Journal of Orthopaedic Research®最新文献

{"title":"Effects of Plate-Bone Contact on Bridge Plate Fracture Fixation Biomechanics: Computational, Experimental, and Analytical Modeling.","authors":"Zachary A Koroneos, Hwabok Wee, J Spence Reid, Gregory S Lewis","doi":"10.1002/jor.26114","DOIUrl":"https://doi.org/10.1002/jor.26114","url":null,"abstract":"<p><p>Bridge plating is commonly used for internal fixation of comminuted fractures. The inner working length between screws has been established as a key parameter controlling postoperative biomechanical stability. However, plate-bone contact may affect these biomechanics in complex ways, and the offset between the plate and bone is variable across surgeries. The objective of this study was to examine the effects of construct and loading parameters on interfragmentary motion and maximum plate stress of bridge plating constructs. Finite element models were developed with variations in inner working length, plate-bone offset, fracture gap size, and loading type and magnitudes. Experiments with synthetic bones were conducted in parallel to support model credibility. Analytical models were also developed based on beam bending and torsion of the plate, assuming rigidity outside the inner working length. Finite element and experimental results of axial and torsional loading scenarios without plate-bone contact confirmed linear relationships between inner working length and interfragmentary motion. Analytical predictions of interfragmentary motion showed very good agreement with the finite element simulations in these scenarios. Conversely, in cases with plate-bone contact, a shorter effective working length was formed, and results were dependent on additional variables such as fracture gap. The study shows how the mechanics of bridge plating can be understood and predicted based on beam theory up to the point of plate-bone contact, and how interfragmentary motions and maximum plate stresses are influenced by the interaction of surgical variables in the presence of plate-bone contact.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248303","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":"Changes in Glenohumeral Musculoskeletal Development Following Brachial Plexus Birth Injury.","authors":"Emily B Fawcett, Kyla B Bosh, Katherine R Saul, Jacqueline H Cole","doi":"10.1002/jor.26104","DOIUrl":"https://doi.org/10.1002/jor.26104","url":null,"abstract":"<p><p>Brachial plexus birth injury (BPBI), one of the most common nerve injuries in children, often leads to impaired shoulder development, resulting in sustained postural and bone deformity and muscle weakness. Despite the substantial long-term consequences, clinical consensus is lacking for what BPBI treatments are optimal in terms of timing and approach, primarily because BPBI sequelae are complex, involving stunted muscle growth, muscle denervation, and limb disuse that can disrupt glenohumeral joint development. Injury can occur as nerve rupture (postganglionic injury) or nerve avulsion (preganglionic injury), which have distinct musculoskeletal consequences yet are often treated similarly clinically due to their similar initial presentations and the inability of existing methods to distinguish between them. Most of our clinical knowledge about the musculoskeletal detriments in the shoulder comes from studies in nerve rupture patients. Knowledge is generally lacking for the specific effects of injury location on the development and progression of muscle and bone deficits following BPBI. A better understanding of the distinct effects of postganglionic and preganglionic BPBI is important for developing more effective and targeted treatments. More studies are needed to elucidate differences between nerve rupture and nerve avulsion and the particular factors driving glenohumeral deformity development. This paper reviews current knowledge about clinical musculoskeletal deformity development in the shoulder following BPBI, as well as additional insights gleaned from animal and computational models, and identifies key gaps that need to be addressed in future studies to inform better approaches for mitigating and preventing glenohumeral deformity in these patients.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248302","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":"Multi-Scale Analysis of Regional Pathology in the Human Trapezium During Osteoarthritis Progression.","authors":"Brendan D Stoeckl, Kendall M Masada, Lorielle G Laforest, Hannah H Lee, Robert L Mauck, David R Steinberg","doi":"10.1002/jor.26112","DOIUrl":"https://doi.org/10.1002/jor.26112","url":null,"abstract":"<p><p>Trapeziometacarpal (TMC) osteoarthritis (OA) is a prevalent condition that significantly impacts hand function and quality of life. In this study we sought to close gaps in knowledge related to the initiation and progression of TMC OA on the tissue scale by evaluating the morphology and gross appearance, wear patterns, mechanical properties, subchondral bone morphology, and histological characteristics of the tissue across a spectrum of disease severity and by correlating each of these properties to the clinically assessed radiographic grade. Thirty-two cadaveric hand specimens were first assigned a radiographic grade by three hand surgeons. Trapezia were then evaluated for cartilage wear and eburnation. Cartilage mechanics were assessed via indentation testing across the TMC surface. Bone morphology was evaluated via micro-computed tomography, and stained histologic sections were assessed with histopathology scoring. Analysis revealed that radiographic grading is a lagging indicator of joint pathology, with degenerative changes occurring before radiographic evidence. While cartilage wear followed regional patterns (beginning at the volar and radial aspects), mechanical weakening of cartilage occurred uniformly across the joint. These findings suggest TMC OA involves both mechanical wear and biological factors, rather than being purely a \"wear and tear\" disease. We confirmed that radiographic staging is not sensitive to TMC OA initiation and early progression; however, it may still be useful for its predictive power in later stages of disease, given its strong correlations to both functional (cartilage mechanical properties) and structural (osteochondral histology score) outcomes. This understanding could inform the development of early interventions and more effective treatments.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225781","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":"Differences in Intersegmental Foot and Ankle Motion Between Patients With Varus and Valgus Ankle Osteoarthritis.","authors":"Min Gyu Kyung, Jahyung Kim, Joonhee Kim, Kyoung Min Lee, Dong Yeon Lee","doi":"10.1002/jor.26106","DOIUrl":"https://doi.org/10.1002/jor.26106","url":null,"abstract":"<p><p>In instances of ankle osteoarthritis (OA), a significant proportion of patients exhibit varus ankle OA, while valgus ankle OA is less commonly seen. Both types employ distinct compensatory mechanisms to sustain a plantigrade gait. This study explored the variations in intersegmental foot and ankle motions between patients with varus and valgus ankle OA using multisegment foot gait analysis. The study included 55 patients with varus and 13 with valgus end-stage ankle OA. The DuPont foot model was utilized to evaluate intersegmental foot and ankle kinematics, and temporospatial gait parameters were also analyzed. Both groups displayed comparable temporospatial parameters. Notably, the varus ankle OA group showed significantly reduced sagittal range of motion (ROM) in both the forefoot and hindfoot but increased coronal ROM in the forefoot compared to their counterparts. The valgus ankle OA group demonstrated a significantly greater hindfoot coronal ROM compared to the varus ankle OA group. The varus ankle OA group exhibited significant hallux dorsiflexion during the terminal stance phase. In addition, the varus ankle OA group demonstrated significant forefoot plantar flexion and adduction during the stance phase and forefoot eversion throughout the gait cycle. In contrast, the valgus ankle OA group showed significant hindfoot eversion throughout the gait cycle and hindfoot dorsiflexion during the terminal stance phase. Although both groups displayed similar absolute talar tilt angles, distinct differences in the ROM and intersegmental positions highlighted unique compensatory mechanisms, emphasizing the value of kinematic analysis in assessing functional adaptations related to coronal alignment.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191866","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":"In Vivo Intramuscular pH in Tibia Fractures Is Acidic Prior to Stabilization and Equilibrates Toward Systemic pH 48 h Post Stabilization.","authors":"Danielle F Peterson, Loren O Black, Karalynn Lancaster, J Samuel Cheesman, Jennifer Shatzer, Ramya Ramesh, Seiji Koike, James E Meeker, Darin M Friess, Jung U Yoo, Zachary M Working","doi":"10.1002/jor.26108","DOIUrl":"https://doi.org/10.1002/jor.26108","url":null,"abstract":"<p><p>Early and reliable diagnosis of acute compartment syndrome (ACS) remains challenging for providers. Transcutaneous intramuscular pressure (TIMP) measurements, historically proposed for ACS diagnosis, are unreliable and prone to errors. Little is known about In Vivo limb pH balance in lower extremity injuries. The aim of this observational study was to quantify acid-base chemistry through invasive measurement of intramuscular pH (IpH) adjacent to tibia fractures. Patients with tibial shaft or plateau fractures undergoing intramedullary nail or external fixator application were included. We compared anterior compartment IpH to venous pH (VpH) measurements at presurgery and 12, 24, 36, and 48 h postoperatively, as well as TIMP measurements at the beginning and end of surgery. A total of 39 patients with tibia fractures (11 plateau, 27 shaft) provided consent. Initial IpH was universally acidic (mean [SD] 6.57 [0.506]) compared to VpH (7.35 [0.0600]). Final IpH at 48 h converged to VpH (IpH 7.41 [0.408], VpH 7.40 [0.0305]). IpH and VpH demonstrated a significant positive correlation over all 48 h (r_rm = 0.476, df = 115, analytic 95% CI [0.322, 0.605], p < 0.0001). There was no correlation between TIMP and IpH (r_rm = 0.041, df = 33, analytic 95% CI [-0.296, 0.369], p = 0.816). In tibia fractures requiring operative stabilization, adjacent musculature demonstrated nearly 1 order of magnitude more acidic than systemic circulating physiology prior to skeletal stabilization. Limb IpH converged to systemic VpH within 48 h after surgery. No correlation exists between heritage TIMP measurements and direct measures of intramuscular physiology in the form of In Vivo IpH; improvements in diagnostic modalities for muscular diagnoses, such as compartment syndrome, remain valuable. Level of Evidence: Level 2 prospective observational cohort. Clinical Significance: This study provides a critical foundation for understanding the In Vivo acid-base balance of muscle tissue adjacent to fractures, allowing for future research into the consequence of tissue acidity on inflammation, immune response, and fracture healing.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191867","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":"Risk of Distal Femur Fracture in Antegrade Intramedullary Nail Fixation of Proximal Femur Fractures: A Finite Element Study.","authors":"Gregory R Roytman, Sophia Lahik, Steven M Tommasini, Daniel H Wiznia, Brianna R Fram","doi":"10.1002/jor.26113","DOIUrl":"https://doi.org/10.1002/jor.26113","url":null,"abstract":"<p><p>Surgeons often use long antegrade intramedullary nails (aIMNs) when fixing fractures of the proximal femur in geriatric patients. However, risk of peri-implant fracture in relation to aIMN termination level has not yet been studied. We therefore studied the correlation between aIMN nail tip termination level and extent of distal femur fracture in three different loading scenarios using finite element models of seven different length aIMNs. These were loaded into 3D models of synthetic osteoporotic femurs, which were loaded in single-leg stance (SLS) with body weight load at the femoral head, torsion (TOR) counterclockwise to failure with 120 Nm of torque, and distal impact/fall (DIF) simulating direct fall on the knees at 1000 mm/sec. The maximum stress in SLS and percentage of failed elements for TOR and DIF were recorded. For SLS, aIMN tip termination and maximum stress were not correlated (ρ = 0.1429, p = 0.7599) and there was no apparent trend in the data. For TOR, more proximal aIMN tip termination demonstrated a significant correlation with greater percentage of failed area (ρ = 0.9286, p = 0.0025). For DIF, aIMN tip termination was not correlated with the percentage of failed elements (ρ = -0.6071, p = 0.1482), but demonstrated a statistically significant Gaussian relationship (coeffs: <math> <semantics> <mrow><mrow><mi>a</mi></mrow> </mrow> <annotation>$a$</annotation></semantics> </math>  = 2.22 (p = 1.13 × 10^-3), <math> <semantics> <mrow><mrow><mi>b</mi></mrow> </mrow> <annotation>$b$</annotation></semantics> </math>  = 58.61 (p = 1.89 × 10^-5), <math> <semantics> <mrow><mrow><mi>c</mi></mrow> </mrow> <annotation>$c$</annotation></semantics> </math>  = 17.46 (p = 1.79 × 10^-3)) where 60 mm aIMN tip termination demonstrated the greatest percentage of failed area. Therefore, we found a strong linear relationship between more proximal aIMN termination in the femur and extent of failure in TOR. There was a statistically significant Gaussian relationship between metaphyseal termination and extent of failure in DIF.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180325","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":"Comparative Proteomic Analysis of Osteoarthritis and Rheumatoid Arthritis: Identifying Potential Biomarkers.","authors":"Bhavneet Kaur, Diksha Rana, Monidipa Konar, Rinkle Sharma, Devendra K Chouhan, Uttam Chand Saini, Mahesh Prakash, Amit Arora, Mandeep S Dhillon, Jyotdeep Kaur, Indu Verma, Sadhna Sharma","doi":"10.1002/jor.26092","DOIUrl":"https://doi.org/10.1002/jor.26092","url":null,"abstract":"<p><p>This study investigates proteomic differences between knee osteoarthritis (OA) and rheumatoid arthritis (RA) to identify protein signatures with potential diagnostic and therapeutic relevance. Using SWATH mass spectrometry, synovial fluid proteome from OA patients across Kellgren-Lawrence OA grades 2, 3, and 4 was analyzed and compared with RA patients. Out of 333 quantified proteins, 45 were differentially expressed, including aggrecan, versican, and inflammation-related proteins (e.g., CRP, APCS, S100A8, and SAA2). ELISA validation confirmed aggrecan, versican, and cartilage oligomeric matrix protein (COMP) as significantly altered proteins in OA compared to RA, along with distinct trends with OA progression and mirrored patterns in paired serum samples. ROC curve analysis highlighted COMP's strong diagnostic potential, with an AUC of 96%, 87.2%, and 85.2% for OA grades 2, 3, and 4 versus RA, respectively. COMP differentiated OA from RA at a synovial fluid concentration of < 3136 ng/mL, AUC of 92.1%, 89% sensitivity, and 82% specificity. Versican also demonstrated diagnostic utility, particularly in later OA stages. Gender-specific analysis revealed no differences for aggrecan and versican, while COMP levels were significantly higher in males. Simultaneously, a lower aggrecan, versican, and COMP levels were observed in OA (females) as compared to RA, potentially linked to estrogen decline with age and cartilage degradation. However, gender variability underscores the need for a larger, sex-balanced cohort study. Future studies could aim to account for validating COMP's diagnostic potential with healthy controls, demonstrating its reliability to characterize different OA grades.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159700","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":"AI in Orthopedic Research: A Comprehensive Review.","authors":"Abdulhamit Misir, Ali Yuce","doi":"10.1002/jor.26109","DOIUrl":"https://doi.org/10.1002/jor.26109","url":null,"abstract":"<p><p>Artificial intelligence (AI) is revolutionizing orthopedic research and clinical practice by enhancing diagnostic accuracy, optimizing treatment strategies, and streamlining clinical workflows. Recent advances in deep learning have enabled the development of algorithms that detect fractures, grade osteoarthritis, and identify subtle pathologies in radiographic and magnetic resonance images with performance comparable to expert clinicians. These AI-driven systems reduce missed diagnoses and provide objective, reproducible assessments that facilitate early intervention and personalized treatment planning. Moreover, AI has made significant strides in predictive analytics by integrating diverse patient data-including gait and imaging features-to forecast surgical outcomes, implant survivorship, and rehabilitation trajectories. Emerging applications in robotics, augmented reality, digital twin technologies, and exoskeleton control promise to further transform preoperative planning and intraoperative guidance. Despite these promising developments, challenges such as data heterogeneity, algorithmic bias, and the \"black box\" nature of many models-as well as issues with robust validation-remain. This comprehensive review synthesizes current developments, critically examines limitations, and outlines future directions for integrating AI into musculoskeletal care.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142843","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":"Variation in Mechanical Properties of 5.5 mm Cobalt Chromium and Titanium Spinal Rods Across Suppliers.","authors":"Vidyadhar V Upasani, Dylan G Kluck, Christine L Farnsworth, Naman U Shah, Burt Yaszay, Jason P Caffrey, Peter O Newton","doi":"10.1002/jor.26107","DOIUrl":"https://doi.org/10.1002/jor.26107","url":null,"abstract":"<p><p>Cobalt chromium (CoCr) and titanium (Ti) alloys are popular spinal rod choices due to biocompatibility, less imaging artifact than stainless steel, and greater corrosion resistance. This study assesses the mechanical behavior in bending of commercially available 5.5 mm diameter CoCr and Ti spinal rods in a four-point bending configuration. For each supplier, rod segments were loaded to 20 mm of deflection with continuous load and displacement recording. Rod mechanical properties were calculated. Suppliers were compared by ANOVA, with post hoc pairwise comparisons. For CoCr rods, flexural modulus and flexural stiffness varied across suppliers with maximum differences of 18.0 GPa and 47.0 N/mm, respectively, representing 11% and 15% variation. Range for CoCr rod yield load was 780-1004 N (29% variation), yield displacement was 2.3-2.8 mm, elastic displacement was 2.2-2.7 mm, and maximum load was 1791-2181 N, representing 22% variation. For Ti rods, flexural modulus and flexural stiffness varied across suppliers with maximum differences of 7.3 GPa and 24.3 N/mm, respectively, representing 9% and 14% variation. Range for Ti rod yield load was 1054-1207 N (14% variation), yield displacement was 5.9-7.0 mm, elastic displacement was 5.8-6.9 mm, and maximum load was 1515-1678 N, representing 11% variation. There is substantial variation in mechanical behavior in bending of CoCr and Ti rods (5.5 mm diameter) amongst suppliers, suggesting that they are not mechanically equivalent. Surgeons must ensure that the mechanical properties of a particular rod meet the requirements of the surgical correction required.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142865","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":"Open High Tibial Osteotomy Alters Lower Limb Muscle Activation During Gait Stance Phase.","authors":"Jie Dong, Hujun Wang, Yuling Wang, Hongqing Wang, Fenglong Sun, Kemin Liu","doi":"10.1002/jor.26110","DOIUrl":"https://doi.org/10.1002/jor.26110","url":null,"abstract":"<p><p>This study investigated the impact of changes in weight-bearing line following open-wedge high tibial osteotomy (HTO) on muscle activation within the lower limb kinetic chain in patients with medial knee osteoarthritis (KOA). A cohort study was conducted with 21 patients diagnosed with KOA who underwent HTO. Three-dimensional gait analysis and surface electromyography were performed preoperatively and at 6 and 12 months postoperatively. Seven lower limb muscles were assessed for co-contraction index, integrated electromyography, root mean square, duration, and SMA during the stance phase. Intragroup and intergroup comparisons were made using one-way and repeated-measures analysis of variance. Preoperatively, the co-contraction indices of the vastus medialis-biceps femoris and vastus medialis-gastrocnemius were significantly higher compared with other muscle pairs (p < 0.05), but these indices decreased significantly at 6 and 12 months postoperatively (p < 0.05). The integrated electromyography and root mean square values for six muscles, excluding the vastus lateralis, significantly increased at 6 months postsurgery (p < 0.05). At 12 months, the root mean square value of the vastus lateralis decreased significantly compared with preoperative levels (p < 0.05). The gluteus medius and vastus medialis showed significant increases in integrated electromyography, root mean square, and duration of muscle activation at 12 months postoperatively, along with earlier muscle activation timing (p < 0.05). The vastus medialis demonstrated improved activation compared with preoperative levels. HTO reduces co-contraction indices, enhances muscle activation, and improves lower limb muscle coordination within 1 year postoperatively.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142864","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}