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Knee Injuries: Personalized Diagnosis, Treatment and Management
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Knee Injuries: Personalized Diagnosis, Treatment and Management

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: 17 April 2027 | Viewed by 2972

Editors

Dr. Gavin Wood

E-Mail Website
Guest Editor
Adult Hip and Knee Reconstructive Surgery, Division of Orthopaedic Surgery, Department of Surgery, Queen’s University & Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
Interests: hip; hip and knee replacement; knee injury; arthroscopy
Dr. Fernando Diaz Dilernia

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Guest Editor Assistant
Division of Orthopaedic Surgery, Department of Surgery, Queen's University & Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
Interests: hip and knee primary arthroplasty; hip and knee revision arthroplasty; periprosthetic joint infection; periprosthetic fracture complications

Special Issue Information

Dear Colleagues,

Knee injuries can affect the surrounding bones, cartilage, and ligaments, thereby impacting people's normal activities. Among these, knee osteoarthritis (OA) is a progressive degenerative joint disease characterized by the breakdown of cartilage, subchondral bone remodeling, synovial inflammation, and the formation of osteophytes. It is one of the leading causes of pain, disability, and reduced quality of life. When conservative management—including pharmacological treatment, physical therapy, and intra-articular injections—fails, total knee arthroplasty (TKA) becomes the definitive treatment.

TKA is a highly effective surgical procedure that aims to relieve pain, restore function, and improve mobility by replacing the damaged surfaces with prosthetic components. TKA has shown excellent long-term outcomes. However, as with any major surgery, it carries the risk of complications. These may include infection, deep vein thrombosis, aseptic loosening, periprosthetic fracture, stiffness, neurovascular injury, postoperative pain, and dissatisfaction due to unmet expectations or unexplained discomfort.

Understanding the pathophysiology of knee OA, the indications for TKA, and the potential complications is essential for selecting patients appropriately, providing preoperative counseling, and managing postoperative outcomes to optimize clinical outcomes.

This Special Issue aims to promote the development of diagnosis and treatment models of knee injuries in the era of personalized medicine, promote the transformation from basic research to clinical practice, and ultimately improve the quality of life of patients.

We welcome scholars to submit review articles and original research articles related to knee injuries and personalized medicine.

Dr. Gavin Wood
Guest Editor

Dr. Fernando Diaz Dilernia
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • knee osteoarthritis
  • personalized medicine
  • precision diagnosis
  • partial and total knee arthroplasty
  • periprosthetic frac-ture
  • complications
  • functional outcomes
  • instability
  • survivorship
  • periprosthetic joint infection

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

12 pages, 7920 KB  
Article
Robotic-Arm-Assisted Versus Manual Total Knee Arthroplasty: A Comparative Cohort Study of Gait and Postural Outcomes
by Dimitris Koukoulias, Eustathios Kenanidis, Michael Potoupnis, Panagiotis V. Tsaklis and Eleftherios Tsiridis
J. Pers. Med. 2026, 16(7), 386; https://doi.org/10.3390/jpm16070386 - 19 Jul 2026
Viewed by 474
Abstract
Background/objectives: Evidence on gait and postural recovery after robotically assisted total knee arthroplasty (raTKA), particularly with the ROSA system, remains limited. This study compared early gait, postural, functional, and patient-reported outcomes (PROMs) between ROSA raTKA and manual TKA (mTKA), with PROMs also assessed [...] Read more.
Background/objectives: Evidence on gait and postural recovery after robotically assisted total knee arthroplasty (raTKA), particularly with the ROSA system, remains limited. This study compared early gait, postural, functional, and patient-reported outcomes (PROMs) between ROSA raTKA and manual TKA (mTKA), with PROMs also assessed at final follow-up. Methods: This comparative cohort study included primary TKA patients treated by a single senior surgeon using the same implant and alignment strategy. Patients underwent either ROSA raTKA or mTKA. At three months, a senior physiotherapist assessed quadricep and tibialis anterior maximum voluntary isometric strength (MVIS), centre-of-mass (CoM) kinematics, lower-limb weight distribution, timed-up-and-go (TUG), range of motion (ROM), KOOS Pain, activities of daily living (ADL), and quality of life (QoL). The same KOOS domains were compared at final follow-up. Results: Seventy primary TKAs were included: 46 raTKAs and 24 mTKAs. No intraoperative complications occurred. Groups were comparable for age, BMI, sex, grip strength, and preoperative KOOS. At three months, no significant differences were found in quadricep MVIS (p = 0.257), tibialis anterior MVIS (p = 0.327), CoM kinematics (p = 0.066), weight distribution (p = 0.189), TUG (p = 0.599), ROM (p = 0.165), or KOOS domains. At final follow-up, KOOS-ADL (p = 0.041) and QoL (p = 0.032) were better in the raTKA group, but after Holm–Bonferroni correction, they were no longer significant (QoL, p = 0.384; ADL, p = 0.451). Conclusions: ROSA raTKA showed comparable early gait and postural recovery to mTKA. The marginal differences in KOOS domains are exploratory, as they were no longer significant after multiple-comparisons correction. Full article
(This article belongs to the Special Issue Knee Injuries: Personalized Diagnosis, Treatment and Management)
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15 pages, 10709 KB  
Article
Consistency of Subcortical Osseous Structures in Femoral Cruciate Ligament Attachment Sites: A Combined 3D-CT and Histological Anatomical Study
by Johannes Moritz Mittendorfer, Zehra Duezguen, Lukas Horak, Andreas Gahleitner, Elisabeth Marlene Mandler and Lena Hirtler
J. Pers. Med. 2026, 16(7), 352; https://doi.org/10.3390/jpm16070352 - 29 Jun 2026
Viewed by 282
Abstract
Background/Objectives: Accurate identification of the functional femoral attachment of the anterior (ACL) and posterior cruciate ligament (PCL) is essential for anatomic reconstruction and for patient-specific femoral tunnel planning, yet correct intraoperative localization remains inconsistent. This anatomical study investigated whether subcortical bone features [...] Read more.
Background/Objectives: Accurate identification of the functional femoral attachment of the anterior (ACL) and posterior cruciate ligament (PCL) is essential for anatomic reconstruction and for patient-specific femoral tunnel planning, yet correct intraoperative localization remains inconsistent. This anatomical study investigated whether subcortical bone features provide evidence of functional cruciate ligament attachment and whether surrounding osseous ridges are reliable landmarks. Methods: Computed tomography (CT) scans of 20 paired, fresh-frozen distal femora (10 body donors) were processed using 3D volume rendering to visualize the intercondylar fossa walls and to assess the presence of four characteristic ridges: lateral intercondylar ridge (LIR), lateral bifurcate ridge (LBR), medial intercondylar ridge (MIR) and medial bifurcate ridge (MBR). In addition, thin-ground section histology of the femoral insertion sites was performed to characterize insertion morphology. Results: Histology demonstrated distinct direct and indirect insertions for both ligaments; the direct insertion exhibited a characteristic four-layer transition (ligament, non-calcified fibrocartilage, calcified fibrocartilage, bone), whereas the indirect insertion showed collagen fibers attaching directly to bone. The LIR and MIR were present in 85% and 80% of specimens, respectively, while the LBR and MBR were less frequent (LBR 25%, MBR 10%). No significant associations were found between ridge presence and age, sex or laterality. Conclusions: These findings support the direct insertion as the functional cruciate attachment and suggest that the LIR and MIR—due to their consistent occurrence and location at the rim of the direct insertion—are the most useful bony landmarks for individualized femoral tunnel orientation, whereas bifurcate ridges should be considered adjunctive when present. The observed variability provides a rationale to stratify cases requiring adjunct imaging or navigation. Full article
(This article belongs to the Special Issue Knee Injuries: Personalized Diagnosis, Treatment and Management)
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11 pages, 615 KB  
Article
Patellofemoral Joint Replacement for Isolated Patellofemoral Osteoarthritis: Mid- to Long-Term Survivorship and Functional Outcomes
by Fernando Diaz Dilernia, Mutaz Tageldein, Emad Anam, Aaron Campbell and Gavin Wood
J. Pers. Med. 2026, 16(7), 345; https://doi.org/10.3390/jpm16070345 - 25 Jun 2026
Viewed by 374
Abstract
Background/Objectives: Patellofemoral joint (PFJ) replacement is a bone-preserving option for isolated patellofemoral osteoarthritis; however, reported survivorship and failure patterns remain variable. This study evaluated implant survivorship, functional outcomes, reoperations, and failure mechanisms following PFJ replacement using standard second-generation implant systems, with or without [...] Read more.
Background/Objectives: Patellofemoral joint (PFJ) replacement is a bone-preserving option for isolated patellofemoral osteoarthritis; however, reported survivorship and failure patterns remain variable. This study evaluated implant survivorship, functional outcomes, reoperations, and failure mechanisms following PFJ replacement using standard second-generation implant systems, with or without patellar resurfacing. Methods: We retrospectively reviewed a consecutive cohort of 39 patients (48 knees) who underwent PFJ replacement for isolated patellofemoral osteoarthritis between 2011 and 2021. Median age at surgery was 59 years, and median body mass index (BMI) was 31 kg/m2. Median follow-up for clinical and revision surveillance was 9 years (IQR 8–10). Functional outcomes were assessed using the Oxford Knee Score (OKS) and SF-12 Physical and Mental Component Scores (PCS and MCS). Implant survivorship was analyzed using Kaplan–Meier methodology, with conversion to total knee arthroplasty (TKA) as the endpoint. Statistical analyses were primarily descriptive and exploratory because only five TKA revisions occurred. Results: Median OKS improved from 19 (IQR 16–24) preoperatively to 36 (IQR 24–42) at the latest follow-up, with a median paired improvement of 17 points. SF-12 PCS improved from 25 to 47, and SF-12 MCS from 36 to 55. Eight knees (16.7%) underwent non-revision reoperation, and five knees (10.4%) underwent conversion to TKA. All TKA revisions were performed for the progression of tibiofemoral osteoarthritis. Kaplan–Meier survivorship free from TKA revision was 89.6% at 9 years (95% CI 76.8–95.5). No clear difference in TKA-free survivorship was detected between resurfaced and non-resurfaced knees. Conclusions: PFJ replacement demonstrated substantial functional improvement and mid- to long-term survivorship comparable to published registry ranges in a selected cohort with isolated patellofemoral osteoarthritis. TKA revision was uncommon and was attributable to the progression of tibiofemoral osteoarthritis. Because of the retrospective design, small cohort size, bilateral cases, and limited number of revision events, subgroup and risk-factor analyses should be interpreted as exploratory. Full article
(This article belongs to the Special Issue Knee Injuries: Personalized Diagnosis, Treatment and Management)
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11 pages, 224 KB  
Article
Personalized Surgical Decision-Making in Meniscal Tears: Short-Term Outcomes of Repair vs. Partial Meniscectomy in Mongolian Patients
by Orgil Zorigtbaatar, Nomin-Erdene Minjuurdorj, Baatarjav Sosor, Gonchigsuren Dagvasumberel, Bayasgalan Gombojav and Naranbat Lkhagvasuren
J. Pers. Med. 2025, 15(12), 578; https://doi.org/10.3390/jpm15120578 - 28 Nov 2025
Viewed by 1327
Abstract
Objectives: Arthroscopic meniscal surgery (AMS) is one of the most common orthopedic procedures worldwide, and its prevalence has been steadily increasing. In this study, we aimed to compare the short-term clinical outcomes (STCOs) and patient-reported outcome measures (PROMs) with anxiety and satisfaction [...] Read more.
Objectives: Arthroscopic meniscal surgery (AMS) is one of the most common orthopedic procedures worldwide, and its prevalence has been steadily increasing. In this study, we aimed to compare the short-term clinical outcomes (STCOs) and patient-reported outcome measures (PROMs) with anxiety and satisfaction in Mongolian patients. Methods: A prospective cohort study involved 103 patients who underwent arthroscopic knee surgery at The National Trauma Orthopedic Research Center and Grandmed Hospital in Mongolia between 2020 and 2023. STCO and PROM were calculated for the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores, the visual analog scale was assessed for pain (VAS), and Knee Range of Motion (ROM), Measures of Anxiety State-Trait Anxiety Inventory (STAI), and The Surgical Satisfaction Questionnaire (SSQ-8) were also used. Results: Out of 103 patients (69 for partial meniscectomy and 34 for meniscal repair), KOOSs improved significantly from pre-operative to post-operative levels. The Koos subscores for pain were 57.93 ± 12.58 pre-operatively and 80.93 ± 5.70 post-operatively; Koos subscores for Symptoms (KOOS Sx) were 54.13 ± 12.73, 80.27 ± 6.22; Koos subscores for Activities of Daily Living (KOOS ADL) were 61.28 ± 13.19, 79.61 ± 4.91; Koos subscores for Sports/Recreation (KOOS SR) were 42.28 ± 13.21, 72.04 ± 6.88; and Koos subscores for Quality of Life (KOOS QOL) were 45.08 ± 12.46, 77.85 ± 7.96. On the other hand, the pre-operative and post-operative results of the STAI were not significant (46.03 ± 8.2 vs. 39.59 ± 7.13, p = 0.781). Conclusions: In the present study, we elucidated patient- and injury-specific factors that may guide personalized surgical decision-making in Mongolian patients. Our findings suggest that AMS is a viable option for alleviating pain and enhancing function in the short term for patients with meniscal tears. The high PROMs and satisfaction scores reflect good-to-excellent results, and meniscal repair was associated with better outcome scores. While pre-operative anxiety levels were high, they decreased after surgery, although they did not entirely disappear. Full article
(This article belongs to the Special Issue Knee Injuries: Personalized Diagnosis, Treatment and Management)
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