Journal of Experimental Orthopaedics最新文献

{"title":"Mid-term performance of a unicompartmental knee prosthesis","authors":"Akbar Nawab,&nbsp;Patricia Bartelt,&nbsp;Ryan Molli,&nbsp;J. Mandume Kerina,&nbsp;Samuel Wellman,&nbsp;Dean Sukin,&nbsp;Stefano Biguzzi,&nbsp;Colleen Nawab,&nbsp;Daniel Hass,&nbsp;Ashton Dukes,&nbsp;Anthony Robins","doi":"10.1002/jeo2.70670","DOIUrl":"10.1002/jeo2.70670","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The objective of this study was to report midterm patient-reported outcomes (PROs) and survivorship of the Medacta MOTO Medial® Unicompartmental prosthesis (<i>Medacta International</i>, <i>Castel San Petro, Switzerland</i>) and surgical technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, multicentre study included 207 adults aged 43–85. Of these, 170 reached 2-year and 90 reached 5-year follow-up. PROs included the forgotten joint score (FJS), Oxford knee score (OKS) and knee injury and osteoarthritis outcome score (KOOS) subscales: Pain, Symptoms, ADL, Sport and QOL. Stress radiographs were divided into three types, quantifying the amount of medial space opening and deformity correction. Data were collected at preoperative, intraoperative, 4 weeks, 6 months, 1-year, 2-year and 5-year. Complications, revisions and Kaplan–Meier survivorship were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All PROs showed statistically significant improvements starting at 6 months and maintained through 5-year. Pre-operative standing full-length x-rays, averaged 6.5° varus. The average change in mechanical axis was less than 1° at 5-year. No difference in PROs was found between patients with (<i>N</i> = 63) and without (<i>N</i> = 27) radiolucencies. Only two cases with radiolucencies progressed to revision. There was one superficial infection and four revisions to the total knee arthroplasty. No thromboembolic, instability or arthrofibrosis complications occurred. Kaplan–Meier survivorship was 98.5% at 2-year and 98.1% at 5-year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Unicompartmental knee replacement with implant system that allows surgical flexibility and independent balancing is a surgical option with promise of excellent functional outcomes, low complication rates and high survivorship (98.1% at 5-year). These results challenge previous studies indicating high revision rates and support the utilisation of unicompartmental arthroplasty for properly indicated patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II, prognostic studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147299956","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":"LARS-augmented hamstring ACL reconstruction shows better early but similar long-term outcomes compared with hamstring autograft alone: A systematic review and meta-analysis","authors":"Panagiotis Antzoulas,&nbsp;Vasileios Giannatos,&nbsp;Andreas Panagopoulos,&nbsp;John Lakoumentas,&nbsp;Vasileios Athanasiou,&nbsp;Antonios Kouzelis,&nbsp;Zinon Kokkalis,&nbsp;Irini Tatani,&nbsp;Spyridon Plesas,&nbsp;John Gliatis","doi":"10.1002/jeo2.70654","DOIUrl":"https://doi.org/10.1002/jeo2.70654","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review aimed to evaluate whether augmenting hamstring autografts with the Ligament Augmentation and Reconstruction System (LARS) during anterior cruciate ligament reconstruction (ACLR) enhances early recovery, improves functional outcomes, and accelerates return to sport (RTS), compared to standard hamstring autografts alone. With increasing emphasis on accelerated rehabilitation, the study seeks to clarify the clinical role of synthetic graft augmentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, a comprehensive systematic review was conducted focusing on ACLR using hamstring autografts augmented with LARS. The protocol was registered on PROSPERO (CRD42024536835). A literature search was performed using PubMed and Scopus databases. Primary outcome was anterior laxity based on KT-1000, while secondary outcomes included the Lysholm score, Tegner activity scale, Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), anterior cruciate ligament-return to sport after injury (ACL-RSI), complication rates, graft failure and RTS. Methodological quality was assessed using the Newcastle–Ottawa Scale. Six studies involving a total of 764 patients met the inclusion criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LARS-augmented ACLR was associated with significantly better early functional outcomes, including higher Lysholm, IKDC and Tegner scores (standardized mean difference [SMD] = 0.83, 0.5 and 0.72, respectively), higher psychological readiness (ACL-RSI) and earlier RTS. KT-1000 measurements showed no statistically significant difference between the hybrid and autograft groups. However, long-term outcome differences between augmented and non-augmented groups were minimal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LARS augmentation in ACLR is a promising technique, supporting early rehabilitation, secure graft stability and timely return to activity, potentially benefiting older individuals or those with higher body mass index (BMI). Selective use of LARS may be advantageous in high-demand patients or early RTS protocols, while future implications could include augmentation in case of suboptimal graft quality.</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 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147288510","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":"Return to sport outcomes after inverted V-shaped (IV) high tibial osteotomy were comparable to those after medial opening-wedge high tibial osteotomy, even though the IV cohort had more severe preoperative disease","authors":"Taku Ebata,&nbsp;Eiji Kondo,&nbsp;Koji Yabuuchi,&nbsp;Koji Iwasaki,&nbsp;Dai Sato,&nbsp;Masatake Matsuoka,&nbsp;Tomohiro Onodera,&nbsp;Kazunori Yasuda,&nbsp;Tomonori Yagi,&nbsp;Norimasa Iwasaki","doi":"10.1002/jeo2.70667","DOIUrl":"10.1002/jeo2.70667","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary aim was to compare return to sport (RTS) outcomes following inverted V-shaped high tibial osteotomy (IV-HTO) versus medial opening-wedge (OW)-HTO for medial knee osteoarthritis (OA). The secondary aim was to compare patient-reported outcomes and radiographic parameters between the procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included patients who underwent HTO for medial knee OA between 2017 and 2022. Inclusion criteria were preoperative sports participation and 2-year follow-up. Patients were allocated to IV-HTO (IV group) or OW-HTO (OW group) according to indications based on the planned correction angle and patellofemoral OA grade. Outcomes were assessed preoperatively and at 2 years. Between-group comparisons used appropriate parametric/nonparametric tests, with <i>p</i> &lt; 0.05 considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 107 patients were analysed (IV group: 54 patients; OW group: 53 patients). Mean age was 58.4 years, body mass index (BMI) 25.6 kg/m² and follow-up 29.5 months. Preoperative femorotibial and patellofemoral Kellgren–Lawrence grades and varus deformity (% mechanical axis) were more severe in the IV group (both <i>p</i> &lt; 0.001). RTS rates were 91% (49/54) in the IV group and 91% (48/53) in the OW group (<i>p</i> = 0.975), with mean time to RTS of 8.4 and 8.8 months, respectively (<i>p</i> = 0.523). Lysholm score and Knee Injury and Osteoarthritis Outcome Score (KOOS) improved significantly in both groups (all <i>p</i> &lt; 0.001), with similar minimal clinically important difference (MCID) responder rates. From preoperative to postoperative assessments, OW-HTO increased posterior tibial slope (9.3 ± 2.3° to 10.2 ± 2.4°, <i>p</i> &lt; 0.001), whole leg length (800 ± 59 to 808 ± 59 mm, <i>p</i> &lt; 0.001) and decreased the Caton–Deschamps ratio (1.03 ± 0.13 to 0.88 ± 0.14, <i>p</i> &lt; 0.001), whereas IV-HTO showed no significant changes (all <i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IV-HTO achieved RTS and patient-reported outcomes comparable to OW-HTO at 2 years in patients with more severe preoperative disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective comparative study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285577","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":"Comparable clinical and functional outcomes between biological and synthetic grafts for medial patellofemoral ligament reconstruction: A systematic review and meta-analysis","authors":"Saran Singh Gill,&nbsp;Pratik Ramkumar,&nbsp;Akash Patel,&nbsp;Fahad Siddique Hossain,&nbsp;Raj R. Thakrar","doi":"10.1002/jeo2.70627","DOIUrl":"10.1002/jeo2.70627","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The medial patellofemoral ligament (MPFL) is an essential static stabiliser of the patella. In patients with patellofemoral dislocations and MPFL damage, surgical intervention is often necessary to restore stability. This typically involves reconstruction using either an autograft, allograft or synthetic graft. This study aimed to evaluate long-term outcomes of biological grafts (autografts and allografts) versus synthetic grafts, by analysing parameters such as stability and complication rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search on Ovid, Medline, Embase, PubMed and Cochrane electronic databases was performed. Studies were included if they enroled adult patients (≥18 years) who had undergone isolated MPFL reconstruction for chronic patellofemoral instability, with a minimum follow-up of 12 months. Data were pooled through meta-analysis using an inverse-variance and mixed-effects model in RStudio to generate standardised mean differences or rate ratios with 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two studies were included in this study, with 1508 patients. 224 were treated with synthetic grafts and 1284 with biological grafts. No statistically significant differences were observed between synthetic and biological grafts across all primary and secondary outcomes: Kujala score (<i>Q</i> = 1.24, <i>p</i> = 0.27), Lysholm score (<i>Q</i> = 1.62, <i>p</i> = 0.20), Tegner score (<i>Q</i> = 0.11, <i>p</i> = 0.74), postoperative complication rate (<i>χ</i>² = 0.0.1, <i>p</i> = 0.94), nor redislocation rates (<i>χ</i>² = 0.34, <i>p</i> = 0.56). These findings indicate comparable functional outcomes and safety profiles for biological versus synthetic grafts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study have shown clinical and functional outcomes to be similar when comparing synthetic and biologic grafts for MPFL reconstruction. These findings support the use of synthetic grafts as a viable alternative in the surgical treatment of chronic patella instability and emphasise the need for a meticulous and informed approach to graft selection for MPFL surgery.</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 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272195","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":"Cartilage thickness at the apex of femoral resections in kinematically aligned total knee arthroplasty is close to 2.5 millimeters","authors":"Saahil Sandhar,&nbsp;Alexander J. Nedopil,&nbsp;Maury L. Hull","doi":"10.1002/jeo2.70641","DOIUrl":"10.1002/jeo2.70641","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Determining the correct resection thickness on worn femoral surfaces in kinematically aligned (KA) total knee arthroplasty (TKA) is uncertain since cartilage thickness is unknown. In the past, a 2 mm fixed adjustment has been used, but this may not reflect cartilage thickness at the apices of resections. Our objectives were to determine apex thickness for each resection based on a new method involving MR images, compare this thickness to direct measurements using calibrated photographs, and determine whether an increase in the 2 mm fixed adjustment is a refinement of interest to an already highly successful surgical procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MR images from 100 knees without evidence of OA were accessed in the Osteoarthritis Initiative (OAI) database. After aligning images in kinematic planes, the apices of the distal and posterior femoral resections were identified, and the apex cartilage thickness was computed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From MR images and calibrated photographs, respectively, apex cartilage thickness was 2.3 mm ± 0.5 mm vs. 2.6 mm ± 0.7 mm for the distal medial resection, 2.3 mm ± 0.4 mm vs. 2.7 mm ± 0.6 mm for the distal lateral resection, 2.4 mm ± 0.5 mm vs. 2.7 mm ± 0.6 mm for the posterior medial resection, and 2.4 mm ± 0.6 mm vs 2.5 mm ± 0.5 mm for the posterior lateral resection. Mean differences were statistically significant (<i>p</i> ≤ 0.0035) except for the posterior lateral cartilage thickness (<i>p</i> = 0.1498).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Apex cartilage thickness for MR image measurements was closer to 2.5 mm than 2 mm for all four resections. Apex cartilage thickness for calibrated photographs was greater than 2.5 mm and was comparable for all four resections. Although unlikely to affect patient-reported outcome measures, a fixed adjustment for worn cartilage on the femur in KA TKA of 2.5 mm is a refinement of interest to bring more patients closer to the ideal alignment.</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 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272252","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 accuracy of artificial intelligence in 3D preoperative planning for total hip arthroplasty: A systematic review and meta-analysis","authors":"Seif B. Altahtamouni,&nbsp;Loay A. Salman,&nbsp;Abdallah Al-Ani,&nbsp;Ghalib Ahmed","doi":"10.1002/jeo2.70427","DOIUrl":"10.1002/jeo2.70427","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review and meta-analysis compare AI-assisted 3-dimensional (3D) preoperative planning in total hip arthroplasty (THA) to traditional 2-dimensional (2D) templating.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Scopus, and Embase were searched from inception until October 2024 for studies on the accuracy of 3D preoperative planning in THA. Statistical analysis was performed using R (v4.3.3) with a random-effects model due to high heterogeneity. Odds ratios with 95% confidence intervals were calculated for dichotomous outcomes. Heterogeneity was assessed using the <i>I</i>² statistic, and publication bias was evaluated through funnel plots and Egger's test. The primary outcome was the accuracy of detecting acetabular cup and femoral stem size. This meta-analysis followed PRISMA guidelines for systematic reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies with 1371 participants from China were analysed. The mean age was 54.48 ± 12.98 years, and the mean BMI was 24.63 ± 3.73 kg/m². The Newcastle–Ottawa Scale (NOS) scores ranged from 6 to 9. The AI model effectively predicted acetabular cup and femoral stem sizes, with an odds ratio (OR) of 3.85 for the exact cup size (95% CI: 2.79–5.32; <i>p</i> &lt; 0.0001) and an OR of 3.49 for predictions within one standard deviation (95% CI: 1.21–10.13; <i>p</i> = 0.0212). Heterogeneity was 42% and 81%, respectively. For the femoral stem, the AI achieved an OR of 3.28 for exact size predictions (95% CI: 2.56–4.22; <i>p</i> &lt; 0.0001) and an OR of 5.35 for size within one standard deviation (95% CI: 3.84–7.45; <i>p</i> &lt; 0.0001), with no significant heterogeneity (<i>I</i>² = 0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis confirms that AI-assisted 3D preoperative planning in THA provides better accuracy for predicting the acetabular cup and femoral stem sizes than traditional 2D templating methods. Further studies with larger sample sizes and more extended follow-up periods across multiple countries are warranted to validate our findings.</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 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272212","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":"Hamstring autografts favour knee extension strength recovery while quadriceps autografts optimise flexion strength recovery: A systematic review of randomised controlled trials","authors":"Maximilian Heinz,&nbsp;Jonathan Lettner,&nbsp;Yasemin Begüm Topkarci,&nbsp;Aleksandra Królikowska,&nbsp;Nikolai Ramadanov,&nbsp;Marko Ostojic,&nbsp;Roland Becker,&nbsp;Robert Prill","doi":"10.1002/jeo2.70665","DOIUrl":"10.1002/jeo2.70665","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Quadriceps tendon (QT), hamstring tendon (HT) and patellar tendon (PT) autografts are the most common grafts for anterior cruciate ligament reconstruction (ACLR). However, the specific impact of graft selection on postoperative knee extension and flexion strength remains controversial. This systematic review analysed randomised controlled trials (RCTs) comparing isokinetic muscle strength outcomes following primary ACLR using QT, HT or PT autografts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted by searching Medline (PubMed), Epistemonikos and ScienceDirect (January 2014–10 May 2025) to identify RCTs that included patients aged ≥16 years undergoing primary, unilateral ACLR using an ipsilateral QT, HT or PT autograft. Studies had to report isokinetic strength outcomes at predefined postoperative intervals (approximately 3, 6, 12 and/or ≥ 24 months) and at one or more angular velocities. The PRISMA guidelines were followed for literature analysis. Two reviewers independently screened, extracted and appraised data using the JBI Checklist for RCTs. A narrative synthesis was performed due to significant clinical and methodological heterogeneity among the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1509 records screened, 13 RCTs met the criteria, encompassing 5 studies using QT, 13 HT and 4 PT. The synthesis revealed distinct recovery patterns: HT autografts showed more favourable recovery of knee extension strength, particularly between 6 and 12 months postoperatively. Conversely, QT autografts consistently resulted in superior recovery of knee flexor strength across all follow-up periods. The results for PT autografts were heterogeneous, showing some short-term advantages but no consistent superiority. Patient-reported outcomes (PROMs) generally improved in all groups, though patterns varied by instrument and time point.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current evidence indicates graft-specific profiles of strength recovery after ACLR, with HT autografts favouring knee extension and QT autografts favouring knee flexion recovery. However, heterogeneity in testing protocols, angular velocities and the reporting of limb symmetry indices limits the strength of these conclusions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228873","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":"Association between discoid lateral meniscus and medial meniscus posterior root tear: A retrospective cohort study","authors":"Ryosuke Yamashita,&nbsp;Yuki Okazaki,&nbsp;Keisuke Kintaka,&nbsp;Koki Kawada,&nbsp;Toshiki Kohara,&nbsp;Takayuki Furumatsu","doi":"10.1002/jeo2.70666","DOIUrl":"10.1002/jeo2.70666","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Medial meniscus (MM) posterior root tear (PRT) has gained increasing attention because of its biomechanical impact and rapid progression to osteoarthritis. Identifying the risk factors for MMPRT is essential for early diagnosis. Although the discoid lateral meniscus (DLM) is a common congenital variant, no studies have reported on the relationship between MMPRT and DLM. This study aimed to examine the relationship between MMPRT and DLM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 94 matched knees that underwent arthroscopic surgery between 2015 and 2021 (58 with MMPRT and 36 with other MM injuries). The matching was performed according to age and sex. Morphological analysis of the lateral meniscus (LM) was performed using coronal magnetic resonance imaging (MRI). DLM was defined as an LM ratio (LM width/tibial width) &gt; 0.20. LM width, LM ratio and DLM prevalence were compared between the two groups. In the MMPRT group, subgroup analysis compared the preoperative and 1-year postoperative clinical outcomes between patients with and without DLM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PRT group showed significantly greater LM width (12.6 ± 3.1 mm vs. 11.1 ± 2.2 mm; <i>p</i> = 0.03) and LM ratio (0.18 ± 0.04 vs. 0.16 ± 0.03; <i>p</i> = 0.01) compared with the other group. The incidence of DLM was also significantly higher in the PRT group (29.3% vs. 8.3%; <i>p</i> = 0.02). No significant differences in clinical scores were observed between the two subgroups either preoperatively or 1 year postoperatively. However, both groups demonstrated significant improvement in all clinical outcomes 1 year postoperatively (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DLM was significantly more prevalent in patients with MMPRT than in those with other MM injuries. Favourable clinical outcomes were achieved following pullout repair in MMPRT knees regardless of the presence of DLM.</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":"13 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228877","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":"Decision-making in return to sport clearance after ACL reconstruction is primarily based on objective criteria: Insights from AGA knee experts","authors":"Philipp W. Winkler,&nbsp;Andrea E. Achtnich,&nbsp;Christian Schoepp,&nbsp;Georg Brandl,&nbsp;Tobias C. Drenck,&nbsp;Johannes Glasbrenner,&nbsp;Christoph Kittl,&nbsp;Gerd Rauch,&nbsp;Thomas Stein,&nbsp;Björn H. Drews,&nbsp;Lukas Willinger","doi":"10.1002/jeo2.70662","DOIUrl":"10.1002/jeo2.70662","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To identify current surgical strategies and objective criteria used for return to sport (RTS) clearance after primary isolated anterior cruciate ligament (ACL) reconstruction, based on a survey of knee surgery experts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey was developed by the ‘Knee Ligament’ committee of the German-speaking Arthroscopy Society (AGA) and distributed to certified ‘AGA Knee Experts’ in November and December 2023. The final questionnaire consisted of 26 questions covering surgical strategies, postoperative evaluation, and RTS clearance after primary isolated ACL reconstruction. Participants were asked to rank objective RTS criteria, and weighted mean ranks were calculated to assess their relative importance (1 = most important, 8 = least important). Data were analysed descriptively to reflect current expert practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 113 board-certified knee surgeons from Germany, Austria, and Switzerland participated in this survey. Hamstring tendon autografts were the preferred graft choice for primary isolated ACL reconstruction (87%), with over half of the respondents (58%) adapting graft selection based on the patient's activity level. RTS testing is routinely performed by 64% of participants. The most frequently used RTS tests are hop tests (93%), assessment of movement quality (59%), and postural stability (56%). The most important objective criteria for RTS clearance were time since ACL reconstruction (mean rank, 2.7), manual clinical examination (mean rank, 2.7), and RTS assessment tools (mean rank, 3.2). Concomitant surgical procedures such as cartilage treatment, meniscus repair, and osteotomies affect RTS clearance. Sport psychological assessment is rarely used (12%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found that knee experts prioritised time since surgery, clinical examination, and RTS assessment tools as the most important criteria for unrestricted RTS clearance after primary isolated ACL reconstruction. RTS clearance is affected by concomitant surgical procedures, whereas psychological assessment remains uncommon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level V.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221324","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":"Malrotated lateral radiographs do not allow for proper assessment of patellar height using the Caton-Deschamps Index","authors":"Moses Kamal Dieter El Kayali,&nbsp;Luis Vincent Bürck,&nbsp;Rosa Berndt,&nbsp;Alan Getgood,&nbsp;Clemens Gwinner,&nbsp;Lorenz Pichler","doi":"10.1002/jeo2.70663","DOIUrl":"10.1002/jeo2.70663","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare patellar height measurement (PHM) using the Caton-Deschamps Index (CDI) on malrotated versus properly positioned lateral knee radiographs within the same patients. It was hypothesised that malrotation would significantly alter CDI values. A secondary aim was to establish an anterior–posterior distance (APD) cut-off for malrotation corresponding to a minimally clinically important difference (MCID) of 0.1 in ΔCDI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective analysis included patients with lateral knee radiographs between January 2020 and March 2023 at a single academic institution. Patients were included if at least two radiographs were available: one with malrotation (APD ≥ 1 mm) and one properly aligned (APD &lt; 1 mm). Radiographs with tilt, prior osseous surgery, or fractures were excluded. Patellar height was measured using the CDI. Inter and intrarater reliability were assessed via intraclass correlation coefficients (ICC). Paired <i>t</i>-tests compared CDI values. Cases with a ΔCDI exceeding the MCID of ≥0.1 were identified. The APD cut-off corresponding to a ΔCDI of 0.1 was determined by regression of ΔCDI on APD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 126 lateral knee radiographs from 63 patients (57% female) were analysed. Inter and intrarater reliability was excellent (ICC &gt; 0.8 for all comparisons). The mean CDI was 0.96 ± 0.06 on properly aligned and 1.03 ± 0.08 on malrotated radiographs, with a significant mean difference of 0.07 ± 0.05 (<i>p</i> &lt; 0.001). In 34.9% of patients, CDI differed by ≥0.1 between imaging conditions. Linear regression of ΔCDI on APD showed a slope of 0.016 per mm (<i>R</i>² = 0.57). The APD cut-off corresponding to a ΔCDI of 0.1 was 6.3 mm (95% CI, 5.7–6.9 mm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Malrotation significantly alters PHM using the CDI on lateral knee radiographs. A clinically relevant difference of ≥0.1 in ΔCDI occurred in over one-third of patients. Malrotated radiographs should be used with caution, and repeat imaging should be considered when CDI values approach clinical decision thresholds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, diagnostic study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214564","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}