Anoop S. Chandrashekar, Jacob A. Fox, Logan M. Locascio, Gregory G. Polkowski, Martin Faschingbauer, J. Ryan Martin
Purpose
This study sought to validate intraoperative robotic measurements of femoral and tibial component coronal alignment in total knee arthroplasty (TKA) by comparing to pre- and post-operative standing, double stance, long-leg radiographs (LLR).
Methods
This retrospective cohort study included 59 unique patients undergoing primary TKA at a single institution. Pre- and post-operative femoral and tibial coronal alignment were measured on LLRs using a deep learning artificial intelligence model and compared to measurements obtained from the imageless robotic system to evaluate the robot's accuracy and reliability.
Results
Robotic measurements were highly correlated with measurements from preoperative LLR (Pearson r2 = 0.68). There was no significant difference in preoperative constitutional alignment between the two methodologies (p = 0.28). Additionally, the intraoperative and post-operative alignment of femoral and tibial implants were not significantly different (p = 0.12 and p = 0.95, respectively) and were strongly correlated (Pearson r2 = 0.5 and Pearson r2 = 0.6 respectively). The mean difference in femoral alignment was 0.43° and the mean difference in tibial alignment was 0.01°.
Conclusions
The findings of this study suggest that there were no significant differences in the coronal alignment of TKA when assessed by a robotic system compared to LLR. This signifies the robotic system's high intraoperative accuracy and reliability in determining coronal alignment.
Level of Evidence
Level III.
{"title":"Intraoperative robotic measurements of coronal alignment in total knee arthroplasty correlate with pre- and post-operative long-leg radiographs","authors":"Anoop S. Chandrashekar, Jacob A. Fox, Logan M. Locascio, Gregory G. Polkowski, Martin Faschingbauer, J. Ryan Martin","doi":"10.1002/jeo2.70220","DOIUrl":"https://doi.org/10.1002/jeo2.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study sought to validate intraoperative robotic measurements of femoral and tibial component coronal alignment in total knee arthroplasty (TKA) by comparing to pre- and post-operative standing, double stance, long-leg radiographs (LLR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 59 unique patients undergoing primary TKA at a single institution. Pre- and post-operative femoral and tibial coronal alignment were measured on LLRs using a deep learning artificial intelligence model and compared to measurements obtained from the imageless robotic system to evaluate the robot's accuracy and reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Robotic measurements were highly correlated with measurements from preoperative LLR (Pearson <i>r</i><sup>2</sup> = 0.68). There was no significant difference in preoperative constitutional alignment between the two methodologies (p = 0.28). Additionally, the intraoperative and post-operative alignment of femoral and tibial implants were not significantly different (<i>p</i> = 0.12 and <i>p</i> = 0.95, respectively) and were strongly correlated (Pearson <i>r</i><sup>2</sup> = 0.5 and Pearson <i>r</i><sup>2</sup> = 0.6 respectively). The mean difference in femoral alignment was 0.43° and the mean difference in tibial alignment was 0.01°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study suggest that there were no significant differences in the coronal alignment of TKA when assessed by a robotic system compared to LLR. This signifies the robotic system's high intraoperative accuracy and reliability in determining coronal alignment.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646174","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}
Alireza Mirahmadi, Pooya Hosseini-Monfared, Shahrzad Ghane, Mohammad Mortazavi, Ramin Abrishami, Mohammad Hossein Hooshangi, Vahid Shameli, Seyed Morteza Kazemi
Purpose
Patients undergoing total knee arthroplasty (TKA) are at a high risk of thromboembolic events, which is higher in obese patients. Determining the appropriate prophylaxis for venous thromboembolism (VTE) in obese patients is challenging. Therefore, we aimed to compare the effects of low molecular weight heparin (LMWH) with aspirin (ASA) and their combination for the prevention of thromboembolic events after TKA in obese patients.
Methods
In a retrospective study, 245 obese patients with BMIs over 30 who underwent TKA were enroled. Eligible patients were divided into three groups: Group A was given LMWH sodium (Clexane®) for 14 days, Group B was given ASA for 14 days, and Group C was given LMWH sodium (Clexane®) for 5 days and then ASA twice daily for the days between 5 and 14 postoperatively. The primary outcome was the incidence of VTE within three months. Secondary outcomes included routine laboratory evaluations (PT, PTT, INR, Hb, Hct, platelets, BUN and Cr) and adverse effects of ASA and LMWH, such as bleeding, anaemia, thrombocytopenia, and gastrointestinal or neurological symptoms.
Results
Regarding the incidence of DVT and PTE, we did not observe significant differences between groups (p > 0.05). A total of seven symptomatic VTE was observed in six patients. We observed two cases with PE who were in the Clexane group. Moreover, five individuals had DVT in the follow-up: three cases in the Clexane group, one in the ASA group, and one in the ASA + Clexane group, which was not statistically significant (p > 0.05). There were no differences between groups regarding the risk of adverse events and complications.
Conclusion
We found that ASA is not inferior to enoxaparin in reducing VTE after TKA in obese patients. Therefore, given ASA's low cost and greater convenience, it may be considered a reasonable alternative for extended VTE prophylaxis for TKA surgery in obese patients.
Level of Evidence
Level III.
{"title":"Comparison of low molecular weight heparin, aspirin, and their combination for the prevention of thrombosis after total knee arthroplasty in obese patients","authors":"Alireza Mirahmadi, Pooya Hosseini-Monfared, Shahrzad Ghane, Mohammad Mortazavi, Ramin Abrishami, Mohammad Hossein Hooshangi, Vahid Shameli, Seyed Morteza Kazemi","doi":"10.1002/jeo2.70218","DOIUrl":"https://doi.org/10.1002/jeo2.70218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patients undergoing total knee arthroplasty (TKA) are at a high risk of thromboembolic events, which is higher in obese patients. Determining the appropriate prophylaxis for venous thromboembolism (VTE) in obese patients is challenging. Therefore, we aimed to compare the effects of low molecular weight heparin (LMWH) with aspirin (ASA) and their combination for the prevention of thromboembolic events after TKA in obese patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective study, 245 obese patients with BMIs over 30 who underwent TKA were enroled. Eligible patients were divided into three groups: Group A was given LMWH sodium (Clexane®) for 14 days, Group B was given ASA for 14 days, and Group C was given LMWH sodium (Clexane®) for 5 days and then ASA twice daily for the days between 5 and 14 postoperatively. The primary outcome was the incidence of VTE within three months. Secondary outcomes included routine laboratory evaluations (PT, PTT, INR, Hb, Hct, platelets, BUN and Cr) and adverse effects of ASA and LMWH, such as bleeding, anaemia, thrombocytopenia, and gastrointestinal or neurological symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regarding the incidence of DVT and PTE, we did not observe significant differences between groups (<i>p</i> > 0.05). A total of seven symptomatic VTE was observed in six patients. We observed two cases with PE who were in the Clexane group. Moreover, five individuals had DVT in the follow-up: three cases in the Clexane group, one in the ASA group, and one in the ASA + Clexane group, which was not statistically significant (<i>p</i> > 0.05). There were no differences between groups regarding the risk of adverse events and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found that ASA is not inferior to enoxaparin in reducing VTE after TKA in obese patients. Therefore, given ASA's low cost and greater convenience, it may be considered a reasonable alternative for extended VTE prophylaxis for TKA surgery in obese patients.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646175","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}
Eduard van Eecke, Alexander Macken Arno, Derek van Deurzen, Thibault Lafosse, Antoon van Raebroeckx, Alexander Buijze Geert, Michel van den Bekerom, AC Instability Collaborator Group
Purpose
The aim of this study is to investigate the influence of patient-specific factors, including age, lifestyle considerations as well as the extent of injury according to the Rockwood classification (RW), on the surgeon's decision-making in the choice between operative and nonoperative treatment for acute, high-grade acromioclavicular (AC) joint dislocations.
Methods
Orthopaedic and trauma surgeons were requested to complete an online questionnaire consisting of closed and open questions regarding the treatment of acute, high-grade AC joint dislocations and 24 fictive clinical scenarios.
Results
A total of 133 answered questionnaires were collected. 27 different nationalities from five continents were represented. The included participants had a median experience of 12 years (interquartile range: 2–41). Overall, the treatment option for surgery (answer: YES) was chosen in 2426 answers (76% of cases) compared to ‘NO’ in 766 (24% of cases). RW classification was considered the most important factor influencing surgical decision-making for most surgeons (69%). Two thirds of the participants answered that smoking does not impact their decision towards surgery and as to the influence of body mass index (BMI) on decision-making, half of the respondents would not alter their preferred treatment based on BMI. Finally, there were no significant differences in decision-making regarding the influence of the participant's demographics.
Conclusion
This study highlights that RW classification is the most important factor to consider in the surgeon's decision-making between operative and nonoperative treatment in acute, high-grade AC joint dislocations. Participants preferred operative treatment over nonoperative treatment in acute, high-grade AC joint dislocation in 76% of case scenarios, increasing up to 90% when RW Grade III lesions were not taken into account. These findings contrast with recent studies reporting good functional outcomes of conservatively treated acute, high-grade AC injuries and highlight the need to bridge the gap between evidence and practice.
Level of Evidence
Level V.
{"title":"Surgeons consider Rockwood classification the most important factor for decision-making in acute, high-grade acromioclavicular dislocations","authors":"Eduard van Eecke, Alexander Macken Arno, Derek van Deurzen, Thibault Lafosse, Antoon van Raebroeckx, Alexander Buijze Geert, Michel van den Bekerom, AC Instability Collaborator Group","doi":"10.1002/jeo2.70203","DOIUrl":"https://doi.org/10.1002/jeo2.70203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study is to investigate the influence of patient-specific factors, including age, lifestyle considerations as well as the extent of injury according to the Rockwood classification (RW), on the surgeon's decision-making in the choice between operative and nonoperative treatment for acute, high-grade acromioclavicular (AC) joint dislocations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Orthopaedic and trauma surgeons were requested to complete an online questionnaire consisting of closed and open questions regarding the treatment of acute, high-grade AC joint dislocations and 24 fictive clinical scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 133 answered questionnaires were collected. 27 different nationalities from five continents were represented. The included participants had a median experience of 12 years (interquartile range: 2–41). Overall, the treatment option for surgery (answer: YES) was chosen in 2426 answers (76% of cases) compared to ‘NO’ in 766 (24% of cases). RW classification was considered the most important factor influencing surgical decision-making for most surgeons (69%). Two thirds of the participants answered that smoking does not impact their decision towards surgery and as to the influence of body mass index (BMI) on decision-making, half of the respondents would not alter their preferred treatment based on BMI. Finally, there were no significant differences in decision-making regarding the influence of the participant's demographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights that RW classification is the most important factor to consider in the surgeon's decision-making between operative and nonoperative treatment in acute, high-grade AC joint dislocations. Participants preferred operative treatment over nonoperative treatment in acute, high-grade AC joint dislocation in 76% of case scenarios, increasing up to 90% when RW Grade III lesions were not taken into account. These findings contrast with recent studies reporting good functional outcomes of conservatively treated acute, high-grade AC injuries and highlight the need to bridge the gap between evidence and practice.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602531","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}
Guus Felix Kerkvliet, Gijs Bram Peter Cornelis van der Ree, Inger Nicoline Sierevelt, Gino M. M. J. Kerkhoffs, Bart Muller
Purpose
To compare postoperative activity levels between patients who received an anterior cruciate ligament reconstruction (ACLR) with- and without a lateral extra-articular procedure (LEAP).
Objectives
The primary objective is to examine whether patients treated with an ALCR and LEAP have a greater chance to return to sport (RTS) and return to their pre-injury level of sport (RTPS). The re-rupture rates between the two groups will also be analysed as this is of great influence on the RTS and RTPS.
Methods
A thorough search according to PRISMA guidelines was conducted through the PubMed and Embase databases in May 2024. Randomised controlled trials (RCT) and retrospective cohort studies on patients who underwent primary ACLR with- or without a LEAP were included. Postoperative Tegner score, RTS, RTPS and re-rupture rate were evaluated. All articles were revised according to Cochrane risk of bias tools (RoB 2.0 and ROBINS-I).
Results
Twenty-four studies were included after examining 966 titles, abstracts and manuscripts. A total of 33,527 patients were included in this review with a weighted mean age of 24.9 years. Pooled data demonstrates that the ACLR + LEAP group shows significantly higher postoperative Tegner scores (MD, 0.43 [95% confidence interval, 0.21–0.65]; p < 0.01). 62% of patients who underwent ACLR + LEA returned to their pre-injury level of sport compared to 40% in ACLR group (reported in nine studies).
Conclusion
This meta-analysis demonstrates that patients undergoing a LEAP procedure in addition to ACLR return to higher postoperative activity levels and are more likely to return to their pre-injury level of sport. These results -in addition to further research- may help dictate when to add a LEAP, and whether LEAP in addition to ACLR should become the golden standard.
Level of Evidence
Level III, retrospective cohort studies have been analysed, alongside RCT's, and thus this is the level of evidence.
{"title":"Lateral extra-articular procedures combined with ACL reconstructions lead to a higher return to pre-injury level of sport: A systematic review and meta-analysis","authors":"Guus Felix Kerkvliet, Gijs Bram Peter Cornelis van der Ree, Inger Nicoline Sierevelt, Gino M. M. J. Kerkhoffs, Bart Muller","doi":"10.1002/jeo2.70196","DOIUrl":"https://doi.org/10.1002/jeo2.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare postoperative activity levels between patients who received an anterior cruciate ligament reconstruction (ACLR) with- and without a lateral extra-articular procedure (LEAP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective is to examine whether patients treated with an ALCR and LEAP have a greater chance to return to sport (RTS) and return to their pre-injury level of sport (RTPS). The re-rupture rates between the two groups will also be analysed as this is of great influence on the RTS and RTPS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A thorough search according to PRISMA guidelines was conducted through the PubMed and Embase databases in May 2024. Randomised controlled trials (RCT) and retrospective cohort studies on patients who underwent primary ACLR with- or without a LEAP were included. Postoperative Tegner score, RTS, RTPS and re-rupture rate were evaluated. All articles were revised according to Cochrane risk of bias tools (RoB 2.0 and ROBINS-I).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four studies were included after examining 966 titles, abstracts and manuscripts. A total of 33,527 patients were included in this review with a weighted mean age of 24.9 years. Pooled data demonstrates that the ACLR + LEAP group shows significantly higher postoperative Tegner scores (MD, 0.43 [95% confidence interval, 0.21–0.65]; <i>p</i> < 0.01). 62% of patients who underwent ACLR + LEA returned to their pre-injury level of sport compared to 40% in ACLR group (reported in nine studies).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis demonstrates that patients undergoing a LEAP procedure in addition to ACLR return to higher postoperative activity levels and are more likely to return to their pre-injury level of sport. These results -in addition to further research- may help dictate when to add a LEAP, and whether LEAP in addition to ACLR should become the golden standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective cohort studies have been analysed, alongside RCT's, and thus this is the level of evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594941","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}
Mark K. Timmons, Hunter G. Copley, Dustin T. Darnell, Seth T. Jude, Gary McIlvain
Purpose
Individuals with excessive knee rotation have higher levels of dysfunction and disability. An inexpensive, and reliable method to assess knee internal (IR) and external (ER) rotation will improve the assessment of knee injuries. The study explored the reliability and measurement error of two methods of knee rotation measurement. The study tested the hypothesis that the digital inclinometer will provide reliable measures of knee internal and external rotation and that the digital inclinometer measurements will be consistent with the measurements made with the electromagnetic tracking system.
Methods
Twenty (20) participants without knee injury participated. Knee IR and ER were measured using electromagnetic tracking and a digital inclinometer. The intraclass correlation coefficient (ICC(2,1)) was calculated for both techniques.
Results
The within device ICC values ranged from 0.826 to 0.939 for both devices. The within-device minimal detectable change (MDC) ranged from 1.2° to 1.9°. The ICC values for EI and IR measures collapsed between the devices, ranged from 0.717 to 0.859. The MDC calculated between devices ranged from 1.6° to 1.9°.
Conclusion
The results of the current study show that knee IR and ER can be measured reliably with both measurement techniques. The measurement of knee ER and IR did not differ between the two devices or between the right and left sides.
Level of Evidence
Level IV, diagnostic, case series study.
{"title":"Measures of knee internal and external rotation made with a digital inclinometer are consistent with the measures made with an electromagnetic tracking system","authors":"Mark K. Timmons, Hunter G. Copley, Dustin T. Darnell, Seth T. Jude, Gary McIlvain","doi":"10.1002/jeo2.70209","DOIUrl":"https://doi.org/10.1002/jeo2.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Individuals with excessive knee rotation have higher levels of dysfunction and disability. An inexpensive, and reliable method to assess knee internal (IR) and external (ER) rotation will improve the assessment of knee injuries. The study explored the reliability and measurement error of two methods of knee rotation measurement. The study tested the hypothesis that the digital inclinometer will provide reliable measures of knee internal and external rotation and that the digital inclinometer measurements will be consistent with the measurements made with the electromagnetic tracking system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty (20) participants without knee injury participated. Knee IR and ER were measured using electromagnetic tracking and a digital inclinometer. The intraclass correlation coefficient (ICC<sub>(2,1)</sub>) was calculated for both techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The within device ICC values ranged from 0.826 to 0.939 for both devices. The within-device minimal detectable change (MDC) ranged from 1.2° to 1.9°. The ICC values for EI and IR measures collapsed between the devices, ranged from 0.717 to 0.859. The MDC calculated between devices ranged from 1.6° to 1.9°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of the current study show that knee IR and ER can be measured reliably with both measurement techniques. The measurement of knee ER and IR did not differ between the two devices or between the right and left sides.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, diagnostic, case series study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594904","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}
Treatment options for acute acromioclavicular joint (ACJ) instability include several surgical and non-surgical approaches. Recent trends indicate a shift towards nonoperative treatment, even for severe Rockwood type V injuries, which traditionally required surgery. Despite this shift, some patients may still benefit from surgical stabilisation, particularly if significant pain and disability persist. Modern surgical techniques focus on cortical button systems and restoration of the coracoclavicular ligaments, emphasising the importance of the posterosuperior acromioclavicular capsuloligamentous complex in managing horizontal instability. Clavicular hook plates offer rigid stability but present risks, such as damage to the subacromial structures and acromial erosion. Although anatomical repair techniques have gained prominence due to their biomechanical advantages and have been endorsed by international societies, non-anatomic methods may also provide acceptable outcomes with lower costs. The use of tendon grafts in chronic ACJ instability has shown promise, although evidence for their use in acute cases remains limited. This review discusses various treatment strategies, including operative and nonoperative management, focusing on patient outcomes, complication rates, and return-to-sport scenarios. Ultimately, the choice between surgical and non-surgical treatment must consider individual patient needs and the potential for long-term recovery.
Level of Evidence: Not applicable.
{"title":"Surgical treatment of acute high-grade acromioclavicular joint dislocations","authors":"Theodorakys Marín Fermín, Chih-Kai Hong, Lucca Lacheta, Lukas N. Münch, Knut Beitzel, Eoghan T. Hurley, Kai-Lan Hsu, Emmanouil Brilakis, Berte Bøe, Davide Cucchi","doi":"10.1002/jeo2.70173","DOIUrl":"https://doi.org/10.1002/jeo2.70173","url":null,"abstract":"<p>Treatment options for acute acromioclavicular joint (ACJ) instability include several surgical and non-surgical approaches. Recent trends indicate a shift towards nonoperative treatment, even for severe Rockwood type V injuries, which traditionally required surgery. Despite this shift, some patients may still benefit from surgical stabilisation, particularly if significant pain and disability persist. Modern surgical techniques focus on cortical button systems and restoration of the coracoclavicular ligaments, emphasising the importance of the posterosuperior acromioclavicular capsuloligamentous complex in managing horizontal instability. Clavicular hook plates offer rigid stability but present risks, such as damage to the subacromial structures and acromial erosion. Although anatomical repair techniques have gained prominence due to their biomechanical advantages and have been endorsed by international societies, non-anatomic methods may also provide acceptable outcomes with lower costs. The use of tendon grafts in chronic ACJ instability has shown promise, although evidence for their use in acute cases remains limited. This review discusses various treatment strategies, including operative and nonoperative management, focusing on patient outcomes, complication rates, and return-to-sport scenarios. Ultimately, the choice between surgical and non-surgical treatment must consider individual patient needs and the potential for long-term recovery.</p><p><b>Level of Evidence</b>: Not applicable.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581321","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}
Ben Efrima, Agustin Barbero, Amit Benady, Yair Green Halimi, Jari Dahmen, Gino M. M. J. Kerkhoffs, Jon Karlsson, Cristian Indino, Camila Maccario, Federico G. Usuelli
Purpose
Weight-bearing computed tomography (WBCT) creates colour-coded distance maps (DM) to analyze intraarticular contact areas, offering a detailed assessment of joint surface interactions. However, clinical applications of DM remain underexplored. This study introduces the ‘Battleship technique (BST)’ to evaluate contact area patterns in patients with osteoarthritis (OA) of the talar dome, producing a single point representing the distance map weighted sum (DMWS). The DMWS serves as a potential reference for assessing hindfoot deformities and guiding clinical decisions, including surgical planning and alignment correction. We hypothesize that the BST is reliable for calculating the DMWS and that the DMWS correlates with hindfoot alignment, providing a novel tool to improve the evaluation of complex deformities. The primary aim was to evaluate the reliability of the BST, and the secondary aim was to determine whether the DMWS is influenced by hindfoot alignment.
Methods
Two raters independently calculated DMWS using BST for forty ankle OA patients. Based on DMWS location relative to the joint centre, patients were categorized into coronal (varus/valgus) and sagittal (anterior/posterior) groups. Hindfoot alignment was statistically compared between groups.
Results
Excellent interobserver and intraobserver agreement was observed. Significant differences were found in α angle, tibiotalar surface angle (TSA), hindfoot alignment angle (HFA) and talar tilt (TT) (p = 0.047, p < 0.001, p = 0.003 and p = 0.04) between coronal groups, and in β angle and tibiotalar ratio (TTR) (p < 0.001) between sagittal groups. Correlations were identified between DMWS and TSA (r = 0.6, p < 0.001), TT (r = −0.6, p < 0.001), β angle (r = 0.2, p < 0.001) and TTR (r = −0.4, p < 0.001).
Conclusion
The BST reliably calculates the DMWS, correlating with foot and ankle alignment. BST provides a standardized, non-invasive method to evaluate intraarticular contact patterns, offering valuable insights for preoperative planning and post-operative assessment. Its integration into practice may enhance surgical precision in complex realignment procedures.
Level of Evidence
Level IV.
{"title":"The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment","authors":"Ben Efrima, Agustin Barbero, Amit Benady, Yair Green Halimi, Jari Dahmen, Gino M. M. J. Kerkhoffs, Jon Karlsson, Cristian Indino, Camila Maccario, Federico G. Usuelli","doi":"10.1002/jeo2.70190","DOIUrl":"https://doi.org/10.1002/jeo2.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Weight-bearing computed tomography (WBCT) creates colour-coded distance maps (DM) to analyze intraarticular contact areas, offering a detailed assessment of joint surface interactions. However, clinical applications of DM remain underexplored. This study introduces the ‘Battleship technique (BST)’ to evaluate contact area patterns in patients with osteoarthritis (OA) of the talar dome, producing a single point representing the distance map weighted sum (DMWS). The DMWS serves as a potential reference for assessing hindfoot deformities and guiding clinical decisions, including surgical planning and alignment correction. We hypothesize that the BST is reliable for calculating the DMWS and that the DMWS correlates with hindfoot alignment, providing a novel tool to improve the evaluation of complex deformities. The primary aim was to evaluate the reliability of the BST, and the secondary aim was to determine whether the DMWS is influenced by hindfoot alignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two raters independently calculated DMWS using BST for forty ankle OA patients. Based on DMWS location relative to the joint centre, patients were categorized into coronal (varus/valgus) and sagittal (anterior/posterior) groups. Hindfoot alignment was statistically compared between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Excellent interobserver and intraobserver agreement was observed. Significant differences were found in <i>α</i> angle, tibiotalar surface angle (TSA), hindfoot alignment angle (HFA) and talar tilt (TT) (<i>p</i> = 0.047, <i>p</i> < 0.001, <i>p</i> = 0.003 and <i>p</i> = 0.04) between coronal groups, and in <i>β</i> angle and tibiotalar ratio (TTR) (<i>p</i> < 0.001) between sagittal groups. Correlations were identified between DMWS and TSA (<i>r</i> = 0.6, <i>p</i> < 0.001), TT (<i>r</i> = −0.6, <i>p</i> < 0.001), <i>β</i> angle (<i>r</i> = 0.2, <i>p</i> < 0.001) and TTR (<i>r</i> = −0.4, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The BST reliably calculates the DMWS, correlating with foot and ankle alignment. BST provides a standardized, non-invasive method to evaluate intraarticular contact patterns, offering valuable insights for preoperative planning and post-operative assessment. Its integration into practice may enhance surgical precision in complex realignment procedures.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571334","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}
Julia Elisabeth Lenz, Moritz Riedl, Dominik Szymski, Stefan Landgraeber, Volker Alt, Stefan Fickert
Purpose
Triple-Osteotomy (TO) is a hip-preserving surgical technique designed to correct symptomatic hip dysplasia by achieving three-dimensional acetabular reorientation and improving femoral head coverage. This procedure has shown promising outcomes in pain reduction, functional recovery, and quality of life, particularly in young, active patients. While periacetabular-osteotomy (PAO) is another well-established method for hip preservation, the specific advantages of TO, especially in early recovery and patient-reported outcomes (PROMs), remain underexplored. This study evaluates the mid-term outcomes of TO using the iHOT33 tool to provide a comprehensive understanding of its clinical benefits.
Methods
This non-randomised, retrospective registry study within the German Cartilage Registry included 48 patients with symptomatic, radiologically confirmed hip dysplasia who underwent TO by the same specialist. The follow-up rate at 24 months was 60.4% with a mean follow-up time of 24 months. Outcomes measured included iHOT33 scores, quality of life, VAS for pain, satisfaction, perceived treatment benefit, and unemployment rate. Paired t-tests and regression analysis (p < 0.05) were applied.
Results
Preoperative iHOT33 scores averaged 46.9, increasing to 70.8 after 24 months (Δ 23.9), with notable improvement in the first 6 months (Δ 15.8). The “social” subdomain showed the greatest improvements (Δ 30 points), alongside improvements in quality of life and pain reduction (VAS). Postoperative angles (VCE 31° ± 4°, acetabular index 0° ± 3°) were within the normal range. No significant correlation was found between angle changes and iHOT33 scores, indicating benefits across dysplasia severities.
Conclusions
Triple-osteotomy offers significant and rapid improvements in patient-reported outcomes for individuals with hip dysplasia, particularly in enhancing social and sports-related quality of life as measured by iHOT33 and other subjective assessments. Its potential advantages over Periacetabular-osteotomy, especially in terms of early recovery, warrant further investigation through prospective, comparative studies to better define its role in hip-preserving surgical strategies.
Level of Evidence
Level III.
{"title":"Triple-Osteotomy leads to substantially improved quality of life in patients with hip dysplasia","authors":"Julia Elisabeth Lenz, Moritz Riedl, Dominik Szymski, Stefan Landgraeber, Volker Alt, Stefan Fickert","doi":"10.1002/jeo2.70208","DOIUrl":"https://doi.org/10.1002/jeo2.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Triple-Osteotomy (TO) is a hip-preserving surgical technique designed to correct symptomatic hip dysplasia by achieving three-dimensional acetabular reorientation and improving femoral head coverage. This procedure has shown promising outcomes in pain reduction, functional recovery, and quality of life, particularly in young, active patients. While periacetabular-osteotomy (PAO) is another well-established method for hip preservation, the specific advantages of TO, especially in early recovery and patient-reported outcomes (PROMs), remain underexplored. This study evaluates the mid-term outcomes of TO using the iHOT33 tool to provide a comprehensive understanding of its clinical benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This non-randomised, retrospective registry study within the German Cartilage Registry included 48 patients with symptomatic, radiologically confirmed hip dysplasia who underwent TO by the same specialist. The follow-up rate at 24 months was 60.4% with a mean follow-up time of 24 months. Outcomes measured included iHOT33 scores, quality of life, VAS for pain, satisfaction, perceived treatment benefit, and unemployment rate. Paired t-tests and regression analysis (<i>p</i> < 0.05) were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preoperative iHOT33 scores averaged 46.9, increasing to 70.8 after 24 months (Δ 23.9), with notable improvement in the first 6 months (Δ 15.8). The “social” subdomain showed the greatest improvements (Δ 30 points), alongside improvements in quality of life and pain reduction (VAS). Postoperative angles (VCE 31° ± 4°, acetabular index 0° ± 3°) were within the normal range. No significant correlation was found between angle changes and iHOT33 scores, indicating benefits across dysplasia severities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Triple-osteotomy offers significant and rapid improvements in patient-reported outcomes for individuals with hip dysplasia, particularly in enhancing social and sports-related quality of life as measured by iHOT33 and other subjective assessments. Its potential advantages over Periacetabular-osteotomy, especially in terms of early recovery, warrant further investigation through prospective, comparative studies to better define its role in hip-preserving surgical strategies.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571330","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}
Carolina Kekki, Riccardo Cristiani, Anders Stålman, Christoffer von Essen
Purpose
To compare displaced bucket-handle meniscus repair (BHMR) failure rates, subjective and objective knee function after BHMR in the setting of ACLR performed as a single-or two-stage procedure, and assess factors associated with BHMR survival.
Methods
This retrospective study included patients who underwent surgery between February 2015 and December 2021 at one institution. Patients with a displaced bucket-handle meniscus tear (BHMT) and ACL-injury undergoing BHMR and ACLR as a single- (concomitant BHMR and ACLR) or two-stage (BHMR and subsequent ACLR) procedure were identified. The primary outcome was the 2-year BHMR failure rate following ACLR, defined as reoperation with meniscus re-repair or resection. Additionally, 6-month range of motion (ROM), isokinetic knee (extension, flexion) strength, 1-and 2-year Knee injury and Osteoarthritis Outcome Score (KOOS), Patient-acceptable symptom state (PASS), treatment failure (TF) were compared between the groups. Kaplan-Meier analysis was performed to assess BHMR survival, factors associated with repair survival were analysed through Cox proportional hazard regression analysis.
Results
The cohort included 159 displaced BHMRs, 120 (75.5%) underwent single-stage surgery. The overall BHMR failure rate was 27% (43/159). The single-stage surgery group had significantly lower failure rate (15% vs. 35.9%, p = 0.006). BHMT laterality, subjective (KOOS, PASS and TF) and objective (ROM, isokinetic strength) knee function did not differ significantly between the groups.
Conclusion
Patients who underwent single-stage displaced BHMR and ACLR had significantly lower BHMR failure rate compared to those who underwent two-stage surgery. Therefore, single-stage displaced BHMR and ACLR should be advocated, although patient-specific factors and further prospective studies remain important considerations.
Level of Evidence
Level III.
{"title":"Single-stage ACL reconstruction and displaced bucket handle Meniscus repair is associated with lower Meniscus repair failure rates compared to two-stage surgery","authors":"Carolina Kekki, Riccardo Cristiani, Anders Stålman, Christoffer von Essen","doi":"10.1002/jeo2.70199","DOIUrl":"https://doi.org/10.1002/jeo2.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare displaced bucket-handle meniscus repair (BHMR) failure rates, subjective and objective knee function after BHMR in the setting of ACLR performed as a single-or two-stage procedure, and assess factors associated with BHMR survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included patients who underwent surgery between February 2015 and December 2021 at one institution. Patients with a displaced bucket-handle meniscus tear (BHMT) and ACL-injury undergoing BHMR and ACLR as a single- (concomitant BHMR and ACLR) or two-stage (BHMR and subsequent ACLR) procedure were identified. The primary outcome was the 2-year BHMR failure rate following ACLR, defined as reoperation with meniscus re-repair or resection. Additionally, 6-month range of motion (ROM), isokinetic knee (extension, flexion) strength, 1-and 2-year Knee injury and Osteoarthritis Outcome Score (KOOS), Patient-acceptable symptom state (PASS), treatment failure (TF) were compared between the groups. Kaplan-Meier analysis was performed to assess BHMR survival, factors associated with repair survival were analysed through Cox proportional hazard regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 159 displaced BHMRs, 120 (75.5%) underwent single-stage surgery. The overall BHMR failure rate was 27% (43/159). The single-stage surgery group had significantly lower failure rate (15% vs. 35.9%, <i>p</i> = 0.006). BHMT laterality, subjective (KOOS, PASS and TF) and objective (ROM, isokinetic strength) knee function did not differ significantly between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients who underwent single-stage displaced BHMR and ACLR had significantly lower BHMR failure rate compared to those who underwent two-stage surgery. Therefore, single-stage displaced BHMR and ACLR should be advocated, although patient-specific factors and further prospective studies remain important considerations.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571331","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}
Umile Giuseppe Longo, Rocco Papalia, Alessandro Mazzola, Sergio De Salvatore, Alessandro Tancioni, Valentina Piccioni, Alessandro de Sire, Kristian Samuelsson, Stefano Zaffagnini, Ilaria Piergentili, Pieter D'Hooghe, Vincenzo Denaro
Purpose
This study aimed to evaluate the demographic features of patients undergoing wrist arthroscopy in Italy. A secondary aim was to perform an economic analysis of this type of surgery.
Methods
The National Hospital Discharge Records database was employed to conduct the analysis. Wrist arthroscopy surgical procedures were defined by the primary procedure code 80.23, according to the International Classification of Diseases, Ninth Revision–Clinical Modification code. Incidence rates were computed by dividing the number of annual cases by the size of the adult population reported annually by the National Institute for Statistics.
Results
7875 wrist arthroscopy procedures were performed in Italy. The cumulative incidence rate was 1 for every 100,000 Italian residents. The need for wrist arthroscopy in Italy increased from 2001 to 2008 and then progressively declined up to 2016. The highest number of procedures was found between 40 and 49 years. Most patients undergoing wrist arthroscopy were females (50.6%). The mean age of patients was 41.6 ± 14.5. Wrist arthroscopy in Italy costs an average of 721,102 ± 171,195€ each year.
Conclusions
The incidence of this type of surgery peaked throughout the course of the 15 years, in 2006 and 2008. However, the number of procedures per 100,000 inhabitants has decreased since 2008. The economic analysis revealed that the cost of wrist arthroscopy is relevant to the healthcare system in Italy.
Level of Evidence
Level II.
{"title":"National trends of wrist arthroscopy in Italy: Analysis from 2001 to 2016","authors":"Umile Giuseppe Longo, Rocco Papalia, Alessandro Mazzola, Sergio De Salvatore, Alessandro Tancioni, Valentina Piccioni, Alessandro de Sire, Kristian Samuelsson, Stefano Zaffagnini, Ilaria Piergentili, Pieter D'Hooghe, Vincenzo Denaro","doi":"10.1002/jeo2.70193","DOIUrl":"https://doi.org/10.1002/jeo2.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the demographic features of patients undergoing wrist arthroscopy in Italy. A secondary aim was to perform an economic analysis of this type of surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Hospital Discharge Records database was employed to conduct the analysis. Wrist arthroscopy surgical procedures were defined by the primary procedure code 80.23, according to the International Classification of Diseases, Ninth Revision–Clinical Modification code. Incidence rates were computed by dividing the number of annual cases by the size of the adult population reported annually by the National Institute for Statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>7875 wrist arthroscopy procedures were performed in Italy. The cumulative incidence rate was 1 for every 100,000 Italian residents. The need for wrist arthroscopy in Italy increased from 2001 to 2008 and then progressively declined up to 2016. The highest number of procedures was found between 40 and 49 years. Most patients undergoing wrist arthroscopy were females (50.6%). The mean age of patients was 41.6 ± 14.5. Wrist arthroscopy in Italy costs an average of 721,102 ± 171,195€ each year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of this type of surgery peaked throughout the course of the 15 years, in 2006 and 2008. However, the number of procedures per 100,000 inhabitants has decreased since 2008. The economic analysis revealed that the cost of wrist arthroscopy is relevant to the healthcare system in Italy.</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 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571333","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}
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