Journal of Orthopaedic Surgery and Research最新文献

{"title":"Virtual and augmented reality for anxiety reduction in orthopedic patients and providers: a systematic review.","authors":"Negarsadat Namazi, Yashar Khani, Amirhossein Salmannezhad, Mohammad Behdadfard, Ehsan Safaee, Mohammad Nouroozi, Amir Mehrvar","doi":"10.1186/s13018-025-05690-7","DOIUrl":"https://doi.org/10.1186/s13018-025-05690-7","url":null,"abstract":"<p><strong>Background: </strong>Anxiety impacts patients and healthcare providers during orthopedic procedures, yet virtual reality (VR) and augmented reality (AR) effectiveness remains inconsistently reported, lacking systematic synthesis in this setting. This review addresses this gap.</p><p><strong>Methods: </strong>Per PRISMA guidelines (PROSPERO: CRD42024553394), we searched PubMed, Scopus, Web of Science, and Embase in March 2024 for studies on VR/AR/mixed reality (MR) interventions for anxiety in orthopedic procedures. Data were narratively synthesized; bias assessed via RoB-2 and ROBINS-I.</p><p><strong>Results: </strong>Twenty-four studies (16 RCTs, 8 cohort, n = 1714) showed VR (22 studies) and AR (2 studies) significantly reduced anxiety across procedure phases, notably in pediatrics. Healthcare providers (HCPs) reported lower anxiety and higher confidence with VR. Satisfaction rose, anesthetic use dropped, though inconsistent tools and methods limited comparisons.</p><p><strong>Conclusion: </strong>VR/AR reduce pediatric anxiety in orthopedics, with less conclusive adult/HCP benefits. Clinicians could adopt preoperative VR. Research needs standardized tools and adult-focused RCTs.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"327"},"PeriodicalIF":2.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Evaluation and testing of polymethylmetacrylic (PMMA) bone cements with admixed Amphotericin B.","authors":"Florian A Frank, Barbara Krampitz, Julia Steiner, Rainer Strathausen, Mario Morgenstern, Martin Clauss, Klaus-Dieter Kühn","doi":"10.1186/s13018-025-05643-0","DOIUrl":"https://doi.org/10.1186/s13018-025-05643-0","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"325"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MiR-103-3p regulates chondrocyte autophagy, apoptosis, and ECM degradation through the PI3K/Akt/mTOR pathway by targeting CPEB3.","authors":"Jun Li, Farui Sun, Yuanjin Zhang, Xian Pan, Bo Li, Guofu Zhang, Qian Zhou","doi":"10.1186/s13018-025-05719-x","DOIUrl":"https://doi.org/10.1186/s13018-025-05719-x","url":null,"abstract":"<p><strong>Background: </strong>Chondrocyte apoptosis is associated with the severity of cartilage destruction and matrix degeneration in the progression of osteoarthritis. Increasing evidence indicates that autophagy has a significant cytoprotective effect against chondrocyte apoptosis. Here, we investigated the role of microRNA-103-3p (miR-103-3p) in regulating chondrocyte function and elucidated the underlying mechanism.</p><p><strong>Methods: </strong>MiR-103-3p expression in interleukin-1β (IL-1β)-stimulated chondrocytes was evaluated using RT-qPCR. The targets of miR-103-3p predicted by online databases were verified using biotin-based pulldown assay and luciferase reporter assay. IL-1β stimulated-chondrocytes were transfected with miR-103-3p inhibitor along with siRNA targeting cytoplasmic polyadenylation element-binding protein3 (siCPEB3), the autophagy inhibitor 3-MA, or the PI3K agonist 740 Y-P. Chondrocyte proliferation was evaluated using cell counting kit-8. Apoptosis was detected by flow cytometry. The levels of apoptosis-, extracellular matrix (ECM)-, autophagy-, and the PI3K/Akt/mTOR pathway-related proteins in chondrocytes were detected using immunoblotting or immunofluorescence.</p><p><strong>Results: </strong>We found that IL-1β stimulation upregulated miR-103-3p and downregulated CPEB3 in mouse chondrocytes. Inhibiting miR-103-3p reduced IL-1β-induced apoptosis and ECM macromolecule degradation while enhancing autophagy in chondrocytes. MiR-103-3p targeted CPEB3, and its downregulation rescued the expression of level in IL-1β stimulated-chondrocytes. MiR-103-3p downregulation inhibited the PI3K/Akt/mTOR pathway in IL-1β stimulated-chondrocytes by upregulating CPEB3. 3-MA, 740 Y-P, or CPEB3 knockdown counteracted the effect of miR-103-3p downregulation on chondrocyte apoptosis, ECM macromolecule degradation, and autophagy.</p><p><strong>Conclusion: </strong>Overall, inhibition of miR-103-3p reduces IL-1β-induced apoptosis and ECM macromolecule degradation in chondrocytes by enhancing autophagy through the CPEB3/PI3K/Akt/mTOR pathway.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"324"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence and risk factors of phobic movement disorder after hip fracture internal fixation surgery.","authors":"Liming Xu, Wenjie Chen","doi":"10.1186/s13018-025-05750-y","DOIUrl":"https://doi.org/10.1186/s13018-025-05750-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyze the cumulative incidence and associated risk factors of phobic movement disorder (PMD) after hip fracture internal fixation surgery, with the goal of optimizing postoperative rehabilitation management and improving the quality of life in elderly patients.</p><p><strong>Methods: </strong>A total of 269 patients who underwent hip fracture internal fixation surgery at our hospital from June 2022 to June 2024 were retrospectively included. Clinical data, including age, sex, BMI, underlying diseases, psychological status, postoperative hip joint function, and self-efficacy, were collected. PMD was assessed using the Tampa Scale for Kinesiophobia (TSK), pain acceptance was evaluated using the Chronic Pain Acceptance Questionnaire (CPAQ-8), anxiety and depression status were assessed with the Hospital Anxiety and Depression Scale (HADS), hip joint function was measured using the Harris Hip Score, and self-efficacy was evaluated using the General Self-Efficacy Scale (GSE). Univariate analysis and multivariate binary logistic regression analysis were used to identify independent risk factors for PMD. The variance inflation factor (VIF) was calculated to assess multicollinearity.</p><p><strong>Results: </strong>The cumulative incidence of PMD was 34.9%. Univariate analysis revealed that BMI ≥ 30 kg/m², low pain acceptance, anxiety and depression, poor postoperative hip joint function, and low self-efficacy were significantly associated with PMD (P < 0.001). Multivariate logistic regression analysis further confirmed that BMI ≥ 30 kg/m² (OR = 4.07, 95% CI [2.39, 6.94]), low pain acceptance (OR = 4.67, 95% CI [2.69, 8.10]), anxiety and depression (OR = 4.14, 95% CI [2.44, 7.04]), poor postoperative hip joint function (OR = 10.61, 95% CI [5.67, 19.87]), and low self-efficacy (OR = 4.19, 95% CI [2.44, 7.18]) were independent risk factors for PMD. All VIF values were < 5, indicating no significant multicollinearity.</p><p><strong>Conclusion: </strong>PMD is common after hip fracture internal fixation surgery and is closely associated with high BMI, low pain acceptance, anxiety and depression, poor postoperative hip joint function, and low self-efficacy. The VIF analysis showed no significant multicollinearity, indicating stable results. Comprehensive interventions targeting high-risk factors may help reduce the incidence of PMD and improve postoperative recovery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"323"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty.","authors":"Hiroki Hijikata, Tomoharu Mochizuki, Keisuku Maeda, Osamu Tanifuji, Go Omori, Noriaki Yamamoto, Hiroyuki Kawashima","doi":"10.1186/s13018-025-05741-z","DOIUrl":"https://doi.org/10.1186/s13018-025-05741-z","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare three-dimensional (3D) and two-dimensional (2D) evaluation of the stress X-rays following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This prospective study analyzed 51 consecutive rTKAs (four males and 44 females, both aged 74 ± 6 years). Postoperative varus/valgus stress X-rays were taken at maximum manual varus/valgus stress during knee extension under anesthesia, and were analyzed three-dimensionally using a 3D-2D image matching technique with 3D bone and component models. The 3D models of the femur and tibia, along with component-bone constructs, were reconstructed from CT data using 3D modeling software. The 2D evaluation of varus/valgus stress X-rays were carried out directly on the stress X-rays. The varus/valgus angle (VV angle) between components, Medial joint opening (MJO) and lateral joint opening (LJO) were assessed under conditions of no stress, valgus stress, and varus stress.</p><p><strong>Results: </strong>The VV angles under no stress, valgus stress, and varus stress in 3D and 2D evaluation were 3.6 ± 1.1 / 3.6 ± 1.1°, -0.6 ± 1.6 / -0.6 ± 1.6°, 7.1 ± 1.9 / 6.8 ± 2.5°, respectively. The MJO in the non-stress condition and under valgus stress in 3D and 2D evaluation were 0.0 ± 0.5 / -1.8 ± 0.8 mm,1.4 ± 1.0 / -0.2 ± 1.4 mm, and the LJO in the non-stress condition and under varus stress in 3D and 2D evaluation were 0.9 ± 1.0 / -0.6 ± 1.0 mm, 3.5 ± 1.9 / 2.1 ± 1.9 mm, respectively.</p><p><strong>Conclusions: </strong>This prospective study revealed that the 3D evaluation of varus/valgus stress X-rays following total knee arthroplasty is equivalent to 2D evaluation in VV angles, whereas different from 2Devaluation in MJO and LJO.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"326"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriate patient selection based on joint line convergence angle minimizes the difference between the mechanical axis in the standing and supine positions after open-wedge high tibial osteotomy and distal tuberosity osteotomy.","authors":"Naosuke Nagata, Takehiko Matsushita, Shu Watanabe, Yuta Nakanishi, Kyohei Nishida, Kanto Nagai, Noriyuki Kanzaki, Yuichi Hoshino, Tomoyuki Matsumoto, Ryosuke Kuroda","doi":"10.1186/s13018-025-05711-5","DOIUrl":"10.1186/s13018-025-05711-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the differences between the mechanical axis (MA) in standing and supine positions in patients who underwent high tibial osteotomy (HTO) or distal tuberosity osteotomy (DTO) based on the surgical indication for the joint line convergence angle (JLCA).</p><p><strong>Methods: </strong>Seventy-one knees of 69 patients with JLCA of < 6° in standing position and a difference of < 3° between the JLCA in the standing and supine positions who had undergone medial open-wedge HTO or DTO were included in this study. The %MA in the standing and supine positions (%MAst and %MAsp, respectively) and JLCA in the standing and supine positions (JLCAst and JLCAsp, respectively) were determined using preoperative and postoperative long-leg-view radiographs. The difference between %MA and JLCA in the standing and supine positions (Δ%MA and ΔJLCA, respectively) was calculated by subtracting the measurement value in the supine position from that in the standing position.</p><p><strong>Results: </strong>The preoperative %MAst, %MAsp, JLCAst, and JLCAsp were 23.8 ± 9.5%, 28.7 ± 8.0%, 2.9 ± 1.4°, and 1.6 ± 1.4° respectively. The preoperative Δ%MA and ΔJLCA were - 4.9 ± 5.9% and 1.3 ± 1.0° respectively. The postoperative %MAst, %MAsp, JLCAst, and JLCAsp were 58.8 ± 6.9%, 59.0 ± 6.2%, 1.7 ± 1.0°, and 1.5 ± 1.1°, respectively. No significant differences were observed between the postoperative %MAst and %MAsp. The postoperative Δ%MA and ΔJLCA were - 0.2 ± 3.0% and 0.3 ± 0.6°, respectively. The postoperative Δ%MA was - 5 to 5% in 68 knees (95.8%).</p><p><strong>Conclusion: </strong>Minimal differences were observed between the Δ%MA after HTO and DTO among patients with preoperative JLCAst of < 6° and ΔJLCA and of < 3°, respectively. Appropriate surgical indications could minimize this difference.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"321"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of preoperative handgrip strength on postoperative outcomes following transforaminal lumbar interbody fusion.","authors":"Duy Nguyen Anh Tran, Yu-Pin Chen, Hui-En Lin, Tan Thanh Nguyen, Hoan Le Nguyen, Yi-Jie Kuo","doi":"10.1186/s13018-025-05717-z","DOIUrl":"10.1186/s13018-025-05717-z","url":null,"abstract":"<p><strong>Background: </strong>With an aging population, the prevalence of lumbar spinal diseases necessitating surgical intervention is increasing. Handgrip strength (HGS) has emerged as a simple measure of muscle function that may correlate with surgical outcomes. However, the role of HGS concerning postoperative recovery following transforaminal lumbar interbody fusion (TLIF) is not well-studied, highlighting a gap in the literature regarding its potential as a prognostic tool.</p><p><strong>Methods: </strong>This prospective observational study included 89 patients who underwent TLIF performed by a single surgeon. Patients were categorized into normal and low HGS groups based on preoperative HGS measurements. Demographics, baseline HGS, and surgical details were recorded, and outcomes were assessed using the JOA, EQ-5D-3L, and Barthel Index at 3, 6, and 12 months postoperatively. Generalized Estimating Equations were used to examine associations between baseline parameters and outcomes over time.</p><p><strong>Results: </strong>All patients were followed for at least one year, except for 15 (15.6%) who were lost to follow-up before the one-year mark. Patients with lower preoperative HGS were associated with significantly poorer postoperative functional outcomes. Specifically, a one-unit decrease in HGS was associated with a 2.551-point decrease in the JOA score (p = 0.008), a 0.142-point decrease in the EQ-5D-3L score (p = 0.007), and a 5.784-point decrease in the Barthel Index (p = 0.036). Additionally, male sex, higher body mass index, and lower Charlson comorbidity index were associated with better postoperative outcomes.</p><p><strong>Conclusions: </strong>Low preoperative handgrip strength is associated with poorer functional, quality of life, and independence outcomes up to 12 months after TLIF surgery. Assessing HGS preoperatively may provide clinicians with valuable information for identifying patients at risk of suboptimal recovery. Future research could explore intervention strategies to improve preoperative muscle function and potentially enhance recovery outcomes for patients undergoing TLIF.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"320"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel external fixation for treating tibial fractures: a finite element and biomechanical study.","authors":"Shen Liu, Xiangdang Liang, Songyang Liu, Zhanshe Guo, Xing Wei, Yonghui Liang","doi":"10.1186/s13018-025-05681-8","DOIUrl":"10.1186/s13018-025-05681-8","url":null,"abstract":"<p><strong>Objective: </strong>Design a new type of external fixation device that is small in size, high in strength, and capable of achieving the mechanical requirements for fracture healing. Verify the rationality and effectiveness of the device in treating tibial fractures through finite element analysis and biomechanical comparative tests.</p><p><strong>Methods: </strong>Finite element simulation was performed on the new external fixation device to treat fractures, to verify whether the mechanical properties of the device meet the requirements of fracture healing. A fracture gap model was created using Sawbones to simulate midshaft tibial comminuted fractures. The experiment was divided into four groups, testing the mechanical characteristics of the new external fixation (NEF), locking compression plate (LCP), the unilateral external fixation (UEF), and the externalized locking compression plate (E-LCP). The axial compression, torsion, fatigue and ultimate load tests were performed separately. Data were collected and statistical analysis was performed to verify whether there were statistical differences between the four groups.</p><p><strong>Results: </strong>The finite element analysis of NEF demonstrated that the fracture end was displaced by 0.512 mm under 700 N loading, and the maximum stress value of the device was 189 MPa, which met the mechanical requirements. Axial compression tests showed that LCP (2108.596 N/mm) had the highest stiffness, and NEF (519.489 N/mm) had higher stiffness than both UEF (327.153 N/mm) and E-LCP (316.763 N/mm) (p < 0.05), but no significant difference between UEF and E-LCP (p = 0.313). There was a significant difference in mean torsional stiffness among UEF (1.412 N·m/deg), NEF (1.398 N·m/deg), LCP (1.128 N·m/deg), and E-LCP (0.838 N·m/deg). No structural failures occurred during fatigue testing spanning 108,000 cycles. In ultimate load tests, NEF withstood the highest load, followed sequentially by LCP, UEF, and E-LCP. Significant differences were found between the groups (p < 0.05), with frame bending and secondary bone fractures noted in post-test evaluations.</p><p><strong>Conclusions: </strong>The NEF for tibial fractures is well-designed to meet the fracture healing requirements. It has certain advantages in comparison with other fixation methods and can be used as a new method for the treatment of tibial fractures.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"319"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of miR-654-3p targeting EMP1 on osteoblast activity and differentiation in delayed fracture healing.","authors":"Shantao Wang, Mingwei Wang, Shengliang Sun, Xinsheng Liu, Danzhi Li","doi":"10.1186/s13018-025-05736-w","DOIUrl":"https://doi.org/10.1186/s13018-025-05736-w","url":null,"abstract":"<p><strong>Background: </strong>Delayed fracture healing (DFH) is a common postoperative complication in fracture patients, and a validated serum marker may aid in the clinical management and improve the prognosis of fracture patients. In this study, we investigated the diagnostic role and potential regulatory mechanisms of miR-654-3p in DFH.</p><p><strong>Methods: </strong>73 patients with DFH and 75 patients with normal fracture healing (NFH) were included. Expression of miR-654-3p and EMP1 and several mRNA markers of osteogenic differentiation were evaluated by RT-qPCR. The diagnostic value of miR-654-3p and EMP1 alone and in combination was assessed using ROC curves. Cell proliferation capacity was assessed by CCK-8 and apoptosis rate by flow cytometry. DLR experiments demonstrated the targeting relationship between miR-654-3p and EMP1.</p><p><strong>Results: </strong>Levels of miR-654-3p were found to be significantly lower in DFH compared to NFH. Following cell differentiation treatment, miR-654-3p levels increased and EMP1 levels decreased. Furthermore, a negative correlation was identified between miR-654-3p and EMP1 target binding and expression levels. The combination of miR-654-3p and EMP1 holds significant diagnostic value for DFH. miR-654-3p high expression can inhibit EMP1 levels, which promotes cell proliferation, increases osteoblast activity and levels of differentiation markers, and decreases the rate of apoptosis.</p><p><strong>Conclusion: </strong>miR-654-3p and EMP1 are aberrantly expressed in DFH, and both have high diagnostic value for DFH. miR-654-3p is involved in the proliferation, differentiation, and apoptotic activities of osteoblasts by regulating the level of EMP1, thus affecting the progression of DFH.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"322"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cup positioning relative to the acetabular rim planned with three-dimensional computed tomography improves precision in total hip arthroplasty: a randomized controlled trial.","authors":"Anuwat Pongkunakorn, Napon Wongkamthong, Rukthanin Ruktrakul","doi":"10.1186/s13018-025-05704-4","DOIUrl":"10.1186/s13018-025-05704-4","url":null,"abstract":"<p><strong>Background: </strong>Accurate acetabular cup positioning is essential for successful total hip arthroplasty (THA) outcomes. The conventional mechanical alignment guide (MAG) method provides moderate accuracy. We developed a novel technique for cup positioning that utilizes preoperative three-dimensional computed tomography (3D-CT) planning based on the native acetabular rim's relative position and compared cup orientation between this method and the MAG technique.</p><p><strong>Methods: </strong>A randomized controlled trial with 120 patients undergoing primary THA via the posterolateral approach targeted cup positions of 40° radiographic inclination (RI) and 20° radiographic anteversion (RA). The control group (n = 40) used a MAG for cup placement, while the study group (n = 80) utilized preoperative 3D-CT to measure native RI, calculate RA, and determine the cup overhang distance (COD). The cup inclination was positioned relative to the superior rim point and the transverse acetabular notch. The cup anteversion was adjusted to achieve overhang at the posterior or anterior rim point according to the planned COD. Postoperative RI and RA were assessed using tilt-adjusted plain radiographs and CT scans. The percentages of cups positioned within 5° of the target position (RI/RA of 40°/20° ± 5°), and within the Grammatopoulos aiming zone (RI/RA of 40°/20° ± 10°) were compared between the two groups.</p><p><strong>Results: </strong>The mean RI was 41.7° ± 5.4° (range, 33°-59°) in the control group and 39.9° ± 3.2° (range, 33.8°-45.5°) in the study group (p = 0.019). The mean RA was 19.5° ± 7.6° (range, 3°-33°) in the control group and 20.2° ± 3.3° (range, 12.9°-28.3°) in the study group (p = 0.356). Cup alignment within 5° of the target was achieved in 86.2% (69 hips) of the study group and 32.5% (13 hips) of the control group (p < 0.001). The study group had a significantly higher percentage of cups within Grammatopoulos aiming zone (100% vs. 77.5%, p < 0.001).</p><p><strong>Conclusions: </strong>3D-CT-guided cup positioning relative to the acetabular rim can enhance the precision of cup placement in THA to achieve alignment within 5° of the target position.</p><p><strong>Trial registration: </strong>Thai Clinical Trials Registry (TCTR 20201220001). Registered on 20 December 2020. Prospectively registered.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"318"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}