Journal of Experimental Orthopaedics最新文献

{"title":"Derotational osteotomy is a relevant procedure in the management of lateral patellar dislocation: An expert survey of the International Patellofemoral Study Group","authors":"Guido Wierer,&nbsp;Danko Milinkovic,&nbsp;Gerd Seitlinger,&nbsp;Michael Liebensteiner,&nbsp;William Post,&nbsp;Philipp W. Winkler","doi":"10.1002/jeo2.70116","DOIUrl":"https://doi.org/10.1002/jeo2.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate current knowledge and discover potential controversies in treating torsional deformities of the lower limb in patients with lateral patellar dislocation (LPD) among patellofemoral experts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey was distributed to all active International Patellofemoral Study Group (IPSG) members, representing an international sample of orthopaedic surgeons with a specific interest and experience in patellofemoral joint disorders. The survey included 21 single- and multiple-choice questions and was distributed by email between 2022 and 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-five members (54%) completed the questionnaire. The responding experts conduct a hip–knee–ankle magnetic resonance imaging or computed tomography following first-time and recurrent patellar dislocation based on clinical examination (43% and 49%, respectively), routinely (6% and 23%, respectively), or not at all (51% and 29%, respectively). Two thirds of the experts perform derotational osteotomies of the femur, and 37% perform derotational osteotomies of the tibia. Most of these surgeons (61% and 69%, respectively) perform less than five derotational osteotomies of the femur or tibia per year. The most important factors for performing derotational osteotomy are abnormal torsion (100%), abnormal gait pattern (57%), revision cases (74%) and recurrent patellar instability (61%). Most surgeons (65%) agree on a cut-off value of &gt;30° of femoral ante-torsion and &gt;35° of external tibial torsion to perform derotational osteotomy, but the preferred measurement techniques vary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Torsional deformities of the lower limb are a clinically relevant topic in the management of patients with recurrent LPD. Although the caseload is low, most experts perform derotational osteotomies. Diagnostic and therapeutic algorithms overlap widely between surgeons, but the indication and cut-off values for performing derotational osteotomy must be further established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Survey.</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":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396807","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":"Comparison of coronal and sagittal alignment in patients without osteoarthritis but with knee complaints","authors":"Mikiko Handa,&nbsp;Tsuneari Takahashi,&nbsp;Akihiro Saitsu,&nbsp;Masaki Iguchi,&nbsp;Katsushi Takeshita","doi":"10.1002/jeo2.70165","DOIUrl":"https://doi.org/10.1002/jeo2.70165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to clarify lower limb alignment characteristics and the relationship between coronal and sagittal lower limb alignment in Japanese patients with knee complaints but without knee osteoarthritis (KOA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 200 knees from Japanese patients with knee complaints but without KOA aged 60 years and under presenting with knee complaints between May 2020 and May 2023. We assessed coronal parameters, including mechanical hip knee angle (mHKA), arithmetic HKA (aHKA) mechanical lateral distal femoral angle and medial proximal tibial angle (MPTA), and sagittal parameters, such as medial posterior tibial slope (MPTS) and lateral posterior tibial slope (LPTS). In addition, we compared differences between CPAK types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A weak positive correlation was found between mHKA and MPTS, but not with aHKA. Moderate negative and moderate positive correlations were found between mHKA and MPTA and between medial and LPTS, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Little correlation was found between the coronal and sagittal parameters in patients with knee complaints but without KOA.</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":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380050","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":"Anterolateral corner of knee: Current concepts","authors":"Amit Meena,&nbsp;Manish Attri,&nbsp;Luca Farinelli,&nbsp;Vicente Campos,&nbsp;Karan Rajpal,&nbsp;Riccardo D'Ambrosi,&nbsp;Shahbaz Malik,&nbsp;Darren de Sa,&nbsp;Christian Fink,&nbsp;Sachin Tapasvi","doi":"10.1002/jeo2.70172","DOIUrl":"https://doi.org/10.1002/jeo2.70172","url":null,"abstract":"<p>The anatomy of the antero-lateral corner (ALC) has been the topic of recent interest, as evidenced by the increasing number of publications. Knowledge needs to be improved amongst clinicians regarding the anatomy and biomechanical function of this vital structure and its implications on the rotational stability of the knee. There has yet to be a consensus on the role of surgical procedures and their indications for addressing the instability associated with the injury to these structures. Through this article, the authors have tried to outline the existing literature regarding Anterolateral knee instability, the associated structures, and the management of its injuries, emphasising the role of the anterolateral capsule and reconstructive procedures in combined ligamentous knee injuries.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380051","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":"Distribution analysis of structural properties of native porcine humerus–rotator cuff–scapular complex using universal testing machine","authors":"Tsuneari Takahashi,&nbsp;Hideyuki Sasanuma,&nbsp;Katsushi Takeshita","doi":"10.1002/jeo2.70164","DOIUrl":"https://doi.org/10.1002/jeo2.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the effectiveness of an original mechanical testing setup including the humerus, myotendinous junction and scapula designed to assess the structural properties of rotator cuff attachments in large animals and determine optimal conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight domestic pigs (age, 4–6 months; weight, 30–52 kg) without genetic modifications were euthanized under intubated general anaesthesia control. The scapula–supraspinatus tendon complex with the humerus was excised as a single unit. A device was developed on a universal testing machine to pull in the direction of the tendon's path. After preconditioning at 5 N for 30 s, the composite was stretched to failure at 50 mm/min, and the failure mode was observed. The normality of each structural property was evaluated using the Shapiro–Wilk test. Student's <i>t</i> test or the Mann–Whitney U-test was used to compare whether the structural properties vary in failure modes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine shoulders (56%) ruptured at the humeral attachment; in the remaining seven, the tendon was pulled out from the scapula, leading to rupture. The maximum load and elongation at failure showed normality, whereas the yield load and linear stiffness did not show normality. The mean (standard deviation) maximum load and elongation at failure were 346.4 (99.2) N and 43.1 (12.2) mm, respectively. The median (first and third quartiles) yield load and linear stiffness were 81.2 (63.0, 121.6) N and 15.8 (14.8, 17.5) N/mm, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This mechanical testing system is useful for evaluating the structural properties of porcine rotator cuff attachments and should be additionally evaluated by cyclic testing.</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":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380048","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":"Recurrence of arthroscopic treatment of pigmented villonodular synovitis of the knee: A systematic review and meta-analysis","authors":"Sohrab Keyhani,&nbsp;Mehran Soleymanha,&nbsp;Fardis Vosoughi,&nbsp;Ali Nikibakhsh,&nbsp;Ervin Zadgari,&nbsp;Maryam Mousavi,&nbsp;Robert F. LaPrade","doi":"10.1002/jeo2.70169","DOIUrl":"https://doi.org/10.1002/jeo2.70169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to assess the efficacy of arthroscopic intervention on the treatment of pigmented villonodular synovitis (PVNS) patients, with a focus on the potential advantages of this approach in lowering the risk of disease recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic review and meta-analysis following the PRISMA 2020 protocol. Our search encompassed five databases, namely PubMed, Embase, Scopus, Web of Science and Cochrane Library. Statistical analysis was conducted on the extracted data by using the R ver. 4.4.0 software. This study included English-language observational studies (case series and cohort studies) published up to 31 March 2024, focusing on in vivo human subjects with at least 2 years of follow-up. Studies with less than 2 years of follow-up, non-arthroscopic treatment methods or addressing PVNS in structures other than the knee were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 24 articles, comprising 7 case series and 17 cohort studies, based on title, abstract, and quality assessments. Approximately 16% (95% confidence interval [CI]: 10.4%–24.75%) of knees that underwent arthroscopic surgery were found to be at risk of recurrence. In line with our expectations, sub-group analysis comparing recurrence rates among different subtypes of PVNS found that the diffuse subtype exhibited a higher recurrence rate of 19.4% (95% CI: 10.01%–34.15%), compared to the local subtype, which had a recurrence rate of 9.5% (95% CI: 4.47%–19.01%). Based on the meta-regression analysis, no significant association was found between the recurrence rate and the publication year or patient mean age. However, there was a noticeable rise in the recurrence rate with a longer follow-up period, indicating a probable correlation between extended follow-up and increased recurrence rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that arthroscopic surgery for PVNS, particularly for the diffuse subtype, results in a higher recurrence rate compared to the localized subtype. However, the inherent challenges in achieving complete resection through arthroscopy, particularly in cases with extensive disease involvement, may contribute to the observed recurrence rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III systematic review and meta-analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380052","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":"One-stage minced cartilage autograft with platelet-rich plasma improves early clinical outcomes: A multicentric retrospective study","authors":"Arthur Barbaret,&nbsp;Frank Wein,&nbsp;Christophe Jacquet,&nbsp;Matthieu Ollivier","doi":"10.1002/jeo2.70162","DOIUrl":"https://doi.org/10.1002/jeo2.70162","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Knee cartilage defects are a therapeutic challenge, often requiring multiple costly procedures with modest improvements. This study evaluates whether a one-stage minced cartilage autograft with platelet-rich plasma (PRP) improves clinical and radiological outcomes after at least 1 year.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A multicentric, non-randomized, retrospective analysis was conducted using data from two sports medicine centres. Sixty-six patients aged 18–50 years with symptomatic International Cartilage Repair Society Grade III/IV chondral defects underwent the minced cartilage autograft and PRP procedure between January 2021 and April 2023. The minimum follow-up was 1 year. Clinical scores for Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Score and Self Knee Value (SKV) were collected from medical records and by an independent examiner at the latest follow-up. Magnetic resonance imaging (MRI) assessments using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scoring system were performed at the latest follow-up in 46 patients (70%).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The mean follow-up was 20.5 ± 7.5 months. The study demonstrated significant improvements in knee function and pain relief following the minced cartilage autograft with the PRP procedure. The mean KOOS total score started from 45.3 to 71.5 points, mean KOOS pain started from 51.9 to 80.4 points, mean KOOS activities of daily living started from 62.1 to 85.3 points, mean KOOS symptoms started from 53.1 to 79 points, mean KOOS sports started from 38.7 to 74.8 points, mean KOOS quality of life started from 43.3 to 73.7 points. The mean IKDC score improved by 27.7 ± 15.7 points. All these scores have been significantly improved (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). MRI assessments confirmed the successful integration of repair tissue with a mean MOCART 2.0 score of 80.5 ± 12.5 points.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The minced autograft cartilage technique with PRP provides favourable early clinical and radiological outcomes for limited chondral defects in the knee. This method offers a single-procedure approach with minimal grafting requirements and does not necessitate a laboratory or specialized personnel, unlike other techniques.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Level III retrospective multicentric study.&lt;/p&gt;\u0000 ","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380603","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 minimal clinically important difference changes greatly based on the patient's baseline clinical status","authors":"Marco Franceschini,&nbsp;Angelo Boffa,&nbsp;Alessandro Di Martino,&nbsp;Elettra Pignotti,&nbsp;Luca Andriolo,&nbsp;Stefano Zaffagnini,&nbsp;Giuseppe Filardo","doi":"10.1002/jeo2.70137","DOIUrl":"https://doi.org/10.1002/jeo2.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To quantify the influence of baseline values of a specific patient-reported outcome measure (PROM) on the minimal clinically important difference (MCID) calculation in a homogeneous series of knee osteoarthritis patients treated with platelet-rich plasma (PRP) injections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A data set of 312 patients with knee osteoarthritis treated with intra-articular PRP injections was used. Patients were evaluated through the International Knee Documentation Committee (IKDC) subjective score at 6 months after treatment. According to the baseline IKDC score, the study population was stratified into eight clusters in the first phase (&lt;20, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79 and ≥80) and in three macro clusters in the second phase (&lt;40, 40–69 and ≥70). MCID for the IKDC score was calculated through an anchor-based method in both phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The MCID calculation was performed for the eight clusters according to the baseline IKDC values, obtaining values from 16.2 to −3.1. Afterwards, further MCID calculation was performed after unifying patients in three major clusters based on the similarity of the previously obtained MCID values. Ninety-six patients reported a baseline IKDC score &lt;40, 173 patients between 40 and 70, and 43 patients ≥70. MCID values for the three macro clusters were: 14.6 for patients with baseline IKDC score &lt;40, 7.2 for patients with values between 40 and 69, while patients with values ≥70 reported an MCID value of −2.8.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated that the baseline patient clinical status influences the improvement needed to be perceived as clinically relevant. Patients with a worse baseline clinical status presented higher MCID levels, while MCID lost significance in patients with high baseline clinical values. These findings warrant applying general thresholds to a patients' cohort, showing the remarkable impact of the baseline clinical status. Patient stratification ensures a proper quantification of MCID values and the identification of patients benefiting from the studied treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380609","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":"Greater anterior pelvic tilt and lumbar mobility in females compared to males undergoing periacetabular osteotomy: A matched cohort study","authors":"Maximilian Fischer,&nbsp;Lars Nonnenmacher,&nbsp;Andreas Nitsch,&nbsp;Matthias R. Mühler,&nbsp;Andre Hofer,&nbsp;Georgi I. Wassilew","doi":"10.1002/jeo2.70167","DOIUrl":"https://doi.org/10.1002/jeo2.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The functional hip–spine interaction is increasingly noted in hip preservation by periacetabular osteotomy (PAO), while potentially affecting the impingement-free acetabular reorientation. However, the clinically relevant sex-related differences in lumbopelvic alignment have been poorly studied. Thus, the purpose of this study was to evaluate a matched PAO patient cohort for sex-related differences in lumbopelvic alignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Out of 138 patients undergoing PAO between January 2024 and September 2024 at one high-volume centre, there were 68 data sets (34 male, 34 female) included. The data sets of this diagnostic cohort study were prospectively collected, and the patients were matched in a 1:1 ratio for sex, age and acetabular morphology (hip dysplasia, borderline hip dysplasia, acetabular retroversion). Lumbopelvic alignment was assessed with serial sagittal lumbopelvic radiographs in standing, relaxed-seated and deep-seated positions. Each radiograph was reviewed for pelvic tilt (PT), lumbar lordosis and sacral slope.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Females showed a significantly lower PT in standing (7.8 vs. 14.3°, <i>p</i> &lt; 0.001), relaxed-seated (28.1 vs. 34.9°, <i>p</i> = 0.012) and deep-seated (3.7 vs. 11.0°, <i>p</i> = 0.013) positions. Furthermore, females had a significantly increased lumbar mobility (Δ relaxed-seated − deep-seated position − 35.4° vs. 27.0°, <i>p</i> = 0.003), while there was no sex-related difference in sacral mobility (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There are sex-related differences in functional lumbopelvic alignment across various positions of daily living in patients undergoing PAO. With a greater anterior PT, females are at risk of an anterior hip impingement. Thus, the intraoperative anterior and posterior wall reorientation by PAO should be adapted to the sex-related lumbopelvic alignment to ensure an impingement-free surgical outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, case series.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380610","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":"VELYS robotic-assisted total knee arthroplasty: Enhanced accuracy and comparable early outcomes versus manual instrumentation during adoption","authors":"Timothy B. Alton,&nbsp;Erik P. Severson,&nbsp;Marcus C. Ford,&nbsp;James Lesko,&nbsp;Ian J. Leslie","doi":"10.1002/jeo2.70163","DOIUrl":"https://doi.org/10.1002/jeo2.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study assessed the accuracy and early clinical outcomes of the VELYS™ Robotic-Assisted solution for total knee arthroplasty (TKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter, prospective non-randomized 1:1 cohort study was conducted at five sites. Subjects underwent TKA with either manual instrumentation or with robotic-assistance (RA). RA procedures were the first conducted at each site, therefore, representing the adoption phase for each surgeon. Mechanical alignment was targeted in the manual arm, while the target and technique varied in the RA arm. The primary objective was a non-inferiority (NI) analysis of the accuracy of the hip–knee–ankle (HKA) for RA versus manual, with a 1.5° NI margin. The accuracy of the mechanical medial distal femoral angle (mMDFA), mechanical medial proximal tibial angle (mMPTA) tibial posterior slope (TPS) angles were measured. Adverse events (AEs) and patient-reported outcome measures (PROMs) were collected at 12 weeks and 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred participants were recruited for both manual and RA groups, the mean preoperative demographics and PROM scores were similar. The primary endpoint NI analysis was successful (<i>p</i> &lt; 0.0001). The RA group demonstrated improved alignment accuracy of the femoral and tibial components compared to manual (mMDFA 1.3 vs. 1.9, <i>p</i> = 0.0026, mMPTA 1.2 vs. 1.5, <i>p</i> = 0.026, TPS 1.7 vs. 2.8, <i>p</i> &lt; 0.0001). Serious AEs occurred in fewer RA subjects than in the manual (6 vs. 16, <i>p</i> = 0.040). Mean PROMs at 12 weeks and 1 year in the RA group compared to manual were either equivalent or improved (Forgotten Joint Score and pain at 12 weeks).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found that the RA system can be safely adopted without adversely impacting the long leg alignment or increasing the risk of complications. Further, it was observed that the accuracy of the femoral and tibial component positioning was improved, and there were positive trends in the rate of serious AEs and some PROMs at early follow-up.</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":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380049","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":"3D printing technology is a more accurate tool than an experienced surgeon in performing femoral bone tunnels in multi-ligament knee injuries","authors":"Núria Fernández-Poch,&nbsp;Ferran Fillat-Gomà,&nbsp;Mireia Gamundi,&nbsp;Giovanni Grillo,&nbsp;Christian Yela-Verdú,&nbsp;Sergi Gil-Gonzalez,&nbsp;Xavier Pelfort","doi":"10.1002/jeo2.70159","DOIUrl":"https://doi.org/10.1002/jeo2.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Current surgical methods for multi-ligament knee reconstruction involve the creation of several reconstruction tunnels in the distal femur. However, the limited bone mass in the knee increases the risk of tunnel convergence. Increasing the accuracy of tunnel direction can minimize tunnel collision during anatomical reconstruction. 3D-printed patient-specific instrumentation (PSI) has gained prominence in orthopaedic surgery due to its precision. This study aims to compare the accuracy of PSI with that of the ‘freehand’ approach by an experienced surgeon for drilling the medial and lateral femoral tunnels while adhering to the recommended angulations for multi-ligament knee injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten cadaveric knees underwent computerized tomography (CT) scans to identify anatomical femoral attachments of the lateral collateral ligament (LCL), popliteal tendon (PT), medial collateral ligament (MCL) and posterior oblique ligament (POL). Using Materialise Mimics Medical v25.0 software, virtual planning of a bone tunnel for each ligament was performed, and a total of four tunnels per knee were obtained. Ten PSIs were designed for five knees: five for the medial side and five for the lateral side. The first five knees were operated on via PSI, and the other five knees were operated on by an experienced surgeon using freehand drilling based on preoperative plans. The angular deviation and entry point were assessed by overlaying post-operative CT images onto preoperative CT images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the freehand group, the median angular deviation was 22.3°, with an interquartile range (IQR) of 17.6–25.2°. The PSI group presented a significantly greater accuracy in angular deviation for femoral tunnels of 5.7°, with an IQR of 4–8.2° (<i>p</i> &lt; 0.001). Compared with that in the preoperative planning group, the median entry point distance in the freehand group was 5.5 mm, with an IQR of 2.6–8.8 mm. The PSI group had a median entry point distance of 4.2 mm, with an IQR of 3.6–5.7 mm (<i>p</i> = n.s).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with the freehand technique performed by an experienced surgeon, PSI demonstrated significantly greater accuracy in terms of the mean angular deviation.</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":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248821","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}