Journal of Experimental Orthopaedics最新文献

{"title":"Navigated instrumentation and ligament tensioning device enhances initial gap acquisition during total knee arthroplasty procedure: A cadaveric study","authors":"François Boux de Casson,&nbsp;Laurent Angibaud,&nbsp;Florian Kerveillant,&nbsp;Faustine Nogaret,&nbsp;Joris Ruffin,&nbsp;Léonard Duporté,&nbsp;Gérard Giordano,&nbsp;Louis Dagneaux","doi":"10.1002/jeo2.70107","DOIUrl":"10.1002/jeo2.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Gap-balanced total knee arthroplasty (TKA) technique relies on initial ligament evaluation, particularly in patient-specific implantation using computer-assisted technologies. This cadaveric study aimed to compare the reproducibility and reliability of medial and lateral gap measurements between manual stress testing and dynamic ligament balancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Initial gap acquisitions were assessed from eight cadaveric knees (four specimens) during the same navigated TKA procedure by five differently skilled surgeons (three seniors and two juniors). Medial and lateral gaps were sequentially acquired from extension to maximum knee flexion, applying manual stress prior to any bone cuts (conventional technique), and using intra-articular tensioning device placed between the tibial cut and the native femur (instrumented technique). Reproducibility was assessed using intraclass correlation coefficient (ICC), stratified by the measurement technique, the type of gaps and the operator experience. Differences in gaps (mm) between techniques were assessed using the Bland and Altmann method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The instrumented technique showed higher ICCs than the conventional technique for medial and lateral gaps (0.87 vs. 0.60, <i>P</i> = 0.002, and 0.92 vs. 0.25, <i>p</i> &lt; 0.0001, respectively), and showed no difference in ICCs between medial and lateral gap acquisitions (0.87 vs. 0.92, <i>p</i> = 0.8). Senior surgeons achieved higher ICCs than juniors, while non-significant with both techniques. Differences in gaps between techniques increased with knee flexion angle (0.8, 2.8 and 3.5 mm at 10°, 45° and 90° of flexion angle, respectively) and decreased with the operator experience (<i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The instrumented balancing technique offered better reproducibility than using manual valgus and varus stress, when measuring medial and lateral gaps. Tensioning devices may play a significant role in enhancing initial gap acquisition, disregarding the flexion angle and the operator experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV (observational study involving cadaveric specimens).</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980162","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":"Patellofemoral arthroplasty provides similar long-term survival rate and complications with better clinical outcomes compared to facetectomy for the treatment of isolated patellofemoral osteoarthritis","authors":"J. Martinez-Lozano,&nbsp;L. Martorell-de Fortuny,&nbsp;L. A. Martin-Domínguez,&nbsp;R. Torres-Claramunt,&nbsp;J. Sánchez-Soler,&nbsp;S. Perelli,&nbsp;P. Hinarejos,&nbsp;J. C. Monllau","doi":"10.1002/jeo2.70136","DOIUrl":"10.1002/jeo2.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to analyse the clinical outcomes and survival of patellofemoral arthroplasty (PFA) in treating isolated patellofemoral osteoarthritis (IPFOA) at our centre. The secondary objective was to compare these results with a historical cohort treated with partial lateral facetectomy plus Insall realignment (PLFIR). We hypothesised that clinical outcomes and survival with PFA are superior to PLFIR and comparable to the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of 120 patients with IPFOA was conducted. The PFA series included 33 patients treated between 2012 and 2019 with a minimum follow-up of 5 years (range 1.2–12.1 years). The PLFIR historical cohort treated between 1995 and 2002 (range 4.1–15.7 years) consisted of 87 patients. Preoperative and post-operative clinical outcomes were assessed using the Knee Society Score (KSS) and Kujala score, and survivorship was evaluated via Kaplan–Meier analysis. Cox regression analysis was used to identify factors influencing surgical failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PFA group demonstrated a 75.8% survival rate at 10 years, with a 24.2% failure rate requiring conversion to total knee arthroplasty (TKA). In the PLFIR group, the 10-year survival rate was 79.3%, although 26.4% required TKA. Both groups exhibited significant improvements in KSS and Kujala score, with PFA showing superior Kujala score improvement (<i>p</i> = 0.012). No statistically significant difference in survival between the two groups was observed at 10 years (<i>p</i> = 0.056), but PFA showed better long-term clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PFA demonstrated comparable survival rates to PLFIR in the treatment of IPFOA. Despite a higher initial failure rate, PFA showed a potential for greater improvement in the long term, particularly in terms of anterior knee pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, retrospective case series analysis compared with a historical cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Norwegian version of the Norwich Patellar Instability score has good validity and moderate reproducibility","authors":"T. Hysing-Dahl,&nbsp;A. G. Faleide,&nbsp;L. H. Magnussen,&nbsp;E. Inderhaug","doi":"10.1002/jeo2.70095","DOIUrl":"10.1002/jeo2.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To translate and adapt the Norwich Patellar Instability (NPI) score into Norwegian, and second, to examine the psychometric properties of the Norwegian version (NPI-No).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>NPI was translated according to international guidelines. A cohort of 107 patients surgically treated for recurrent patellofemoral instability completed NPI-No, related questionnaires and functional tests prior to and six months post-surgery. Validity (face, content and construct validity), internal consistency (Cronbach's alpha [<i>α</i>]), test–retest reliability (intraclass correlation coefficient [ICC]], measurement error (standard error of measurement [SEM] and smallest detectable change at individual [SDC_ind] and group level [SDC_group]) and construct validity (hypotheses testing; independent <i>t</i> tests, Pearson's <i>r</i>) were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>NPI-No had good face and content validity. Internal consistency was satisfactory (<i>α</i> = 0.88), test–retest reliability was moderate ICC_2.1 0.65 (95% confidence interval = 0.47–0.77) and measurement error low (SEM = 7.8). SDC_ind was 21.7 points and SDC_group was 2.8. Seven of the 10 hypotheses about construct validity were confirmed. While there was no ceiling effect pre- or post-operatively, a substantial floor effect (28%) was observed at the 6-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The NPI-No is valid for assessment of self-perceived patellar instability before and after surgery in Norwegian patients. However, reproducibility was found to be only moderate. This study adds further knowledge about the measurement properties of the NPI.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972487","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":"Stem fixation techniques in revision total knee arthroplasty: A systematic review and meta-analysis","authors":"Francesco Onorato,&nbsp;Riccardo Giai Via,&nbsp;Francesco Bosco,&nbsp;Alessandro Dario Lavia,&nbsp;Luca Barberis,&nbsp;Marcello Capella,&nbsp;Alessandro Massè,&nbsp;Salvatore Risitano","doi":"10.1002/jeo2.70086","DOIUrl":"10.1002/jeo2.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review and meta-analysis aimed to compare the clinical and radiological outcomes of patients undergoing revision total knee arthroplasty (rTKA) using uncemented press-fit stems (hybrid fixation) versus cemented stems (cemented fixation). It is also examined whether cemented fixation offers any superiority over hybrid fixation regarding implant survival, clinical function, imaging analysis and complication rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the PRISMA guidelines, a systematic review and meta-analysis were conducted on five databases (Pubmed, Scopus, Embase, Medline and Cochrane). Articles were evaluated according to levels of evidence (LoE). Retrospective studies were analysed with risk of bias in nonrandomised studies of interventions (Robins-I) and randomised controlled trials with risk of bias 2 (RoB-2). This review was registered in the International Prospective Register of Systematic Reviews database. Meta-analysis was performed using R software, with <i>p</i> &lt; 0.05 considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 12 comparative studies with 1303 patients (1352 rTKAs) were analysed. Survival rates of hybrid and cemented fixations were comparable, with a significant trend favouring hybrid fixation (<i>p</i> = 0.04). Infection and aseptic loosening were the most common causes of failure. Radiographic failure rates showed no significant differences between fixation methods (<i>p</i> = 0.4). Meta-analysis indicated better results with hybrid fixation, although not statistically significant (KSS functional <i>p</i> = 0.15; KSS clinical <i>p</i> = 0.5). High heterogeneity was observed due to variations in patient characteristics and surgical strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both hybrid and cemented fixation techniques achieve satisfactory clinical results in rTKA, with hybrid fixation demonstrating an overall lower failure rate. The choice of fixation method must be tailored to individual patient characteristics and surgical considerations. Further high-quality randomised trials are needed to refine these results and optimise fixation strategies to 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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956392","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-level osteotomy (DLO) for varus deformity results in over a decade of mean survival without compromising subsequent total knee arthroplasty function at a mean 26-year follow-up","authors":"Sean C. Clark,&nbsp;Karissa N. Simon,&nbsp;Daniel B. F. Saris,&nbsp;Michael J. Taunton,&nbsp;Aaron J. Krych,&nbsp;Mario Hevesi","doi":"10.1002/jeo2.70140","DOIUrl":"10.1002/jeo2.70140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Double-level osteotomies (DLOs) have shown promising results for knee joint preservation, however, most ultimately progress in terms of degenerative disease resulting in conversion to total knee arthroplasty (TKA). Therefore, the purpose of this study was to examine the time to TKA conversion, long-term clinical outcomes and revision rates of patients who have undergone TKA after prior ipsilateral DLO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent simultaneous or staged DLO and subsequently underwent conversion to TKA at a single academic institution from 1997 to 2022 were evaluated. The type of osteotomy performed (opening- vs. closing-wedge), osteotomy hardware fixation, when and if osteotomy hardware was removed, implanted TKA components and revision rates were recorded. Postoperative outcomes, including Forgotten Joint Score-12 (FJS-12), Tegner Activity Scale score and subjective knee preference were also obtained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 22 patients (24 knees) underwent TKA following DLO and were followed for an average of 26.1 ± 7.7 years. The average time from DLO to TKA conversion was 14.1 ± 6.5 years, with 70.8% of knees converting to TKA more than 10 years after DLO. The mean follow-up after conversion to TKA was 12.0 ± 7.7 years. Only 12.5% of patients received a varus-valgus or hinged-constrained TKA. At the final follow-up, the mean FJS-12 was 75.8 ± 23.1, while the mean Tegner Activity Scale score was 2.5 ± 1.1. Seventy-seven percent of patients had no subjective knee preference or preferred their DLO-TKA knee. Only two knees (7.4%) underwent subsequent revision after index arthroplasty at a mean of 9.3 years postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A majority of DLOs (70.8%) converted to TKA after more than a decade. Subsequent TKA function was favorable as most patients had either no subjective knee preference or preferred their DLO-TKA knee. This study demonstrates both long-term joint preservation and uncompromised TKA function after prior DLO.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956388","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":"Mapping the reporting practices in recent randomised controlled trials published in Knee Surgery, Sports Traumatology, Arthroscopy: A scoping review of methodological quality","authors":"Aleksandra Królikowska,&nbsp;Natalia Urban,&nbsp;Marcin Lech,&nbsp;Paweł Reichert,&nbsp;Nikolai Ramadanov,&nbsp;Mahmut Enes Kayaalp,&nbsp;Robert Prill","doi":"10.1002/jeo2.70117","DOIUrl":"10.1002/jeo2.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>The official medical journals of scientific societies advocate for high-quality standards. It's important to assess whether randomized controlled trials (RCTs) in influential journals, such as the hybrid journal of the European Society of <i>Sports Traumatology, Knee Surgery</i>, and <i>Arthroscopy</i> (<i>ESSKA</i>), adhere to reporting guidelines and best practices. Therefore, the present scoping review aimed to explore and map the reporting practices and methodological quality in recent RCTs published in the <i>Knee Surgery, Sports Traumatology, Arthroscopy</i> (<i>KSSTA</i>) journal, focusing on identifying gaps in adherence to reporting guidelines and transparency. The study was preregistered and followed the PRISMA-ScR checklist. RCTs published in <i>KSSTA</i> between 2022 and 2023 were included. The search was conducted via PubMed. A two-stage selection process was employed, with two independent reviewers conducting study selection and data extraction. Data collected included study characteristics, intervention details, sample size calculation reporting, data transparency, and adherence to Consolidated Standards of Reporting Trials (CONSORT) guidelines. Critical appraisal was conducted using the JBI tool for RCTs. All included RCTs (<i>n</i> = 25) reported a predetermined minimum sample size. Study protocol preregistration was reported in 52% of the RCTs, while only 24% provided data availability statements. Most RCTs offering data availability indicated data would be shared upon request. Adherence to CONSORT guidelines was reported in 96% of studies, with only one RCT not adhering to recognized reporting standards. All the included studies adequately addressed statistical conclusion validity. However, internal validity was less consistently addressed across the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While most recently published RCTs in <i>KSSTA</i> adhered to CONSORT guidelines, there is potential for improvement in the reporting of protocol preregistration and data availability statements. Although all studies reported sample size calculations, transparency in data sharing remains limited.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956390","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":"Greater return to sports after anterior cruciate ligament reconstruction combined with anterolateral ligament reconstruction compared with anterior cruciate ligament reconstruction alone: A systematic review and meta-analysis","authors":"Imelda Lumban-Gaol,&nbsp;Dananjaya Putramega,&nbsp;Krisna Yuarno Phatama,&nbsp;Dwikora Novembri Utomo,&nbsp;Nicolaas C. Budhiparama","doi":"10.1002/jeo2.70127","DOIUrl":"10.1002/jeo2.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to compare the return to sports, return to competition, Tegner score and anterior cruciate ligament-return to sports injury (ACL-RSI) scores between patients who underwent ACL reconstruction (ACLR) combined with anterolateral ligament reconstruction (ALLR) and those who underwent ACLR alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two independent reviewers conducted a literature search in PubMed (MEDLINE), EMBASE, Google Scholar and the Cochrane Library in July 2024, followed by data extraction and quality assessment. This study followed the Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines. The return to sports rate, return to competition rate, Tegner score and ACL-RSI score were compared between patients who underwent primary ACLR with ALLR and those who underwent isolated primary or revision ACLR. The methodological quality of the included studies was assessed via the Cochrane risk-of-bias tool and methodological items for nonrandomized studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 12,139 studies were screened, and 14 (four randomized controlled trials and 10 nonrandomized studies) studies were ultimately evaluated. Compared with isolated ACLR, ACLR combined with ALLR resulted in a higher rate of return to sports and competition. Nevertheless, no significant differences were found in the Tegner score or ACL-RSI score between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients who underwent ACLR in combination with ALLR had higher rates of return to sports and competition, but their Tegner activity and ACL-RSI scores were similar to those of patients who underwent ACLR alone. This finding may assist surgeons in making decisions when treating patients undergoing ACLR, especially athletes.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047860","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 sports after unilateral medial opening wedge high tibial osteotomy in highly active patients: Analysis of factors affecting functional recovery","authors":"Hiroshi Nakayama,&nbsp;Ryo Kanto,&nbsp;Shintaro Onishi,&nbsp;Takuya Iseki,&nbsp;Yoshitaka Nakao,&nbsp;Toshiya Tachibana,&nbsp;Kenta Amai,&nbsp;Shinichi Yoshiya,&nbsp;Tomoya Iseki","doi":"10.1002/jeo2.70083","DOIUrl":"10.1002/jeo2.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to examine the outcomes following opening-wedge high tibial osteotomy (HTO) focusing on return to sports in a consecutive series of highly active patients who underwent a unilateral osteotomy procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-three consecutive patients with preoperative Tegner's activity score of five or more who underwent unilateral HTO for varus osteoarthritic knees were included in this study. The clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score. In radiological assessment, the following parameters were measured in full-length weight-bearing radiographs both pre- and postoperatively; mechanical tibiofemoral angle (mTFA), mechanical medial proximal tibial angle (mMPTA) and joint-line convergence angle. As regard postoperative functional recovery, inability to return to sports activities and reduction in the activity level on the Tegner scale were considered as failure to return to sports. Potential prognostic factors examined with logistic regression analysis were as follows: age ≥ 70, body mass index &gt; 25, postoperative mTFA &gt; 3° valgus or &lt;0° varus, postoperative mMPTA &gt; 90°, opening gap &gt; 10 mm and Kellgren–Laurence classification (KL) grade 4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 2 years after surgery, the KOOS and the IKDC score improved from 231 to 437 and from 34 to 72, respectively, with significant improvements in both scores. As for functional recovery, 50 patients (79.4%) could return to high-impact sports activities at the presymptomatic level with a mean time period of 8.0 months. Statistical analysis of the prognostic factors showed that postoperative mTFA &gt; 3° valgus, opening gap &gt;10 mm and KL grade 4 were the factors significantly affecting the postoperative return to sports.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Presence of postoperative mTFA &gt; 3° valgus, opening gap &gt;10 mm and KL grade 4 were identified as risk factors impairing postoperative return to high-impact sports.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932917","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":"Accelerometers can correctly count orthopaedic patients' early post-operative steps while using walking aids","authors":"Spiros Tsamassiotis,&nbsp;Michael Schwarze,&nbsp;Philipp Gehring,&nbsp;Roman F. Karkosch,&nbsp;Lars-René Tücking,&nbsp;Ann-Kathrin Einfeldt,&nbsp;Eike Jakubowitz","doi":"10.1002/jeo2.70134","DOIUrl":"10.1002/jeo2.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Effective rehabilitation after orthopaedic surgery is critical. The early post-operative phase is increasingly managed in outpatient settings, necessitating objective measures such as step counts to monitor rehabilitation progress. However, it remains unclear if commercially available wearables or accelerometers using simple algorithms can accurately count steps in early post-operative conditions. We hypothesised that only accelerometers could accurately determine the number of steps under these conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case series involved 20 healthy subjects, 7 female and 13 males, walking in a circle at varying speeds under partial loading with three different walking aids (forearm crutches, walking frame and rolling walker) and four wearables (Vivofit 4, Fenix 3HR, Fitbit Charge 3 and Omron HJ-325) and one accelerometer (AX6) worn on the wrist, hip and ankle. The two-point and modified three-point gait patterns commonly used post-operatively were simulated. The primary end point was the relative error (RE), defined as RE = (manual count − automated count)/manual count, of each wearable measurement compared to visual and video step counting, the gold standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The RE of AX6 and Fitbit was less than 0.1 for all walking aids except the rolling walker, with AX6 showing the lowest standard deviation (SD) compared to other wearables. Other wearables had significantly higher RE. Increased gait speed generally improved accuracy, reducing RE in most devices, except for the AX6, which showed the opposite trend. At 0.6 m/s, only AX6 achieved an RE below 0.1. The ankle was identified as the best measuring location.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>During the early post-operative period, commercial wearables can only accurately count steps under specific conditions and should be used cautiously for monitoring steps in the early post-operative phase. However, accelerometers with appropriate coding appear suitable for this purpose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III diagnostic study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932914","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":"Virtual triple-bundle ACL graft via femoral tunnels behind the resident's ridge on 3D CT demonstrates equivalent orientation to native ACL","authors":"Narihiro Okazaki,&nbsp;Konsei Shino,&nbsp;Hiroyuki Yokoi,&nbsp;Tomoki Ohori","doi":"10.1002/jeo2.70125","DOIUrl":"10.1002/jeo2.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To clarify the femoral tunnel location for a virtual anterior cruciate ligament (ACL) graft to simulate the native ACL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three-dimensional (3D) computed tomography (CT) and magnetic resonance imaging (MRI) were obtained in 14 normal knees in full extension. Two types of virtual triple bundle ACL grafts (VACLG) were created. In one type, the femoral tunnels for anteromedial bundle (AM = AMM/anteromedial bundle medial part + AML/anteromedial bundle lateral part) and posterolateral bundle (PL) were positioned behind the resident's ridge (RR) based on the bone landmark strategy (BR-VACLG group). In the other type, the tunnels were placed on the RR (OR-VACLG group). VACLG was displayed as three straight lines by connecting the two centres of the femoral attachment areas of AM and PL to those of the three tibial footprints of AMM, AML and PL attachments on 3D CT, and then superimposed on MRI. The ACL/ACL graft-the tibial plateau (ACL-TP) angles were compared among normal ACL (N-ACL), BR-VACLG and OR-VACLG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean ACL-TP angles of N-ACL, BR-VACLG and OR-VACLG were 74.4 ± 3.4°, 75.2 ± 4.5° and 68.7 ± 5.0° for AMM, 81.9 ± 3.8°, 82.9 ± 5.1° and 76.3 ± 4.0° and for AML, 71.1 ± 6.4°, 70.0 ± 7.2° and 61.0 ± 4.7° for PL on the oblique-coronal slices; 55.3 ± 4.9° 53.9 ± 4.4° and 50.5 ± 4.3° for AMM; 54.9 ± 4.5°, 54.7 ± 2.6° and 50.7 ± 3.2° for AML; 51.4 ± 3.3°, 51.2 ± 2.4° and 48.1 ± 2.0° for PL on the oblique-sagittal slices. There was no significant difference in the angles between N-ACL and BR-VACLG, while those of AMM and PL in OR-VACLG were significantly lower compared to N-ACL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The virtual triple bundle ACL graft via femoral tunnels behind the RR on 3D CT shows equivalent orientation to the native ACL on MRI in full extension.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932921","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}