Dr. Lambl

A synthesis of current research on the treatment of knee osteoarthritis — presented in three parts, by patient age group.

Refreshed May 28, 2026122 references

Knee Arthritis in Ages 0–30: What the Research Says

For people under 30, knee arthritis is rarely the "wear and tear" osteoarthritis seen in older adults. Instead, it usually arises from one of three pathways: (1) an autoimmune condition like juvenile idiopathic arthritis (JIA), (2) post-traumatic damage from a sports injury such as an ACL tear, meniscus tear, patellar dislocation, or osteochondral fracture, or (3) an infection in the joint (septic arthritis). The treatment landscape is therefore very different from older adults: the goal is almost always to preserve the joint and prevent arthritis decades down the road, not to replace it.

Epidemiology

Globally, knee osteoarthritis (OA) is overwhelmingly a disease of middle and older age, but its seeds are often planted in this younger group. The under-30 population contributes to the OA burden mainly through traumatic and inflammatory causes:

  • Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood. Across cohorts, the knee is by far the most frequently involved joint — 63.7% of cases in a Palestinian pediatric cohort PMID:41761264 and 82.6% in a Turkish oligoarticular cohort PMID:41082757. Persistent oligoarticular JIA (affecting ≤4 joints) is the most common subtype.
  • ACL injuries in children and teens are rising sharply, prompting national audits like the UK's PANA study, which found wide variability in how pediatric ACL injuries are managed PMID:41747609.
  • Patellofemoral instability (PFI) — repeated kneecap dislocations — is common in adolescents and young adults, particularly females PMID:41655186.
  • Septic arthritis in young people most often affects the knee, with Kingella kingae the leading culprit in children under 4 and Staphylococcus aureus dominating in older kids [PMID:40828529, PMID:41366651].
  • Osteochondral lesions (damage to cartilage plus the underlying bone), including osteochondritis dissecans (OCD), are an important early-life cause of later arthritis PMID:41136105.

Global Burden of Disease data confirm that while symptomatic OA rates in this age group are low, the lifetime risk of OA — roughly 1 in 7 people — is being established by injuries and inflammatory disease that often start young [PMID:40696488, PMID:41152934].

Cause Factors

The major drivers of knee arthritis risk in this age group are:

  • ACL rupture and subsequent reconstruction (ACLR). Even with surgery, ACL injury substantially raises long-term OA risk. Wearable-sensor research can already detect altered knee mechanics (especially reduced rotational motion) in people with prior ACLR, hinting at early biomechanical changes linked to future OA PMID:41014689. Stiff landing patterns and asymmetric loading during walking after ACLR are thought to drive this risk [PMID:40413614, PMID:40258593].
  • Meniscus loss. Total or subtotal meniscectomy dramatically accelerates OA. In athletes with discoid meniscus (a congenital variant), 38% who had subtotal/total meniscectomy developed advanced OA at ~13 years, versus only mild changes in those whose meniscus was preserved PMID:40407384.
  • Recurrent patellar dislocation. Untreated PFI leads to cartilage damage and patellofemoral OA. A long-term comparison in adolescents showed patellofemoral OA in 60% of knees after the older Insall proximal realignment surgery versus only 6.7% after modern medial patellofemoral ligament reconstruction (MPFLR) PMID:40759934.
  • Tibial plateau fractures and articular step-offs. Even a 2 mm gap in the joint surface after a tibial plateau fracture is linked to malalignment and post-traumatic OA [PMID:41398669, PMID:40903611].
  • Osgood-Schlatter disease. Once thought benign, new long-term data show adults with a history of adolescent Osgood-Schlatter have meaningfully worse knee health than peers, with a strikingly high risk of jumper's knee (patellar tendinopathy) PMID:40439870.
  • Inflammatory disease. In JIA, certain subtypes (RF-positive polyarticular, systemic) drive worse outcomes [PMID:41761264, PMID:41974575]. Rare overlap conditions like juvenile rhupus syndrome (JIA + lupus) and A20 haploinsufficiency add complexity [PMID:41578476, PMID:40859316].
  • Septic arthritis. Beyond the obvious cartilage damage from infection, infection is more common than people realize after knee surgery — including rare organisms like Proteus mirabilis, Abiotrophia defectiva, and even fungi like Arthrographis kalrae after a penetrating injury [PMID:41747021, PMID:41659218, PMID:40819439].
  • Obesity. High BMI is the dominant modifiable risk factor for OA globally and is increasingly relevant for younger populations [PMID:41242948, PMID:40598022].

Conservative (Non-Surgical) Treatment

For young patients, conservative care does two jobs: managing current symptoms and protecting the joint for the future.

Weight, lifestyle, and overall health

While direct trials in under-30s are limited, the Global Burden of Disease data make clear that high BMI is a major and growing contributor to knee OA — including in younger groups — so weight management started early matters [PMID:41242948, PMID:40598022, PMID:40696488]. Sustainable physical activity also matters long-term: more than 30 years after an ACL injury, two-thirds of people still met WHO physical activity recommendations, regardless of whether they had surgery or developed OA — meaning an ACL tear does not doom you to inactivity PMID:40404550.

Exercise and physical therapy

Exercise is the backbone of conservative care.

  • For ACL injuries, a nationwide Norwegian study found that two-thirds of people who started with non-operative rehab were still doing fine and had avoided surgery at 2 years. Younger patients (under 25), those in pivoting sports, and those with meniscal injuries were more likely to eventually have ACL reconstruction, but knee-related quality of life and sport function scores were similar between those who had surgery and those who didn't PMID:41093364.
  • For degenerative meniscus tears, supervised neuromuscular exercise with a physiotherapist outperforms an unsupervised home program for pain, function, and quality of life PMID:40567077. In a broader 12-month UK study of meniscal tears, baseline pain symptoms — not mechanical "clicking" or "locking" — predicted outcome, so surgical decisions should not hinge on mechanical symptoms alone PMID:41173042.
  • For juvenile idiopathic arthritis, hydrotherapy (water-based exercise) significantly reduces pain and improves cardiovascular fitness compared with standard care, though it does not consistently improve general function scores PMID:40982358.
  • Post-ACLR rehab: prolonged vibration of the hamstrings has been shown to acutely reduce stiff limb loading during landing — a mechanism that may help reduce future OA risk PMID:40413614. Walking speed also matters: walking slower reduces loading at the surgical knee, though it does not fix the side-to-side asymmetry that drives OA risk PMID:40258593. Real-time visual feedback during downhill walking can improve knee alignment and load distribution PMID:41430600.

A digital rehab program called Stop OsteoARthritis (SOAR) is now being tested in a randomized trial for young people 9–36 months after ACLR who still have symptoms; results will help define what comprehensive post-injury knee-preservation care should look like PMID:40542399.

Thermotherapy and electrotherapy

Limited direct evidence in this age group, but high-intensity continuous ultrasound combined with active knee exercise reduces stiffness in the infrapatellar fat pad (a common source of anterior knee pain) and improves how it glides during knee bending PMID:41653828. This is a plausible adjunct for young people with anterior knee pain, though osteoarthritis-specific trials are needed.

Footwear

A scoping review found that minimalist footwear has mostly been tested in adolescents with patellofemoral pain and older adults, with mixed but generally encouraging effects on knee mechanics PMID:40411499.

Medications

  • For JIA, the treatment ladder is well established: NSAIDs and intra-articular steroid injections for milder disease, then methotrexate, then biologics (TNF inhibitors and others) for more aggressive disease. In a Palestinian cohort, NSAIDs were used in 62%, methotrexate in 79.5%, and biologics in 22.2% PMID:41761264. Long-term Turkish data show 85% of oligoarticular JIA patients reach remission on medication PMID:41082757. New RF-positive polyarticular JIA data confirm these patients often need two or more biologic drugs to reach remission PMID:41974575.
  • For axial spondyloarthritis and psoriatic arthritis (which can affect knees), TNF inhibitors, non-TNF biologics, and conventional DMARDs all reduce the eventual need for joint replacement compared with NSAIDs; JAK inhibitors look promising but evidence is not yet conclusive PMID:40936006.
  • For symptomatic young adults with early knee OA who are too young for replacement, a novel trial is testing recombinant human growth hormone alongside exercise to boost quadriceps strength — recognizing that strength gains are notoriously hard to maintain in this group PMID:41638751.
  • Injections: Survey data from China show low awareness of biological injection therapies for KOA among patients, with efficacy being the most important factor in their preferences PMID:40839199.
  • For knee OA in general (mostly tested in older adults): a randomized trial of micro-fragmented adipose tissue injection vs. saline placebo showed both improved symptoms significantly, but the fat injection was not better than placebo — a sobering finding for biologic injection enthusiasm PMID:40101939.

Septic arthritis treatment

For most pediatric and young-adult septic arthritis, prompt diagnosis, joint drainage, and targeted antibiotics produce full recovery [PMID:40878450, PMID:41659218]. An important nuance: in low-velocity gunshot wounds that enter a joint, adult studies found surgical debridement did not reduce infection rates compared with antibiotics alone PMID:41498830, and a pediatric study reached the same conclusion — no joint infections occurred whether children received formal surgical washout or just antibiotics PMID:41263579. A serious warning: children with infections in the back of the knee (popliteal fossa) have a 13% rate of deep vein thrombosis, and one child in a recent study died from a pulmonary embolism — so the popliteal area should be examined and imaged urgently when infection is suspected PMID:41051763.

Surgical Treatment

When surgery is needed in young patients, the principle is joint preservation: fix the structural problem to delay or prevent future arthritis, and save joint replacement as an absolute last resort.

ACL reconstruction (ACLR)

ACLR is the standard surgery when non-operative management fails or when instability persists.

  • Graft choice: A large Swedish registry analysis found revision rates at 2 years are similar (~2.3%) across hamstring, patellar tendon, and quadriceps tendon autografts. However, women receiving quadriceps tendon grafts had worse patient-reported outcomes than those getting hamstring grafts; this difference was not seen in men PMID:41588802. Concurrent meniscal injury treatment did not change ACL revision rates, but hamstring autograft was associated with better subjective knee function than patellar tendon autograft when the meniscus was resected or left in situ PMID:39844666.
  • Tunnel widening and graft maturation: At 5 years post-ACLR, the bone tunnel enlarges then partially shrinks back, and graft signal on MRI normalizes — these changes correlate with knee laxity but not with worse patient-reported outcomes PMID:41854376. MRI at 12 months can identify grafts at higher risk of re-tearing based on signal intensity PMID:40848738.
  • Predicting revision risk: A machine-learning model from the Danish registry can predict ACLR revision risk using just age and three KOOS questionnaire items at 12 months PMID:40839712.
  • Identifying poor outcomes: A two-subgroup machine-learning analysis showed that ACLR strongly protects against post-traumatic OA and future knee replacement in patients with favorable profiles, but it is less protective in older, heavier patients with meniscal injuries PMID:40815848.
  • Acceptable symptoms after ACLR: At 2 years post-ACLR, nearly two-thirds of people do not achieve an acceptable symptom state on all KOOS subscales — and those who don't show knee loading patterns linked to higher OA risk PMID:40566928.
  • ACL repair vs. reconstruction: For proximal ACL tears with good tissue quality, primary ACL repair with suture tape augmentation achieved similar 2-year outcomes to traditional reconstruction PMID:39069021.
  • Meniscus + ACL combined: When both are injured, doing meniscus repair followed later by ACLR (a two-stage approach) has a 36.7% meniscus repair failure rate at 3 years. Longer delays between surgeries, medial meniscus repairs, and female sex all increased failure risk PMID:39878124.
  • Combined ACL + MCL injuries: Whether the MCL is repaired, braced with suture tape, or left alone (relying on ACL reconstruction for stability), 2-year outcomes are similar PMID:39343075.
  • Septic arthritis after ACLR: When it happens, prompt arthroscopic washout with graft retention restores function to near-normal at 7 years, though return to sport takes about 2 months longer PMID:41072725.

Patellar instability surgery

For repeated patellar dislocations:

  • MPFL reconstruction is now the workhorse procedure and is clearly superior to non-operative care: at 3 years, only 16.7% of MPFL-reconstructed patients had ongoing instability vs. 53.6% with rehabilitation alone PMID:41655186.
  • A long-term comparison in adolescents found MPFLR produced far less patellofemoral OA at ~9 years (6.7%) compared with the older Insall procedure (60%) and required zero reoperations vs. 40% PMID:40759934.
  • An international study suggests MPFLR alone can succeed even in patients with anatomic risk factors (mild patella alta, moderate TT-TG distance) that traditionally prompted adding a tibial tubercle osteotomy PMID:41176161.
  • For more severe anatomy, combined MPFLR with tibial tubercle osteotomy (TTO) works well even in revision settings after a prior failed stabilization: zero recurrent instability in the revision group at 2 years and high return-to-sport rates PMID:41588807.
  • For high-grade trochlear dysplasia (a misshapen groove for the kneecap), Bereiter trochleoplasty combined with other procedures gave a redislocation rate of just 1.1% and significant functional gains in a large 368-knee cohort PMID:40130493. A long-term study of a related procedure (recession wedge trochleoplasty) showed no recurrence and no meaningful arthritis at 11 years PMID:39710256.
  • Disease-specific outcome scores: The BPII 2.0 questionnaire is more sensitive than knee-region scores (KOOS, IKDC, Kujala) for tracking change after PFI surgery in adolescents PMID:41546179. A shortened KOOS (just the sport and quality-of-life subscales) may be all that's needed for tracking outcomes in this group PMID:40350079.
  • A reality check: even after successful MPFL reconstruction, the operated knee still doesn't fully match the contralateral healthy knee on functional scores PMID:41138536.

Cartilage and osteochondral repair

This is where joint preservation really matters in young people.

  • Fresh osteochondral allograft (OCA) transplantation — placing donor cartilage-and-bone plugs into defects — works well in young patients. A Turkish series of 10 patients (mean age 30) showed marked improvements in pain and function at 26 months PMID:41942367. A large US registry of 527 patients (mean age 32.6) reported graft survivorship of 89% at 5 years, 83% at 10 years, and 75% at 15 years; age over 30, BMI over 30, larger grafts (>8 cm²), and degenerative diagnoses all predicted failure PMID:40671241. The "snowman" technique (multiple plugs for irregular defects) performs as well as single-plug OCA for similar-sized defects PMID:40618236. Hemicondylar allografts also have durable 10-20 year results PMID:40923897. Combining OCA with meniscal allograft transplantation in patients with both cartilage and meniscus loss produces meaningful improvements with high satisfaction PMID:39914608. Meniscal allograft transplantation can also help young patients with substantial cartilage disease, with sustained 10-year benefits PMID:39506549. A novel option using peroneus longus tendon autograft as a meniscal substitute has shown promising 2-year results PMID:40554011.
  • Matrix-induced autologous chondrocyte implantation (MACI) continues to show good 10-year outcomes for large cartilage defects, with thresholds defined for "acceptable" symptom states; men and people with BMI 20-29 do best PMID:40151960. A newer minced cartilage technique with a synovial flap matches or beats MACI at 2 years for large defects PMID:40417794. Spheroid-based MACI with bone grafting also gives sustained 3.5-year benefits, though gait abnormalities persist PMID:39901823.
  • Microfracture vs. arthroscopic debridement: In a randomized trial for small (<2 cm²) cartilage lesions, microfracture was not superior to simple debridement at 2 years, and microfracture had more complications PMID:40570306.
  • A new aragonite-based scaffold (made from coral-derived material) outperformed standard treatments (microfracture or debridement) at 5 years in a multicenter trial — including in patients with mild-to-moderate OA, who are usually excluded from cartilage trials. The failure rate was 15% vs. 35.7% for standard care PMID:41992573.
  • Osteochondral fragment fixation: In children and teens with traumatic osteochondral fractures, bioabsorbable implants give excellent radiographic healing and an 88% return-to-sport rate at 6 years PMID:40711638. Innovative transosseous suture techniques also work well for recurrent patellar dislocations with osteochondral fractures PMID:40659585.
  • Patellofemoral OA in young people: A modified "patellar triple surgery" (arthroscopic lateral release + MPFL reconstruction + modified Fulkerson osteotomy) showed good 1-year results in young adults with early patellofemoral OA PMID:40461115.
  • Focal metal implants with 3D-printed porous tantalum offer a cartilage-preserving alternative to unicompartmental knee replacement for focal defects in young patients PMID:41588442.

Joint replacement (rare in this age group)

Joint replacement should generally be avoided in young patients but is sometimes unavoidable:

  • For JIA patients who need revision knee replacement after a failed primary, implants last about 75% at 10 years and 70% at 20 years, but patient-reported outcomes are modest and surgeons should counsel realistically PMID:40107573.
  • Treatment patterns for rheumatoid arthritis show that better disease-modifying drugs are reducing — but not eliminating — the need for joint replacement PMID:41592741.
  • For severe deformities combined with arthritis (e.g., multiple epiphyseal dysplasia), simultaneous TKA with corrective osteotomy using patient-specific instrumentation can succeed in young patients PMID:40911070.
  • Hemophilic arthropathy patients also do well with TKA when the joint is destroyed PMID:40420097.

Other surgical considerations

  • Tibial plateau fractures in young patients: most regain function for daily activities, but many — especially those needing operative fixation — don't return to pre-injury sport levels PMID:40903611. Careful joint surface reduction (under 2 mm step-off) prevents valgus malalignment and later OA PMID:41398669.
  • Multiligament knee injuries: A 20-item surgical planning checklist used in a Tel Aviv series produced acceptable mid-term outcomes PMID:41506463.
  • Tourniquet use: In PCL reconstruction, skipping the tourniquet reduced swelling and bruising without compromising surgical outcomes PMID:41193575.
  • Pediatric ACL care: A UK audit (PANA) showed inconsistent adherence to best-practice guidelines, with under half of centers reporting re-rupture rates — highlighting the need for standardization PMID:41747609.
  • OCD lesions: Stable lesions in younger patients (<12 or with open growth plates) often heal with rest and bracing; unstable lesions need surgery (drilling, fixation, or cell-based or structural cartilage treatments). Return-to-sport rates exceed 85% [PMID:41136105, PMID:41110704].

Prophylaxis — Preventing Knee Arthritis Before It Starts

For Ages 0–30, prevention is everything. The evidence supports:

  • Aggressive early treatment of inflammatory arthritis. Earlier and better disease-modifying therapy in JIA prevents joint damage [PMID:41761264, PMID:41082757].
  • Don't sacrifice the meniscus. Meniscus-preserving surgery dramatically reduces future OA compared with meniscectomy PMID:40407384. In meniscal tears with no advanced arthritis, exercise-based care can avoid surgery entirely in many young patients [PMID:41093364, PMID:41173042].
  • Recognize delayed knee pain after ACL injury or surgery. Failure to achieve a "Patient Acceptable Symptom State" 2 years after ACLR is a red flag — these patients have abnormal loading patterns that predict future OA, and they may benefit from intensified rehab PMID:40566928. Wearable sensors can now detect at-risk movement patterns even at home PMID:41014689.
  • Educate, exercise, and modify movement. The Stop OsteoARthritis (SOAR) digital program is testing whether structured digital coaching plus exercise can prevent OA after ACLR PMID:40542399. Patients are generally willing to consider preventive treatments for post-traumatic OA, including medications PMID:39936242.
  • Don't miss SCFE. Adolescents (especially overweight ones) presenting with knee pain may actually have a slipped capital femoral epiphysis (hip problem) — a 3-month diagnostic delay nearly doubles the risk of chondrolysis, OA, and need for hip reconstruction PMID:40423092.
  • Take Osgood-Schlatter seriously. Long-term data show this is not always benign; longer symptom duration and higher pain in adolescence predict worse adult knee health, so management should aim to preserve knee health over time, not just wait it out PMID:40439870.
  • Watch the popliteal fossa in pediatric infection. Routine examination and imaging when infection is suspected can catch the 13% of children with associated DVT and prevent fatal pulmonary embolism PMID:41051763.
  • Address obesity and metabolic health. High BMI is the single largest modifiable population-level driver of OA [PMID:41242948, PMID:40598022].
  • Consider non-routine surgical debridement for joint trauma carefully. For low-velocity gunshot wounds entering a joint, antibiotics alone may be enough [PMID:41263579, PMID:41498830].
  • Manage leg-length discrepancy. Modern epiphysiodesis procedures show no significant OA progression or alignment problems at 28-40 years of follow-up PMID:41400744.
  • Be alert to atypical causes of monoarthritis in children — including retained radiolucent foreign bodies that imaging misses PMID:40632943 and tumors like tenosynovial giant cell tumor that mimic arthritis PMID:40681854.

What's Still Uncertain

  • Whether biologic injections genuinely modify disease in young knees. A high-quality placebo-controlled trial of micro-fragmented fat injection found no benefit over saline PMID:40101939. The hype around stem cells, platelet-rich plasma, and similar therapies is not yet matched by rigorous evidence in this age group.
  • Whether early intervention prevents post-traumatic OA after ACL injury. The SOAR trial will help, but we don't yet know which exercise, movement-retraining, or pharmacologic strategies actually delay arthritis decades later PMID:40542399.
  • Optimal graft choice for ACLR, especially for women, who appear to do worse with quadriceps tendon autografts than men PMID:41588802.
  • The right cutoff for considering surgery in patellar instability — recent data suggest isolated MPFL reconstruction may work even with anatomic risk factors traditionally considered indications for bony surgery PMID:41176161.
  • Best management of meniscus + ACL injuries — staged surgery has high meniscus failure rates and the ideal timing remains unclear PMID:39878124.
  • Long-term role of newer cartilage scaffolds and minced cartilage techniques vs. established MACI and OCA [PMID:41992573, PMID:40417794].
  • Whether recombinant growth hormone or other muscle-building drugs help young people with early OA who are too young for joint replacement — currently only pilot trial data PMID:41638751.
  • Whether feedback-based gait retraining and wearable sensors translate into long-term OA prevention [PMID:41014689, PMID:41430600, PMID:40413614].
  • Long-term consequences of Osgood-Schlatter and how aggressively to manage it in adolescence to protect adult knee health PMID:40439870.
  • Optimal antibiotic strategies and surgical thresholds for septic arthritis in young patients, where atypical organisms are increasingly being identified [PMID:41747021, PMID:41659218, PMID:40819439].

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  31. The MEniscal TeaR Outcome (METRO) study : a prospective cohort study exploring the factors that affect outcomes in patients undergoing treatment for a meniscal tear.
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  32. Epidemiological trends of osteoarthritis at the global, regional, and national levels from 1990 to 2021 and projections to 2050.
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  33. Comparison of knees after patellofemoral stabilisation with asymptomatic contralateral knees.
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  34. Juvenile Knee Osteochondritis Dissecans.
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  35. Treatment of multiple chondral/osteochondral lesions in the knee of a juvenile athlete: A case report with literature review.
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  36. Non-operative treatment of anterior cruciate ligament injuries: two-thirds avoid surgery at 2-year follow-up in a nationwide cohort.
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  37. The long-term follow up of patients with oligoarticular juvenile idiopathic arthritis: a single center experience.
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  38. Functional results of septic arthritis after anterior cruciate ligament reconstruction treated by arthroscopic lavage with preservation of the graft: Case-control study at 7 years follow-up.
    Tripon M, Bougard M, Gras A, et al. · Orthopaedics & traumatology, surgery & research : OTSR · 2026PMID 41072725
  39. Popliteal Fossa Infection, Septic Arthritis of the Knee, Pyomyositis, and Deep Vein Thrombosis Risk in Children.
    Mitchell PD, Blanco J, Chomicki M, et al. · Journal of pediatric orthopedics · 2026PMID 41051763
  40. Feasibility of automatic knee kinematic feature learning for discriminating between individuals with and without a history of an anterior cruciate ligament reconstruction.
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  41. Effects of Hydrotherapy on Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis.
    Verit G, Anwar D, Greenberg M, et al. · Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association · 2026PMID 40982358
  42. Targeted and biologic therapies and risk of total knee or hip replacement in axial spondyloarthritis and psoriatic arthritis.
    Achkar A, Peloquin C, Liew JW, et al. · Clinical rheumatology · 2025PMID 40936006
  43. Long-Term Functional Outcomes and Modes of Failure of Fresh Frozen Hemicondylar Allografts: A Retrospective Cohort Study.
    De Pena AM, Gonzalez MR, Connolly JJ, et al. · Journal of surgical oncology · 2025PMID 40923897
  44. Total knee arthroplasty with simultaneous triplanar osteotomy of the distal femur using patient-specific instrumentation : A case report.
    Szerksznis W, Tramś E, Kamiński R, et al. · Orthopadie (Heidelberg, Germany) · 2026PMID 40911070
  45. Most patients with tibial plateau fractures regain function for daily activities but do not return to their pre-injury level of sport: comparison of multicenter cohort of 1101 patients and age-related peers.
    Vaartjes TP, van der Sluis FJ, Bosma E, et al. · European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025PMID 40903611
  46. Relationships between smoking, high BMI and the results of arthroscopic treatment of isolated medial meniscus tear - a cross-sectional study.
    Turoń B, Małkowski D, Zabrzyńska M, et al. · BMC musculoskeletal disorders · 2025PMID 40898186
  47. [Septic Arthritis of the Glenohumeral Joint: Treatment Options and Outcomes Achieved in Our Study Population].
    Mařík J, Klouda J, Musil D, et al. · Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca · 2025PMID 40878450
  48. Clinical features and genetic analysis of A20 haploinsufficiency.
    Xue F, An C, Lei Z, et al. · Orphanet journal of rare diseases · 2025PMID 40859316
  49. Inflammation-profiling reveals activated pathways and biomarkers with predictive potential in oligoarticular juvenile idiopathic arthritis.
    Wen X, Aulin C, Sundberg E, et al. · Frontiers in immunology · 2025PMID 40852723
  50. Twelve-month magnetic resonance imaging after anterior cruciate ligament reconstruction can identify risk factors for subsequent graft rupture and used to guide the return to sport. Results from a high-volume institution.
    Lutz C, Mancino F, Parker DA · Journal of ISAKOS : joint disorders & orthopaedic sports medicine · 2025PMID 40848738
  51. Predicting Anterior Cruciate Ligament Reconstruction Revision Risk: An Enhanced Machine Learning Analysis of the Danish Knee Ligament Reconstruction Registry.
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  52. Questionnaire on willingness and preference for biological treatment of knee osteoarthritis: a single-center cross-sectional survey.
    Wang F · Clinical rheumatology · 2025PMID 40839199
  53. Comparison of clinical and biological data between septic arthritis of the hip and those of the knee caused by Kingella kingae.
    De Marco G, Cochard B, Ramadani A, et al. · Journal of pediatric orthopedics. Part B · 2025PMID 40828529
  54. Mycotic arthritis of the knee caused by Arthrographis kalrae in an immunocompetent child: A case report and litterature review.
    Lemaigre C, Cros-Labrit J, Yaouanc F, et al. · Diagnostic microbiology and infectious disease · 2025PMID 40819439
  55. Establishing Clinically Distinct Patient Treatment Subgroups Following Anterior Cruciate Ligament Reconstruction: A Machine Learning Clustering Analysis.
    Lu Y, Kang L, Mavrommatis S, et al. · The American journal of sports medicine · 2025PMID 40815848
  56. MPFL reconstruction vs. Insall procedure for adolescent patellar instability: nine-year follow-up on osteoarthritis, redislocations, and return to sports.
    Jääskelä M, Perhomaa M, Lempainen L, et al. · BMC musculoskeletal disorders · 2025PMID 40759934
  57. Mid-term results of treatment of traumatic knee osteochondral fractures in pediatric and adolescent population with bioabsorbable implants.
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  58. Global, regional, and country-specific lifetime risks of osteoarthritis, 1990-2021: a systematic analysis for the global burden of disease study 2021.
    Zhang X, Huang C, Hu Z, et al. · Global health research and policy · 2025PMID 40696488
  59. Tenosynovial giant cell tumor and its differential diagnosis in children.
    Inarejos Clemente EJ, Moreno Romo D, Barber I, et al. · Pediatric radiology · 2025PMID 40681854
  60. Juvenile Idiopathic Arthritis-Associated Peripheral Ulcerative Keratitis and Anterior Uveitis in a Pediatric Patient with Trisomy 21.
    Sandozi H, Moon JY, Ketkar S, et al. · Ocular immunology and inflammation · 2025PMID 40674696
  61. Clinical Factors Affecting Outcomes of Osteochondral Allograft Transplantation: A Multivariable Analysis of 560 Knees.
    Wang T, Dees RL, Görtz S, et al. · The American journal of sports medicine · 2025PMID 40671241
  62. [Early effectiveness of transosseous suture fixation in treatment of recurrent acute patellar dislocation with patellar osteochondral fractures].
    Liu J, Zhai L, Xu Z, et al. · Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025PMID 40659585
  63. Nonspecific Knee Synovitis Caused by Foreign Bodies Undetectable on Imaging Studies: Four Cases and Literature Review.
    Brandstetter AS, Qual R, Benady A, et al. · Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025PMID 40632943
  64. Comparison of Snowman and Single-Plug Circular Osteochondral Allograft Transplantation Techniques for Similarly Sized Defects: A Matched Cohort Analysis.
    Mufti YN, Sachs JP, Franzia CH, et al. · The American journal of sports medicine · 2025PMID 40618236
  65. Use of Antibiotic Eluting Calcium Sulfate Beads in High-Risk Primary Total Knee Arthroplasty.
    Su L, Park J, Mao Y, et al. · The journal of knee surgery · 2025PMID 40609967
  66. Burden of knee osteoarthritis in China and globally: 1990-2045.
    Li M, Xia Q, Nie Q, et al. · BMC musculoskeletal disorders · 2025PMID 40598022
  67. Avascular Necrosis of the Metacarpal Head in Skeletally Immature Patients Treated with Osteochondral Autograft Transfer System.
    Brown CC, Cohen-Brown J, Li Z · Journal of surgical orthopaedic advances · 2025PMID 40576507
  68. Arthroscopic Resection of Infrapatellar Fat Pad Impingement Syndrome: Long-Term Clinical Results at Minimum 10-Year Follow-Up.
    Park YC, Kim YM, Joo YB · Medicina (Kaunas, Lithuania) · 2025PMID 40572684
  69. Microfracture Versus Arthroscopic Debridement for the Treatment of Symptomatic Cartilage Lesions of the Knee: 2-Year Results From a Multicenter Double-Blinded Randomized Controlled Trial.
    Randsborg PH, Aae TF, Visnes H, et al. · The American journal of sports medicine · 2025PMID 40570306
  70. Effectiveness of a neuromuscular exercise program conducted with a physiotherapist in individuals with degenerative meniscal tears.
    Aksu ZB, Genç H · Journal of back and musculoskeletal rehabilitation · 2026PMID 40567077
  71. Failure to Achieve the Patient Acceptable Symptom State 2 Years After Anterior Cruciate Ligament Reconstruction Reflects Poor Knee Loading Patterns.
    He J, Williams AA, Erhart-Hledik JC, et al. · The American journal of sports medicine · 2025PMID 40566928
  72. Clinical and diagnostic insights into brucellar arthritis: a single-center retrospective cohort study.
    Feng Q, Song Y, Xing Y, et al. · Frontiers in cellular and infection microbiology · 2025PMID 40557315
  73. Can tendon autograft function as a meniscal transplant?
    Gad AM, Khalil MH · The Knee · 2025PMID 40554011
  74. Digital education and exercise therapy versus minimal intervention for young people at high risk of early onset knee osteoarthritis after ACL reconstruction: a study protocol for the Stop OsteoARthritis (SOAR) randomized controlled trial.
    Whittaker JL, Cammalleri A, Archibald C, et al. · Trials · 2025PMID 40542399
  75. The Test-Retest Reliability of Multiple Patient-Reported and Clinician-Based Outcomes in People With a History of Anterior Cruciate Ligament Reconstruction.
    Hoch JM, Kleis RR, Hoch MC, et al. · Journal of sport rehabilitation · 2025PMID 40473239
  76. [Modified patellar triple surgery for early patellofemoral osteoarthritis].
    Wu BL, Yan XY · Zhongguo gu shang = China journal of orthopaedics and traumatology · 2025PMID 40461115
  77. Long-Term Knee Health in Adults with a History of Adolescent Osgood-Schlatter: A National Cohort Study of Patients in Secondary Care in Denmark 1977-2020.
    Krommes K, Bjerre A, Thorborg K, et al. · Sports medicine (Auckland, N.Z.) · 2025PMID 40439870
  78. Femoral Trochlear Dysplasia Is Common in Lower Limbs With Hartofilakidis C2 Hip Dysplasia.
    Huang Y, Li M, Zhao F, et al. · Clinical orthopaedics and related research · 2025PMID 40434850
  79. Global, regional, and national burden of osteoarthritis from 1990 to 2021 and projections to 2035: A cross-sectional study for the Global Burden of Disease Study 2021.
    Xie X, Zhang K, Li Y, et al. · PloS one · 2025PMID 40424273
  80. Impact of Hip Versus Knee Pain as the Presenting Symptom of Slipped Capital Femoral Epiphysis on Time to Imaging, Surgery, and Complications.
    Momtaz D, Hosseinzadeh S, Mittal MM, et al. · Journal of pediatric orthopedics · 2025PMID 40423092
  81. Clinical outcomes of total hip and knee arthroplasty for end-stage hemophilic arthropathy in patients with hemophilia: a retrospective study.
    BaHeTe A, Shao Y, Kang P · Journal of orthopaedic surgery and research · 2025PMID 40420097
  82. Satisfactory functional outcomes and low recurrence rates at a mean 10-year follow-up after combined staged synovectomy and external radiotherapy for diffuse pigmented villonodular synovitis of the knee.
    Fahmy FS, ElAttar M, Farhan AH, et al. · Journal of ISAKOS : joint disorders & orthopaedic sports medicine · 2025PMID 40419142
  83. Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap leads to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months: A controlled clinical trial.
    Mayr J, Warth F, Oehler N, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026PMID 40417794
  84. Acute Prolonged Hamstrings Vibration Reduces Limb Stiffness Following Anterior Cruciate Ligament Reconstruction During a Single-Limb Drop-Jump Task.
    Lowe T, Hsiao HY, Dong XN, et al. · Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025PMID 40413614
  85. Minimalist Footwear in the Treatment and Rehabilitation of Lower Limb Impairments Across the Life Course: A Scoping Review.
    Morrison SC, Langley B, Luo B, et al. · Musculoskeletal care · 2025PMID 40411499
  86. Accelerometer-assessed physical activity levels 32-37 years after anterior cruciate ligament rupture - Does initial treatment strategy or the presence of osteoarthritis matter?
    Filbay S, Sonesson S, Kuster RP, et al. · Journal of science and medicine in sport · 2025PMID 40404550
  87. Association Between ACL Continuity on Magnetic Resonance Imaging at 5 Years After an Acute ACL Rupture and 11-Year Outcomes: A Secondary Analysis From the KANON Trial.
    Filbay SR, Roemer F, Roos EM, et al. · The American journal of sports medicine · 2025PMID 40387842
  88. Risk factors and long-term outcomes in anterior iliac and obturator hip dislocation.
    Jaecker V, Regenbogen S, Märdian S, et al. · European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025PMID 40380987
  89. Assessment of the Damage Index and Its Dynamics in Patients with Non-Systemic Variants of Juvenile Arthritis during the Treatment with Biologics.
    Kolkhidova ZA, Nikishina IP, Glukhova SI · Doklady. Biochemistry and biophysics · 2025PMID 40353966
  90. A shortened Knee Injury and Osteoarthritis Outcome Score (KOOS) is sufficient for measuring change in a cohort of patellofemoral instability patients.
    Webster KE, Agel J, Feller JA, et al. · Journal of ISAKOS : joint disorders & orthopaedic sports medicine · 2025PMID 40350079
  91. [Rheumatic shoulder joints in childhood].
    Windschall D, Bork H, Gohar F, et al. · Zeitschrift fur Rheumatologie · 2025PMID 40346183
  92. Reducing Walking Speed Decreases Surgical Knee Loading but Not Between-Limb Symmetry in Individuals With Anterior Cruciate Ligament Reconstruction.
    Cottmeyer DF, Lyle MA, Sims MM, et al. · Journal of applied biomechanics · 2025PMID 40258593
  93. The patient acceptable symptomatic state for commonly used outcome scores 10 years after matrix-associated autologous chondrocyte implantation.
    Koch KA, Trefzer R, Hariri M, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026PMID 40151960
  94. Very low dislocation rate and good clinical outcome after Bereiter trochleoplasty and additional procedures following the Copenhagen patella-femoral instability algorithm: One- and two-years outcomes from a consecutive cohort of 368 cases.
    Dippmann C, Siersma V, Rechter S, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026PMID 40130493
  95. Overlapping Aicardi-Goutières and Singleton-Merten syndromes with a heterozygous gain-of-function mutation in IFIH1 mimicking juvenile idiopathic arthritis.
    Yamazaki S, Kaneko S, Shimbo A, et al. · Immunological medicine · 2025PMID 40116369
  96. Revision Total Knee Arthroplasty for Juvenile Idiopathic Arthritis: Implant Survivorship and Clinical Outcomes the Second Time Around.
    Cheng R, Coxe FR, Chiu YF, et al. · The Journal of arthroplasty · 2025PMID 40107573
  97. Treatment of knee osteoarthritis with a single injection of autologous micro-fragmented adipose tissue is not superior to a placebo saline injection: a blinded randomised controlled trial with 2-year follow-up.
    Barfod KW, Blønd L, Mikkelsen RK, et al. · British journal of sports medicine · 2025PMID 40101939
  98. Different arthritis patterns in pediatric familial Mediterranean fever: Focus on exon 10 biallelic pathogenic genotypes.
    Tunce E, Atamyildiz Uçar S, Sözeri B · Joint bone spine · 2025PMID 40096885
  99. Balancing Tumor Control and Cartilage Preservation for Patients with Giant Cell Tumor of Bone Around the Knee: A Clinical Report from a Single Institute.
    Chen KL, Chen CF, Wu PK, et al. · The Journal of bone and joint surgery. American volume · 2025PMID 40048502
  100. Relationships Between PROMIS and Legacy Patient-Reported Outcome Measure (PROM) Scores in the MARS Cohort at 10-Year Follow-up.
    MARS Group · The Journal of bone and joint surgery. American volume · 2025PMID 39965036
  101. Patient Perceptions of Medication Therapy for Prevention of Posttraumatic Osteoarthritis Following Anterior Cruciate Ligament Injury: A Qualitative Content Analysis.
    Waddell LM, Mitchener DP, Frier KC, et al. · Arthritis care & research · 2025PMID 39936242
  102. AKIRA: Deep learning tool for image standardization, implant detection and arthritis grading to establish a radiographic registry in patients with anterior cruciate ligament injuries.
    Lu Y, Yang L, Mulford K, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025PMID 39925136
  103. Osteochondral Allograft Transplantation With Concomitant Meniscal Allograft Transplantation Improves Clinical Outcomes and Yields High Patient Satisfaction: A Systematic Review.
    Carpenter ML, Cotter EJ, Villarreal-Espinosa JB, et al. · Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2025PMID 39914608
  104. Autologous bone grafting combined with spheroid-based matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: Good clinical outcomes alongside abnormal postoperative gait patterns.
    Oehme S, Milinkovic DD, Paolucci A, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025PMID 39901823
  105. High failure rate in meniscal repair when preceding anterior cruciate ligament reconstruction: An analysis of two-stage surgery for concomitant ACL injury and traumatic meniscus tear.
    López Personat A, Cristiani R, Stålman A, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025PMID 39878124
  106. No difference in ACL revision rates between hamstring and patellar tendon autograft in patients with ACL-R and a concurrent meniscal injury irrespective of meniscal treatment.
    Högberg J, Petersson L, Zsidai B, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025PMID 39844666
  107. No secondary osteoarthritis after recession wedge trochleoplasty associated with tibial tubercle osteotomy for treating recurrent patellar dislocation in high-grade dysplasia.
    Barbotte F, Landon C, Djebara A, et al. · Orthopaedics & traumatology, surgery & research : OTSR · 2025PMID 39710256
  108. Higher isokinetic quadriceps peak force is associated with a patient-acceptable symptom-state 1 and 3 years after ACL reconstruction.
    Ashnai F, Thomeé R, Hamrin Senorski E, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025PMID 39564974
  109. Psychometric properties of the Thai version of the Simple Knee Value in patients with patellofemoral pain.
    Suphakitchanusan W, Reosanguanwong K, Lertwanich P · Disability and rehabilitation · 2025PMID 39526587
  110. Meniscal allograft transplantation in patients with substantial cartilage disease led to a sustained long-term improvement in patient-reported outcome measures.
    Ahmed I, Khatri C, Spalding T, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025PMID 39506549
  111. Physical Activity Variability in Patellofemoral Pain: Relationships With Clinical and Psychological Outcomes.
    Kim S, Glaviano NR · Archives of physical medicine and rehabilitation · 2025PMID 39489206
  112. Results of the AMIC® method in patients operated on for an osteochondral lesion of the talar dome (OLTD) at a mean follow-up of 34 months. A retrospective multicenter study.
    Peras M, Bilichtin É, Choufani C, et al. · Orthopaedics & traumatology, surgery & research : OTSR · 2025PMID 39406585
  113. MRI features distinguishing pediatric Lyme arthritis from septic arthritis.
    Powell JE, Lee VK, Parikh SS, et al. · Skeletal radiology · 2025PMID 39373749
  114. Medial Collateral Ligament Repair, Isolated Suture-Tape-Bracing and No Repair for Grade III Medial Collateral Ligament Tears During Anterior Cruciate Ligament Reconstruction Have Similar Outcome for Combined Anterior Cruciate Ligament With Medial Collateral Ligament Injury: A 3-Arm Randomized Controlled Trial.
    Ramakanth R, Sundararajan SR, Sujith BSG, et al. · Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2025PMID 39343075
  115. Anterior Cruciate Ligament Repair With Suture Tape Augmentation of Proximal Tears and Early Anterior Cruciate Ligament Reconstruction With Suture Tape Augmentation Result in Comparable Clinical Outcomes With Anterior Cruciate Ligament Reconstruction at 2-Year Follow-Up.
    Simard SG, Greenfield CJ, Khoury AN · Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2025PMID 39069021
  116. Post-traumatic and OA-related lesions in the knee at baseline and 2 years after traumatic meniscal injury: Secondary analysis of a randomized controlled trial.
    van der Graaff SJA, Oei EHG, Reijman M, et al. · Osteoarthritis and cartilage · 2025PMID 38574801
  117. Five-Year Follow-up of a Multicenter Randomized Controlled Trial Comparing an Aragonite-Based Scaffold With Microfracture and Debridement for Chondral and Osteochondral Knee Lesions.
    Altschuler N, Zaslav KR, Di Matteo B, et al. · The American journal of sports medicine · 2026PMID 41992573
  118. [Clinical characteristics and outcomes of children with rheu-matoid factor-positive polyarticular juvenile idiopathic arthritis].
    Zhou Y, Wu J, Lu M · Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2026PMID 41974575
  119. Effect of Inflammatory Biomarkers on Patient Symptomatic State at Time of Knee Chondroplasty.
    Elias TJ, Haneberg E, Danilkowicz R, et al. · The American journal of sports medicine · 2026PMID 41934356
  120. Transitioning between medical equipment suppliers does not affect ACL reconstruction outcomes in a high-volume setting.
    Rizvanovic D, Stålman A, von Essen C · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026PMID 40652381
  121. Long-term clinical and MRI outcomes of a polyurethane meniscal scaffold implantation for the treatment of partial meniscal deficiency: A minimum 10-year follow-up study.
    Akrivos VS, Komnos GA, Ujvari B, et al. · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026PMID 40517421
  122. From Surgery to Sports Career: The Long-Term Fate of Athletes With Discoid Meniscus.
    Erden T, Agir M, Ali J, et al. · Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine · 2026PMID 40407384