Journal of Orthopaedic Surgery and Research最新文献

{"title":"Modification of the coronal plane alignment of the knee classification considering the joint line convergence angle in high tibial osteotomy: a geometric approach.","authors":"Ju-Ho Song, Bum-Sik Lee, Jong-Min Kim, Seong-Il Bin, Jaejung Ryu","doi":"10.1186/s13018-026-06922-0","DOIUrl":"https://doi.org/10.1186/s13018-026-06922-0","url":null,"abstract":"<p><strong>Background: </strong>Excessive joint line obliquity (JLO) is associated with poor outcomes in open wedge high tibial osteotomy (OWHTO). The Coronal Plane Alignment of the Knee (CPAK) classification categorizes knee phenotypes by alignment and JLO but overlooks the joint line convergence angle (JLCA), which impacts JLO pre- and postoperatively in OWHTO. This study aims to modify JLO calculation by incorporating JLCA through a geometric approach, with the goal of better reflecting the knee joint orientation under weight-bearing conditions.</p><p><strong>Methods: </strong>323 knees that received OWHTO were retrospectively reviewed. The study included OWHTO patients who had pre- and 1-year postoperative long-standing hip-to-ankle radiographs for CPAK classification and JLCA measurement. JLOs were calculated using two methods based on a geometric approach: conventional JLO (cJLO), defined as (lateral distal femoral angle [LDFA] + medial proximal tibial angle [MPTA])/2-90°, and modified JLO (mJLO), which incorporates the JLCA, defined as (LDFA + MPTA)/2 + JLCA/2° - 90°. These were compared to the knee joint orientation using intraclass correlation coefficients (ICCs) and Bland-Altman plots. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) score.</p><p><strong>Results: </strong>Mechanical hip-knee-ankle angle (mHKA) was corrected from - 7.1 ± 2.7° preoperatively to 2.1 ± 2.3° at 1 year postoperatively, and JLCA decreased from 3.1 ± 1.9° to 2.4 ± 1.7°. The HSS scores showed significant improvement, rising from 68.6 ± 11.7 preoperatively to 91.3 ± 7.4 postoperatively (p < 0.001). The knee joint orientation was measured at - 1.0 ± 1.9° preoperatively and 1.9 ± 2.3° postoperatively at 1 year. Comparatively, cJLO values were - 3.3 ± 1.5° and 0.9 ± 2.0°, while mJLO values were - 1.8 ± 1.8° and 2.1 ± 2.3°. ICCs showed preoperative and 1-year postoperative cJLO at 0.842 (95% CI, 0.804-0.873) and 0.927 (95% CI, 0.909-0.941), respectively, while mJLO demonstrated 0.881 (95% CI, 0.851-0.904) and 0.949 (95% CI, 0.936-0.959). Bland-Altman plots showed that both preoperative and 1-year postoperative mJLO had smaller differences from the knee joint orientation than cJLO, indicating that mJLO more closely reflects functional joint orientation.</p><p><strong>Conclusion: </strong>The mJLO, derived through a geometric approach that incorporates JLCA, was found to more closely reflect the knee joint orientation compared to the cJLO described in the CPAK classification. To effectively apply the CPAK classification in OWHTO, it is essential to account for JLCAs before and after surgery. Accordingly, mJLO can be represented as (LDFA + MPTA)/2 + JLCA/2° - 90°.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856519","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":"Using medial column support instead of screw density to predict radiological failure requiring revision in osteoporotic proximal humerus fractures.","authors":"Evren Karaali, Osman Çiloğlu, Burak Keklikçioğlu, Hakan Uslu, Bedirhan Sarı, Özhan Pazarcı, Harun Sidar Seçkin","doi":"10.1186/s13018-026-06921-1","DOIUrl":"https://doi.org/10.1186/s13018-026-06921-1","url":null,"abstract":"<p><strong>Background: </strong>Proximal humerus fractures (PHFs) are fragility fractures that commonly occur in elderly patients and are frequently associated with osteoporosis. Despite the widespread use of locking plate fixation for displaced fractures, complication and reoperation rates remain high, particularly in complex three- and four-part fracture patterns. Although increasing screw density improves fixation stability, the relative significance between screw number and screw position (particularly medial column support) remains unclear. This study aims to determine whether fixation failure is driven by screw density or by the quality of medial column support and fracture biology in osteoporotic PHFs.</p><p><strong>Methods: </strong>This retrospective cohort study included elderly patients (≥ 65 years) with confirmed osteoporosis who underwent locking plate fixation for three- or four-part PHFs between January 2018 and December 2023 with a minimum radiological follow-up of 24 months and subsequently required revision surgery due to radiological failure. The patients were classified based on screw density (low vs. high), and the distribution of mechanical and biological causes of revision was analyzed. In a second analysis, patients who underwent revision surgery were compared with those who did not to examine the relationship between medial support quality (defined by inferomedial and calcar screw placement) and the likelihood of revision.</p><p><strong>Results: </strong>A total of 24 patients who required revision surgery were included in the primary analysis (15 with low and nine with high screw density). The distribution of revisions for mechanical and biological reasons did not differ between the groups (p > 0.05). In a secondary analysis involving 166 patients (24 revision, 142 non-revision), limited medial support (one inferomedial/calcar screw) was significantly more common among revision cases than non-revision cases (37.5% vs. 4.9%), whereas adequate medial support (≥ 2 inferomedial/calcar screws) predominated in patients without revision (95.1%) (p < 0.001).</p><p><strong>Conclusion: </strong>In osteoporotic PHFs requiring surgical fixation, revision risk is not determined by the total number of screws but by the quality of medial column support. Adequate inferomedial and calcar screw placement was strongly associated with a lower revision rate, emphasizing that targeted screw positioning rather than increased screw density is the critical determinant of fixation durability in osteoporotic bones.</p><p><strong>Level of evidence iii: </strong>Retrospective cohort study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856568","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":"Microfracture effectively fills majority of talus osteochondral lesions at 4-6 months in patients with concomitant chronic lateral ankle instability: a second-look arthroscopy study of staged surgery.","authors":"Zhidong Zhao, Shengxuan Li, Pengtao Shi, Chen Yang, Zhijiang Li, Yanpeng Zhao, Qi Quan, Min Wei","doi":"10.1186/s13018-026-06879-0","DOIUrl":"https://doi.org/10.1186/s13018-026-06879-0","url":null,"abstract":"<p><strong>Background: </strong>Microfracture (MF) is the first-line treatment strategy for Osteochondral lesions of the talus (OLT), while its clinical outcomes have been reported, the early-stage (4-6 months) healing effects of MF for OLT has been poorly characterized. This study investigated the early MF repairing outcomes in patients with concurrent OLT and CLAI treated with staged surgery.</p><p><strong>Methods: </strong>We retrospectively evaluated 34 consecutive patients with concomitant OLT and CLAI who underwent staged surgery, consisting of first-stage MF for OLT and second-stage modified Brostrom-Gould repair with second-look arthroscopy. Repair quality was assessed using the Ferkel and Cheng staging system and the International Cartilage Repair Society (ICRS) score. Preoperative and postoperative magnetic resonance imaging (MRI) was evaluated using the Hepple classification. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) scores. Spearman correlation analysis was used to examine associations among preoperative variables, postoperative clinical scores, and second-look repair grades.</p><p><strong>Results: </strong>All lesions showed effective filling at second-look arthroscopy; however, four patients with contiguous lesions involving zones 4 and 1 underwent revision MF because of poor integration in anterior zone 1. According to the Ferkel and Cheng system, repair quality was Grade A in 2.9%, Grade B in 70.6%, Grade C in 20.6%, and Grade D in 5.9% of cases. MRI demonstrated nearly intact cartilage surfaces with persistent subchondral bone edema. Hepple classification showed a trend toward improvement (Z = - 1.83, p = 0.070). AOFAS and VAS scores improved significantly by the second procedure. Preoperative subchondral bone cysts and lesion number were not significantly associated with repair quality. No significant correlation was found between arthroscopic repair grades and clinical scores at early follow-up.</p><p><strong>Conclusion: </strong>MF achieved satisfactory early filling in most OLTs at 4-6 months in patients with concomitant CLAI undergoing staged surgery. However, integration in anterior zone 1 warrants particular attention in lesions extending across zones 4 and 1.</p><p><strong>Case series: </strong>Level of evidence, 4.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856533","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":"The role of Poller screws in intramedullary nailing for lower limb extra-isthmic fractures.","authors":"Zhanyu Yang, Bin Sheng, Delong Liu, Ying Lu, Bin Chen","doi":"10.1186/s13018-026-06900-6","DOIUrl":"https://doi.org/10.1186/s13018-026-06900-6","url":null,"abstract":"<p><strong>Introduction: </strong>Intramedullary nailing is the preferred treatment for lower limb long bone fractures, but stability is reduced in extra-isthmic fractures due to nail-metaphysis mismatch. Poller screws may help, but their use is controversial. This study evaluates whether Poller screws are associated with improved prognosis in intramedullary nailing for lower limb extra-isthmic fractures and explores their mechanical mechanisms.</p><p><strong>Methods: </strong>PubMed, EMBASE, Cochrane Library, and Web of Science were searched up to December 2025 using keywords like 'Fracture,' 'Intramedullary nail,' 'Poller screw,' and 'Blocking screw.' Studies were screened, and data were collected for meta-analysis. A 3D tibial model was created, and finite element analysis assessed Poller screws' effect on distal tibial fractures under axial load.</p><p><strong>Results: </strong>Out of 1134 studies, 5 trials with 413 participants were included. The Poller screw group showed increased union rates (OR = 2.48; 95% CI, 1.13-5.46; p = 0.020). Surgery duration increased, but secondary surgical procedures decreased. No differences were found in malalignment, time to union, or infection. Poller screws reduced fracture site displacement by 54.88%.</p><p><strong>Conclusion: </strong>The use of Poller screws in intramedullary nailing for lower limb extra-isthmic fractures is associated with higher union rates without affecting alignment or healing time. While surgery duration increases, infection remains unchanged, and secondary surgery decreases. The improved healing outcomes may contribute to Poller screws enhancing construct stiffness and reducing micro-motion.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838929","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":"The correlation between preoperative patellar tilt and clinical outcomes following unicompartmental knee arthroplasty.","authors":"Hongxin Hu, Mei Lin, Changyu Huang, Hanglin Qiu, Xinxuan Lai, Jinping Zhang, Yijun Lin, Xianwei Wu, Zhikun Zhuang, Guoli Chen","doi":"10.1186/s13018-026-06896-z","DOIUrl":"https://doi.org/10.1186/s13018-026-06896-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between preoperative patellar tilt angle and clinical outcomes following unicompartmental knee arthroplasty (UKA).</p><p><strong>Methods: </strong>In this retrospective study, 148 UKA patients were stratified into normal (patellar tilt < 10°, n = 99) and abnormal (≥ 10°, n = 49) groups. Radiographic alignment -including the hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), and posterior tibial slope were compared. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain, the Hospital for Special Surgery (HSS) score, the Feller patellar score, and the incidence of anterior knee pain (AKP). Additional patellofemoral parameters (patellar shift, Caton-Deschamps index, Iwano classification) were also analyzed.</p><p><strong>Results: </strong>Postoperative mechanical alignment (HKA, mLDFA, MPTA) was successfully corrected to the ideal range (approximately 3° of physiological varus) in both groups, with no significant differences. However, clinical outcomes were significantly worse in the abnormal group compared to the normal group: higher postoperative VAS scores (median 1 vs. 0, p = 0.010), lower HSS scores (median 83 vs. 85, p = 0.000), lower Feller scores (median 19 vs. 20, p = 0.000), and a higher incidence of AKP (12.24% vs. 3.03%, p = 0.027). No significant intergroup differences were found in the additional patellofemoral parameters.</p><p><strong>Conclusion: </strong>A preoperative patellar tilt angle ≥ 10° is significantly associated with inferior early clinical outcomes and a markedly increased risk of AKP after UKA, despite successful mechanical alignment correction. Preoperative assessment of patellar tilt may provides valuable prognostic information and may help identify patients requiring heightened intraoperative attention to patellofemoral kinematics or tailored rehabilitation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838871","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":"A novel transparent visual channel translates into enhanced surgical safety and efficiency for prolapsed lumbar disc herniation: a comparative clinical study.","authors":"Junwei Zhang, Gen Li, Yang Sun, Shuo Feng, Bin Pan, Maji Sun, Feng Yuan","doi":"10.1186/s13018-026-06902-4","DOIUrl":"https://doi.org/10.1186/s13018-026-06902-4","url":null,"abstract":"<p><strong>Background: </strong>The standard metal working channel in percutaneous translaminar endoscopic discectomy (PTED) creates a significant visual \"blind spot,\" presenting a particular challenge during surgery for prolapsed lumbar disc herniation (PLDH). This obstruction can result in semi-blind surgical maneuvers, elevating the risk of neural injury and incomplete fragment removal. To overcome this fundamental limitation, we developed a novel transparent visual channel (TVC) and assessed its clinical performance.</p><p><strong>Methods: </strong>In a retrospective comparative study, we analyzed 65 patients with PLDH who underwent PTED, utilizing either the novel TVC (n = 29) or the conventional metal working channel (n = 36). Key metrics for comparison included surgical field of view (quantified using the structural similarity index measure [SSIM]), total operation time, frequency of intraoperative neurophysiological monitoring alerts, standard perioperative clinical indicators, complication rates, and patient-reported outcomes (Visual Analog Scale [VAS] for pain, Oswestry Disability Index [ODI], and MacNab criteria).</p><p><strong>Results: </strong>The TVC group demonstrated a significantly larger and more consistent surgical field of view, evidenced by a markedly higher SSIM (98.2% ± 1.1% vs. 54.6% ± 8.3%, P < 0.05). Operative efficiency was improved in the TVC group, with a significantly shorter mean operation time (83.2 ± 9.7 min vs. 97.5 ± 8.9 min, P < 0.05). Critically, the use of the TVC was associated with enhanced intraoperative safety, as indicated by a significant reduction in the number of intraoperative neurophysiological monitoring alerts during neural decompression (2 vs. 11, P < 0.05). Both groups exhibited significant and comparable improvements in VAS scores, ODI scores, and MacNab outcomes at follow-up, with no statistically significant differences between the groups (P > 0.05).</p><p><strong>Conclusion: </strong>The novel transparent visual channel effectively converts the PTED procedure from a semi-blind technique to a fully visualized one. This material innovation delivers direct clinical advantages by improving intraoperative safety through reduced neural irritation and increasing procedural efficiency, all while maintaining the excellent clinical outcomes associated with standard PTED. This study substantiates the TVC as a significant advancement in endoscopic spine surgery instrumentation, directly addressing a core visual constraint of the established technique.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839207","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":"Clinical study on the fixation of coracoid process fracture of the scapula with cannulated screws assisted by robot navigation combined with O-arm imaging.","authors":"Hongfei Qi, Zhong Li, Hua Lin, Shuai Ji, Chengcheng Zhang, Bo Wu, Bing Du, Kun Zhang, Ming Li","doi":"10.1186/s13018-026-06903-3","DOIUrl":"https://doi.org/10.1186/s13018-026-06903-3","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical effect of cannulated screw fixation for coracoid process fractures of the scapula assisted by robot navigation combined with O-arm imaging.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of the clinical data from 19 patients with scapular coracoid process fractures who underwent surgical treatment at our center from January 2022 to July 2023. All the patients had their coracoid process fractures fixed with screws assisted by the robot navigation system combined with the O-arm imaging navigation system by experienced orthopedic surgeons. Three patients were excluded due to insufficient follow-up, and finally 16 patients were included in the study. The patients' surgical conditions (operation time, intraoperative blood loss) and fracture healing time were recorded. During the outpatient follow-up 12 months after the operation, the Constant score was used to evaluate the function of the patients' shoulder joints, and the Visual Analogue Scale (VAS) pain score was applied to assess the residual pain of the patients' shoulder joints.</p><p><strong>Results: </strong>All patients were followed for at least 12 months, with an average of 14.2 months (ranging 12 to 19 months). The average operation time of the 16 patients was 75.8 min (ranging from 52 to 98 min), and the average intraoperative blood loss was 47.3 ml (ranging from 28 to 75 ml). All 16 fractures healed without nonunion or loss of reduction, and the average healing time was 10.2 weeks (range, 8 to 14 weeks). One year after the operation, the shoulder joint functions of all 16 patients were good. The average Constant score was 90.5 points (ranging from 82 to 97 points), and the average VAS score of the shoulder joints was 1.0 points (ranging from 0 to 4 points). No cases of blood vessel or nerve injury related to surgical operation were found in all patients during the perioperative period and follow-up period.</p><p><strong>Conclusion: </strong>In this retrospective case series, robot-assisted cannulated screw fixation with O-arm navigation for coracoid process fractures resulted in satisfactory fracture healing and shoulder function, with minimal blood loss and low perioperative complication rates. The proceduralized workflow may facilitate surgical standardization. Given the study's exploratory nature and low level of evidence, further controlled studies are needed to confirm comparative advantages.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839218","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":"Excellent 12-month outcomes after hip arthroscopy for femoroacetabular impingement: role of spinopelvic alignment and hip morphology-a multicenter study.","authors":"Rémy Coulomb, Youssef Jamaleddine, Olivier May, Nicolas Bonin, Mathieu Thaunat, Nicolas Tardy, Nicolas Krantz, Pascal Kouyoumdjian","doi":"10.1186/s13018-026-06887-0","DOIUrl":"https://doi.org/10.1186/s13018-026-06887-0","url":null,"abstract":"<p><strong>Background: </strong>Hip arthroscopy for femoroacetabular impingement yields favorable average results, yet many patients do not achieve truly excellent function. The influence of pre-operative radiographic and spinopelvic parameters on excellent short-term outcomes remains uncertain. We aimed to identify pre-operative radiographic and spinopelvic factors associated with achieving an excellent patient-reported outcome at 12 months after arthroscopic treatment of femoroacetabular impingement.</p><p><strong>Methods: </strong>A retrospective multicenter study of prospectively collected data was performed across six French centers. Consecutive patients treated arthroscopically for symptomatic femoroacetabular impingement between September 2020 and October 2021 were included if the 12-month Non-Arthritic Hip Score was available. Standard hip radiographs were used to measure degenerative grade, lateral centre-edge angle, and the Dunn alpha angle. Spinopelvic parameters were assessed on low-dose biplanar imaging in standing and sitting, including intrinsic pelvic mobility (standing minus sitting sacral slope). The primary endpoint was an excellent outcome defined as a 12-month Non-Arthritic Hip Score of at least 92. Missing spinopelvic data were handled by multiple imputation, and univariate then multivariable logistic regression was used, adjusted for age, sex, and body mass index.</p><p><strong>Results: </strong>Of 200 eligible patients, 178 (89.0%) had 12-month outcome data; 82 (46.1%) achieved a Non-Arthritic Hip Score of at least 92. In the adjusted model, standing pelvic tilt of 10 degrees or less (odds ratio 2.82; 95% confidence interval 1.35-5.90), degenerative grade 0 (odds ratio 5.15; 95% confidence interval 2.19-12.09), lateral centre-edge angle greater than 25 degrees (odds ratio 3.08; 95% confidence interval 1.41-6.74), and male sex (odds ratio 3.18; 95% confidence interval 1.38-7.32) independently predicted an excellent outcome. Intrinsic pelvic mobility, standing lumbar lordosis, Dunn alpha angle, age, and body mass index were not independently associated with excellent outcome.</p><p><strong>Conclusions: </strong>Only about half of patients undergoing hip arthroscopy for femoroacetabular impingement achieved an excellent 12-month outcome. Tonnis grade 0, lateral centre-edge angle greater than 25 degrees, standing pelvic tilt of 10 degrees or less, and male sex independently predicted excellent results, whereas pelvic mobility, standing lumbar lordosis, age, and body mass index did not.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839339","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":"LncRNA GAS5 inhibits the remodeling of the tumor microenvironment by binding to miR-93-5p, thereby suppressing the development of osteosarcoma.","authors":"Tianbo Zhu, Xiaokang Zhu, You Zhou, Wenyao Chen, Wei Huang, Yafeng Lv, Xiangyong Que, Yi Li, Qingsong Tian, Mireadeli Abulimiti, Xinzhi Li","doi":"10.1186/s13018-026-06852-x","DOIUrl":"https://doi.org/10.1186/s13018-026-06852-x","url":null,"abstract":"<p><p>The inflammatory tumor immune microenvironment is being increasingly recognized as a key driver of osteosarcoma (OS) progression; however, the molecular mechanisms linking long noncoding RNAs (lncRNAs) to inflammasome signaling in OS remain poorly understood. In this study, we investigated the role of growth arrest-specific transcript 5 (GAS5) in regulating inflammatory remodeling and tumor development. We found that GAS5 expression was significantly decreased in osteosarcoma cells, whereas miR-93-5p expression was upregulated, indicating a potential inverse regulatory relationship. Mechanistically, GAS5 functioned as a competing endogenous RNA for miR-93-5p, thereby alleviating miR-93-5p-mediated downregulation of the E3 ubiquitin ligase TRIM31. Restoration of TRIM31 expression promoted NLRP3 protein turnover and attenuated inflammasome activation, as evidenced by reduced cleaved caspase-1, GSDMD-N, and IL-18 secretion. Functionally, GAS5 overexpression suppressed inflammatory cytokine production and limited protumorigenic inflammatory remodeling, ultimately inhibiting osteosarcoma cell progression. Collectively, our findings reveal a novel GAS5/miR-93-5p/TRIM31/NLRP3 regulatory axis that connects lncRNA-mediated posttranscriptional control to inflammasome signaling in osteosarcoma, providing new mechanistic insight and a potential therapeutic framework for targeting inflammation-associated OS progression.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839281","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":"Optimal tibial component size set in unicompartmental knee arthroplasty for Chinese patients and comparison with existing implants.","authors":"Yandong Sun, Diyang Zou, Huarui Shen, Jingchi Li, Rongshan Cheng, Pingyue Li, Tsung-Yuan Tsai","doi":"10.1186/s13018-026-06878-1","DOIUrl":"https://doi.org/10.1186/s13018-026-06878-1","url":null,"abstract":"<p><strong>Background: </strong>The coverage of the tibial component affects the success of unicompartmental knee arthroplasty (UKA). However, most UKA implants used in China are designed based on the knee morphology of Caucasian populations. The purposes of this study were to (1) provide accurate anatomical parameters of the medial tibial plateau in the Chinese population, (2) define an optimal set of UKA tibial component sizes based on anthropometric data, and (3) compare the tibial coverage of several commercially available UKA tibial designs with that of the suggested optimal tibial component.</p><p><strong>Methods: </strong>A standard virtual tibial resection was performed on 620 healthy knees using three-dimensional (3D) reconstructed models derived from computed tomography (CT) scans. The anteroposterior (AP) and mediolateral (ML) dimensions of the medial tibial plateau were measured. For implant sizing optimization, priority was given to the implant size that resulted in ≤ 1 mm of ML overhang; among those satisfying this criterion, the size with the smallest AP mismatch was selected. We designed sets of tibial component sizes (containing 6, 8, and 10 sizes) and optimized their configurations using a cost function defined as the weighted sum of AP and ML errors to evaluate prosthesis coverage. Commercially available UKA tibial implant designs were included to compare their mismatch errors with those of the suggested optimal tibial component.</p><p><strong>Results: </strong>In the conventional designs, the highest and lowest percentages of best-fit (within the range of -2 mm to 1 mm) in the mediolateral (ML) dimension were observed for the Zimmer Unicompartmental High Flex Knee (ZUK)/Journey (95.0%) and the Sled (41.3%), respectively. In the anteroposterior (AP) dimension, the highest and lowest percentages were found in the Oxford (49.5%) and the Journey (15.3%). In the three optimal designs, the percentages of best-fit in the ML dimension were 83.1%, 86.0%, and 88.1% for the 6-, 8-, and 10-size sets, respectively. In the AP dimension, the corresponding percentages were 55.5%, 72.6%, and 77.1%.</p><p><strong>Conclusion: </strong>Most commercially available UKA tibial component size sets cannot fully accommodate the anatomical variation of the tibia in the Chinese population. Ethnic-specific designs similar to the optimal designs proposed in this study are needed.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838849","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}