Indian Journal of Orthopaedics最新文献

{"title":"Comparing Suture Anchor and Transosseous Methods for Patellar Fixation in Medial Patellofemoral Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Napatpong Thamrongskulsiri, Thun Itthipanichpong, Thanathep Tanpowpong, Somsak Kuptniratsaikul, Danaithep Limskul","doi":"10.1007/s43465-025-01453-y","DOIUrl":"10.1007/s43465-025-01453-y","url":null,"abstract":"<p><strong>Background: </strong>Two commonly used techniques for securing the tendon graft to the patella in medial patellofemoral ligament (MPFL) reconstruction include the suture anchor (SA) method and the transosseous (TO) method. This study aimed to compare the outcomes in groups of patients who underwent SA and TO methods for patellar fixation in MPFL reconstruction.</p><p><strong>Methods: </strong>A systematic review was carried out. The evaluation of methodological quality for the included studies utilized the Modified Coleman Methodology Score and Methodology Index for Non-Randomized Studies criteria.Meta-analysis was performed using odds ratios (OR) for dichotomous outcomes and mean differences (MD) for continuous outcomes.</p><p><strong>Results: </strong>Four articles were included in this analysis, encompassing a total of 259 knees. Two studies were categorized as the level of evidence II, and two studies were categorized as the level of evidence III. Postoperative clinical outcomes, including Kujala, Lysholm, and International Knee Documentation Committee scores, did not statistically significantly differ between the SA and TO methods. Radiographic outcomes showed no statistically significant difference in congruence angle and patellar tilt angle between the two approaches at the minimal 2-year follow-up. Furthermore, the incidence of complications, specifically redislocation and patella fracture, was generally low, with no differences observed between the SA and TO methods.</p><p><strong>Conclusions: </strong>Both the SA and TO methods for patellar fixation in MPFL reconstruction contribute to improved clinical outcomes, displaying low complication rates. No statistically significant differences were observed in clinical and radiographic outcomes, as well as complications, between these two techniques.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-025-01453-y.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1101-1111"},"PeriodicalIF":1.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Meta-Analysis and Systematic Review on the Use of Adipose-Derived Mesenchymal Stem Cells for Knee Osteoarthritis Management.","authors":"Yu Yang, Ibrahim Serag, De-Yu Cao, Mahmoud G A Saleh, E A Shaban, Ahmad Alkabi, Mostafa Hossam El Din Moawad","doi":"10.1007/s43465-025-01441-2","DOIUrl":"10.1007/s43465-025-01441-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Knee osteoarthritis (KOA) is one of the most common forms of joint degeneration, frequently resulting in persistent pain, reduced mobility, and impaired quality of life. The disease is characterized by the progressive breakdown of articular cartilage, synovial inflammation, and subchondral bone changes. Conventional management options such as analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and surgical procedures are primarily aimed at alleviating symptoms rather than reversing or halting disease progression. In recent years, interest has grown in regenerative strategies, particularly the use of human adipose-derived mesenchymal stem cells (hAD-MSCs), due to their ability to modulate inflammation, promote tissue repair, and potentially regenerate damaged cartilage. These stem cells are favored for their ease of harvest, high yield, and ability to differentiate into chondrocytes. Despite their promising biological properties, the clinical benefit of intra-articular hAD-MSC therapy in KOA remains a subject of ongoing investigation, with varying outcomes reported across studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This systematic review and meta-analysis aims to assess the therapeutic efficacy of intra-articular hAD-MSC injections in individuals with knee osteoarthritis by analyzing data from randomized controlled trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An extensive search of the literature was performed in alignment with the PRISMA framework, using four major databases: PubMed, Scopus, Web of Science, and the Cochrane Library. Studies considered for inclusion were randomized controlled trials (RCTs) examining the effects of intra-articular human adipose-derived mesenchymal stem cell (hAD-MSC) therapy in individuals diagnosed with knee osteoarthritis (KOA). Risk of bias in the selected trials was evaluated using the Cochrane Risk of Bias 2 (ROB2) tool. Statistical pooling of data was conducted using a random-effects model via Review Manager (RevMan) version 5.3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 11 RCTs, encompassing 510 patients, met the eligibility criteria for inclusion in the meta-analysis. Treatment with hAD-MSCs led to statistically significant improvements in WOMAC scores (mean difference [MD] =  - 25.32, 95% confidence interval [CI]  - 31.30 to  - 19.34; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001) and VAS pain ratings (MD =  - 3.45, 95% CI  - 3.74 to  - 3.15; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001). Furthermore, patient-reported quality of life showed meaningful enhancement following treatment (MD = 18.28, 95% CI 10.35-26.21; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001). However, analysis of KOOS-Symptom domain scores did not show a statistically significant difference. The degree of heterogeneity differed between outcome measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This meta-analysis demonstrates that intra-articular administration of hAD-MSCs can effectively reduce pain and enhance joint function and quality of life in patients with knee","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1078-1089"},"PeriodicalIF":1.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Biodegradable Orthopaedic Implants: A Literature Review.","authors":"Anil Kumar Kotteda, Talari Saikumar, Akshay A Shreegan","doi":"10.1007/s43465-025-01445-y","DOIUrl":"10.1007/s43465-025-01445-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Biodegradable orthopaedic implants have emerged as an innovative alternative to traditional permanent metallic or inert polymer implants, aiming to provide mechanical support during critical healing phases and subsequently degrade in vivo. Their primary advantage lies in eliminating the need for a second surgery to remove hardware, thus potentially reducing patient morbidity and healthcare costs. Despite these benefits, challenges related to unpredictable degradation kinetics, mechanical strength, and biocompatibility have restricted their widespread clinical application.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review synthesizes existing literature on the historical development of biodegradable orthopaedic implants, the range of biomaterials investigated-including polymers (e.g., PLA, PLGA), metals (e.g., Mg, Fe, Zn), and bio ceramics (e.g., HA, TCP)-and the manufacturing techniques used, such as extrusion, injection molding, and advanced additive manufacturing. We have searched across major databases like Pubmed, Scopus, Google scholar and Science direct. We considered the articles published from 1985 till 2024. We used the search strategy incorporating the Medical Subject headings(MeSH).The following keywords were used \"biodegradable orthopedic implants\", \"resorbable implants\", \"absorbable fixation devices\", \"polylactic acid(PLA)\", \"PLGA\", \"Polycaprolactone(PCL)\", \"Magnesium alloys\", \"zinc alloys\", \"bioceramics\", \"tricalcium phosphate\", \"fracture fixation\", \"implant degradation\", \"corrosion\", \"hydrolytic degradation\", \"biocompatibility\", \"inflammatory response\", \"toxicology\", \"FDA guidelines\", \"biodegradable implant approval\", \"clinical trials\", \"long-term outcomes\", \"postmarket surveillance\". Boolean operators AND and OR were used to combine keywords (e.g., \"biodegradable implants\" AND \"magnesium alloys\" AND \"fracture fixation\"). Filters were used to select the articles published only in English. The mechanisms of degradation for different material classes were examined, alongside preclinical and clinical findings. Regulatory guidelines and ongoing innovations, including multifunctional (e.g., drug-delivering) and smart biodegradable implants, were also analysed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Findings indicate that biodegradable polymers offer well-characterized degradation profiles and have been successfully used in lower-load applications, including paediatric fracture fixation and ligament repairs. Magnesium- and iron-based alloys show promise in load-bearing contexts, although controlling corrosion remains an ongoing challenge. Composite approaches that integrate metals, polymers, and ceramics can better tailor mechanical properties and degradation rates to specific clinical needs. Early clinical results generally demonstrate favourable outcomes in fracture fixation, spinal surgery, and maxillofacial procedures; however, long-term data and large-scale trials are still limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/str","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1090-1100"},"PeriodicalIF":1.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporotic Distal Radius Fracture: Surgical Care.","authors":"Akram Jawed, Sagar Bhat, Kanika Gupta, Vikas Gupta","doi":"10.1007/s43465-025-01407-4","DOIUrl":"10.1007/s43465-025-01407-4","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures (DRFs) are among the most frequent injuries in older adults, especially those with osteoporosis. In India, these fractures are becoming more common due to longer life spans, changing lifestyles, and increasing rates of undiagnosed osteoporosis.</p><p><strong>Objective: </strong>To explore the growing burden of osteoporotic DRFs and evaluate current approaches to their management, focusing on both non-surgical and surgical strategies tailored for the aging population.</p><p><strong>Methods: </strong>This review brings together recent research and clinical insights on the causes, challenges, and treatments of osteoporotic DRFs. It covers conservative care, surgical options like volar locking plates and external fixators, and newer techniques such as bone grafting, augmentation, and hemiarthroplasty.</p><p><strong>Results: </strong>This review brings together recent research and clinical insights on the causes, challenges, and treatments of osteoporotic DRFs. It covers conservative care, surgical options like volar locking plates and external fixators, and newer techniques such as bone grafting, augmentation, and hemiarthroplasty.</p><p><strong>Conclusion: </strong>Managing osteoporotic DRFs requires a personalized approach that balances bone quality, fracture type, and patient needs. Early diagnosis of osteoporosis and appropriate treatment choices can significantly improve healing, function, and overall quality of life.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1032-1052"},"PeriodicalIF":1.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Matters: Comparative Analysis of Fibular Tunnel Trajectories in PLC Reconstruction: A Cadaveric Study.","authors":"Ponnanna Karineravanda Machaiah, Suraj Prakash, P Ashok Kumar","doi":"10.1007/s43465-025-01442-1","DOIUrl":"10.1007/s43465-025-01442-1","url":null,"abstract":"<p><strong>Introduction: </strong>Posterolateral corner (PLC) injuries are challenging to manage due to the complex anatomy involved and the need for modified reconstruction to restore knee stability. Current reconstruction techniques vary, with the anterior-posterior (A-P) tunnel placement being widely used. However, newer methods, such as the 50°/60° fibular tunnel trajectory, aim to replicate the natural anatomical insertion points of the fibular collateral ligament (FCL) and popliteofibular ligament (PFL), potentially offering better outcomes.</p><p><strong>Methods: </strong>This study evaluated the biomechanical effectiveness and procedural safety of the 50°/60° fibular tunnel trajectory compared to the traditional A-P tunnel technique in 18 cadaveric knee specimens. Key outcomes measured included varus opening, neurovascular proximity, and incidence of fibular tunnel blowouts.</p><p><strong>Results: </strong>The 50°/60° technique significantly reduced varus opening (mean 1.54 mm) compared to the A-P technique (mean 2.06 mm). It also preserved more post-lateral fibular bone stock (7.43 mm vs. 5.10 mm) and did not lead to any tunnel blowouts, while two blowouts were noted in the A-P group. Neurovascular safety was maintained in both techniques, with no significant risk of injury.</p><p><strong>Conclusion: </strong>The 50°/60° fibular tunnel technique may offer a biomechanical advantage over the A-P technique by providing better knee stability and preserving bone stock. These findings suggest that the 50°/60° method is a safer and more effective option for PLC reconstruction.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1241-1248"},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Joint Arthroplasty in Ochronotic Arthritis of Lower Extremities.","authors":"Praveen L Basanagoudar, Deepak N Inamdar, Ranganath Thimmegowda B, Vijay Tubaki","doi":"10.1007/s43465-025-01431-4","DOIUrl":"10.1007/s43465-025-01431-4","url":null,"abstract":"<p><strong>Background: </strong>Ochronotic arthropathy is an inherited metabolic disease manifestation of alkaptonuria (AKU), commonly involving the spine, knees and hips. End-stage ochronotic arthritis (OcA) requiring total joint arthroplasty (TJA) is uncommon, with only few case series being described in English literature.</p><p><strong>Materials: </strong>The objective of current study is to share our surgical experience of treating four patients with end-stage arthritis, who underwent eight TJAs of the lower extremity (5 hips and 3 knees) in whom an intraoperative diagnosis of ochronosis was suspected after surgical exposure of the operated joint. We describe the intraoperative challenges faced during surgical treatment, diagnostic tests and mid-term follow-up results.</p><p><strong>Results: </strong>Four AKU patients (3 females) with end-stage OcA of the hips and/or knees, underwent eight total joint replacement surgeries, under neuraxial anesthesia in the majority. All patients were either in their late fifties or sixties at the time of their index TJA. We encountered one case each of peri-prosthetic fracture, medullary canal perforation and early prosthetic infection, all of which were successfully treated. The mean follow-up was 5.2 years (1-10 years) and all patients had satisfactory clinical outcomes at the last follow-up.</p><p><strong>Conclusions: </strong>The surprise intraoperative diagnosis of OcA, along with associated juxta-articular sclerosis or osteopenia can lead to intra-operative complications. These complications when addressed appropriately did not adversely affect the clinical outcomes of TJA for end-stage hip and knee arthritis, at a medium-term follow-up.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1200-1210"},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of the Barrack and Gruen Grading Systems in Assessing Cement Mantle Quality in Hip Arthroplasty.","authors":"Manel Fa-Binefa, Alex Grau-Blanes, Esther Moya-Gomez, Ignasi Gich-Saladich, Marius Valera-Pertegás","doi":"10.1007/s43465-025-01394-6","DOIUrl":"10.1007/s43465-025-01394-6","url":null,"abstract":"<p><strong>Background: </strong>Aseptic loosening is the most common cause of failure of cemented femoral stems. This complication, which is directly related to cementation quality, can be assessed radiographically using the Gruen or Barrack bone cementation quality grading systems. However, the reproducibility of these grading systems is uncertain. The aim of this study was to determine the intra- and interobserver reproducibility of these two grading systems for the assessment of the bone-cement and cement-prosthesis interfaces.</p><p><strong>Methods: </strong>Three observers independently evaluated bone cementation quality according to the Barrack and Gruen systems on radiographs obtained from 40 patients (80 radiographs; anterior-posterior [AP] and axial views) who had undergone cemented hip hemiarthroplasty after intracapsular femoral fracture. The 40 patients were randomly selected from 152 consecutive cases. The radiographs were evaluated twice over a 4-week period, once with the Barrack system and once with the Gruen system, in random order. In all cases, the same type of femoral stem and cement was used. The weighted kappa coefficient was determined to assess intraobserver and interobserver agreement.</p><p><strong>Results: </strong>Most cases were classified as either Barrack B or C (72.8%). In the AP view, radiolucencies were present in 54.9% (95% CI: 46.6-63.1) of cases in the bone-cement interface (Gruen zones). For the Barrack system, the weighted kappa ranged from 0.42 to 0.57 for the intraobserver analysis and from 0.22 to 0.32 for the interobserver analysis, indicating a fair to moderate strength of agreement. The corresponding coefficients for the Gruen system were 0.40-0.55 (intraobserver) and 0.08-0.28 (interobserver), indicating a slight to moderate strength of agreement.</p><p><strong>Conclusion: </strong>The findings of this study suggest that the Gruen and Barrack cementation grading systems are not sufficiently reliable to accurately evaluate cement mantle quality at the bone-cement and cement-prosthesis interfaces. Consequently, the routine use of these grading systems in hip orthopaedic practices should be reconsidered.<i>Level of Evidence</i>: Level IV.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1172-1179"},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single vs Double Index Screws in Thoracolumbar Burst Fractures: A Retrospective Analysis.","authors":"Vinoth Thangamani, Ganesh Kumar, Niren Dalvey Raj, Bharatkumar Ramalingam Jeyashankaran, Sivakumar Raju, Chidambaram Muthu","doi":"10.1007/s43465-025-01433-2","DOIUrl":"10.1007/s43465-025-01433-2","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>To assess the radiological, clinical, and neurological outcome of patients who had thoracolumbar burst fractures and had undergone short-segment posterior stabilization with single-index screw (SIS) or double-index screws (DIS) at the fractured vertebra.</p><p><strong>Methods: </strong>We included patients with AO type A and B with thoracolumbar injury classification and severity score (TLICS) ≥ 5, load-sharing classification (LSC) score ≥ 7, and a follow-up period of more than 2 years. Of 94 patients, 45 had DIS fixation, and 49 had SIS fixation. All patients' pre-operative, immediate post-operative, and final follow-up visit X-rays were analyzed for Cobb's angle (CA), vertebral wedge angle (VWA), and vertebral body compression ratio (VBCR) in a neutral lateral view and transverse spinal area (TSA) in axial CT section. Clinical and neurological outcomes were assessed using the Visual Analog Scale (VAS) for back pain, the Oswestry Disability Index (ODI), and the American Spinal Injury Association (ASIA) Impairment Scale (AIS) at their final follow-up visit.</p><p><strong>Results: </strong>The radiological parameters between both groups showed significant differences in terms of CA, VWA, and VBCR at the latest follow-up (SIS: 12.5°, 15°, 80.1% vs DIS: 8.04°, 11.2°, 87.1%) (<i>p</i> < 0.05). VAS and ODI were better in the DIS group but were statistically insignificant (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Short-segment posterior stabilization with DIS in the fractured vertebra resulted in radiologically better maintenance of CA, VWA, and VBCR compared to SIS. There were no significant differences in terms of clinical (VAS and ODI), neurological outcome (AIS), and spinal canal remodeling (TSA).</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1265-1273"},"PeriodicalIF":1.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Analysis of Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Compression Fractures and Postoperative Sagittal Balance.","authors":"Mehmet Yigit Akgun, Ege Anil Ucar, Gumral Mamedova, Tunc Oktenoglu, Ozkan Ates, Ali Fahir Ozer","doi":"10.1007/s43465-025-01438-x","DOIUrl":"10.1007/s43465-025-01438-x","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic vertebral compression fractures (OVCFs) lead to posture restrictions, back muscle fatigue, difficulty walking, impaired lung function, an increased risk of disability, and severe pain. Collectively, these symptoms significantly diminish patients' quality of life. While non-surgical management is often attempted, it may prove inadequate for cases involving walking difficulties and sagittal imbalance. In such instances, surgical interventions like vertebroplasty (VP) and kyphoplasty (KP) become necessary. To our knowledge, no study in the literature has directly compared VP and KP in terms of their effectiveness in improving sagittal balance.</p><p><strong>Aim: </strong>This study aims to compare the clinical and radiological outcomes of VP and KP, with a specific focus on their impact on global spinal alignment and sagittal balance.</p><p><strong>Methods: </strong>Seventy-six patients with OVCFs (mean age: 64.12 ± 11.85 years) underwent either kyphoplasty (59%) or vertebroplasty (41%). Radiological parameters, clinical outcomes, operation time, and complications were evaluated at 6-month, 12-month, and 24-month follow-ups. The improvement in sagittal balance was compared between the KP and VP groups.</p><p><strong>Results: </strong>Only KP significantly increased vertebral height, though no significant postoperative differences in vertebral height were observed between the KP and VP groups. Similarly, KP was the only procedure that improved thoracic kyphosis in OVCF patients. Neither VP nor KP demonstrated significant improvement in sagittal balance, including pelvic parameters and the sagittal vertical axis. However, both groups showed marked pain relief, as evaluated by the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Complication rates were low in both groups, and there was no significant difference in the incidence of cement leakage.</p><p><strong>Conclusion: </strong>While both KP and VP demonstrated efficacy in treating OVCFs, neither procedure showed clear superiority in terms of pain relief, sagittal balance, or complication rates. However, only KP significantly increased vertebral height and improved thoracic kyphosis in OVCF patients.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-025-01438-x.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1219-1226"},"PeriodicalIF":1.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Ultrasound-Guided Corticosteroid Injection and Radial Extracorporeal Shock Wave Therapy for Plantar Fasciitis: A Double-Blind Randomized Controlled Trial.","authors":"P Aiswarya, Keshav Dev, Mukesh Kumar Yadav, Neethu Sunilkumar, Mrinal Joshi, Astha Patni","doi":"10.1007/s43465-025-01422-5","DOIUrl":"10.1007/s43465-025-01422-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Plantar fasciitis (PF) is one of the most prevalent causes of heel pain, involving inflammation of the plantar fascia leading to pain and functional disability. The treatment options of PF include conservative, minimally invasive procedures, and surgery. Of these, radial extracorporeal shock wave therapy (rESWT) and corticosteroid injections (CSI) are widely practised treatments for PF, but its treatment outcome is often debated. Understanding the treatment course, symptom improvement rate, and cure of the underlying pathology is always essential to choose a treatment modality. This study is aimed to evaluate the early effectiveness of ultrasound-guided CSI and rESWT in the treatment of PF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;A hospital-based, randomized, double-blind interventional study was conducted in our tertiary center to evaluate the efficacy of CSI and rESWT in participants presenting with plantar heel pain. A total of 170 participants were enrolled and randomly assigned to either the CSI or rESWT group. After treatment completion, follow-up was completed in the 70 participants in each group. The CSI group received an injection comprising 2 mL of methyl prednisolone acetate (40 mg/mL) combined with 2 ml of 2% lignocaine, while the rESWT group received 2000 shock impulses at a pressure of 2.5 bars and a frequency of 15 Hz for three consecutive weeks. The participants were assessed at baseline (week 0), 4 weeks, and 8 weeks post-treatment as this study is aimed to focus mainly on the early outcome of both primary modalities. Outcome measures included the visual analogue scale (VAS) at three instances of a day such as 'first step in the morning', 'at rest' and 'during activities of daily living' for pain assessment, the Foot and Ankle Ability Measure (FAAM) with Activities of Daily Living (ADL) and Sports subscales for functional evaluation, and ultrasonographic measurement of plantar fascia thickness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After 4 weeks and 8 weeks, VAS score continued to decrease in all the three time instances in the CSI group, whereas even though it started reducing for rESWT at 4 weeks, pain with respect to VAS score showed an increasing trend by 8 weeks. By 4 weeks, significant differences appeared within the CSI group compared to rESWT in all three instances. By 8 weeks, these differences became even more pronounced and statistically significant (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In terms of the FAAM scale, both groups showed increase in the score, where a higher score indicates better function. CSI resulted in more significant improvement in terms of ADL (&lt;i&gt;p&lt;/i&gt; = 0.0001) and Sports subscale (&lt;i&gt;p&lt;/i&gt; = 0.01). rESWT, while showing some improvement, was less effective than CSI, especially in the ADL subscale at 8 weeks. In terms of plantar fascia thickness, both groups showcased reduction in thickness, but there was no statistically significant difference between the two groups at 4 weeks (&lt;i&gt;p&lt;/i&gt; = 0.16","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1227-1240"},"PeriodicalIF":1.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}