Journal of Experimental Orthopaedics最新文献

{"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}

{"title":"Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis","authors":"Abbas Aghayev,&nbsp;Burak Duymaz,&nbsp;Selahaddin Aydemir,&nbsp;Pınar Akokay Yılmaz,&nbsp;Gurhan Tukel,&nbsp;Resit Bugra Husemoglu,&nbsp;Onur Gürsan,&nbsp;Onur Hapa","doi":"10.1002/jeo2.70267","DOIUrl":"https://doi.org/10.1002/jeo2.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study evaluates the effects of hip capsule repair and cam lesion excision on capsular healing by assessing biomechanical strength and histological integrity in an in vivo rabbit model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An in vivo rabbit model with 80 rabbits was used, where capsulotomy was performed on the right hip of each subject. The rabbits were assigned into four groups: Group 1 (capsulotomy without repair), Group 2 (capsulotomy with capsule repair), Group 3 (capsulotomy + cam resection without repair), Group 4 (capsulotomy + cam resection + capsule repair). Each group was stratified into 4-week and 8-week follow-up subgroups. Biomechanical testing assessed maximum tensile strength, while histological evaluation included semiquantitative grading of collagen arrangement, inflammatory response, osteogenesis, and angiogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histological analysis revealed superior healing in the capsule repair + cam resection group (Group 4) compared to the unrepaired capsulotomy group (Group 1) (<i>p</i> = 0.01). Biomechanical testing demonstrated that capsule repair (Group 2) improved strength over unrepaired capsulotomy (135.2 N vs. 111.9 N, <i>p</i> = 0.03). Cam resection alone (Group 3) resulted in significantly higher strength than unrepaired capsulotomy (163.2 N vs. 111.9 N, <i>p</i> = 0.01). The combination of cam resection and capsule repair (Group 4) demonstrated superior strength, outperforming capsule repair alone (176 N vs. 135.2 N, <i>p</i> = 0.01). At 8 weeks, the capsule repair + cam resection group (Group 4a) showed significantly enhanced biomechanical strength compared to the unrepaired capsulotomy group (Group 1a) (181.6 N vs. 120.9 N, <i>p</i> = 0.001) and capsule repair alone (Group 2a) (181.6 N vs. 125.8 N, <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings indicate that cam resection, particularly when combined with capsule repair, significantly improves biomechanical strength and enhances the healing process of the capsule. These findings offer practical guidance for optimising surgical strategies to enhance patient outcomes and long-term joint function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, experimental therapeutic study (prospective and controlled).</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/jeo2.70267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085476","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 role of hinged external fixation in the treatment of knee dislocation, subluxation and fracture-dislocation: A systematic review of indications","authors":"Ekrem M. Ayhan,&nbsp;Sarah Levitt,&nbsp;Geoffrey D. Abrams,&nbsp;James P. Stannard,&nbsp;Michael J. Medvecky","doi":"10.1002/jeo2.70275","DOIUrl":"https://doi.org/10.1002/jeo2.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>While rigid knee-spanning external fixation is more commonly utilized in the treatment of complex knee injuries compared to hinged external fixation (HEF), HEF has the added benefit of providing stability while also permitting early controlled range of motion. However, there is limited existing literature on the indications for HEF of the knee. The aim of this study was to review the clinical indications for HEF in the management of acute and chronic knee dislocations (KD), tibiofemoral subluxations and knee fracture-dislocations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five databases, including PubMed, CINAHL, Cochrane, Scopus and SPORTDiscus, were systematically searched. Included studies were those that involved comparative or non-comparative evaluation of patients with an HEF applied for an acute or chronic KD, tibiofemoral subluxation or knee fracture-dislocation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen studies ranging from 1998 to 2023 met inclusion criteria, with a total of 184 knees treated with HEF for an acute or chronic KD, tibiofemoral subluxation, or knee fracture-dislocation. The most common primary indication for HEF was acute or chronic KD. The most common secondary indications included combined osseous and ligamentous deficiency, associated vascular or soft-tissue injury, status post extensive capsular release for arthrofibrosis, and associated extensor mechanism disruption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While uncommon, HEF is a valuable option in the treatment of complex knee injuries where both stability and controlled mobilization are essential. Due to limitations in the available evidence, further high-quality research is needed to establish guidelines for the utilization of HEF about the knee.</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":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085217","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":"Is the meniscus posterior root the “Death Zone” of the knee joint?","authors":"Angelo V. Vasiliadis,&nbsp;Vasileios Giovanoulis,&nbsp;Dimitrios Chytas,&nbsp;Luca Macchiarola","doi":"10.1002/jeo2.70277","DOIUrl":"https://doi.org/10.1002/jeo2.70277","url":null,"abstract":"&lt;p&gt;The meniscus has a well-recognized crucial multifunctional role in the function of the knee joint, including load transmission, shock absorption, stability, lubrication, proprioception and nutrient supply [&lt;span&gt;11&lt;/span&gt;]. Thus, more and more surgeons support the idea to ‘Save the meniscus’, underlying the importance of the meniscus integrity in the prevention of early degenerative alterations in the knee joint [&lt;span&gt;10&lt;/span&gt;]. It is also supported that the meniscus preservation should be part of every surgeon's treatment algorithm with an increased need to aggressively repair every amenable meniscal pathology, such as ramp lesions, radial tears, bucket handle tears and root tears. Meniscal root tears are defined either as an avulsion of the meniscal insertion or a complete radial tear within 10 mm of the meniscal root insertion [&lt;span&gt;1&lt;/span&gt;]. Interestingly, the recent recognition of pathology of meniscal root tears to alter joint biomechanics and accelerate articular cartilage degeneration, has characterized this type of meniscal injury as a ‘silent epidemic’ of the knee joint [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In mountaineering, the higher we go, the less oxygen we have in order to breathe, while passing an altitude above 8000 m, the body enters what climbers call the ‘Death Zone’. As surgeons, who deal with meniscal injuries, we would like to answer the question; is the meniscus posterior root the ‘Death Zone’ of the knee joint? Paraphrasing the ‘Death Zone’ of 8000 m in mountains, in the knee joint and especially in the meniscus, the more posterior we go, the more compressive forces and shear stresses are exposed to the meniscus, between the posterior femoral condyle and tibial plateau during deep flexion, increasing the risk of meniscal root tears. It is well documented in the literature that the natural history of an unrepaired meniscal posterior root tear can progressively lead to functional alterations, joint space narrowing and other degenerative changes in the knee joint, increasing the prevalence of a future arthroplasty procedure [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;It is noteworthy that recently published cadaveric, biomechanical and clinical studies have elucidated this pathology, underlying the necessity of meniscal posterior root repair [&lt;span&gt;5-9&lt;/span&gt;]. From a biomechanical point of view, a meniscal posterior root tear and the loss of associated function is equivalent to a total meniscectomy, leading to an increase in pressure of the affected compartment and subsequently rapid development of osteoarthritis [&lt;span&gt;9&lt;/span&gt;]. Lee et al., in their systematic review, tried to examine the radiological and clinical outcomes after repair, partial meniscectomy and nonoperative treatment in the management of meniscal root tears [&lt;span&gt;6&lt;/span&gt;]. They found that meniscal posterior root repair may be the most viable treatment option in lessening joint space narrowing and producing improvements in patient-reported outcomes, as measured by the Internat","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/jeo2.70277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085473","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":"Appropriate hinge position to prevent hinge fracture in open wedge distal tuberosity tibial osteotomy","authors":"Atsuki Tanaka,&nbsp;Daisuke Araki,&nbsp;Takahiro Yamashita,&nbsp;Shohei Sano,&nbsp;Ryo Okada,&nbsp;Mitsuhiko Takahashi,&nbsp;Yasushi Hashimoto","doi":"10.1002/jeo2.70278","DOIUrl":"https://doi.org/10.1002/jeo2.70278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Open wedge distal tuberosity tibial osteotomy (owDTO) is an effective treatment for varus knee osteoarthritis. Hinge fracture is a major complication, and hinge position is a contributing factor. This study aimed to investigate the relationship between hinge position and fractures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study examined 42 knees that underwent owDTO. The level of the proximal tibiofibular joint (PTFJ) hinge fracture was investigated on postoperative computed tomography (CT) images measuring the distances and angles around hinge area. Based on previous reports, the hinge position was classified, and hinge fractures were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No cases were found with a hinge position above PTFJ, 41 cases were within PTFJ, and one case was distal to PTFJ. Hinge fractures were observed in 10 patients (23.8%). According to the hinge position classification, seven cases were type I (a fracture within PTFJ), three were type II (a fracture that reaches the distal portion of PTFJ), and no cases were type III (intra-articular fracture). The anteroposterior hinge width measured perpendicular to the descending cut of the flange on axial CT images at the proximal level of the PTFJ was significantly shorter in the hinge fracture group (<i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The owDTO hinge fracture rate in our study was comparable to that in previous reports on open wedge high tibial osteotomy. As the risk of hinge fracture increases with the shortening of the anterior-posterior hinge width, our results indicate that preservation of the anterior-posterior hinge width may help reduce hinge fractures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, Retrospective study.</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/jeo2.70278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085446","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":"Occupational motions such as kneeling and squatting are associated with the increased development of medial meniscus posterior root tears, regardless of the medial posterior tibial slope angle","authors":"Koki Kawada,&nbsp;Yusuke Yokoyama,&nbsp;Masanori Tamura,&nbsp;Yuki Okazaki,&nbsp;Toshifumi Ozaki,&nbsp;Takayuki Furumatsu","doi":"10.1002/jeo2.70276","DOIUrl":"https://doi.org/10.1002/jeo2.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The relationship between occupational motions and the medial posterior tibial slope (MPTS) with the development of medial meniscus posterior root tears (MMPRTs) has not been investigated. The development of non-traumatic degenerative MMPRTs may be influenced by repetitive occupational motions and bone morphological characteristics. Herein, we examined the association between occupational motions and MPTS in patients with MMPRT development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>During the first medical examination, MPTS was measured using lateral knee radiographic images, and occupational motions were investigated in 559 patients (591 knees). Occupational motions were classified as kneeling and squatting, standing and walking, sitting, lifting heavy weights, and housework. Mann–Whitney <i>U</i> test was used to compare patient characteristics between male and female patients and MPTS relative to occupational motion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most frequent occupational motion was housework (160/559 patients, 28.6%), followed by kneeling and squatting (140/559, 25.0%), standing and walking (128/559, 22.9%), sitting (82/559, 14.7%), and lifting heavy weights (49/559, 8.8%). Furthermore, housework (10.0 ± 2.6°) involved significantly greater MPTS than kneeling and squatting (9.3 ± 2.7°; <i>p</i> = 0.012). However, the MPTS associated with other occupational motions was not significantly different from that associated with housework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The most frequent occupational motion among patients with MMPRTs was housework, followed by kneeling and squatting. Patients who performed housework tended to have a higher MPTS. Occupational motions such as kneeling and squatting potentially increase the development of MMPRTs, even without a high MPTS.</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":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085216","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":"Comparable joint awareness and implant survival at midterm follow-up between CR and PS TKA: An anatomic phenotype-based propensity score-matched analysis","authors":"Lars-Rene Tuecking,&nbsp;Tobias Welzel,&nbsp;Max Ettinger,&nbsp;Henning Windhagen,&nbsp;Peter Savov","doi":"10.1002/jeo2.70242","DOIUrl":"https://doi.org/10.1002/jeo2.70242","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Recent studies highlight the role of joint awareness and the influence of preoperative anatomy on outcomes of cruciate-retaining (CR) versus posterior-stabilized (PS) implants in total knee arthroplasty (TKA). There is currently a lack of studies comparing CR and PS prostheses while adjusting for important anatomical parameters and anatomical phenotypes with large group sizes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This retrospective single-centre study analyzed patients who underwent primary TKA with the Triathlon® CR or PS implant system from 2008 to 2014 with a minimum follow-up of 6.5 years. Patients were matched using propensity scores based on demographics (age, gender and body mass index) and preoperative anatomic angle parameters (lateral distal femoral angle [LDFA], medial proximal tibia angle, hip–knee–ankle angle [HKA], arithmetic HKA and joint line obliquity) and Coronal Plane Alignment of the Knee (CPAK) types. Outcome data included patient-reported outcomes (PROMs: Forgotten Joint Score, Oxford Knee Score, Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, visual analogue scale and University of California at Los Angeles), demographic data, post-operative clinical course data. Statistical analysis was conducted using R, with significance set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 728 patients (513 CR and 215 PS) were included, leaving 519 patients (346 CR and 173 PS) being analyzed after propensity score matching. Joint awareness and further clinical scores showed no differences between CR and PS implants (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Implant survival at 5 and 10 years was similar for both types (log-rank test: &lt;i&gt;p&lt;/i&gt; = 0.164 and &lt;i&gt;p&lt;/i&gt; = 0.163), though CR implants had lower survival rates overall. Valgus CPAK types III and VI showed the lowest survival rates, especially for CR implants. Regression analysis revealed younger patient age significantly affected CR implant survival, while increasing valgus LDFA decreased PS implant survival.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;No differences were found in the joint awareness of CR and PS prostheses in the medium to long-term follow-up, while controlling for preoperative anatomy. Similarly, there were no significant variations in implant survival. Noticeably higher revision rates in the valgus CPAK phenotypes were found for both systems. A high valgus LDFA angle was identified as a risk factor for revisions in PS systems.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000","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/jeo2.70242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085067","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":"Targeted adjustment of the posterior tibial slope in unicompartmental knee arthroplasty is feasible without altering the medial proximal tibial angle","authors":"Moses K. D. El Kayali,&nbsp;Rosa Berndt,&nbsp;Clemens Gwinner,&nbsp;Lorenz Pichler","doi":"10.1002/jeo2.70286","DOIUrl":"https://doi.org/10.1002/jeo2.70286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Recommendations regarding the surgical modification of the medial posterior tibial slope (mPTS) in medial unicompartmental knee arthroplasty (UKA) vary. Given the high preoperative variability, this often results in a significant change in the patient's mPTS through UKA. However, it is unclear whether this change in mPTS impacts the coronal alignment, specifically the medial proximal tibial angle (MPTA). Therefore, the purpose of this study was to report on the preoperative to post-operative changes in mPTS and MPTA and their potential correlation in UKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pre- and post-operative radiographs of 96 consecutive patients undergoing conventional medial UKA were analyzed. Pre- and post-operative mPTS and MPTA were measured on radiographs by two observers and reported. Their differences, as well as the difference from the target value of 7°, were analyzed. Cases were grouped regarding their mPTS change into cases with &lt;3° and cases with ≥3° mPTS change, and the correlation between changes in mPTS and changes in MPTA was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean mPTS was reported at 9.27° (standard deviation [SD], 3.41°) preoperatively and 7.25° (SD, 2.23°) post-operatively, with a mean change of −2.02° (SD, 3.84°; <i>p</i> &lt; 0.001). Overall, 71.7% of cases had a post-operative mPTS within ±2° of 7° without significant difference from the target value of 7° (<i>p</i> = 0.797). At a mean preoperative MPTA of 85.39° (SD, 2.34°) and a mean post-operative MPTA of 84.12° (SD, 2.55°), UKA resulted in an average change of MPTA of −1.28° (SD, 2.55°; <i>p</i> &lt; 0.001). Correlation coefficients revealed very weak correlations between the change in mPTS and the change in MPTA for all groups (<i>r</i> &lt; −0.13 in all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Targeted mPTS modification can be achieved, which implies a significant change from preoperative mPTS values in patients undergoing UKA. However, the change in mPTS does not affect the change in MPTA.</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/jeo2.70286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085474","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}