Search

Quantitative methods to characterize bone contusions and associated cartilage injury remain limited. We combined standardized voxelwise normalization and 3D mapping to automate bone contusion segmentation post‐anterior cruciate ligament (ACL) injury and evaluate anomalies in articular cartilage overlying bone contusions. Forty‐five patients (54% female, 26.4 ± 11.8 days post‐injury) with an ACL tear underwent 3T magnetic resonance imaging of their involved and uninvolved knees. A novel method for voxelwise normalization and 3D anatomical mapping was used to automate segmentation, labeling, and localization of bone contusions in the involved knee. The same mapping system was used to identify the associated articular cartilage overlying bone lesions. Mean regional T1ρ was extracted from articular cartilage regions in both the involved and uninvolved knees for quantitative paired analysis against ipsilateral cartilage within the same compartment outside of the localized bone contusion. At least one bone contusion lesion was detected in the involved knee within the femur and/or tibia following ACL injury in 42 participants. Elevated T1ρ (p = 0.033) signal were documented within the articular cartilage overlying the bone contusions resulting from ACL injury. In contrast, the same cartilaginous regions deprojected onto the uninvolved knees showed no ipsilateral differences (p = 0.795). Automated bone contusion segmentation using standardized voxelwise normalization and 3D mapping deprojection identified altered cartilage overlying bone contusions in the setting of knee ACL injury. [ABSTRACT FROM AUTHOR]

We aimed to report the trajectory of self‐reported outcomes up to 11 years post‐ACLR. We also explored the relationship between hop performance at 1 year and: (i) future self‐reported knee outcomes; and (ii) risk of subsequent knee events. 124 participants (43 women, mean age 31 ± 8 years) were recruited at 1 year following hamstring‐autograft ACLR. Hop performance was assessed with single‐forward and side‐hop tests. Follow‐up was completed at 3 (n = 114), 5 (n = 89) and 11 years (n = 72) post‐ACLR. Self‐reported outcomes were assessed at each follow‐up with the Knee injury Osteoarthritis Outcome Score (KOOS) pain and quality of life (QOL) subscales. Generalized linear mixed models estimated the relationship between hop performance and self‐reported outcomes. Subsequent knee events (new injury/surgery) to either knee were recorded, with the relationship between hop performance and risk of subsequent knee events analyzed with Cox proportional hazards. Self‐reported knee outcomes were stable (mean change < 10 points) across all timepoints but with major within‐sample variability. There was a modest relationship between greater hop performance at 1 year and better future KOOS‐pain (average marginal effect [AME] % improvement with + 1 cm single forward hop = 0.06% [95% CI 0.02–0.10]). A nonlinear spline relationship showed better single‐forward hop performance was associated with better KOOS‐QOL for scores < 108 cm, not present for higher hop scores > 108 cm. There were 21 index and 11 contralateral subsequent knee events. Hop performance was not related to risk of a subsequent knee event (hazard ratio index knee 0.99 [95% CI 0.98–1.02]). In conclusion, self‐reported knee pain and quality of life were generally stable across the 11‐year follow‐up period. Greater hop performance at 1‐year post‐ACLR was related to better self‐reported knee outcomes up to 11‐year follow‐up (of questionable clinical importance), but not associated with the risk of subsequent knee injury/surgery. [ABSTRACT FROM AUTHOR]

Proteomics is a growing field that offers insights into various aspects of disease processes and therapy responses. Within the field of orthopedics, there are a variety of diseases that have a poor prognosis due to a lack of targeted curative therapy or disease modifying therapy. Other diseases have been difficult to manage in part due to lack of clinical biomarkers that offer meaningful insight into disease progression or severity. As an emerging technology, proteomics has been increasingly applied in studying bone biology and an assortment of orthopedics related diseases, such as osteoarthritis, osteosarcoma and bone tumors, osteoporosis, traumatic bone injury, spinal cord injury, hip and knee arthroplasty, and fragile healing. These efforts range from mechanistic studies for elucidating novel insights in tissue activity and metabolism to identification of candidate biomarkers for diagnosis, prognosis, and targeted treatment. The knowledge gained from these proteomic and functional studies has provided unique perspectives in studying orthopedic diseases. In this review, we seek to report on the current state of the proteomic study in the field of orthopedics, overview the advances in clinically applicable discoveries, and discuss the opportunities that may guide us for future research. [ABSTRACT FROM AUTHOR]

Objective: Both porous metal cones and metaphyseal sleeves are excellent implants for reconstructing severe bone defects in the knee joint, but they both exhibit design limitations. The porous metal cone, especially, has significant room for improvement in its shape design. The existing porous metal cones often feature a conical external surface with a relatively small taper, potentially compromising both rotational and axial stability. To improve both axial and rotational stability in porous metal cones, we developed a 3D‐printed stepped porous metal cone. This study aimed to assess the short‐term clinical outcome of the 3D‐printed stepped porous metal cone and to compare it with the clinical outcome of patients who underwent revision total knee arthroplasty (rTKA) with the metaphyseal sleeves during the same period. Method: Patients who underwent total knee arthroplasty revision with metaphyseal bone defect reconstruction from 2019 to 2021 were retrospectively analyzed. A total of 61 patients were enrolled in the study, including 15 patients using 3D‐printed stepped porous metal cones and 46 patients using metaphyseal metal sleeves. Thirty patients using metaphyseal sleeves were screened by propensity score matching method and compared with those using stepped cones. Analysis included the American Knee Society Score, the Hospital for Special Surgery knee score, the Western Ontario and McMaster Universities Arthritis index, the Short Form 12 (SF‐12) health survey, and radiographic assessment with a mean follow‐up of 28.5 ± 8.3 months. To conduct comparative analyses, unpaired Student's t‐tests were employed for continuous variables, while categorical variables were analyzed using the appropriate Fisher exact or chi‐squared test. Results: In this study, the survival rates of both the stepped cone and metaphyseal sleeve were 100%. There was no statistically significant difference in postoperative knee function scores between the two groups (p > 0.05). However, patients in the cone group had significantly higher mental component summary scores on the SF‐12 scale (p < 0.05) and higher increases in mean postoperative physical component summary scores than patients in the sleeve group (p < 0.05). In addition, patients in the cone group experienced fewer intraoperative and postoperative complications compared to the sleeve group. Conclusion: The 3D‐printed stepped porous metal cone can effectively reconstruct bone defects in complex rTKA and provide satisfactory early clinical and radiographic results. The 3D‐printed stepped cone provides a more stable structure similar to the sleeve while maintaining the original benefits of the cone making it a promising choice for rTKA. [ABSTRACT FROM AUTHOR]

Objective: In orthopedic trauma, identification of extremity trauma combined with vascular injury is challenging. Missed diagnosis may result in amputation or even death. The purpose of this study was to investigate whether physical examination combined with handheld vascular ultrasound Doppler examination could be an effective method of screening for peripheral vascular injury and to explore the characteristics of vascular injuries in orthopedic trauma patients. Methods: Retrospective analysis of patients in the emergency department of orthopedic trauma in our hospital from January 2022 to October 2023. Physical examination combined with handheld vascular ultrasound Doppler examination was used as a screening method for suspected vascular injuries. Patients with suspected vascular injury would undergo further angiography and receive multidisciplinary treatment. Angiography was used as the gold standard for diagnosing vascular injuries. Patient demographics, mechanism of injury, location and type of injury, angiographic results, surgical notes, and early treatment outcome data were recorded. Results: A total of 55 cases (58 limb injuries) with suspected vascular injury were ultimately included. Angiography revealed that 53 cases (55 limbs, positive rate 94.8%) were considered to have confirmed vascular injuries. Forty‐three were male (81.1%) and 10 were female (18.9%), with mean age 44.1 ± 16.6 years. The main mechanism of injury was traffic accident (30, 56.7%). Most common site of vascular injuries was knee joint (30/55, 54.5%), and popliteal artery (23, 47.9%) was the most commonly injured blood vessel. After multidisciplinary collaborative treatment, overall patient mortality was 3.8% (2/53), and limb survival rate among surviving patients was 81.1% (43/53) in our study. Conclusion: In orthopedic trauma, "Hard signs" and "soft signs" combined with handheld vascular ultrasound Doppler examination were effective ways to screen for suspected vascular injuries. Most limbs had associated fractures or dislocations at the site of vascular injury. Collaboration of vascular surgery, microsurgery and orthopedic trauma may help improve patients' prognosis. [ABSTRACT FROM AUTHOR]

Background: Delayed anterior cruciate ligament (ACL) reconstruction often causes residual anterolateral rotatory instability (ALRI) and consequent knee osteoarthritis, warranting the recommendation of early ACL reconstruction within 6 months after injury. Nonetheless, some cases show notable instability, even shortly after injury. The purpose of this study was to identify risk factors for an increase in quantitatively measured pivot shift in patients with ACL‐deficient knees within 6 months after injury. Methods: Patients with primary ACL reconstruction within 6 months after injury and quantitative triaxial accelerometer measurements of preoperative pivot shift were included. Descriptive statistics were calculated for 11 independent variables (age, gender, time from injury to surgery, KT‐1000, knee extension angle, lateral and medial posterior tibial slope angle, medial and lateral meniscus tears, ramp lesion and Tegner active scale). A single regression analysis was performed on the 11 items and acceleration during the pivot shift, and a multiple regression analysis was performed for items with p value less than 0.1. Results: Overall, 111 patients met the inclusion criteria. Single regression analysis showed that medial posterior tibial slope angle, medial meniscus tear and ramp lesion were significantly correlated with acceleration during the pivot shift (p < 0.001, p = 0.04 and p = 0.001). Multiple regression analysis identified medial posterior tibial slope angles and ramp lesions as independent factors for increased preoperative pivot shift (p = 0.005 and 0.01). Conclusion: A steep medial posterior tibial slope angle and ramp lesion were independent risk factors for increased quantitatively measured pivot shift in patients with ACL‐deficient knees. Level of Evidence: Level IV, case series study. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to elucidate changes in the tibiofemoral relationship over time following anterior cruciate ligament (ACL) injury, and investigate the correlation between the tibiofemoral relationship and patient‐related outcome measures (PROMs). Methods: Overall, 203 primary ACL reconstructions were performed using autologous hamstring grafts. Medial and lateral anterior tibial translation (ATT) in the sagittal plane and tibial tubercle‐trochlear groove (TT‐TG) distance in the axial plane were measured using pre‐operative magnetic resonance imaging and post‐operative computed tomography. The difference between pre‐operative and post‐operative values for each parameter was calculated: ΔMesdial ATT, ΔLateral ATT and ΔTT‐TG distance. The correlation between each calculated value and the time elapsed since ACL injury, and the correlation between each calculated value and PROMs—evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS)—were assessed. Results: Sixty‐four patients were enroled. Medial ATT, lateral ATT and TT‐TG distance were significantly different pre‐operatively compared to post‐operative values, with the tibia translating anteriorly and rotating internally relative to the femur. ΔMedial ATT, ΔLateral ATT and ΔTT‐TG distance were 1.6, 8.8 and −4.8 mm, respectively. A negative correlation was observed between the ΔTT‐TG distance and the time elapsed since the injury (r = −0.44, p < 0.01). No correlation was found between ΔMedial ATT and the time elapsed since the injury, nor between ΔLateral ATT and the time elapsed since the injury. Neither the ΔMedial ATT, ΔLateral ATT, nor ΔTT‐TG distance correlated with the pre‐operative or post‐operative KOOS subscale scores. Conclusions: The tibia underwent internal rotation relative to the femur over time following ACL injury, highlighting the importance of assessing rotational changes in ACL‐injured knees. Level of Evidence: Level Ⅲ. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate if the operated knee environment remains abnormal in patients successfully treated with anterior cruciate ligament reconstruction (ACL‐R). Methods: Thirty asymptomatic patients were enrolled (28 men, 2 women, age 28.6 ± 6.54 years, body mass index: 24.9 ± 3.0 kg/m2) and evaluated at 42.2 ± 12.5 months after surgery. Patients were assessed with patient‐reported outcome measurements and with a triaxial accelerometer. The temperature of the knees as well as four regions of interest were evaluated with an infrared thermographic camera FLIR T1020 (FLIR® Systems) according to a standardised protocol including a baseline evaluation and further evaluations immediately after exercise and after 5, 10 and 20 min. The temperature of the ACL‐R knee was compared to that of the contralateral healthy knee for the purpose of the study. Results: The mean temperature of the knee was higher (p = 0.010) for the ACL‐R knees (31.4 ± 1.4°C) compared to the healthy knees (31.1 ± 1.6°C), as well as for the patellar area (p = 0.005), the lateral area (p = 0.016) and the medial area (p = 0.014). The analysis of the response to the exercises of the ACL‐R knees showed similar trends to the healthy knees but higher temperature values at all time points (p < 0.05). Patients who underwent ACL‐R with concomitant meniscal treatment showed higher knee temperatures compared to ACL‐R knees without concomitant meniscal treatment after 5 (p = 0.047), 10 (p = 0.027) and 20 min (p = 0.048). Conclusions: The temperature of asymptomatic knees previously treated with ACL‐R is higher than the contralateral healthy knee, both at rest and after exercise, with a further increase in knees that underwent both ACL‐R and meniscal treatment. These results suggest an inflammatory state persisting years after the surgery, which could predispose to the early onset of knee degeneration. Level of Evidence: III, Case–control study. [ABSTRACT FROM AUTHOR]

Purpose: The duration for which anterior cruciate ligament reconstruction (ACLR) can be delayed without resulting in a risk of subsequent meniscus injury has remained a debatable topic. The main purpose of this study was to determine the safest delay interval for a delayed ACLR. Methods: This retrospective study included all patients who underwent ACLR between January 2020 and January 2022. The patients were divided into four groups based on the delay interval: <3 months, 3–6 months, 6–12 months and >12 months. Clinical outcomes were assessed using the International Knee Documentation Committee (IKDC) score and Knee Injury and Osteoarthritis Outcomes Score (KOOS) at 1‐year postoperatively. Results: A total of 95 patients were included in this study. ACLR delay of 3–6 months was not associated with the risk of meniscus injury, while a delay of 6–12 months (odds ratio [OR] = 4.35; 95% confidence interval [CI] = 1.13–16.79; p = 0.031) and >12 months (OR = 10.68; 95% CI = 2.55–42.22; p = 0.001) was associated with a likelihood of developing meniscus injury. Meniscus injury risk increased by 12% for each month of ACLR delay (OR = 1.12; 95% CI = 1.04–1.22; p = 0.003). Regarding clinical outcomes at 1‐year postoperatively, all groups exhibit the same clinical results. Conclusion: ACLR can be safely delayed up to 6 months after the initial injury. However, a delay for >6 months must be avoided, as it was found to significantly increase the likelihood of developing a meniscus injury. Level of Evidence: Level III, retrospective comparative study. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study is to define the minimal clinically important difference (MCID) for International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) for patients undergoing tibial tubercle osteotomy (TTO) for either (1) patellofemoral pain or (2) patellar instability. Methods: Patients undergoing TTO for either patellofemoral pain or patellar instability by one of two sports medicine fellowship‐trained surgeons at a single institution between September 2014 and May 2023 were included in the study. IKDC and KOOS scores were collected preoperatively and minimum 1 year postoperatively. Distribution‐based methods were used to calculate the MCID. Results: Seventy‐seven patients (82 knees) were included, with a median age of 29.3 years (interquartile range [IQR]: 22.2−36.3 years) and a median BMI of 24.5 kg/m2 [IQR: 22.3−28.3 kg/m2]. Fifty‐seven patients (74%) were female, and there were 40 right knees (49%). The median time to IKDC and KOOS score was 1.8 and 1.7 years, respectively. Forty‐five patients (46 knees) underwent TTO for patellofemoral instability, and 32 patients (36 knees) underwent TTO for patellofemoral pain. The MCID was 11.5 for IKDC, 10.2 for KOOS pain, 10.1 for KOOS symptoms, 9.9 for KOOS ADL, 14.2 for KOOS sport and 14.2 for KOOS QoL for patients undergoing TTO for patellofemoral pain. The MCID was 11.2 for IKDC, 10.1 for KOOS pain, 10.6 for KOOS symptoms, 10.2 for KOOS ADL, 16.0 for KOOS sport and 13.2 for KOOS QoL for patients undergoing TTO for patellar instability. Conclusion: We define the MCIDs for commonly used patient‐reported outcome measures for patients undergoing TTO for either patellofemoral pain or patellar instability. Level of Evidence: Level II. [ABSTRACT FROM AUTHOR]

Purpose: The majority of anterior cruciate ligament reconstruction (ACLr) patients wish to return to sport. Clinical evaluations after ACLr often do not include physical testing, making it difficult to determine the patient's readiness to return to sport. Thus, it would be helpful to identify easily assessable factors associated with physical function in ACLr patients that could inform planning of patients' return to sport. This study sought to evaluate the associations between physical test performance in ACLr patients and known ACL injury risk factors, knee laxity and patient‐reported outcomes at 1‐year follow‐up. Methods: The cohort included isolated primary ACLr patients operated between 2009 and 2014. Patients were invited to a 1‐year visit to clarify their readiness to return to sport. A test battery was performed, including clinical evaluation, patient‐reported outcomes and three physical tests, from which the Leg Symmetry Index (LSI) was calculated. Multivariate regression analyses were performed for each of the physical tests, including known risk factors, clinical outcomes and patient‐reported outcomes. Laxity <3 mm, pivot shift = 0, Knee Injury and Osteoarthritis Outcome Score (KOOS) sport >75, International Knee Documentation Committee (IKDC) >75.9, and Single Assessment Numeric Evaluation (SANE) >92.7 were applied as cut‐off values for good versus poor status. Results: A total of 480 ACLr patients were included in the study. Laxity <3 mm had a negative impact on the single‐hop LSI, whereas a pivot shift = 0 or IKDC >75.9 had a positive impact on the single‐hop LSI. Age <20, a pivot shift grade of 0 and KOOSsport >75 were positively associated with the triple‐hop LSI. Finally, age <20 and IKDC >75.9 were positively associated with the leg extension strength LSI. Conclusions: Age, sagittal laxity, pivot shift and patient‐reported outcomes were associated with physical test performance 1 year after ACLr. However, the associations were not completely uniform and strong, so information on age, sagittal laxity, pivot shift and patient‐reported outcomes cannot replace a return‐to‐sport functional test battery in determining when it is safe to return to sport after ACLr. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Purpose: Patellar cartilage lesions are a frequent and challenging finding in orthopaedic clinical practice. This study aimed to evaluate a chitosan‐based scaffold's mid‐term clinical and imaging results patients with patellar cartilage lesions. Methods: Thirteen patients (nine men, four women, 31.3 ± 12.7 years old) were clinically evaluated prospectively at baseline, 12, 24 and at a final minimum follow‐up of 60 months (80.2 ± 14.7) with International Knee Documentation Committee (IKDC) subjective, Knee Injury and Osteoarthritis Outcome Score and Tegner scores. A magnetic resonance analysis was performed at the last follow‐up using the Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) 2.0 score. Results: An overall significant clinical improvement in the scores was observed from baseline to all follow‐ups, with stable clinical results from 24 months to the mid‐term evaluation. The IKDC subjective score passed from 46.3 ± 20.0 at baseline to 70.1 ± 21.5 at the last follow‐up (p = 0.029). Symptoms' duration before surgery negatively correlated with the clinical improvement from baseline to the final follow‐up (p = 0.013) and sex influenced the improvement of activity level from the preoperative evaluation to the final follow‐up, with better results in men (p = 0.049). In line with the clinical findings, positive results were documented in terms of cartilage repair quality with a mean MOCART 2.0 score of 72.4 ± 12.5. Conclusions: Overall, the use of this chitosan‐based scaffold provided satisfactory results with a stable clinical improvement up to mid‐term follow‐up, which should be confirmed by further high‐level studies to be considered a suitable surgical option to treat patients affected by patellar cartilage lesions. Level of Evidence: Level IV, prospective case series. [ABSTRACT FROM AUTHOR]

Objectives: Multiple ligament knee injuries (MLKIs) are disruptive injuries, however, there are controversies in the results of acute and delayed reconstruction. Also, clinical outcomes between patients older or younger than 40 have not been compared in MLKIs. This study was designed to investigate the influence of age and timing of reconstruction on the outcomes of single‐stage reconstruction of MLKIs. Methods: The patients who underwent reconstruction of multiple injured ligaments because of MLKIs between May 2013 and July 2019 were added to the cohort. The postoperative complications, knee range of motion (ROM), Lysholm score, International Knee Documentation Committee (IKDC) 2000 score, Tegner activity level, patient satisfaction, and SF‐36 score were compared between young (≤ 40 years old, n = 41) and old patients (n = 61); acute (≤ 3 weeks after injury, n = 75) and delayed reconstruction (n = 27), using Mann–Whitney U test or χ2 test. Results: A total of 102 MLKI patients managed by single‐stage multi‐ligament reconstruction were retrospectively reviewed. Patients were followed up after surgery for a mean of 7.3 years (5.2‐10.7 years). At the last follow‐up, no significant difference was found in knee ROM, functional scores, and patient‐reported outcomes between patients older or younger than 40; acute and delayed reconstruction (p > 0.05). The rate of complications in the delayed reconstruction group was higher than that of the acute reconstruction group (22.2% vs 5.3%, p < 0.05). The IKDC objective scores reached grade A in 63.7%–80.4% of patients, and grade B in 11.8%–23.5% patients. Conclusion: The single‐stage reconstruction of MLKIs can obtain comparative long‐term functional and objective outcomes regardless of patients older or younger than 40; acute and delayed reconstruction, however, delayed reconstruction is related to a high rate of postoperative complications. [ABSTRACT FROM AUTHOR]

The aim was to determine how jump load affects knee complaints in elite men's volleyball. We collected data from four men's premier league volleyball teams through three seasons in a prospective cohort study (65 players, 102 player‐seasons). Vert inertial measurement devices captured the jump load (jump frequency and jump height) from 21 088 daily player sessions, and knee complaints were reported in 3568 weekly OSTRC‐O questionnaires. Mixed complementary log–log regression models described the probability of (i) experiencing symptoms if players were currently asymptomatic, (ii) worsening symptoms if players had symptoms, and (iii) recovery from knee complaints. Based on our causal assumptions, weekly jump load was modeled as the independent variable, adjusted for age (years), weight (kg), position on volleyball team, and past jump load. No certain evidence of an association was found between weekly jump load and probability of (i) knee complaints (p from 0.10 to 0.32 for three restricted cubic splines of load), (ii) worsening symptoms if the player already had symptoms (p from 0.11 to 0.97), (iii) recovery (p from 0.36 to 0.63). The probability of knee complaints was highest for above‐average weekly jump load (~1.2% for an outside hitter with mean age and height) compared with low loads (~1%) and very high loads (→ ~ 0%). The association between jump load and knee complaints risk remains unclear. Small differences in risk across observed jump load levels were observed. It would likely require substantially increased sample sizes to detect this association with certainty. [ABSTRACT FROM AUTHOR]

Objective: We estimate the treatment effect of total knee arthroplasty (TKA) versus an education and exercise (Edu+Ex) program on pain, function, and quality of life outcomes 3 and 12 months after treatment initiation for knee osteoarthritis (OA). Methods: Patients with knee OA who had undergone TKA were matched on a 1:1 ratio with participants in an Edu+Ex program based on a propensity score fitted to a range of pretreatment covariates. After matching, between‐group differences in improvement (the treatment effect) in Knee Injury and Osteoarthritis Outcome Score 12‐item version (0, worst to 100, best) pain, function, and quality of life from baseline to 3 and 12 months were estimated using linear mixed models, adjusting for unbalanced covariates, if any, after matching. Results: The matched sample consisted of 522 patients (Edu+Ex, n = 261; TKA, n = 261) who were balanced on all pretreatment characteristics. At 12‐month follow‐up, TKA resulted in significantly greater improvements in pain (mean difference [MD] 22.8; 95% confidence interval [95% CI] 19.7–25.8), function (MD 21.2; 95% CI 17.7–24.4), and quality of life (MD 18.3; 15.0–21.6). Even so, at least one‐third of patients receiving Edu+Ex had a clinically meaningful improvement in outcomes at 12 months compared with 75% of patients with TKA. Conclusion: TKA is associated with greater improvements in pain, function, and quality of life, but these findings also suggest that Edu+Ex may be a viable alternative to TKA in a meaningful proportion of patients, which may reduce overall TKA need. Confirmatory trials are needed. [ABSTRACT FROM AUTHOR]

Background: Traumatic cartilage injury is an important cause of osteoarthritis (OA) and limb disability, and toll‐like receptors (TLRs) mediated innate immune response has been confirmed to play a crucial role in cartilage injury. In the previous study, we found that the activation of TLR8 molecules in injured articular cartilage was more obvious than other TLRs by establishing an animal model of knee impact injury in rabbits, and the changes of TLR8 molecules could significantly affect the process of articular cartilage injury and repair. Objective: To verify how mir‐99a‐5p regulates TLR8 receptor mediated innate immune response to treat traumatic cartilage injury. Methods: The impact of a heavy object on the medial condyle of the rabbit's knee joint caused damage to the medial condylar cartilage. Through pathological and imaging analysis, it was demonstrated whether the establishment of an animal model of traumatic cartilage injury was successful. Establishing a cell model by virus transfection of chondrocytes to demonstrate the role of TLR8 in the innate immune response to impact cartilage injury. Through transcriptome sequencing, potential targets of TLR8, mir‐99a‐5p, were predicted, and basic experiments were conducted to demonstrate how they interact with innate immune responses to impact cartilage damage. Results: TLR8 is a receptor protein of the immune system, which is widely expressed in immune cells. In our study, we found that TLR8 expression is localized in lysosomes and endosomes. Mir‐99a‐5p can negatively regulate TLR8 to activate PI3K‐AKT molecular pathway and aggravate cartilage damage. Inhibiting TLR8 expression can effectively reduce the incidence of articular cartilage damage. Conclusion: Based on the results from this study, mir‐99a‐5p may be an effective molecular marker for predicting traumatic cartilage injury and targeting TLR8 is a novel and promising approach for the prevention or early treatment of cartilage damage. [ABSTRACT FROM AUTHOR]

Background: To determine the effects of negative heel shoes on perceived pain and knee biomechanical characteristics of runners with patellofemoral pain (PFP) during running. Methods: Sixteen runners with PFP ran in negative (−11 mm drops) and positive (5 mm drops) heel shoes while visual analog scale (VAS) scores, retroreflective markers, and ground reaction force were acquired by applying a 10‐cm VAS, infrared motion capture system, and a three‐dimensional force plate. Knee moment, patellofemoral joint stress (PFJS), and other biomechanical parameters during the stance phase were calculated based on inverse dynamics and a biomechanical model of the patellofemoral joint. Results: The foot inclination angle, peak PFJS during the stance phase, patellofemoral joint reaction force, knee extension moment, and quadriceps force at the time of peak PFJS of runners with PFP in negative heel shoes were lower than that in positive heel shoes, no significant difference was found in VAS scores, knee flexion angle, patellofemoral contact area, and quadriceps moment arm at the time of peak PFJS. Conclusions: Compared to positive heel shoes, running in negative heel shoes decreases peak PFJS in runners with PFP, which may decrease patellofemoral joint loading, thus reducing the possibility of further development of PFP. Trail Registration: Sports Science Experiment Ethics Committee of Beijing Sport University. 2023095H, April 18, 2023 (prospectively registered). [ABSTRACT FROM AUTHOR]

This case report discusses the presentation of an 8-year-old boy with atlanto-axial rotatory dislocation (AARD) and basilar invagination, a rare complication of inflammatory bowel disease unclassified (IBDU). Basilar invagination is an anomaly of the craniovertebral junction that can be associated with other abnormalities. The patient initially underwent evaluation at a local hospital, where no pathologies were found. However, further examination revealed signs of spondylarthritis and basilar invagination. The patient underwent surgical stabilization and received biological treatment, resulting in a significant reduction in symptoms. This case highlights the importance of thorough examination and imaging methods in pediatric cases of torticollis associated with IBDU to prevent life-threatening complications. [Extracted from the article]

This study aimed to assess the acute effect of a competitive football match on jump performance and kinematic parameters during jump landing in semiprofessional female football players. Twenty‐two semiprofessional players (20 ± 3 years) underwent a drop jump task for a posterior video analysis of the landing phase. These measurements were obtained at (1) baseline, (2) after, and (3) 48 h after a competitive football match. A one‐way ANOVA with repeated measures was employed to detect differences over the time. There was a main effect of time for maximal knee flexion angle during drop landing (p = 0.001). In comparison with baseline, maximal knee flexion angle was reduced immediately post‐match and was still reduced 48 h after the match (63.4 ± 8.6 vs 57.0 ± 11.7 vs 48.9 ± 19.1, p ≤ 0.038). There was also a main effect of time for drop jump height (p < 0.001). Drop jump height was reduced immediately post‐match and remained low 48 h after the match in comparison with baseline (27.3 ± 3.6 vs 24.5 ± 2.8 ~ 25.5 ± 3.0 cm, p ≤ 0.002). There was a main effect of time on hip flexion angle during landing (p = 0.001), but the pairwise comparison revealed that this variable was not affected immediately post‐match but was lower 48 h after the match than at baseline (50.1 ± 10.1 ~ 50.8 ± 13.2 vs 38.1 ± 17.8 °, p ≤ 0.005). A competitive football match worsened jump performance and several landing biomechanical parameters in female football players, which were still decreased in comparison with baseline even 48 h after the match. [ABSTRACT FROM AUTHOR]

In this cross‐sectional study, we compared patellofemoral geometry in individuals with a youth‐sport‐related intra‐articular knee injury to uninjured individuals, and the association between patellofemoral geometry and magnetic resonance imaging (MRI)‐defined osteoarthritis (OA) features. In the Youth Prevention of Early OA (PrE‐OA) cohort, we assessed 10 patellofemoral geometry measures in individuals 3–10 years following injury compared with uninjured individuals of similar age, sex, and sport, using mixed effects linear regression. We also dichotomized geometry to identify extreme (>1.96 standard deviations) features and assessed likelihood of having extreme values using Poisson regression. Finally, we evaluated the associations between patellofemoral geometry with MRI‐defined OA features using restricted cubic spline regression. Mean patellofemoral geometry did not differ substantially between groups. However, compared with uninjured individuals, injured individuals were more likely to have extremely large sulcus angle (prevalence ratio [PR] 3.9 [95% confidence interval, CI: 2.3, 6.6]), and shallow lateral trochlear inclination (PR 4.3 (1.1, 17.9)) and trochlear depth (PR 5.3 (1.6, 17.4)). In both groups, high bisect offset (PR 1.7 [1.3, 2.1]) and sulcus angle (PR 4.0 [2.3, 7.0]) were associated with cartilage lesion, and most geometry measures were associated with at least one structural feature, especially cartilage lesions and osteophytes. We observed no interaction between geometry and injury. Certain patellofemoral geometry features are correlated with higher prevalence of structural lesions compared with injury alone, 3–10 years following knee injury. Hypotheses generated in this study, once further evaluated, could contribute to identifying higher‐risk individuals who may benefit from targeted treatment aimed at preventing posttraumatic OA. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate a sit to stand test with the walk test for the identification of unilateral cranial cruciate ligament rupture in dogs. Materials and Methods: Peak vertical force and vertical impulse were measured on a pressure‐sensitive walkway, during a sit to stand test and walk test, and in 10 dogs with unilateral cranial cruciate ligament rupture and 18 non‐lame dogs. Data collected were used to calculate symmetry indices (SI) of ipsilateral and contralateral hindlimbs (HL), diagonal limb pairs (DLP) and ipsilateral limb pairs (ILP). Results: The symmetry indices of peak vertical force of HL during the walk test and sit to stand test were 100% and 90% sensitive for discriminating lame and non‐lame dogs respectively. The symmetry indices of vertical impulse of HLs during the walk test and sit to stand test were 100% and 50% sensitive for discriminating lame and non‐lame dogs respectively. Analysis of ipsilateral and diagonal limb pairs did not improve the discrimination in either test. The time taken to collect data from the sit to stand test data was shorter than for the walk test. Clinical Significance: Whilst the sit to stand test required a shorter time for collection of data than the walk test, it did not accurately identify all dogs with lameness associated with CCLR, and thus has relatively limited clinical utility in its tested form. [ABSTRACT FROM AUTHOR]

Background and Aims: Dressings containing silver ions are an accepted and common option for wound treatment. However, some wounds fail to heal at the desired rate despite optimal management. The aim of the study was to examine the effect of copper dressings in noninfected wounds. Methods: The study included 20 patients aged 18–85 years with 2–30 cm2 noninfected wounds treated for 17–41 days with silver wound dressings that failed to reduce by >50% the wound size, who were then treated with copper dressings. Ten patients were diabetics, 10 suffered from hypertension, and six suffered from peripheral vascular disease (PVD). Two patients suffered from two wounds. Most were amputation wounds below the knee. Results: Five patients dropped out from the study due to complications not related to the wound. The mean period of silver and copper dressings treatment was 25.6 and 29.6 days, respectively (p = 0.25; t test). None of the wounds became infected. Comparing a period of 25 days, during the copper dressings treatment, the mean wound area reduction was ~2.4 times higher than during the silver dressing treatment, 87.35 ± 22.4% versus 37.02 ± 25.11% (mean ± SD; p < 0.001; paired t test), respectively. The average decline during the silver and copper treatments were 1.2% and 2.14% per day (p = 0.002; multiple regression analysis), respectively. Conclusions: The enhanced wound healing process observed with the copper dressings may be explained by the integral role of copper throughout all physiological skin repair processes. Silver in contrast has no physiological role in wound healing. The results of our study confirm case reports showing enhanced wound healing of hard‐to‐heal wounds with copper dressings, both of infected and noninfected wounds. Taken together, the results of the current study support the hypothesis that the application of copper dressings in situ for noninfected wounds results in the stimulation of the wound healing processes, as opposed to silver dressings. [ABSTRACT FROM AUTHOR]

Ramp lesions of the medial meniscus and posterior lateral meniscus root tears (LMPRT) can be present simultaneously in up to 8% of patients undergoing anterior cruciate ligament (ACL) reconstruction. The prevalence of these complex and highly unstable meniscal tears increases exponentially with the severity of the injury. The posteromedial capsule (PMC) has often been disregarded in the past when discussing ligamentous and meniscal injuries, but the recent interest in ramp lesions has drawn surgeons' attention to the posteromedial structures of the ACL injured knee. While the meniscocapsular junction is commonly repaired in unstable ramp lesions, in the current literature there is no report regarding proximal PMC lesions, be they in isolation or associated with complex meniscal injuries. We report here two cases of proximal posteromedial capsular lesions associated with medial meniscus instability and posterior lateral root tears after ACL injury. The first case involves a meniscus ramp lesion associated with a proximal PMC tear and a posteromedial fluid collection in the muscle plane on magnetic resonance in a 22-year-old male soccer player. The second case involves a 21-year-old female soccer player who presented with a PMC lesion after hyperextension/valgus knee injury. The capsular lesions were repaired to restore capsular tension and improve medial meniscus posterior horn stability. [ABSTRACT FROM AUTHOR]

Pain experiences in patients with knee osteoarthritis (OA) may be influenced differently by OA risk factors, reducing the translatability of preclinical research into the clinic. Our objective was to contrast evoked pain patterns after exposure to different OA risk factors including acute joint trauma, chronic instability, or obesity/metabolic syndrome using rat models of experimental knee OA. We tested longitudinal patterns of evoked pain behaviors (knee pressure pain threshold and hindpaw withdrawal threshold) in young male rats exposed to different OA‐inducing risk factors including (1) nonsurgical joint trauma (impact‐induced anterior cruciate ligament (ACL) rupture); (2) surgical joint destabilization (ACL + medial meniscotibial ligament transection); and (3) high fat/sucrose (HFS) diet‐induced obesity. Histopathology for synovitis, cartilage damage, and subchondral bone morphology was performed. Pressure pain threshold was reduced (more pain) most, and earlier by joint trauma (Week 4–12) and HFS (Week 8–28) than by joint destabilization (Week 12). Hindpaw withdrawal threshold was reduced transiently after joint trauma (Week 4), with smaller and later reductions after joint destabilization (Week 12), but not with HFS. Synovial inflammation occurred at Week 4 after joint trauma and instability but only coincided with pain behaviors after joint trauma. Cartilage and bone histopathology were most severe after joint destabilization and least severe with HFS. The pattern, intensity, and timing of evoked pain behaviors varied due to OA risk factor exposure and were inconsistently associated with histopathological OA features. These findings may help to explain the challenges with translating preclinical OA pain research to multimorbid clinical OA contexts. [ABSTRACT FROM AUTHOR]

As the lower extremity is a linked‐joint system, the contribution of movements at the hip and ankle, in addition to the knee, to gait patterns should be considered for persons with knee osteoarthritis (OA). However, the relationships of joint coordination variability to OA symptoms, particularly knee pain, and joint loading is unknown. The purpose of this study was to determine the relationship of joint coordination variability to knee pain severity and joint loading in persons with knee OA. Thirty‐four participants with knee OA underwent gait analysis. Vector coding was used to assess coordination variability during the early, mid, and late stance phase. Hip–knee coupling angle variability (CAV) during midstance was associated with Knee Injury and Osteoarthritis Outcome Score (KOOS) pain (r = −0.50, p = 0.002) and Visual Analog Scale pain (r = 0.36, p = 0.04). Knee–ankle CAV during midstance was associated with KOOS pain (r = −0.34, p = 0.05). Hip–knee CAV during early and midstance were associated with knee flexion moment (KFM) impulses (r = −0.46, p = 0.01). Knee–ankle CAV during early and midstance were associated with peak KFM (r = −0.51, p < 0.01; r = −0.70, p < 0.01). Moreover, knee–ankle CAV during early, mid, and late stance phase were associated with KFM impulses (r = −0.53, p < 0.01; r = −0.70, p < 0.01; r = −0.54, p < 0.01). These findings suggest that joint coordination variability may be a factor that influences pain and knee joint loading in persons with knee OA. Statement of Clinical Significance: Movement coordination of the hip, knee, and ankle should be considered in the clinical management and future research related to knee OA. [ABSTRACT FROM AUTHOR]

58-year-old male presented with knee extension contracture (25°) with iatrogenic fixed anterior tibial subluxation. Consecutive arthroscopic arthrolysis, manipulation under anesthesia, and quadriceps-Z-plasty during one surgery failed to restore flexion. Therefore, shortened posterior cruciate ligament was released, which eliminated subluxation and allowed 115° flexion. Despite physiotherapy, flexion progressively decreased to 70° postoperatively. Revision quadricepsplasty by transverse incisions restored 120° of flexion maintained at 31-months follow-up. International Knee Documentation Committee increased 4/87- > 50/87, Knee injury and Osteoarthritis Outcome 7/100- > 68/100 at follow-up. Posterior cruciate ligament release and repeated quadricepsplasty could be a viable salvage option in severe extension contracture with fixed anterior tibial subluxation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to assess the internal rotation of the tibia on Magnetic Resonance Imaging (MRI) in a series of consecutive athletes with Anterior cruciate Ligament (ACL) tears. Methods: Retrospective analysis of prospectively collected data was performed to include all consecutive patients who had undergone primary ACL reconstruction between January 2022 and June 2022. The angle between surgical epicondylar axes (SEA) of the knee and posterior tibial condyles (PTC) was measured. A negative value was defined as internal torsion. KFs and ALL injuries were reported. Analysis of covariance (ANCOVA) was performed to examine the independent associations between SEA-PTC angle and injuries of KFs and ALL adjusted for physical variables (age, gender and body mass index [BMI]). Statistical significance was set at a p-value of < 0.05. Results: A total of 83 eligible patients were included. The result of multiple linear regression analysis showed that internal tibial rotation was associated with KFs and ALL injuries. The estimated average of SEA-PTC angle in relation to ALL injuries controlling the other variables was -5.49 [95%CI -6.79 – (-4.18)] versus -2.99 [95%CI -4.55 – (-1.44)] without ALL injuries. On the other hand, the estimated average of SEA-PTC angle in relation to KFs lesions controlling the other variables was -5.73 [95%CI -7.04 – (-4.43)] versus -2.75 [95%CI -4.31 – (-1.18)] without KFs injuries. Conclusions: KFs and ALL injuries were associated with an increased intra-articular internal tibial rotation in ACL-deficient knees. The measurement of femorotibial rotation on axial MRI could be useful to detect indirect signs of anterolateral complex (ALC) injuries. [ABSTRACT FROM AUTHOR]

Background: Locoregional flap options for reconstructing defects of the anterolateral distal thigh/knee region are limited. The distal profunda artery perforator island (PAPI) flap is a local fasciocutaneous propeller‐type flap that utilizes the most distal perforator of the profunda femoris artery. The aim of this study is to conduct a CT‐based angiographic analysis of the perforator system of the profunda femoris artery and present outcomes on the application of the PAPI flap in the management of post‐oncologic defects of the distal thigh and knee. Methods: CT angiograms were utilized on the lower limbs of 25 healthy patients (mean age, 57 years; 76% male) and the number and location of septocutaneous perforators with a diameter greater than 1 mm were measured. A case series of patients undergoing reconstruction of post‐ablative defects which involved the anterolateral and posterior knee performed by the senior author were reviewed. Results: CT angiography demonstrated a robust collection (mean 3.5, range 2 to 5) of septocutaneous perforators from the profunda femoris artery with the most distal perforator located 3.3 cm from the superior patella border. The PAPI flap was successfully used in 10 patients (6F; 4M; mean age 60.6 years; range 30 to 88 years) with a mean defect size of 87.5 cm2 (range 48 to 150 cm2). Hand‐held Doppler was used to detect the perforator. No flap loss was encountered, and no knee function limitation was noted at follow‐up. Minor complications include seroma (1) and intra‐articular infection (2). Conclusions: We conclude that the distal PAPI flap is a reliable and versatile flap that has potentially wide applications. [ABSTRACT FROM AUTHOR]

An echogenic fascial plane/muscle aponeuroses is normally visualized separating the medial head of the gastrocnemius from the deep soleus muscle. Imaging instead most commonly exhibits injury of the medial head of the gastrocnemius and aponeurosis, and often with a fluid collection interposed between the medial gastrocnemius and soleus. Surgical and autopsy studies indicate that the most common lesion responsible for the "tennis leg" presentation is actually an injury of the gastrocnemius.[[1], [3]] Isolated injury to the plantaris muscle is rare. [Extracted from the article]

Purpose: Knee cartilage experiences repetitive loading during physical activities, which is altered during the pathogenesis of diseases like osteoarthritis. Analyzing the biomechanics during motion provides a clear understanding of the dynamics of cartilage deformation and may establish essential imaging biomarkers of early‐stage disease. However, in vivo biomechanical analysis of cartilage during rapid motion is not well established. Methods: We used spiral displacement encoding with stimulated echoes (DENSE) MRI on in vivo human tibiofemoral cartilage during cyclic varus loading (0.5 Hz) and used compressed sensing on the k‐space data. The applied compressive load was set for each participant at 0.5 times body weight on the medial condyle. Relaxometry methods were measured on the cartilage before (T1ρ, T2) and after (T1ρ) varus load. Results: Displacement and strain maps showed a gradual shift of displacement and strain in time. Compressive strain was observed in the medial condyle cartilage and shear strain was roughly half of the compressive strain. Male participants had more displacement in the loading direction compared to females, and T1ρ values did not change after cyclic varus load. Compressed sensing reduced the scanning time up to 25% to 40% when comparing the displacement maps and substantially lowered the noise levels. Conclusion: These results demonstrated the ease of which spiral DENSE MRI could be applied to clinical studies because of the shortened imaging time, while quantifying realistic cartilage deformations that occur through daily activities and that could serve as biomarkers of early osteoarthritis. [ABSTRACT FROM AUTHOR]

Purpose: To identify potential prognostic factors for patient-reported outcomes in an Icelandic cohort of ACL injured subjects. Methods: All knee MRI reports written in Iceland between the years 2001 to 2011 were read to identify individuals with a possible ACL injury. These individuals were contacted and asked to complete an online questionnaire regarding their injury and current knee related health. The questionnaire collected information on years since surgery, injury circumstance, brace use, physiotherapy, ACL surgery, second ACL injury and current smoking status. In addition, the baseline status of their meniscii were assessed from the original MRI report and medical records were used to identify any subsequent, non-ACL surgery. The patient-reported Knee Osteoarthritis and Injury Outcome Score (KOOS) was used assess current knee related health. A Bayesian proportional odds model was used to assess the effect of all potential prognostic factors above as well as age and sex on KOOS outcomes. Results: A total of 408 subjects completed the questionnaire indicating that they did rupture their ACL. The following variables were associated with worse outcomes across all KOOS subscales: having a subsequent arthroscopy, reinjury to your ACL, and smoking. Having physiotherapy for 9 months was associated with worse KOOS pain scores than having 6 months of physiotherapy. Conversely KOOS pain score tended to be higher if you injured your knee during sports. Conclusion: Reinjuring your ACL, smoking and having subsequent (non-ACLR) surgery predict your knee related health following an ACL injury. Strategies should be implemented to reduce the risk of secondary ACL injury, and patients should be strongly advised not to smoke. [ABSTRACT FROM AUTHOR]

The standard grafts used for anterior cruciate ligament (ACL) reconstruction are tendon, either patellar tendon, hamstring, or quadriceps. However, the microstructure and composition of tendon differs from ligament. Ideally, the ACL would be replaced with the same tissue. To evaluate the incorporation of a bone‐ACL‐bone (B‐ACL‐B) graft for ACL reconstruction, we performed a controlled laboratory study in a rabbit model with microcomputed tomography (μCT). Forty‐six New Zealand white rabbits were used, with 17 donor rabbits to harvest bilateral B‐ACL‐B allografts and 29 rabbits undergoing unilateral ACL reconstruction with B‐ACL‐B allograft. Knee specimens were collected for biomechanical testing (n = 14) at 4 and 8 weeks and for μCT analysis (n = 15) at 2, 4, and 8 weeks after surgery. Gross inspection and μCT examination confirmed bone blocks in the appropriate anatomic position. Biomechanical tests revealed no difference in mean load‐to‐failure force for B‐ACL‐B allografts between 4 and 8 weeks. Progressive healing occurred between the bone block and the tunnel as demonstrated by a gradual increase on average bone‐volume fraction and total mineral density (TMD) in both femoral and tibial tunnels. Remodeling of the bone block was evidenced by a significant decrease in TMD of both tibial and femoral bone blocks. This is a report of a novel rabbit B‐ACL‐B allograft reconstruction model demonstrating early signs of graft remodeling and incorporation. Clinical Relevance: This study demonstrates ACL reconstruction using an anatomically matched ACL allograft, rather than a tendon graft, may be possible based on early findings in this lapine model. [ABSTRACT FROM AUTHOR]

Objective: The association between knee injury and knee osteoarthritis (OA) is understudied relative to its importance, particularly in younger populations. This study was undertaken to examine the association of knee injury with radiographic features of knee OA in military officers, who have a physically demanding profession and high rates of knee injury. Methods: Participants were recruited in 2015–2017 from an existing program that enrolled 6,452 military officers during 2004–2009. Officers with a history of knee ligament or meniscal injuries (n = 117 via medical record review) were compared to officers with no history of knee injury (n = 143). Bilateral posteroanterior knee radiographs were obtained using a standardized fixed‐flexion positioning frame. All images were read for Kellgren/Lawrence (K/L) grade, osteophyte (OST), and joint space narrowing (JSN) scores. Data were analyzed using linear‐risk regression models with generalized estimating equations. Results: Injured and noninjured participants were similar (mean age 28 years, mean body mass index 25 kg/m2, ~40% female). The mean time from first knee injury to imaging among injured participants was 9.2 years. Compared with noninjured knees, greater prevalence of radiographic OA (K/L grade ≥ 2), OST (grade ≥ 1), and JSN (grade ≥ 1) was observed among injured knees, with prevalence differences of +16% (95% confidence interval [95% CI] 10%, 22%), +29% (95% CI 20%, 38%), and + 17% (95% CI 10%, 24%), respectively. Approximately 1 in 6 officers with prior knee injury progressed to radiographic OA by age 30 years. Conclusion: At the midpoint of a projected 20‐year military career, officers with a history of traumatic knee injury have a markedly increased prevalence of knee radiographic OA compared to officers without injury. [ABSTRACT FROM AUTHOR]

Purpose: The effect of open-wedge high tibial osteotomy (OWHTO) on the preoperative neutral alignment of the knee is unknown. The purpose of this study was to clarify the clinical outcome of OWHTO with neutral alignment, defined as within 4 degrees of varus. Methods: This retrospective study included 72 knees with varus that underwent medial OWHTO. The knees were divided according to the preoperative hip-knee-ankle angle into a neutral alignment group (≤ 4° of varus alignment) and a varus alignment group (> 4° of varus alignment). The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Forgotten Joint Score-12 (FJS-12) were evaluated preoperatively and during at least 2 years of follow-up postoperatively. Results: There were no significant differences between the preoperative FJS-12 (17.9 versus 23.7; p = 0.16) and postoperative FJS-12 (57.3 versus 60.6; p = 0.52) or KOOS subscale scores (p > 0.05) in the neutral alignment group or the varus alignment group. Each group had a mean change in the KOOS subscale scores that exceeded the minimum clinically important difference. Conclusion: The short-term clinical results of OWHTO for neutral alignment were as favourable as those for varus malalignment. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Objective: To quantify the incidence rate of anterior cruciate ligament (ACL) injuries and ankle sprains according to player sex, playing level, and exposure setting (training vs. games) in basketball players. Methods: PubMed, MEDLINE, Google Scholar, and ScienceDirect were searched. Only studies reporting the number of ACL injuries and/or ankle sprains alongside the number of athlete‐exposures (training sessions and/or games) in basketball players were included. Results: Thirty studies (17 reporting ACL injuries and 16 reporting ankle sprains) were included in the meta‐analysis. Higher (p < 0.05) ACL injury incidence rates per 1000 athlete‐exposures were recorded in females (female: 0.20 95% confidence intervals [0.16–0.25]; male: 0.07 [0.05–0.08]; female‐to‐male ratio: 3.33 [3.10–3.57]), in players competing at higher playing levels (amateur: 0.06 [0.04–0.09]; intermediate: 0.16 [0.13–0.20]; elite: 0.25 [0.14–0.64]), and in games (games: female, 0.27 [0.21–0.32]; male, 0.06 [0.03–0.08]; training: female, 0.03 [0.02–0.05]; male: 0.01 [0.00–0.02]; game‐to‐training ratio: 7.90 [4.88–12.91]). Higher (p < 0.05) ankle sprain incidence rates per 1000 athlete‐exposures were observed in males (female: 0.82 [0.61–1.03]; male: 0.90 [0.61–1.19]; female‐to‐male ratio: 0.91 [0.83–0.99]), in players competing at higher playing levels (amateur: 0.54 [0.51–0.57]; intermediate: 1.12 [1.00–1.24]; elite: 1.87 [1.29–2.46]), and in games (games: 2.51 [1.85–3.16]; training: 0.80 [0.52–0.80]; game‐to‐training ratio: 2.77 [2.35–3.26]). Conclusion: According to player sex, ACL injury incidence rate is higher in females, while ankle sprain incidence rate is greater in males. ACL injury and ankle sprain incidence rates are greater in players competing at higher playing levels and during games compared to training. [ABSTRACT FROM AUTHOR]

Hoffa fractures are rare fractures of the femoral condyle that occur in the coronal plane of the bone. In most cases, high‐energy trauma leads to isolated coronal fractures of one of the femoral condyles, medial or lateral. Even with a typical unicondylar Hoffa fracture, our patient sustained a bicondylar Hoffa fracture in his right knee after falling from high and suffering direct trauma as well. The fracture was approached from both the medial and lateral sides of the distal femur. Three‐month follow‐up showed excellent functional scores, no laxity, and no pain. [ABSTRACT FROM AUTHOR]

The aim was to analyse the application value of magnetic resonance imaging (MRI) in the injury evaluation of posterolateral corner (PLC) caused by sports, and the ant colony‐based crowding degree of fish swarm optimization algorithm for image segmentation optimization of MRI images. The crowding degree of fish swarm was introduced to construct the ant colony optimization algorithm (ACOA), and the maximum and minimum ant system (MMAS) and ant colony algorithm based on variation features (VF‐based ACA) were introduced to compare with ACOA. Besides, ACOA was applied to the MRI diagnosis of 98 patients with PLC injuries. Then the number of Degree I, Degree II, and Degree III in PLC patients were compared. The results showed that the iteration times and running time of the optimal solution were obtained by ACOA when the number of cities was 10, which were compared with those obtained by MMAS and VF‐based ACA with no great differences (P > 0.05), and the iteration times and running time of ACOA were greater than those of MMAS and VF‐based ACA when the number of cities was 50 (P < 0.05). There were 73 patients with PLC injuries involved 2 or more structures, 11 patients with PLC injuries only involved the lateral collateral ligament (LCL), and 7 patients with PLC injuries only involved the popliteal tendon (PLT). The injury rates of LCL, medial collateral ligament, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and PLT were 87.02%, 51.33%, 72.45%, 41.75%, and 84.06%, respectively. The number of patients with PLC injuries combined with Grade I of LCL, PCL, ACL, PCL, biceps femoris tendon, and PLT was higher than that of patients with Grade II and III (P < 0.05). In conclusion, ACOA was much better than MMAS and VF‐based ACA in dealing with complex work, which effectively improved the ergodicity of search and reduced the running time. There were more common in PLC injuries combined with LCL, PCL, ACL, PCL, and PLT, MRI images based on ACOA could clearly show the degree of ligament and tendon injuries. [ABSTRACT FROM AUTHOR]

Introduction: Puberty substantially alters the body's mechanical properties, neuromuscular control, and sex differences therein, likely contributing to increased, sex‐biased knee injury risk during adolescence. Female adolescents have higher risk for knee injuries than male adolescents of similar age engaging in similar physical activities, and much research has investigated sex differences in mechanical risk factors. However, few studies address the considerable variation in pubertal growth (timing, pace), knee mechanics, and injury susceptibility within sexes, or the impact of such growth variation on mechanical injury risk. Objectives: The present study tested for effects of variation in pubertal growth on established mechanical knee injury risk factors, examining relationships between and within sexes. Methods: Pubertal growth indices describing variation in the timing and rate of pubertal growth were developed using principal component analysis and auxological data from serial stature measurements. Linear mixed models were applied to evaluate relationships between these indices and knee mechanics during walking in a sample of adolescents. Results: Later developing female adolescents with slower pubertal growth had higher extension moments throughout stance, whereas earlier developers had higher valgus knee angles and moments. In male adolescents, faster and later growth were related to higher extension moments throughout gait. In both sexes, faster growers had higher internal rotation moments at foot‐strike. Conclusions: Pubertal growth variation has important effects on mechanical knee injury risk in adolescence, affecting females and males differently. Earlier developing females exhibit greater injury risk via frontal plane factors, whereas later/faster developing males have elevated risk via sagittal plane mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to report on the current accuracy measures specific to 1.5-Tesla MRI of the knee in the patient population prone to injuries of the anterior cruciate ligament (ACL), the menisci, and the articular cartilage. Methods: We accrued patients between January 2018 through August 2021 who underwent a preoperative MRI and were diagnosed with an articular cartilage injury either due to unevenness of articular cartilage in T2-weighted sequences or due to the irregularity of subchondral bone in T1-weighted sequences. All patients were treated arthroscopically. Sensitivity, specificity, and accuracy were calculated for the detection of ACL, meniscus, and cartilage injuries. A P-value of < 0.05 represented statistical significance. Results: One-hundred and forty-seven cases which included 150 knee joints were enrolled in this study. The mean age at the time of surgery was 42.9 years-old. The sensitivity in the diagnosis of ACL injuries was significantly greater than that in the diagnosis of cartilage injuries (P = 0.0083). The ratios of the equality of operative indication in 6 recipient sites were found to be between 90.0% and 96.0%. The diagnostic critical point was within a 1 cm in diameter. Conclusion: The diagnostic sensitivity in cartilage injuries was significantly lower than ones of ACL and meniscal injuries. The ratios of the equality of operative indication was determined to be between 90.0% and 96.0%, if we consider the unevenness of articular cartilage or the irregularity of subchondral bone. Level of evidence: Level III, Prospective diagnostic cohort study. [ABSTRACT FROM AUTHOR]

Background: Total dislocation of the talus from all its surrounding joints (talonavicular, tibiotalar, subtalar) is one kind of serious injury of the lower extremity with rare occurrence. It is usually accompanied by fractures of the talus and its periphery, as well as severe soft tissue injury, which is difficult to reset. Complications such as skin necrosis and infection are prone to occur in the early stage, and talus necrosis are prone to occur in the late stage, all of which aggravate disease severity and increase difficulties for its treatment. Case Presentation: Herein, we reported a case of right talus total dislocation accompanied by medial malleolus fracture and posterior tubercle fracture caused by traffic accident. One hour after injury, the doctor tried to perform manual reduction but failed. Then, we successfully performed manual reduction and plaster external fixation on this patient under anesthesia 6 h after injury, followed by the oral administration of Chinese medicine for 3 months. Twenty months of follow‐up investigations revealed that no skin necrosis, talus dislocation, talus necrosis, or other complications occurred; no obvious joint degeneration was observed and the fractures of medial malleolus and talus healed well. MRI of ankle joint indicated the disappearance of ankle effusion caused by injury, and the bone marrow edema had also subsided at talus, medial malleolus, and lateral malleolus and calcaneus. Patient presented with no ligament relaxation, ankle instability, pain, swelling, or functional limitation of the injured limb. AOFAS score reached 100. Daily functions and recreation activities were recovered back to the normal level. Conclusion: For patients with closed total dislocation of the talus, fine therapeutic effects can be achieved by early closed manual reduction and plaster external fixation under anesthesia, in combination with oral Chinese herbal medicine afterwards. It is worthy of reference for clinicians. [ABSTRACT FROM AUTHOR]

Objective: In most cases, complete resection of the intradural tumor is accompanied by long‐term neurological complications. Postoperative spinal deformity is the most common complication after surgical resection of intradural tumors, and posterior longitudinal ligament complex (PLC) plays an important role in postoperative spinal deformity. In this study, we investigated the role of PLC in spinal deformity after the surgical treatment of intradural tumors. Methods: We analyzed the data of 218 consecutive patients who underwent intradural tumor resection from 2000 to 2018 in this retrospective study. Before 2010, patients underwent laminoplasty without maintaining the integrity of PLC (laminoplasty group, n = 155). After 2010, patients performed single‐port laminoplasty to maintain the integrity of PLC (laminoplasty retain posterior ligament complex group, n = 63). The score of quality of life, painful cortex, spinal cord movement, progressive kyphosis or scoliosis, perioperative morbidity, and neurological results were analyzed in the laminoplasty group and laminoplasty retain posterior ligament complex group. The distributed variable was shown as mean ± standard deviation and an independent t‐test or one‐way analysis of variance was calculated. Results: There are 155 patients (71.1%) included in the laminoplasty group, and 63 patients (28.9%) in the laminoplasty retain posterior ligament complex group. The average age of patients was 42 ± 2.3 years, and the average modified McCormick score was 2. There were 158 (72.4%) patients with intramedullary tumors and 115 (52.7%) patients with extramedullary tumors. The length of hospital stays (8 days vs. 6 days; p = 0.023) and discharge to inpatient rehabilitation (48.4% vs. 26.9%; p = 0.012) were significantly lower in the laminoplasty retain posterior ligament complex group than the laminoplasty group. There was no significant difference in the risk of progressive deformity between the two groups at 18 months after surgery (relative risk 0.12; 95% confidence interval [CI] 0.43–1.25; p = 0.258) and at 20 months after surgery (relative risk 0.24; 95% CI 0.21–2.1). Conclusion: Laminoplasty retains posterior ligament complex showed no impact on the spinal deformities compared with laminoplasty, but significantly improved the postoperative spinal activity, alleviated pain symptoms, and reduced hospital recovery time. [ABSTRACT FROM AUTHOR]

Knee injury negatively impacts routine activities and quality of life of millions of people every year. Disruption of tendons, ligaments, and articular cartilage are major causes of knee lesions, leading to social and economic losses. Besides the attempts for an optimal recovery of knee function after surgery, the joint healing process is not always adequate given the nature of intra‐articular environment. Based on that, different therapeutic methods attempt to improve healing capacity. Hyperbaric oxygen therapy (HBOT) is an innovative biophysical approach that can be used as an adjuvant treatment post‐knee surgery, to potentially prevent chronic disorders that commonly follows knee injuries. Given the well‐recognized role of HBOT in improving wound healing, further research is necessary to clarify the benefits of HBOT in damaged musculoskeletal tissues, especially knee disorders. Here, we review important mechanisms of action for HBOT‐induced healing including the induction of angiogenesis, modulation of inflammation and extracellular matrix components, and activation of parenchyma cells—key events to restore knee function after injury. This review discusses the basic science of the healing process in knee injuries, the role of oxygen during cicatrization, and shed light on the promising actions of HBOT in treating knee disorders, such as tendon, ligament, and cartilage injuries. [ABSTRACT FROM AUTHOR]

To determine the cross‐sectional and longitudinal associations of patella alignment with cartilage relaxation and patients' self‐reported symptoms. Thirty participants with isolated patellofemoral joint (PFJ) degeneration (six males, 53.7 ± 9.3 years) and 24 controls (12 males, 47.6 ± 10.7 years) were included. Magnetic resonance assessment was performed to provide grading of structural abnormalities, cartilage relaxation times, and patella alignment. Self‐reported symptoms were assessed using the self‐administrated knee injury and osteoarthritis outcome score (KOOS). All participants were examined at baseline and 3 years. Statistical parametric mapping and Pearson partial correlation were used to evaluate the associations between patella alignment with cartilage relaxation times and self‐reported symptoms, respectively. The analyses were performed between baseline (cross‐sectional) as well as the baseline against 3 years (longitudinal). Results indicated that patella height and patella flexion were associated with T1ρ and T2 relaxation times at baseline (percentages of voxels showing significant correlation [PSV] = 10.1%–24.8%; mean correlations [R] = 0.34–0.36; mean p = 0.015–0.026). Furthermore, greater patella lateral alignment, lateral tilt, and lateral spin were associated with longer T2 times at 3 years (PSV = 11.0%–14.4%, R = 0.39–0.44, p = 0.017–0.028). Last, a higher patella was associated with a lower KOOS at baseline and at 3 years (R = −0.33 to −0.35). The study suggests that patella malalignment is a risk factor for worsening cartilage health, informing clinicians of a better rehabilitation program that targets PFJ degeneration. [ABSTRACT FROM AUTHOR]

Purpose: Gait analysis was used to evaluate knee kinematics in patients who underwent successful primary total knee arthroplasty (TKA) using two modern bi-cruciate substituting designs. The knee joint was balanced intraoperatively using real-time sensor technology, developed to provide dynamic feedback regarding stability and tibiofemoral load. The authors hypothesized that major differences exist in gait parameters between healthy controls and post-TKA patients. Methods: Ten patients who underwent successful TKA using bi-cruciate substituting designs were evaluated at a minimum of 9 months postoperatively using three-dimensional knee kinematic analysis; a multi-camera optoelectronic system and a force platform were used. Sensor-extracted kinematic data included knee flexion angle at heel-strike (KFH), peak midstance knee flexion angle (MSKFA), maximum and minimum knee adduction angle (KAA) and knee rotational angle at heel-strike. Multiple gait analysis data from the study group were compared to a group of ten healthy controls who were matched by age, sex and BMI. Clinical outcome in the TKA group was also measured using the Knee injury and Osteoarthritis Outcome Score (KOOS). Results: Clinically, at final follow-up, a statistically significant difference in pain, general symptoms, and activities of daily living was seen between the groups. From a gait analysis standpoint, TKA patients had significantly less rotation at heel strike (p = 0.04), lower late stance peak extension moments (p = 0.02), and less Knee Adduction Angle excursion during swing phase (p = 0.04) compared to the control group. No statistically significant difference was observed for knee flexion angle at heel strike, knee adduction moment, or peak knee flexion moment between the groups. Conclusions: Modern bi-cruciate substituting TKA designs failed to reproduce normal knee kinematics. The lack of full knee extension during the stance phase, absence of the "screw-home mechanism" typical of an ACL functioning knee, and the reduced fluctuation in knee adduction angle during the swing phase still represent major proprioceptive and muscular recruitment differences between normal and replaced knees. [ABSTRACT FROM AUTHOR]

Purpose: The anterior cruciate ligament is probably one of the ligaments with the lowest healing potential. Many authors have reported cases of spontaneous healing but nowadays it is difficult to predict successful healing of an anterior cruciate ligament rupture and, even more, residual functionality and capability to return to sport. The aim of this study was to investigate cases of spontaneous healing in a population that received non-surgical treatment after anterior cruciate ligament rupture and to perform an updated review of contemporary literature. Methods: The authors retrospectively reviewed patients who suffered from an acute complete anterior cruciate ligament rupture and underwent non-surgical treatment. No specific rehabilitation protocol was prescribed. A new magnetic resonance imaging study was conducted 6 months after the injury for all patients. A literature review was conducted regarding spontaneous healing of the anterior cruciate ligament. The papers included in the analysis were reports of any level of evidence, written in English, Italian, or French languages; articles were excluded if they reported non-human studies, histological studies, studies conducted without magnetic resonance imaging or arthroscopic second look, or partial anterior cruciate ligament tear. Results: Case series: Six patients were enrolled in the study. All patients had a proximal anterior cruciate ligament lesion. The minimum follow-up was 13 months (range 6–20 months). At the last follow-up the mean score on the Lysholm scale was 97, the mean IKDC score was 94, and the mean KOOS score was 96. All patients returned to their own sport activities; no one reported significant differences. The magnetic resonance imaging study at 6 months revealed an end-to-end continuous anterior cruciate ligament with homogeneous signal. No one had any new knee injury at last follow-up. Literature review: A search of comprehensive databases retrieved 1057 articles; 8 full-text articles met the eligibility criteria. The studies were heterogeneous regarding the populations analysed, sport activity level, treatment applied, healing definition, and follow-up. The failure rate of non-surgical management ranged among the papers from 0 to 73%. Conclusions: The study findings show that spontaneous anterior cruciate ligament healing is possible and there are chances of clinical recovery for patients not suitable for surgery. However, there is still a lack of evidence about predictors, clinical outcomes, and adequate rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Objective: Middle‐aged subjects with meniscal tear treated with arthroscopic partial meniscectomy (APM) experience greater progression of damage to joint structures on imaging than subjects treated nonoperatively. It is unclear whether these changes are clinically relevant. The goal of this study was to assess whether worsening in magnetic resonance imaging (MRI)–assessed tissue damage over 18 months leads to subsequent worsening in knee pain over the subsequent 3.5 years. Methods: We used data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial of APM versus physical therapy for subjects ages ≥45 years with knee pain, cartilage damage, and meniscal tear. We assessed whether change in cartilage surface area damage score (and other structural measures) from baseline to 18 months, assessed on MRI with the MRI Osteoarthritis Knee Score (MOAKS) system, was associated with change in Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score (range 0–100; 100 = worst) from 18 to 60 months. Results: The primary analysis included 168 subjects with complete MRI data at baseline and 18 months and KOOS data at 18 and 60 months. We did not observe clinically important associations between change in cartilage surface area score between baseline and 18 months and change in pain scores from 18 to 60 months. Pain scores in the worst tertile for cartilage surface area damage score progression worsened by 0.45 points more than in the best tertile (95% confidence interval –4.45, 5.35). Similarly, we did not observe clinically important associations between changes in bone marrow lesions, osteophytes, or synovitis and subsequent pain. Conclusion: We did not observe clinically important associations between early changes in cartilage damage and other structural measures and worsening in pain over the subsequent 3.5 years. Further follow‐up is required to assess this association over a longer follow‐up period. [ABSTRACT FROM AUTHOR]

Purpose: Meniscus tears are one of the most frequent orthopedic knee injuries, which are currently often treated performing meniscectomy. Clinical concerns comprise progressive degeneration of the meniscus tissue, a change in knee biomechanics, and an early onset of osteoarthritis. To overcome these problems, meniscal transplant surgery can be performed. However, adequate meniscal replacements remain to be a great challenge. In this research, we propose the use of a decellularized and sterilized human meniscus allograft as meniscal replacement. Methods: Human menisci were subjected to a decellularization protocol combined with sterilization using supercritical carbon dioxide (scCO2). The decellularization efficiency of human meniscus tissue was evaluated via DNA quantification and Hematoxylin & Eosin (H&E) and DAPI staining. The mechanical properties of native, decellularized, and decellularized + sterilized meniscus tissue were evaluated, and its composition was determined via collagen and glycosaminoglycan (GAG) quantification, and a collagen and GAG stain. Additionally, cytocompatibility was determined in vitro. Results: Human menisci were decellularized to DNA levels of ~ 20 ng/mg of tissue dry weight. The mechanical properties and composition of human meniscus were not significantly affected by decellularization and sterilization. Histologically, the decellularized and sterilized meniscus tissue had maintained its collagen and glycosaminoglycan structure and distribution. Besides, the processed tissues were not cytotoxic to seeded human dermal fibroblasts in vitro. Conclusions: Human meniscus tissue was successfully decellularized, while maintaining biomechanical, structural, and compositional properties, without signs of in vitro cytotoxicity. The ease at which human meniscus tissue can be efficiently decellularized, while maintaining its native properties, paves the way towards clinical use. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty is a common procedure for treating knee conditions; however, significant proportions of patients report dissatisfaction post‐operatively. Recent data suggests accurate coronal alignment may not be essential for optimizing prosthesis functionality and survivorship. This narrative review utilized a systematic approach to analyse the literature comparing post‐operative coronal alignment and PROMs following knee replacement. Methods: A systematic search of MEDLINE was utilized to identify publications that directly compare the relationship between coronal alignment and PROMs. Results: Thirty‐one eligible publications were identified. Variability in both study design and findings were observed, with no studies being without risk of bias. Conclusion: Given this variability and lack of consensus among the reported publications, current literature is ill‐equipped to describe the exact nature of the relationship between coronal alignment and PROMs following TKA. Further research would ideally utilize both validated generic, and knee‐specific PROMs, make use of pre‐operative outcome data, and standardized follow‐up to develop reliable assessments of coronal alignment and its impact upon both functionality and quality of life. [ABSTRACT FROM AUTHOR]

Importance of degradation of newly synthesized collagen in regulating collagen production. We read with great interest the article by Jabbari et al. on the role of collagen supplementation in rheumatoid arthritis (RA) and osteoarthritis (OA).[1] We appreciate the authors' valuable contribution to this comprehensive systematic review; however, we would like to highlight some key points. 2022; 74 (7): 1296 - 1297. doi: 10.1002/art.42106 32 Ma KS-K, Wang L-T, Tsai S-Y. Correspondence to: 'Combination of human umbilical cord mesenchymal (stromal) stem cell transplantation with IFN- treatment synergistically improves the clinical outcomes of patients with rheumatoid arthritis. Is collagen supplementation friend or foe in rheumatoid arthritis and osteoarthritis?. [Extracted from the article]

Objective: This study explores LncRNA TM1‐3P effects on the proliferation, apoptosis, and inflammatory response of fibroblasts in osteoarthritis (OA) and its underlying mechanism. Methods: Bioinformatics was performed to analyze OA disease‐related genes, miRNA profiles, and function. The targeted regulation of LncRNA TM1‐3P and miR‐144‐3p, ONECUT2 and miR‐144‐3p were analyzed by dual luciferase reporter gene assay, RNA Binding Protein Immunoprecipitation (RIP), and RNA pull down. Histopathological morphology of the knee joint was observed by hematoxylin–eosin (HE) and Annona Red O/Fast Green. The expressions of mRNAs and proteins were detected by RT‐qPCR, Western blot, and immunohistochemistry. Unpaired T test was used between groups, and the one‐way analysis of variance of repeated measurement data was applied for multi‐group comparison, following Tukey's post‐test. Results: ONECUT2 and Smurf2 genes were significantly elevated in the osteoarthritis group compared with the normal group (P < 0.001, P < 0.001). Expressions of ONECUT2 and LncRNA TM1‐3P were increased, and expression of miR‐144‐3p was decreased in interleukin (IL)‐1β‐induced human fibroblast synovial cells (hFSCs) (mRNA: 1.06 ± 0.24 vs. 3.29 ± 0.73, proteins: 0.22 ± 0.03 vs. 0.46 ± 0.22, 1.23 ± 0.22 vs. 3.76 ± 0.73, 1.06 ± 0.25 vs. 0.37 ± 0.13, P < 0.01, P < 0.001, P < 0.01, P < 0.05). Overexpression of miR‐144‐3p down‐regulated the ONECUT2 expression, reduced cell proliferation, promoted apoptosis in hFSCs induced by IL‐1β (mRNA: 0.89 ± 0.14 vs. 0.15 ± 0.01, P < 0.05; proteins: 0.46 ± 0.01 vs. 0.23 ± 0.01, P < 0.001; CCK8: 1.88 ± 0.07 vs. 1.65 ± 0.07; P < 0.05; EDU: 55.82 ± 1.44 vs 40.57 ± 2.24, P < 0.05; apoptosis: 10.57 ± 0.79 vs 16.36 ± 0.35, P < 0.0001). Overexpression of LncRNA TM1‐3P up‐regulated the expression of ONECUT2, promoted cell proliferation, and inhibited apoptosis (mRNA: 0.9 ± 0.09 vs 1.94 ± 0.12, P < 0.05; proteins: 0.61 ± 0.05 vs 0.76 ± 0.03, P > 0.05; CCK8: 2.07 ± 0.05 vs 2.47 ± 0.06; P < 0.01; EDU: 52.67 ± 1.17 vs 60.06 ± 3.24, P < 0.05; apoptosis: 10.57 ± 0.79 vs 16.36 ± 0.35, P < 0.001), which were reversed by the overexpression of miR‐144‐3p treatment (mRNA: 1.82 ± 0.07 vs 0.31 ± 0.07, P < 0.0001; proteins: 0.74 ± 0.02 vs 0.35 ± 0.01, P < 0.01; CCK8: 2.41 ± 0.01 vs 1.67 ± 0.02; P < 0.0001; EDU: 66.85 ± 2.86 vs 44.68 ± 1.97, P < 0.0001; apoptosis: 7.19 ± 0.19 vs 13.36 ± 0.53, P < 0.0001). Silencing LncRNA TM1‐3P attenuated the injury of knee joint tissue, down‐regulated the expression of ONECUT2, Smurf2, IL‐1β, IL‐6, TNF‐α, and improved the expression of Rap1 in rats (0.71 ± 0.04 vs 0.48 ± 0.02, 0.68 ± 0.06 vs 0.36 ± 0.02, 0.74 ± 0.03 vs 0.49 ± 0.04, 0.78 ± 0.01 vs 0.54 ± 0.03, 0.68 ± 0.02 vs 0.4 ± 0.04, 0.24 ± 0.01 vs 0.4 ± 0.03, P < 0.05, P < 0.05, P < 0.05, P < 0.01, P < 0.01, P < 0.05). Conclusion: LncRNA TM1‐3P improved inflammation and damage of knee joints in OA rats through miR‐144‐3p/ONECUT2 axis, providing a new theoretical basis for gene therapy of OA. [ABSTRACT FROM AUTHOR]