Journal of Experimental Orthopaedics最新文献

{"title":"Simultaneous bilateral total knee arthroplasty with and without patellar resurfacing using a zirconium ceramic femoral component demonstrated equivalent short-term outcomes: A prospective randomised clinical trial.","authors":"Hiroki Katagiri, Hideyuki Koga, Ryusuke Saito, Yusuke Nakagawa, Tomomasa Nakamura, Ichiro Sekiya, Toshifumi Watanabe","doi":"10.1002/jeo2.70436","DOIUrl":"https://doi.org/10.1002/jeo2.70436","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal management of the patella during total knee arthroplasty (TKA) has not been updated with the development of prosthesis. The purpose of this prospective randomised clinical trial was to compare the physical findings and patient-reported outcome measures between knees with patellar resurfacing and those without patellar resurfacing in the same patients undergoing simultaneous bilateral TKA using a contemporary zirconium ceramic femoral component.</p><p><strong>Methods: </strong>Forty patients (80 knees) scheduled for simultaneous bilateral primary TKA due to osteoarthritis received patellar resurfacing on one side knee indicated by randomisation (either left or right) and patellar non-resurfacing on the opposite side. A posterior-stabilised prosthesis with the contemporary zirconium ceramic patella-friendly femoral component (ACTIYAS Kyocera, Kyoto, Japan) was used with the measured resection technique with mechanical alignment in all cases. All patients were followed for a minimum of 2 years. Knee Society knee score and function score, the 2011 Knee Society score, numerical rating scale for pain, patient overall assessment of the knee (0 being \"worst\"-100 being \"normal\"), and symptom around the patella were compared between the two groups.</p><p><strong>Results: </strong>There were no significant differences in postoperative objective knee indicators, postoperative patient-reported outcome measures, and postoperative examination of the patellofemoral joint between the knees that received patellar resurfacing and patellar non-resurfacing, without baseline differences. Patient overall assessment of the knee averaged 86.3 in the patella resurfacing group while 84.2 in the non-resurfacing group (<i>p</i> = 0.142). Objective knee indicators and the patient-reported outcome measures increased significantly after surgery in both groups. Secondary resurfacing and reoperation were not required for any patellar resurfacing or non-resurfacing knees.</p><p><strong>Conclusion: </strong>Excellent physical findings and patient-reported outcome measures were observed following TKA with the contemporary zirconium ceramic femoral component, regardless of whether patellar resurfacing was performed, in the short term.</p><p><strong>Level of evidence: </strong>Level II, lower quality randomised trials.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 4","pages":"e70436"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245357","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":"Physeal-sparing anterior cruciate ligament reconstruction provides better initial joint biomechanics than complete transphyseal reconstruction in an early adolescent porcine model.","authors":"Yukun Zhang, Kaan Gurbuz, Logan Opperman, Jeffrey T Spang, Matthew B Fisher","doi":"10.1002/jeo2.70289","DOIUrl":"https://doi.org/10.1002/jeo2.70289","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare initial joint kinematics and tissue forces following complete transphyseal, partial transphyseal and physeal-sparing anterior cruciate ligament (ACL) reconstruction (ACLR) in an early adolescent porcine model.</p><p><strong>Methods: </strong>Eighteen early adolescent porcine knees were tested using a six-degree-of-freedom robotic testing system at 40° and 60° of flexion. An 80 N anterior-posterior (AP) force, 120 N compression force and 4 N m varus-valgus torque were applied to the tibia in intact, ACL transected and ACLR states. Complete transphyseal, partial transphyseal, and physeal-sparing surgical techniques were performed (<i>n</i> = 6 legs/technique). Kinematics under applied loads were recorded to assess joint stability and compared across each state. Individual tissue forces were calculated using the principle of superposition. For comparisons between surgical techniques, both joint stability and tissue forces were normalized to intact control data from the same joints.</p><p><strong>Results: </strong>At 40° of flexion, the increase in AP tibial translation following physeal-sparing ACLR was 3.8 mm smaller than the complete transphyseal (<i>p</i> = 0.02). Under anterior tibial loading, the anterior force taken by the reconstructed ACL graft significantly decreased similarly following reconstruction by each technique, which shifted to the medial collateral ligament (MCL). The increase in anterior MCL forces following complete transphyseal reconstruction was 283% higher than that after physeal-sparing reconstruction (<i>p</i> = 0.04). Under valgus torque, the change in compression force in the lateral meniscus following physeal-sparing reconstruction was 82% smaller than that after partial transphyseal reconstruction (<i>p</i> = 0.02). At 60° of flexion, the average increase in ATT under compression following partial transphyseal and physeal-sparing reconstruction was 5.0 and 6.9 mm smaller than following complete transphyseal reconstruction (<i>p</i> ≤ 0.001 for each).</p><p><strong>Conclusion: </strong>In early adolescent porcine joints, the physeal-sparing technique led to better initial joint stability with less anterior force shifted to the MCL compared to the complete transphyseal technique.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 4","pages":"e70289"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245431","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 novel handheld wireless robot for total knee arthroplasty: Early experiences and clinical results","authors":"Alexander P. Sah,&nbsp;James L. Womack,&nbsp;Yair D. Kissin,&nbsp;Eytan M. Debbi,&nbsp;Trevor R. Cotter","doi":"10.1002/jeo2.70444","DOIUrl":"10.1002/jeo2.70444","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The percentage of total knee arthroplasty (TKA) performed robotically (rTKA) is rising exponentially. While this technique has well-established accuracy improvements, there are mixed patient-reported outcome measure (PROM) benefits compared to manual TKA (mTKA). Potential challenges in workflow, restricted implant compatibility to the robot and system cost have limited robotic adoption. A new robot seeks to address these and other rTKA concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single surgeon retrospective series of the first 25 rTKA cases performed with a novel, wireless, handheld, open-implant robot and 25 mTKA cases. Data were recorded to observe performance and safety outcomes, including X-ray-based hip-knee-ankle (HKA) angle measurements, adverse events (AEs), range of motion (ROM), and PROMs including pain and knee society score (KSS). Case times for a subset of cases were recorded. rTKA cases were completed with implants not previously used by the surgeon. mTKA cases used implants and instrumentation standard to the surgeon's practice. Patients were tracked up to 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>rTKA and mTKA cases both yielded positive clinical results. There were 0/25 HKA angle outliers (&gt;3° from plan) and 1/25 outliers in the rTKA and mTKA cohorts, respectively. No AEs were observed in either group at follow-up. rTKA case times were similar to mTKA by case 5, with rTKA setup under 8 min for most cases. There were no differences in ROM or PROMs between cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>rTKA preliminarily showed safe and effective outcomes in early results. Surgeon and staff adoption showed minimal hurdles at this institution, as rTKA case with an implant system new to the surgeon were similar within five cases to mTKA case times using an implant system known to the surgeon, with comparable clinical results. This initial experience suggests the system may offer a more accessible alternative to existing robotic options, though further study is needed.</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 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201618","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":"Refining patient education on autologous chondrocyte implantation for chondral lesions of the knee: A fine-tuned ChatGPT-4o model improves readability and quality","authors":"Maha Alsadaan,&nbsp;Stephen Fahy,&nbsp;Danko Dan Milinkovic,&nbsp;Benjamin Bartek,&nbsp;Tobias Winkler,&nbsp;Tobias Jung,&nbsp;Stephan Oehme","doi":"10.1002/jeo2.70445","DOIUrl":"https://doi.org/10.1002/jeo2.70445","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;Autologous chondrocyte implantation (ACI) is a complex procedure for cartilage defects, requiring patient understanding of treatment and recovery, as health literacy impacts outcomes. This study evaluated the quality and readability of AI-generated ACI materials using ChatGPT-4o as adjuncts to physician-led education. We compared responses from the native model and a fine-tuned version and hypothesised that the fine-tuned model would provide improved quality and readability.&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;Twenty-two frequently asked questions were identified using Google's ‘People Also Asked’ feature. Two ChatGPT-4o configurations were evaluated: the native model and a fine-tuned version (ACI guide) optimised by instruction-based fine-tuning and reinforcement learning from human feedback. Two orthopaedic surgeons independently scored the responses. Quality was assessed using the DISCERN criteria and readability by the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). Interrater reliability was determined using intraclass correlation coefficient (ICC) in a two-way mixed-effects model.&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 fine-tuned ACI Guide outperformed the native ChatGPT-4o on all parameters. The native model produced poor-quality responses with a mean DISCERN score of 35.29 ± 5.0 (range: 23–45), while the ACI Guide achieved a significantly higher score of 43.18  ± 3.92 (range: 34–53; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), reflecting moderate quality. Regarding readability, the native model reached FKGL of 13.45 ± 1.30 (university sophomore level)&lt;b&gt;.&lt;/b&gt; In contrast, the ACI Guide achieved FKGL of 9.25 ± 1.64 (9th-grade level). The FRES was also significantly higher for the ACI Guide (49.59 ± 10.44) than the native model (35.68 ± 5.08; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Interrater reliability was strong (ICC = 0.767), indicating good agreement.&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;ChatGPT-4o's responses were of poor quality and written at a readability level substantially exceeding recommended thresholds for patient education materials, limiting their applicability in clinical communication and patient education. Fine-tuning ChatGPT-4o improved the readability and quality of ACI patient education materials, generating content closer to the 8th–9th-grade level. It may serve as a useful adjunct to physician-led education in enhancing patient understanding of complex orthopaedic procedures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 ","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146629","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":"Validity of a wireless instrumented insole (WalkinSense system) for measuring gait metrics","authors":"Melanie Eckelt,&nbsp;Jennifer Fayad,&nbsp;Anne Backes,&nbsp;Gaëlle Schurmans,&nbsp;Frederic Garcia,&nbsp;Bernd Grimm,&nbsp;Valeria Serchi,&nbsp;Tobias Meyer,&nbsp;Thomas Solignac,&nbsp;Caroline Mouton,&nbsp;Romain Seil,&nbsp;Laurent Malisoux","doi":"10.1002/jeo2.70438","DOIUrl":"https://doi.org/10.1002/jeo2.70438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Gait analysis has become a valuable tool in assessing abnormal gait patterns and quantifying improvements resulting from interventions, particularly in the rehabilitation of orthopaedic patients. Wearables can measure gait metrics in daily life settings, but they must first be validated before being applied in such contexts. This study aims to assess the validity of a wireless instrumented insole (WalkinSense).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Recordings of 104 healthy participants were obtained at various speed and slope conditions (3 km/h, 4.5 km/h [−3°, −6°, +3° and +6°], 6 km/h and 9 km/h). Spatiotemporal and kinematic variables were collected simultaneously with an instrumented treadmill, a three-dimensional motion capture system and with the WalkinSense system. Mean bias between the systems was assessed using separate Bland–Altman analyses for each metric and condition. Mean error and limits of agreement (absolute and percentage) were calculated and the agreement was statistically quantified using a priori set thresholds (excellent &lt;5%, good &lt;10%, acceptable &lt;15% and poor &gt;15%). MAPE scores and a two-way mixed model intraclass correlation coefficient (ICC) for consistency were also calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All spatiotemporal variables (except double support time) showed good or excellent agreement, MAPE scores lower than 5% and ICC values &gt; 0.88 in the walking speeds. Data collected with the WalkinSense system showed acceptable or good agreement for the spatiotemporal variables in running. Kinematic variables showed only poor agreements across all speeds and slopes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest that the WalkinSense system may be useful to quantify spatiotemporal variables with good to excellent accuracy across various walking speeds. However, based on the results of this study indicate that the WalkinSense system is not suitable for measuring kinematic variables without substantial improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, diagnostic studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146828","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":"Even minor concomitant meniscus injuries are associated with posttraumatic osteoarthritis 15 years after anterior cruciate ligament reconstruction","authors":"Padmini Naga Karamchedu,&nbsp;Anika N. Breker,&nbsp;Meggin Q. Costa,&nbsp;Gary J. Badger,&nbsp;Paul D. Fadale,&nbsp;Michael J. Hulstyn,&nbsp;Robert M. Shalvoy,&nbsp;Holly C. Gil,&nbsp;Tannin A. Schmidt,&nbsp;Braden C. Fleming","doi":"10.1002/jeo2.70440","DOIUrl":"https://doi.org/10.1002/jeo2.70440","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim was to evaluate the associations between baseline variables on the development of a symptomatic knee and imaging evidence of posttraumatic osteoarthritis (PTOA) 15 years after anterior cruciate ligament (ACL) surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 42 subjects enroled in the Tension Trial (NCT00434837) were evaluated at 15-year follow-up. Patient sex, meniscus injury, preoperative patient-reported outcomes (Knee Osteoarthritis Outcome Score [KOOS] function sports and recreation subscore [KOOS-sport], Short Form [SF]-36 mental health score), initial graft tension, and subsequent ACL surgery were evaluated to identify patients with a symptomatic knee using KOOS criteria (KOOS-Quality of life ≤87.5 and with at least two other subscores meeting the following thresholds (i.e., KOOS-Pain ≤86.1, KOOS-Symptoms ≤85.7, KOOS-Activities of daily living ≤86.8 and KOOS-Sport ≤85.0) and imaging evidence of PTOA (Osteoarthritis Research Society International [OARSI] radiographic score and Whole-Organ Magnetic Resonance Imaging Score [WORMS]) 15 years post-surgery using stepwise regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The presence of a baseline meniscus tear was associated with a seven-fold increase (<i>p</i> = 0.03) in odds for a symptomatic knee at 15 years. A higher preoperative KOOS-sport was associated with a decreased occurrence of a symptomatic knee (<i>p</i> = 0.06). A higher KOOS-sport and the presence of a meniscus tear at baseline were associated with a greater OARSI difference score (<i>p</i> = 0.03 and <i>p</i> = 0.05, respectively) 15 years after ACL reconstruction. The presence of the baseline meniscus tear was associated with a higher WORMS (<i>p</i> = 0.07) 15 years after ACL reconstruction. All other variables were not significant predictors, though loss to follow-up was over 50%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The presence of a minor meniscus injury was associated with a higher occurrence of a symptomatic knee and imaging evidence of posttraumatic osteoarthritis 15 years after ACL reconstruction. Furthermore, a higher preoperative KOOS-sport was associated with decreased occurrence of a symptomatic knee. Further studies are required to elucidate the associations of KOOS-sport with imaging PTOA.</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 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146826","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":"High prevalence of femoral and tibial torsional abnormalities in female patients with anterior knee pain resistant to conservative treatment: A CT-based study","authors":"Vicente Sanchis-Alfonso,&nbsp;Cristina Ramírez-Fuentes,&nbsp;Erik Montesinos-Berry,&nbsp;Julio Doménech-Fernández","doi":"10.1002/jeo2.70446","DOIUrl":"https://doi.org/10.1002/jeo2.70446","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess acetabular version (AV) and to determine the prevalence of femoral and tibial torsional abnormalities in female patients with anterior knee pain (AKP) unresponsive to conservative treatment. The study also aimed to evaluate the prevalence of combined abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-three AKP female patients resistant to conservative treatment evaluated between 2013 and 2024 were included. Torsional computed tomography (CT) of the lower limbs was performed on all cases, resulting in the evaluation of 146 limbs. Femoral anteversion (FAV) was measured using Murphy's method, external tibial torsion (ETT) using Jend's technique and AV using the method described by Tönnis and Heinecke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Torsional abnormalities were highly prevalent. Only 13.0% of limbs had normal ETT, 43.2% showed moderate abnormalities and 43.8% severe abnormalities. FAV was within normal limits in 48.6% of cases, while 26.7% had moderate anteversion, 22.6% severe anteversion and 2.1% retroversion. AV was normal in 82.9% of limbs, with 13.7% showing retroversion and 3.4% anteversion. Only 4.1% of patients exhibited normal across all three parameters, while 8.2% presented combined abnormalities. The most common paired association was observed for ETT and FAV (35.6%). Chi-squared analyses did not reveal statistically significant associations among the degrees of deformity. Pearson correlation analysis showed a weak but statistically significant correlation between ETT and FAV (<i>r</i> = 0.176, <i>p</i> = 0.034).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In young female patients with AKP unresponsive to conservative treatment, assessment of femoral and tibial torsion using CT imaging should be systematically considered. This approach is essential for guiding clinical decision-making. The range of possible torsional abnormalities highlights the importance of patient-specific evaluation.</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 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146827","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":"Evaluating drill speed effects on tunnel diameter in ACL reconstruction: Insights from an experimental animal study","authors":"Jamil Alasov,&nbsp;Nelo João Zeca Chihal Lima,&nbsp;Mehmet Erduran","doi":"10.1002/jeo2.70406","DOIUrl":"10.1002/jeo2.70406","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine how drilling speeds affect tunnel enlargement during cruciate ligament reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve adult female New Zealand rabbits, each weighing between 3 and 3.5 kg, were randomly assigned to two groups based on drilling speeds (400 RPM and 1500 RPM). Following sedation, the knee and tibia regions were shaved, and the knee joint was accessed using a medial parapatellar approach. The anterior cruciate ligament (ACL) was incised using a scalpel. Tibial and femoral tunnels were drilled with a 2 mm blunt-tip drill at the assigned group speeds. Room temperature saline was used for irrigation throughout the drilling procedure. An extensor tendon graft was harvested from the anterior cruris and sutured using the Krakow technique with 4-0 Vicryl. The graft was passed through the tunnel and secured to a pre-placed screw near the tunnels. Post-surgery, the operated extremity was not immobilised, and the rabbits were observed while moving freely within the cage. Twelve weeks post-operatively, the animals were humanely euthanized, and micro-computed tomography (CT) was employed to assess the diameters of the femoral and tibial tunnels at the proximal, middle and distal regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No statistically significant differences were found between radiological femoral and tibial tunnel diameter measurements of the 400 and 1500 RPM drilling groups 12 weeks after arthroscopically assisted ACL reconstruction in New Zealand rabbits. However, within the 400 RPM group, there was a measurable increase in the tunnel diameter in the proximal tibia and distal femur regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of our study suggest that concerns about higher drilling speeds in ACL surgery may be overstated, as higher speeds did not lead to significant radiological tunnel enlargement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145122639","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":"Superior long-term stability and function associated with femoral cortical button versus interference screw fixation in ACL reconstruction: A systematic review and meta-analysis","authors":"Jonathan Elias,&nbsp;Mitchell Kaplan,&nbsp;Michael Bickford,&nbsp;Thomas Oliver,&nbsp;Kunal Shah,&nbsp;Elizabeth Ford,&nbsp;Sean McMillan","doi":"10.1002/jeo2.70439","DOIUrl":"10.1002/jeo2.70439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There are two main methods of femoral graft fixation during anterior cruciate ligament reconstruction (ACLR): cortical button (CB) and interference screws (IS). Each fixation yields its own unique outcomes; however, there is yet to be an established gold standard. We seek to compare femoral CB to IS fixation in ACLR using all soft-tissue, autograft hamstring grafts. We hypothesise that there will be 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. PubMed, Cochrane, Embase, Web of Science and Scopus were screened for potential randomised studies. The studies must have utilised both the semitendinosus and gracilis, and utilised either metallic or bioabsorbable IS, or fixed or adjustable loop CB fixation on femoral fixation. All studies in both groups must have used interference screws on the tibial side. The 2-year follow-up analysed KT-1000 side-to-side differences, while the 5–10 year follow-up compared Lysholm and Tegner scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 randomised studies were included in the final systematic review, providing an evaluation of 583 distinct patients. Two of the studies were excluded from the meta-analysis, due to not providing pre- and post-operative means and standard deviations. At 2-year and 5-10 year follow-ups, the mean ages were 30.5 ± 8.7 and 30.2 ± 8.1, respectively. Analysis of the 2-year follow-up favour of CB (<i>p</i> = 0.01) in regards to the reduction in KT-1000 side-to-side differences. Analysis of the 5–10 year follow-up revealed favour of CB in regards to the Lysholm Score (<i>p</i> &lt; 0.01), and the Tegner Score (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At 2-years postoperatively, femoral fixation utilising cortical buttons portrayed less knee laxity than interference screws. At the 5–10 year follow-up, cortical buttons yielded more sports and work-related activity, less pain, and overall greater function than did the interference screws.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145122642","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":"Similar results with quadrupled semitendinosus and semitendinosus-gracilis graft in anterior cruciate ligament reconstruction: A randomised controlled trial with 2-year follow-up","authors":"Juan P. Martinez-Cano,&nbsp;Alejandro Gallego,&nbsp;Janio Cuadros,&nbsp;Laura Ibarra,&nbsp;Fernando M. Mejía,&nbsp;María V. Velasquez-Hammerle,&nbsp;Alfredo Martinez-Rondanelli","doi":"10.1002/jeo2.70399","DOIUrl":"https://doi.org/10.1002/jeo2.70399","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>to compare quadrupled semitendinosus (STx4) with semitendinosus-gracilis graft in anterior cruciate ligament (ACL) reconstruction surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Parallel randomised controlled trial with two groups of treatment (<i>n</i> = 42) in primary ACL reconstruction surgery. Follow-up during 2 years after surgery with visits at 3, 6, 12 and 24 months. Primary outcome: quadriceps and hamstrings strength in newtons (N). Secondary outcomes: ACL re-rupture, additional surgeries, return to sport and patient-reported outcomes (PROMs): knee injury and osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) and Tegner-Lysholm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was 1/21 ACL re-rupture for STx4 and 2/21 for the control group (<i>p</i> = 0.9). One additional surgery for each group: ACL revision (control group) and meniscectomy (STx4). There were no other complications and no differences in PROMs between grafts, except for Tegner-Lysholm at 3 months, that favoured the STx4 group (76.0, confidence interval [CI]: 56.0–86.0 vs. 85.0, CI: 77.0–93.0), <i>p</i> = 0.04. The median surgery satisfaction was good in both groups STx4 (95%, interquartile range (IQR): 90%–98%) and ST-G (98%, IQR: 95%–100%) (<i>p</i> = 0.13). Return to sport was 90% (<i>n</i> = 19) for the STx4 group and 81% (<i>n</i> = 17) for the ST-G group (<i>p</i> = 0.37). Quadriceps strength recovered sooner (6 months) than hamstrings (24 months) in both groups. There were no statistically significant differences in strength between STx4 and ST-G at final follow-up (hamstrings in flexion [mean ± SD]: 173 ± 53 N vs. 166 ± 51 N, <i>p</i> = 0.7; hamstrings in extension: 204 ± 61 N vs. 199 ± 64 N, <i>p</i> = 0.8; quadriceps in flexion: 217 ± 42 N vs. 209 ± 47 N, <i>p</i> = 0.6; quadriceps in extension: 193 ± 51 N vs. 191 ± 46 N, <i>p</i> = 0.9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found no statistically significant differences at 2 years between a STx4 and a ST-G graft configuration for primary ACL reconstruction regarding strength, PROMs, return to sport, failure rates and complications; larger studies are required to confirm noninferiority. Clinical Trials number: NCT03433170.</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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146406","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}