Clinical Orthopaedics and Related Research®最新文献

{"title":"Does Valgus Bracing Reduce Estimates of Medial Tibial, Medial Femoral, and Patella Cartilage Contact Pressure in Varus Malaligned Medial Knee Osteoarthritis?","authors":"Scott C Starkey,Amir Esrafilian,David J Saxby,Laura E Diamond,Rami K Korhonen,Michelle Hall","doi":"10.1097/corr.0000000000003611","DOIUrl":"https://doi.org/10.1097/corr.0000000000003611","url":null,"abstract":"BACKGROUNDValgus bracing may be particularly effective for the management of varus malaligned medial knee osteoarthritis (OA). Among several potential mechanisms, valgus bracing may impart clinical benefit by reducing medial tibiofemoral joint contact force. However, prior research shows a tenuous effect of valgus bracing on medial tibiofemoral joint contact force. Tissue-level knee mechanics, such as the magnitude and location of cartilage pressure, may provide important insights into potential mechanisms but remain underinvestigated.QUESTIONS/PURPOSES(1) Does valgus bracing reduce estimates of medial tibial, medial femoral, and patella cartilage contact pressure during walking compared with unbraced walking in patients with varus malaligned medial knee OA? (2) Are there changes in the region of cartilage pressure upon the medial tibia, medial femoral condyle, and patella between braced and unbraced walking?METHODSBaseline data from 28 clinical trial participants with varus malalignment and knee OA walking braced and unbraced were used. Volunteers were recruited from the community in Melbourne, Australia between April 2019 and November 2019. Major inclusion criteria included having radiographic tibiofemoral joint OA and varus malalignment, age ≥ 50 years, and current and > 3-month history of knee pain. Because of incomplete MRI data (n = 3), 25 of the original 28 participants were included in this secondary analysis. The cohort had a mean ± SD age of 64 ± 5 years, BMI of 29.4 ± 3.1 kg/m2, and more males (n = 14) than females (n = 11). A validated 12 degrees of freedom knee model with MRI-derived cartilage morphology and ligament insertion points was combined with a calibrated EMG-informed neuromusculoskeletal model to simulate knee contact mechanics. Tibiofemoral and patellofemoral cartilage contact simulations were performed across the stance phase of walking for four braced and unbraced trials using a nonlinear elastic foundation contact model. Outcomes addressing our first study question were estimates of maximum and mean medial tibial, medial femoral, and patella cartilage contact pressure (in megapascals [MPa]). Outcomes addressing our second study question were change in center of pressure from heel strike in the anatomic medial-lateral direction (normalized to % of cartilage width) and AP direction (normalized to % of cartilage length). Primary statistical analysis was statistical parametric mapping using one-way repeated-measures ANOVA models, which evaluate time-varying differences across stance. The point in stance with the largest differences was reported as mean difference and 95% confidence interval (CI).RESULTSBraced walking had a lower maximum medial tibial cartilage contact pressure compared with unbraced walking during 7% to 15%, 26% to 40%, and 65% to 90% of stance, with the largest difference at 87% of stance (mean ± SD unbraced 16.0 ± 4.3 MPa, braced 14.0 ± 3.6 MPa, mean difference -2.0 MPa [95% CI -3.5 to -0.6]; p < 0.001) (","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"8 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: Modic Changes Are Associated With Increased Pain Intensity, Greater Disability, and Reduced Quality of Life in Low Back Pain: A Cross-Sectional Study.","authors":"Alpaslan Senkoylu","doi":"10.1097/CORR.0000000000003619","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003619","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical Groupings of Mental Health and Osteoarthritis Severity Correlate With 10-year Trajectories of Levels of Capability and Comfort Among People With Hip Pain: A Nationwide Prospective Cohort Study (CHECK).","authors":"Melle M Broekman,Niels Brinkman,Cornelis L P van de Ree,David Ring,Job N Doornberg,Rintje Agricola,Prakash Jayakumar","doi":"10.1097/corr.0000000000003612","DOIUrl":"https://doi.org/10.1097/corr.0000000000003612","url":null,"abstract":"BACKGROUNDAmong patients seeking care for osteoarthritis (OA), there is evidence that mindsets contribute more to variation in levels of musculoskeletal discomfort and incapability than does radiographic severity. While the importance of mindsets among those seeking specialty care is well established, less is known about the relationship of thoughts and feelings with levels of joint-related discomfort and incapability in the general population, many of whom experience symptoms of aging joints and are accommodating these symptoms. By studying individuals with hip pain who have not sought specialty care, using a statistical technique that can account for the interrelationship of psychological and social variables (cluster analysis) and accounting for levels of OA, we can better study the association of mindset with levels of discomfort and incapability relative to the grade of OA while limiting or avoiding the potential for distortion of linear and logistic regression by even relatively lower levels of collinearity among mental health variables.QUESTIONS/PURPOSESUsing a Dutch population-based cohort we asked: (1) Are there distinct 10-year trajectories of comfort and capability by statistical grouping based on mental health measures and grade of OA in a population-based cohort of individuals with hip pain? (2) Are groupings with less healthy mindsets associated with worse 10-year trajectories for both comfort and capability compared with groups defined by healthier mindsets?METHODSWe analyzed data from a prospective longitudinal cohort from the Dutch general population from between October 2002 and September 2005. Individuals age 45 to 65 years were included if they experienced new onset of hip or knee pain or stiffness and either had not sought care for their symptoms or their first general practitioner consultation for symptoms was within 6 months of enrollment. Originally, a total of 1002 participants were included, of which 74% (n = 740, 79% [584 of 740] women, mean ± SD age 56 ± 5 years) met our inclusion criteria and were included in this study. Each year for 10 years, participants completed the SF-36 (measuring general capability and mental health, with higher scores indicating better overall health); the WOMAC questionnaire (measuring capability specifically for hip and knee OA, with lower scores indicating greater capability); the EuroQol-5D-3L (EQ-5D-3L) questionnaire, which measures five domains of health (mobility, self-care, usual activities, pain, and anxiety/depression); and the VAS for pain intensity. All 740 included participants completed the WOMAC, the SF-36 physical component summary, and the Numeric Rating Scale for pain at 10 years. Cluster analysis identified statistical groupings of participants with similar scores on the SF-36 mental component summary (MCS), EQ-5D-3L anxiety/depression item, and Kellgren-Lawrence grade of radiographic hip OA. We then constructed a conditional growth model, which is a statistical technique t","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"7 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Can a Liquid Biopsy Detect Circulating Tumor DNA With Low-passage Whole-genome Sequencing in Patients With a Sarcoma? A Pilot Evaluation.","authors":"Yuan Fu,Biao Cui,Dan Jin","doi":"10.1097/corr.0000000000003571","DOIUrl":"https://doi.org/10.1097/corr.0000000000003571","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"7 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Synthesis: What Is the Role of Proinflammatory Markers in Diagnosing Periprosthetic Joint Infection and Guiding Outcome Prediction in Shoulder Implants?","authors":"Asimina Lazaridou,Georg Duda,Markus Scheibel","doi":"10.1097/corr.0000000000003614","DOIUrl":"https://doi.org/10.1097/corr.0000000000003614","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"24 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: Femoral Trochlear Dysplasia Is Common in Lower Limbs With Hartofilakidis C2 Hip Dysplasia.","authors":"Evelyn Kuong","doi":"10.1097/corr.0000000000003617","DOIUrl":"https://doi.org/10.1097/corr.0000000000003617","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"108 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144630453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Ankle Instability Is Associated With Smaller Sensorimotor Deficits and Greater Integrity of the Superior Cerebellar Peduncles With Aging.","authors":"Zikun Wang,Xiao'ao Xue,Shanshan Zheng,Yi Li,Ziyuan Wang,Yuwen Zhang,Yushi Chen,Rong Lu,Yang Sun,He Wang,Yinghui Hua","doi":"10.1097/corr.0000000000003604","DOIUrl":"https://doi.org/10.1097/corr.0000000000003604","url":null,"abstract":"BACKGROUNDChronic ankle instability is associated with balance deficits and maladaptive cerebellar neuroplasticity across age groups. However, it remains unclear how aging and chronic ankle instability interact to influence these abnormalities, particularly in cerebellar structures that are essential for proprioception and motor coordination. This gap in understanding limits the development of age-specific rehabilitation strategies.QUESTIONS/PURPOSESThis study aimed to: (1) determine the interaction effect of chronic ankle instability and aging on sensorimotor deficits, (2) assess whether this interaction is reflected in superior and inferior cerebellar peduncle microstructure changes, and (3) evaluate the correlation between altered cerebellar peduncle integrity and balance performance in patients with chronic ankle instability and a control cohort.METHODSBetween August 2022 and January 2024, we screened 134 individuals for participation. Of these, 61% (82 of 134) were considered potentially eligible based on the inclusion criteria. One patient in the control group was excluded because of poor imaging quality. Ultimately, 60% (81 of 134) of participants were included in the final analysis, consisting of 51% (41 of 81) in the chronic ankle instability group (18 females, age 30 ± 6 years) and 49% (40 of 81) in the control group (17 females, age 29 ± 8 years). We collected participants' demographic information, clinical history, as well as clinical data, including Cumberland Ankle Instability Tool scores for self-reported instability and Tegner activity scores. All participants underwent the Y-balance test to evaluate sensorimotor deficits and diffusion-weighted imaging to assess the structure of the central nervous system. We focused on the superior and inferior cerebellar peduncles as regions of interest and performed both traditional diffusion tensor imaging and advanced neurite orientation dispersion and density imaging to evaluate the cerebellar white matter microstructure. Multivariable linear regressions with interaction terms were conducted to examine the interaction effects of chronic ankle instability and age on primary clinical outcomes (Y-balance test scores and diffusion tensor imaging/neurite orientation dispersion and density imaging outcomes). Correlation analyses between posteromedial reach distances on the Y-balance test and significant diffusion tensor imaging/neurite orientation dispersion and density imaging outcomes were performed within the chronic ankle instability and the control groups, respectively. In particular, we calculated a standardized beta coefficient (β*) for each regression model to facilitate comparison of effect sizes across variables to more easily judge which predictors contributed more substantially to the outcomes.RESULTSAfter controlling for potential confounding factors including sex, BMI, and Tegner activity scores, we found that although participants with chronic ankle instability generally had poorer ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"16 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifth Metatarsal Stress Fractures Are Associated With Increased Bone Density and Altered Alignment on Weightbearing CT.","authors":"François Lintz,Wolfram Grün,Enrico Pozzessere,Emily Luo,Erik Jesus Huanuco Casas,Pierre-Henri Vermorel,Antoine Acker,Cesar de Cesar Netto","doi":"10.1097/corr.0000000000003613","DOIUrl":"https://doi.org/10.1097/corr.0000000000003613","url":null,"abstract":"BACKGROUNDStress fractures of the fifth metatarsal (M5) are common among individuals engaging in repetitive impact activities or patients with preexisting deformities. Compared with patients who have traumatic fractures, those with stress fractures often develop delayed union, nonunions, or recurrence. Risk factors such as hindfoot varus and foot adduction have been implicated. The recent advent of weightbearing CT enables the study of specific bone density and orientation characteristics that have not, to our knowledge, previously been explored. Such tools could detect higher risk patients and help trigger potential preventive measures.QUESTIONS/PURPOSESDo patients with an M5 stress fracture present altered three-dimensional orientation and alignment parameters compared with an age- and sex-matched control group? (2) Do the feet and M5s of patients with an M5 stress fracture present different foot ankle offset (FAO) parameters compared with the control group? (3) Do the M5s of patients with an M5 stress fracture present with altered bone density patterns compared with the control group, and is a clinically relevant threshold identifiable?METHODSThis institutional review board-approved retrospective case-control study analyzed 15 feet of patients with M5 stress fractures and 15 feet of a control group using weightbearing CT. Between February 2022 and May 2024, a total of 74 patients with available weightbearing CT scans were treated for an M5 fracture. Among those patients, we considered 77% (57) of proximal fractures as potentially eligible. Of those patients, 39% (22 of 57) were included; a further 32% (7 of 22) were later excluded because of metal artifact conflicting with M5 bone density assessment, leaving 68% (15 of 22) for analysis here. Controls were selected from our weightbearing CT archive, matched for age and sex and excluded if any foot disorder or prior intervention was identified. Accordingly, there were seven males and eight females in each group, and five and nine left sides, respectively, in the stress fractures and control groups. The mean ± SD age was 53 ± 13 years for the stress fractures group versus 51 ± 12 years for controls. Mean ± SD BMI was 34.4 ± 10.2 kg/m2 for the stress fractures group and 36.8 ± 8.2 kg/m2 for controls. For the first study question, M5 orientations and baseline foot alignment parameters were evaluated based on Digital Imaging and Communications in Medicine (DICOM) data sets using weightbearing CT software. For the second study question, weightbearing CT software was used to measure the FAO and assess the spatial relationship of the M5 with the foot tripod. For the third study question, segmentation and bone density measurements, using Hounsfield units (HUs), were performed with commercially available and open-source software. Receiver operating characteristic analysis with the Youden index was performed to determine the sensitivity and specificity of the HU M5/HU talus density ratio for identifying s","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"37 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Risk-stratified Care Improves Pain-related Knowledge and Reduces Psychological Distress for Low Back Pain: A Secondary Analysis of a Randomized Trial.","authors":"Chengbo Yang,Qiang Dou","doi":"10.1097/corr.0000000000003607","DOIUrl":"https://doi.org/10.1097/corr.0000000000003607","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"195 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: What Is the Anatomic Footprint of the Anterolateral Ligament of the Knee? A Race- and Sex-based MRI Analysis.","authors":"Hollis G Potter","doi":"10.1097/corr.0000000000003615","DOIUrl":"https://doi.org/10.1097/corr.0000000000003615","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"5 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}