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Influence of limb position on femoral neck anteversion angle measurement during computed tomography imaging 计算机断层扫描成像时肢体位置对股骨颈内翻角测量的影响
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-04-01 DOI: 10.1016/j.asmart.2025.04.003
Rika Shigemoto, Takehiko Matsushita, Kyohei Nishida, Kanto Nagai, Yuta Nakanishi, Tetsuya Yamamoto, Tomoyuki Matsumoto, Noriyuki Kanzaki, Yuichi Hoshino, Ryosuke Kuroda

Background

The femoral neck anteversion angle has been used as a surgical indicator for hip and patellofemoral joint disorders. However, the influence of limb position on femoral neck anteversion angle measurements during imaging remains unclear. Therefore, this study aimed to investigate the influence of limb position on femoral neck anteversion angle measurements.

Methods

Computed tomography images of 20 femurs from 10 patients were obtained. The angle between the line passing through the center of the femoral head and the center of the femoral neck and the tangential line of the femoral posterior condyles on axial slices was measured as the femoral neck anteversion angle. Raw femoral neck anteversion angle data was defined as the original femoral neck anteversion angle. The cutting direction of the axial plane was changed from −20° to 20° in 5° increments to simulate limb position changes for each of the following measurements: hip flexion/extension, abduction/adduction angles, and their combined directions. The femoral neck anteversion angle was measured under each condition, and the change in the angle was calculated. The correlation between hip angle and femoral neck anteversion angle change was analysed by Spearman's rank correlation coefficient.

Results

The mean original femoral neck anteversion angle was 17.6°. There was a strong negative correlation between hip flexion/extension change and femoral neck anteversion angle change (r = −0.96, p < 0.001). There was a weak correlation between hip adduction/abduction change and femoral neck anteversion angle change (r = 0.35, p < 0.001). The average maximum potential difference in femoral neck anteversion angle measurement combining flexion/extension and abduction/adduction was 21.0° ± 4.9°.

Conclusions

The femoral neck anteversion angle changed in association with changes in limb position, particularly with hip flexion and extension. Careful attention to limb position and conditions of the slice is needed to consistently evaluate the femoral neck anteversion angle.
{"title":"Influence of limb position on femoral neck anteversion angle measurement during computed tomography imaging","authors":"Rika Shigemoto,&nbsp;Takehiko Matsushita,&nbsp;Kyohei Nishida,&nbsp;Kanto Nagai,&nbsp;Yuta Nakanishi,&nbsp;Tetsuya Yamamoto,&nbsp;Tomoyuki Matsumoto,&nbsp;Noriyuki Kanzaki,&nbsp;Yuichi Hoshino,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.asmart.2025.04.003","DOIUrl":"10.1016/j.asmart.2025.04.003","url":null,"abstract":"<div><h3>Background</h3><div>The femoral neck anteversion angle has been used as a surgical indicator for hip and patellofemoral joint disorders. However, the influence of limb position on femoral neck anteversion angle measurements during imaging remains unclear. Therefore, this study aimed to investigate the influence of limb position on femoral neck anteversion angle measurements.</div></div><div><h3>Methods</h3><div>Computed tomography images of 20 femurs from 10 patients were obtained. The angle between the line passing through the center of the femoral head and the center of the femoral neck and the tangential line of the femoral posterior condyles on axial slices was measured as the femoral neck anteversion angle. Raw femoral neck anteversion angle data was defined as the original femoral neck anteversion angle. The cutting direction of the axial plane was changed from −20° to 20° in 5° increments to simulate limb position changes for each of the following measurements: hip flexion/extension, abduction/adduction angles, and their combined directions. The femoral neck anteversion angle was measured under each condition, and the change in the angle was calculated. The correlation between hip angle and femoral neck anteversion angle change was analysed by Spearman's rank correlation coefficient.</div></div><div><h3>Results</h3><div>The mean original femoral neck anteversion angle was 17.6°. There was a strong negative correlation between hip flexion/extension change and femoral neck anteversion angle change (<em>r</em> = −0.96, p &lt; 0.001). There was a weak correlation between hip adduction/abduction change and femoral neck anteversion angle change (<em>r</em> = 0.35, p &lt; 0.001). The average maximum potential difference in femoral neck anteversion angle measurement combining flexion/extension and abduction/adduction was 21.0° ± 4.9°.</div></div><div><h3>Conclusions</h3><div>The femoral neck anteversion angle changed in association with changes in limb position, particularly with hip flexion and extension. Careful attention to limb position and conditions of the slice is needed to consistently evaluate the femoral neck anteversion angle.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 29-34"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cross-cultural adaptation and validation of the Vietnamese version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in patients with knee osteoarthritis 膝关节骨性关节炎患者膝关节损伤和骨性关节炎结果评分(KOOS)越南语版的跨文化改编和验证
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-04-01 DOI: 10.1016/j.asmart.2025.04.002
Thanh-Van Le , Massimo Penta , Thi Bich Hanh Tran , Long Bien Tran , Minh Sang Nguyen , Bénédicte Schepens

Background

Knee osteoarthritis (KOA) is common in Vietnam, affecting about 34 % of individuals over 40 years of age. The Knee Injury and Osteoarthritis Outcome Score (KOOS) is an internationally recognized patient-reported outcome used to assess the impact of KOA but it is not yet available in Vietnamese.

Objective

This study aimed to translate the KOOS into Vietnamese and assess the psychometric properties of the translation (KOOS-V).

Methods

The translation process involved forward/back translation, expert review and cognitive interviews for pretesting. Content validity was assessed by seven experts using the Content validity Index (CVI). A sample of 133 Vietnamese KOA patients (mean age: 63.7 years, 83 % female) completed the KOOS-V, Short Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (NPRS), and 67 of them were re-assessed after 5–8 days. Psychometric analyses included internal consistency, test-retest reliability, construct validity and cross-cultural comparison of KOOS-V subscales.

Results

KOOS-V exhibited excellent content validity (CVI = 0.86–1.00), satisfactory internal consistency (Cronbach's α = 0.70–0.98) and good to excellent test-retest reliability (ICC = 0.77–0.90). Construct validity was confirmed by moderate to strong correlations with SF-36 Physical Functioning (Spearman's ρ = 0.66 to 0.82) and moderate correlations with NPRS (ρ = −0.49 to −0.62). The cross-cultural comparison showed that the KOOS subscales in Vietnam presents the same challenge as in other cultures.

Conclusions

The KOOS-V is a reliable, valid tool for assessing the functional impact of KOA in Vietnamese patients, contributing to its broader use worldwide in clinical and research settings.
{"title":"Cross-cultural adaptation and validation of the Vietnamese version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in patients with knee osteoarthritis","authors":"Thanh-Van Le ,&nbsp;Massimo Penta ,&nbsp;Thi Bich Hanh Tran ,&nbsp;Long Bien Tran ,&nbsp;Minh Sang Nguyen ,&nbsp;Bénédicte Schepens","doi":"10.1016/j.asmart.2025.04.002","DOIUrl":"10.1016/j.asmart.2025.04.002","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (KOA) is common in Vietnam, affecting about 34 % of individuals over 40 years of age. The Knee Injury and Osteoarthritis Outcome Score (KOOS) is an internationally recognized patient-reported outcome used to assess the impact of KOA but it is not yet available in Vietnamese.</div></div><div><h3>Objective</h3><div>This study aimed to translate the KOOS into Vietnamese and assess the psychometric properties of the translation (KOOS-V).</div></div><div><h3>Methods</h3><div>The translation process involved forward/back translation, expert review and cognitive interviews for pretesting. Content validity was assessed by seven experts using the Content validity Index (CVI). A sample of 133 Vietnamese KOA patients (mean age: 63.7 years, 83 % female) completed the KOOS-V, Short Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (NPRS), and 67 of them were re-assessed after 5–8 days. Psychometric analyses included internal consistency, test-retest reliability, construct validity and cross-cultural comparison of KOOS-V subscales.</div></div><div><h3>Results</h3><div>KOOS-V exhibited excellent content validity (CVI = 0.86–1.00), satisfactory internal consistency (Cronbach's α = 0.70–0.98) and good to excellent test-retest reliability (ICC = 0.77–0.90). Construct validity was confirmed by moderate to strong correlations with SF-36 Physical Functioning (Spearman's ρ = 0.66 to 0.82) and moderate correlations with NPRS (ρ = −0.49 to −0.62). The cross-cultural comparison showed that the KOOS subscales in Vietnam presents the same challenge as in other cultures.</div></div><div><h3>Conclusions</h3><div>The KOOS-V is a reliable, valid tool for assessing the functional impact of KOA in Vietnamese patients, contributing to its broader use worldwide in clinical and research settings.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 23-28"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment of a medial plica in the knee among German knee surgeons – The Plica Survey
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-02-01 DOI: 10.1016/j.asmart.2025.01.003
Svea Faber , Philipp W. Winkler , Ralf Henkelmann , Theresa Diermeier , Wolf Petersen , Maurice Balke , Sebastian Metzlaff , Sebastian Colcuc , Gerald Zimmermann , Philip P. Roessler , Thomas R. Niethammer

Purpose

The MPP (medial patella plica) has garnered increasing clinical attention due to its potential role in patellofemoral pain syndromes. While often an anatomical relic without pathological significance, inflammation or mechanical irritation of this structure can lead to plica syndrome, causing significant clinical symptoms. The purpose of this study was to analyze the current care situation regarding plica syndrome of the knee among a large number of experienced knee surgeons.

Methods

An online survey targeting the current care practices for plica syndrome was conducted among members of the German Knee Society (DKG). The survey was comprised 15 questions regarding diagnostic and treatment approaches. Data were collected anonymously and analyzed using IBM SPSS Statistics Version 26.0.

Results

A total of 238 surgeons participated. Most respondents (84 %) agreed that plica syndrome could cause patellofemoral pain. The typical patient profile was predominantly female (77.7 %), aged 21–30 years (57.6 %). The majority of surgeons use magnetic resonance imaging (MRI) combined with clinical examination (58.0 %) to diagnose an MPP, and 54.2 % of surgeons resected the plica upon finding significant intraoperative evidence of impact on the patellofemoral joint. Hemarthrosis and persistent pain were the most reported complications, though 83.2 % of surgeons observed a complication rate below 11 %.

Conclusion

This study provides a comprehensive overview of current practices and opinions regarding plica syndrome among experienced German knee surgeons. It emphasizes the need for further research to standardize diagnostic and therapeutic approaches, aiming to optimize patient outcomes in plica-related knee pathologies.
{"title":"Treatment of a medial plica in the knee among German knee surgeons – The Plica Survey","authors":"Svea Faber ,&nbsp;Philipp W. Winkler ,&nbsp;Ralf Henkelmann ,&nbsp;Theresa Diermeier ,&nbsp;Wolf Petersen ,&nbsp;Maurice Balke ,&nbsp;Sebastian Metzlaff ,&nbsp;Sebastian Colcuc ,&nbsp;Gerald Zimmermann ,&nbsp;Philip P. Roessler ,&nbsp;Thomas R. Niethammer","doi":"10.1016/j.asmart.2025.01.003","DOIUrl":"10.1016/j.asmart.2025.01.003","url":null,"abstract":"<div><h3>Purpose</h3><div>The MPP (medial patella plica) has garnered increasing clinical attention due to its potential role in patellofemoral pain syndromes. While often an anatomical relic without pathological significance, inflammation or mechanical irritation of this structure can lead to plica syndrome, causing significant clinical symptoms. The purpose of this study was to analyze the current care situation regarding plica syndrome of the knee among a large number of experienced knee surgeons.</div></div><div><h3>Methods</h3><div>An online survey targeting the current care practices for plica syndrome was conducted among members of the German Knee Society (DKG). The survey was comprised 15 questions regarding diagnostic and treatment approaches. Data were collected anonymously and analyzed using IBM SPSS Statistics Version 26.0.</div></div><div><h3>Results</h3><div>A total of 238 surgeons participated. Most respondents (84 %) agreed that plica syndrome could cause patellofemoral pain. The typical patient profile was predominantly female (77.7 %), aged 21–30 years (57.6 %). The majority of surgeons use magnetic resonance imaging (MRI) combined with clinical examination (58.0 %) to diagnose an MPP, and 54.2 % of surgeons resected the plica upon finding significant intraoperative evidence of impact on the patellofemoral joint. Hemarthrosis and persistent pain were the most reported complications, though 83.2 % of surgeons observed a complication rate below 11 %.</div></div><div><h3>Conclusion</h3><div>This study provides a comprehensive overview of current practices and opinions regarding plica syndrome among experienced German knee surgeons. It emphasizes the need for further research to standardize diagnostic and therapeutic approaches, aiming to optimize patient outcomes in plica-related knee pathologies.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 18-22"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155486","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}
引用次数: 0
Long-term outcomes after fixation of pure chondral fragment from the femoral trochlea in adolescents –three case reports-
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-01-29 DOI: 10.1016/j.asmart.2025.01.004
Shuto Yamashita , Ryohei Uchida , Tomohiko Matsuo , Norimasa Nakamura , Shuji Horibe , Yukiyoshi Toritsuka

Purpose

Pure chondral fragments in adolescents are very rare, especially, fragments from the femoral trochlea. While satisfactory short-term outcomes after fixation were reported in several reports, long-term outcomes have still been unknown. Our objective is to evaluate the long-term outcomes after fixation for pure chondral fragment from the trochlea.

Materials & Methods

Three adolescent patients (aged 13, 14, and 14 years) with pure chondral fragment from the trochlea underwent internal fixation using bio-absorbable pins at our institution. All patients were followed up for more than eight years. At final follow-up, all three patients were assessed by radiographs and magnetic resonance imaging (MRI) as well as clinical scores, including Lysholm questionnaires, and IKDC (International Knee Documentation Committee) score, KOOS (Knee injury and Osteoarthritis Outcome Score).

Results

At final follow-up (12, 8, and 9 years postoperatively) all three patients were able to continue to play sports without any restriction. Radiographs showed no osteoarthritic changes and MRI showed good integration with the surrounding native cartilage and smooth surface in all cases. In all cases, Lysholm score and IKDC score were over 95, and most of KOOS were over 90.

Conclusion

Fixation for pure chondral fragment from the femoral trochlea resulted in successful healing in adolescent patients with excellent radiographic and clinical outcomes in the long-term.
{"title":"Long-term outcomes after fixation of pure chondral fragment from the femoral trochlea in adolescents –three case reports-","authors":"Shuto Yamashita ,&nbsp;Ryohei Uchida ,&nbsp;Tomohiko Matsuo ,&nbsp;Norimasa Nakamura ,&nbsp;Shuji Horibe ,&nbsp;Yukiyoshi Toritsuka","doi":"10.1016/j.asmart.2025.01.004","DOIUrl":"10.1016/j.asmart.2025.01.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Pure chondral fragments in adolescents are very rare, especially, fragments from the femoral trochlea. While satisfactory short-term outcomes after fixation were reported in several reports, long-term outcomes have still been unknown. Our objective is to evaluate the long-term outcomes after fixation for pure chondral fragment from the trochlea.</div></div><div><h3>Materials &amp; Methods</h3><div>Three adolescent patients (aged 13, 14, and 14 years) with pure chondral fragment from the trochlea underwent internal fixation using bio-absorbable pins at our institution. All patients were followed up for more than eight years. At final follow-up, all three patients were assessed by radiographs and magnetic resonance imaging (MRI) as well as clinical scores, including Lysholm questionnaires, and IKDC (International Knee Documentation Committee) score, KOOS (Knee injury and Osteoarthritis Outcome Score).</div></div><div><h3>Results</h3><div>At final follow-up (12, 8, and 9 years postoperatively) all three patients were able to continue to play sports without any restriction. Radiographs showed no osteoarthritic changes and MRI showed good integration with the surrounding native cartilage and smooth surface in all cases. In all cases, Lysholm score and IKDC score were over 95, and most of KOOS were over 90.</div></div><div><h3>Conclusion</h3><div>Fixation for pure chondral fragment from the femoral trochlea resulted in successful healing in adolescent patients with excellent radiographic and clinical outcomes in the long-term.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 12-17"},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155485","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}
引用次数: 0
Using deep learning for ultrasound images to diagnose chronic lateral ankle instability with high accuracy
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-01-22 DOI: 10.1016/j.asmart.2025.01.001
Masamune Kamachi, Kohei Kamada, Noriyuki Kanzaki, Tetsuya Yamamoto, Yuichi Hoshino, Atsuyuki Inui, Yuta Nakanishi, Kyohei Nishida, Kanto Nagai, Takehiko Matsushita, Ryosuke Kuroda
The purpose of this study is to calculate diagnostic accuracy of chronic lateral ankle instability (CLAI) from a confusion matrix using deep learning (DL) on ultrasound images of anterior talofibular ligament (ATFL). The study included 30 ankles with no history of ankle sprains (control group), and 30 ankles diagnosed with CLAI (injury group). A total of 2000 images were prepared for each group by capturing ultrasound videos visualizing the fibers of ATFL under the anterior drawer stress. The images of 20 feet in each group were randomly selected and used for training data and the images of remaining 10 feet in each group were used as test data. Transfer learning was performed using 3 pretraining DL models, and the accuracy, precision, recall (sensitivity), specificity, F-measure, and the area under the receiver operating characteristic curve (AUC) were calculated based on the confusion matrix. The important features were visualized using occlusion sensitivity, a method for visualizing areas that are important for model prediction. DL was able to diagnose CLAI using ultrasound imaging with very high accuracy and AUC in three different learning models. In visualization of the region of interest, AI focused on the substance of the ATFL and its attachment on the fibula for the diagnosis of CLAI.
{"title":"Using deep learning for ultrasound images to diagnose chronic lateral ankle instability with high accuracy","authors":"Masamune Kamachi,&nbsp;Kohei Kamada,&nbsp;Noriyuki Kanzaki,&nbsp;Tetsuya Yamamoto,&nbsp;Yuichi Hoshino,&nbsp;Atsuyuki Inui,&nbsp;Yuta Nakanishi,&nbsp;Kyohei Nishida,&nbsp;Kanto Nagai,&nbsp;Takehiko Matsushita,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.asmart.2025.01.001","DOIUrl":"10.1016/j.asmart.2025.01.001","url":null,"abstract":"<div><div>The purpose of this study is to calculate diagnostic accuracy of chronic lateral ankle instability (CLAI) from a confusion matrix using deep learning (DL) on ultrasound images of anterior talofibular ligament (ATFL). The study included 30 ankles with no history of ankle sprains (control group), and 30 ankles diagnosed with CLAI (injury group). A total of 2000 images were prepared for each group by capturing ultrasound videos visualizing the fibers of ATFL under the anterior drawer stress. The images of 20 feet in each group were randomly selected and used for training data and the images of remaining 10 feet in each group were used as test data. Transfer learning was performed using 3 pretraining DL models, and the accuracy, precision, recall (sensitivity), specificity, F-measure, and the area under the receiver operating characteristic curve (AUC) were calculated based on the confusion matrix. The important features were visualized using occlusion sensitivity, a method for visualizing areas that are important for model prediction. DL was able to diagnose CLAI using ultrasound imaging with very high accuracy and AUC in three different learning models. In visualization of the region of interest, AI focused on the substance of the ATFL and its attachment on the fibula for the diagnosis of CLAI.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 1-6"},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155484","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}
引用次数: 0
Changes in the position of the medial meniscus owing to degenerative meniscus tears
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-01-22 DOI: 10.1016/j.asmart.2025.01.002
Tomoyuki Kanayama, Yasushi Takata, Yoshihiro Ishida, Naoki Takemoto, Manase Nishimura, Satoru Demura, Junsuke Nakase

Background

While meniscal extrusion has been recognized as a key factor in meniscal dysfunction and osteoarthritis (OA) development, the specific movement of the posterior horn of the medial meniscus (MM) during extrusion, particularly in early-stage OA, remains unexplored. Therefore, in this study, we investigated the position of the MM in patients with medial knee pain and a Kellgren–Lawrence grade ≤1, investigating the relationship between meniscal extrusion and degenerative tears. We hypothesized that the MM extrusion (MME) would be larger when degenerative tears are present; the anterior horn would move posteriorly, and the posterior horn would move anteriorly, accordingly.

Methods

A total of 181 knees (mean age 61.7 ± 12.1 years; 97 men and 84 women) were included. Simple radiographs were used to measure the weight-bearing line ratio and medial proximal tibia angle. Magnetic resonance imaging was used to measure the medial proximal tibia slope, medial meniscus extrusion, anterior and posterior horn position, and degenerative tears on the posterior segment of the medial meniscus. Those with degenerative tears were designated as group T and those without were designated as group C. Student's t-test and Pearson's χ2 test were performed to compare groups T and C. Statistical significance was set at p < 0.05.

Results

Group T had a significantly larger medial posterior tibial slope (group T: 7.4 ± 2.3°; group C: 6.6 ± 2.2°, p = 0.010) and medial meniscus extrusion (group T: 2.7 ± 1.4 mm; group C: 1.9 ± 1.2 mm, p < 0.001) scores compared with group C. Furthermore, the posterior point of the anterior horn (group T: 16.3 ± 5.0 %; group C: 14.3 ± 3.8 %, p = 0.004) and anterior point of the posterior horn (group T: 36.4 ± 7.1 %; group C:26.9 ± 5.9 %, p < 0.001) were significantly larger in group T than in group C.

Conclusion

Degenerative MM tears cause not only MME but also an anteroposterior shift.
{"title":"Changes in the position of the medial meniscus owing to degenerative meniscus tears","authors":"Tomoyuki Kanayama,&nbsp;Yasushi Takata,&nbsp;Yoshihiro Ishida,&nbsp;Naoki Takemoto,&nbsp;Manase Nishimura,&nbsp;Satoru Demura,&nbsp;Junsuke Nakase","doi":"10.1016/j.asmart.2025.01.002","DOIUrl":"10.1016/j.asmart.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>While meniscal extrusion has been recognized as a key factor in meniscal dysfunction and osteoarthritis (OA) development, the specific movement of the posterior horn of the medial meniscus (MM) during extrusion, particularly in early-stage OA, remains unexplored. Therefore, in this study, we investigated the position of the MM in patients with medial knee pain and a Kellgren–Lawrence grade ≤1, investigating the relationship between meniscal extrusion and degenerative tears. We hypothesized that the MM extrusion (MME) would be larger when degenerative tears are present; the anterior horn would move posteriorly, and the posterior horn would move anteriorly, accordingly.</div></div><div><h3>Methods</h3><div>A total of 181 knees (mean age 61.7 ± 12.1 years; 97 men and 84 women) were included. Simple radiographs were used to measure the weight-bearing line ratio and medial proximal tibia angle. Magnetic resonance imaging was used to measure the medial proximal tibia slope, medial meniscus extrusion, anterior and posterior horn position, and degenerative tears on the posterior segment of the medial meniscus. Those with degenerative tears were designated as group T and those without were designated as group C. Student's t-test and Pearson's χ<sup>2</sup> test were performed to compare groups T and C. Statistical significance was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Group T had a significantly larger medial posterior tibial slope (group T: 7.4 ± 2.3°; group C: 6.6 ± 2.2°, p = 0.010) and medial meniscus extrusion (group T: 2.7 ± 1.4 mm; group C: 1.9 ± 1.2 mm, p &lt; 0.001) scores compared with group C. Furthermore, the posterior point of the anterior horn (group T: 16.3 ± 5.0 %; group C: 14.3 ± 3.8 %, p = 0.004) and anterior point of the posterior horn (group T: 36.4 ± 7.1 %; group C:26.9 ± 5.9 %, p &lt; 0.001) were significantly larger in group T than in group C.</div></div><div><h3>Conclusion</h3><div>Degenerative MM tears cause not only MME but also an anteroposterior shift.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 7-11"},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155483","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}
引用次数: 0
Reviewer Acknowledgement 2024
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-01-01 DOI: 10.1016/j.asmart.2025.01.005
{"title":"Reviewer Acknowledgement 2024","authors":"","doi":"10.1016/j.asmart.2025.01.005","DOIUrl":"10.1016/j.asmart.2025.01.005","url":null,"abstract":"","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Page I"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153541","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}
引用次数: 0
Neural structural alterations correlates of quadriceps muscle strength deficits in patients after anterior cruciate ligament reconstruction 神经结构改变与前交叉韧带重建患者股四头肌力量不足相关。
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-01-01 DOI: 10.1016/j.asmart.2024.11.001
Le Yu , Shanshan Zheng , Yushi Chen , Xiao'ao Xue , Zikun Wang , JiaYan Cheng , Yang Sun , He Wang , Yinghui Hua

Background

Persistent maladaptive changes of corticospinal tract (CST) and quadriceps strength deficits exist in patients with anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate the relationships between the structural alterations of CST and quadriceps muscle strength deficits in patients with ACLR.

Methods

Twenty-nine participants who had undergone unilateral ACLR (29 males; age = 32.61 ± 6.72 years) were enrolled in a cross-sectional investigation. We chose CST as a region of interest and performed diffusion tensor imaging (DTI) that measured the microstructure of white matter tracts. Maximal voluntary isometric quadriceps muscle strength was assessed using a hand-held dynamometer. Simple and partial correlation analyses were performed between the DTI outcomes and quadriceps muscle strength deficits in patients with ACLR before and after controlling for age, sex, BMI, Tegner activity score, and graft type. Sub-group analyses were also performed to investigate the relationships between the DTI outcomes of CST structure and quadriceps muscle strength deficits according to the graft type before and after controlling for age, sex, BMI, and Tegner activity score.

Results

Lower limb symmetry index (LSI) of quadriceps muscle strength was associated with a higher ratio of radial diffusivity (RD, r = −0.379, p = 0.042) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score and graft type. In subgroup analyses of ACLR patients with hamstring autografts, we found that higher injured quadriceps muscle strength was associated with higher axial diffusivity (AD, r = 0.616, p = 0.033) of CST structure and lower LSI of quadriceps muscle strength was associated with higher ratio of mean diffusivity (MD, r = −0.682, p = 0.014) and RD (r = −0.759, p = 0.004) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score.

Conclusion

Decreased integrity (higher ratio of RD) of CST microstructure in ACLR patients was significantly associated with lower quadriceps limb symmetry index, which hinted that quadriceps muscle strength deficits of injured side may be a demyelinating process of CST microstructure in ACLR.
背景:前交叉韧带重建(ACLR)患者存在持续的皮质脊髓束(CST)不适应变化和股四头肌力量缺陷。本研究旨在探讨ACLR患者CST结构改变与股四头肌力量不足之间的关系。方法:29例接受单侧ACLR的患者(男性29例;年龄= 32.61±6.72岁),纳入横断面调查。我们选择CST作为感兴趣的区域,并进行扩散张量成像(DTI),测量白质束的微观结构。最大自愿等长四头肌力量评估使用手持式测功机。在控制年龄、性别、BMI、Tegner活动评分和移植物类型前后,对ACLR患者DTI结果与股四头肌力量缺陷进行简单和部分相关分析。在控制年龄、性别、BMI和Tegner活动评分前后,我们还进行了亚组分析,根据移植物类型调查CST结构DTI结果与股四头肌力量缺陷之间的关系。结果:在控制年龄、BMI、Tegner活动评分和移植物类型后,ACLR患者下肢四头肌力量对称性指数(LSI)与损伤半球皮质脊髓束桡骨弥散度比值(RD, r = -0.379, p = 0.042)高于非损伤半球。ACLR肌腱缺损患者群分析,我们发现受伤的股四头肌肌肉力量与高轴向扩散系数(广告,r = 0.616, p = 0.033)春秋国旅的结构和较低的LSI的股四头肌肌肉力量更高比例的意思是扩散系数(医学博士,r = -0.682, p = 0.014)和RD (r = -0.759, p = 0.004)在受伤的半球皮质脊髓束的non-injured半球ACLR患者在控制了年龄,BMI, Tegner活动评分。结论:ACLR患者CST微结构完整性降低(RD比值升高)与下四头肌肢体对称指数显著相关,提示损伤侧四头肌肌力缺失可能是ACLR CST微结构脱髓鞘过程。
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引用次数: 0
Novel application of an imageless robotic system in simultaneous unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction 无图像机器人系统在单室膝关节置换术和前交叉韧带重建中的新应用。
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2025-01-01 DOI: 10.1016/j.asmart.2024.12.001
Joshua Yeuk Shun Tran , Rex Wang-Fung Mak , Kevin Ki-Wai Ho , Jonathan Patrick Ng , Cham Kit Wong , Gloria Yan-Ting Lam , Tsz Lung Choi , Michael Tim-Yun Ong , Patrick Shu-Hang Yung
This technical note explores the novel use of an imageless robotic surgical system for simultaneous unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament reconstruction (ACLR). Knee osteoarthritis (OA) and anterior cruciate ligament (ACL) insufficiency are common conditions that traditionally require separate management. The integration of robotic assistance offers enhanced precision in surgical procedures, addressing both medial compartment OA and ACL insufficiency in a single operation.
We present a case involving a 47-year-old patient with medial compartment osteoarthritis and complete ACL rupture. The patient underwent a simultaneous robotic-assisted UKA and ACLR using the CORI Surgical System (Smith&Nephew, London, UK). This approach enables accurate tibial tunnel placement and precise soft tissue balancing. The robotic system facilitates real-time gap assessment and balancing, reducing the risk of over- or under-constraint during ACL graft tensioning.
The procedure was performed with a standard medial parapatellar approach. Key steps included hamstring autograft harvesting, femoral and tibial tunnel creation, and robotic-assisted implant positioning. Post-operative rehabilitation allowed full weight-bearing by the third week.
This case represents the first reported instance of using an imageless robotic system for simultaneous UKA and ACLR, highlighting its potential to standardize and improve results in complex knee surgeries.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
本技术说明探讨了将无图像机器人手术系统用于同时进行单髁膝关节置换术(UKA)和前交叉韧带重建术(ACLR)的新方法。膝关节骨关节炎(OA)和前交叉韧带(ACL)功能不全是常见疾病,传统上需要分别进行治疗。机器人辅助技术的整合提高了手术的精确性,一次手术即可同时解决内侧室 OA 和前交叉韧带损伤问题。我们介绍了一例内侧室骨关节炎和前十字韧带完全断裂的 47 岁患者。患者使用 CORI 手术系统(Smith&Nephew,英国伦敦)同时接受了机器人辅助的 UKA 和 ACLR 手术。这种方法可实现胫骨隧道的精确放置和软组织的精确平衡。机器人系统可进行实时间隙评估和平衡,降低前交叉韧带移植物张力过大或过小的风险。手术采用标准的髌旁内侧入路。关键步骤包括腘绳肌自体移植物采集、股骨和胫骨隧道创建以及机器人辅助植入物定位。术后康复在第三周即可完全负重。该病例是首次报道使用无图像机器人系统同时进行UKA和ACLR手术,凸显了其在标准化和改善复杂膝关节手术效果方面的潜力。本研究未从公共、商业或非营利部门的资助机构获得任何特定资助。
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引用次数: 0
Optimal suturing techniques in patch-bridging reconstruction for massive rotator cuff tears: A finite element analysis 大面积肩袖撕裂补片桥接重建中的最佳缝合技术:有限元分析
IF 1.5 Q3 ORTHOPEDICS Pub Date : 2024-11-28 DOI: 10.1016/j.asmart.2024.10.002
Yuting Zhong , Chengxuan Yu , Sijia Feng , Han Gao , Luyi Sun , Yunxia Li , Shiyi Chen , Jun Chen

Purpose

To use a finite element method to construct a patch-bridge repair model for massive rotator cuff tears (MRCTs) and investigate the effects of different suture methods and knot numbers on postoperative biomechanics.

Methods

A finite element model based on intact glenohumeral joint data was used for a biomechanical study. A full-thickness defect and retraction model of the supraspinatus tendon simulated MRCTs. Patch, suture, and anchor models were constructed, and the Marlow method was used to assign the material properties. Three suturing models were established: 1-knot simple, 1-knot mattress, and 2-knot mattress. The ultimate failure load, failure mode, stress distribution of each structure, and other biomechanical results of the different models were calculated and compared.

Results

The ultimate failure load of the 1-knot mattress suture (71.3 N) was 5.6 % greater than that of the 1-knot simple suture (67.5 N), while that (81.5 N) of the 2-knot mattress was 14.3 % greater than that of the 1-knot mattress. The stress distribution on the patch and supraspinatus tendon was concentrated on suture perforation. Failure of the bridging reconstruction mainly occurred at the suture perforation of the patch, and the damage forms included cutting-through and isthmus pull-out.

Conclusion

A finite element model for the patch-bridging reconstruction of MRCTs was established, and patch-bridging restored the mechanical integrity of the rotator cuff. The 2-knot mattress suture was optimal for patch-bridging reconstruction of MRCTs.
目的使用有限元方法构建大面积肩袖撕裂(MRCT)的补片-桥接修复模型,并研究不同缝合方法和结数对术后生物力学的影响。冈上肌腱的全厚缺损和回缩模型模拟了 MRCT。建立了补片、缝合和锚定模型,并使用马洛法分配材料属性。建立了三种缝合模型:单结简单缝合、单结褥疮缝合和双结褥疮缝合。结果单结褥式缝合的终极失效载荷(71.3 N)比单结简式缝合(67.5 N)大 5.6%,而双结褥式缝合的终极失效载荷(81.5 N)比单结褥式缝合大 14.3%。补片和冈上肌腱上的应力分布主要集中在缝线穿孔处。桥接重建的失败主要发生在补片的缝合穿孔处,损伤形式包括切穿和峡部拉断。 结论 建立了 MRCT 补片桥接重建的有限元模型,补片桥接恢复了肩袖的机械完整性。双结褥式缝合是 MRCT 补丁桥接重建的最佳方法。
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引用次数: 0
期刊
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology
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