Journal of orthopaedics最新文献

{"title":"A prospective randomized controlled trial comparing extracorporeal shockwave therapy and physiotherapy in the treatment of acute plantar fasciitis","authors":"Samuel Sing Li Ong,&nbsp;David Weijia Mao,&nbsp;Raj Kumar Socklingam,&nbsp;Ing How Moo,&nbsp;Charles Kon Kam King","doi":"10.1016/j.jor.2025.03.015","DOIUrl":"10.1016/j.jor.2025.03.015","url":null,"abstract":"<div><h3>Aims</h3><div>We aimed to evaluate whether the addition of early extracorporeal shockwave therapy (ESWT) to physiotherapy improved outcomes in patients with acute plantar fasciitis.</div></div><div><h3>Methods</h3><div>We conducted a randomized controlled trial in a tertiary hospital in Singapore. Eligibility criteria were patients ≥21 years old presenting from April 2017 to November 2019 with untreated plantar fasciitis for &lt;1 month with no prior physiotherapy. Exclusion criteria included history of plantar fasciitis, calcaneal fractures, chronic steroid use, pregnancy, chronic limb injuries and risks for venous thromboembolism. Patients were randomized using a random number generator into either Group A (ESWT + physiotherapy) or Group B (physiotherapy only). Visual Analogue Scale (VAS), 36-Item Short Form Survey (SF-36) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were measured at baseline and 3 months. T-tests were performed for statistical significance.</div></div><div><h3>Results</h3><div>46 patients were eligible for the trial. 10 were lost to follow up. 15 in Group A and 21 in Group B were treated and assessed. Mean age was 51.6. Baseline VAS scores were Group A (5.5 ± 2.3) and Group B (6.1 ± 2.1) (p = 0.451). There was no significant difference in 3-month VAS scores between Group A (4.7 ± 2.2) and Group B (5.2 ± 2.6) (p = 0.543). Baseline AOFAS scores were Group A (72.7 ± 12.8) and Group B (73.9 ± 14.2) (p = 0.801). There was also no significant difference in 3-month AOFAS scores between Group A (76.7 ± 5.1) and Group B (77.2 ± 13.4) (p = 0.876). No significant difference in SF-36 scores was seen at 3 months between the two groups.</div></div><div><h3>Conclusion</h3><div>The addition of early ESWT to physiotherapy did not result in better outcomes compared to physiotherapy alone for acute plantar fasciitis.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 25-28"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683321","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":"Short-term results of metaphyseal sleeves in total knee arthroplasty for severe bone defects of the tibia","authors":"Fumiyoshi Kawashima,&nbsp;Hiroshi Takagi","doi":"10.1016/j.jor.2025.03.017","DOIUrl":"10.1016/j.jor.2025.03.017","url":null,"abstract":"<div><h3>Purpose</h3><div>Severe bone defects pose a major challenge in total knee arthroplasty (TKA); however, metaphyseal sleeves may be a viable option to treat Anderson Orthopedic Research Institute (AORI) classification Type II bone defects. This study reports the short-term results of metaphyseal sleeves for severe bone defects in the proximal tibia.</div></div><div><h3>Methods</h3><div>From 2013 to 2019, a total of 10 cases were treated at our hospital with metaphyseal sleeve implants (ATTUNE revision system; DePuy-Synthes MBT, Warsaw, IN, USA), of which 2 cases underwent primary TKA for severe varus deformity, 5 underwent revision, and 3 underwent re-revision. The mean age was 71.2 (57–81) years, and the mean observation period was 5.3 years.</div></div><div><h3>Results</h3><div>There were 5 cases of AORI Type IIa and 5 cases of Type IIb. The mean implant survival time was approximately 4.7 (3.0–6.2) years. There was one case that underwent revision surgery. One patient underwent arthrodesis after implant removal due to infection. The Knee Society score (KSS) was 75 (60–95) points preoperatively and 120 (90–145) points 12-months postoperatively. Excluding 2 cases that underwent revision surgery, no progression of the radiolucent zone, implant migration, or fracture was observed up to the final follow-up of at least 24-months postoperatively.</div></div><div><h3>Conclusions</h3><div>Metaphyseal sleeves can potentially replace more invasive procedures if the severe defect has little effect on the medial collateral ligament or patellar tendon attachment site with no observable mediolateral instability.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 101-106"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686903","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":"Etiology and effects of cyclops lesions in double-bundle anterior cruciate ligament reconstruction: A case-control study","authors":"Takafumi Mizuno ,&nbsp;Shinya Ishizuka ,&nbsp;Kazutoshi Kurokouchi ,&nbsp;Junichiro Yasui ,&nbsp;Hiroki Oba ,&nbsp;Takefumi Sakaguchi ,&nbsp;Shigeo Takahashi ,&nbsp;Shiro Imagama","doi":"10.1016/j.jor.2025.03.010","DOIUrl":"10.1016/j.jor.2025.03.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated background factors and bone tunnel location related to cyclops lesions and knee extension loss after anterior cruciate ligament (ACL) reconstruction, and the relationship between cyclops lesions and postoperative muscle strength changes.</div></div><div><h3>Methods</h3><div>This study included 192 patients (101 male and 91 female patients, mean age of 27.9 years [range, 13–70 years]) who had undergone ACL double-bundle reconstruction and had cyclops lesions evaluated by magnetic resonance imaging or second-look arthroscopy. The bone tunnel position was measured using computed tomography, and knee extension limitation was measured postoperatively. Knee extension and flexion strength was measured preoperatively and postoperatively. Differences between the cyclops and no-cyclops groups were analyzed.</div></div><div><h3>Results</h3><div>The presence of cyclops lesions was significantly associated with a shallower femoral bone tunnel of the posterolateral bundle (p = 0.03). In the presence of a cyclops lesion, the higher position of the femoral bone tunnel of the anteromedial bundle (p = 0.01) and the posterior location of the tibial bone tunnel (p = 0.048) cause extension limitation. There was no difference in knee extension strength between the cyclops and no-cyclops groups preoperatively (p = 0.73), and the postoperative differences at 4, 6, 9,12 months (each p &lt; 0.05) were significantly larger, with the cyclops group having lower values than the no-cyclops groups. There was no significant difference in knee flexion strength (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Bone tunnel position and graft size are associated with the formation of cyclops lesions, and subsequent extension loss and cyclops lesions are related to weakness in extension strength one year after ACL reconstruction.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 13-19"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683384","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":"Matching lines to designs: A novel radiographic index for shorter femoral stems in total hip arthroplasty","authors":"Catalina Baez ,&nbsp;Blane Kelly ,&nbsp;Sunny Trivedi ,&nbsp;Jeff Dela Cruz ,&nbsp;Justin Deen ,&nbsp;Chancellor F. Gray ,&nbsp;Hernan Prieto ,&nbsp;Luis Pulido ,&nbsp;MaryBeth Horodyski ,&nbsp;Hari Parvataneni","doi":"10.1016/j.jor.2025.03.036","DOIUrl":"10.1016/j.jor.2025.03.036","url":null,"abstract":"<div><h3>Introduction</h3><div>Matching stem design and femoral morphology to balance stability and osseointegration with complication risk is critical in total hip arthroplasty (THA). Several historical radiographic measurements have assisted surgeons in selecting the best stem design for a patient. As these measurements were developed for longer stems (&gt;150 mm) they have less utility for shorter stems (&lt;120 mm). This study evaluated a set of new radiographic measurements tailored to shorter stems and the relative radiographic performance of several medial-to-lateral (ML) and metaphyseal-filling (MF) stems.</div></div><div><h3>Methods</h3><div>Retrospective cohort study on all elective primary THAs between January 2011 and August 2020 at a single institution. Patients received a short metaphyseal-engaging stem and a minimum six-month follow-up with standardized radiographs. Six radiographic indices were created based on validated reference points. Postoperative radiographs were evaluated for stable fixation by bone ingrowth and lucent zones.</div></div><div><h3>Results</h3><div>There were 748 cases, with a mean age of 63 (±12.2) years. Radiolucencies were evident in 13.6 % of stems. Metaphyseal-filling stems had a lower incidence of radiolucencies than ML stems (9.1 vs 19.3 %, <strong><em>p &lt; 0.001</em></strong>). A Metaphyseal Flair Index (MFI) below 0.6 and a Lesser Cortical Index (LCI) above 0.3 significantly predicted higher rates of radiolucency (<strong><em>p &lt; 0.001</em></strong>). Patients with an LCI of 0.3 or higher had a 93 % probability of developing radiolucencies when using ML stems (<strong><em>p &lt; 0.001</em></strong>).</div></div><div><h3>Conclusion</h3><div>Two indices (MFI and LCI) predicted areas of osseointegration in modern short femoral stems. Metaphyseal-filling stems have lower radiolucency rates than ML stems. Due to the higher probability of radiolucencies, surgeons should consider avoiding ML stems in patients with LCI values above 0.3.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 39-47"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683262","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":"Older age at anterior cruciate ligament reconstruction associates with a lower systemic inflammation response index after surgery","authors":"Sonu Bae ,&nbsp;Christopher C. Kaeding ,&nbsp;David C. Flanigan ,&nbsp;Tyler Barker","doi":"10.1016/j.jor.2025.03.019","DOIUrl":"10.1016/j.jor.2025.03.019","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to investigate the association of age at anterior cruciate ligament reconstruction (ACLR) with systemic indices of the immune system and inflammation after surgery.</div></div><div><h3>Methods</h3><div>This study consisted of a retrospective, cohort design. Patients (male and female, ≥18 years) that underwent ACLR at a single academic institution and with complete blood cell (CBC) count data obtained ≥ 1-year after surgery were included. Patients with a documented diagnosis of knee osteoarthritis (OA) before ACLR were excluded, while those with a documented diagnosis of knee OA after ACLR were included in this study. The systemic inflammation response index (SIRI), systemic immune-inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated from the CBC data. Patients (n = 198) were separated into groups based on age at ACLR: (1) 18–29 y (n = 96), (2) 30–39 y (n = 50), or (3) ≥40 y (n = 52).</div></div><div><h3>Results</h3><div>Subject characteristics (patient sex, height, body mass, and body mass index), follow-up interval, time from ACLR to CBC assessment, and concomitant procedures performed at ACLR were not significantly different between age groups. The PLR, NLR, MLR, and SII were not significantly different between groups, while the SIRI was significantly lower in the 30–39 (p &lt; 0.01) and ≥40 y (p &lt; 0.01) groups compared to the 18–29 y group. An older age at ACLR (i.e., 30–39 y and ≥40 y) was associated with an increased occurrence (11.5 and 12 %, respectively) of a knee OA diagnosis following surgery compared to that in the younger age group (18–29 y, 1.0 %; p = 0.04).</div></div><div><h3>Conclusion</h3><div>We conclude that an older age at ACLR associated with a lower systemic inflammatory response index at a minimum of 1-year following surger.</div></div><div><h3><em>Level of evidence</em></h3><div>Level III.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 137-141"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686875","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":"Underestimated incidence of acute lateral hinge fractures in medial opening wedge high tibial osteotomy: The role of MRI in early detection","authors":"Woon-Hwa Jung ,&nbsp;Minish Raghunath Katkar ,&nbsp;Min-Seok Seo ,&nbsp;Dong-Hyun Kim ,&nbsp;Ryohei Takeuchi","doi":"10.1016/j.jor.2025.03.026","DOIUrl":"10.1016/j.jor.2025.03.026","url":null,"abstract":"<div><h3>Objective</h3><div>1) Investigate the incidence of lateral-hinge fractures after medial opening wedge high tibial osteotomy using MRI postoperatively alongside radiographs. 2) Determine the number of missed acute lateral-hinge fractures and distinguish them from true delayed fractures 3)Evaluate the complications associated with these fractures.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 250 knees from 227 patients who underwent medial opening-wedge high tibial osteotomy. Radiological evaluation was performed using radiographs, CT scans, and MRI. Patients were categorized into four groups: (1) Acute Lateral-hinge fractures, (2) missed Lateral-hinge fractures, (3) delayed Lateral-hinge fractures and (4) no fractures.</div></div><div><h3>Results</h3><div>MRI detected lateral hinge fractures (LHF) in 59.6 % of cases, nearly doubling the detection rate of radiographs and CT scans (33.2 %), revealing a significant underestimation of LHF in MOWHTO. Additionally, 73.49 % of presumed delayed fractures were actually missed acute fractures, with a true delayed fracture incidence of only 1.6 %. The fracture groups had a longer healing time and were associated with a loss of correction.</div></div><div><h3>Conclusion</h3><div>The incidence of lateral-hinge fractures after medial opening-wedge high tibial osteotomy is significantly underestimated, with most occurring intra-operatively but often missed on postoperative radiographs and misclassified as delayed fractures. MRI, highly sensitive for early detection and prevention of misclassification, helps optimize rehabilitation strategies and improve patient outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 117-123"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686899","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":"Pain worsens peripartum after hip arthroscopy for femoroacetabular impingement and may not return to pre-pregnancy improvement","authors":"Allison M. Morgan,&nbsp;Dhruv S. Shankar,&nbsp;Andrew S. Bi,&nbsp;Zachary I. Li,&nbsp;Jairo Triana,&nbsp;Thomas Youm","doi":"10.1016/j.jor.2025.03.008","DOIUrl":"10.1016/j.jor.2025.03.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess hip symptomatology during the perioperative and peripregnancy periods and postoperative outcomes among reproductive age females undergoing arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) and pregnancy complications in females after hip arthroscopy.</div></div><div><h3>Methods</h3><div>Females aged 18–44 years who underwent hip arthroscopy for the treatment of FAIS with a single surgeon were included in the study. Postoperatively, patients were surveyed regarding obstetric history, hip symptomology, and post-surgery pregnancy experiences. Subjects were classified as nulligravid (Group 1), pregnant at least once before hip surgery but never again following surgery (Group 2), or pregnant at least once following hip surgery (Group 3). Hip pain intensity was reported on a 10-point Visual Analog Scale (VAS) and hip function was reported using the modified Harris Hip Score (mHHS). Patients self-reported pregnancy outcomes and complications.</div></div><div><h3>Results</h3><div>85 patients were enrolled with a mean age of 32.3 ± 6.5 years at the time of surgery. Mean follow-up time was 51.9 ± 34.5 months. There were 39 subjects in Group 1 (45.9 %), 20 in Group 2 (23.5 %), and 26 in Group 3 (30.6 %). There were no significant inter-group differences in mHHS preoperatively or at final follow-up (p = 0.95). Group 3 subjects reported that both postoperative and post-pregnancy VAS remained significantly lower than the preoperative baseline (p &lt; 0.001). 69.2 % and 73.1 % report worsened hip pain during the third trimester and postpartum, respectively. 57.9 % reported that their hip pain returned to the pre-pregnancy baseline by time of survey completion.</div></div><div><h3>Conclusion</h3><div>Females of reproductive age with FAIS can expect clinical improvements relative to their baseline after hip arthroscopy regardless of pregnancy timing relative to surgical intervention. A majority of patients who become pregnant post-arthroscopy experience a peripartum recurrence of their symptoms. Most but not all of these patients return to the level of maximal improvement they had initially experienced postoperatively.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 119-125"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724692","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":"Evaluating barbed sutures: A porcine biomechanical comparison of Z-plasty and turndown flap according to Silfverskiöld","authors":"Henry V. Bürger ,&nbsp;Jahnke Alexander ,&nbsp;Harz Torben ,&nbsp;Carlos A. Fonseca-Ulloa ,&nbsp;Markus Rickert ,&nbsp;Dirk Stolz","doi":"10.1016/j.jor.2025.03.003","DOIUrl":"10.1016/j.jor.2025.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>It is not possible to add an infinite amount of suture material to tendon plasties and repairs in vivo. Each additional knot can reduce the tensile strength by up to 50 %. Therefore, barbed sutures, as a knotless suturing system, should be investigated as a potential alternative to traditional sutures to minimize knot-related weakening.</div></div><div><h3>Material and methods</h3><div>Superficial porcine flexors were randomized into five groups. A non-contact measurement was utilized. The Z-plasty and the turndown flap according to Silfverskiöld were used. The Stratafix barbed knotless suture was compared to regular smooth polydioxanone. The biomechanical protocol included a creep test, a cyclic test, and a tear-off test.</div></div><div><h3>Results</h3><div>The Z-plasty with Stratafix showed significantly improved maximum force compared to the Z-plasty with Polydioxanon (PDS 108.5 ± 22.2N, Stratafix 142.3 ± 23.5N, p &lt; .01). The Z-plasty was significantly superior to the turndown flap in maximum Force (turndownflap with Stratafix 52.4 ± 14.6N, Z-plasty with Stratafix 108.5 ± 22.2N, p &lt; .001).</div></div><div><h3>Conclusion</h3><div>The Stratafix barbed suture can significantly improve the Z-plasty in maximum tension by up to 32 % when compared to regular PDS. To formulate a more precise indication, biological factors must be further investigated.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 30-36"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600941","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":"Proximal fibular osteotomy definitively ameliorates medial compartment knee osteoarthritis: A finite element analysis","authors":"Quan Sun ,&nbsp;Kaiwei Zhang ,&nbsp;Di Yang ,&nbsp;Yang Liu ,&nbsp;Yuankun Xu ,&nbsp;Shuguang Zheng","doi":"10.1016/j.jor.2025.03.005","DOIUrl":"10.1016/j.jor.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study was designed to explore the biomechanical impacts of the proximal fibular osteotomy (PFO) on medial compartment knee osteoarthritis (KOA). Furthermore, this study utilized finite element analysis (FEA) to examine the biomechanical impacts of PFO on medial compartment KOA both pre- and post-surgery.</div></div><div><h3>Methods</h3><div>Fifteen individuals with medial compartment KOA were selected randomly. Three-dimensional reconstruction software, coupled with FEA software, was employed to model PFO, allowing observation of changes in stress distribution, peak stress, and contact area of articular cartilage in femoral cartilage, tibial plateau cartilage, and meniscus before and after PFO.</div></div><div><h3>Results</h3><div>After PFO, significant changes in peak stress and stress distribution in the knee joint (KJ) were observed. The stress distribution shifts notably from the medial side to the lateral side. A significant reduction in peak values was observed in the medial femoral cartilage (changing from 1.91 ± 0.44 to 1.40 ± 0.14), medial meniscus (2.89 ± 0.72 to 2.05 ± 0.49), and medial tibial plateau cartilage (2.25 ± 0.65 to 1.60 ± 0.38). On the contrary, an increase in these metrics was recorded in the lateral femoral cartilage (changing from 1.10 ± 0.32 to 1.59 ± 0.30), lateral meniscus (1.82 ± 0.58 to 2.49 ± 0.60), and lateral tibial plateau cartilage (0.95 ± 0.21 to 1.40 ± 0.26). In addition, the stress distribution area of articular cartilage was reduced significantly in the medial dimension (346.25 ± 55.66 to 267.05 ± 51.05) and increased in the lateral dimension (219.35 ± 38.89 to 333.25 ± 29.90).</div></div><div><h3>Conclusion</h3><div>PFO demonstrates effectiveness in alleviating stress within the medial compartment of the KJ, presenting a straightforward and efficacious approach for managing medial compartment KOA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 47-52"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628132","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":"Appropriately planned resection depth can impact outcomes after robotic total knee arthroplasty","authors":"Jayson Zadzilka ,&nbsp;Bernard Stulberg ,&nbsp;Brian Davis","doi":"10.1016/j.jor.2025.03.004","DOIUrl":"10.1016/j.jor.2025.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>There are many factors to consider while planning and executing a successful total knee arthroplasty. One of these, the amount of bony resection, is determined in part based on the patients’ anatomy and preoperative deformity. Utilizing intraoperative technology such as robotics allows for resection to be done accurately. Therefore, the goal of this study was to investigate the relationship between tibial &amp; femoral resection depths and postoperative outcomes. Additionally, a quantitative method for preoperatively determining the level of resection depth needed was developed.</div></div><div><h3>Methods</h3><div>A de-identified dataset containing 107 robotic total knee arthroplasty cases was reviewed. Preoperative demographics, preoperative planning details, and sub-scale scores from the Knee Society Scoring System were reviewed. Analysis was performed to find significant associations with the sub-scale scores. Additionally, multiple regression models were developed to predict resection depth values.</div></div><div><h3>Results</h3><div>Associations were found between femoral resection depth and Satisfaction &amp; Function scores three months postoperatively. Additionally, Satisfaction and Function were 6 % and 16 % higher respectively when the native alignment strategy was used rather than mechanical alignment of the lower limb. Three-month Function scores were also 6 % higher for males than females. The models to predict resection depth included alignment strategy, preoperative knee deformity, and gender as the significant contributors.</div></div><div><h3>Conclusion</h3><div>Tibial and femoral resection depth can influence postoperative outcomes. Therefore, it is important to understand what factors contribute to the determination of how much bone should be resected. With that information, patient-specific preoperative plans can be developed with the intent of optimizing postoperative outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 42-46"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628131","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}