Fernando Macedo, João Lucas, Patrícia Cunha, Miguel Rocha, Rui Cerqueira, Tiago Basto, João Moura
{"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, João Lucas, Patrícia Cunha, Miguel Rocha, Rui Cerqueira, Tiago Basto, 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}
Martin Lind, Torsten Grønbech Nielsen, Flemming K. Nielsen, Ole G. Sørensen, Bjarne Mygind-Klavsen, Peter Faunø
{"title":"Resorption characteristics of an open architecture biocomposite interference screw after ACL reconstruction","authors":"Martin Lind, Torsten Grønbech Nielsen, Flemming K. Nielsen, Ole G. Sørensen, Bjarne Mygind-Klavsen, 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 & 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 (<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}
{"title":"The role of radial head morphology in proximal radioulnar joint congruency during forearm rotation","authors":"Hailong Zhang, Guang Yang, Yi Lu","doi":"10.1002/jeo2.70059","DOIUrl":"10.1002/jeo2.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Congruency of the proximal radioulnar joint (PRUJ) is important in the rotation of the forearm while any compromise would significantly impair the elbow function. The purpose of this study is to determine the morphological features of the radial head and investigate its role in the congruency of the PRUJ during forearm rotation. The hypothesis is that the PRUJ is more congruent in the maximal pronation and supination positions than in the neutral position.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty sets of computed tomography images of the elbow were acquired, and a three-dimensional model of the proximal radius and ulna was generated. The radius of curvature of the radial head and the radial head at the maximal pronation, neutral positions and maximal supination were calculated and compared with a one-way analysis of variance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The point on the radial head contacting the middle point of radial head at the maximal pronation and supination was located at the ends of the semi-major axis of the ellipse, while it was located at one end of the semi-minor axis at neutral position. The radii of curvature of the pronation, neutral and supination points of the radial head were 14.72 ± 1.51, 9.74 ± 1.49 and 14.58 ± 1.70 mm, respectively. The value of the neutral point was significantly smaller than that of the pronation and supination points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study quantitatively evaluated the morphology of the radial head and suggested that the best congruency of the PRUJ was achieved at maximal pronation and supination, while the neutral position was associated with the least congruency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Basic Science Study.</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/PMC11491982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476789","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}
Michael T. Hirschmann, Rüdiger von Eisenhart-Rothe, Heiko Graichen, Stefano Zaffagnini
{"title":"AI may enable robots to make a clinical impact in total knee arthroplasty, where navigation has not!","authors":"Michael T. Hirschmann, Rüdiger von Eisenhart-Rothe, Heiko Graichen, Stefano Zaffagnini","doi":"10.1002/jeo2.70061","DOIUrl":"10.1002/jeo2.70061","url":null,"abstract":"<p>Total knee arthroplasty (TKA) is on the verge of being revolutionized by artificial intelligence (AI), which will make it possible for robots to have a clinical influence in areas where navigation systems have been rendered ineffective. Navigation has been shown to increase surgical accuracy; nevertheless, it has not been shown to provide major gains in terms of clinical outcome for the patient. On the other hand, robotic systems that are powered by artificial intelligence have the potential to improve functional outcomes, boost precision, and tailor procedures to the specific anatomy of each unique patient. Through the utilization of real-time data and prediction algorithms, artificial intelligence-guided robots have the potential to overcome the limits of conventional approaches, thereby establishing a new benchmark for TKA.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476783","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}
Michael T. Hirschmann, George Avram, Heiko Graichen, Reha N. Tandogan, Natalie Mengis, Stefano Zaffagnini
{"title":"Same same but different—Image-based versus imageless robotic-assisted total knee arthroplasty!","authors":"Michael T. Hirschmann, George Avram, Heiko Graichen, Reha N. Tandogan, Natalie Mengis, Stefano Zaffagnini","doi":"10.1002/jeo2.70062","DOIUrl":"10.1002/jeo2.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Robotic-assisted total knee arthroplasty (RTKA) has gained widespread acceptance due to its demonstrated ability to improve surgical accuracy compared to conventional total knee arthroplasty (CTKA). While the precise impact of RTKA on postoperative patient-reported outcome measures (PROMs) remains inconclusive, the increased accuracy in alignment and joint kinematics suggests potential improvements in patient satisfaction and functional outcomes. Two primary RTKA systems exist: image-based, which uses preoperative CT scans for detailed 3D modeling, and image-less, which relies on intra-operative digitization of anatomical landmarks. Both systems aim to achieve accurate implant placement and soft-tissue balancing, yet they differ in methodology and reliance on preoperative data.</p>\u0000 \u0000 <p>Despite RTKA's theoretical advantages, there is ongoing debate about whether accuracy alone is sufficient to achieve optimal postoperative outcomes, particularly concerning joint kinematics and alignment strategies. Literature reveals no significant difference in coronal plane alignment between image-based and image-less systems, though image-less systems may be more prone to varus errors due to the reliance on intra-articular landmarks. Additionally, image-free systems may face challenges in replicating native knee anatomy, especially in the sagittal plane, leading to potential limitations in achieving ideal tibial slope reconstruction.</p>\u0000 \u0000 <p>The future of RTKA may lie in refining implant positioning strategies that minimize postoperative alterations to pre-arthritic knee kinematics, particularly with standardized off-the-shelf implants. As robotic technology evolves, there is potential to enhance surgical outcomes by combining accuracy with personalized alignment approaches that better address individual patient anatomy. Further research is needed to assess the long-term clinical benefits of RTKA and its capacity to improve patient-specific functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>level 5</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476788","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}
Varun Gopinatth, Garrett R. Jackson, Daniel C. Touhey, Jorge Chahla, Matthew V. Smith, Matthew J. Matava, Robert H. Brophy, Derrick M. Knapik
{"title":"Microfracture for medium size to large knee chondral defects has limited long-term efficacy: A systematic review","authors":"Varun Gopinatth, Garrett R. Jackson, Daniel C. Touhey, Jorge Chahla, Matthew V. Smith, Matthew J. Matava, Robert H. Brophy, Derrick M. Knapik","doi":"10.1002/jeo2.70060","DOIUrl":"10.1002/jeo2.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate clinical and radiographic outcomes, return to sport, failure rate, operations and complications in patients undergoing microfracture of the knee, including the femoral condyle, tibial plateau, patella and trochlea, at a mean 10-year or greater follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was performed by querying SCOPUS, PubMed, Medline and the Cochrane Central Register for Controlled Trials from database inception through May 2023 according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Inclusion criteria were level I-IV human studies reporting on outcomes, reoperations and complications following microfracture of the knee at a mean 10-year or greater follow-up. Biomechanical and epidemiological studies, including patients undergoing concomitant realignment procedures, and studies with patients under 18 years old were excluded. Data regarding failure, as defined by each study, as well as reoperations were gathered. Study quality was assessed via the Methodological Index for Nonrandomized Studies criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies from 2003 to 2018, consisting of 727 patients (mean age 38.9 ± 8.1 years; range 25.8–47.6) undergoing microfracture for chondral defects in the knee were identified. Mean follow-up ranged from 10 to 17 years. Males composed 56.5% of patients, with a mean defect size ranging from 2.3 to 4.01 cm<sup>2</sup>. Based on radiographs at follow-up, osteoarthritis progression occurred in 40%–48% of patients. Magnetic Resonance Observation of Cartilage Repair Tissue scores were low. Patient-reported outcome measures showed significant improvement in postoperative scores at final follow-up. Return-to-sport rate ranged from 17.2% to 20%. Longitudinal analysis revealed declining clinical outcomes and return-to-sport rates from short- and mid- to long-term follow-up. There was high variability in failure definition and reoperations, with 2.9%–41% of patients requiring total knee arthroplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At a mean 10-year or greater follow-up, microfracture for chondral defects of the knee 2–4 cm<sup>2</sup> in size demonstrated a high rate of osteoarthritis progression with poor healing of the chondral defect and low overall return-to-sport rates. Failure and reoperation rates ranged from 2.9% to 41%, with declining outcomes from short- and mid- to long-term follow-up. The advantages of microfracture relating to availability, complexity, and ","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476784","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}
Ahmed Mahmoud, Bashirr Garba, Tim McMeniman, Brett Collins, Peter McMeniman, Peter Myers
{"title":"Lateral closing wedge high-tibial osteotomy is a long-lasting option for patients under the age of 55 with medial compartment osteoarthritis","authors":"Ahmed Mahmoud, Bashirr Garba, Tim McMeniman, Brett Collins, Peter McMeniman, Peter Myers","doi":"10.1002/jeo2.70040","DOIUrl":"https://doi.org/10.1002/jeo2.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Assess the survival of the closing wedge high tibial osteotomy (CWHTO) with failure defined as progression to total knee arthroplasty (TKA) and perioperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients undergoing CWHTO in a single centre were included in this study. The patient's demographics, operative data and patient-reported outcome measures were collected from the medical records. The outcomes assessed were progression to TKA, complications and patient-reported outcome measures. The Australian joint registry was used to assess which patients progressed to TKA. A binary logistics regression is used to determine if any of the collected factors increase the likelihood of conversion to arthroplasty. Survival analysis is conducted using a Kaplan–Meier survivorship analysis with failure defined as progression to TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred and fifty-four (244 males and 110 females) patients were included in the study. The average age of the group was 51 years with an average follow-up of 18 years. Patients under the age of 55 had a lower rate of progression to TKA. At 15 years, the rate of progression to TKA was 64% and 85% for those under the age of 55 and over 55, respectively. The complication rate was 6% without any peroneal nerve palsies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CWHTO is a good surgical option particularly when indicated in patients under the age of 55. Additionally, this technique results in a low overall complication rate with an absence of the often-feared complication of peroneal nerve palsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, Retrospective study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443563","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}
Shintaro Onishi, Youngji Kim, Hiroshi Nakayama, Christophe Jacquet, Ahmed Mabrouk, Matthieu Ollivier
{"title":"Alignment rod and gap measurement methods achieve comparable alignment correction in opening wedge high tibial osteotomy for varus osteoarthritic knees","authors":"Shintaro Onishi, Youngji Kim, Hiroshi Nakayama, Christophe Jacquet, Ahmed Mabrouk, Matthieu Ollivier","doi":"10.1002/jeo2.70038","DOIUrl":"https://doi.org/10.1002/jeo2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare clinical and radiological outcomes of medial opening wedge high tibial osteotomy (MOWHTO) using two different alignment methods: the alignment rod (AR) versus the gap measurement (GM) method. The primary outcome was to report the surgical accuracy of coronal plane corrections in each method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent MOWHTO with either AR or GM method between 2014 and 2022 at a single institution, with a minimum of 2 years of follow-up, were included. The opening gap was gradually spread with an AR under fluoroscopic control in the AR group, whereas the osteotomy site was opened to the value of the measured gap distance in addition to the thickness of the bone saw in the GM group. Radiological assessment of geometric characteristics included hip–knee–ankle angle (HKA), medial proximal tibial angle (MPTA), mechanical lateral distal femoral angle and joint line convergence angle. Surgical accuracy, which is the deviation (Δ) between the intended and achieved correction, was compared between both methods. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 110 patients (<i>n</i> = 110 knees) with a mean age of 54.1 ± 8.4 years were included in the study. Radiological parameters were significantly improved as reflected by HKA correction from 171.6° ± 2.0° to 181.1° ± 2.6° in the AR group and from 171.0° ± 2.3° to 181.1° ± 2.8° in the GM group at 2 years (Intergroup n.s). There was no significant intergroup difference for all radiological parameters and clinical outcomes. There was no intergroup difference in the surgical accuracy as evaluated by Δvalues and absolute Δvalues of both HKA and MPTA (n.s).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Comparable correction accuracy was achieved in MOWHTO using either the AR or GM method. The GM method is simple and reliable in achieving the intended correction in MOWHTO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Ⅲ retrospective comparative study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443488","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}
Felix Alarcón, Olof Sköldenberg, Martin Magnéli, Michael Axenhus
{"title":"Periprosthetic and peri-implant femoral fractures and timeliness to surgery: A retrospective matched cohort study","authors":"Felix Alarcón, Olof Sköldenberg, Martin Magnéli, Michael Axenhus","doi":"10.1002/jeo2.70037","DOIUrl":"https://doi.org/10.1002/jeo2.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Periprosthetic (PPFF) and peri-implant femoral fractures (PIFFs) are troublesome complications of prosthetic and implant surgery, the prior being described to have a greater delay to surgery when compared with standard hip fractures. The implications of PPFF delay being disputed in the current literature and those of PIFF have not been investigated. The aim of this study was to determine whether the time from radiological examination to surgery differs between hip fractures and PPFF/PIFF, and the possible consequences of delay and group affiliation on morbidity, mortality, and readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and thirty-six participants were admitted to Danderyd hospital during 2020, cases exposed to PPFF or PIFF (<i>n</i> = 35) and hip fracture controls (<i>n</i> = 101) matched at 1:3 with respect to age and sex. Timestamps from radiology, surgery, and death were retrieved from the Swedish fracture registry, data on adverse events (AEs), and readmissions were collected through retrospective medical record review for 90-days postsurgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Linear regression showed that time to surgery differed in case and control cohorts by a mean of 24.8 h, <i>p</i> < 0.001, and AEs were significantly more common in cases, <i>p</i> = 0.046. Unadjusted binary logistic regression indicated a possible relationship between time to surgery increasing the rate of AEs by 1.3% per hour of delay, 95% confidence interval [CI]: (1–1.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study reveals a significant delay in surgery for PPFFs and PIFFs compared with standard hip fractures, leading to higher adverse event rates. While mortality and readmissions did not differ significantly, the delay underscores the need for timely intervention in these complex cases. Further research is needed to address these challenges and improve patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>III</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443454","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}
Fabian Blanke, Franziska Warth, Nicola Oehler, Johanna Siegl, Wolf Christian Prall
{"title":"Autologous platelet-rich plasma and fibrin-augmented minced cartilage implantation in chondral lesions of the knee leads to good clinical and radiological outcomes after more than 12 months: A retrospective cohort study of 71 patients","authors":"Fabian Blanke, Franziska Warth, Nicola Oehler, Johanna Siegl, Wolf Christian Prall","doi":"10.1002/jeo2.70051","DOIUrl":"https://doi.org/10.1002/jeo2.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The treatment of cartilage lesions remains a challenge. Matrix-associated autologous chondrocyte implantation has evolved to become the gold standard procedure. However, this two-step procedure has crucial disadvantages, and the one-step minced cartilage procedure has gained attention. This retrospective study aimed to evaluate the clinical and radiological outcome of an all-autologous minced cartilage technique in cartilage lesions at the knee joint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective cohort study, 71 patients (38.6 years ± 12.0, 39,4% female) with a magnetic resonance imaging (MRI) confirmed grade III–IV cartilage defect at the medial femur condyle (<i>n</i> = 20), lateral femur condyle (<i>n</i> = 2), lateral tibia plateau (<i>n</i> = 1), retropatellar (<i>n</i> = 28) and at the trochlea (<i>n</i> = 20) were included. All patients were treated with an all-autologous minced cartilage procedure (AutoCart™). Clinical knee function was evaluated by the Tegner score, visual analogue scale, the subjective and objective evaluation form of the International Knee Documentation Committee and the Knee Injury and Osteoarthritis Outcome Score (KOOS). MRI analyses were performed by magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 knee score. Follow-up examination was 13.7 ± 4.2 (12–24) months postoperative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All clinical scores significantly improved after surgical intervention (<i>p</i> < 0.0001), especially the subgroup sports and recreation of KOOS showed clear changes from baseline in the follow-up examination. In the postoperative MRI evaluation, 39 of 71 patients showed a complete fill of the cartilage defect without subchondral changes in 78% of the patients in the MOCART 2.0 score in the follow-up analysis. None of the patients showed adverse effects, which are linked to the minced cartilage procedure during the time of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An all-autologous minced cartilage technique for chondral lesions at the knee joint seems to be an effective and safe treatment method with good clinical and radiological short-term results.</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":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443455","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}