Journal of Experimental Orthopaedics最新文献

{"title":"Patients with cyclops syndrome exhibit elevated synovial fluid interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels and disorganized collagen remodelling within the lesion: A histological and molecular study","authors":"Luca Morici, Philippe M. Tscholl, Eline. L. Skau, Klaus Eyer, Lukas Clerc, Morgan Gauthier, Ines Nikolic","doi":"10.1002/jeo2.70953","DOIUrl":"https://doi.org/10.1002/jeo2.70953","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Cyclops syndrome is a clinically relevant complication of anterior cruciate ligament (ACL) reconstruction characterized by the formation of a fibrotic nodule (cyclops lesion) that causes extension loss and often requires a revision surgery. Biological mechanisms underlying lesion formation remain poorly understood. The purpose of this study is to characterize the tissue architecture, cellular composition, inflammatory profile and single-cell cytokine secretion patterns of patient-derived biopsies to gain mechanistic insight into disease pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational comparative study included three patient groups: patients undergoing revision surgery for cyclops syndrome (<i>n</i> = 10), patients undergoing primary ACL reconstruction with subsequent successful recovery (<i>n</i> = 10) and patients undergoing revision surgery for ACL graft re-rupture (<i>n</i> = 2). Tissue biopsies and synovial fluid samples were collected intraoperatively and used for histological, cellular and cytokine analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histological analyses demonstrated that cyclops lesions exhibited disorganized collagen architecture, neovascularization and infiltration of immune cells. Flow cytometry identified activated FAP<sup>+</sup>CD54<sup>+</sup> fibroblasts as the predominant cell population (~80%), accompanied by CD206<sup>+</sup> pro-fibrotic macrophages. Synovial fluid from cyclops patients contained significantly elevated IL-6 and TNF-α concentrations, whereas IL-1β levels did not differ among the groups. Looking at the cells, single-cell cytokine secretion profiles revealed detectable IL-6 secretion in up to 11% of cells, while IL-1β, TNF-α and TGF-β secretion were not detected, indicating that at least the source of TNF-α has to be found elsewhere.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our preliminary data from a small patient cohort show that cyclops syndrome may be observed as an active fibro-inflammatory process rather than a purely mechanical post-operative complication. Patient-derived samples revealed persistent inflammatory activity characterized by immune cell infiltration, elevated levels of pro-inflammatory mediators, and sustained activation of fibroblasts. The absence of detectable TGF-β secretion despite established fibrosis suggests that lesion persistence may be maintained through alternative fibrotic pathways (non-TGF-β/non-canonical pathways), which requires further investigation.</p>\u0000 </s","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206027","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":"Nutritional disorders have adverse effect on clinical outcomes and may increase healthcare costs following hip and knee arthroplasty—A systematic review","authors":"Christopher David John Little,&nbsp;Hariharan Subbiah Ponniah,&nbsp;Shvaita Ralhan,&nbsp;Louise Strickland,&nbsp;Antony Palmer,&nbsp;Thomas William Hamilton","doi":"10.1002/jeo2.70657","DOIUrl":"https://doi.org/10.1002/jeo2.70657","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To report the effect of nutritional disorder on outcomes following hip and knee arthroplasty using European Society of Clinical Nutrition and Metabolism (ESPEN) diagnostic criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review of level 1–4 evidence was conducted as per the PRISMA statement and Cochrane Handbook for Systematic Review (PROSPERO ID: CRD42023360517). In March 2024, AMED, CENTRAL, EMABASE, MEDLINE, Scopus and Web of Science were searched. Articles were included if they defined and reported the effect of nutritional disorder on outcome(s) of interest following hip and/or knee arthroplasty. Exclusion criteria were pathological fracture and &lt;50 cases. The ROBINS-I was used to assess study bias. Data were presented with effect sizes if reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-eight studies were included (2,076,289 patients). Malnutrition, as per ESPEN criteria, increased mortality, post-op pain and length of hospital stay. Sarcopenia, diagnosed via computed tomography, increased surgical site infection rate following primary arthroplasty and mortality following hip fracture arthroplasty. Frailty worsened clinical outcomes following primary, revision and hip fracture arthroplasty. One included study reported healthcare cost; these were higher among frail patients undergoing primary total knee arthroplasty: $19,841 versus $6104, <i>p</i> = 0.001.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nutritional disorder was associated with adverse clinical outcomes following primary, revision and hip fracture arthroplasty. Moderate-to-severe bias, heterogenous definitions of nutritional disorder and lack of standardised outcome reporting limited analyses, particularly analyses of healthcare costs which likely increase with nutritional disorder. Prospective study is required to examine potential for cost-saving and improved patient outcome following treatment of nutritional disorder in hip and knee arthroplasty populations.</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":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205583","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":"Patient-reported evolution of the Cumberland Ankle Instability Tool after arthroscopic anatomic lateral ligament reconstruction: A retrospective study of 134 cases","authors":"Ibrahim Saliba,&nbsp;Olivier Grimaud,&nbsp;Vincent Fontanier,&nbsp;Frederic Khiami,&nbsp;Yoann Bohu,&nbsp;Nicolas Lefevre,&nbsp;Alexandre Hardy","doi":"10.1002/jeo2.70952","DOIUrl":"https://doi.org/10.1002/jeo2.70952","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To describe the longitudinal evolution of the Cumberland Ankle Instability Tool (CAIT) after arthroscopic anatomic lateral ligament reconstruction (AALR) and examine associations between CAIT-defined patient-perceived stability, return to sport (RTS) and preoperative factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-centre cohort included 134 athletic patients who underwent AALR between January 2019 and January 2023 and had at least 12 months of follow-up. CAIT was assessed preoperatively and at 3, 6 and 12 months. Patient-perceived stability was defined as CAIT ≥ 24. Repeated continuous and binary outcomes were assessed using paired-data methods. RTS was defined as self-reported resumption of sport by 12 months, irrespective of level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median CAIT increased from 8 preoperatively to 23, 26 and 28 at 3, 6 and 12 months, respectively (overall <i>p</i> &lt; 0.001). CAIT-defined stability increased from 5/134 (3.7%) preoperatively to 55/134 (41.0%), 91/134 (67.9%) and 96/134 (71.6%) at 3, 6 and 12 months (overall <i>p</i> &lt; 0.001). Most improvement occurred by 6 months. Overall, 112 patients (83.6%) reported RTS by 12 months. Higher CAIT at 3, 6 and 12 months was associated with RTS. In exploratory multivariable analysis, preoperative ankle ligament reconstruction-return to sport after injury was positively associated with 12-month CAIT-defined stability (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.00–1.04; <i>p</i> = 0.043), whereas nonpivot sport was negatively associated compared with pivot-contact sport (OR: 0.27, 95% CI: 0.09–0.75; <i>p</i> = 0.014). Four patients (3.0%) underwent fibular button removal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patient-reported ankle function measured by CAIT improved during the first postoperative year after AALR, with the largest change occurring by 6 months. CAIT may complement, but should not replace, objective examination and multidimensional RTS assessment. The identified associations are exploratory and require prospective validation.</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":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70952","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205686","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":"Unsupervised machine learning identifies two distinct posterior tibial slope clusters largely independent of Coronal Plane Alignment of the Knee in osteoarthritic knees","authors":"Dinko Vidović,&nbsp;Dejan Blažević,&nbsp;Josip Baković,&nbsp;Fabijan Čukelj Jr.,&nbsp;Tin Karakaš,&nbsp;Borna Vojvodić,&nbsp;Anja Barešić,&nbsp;Tomislav Šmuc,&nbsp;David Glavaš Weinberger","doi":"10.1002/jeo2.70945","DOIUrl":"10.1002/jeo2.70945","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;Coronal-plane classifications such as the Coronal Plane Alignment of the Knee (CPAK) classification support individualized total knee arthroplasty (TKA) planning but do not account for sagittal-plane morphology, particularly the posterior tibial slope (PTS). This study aimed to determine whether unsupervised machine learning (k-means clustering) could identify naturally occurring PTS phenotypes in osteoarthritic knees and to evaluate their association with CPAK classification and joint line obliquity (JLO).&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 radiographic cohort study included 3337 osteoarthritic knees from 1746 patients. PTS was measured on lateral knee radiographs in all 3337 knees, using the posterior tibial cortex and the medial tibial plateau as reference lines. Full-length standing radiographs were available for 464 knees; in these knees, the medial proximal tibial angle (MPTA) and the lateral distal femoral angle (LDFA) were measured to calculate the arithmetic hip–knee–ankle angle (aHKA) and JLO, and each knee was classified according to CPAK. K-means clustering was used to identify PTS subgroups without predefined thresholds, and cluster validity was assessed using the elbow method and silhouette analysis. Associations between PTS clusters, CPAK phenotypes and radiographic parameters were analysed using the &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test, adjusted standardized residuals, Fisher's exact test and correlation analysis.&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 median PTS was 5.6° (interquartile range 3.4°–7.7°). K-means clustering identified two PTS clusters: a shallow-slope cluster centred at 3.56°, comprising 55.91% of the knees and a steep-slope cluster centred at 8.52°, comprising 44.09%. No individual CPAK phenotype was significantly overrepresented within either cluster. When phenotypes were grouped according to joint line orientation, however, apex-distal phenotypes (I–III) were more frequently assigned to the steep-slope cluster, whereas apex-neutral phenotypes (IV–VI) were more frequently assigned to the shallow-slope cluster. JLO was significantly higher in the shallow-slope cluster and PTS showed a modest inverse correlation with JLO.&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;Unsupervised k-means clustering identified two distinct sagittal PTS phenotypes in osteoarthritic knees. PTS varied largely independently of the individual CPAK phenotypes, although an association with JLO was observed. Sagittal morphology may therefore provide complementary informati","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184825","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":"Restoration of shoulder kinematics during active throwing after the Latarjet procedure in anterior shoulder instability: A dynamic radiostereometric study.","authors":"Josephine Olsen Kipp, Emil Toft Petersen, Maiken Stilling, Anna Zejden, Rikke Jellesen Åberg, Thomas Falstie-Jensen, Theis Muncholm Thillemann","doi":"10.1002/jeo2.70930","DOIUrl":"https://doi.org/10.1002/jeo2.70930","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate glenohumeral joint (GHJ) kinematics during a throwing motion in patients with anterior shoulder instability before and 1 year after the Latarjet procedure.</p><p><strong>Methods: </strong>In this prospective study, 13 patients with unilateral, traumatic anterior shoulder instability scheduled for the Latarjet procedure were examined preoperatively and at 1-year follow-up. GHJ kinematics were assessed during a standardized throwing motion using dynamic radiostereometric analysis. Preoperatively, both the injured and contralateral healthy shoulders were assessed. One year post-operatively, only the injured shoulder was assessed. GHJ kinematics were evaluated in six degrees of freedom, including rotations and translations of the humeral head centre and contact point, as well as the glenohumeral contact area, throughout the throwing motion.</p><p><strong>Results: </strong>Post-operatively, the humeral head centre shifted up to 1.1 mm posteriorly (95% confidence interval [CI]: 0.3-1.9) and 0.4 mm superiorly (95% CI: 0.0-0.7) compared with the injured shoulder and was 1.4 mm (95% CI: -1.2 to 4.1) more posterior compared with the healthy shoulder. The contact point translations showed similar patterns, although not statistically significant. The GHJ contact area increased post-operatively by up to 87.0 mm² (95% CI: 35.9-138.0) compared with the injured shoulder and with no statistically significant difference compared with the healthy shoulder.</p><p><strong>Conclusions: </strong>The Latarjet procedure produced a posterior-superior shift of the humeral head compared with the preoperative injured shoulder and restored glenohumeral contact area to levels similar to the healthy shoulder during an active throwing motion. These findings support the stabilizing effect of Latarjet procedures under functional, load-bearing conditions relevant to overhead athletes.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 4","pages":"e70930"},"PeriodicalIF":3.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170376","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 inwardly pointing knee angle: A novel computed tomography-based measurement technique and validation study","authors":"Ricardo David Manilov,&nbsp;Angel Sebastián Maldonado,&nbsp;Adrián Bórbore,&nbsp;Estefanía Ivana Vrancovich,&nbsp;Raúl Oscar Cáceres Orellano,&nbsp;Daniela Bravo,&nbsp;Felix Ferner,&nbsp;Matthieu Ollivier","doi":"10.1002/jeo2.70938","DOIUrl":"10.1002/jeo2.70938","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;Inwardly pointing knee (IPK) is a clinically recognized manifestation of torsional malalignment in patients with patellofemoral pain and instability. However, current imaging protocols primarily quantify isolated components of malalignment, such as femoral anteversion or tibial torsion, without also capturing the net orientation of the knee relative to the direction of gait. The purposes of this study were to describe a functional computed tomography (CT) protocol for patellofemoral assessment and to introduce and validate the measurement of the inwardly pointing knee angle (IPKA).&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;A total of 1230 bilateral CT examinations, performed between 2017 and 2025 in patients with anterior knee pain and/or patellofemoral instability, were retrospectively reviewed. Patients were positioned according to their individual foot progression angle (FPA), documented from plantar footprints obtained during walking before image acquisition. CT scans were obtained with the knees in full extension (0°) and at 30° of flexion while the feet remained fixed on the recorded FPA footprint. In addition to conventional torsional and patellofemoral parameters, IPKA, FPA and AVA were measured on these images. Reliability of IPKA was assessed in 60 randomly selected knees measured by three observers on three occasions, using intraclass correlation coefficients (ICCs), the standard error of measurement (SEM) and the smallest detectable change (SDC).&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 IPKA was 13.97° ± 7.46° at 0° of flexion and 6.52° ± 5.56° at 30° of flexion. Interobserver reliability was excellent at both 0° (ICC 0.962) and 30° (ICC 0.986) of knee flexion and intra-observer agreement was excellent (ICC 0.972–0.978 in full extension and 0.989–0.992 at 30°). The SEM was 1.76° in full extension and 0.88° at 30°, with corresponding SDC of 4.88° and 2.43°.&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;This functional CT protocol enables assessment of the net axial orientation of the knee relative to the body's line of progression during gait, rather than the assessment of isolated torsional variables alone. IPKA demonstrated high reproducibility and may serve as a useful adjunct in the preoperative evaluation of patients with patellofemoral pain or instability and suspected torsional malalignment. IPKA provides a reproducible, objective measure of the combined torsional effect of the acetabulum, femur, tibia and FPA during gait and, pending validation of normative values and cli","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168233","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":"Interviewer-assisted administration of patient-reported outcome measures with intentional interviewer influence consistently produces more favourable scores than self-administration after total knee arthroplasty: A prospective within-subject comparative study","authors":"Mara Hold,&nbsp;Sophie Berg,&nbsp;Alexander Derksen,&nbsp;Jan Dirk Kiene,&nbsp;Mats Zander,&nbsp;Marco Haertlé,&nbsp;Spiros Tsamassiotis,&nbsp;Henning Windhagen,&nbsp;Lars-Rene Tuecking","doi":"10.1002/jeo2.70899","DOIUrl":"10.1002/jeo2.70899","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patient-reported outcome measures (PROMs) are key instruments for evaluating outcomes after total knee arthroplasty (TKA), but differences across studies suggest that methodological factors, including interviewer bias, may affect their validity. The purpose of this prospective within-subject study was to determine whether intentionally influenced interviewer-assisted administration produces more favourable Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) scores than self-administration after TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three months after TKA, consecutive eligible patients completed the WOMAC, FJS and OKS twice: first independently at home and later in an intentionally influenced interviewer-assisted format during routine follow-up. During interviewer-assisted administration, questions were clarified when needed, and when patients were unsure between two response options, the more favourable answer was suggested. Paired <i>t</i> tests and standardized paired effect sizes (<i>dz</i>) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients with complete paired assessments were included (41 women and 19 men; mean age 63.7 ± 8.2 years). Interviewer-assisted administration yielded mean differences of 35.9 ± 17.7 points for the FJS (<i>p</i> &lt; 0.001; <i>dz</i> = 2.03), 6.8 ± 4.7 points for the OKS (<i>p</i> &lt; 0.001; <i>dz</i> = 1.44) and 8.4 ± 10.9 points for the WOMAC (<i>p</i> &lt; 0.001; <i>dz</i> = 0.77), consistently indicating more favourable scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PROMs after TKA are strongly influenced by the mode of administration. Interviewer-assisted administration involving intentional influence resulted in systematically more favourable scores across all questionnaires. For meaningful comparison of PROM-based outcomes, the mode of administration and any interviewer guidance should be standardized or at least clearly reported.</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":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171332","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":"Does meniscal tear morphology independently predict repair failure? A context-adjusted analysis of 500 consecutive arthroscopic meniscal repairs","authors":"Horacio Rivarola,&nbsp;Cristian Collazo,&nbsp;Marcos Palanconi,&nbsp;Marcos Meninato,&nbsp;Carlos Peñaherrera-Carrillo,&nbsp;Alejandro Barros Castro,&nbsp;Francisco Endara Urresta","doi":"10.1002/jeo2.70947","DOIUrl":"https://doi.org/10.1002/jeo2.70947","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;To determine whether meniscal tear morphology independently predicts repair failure following arthroscopic meniscal repair after adjustment for patient-, meniscal- and repair-related characteristics and to quantify the incremental prognostic value of tear morphology beyond established clinical predictors.&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;A retrospective multicenter cohort study included 500 consecutive patients undergoing primary arthroscopic meniscal repair with a minimum follow-up of 24 months. Repairable tear morphologies included longitudinal vertical, bucket-handle, radial, horizontal cleavage, complex, ramp and root tears. Patients undergoing revision meniscal repair, previous ipsilateral meniscal repair or transplantation, treatment of discoid meniscus, repair of degenerative root tears associated with advanced osteoarthritis, concomitant corrective osteotomy or arthroplasty or with insufficient operative or follow-up data were excluded. Meniscal characteristics included tear morphology, laterality, vascular zone and intraoperatively assessed tissue quality based on structural integrity, macroscopic degeneration and suture-holding capacity. Repair-related variables included repair technique (all-inside, inside-out or hybrid), number of fixation sutures, suture density and concomitant anterior cruciate ligament reconstruction. Repair failure was defined as subsequent ipsilateral meniscal reoperation. Kaplan–Meier analysis and multivariable Cox proportional hazards regression were used to evaluate repair survival and independent predictors of failure.&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;During a median follow-up of 45 months, 81 patients (16.2%) underwent reoperation. Five-year repair survivorship was 82.6%. Although repair survival differed among tear morphologies in univariable analysis (log-rank &lt;i&gt;p&lt;/i&gt; = 0.012), tear morphology was no longer independently associated with failure after multivariable adjustment. Independent predictors of failure included medial meniscal repair (hazard ratio [HR] 2.18), poor tissue quality (HR 2.74), avascular tear location (HR 1.89), lower suture density (HR 0.71 per additional suture/cm) and absence of concomitant anterior cruciate ligament reconstruction (HR 1.67). Addition of tear morphology to the clinical prediction model produced only a modest improvement in discrimination (Harrell's C-index 0.782 vs. 0.794) and minimal improvement in calibration.&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;Meniscal tear morphology demonstrated limited i","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70947","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146076","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":"Acute rather than insidious symptom onset is associated with better postoperative outcomes after transtibial pull-out repair for medial meniscus posterior root tears","authors":"Zheng-Zheng Zhang,&nbsp;Shu-Yang Guo,&nbsp;Wen-Nan Xu,&nbsp;Jia-Hao Zhu,&nbsp;Jia-Long Luo,&nbsp;Jing-Song Wang,&nbsp;Chuan Jiang,&nbsp;Bo He,&nbsp;Wei-Ping Li","doi":"10.1002/jeo2.70948","DOIUrl":"https://doi.org/10.1002/jeo2.70948","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare clinical and radiologic outcomes after transtibial pull-out repair for medial meniscus posterior root tears (MMPRTs) between patients with acute and insidious symptom onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent transtibial pull-out repair for MMPRTs between March 2022 and December 2023 and had a minimum 2-year follow-up were retrospectively reviewed. Patients were classified into an acute-onset group, defined by abrupt symptom onset during or immediately after a clear inciting knee incident, or an insidious-onset group, defined by gradually progressive symptoms without a definite precipitating event. Outcomes included patient-reported outcome measures (PROMs) and radiologic parameters. PROMs comprised the International Knee Documentation Committee (IKDC) and Lysholm scores, with minimal clinically important difference (MCID) achievement also assessed. Radiologic outcomes included Kellgren–Lawrence (KL) grade progression, meniscal extrusion and magnetic resonance imaging (MRI) healing status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 49 patients were included (28 acute-onset, 21 insidious-onset). Both groups showed significant improvement in IKDC and Lysholm scores, with similar MCID achievement rates. At final follow-up, the Acute Group had higher median IKDC scores than the Insidious Group (73.0 [66.8–79.0] vs. 67.0 [62.0–69.0]; <i>p</i> = 0.02) and Lysholm scores (76.0 [73.0–78.0] vs. 71.0 [70.0–74.0]; <i>p</i> &lt; 0.01). KL-grade progression was less frequent in the Acute Group (1/28 [3.6%] vs. 8/21 [38.1%]; <i>p</i> &lt; 0.01). Meniscal extrusion was also lower (3.3 [2.9–3.5] vs. 3.9 [3.1–4.0] mm; <i>p</i> = 0.01), although the absolute difference was small. MRI healing status did not differ between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Acute-onset MMPRTs were associated with better postoperative functional outcomes and less radiologic progression than insidious-onset MMPRTs, although the clinical relevance of the small difference in meniscal extrusion remains uncertain. Therefore, symptom-onset pattern may provide potentially useful information for preoperative prognostic counselling, but this association should be interpreted cautiously and confirmed in prospective studies.</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":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146156","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":"Anterolateral ligament injury in ACL-injured patients is not associated with the presence of the deep lateral femoral notch sign: A cross-sectional study","authors":"David Santos-Nunes,&nbsp;Daniel Medina-Dias,&nbsp;Pedro Poças,&nbsp;Pedro Sá,&nbsp;Miguel Castro,&nbsp;Paulo Oliveira,&nbsp;Francisco Serdoura,&nbsp;Manuel Gutierres","doi":"10.1002/jeo2.70950","DOIUrl":"https://doi.org/10.1002/jeo2.70950","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The anterolateral ligament (ALL) has been proposed as a secondary stabiliser of the knee against tibial internal rotation in anterior cruciate ligament (ACL)-injured knees. The deep lateral femoral notch sign (DLFNS) has been proposed as an indirect imaging marker of high-energy pivot-shift trauma in ACL-injured knees. This study investigates the association between ALL injury and magnetic resonance imaging (MRI) anterolateral rotatory instability signs—including DLFNS and medial and lateral anterior tibial translation—in acute ACL injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted on 176 patients (aged 18–50) who underwent primary ACL reconstruction. Patients were stratified by MRI-based ALL status: injured and intact. Two observers independently assessed ALL injury. Primary outcomes were the presence of DLFNS (depth &gt; 2 mm) and medial and lateral anterior tibial translation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ALL injury was identified in 40/176 (22.7%) of patients with acute ACL injury. Interobserver agreement for ALL injury assessment was substantial (<i>κ</i> = 0.715). DLFNS prevalence did not differ significantly between ALL-injured and intact groups (10/40 (25.0%) vs. 29/136 (21.3%); <i>p</i> = 0.623). No significant differences were found in medial or lateral anterior tibial translation between groups. On multivariable logistic regression, concomitant bone bruise was the only factor independently associated with ALL injury (adjusted odds ratio 2.192, 95% confidence interval [1.012–4.748]; <i>p</i> = 0.047), whereas no association was found with time to MRI or LFNS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>No direct association was found between ALL injury and MRI signs of anterolateral rotatory instability, and bone bruise was the only independent factor associated with ALL injury. This finding may be consistent with ALL injury occurring within a broader injury pattern, which may not be reliably captured by DLFNS alone. The significantly greater lateral than medial anterior tibial subluxation suggests increased tibial internal rotation in ACL-injured knees, independent of ALL injury status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, cross-sectional study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146400","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}