Journal of Experimental Orthopaedics最新文献

{"title":"Instrumented gait analysis post-anterior cruciate ligament reconstruction in pediatric patients: A non-invasive method for quantifying the static and dynamic leg axis","authors":"Leonie Kijewski, Eva Böker, Karoline Hofmann, Thomas Engel, Pierre Hepp, Maren Witt","doi":"10.1002/jeo2.70320","DOIUrl":"https://doi.org/10.1002/jeo2.70320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study explores the potential of Instrumented gait analysis (IGA) as a non-invasive tool for monitoring rehabilitation in pediatric patients with anterior cruciate ligament (ACL) injuries. Current clinical assessments, such as physical exams and X-rays, have limitations in evaluating dynamic knee alignment and loading. IGA may offer a more precise method to track rehabilitation progress and detect altered gait biomechanics following ACL reconstruction (ACLR). We hypothesize that IGA can provide insights into differences in frontal knee alignment and mechanical loading between static and dynamic conditions in pediatric patients following ACLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>IGA was conducted on 18 patients (mean age: 15 ± 2 years) at 3 and 12 months following ACLR, and seven conservatively treated patients (mean age: 12 ± 3) at 12 months post-injury. Retroreflective markers were placed using the CAST lower body model. The gait was recorded in 3D using 12 infrared and two video cameras. Ground reaction forces were measured with force plates. Frontal knee alignment was assessed from kinematic data at four gait events: double-limb stance, initial contact, loading response, and mid-stance, identified by C-Motion Visual3D Professional. Frontal knee joint moments were calculated based on inverse kinematic and dynamic in Newton-meters per kilogram (Nm/kg) at the specified gait events. Repeated-measures ANOVA was used to compare frontal knee alignment between static and dynamic conditions, while paired t-tests assessed differences between injured and uninjured extremities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the surgical group, a significant increase in body height occurred between 3 and 12 months (<i>p</i> = 0.001) without notable changes in the static or dynamic frontal axis (<i>p</i> > 0.05). At 12 months post-surgery, mean frontal knee alignment differed significantly between gait events (<i>p</i> < 0.001), showing a transition from valgus during stance to a nearly neutral axis during loading response. A significant difference was observed at initial contact, where the affected leg remained in greater valgus than the unaffected side (<i>p</i> = 0.026). Joint moments showed no significant differences between the healthy and affected sides (<i>p</i> > 0.05). No significant differences were found between the surgical and conservative groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study suggest that IGA can detect dynamic alignment deviations, suppo","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514590","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":"Meniscal centralization significantly improve clinical outcomes and reduce meniscal extrusion with minimal complications: A systematic review","authors":"Alessandro Carrozzo,&nbsp;Francesco Bosco,&nbsp;Leandro Ramazzini,&nbsp;Fortunato Giustra,&nbsp;Virginia Masoni,&nbsp;Marcello Capella,&nbsp;Michele Malavolta,&nbsp;Jae-Sung An,&nbsp;Hideyuki Koga","doi":"10.1002/jeo2.70308","DOIUrl":"https://doi.org/10.1002/jeo2.70308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Meniscal extrusion alters joint biomechanics and accelerates cartilage degeneration, contributing to the progression of knee osteoarthritis (OA). Meniscal centralization techniques aim to reposition the meniscus, addressing extrusion and restoring load distribution. This systematic review aims to evaluate meniscal centralization's clinical and radiological outcomes, hypothesizing its efficacy in treating symptomatic meniscal extrusion with minimal complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD42023484353). Literature searches were conducted in PubMed, Science Direct and Scopus. Studies reporting clinical and/or radiological outcomes of meniscal centralization with ≥24 months of follow-up were included. Data on demographics, surgical techniques, patient-reported outcome measures (PROMs), imaging findings and complications were extracted. Methodological quality was assessed using the ROBINS-I tool, and heterogeneity was evaluated via the <i>I</i>² statistic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four studies (113 patients, mean follow-up: 24–35 months) met inclusion criteria. Arthroscopic meniscal centralization with suture anchors significantly improved PROMs, including International Knee Documentation Committee (IKDC), Lysholm and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores, demonstrating symptom relief and functional recovery. Lysholm scores improved from 46.0 to 96.5, KOOS pain from 47.4 to 88.9, and IKDC from 51.8 to 75.8 (<i>p</i> &lt; 0.05 for all). Imaging showed reduced meniscal extrusion and improved joint space width. Complications were minimal, though one study reported a 26.9% failure rate due to incomplete healing and OA progression. Rehabilitation protocols allowed return to full activity within 4–6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Meniscal centralization effectively reduces extrusion, improves clinical outcomes, and restores knee function with minimal complications. However, further long-term and comparative studies are needed to validate these findings and refine surgical indications.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292585","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":"Indications and outcomes in bi-unicondylar knee arthroplasty: A systematic review","authors":"Luca Bertolino,&nbsp;Alberto Favaro,&nbsp;Francesco Iacono,&nbsp;Maurilio Marcacci,&nbsp;Tommaso Bonanzinga","doi":"10.1002/jeo2.70266","DOIUrl":"https://doi.org/10.1002/jeo2.70266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this systematic review is to analyze and provide an overview of the indications, contraindications and the clinical outcomes to bi-unicondylar knee arthroplasty (Bi-UKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search was conducted to identify original studies written in English reporting indication criteria or clinical outcomes on Bi-UKA) performed simultaneously or at two different stages. Studies reporting patellofemoral implants with medial or lateral implants, ex-vivo or cadaveric studies were excluded. The study was carried out in accordance with PRISMA guidelines, with the search covering studies up to February 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The literature search identified 783 articles, nine of which were included in this review. A total of 343 patients were identified, of which 257 patients underwent bi-UKA. Medial and lateral osteoarthritis (OA) are the main indications for Bi-UKA. The condition of the anterior cruciate ligament (ACL) was taken into consideration by eight studies and 49 patients (19.02%) presenting functional or macroscopic intact ACL were eligible for Bi-UKA. Age was considered as an eligibility criterion in one study alone. In all studies, Bi-UKA led to the improvement of clinical scores compared to their pre-operative values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both staged and simultaneous Bi-UKA are viable options to treat knee osteoarthritis. However, further research is needed to better investigate bi-UKA.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292584","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 novel meniscal root refixation pull-in technique with an all-suture anchor shows biomechanical properties comparable to standard suture anchor and transtibial pull-out techniques","authors":"Thorben Briese,&nbsp;Amaris Kieninger,&nbsp;Christian Peez,&nbsp;Adrian Deichsel,&nbsp;Elmar Herbst,&nbsp;Maurice Balke,&nbsp;Michael J. Raschke,&nbsp;Christoph Kittl","doi":"10.1002/jeo2.70310","DOIUrl":"https://doi.org/10.1002/jeo2.70310","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;Repair techniques for posterior meniscal root (PMMR) tears include repair with transtibial pull-out and anchors. An alternative approach uses all-suture anchors pulled in, avoiding a posterior medial portal. While clinical feasibility has been assessed, biomechanical properties of this technique remain unknown. We hypothesised that the biomechanical properties using the pull-in technique would be comparable to those achieved with conventional repair techniques.&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;Fifty fresh-frozen porcine tibiae were fixed in a steel pot. Whereas in group (1) the native meniscal root was kept intact (native meniscal root (NM)), the PMMR was sectioned and refixed in groups (2)–(5): (2) Double-loaded suture anchor (screw anchor) (SA), (3) transtibial pull-out repair with two sutures (TTPO), (4) double-loaded pull-in repair with all-suture anchor that was pulled into the subcortical bone which was predrilled from retrograde direction (PULL) and (5) double-loaded push-in repair with all-suture anchor traditionally pushed into the predrilled subcortical bone in antegrade direction (PUSH). Testing was performed using a universal testing machine with 1000 cycles (5–20 N/0.5 Hz) with subsequent load-to-failure (LTF) meaning failure of the NM or refixation. Outcomes measured included LTF (N), cyclic displacement (mm), and stiffness (N/mm). The failure mode was documented macroscopically.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Controlled laboratory study.&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 repair technique restored the stability of the NM, reaching 1064.6 ± 226.0 N in LTF (&lt;i&gt;p&lt;/i&gt; ≤ 0.0001). Reconstructions had significantly lower LTF: SA (251.4 ± 52.8 N), TTPO (233.4 ± 50.0 N), PULL (206.2 ± 86.5 N) and PUSH (214.3 ± 55.2 N). The NM showed the highest stiffness with 156.1 ± 76.3 N/mm (&lt;i&gt;p&lt;/i&gt; ≤ .0001) compared to (SA) 36.2 ± 10.1 N/mm, (TTPO) 33.6 ± 6.2 N/mm, (PULL) 36.8 ± 12.7 N/mm, (PUSH) 27.7 ± 6.6 N/mm. Increased displacement after 1000 cycles was shown, with (2.3 ± 0.7 mm) in PULL, only with significant differences noted between NM (1.5 ± 0.8 mm) and PUSH (3.1 ± 0.7 mm) (&lt;i&gt;p&lt;/i&gt; ≤ .001), NM and SA (2.5 ± 0.8 mm) (&lt;i&gt;p&lt;/i&gt; ≤ .05), and TTPO (2.1 ± 0.7 mm) and PUSH (&lt;i&gt;p&lt;/i&gt; ≤ .05). No failures occurred during cyclic loading. Failure after LTF was always a suture cut-out at the meniscus.&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;Current repair techniques f","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292581","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":"Tibio-tarsal arthrodesis in Italy: Results from an epidemiological 16-year nationwide study","authors":"Umile Giuseppe Longo,&nbsp;Rocco Papalia,&nbsp;Alessandro Mazzola,&nbsp;Alessandra Corradini,&nbsp;Alessandro De Sire,&nbsp;Pieter D'Hooghe,&nbsp;Ilaria Piergentili,&nbsp;Kristian Samuelsson,&nbsp;Stefano Zaffagnini,&nbsp;Vincenzo Denaro","doi":"10.1002/jeo2.70302","DOIUrl":"https://doi.org/10.1002/jeo2.70302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The goal of this study was to assess the annual incidence of tibiotarsal arthrodesis in Italy and the epidemiological characteristics of patients requiring surgery. A secondary aim was to assess the economic impact of this type of surgery on the healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The analysis was conducted by using the National Hospital Discharge Records (NHDR) database provided by the Italian Ministry of Health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>8380 tibiotarsal arthrodeses were performed in Italy. One procedure per 100,000 adult Italians was the cumulative incidence. The age group of 60–64 years required the highest number of procedures. Males represented the majority of patients undergoing surgery (59.6%). The median length of hospital stay was 7.3 ± 10.8 days. On average, older patients had more days of hospitalization. Main primary diagnosis codes according to the ICD-9-CM were: 715.27 (17.5%); 905.4 (15.8%); 715.17 (11.7%); 716.17 (5.1%); 733.82 (3.9%); 718.47 (3.4%). The admission reimbursement in Italy ranges from 1887€ to 4405€ depending on the length of stay. In 16 years, a total expenditure of 36,803,844€ was projected. The procedure in Italy costed an average of 2,300,240 ± 373,514€ per year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The socioeconomic impact of tibiotarsal arthrodesis in Italy is relevant. Between 2001 and 2016, the frequency of this procedure progressively rose. Patients undergoing surgery in Italy are mainly men, still active and part of the working population. Nationwide epidemiologic studies are useful to understand the present and future development of the management of ankle diseases.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292582","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":"High survivorship and excellent functional outcome in third-generation patellofemoral arthroplasty","authors":"Mustafa Hariri,&nbsp;Hannah Schwab,&nbsp;Kevin-Arno Koch,&nbsp;Paul Mick,&nbsp;Timo Nees,&nbsp;Johannes Weishorn,&nbsp;Tilman Walker,&nbsp;Tobias Reiner","doi":"10.1002/jeo2.70287","DOIUrl":"https://doi.org/10.1002/jeo2.70287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study presents the short- to mid-term implant survival rates, along with the clinical and radiographic outcomes, in a consecutive series of patients who underwent third-generation patellofemoral arthroplasty (PFA) at a non-designer centre. Additionally, it explores the impact of prior surgery on clinical outcomes following PFA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of prospectively collected data was conducted for 27 PFAs performed in 23 patients between 2016 and 2023 using the Gender Solutions® Patello-Femoral Joint System. Patients had a mean follow-up of 4.3 years, with clinical assessments including the Oxford Knee Score (OKS), Visual Analogue Scale (VAS), Forgotten Joint Score (FJS), and activity levels (TAS, UCLA). Implant survivorship was analysed using Kaplan-Meier estimators, with endpoints of revision and reoperation</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age at time of surgery was 51.7 ± 10.5 years, with 92.6% of patients being women. The mean body mass index (BMI) was 28.3 ± 4.5. The 5-year implant survival rate was 100% for revisions and 96.3% for reoperations. Statistically significant improvements were observed in OKS (24.7 ± 8.0 to 39.2 ± 8.3, <i>p</i> &lt; 0.001), VAS (7.1 ± 2.3 to 2.3 ± 2.8, <i>p</i> &lt; 0.001) and range of motion (ROM) (122.1° ± 17° to 134.7° ± 6.8°, <i>p</i> = 0.007). Over 85% of patients achieved good to excellent OKS scores, with 92.3% reporting satisfaction. Patients with prior surgery on the affected knee showed higher satisfaction and greater ROM improvement. Obesity was associated with minor reductions in ROM but did not significantly impact overall outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The short- to mid-term results following third-generation PFA demonstrated high survivorship and excellent clinical outcomes in an independent series. Prior surgery and obesity were not associated with poorer clinical outcomes, supporting the consideration of PFA for these patients when appropriately indicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292583","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":"Increased implant thickness in mechanically aligned off-the-shelf total knee replacement compared to bone resection","authors":"Filippo Calanna,&nbsp;Riccardo Compagnoni,&nbsp;Luca Tanel,&nbsp;Alessandra Menon,&nbsp;Alessio Maione,&nbsp;Carlo Minoli,&nbsp;Paolo Ferrua,&nbsp;Pietro Simone Randelli","doi":"10.1002/jeo2.70307","DOIUrl":"https://doi.org/10.1002/jeo2.70307","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Total knee arthroplasty (TKA) with mechanical alignment (MA) aims to align the leg neutrally, optimising stability and load distribution. To achieve this, bone cuts are performed, modifying the constitutional alignment of the knee and determining a mismatch between the implant thickness and the bone resection across the various compartments of the knee (bone–implant mismatch). This study aims to quantify the bone–implant mismatch in TKA with MA using an off-the-shelf implant and investigate how this ratio is influenced by the preoperative coronal knee alignment phenotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 100 patients who underwent primary off-the-shelf TKA with MA with a medial pivot design implant from January 2021 to September 2023 were analysed. Preoperative alignment phenotype was determined via long-leg weightbearing radiographs. During surgery, bone resections were measured with a caliper for each compartment. Bone–implant mismatch was determined for each compartment, analysing differences between medial and lateral compartments and the influence of preoperative alignment phenotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall implant thickness was 14.2% greater than the bone resection. In the patello-femoral compartment the implant thickness was 16.0% ± 19.0 less than the bone resection. Bone-implant mismatch was observed in the tibio-femoral joint across all the compartments with a significant difference between medial and lateral (<i>p</i> &lt; 0.001). No significant differences in bone–implant mismatch were found based on preoperative alignment phenotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In mechanically aligned off-the-shelf TKA, implant thickness exceeds bone resection by an average of 14.2%, with a consistent bone–implant mismatch observed in all tibiofemoral compartments—significantly greater medially than laterally. Conversely, in the patellofemoral joint, bone resection surpasses implant thickness. Preoperative coronal alignment phenotype does not significantly influence this mismatch. These findings highlight a systematic discrepancy between bone resections and implant geometry, suggesting potential benefits from adjusted surgical techniques or implant design modifications to improve anatomical congruence and joint kinematics.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264573","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":"Growth differentiation factor 5 improves meniscal healing in a pilot study on rats","authors":"David Mazy,&nbsp;Nathaniel Léveillé,&nbsp;Line Séguy,&nbsp;Irene Londono,&nbsp;Florina Moldovan,&nbsp;Marie-Lyne Nault","doi":"10.1002/jeo2.70309","DOIUrl":"https://doi.org/10.1002/jeo2.70309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Meniscus injuries are common, but failed repairs remain an issue. The aim of this study was to demonstrate, in an in vivo rat model, the ability of growth differentiation factor 5 (GDF5) to improve meniscal tear healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight Lewis rats (four females and four males) underwent radial tear of the medial meniscus on the right knee. There were two post-operative treatments: the GDF5 group (<i>n</i> = 4) received 0.1 mg/mL of GDF5, and the saline group (<i>n</i> = 4) a saline injection. The eight left knees were the control without surgery. Sacrifice was six weeks post-operatively. The GDF5 and saline groups were compared according to histology and meniscus healing score (MHS) in different zones: red-red (R-R), red-white (R-W) and white-white (W-W).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the R-R zone, the median [interquartile range, IQR] MHS was 2.5 [2–3] in the GDF5 group and 2 [1.25–2] in the saline group (<i>p</i> = 0.200), and in the W-R zone it was 2 [2–2.75] for GDF5 and 1 [1–1.75] for saline (<i>p</i> = 0.047). There was no difference in the W-W zone (median MHS under one; <i>p</i> = 0.686). Regardless of groups, median [IQR] MHS in R-R (2 [2–2.75]) and R-W zones (2 [1–2]) were significantly higher (<i>p</i> &lt; 0.001) than in the W-W zone (0 [0–1]). MHS intraclass correlation coefficient inter-observer was 0.88 and intra-observer was 0.90.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GDF5 increases meniscal healing, especially in the R-W zone, although the W-W zone remains challenging. GFD5 is a promising factor for improving meniscus healing. The small sample size and absence of biomechanical evaluation are limitations that warrant caution when interpreting these findings. Further studies with larger sample sizes in larger animal models, combined with meniscal repair, are required to confirm these preliminary results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Animal laboratory study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V, animal study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264574","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":"ACL Pacinian mechanoreceptors: Conceptualizing a vasoregulatory microtrauma healing function","authors":"John Nyland,&nbsp;Jacob Williamson,&nbsp;Jonathon Lewis,&nbsp;Brandon Pyle,&nbsp;Jarod Richards,&nbsp;Ryan Krupp","doi":"10.1002/jeo2.70305","DOIUrl":"https://doi.org/10.1002/jeo2.70305","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Improved understanding of important natural anterior cruciate ligament (ACL) tissue functions may strengthen the case for their preservation. This commentary revisits human and comparative animal research studies of Pacinian mechanoreceptor histology, morphology and function, including those near the native proximal ACL and relates these findings to accumulated microtrauma healing and graft remodelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the PubMed, Google Scholar and Web of Science databases, the medical literature was searched for peer-reviewed information related to ACL morphology, knee joint circulation, ligament neuropeptides and vasoregulation, autonomic nervous system vasoregulation, Pacinian mechanoreceptors, ACL remodelling and nutrition, and psychological stressors and vasoregulation. Information from these searches was then synthesized into a conceptualization of a possible Pacinian mechanoreceptor role in primary ACL microtrauma healing and post-surgical repair or reconstruction tissue remodelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In association with autonomic nervous system function, Pacinian mechanoreceptors in the ACL may serve an important vasoregulatory function in addition to proprioception.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pacinian mechanoreceptor-mediated vasoregulation may be important for post-sport performance or exercise training during primary ACL healing from accumulated microtrauma. Proximal remnant preservation during ACL reconstruction or repair may facilitate the angiogenic and neurogenic processes that drive native tissue and graft remodelling. Experimental and clinical studies are needed to confirm these concepts.</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":"12 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264572","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 description, measurement with inter- and intra-observer reliability of calcaneal tunnel placement for tendon transfer in Achilles tendon reconstruction","authors":"Michael R. Carmont,&nbsp;Tor Kristian Andresen,&nbsp;Fraser Morgan,&nbsp;Katarina Nilsson-Helander,&nbsp;Elisabeth Ellingsen Husebye","doi":"10.1002/jeo2.70223","DOIUrl":"https://doi.org/10.1002/jeo2.70223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>A tendon transfer is a common method of treating ankle plantar flexion weakness and tendon end non-union following chronic Achilles tendon rupture and delayed representation following Achilles tendon re-rupture. Commonly, the transferred tendon is fixed into a bone tunnel on the postero-superior surface of the calcaneum close to the distal Achilles tendon insertion. To date, there is no standardised description or measurement of calcaneal tunnel position. The aim of this study is to describe the anatomic location for calcaneal tunnel placement and to determine the reliability of a method of measuring tunnel position and direction within the calcaneum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The routine post-operative lateral ankle radiographs from 40 patients (40 ft) following Achilles tendon reconstruction using tendon transfer into the calcaneum: calcaneal tunnel zone (CTZ), calcaneal tunnel ratio (CTR) and calcaneal tunnel angle (CTA) were tested for reliability using test-retest between three observers. Additionally, CTR and CTA were compared in cases where a calcaneoplasty was performed or not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intraclass correlation coefficient (ICC) of the CTR and CTA was found to be 0.86–0.95 (95% confidence interval [CI]: 0.75-0.98) and 0.95–0.99 (95% CI: 0.92–0.99), respectively, indicating good and excellent reliability. Patients who received a calcaneoplasty had a significantly greater CTR of 0.74 (0.1) and a lower CTA of 76.1° (10.8) compared to those who did not have a CTR of 0.61 (0.1) and 100.9 (12.4), Diff 95% CI: 0.13 (0.08–0.18) and −25 (−32 to −17), respectively, both <i>p</i> &lt; 0.001.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CTR and CTA were reliable measures for the calcaneal tunnel following Achilles tendon reconstruction using tendon transfer within the limitations of the sagittal radiographic view. When a calcaneoplasty was performed, it resulted in a significantly greater CTR. These measurements should be used to describe calcaneal tunnels rather than a description of tunnel placement to optimise predictive factors following Achilles tendon reconstruction.</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 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264512","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}