Journal of Experimental Orthopaedics最新文献

{"title":"High prevalence of femoral and tibial torsional abnormalities in female patients with anterior knee pain resistant to conservative treatment: A CT-based study","authors":"Vicente Sanchis-Alfonso,&nbsp;Cristina Ramírez-Fuentes,&nbsp;Erik Montesinos-Berry,&nbsp;Julio Doménech-Fernández","doi":"10.1002/jeo2.70446","DOIUrl":"https://doi.org/10.1002/jeo2.70446","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess acetabular version (AV) and to determine the prevalence of femoral and tibial torsional abnormalities in female patients with anterior knee pain (AKP) unresponsive to conservative treatment. The study also aimed to evaluate the prevalence of combined abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-three AKP female patients resistant to conservative treatment evaluated between 2013 and 2024 were included. Torsional computed tomography (CT) of the lower limbs was performed on all cases, resulting in the evaluation of 146 limbs. Femoral anteversion (FAV) was measured using Murphy's method, external tibial torsion (ETT) using Jend's technique and AV using the method described by Tönnis and Heinecke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Torsional abnormalities were highly prevalent. Only 13.0% of limbs had normal ETT, 43.2% showed moderate abnormalities and 43.8% severe abnormalities. FAV was within normal limits in 48.6% of cases, while 26.7% had moderate anteversion, 22.6% severe anteversion and 2.1% retroversion. AV was normal in 82.9% of limbs, with 13.7% showing retroversion and 3.4% anteversion. Only 4.1% of patients exhibited normal across all three parameters, while 8.2% presented combined abnormalities. The most common paired association was observed for ETT and FAV (35.6%). Chi-squared analyses did not reveal statistically significant associations among the degrees of deformity. Pearson correlation analysis showed a weak but statistically significant correlation between ETT and FAV (<i>r</i> = 0.176, <i>p</i> = 0.034).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In young female patients with AKP unresponsive to conservative treatment, assessment of femoral and tibial torsion using CT imaging should be systematically considered. This approach is essential for guiding clinical decision-making. The range of possible torsional abnormalities highlights the importance of patient-specific evaluation.</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 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating drill speed effects on tunnel diameter in ACL reconstruction: Insights from an experimental animal study","authors":"Jamil Alasov,&nbsp;Nelo João Zeca Chihal Lima,&nbsp;Mehmet Erduran","doi":"10.1002/jeo2.70406","DOIUrl":"10.1002/jeo2.70406","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine how drilling speeds affect tunnel enlargement during cruciate ligament reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve adult female New Zealand rabbits, each weighing between 3 and 3.5 kg, were randomly assigned to two groups based on drilling speeds (400 RPM and 1500 RPM). Following sedation, the knee and tibia regions were shaved, and the knee joint was accessed using a medial parapatellar approach. The anterior cruciate ligament (ACL) was incised using a scalpel. Tibial and femoral tunnels were drilled with a 2 mm blunt-tip drill at the assigned group speeds. Room temperature saline was used for irrigation throughout the drilling procedure. An extensor tendon graft was harvested from the anterior cruris and sutured using the Krakow technique with 4-0 Vicryl. The graft was passed through the tunnel and secured to a pre-placed screw near the tunnels. Post-surgery, the operated extremity was not immobilised, and the rabbits were observed while moving freely within the cage. Twelve weeks post-operatively, the animals were humanely euthanized, and micro-computed tomography (CT) was employed to assess the diameters of the femoral and tibial tunnels at the proximal, middle and distal regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No statistically significant differences were found between radiological femoral and tibial tunnel diameter measurements of the 400 and 1500 RPM drilling groups 12 weeks after arthroscopically assisted ACL reconstruction in New Zealand rabbits. However, within the 400 RPM group, there was a measurable increase in the tunnel diameter in the proximal tibia and distal femur regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of our study suggest that concerns about higher drilling speeds in ACL surgery may be overstated, as higher speeds did not lead to significant radiological tunnel enlargement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145122639","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":"Superior long-term stability and function associated with femoral cortical button versus interference screw fixation in ACL reconstruction: A systematic review and meta-analysis","authors":"Jonathan Elias,&nbsp;Mitchell Kaplan,&nbsp;Michael Bickford,&nbsp;Thomas Oliver,&nbsp;Kunal Shah,&nbsp;Elizabeth Ford,&nbsp;Sean McMillan","doi":"10.1002/jeo2.70439","DOIUrl":"10.1002/jeo2.70439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There are two main methods of femoral graft fixation during anterior cruciate ligament reconstruction (ACLR): cortical button (CB) and interference screws (IS). Each fixation yields its own unique outcomes; however, there is yet to be an established gold standard. We seek to compare femoral CB to IS fixation in ACLR using all soft-tissue, autograft hamstring grafts. We hypothesise that there will be no significant differences between the two methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted following the 2020 PRISMA guidelines. PubMed, Cochrane, Embase, Web of Science and Scopus were screened for potential randomised studies. The studies must have utilised both the semitendinosus and gracilis, and utilised either metallic or bioabsorbable IS, or fixed or adjustable loop CB fixation on femoral fixation. All studies in both groups must have used interference screws on the tibial side. The 2-year follow-up analysed KT-1000 side-to-side differences, while the 5–10 year follow-up compared Lysholm and Tegner scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 randomised studies were included in the final systematic review, providing an evaluation of 583 distinct patients. Two of the studies were excluded from the meta-analysis, due to not providing pre- and post-operative means and standard deviations. At 2-year and 5-10 year follow-ups, the mean ages were 30.5 ± 8.7 and 30.2 ± 8.1, respectively. Analysis of the 2-year follow-up favour of CB (<i>p</i> = 0.01) in regards to the reduction in KT-1000 side-to-side differences. Analysis of the 5–10 year follow-up revealed favour of CB in regards to the Lysholm Score (<i>p</i> &lt; 0.01), and the Tegner Score (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At 2-years postoperatively, femoral fixation utilising cortical buttons portrayed less knee laxity than interference screws. At the 5–10 year follow-up, cortical buttons yielded more sports and work-related activity, less pain, and overall greater function than did the interference screws.</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":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145122642","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":"Similar results with quadrupled semitendinosus and semitendinosus-gracilis graft in anterior cruciate ligament reconstruction: A randomised controlled trial with 2-year follow-up","authors":"Juan P. Martinez-Cano,&nbsp;Alejandro Gallego,&nbsp;Janio Cuadros,&nbsp;Laura Ibarra,&nbsp;Fernando M. Mejía,&nbsp;María V. Velasquez-Hammerle,&nbsp;Alfredo Martinez-Rondanelli","doi":"10.1002/jeo2.70399","DOIUrl":"https://doi.org/10.1002/jeo2.70399","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>to compare quadrupled semitendinosus (STx4) with semitendinosus-gracilis graft in anterior cruciate ligament (ACL) reconstruction surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Parallel randomised controlled trial with two groups of treatment (<i>n</i> = 42) in primary ACL reconstruction surgery. Follow-up during 2 years after surgery with visits at 3, 6, 12 and 24 months. Primary outcome: quadriceps and hamstrings strength in newtons (N). Secondary outcomes: ACL re-rupture, additional surgeries, return to sport and patient-reported outcomes (PROMs): knee injury and osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) and Tegner-Lysholm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was 1/21 ACL re-rupture for STx4 and 2/21 for the control group (<i>p</i> = 0.9). One additional surgery for each group: ACL revision (control group) and meniscectomy (STx4). There were no other complications and no differences in PROMs between grafts, except for Tegner-Lysholm at 3 months, that favoured the STx4 group (76.0, confidence interval [CI]: 56.0–86.0 vs. 85.0, CI: 77.0–93.0), <i>p</i> = 0.04. The median surgery satisfaction was good in both groups STx4 (95%, interquartile range (IQR): 90%–98%) and ST-G (98%, IQR: 95%–100%) (<i>p</i> = 0.13). Return to sport was 90% (<i>n</i> = 19) for the STx4 group and 81% (<i>n</i> = 17) for the ST-G group (<i>p</i> = 0.37). Quadriceps strength recovered sooner (6 months) than hamstrings (24 months) in both groups. There were no statistically significant differences in strength between STx4 and ST-G at final follow-up (hamstrings in flexion [mean ± SD]: 173 ± 53 N vs. 166 ± 51 N, <i>p</i> = 0.7; hamstrings in extension: 204 ± 61 N vs. 199 ± 64 N, <i>p</i> = 0.8; quadriceps in flexion: 217 ± 42 N vs. 209 ± 47 N, <i>p</i> = 0.6; quadriceps in extension: 193 ± 51 N vs. 191 ± 46 N, <i>p</i> = 0.9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found no statistically significant differences at 2 years between a STx4 and a ST-G graft configuration for primary ACL reconstruction regarding strength, PROMs, return to sport, failure rates and complications; larger studies are required to confirm noninferiority. Clinical Trials number: NCT03433170.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146406","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":"Sex differences in intra-articular treatment outcomes for knee osteoarthritis: Current evidence and research gaps: A systematic review and meta-analysis","authors":"Gae Fattini Fellini,&nbsp;Giacomo A. Fumagalli,&nbsp;Andrea Piano,&nbsp;Alessandro Bensa,&nbsp;Giuseppe Filardo","doi":"10.1002/jeo2.70432","DOIUrl":"10.1002/jeo2.70432","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this systematic review and meta-analysis was to quantify and compare the evidence on sex-specific outcomes following intra-articular injections of corticosteroids (CS), hyaluronic acid (HA), platelet-rich plasma (PRP) and cell-based therapies in patients affected by knee osteoarthritis (OA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was conducted on PubMed, Cochrane and Web of Science in October 2024 according to PRISMA guidelines. Inclusion criteria were clinical studies of any level of evidence, a minimum of six patients, English language, no time limitations, on the use of intra-articular CS, HA, PRP and cell-based therapies for knee OA treatment. A meta-analysis was conducted for each product on the outcomes with sufficient data at short-term (&lt;3 months) and mid/long-term (≥3 months) follow-ups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 848 studies were included reporting on 99,443 patients (61.5 ± 24.7 years old, 65.8% women, 34.2% men). Out of these, only 21 articles (2.5% of the total, 2265 patients) presented sex-disaggregated data, including four studies with a CS treatment group (1.9% of CS patients), three with a HA group (0.2% of HA patients), 11 with a PRP group (5.9% of PRP patients) and eight with a cell-based therapy group (10.2% of cell-based therapies patients). The meta-analysis was performed on 15 studies (1387 patients) and did not show any statistically significant difference of VAS and WOMAC improvements at short- and mid/long-term follow-ups for any of the four injectable treatment approaches analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a staggering lack of sex-disaggregated data in studies evaluating the most used intra-articular injective therapies for knee OA, with only 2.5% analysing women- and men-specific outcomes for CS, HA PRP and cell-based therapies. The analysis of this limited amount of sex-disaggregated data did not show statistically significant differences between women and men for any of the investigated injectable approaches. The substantial lack of disaggregation hinders the understanding of potential sex-specific effects of these treatments and underscores the need for a shift in data reporting in this field, with more robustly designed studies incorporating sex-stratified analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145122651","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":"Five-year clinical study of a novel porcine xenograft for anterior cruciate ligament reconstruction: Positive safety and performance outcomes","authors":"Neil Hunt,&nbsp;Gabriel Oliver,&nbsp;Alberto Francés Borrego,&nbsp;William S. Pietrzak","doi":"10.1002/jeo2.70433","DOIUrl":"10.1002/jeo2.70433","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Many graft choices exist for anterior cruciate ligament (ACL) reconstruction including autograft, allograft and, to a lesser extent, synthetic graft, with all having significant limitations. While xenograft can circumvent many of these limitations, potential immunogenic response remains a concern. A novel decellularization process has been developed to remove the principal immunogenic epitopes from porcine digital extensor tendon to produce a nonimmunogenic, biomechanically appropriate ACL xenograft for clinical use. This study reports the first in-human series utilising this xenograft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a 5-year study of 40 patients, mean age 31.9 years (range: 18–48), 70% male, with mean follow-up of 41.9 months (6–60 months) and 19 reaching 5 years. Radiographic and MRI analysis was performed as were a variety of clinical assessments, including arthrometric measurement of anterior tibial translation, Lachman test, Pivot Shift test, International Knee Documentation Committee (IKDC) Subjective questionnaire, and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. All adverse events were recorded. Clinical outcomes were compared to those reported in the literature for autograft and/or allograft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adverse events included six graft ruptures which were limited to young males. No evidence of an immunogenic response was noted. Clinical outcome assessments and imaging analysis were in line with those reported in the literature for autograft and/or allograft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This first in-human study of a novel porcine ACL xenograft demonstrated that it is biomechanically and immunologically suitable for clinical use with no safety concerns evident.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145122652","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":"Diagnostic and prognostic potential of biomarkers in femoroacetabular impingement syndrome: A systematic review","authors":"Junya Yoshitani,&nbsp;Seper Ekhtiari,&nbsp;Joseph Dulleston,&nbsp;Ajay Malviya,&nbsp;Vikas Khanduja","doi":"10.1002/jeo2.70417","DOIUrl":"10.1002/jeo2.70417","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Early diagnosis of femoroacetabular impingement syndrome (FAIS) is essential. This systematic review aimed to identify biomarkers useful for diagnosing FAIS and predicting its progression to hip osteoarthritis. Our hypothesis was that there are biomarkers that are useful for the diagnosis and/or prognosis of FAIS. Our research questions were: (1) which biomarkers support diagnosis or screening of FAIS? and (2) which biomarkers predict disease progression?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review using the PRISMA guidelines was conducted to investigate the relationship between biomarkers and FAIS. The diagnosis of FAIS was based on the criteria used in each original study, typically involving clinical symptoms and radiographic evidence of CAM or pincer morphology. The protocol for the review has been published in PROSPERO. Literature search was performed using three databases: Embase, MEDLINE and Cochrane Library. The initial search yielded 683 articles of which 16 articles were included for final analysis. Data from a total of 2134 participants were analysed. Sixty-eight unique biomarkers associated with FAIS were identified and measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Diagnostically, 19 biomarkers were identified, of which 12 could significantly detect a difference between patients with FAIS and healthy controls. Forty-two biomarkers predicting the association of FAIS with hip osteoarthritis or late FAIS were identified, of which 16 biomarkers were statistically significant. Only 4-aminobutyrate aminotransferase promoter (ABAT) and peroxisome proliferator-activated receptor gamma (PPARγ) were associated with both diagnosis and prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Biomarkers may support the diagnosis and monitoring disease progression in patients with FAIS. Twelve biomarkers may detect early changes, and 16 may predict progression to osteoarthritis. Further refinement is required to identify those most useful in clinical practice. ABAT and PPARγ may be linked to both diagnosis and progression. While primarily preclinical, these findings may improve diagnostic accuracy, reduce overtreatment and aid decisions regarding joint preservation strategies.</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":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111221","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":"Portable exoskeletons for upper limb rehabilitation: A systematic review","authors":"Arianna Carnevale,&nbsp;Guido Nicodemi,&nbsp;Matteo Giuseppe Pisani,&nbsp;Alberto Lalli,&nbsp;Francesco Scotto di Luzio,&nbsp;Pieter D'Hooghe,&nbsp;Loredana Zollo,&nbsp;Emiliano Schena,&nbsp;Umile Giuseppe Longo","doi":"10.1002/jeo2.70416","DOIUrl":"10.1002/jeo2.70416","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review evaluates the efficacy and feasibility of portable exoskeletons for upper limb rehabilitation in patients post-stroke and with postoperative neurological complications. It focuses on motor function, range of motion (ROM), spasticity reduction and improvements in daily living activities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines [12], PubMed, Cochrane, and Scopus databases were searched up to October 2024 using combinations of keywords and MeSH terms such as “exoskeleton devices” and “shoulder rehabilitation.” Included studies (January 2008–October 2023) assessed portable exoskeletons for upper limb function in patients with chronic stroke or postoperative neurological complications. Excluded were studies on non-portable robots, animal studies, protocols, those without quantitative outcomes, and those not involving human patients. The Joanna Briggs Institute (JBI) Critical Appraisal tool, and the Risk Of Bias 2 (ROB2) tool assessed study bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five selected studies included 70 patients. Evaluated exoskeletons included the Tenodesis-Induced-Grip Exoskeleton Robot (TIGER), Wilmington Robotic Exoskeleton (WREX), Hybrid Exoskeleton Upper Limb 30A (HEXO-UR30A), and Hybrid Assistive Limb (HAL). These devices demonstrated significant improvements in motor function, ROM, spasticity reduction, and kinematic parameters. High adherence and absence of severe adverse events supported feasibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Portable exoskeletons are promising tools for upper limb rehabilitation post-stroke and after neurological surgery. They enhance motor recovery and functional outcomes. However, moderate risk of bias, small sample sizes, and limited data in orthopedic contexts—especially comparisons with conventional rehabilitation—underscore the need for further high-quality RCTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111220","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":"High return to sport after rotator cuff repair in racket sport players","authors":"Ayham Jaber,&nbsp;Yazan Jaber,&nbsp;Christopher J. Hawryluk,&nbsp;Silvia Cardarelli,&nbsp;Gianmarco Marcello,&nbsp;Peter J. Millett,&nbsp;Giovanni Di Giacomo,&nbsp;Filippo Familiari","doi":"10.1002/jeo2.70396","DOIUrl":"10.1002/jeo2.70396","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess the return-to-sport (RTS) rates and outcomes in racket sports players after isolated supraspinatus full thickness tears, and to investigate the influence of patient-, injury-, and treatment-specific factors on these outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study reviewed 38 racket sport players (tennis and padel) who underwent primary arthroscopic RCR performed by the senior author (G.D.G.). Inclusion criteria included patients aged 16 years or older with a history of rotator cuff tear, playing racket sports at least weekly prior to injury, and a minimum two-year follow-up. Functional outcomes were assessed using the Visual Analogue Scale for pain (VAS-score) and the 12-Item Short Form Survey (SF-12). RTS was defined as returning to the same or higher level. Statistical analysis was performed to analyse categorical and continuous variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety percent all participants were male, with a mean age of 58 years. The majority (95%) played racket sports recreationally, with tennis being the most common sport. Most participants (80%) played on clay courts. Thirty-four participants (85%) returned to sport, with 69% returning at the same level and 10% at a higher level. The median postoperative VAS score was 0 (IQR 0–0). Patient satisfaction was high, with 97.5% of patients reporting satisfaction. No significant differences in RTS were found based on injury mechanism or symptom duration, though patients with traumatic injuries reported higher mental component summary scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most racket sport players who undergo arthroscopic RCR for full-thickness supraspinatus tears are able to return to sport, with most returning at the same or higher level of play. Trauma-related injuries may positively influence mental recovery compared to degenerative injuries. Further prospective studies with larger cohorts and a greater focus on competitive athletes are needed to better predict 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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111348","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":"Limited clinical benefit of medial meniscus posterior root repair combined with high tibial osteotomy in varus knee osteoarthritis: A systematic review and meta-analysis","authors":"Gabriele Cortina,&nbsp;Stefano Mauro Antuofermo,&nbsp;Giuseppe Francesco Papalia,&nbsp;Raffaele Cortina,&nbsp;Vincenzo Condello,&nbsp;Simone Perelli,&nbsp;Joan Carles Monllau,&nbsp;Vincenzo Madonna","doi":"10.1002/jeo2.70431","DOIUrl":"10.1002/jeo2.70431","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;Medial meniscus posterior root tears (MMPRTs) are biomechanically comparable to total meniscectomy, leading to meniscal extrusion, increased tibiofemoral contact pressure and accelerated osteoarthritis (OA) in varus-aligned knees. While high tibial osteotomy (HTO) is effective in unloading the medial compartment, the added value of repairing the MMPRT during HTO remains debated. This systematic review and meta-analysis aimed to evaluate whether combined MMPRT repair and HTO provide superior short-term clinical and radiological outcomes compared to HTO alone.&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 search of PubMed, Cochrane and Scopus was performed in March 2025. Comparative studies evaluating HTO with or without concurrent MMPR repair in patients with varus knee and medial OA were included. Primary outcomes were clinical scores (International Knee Documentation Committee [IKDC], Lysholm, Knee Society Score [KSS] and Hospital for Special Surgery [HSS]), radiographic parameters (joint line convergence angle [JLCA], hip–knee–ankle [HKA] angle and joint space width), meniscal extrusion and second-look arthroscopic findings. Statistical analysis was conducted using a random-effects model with Review Manager 5.4.&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;Eight retrospective comparative studies (&lt;i&gt;n&lt;/i&gt; = 630 patients) met the inclusion criteria. MMPRT repair plus HTO demonstrated statistically higher IKDC scores (MD = 3.56; &lt;i&gt;p&lt;/i&gt; = 0.001) compared to HTO alone; however, there were no significant differences between groups in terms of Lysholm, KSS function and HSS scores. Radiographically, minimal improvements were noted in JLCA (MD = −0.25; &lt;i&gt;p&lt;/i&gt; = 0.006), without clear clinical implications. Meniscal extrusion did not differ significantly between groups (MD = 0.30; &lt;i&gt;p&lt;/i&gt; = 0.72). Second-look arthroscopy revealed complete root healing in 22% of cases. The risk of bias was moderate to high.&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;Short-term follow-up shows that combining MMPRT repair with HTO yields statistically better IKDC clinical scores. Furthermore, the actual benefit of combining MMPRT repair with HTO in routine clinical practice is questionable. Prospective studies with longer follow-up are required to clarify the long-term clinical impact of MM.&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, systematic review and meta-analysis.&lt;/p&gt;\u0000 &lt;/","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111251","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}