Journal of Experimental Orthopaedics最新文献

{"title":"Optimizing operating room efficiency in robotic-assisted total knee arthroplasty through manufacturing efficiency principles","authors":"Akito Hiraoka,&nbsp;Bart Swinnen,&nbsp;Aline Vandeputte,&nbsp;Willem Franssen,&nbsp;Geert Leirs","doi":"10.1002/jeo2.70283","DOIUrl":"https://doi.org/10.1002/jeo2.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Recent studies have explored the application of manufacturing efficiency principles as a framework for improving operating room (OR) throughput, quality of care and patient outcomes. However, these principles have not yet been validated with real-world research data. In this study, we investigated whether applying these principles has an impact on the operational excellence and teams' consistency of robotic-assisted total knee arthroplasty (RATKA) procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 31 patients, divided over eight surgery days, were included in the study. The aim of the study was to answer the research question: ‘Does applying efficiency principles have an impact on the operational excellence of RATKA surgery?’ The efficiency of the procedures was monitored using the artificial intelligence (AI)-enabled camera application and analyzed utilizing an AI-backed process digital twin platform. Normally distributed continuous variables were compared using the independent <i>t</i> test. Equality of variances was assumed using the Levene's test for equality of variances. Non-normally distributed continuous variables were analyzed using the Mann–Whitney <i>U</i> test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After analyzing the baseline group, four procedural modifications were implemented according to the lean principles. There was a significant difference in preparation time (mean difference = 4.3, 95% confidence interval = 1.3–7.3, <i>p</i> = 0.007), showing the efficiency gain during preparation after efficiency implementation. The number of sets opened per case was reduced from ten to seven sets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings indicate that better OR preparation, consistent staff allocation and effective staff training can reduce surgical times, minimize waste and improve OR throughput. Addressing primary constraints, parallelizing flows and breaking down processes decreases surgical wait times, enhances patient flow and streamlines OR operations.</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":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135577","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":"Robotic-assisted hip and knee revision arthroplasty: A scoping review","authors":"Michele Venosa,&nbsp;Giandomenico Logroscino,&nbsp;Emilio Romanini,&nbsp;Gianpiero Cazzato,&nbsp;Giuseppe Petralia,&nbsp;Andrea Vespasiani,&nbsp;Giacomo Placella,&nbsp;Patrizio Caldora","doi":"10.1002/jeo2.70285","DOIUrl":"https://doi.org/10.1002/jeo2.70285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Technological advances have significantly revolutionised orthopaedic surgery over the past decades. The introduction of robotic-assisted (RA) systems in total joint arthroplasty (TJA) surgery, especially in total hip arthroplasty (THA) and total knee arthroplasty (TKA), represents a key innovation. While the advantages of robotic assistance in primary joint replacement surgery are relatively well known, its application in hip and knee revision surgery implies a more complex and challenging scenario. The procedures needed are inherently more difficult compared to primary arthroplasties because of considerable bone loss, scar tissue, compromised anatomical landmarks, and at times even damaged or eroded joint structures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review synthesises existing literature on the application of RA systems in revision hip and knee arthroplasty. A systematic search on the six major databases in September 2024 identified 24 eligible studies for inclusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although various studies and case reports have demonstrated the successful use of robotics in TJA surgeries, the existing body of literature concerning revision surgery is still limited, and many questions remain unanswered. While, for instance, robotic systems seem to have held some promise for better improvement in implant positioning and alignment, it is still quite unclear whether this development in technological advancement will translate into better long-term outcomes such as improved implant longevity and lower revision rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although early data are promising, having some possible short-term advantages, wide diffusion is limited because of high costs, significant training requirements, and limited long-term outcome data. By identifying gaps in the current literature and emphasising areas for future investigation, this review aims to define the ongoing development and refinement of RA applications in revision arthroplasty, ultimately seeking to determine whether these technologies can achieve sustainable improvements in implant longevity and patient satisfaction.</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":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135727","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 are becoming widely accepted and increasingly used, but rehabilitation techniques still vary widely between surgeons: A survey on current trends","authors":"Nicholas I. Kennedy,&nbsp;Nicholas N. DePhillipo,&nbsp;Luke V. Tollefson,&nbsp;Robert F. LaPrade","doi":"10.1002/jeo2.70270","DOIUrl":"https://doi.org/10.1002/jeo2.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this research survey was to report the current trends regarding the frequency, indications and techniques of knee osteotomies used in sports medicine practices over the past 5 years and during fellowship training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two Institutional Review Board-exempt anonymous surveys were electronically distributed between May 2023 and August 2023. A 19-question survey was sent to active members of the American Orthopaedic Society for Sports Medicine and European Society of Sports Traumatology, Knee Surgery and Arthroscopy societies and another 36-question survey was sent to orthopaedic sports medicine fellows near the end of their training. The surveys included questions regarding type and frequency of osteotomies performed, surgical indications, surgical techniques, preoperative planning and post-operative weight-bearing restrictions. Inclusion criteria were those who currently perform knee osteotomy surgery. Descriptive statistics were used for all comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 100 sports medicine surgeons and 26 sports medicine fellows participated in the survey. The most common type of osteotomy performed was a medial opening-wedge proximal tibial osteotomy for both surgeons (96%) and fellows (92%). The most used methods to assess coronal and sagittal alignment were long-leg radiographs (98% for surgeons) and lateral radiographs (66% for surgeons), respectively. Rehabilitation techniques varied between surgeons and fellows and depended on the technique, size of correction and hardware.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Osteotomies are becoming widely accepted as useful techniques to correct bony malalignment. Surgeons are increasing their use of osteotomies, and fellows in training are optimistic about the use of new technologies for osteotomy planning and execution. Trends suggest that osteotomies to correct varus and valgus malalignment for osteoarthritis are the most common, and rehabilitation techniques vary widely between surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135574","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":"Posterolateral tibial plateau impaction fractures in patients undergoing primary anterior cruciate ligament reconstruction—An MRI analysis of 556 cases","authors":"Andreas Fuchs,&nbsp;Spartak Ovsepyan,&nbsp;Andreas Frodl,&nbsp;Tayfun Yilmaz,&nbsp;Markus Siegel,&nbsp;Matthias Krause,&nbsp;Thomas Stein,&nbsp;Hagen Schmal,&nbsp;Kaywan Izadpanah","doi":"10.1002/jeo2.70284","DOIUrl":"https://doi.org/10.1002/jeo2.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Posterolateral impaction fractures of the tibial plateau are known to be associated with anterior cruciate ligament (ACL) tears. These fractures are often related to high energy pivoting injuries, which is why the frequency of such injuries is of key concern for patients undergoing primary ACL reconstruction. The objective of this study is to evaluate the occurrence of posterolateral tibial fractures, as well as concomitant injuries in patients undergoing primary ACL reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective case series was conducted to study the occurrence and type of posterolateral tibial impaction fractures in patients undergoing ACL reconstruction between October 2015 and October 2020. Patients records were reviewed to collect patient demographics, exact injury patterns and details about concomitant injuries. Descriptive statistics were performed to determine the incidence of each type of posterolateral tibial plateau impaction fracture, as well as concomitant injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 556 knees with primary ACL reconstruction, a total of 171 posterolateral tibial plateau impaction fractures were identified. 385 patients showed no fracture. Intraoperative arthroscopic examination showed lateral meniscus (LM) tears in 144 cases and medial meniscus (MM) tears in 163 cases. LM posterior root tears were found in 21 patients, MM posterior root tears in eight patients. Medial meniscal ramp lesions were found in a total of 39 knees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>30.8% of the patients showed posterolateral tibial plateau impression fractures, here LM tears were more frequent with the highest incidence in IIIB fractures. MM tears are more frequent in patients without posterolateral impaction fractures, while LM posterior root tears are more frequent than MM posterior root tears among the whole study population. The clinical relevance of this study lies in the exact analysis of posterolateral tibial plateau fractures in patients with ACL lesions, with the resulting therapeutic consequences dependent on the fracture type and concomitant injuries.</p>\u0000 \u0000 <p><b>Level of Evidence:</b> Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135575","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":"Variations in bone mineral density after joint replacement: A systematic review examining different anatomical regions, fixation techniques and implant design","authors":"Domenico Alesi,&nbsp;Raffaele Zinno,&nbsp;Maria Scoppolini Massini,&nbsp;Giuseppe Barone,&nbsp;Davide Valente,&nbsp;Erika Pinelli,&nbsp;Stefano Zaffagnini,&nbsp;Agostino Igor Mirulla,&nbsp;Laura Bragonzoni","doi":"10.1002/jeo2.70187","DOIUrl":"https://doi.org/10.1002/jeo2.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to evaluate postoperative periprosthetic bone mineral density (BMD) at various time points following joint replacement with different implant designs and fixation techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Database search was conducted on MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL for studies analyzing bone remodelling after joint replacement (March 2002–January 2024). Inclusion criteria: English-language articles; total joint replacement; at least two BMD evaluations; observational studies, cross-sectional, prospective, retrospective, randomised controlled trials, and clinical trials. Exclusion criteria: no BMD measurement within one month after surgery; BMD data only expressed as percentage changes or graphs without numerical values; no Gruen zone evaluation for hip replacement; no periprosthetic bone evaluation for knee replacement; pharmacological treatment or comorbidities affecting BMD; revision joint replacements; irrelevant articles; no full text or no original data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-eight articles matched the selection criteria. Fifty-five focused on the hip joint, 12 on the knee, and one on the shoulder. After total hip arthroplasty, the greatest bone resorption occurred in the proximal femur, peaking at 6 months. Cemented implants and tapered stems showed greater bone resorption than cementless implants and anatomical stems. BMD around the acetabular component decreased during the first 6 months but increased in regions subjected to higher loads. In total knee arthroplasty, bone loss occurred in the anterior distal femur and medial tibial plateau, with cemented and posterior-stabilised implants showing greater bone loss than cementless and cruciate-retaining designs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The periprosthetic BMD decreases progressively after joint replacement. The fixation technique and implant design influence the extent and pattern of this decline. These factors must be considered during the surgical planning, as they can have long-term implications for bone health and implant longevity. Further research is needed to optimise implant design and surgical techniques to mitigate BMD loss and improve patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100461","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":"Assessing information provided via artificial intelligence regarding distal biceps tendon repair surgery","authors":"Suhasini Gupta,&nbsp;Brett D. Haislup,&nbsp;Ryan A. Hoffman,&nbsp;Anand M. Murthi","doi":"10.1002/jeo2.70281","DOIUrl":"https://doi.org/10.1002/jeo2.70281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to analyze the quality, accuracy, reliability and readability of information provided by an Artificial Intelligence (AI) model ChatGPT (Open AI, San Francisco) regarding Distal Biceps Tendon repair surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ChatGPT 3.5 was used to answer 27 commonly asked questions regarding ‘distal biceps repair surgery’ by patients. These questions were categorized using the Rothwell criteria of <i>Fact, Policy</i> and <i>Value</i>. The answers generated by ChatGPT were analyzed using the DISCERN scale, <i>Journal of the American Medical Association</i> (JAMA) benchmark criteria, Flesch-Kincaid Reading Ease Score (FRES) and grade Level (FKGL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The DISCERN score for <i>Fact</i>-based questions was 59, <i>Policy</i> was 61 and <i>Value</i> was 59 (all considered ‘good scores’). The JAMA benchmark criteria were 0, representing the lowest score, for all three categories of <i>Fact, Policy</i> and <i>Value</i>. The FRES score for the <i>Fact</i> questions was 24.49, <i>Policy</i> was 22.82, <i>Value</i> was 21.77 and the FKGL score for <i>Fact</i> was 14.96, <i>Policy</i> was 14.78 and <i>Value</i> was 15.00.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The answers provided by ChatGPT were a ‘good’ source in terms of quality assessment, compared to other online resources that do not have citations as an option. The accuracy and reliability of these answers were shown to be low, with nearly a college-graduate level of readability. This indicates that physicians should caution patients when searching ChatGPT for information regarding distal biceps repairs. ChatGPT serves as a promising source for patients to learn about their procedure, although its reliability and readability are disadvantages for the average patient when utilizing the software.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085447","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":"Lateral extra-articular tenodesis improves functional movement outcomes in ACL reconstruction patients","authors":"Luyckx Thomas,&nbsp;Wen Zhishen,&nbsp;Kluyskens Louis,&nbsp;Tampere Thomas,&nbsp;Vanrenterghem Jos,&nbsp;Claeys Kurt","doi":"10.1002/jeo2.70269","DOIUrl":"https://doi.org/10.1002/jeo2.70269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary aim was to evaluate the functional impact of adding lateral extra-articular tenodesis (LET) to an anterior cruciate ligament (ACL) reconstruction (ACLR). The secondary aim was to assess whether LET provides benefits in muscle strength, patient-reported outcome measures (PROMs) and return to sport (RTS) pass rate, as well as to examine the influence of meniscal injury on performance in ACLR patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort of prospectively collected data on all ACL procedures was performed at AZ Delta Roeselare between 2017 and 2019. The patients followed a 7-month rehabilitation programme and were assessed according to standardised RTS criteria. Patients were divided into two groups according to whether they received LET technique or not, and then each group was further divided based on the presence or absence of meniscal injury. The primary outcomes were the functional movement tests including agility t-test and hop tests. The secondary outcomes were the muscle strength, PROMs and RTS pass rate. A two-way ANCOVA test or a non-parametric test was used to investigate clinical and functional differences among the four groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 105 ACL injury patients who underwent ACLR with or without LET were included. The cohort consisted of 74 males and 31 females, with an average age of 25.0 ± 6.2 years. Significantly statistical differences among groups were found for the functional movement tests at 7 months post-operatively in favour of the ACLR with LET groups compared with isolated ACLR groups (agility t-test: 95% confidence interval [CI] 0.3–1.2, <i>p</i> = 0.003; cross-over hop test: injured leg: 95%CI 20–86, <i>p</i> = 0.002; uninjured leg: 95%CI 12–76, <i>p</i> = 0.008; triple hop test: injured leg: 95%CI 7–77, <i>p</i> = 0.019). There were no significant differences in muscle strength, PROMs or RTS pass rates among the groups. Meniscal injury had no significant effect on any variable of interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The addition of a LET procedure to an ACLR showed important improvements in functional movement outcomes at 7 months post-operatively with no negative effect on muscle strength or PROMs.</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":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085068","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":"Return to sport and patient reported outcomes in athletes participating in martial arts after anterior cruciate ligament reconstruction at mean follow-up of 12 years","authors":"Yunseo Linda Park,&nbsp;Anja M. Wackerle,&nbsp;Brooke Collins,&nbsp;Ehab M. Nazzal,&nbsp;Joseph D. Giusto,&nbsp;Matthew Kolevar,&nbsp;James J. Irrgang,&nbsp;Jonathan D. Hughes,&nbsp;Volker Musahl","doi":"10.1002/jeo2.70272","DOIUrl":"https://doi.org/10.1002/jeo2.70272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to assess anterior cruciate ligament reconstruction (ACLR) outcomes and return to pre-injury sports (RTPS) characteristics in athletes participating in martial arts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Martial arts athletes over the age of 14 years who underwent primary ACLR with a minimum 1-year follow-up were eligible for this study. This study defined RTPS as reaching pre-injury levels of martial arts participation. Patients completed a questionnaire assessing sports participation, reinjury, and patient reported outcomes (PROs) including International Knee Documentation Committee Subjective Knee Form (IKDC SKF), Marx activity score, Tegner activity scale, and visual analogue scale (VAS). Demographics, surgical data, and preoperative PROs were collected retrospectively. Patients were grouped into those who achieved RTPS and those who did not. Statistical analyses included chi-square, Fisher's exact, Mann–Whitney <i>U</i>, and t-tests. Statistical significance was set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-two individuals who participated in martial arts (mean age 30.6 ± 11.0 years, 21% female) completed the questionnaire at a mean follow-up of 12.1 ± 7.8 years. Of the cohort, 35 patients (67%) participated in competitive, varsity, or elite martial arts prior to injury. Of those who did not return to martial arts at all, fear of reinjury was the most common reason. The rate of RTPS was 58%. Age, pre-injury martial arts participation (frequency and competitiveness), and surgical characteristics did not differ between groups. Those who did not achieve RTPS had a higher rate of minor and major postoperative complication (41% vs. 13%, <i>p</i> = 0.02), which included stiffness, infection, effusion, and reinjury. The RTPS group reported statistically higher IKDC SKF scores (71.4 ± 11.7 vs. 68.4 ± 7.2, <i>p</i> &lt; 0.01) and Tegner activity scores (6.9 vs. 5.6, <i>p</i> = 0.04) at final follow-up. Graft failure rate for all study participants was 12% and did not differ between groups (<i>p</i> = 0.69). Reinjury rate of the RTPS group was 17%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Martial arts athletes demonstrated a rate of 58% return to pre-injury participation levels after ACLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>Case series; level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085390","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":"Anatomical landmarks are more accurate in identifying the ideal femoral insertion for modified Larson reconstruction of posterolateral corner than radiological landmarks","authors":"Christian Coppola,&nbsp;Maximilian Sigloch,&nbsp;Romed Hörmann,&nbsp;Werner Schmoelz,&nbsp;Raul Mayr","doi":"10.1002/jeo2.70282","DOIUrl":"https://doi.org/10.1002/jeo2.70282","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In surgery for posterolateral knee instabilities, the modified Larson technique (MLT) is a fibular tunnel–based reconstruction technique with a single femoral tunnel aiming for an isometric graft insertion point (IGIP). The IGIP can be located intraoperatively using an anatomically referenced method (ARM) or a radiological method (RM). The purpose of this experimental study was to compare the ARM with the RM in terms of isometric behaviour and to report the location of the ARM and RM in relation to the lateral epicondyle (LE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Flexion/extension movement of eight fresh-frozen human knee joints was simulated in a custom-made knee test bench. A fibular tunnel was created as described in the MLT, and a suture was shuttled from the IGIP through the tunnel and connected to a displacement transducer. The isometry of the IGIP of the ARM and RM was evaluated on the basis of suture displacement during flexion/extension motion. The position of the determined IGIP relative to the centre of the LE was measured on true lateral X-rays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Comparison of the isometry behaviour of the two techniques showed that RM resulted in a displacement of 10.46 ± 3.69 mm, whereas the ARM showed a of 6.09 ± 2.11 mm during flexion/extension motion (<i>p</i> = 0.017). The median location of the ARM and RM was 6.5 mm (IQR 8.375 mm), 5.45 mm (IQR 3.5 mm) distal and 3.95 mm (IQR 6.9 mm), 4.55 mm (IQR 5.75 mm) anterior to the centre of the LE, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the present in vitro experiment, the ARM was capable of determining the femoral IGIP more accurately than the radiological method. For clinical practice, it is recommended to start approximately 6.5 mm distal and 3.95 mm anterior to the centre of the LE in order to determine the IGIP when performing MLT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085475","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":"Slope reducing high tibial osteotomy and revision anterior cruciate ligament reconstruction leads to satisfying clinical results and a low failure rate","authors":"Lorenz Fritsch,&nbsp;Konstantin Dworschak,&nbsp;Maximilian Hinz,&nbsp;Philipp W. Winkler,&nbsp;Bastian Scheiderer,&nbsp;Sebastian Siebenlist,&nbsp;Romed Vieider,&nbsp;Lukas Willinger,&nbsp;Stefan Hinterwimmer,&nbsp;Julian Mehl","doi":"10.1002/jeo2.70260","DOIUrl":"https://doi.org/10.1002/jeo2.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to assess clinical and radiological outcomes after two-staged slope-reducing high tibial osteotomy (HTO) and revision anterior cruciate ligament reconstruction (ACLR) for recurrent ACL insufficiency with an increased posterior tibial Slope (PTS) &gt; 12°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients operated in two centres between 01/2015 and 01/2022 were included after a minimum follow-up of 24 months after revision ACLR. The postoperative pain and the following scores were obtained: IKDC, KOOS, Lysholm, TAS. The Slope was measured using the Dejour technique postoperatively using lateral X-rays being compared to a preoperative X-ray. Also, a clinical examination including range of motion, anterior + posterior translation and pivot-shift were performed. The Rolimeter was used for anterior tibial translation (ATT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four patients (18 m, 6 f; age: 27 ± 8 y) were examined after a mean follow-up of 34 ± 10 months. PTS was reduced from 15.2° ± 2.4° to 5.7° ± 3.8°. Scores at final follow-up: IKDC 75.5 ± 1.5, Lysholm 79.9 ± 12.7, KOOS 77.5 ± 11.5, TAS was 5 (interquartile range 4–7). Postoperative Pain was significantly reduced (VAS: 4.0 ± 2.8 vs. 1.4 ± 1.3; <i>p</i> &lt; 0.001). Compared to the contralateral side, ATT was higher in the operated knee (2.5 ± 2.9 mm; <i>p</i> = &lt;0.01). Four patients underwent revision surgery (2x non-traumatic instability; 2x traumatic ACL rupture). Additionally, 75% of patients returned to sports, while 64.3% of patients could return to their prior level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combined slope-reducing HTO and ACLR lead to good clinical outcomes, high patient satisfaction, and a low failure rate. Patients were able to return to activity, but often at a lower sports level. Anterior tibial translation remains slightly increased compared to the healthy side.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Therapeutic study Level IV, case series.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085066","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}