Journal of Experimental Orthopaedics最新文献

{"title":"In vivo three-dimensional kinematics in unicompartmental knee arthroplasty: A sports activity cluster analysis.","authors":"Kenichi Kono, Ryota Yamagami, Kohei Kawaguchi, Hiroshi Inui, Shuji Taketomi, Takaharu Yamazaki, Tetsuya Tomita, Sakae Tanaka","doi":"10.1002/jeo2.70918","DOIUrl":"10.1002/jeo2.70918","url":null,"abstract":"<p><strong>Purpose: </strong>The specific kinematics relevant to sports activities after unicompartmental knee arthroplasty (UKA) remain unclear. We aimed to clarify the kinematic factors associated with sports activities after UKA.</p><p><strong>Methods: </strong>Twenty-five knees that had undergone UKA were examined fluoroscopically during squatting (weight-bearing [WB]) and active-assisted knee flexion (non-weight-bearing [NWB]). Patients who were able to perform deep squatting were included. A two-dimensional/three-dimensional registration technique was used to evaluate tibiofemoral kinematics, including flexion angle, axial rotation angle, varus-valgus angle, and anteroposterior translation (APT) of the femur relative to the tibia. Patients were divided into two groups using hierarchical cluster analysis based on 1-year postoperative sports scores from the Knee Injury and Osteoarthritis Outcome Score and the 2011 Knee Society Score (low-to-moderate score group [<i>n</i> = 15] and high score group [<i>n</i> = 10]).</p><p><strong>Results: </strong>The sports subscale Knee Injury and Osteoarthritis Outcome Scores, except for jumping, were significantly higher in the high-score group than in the low-score group. During WB, the flexion angle was significantly greater in the high-score group (136.2 ± 8.5°) than in the low-score group (126.3 ± 14.2°). In contrast, no significant difference in flexion angle was observed during NWB. Regarding lateral APT, the high-score group showed a more posterior position than the low-score group throughout the flexion range during WB. No significant between-group differences were observed in terms of axial rotation, varus-valgus angle, or medial APT.</p><p><strong>Conclusions: </strong>The ability to achieve greater flexion during weight-bearing activities is an important factor for sports performance after UKA.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70918"},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018070","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 lateral column lengthening reach the ankle? Lateral calcaneal lengthening for flatfoot and medial talar dome osteochondral lesions: A weight-bearing CT 3D modelling analysis.","authors":"Marco Di Ponte, Silvio Caravelli, Giammarco Gardini, Claudia Capellini, Claudio Belvedere, Alberto Leardini, Carlo Capodagli, Victor Valderrabano, Cesar De Cesar Netto, Massimiliano Mosca","doi":"10.1002/jeo2.70915","DOIUrl":"10.1002/jeo2.70915","url":null,"abstract":"<p><strong>Purpose: </strong>Osteochondral lesions (OCL) of the medial talar dome are frequently observed in progressive collapsing foot deformity (PCFD), and hindfoot malalignment is believed to influence their natural history. It is not established whether, or to what extent, a realignment osteotomy modifies the articular relationship at the site of such a lesion, nor is there quantitative guidance on the size of opening wedge to be selected.</p><p><strong>Methods: </strong>Starting from a severe PCFD case analysed via weight-bearing computed tomography, a 3D model was created using segmentation software. In the model, a lateral calcaneal lengthening osteotomy (LCLOT) was performed 15 mm proximally to the calcaneocuboid joint: Evans Technique. Three standard LCLOT-wedges (8-10-12 mm) were virtually applied at the osteotomy site.</p><p><strong>Results: </strong>The 3D rotation of the anterior osteotomy stump with 8 mm wedge implied, with respect to the original talar position, 6.6° of dorsiflexion, 2.9° of inversion and 10.9° of external rotation; corresponding values for the ten and twelve mm wedges were 8.6°, 5.9° and 12.6°, and 14.2°, 10.2° and 22.2°. Further distance map analysis of the calcaneal posterior facet revealed a distancing effect on the posterolateral zone of the posterior subtalar joint with each wedge size. Additionally, the distance maps of the tibiotalar joint, where a concomitant medial osteochondral lesion of the talar dome was present, showed an increase in inter-surface distance between the medial talar zone and the mortise. This increase was progressively greater with the use of larger LCLOT wedges.</p><p><strong>Conclusions: </strong>The model confirms that Evans LCLOT produces a triplanar deformity correction, increasing the inter-surface distance at the anteromedial tibiotalar joint adjacent to the medial OCL. Patient-specific modelling may therefore inform preoperative planning when a talar dome OCL coexists with PCFD.</p><p><strong>Level of evidence: </strong>Level V, preclinical simulation study.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70915"},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018108","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":"Side-to-side repair improves coronal meniscal extrusion in lateral meniscus oblique radial tears concomitant with anterior cruciate ligament reconstruction.","authors":"Kyota Ishibashi, Hikaru Kristi Ishibashi, Eiji Sasaki, Yuka Kimura, Yasuyuki Ishibashi","doi":"10.1002/jeo2.70916","DOIUrl":"10.1002/jeo2.70916","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the proportion of lateral meniscus oblique radial tear repairs during anterior cruciate ligament reconstruction and compare extrusion and clinical outcomes between side-to-side repair of lateral meniscus oblique radial tear and posterior longitudinal tear repair.</p><p><strong>Methods: </strong>Among 609 primary anterior cruciate ligament reconstructions from 2016 to 2023, 34 patients with intraoperatively confirmed lateral meniscus oblique radial tear underwent side-to-side repair and magnetic resonance imaging at 6 months and 1 year; 27 with posterior longitudinal tears underwent all-inside repair. Coronal and sagittal lateral meniscal extrusion, clinical outcomes, knee stability and Knee Injury and Osteoarthritis Outcome Score subscales were compared. Multivariate regression assessed predictors of preoperative-to-1-year coronal extrusion change; receiver operating characteristic analysis assessed whether preoperative lateral meniscal extrusion distinguished tear types.</p><p><strong>Results: </strong>Lateral meniscus oblique radial tear treated with side-to-side repair accounted for 7.4% of cases. Preoperative coronal lateral meniscal extrusion was greater in the lateral meniscus oblique radial tear group than in the longitudinal tear group (1.71 ± 1.31 vs. 0.32 ± 0.61 mm; <i>p</i> < 0.001). Coronal extrusion improved by approximately 0.6 mm after lateral meniscus oblique radial tear repair and was similar between groups at 1 year; sagittal extrusion increased slightly in both groups. Clinical outcomes were similar at 1 year and final follow-up. Preoperative coronal lateral meniscal extrusion was an independent predictor of coronal extrusion change (<i>β</i> = -0.514, <i>p</i> < 0.001). Preoperative coronal lateral meniscal extrusion >1.0 mm identified lateral meniscus oblique radial tear with acceptable diagnostic performance (area under the curve = 0.787, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Side-to-side lateral meniscus oblique radial tear repair during anterior cruciate ligament reconstruction reduced coronal extrusion by 1 year to levels comparable to those of longitudinal tear repair, with similar clinical outcomes. These findings support side-to-side repair as a reliable meniscal preservation strategy.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70916"},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018150","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":"FIRM-P separates knee phenotype from patient context in anterior cruciate ligament-related instability: A conceptual framework integrating arthrogenic muscle inhibition as a cross-domain modifier","authors":"Dario Giunchi,&nbsp;Matteo Denti,&nbsp;Marc Barrera Uso","doi":"10.1002/jeo2.70914","DOIUrl":"10.1002/jeo2.70914","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Clinical reasoning after anterior cruciate ligament (ACL) injury is still often built on isolated proxies such as imaging, instrumented laxity, functional testing or patient-reported instability. These variables are clinically useful, but they are not interchangeable and do not answer the same question. The purpose of this work is to propose FIRM-P (Functional, Individual, Radiological and Mechanical instability plus patient context) as a practical conceptual framework that separates the ACL-related knee phenotype from patient-context indication, while integrating arthrogenic muscle inhibition (AMI) as a cross-domain modifier rather than as a separate instability pillar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>FIRM-P has two layers. FIRM describes the knee through Functional, Individual, Radiological and Mechanical instability. P describes the patient context through performance demands, priorities and expectations, rehabilitation potential and personal modifiers. Each domain is interpreted as favourable, borderline or unfavourable. Discordant patterns do not directly produce treatment decisions; they trigger a verification loop. AMI is integrated as a mechanism that may alter the expression of Functional and Individual instability, may coexist with true ACL insufficiency and may influence the timing of elective surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After verification, an explicit classification rule assigns the knee to one of four mutually exclusive phenotypes: low-instability/non-ACL, occult or associated-instability, compensated ACL-deficient or overt ACL-instability. Patient context is applied only after the knee has been phenotyped. A simplified decision pathway is provided in the main manuscript; the full operational 32-scenario matrix and an interactive HTML prototype that allows readers to simulate the algorithm across the 32 operational scenarios are provided as Supporting Information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FIRM-P is proposed as a conceptual framework, not a validated score. Its immediate value is to organize ACL-related instability reasoning into a transparent sequence: phenotype the knee, verify discordance and then apply patient context. Its future value will depend on content validation, reliability testing and prospective derivation work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008981","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":"Lateral extra-articular procedures in primary anterior cruciate ligament reconstruction reduce graft failure rates in elite and competitive athletes: A systematic review","authors":"Laurin Kratochwil,&nbsp;Simon Kienberger,&nbsp;Adrian Deichsel,&nbsp;Tobias Gotterbarm,&nbsp;Philipp W. Winkler","doi":"10.1002/jeo2.70908","DOIUrl":"10.1002/jeo2.70908","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this systematic review was to evaluate clinical outcomes of combined primary anterior cruciate ligament reconstruction (ACLR) and lateral extra-articular procedures (LEAP) in elite and competitive athletes. Where enough data were available, the review also aimed to differentiate between various LEAP techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines using the PubMed, Scopus, Embase and Web of Science databases. Two independent observers screened and assessed the studies; the data were analysed cumulatively where possible and reported narratively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 studies met the inclusion criteria, reporting data on 1.719 knees that underwent primary ACLR. An additional LEAP was performed in 783 cases, including anterolateral ligament reconstruction (ALLR), the modified Lemaire and MacIntosh Coker–Arnold techniques. Notably lower graft failure rates were observed, ranging from 0% to 6.5% in the combined ACLR and LEAP groups, compared to 0%–34.0% in the isolated ACLR groups. The cumulative graft failure rate was 3.4% (10/292) for combined ACLR and ALLR, and 2.5% (4/158) for combined ACLR and modified Lemaire, compared to 10.7% (81/758) for isolated ACLR. Return to sport (RTS) rates were similar, ranging from 85.7% to 100% in the combined ACLR and LEAP group, and from 85.6% to 100% in the isolated ACLR group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on this study, adding a LEAP to primary ACLR was associated with lower observed graft failure rates and improved knee stability, while return-to-sport rates remained similar in elite and competitive athletes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, systematic review.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991704","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-term patient-reported outcomes following rectus femoris versus quadriceps tendon and hamstring tendon autografts for ACL reconstruction with concomitant anterolateral procedure: A prospective comparative study","authors":"Tomas Pineda,&nbsp;Nathan H. Varady,&nbsp;Christophe Jacquet,&nbsp;Grigore Mihai,&nbsp;Julien Druel,&nbsp;Matthieu Ollivier","doi":"10.1002/jeo2.70901","DOIUrl":"10.1002/jeo2.70901","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare short-term patient-reported outcomes following anterior cruciate ligament reconstruction (ACLR) with concomitant anterolateral procedure, using rectus femoris (RF), quadriceps tendon (QT) and hamstring tendons (HS) autografts. It was hypothesized that short-term patient-reported outcomes would not differ significantly across graft strategies at 1-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective comparative non-randomized study was conducted, including 90 consecutive patients undergoing primary ACLR between May 2022 and June 2023 (30 per group). Outcomes were assessed at a median follow-up of 15.0 months (range: 12–22) using the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain and Quality of Life (QoL) subscales, EuroQOL 5-dimensions 5-level index (EQ-5D-5L), global satisfaction (0–100) and the Patient and Observer Scar Assessment Scale (POSAS). Continuous variables were compared using one-way analysis of variance with Bonferroni-corrected post hoc comparisons and categorical variables using <i>χ</i>² tests. A multivariable logistic regression model was used to assess predictors of POSAS ≤ 20.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 90 consecutive patients initially included, one patient in the RF group was excluded following graft failure and revision surgery prior to outcome assessment, leaving 89 patients available for analysis. Mean global satisfaction was 86.5 ± 10.9, KOOS Pain 89.1 ± 13.2, KOOS QoL 71.4 ± 22.2 and EQ-5D-5L Index 0.85 ± 0.15. No statistically significant differences were observed between graft types in KOOS QoL (<i>p</i> = 0.344), KOOS Pain (<i>p</i> = 0.716), EQ-5D-5L (<i>p</i> = 0.386) or POSAS (<i>p</i> = 0.748). Global satisfaction did not differ significantly across graft groups (<i>p</i> = 0.074).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No statistically significant differences in short-term patient-reported outcomes were observed among RF, QT and HS autografts at 1-year follow-up. Graft strategy was not associated with differences in short-term postoperative patient-reported outcomes within the available sample.</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":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991727","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":"Medial meniscus extrusion during gait identifies altered knee mechanical loading in early osteoarthritis of the knee.","authors":"Yosuke Ishii, Kyohei Nakata, Akinori Nekomoto, Atsuo Nakamae, Masakazu Ishikawa, Yuko Nakashima, Shigeru Sato, Naoto Fujita, Nobuo Adachi","doi":"10.1002/jeo2.70910","DOIUrl":"10.1002/jeo2.70910","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop a modified knee adduction moment (KAM) measure as a composite measure of mechanical loading, incorporating medial meniscal extrusion (MME), and investigate whether it could distinguish patients with the biomechanical pathology of early knee osteoarthritis (OA) from healthy individuals.</p><p><strong>Methods: </strong>This study included 23 patients with early knee OA (Kellgren-Lawrence grade 1-2), 14 healthy young (younger group) and 13 healthy elderly individuals (older group). In patients with knee OA, knee alignment was evaluated using hip-knee-ankle angle. For investigating the gait-related mechanical loading, the KAM, including the impulse value, was measured during walking using a motion analysis system synchronised with an ultrasound. MME waveforms were generated from continuous MME values obtained using ultrasound in video mode, and the difference between the minimum and maximum values of the MME behaviour was shown as the ΔMME. Furthermore, the modified KAM was calculated by multiplying the KAM impulse by the ΔMME value.</p><p><strong>Results: </strong>No significant differences were observed in the KAM impulse among all groups. ΔMME and modified KAM were significantly higher in the knee OA group than in the younger and older groups. In the knee OA group, a significant correlation was observed only between the modified KAM and the hip-knee-ankle angle, whereas no significant correlation was found for the KAM or ΔMME alone.</p><p><strong>Conclusions: </strong>The modified KAM identified biomechanical features associated with mechanical loading stress in the medial compartment in patients with early-stage knee OA.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70910"},"PeriodicalIF":3.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977960","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 Ankle-GO™ score predicts return to sport after surgically treated unstable syndesmotic injuries","authors":"Andrei Corbu,&nbsp;Ronny Lopes,&nbsp;Eugénie Valentin,&nbsp;Mette Renate Andersen,&nbsp;François Fourchet,&nbsp;Gauthier Rauline,&nbsp;Brice Picot,&nbsp;Alexandre Hardy","doi":"10.1002/jeo2.70907","DOIUrl":"10.1002/jeo2.70907","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Objective return to sport (RTS) criteria following syndesmotic stabilization are limited. The purpose of this study was to explore the discriminative and predictive ability of the Ankle-GO™ score for RTS status following syndesmotic stabilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>At 3 and 6 months postoperatively, 50 patients were assessed using the Ankle-GO^TM score, which consists of four functional tests and two self-reported questionnaires. At 6 months, patients reported their RTS status using three possible responses: no RTS, RTS at a lower level or RTS at the same or a higher level than before injury. Responsiveness of Ankle-GO^TM was calculated by comparing 3- and 6-month scores using the Wilcoxon signed-rank test for paired samples. Discriminant validity was calculated by comparing 6-month scores between patients according to their RTS status. Area under the receiver operating curve (AUC) and logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs) were used to determine the ability of the 3-month Ankle-GO^TM score to predict RTS status at 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 6 months, 80% of patients (40) RTS, with 58% of these (29 patients) at their pre-injury level. The median Ankle-GO™ score increased significantly from 13 points (interquartile range [IQR], 10.0–16.0) at 3 months to 19 points (IQR, 16.0–22.0) at 6 months (<i>p</i> &lt; 0.0001). The 3-month score showed excellent predictive ability of RTS status at 6 months (AUC = 0.93; 95% CI: 0.86–1.00). Patients scoring above 12 points are more likely to RTS (OR = 42.78, 95% CI: 2.33–785.93, <i>p</i> &lt; 0.01). A score above 14 points predicted RTS to the preinjury level (AUC = 0.83, 95% CI: 0.73–0.94; OR = 9.44, 95% CI: 2.66–40.7, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Ankle-GO™ demonstrated promising discriminative and predictive ability for assessing RTS status after syndesmotic stabilization. Further studies are needed to confirm these results and the ability of this tool to identify patients who will suffer recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, prospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971555","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 apTTTG distance decreases linearly with knee flexion: A dynamic CT-based analysis in patients with patellofemoral instability","authors":"Sebastian Schmidt,&nbsp;Alexander Bumberger,&nbsp;Miho J. Tanaka","doi":"10.1002/jeo2.70893","DOIUrl":"10.1002/jeo2.70893","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The anterior–posterior tibial tubercle–trochlear groove (apTTTG) distance is a radiographic parameter describing the sagittal alignment of the patellofemoral joint and has been proposed as an indirect estimate of patellofemoral contact pressure, but its dynamic behaviour across different degrees of knee flexion remains unclear. This study aimed to evaluate flexion-dependent changes in apTTTG using dynamic kinematic computed tomography (DKCT) imaging and to compare its behaviour with other established patellofemoral alignment parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was designed as a retrospective analysis of prospectively enroled patients with unilateral patellofemoral instability who underwent bilateral DKCT imaging as part of their diagnostic evaluation. The apTTTG was measured as the antero-posterior distance from the deepest point of the trochlear groove to the central prominence of the tibial tubercle. This was measured at 0°, 30° and 60° of flexion. Changes in apTTTG were compared across flexion states using nonparametric statistics. Linear, quadratic and generalized additive models (GAMs) were used to characterize the relationship between apTTTG and knee flexion. Multivariable models included morphologic risk factors for patellar instability, including tibiofemoral rotation angle (TFRA), TT–TG, patellar tilt, bisect offset and sulcus angle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two knees from 21 patients (mean age 22.5 ± 7.2 years) were included. The apTTTG decreased from −3.8 ± 5.7 mm in extension to −8.9 ± 7.4 mm at 30° and −17.8 ± 8.4 mm at 60° of flexion (<i>p</i> &lt; 0.001). Linear regression demonstrated a strong inverse association between knee flexion and apTTTG, corresponding to a reduction of 0.29 mm per degree of knee flexion (<i>β</i> = −0.29, <i>R</i> = 0.75, <i>p</i> &lt; 0.001). In contrast, rotational alignment and patellar positioning parameters exhibited their most pronounced changes between extension and midflexion. No other anatomical parameter independently predicted apTTTG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The apTTTG distance decreases linearly with increasing knee flexion, whereas other patellofemoral alignment parameters change predominantly between extension and midflexion.</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":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956664","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":"Orthobiologics in anterior cruciate ligament injuries","authors":"Marc Daniel Bouchard,&nbsp;José Leonardo Rocha De Faria,&nbsp;Gustavo Vinagre,&nbsp;Douglas Mello Pavão,&nbsp;Nelson Merchan,&nbsp;Emmanouil Papakostas,&nbsp;Gilbert Moatshe,&nbsp;Pedro Bernáldez Domínguez,&nbsp;Theodorakys Marín Fermín,&nbsp;Ignacio Dallo,&nbsp;Ashraf Hantouly","doi":"10.1002/jeo2.70905","DOIUrl":"10.1002/jeo2.70905","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Anterior cruciate ligament (ACL) injury remains a major challenge in sports medicine because it affects a young and active population and is associated with instability, secondary meniscal and chondral damage, delayed return to sport and post-traumatic osteoarthritis. This narrative review provides an ACL-specific overview of orthobiologics, with an emphasis on the biologic rationale, current clinical applications and the strength of the available evidence. The biologic limitations of the native ACL, particularly its poor intrinsic healing capacity in the intra-articular environment, have spurred interest in strategies to improve graft ligamentization, tendon–bone healing, modulation of inflammation and preservation of native ligament tissue. Platelet-rich plasma is the most widely investigated orthobiologic in ACL surgery; however, clinical findings remain inconsistent, largely because of substantial heterogeneity in preparation methods, leukocyte content, activation protocols and delivery sites. Bone marrow aspirate concentrate may provide a broader cellular and cytokine profile, but current studies suggest that any benefit is limited mainly to selective early imaging or functional recovery parameters, without consistent improvement in longer-term patient-reported outcomes. Other cell-based approaches, including adipose- and synovium-derived therapies, remain investigational and lack sufficient evidence to support routine clinical use. In contrast, scaffold-based biologic repair, particularly bridge-enhanced ACL repair, currently represents the most convincing example of successful biologic translation in this field, with prospective clinical studies demonstrating non-inferior outcomes compared with autograft reconstruction in appropriately selected patients. The available literature remains difficult to interpret because of inconsistent product characterization, variable indications, heterogeneous surgical techniques, frequent reliance on surrogate imaging outcomes and underpowered clinical trials. Orthobiologics in ACL surgery should therefore be considered selective adjuncts rather than standard treatment. Future progress will depend on indication-specific trial design, improved reporting of biologic composition and delivery methods and prioritization of clinically relevant outcomes such as graft failure, knee stability, return to sport and long-term joint preservation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V, narrative review.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956609","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}