Journal of Experimental Orthopaedics最新文献

{"title":"High tibial osteotomy effectively restores motor function during daily activities in patients with knee osteoarthritis and varus deformity","authors":"Giordano Valente,&nbsp;Giulia Grenno,&nbsp;Giacomo Dal Fabbro,&nbsp;Alberto Grassi,&nbsp;Alberto Leardini,&nbsp;Lisa Berti,&nbsp;Stefano Zaffagnini,&nbsp;Fulvia Taddei","doi":"10.1002/jeo2.70410","DOIUrl":"10.1002/jeo2.70410","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study evaluated the effects of high tibial osteotomy (HTO) on spatio-temporal parameters, kinematics and kinetics during walking, stair ascent and descent, in patients with medial knee osteoarthritis and varus malalignment, by using a prospective randomized case-control design, which compares the effects of HTO with a non-surgical conservative treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 49 patients with medial knee osteoarthritis and varus malalignment were enroled in a prospective randomized case-control study. Patients were randomly assigned to the Surgical Group (<i>n</i> = 25), which underwent open-wedge HTO, or the Conservative Group (<i>n</i> = 24), which followed non-surgical conservative treatment. An additional 20 healthy subjects were included as controls. Radiographs in double-leg stance and gait analysis during the motor activities were conducted at baseline and follow-up. Statistical comparisons of spatio-temporal parameters, joint rotations and joint moments were performed to assess the effects of surgery on motor function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the Surgical Group, HTO significantly corrected the tibiofemoral angle (from 8.3 ± 3.3° to 0.9 ± 2.4°, <i>p</i> &lt; 0.001), restoring values comparable to healthy controls. Knee and ankle adduction were fully restored in all motor tasks, with significant improvements in at least 60% of the movement cycle (<i>p</i> &lt; 0.05). Knee adduction and rotation moments were significantly reduced, with some patients even showing lower-than-normal knee adduction moments during walking, suggesting possible overcorrection. However, pelvic obliquity and ankle flexion remained altered, and no significant changes were observed in walking speed or stride length. The Conservative Group showed no improvements at follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HTO effectively restores knee alignment and major motor function parameters during walking and stair tasks, whereas non-surgical conservative treatments do not lead to any improvement. However, some residual motor function deviations persist after surgery, suggesting that certain biomechanical adaptations may remain after surgical correction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I, randomized controlled trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062794","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":"Operative and non-operative management can result in acceptable long-term outcomes for isolated posterior cruciate ligament injuries in paediatric patients","authors":"Morgan G. Batley,&nbsp;Nathan Chaclas,&nbsp;Katherine Ashe,&nbsp;Caroline L. Kim,&nbsp;Theodore J. Ganley,&nbsp;Kathleen J. Maguire,&nbsp;Brendan A. Williams","doi":"10.1002/jeo2.70421","DOIUrl":"10.1002/jeo2.70421","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate the injury characteristics, treatment, and outcome of paediatric patients with isolated posterior cruciate ligament (PCL) injuries treated at a single center. Authors hypothesised that both treatment cohorts would successfully return to sport participation with a low risk of PCL retear or ongoing knee-related symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review and cross-sectional outcomes assessment were performed identifying patients &lt;18 years old with PCL injuries from a single treatment center between 2015 to 2021 using ICD-10 coding. Patients with concomitant collateral or cruciate ligament injury were excluded. Studied variables included patient demographics, injury characteristics, treatment strategies, and patient outcomes (PROMIS, IKDC and Lysholm scores and reinjury). A cross-sectional follow-up survey was distributed to all patients in spring 2023. Descriptive statistics were performed for continuous and categorical outcomes. Bivariate analyses were performed on all variables between operative and nonoperative treatment groups. A non-response analysis was completed to evaluate non-response bias of the cross-sectional cohort due to the incomplete response rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four patients meeting inclusion criteria were identified. Injured patients had a mean age of 13.2 years old and were predominantly male (67%). Injuries most occurred during sport participation (75%) and were managed nonoperatively (67%). Overall, there were no differences between treatment groups regarding complications or return to sport. Eleven (46%) completed the cross-sectional outcomes assessment at an average of 4.7 years from injury. Most patients had successfully returned to sport without sustaining an ipsilateral knee injury with patient reported outcome scores within normative ranges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results suggest that both operative and non-operative treatment strategies are reasonable in the short- and long-term management of paediatric PCL injuries.</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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70421","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145037904","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":"Phenotyping the knee joint—A critical appraisal of CPAK for alignment classification","authors":"Randa Elsheikh,&nbsp;Yuma Onoi,&nbsp;George M. Avram,&nbsp;Heiko Graichen,&nbsp;Michael T. Hirschmann","doi":"10.1002/jeo2.70409","DOIUrl":"10.1002/jeo2.70409","url":null,"abstract":"&lt;p&gt;The last decade has witnessed the intensification of the pursuit of personalisation in total knee arthroplasty (TKA), driven by the mounting evidence that a one-size-fits-all approach to alignment technique might not yield optimal results for every patient [&lt;span&gt;19&lt;/span&gt;]. This has led to the questioning of the mechanical alignment technique, which aims at achieving a neutral alignment without properly considering the anatomical variability of the knee. Consequently, several alignment techniques have been developed, all aiming to tailor surgical technique to an individual's native knee morphology and biomechanics [&lt;span&gt;44, 45&lt;/span&gt;], although current evidence remains inconclusive as to which approach yields the best outcomes [&lt;span&gt;26&lt;/span&gt;]. Clearly, this evolution was accompanied by the need for tools that might aid surgeons in stratifying patients into distinct anatomical or functional categories. Among these tools, the coronal plane alignment of the knee (CPAK) classification has attracted considerable attention, largely owing to its simplified approach and its practical compatibility with routine radiographic assessments [&lt;span&gt;33&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Originally introduced to support alignment decisions using native coronal plane anatomy, CPAK classifies patients into nine categories based on the arithmetic hip-knee-ankle (aHKA) angle and joint line obliquity (JLO) measured on anterior-posterior knee radiographs [&lt;span&gt;33&lt;/span&gt;]. By combining these two values, each knee is classified into a grid of 3 × 3 phenotypes: neutral, varus, or valgus aHKA crossed with apex distal, neutral, or apex proximal JLO (Figure 1). Owing to the ability of the grid-based approach to offer a simplified yet systematic categorisation of knee alignment while adhering to traditional imaging workflows, CPAK has been frequently described as a method for ‘knee phenotyping’ both in the academic and clinical literature [&lt;span&gt;38, 39, 49&lt;/span&gt;]. However, systematic approaches are often based on the notion that all knees are the same and therefore neglect the intrinsic anatomical variability of each joint [&lt;span&gt;14&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Importantly, the use of the term ‘phenotype’ warrants closer scrutiny. Referring to CPAK as a phenotyping system risks overstating its capabilities and oversimplifying a highly complex anatomical and functional construct. In fact, while little variability is observed in mean coronal alignment, substantial inter-individual variation is detected even in native knees, which makes the classification of coronal alignment into neutral, valgus and varus overly simplistic and rather limiting [&lt;span&gt;14, 15, 19&lt;/span&gt;]. Phenotyping, particularly in the context of knee arthroplasty, requires a comprehensive understanding of patient-specific factors, including three-dimensional bone morphology and dynamic kinematics. In contrast, CPAK offers a static, two-dimensional alignment based solely on coronal plane geometry, while ignoring axial and sagittal plane","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145037903","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":"Smokers present a three times higher risk of graft failure after ACL reconstruction: A single-centre retrospective analysis","authors":"Filip R. Hendrikx,&nbsp;Pietro Conte,&nbsp;Annemieke Van Haver,&nbsp;Kristien Vuylsteke,&nbsp;Koen Carl Lagae,&nbsp;Peter Verdonk","doi":"10.1002/jeo2.70422","DOIUrl":"10.1002/jeo2.70422","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine whether patients actively smoking at the time of primary anterior cruciate ligament reconstruction (ACLR) have higher failure rates, defined as the need for revision ACLR procedures over time, compared to non-smokers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective evaluation on a single-centre cohort of patients who underwent primary ACLR between 2010 and 2015. Patients were included if they had a minimum follow-up of two years and were classified according to their smoking status at the time of the surgery. The primary outcome was graft failure, defined as the need for revision ACLR surgery due to symptomatic ACL instability. Additionally, subgroup analyses were performed on patient groups known to be at high risk of ACLR failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort consisted of 537 patients, including 96 (18%) smokers and 441 (82%) non-smokers, with a mean follow-up of 56 months (range 24–89). Demographic characteristics were similar between smokers and non-smokers at baseline. Overall, 22 patients (4.1%) underwent revision ACLR. The failure rate was significantly higher in smokers (9.4%, 9/96) compared to non-smokers (2.9%, 13/441) (<i>p</i> = 0.008, odds-ratio (OR): 3.41, 95% confidence interval (CI): 1.41–8.22). This difference was even greater in specific subgroups: smokers had significantly higher failure rates than non-smokers among patients under 25 years of age (31% vs. 9.8%, <i>p</i> = 0.006, OR: 4.13, 95% CI: 1.54–11.07), highly active patients (20.7% vs. 7.7%, <i>p</i> = 0.044; OR; 3.13, 95% CI: 1.01–9.30) and male patients (13.3% vs. 3.9%, <i>p</i> = 0.010; OR: 3.83, 95% CI: 1.41–10.40).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Smoking at the time of ACLR was associated with a threefold increased risk of ACLR failure. The ACLR failure risk was even greater in patients under 25 years of age, male and those participating in high-activity sports. Notably, a failure rate of 31% was observed in smokers under 25 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, case series with no comparison group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022139","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 interplay between metabolic disorders and tendinopathies: Systematic review and meta-analysis","authors":"Paola De Luca,&nbsp;Giulio Grieco,&nbsp;Silvia Bargeri,&nbsp;Cecilia Colombo,&nbsp;Stefania Guida,&nbsp;Michela M. Taiana,&nbsp;Laura de Girolamo","doi":"10.1002/jeo2.70429","DOIUrl":"10.1002/jeo2.70429","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the prevalence of tendinopathies in relation to metabolic factors and to investigate associations between tendinopathies and metabolic conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The current review synthesised screened articles in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines predesigned criterion which were from PubMed, Scopus and Web of Science published up to 31 March 2024. Eligible studies included cohort, case-control or cross-sectional designs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-three studies were included. Achilles tendinopathy emerged as highly prevalent in diabetic individuals (6%; 95% confidence interval [CI]: 42%–91%). Moreover, diabetes was identified as a risk factor for Achilles tendinopathy development with an odds ratio (OR) of 7.22 (95% CI: 2.61–19.97). Diabetes was also linked to upper limb tendinopathies, including medial epicondylitis (OR: 11.27, 95% CI: 2.01–63.02) and trigger finger (OR: 3.79, 95% CI: 1.87–7.65). A pooled prevalence estimate found that 13% (95% CI: 4%–21%) of tendinopathy patients had hypercholesterolaemia and a prevalence of 38% (95% CI: 5%–80%) of tendinopathy was found among statin users. However, high study heterogeneity limited the reliability of these two findings. Even if body mass index alterations were observed in tendinopathy patients with a pooled prevalence of 64% (95% CI: 62%–66%), a causation could not be definitively established. The analysis of the impact of sex exhibited men higher rates of tendon pathology associated with dyslipidaemia, whereas diabetic women demonstrated a greater prevalence of trigger finger tendinopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results showed that diabetes, dyslipidaemia and obesity contribute to the tendinopathies development, highlighting their multifactorial aetiology with sex differences influencing specific pathologies. These findings suggested periodic metabolic evaluations in susceptible individuals to tendon overload, chronic pain or recurrent injuries.</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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70429","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022140","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":"Letter to the Editor Josefsson et al. ‘Reduced periprosthetic fracture rate for a cemented anatomical versus a tapered polished stem in hip arthroplasty: A 6-year follow-up of a prospective observational cohort study’","authors":"Peter Wahl,&nbsp;Emanuel Gautier","doi":"10.1002/jeo2.70412","DOIUrl":"10.1002/jeo2.70412","url":null,"abstract":"&lt;p&gt;We read with great interest the recent publication in the &lt;i&gt;Journal of Experimental Orthopaedics&lt;/i&gt; by Josefsson et al., entitled ‘Reduced periprosthetic fracture rate for a cemented anatomical versus a tapered polished stem in hip arthroplasty: A 6-year follow-up of a prospective observational cohort study’ [&lt;span&gt;4&lt;/span&gt;]. As long-standing proponents of the view that classifying fixation in total hip arthroplasty merely as ‘cemented’ or ‘uncemented’ is overly simplistic, not doing justice to essential outcome determinants, we were pleased to see the authors address differences between cemented stems using either a force-closed (or taper-slip) or a shape-closed concept. These distinctions are often underappreciated, despite their clinical relevance. Notably, variation in revision rates between fixation principles have been observed, particularly higher and progressively increasing revision risks associated with mixed concepts such as the French paradox technique [&lt;span&gt;7&lt;/span&gt;]. Among the pure concepts, shape-closed designs perform much better than force-closed designs regarding the risk of periprosthetic fractures (PPF) of the proximal femur, as corroborated by both the present study [&lt;span&gt;4&lt;/span&gt;] and a recently published systematic review of the literature with meta-analysis [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;However, we would like to draw attention to a likely error in Figure 1, where the legend appears to have been inverted. Given the importance of this figure in conveying the study's key findings, we suggest issuing a corrigendum: the orange curve should correspond to polished tapered stems, and the blue curve to anatomic stems.&lt;/p&gt;&lt;p&gt;Beyond this, we believe the results merit a more nuanced discussion, particularly in light of potential confounding factors not addressed in the analysis. The temporal pattern of occurrence of PPF after THA in the force-closed stem group appears atypical, resembling more closely the early postoperative profile of uncemented stems [&lt;span&gt;1&lt;/span&gt;]. This may reflect intraoperative issues rather than inherent shortcomings of the cementation concept. The distribution of fracture types (illustrated in Figure 2 of the original publication) might similarly indicate surgical technique issues, such as overly aggressive broaching. Additional design features of the collarless polished taper (CPT) stem (Zimmer Biomet, Zug, Switzerland)—such as its length, its shoulder profile requiring sufficient lateral broaching, and the integrated cement mantle of 2 mm incorporated into the broaches of Exeter designs—may have contributed to technical difficulties, particularly in patients with narrow medullary canals. Furthermore, the higher dislocation rates in the force-closed group might reinforce concerns regarding a suboptimal technique. This interpretation is further supported by the uncommonly high rate of periprosthetic joint infection (PJI) in this study, as the global rate of PJI was 2.6%, and particularly high in the force-cl","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012984","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":"Magnetic resonance imaging offers advantages over computer tomography for measurement of the shoulder stability ratio","authors":"Christian D. Schenk,&nbsp;Sebastian Oenning,&nbsp;Jens Wermers,&nbsp;Marcel Wilken,&nbsp;Julia Sußiek,&nbsp;Arne Riegel,&nbsp;Michael J. Raschke,&nbsp;J. Christoph Katthagen","doi":"10.1002/jeo2.70423","DOIUrl":"10.1002/jeo2.70423","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Recent studies indicate that bony shoulder stability ratio (BSSR) is a useful parameter for estimating glenohumeral stability provided by concavity-compression. In cases of bony glenoid defects, the BSSR may help to optimise surgical decision-making. However, the shapes of cartilage and labrum differ from the subchondral bony concavity. The aim of this study was to investigate the influence of cartilage and labrum on glenoid concavity and glenohumeral stability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten cadaveric shoulders were examined by computer tomography (CT) and magnetic resonance imaging (MRI). Thereby radius, depth and stability ratio in anterior-posterior and superior-inferior directions were measured. MRI measurements were performed once including and once excluding the labrum. From these, BSSR, osteochondral shoulder stability ratio (OSSR) and fibrocartilaginous shoulder stability ratio (FCSSR) were calculated, and correlations were investigated to assess the transferability between imaging modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CT and MRI did not provide comparable results due to the influence of cartilage and labrum. The FCSSR showed a significantly higher stability ratio than BSSR in anterior-posterior and the same tendency in superior-inferior direction. OSSR and BSSR did not differ significantly. The labrum contributed to a significantly higher depth and lower radius in the anterior-posterior direction. Cartilage alone led to a significantly lower radius in both directions, without significant differences in depth. Comparison of CT and MRI measurements showed only weak correlations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Labrum and cartilage lead to an increased depth and decreased radius, resulting in a higher glenoid concavity and, consequently, a higher stability ratio. Comparing FCSSR and BSSR, the influence of labrum and cartilage led to a 25% higher stability ratio in anterior-posterior direction and a 7.7% higher stability ratio in superior-inferior direction. By finding no significant differences between bony and osteochondral stability ratios, the labrum of the glenoid appears to be the major factor for the increase in stability ratio. Moreover, CT and MRI measurements showed no transferability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, diagnostic study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012878","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 and component rotational mismatches negatively affect postoperative outcomes in total knee arthroplasty","authors":"Kohei Kawaguchi,&nbsp;Ryota Yamagami,&nbsp;Kenichi Kono,&nbsp;Junfeng Zhang,&nbsp;Shuji Taketomi,&nbsp;Hiroshi Inui,&nbsp;Sakae Tanaka","doi":"10.1002/jeo2.70415","DOIUrl":"10.1002/jeo2.70415","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Anatomical rotational mismatch (ARM) refers to postoperative malrotation between the femur and tibia, and component rotational mismatch (CRM) refers to malrotation between the femoral and tibial components in total knee arthroplasty (TKA). This study aimed to quantify ARM and CRM and assess their individual and combined effects on postoperative outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analysed 224 knees that underwent primary TKA. Postoperative axial rotational angles between the femoral and tibial components (component rotational angle [CRA]) and between the femur and tibia (anatomical rotational angle [ARA]) were measured using computed tomography. Internal tibial or tibial component rotation relative to the femur or femoral component was assigned a positive value. Rotational mismatch was defined as CRA and ARA over ±10°. Clinical outcomes were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) 1 year postoperatively. Hierarchical cluster analysis categorised knees into two groups based on CRA and ARA (Groups 1 and 2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean ± standard deviation (SD) postoperative ARA was 5.2° ± 5.3°, with ARM present in 16.1% of cases (36 knees). Knees with ARM showed significantly worse improvement in the KOOS pain subscale than those without ARM (<i>p</i> = 0.02). Postoperative CRA was 1.5° ± 4.5°, with CRM observed in 2.7% of cases (6 knees), but CRM alone did not significantly affect postoperative outcomes. Cluster analysis identified two groups (Group 1: 185 knees; Group 2: 39 knees), with Group 2 exhibiting greater CRAs and ARAs compared to Group 1 (both <i>p</i> &lt; 0.01). Group 2 also had significantly worse KOOS pain and activities of daily living improvement relative to Group 1 (<i>p</i> &lt; 0.01, 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both CRM and ARM were observed following TKA. ARM negatively impacted postoperative outcomes, and the combined presence of CRM and ARM further worsened clinical results.</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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012028","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":"Evaluating the accuracy of ultrasonography in the diagnosis of subtle Lisfranc injuries","authors":"Kensei Yoshimoto,&nbsp;Toru Omodani,&nbsp;Kotaro Ishizuka,&nbsp;Kazunori Maruyama,&nbsp;Mitsuki Kumaki,&nbsp;Masahiko Noguchi,&nbsp;Ken Okazaki","doi":"10.1002/jeo2.70434","DOIUrl":"10.1002/jeo2.70434","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Weight-bearing (WB) computed tomography or plain radiography provides the most accurate diagnosis of subtle Lisfranc injuries. However, WB is often challenging for patients due to pain, and these modalities can be inconvenient. Recently, the utility of ultrasonography (US), which enables easy and convenient assessment and bilateral comparison, has gained attention. This study aimed to assess whether US can accurately diagnose these injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-five patients with subtle Lisfranc injuries, defined as a &gt; 2 mm distance between the first cuneiform (C1) and second metatarsal (M2) on WB anteroposterior plain foot radiographs, were included in this cross-sectional study. Bilateral foot radiographs were used for intra-individual comparison, and the contralateral side was confirmed to be uninjured. US without stress or WB was performed after radiography, and the C1–M2 dorsal and articular distances were measured to assess whether this modality could accurately diagnose subtle Lisfranc injuries. Patients with uninjured contralateral feet were evaluated as healthy subjects. All patients had ligament injury and instability confirmed intraoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>US measurements demonstrated strong reliability: the intraclass correlation coefficients for the C1–M2 dorsal distance were 0.91 (intra-observer) and 0.92 (inter-observer), and for the articular distance, 0.95 and 0.94, respectively. The C1–M2 dorsal and articular distances were significantly greater on the injured side. The cutoff values for the C1–M2 dorsal and articular distances in diagnosing subtle Lisfranc injury were 9.3 mm and 2.1 mm, respectively. The sensitivity and specificity of the cutoff value for the C1–M2 dorsal distance were 0.88 and 0.72, respectively, whereas those of the cutoff value for the C1–M2 articular distance were 0.76 and 0.96, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although US examination requires experience, it demonstrated high diagnostic accuracy in detecting subtle Lisfranc injuries without the need for stress or WB imaging and showed high consistency in both intra- and inter-observer measurements of the C1–M2 distance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Levels of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012904","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":"Obesity has no adverse effect on the survival of unicompartmental knee arthroplasty in a long-term follow-up of 16 years","authors":"David Zhu,&nbsp;Regis Pailhe,&nbsp;Dany Mouarbes,&nbsp;Ali Alayane,&nbsp;Samy Saoudi,&nbsp;Hasnae Ben-Roummane,&nbsp;Emilie Bérard,&nbsp;Etienne Cavaignac","doi":"10.1002/jeo2.70426","DOIUrl":"10.1002/jeo2.70426","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The role of obesity in unicompartmental knee arthroplasty (UKA) outcomes remains debated. The aim of this study is to clarify the impact of obesity on revision rates and functional outcomes of UKA in a long-term follow-up. The hypothesis was that body mass index and weight do not significantly affect the long-term survival of UKAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted on 143 UKAs performed over a 16-year period. Patients were stratified by BMI (&lt;30 vs. ≥30 kg/m²) and weight (&lt;82 vs. ≥82 kg). Kaplan–Meier survivorship analysis assessed the 16-year survival rates across subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 16-year survival rates were comparable in the BMI subgroups (≥30 kg/m²: 78% (95% confidence interval [CI]: 60–88); &lt;30 kg/m²: 84% [95% CI: 75–90]; <i>p</i> = 0.093) but demonstrated a significant difference in the weight subgroups (&lt;82 kg: 85% [95% CI: 76–90]; ≥82 kg: 76% [95% CI: 59–87]; <i>p</i> = 0.045). Multivariate analysis, adjusted for confounders, showed no statistically significant impact of BMI (<i>p</i> = 0.202) or weight (<i>p</i> = 0.280) on the risk of revision. Functional outcomes, measured by knee society and self knee value scores, were unaffected by BMI at the final follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study confirms that BMI and weight do not significantly influence the long-term survival or functional outcomes of UKA, supporting its use in obese patients when appropriately indicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, retrospective case series.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012874","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}