Journal of Experimental Orthopaedics最新文献

{"title":"Placing the transtibial centralisation stitch at the posterior horn of the medial meniscus best restores tibiofemoral contact mechanics and extrusion following medial meniscus posterior root tears: An in vitro biomechanical study using porcine knee joints","authors":"Khalis Boksh,&nbsp;Duncan E. T. Shepherd,&nbsp;Daniel M. Espino,&nbsp;Arijit Ghosh,&nbsp;Randeep Aujla,&nbsp;Michael E. Hantes,&nbsp;Tarek Boutefnouchet","doi":"10.1002/jeo2.70217","DOIUrl":"https://doi.org/10.1002/jeo2.70217","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate whether the position of the transtibial centralisation tunnel, on the background of an anatomical transtibial pull-through root repair (ATPR), affects the tibiofemoral contact mechanics and meniscal extrusion for medial meniscus posterior root tears (MMPRT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Meniscal extrusion and contact mechanics were measured using two-dimensional imaging and pressure films in 10 porcine knee joints. The posterior root was tested under six states: (1) intact; (2) MMPRT; (3) ATPR; (4) ATPR with TTC at the posterior horn (TTC-PH); (5) ATPR with TTC midway between the PH and posterior border of medial collateral ligament (MCL) (TTC-MID) and (6) ATPR with TTC behind the MCL (TTC-MCL). The testing protocol loaded knees with 200-N axial compression at four flexion angles (30°, 45°, 60° and 90°). At each angle and state, meniscal extrusion was measured as the difference in its position under load to that of the unloaded condition in the intact state. Contact area and pressure were recorded for all states at all angles and were analysed using a MATLAB programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ATPR + TTC-PH led to greater reduction in extrusion compared to both ATPR and ATPR + TTC-MCL at 60° and 90° (<i>p</i> &lt; 0.02 and <i>p</i> &lt; 0.05, respectively). ATPR + TTC-PH improved contact area compared to ATPR at 60° (<i>p</i> = 0.037) and 90° (<i>p</i> = 0.014), and to ATPR + TTC-MCL at 90° (<i>p</i> = 0.042). ATPR + TTC-MID improved contact area compared to ATPR at 90° (<i>p</i> = 0.035). ATPR + TTC-PH reduced peak contact pressure compared to ATPR at 45° (<i>p</i> = 0.046) and 60° (<i>p</i> = 0.019), and to ATPR + TTC-MCL at 60° (<i>p</i> = 0.040). The intact meniscus, TTC-PH and TTC-MID repair states performed similarly across all angles with regards to contact mechanics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combining ATPR with TTC-PH provides the most appropriate biomechanical properties in reducing extrusion and improving contact mechanics following a MMPRT in porcine knees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not applicable (laboratory study).</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689379","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":"Low lateral inclination angle, high sulcus angle, high trochlear height and patella alta are risk factors for first lateral patellar dislocation and complete MPFL rupture, comparative study","authors":"Serhat Akcaalan,&nbsp;Ismail Duran,&nbsp;Abdurrahim Kavaklilar,&nbsp;Fatih Beser,&nbsp;Ceyhun Caglar,&nbsp;Mahmut Ugurlu","doi":"10.1002/jeo2.70213","DOIUrl":"https://doi.org/10.1002/jeo2.70213","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;To identify risk factors for complete medial patello-femoral ligament (MPFL) rupture after first lateral patellar dislocation (LPD) and to develop a model to predict the risk of rupture.&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;Patients who presented with first LPD between February 2019 and June 2024 and were diagnosed with complete MPFL rupture on magnetic resonance imaging (MRI) were retrospectively reviewed. Patients with normal MRI findings in a 1:1 ratio were selected as the control group by computer-assisted randomisation.All patients in both groups were asked to perform MRI on, tibial tuberosity–trochlear groove (TT–TG) distance, lateral trochlear inclination (LTI) angle, sulcus angle (SA), medial femoral condyle height (MFCH), lateral femoral condyle height (LFCH), trochlear height (TH), patellotrochlear index (PTI), Koshino–Sugimoto Index (KSI), Caton–Deschamps Index (CDI) and Insall–Salvati Index (ISI) were measured and recorded. All measurements were made by two different orthopaedists and intra-observer reliability was evaluated. The measurements between the groups were compared statistically.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Result&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 98 patients, including 49 patients with complete MPFL rupture (study group) and 49 patients in the control group, were included in the study. Thirty of the patients in both groups were males and 19 were females. Mean age was 23.55 years in the study group and 24.29 years in the control group (&lt;i&gt;p&lt;/i&gt; = 0.447). Satisfactory ICC scores were obtained in all measurements. LTI was lower in the study group than in the control group (&lt;i&gt;p&lt;/i&gt; = 0.002), while SA was higher in the study group than in the control group. Both CDI and ISI were statistically significantly higher in the study group compared to the control group (&lt;i&gt;p&lt;/i&gt; = 0.002, &lt;i&gt;p&lt;/i&gt; = 0.003). The probability of predicting the risk of complete MPFL rupture of the risk analysis model created with radiological risk factors for complete MPFL rupture was 70.4%.&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;LTI, SA, TH and patella alta are risk factors for complete MPFL rupture after first LPD. Risk analysis of complete MPFL rupture after first dislocation can be successfully performed with MRI findings. This risk analysis can be used to predict the risk of developing complete MPFL after primary LPD, especially in risky patient groups, and can be used in a simple way to decide which patients will receive a preventive programme without the need for additional examination.&lt;/p&gt;\u0000 &lt;/se","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689315","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":"Revolutionizing total hip arthroplasty: The role of artificial intelligence and machine learning","authors":"Umile Giuseppe Longo,&nbsp;Sergio De Salvatore,&nbsp;Alice Piccolomini,&nbsp;Nathan Samuel Ullman,&nbsp;Giuseppe Salvatore,&nbsp;Margaux D'Hooghe,&nbsp;Maristella Saccomanno,&nbsp;Kristian Samuelsson,&nbsp;Rocco Papalia,&nbsp;Ayoosh Pareek","doi":"10.1002/jeo2.70195","DOIUrl":"https://doi.org/10.1002/jeo2.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There has been substantial growth in the literature describing the effectiveness of artificial intelligence (AI) and machine learning (ML) applications in total hip arthroplasty (THA); these models have shown the potential to predict post-operative outcomes using algorithmic analysis of acquired data and can ultimately optimize clinical decision-making while reducing time, cost and complexity. The aim of this review is to analyze the most updated articles on AI/ML applications in THA as well as present the potential of these tools in optimizing patient care and THA outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search was completed through August 2024, according to the PRISMA guidelines. Publications were searched using the Scopus, Medline, EMBASE, CENTRAL and CINAHL databases. Pertinent findings and patterns in AI/ML methods utilization, as well as their applications, were quantitatively summarized and described using frequencies, averages and proportions. This study used a modified eight-item Methodological Index for Non-Randomized Studies (MINORS) checklist for quality assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen articles were eligible for this study. The selected studies were published between 2016 and 2024. Out of the various ML algorithms, four models have proven to be particularly significant and were used in almost 20% of the studies, including elastic net penalized logistic regression, artificial neural network, convolutional neural network (CNN) and multiple linear regression. The highest area under the curve (=1) was reported in the preoperative planning outcome variable and utilized CNN. All 20 studies demonstrated a high level of quality and low risk of bias, with a modified MINORS score of at least 7/8 (88%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Developments in AI/ML prediction models in THA are rapidly increasing. There is clear potential for these tools to assist in all stages of surgical care as well as in challenges at the broader hospital administrative level and patient-specific level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689316","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":"Lower button-cortex distance and lower revision rates with adjustable-loop compared to fixed-loop cortical suspension devices for anterior cruciate ligament reconstruction","authors":"Ron Gilat,&nbsp;Amit Gilad,&nbsp;Ilan Y. Mitchnik,&nbsp;Yoav Comay,&nbsp;Assaf Moriah,&nbsp;Gabriel Agar,&nbsp;Yiftah Beer,&nbsp;Dror Lindner","doi":"10.1002/jeo2.70212","DOIUrl":"https://doi.org/10.1002/jeo2.70212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare button position following femoral fixation of an anterior cruciate ligament (ACL) graft using fixed-loop cortical suspension device vs. an adjustable-loop device. Subsequently, to assess the association of button position-related factors and revision ACL reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective cohort study of consecutive patients undergoing ACL reconstruction using fixed-loop (Endobutton CL) and adjustable-loop cortical suspension device (Ultrabutton) for femoral fixation in a single institution between 2009 and 2022. Demographic and operative characteristics were recorded. To assess soft tissue interposition the distance between the button and the lateral femoral condyle (LFC) was measured on X-rays made on the first post-operative day. Other measurements included button angle, relative position (anterior/middle/posterior), and button migration (assessed using most recent X-rays).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 244 patients were included in the study. 59% of patients in the fixed-loop group and 41% in the adjustable-loop group. Hamstrings autograft was utilised most commonly (91%), while the rest of the procedures included allografts. A significantly shorter button distance from the LFC was noted in the post-operative Antero-posterior (AP) X-ray of the adjustable-loop button, 0.44 ± 0.52 mm versus 0.72 ± 0.84 mm, respectively (<i>p</i> = 0.002). Revision rates were significantly lower in the adjustable-loop group (4%) versus the fixed-loop group (12%, <i>p</i> = 0.035). No statistically significant direct association was found between button distance from the LFC and revision ACL reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adjustable-loop cortical suspension devices for femoral fixation of an ACL reconstruction were associated with lower revision rates and a lower button-LFC distance when compared to fixed-loop devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective comparative cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689371","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":"Intraoperative robotic measurements of coronal alignment in total knee arthroplasty correlate with pre- and post-operative long-leg radiographs","authors":"Anoop S. Chandrashekar,&nbsp;Jacob A. Fox,&nbsp;Logan M. Locascio,&nbsp;Gregory G. Polkowski,&nbsp;Martin Faschingbauer,&nbsp;J. Ryan Martin","doi":"10.1002/jeo2.70220","DOIUrl":"https://doi.org/10.1002/jeo2.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study sought to validate intraoperative robotic measurements of femoral and tibial component coronal alignment in total knee arthroplasty (TKA) by comparing to pre- and post-operative standing, double stance, long-leg radiographs (LLR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 59 unique patients undergoing primary TKA at a single institution. Pre- and post-operative femoral and tibial coronal alignment were measured on LLRs using a deep learning artificial intelligence model and compared to measurements obtained from the imageless robotic system to evaluate the robot's accuracy and reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Robotic measurements were highly correlated with measurements from preoperative LLR (Pearson <i>r</i>² = 0.68). There was no significant difference in preoperative constitutional alignment between the two methodologies (p = 0.28). Additionally, the intraoperative and post-operative alignment of femoral and tibial implants were not significantly different (<i>p</i> = 0.12 and <i>p</i> = 0.95, respectively) and were strongly correlated (Pearson <i>r</i>² = 0.5 and Pearson <i>r</i>² = 0.6 respectively). The mean difference in femoral alignment was 0.43° and the mean difference in tibial alignment was 0.01°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study suggest that there were no significant differences in the coronal alignment of TKA when assessed by a robotic system compared to LLR. This signifies the robotic system's high intraoperative accuracy and reliability in determining coronal alignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646174","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":"Comparison of low molecular weight heparin, aspirin, and their combination for the prevention of thrombosis after total knee arthroplasty in obese patients","authors":"Alireza Mirahmadi,&nbsp;Pooya Hosseini-Monfared,&nbsp;Shahrzad Ghane,&nbsp;Mohammad Mortazavi,&nbsp;Ramin Abrishami,&nbsp;Mohammad Hossein Hooshangi,&nbsp;Vahid Shameli,&nbsp;Seyed Morteza Kazemi","doi":"10.1002/jeo2.70218","DOIUrl":"https://doi.org/10.1002/jeo2.70218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patients undergoing total knee arthroplasty (TKA) are at a high risk of thromboembolic events, which is higher in obese patients. Determining the appropriate prophylaxis for venous thromboembolism (VTE) in obese patients is challenging. Therefore, we aimed to compare the effects of low molecular weight heparin (LMWH) with aspirin (ASA) and their combination for the prevention of thromboembolic events after TKA in obese patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective study, 245 obese patients with BMIs over 30 who underwent TKA were enroled. Eligible patients were divided into three groups: Group A was given LMWH sodium (Clexane®) for 14 days, Group B was given ASA for 14 days, and Group C was given LMWH sodium (Clexane®) for 5 days and then ASA twice daily for the days between 5 and 14 postoperatively. The primary outcome was the incidence of VTE within three months. Secondary outcomes included routine laboratory evaluations (PT, PTT, INR, Hb, Hct, platelets, BUN and Cr) and adverse effects of ASA and LMWH, such as bleeding, anaemia, thrombocytopenia, and gastrointestinal or neurological symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regarding the incidence of DVT and PTE, we did not observe significant differences between groups (<i>p</i> &gt; 0.05). A total of seven symptomatic VTE was observed in six patients. We observed two cases with PE who were in the Clexane group. Moreover, five individuals had DVT in the follow-up: three cases in the Clexane group, one in the ASA group, and one in the ASA + Clexane group, which was not statistically significant (<i>p</i> &gt; 0.05). There were no differences between groups regarding the risk of adverse events and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found that ASA is not inferior to enoxaparin in reducing VTE after TKA in obese patients. Therefore, given ASA's low cost and greater convenience, it may be considered a reasonable alternative for extended VTE prophylaxis for TKA surgery in obese patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646175","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":"Surgeons consider Rockwood classification the most important factor for decision-making in acute, high-grade acromioclavicular dislocations","authors":"Eduard van Eecke,&nbsp;Alexander Macken Arno,&nbsp;Derek van Deurzen,&nbsp;Thibault Lafosse,&nbsp;Antoon van Raebroeckx,&nbsp;Alexander Buijze Geert,&nbsp;Michel van den Bekerom,&nbsp;AC Instability Collaborator Group","doi":"10.1002/jeo2.70203","DOIUrl":"https://doi.org/10.1002/jeo2.70203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study is to investigate the influence of patient-specific factors, including age, lifestyle considerations as well as the extent of injury according to the Rockwood classification (RW), on the surgeon's decision-making in the choice between operative and nonoperative treatment for acute, high-grade acromioclavicular (AC) joint dislocations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Orthopaedic and trauma surgeons were requested to complete an online questionnaire consisting of closed and open questions regarding the treatment of acute, high-grade AC joint dislocations and 24 fictive clinical scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 133 answered questionnaires were collected. 27 different nationalities from five continents were represented. The included participants had a median experience of 12 years (interquartile range: 2–41). Overall, the treatment option for surgery (answer: YES) was chosen in 2426 answers (76% of cases) compared to ‘NO’ in 766 (24% of cases). RW classification was considered the most important factor influencing surgical decision-making for most surgeons (69%). Two thirds of the participants answered that smoking does not impact their decision towards surgery and as to the influence of body mass index (BMI) on decision-making, half of the respondents would not alter their preferred treatment based on BMI. Finally, there were no significant differences in decision-making regarding the influence of the participant's demographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights that RW classification is the most important factor to consider in the surgeon's decision-making between operative and nonoperative treatment in acute, high-grade AC joint dislocations. Participants preferred operative treatment over nonoperative treatment in acute, high-grade AC joint dislocation in 76% of case scenarios, increasing up to 90% when RW Grade III lesions were not taken into account. These findings contrast with recent studies reporting good functional outcomes of conservatively treated acute, high-grade AC injuries and highlight the need to bridge the gap between evidence and practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602531","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":"Lateral extra-articular procedures combined with ACL reconstructions lead to a higher return to pre-injury level of sport: A systematic review and meta-analysis","authors":"Guus Felix Kerkvliet,&nbsp;Gijs Bram Peter Cornelis van der Ree,&nbsp;Inger Nicoline Sierevelt,&nbsp;Gino M. M. J. Kerkhoffs,&nbsp;Bart Muller","doi":"10.1002/jeo2.70196","DOIUrl":"https://doi.org/10.1002/jeo2.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare postoperative activity levels between patients who received an anterior cruciate ligament reconstruction (ACLR) with- and without a lateral extra-articular procedure (LEAP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective is to examine whether patients treated with an ALCR and LEAP have a greater chance to return to sport (RTS) and return to their pre-injury level of sport (RTPS). The re-rupture rates between the two groups will also be analysed as this is of great influence on the RTS and RTPS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A thorough search according to PRISMA guidelines was conducted through the PubMed and Embase databases in May 2024. Randomised controlled trials (RCT) and retrospective cohort studies on patients who underwent primary ACLR with- or without a LEAP were included. Postoperative Tegner score, RTS, RTPS and re-rupture rate were evaluated. All articles were revised according to Cochrane risk of bias tools (RoB 2.0 and ROBINS-I).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four studies were included after examining 966 titles, abstracts and manuscripts. A total of 33,527 patients were included in this review with a weighted mean age of 24.9 years. Pooled data demonstrates that the ACLR + LEAP group shows significantly higher postoperative Tegner scores (MD, 0.43 [95% confidence interval, 0.21–0.65]; <i>p</i> &lt; 0.01). 62% of patients who underwent ACLR + LEA returned to their pre-injury level of sport compared to 40% in ACLR group (reported in nine studies).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis demonstrates that patients undergoing a LEAP procedure in addition to ACLR return to higher postoperative activity levels and are more likely to return to their pre-injury level of sport. These results -in addition to further research- may help dictate when to add a LEAP, and whether LEAP in addition to ACLR should become the golden standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective cohort studies have been analysed, alongside RCT's, and thus this is the level of evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594941","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":"Measures of knee internal and external rotation made with a digital inclinometer are consistent with the measures made with an electromagnetic tracking system","authors":"Mark K. Timmons,&nbsp;Hunter G. Copley,&nbsp;Dustin T. Darnell,&nbsp;Seth T. Jude,&nbsp;Gary McIlvain","doi":"10.1002/jeo2.70209","DOIUrl":"https://doi.org/10.1002/jeo2.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Individuals with excessive knee rotation have higher levels of dysfunction and disability. An inexpensive, and reliable method to assess knee internal (IR) and external (ER) rotation will improve the assessment of knee injuries. The study explored the reliability and measurement error of two methods of knee rotation measurement. The study tested the hypothesis that the digital inclinometer will provide reliable measures of knee internal and external rotation and that the digital inclinometer measurements will be consistent with the measurements made with the electromagnetic tracking system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty (20) participants without knee injury participated. Knee IR and ER were measured using electromagnetic tracking and a digital inclinometer. The intraclass correlation coefficient (ICC_(2,1)) was calculated for both techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The within device ICC values ranged from 0.826 to 0.939 for both devices. The within-device minimal detectable change (MDC) ranged from 1.2° to 1.9°. The ICC values for EI and IR measures collapsed between the devices, ranged from 0.717 to 0.859. The MDC calculated between devices ranged from 1.6° to 1.9°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of the current study show that knee IR and ER can be measured reliably with both measurement techniques. The measurement of knee ER and IR did not differ between the two devices or between the right and left sides.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, diagnostic, case series study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594904","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":"Surgical treatment of acute high-grade acromioclavicular joint dislocations","authors":"Theodorakys Marín Fermín,&nbsp;Chih-Kai Hong,&nbsp;Lucca Lacheta,&nbsp;Lukas N. Münch,&nbsp;Knut Beitzel,&nbsp;Eoghan T. Hurley,&nbsp;Kai-Lan Hsu,&nbsp;Emmanouil Brilakis,&nbsp;Berte Bøe,&nbsp;Davide Cucchi","doi":"10.1002/jeo2.70173","DOIUrl":"https://doi.org/10.1002/jeo2.70173","url":null,"abstract":"<p>Treatment options for acute acromioclavicular joint (ACJ) instability include several surgical and non-surgical approaches. Recent trends indicate a shift towards nonoperative treatment, even for severe Rockwood type V injuries, which traditionally required surgery. Despite this shift, some patients may still benefit from surgical stabilisation, particularly if significant pain and disability persist. Modern surgical techniques focus on cortical button systems and restoration of the coracoclavicular ligaments, emphasising the importance of the posterosuperior acromioclavicular capsuloligamentous complex in managing horizontal instability. Clavicular hook plates offer rigid stability but present risks, such as damage to the subacromial structures and acromial erosion. Although anatomical repair techniques have gained prominence due to their biomechanical advantages and have been endorsed by international societies, non-anatomic methods may also provide acceptable outcomes with lower costs. The use of tendon grafts in chronic ACJ instability has shown promise, although evidence for their use in acute cases remains limited. This review discusses various treatment strategies, including operative and nonoperative management, focusing on patient outcomes, complication rates, and return-to-sport scenarios. Ultimately, the choice between surgical and non-surgical treatment must consider individual patient needs and the potential for long-term recovery.</p><p><b>Level of Evidence</b>: Not applicable.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581321","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}