Timothy Lowe, Hao-Yuan Hsiao, Xuanliang Neil Dong, Lisa Griffin
{"title":"Acute Prolonged Hamstrings Vibration Reduces Limb Stiffness Following Anterior Cruciate Ligament Reconstruction During a Single-Limb Drop-Jump Task.","authors":"Timothy Lowe, Hao-Yuan Hsiao, Xuanliang Neil Dong, Lisa Griffin","doi":"10.1002/jor.26105","DOIUrl":"https://doi.org/10.1002/jor.26105","url":null,"abstract":"<p><p>Impaired quadriceps function influences lower limb biomechanics following anterior cruciate ligament reconstruction (ACLR). This often results in stiff limb loading which leads to the development of knee osteoarthritis. Greater hamstrings/quadriceps co-activation is common after ACLR and is, in part, responsible for impaired quadriceps function. Prolonged vibration of the hamstrings can alleviate reciprocal inhibition of the quadriceps and enhance quadriceps activation. We hypothesize that this will also reduce limb stiffness. Fourteen participants with unilateral ACLR, and 14 non-injured individuals performed a single-leg drop-landing task, before and after 20 min of hamstrings vibration. Limb stiffness, peak vertical ground reaction force, peak instantaneous loading rate, knee excursion, and peak knee extension moment were calculated during the loading phase of the drop-landing task. The ACLR group had significantly greater limb stiffness (p = 0.002), peak vertical ground reaction force (p = 0.004), loading rate (p = 0.001), significantly less knee excursion (p = 0.009) and knee extension moment (p = 0.013) before vibration than non-injured controls. Vibration significantly reduced limb stiffness (p = 0.001), peak vertical ground reaction force (p = 0.001), loading rate (p < 0.001), significantly increased knee excursion (p = 0.01) and knee extension moment (p < 0.001) in the ACLR group. No significant differences were found following vibration in the non-injured control group. CLINICAL SIGNIFICANCE: These results demonstrate that prolonged vibration of the hamstrings has the potential to mitigate the stiff limb loading strategy linked to knee osteoarthritis development, and may represent an effective adjunct therapy for ACLR rehabilitation.</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":"144142842","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}
Vahid Danesh, Paul Arauz, Maede Boroji, Andrew Zhu, Mia Cottone, Elaine Gould, Fazel A Khan, Imin Kao
{"title":"Improved Accuracy in Pelvic Tumor Resections Using a Real-Time Vision-Guided Surgical System.","authors":"Vahid Danesh, Paul Arauz, Maede Boroji, Andrew Zhu, Mia Cottone, Elaine Gould, Fazel A Khan, Imin Kao","doi":"10.1002/jor.26111","DOIUrl":"https://doi.org/10.1002/jor.26111","url":null,"abstract":"<p><p>Pelvic bone tumor resections remain significantly challenging due to complex three-dimensional anatomy and limited surgical visualization. While accurate, current navigation systems and patient-specific instruments present limitations, including high costs, radiation exposure, workflow disruption, long production time, and lack of reusability. This study evaluates a real-time vision-guided surgical system combined with modular jigs to improve accuracy in pelvic bone tumor resections. A vision-guided surgical system combined with modular cutting jigs and real-time optical tracking was developed and validated. Five male pelvis sawbones were used, with each hemipelvis randomly assigned to either the vision-guided and modular jig system or the traditional freehand method. A total of 20 resection planes were analyzed for each method. Accuracy was assessed by measuring distance and angular deviations from the planned resection planes. The vision-guided and modular jig system significantly improved resection accuracy compared to the freehand method, reducing the mean distance deviation from 2.07 ± 1.71 mm to 1.01 ± 0.78 mm (p = 0.0193). In particular, all specimens resected using the vision-guided system exhibited errors of less than 3 mm. Angular deviations also showed significant improvements with roll angle deviation reduced from 15.36 ± 17.57° to 4.21 ± 3.46° (p = 0.0275), and pitch angle deviation decreased from 6.17 ± 4.58° to 1.84 ± 1.48° (p < 0.001). The proposed vision-guided and modular jig system significantly improves the accuracy of pelvic bone tumor resections while maintaining workflow efficiency. This cost-effective solution provides real-time guidance without the need for referencing external monitors, potentially improving surgical outcomes in complex pelvic bone tumor cases.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127954","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}
McKenzie S White, Steven A Garcia, Yuxi Pang, Claire M Casey, Riann M Palmieri-Smith, Lindsey K Lepley
{"title":"Patellofemoral Cartilage Changes Are Not Associated With Quadriceps Metrics After ACLR With Patellar Tendon Autografts.","authors":"McKenzie S White, Steven A Garcia, Yuxi Pang, Claire M Casey, Riann M Palmieri-Smith, Lindsey K Lepley","doi":"10.1002/jor.26102","DOIUrl":"https://doi.org/10.1002/jor.26102","url":null,"abstract":"<p><p>Quadriceps dysfunction (e.g., weakness or atrophy) is often implicated in the increased prevalence of posttraumatic osteoarthritis (PTOA) following anterior cruciate ligament reconstruction (ACLR). However, the relationship between quadriceps dysfunction and PTOA development relies on limited insight. To this end, magnetic resonance T1rho relaxation times directly assess cartilage composition, yet the long-term relationship between cartilage composition and quadriceps dysfunction has not yet been explored within a single graft type. Our objectives were to assess cartilage composition using T1rho values 3 years post-ACLR via patellar tendon autograft and to examine associations between quadriceps strength or volume and cartilage composition. Twenty-four individuals with ACLR (male/female = 15/9, age = 22.8 ± 3.6 years, BMI = 23.2 ± 1.9, time since surgery = 3.3 ± 0.9 years) and 24 Controls (male/female = 14/10, age = 22.0 ± 3.1 years, BMI = 23.3 ± 2.6) participated. Linear mixed-effects models assessed T1rho values between ACLR, Contralateral, and Control Limbs. Linear regressions determined associations between quadriceps strength or volume with T1rho in significant regions identified by the linear mixed-effects models. T1rho values in the ACLR limb were 7%-12% longer in the medial and lateral patella, and trochlea compared to Contralateral and/or Control limbs (p = 0.009-0.049), with no associations with strength or volume (p > 0.05). Three years following ACLR via patellar tendon autograft, the patellofemoral joint exhibited compositional changes that were not associated with quadriceps strength or size. Future studies should explore if similar changes occur with other graft types and investigate the role of additional factors known to impact joint health (e.g., walking mechanics).</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119943","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}
Elizabeth Bjornsen, Alyssa Evans-Pickett, Hope Davis-Wilson, Amanda E Munsch, J Troy Blackburn, Jason R Franz, Todd A Schwartz, Jeffrey Spang, Brian Pietrosimone
{"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}
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
{"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/m<sup>2</sup>; n = 18) or normal (< 25 kg/m<sup>2</sup>; 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 (ΔR<sup>2</sup> = 0.28, p = 0.03; ΔR<sup>2</sup> = 0.25, p = 0.04, respectively) and tibial plateau (ΔR<sup>2</sup> = 0.55, p < 0.001; ΔR<sup>2</sup> = 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/m<sup>2</sup>.</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}
Ryan Siskey, Patrick Hall, Ruth Heckler, David Safranski, James Johnson, Ariel Palanca
{"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}
Samuel J Mlawer, Felicia R Pinto, Katie J Sikes, Brianne K Connizzo
{"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}
Lorenza Mattei, Andrea Di Pietro, Francesca Di Puccio
{"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}