Journal of Experimental Orthopaedics最新文献

{"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}

{"title":"Anatomical insights beyond the centre edge angle in borderline hip dysplasia: A computerised tomography study","authors":"Joaquín Lara,&nbsp;Alejandro Neira,&nbsp;Alan Garín,&nbsp;Javier del Río,&nbsp;Alexander Tomic,&nbsp;Nicolás García,&nbsp;Matías Roby,&nbsp;Carlos De la Fuente","doi":"10.1002/jeo2.70268","DOIUrl":"https://doi.org/10.1002/jeo2.70268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Borderline hip dysplasia (BhD) may be associated with insufficient acetabular coverage. Thus, we investigated potential differences in acetabular anatomical measurements derived from computerised tomography (CT) that characterise BhD compared with healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>BhD patients (lateral centre edge angle [LCEA] between 18° and 25°) and healthy controls (LCEA between 25° and 40°) underwent anteroposterior pelvic X-ray and CT scans to study the Wiberg and Tönnis angle, the extrusion and Fear indices, notch width and depth, anterior and posterior wall heights, anterior and posterior articular surfaces, articular circumference, the ratio between the anterior articular surface and the articular circumference, the ratio between the posterior articular surface and the articular circumference, and the ratio between the notch width and the articular circumference. Independent two-tailed <i>t</i>-tests, Mann–Whitney <i>U</i> tests, and odds ratios were obtained (<i>α</i> = 5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three BhD patients (aged 31.5 ± 8.3 years and LCEA 21.6° ± 4.0°) and thirty-one healthy controls (aged 34.1 ± 8.0 years and LCEA 33.7° ± 5.5°) were included. The CT features most sensitive for detecting BhD were the anterior acetabular surface (<i>p</i> &lt; 0.001) and ratios of anterior (<i>p</i> = 0.009), anteroposterior (<i>p</i> = 0.008) and posterior (<i>p</i> &lt; 0.008) acetabular surfaces, as well as acetabular notch width (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CT characterisation showed insufficient acetabular coverage in BhD patients along the superior axis (lower Wiberg angle, and increased Tönnis angle and extrusion index), anterior axis (lower anterior acetabular surface and anteroposterior acetabular surface ratio, and increased posterior acetabular ratio), and inferior axis (increased acetabular notch width). These structural alterations suggest that periacetabular osteotomy may address persistent pathological deformation and stress on soft tissues and cartilage-bone structures more effectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Diagnostic 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/jeo2.70268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085065","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":"Side-to-side characterisation of cellular content, soluble factors and in vitro potential on chondrocytes for bone marrow aspirate concentrate and adipose-derived stromal vascular fraction","authors":"Enrico Ragni,&nbsp;Michela Taiana,&nbsp;Caterina Visconte,&nbsp;Elizaveta Kon,&nbsp;Simona Landoni,&nbsp;Cecilia Colombo,&nbsp;Laura Mangiavini,&nbsp;Giuseppe Peretti,&nbsp;Laura de Girolamo","doi":"10.1002/jeo2.70254","DOIUrl":"https://doi.org/10.1002/jeo2.70254","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;Orthobiologics gained popularity for the treatment of musculoskeletal pathologies, including osteoarthritis (OA). Bone marrow aspirate concentrate (BMAC) and adipose-derived stromal vascular fraction (SVF) were reported to reduce OA symptoms, contributing to the restoration of joint homoeostasis. Variability in production protocols and lack of extensive characterisation hinder a clear indication for the choice of a product over the other. The purpose of this study was to characterise side-by-side BMAC and SVF obtained with the same family of devices, by assessing cell immunophenotype, release of soluble factors and their ability to reduce inflammation in a pathologic in vitro chondrocyte model.&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;BMAC (iliac crest) and SVF (abdomen liposuction) were obtained from 28 (55 years old ± 8) and 39 patients (56 years old ± 9), with Hy-Tissue BMAC and Hy-Tissue SVF. BMAC/SVF were characterised for cellular content. The number of mesenchymal stromal cells (MSCs) was investigated by flow cytometry (CD45&lt;sup&gt;−&lt;/sup&gt;CD31&lt;sup&gt;−&lt;/sup&gt;CD34&lt;sup&gt;+&lt;/sup&gt;CD90&lt;sup&gt;+&lt;/sup&gt;CD105&lt;sup&gt;−/L&lt;/sup&gt;CD146&lt;sup&gt;−&lt;/sup&gt;, adipose-MSCs; CD45&lt;sup&gt;−&lt;/sup&gt;CD271&lt;sup&gt;+&lt;/sup&gt;, bone marrow-MSCs). Two-hundred factors (cytokines, chemokines, receptors, growth factors and inflammatory molecules) were tested by enzyme-linked immunosorbent assay (ELISA). Anti-inflammatory potential was assayed in vitro on interleukin-1 beta (IL1β)-treated chondrocytes by quantitative reverse transcription polymerase chain reaction (qRT-PCR) arrays of 84 genes involved in inflammatory processes.&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;BMAC had higher concentration for white cells (213x), erythrocytes (49x) and platelets (25x), while the number of MSCs resulted comparable between the two products (1000 cells/mL). One-hundred and twenty-one soluble factors were identified in all analysed samples, with 88 more abundant in BMAC and one in SVF. Gene ontology revealed that the higher concentrated molecules were mainly growth factors and/or involved in differentiation processes. Both orthobiologics reduced inflammation in the in vitro chondrocyte model, with BMAC showing higher efficacy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Using specific commercial systems, both orthobiologics showed anti-inflammatory effects in vitro. BMAC had higher blood cell and growth factor concentrations than SVF, with greater efficacy. However, variability in commercial systems limits generalisation, requiring further study to draw conclusions w","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939484","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":"Kinematic alignment in Japanese patients shows significant improvement 2 years after total knee replacement surgery","authors":"Takao Yamamoto,&nbsp;Shigenobu Fukushima,&nbsp;Shuji Toyono,&nbsp;Takahiro Miyaji,&nbsp;Taku Nakajima,&nbsp;Yoshihiro Wanezaki,&nbsp;Takashi Ito","doi":"10.1002/jeo2.70264","DOIUrl":"https://doi.org/10.1002/jeo2.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the 2-year post-operative results of the unrestricted kinematic alignment technique in total knee arthroplasty (TKA) among Japanese patients and understand the potential benefits of this technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 207 patients who underwent kinematic alignment in TKA for knee osteoarthritis between 2019 and 2021 were retrospectively reviewed. After applying the exclusion criteria, 164 knees remained for analysis (130 and 34 knees from female and male patients, respectively). The average age and body mass index were 74.5 ± 8.0 years and 26.4 ± 4.1 kg/m², respectively. Radiographic measurements were conducted preoperatively and post-operatively, while clinical evaluations—including knee extension, flexion angles, muscle strength, gait patterns and Knee Society scores (patient satisfaction and function)—were performed preoperatively, 1 year post-operatively and 2 years post-operatively. Statistical analysis was used to determine interobserver reliability and compare the preoperative and post-operative values. Radiographic evaluations were analyzed using a paired Student's <i>t</i> test, while clinical evaluations were analyzed using one-way ANOVA followed by a Tukey–Kramer multiple comparison test. 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>After surgery, statistically significant improvements were observed in both knee extension and flexion angles, as well as muscle strength (<i>p</i> &lt; 0.01). Two years after surgery, the rates of independent indoor walking and stair climbing were 89.6% and 58.9%, respectively. Additionally, the Knee Society Scores (patient satisfaction and function) significantly improved compared with the preoperative status (<i>p</i> &lt; 0.01). Complications were minimal; revision surgery was not required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In Japanese patients, kinematic alignment in TKA demonstrated significant improvements and promising outcomes over 2 years. Although alignment characteristics prior to arthritis may vary due to ethnic differences, this method—designed to replicate patient-specific alignments—is considered to have achieved favourable outcomes by tailoring to individual alignments. Further research comparing kinematic alignment with conventional alignment techniques could provide more valuable insights.</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":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939486","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":"Younger age, medial meniscectomy and remnant-sacrificing reconstruction techniques affect residual pivot shift after anterior cruciate ligament reconstruction using hamstring tendons","authors":"Atsuo Nakamae,&nbsp;Eisaku Fujimoto,&nbsp;Mitsuhiro Nakamura,&nbsp;Tsuyoshi Takada,&nbsp;Yusuke Tsuyuguchi,&nbsp;Toshiya Kano,&nbsp;Akinori Nekomoto,&nbsp;Nobuo Adachi","doi":"10.1002/jeo2.70265","DOIUrl":"https://doi.org/10.1002/jeo2.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the factors affecting residual pivot shift after anterior cruciate ligament (ACL) reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre prospective cohort study included patients who underwent primary ACL reconstruction using an autologous hamstring tendon graft with or without the ACL remnant-preserving technique. Multivariable logistic regression analysis was conducted to identify the factors that influenced residual pivot shift 1 year after ACL reconstruction. Age, sex, body mass index, interval between injury and surgery, preoperative pivot-shift grade, side-to-side differences in anterior knee laxity, hyperextension, lateral and medial meniscus treatments, and ACL reconstruction procedure (remnant-sacrificing single-bundle reconstruction, remnant-sacrificing double-bundle reconstruction or remnant-preserving single-bundle reconstruction) were selected as independent variables in the multivariable model. Patients who underwent additional lateral extra-articular tenodesis or anterolateral ligament reconstruction were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 760 patients, including 394 males and 366 females (average age at surgery, 29.1 years; age range, 14–67 years), were enroled in this study. The postoperative side-to-side difference in anterior knee laxity was 0.8 ± 2.3 mm, and pathological positive results in the pivot-shift test 1 year after ACL reconstruction were observed in 95 patients (12.5%). Factors that significantly affected postoperative positive pivot-shift test results were younger age (odds ratio [OR] 1.71; <i>p</i> = 0.033), medial meniscectomy (OR, 3.48; <i>p</i> &lt; 0.001), remnant-sacrificing single-bundle reconstruction (OR, 3.54; <i>p</i> &lt; 0.001) and remnant-sacrificing double-bundle reconstruction (OR, 2.18; <i>p</i> = 0.034).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Younger age, medial meniscectomy and remnant-sacrificing ACL reconstruction techniques were associated with residual pivot shift 1 year after ACL reconstruction. Identifying risk factors for postoperative residual pivot-shift is important for optimizing treatment decisions.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939487","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":"Gaps in diversity and inclusion reporting in United States knee injury clinical trials: A systematic review and meta-analysis","authors":"Faith Hendrickson,&nbsp;Caleb Uhunmwangho,&nbsp;Christian Hemmerich,&nbsp;Garrett Jones,&nbsp;J. Tyler Babek,&nbsp;Haley Howard,&nbsp;Jake Checketts,&nbsp;Alicia Ito Ford,&nbsp;Matt Vassar","doi":"10.1002/jeo2.70255","DOIUrl":"https://doi.org/10.1002/jeo2.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Diversity and inclusion in clinical trials are critical for increasing the generalizability of research. Our objective was to examine the diversity and inclusion of historically marginalized populations in clinical trials focused on knee injuries in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our systematic review and meta-analysis evaluated the diversity and representation of clinical trials concerning knee injuries published between 2018 and 2023. Published manuscripts of relevant knee injury clinical trials were identified using the medical literature databases MEDLINE (PubMed) and Embase (Elsevier). Two masked authors independently completed data screening and extraction. We evaluated studies using the Clinical trial Diversity Rating framework to assess their inclusion across multiple demographic characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13 studies met the inclusion criteria for the final meta-analysis. Only 1 out of 13 (7.7%) received a ‘Fair’ representation score for race/ethnicity participation, and 1 out of 13 (7.7%) received a ‘Poor’ representation score. The remaining 11 out of 13 (84.6%) studies did not report information on the race/ethnicity of their participants. Eight out of 13 (61.5%) trials received a ‘Good’ representation score when evaluating the inclusion of males and females, 3/13 (23.1%) were ‘Fair’ and 2/13 (15.4%) were ‘Poor’. None of the studies reported the number of participants aged ≥65 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this study highlight a lack of demographic reporting in knee injury clinical trials, with the included studies consistently failing to report information about the race/ethnicity and age breakdown of participants. The lack of diversity goals and insufficient reporting of racial and ethnic minority populations underscores the necessity for strategic approaches going forward to ensure clinical trials are more inclusive and representative of the incidence of knee injuries in the population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, systematic review and meta-analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939485","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":"Artificial intelligence demonstrates potential to enhance orthopaedic imaging across multiple modalities: A systematic review","authors":"Umile Giuseppe Longo,&nbsp;Alberto Lalli,&nbsp;Guido Nicodemi,&nbsp;Matteo Giuseppe Pisani,&nbsp;Alessandro De Sire,&nbsp;Pieter D'Hooghe,&nbsp;Ara Nazarian,&nbsp;Jacob F. Oeding,&nbsp;Balint Zsidai,&nbsp;Kristian Samuelsson","doi":"10.1002/jeo2.70259","DOIUrl":"https://doi.org/10.1002/jeo2.70259","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;While several artificial intelligence (AI)-assisted medical imaging applications are reported in the recent orthopaedic literature, comparison of the clinical efficacy and utility of these applications is currently lacking. The aim of this systematic review is to evaluate the effectiveness and reliability of AI applications in orthopaedic imaging, focusing on their impact on diagnostic accuracy, image segmentation and operational efficiency across various imaging modalities.&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;Based on the PRISMA guidelines, a comprehensive literature search of PubMed, Cochrane and Scopus databases was performed, using combinations of keywords and MeSH descriptors ('AI', 'ML', 'deep learning', 'orthopaedic surgery' and 'imaging') from inception to March 2024. Included were studies published between September 2018 and February 2024, which evaluated machine learning (ML) model effectiveness in improving orthopaedic imaging. Studies with insufficient data regarding the output variable used to assess the reliability of the ML model, those applying deterministic algorithms, unrelated topics, protocol studies, and other systematic reviews were excluded from the final synthesis. The Joanna Briggs Institute (JBI) Critical Appraisal tool and the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool were applied for the assessment of bias among the included studies.&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;The 53 included studies reported the use of 11.990.643 images from several diagnostic instruments. A total of 39 studies reported details in terms of the Dice Similarity Coefficient (DSC), while both accuracy and sensitivity were documented across 15 studies. Precision was reported by 14, specificity by nine, and the F1 score by four of the included studies. Three studies applied the area under the curve (AUC) method to evaluate ML model performance. Among the studies included in the final synthesis, Convolutional Neural Networks (CNN) emerged as the most frequently applied category of ML models, present in 17 studies (32%).&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;The systematic review highlights the diverse application of AI in orthopaedic imaging, demonstrating the capability of various machine learning models in accurately segmenting and analysing orthopaedic images. The results indicate that AI models achieve high performance metrics across different imaging modalities. However, the current body of literature lacks comprehensive statistical analysis and rand","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}