Journal of Experimental Orthopaedics最新文献

{"title":"The increasing presence and relevance of the shoulder in European Society for Sports Traumatology, Knee Surgery and Arthroscopy","authors":"Miguel Angel Ruiz Iban, Berte Böe, Emmanouil Brilakis","doi":"10.1002/jeo2.70299","DOIUrl":"https://doi.org/10.1002/jeo2.70299","url":null,"abstract":"<p>When a young orthopaedic surgery resident is introduced to the bewildering ecosystem of scientific societies in our speciality, she (or he) is soon aware of European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), a cornerstone among sports-related societies in Europe and around the World: ‘ESSKA is involved in all aspects of sports orthopaedics, from arthroscopy of any joint to sport-specific medicine, including, of course, a lot of knee surgery, including arthroplasty’. This resident probably thinks the shoulder is included in the mix: ‘There are not one but two “S” in the title, so one must be for shoulder….’. But a senior fellow soon will prove him (or her) wrong: ‘Shoulder surgeons are a quite special lot; although they deal with a lot of sport-related injuries and, indeed, they perform a lot of arthroscopic procedures, they also tend to support only a few strong, independent, national, European and worldwide shoulder societies’. This same budding resident will eventually later check for herself (or himself) and find that many top shoulder surgeons are ESSKA members, ESSKA supports a lot of shoulder-based activities, the ESSKA congress has a dozen ‘shoulder focused’ sessions, and within the society, there is a specific section focused on the shoulder: European Shoulder Associates (ESA).</p><p>The birthing of ESSKA was humble but ambitious in the divided Berlin of 1982. The founding of the society was complex and fraught with uncertainties. Still, the leadership of Dr. Ejnar Erickson and the ingenuity of the newly founded board members made the society instantly successful with surgeons, attracting 800 participants in the first congress in Berlin in 1984 [<span>3</span>]. The minutes of the first Board meeting, signed on 1 September 1982, do not mention the shoulder at all, as the focus was the knee and arthroscopic techniques [<span>4</span>], and shoulder arthroscopy was only nascent at that time [<span>5</span>]. Things changed quickly, and, already in the 6th ESSKA Congress in Berlin 1994, there were two sessions dedicated to the shoulder, one focused on arthroscopic surgery, and another focused on shoulder instability, at that time a mainly nonarthroscopy issue [<span>2</span>].</p><p>If one should select a pivotal moment in the history of the shoulder in ESSKA, it would most certainly be the founding of the ESA section in 2010, with the initial leadership of Pascal Gleyze [<span>3</span>]. The development of this section, with a focus on all things shoulder and elbow and a friendly relationship with the European Society for Surgery of the Shoulder and the Elbow, helped to define the key role that shoulder surgery had in ESSKA. ESA has been highly active inside ESSKA: it supports the development of the Congress agenda, participates in the Speciality Days, and promotes biennial closed meetings (newly renamed as Focus meetings). More recently, it has embraced the push for high-quality, evidence-based, knowledge, c","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70299","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611973","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 relationship between stress shielding, bone density changes and implant migration, failure and fracture after total knee arthroplasty: A systematic review","authors":"Giulio Senesi,&nbsp;Giuseppe Barone,&nbsp;Salvatore Pinelli,&nbsp;Maria Scoppolini Massini,&nbsp;Raffaele Zinno,&nbsp;Domenico Alesi,&nbsp;Erika Pinelli,&nbsp;Laura Bragonzoni","doi":"10.1002/jeo2.70350","DOIUrl":"https://doi.org/10.1002/jeo2.70350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Total knee arthroplasty (TKA) represent a well-established treatment for advanced osteoarthritis. Despite advancements in implant design and materials, the impact of stress shielding on bone mineral density (BMD) and its relationship with implant migration, loosening, and fracture remains insufficiently explored. This study aims to evaluate the association between stress shielding, BMD changes, and implant outcomes after TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Four major databases (MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WOS), EMBASE) were thoroughly reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 491 studies were initially identified, of which nine met the inclusion criteria and were included in the final review. Eight were randomised controlled trials, and one was a prospective observational study. All studies were conducted in clinical settings, comprising a total of 467 patients. BMD variations due to stress shielding were most pronounced during the first 6–12 months postoperatively. However, except for one isolated case, no direct correlation was identified between BMD changes caused by stress shielding and implant migration, loosening or fracture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This systematic review highlights that variations in bone mineral density due to stress shielding are not directly correlated with implant failure, migration or loosening in TKA. Stress shielding remains a critical phenomenon, particularly in the early postoperative phases, emphasising the importance of optimised materials, fixation methods and implant designs to reduce bone loss and improve long-term stability. Due to its recognised occurrence in clinical practice, further in vivo studies would contribute to a better understanding of the stress shielding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, systematic review of studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612011","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":"Evaluation of the learning curve in robot-assisted knee arthroplasty: A Systematic review","authors":"Emidio Di Gialleonardo,&nbsp;Guido Bocchino,&nbsp;Giacomo Capece,&nbsp;Matteo Salvini,&nbsp;Marco Barbaliscia,&nbsp;Giuseppe Malerba,&nbsp;Omar El Ezzo,&nbsp;Giulio Maccauro,&nbsp;Raffaele Vitiello","doi":"10.1002/jeo2.70292","DOIUrl":"https://doi.org/10.1002/jeo2.70292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Robot-assisted (RA) surgery has transformed total knee arthroplasties (TKA) and unicompartmental knee arthroplasties (UKA) by significantly enhancing the accuracy of prosthetic implantation and reducing complications. Different robotic systems offer unique approaches to assist surgeons during procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and evaluated the learning curve associated with RA technologies, focusing on their surgical efficacy. A comprehensive literature search identified and analysed studies published since 2010, ultimately selecting 28 relevant articles that addressed robotic techniques in knee arthroplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings indicate that surgeons generally require an average of 21 procedures to achieve proficiency with robotic techniques. However, the learning curve varies among robotic systems: MAKO requires 15–25 cases, ROSA 20–30 cases and NAVIO 18–28 cases for surgeons to reach proficiency. The MAKO system emerged as the most frequently used (33.3% of studies), followed by ROSA (23.3%) and NAVIO (16.7%). Evidence suggests that the adoption of these robotic systems is associated with reduced operative times and lower rates of postoperative complications, thereby improving overall surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RA arthroplasties present significant advancements in surgical precision and patient outcomes. With targeted investments in training and technology, the adoption of robotic techniques could further increase, ultimately enhancing the quality of orthopaedic care and patient recovery. This review highlights the importance of addressing training needs and resource allocation to fully realise the potential of robotic surgery in knee arthroplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not applicable, systematic review.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612024","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":"Clinical outcomes of kinematically aligned medial pivot total knee arthroplasty: A systematic review and meta-analysis of current evidence","authors":"Francesco Bosco,&nbsp;Giorgio Cacciola,&nbsp;Virginia Masoni,&nbsp;Carmelo Burgio,&nbsp;Mariazzurra Carlino,&nbsp;Michele Centola,&nbsp;Ferdinando Tosto,&nbsp;Daniele Vezza,&nbsp;Lawrence Camarda,&nbsp;Luigi Sabatini","doi":"10.1002/jeo2.70348","DOIUrl":"https://doi.org/10.1002/jeo2.70348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Kinematic alignment (KA) in total knee arthroplasty (TKA) focuses on restoring the natural joint line and ligament balance, potentially improving biomechanics and outcomes over mechanical alignment (MA). The medial pivot (MP) implant enhances joint stability by mimicking physiological knee motion. Still, its role within a KA protocol and the effects of retaining versus sacrificing the posterior cruciate ligament (PCL) are unclear. This study aimed to evaluate the clinical effectiveness, functional outcomes and biomechanical benefits of KA-TKA with MP implants based on the available literature. It also aimed to assess whether PCL retention or sacrifice leads to better postoperative function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted following PRISMA guidelines. A comprehensive search of PubMed, Embase and Web of Science up to January 2025 identified studies assessing KA-TKA with MP implants. Primary outcomes included patient-reported outcome measures (PROMs), range of motion (ROM), complication rates and implant survivorship. Subgroup analysis compared PCL retention and sacrifice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen studies (955 patients) met inclusion criteria. KA-TKA with MP implants resulted in significant ROM improvements (+11.35°, increased to +12.50° after sensitivity analysis) and enhanced PROMs (Oxford Knee Score +18.23, increased to +22.27 after sensitivity analysis; Knee Society Score [KSS] +49.61, functional KSS +42.50). No aseptic loosening or implant failures were reported. PCL sacrifice was associated with greater postoperative flexion (125.4° ± 12.1° vs. 116.4° ± 11.8°, <i>p</i> &lt; 0.001), but functional outcomes were comparable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>KA-TKA with MP implants improves functional recovery, patient satisfaction, and short- to mid-term survivorship, supporting its adoption as a viable alternative to conventional TKA. Further long-term, randomized trials are needed to optimize PCL management and confirm its durability.</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":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612028","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":"Blood transfusion in total knee arthroplasty and total hip arthroplasty: A nationwide study of complications, costs and predictive modelling","authors":"David Maman,&nbsp;Maneesh Nandakumar,&nbsp;Michael T. Hirschmann,&nbsp;Hadas Ofir,&nbsp;Madlene Haddad,&nbsp;Butrus Samir,&nbsp;Yaniv Steinfeld,&nbsp;Yaron Berkovich","doi":"10.1002/jeo2.70317","DOIUrl":"https://doi.org/10.1002/jeo2.70317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Blood transfusion during total knee and hip arthroplasty is associated with increased postoperative complications, prolonged hospital stays and greater healthcare costs. As outpatient arthroplasty expands, identifying patients at high transfusion risk is essential. This study analyses over 4 million arthroplasty procedures from the Nationwide Inpatient Sample (NIS) to assess the clinical and economic impact of transfusion and develop a machine learning-based risk prediction tool. We hypothesised that transfused patients would experience higher complication rates, longer hospital stays and increased hospitalisation costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using NIS data (2016–2019) including primary total knee arthroplasty and total hip arthroplasty cases. Propensity score matching (PSM) was used to balance clinical and demographic variables. Outcomes included length of stay (LOS), total charges, complications and mortality. Logistic regression, random forest and deep neural networks (DNNs) were trained to predict transfusion using preoperative data. Validation methods included hold-out testing, class weighting and dropout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After matching, transfusion was linked to increased surgical site infection (TKA RR = 17.0; THA RR = 13.5), sepsis (TKA RR = 13.4; THA RR = 5.0) and pulmonary embolism (TKA RR = 6.0; THA RR = 3.5). Transfused patients had longer LOS (TKA: 4.2 vs. 2.7 days; THA: 4.0 vs. 2.9 days) and higher charges (TKA: $79,996 vs. $59,600; THA: $89,283 vs. $77,239). The DNN achieved the best predictive performance (area under the curve: 0.8644–0.8783). Top preoperative predictors of transfusion included chronic anaemia, chronic kidney disease, female gender and osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Blood transfusion significantly worsens clinical outcomes and increases costs in arthroplasty. Our machine learning tool, while not clinically implemented yet, shows promise in identifying high-risk patients and supporting preoperative planning.</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":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612023","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":"Preoperative anxiety differentiates post-surgical opioid use in patients undergoing anterior cruciate ligament reconstruction","authors":"Brittany L. Nelson,&nbsp;Shayla M. Warren,&nbsp;Thea Xeroegeanes,&nbsp;Taylor M. Zuleger,&nbsp;Ajay Premkumar,&nbsp;Gregory D. Myer,&nbsp;Susmita Kashikar-Zuck,&nbsp;Jed A. Diekfuss","doi":"10.1002/jeo2.70352","DOIUrl":"https://doi.org/10.1002/jeo2.70352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Opioids prescribed to reduce pain and aid in recovery following anterior cruciate ligament reconstruction (ACLR) may pose a risk of future substance use disorder. The purpose of this study was to determine if pre-operative anxiety and depression differentiated opioid intake following ACLR. The contribution of sex, age, and graft type to post-operative opioid usage was also explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 237 participants (<i>M</i> = 30.75 ± 13.29 years; 57% females; 76% all-soft tissue quadriceps tendon autograft) were analysed. Four-item Anxiety and Depression Patient Reported Outcomes Measurement Information System (PROMIS) scales were administered on the day of surgery, and opioid intake was assessed post-operatively. Patients were classified into 'anxious' or 'depressed' groups based on their PROMIS scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients took an average of one opioid pill daily. Females with pre-operative anxiety reported significantly greater post-operative opioid intake (<i>M</i> = 4.40 ± 3.98) than females with no anxiety (<i>M</i> = 2.90 ± 3.97) (<i>W</i> = 2199, <i>p</i> = 0.03; <i>d</i> = 0.36). No other significant effects were found (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anxiety, but not depression, was a risk factor for elevated opioid use in females undergoing ACLR. Interestingly, opioid intake between males and females, as well as by age and graft type, were comparable overall, indicating the unique influence of psychological rather than biological or demographic factors on opioid use following ACLR. Clinicians should consider biopsychosocial assessments to support preoperative opioid counselling, particularly in females with anxiety undergoing ACLR.</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":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611970","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 graft, short tunnel ACL reconstruction with single hamstring and internal brace leads to comparable outcomes to conventional double hamstring technique: A retrospective study","authors":"Thana Buranapuntaruk,&nbsp;Thun Itthipanichpong,&nbsp;Chatree Tangpatthanasombat,&nbsp;Danaithep Limskul,&nbsp;Numphung Numkarunarunrote,&nbsp;Sasipa Buranapuntalug","doi":"10.1002/jeo2.70338","DOIUrl":"https://doi.org/10.1002/jeo2.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of our study was to compare (1) ACL graft healing, (2) patient-reported outcome, and (3) complications after short graft (length &lt; 65 mm), short tunnel (femoral tunnel &lt; 20 mm) single hamstring ACL reconstruction with an internal brace (SGST-ACLR) technique and double hamstring autograft conventional ACL reconstruction (CON-ACLR) technique at minimum 2-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort of patients underwent arthroscopic ACL reconstruction using a hamstring graft, with a minimum 2-year follow-up. Graft healing was evaluated at 1 year using a magnetic resonance imaging scan, with the mean signal-to-noise quotient ratio (SNQ) measured from three areas: proximal, middle, and distal to the ACL graft. Patients' demographics data, meniscal lesion, chondral lesion, time to operation, time to evaluation, PROMs (International Knee Documentation Committee [IKDC] scores, Tegner activity scale, and Lysholm score), and complications were evaluated. ACL laxity was measured using a side-to-side difference (SSD) by a lachmeter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 51 patients, comprising 25 in the SGST-ACLR group and 26 in the CONV-ACLR group, were analysed. The ACL graft diameter was comparable between the two groups (<i>p</i> = 0.32). The mean SNQ at 1-year postoperative MRI showed no significant difference (<i>p</i> = 0.21). Furthermore, no statistically significant differences were observed in the postoperative IKDC scores (<i>p</i> = 0.36), Lysholm scores (<i>p</i> = 0.22), Tegner activity scores (<i>p</i> = 0.30), or side-to-side differences (<i>p</i> = 0.38) at the final follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>At two years postoperatively, this study demonstrates that SGST-ACLR with an internal brace provides comparable outcomes in all parameters to CONV-ACLR. Thus, SGST-ACLR offers a viable alternative technique for ACL reconstruction, with the added advantage of minimising graft usage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, retrospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611974","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":"Low frequency of radiolucent lines in 3D-printed porous-coated tibial cementless baseplate at 1-year follow-up","authors":"Yoshinori Mikashima,&nbsp;Hitoshi Imamura,&nbsp;Koichiro Yano,&nbsp;Katsunori Ikari,&nbsp;Hiroshi Takagi,&nbsp;Ken Okazaki","doi":"10.1002/jeo2.70356","DOIUrl":"https://doi.org/10.1002/jeo2.70356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>A recently introduced 3D-printed porous-coated tibial baseplate (ATTUNE AFFIXIUM, DePuy Synthes) was hypothesised to yield radiographical and clinical results that are comparable to those of its cementless predecessor with sintered beaded porous coating (POROCOAT, DePuy Synthes).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A consecutive series of total knee arthroplasties (TKAs) was performed by a single surgeon using a baseplate covered with either AFFIXIUM® 3D-printed porous coating or POROCOAT® sintered beaded porous coating. The presence of radiolucent lines (RLLs) and bone on-growth over the surface of the tibial baseplate were retrospectively reviewed at 1 week, 1, 2, 4, 6 months and 1 year postoperatively. The 2011 Knee Society Score, Forgotten Joint Score-12 (FJS-12), hip–knee–ankle (HKA) angle were also reviewed. One-to-one matching was performed for age, sex, body mass index and preoperative University of California, Los Angeles score. Fisher's exact test or independent Student's <i>t</i>-test was used for statistical analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty AFFIXUM® and 50 POROCOAT® cementless TKAs were reviewed after 1:1 matching at 1 year postoperatively. RLLs appeared in 15 knees (30%) of POROCOAT® TKAs at 6 months postoperatively, whereas RLLs appeared in two knees (4%) of AFFIXIUM® TKAs (&lt;0.01). RLLs in 6 of 15 POROCOAT TKAs (40%) and 1 of 2 AFFIXIUM TKAs (50%) disappeared 1 year postoperatively. Bone on-growth over the surface of the tibial baseplate was observed in the same way in both groups. There were no significant differences in the 2011 Knee Society Scores and Forgotten Joint Scores-12 between the cohorts, with no patients requiring revision surgery (not significant).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A very low frequency of RLLs was observed on a newer 3D-printed porous-coated tibial baseplate design for TKA at 1-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612010","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":"Comparative effectiveness of combined ATFL and CFL repair versus ATFL-only repair for severe chronic lateral ankle instability","authors":"Kensei Yoshimoto,&nbsp;Masahiko Noguchi,&nbsp;Ayako Tominaga,&nbsp;Mitsuki Kumaki,&nbsp;Takumi Koseki,&nbsp;Ken Okazaki","doi":"10.1002/jeo2.70345","DOIUrl":"https://doi.org/10.1002/jeo2.70345","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Repairing only the anterior talofibular ligament (ATFL) remnant in severe chronic lateral ankle instability (CLAI) with a concurrent calcaneofibular ligament (CFL) injury can result in persistent instability, highlighting the need to include CFL repair. Thus, this study aimed to examine the effectiveness of combined CFL and ATFL repair in severe CLAI with a concurrent CFL injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighty ankles from 77 patients with severe CLAI with a concurrent CFL injury who underwent lateral ankle ligament repair were retrospectively examined. Severe CLAI with a concurrent CFL injury was defined as an ATFL that exhibited no mechanical resistance to hook palpation during arthroscopy. Among them, 39 ankles from 38 patients underwent arthroscopic ATFL repair between 2018 and 2021 (ATFL-only group), whereas 41 ankles from 39 patients underwent open ATFL and CFL repair between 2021 and 2024 (CFL-repair group). Outcomes included recurrent ankle instability (respraining of the operated ankle following surgery) and Self-Administered Foot Evaluation Questionnaire (SAFE-Q) scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were observed between patient demographics in the two groups. Overall, 16 (41.0%) cases of recurrent ankle instability were observed in the ATFL-only group compared with 7 (17.1%) in the CFL-repair group, showing a significant difference (<i>p</i> = 0.026). No significant differences were found in the postoperative SAFE-Q scores between the two groups. Multivariate analysis adjusted for age, sex, body mass index, follow-up periods and sports participation revealed that ATFL-only repair was associated with a significantly higher risk of recurrent ankle instability compared with combined ATFL and CFL repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although no significant difference was observed in postoperative SAFE-Q scores between the two groups, repairing ATFL along with CFL could be more effective in achieving stable ankle than ATFL-only repair for severe CLAI with a concurrent CFL injury.</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":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612015","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":"Deep learning classification models demonstrate high accuracy and clinical potential in radiograph interpretation in the arthroplasty clinical pathway: A systematic review and meta-analysis","authors":"Omar Musbahi,&nbsp;Amal Ahmed,&nbsp;Thomas Hall,&nbsp;Kamila Kutyla,&nbsp;Muhayman Sadiq,&nbsp;Justin Cobb,&nbsp;Alex Bottle,&nbsp;Richard Van Arkel,&nbsp;Gareth Jones","doi":"10.1002/jeo2.70342","DOIUrl":"https://doi.org/10.1002/jeo2.70342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Imaging is a cornerstone of the osteoarthritis (OA)-arthroplasty clinical pathway: the continuum of care that patients with OA undergo, from initial diagnosis through to arthroplasty and postoperative follow-up. With growing interest from the orthopaedic community, this meta-analysis broadly evaluates the performance of deep learning algorithms in interpreting radiographs and cross-sectional imaging in this pathway. The authors hypothesise that deep learning algorithms will have comparable performance to clinicians when interpreting radiographs, but not cross-sectional imaging, with negligible difference in diagnostic and prognostic tasks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ovid Medline, Ovid Embase, Scopus and Web of Science were searched for studies published between January 1, 2012, and April 1, 2024, evaluating deep learning algorithms for diagnostic and prognostic tasks along the pathway. Eligible studies included those that used established diagnostic or surgical candidacy assessments as ground truth. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool, and pooled sensitivity and specificity were determined. Hierarchical summary receiver operating characteristic curves assessed diagnostic performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The meta-analysis of artificial intelligence (AI) interpretation included 66 studies, with a pooled sensitivity of 0.88 (95% confidence interval [CI]: 0.81–0.92) and a pooled specificity of 0.91 (95% CI: 0.87–0.94). Sensitivity and specificity values were higher for AI interpretation of radiographs (55 studies) compared to cross-sectional imaging, with no significant difference in performance between diagnostic and prognostic tasks. For clinician interpretation, 11 studies showed a pooled sensitivity of 0.76 (95% CI: 0.64–0.85) and a pooled specificity of 0.79 (95% CI: 0.59–0.90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This meta-analysis highlights the potential of deep learning algorithms to improve efficiency in OA classification and prognosis in the arthroplasty pathway based on low-to-moderate quality evidence. Although the results are not generalisable, the findings suggest deep learning models have the potential to be adopted in OA treatment pathways, warranting further exploration of its role in patient care.</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":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612027","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}