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.
Methods
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 t test or the Mann–Whitney U-test was used to compare whether the structural properties vary in failure modes.
Results
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.
Conclusion
This mechanical testing system is useful for evaluating the structural properties of porcine rotator cuff attachments and should be additionally evaluated by cyclic testing.
Level of Evidence
Level IV.
{"title":"Distribution analysis of structural properties of native porcine humerus–rotator cuff–scapular complex using universal testing machine","authors":"Tsuneari Takahashi, Hideyuki Sasanuma, 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}
Sohrab Keyhani, Mehran Soleymanha, Fardis Vosoughi, Ali Nikibakhsh, Ervin Zadgari, Maryam Mousavi, Robert F. LaPrade
Purpose
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.
Methods
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.
Results
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.
Conclusion
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.
Level of Evidence
Level III systematic review and meta-analysis.
{"title":"Recurrence of arthroscopic treatment of pigmented villonodular synovitis of the knee: A systematic review and meta-analysis","authors":"Sohrab Keyhani, Mehran Soleymanha, Fardis Vosoughi, Ali Nikibakhsh, Ervin Zadgari, Maryam Mousavi, 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}
Arthur Barbaret, Frank Wein, Christophe Jacquet, Matthieu Ollivier
<div> <section> <h3> Purpose</h3> <p>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.</p> </section> <section> <h3> Methods</h3> <p>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%).</p> </section> <section> <h3> Results</h3> <p>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 (<i>p</i> < 0.05). MRI assessments confirmed the successful integration of repair tissue with a mean MOCART 2.0 score of 80.5 ± 12.5 points.</p> </section> <section> <h3> Conclusion</h3> <p>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.</p> </section> <section> <h3> Level of Evidence</h3> <p>Level III retrospective multicentric study.</p>
{"title":"One-stage minced cartilage autograft with platelet-rich plasma improves early clinical outcomes: A multicentric retrospective study","authors":"Arthur Barbaret, Frank Wein, Christophe Jacquet, Matthieu Ollivier","doi":"10.1002/jeo2.70162","DOIUrl":"https://doi.org/10.1002/jeo2.70162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> < 0.05). MRI assessments confirmed the successful integration of repair tissue with a mean MOCART 2.0 score of 80.5 ± 12.5 points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III retrospective multicentric study.</p>\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}
Marco Franceschini, Angelo Boffa, Alessandro Di Martino, Elettra Pignotti, Luca Andriolo, Stefano Zaffagnini, Giuseppe Filardo
Purpose
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.
Methods
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 (<20, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79 and ≥80) and in three macro clusters in the second phase (<40, 40–69 and ≥70). MCID for the IKDC score was calculated through an anchor-based method in both phases.
Results
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 <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 <40, 7.2 for patients with values between 40 and 69, while patients with values ≥70 reported an MCID value of −2.8.
Conclusions
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.
Level of Evidence
Level 4.
{"title":"The minimal clinically important difference changes greatly based on the patient's baseline clinical status","authors":"Marco Franceschini, Angelo Boffa, Alessandro Di Martino, Elettra Pignotti, Luca Andriolo, Stefano Zaffagnini, 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 (<20, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79 and ≥80) and in three macro clusters in the second phase (<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 <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 <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}
Maximilian Fischer, Lars Nonnenmacher, Andreas Nitsch, Matthias R. Mühler, Andre Hofer, Georgi I. Wassilew
Purpose
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.
Methods
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.
Results
Females showed a significantly lower PT in standing (7.8 vs. 14.3°, p < 0.001), relaxed-seated (28.1 vs. 34.9°, p = 0.012) and deep-seated (3.7 vs. 11.0°, p = 0.013) positions. Furthermore, females had a significantly increased lumbar mobility (Δ relaxed-seated − deep-seated position − 35.4° vs. 27.0°, p = 0.003), while there was no sex-related difference in sacral mobility (p > 0.05).
Conclusion
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.
Level of Evidence
Level IV, case series.
{"title":"Greater anterior pelvic tilt and lumbar mobility in females compared to males undergoing periacetabular osteotomy: A matched cohort study","authors":"Maximilian Fischer, Lars Nonnenmacher, Andreas Nitsch, Matthias R. Mühler, Andre Hofer, 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> < 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> > 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}
Timothy B. Alton, Erik P. Severson, Marcus C. Ford, James Lesko, Ian J. Leslie
Purpose
This study assessed the accuracy and early clinical outcomes of the VELYS™ Robotic-Assisted solution for total knee arthroplasty (TKA).
Methods
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.
Results
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 (p < 0.0001). The RA group demonstrated improved alignment accuracy of the femoral and tibial components compared to manual (mMDFA 1.3 vs. 1.9, p = 0.0026, mMPTA 1.2 vs. 1.5, p = 0.026, TPS 1.7 vs. 2.8, p < 0.0001). Serious AEs occurred in fewer RA subjects than in the manual (6 vs. 16, p = 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).
Conclusions
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.
Level of Evidence
Level II.
{"title":"VELYS robotic-assisted total knee arthroplasty: Enhanced accuracy and comparable early outcomes versus manual instrumentation during adoption","authors":"Timothy B. Alton, Erik P. Severson, Marcus C. Ford, James Lesko, 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> < 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> < 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}
Núria Fernández-Poch, Ferran Fillat-Gomà, Mireia Gamundi, Giovanni Grillo, Christian Yela-Verdú, Sergi Gil-Gonzalez, Xavier Pelfort
Purpose
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.
Methods
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.
Results
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° (p < 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 (p = n.s).
Conclusions
Compared with the freehand technique performed by an experienced surgeon, PSI demonstrated significantly greater accuracy in terms of the mean angular deviation.
Level of Evidence
Level V.
{"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, Ferran Fillat-Gomà, Mireia Gamundi, Giovanni Grillo, Christian Yela-Verdú, Sergi Gil-Gonzalez, 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> < 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}
Zoltán Nyőgér, Csenge A. Molnár, Norbert Szakály, Anna Várnagy, Tamás Terebessy, Tibor Gunther, Gábor Skaliczki
Purpose
In rotator cuff tears, scapular dyskinesis is often observed. The aim of our study is to better understand the cause and the role of scapular dyskinesis in rotator cuff tears and evaluate changes in scapulothoracic kinematics after Lidocaine subacromial injection and surgery in patients with medium-sized (1–3 cm) rotator cuff tear.
Methods
The scapular motion during humerus sagittal flexion of nine healthy persons (healthy group, HG) and nine persons with a medium-sized rotator cuff tear (surgery group, SG) was investigated using the VICON motion capture system and upper limb evaluation in movement analysis software. In addition, quality of life and functional outcomes were assessed in the SG group using American Shoulder and Elbow Surgeons, Oxford and Constant-Murley scores and rotator muscle force and Visual Analogue Scale score were evaluated. The SG was further divided into three subgroups: measurements were performed preoperatively (before surgery native subgroup—BSN), then after subacromial Lidocaine injection (before surgery injection subgroup—BSI) and 6 months after rotator cuff reconstruction (after surgery subgroup—AS). Changes observed after injection (BSI) and surgery (AS) were compared to the BSN.
Results
In the BSI, a significant reduction (p < .025) in protraction was observed in the raising phase between 20° and 70° comparing it to the BSN, protraction decreased by 5.3° ± 7.9° (mean ± standard deviation [SD]). In the lowering phase between 80° and 30°, we registered a decrease of protraction by 6.0° ± 8.3° (mean ± SD). In the AS, we observed an approximation of protraction to the HG, but no significant change was detected.
Conclusion
Significant reduction in scapular protraction was demonstrated with Lidocaine subacromial injection during both the arm raising and lowering phases. Six months of rehabilitation treatment in the postoperative period is not enough to fully eliminate scapular dyskinesis.
Level of Evidence
Level II.
{"title":"Scapula dyskinesis in medium-sized full-thickness rotator cuff tear after subacromial Lidocaine infiltration and rotator cuff reconstruction","authors":"Zoltán Nyőgér, Csenge A. Molnár, Norbert Szakály, Anna Várnagy, Tamás Terebessy, Tibor Gunther, Gábor Skaliczki","doi":"10.1002/jeo2.70154","DOIUrl":"https://doi.org/10.1002/jeo2.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In rotator cuff tears, scapular dyskinesis is often observed. The aim of our study is to better understand the cause and the role of scapular dyskinesis in rotator cuff tears and evaluate changes in scapulothoracic kinematics after Lidocaine subacromial injection and surgery in patients with medium-sized (1–3 cm) rotator cuff tear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The scapular motion during humerus sagittal flexion of nine healthy persons (healthy group, HG) and nine persons with a medium-sized rotator cuff tear (surgery group, SG) was investigated using the VICON motion capture system and upper limb evaluation in movement analysis software. In addition, quality of life and functional outcomes were assessed in the SG group using American Shoulder and Elbow Surgeons, Oxford and Constant-Murley scores and rotator muscle force and Visual Analogue Scale score were evaluated. The SG was further divided into three subgroups: measurements were performed preoperatively (before surgery native subgroup—BSN), then after subacromial Lidocaine injection (before surgery injection subgroup—BSI) and 6 months after rotator cuff reconstruction (after surgery subgroup—AS). Changes observed after injection (BSI) and surgery (AS) were compared to the BSN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the BSI, a significant reduction (<i>p</i> < .025) in protraction was observed in the raising phase between 20° and 70° comparing it to the BSN, protraction decreased by 5.3° ± 7.9° (mean ± standard deviation [SD]). In the lowering phase between 80° and 30°, we registered a decrease of protraction by 6.0° ± 8.3° (mean ± SD). In the AS, we observed an approximation of protraction to the HG, but no significant change was detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Significant reduction in scapular protraction was demonstrated with Lidocaine subacromial injection during both the arm raising and lowering phases. Six months of rehabilitation treatment in the postoperative period is not enough to fully eliminate scapular dyskinesis.</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":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248822","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}
Enrico Tassinari, Andrea Minerba, Tommaso Basile, Alessio Bucciarelli, Francesco Traina, Brunella Grigolo, Stefano Zaffagnini, Eleonora Olivotto
Purpose
This study aimed to compare the use of cortisone (C), intra-articular injected at the end of hip arthroscopy in patients with femoroacetabular impingement (FAI), to a new Class III medical device based on hydrolyzed collagen peptides ‘PEPTYS’ (P) and, to investigate potential associations among preoperative symptoms and hip function, outcomes after arthroscopic surgery and presence of inflammatory biomarkers in synovial fluids (SFs) at basal condition.
Methods
The two treatments were administrated to patients scheduled for arthroscopy with simple blind randomization sampling. Based on the sample size calculation, the number necessary to recruit was at least 20 patients for the C group and 20 for the P group. SFs, when available, were obtained by aspiration just prior to surgical intervention. At the baseline, osteoarthritis (OA) severity was assessed with a radiographic scoring system (Tönnis classification). Physical examination and clinical assessment using the Hip disability and Osteoarthritis Outcome Score (HOOS) and visual analogue scale (VAS) score for pain were performed at the time of surgery and at 1 and 6 months of follow-up. At the time of surgery, chondral (Outerbridge score) and labral pathology based on direct arthroscopic visualization were also evaluated.
Results
Forty-seven FAI patients were enroled, with a median age of 35 years with a standard deviation (SD) of 10.6 and a body mass index of 24.3kg/m² with an SD of 4.5. 24 patients were treated with C and 23 with P. Both treatments did not show any statistically significant difference in hip function and pain. High expression of inflammatory molecules in SFs was correlated with the worst post-operative articular function.
Conclusions
Our study showed that the use of P was completely comparable to cortisone. Therefore, PEPTYS might be a valuable candidate to improve early recovery, in terms of pain and function, from arthroscopic FAI treatment.
Level of Evidence
Level III, comparative and randomized study.
{"title":"Post-operative injection of hydrolyzed collagen peptides shows anti-inflammatory effect in patients with femoroacetabular impingement improving the early recovery","authors":"Enrico Tassinari, Andrea Minerba, Tommaso Basile, Alessio Bucciarelli, Francesco Traina, Brunella Grigolo, Stefano Zaffagnini, Eleonora Olivotto","doi":"10.1002/jeo2.70158","DOIUrl":"10.1002/jeo2.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to compare the use of cortisone (C), intra-articular injected at the end of hip arthroscopy in patients with femoroacetabular impingement (FAI), to a new Class III medical device based on hydrolyzed collagen peptides ‘PEPTYS’ (P) and, to investigate potential associations among preoperative symptoms and hip function, outcomes after arthroscopic surgery and presence of inflammatory biomarkers in synovial fluids (SFs) at basal condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The two treatments were administrated to patients scheduled for arthroscopy with simple blind randomization sampling. Based on the sample size calculation, the number necessary to recruit was at least 20 patients for the C group and 20 for the P group. SFs, when available, were obtained by aspiration just prior to surgical intervention. At the baseline, osteoarthritis (OA) severity was assessed with a radiographic scoring system (Tönnis classification). Physical examination and clinical assessment using the Hip disability and Osteoarthritis Outcome Score (HOOS) and visual analogue scale (VAS) score for pain were performed at the time of surgery and at 1 and 6 months of follow-up. At the time of surgery, chondral (Outerbridge score) and labral pathology based on direct arthroscopic visualization were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-seven FAI patients were enroled, with a median age of 35 years with a standard deviation (SD) of 10.6 and a body mass index of 24.3kg/m² with an SD of 4.5. 24 patients were treated with C and 23 with P. Both treatments did not show any statistically significant difference in hip function and pain. High expression of inflammatory molecules in SFs was correlated with the worst post-operative articular function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study showed that the use of P was completely comparable to cortisone. Therefore, PEPTYS might be a valuable candidate to improve early recovery, in terms of pain and function, from arthroscopic FAI treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, comparative and randomized study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081306","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}
Mikel Sánchez, Izarbe Yarza, Cristina Jorquera, Jose María Aznar, Leonor López de Dicastillo, Cristina Valente, Renato Andrade, João Espregueira-Mendes, David Celorrio, Beatriz Aizpurua, Juan Azofra, Diego Delgado
Purpose
To identify genes and patient factors that are related to the development of arthrofibrosis in patients after anterior cruciate ligament (ACL) reconstruction and to develop a prognostic model.
Methods
The study included patients diagnosed with ACL injury who underwent ACL reconstruction. Patients were enroled consecutively and divided into non-fibrotic (controls) and fibrotic (cases) groups until a balanced sample of matched case–control was achieved. Arthrofibrosis was considered pathological if the range of motion achieved 3 months after surgery decreased by at least 25% compared to its initial full range of motion. Patient variables and saliva samples were collected from each patient to perform a genetic approach by screening a set of candidate genes implicated in arthrofibrosis. Chi-squared was used to analyze the association between the development of arthrofibrosis and different independent variables. Binary logistic regression was used to develop a prognostic algorithm.
Results
A total of 45 controls (non-fibrotic patients) (50.1%) and 44 cases (fibrotic patients) (49.9%) were included for analysis. The median age was 34.0 years (95% confidence interval = 29.0–38.0) and the number of women was 32 (35.9%). Seven genetic polymorphisms showed significant association with the development of arthrofibrosis (p < 0.05). After binary regression analysis, the regression model included the polymorphisms rs4343 (ACE), rs1800947 (CRP), rs8032158 (NEDD4) and rs679620 (MMP3). This analysis also indicated that female gender was a risk factor while the use of platelet-rich plasma (PRP) during surgery was a preventive factor (p < 0.05).
Conclusion
Genetic alterations involved in inflammation and extracellular matrix turnover predispose to the development of arthrofibrosis after ACL reconstruction. Female sex was a risk factor in the development of this condition, while the application of PRP provided a preventive effect. The combination of patient and genetic variants of a patient allows the development of a prognostic algorithm for the risk of post-surgical arthrofibrosis.
Level of Evidence
level III.
{"title":"Genetics, sex and the use of platelet-rich plasma influence the development of arthrofibrosis after anterior cruciate ligament reconstruction","authors":"Mikel Sánchez, Izarbe Yarza, Cristina Jorquera, Jose María Aznar, Leonor López de Dicastillo, Cristina Valente, Renato Andrade, João Espregueira-Mendes, David Celorrio, Beatriz Aizpurua, Juan Azofra, Diego Delgado","doi":"10.1002/jeo2.70156","DOIUrl":"10.1002/jeo2.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To identify genes and patient factors that are related to the development of arthrofibrosis in patients after anterior cruciate ligament (ACL) reconstruction and to develop a prognostic model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included patients diagnosed with ACL injury who underwent ACL reconstruction. Patients were enroled consecutively and divided into non-fibrotic (controls) and fibrotic (cases) groups until a balanced sample of matched case–control was achieved. Arthrofibrosis was considered pathological if the range of motion achieved 3 months after surgery decreased by at least 25% compared to its initial full range of motion. Patient variables and saliva samples were collected from each patient to perform a genetic approach by screening a set of candidate genes implicated in arthrofibrosis. Chi-squared was used to analyze the association between the development of arthrofibrosis and different independent variables. Binary logistic regression was used to develop a prognostic algorithm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 45 controls (non-fibrotic patients) (50.1%) and 44 cases (fibrotic patients) (49.9%) were included for analysis. The median age was 34.0 years (95% confidence interval = 29.0–38.0) and the number of women was 32 (35.9%). Seven genetic polymorphisms showed significant association with the development of arthrofibrosis (<i>p</i> < 0.05). After binary regression analysis, the regression model included the polymorphisms rs4343 (ACE), rs1800947 (CRP), rs8032158 (NEDD4) and rs679620 (MMP3). This analysis also indicated that female gender was a risk factor while the use of platelet-rich plasma (PRP) during surgery was a preventive factor (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Genetic alterations involved in inflammation and extracellular matrix turnover predispose to the development of arthrofibrosis after ACL reconstruction. Female sex was a risk factor in the development of this condition, while the application of PRP provided a preventive effect. The combination of patient and genetic variants of a patient allows the development of a prognostic algorithm for the risk of post-surgical arthrofibrosis.</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":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068561","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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