Journal of Orthopaedic Surgery最新文献

{"title":"Alteration of foot loading pattern in patients with lower limb endoprothesis surgery and functional outcome: A pilot study.","authors":"Vivek Ajit Singh, Hartharanjeet Singh Phinder, Amber Haseeb, Rupini Devi Santharalinggam, Nor Faissal Yasin","doi":"10.1177/10225536251326059","DOIUrl":"https://doi.org/10.1177/10225536251326059","url":null,"abstract":"<p><p>IntroductionEndoprosthetic reconstruction is a widely used technique; however, it is associated with various postoperative complications. One often overlooked complication is the alteration of foot loading patterns. This pilot study evaluated functional outcomes with postoperative static foot loading patterns in patients undergoing endoprosthesis replacements compared to the contralateral limb.ObjectiveThis study evaluates static foot loading patterns in patients undergoing endoprosthetic replacements. It explores the relationship between the functional outcomes of the operated limb and foot loading patterns in a standing position. Additionally, the study considers factors such as the anatomical location of the endoprosthetic reconstruction, limb length discrepancy, age, gender, and body mass index (BMI).Materials and MethodsThis prospective cross-sectional study included 100 patients over 15 years who had undergone lower limb endoprosthetic reconstruction at least 1 year prior and could walk unaided. Data collection encompassed patient demographics, diagnosis, anthropometric measurements, postoperative functional status (evaluated using AOFAS-Hindfoot, MSTS, and TESS scores), and postoperatively analysis of foot loading patterns.ResultsThe patient group has a significantly higher prevalence of abnormal foot arches compared to the expected population proportion. Notably, 10% of patients transitioned from a normal arch to flatfoot, while 40% developed a high arch post-surgery. Asymmetrical arches were observed in 30 patients. Post-surgery, 18.5% of patients experienced a transition from a normal foot arch to a high arch, and 4.6% transitioned to flatfoot. Analysis of variables such as surgical site, limb length discrepancy, age, gender, BMI, foot loading patterns and functional scores (MSTS, TESS and AOFAS) showed no significant associations with these changes.ConclusionAlthough no significant correlation was identified between functional scores and foot loading patterns following lower limb endoprosthetic surgery, a notable prevalence of abnormal foot arches was observed. We recommend routine podiatry consultations for these patients to address and manage potential foot-related complications.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251326059"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649317","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":"Dynamic evaluation of vertebral alveolar echinococcosis using MR T2 mapping.","authors":"Jinhuan Han, Yushan Chang, Hui Guo","doi":"10.1177/10225536251318140","DOIUrl":"https://doi.org/10.1177/10225536251318140","url":null,"abstract":"<p><strong>Objective: </strong>To explore the diagnostic value of MR T2 mapping in monitoring and evaluating the rabbit vertebral model with <i>Echinococcus multilocularis</i> infection.</p><p><strong>Materials and methods: </strong>24 New Zealand white rabbits were randomly divided into the experimental group (<i>n</i> = 16), saline control group (<i>n</i> = 4), and blank control group (<i>n</i> = 4). The experimental group underwent surgery to drill holes on the surface of the spinous process of the 12th thoracic vertebra, fill it with a gelatin sponge, and adsorb multilocular hydatid suspension. The saline control group received an operation with saline, and the blank control group did not receive any intervention. The model rabbits were dynamically evaluated by routine MRI and MR T2 mapping once a month after surgery, 6 times. Two rabbits with positive imaging results were randomly selected every 2 months for histopathological examination to evaluate the severity and pathological features of the rabbit model with <i>Echinococcus multilocular</i> infection.</p><p><strong>Results: </strong>There was no significant difference in the T2 mapping values between the diseased vertebrae and the undiseased vertebrae in the experimental group at the 1st month after surgery (<i>t</i> = 1.7, <i>p</i> = .119), and the differences were statistically significant at the 2nd to 6th month after surgery (<i>p</i> < .05). In the 1st and 2nd months after an operation, there was no significant difference in T2 values between the vertebrae of the saline control group, the blank control group, and the experimental group. In the third, fourth, fifth, and sixth months after surgery, the vertebrae of the experimental group were compared with that of the saline control group and the blank control group, and the difference was statistically significant (<i>p</i> < .05). There was no significant difference in T2 mapping values every month after surgery between the saline control group and the blank control group (<i>p</i> > .05).</p><p><strong>Conclusion: </strong>The MR T2 mapping technique can quantitatively evaluate the changes of vertebral alveolar echinococcosis, and it shows sensitivity to pathological changes in vertebrae prior to detectable damage using conventional MRI; this offers potential for early detection of vertebral alveolar echinococcosis.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251318140"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382426","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 future outlook for data in orthopedic surgery: A new era of real-time innovation.","authors":"Nicolaas C Budhiparama, Nanne P Kort, Rèmigio Kort, Imelda Lumban-Gaol","doi":"10.1177/10225536251331664","DOIUrl":"https://doi.org/10.1177/10225536251331664","url":null,"abstract":"<p><p>The orthopedic field is on the brink of a significant transformation-a shift from retrospective analysis to real-time decision-making fueled by data. The dependence on historical trends or long-term studies is yielding to an era where data flows dynamically, allowing medical professionals to adjust protocols instantly. This isn't just an evolution; it's a revolution. Data is no longer a passive observer of outcomes-it's an active participant in shaping them.Imagine a future where wearable devices, artificial intelligence (AI) algorithms, and predictive analytics come together to guide surgeons in real time. For example, wearables monitor vital signs during surgery and oversee rehabilitation while AI analyzes data to predict complications. Postoperative protocols adapt to individual recovery journeys, not averages. Complication risks are flagged preemptively, and treatment plans evolve with patient progress. This shift empowers orthopedic professionals to respond and anticipate, creating a level of care precision that was once unimaginable.What if we viewed data not merely as a tool but as collaborators? With AI and machine learning, the surgical suite of tomorrow transforms into ecosystems where data communicates directly providing insights, suggesting strategies, and enhancing outcomes. This collaborative approach encourages our conventional medical mindset to prioritize adaptability and individualization.The provocative truth is that the game-changer in orthopedics isn't a new implant design or surgical technique-it's the mindset shift to trust real-time data as the foundation of every decision. Orthopedics is no longer about perfecting procedures but refining protocols for every patient consistently.As we race toward the future, equitable access becomes crucial. As William Gibson noted, \"The future is already here - it's just not very evenly distributed.\" We must ensure these breakthroughs reach everyone, bridging the gap between potential and practice. The future of orthopedics isn't just a vision - it's a promise, and it's time to deliver.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251331664"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764193","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":"Comparitive performance of artificial intelligence-based large language models on the orthopedic in-training examination.","authors":"Andrew Y Xu, Manjot Singh, Mariah Balmaceno-Criss, Allison Oh, David Leigh, Mohammad Daher, Daniel Alsoof, Christopher L McDonald, Bassel G Diebo, Alan H Daniels","doi":"10.1177/10225536241268789","DOIUrl":"https://doi.org/10.1177/10225536241268789","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) have many clinical applications. However, the comparative performance of different LLMs on orthopedic board style questions remains largely unknown.</p><p><strong>Methods: </strong>Three LLMs, OpenAI's GPT-4 and GPT-3.5, and Google Bard, were tested on 189 official 2022 Orthopedic In-Training Examination (OITE) questions. Comparative analyses were conducted to assess their performance against orthopedic resident scores and on higher-order, image-associated, and subject category-specific questions.</p><p><strong>Results: </strong>GPT-4 surpassed the passing threshold for the 2022 OITE, performing at the level of PGY-3 to PGY-5 (<i>p</i> = .149, <i>p</i> = .502, and <i>p</i> = .818, respectively) and outperforming GPT-3.5 and Bard (<i>p</i> < .001 and <i>p</i> = .001, respectively). While GPT-3.5 and Bard did not meet the passing threshold for the exam, GPT-3.5 performed at the level of PGY-1 to PGY-2 (<i>p</i> = .368 and <i>p</i> = .019, respectively) and Bard performed at the level of PGY-1 to PGY-3 (<i>p</i> = .440, .498, and 0.036, respectively). GPT-4 outperformed both Bard and GPT-3.5 on image-associated (<i>p</i> = .003 and <i>p</i> < .001, respectively) and higher-order questions (<i>p</i> < .001). Among the 11 subject categories, all models performed similarly regardless of the subject matter. When individual LLM performance on higher-order questions was assessed, no significant differences were found compared to performance on first order questions (GPT-4 <i>p</i> = .139, GPT-3.5 <i>p</i> = .124, Bard <i>p</i> = .319). Finally, when individual model performance was assessed on image-associated questions, only GPT-3.5 performed significantly worse compared to performance on non-image-associated questions (<i>p</i> = .045).</p><p><strong>Conclusion: </strong>The AI-based LLM GPT-4, exhibits a robust ability to correctly answer a diverse range of OITE questions, exceeding the minimum <b>score for the 2022 OITE</b>, and outperforming predecessor GPT-3.5 and Google Bard.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536241268789"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542373","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":"Prognosis after one- and two-stage revision surgery for periprosthetic joint infection: A systematic review and meta-analysis.","authors":"Yiyuan Sun, Menghao Liu, Dan Xiao, Qi Li, Huan Xiong, Xue Luo, Boyu Zhu, Weili Fu","doi":"10.1177/10225536251315973","DOIUrl":"https://doi.org/10.1177/10225536251315973","url":null,"abstract":"<p><strong>Objective: </strong>Revision surgeries for periprosthetic joint infections (PJIs) in arthroplasty can follow either one- or two-stage treatment protocols. Previous studies have reported similar reinfection rates and reductions in complication rates for both treatment options. However, the literature on the selection of one protocol is still controversial. Thus, our aim was to compare the outcomes, including reinfections, complications, reoperations, and mortality, associated with one- and two-stage revision surgeries for PJI via a systematic review and meta-analysis of comparative studies.</p><p><strong>Methods: </strong>Comparative studies were identified through searches in PubMed, EMBASE, the Web of Science, and the Cochrane Library as of November 2023. RevMan version 5.3 was used for the analyses. The included studies directly compared one-stage revisions with two-stage revisions for PJI. The primary outcomes included reinfection, complications, reoperation, and mortality.</p><p><strong>Results: </strong>Sixteen cohort studies (fifteen retrospective and one prospective) were included in the systematic review. All studies comprising 2039 patients were included in the meta-analysis. Fourteen studies reported reinfection patient risk postrevision; when pooled via random effects models, 10.02% of patients in the one-stage group and 14.75% of patients in the two-stage group were reinfected, indicating low heterogeneity (risk ratio = 0.69; 95% CI = 0.50 - 0.94, I² = 0%). A pooled analysis of ten studies reported complications between the two groups. Compared with the two-stage group, the one-stage group was associated with significantly fewer complications (risk ratio = 0.76; 95% CI = 0.63 - 0.91, I² = 27%). The meta-analysis revealed no significant difference in reoperation events between the 1st-stage and 2nd-stage groups in nine studies (risk ratio = 0.77; 95% CI = 0.59 - 1.01, I² = 20%) or in mortality in ten studies (risk ratio = 0.93; 95% CI = 0.49 - 1.78, I² = 0%).</p><p><strong>Conclusions: </strong>Among the available observational studies, the meta-analysis revealed a lower incidence of reinfection and complications in the one-stage group than in the two-stage group, but there were no significant differences in reoperation events or mortalities.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251315973"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046494","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":"Relationships of PedsQL 4.0 generic core scales with other validated HRQoL instruments in braced idiopathic scoliosis patients: An age and curve severity-specific analysis.","authors":"Kai Chun Augustine Chan, Kai Him Ambrose Chan, See Laam Wong, Jason Pui Yin Cheung, Prudence Wing Hang Cheung","doi":"10.1177/10225536251321122","DOIUrl":"https://doi.org/10.1177/10225536251321122","url":null,"abstract":"<p><p><b>Purpose:</b> This study aims to investigate if the addition of PedsQL 4.0 generic core scales (PedsQL) with other validated instruments in day-to-day clinical context is feasible. <b>Methods:</b> Patients with idiopathic scoliosis who were undergoing brace treatment and aged 8-18 were asked to fill in the PedsQL 4.0 generic core scales, SRS-22r and EQ5D questionnaires at the spine specialist outpatient clinic and were followed up at 6 months by phone consultation. Questionnaire scores at baseline and follow-up were compared. Correlation of score changes of different questionnaires were tested. <b>Results:</b> A total of 232 patients (58 males, 174 females) were included. PedsQL school functioning scores and total scores at follow-up were lower than at baseline (<i>p</i> < 0.001), with greatest reductions in school functioning domain (range: -2.8 ± 7.0 to -5.1 ± 3.6). For those aged 13-18 years, changes of PedsQL school functioning correlated with changes of SRS total score (<i>r</i> = 0.20; <i>p</i> = 0.042). For patients with baseline major Cobb angle >30°, changes in PedsQL physical functioning correlated with SRS domain score changes in function (<i>r</i> = 0.25; <i>p</i> = 0.017), pain (<i>r</i> = 0.24; <i>p</i> = 0.021) and SRS total score (<i>r</i> = 0.26; <i>p</i> = 0.016). Both changes in PedsQL school functioning (<i>r</i> = 0.23; <i>p</i> = 0.032) and total score (<i>r</i> = 0.22; <i>p</i> = 0.043) correlated with SRS total score changes. <b>Conclusion:</b> PedsQL was sensitive to changes of HRQoL together with SRS-22r and EQ-5D-Y-5L questionnaires. Changes in PedsQL scores were related to changes in SRS-22r scores in patients of 13-18 years with more severe curves (>30°). PedsQL is recommended to be used in conjunction with validated instruments like SRS-22r with its ability to assess changes of patient's school functioning and overall HRQoL. The short-term nature of our study highlighted the need for future research with a larger cohort and longer duration to investigate long-term HRQoL outcomes assessed by individual questionnaires.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251321122"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441129","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":"Observation of the effect of artificial dermis technology combined with full-thickness skin graft coverage in the treatment of foot and ankle wound defects in the elderly.","authors":"Qiang Xie, Yu Hao, Yu Kong, Pei Wang","doi":"10.1177/10225536251324055","DOIUrl":"https://doi.org/10.1177/10225536251324055","url":null,"abstract":"<p><p>PurposeTo analyze the effect of artificial dermis technology combined with full-thickness skin graft coverage in the treatment of foot and ankle wound defects in the elderly.MethodsA total of 90 elderly patients treated for foot and ankle wound defects from January 2021 to December 2022 were selected as the study subjects and were divided into a control group of 40 cases and a study group of 50 cases according to the random number table method. The control group was treated with retrograde saphenous nerve flap transplantation, while the study group was treated with artificial dermis technology combined with full-thickness skin graft coverage. The therapeutic effect of artificial dermis technology combined with full-thickness skin graft coverage was observed. The ankle function, pain level, postoperative wound recovery, relevant indicators, and postoperative wound complications were compared between the two groups.ResultsAt 2 and 4 weeks after treatment, the ankle function of both groups was higher than before treatment, and the ankle function of the study group was higher than that of the control group (<i>p</i> < .05). At 2 and 4 weeks after treatment, the VAS and PPI scores of both groups were lower than before treatment, and the VAS and PPI scores of the study group were lower than those of the control group (<i>p</i> < .05). Compared with the control group, the study group had lower color, thickness, vascular distribution, and softness, as well as shorter surgical preparation time, hospital stay, antibiotic use, and fewer dressing changes. The overall incidence of flap edema, wound infection, and total wound infection was lower in the study group (<i>p</i> < .05).ConclusionThe use of artificial dermis technology combined with full-thickness skin graft coverage in the treatment of foot and ankle wound defects in the elderly helps to improve ankle joint function, reduce the degree of pain, and results in better postoperative wound recovery and a lower complication rate.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251324055"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677168","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 relationship between the expression of serum asprosin and miR-21 in patients with osteoporosis and delayed healing after OVCF surgery.","authors":"Gaoming Song, Silong Lin, Xianqi Zhang, Hong Pan","doi":"10.1177/10225536251331325","DOIUrl":"https://doi.org/10.1177/10225536251331325","url":null,"abstract":"<p><p><b>Objective:</b> To explore the relationship between serum asprosin, microRNA-21 (miR-21) expression, and delayed healing after surgery in patients with osteoporotic vertebral compression fractures (OVCF), and to construct a nomogram model. <b>Methods:</b> A prospective study inducted 300 OVCF patients treated with percutaneous vertebroplasty (PVP) from June 2022 to June 2024. Serum asprosin and miR-21 were measured preoperatively, and fracture healing was assessed via X-ray 3 months post-surgery. Patients were categorized into delayed healing and normal healing groups based on outcomes. The least absolute shrinkage and selection algorithm (LASSO) regression identified factors influencing delayed healing, followed by binary logistic regression analysis. A nomogram model was constructed to predict delayed healing, and its predictive value was evaluated using the receiver operating curve (ROC) analysis. <b>Results:</b> Results showed higher rates of delayed weight-bearing (58.11% vs 33.19%), diabetes prevalence (52.70% vs 42.48%), bone cement injection volume (4.68 ± 1.14 mL vs 3.81 ± 1.09 mL), and serum asprosin levels (4.09 ± 1.39 ng/mL vs 3.14 ± 1.07 ng/mL) in the delayed healing group compared to the normal healing group. Serum miR-21 levels were lower in the delayed healing group (0.69 ± 0.19) than in the normal group (0.92 ± 0.31) (<i>p</i> < 0.05). Bone density T scores in OVCF patients correlated positively with asprosin (r = 0.281, <i>p</i> < 0.001) and negatively with miR-21 (r = -0.184, <i>p</i> = 0.001). The LASSO regression identified five factors associated with delayed healing: bone cement volume, delayed weight-bearing, diabetes, and serum asprosin (risk factors), while high miR-21 was protective. Logistic regression indicated significant risk factors with an overall C-index of 0.867 and AUC of 0.868 (sensitivity 0.892, specificity 0.686). After 3 months of treatment, serum Asprosin [(3.46 ± 1.22) ng/ml] in OVCF patients was lower than that before treatment [(3.03 ± 1.03) ng/ml], and serum miR-21 (0.85 ± 0.30) was higher than that before treatment [(0.99 ± 0.33)] (<i>t</i> = 4.039, 4.318, <i>p</i> < 0.05). <b>Conclusion:</b> Serum asprosin and miR-21 levels are closely related to delayed healing after surgery in patients with OVCF. Additionally, the bone cement injection volume, delayed weight-bearing, and concomitant diabetes mellitus are also important factors affecting fracture healing in patients. The nomogram model based on these factors can effectively predict the risk of delayed healing in patients with OVCF after surgery.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251331325"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735963","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":"Chondroblastoma in 28 cases: The risk of local recurrence increases with larger tumor size.","authors":"Di Yang, Zhongliang Wang","doi":"10.1177/10225536251328099","DOIUrl":"https://doi.org/10.1177/10225536251328099","url":null,"abstract":"<p><p><b>Introduction:</b> Chondroblastoma (CBL) is a rare benign bone tumor with potentially local recurrence and metastases. At present, the local recurrence risk factors are controversial. The purpose of this study is to analysis local recurrence factors in our medical center. <b>Methodology:</b> A retrospective analysis was conducted on 18 male and 10 female patients who presented at our hospital between 2016 and 2023. The clinical data included radiological images, histological results, treatment modalities, functional outcomes, and local recurrence rates. Surgical interventions comprised curettage, followed by bone grafting and adjunctive techniques. Furthermore, all patients were stratified into two groups based on tumor volume, with a threshold of 25 cm³, to explore the relationship between tumor volume and recurrence. <b>Results:</b> Among the 28 patients, with an average age of 13 years (range: 9 to 16 years) and an average follow-up duration of 33 months (range: 8 to 91 months). The mean Musculoskeletal Tumor Society (MSTS) score was 27 points (range: 14 to 30). Notably, recurrence was observed in 3 pediatric patients. A statistically significant difference in recurrence rates was found between tumors with volumes less than 25 cm³ and those greater than 25 cm³ (<i>p</i> < .05). <b>Conclusion:</b> Curettage, combined with alcohol as an adjuvant, resulted in local control and good outcomes in most pediatric patients. It was noteworthy that a larger tumor size correlated with an increased likelihood of recurrence.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251328099"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630483","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":"Prognostic impact of oligometastases in orthopaedic surgery for metastatic bone disease.","authors":"Wolfram Weschenfelder, Friederike Weschenfelder, Christian Spiegel, Karin Gabriela Schrenk, Thomas Ernst, Gunther Olaf Hofmann","doi":"10.1177/10225536251315983","DOIUrl":"https://doi.org/10.1177/10225536251315983","url":null,"abstract":"<p><strong>Introduction: </strong>The rising number of cancer patients with metastatic bone disease (MBD) reflects advancements in treatment. The concept of oligometastatic disease, associated with improved prognosis, has emerged. This study evaluated prognostic factors, including oligometastases, in patients undergoing urgent orthopaedic surgery for MBD to inform preoperative decision-making and reduce morbidity and mortality from immobilization.</p><p><strong>Materials and methods: </strong>We retrospectively analysed records of patients who underwent surgery for MBD between 2005 and 2022. Data included medical history, tumour type, metastatic status, surgical method, lesion location, imaging, and survival outcomes. Multivariate survival analyses were conducted.</p><p><strong>Results: </strong>The number of metastases and presence of visceral metastases significantly influenced survival. Patients with single metastases had a median survival of 65 months, oligometastases 25 months, and polymetastases 11 months. Visceral metastases were associated with a median survival of 9 months versus 27 months without. Tumour type also impacted prognosis, with thyroid cancer patients having the highest median survival and lung cancer patients the lowest. Pathological fractures reduced survival significantly (11 months vs 36 months without fractures).</p><p><strong>Conclusion: </strong>Oligometastatic disease is a strong prognostic factor for MBD patients undergoing orthopaedic surgery, with better outcomes compared to polymetastatic disease. Other key factors include tumour type, visceral metastases, and pathological fractures. Improved staging, risk assessment, and early interdisciplinary collaboration could mitigate pathological fractures and improve outcomes.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 1","pages":"10225536251315983"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441071","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}