Do knee alignment patterns differ between Middle Eastern and East Asian populations? A propensity-matched analysis using artificial intelligence.

Introduction: Population-based differences in knee alignment patterns may impact osteoarthritis (OA) progression. This study compares lower extremity alignment in knee OA between Middle Eastern (UAE) and East Asian (South Korean) populations using artificial intelligence (AI)-assisted analysis.

Methods: A retrospective review included patients with knee symptoms from South Korea (2009-2019) and the United Arab Emirates (UAE) (2015-2024).

Satisfactory Clinical Outcomes of Revision Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Allograft.

Backgroud: Allografts are preferred in certain cases of revision anterior cruciate ligament reconstructions to avoid additional graft harvesting and to fill in enlarged tunnels. The clinical outcomes of quadriceps tendon-patellar bone allograft in revision anterior cruciate ligament reconstruction are not well-known. This study was performed to evaluate the clinical outcomes of revision anterior cruciate ligament reconstructions using quadriceps tendon-patellar bone allografts.

Association of radiographic structure deformity phenotypes of knee OA to clinical symptoms and risk for progression: Proposing a modification of Kellgren-Lawrence grade - Data from the Osteoarthritis Initiative and the MOST study.

Objective: This study aims to define Kellgren-Lawrence grade (KLG) using OARSI grade and stratify radiographic knee osteoarthritis (KOA) into distinct phenotypes based on radiographic structure changes and compare clinical symptoms and disease progression.

Design: We used radiographic grading data provided by the OAI and MOST study. Decision tree was used to (1) Find OARSI grade criteria for each KLG and (2) Phenotype early osteoarthritic knees (=KLG1, 2) by the radiographic structure changes.

Automated measurement of pelvic parameters using convolutional neural network in complex spinal deformities: overcoming challenges in coronal deformity cases.

Background Context: Accurate and consistent measurement of sagittal alignment is challenging, particularly in patients with severe coronal deformities, including degenerative lumbar scoliosis (DLS).

Purpose: This study aimed to develop and validate an artificial intelligence (AI)-based system for automating the measurement of key sagittal parameters, including lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope, with a focus on its applicability across a wide range of deformities, including severe coronal deformities, such as DLS.

Design: Retrospective observational study.

Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study.

Background: Patellofemoral pain syndrome (PFPS) is one of the most common conditions affecting the knee joint, yet its pathomechanics remain unclear. The aim of this study was to investigate changes in muscle activation and gait patterns and to analyze the relationship between muscle activation and kinetic gait patterns in patients with PFPS.

Methods: This study included 31 patients with PFPS and 28 healthy volunteers without any symptoms.

Risk factors of recurrent periprosthetic joint infection of the knee after two-stage reimplantation.

Introduction: Prosthetic joint infection (PJI) is one of the most common and detrimental complications of total knee replacement arthroplasty (TKA). Despite extensive efforts, including two-stage reimplantation, to eradicate PJI, it still recurs in a substantial number of patients. However, the risk factors of recurrence after two-stage reimplantation of the knee have not been established.

Coronal Plane Alignment of the Knee (CPAK) Type Shifts Toward Constitutional Varus with Increasing Kellgren and Lawrence Grade: A Radiographic Analysis of 17,365 Knees.

Background: Studies investigating constitutional alignment across various grades of osteoarthritis (OA) are limited. This study explored the distribution of Coronal Plane Alignment of the Knee (CPAK) types and associated radiographic parameters with increasing OA severity.

Methods: In this retrospective cross-sectional study, 17,365 knees were analyzed using deep learning software for radiographic measurements.

Machine learning-based prediction of contralateral knee osteoarthritis development using the Osteoarthritis Initiative and the Multicenter Osteoarthritis Study dataset.

Having osteoarthritis in one knee is reported as an independent risk factor for developing contralateral knee osteoarthritis (KOA). However, no study has been designed to predict the development of contralateral KOA (cKOA). The authors hypothesized that specific risk factors for cKOA development exist and that it could be accurately predicted with the assistance of machine learning.

Medial Joint Opening in the Operated Knee After Unilateral High Tibial Osteotomy: Risk of Osteoarthritis and Future Surgery in the Operated and Nonoperated Knee.

Background: High tibial osteotomy (HTO) modifies the mechanics of the affected knee but can also affect the nonoperated knee. However, no research has reported on the prognosis and risk factors related to the nonoperated knee after unilateral HTO.

Purpose: To assess the radiological parameters associated with osteoarthritis (OA) progression and the need for surgery in the nonoperated knee after unilateral HTO, with concurrent assessment of the operated knee.

Can individual functional improvements be predicted in osteoarthritic patients after total knee arthroplasty?

Purpose: Total knee arthroplasty (TKA) is an effective treatment for advanced osteoarthritis, and achieving optimal outcomes can be challenging due to various influencing factors. Previous research has focused on identifying factors that affect postoperative functional outcomes. However, there is a paucity of studies predicting individual postoperative improvement following TKA.

Fixed-Bearing and Higher Postoperative Knee Flexion Angle as Predictors of Satisfaction in Asian Patients Undergoing Posterior-Stabilized Total Knee Arthroplasty.

Background: Patient-reported satisfaction following total knee arthroplasty (TKA) can be affected by various factors. This study aimed to assess patient satisfaction rates and identify factors related to patients, surgery, and postoperative knee motion associated with satisfaction in posterior-stabilized TKA among Asian patients.

Methods: A retrospective cross-sectional study was conducted in patients with primary osteoarthritis who underwent TKA and had a follow-up period of over 2 years.

Development of the machine learning model that is highly validated and easily applicable to predict radiographic knee osteoarthritis progression.

Many models using the aid of artificial intelligence have been recently proposed to predict the progression of knee osteoarthritis. However, previous models have not been properly validated with an external data set or have reported poor predictive performances. Therefore, the purpose of this study was to design a machine learning model for knee osteoarthritis progression, focusing on high validation quality and clinical applicability.

Primary Total Knee Arthroplasty for Treating Osteoarthritic Knees with Neglected Patellar Dislocation.

: Neglected patellar dislocation in the presence of end-stage osteoarthritis (OA) is a rare condition characterized by the patella remaining laterally dislocated without reduction. Due to the scarcity of reported cases, the optimal management approach is still uncertain. However, primary total knee arthroplasty (TKA) can serve as an effective treatment option.

Accurate, automated classification of radiographic knee osteoarthritis severity using a novel method of deep learning: Plug-in modules.

Background: Fine-grained classification deals with data with a large degree of similarity, such as cat or bird species, and similarly, knee osteoarthritis severity classification [Kellgren-Lawrence (KL) grading] is one such fine-grained classification task. Recently, a plug-in module (PIM) that can be integrated into convolutional neural-network-based or transformer-based networks has been shown to provide strong discriminative regions for fine-grained classification, with results that outperformed the previous deep learning models. PIM utilizes each pixel of an image as an independent feature and can subsequently better classify images with minor differences.

Isolated Polyethylene Insert Exchange for Instability after Total Knee Arthroplasty: Comparable Survival Rates and Range of Motion and Improved Clinical Scores Regardless of Hyperextension.

Background: Isolated polyethylene insert exchange (IPIE) has not been established as a treatment option for hyperextension instability after primary total knee arthroplasty (TKA). The purpose of the study was to evaluate the survival rate and clinical outcomes of IPIE for the treatment of instability with or without hyperextension after TKA.

Methods: This study retrospectively reviewed 46 patients who underwent IPIE for symptomatic prosthetic knee instability by dividing them into 2 groups based on the presence of hyperextension (without for group I and with for group IH).

Performance of ChatGPT on Solving Orthopedic Board-Style Questions: A Comparative Analysis of ChatGPT 3.5 and ChatGPT 4.

Background: The application of artificial intelligence and large language models in the medical field requires an evaluation of their accuracy in providing medical information. This study aimed to assess the performance of Chat Generative Pre-trained Transformer (ChatGPT) models 3.5 and 4 in solving orthopedic board-style questions.

Comparative analysis of gait: Similar coronal but different sagittal effects between closing-wedge and opening-wedge high tibial osteotomy.

Background: High tibial osteotomy is an established surgical option for medial compartment osteoarthritis of the knee with varus alignment. It can be divided into open wedge and closing wedge by operative technique. Although they have fundamental differences, little is known about the biomechanical consequences of the two surgical methods.

Shallow trochlear groove and narrow medial trochlear width at the proximal trochlea in patients with trochlear dysplasia: A three-dimensional computed tomography analysis.

Purpose: Although the Dejour classification is the primary classification system for evaluating trochlear dysplasia, concerns have been raised about its reliability owing to its qualitative criteria and challenges associated with obtaining accurate radiographs. This study aimed to quantify trochlear dysplasia using three-dimensional (3D) computed tomography (CT) reconstruction with novel parameters related to the transepicondylar axis (TEA).

Methods: Sixty patients were enrolled, including 20 with trochlear dysplasia and 40 healthy controls.

Patella Cartilage Status Does Not Affect the Clinical Outcomes of Non-resurfaced Patella in Mobile-Bearing Total Knee Arthroplasty.

Background: During total knee arthroplasty (TKA), patellar retention is performed when the cartilage is fairly well preserved and the thickness of the patella is relatively thin. However, clinical outcomes of the non-resurfaced patella in TKA according to the cartilage status are lacking in the literature. The purpose of this study was to compare patient-reported outcome measures (PROMs) according to the grade and location of the patellar cartilage lesion in TKA patients.

Selective targeting of dipeptidyl-peptidase 4 (DPP-4) positive senescent chondrocyte ameliorates osteoarthritis progression.

Senescent cells increase in many tissues with age and induce age-related pathologies, including osteoarthritis (OA). Senescent chondrocytes (SnCs) are found in OA cartilage, and the clearance of those chondrocytes prevents OA progression. However, targeting SnCs is challenging due to the absence of a senescent chondrocyte-specific marker.

Prediction of postoperative gait speed change after bilateral primary total knee arthroplasty in female patients using a machine learning algorithm.

Background: An important aim of total knee arthroplasty is to achieve functional recovery, which includes post-operative increase in walking speed. Therefore, predicting whether a patient will walk faster or slower after surgery is important in TKA, which has not been studied in previous literatures. Who walks faster and who walks slower after TKA? Can we predict these kinds of patients before surgery?

Hypothesis: Whether or not a patient walk faster after total knee arthroplasty can be predicted with preoperative characteristics.

Minimal impact of beam projection angle deviations in skyline (Laurin) view and the efficacy of the anterior border of proximal tibia as a guiding landmark.

Objective: Obtaining an optimal knee skyline view is challenging due to inaccuracies in beam projection angles (BPAs) and soft tissue obscuring bony landmarks. This study aimed to assess the impact of BPA deviations on patellofemoral index measurements and assessed the anterior border of the proximal tibia as an anatomic landmark for guiding BPAs.

Materials And Methods: This retrospective study consisted of three parts.