Journal of Orthopaedic Science最新文献

{"title":"In vivo kinematics of mobile-bearing posterior-stabilized total knee arthroplasty developed from three dimensional computed tomography system measurements of Japanese knee joints","authors":"Kengo Sakakura ,&nbsp;Shigeru Sasaki ,&nbsp;Yukinori Sato ,&nbsp;Keiji Suzuki ,&nbsp;Akihiro Kotani ,&nbsp;Tetsuya Tomita ,&nbsp;Kazuomi Sugamoto ,&nbsp;Takaharu Yamazaki ,&nbsp;Takeshi Morii ,&nbsp;Shoichi Ichimura ,&nbsp;Naobumi Hosogane","doi":"10.1016/j.jos.2025.10.002","DOIUrl":"10.1016/j.jos.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>The mobile-bearing posterior-stabilized (PS) total knee arthroplasty (TKA) tailored to the bone morphology of Japanese patients has the kinematic features such as medial pivot motion (MP), external femoral rotation relative to the tibia during knee flexion, and bicondylar rollback, the backward movement of the femur relative to the tibia, both resembling those of a normal knee. However, these concepts have not been confirmed <em>in vivo</em>. This study aimed to analyze the in vivo kinematics of this TKA and confirm the reproducibility of the concepts.</div></div><div><h3>Methods</h3><div>A two dimensional to three dimensional (2D/3D) registration technique was used to analyzed the <em>in vivo</em> kinematics of mobile-bearing PS TKA designed based on morphological characteristics of Japanese patients. We also investigated the relationship between the setting position of implants and <em>in vivo</em> kinematics. The setting position of the implants was evaluated using the hip-knee-ankle angle and the alpha, beta, gamma, and delta angles.</div></div><div><h3>Results</h3><div>Analysis was performed on 17 knees in 11 patients with a mean age of 73.0 ± 6.7 years. Loaded flexion caused 8.39 ± 3.4° of external rotation of the femoral component relative to the tibial component. Regarding kinematics, an MP pattern was observed during the initial flexion, and bicondylar rollback was observed beyond approximately 80° of flexion. Patients were subdivided into two groups according to the presence of the MP pattern (MP and non-MP groups). No evident relationship between the setting position of the implants and in vivo kinematics was observed, except for γ angle.</div></div><div><h3>Conclusion</h3><div>This study verified the <em>in vivo</em> kinematics of the PS-mobile-type implant and demonstrated that it reproduced its intended design in most cases. Although a significant difference was found in the γ angle, no consistent relationship was observed between the presence of the MP pattern and other implant positioning parameters. Therefore, the factors contributing to the absence of medial pivot motion in some cases remain unclear. Despite this limitation, our findings suggest that the design principles of the implant were found to be reproducible to a certain extent, suggesting potential applicability in replicating natural knee motion in clinical settings.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 596-602"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term postoperative outcomes of post-axial polydactyly of the foot with an emphasis on collateral ligament reconstruction","authors":"Toshiki Zeniya ,&nbsp;Kousuke Iba ,&nbsp;Megumi Hanaka ,&nbsp;Kenichi Takashima ,&nbsp;Makoto Emori ,&nbsp;Atsushi Teramoto","doi":"10.1016/j.jos.2025.10.009","DOIUrl":"10.1016/j.jos.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have reported surgical techniques and favorable postoperative outcomes of post-axial polydactyly of the foot; however, few studies have investigated the long-term postoperative outcomes. The aim of this study was to evaluate long-term results of our surgical treatment, which emphasized the alignment between the distal and proximal phalanges, and the ligamentous stability.</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of patients who underwent surgery for post-axial polydactyly and were followed up until epiphyseal closure of the foot. The study included 13 feet from 12 patients with a mean age at initial surgery of 22 months and postoperative follow-up of 161 months. The surgical method emphasized phalangeal alignment during resection of excess bones and collateral ligament reconstruction to obtain joint stability. Postoperative outcomes included functional problems, varus or valgus deformities, thickening of the reconstructed toe, postoperative complications, additional surgery, esthetic appearance evaluated using the scoring system, and subjective evaluation by patients and the parents.</div></div><div><h3>Results</h3><div>At the latest evaluation after epiphyseal closure of the foot, there were no cases with functional problem or valgus deformities based on morphologic findings. The esthetic appearance of the reconstructed toes was favorable in all but 1 case. Subjective evaluation was more than “satisfied” in 12 toes. In one case, additional surgery to excise scar and excessive soft tissue was performed due to pain. Visible thickening was found in 5 toes, although subjective evaluation by patients and their parents was more than “satisfied.”</div></div><div><h3>Conclusion</h3><div>We have demonstrated the long-term postoperative outcomes in post-axial polydactyly of the foot with an emphasis on the phalangeal alignment and ligamentous stability until epiphyseal closure as a sign of skeletal maturity. We obtained favorable long-term postoperative outcomes of the reconstructed toes.</div></div><div><h3>Clinical question/level of evidence</h3><div>Therapeutic, IV.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 676-681"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of trunk muscles in lumbar degenerative disease using magnetic resonance imaging T2 mapping: Association with computed tomography parameters and body composition","authors":"Noritaka Suzuki ,&nbsp;Yawara Eguchi ,&nbsp;Shuhei Iwata ,&nbsp;Sumihisa Orita ,&nbsp;Kazuhide Inage ,&nbsp;Yasuhiro Shiga ,&nbsp;Masahiro Inoue ,&nbsp;Kohei Okuyama ,&nbsp;Soichiro Tokeshi ,&nbsp;Shuhei Ohyama ,&nbsp;Kosuke Takeda ,&nbsp;Seiji Ohtori","doi":"10.1016/j.jos.2025.09.013","DOIUrl":"10.1016/j.jos.2025.09.013","url":null,"abstract":"<div><h3>Background</h3><div>In lumbar degenerative diseases, degeneration occurs in spinal structures, including the paravertebral muscles (PVM) and psoas major (PM). Current methods for assessing muscle degeneration lack standardization and quantitative measures. MRI T2 mapping provides a qualitative assessment of muscle tissue, but its utility in evaluating PVM and PM remains unclear. This study aimed to measure PVM and PM T2 relaxation times and assess its utility for quantitative evaluation of muscle quality.</div></div><div><h3>Methods</h3><div>Sixty patients (30 males; mean age 70.0 years) who underwent surgery for lumbar degenerative diseases were included. T2 relaxation times of the PVM and PM were measured using preoperative MRI T2 mapping at the L4/5 level. CT numbers and cross-sectional areas (CSA) were obtained from preoperative CT scans. Skeletal muscle mass and phase angle (PhA) were assessed using bioelectrical impedance analysis. Correlations between T2 relaxation times and radiological and body composition parameters were evaluated using Spearman's rank correlation coefficient.</div></div><div><h3>Results</h3><div>Mean T2 relaxation times for PVM and PM were 68.4 ms and 56.8 ms, respectively. PVM T2 relaxation times exhibited a strong negative correlation with CT numbers (r = −0.824) and positively correlated with age (r = 0.466). Furthermore, PVM T2 relaxation times were negatively correlated with systemic skeletal muscle mass (r = −0.466) and PhA (r = −0.480). In contrast, PM T2 relaxation times showed no significant correlations with skeletal muscle mass and PhA.</div></div><div><h3>Conclusions</h3><div>This study suggests that MRI T2 mapping may be a useful non-invasive tool for the quantitative assessment of trunk muscle quality in patients with lumbar degenerative disease. The strong correlations observed between PVM T2 relaxation time and both CT values and systemic sarcopenia markers indicate its potential for evaluating paravertebral muscle health without radiation exposure. These findings may also contribute to a deeper understanding of sarcopenia in patients with spinal disorders.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 513-520"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative administration of denosumab is a feasible adjuvant option for the treatment of resectable giant cell tumor of bone in the spine: A multi-institutional study by the Japanese Musculoskeletal Oncology group","authors":"Takeshi Morii ,&nbsp;Naofumi Asano ,&nbsp;Robert Nakayama ,&nbsp;Hiroaki Kimura ,&nbsp;Makoto Endo ,&nbsp;Eiji Nakata ,&nbsp;Kensaku Yamaga ,&nbsp;Koichi Ogura ,&nbsp;Takuya Watanabe ,&nbsp;Hiroshi Kobayashi ,&nbsp;Hiroaki Murata ,&nbsp;Tomoki Nakamura ,&nbsp;Toru Akiyama ,&nbsp;Shunji Nishimura ,&nbsp;Masami Hosaka ,&nbsp;Jungo Imanishi ,&nbsp;Naobumi Hosogane ,&nbsp;Hirotaka Kawano","doi":"10.1016/j.jos.2025.10.011","DOIUrl":"10.1016/j.jos.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Although the significance of preoperative denosumab administration for giant cell tumor of bone (GCTB) is still controversial, sporadic reports have suggested a clinical benefit of administration prior to surgery for spinal GCTB. In this retrospective, multi-institutional study, we assessed the effects of preoperative denosumab administration for spinal GCTB.</div></div><div><h3>Methods</h3><div>Ten cases of GCTB in the spine with preoperative denosumab administration (the denosumab group) and 19 cases without preoperative denosumab administration (the control group) were included. Oncological outcomes (local recurrence, distant metastasis, and overall survival), duration of the surgery, intraoperative blood loss, functional outcomes as evaluated by the Frankel classification, perioperative complications, adverse events associated with denosumab administration, and margin status in resection cases were surveyed.</div></div><div><h3>Results</h3><div>The median frequency of preoperative denosumab administration was four times in the denosumab group. Curettage against resection and no preoperative denosumab administration were revealed as independent risks for local recurrence. Preoperative denosumab administration significantly reduced intraoperative blood loss. It also resulted in significantly better postoperative function. Periodontitis as an adverse effect of denosumab administration was found only in two cases in the control group, where it was applied for controlling local recurrence. Cases with local recurrence showed worse function at the final follow-up, suggesting the significant impact of local recurrence on function. The negative margin rate was significantly higher in the denosumab group. No significant difference was noted in the risk for metastasis and lethal events, duration of surgery, and incidence of postoperative complications between the two groups.</div></div><div><h3>Conclusions</h3><div>Preoperative denosumab administration resulted in better local control, reduced intraoperative blood loss, and better function. The present data suggest that it has a clinical benefit in the treatment of spinal GCTB.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 724-730"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative assessment of distraction osteogenesis regenerates on digital radiographs using computerized image analysis techniques: A pilot study","authors":"Shahnawaz Khan ,&nbsp;Siddhartha Sharma ,&nbsp;Pebam Sudesh ,&nbsp;Uttam Chand Saini ,&nbsp;Mahesh Prakash ,&nbsp;Sujit Kumar Tripathy","doi":"10.1016/j.jos.2025.12.002","DOIUrl":"10.1016/j.jos.2025.12.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Assessment of distraction osteogenesis (D.O.) regenerates has traditionally relied on qualitative assessment on plain radiographs. The commonly employed methods are qualitative and are prone to inter-observer bias. Quantitative methods like the pixel density ratio have been described, but these have certain limitations. This study aimed to describe a novel technique to quantify regenerates from plain digital radiographs and compare it with the conventional Bone Mineral Density.</div></div><div><h3>Methods</h3><div>This was a prospective study. Eleven subjects underwent distraction osteogenesis; each patient was followed up monthly with digital radiographs and regenerate bone mineral density (BMD ratio) assessment by DEXA scan monthly for a minimum of 6 months. Quantitative analysis was performed by a novel technique using the ImageJ software, and the Area Fraction (AF) &amp; Fractal Dimension (FD) of the regenerates were determined and compared with the BMD ratio.</div></div><div><h3>Results</h3><div>AF increased steadily and FD decreased steadily as the regenerate matured. A weak negative correlation was found between the BMD ratio and FD (AP view: r = −0.28, p = 0.1 and lateral view: r = −0.16, p = 0.36). A moderate correlation was found between BMD ratio and AF (AP view: r = 0.46, p = 0.005 and lateral view: r = 0.34, p = 0.004). There was a significant difference in AF and FD values in the initial and final regenerates.</div></div><div><h3>Conclusion</h3><div>Our novel quantitative image-based analysis technique using AF and FD has the potential to efficiently quantify and monitor distraction osteogenesis regenerates. However, these results must be validated in larger patient cohorts before this technique can be used in routine clinical practice.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 751-759"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of anterior cervical decompression and fusion versus posterior decompression for cervical spondylosis presenting with unilateral proximal upper limb muscle weakness","authors":"Reo Shibata ,&nbsp;Narihito Nagoshi ,&nbsp;Junichi Yamane ,&nbsp;Hitoshi Kono ,&nbsp;Soraya Nishimura ,&nbsp;Kazuki Takeda ,&nbsp;Norihiro Isogai ,&nbsp;Masahiro Ozaki ,&nbsp;Yosuke Horiuchi ,&nbsp;Shinichi Ishihara ,&nbsp;Satoshi Suzuki ,&nbsp;Toshiki Okubo ,&nbsp;Morio Matsumoto ,&nbsp;Masaya Nakamura ,&nbsp;Kota Watanabe","doi":"10.1016/j.jos.2025.09.009","DOIUrl":"10.1016/j.jos.2025.09.009","url":null,"abstract":"<div><h3>Study design</h3><div>A retrospective cohort study.</div></div><div><h3>Objectives</h3><div>While numerous studies have investigated surgical outcomes for cervical spondylosis, limited research has examined the impact of surgical techniques in patients with unilateral upper extremity proximal muscle weakness. This study compares clinical outcomes between anterior cervical decompression and fusion (ACDF) and posterior decompression (PD) with foraminotomy in patients with cervical spondylosis presenting with unilateral proximal muscle weakness.</div></div><div><h3>Methods</h3><div>This study included 45 patients diagnosed with either cervical spondylotic amyotrophy (CSA) or cervical spondylotic radiculopathy (CSR) with unilateral proximal muscle weakness. Twenty CSA and five CSR patients underwent ACDF (anterior group), whereas 16 CSA and four CSR patients underwent PD with foraminotomy (posterior group). Muscle strength was assessed using the Manual Muscle Test (MMT) in the most improved muscle. Preoperative and postoperative MMT scores, Japanese Orthopaedic Association (JOA) scores, and imaging findings were analyzed.</div></div><div><h3>Results</h3><div>The mean age at surgery was 63.2 years in the anterior group and 61.3 years in the posterior group (p = 0.31). No significant differences were observed in preoperative MMT (2.0 vs. 2.1, p = 0.75), JOA scores (13.9 vs. 13.5, p = 0.60), or C2–C7 angles (2.3° vs. −0.9°, p = 0.55). Postoperative JOA scores (15.6 vs. 15.1, p = 0.19) and C2–C7 angles (3.0° vs. 3.9°, p = 0.78) were comparable. Both groups showed significant improvement in MMT (p &lt; 0.01); however, the difference in improvement between the ACDF and PD groups (2.5 vs. 1.9) did not reach statistical significance (p = 0.06).</div></div><div><h3>Conclusions</h3><div>Postoperative outcomes were similarly favorable for both ACDF and PD with foraminotomy, suggesting that each procedure represents an effective treatment option for cervical spondylotic disease presenting with unilateral proximal upper limb muscle weakness.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 501-506"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical approach selection algorithm based on fracture patterns for scapular body fractures","authors":"Yuta Izawa ,&nbsp;Masahiro Nishida ,&nbsp;Kentaro Futamura ,&nbsp;Hiroko Murakami ,&nbsp;Kazuo Sato ,&nbsp;Mizuki Minegishi ,&nbsp;Yoshihiko Tsuchida","doi":"10.1016/j.jos.2025.09.014","DOIUrl":"10.1016/j.jos.2025.09.014","url":null,"abstract":"<div><h3>Background</h3><div>Scapular body fractures are uncommon injuries often managed nonoperatively. However, in cases with significant displacement, surgical intervention may be required to restore shoulder function. While various surgical approaches have been described, no standardized method exists for selecting the optimal approach based on fracture morphology. The purpose of this study is to retrospectively evaluate surgical treatment and its outcomes for scapular body fractures, and to validate an appropriate method for selecting surgical approaches according to fracture patterns of the scapular body.</div></div><div><h3>Methods</h3><div>A retrospective case series was conducted on patients who underwent surgical fixation for scapular body fractures between 2013 and 2024. Fractures involving the glenoid fossa or isolated acromion/coracoid fractures were excluded. Surgical indications included glenopolar angle &lt;22°, coronal angulation &gt;45°, or lateral border offset ≥20 mm. Based on fracture characteristics, four surgical approaches were selected: Brodsky approach, double incision (for medial border translation), modified Judet approach (for scapular spine involvement), and classical Judet approach (for chronic fractures). Postoperative outcomes included radiographic alignment, complications, range of motion (ROM), and pain scores.</div></div><div><h3>Results</h3><div>Ten patients (mean age 51.3 years) sustained scapular body fractures primarily due to traffic accidents. Surgical approaches included Brodsky approach (n = 6), double incision (n = 2), modified Judet approach (n = 1), and classical Judet approach (n = 1). Postoperative imaging confirmed improved alignment parameters. No infections or nonunions were observed; one clavicle refracture occurred. Final mean ROM showed favorable outcomes in forward flexion, abduction, and external rotation, with low pain scores reported.</div></div><div><h3>Conclusions</h3><div>We retrospectively evaluated surgical treatment and outcomes in 10 cases of scapular body fractures. All cases achieved satisfactory reduction and functional prognosis, with no serious complications observed. The surgical approach selection method we propose is a rational treatment strategy that optimizes both reduction quality and invasiveness.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 693-698"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of meniscal tears on anterior tibial translation and rotatory instability in anterior cruciate ligament-deficient knees: Retrospective analysis of 306 cases","authors":"Arcangelo Russo ,&nbsp;Giuseppe Gianluca Costa ,&nbsp;Gianluca Zocco ,&nbsp;Rosario Cutaia ,&nbsp;Calogero Di Naro ,&nbsp;Francesco Moncada ,&nbsp;Emilia Lo Giudice ,&nbsp;Francesco Pegreffi ,&nbsp;Vincenzo Cristian Francavilla","doi":"10.1016/j.jos.2025.10.008","DOIUrl":"10.1016/j.jos.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>There is biomechanical evidence of the contribution of meniscal tears on knee stability when anterior cruciate ligament (ACL) is torn. However, clinical studies on this topic remain limited, and the conclusions derived from existing research are still incomplete. This study aims to clinically evaluate the impact of medial and lateral meniscus tears on anteroposterior laxity and the pivot-shift phenomenon in a cohort of patients with ACL-deficient knees.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 306 ACL-deficient patients, which were categorized into 4 groups: 1) isolated ACL injury, 2) ACL injury with medial meniscus tears (ACL + MM), 3) ACL injury with lateral meniscus tears (ACL + LM), 4) ACL injury with combined medial and lateral meniscus tears (ACL + MM + LM). Statistical comparison was performed regarding demographic characteristics, sport activity level, time from injury to treatment, prevalence of high-grade Lachman test, prevalence of high-grade pivot-shifts and KT1000 arthrometric measurements. Statistical significance was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Associated meniscal tears were observed in 202 out of 306 cases (66.0 %). Patients in ACL + MM group presented significant higher age, body mass index, longer time from injury, and lower activity level compared to those with isolated ACL tears. Patients in the ACL + MM group showed higher KT1000 values (5.5 ± 1.3 mm) when compared to isolated tears (4.9 ± 1.2 mm, p = 0.0012), but not significant difference in rates of high-grade pivot shift grade. Patients in the ACL + LM group demonstrated significantly increased rates of high-grade pivot-shift grade (p &lt; 0.0001), but no significant differences in KT1000 values. Patients in the ACL + MM + LM group showed increased rates of pivot shift grade ≥2 (p = 0.0003) and significantly increased KT1000 values (6.1 ± 1.9 mm) compared to isolated ACL tears (p &lt; 0.0001) but also compared to ACL + MM patients (p = 0.0153) and ACL + LM patients (p = 0.0030).</div></div><div><h3>Conclusions</h3><div>Concomitant meniscus tears in ACL-deficient knees significantly increase anterior tibial translation and rotational joint laxity, suggesting a secondary but significant role in knee stability.</div></div><div><h3>Level of evidence</h3><div>IV, retrospective case series.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 622-628"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic analysis based on functional pelvic plane of spinopelvic malalignments: Adverse pelvic mobility, flatback deformity, and stiff spinopelvic mobility","authors":"Tetsunari Harada ,&nbsp;Satoshi Hamai ,&nbsp;Toshiki Konishi ,&nbsp;Hirokazu Saiwai ,&nbsp;Hirotaka Gondo ,&nbsp;Satoru Ikebe ,&nbsp;Hidehiko Higaki ,&nbsp;Yasuharu Nakashima","doi":"10.1016/j.jos.2025.11.001","DOIUrl":"10.1016/j.jos.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>To examine the characteristics of hip dynamics caused by abnormal spinopelvic alignment in patients with spinal fusion and identify appropriate targets for acetabular component placement in such patients undergoing total hip arthroplasty.</div></div><div><h3>Methods</h3><div>Dynamic imaging of the chair-rising motion and computed tomography images in the supine position were obtained for 40 patients with spinal fusion and normal hips. The sagittal pelvic tilt and hip flexion angle were measured with three-dimensional dynamic analysis using the image-matching method. The hip flexion angle based on the functional pelvic plane in the supine position (supine-FPP) was calculated using pelvic tilt and hip flexion angles. The hip flexion angle based on supine-FPP was compared in participants with and without adverse pelvic mobility in extension (APM; posterior pelvic tilt &gt;13° from supine to standing), flatback deformity (pelvic incidence-lumbar lordosis mismatch ≥10°), and stiff spinopelvic mobility (stiff-SPM; posterior pelvic tilt &lt;10° between standing and sitting).</div></div><div><h3>Results</h3><div>The flexion angle based on supine-FPP was 5.4°–7.2° lower in patients with APM than in those without APM throughout the chair-rising motion (sitting, deep-sitting, and standing), and there were no significant differences between patients with and without flatback deformity throughout the chair-rising motion and 11.1° and 9.9° higher in patients with stiff-SPM than in those without stiff-SPM in sitting and deep-sitting positions, respectively, but there were no significant differences in standing position.</div></div><div><h3>Conclusions</h3><div>The importance of adjusting cup placement according to abnormal spinopelvic alignment was demonstrated in the following cases: APM requires a decrease in cup anteversion based on supine-FPP, cup anteversion based on supine-FPP is an appropriate target for flatback deformity, and stiff-SPM requires an increase in cup anteversion.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 582-588"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Kirschner-wire-distractor assisted reduction versus manual reduction in elastic stable intramedullary nailing for pediatric AO/OTA 32-A3 femoral fractures: A retrospective cohort study","authors":"Qineng Mo ,&nbsp;Chunli Ling ,&nbsp;Xiansheng Xia ,&nbsp;Guoxin Nan ,&nbsp;Yingcong Zhou ,&nbsp;Jialiang Chen","doi":"10.1016/j.jos.2025.11.005","DOIUrl":"10.1016/j.jos.2025.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Femoral shaft fractures represent common pediatric injuries. AO/OTA 32-A3 fractures pose significant challenges for closed reduction due to shortening displacement and muscular traction, frequently necessitating open reduction. This study describes a novel Kirschner-wire distractor-assisted technique and evaluates its efficacy versus traditional manual reduction in children with AO/OTA 32-A3 femoral shaft fractures.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted on 33 pediatric patients with AO/OTA 32-A3 femoral shaft fractures treated at our hospital from October 2014 to January 2025. The patients were divided into two groups (Group A and Group B) based on the reduction methods used. Group A (n = 15) underwent closed reduction assisted by a Kirschner-wire distractor, whereas Group B (n = 18) received traditional manual reduction. Both groups underwent fracture stabilization using elastic stable intramedullary nailing. We compared closed reduction success rates between Group A and Group B. Group B was further subdivided into successful closed reduction cases (Subgroup B1) and failed closed reduction cases (Subgroup B2). Surgical parameters including incision length, operative time, number of intraoperative fluoroscopy exposures, intraoperative blood loss, postoperative pain scores, and bone union time were then compared between Group A and B.</div></div><div><h3>Results</h3><div>The K-wire distractor group (Group A) achieved 100 % closed reduction success (15/15) versus 66.7 % (12/18) in the manual reduction group (Group B) (P = 0.02). Compared to Group B1, Group A required significantly fewer fluoroscopies and less operative time (P = 0.01), no statistically significant differences were observed in the remaining postoperative parameters, include incision length, intraoperative blood loss, postoperative pain scores and bone union time. Compared to Group B's failed reduction subgroup (B2), Group A showed superior outcomes in all parameters (all P &lt; 0.001): shorter incision, operative time, reduced Fluoroscopy, reduced blood loss, lower pain scores, and faster union.</div></div><div><h3>Conclusion</h3><div>Kirschner-wire distractor-assisted closed reduction demonstrates superior efficacy compared to conventional manual reduction for AO/OTA 32-A3 femoral fractures.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 3","pages":"Pages 709-716"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145635094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}