Journal of Orthopaedic Research®最新文献

{"title":"Decreased Thigh Muscle Cross-Sectional Area Following Anterior Cruciate Ligament Injury Depends on Concomitant Meniscal Injury and Subject Sex","authors":"Kate French,&nbsp;Michael J. Toth,&nbsp;Niccolo Fiorentino,&nbsp;Pamela Vacek,&nbsp;Mike DeSarno,&nbsp;Timothy W. Tourville,&nbsp;Matthew Failla,&nbsp;Andrew Geeslin,&nbsp;Mathew Geeslin,&nbsp;Mack Gardner-Morse,&nbsp;Patrick Parkinson,&nbsp;Bruce Beynnon","doi":"10.1002/jor.70247","DOIUrl":"10.1002/jor.70247","url":null,"abstract":"<p>This study characterized acute changes in thigh muscle cross-sectional area (CSA) in subjects who suffered their first severe knee trauma. Ninety-one males and females who suffered ACL rupture with or without concomitant meniscus injury underwent bilateral mid-thigh axial T1-weighted, fast field echo magnetic resonance imaging early after the index trauma and prior to reconstruction. The extensor and flexor muscle groups were segmented bilaterally, and CSA measured. Within-person injured-to-contralateral normal side differences in CSA (injured minus normal limb) were evaluated. ACL-injured male and female subjects were classified into four meniscal injury groups (lateral, medial, both lateral and medial, or normal meniscus). A separate sample of healthy subjects with no history of knee injury or disease underwent the same protocol to determine the magnitude of side-to-side differences in thigh muscle CSA in uninjured individuals. ACL-injured individuals had a substantially greater between-leg differences in thigh extensor muscle CSA after injury and prior to reconstruction than healthy subjects. The between leg difference in thigh extensor muscle CSA of the injured leg was largest in males with meniscus injury involving both compartments, with males having twice as much atrophy of the extensor muscles in the injured leg compared to females in that group. The sex-specific response of thigh muscle to severe knee trauma involving the ACL and meniscus suggests that males and females may require tailored rehabilitation programs pre- and post-surgery to recover muscle size and improve muscular strength and symmetry.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412168","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":"Mechanical Contribution of the Anterior Talofibular Ligament to Ankle Stability: 3D Anatomical Finite Element Analysis","authors":"Akinobu Minagawa,&nbsp;Naomichi Ogihara,&nbsp;Makoto Kubota,&nbsp;Yuka Matsumoto,&nbsp;Kohta Ito,&nbsp;Tadashi Kimura,&nbsp;Takumi Kihara,&nbsp;Hirotaka Fukushima,&nbsp;Mitsuru Saito","doi":"10.1002/jor.70241","DOIUrl":"10.1002/jor.70241","url":null,"abstract":"<p>Ankle sprains are among the most common musculoskeletal injuries, with the anterior talofibular ligament (ATFL) most frequently affected. Although cadaveric and in vivo studies have demonstrated the ATFL's role in restraining anterior talar translation and inversion, its isolated mechanical contribution remains unclear due to technical challenges in selectively altering individual ligaments. In this study, we developed a three-dimensional finite element (FE) model of the human foot and ankle to investigate ATFL function. The model was validated against experimental data using the anterior drawer test (ADT), with talar translation in the ATFL-intact condition falling within reported ranges. Simulations compared ATFL-intact and ATFL-injured conditions under ADT, Telos loading, and ankle varus loading. The ATFL-injured model showed increased anterior talar translation, inversion, and internal rotation, suggesting that the ATFL plays an important role in ankle stability. Fascicular analysis in the present model suggested that the inferior fascicle mainly contributed to resisting anterior translation, whereas the superior fascicle experienced greater model-predicted loading under inversion and plantar-flexion positions representative of ankle-sprain–like postures, suggesting possible vulnerability to injury. These findings provide model-based biomechanical insight for the ATFL's role in ankle stability and may provide a computational platform for future investigations into chronic ankle instability and surgical reconstruction outcomes.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391209","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":"Repurposing Metformin to Promote Fracture Callus Maturation via AMPK-Driven Metabolic Activation","authors":"Vasyl Pastukh,&nbsp;Jianying Zhang,&nbsp;Peter G. Alexander,&nbsp;Satyaj Bhargava,&nbsp;Arshia Shams,&nbsp;Celina Zhao,&nbsp;MaCalus V. Hogan,&nbsp;James H-C. Wang","doi":"10.1002/jor.70246","DOIUrl":"10.1002/jor.70246","url":null,"abstract":"<p>Femoral shaft fractures cause prolonged disability, and therapies that accelerate bone repair remain limited. Repurposing clinically approved drugs that target biological bottlenecks in healing is a promising strategy. This study investigated whether systemic metformin administration, an anti-diabetic medication with known metabolic regulatory effects, enhances fracture repair in a rat open femoral shaft fracture model. Histological, immunofluorescent, micro-CT, and biomechanical analyses were performed at 6 weeks post-injury comparing metformin-treated and vehicle-treated animals. Metformin markedly accelerated callus maturation, evidenced by earlier hyaline cartilage ossification, increased collagen I deposition and fiber organization, and reduced collagen II and III expression compared with controls. Micro-CT analysis demonstrated increased tissue mineral density, trabecular thickness, and bone volume fraction along with reduced connectivity density, indicating more advanced structural consolidation of the callus. Although biomechanical parameters were not significantly different at intermediate time point, ultimate load and stiffness trended higher in metformin-treated animals, consistent with structural advancement. Mechanistically, metformin increased p-AMPK expression, elevated mitochondrial markers (NDUFB8, TFAM), and reduced extracellular HMGB1 release, suggesting enhanced metabolic capacity and attenuated inflammatory stress during repair. Importantly, metformin's effects were most pronounced during the cartilage-to-bone transition phase, supporting a role for metabolic activation in promoting endochondral ossification. Together, these findings demonstrate that systemic metformin administration promotes earlier structural consolidation of the fracture callus through coordinated metabolic and inflammatory modulation, supporting the potential repurposing of this safe and inexpensive drug as an adjunct strategy to enhance bone repair.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382242","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":"Biomechanical Assessment of Functional Tasks Beyond Level Walking Following Total Hip Arthroplasty: A Scoping Review","authors":"Haithem M'barki,&nbsp;Ariane Lavoie-Hudon,&nbsp;Martine Gagnon,&nbsp;Katia Turcot,&nbsp;Etienne L. Belzile","doi":"10.1002/jor.70245","DOIUrl":"10.1002/jor.70245","url":null,"abstract":"<div>\u0000 \u0000 <p>The aim of this scoping review was to summarize and to synthesize the existing literature on the most performed functional tasks and their associated biomechanical outcomes following total hip arthroplasty (THA). Five databases, including Medline, Embase, CINAHL, Web of Science, and Ergonomics Abstracts were searched based on 3 main concepts: Total hip arthroplasty, functional tasks and biomechanical outcomes. Studies were screened based on titles and abstracts, followed by a full text reading conducted by two authors following inclusion and exclusion criteria. Eighty three studies with a total of 2047 THA and 170 hip resurfacing arthroplasty (HRA) patients were included. Postural balance was the most frequently evaluated functional task, followed by sit-to-stand and stair negotiation. Most participants were older than 60 years, and the surgical approach was infrequently reported. Patient-reported outcome measures were rarely reported alongside motion analysis, with the Harris hip score and the Oxford Hip Score being the most commonly used. Factors such as age, population characteristics, surgical approaches and follow-up durations may influence the biomechanical outcomes of hip replacement. Therefore, caution is warranted when generalizing these findings to all THA population. Further research on young THA and HRA patients in more demanding task such as squat and work-related tasks are required to better understand functional recovery and implant performance under higher mechanical loads.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait Characteristics and Intersegmental Foot and Ankle Motion in Patients With Neglected Achilles Tendon Rupture","authors":"Min Gyu Kyung,&nbsp;Jahyung Kim,&nbsp;Seongjae Hwang,&nbsp;Yong Cheol Hong,&nbsp;Kyoung Min Lee,&nbsp;Dong Yeon Lee","doi":"10.1002/jor.70240","DOIUrl":"10.1002/jor.70240","url":null,"abstract":"<div>\u0000 \u0000 <p>Neglected Achilles tendon rupture is associated with persistent weakness and altered gait; however, the detailed intersegmental foot and ankle biomechanics have not been fully characterized. This study quantitatively evaluated temporospatial, kinematic, and kinetic gait alterations in patients with neglected Achilles tendon rupture using a multi-segment foot model. Thirteen patients were compared with 26 healthy participants selected by propensity score matching based on age, sex, and body mass index. Intersegmental foot and ankle kinematics were calculated using the DuPont foot model, and ankle kinetics, including plantarflexion moment and ankle power, were evaluated along with temporospatial parameters. Patients with neglected Achilles tendon rupture walked more slowly with shorter strides, a wider step width, and a larger stance phase proportion than matched controls. During the terminal stance phase, the hallux dorsiflexion and hindfoot plantarflexion were reduced. Hallux sagittal range of motion decreased, whereas hindfoot sagittal range of motion did not differ significantly. In the coronal plane, the forefoot and hindfoot range of motion were reduced, with a more everted forefoot and a more inverted hindfoot position. The neglected Achilles tendon rupture group demonstrated significantly lower ankle power during the terminal stance phase and reduced ankle plantarflexion moment during the late stance phase compared with the control group. Collectively, these gait-based findings demonstrate measurable functional deficits in patients with neglected Achilles tendon rupture and highlight the clinical importance of recognizing and appropriately treating this condition.</p></div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376052","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":"A Biomechanical Proof-of-Concept Study of Scaffold-Augmented Distraction Osteogenesis Using 3D-Printed Hyperelastic Bone™ in a Rabbit Tibial Lengthening Model","authors":"Anirejuoritse Bafor,&nbsp;Daryn Strub,&nbsp;Benjamin Brooks,&nbsp;Sara McBride-Gagyi,&nbsp;Christopher Iobst","doi":"10.1002/jor.70244","DOIUrl":"https://doi.org/10.1002/jor.70244","url":null,"abstract":"<div>\u0000 \u0000 <p>Distraction osteogenesis (DO) for limb lengthening often requires prolonged fixation while the regenerate consolidates. Adjuncts that improve the regenerate quality could reduce morbidity and treatment time. Hyperelastic Bone™ (HEB) is a 3D-printed hydroxyapatite (HA)/polylactic-co-glycolic acid (PLGA) scaffold, but its efficacy as an osteotomy-site adjunct during DO is unclear. After IACUC approval, rabbits underwent left tibial lengthening with a mini-rail external fixator distracted at 0.75 mm/day to 20% tibial length and received no scaffold (control), traditional Hyperelastic Bone™ (10% PLGA/90% HA), or a biphasic formulation (10% PLGA/70% HA/20% β-tricalcium phosphate [β-TCP]) placed subperiosteally at the osteotomy site. The contralateral tibiae served as references. After 8 weeks of consolidation, radiographs, micro-CT (prespecified endpoint: regenerate BMD), and torsional testing (prespecified endpoint: stiffness) were performed. Fourteen rabbits underwent attempted lengthening. Intraoperative fractures (n = 2) and fixation loss (n = 3) reduced complete terminal datasets to nine, all of which completed micro-CT and torsion testing. Radiographs confirmed regenerate formation. Regenerate BMD remained below contralateral values with controls being intermediate to the traditional and biphasic HEB formulations (60.5%, 63.8%, and 54.7% of contralateral, respectively). Despite no mineral density improvement, scaffold-treated regenerate demonstrated higher torsional stiffness and strength metrics, greatest with the biphasic formulation, with lower failure displacement and higher polar moment of inertia.</p>\u0000 <p><b>Statement of Clinical Significance:</b> A scaffold that improves functional regenerate performance could enable earlier safer weight bearing and device removal and reduce nonunion/refracture risk in DO.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358082","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":"Predicting Primary Stability of Stemless TSA From Preoperative Bone Density and Surgical Factors","authors":"Ingmar Fleps,&nbsp;Ghislain Maquer,&nbsp;Kyle Snethen,&nbsp;Christine Mueri,&nbsp;Taku Hatta,&nbsp;Jeff Bischoff,&nbsp;Philippe Favre","doi":"10.1002/jor.70238","DOIUrl":"10.1002/jor.70238","url":null,"abstract":"<div>\u0000 \u0000 <p>This study investigated how preoperative bone quality, patient and implant factors can predict the primary stability of a stemless humeral component in total shoulder arthroplasty (TSA). Thirty‑one cadaveric humeri were CT‑scanned with a calibration phantom, and trabecular bone density within the metaphysis was quantified. Specimens were implanted and subjected to cyclic loading at 500 N and 870 N along physiologically representative directions and implant‑to‑bone micromotion was measured using motion capture. Generalized linear models were developed to predict implant micromotion based on patient and implant size factors, including age, height, weight, gender, ethnicity, cancer history, chemotherapy status, apparent peri-implant density, anchor size, head size, resection angle, and load level. Micromotion was significantly larger at 870 N than at 500 N, and males exhibited significantly lower micromotion than females, consistent with the associated higher bone density and larger implant sizes. Peri‑implant density was the strongest individual predictor explaining 34% of micromotion variation. Model predictions went up 49% of micromotion variation if load level was accounted for. Adding anchor and head sizes markedly improved this predictive power to 71%, which outperformed models incorporating patient height and gender (67%). Moderate improvement (73%) was seen when density, load level, height, gender, and anchor size were included after automatic backward selection. These findings demonstrate that bone density only partially predicts primary stability of anatomic stemless shoulder arthroplasty, and that incorporating implant sizing substantially improves predictive accuracy. This preoperative information can provide a more objective and consistent identification of patients with adequate bone quality for stemless fixation.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226079","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":"Locking Compression Plate Versus Dynamic or Limited Contact Dynamic Compression Plate Fixation for Forearm Fractures: A Systematic Review and Meta-Analysis","authors":"Ali Rteil,&nbsp;Majd Mzeihem,&nbsp;Brendon Wang,&nbsp;Mark H. Gonzalez,&nbsp;Farid Amirouche","doi":"10.1002/jor.70237","DOIUrl":"10.1002/jor.70237","url":null,"abstract":"<div>\u0000 \u0000 <p>Locking compression plates (LCPs) offer angular stability and may improve fixation in challenging forearm fractures. Still, they are substantially more expensive than dynamic compression plates (DCPs) or limited contact DCPs (LC-DCPs). This study compared union time, functional outcomes, and complications between LCPs and nonlocking compression plates for diaphyseal radius and ulna fractures. A systematic review and meta-analysis were performed in accordance with PRISMA guidelines. Eligible studies included skeletally mature patients with acute diaphyseal radius and or ulna fractures, compared LCPs with DCPs or LC-DCPs, and reported at least one clinical or radiographic outcome. Primary outcomes were time to union, delayed union, and nonunion. Secondary outcomes included functional scores, range of motion, and complications. Data were pooled using a random-effects model to calculate mean differences or odds ratios with 95% confidence intervals. Eight studies encompassing 525 patients met the inclusion criteria. Five studies comparing LCPs and DCPs showed a significantly shorter mean time to union with LCPs, while rates of delayed union, nonunion, complications, functional scores and range of motion were similar. Three studies compared LCPs and LC-DCPs. LCPs showed a non-significant trend toward shorter union time, with no differences in functional outcomes or complications. In conclusion, LCP fixation results in a modest reduction in time to radiographic union compared with DCPs but does not confer clear advantages in union rates, function, or complications. Given their higher cost and potential challenges at implant removal, LCPs should be used selectively rather than as routine implants for all forearm fractures.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148225404","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":"Synovial Fluid Biomarkers Reflect Pre- and Postoperative Clinical Features in Rotator Cuff Tears, Independent of Tear Size","authors":"Seungmin Jeong,&nbsp;Jong Min Lee,&nbsp;Jeong-Hyun Koh,&nbsp;Doohyung Lee","doi":"10.1002/jor.70235","DOIUrl":"10.1002/jor.70235","url":null,"abstract":"<p>Synovitis is a major contributor to pain and dysfunction in rotator cuff tears (RCTs), yet it remains unclear whether routine synovial fluid (SF) parameters reflect clinical features independent of tear size, operation method, and patient age. This prospective cohort study aimed to evaluate the associations between routine SF parameters and clinical features before and after rotator cuff repair. Preoperative glenohumeral SF was aspirated from 109 patients undergoing arthroscopic repair, and interleukin-6, total protein levels, and differential white blood cell counts were analyzed. Clinical features, including pain, active range of motion, strength, Constant score, and American Shoulder and Elbow Surgeons (ASES) score, were assessed preoperatively and at 3 and 6 months postoperatively. Associations between SF parameters and clinical features were examined after adjusting for tear size, operation method, and age. Higher interleukin-6 and total protein levels were associated with lower range of motion and functional score, and these relationships persisted at 3 and 6 months. A higher neutrophil percentage was negatively correlated with preoperative range of motion, strength; with range of motion and Constant score at 3 months. Routine SF parameters, including interleukin-6, total protein, and neutrophil percentage, were associated with poorer preoperative clinical features and remained related to early postoperative outcomes. These findings suggest that routine SF parameters are linked to the clinical features of RCT, independent of cuff tear size, operation method, and patient age, and may serve as practical biomarkers for predicting both preoperative and postoperative outcomes.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218117","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":"Assessing Lateral Patellofemoral Dislocations on MRI: A Novel Contusion Grading Approach for Predicting Recurrence and Prognosis","authors":"Nikhil Patel,&nbsp;Griffin Harris,&nbsp;Emily Johnson,&nbsp;Michael Nahouraii,&nbsp;Sagar Gulati,&nbsp;Jean Jose","doi":"10.1002/jor.70234","DOIUrl":"10.1002/jor.70234","url":null,"abstract":"<div>\u0000 \u0000 <p>This retrospective cohort study evaluated the relationship between the location of lateral patellofemoral bony contusions on magnetic resonance imaging (MRI) and rates of recurrent patellar dislocation and surgical intervention using a novel MRI-based grading system. A total of 235 patients with MRI-confirmed lateral patellar dislocations were identified at a single academic institution, including 46 patients who underwent medial patellofemoral ligament (MPFL) reconstruction. Outcomes of patients managed nonoperatively were compared with those requiring surgical intervention. Bony contusions were identified in 66.8% of patients and were most commonly located within the anterior third of the lateral femoral condyle. Although contusion location was not significantly associated with the need for surgical intervention (p = 0.364), the presence of a bony contusion significantly predicted reinjury (p = 0.003), with 86% of reinjured patients demonstrating contusions on imaging. These findings suggest that while the location of the contusion may not influence the likelihood of surgery, the presence of a bony contusion is associated with an increased risk of recurrent instability. This novel MRI grading system offers a framework for future studies to stratify lateral patellar dislocations.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"44 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205215","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}