Journal of Experimental Orthopaedics最新文献

{"title":"Posterior tibial slope has no impact on treatment outcome in anterior cruciate ligament revision patients","authors":"Jacob Sorwad,&nbsp;Torsten Grønbech Nielsen,&nbsp;Ole Gade Sørensen,&nbsp;Lars Konradsen,&nbsp;Martin Lind","doi":"10.1002/jeo2.70377","DOIUrl":"10.1002/jeo2.70377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the impact of posterior tibial slope (PTS) on postoperative outcome in an anterior cruciate ligament (ACL) revision cohort, based on sagittal knee stability and subjective, patient-reported knee function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Lateral knee radiographs from 105 ACL revision patients (mean age 27.2 ± 6.5 years) were retrospectively reviewed and both medial and lateral posterior tibial slope was measured. Objective sagittal knee stability was based on Rolimeter measurements. The subjective knee function was obtained through the Knee Numeric-Entity Evaluation Score (KNEES-ACL), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner Activity Scale (TAS) questionnaires. Objective anterior–posterior (AP) knee laxity was examined prior to ACL revision surgery and at a one-year follow-up, and the patient reported outcome measures (PROMs) were obtained prior to ACL revision surgery and after a two-year follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No correlation was found between medial PTS and knee stability before (0.16; 95% confidence interval [CI], −0.06 to 0.36, <i>p</i> = 0.15) or one year after ACL revision surgery (0.07; 95% CI, −0.14 to 0.27, <i>p</i> = 0.54). Likewise, no correlation was found between lateral PTS and knee stability before (0.30; 95% CI, 0.09–0.48, <i>p</i> = 0.01) and one year after ACL revision surgery (0.15; 95% CI, −0.06 to 0.35, <i>p</i> = 0.16). Likewise, there was no correlation between medial and lateral PTS and KOOS, KNEES-ACL and TAS. The mean lateral PTS was 2.6° steeper than the medial PTS (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the present study, PTS was not found to be associated with either sagittal knee stability or subjective knee function in ACL revision patients. Patients undergoing ACL revision surgery have a large mean difference between the medial and the lateral PTS.</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":2.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914932","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":"Patient-specific versus off-the-shelf unicompartmental knee arthroplasty during level walking","authors":"Haithem M'barki,&nbsp;Etienne L. Belzile,&nbsp;Katia Turcot","doi":"10.1002/jeo2.70347","DOIUrl":"10.1002/jeo2.70347","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Personalised unicompartmental knee arthroplasty (UKA) improves tibial implant positioning and clinical outcomes compared to an off-the-shelf UKA. However, no biomechanical study has confirmed the functional superiority of custom implants. The study aimed to assess potential differences between personalised and off-the-shelf UKA in knee joint function in terms of both biomechanical and clinical outcomes during level walking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-two patients and 22 healthy individuals (control group [CG]), matched for age and height, were recruited. Eight patients were implanted with a Bodycad UKS (BUKS) prosthesis, and 14 patients with an Oxford UKA (OUKA) prosthesis. Participants walked barefoot along a 10 m walkway. To quantify 3D kinematics and kinetics, a 10-camera motion analysis system and four force plates were used. The knee injury and osteoarthritis outcome score (KOOS) was utilised to measure knee function. 3D lower limbs angles and moments were estimated, and total support moment (TSM) was calculated. Biomechanical outcomes were compared along the gait cycle (GC) (0%–100%) between groups using statistical parametric mapping (SPM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed higher KOOS total score for BUKS compared to OUKA (<i>p</i> = 0.020, effect size [ES] = 0.62). No significant differences were observed between BUKS and OUKA for the biomechanical variables (<i>p</i> &gt; 0.05). Significant decrease of knee extension angle for OUKA compared to CG between 27% and 46% of GC (<i>p</i> &lt; 0.001) was observed. Knee moments showed a significant decrease for the external knee flexor moment for OUKA compared to CG between 55% and 76% of the stance phase (SP) (<i>p</i> &lt; 0.001). A reduction of the contribution of the knee to the first peak of TSM was observed for both BUKS and OUKA compared to CG (<i>p</i> = 0.019, ES = 0.34).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BUKS patients demonstrated similar knee function compared to OUKA. OUKA group exhibited a protective mechanism by reducing the knee extension. Neither BUKS nor OUKA restored knee joint function comparable to a native knee, with compensation mechanism occurring through adjacent joints.</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":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905486","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":"Artificial intelligence-guided assessment of the hip-knee-ankle angle shows excellent correlation with experienced human raters","authors":"Mikhail Salzmann,&nbsp;Robert Prill,&nbsp;Roland Becker,&nbsp;Andreas G. Schreyer,&nbsp;Simon Shabo,&nbsp;Nikolai Ramadanov","doi":"10.1002/jeo2.70383","DOIUrl":"10.1002/jeo2.70383","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The hip-knee-ankle angle is a crucial parameter in orthopaedic surgery for lower limb assessment. However, traditional methods for measuring the hip-knee-ankle angle on standing long-leg anteroposterior radiographs are time-consuming, require significant expertise and lack reproducibility. Given the emergence of artificial intelligence as a promising tool to automate these measurements, this study aimed to assess the accuracy of Gleamer BoneMetrics for hip-knee-ankle angle measurement and its correlation with assessments by experienced orthopaedic surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 75 patients who underwent knee arthroplasty between October 2023 and June 2024 were included. Preoperative and postoperative long-leg anteroposterior radiographs were analysed both by two experienced orthopaedic surgeons who manually measured the hip-knee-ankle angle and by the Gleamer BoneMetrics software; the analyses were tested for both inter- and intra-rater reliability. Statistical analysis was performed using intraclass correlation coefficients and Bland-Altman plots to assess the correlation between the Gleamer BoneMetrics and the human raters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Gleamer BoneMetrics demonstrated excellent inter- and intra-rater reliability, with intraclass correlation coefficient values ranging from 0.995 to 0.998, which were comparable to the surgeons' measurements of 0.997–0.998. The Gleamer BoneMetrics's intra-rater reliability was also excellent, with intraclass correlation coefficient values of 1.0 preoperatively and 0.996 postoperatively. Bland–Altman analysis showed minimal measurement discrepancies between Gleamer BoneMetrics and the human raters. However, in 2% of the cases (<i>n</i> = 3), Gleamer BoneMetrics was not able to provide measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The artificial intelligence-based BoneMetrics software offers an efficient and accurate method for hip-knee-ankle angle measurement, with performance comparable to experienced orthopaedic surgeons. While promising, further development is necessary to address cases in which image quality or positioning issues prevent automated measurement and to reduce reliance on human quality control.</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":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905387","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":"Decellularisation of human meniscus tissue using sodium dodecyl sulphate (SDS): Preserving biomechanical integrity for scaffold-based meniscal repair","authors":"Dominic Simon,&nbsp;Benjamin Bartz,&nbsp;Manuel Kistler,&nbsp;Susanne Mayer-Wagner,&nbsp;Peter E. Müller,&nbsp;Thomas R. Niethammer,&nbsp;Boris M. Holzapfel,&nbsp;Gautier Beckers","doi":"10.1002/jeo2.70375","DOIUrl":"10.1002/jeo2.70375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Meniscal tears are common knee injuries and a major risk factor for secondary osteoarthritis. Recently, there has been a paradigm shift toward meniscal preservation, reflecting the meniscus's vital role. In this context, tissue engineering approaches such as the development of meniscal scaffolds have gained attention. However, to reduce the immune response and improve biocompatibility, decellularization of allografts, while preserving the histoarchitectural and meniscal properties, is essential. The current study aimed to evaluate the effectiveness of decellularization and its impact on the biomechanical properties of the human meniscus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one human meniscus specimens were collected between July and December 2023 during total knee arthroplasty. Preoperative MRI was performed to verify meniscal integrity. The specimens were decellularized using a sodium dodecyl sulphate (SDS) protocol and compared to native meniscus samples in terms of cell count, assessed through hematoxylin and eosin staining, and biomechanical properties, specifically Young's modulus, measured using a universal testing machine (Zwick Z010).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cell count in the decellularized menisci was 11 cells/mm² (SD = 13; 95% CI: 2–20), representing a significant reduction compared to the native meniscus samples, which had a cell count of 111 cells/mm² (SD = 42; 95% CI: 81–141; <i>p</i> &lt; 0.01). Young's modulus of elasticity was 35.3 versus 36.8 MPa in the anterior region (<i>p</i> = 0.8), 32.6 versus 35.6 MPa in the central region (<i>p</i> = 0.7) and 36.5 versus 35.8 MPa in the posterior region (<i>p</i> = 0.9) for native versus decellularized samples, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated that the modified SDS-based decellularization protocol effectively decellularizes the human meniscus. Moreover, the decellularized tissue retained biomechanical properties comparable to those of native meniscus tissue. Tissue decellularization is a promising technique in regenerative medicine, enabling the use of scaffolds for tissue repair, particularly in applications such as meniscus transplantation following meniscectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, controlled laboratory study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905451","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":"Efficacy of isolated femoral revision in cruciate-retaining total knee arthroplasty instability: A comparative study","authors":"Lars-Rene Tuecking,&nbsp;Mats Tobias Wormit,&nbsp;Henning Windhagen,&nbsp;Max Ettinger,&nbsp;Peter Savov","doi":"10.1002/jeo2.70337","DOIUrl":"10.1002/jeo2.70337","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study compares clinical outcomes, implant survival rates and perioperative factors between isolated femoral total knee arthroplasty (TKA) revision (prTKA) and full TKA revision (frTKA) for flexion instability in cruciate-retaining (CR) prostheses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This retrospective, controlled case series included 66 consecutive patients treated with either full TKA revision (&lt;i&gt;n&lt;/i&gt; = 34) or isolated femoral TKA revision (&lt;i&gt;n&lt;/i&gt; = 32) with flexion instability after CR TKA between 2015 and 2021. To ensure that the groups were uniformly comparable, only patients with one implant system (Triathlon, Stryker) were included. Preoperative demographic data and radiological parameters (e.g., quantification of anteroposterior instability and midflexion instability) were compared between the groups. Postoperative evaluation of implant survival and clinical outcome scores was performed with a minimum follow-up of 2 years. Patient-reported outcome measures (PROM) analysis included the Visual Analogue Scale, Kujala, Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, University of California at Los Angeles Activity-Level Scale and Knee Osteoarthritis Outcome scores. Statistical evaluations included unpaired, nonparametric &lt;i&gt;t&lt;/i&gt;-tests and Wilcoxon tests for nominal data. Implant survival analysis was conducted using Kaplan–Meier analysis and log-rank test. Statistical significance was defined as a &lt;i&gt;p&lt;/i&gt;-value &lt; 0.05.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;No significant differences were found in the clinical outcomes between the prTKA and frTKA groups across various PROMs. Implant survival rates were comparable (96.9% for prTKA vs. 97.1% for frTKA). Compared to frTKA, prTKA resulted in significantly shorter hospital stays (&lt;i&gt;p&lt;/i&gt; = 0.002), reduced operative time (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), lower blood loss (&lt;i&gt;p&lt;/i&gt; = 0.001) and a decreased inflammatory response (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Partial femoral TKA revision for flexion instability in cruciate-retaining prostheses yielded clinical outcomes and implant survival rates comparable to full TKA revision in the short- to mid-term follow-up. These findings suggest that partial femoral revision may be a viable option for carefully selected patients with flexion instability, offering similar clinical efficacy and potential perioperative advantages over complete revision.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;se","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869807","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":"A non-interventional study to evaluate the safety and effectiveness of a biphasic, chondrocyte-containing biomaterial (NOVOCART® 3D) in the treatment of localized full-thickness cartilage defects or osteochondral lesions of the knee joint (NISANIK)","authors":"Julia Elisabeth Lenz,&nbsp;Johannes Weber,&nbsp;Johannes Zellner,&nbsp;Gerald Zimmermann,&nbsp;Peter E. Müller,&nbsp;Alexander Barié,&nbsp;Dominik Popp,&nbsp;Sven Ostermeier,&nbsp;Tilmann Krackhardt,&nbsp;Julian Mehl,&nbsp;Volker Alt,&nbsp;Peter Angele","doi":"10.1002/jeo2.70346","DOIUrl":"10.1002/jeo2.70346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The focus of this study was to evaluate the safety and efficacy of NOVOCART® 3D-treatment over a period of 36 months post-transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was designed as a prospective, multicenter, single-arm, non-interventional investigation, aimed at evaluating the safety and efficacy of NOVOCART® 3D in patients with localized cartilage defects in the knee joint. 80 patients were enroled across 8 study centres and were followed post-operatively for a duration of 36 months. Safety assessments were conducted throughout the study period, while effectiveness data were evaluated pre-operatively and at 3, 12, 18, 24, and 36 months following cell transplantation, utilizing the International Knee Documentation Committee 2000 score (IKDC 2000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the 3-year observation period among the 80 study patients, the incidence of surgery or product-related adverse events stood at 12.5%. Subjective scores according to IKDC 2000 demonstrated improvement, with a mean change from baseline of 30.5 ± 21.5 score points at 36 months. Similarly, the mean IKDC function score exhibited continuous enhancement, with a mean difference of 3.2 ± 3.0 score points. These changes from baseline were associated with nominally significant <i>p</i>-values from the 12-month mark onwards. The subgroup analysis revealed that only higher baseline scores and concurrent surgeries negatively impacted outcome parameters. Female sex, retro-patellar lesions, uncontained lesions, lesions with intralesional osteophytes or osteochondral defects did not exhibit any significant influence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The NISANIK study indicates the safety of NOVOCART® 3D treatment. Regarding effectiveness, patients in the study demonstrated a notable and progressively increasing mean improvement compared to their pre-operative condition. The study furthermore demonstrated that NOVOCART® is universally applicable across all age groups and Body Mass Index ranges, and it can also be effectively used in patients with female sex, larger lesions, retro-patellar lesions and in such having received bone-grafting without compromising the outcome, unlike related procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, therapeutic, prospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833188","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":"In vivo dynamic intrusion and extrusion of the menisci in varus and valgus load within a healthy population","authors":"Sebastian F. Bendak,&nbsp;Joachim Georgii,&nbsp;Elham Taghizadeh,&nbsp;Stefan Heldmann,&nbsp;Hans Meine,&nbsp;Thomas Lange,&nbsp;Jonas Buchholtz,&nbsp;Andreas Fuchs,&nbsp;Moritz Mayr,&nbsp;Hagen Schmal,&nbsp;Kaywan Izadpanah","doi":"10.1002/jeo2.70325","DOIUrl":"10.1002/jeo2.70325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Axial loading, varus and valgus stress lead to meniscal motion towards the joint periphery, defined as meniscal extrusion. Direction and amount of extrusion is unknown as this is a dynamic process within a 3D environment dependent on joint loading as well as individual anatomy. We propose that there is motion in all compartments of the medial and lateral meniscus during valgus and varus stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>MRI scans of 31 healthy subjects in varus or valgus stress positions were acquired with the help of a pneumatic loading device. Semiautomatic segmentation of the menisci, the femur and the tibia (with corresponding cartilages) was carried out. An individual 3D model of the joint was generated. The meniscal movement was calculated within a tibia-based coordinate system and broken down into total and partial meniscal movement (anterior/posterior horn, intermediate part).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Under valgus load the medial meniscus (MM) showed average movement of 1.5 (±0.5) mm in lateral-posterior direction with most lateral motion of 1.4 (±0.7) mm in the intermediate part. The lateral meniscus averaged 1.6 (±1.0) mm in lateral-anterior motion, exhibiting maximal lateral motion in the anterior horn (AH) 0.7 (±0.8) mm and posterior horn 0.6 (±0.6) mm. In response to the varus load, average MM motion was 0.9 (±0.5) mm in medial-anterior direction with the largest medial movement in the AH 0.9 (±1.1) mm. The lateral meniscus moved in average 1.6 (±0.8) mm into lateral-posterior direction with the intermediate part showing the largest medial motion of 0.6 (±0.4) mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a healthy population, the menisci extrude up to 1.5 mm during varus and valgus loading. The anterior and posterior horn show greater dynamic extrusion than the intermediate part. However, an in vivo dynamic intrusion mechanism of meniscus when discharged (medial 1.45 mm, lateral 1.56 mm) could be demonstrated. Quantification and reconstruction of this phenomenon might be of crucial importance during meniscal root or meniscal transplantation surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, descriptive laboratory study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833189","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":"Restoring prearthritic alignment improves joint perception in medial unicompartmental knee arthroplasty","authors":"Zhaolun Wang,&nbsp;Wang Deng,&nbsp;Yixin Zhou,&nbsp;Yong Huang,&nbsp;Shaoyi Guo,&nbsp;Yunfeng Zhang","doi":"10.1002/jeo2.70389","DOIUrl":"10.1002/jeo2.70389","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to investigate whether restoring prearthritic alignment improves joint perception in medial unicompartmental knee arthroplasty (UKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analysed 244 patients who underwent nonrobotic-assisted medial fixed-bearing UKA between 2015 and 2018 with a minimum 2-year follow-up. Patients were categorised into prearthritic and nonprearthritic alignment groups based on the difference between their postoperative alignment and prearthritic hip-knee-ankle angle. Postoperative outcomes, including the Forgotten Joint Score (FJS-12), Oxford Knee Score (OKS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS) and University of California Los Angeles (UCLA) activity score were compared between the groups. Additional analysis was performed in a subgroup of patients with constitutional varus alignment (CPAK types I, IV and VII). Multivariable logistic regression was used to identify predictors of achieving a forgotten joint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with restored prearthritic alignment had significantly higher FJS-12 (71.9 vs. 63.4, <i>p</i> = 0.005), OKS (40.7 vs. 38.1, <i>p</i> = 0.003) and WOMAC (91.2 vs. 88.1, <i>p</i> = 0.017) scores compared to those with nonprearthritic alignment. In the constitutional varus subgroup, prearthritic alignment was associated with higher FJS-12, UCLA, OKS and KOOS ADL scores. The prearthritic alignment group also had a higher likelihood of achieving the ‘forgotten joint’ state. A 1-degree deviation from prearthritic alignment was associated with a 21% decrease in the probability of achieving a forgotten joint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Restoring prearthritic alignment in UKA is associated with improved postoperative joint perception and function, especially in patients with constitutional varus alignment. This personalised alignment approach may lead to better outcomes than the traditional goal of neutral alignment. Further research with a longer follow-up period is required to validate these findings and explore their impact on prosthesis survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Levels of Evidence</h3>\u0000 \u0000 <p>Level II.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No differences in knee anthropometric-related risk factors between unilateral and bilateral ACL reconstruction: A matched MRI-based cohort study","authors":"Riccardo D'Ambrosi,&nbsp;Fabrizio Di Maria,&nbsp;Prof. Luca Maria Sconfienza,&nbsp;Stefano Fusco,&nbsp;Maria Vittoria Bausano,&nbsp;Mattia Sica,&nbsp;Francesco Silletta,&nbsp;Elisabeth Abermann,&nbsp;Prof. Christian Fink","doi":"10.1002/jeo2.70394","DOIUrl":"10.1002/jeo2.70394","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary aims of this retrospective study were to (1) compare medial posterior tibial slope (mPTS), lateral posterior tibial slope (lPTS), notch index and lateral femoral condyle ratio (LFCR) between patients who have undergone unilateral versus bilateral anterior cruciate ligament reconstruction (ACLR), measured on magnetic resonance imaging (MRI) using a matched cohort analysis; (2) evaluate whether subgroup differences exist based on age, gender and side; (3) assess risks factors for ACL injury using logistic models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included patients who underwent primary ACLR between 2015 and 2019. Measurements of the unilaterally operated knee (<i>n </i>= 45) were matched using propensity score-matched in a ratio of 1:1 with the corresponding knee in the bilateral group (<i>n</i> = 45) based on age, sex, side, using the greedy nearest neighbour method. Exclusion criteria included inadequate MRI quality (&lt;1.5 Tesla), concomitant ligament injuries or fractures, and &lt;6-year follow-up for unilateral ACLR patients. Five blinded reviewers measured mPTS, lPTS, femoral notch index and LFCR on MRI scans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were observed between the bilateral and unilateral groups for mPTS, lPTS, femoral notch index or LFCR. The mean values for the bilateral group were: mPTS, 3.84° ± 2.54°; lPTS, 6.03° ± 3.63°; notch index, 0.27 ± 0.02; and LFCR, 0.73 ± 0.07. Corresponding values for the unilateral group were: mPTS, 3.92° ± 2.94°; lPTS, 6.37° ± 3.13°; notch index, 0.27 ± 0.03; and LFCR, 0.71 ± 0.06 (all <i>p</i> &gt; 0.05). Subgroup analysis revealed a statistically significant difference only for the femoral notch index in patients older than 25 years: bilateral ACLR (0.29 ± 0.03) versus unilateral ACLR (0.27 ± 0.03; <i>p</i> = 0.027).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients who underwent bilateral ACLR showed no significant differences in mPTS, lPTS, femoral notch index or LFCR, compared with those who underwent unilateral ACLR, irrespective of age, gender and side.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, cross-sectional study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773509","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 anatomy of the pectoralis major, pectoralis minor, latissimus dorsi and teres major for tendon transfer in irreparable subscapularis tendon tears","authors":"Lin Lin,&nbsp;Qiang Liu,&nbsp;Fengyuan Zhao,&nbsp;Dingyu Wang,&nbsp;Hui Yan","doi":"10.1002/jeo2.70391","DOIUrl":"10.1002/jeo2.70391","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Tendon transfer of the pectoralis major (PM), pectoralis minor (Pm), latissimus dorsi (LD) and teras major (TM) is recommended for irreparable subscapularis (SSC) tears. This study aimed to describe the landmarks and neurovascular structures in the regions of the four muscles to facilitate their transfer to irreparable SSC tears.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Descriptive laboratory study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve fresh-frozen adult specimens were dissected and important neurovascular structures around the four tendons were identified. The relationships between the tendons and neurovascular structures were quantitatively investigated during tendon transfer procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average distance of medial pectoralis nerve (MPN) to the insertion of Pm on the coracoid was 6.5 cm (5.4–8.1 cm). The MPN travelled with the lateral thoracic artery (LTA) to pierce the PM with an average of 9.7 cm (8.3–12.1 cm) medial to the humeral insertion. Axillary nerve and posterior humeral circumflex vessels were above the superior margin of TM muscle with average of 0.8 cm (0.5–1.2 cm). These neurovascular structures crossed posterior to the plane of the LD and TM at 2.6 cm (1.9–3.3 cm) from the humeral insertion of these two muscles. The radial nerve (RN) and its motor branch to triceps were found to lie an average of 2.7 cm (2.0–4.3 cm) medial to the humerus at the superior border of the LD, and an average of 2.4 cm (1.8–3.5 cm) medial to the humerus at the inferior border of the TM. The neurovascular pedicles to the LD and TM were at an average of 12.7 cm (10.2–15.6 cm) and 7.0 cm (5.6–8.5 cm) to the humeral insertions, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results clarify the complex local anatomic structures of the PM, Pm, LD and TM for tendon transfer to treat irreparable SSC tears and provide potentially useful references for tendon transfer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773988","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}