Search Results (128)

Background/Objectives: Total knee arthroplasty (TKA) is an effective surgical intervention for end stage knee osteoarthritis in elderly patients, with emerging robotically assisted techniques aiming to enhance surgical precision and patient outcomes. This study aimed to compare medium-term balance and functional outcomes between robotically assisted and conventional manual TKA in community-dwelling elderly patients. Methods: This cross-sectional study included 50 elderly patients undergoing TKA, who were divided into robotically assisted (n = 25) and conventional manual (n = 25) groups. Demographic and clinical data, balance performance, and functional outcomes were compared at nearly 1.5 years postoperatively. Outcome measures included balance performance assessed by the Berg Balance Scale (BBS), pain via the Visual Analog Scale (VAS), knee function as measured by the Lysholm Knee Scoring Scale, quality of life using the Short Form-12 (SF-12), joint awareness as evaluated by the Forgotten Joint Score-12 (FJS-12), and surgical satisfaction. Results: The groups had similar demographic and clinical data regarding age, gender, follow-up duration, surgical time, and anesthesia type (p > 0.05). The robotically assisted group demonstrated better balance performance on the BBS (p = 0.043) and had a statistically shorter length of hospital stay (1.22 vs. 1.42 days; p = 0.005). However, no statistically significant differences were observed in VAS activity pain (p = 0.053), Lysholm Knee Scoring Scale (p = 0.117), SF-12 physical and mental scores (p = 0.174 and p = 0.879), FJS-12 (p = 0.760), and surgical satisfaction (p = 0.218). Conclusions: Robotically assisted TKA is associated with advantageous postoperative recovery, particularly in terms of balance performance, showing no clinical difference in other functional outcomes compared to the conventional manual technique. From a physical therapy perspective, these findings emphasize the importance of developing tailored and effective rehabilitation strategies in the medium term for functional recovery in the elderly population. Full article

Background/Objectives: Patellar instability in adolescents is a significant cause of short- and long-term morbidity and disability. Traditionally, patients with first-time patellar dislocation are managed nonoperatively, although most studies are not focusing on the adolescent athletic population. The primary objective of the current study was to compare patient-reported outcomes and complications in adolescent athletes who underwent surgery either after the first patellar dislocation or after the recurrence of the dislocation with a minimum postoperative follow-up of 48 months (48–75 months). Methods: A total of 39 adolescent athletes who underwent medial patellofemoral ligament (MPFL) reconstruction (Group A, after the first dislocation, and Group B, recurrent patella dislocation) were included in this study. In all the patients, the same MPFL reconstruction technique was applied using a semitendinosus autograft. The graft was fixed on the patella using a transverse tunnel and adjustable loop button fixation and, in the femur, using a tunnel and absorbable screw fixation. The tunnel was drilled obliquely to prevent penetration of the distal femoral physis. The preoperative and postoperative clinical and functional evaluations of the patients were conducted via the visual analog scale (VAS), the Lysholm Knee Scoring System, the Kujala Anterior Knee Pain Scale, and the Pediatric International Knee Documentation Committee (Pedi-IKDC), and the return to sports score was assessed via the Tegner Activity Scale (TAS). Results: At the latest follow-up, both groups demonstrated significant improvement in the Lysholm scores, with Group A achieving a mean of 92.57 ± 6.21 and Group B achieving a mean of 90.53 ± 8.21 (p = 0.062). Postoperatively, Group A achieved a mean Kujala score of 94.21 ± 9.23, whereas Group B reached 92.76 ± 12.39, with no statistically significant difference (p = 0.08). The Pedi-IKDC score improved postoperatively in both groups. In Group A, it increased from 67.98 ± 12.29 to 93.65 ± 4.1, and in Group B, from 56.21 ± 13.6 to 91.67 ± 6.21 (p = 0.067). The preoperative visual analog scale (VAS) score for pain was significantly lower in Group A (3.1 ± 1.13) than in Group B (4.2 ± 3.01, p < 0.01). At the latest follow-up, the VAS scores improved in both groups, with Group A reporting a mean score of 0.47 ± 1.01 and Group B 0.97 ± 1.32 (p = 0.083). The Tegner activity scores were similar between the groups preoperatively, with Group A at 7.72 ± 1.65 and Group B at 7.45 ± 2.09 (p = 0.076). Postoperatively, Group A had a mean score of 7.28 ± 2.15, whereas Group B had a mean score of 6.79 ± 3.70 (p = 0.065). The mean time to return to sports was significantly shorter in Group A (5.1 ± 1.3 months) than in Group B (7.6 ± 2.1 months) (p < 0.01). Overall, 84.61% of the patients returned to their previous activity level. Specifically, 95.2% (20/21) of patients in Group A achieved this outcome, whereas 72.22% (13/18) achieved it in Group B. Patient satisfaction was generally high, with 76% (16/21) of patients in Group A reporting being satisfied or very satisfied, compared with 77% (14/18) in Group B. Conclusions: MPFL reconstruction is a safe and effective procedure for both acute and recurrent patellar dislocation in adolescent athletes. While patients who underwent acute reconstruction returned to sport more quickly and showed higher absolute postoperative scores, the greatest overall improvement from preoperative to final follow-up was observed in those treated for recurrent instability. Both surgical approaches demonstrated high satisfaction rates and minimal complications, supporting MPFL reconstruction as a reliable option in both acute and recurrent cases. Full article

Background and Objectives: This study aimed to evaluate the influence of the angle and position of the tibial tunnel in the coronal and sagittal planes on short-term postoperative clinical outcomes following arthroscopic anterior cruciate ligament reconstruction (ACLR). Materials and Methods: This retrospective study included 40 patients who underwent anatomical ACLR between 1 January 2023 and 31 December 2023 and had a follow-up period of at least 4 months. The angle of the tibial tunnel on the AP radiograph and both the angle and anteroposterior position on the lateral radiograph were measured. Clinical evaluations were conducted using the Visual Analogue Scale (VAS), the International Knee Documentation Committee (IKDC) score, and the Lysholm Knee Score, along with measurements of knee flexion and extension, to assess short-term outcomes at 1, 2, and 4 months postoperatively. Results: In patients whose tibial tunnels were positioned at 40–50° in the coronal plane, Lysholm scores were significantly higher at the 2nd and 4th months compared to other angles. In the sagittal plane, a tunnel angle between 30° and 40° was associated with significantly increased IKDC scores at both the 2nd and 4th months. Additionally, tunnels with an anterior–posterior ratio of 0.4–0.6 in the sagittal plane were associated with limitations in flexion and extension at the 4th month. There was no significant difference in VAS scores between the groups. Conclusions: Our findings suggest that optimizing the tibial tunnel angle in both the coronal and sagittal planes may play a crucial role in early postoperative knee function. Specifically, tibial tunnels placed between 40° and 50° in the coronal plane and 30° and 40° in the sagittal plane were associated with higher functional scores. However, tunnels positioned with an anterior–posterior ratio of 0.4 to 0.6 were linked to greater joint motion limitation. These findings indicate that angular and positional optimization of the tibial tunnel may have contributed to improved functional recovery following ACL reconstruction. Full article

Background and Objectives: A prominent area of research in adolescent ACL reconstruction (ACLR) involves graft selection, with particular interest in the quadriceps tendon (QT) as an alternative to hamstring tendon (HT) autografts, although comparative studies on muscle strength outcomes and patient satisfaction in adolescents remain limited. This study aims to evaluate the influence of QT and HT autografts on muscle strength and satisfaction outcomes post-ACLR in adolescents. Methods: This prospective study was conducted at the Lithuanian University of Health Sciences, enrolling 68 patients aged 12–17. ACLRs were performed using QT or HT autografts. Muscle strength was assessed using an isokinetic dynamometer (Biodex), while patient satisfaction was evaluated through IKDC, Lysholm, and ACL-RSI surveys preoperatively and 12 months postoperatively. Results: 54 patients (24 QT and 30 HT) completed the study. The data are non-parametric and are presented as median (IQR). Isokinetic measurements indicated that QT harvesting led to significantly lower extension strength compared to HT 6 months (p = 0.019) and 12 months post-op (p < 0.001) but showed better H/Q ratios 6 months (p = 0.019) and 12 months post-op (p < 0.001). There was no significant difference between the QT and HT groups in ACL-RSI and Lysholm scores. IKDC scores were significantly higher in the HT group (p = 0.009). Conclusions: QT autografts provide favorable H/Q ratios, yet they exhibit weaker extension strength and lower satisfaction outcomes compared to HT. These results suggest a need for individualized rehabilitation protocols and further research to optimize ACLR graft selection for adolescents. Full article

Background and Objectives: The anterior cruciate ligament (ACL) is crucial for knee stability, preventing anterior displacement of the tibia and rotation relative to the femur. Despite ACL reconstruction (ACLR), residual instability is common, affecting knee function. Anterolateral ligament reconstruction (ALLR) alongside ACLR improves outcomes, as the ALL plays a significant role in rotational stability. This study aims to assess the clinical and functional outcomes of the ACLR+ALLR combination using biomechanical testing in patients with at least ten months of follow-up. Materials and Methods: This cross-sectional comparative cohort study involves patients with ACLR. Inclusion criteria were adult patients who underwent ACLR within the last 3 years, with the same surgical technique performed by a single operator. Patients underwent anamnestic and clinical evaluation and completed Lysholm and KOOS questionnaires. Biomechanical tests included a Unilateral Drop Jump, a Countermovement Jump with knee rotation, and a five-repetition Sit-To-Stand. Force platforms, a camera, and surface electromyography were used to assess biomechanical stability and joint function. Results: This study included 18 subjects, 5 with ACLR and ALLR, and 13 with ACLR alone. The groups showed no significant differences in the KOOS and Lysholm scales and clinical outcomes. Muscle trophism reduction compared to the contralateral limb was noted in both groups. Biomechanical evaluations showed no difference in Quadriceps muscle activity during the landing phase of the Drop Jump. However, the ACL-ALL group exhibited fewer spikes and fewer knee joint angular excursions during ground impact stabilization. In the 5-STS task, a significant difference was observed in the vertical force peak. Differences in muscle activity during foot rotation and force components during the jumping phase were noted in the Countermovement Jump. Conclusions: ACLR combined with ALLR shows similar perceived joint function but improved biomechanical joint stability. Further studies with larger samples and longer follow-ups are needed for validation. Full article

Background and Objectives: Infrapatellar fat pad impingement syndrome (IFPIS) is a relatively underdiagnosed cause of anterior knee pain. While conservative management is the initial approach, some patients require surgical intervention. This study aimed to evaluate the long-term clinical and radiologic outcomes following arthroscopic resection of the infrapatellar fat pad in patients with IFPIS. Materials and Methods: Eighteen patients (10 females, 8 males; median age 22) diagnosed with IFPIS and unresponsive to conservative therapy underwent arthroscopic partial or subtotal resection between 2007 and 2013. Diagnosis was based on physical examination (Hoffa’s test), MRI findings, and response to lidocaine injection. Clinical outcomes (VAS, IKDC-2000, Kujala, Lysholm, Tegner activity scores) and radiologic assessments (ISR, CDI, PFJ osteoarthritis grade) were evaluated preoperatively, at 2 years, and at a final follow-up (mean 148.7 months). Results: All clinical scores significantly improved postoperatively. VAS decreased from 7.25 ± 0.79 to 2.43 ± 1.50 at 2 years, and to 3.66 ± 1.50 at the final follow-up (p < 0.001). Similar long-term improvements were observed in the Kujala, IKDC-2000, Lysholm, and Tegner scores (all p < 0.001). Radiographic parameters including ISR and CDI remained stable, and there was no statistically significant progression in patellofemoral osteoarthritis. However, 5 of 18 patients (27.8%) reported persistent symptoms at long-term follow-up. Conclusions: Arthroscopic resection of the infrapatellar fat pad in patients with IFPIS showed favorable and sustained clinical outcomes over a 10-year follow-up, without significant radiological changes. These results suggest that arthroscopic resection is a viable treatment option when accurate diagnosis is established. Full article

The acquisition of electroencephalography (EEG) concurrently with functional magnetic resonance imaging (fMRI) requires a careful consideration of the health hazards resulting from interactions between the scanner’s electromagnetic fields and EEG recording equipment. The primary safety concern is excessive RF-induced heating of the tissue in the vicinity of electrodes. We have previously demonstrated that concurrent intracranial EEG (icEEG) and fMRI data acquisitions (icEEG-fMRI) can be performed with acceptable risk in specific conditions using a head RF transmit coil. Here, we estimate the potential additional heating associated with the addition of scalp EEG electrodes using a body transmit RF coil. In this study, electrodes were placed in clinically realistic positions on a phantom in two configurations: (1) icEEG electrodes only, and (2) following the addition of subdermal scalp electrodes. Heating was measured during MRI scans using a body transmit coil with a high specific absorption rate (SAR), TSE (turbo spin echo), and low SAR gradient-echo EPI (echo-planar imaging) sequences. During the application of the high-SAR sequence, the maximum temperature change for the intracranial electrodes was +2.8 °C. The addition of the subdural scalp EEG electrodes resulted in a maximum temperature change for the intracranial electrodes of 2.1 °C and +0.6 °C across the scalp electrodes. For the low-SAR sequence, the maximum temperature increase across all intracranial and scalp electrodes was +0.7 °C; in this condition, the temperature increases around the intracranial electrodes were below the detection level. Therefore, in the experimental conditions (MRI scanner, electrode, and wire configurations) used at our centre for icEEG-fMRI, adding six scalp EEG electrodes did not result in significant additional localised RF-induced heating compared to the model using icEEG electrodes only. Full article

Background: The isolated rectus femoris tendon (RT) is a less commonly used autograft for anterior cruciate ligament (ACL) reconstruction. Graft selection is a critical part of ACL reconstruction, especially in revision surgery. Hypothesis: This study compares patient-reported outcome measurements (PROMs) between revision ACL reconstruction with an RT autograft and a hamstring tendon (HT) autograft. We hypothesized that the RT autograft will yield comparable functional results and high patient satisfaction. Study Design: This was a cohort study; the level of evidence is III. Methods: Fifty-five patients (RT n = 28; HT n = 27) who underwent revision ACL reconstruction were included in this study, with a mean follow-up time of 40.3 months (range, 16.4–64.8) for RT and 61.2 months (range, 34.6–86.3) for HT. Apart from the harvesting technique, the surgical technique was the same for both groups. Clinical and intraoperative data were collected for our postoperative registry. In addition, funcinal outcome was measured using the International Knee Documentation Committee score (IKDC), the Lysholm score, Tegner activity scale, and numeric rating scale (NRS). The type and frequency of postoperative complications were documented. Results: At the final follow-up, no significant differences were observed between the RT and HT groups in the IKDC (mean ± SD: 74.7 ± 10.9 vs. 74.9 ± 12.9), Lysholm score (90.9 ± 15.0 vs. 89.0 ± 14.6), or Tegner activity scale (median [IQR]: 5 [4–6] vs. 5 [4–6]). The mean femoral tunnel diameter was 9.0 mm (range, 7.5–10 mm) for the RT and 8.2 mm (range 7.0–9.5 mm) for the HT. The use of the RT reduced the need for a two-stage procedure by 50% compared to HT (n = 5 vs. n = 10), although this difference was not statistically significant (p = 0.11). Stability measured by the Lachman test improved significantly in both groups from the pre- to postoperative period. Retear of the ACL graft was observed in two patients in both groups (7.1% RT and 7.4% HT). Conclusions: The RT and HT autografts achieved similar outcomes in PROMs for revision ACL reconstruction. Good tendon quality with parallel fibers and adjustable thickness characterize the RT. A tendency for a reduced rate of two-stage surgery with RT was noticed. Clinical Relevance: The incidence of revision ACL reconstruction is rising. Surgeons should be aware of all the available graft options. The isolated RT expands the range of autografts available for ACL reconstruction. Full article

Background: Total hip arthroplasty (THA) in adult patients with developmental dysplasia of the hip (DDH) presents unique surgical challenges due to altered hip anatomy and biomechanics. One of the most critical factors influencing surgical success is correcting femoral anteversion. This study evaluates the effects of different anteversion corrections (increased, unchanged, and decreased) during THA on clinical outcomes in adult Crowe type 3-4 DDH patients. Methods: A retrospective analysis was conducted on 130 patients who underwent THA with anteversion correction between 2008 and 2017 at a tertiary university hospital. Patients were divided into three groups: Group 1 (increased anteversion), Group 2 (unchanged anteversion), and Group 3 (decreased anteversion). Clinical outcomes were assessed using AOFAS and Lysholm scores, Q-angle measurements, and physical examinations, while radiological evaluations were performed to determine implant stability and complications. Results: Postoperative assessments show that increased anteversion is associated with higher rates of instability, knee dysfunction, and pain. Group 1 had significantly lower AOFAS scores (p < 0.001) and fell due to rotational deformity (25.6%). Group 2 exhibited the best clinical outcomes, with the lowest rates of instability and the highest functional scores. Group 3 had moderate functional improvements but a higher dislocation rate (17.1%) than Group 2. Conclusions: Our findings suggest that excessive changes in femoral anteversion during THA, remarkably increasing it, may negatively impact clinical outcomes by causing instability and pain. Preserving the anteversion angle as much as possible is the most favorable approach for optimizing functional recovery and implant stability. Further large-scale, long-term studies are required to confirm these findings and refine surgical strategies for DDH patients undergoing THA. Full article

Background: Anterior cruciate ligament (ACL) injuries are common among athletes and significantly impact their knee stability and performance. Surgical reconstruction is the standard treatment. The modified transtibial technique has emerged as a promising surgical approach for optimal graft positioning and complication reduction. Methods: A retrospective study of athletes who underwent primary ACL reconstruction with the modified transtibial technique was conducted. Clinical outcomes were evaluated using the Lysholm and International Knee Documentation Committee (IKDC) subjective scores and objective knee stability assessments. Return-to-sport rates and associated factors were analyzed. Results: Forty-four athletes were included (thirty-seven males, seven females; mean age 21.2 ± 5.0 years). At mean follow-up of 27.0 ± 12.2 months, significant improvements in the Lysholm and IKDC subjective scores were observed. Overall, 88.2% of athletes returned to sports, and 65.9% achieved their pre-injury levels. Return to pre-injury level was defined as regaining the same type, intensity, and frequency of sport participation as before the injury occurred. Professional athletes showed significantly higher return-to-pre-injury-sport rates (79.3%) than recreational athletes (40.0%, p = 0.0091). Concomitant meniscus injuries negatively impacted return-to-sport rates (92.9% versus 66.7%, p = 0.0397). The overall failure rate was 4.6% (2/44; 95% confidence level [CI]: 0.6–15.5%) with two cases of graft insufficiency or re-rupture. Conclusions: ACL reconstruction with the modified transtibial technique provides favorable clinical outcomes, high return-to-sport rates, and low failure rates, particularly among professional athletes. Meniscus preservation is crucial for optimizing post-operative recovery. Future research should focus on long-term outcomes and comparative studies with other ACL reconstruction techniques. Full article

Anterior cruciate ligament reconstruction with concurrent lateral extra-articular tenodesis enhances rotational stability. However, not many studies describe radiological features following the abovementioned procedure. The purpose of this study was to evaluate the visibility and describe the sonographic morphology of the iliotibial band strip harvested during the modified Lemaire technique and to establish a correlation between these findings and clinical outcomes. Thirty-two consecutive patients underwent primary or revision anterior cruciate ligament reconstruction with the addition of lateral extra-articular tenodesis by the mini-open modified Lemaire technique. All individuals completed the following preoperative and postoperative questionnaires: the KOOS-pain, KOOS-symptoms, KOOS-ADL, KOOS-sport, KOOS-quality, IKDC, Lysholm, and WOMAC. Each patient underwent a postoperative ultrasound examination to evaluate the lateral extra-articular procedure, especially the harvested iliotibial band strip. The most common ultrasound findings of the iliotibial band strip were its hyperechoic appearance (87.1%), location at the level of the femur (58.1%), no surrounding effusion (83.9%), and no power Doppler signal (100%). Effusion seen in sonographic images was correlated with KOOS-symptoms postoperative scores (p = 0.0115). However, there were no correlations between other iliotibial band strip sonographic features and clinical outcomes. The functional score value increased in each patient compared to preoperative measurements. This is the first study that evaluated the sonographic features of the iliotibial band strip after the lateral extra-articular procedure by the mini-open modified Lemaire technique. Our study indicates that ultrasonography is a useful tool in identifying the iliotibial band strip after the mentioned procedure. Effusion observed around the strip on ultrasound was significantly associated with worse KOOS-symptoms scores, suggesting potential clinical relevance. Full article

Background/Objective: Tibial eminence avulsion fracture (TEAF) is a traumatic injury of the anterior cruciate ligament that occurs in children with an immature skeletal system. It has an incidence of 3 per 100,000 children, with an increasing prevalence over time. The objective of this study was to evaluate the long-term clinical and subjective outcomes of displaced TEAF requiring surgical intervention and to assess the return to sport. Methods: A retrospective cohort study was conducted, identifying all patients who underwent arthroscopic-assisted TEAF refixation at HFR-Fribourg between 2012 and 2020, performed by a single surgeon. A total of fifteen patients were included for descriptive analysis, while twelve patients underwent clinical assessment of knee joint stability and functional outcomes using patient-reported outcome measures (PROMs): Pedi-IKDC, Lysholm, Tegner, and Marx. Results: Of the fifteen patients, fourteen had type III and one had type II TEAF according to the McKeever classification. The mean age at the time of injury was 11.5 years, and the average time between surgery and long-term follow-up was 5.1 years (range: 0.9–8.9 years). For the primary outcomes of the operated knee, no significant differences were observed in muscle mass or range of motion between the operated and non-operated limbs (p > 0.05). Anterior knee stability, as assessed by the Lachman test and Rolimeter, showed no significant difference between the operated and non-operated knee (p > 0.05). Regarding secondary outcomes, the Pedi-IKDC and Lysholm scores were 98 out of 100, the Tegner score was 5.5 out of 10, and the Marx score was 14.5 out of 20 at the final follow-up. There were no significant differences in the number of hours per week or frequency of sport activity (mean three times per week) before and after surgery. Conclusions: The surgical treatment for displaced TEAF, specifically the pull-out suture technique with arthroscopic assistance, demonstrates excellent clinical and functional outcomes, with high recovery rates and restored knee stability. This technique allows patients to return to sports without significant impairment. Although no comparative analysis was performed, these findings provide a foundation for future studies to further validate and compare the effectiveness of this surgical approach. Full article

Background and Objectives: The present systematic review investigated the efficacy of lateral extra-articular tenodesis (LET) and anterolateral ligament (ALL) as lateral extra-articular procedures (LEAPs) for anterior cruciate ligament (ACL) reconstruction. ACL reconstruction using LEAP may reduce graft rupture and rotatory laxity and allow a quicker return to sports. The outcomes of interest were patient-reported outcome measures (PROMs), return to sport, laxity, failure rate, and safety profile. Materials and Methods: The present systematic review followed the 2020 PRISMA guidelines. In December 2024, PubMed, EMBASE, and Web of Science were accessed without constraints. All clinical investigations evaluating LEAP for ACL reconstruction were considered. Only studies that considered LET and ALL as LEAP were considered. Only studies using a hamstring tendon autograft associated with LET or ALL were considered. Results: Data from 27 clinical studies (3423 patients) were retrieved. The mean length of follow-up was 61.8 ± 39.5 months. ACL reconstruction using LEAP led to a statistically significant improvement in the Lysholm score (p < 0.01) and IKDC (p < 0.01). The mean joint laxity, as measured by the arthrometer, was 1.5 ± 1.8 mm. Finally, 72.3% (623 of 668) of patients returned to their pre-injury level of sport at a mean of 6.3 ± 4.4 months. At the last follow-up, the LET group showed greater IKDC (p = 0.04). On the other hand, there was a statistically significant greater rate of patients positive to the Lachman test (p < 0.01), return to sport (p < 0.01), and reoperation (p = 0.01). No significant differences were found in Lysholm scores (p = 0.6), Tegner scores (p = 0.2), arthrometer measurements (p = 0.2), Pivot shift test results (p = 0.1), time to return to sport (p = 0.3), and failure rates (p = 0.7). Conclusions: LEAP for ACL reconstructions seems to be effective and safe. Most patients returned to their pre-injury level of sport after a mean of 6 months. LET-based ACL reconstruction may be associated with greater clinical outcomes and a higher reoperation rate compared to ALL-based reconstruction. Full article

Background/Objectives: Popliteal artery injury is a rare but devastating complication of knee dislocations, significantly increasing the risk of limb ischemia, amputation, and poor functional outcomes if not promptly managed. This systematic review primarily evaluates the functional outcomes associated with this injury but also reviews current research on diagnostic modalities and treatment strategies to provide a comprehensive understanding of this severe orthopedic and vascular injury. Methods: A systematic search of PubMed, in accordance with PRISMA Guidelines, identified 144 studies, of which 13 full-text articles were assessed for eligibility after excluding 131 during the title and abstract screening. Six studies were excluded due to missing vascular injury or functional outcome data or being written in a foreign language, leaving seven studies for inclusion. These studies were predominantly retrospective, focusing on knee dislocations with popliteal artery injury and reporting validated functional outcomes such as the Lysholm and International Knee Documentation Committee (IKDC) scores. The data were synthesized narratively due to heterogeneity in the study designs, interventions, and outcome reporting. Results: Patients with vascular injuries consistently demonstrated poorer functional outcomes compared to those without, with mean or median Lysholm and IKDC scores consistently being lower than non-vascular injury patients. Increased BMI, delayed intervention, and multi-ligamentous injury were associated with worse outcomes, highlighting the importance of timely surgical management. Early repair and grafting techniques improved functional recovery, while diagnostic modalities such as Doppler ultrasound and CT angiography showed high sensitivity in detecting vascular injury. Complications included limb ischemia, prolonged rehabilitation, and amputation, often linked to delayed diagnosis. Conclusions: Knee dislocations with popliteal artery injury require rapid diagnosis and early surgical intervention to optimize functional outcomes and reduce complications. Standardized outcome measures and high-quality prospective research are needed to refine management strategies and address patient-specific factors like BMI. Full article

Background/Objectives: Multiligament knee injuries, involving damage to multiple stabilizing structures, present a significant challenge in orthopedic surgery, often resulting in knee instability and compromised function. While anatomic ligament reconstruction has been traditionally advocated, non-anatomic techniques may provide effective alternatives, particularly for patients with moderate functional demands who do not require high-level athletic performance. Material and methods: In this study, we assessed the outcomes of a non-anatomic, hybrid surgical approach involving combined arthroscopic and open non-anatomic ligament reconstruction in 60 patients with multiligament knee injuries. Using simplified reconstruction methods for the medial collateral ligament (MCL) and lateral collateral ligament (LCL), we tailored the procedures to the needs of active, non-professional patients. Functional outcomes were evaluated using the International Knee Documentation Committee (IKDC) Questionnaire, Lysholm Knee Scoring Scale, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: Postoperative improvements were significant, with the total IKDC score increasing from a median of 39.1 preoperatively to 75.9 postoperatively, Lysholm from 61.0 to 87.0, and KOOS from 47.6 to 85.7 (p < 0.01). The results demonstrated significant improvements across all scoring systems, with enhanced knee stability, reduced pain, and better quality of life. Conclusions: These findings support the feasibility of non-anatomic reconstructions as a practical solution for patients seeking a return to daily activities and recreational sports without the complexity of full anatomic reconstruction. Full article