Journal of orthopaedics最新文献

{"title":"Patellar alignment compared between kinematic and mechanical unicompartmental knee arthroplasties","authors":"Callie Fernandez ,&nbsp;Mckenna Brownell ,&nbsp;Rachel Eom ,&nbsp;Tobenna Nwankwo ,&nbsp;Jasmine Gulati ,&nbsp;Christopher P. Bellaire ,&nbsp;Kamran Sadr ,&nbsp;Evan Argintar","doi":"10.1016/j.jor.2025.03.046","DOIUrl":"10.1016/j.jor.2025.03.046","url":null,"abstract":"<div><h3>Background</h3><div>Surgical treatment of unicompartmental knee arthritis is typically treated by unicompartmental knee arthroplasty (UKA). UKA may be performed by more traditional mechanical alignment, or alternatively, kinematic alignment. The purpose of this study is to compare pre- and post-operative patellar tendon alignment between mechanical and kinematic UKA.</div></div><div><h3>Methods</h3><div>A retrospective study at Medstar Washington Hospital Center from 2015 to 2022 identified 156 cases of partial knee arthroplasties. Of these, 95 had mechanical alignments and 61 had kinematic alignments. Patients were evaluated pre and post-surgically for Insall-Salvati and Blackburne-Peel ratios. Analysis of joint imaging x-ray imaging was performed by a blinded MSK-trained radiologist.</div></div><div><h3>Results</h3><div>Pre-and-post-operative Insall-Salvati and Blackburne-Peel ratios were calculated for kinematic and mechanical knee replacement patients. The ratio differences for the kinematically aligned cohort demonstrated an average for Blackburne-Peele operative ratio difference of 0.089 ( ± 0.30) and an average Insall-Salvati ratio difference of 0.18 ( ± 0.34), whereas for mechanically aligned patients, the Blackburne-Peele ratio difference was 0.054 ( ± 0.47) and the Insall-Salvati ratio difference was 0.41 ( ± 0.31). There was a statistically significant difference in operative Insall-Salvati ratios between kinematic and mechanical patients. Additionally, a two-sample <em>t</em>-test found a significant difference between the postoperative Blackburne-Peel and Insall-Salvati ratios for the kinematically aligned knees with a p-value of 2.33 × 10⁻¹⁶ below the significance level of 0.05. A two-sample f-test found a significant difference in the standard deviation of the difference between mechanical and kinematically aligned knees with respect to the Blackburne-Peel ratio, with a p-value of 0.00183.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that sagittal patella-femoral knee alignment when comparing Blackburne-Peel and Insall-Salvati ratios are more accurately reproduced with kinematically aligned knees, and a greater variability among the kinematically aligned knees.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 77-81"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for readmission and mortality after irrigation & debridement for septic arthritis in persons who inject drugs","authors":"Gabriel S. Linden ,&nbsp;Laura M. Krivicich ,&nbsp;Richard N. Puzzitiello ,&nbsp;Sophie E. Lipson ,&nbsp;Vineet Desai ,&nbsp;Jared M. Alswang ,&nbsp;Daniel Gabriel ,&nbsp;Alysse G. Wurcel ,&nbsp;Scott P. Ryan ,&nbsp;Antonia F. Chen ,&nbsp;Matthew J. Salzler","doi":"10.1016/j.jor.2025.03.047","DOIUrl":"10.1016/j.jor.2025.03.047","url":null,"abstract":"<div><h3>Background and objective</h3><div>Persons who inject drugs (PWID) are associated with increased risk of repeat irrigation &amp; debridement (I&amp;D) in the setting of native joint septic arthritis. Despite these associations, there is a lack of data regarding postoperative outcomes for PWID with septic arthritis. The primary aim of this study was to determine if PWID were associated with increased rates of readmission and mortality after I&amp;D for septic arthritis.</div></div><div><h3>Materials and methods</h3><div>Patients from two level one trauma centers with native joint septic arthritis from 2015 to 2019 were retrospectively identified. Patients were included if they had a clinical presentation consistent with septic arthritis. Independent sample T-tests and Fisher's Exact testing were used to compare outcomes by PWID and repeat I&amp;D status. Primary outcomes included 30 and 90-day readmission, 30 and 90-day readmission related to septic arthritis, and 30 and 90-day mortality. Binary logistic regression testing was used to control for confounders such as human immunodeficiency virus (HIV), tobacco use disorder, diabetes, and immunocompromised status.</div></div><div><h3>Results</h3><div>192 patients with septic arthritis were identified (female, n = 70; male, n = 122). 231 joints were included in the analysis. There were 67 cases associated with PWID (29 %). Notably, PWID were associated with increased rates of tobacco use disorder (92 % vs. 24 %, p &lt; 0.001) and increased immunocompromised status (81 % vs. 24 %, p &lt; 0.001). PWID were associated with increased rates of 30-day and 90-day readmission (35 % vs. 12 %, p = 0.008; 61 % vs. 21 %, p = 0.002), and increased 30-day and 90-day mortality rate (22 % vs. 0.03 %, p &lt; 0.001; 35 % vs 0.09 %, p = 0.001). However, these associations did not remain significant after controlling for confounders. Repeat I&amp;D was significantly associated with increased 90-day readmission rates (OR 6.32, p &lt; 0.001), which remained significant when controlling for confounders.</div></div><div><h3>Conclusions</h3><div>This multicenter study demonstrated a strong association between repeat I&amp;D and 90-day readmission rate in the setting of native joint septic arthritis. Reassuringly, repeat I&amp;D was not associated with increased rates of postoperative mortality. PWID were associated with increased 30 and 90-day readmission and mortality rates, but these were no longer significant after controlling for confounders.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"62 ","pages":"Pages 156-159"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of adipose-derived stem cells and stromal vascular fraction for pain relief in Kellgren-Lawrence grade II-III knee osteoarthritis: A systematic review (2019–2024)","authors":"Tri Anh Nguyen ,&nbsp;Anne Hogden ,&nbsp;Anmol Khanna ,&nbsp;Donald Kuah","doi":"10.1016/j.jor.2025.03.029","DOIUrl":"10.1016/j.jor.2025.03.029","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (KOA) is a common degenerative condition, affecting individuals aged 40 and above. Current therapeutic options often fail to prevent disease progression and provide only short-term pain relief, leading to an increasing interest in regenerative medicine. Adipose-derived mesenchymal stem cells (ADMSCs) and stromal vascular fraction (SVF) have emerged as promising alternatives due to their potential to modulate inflammation and promote tissue repair. However, limited studies compare the efficacy of these two therapies for KOA.</div></div><div><h3>Methods</h3><div>A systematic review (2019–2024) across PubMed, CINAHL, and Embase included studies on patients aged 40+ with Grade II–III knee osteoarthritis (Kellgren-Lawrence) treated with intra-articular ADMSC and SVF injections. Inclusion criteria followed the SPIDER framework, focusing on pain relief and joint function improvement over ≥3 months, measured via VAS, KOOS, and WOMAC. MeSH terms for KOA and ADMSC/SVF therapies were used, with bias assessed via GRADE.</div></div><div><h3>Results</h3><div>Ten studies, including three randomized controlled trials and two observational studies, met the criteria, encompassing 452 patients. Results indicate that ADMSC therapies demonstrate prolonged pain relief and enhanced joint function up to 24 months post-treatment, with superior outcomes in cartilage regeneration compared to SVF. SVF provided quicker symptom relief due to its diverse cell composition but plateaued around 12 months. Both treatments had minimal adverse effects, with lipoaspiration-related symptoms being the most common.</div></div><div><h3>Conclusion</h3><div>ADMSC and SVF stem cell therapies represent promising non-surgical options for managing knee osteoarthritis (KOA) in patients over 40. ADMSC demonstrates higher efficacy in sustaining long-term pain relief and joint health, with significant potential for cartilage regeneration. The chondrogenic properties of ADMSCs make them particularly beneficial for patients younger than 62 years old. Conversely, SVF, with its heterogeneous cell composition, provides rapid paracrine effects, offering early symptom relief and broader applicability for older or obese patients, including those with a Body Mass Index (BMI) over 30.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 95-106"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aqueous extract of Ormocarpum cochinchinense augments proliferation and promotes osteogenesis in osteoblast like MG63 cells","authors":"Preethi Vincent,&nbsp;Krishna Priya Mani","doi":"10.1016/j.jor.2025.03.035","DOIUrl":"10.1016/j.jor.2025.03.035","url":null,"abstract":"<div><h3>Background</h3><div>Bone tissue engineering requires a high restorative index as a demand from modern day requirements. Therapeutic agents derived from natural sources play a vital role as modulators in promoting bone regeneration. <em>Ormocarpum cochinchinense,</em> a shrub, is used by the traditional healers of southern East Asia to treat bone fractures. However, there remains a dearth in the exploration of its bone healing properties.</div></div><div><h3>Methods</h3><div>The present study reports a systematic analysis of the aqueous extract of <em>Ormocarpum cochinchinense</em> (OCE) as a repository of natural bio-actives capable of eliciting <em>in vitro</em> biomineralization and thereby osteogenesis. MTT assay, and Live/dead cell staining assay were used to evaluate the cell viability of MG-63 cells. Alizarin staining evaluated the mineralization by OCE, and ALP enzyme activity was measured both qualitatively and quantitatively. Gene expression of osteogenic markers (Runx2, ALP, Collagen type 1, BMP2, Osteocalcin, and Osteopontin) was measured by RT-qPCR.</div></div><div><h3>Results</h3><div>The MTT, and Live/Dead staining results exemplified significant proliferation index. Augmented biomineralization as early as 7 days was validated by Alizarin Red staining with increased mineralized nodules. The activity of Alkaline phosphatase (an early bone marker) was significantly enhanced by OCE. Furthermore, the expression levels of early and late osteogenic markers were increased profoundly after OCE treatment in a dose-dependent manner.</div></div><div><h3>Conclusion</h3><div>The present study demonstrates the potential of <em>Ormocarpum cochinchinense</em> to promote osteogenesis, exemplifying its potential for bone tissue engineering.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 70-76"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin for thromboembolism prophylaxis after fracture surgery","authors":"Wei-Lin Liang ,&nbsp;Rui Wang ,&nbsp;Xin He ,&nbsp;Bo Liang","doi":"10.1016/j.jor.2025.03.030","DOIUrl":"10.1016/j.jor.2025.03.030","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism poses a significant risk of fatal complications following fracture surgery. Clinical studies indicated that aspirin is prescribed in thromboprophylaxis but the efficacy and safety are not fully certain yet.</div></div><div><h3>Methods</h3><div>A meta-analysis was conducted to assess the safety and efficacy of aspirin in preventing thromboembolism prophylaxis in patients who have undergone fracture surgery. We searched several databases (Pubmed, Web of Science, and Cochrane Library) up to date January 29, 2023. Only randomized controlled trials were included. Our primary outcomes were all-cause death and bleeding and our secondary outcomes were venous thromboembolism events (pulmonary embolism or deep vein thrombosis) and surgical site infection. Risk ratios (RR), and corresponding 95 % confidence intervals (CI) were used as summary statistics.</div></div><div><h3>Results</h3><div>Two randomized controlled trials (ADAPT and REVENT CLOT) with 12,540 patients were included in our study. All included studies were of high methodological quality. We found nonsignificant trends towards death (RR = 1.07, 95 %CI = 0.71–1.59), bleeding (RR = 0.96, 95 %CI = 0.89–1.05), pulmonary embolism (RR = 0.96, 95 %CI = 0.72–1.27), and surgical site infection (RR = 1.12, 95 %CI = 0.87–1.46) without heterogeneity. Patients receiving aspirin had a higher risk of deep vein thrombosis (RR = 1.48, 95 %CI = 1.16–1.89) without heterogeneity compared to those receiving enoxaparin at 90-day follow-up. Sub-analyses indicated nonsignificant trends towards massive pulmonary embolism (RR = 0.33, 95 %CI = 0.03–3.21), sub-massive pulmonary embolism (RR = 1.47, 95 %CI = 0.76–2.83), and symptomatic pulmonary embolism (RR = 0.90, 95 %CI = 0.64–1.26).</div></div><div><h3>Conclusion</h3><div>Although aspirin increased the deep venous thrombosis events, the available data showed no significant difference in all-cause mortality, bleeding, pulmonary embolism, and surgical site infection compared with enoxaparin.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 82-87"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients prefer In-Office Needle Arthroscopy (IONA) over traditional surgical arthroscopy","authors":"Gurjovan Sahi ,&nbsp;Ajay Shah ,&nbsp;Aazad Abbas ,&nbsp;Johnathan R. Lex ,&nbsp;Jihad Abouali ,&nbsp;Jay Toor","doi":"10.1016/j.jor.2025.03.016","DOIUrl":"10.1016/j.jor.2025.03.016","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;In-Office Needle Arthroscopy (IONA) is an emerging technology that has been primarily studied as a diagnostic tool. Recent evidence shows that it is a cost-effective alternative to hospital- and community-based MRI with comparable accuracy. Although exciting for surgeons and administrators, little is known about patients' perceptions of IONA. Level IV evidence shows that patients with claustrophobia or contra-indications to sedation prefer IONA to MRI for diagnostic purposes. However, no study to date has examined patients' preferences regarding IONA and traditional surgical arthroscopy. Therefore, this study was conceived with the purpose of gathering patients’ perspectives on IONA as an alternative to traditional surgical arthroscopy through semi-structured interviews. A secondary outcome was to determine the real-life financial impact with respect to profit and cost of introducing IONA at an academic mid-sized Canadian hospital.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;All patients undergoing arthroscopic non-ligamentous knee surgery within a three-month period at a mid-sized academic hospital were approached for this study. A trained researcher conducted telephone interviews regarding patient experience with the entire surgical process, including diagnosis and treatment, suffering an injury, referral for MRI and sports surgeon, and booking arthroscopic surgery. Participants were provided information on IONA, including risks and benefits as an alternative to traditional arthroscopy, and were asked about their likelihood of choosing IONA as an alternative to their treatment pathway. Thematic and quantitative analysis was conducted based on interview results, with quantitative analysis conducted using a 5-point Likert scale. Financial analysis was conducted by observing the propensity to choose IONA via patients’ response to the 5-point Likert scale and then modeled for cost effectiveness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-one patients were interviewed. The mean age was 32.3 (SD: 9.8) years old with 12 (57.1 %) females. Mean time from surgery to interview was 10.2 weeks (SD: 11.4). In general, patients’ perceptions of IONA were favorable. When asked how likely they would have been to opt for IONA over traditional arthroscopy, the mean response was “very likely” (4.10 [1.26]). The mean likelihood for males to select IONA was higher than females (4.78 versus 3.58). Common reasons for wanting IONA were to speed up the time between injury and surgery (n = 9), avoiding a general anesthetic/intubation and associated complications (n = 7), and avoiding the fear/anxiety of surgery (n = 6). Most patients listed the lack of primary data on the effectiveness, pain, revision rate, and PROMs as the primary hesitation (n = 6). Financial analysis revealed that IONA would reduce costs by $21,832.66 (p &lt; 0.0001), resulting in an increase in profit of $21,468.80 (p &lt; 0.0001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The most si","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 107-112"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel and objective tool for determining total and shear joint contact forces after primary total hip arthroplasty","authors":"Katharina Jäckle ,&nbsp;Tim Alexander Walde ,&nbsp;Marc-Pascal Meier ,&nbsp;Thelonius Hawellek ,&nbsp;Paul-Jonathan Roch ,&nbsp;Colja Homann ,&nbsp;William H.M. Castro ,&nbsp;Heiko Wagner ,&nbsp;Kim Boström ,&nbsp;Wolfgang Lehmann ,&nbsp;Lukas Weiser","doi":"10.1016/j.jor.2025.03.028","DOIUrl":"10.1016/j.jor.2025.03.028","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Total hip arthroplasty, a common surgical procedure in orthopedics, is used in patients with severe hip osteoarthritis to relieve pain and to restore the function. The surgery has been shown to be effective, but patients may experience gait limitations after surgery. We used a novel and innovative tool, Computed MyoGraphy (CMG), to analyse the gait kinematics and forces acting within the musculoskeletal system after total hip arthroplasty. Data obtained at different time points before and after surgery were compared with those of healthy subjects.</div></div><div><h3>Methods</h3><div>The gait patterns of patients with primary hip osteoarthritis patients and healthy subjects were compared using the Xsens Awinda system in combination with the CMG system. Joint contact forces and shear joint contact forces were assessed preoperatively at the 5th postoperative day as well as after the rehabilitation examining two types of movements, “walking” and “squatting\".</div></div><div><h3>Results</h3><div>As revealed by CMG during both, normal walking and in particular during squatting, pre- and postoperative patients showed lower values for total and shear hip joint contact forces on both sides of the body when compared to healthy subjects. These initial differences in the total and shear joint contact forces at the hip vanished after the completion of the rehabilitation process.</div></div><div><h3>Conclusions</h3><div>Total hip arthroplasty patients are initially limited to squat and walk normally, as they exert lower total and shear hip joint contact forces, interestingly not only on the affected side but also on the contralateral side. Rehabilitation improves the force development to a degree similar to healthy patients. CMG provides clinical usability that objectifies gait analyses and provide useful additional functional information for clinical practice.</div></div><div><h3>Trial registration</h3><div>Prospective study of gait analysis after primary total hip arthroplasty measured by Computed MyoGraphy (CMG) using Myonardo, DRKS00028175. Registered February 16, 2022 - Prospectively registered. Trial registration number DRKS00028175.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 54-62"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All-inside ramp lesion repair via anterior portals and pie-crusting: Excellent outcomes and survivorship at one-year follow-up","authors":"Antonio Clemente ,&nbsp;Domenico Zaccari ,&nbsp;Federico Verdone ,&nbsp;Glauco Loddo ,&nbsp;Francesco Bosco ,&nbsp;Francesco Saccia","doi":"10.1016/j.jor.2025.03.014","DOIUrl":"10.1016/j.jor.2025.03.014","url":null,"abstract":"<div><h3>Background</h3><div>Ramp lesions, located in the posterior horn of the medial meniscus, are commonly associated with anterior cruciate ligament (ACL) injuries and contribute to knee instability if untreated. Traditional repair methods use posteromedial portals, but newer approaches, such as the all-inside technique through anterior arthroscopic portals with pie-crusting of the posterior oblique ligament (POL), offer improved access and reduced morbidity. This study aimed to assess the clinical outcomes, return-to-sport rates, and failure rates of this technique compared to established methods.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis included 54 patients (mean age: 29.1 years) who underwent ramp lesion repair using the all-inside technique between January 2019 and December 2022. Clinical outcomes were evaluated with the IKDC score, Lysholm score, and Tegner activity scale. Failure was defined as the need for revision surgery.</div></div><div><h3>Results</h3><div>At a mean follow-up of 30.7 months, patients had a mean IKDC score of 81.5 ± 7.1 and Lysholm score of 94.5 ± 7.4. The Tegner activity scale declined slightly from 7.2 ± 1.2 preoperatively to 6.8 ± 1.3 postoperatively. All patients returned to sport within 9.2 ± 2.5 months, with a failure rate of 12.9 % and an average revision time of 13.1 ± 8.2 months.</div></div><div><h3>Conclusion</h3><div>The all-inside technique for ramp lesion repair via anterior portals provides excellent clinical outcomes and return-to-sport rates, with failure rates comparable to other methods. This minimally invasive approach offers improved access, reduced morbidity, and a reliable option for managing ramp lesions in ACL-injured patients.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 113-118"},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transphyseal ACL reconstruction resulted in small incidence of tibial physeal bars at 1-year follow-up","authors":"Mahsa Sarrami ,&nbsp;Payam Tarassoli ,&nbsp;Yoong Ping Lim ,&nbsp;Alex Nicholls","doi":"10.1016/j.jor.2025.03.007","DOIUrl":"10.1016/j.jor.2025.03.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Transphyseal anterior cruciate ligament reconstruction (ACLR) is associated with a risk of angular limb deformity and limb length discrepancy particularly when there is a significant period of growth remaining.</div><div>Previous studies on the effects of transphyseal ACLR have used inconsistent methodology to estimate bone age, and therefore subjects may have underestimated the effect on the physis.</div><div>This study sought to evaluate the incidence of iatrogenic physeal bar formation following ACLR using high-resolution MRI and a validated bone age atlas.</div></div><div><h3>Methods</h3><div>A prospective series of patients undergoing transphyseal ACLR at a single institute, with high resolution 3T MRIs at 12 months, were included. MRI-validated knee bone age atlas was then used to exclude patients with evidence of physiological physeal closure. The remaining skeletally immature MRI scans were appraised by two independent reviewers for the presence of physeal bar formation adjacent to transphyseal ACL tunnels.</div></div><div><h3>Results</h3><div>From 142 patients undergoing transphyseal ACLR with post-operative MRI, 94 patients were found to exhibit evidence of complete closure of either the tibial or femoral physis and were excluded. 48 patients (38 male – mean age 14.1; 10 female – mean age 13.9) meeting inclusion criteria were included. Mean tibial tunnel diameter was 8.2 mm (SD ± 0.81) and mean femoral tunnel diameter was 7.9 mm (SD ± 0.88). There were two cases (4.2 % of total) of physeal bar formation in the proximal tibia in males (aged 14.2 and 14.7 years) with otherwise open physes. No leg length discrepancy was observed for these patients at a 12 months. No cases of femoral physeal bar formation were identified in our cohort.</div></div><div><h3>Conclusion</h3><div>High resolution 3T MRI scan performed 12 months after transphyseal ACL reconstruction demonstrated 4.2 % incidence of tibial physeal bars and no femoral physeal bars. Neither of the cases physeal bar cases exhibited angular deformity or limb length discrepancy. Central physiological closure of the tibial physis was commonly seen in this age group and may be easily confused with physeal bar formation.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"63 ","pages":"Pages 135-140"},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative complications rates and outcomes following total hip arthroplasty in patients with ankylosing spondylitis: A systematic review","authors":"Omkar Anaspure ,&nbsp;Andrew Newsom ,&nbsp;Shiv Patel ,&nbsp;Anthony N. Baumann ,&nbsp;Krishna K. Eachempati ,&nbsp;Weston Smith ,&nbsp;Neil P. Sheth","doi":"10.1016/j.jor.2025.03.037","DOIUrl":"10.1016/j.jor.2025.03.037","url":null,"abstract":"<div><h3>Purpose</h3><div>This study sought to identify key postoperative complications and clinical outcomes in patients with Ankylosing Spondylitis (AS) undergoing total hip arthroplasty (THA).</div></div><div><h3>Methods</h3><div>This systematic review evaluated postoperative complications and clinical outcomes in this population by querying PubMed, Embase, and CINAHL, up till June 19th, 2024.</div></div><div><h3>Results</h3><div>Nineteen observational studies (n = 2003; 81.72 % male; mean age 38.95 ± 10.08 years; mean follow-up 76 ± 22.10 months) were included. Surgical approaches were posterolateral (n = 11 studies), Watson-Jones anterior (n = 1 study), and minimally invasive 2-incision (n = 1 study). Complications included infection (n = 65; 5.14 %), heterotopic ossification (n = 51; 4.03 %), prosthetic joint noise (n = 24; 1.90 %), perioperative fracture (n = 18; 1.42 %), improper implant placement (n = 14; 1.11 %), re-infection (n = 11; 0.87 %), and implant loosening (n = 8; 0.63 %). Hip dislocation occurred in 2.64 % (n = 22) of patients across 8 studies, and 4.06 % (n = 21) of patients required revision THA in six studies for various reasons, such as leg length discrepancy, joint loosening, or instability. HO was reported in 11 studies (n = 880), affecting 15.11 % (n = 133/880) of patients. All four studies assessing range of motion (ROM) found significant improvement after THA.</div></div><div><h3>Conclusion</h3><div>Observed trends suggest a noticeable occurrence of complications, such as joint dislocation and HO, following THA in patients with AS. While postoperative improvements in ROM and patient outcomes were reported, these qualitative findings warrant further investigation to confirm their significance. We recommend increased awareness and the exploration of strategies to minimize the risk of complications for high-risk patients with history of HO and other preexisting comorbidities to prevent progression of the complication profile seen in patients with AS.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 86-95"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}