Journal of Experimental Orthopaedics最新文献

{"title":"A small notch width index, steeper medial and lateral tibial slope and higher lateral/medial tibial slope ratio are relevant knee morphological factors for ACL injuries in skeletally immature patients—A systematic review","authors":"Robin Voskuilen,&nbsp;Martijn Dietvorst,&nbsp;Marieke van der Steen,&nbsp;Rob P. A. Janssen","doi":"10.1002/jeo2.70211","DOIUrl":"https://doi.org/10.1002/jeo2.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The incidence of anterior cruciate ligament (ACL) injuries in skeletally immature patients has drastically increased over the last decades. Morphology of the knee might play an important role. This literature review provides a systematic overview of knee morphological factors relevant to ACL injury in skeletally immature patients. The hypothesis of the present study is that multiple knee morphological parameters—such as a steep medial and lateral tibial slope (MTS and LTS) and a narrow intercondylar notch—can be identified as potentially relevant factors for ACL injury in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic review according to PRISMA guidelines. MEDLINE, Embase and Cochrane were searched in December 2023 for studies reporting on knee morphology and ACL injury in skeletally immatures. The following inclusion criteria were used: English/Dutch studies, full-text available, human studies and skeletally immature patients. Parameters with clinical homogeneity and presented in two or more studies as means with standard deviation were included in a meta-analysis using RevMan. Parameters that could not be included in the meta-analyses were presented in a descriptive manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After screening 1825 studies, a total of 18 studies were included, of which 16 studies had parameters included in the meta-analyses. These studies investigated 31 knee morphological factors for ACL injury in skeletally immatures. Meta-analyses identified a smaller notch width index (NWI) (0.25 vs. 0.26, mean difference: −0.02 95% confidence interval [CI]: −0.03 to −0.01, <i>p</i> ≤ 0.00001) steeper MTS and LTS (4.8° vs. 3.6° (mean difference: 0.55° 95% CI: 0.09–1.01, <i>p</i> = 0.02) and 4.3° vs 2.8° (mean difference: 2.04° 95% CI: 0.75–3.32, <i>p</i> = 0.0003), respectively) and higher LTS/MTS ratio as risk factors for ACL injury in skeletally immature patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A small NWI, steeper MTS and LTS and higher LTS/MTS ratios were identified as relevant knee morphological factors for ACL injuries in skeletally immature 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":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689311","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":"Severity-dependent recovery time in acute lateral ankle sprains: An ultrasonographic assessment of talofibular displacement","authors":"Yuto Uchida,&nbsp;Masashi Kawabata,&nbsp;Yusuke Kumazawa,&nbsp;Kazuya Takagi,&nbsp;Kazuma Miyatake,&nbsp;Takumi Kobayashi,&nbsp;Tomonori Kenmoku,&nbsp;Hiroyuki Watanabe,&nbsp;Naonobu Takahira","doi":"10.1002/jeo2.70204","DOIUrl":"https://doi.org/10.1002/jeo2.70204","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There is no consensus on treatment protocols based on severity and timing for acute lateral ankle sprain (LAS). Appropriate decision-making is necessary to prevent reinjury or chronic ankle instability. In this retrospective observational study, we clarified the duration of recovery from anterior ankle joint displacement in patients with initial acute LAS of several severities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall, 101 patients with varying grades of initial unilateral LAS were included. Injury severity was based on ligament tears and anterior ankle joint displacement using the reverse anterior drawer test with ultrasonography. The automated length measurement system software measured changes in the talofibular distance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median (95% confidence interval) change in the talofibular distance on the affected side was 1.24 (0.96–1.76), 3.03 (2.91–3.74) and 3.06 (2.37–4.69) mm for LAS grades I, II and III, respectively, on the first medical examination. The increase in talofibular distance for grade I injuries was significantly smaller than for Grades II and III (<i>p</i> &lt; 0.01). The regression equation was <i>y</i> = –0.02 × days + 1.43, –0.05 × days + 3.30 and –0.05 × days + 3.42 for Grades I, II and III, respectively; the time it took to reach the value of the unaffected side was 14.5, 43.2 and 45.6 days, respectively. Regression coefficients were significantly greater for Grades II and III than for Grade I (<i>p</i> &lt; 0.01 and <i>p</i> = 0.01, respectively). No significant differences were observed between Grades II and III.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results revealed that the recovery time for displacement varies according to the severity of the sprain, suggesting the need to develop optimal treatment protocols.</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/jeo2.70204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689312","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":"Risk factors for the recurrence of instability after operative treatment of chronic lateral ankle instability: A systematic review","authors":"Ronny Lopes,&nbsp;Choon Chiet Hong,&nbsp;James Calder,&nbsp;Gino M. M. J. Kerkhoffs","doi":"10.1002/jeo2.70214","DOIUrl":"https://doi.org/10.1002/jeo2.70214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To identify, review and summarize risk factors for failure of lateral ankle ligament operative treatment for chronic lateral ankle instability (CLAI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Systematic review according to PRISMA guidelines was performed. In July 2023, a bibliographic search of the PubMed, Medline, CINAHL, Cochrane, and Embase databases was performed. Articles were included if they were quantitative studies published in English and reported risk factors for recurrence of instability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 496 articles were identified using the search strategy, and nine articles were included. All were low-quality cohort studies (level 3 or 4 evidence). These nine studies comprising 762 participants met the criteria for inclusion. Eighty-nine patients (11%) had treatment failure as defined by recurrence of instability, with rates ranging from 5.7% to 28.5%. Six risk factors were divided into three categories: patient demographics (generalized joint laxity [GJL], high-level sports activities and female sex), imaging features (varus hindfoot alignment), and surgical findings (poor quality of the remnant lateral ligaments, intraoperative syndesmosis widening).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The presence of risk factors such as GJL, high-level sports activities, female sex, varus hindfoot alignment, poor ligament quality, and intraoperative syndesmosis widening should guide surgical strategy to reduce the risk of treatment failure in lateral ankle ligament repair for CLAI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, systematic review.</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/jeo2.70214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689314","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":"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}