Journal of Orthopaedic Research®最新文献

{"title":"Peak Vertical Ground Reaction Force Modifies Gait Biomechanics Bilaterally Following ACL Reconstruction: A Randomized Experiment.","authors":"Elizabeth Bjornsen, Alyssa Evans-Pickett, Hope Davis-Wilson, Amanda E Munsch, J Troy Blackburn, Jason R Franz, Todd A Schwartz, Jeffrey Spang, Brian Pietrosimone","doi":"10.1002/jor.26101","DOIUrl":"https://doi.org/10.1002/jor.26101","url":null,"abstract":"<p><p>Vertical ground reaction force (vGRF) is a promising target for modifying aberrant gait biomechanics in individuals post-anterior cruciate ligament reconstruction (ACLR). However, an adequate sample size and arandomized, mechanistic study is needed to determine acute effects of vGRF biofeedback on biomechanical outcomes. The purpose of the study is to determine differences in discrete gait biomechanical variables (i.e., first and second peak vGRF, midstance vGRF, peak knee flexion angle (KFA), KFA range-of-motion (ROM), peak knee extension moment (KEM), and peak knee abduction moment (KAM) following a treadmill walking protocol between limbs and across four separate conditions in individuals 6-12 months post-ACLR. We utilized a randomized, cross-over mechanistic trial where participants walked for 3000 steps for three visual feedback conditions (i.e., HIGH, LOW, and SYMMETRICAL vGRF loading) and a control condition on a dual-belt treadmill. We constructed a mixed effects linear model to determine within-subject biomechanical changes between limbs and conditions. The HIGH condition elicited greater first peak vGRF, sagittal plane motion (i.e., peak KFA, KFA ROM), and peak KEM compared to the control condition (p < 0.01). The LOW condition observed first peak vGRF and KFA ROM decreases but increased peak KFA and KEM (p < 0.01) compared to the control condition. No notable biomechanical changes were observed between the SYMMETRICAL and control conditions. The HIGH condition produced acute, sagittal plane kinematic and kinetic profile improvements in ACLR individuals. vGRF is a viable target for modifying gait biomechanics; future work should determine the long-term health effects of vGRF-driven feedback treatment to improve gait profiles post-ACLR.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111027","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":"Aberrant Gait Biomechanics Linked to Cartilage Changes After ACL Reconstruction in Those With High Body Mass Index.","authors":"Hyunwook Lee, Ashley N Buck, Cortney Armitano-Lago, Robert A Creighton, Ganesh M Kamath, Jeffrey T Spang, Xiaojuan Li, David Lalush, Jason R Franz, J Troy Blackburn, Brian Pietrosimone","doi":"10.1002/jor.26099","DOIUrl":"https://doi.org/10.1002/jor.26099","url":null,"abstract":"<p><p>A history of anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong risk factors for incident knee osteoarthritis. Limited research has evaluated the interaction between ACLR and high BMI on limb-level loading and early deleterious changes in cartilage health. The purpose of this study was to separately investigate the association between vertical ground reaction force (vGRF) loading profiles during gait and tibiofemoral cartilage composition in ACLR patients with high and normal BMI. Forty-three participants with primary unilateral ACLR (17 ± 14 months post-ACLR) were categorized as high (≥ 25 kg/m²; n = 18) or normal (< 25 kg/m²; n = 25) BMI and performed an overground gait at self-selected speed. For biomechanical outcomes, we calculated the differences between first peak and midstance minimum (∆vGRF1) and between the second peak and midstance minimum (∆vGRF2). T1ρ relaxation time interlimb ratios (ILR), calculated as the T1ρ relaxation time in the ACLR relative to the uninjured limb, were calculated for the medial and lateral tibia and femur. Stepwise linear regressions were used to determine associations between biomechanical outcomes and T1ρ relaxation time ILR for each region of interest. Lesser ∆vGRF1 and ∆vGRF2 in the high-BMI group significantly associated with greater T1ρ relaxation time ILR for the medial femoral condyle (ΔR² = 0.28, p = 0.03; ΔR² = 0.25, p = 0.04, respectively) and tibial plateau (ΔR² = 0.55, p < 0.001; ΔR² = 0.25, p = 0.004, respectively). Aberrant limb-level loading, characterized by less dynamic limb loading, is linked to deleterious changes in tibiofemoral cartilage in ACLR patients with high BMI, suggesting that gait retraining may be more critical for ACLR with a BMI ≥ 25 kg/m².</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094037","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":"Advanced Testing Protocols Simulate Failures and Validate Antioxidant Polyethylene in Ankle Implants.","authors":"Ryan Siskey, Patrick Hall, Ruth Heckler, David Safranski, James Johnson, Ariel Palanca","doi":"10.1002/jor.26103","DOIUrl":"https://doi.org/10.1002/jor.26103","url":null,"abstract":"<p><p>Total ankle replacement (TAR) has become an effective treatment for end-stage ankle osteoarthritis. Multiple factors, including patient characteristics, surgical technique, alignment, and bearing surfaces, influence TAR survivorship. Polyethylene (PE) fatigue is a key consideration in improving outcomes. This study establishes a novel, clinically relevant testing protocol incorporating varus-valgus rotation to simulate polyethylene fatigue failures observed in mobile-bearing total ankle replacements. Using this robust methodology, we evaluated the impact of oxidation and antioxidant stabilization on ultrahigh-molecular-weight polyethylene (UHMWPE) performance in a mobile bearing implant application. A six-degree-of-freedom simulator was used to iteratively adjust loading parameters (1500-3000 N, -4° to +8° flexion-extension, ±5° axial rotation, and ±3° or ±8° varus-valgus rotation at 37 ± 3°C in 20 g/L bovine serum) until clinically observed midline fractures were replicated. Oxidation levels were measured by Fourier-transform infrared spectroscopy per ASTM F2102. This validated loading protocol was then applied to conventional (25 kGy GUR 1020) and vitamin E-stabilized (75 kGy GUR 1020-E) UHMWPE inserts and tested to visible fracture or a 3-million-cycle runout. Post-test fractographic analysis identified crack initiation sites. Conventional aged UHMWPE demonstrated fatigue failure under varus-valgus rotation (OI = 2.59 ± 1.11) but no failure without rotation. Vitamin E-stabilized UHMWPE showed no fatigue failure after 3 million cycles, even under varus-valgus rotation (OI = 0.23 ± 0.02). Fractography revealed fractures originating at the trough and propagating with cyclic loading. Oxidation significantly reduces polyethylene fatigue life, and varus-valgus rotation exacerbates this effect in mobile bearing TAR implants. Antioxidant-stabilized UHMWPE showed promising resistance to fatigue and oxidation. These findings support the role of antioxidant stabilization in improving TAR performance, and the protocols developed here provide a framework for assessing the safety of alternative materials.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094041","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":"Coordination of Glucose and Glutamine Metabolism in Tendon Is Lost in Aging.","authors":"Samuel J Mlawer, Felicia R Pinto, Katie J Sikes, Brianne K Connizzo","doi":"10.1002/jor.26100","DOIUrl":"10.1002/jor.26100","url":null,"abstract":"<p><p>Tendinopathy is a chronic, degenerative disease that has increased prevalence in aged populations, and is characterized by a loss in extracellular matrix (ECM) integrity. Recent work has clearly demonstrated age-related deficits in ECM synthesis with aging, as well as some changes to metabolic activity. Since glucose metabolism is critical to protein synthesis and known to be altered in aging, we sought to investigate if age-related changes in metabolism are linked to changes in ECM remodeling. We used our previously developed flexor tendon explant model to expose young and aged tendon explants to various concentrations of glucose and glutamine supplementation and observe changes in metabolic activity, matrix composition, matrix biosynthesis, and expression of metabolic and ECM genes. We hypothesized that elevated levels of glucose and glutamine would lead to increased ECM remodeling as well as elevated gene expression of their respective pathways in young tendons, with no such effect in aged tendons. Interestingly, we found that glutamine processing is affected by glucose levels with increased expression of key glutamine processing pathways with increased glucose, but this effect was lost with aging. We also observed that ECM remodeling is directly related to both glucose and glutamine processing with altered glycosaminoglycan and collagen synthesis with glucose and glutamine media concentration. Overall, our work reveals that glucose and glutamine are intricately linked for both tenocyte health and ECM homeostasis and that their metabolism could be one of the key drivers of age-related deficiencies in tissue maintenance.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094044","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":"How Patients' Lifestyle Affects the Wear of Hip Implants: An In-Silico Study.","authors":"Lorenza Mattei, Andrea Di Pietro, Francesca Di Puccio","doi":"10.1002/jor.26098","DOIUrl":"https://doi.org/10.1002/jor.26098","url":null,"abstract":"<p><p>The validation of new hip replacement designs traditionally relies on lengthy and costly In-Vitro wear tests that replicate basic In-Vivo conditions, as the simplified walking recommended in the ISO 14242 guidelines. These tests overlook the diverse motor tasks and lifestyle differences among patients. This study seeks to establish the foundation for In-Silico clinical trials of total hip replacements, enabling wear simulations of patients with different lifestyles, not feasible with In-Vitro tests. The impact of diverse kinematic and loading histories on the wear of metal-on-plastic hip replacements is investigated in a novel way, considering the combined effect of six daily activities (e.g., walking, fast walking, sit/stand, stairs up/down, lunging), different activity frequencies across five patient profiles (from sedentary elderly to active young), and the effect of load sequence. The results reveal that both the type and frequency of motor tasks significantly influence implant wear. The most critical tasks and at-risk patients were stair climbing and the most active individuals, regardless of age. Load sequence also plays a key role in long-term wear predictions. Accuracy and computational cost were balanced by simulating walking, stair climbing, and sit/stand cycles, ensuring equivalent wear to a complete motor task sequence. ISO standards conditions notably tend to underestimate volumetric wear by up to 60% compared to the simulated patient types. They also fail to predict realistic wear patterns for activities like squatting and lunging where edge contact occurs.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078639","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.25888","DOIUrl":"https://doi.org/10.1002/jor.25888","url":null,"abstract":"","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1055-1058"},"PeriodicalIF":2.1,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.25888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939019","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":"Issue Information - Cover","authors":"","doi":"10.1002/jor.25889","DOIUrl":"https://doi.org/10.1002/jor.25889","url":null,"abstract":"","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.25889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939020","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":"Enhancing the Reliability of Cartilage Repair Evaluation: A Simplified Volume-Based Approach.","authors":"Jani Puhakka, Teemu Paatela, Eve Salonius, Virpi Muhonen, Anna Meller, Anna Vasara, Hannu Kautiainen, Jussi Kosola, Ilkka Kiviranta","doi":"10.1002/jor.26096","DOIUrl":"https://doi.org/10.1002/jor.26096","url":null,"abstract":"<p><p>The purpose of this study was to explore methods for enhancing the reliability of arthroscopic cartilage repair evaluation. We compared a new volume-based scoring technique that assessed the extent of high-quality cartilage repair tissue in four quadrants of the repair tissue with the International Cartilage Repair Society (ICRS) score. Using a porcine cartilage repair model, we evaluated the inter- and intrarater reliability of the new volume-based technique. Nine defects were treated with a recombinant human Type III collagen/polylactide scaffold, whereas nine were left to heal spontaneously. The reliability of the volume-based score was analyzed using intraclass correlation coefficients (ICCs), and external validation was performed by comparing the score with histological ICRS II results. The volume-based score demonstrated moderate to good interrater reliability (ICC 0.67-0.78) and intrarater reliability (ICC 0.58-0.84), outperforming the ICRS score in consistency. Moderate positive correlations were observed between the volume-based score and histological ICRS II subscores (r_s = 0.62-0.64, p < 0.001). These findings suggest that the volume-based approach may improve the reliability of arthroscopic cartilage repair assessment without significantly compromising the alignment with histological evaluations. Although the simplified system offers advantages in reproducibility, further refinement is necessary to balance reliability with the need for comprehensive tissue evaluation. LEVEL OF EVIDENCE: Diagnostics, Level III (based on comparative studies in an animal model with blinding between observers). STATEMENT OF CLINICAL SIGNIFICANCE: This study provides insights into improving the reliability of arthroscopic cartilage repair evaluations, potentially leading to more consistent and accurate assessments in both clinical and research settings.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014934","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":"Analysis of Article Processing Charges of Orthopaedic Journals in the United States.","authors":"Allyson N Pfeil, Zachary Rickmeyer, Joshua H Taylor, Davin K Fertitta, Anay R Patel, T Bradley Edwards, Corey F Hryc","doi":"10.1002/jor.26097","DOIUrl":"https://doi.org/10.1002/jor.26097","url":null,"abstract":"<p><p>In the United States, article processing charges for orthopaedic journals can be excessive and may offer a poor cost-to-benefit ratio regarding article engagement. This study hypothesizes that article processing charges will not strongly correlate with metrics of engagement such as citations, regardless of publication model. The Journal Citation Reports (Clarivate, Philadelphia, PA) identified 136 orthopaedic journals, of which 83 were non-United States journals and six were not suitable for analysis, resulting in 47 journals for analysis. The collected variables included access options, article processing charge, publisher, impact factor with and without self-citations, immediacy index, normalized Eigenfactor (journal influence), article influence score, total citations, total articles, citations per open access article, and citations per restricted and free article. T- and Chi-square tests statistically compared continuous and categorical variables, respectively, and significance was determined at p < 0.05. Linear regressions computed a coefficient of determination to assess any correlation between cost and metrics of engagement, with strong correlation assessed at ≥ 0.80. Publishing unrestricted open access was significantly more expensive in hybrid journals. Hybrid journals received significantly more total citations than open access, however, no difference between hybrid or open access journals was noted when comparing citations per article within 3 years. No other differences or correlations were found in engagement metrics, publication models, or cost. Access and incorporation of novel findings into clinical practice may depend on scientific publishing practices and, specifically, our ability to maximize viewership while maintaining cost-effectiveness.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005929","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":"Comparison of Artificial Vertebral Body Analogs to Evaluate Initial Stability of Cervical Disc Replacements.","authors":"Jenna M Wahbeh, Labiba Alam, Edward Ebramzadeh, Sophia N Sangiorgio","doi":"10.1002/jor.26095","DOIUrl":"https://doi.org/10.1002/jor.26095","url":null,"abstract":"<p><p>Recent studies have raised concerns regarding migration of cervical disc replacements as a significant clinical complication associated with failure. To date, no laboratory models have addressed migration. Bone analog models have been established for fixation studies of large joint replacements. Therefore, this study aimed to develop models to assess micromotions of cervical disc replacements. Five cervical disc replacement designs were biomechanically tested in flexion/extension, lateral bending, and axial rotation. These were selected to represent different clinical outcomes, including some with significant in vivo migration. Each device was tested in a (1) previously validated 3D-printed biomimetic model and (2) commercially available rigid polyurethane foam blocks. Sagittal and coronal plane micromotions were continuously measured throughout testing. Cyclic displacements were compared as a function of device design and bone analog model type. One ball-and-socket cervical device, the PCM, exhibited significantly greater micromotion in the polyurethane foam model than in the 3D-printed biomimetic model during flexion-extension and lateral bending, specifically 25.8 ± 11.4 µM versus 15.0 ± 9.5 µM (p = 0.04) and 122 ± 64 µM versus 14.5 ± 6.4 µM (p = 0.06), respectively. The large amount of micromotion with the PCM device design was consistent with clinical reports of migration leading to failure. In contrast, motions measured in the 3D-printed biomimetic model did not establish the same differences. In summary, the polyurethane foam model indicated differences between devices better in comparison to the 3D-printed biomimetic model. However, the 3D-printed model has greater potential for further material refinements to more precisely predict clinical performance with better simulation of bone mechanical properties.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997698","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}