Journal of orthopaedics最新文献

{"title":"Sociodemographic variables are rarely included in femoral neck fracture randomized controlled trials: A systematic review","authors":"Avanish Yendluri,&nbsp;Jennifer Yu,&nbsp;Carolina Stocchi,&nbsp;Mark Kurapatti,&nbsp;Nikan K. Namiri,&nbsp;Junho Song,&nbsp;John J. Corvi,&nbsp;John K. Cordero,&nbsp;Steven Yacovelli,&nbsp;Brett L. Hayden,&nbsp;David A. Forsh","doi":"10.1016/j.jor.2025.03.023","DOIUrl":"10.1016/j.jor.2025.03.023","url":null,"abstract":"<div><h3>Introduction</h3><div>Sociodemographic factors may affect outcomes after surgery for patients with femoral neck fractures. The purpose of this study was to assess the inclusion of sociodemographic variables in high-impact randomized controlled trials (RCTs) related to femoral neck fracture operative management.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Medline were queried from January 1, 2017 to March 31, 2024 for RCTs pertaining to operative treatment of femoral neck fracture patients in high impact journals were included. The journal of publication, year of publication, and interventions assessed by the RCTs were extracted. Each RCT was assessed for inclusion of the following sociodemographic variables: age, sex/gender, body mass index (BMI)/weight, race/ethnicity, education level, insurance, smoking/tobacco use, socioeconomic status, marital status, alcohol use, English proficiency, geographic measures (i.e. proximity to hospital), employment status, and prefracture residence status. Temporal reporting trends were analyzed using Chi-square test.</div></div><div><h3>Results</h3><div>Of 1038 RCTs identified, 37 were included for analysis. All 37 studies reported age and sex/gender. BMI/weight was reported in 22 studies (59.5 %). Patients’ prefracture residence status was reported in 11 studies (29.7 %). Smoking/tobacco use was reported in 9 studies (24.3 %). Race/ethnicity was reported in only 5 studies (13.5 %). Socioeconomic status, English proficiency, geographic measures, marital status, education level, insurance, and employment variables were all reported in less than 10 % of the analyzed RCTs. Furthermore, there was no significant difference in the proportion of studies reporting at least one sociodemographic variable (excluding age, sex/gender, and BMI/weight) in 2017–2020 (10/22) versus 2021–2024 (8/15; <em>p</em> = 0.743).</div></div><div><h3>Conclusion</h3><div>Our analysis of high-impact RCTs revealed a large gap in the reporting of sociodemographic variables. RCTs relating to femoral neck fracture management should consistently report key sociodemographic variables to ensure generalizability of study findings.</div></div><div><h3>Level of evidence</h3><div>1</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 79-85"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644439","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 biomechanics between two different external fixation methods in the treatment of A1b tibial fractures based on finite element analysis","authors":"Jinkun Guo ,&nbsp;Ling Zhang ,&nbsp;Shitao Fang ,&nbsp;Yun Wang ,&nbsp;Ming Zhang ,&nbsp;Lei Mi","doi":"10.1016/j.jor.2025.03.021","DOIUrl":"10.1016/j.jor.2025.03.021","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the biomechanical stability between two different external fixation methods (locked steel plates versus external fixation frame) for the treatment of A1b tibial fractures based on finite element analysis, and to provide theoretical reference for clinical application.</div></div><div><h3>Methods</h3><div>Based on CT data of the left tibia from a healthy male volunteer, a normal three-dimensional (3D) tibial model was constructed using modeling software, which was further derived into a A1b tibial fracture model. Then, On the basis of the fracture model constructed above, the finite element models of locking compression plate and unilateral external fixator were fixed respectively. Further, 4 different test conditions (i.e., 4-point bending, axial compression, clockwise torsion, and counterclockwise torsion) were simulated under the same loading and constraint conditions for both models, in order to comparatively evaluate the equivalent peak stress and peak overall displacement of the fracture site between the two methods.</div></div><div><h3>Results</h3><div>From the experimental data corresponding to the maximum load under 4 different test conditions, it was found that the peak stress of tibia and the equivalent peak stress of fractured tibia with external fixation was roughly ranged 49.16–269.59 MPa and 34.99–559.58 MPa in the two fixation methods under various test conditions. Overall, external fracture fixation with locked steel plates showed a greater equivalent peak stress and a smaller peak overall tibial displacement than that with external fixation frame did.</div></div><div><h3>Conclusions</h3><div>Locked steel plates may be superior external fixation frame in terms of biomechanical properties in the treatment of A1b tibial fractures, and can be used as an alternative option for patients who cannot tolerate external fixation frame.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683381","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":"Greater socioeconomic deprivation predicts worse functional status two years after orthopaedic surgery, but not magnitude of change from baseline","authors":"Evan L. Honig,&nbsp;Samir Kaveeshwar,&nbsp;Nathan N. O'Hara,&nbsp;Dominic J. Ventimiglia,&nbsp;Isaiah Harris,&nbsp;Samuel Q. Li,&nbsp;Craig Shul,&nbsp;Natalie R. Danna,&nbsp;R. Frank Henn 3rd,&nbsp;Christopher G. Langhammer","doi":"10.1016/j.jor.2025.03.022","DOIUrl":"10.1016/j.jor.2025.03.022","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to analyze if Area Deprivation Index (ADI), as a geography-based proxy for socioeconomic status (SES), is associated with differences in patient-reported outcomes (PROs) 2 years after outpatient orthopaedic surgery.</div></div><div><h3>Methods</h3><div>Patients undergoing outpatient orthopaedic surgery from June 2015 to November 2018 were administered Patient-Reported Outcomes Measurement Information System (PROMIS) and joint-specific surveys at baseline and 2 years postoperatively. ADI was computed from home address. Tests of association were used to characterize 2-year PROs dependence on ADI. This informed covariate selection for multivariable linear regression examined PRO change over 2 years with ADI in the context of other self-reported socioeconomic covariates.</div></div><div><h3>Results</h3><div>Enrollment was 2117 patients, 1483 (70 %) completed follow-up. Lower SES as measured by home address was associated with lower function and less improvement from baseline at 2 years postoperatively. This trend was most apparent in PROMIS instruments.</div></div><div><h3>Conclusion</h3><div>SES as approximated by ADI is associated with PROs at 2 years after outpatient orthopaedic surgery for a subset of PROs. ADI should be considered for inclusion in statistical models using an SES-sensitive PRO as an outcome, understanding that model performance may also depend on if a single value or change over time is being estimated.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 33-38"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683260","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":"One stage total hip arthroplasty and contralateral hip arthroscopy for bilateral femoroacetabular impingement and osteoarthritis: A clinical trial","authors":"Filippo Migliorini ,&nbsp;Francesco Coppola ,&nbsp;Marco Rosolani ,&nbsp;Alessio D'Addona ,&nbsp;Vincenzo Di Francia ,&nbsp;Guido Grappiolo ,&nbsp;Federico Della Rocca","doi":"10.1016/j.jor.2025.03.012","DOIUrl":"10.1016/j.jor.2025.03.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The management of cam morphology of FAI associated with osteoarthritis (OA) is debated. However, current surgical indications are becoming obsolete, and hip arthroscopy spreads in different settings. The present clinical trial evaluated the outcome of one-stage unilateral hip arthroscopy and contralateral total hip arthroplasty (THA) in patients with bilateral cam deformity associated with labral tears and early and advanced OA stages, respectively. The outcomes of interest were patient-reported outcome measures (PROMs) and the rate of complications.</div></div><div><h3>Methods</h3><div>All patients who underwent one-stage THA and contralateral hip arthroscopic for symptomatic cam deformity were prospectively invited to participate in the present study. Arthroscopies were performed first with patients in a supine position on a traction bed under fluoroscopic control. Three standard portals were used. The intraarticular joint space was inspected, and the peripheral acetabular labral lesions were selectively debrided. Cam bunectomy was performed, and labral tears were debrided and repaired using bio-resorbable anchors. After arthroscopy, patients were positioned in a lateral position, and THA was performed using a minimally invasive posterolateral approach. All patients received uncemented short stems with ceramic heads and vitamin-E augmented polyethylene (GTS, Zimmer Biomet, United States or 3C, Link, Germany).</div></div><div><h3>Results</h3><div>All 16 patients were men, with a mean age of 41 years ±7.9. The mean length of the follow-up was 4.2 ± 1.3 years (range, 2 to 6). All patients returned to their normal daily activities within one month. PROMs were statistically significantly increased from baseline to the last follow-up in all patients. No patient experienced minor or major complications. One patient required THA five years after arthroscopy for symptomatic and radiographic progression of osteoarthritis. No other patients progressed to THA. No patient underwent revision surgery for failed arthroscopy.</div></div><div><h3>Conclusion</h3><div>One-stage arthroscopy and contralateral arthroplasty are effective in managing FAI combined with early and mild to severe OA, respectively.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 133-137"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737817","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":"Templating femoral offset in patients with coxa valga and antetorta undergoing THA: Critical need for a minimum 5 mm increase","authors":"Conradin Schweizer ,&nbsp;Oliver Niggemeyer ,&nbsp;Jan-Hauke Jens ,&nbsp;Marius Junker","doi":"10.1016/j.jor.2025.03.025","DOIUrl":"10.1016/j.jor.2025.03.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Total hip arthroplasty (THA) is a common procedure in which accurate restoration of femoral offset is crucial to prevent complications. In patients with coxa valga and antetorta (CVA), excessive femoral antetorsion may lead to inaccurate prediction of femoral offset during digital templating. The purpose of this study was to assess the accuracy of templated femoral offset in patients with CVA compared to a control group.</div></div><div><h3>Material and methods</h3><div>A retrospective analysis was conducted on 35 CVA patients and 56 controls who underwent cementless THA. Preoperative and postoperative pelvis radiographs were taken following a standardized procedure. A CVA group was defined by a caput-collum-diaphyseal (CCD) angle &gt;140°, while the control group had a CCD angle of 125°–135°. Femoral antetorsion was assessed using the size of the lesser trochanter on pelvis radiographs. Preoperative templating was performed with mediCAD, and radiographs were analyzed for femoral offset, neck resection level, and leg length discrepancy. Intraoperative head length changes and 90-day postoperative adverse events were also recorded.</div></div><div><h3>Results</h3><div>CVA patients had a significantly lower native femoral offset than controls (34.9 mm vs. 41.7 mm; p &lt; 0.001). Postoperatively, CVA patients showed an offset increase of only 1.1 mm, despite a templated increase of 5.1 mm (p &lt; 0.001), while the control group had no significant difference between templated and postoperative offsets (p = 0.893). Larger head sizes than templated were used twice as often in the CVA group. No significant leg length differences were observed.</div></div><div><h3>Discussion</h3><div>Digital templating for femoral offset in CVA patients proves to be inaccurate, with postoperative radiographs showing a significant reduction compared to the templated femoral offset. To prevent postoperative offset reduction and associated complications, a templated femoral offset increase of at least 5 mm should be targeted when performing THA in CVA patients.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 73-77"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644392","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":"The risk analysis index predicts 30-day periprosthetic fracture following primary total hip arthroplasty","authors":"Jared Sasaki ,&nbsp;Victor Koltenyuk ,&nbsp;Staton Albert ,&nbsp;Hirmand Salehi ,&nbsp;Tanmaya D. Sambare ,&nbsp;John Andrawis","doi":"10.1016/j.jor.2025.03.018","DOIUrl":"10.1016/j.jor.2025.03.018","url":null,"abstract":"<div><h3>Introduction</h3><div>As the number of patients requiring total hip arthroplasty (THA) continues to increase, it is critical to develop tools that predict postoperative periprosthetic fracture (PPF). One way to risk stratify patients undergoing THA is using a frailty score. Recently, the Risk Analysis Index (RAI) has emerged as a potentially more accurate marker of frailty and predictor of postoperative complications following spine surgery. Our study aims to assess the association between frailty, as rated by RAI, and PPF within 30 days following primary THA.</div></div><div><h3>Methods</h3><div>The ACS NSQIP database was queried from the years 2015–2020 analyzing patients who underwent primary THA. The RAI scored patients on a scale from 0 to 81 and grouped them into four categories based on their frailty score: robust, normal, frail, and severely frail. Multivariate analysis was performed, controlling for age, female sex, American Society of Anesthesiologists (ASA) score, and tobacco smoking, with the primary outcome being PPF within 30 days of surgery.</div></div><div><h3>Results</h3><div>A total of 186,756 patients were included in this study– 372 (0.2 %) of which had PPFs within the 30-day postoperative period. Increasing frailty, as measured by RAI, was a significant predictor of PPF following primary THA in normal, frail, and severely frail patients. Female sex and ASA status also showed increased risk of PPF. Furthermore, each additional unit on the RAI scale increased the odds of PPF by 7.5 %.</div></div><div><h3>Discussion</h3><div>Frailty has been identified as a predictor of adverse postoperative outcomes in patients undergoing THA, however, this study is the first to find a significant association between frailty and PPF within 30 days of THA. Incorporating frailty assessment into preoperative discussions may aid surgeons in risk stratification, inform surgical decision-making, and enhance the effectiveness of postoperative monitoring following THA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 112-116"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686898","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":"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":"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":"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}