Journal of Experimental Orthopaedics最新文献

{"title":"Effect of design and surgical parameters variations in mobile-bearing versus fixed-bearing unicompartmental knee arthroplasty: A finite element analysis","authors":"Thomas Luyckx,&nbsp;Edoardo Bori,&nbsp;Rachele Saldari,&nbsp;Sara Fiore,&nbsp;Virginia Altamore,&nbsp;Bernardo Innocenti","doi":"10.1002/jeo2.70053","DOIUrl":"10.1002/jeo2.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Unicompartmental knee arthroplasty (UKAs) are available in the market as fixed- and mobile-bearing (FB and MB) and can be characterised by a different set of design parameters in terms of geometries, materials and surgical approaches, with overall good clinical outcomes. However, clear biomechanical evidence concerning the consequences of variations of these features on knee biomechanics is still lacking; therefore, the present study aims to perform a sensitivity analysis to see which outcomes are affected by these variations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For both MB-UKA and FB-UKA, five design and surgical parameters were defined (bearing insert thickness, tibial component material, implant components friction coefficient, antero-posterior slope angle and level of tibial bone resection). Two control models were defined based on standard configurations for both implants. Finite element analysis was chosen to perform this study, and different parameter combinations (216 models in total) were implemented and tested at both 0° and 90° of flexion, using a previously validated finite element knee model. The results were then evaluated in terms of bone and polyethylene Von Mises stress and tibio-femoral contact area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bearing thickness, tibial bone cut and slope angle were found to be the most sensitive parameters for both types of UKAs. Specifically, changes in these parameters in the FB-UKA appeared to induce more significant variations in the polyethylene insert (both in terms of polyethylene stress and contact area), while in the MB-UKA, these changes influenced bone stress distribution more.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Surgical parameters returned to have a more significant influence than material and friction variations; furthermore, the outcomes most affected by parameter variations were the insert-related ones for FB-UKA while for the MB-UKA were the ones regarding tibial bone stresses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not Applicable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509710","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":"Variability of three-dimensional knee morphology cannot be effectively assessed using a coronal plane knee alignment classification in total knee arthroplasty patients","authors":"Ishaan Jagota,&nbsp;Joshua Twiggs,&nbsp;Brad Miles,&nbsp;Jonathan V. Baré","doi":"10.1002/jeo2.70039","DOIUrl":"10.1002/jeo2.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Optimal reproduction of the native three-dimensional (3D) alignment in total knee arthroplasty (TKA) influences outcomes; however, much of the modern TKA alignment research, such as the coronal plane alignment of the knee (CPAK), focuses only on coronal alignment. Tibial, femoral and tibiofemoral measurements on the axial and sagittal planes were evaluated for their relationship to the arithmetic hip-knee-ankle angle (aHKA) and joint-line obliquity (JLO). These 3D anatomical measurements are also evaluated across CPAK groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of the 360 Med Care computed tomography (CT) database was performed. Patient CT scans were segmented and landmarked. Linear regression analysis compared 12 axial and sagittal plane measurements (representing tibial, femoral and tibiofemoral rotation, tibial slope and femoral flexion) with both aHKA and JLO. Nonparametric tests assessed these anatomical measurements across the different CPAK groups, while Cohen's delta (<i>d</i>) determined the effect size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>With a sample size of 7450 osteoarthritic knees, significant but weak relationships (<i>r</i> &lt; 0.30) were observed between all 12 anatomical measurements and both aHKA and JLO. Tibiofemoral rotations between Insall's axis and both the posterior condylar and the surgical transepicondylar axes demonstrated large effect sizes (<i>d</i> &gt; 0.80). However, trivial to small effect sizes (<i>d</i> &lt; 0.50) were broadly observed across the 12 axial and sagittal measurements, underscoring their limited clinical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While useful for describing coronal knee anatomy, CPAK phenotypes fail to differentiate tibial, femoral and tibiofemoral rotation, tibial slope or femoral flexion—crucial aspects of 3D surgical planning. Therefore, more comprehensive knee phenotyping solutions are required to guide individualised TKA alignment strategies.</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":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509715","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":"Harnessing deep learning and statistical shape modelling for three-dimensional evaluation of joint bony morphology","authors":"Jacob F. Oeding,&nbsp;Allen A. Champagne,&nbsp;Eoghan T. Hurley,&nbsp;Kristian Samuelsson","doi":"10.1002/jeo2.70070","DOIUrl":"10.1002/jeo2.70070","url":null,"abstract":"&lt;p&gt;Medical research has continued to evolve at a rapid pace, due in large part to advancements in computational technology that have enabled new avenues for investigating clinical challenges. Deep learning (DL) and statistical shape modelling (SSM) are two such technologies with the potential to create new ways of addressing clinical questions in orthopaedic research. Specifically, computational pipelines that harness the two in a synergistic fashion have particular promise. This review describes how DL and SSM can be effectively employed to investigate orthopaedic clinical research questions and enhance patient care and surgical outcomes. While the applications of each of these technologies are nearly infinite, this review will focus primarily on how these technologies enable large-scale analysis of bony morphology to gather valuable insights into the prediction of clinical outcomes, using examples from the surgical management of anterior cruciate ligament (ACL) reconstruction and shoulder instability. We begin by discussing each technology individually, then expand on their integration towards enhancing the capabilities of one another, in a synergistic manner.&lt;/p&gt;&lt;p&gt;DL is a subset of artificial intelligence (AI) that utilizes neural networks with multiple layers that can learn and make predictions from large amounts of unstructured data, such as images [&lt;span&gt;4, 5&lt;/span&gt;]. In orthopaedic research, DL has shown emerging potential in automating the analysis of medical imaging data, including X-rays, computed tomography (CT) scans and magnetic resonance imagings (MRIs) [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Given the growing role of peri-operative imaging, the development of DL has been of great interest in terms of assisting the clinical integration of advanced imaging analyses. For instance, after ACL reconstruction, DL algorithms can be trained to analyze MRI images to detect subtle changes in the bone and surrounding tissues that might not be apparent to the naked eye [&lt;span&gt;1&lt;/span&gt;]. For instance, DL models have been explored to predict the likelihood of complications, such as graft failure or post-traumatic osteoarthritis development, eventually enabling tailored patient-specific rehabilitation protocols and improving long-term outcomes. In the case of shoulder instability, DL may assist in outcome evaluation by analyzing pre- and post-operative imaging to assess as a substrate for understanding risk factors that may indicate the need for soft tissue or bone augmentation in terms of predicting the success of surgical stabilization, or the positioning of surgical implants. Taken together, the above examples serve to emphasize that access to automated image analyses reduces the large manual burden associated with these advanced analyses, which in turn fosters a more efficient workflow for clinical integration and objectifies the assessment of advanced imaging as part of the orthopaedic work-up. This efficiency not only contributes to accelerating research b","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509711","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":"Successful ACL repair by dynamic intraligamentary stabilisation is non-inferior in functional performance and worse in proprioception compared to healthy controls in a case-matched study","authors":"Sophie A. Gommers,&nbsp;Ajmal Farid,&nbsp;Jeroen de Groot,&nbsp;Inger N. Sierevelt,&nbsp;Daniël Haverkamp,&nbsp;Dutch ACL repair study group","doi":"10.1002/jeo2.70047","DOIUrl":"10.1002/jeo2.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary aim of this study was to assess non-inferiority in functional performance of the knee after dynamic intraligamentary stabilisation (DIS) surgery at a minimal follow-up of 1 year compared to healthy controls, based on limb symmetry index (LSI) of the single leg hop test (SLH). Additionally, functional performance based on the single leg triple hop test (SLTH) and side hop test (SH), proprioception and subjective outcome were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 45 DIS patients were 1-to-1 matched to a healthy control. Functional performance was evaluated by LSI and absolute values on the SLH, SLTH and SH. Proprioception was assessed by joint position sense (JPS) test and International Knee Documentation Committee (IKDC) scores were obtained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Non-inferiority in functional performance after DIS compared to healthy controls was confirmed based on the mean LSI of the SLH and SLTH (97.6% vs. 99.6% and 97.5% vs. 100.6%, respectively) and non-confirmed on the SH (98.8% vs. 100.0%, respectively). No significant differences were found in absolute value of the SLH and SLTH and a significantly higher absolute value of the SH was found in the DIS group (<i>p</i> = 0.01). JPS absolute angular error was significantly higher in the DIS group compared to the control group (<i>p</i> = 0.01). The median IKDC score of the DIS group was significantly lower (92, IQR 85–95) than the control group (100, IQR 99–100), <i>p</i> &lt; 0.001.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, functional performance after DIS was confirmed non-inferior compared to healthy controls based on the SLH and SLTH, although non-confirmed on the SH.</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":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509713","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":"Short arm splints for wrist stabilization: A mechanical material test and cadaveric radiography study","authors":"Hans Christian Rasmussen,&nbsp;Maya Bang,&nbsp;Johanne Gade Lilleøre,&nbsp;Josephine Olsen Kipp,&nbsp;Lars Lindgren,&nbsp;Annemarie Brüel,&nbsp;Mats Bue,&nbsp;Mads Kristian Duborg Mikkelsen,&nbsp;Jesper Skovhus Thomsen,&nbsp;Maiken Stilling","doi":"10.1002/jeo2.70065","DOIUrl":"10.1002/jeo2.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Documentation of the wrist stabilizing effect and mechanical properties of common splinting materials is warranted to support evidence-based condition-specific recommendations for wrist immobilization. The objectives of this study were to assess the wrist stabilizing properties of volar and dorsal short-arm splints made of four different materials and evaluate the mechanical properties of the splinting materials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Dorsal and volar short arm splints made of plaster of Paris (PoP) (eight layers), Woodcast (2 mm, rigid vented), X-lite (classic, two layers) or a 3D-printed material (polypropylene) were sequentially mounted on 10 cadaveric arm specimens and fixed in a radiolucent fixture. This enabled the evaluation of maximum wrist flexion and extension relative under an orthogonal load of 42 N via radiographic images. In addition, a three-point bending test was performed on ten sheet duplicates of each of the four splinting materials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>When applied as a volar splint, PoP had the highest capability to resist wrist flexion and extension. However, when applied as a dorsal splint, Woodcast exhibited a lower wrist flexion and a similar wrist extension. The 3D-printed splints—both volar and dorsal—showed the highest mean wrist flexion and extension. The mechanical properties of the Woodcast, X-lite and 3D-printed splinting materials were very similar. PoP exhibited distinct properties with a stiffness of 146 (95% confidence interval [CI]: 120–173) N/mm and a deflection at <i>F</i>_max of 0.6 (95% CI: 0.5–0.7) mm compared to ≤7.7 (95% CI: 7.4–7.9) N/mm and ≥20 (95% CI: 18–22) mm for the other materials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PoP displayed better wrist stabilizing properties and material stiffness than Woodcast, X-lite and 3D-printed polypropylene. When considering wrist stabilizing properties, PoP may still prove to be the preferred choice for wrist immobilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509712","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":"The epidemic of alignment classifications in total knee arthroplasty forgives the kinematic of the human knee","authors":"Pier Francesco Indelli","doi":"10.1002/jeo2.70052","DOIUrl":"10.1002/jeo2.70052","url":null,"abstract":"&lt;p&gt;The constitutional limb alignment has been historically described as varus, neutral, or valgus while, in modern times, it has been defined as the hip–knee–ankle angle (HKA). This alignment measurement represents the angle between the mechanical axes of the femur and the tibia, and it is routinely measured on a static, full-length lower-limb radiograph. Arthroplasty surgeons, for more than 30 years [&lt;span&gt;11&lt;/span&gt;], had the intraoperative goal of reproducing a neutral HKA during the total knee arthroplasty (TKA) procedure, disregarding individual morphological variations for reliability and simplicity.&lt;/p&gt;&lt;p&gt;The recent, growing interest in individualized alignment techniques in TKA has created a push in the development of multiple radiological classifications to categorize the coronal alignment of knee phenotypes during weightbearing. Lin et al. [&lt;span&gt;12&lt;/span&gt;] were among the first to propose a classification system with 27 possible phenotypes but only five of them were originally considered clinically relevant. Later, Hirschmann et al. [&lt;span&gt;6&lt;/span&gt;] introduced the concept of the functional knee phenotype, with 125 possible phenotypes, 43 of which were considered clinically relevant. In 2021 MacDessi et al. [&lt;span&gt;13&lt;/span&gt;] proposed the Coronal Plane Alignment of the Knee (CPAK) Classification, defining nine CPAK phenotypes. These classifications [&lt;span&gt;6, 12, 13&lt;/span&gt;] combined several variables, including the mechanical limb alignment, the proximal tibial angle, the distal femoral angle, the joint line obliquity, and the arithmetic HKA. The common denominator of all these classification systems is characterized by the fact that all measurements were taken on double-leg, weightbearing, long-leg radiographs which represent a “static” modality. These multiple phenotypes have become the targets of multiple surgical techniques, recently developed to support surgeons in the intraoperative decision-making process: the adjusted mechanical alignment (AMA) [&lt;span&gt;7&lt;/span&gt;], the anatomical alignment [&lt;span&gt;9&lt;/span&gt;], the kinematic alignment (KA) [&lt;span&gt;8&lt;/span&gt;], the restricted KA [&lt;span&gt;21&lt;/span&gt;], the inverse KA [&lt;span&gt;22&lt;/span&gt;] and, finally, the functional alignment [&lt;span&gt;16&lt;/span&gt;] were all designed to match the patient's constitutional alignment as measured on the preoperative standing films.&lt;/p&gt;&lt;p&gt;Interestingly, this massive research effort did not take into consideration that the HKA axis varies significantly during the gait cycle: the hypothesis that the standing coronal alignment remains constant during the gait cycle, especially at the first (mid-stance phase of the gait cycle) and second knee flexion peaks (mid-swing phase of the gait cycle), remains highly controversial [&lt;span&gt;16&lt;/span&gt;]. Miller et al. [&lt;span&gt;14&lt;/span&gt;] showed that the dynamic loading on the tibial plateau is affected by limb position, muscle contraction, soft-tissue stability, and walking speed, hypothesizing that the standing coronal alignment does not predict th","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509714","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":"Anatomic physeal-sparing MPFL reconstruction in skeletally immature patients shows favourable outcomes at a minimum of 24-month follow-up","authors":"Panagiotis Ntagiopoulos,&nbsp;Pierrenzo Pozzi,&nbsp;Georgios Kalinterakis,&nbsp;Dimitris Fligkos,&nbsp;Triantafyllia Dimou,&nbsp;Riccardo Compagnoni,&nbsp;Paolo Ferrua,&nbsp;Pietro Simone Randelli","doi":"10.1002/jeo2.70063","DOIUrl":"10.1002/jeo2.70063","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;Recurrent patellar dislocation is a prevalent orthopaedic issue among active paediatric and adolescent populations. Bony surgical procedures are not recommended in growing patients; therefore, the focus of surgery is on restoring the medial patellar ligaments, with different reconstructive techniques available. This retrospective case series focuses on the 2-year outcomes of medial patellofemoral ligament (MPFL) reconstruction in skeletally immature patients with open physis.&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;Twenty-four consecutive patients with patellofemoral instability and open growth plates underwent anatomic MPFL reconstruction with a physeal-sparing technique. All subjects have had more than three episodes of true patellar dislocations. Preoperative radiographic examination included anteroposterior and lateral views to assess patella alta and limb alignment. Magnetic resonance imaging was performed to evaluate trochlear dysplasia and tibial tubercle–trochlear groove (TT–TG) distance. The patients were questioned regarding complications and clinical outcomes using the visual analogue scale (VAS), Kujala and Paediatric International Knee Documentation Committee (Pedi-IKDC) score. Variables were evaluated using paired &lt;i&gt;t&lt;/i&gt; test with significance at &lt;i&gt;p&lt;/i&gt; &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;The mean age at the time of operation was 13.04 years (9–16 years). The cohort was followed for a mean duration of 38.66 months (24–86 months). The mean time from injury to surgery was 50.45 days (16–80 days). No growth arrest, limb-length discrepancies or angular deformities were observed post-operatively during the whole follow-up period. No patellar re-dislocations were recorded throughout the study period. The VAS score improved significantly from 5.67 (4–8) to 1.88 (0–4) (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). The Kujala score improved significantly from 64.67 (44–81) preoperatively to 87.58 (77–100) post-operatively (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). The Pedi-IKDC also increased significantly from 58.81 (34.80–77.70) preoperatively to 90.64 (70.70–100) post-operatively (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). The vast majority of patients (87.5%) returned to their pre-injury activity level. Boys scored better than girls in VAS, Pedi-IKDC and Kujala score post-operatively, but these differences were not statistically significant.&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;Physeal-sparing MPFL reconstruction in children and adolescents yields excellent midterm results and allows patients to return to sports without redislo","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509709","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":"Mid-term patient-reported outcomes are inferior in opening-wedge high tibial osteotomy patients with untreated medial meniscus posterior root tear","authors":"Eiji Sasaki,&nbsp;Shugo Maeda,&nbsp;Takahiro Tsushima,&nbsp;Yuka Kimura,&nbsp;Yukiko Sakamoto,&nbsp;Eiichi Tsuda,&nbsp;Yasuyuki Ishibashi","doi":"10.1002/jeo2.70064","DOIUrl":"10.1002/jeo2.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The impact of untreated medial meniscus posterior root (MMPR) tear (MMPRT) during opening-wedge high tibial osteotomy (OWHTO) on patient-reported outcomes (PROs) remains poorly understood. This retrospective cohort study aimed to investigate the association between the presence of MMPRT and post-operative PROs in patients who underwent OWHTO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 83 knees that underwent OWHTO that were followed up for 6.6 years were included. Post-operative PROs were assessed using the knee injury and osteoarthritis outcome score (KOOS) subscales. Medial meniscus extrusion (MME) was measured by magnetic resonance imaging (MRI). MMPRT was diagnosed based on preoperative MRI and intraoperative arthroscopy findings. The participants were categorized into the MMPRT and MMPR intact (MMPRI) groups, and their KOOS subscales were compared. Additionally, logistic regression analysis was conducted to explore the correlation between KOOS and MMPRT presence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 29 out of 80 (36.3%) knees were classified into the MMPRT group, while three knees underwent total knee arthroplasty. Preoperative MME was 3.5 ± 1.9 (range 0–8.9) mm, showing correlation with the presence of MMPRT (<i>p</i> = 0.004) by regression analysis. The post-operative KOOS subscales of the MMPRT group were lower than the MMPRI group for pain (<i>p</i> = 0.017), activities of daily living (ADLs) (<i>p</i> = 0.001), sports (<i>p</i> &lt; 0.001) and quality of life (QOL) (<i>p</i> &lt; 0.001). Additionally, regression analysis showed the presence of MMPRT was correlated with lower KOOS subscale scores for pain (<i>p</i> = 0.041), ADLs (p = 0.011), sports (<i>p</i> &lt; 0.001) and QOL (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative MMPRT correlated with a reduction in mid-term post-operative PROs, as assessed using the KOOS, among patients who underwent OWHTO. Surgeons should consider addressing an MMPRT at the time of OWHTO.</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":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476785","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":"No difference in patient-reported outcomes or range of motion between ultracongruent and posterior stabilized total knee arthroplasty: A randomized controlled trial","authors":"Fernando Macedo,&nbsp;João Lucas,&nbsp;Patrícia Cunha,&nbsp;Miguel Rocha,&nbsp;Rui Cerqueira,&nbsp;Tiago Basto,&nbsp;João Moura","doi":"10.1002/jeo2.70043","DOIUrl":"10.1002/jeo2.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Ultracongruent (UC) inserts were designed to overcome potential issues with posterior stabilized (PS) inserts, including bone resection, post-breakage, and patellar clunk syndrome. However, there remains a shortage of high-quality studies directly comparing this insert design to the established PS Total Knee Arthroplasty (TKA). This prospective randomized controlled trial (RCT) aimed to compare clinical outcomes, range of motion, and complications of UC and PS TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ninety six patients with primary knee osteoarthritis were randomly assigned to either the PS or the UC group. There were no significant differences between the groups regarding age, body mass index, sex, or Osteoarthritis grade. The measured outcomes were Knee Injury and Osteoarthritis Outcome Score (KOOS) and Range of Motion (ROM), recorded preoperatively and at 3 and 6 months postoperative. Both the patient and interviewer were blinded to the allocation group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty one patients were included in the analysis, with a mean follow-up of 1.3 years. Both groups exhibited a gradual improvement in KOOS. Still, no statistically significant differences were observed between the groups during the follow-up examinations at 3 or 6 months in KOOS or range of motion. No complication occurred in either group during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both designs demonstrated comparable positive outcomes, reinforcing the viability of UC designs as an alternative to the well-established PS TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Levels of Evidence</h3>\u0000 \u0000 <p>Level l, randomized controlled trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476786","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":"Resorption characteristics of an open architecture biocomposite interference screw after ACL reconstruction","authors":"Martin Lind,&nbsp;Torsten Grønbech Nielsen,&nbsp;Flemming K. Nielsen,&nbsp;Ole G. Sørensen,&nbsp;Bjarne Mygind-Klavsen,&nbsp;Peter Faunø","doi":"10.1002/jeo2.70016","DOIUrl":"10.1002/jeo2.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Absorbable interference screws for anterior cruciate ligament reconstruction (ACLR) can lead to tunnel widening and cyst formation. The Biosure Regenesorb interference screw (Smith &amp; Nephew). has been developed with an optimised calcium phosphate/polymer composition to promote bone formation during resorption. The present study aims to investigate screw resorption, new bone formation, and tunnel geometry following ACLR with Biosure Regenesorb screw tibial fixation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study is a prospective single-centre case series of 12 patients with ACL lesions and treated with ACLR using hamstring tendon autograft with Biosure Regenesorb interference screw tibial fixation with a two-year follow-up period. The Biosure Regenesorb consists of 65% polylactide-glycolic acid poly. 20% calcium sulphate and 15% tricalcium phosphate. Primary endpoint: Tunnel volume. implant volume and new bone formation in the tibial tunnel is evaluated by quantitative computed tomography (CT) scanning. Secondary endpoints: Arthrometric knee laxity, International Knee Documentation Committee (IKDC) and Knee Osteoarthritis and Injury Outcome Scores (KOOS) and Tegner activity scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Screw volume decreased to 44% within the two-year follow-up period while tunnel volume remained unchanged. Only a minor amount (&lt;1% of tunnel volume) of new bone formation in the screw remnants was observed. Sagittal knee laxity at one year was 0.9 mm. The IKDC score increased by 15 points and the KOOS sport and KOOS quality of life scores increased by 25 and 26 points. respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ACLR using Biosure Regenesorb interference screw does not result in tunnel widening. showing a screw resorption of 44% after two years and minor new bone formation. Knee stability and subjective outcome improvements are as expected after other ACLR methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476787","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}