Journal of Experimental Orthopaedics最新文献

{"title":"Decreasing utilization of tibial osteotomy and regional disparities: A population-based study of all surgeries in Sweden from 2008 to 2023","authors":"Gustav Nilsson,&nbsp;Viktor Schmidt,&nbsp;Michael Axenhus","doi":"10.1002/jeo2.70386","DOIUrl":"10.1002/jeo2.70386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Tibial osteotomy (TO) is a surgical procedure used to treat unicompartmental gonarthrosis and correct lower extremity deformities. While historically effective, TO utilization has declined, possibly due to advances in alternative procedures such as unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). The aim of this study is to describe and highlight demographic characteristics, trends in utilization and regional variance of TO in Sweden during 2008 to 2023 as well as estimate the usage by 2030.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted using the Swedish National Patient Register, including all TO procedures performed between 1 January 2008 and 31 December 2023. Incidence rates per 100,000 inhabitants were calculated. Statistical analyses included descriptive statistics, Student's <i>t</i> tests for group comparisons, and regression modelling for future incidence trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4729 TO procedures were performed, averaging 296 per year. The overall incidence declined from 5.0 per 100,000 in 2008 to 2.3 in 2023. The decline was greater among men than women, narrowing the sex-based incidence gap. Most TOs were performed in patients aged 45–54 years (35%), followed by 55–64 years (24%). Large regional variations were observed, with regions both over- and underperforming the national average of TOs significantly. Predictive modelling suggests a continued decline, with an estimated incidence of 0.8 per 100,000 by 2030.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TO utilization in Sweden has declined and is estimated to continue decreasing in the future, likely due to increased UKA and TKA adoption. Regional disparities suggest variations in clinical practice and healthcare accessibility. Further research is needed to evaluate indications for TO as well as to establish the role of TO in current knee osteoarthritis management.</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":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712061","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 modified technique for mechanical isolation of stromal vascular fraction yields increased final product volume and high viable nucleated cells count","authors":"Trifon Totlis,&nbsp;Panagiotis-Konstantinos Emfietzis,&nbsp;Argiro Niti,&nbsp;Vlasiοs Achlatis,&nbsp;Lucienne A. Vonk,&nbsp;Ioannis Terzidis,&nbsp;Kokkona Kouzi-Koliakou","doi":"10.1002/jeo2.70378","DOIUrl":"10.1002/jeo2.70378","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Purpose of the present study is to report a modified protocol for stromal vascular fraction (SVF) isolation from abdominal fat, analyse its cellular composition and gene expression profile, and verify the safety and feasibility of the harvesting-preparation technique and subsequent intra-articular knee injection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SVF was obtained after mechanical dissociation of the autologous harvested adipose tissue. It was combined with autologous platelet-rich plasma and subsequently intra-articularly injected into both knees of patients with osteoarthritis. Part of the SVF solution was used to analyse its cellular composition via flow cytometry and its gene expression profile via real-time polymerase chain reaction. Any postinjection complications were documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three patients (10 female; 62.4 ± 8.4 years old) were enrolled. Posttreatment adverse events were mild and spontaneously resolved. Patients needed 3.7 ± 1.3 days for their knee to feel the same as before the injection. No patient provided less than 60 mL of lipoaspirate. Per 1 mL of SVF the total amount of viable nucleated cells was 49.7 ± 22.9 × 10⁶ on average, including 44.5 ± 23.2 × 10⁶ CD90+/CD105+ adipose-derived stem cells, 0.54 ± 0.18 × 10⁶ hematopoietic stem cells, 2.71 ± 1.18 × 10⁶ pericytes and 1.88 ± 0.64 × 10⁶ endothelial cells. The polymerase chain reaction analysis revealed the following average values: Transforming growth factor beta 7.94 ± 3.31; vascular endothelial growth factor 12.43 ± 5.20; interleukin-10 7.54 ± 2.88; octamer-binding transcription factor 3/4 2.65 ± 1.69; interleukin-1 beta 5.45 ± 3.27 and ki-67 6.01 ± 3.65.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A modification of an existing mechanical SVF preparation technique was introduced. The technique was feasible, safe and yielded a substantial volume of SVF (2.5–5 mL). The SVF obtained had a high cellular composition. Age, gender and body mass index (BMI) did not affect the cell count, but elder patients presented a decreased composition in cytokines and growth factors.</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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712062","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":"Poor consideration of tissue loading in randomised trials of MSC interventions for tendon pathology: A systematic review using the TIDieR framework","authors":"Ben Dyck,&nbsp;Chris Clifford,&nbsp;Gordon J. Hendry,&nbsp;Graeme P. Hopper,&nbsp;David F. Hamilton","doi":"10.1002/jeo2.70388","DOIUrl":"10.1002/jeo2.70388","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;Mesenchymal Stem Cell (MSC) interventions are a new frontier in the clinical management of tendon injury. In terms of tissue repair and regeneration, both tendon cells and stem cells are mechanotransductive, i.e. they require mechanical stimulus, it therefore follows that well-structured post-intervention rehabilitation is needed to support MSC interventions and should be well considered in MSC clinical trials. This review evaluates the completeness of reporting of rehabilitation following MSC interventions for tendon pathology in clinical trials.&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 systematic review of randomised controlled trials was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and using the Template for Intervention Description and Replication (TIDieR) framework. We applied a PICO framework to inform our search strategy to find clinical trials that used either bone marrow or adipose-derived MSCs as an intervention on human tendons. Electronic searches were conducted in Medline, PubMed, CINAHL and SPORTDiscus, from inception to May 2024. MeSH terms and Boolean operators were employed, with English language the only filter. Data was extracted to complete the TIDieR checklist separately by three researchers and cross checked by a third to ensure consistency. The Cochrane risk of bias tool 2 was employed to review trial internal validity.&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;The search returned 142 articles. Following removal of duplicates, 118 papers were evaluated against the inclusion criteria. Eight RCTs were included, comprising five in rotator cuff pathology and individual trials in Achilles, gluteal and patellar tendinopathies. Various MSC preparations were utilised and reported, however the accompanying rehabilitation framework was poorly described with a mean TIDieR score of 2.38 ± 2.56 points (of a maximum of 12). The maximum score was 6/12 for a single trial, while 3 scored 0/12. There was large variability in rehabilitation reporting, however ‘why’, and ‘where’ domains were reported in only 1 study, with ‘tailoring’, ‘modifications’, ‘adherence’ and ‘fidelity’ TIDieR domains not reported in any trial. The included studies demonstrate a high risk of bias. Concerns regarding participant randomisation, participant blinding and group allocation were common across the included studies.&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 randomised controlled trials demonstrate a poor standard of reporting of phys","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712112","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":"Combined revision ACL reconstruction with slope-correction osteotomy and lateral extra-articular tenodesis improves stability in patients with high posterior tibial slope and pivot shift","authors":"Jesper Fritz,&nbsp;Alan Getgood,&nbsp;Ronald van Heerwaarden,&nbsp;Sebastien Parratte,&nbsp;Charles Brown,&nbsp;Luke V. Tollefson,&nbsp;Robert F. LaPrade","doi":"10.1002/jeo2.70384","DOIUrl":"10.1002/jeo2.70384","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate the outcomes of patients undergoing single-stage revision anterior cruciate ligament (ACL) reconstruction (ACLR) with bone-patellar tendon-bone (BPTB) autograft, anterior closing wedge proximal tibial osteotomy (ACWPTO) and lateral extra-articular tenodesis (LET).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An institutional review board-approved retrospective study of all patients who underwent a revision ACLR using a BPTB autograft, ACWPTO and LET from a single centre from 2018 to 2023 was performed. Inclusion criteria were patients &gt;18 years of age with a failed ACLR, posterior tibial slope (PTS) of &gt;15°, previous ACL-tunnel diameters of &lt;14 mm, and intact ipsilateral patellar tendon. PTS and anterior tibial translation (ATT) were measured using the mechanical axis on long weight-bearing lateral tibial radiographs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine patients, all men, were evaluated with a mean age of 31.1 years and a mean follow-up of 31.4 months. The PTS significantly decreased from 16.8° (range: 15.1°–18.9°) preoperatively to 9.3° (range: 5.0°–14.7°) post-operatively (<i>p</i> &lt; 0.001) and ATT significantly decreased from 14.6 mm (range: 10.7–19.0 mm) preoperatively to 6.3 mm (range: 1.3–11.5 mm) post-operatively (<i>p </i>&lt; 0.001). Preoperatively, all patients showed significant instability with the Lachman test Grade 2/3 and the pivot shift test Grade 2/3. Post-operatively, Lachman test grade was 0 and Pivot shift test grade was 0 in all patients (<i>p</i> &lt; 0.01), and the average post-operative subjective International Knee Documentation Committee (IKDC) score was 79.4 (range: 60.9–95.4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Single-stage revision ACLR using BPTB autograft, ACWPTO and LET in an ACL-deficient knee with high-grade pivot shift and increased PTS was safe and reliable, with significantly improved clinical and objective outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, case series.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688208","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 medial and lateral meniscus prostheses mimic kinematics of the native meniscus without affecting knee joint motion: A cadaveric study","authors":"Branco S. van Minnen,&nbsp;Alexis R. Sturm,&nbsp;Albert J. van der Veen,&nbsp;Sebastiaan A. W. van de Groes,&nbsp;Nico Verdonschot,&nbsp;Tony G. van Tienen","doi":"10.1002/jeo2.70379","DOIUrl":"10.1002/jeo2.70379","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This exploratory study tested the hypothesis that total medial and lateral meniscus prostheses have no adverse effect on range of motion, kinematics and laxity of the knee joint. Furthermore, it was investigated whether the prosthesis kinematics were similar to the native meniscus kinematics during flexion and under knee loading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A dedicated knee testing rig was used to apply different flexion angles and joint loads to 13 cadaveric knee joints. Roentgen stereophotogrammetric analysis (RSA) was used to analyse the kinematics of the knee joint and the meniscus. For both the medial and lateral compartment, linear mixed models were used to make a comparison between the native condition, the meniscectomized knee joint, a meniscal allograft transplant and the meniscus prosthesis. A Lachman test was simulated to measure the effect of the different meniscal conditions on anteroposterior knee laxity, with and without the anterior cruciate ligament intact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>None of the meniscal conditions restricted range of motion or adversely affected joint kinematics. During flexion and loading, the medial and lateral meniscus prostheses translated over the tibial plateau in a comparable way as the native meniscus, although some differences were identified. Anteroposterior knee laxity was not significantly altered by any of the meniscal conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The artificial medial and lateral meniscus prostheses did not affect knee range of motion. Only minor differences in knee joint and meniscus kinematics were found between the prostheses and the native meniscus, and no effect on joint laxity was found.</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 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687996","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":"Endoscopic versus open surgery for insertional achilles tendinopathy: A systematic review and meta-analysis of comparative outcomes","authors":"Po-Yuan Chen,&nbsp;I-Shiang Tzeng,&nbsp;Kai-Chiang Yang,&nbsp;Chen-Chie Wang","doi":"10.1002/jeo2.70374","DOIUrl":"10.1002/jeo2.70374","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Insertional Achilles tendinopathy (IAT) causes chronic hindfoot pain and functional impairment. Although conservative treatment remains the first-line management approach, surgery is often necessary when nonoperative measures fail. Both open and endoscopic techniques are commonly used, but their comparative efficacy remains debated. Accordingly, this meta-analysis compared surgical outcomes, complications and recovery between open and endoscopic techniques; it also conducted a subgroup analysis to assess return to sports in highly active individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted in PubMed, the Cochrane Library, Scopus, ScienceDirect, Web of Science and Embase (2003–2024). Studies were included if they reported outcomes for open or endoscopic IAT surgery with ≥20 patients and ≥6 months of follow-up. Outcomes included the American Orthopaedic Foot and Ankle Society (AOFAS) scores, time to return to sports, complication rates and additional functional outcome measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-nine studies (1559 patients, 1625 procedures) were included. Mean AOFAS scores improved from 56.07 to 89.17 (<i>p</i> &lt; 0.001), with no significant difference between surgical techniques (<i>p</i> = 0.18). However, endoscopic surgery was associated with a lower complication rate and faster recovery, enabling earlier return to daily activities (6.75 ± 2.25 vs. 22.45 ± 4.74 weeks, <i>p</i> &lt; 0.001) and sports (12.63 ± 2.2 vs. 22.13 ± 7.42 weeks, <i>p</i> &lt; 0.001). Among highly active individuals, endoscopic surgery facilitated return to sports within 12–18 months, whereas open surgery required 20–30 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endoscopic surgery demonstrates a low complication rate and expedited recovery, making it a preferable option for patients requiring an early return to activity. More high-quality studies, such as randomized controlled trials and standardized protocols, are needed to improve surgical decisions and treatment strategies for IAT.</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":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688206","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 role of lateral wall reconstruction in improving surgical outcomes for intertrochanteric femur fractures","authors":"Sanaz Bordbar,&nbsp;Mehdi Komijani,&nbsp;Fereshteh Eidy,&nbsp;Mohammad Hossein Nabian,&nbsp;Leila Zanjani","doi":"10.1002/jeo2.70385","DOIUrl":"10.1002/jeo2.70385","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Intertrochanteric fractures are the most common type of proximal femur fractures, with lateral wall fractures occurring in approximately 33% of cases. This meta-analysis compared the effectiveness of intramedullary fixation methods, specifically the proximal femoral nail (PFN) and the proximal femoral nail anti-rotation (PFNA), to other treatment options.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted using PubMed, Scopus, Web of Science and Embase, following PRISMA guidelines. We included clinical trials on intertrochanteric femur fractures with lateral wall involvement. Random effects models were used to analyze mean differences across treatment methods, with statistical evaluations including <i>I</i>², Cochran's Q, sensitivity analyses, and Egger's test. Additionally, a subgroup analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the initial 1009 results, 10 studies involving 516 patients were included. The surgical methods assessed included PFN/PFNA, PFN with trochanteric buttress plates, screw-augmented PFN, PFNA with a sliding compression plate and InterTan. Blood loss was significantly greater in the experimental models (MD: 31.83, 95% confidence interval [CI]: 0.28–63.38, <i>p</i> &lt; 0.001, <i>I</i>² = 99%). Union time was reduced in the experimental models (MD: −0.60, 95% CI: −0.95 to −0.24, <i>p</i> = 0.18, <i>I</i>² = 42%). The Harris hip score (HHS) was also higher (MD: 7.03, 95% CI: 4.81–9.26, <i>p</i> = 0.74, <i>I</i>² = 0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combining PFN with lateral wall reconstruction techniques may increase blood loss, decrease union times, and improve functional outcomes, suggesting advantages over PFN or PFNA alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The PROSPERO registration number: CRD42024602939.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, systematic review of Level II studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70385","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688207","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":"Isolated tibial deformity is the most prevalent varus pattern in North American patients undergoing medial opening wedge high tibial osteotomy","authors":"Takaaki Hiranaka,&nbsp;Takeo Tokura,&nbsp;Nicola D. Mackay,&nbsp;Ryan M. Degen,&nbsp;Kevin R. Willits,&nbsp;Robert B. Litchfield,&nbsp;Alan M. J. Getgood","doi":"10.1002/jeo2.70357","DOIUrl":"10.1002/jeo2.70357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the location of deformity in varus alignment in a North American population and assess early total knee arthroplasty (TKA) conversion rates and TKA-free survival following medial opening wedge high tibial osteotomy (MOWHTO) based on the bony deformity location.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was performed on patients with varus alignment who underwent MOWHTO. Deformity analysis measured the hip–knee–ankle (HKA) angle, mechanical medial proximal tibial angle (mMPTA) and mechanical lateral distal femoral angle (mLDFA) using automated software. An abnormal mMPTA was defined as &lt;85° and an abnormal mLDFA was defined as &gt;90°. Cases were classified into four groups based on deformity location: tibial, femoral, combined or no bony deformity. The differences in TKA conversion rates among groups were analysed using the chi-square test, while TKA-free survival was determined using Kaplan–Meier survival analysis, with between-group differences assessed using the log-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 271 patients were included (mean age: 51.6 years; mean follow-up: 3.6 years). The mean HKA angle was 173.0° ± 3.1°. Among the 271 patients, 38% (<i>n</i> = 103), 18% (<i>n</i> = 48), 11% (<i>n</i> = 30) and 33% (<i>n</i> = 90) had tibial, femoral, combined and no bony deformity, respectively. TKA conversion rates were 3% (<i>n</i> = 3/103), 0% (<i>n</i> = 0/48), 7% (<i>n</i> = 2/30) and 9% (<i>n</i> = 8/90) for the tibial, femoral, combined and no bony deformity groups, respectively, with no significant difference among the groups (<i>p</i> = 0.080). Kaplan–Meier survival analysis showed no significant difference in TKA-free survival among the four groups (<i>p</i> = 0.185).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this North American cohort, various varus deformity locations were analysed, with isolated tibial deformity being the most prevalent. Regardless of deformity location, TKA conversion rates remained low, suggesting that MOWHTO may be beneficial even in patients without isolated tibial deformity.</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":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688210","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":"Characteristics of gait pelvic jerk in individuals with femoroacetabular impingement syndrome","authors":"Satoshi Machida,&nbsp;Masahiro Tsutsumi,&nbsp;Hajime Utsunomiya,&nbsp;Takuya Ibara,&nbsp;Shintarou Kudo","doi":"10.1002/jeo2.70373","DOIUrl":"10.1002/jeo2.70373","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Despite a consensus on gait kinematic changes caused by femoroacetabular impingement (FAI), the characteristics of kinetic changes in patients with FAI remain unclear. Therefore, this study aimed to investigate whether pelvic jerk, which can be assessed by inertial sensors, can detect kinetic differences between individuals with FAI and asymptomatic controls and the association between pelvic jerk and patient-reported outcome measures in individuals with FAI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty patients with FAI and 30 asymptomatic controls participated in this study. To obtain the pelvic jerk time series, all participants walked 10 m at a self-selected speed using a third lumbar internal sensor. The peak values of the pelvic jerk in the first and second halves of the stance phases (1st- and 2nd-peak pelvic jerks) were also analysed. The patient-reported outcome measures of individuals with FAI were the international hip outcome tool-33, hip outcome score-activities of daily living, and modified Harris hip score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The FAI group showed lower pelvic jerk than the control group in the first (3%–18% gait cycle) and second halves (42%–54%, 57%–67%) of the stance phase based on the statistical parametric mapping analysis (<i>p</i> &lt; 0.05), and also lower peak values corresponding to the respective gait cycles (1st-peak pelvic jerk, <i>p</i> &lt; 0.001; 2nd-peak pelvic jerk, <i>p</i> = 0.002). Multivariate linear regression analysis showed that 1st-peak pelvic jerk was positively associated with all patient-reported outcome measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gait kinetic changes in the FAI group were characterised by reduced 1st- and 2nd-peak pelvic jerks. The reduced 1st-peak pelvic jerk is associated with hip function disability in individuals with FAI. Pelvic jerk may be a simple and quantitative indicator of FAI, although the relevance of this metric must be confirmed in the future studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, case–control study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687995","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":"Preoperative activity, postoperative flexion contractures, and degree of medial cartilage damage affects achievement of high physical activity after open wedge high tibial osteotomy","authors":"Fumiyoshi Kawashima,&nbsp;Jun Oike,&nbsp;Kazuyuki Segami,&nbsp;Koji Kanzaki","doi":"10.1002/jeo2.70372","DOIUrl":"10.1002/jeo2.70372","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate factors that affect return to physical activities after open wedge high tibial osteotomy (OWHTO), and to determine whether an optimal correction angle exists for return to physical activities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with medial osteoarthritis of the knee who underwent OWHTO at our institution were evaluated. Radiographic evaluations were performed using bilateral weight bearing long leg radiographs. The clinical evaluation consisted of the Tegner activity scale, the Knee Injury and Osteoarthritis Outcome Score (KOOS) Sports/Rec subscore, and the presence of residual flexion contracture of 10° or more in unstable hinge fractures. In addition, the degree of cartilage damage in the medial compartment was evaluated via arthroscopic surgical findings according to the ICRS classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients (70 knees; 25 males and 45 females; mean age, 55.2 [32–75] years; mean follow-up, 8.5 [3.8–12.4] years) were included in the study. The preoperative alignment defined by mean WBLR (%) was significantly higher in the Return to High Physical Activity Group (H Group: 31.0 ± 18.6) than the Return to Low Physical Activity Group (L Group: 15.9 ± 13.9). Logistic analysis showed that low preoperative WBLR and the absence of severe cartilage damage to the medial compartment, postoperative flexion contracture, and unstable hinge fracture were factors affecting return to sport. In addition, the cutoff values using the Youden Index based on ROC analysis were preoperative Tegner activity score of 4.0 and preoperative KOOS (Sports/Rec) of 35.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative KOOS (Sports/Rec) was a useful index for predicting postoperative return to high physical activities. Depending on the degree of arthroscopic cartilage damage, the under-collection of cases with severe cartilage damage should be avoided.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, retrospective case series.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688209","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}