Search Results (1,099)

Meniscal preservation is increasingly recognized as a critical determinant of long-term knee joint health, yet successful repair remains challenging due to the meniscus’s limited intrinsic healing capacity. The adult meniscus is characterized by restricted vascularity, low cellularity, a dense extracellular matrix, complex biomechanical loading, and a hostile post-injury intra-articular inflammatory environment—factors that collectively impair meniscus healing, particularly in the avascular zones. Over the past several decades, a wide range of biologic augmentation strategies have been explored to overcome these barriers, including synovial abrasion, fibrin clot implantation, marrow stimulation, platelet-derived biologics, cell-based therapies, scaffold coverage, and emerging biologic and biophysical interventions. This review summarizes the biological basis of meniscal healing, critically evaluates current and emerging biologic augmentation techniques, and integrates these approaches within a unified framework of vascular, cellular, matrix, biomechanical, and immunologic targets. Understanding and modulating the cellular and molecular mechanisms governing meniscal degeneration and repair may enable the development of more effective, mechanism-driven strategies to improve healing outcomes and reduce the risk of post-traumatic osteoarthritis. Full article

Background/Objectives: Lower extremity injuries represent a major health concern in elite snowsport disciplines, where high mechanical loads, complex movement patterns, and demanding environmental conditions substantially increase injury risk. Understanding injury incidence and burden in this population is essential for developing sport- and sex-specific prevention strategies. This retrospective study determined lower extremity injury incidence and burden among elite snowsport athletes. Methods: Ninety-nine Turkish National Snowsport Teams Training Camp athletes (34 females; 65 males) consented to a review of their medical records for injury incidence. Overall, sex- and sport-specific injury incidence (number/10,000 h) and burden (weeks missing/10,000 h) were calculated. Results: Overall, medial tibial stress syndrome (MTSS) was the highest burden (9.5 ± 38.7), and ankle sprain (1.7 ± 0.4) was the highest-incident injury. However, injury incidence and burden patterns differed by sex and sport. Notably, medial tibial stress syndrome (MTSS) showed comparable incidence in female and male athletes but resulted in a substantial injury burden in both sexes, reflecting prolonged time-loss from training and competition and indicating a meaningful negative impact on athletic performance. Specifically, the highest-burden injury for women was anterior cruciate ligament (ACL) rupture (16.2 ± 64.5), and for men the most common injury was MTSS (9.7 ± 40.7). For cross-country skiers, MTSS had the highest burden and incidence. For all other sports, and across sexes, ankle sprain was the highest incidence injury—women (1.3 ± 3.0), men (2.0 ± 4.5), biathletes (2.3 ± 5.7), Alpine skiers (2.8 ± 4.5), ski jumpers (1.6 ± 3.1), and snowboarders (3.2 ± 4.7)—plus the highest-burden injury for biathletes (6.9 ± 14.3) and ski jumpers (6.0 ± 14.0). The highest burden injury for Alpine skiers was ACL damage (34.3 ± 87.2), and for snowboarders it was knee collateral ligament injury (27.8 ± 78.6). Moreover, patellar tendinitis, hamstring strains, calf strains, Achilles ruptures, anterior tibial pain, meniscus tears, and hip injuries were frequently observed in injury patterns. Conclusions: Ankle sprains were the most frequent lower extremity injury in elite snowsport athletes, whereas medial tibial stress syndrome (MTSS) and anterior cruciate ligament (ACL) injuries accounted for the greatest injury burden. Injury incidence and burden differed by sex and snowsport discipline. Full article

Background: Patient-reported outcome measures (PROMs) provide important insights into recovery after anterior cruciate ligament reconstruction (ACLR). Previous research suggests that males and females recover differently after ACLR, with females reporting greater pain, slower functional gains, and lower psychological readiness at later stages of rehabilitation. However, it is unknown if patient-reported outcomes differ by sex early after ACLR. To address this gap, we conducted a cross-sectional analysis comparing patient-reported outcome measures between sexes three months after ACLR. We hypothesized that females would report worse PROMs compared to males. Methods: This cross-sectional analysis used data from a prospectively maintained ACL reconstruction cohort. Fifty-six individuals (female: 23 and male: 33) with primary, unilateral ACLR completed PROMs three months after surgery. These PROMs included the Knee Injury and Osteoarthritis Outcome Score (KOOS; Symptoms, Pain, Activities of Daily Living, Sport and Recreation, Quality of Life), International Knee Documentation Committee (IKDC) subjective score, Knee Outcome Survey–Activities of Daily Living Scale (KOS-ADLS), Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI), and the Tampa Scale of Kinesiophobia (TSK). All outcomes were expressed on a 0 to 100 percent scale, with higher scores indicating better outcomes, except for TSK, where lower scores indicated better outcomes. Normality was assessed within sex, using the Shapiro–Wilk test. Two-tailed independent-samples t-tests with Welch correction were used for approximately normal variables; otherwise, Mann–Whitney U tests were utilized (α = 0.05). Several outcomes had limited statistical power to detect MCID-sized differences, and findings for these measures should be interpreted cautiously. Results: No significant differences between sexes were found for any of the PROMs. Males trended towards having better KOOS Sport and Recreation and IKDC, but these were not statistically significant, and the effect sizes were small-to-moderate. Conclusions: No statistically significant sex-based differences were detected in PROMs at approximately 3 months after ACLR, indicating that any sex-related divergences between these measures may not occur until later in recovery. Full article

Background: The optimal timing and staging of anterior cruciate ligament reconstruction (ACLR) in patients with concomitant medial collateral ligament (MCL) injury remain controversial. This study aimed to compare clinical outcomes between a one-stage ACLR group and a two-stage ACLR group in patients with combined ACL and MCL injuries in which the MCL was surgically managed. Methods: This retrospective study included 68 patients with combined ACL and grade III MCL injuries treated with ACLR and MCL surgery. Patients were divided into the one-stage ACLR group (n = 42) and the two-stage ACLR group (n = 26) according to the timing and staging of ACLR relative to MCL surgery. Clinical outcomes, including knee stability, patient-reported outcomes, and range of motion (ROM), were compared between groups. Results: After a minimum 2-year follow-up, both groups demonstrated significant improvements in clinical and stability outcomes, with enhanced anterior knee stability, improved patient-reported outcomes, and better objectively assessed knee function. No significant differences were found between groups in anterior, valgus (one-stage: 1.8 ± 1.1 mm, two-stage: 2.3 ± 1.3 mm; p = 0.160), or rotational stability. Likewise, there were no significant differences in mean flexion deficits (one-stage: 2.6 ± 4.1°, two-stage: 1.0 ± 2.0°; p = 0.137), mean extension deficits (one-stage: 1.5 ± 2.5°, two-stage: 1.3 ± 2.0°; p = 0.137), flexion deficits ≥10° (one-stage: 9.5% [4/42], two-stage: 0%; p = 0.290), extension deficits ≥ 5° (one-stage: 9.5% [4/42], two-stage: 3.8% [1/26]; p = 0.642), or additional procedures for postoperative stiffness (one-stage: 16.7% [7/42], two-stage: 11.5% [3/26]; p = 0.730). Patient-reported outcomes, including the Lysholm and IKDC subjective scores, were also comparable between groups. Conclusions: Both the one-stage ACLR group and the two-stage ACLR group for surgically managed combined ACL and MCL injuries yielded comparable clinical and stability outcomes, suggesting that one-stage ACLR can be performed without an apparent increase in the risk of postoperative stiffness or ROM limitations. However, given the limited sample size, these results should be interpreted cautiously because the study may have been insufficiently powered to detect small clinically meaningful differences. Full article

Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction is widely recognised as the primary treatment for ACL injuries. However, with the increasing incidence of sports-related injuries and growing demand for rehabilitation services, conventional rehabilitation models—largely reliant on therapists’ experience and subjective assessment—are increasingly insufficient to meet the clinical need for precise and individualised rehabilitation programmes. This study aimed to evaluate the effectiveness of a rehabilitation protocol incorporating an artificial intelligence (AI)-based assessment and correction system on functional recovery following ACL reconstruction. Methods: Using convenience sampling, 80 patients undergoing ACL reconstruction between June to December 2024 were recruited for this randomised controlled trial. Participants were randomly assigned to either a control group (n = 40), which received conventional functional exercise training, or a trial group (n = 40), which received rehabilitation intervention guided by an AI-based assessment and correction system. Knee function scores (Lysholm score, IKDC score), Berg Balance Scale (BBS) scores, joint range of motion (ROM), and rehabilitation exercise compliance scores were collected and analysed 1, 2, 3, and 4 months postoperatively. Results: Compared with the control group, the trial group demonstrated significantly greater improvements in Lysholm score, IKDC score, BBS score, and active knee joint ROM (p < 0.05) at postoperative assessment points. Additionally, rehabilitation exercise adherence was significantly higher in the trial group compared to the control group (p < 0.05). Conclusions: Rehabilitation protocols integrating AI-based assessment and correction systems effectively enhance knee function recovery, joint mobility and balance ability following ACL reconstruction. Moreover, these protocols significantly improve rehabilitation exercise adherence, demonstrating superior efficacy compared to conventional rehabilitation approaches. This digital rehabilitation model represents an efficient and promising intervention for postoperative ACL rehabilitation. Full article

Total hip arthroplasty (THA) is a widely performed procedure that significantly enhances patients’ quality of life. However, nerve injury remains a concerning complication, with an incidence ranging from 0.6% to 3.7%, depending on patient and surgical variables. This narrative review provides a comprehensive overview of nerve injuries associated with THA, focusing on etiology, risk factors, clinical manifestations, prevention, and treatment strategies. The most affected nerves include the sciatic, femoral, lateral femoral cutaneous (LFCN), superior gluteal, and obturator nerves. Anatomical factors such as developmental hip dysplasia (DDH), limb length discrepancy, and aberrant nerve courses, along with patient-specific conditions like female sex, obesity, and pre-existing spinal disorders, increase the risk of nerve damage. Surgical complexity, revision procedures, and surgeon experience also influence injury likelihood. Clinical manifestations range from sensory disturbances to motor deficits including foot drop, Trendelenburg gait, or impaired knee extension, depending on the nerve involved. Diagnosis is primarily clinical, supported by electrophysiological studies and imaging when needed. Prevention hinges on careful preoperative planning, appropriate surgical approach selection, meticulous intraoperative technique, and attention to limb positioning. Treatment is typically conservative, involving pain control, physical therapy, and neurostimulation. In refractory or severe cases, interventions such as nerve decompression, repair, or tendon transfer may be considered. Pharmacological agents including vitamin B12, tacrolimus, and melatonin show potential in promoting nerve regeneration. Although most nerve injuries resolve spontaneously or with conservative measures, some cases may result in long-term deficits. Understanding the mechanisms, risk factors, and management strategies is essential to mitigating complications and optimizing functional outcomes in patients undergoing THA. Full article

Cleated footwear in football increasingly incorporates sex-specific design features intended to address a clear gap in anthropometric and biomechanical differences in female athletes. However, experimental evidence evaluating how these designs may influence lower-extremity biomechanics during sport tasks in female athletes remains limited. The purpose of this exploratory pilot study was to examine the effects of sex-specific footwear on lower-extremity biomechanics, plantar pressure distribution, and perceived comfort in female football players during unanticipated side-step cutting. The study used a controlled laboratory-based repeated measures design. Twenty female football players performed unanticipated side-step cutting tasks in two randomized footwear conditions: a standard commercially available control cleat (CT) and a female-specific prototype cleat (PT). Ankle and knee biomechanics, in-shoe pressure distribution, and subjective comfort ratings were assessed. Compared with the CT, the PT cleat had reduced peak ankle inversion angle, inversion angular velocity, and inversion moment, indicating altered ankle biomechanics during cutting. No differences were observed in knee abduction between footwear conditions. However, participants subjectively rated greater comfort in CT compared to PT. Peak pressure was higher in the midfoot and central forefoot in the PT footwear compared to the CT. Given the pilot nature of the study, with multiple footwear alterations, the findings should be interpreted as hypothesis-generating and used to inform future targeted investigations. Full article

Background/Objectives: Meniscal root tears, particularly those of the posterolateral root, are frequently associated with anterior cruciate ligament (ACL) injuries and significantly alter load distribution and knee stability. Surgical repair of the posterolateral meniscal root (PLMR) aims to restore normal biomechanics; however, postoperative rehabilitation strategies remain heterogeneous. The objective of this systematic review was to describe and analyze postoperative weight-bearing (WB) and range-of-motion (ROM) protocols following concomitant PLMR repair and anterior cruciate ligament reconstruction (ACLR), integrating both clinical and biomechanical perspectives. Methods: This systematic review followed PRISMA guidelines and analyzed biomechanical and clinical studies assessing postoperative WB and ROM management following PLMR repair combined with ACLR. Results: Eleven studies were included, describing heterogeneous postoperative rehabilitation protocols for WB and ROM following posterolateral meniscal root repair with ACLR. Biomechanical data consistently showed that root section increased tibial internal rotation and contact pressure on the lateral tibial plateau, whereas repair restored near-native load sharing. Clinically, most authors recommended non-weight-bearing or toe-touch loading for 4–6 weeks and flexion limited to 0–90° during early rehabilitation. Gradual progression to full loading and motion between 8 and 12 weeks was the most consistent strategy. Conclusions: Although the current evidence is limited and mainly based on low-level studies, available data suggest that a cautious and progressive rehabilitation protocol after PLMR repair with ACLR early controlled motion and delayed full loading may optimize repair healing while protecting graft integrity. Full article

Background and Objectives: Lower-extremity injuries are common among female athletes; however, their multifactorial predictors remain insufficiently understood. Given the interplay between physiological and psychological readiness in athletic performance, identifying the factors that influence lower limb performance is crucial for effective injury prevention. This study aimed to evaluate the predictive effects of physiological (VO₂peak, anaerobic power, agility, and isokinetic strength) and psychological (resilience and self-efficacy) variables on functional performance related to risk of injury. Materials and Methods: This cross-sectional study included 60 athletes with a mean age of 24.5 ± 6.90 years and mean body mass index of 23.12 ± 3.6 kg/m² (range: 16–30 kg/m²). The testing protocol included anthropometric measurements, the Lower Extremity Functional Test (LEFT), Wingate anaerobic cycling test, assessments of aerobic capacity, isokinetic muscle strength, and jumping performance (Single-Leg Hop [SLH] and Standing Long Jump [SLJ] tests). Psychological assessments included the General Self-Efficacy Scale (GSES) and a resilience questionnaire. A hierarchical regression analysis was performed. Results: The participants trained 5 ± 2 days per week and had 42 ± 39 months of sports experience. The mean VO_2peak was 40.82 ± 5.8 mL·kg⁻¹·min⁻¹, relative anaerobic peak power was 7.53 ± 1.92 W/kg, and fatigue index was 60.63 ± 15.41%. The mean isokinetic knee extension and flexion torque were 184.55 ± 44.60 N·m and 95.08 ± 21.44 N·m, respectively, with a flexion-to-extension ratio of 53.5%. The mean LEFT completion time was 160 ± 22 s. The participants demonstrated moderate resilience (BRS = 21 ± 4) and good self-efficacy (GSES = 33 ± 7.5). Among the psychological variables, GSES exhibited a modest negative correlation with LEFT (r = −0.28, p = 0.02). No significant associations were found between LEFT and psychological resilience. Longer LEFT completion times were associated with lower VO_2peak, mean power, and jump distance (p < 0.01). In the final model (R² = 0.58, p = 0.02), SLH (β = −0.54), VO_2peak (β = −10.32), and GSES (β = −0.70) were the strongest independent predictors of LEFT performance. Conclusions: SLH distance, VO_2peak, and general self-efficacy are key predictors of functional performance on the LEFT among female athletes. These factors may serve as practical indicators for identifying athletes who could benefit from targeted injury prevention programs. Full article

Background, Clinical Significance: Anterior cruciate ligament (ACL) injuries are common, however the occurrence of concurrent gastrocnemius muscle tears is exceptionally rare. Given this, the diagnosis and management of this pattern of injury is poorly characterised, with lack of current clinically relevant classification systems and evidence-based guidelines to guide treatment. Early recognition is essential. with advanced imaging critical to guiding the diagnosis and management of patients with this pattern of injury. Case presentation: A 39 year old man presented with acute right knee swelling, pain and difficulty weightbearing following a sports-related fall. Clinical examination was suspicious for an ACL injury. Magnetic Resonance Imaging (MRI) of the knee demonstrated the disrupted and displaced ACL fibres, with extensive peri-cruciate oedema around the expected position of the ACL. It was associated with partial avulsion of the medial gastrocnemius origin and incomplete avulsion of the lateral gastrocnemius origin. The patient was referred for an urgent orthopaedics review and is currently on trial of conservative management. Conclusions: In this case report and review of the literature, we evaluate the current understanding of the complexities of combined musculoskeletal injuries and limitations of existing classifications in providing accurate diagnosis and management strategies. Given the rarity of this presentation, the case underscores the lack of evidence-based recommendations for early management, particularly in young, active individuals who are at risk of significant long-term functional impact. Full article

Background: This study aims to evaluate the effect of hand grip strength (HGS) on perioperative outcomes—particularly postoperative delirium (POD)—in patients scheduled for total knee arthroplasty (TKA). Methods: Older female patients, aged ≥ 65 years, who were scheduled for TKA under general anesthesia were enrolled in this study. We measured preoperative HGS and clinical frailty scale. The primary outcome was the incidence of POD within 30 days of surgery. Secondary outcomes included intraoperative hypotension, surgical site infection, postoperative pulmonary complications, postoperative nausea and vomiting, acute kidney injury, postoperative urinary retention, and hospital length of stay. Results: The final analysis was conducted on 78 participants. The median HGS was 17.9 kg, the patients were divided into Weak (HGS ≤ 17.9, n = 39) and Strong groups (HGS > 17.9, n = 39). POD was more prevalent in the Weak group (23.1% vs. 0.0%, p = 0.005). As secondary outcomes, there were no significant differences between the two groups, except the postoperative estimated glomerular filtration rate (101 [90; 120.5] mL/min/1.73 m² in the Weak group vs. 122 [104; 138] mL/min/1.73 m² in the Strong group; p = 0.007). In the receiver operating characteristic curve analysis of POD occurrence according to HGS, the cutoff value was 17.5 (area under curve 0.88, p < 0.001). In univariate logistic regression analysis, age and HGS were associated with the occurrence of POD. In multivariate logistic regression analysis, HGS was the only factor that affects POD. For each 1 kg increase in HGS, the risk of POD decreased by 28% (Odds ratio: 0.72). Conclusions: In this study, lower preoperative HGS was significantly associated with the occurrence of POD. Full article

Background: Focal chondral lesions of the knee are frequently underdiagnosed, and their clinical presentation does not always correlate with structural severity. This study aimed to evaluate the diagnostic utility of clinical examination tests and musculoskeletal ultrasound (MSK-US) in identifying high-grade chondral defects, using MRI-based ICRS grading as the reference standard. Methods: In this observational cross-sectional study, 57 consecutive patients with mechanical knee pain and MRI-confirmed focal chondral lesions were evaluated through standardized clinical examination, MSK-US, and MRI. Clinical maneuvers—including Wilson’s test, McMurray’s test, and ligamentous stability tests—were analyzed using Chi-square tests, Pearson correlations, and odds ratios (OR). Statistical processing was performed in Python. Results: According to MRI grading, 87.7% of lesions were ICRS 3, and 12.3% were ICRS 4. Pain and functional impairment (as measured by the WOMAC) were moderate and comparable across lesion grades. Wilson’s test showed high sensitivity in both ICRS 3 (66%) and ICRS 4 (100%) lesions, but no statistical association with lesion severity (p = 0.955). McMurray’s test demonstrated strong discriminative value, being positive in 30% of ICRS 3 versus 86% of ICRS 4 lesions, and was the only clinical maneuver significantly associated with lesion grade (χ² = 4.29, p = 0.038; OR = 0.20, 95% CI: 0.05–0.79). Correlation analysis revealed weak associations between clinical tests and the location of compartment-specific defects. MRI identified meniscal tears in 86% of ICRS 4 lesions compared with 30% of ICRS 3 lesions. Conclusions: Symptom severity alone does not reliably distinguish between ICRS Grade 3 and Grade 4 focal chondral lesions. McMurray’s test, while not cartilage-specific, was associated with lesion complexity due to its reflection of concomitant meniscal pathology rather than cartilage depth itself. Accordingly, McMurray’s test should be interpreted as an indirect clinical indicator of combined osteochondral–meniscal involvement. The integration of targeted clinical tests (Wilson’s and McMurray’s), MSK-US and MRI-based ICRS grading may support clinical orientation and preoperative risk stratification, forming a pragmatic diagnostic framework rather than a definitive staging tool. Full article

Background and Objectives: Meniscus injuries, particularly Grade I and II, are common knee injuries that can affect pain, joint function and quality of life, but the effectiveness of non-invasive treatments like Kinesiology taping (KT) in this population remains limited. This pilot randomized controlled trial aimed to explore the short-term effects of KT on pain, fear of movement, muscle strength, proprioceptive force sense, joint range of motion, joint position sense and quality of life in individuals with Grade I/II meniscus injuries. Materials and Methods: 26 participants diagnosed with Grade I-II meniscus injury were randomly assigned to two groups: the experimental group was applied ‘Y shaped’ kinesiology taping on quadriceps femoris muscle, based on facilitation technique with 25–50% tension. The control (placebo) group was applied a tape without tension, perpendicular to the quadriceps femoris muscle. Outcomes were evaluated before and 48–72 h after taping. Results: Between-group analysis demonstrated a significant improvement in joint position sense at 60° flexion with eyes closed in KT group compared with placebo (p = 0.002). Additionally, the KT group showed significantly greater improvements in the physical function (p = 0.006) and energy (p = 0.013) subdomains of the SF-36 quality of life scale. No significant between-group differences were observed for pain, fear of movement, muscle strength, proprioceptive force sense, or joint range of motion. Conclusions: In this pilot study, KT showed acute benefits in proprioception and quality of life in grade I-II meniscus injuries, but no advantage over placebo taping for pain, fear of movement, joint range of motion or muscle strength. Given the exploratory nature and limited sample size, these findings should be interpreted cautiously. Larger trials should confirm these results and determine the role of KT within multimodal rehabilitation programs. Full article

Background/Objectives: Combat trauma involving large joints is associated with a high risk of thromboinflammatory complications. Early identification of laboratory markers for hypercoagulability is essential to optimise perioperative management. This study aimed to evaluate the dynamics of inflammation and haemostasis indicators in patients with combat-related joint trauma and to identify the most informative markers for preoperative risk assessment. Methods: A total of 29 patients with combat injuries to the hip, knee, elbow, or ankle joints were examined. Blood samples were taken 1–3 days prior to surgery and again on the first postoperative day. Parameters of coagulation (e.g., PT, INR, fibrinogen, D-dimer, soluble fibrin complexes, antithrombin III), fibrinolysis, and inflammation (e.g., CRP, haptoglobin, sialic acid, ESR, LSI, LII) were analysed and compared to those of 30 healthy controls. Statistical analysis included Student’s t-test and Pearson’s correlation. Results: At baseline, patients demonstrated significant increases in inflammatory markers (CRP 64.2 ± 7.3 mg/L, ↑738.9%; haptoglobin 3.25 ± 0.4 g/L, ↑164.3%; ESR 46.8 ± 5.2 mm/h, ↑313.8%) and procoagulant activity (D-dimer 1.42 ± 0.18 µg/mL, ↑136.6%; fibrinogen 6.12 ± 0.51 g/L, ↑102.4%; soluble fibrin complexes 38.7 ± 4.9 mg/L, ↑597.3%), together with a reduction in antithrombin III activity (63.5 ± 6.2%, ↓39.5%) and prolonged fibrinolysis time (increase by 197%). Postoperatively, these abnormalities intensified, indicating a sustained thromboinflammatory response. Strong correlations were found between inflammatory and haemostatic markers. Conclusions: Combat trauma of large joints is associated with preoperative thromboinflammatory dysregulation, which is exacerbated by surgery. Monitoring specific biochemical and haematological markers—such as CRP, fibrinogen, D-dimer, and soluble fibrin complexes—may support preoperative risk assessment and postoperative monitoring strategies for hypercoagulable states in this high-risk group. These findings lay the groundwork for future prospective studies aimed at developing stratified therapeutic protocols and predictive models for thromboinflammatory complications in orthopaedic trauma care. Full article

Background and Objectives: Chronic knee pain (cKP) affects approximately 25% of adults worldwide, with prevalence increasing over recent decades. While conventional treatments have clinical limitations, several types of electrical stimulation have been suggested to improve patients’ quality of life. The electrical stimulation literature contains inadequate patient-reported outcome measures (PROMs) data. Encouraging preliminary H-Wave^® device PROMs results for chronic neck, shoulder, and low back pain have previously been published. This PROMs study’s goal is to similarly assess the efficacy of H-Wave^® device stimulation (HWDS) in patients with differing knee disorders. Materials and Methods: This is an independent, retrospective, observational cohort study analyzing H-Wave^® PROMs data, prospectively and sequentially collected over 4 years. In total, 34,192 pain management patient final surveys were screened for participants who were at least 18 years old, used H-Wave^® for any knee-related disorder, reporting chronic pain from 90 to 730 days, with device treatment duration from 22 to 365 days. PROMs included effects on function, pain, sleep quality, need for medications, ability to work, and patient satisfaction; additional data includes gender, age (when injured), chronicity of pain, prior treatments, and frequency and length of device use. Results: PROMs surveys from 34,192 HWDS patients included 1143 with “all knee”, 985 “knee injury”, and 124 “knee degeneration” diagnoses. Reported improvements in function/ADL (96.51%) and work performance (84.63%) were significant (p < 0.0001), with ≥20% pain relief in 86.76% (p < 0.0001), improving 2.96 points (average 0–10 NRS). Medication use decreased (69.85%, p = 0.0008), while sleep improved (55.33%) in knee injury patients. Patient satisfaction measures exceeded 96% (p < 0.0001). Subgroup analysis suggests that longer device use and shorter pain chronicity resulted in increased (p < 0.0001) HWDS benefits. Conclusions: HWDS PROMs data analysis demonstrated similarly encouraging outcomes for cKP patients, as previously reported for several other body regions. Knee injury and degeneration subgroups had near-equivalent benefits, as observed for all knee conditions. Despite many reported methodological limitations, which limit causal inference and preclude broader recommendations, HWDS appears to potentially offer several benefits for refractory cKP patients, requiring further studies. Full article