Journal of Experimental Orthopaedics最新文献

{"title":"Platelet rich plasma compared to viscosupplementation in the treatment of knee osteoarthritis: A systematic review and meta-analysis of randomised controlled trials with 6 month and 12 month follow-up","authors":"Kian Bagheri,&nbsp;Adithya Shekhar,&nbsp;Eric Kwok,&nbsp;Danton Dungy,&nbsp;Susan L. Stewart,&nbsp;Amir A. Jamali","doi":"10.1002/jeo2.70335","DOIUrl":"https://doi.org/10.1002/jeo2.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Platelet rich plasma (PRP) and hyaluronic acid (HA) have been utilised in the last few decades as a conservative treatment for knee osteoarthritis (OA). We sought to evaluate the patient reported outcomes at specific intermediate term endpoints comparing PRP to HA through a systematic review and meta-analysis of randomised controlled trials (RCTs). We also sought to determine the effect of platelet concentration on the relative outcomes between PRP and HA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Embase, PubMed, Scopus and Cochrane databases were searched for terms related to PRP and osteoarthritis. RCTs comparing PRP and HA in the treatment of knee OA were selected. A total of 26 trials with 1650 knees were included. The two treatments were compared based on the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) at specific time points of baseline, 6 months, and 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PRP had a significant benefit over HA based on the WOMAC at 6 months and at 12 months. It also had a significant benefit over HA on the VAS at 6 months and at 12 months. When limiting the analysis to 6 month follow-up and separating the studies by platelet count, PRP had a statistically significant benefit over HA for platelet counts corresponding to ‘greater than baseline to 1,250,000 platelets/μL’ for the WOMAC score and platelet counts corresponding to ‘between 750,000 and 1,250,000 platelets/μL’ for the VAS score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>When taken as a whole, PRP demonstrates a significantly superior clinical result compared to HA at 6 months and 12 months. These findings must be considered in light of the numerous preparation protocols and PRP classifications detailed in this report for the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 1, systematic review of Level-1 randomised controlled studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647232","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":"Hamstring autograft, bone-patellar-tendon-bone autograft and synthetic graft in primary anterior cruciate ligament reconstruction: A meta-analysis of comparative studies","authors":"Michele Mercurio,&nbsp;Erminia Cofano,&nbsp;Orlando Cosentino,&nbsp;Katia Corona,&nbsp;Fabrizio Mocini,&nbsp;Umberto Rossi,&nbsp;Olimpio Galasso,&nbsp;Giorgio Gasparini,&nbsp;Simone Cerciello","doi":"10.1002/jeo2.70326","DOIUrl":"https://doi.org/10.1002/jeo2.70326","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Anterior cruciate ligament reconstruction (ACLR) yields favourable results, but failure and reinjury rates are still a concern. Graft choice is a modifiable risk factor for surgeons to avoid failure. The topic of optimal graft selection remains a subject of ongoing debate. Graft choices include autografts, allografts and synthetic grafts. The purpose of this meta-analysis was to compare functional outcomes and complications between autografts, hamstring (HT) tendon and bone-patellar-tendon-bone, and synthetic graft in primary ACLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PubMed, MEDLINE, Scopus and Cochrane Central databases were used for the research, and nine studies were included. The first author, journal name, year of publication, patient demographics, type of surgery, type of graft used for ACLR, time from injury to surgery, and follow-up period were recorded. The data extracted for quantitative analysis included Lysholm activity scale score, Tegner activity scale score, International Knee Documentation Committee (IKDC) score, laxity measured with the KT-1000 knee arthrometer (KT-1000), number of complications, re-rupture, and re-intervention rates. Random and fixed effect models were used for the meta-analysis of pooled mean differences (MDs) and odds ratios (ORs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 734 patients were identified, 377 of whom underwent ACLR with autograft and 326 with synthetic graft. The mean age was 28.7 ± 20.3 and 31.6 ± 9.3 years for the ACLR with autograft and ACLR with synthetic graft groups. The mean follow-up durations were 82.3 ± 38 and 81.4 ± 39.2 months. Comparable postoperative Lysholm knee score (<i>p</i> = 0.06), Tegner activity scale score (<i>p</i> = 0.64) and IKDC score (<i>p</i> = 0.15) were found between groups. Significantly greater knee laxity was found in the autograft group (2.6 ± 1.4 and 1.5 ± 1.4 mm; MD = 1.22, 95% confidence interval [CI]: 0.96, 1.48; <i>p</i> &lt; 0.001). Comparable overall complications (<i>p</i> = 0.70), re-rupture (<i>p</i> = 0.81) and re-intervention (<i>p</i> = 0.85) rates were found between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared to ACLR with HT autograft, the ACLR with synthetic graft showed statistically but not clinically important decreased knee laxity. Comparable functional outcomes, complication and re-rupture rates were found between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I, meta-analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647456","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 impact of total knee arthroplasty on functional outcomes and mental health: A prospective study","authors":"Bassem Haddad,&nbsp;Tasneem N. Alhosanie,&nbsp;Noor Yousef,&nbsp;Ali Kanaan,&nbsp;Leen A. Mazahreh,&nbsp;Khuzama Mohammad,&nbsp;Aya Al-Zurgan,&nbsp;Leen Al-Zghoul,&nbsp;Tala M. Mesmar,&nbsp;Fahad Alabhoul,&nbsp;Abdel Rahman Abuawad,&nbsp;Feras Abuhajleh,&nbsp;Mohammad Hamdan","doi":"10.1002/jeo2.70314","DOIUrl":"https://doi.org/10.1002/jeo2.70314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Knee osteoarthritis (OA) is a leading cause of disability and chronic pain; total knee arthroplasty (TKA) is the effective treatment in the end stages of knee OA after failure of conservative management. This study has focused on the effects of primary TKA on knee function, levels of depression, and anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study population is a cohort of 100 patients who underwent primary TKA in a tertiary center in Jordan. Oxford Knee Score (OKS), Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 score assessments were performed preoperatively and three months postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed a dramatic improvement in knee function, with the mean OKS increasing from 17.9 preoperatively to 38.4 postoperatively (<i>p</i> &lt; 0.001). Moreover, the percentage of patients who reported no or mild depression increased from 62% to 91%, and those who reported minimal or mild anxiety also increased from 76% to 95%. A multivariate linear regression showed that age, osteoporosis, and smoking were independently associated with the anxiety and depression score changes. These represent not only pain improvement but also a dual benefit in the field of mental health following TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Primary TKA showed significant improvement in patients' depression and anxiety, along with the improvement of their knee functional scores. Discussing psychological factors with patients preoperatively might be important along with the functional outcome in making the surgical decision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, prospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647093","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 HKA axis varies significantly with knee motion: A robot-assisted intraoperative evaluation during total knee arthroplasty supports the use of dynamic, not static, alignment classifications","authors":"Fjorela Qordja,&nbsp;Pieralberto Valpiana,&nbsp;Luca Andriollo,&nbsp;Stefano Marco Paolo Rossi,&nbsp;Andrea Giordano Salvi,&nbsp;Guido Bocchino,&nbsp;Karlos Zepeda,&nbsp;Francesco Benazzo,&nbsp;Pier Francesco Indelli","doi":"10.1002/jeo2.70370","DOIUrl":"https://doi.org/10.1002/jeo2.70370","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;New alignment classifications based on phenotype reproduction have recently been introduced in total knee arthroplasty (TKA) as alternatives to traditional mechanical alignment. These classifications were designed according to the static hip–knee–ankle angle (sHKA) measurement from long leg radiographs (LLRs). This study aimed to understand whether and how the HKA varied throughout the knee's range of motion (ROM) during robot-assisted TKA.&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;This prospective, bi-centric cohort study involved 107 consecutive patients undergoing primary robot-assisted TKA. The surgical technique adhered to restricted kinematic alignment (HKA ± 3°) with asymmetric gap balancing principles. The HKA's dynamic variation (dHKA) was assessed intraoperatively at full extension, as well as at 30°, 45°, 60°, 90° and 120°, both before bone cuts and after the positioning of the trial components. The overall cohort was initially analyzed, followed by a subgroup analysis based on varus, neutral and valgus phenotypes. A descriptive analysis was conducted to evaluate dHKA trends. Collected data were then analyzed using one-way repeated measures analysis of variance with Bonferroni correction and Bland–Altman plots to assess significant variations in dHKA across the ROM during flexion and to quantify outliers from the established safe boundaries of ±3°.&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;Out of 107 knees, the pre-cut dHKA demonstrated a biphasic trend, decreasing in varus until 60° and then transitioning toward valgus, with significant differences primarily noted at 90° and 120°. Post-cut, the dHKA exhibited an overall varus trend, increasing from full extension to 60° before experiencing a partial recovery. Significant differences were detected primarily at the initial flexion angles. Outlier rates increased with flexion: pre-cut from 6.5% to 43.0%, and post-cut from 1.9% to 30.8%, highlighting progressive inter-individual variability throughout. Although the analysis was stratified by knee phenotype, the post-cut dHKA trend did not differ among the various phenotypes or in comparison to the overall cohort trend.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The main finding of the current study was that intraoperative dHKA differs significantly from sHKA during robot-assisted TKA. Moreover, the sHKA was limited in predicting the actual kinematic HKA. Planning the final TKA alignment on static, standing LLRs may have limited value compared to intraoperative planning conducted with enabl","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647088","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":"Double-loop suture repair of radial meniscal tears provides favourable biomechanical performance compared to conventional repair techniques: A biomechanical study","authors":"Antonio Petillo,&nbsp;Alessandro Di Rosa,&nbsp;Carmelo Burgio,&nbsp;Sofia Di Leonardo,&nbsp;Gaetano Burriesci,&nbsp;Francesco Bosco,&nbsp;Ludovico Lucenti,&nbsp;Lawrence Camarda","doi":"10.1002/jeo2.70366","DOIUrl":"https://doi.org/10.1002/jeo2.70366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Radial meniscal tears significantly impact knee biomechanics and can lead to joint degeneration if untreated. While various suture techniques exist, no consensus has been reached on the optimal method. The hypothesis was that the double-loop suture can significantly reduce displacement between tear segments and achieve a higher ultimate failure load than conventional techniques. This study aims to biomechanically compare conventional repair techniques to a novel double-loop suture to enhance tensile strength, reduce displacement and improve meniscal repair outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty fresh-frozen porcine menisci with full-thickness radial tears were repaired using four techniques: double vertical, double horizontal, cross-tie and double-loop sutures. Biomechanical testing included cyclic loading (200 cycles, 5–19 N) and ultimate failure load evaluation. Key outcomes measured were displacement after cyclic loading, failure load, and failure modes. A one-way analysis of variance (ANOVA) was conducted to identify significant differences among groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the evaluated techniques, the double-loop suture demonstrated the highest ultimate failure load (111.1 ± 17.3 N, <i>p</i> &lt; 0.01). Displacement after cyclic loading was minimal across techniques, except for the double vertical suture, which showed significantly higher displacement. Knot breakage was the primary failure mode in conventional sutures, whereas the double-loop suture also exhibited tissue cutting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The double-loop suture provides superior biomechanical performance, offering greater tensile strength and stability than conventional methods. Its simplicity and arthroscopic applicability highlight its potential for advanced meniscal repair. The double-loop suture could be applied in the arthroscopic setting, improving the outcomes for treating radial tears. Further clinical studies are needed to confirm long-term efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, cadaveric study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70366","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647489","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":"Two-dimensional robot-assisted physeal-sparing medial patellofemoral ligament reconstruction can achieve favourable clinical outcomes for skeletally immature patients with recurrent patellar dislocation","authors":"Qiuzhen Liang,&nbsp;Zandong Zhao,&nbsp;Hongwei Zhan,&nbsp;Peidong Liu,&nbsp;Chaofan Liao,&nbsp;Junxuran Li,&nbsp;Yongchao Duan,&nbsp;Xin Kang,&nbsp;Bin Tian,&nbsp;Bo Ren,&nbsp;Jiang Zheng,&nbsp;Liang Zhang","doi":"10.1002/jeo2.70294","DOIUrl":"https://doi.org/10.1002/jeo2.70294","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;The surgical treatment of recurrent patellar dislocation (PRD) in adolescents faces particular difficulties, since the integrity of open growth plates may be compromised by standard surgical methods used in adults. This study aimed to review a series of adolescents with RPD who underwent robot-assisted physeal-sparing medial patellofemoral ligament (MPFL) reconstruction, compare the clinical results with those of a non-robot-assisted group, and measure the vertical distance between Schöttle point and the physis intraoperatively.&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;This retrospective clinical analysis included 55 adolescents with RPD who had no significant bone deformities and underwent MPFL reconstruction using either a robot-assisted technique or a non-robot-assisted method between February 2019 to November 2023. Using a 2D intraopertive navigation system, the vertical distance between Schöttle point and the medial distal femoral physis was measured in the robot-assisted group. The operation duration, the number of fluoroscopies and guide needle punctures were recorded in both groups. The anterior and distal tilt angles of the bone tunnel, as well as the distance between Schöttle point and the femoral insertion of the bone tunnel (DST), were measured using postoperative CT imaging in both groups. In addition to CT, MRI, and radiographic evaluations, the International Knee Documentation Committee (IKDC), Lysholm and Kujala scores were used to assess the clinical outcomes.&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;The mean patient age was 13.1 years (range, 11–16 years). At a mean of 35.5 ± 8.5 months postoperativel, all patients returned for evaluation. In the robot-assisted group, the mean distance from the Schöttle point to medial femoral physis was 6.97 ± 1.92 mm, with all Schöttle points positioned distal to the physis in every case. The IKDC, Lysholm and Kujala scores in the robot-assisted group were significantly higher than those in the non-robot-assisted group three months post-operatively (87.1 ± 6.1 vs. 82.9 ± 5.7, &lt;i&gt;p&lt;/i&gt; = 0.011; 85.3 ± 5.7 vs. 81.1 ± 5.2, &lt;i&gt;p&lt;/i&gt; = 0.007; 82.7 ± 6.0 vs. 77.5 ± 5.1, &lt;i&gt;p&lt;/i&gt; = 0.001); however, at the last follow-up, there was no significant difference (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). No patients experienced recurrent patellar instability or physeal invasion following surgery, and significantly improved functional scores and patellar tilt angles were noted at the final follow-up (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In the robot-assisted group, the number of fluoroscopy and guide needle punctures was significantly lower (3.7 ± 0.5 vs. 10.3 ± 1.8; 1.1 ± 0.3 vs. 5.7 ± 1.1, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), with smaller anterior tilt angles (14.5 ± 1.7 vs","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647453","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":"Three-dimensional reconstruction of the knee joint based on automated 1.5T magnetic resonance image segmentation: A feasibility study","authors":"Charles Pioger,&nbsp;Laura Marin,&nbsp;Yvon Gautier,&nbsp;Julien Cléchet,&nbsp;Pierre Imbert,&nbsp;Christian Lutz,&nbsp;Étienne Cavaignac,&nbsp;Bertrand Sonnery-Cottet","doi":"10.1002/jeo2.70361","DOIUrl":"https://doi.org/10.1002/jeo2.70361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To validate the accuracy of three-dimensional (3D) bone and cartilage reconstructions of the distal femur and proximal tibia derived from 1.5 Tesla magnetic resonance imaging (MRI), using fully automated and semi-automated segmentation methods, compared to surface laser scanning (LS) as the reference standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eleven fresh-frozen cadaveric knees were imaged using a 1.5 T MRI scanner. Manual (MS), fully automated (A), and semi-automated (SA) segmentations were performed to generate 3D models of the distal femur and proximal tibia. A transformer-based deep learning model (UNet-R) was used for automated segmentation. Laser surface scanning provided high-resolution ground-truth 3D models. Point-to-surface distances between MRI-based and LS-derived models were calculated to assess reconstruction accuracy. Bland-Altman analyses were performed to compare segmentation methods. Time to generate 3D models was recorded for each method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean absolute point-to-surface distance for femoral models was 1.19 mm (±0.42) for MRI A, 1.05 mm (±0.09) for MRI SA, and 0.99 mm (±0.08) for MRI MS. For tibial models, the corresponding values were 1.54 mm (±1.02), 1.03 mm (±0.17), and 0.93 mm (±0.14), respectively. MRI A showed larger variability, which required manual correction. Time analysis revealed significant efficiency gains: 27 s for MRI A, 1520 s for MRI SA, and 14,191 s for MRI MS (<i>p</i> &lt; 0.001). Bland-Altman plots confirmed improved agreement of MRI SA with MRI MS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MRI-based 3D reconstructions of the knee using a 1.5 T system and semi-automated segmentation achieved sub-millimetre accuracy comparable to manual segmentation and significantly outperformed fully automated models in precision, while substantially reducing segmentation time. These findings support the integration of AI-assisted 3D reconstruction into preoperative planning workflows for knee ligament surgery, offering a reliable, radiation-free alternative to CT-based modelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, controlled laboratory study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647488","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":"Increased femoral antetorsion results in decreased difference between the radiographic and anatomic determined Schoettle's point in MPFL reconstruction","authors":"Luca Maddaloni,&nbsp;Thaddäus Muri,&nbsp;Fabio Bekcic,&nbsp;Lazaros Vlachopoulos,&nbsp;Sandro F. Fucentese,&nbsp;Lukas Jud","doi":"10.1002/jeo2.70376","DOIUrl":"https://doi.org/10.1002/jeo2.70376","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Medial patellofemoral ligament (MPFL) reconstruction serves as a cornerstone in surgical treatment of patellofemoral instability. An intraoperative lateral knee radiograph is used to identify the femoral insertion of the MPFL, respectively the Schoettle's point (SP). However, anatomical differences of the distal femur may impair the acquisition of the lateral knee radiograph and therefore compromise the identification of the SP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients who underwent MPFL-reconstruction from January 2014 to December 2023 and with an available full radiographic dataset were included. The SP was determined both, radiographically and anatomically, using three-dimensional (3D) surface models. The differences between the two methods were calculated and the relationship to the measured distal femoral anatomical parameters assessed using binary logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy knees (36 left and 34 right) in 65 patients (48 females and 17 males) were included. The mean value of the distance between the radiographic and anatomic SP was 5.1 mm ±2.5 mm, in 15 knees the distance was bigger than 7 mm. Femoral torsion was the only significant parameter in the binary logistic regression, indicating lower femoral torsion increasing the likelihood of a distance between the radiographic and anatomic SP exceeding 7 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among all assessed distal femoral anatomical parameters, only decreased femoral torsion was associated with increased differences between the radiographic and anatomic determined SP. Hence, the intraoperative clinical control of the isometric MPFL insertion remains advisable.</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 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70376","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647457","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":"Shoes size can predict implant sizes for primary total knee arthroplasty in a quick, reliable and costless manner","authors":"Corentin Philippe,&nbsp;Alexandre Leguen,&nbsp;Nicolas Vari,&nbsp;Pablo Froidefond,&nbsp;Gary Kolenc,&nbsp;Emilie Berard,&nbsp;Etienne Cavaignac","doi":"10.1002/jeo2.70363","DOIUrl":"https://doi.org/10.1002/jeo2.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Knowing the component sizes needed for a specific patient before total knee arthroplasty (TKA) surgery could help to optimise the logistics of medical device availability. Previous studies have correlated component size with patient age, sex, height, weight, and shoe size, but none have validated this method using the European shoe sizing system. The primary objective of this study was to determine the correlation between a patient's European shoe size at the time of surgery and the size of the tibial and femoral components used during primary TKA. The secondary objective was to evaluate the accuracy within ±1 size between the European shoe size and the component size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective observational, single-centre, single-surgeon study of 227 primary TKA procedures done with the Score II implant (AMPLITUDE®, Valence, France) between 1 April 2022 and 1 July 2023. Data on the patient's shoe size was determined before the surgery. This information was retrospectively correlated with the size of the components used in the TKA surgery that was recorded in the operative report.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The correlation between a patient's shoe size and the component size was very strong: Spearman rho of 0.8095 for femur, 0.8400 for tibia and 0.6393 for patella (<i>p</i> &lt; 0.001). The correlation between a patient's shoe size and the size of the PE insert was weak: Spearman rho 0.1532 (<i>p</i> = 0.0210). After adjusting for sex, the femoral component was predicted accurately within ±1 size in 92% (210/227) of procedures and the tibial component in 94% (213/227). After adjusting for sex and BMI, the patellar implant was predicted accurately within ±1 size in 97% (220/227) of procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our model provides a cost-effective, assignable and easily implementable method for predicting tibial and femoral component sizes using European shoe size, demonstrating high accuracy (≥92%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, retrospective observational study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647458","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":"Infrapatellar fat pad fibrosis after anterior cruciate ligament reconstruction is associated with male sex, high body mass index, prolonged operation time and articular cartilage damage, with detrimental effects on one-year clinical outcomes","authors":"Ryu Yoshida,&nbsp;Hideyuki Koga,&nbsp;Tomomasa Nakamura,&nbsp;Nobutake Ozeki,&nbsp;Mai Katakura,&nbsp;Masaki Amemiya,&nbsp;Takashi Hoshino,&nbsp;Aritoshi Yoshihara,&nbsp;Toyohiro Katsumata,&nbsp;Yasumasa Tokumoto,&nbsp;Ichiro Sekiya,&nbsp;Yusuke Nakagawa","doi":"10.1002/jeo2.70365","DOIUrl":"https://doi.org/10.1002/jeo2.70365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to examine the risk factors of infrapatellar fat pad (IFP) fibrosis and the associations between the degree of IFP fibrosis and clinical outcomes in patients who underwent anterior cruciate ligament reconstruction (ACLR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 97 patients who underwent primary ACLR using autologous hamstring tendons were divided into the mild fibrosis group (M group) and severe fibrosis group (S group), based on IFP fibrosis scoring (Grades 0–5) on magnetic resonance imaging at 3 months postoperatively. Clinical outcomes at 1 year postoperatively were compared between groups. Univariate logistic regression analysis was performed to determine factors associated with IFP fibrosis. Additionally, multiple linear regression analysis was performed to investigate whether IFP fibrosis affected clinical outcomes at 1 year postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients were classified into the S group (<i>n</i> = 21) and the M group (<i>n</i> = 76). There were significantly more males (<i>p</i> = 0.036), higher body mass index (<i>p</i> = 0.004), longer operation times (<i>p</i> = 0.031), and more cartilage injuries identified during arthroscopy (<i>p</i> = 0.030) in the S than M group. International Knee Documentation Committee (IKDC) subjective scores (<i>p</i> = 0.040), and Knee Injury and Osteoarthritis Outcome Score (KOOS) symptoms (<i>p</i> = 0.009) and quality of life values (<i>p</i> = 0.026) were significantly lower in the S than M group. The range of motion was significantly worse on both extension (<i>p</i> &lt; 0.001) and flexion (<i>p</i> = 0.002) in the S than M group. Multiple regression analysis revealed IFP fibrosis as an independent factor affecting the IKDC subjective score (<i>p</i> = 0.037), KOOS-symptom subscore (<i>p</i> = 0.037) and extension angle (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Male sex, high BMI, prolonged surgery, and articular cartilage damage are risk factors for IFP fibrosis after ACLR. IFP fibrosis affects the range of motion and subjective patient evaluations at 1 year postoperatively. MRI-based evaluation at 3 months may help identify high-risk patients, and early interventions targeting fibrosis could improve postoperative recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, case–control study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647089","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}