Journal of Orthopaedic Research®最新文献

{"title":"Iso-Height Axis Provides More Physiologic Description of Condylar Kinematics and Frontal Plane Stability During Functional Activities After Unicompartmental Knee Arthroplasty.","authors":"Tianyun Gu, Chunjie Xia, Huiyong Dai, Huarui Shen, Jingchi Li, Qi Wang, Nan Zheng, Zhiyong Hou, Tsung-Yuan Tsai","doi":"10.1002/jor.70205","DOIUrl":"https://doi.org/10.1002/jor.70205","url":null,"abstract":"<p><p>Accurate characterization of femoral condylar kinematics and its association with collateral ligament behavior are essential for maintaining overall knee stability, particularly frontal plane stability after medial unicompartmental knee arthroplasty (UKA). Conventional reference flexion axes, such as the transepicondylar axis (TEA) and geometric center axis (GCA), provide only static representations of motion. The recently proposed iso-height axis (IHA) offers a dynamic reference, yet its clinical relevance under weight-bearing conditions after UKA remains unclear. 24 patients, 13 fixed-bearing (FB) and 11 mobile-bearing (MB) UKA, underwent dual fluoroscopic imaging (DFIS) during weight-bearing (single-leg lunge, sit-to-stand) and non-weight-bearing (open-chain leg raising) maneuvers. Femoral condyle kinematics were analyzed using TEA, GCA, and IHA, with statistical analysis comparing native and UKA knees. In FB UKA, A-P condylar translation was consistently the smallest with IHA (UKA: 0.78-1.69 mm across tasks), compared with GCA (2.98-3.62 mm) and TEA (2.99-6.03 mm; mean across medial/lateral condyles). FB UKA demonstrated robust correlations between condylar kinematics and ligament changes across all three axes, with IHA uniquely capturing bilateral lateral collateral ligament (LCL) correlations during lunge (lateral: β = 0.031,β* = 0.43; medial: β = 0.028, β* = 0.39). MB UKA had reduced correlations, primarily limited to LCL-TEA during open-chain leg raising. Flexion-axis choice substantially affects the interpretation of femoral condylar kinematics after UKA. Weight-bearing assessment better reveals clinically relevant abnormalities, and IHA may provide a more physiologically meaningful reference than TEA or GCA.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70205"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-Articular Purified Exosome Product and Hyaluronan Attenuate Osteoarthritis Progression in a Minimally Invasive Turkey Model.","authors":"Xing Lei, Lei Wang, Ramona L Reisdorf, Maggie A Brosig, Steven L Moran, Christopher H Evans, Chunfeng Zhao","doi":"10.1002/jor.70207","DOIUrl":"https://doi.org/10.1002/jor.70207","url":null,"abstract":"<p><p>Our study aimed to develop a novel, reproducible, minimally invasive turkey knee osteoarthritis (OA) model and evaluate whether intra-articular hyaluronan (HA) alone or combined with purified exosome product (PEP) attenuates OA-related functional and structural deterioration. OA was induced arthroscopically by transection of the anterior and posterior cruciate ligaments with resection of the anterior horn of the medial meniscus. Animals received intra-articular injections of saline, HA, or PEP + HA at postoperative 2-5 weeks. Gait was assessed at 4, 8, and 12 weeks, and cartilage degeneration, subchondral bone sclerosis, osteophyte formation, synovial fibrosis, heterotopic ossification, and meniscal integrity were evaluated by quantitative CT and histology at week 12. Compared with saline, HA improved lameness, preserved cartilage glycosaminoglycan content, and reduced meniscal rupture, subchondral bone sclerosis, and periarticular heterotopic ossification. PEP + HA provided additional benefits, including prolonged stance phase, reduced synovial fibrosis, and greater chondroprotection than HA alone, while plantar pressure variables, subchondral bone remodeling, and patellar osteophytes did not differ between HA and PEP + HA. This turkey model reliably produces human-like OA changes and enables longitudinal functional and structural assessment. Intra-articular HA mitigated OA progression, and the addition of PEP conferred incremental joint protection.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70207"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-Printed Patient-Specific Guides Versus Conventional Techniques for Scaphoid Reconstruction: A Comparative Study of 89 Cases.","authors":"Sylvano Mania, Mauro Maniglio, Michael A Wirth, Ladislav Nagy, Lisa Reissner, Andreas Schweizer","doi":"10.1002/jor.70220","DOIUrl":"10.1002/jor.70220","url":null,"abstract":"<p><p>Scaphoid non-union or malunion often produces a three-dimensional (3D) deformity that alters wrist biomechanics. Patient-specific instrumentation (PSI) has been introduced to improve reconstruction accuracy, but quantitative comparisons with conventional free-hand techniques remain limited. We retrospectively analyzed 115 scaphoid reconstructions performed between 2010 and 2019; 89 cases met inclusion criteria (45 PSI, 44 conventional). Distal-fragment rotation (flexion/extension, ulnar/radial inclination, pronation/supination) and translation were quantified using a Cartesian coordinate system centered on the proximal pole. A composite 3D deformity angle was calculated to assess global malalignment. PSI achieved greater absolute correction across several parameters. Sagittal flexion improved by 8.9° with PSI versus 5.8° with conventional reconstruction (p = 0.007 and p = 0.043, respectively). Ulnar inclination improved by 3° with PSI (p = 0.017) but not significantly with the conventional technique. The composite 3D deformity angle decreased by 8.4° with PSI and 6.9° conventionally. Despite a longer preoperative non-union duration in the PSI group, consolidation rates (91% vs 93%) and mean times to union were comparable between techniques. Vascularized grafts showed shorter, but non-significant, consolidation times. Both techniques effectively corrected scaphoid deformity. PSI enabled larger morphological corrections in cases with more severe baseline deformity. These findings suggest that PSI may facilitate correction in complex or long-standing non-unions; however, the clinical relevance of the observed 3D differences and operative efficiency remain to be determined.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70220"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetabular Bone Preservation in H1 Ceramic Hip Resurfacing: A Comparison With A Conventional Metal-on-Metal Hip Resurfacing.","authors":"Yuki Yamamuro, Simon Harris, Rima Nasser, Amir Ardakani, Justin Cobb","doi":"10.1002/jor.70221","DOIUrl":"10.1002/jor.70221","url":null,"abstract":"<p><p>This study compared the volume of acetabular bone resection between an anatomically designed cementless ceramic-on-ceramic hip resurfacing arthroplasty (H1HR) and metal-on-metal hip resurfacing (Birmingham Hip Resurfacing; BHR). We hypothesized that the anatomical design of the H1 cup would reduce the need for medialization to avoid rim overhang, thereby preserving acetabular bone stock. A retrospective three-dimensional simulation study was performed in 12 hips with osteoarthritis and femoral head size ≥ 48 mm. H1HR and BHR were virtually implanted using 3D planning software to minimize the risk of groin pain. The primary outcome was the volume of acetabular bone resection. Secondary outcomes included the position of the cup relative to the native hip centre and the cup non-coverage ratio. H1 cups required a mean volume of acetabular bone resection of 11 cm³, while BHR cups required 17 cm³. This 35% reduction was statistically significant. H1 cups had less medialization (-1 mm vs. -6 mm), superior displacement (-1 mm vs. -2 mm), and posterior displacement (-1 mm vs. -3 mm). The mean cup non-coverage ratio was not significantly different (10% vs. 8%). The anatomically designed H1HR achieved a significant 35% reduction in acetabular bone resection compared with BHR. This substantial volume of bone preservation was primarily attributed to the design enabling cup placement with minimal medialization, without increasing the cup non-coverage ratio. Although further validation in cadaveric or postoperative imaging studies is needed, H1 may be a promising option for bone preservation, particularly for young, active patients who might require future revision surgery.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70221"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Progression of Meniscal Degeneration in Silent Information Regulator 2 Ortholog 1 Knock-In Mouse.","authors":"Shohei Sano, Ryo Okada, Tetsuya Yamamoto, Kenjiro Okimura, Kiminari Kataoka, Koji Nukuto, Yuta Nakanishi, Masanori Tsubosaka, Kyohei Nishida, Kanto Nagai, Naoki Nakano, Noriyuki Kanzaki, Yuichi Hoshino, Tomoyuki Matsumoto, Ryosuke Kuroda, Takehiko Matsushita","doi":"10.1002/jor.70218","DOIUrl":"https://doi.org/10.1002/jor.70218","url":null,"abstract":"<p><p>This study aimed to examine the inhibitory effects of silent information regulator 2 ortholog 1 (SIRT1) on meniscal degeneration. First, SIRT1 expression in human and mouse menisci was examined using reverse transcription polymerase chain reaction (PCR) and immunostaining, which confirmed its presence. Meniscus degeneration in wild-type (WT) and SIRT1-knock-in (KI) mice was evaluated at 1, 3, 6, 9, and 12 months of age using the Kwok scoring system. The meniscus degeneration score for the anterior segment was significantly lower in KI mice than in WT mice at 9 and 12 months of age (p < 0.01). Furthermore, osteoarthritis (OA) was induced in 3-month-old mice via medial meniscus destabilization to evaluate meniscal degeneration during OA progression. In the OA model, the meniscus degeneration score for anterior segment in KI mice was significantly lower than those in WT mice at 8, 12, and 16 weeks post-surgery (p < 0.01). Additionally, RNA was extracted from the menisci of 1- and 3-month-old KI and WT mice, and gene expression was analyzed using real-time PCR. Gene expression analysis showed significantly higher levels of Sirt1, Col1a1, Col2a1, and aggrecan, and lower levels of Mmp-3, Mmp-13, and Adamts-5 in KI mice at 3 months compared with WT mice. These findings suggest that SIRT1 may delay meniscal degeneration by modulating the expression of cartilage matrix genes and matrix-degrading enzymes.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70218"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Deformity Severity Dictate Which Side Initially Develops Symptoms in Bilaterally Dysplastic Hips?","authors":"Madison M Wissman, Jiayi Sun, Benjamin E Northrup, Mohammadreza Movahhedi, Ata M Kiapour, John C Clohisy, Michael D Harris","doi":"10.1002/jor.70215","DOIUrl":"https://doi.org/10.1002/jor.70215","url":null,"abstract":"<p><p>Most patients with developmental dysplasia of the hip (DDH) have bilateral deformities, yet have asymmetric symptom development that is not well understood. This study aimed to identify relationships between deformity severity and symptom asymmetry in patients with bilateral DDH. Hip geometry from N = 230 patients was measured using lateral center-edge angle (LCEA), acetabular inclination, neck-shaft angle, alpha angle, and femoral version, and compared between initially symptomatic and contralateral hips. Patients were grouped into those with a \"more dysplastic hip\" (n = 133, based on >3° side-to-side LCEAs) or similar side-to-side deformities. Self-reported activity levels were also compared between those whose symptomatic hips were more severely deformed and those whose contralateral hips were more severely deformed. Symptomatic hips had more severe acetabular deformities, based on the LCEA and acetabular inclination, in 80% of subjects (p < 0.001). The only femoral measure to reveal differences between symptomatic and contralateral hips was neck-shaft angle; most patients had more severe angles on their symptomatic side (p = 0.003) though with a small effect (d = 0.14). Thus, acetabular deformities appear to drive asymmetric symptom development more than femoral deformities. Among the 20% of patients with more deformed contralateral hips, activity levels were not different from those with more deformed symptomatic hips. While self-reported activity was not linked to symptom asymmetry, factors not captured, such as limb dominance and activity type, may contribute. These findings further understanding of disease progression and symptom onset in bilateral DDH and can inform anticipatory interventions to reduce pain and promote long-term joint health.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70215"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Radioimmunotherapy and Antibiotics on Biofilm-Associated Implant Infections in a Preclinical Rat Model.","authors":"F Ruben H A Nurmohamed, Kevin J H Allen, Mackenzie E Malo, Connor Frank, Colleen Nesbitt, J Fred F Hooning van Duyvenbode, Michelle Buijs, Berend van der Wildt, Alex J Poot, Marnix G E H Lam, Jos A G van Strijp, Johannes M van der Merwe, H Charles Vogely, Harrie Weinans, Bart C H van der Wal, Ekaterina Dadachova","doi":"10.1002/jor.70216","DOIUrl":"10.1002/jor.70216","url":null,"abstract":"<p><p>Indwelling medical implants are susceptible to developing biofilm-associated infections that are notoriously difficult to eradicate. These persistent infections often cannot be resolved with antibiotics alone and typically require surgical intervention for effective management. An alternative approach is radioimmunotherapy (RIT) which uses specific antibodies linked to radioisotopes to selectively destroy bacteria. This antimicrobial approach bypasses traditional antibiotic mechanisms, and RIT is hypothesized to enhance outcomes beyond antibiotic therapy alone. RIT bactericidal effects were studied in Wistar Han rats fitted with femoral rod implants covered by matured 3-day biofilms. The rats (six per group) were treated with either: RIT with ¹⁷⁷Lu-labeled 4497 antibody to S. aureus teichoic wall acid (WTA) (116.6 MBq/kg), or vancomycin (88 mg/kg), or combination of RIT (116.8 MBq/kg) and vancomycin, or left untreated. To evaluate efficacy, bacterial counts were taken from the joint capsule, bone, and implant after 7 days. Uptake and biodistribution were assessed via non-invasive in vivo SPECT/CT imaging and ex vivo gamma counting. Single administration of RIT achieved a 2.7-log (99.78%) reduction of bacterial burden in the infected joint capsule, had no effect on the infected femur, and resulted in 72.5% reduction of bacterial burden on the infected implant when compared to untreated controls. RIT reduced bacterial burden and inflammation in experimental PJI with no side effects. These findings underscore the potential of RIT in the treatment of infected indwelling devices and warrant further study.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70216"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinetic Biomarkers of Cumulative Loading and Daily Step Count as Predictors of Functional Recovery Following Primary Unilateral Total Hip Arthroplasty.","authors":"Jesse C Christensen, Dana L Judd, Peter B Thomsen-Freitas, Hope Davis-Wilson, Cory L Christiansen, Jennifer E Stevens-Lapsley","doi":"10.1002/jor.70203","DOIUrl":"https://doi.org/10.1002/jor.70203","url":null,"abstract":"<p><p>Many adults experience persistent limitations in physical activity following total hip arthroplasty (THA) despite improvements in pain. Although atypical limb loading and reduced daily step count have each been linked to poorer recovery, these factors are typically evaluated independently and do not reflect cumulative mechanical exposure during daily ambulation. Integrating load magnitude, loading rate, and activity volume into kinetic biomarkers may provide novel insight into functional recovery post-THA. This study included 56 adults who underwent primary unilateral THA. Three kinetic biomarkers were evaluated: cumulative loading rate (vertical ground reaction force [vGRF] loading rate × daily step count), cumulative force (peak vGRF × daily step count), and cumulative impulse (vGRF × time × daily step count). Physical function outcomes included the 6-min walk test (6MWT), 30-s sit-to-stand (STS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and lower-extremity muscle strength (hip abductor, knee extensor, knee flexor), assessed 26 weeks post-THA. Multivariable regression models were used, adjusting for confounders. Cumulative loading rate of the surgical limb demonstrated the strongest positive associations with 6MWT distance (p < 0.01), STS performance (p = 0.03), hip abductor strength (p = 0.01), and WOMAC physical function (p = 0.01), whereas cumulative force and impulse were less predictive. Clinical Significance: By integrating limb loading rate with activity volume, cumulative loading rate may better capture clinically meaningful deficits in physical function post-THA than gait measures or step count alone.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70203"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinetic Interlimb Asymmetries in Loading and Propulsion During Walking From 2 to 8 Months After Anterior Cruciate Ligament Reconstruction.","authors":"Romain Brebels, Guillaume J Bastien, Fabian Dandois, Bénédicte Schepens, Massimo Penta","doi":"10.1002/jor.70206","DOIUrl":"https://doi.org/10.1002/jor.70206","url":null,"abstract":"<p><p>Normalization of walking is a rehabilitation goal after anterior cruciate ligament reconstruction (ACLR). However, no consensus is currently established on the kinetic variables supporting rehabilitation. We examined interlimb loading asymmetries and deviations from controls from 2 to 8 months post-ACLR at two different speeds. Ground reaction force of 14 patients with ACLR (23.9 years, 7 females) were assessed at 2-, 4-, 6-, and 8-months post-surgery while walking on instrumented treadmill at 5 and 6 km/h. Gait cycle characteristics, including stance phase durations, peak force, center-of-mass displacement and total power, were compared at each time point with matched controls (t-tests) and between involved and uninvolved limbs (mixed linear model). We observed that kinetic asymmetries were largest at 2 months and most persisted up to 8 months post-ACLR. An unloading strategy was observed on the involved limb, especially at 6 km/h, concerning the loading peak force (-6.6% at 4 months), the braking peak force (-9% at 6 months), the power absorption (-15.7% at 8 months) and the single support duration (-1.8% at 6 months compared to controls). These findings indicate that walking recovery after ACLR is characterized by unloading of the involved limb especially during the loading response and a compensation from the uninvolved limb throughout the stance, lasting up to 8 months when walking at 5 and 6 km/h. Walking at higher, controlled walking speeds should be assessed and retrained early after ACLR to identify and reduce residual loading asymmetries.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 5","pages":"e70206"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait Biomechanical Profiles Following Anterior Cruciate Ligament Reconstruction in Sexually-Immature Pediatrics","authors":"Elizabeth Bjornsen,&nbsp;J. Troy Blackburn,&nbsp;Jason R. Franz,&nbsp;W. Zachary Horton,&nbsp;Darin Padua,&nbsp;Sandra Shultz,&nbsp;Samantha Tayne,&nbsp;Brian Pietrosimone","doi":"10.1002/jor.70196","DOIUrl":"10.1002/jor.70196","url":null,"abstract":"<p>Aberrant gait biomechanics following ACL reconstruction (ACLR) are linked to knee osteoarthritis development in adult patients. However, limited research exists to characterize walking biomechanics profiles of pediatric ACLR patients. The study purpose was to determine (1) differences in biomechanical profiles between pediatric ACLR patients (Tanner Stage I–IV) and two comparison-control groups (i.e., uninjured, matched pediatrics, adult-matched ACLR); (2) associations between biomechanical and Knee Osteoarthritis Outcomes Score (KOOS)-Child outcomes in pediatric ACLR patients. Gait biomechanics were collected in pediatric ACLR (<i>n</i> = 25), pediatric controls (<i>n</i> = 25), and adult ACLR groups (<i>n</i> = 25). Pediatric patients completed the KOOS-Child at the same session. A functional mixed effects model determined between-group differences in biomechanical variables. Uncorrected partial correlations, controlling for gait speed, were utilized to determine the association between discrete biomechanics and KOOS-Child scores. Pediatric ACLR patients demonstrated lesser first and second peak vertical ground reaction force (vGRF) and greater midstance vGRF than pediatric controls. Pediatric ACLR patients exhibited lesser midstance and greater late stance vGRF compared to the adult ACLR group. Pediatric ACLR patients demonstrated lesser knee flexion angle, knee extension moment, and knee abduction moment profiles compared to pediatric controls and adult ACLR patients throughout the majority of the stance phase. Greater midstance vGRF was associated with greater KOOS-Child Quality of Life scores in the contralateral limb (<i>r</i> = 0.54, <i>p</i> = 0.006). Pediatric ACLR patients exhibit unique biomechanical profiles compared to pediatric controls and adult ACLR patients; however, the associations with patient-reported outcomes remain unclear. Pediatrics may experience an exaggerated response to ACLR that may impact knee joint health.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}