Enejd Veizi, Şahan Güven, Başak Sinem Sezgin, Christos Koutserimpas, Nevzat Arıcan, Ahmet Fırat, Çetin Işık, Murat Bozkurt
{"title":"Coronal plane changes in fixed- versus mobile-bearing unicompartmental knee replacements: Clinical and revision outcomes","authors":"Enejd Veizi, Şahan Güven, Başak Sinem Sezgin, Christos Koutserimpas, Nevzat Arıcan, Ahmet Fırat, Çetin Işık, Murat Bozkurt","doi":"10.1002/jeo2.70221","DOIUrl":"https://doi.org/10.1002/jeo2.70221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the relationship between coronal plane changes after mobile- and fixed-bearing (MB and FB) unicompartmental knee replacement (UKR) and clinical outcomes while also comparing revision rates and joint awareness between the two surgical modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who operated between 2014 and 2017 with a UKR (FB or MB) were eligible for inclusion. Inclusion criteria were a minimum follow-up of 5 years, presence of clinical outcome scores, Forgotten Joint Scores and radiological data (joint obliquity angles, tibial component alignment, angle between the medial and lateral joint lines, change in overall knee alignment, change in the medial proximal tibial angle). Outcome variables were compared between the MB and FB UKRs, and correlation analyses were performed to assess the effect of radiological changes on clinical and awareness scores. Two separate researchers performed all radiological measurements on direct radiographs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 229 patients, 197 were eligible for inclusion. Basic demographic data (mean age, sex, body mass index and follow-up time) were comparable between the FB and MB groups. There were more revisions in the mobile bearing group (6.5% vs. 12.5%), though the results did not reach statistical significance. Clinical outcomes and joint awareness were similar in the two groups. Overall, the change in joint line obliquity or alignment was comparable between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinical outcomes and joint awareness scores are similar in both fixed and mobile-bearing UKRs. Revision is more frequent, though not statistically significant, following an MB UKR. Overall, change in knee alignment and medio-lateral joint lines is similarly well tolerated in both implant modalities.</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":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741113","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}
Danielle E. Chipman, Emilie Lijesen, Peter M. Cirrincione, Danielle S. Gorelick, Shae K. Simpson, Douglas N. Mintz, Daniel W. Green
{"title":"The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis","authors":"Danielle E. Chipman, Emilie Lijesen, Peter M. Cirrincione, Danielle S. Gorelick, Shae K. Simpson, Douglas N. Mintz, Daniel W. Green","doi":"10.1002/jeo2.70202","DOIUrl":"https://doi.org/10.1002/jeo2.70202","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 thickness of the lateral patellar retinaculum (LPR) and patellar tilt in paediatric and adolescent patients who undergo a medial patellofemoral ligament (MPFL) reconstruction. The authors hypothesise that patients undergoing MPFL reconstruction will have a thicker LPR and increased patellar tilt when compared to a comparison cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Preoperative magnetic resonance imaging (MRI) of patients ≤ 18 years old who underwent an MPFL reconstruction was retrospectively reviewed. Patients were included if they had a proton density preoperative axial MRI performed internally at our institution. Included patients were matched to a comparison cohort. LPR thickness and patellar tilt were measured on MRI. LPR thickness and patellar tilt were compared between the MPFL cohort and the comparison cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 363 patients were identified. 145 participants were successfully matched to the comparison cohort. The mean age in the MPFL cohort was 14.4 ± 2.0 years and 68% were female. The LPR thickness in the MPFL cohort was significantly greater than the LPR thickness in the comparison cohort (<i>p</i> < 0.001). The patellar tilt was significantly greater in the MPFL cohort compared to the control cohort (<i>p</i> < 0.001). There was no statistical difference in patients undergoing MPFL reconstruction and the occurrence of a lateral release/lengthening procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The LPR was significantly thicker on preoperative MRI in patients undergoing MPFL reconstruction compared to a comparison cohort, indicating that increased LPR thickness is a potential marker of patellofemoral instability on imaging.</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":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741309","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}
Azmi Rahman, Merrill Lee, Lenice Tan, Sabine Wong, Michael Saturnino, Glen Purnomo, Ming Han Lincoln Liow, Keng Jin Darren Tay, Hee Nee Pang, Seng Jin Yeo
{"title":"Coronal Plane Alignment of the Knee (CPAK) distribution in a diverse Asian population: Influence of ethnicity, sex and bilaterality","authors":"Azmi Rahman, Merrill Lee, Lenice Tan, Sabine Wong, Michael Saturnino, Glen Purnomo, Ming Han Lincoln Liow, Keng Jin Darren Tay, Hee Nee Pang, Seng Jin Yeo","doi":"10.1002/jeo2.70192","DOIUrl":"https://doi.org/10.1002/jeo2.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In total knee arthroplasty (TKA), it remains unclear which patients benefit from correction versus restoration of native knee alignment. The Coronal Plane Alignment of the Knee (CPAK) classification system was introduced in 2021 to describe native alignment, helping to characterise the effect of different TKA alignment techniques. This study aims to describe CPAK in an ethnically diverse population and characterise the relationship between CPAK and ethnicity, as well as the bilaterality of osteoarthritis and other patient factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>503 primary TKAs were performed in a large tertiary institution in Singapore from 2014 to 2021. Pre-operative anteroposterior knee radiographs were collected for 441 procedures—all had ethnicity, age, sex and body mass index data. The medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA) were measured with good inter-observer correlation. Knees were then classified into nine CPAK categories based on arithmetic hip–knee–ankle (aHKA) angle and joint line obliquity (JLO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>77% of the cohort were apex-distal (CPAK 1, 2 and 3), and 59% were varus (CPAK 1, 4 and 7); 44% were CPAK 1 (varus + apex-distal). Chinese and Indian knees followed near-identical patterns: CPAK 1 (46%) > CPAK 2 (20%) > CPAK 4 (15%). Malay knees had significantly fewer CPAK 1 (<i>p</i> = 0.0183), with CPAK 1 (29%) ≈ CPAK 2 (29%) ≈ CPAK 4 (21%). Thirty-eight patients had bilateral TKA. Identical categories were recorded bilaterally in 45% of CPAK, 67% of JLO and 70% of aHKA. Bilateral TKA were more likely when knees were in valgus alignment than unilateral TKA (<i>p</i> = 0.00457).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Malay knees are less likely to be CPAK-1; this novel finding may explain ethnic differences in TKA outcomes described in the literature. Less than half of the bilateral knees had the same CPAK category bilaterally. The implications of this bilateral CPAK incongruence are unclear and require further study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, prospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741114","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}
Renato Locks, Eliane C. Guadagnin, Guilherme Pradi Adam, Felipe F. Gonzalez, Jorge Chahla, Liszt Palmeira de Oliveira, Leonardo Metsavaht, Gustavo Leporace
{"title":"Impact of contralateral pelvic drop and femoral adduction on the femoral head acetabular coverage: A study on the reproducibility of a new radiographic measurement method","authors":"Renato Locks, Eliane C. Guadagnin, Guilherme Pradi Adam, Felipe F. Gonzalez, Jorge Chahla, Liszt Palmeira de Oliveira, Leonardo Metsavaht, Gustavo Leporace","doi":"10.1002/jeo2.70215","DOIUrl":"https://doi.org/10.1002/jeo2.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Traditional radiographic measurements for acetabular dysplasia and femoroacetabular impingement syndrome (FAIS) are typically done in static positions, overlooking dynamic behaviours. This study investigated the reproducibility of a new radiographic method that incorporates pelvic and femoral motion during running.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional retrospective study included 10 patients (5 males/5 females; Mean 42.4, SD: 3.0 years) with symptomatic unilateral FAIS. Participants underwent three-dimensional running analysis and standard supine anteroposterior (AP) pelvis radiographs. Using specialised software, the femur and pelvis were rotated in the coronal plane according to peak angles of contralateral pelvic drop and femoral adduction from the running analysis, preserving the original hip joint centre. Two experienced physicians measured the lateral centre edge angle (LCEA), acetabular index (AI), sharp angle (SA), extrusion index (EI), and femoro-epiphyseal acetabular roof index (FEAR INDEX) on both standard and manipulated (M) radiographs in two rounds, with a 15-day interval. Differences between the original and manipulated measurements (VAR) were also calculated. Intra- and inter-rater reliability were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman method, with a significance level of 5%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average contralateral pelvic drop and femoral adduction used for image manipulation were 4.7° (SD: 2.7) and 6.2° (SD: 2.4), respectively. Of the 15 radiographic measurements, 14 showed good to excellent inter-rater reliability in the first assessment (range: 0.76-0.98), which decreased to 11 in the second assessment (range: 0.80–0.96). Intra-rater reliability showed 13 and 12 measurements with good or excellent reliability for raters 1 (range: 0.75–0.97) and 2 (range: 0.79–0.97), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that incorporating dynamic motion into femoral head acetabular coverage radiographic measurements provides potential reliable assessments for most parameters. Integrating motion analysis with radiography could improve understanding of acetabular coverage in active individuals and support surgical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>Diagnostic Study, Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741116","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}
Andrea Pasquini, Radu Prejbeanu, Octav Russu, Riccardo D'Ambrosi, Cosmin Ioan Faur, Giulio Maria Marcheggiani Muccioli, Mihail Lazar Mioc
{"title":"Effect of vitamin D on anterior cruciate ligament injury rates and post-reconstruction function—A systematic review","authors":"Andrea Pasquini, Radu Prejbeanu, Octav Russu, Riccardo D'Ambrosi, Cosmin Ioan Faur, Giulio Maria Marcheggiani Muccioli, Mihail Lazar Mioc","doi":"10.1002/jeo2.70224","DOIUrl":"https://doi.org/10.1002/jeo2.70224","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review aimed to investigate the association between serum vitamin D levels and key outcomes following anterior cruciate ligament reconstruction (ACLR), including ACL injury risk, postoperative muscle recovery and post-reconstruction functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive search across five databases (Cochrane Library, EMBASE, MEDLINE, Scopus and Web of Science) until July 2024. Studies were selected based on specific inclusion criteria, such as studies evaluating the relationship between vitamin D and injury risk, ACLR outcomes and muscle strength. Risk of bias was assessed using the MINORS tool, and results were synthesized narratively due to study heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five studies with 656,243 participants met the inclusion criteria. Most studies reported that low vitamin D levels were associated with a significantly increased risk of ACL injuries and poorer postoperative muscle strength recovery. However, evidence regarding bone health and functional outcomes was inconsistent. No meta-analysis was conducted due to the variability of study designs and outcomes, but qualitative synthesis indicated a potential protective role of vitamin D in ACL recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vitamin D deficiency appears to increase the risk of ACL injury and impede muscle recovery post-surgery. However, limitations include a high risk of bias and inconsistent evidence on functional outcomes, underscoring the need for further research. The review was registered in PROSPERO (ID: CRD42024584483).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, systematic review.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741118","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}
Matthieu Ollivier, Jean-François Gonzalez, Axel Machado, Sachin Tapasvi, Raghbir Khakha, Ronald van Heerwaarden, Grégoire Micicoi
{"title":"The top 100 most-cited knee osteotomy publications","authors":"Matthieu Ollivier, Jean-François Gonzalez, Axel Machado, Sachin Tapasvi, Raghbir Khakha, Ronald van Heerwaarden, Grégoire Micicoi","doi":"10.1002/jeo2.70175","DOIUrl":"https://doi.org/10.1002/jeo2.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To objectively identify the 100 most influential scientific publications in knee osteotomy and provide an analysis of their main characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Clarivate Analytics Web of Knowledge database was used to obtain data and metrics on knee osteotomy research. The search list was sorted by the number of citations, and articles were included or excluded based on relevance to knee osteotomy. The information extracted for each article included the author's name, publication year, country of origin, journal name, article type and the level of evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>These 100 studies generated a total of 16,246 citations, with an average of 162.5 citations per article. The most-cited article was cited 752 times. The 100 studies included in this analysis were published between 1976 and 2015. Twenty-one different journals published these 100 publications. The majority of the publications were from the United States (<i>n</i> = 30), followed by Germany (<i>n</i> = 17) and Japan (<i>n</i> = 11). The most prevalent study designs were case series (<i>n</i> = 55) and cohort studies (<i>n</i> = 19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 100 most influential publications in knee osteotomy were cited a total of 16,246 times. The study designs most used were case series and cohort studies with low-level evidence. This publication serves as a reference to direct orthopaedic practitioners to the 100 most influential studies in knee osteotomy and target future research directions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>This analysis of the 100 most influential (or cited) scientific publications in osteotomy around the knee will provide a comprehensive inventory of the most impactful academic contributions to a field that has recently regained interest among medical students, residents, fellows and attending physicians.</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":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741117","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":"Improvement in gait pattern after total knee arthroplasty for knee osteoarthritis","authors":"Yasushi Oshima, Tokifumi Majima","doi":"10.1002/jeo2.70103","DOIUrl":"https://doi.org/10.1002/jeo2.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Knee osteoarthritis (KOA) leads to gait and balance deficiency, and to hinder activities of daily living (ADLs); all these factors may increase the risk of falls. Total knee arthroplasty (TKA) improves gait and balance; however, the effect of the contralateral knee's condition on this improvement has not been examined. This study evaluated the variation in gait pattern following TKA in relation to the different KOA levels or post-TKA conditions of the contralateral knee, examining the potential role of TKA in fall prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included 53 post-TKA patients at 1-year follow-up. The gait parameters of symmetry—namely gait ability, uniformity as an index of gait and balance, and steps to reflect the level of ADL—were measured using the application software installed on the smart phone. Repeated measures analysis of variance was used for statistical analysis. The gaits were compared between patients with cruciate-retaining (CR) and posterior-stabilized (PS) implants and those with different conditions of the contralateral knee.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The preoperative uniformity, symmetry and steps were 59.0 ± 12.2%, 60.9 ± 12.9% and 50.4 ± 8.7, respectively. These gait parameters significantly decreased to 56.5 ± 12.2%, 58.5 ± 12.8% and 47.9 ± 8.6, respectively, 3 weeks after TKA; however, they significantly improved to 66.2 ± 10.7%, 68.5 ± 11.1% and 53.8 ± 4.9 1 year after TKA, respectively (<i>p</i> < 0.05). The variations of these parameters were similar between patients with CR and PS. Preoperative symmetry and uniformity declined with the progression of contralateral KOA grades, even after TKA. In contrast, the preoperative steps did not decrease with the increasing severity of contralateral KOA grades.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Gait parameters of KOA patients deteriorated with contralateral KOA and even after TKA over time. However, TKA could improve knee function, gait patterns and ADL, thereby potentially preventing falls.</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":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741119","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":"Optimum storage conditions for osteochondral allograft plugs: An ex vivo comparative study of 12 storage protocols","authors":"Ramin Shayan-Moghadam, Arash Sherafatvaziri, Fardis Vosoughi, Alireza Mirzamohamadi, Hiva Saffar, Mahdi Shafieian, Leila Oryadi Zanjani, Hossein Nematian, Mohammad Hossein Nabian","doi":"10.1002/jeo2.70206","DOIUrl":"https://doi.org/10.1002/jeo2.70206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Physiological storage temperature and chondrogenic supplements can enhance tissue viability, potentially overcoming the limitations associated with osteochondral allograft transplantation. This study aimed to evaluate the quality of macroscopically healthy cartilage across 12 different storage protocols to find optimum storage conditions for osteochondral allograft plugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Osteochondral plugs were obtained from arthroplasty candidates and divided into 12 groups based on two culture media (Media 1 [supplemented Dulbecco's modified Eagle's medium {DMEM}/Ham's Nutrient Mixture F12] or Media 2 [enriched Media 1 with 10 ng/mL of transforming growth factor-beta {TGF-β}]), two culture conditions (static or dynamic), and three temperatures (−70°C, 4°C and 37°C). Subsequently, samples were evaluated on Days 1, 14, 28 and 60 for biochemical, biomechanical and histopathological characteristics alongside bacterial surveillance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4338 plugs from 843 donors were assessed. Chondrocyte viability and proteoglycan synthesis were highest in the DMEM enriched with TGF-β at 37°C and 4°C. Although biomechanical properties decreased over time in all groups, dynamic culture conditions resulted in smaller decreases compared to other storage protocols. Viscoelasticity was observed in all samples, with dynamic media groups being maintained the most. Histological evaluation showed signs of degeneration, and temperature variations affected the preservation of the tissue differently. Bacterial surveillance identified contamination in specific storage conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Storing osteochondral allografts at 37°C in TGF-β supplemented media under dynamic conditions may extend the grafting window from 14 to 60 days. This extension could improve tissue availability, reduce costs and minimize graft wastage, thereby advancing joint resurfacing techniques. Further research is needed to confirm the safety and efficacy of this storage protocol.</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":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741684","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}
Thorben Briese, Christian Peez, Alina Albert, Arian Große-Allermann, Elmar Herbst, Adrian Deichsel, Michael J. Raschke, Christoph Kittl
{"title":"Impact of screw design on refixation of solid avulsion fractures of the posterior cruciate ligament—A biomechanical feasibility study","authors":"Thorben Briese, Christian Peez, Alina Albert, Arian Große-Allermann, Elmar Herbst, Adrian Deichsel, Michael J. Raschke, Christoph Kittl","doi":"10.1002/jeo2.70225","DOIUrl":"https://doi.org/10.1002/jeo2.70225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Avulsion fractures of the posterior cruciate ligament (PCL) are commonly treated with refixation. Headless compression screws (HCS) offer benefits, compared to conventional techniques, such as reduced material irritation and option of bioabsorbable materials, possibly avoiding implant removal. Proofing its clinical applicability, the authors hypothesized that (1) biomechanical properties of HCS would be comparable to conventional techniques and (2) magnesium-based HCS would provide comparable properties to titanium HCS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Controlled laboratory study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty fresh frozen porcine knees were dissected keeping the menisci and ligaments intact. A solid avulsion fracture of the tibial PCL (20 mm [length] × 20 mm [width] × 10 mm [depth]) was created with a chisel. Specimens were randomized into four groups: (1) the native PCL, the tibial PCL avulsion refixed with parallel arranged, (2) two 3.5 mm cortical screws with washer (Ti-CS), (3) two titanium headless compression screws (Ti-HCS) or (4) two magnesium based headless compression screws (Mg-HCS). Femur and tibia were mounted in a universal uniaxial testing machine (Zwick) simulating a posterior drawer testing, by performing axial load on the femur while the tibia was fixed in 90° flexion. After preconditioning, 500 cycles (200 mm/min) were performed with 10–100 N, followed by load-to-failure (LTF). Key parameters measured included stiffness, yield load, LTF and cyclic displacement. Differences were analyzed using an analysis of variance with a significance level of <i>p</i> < 0.05. The macroscopic failure mode was documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LTF of the intact PCL (1982.0 ± 285.4 N; <i>p</i> ≤ 0.001) significantly exceeded that of all refixations. Whereas LTF of Ti-CS (1034.8 ± 236.1 N) significantly (<i>p</i> ≤ 0.01) exceeded those of HCS, no significance was seen between titanium (Ti-HCS: 693.9 ± 220.5 N) or magnesium (Mg-HCS: 686.7 ± 174.6 N) based HCS. No significant differences were found among the refixation methods regarding cyclic displacement or yield load. Stiffness for the Ti-CS (144.0 ± 15.4 N/mm), Ti-HCS (150.0 ± 22.9 N/mm) and Mg-HCS (170.0 ± 20.9 N/mm) was lower than that of the intact PCL (190.9 ± 8.6 N/mm). Failure modes varied, with the Ti-CS group showing PCL tears and the HCS groups always experiencing fragment luxation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Co","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741554","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":"Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity-score matched study","authors":"Liru Ge, Junjie Wang, Haonan Fang, Yining Wang, Ziyuan Shen, Guoqi Cai","doi":"10.1002/jeo2.70185","DOIUrl":"https://doi.org/10.1002/jeo2.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the effects of total knee arthroplasty (TKA) on symptoms, function and activity over 5 years in knee osteoarthritis (KOA) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were from the Osteoarthritis Initiative (OAI). Participants who conducted the first TKA from (not before) enrolment to 48 months were propensity score matching (PSM) on their characteristics at the visit before surgery (treated as baseline) to those who did not conduct a TKA at 48 months (treated as baseline). Changes in knee pain and functional disability were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function subscales. Changes in physical activity, physical function and overall physical health and mental health were assessed using the Physical Activity Scale for the Elderly, the 20-m walk speed and the five times chair-to-stand tests and the 12-Item Short Form Survey, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-two pairs of participants in the TKA (56% women, mean 64.8 ± 8.4 years) and non-TKA groups were matched. Knee symptoms were significantly improved in the TKA group and flatted from 24 months (Pain: <i>β</i> = −3.29, 95% confidence interval [CI] = [−4.59 to −1.99], <i>p</i> < 0.001; Function: <i>β</i> = −10.12, 95% CI = [−14.21 to −6.03], <i>p</i> < 0.001). Physical function and overall physical health but not physical activity or mental health (PASE: <i>β</i> = 5.72, 95% CI = [−15.46 to 26.90], <i>p</i> = 0.597; Mental: <i>β</i> = 0.04, 95% CI = [−2.47 to 2.54], <i>p</i> = 0.976) was improved in the TKA group over 24 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TKA substantially improved knee symptoms and physical function over 60 months and physical health over 48 months, compared to those who had a similar severity of KOA but did not have a TKA, but this did not translate into increased physical activity or mental health.</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":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689313","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}