Journal of Experimental Orthopaedics最新文献

{"title":"Does implant weight matter? The effect of total knee arthroplasty on thigh mass distribution and estimated hip loading.","authors":"Roberto Rossi, Federica Rosso, Mattia Sisella, Francesco Romano, Tommaso Nosenzo, Bernardo Innocenti","doi":"10.1002/jeo2.70925","DOIUrl":"10.1002/jeo2.70925","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies in the literature have evaluated the effect of weight changes on knee joint biomechanics induced by total knee arthroplasty (TKA). The aim of this study was to evaluate changes in the hip muscular moment and the thigh centre of mass following primary TKA.</p><p><strong>Methods: </strong>All primary TKAs performed with conventional instrumentation between April and December 2024 were prospectively included. Radiographic measurements were obtained to develop an analytical biomechanical model. The resected bone was collected and weighed intraoperatively, together with the femoral component and implanted cement. An analytical biomechanical model was developed to estimate changes in thigh weight, centre of mass position and hip muscular moment before and after TKA.</p><p><strong>Results: </strong>A total of 70 patients were included in the study. Primary TKA resulted in a statistically significant increase in thigh weight and a distal shift of the thigh centre of mass (<i>p</i> < 0.05). The average increase in implant-related knee weight after TKA was 333.5 g (standard deviation [SD] 51.0 g), while the femoral weight increased by 199.1 g (SD 40.1 g), resulting in an average increase in total thigh weight of 2.8% (SD 0.6%; range: 1.6-4.2%). The analytical biomechanical model showed a statistically significant distal shift of the thigh centre of mass of 6.4 mm (SD 1.5 mm; range: 3.7-9.7 mm) after TKA (<i>p</i> < 0.05). This redistribution of thigh mass was associated with a statistically significant estimated increase in hip muscular moment of 6.3% (SD 1.4%; maximum increase 9.3%; <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Primary TKA alters thigh mass distribution through an increase in limb weight and a distal shift of its centre of mass. Within the assumptions of this analytical model, these changes result in an increase in estimated hip muscular moment. Further biomechanical and clinical studies are needed to determine the clinical relevance of these theoretical findings.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70925"},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064895","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":"Surgical treatments of bone marrow lesions","authors":"Luca Andriolo,&nbsp;Alessandro Sangiorgio,&nbsp;Mats Brittberg,&nbsp;Vincenzo Condello,&nbsp;Jack Farr,&nbsp;Elizaveta Kon,&nbsp;Andrew S. Levy,&nbsp;Giuseppe Filardo","doi":"10.1002/jeo2.70249","DOIUrl":"https://doi.org/10.1002/jeo2.70249","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Bone marrow lesions (BMLs) of the knee are a common magnetic resonance imaging finding, defined as an alteration of the bone marrow detectable as a high signal on fluid-sensitive sequences. A wide range of pathologies can present with BMLs, including traumatic lesions, osteoarthritis, subchondral insufficiency fractures and osteonecrosis. Several treatment options have been proposed to address BML, from conservative to surgical approaches. If nonoperative treatments fail, operative treatments are indicated. These procedures include intraosseous injections, unloading procedures and meniscus implants. In detail, intraosseous injections may be performed with biomaterials like calcium phosphate, or with orthobiologics like platelet-rich plasma or mesenchymal stromal cells. Aim of these interventions is either to stabilise the microtrabecular tissue or to promote a healing response. Good results have been reported in the literature for many of the available surgical options, but the level of evidence is still suboptimal, and the best approach has not yet been identified.</p>\u0000 \u0000 <p><b>Level of Evidence</b>: Level V, expert opinion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048514","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":"Multimodal evaluation of periosteal versus collagen membrane coverage in atelocollagen-associated autologous chondrocyte implantation for large knee cartilage defects.","authors":"Takuma Kaibara, Eiji Kondo, Yuki Ogawa, Masatake Matsuoka, Koji Iwasaki, Tomohiro Onodera, Yoshitaka Oda, Zen-Ichi Tanei, Daisuke Momma, Shinya Tanaka, Kazunori Yasuda, Tomonori Yagi, Norimasa Iwasaki","doi":"10.1002/jeo2.70924","DOIUrl":"10.1002/jeo2.70924","url":null,"abstract":"<p><strong>Purpose: </strong>Atelocollagen-associated autologous chondrocyte implantation (A-ACI) with periosteal coverage shows favourable outcomes for large knee cartilage defects but is associated with complications such as graft hypertrophy. Collagen membrane coverage remains under-investigated in this technique. This study aimed to evaluate periosteal versus collagen membrane coverage using clinical, radiological, arthroscopic and histological assessments.</p><p><strong>Methods: </strong>Between 2014 and 2022, patients with ≥4.0 cm² full-thickness chondral lesions underwent A-ACI using periosteal (<i>n</i> = 13) or collagen membrane (<i>n</i> = 13) coverage in a non-randomized sequential comparative study. Clinical and radiological outcomes were assessed at 12 and 24 months using the Lysholm score, Knee injury and Osteoarthritis Outcome Score and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score. Second-look arthroscopy included International Cartilage Repair Society (ICRS) and Oswestry Arthroscopy Score (OAS) assessments, with histological analysis using the ICRS II scoring system. Minimum follow-up was 24 months.</p><p><strong>Results: </strong>Both groups demonstrated significant clinical improvement at 24 months without significant between-group differences. MOCART 2.0 scores were significantly higher in the collagen membrane group at 12 and 24 months (83 vs. 60 at 24 months, <i>p</i> = 0.001). OAS scores were significantly higher in the collagen membrane group (8.5 vs. 6.7, <i>p</i> = 0.034), while ICRS scores were comparable. Histological parameters, including tissue morphology, basal integration and subchondral bone quality, were significantly higher in the collagen membrane group. Complication profiles differed: graft hypertrophy and delamination in the periosteal group (46%) versus subchondral bone cysts in the collagen membrane group (15%). Collagen membrane coverage remained associated with higher MOCART 2.0 scores after limited adjustment for concomitant osteotomy.</p><p><strong>Conclusions: </strong>The primary clinical outcomes improved similarly in both groups at two years without meaningful between-group superiority. While collagen membrane coverage was associated with higher MOCART 2.0 scores after adjustment for concomitant osteotomy, all structural evaluations should be regarded strictly as secondary and exploratory.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70924"},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior clinical outcomes with combined intra-articular platelet-rich plasma and hyaluronic acid compared with hyaluronic acid alone in knee osteoarthritis: A prospective comparative study","authors":"Trifon Totlis,&nbsp;Vlasiοs Achlatis,&nbsp;Panagiotis-Konstantinos Emfietzis,&nbsp;Dimitris Tsigenopoulos,&nbsp;Mikail Chatzivasiliadis,&nbsp;Vassilis Ediaroglou,&nbsp;Stavros Savvakis,&nbsp;Efthymios Papasoulis,&nbsp;Ioannis Terzidis","doi":"10.1002/jeo2.70909","DOIUrl":"10.1002/jeo2.70909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Although platelet-rich plasma (PRP) and hyaluronic acid (HA) are widely used for knee osteoarthritis (KOA), it remains unclear whether combining them provides greater benefit than HA alone. This study compared the efficacy and safety of three combined injections of PRP and high molecular weight (HMW) HA to three injections of HMW HA alone in patients with KOA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective comparative analysis was conducted in patients with Kellgren–Lawrence (KL) Grade II–IV KOA who underwent either three intra-articular PRP-HA injections (Group A) or three intra-articular injections of HA (Group B). The Knee Injury and Osteoarthritis Outcome Score (KOOS) and subscales, the visual analogue scale (VAS) and the EuroQuality of Life–5 Dimensions–5 Levels (EQ-5D-5L) were assessed at baseline, 3, 6 and 12 months post-injection. Statistical analysis was applied to compare the outcomes between the two groups. The HA used in both groups had a concentration of 1% (20 mg/2 mL) and a molecular weight of 2.8–3.2 MDa. The PRP used had been previously analysed and classified according to the Dose of injected Platelets, Efficiency of production, Purity of the PRP, Activation of the PRP (DEPA) classification as CCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 150 knees from 150 patients (Group A: 75 and Group B: 75). The VAS, KOOS total and EQ-5D-5L scores significantly improved within each group at every time point compared to baseline (<i>p</i> &lt; 0.05). The PRP-HA group achieved significantly superior outcomes than the HMW-HA group in VAS, KOOS total and EQ-5D-5L scores at 6- and 12-month follow-up post-injection (<i>p</i> &lt; 0.05). No serious adverse events were reported in either group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both PRP-HA and HA only injections significantly improved pain, function and quality of life in patients with KOA. The PRP-HA group achieved significantly better outcomes than the HA group in all three patient-reported outcome measures at 6- and 12-month follow-up, and in the proportion of patients who achieved Patient Acceptable Symptom State and minimum clinically important difference, especially at 12 months post-injection.</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":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041104","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":"Pre-operative radiological grading and inflammatory mediators as candidate biomarkers of early joint degeneration in patients with femoroacetabular impingement.","authors":"Eleonora Olivotto, Elisa Bubbico, Alessio Bucciarelli, Andrea Burla, Irene Tampieri, Giorgia Borciani, Stefano Zaffagnini, Enrico Tassinari","doi":"10.1002/jeo2.70923","DOIUrl":"10.1002/jeo2.70923","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to identify potential biomarkers of pre-arthritic condition and early osteoarthritis (OA) in patients with femoroacetabular impingement (FAI), by analysing clinical data and quantifying inflammatory molecules, typically involved in OA pathology, in body fluids.</p><p><strong>Methods: </strong>FAI patients undergoing hip arthroscopy were enroled after providing written informed consent. Demographic data (age, sex, body mass index [BMI]) were collected, together with radiographic grading of hip degeneration (Tönnis scale) and intra-articular pathology grading (Outerbridge classification). Cartilage degradation markers and immunomodulating molecules were quantified by commercially available sandwich-enzyme-linked assay and multiplex bead-based sandwich immunoassay kits.</p><p><strong>Results: </strong>Forty-nine patients were enroled, 38 synovial fluids (SFs) and urine samples were available. Median age 32 years ± 8.35 standard deviation (SD); median BMI 24 kg/m² ± 4.89 SD. Higher BMI corresponded to acetabular chondropathy and was associated with increased C-telopeptide fragments of Type II collagen (CTX-II) release in both SFs and urine. Radiological and intra-operative scores showed moderate-to-strong positive correlation with synovial CTX-II and slight-to-strong positive correlation with vascular endothelial growth factor (VEGF). CTX-II and Cartilage Oligomeric Matrix Protein (COMP) in SFs were positively correlated, showing a high-to-moderate positive correlation with VEGF. VEGF demonstrated a high-to-moderate positive correlation with interleukin (IL)-6 and IL-8. IL1-β correlates moderately positively with IL-8, MIP-3β and TNF-α, which in turn is linked to the release of 6kine, MIP-3β and RANTES. Except for IL-8, all chemokines showed a similar release pattern, suggesting a synergistic and continuous inflammatory mechanism.</p><p><strong>Conclusions: </strong>A higher BMI was associated with increased CTX-II in both body fluids, suggesting a potential link between metabolic status and early cartilage degradation in FAI patients. Radiographic and intraoperative indicators of joint degeneration were also associated with selected synovial biomarkers (CTX-II, VEGF, IL-6, IL-8). These findings suggest that synovial and urinary biomarkers may represent candidate markers of early joint degeneration in FAI, useful for clinical evaluation of FAI patients at risk of progression toward OA.</p><p><strong>Level of evidence: </strong>Level IV, case series with no comparison group.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70923"},"PeriodicalIF":3.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041001","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":"Does travel distance influence short-term outcome after periacetabular osteotomy?—A cohort study","authors":"Quentin Karisch,&nbsp;Chiara Heller,&nbsp;Justus Stamp,&nbsp;Marco Haertlé,&nbsp;Henning Windhagen,&nbsp;Sufian S. Ahmad","doi":"10.1002/jeo2.70912","DOIUrl":"10.1002/jeo2.70912","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Periacetabular osteotomy (PAO) is an established joint-preserving procedure for the treatment of developmental dysplasia of the hip (DDH). As PAO is typically concentrated in specialized centres, many patients travel considerable distances for treatment. The purpose of this study was to evaluate the influence of travel distance on short-term outcomes following PAO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective registry study included 296 hips undergoing PAO for DDH between January 2022 and May 2025 by a single experienced surgeon. Travel distance was determined using driving distance, and hips were stratified into two groups: ≤80.5 and &gt;80.5 km from the treating centre. Radiographic parameters, patient-reported outcome measures (PROMs) and rates of achieving the Patient Acceptable Symptom State (PASS) and Minimal Clinically Important Difference (MCID) for the modified Harris Hip Score (mHHS) and international Hip Outcome Tool-12 (iHOT-12) were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 126 hips (43%) resided ≤80.5 km and 170 hips (57%) &gt;80.5 km from the treating centre. Hips of patients travelling longer distances demonstrated a lower preoperative lateral centre-edge angle (<i>p</i> = 0.005) and a higher extrusion index (<i>p</i> = 0.034). No significant differences were observed in demographics, comorbidities, concomitant procedures or preoperative PROMs. All PROMs improved significantly in both groups (all <i>p</i> &lt; 0.05). Postoperative PROMs, magnitude of improvement, PASS and MCID achievement rates and complication rates did not differ significantly between groups. Travel distance was not an independent predictor of postoperative outcomes in multivariable regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Travel distance to a specialized hip preservation centre does not influence short-term outcomes following PAO. Comparable functional outcomes and complication rates can be achieved irrespective of travel distance, supporting the feasibility of centralized PAO care in specialized high-volume centres.</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":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041023","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":"Auxiliary medial small locking plate fixation enhances bone healing and minimizes delayed union in inverted V-shaped high tibial osteotomy: A comparative study of 154 knees.","authors":"Takuma Kaibara, Kazunori Yasuda, Eiji Kondo, Koji Yabuuchi, Masayuki Inoue, Norimasa Iwasaki, Tomonori Yagi","doi":"10.1002/jeo2.70919","DOIUrl":"10.1002/jeo2.70919","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether auxiliary fixation with a T-shaped small locking plate (SLP) placed on the medial tibial cortex can enhance bone healing and reduce delayed union compared with the conventional inverted V-shaped high tibial osteotomy (iVHTO) fixed with a locking compression plate (LCP).</p><p><strong>Methods: </strong>This retrospective cohort study included 154 knees (135 patients) that underwent iVHTO. The knees were allocated to Group S (<i>n</i> = 72), treated with conventional single LCP fixation, and Group D (<i>n</i> = 82), treated with auxiliary medial SLP fixation in addition to the conventional procedure. Radiological and clinical evaluations were performed with a minimum follow-up of 2 years. Bone healing was assessed using radiographs and computed tomography scans, and the time to complete union was quantitatively evaluated with an established scoring system.</p><p><strong>Results: </strong>The time to union was significantly shorter in Group D than in Group S (median, 8 vs. 12 weeks; <i>p</i> < 0.001; 95% confidence interval [CI] for the difference, 0.0-4.0 weeks). The incidences of delayed union and non-union were both significantly lower in Group D than in Group S (2.4% vs. 20.8% and 0% vs. 5.6%, respectively; <i>p</i> < 0.001 and <i>p</i> = 0.046; 95% CIs, 8.6%-29.3% and 0.0%-13.4%). The rate of other complications, including transient anterior compartment syndrome and superficial infection, did not differ significantly between the groups (4.9% vs. 4.2%; <i>p</i> = 0.98; 95% CI, -7.2% to 8.2%). The Lysholm score was slightly but significantly higher in Group D than in Group S (<i>p</i> = 0.043; 95% CI, 0.0-5.0), whereas no significant differences were observed in the other clinical scores.</p><p><strong>Conclusion: </strong>Auxiliary medial fixation using an SLP enhanced bone healing and minimized the incidence of delayed union or non-union following conventional iVHTO with single lateral LCP fixation, without increasing other complications or compromising clinical outcomes.</p><p><strong>Level of evidence: </strong>Level III, prospective cohort study.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70919"},"PeriodicalIF":3.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040988","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":"Perioperative outcomes of total and unicompartmental knee arthroplasty in patients with Type 2 diabetes mellitus: A propensity score-matched analysis.","authors":"Yu Mori, Kunio Tarasawa, Ryuichi Kanabuchi, Hidetatsu Tanaka, Naoko Mori, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori","doi":"10.1002/jeo2.70917","DOIUrl":"10.1002/jeo2.70917","url":null,"abstract":"<p><strong>Purpose: </strong>Type 2 diabetes mellitus is a common comorbidity in patients undergoing knee arthroplasty and is associated with higher risks of thromboembolic, infectious and postoperative cognitive complications. The extent to which total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) differ in short-term perioperative risk among patients with Type 2 diabetes remains unclear.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using Japan's nationwide Diagnosis Procedure Combination database, including patients with Type 2 diabetes who underwent primary TKA or UKA for osteoarthritis between April 2016 and March 2023. Outcomes included deep vein thrombosis, pulmonary embolism, surgical site infection, postoperative delirium, blood transfusion, length of hospital stay and discharge destination. A 1:1 propensity score (PS)-matched analysis was performed using demographic and clinical characteristics. Additional PS-matched and interaction analyses were performed in patients without Type 2 diabetes and in the overall cohort, respectively.</p><p><strong>Results: </strong>Among 263,838 eligible patients, 49,373 with Type 2 diabetes underwent TKA and 5,801 underwent UKA; 5783 matched pairs were analysed. After matching, TKA was associated with higher incidences of deep vein thrombosis (odds ratio [OR] 1.46; 95% confidence interval [CI] 1.29-1.66) and postoperative delirium (OR 2.35; 95% CI 1.39-3.96), longer hospital stay, lower rates of direct discharge to home and greater transfusion volume. Similar differences were observed in patients without Type 2 diabetes, and no significant interactions between diabetes status and surgical procedure were observed for deep vein thrombosis or postoperative delirium.</p><p><strong>Conclusions: </strong>Among patients with Type 2 diabetes undergoing knee arthroplasty, UKA was associated with a more favourable short-term perioperative profile than TKA. Similar differences in deep vein thrombosis and postoperative delirium were observed in patients without Type 2 diabetes, with no significant interaction by diabetes status, suggesting that these differences were not specific to diabetes.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70917"},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026238","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":"Greater deformation and lower stiffness, but similar ultimate failure strength with fixed-loop cortical suspensory device compared to metal interference screw for femoral fixation of bone-patellar tendon-bone grafts in anterior cruciate ligament reconstruction.","authors":"Alexander Nagel Tandberg, Marek Zegzdryn, Jan-Egil Brattgjerd, Gilbert Moatshe, Arne Kristian Aune","doi":"10.1002/jeo2.70921","DOIUrl":"10.1002/jeo2.70921","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare a contemporary fixed-loop cortical suspensory devices (CSDs) with metal interference screws (IS) for femoral bone-patellar tendon-bone (BPTB) graft fixation in anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Methods: </strong>Seven matched pairs of fresh-frozen human cadaveric knees underwent anatomical ACLR with BPTB grafts. Femoral fixation was randomized to a fixed-loop CSD or metal IS. Specimens underwent cyclic loading at 50 and 100 N at 1 Hz until failure or up to 1000 cycles. Comparison between the fixation methods for cyclic displacement, displacement at failure, construct stiffness and ultimate load to failure was performed. Comparisons between fixation methods were performed using paired <i>t</i> tests.</p><p><strong>Results: </strong>Fixed-loop CSD fixation demonstrated significantly greater cyclic displacement than IS fixation (2.8 ± 0.9 vs. 1.7 ± 0.5 mm; <i>p</i> = 0.008). Displacement at failure was significantly higher (12.3 ± 1.7 vs. 7.9 ± 1.1 mm; <i>p</i> = 0.004), and construct stiffness was lower (46 ± 10 vs. 84 ± 18 N/mm; <i>p</i> = 0.002) with CSD fixation compared to IS fixation. There was no significant difference in ultimate load to failure (CSD fixation; 563 ± 109 vs. IS fixation; 668 ± 217 N; <i>p</i> = 0.31). Failure occurred mainly as lateral cortical fractures with CSD and proximal graft avulsions with IS fixation.</p><p><strong>Conclusion: </strong>Fixed-loop CSD fixation of BPTB grafts demonstrated greater deformation and lower stiffness than IS fixation, and with similar ultimate failure strength. The clinical relevance of the observed difference remains uncertain.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70921"},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026264","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 effects of platelet-rich plasma therapy on outcomes after anterior cruciate ligament reconstruction: A systematic review and meta-analysis","authors":"André Bosio Castro,&nbsp;Eiki Kobayashi,&nbsp;Laura Azevedo,&nbsp;Pedro Jorge","doi":"10.1002/jeo2.70913","DOIUrl":"10.1002/jeo2.70913","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine whether platelet-rich plasma (PRP) improves outcomes after anterior cruciate ligament reconstruction (ACLR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE via PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials and the Latin American and Caribbean Health Sciences Literature database were searched through 16 July 2026 for comparative studies of PRP in primary ACLR. Outcomes included International Knee Documentation Committee (IKDC) and Lysholm scores, pain measured with a visual analogue scale, instrumented knee stability and magnetic resonance imaging (MRI) findings. Random-effects meta-analyses used restricted maximum likelihood estimation with Hartung–Knapp–Sidik–Jonkman adjustments. Post hoc sensitivity analyses included randomized controlled trials only. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies were included. In analyses combining randomized and nonrandomized studies, PRP was associated with small improvements in IKDC scores at 6 months (mean difference [MD], 1.66; 95% confidence interval [CI], 0.31–3.01) and 12 months (MD, 2.37; 95% CI, 1.19–3.54). These differences were no longer statistically significant in randomized-trial analyses. No robust differences were observed in Lysholm scores at 3, 6 or 12 months. A small late post-operative Lysholm difference persisted in the randomized-trial analysis but was based on two trials and was clinically trivial. Pain at approximately 12 months did not differ between groups (MD, −0.60; 95% CI, −1.64 to 0.44). No consistent benefits were demonstrated for objective knee stability or MRI outcomes. Certainty of evidence ranged from very low to low.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PRP does not provide consistent or clinically meaningful benefits after ACLR. Current evidence does not support its routine use.</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":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018128","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}