Journal of Orthopaedic Surgery and Research最新文献

{"title":"Delta large-channel endoscopy versus unilateral biportal endoscopy decompressive laminectomy for lumbar spinal stenosis: a prospective randomized controlled trial.","authors":"Rushuo Wei, Weiqiang Liu, Mingdong Yu, Yushan Zhu, Ruzhan Yao, Bingwu Wang, Jesse Li-Ling","doi":"10.1186/s13018-024-05409-0","DOIUrl":"10.1186/s13018-024-05409-0","url":null,"abstract":"<p><strong>Background: </strong>Delta large-channel endoscopy and unilateral biportal endoscopy (UBE) are prominent minimally invasive techniques for treating lumbar spinal stenosis, known for minimal tissue damage, clear visualization, and quick recovery. However, rigorous controlled research comparing these procedures is scarce, necessitating further investigation into their respective complications and long-term effectiveness. This randomized controlled trial aims to compare their perioperative outcomes, focusing on postoperative recovery and complications over time.</p><p><strong>Methods: </strong>In total, 101 participants were randomly assigned to Delta large-channel endoscopy group (n = 50) or UBE group (n = 51). Primary measures were Oswestry Disability Index (ODI) scores and operation time. Secondary measures included VAS, EQ-5D, JOA scores, intraoperative blood loss, hospital stay duration, and costs. Perioperative complications such as dural tears, incision infections, hematomas, thrombosis, and reoperation rates were recorded.</p><p><strong>Results: </strong>The Delta group consistently showed lower mean ODI scores throughout the follow-up than UBE group, with significant differences at 2 weeks postoperative (P = 0.048), though they were not significant by 1 month (P = 0.124), 2 months (P = 0.821) and 3 months (P = 0.350). Operation times were shorter in the Delta group (P < 0.001). Hospitalization costs and intraoperative blood loss were slightly higher in the UBE group (P < 0.001). No significant differences were noted in the other secondary outcomes at various post-surgery intervals, such as VAS, EQ-5D, JOA scores, hospital stay duration and complications.</p><p><strong>Conclusion: </strong>Both techniques are safe and effective when performed by experienced surgeons. Compared to UBE, Delta large-channel endoscopy can shorten surgery time and reduce blood loss, and more importantly, it promotes faster recovery of lumbar function in the early postoperative period.</p><p><strong>Research registration unique identifying number (uin): </strong>Name of the registry: Chinese Clinical Trial Registry chictr.org.cn. ( http://www.chictr.org.cn/index.aspx ). Unique Identifying number or registration ID: ChiCTR2300076237. Hyperlink to your specific registration (must be publicly accessible and will be checked): https://www.chictr.org.cn/showproj.html?proj=207 ,844.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"10"},"PeriodicalIF":2.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927190","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":"Comparison of the clinical efficacy of lateral versus medial unicondylar replacement for unicompartmental osteoarthritis of the knee: a meta-analysis.","authors":"Haowei Bai, Pengyu Liu, Hao Li, Jiaju Yang, Zhitong Li, Qidong Guo, Min Zhang","doi":"10.1186/s13018-024-05404-5","DOIUrl":"10.1186/s13018-024-05404-5","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis evaluates the comparative efficacy of lateral unicompartmental arthroplasty (UKA) versus medial UKA in treating unicompartmental knee osteoarthritis (KOA).</p><p><strong>Methods: </strong>We systematically searched Cochrane, PubMed, Embase, and Web of Science databases from January 2000 to September 2024. Literature screening, quality assessment, and data extraction were conducted based on predefined inclusion and exclusion criteria. Review Manager 5.4 software was used to analyze postoperative functional scores, pain scores, aseptic loosening, progression of contralateral arthritis, and prosthesis survival.</p><p><strong>Results: </strong>Fifteen cohort studies, encompassing 2,592 knees with medial UKA and 614 knees with lateral UKA, were included. The analysis showed no statistically significant differences in functional scores [SMD = 0.11, 95% CI (- 0.10, 0.33), I² = 64%, P = 0.31], pain scores [SMD = 0.23, 95% CI: (- 0.22, 0.67), I² = 91%, P = 0.32], aseptic loosening [OR = 1.33, 95% CI: (0.31, 5.78), I² = 0%, P = 0.70], progression of contralateral arthritis [OR = 0.37, 95% CI: (0.07, 1.91), I² = 0%, P = 0.23], short- to intermediate-term survival [OR = 1.40, 95% CI: (0.84, 2.35), I² = 0%, P = 0.20], and long-term survival [OR = 1.12, 95% CI: (0.61, 2.05), I² = 0%, P = 0.70].</p><p><strong>Conclusion: </strong>Our findings indicate no significant differences in functional outcomes, pain relief, aseptic loosening, progression of contralateral arthritis, or prosthesis survival between lateral and medial UKA. Thus, both approaches are reliable options for patients with unicompartmental KOA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"12"},"PeriodicalIF":2.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927188","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":"YBX1 alleviates ferroptosis in osteoporosis via the ATF4/FSP1 axis in an m⁵C manner.","authors":"Lei Tong, Yanbo Chen, Yan Gao, Xiaoming Gao, Yanming Hao","doi":"10.1186/s13018-024-05119-7","DOIUrl":"10.1186/s13018-024-05119-7","url":null,"abstract":"<p><strong>Background: </strong>Interactions between RNA-binding proteins and RNA regulate RNA transcription during osteoporosis. Ferroptosis, a programmed cell death caused by iron metabolism, plays a vital role in osteoporosis. However, the mechanisms by which RNA-binding proteins are involved in ferroptosis during osteoporosis remain unclear.</p><p><strong>Methods: </strong>We established an in vitro model of osteoporosis induced by D-galactose (D-gal) in MC3T3-E1 cells. Ferroptosis suppressor protein 1 (FSP1), activating transcription factor 4 (ATF4), and Y-box binding protein 1 (YBX1) knockdown MC3T3-E1 cells were generated, and their effects on ferroptosis were verified by measuring lipid reactive oxygen species levels and cellular Fe²⁺. Chromatin immunoprecipitation and luciferase assays were performed to confirm the binding of ATF4 to the FSP1 promoter. RNA pulldown and RNA immunoprecipitation experiments were used to determine the binding between YBX1 and ATF4 mRNA and to test the effect of YBX1 on ATF4 mRNA stability in a 5-methylcytosine (m⁵C)-dependent manner.</p><p><strong>Results: </strong>FSP1 or YBX1 knockdown led to a D-gal-induced increase in lipid reactive oxygen species levels and cellular Fe²⁺ in MC3T3-E1 cells, which was alleviated by ATF4 overexpression. ATF4 inhibits ferroptosis by binding to the FSP1 promoter. In addition, YBX1 increased ATF4 mRNA stability through m⁵C RNA modification and inhibited ferroptosis in MC3T3-E1 cells via the ATF4/FSP1 axis.</p><p><strong>Conclusion: </strong>Our results showed that YBX1 could alleviate ferroptosis via the ATF4/FSP1 axis in an m⁵C-dependent manner in D-gal-induced osteoblasts, suggesting that YBX1 may be a new target for osteoporosis treatment.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"685"},"PeriodicalIF":2.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927216","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":"Alone or in combination, hyaluronic acid and chondroitin sulfate alleviate ECM degradation in osteoarthritis by inhibiting the NF-κB pathway.","authors":"Yiran Ma, Xin Yang, Min Jiang, Wangjuan Ye, Hong Qin, Songwen Tan","doi":"10.1186/s13018-024-05411-6","DOIUrl":"10.1186/s13018-024-05411-6","url":null,"abstract":"<p><strong>Backgrounds: </strong>Osteoarthritis (OA) significantly impacts the elderly, leading to disability and decreased quality of life. While hyaluronic acid (HA) and chondroitin sulfate (CS) are recognized for their therapeutic potential in OA, their effects on extracellular matrix (ECM) degradation are not well understood. This study investigates the impact of HA and CS, individually and combined, on ECM degradation in OA and the underlying mechanisms.</p><p><strong>Methods: </strong>OA was modeled in rats through anterior cruciate ligament transection and in cells using IL-1β pretreatment. Treatments included HA and CS, alone or combined, with and without PMA (an NF-κB pathway activator). Cartilage tissue was analyzed using HE and Saffron O-fast green staining, with degradation assessed via the OARSI score. Inflammatory factors were measured by ELISA, and ECM-related proteins were detected by immunohistochemistry, immunofluorescence, and Western blotting. Chondrocyte viability was assessed using CCK8.</p><p><strong>Results: </strong>HA and CS treatments significantly reduced cartilage damage, decreased inflammatory factor release, alleviated ECM degradation, and inhibited NF-κB pathway activation compared to the OA group (P < 0.05). The combination of HA and CS further enhanced these therapeutic effects (P < 0.05). However, these benefits were reversed when PMA was introduced (P < 0.05).</p><p><strong>Conclusion: </strong>HA and CS, whether used alone or in combination, mitigate ECM degradation in osteoarthritis by inhibiting the NF-κB pathway, offering potential therapeutic benefits for OA management.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"11"},"PeriodicalIF":2.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927179","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":"Assessing the relationship between wrist synovitis and anxiety: a study using clinical statistics and Mendelian randomization analysis.","authors":"Xunhao Wang, Linyi Zhu, Jingyi Mi, Fei Xiong","doi":"10.1186/s13018-024-05432-1","DOIUrl":"10.1186/s13018-024-05432-1","url":null,"abstract":"<p><strong>Background: </strong>Wrist synovitis often leads to persistent pain, swelling, and limited mobility, causing significant functional impairment and psychological distress, including anxiety. Although arthroscopic synovectomy can alleviate physical symptoms, whether it also improves anxiety and the causal relationship between synovitis and anxiety remains unclear.</p><p><strong>Methods: </strong>A prospective study was conducted on 44 patients diagnosed with wrist synovitis who underwent arthroscopic synovectomy. Patients were assessed preoperatively and at 2 and 4 weeks postoperatively using the Visual Analog Scale (VAS), Mayo Wrist Score, and Self-Rating Anxiety Scale (SAS). MR analysis was employed to investigate the causal relationship between wrist synovitis and anxiety using genome-wide association studies (GWAS) summary data.</p><p><strong>Results: </strong>Significant reductions in SAS and VAS scores were observed at 2 and 4 weeks postoperatively, along with improvements in wrist function as measured by the Mayo Wrist Score. MR analysis did not find statistically significant evidence of a direct causal relationship between wrist synovitis and anxiety, though a positive trend suggests that wrist synovitis may be a risk factor for anxiety.</p><p><strong>Conclusions: </strong>Arthroscopic synovectomy may alleviate anxiety symptoms and may improve wrist function in patients with wrist synovitis. While a direct causal link between wrist synovitis and anxiety was not conclusively established, the observed associations highlight the need for integrated management of physical and psychological health in these patients. Trial registration This study was retrospectively registered with the WuXi 9th People's Hospital (WuXi Orthopaedics Hospital) Medical Ethical Committee on August 6, 2023, with reference number KS2023081.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"3"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927181","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":"Comparative finite element analysis: internal fixation plate versus intramedullary nail for neer type III-VI proximal humeral fractur.","authors":"Yan Shi, Junlin Zhou","doi":"10.1186/s13018-024-05418-z","DOIUrl":"10.1186/s13018-024-05418-z","url":null,"abstract":"<p><strong>Background: </strong>Finite element analysis (FEA) could advance the understanding of fracture fixation and guide the choice of surgical treatment. This study aimed to compare two internal fixation methods in the treatment of displaced proximal humeral fracture (PHF) through FEA.</p><p><strong>Methods: </strong>Three-dimensional FEA model based on the left shoulder joint of a 67-year-old female patient with PHFs and osteoporosis was adopted, in order to analyze the fixation effect and load stress distribution of internal fixation plates with open reduction and intramedullary nails without opening the fracture in the treatment of Neer III-VI PHF.</p><p><strong>Results: </strong>The displacement of the distal humerus with intramedullary nail fixation was more obvious than that of the distal humerus with bone plate fixation, and the resistance of intramedullary nail fixation was less than that of bone plate fixation under the same stress load. Maximum stress on the screw when adopting the intramedullary nail fixation was smaller than that when adopting the internal fixation with the internal fixation plates. The strain data indicate that the strain of both the fixation device and the bone when adopting the internal fixation with the intramedullary nails is less than that when adopting the internal fixation with the internal fixation plates.</p><p><strong>Conclusions: </strong>Biomechanical analysis demonstrated that for complex fracture types with osteoporosis intramedullary nail system without opening the fracture had better stress dispersion than internal fixation plates with open reduction, and the risk of failure of central fixation was lower.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"4"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927183","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":"Intelligent measurement of adolescent idiopathic scoliosis x-ray coronal imaging parameters based on VB-Net neural network: a retrospective analysis of 2092 cases.","authors":"Jinlong Liu, Haoran Zhang, Pei Dong, Danyang Su, Zhen Bai, Yuanbo Ma, Qiuju Miao, Shenyu Yang, Shuaikun Wang, Xiaopeng Yang","doi":"10.1186/s13018-024-05383-7","DOIUrl":"10.1186/s13018-024-05383-7","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity, and up to now, there has been no literature reporting the analysis of a large sample of X-ray imaging parameters based on artificial intelligence (AI) for it. This study is based on the accurate and rapid measurement of x-ray coronal imaging parameters in AIS patients by AI, to explore the differences and correlations, and to further investigate the risk factors in different groups, so as to provide a theoretical basis for the diagnosis and surgical treatment of AIS.</p><p><strong>Methods: </strong>Retrospective analysis of 3192 patients aged 8-18 years who had a full-length orthopantomogram of the spine and were diagnosed with AIS at the First Affiliated Hospital of Zhengzhou University from January 2019 to March 2024. After screened 2092 cases were finally included. The uAI DR scoliosis analysis system with multi-resolution VB-Net convolution network architecture was used to measure CA, CBD, CV, RSH, T1 Tilt, PT, LLD, SS, AVT, and TS parameters. The results were organized and analyzed by using R Studio 4.2.3 software.</p><p><strong>Results: </strong>The differences in CA, CBD, CV, RSH, TI tilt, PT, LLD and SS were statistically significant between male and female genders (p < 0.05); Differences in CA, CBD, T1 Tilt, PT, SS, AVT and TS were statistically significant in patients with AIS of different severity (p < 0.001), and T1 Tilt, AVT, TS were risk factors; Differences in CA, CBD, CV, RSH, T1 Tilt, PT, LLD, SS, AVT and TS were statistically significant (p < 0.05) in patients with AIS of different curve types, and TS was a risk factor; Analyzing the correlation between parameters revealed a highly linear correlation between CV and RSH (r = 0.826, p < 0.001), and a significant linear correlation between CBD and TS, and PT and SS (r = 0.561, p < 0.001; r = 0.637, p < 0.001).</p><p><strong>Conclusion: </strong>Measurements based on VB-Net neural network found that x-ray coronal imaging parameters varied among AIS patients with different curve types and severities. In clinical practice, it is recommended to consider the discrepancy in parameters to enable a more accurate diagnosis and a personalized treatment plan.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"9"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927118","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":"Imaging abnormalities of the acromioclavicular joint and subacromial space are common in asymptomatic shoulders: a systematic review.","authors":"Thomas Ibounig, Lasse Rämö, Romi Haas, Mark Jones, Teppo L N Järvinen, Simo Taimela, Sean Docking, Sharon Sanders, Rachelle Buchbinder","doi":"10.1186/s13018-024-05378-4","DOIUrl":"10.1186/s13018-024-05378-4","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of acromioclavicular (AC) joint and subacromial space imaging abnormalities in asymptomatic adults, with a secondary objective of comparing findings between asymptomatic and symptomatic shoulders within the same study populations.</p><p><strong>Methods: </strong>We conducted a systematic review of studies examining shoulder imaging abnormalities detected by X-ray, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in asymptomatic adults (PROSPERO registration CRD42018090041). This report focuses on AC joint and subacromial space abnormalities. Databases searched included Ovid MEDLINE, Embase, CINAHL and Web of Science from inception to June 2023. Our primary analysis used data from population-based studies, and risk of bias and certainty of evidence were evaluated with tools for prognostic studies.</p><p><strong>Results: </strong>Thirty-one studies (4 X-ray, 11 US, 15 MRI, 1 both X-ray and MRI) provided useable prevalence data. One study was population-based (20 shoulders), 16 included miscellaneous study populations (2436 shoulders) and 14 focused on athletes (708 shoulders). The certainty of evidence was very low mainly due to high risk of bias, imprecision, and indirectness across studies. Clinical diversity precluded pooling. Population-based prevalence of acromioclavicular osteoarthritis (AC OA) ranged from 85% on MRI to 95% on X-ray. In other study populations, AC OA prevalence in asymptomatic shoulders varied from 6 to 47% on X-ray, 1 to 65% on US, and 0 to 82% on MRI. Among eight studies that included both asymptomatic and symptomatic shoulders, AC OA prevalence ranged from 13 to 95% in asymptomatic shoulders and from 20 to 100% in symptomatic shoulders.</p><p><strong>Conclusion: </strong>The prevalence of AC joint and subacromial space abnormalities in asymptomatic shoulders is highly variable, and often comparable to that in symptomatic shoulders. Due to the low certainty of evidence and significant variation among study populations, further research is needed to clarify these prevalence estimates and to guide evidence-based management of shoulder abnormalities.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"7"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927196","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 role of the NOTCH1 signaling pathway in the maintenance of mesenchymal stem cell stemness and chondrocyte differentiation and its potential in the treatment of osteoarthritis.","authors":"Fuming Wu, Haiquan Yu","doi":"10.1186/s13018-024-05236-3","DOIUrl":"10.1186/s13018-024-05236-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the potential role of mesenchymal stem cells (MSCs) in the treatment of osteoarthritis (OA), particularly the function of the NOTCH1 signaling pathway in maintaining the stemness of MSCs and in chondrocyte differentiation.</p><p><strong>Methods: </strong>Utilizing diverse analytical techniques on an osteoarthritis dataset, we unveil distinct gene expression patterns and regulatory relationships, shedding light on potential mechanisms underlying the disease. Techniques used include the culture of MSCs, induction of differentiation into chondrocytes, establishment of stable cell lines, Western Blot, and immunofluorescence. Through the construction of lentiviruses overexpressing and knocking out NOTCH1, the effects of NOTCH1 on the stemness of MSCs and chondrocyte differentiation were investigated. Additionally, the effects of NOTCH1 on chondrocyte homeostasis and apoptosis were evaluated by adding the EZH2 inhibitor GSK126 and the endoplasmic reticulum stress inducer tunicamycin.</p><p><strong>Results: </strong>Experimental results demonstrated that NOTCH1 expression can influence the maintenance of MSC stemness and chondrocyte differentiation by regulating EZH2. Knockout of NOTCH1 decreased the expression of chondrocyte markers, while overexpression increased their expression. Under conditions of endoplasmic reticulum stress, NOTCH1 expression helped reduce the expression of stress-related proteins, maintain chondrocyte homeostasis, and inhibit apoptosis.</p><p><strong>Conclusion: </strong>The NOTCH1 signaling pathway plays a crucial role in maintaining the stemness of MSCs, differentiating into chondrocytes, and in the treatment of osteoarthritis. NOTCH1 influences the differentiation fate of MSCs and the homeostasis of chondrocytes by regulating EZH2 and other related genes, offering new targets and strategies for the treatment of diseases like osteoarthritis.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"772"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927289","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":"Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures.","authors":"Amr A Fadle, Ahmed A Khalifa, Peter Mamdouh Shehata, Wael El-Adly, Ahmed Ekram Osman","doi":"10.1186/s13018-024-05345-z","DOIUrl":"10.1186/s13018-024-05345-z","url":null,"abstract":"<p><strong>Aims: </strong>Which is the best extensile lateral (ELA) or sinus tarsi (STA) approach for osteosynthesis displaced intraarticular calcaneal fracture (DIACF) is still debatable. The current RCT's primary objective was to compare the complications incidence after open reduction and internal fixation of DIACFs through STA vs. ELA. The secondary objectives were the differences in intraoperative radiation exposure, time to fracture union, functional and radiological outcomes.</p><p><strong>Methods: </strong>Between August 2020 and February 2023, 157 patients with Sanders type II and III fractures were randomly assigned to either ELA (81 patients with 95 fractures) or STA (76 patients with 91 fractures). The primary outcome was the incidence of complications. The secondary outcomes were Böhler's and Gissane angles angle, fracture union, and American Orthopaedic Foot and Ankle Society (AOFAS) score.</p><p><strong>Results: </strong>No statistical differences between both groups regarding basic demographic data, injury characteristics, and fracture classification; however, patients in the STA group were operated upon significantly earlier (4.43 ± 7.37 vs. 7 ± 6.42 days, p = 0.001). STA's operative time was significantly shorter (55.83 ± 7.35 vs. 89.66 ± 7.12 min, p < 0.05), and no statistical difference regarding intraoperative radiation exposure. The time to fracture union was significantly shorter in STA (6.33 ± 0.8 vs. 7.13 ± 0.7 weeks, p = 0.000). Skin complications (superficial or deep infection) and Subtalar osteoarthritis were significantly higher in ELA (18.9% vs. 3.3%, p = 0.001) and (32.6% vs. 9.9%, p = 0.001), respectively. The radiological parameters were significantly better in STA postoperatively and at the last follow up. The AOFAS scores were significantly better in STA (83.49 ± 7.71 vs. 68.62 ± 7.05, respectively, p = 0.000).</p><p><strong>Conclusion: </strong>During osteosynthesis of Sanders type II and III DIACFs, STA is superior to ELA in terms of operating earlier, shorter operative time, fewer complications, and better radiological and functional outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"8"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927194","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}