Journal of Orthopaedic Surgery最新文献

{"title":"Evaluation of \"spin\" in systematic reviews and meta-analyses of physical therapy for plantar fasciitis: A Systematic Review.","authors":"Prajwal Guruprasad, Pranav Sivaram, Pierce Bombard, Suhanee Mitragotri, Omkar Anaspure, Albert T Anastasio","doi":"10.1177/10225536261483752","DOIUrl":"10.1177/10225536261483752","url":null,"abstract":"<p><p>BackgroundPhysical therapy and exercise form the cornerstone of plantar fasciitis management, and clinicians rely heavily on systematic reviews to navigate a crowded and heterogeneous evidence base. Exercise interventions are inherently difficult to blind, outcome measures vary widely across trials, and protocols differ in dosage, supervision, and adherence, creating ample opportunity for selective framing. Whether spin, reporting behavior that inflates perceived benefit without falsification, has shaped this literature remains unknown.MethodsPubMed, Embase, Web of Science, and the Cochrane Library were searched. Spin was classified using the Yavchitz et al. taxonomy across misleading interpretation, misleading reporting, and inappropriate extrapolation domains. Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews, Version 2 (AMSTAR-2).ResultsSeven systematic reviews were included. Selective overemphasis on efficacy outcomes and selective focus on statistically significant results each affected 4 of 7 reviews (57%), and conclusions claiming benefit despite high risk of bias were present in 3 of 7 (43%). On AMSTAR-2, no review reported primary study funding sources (0/7), no review provided a list of excluded studies (0/7), and duplicate data extraction was performed in only 2 of 7 (29%).ConclusionsSpin in the physical therapy plantar fasciitis literature operates subtly, not through overreaching extrapolation but through selective framing of results already within the data. This form is harder to detect and correct than outright misrepresentation. Strengthened protocol pre-registration, funding disclosure, and peer review processes that explicitly assess data-conclusion alignment are necessary to produce a trustworthy evidence base for this foundational treatment category.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261483752"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, anthropometric, and spinopelvic factors associated with insufficient functional recovery after percutaneous endoscopic lumbar discectomy in elderly patients: A prospective cohort study.","authors":"Jialun Han, Yuanyuan Li, Meng Li, Jianhua Ren, Xianzhong Meng","doi":"10.1177/10225536261480409","DOIUrl":"https://doi.org/10.1177/10225536261480409","url":null,"abstract":"<p><p>BackgroundPercutaneous endoscopic lumbar discectomy (PELD) is widely used for elderly patients with lumbar disc herniation (LDH), yet some patients fail to achieve clinically meaningful functional recovery. Factors associated with insufficient recovery remain incompletely defined.ObjectiveTo evaluate approximately one-year functional outcomes after PELD in elderly patients with LDH and identify clinical, anthropometric, and spinopelvic factors associated with insufficient functional recovery.MethodsThis single-center prospective cohort study screened 325 consecutive patients undergoing single-level PELD for LDH between June 2023 and December 2024. After eligibility assessment and follow-up, 260 elderly patients with complete baseline and final follow-up data were analyzed. Functional outcomes were assessed using the Oswestry Disability Index (ODI) preoperatively and at 3, 6, and approximately 12 months postoperatively. Insufficient functional recovery was defined as an ODI improvement rate <30% at final follow-up. Univariable and multivariable logistic regression analyses were performed.ResultsOf 260 patients, 212 (81.5%) achieved adequate ODI improvement, whereas 48 (18.5%) had insufficient improvement. In the initial prespecified multivariable model, waist circumference remained associated with insufficient recovery (OR 1.10, 95% CI 1.04-1.17; P = 0.001). After adding preoperative pelvic tilt (PT), PT was independently associated with insufficient recovery (OR 1.19, 95% CI 1.02-1.39; P = 0.031), while the association of waist circumference was attenuated (OR 1.06, 95% CI 0.99-1.13; P = 0.121). In the exploratory extended model, diabetes, longer symptom duration, and severe radiographic degeneration remained associated with insufficient recovery, whereas waist circumference was further attenuated.ConclusionPELD provided favorable approximately one-year outcomes in most elderly patients with LDH. Insufficient recovery appears multifactorial. Waist circumference may serve as a clinically accessible risk marker, but diabetes, symptom duration, and severe degeneration showed more robust associations in exploratory analysis.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261480409"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The nerve-first paradigm: Preoperative EMG severity as a prognostic marker of clinically meaningful recovery after adult spinal deformity surgery.","authors":"Vugar Nabi, Fatih Duygun, Aydogan Askin, Suleyman Avci","doi":"10.1177/10225536261462605","DOIUrl":"10.1177/10225536261462605","url":null,"abstract":"<p><p>PurposeTo determine whether preoperative EMG severity predicts clinically meaningful recovery after adult spinal deformity surgery.MethodsIn this single-center observational cohort, prospectively collected data from 84 patients undergoing adult spinal deformity surgery were retrospectively analyzed. EMG radiculopathy severity was graded 1-3; grade 3 defined severe abnormality. 24-month ODI and VAS-leg improvement, MCID achievement, satisfaction, complications, and reoperations were compared. Regression models adjusted for baseline score, age, and fused levels.ResultsODI improved by 16.20 points and VAS-leg by 3.38 points overall; however, only 51.2% achieved ODI MCID. Severe EMG patients had less ODI improvement (9.09 vs 17.62 points; difference, 8.53; 95% CI, 4.23-12.84) and less VAS-leg improvement (1.15 vs 3.82 points; difference, 2.67; 95% CI, 1.83-3.52). Increasing EMG severity independently predicted less improvement and higher ODI MCID failure.ConclusionMajor adult spinal deformity surgery improved average patient-reported outcomes; however, severe preoperative EMG abnormality identified a distinct high-risk, low-benefit phenotype in whom surgery was less likely to produce clinically meaningful radicular pain relief and more likely to be followed by poor satisfaction, complications, and reoperation.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261462605"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does retrograde entry in femoral lengthening over nail allow greater lengthening without increasing complications? A single-surgeon cohort study.","authors":"Melih Civan, Emre Meric, Cengiz Sen, Mehmet Kocaoglu","doi":"10.1177/10225536261459496","DOIUrl":"10.1177/10225536261459496","url":null,"abstract":"<p><p>BackgroundDespite advances in motorized internal lengthening nails, the lengthening over an intramedullary nail (LON) technique remains relevant in selected clinical scenarios. In femoral LON, both antegrade and retrograde nailing directions may be considered according to osteotomy level, deformity characteristics, and planned lengthening. Although antegrade entry is more commonly preferred, retrograde entry may offer technical advantages in selected cases. This study compared outcomes and complications between antegrade and retrograde femoral LON in a single-surgeon cohort.MethodsA retrospective cohort of 44 femoral lengthening procedures between 1997 and 2018 was analyzed. Patients were divided into antegrade (<i>n</i> = 18) and retrograde (<i>n</i> = 26) groups based on nail entry direction. Demographic characteristics, lengthening parameters, consolidation indices, callus quality, outcome scores, and complications, which were classified using a standardized system, were compared between groups. Statistical significance was set at <i>p</i> < 0.05.ResultsThe mean lengthening amount and percentage were higher in the retrograde group. The consolidation index and regenerate quality were comparable between groups. No statistically significant difference was observed between groups in overall complication rates or Grade 3 complications. Outcome scores were significantly higher in the antegrade group. Difficulty level was positively correlated with Grade 3 complications and poor callus quality.ConclusionsIn this retrospective single-surgeon cohort, retrograde entry in femoral LON was associated with a higher amount of achieved lengthening and percentage compared with antegrade entry, without an observed increase in overall complication rates. However, these findings should not be interpreted as evidence that retrograde entry independently permits greater lengthening or carries no additional risk, because entry direction was likely influenced by preoperative case selection, planned lengthening amount, osteotomy location, deformity characteristics, and surgeon-specific decision-making. Retrograde entry may be considered a viable option in carefully selected femoral LON cases, but larger prospective studies are needed to clarify its indications, complication profile, and comparative effectiveness.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261459496"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and readability analysis of ChatGPT responses to frequently asked questions about olecranon fractures.","authors":"İbrahim Halil Dadir","doi":"10.1177/10225536261469293","DOIUrl":"https://doi.org/10.1177/10225536261469293","url":null,"abstract":"<p><p>PurposeThis study aimed to evaluate the reliability, quality, and readability of ChatGPT-generated responses to common patient questions about olecranon fractures.MethodsIn this cross-sectional study, twenty frequently asked questions were identified using Google's \"People also ask\" feature and submitted to ChatGPT-4o in separate sessions between October 1 and October 10, 2025. Two orthopaedic surgeons independently assessed the responses using the DISCERN instrument and Global Quality Score (GQS). Readability was analysed using Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFI).ResultsMean DISCERN and GQS scores (51.25 ± 4.13 and 4.10 ± 0.58) indicated good quality and reliability. The mean FRE was 62.00 ± 5.12, and mean FKGL, SMOG, and GFI values (9.23, 8.42, 9.37) corresponded to a ninth-grade reading level. DISCERN and GQS were strongly correlated (r = 0.913, p < 0.001) and negatively associated with FKGL.ConclusionChatGPT-4o produced coherent responses of generally good quality and reliability regarding olecranon fractures; however, readability levels exceeded those recommended for patient comprehension. These findings suggest that while ChatGPT may serve as a supportive informational tool, clinician guidance remains essential to ensure appropriate patient understanding and prevent potential misinformation.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261469293"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragility fracture prediction in the Mediterranean region: Evaluating the performance of trabecular bone score in Lebanese postmenopausal women.","authors":"Raymonde Dahdouh, Souheil Hallit, Wissam Boueri, Wael Bayoud, Ghassan Maalouf, Falah Bachour","doi":"10.1177/10225536261478439","DOIUrl":"https://doi.org/10.1177/10225536261478439","url":null,"abstract":"<p><p>PurposeThis article aims at studying the correlation between Trabecular Bone Score and fragility fracture risk in a population of Lebanese postmenopausal women aged 65 years and older.MethodsA retrospective cohort study was done on 114 postmenopausal Lebanese women, who underwent bone densitometry (DEXA scan) at Bellevue Medical Center, between the years 2018 and 2020. These women were then followed for the presence or absence of fractures during the 5 years following their scan results. A bivariate and multivariate logistic regression was computed to analyze the results.ResultsOur logistic regression showed that neither TBS nor BMD were significant predictors of fragility fracture occurrence during the next five year follow up. In the unadjusted model, TBS was not associated with fracture occurrence (OR=0.14; 95% CI: 0.003-5.69; p=0.296). Even after adjustment, this association remained non-significant (aOR=0.98; 95% CI: 0.01-67.55; p=0.992).ConclusionThe Trabecular Bone Score failed to serve as a predictability tool for fragility fractures in elderly postmenopausal Lebanese women.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261478439"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergic contact dermatitis following usage of adhesive mesh dressing in knee replacement surgeries does not affect short term outcome.","authors":"Jonathan Kow, Shawn Js Seah, Cheryl Gatot, Darren Keng Jin Tay","doi":"10.1177/10225536261486165","DOIUrl":"https://doi.org/10.1177/10225536261486165","url":null,"abstract":"<p><p>PurposeDermabond Prineo, a 2-octyl cyanoacrylate adhesive mesh dressing, is widely used in knee arthroplasty for rapid watertight closure. Allergic contact dermatitis (ACD) has been reported in approximately 5% of Western cohorts, with repeat exposure as a key risk factor. This study evaluated incidence, risk factors, and short-term outcomes in an Asian population.MethodsA single-centre retrospective cohort study included 290 consecutive patients undergoing primary total or unicompartmental knee arthroplasty (2022-2023) with 6-month follow-up. ACD was diagnosed clinically. Outcomes included ROM, KSS, KSF, OKS, and SF-36 scores. Logistic regression identified risk factors.ResultsACD occurred in 19 patients (6.6%) at a mean of 21 days. No cases progressed to prosthetic joint infection. Younger age (OR 0.90, p=0.003) and prior Dermabond exposure (adjusted OR 3.12, p=0.034) independently predicted ACD. Six-month outcomes were comparable between groups.ConclusionACD is uncommon and does not affect short-term outcomes, though younger and previously exposed patients are at higher risk.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261486165"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An XGBoost-based integrated prediction model for short-term response to platelet-rich plasma therapy in osteoarthritic joint disease: A retrospective cohort study.","authors":"Fangbin Chen, Siye Yi, Jiahe Han, Yannan Zhu","doi":"10.1177/10225536261481196","DOIUrl":"https://doi.org/10.1177/10225536261481196","url":null,"abstract":"<p><p>ObjectiveResponse to platelet-rich plasma (PRP) therapy varies among patients with osteoarthritic joint disease, underscoring the need for interpretable tools to support individualized prediction.MethodsThis single-center retrospective study screened adults with osteoarthritic joint disease receiving intra-articular PRP therapy at a tertiary Grade A hospital in China. Treatment response at 3 months was defined as both a ≥50% reduction in VAS pain score and a ≥20% reduction in WOMAC total score from baseline. Baseline VAS and WOMAC were excluded from the primary model to minimize outcome-definition-related bias. Candidate predictors were selected in the training cohort using LASSO regression and bootstrap stability selection. Logistic regression, random forest, support vector machine, XGBoost, and LightGBM models were developed and assessed for discrimination, calibration, clinical utility, internal validation, and interpretability.ResultsAmong 312 screened patients, 226 were included; 136 were responders and 90 were non-responders. The training and validation cohorts included 158 and 68 patients, respectively. Five predictors were retained: KL grade IV, platelet concentration fold-change, BMI, disease duration, and IL-6. KL grade IV was associated with lower response probability (OR 0.312, 95% CI 0.136-0.716), whereas platelet concentration fold-change was associated with higher response probability (OR 1.636, 95% CI 1.202-2.226). Higher BMI, longer disease duration, and higher IL-6 were inversely associated with response. In the validation cohort, XGBoost achieved the numerically highest AUC of 0.896 (95% CI 0.817-0.958), with accuracy of 88.2%, sensitivity of 85.4%, specificity of 92.6%, and Brier score of 0.098. The optimism-corrected XGBoost AUC was 0.883.ConclusionAn integrated post-preparation model combining patient characteristics and PRP preparation parameters showed favorable performance in predicting short-term response after PRP therapy in patients with osteoarthritic joint disease. External validation is required before clinical use.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261481196"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multimodal endoscopic surgical strategy for refractory plantar fasciitis: Clinical outcomes of the DORR technique with adjunctive gastrocnemius recession.","authors":"Adriel You Wei Tay, Walter-Soon-Yaw Wong, Linus Ren Hao Tan, Eric Wei Liang Cher, Inderjeet Singh Rikhraj, Keen Wai Chong, Wenxian Png","doi":"10.1177/10225536261474217","DOIUrl":"https://doi.org/10.1177/10225536261474217","url":null,"abstract":"<p><p>BackgroundPlantar fasciitis is a prevalent cause of heel pain, often managed nonoperatively. For patients who remain symptomatic despite nonoperative treatment, surgical options are considered. The debridement, ostectomy, release, and radiofrequency (DORR) procedure-a novel endoscopic suprafascial approach-aims to address multiple pathological components of chronic plantar fasciitis to achieve best outcomes.MethodsA retrospective review of 37 patients who underwent the DORR procedure with endoscopic gastrocnemius recession for chronic plantar fasciitis between 2023 and 2024 was performed. Patients had recalcitrant symptoms despite at least 6 months of nonoperative therapy. The procedures included a suprafascial arthroscopic debridement and calcaneal spur removal, medial plantar fascia release, radiofrequency microtenotomy and endoscopic gastrocnemius recession. Clinical outcomes included the European Foot and Ankle Society (EFAS) score, Visual Analogue Scale (VAS) for pain, patient satisfaction, and expectation fulfilment, assessed preoperatively and at 6 months.ResultsSignificant improvements were observed in EFAS scores (from 9.11 ± 2.62 to 19.19 ± 3.07, P < .001) and VAS pain scores (from 7.73 ± 1.10 to 2.43 ± 2.08, P < .001). Overall, 86.5% of patients reported satisfaction with the procedure, and 94.6% felt their expectations were met. Complication rates were low, with one case each (2.7%) of recurrent heel pain and transient toe abduction weakness. No cases of lateral foot numbness were observed.ConclusionThe DORR procedure with adjunctive endoscopic gastrocnemius recession appears to be a safe and effective surgical option for patients with recalcitrant plantar fasciitis. By addressing all postulated pathology, both structural and functional contributors to heel pain, this approach may offer a more comprehensive solution than conventional techniques. Further prospective studies are warranted.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261474217"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-based normative reference values for medial and lateral meniscal extrusion in asymptomatic Korean knees.","authors":"Woon Hwa Jung, Kaushik Are, Harshit Khare, Dong Hyun Kim, Seung-Su Jeon, Jong-Hyun Kim","doi":"10.1177/10225536261459495","DOIUrl":"10.1177/10225536261459495","url":null,"abstract":"<p><p>PurposeTo establish MRI-based normative reference values for medial and lateral meniscal extrusion in asymptomatic Korean adults and to assess compartmental differences using absolute and proportional indices.MethodsA retrospective study of 38 independent knees from asymptomatic adults (mean age, 30.6 ± 4.5 years; 13 male, 25 female) was performed using a single-knee-per-subject protocol. Knees with trauma, ligament injury, significant effusion, meniscal tears, meniscotibial abnormalities, cartilage defects, or bone marrow lesions were excluded. Mid-coronal 1.5-T fat-suppressed proton density MRI was used to measure absolute extrusion and calculate the Meniscal Extrusion Index (MEI). Upper reference values were determined using mean + 2 SD and the 95th percentile. Compartments were compared using paired t-tests.ResultsMean medial meniscal extrusion (MME) was 1.86 ± 0.64 mm (95% CI, 1.65-2.07), with a mean + 2 SD of 3.13 mm and a 95th percentile of 2.84 mm. Mean lateral meniscal extrusion (LME) was 1.40 ± 0.59 mm (95% CI, 1.20-1.59), with a mean + 2 SD of 2.58 mm and a 95th percentile of 2.40 mm. Medial extrusion was greater than lateral extrusion (p = 0.0029; Cohen's d = 0.52). Mean medial and lateral MEI values were 22.5% ± 8.9% and 15.4% ± 9.2%, respectively.ConclusionsMild meniscal extrusion is present in structurally intact knees. Medial values approaching 3 mm and lateral values approaching 2.6 mm may represent normal anatomical variation. Interpretation should incorporate compartment-specific reference limits and proportional indices such as the MEI.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261459495"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}