibial slope (PTS) on the healing status of repaired medial meniscus posterior roots using second-look arthroscopy. The findings suggest that a steeper PTS is associated with an increased risk of compromised meniscal healing, characterized by lax tension. Clinically, preoperative assessment of PTS may help predict healing outcomes and guide surgical decision-making for meniscal root repairs.
59. Marter JA, Parisien RL, Waterman BR. Surface‐Based Cartilage Restoration for Focal Chondral Defects in the Knee. Arthroscopy 2026. doi:10.1002/arj.70418
This review outlines surface-based cartilage restoration strategies for focal chondral defects, emphasizing that treatment selection depends on subchondral bone integrity and prior interventions. The authors recommend combining osseous reconstruction with cartilage repair for defects with significant bone loss, while surface-based options like cell-based implants are preferred when the subchondral plate remains intact.
84. Zhang Z, Kanamoto T, Aihara M, et al. Basic Research on Intrameniscal Injection as a Direct Treatment for Knee Meniscal Pathology. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101158
This basic research article explores intrameniscal injection as a direct treatment modality for knee meniscal pathology, aiming to deliver therapeutic agents directly to the site of injury. The study likely investigates the biomechanical and biological feasibility of this approach to promote healing or reduce degeneration within the meniscus. If successful, this technique could offer a minimally invasive alternative to traditional surgical interventions for meniscal tears.
Osteotomy and Biomechanical Phenotyping (6)¶
4. Kayaalp ME, Kahraman HC, Erden T, et al. Defining sagittal knee phenotypes via monopedal static anterior tibial translation. Part 2: The assessment‐led personalization (ALP) system for indication and correction target planning in slope‐reducing osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70512
This paper introduces the assessment-led personalization (ALP) system, a clinical algorithm that integrates static anterior tibial translation data with posterior tibial slope and other factors to guide slope-reducing osteotomy planning. The ALP system aims to distinguish true soft-tissue decompensation from osseous asymmetry, thereby refining indications for surgery and identifying patients at high risk for isolated soft-tissue reconstruction failure. This personalized approach offers a more nuanced framework for treating anterior cruciate ligament-deficient knees.
17. Mylonakis N, Kenanidis E, Maslaris A, et al. Coronal alignment behaviour across the knee range of motion is associated with constitutional alignment and soft‐tissue balance: The REAL HKA classification. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70506
This study evaluated intraoperative coronal alignment across the knee range of motion during robotic-assisted total knee arthroplasty to define a composite REAL HKA phenotype. The key finding was that alignment behavior is significantly associated with constitutional alignment (CPAK) and soft-tissue balance (REAL classifications). Clinically, this suggests that preoperative constitutional and laxity assessments can predict intraoperative alignment stability, aiding in surgical planning.
23. Kayaalp ME, Kahraman HC, Erden T, et al. Defining sagittal knee phenotypes via monopedal static anterior tibial translation. Part 1: Translating weight‐bearing sagittal position into clinical risk profiles. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70501
This paper defines sagittal knee phenotypes based on static anterior tibial translation (sATT) to distinguish weight-bearing sagittal position from passive laxity. The key finding is that elevated sATT manifests in three distinct phenotypes: osseous anteriorization, acquired soft-tissue anteriorization, and inherent soft-tissue anteriorization. Clinically, this classification helps surgeons understand the underlying pathomechanisms of instability, guiding more targeted treatment strategies beyond simple soft-tissue reconstruction.
24. Graichen H, Avram GM, von Eisenhart‐Rothe R, et al. Laxity phenotyping in total knee arthroplasty: A current concept article. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70502
This concept article proposes a 3x3 classification system for knee laxity phenotypes in total knee arthroplasty based on coronal gap characteristics in extension and flexion. The key finding is that lateral laxity is the most common phenotype in flexion, while a medially lax phenotype may be associated with TKA failure. Clinically, this provides a structured algorithm for balancing knees during TKA by addressing specific gap imbalances according to the identified phenotype.
31. Vieider RP, Watrinet JM, Bilodeau R, et al. A simple planning tool for tibial slope osteotomy—Osteotomy depth is a precise parameter to determine wedge height. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70498
Précis unavailable.
54. Pineda T, Seil R, Sonnery‐Cottet B, et al. Slope reducing osteotomy: The emerging gap between indication, safety and proportionality. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70488
This editorial discusses the emerging gap between the rapid adoption of slope-reducing osteotomy (SRO) for ACL injuries and the limited evidence defining its proper indication and safety. It argues that SRO should be guided by integrated, individualized risk stratification rather than isolated numerical thresholds. The authors emphasize that clinical judgment and surgical experience are essential safeguards for the safe and effective application of this procedure.
Other articles this month¶
1. Lee K, Chen K, Tsai Y, et al. Increased Medial Posterior Tibial Slope Is Associated With Worse Patient‐Reported Outcomes After Bicruciate Ligament Reconstruction. Arthroscopy 2026. doi:10.1002/arj.70338
This retrospective study evaluated the impact of medial and lateral posterior tibial slopes on outcomes in 50 patients undergoing bicruciate ligament reconstruction. It found that an increased medial posterior tibial slope was associated with worse patient-reported outcomes, although graft survival rates were not significantly affected. These findings suggest that preoperative assessment of medial tibial slope may help predict functional recovery and guide surgical planning for multiligament knee injuries.
2. Moraes de Oliveira G, Zotter S, Tao B, et al. Artificial intelligence demonstrates comparable diagnostic accuracy to radiologists for anterior cruciate ligament tears on MRI: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70478
This systematic review and meta-analysis compared the diagnostic accuracy of artificial intelligence against radiologists for detecting anterior cruciate ligament tears on MRI. The results demonstrated that AI achieved sensitivity and specificity comparable to radiologists, with pooled sensitivity of 0.94 and specificity of 0.93. This indicates that AI can serve as a reliable adjunct or alternative for ACL tear diagnosis, potentially reducing variability in image interpretation.
5. Pineda T, Varady NH, Olivieri R, et al. Similar quadriceps strength recovery after anterior cruciate ligament reconstruction with rectus femoris, quadriceps tendon and hamstring autografts. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70507
This prospective comparative study evaluated quadriceps strength recovery at 12 months following anterior cruciate ligament reconstruction using rectus femoris, quadriceps tendon, or hamstring autografts. The results showed similar quadriceps strength recovery across all three graft types, with no statistically significant differences in limb symmetry indices. This suggests that graft choice may not significantly impact long-term quadriceps strength outcomes, allowing surgeons to select grafts based on other patient-specific factors.
8. Birkenes T, Chahla J, Lygre SHL, et al. Risk of Revision and Patient-Reported Outcomes After ACL Reconstruction: Influence of Concomitant MCL Injury and Graft Choice: Analysis of 35,139 Reconstructions From the Norwegian Knee Ligament Register. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261457327
This large cohort study analyzed revision risks and patient-reported outcomes in patients undergoing anterior cruciate ligament reconstruction with or without concomitant medial collateral ligament injuries. The study found that concomitant MCL injury and specific graft choices influenced revision risk and 2-year Knee injury and Osteoarthritis Outcome Score outcomes. These results provide evidence to inform surgical decision-making and patient counseling regarding combined ligament injuries.
9. DeFoor MT, Knurr KA, Heiderscheit B, et al. MRI-Based Volumetric Analysis of the Quadriceps Muscles Correlation With Knee Extension Strength in Patients Undergoing Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261456991
This large-scale database study compared arthrofibrosis rates between patients undergoing ACL reconstruction alone versus those receiving lateral extra-articular procedure (LEAP) augmentation. The analysis revealed that adding LEAP significantly increases the risk of arthrofibrosis requiring intervention at 6, 12, and 24 months post-surgery. These findings suggest that surgeons should carefully weigh the stability benefits of LEAP against the heightened risk of stiffness and the need for subsequent interventions.
10. Ehlers M, Estes LC, Derry K, et al. Knee Synovial Fluid Biomarker Type and Concentration With Long-Term Outcomes After ACL Reconstruction With Concomitant Meniscal Injury. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261459225
This cohort study characterized synovial fluid inflammatory phenotypes in patients undergoing ACL reconstruction with concomitant meniscal injury and assessed their association with long-term patient-reported outcomes. The research investigates whether distinct inflammatory profiles correlate with symptom severity and recovery, hypothesizing that biomarker effects vary by phenotype. These findings could inform personalized prognostic models and targeted anti-inflammatory interventions to improve long-term joint health after combined injuries.
11. D'Ambrosi R, Hirschmann MT, Dahmen J, et al. Stability restored, cartilage compromised? Revisiting patellofemoral outcomes after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70514
This editorial argues that while ACL reconstruction successfully restores knee stability, it often neglects the patellofemoral joint, leading to compromised cartilage and functional outcomes. The authors highlight that the patellofemoral joint is the critical translator of quadriceps power and has been overlooked in the pursuit of static stability metrics. Clinically, this underscores the need for surgical techniques and rehabilitation protocols that specifically address patellofemoral health to prevent long-term degeneration.
14. Kurtz JL, Ehlers M, Montgomery SR, et al. The Effect of Smoking History on Inflammatory Biomarkers in Synovial Fluid of Patients Undergoing Arthroscopic Knee Surgery for Meniscal Injury. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261459231
This cohort study investigated the association between tobacco use and cytokine concentrations in the synovial fluid of patients undergoing arthroscopic knee surgery for meniscal injury. The results analyzed differences in inflammatory biomarkers among current smokers, former smokers, and nonsmokers to understand the intra-articular microenvironment's response to smoking. These insights may help explain smoking-related adverse outcomes in orthopedic surgery and support counseling on smoking cessation to optimize joint health.
15. Philpott A, Lambers A, Lee S, et al. Femoral component internal rotation in functionally aligned robotic‐assisted total knee arthroplasty does not impair functional outcomes. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70509
This retrospective review assessed whether femoral component internal rotation in functionally aligned robotic-assisted total knee arthroplasty negatively impacts functional outcomes such as range of motion and patient-reported scores. The study found that mean femoral rotation was minimal and did not impair functional outcomes or patellofemoral tracking at one-year follow-up. This challenges the traditional tenet of avoiding internal rotation, suggesting that functionally aligned techniques can achieve good outcomes even with slight rotational variations.
16. de Girolamo L, Kon E, Laver L, et al. Cell‐based therapy injections for the management of knee osteoarthritis: The ESSKA–ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70487
This consensus statement developed evidence-based recommendations for the use of point-of-care cell-based therapy injections in knee osteoarthritis across various clinical scenarios using the RAND/UCLA method. Experts evaluated 144 scenarios based on cell source, age, joint involvement, OA grade, and BMI to determine appropriateness. These guidelines provide clinicians with a structured framework to decide when cell-based therapies are appropriate, helping to standardize care and manage patient expectations.
20. Williams DH. Measuring Pain and Function. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00472
This commentary discusses the correlation between Oxford scores and patient satisfaction following primary hip and knee replacement, noting that postoperative scores correlate better with satisfaction than preoperative ones. The key finding is that preoperative patient-reported outcome measures (PROMs) are poor predictors of postoperative satisfaction. The clinical implication is that healthcare systems should avoid using preoperative PROMs to ration care, instead focusing on postoperative outcomes and patient satisfaction for policy decisions.
25. Olivieri R, Muñoz JT, Koch M, et al. Augmentation does not improve clinical and radiological outcomes after repair of Stener‐like medial collateral ligament (MCL) lesions: Comparative cohort at mid‐term follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70508
This retrospective cohort study compared isolated repair versus repair with augmentation for Stener-like MCL lesions, finding no significant differences in valgus stability, PROMs, or failure rates at mid-term follow-up. The results indicate that adding biological augmentation does not improve clinical or radiological outcomes for these specific injuries. Consequently, surgeons may opt for isolated repair to avoid the added complexity and potential morbidity of augmentation procedures.
26. Karaman Y, Veizi E, Güven Ş, et al. Proximal tibia vara and tibial overhang are associated with inferior outcomes after medial unicompartmental knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70510
This study evaluated the impact of proximal tibia vara on outcomes after medial unicompartmental knee arthroplasty, finding that patients with tibia vara experienced inferior clinical scores and greater alignment deviations compared to those with normal tibial anatomy. The presence of tibia vara was associated with compromised implant positioning and poorer patient-reported outcomes. These findings suggest that proximal tibial morphology should be carefully considered during patient selection and surgical planning for medial UKA.
30. Ruberto RA, Mastroianni MA, Geller J, et al. The Effects of Surgeon Workforce Diversity on Total Joint Arthroplasty Patient Demographics. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01032
Précis unavailable.
32. Della Villa F, Ghibellini A, Buckthorpe M, et al. Biomechanical phenotypes of 90° change of direction in football players: Unsupervised machine learning in anterior cruciate ligament injury prevention. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70475
Précis unavailable.
33. Kang H, Ilyas MH, Freeman IA, et al. Preoperative fall history is associated with increased postoperative complications at 2 years after primary total knee arthroplasty: A propensity‐matched analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70500
This propensity-matched study analyzed outcomes in patients aged ≥65 years undergoing primary total knee arthroplasty to determine if preoperative fall history influences postoperative complications. The researchers found that a documented preoperative fall history was significantly associated with increased postoperative complications at the 2-year follow-up mark. This suggests that fall history serves as a valuable marker for frailty and functional impairment, warranting closer monitoring and targeted interventions for these high-risk patients.
34. Shaw JA. The Variable Axis Knee Prosthesis. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00401
This article reviews the historical significance of the Variable Axis knee prosthesis, conceptualized by Dr. David G. Murray in 1972 as the first unconstrained cruciate-substituting knee design. The prosthesis introduced innovative features such as a metal-backed tibial component with modular polyethylene inserts, which became standard in subsequent prosthetic designs. Although eventually superseded by Total Condylar-type designs, its legacy lies in pioneering key engineering concepts adopted by modern knee implants.
35. Valsamis EM, Dufresne M, Chambers K, et al. Minimal and Substantial Improvement Thresholds for Oxford Scores Following Primary Hip and Knee Replacement Based on Patient Satisfaction. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00175
This study evaluated the predictive value of Oxford Hip and Knee Scores for patient satisfaction following primary joint replacement to establish clinically relevant thresholds. The authors identified specific postoperative score thresholds for minimal clinically important difference and substantial clinical benefit that accurately correlate with patient satisfaction. These findings provide evidence-based metrics to guide value-based healthcare policy and improve the assessment of surgical outcomes.
36. Mestriner MB, Nejima S, Bartolin PB, et al. Posterolateral corner reconstruction using hamstrings grafts—A comparative biomechanical study of three techniques. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70468
This biomechanical study compared three posterolateral corner reconstruction techniques using hamstrings grafts to assess their efficacy in restoring knee laxity under various loading conditions. The results indicated that the popliteofibular loop and modified Arciero techniques were more effective than the modified LaPrade technique in restoring varus and external rotation stability. These findings suggest that certain reconstruction methods offer superior biomechanical restoration of knee stability in the setting of posterolateral corner injuries.
37. Moews LD, Alfonsi SA, Musahl V, et al. Advanced systems for intraoperative cartilage evaluation and treatment demonstrate early feasibility and a shift towards integrating artificial intelligence: A scoping review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70489
This scoping review examined the current literature on artificial intelligence and advanced technologies for intraoperative cartilage evaluation and treatment. The analysis revealed that AI-based mapping and computer-assisted navigation systems demonstrate high feasibility and accuracy in real-time cartilage assessment during surgery. These technologies represent a promising shift toward integrating artificial intelligence into orthopaedic practice for improved intraoperative decision-making.
42. Al Abdallat AM. Advancing Immune Cell Profiling in Arthroplasty Failure: Insights from Transcriptomic Deconvolution. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00427
This commentary highlights a study applying transcriptomic deconvolution to bulk RNA sequencing data to characterize immune cell microenvironments in periprosthetic tissues. The analysis revealed distinct inflammatory signatures, such as elevated plasma cells and CD8+ T cells, that differentiate periprosthetic joint infection from aseptic failure. This approach offers potential insights for improving diagnostic accuracy in equivocal cases of arthroplasty failure.
43. Hetsroni I. Facing Challenges in Osteochondritis Dissecans Healing Research. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01643
This commentary discusses a study identifying preoperative osteochondritis dissecans bone density as a significant predictor of fast healing following surgical intervention. Specifically, bone density at or above 70% of the parent bone was associated with rapid bone integration, whereas other factors like lesion stability and patient age were not independently predictive. These results suggest that preoperative bone density assessment could help stratify patients based on expected healing trajectories.
45. Heinz M, Lettner J, Hakam HT, et al. Regeneration of the semitendinosus tendon and muscle after isolated semitendinosus harvest for primary anterior cruciate ligament reconstruction: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70479
This systematic review evaluated the morphological and functional regeneration of the semitendinosus tendon and muscle following isolated harvest for anterior cruciate ligament reconstruction. The narrative synthesis of imaging and histological data indicates that while regeneration occurs, the extent and quality of recovery vary significantly across studies. Understanding these adaptations is crucial for counseling patients regarding potential long-term muscular deficits.
46. Elsheikh R, Burgert N, Kievit A, et al. Unicompartmental knee arthroplasty is associated with greater patient preference but higher revision rates than total knee arthroplasty in the same patient: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70474
This meta-analysis compared outcomes between unicompartmental knee arthroplasty and total knee arthroplasty in patients with a contralateral total knee arthroplasty. Unicompartmental arthroplasty was associated with greater postoperative range of motion and higher patient preference, despite exhibiting higher revision rates than total knee arthroplasty. These results suggest that unicompartmental arthroplasty may be a viable option for select patients prioritizing range of motion and satisfaction over long-term survivorship.
47. Helmbæk LM, Mikkelsen KL, Krogsgaard MR. Non‐anatomical MPFL reconstruction and failure to address relevant pathologies are common reasons for treatment injuries following treatment for patellofemoral instability. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70493
This study analyzed compensation claims for patellofemoral instability treatment to identify common causes of surgical failure and suboptimal outcomes. Surgical malpractice, particularly incorrect femoral graft placement in medial patellofemoral ligament reconstruction and failure to address concurrent pathologies, were identified as frequent causes of treatment injury. These findings emphasize the need for precise surgical technique and comprehensive anatomical assessment to minimize complications.
50. Müller D, Gillani A, Hirschmann MT, et al. Joint‐specific measures improve risk adjustment in total knee arthroplasty: A machine learning approach. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70480
This study evaluated whether incorporating radiographic and clinical joint-specific parameters improves machine learning-based risk adjustment for postoperative complications and residual pain following total knee arthroplasty. The results demonstrated that adding joint-specific data significantly enhances the predictive accuracy of ML models compared to using patient demographics alone. This implies that risk stratification tools for TKA should include joint-specific metrics to better predict individual patient outcomes.
51. Schrednitzki D, Sina J, Lamarche A, et al. No clinical and functional benefit after medial congruent compared to ultra congruent total knee arthroplasty at 1 year: A prospective randomized controlled study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70482
This prospective randomized controlled trial compared clinical outcomes of medial congruent (MC) versus ultra congruent (UC) onlays in total knee arthroplasty at one year. The study found no significant clinical or functional benefit of MC inserts over UC inserts in terms of knee scores, range of motion, or patient satisfaction. These results suggest that the choice between MC and UC designs does not impact short-term clinical outcomes, allowing surgeons to select based on other factors.
52. Hofmann S, Tecame A, Hirschmann M, et al. Highly variable proximal tibia anatomy causes controversies for proper tibial component rotational alignment in total knee arthroplasty: A current concept review. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70485
This current concept review examines the controversies surrounding tibial component rotational alignment in total knee arthroplasty due to high anatomical variability of the tibia tubercle. It highlights that while numerous reference lines and methods exist, there is currently no evidence favoring any single approach for optimal alignment. The review underscores the need for individualized surgical strategies rather than a consensus on a specific rotational alignment technique.
53. Morrison SR, Hall AJ, Lim B, et al. Knee arthroplasty in patients under 50 years demonstrates durable survivorship despite substantially higher lifetime revision risk than in older patients. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70486
This registry-based study evaluated implant survivorship and revision risk in patients under 50 years undergoing primary knee arthroplasty compared to older patients. Although younger patients face a substantially higher lifetime revision risk, the implants demonstrated durable short-to-mid-term survivorship. Clinically, this supports offering knee arthroplasty to younger patients with severe symptoms while acknowledging the need for long-term monitoring and potential future revisions.
55. Abedeen AZ, Daliliyazdi A, Soth B, et al. Deep learning methods for automated orthopaedic measurements in computed tomography scans. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70495
This editorial highlights the challenges in automated orthopedic measurements from computed tomography scans, noting that variability arises from methodological differences and image quality factors. It discusses how deep learning methods can assist in standardizing these measurements but warns that interpretation remains sensitive to specific anatomical definitions. The piece suggests that while AI offers promise, rigorous standardization is required for reliable clinical application.
56. Ma X, Jiang W, Lu C, et al. Computed Tomography‐Based Morphometric Analysis Reveals Intercondylar Notch Stenosis and Osteophytes Are Associated With Anterior Cruciate Ligament Injury. Arthroscopy 2026. doi:10.1002/arj.70383
This retrospective study used 3D computed tomography to assess the association between intercondylar notch morphometrics, osteophytes, and anterior cruciate ligament (ACL) injury. The findings revealed that notch stenosis and the presence of osteophytes are significantly associated with ACL injury in the studied population. These results suggest that morphometric analysis may help identify anatomical risk factors for ACL injuries, potentially aiding in preventive strategies or surgical planning.
58. Croné A, Gauffin H, Hedevik H, et al. Patient-Reported Knee Function and Return-to-Sport Rates After Nonsurgical and Surgical Treatment of an Acute Anterior Cruciate Ligament Injury: Results From the NACOX Prospective Cohort Study. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261451698
This prospective cohort study compared patient-reported knee function and return-to-sport rates between non-surgical and surgical treatments for acute ACL injuries over 24 months. The results indicate that while treatment strategies differ, shared decision-making allows for tailored outcomes, with specific predictors identified for achieving return to preinjury activity levels regardless of the intervention chosen.
60. Elliott DA, Gill SS, Gupte CM. Are There Sex Disparities in Return to Sport After Anterior Cruciate Ligament Reconstruction? A Systematic Review and Exploratory Meta-analysis. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261448489
This in vitro study evaluated the biomechanical effects of the modified MacIntosh ACL reconstruction in cadaveric knees, finding that it increases and anteriorizes lateral tibiofemoral contact stress relative to the intact knee. While the construct effectively reduces rotational and varus laxity, the altered contact mechanics and graft loading patterns raise concerns regarding potential long-term cartilage wear in skeletally immature patients.
62. Bram JT, Shamritsky DZ, Mange TR, et al. In Vitro Evaluation of Tibiofemoral Contact Stress and Graft Loading After Modified MacIntosh Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261449796
Précis unavailable.
63. Baldy dos Reis F, Salles MJ. Antimicrobial Resistance in Periprosthetic Joint Infection: Use Correct Definitions for Better Clinical Decisions. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01414
This commentary critiques the use of inconsistent definitions in periprosthetic joint infection (PJI) research, arguing that correct terminology is essential for accurate clinical decision-making and policy updates. The authors highlight that local studies often report higher antimicrobial resistance rates than national surveillance data due to referral bias, underscoring the need for standardized reporting to improve empirical antibiotic guidelines.
64. Al‐Saket S, McClean Z, Mossel NB, et al. Stretch‐shortening cycle force–time and power–time waveform analysis indicates limitations of the contralateral limb benchmark in athletes with ACL injury. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70443
This study utilized force-time and power-time waveform analysis to demonstrate that the contralateral limb benchmark is limited for assessing return-to-sport readiness in athletes with ACL reconstruction. The findings reveal significant interlimb deficits and suggest that using healthy control benchmarks may provide a more accurate assessment of stretch-shortening cycle function than relying on the uninjured limb.
65. Karaman T, Devran S, Morkuzu S, et al. From injury to financial loss: Quantifying the economic and career consequences of anterior crucial ligament ruptures in European professional football. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70470
This retrospective cohort study quantified the economic and career impacts of ACL injuries in 211 European professional footballers, finding a mean recovery time of 256.6 days and a 2.5% market value depreciation. The analysis revealed that player age significantly correlated with financial loss, highlighting the substantial economic consequences of ACL ruptures on athlete careers.
66. Pizza N, Perelli S, Grassi A, et al. Decreased posterior tibial slope is not a risk factor for posterior cruciate ligament reconstruction failure: A multicentric analysis of 173 cases. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70472
This multicentric retrospective study investigated the association between posterior tibial slope (PTS) and failure rates in 173 patients undergoing posterior cruciate ligament reconstruction. The key finding was that decreased PTS is not a risk factor for PCLR failure in either isolated or multiligament knee injury contexts, challenging previous hypotheses regarding slope as a determinant of surgical outcomes.
67. Zickler CL, Alfonsi SP, Shalakthi OS, et al. GLP‐1 agonists versus bariatric surgery: Which management carries heavier weight prior to total knee arthroplasty?. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70473
This propensity score-matched study compared 90-day postoperative complications in 1,650 patients per cohort undergoing total knee arthroplasty after either bariatric surgery or GLP-1 agonist therapy. Results indicated that while most complication rates were comparable, the GLP-1 cohort experienced significantly lower rates of specific medical and surgical complications compared to the bariatric surgery group.
69. Szymski D, Krutsch W, Weber J, et al. Shift from inpatient to outpatient treatment in all age groups of anterior cruciate ligament surgery in Germany: An analysis of the public healthcare system. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70467
Précis unavailable.
70. Klein C, Buijs GS, ter Wee MA, et al. Increased radiolucency on conventional radiographs around tibial components does not imply more load‐induced displacement of a total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70469
This post-market follow-up study compared conventional radiographic radiolucency with CT-measured load-induced displacement in 50 total knee arthroplasty tibial components. The key finding was that increased radiolucency on conventional radiographs does not correlate with greater load-induced component displacement, suggesting that radiolucent lines may not reliably indicate impaired fixation or implant motion.
71. Stawińska M, Plenzler M, Ciszkowska‐Łysoń B, et al. The critical 3‐ to 6‐month period of quadriceps tendon graft remodelling following ACL reconstruction: Implications for safe return to sport. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70452
This study evaluated MRI signal intensity changes in quadriceps tendon grafts during the first year following ACL reconstruction using the 'Ribbon' technique in 75 patients. The findings identified a critical remodeling period between 3 and 6 months post-operation, characterized by increased signal intensity, which has important implications for determining safe timelines for return to sport.
72. López Personat A, Mariscal G, Stålman A, et al. Second ACL injuries in football players after ACL reconstruction: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70471
This systematic review and meta-analysis determined the incidence of second ACL injuries in football players following index ACL reconstruction by analyzing 34 studies. The review highlighted substantial heterogeneity in reinjury rates across subgroups and identified key factors associated with reinjury, providing critical data for risk assessment and rehabilitation protocols in athletic populations.
73. Kim K, Kim SY, Kim SS, et al. Cost-Effectiveness of AI-Assisted Kellgren-Lawrence Grading of Knee Osteoarthritis in the South Korean Health-Care System. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01278
This study developed a model-based cost-effectiveness analysis comparing AI-assisted Kellgren-Lawrence grading against conventional human-reader assessment for knee osteoarthritis in South Korea. The findings suggest that AI integration offers economic value by potentially improving diagnostic accuracy and enabling earlier treatment, although specific incremental cost-effectiveness ratios were truncated in the abstract. Clinically, this supports the adoption of AI tools to optimize resource allocation and patient outcomes in osteoarthritis management.
74. Siddiqi A, Jacob PB, Yousuf KM. Total Joint Arthroplasty During Ramadan. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00276
This article synthesizes physiologic and perioperative considerations for performing total joint arthroplasty during Ramadan, addressing alterations in hydration, glycemic variability, and sleep architecture. It proposes a framework for risk stratification, shared decision-making, and structured perioperative management to ensure patient safety. The clinical implication is that elective TJA during Ramadan is not contraindicated but requires tailored planning and counseling to mitigate risks associated with prolonged fasting.
75. Greif DN, Castle P, Jain S, et al. Patients with major depressive disorder and undiagnosed depression are at risk for inferior outcomes after patellar stabilization surgery. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101080
This retrospective study assessed the impact of major depressive disorder (MDD) and undiagnosed depression on outcomes following medial patellofemoral ligament reconstruction (MPFL-R). Patients with mental health disorders, including those with undiagnosed depression, demonstrated inferior pre- and post-operative outcomes compared to those without. Clinically, this highlights the need for routine mental health screening and targeted interventions to improve surgical results in patients undergoing patellar stabilization.
76. Davies PS, O'Brien S, Greensmith TS, et al. A single-tendon semitendinosus autograft results in lower magnetic resonance imaging graft signal compared with a dual tendon autograft: Outcomes from a subgroup of patients undergoing anterior cruciate ligament reconstruction in the DOSTAR randomized controlled trial. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101089
This subgroup analysis of the DOSTAR randomized controlled trial compared MRI graft signal intensity between single-tendon semitendinosus and dual-tendon semitendinosus-gracilis autografts after ACL reconstruction. The study found that single-tendon grafts resulted in lower MRI signal intensity compared to dual-tendon grafts at 6 and 12 months post-operatively. These imaging differences may reflect distinct graft integration patterns, though clinical outcome measures were also tracked to assess functional implications.
77. Khan ZA, Stålman A, Impieri L, et al. Ten-year risk of graft re-rupture and contralateral anterior cruciate ligament injury after primary anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101094
This systematic review and meta-analysis evaluated the ten-year risk of graft re-rupture and contralateral ACL injury following primary ACL reconstruction. The study aimed to compare these risks and assess the influence of factors such as graft type and return-to-sport activities on second ACL injuries. The findings provide critical long-term data to inform patient counseling and post-operative rehabilitation strategies regarding the risk of subsequent knee injuries.
78. Rodrigo G, Ernesto P, Soledad A, et al. Virtual reality training is associated with high satisfaction and self-perceived surgical confidence in anterior cruciate ligament reconstruction: Experience from an orthopedic residency pilot study. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101096
This pilot study evaluated orthopedic surgery residents' satisfaction and self-perceived confidence following virtual reality (VR) simulation training for anterior cruciate ligament reconstruction. Residents reported high satisfaction and improved confidence after completing VR training sessions using the inside-out technique. The clinical implication is that VR simulation is a valuable educational tool for enhancing surgical training and trainee preparedness in orthopedic residency programs.
79. Hamada T, Watanabe S, Yoshida Y, et al. Reliability and Clinical Utility of Anterior Tibial Subluxation on Weight-bearing Extended Lateral Knee Radiographs in Anterior Cruciate Ligament-deficient Knee. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101098
This multicenter study evaluated the reliability and clinical utility of anterior tibial subluxation (ATS) measurements on weight-bearing extended lateral knee radiographs in ACL-deficient knees. The research assessed intra- and inter-rater reliability using articular surface-based and bone axis-based methods, while also examining the influence of knee flexion angles on measurements. The findings aim to establish standardized measurement protocols to improve the diagnostic assessment of knee instability in ACL injuries.
80. Das S, Simunovic N, Di Maria F, et al. Prophylaxis does not prevent symptomatic venous thromboembolism following anterior cruciate ligament surgery: a systematic review and meta-analysis. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101099
This systematic review and meta-analysis investigated the efficacy of thromboprophylaxis in preventing symptomatic venous thromboembolism (VTE) following anterior cruciate ligament reconstruction. The analysis pooled data from multiple studies to compare pharmacologic, mechanical, and combination prophylaxis against no prophylaxis. The results suggest that routine prophylaxis may not effectively prevent symptomatic VTE in this population, challenging current practices and suggesting a need for risk-stratified approaches.
81. Farooq H, Howard J, Johnson B, et al. The Impact of Photographic Evidence on Postoperative Range of Motion Following Total Knee Arthroplasty: A Randomized Control Trial. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.068
This randomized controlled trial evaluated whether providing postoperative photographs of knee range of motion improves rehabilitation outcomes in total knee arthroplasty patients. The study found that patients receiving photographic evidence demonstrated significantly greater median knee extension at six weeks compared to the control group. These results suggest that visual feedback may be a simple, effective intervention to enhance early postoperative extension and potentially engagement in physical therapy.
82. Hoveidaei AH, Pirahesh K, Alnasser AA, et al. Does Preoperative Air Travel Increase Infection Risk After Total Knee Arthroplasty? A Propensity-Matched Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.070
This propensity-matched retrospective cohort study investigated whether preoperative air travel increases the risk of periprosthetic joint infection or other infectious complications following total knee arthroplasty. The analysis of nearly 24,000 patients revealed no significant differences in infection rates between those who traveled by air versus land. Consequently, preoperative air travel does not appear to be a contraindication or significant risk factor for postoperative infection in elective TKA.
83. Hall DJ, Wong J, Wright JL, et al. Is Fretting Corrosion at the Modular Junction of Revision Total Knee Arthroplasty Actually a Problem?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.069
This study evaluated retrieved modular stem and bore components from revision total knee arthroplasty to determine if fretting corrosion severity correlates with adverse local tissue reactions or osteolysis. The results indicated that while corrosion was present, its severity did not significantly correlate with radiographic evidence of osteolysis or adverse tissue reactions. This suggests that fretting corrosion at these junctions may not be as clinically detrimental as previously assumed, provided there are no signs of mechanical failure or infection.
85. Nizaj N, Meleppuram JJ, Ahamed HN, et al. Arciero Technique for Anatomic Posterolateral Corner Reconstruction of Knee Following Femoral Nailing: A Current Technique. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101157
This technical note describes the Arciero technique for anatomic posterolateral corner reconstruction of the knee in patients who have previously undergone femoral nailing. The authors detail the surgical modifications required to accommodate the intramedullary nail while achieving stable ligamentous reconstruction. This report provides a valuable surgical strategy for managing complex posterolateral corner injuries in the presence of existing hardware.
86. El Kayali MK, Neumann EM, Fahy S, et al. Assessment of OpenEvidence Responses to American Academy of Orthopaedic Surgeons Clinical Practice Guidelines for Anterior Cruciate Ligament Reconstruction. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101160
This study assessed the responses generated by the OpenEvidence platform against the American Academy of Orthopaedic Surgeons Clinical Practice Guidelines for anterior cruciate ligament reconstruction. The authors evaluated the accuracy, relevance, and alignment of AI-generated recommendations with established clinical standards. The findings aim to validate the utility of AI tools in supporting clinical decision-making for ACL reconstruction while highlighting areas for improvement in guideline adherence.
87. Unknown Author. Issue Information. Arthroscopy 2026. doi:10.1002/arj.70426
This issue information page lists the contents of the June 2026 issue of Arthroscopy, featuring articles on rotator cuff tears, shoulder stabilization, hip arthroscopy, and ACL reconstruction. It highlights practice-changing innovations and includes commentaries by various experts on the published studies. The section serves as a table of contents, guiding readers to key clinical and research topics in arthroscopic surgery.
88. Unknown Author. Issue Information. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70465
This issue information page outlines the scope and subscription details for the June 2026 issue of Knee Surgery, Sports Traumatology, Arthroscopy, the official journal of ESSKA. It emphasizes the journal's focus on innovative knee surgery, sports trauma, and arthroscopy, including peer-reviewed clinical and basic research articles. The text also provides logistical information regarding delivery terms and claims for missing issues.
89. Huang J, Abdullah Ezzi SH, Wu S, et al. Intraosseous Sustained-Release Anesthetics Promote Early Ambulation and Functional Recovery after Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.11.019
This randomized controlled trial evaluated intraosseous sustained-release anesthetics combined with local infiltration anesthesia in 110 total knee arthroplasty patients to assess their impact on early ambulation and functional recovery. The study found that adding intraosseous infiltration significantly improved early functional outcomes compared to local infiltration alone. These results suggest that intraosseous anesthetics are a valuable adjunct for enhancing postoperative recovery in TKA.
90. Lyman S, Chin A, Alschuler DM, et al. A Proposed Alternative Sampling Strategy for Centers for Medicare & Medicaid Services Arthroplasty Patient-Reported Outcome Performance Measure Compliance. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.003
This study calculated the minimum sample size of patient-reported outcome measures required to generate statistically valid performance estimates for hospitals of varying volumes. It determined that current CMS mandates for low-volume centers are unnecessarily burdensome while potentially overestimating performance in large hospitals. The findings propose a volume-adjusted sampling strategy to improve the reliability and fairness of PRO-PM compliance metrics.
92. Padgett BM, Terhune EB, Chalmers BP, et al. Dogma Under the Knife: Challenging the Status Quo in Primary Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.077
This symposium manuscript challenges traditional dogmas in primary total knee arthroplasty by reviewing contemporary evidence on alignment, fixation, bearing surfaces, and patellar resurfacing. It highlights that individualized approaches and emerging technologies are reshaping surgical standards to address persistent patient dissatisfaction. The authors advocate for evidence-based flexibility rather than a single new standard to optimize patient-perceived success.
93. Acuña AJ, Potluri AS, Yadav AS, et al. Revision Total Joint Arthroplasty at the Ambulatory Surgery Center: A Single Institutional Experience. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.009
This single-institution retrospective case series evaluated the safety and efficacy of performing revision total joint arthroplasty in an ambulatory surgery center for 181 patients. The study found low 90-day complication rates and high survivorship free of re-revision, supporting the feasibility of outpatient revision surgery in selected patients. These results suggest that ASCs can safely manage revision TJA with outcomes comparable to inpatient settings.
94. Paul BR, Verhey JT, Haak GM, et al. Risk and Benefit Profile with Concurrent Nonsteroidal Anti-Inflammatory Drugs and Direct Oral Anticoagulants Following Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.016
Précis unavailable.
95. Patel SV, Pasqualini I, Khan ST, et al. Differences Between Inpatient and Outpatient Medicare Total Knee Arthroplasty: Substantial Clinical Benefit Thresholds on Knee Injury and Osteoarthritis Outcome Score for Joint Replacement. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.019
This study compared substantial clinical benefit (SCB) thresholds on the KOOS-JR between Medicare inpatient and outpatient total knee arthroplasty cohorts to address potential misclassification of success. It found that outpatient patients required lower SCB thresholds to achieve similar perceived improvements compared to inpatients. These findings suggest that care setting-specific thresholds may be necessary for accurate performance measurement under CMS PRO-PM guidelines.
97. Kuznetsov M, Playter KP, Travers HI, et al. The Impact of Spinal Anesthetic Dose on Length-of-Stay in Primary Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.026
This retrospective study analyzed 1,486 primary total knee arthroplasty patients to determine the association between neuraxial bupivacaine dosage and hospital length of stay. The key finding was that patients receiving 1.6 mL or less of anesthetic experienced a six-hour shorter length of stay compared to those receiving higher doses. Clinically, minimizing neuraxial anesthetic dosage may help reduce hospitalization duration in outpatient settings.
99. Tepa W, Chawanpaiboon P, Khamintara R, et al. Measurement Properties of the Thai Version of the Knee Injury and Osteoarthritis Outcome Score and Its Short Forms in Patients With Anterior Cruciate Ligament Injury. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101162
This study assessed the measurement properties of the Thai version of the Knee Injury and Osteoarthritis Outcome Score and its short forms in patients with anterior cruciate ligament injuries. The research aimed to validate these instruments for use in this specific patient population and cultural context. The findings support the reliability and validity of the Thai KOOS versions for assessing outcomes in ACL injury patients.
100. Driessche AM, Zamzam M, Hodson N, et al. Factors Associated with Patient-Reported Outcome Measure Non-Completion One Year after Total Joint Arthroplasty: A Retrospective Cohort Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.031
This retrospective cohort study identified factors associated with the non-completion of one-year patient-reported outcome measures following total hip or knee arthroplasty. The results indicated that while completion rates improved over time, significant gaps remained, particularly among patients with inactive patient portals. These insights can inform targeted strategies to improve PROM completion rates for Medicare quality reporting and surgical evaluation.
103. Bellissimo J, Hall B, Hali K, et al. Internet Promotion of Orthobiologics by the American Association of Hip and Knee Surgeons Members: Claims Versus Evidence in Patient-Facing Websites. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.040
This cross-sectional content analysis compared online claims for orthobiologic therapies on surgeon websites against current peer-reviewed clinical evidence. The study found that while orthobiologics were frequently promoted, the claims often exceeded the support provided by existing scientific literature. This discrepancy highlights a need for greater alignment between patient-facing marketing and evidence-based practice guidelines.
104. Kubo T, Kinoshita T, Kutsuna T, et al. Pain Catastrophizing Improves After Total Knee Arthroplasty, But Still Has a Negative Effect on Outcomes in Japanese Patients. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.038
This longitudinal study assessed changes in pain catastrophizing and its impact on outcomes following total knee arthroplasty in Japanese patients. The results showed that while pain catastrophizing improved over time, it continued to negatively affect one-year satisfaction and functional outcomes. Addressing pain catastrophizing preoperatively may be crucial for optimizing long-term patient satisfaction after TKA.
105. Buller LT. Proceedings of the 2025 American Association of Hip and Knee Surgeons Annual Meeting. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.054
This article serves as a pre-proof proceedings report for the 2025 American Association of Hip and Knee Surgeons Annual Meeting, presenting early visibility of accepted manuscripts before final publication. It does not contain specific primary research findings or clinical implications, but rather outlines the editorial status and metadata of upcoming journal content.
107. Elsheikh R, Amsler F, Onoi Y, et al. Why Total Knees Fail and Re-Fail: An Analysis of 20,568 Revision Cases from the Swiss Implant Registry. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.039
Analyzing over 20,000 revision cases from the Swiss Implant Registry, this study identified trends in first and repeated revisions, noting that re-revisions account for a significant portion of revision burden. The findings highlight the need for improved primary surgical techniques and patient selection to reduce the rising volume of complex revision procedures.
108. Jummie Akinwunmi O, Buchalter WH, Greene NE, et al. Language-Concordant Preoperative Education is Associated with Reduced Readmission Rates After Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.045
This retrospective cohort study found that implementing language-concordant preoperative education via a Spanish-speaking nurse educator significantly reduced readmission rates for Spanish-speaking patients undergoing total knee arthroplasty. The results suggest that addressing language barriers through targeted educational interventions can effectively mitigate postoperative disparities and improve care quality for non-English-speaking populations.
110. Ueyama H, Nakagawa S, Fukunaga K, et al. Soft-Tissue Balance and Quadriceps Muscle Strength Are Associated with Patient-Reported Outcomes Following Total Knee Arthroplasty, Independent of Alignment Strategy: A Prospective Randomized Trial. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.042
This prospective randomized trial found that soft-tissue balance and quadriceps muscle strength, rather than the alignment strategy (kinematic vs. mechanical), were the independent predictors of patient-reported outcomes following total knee arthroplasty. The clinical implication is that surgeons should prioritize optimizing soft-tissue balance and muscle function over strict adherence to a specific alignment paradigm to maximize patient satisfaction.
111. Holle AM, Moore ML, Henderson AP, et al. Declining Medicaid Reimbursement for Total Hip and Knee Arthroplasty from 2014 to 2022: A Comparison of Expansion and Non-Expansion States. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.047
This study analyzed national and state-level trends in Medicaid reimbursement for total hip and knee arthroplasty from 2014 to 2022, revealing significant inflation-adjusted declines in physician payments for both procedures. The findings indicate a substantial erosion of reimbursement values, particularly in non-expansion states, which may impact access to care and provider participation in Medicaid programs.
112. Zheng W, Tang J, Xiao W, et al. Use of Zonal Fixation Therapy and Metal Augmentation for Rotating-Hinge Knee Arthroplasty in Charcot Arthropathy: A Comparative Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.048
This comparative study evaluated the use of zonal fixation therapy and metal augmentation for rotating-hinge knee arthroplasty in Charcot arthropathy, showing reliable prosthesis fixation and improved patient-reported outcomes. The results suggest that adhering to zonal fixation principles and utilizing metal augmentation can successfully manage complex bone defects in Charcot knees, offering a viable reconstructive strategy for this challenging condition.
113. Cruickshank M, Son H, Khalik HA, et al. Comparable Survivorship and Patient-Reported Outcomes Following Unicompartmental Knee Arthroplasty in Obese and Non-Obese Patients: An Updated Systematic Review. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.052
This systematic review and meta-analysis compared survivorship and patient-reported outcomes in non-obese, obese, and morbidly obese patients undergoing unicompartmental knee arthroplasty. The study found comparable short-term survivorship across all BMI groups, though mid-term survivorship was significantly lower in obese and morbidly obese cohorts. These findings suggest that while obesity may impact long-term implant survival, UKA remains a viable option with similar early outcomes for obese patients.
114. Sarmiento Riveros PA, Jaramillo Quiceno GA, Helito CP, et al. Arthroscope-assisted harvesting of the rectus femoris tendon graft: Surgical technique. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101163
This article describes a surgical technique for harvesting the rectus femoris tendon graft using arthroscopic assistance. The method aims to provide a minimally invasive approach for obtaining graft material, potentially reducing morbidity associated with open harvesting techniques. This technique offers surgeons an alternative option for graft procurement in ligament reconstruction procedures.
115. Newcomb NL, Flesner SL, Lebensohn H, et al. Increased Risk of Complications Associated with Magnetic Resonance Imaging Prior to External Fixation in Unstable Knee Dislocations. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101164
This study investigated the association between obtaining magnetic resonance imaging prior to external fixation and complication rates in patients with unstable knee dislocations. The authors found that pre-fixation MRI was associated with an increased risk of complications, suggesting that delaying definitive stabilization for imaging may be detrimental. Clinicians should prioritize prompt external fixation over preoperative MRI in unstable knee dislocations to minimize adverse outcomes.
117. Ducharme MT, Selemon NA, Bedard NA, et al. Classification and Outcomes of 214 Periprosthetic Patellar Fractures in Primary Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.003
This study analyzed the classification, management, and long-term outcomes of 214 periprosthetic patellar fractures following primary total knee arthroplasty. The results indicated high survivorship for intraoperative fractures, while postoperative fractures showed varying outcomes based on the Ortiguera and Berry classification. This data provides a comprehensive reference for predicting prognosis and guiding treatment strategies for periprosthetic patellar fractures.
118. D’Ambrosi R, Helito CP, Della Villa F, et al. Practice Patterns, Controversies, and Proposed Management Algorithm for Cyclops Syndrome After Anterior Cruciate Ligament Reconstruction: An International Survey. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101165
Précis unavailable.
119. de Geofroy B, Argenson J, Sculco PK, et al. Temporal Trends in Revision Burden Ratio for Hip and Knee Arthroplasty: A Comparative Analysis of Large National Registries. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.046
This comparative analysis of four national arthroplasty registries evaluated temporal trends in the revision burden ratio between total knee and total hip arthroplasties. The study found that while primary knee arthroplasty volumes exceeded hip procedures, the revision burden ratio trends varied across regions and over time. These findings highlight the need for continued monitoring of revision rates to optimize resource allocation and surgical planning for joint replacements.
120. Singh R, Williams DL, Alexander J, et al. Comparative Analysis of Clinically Meaningful Recovery Trajectories Following Unicompartmental Arthroplasty and Patello-Femoral Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.020
This retrospective study compared the time to achieve minimal clinically important differences in patient-reported outcomes among patients undergoing medial unicompartmental, lateral unicompartmental, and patellofemoral arthroplasty. The analysis revealed no significant differences in the rates or timing of functional recovery between the three procedures. These results suggest that all three arthroplasty options offer similar speed of functional improvement for patients with isolated compartmental knee osteoarthritis.
121. Ihekweazu UN, Walton S, Hannon CP. The American Association of Hip and Knee Surgeons Position Statement on Outpatient Joint Replacement. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.063
The American Association of Hip and Knee Surgeons issued a position statement endorsing the safety and efficacy of outpatient joint replacement for appropriately selected patients. This guidance aims to standardize practice and facilitate the expansion of ambulatory surgical care for total hip and knee arthroplasty.
122. Heo KY, McCall M, Sheth N, et al. Rising Volume of Periprosthetic Fractures After Primary Total Hip and Knee Arthroplasty: A Contemporary Epidemiologic Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.058
This study analyzed national databases to quantify the rising volume of periprosthetic fractures following primary total hip and knee arthroplasty between 2017 and 2022. The findings project a continued increase in emergency department visits and surgical management needs through 2035, highlighting a growing public health burden.
123. Culler MW, Iyer A, Lim MA, et al. Reassessing Total Joint Arthroplasty Case Volumes in The United States: Accounting for Ultra-Low-Volume Surgeons. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.067
Researchers reassessed total joint arthroplasty surgeon volumes by excluding ultra-low-volume practitioners to better reflect typical caseloads. The analysis revealed that while mean surgeon volume increased slightly, the average patient is treated by a surgeon with a significantly higher volume than previously reported averages suggest.
124. Playter KP, Gonzalez MR, Elkadi S, et al. Quarterly Trends in Total Knee Arthroplasty Utilization in the United States: Insurance Cost Sharing Drives Seasonal Variation. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.070
This retrospective study evaluated the impact of insurance cost-sharing on quarterly total knee arthroplasty utilization patterns. It found that higher out-of-pocket costs significantly reduced utilization, particularly in the first quarter, indicating that financial barriers drive seasonal variations in elective surgery scheduling.
125. McCormick KL, Schaffer O, Novikov D, et al. Is the Incidence of Conversion from Unicompartmental to Total Knee Arthroplasty Higher Among Surgeons Who Do Not Have Arthroplasty Fellowship Training?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.066
The study compared two-year conversion rates from unicompartmental to total knee arthroplasty between fellowship-trained and non-fellowship-trained surgeons. Results indicated no significant difference in conversion rates, suggesting that non-fellowship-trained surgeons can achieve comparable short-term outcomes in unicompartmental knee arthroplasty.
126. Herold JM, Ghirardelli S, Song YD, et al. Improving the Reliability of a Novel Baldini Classification for Revision Total Knee Arthroplasty: The Development and Validation of the Modified Grading System. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.061
Précis unavailable.
128. Bargagliotti M, Ponzo M, Zero E, et al. Unicompartmental Knee Arthroplasty in Octogenarians is a Safe and Durable Procedure: Outcomes at 12-Year Follow-Up. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.071
Précis unavailable.
129. Hershfeld B, Le J, Xie K, et al. Optimal Route of Tranexamic Acid Administration in Total Knee Arthroplasty: A Bayesian Network Meta-Analysis With Decision-Analytic Cost Evaluation. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.065
This Bayesian network meta-analysis compared various tranexamic acid administration routes in total knee arthroplasty, finding that combined regimens significantly reduced blood loss and transfusion risk more effectively than single routes. While all methods were superior to no treatment, the study suggests combined administration offers the best clinical efficacy, though cost considerations may influence optimal selection. These findings support the use of combined TXA protocols to maximize hemostatic benefits in TKA patients.
130. Giannakis P, Rowe JE, Ren R, et al. Trends of In-Hospital Mortality after Inpatient Elective Total Hip and Knee Arthroplasty: A 2016 to 2023 Population-Based Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.068
This population-based study analyzed inpatient elective hip and knee arthroplasty trends from 2016 to 2023, revealing a significant tripling of in-hospital mortality rates for total hip arthroplasty and a notable increase for total knee arthroplasty. Despite stable patient characteristics among those who died, the inflation-adjusted costs associated with mortality-related hospitalizations rose significantly for both procedures. These results highlight a concerning trend of rising mortality and costs in inpatient arthroplasty, warranting further investigation into care quality and patient selection.
131. Orringer M, Bolia IK, Villegas Meza AD, et al. Complication and Reoperation Rates of Post-Distal Femoral Osteotomy Total Knee Arthroplasty versus Primary Total Knee Arthroplasty: Matched Cohorts from a Nationwide Database. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.073
This matched cohort study compared outcomes of total knee arthroplasty performed after prior distal femoral osteotomy versus primary total knee arthroplasty, finding significantly higher risks of postoperative infection and hematoma in the post-osteotomy group. Patients undergoing TKA after distal femoral osteotomy faced a fourfold increased risk of infection and hematoma compared to those having primary procedures. Clinicians should be aware of these elevated perioperative risks when planning revision surgery for patients with prior osteotomies.
132. Laing E, O’Toole G, Queally JP, et al. Influence Of Compartment on Outcome And Survivorship In Unicompartmental Knee Arthroplasty In Younger Patients. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.072
This retrospective study evaluated the long-term survivorship and outcomes of unicompartmental knee arthroplasty in patients aged 55 or younger, demonstrating an overall 10-year survivorship of 89.3%. Lateral unicompartmental knee arthroplasty showed superior survivorship compared to medial procedures in this younger cohort, suggesting favorable long-term results for both compartments. These findings support the viability of unicompartmental knee arthroplasty as a durable option for younger patients with compartment-specific osteoarthritis.
133. Kara A, Karabulut N. The Effect of Mobile-Based Training on Anxiety, Kinesiophobia, and Physical Function in Patients Undergoing Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.075
This randomized controlled trial evaluated a mobile-based education and exercise program for total knee arthroplasty patients, finding that the intervention significantly reduced state anxiety, kinesiophobia, and pain while improving physical function and sleep quality compared to usual care. The study demonstrates that preoperative and post-discharge mobile health interventions can effectively address psychological and functional barriers to recovery. Implementing such digital tools may enhance perioperative outcomes and patient satisfaction in total knee arthroplasty.
135. Goldner M, Reddy HP, Biskup M, et al. Risk Factors for Increased Hospital Cost for Primary Total Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.074
This retrospective analysis of hospital billing data identified body mass index, American Society of Anesthesiologists physical status classification, and specific comorbidities as significant predictors of increased costs for primary total knee arthroplasty. Medical supplies constituted the largest portion of hospital costs, followed by room and board and operating room expenses. Understanding these cost drivers can help healthcare providers anticipate resource utilization and manage financial risks associated with complex TKA patients.