Journal of Experimental Orthopaedics最新文献

{"title":"The positive impact of robotic-assisted BCR TKA on post-operative joint line restoration, lateral posterior condylar offset and standard and advanced activity in the 2011 Knee Society Score than the conventional jig-based technique","authors":"Takao Kaneko,&nbsp;Kosuke Shiga,&nbsp;Ayakane Yamamoto,&nbsp;Kazuki Amemiya,&nbsp;Masaru Omata,&nbsp;Shu Yoshizawa","doi":"10.1002/jeo2.70288","DOIUrl":"https://doi.org/10.1002/jeo2.70288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to compare post-operative short-term patient-reported outcome measurements (PROMs) between robotic-assisted (RA) and the conventional jig-based technique using bi-cruciate retaining total knee arthroplasty (BCR TKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-surgeon consecutive cohort analysis compares 33 RA-BCR TKA patients (Robot group) to 32 conventional TKA patients (Conventional group). Lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), femoral and tibial component rotational alignment, distal and posterior femoral osteotomy (mm) were compared between the two groups using three-dimensional computed tomography (3DCT) measurements. 2011 Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Forgotten Joint Score and Patella score were collected more than 1 year after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-operative knee scores were significantly higher in the Robot group (mean: 20.5) than in the Conventional group (mean: 16.8), while functional scores were significantly lower in the Robot group (mean: 57.7) than in the Conventional group (mean: 69.6). The Robot group showed significantly greater improvements in post-operative extension angle (<i>p</i> &lt; 0.01), and standard and advanced activity in the 2011 KSS (<i>p</i> &lt; 0.01). LDFA, MPTA and rotational alignment of the femoral and tibial components showed no significant difference between the two groups. Medial distal femoral osteotomy (mm) was significantly greater in the Conventional group (<i>p</i> &lt; 0.01). Lateral posterior femoral osteotomy (mm) was significantly greater in the Robot group (<i>p</i> &lt; 0.01). The robotic group had significantly more cases of joint line restoration and reduced lateral posterior condylar offset than the Conventional group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RA-BCR TKA improved post-operative extension angle and standard and advanced activity in the 2011 KSS more than the Conventional TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185881","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":"Outcomes following surgical management of patellar instability in hypermobile patients are favourable compared to non-operative management in non-hypermobile patients: A systematic review and meta-analysis","authors":"Joshua Dworsky-Fried,&nbsp;Benjamin Blackman,&nbsp;Dan Cohen,&nbsp;Devin Peterson,&nbsp;Olufemi R. Ayeni,&nbsp;Volker Musahl,&nbsp;Darren de SA","doi":"10.1002/jeo2.70256","DOIUrl":"https://doi.org/10.1002/jeo2.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess the outcomes of surgical management of patellar instability in hypermobile patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three online databases (PubMed, MEDLINE and EMBASE) were searched from inception to 27 September 2024, to identify studies investigating the surgical management options for patellar instability in hypermobile patients. Data pertaining to patient demographics, patient management, redislocation rates and Kujala scores were abstracted. Weighted means and meta-analyses were conducted to compare rates of redislocation as well as post-operative Kujala scores. However, data pooling was not performed in cases of high heterogeneity. The quality of included studies was assessed using the MINORS criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of nine studies and 303 patients were included in this review. The pooled mean post-operative redislocation rate was 9% at a mean follow-up time of 45.4 months. The mean post-operative redislocation rate ranged from 7.3% to 28.5% following medial patellofemoral reconstruction (MPFLR). The mean post-operative Kujala score ranged from 64.3 to 95.3. The post-operative complication rate was 11.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This systematic review demonstrated that surgical management, particularly MPFLR, of patellar instability in hypermobile patients may result in lower redislocation rates and favourable post-operative outcomes compared to non-operative management in non-hypermobile patients. The current available literature for this patient population is highly heterogeneous, indicating the need for high-quality studies to more accurately assess intrinsic risk factors and surgical techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185895","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":"Enhanced early rehabilitation and pain management with all-arthroscopic medial patellofemoral ligament reconstruction: A comparative study","authors":"Yi-Fan Song,&nbsp;Hai-Jun Wang,&nbsp;Xin Yan,&nbsp;Zi-Jie Xu,&nbsp;Xin-Jie Wang,&nbsp;Fei Wang,&nbsp;Jia-Kuo Yu","doi":"10.1002/jeo2.70291","DOIUrl":"https://doi.org/10.1002/jeo2.70291","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;The purpose of this study was to evaluate the accuracy of femoral tunnel location, post-operative pain management, functional rehabilitation and clinical outcomes in medial patellofemoral ligament (MPFL) reconstruction using all-arthroscopic technique.&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;Between 2020 and 2021, 160 patients with recurrent patellar dislocation undergoing MPFL reconstruction were categorized into control (traditional surgery) and study (all-arthroscopic technique) groups. Femoral tunnel accuracy was assessed via computed tomography scans, pain management, functional rehabilitation, knee range of motion and daily activities were evaluated up to 6 months post-operatively. Knee function was assessed using Kujala and Lysholm scores at post-operative 12 months.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Seventy-one patients in the control group and 69 patients in the study group reached the final follow-up with no demographic differences. Follow-up duration was 12.65 ± 0.68 vs 12.77 ± 0.73 months in the control and study groups (&lt;i&gt;p&lt;/i&gt; = 0.3145). The intra-class correlation coefficient was excellent (&lt;i&gt;r&lt;/i&gt; = 0.97). In femoral tunnels, 93.5% in the control group and 92.4% in the study group were correctly localized. In patellar tunnels, 96.1% in the control group and 96.2% in the study group were correctly localized (&lt;i&gt;p&lt;/i&gt; &gt; 0.9999). Post-operative strong opioid analgesics were used 25.9 ± 31.0 versus 12.0 ± 22.2 mg/day in the control and study groups (&lt;i&gt;p&lt;/i&gt; = 0.0016). The pain score was 3.4 ± 1.1 versus 2.7 ± 1.2 in the control and study groups (&lt;i&gt;p&lt;/i&gt; = 0.0006) during post-operative functional rehabilitation. Time to resume daily living was 8.2 ± 0.6 versus 7.6 ± 0.6 weeks in the control and study groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Time to resume low-intensity exercise was 12.3 ± 0.6 versus 11.7 ± 0.6 weeks in the control and study groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001). In the more than 1-year follow-up, no significant difference was found in the Kujala and Lysholm scores.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The all-arthroscopic technique for MPFL reconstruction in recurrent patellar dislocation ensures precise femoral tunnel placement. It offers advantages in early post-operative pain management and functional recovery, enabling faster rehabilitation compared to traditional non-all-arthroscopic techniques.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Level III","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140830","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":"Total knee arthroplasty revision risks depending on the bone cement used—Data from 50,545 knee replacements of the Catalan Arthroplasty Registry","authors":"Daniel Perez-Prieto,&nbsp;Katharina Koetter,&nbsp;Albert Fontanellas-Fes,&nbsp;Olga Martínez-Cruz,&nbsp;the RACat working group","doi":"10.1002/jeo2.70271","DOIUrl":"https://doi.org/10.1002/jeo2.70271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Clinical data on individual bone cement brands and viscosities in cemented total knee arthroplasty (TKA) is scarce. The Catalan arthroplasty registry (RACat) documents usage of cement brands including viscosities and the inclusion of antibiotics. The objective was to compare the clinical performance of the widely used bone cement brand PALACOS® to other blinded bone cement brands in TKA using data from the RACat.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient data on 50,545 primary TKA between 2007 and 2017 in the RACat were analysed retrospectively. Implant survival of PALACOS bone cement was compared to other blinded bone cement brand groups using the all-cause revision risk as primary study endpoint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Comparing implant survival, it was found that (1) PALACOS® (with or without gentamicin) was associated with a significantly lower revision risk compared to other cement brands (with or without antibiotics) (<i>p</i> = 0.001): RR PALACOS 2.03% versus RR other brands 3.88%, and RR PALACOS+G 1.84% versus RR other antibiotic-loaded bone cements (ALBC) 3.85%; (2) ALBC (all brands) did not reduce the risk of revisions (<i>p</i> = n.s) compared to plain bone cements (PBC); and (3) the medium viscosity PALACOS MV+G showed the lowest reoperation risk versus other ALBC (all viscosities): RR 1.12% versus RR 3.85%. Competing-risk regression models confirmed reduction in revision risk for all PALACOS compared with other brands (<i>p</i> = 0.001) and for PALACOS+G compared with other ALBC (<i>p</i> &lt; 0.001) but showed no difference when comparing all ALBC with all PBC (<i>p</i> = 0.403). Comparing PALACOS MV+G with all other ALBC showed reduction of revision risk (<i>p</i> &lt; 0.001) and no difference when comparing PALACOS medium viscosity (MV) with all other PBC (<i>p</i> = 0.108).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Type of cement brand, viscosity and the addition of antibiotics have an impact on revision risk of TKA. Medium viscosity cement with gentamicin (PALACOS MV+G), for which no clinical data were previously available, was associated with the lowest revision risk in TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective comparative study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135650","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":"Editorial – Current capacities and future possibilities of large language models in orthopaedic surgery","authors":"Assil Mahamid,&nbsp;Lior Laver,&nbsp;Sana Zahalka,&nbsp;Felix Oettl,&nbsp;Eyal Behrbalk,&nbsp;Michael Hirschmann,&nbsp;Kristian Samuelsson","doi":"10.1002/jeo2.70273","DOIUrl":"https://doi.org/10.1002/jeo2.70273","url":null,"abstract":"&lt;p&gt;The accelerated advancement of artificial intelligence (AI) and large language models (LLMs) like GPT-4 has paved the way for revolutionary shifts in almost all medical specialties. Orthopaedic surgery, traditionally characterized by its reliance on physical and radiographic diagnosis as well as surgical expertise, is increasingly integrating these advanced AI technologies into clinical practice. This editorial evaluates the use of LLMs in orthopaedic surgery, the influence that prominent LLMs have had on the field, and the potential these technologies hold to improve patient care and medical research in the future. Figure 1 provides a concise explanation of the operational mechanism of the LLM.&lt;/p&gt;&lt;p&gt;There has been an increasing interest in using LLMs in the medical field in general and orthopaedic surgery in particular. The potential use of LLMs in orthopaedic surgery has been vast and variable in fields in clinical use, research conduction, medical education, as well as patient education.&lt;/p&gt;&lt;p&gt;Recent studies show that AI and LLMs can aid in creating clinical letters and care strategies for typical orthopaedic scenarios in clinical practice. Large volumes of unstructured data, including imaging reports, surgical notes and patient records, are processed by these models, offering a more thorough understanding of patient conditions and generating understandable, efficient and generally accurate texts. However, occasionally, the omitted output may be inconsistent, lack key details or offer general recommendations [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Interestingly, LLMs can offer treatment recommendations based on clinical data, such as magnetic resonance imaging reports. Still, their utility is limited by a need for further context and specificity, necessitating oversight by healthcare professionals [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Furthermore, LLMs can assist clinicians as early on in their careers as medical school and residency, as several noteworthy studies have demonstrated that LLMs meet the passing criteria for both the United States Medical Licensing Examination (USMLE) and the Orthopaedic board examinations [&lt;span&gt;5-8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Apart from clinicians, LLMs may deliver clear and concise answers to frequently asked patient inquiries, providing a dependable knowledge source for prevalent orthopaedic issues. Those models can condense complex facts into comprehensible summaries, which are useful for patients aiming to understand their conditions and therapy alternatives, subsequently referring them to the appropriate specialist, potentially cutting back unwarranted appointments and alleviating the workload of general physicians [&lt;span&gt;3, 9, 10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Several LLM platforms have emerged as leaders in this domain, each bringing unique strengths to orthopaedic practice. OpenAI's GPT-4, and Anthropic's Claude AI are among the most notable. These platforms are designed to understand and generate human-like text, making them invaluable tools for both cli","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135576","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":"Optimizing operating room efficiency in robotic-assisted total knee arthroplasty through manufacturing efficiency principles","authors":"Akito Hiraoka,&nbsp;Bart Swinnen,&nbsp;Aline Vandeputte,&nbsp;Willem Franssen,&nbsp;Geert Leirs","doi":"10.1002/jeo2.70283","DOIUrl":"https://doi.org/10.1002/jeo2.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Recent studies have explored the application of manufacturing efficiency principles as a framework for improving operating room (OR) throughput, quality of care and patient outcomes. However, these principles have not yet been validated with real-world research data. In this study, we investigated whether applying these principles has an impact on the operational excellence and teams' consistency of robotic-assisted total knee arthroplasty (RATKA) procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 31 patients, divided over eight surgery days, were included in the study. The aim of the study was to answer the research question: ‘Does applying efficiency principles have an impact on the operational excellence of RATKA surgery?’ The efficiency of the procedures was monitored using the artificial intelligence (AI)-enabled camera application and analyzed utilizing an AI-backed process digital twin platform. Normally distributed continuous variables were compared using the independent <i>t</i> test. Equality of variances was assumed using the Levene's test for equality of variances. Non-normally distributed continuous variables were analyzed using the Mann–Whitney <i>U</i> test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After analyzing the baseline group, four procedural modifications were implemented according to the lean principles. There was a significant difference in preparation time (mean difference = 4.3, 95% confidence interval = 1.3–7.3, <i>p</i> = 0.007), showing the efficiency gain during preparation after efficiency implementation. The number of sets opened per case was reduced from ten to seven sets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings indicate that better OR preparation, consistent staff allocation and effective staff training can reduce surgical times, minimize waste and improve OR throughput. Addressing primary constraints, parallelizing flows and breaking down processes decreases surgical wait times, enhances patient flow and streamlines OR operations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135577","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":"Robotic-assisted hip and knee revision arthroplasty: A scoping review","authors":"Michele Venosa,&nbsp;Giandomenico Logroscino,&nbsp;Emilio Romanini,&nbsp;Gianpiero Cazzato,&nbsp;Giuseppe Petralia,&nbsp;Andrea Vespasiani,&nbsp;Giacomo Placella,&nbsp;Patrizio Caldora","doi":"10.1002/jeo2.70285","DOIUrl":"https://doi.org/10.1002/jeo2.70285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Technological advances have significantly revolutionised orthopaedic surgery over the past decades. The introduction of robotic-assisted (RA) systems in total joint arthroplasty (TJA) surgery, especially in total hip arthroplasty (THA) and total knee arthroplasty (TKA), represents a key innovation. While the advantages of robotic assistance in primary joint replacement surgery are relatively well known, its application in hip and knee revision surgery implies a more complex and challenging scenario. The procedures needed are inherently more difficult compared to primary arthroplasties because of considerable bone loss, scar tissue, compromised anatomical landmarks, and at times even damaged or eroded joint structures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review synthesises existing literature on the application of RA systems in revision hip and knee arthroplasty. A systematic search on the six major databases in September 2024 identified 24 eligible studies for inclusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although various studies and case reports have demonstrated the successful use of robotics in TJA surgeries, the existing body of literature concerning revision surgery is still limited, and many questions remain unanswered. While, for instance, robotic systems seem to have held some promise for better improvement in implant positioning and alignment, it is still quite unclear whether this development in technological advancement will translate into better long-term outcomes such as improved implant longevity and lower revision rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although early data are promising, having some possible short-term advantages, wide diffusion is limited because of high costs, significant training requirements, and limited long-term outcome data. By identifying gaps in the current literature and emphasising areas for future investigation, this review aims to define the ongoing development and refinement of RA applications in revision arthroplasty, ultimately seeking to determine whether these technologies can achieve sustainable improvements in implant longevity and patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135727","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":"Knee osteotomies are becoming widely accepted and increasingly used, but rehabilitation techniques still vary widely between surgeons: A survey on current trends","authors":"Nicholas I. Kennedy,&nbsp;Nicholas N. DePhillipo,&nbsp;Luke V. Tollefson,&nbsp;Robert F. LaPrade","doi":"10.1002/jeo2.70270","DOIUrl":"https://doi.org/10.1002/jeo2.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this research survey was to report the current trends regarding the frequency, indications and techniques of knee osteotomies used in sports medicine practices over the past 5 years and during fellowship training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two Institutional Review Board-exempt anonymous surveys were electronically distributed between May 2023 and August 2023. A 19-question survey was sent to active members of the American Orthopaedic Society for Sports Medicine and European Society of Sports Traumatology, Knee Surgery and Arthroscopy societies and another 36-question survey was sent to orthopaedic sports medicine fellows near the end of their training. The surveys included questions regarding type and frequency of osteotomies performed, surgical indications, surgical techniques, preoperative planning and post-operative weight-bearing restrictions. Inclusion criteria were those who currently perform knee osteotomy surgery. Descriptive statistics were used for all comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 100 sports medicine surgeons and 26 sports medicine fellows participated in the survey. The most common type of osteotomy performed was a medial opening-wedge proximal tibial osteotomy for both surgeons (96%) and fellows (92%). The most used methods to assess coronal and sagittal alignment were long-leg radiographs (98% for surgeons) and lateral radiographs (66% for surgeons), respectively. Rehabilitation techniques varied between surgeons and fellows and depended on the technique, size of correction and hardware.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Osteotomies are becoming widely accepted as useful techniques to correct bony malalignment. Surgeons are increasing their use of osteotomies, and fellows in training are optimistic about the use of new technologies for osteotomy planning and execution. Trends suggest that osteotomies to correct varus and valgus malalignment for osteoarthritis are the most common, and rehabilitation techniques vary widely between surgeons.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135574","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":"Posterolateral tibial plateau impaction fractures in patients undergoing primary anterior cruciate ligament reconstruction—An MRI analysis of 556 cases","authors":"Andreas Fuchs,&nbsp;Spartak Ovsepyan,&nbsp;Andreas Frodl,&nbsp;Tayfun Yilmaz,&nbsp;Markus Siegel,&nbsp;Matthias Krause,&nbsp;Thomas Stein,&nbsp;Hagen Schmal,&nbsp;Kaywan Izadpanah","doi":"10.1002/jeo2.70284","DOIUrl":"https://doi.org/10.1002/jeo2.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Posterolateral impaction fractures of the tibial plateau are known to be associated with anterior cruciate ligament (ACL) tears. These fractures are often related to high energy pivoting injuries, which is why the frequency of such injuries is of key concern for patients undergoing primary ACL reconstruction. The objective of this study is to evaluate the occurrence of posterolateral tibial fractures, as well as concomitant injuries in patients undergoing primary ACL reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective case series was conducted to study the occurrence and type of posterolateral tibial impaction fractures in patients undergoing ACL reconstruction between October 2015 and October 2020. Patients records were reviewed to collect patient demographics, exact injury patterns and details about concomitant injuries. Descriptive statistics were performed to determine the incidence of each type of posterolateral tibial plateau impaction fracture, as well as concomitant injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 556 knees with primary ACL reconstruction, a total of 171 posterolateral tibial plateau impaction fractures were identified. 385 patients showed no fracture. Intraoperative arthroscopic examination showed lateral meniscus (LM) tears in 144 cases and medial meniscus (MM) tears in 163 cases. LM posterior root tears were found in 21 patients, MM posterior root tears in eight patients. Medial meniscal ramp lesions were found in a total of 39 knees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>30.8% of the patients showed posterolateral tibial plateau impression fractures, here LM tears were more frequent with the highest incidence in IIIB fractures. MM tears are more frequent in patients without posterolateral impaction fractures, while LM posterior root tears are more frequent than MM posterior root tears among the whole study population. The clinical relevance of this study lies in the exact analysis of posterolateral tibial plateau fractures in patients with ACL lesions, with the resulting therapeutic consequences dependent on the fracture type and concomitant injuries.</p>\u0000 \u0000 <p><b>Level of Evidence:</b> Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135575","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":"Variations in bone mineral density after joint replacement: A systematic review examining different anatomical regions, fixation techniques and implant design","authors":"Domenico Alesi,&nbsp;Raffaele Zinno,&nbsp;Maria Scoppolini Massini,&nbsp;Giuseppe Barone,&nbsp;Davide Valente,&nbsp;Erika Pinelli,&nbsp;Stefano Zaffagnini,&nbsp;Agostino Igor Mirulla,&nbsp;Laura Bragonzoni","doi":"10.1002/jeo2.70187","DOIUrl":"https://doi.org/10.1002/jeo2.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to evaluate postoperative periprosthetic bone mineral density (BMD) at various time points following joint replacement with different implant designs and fixation techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Database search was conducted on MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL for studies analyzing bone remodelling after joint replacement (March 2002–January 2024). Inclusion criteria: English-language articles; total joint replacement; at least two BMD evaluations; observational studies, cross-sectional, prospective, retrospective, randomised controlled trials, and clinical trials. Exclusion criteria: no BMD measurement within one month after surgery; BMD data only expressed as percentage changes or graphs without numerical values; no Gruen zone evaluation for hip replacement; no periprosthetic bone evaluation for knee replacement; pharmacological treatment or comorbidities affecting BMD; revision joint replacements; irrelevant articles; no full text or no original data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-eight articles matched the selection criteria. Fifty-five focused on the hip joint, 12 on the knee, and one on the shoulder. After total hip arthroplasty, the greatest bone resorption occurred in the proximal femur, peaking at 6 months. Cemented implants and tapered stems showed greater bone resorption than cementless implants and anatomical stems. BMD around the acetabular component decreased during the first 6 months but increased in regions subjected to higher loads. In total knee arthroplasty, bone loss occurred in the anterior distal femur and medial tibial plateau, with cemented and posterior-stabilised implants showing greater bone loss than cementless and cruciate-retaining designs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The periprosthetic BMD decreases progressively after joint replacement. The fixation technique and implant design influence the extent and pattern of this decline. These factors must be considered during the surgical planning, as they can have long-term implications for bone health and implant longevity. Further research is needed to optimise implant design and surgical techniques to mitigate BMD loss and improve patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100461","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}