Journal of Experimental Orthopaedics最新文献

{"title":"Short learning curve associated with robotic total knee arthroplasty: A retrospective study","authors":"Alexandre Le Guen,&nbsp;Antoine Mouton,&nbsp;Guillaume Auberger,&nbsp;Vincent Le Strat,&nbsp;Simon Marmor,&nbsp;Thomas Aubert","doi":"10.1002/jeo2.70401","DOIUrl":"https://doi.org/10.1002/jeo2.70401","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Robotic-assisted total knee arthroplasty (RA-TKA), which is increasingly used to improve surgical precision, can face adoption difficulties due to a learning curve marked by longer operating times. The aim of this study was to evaluate the learning curve associated with the VELYS™ robot in five surgeons from the same centre with different annual arthroplasty volumes using navigated assistance with personalised alignment. The primary aim was to assess the learning curve for each surgeon. Secondary aims were to identify the factors associated with extended operative times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective comparative study, 367 patients who underwent primary TKA between January and December 2024 were included, comprising 149 with robotic assistance and 218 with navigated assistance. The surgical learning curve, based on skin-to-skin operating time, was assessed using the cumulative summation method. Five surgeons were evaluated: two high-volume surgeons (&gt;150 TKAs per year), a medium-volume surgeon (between 50 and 150) and two low-volume surgeons (&lt;50). Pre- and intra-operative data (age, gender, body mass index, American Society of Anesthesiologists score, pre-operative hip–knee–ankle, range of motion, approach, size and implant constraint and type of assistance) were collected to identify extended operative time factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The learning curve was reached after performing between 4 and 11 cases (11 procedures for surgeon no. 1, 4 for surgeon no. 2, 6 for surgeon no. 3, 4 for surgeon no. 4 and 4 for surgeon no. 5). The robotic operating time was 57.1 min compared to 54.1 min (<i>p</i> = 0.017) with navigation. The increase was statistically significant only for one low-volume surgeon (<i>p</i> = 0.008). Use of the robot (<i>p</i> &lt; 0.001), surgeon (<i>p</i> &lt; 0.001), use of a posterior-stabilised implant (<i>p</i> &lt; 0.001) and varus of more than 10° (<i>p</i> = 0.0191) were independent factors associated with extended operative time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The learning curve associated with VELYS™ was between 4 and 11 procedures. The small increase in operative time compared to navigation should not be a barrier to its adoption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, case–control retrospective analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935189","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":"Combined anterior cruciate ligament reconstruction and lateral meniscal root repair yields low failure rates, but inferior subjective outcomes compared to isolated anterior cruciate ligament reconstruction: A comparative study of independent tunnel and anterior cruciate ligament bone tunnel techniques","authors":"Christoffer von Essen,&nbsp;Riccardo Cristiani,&nbsp;Björn Barenius,&nbsp;Anders Stålman","doi":"10.1002/jeo2.70405","DOIUrl":"https://doi.org/10.1002/jeo2.70405","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess the functional and subjective outcomes of combined anterior cruciate ligament reconstruction (ACLR) and lateral meniscal root tear (LMRT) repair. Additionally, to compare the use of an independent tunnel for LMRT repair with the ACL bone tunnel technique and to assess the failure rates of LMRT repair to isolated ACLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent primary ACLR and concomitant LMRT repair from May 2017 to May 2022 at Capio Artro Clinic, Stockholm, Sweden, were retrospectively identified and matched 1:3 (age, sex and graft type) with patients who underwent isolated ACLR during the same period. Functional outcomes, including range of motion (ROM), anterior knee laxity and isokinetic strength, were assessed preoperatively and at 6 months, and the knee injury and osteoarthritis outcome score (KOOS) at 2 years. Failure of LMRT repair was defined as the need for reoperation with meniscal resection during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 84 patients were included (mean age 31.1 ± 11.1 years; 61.9% male). LMRT repair failure occurred in 7.1% of cases. No significant differences were observed between tunnel techniques in ROM, laxity, or strength. At 2 years, KOOS scores were significantly lower in the ACLR + LMRT group compared to the isolated ACLR group in pain (86.1 ± 15.2 vs. 91.3 ± 13.3, <i>p</i> = 0.039), symptoms (79.3 ± 19.1 vs. 86.3 ± 17.3, <i>p</i> = 0.017), sport (69.2 ± 26.4 vs. 82.1 ± 25.3, <i>p</i> = 0.017) and quality of life (61.2 ± 25.3 vs. 75.3 ± 26.2, <i>p</i> = 0.03). Only 29.2% of patients in the LMRT group achieved a patient acceptable symptom state (PASS), compared to 65.2% in the isolated ACLR group (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combined ACLR and LMRT repair resulted in a 7.1% failure rate. However, the addition of LMRT repair results in lower subjective outcomes compared to isolated ACLR. The use of an independent tibial tunnel for LMRT repair does not confer additional clinical benefit over the shared ACL tunnel technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935078","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":"Navigated versus non-navigated total knee arthroplasty: A large single-implant cohort analysis of clinical outcomes and survivorship","authors":"Alessandro Carrozzo,&nbsp;Régis Pailhé,&nbsp;Ophélie Manchec,&nbsp;Sebastien Lustig,&nbsp;Émilie Bérard,&nbsp;Etienne Cavaignac","doi":"10.1002/jeo2.70408","DOIUrl":"https://doi.org/10.1002/jeo2.70408","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to compare implant survival, clinical outcomes and radiographic alignment between navigated and non-navigated total knee arthroplasty (TKA) performed with a single implant system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective multicenter analysis of prospectively collected data from 6078 TKAs performed for primary osteoarthritis using a single implant system was performed. Procedures were divided into two groups: navigated (<i>n</i> = 3602) and non-navigated (<i>n</i> = 2476). The primary outcome was implant survival. Secondary outcomes included re-intervention rates, patient-reported outcomes measures (PROMs, International Knee Society scores), and range of motion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five-year implant survival was similar between the non-navigated (98.9%; 95% confidence interval [CI], 98.2%–99.3%) and navigated (98.3%; 95% CI, 97.6%–98.8%) groups (<i>p</i> = 0.505). After adjustment for potential confounders, navigated procedures showed a slightly higher risk of surgical reintervention excluding infection (hazard ratio 1.42, 95% CI: 1.02–1.96, <i>p</i> = 0.036). PROM analyses were restricted to patients with both baseline and 5-year questionnaires (<i>n</i> = 470). The improvement of patient-reported functional outcomes at 5 years was not significantly different between groups (<i>p</i> = 0.893 after adjustment for potential confounders).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Navigation was equivalent to conventional instrumentation TKA with respect to implant survival. After adjusting for confounders and excluding septic revisions, navigated procedures showed a slightly higher reoperation risk. No significant advantage in functional outcomes was observed at mid-term follow-up. These findings do not support a clear clinical benefit for routine use of navigation in this setting.</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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935077","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":"Suture-augmented anterior cruciate ligament repair leads to comparable short-term function but a modestly higher re-rupture risk than anterior cruciate ligament reconstruction: A systematic review and meta-analysis","authors":"Alessandro Carrozzo,&nbsp;Émilie Bérard,&nbsp;Valerio Nasso,&nbsp;Edoardo Monaco,&nbsp;Jonathan Rioual,&nbsp;Régis Pailhé,&nbsp;Etienne Cavaignac","doi":"10.1002/jeo2.70404","DOIUrl":"https://doi.org/10.1002/jeo2.70404","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 aim of this study was to conduct a meta-analysis of the current literature on the treatment of anterior cruciate ligament (ACL) rupture with suture-augmented ACL repair (SA-ACLRep) compared to the gold standard ACL reconstruction (ACLR). The meta-analysis was designed to provide clinical outcomes, including re-rupture rates (as primary end point), knee stability, functional outcomes, return to sport and complications.&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;A systematic literature search was conducted in PubMed, Embase and the Cochrane Library up to 30 August 2024, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comparative clinical studies were included if they conducted a comparative analysis on the clinical outcome of SA-ACLRep versus ACLR with a minimum of 2 years of follow-up (FU). The primary outcome was ACL re-rupture rate; secondary outcomes included complications, knee stability (arthrometer measurements), patient-reported outcome measures (PROMs) and return-to-sport. A random effects model (based on the restricted maximum likelihood method) was used for all pooled analyses.&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;Four studies met the inclusion criteria and included 687 patients (276 SA-ACLRep and 411 ACLR). There was no statistically significant difference between the two groups in terms of re-rupture rates (11.5% with SA-ACLRep and 8.4% with ACLR; &lt;i&gt;p&lt;/i&gt; = 0.094). PROMs, including International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score subscales, Lysholm, visual analogue scale pain, Single Assessment Numeric Evaluation and Tegner scores, showed no significant differences between SA-ACLRep and ACLR. No significant differences were found in return to sport rates (72.3% with SA-ACLRep and 65.0% with ACLR; &lt;i&gt;p&lt;/i&gt; = 0.541) or timing (mean difference = −0.93 months [95% confidence interval: −2.54, 0.69]; p = 0.261).&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;SA-ACLRep with internal bracing and ACLR showed comparable short-term (≥24 months) FU results, with no statistically significant differences observed in re-rupture rates, PROMs or return-to-play rates. This may suggest that SA-ACLRep may be a viable alternative for appropriately indicated proximal ACL tears. Heterogeneity in study design, the small number of studies included, the repair timing and reconstruction techniques limit the generalizability of the results.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934957","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":"Validity and reliability of the Arabic version of the patient's joint perception question in patients undergoing knee arthroplasty","authors":"Khalid A. Alsheikh,&nbsp;Firas M. Alsebayel,&nbsp;Abdulrahman A. Alzahrani,&nbsp;Bader K. Alqahtani,&nbsp;Jude N. Abanmi,&nbsp;Abdulaziz F. Altammami","doi":"10.1002/jeo2.70402","DOIUrl":"https://doi.org/10.1002/jeo2.70402","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Total knee arthroplasty (TKA) aims to alleviate pain and restore function in patients with knee osteoarthritis. While the Forgotten Joint Score (FJS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) are established measures of patient satisfaction and functional outcomes after TKA, they may not directly capture the patient's subjective perception of the joint itself. The FJS was used to assess concurrent validity, as it reflects the degree to which patients are unaware of their artificial joint, which is related to joint perception. The patient's joint perception (PJP) question offers a simplified alternative to evaluate joint awareness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study included patients who underwent TKA between 2018 and 2023. An Arabic version of the PJP (Ar-PJP) question was translated using a forward-backwards translation process. Participants completed the PJP, FJS, and reduced WOMAC at two time points, three weeks apart. Statistical analyses assessed validity and reliability using Pearson's correlation coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 100 participants were included in the study. The mean PJP score was 28.9 (standard deviation [SD]: 13.7), and the mean WOMAC score was 46.1 (SD: 17.8). A moderate negative correlation was found between the Ar-PJP score and FJS (<i>r</i> = −0.683; <i>p</i> &lt; 0.001), A moderate negative correlation was found between the Ar-PJP score and FJS (<i>r</i> = −0.683; <i>p</i> &lt; 0.001), while the correlation with WOMAC was weak and non-significant (<i>r</i> = −0.088; <i>p</i> = 0.382), supporting discriminant validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Ar-PJP is a valid and reliable tool for assessing patients' perceptions post-TKA. As a single-question measure, it simplifies evaluations and enhances patient care in Arabic-speaking populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920583","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":"Posterior tibial slope has no impact on treatment outcome in anterior cruciate ligament revision patients","authors":"Jacob Sorwad,&nbsp;Torsten Grønbech Nielsen,&nbsp;Ole Gade Sørensen,&nbsp;Lars Konradsen,&nbsp;Martin Lind","doi":"10.1002/jeo2.70377","DOIUrl":"https://doi.org/10.1002/jeo2.70377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the impact of posterior tibial slope (PTS) on postoperative outcome in an anterior cruciate ligament (ACL) revision cohort, based on sagittal knee stability and subjective, patient-reported knee function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Lateral knee radiographs from 105 ACL revision patients (mean age 27.2 ± 6.5 years) were retrospectively reviewed and both medial and lateral posterior tibial slope was measured. Objective sagittal knee stability was based on Rolimeter measurements. The subjective knee function was obtained through the Knee Numeric-Entity Evaluation Score (KNEES-ACL), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner Activity Scale (TAS) questionnaires. Objective anterior–posterior (AP) knee laxity was examined prior to ACL revision surgery and at a one-year follow-up, and the patient reported outcome measures (PROMs) were obtained prior to ACL revision surgery and after a two-year follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No correlation was found between medial PTS and knee stability before (0.16; 95% confidence interval [CI], −0.06 to 0.36, <i>p</i> = 0.15) or one year after ACL revision surgery (0.07; 95% CI, −0.14 to 0.27, <i>p</i> = 0.54). Likewise, no correlation was found between lateral PTS and knee stability before (0.30; 95% CI, 0.09–0.48, <i>p</i> = 0.01) and one year after ACL revision surgery (0.15; 95% CI, −0.06 to 0.35, <i>p</i> = 0.16). Likewise, there was no correlation between medial and lateral PTS and KOOS, KNEES-ACL and TAS. The mean lateral PTS was 2.6° steeper than the medial PTS (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the present study, PTS was not found to be associated with either sagittal knee stability or subjective knee function in ACL revision patients. Patients undergoing ACL revision surgery have a large mean difference between the medial and the lateral PTS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914932","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":"Patient-specific versus off-the-shelf unicompartmental knee arthroplasty during level walking","authors":"Haithem M'barki,&nbsp;Etienne L. Belzile,&nbsp;Katia Turcot","doi":"10.1002/jeo2.70347","DOIUrl":"https://doi.org/10.1002/jeo2.70347","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Personalised unicompartmental knee arthroplasty (UKA) improves tibial implant positioning and clinical outcomes compared to an off-the-shelf UKA. However, no biomechanical study has confirmed the functional superiority of custom implants. The study aimed to assess potential differences between personalised and off-the-shelf UKA in knee joint function in terms of both biomechanical and clinical outcomes during level walking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-two patients and 22 healthy individuals (control group [CG]), matched for age and height, were recruited. Eight patients were implanted with a Bodycad UKS (BUKS) prosthesis, and 14 patients with an Oxford UKA (OUKA) prosthesis. Participants walked barefoot along a 10 m walkway. To quantify 3D kinematics and kinetics, a 10-camera motion analysis system and four force plates were used. The knee injury and osteoarthritis outcome score (KOOS) was utilised to measure knee function. 3D lower limbs angles and moments were estimated, and total support moment (TSM) was calculated. Biomechanical outcomes were compared along the gait cycle (GC) (0%–100%) between groups using statistical parametric mapping (SPM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed higher KOOS total score for BUKS compared to OUKA (<i>p</i> = 0.020, effect size [ES] = 0.62). No significant differences were observed between BUKS and OUKA for the biomechanical variables (<i>p</i> &gt; 0.05). Significant decrease of knee extension angle for OUKA compared to CG between 27% and 46% of GC (<i>p</i> &lt; 0.001) was observed. Knee moments showed a significant decrease for the external knee flexor moment for OUKA compared to CG between 55% and 76% of the stance phase (SP) (<i>p</i> &lt; 0.001). A reduction of the contribution of the knee to the first peak of TSM was observed for both BUKS and OUKA compared to CG (<i>p</i> = 0.019, ES = 0.34).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BUKS patients demonstrated similar knee function compared to OUKA. OUKA group exhibited a protective mechanism by reducing the knee extension. Neither BUKS nor OUKA restored knee joint function comparable to a native knee, with compensation mechanism occurring through adjacent joints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-guided assessment of the hip-knee-ankle angle shows excellent correlation with experienced human raters","authors":"Mikhail Salzmann,&nbsp;Robert Prill,&nbsp;Roland Becker,&nbsp;Andreas G. Schreyer,&nbsp;Simon Shabo,&nbsp;Nikolai Ramadanov","doi":"10.1002/jeo2.70383","DOIUrl":"https://doi.org/10.1002/jeo2.70383","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The hip-knee-ankle angle is a crucial parameter in orthopaedic surgery for lower limb assessment. However, traditional methods for measuring the hip-knee-ankle angle on standing long-leg anteroposterior radiographs are time-consuming, require significant expertise and lack reproducibility. Given the emergence of artificial intelligence as a promising tool to automate these measurements, this study aimed to assess the accuracy of Gleamer BoneMetrics for hip-knee-ankle angle measurement and its correlation with assessments by experienced orthopaedic surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 75 patients who underwent knee arthroplasty between October 2023 and June 2024 were included. Preoperative and postoperative long-leg anteroposterior radiographs were analysed both by two experienced orthopaedic surgeons who manually measured the hip-knee-ankle angle and by the Gleamer BoneMetrics software; the analyses were tested for both inter- and intra-rater reliability. Statistical analysis was performed using intraclass correlation coefficients and Bland-Altman plots to assess the correlation between the Gleamer BoneMetrics and the human raters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Gleamer BoneMetrics demonstrated excellent inter- and intra-rater reliability, with intraclass correlation coefficient values ranging from 0.995 to 0.998, which were comparable to the surgeons' measurements of 0.997–0.998. The Gleamer BoneMetrics's intra-rater reliability was also excellent, with intraclass correlation coefficient values of 1.0 preoperatively and 0.996 postoperatively. Bland–Altman analysis showed minimal measurement discrepancies between Gleamer BoneMetrics and the human raters. However, in 2% of the cases (<i>n</i> = 3), Gleamer BoneMetrics was not able to provide measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The artificial intelligence-based BoneMetrics software offers an efficient and accurate method for hip-knee-ankle angle measurement, with performance comparable to experienced orthopaedic surgeons. While promising, further development is necessary to address cases in which image quality or positioning issues prevent automated measurement and to reduce reliance on human quality control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905387","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":"Decellularisation of human meniscus tissue using sodium dodecyl sulphate (SDS): Preserving biomechanical integrity for scaffold-based meniscal repair","authors":"Dominic Simon,&nbsp;Benjamin Bartz,&nbsp;Manuel Kistler,&nbsp;Susanne Mayer-Wagner,&nbsp;Peter E. Müller,&nbsp;Thomas R. Niethammer,&nbsp;Boris M. Holzapfel,&nbsp;Gautier Beckers","doi":"10.1002/jeo2.70375","DOIUrl":"https://doi.org/10.1002/jeo2.70375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Meniscal tears are common knee injuries and a major risk factor for secondary osteoarthritis. Recently, there has been a paradigm shift toward meniscal preservation, reflecting the meniscus's vital role. In this context, tissue engineering approaches such as the development of meniscal scaffolds have gained attention. However, to reduce the immune response and improve biocompatibility, decellularization of allografts, while preserving the histoarchitectural and meniscal properties, is essential. The current study aimed to evaluate the effectiveness of decellularization and its impact on the biomechanical properties of the human meniscus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one human meniscus specimens were collected between July and December 2023 during total knee arthroplasty. Preoperative MRI was performed to verify meniscal integrity. The specimens were decellularized using a sodium dodecyl sulphate (SDS) protocol and compared to native meniscus samples in terms of cell count, assessed through hematoxylin and eosin staining, and biomechanical properties, specifically Young's modulus, measured using a universal testing machine (Zwick Z010).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cell count in the decellularized menisci was 11 cells/mm² (SD = 13; 95% CI: 2–20), representing a significant reduction compared to the native meniscus samples, which had a cell count of 111 cells/mm² (SD = 42; 95% CI: 81–141; <i>p</i> &lt; 0.01). Young's modulus of elasticity was 35.3 versus 36.8 MPa in the anterior region (<i>p</i> = 0.8), 32.6 versus 35.6 MPa in the central region (<i>p</i> = 0.7) and 36.5 versus 35.8 MPa in the posterior region (<i>p</i> = 0.9) for native versus decellularized samples, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated that the modified SDS-based decellularization protocol effectively decellularizes the human meniscus. Moreover, the decellularized tissue retained biomechanical properties comparable to those of native meniscus tissue. Tissue decellularization is a promising technique in regenerative medicine, enabling the use of scaffolds for tissue repair, particularly in applications such as meniscus transplantation following meniscectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, controlled laboratory study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905451","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":"Efficacy of isolated femoral revision in cruciate-retaining total knee arthroplasty instability: A comparative study","authors":"Lars-Rene Tuecking,&nbsp;Mats Tobias Wormit,&nbsp;Henning Windhagen,&nbsp;Max Ettinger,&nbsp;Peter Savov","doi":"10.1002/jeo2.70337","DOIUrl":"https://doi.org/10.1002/jeo2.70337","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;This study compares clinical outcomes, implant survival rates and perioperative factors between isolated femoral total knee arthroplasty (TKA) revision (prTKA) and full TKA revision (frTKA) for flexion instability in cruciate-retaining (CR) prostheses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This retrospective, controlled case series included 66 consecutive patients treated with either full TKA revision (&lt;i&gt;n&lt;/i&gt; = 34) or isolated femoral TKA revision (&lt;i&gt;n&lt;/i&gt; = 32) with flexion instability after CR TKA between 2015 and 2021. To ensure that the groups were uniformly comparable, only patients with one implant system (Triathlon, Stryker) were included. Preoperative demographic data and radiological parameters (e.g., quantification of anteroposterior instability and midflexion instability) were compared between the groups. Postoperative evaluation of implant survival and clinical outcome scores was performed with a minimum follow-up of 2 years. Patient-reported outcome measures (PROM) analysis included the Visual Analogue Scale, Kujala, Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, University of California at Los Angeles Activity-Level Scale and Knee Osteoarthritis Outcome scores. Statistical evaluations included unpaired, nonparametric &lt;i&gt;t&lt;/i&gt;-tests and Wilcoxon tests for nominal data. Implant survival analysis was conducted using Kaplan–Meier analysis and log-rank test. Statistical significance was defined as a &lt;i&gt;p&lt;/i&gt;-value &lt; 0.05.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;No significant differences were found in the clinical outcomes between the prTKA and frTKA groups across various PROMs. Implant survival rates were comparable (96.9% for prTKA vs. 97.1% for frTKA). Compared to frTKA, prTKA resulted in significantly shorter hospital stays (&lt;i&gt;p&lt;/i&gt; = 0.002), reduced operative time (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), lower blood loss (&lt;i&gt;p&lt;/i&gt; = 0.001) and a decreased inflammatory response (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&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;Partial femoral TKA revision for flexion instability in cruciate-retaining prostheses yielded clinical outcomes and implant survival rates comparable to full TKA revision in the short- to mid-term follow-up. These findings suggest that partial femoral revision may be a viable option for carefully selected patients with flexion instability, offering similar clinical efficacy and potential perioperative advantages over complete revision.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;se","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869807","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}