Journal of Orthopaedic Surgery最新文献

{"title":"Opportunities to optimise care and choice in joint replacement surgery using a digitally delivered, holistic PreHab pathway.","authors":"Eleanor R Bills, Anastasia Dimopoulos, Anne Lj Burke, Kathryn L Collins, Ecushla C Linedale, Vicki Hume, Jackie Yeoh, Sharyn Coles, Mandy Nolan, Kate Southam, Lesley Thomas, Melanie Ramsey, Jane M Andrews","doi":"10.1177/10225536241234032","DOIUrl":"10.1177/10225536241234032","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the implementation and evaluation of a hospital-initiated, community-based, digital prehabilitation program (<i>My PreHab Program</i>: MPP<i>)</i> for adults referred for elective joint replacement.</p><p><strong>Methods: </strong>MPP was implemented July 2022 and comprises a personalised digital health screen that guides the provision of self-management resources. Adults (<u>></u>18 years) referred and accepted, or already waitlisted, for total knee/hip replacement surgery were eligible. Individuals requiring category 1 (urgent) or emergency surgery and those without a mobile phone were excluded. Implementation and intervention outcome measures (program adoption, equity of reach, fidelity, acceptability, appropriateness, feasibility, engagement, preliminary surgical outcomes) were explored via study-specific measures and hospital records.</p><p><strong>Results: </strong>Of those invited (<i>N</i> = 689), 77.8% participated. Participants and non-participants were similar in key demographic variables except regional invitees were more likely to participate than metropolitan (88.0% vs 75.4%, <i>p</i> = .002) and non-participants tended to be older (median age = 69.0 vs 64.0, <i>p</i> = .005). Participants reported on average four modifiable risk factors: most commonly chronic pain (79.1%), obesity (57.3%), and frailty (40.9%). Most participants (80.4%) reviewed all resources provided and reported action/intention to address issues identified (90.9%). Participants perceived MPP as acceptable (3.2/5), appropriate (3.3/5), and feasible (3.4/5). Early trends for participants progressing to surgery (<i>n</i> = 33) show a reduced length of stay (MPP = 4.3, baseline = 5.3 days).</p><p><strong>Conclusion: </strong>MPP demonstrated high adoption, fidelity, and participant engagement. It is acceptable, appropriate and feasible and has the potential to be scaled-up digitally at low-cost. Modifiable risk factors were prevalent and early indications suggest this preoperative intervention may benefit both patients and the healthcare system.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241234032"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065983","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":"Double-pulley, V-shaped fixation technique for arthroscopic repair of ideberg type IA glenoid fracture.","authors":"Baichuan Li, Ke Rong, Haiquan Deng, Zhongfei Tang, Jian Tang, Jianchao Sun","doi":"10.1177/10225536241254913","DOIUrl":"10.1177/10225536241254913","url":null,"abstract":"<p><p>Different techniques have been described for glenoid fractures, there is still a need for safe and effective agents to promote outcomes. From January 2016 to April 2021, the clinical data of 17 patients with pulley type IA fractures treated by the V-shaped fixation technique under shoulder arthroscopy were retrospectively analyzed. Preoperative X-ray, CT, and MRI examinations were completed. The functional score of the shoulder joint, such as the visual analog scale (VAS), Constant score, and Modified Rowe score, was used to evaluate the preoperative and final follow-up clinical outcomes. The active shoulder range of motion (ROM) was also collected preoperatively and at the final postoperative follow-up. Accordingly, intraoperative and postoperative complications were also observed. The mean follow-up was 49.52 months (16-79 months). The patients' follow-up exams showed that shoulder joint flexion, abduction, external rotation, internal rotation, and pain were not significantly different from those of the contralateral side (<i>p</i> > .05). The mean Constant score was 83.52 (58-98), and the average Modified Rowe score was 94.29 (70-100). X-ray and CT films of all cases showed good healing without articular depression or steps. Three patients had traumatic arthritis, with VAS <3 pain. No postoperative complications, such as infections, nerve or vessel damage, or suture anchor problems occurred during the follow-up period. Using the Double-pull, V-shaped fixation technique can stabilize the reduction of glenoid fractures while reducing the possibility of bone destruction. It is a good solution and provides an opportunity to treat rotator cuff tears associated with the procedure.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241254913"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943675","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 \"Intraoperative intravenous versus periarticular injection of glucocorticoids in improving clinical outcomes after total knee arthroplasty: A prospective, randomized and controlled study\".","authors":"Xinjie Wang, Hui Ma","doi":"10.1177/10225536241263655","DOIUrl":"10.1177/10225536241263655","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241263655"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317479","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":"Less risk of patellofemoral degeneration without significant clinical and survivorship difference for distal tibial tuberosity high tibial osteotomy compared to biplanar high tibial osteotomy over a mid-term follow-up.","authors":"Ke Li, Hengbing Guo, Fenglong Sun, Hongqing Wang","doi":"10.1177/10225536241273925","DOIUrl":"10.1177/10225536241273925","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the mid-term radiographic, clinical results and survivorship between distal tibial tuberosity high tibial osteotomy (DTT-HTO) and conventional biplanar medial open-wedge high tibial osteotomy (cOW-HTO).</p><p><strong>Methods: </strong>The weight-bearing line ratio (WBL%) and medial proximal tibial angle (MPTA) were evaluated using a standing anteroposterior view of lower extremity. The posterior tibial slope (PTS), Caton-Deschamps index (CDI), tilting angle (TT) and lateral shift ratio (LSR) were evaluated using the lateral views and Merchant views. The Knee Society (KS) knee and function score, Lysholm score, and Anterior Knee Pain Scale (Kujala score) were were used to evaluate the functional outcomes. All parameters were evaluated preoperatively and at the final follow-up. The postoperative complications and survivorship for both groups were also evaluated during the follow-up period.</p><p><strong>Results: </strong>The WBL% and MPTA exhibited no significant differences between the two groups preoperatively and at the final follow-up. The postoperative CDI and TT in the cOW group decreased significantly compared with the DTT group (<i>p</i> = .037 and .041, respectively). The PF grade showed a significant increase after DTT-HTO and cOW-HTO (<i>p</i> = .036 and <0.001, respectively). Furthermore, the postoperative PF grade of cOW group was significantly higher than that of DTT group (<i>p</i> = .039). The KS knee and function score, Lysholm score, and Kujala score for both groups improved similarly at the final follow-up. The survivorship free of revision was 92.7 % in the DTT group and 94.2% in the OW group.</p><p><strong>Conclusions: </strong>Despite observing a lower risk of PF joint progression in DTT-HTO compared to cOW-HTO, the clinical outcomes and survivorship after DTT-HTO and cOWHTO were comparable over a mid-term follow-up.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241273925"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902029","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 Letter to the Editor regarding \"Artificial intelligence- and computer-assisted navigation for shoulder surgery\".","authors":"Kang-San Lee, Seung Ho Jung, Dong-Hyun Kim, Seok Won Chung, Jong Pil Yoon","doi":"10.1177/10225536241263658","DOIUrl":"10.1177/10225536241263658","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241263658"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432093","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":"Role of bone single photon emission computed tomography/computed tomography in managing chronic fracture-related infections: Determining the depth of infection and avoiding unnecessary bone procedures.","authors":"Seung Hoo Lee, Min Bom Kim, Yeong June Jeon","doi":"10.1177/10225536241264977","DOIUrl":"10.1177/10225536241264977","url":null,"abstract":"<p><strong>Purpose: </strong>Fracture-related infections (FRIs) encompass a broad range of infections associated with bone fractures; they remain a significant clinical challenge. Here, we aimed to investigate the viability of focusing on soft-tissue management in patients suspected of chronic FRI, who exhibit no significant bony uptake on bone single photon emission computed tomography (SPECT)/computed tomography (CT) scans.</p><p><strong>Methods: </strong>Between January 2016 and January 2022, we managed 25 patients with chronic FRI or post-traumatic osteomyelitis using technetium 99m-methyl diphosphonate bone SPECT/CT to assess infection depth. Among them, 13 patients showing negligible bony uptake were included and categorized into two groups based on wound discharge reaching the bone/implant (Criteria 1, <i>n</i> = 6) or not (Criteria 2, <i>n</i> = 7).</p><p><strong>Results: </strong>Patients in the Criteria 1 group were treated with antibiotics and soft tissue debridement without bony procedure. The average duration of antibiotic therapy was 6.7 weeks. Treatments were individualized, including implant changes, local flaps, skin grafts, and negative pressure wound therapy. No recurrence was reported in the mean follow-up of 21.3 months. Patients in the Criteria 2 group were treated with oral antibiotics (mean duration: 5.9 weeks) and daily wound dressings. No recurrence was reported in the mean follow-up of 26.0 months, and no surgical interventions were required.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility of focusing on soft-tissue management in patients with chronic FRI showing minimal bony uptake on bone SPECT/CT. Our treatment protocol avoided unnecessary surgical bone procedures, resulting in successful clinical outcomes with no recurrences.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241264977"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427021","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":"Three-dimensional analysis of bone site grafting on the upper extremity on computed tomography scans.","authors":"Gregorio Alejandro Villarreal-Villarreal, Mario Simental-Mendía, Diego Arturo Ramírez Mendoza, Víctor Manuel Peña-Martínez, Adrian A Negreros-Osuna, Carlos Alberto Acosta-Olivo","doi":"10.1177/10225536241268607","DOIUrl":"10.1177/10225536241268607","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a quantitative analysis of the amount of cancellous bone in the distal radius and olecranon process by segmentation of computed tomographic scans. As a secondary analysis, the bone density by Hounsfield units was evaluated at the same sites.</p><p><strong>Methods: </strong>Computed tomography angiography images of the upper extremity were analyzed using 3-D Slicer™ medical imaging software. Bone volume (cm³) and density (Hounsfield units) from the cancellous bone between the distal radius and the olecranon process were compared by creating an advanced three-dimensional model. The images were analyzed in duplicate, and an intraclass correlation was performed to assess measurement consistency.</p><p><strong>Results: </strong>Twenty subjects were included. A total volume of 5.01 ± 1.21 cm³ and 5.81 ± 1.61 cm³ for the distal radius and the olecranon process (<i>p</i> < .0001), respectively, was found. Regarding Hounsfield units, the density of the olecranon process was 303.1 ± 73.26, and the distal radius was 206.5 ± 63.73 (<i>p</i> < .0001). All intraclass correlation coefficients were >0.992.</p><p><strong>Conclusion: </strong>These results suggest that the olecranon process has a greater volume and a higher bone mineral density than the distal radius. With these results, the surgeon will have the ability to decide the quantity and quality of bone grafts according to the surgical procedure.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241268607"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759307","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":"Patient sex and race are associated with differences in coronal plane alignment classification in native arthritic knees.","authors":"Caitlin Grant, Niall Cochrane, Mikhail Bethell, Christopher Holland, Jay Levin, Joshua Helmkamp, Thorsten Seyler","doi":"10.1177/10225536241276887","DOIUrl":"10.1177/10225536241276887","url":null,"abstract":"<p><p><b>Purpose:</b> The purpose of this study was to evaluate associations between demographics and Coronal Plane Alignment of the Knee (CPAK) classification in pre-surgical TKA patients. <b>Methods:</b> This is a retrospective study of 1167 patients with knee osteoarthritis who underwent TKA. CPAK categories I-IX were determined by arithmetic mechanical hip-knee-ankle angle and joint line obliquity measurements from pre-operative bone length radiographs. Patient age, sex, body mass index (BMI) and race were collected. Chi-square test of independence and adjusted Pearson's residuals evaluated associations between CPAK classification and demographics. <b>Results:</b> There was a significant association between CPAK phenotypes I-IX and patient sex (X² = 5.8, <i>p</i> < 0.01). A positive association was found between both men and CPAK phenotype I, and women and CPAK phenotype VII. A positive association was found between African American patients and CPAK phenotype III and a negative association was found between African American patients and CPAK phenotype I (X² =14.8, <i>p</i>-value = 0.01). There was no association between age and BMI with CPAK phenotypes (n.s.). <b>Conclusion:</b> These results indicate that there are unidentified sex and race differences that exist in the CPAK classification of native arthritic knees. Patient characteristics play a significant role in determining patient knee phenotypes. Further research should investigate whether these characteristics warrant inclusion in pre-operative preparations, aiming to enhance the personalization of arthroplasty procedures.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241276887"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046768","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":"Diagnostic biomarkers in knee osteoarthritis: Based on bioinformatics and experimental verification <i>in vivo</i> and <i>in vitro</i>.","authors":"Yaqian Wen, Mengdi Zou, Chujie Chen","doi":"10.1177/10225536241267027","DOIUrl":"10.1177/10225536241267027","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a multifactorial whole-joint disease with a high rate of disability. Considering the complexity of KOA, there is an urgent need to discover new molecular pathological markers and multi-target treatment strategies.</p><p><strong>Methods: </strong>Two datasets, GSE51588 and GSE57218, were downloaded from the Gene Expression Omnibus database and screened for differentially expressed genes (DEGs) using the Gene Expression Omnibus 2R (GEO2R). Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of DEGs were performed. A protein-protein interaction (PPI) network was constructed and hub genes were identified using Molecular Complex Detection (MCODE). Receiver-operating characteristic curves (ROC) were plotted for the genes, and their prognostic values were evaluated. The expression levels of the hub genes in the monosodium iodoacetate (MIA)-induced KOA rat model and lipopolysaccharide (LPS)-stimulated C28/I2 cells were verified using reverse transcription quantitative real-time PCR (RT-qPCR).</p><p><strong>Results: </strong>Overall, 33 DEGs were up-regulated and 6 DEGs were down-regulated in the two datasets. A total of 12 hub genes were identified, including <i>COL15A1</i>, <i>THY1</i>, <i>COL1A1</i>, <i>COL5A1</i>, <i>CTHRC1</i>, <i>MXRA5</i>, <i>FN1</i>, <i>COL1A2</i>, <i>COL3A1</i>, <i>SPARC</i>, <i>COL8A1</i>, and <i>COL2A1</i>, which all could be used as biomarkers to differentiate KOA samples from healthy controls. More importantly, we found that <i>THY1</i>, <i>CTHRC1</i>, <i>SPARC</i>, and <i>COL8A1</i> were significantly upregulated <i>in vivo</i> and <i>in vitro</i> compared with the controls (<i>p</i> < .01).</p><p><strong>Conclusions: </strong>The expression levels of <i>THY1</i>, <i>CTHRC1</i>, <i>SPARC</i>, and <i>COL8A1</i> were elevated and had good prognostic values as biomarkers in KOA.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241267027"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902028","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":"Naringenin alleviates bone cancer pain via NF-κB/uPA/PAR2 pathway in mice.","authors":"Yaoyuan Li, Guangda Zheng, Yiting Tang, Yupeng Chen, Mingzhu Yang, Qiuhui Zheng, Yanju Bao","doi":"10.1177/10225536241266671","DOIUrl":"10.1177/10225536241266671","url":null,"abstract":"<p><strong>Purpose: </strong>This investigation aims to explore the protective role of Naringenin (Nar) in bone cancer pain (BCP) via TNF-α-mediated NF-κB/uPA/PAR2 pathway.</p><p><strong>Methods: </strong>BCP model was manipulated by the injection of LL2 cells into femur of mice. The levels of TNF-α and uPA in bone tissue and serum were studied by ELISA. The expressions of PAR2, PKC-γ, PKA and TRPV1 were determined by qPCR and western blot. Levels of p-IKKβ, IKKβ, p-p65, p65 were determined by western blot. Levels of p-p65 and uPA in bone tissue were studied by immunohistochemistry. Behavior tests in this investigation included paw withdrawal latency (PWL) and the paw withdrawal threshold (PWT). Radiological analysis and micro-CT were used to study bone structure. The lesions of bone tissue were determined by HE staining. The Dorsal root ganglia (DRG) isolated from mice were used to determine the level of PAR2 pathway.</p><p><strong>Results: </strong>Naringenin improved the BCP-induced bone damage based on the increases of BV/TV, Conn. D, BMD and BMC and the decrease of bone destruction score. Naringenin repressed the reductions of PWT and PWL in BCP mice. Naringenin decreased the levels of PAR2, PKC-γ, PKA and TRPV1 of DRG and reduced the levels of p-IKKβ, p-p65, and uPA in serum and bone tissue in BCP. Importantly, naringenin suppressed the enhancement of TNF-α in serum and bone tissue in BCP mice.</p><p><strong>Conclusion: </strong>Naringenin alleviated pain sensitization and bone damage of mice with BCP via TNF-α-mediated NF-κB/uPA/PAR2 pathway. We demonstrated a novel pathway for anti-BCP treatment with naringenin.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 2","pages":"10225536241266671"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902030","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}