Journal of Orthopaedic Surgery最新文献

{"title":"Association between union time and clinical and functional outcomes following reconstruction with free vascularized fibular graft in patients with bone tumors.","authors":"Mehmet Can Gezer, Mustafa Onur Karaca, Hüseyin Yusuf Yıldız","doi":"10.1177/10225536251345182","DOIUrl":"10.1177/10225536251345182","url":null,"abstract":"<p><p><b>Background:</b> Large segment bone defects resulting from resections done for bone tumors or chronic osteomyelitis may need various treatment options for reconstruction of which use of free vascularized bone grafting is the most commonly used technique due to its ability to maintain biological continuity. In this study, we aimed to investigate the relationship between union time and functional scores in patients who underwent reconstruction with free vascularized fibular grafts (FVFG) for large segment bony defects resulting from resection of bone tumors. <b>Methods:</b> This retrospective study aims to evaluate the clinical outcomes of using free vascularized fibula grafts for the reconstruction of segmental defects following tumor resection at our institution between 2005 and 2021. The tools used for clinical assessment included the Visual Analog Scale (VAS), the Musculoskeletal Tumor Society (MSTS) score, and the Short Form-36 (SF-36) quality of life scale. The relationship between functional outcomes and union time was analyzed retrospectively. The patients were divided into two groups based on union time: those with a union time shorter than 6 months and those with a union time longer than 6 months. The relationship between union time and functional outcomes was analyzed. Additionally, the effects of gender, affected extremity, tumor location, defect size, preoperative and postoperative chemotherapy (CT) and/or radiotherapy (RT) status, presence of distant metastasis, postoperative complications, and hospital stay duration on union time were investigated. <b>Results:</b> A total of 45 patients were included in the study, comprising 20 females and 25 males, with a mean age of 31.3 years (min: 10, max: 74). Seventeen patients had tumors of the upper extremity, while 28 had tumors of the lower extremity. All patients underwent reconstruction of segmental bone defects using free vascularized fibula grafting (FVFG). Preoperative SF-36 quality of life scores were significantly lower when compared to postoperative scores. The patients were categorized into two groups based on union time: those who achieved union within 6 months and those with a union time exceeding 6 months. The analysis demonstrated that patients with upper extremity tumors had a faster union time, while those who experienced postoperative complications had a prolonged union time. Furthermore, extended hospital stays, the presence of preoperative and/or postoperative chemotherapy (CT) and/or radiotherapy (RT), and distant metastasis were associated with lower MSTS scores. However, this decrease in MSTS scores was not statistically significant. <b>Conclusions:</b> Free vascularized fibula grafts are effective biological reconstruction methods that accelerate bone union. The average union time is 6 months, extending up to 9-12 months in some cases. However, by 2 years postoperatively, functional scores are similar, with both mood and extremity function significantly improve","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345182"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological and clinical outcomes of patients diagnosed with intraosseous ganglion cysts of the lunate treated with arthroscopic dorsal ligamento capsulodesis with or without grafting: Minimum 1-year follow-up.","authors":"Ömer Ayik, Serkan Bayram, Ahmet Emre Paksoy, İsmail Bülent Özçelik","doi":"10.1177/10225536251340115","DOIUrl":"https://doi.org/10.1177/10225536251340115","url":null,"abstract":"<p><p>PurposeWe aimed to compare radiological and clinical results between patients diagnosed with Intraosseous ganglion cysts of the lunate (IGCL)-treated arthroscopic dorsal ligamento capsulodesis (ADLC) with or without grafting.Methods26 patients who underwent wrist arthroscopy with the diagnosis of intraosseous ganglion cysts of the lunate were included in the study. The patients in the series were divided into two groups according to the surgery they underwent: patients who underwent isolated ADLC in group A and ADLC with autografting in group B. The wrist range of motion, patient satisfaction, Visual Analogue Scale (VAS) and the Mayo Wrist Score (MWS) were used for clinical and functional results.ResultsGroup A consisted of 12 (7 females - 5 males), Group B consisted of 14 (9 females - 5 males). The mean age was 33,1 years in Group A (range 22-49), and 32,3 years in Group B (range 21-47). The VAS, Mayo Wrist Score, wrist range of motion, and the level of patient satisfaction were similar in the two groups. In Group A, the postoperative mean cyst diameter (CD) was 4.2 (range: 1.3 - 7.3 mm), comparable to the mean cyst diameters before surgery. In Group B, trabeculation was observed in 13 patients, and CD was not calculated. Only one patient in Group B had a 3.5 mm (preoperative 3.6 mm) cyst, attributed to graft lysis.ConclusionAs we have observed scapholunate instability at different stages in this case series diagnosed with IGCL, we believe that the source of pain is related to instability and treatment should focus on the existing instability. This hypothesis is supported by our obtaining similar results when comparing only ADCLs for instability, which were chosen according to our clinical experience, with those who underwent ADCLs with bone grafting.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251340115"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of a jaw-designed suture passer as compared to the Lasso-loop suture technique for arthroscopic treatment of chronic lateral ankle instability.","authors":"Weiwei Mao, Zhigao Jin, Yong Zhang, Wei Li, Ying Zhu, Weiqi Kong, Ying Wang, Jianzhong Qin","doi":"10.1177/10225536251345185","DOIUrl":"https://doi.org/10.1177/10225536251345185","url":null,"abstract":"<p><p>PurposeThis study compares the clinical outcomes of the Lasso-loop and Jaw-designed suture passer techniques for arthroscopic treatment of chronic lateral ankle instability (CLAI) caused by anterior talofibular ligament (ATFL) injuries. We aimed to assess whether the Jaw-designed technique provides similar outcomes with reduced intraoperative stitch time.MethodsThis retrospective cohort study included 40 patients with CLAI, who underwent arthroscopic ligament repair between February 2019 and February 2022. They were divided into two groups: 20 treated with the Lasso-loop technique and 20 with the Jaw-designed suture passer. Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale, Karlsson Ankle Functional Score (KAFS), Tegner activity scale (TAS), and Visual Analog Scale (VAS) for pain. Intraoperative ligament stitch time was also recorded for both groups.ResultsBoth groups showed significant improvement in AOFAS, KAFS, TAS, and VAS scores from preoperative to final follow-up (<i>p</i> < .001). The mean intraoperative ligament stitch time was significantly shorter in the Jaw-designed group (9.1 min) compared to the Lasso-loop group (16.5 min) (<i>p</i> < .001). However, no significant differences in final functional outcomes (AOFAS, KAFS, TAS, and VAS scores) were observed between the two groups (<i>p</i> > .05).ConclusionThe Jaw-designed suture passer technique for repairing the ATFL in CLAI offers clinical outcomes comparable to the Lasso-loop technique, with the added benefits of a shorter suture time and simpler execution. This technique may be particularly beneficial for novice surgeons and can serve as a reliable alternative to the Lasso-loop suture technique in the arthroscopic repair of CLAI.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345185"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI measurement analysis of risk factors for popliteal artery injury in knee surgery.","authors":"Zheng Jing, Yu Han, Yan Xu, Xinlin Nie, Lihui Sun, Dongbo Li, Dongsong Li","doi":"10.1177/10225536251330659","DOIUrl":"https://doi.org/10.1177/10225536251330659","url":null,"abstract":"<p><p><b>Purpose:</b> Popliteal artery (PA) injury during knee surgery poses significant challenges for orthopedic surgeons. This study aims to determine the precise distance between the PA and anatomical landmarks of the knee joint and identify influencing factors using knee magnetic resonance imaging (MRI), in order to establish targeted preventive measures for knee surgery based on the actual situation of the patient. <b>Methods:</b> We conducted a retrospective analysis of knee MRI scans from 172 patients. Patients were categorized into two groups: the osteoarthritis group (Group A) and the non-osteoarthritis group (Group B). We measured the shortest distance from the PA to the posterior femoral condyle (PFC), posterior horn of the lateral meniscus (PHLM), posterior wall of the joint capsule (JC), and the posterior tibial cortex (PTC) located 10 mm below the articular surface on MRI axial views. And we also analyzed the effects of age, height, weight, BMI, and leg circumference on the aforementioned distances. <b>Results:</b> The four distances in Group A were significantly greater than those in Group B. Height and thigh circumference mainly correlated with distance from the PA to the posterior femoral condyle. Height and weight mainly correlated with distance from the PA to posterior horn of the lateral meniscus. Weight, BMI, and calf circumference mainly correlated with distance from PA to posterior tibial cortex. <b>Conclusions:</b> The distance between the popliteal artery and the posterior bony landmarks of the knee joint increases in patients with osteoarthritis, higher stature, bigger weight, thicker leg circum ference and elderly patients, which maybe can reduce the risk of popliteal artery injury during surgical procedures.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251330659"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of 1,021 consecutive cases utilizing a triple tapered collared stem and automated broaching system.","authors":"Ravi R Agrawal, Maria T Schwabe, Helena F Barber, Ethan Blum, Joseph T Gibian, Ryan M Nunley, Ilya Bendich","doi":"10.1177/10225536251340118","DOIUrl":"https://doi.org/10.1177/10225536251340118","url":null,"abstract":"<p><p><b>Background:</b> For total hip arthroplasty (THA), a number of different femoral stem designs exist, each offering potential benefits and risks to patients. Preparation and implantation of the femoral component may be performed with manual instrumentation or with automated broaching systems. The combination of stem and femoral preparation choice may influence patient outcomes. The purpose of this study was to report on a large consecutive series of a collared, triple tapered, cementless stem broached and impacted with an automated system through a mini-posterior approach. <b>Methods:</b> 1021 consecutive THAs with a cementless triple-tapered fully coated titanium femoral stem performed by a single surgeon via a minimally invasive posterior approach all utilizing automated broaching (AB) were collected retrospectively. Patient demographic data, proximal femoral anatomical features, radiographic outcomes (e.g., subsidence), PROMIS scores, and intra-operative and postoperative complications were collected and analyzed. <b>Results:</b> 7/1021 (0.68%) intra-operative calcar fractures and 11/1021 (1.08%) postoperative periprosthetic femoral fractures were observed. The average postoperative subsidence was 0.5 mm. Subsidence was not associated with age, BMI, or proximal femoral anatomy (Dorr C). There were no revisions for postoperative mechanical loosening or instability. No increase in periprosthetic fracture was noted amongst the first 100 cases using AB (0/100) when compared to the subsequent 100 (0/100). All patients experienced statistically significant improvement in PROMIS scores postoperatively at 1-year follow-up. <b>Conclusion:</b> This large, consecutive, single surgeon series demonstrates excellent results of the aforementioned stem prepared and impacted with AB. At mid-term follow-up, there were no revisions for mechanical loosening and all-cause survivorship was 98.2%.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251340118"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 regarding \"innovative 3D-printed porous TC4 prosthesis with nano-thin tantalum coating for treating complex wrist bone defects: A preliminary report of 3 cases\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/10225536251347709","DOIUrl":"https://doi.org/10.1177/10225536251347709","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251347709"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to letter to the Editor regarding innovative 3D-printed porous TC4 prosthesis with nano-thin tantalum coating for treating complex wrist bone defects: A preliminary report of 3 cases.","authors":"Chang Chen, Fuyou Wang","doi":"10.1177/10225536251347719","DOIUrl":"https://doi.org/10.1177/10225536251347719","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251347719"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multivariate logistic regression analysis to explore the high-risk factors of deep vein embolism/pulmonary embolism after knee replacement in the elderly.","authors":"Ming Liu, Zhanwen Zhou, Xiaohu Ma, Jinguo Ma, Xiaojin Wu, Binghan Chen, Yanbin Tian","doi":"10.1177/10225536251345202","DOIUrl":"https://doi.org/10.1177/10225536251345202","url":null,"abstract":"<p><p>ObjectiveThis study aims to identify and quantify the high-risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE) in elderly patients undergoing total knee replacement (TKA).Methods621 patients who underwent TKA were divided into DVT/PE positive group (<i>N</i> = 52) and a negative group (<i>N</i> = 569).ResultStatistically significant differences were observed in the following factors: Caprini score (χ² = 11.385, <i>p</i> < .001), prevalence of chronic obstructive pulmonary disease (COPD) (χ² = 4.502, <i>p</i> = .034), history of heart failure (χ² = 4.326, <i>p</i> = .012), duration of surgery (t = 3.723, <i>p</i> = .002), and early postoperative activity (χ² = 4.014, <i>p</i> = .045). The incidence of DVT/PE was significantly higher in the very high-risk group compared to the high-risk group (9.89% vs 4.84%, χ² = 2.080, <i>p</i> = .032). Multivariate logistic regression analysis identified the Caprini score as an extremely high-risk factor (adjusted OR = 2.87, 95% CI: 1.53-5.39, <i>p</i> = .001), alongside COPD (OR = 1.94, 95% CI: 1.08-3.48, <i>p</i> = .026), history of heart failure (OR = 1.68, 95% CI: 1.01-2.78, <i>p</i> = .048), and surgical duration exceeding 2 hours (OR = 1.35, 95% CI: 1.08-1.68, <i>p</i> = .008) as independent risk factors. The model, developed using multi-factor regression variables, demonstrates strong predictive performance for the occurrence of DVT/PE, with an area under the receiver operating characteristic curve of 0.842 (95%CI: 0.791-0.894).ConclusionIn elderly patients undergoing TKA, even with standard anticoagulation prophylaxis, a high Caprini risk score, COPD, a history of heart failure, and prolonged operative time remain independent risk factors for DVT. Early postoperative mobilization has been shown to have a protective effect.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345202"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic additional biceps augmentation and biceps superior capsular reconstruction yield similar clinical and radiological outcomes for patients with medium to large rotator cuff tears.","authors":"Meng Huan Tsai, Poyu Chen, Alexandre Lädermann, Cheng-Pang Yang, You-Hung Cheng, Chen-Heng Hsu, Joe Chih-Hao Chiu","doi":"10.1177/10225536251345183","DOIUrl":"https://doi.org/10.1177/10225536251345183","url":null,"abstract":"<p><p><b>Purpose:</b> To compare the outcomes of additional biceps augmentation (ABA) and biceps superior capsule reconstruction (BSCR) in arthroscopic medium to large rotator cuff tear (RCT) repair. <b>Hypothesis:</b> Both ABA and BSCR yielded comparable clinical and radiological outcomes and retear rates at the 2-year follow-up in patients with medium to large RCTs. <b>Methods:</b> Patients undergoing ABA or BSCR for RCT repairs were included retrospectively between January 2019 and May 2020. The preoperative and postoperative Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), visual analog scale (VAS), and range of motion (ROM) were recorded, as well as the radiographic evaluation. <b>Results:</b> 67 patients (41 with ABA, 26 with BSCR) were included. There were no significant differences regarding preoperative patient demographics between groups unless forward flexion. In the ABA group, CMS, ASES, SSV, and VAS improved significantly from 33.9 ± 6.0, 37.3 ± 8.7, 24.9 ± 12.3, and 5.1 ± 1.1 to 79.3 ± 8.4, 82.7 ± 8.4, 77.5 ± 10.9, and 2.4 ± 0.6, at 2-year follow-up (all <i>p</i> < .001). In the BSCR group, the CMS, ASES, SSV, and VAS significantly improved from 33.9 ± 5.5, 33.5 ± 11.6, 20.8 ± 9.8, and 5.3 ± 1.5 to 72.8 ± 12.9, 79.6 ± 12.1, 73.1 ± 10.2, and 2.7 ± 0.8, at follow-up (all <i>p</i> < .001). All ROM improved at follow-up in both groups (all <i>p</i> < .001). No significant differences were found between the two groups regarding the postoperative clinical and radiological results. All patients reached minimal clinically important differences for CMS, ASES, SSV, and VAS at the final follow-up. The retear rates in the ABA and BSCR groups were 0% and 7.7%, respectively (<i>p</i> = .001). <b>Conclusions:</b> Both ABA and BSCR provided similar clinical and radiological outcomes in patients with medium to large RCTs. The BSCR group had a higher retear rate than the ABA group. <b>Level of Evidence:</b> Level III, Retrospective comparative therapeutic trial. <b>Clinical Relevance:</b> Both ABA and BSCR provided comparable clinical and radiological outcomes in patients with medium to large RCTs.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345183"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensemble learning guided survival prediction and chemotherapy benefit analysis in high-grade chondrosarcoma: A study based on the surveillance, epidemiology, and end results (SEER) database.","authors":"Xu Zheng, Longqiang Shu, Shanyi Lin, Hanqiang Jin, Xiaoyu Wang, Ting Yuan","doi":"10.1177/10225536251340113","DOIUrl":"https://doi.org/10.1177/10225536251340113","url":null,"abstract":"<p><p><b>Purpose:</b> The chemotherapy benefit for high-grade chondrosarcoma remains controversial. Ensemble learning has better overall performance than single computational approaches for clinical decision. The primary objective was to select prognostic variables and develop optimal ensemble learning algorithms for survival prediction and analyzing chemotherapy benefit in high-grade chondrosarcoma. The secondary objective included identifying specific patient groups with estimated survival benefit for guidance in chemotherapy strategies. <b>Methods:</b> The data of 1931 patients with chondrosarcoma from 2000 to 2019 were obtained from the Surveillance, Epidemiology, and End Results database to conduct the retrospective analysis. Among 468 patients with high-grade chondrosarcoma, cox proportional hazards models and random survival forests were used for feature selection. Ensemble learning and survival support vector machine with different kernel methods were developed and compared for their prognostic performance. <b>Results:</b> Ensemble learning outperformed the single models, with the concordance index reaching 0.764 (based on inverse probability of censoring weights) and the mean area under time-dependent receiver operating characteristic curve of 0.851. According to the ensemble model, overall survival generally improved in younger patients after chemotherapy. Age-stratified analysis revealed differential chemotherapy benefits across various clinical subgroups. Survival benefits were observed in: Age ≤ 10 with dedifferentiated chondrosarcoma, amputation, local surgical treatment, absence of distant metastasis, or grade III tumor; Age ≤ 20 who were male with clear cell chondrosarcoma, non-axial primary sites, or no radiotherapy; Age ≤ 30 who were female with primary site at pelvis/limb, received radiotherapy, extension beyond periosteum, further extension, or distant metastasis; Age≤40 with chondrosarcoma NOS (including mesenchymal, juxtacortical and classical chondrosarcoma); Age ≤ 50 with grade IV tumor or no surgery received. <b>Conclusion:</b> Ensemble learning algorithms demonstrate outstanding overall performance in prognostic assessment of high-grade chondrosarcoma and identification of age-specific factors associated with chemotherapy benefit for tailored chemotherapy strategy.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251340113"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}