Journal of Orthopaedic Research®最新文献

{"title":"Biomechanical Characterization of Metacarpal Fixation: Internal Load Determination and Evaluation of a Novel Adhesive Osteosynthesis","authors":"Peter Schwarzenberg,&nbsp;Gordian Banzer,&nbsp;Guillaume Patt-Lafitte,&nbsp;Jérôme Schlatter,&nbsp;Daniel J. Hutchinson,&nbsp;Michael Malkoch,&nbsp;Peter Varga,&nbsp;Tatjana Pastor","doi":"10.1002/jor.70027","DOIUrl":"10.1002/jor.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Metal plates are commonly used for the fixation of metacarpal fractures, but are associated with complications such as tendon adhesions that impair finger mobility. AdhFix, a novel osteosynthesis material, may reduce these complications, but its biomechanical performance in the metacarpal region remains untested. This study aimed to evaluate internal bending moments during postoperative rehabilitation and assess the biomechanical potential of AdhFix in treating comminuted metacarpal shaft fractures using a human cadaveric model. In five cadaveric hands, unstable shaft fractures of the second, third, and fourth metacarpals were simulated using a 3 mm osteotomy gap and stabilized with polyether ether ketone (PEEK) plates and stainless-steel cortical screws. A custom 3D-printed guide ensured accurate osteotomy and screw positioning. Tendon loading was simulated by pulling flexor digitorum profundus tendons until fingertip-to-palm contact was achieved, followed by wrist flexion using 100 N of force on the flexor carpi radialis and ulnaris tendons. Bending of the fixation was captured using stereographic imaging, and internal bending moments were calculated via finite element modeling. After removal of the PEEK plate, the procedure was repeated using AdhFix for fixation. Maximum internal bending moments were 6.14 ± 2.03 Nmm during finger flexion and 3.37 ± 1.64 Nmm during wrist flexion. AdhFix demonstrated mechanical integrity under both conditions with no observed failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Statement of Clinical Significance</h3>\u0000 \u0000 <p>AdhFix may provide a mechanically stable alternative to conventional plates during early rehabilitation, potentially reducing tendon adhesions and preserving finger mobility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1787-1795"},"PeriodicalIF":2.3,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718077","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":"In Vivo Study of Bone Growth Around Additively Manufactured Implants With Ti-6Al-4V and Bioactive Glass Powder Composites","authors":"Chih-Yu Lee,&nbsp;Pei-Ching Kung,&nbsp;Chih-Chieh Huang,&nbsp;Shao-Ju Shih,&nbsp;E-Wen Huang,&nbsp;San-Yuan Chen,&nbsp;Meng-Huang Wu,&nbsp;Nien-Ti Tsou","doi":"10.1002/jor.70037","DOIUrl":"10.1002/jor.70037","url":null,"abstract":"<p>Effective osseointegration is a fundamental requirement in biomedical implant applications. Additive manufacturing allows precise control over implant geometry and material composition, enhancing implant design flexibility. Bioactive glass (BG) can substantially enhance bone binding and bioactivity; however, limited research has been conducted on its incorporation into additively manufactured implants. The performance of BG varies depending on the incorporation method, and the spatial and temporal evolution of its integration remains unclear. In this study, we synthesized Ti-6Al-4V/58S BG composites by using the selective laser melting method and systematically compared the effects of BG coating and doping in additively manufactured implants. In vivo histological results from animal tests were statistically analyzed and discussed in terms of osseointegration over 4- and 12-week periods. Bone-to-implant contact (BIC) and bone density (BD) were used as quantitative metrics to evaluate interactions between the implants and surrounding bone. Our findings indicate that both BG-doped and BG-coated implants accelerated bone ingrowth during the early stages of healing. BG-coated implants demonstrated a greater improvement than did pure 3D-printed Ti-6Al-4V implants. However, the effects of BG became nonsignificant during the later healing stage (12 weeks). This study provides a foundation for systematically investigating BG incorporation methods in 3D-printed biomedical implants and their effect on osseointegration.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1796-1804"},"PeriodicalIF":2.3,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718078","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":"Investigation Into the Effect of Over-Inserted Cemented Acetabular Cups After Total Hip Arthroplasty (THA)","authors":"Teresa Alonso-Rasgado,&nbsp;Jose F. Del-Valle-Mojica,&nbsp;Marcial Arrambi-Diaz,&nbsp;Israel Miguel-Andres,&nbsp;Roberto Leonardo-Diaz,&nbsp;Colin G. Bailey,&nbsp;Tim N. Board","doi":"10.1002/jor.70031","DOIUrl":"10.1002/jor.70031","url":null,"abstract":"<div>\u0000 \u0000 <p>A nonuniform cement mantle significantly affects the long-term success of cemented total hip arthroplasty (THA). Over-insertion of the acetabular cup leads to an uneven layer of cement mantle, which can cause stress concentration and potential failure, such as implant loosening. This study investigates the effect of over-insertion of the acetabular cup on the stress distribution at the cement-cup and cement-bone interface after THA and compares with the non-over-inserted case. Finite element models of synthetic bone hemipelves implanted with over-inserted cemented cups with internal diameters of 28 and 36 mm were created from CT scan data. The models were validated with surface strains obtained from a composite hemipelvis implanted with a cemented all-polyethylene acetabular cup and used to simulate a one-leg standing activity of an average weight subject of 700 N. Over-insertion of the acetabular cup led to a thinner, nonuniform cement mantle, resulting in higher stresses in the superior and anterior periacetabular regions of the cortical bone and at the bone-cement and cement-cup interface, compared to the corresponding non-over-inserted case. At the bone-cement interface, our model predicted stress increases of up to 50% in the antero-superior and 35% in the postero-superior quadrant of the joint, an area where debonding frequently initiates. In addition, a larger head diameter was associated with lower rises in bone and cement stresses resulting from uneven cement mantles. Although stresses in the cement were below yield, raised stresses in this region are associated with crack formation and growth, which could lead to implant loosening.</p></div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1840-1854"},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707778","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":"Laser Disinfection Acts as Biofilm-Disrupter in Periprosthetic Joint Infection (PJI).","authors":"Lukas K Kriechbaumer, Christian Deininger, Alexander Planitzer, Marian Mitterer, Wolfgang Happak, Sylvia Nürnberger, Patrick Marko, Sebastian Filipp, Gerhild Thalhammer, Stephan Frenzel, Laura Hruby, Gundobert Korn","doi":"10.1002/jor.70035","DOIUrl":"https://doi.org/10.1002/jor.70035","url":null,"abstract":"<p><p>Infections after joint arthroplasties represent a devastating and progressively escalating complication with increased morbidity and mortality. The eradication of biofilms from infected implants is still an unsolved challenge. The erbium-doped yttrium aluminum garnet (Er:YAG) laser, which delivers high-energy light for rapid tissue ablation, may offer an advancement. This study aimed to evaluate the effectiveness of this laser in removing biofilms from infected implant surfaces. In this prospective study, 31 patients with 33 early postoperative or acute hematogenous periprosthetic joint infections (PJIs) were treated with our modified procedure of debridement, antibiotics, laser irradiation and implant retention (DALIR). Biofilm removal was compared between mechanical cleansing alone and the additional use of Er:YAG laser light. Therefore, swab cultures from the implants were taken at three distinct occasions: post-arthrotomy, after mechanical cleansing with a fluid disinfectant (LavaSurge), and after additional Er:YAG laser irradiation. The success rate of the DALIR procedure was compared with a prior group (n = 34) that underwent DAIR procedures without the Er:YAG laser at our clinic. The implementation of the laser system in our DAIR procedure was uncomplicated. The additional Er:YAG laser therapy significantly reduced viable microorganisms on implant surfaces (9.1%) compared to mechanical cleaning alone (42.4%; p < 0.01). The healing rate in our cohort was 78.1%, a substantial improvement over the previous rate of 44.1% (p < 0.01). Therefore, we recommend the use of Er:YAG laser irradiation as an additional tool for surface disinfection of metal implants in PJIs whenever a DAIR procedure seems to be beneficial. Trial Registration: ClinicalTrials.gov identifier: NCT06440564. LEVEL OF EVIDENCE: 2B.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698877","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":"The Majority of Studies Investigating Biofilm in Orthopedics Score Poorly Using a Standardized Measure of Quality: A Systematic Review","authors":"Daniel A. Driscoll,&nbsp;Tyler Khilnani,&nbsp;Taylor Coates,&nbsp;Ajay Premkumar,&nbsp;Sita Nirupama Nishtala,&nbsp;Mathias P. G. Bostrom,&nbsp;Alberto V. Carli","doi":"10.1002/jor.70034","DOIUrl":"10.1002/jor.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>The development of bacterial biofilm is central to the pathogenesis of periprosthetic joint infections following arthroplasty. Consequently, biofilm research in orthopedic surgery has expanded. This study assessed the quality of current orthopedic literature pertaining to the study of biofilm and identified the most commonly used study designs and techniques. A literature search was conducted in PubMed and adapted for Embase and the Cochrane Library. Studies were stratified into in vitro, in vivo (animal), and clinical (human) studies. Studies were included if they evaluated biofilm in an orthopedic context. Clinical studies were included if biofilm was confirmed by a quantification or visualization. Studies were assessed based on study design, biofilm quantification and visualization techniques and quality using the MIABiE score, a standardized tool in appraising biofilm studies. Of 258 studies identified; 65 studies were included after screening. There were 35 studies (50.7%) that evaluated techniques for biofilm treatment, 14 studies (20.3%) evaluated materials for prevention of biofilm formation, and 20 studies (29.0%) investigated descriptive biofilm properties unrelated to treatment or prevention. In vitro studies were most common (62.3%, <i>n</i> = 43). Biofilm quantification techniques were used in 83.0% of studies (<i>n</i> = 57), while only 29 studies (42.0%) used visualization techniques. Most studies (<i>n</i> = 55, 84.6%) were classified as low-quality based on MIABiE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1865-1874"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690497","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":"Osteogenic Small Molecule FK506 for Enhanced Bone Formation in a Rabbit Ankle Fusion Model","authors":"Nicholas Huffman,&nbsp;Amogh Magesh,&nbsp;Hanna Solomon,&nbsp;Caroline Dingler,&nbsp;Sreedhara Sangadala,&nbsp;Jay M. Patel,&nbsp;Jason T. Bariteau","doi":"10.1002/jor.70036","DOIUrl":"10.1002/jor.70036","url":null,"abstract":"<p>Non-union remains a significant complication following ankle fusion procedures, underscoring the need for effective osteogenic adjuvants to improve boney healing and fusion outcomes. This study investigates the osteogenic potential of FK506 (Tacrolimus), both in vitro and in vivo, for enhanced ankle fusion. Known orthobiologics in the market, such as recombinant human platelet-derived growth factor-BB (rhPDGF-BB), have been utilized to promote bone healing and were included in this study to assess their comparative and combinatory effects with FK506. Bovine marrow-derived cells (MDCs) were cultured in 2D and 3D environments to assess temporal markers of osteogenesis: RUNX2 nuclear localization (early), Alizarin Red S staining (intermediate), and mineral deposition with micro-computed tomography (late). A rabbit ankle fusion model (<i>t</i> = 4 weeks) was utilized to evaluate FK506's early in vivo efficacy. In 2D cultures, FK506 resulted in an increase, but rhPDGF-BB and the combination of rhPDGF-BB and FK506 yielded the highest mineral deposition. However, in 3D fibrin gel cultures, FK506 alone demonstrated the greatest bone volume and tissue mineralization. In vivo rabbit ankle studies revealed that while ankle joint fusion was not achieved, FK506-treated animals consistently showed substantial bone formation anterior to the joint, indicating its potential for localized osteogenesis in the ankle environment. This study demonstrates FK506's osteogenic potential as a standalone or combinatorial therapy. These findings highlight the need for further optimization of FK506 delivery methods and fixation strategies to maximize its clinical utility in ankle fusion procedures.</p><p><b>Statement of Clinical Significance:</b> The investigation of FK506 represents a potential pharmacological strategy for enhancing fusion healing and improving patient outcomes.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1805-1812"},"PeriodicalIF":2.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675073","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":"Activity of Phage and Vancomycin in a Murine Staphylococcus aureus Periprosthetic Joint Infection Model Managed With Debridement and Implant Retention","authors":"Sebastian C. Herren,&nbsp;Melissa J. Karau,&nbsp;Sergio F. Guarin Perez,&nbsp;Christina A. Koscianski,&nbsp;Jay Mandrekar,&nbsp;Robin Patel,&nbsp;Nicholas A. Bedard","doi":"10.1002/jor.70029","DOIUrl":"10.1002/jor.70029","url":null,"abstract":"<div>\u0000 \u0000 <p>Periprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty (TJA), with <i>Staphylococcus aureus</i> being one of the most common causative organisms. Irrigation and debridement with component retention (IDCR) is often performed to manage PJI. Antimicrobial treatment that targets <i>S. aureus</i> biofilms on prosthesis surfaces and within bone may be especially helpful when retaining a prosthesis. Phages, viruses that specifically infect bacteria, are a potential therapeutic consideration. Using a biofilm time kill assay in bovine synovial fluid, bactericidal activity of vancomycin or phage K (32 µg/mL and 10¹¹ pfu/mL, respectively) as well as the combination of phage K (10¹⁰ pfu/mL) and vancomycin (32 µg/mL) was observed against a methicillin-resistant <i>S. aureus</i> (MRSA) strain. Using a murine PJI model, mice infected with MRSA underwent IDCR followed by phage administration into the joint space with or without systemically administered vancomycin. Mice receiving both phage and vancomycin had significant reductions in MRSA on the prosthesis surface compared to untreated or vancomycin-treated mice. Phage K showed bactericidal activity in vitro and was active when locally delivered in combination with systemically administered vancomycin in a murine PJI model managed with IDCR.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1767-1775"},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675061","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 Siglec-15 Antibody Promotes High Quality Bone Formation in Adult Female Mice With Osteogenesis Imperfecta","authors":"Ketsia Seide,&nbsp;Jack E. Mulcrone,&nbsp;Jonathan Chacko,&nbsp;Erin M. Carter,&nbsp;Alyssa Veneziale,&nbsp;Nancy Pleshko,&nbsp;Priyanka Kothari,&nbsp;Sol Langermann,&nbsp;Shanmugam Selvam,&nbsp;Cathleen L. Raggio","doi":"10.1002/jor.70019","DOIUrl":"10.1002/jor.70019","url":null,"abstract":"<div>\u0000 \u0000 <p>Osteogenesis imperfecta (OI) is a heterogenous type 1 collagenopathy that results in bone fragility and fractures. There is no standard-of-care treatment to reduce fracture risk for adults with OI. The sialic acid-binding immunoglobulin-like lectin 15 (Siglec 15) immunoreceptor modulates osteoclast development and bone resorption. Prior studies in growing rats demonstrated that Siglec 15 antibodies increased bone mass and improved bone mechanical properties. This study evaluated the safety and efficacy of a Siglec 15 monoclonal antibody, NP159 (NextCure Inc.), in female oim/oim and wildtype (WT) mice. Mice (n = 20/group) were treated from 14 to 26 weeks with either NP159 (10 mg/kg/dose weekly for 4 weeks, then biweekly for 8 weeks), weekly alendronate (ALN, 0.21 mg/kg), or weekly saline (equivalent to NP159). Faxitron images (anterior-posterior and medial-lateral) were taken at enrollment and sacrifice to evaluate fracture incidence and healing. Left femurs were analyzed for length, micro-CT parameters, and biomechanical testing. Right tibias were analyzed by Fourier transform infrared spectroscopy. NP159 reduced fracture incidence in oim/oim, 85% of whom were fracture-free at sacrifice compared to 65% in the ALN group and 55% in the saline group. NP159 treatment enhanced bone strength and structure in oim/oim, with mineral:matrix and carbonate:phosphate content that normalized towards the WT saline group. Unlike ALN, NP159 had a larger increase in bone stiffness(<i>p</i> &lt; 0.05) and enhanced both bone microarchitecture and mineralization without altering Bone Mineral Density. Overall, these findings demonstrate the therapeutic value of NP159 in addressing the presently unmet clinical need for safe and efficacious long-term treatments for adults with OI.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1776-1786"},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667846","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":"Hip Stability After Total Hip Arthroplasty: Quantifying Capsule and Passive Muscle Contributions","authors":"Huizhou Yang,&nbsp;Kathryn Colone,&nbsp;Brian Haas,&nbsp;Casey A. Myers,&nbsp;Paul J. Rullkoetter,&nbsp;Chadd W. Clary","doi":"10.1002/jor.70030","DOIUrl":"10.1002/jor.70030","url":null,"abstract":"<div>\u0000 \u0000 <p>This study developed a computational model that incorporated the hip capsule and local muscles, as well as hip stem alignment variability, to quantify contributions to hip passive stability following total hip arthroplasty (THA). Soft tissue properties were calibrated to minimize the root mean square error between the model and experimentally measured torque responses across various hip flexion angles. Our results demonstrated that the capsule contributed an average of 31.0% to the resistance against hip internal-external rotation, while local passive muscle constraint accounted for 69.0%. Notably, the capsule's contribution was significantly higher during hip extension, accounting for 81.4% of the resistance to femur external rotation at 20° hyperextension and 63.1% at 0° flexion. Specifically, the iliofemoral ligament and gluteus medius were identified as the primary structures restricting anterior dislocation, with the former contributing up to 80.8% resistance to femur external rotation in hyperextension and the latter providing approximately 48.3% resistance during hip flexion. In contrast, the ischiofemoral ligament and external rotators, particularly the quadratus femoris, played a critical role in resisting posterior dislocation, collectively providing approximately 78.9% resistance to femur internal rotation across all tested hip flexion angles. These structures should be preserved or carefully repaired during THA whenever possible. Optimizing implant alignment can influence hip stability by improving the implant-bone relative position and altering soft tissue tension. For patients at higher risk of dislocation, a slightly superior stem alignment increased dislocation resistance by 18.3%. In contrast, excessive external positioning resulted in early impingement during anterior dislocation simulations, suggesting a potential risk of impingement-related instability.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1826-1839"},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667847","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":"Mobile-Bearing Unicompartmental Knee Arthroplasty Enhances Patellofemoral Function and Preserves Contralateral Knee Health Versus Fixed-Bearing","authors":"Tianyun Gu,&nbsp;Nan Zheng,&nbsp;Chunjie Xia,&nbsp;Diyang Zou,&nbsp;Qi Wang,&nbsp;Tsung-Yuan Tsai","doi":"10.1002/jor.70017","DOIUrl":"10.1002/jor.70017","url":null,"abstract":"<div>\u0000 \u0000 <p>Unicompartmental knee arthroplasty (UKA) effectively treats unicompartmental osteoarthritis (OA), but longterm outcomes are often compromised by disease progression in other compartments. Distinct impacts of fixed-bearing (FB) and mobile-bearing (MB) UKA on patellofemoral joint (PFJ) kinematics and soft tissue mechanics remain unclear. Our study aims to analyze effects of FB and MB UKA on PFJ kinematics and patellar tendon (PT) elongation and assess UKA's impact on UKA and contralateral side. A total of 24 patients (13 FB UKA, 11 MB UKA) were recruited, all with varying knee dysfunction. PFJ six-degrees-of-freedom motion, patellar lever arm and PT elongation were assessed during functional maneuvers using dual fluoroscopic imaging and virtual ligament analysis. Differences between parameters were analyzed using paired <i>t</i>-tests, while correlations between parameters and functional scores were assessed using Spearman correlation, with false discovery rate correction applied. We found that FB UKA resulted in a more distal and medial patellar position and increased flexion with posterior shift correlating with worse KSS scores (<i>p</i> &lt; 0.05). MB UKA showed greater patellar extension and better lateral patellar positioning and better KSS scores (<i>p</i> &lt; 0.05). Patellar lever arm was longer after MB UKA during single-leg lunge, whereas FB UKA differed during early sit-to-stand. Both groups experienced PT elongation on UKA side and correlated with OKS and FJS (<i>p</i> &lt; 0.05). In conclusion, FB UKA offers greater knee stability but may restrict rotation and increase patellofemoral stress, requiring focused rehabilitation on alignment and quadriceps function. MB UKA better restores natural kinematics, making it preferable for active patients.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 10","pages":"1757-1766"},"PeriodicalIF":2.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642777","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}