Journal of Orthopaedic Surgery and Research最新文献

{"title":"Exenatide, a glucagon-like peptide-1 receptor agonist, may negatively impact bone healing in rats: histopathological, biochemical, and in silico findings.","authors":"Fatih Ugur, Ibrahim Yilmaz, Ersin Guner, Mehmet Albayrak, Recep Taskin, Nurtac Sarikas, Mehmet Akif Bildirici, Ayse Basak Dellalbasi, Candemir Ozcan","doi":"10.1186/s13018-025-06300-2","DOIUrl":"https://doi.org/10.1186/s13018-025-06300-2","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the effects of exenatide (EXE), a glucagon-like peptide-1 (GLP-1) receptor agonist, on bone healing in rats using a single radius cortical defect model and histopathological, biochemical, and in silico methods.</p><p><strong>Methods: </strong>Forty-two male Sprague-Dawley rats, excluding controls, were divided into 7 groups after receiving a standard radius defect. The serum levels of total protein (TP), calcium (Ca²⁺), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (OC), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each specimen were measured. Radius samples were examined histopathologically using hematoxylin and eosin (H&E) and Masson's trichrome staining. Molecular docking analyses were used to assess EXE interactions with the GLP-1 receptor and osteogenic transcription factors. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Changes in the selected serum markers were observed in the blood samples obtained from the specimens; however, these changes may not have been due to EXE administration. No significant negative effect on bone healing was observed in the groups that received subcutaneous EXE after the bone defect was created. By contrast, it was observed that for the treatment group that received EXE for 7 consecutive days before the bone defect was created on Day 7, bone healing progressed more slowly than in the groups treated with saline. Regarding the binding of EXE to the other target receptors, root mean square deviation (RMSD) values were low, bruised surface area (BSA) was high, and electrostatic interactions were strong, indicating that the ligand (i.e., EXE) binds to the selected receptor surfaces.</p><p><strong>Conclusion: </strong>Although the data obtained from the in vitro analyses in this study were verified using molecular docking, it should be noted that its design is preclinical. Given the widespread clinical use of GLP-1 receptor agonists in the management of type 2 diabetes mellitus (T2DM), our research findings may have translational relevance. Although derived from an experimental animal model, these results suggest that GLP-1 agonists such as EXE can exert additional effects on bone healing and inflammatory processes, thus warranting further studies, including controlled clinical investigations, to elucidate the potential implications for patient care.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"883"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251325","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":"Roles of TGF-β in the therapeutic potential of hypoxic mesenchymal stem cells for treating osteoarthritis in a Rabbit model.","authors":"En-Rung Chiang, Kun-Hui Chen, Hsuan-Hsiao Ma, Jung-Pan Wang, Hsiao-Li Ma","doi":"10.1186/s13018-025-06184-2","DOIUrl":"https://doi.org/10.1186/s13018-025-06184-2","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is the most prevalent musculoskeletal disease worldwide. Cell-based therapies have emerged as a promising approach for OA therapy. The therapeutic potential of mesenchymal stem cells (MSCs) has been demonstrated in a wide array of inflammatory diseases. A previous study demonstrated that the injection of the allogeneic MSCs cultured under hypoxia could reduce the progression of osteoarthritis in an anterior cruciate ligament transection (ACLT) model of OA in rabbits. The possible factors involved in the therapeutic effect of hypoxic MSCs in OA were further analyzed in the current study.</p><p><strong>Methods: </strong>Using the ACLT model of OA, we investigated gene expression changes in the groups of control, OA, and OA treated by hyaluronic acid (OA + HA), and additionally injected with hypoxic MSCs (OA + HA + MSC) by PCR array.</p><p><strong>Results: </strong>Increased expression of TGF-β in the group treated with hypoxic MSCs was observed. Significant higher transcript and protein expressions of TGF-β were also demonstrated in cartilage treated with hypoxic MSCs. We further generated TGF-β-knockout (KO) MSCs and observed notably reduced levels of TGF-β in cartilage treated with hypoxic TGF-β KO MSCs. Immunohistochemical analysis revealed that the group treated with TGF-β KO MSCs exhibited significantly decreased type II collagen (COL II) and increased type X collagen (COL X) as compared to that treated with MSCs without TGF-β-KO.</p><p><strong>Conclusions: </strong>Collectively, we suggest hypoxic MSCs might exert therapeutic effects mediated by stimulating TGF-β and subsequently promote and inhibit the expressions of COL II and COL X respectively.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"880"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251374","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":"Non-linear association between surgical duration and length of hospital stay in primary unilateral total knee arthroplasty: a secondary analysis based on a retrospective cohort study in Singapore.","authors":"Jianxiang Zhu, Zengbing Xia, Jikang Min, Wenlin Hu, Heng Li, Chao Mei","doi":"10.1186/s13018-025-06267-0","DOIUrl":"https://doi.org/10.1186/s13018-025-06267-0","url":null,"abstract":"<p><strong>Background: </strong>The relationship between surgical duration and length of hospital stay (LOS) in total knee arthroplasty (TKA) remains incompletely understood. We investigated the potential associations and modulating factors influencing LOS.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed 2,394 patients undergoing primary unilateral total knee arthroplasty at Singapore General Hospital (2013-2014). Surgical duration served as the primary exposure, with LOS as the principal outcome. We employed multivariable linear regression models, including piecewise linear regression, to elucidate the relationship between surgical duration and LOS.</p><p><strong>Results: </strong>A significant non-linear association emerged between surgical duration and LOS. A critical inflection point was identified at 115 min, beyond which LOS increased substantially (adjusted β = 0.047, 95% CI: 0.018-0.076, P = 0.0015). Stratified analyses revealed nuanced effect modifications by anemia status and American Society of Anesthesiologists Physical Status (ASA-PS) scores. Patients with moderate-to-severe anemia and higher ASA-PS scores demonstrated markedly different response patterns, with more pronounced increases in hospitalization duration.</p><p><strong>Conclusion: </strong>Our findings demonstrate a complex, non-linear relationship between surgical duration and LOS in TKA. Anemia status and physiological reserve significantly modulate this association, suggesting the need for personalized perioperative management strategies. These insights may optimize surgical planning and resource allocation in orthopedic interventions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"876"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251306","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":"Combined effects of low temperature, hyperosmolarity and seawater-conditioned pathogens on open fracture healing in a rat model simulating circumpolar environments.","authors":"Shuo Sun, Hui Wang, Bin Han, Hongri Wu, Yangkai Wang, Tianming Xu","doi":"10.1186/s13018-025-06062-x","DOIUrl":"https://doi.org/10.1186/s13018-025-06062-x","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the factors influencing the healing of open fractures in circumpolar latitude region seawater immersion conditions.</p><p><strong>Materials and methods: </strong>A femoral fracture model was established in ninety 6-to-8-week-old male Sprague-Dawley rats, randomly assigned to five groups (n = 18 per group): (1) fracture only, (2) fracture with circumpolar seawater immersion, (3) fracture with low-temperature isotonic solution immersion, (4) fracture with aseptic circumpolar seawater immersion, and (5) fracture with low-temperature aseptic circumpolar seawater immersion. Fractures were confirmed postoperatively by radiographs on days 7, 21, and 42. Micro-CT and H&E staining were performed on day 42 to assess bone healing. Bacterial cultures from internal fixation devices were analyzed on day 3. Blood samples were collected on days 3, 7, and 14 to assess leukocyte and neutrophil counts, and serum ALP and VEGF levels were measured on days 7, 14, and 21. Pathogenic microorganisms in the seawater were identified by metagenomic analysis. Fracture healing and callus formation rates were compared using the Log-rank test.</p><p><strong>Results: </strong>X-ray, micro-CT, and histological analyses revealed significantly impaired fracture healing in the group exposed to circumpolar seawater immersion compared to the fracture-only group (P < 0.05). Bacterial colony counts on internal fixation devices were highest in the circumpolar seawater group (P < 0.05). Leukocyte and neutrophil levels were significantly elevated in this group on days 3 and 7 (P < 0.05), with no significant differences observed on day 14 (P > 0.05). Serum ALP and VEGF levels were significantly reduced on days 7, 14, and 21 (P < 0.05), although ALP levels on day 21 showed no significant difference (P > 0.05). Log-rank analysis indicated that the bone union and callus maturation rates were significantly lower in the circumpolar seawater group compared to the other four groups. Metagenomic analysis identified Flavobacterium, Rhodobacter, and Bacteroides as the dominant pathogens in circumpolar seawater.</p><p><strong>Conclusions: </strong>This study demonstrates that hyperosmolarity, low temperature, and exposure to opportunistic pathogens under circumpolar seawater conditions collectively delay open fracture healing. Among these factors, opportunistic pathogens exert the most significant impact, highlighting microbial contamination as the primary barrier to bone regeneration in such environments and providing direction for future therapeutic strategies.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"875"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251600","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":"Arthroscopic suture-bridge repair of small and medium supraspinatus tears: a simplified Lassoloop technique with single medial and knotless lateral anchors.","authors":"Songlin Liu, Liang Ma","doi":"10.1186/s13018-025-06274-1","DOIUrl":"https://doi.org/10.1186/s13018-025-06274-1","url":null,"abstract":"<p><strong>Background: </strong>The transition in arthroscopic rotator cuff repair from single-row to double-row techniques has highlighted the efficacy of the suture-bridge configuration in providing enhanced biomechanical stability and coverage of the footprint. However, traditional methods often require multiple anchors and complex knot-tying procedures, resulting in prolonged surgical duration and increased costs. This study evaluated a customized suture-bridge approach incorporating a Simplified LassoLoop Suture, utilizing a single medial row anchor and a knotless lateral row anchor, to treat small to medium-sized rotator cuff tears.</p><p><strong>Methods: </strong>A retrospective review was conducted on 132 patients who received treatment at Jingzhou Hospital, Affiliated with Yangtze University, between June 2021 and June 2022. All patients underwent arthroscopic repair utilizing the specified technique. Clinical outcomes were evaluated preoperatively and at the final follow-up using the Visual Analogue Scale (VAS), University of California at Los Angeles (UCLA) shoulder rating scale, and Constant-Murley score.</p><p><strong>Results: </strong>The arthroscopic repair was conducted on 132 patients with small to medium Rotator cuff tears using simplified lassoloop suture technology. The procedure involved a single medium-row suture anchor and knotless lateral Row anchor for suture bridge fixation. Patients were followed up for 12-30 months (mean 23.9 ± 1.75 months) with no observed complications such as joint infection, anchor failure, or Rotator cuff re-tear. All surgical incisions healed without complications. Postoperative pain, assessed by the VAS score, decreased significantly from 7.6 ± 0.5 points preoperatively to 1.1 ± 0.3 points. Functional outcomes, evaluated using the UCLA shoulder rating score, improved considerably from 11.4 ± 1.0 before surgery to 33.0 ± 0.7 postoperatively. The constant-Murley score also significantly increased from 56.4 ± 2.4 before surgery to 94.9 ± 1.1 after surgery. Postoperative range of motion significantly improved compared to preoperative levels (p < 0.05).</p><p><strong>Conclusions: </strong>The Simplified LassoLoop Suture Technique simplifies rotator cuff repair and yielded favorable short-term clinical outcomes for small-to-medium supraspinatus tears while maintaining a streamlined surgical workflow. Although the construct is conceptually intended to capture some features associated with dual-row fixation, our study did not test biomechanical performance, operative time, or cost; these hypotheses warrant validation in comparative and biomechanical studies.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"879"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251695","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 'leaky pipeline' in orthopaedic surgery: why female trainees drop out?","authors":"Ahmad Furqan Anjum, Muhammad Burhan Anjum, Rahmeen Nauman, Raza Ur Rehman Rana","doi":"10.1186/s13018-025-05919-5","DOIUrl":"https://doi.org/10.1186/s13018-025-05919-5","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedic surgery remains one of the least gender-diverse medical specialties, with women making up a small fraction of practicing surgeons despite increasing female enrolment in medical schools. The \"leaky pipeline\" phenomenon describes the progressive loss of female trainees due to systemic barriers such as implicit bias, workplace discrimination, inequitable surgical training opportunities, and inadequate work-life balance policies. Understanding the factors contributing to female trainee attrition is essential for fostering gender equity in orthopaedic surgery.</p><p><strong>Main body: </strong>Female orthopaedic trainees face unique challenges, including stereotypes that question their physical capability, limited access to mentorship and sponsorship, and an unsupportive workplace culture. Many report experiencing discrimination, microaggressions, and exclusion from leadership pathways. Additionally, disparities in surgical case assignments limit skill development and career advancement, further discouraging retention. Work-life balance remains a major concern, as rigid training schedules and insufficient parental leave policies force many female trainees to reconsider their career paths. These systemic barriers contribute to higher attrition rates and hinder efforts to diversify the orthopaedic workforce. To address these issues, institutions must implement targeted reforms. Formal mentorship and sponsorship programs can support female trainees in securing leadership roles and competitive fellowships. Equitable case distribution policies are necessary to ensure fair training opportunities. Institutional commitment to creating inclusive environments through bias training and zero-tolerance policies for discrimination can help improve retention. Additionally, introducing family-friendly policies, such as flexible scheduling and structured parental leave, can make orthopaedic surgery a more viable career choice for women. Early outreach initiatives should also be expanded to encourage female interest in the specialty.</p><p><strong>Conclusion: </strong>Gender disparities in orthopaedic surgery persist due to longstanding systemic challenges. Without targeted interventions, the leaky pipeline will continue to exclude talented female surgeons, limiting diversity, innovation, and patient care. Institutional commitment to mentorship, equitable training opportunities, and supportive workplace policies is essential for retaining female trainees and achieving gender equity in orthopaedics. Addressing these barriers will ensure that success in the field is determined by skill and dedication rather than gender.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"881"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251336","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 surgical team's amputation approaches in orthopaedic traumas following the Great Kahramanmaraş Earthquake.","authors":"Gül Özlem Yildirim, Bektaş Sari, Gülseren Keskin","doi":"10.1186/s13018-025-05767-3","DOIUrl":"https://doi.org/10.1186/s13018-025-05767-3","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to explore and document the surgical team's experiences with amputations in orthopaedic trauma cases following the Great Kahramanmaraş Earthquake.</p><p><strong>Methods: </strong>This research utilized a phenomenological approach to explore the meaning of experiences related to amputation surgery after the earthquake. Twelve orthopaedic surgeons and surgical nurses were selected through purposive sampling. After obtaining ethical approval (Report No: 23-12T/22), data collection commenced on January 6, 2024. Data were collected via 424-minute semi-structured interviews, each lasting 22 to 63 min, and analyzed using MAXQDA software.</p><p><strong>Results: </strong>Elective procedures were cancelled at two remote trauma centres, and patients were evacuated to free up hospital wards. Surgical shifts were organized, and a dedicated communication channel was established via WhatsApp. Triage was performed in the operating room, focusing on pediatric cases. Common cases included lower extremity fractures, with fasciotomy as the typical procedure. The surgical team noted the importance of extending the amputation indication period to save extremities and give patients a chance. The team experienced symptoms such as sorrow, exhaustion, and moments of crying.</p><p><strong>Conclusion: </strong>Orthopaedic surgeons and nurses play a crucial role in earthquake-related surgical procedures. After the Great Kahramanmaraş Earthquake, they volunteered for extended hours beyond their scheduled shifts, deriving moral satisfaction from their efforts. While amputation is complicated and often unwanted, it can be necessary to save lives, resulting in profound emotional experiences such as sadness and fatigue for surgeons and nurses. Mandatory training for all healthcare professionals on earthquake injuries is recommended.</p><p><strong>Reporting method: </strong>Adhered to the COREQ checklist.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"878"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251385","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":"Biomechanical analysis of biodegradable magnesium, zinc, and polylactide pins for fixation of radial head fractures.","authors":"Julian P Maier, Jonas Eck, Benjamin Erdle, Nils Mühlenfeld, Michael Seidenstuecker, Kilian Reising, Hagen Schmal, Ferdinand C Wagner","doi":"10.1186/s13018-025-06346-2","DOIUrl":"https://doi.org/10.1186/s13018-025-06346-2","url":null,"abstract":"<p><strong>Background: </strong>Biodegradable implants have raised constant interest for fixation of displaced radial head fractures due to avoiding implant removal and minimizing cartilage damage. Polylactide pins (PP) are frequently used in clinical practice, but inferior mechanical properties showed higher rates of secondary dislocation compared to metal implants. Magnesium pins (MP) provide superior stability but exhibit inconsistent resorption and relevant hydrogen gas formation. Recently, zinc pins (ZP) have emerged as a promising alternative, offering comparable mechanical strength with favourable biocompatibility. Since these implants have not been tested for specific fracture fixation, this study aims to evaluate their applicability in a validated Mason type II radial head fracture model.</p><p><strong>Methods: </strong>Standardized Mason type II fractures were conducted in biomechanically validated composite radii, and fixed by using either two 2.0 mm MPs, ZPs, or PPs. Biomechanical testing included 10 cycles of transverse loading, 1,000 cycles of axial loading (15-50 N at 0.1 Hz), and load-to-failure testing (2 N/sec). Stability was assessed by stiffness (kN/mm) under axial and transverse loading, fracture displacement (mm) after 1,000 cycles, and failure load (N) at dislocation ≥ 2 mm.</p><p><strong>Results: </strong>MPs demonstrated the highest primary stability, followed by ZPs and PPs under both transverse (PP: 0.36 ± 0.08 kN/mm vs. MP: 1.30 ± 0.31 kN/mm, p < .001; vs. ZP: 0.87 ± 0.33 kN/mm, p = .012) and axial loading (PP: 0.43 ± 0.10 kN/mm vs. MP: 1.25 ± 0.31 kN/mm, p < .001; vs. ZP: 0.77 ± 0.18 kN/mm, p = .035). Fracture displacement after 1,000 cycles was lower with MPs and ZPs than PPs (PP: 0.038 ± 0.009 mm vs. MP: 0.013 ± 0.003 mm, p < .001; vs. ZP: 0.022 ± 0.007 mm, p = .003). MPs (282 ± 26 N) showed the highest load-to-failure at 2 mm dislocation, followed by ZPs (261 ± 38 N) and PPs (215 ± 53 N) (PP vs. MP: p = .032; PP vs. ZP: p = .164; MP vs. ZP p = .650).</p><p><strong>Conclusion: </strong>In this biomechanical model of Mason type II radial head fractures, biodegradable magnesium and zinc pins demonstrated superior primary stability and load-bearing capacity compared to polylactide implants. MP showed the highest stiffness and lowest fracture displacement, while ZP achieved comparable performance in fracture stabilization. These findings suggest that zinc-based implants could offer a clinically valuable alternative for radial head fracture fixation, potentially reducing complications seen with the other implants. Further in-vivo, cadaveric, and clinical studies are necessary to confirm long-term outcomes and biological integration.</p><p><strong>Level of evidence: </strong>Basic Science Study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"870"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251615","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 new technique for severe hallux valgus: mid-shaft chevron osteotomy with spear plate fixation - a retrospective case series.","authors":"Kuan-Jung Chen, Chien-Yuan Wang, Chao-Ching Chiang, Chien-Shun Wang, Chien-Hua Chen, Tzu-Cheng Yang","doi":"10.1186/s13018-025-06273-2","DOIUrl":"https://doi.org/10.1186/s13018-025-06273-2","url":null,"abstract":"<p><strong>Background: </strong>Severe hallux valgus deformity with hallux valgus angle (HVA) greater than 40° presents significant challenges in surgical management. The metatarsal mid-shaft chevron osteotomy (MSCO) with spear plate fixation represents a novel approach for addressing these complex deformities. This study aimed to evaluate its clinical and radiographic outcomes in patients with severe hallux valgus.</p><p><strong>Methods: </strong>This retrospective case series evaluated 54 patients (64 feet) who underwent MSCO with spear plate fixation for severe hallux valgus between January 2023 and March 2024. Inclusion criteria included symptomatic hallux valgus with preoperative HVA greater than 40°, skeletal maturity, and minimum 12-month follow-up. Clinical outcomes were assessed using visual analog scale pain scores (VAS) and American Orthopedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale. Radiographic parameters included HVA, intermetatarsal angle (IMA), and tibial sesamoid position. Osteotomy healing was defined as observed bridging of callus from the two segments.</p><p><strong>Results: </strong>The cohort included 46 females and 8 males with mean age of 50.0 years. Mean osteotomy healing time was 3.1 months. HVA improved significantly from 44.1° preoperatively to 7.5° at final follow-up (p < 0.01). IMA decreased from 17.7° to 2.8° (p < 0.01). Tibial sesamoid position showed significant improvement (p = 0.02). VAS pain scores decreased from 5.4 to 0.8 (p < 0.01), and AOFAS-MTP-IP scores improved from 28.0 to 81.6 points (p < 0.01). Five complications (7.8%) occurred: one osteoarthritis, one hallux varus, and three hallux valgus recurrences.</p><p><strong>Conclusions: </strong>MSCO with spear plate fixation demonstrates excellent clinical and radiographic outcomes for severe hallux valgus deformity, with significant improvements in deformity correction, pain relief, and functional scores, accompanied by low complication rates and reliable bone healing.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"874"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251671","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":"Association of different pain patterns with physical function in participants with knee osteoarthritis: data from the osteoarthritis initiative.","authors":"Shilin Li, Gege Li, Jihua Zou, Ze Gong, Zijun He, Yijin Zhao, Tao Fan, Weichao Fan, Zhuodong Zhang, Manxu Zheng, Guozhi Huang, Qing Zeng","doi":"10.1186/s13018-025-06146-8","DOIUrl":"https://doi.org/10.1186/s13018-025-06146-8","url":null,"abstract":"<p><strong>Background: </strong>Pain is a multidimensional experience and a key symptoms of knee osteoarthritis (KOA). However, it remains unknown whether there is a specific pain pattern that is more strongly associated with physical function compared to other pain patterns among individuals with KOA. This study aimed to compare the correlations between different pain patterns and physical function, and identify the most related pain pattern with physical function in KOA.</p><p><strong>Methods: </strong>412 participants with radiological KOA were included from the Osteoarthritis Initiative (OAI). Pain severity and four pain patterns were assessed, including intermittent, constant, weight-bearing, and non-weight-bearing pain patterns. Physical function was evaluated by the Western Ontario and McMaster Universities Arthritis Index physical function subscale (WOMAC-PF), Knee Injury and Osteoarthritis Outcome Score Function in Sport and Recreation (KOOS-FSR), 20-Meter Walking Test (20-MWT) and Repeated Chair Stand test (RCS).</p><p><strong>Results: </strong>Among pain severity and all pain patterns, the weight-bearing pain pattern had the strongest correlation with WOMAC-PF, and showed significant correlations with both WOMAC-PF and KOOS-FSR at baseline, year-2 follow up, and 2-year change (p < 0.001). All pain patterns and pain severity showed weakly significant correlation with 20-MWT and RCS.</p><p><strong>Conclusions: </strong>Weight-bearing pain pattern was most closely associated with self-reported physical function. Therapeutic targets related to weight-bearing pain should be preferred when administering analgesic therapies to improve physical function in KOA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"877"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251612","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}