Our study presents a framework for predicting image-based social media content popularity that focuses on addressing complex image information and a hierarchical data structure. We utilize the Google Cloud Vision API to effectively extract key image and color information from users’ postings, achieving 6.8% higher accuracy compared to using non-image covariates alone. For prediction, we explore a wide range of prediction models, including Linear Mixed Model, Support Vector Regression, Multi-layer Perceptron, Random Forest, and XGBoost, with linear regression as the benchmark. Our comparative study demonstrates that models that are capable of capturing the underlying nonlinear interactions between covariates outperform other methods.

OBJECTIVE: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. METHODS: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. RESULTS: < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. CONCLUSIONS: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

Purpose To compare the clinical and radiologic efficacy of adipose‐derived stem cells (ADSCs) with fibrin glue and microfracture (MFX) versus MFX alone in patients with symptomatic knee cartilage defects. Methods Patients who were aged 18 to 50 years and had a single International Cartilage Repair Society grade III/IV symptomatic cartilage defect (≥3 cm 2 ) on the femoral condyle were randomized to receive ADSCs with fibrin glue and MFX treatment (group 1, n = 40) or MFX treatment alone (group 2, n = 40). There was a lack of blinding for patients because of the additional intervention method (liposuction). The cartilage defect was diagnosed using preoperative magnetic resonance imaging (MRI), and quantitative and qualitative assessments of the repair tissue were carried out at 24 months by using the Magnetic Resonance Observation of Cartilage Repair Tissue scoring system with follow‐up MRI. Clinical results were evaluated using the Lysholm score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and a 10‐point visual analog scale for pain (0 points, no pain; 10 points, worst possible pain) preoperatively and postoperatively at 3 months, 12 months, and the last follow‐up visit. Results The 2 groups had similar baseline patient characteristics. Follow‐up MRI was performed at 24 months (mean, 24.3 months; range, 24.0 to 25.1 months) after the operation. Group 1 included 26 patients (65%) who had complete cartilage coverage of the lesion at follow‐up compared with 18 patients (45%) in group 2. Significantly better signal intensity was observed for the repair tissue in group 1, with 32 patients (80%) having normal or nearly normal signal intensity (i.e., complete cartilage coverage of the lesion) compared with 28 patients (72.5%) in group 2. The mean clinical follow‐up period was 27.4 months (range, 26 to 30 months). The improvements in the mean KOOS pain and symptom subscores were significantly greater at follow‐up in group 1 than in group 2 (pain, 36.6 ± 11.9 in group 1 and 30.1 ± 14.7 in group 2 [ P = .034]; symptoms, 32.3 ± 7.2 in group 1 and 27.8 ± 6.8 in group 2 [ P = .005]). However, the improvements in the other subscores were not significantly different between group 1 and group 2 (activities of daily living, 38.5 ± 12.8 and 37.6 ± 12.9, respectively [ P = .767]; sports and recreation, 33.9 ± 10.3 and 31.6 ± 11.0, respectively [ P = .338]; quality of life, 38.4 ± 13.1 and 37.8 ± 12.0, respectively [ P = .650]). Among the 80 patients, second‐look arthroscopies were performed in 57 knees (30 in group 1 and 27 in group 2), and biopsy procedures were performed during these arthroscopies for 18 patients in group 1 and 16 patients in group 2. The second‐look arthroscopies showed good repair tissue quality, although no significant intergroup difference was observed. The mean total histologic score was 1,054 for group 1 compared with 967 for group 2 ( P = .036). Age, lesion size, duration of symptoms before surgery, mechanism of injury, and combined procedures were not correlated with clinical results, Magnetic Resonance Observation of Cartilage Repair Tissue scores, and histologic outcomes at short‐term follow‐up. Conclusions Compared with MFX alone, MFX and ADSCs with fibrin glue provided radiologic and KOOS pain and symptom subscore improvements, with no differences in activity, sports, or quality‐of‐life subscores, in symptomatic single cartilage defects of the knee that were 3 cm 2 or larger, with similar structural repair tissue. Level of Evidence Level II, prospective comparative study.

Purpose To compare the relation of extrusion of the graft with the position of the allograft between the parapatellar and transpatellar approaches and to show the primary importance of an anatomically correct position by comparing the chondroprotective effects after lateral meniscal allograft transplantation (MAT) with those of normal healthy knees. Methods Geometrical data from patients who underwent magnetic resonance imaging evaluation after lateral MAT were used as baseline input data for 3‐dimensional and finite element analysis. The inclusion criteria were patients with symptomatic knees that had undergone meniscectomy who underwent lateral MAT with a minimum follow‐up of 2 years. Patients with generalized arthritis, lower limb malalignment with greater than 5° valgus or varus, or uncorrected joint instability caused by ligament structure deficiency were excluded from this study. Patients were divided into the parapatellar group (25 patients) and transpatellar group (20 patients) according to surgical approach. Results The mean width of the extruded meniscus was 4.32 ± 0.58 mm in the parapatellar group and 3.00 ± 0.61 mm in the transpatellar group ( P < .0001). The mean relative percentage of extrusion was 42.48% ± 7.82% in the parapatellar group and 28.21% ± 4.49% in the transpatellar group ( P < .0001). The mean angle between the bony bridge and the center of the tibial plateau was significantly greater in the parapatellar group (16.69° ± 2.68°) than in the transpatellar group (5.29° ± 1.55°, P < .0001). The mean distance from the entry point of the bony bridge to the center of the tibial plateau was also greater in the parapatellar group (16.68 ± 2.56 mm) than in the transpatellar group (10.81 ± 1.37 mm, P < .0001). The distance from the entry point of the bony bridge to the center of the tibial plateau significantly influenced the obliquity of the bony bridge in the parapatellar group ( P = .002). On finite element analysis, the transpatellar approach was more similar to the intact knee model in terms of the contact area and stress of the lateral meniscus and medial meniscus as well as the maximum compressive and maximum shear stresses. Compared with the parapatellar approach, the transpatellar approach had lower maximum contact stress on the menisci and lower maximum compressive stress and maximum shear stress on the femoral and tibial articular surfaces. Conclusions The transpatellar approach led to a more anatomically correct positioning of the grafted meniscus with less meniscal extrusion than did the parapatellar approach in lateral MAT. Furthermore, the transpatellar model had lower maximum contact stress on the menisci than did the parapatellar model, and it also had lower maximum compressive stress and maximum shear stress on the femoral and tibial articular surfaces. Clinical Relevance The transpatellar approach is likely to have a more anatomic placement of graft with a subsequent greater chondroprotective effect; thereby, it may reduce the overall risk of degenerative osteoarthritis after lateral MAT.

Although the application of patient-specific instruments (PSI) for total knee arthroplasty (TKA) increases the cost of the surgical procedure, PSI may reduce operative time and improve implant alignment, which could reduce the number of revision surgeries. We report our experience with TKA using PSI techniques in 120 patients from March to December 2014. PSI for TKA were created from data provided by computed tomography (CT) scans or magnetic resonance imaging (MRI); which imaging technology is more reliable for the PSI technique remains unclear. In the first 20 patients, the accuracy of bone resection and PSI stability were compared between CT and MRI scans with presurgical results as a reference; MRI produced better results. In the second and third groups, each with 50 patients, the results of bone resection and stability were compared in MRI scans with respect to the quality of scanning due to motion artifacts and experienced know-how in PSI design, respectively. The optimized femoral cutting guide design for PSI showed the closest outcomes in bone resection and PSI stability with presurgical data. It is expected that this design could be a reasonable guideline in PSI.

Unicomparmental knee arthroplasty (UKA) is a popular alternative to total knee arthroplasty (TKA) and high tibial osteotomy for unicompartmental knee conditions, especially in young patients. However, failure of UKA occurs due to either progressive osteoarthritis (OA) in the other compartment or wear on the polyethylene (PE) insert. This study used finite element (FE) analysis to investigate the effects of PE insert contact pressure and stress in opposite compartments for fixed- and mobile-bearing UKA. Analysis was performed using high kinematics displacement and rotation inputs, which were based on the kinematics of the natural knee. ISO standards were used for axial load and flexion. The mobile-bearing PE insert had lower contact pressure than the fixed-bearing PE insert. With the mobile-bearing UKA, lower stress on the opposite compartment reduces the overall risk of progressive OA in the knee. The fixed-bearing UKA increases the overall risk of progressive OA in the knee due to higher stress on the opposite compartment. However, the PE insert of mobile-bearing showed pronounced backside stress at the inferior surface.

Purpose The purpose of this study was to evaluate the clinical and imaging results of patients who received intra‐articular injections of autologous mesenchymal stem cells for the treatment of knee osteoarthritis. Methods The study group comprised 18 patients (6 men and 12 women), among whom the mean age was 54.6 years (range, 41 to 69 years). In each patient the adipose synovium was harvested from the inner side of the infrapatellar fat pad by skin incision extension at the arthroscopic lateral portal site after the patient underwent arthroscopic debridement. After stem cells were isolated, a mean of 1.18 × 10 6 stem cells (range, 0.3 × 10 6 to 2.7 × 10 6 stem cells) were prepared with approximately 3.0 mL of platelet‐rich plasma (with a mean of 1.28 × 10 6 platelets per microliter) and injected into the selected knees of patients. Clinical outcome was evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index, the Lysholm score, and the visual analog scale (VAS) for grading knee pain. We also compared magnetic resonance imaging (MRI) data collected both preoperatively and at the final follow‐up. Results Western Ontario and McMaster Universities Osteoarthritis Index scores decreased significantly ( P < .001) from 49.9 points preoperatively to 30.3 points at the final follow‐up (mean follow‐up, 24.3 months; range, 24 to 26 months). Lysholm scores also improved significantly ( P < .001) by the last follow‐up visit, increasing from a mean preoperative value of 40.1 points to 73.4 points by the end of the study. Likewise, changes in VAS scores throughout the follow‐up period were also significant ( P = .005); the mean VAS score decreased from 4.8 preoperatively to 2.0 at the last follow‐up visit. Radiography showed that, at the final follow‐up point, the whole‐organ MRI score had significantly improved from 60.0 points to 48.3 points ( P < .001). Particularly notable was the change in cartilage whole‐organ MRI score, which improved from 28.3 points to 21.7 points ( P < .001). Further analysis showed that improvements in clinical and MRI results were positively related to the number of stem cells injected. Conclusions The results of our study are encouraging and show that intra‐articular injection of infrapatellar fat pad–derived mesenchymal stem cells is effective for reducing pain and improving knee function in patients being treated for knee osteoarthritis. Level of Evidence Level IV, therapeutic case series.