Alexander J. Hoffer, Ahmed Mabrouk, Christophe Jacquet, Matthieu Ollivier
Purpose
To compare the risk of a secondary bucket handle tear (BHT) of the medial and lateral menisci after an anterior cruciate ligament reconstruction (ACLR) with an unrecognized ramp lesion. The hypothesis was that an unrecognized ramp lesion would be associated with a secondary medial meniscus BHT more often than a lateral meniscus BHT.
Methods
A retrospective review of adults aged 18 or older who experienced a meniscal BHT after ACLR was conducted. An analysis of the clinical and radiological data from initial injury to revision surgery was completed. Two experts retrospectively documented the prevalence of ramp lesions present on preoperative magnetic resonance imaging (MRI) at the time of the index ACLR. The predictive value of a ramp lesion for BHT laterality was evaluated using logistic regression.
Results
Seventy-six patients, 46 in the medial BHT group and 30 in the lateral BHT group, were included. A ramp lesion was present on the preoperative MRI in 33 patients in the medial BHT group compared to 13 in the lateral BHT group (p = 0.02, odds ratio: 3.2, 95% confidence interval: 1.2–8.0). In the logistic regression analysis, the only independent factor that predicted the occurrence of a medial BHT compared to a lateral BHT was the presence of a ramp tear on preoperative MRI before the index ACL surgery (logworth = 1.59; p = 0.03).
Conclusion
After a primary ACLR, an untreated ramp lesion was associated with a post-operative medial BHT more often than a lateral BHT. Unrepaired ramp lesions may be a risk factor for subsequent medial meniscus BHT after primary ACLR.
Level of Evidence
Level IV.
{"title":"Unrepaired ramp lesions are associated with a higher risk of secondary medial meniscus bucket handle tear compared to lateral meniscus bucket handle tear after anterior cruciate ligament reconstruction","authors":"Alexander J. Hoffer, Ahmed Mabrouk, Christophe Jacquet, Matthieu Ollivier","doi":"10.1002/jeo2.70176","DOIUrl":"https://doi.org/10.1002/jeo2.70176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare the risk of a secondary bucket handle tear (BHT) of the medial and lateral menisci after an anterior cruciate ligament reconstruction (ACLR) with an unrecognized ramp lesion. The hypothesis was that an unrecognized ramp lesion would be associated with a secondary medial meniscus BHT more often than a lateral meniscus BHT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of adults aged 18 or older who experienced a meniscal BHT after ACLR was conducted. An analysis of the clinical and radiological data from initial injury to revision surgery was completed. Two experts retrospectively documented the prevalence of ramp lesions present on preoperative magnetic resonance imaging (MRI) at the time of the index ACLR. The predictive value of a ramp lesion for BHT laterality was evaluated using logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-six patients, 46 in the medial BHT group and 30 in the lateral BHT group, were included. A ramp lesion was present on the preoperative MRI in 33 patients in the medial BHT group compared to 13 in the lateral BHT group (<i>p</i> = 0.02, odds ratio: 3.2, 95% confidence interval: 1.2–8.0). In the logistic regression analysis, the only independent factor that predicted the occurrence of a medial BHT compared to a lateral BHT was the presence of a ramp tear on preoperative MRI before the index ACL surgery (logworth = 1.59; <i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After a primary ACLR, an untreated ramp lesion was associated with a post-operative medial BHT more often than a lateral BHT. Unrepaired ramp lesions may be a risk factor for subsequent medial meniscus BHT after primary ACLR.</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":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475757","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}
Filippo Familiari, Adnan Saithna, Juan Pablo Martinez-Cano, Jorge Chahla, Juan Miguel Del Castillo, Nicholas N. DePhillipo, Gilbert Moatshe, Edoardo Monaco, Jaime Palos Lucio, Pieter D'Hooghe, Robert F. LaPrade, the ISAKOS Young Professionals Task Force
<div> <section> <h3> Purpose</h3> <p>Through an analysis of findings from a survey about the use of artificial intelligence (AI) in orthopaedics, the aim of this study was to establish a scholarly foundation for the discourse on AI in orthopaedics and to elucidate key patterns, challenges and potential future trajectories for AI applications within the field.</p> </section> <section> <h3> Methods</h3> <p>The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Young Professionals Task Force developed a survey to collect feedback on issues related to the use of AI in the orthopaedic field. The survey included 26 questions. Data obtained from the completed questionnaires were transferred to a spreadsheet and then analyzed.</p> </section> <section> <h3> Results</h3> <p>Two hundred and eleven orthopaedic surgeons completed the survey. The survey encompassed responses from a diverse cohort of orthopaedic professionals, predominantly comprising males (92.9%). There was wide representation across all geographic regions. A notable proportion (52.1%) reported uncertainty or lack of differentiation among AI, machine learning and deep learning (47.9%). Respondents identified imaging-based diagnosis (60.2%) as the primary field of orthopaedics poised to benefit from AI. A considerable proportion (25.1%) reported using AI in their practice, with primary reasons including referencing scientific literature/publications (40.3%). The vast majority expressed interest in leveraging AI technologies (95.3%), demonstrating an inclination towards incorporating AI into orthopaedic practice. Respondents indicated specific areas of interest for further study, including prediction of patient outcomes after surgery (30.8%) and image-based diagnosis of osteoarthritis (28%).</p> </section> <section> <h3> Conclusions</h3> <p>This survey demonstrates that there is currently limited use of AI in orthopaedic practice, mainly due to a lack of knowledge about the subject, a lack of proven evidence of its real utility and high costs. These findings are in accordance with other surveys in the literature. However, there is also a high level of interest in its use in the future, in increased study and further research on the subject, so that it can be of real benefit and make AI an integral part of the orthopaedic surgeon's daily work.</p> </section> <section> <h3> Level of Evidence</h3> <p>Level IV, survey study.</p> </section>
{"title":"Exploring artificial intelligence in orthopaedics: A collaborative survey from the ISAKOS Young Professional Task Force","authors":"Filippo Familiari, Adnan Saithna, Juan Pablo Martinez-Cano, Jorge Chahla, Juan Miguel Del Castillo, Nicholas N. DePhillipo, Gilbert Moatshe, Edoardo Monaco, Jaime Palos Lucio, Pieter D'Hooghe, Robert F. LaPrade, the ISAKOS Young Professionals Task Force","doi":"10.1002/jeo2.70181","DOIUrl":"https://doi.org/10.1002/jeo2.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Through an analysis of findings from a survey about the use of artificial intelligence (AI) in orthopaedics, the aim of this study was to establish a scholarly foundation for the discourse on AI in orthopaedics and to elucidate key patterns, challenges and potential future trajectories for AI applications within the field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Young Professionals Task Force developed a survey to collect feedback on issues related to the use of AI in the orthopaedic field. The survey included 26 questions. Data obtained from the completed questionnaires were transferred to a spreadsheet and then analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and eleven orthopaedic surgeons completed the survey. The survey encompassed responses from a diverse cohort of orthopaedic professionals, predominantly comprising males (92.9%). There was wide representation across all geographic regions. A notable proportion (52.1%) reported uncertainty or lack of differentiation among AI, machine learning and deep learning (47.9%). Respondents identified imaging-based diagnosis (60.2%) as the primary field of orthopaedics poised to benefit from AI. A considerable proportion (25.1%) reported using AI in their practice, with primary reasons including referencing scientific literature/publications (40.3%). The vast majority expressed interest in leveraging AI technologies (95.3%), demonstrating an inclination towards incorporating AI into orthopaedic practice. Respondents indicated specific areas of interest for further study, including prediction of patient outcomes after surgery (30.8%) and image-based diagnosis of osteoarthritis (28%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This survey demonstrates that there is currently limited use of AI in orthopaedic practice, mainly due to a lack of knowledge about the subject, a lack of proven evidence of its real utility and high costs. These findings are in accordance with other surveys in the literature. However, there is also a high level of interest in its use in the future, in increased study and further research on the subject, so that it can be of real benefit and make AI an integral part of the orthopaedic surgeon's daily work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV, survey study.</p>\u0000 </section>\u0000 ","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475805","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}
Shintaro Onishi, Youngji Kim, Oliver Adebayo, Hiroshi Nakayama, Christophe Jacquet, Matthieu Ollivier
Purpose
To compare the radiological outcomes of medial closed wedge distal femoral osteotomy (MCWDFO) and lateral open wedge distal femoral osteotomy (LOWDFO), with a focus on evaluating leg length discrepancy (LLD). It was hypothesised that MCWDFO would result in a greater reduction in leg length compared to LOWDFO.
Methods
Patients who underwent MCWDFO or LOWDFO for valgus deformity at a single institution between 2014 and 2022 with a minimum follow-up of 1 year were included. Radiological assessment included hip–knee–ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), length of the whole leg and femur and LLD. The difference between pre- and post-operative values for each parameter is expressed as Δ. The radiological outcomes were statistically evaluated for each procedure.
Results
Fifty-two patients (26 MCWDFO and 26 LOWDFO) were included. No significant differences were observed between the two groups with respect to demographic data and radiological parameters such as HKA, mLDFA and MPTA. Although Δ length of the femur decreased post-MCWDFO (−2.7 ± 0.6 mm) and increased post-LOWDFO (+2.7 ± 0.4 mm), the Δ length of the whole leg post-MCWDFO decreased (−0.5 ± 3.8 mm) and increased post-LOWDFO (+1.7 ± 2.6 mm) (p < 0.001). The straight-lengthening effect on the length of whole leg was significantly greater in MCWDFO than in LOWDFO (+2.0 ± 4.1 mm vs. −1.1 ± 2.5 mm, p > 0.001).
Conclusions
The straight-lengthening effect of alignment correction minimises changes in overall leg length, regardless of the specific DFO technique.
Level of Evidence
Level III, retrospective comparative study.
{"title":"Both medial closing wedge and lateral opening wedge distal femoral osteotomy for valgus knee deformity can maintain leg length: A radiographic comparative study","authors":"Shintaro Onishi, Youngji Kim, Oliver Adebayo, Hiroshi Nakayama, Christophe Jacquet, Matthieu Ollivier","doi":"10.1002/jeo2.70184","DOIUrl":"https://doi.org/10.1002/jeo2.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare the radiological outcomes of medial closed wedge distal femoral osteotomy (MCWDFO) and lateral open wedge distal femoral osteotomy (LOWDFO), with a focus on evaluating leg length discrepancy (LLD). It was hypothesised that MCWDFO would result in a greater reduction in leg length compared to LOWDFO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent MCWDFO or LOWDFO for valgus deformity at a single institution between 2014 and 2022 with a minimum follow-up of 1 year were included. Radiological assessment included hip–knee–ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), length of the whole leg and femur and LLD. The difference between pre- and post-operative values for each parameter is expressed as Δ. The radiological outcomes were statistically evaluated for each procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-two patients (26 MCWDFO and 26 LOWDFO) were included. No significant differences were observed between the two groups with respect to demographic data and radiological parameters such as HKA, mLDFA and MPTA. Although Δ length of the femur decreased post-MCWDFO (−2.7 ± 0.6 mm) and increased post-LOWDFO (+2.7 ± 0.4 mm), the Δ length of the whole leg post-MCWDFO decreased (−0.5 ± 3.8 mm) and increased post-LOWDFO (+1.7 ± 2.6 mm) (<i>p</i> < 0.001). The straight-lengthening effect on the length of whole leg was significantly greater in MCWDFO than in LOWDFO (+2.0 ± 4.1 mm vs. −1.1 ± 2.5 mm, <i>p</i> > 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The straight-lengthening effect of alignment correction minimises changes in overall leg length, regardless of the specific DFO technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, retrospective comparative study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475802","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}
Alexander Pfarrmaier, Romed P. Vieider, Rodrigo Sanchez, Lukas N. Muench, Lukas Willinger, Sebastian Siebenlist, Armin Runer
Purpose
This study aimed to analyse the 50 most cited publications on trochleoplasty (TP), examine their bibliographic parameters and evaluate the correlations between citation count, methodological quality and other factors.
Methods
In a comprehensive literature search on the Web of Science, the 50 most cited studies on TP were identified. These studies were then evaluated according to their bibliographic parameters, level of evidence (LOE), citation counts, the Modified Coleman Methodological Score (MCMS), the Methodological Index for Non‑Randomised Studies (MINORS) and the Radiologic Methodology and Quality Scale (MQCSRE).
Results
Of the top 50 list, 15 articles (30%) were published in the journal ‘Knee Surgery Sports Traumatology Arthroscopy’ (KSSTA). A total of 39 studies were published by institutes from Europe (78%), with France and Switzerland being represented 10 times each. Of eight different study types, case series (n = 25, 50%) and systematic reviews (n = 16, 32%) were the most prevalent. LOE included Level III (n = 1, 2%), Level IV (n = 41, 82%) and Level V studies (n = 8, 16%) studies. The total citation count amounted to 2481 citations, ranging from 10 to 187 (mean 49.6 ± 41.5) and showed a mean citation density of 5.1 ± 2.6. Quality scores were 60.8 ± 9.8 for MCMS (n = 26), 11.1 ± 2.9 for MINORS (n = 26) and 22.5 ± 2.1 for MQCSRE (n = 25), respectively. High citation counts did not statistically correlate with higher study quality scores (p > 0.05).
Conclusion
Overall, there is growing scientific interest in TP as a treatment option for patients suffering from patellofemoral instability despite the lack of articles with a high LOE and methodological quality. This review of the top 50 most cited studies provides orthopaedic surgeons with a resource to assess the most impactful academic contributions to TP.
{"title":"The 50 most cited studies on trochleoplasty","authors":"Alexander Pfarrmaier, Romed P. Vieider, Rodrigo Sanchez, Lukas N. Muench, Lukas Willinger, Sebastian Siebenlist, Armin Runer","doi":"10.1002/jeo2.70183","DOIUrl":"https://doi.org/10.1002/jeo2.70183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to analyse the 50 most cited publications on trochleoplasty (TP), examine their bibliographic parameters and evaluate the correlations between citation count, methodological quality and other factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a comprehensive literature search on the Web of Science, the 50 most cited studies on TP were identified. These studies were then evaluated according to their bibliographic parameters, level of evidence (LOE), citation counts, the Modified Coleman Methodological Score (MCMS), the Methodological Index for Non‑Randomised Studies (MINORS) and the Radiologic Methodology and Quality Scale (MQCSRE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the top 50 list, 15 articles (30%) were published in the journal ‘Knee Surgery Sports Traumatology Arthroscopy’ (KSSTA). A total of 39 studies were published by institutes from Europe (78%), with France and Switzerland being represented 10 times each. Of eight different study types, case series (<i>n</i> = 25, 50%) and systematic reviews (<i>n</i> = 16, 32%) were the most prevalent. LOE included Level III (<i>n</i> = 1, 2%), Level IV (<i>n</i> = 41, 82%) and Level V studies (<i>n</i> = 8, 16%) studies. The total citation count amounted to 2481 citations, ranging from 10 to 187 (mean 49.6 ± 41.5) and showed a mean citation density of 5.1 ± 2.6. Quality scores were 60.8 ± 9.8 for MCMS (<i>n</i> = 26), 11.1 ± 2.9 for MINORS (<i>n</i> = 26) and 22.5 ± 2.1 for MQCSRE (<i>n</i> = 25), respectively. High citation counts did not statistically correlate with higher study quality scores (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, there is growing scientific interest in TP as a treatment option for patients suffering from patellofemoral instability despite the lack of articles with a high LOE and methodological quality. This review of the top 50 most cited studies provides orthopaedic surgeons with a resource to assess the most impactful academic contributions to TP.</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":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475804","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}
Idiopathic flexible flatfoot (IFF) is a frequent condition in children. Patients refractory to conservative treatments may benefit from surgical procedures. The aim of this study was to evaluate clinical outcomes and sport activity levels in a large cohort of paediatric patients treated with calcaneo-stop (CS) for the symptomatic IFF.
Methods
A single-centre retrospective study was conducted using an institutional database that prospectively collected clinical outcomes of patients treated with CS for symptomatic IFF. The procedure included the implantation of a cancellous screw through the talus, which was subsequently removed after 2 years. A total of 644 feet (336 consecutive patients) followed up to a mean of 41.3 ± 6.7 months after implant removal were included. Foot pain and sport activity were assessed.
Results
A successful outcome, defined as the presence of a painless, corrected foot together with patient satisfaction, was obtained in 94% of the patients, while 35 feet were considered failed. Extracurricular sport participation was possible in most patients after CS screw implantation (55%) and fully recovered after implant removal (77%). No activity level increase was shown compared to baseline. The only factor that correlated significantly with the incidence of failures was the occurrence of adverse events (p = 0.001), which negatively influenced also the sport activity level (p = 0.008). Females obtained lower Tegner scores compared to males (3.5 vs. 5.0, p < 0.0005).
Conclusions
CS procedure provided highly satisfactory clinical results at mid-term follow-up. Full sport activity level was recovered after screw removal and a 94% favourable outcome was obtained in terms of foot pain relief as well as patient and parents satisfaction.
Level of Evidence
Level IV, case series.
{"title":"Calcaneo-stop for paediatric idiopathic flexible flatfoot: High functional results and return to sport in 644 feet at mid-term follow-up","authors":"Simone Silva, Tullia Tavernini, Alessandro Bruschi, Luca Andriolo, Giulia Guizzardi, Margherita Serra, Gino Rocca, Giuseppe Filardo","doi":"10.1002/jeo2.70182","DOIUrl":"https://doi.org/10.1002/jeo2.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Idiopathic flexible flatfoot (IFF) is a frequent condition in children. Patients refractory to conservative treatments may benefit from surgical procedures. The aim of this study was to evaluate clinical outcomes and sport activity levels in a large cohort of paediatric patients treated with calcaneo-stop (CS) for the symptomatic IFF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-centre retrospective study was conducted using an institutional database that prospectively collected clinical outcomes of patients treated with CS for symptomatic IFF. The procedure included the implantation of a cancellous screw through the talus, which was subsequently removed after 2 years. A total of 644 feet (336 consecutive patients) followed up to a mean of 41.3 ± 6.7 months after implant removal were included. Foot pain and sport activity were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A successful outcome, defined as the presence of a painless, corrected foot together with patient satisfaction, was obtained in 94% of the patients, while 35 feet were considered failed. Extracurricular sport participation was possible in most patients after CS screw implantation (55%) and fully recovered after implant removal (77%). No activity level increase was shown compared to baseline. The only factor that correlated significantly with the incidence of failures was the occurrence of adverse events (<i>p</i> = 0.001), which negatively influenced also the sport activity level (<i>p</i> = 0.008). Females obtained lower Tegner scores compared to males (3.5 vs. 5.0, <i>p</i> < 0.0005).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CS procedure provided highly satisfactory clinical results at mid-term follow-up. Full sport activity level was recovered after screw removal and a 94% favourable outcome was obtained in terms of foot pain relief as well as patient and parents satisfaction.</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":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447083","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}
Enhancing implant placement to achieve optimal gap balance is crucial in total knee arthroplasty (TKA). Given the limited precision of traditional instrumentation, tools like computer-assisted surgery and robotic-assisted TKA have emerged. This experimental cadaveric study aimed to evaluate the accuracy and reproducibility of the collaborative image-free Robin robotic system to support its future clinical application.
Methods
Fifteen cadaveric specimens were treated by eight experienced TKA surgeons. All surgeons, experts in computer-assisted TKA but new to the Robin system, received standardized training. The Robin system uses a robotic arm to position and hold a universal cutting jig, while surgeons perform osteotomies. The indicator for registration repeatability was the alignment of the cutting block position with the previous pin placement. Bony resection, angles and axes were evaluated by comparing the preoperative planning values to the ones obtained with the Robin system with a validated navigation system.
Results
There were no statistically significant differences between the planned and measured values for most resection angles, except for femoral and tibial orientation on sagittal plane (0.6 ± 0.8° and 0.6 ± 1.0°, respectively). Similarly, no statistically significant differences were recorded for resection thickness values, except for the distal medial femoral cut (0.8 ± 0.7 mm). Moreover, these results showed consistency among the different first-time users.
Conclusions
The study found that the Robin robotic system closely matched the preoperative plan for TKA, demonstrating high accuracy and consistency among first-time users. This allows surgeons to easily achieve their planned targets without having to adapt their surgical technique, potentially improving both efficiency and outcomes even when handling complex cases.
Level of Evidence
Not applicable.
{"title":"Reproducibility of a new device for robotic-assisted TKA surgery","authors":"Domenico Alesi, Vito Gaetano Rinaldi, Tosca Cerasoli, Davide Valente, Giulio Maria Marcheggiani Muccioli, Stefano Zaffagnini","doi":"10.1002/jeo2.70153","DOIUrl":"https://doi.org/10.1002/jeo2.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Enhancing implant placement to achieve optimal gap balance is crucial in total knee arthroplasty (TKA). Given the limited precision of traditional instrumentation, tools like computer-assisted surgery and robotic-assisted TKA have emerged. This experimental cadaveric study aimed to evaluate the accuracy and reproducibility of the collaborative image-free Robin robotic system to support its future clinical application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifteen cadaveric specimens were treated by eight experienced TKA surgeons. All surgeons, experts in computer-assisted TKA but new to the Robin system, received standardized training. The Robin system uses a robotic arm to position and hold a universal cutting jig, while surgeons perform osteotomies. The indicator for registration repeatability was the alignment of the cutting block position with the previous pin placement. Bony resection, angles and axes were evaluated by comparing the preoperative planning values to the ones obtained with the Robin system with a validated navigation system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no statistically significant differences between the planned and measured values for most resection angles, except for femoral and tibial orientation on sagittal plane (0.6 ± 0.8° and 0.6 ± 1.0°, respectively). Similarly, no statistically significant differences were recorded for resection thickness values, except for the distal medial femoral cut (0.8 ± 0.7 mm). Moreover, these results showed consistency among the different first-time users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study found that the Robin robotic system closely matched the preoperative plan for TKA, demonstrating high accuracy and consistency among first-time users. This allows surgeons to easily achieve their planned targets without having to adapt their surgical technique, potentially improving both efficiency and outcomes even when handling complex cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439238","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}
Adrian Deichsel, Thorben Briese, Wenke Liu, Michael J. Raschke, Alina Albert, Christian Peez, Elmar Herbst, Christoph Kittl
Purpose
The purpose of this study was to determine the role of different fibre areas of the tibial footprint of the posterior cruciate ligament (PCL) in restraining posterior tibial translation.
Methods
A sequential cutting study on cadaveric knee specimens (n = 8) was performed, utilizing a six-degrees-of-freedom robotic test setup. The tibial attachment of the PCL was divided into nine areas, which were sequentially cut in a randomized sequence. After determining the native knee kinematics with 89 N anterior, and posterior tibial translation force at 0°, 30°, 60° and 90° knee flexion, a displacement-controlled protocol was performed replaying the native motion. Utilizing the principle of superposition, the reduction of the restraining force represents the contribution (in-situ forces) of each cut fibre area.
Results
The PCL was found to contribute 25.3 ± 11.1% in 0° of flexion, 49.7 ± 19.2% in 30° of flexion, 58.9 ± 19.3% in 60° of flexion and 50.6 ± 15.1% in 90° of flexion, to the restriction of a posterior drawer force. Depending on the flexion angle, every cut area of the tibial PCL footprint was shown to be a significant restrictor of posterior tibial translation (p ≤ 0.05). When investigating the fibre areas from anterior to posterior, the central fibre areas showed the highest contribution (35.0%–44.3%). When investigating the fibre areas from medial to lateral, the lateral fibre areas showed the highest contribution (41.4%–43.6%) from 0 to 30° knee flexion, while the medial fibre areas showed the highest contribution (41.5%) in 90° knee flexion.
Conclusion
The central row areas in the tibial footprint of the PCL were identified to be the main contributors inside the tibial footprint, while, depending on the flexion angle, the medial or lateral column fibre areas showed a higher contribution. These findings might inform the clinician to place a PCL graft centrally into the tibial footprint during reconstruction.
Level of Evidence
Not applicable.
{"title":"The central fibre areas in the tibial footprint of the posterior cruciate ligament show the highest contribution to restriction of a posterior drawer force—A biomechanical robotic investigation","authors":"Adrian Deichsel, Thorben Briese, Wenke Liu, Michael J. Raschke, Alina Albert, Christian Peez, Elmar Herbst, Christoph Kittl","doi":"10.1002/jeo2.70174","DOIUrl":"https://doi.org/10.1002/jeo2.70174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to determine the role of different fibre areas of the tibial footprint of the posterior cruciate ligament (PCL) in restraining posterior tibial translation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A sequential cutting study on cadaveric knee specimens (<i>n</i> = 8) was performed, utilizing a six-degrees-of-freedom robotic test setup. The tibial attachment of the PCL was divided into nine areas, which were sequentially cut in a randomized sequence. After determining the native knee kinematics with 89 N anterior, and posterior tibial translation force at 0°, 30°, 60° and 90° knee flexion, a displacement-controlled protocol was performed replaying the native motion. Utilizing the principle of superposition, the reduction of the restraining force represents the contribution (in-situ forces) of each cut fibre area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PCL was found to contribute 25.3 ± 11.1% in 0° of flexion, 49.7 ± 19.2% in 30° of flexion, 58.9 ± 19.3% in 60° of flexion and 50.6 ± 15.1% in 90° of flexion, to the restriction of a posterior drawer force. Depending on the flexion angle, every cut area of the tibial PCL footprint was shown to be a significant restrictor of posterior tibial translation (<i>p</i> ≤ 0.05). When investigating the fibre areas from anterior to posterior, the central fibre areas showed the highest contribution (35.0%–44.3%). When investigating the fibre areas from medial to lateral, the lateral fibre areas showed the highest contribution (41.4%–43.6%) from 0 to 30° knee flexion, while the medial fibre areas showed the highest contribution (41.5%) in 90° knee flexion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The central row areas in the tibial footprint of the PCL were identified to be the main contributors inside the tibial footprint, while, depending on the flexion angle, the medial or lateral column fibre areas showed a higher contribution. These findings might inform the clinician to place a PCL graft centrally into the tibial footprint during reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424303","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}
To develop and validate a short and mini version of the ALR-RSI (Ankle Ligament Reconstruction-Return to Sport after Injury) scale.
Methods
The ALR-RSI scale contains 12 items and was administered to 109 patients following arthroscopic anatomical lateral ankle reconstruction. The short (6-item) and mini (3-item) versions were developed using a systematic selection process to eliminate items based on their category, mean, standard deviation and pertinence. A second group of 75 patients participated in an analysis to validate the predictive value of these scores. These patients filled out all three ALR-RSI versions 6 months after arthroscopic anatomical reconstruction of the lateral ankle to determine the predictive value for the return to sport (RTS) at 12 months. The predictive value was evaluated with receiver operating characteristic curves (area under the curve [AUC]).
Results
The long version of the ALR-RSI had a high internal consistency (Cronbach's α = 0.97), suggesting redundancy of certain items. A short version of 6 items was developed (Cronbach's α = 0.94). A mini version of 3 items was also developed which retained one key item from each category. Factorial analysis confirmed that only one factor explained 76% of the total variance in the mini version (Cronbach's α = 0.89). The scores of the three versions were higher in patients who returned to sport at the same pre-injury level of play or better (p < 0.0001). Both versions were found to have a good predictive value for the RTS at 12 months, with comparable AUC values (full version AUC 0.70 [95% confidence interval; CI, 0.57–0.83]; short version AUC 0.72 [95% CI, 0.59–0.84]); mini version, AUC 0.73 [95% CI, 0.61–0.85].
Conclusion
The shorter versions (6 and 3 items) of the ALR-RSI may be used to predict the RTS at the pre-injury level without affecting the psychometric characteristics of the long score.
Level of Evidence
Level II prospective cohort study.
{"title":"The short version of the ALR-RSI scale is a valid and reproducible scale to evaluate psychological readiness to return to sport after ankle lateral reconstruction","authors":"Alizée Mahieu, Mohamad K. Moussa, Eugénie Valentin, Ronny Lopes, Alexandre Hardy","doi":"10.1002/jeo2.70160","DOIUrl":"https://doi.org/10.1002/jeo2.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To develop and validate a short and mini version of the ALR-RSI (Ankle Ligament Reconstruction-Return to Sport after Injury) scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The ALR-RSI scale contains 12 items and was administered to 109 patients following arthroscopic anatomical lateral ankle reconstruction. The short (6-item) and mini (3-item) versions were developed using a systematic selection process to eliminate items based on their category, mean, standard deviation and pertinence. A second group of 75 patients participated in an analysis to validate the predictive value of these scores. These patients filled out all three ALR-RSI versions 6 months after arthroscopic anatomical reconstruction of the lateral ankle to determine the predictive value for the return to sport (RTS) at 12 months. The predictive value was evaluated with receiver operating characteristic curves (area under the curve [AUC]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The long version of the ALR-RSI had a high internal consistency (Cronbach's <i>α</i> = 0.97), suggesting redundancy of certain items. A short version of 6 items was developed (Cronbach's <i>α</i> = 0.94). A mini version of 3 items was also developed which retained one key item from each category. Factorial analysis confirmed that only one factor explained 76% of the total variance in the mini version (Cronbach's <i>α</i> = 0.89). The scores of the three versions were higher in patients who returned to sport at the same pre-injury level of play or better (<i>p</i> < 0.0001). Both versions were found to have a good predictive value for the RTS at 12 months, with comparable AUC values (full version AUC 0.70 [95% confidence interval; CI, 0.57–0.83]; short version AUC 0.72 [95% CI, 0.59–0.84]); mini version, AUC 0.73 [95% CI, 0.61–0.85].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The shorter versions (6 and 3 items) of the ALR-RSI may be used to predict the RTS at the pre-injury level without affecting the psychometric characteristics of the long score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level II prospective cohort study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431406","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}
Jacob F. Oeding, Kyle N. Kunze, Ayoosh Pareek, Kristian Samuelsson
Purpose
Treatment options for irreparable rotator cuff tears (IRCTs) remain controversial and include superior capsular reconstruction (SCR), lower trapezius tendon transfer (LTTT), subacromial balloon spacer (SABS), and reverse shoulder arthroplasty (RSA). Despite reports of positive treatment responses with all approaches, the relative clinical benefit in the context of associated cost has not been well delineated. The purpose of this study was to determine the most cost-effective treatment strategy among SCR, LTTT, SABS, and RSA for patients with massive IRCTs.
Methods
A Markov Chain Monte Carlo probabilistic model was developed to evaluate the outcomes and costs of 1000 simulated patients undergoing either SCR, LTTT, SABS, or RSA for massive IRCTs. Upfront costs, health utility values, and reoperation rates including revisions and conversion to RSA were derived from the published literature. Outcome measures included costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER).
Results
Mean total costs of SCR, RSA, LTTT, and SABS were $30,540 ± 5,770, $26,896 ± 5,622, $25,819 ± 4,325, and $16,412 ± 2,583, respectively. On average, total QALYs from SCR, RSA, LTTT, and SABS were 6.17 ± 0.53, 3.78 ± 0.38, 5.33 ± 0.49, and 5.59 ± 0.48. Overall, SCR was determined the preferred, most cost-effective strategy in 60% of patients included in the microsimulation model, with SABS the optimal strategy in 31% of cases and LTTT the optimal strategy in 9% of cases.
Conclusion
SCR was found to be the most cost-effective treatment option for IRCTs based on the current microsimulation and probabilistic sensitivity analyses, although LTTT and SABS were also found to be cost-effective in select patients. Given that this statistical model does not consider the unique experiences of individual patients, shared decision-making remains an important component in determining the optimal treatment strategy for IRCTs.
Level of Evidence
Level III, economic decision model.
{"title":"Which treatment strategy for irreparable rotator cuff tears is most cost-effective? A Markov model-based cost-utility analysis comparing superior capsular reconstruction, lower trapezius tendon transfer, subacromial balloon spacer implantation and reverse shoulder arthroplasty","authors":"Jacob F. Oeding, Kyle N. Kunze, Ayoosh Pareek, Kristian Samuelsson","doi":"10.1002/jeo2.70180","DOIUrl":"https://doi.org/10.1002/jeo2.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Treatment options for irreparable rotator cuff tears (IRCTs) remain controversial and include superior capsular reconstruction (SCR), lower trapezius tendon transfer (LTTT), subacromial balloon spacer (SABS), and reverse shoulder arthroplasty (RSA). Despite reports of positive treatment responses with all approaches, the relative clinical benefit in the context of associated cost has not been well delineated. The purpose of this study was to determine the most cost-effective treatment strategy among SCR, LTTT, SABS, and RSA for patients with massive IRCTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Markov Chain Monte Carlo probabilistic model was developed to evaluate the outcomes and costs of 1000 simulated patients undergoing either SCR, LTTT, SABS, or RSA for massive IRCTs. Upfront costs, health utility values, and reoperation rates including revisions and conversion to RSA were derived from the published literature. Outcome measures included costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean total costs of SCR, RSA, LTTT, and SABS were $30,540 ± 5,770, $26,896 ± 5,622, $25,819 ± 4,325, and $16,412 ± 2,583, respectively. On average, total QALYs from SCR, RSA, LTTT, and SABS were 6.17 ± 0.53, 3.78 ± 0.38, 5.33 ± 0.49, and 5.59 ± 0.48. Overall, SCR was determined the preferred, most cost-effective strategy in 60% of patients included in the microsimulation model, with SABS the optimal strategy in 31% of cases and LTTT the optimal strategy in 9% of cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SCR was found to be the most cost-effective treatment option for IRCTs based on the current microsimulation and probabilistic sensitivity analyses, although LTTT and SABS were also found to be cost-effective in select patients. Given that this statistical model does not consider the unique experiences of individual patients, shared decision-making remains an important component in determining the optimal treatment strategy for IRCTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level III, economic decision model.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396767","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}
Youichi Yasui, Wataru Miyamoto, Jun Sasahara, Tsukada Keisuke, Maya Kubo, Gen Sasaki, Asako Yamamoto, Hirotaka Kawano
Purpose
Double-blind, randomized, placebo-controlled trials evaluating the efficacy and safety of Platelet-rich plasma (PRP) in the treatment of Achilles tendon rupture (ATR) have been scant. This study examines the therapeutic impact of PRP injection 3 weeks after surgery in middle-aged males.
Methods
This double-blind, randomized, placebo-controlled trial included consecutive ATR patients who satisfied the inclusion criteria and was conducted from 5 September 2018 to 24 June 2021. Three weeks after surgery using the side-locking loop technique, PRP or saline was injected at the suture site under ultrasound guidance. Evaluations were conducted at predetermined intervals (6, 10, 12, 16 and 24 weeks and 1 and 2 years) after surgery. The primary outcome was the period needed to perform a bilateral heel raise, and the important secondary outcomes were the periods needed to perform a single heel raise and 20 unilateral heel raises, respectively.
Results
There were seven participants in the PRP group and seven in the saline group. Demographically, both groups exhibited comparable characteristics. No complications were reported. At 6 weeks after surgery, all participants achieved bilateral heel raise. The PRP and saline groups averaged 12.3 ± 2.7 and 15.7 ± 5.9 weeks to achieve a single heel raise and 14.3 ± 2.7 and 17.7 ± 4.5 weeks to achieve 20 unilateral heel raises, respectively, with no significant differences between both groups. Moreover, no substantial disparities in clinical scores, period of jogging initiation and magnetic resonance imaging tendon assessments were noted.
Conclusions
PRP did not offer a distinct advantage over saline in terms of recovery from ATR in middle-aged males. This finding underscores the need to reassess the post-operative significance of PRP and highlights the importance of further research to determine its potential advantages and risks.
Level of Evidence
Level I.
{"title":"No significant impact of platelet-rich plasma on recovery after Achilles tendon surgery: A double-blind randomized controlled trial","authors":"Youichi Yasui, Wataru Miyamoto, Jun Sasahara, Tsukada Keisuke, Maya Kubo, Gen Sasaki, Asako Yamamoto, Hirotaka Kawano","doi":"10.1002/jeo2.70168","DOIUrl":"https://doi.org/10.1002/jeo2.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Double-blind, randomized, placebo-controlled trials evaluating the efficacy and safety of Platelet-rich plasma (PRP) in the treatment of Achilles tendon rupture (ATR) have been scant. This study examines the therapeutic impact of PRP injection 3 weeks after surgery in middle-aged males.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This double-blind, randomized, placebo-controlled trial included consecutive ATR patients who satisfied the inclusion criteria and was conducted from 5 September 2018 to 24 June 2021. Three weeks after surgery using the side-locking loop technique, PRP or saline was injected at the suture site under ultrasound guidance. Evaluations were conducted at predetermined intervals (6, 10, 12, 16 and 24 weeks and 1 and 2 years) after surgery. The primary outcome was the period needed to perform a bilateral heel raise, and the important secondary outcomes were the periods needed to perform a single heel raise and 20 unilateral heel raises, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were seven participants in the PRP group and seven in the saline group. Demographically, both groups exhibited comparable characteristics. No complications were reported. At 6 weeks after surgery, all participants achieved bilateral heel raise. The PRP and saline groups averaged 12.3 ± 2.7 and 15.7 ± 5.9 weeks to achieve a single heel raise and 14.3 ± 2.7 and 17.7 ± 4.5 weeks to achieve 20 unilateral heel raises, respectively, with no significant differences between both groups. Moreover, no substantial disparities in clinical scores, period of jogging initiation and magnetic resonance imaging tendon assessments were noted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PRP did not offer a distinct advantage over saline in terms of recovery from ATR in middle-aged males. This finding underscores the need to reassess the post-operative significance of PRP and highlights the importance of further research to determine its potential advantages and risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397189","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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