Journal of orthopaedics最新文献

{"title":"Total ankle arthroplasty versus ankle arthrodesis in end-stage osteoarthritis: A meta-analysis of comparative outcomes","authors":"Jiayong Liu,&nbsp;Thomas Cho,&nbsp;Isaac A. Arefi,&nbsp;Austin Lawrence,&nbsp;A Champa Jayasuriya","doi":"10.1016/j.jor.2025.03.056","DOIUrl":"10.1016/j.jor.2025.03.056","url":null,"abstract":"<div><div>The treatments for end-stage ankle arthritis are challenging. Standard treatment methods include ankle arthrodesis (AA) and total ankle arthroplasty (TAA). This meta-analysis compares the outcomes of TAA and AA based on comparative studies. Literature databases include PubMed, Embase, and Google Scholar. Keywords related to the treatment of end-stage ankle osteoarthritis with AA compared to TAA were used. The outcome measurements include functional outcomes and revision rates. Review Manager 5.4 was used to conduct statistical analysis. A standard p-value of &lt;0.05 indicated statistical significance. 27 comparison articles, including data from 12,341 patients, were included in the meta-analysis. 4917 patients underwent total ankle arthroplasty, while 7440 underwent ankle arthrodesis. The results showed a significant difference in the AOFAS score favoring TAA (p &lt; 0.001). Dorsiflexion range of motion (ROM) also showed a significant difference in favor of TAA (p &lt; 0.001). Additionally, the TAA group's plantarflexion ROM was significantly superior (p &lt; 0.001). The overall SF-36 score, which measures quality of life, reported improved outcomes for patients who underwent TAA compared to those with AA (p &lt; 0.001). The Activities of Daily Living, calculated by the Foot and Ankle Ability Measure (FAAM) score, also showed significant improvement in patients who had TAA compared to those who received AA (p &lt; 0.001). When both the Activities of Daily Living and Sports subscales were combined, there was a significant improvement in the total FAAM score for TAA patients (p &lt; 0.001). However, there was a significant difference in revision rates favoring AA (p &lt; 0.001). This meta-analysis compared postoperative outcomes of ankle arthrodesis (AA) and total ankle arthroplasty (TAA) through patient-reported and functional measures. By synthesizing qualitative and quantitative data, we identified TAA as the superior intervention, demonstrating significant advantages in AOFAS scores, FAAM activities of daily living, FAAM total scores, SF-36 total scores, and range of motion. These findings aid in tailoring surgical decisions for end-stage ankle osteoarthritis, particularly when patient-specific factors such as anatomical suitability, comorbidities, or access to advanced care limit treatment options. Additionally, this study supports the recent trend of showing comparable revision rates between TAA and AA.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"63 ","pages":"Pages 157-164"},"PeriodicalIF":1.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783420","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":"Variability in the classification, management, and outcome reporting for avascular necrosis of the femoral head: A systematic review","authors":"Katrina Nietsch ,&nbsp;Avanish Yendluri ,&nbsp;John J. Corvi ,&nbsp;Joshua J. Chiang ,&nbsp;Alexander K. Hahn ,&nbsp;Nikan K. Namiri ,&nbsp;Michael N. Megafu ,&nbsp;Calin S. Moucha ,&nbsp;Thomas A. Einhorn ,&nbsp;Robert L. Parisien ,&nbsp;Investigation Performed By The Scientific Collaborative For Orthopaedic Research And Education (SCORE) Group","doi":"10.1016/j.jor.2025.03.013","DOIUrl":"10.1016/j.jor.2025.03.013","url":null,"abstract":"<div><h3>Introduction</h3><div>There is no universally-utilized classification system for avascular necrosis of the femoral head (AVNFH), a debilitating condition that arises due to impaired blood supply resulting in cortical collapse. AVNFH may require early intervention to prevent irreversible damage leading to total hip arthroplasty. The purpose of this study is to assess the variability in classification, management, and outcomes reported in randomized controlled trials (RCTs) related to AVNFH.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Medline were queried for RCTs on the treatment of AVNFH (2010–2023). The number of patients, number of femoral heads, minimum follow-up, AVNFH classification system, treatment interventions, and outcome measures were extracted. Variability in classification, management approach, and reporting of outcomes was evaluated.</div></div><div><h3>Results</h3><div>A total of 30 RCTs met inclusion criteria, encompassing 1891 total patients. The mean number of patients in each study was 63 (SD = 41), with a mean minimum follow-up of 30 months (SD = 17). The Association Research Circulation Osseous classification system was utilized in 63 % (n = 19) of studies, Ficat and Arlet in 20 % (n = 6) of studies, Steinberg in 10 % (n = 3), Mitchell in 3 % (n = 1), and the China-Japan Friendship Hospital classifications in 3 % (n = 1). There were 61 treatment interventions, stratified into nine categories. Radiographic imaging was most commonly used to evaluate patients at follow-up.</div></div><div><h3>Conclusion</h3><div>There are a variety of classification systems, treatments, and outcome measures utilized in the literature to categorize and quantify AVNFH. The utilization of a universally-accepted classification system and standardized outcome reporting may help to ensure reproducibility and accuracy given a continued lack of consensus.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"63 ","pages":"Pages 148-156"},"PeriodicalIF":1.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777540","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":"Full-endoscopic posterior longitudinal ligament coverage suturing for lumbar disc herniation with annular defects","authors":"Quan Zhang ,&nbsp;Bo He ,&nbsp;Zijin Liu ,&nbsp;Zhenfei Wang ,&nbsp;Jinhui Bu ,&nbsp;Minghui Dong ,&nbsp;Zhaobo Liu ,&nbsp;Mengzi Hu ,&nbsp;Chao Ma ,&nbsp;Guangwang Liu","doi":"10.1016/j.jor.2025.03.048","DOIUrl":"10.1016/j.jor.2025.03.048","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the clinical efficacy of full-endoscopic posterior longitudinal ligament (PLL) coverage suturing in the area of the defective annulus fibrosus for the treatment of lumbar disc herniation (LDH).</div></div><div><h3>Methods</h3><div>Retrospective analysis of patients who underwent full-endoscopic surgery for LDH in our hospital from March 2018 to July 2023, there were 56 cases presented with partial defects of the annulus fibrosus detected microscopically. Among these, 34 cases were treated with full-endoscopic lumbar discectomy alone (control group), whereas 22 cases were treated with posterior longitudinal ligament coverage of annulus fibrosus defects with suturing following lumbar discectomy (observation group). Perioperative, follow-up and imaging data were compared between the two groups.</div></div><div><h3>Results</h3><div>No severe complications occurred in either group. The observation group had longer surgical time (67.23 ± 8.85 vs. 54.38 ± 8.16 min, <em>P</em> &lt; 0.05), but no differences in incision length, blood loss, or hospital stay (<em>P</em> &gt; 0.05). At 12–18-month follow-up (mean 14.3 ± 0.2 months), recurrence was observed in 6 patients (17.6 %) in the control group versus none in the observation group (<em>P</em> &lt; 0.05); one recurrence required reoperation, with no intergroup difference in reoperation rates (<em>P</em> &gt; 0.05). Preoperative VAS and ODI scores were comparable (<em>P</em> &gt; 0.05), and both groups showed significant postoperative reductions (<em>P</em> &lt; 0.05), though intergroup differences were insignificant (<em>P</em> &gt; 0.05). Pfirrmann grading improved significantly in both groups postoperatively (<em>P</em> &lt; 0.05) but did not differ between groups (<em>P</em> &gt; 0.05). Full-endoscopic posterior longitudinal ligament coverage suturing effectively repaired annular defects, reduced recurrence, and demonstrated clinical efficacy for lumbar disc herniation.</div></div><div><h3>Conclusions</h3><div>Lumbar disc herniation with annulus fibrosus defects can be treated with satisfactory clinical efficacy by using full-endoscopic posterior longitudinal ligament coverage suturing in the area of the defective annulus fibrosus, which can effectively repair fibrous annulus defects and reduce the recurrence rate of LDH.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"63 ","pages":"Pages 165-170"},"PeriodicalIF":1.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800586","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":"Increased prevalence of lateral trochlear groove wear among valgus alignment subtypes by coronal knee alignment classification: A retrospective single-center study","authors":"Danielle DeMoes ,&nbsp;Roham Borazjani ,&nbsp;Alexander D. Orsi ,&nbsp;Christopher Plaskos ,&nbsp;Stefan Kreuzer","doi":"10.1016/j.jor.2025.03.050","DOIUrl":"10.1016/j.jor.2025.03.050","url":null,"abstract":"<div><h3>Introduction</h3><div>The Coronal Plane Alignment of The Knee (CPAK) classification aims to restore the constitutional knee alignment, although it neglects the patellofemoral joint. Therefore, this study aims to examine the correlation between trochlear groove wear (TGW) patterns and CPAK classifications.</div></div><div><h3>Methods</h3><div>Our institutional database was queried to include unilateral primary total knee arthroplasties (TKA) between 2021 and 2025. TGW was categorized into central, medial, lateral, and no TGW based on the most prominent wear observed intraoperatively. Using OMNIBotics® surgical navigation system (Corin Ltd.), nine CPAK phenotypes were determined by intraoperative registration of the arithmetic hip–knee–ankle angles (aHKA), joint line obliquity (JLO), lateral distal femoral angle (LDFA), and medial proximal tibial angle (MPTA).</div></div><div><h3>Results</h3><div>Among 559 cases, central TGW (53.7 %), followed by lateral (21.8 %) and medial (15.2 %), were the most frequent TGW. Lateral TGW had a higher mean of MPTA (88.5 ± 2.3), while medial TGW had a significantly higher mean of LDFA (87.3 ± 2.2) than the other groups. Central TGW was the most prevalent wear in all aHKA groups, with the lateral TGW being more frequent (33 %) in the valgus knees than the medial TGW (8.4 %). Forty-two percent of cases with lateral TGW had CPAK type Ⅲ, followed by CPAK type Ⅱ (30 %) and CPAK type Ⅵ (13.0 %). The most frequently observed CPAK phenotypes with the central TGW were type Ⅱ (40 %), type Ⅲ (25 %), and typeⅠ (17 %). The same trend was detected for medial TGW and those without wear.</div></div><div><h3>Conclusion</h3><div>The interplay between joint health and structural alignment can impact surgical planning, as we observed a significant association between the TGW and CPAK parameters. Surgeons may adjust femoral component rotation in CPAK Ⅲ with lateral TGW to address patellar maltracking, though further research is needed.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"63 ","pages":"Pages 141-147"},"PeriodicalIF":1.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767754","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":"Effect of the friction coefficient between bone cement and polished stem on subsidence of the stem in total hip arthroplasty","authors":"Yuta Nakajo ,&nbsp;Ayumi Kaneuji ,&nbsp;Noriyuki Takano","doi":"10.1016/j.jor.2025.03.055","DOIUrl":"10.1016/j.jor.2025.03.055","url":null,"abstract":"<div><div>The effect of the friction coefficient between bone cement and polished stems on stem subsidence was investigated in total hip arthroplasty (THA) using nonlinear finite element analysis. Stem subsidence results from both stem slip and shear deformation of the cement. On the lateral side, subsidence is mainly caused by stem slip, while on the medial side, cement deformation is involved. With low friction coefficients, \"Reverse subsidence\" occurs after load release, where the stem moves upward, and compressive stress is transmitted to the cement. On the other hand, with high friction coefficients, more significant shear deformation of the cement mantle occurs, and residual strain accumulates in the proximal region. The present study implies a trade-off relationship: high friction increases the risk of periprosthetic fractures (PPFs) in the proximal region, while low friction increases the risk in the distal region.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"62 ","pages":"Pages 148-151"},"PeriodicalIF":1.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734739","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":"Cemented vs. uncemented total knee arthroplasty in obese patients: A systematic review of implant survival, complications, and clinical outcomes","authors":"Lorenzo Lo Carmine ,&nbsp;Francesco Onorato ,&nbsp;Carmelo Burgio ,&nbsp;Zepeda Karlos ,&nbsp;Virginia Masoni ,&nbsp;Marcello Capella ,&nbsp;Lawrence Camarda ,&nbsp;Danilo Francesco Chirillo ,&nbsp;Alessandro Massè ,&nbsp;Francesco Bosco","doi":"10.1016/j.jor.2025.03.049","DOIUrl":"10.1016/j.jor.2025.03.049","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is a primary global health concern that negatively affects the outcomes of total knee arthroplasty (TKA). To mitigate complications, both cemented and uncemented fixation techniques have been considered. However, there remains no consensus in the literature regarding the optimal fixation method for obese patients despite the renewed interest in uncemented fixation. This systematic review aims to compare the survival rates, causes of failure, and patient-reported outcome measures (PROMs) between cemented TKA (cTKA) and uncemented TKA (uTKA) in the obese population.</div></div><div><h3>Materials and methods</h3><div>A comprehensive literature search was conducted according to PRISMA guidelines across five databases—PubMed, Scopus, Embase, Medline, and Cochrane—focusing on studies directly comparing cTKA and uTKA in obese patients. The ROBINS-I tool was used to assess the risk of bias, while the PRISMA flow diagram guided the study selection process based on predefined inclusion and exclusion criteria. This systematic review was registered on PROSPERO.</div></div><div><h3>Results</h3><div>Four retrospective studies encompassing 1622 patients met the inclusion criteria and were included in the final qualitative analysis. Among these, 50 % of patients underwent uTKA, with three studies exclusively analyzing individuals with at least class II obesity (BMI ≥35 kg/m²). All four studies reported higher rates of aseptic loosening in the cemented fixation group. However, only two studies demonstrated a statistically significant improvement in implant survival, reduced aseptic loosening, and lower revision rates with cementless fixation in the short-to mid-term follow-up. Regarding clinical outcomes, only one study reported a significant improvement in Knee Society Score (KSS) function, range of motion (ROM), and pain scores in the cementless group compared to the cemented group, particularly in the subgroup analysis of posterior-stabilized constrained TKA.</div></div><div><h3>Conclusion</h3><div>This systematic review suggests that in obese patients, particularly those with BMI ≥35 kg/m², cementless fixation offers comparable or superior implant survival rates and lower rates of aseptic loosening compared to cemented fixation in the short-to mid-term follow-up. Furthermore, cementless fixation may provide similar or enhanced clinical outcomes in this high-risk and growing patient population.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 126-132"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724690","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":"The Reverse Dorr: Preoperative radiographic evaluation of bone quality correlates to bone mineral density in total knee arthroplasty","authors":"Timothy Carlson ,&nbsp;Aaron Beck ,&nbsp;James Kohler ,&nbsp;Samuel Mosiman ,&nbsp;Brian Nickel","doi":"10.1016/j.jor.2025.03.052","DOIUrl":"10.1016/j.jor.2025.03.052","url":null,"abstract":"<div><h3>Background</h3><div>There has been an increase in cementless total knee arthroplasty (TKA) across the country. Although radiographic classification systems of the knee exist, these algorithms have not been correlated to bone mineral density (BMD). We aimed to correlate radiographic measurements of the knee with preoperative BMD and develop a model predictive of osteopenia.</div></div><div><h3>Materials and methods</h3><div>We prospectively enrolled 100 patients, scheduled to undergo elective TKA, to obtain a preoperative dual energy x-ray absorptiometry (DEXA) scan. Four independent surgeons measured cortical indices of the knee on preoperative radiographs and correlated these ratios with local BMD. Intraclass correlations (ICC) were used to assess interobserver reliability and Pearson correlation coefficients (PCC) to describe the strength of relationship between BMD and radiographic ratios. A “Reverse Dorr” model was created to evaluate the ratio of the distal femur cortical indices. Logistic regression was used to predict the odds of having osteopenia.</div></div><div><h3>Results</h3><div>We found several cortical ratios of the knee correlated with bone mineral density, but the lateral radiograph had the highest correlation. All measurements showed, at a minimum, fair interobserver reliability with most achieving an ICC &gt;0.81. The proximal femur, distal femur ratio, “Reverse Dorr” model, was found to be a strong predictor of osteopenia with an ROC of 0.7335.</div></div><div><h3>Conclusions</h3><div>This radiographic assessment demonstrates that cortical thickness of the knee is correlated with bone mineral density—most notably on the lateral radiograph. Utilization of the “Reverse Dorr” model was strongly predictive of osteopenia and may help guide implant selection.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 138-144"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737796","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":"Accuracy of matching tibial slope in manual kinematically aligned total knee arthroplasty","authors":"Whisper Grayson ,&nbsp;Ethan Teich ,&nbsp;Nicholas M. Brown","doi":"10.1016/j.jor.2025.03.033","DOIUrl":"10.1016/j.jor.2025.03.033","url":null,"abstract":"<div><h3>Background</h3><div>Reproduction of the posterior tibial slope (PTS) during total knee arthroplasty (TKA) improves patient outcomes and minimizes complications including subsidence, polyethylene wear, and instability. The use of imaging has been previously studied as a way of measuring PTS angle and its association with surgical outcomes. There is a lack of literature on the accuracy of matching PTS during manual kinematically aligned (KA) TKA.</div></div><div><h3>Methods</h3><div>This is a retrospective study including 299 primary manual KA TKAs between October 2021 and August 2024 by a single surgeon. The primary outcome was comparison of pre-operative and post-operative PTS angles. Measurements were performed on lateral radiographs as the angle between the tangent line of the tibial plateau and a line perpendicular to the tibial shaft axis.</div></div><div><h3>Results</h3><div>The average pre-operative tibial slope was 10.3<strong>°</strong> (std dev, 4.8) compared to an average post-operative measurement of 5.3<strong>°</strong> (std dev, 3.2) (p &lt; 0.00001). Range of motion improved post-operatively, with average extension increasing from 4.4<strong>°</strong> to 0.9<strong>°</strong> and flexion maintained from 118.5<strong>°</strong> to 117.2<strong>°</strong>. Complications were infrequent, with one superficial infection, two prosthetic joint infections requiring revision, two additional reoperations for polyethylene exchanges, and five manipulations under anesthesia with subsequent improvement in range of motion.</div></div><div><h3>Conclusion</h3><div>In this study, we found a significant difference in pre-operative and post-operative tibial slope angle on radiographic measurements following manual KA TKA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"62 ","pages":"Pages 152-155"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734740","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":"Comparison of patient-specific instrumentation (PSI) versus conventional instrumentation (CI) in shoulder arthroplasties: A Meta-Analysis and Systematic Review","authors":"Francis Jia Yi Fong ,&nbsp;Jason Derry Onggo ,&nbsp;Michael Gui Jie Yam","doi":"10.1016/j.jor.2025.03.044","DOIUrl":"10.1016/j.jor.2025.03.044","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluates the effectiveness of patient-specific instrumentation (PSI) versus conventional instrumentation (CI) in shoulder arthroplasties. Accurate glenoid component placement is crucial for successful shoulder replacements, and PSI offers the potential to improve this accuracy.</div></div><div><h3>Methods</h3><div>Electronic database search of PubMed, Embase, Scopus, Web of Science and Cochrane was performed on April 10, 2024, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for scoping reviews. The searches were conducted using the keywords relating to “shoulder arthroplasty” and “three-dimensional printing”. No restrictions were placed on the date of publication.</div></div><div><h3>Results</h3><div>10 clinical studies involving 4092 patients, comparing PSI and CI were included. The results show that PSI generally improves radiological outcomes, with lower anterior-posterior offset errors, longer screw lengths, and near statistically significant reductions in version, inclination, and superior-inferior offset errors. However, there was no significant difference between PSI and CI in terms of operative duration, complication rates, or short-term patient-reported outcomes such as the Constant Murley Score.</div></div><div><h3>Conclusion</h3><div>While PSI did not significantly reduce short-term complications or alter patient-reported outcomes, it demonstrated a promising potential to enhance glenoid component positioning. Accurate placement of the glenoid component is crucial for long-term success, and PSI may reduce postoperative complications such as glenoid loosening. However, the lack of long-term follow-up in most studies limits the ability to fully assess these benefits.</div><div>The study also highlights the variability in PSI design and calls for standardized protocols to improve data consistency and accuracy.Longer follow-up studies are recommended to better assess the impact of PSI on long-term outcomes. In conclusion, PSI may improve radiological outcomes without increasing surgical complexity, representing a promising alternative to CI in shoulder arthroplasty.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"62 ","pages":"Pages 139-147"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725731","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":"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}