Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Periarticular Versus Intravenous Corticosteroids in Total Knee Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Ralph Maroun, Mohammad Daher, Jonathan Liu, Alan H Daniels, Thomas J Barrett, Mouhanad M El-Othmani","doi":"10.22038/ABJS.2025.84324.3834","DOIUrl":"10.22038/ABJS.2025.84324.3834","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the extensive research revolving around total knee arthroplasty (TKA), the optimal steroid administration route remains unclear. This study aimed to compare the clinical efficacy of intravenous (IV) to periarticular (PA) steroid administration in TKA.</p><p><strong>Methods: </strong>Embase, PubMed, Cochrane, and Google Scholar were searched till April 2024 for randomized controlled trials (RCT) comparing IV to PA steroids in TKA. Each trial was assessed using the Cochrane risk-of-bias tool and classified as having a High, Low, or Unclear risk of bias. The clinical outcomes of interest were post-operative pain (reported as the Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS)), vomiting, post-operative range of motion (reported as knee flexion angle), post-operative IL-6 and CRP, and glucose levels. Post-operative complications such as surgical site or deep infections, and wound dehiscence following TKA were also recorded and assessed.</p><p><strong>Results: </strong>Five RCTs with a total of 501 patients were included in this review. There were no significant differences in pain at rest on post-operative day (POD) 1 and 2 and during activity between PA and IV administration, while pain at rest on POD 3 was lower in the PA group (I2 =38% SMD=-0.27; 95% CI: -0.5, -0.04, P=0.02). Post-operative complications, knee flexion, and laboratory values such as IL-6, CPR, and glucose showed no significant difference between the groups, while vomiting rates were significantly higher in the PA group (I2= 0% OR=2.43; 95% CI: 1.36-4.35, P=0.003).</p><p><strong>Conclusion: </strong>PA and IV peri-operative administration of glucocorticoids in TKA have similar clinical outcomes in inflammation reduction, knee flexion function, adverse event rates, and post-operative pain at rest during the first 48 hours post-operatively and at activity, while the PA group is associated with lower pain at rest on POD 3 and a higher rate of post-operative vomiting.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 5","pages":"237-248"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592603","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":"Structural Failure After Acromioclavicular Joint Reconstruction: Factors Affecting Clinical Outcomes.","authors":"Benjamin Read Campbell, Omar Sarhan, Ryan Lopez, Hamd Mahmood, Cassandra Sanko, Surena Namdari","doi":"10.22038/ABJS.2025.88607.4017","DOIUrl":"10.22038/ABJS.2025.88607.4017","url":null,"abstract":"<p><strong>Objectives: </strong>Management of acromioclavicular (AC) joint injuries remains controversial regarding ideal surgical indications and technique. While loss of reduction following AC reconstruction is common, its relationship to clinical outcomes is uncertain. The purpose of this study was to evaluate outcomes and potential predictors of suboptimal results in patients with structural failure following AC reconstruction.</p><p><strong>Methods: </strong>Patients with structural failure following AC reconstruction from 2013-2019 were identified, defined as 50% loss of coronal AC joint reduction between immediate and final postoperative radiographs. Failures were categorized by degree of displacement and mechanism, which included traumatic reinjury versus spontaneous subsidence of AC reduction. Suboptimal clinical outcomes were defined as undergoing reoperation or postoperative American Shoulder and Elbow Surgeons (ASES) score less than 80. Bivariate analyses were performed to identify risk factors for suboptimal clinical results and compare outcomes between operative versus nonoperative management of structural failure.</p><p><strong>Results: </strong>Twenty-nine patients were evaluated with mean follow-up of 7.4 years (range 4.0-10.5 years). 21% underwent revision surgery (n = 6) and 79% were treated nonoperatively (n = 23). Mean postoperative ASES, Numerical Rating Scale (NRS), and Single Assessment Numeric Evaluation (SANE) scores at final follow-up were 82 +/- 20 (range 33-100), 1.6 +/- 2.2 (range 0-7), and 82 +/- 20 (range 22-100) respectively. 41% of the total cohort (n = 12) had a suboptimal clinical result. On bivariate analysis, structural failure following acute reinjury was associated with suboptimal clinical outcomes (50% vs 6%, p = 0.011) and a higher likelihood of reoperation (67% vs 13%, p = 0.018).</p><p><strong>Conclusion: </strong>Structural failures of AC reconstruction following an acute injury are more likely to experience suboptimal clinical outcomes and undergo reoperation compared to spontaneous loss of reduction. Larger analyses are warranted to determine if there are additional factors which may affect outcomes and guide management in these clinical scenarios.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 12","pages":"807-815"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935101","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":"Reliability of Image J. Software to Evaluate the Craniovertebral Angle in Participants with and without Neck Pain.","authors":"Fatemeh Binaei, Amir Hossein Kahlaee, Mohammad Ali Mohseni Bandpei, Nahid Rahmani, Cyrus Taghizadeh Delkhoush, Mohammad Saatchi, Hamidreza Goudarzi","doi":"10.22038/ABJS.2025.86598.3935","DOIUrl":"10.22038/ABJS.2025.86598.3935","url":null,"abstract":"<p><strong>Objectives: </strong>Forward head posture (FHP) is one of the most common postural disorders affecting the head and neck region, typically assessed by measuring the craniovertebral angle (CVA). Selecting an appropriate tool for quantifying this angle is crucial. The primary aim of the present study was to evaluate the reliability of ImageJ software in assessing the CVA in participants with and without neck pain.</p><p><strong>Methods: </strong>The study included twenty participants with neck pain and twenty without. Reflective markers were placed on the tragus of the ear and the spinous process of C7. Three lateral images were captured from the dominant side while the participants were seated, with measurements taken at two-hour and one-week intervals. The craniovertebral angle (CVA) was then analyzed using ImageJ software.</p><p><strong>Results: </strong>The Intraclass Correlation Coefficient (ICC) values for both within-day and between-day reliability in both groups ranged from 0.89 to 0.94. The Standard Error of Measurement (SEM) ranged from 0.92° to 1.02°, while the Minimal Detectable Change (MDC) values ranged from 2.56° to 2.84°. Furthermore, the absolute Technical Error of Measurement (TEM) ranged from 0.91° to 1.06°, and the relative TEM (rTEM) ranged from 2.13% to 2.42%.</p><p><strong>Conclusion: </strong>ImageJ software appears to be a suitable tool for assessing the craniovertebral angle (CVA) in individuals with or without neck pain, demonstrating good to excellent reliability.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 12","pages":"849-856"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935155","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":"From Algorithms to Academia: An Endeavor to Benchmark AI-Generated Scientific Papers against Human Standards.","authors":"Jackson Woodrow, Nour Nassour, John Y Kwon, Soheil Ashkani-Esfahani, Mitchel Harris","doi":"10.22038/ABJS.2024.80093.3669","DOIUrl":"https://doi.org/10.22038/ABJS.2024.80093.3669","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to quantitatively investigate the accuracy of text generated by AI large language models while comparing their readability and likelihood of being accepted to a scientific compared to human-authored papers on the same topics.</p><p><strong>Methods: </strong>The study consisted of two papers written by ChatGPT, two papers written by Assistant by scite, and two papers written by humans. A total of six independent reviewers were blinded to the authorship of each paper and assigned a grade to each subsection on a scale of 1 to 4. Additionally, each reviewer was asked to guess if the paper was written by a human or AI and explain their reasoning. The study authors also graded each AI-generated paper based on factual accuracy of the claims and citations.</p><p><strong>Results: </strong>The human-written calcaneus fracture paper received the highest score of a 3.70/4, followed by Assistant-written calcaneus fracture paper (3.02/4), human-written ankle osteoarthritis paper (2.98/4), ChatGPT calcaneus fracture (2.89/4), ChatGPT Ankle Osteoarthritis (2.87/4), and Assistant Ankle Osteoarthritis (2.78/4). The human calcaneus fracture paper received a statistically significant higher rating than the ChatGPT calcaneus fracture paper (P = 0.028) and the Assistant calcaneus fracture paper (P = 0.043). The ChatGPT osteoarthritis review showed 100% factual accuracy, the ChatGPT calcaneus fracture review was 97.46% factually accurate, the Assistant calcaneus fracture was 95.56% accurate, and the Assistant ankle osteoarthritis was 94.98% accurate. Regarding citations, the ChatGPT ankle osteoarthritis paper was 90% accurate, the ChatGPT calcaneus fracture was 69.23% accurate, the Assistant ankle osteoarthritis was 35.14% accurate, and the Assistant calcaneus fracture was 39.68% accurate.</p><p><strong>Conclusion: </strong>Through this paper we emphasize that while AI holds the promise of enhancing knowledge sharing, it must be used responsibly and in conjunction with comprehensive fact-checking procedures to maintain the integrity of the scientific discourse.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 4","pages":"212-222"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990197","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":"Total Ankle Replacement in Hemophilia.","authors":"E Carlos Rodriguez-Merchan","doi":"10.22038/ABJS.2025.85093.3876","DOIUrl":"10.22038/ABJS.2025.85093.3876","url":null,"abstract":"<p><p>The objective of this paper is to carry out a review of the literature on the contemporary situation of total ankle replacement (TAR) in people with hemophilia (PWH). A search was performed in PubMed on December 29, 2024, utilizing the keywords \"hemophilia\" and \"total ankle replacement.\" To date solely 8 papers (136 TARs) in 103 PWH have been reported. All published series showed improvement in preoperative pain and function. However, the complication rate was 8.8% (intra-operative fractures of the medial malleolus, delayed wound healings, hematomas). Additional surgery is required in 5.1% of the TARs implanted (ankle arthrolysis due to painful arthrofibrosis, major surgeries, revision surgeries). The estimated 10-year survival free of any TAR removal or ankle fusion (AF) is 92.2%. Regarding the controversy AF or TAR in PWH, a recent systematic review and meta-analysis have found similar clinical results and rates of adverse events between TAR and AF in PWH.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 10","pages":"663-667"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12576326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432593","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 Systematic Review and Meta-Analysis of Regorafenib's Effectiveness and Safety in the Treatment of Bone Sarcoma.","authors":"Mohsen Rahmanian, Sara Khoropanah, Sepehr Hosseinzadeh Moghaddam, Abulfazl Vatankhah, Elaheh Abdi Bastamie, Soheila Roashanzamir, Amir Rahmanian Sharifabad, Reza Ganji","doi":"10.22038/ABJS.2025.87671.3969","DOIUrl":"10.22038/ABJS.2025.87671.3969","url":null,"abstract":"<p><strong>Objectives: </strong>Bone sarcomas are rare, aggressive tumors with poor outcomes and limited systemic options in advanced stages. This systematic review and meta-analysis evaluated its efficacy and safety in bone sarcomas using randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>We searched PubMed, Scopus, and Web of Science for RCTs published from September 27, 2012, to October 14, 2024. After removing duplicates, 350 records were screened, and five RCTs met the inclusion criteria. Primary outcomes were progression-free survival (PFS), overall survival (OS), and adverse events (AEs). Study quality was assessed using the Cochrane Risk of Bias 2 (RoB2) tool. Meta-analyses were performed with a random-effects model, and heterogeneity was evaluated using I² statistics. All analyses were conducted using R version 4.3.1.</p><p><strong>Results: </strong>A total of 350 records were screened after duplicate removal, of which 339 were excluded based on title and abstract. Eleven full-text articles were assessed for eligibility, and six were excluded for not meeting RCT criteria, resulting in five RCTs being included. Most had metastatic disease at baseline. Regorafenib significantly improved PFS (MD = 9.69 weeks; 95% CI: 4.54-14.84; I² = 0%), with no statistically significant overall survival (OS) benefit (MD = 0.85 weeks; 95% CI: -36.33 to 38.02; I² = 0%). These findings were consistent across studies and histological subtypes. All pooled analyses demonstrated zero or near-zero heterogeneity (I² = 0%), indicating highly consistent treatment effects among trials. No significant between-group heterogeneity was observed in subgroup analyses, confirming that regorafenib's benefit on progression-free survival was stable across different bone sarcoma types. Common regorafenib-related AEs included hand-foot skin reaction, hypertension, fatigue, and diarrhea. Grade 3-5 events were mostly hypertension and pain, generally manageable with dose modifications. Safety results were also consistent across studies, showing zero or near-zero heterogeneity (I² = 0%) and no significant subgroup differences, indicating a homogeneous safety profile across sarcoma subtypes.</p><p><strong>Conclusion: </strong>Regorafenib significantly improves progression-free survival in bone sarcomas across multiple subtypes, with a manageable toxicity profile. These results support its use as a novel therapy and highlight the need for future trials focused on optimizing dosing and patient selection. .</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 12","pages":"776-787"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935623","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":"How to Perform an Accurate and Safe Medial Open Wedge High Tibial Osteotomy; A Technical Note.","authors":"Arash Sherafat Vaziri, Hossein Ahmadzadeh, Nima Hosseinzadeh","doi":"10.22038/ABJS.2025.81222.3703","DOIUrl":"10.22038/ABJS.2025.81222.3703","url":null,"abstract":"<p><p>Medial open-wedge high tibial osteotomy (MOWHTO) is increasingly recognized as the preferred treatment option for active patients with varus malalignment and medial compartment osteoarthritis of the knee. This procedure aims to delay the degenerative process while alleviating pain and dysfunction. In this technical note, we aim to describe the tips and tricks for performing a safe MOWHTO, drawing on recent literature.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 6","pages":"378-382"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609928","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":"Outcomes of Patients with Bennett Fracture Treated with Three Different Surgical Techniques: A Systematic Review.","authors":"Eduardo Velásquez-Girón, Edna Rocio Buitrago-Quiñonez, Jorge Hernández-Guevara, Álvaro Antonio Kafury","doi":"10.22038/ABJS.2024.81116.3702","DOIUrl":"10.22038/ABJS.2024.81116.3702","url":null,"abstract":"<p><strong>Objectives: </strong>Bennett's fracture, the most common intra-articular fracture occurring at the base of the thumb, accounts for less than 1% of all hand fractures. It typically results from specific traumatic mechanisms, deforming forces, and ligamentous injuries. To compare the functional outcomes and sequelae in patients with Bennett's fracture treated surgically using: Open reduction and internal screw fixation, closed reduction and percutaneous fixation, arthroscopy-assisted reduction and screw fixation.</p><p><strong>Methods: </strong>A systematic literature review was conducted to identify studies on Bennett's fracture dislocations in patients over 18 years of age without additional injuries. Searches were performed in PubMed, Scopus, Cochrane Central, Web of Science, Scielo, Lilacs, Oneme, and Epistemonikos databases, with language restrictions in English, French, Spanish, Portuguese, Italian, and German, and no date restrictions. Primary outcome variables included measures of functionality and secondary outcomes such as pain, stiffness, and osteoarthritis.</p><p><strong>Results: </strong>A total of 18 studies met the selection criteria, with most being retrospective (94.45%). Pain measures were reported in 77.78% of the studies, predominantly using the VAS (min=0 and max=2). All techniques seemed to achieve similar functional outcomes. The main difference was the pain registered at follow-up, mainly by patients treated with open reduction. Osteoarthritis appeared as a common consequence of these fractures, regardless of the treatment type -excluding arthroscopy-assisted reduction as there was not enough data.</p><p><strong>Conclusion: </strong>The three techniques had similar functional outcomes. Closed reduction and percutaneous fixation appear to result in less pain; however, both closed reduction with percutaneous fixation and open reduction with internal screw fixation have similar rates of osteoarthritis at follow-up. Unfortunately, there is insufficient data to evaluate arthroscopy-assisted reduction with screw fixation, suggesting the need for rigorous follow-up in patients undergoing this surgical intervention.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 1","pages":"4-16"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068704","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":"Applications, Implications, and Drawbacks of Artificial Intelligence in Medical Publications.","authors":"Kylen Bruey, Amir R Kachooei","doi":"10.22038/ABJS.2024.82343.3751","DOIUrl":"10.22038/ABJS.2024.82343.3751","url":null,"abstract":"","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 1","pages":"1-3"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068767","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":"Diagnostic Accuracy and Reliability of Dynamic Handheld Ultrasound Testing in Detecting Anterior Cruciate Ligament Tears: A Cadaveric Study.","authors":"Yuzuru Sakakibara, Vasundhara Mathur, David O Osei-Hwedieh, Rohan Bhimani, Atta Taseh, Soheil Ashkani-Esfahani, Miho J Tanaka","doi":"10.22038/ABJS.2025.87885.3980","DOIUrl":"10.22038/ABJS.2025.87885.3980","url":null,"abstract":"<p><strong>Objectives: </strong>Anterior cruciate ligament (ACL) injuries can go undetected in the initial encounter, and delayed diagnosis can cause instability and an elevated risk of osteoarthritis. We hypothesized that dynamic testing under handheld ultrasound assessments of ACL insufficiency offers high diagnostic accuracy and reliability.</p><p><strong>Methods: </strong>Ten fresh-frozen knee specimens were evaluated in three conditions: (1) intact ACL, (2) complete ACL deficiency, and (3) ACL and Anterolateral ligament (ALL) deficiency. Dynamic testing under ultrasound was performed while simulating the Lachman test (tibial anterior translation with 0 and 100N, at 20 degrees knee flexion) and pivot shift test (internal rotation torque with 0 and 10Nm). The probe was placed at the anterior medial (AM) and lateral (AL) joint line, and anterior translation of the tibia (ΔD) relative to the femur was calculated. Intra-observer and inter-observer reliability were calculated, and receiver operating characteristic (ROC) curve analysis was performed for an ideal cutoff point for detecting knee instability.</p><p><strong>Results: </strong>From the AM view, ACL-deficient and ACL+ALL-deficient conditions significantly increased ΔD of the tibia during anterior loading compared to the intact ACL condition. The median ΔD values of the tibia in AM view with anterior drawer load were 0.64 (-0.10, 2.67) mm (intact ACL), 4.76 (2.46, 7.21) mm (ACL deficiency), and 3.88 (2.08, 7.23) mm (ACL+ALL deficiencies). The area under the ROC curve identifying ACL deficiency was 0.89 (95%CI, 0.66-0.97) in the AM view with anterior loading simulating the Lachman test. The optimal cut-off value to distinguish between the intact and ACL-deficient condition for anterior tibial translation with loading was 2.6 mm (sensitivity=80%, specificity=90%).</p><p><strong>Conclusion: </strong>Dynamic examination of the knee using portable handheld ultrasound from an AM view has high sensitivity and specificity in diagnosing ACL injury.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 12","pages":"823-830"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935595","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}