Journal of Experimental Orthopaedics最新文献

{"title":"Knee osteotomies significantly influence coronal ankle alignment: A radiographic analysis","authors":"Alessio Maione,&nbsp;Carlo Minoli,&nbsp;Matteo Davide Parmigiani,&nbsp;Martino Travi,&nbsp;Filippo Calanna,&nbsp;Daniele Marcolli,&nbsp;Riccardo Compagnoni,&nbsp;Paolo Ferrua,&nbsp;Massimo Berruto,&nbsp;Pietro Simone Randelli","doi":"10.1002/jeo2.70252","DOIUrl":"https://doi.org/10.1002/jeo2.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the effect of lateral closing-wedge high tibial osteotomy (LCW-HTO) and medial closing-wedge distal femoral osteotomy (MCW-DFO) on tibio-talar inclination (TTI) and Mikulicz lateral distal tibial angle (M-LDTA). We hypothesized that knee osteotomies significantly alter ankle coronal alignment by modifying TTI and distal tibial alignment in relation to the mechanical axis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective radiographic analysis was conducted on 60 knees from 52 patients (37 LCW-HTO and 23 MCW-DFO) treated between 2006 and 2020. Inclusion criteria included full-length weight-bearing radiographs pre- and post-operatively, no prior ipsilateral lower limb surgery, absence of shaft deformities or advanced ankle osteoarthritis (Takakura grade &gt;1), and age ≥16 years with ≥2 years of follow-up. Radiographic parameters measured included LDTA, hip-knee-ankle angle, M-LDTA and TTI, with ankle realignment quantified through differences between LDTA and M-LDTA and between pre- and post-operative TTI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the MCW-DFO group, the difference between LDTA and M-LDTA decreased from 3.5 ± 2.3° to 1.3 ± 1.1° (<i>p</i> &lt; 0.0001), indicating improved alignment. The LCW-HTO group showed a smaller but significant reduction from 4.5 ± 1.8° to 2.2 ± 1.7° (<i>p</i> &lt; 0.0001). TTI improved significantly in both groups, with a greater adjustment in MCW-DFO (ΔTTI = 7.0 ± 4.3°, <i>p</i> &lt; 0.01) compared to LCW-HTO (ΔTTI = 4.2 ± 2.7°, <i>p</i> &lt; 0.01). The difference between LDTA and TTI decreased in both groups, reflecting post-operative convergence of the mechanical and anatomical axes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Knee osteotomies significantly influence ankle coronal alignment, particularly modifying TTI and M-LDTA. Higher-level osteotomies (MCW-DFO) exert a greater effect on ankle alignment than LCW-HTO. Preoperative valgus or varus knee deformities must be carefully evaluated to anticipate post-operative ankle imbalance. Surgeons should assess full-length radiographs to prevent unintended malalignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular diagnostics for perioperative microbial identification in periprosthetic joint infection: A scoping review and proposal of a diagnostic flow chart","authors":"Pier Francesco Indelli,&nbsp;Trifon Totlis,&nbsp;Bruno Lovreković,&nbsp;Michael Engl,&nbsp;Bruno Violante,&nbsp;Pawel Skowronek,&nbsp;Guillaume Demey,&nbsp;Stefano Ghirardelli,&nbsp;Chiara Maci,&nbsp;Antonella Castagna,&nbsp;Laura Schianchi,&nbsp;Chiara Tassan Din,&nbsp;James Harty,&nbsp;Goksel Dikmen,&nbsp;Christian Schaller,&nbsp;Marko Ostojić","doi":"10.1002/jeo2.70263","DOIUrl":"https://doi.org/10.1002/jeo2.70263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Periprosthetic joint infections (PJI) are among the most feared complications of joint reconstruction. Unfortunately, traditional cultures often fail to identify the aetiological agents of PJI. Molecular diagnostics can overcome the limitations of standard synovial fluid culture by utilising information from DNA/RNA samples to identify microbial species. The authors conducted a scoping review to evaluate the current state regarding the use of molecular diagnostics in the decision-making process for the surgical treatment of PJI and to create a flowchart based on molecular diagnostics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was conducted to provide an overview of the literature on molecular diagnostic techniques for detecting perioperative microbial infections in PJI. The population considered included patients undergoing total hip or knee arthroplasty or replacement, with a focus on molecular diagnostic methods within the perioperative period. The database search encompassed PubMed, Embase, Scopus and the Cochrane Library.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-five articles were included after a preliminary review of 1315 records. Each article was assigned to one of four categories to fulfil the purpose of this review: (1) Polymerase chain reaction (PCR) related studies: <i>n</i> = 18; (2) Next-Generation-Sequencing (NGS) related studies: <i>n</i> = 40; (3) comparative studies, including systematic reviews and meta-analyses, between different molecular diagnostic methodologies: <i>n</i> = 7; and (4) general reviews on nucleic acid-based strategies to detect PJIs: <i>n</i> = 10.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review confirmed that molecular diagnostics are becoming extremely valuable tools in the decision-making process for PJI treatment. Culture-based techniques still represent the gold standard in PJI microorganism identification, but our review showed that standard culture, in 2025, could be integrated with newer nucleic acid-based strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of structural bone allograft in revision hip arthroplasty for massive acetabular defect: A systematic review and meta-analysis","authors":"Pietro Cimatti,&nbsp;Nicolandrea Del Piccolo,&nbsp;Alessandro Mazzotta,&nbsp;Benedetta Dallari,&nbsp;Enrico Pennello,&nbsp;Dante Dallari","doi":"10.1002/jeo2.70241","DOIUrl":"https://doi.org/10.1002/jeo2.70241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Managing substantial acetabular defects during revision total hip arthroplasty (rTHA) poses significant challenges, with a range of techniques available and ongoing discussions regarding their efficacy. This meta-analysis aimed to assess the failure rates associated with Paprosky type III and American Academy of Orthopaedic Surgeons (AAOS) types III–IV acetabular defects treated with structural allografts in conjunction with cemented cups, cementless cups, or reinforcement devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was performed utilising PubMed/MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews to identify pertinent studies published from January 1980 to 1 April 2024. The search employed terms related to acetabular impaction bone grafting, rTHA, and associated techniques. The main outcome measure was the implant failure rate over an 8-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight studies met the established inclusion criteria, covering three therapeutic approaches: (1) structural allograft with a cemented cup (four studies), (2) structural allograft with a cementless cup (10 studies), and (3) structural allograft with reinforcement devices (21 studies). The overall 8-year implant failure rate was found to be 16% (95% CI, 11%–21%), with significant differences noted among the treatment modalities (<i>p</i> = 0.017). The failure rate was lowest for reinforcement devices (12%) and highest for cemented cups (30%). The predominant failure mechanism was aseptic loosening (68.9%), followed by infection (20.3%) and dislocation (10.8%). Rates of aseptic loosening were greater with cemented cups compared to cementless cups and reinforcement devices (19% vs. 13% and 6%, respectively; <i>p</i> = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Structural allografts combined with reinforcement devices yield favourable outcomes for managing large acetabular defects during revision THA, demonstrating significantly lower failure rates compared to other techniques. The addition of reinforcement devices substantially reduces the risk of implant failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital hand-held arthrometry is a reliable and accurate adjunct for diagnosing acute anterior cruciate ligament tears","authors":"Richard Norris,&nbsp;Alan Price,&nbsp;Thomas W. Maddox,&nbsp;William Boswell,&nbsp;Cronan Kerin,&nbsp;Rachel A. Oldershaw","doi":"10.1002/jeo2.70251","DOIUrl":"https://doi.org/10.1002/jeo2.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the intrarater reliability and predictive validity of Lachmeter® measurements for diagnosing acute anterior cruciate ligament (ACL) tears, and to propose diagnostic thresholds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Lachmeter® measurements were recorded during the stabilised Lachman test for consecutive participants presenting to an acute knee injury clinic within 21-days of injury. Intrarater reliability for individual limb and side-to-side (STS) difference (injured limb minus uninjured limb) measurements was investigated using a cross-sectional, repeated-measures design and the intraclass correlation coefficient (ICC). The predictive validity of STS difference and injured limb measurements was investigated using a prospective cohort design; sensitivity, specificity, negative (LR−) and positive likelihood ratios (LR+) were calculated using magnetic resonance imaging as the reference standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Intrarater reliability was excellent for individual limb and STS difference measurements in 102 participants. Of the 63 participants included in the validity analysis, 31 had a normal ACL and 32 had an ACL tear. LR- point estimates for STS differences &lt;1.4 mm (0.07 [95% confidence interval [CI]: 0.02–0.29]) or injured limb measurements &lt;7.5 mm (0.09 [95% CI: 0.02–0.34] produced ‘large’ shifts in the probability of ruling out an ACL tear. LR+ point estimates for STS differences ≥3.8 mm (10.67 [95% CI: 2.68–42.51]) or injured limb measurements ≥11.8 mm (10.67 [95% CI: 1.42–80.26]) produced ‘large’ shifts in the probability of ruling in a full-thickness ACL tear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In participants presenting within 21-days of knee injury, intrarater reliability was excellent for Lachmeter® measurements recorded during the stabilised Lachman test. Based on predictive validity estimates, Lachmeter® measurements can be used to differentiate normal from torn ACLs in acute presentations, but not partial from full-thickness ACL tears. Diagnostic thresholds are proposed based on STS difference and injured limb measurements, and with consideration of the Lachman end point.</p>\u0000 \u0000 <p><b>Level of Evidence:</b> Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence applications in the management of musculoskeletal disorders of the shoulder: A systematic review","authors":"Umile Giuseppe Longo,&nbsp;Martina Marino,&nbsp;Guido Nicodemi,&nbsp;Matteo Giuseppe Pisani,&nbsp;Jacob F. Oeding,&nbsp;Christophe Ley,&nbsp;Rocco Papalia,&nbsp;Kristian Samuelsson","doi":"10.1002/jeo2.70248","DOIUrl":"https://doi.org/10.1002/jeo2.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of the present review is to evaluate and report on the available literature discussing artificial intelligence (AI) applications to the diagnosis of shoulder conditions, outcome prediction of shoulder interventions, and the possible application of such algorithms directly to surgical procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In February 2024, a search of PubMed, Cochrane and Scopus databases was performed. Studies had to evaluate AI model effectiveness for inclusion. Research on healthcare cost predictions, deterministic algorithms, patient satisfaction, protocol studies and upper-extremity fractures not involving the shoulder were excluded. The Joanna Briggs Institute Critical Appraisal tool and the Risk of Bias in Non-randomised Studies of Interventions tools were used to assess bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-three studies were included in the analysis. Seven studies analysed the detection of rotator cuff tears (RCTs) in magnetic resonance imaging and found area under the curve (AUC) values ranged from 0.812 to 0.94 for the detection of RCTs. One study reported Area Under the Receiver Operating Characteristics values ranging from 0.79 to 0.97 for the prediction of clinical outcomes following reverse total shoulder arthroplasty. In terms of outcomes of rotator cuff repair, an AUC value ranging from 0.58 to 0.68 was reported for prediction of patient-reported outcome measures, and an AUC range of 0.87–0.92 was found for prediction of retear rate. Five studies evaluated the identification of shoulder implant models following TSA from radiographs, with reported accuracy ranging from 89.90% to 97.20%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI application enables forecasting of clinical outcomes, permits refined diagnostic evaluation and increases surgical accuracy. While promising, the translation of these technologies into routine clinical practice requires careful consideration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure dispersion pad use allows patients to kneel comfortably after total knee arthroplasty","authors":"Kunihiko Watamori,&nbsp;Kazunori Hino,&nbsp;Tatsuhiko Kutsuna,&nbsp;Tomofumi Kinoshita,&nbsp;Takashi Tsuda,&nbsp;Hiromasa Miura,&nbsp;Masaki Takao","doi":"10.1002/jeo2.70157","DOIUrl":"https://doi.org/10.1002/jeo2.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to clarify the contact pressure at which patients with difficulty in kneeling after total knee arthroplasty (TKA) feel pain and the contact pressure at which kneeling can be performed after using a pressure dispersion pad.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty patients (69 knees) who underwent TKA for end-stage knee osteoarthritis were included. The patients performed single stance kneeling on the sheet-type pressure mapping system, and the contact pressure and area were measured before and after using the pressure dispersion pad. The Oxford Knee Score was used to evaluate kneeling ability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The group of patients who were unable to kneel had significantly lower contact pressure than those who were able to kneel easily (0.61 N/cm²/kg vs. 0.99 N/cm²/kg; <i>p</i> = 0.04). No patient reported kneeling as being ‘impossible’ or ‘extremely difficult’ when using the pressure dispersion pad. Moreover, all patients except those without pain had less pain and improved kneeling scores when using the pressure dispersion pad. Use of the pressure dispersion pad significantly reduced contact pressure for all kneeling score groups after TKA (0.12 N/cm²/kg for the impossible group).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The patients who could not kneel after TKA felt pain at 61% of the contact pressure compared to those who could kneel easily. Even patients who were unable to kneel after TKA were able to kneel when the contact pressure was reduced to 12% of that of the patients who could easily kneel using a pressure dispersion pad.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical guide to the implementation of AI in orthopaedic research—Part 7: Risks, limitations, safety and verification of medical AI systems","authors":"Philipp W. Winkler,&nbsp;Bálint Zsidai,&nbsp;Eric Hamrin Senorski,&nbsp;James A. Pruneski,&nbsp;Michael T. Hirschmann,&nbsp;Christophe Ley,&nbsp;Thomas Tischer,&nbsp;Elmar Herbst,&nbsp;Ayoosh Pareek,&nbsp;Volker Musahl,&nbsp;Jacob F. Oeding,&nbsp;Felix C. Oettl,&nbsp;Umile Giuseppe Longo,&nbsp;Kristian Samuelsson,&nbsp;Robert Feldt,&nbsp;ESSKA Artificial Intelligence Working Group","doi":"10.1002/jeo2.70247","DOIUrl":"https://doi.org/10.1002/jeo2.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Artificial intelligence (AI) has been influencing healthcare and medical research for several years and will likely become indispensable in the near future. AI is intended to support healthcare professionals to make the healthcare system more efficient and ultimately improve patient outcomes. Despite the numerous benefits of AI systems, significant concerns remain. Errors in AI systems can pose serious risks to human health, underscoring the critical need for safety, as well as adherence to ethical and moral standards, before these technologies can be integrated into clinical practice. To address these challenges, the development, certification, and deployment of medical AI systems must adhere to strict and transparent regulations. The European Commission has already established a regulatory framework for AI systems by enacting the European Union Artificial Intelligence Act. This review article, part of an AI learning series, discusses key considerations for medical AI systems such as reliability, accuracy, trustworthiness, lawfulness and legal compliance, ethical and moral alignment, sustainability, and regulatory oversight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rate of smoking in patients who have suffered from ACLR graft rupture","authors":"W. P. Yau","doi":"10.1002/jeo2.70237","DOIUrl":"https://doi.org/10.1002/jeo2.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to investigate the rate of smoking in patients who suffered from anterior cruciate ligament reconstruction (ACLR) graft rupture. It was hypothesised that there would be no difference in the ACLR graft rupture rates between smokers and non-smokers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted on patients who underwent primary ACLR using hamstring autograft at the author's institute between 2007 and 2021. Patients with unknown smoking status were excluded. All included patients received post-operative magnetic resonance imaging for assessment of graft integrity. The rate of graft rupture was reported. A case–control study was performed to determine the relationship between smoking and ACLR graft rupture by matching age, sex, chronicity of tear, diameter and type of ACLR graft, Grade 3 pivot-shift, type of ACLR and concomitant anterolateral ligament reconstruction between smokers and non-smokers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 495 primary ACLRs were included. The patients were aged 27.2 ± 8.2 years. There were 397 men and 98 women, with a smoking rate of 20%. The average follow-up was 78 ± 48 months. 16.2% of smokers, compared to 10.1% of non-smokers, suffered from graft rupture. The median yearly rate of graft rupture was 2 per 100 ACLRs (interquartile range [IQR] = 2.4) for smokers, compared to 1 per 100 ACLRs (IQR = 0.6) for non-smokers. One hundred seventy-two patients were matched. Smokers were found to have a higher risk of suffering from graft rupture compared to non-smokers in the case–control matching analysis (odds ratio = 2.6, 95% confidence interval = 1.01–6.63).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a cohort of 495 primary ACLRs operated using hamstring autograft with a 20% smoking rate, the rates of ACLR graft rupture and revision ACLR at a mean follow-up of 6.5 ± 4 years were 11.3% and 8.3%, respectively. Smoking was associated with an increased risk of graft rupture in a case–control matching subgroup analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70237","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"4-Strand hamstring versus single-bundle quadriceps tendon grafts in anterior cruciate ligament reconstruction at 2 years: A systematic review and meta-analysis of randomised controlled trials","authors":"Jonathan Elias,&nbsp;Mitchell Kaplan,&nbsp;Kunal Shah,&nbsp;Michael Bickford,&nbsp;Chelsea McNamara,&nbsp;Elizabeth Ford,&nbsp;Sean McMillan","doi":"10.1002/jeo2.70244","DOIUrl":"https://doi.org/10.1002/jeo2.70244","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare the 2-year postoperative outcomes of hamstring tendon (HT) grafts to quadriceps tendon (QT) grafts in anterior cruciate ligament (ACL) reconstruction. We hypothesised no significant differences between the two methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted following the 2020 PRISMA guidelines. Five online databases (Cochrane, Embase, PubMed, Scopus and Web of Science) were screened for prospective randomised controlled trials (RCT). IKDC, Lysholm, Tegner, side-to-side KT-1000 scores and ages were collected. Statistical analysis was conducted with SPSS v29. Between the two groups, a test of between-subgroup homogeneity <i>p</i>-value &lt; 0.05 was used to assess statistical significance, while a <i>Δ</i> Cohen's <i>d</i> ≥ 0.8 was used to assess clinical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five RCTs were included in the final analysis. The HT group included 87 patients, and the QT group included 93 patients. The mean ages for the HT and QT groups were 28.3 ± 6.6 and 26.5 ± 8.4 years, respectively. HTs yielded clinically higher IKDC scores (<i>Δ</i> Cohen's <i>d</i> = 2.27, <i>p</i> = 0.24), clinically lower side-to-side KT-1000 differences (<i>Δ</i> Cohen's <i>d</i> = 1.65, <i>p</i> = 0.08), and clinically and statistically higher Lysholm scores (<i>Δ</i> Cohen's <i>d</i> = 2.93, <i>p</i> = 0.00). However, QT yielded higher Tegner scores (<i>Δ</i> Cohen's <i>d</i> = 1.68, <i>p</i> = 0.00), whereas HT led to a moderate clinical reduction (Cohen's <i>d</i> = −0.55, <i>p</i> = 0.06, 95% CI [−1.11 to 0.02]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with the use of the QT graft, the HT graft for ACL reconstruction may result in greater knee function and stability, while QT ACL reconstruction may be associated with increased levels of postsurgical activity in terms of return to sports and work. Future long-term RCTs are needed to confirm our findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiligament knee injury patients with limited access to post-operative rehabilitation exhibit similar patient-reported outcomes: A retrospective cohort study","authors":"Shane S. Korber,&nbsp;Amir Fathi,&nbsp;Ioanna K. Bolia,&nbsp;Cailan L. Feingold,&nbsp;Eric H. Lin,&nbsp;Samantha A. Solaru,&nbsp;Neilen Benvegnu,&nbsp;Joseph N. Liu,&nbsp;George F. Rick Hatch 3rd","doi":"10.1002/jeo2.70245","DOIUrl":"https://doi.org/10.1002/jeo2.70245","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Multiligament knee injuries (MLKI) are typically high-energy traumatic injuries requiring surgical reconstruction and extensive post-operative rehabilitation. This study aimed to examine differences in outcomes of patients with different access to post-operative rehabilitation following multiligament knee reconstruction (MLKR). We hypothesize that patients with limited access to rehabilitation will demonstrate worse outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients who sustained an MLKI between 2007 and 2019 and who underwent MLKR by a single surgeon were retrospectively identified and invited to participate. Patients less than 1 year post-operative were excluded. Data recorded included patient demographics, intraoperative procedure performed, patient access to rehabilitation after surgery (limited versus full access), and multiple post-operative patient-reported outcome measures (PROMs). A comparison of PROMs was performed between patients with limited versus full access to rehabilitation using descriptive statistics (STATA). The level of statistical significance was set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Eighty-three patients (17.4% female) met the inclusion criteria and had accessible rehabilitation data. Of those, 69 (83.1%) patients had full access to rehabilitation, and 14 patients (16.9%) had limited access to post-operative rehabilitation. There was no difference in mean follow-up time (2.6 and 2.2 years, respectively, &lt;i&gt;p&lt;/i&gt; = 0.96) or baseline patient characteristics. Patients with limited access to post-operative rehabilitation had significantly worse Patient-Reported Outcome Measurement Information System (PROMIS) Pain (&lt;i&gt;p&lt;/i&gt; = 0.021) and PROMIS Physical Function (&lt;i&gt;p&lt;/i&gt; = 0.023) scores compared to patients with full access to rehabilitation. PROMIS mobility, Lysholm and multiligament quality of life (MLQOL) measures were not significantly different.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients who underwent MLKI reconstruction with limited access to rehabilitation demonstrated worse PROMIS pain and physical function scores than those with full access to rehabilitation in the short term. However, these differences do not meet minimum clinically important difference values, suggesting similar outcomes. Other PROMs, such as PROMIS mobility, Lysholm and MLQOL scores, were similar between patients with and without full access to rehabilitation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 ","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}