Journal of Experimental Orthopaedics最新文献

{"title":"Artificial intelligence demonstrates potential to enhance orthopaedic imaging across multiple modalities: A systematic review","authors":"Umile Giuseppe Longo, Alberto Lalli, Guido Nicodemi, Matteo Giuseppe Pisani, Alessandro De Sire, Pieter D'Hooghe, Ara Nazarian, Jacob F. Oeding, Balint Zsidai, Kristian Samuelsson","doi":"10.1002/jeo2.70259","DOIUrl":"https://doi.org/10.1002/jeo2.70259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>While several artificial intelligence (AI)-assisted medical imaging applications are reported in the recent orthopaedic literature, comparison of the clinical efficacy and utility of these applications is currently lacking. The aim of this systematic review is to evaluate the effectiveness and reliability of AI applications in orthopaedic imaging, focusing on their impact on diagnostic accuracy, image segmentation and operational efficiency across various imaging modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on the PRISMA guidelines, a comprehensive literature search of PubMed, Cochrane and Scopus databases was performed, using combinations of keywords and MeSH descriptors ('AI', 'ML', 'deep learning', 'orthopaedic surgery' and 'imaging') from inception to March 2024. Included were studies published between September 2018 and February 2024, which evaluated machine learning (ML) model effectiveness in improving orthopaedic imaging. Studies with insufficient data regarding the output variable used to assess the reliability of the ML model, those applying deterministic algorithms, unrelated topics, protocol studies, and other systematic reviews were excluded from the final synthesis. The Joanna Briggs Institute (JBI) Critical Appraisal tool and the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool were applied for the assessment of bias among the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 53 included studies reported the use of 11.990.643 images from several diagnostic instruments. A total of 39 studies reported details in terms of the Dice Similarity Coefficient (DSC), while both accuracy and sensitivity were documented across 15 studies. Precision was reported by 14, specificity by nine, and the F1 score by four of the included studies. Three studies applied the area under the curve (AUC) method to evaluate ML model performance. Among the studies included in the final synthesis, Convolutional Neural Networks (CNN) emerged as the most frequently applied category of ML models, present in 17 studies (32%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The systematic review highlights the diverse application of AI in orthopaedic imaging, demonstrating the capability of various machine learning models in accurately segmenting and analysing orthopaedic images. The results indicate that AI models achieve high performance metrics across different imaging modalities. However, the current body of literature lacks comprehensive statistical analysis and rand","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914385","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":"Cementless unicompartmental knee arthroplasty is safe and effective at a minimum follow-up of 4.2 years: A systematic review","authors":"Pierangelo Za,&nbsp;Giuseppe Francesco Papalia,&nbsp;Umberto Cardile,&nbsp;Pietro Gregori,&nbsp;Sebastiano Vasta,&nbsp;Edoardo Franceschetti,&nbsp;Stefano Campi,&nbsp;Rocco Papalia","doi":"10.1002/jeo2.70253","DOIUrl":"https://doi.org/10.1002/jeo2.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Cemented unicompartmental knee arthroplasty (UKA) is a widely used procedure in the treatment of anteromedial and lateral knee osteoarthritis. However, several advantages are reported for cementless UKA, such as improved osseointegration, reduced cement-related costs and complications. The aim of this study was to analyse clinical outcomes, survival, complications, failures and revision rate of cementless UKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was performed on 31 May 2024, on PubMed, Cochrane Library and Scopus. We included randomised clinical trials and prospective and retrospective studies reporting clinical outcomes, implant survival, complications, failures and revision rates of cementless UKA. The following data were extracted: study design, type of implant, number of patients and knees, follow-up, age, sex, pre-operative and post-operative clinical outcomes, reoperations and revisions with causes of failure and overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies were included, involving 3475 patients and 3641 UKA (2568 cementless UKA and 854 cemented UKA). The mean patients' age was 66 years. The mean follow-up was 6.5 years. The Oxford Knee Score improved from 17.8 preoperatively to 40.3 post-operatively in cementless UKA. Knee Society Score improved from 118.2 preoperatively to 168.6 post-operatively in cementless UKA. The reoperation rate was 3.85% for cementless UKA and 9% for cemented UKA. The most common causes of revision were osteoarthritis progression (1.4%), aseptic loosening (0.8%), bearing dislocation and unexplained pain (0.7%). The overall survival of cementless UKA was 96.2% and 93.6% at 5 and 10 years, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cementless UKA is a viable alternative to cemented UKAs with a low failure rate, without a lower clinical benefit at a minimum follow-up of 4.2 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, systematic review of studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914608","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":"Clinical outcomes following medial meniscus posterior root repairs: A minimum of 5-year follow-up study","authors":"Yuki Okazaki,&nbsp;Kazuhisa Sugiu,&nbsp;Yusuke Kamatsuki,&nbsp;Masanori Tamura,&nbsp;Koki Kawada,&nbsp;Tsubasa Hasegawa,&nbsp;Takayuki Furumatsu","doi":"10.1002/jeo2.70262","DOIUrl":"https://doi.org/10.1002/jeo2.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study assessed the clinical outcomes of the FasT-Fix dependent modified Mason-Allen suture (F-MMA) and two simple stitches (TSS) on mid-term postoperative outcomes following medial meniscus (MM) posterior root repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-three patients who underwent transtibial pullout repair for MM posterior root tear (PRT) between November 2016 and September 2018 were initially enrolled. Patients with a femorotibial angle ≤ 180°, Kellgren–Lawrence grade of 0–2, and modified Outerbridge grade I or II cartilage lesions were included. The Lysholm, Tegner activity, International Knee Documentation Committee score, pain visual analogue scale and Knee injury and Osteoarthritis Outcome scores were assessed as clinical outcomes. Conversion surgery to knee arthroplasty was considered as the endpoint. Surgeries other than second-look arthroscopy and plate or screw removal were also recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean follow-up period was 5.9 years. All evaluated 5-year postoperative clinical outcomes were significantly improved compared to the preoperative outcomes (<i>p</i> &lt; 0.001). Both the F-MMA and TSS significantly improved all clinical scores at 5 years postoperatively in patients with MMPRT, whereas the F-MMA and TSS groups showed no significant differences in the pre- and postoperative clinical scores. None of the patients required ipsilateral knee arthroplasty during the follow-up, and the survival rate after pullout repair was 100%. However, the progression of osteoarthritis could not be completely suppressed, although there were no Kellgren–Lawrence grade 4 cases. The rate of subsequent knee-related surgical treatment was 11.6% in pullout-repaired knees, including arthroscopic debridement for arthrofibrosis with a limited range of motion, an additional all-inside suture repair and partial meniscectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both F-MMA and TSS pullout repairs yielded satisfactory clinical outcomes in patients with MMPRT with a mean follow-up of 5.9 years, and no conversion to knee arthroplasty was required. Further follow-up is warranted to assess long-term survival rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914386","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":"Exploring the role of directly coupled alternating electric fields on chondrocyte morphology and redifferentiation capacity with a focus on sex differences","authors":"Zezhong Song,&nbsp;Vivica Freiin Grote,&nbsp;Franziska Sahm,&nbsp;Julius Zimmermann,&nbsp;Christoph Lutter,&nbsp;Anika Jonitz-Heincke,&nbsp;Rainer Bader","doi":"10.1002/jeo2.70261","DOIUrl":"https://doi.org/10.1002/jeo2.70261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In cell-based therapies addressing articular cartilage lesions, a central challenge is to avoid the formation of fibrous cartilage resulting from dedifferentiation processes. Electrical stimulation emerges as a promising approach for promoting chondrocytic redifferentiation. This study investigated the effects of varying electric fields on morphological changes and the redifferentiation capacity of human chondrocytes with regard to alterations in sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Chondrocytes, isolated from the articular cartilage of male and female patients undergoing total knee replacement, were exposed to alternating electric fields of varying strengths ranging from 0.8 to 1.2, 15 to 20 and 100 to 140 V/m. Afterwards, cell morphology and viability, as well as the deposition of collagen (Col) 1 and 2, were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following electrical stimulation, in particular at 15–20 V/m, an increase in the Col2/Col1 ratio and an elevated proportion of rounded, chondrocyte-like cell morphology were observed, indicating a promoting effect on the redifferentiation of chondrocytes. Comparative analysis between both sexes revealed that chondrocytes from female donors exhibit higher Col1 synthesis rates, a decreased Col2/Col1 ratio, and a higher proportion of elongated, fibroblast-like cells compared to chondrocytes derived from male donors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our in vitro study suggests that chondrocytes from male donors are more prone to re-differentiate after electrical stimulation.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908976","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":"Reconstruction of the anterior cruciate ligament using the Press-Fit-Hybrid technique—A cohort study with an up to 10-year follow-up","authors":"Niko Schauer,&nbsp;Martin Fischer,&nbsp;Rejane Golbach,&nbsp;David A. Groneberg,&nbsp;Fabian Holzgreve,&nbsp;Daniel Niederer,&nbsp;Daniela Ohlendorf,&nbsp;Adalbert Missalla","doi":"10.1002/jeo2.70257","DOIUrl":"https://doi.org/10.1002/jeo2.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To examine the long-term results of the Press-Fit-Hybrid fixation technique in anterior cruciate ligament (ACL) reconstruction on self-reported knee function, sport ability, return to sport (RTS) success, quality of life and re-rupture rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults with ACL rupture which was reconstructed between 2011 and 2013 using the Press-Fit-Hybrid fixation technique were included. Participants completed questionnaires before surgery and at 6-month, 1-year, 2-year, 3-year and 10-year follow-ups. Subjective knee function was self-reported using the International Knee Documentation Committee (IKDC) and Lysholm scores. The level of sport activities was assessed using the Tegner Activity Scale (TAS), and quality of life was evaluated with the Knee injury and Osteoarthritis Outcome Score Quality of Life subscale (KOOS-QoL). RTS success rates were categorised into return to participation, RTS and return to performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (<i>N</i> = 135) (81 males, 54 females; aged 32.3 years [SD 11.7]) were included. Mean scores at 2, 3 and 10 years were for IKDC 87.6 (SD 10.5), 89.2 (SD 11.0) and 86.5 (SD 14.8), while for Lysholm 92.1 (SD 8.4), 93.3 (SD 7.8) and 90.6 (SD 12.3). The KOOS-QoL averaged 80.4; 70.0% scored above 80.0. After 3 years, 73% returned to their pre-injury TAS-level; 52% still performed at the pre-injury level after 10 years. Average return to participation was within 5.9 months. 96% returned to sport within 9.6 months on average. 72% returned to performance within a mean of 12.2 months. Re-rupture rates were 2.85% in the first 3 years and 5% between 3 and 10 years post-surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Press-Fit-Hybrid leads to low re-rupture and high RTS rates, restoring knee functionality and improved quality of life. Preliminary results need validation in a randomised controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908977","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":"Tibial tubercle torsion is associated with patellar height when measured by computed tomography","authors":"Joseph D. Giusto,&nbsp;Janina Kaarre,&nbsp;Yongji Kim,&nbsp;Jae-Sung An,&nbsp;Sally LiArno,&nbsp;Faizan Ahmad,&nbsp;Matthieu Ollivier","doi":"10.1002/jeo2.70258","DOIUrl":"https://doi.org/10.1002/jeo2.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To establish an average tibial tubercle (TT) torsion angle from computed tomography (CT) scans of patients without known patellofemoral instability and investigate whether TT torsion angles would differ based on demographics, tibial tubercle-trochlear groove (TT-TG) distance and patellar height.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Stryker Orthopaedics Modeling and Analytics (SOMA) database was queried for patients with CT scans and available measures related to patella and TT position. The mean TT torsion angle was compared in patients with an increased and normal TT-TG distance (≥20 vs. &lt;20 mm) and patellar height (Insall–Salvati [IS] index ≥1.3 vs. &lt;1.3). Measurements of sulcus angle, patellar inclination angle, congruence angle, trochlear groove depth and long limb axis alignment were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 886 knees from 499 patients within the SOMA database were included, with a mean age of 59.4 ± 16.5 years and 238 (48%) females. The mean TT torsion angle for all patients was 24.7 ± 5.2°. Females had a significantly higher mean IS index (1.24 vs. 1.18), TT-TG distance (13.8 mm vs. 11.8 mm) and TT torsion angle (25.5° vs. 24.0°) compared to males. The mean TT torsion angle for patients with a TT-TG distance ≥20 mm and &lt;20 mm was 24.7° in both groups (<i>p</i> = n.s.). There was a significantly greater TT torsion angle in patients with an IS index ≥1.3 (26.6°) compared to those with an IS index &lt;1.3 (24.0°) (<i>p</i> &lt; 0.001). A weak and positive correlation was found between TT torsion angle and IS index (<i>r</i> = 0.242, <i>p</i> &lt; 0.001), but not with other measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The mean TT torsion angle for patients without known patellofemoral instability was 24.7° and increased TT torsion angles were associated with increased patellar height. An association between TT torsion and TT-TG was not found. Findings of the current study describe the relationship between morphologic assessments of the patellofemoral joint using CT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908978","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":"Knee osteotomies significantly influence coronal ankle alignment: A radiographic analysis","authors":"Alessio Maione,&nbsp;Carlo Minoli,&nbsp;Matteo Davide Parmigiani,&nbsp;Martino Travi,&nbsp;Filippo Calanna,&nbsp;Daniele Marcolli,&nbsp;Riccardo Compagnoni,&nbsp;Paolo Ferrua,&nbsp;Massimo Berruto,&nbsp;Pietro Simone Randelli","doi":"10.1002/jeo2.70252","DOIUrl":"https://doi.org/10.1002/jeo2.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the effect of lateral closing-wedge high tibial osteotomy (LCW-HTO) and medial closing-wedge distal femoral osteotomy (MCW-DFO) on tibio-talar inclination (TTI) and Mikulicz lateral distal tibial angle (M-LDTA). We hypothesized that knee osteotomies significantly alter ankle coronal alignment by modifying TTI and distal tibial alignment in relation to the mechanical axis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective radiographic analysis was conducted on 60 knees from 52 patients (37 LCW-HTO and 23 MCW-DFO) treated between 2006 and 2020. Inclusion criteria included full-length weight-bearing radiographs pre- and post-operatively, no prior ipsilateral lower limb surgery, absence of shaft deformities or advanced ankle osteoarthritis (Takakura grade &gt;1), and age ≥16 years with ≥2 years of follow-up. Radiographic parameters measured included LDTA, hip-knee-ankle angle, M-LDTA and TTI, with ankle realignment quantified through differences between LDTA and M-LDTA and between pre- and post-operative TTI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the MCW-DFO group, the difference between LDTA and M-LDTA decreased from 3.5 ± 2.3° to 1.3 ± 1.1° (<i>p</i> &lt; 0.0001), indicating improved alignment. The LCW-HTO group showed a smaller but significant reduction from 4.5 ± 1.8° to 2.2 ± 1.7° (<i>p</i> &lt; 0.0001). TTI improved significantly in both groups, with a greater adjustment in MCW-DFO (ΔTTI = 7.0 ± 4.3°, <i>p</i> &lt; 0.01) compared to LCW-HTO (ΔTTI = 4.2 ± 2.7°, <i>p</i> &lt; 0.01). The difference between LDTA and TTI decreased in both groups, reflecting post-operative convergence of the mechanical and anatomical axes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Knee osteotomies significantly influence ankle coronal alignment, particularly modifying TTI and M-LDTA. Higher-level osteotomies (MCW-DFO) exert a greater effect on ankle alignment than LCW-HTO. Preoperative valgus or varus knee deformities must be carefully evaluated to anticipate post-operative ankle imbalance. Surgeons should assess full-length radiographs to prevent unintended malalignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

{"title":"Double-row suture-bridge technique does not yield better clinical and radiological results than single-row technique in patients older than 55 years at 2 years minimum follow-up: A comparative study","authors":"Vito Gaetano Rinaldi,&nbsp;Sassoli Iacopo,&nbsp;Federico Coliva,&nbsp;Antongiulio Favero,&nbsp;Alberto Bazzocchi,&nbsp;Marco Miceli,&nbsp;Stefano Di Paolo,&nbsp;Stefano Zaffagnini,&nbsp;Giulio Maria Marcheggiani Muccioli","doi":"10.1002/jeo2.70056","DOIUrl":"https://doi.org/10.1002/jeo2.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Arthroscopic rotator cuff repair has evolved, with suture anchor-based techniques like single-row (SR) and Double-row Suture-bridge (DRSB) gaining popularity. Despite improvements, early repair failures remain concerning, necessitating continued assessment of repair methods and devices' lasting impact. This study compares DRSB versus SR repairs at 24 months minimum follow-up, hypothesizing superior clinical outcomes and improved tendon healing with DRSB techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty patients with rotator cuff tears underwent either SR or DRSB repairs. Clinical evaluation included standardized scoring systems and strength testing. Magnetic Resonance Imaging (MRI) assessed tendon integrity. Partial cuff tears were evaluated according to Snyder's Southern California Orthopaedic Institute rotator cuff classification system, which classifies &lt;2 cm lesions as C2 in its scoring system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both groups showed comparable clinical outcomes, strength and MRI findings at 24 months minimum follow-up. No significant correlation was found between repair technique and clinical outcomes or retear rates. Preoperative Patte and Goutallier grades &gt;1 were associated with lower postoperative Constant–Murley scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that both SR and DRSB techniques offer comparable clinical outcomes and tendon healing rates for rotator cuff tears in patients over 55 at 24 months minimum follow-up. While limitations exist, our findings contribute to understanding optimal surgical approaches, emphasizing individualized treatment based on patient characteristics and surgeon expertise. Further research, including randomized controlled trials with long-term follow-up, is needed to refine treatment algorithms and improve patient outcomes in rotator cuff surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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