Journal of Experimental Orthopaedics最新文献

{"title":"Biomechanical differences between females and males with patellofemoral pain: A systematic review and meta-analysis.","authors":"Lucas Pallone, Carolline P Nunes, Felipe F Gonzalez, Talissa O Generoso, Rodrigo Saad-Berreta, Kaitlyn M Joyce, Eliane C Guadagnin, Jorge Chahla, Jonathan A Gustafson, Leonardo Metsavaht, Gustavo Leporace","doi":"10.1002/jeo2.70880","DOIUrl":"10.1002/jeo2.70880","url":null,"abstract":"<p><strong>Purpose: </strong>Patellofemoral pain (PFP) is more prevalent in females and altered lower limb biomechanics have been implicated in its development and persistence. However, it remains unclear whether movement patterns differ between men and women with PFP during functional activities. Many biomechanical studies rely on mixed-sex cohorts, potentially obscuring sex-specific movement patterns. Therefore, this study aimed to systematically review biomechanical differences between females and males with PFP during functional tasks.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Embase, Scopus, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews and Google Scholar were searched from inception to 10 September 2025. Studies comparing in vivo biomechanical characteristics of females and males with PFP during functional tasks were included, whereas studies using mixed-sex cohorts without sex-stratified analysis or focusing exclusively on a single sex were excluded. Extracted data comprised participant demographics, methodological characteristics and kinetic and kinematic outcomes. Methodological quality was assessed using a modified Downs and Black checklist. Random-effects meta-analyses were performed using standardized mean differences.</p><p><strong>Results: </strong>Five cross-sectional studies including 170 individuals with PFP (84 females and 86 males) were analysed. Tasks evaluated included single-leg squat, step-down, mini-squat and single-leg jumping activities. Meta-analysis of single-leg squat data showed greater peak hip adduction in females compared with males (mean difference 4.93°, 95% confidence interval [CI] 2.60-7.25; <i>I</i> ² = 0%). Females also demonstrated greater peak knee abduction (mean difference 5.74°, 95% CI 2.31-9.16; <i>I</i> ² = 66%). No significant differences were observed for contralateral pelvic drop. Qualitative synthesis indicated greater frontal-plane kinematics in females, whereas males demonstrated greater hip, knee and ankle extension moments during jumping tasks. Several findings were based on single studies.</p><p><strong>Conclusions: </strong>Only a limited number of studies evaluated sex-specific biomechanics in individuals with PFP. Despite the small number of studies, consistent differences between females and males were observed, suggesting that sex influences movement strategies and should be considered in biomechanical assessment and rehabilitation.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70880"},"PeriodicalIF":3.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799100","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":"Addition of a second double-row reduces fragment micromotion and increases fixation strength in suture fixation of a bony Bankart injury: A biomechanical study","authors":"Maximilian Hinz,&nbsp;Ayham Jaber,&nbsp;Justin F. M. Hollenbeck,&nbsp;Rio R. Castro,&nbsp;Wyatt H. Buchalter,&nbsp;Matthew T. Provencher,&nbsp;Peter J. Millett","doi":"10.1002/jeo2.70881","DOIUrl":"https://doi.org/10.1002/jeo2.70881","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of the present study was to evaluate micromotion and failure load when the bony Bankart bridge (BBB) is performed with one versus two double-rows. It was hypothesized that the addition of a second double-row would reduce fragment micromotion and increase ultimate failure load.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seven pairs of fresh-frozen cadaveric shoulders (age: 48 years [22–65 years], sex: 57.1% male) with bony Bankart lesions, with a defect width of 25% of the glenoid diameter, were tested in the present study. In a paired design, one shoulder underwent the BBB with one double-row, and the contralateral shoulder underwent the BBB with two double-rows. Micromotion of the bony Bankart fragment was tested by cyclic non-physiological point loading (5–20 N at 1 Hz for 50 cycles) using a dynamic tensile machine. Optical markers and a three-dimensional digitizer established fragment and glenoid coordinate systems, enabling precise tracking of translational and rotational displacements of the fragment. This was followed by failure testing, where the fragment was loaded to failure at 0.5 mm/s. Failure load and stiffness were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Under inferior point loading, the repair with one double-row demonstrated significantly greater rotation about the <i>x</i>-axis (5.20° [3.01°–5.29°] vs. 1.64° [0.94°–2.40°], <i>p</i> = 0.016, <i>q</i> = 0.047) and translation along the <i>z</i>-axis (2.78 mm [1.81–4.20 mm] vs. 1.06 mm [0.51–1.51 mm], <i>p</i> = 0.016, <i>q</i> = 0.047) compared with the repair with two double-rows. Under superior point loading, no significant differences were observed for the rotational or translational outcomes. The repair with one double-row demonstrated a significantly lower failure load than the repair with two double-rows (388 N [243–463 N] vs. 602 N [539–641 N], <i>p</i> = 0.016, <i>q</i> = 0.031). No significant differences in stiffness were found between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fixation with two double-rows resulted in a significantly less fragment micromotion and a significantly greater failure strength compared with the BBB using one double-row.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148783766","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":"Posterior tibial slope is associated with ACL status rather than demographic factors: A cohort of 1406 patients","authors":"Julien Druel,&nbsp;Romir Patel,&nbsp;Christophe Jacquet,&nbsp;Lyes Chaal,&nbsp;Antoine Piercecchi,&nbsp;Matthieu Ollivier","doi":"10.1002/jeo2.70890","DOIUrl":"https://doi.org/10.1002/jeo2.70890","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine whether posterior tibial slope (PTS), measured on lateral radiographs using the proximal anatomical tibial axis defined by two circles, is independently associated with anterior cruciate ligament (ACL) injury status or influenced by age, sex and body mass index (BMI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective single-centre cohort study included all 1406 consecutive eligible patients operated between January 2010 and September 2024: 857 ACL-intact controls undergoing medial patellofemoral ligament reconstruction, 498 patients with primary ACL rupture and 51 patients with ACL re-rupture. PTS was measured on standardized lateral radiographs using the proximal anatomical tibial axis defined by two circles. Multivariable linear regression evaluated the independent associations of ACL status, age, sex and BMI with PTS. Receiver operating characteristic (ROC) analyses assessed discrimination of ACL injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean PTS was 7.3 ± 3.1° in controls, 9.9 ± 3.1° in patients with primary ACL rupture and 10.9 ± 3.5° in patients with ACL re-rupture (<i>p</i> &lt; 0.001). Intraobserver and interobserver reliability were good to excellent (intraclass correlation coefficient [ICC] = 0.88) and moderate to good (ICC = 0.81). Multivariable analysis demonstrated that ACL injury status was the dominant independent determinant of PTS. Compared with controls, primary ACL rupture and ACL re-rupture were associated with 2.52° and 3.63° greater PTS, respectively (both <i>p</i> &lt; 0.001). Age showed a minimal inverse association (−0.019° per year; 95% confidence interval [CI], −0.036° to −0.003°; <i>p</i> = 0.024), whereas sex and BMI were not independently associated with PTS. ROC analysis identified a Youden-derived value of 10°, with an area under the curve of 0.731 (95% CI, 0.705–0.758) for primary ACL rupture and 0.791 (95% CI, 0.741–0.841) for ACL re-rupture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PTS was independently associated with ACL injury and ACL re-rupture, whereas age, sex and BMI had no clinically meaningful independent influence. PTS should be interpreted as one component of a multifactorial anatomical risk profile rather than as a standalone screening test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective comparative cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148783779","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":"External validation of the BABY-Knee Algorithm for treatment decision-making in skeletally immature patients with anterior cruciate ligament injuries: A Dutch cohort study","authors":"Annika Babette Ito,&nbsp;Rob Paulus Augustinus Janssen,&nbsp;Stijn Thomas Henricus Croes,&nbsp;Robin Nicolaas Julian Voskuilen,&nbsp;Alberto Grassi,&nbsp;Maria Christine van der Steen,&nbsp;Martijn Dietvorst","doi":"10.1002/jeo2.70891","DOIUrl":"10.1002/jeo2.70891","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to investigate the external validity of the Best anterior cruciate ligament (ACL)-treatment Based on the Years of the Knee (BABY-Knee) Algorithm, developed based on an Italian population and to assess its applicability to a Dutch patient population treated in accordance with the 2018 International Olympic Committee (IOC) consensus statement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 109 skeletally immature patients with ACL injuries were included from the Dutch contribution to the European Society of Sport Traumatology, Knee Surgery and Arthroscopy (ESSKA) Paediatric Monitoring Initiative (PAMI). The BABY-Knee Algorithm was retrospectively applied to all patients, and corresponding scores were calculated. The predictive performance of the BABY-Knee Algorithm was assessed using the validation approach of the original validation study and an additional failure criterion based on hard clinical endpoints. Results were compared with the previously reported results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 109 patients included, 78 (71.6%) were treated non-operatively, while the remaining 31 (28.4%) underwent operative treatment. However, according to the algorithm, 34 patients (31.2%) had a score of &lt;3, indicating non-operative treatment, whereas 75 patients (68.8%) had a score of ≥3, indicating operative treatment. A statistically significant difference was observed between the algorithm's prediction and the performed treatment (<i>p</i> = 0.003). The original internal validation study reported a positive predictive value (PPV) of 91.7% and a negative predictive value (NPV) of 87.5%. In contrast, application of the BABY-Knee Algorithm to the present study population resulted in a PPV of 51.1% or 31.9% and an NPV of 64.5% or 67.7%, depending on the applied definition of failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The external validation of the BABY-Knee Algorithm showed inferior predictive performance compared with the original internal validation study in an Italian population. These findings suggest that the BABY-Knee Algorithm is not directly applicable to other populations of skeletally immature patients with ACL injuries.</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":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798984","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":"Clustering analysis of hamstring injuries-A pilot study to determine phenogroups based on injury characteristics and recovery duration.","authors":"Bálint Zsidai, György Gulácsi, Tibor Rudisch, Bence Márk Kovács, Pete Friar, Richard Nagy, Robert de Jonge, Eric Hamrin Senorski, Kristian Samuelsson, Gergely Pánics","doi":"10.1002/jeo2.70885","DOIUrl":"https://doi.org/10.1002/jeo2.70885","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this pilot study was to determine clinically relevant phenogroups of professional football players with hamstring injuries using unsupervised cluster analysis based on demographic and injury-related characteristics, and to assess return to play (RTP) duration with respect to the characteristics of these phenogroups.</p><p><strong>Methods: </strong>This retrospective cohort study analysed 57 professional football players from Ferencvárosi Torna Club with magnetic resonance imaging (MRI)-confirmed acute hamstring injuries reported between 2018 and 2024. Three clustering approaches were implemented and compared: k-means clustering, hierarchical clustering using Ward's linkage method, and mixed-type clustering using Gower distance with partitioning around medoids (PAMs). The optimal number of clusters was determined using silhouette analysis. Between-cluster differences in RTP duration and injury characteristics were assessed using Kruskal-Wallis tests for continuous variables and chi-square tests for categorical variables, with post-hoc Bonferroni correction.</p><p><strong>Results: </strong>Mixed-type clustering identified seven phenogroups based on British Athletics Muscle Injury Classification (BAMIC) grade, lesion length, anatomical tear site, affected muscle and injury extensiveness. The average silhouette width was 0.290, indicating weak to moderate cluster separation. Clusters 1, 3, 4, 5 and 6 were characterised by low- to moderate-grade injury parameters and median RTP durations ranging from 9 to 27 days. Clusters 2 and 7 displayed high-grade injury characteristics with considerably prolonged RTP (medians of 46.5 and 94.5 days, respectively). Significant between-cluster differences were observed for days to RTP, lesion length, BAMIC grade, injury severity and anatomical tear site (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Unsupervised machine learning may help identify clinically relevant hamstring injury phenogroups based on MRI-derived tear characteristics, which may facilitate prognosis and inform decision-making regarding expected RTP duration in professional football players.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70885"},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799120","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":"Two-thirds return but performance suffers: ACL reconstruction outcomes across elite European women's soccer leagues","authors":"Haneef Khan,&nbsp;Forest Rodriguez,&nbsp;Amina Khan,&nbsp;Ashley Rosenberg,&nbsp;Stephen Marcaccio","doi":"10.1002/jeo2.70888","DOIUrl":"https://doi.org/10.1002/jeo2.70888","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To analyse return-to-play (RTP) rates, timing and performance outcomes following anterior cruciate ligament (ACL) reconstruction (ACLR) in elite European women's soccer players across the top five leagues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed ACL injuries sustained by female professional soccer players across the Bundesliga, Women's Super League, Primera División Femenina, Serie A Women and Première Ligue between 2007 and 2025. Players were included if they had a confirmed ACL injury requiring ACLR and one season of performance data pre- and post-injury. Players were excluded if the injury occurred during their rookie season or after the 2023 season. Data were collected from Soccerdonna.de and Transfermarkt.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 242 ACL injuries in 206 unique players were included, with a median follow-up of 2.0 seasons (interquartile range [IQR]: 1.0–4.0). The cohort had a median age at injury of 22.7 years (IQR: 20.4–26.0; mean 23.4 ± 3.8 years). Of 242 injuries, 161 (66.8%) resulted in RTP. For those who returned, the median RTP time was 9.8 months (IQR: 7.9–11.4). Only 7 (5.1%) players achieved RTP before 6 months. In the first year following RTP, significant performance decreases were observed: games played (−47.4%, <i>p</i> &lt; 0.001), total minutes (−57.8%, <i>p</i> &lt; 0.001) and minutes per game (−24.4%, <i>p</i> &lt; 0.001). Midfielders experienced the greatest decline in playing time (−41.2%, <i>p</i> &lt; 0.001), while goalkeepers showed minimal change (−8.0%, <i>p</i> = 0.625). No significant age-related differences were observed. Median post-injury career length was 2.0 seasons (IQR: 2.0–4.0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A RTP rate of 66.8% was observed following ACLR in elite European women's soccer; however, returning players faced significant performance decreases in the first year post-return, with notable position-specific variations. These reductions likely reflect a combination of injury-related recovery factors and team selection dynamics. Rehabilitation and RTP strategies should therefore integrate position-specific demands, realistic performance expectations and gradual reintegration plans, particularly for midfielders who demonstrated the greatest performance decline.</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":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and failure rates of combined ‘Over-the-Top’ anterior cruciate ligament reconstruction and lateral extra-articular tenodesis in a cohort of patients with an average age of 60 years","authors":"Lorenzo Bini,&nbsp;Gian Andrea Lucidi,&nbsp;Piero Agostinone,&nbsp;Cristiano Liao,&nbsp;Alberto Grassi,&nbsp;Stefano Zaffagnini","doi":"10.1002/jeo2.70889","DOIUrl":"https://doi.org/10.1002/jeo2.70889","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The management of anterior cruciate ligament (ACL) tears in older adults remains controversial, although recent evidence suggests an increasing trend toward surgical treatment. To date, no studies have specifically investigated the outcomes of combined ACL reconstruction (ACLR) with over-the-top (OTT) technique and lateral extra-articular tenodesis (LET) in this population. The aim of this study was to evaluate clinical outcomes and failure rates of ACLR using OTT plus LET in patients aged 55 years or older.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged ≥55 years who underwent primary ACLR with OTT and LET techniques and had a minimum follow-up of 2 years were included. Clinical outcomes were assessed using clinical scores, such as VAS, Lysholm, KOOS, comparing preoperative and post-operative values. Patient Acceptable Symptom State (PASS) thresholds were applied to KOOS subscales. Reoperations and graft failures were also recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight patients met the inclusion criteria, with a mean age of 60.1 ± 3.2 years and a mean follow-up of 6.5 ± 3.8 years. One graft failure (3.6%) and one reoperation (3.6%) were observed. Significant improvements were noted in all clinical scores. The mean Lysholm score increased from 55.4 ± 15.9 preoperatively to 96.6 ± 6.6 postoperatively. KOOS subscales showed marked improvement, particularly in Quality of Life (41.6 ± 20.2 to 90.3 ± 12.9) and Pain (68.7 ± 12.1 to 94.2 ± 5.7).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ACLR with OTT and LET techniques in older patients demonstrated low failure rates and favourable clinical outcomes. Larger studies are needed to confirm these findings and to establish the role of this combined technique in this population.</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":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784124","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":"Falls after hip arthroscopy for femoroacetabular impingement syndrome: Prevalence and risk factors for revision hip arthroscopy","authors":"Nicholas R. Kossoff,&nbsp;Manuel A. Romero-Padron,&nbsp;Adam Alakhras,&nbsp;Nihal Nagesh,&nbsp;Joshua S. Everhart","doi":"10.1002/jeo2.70887","DOIUrl":"10.1002/jeo2.70887","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;The prevalence and clinical consequences of falls in the early post-operative period after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) remain unknown. The purpose of this study was to determine the prevalence of and risk factors for postoperative falls within 90 days of surgery in patients who undergo hip arthroscopy for FAIS and determine whether falls within 90 days are associated with increased risk of early revision surgery.&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;Consecutive patients who underwent primary hip arthroscopy for FAIS were included. Falls were defined by ground impact by body parts other than the feet, and near-falls were defined as sudden, forceful and unanticipated loading of the operative extremity without impact. Bivariate and multivariate analyses were conducted to identify associations between demographic or clinical factors and fall occurrence as well as revision surgery within 1 year.&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;A total of 192 patients met inclusion criteria (median age 36.7 years, interquartile range [IQR] 23.4, 46.5; 72% female). Of these, 33 patients (17%) experienced a postoperative fall or near-fall (21 falls, 12 near-falls). Median time to fall was 16.5 days (IQR 8.3–44.5). Fall/near-fall patients had significantly higher rates of revision surgery within 1 year compared to controls (27% vs. 4%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001; odds ratio [OR] = 9.4, 95% confidence interval [CI] 3.1–30.5). Fall/near-fall events were associated with worse baseline physical function (Physical Function Short Form of the Hip Disability and Osteoarthritis Outcome Score [HOOS-PS], &lt;i&gt;p&lt;/i&gt; = 0.047), lower mental health scores (Mental Health Inventory-5 [MHI-5], &lt;i&gt;p&lt;/i&gt; = 0.04) and lower activity levels (University of California, Los Angeles [UCLA] score, &lt;i&gt;p&lt;/i&gt; = 0.03). Hearing or visual impairment (OR = 6.6, 95% CI 1.9–23.3, &lt;i&gt;p&lt;/i&gt; = 0.004) and higher HOOS-PS score (OR = 1.1, 95% CI 1.1–1.3, &lt;i&gt;p&lt;/i&gt; = 0.02) were significant predictors of postoperative falls/near-falls.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Falls and near-falls within 90 days after hip arthroscopy were associated with higher rates of revision hip arthroscopy. Surgeons should counsel patients, particularly those with sensory impairments, regarding postoperative fall prevention and emphasize prompt reporting of any fall/near-fall events. Future studies are needed to determine whether reducing postoperative falls can decrease revision rates.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 ","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798971","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":"Patellar tilt correction magnitude, rather than residual tilt, predicts functional outcome after isolated medial femoropatellar ligament reconstruction","authors":"Ella George,&nbsp;Pierre-Henri Vermorel,&nbsp;Frédéric Farizon,&nbsp;Rémi Philippot,&nbsp;Thomas Neri","doi":"10.1002/jeo2.70874","DOIUrl":"10.1002/jeo2.70874","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;Patellar tilt is considered a key factor in patellofemoral instability, with a commonly accepted pathological threshold of 20° on computed tomography (CT) scan assessment. However, the clinical relevance of correcting tilt below this threshold remains unclear. This study aimed to determine whether functional improvement after isolated medial patellofemoral ligament (MPFL) reconstruction is better associated with achieving a postoperative tilt &lt;20° or with the magnitude of tilt correction.&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;A retrospective study was conducted on 182 patients who underwent isolated MPFL reconstruction. Functional outcomes, including International Knee Documentation Committee (IKDC) and Kujala scores, were collected preoperatively and at final follow-up. Patellar tilt was measured on CT scan preoperatively and at 6 months postoperatively, with both contracted and relaxed quadriceps. Patients were analysed according to postoperative tilt thresholds and correction differentials (diffQC and diffQR). Statistical analysis included group comparisons, correlation analyses, analysis of variance across correction categories and generalized linear models.&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;Patellar tilt on CT scan was significantly reduced postoperatively in both contracted and relaxed quadriceps across all groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), with significant improvements in IKDC and Kujala scores at last follow-up (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). No significant differences in IKDC or Kujala scores were observed between patients with postoperative tilt &lt;20° and &gt;20° (all &lt;i&gt;p&lt;/i&gt; &gt; 0.05). No correlation was found between functional outcomes and isolated preoperative or postoperative tilt values. In contrast, greater correction magnitude was significantly associated with improved functional outcomes. A progressive increase in IKDC and Kujala scores was observed with increasing correction, with maximal gains for corrections ≥20°. This relationship was consistent for both contracted and relaxed quadriceps (all &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; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Functional improvement after isolated MPFL reconstruction was more strongly associated with the magnitude of patellar tilt correction than with achieving a specific postoperative tilt threshold. Corrections exceeding 15° in patellar tilt yielded the greatest clinical benefit. These results support an individualized correction-based strategy based on preoperative patellar tilt.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707618","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 combined ACL primary augmentation with autograft reconstruction reduces risk of failure at 3-years follow-up compared to ACL reconstruction?","authors":"Corentin Hercé,&nbsp;Philippe Colombet,&nbsp;Nicolas Bouguennec","doi":"10.1002/jeo2.70886","DOIUrl":"10.1002/jeo2.70886","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Re-rupture after anterior cruciate ligament (ACL) repair is frequent, raising the question of graft integration failure. However, the introduction of new materials and techniques has brought ACL repair back into fashion, especially ACL augmentation using the hamstrings. Purpose To evaluate ACL augmentation, using a hamstring graft, complete remnant conservation and its fixation to the femur, and to compare it with “conventional” ACL reconstruction with a semi-tendinosus graft without anterolateral ligament reconstruction. The re-rupture rate, re-intervention rate, intraoperative data (tunnel size, meniscal lesions, tourniquet time), and post-operative subjective scores (SKV, IKDC, ACL-RSI) at 3 years follow-up were compared for the two techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ACL augmentation was performed in 60 consecutive patients, 47 of whom were evaluated (ACL-A group) (seven excluded for re-rupture and six lost to follow-up). This group was compared with a control group of 63 patients who had undergone “conventional” ACL reconstruction (ACL-R group) with a semi-tendinosus graft without anterolateral ligament reconstruction (three patients were excluded due to re-rupture). Both groups were comparable for sex, age, body mass index, surgical delay, tunnel size and meniscal lesion rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no significant difference between the two groups for clinical outcomes at 3 years follow-up: median scores for ACL-RSI (ACL-A: 75 vs. ACL-R: 72; <i>p</i> = 0.27), IKDC (ACL-A: 90 vs. ACL-R: 86; <i>p</i> = 0.20), Tegner (ACL-A: 7.0 vs. ACL-R: 6.0; <i>p</i> = 0.19) or SKV (ACL-A: 90 vs. ACL-R: 90; <i>p</i> = 0.58). Graft failure rate was also similar at 3 years follow-up (ACL-A: 13.0% vs. ACL-R: 4.8%; <i>p</i> = 0.18), so was complication rate (ACL-A: 16.7% vs. ACL-R: 11.1%; <i>p</i> = 0.44). The ACL-A group had a significantly longer median tourniquet time (42 min) compared to the ACL-R group (35 min) (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ACL augmentation did not improve clinical results, complication rates, or graft failure rate at 3 years post-surgery, despite a longer surgery time and more challenging technique.</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":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707625","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}