Journal of Orthopaedic Research®最新文献

{"title":"Mechanical Evaluation of Posterior Wall Acetabular Facture Fixation: Patient-Specific Implants Versus Conventional Implants.","authors":"Miriam G E Oldhoff, Anne M L Meesters, Joep Kraeima, Mehool R Acharya, Kaj Ten Duis, Jean-Paul P M de Vries, Bram B J Merema, Frank F A IJpma","doi":"10.1002/jor.70062","DOIUrl":"https://doi.org/10.1002/jor.70062","url":null,"abstract":"<p><p>The aim of the study was to design a standardized mechanical test setup and a corresponding finite element analysis to assess the stability and strength of both patient-specific and conventional implants for posterior wall acetabular fractures. Ten synthetic hemi-pelves with posterior wall fractures were biomechanically tested with two types of implants: a patient-specific implant (PSI) and a seven-hole plate conventional implant. 3D-printed guides ensured reproducibility. The models were tested using an Instron machine. The protocol involved 10,000 cyclic load cycles with static tests at 3200 N before and after to simulate early postoperative weightbearing conditions. Construct stiffness, stiffness over cyclic loading and fracture gapping were measured and compared. A finite element analysis was created with similar conditions to investigate stresses within the synthetic bone and fixation materials. The mechanical tests showed comparable stiffness for PSI (1.75 kN/mm) and the conventional implant (1.71 kN/mm, p = 0.47). Stability over 10,000 cycles was similar, and fracture gapping remained minimal (0.0-0.8 mm) without significant differences. No failure or plastic deformation occurred under 3200 N loading. Finite element analysis confirmed that von Mises stresses remained below the yield stress. This study introduces a reproducible workflow for biomechanical testing of acetabular fractures using synthetic bone models and 3D-printed guides. It serves as a step-by-step guideline and standard reference for pelvic biomechanical testing. Both patient-specific and conventional implants, using a seven-hole plate construct with one or two screws through the plate in the fracture fragment, provide stable fixation for large posterior wall fragments.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125050","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":"Porous Additively Manufactured PEKK Improves In Vitro Osteoblastic Performance Compared to PEEK.","authors":"Paul M DeSantis, Emma Barnes, Tabitha Derr, Hannah Spece, Steven M Kurtz","doi":"10.1002/jor.70069","DOIUrl":"https://doi.org/10.1002/jor.70069","url":null,"abstract":"<p><p>Polyetheretherketone (PEEK) is a member of the polyaryletherketone (PAEK) family of semi-crystalline thermoplastics that is increasingly considered as an alternative to metals for use in permanent implants. Another member of the PAEK family, polyetherketoneketone (PEKK), has many similar properties to PEEK, but can vary in its crystallization kinetics due to its varying terephthalic and isophthalic acid (T/I) ratios during manufacturing. We hypothesized that PEKK's differences in chemical structure may produce a better surface for cell adhesion, increasing in vitro osteoblastic performance when compared to PEEK. Solid and porous samples were printed under comparable conditions and cultured with MC3T3-E1 mouse pre-osteoblasts for up to 28 days. A laser confocal microscope was used to evaluate surface roughness of samples as one possible explanation for differences in in vitro performance. Micro-CT was used to visualize the accuracy in printing of porous samples when compared to a digital model. PEKK samples were found to have significantly increased cell attachment, normalized alkaline phosphatase activity, and osteoblastic mineralization at multiple time points (p < 0.05). PEKK samples were also found to be significantly smoother than PEEK samples on the micron scale. Based on micro-CT images, PEKK samples were found to more closely resemble the desired triply periodic minimal surface geometry than PEEK samples. This study suggests that PEKK should be considered in future studies investigating the biological performance of PEEK due to PEKK's encouraging in vitro biocompatibility.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125024","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":"Enhanced Mid-Flexion Stability in Cruciate-Sacrificing Total Knee Replacement: Impact of Optimized Implant Designs Investigated Using Musculoskeletal Multibody Simulation.","authors":"Maeruan Kebbach, Sven Krueger, Leo Ruehrmund, Berna Richter, Yukihide Minoda, Thomas M Grupp, Rainer Bader","doi":"10.1002/jor.70066","DOIUrl":"https://doi.org/10.1002/jor.70066","url":null,"abstract":"<p><p>Total knee replacement (TKR) is a successful intervention for relieving pain and improving quality of life. In this context, mid-flexion instability and paradoxical anterior femoral movement remain challenging. However, the role of implant design in cruciate-sacrificing (CS) scenarios is unclear. Therefore, this study investigated the influence of newly developed CS TKR designs on mid-flexion stability and anterior-posterior (AP) translation using a musculoskeletal multibody simulation during squat motion. The multibody model of the lower extremity, which represented the knee joint with ligaments and muscle structures, was previously validated using instrumented knee data. It was used to analyze newly developed (oneKNEE® cruciate-retaining (CR)/CS and medial-stabilized (MS)) and clinically established (Columbus® ultra-congruent (UC) and P.F.C.™ Sigma® CR) TKR designs. For this purpose, the overall femoral AP translation and tibial internal-external rotation during squat motion (flexion from 0° to 90°) in the CS condition were evaluated. During mid-flexion, the P.F.C.™ Sigma® CR exhibited greater anterior femoral translation than the Columbus® UC, with posterior movement starting at 35.5° (3.4 mm anterior) versus 20° (2.1 mm). In contrast, the oneKNEE® CR/CS and MS designs showed continuous posterior femoral movement (reduced paradoxical translation), with anterior-to-posterior turning points at 9° (1.2 mm) and 13° (0.8 mm) during squat motion, respectively, without inhibiting internal-external rotation. The kinematics of the oneKNEE® designs were achieved by combining the single-radius femoral design and steep anterior ramp of the tibial components. These designs reduced paradoxical anterior femoral movement in mid-flexion in the CS condition, while not restricting tibial internal-external rotation.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092050","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":"Longitudinal Progression of Traumatic Bone Marrow Lesions Following Anterior Cruciate Ligament Injury: Associations With Knee Pain and Concomitant Injuries.","authors":"Callie E Stirling, Nina Pavlovic, Sarah L Manske, Richard E A Walker, Steven K Boyd","doi":"10.1002/jor.70067","DOIUrl":"https://doi.org/10.1002/jor.70067","url":null,"abstract":"<p><p>Traumatic bone marrow lesions (BMLs) occur in ~80% of anterior cruciate ligament (ACL) injuries, typically in the lateral femoral condyle (LFC) and lateral tibial plateau (LTP). Associated with microfractures, vascular proliferation, inflammation, and bone density changes, BMLs may contribute to posttraumatic osteoarthritis. However, their relationship with knee pain is unclear. This study examined the prevalence, characteristics, and progression of BMLs after ACL injury, focusing on associations with pain, meniscal and ligament injuries, and fractures. Participants (N = 100, aged 14-55) with MRI-confirmed ACL tears were scanned within 6 weeks post-injury (mean = 30.0, SD = 9.6 days). BML volumes were quantified using a validated machine learning method, and pain assessed via the Knee Injury and Osteoarthritis Outcome Score (KOOS). Analyses included t-tests, Mann-Whitney U, chi-square, and Spearman correlations with false discovery rate correction. BMLs were present in 95% of participants, primarily in the LFC and LTP. Males had 33% greater volumes than females (p < 0.05), even after adjusting for BMI. Volumes were higher in cases with depression fractures (p = 0.022) and negatively associated with baseline KOOS Symptoms. At 1 year, 92.68% of lesions (based on lesion counts) resolved in Nonsurgical participants, with a 96.13% volume reduction (p < 0.001). KOOS outcomes were similar between groups, except for slightly better Pain scores in the Nonsurgical group. Baseline Pain and Sport scores predicted follow-up outcomes. BMLs are common post-ACL injury, vary by sex and fracture status, and modestly relate to early symptoms. Most resolve within a year, with limited long-term differences by surgical status.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092063","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":"Delayed Lubricin Injection Improves Cartilage Repair Tissue Quality in an In Vivo Rabbit Osteochondral Defect Model.","authors":"Donghwan Yoon, Karan Vishwanath, John Dankert, James J Butler, Mohammad T Azam, Arianna L Gianakos, Marshall J Colville, Serafina G Lopez, Matthew J Paszek, Heidi L Reesink, John G Kennedy, Lawrence J Bonassar, Rebecca M Irwin","doi":"10.1002/jor.70060","DOIUrl":"10.1002/jor.70060","url":null,"abstract":"<p><p>Osteochondral lesions (OCL) are common among young patients and often require surgical interventions since cartilage has a poor capacity for self-repair. Bone marrow stimulation (BMS) has been used clinically for decades to treat OCLs, however a persisting challenge with BMS and other cartilage repair strategies is the inferior quality of the resulting fibrocartilaginous repair tissue. Lubrication-based therapies have the potential to improve the quality of cartilage repair tissue as joint lubrication is linked to local cartilage tissue strains and subsequent cellular responses including death and apoptosis. Recently, a full length recombinant human lubricin (rhLubricin) was developed and has been shown to lower friction in cartilage. This study investigated the effect of a single delayed injection of rhLubricin on cartilage repair in an in vivo rabbit OCL model using gross macroscopic evaluation, surface profilometry, histology, and tribology. Moderate improvement in macroscopic scores for cartilage repair were observed. Notably, quantitative analysis of Safranin-O histology showed that rhLubricin treated joints had significantly higher glycosaminoglycan content compared to saline treated joints, and there were no differences in repair integration between groups. Furthermore, rhLubricin treated joints had significantly lower friction coefficients tested across three sliding speeds compared to saline treated joints (rhLubricin: 0.15 ± 0.03 at 0.1 mm/s to 0.12 ± 0.03 at 10 mm/s, Saline: 0.22 ± 0.06 at 0.1 mm/s to 0.19 ± 0.05 at 10 mm/s). Overall, a single delayed injection of rhLubricin improved the quality and lubricating ability of the repair cartilage tissue without inhibiting repair tissue integration.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058533","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":"Issue Information - Editorial Board and TOC","authors":"","doi":"10.1002/jor.25896","DOIUrl":"https://doi.org/10.1002/jor.25896","url":null,"abstract":"","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1691-1694"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.25896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021828","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":"Monitoring Gait Recovery After Total Knee Arthroplasty Using Wearable Sensors: Responsiveness of Gait Accelerations.","authors":"Arash Ghaffari, Pernille Damborg Clasen, Andreas Kappel, John Rasmussen, Reed D Gurchiek, Søren Kold, Ole Rahbek","doi":"10.1002/jor.70058","DOIUrl":"https://doi.org/10.1002/jor.70058","url":null,"abstract":"<p><p>Functional recovery after total knee arthroplasty (TKA) varies widely among individuals, and traditional assessments often fail to detect subtle changes in real-world walking ability. Wearable sensors offer continuous and objective tracking of gait outside of clinical settings. In this prospective, longitudinal study, thirty-one patients undergoing unilateral TKA wore thigh-mounted accelerometers continuously from 2 weeks before surgery through 90 days postoperatively. We analyzed temporal gait features (stride time and duty factor) and frequency-domain metrics (power of the first five frequencies of triaxial acceleration), along with weekly EQ-5D-3L index scores (a summary measure of health-related quality of life) and visual analog scale (VAS) ratings (patient's self-reported health on a 0-100 scale). Gait acceleration profiles demonstrated significant postoperative disruptions, particularly during mid-stance and terminal swing, followed by gradual normalization, approaching baseline by day 90. Gait temporal parameters also exhibited transient alterations and recovery trends. Using LASSO logistic regression, Fourier-derived gait features discriminated responders and non-responders based on improvements in EQ-5D-3L outcomes above the minimal clinically important difference (AUC: 0.80-0.81). Specific harmonic changes across the vertical, mediolateral, and anteroposterior axes were significantly associated with the perceived health gains. The results indicated that frequency-based gait metrics from wearable sensors are sensitive digital biomarkers for short-term functional improvements.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033439","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":"Reimagining Outcomes: A Perspective Review of Advances in Remote Monitoring Technologies in Post-Arthroplasty Patient Care.","authors":"Janie L Astephen Wilson, Ryan M Chapman","doi":"10.1002/jor.70064","DOIUrl":"https://doi.org/10.1002/jor.70064","url":null,"abstract":"<p><p>Arthroplasty surgery is a common and successful end-stage intervention for advanced osteoarthritis. Yet, postoperative outcomes vary significantly among patients, leading to a plethora of measures and associated measurement approaches to monitor patient outcomes. Traditional approaches rely heavily on patient-reported outcome measures (PROMs), which are widely used, but often lack sensitivity to detect function changes (e.g. gait limitations) that may persist after surgery. Accessible measurement systems for objectively capturing functional outcomes have steadily emerged recently. Notably, wearable motion sensing and sensor-embedded prostheses offer high-resolution, real-time data on patient mobility, revealing discrepancies between PROMs and functional recovery trajectories. Coupled with advancements in mobile health platforms, opportunities for remote monitoring and remotely engaging arthroplasty patients is burgeoning. Smartphone applications have improved adherence to rehabilitation protocols, pain management, and patient satisfaction while enabling remote care and reducing healthcare utilization. However, barriers such as inconsistent protocols, the need for clinical validation, reliance on patient compliance with sensor use, small sample sizes, privacy concerns, cost and reimbursement challenges, and limited long-term data remain. Other emerging technologies are further enabling uptake, including but not limited to smart implants, in-home monitoring systems, and artificial intelligence (AI)/machine learning (ML)-enhanced analyses. Together, these technologies hold promise for more personalized, cost-effective strategies for comprehensive and patient-centered assessments that can inform tailored rehabilitation approaches, allow for near real-time assessment of patient outcomes, improve function, and promote earlier mobilization. Further research should focus on standardization and clinical validation, economic and environmental impact, and long-term efficacy to optimize their integration into routine clinical practice.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033498","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":"Issue Information - Cover","authors":"","doi":"10.1002/jor.70061","DOIUrl":"https://doi.org/10.1002/jor.70061","url":null,"abstract":"","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021985","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":"Influence of Age on Fracture Healing in Young and Middle-Aged Mice in a Proximal Femur Fracture Model.","authors":"Tabea Schmid, Anna Kanewska, Charles Lam, Miriam Kalbitz, Sandra Dieterich, Anita Ignatius, Jana Riegger, Nico Valerio Giger, Esther Wehrle, Ralph S Marcucio, Theodore Miclau, Melanie Haffner-Luntzer","doi":"10.1002/jor.70063","DOIUrl":"https://doi.org/10.1002/jor.70063","url":null,"abstract":"<p><p>Osteoporotic hip fractures are a considerable cause of pain and disability particularly among the elderly. Osteoporosis causes loss of bone stability, which in turn leads to an increased risk of fractures especially in metaphyseal bone. Moreover, the body's capacity for healing is diminished, resulting in prolonged recovery times following these fractures. The underlying mechanisms are not fully elucidated yet. Therefore, the aim of the current study was to determine the influence of age on a murine proximal femur fracture model in young and middle-aged mice and whether the model could be suitable to study the molecular mechanisms of age-related delayed fracture healing. A proximal femur fracture was performed in 12- and 52-week-old male C57BL/6 J mice. Multiplex cytokine analysis was conducted at 6 h and 24 h after fracture. µCT analysis, histomorphometry and immunostainings were performed at 14 and 21 days. Furthermore, spatial transcriptomics was performed at 14 days after fracture. Our data revealed an osteopenic phenotype in intact tibiae in middle-aged animals. Moreover, fracture callus size, cartilage formation, expression of late chondrogenic factors and osteoblast and osteoclast numbers were significantly decreased in the fracture callus of middle-aged mice. This resulted in less bone formation. Our data further suggested increased presence of p21⁺ senescent cells and a higher expression of senescence-associated secretory phenotype (SASP, e.g.: IL-6, CCL-5 and CCL-2) in older mice, whereas CXCL12 expression was reduced in these animals. In conclusion, we could confirm a diminished healing capacity of metaphyseal hip fractures in mice that were 52 weeks old. This was accompanied by differences in gene and protein expression including SASP-factors.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033505","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}