Journal of Orthopaedic Surgery and Research最新文献

{"title":"Muscular profiles of adolescent female soccer players: a cross-sectional comparison of hamstring-to-quadriceps and vastus medialis-to-vastus lateralis characteristics.","authors":"Sonoka Ichikawa, Mikuri Tanaka, Rina Watabe, Ikumi Morikawa, Daigo Matsumoto, Kaede Mada, Ryota Akagi","doi":"10.1186/s13018-026-07063-0","DOIUrl":"10.1186/s13018-026-07063-0","url":null,"abstract":"<p><strong>Background: </strong>To characterize multifaceted muscular profiles potentially associated with knee joint sports injuries in adolescent female athletes, we compared hamstring-to-quadriceps (H:Q) ratios derived from isometric torque and isotonic power, as well as the relative muscle quality characteristics of the vastus medialis (VM) and vastus lateralis (VL), between adolescent female soccer players and recreationally active controls.</p><p><strong>Methods: </strong>In this cross-sectional study, 97 adolescent females (soccer: n = 62; control: n = 35) were categorized into older (≥ 162 months) and younger (< 162 months) cohorts. Assessments of both legs included isometric peak torque and isotonic peak power of the knee extensors and flexors using a dynamometer, along with ultrasound-derived muscle echo intensity and shear modulus of the VM and VL at rest. The H:Q ratios were calculated from both torque and power, whereas VM:VL ratios were derived from echo intensity and shear modulus to evaluate relative muscle quality characteristics.</p><p><strong>Results: </strong>The isometric H:Q ratio was significantly higher in the soccer group than in the control group (pooled across age groups and legs; soccer: 55.3% ± 9.8%; control: 51.0% ± 10.4%). However, no significant between-group differences were observed in the isotonic H:Q ratio (soccer: 86.3% ± 21.1%; control: 81.4% ± 27.9%) or in the VM:VL ratios for echo intensity (soccer: 91.0% ± 10.4%; control: 91.8% ± 7.2%) and shear modulus (soccer: 84.0% ± 22.8%; control: 83.9% ± 23.2%). Furthermore, the isometric H:Q ratio showed no significant effects for age or leg dominance, whereas the isotonic H:Q ratio was significantly higher in younger participants and in the non-dominant leg.</p><p><strong>Conclusions: </strong>These findings suggest that isometric and isotonic H:Q ratios capture distinct aspects of knee muscle function. Additionally, no significant differences were observed between elite soccer players and recreationally active peers in the isotonic H:Q ratio or ultrasound-derived VM:VL ratios, suggesting that highly trained adolescent female soccer players do not necessarily exhibit distinct dynamic power or resting muscle quality. These multifaceted muscular profiles may provide exploratory laboratory-based reference data, although longitudinal studies are needed to determine how these characteristics relate to actual injury incidence.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308393","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":"Differences between skeletally immature and mature patients in recurrent patellar dislocation: a radiological study.","authors":"Yi Hua, Hua Wang, Xu Yang","doi":"10.1186/s13018-026-07052-3","DOIUrl":"10.1186/s13018-026-07052-3","url":null,"abstract":"<p><strong>Objective: </strong>To compare radiological characteristics between skeletally immature and mature patients with recurrent patellar dislocation (RPD).</p><p><strong>Methods: </strong>A retrospective study was conducted involving 85 patients (106 knees) with RPD treated between January 2016 and September 2024. Patients were divided into skeletally immature and skeletally mature groups based on epiphysis closure. Patellar height was assessed using the Caton-Deschamps Index (CDI). Trochlear and patellar morphology were classified according to the Dejour and Wiberg classifications, respectively on computed tomography (CT). Additional CT measurements included tibial tubercle-trochlear groove (TT-TG) distance and patellar tilt angle (PTA). Lower-limb rotational alignment was evaluated in a subset of patients using tibial external rotation angle (TERA) and femoral anteversion angle (FAA) on full-length lower-limb CT.</p><p><strong>Results: </strong>The immature group comprised 24 patients (33 knees, mean age 13.5 ± 1.4 years), and the mature group 61 patients (73 knees, mean age 23.3 ± 6.0). Wiberg type III patellar dysplasia was significantly more prevalent in the mature group (71.2% vs.18.2%, P < 0.001). Type B trochlear dysplasia predominated in the immature group (51.5%), whereas type A was most common in the mature group (46.6%). Mean CDI was significantly higher in the immature group (1.5 ± 0.2 vs. 1.3 ± 0.2, P < 0.001), with patella alta being more frequent (84.8% vs. 60.3%, P = 0.012). PTA (31.3° vs. 27.1°, P = 0.043) and FAA (28.3 ± 9.8° vs. 21.1 ± 9.6°, P = 0.017) were significantly greater in the immature group.</p><p><strong>Conclusions: </strong>In patients with RPD, patella alta is more severe and prevalent in skeletally immature individuals. Immature patients also exhibit greater patellar tilt and increased femoral anteversion but less severe patellar dysplasia compared with skeletally mature adults.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308356","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":"C1 pedicle screw placement risks in patients with ponticulus posticus: a CTA retrospective simulation study.","authors":"Ping Wang, Han Meng, Lifeng Yu, Ruipeng Zhang, Xinyu Song, Tiantian She, Dan Wang, Yuehua Li","doi":"10.1186/s13018-026-07046-1","DOIUrl":"10.1186/s13018-026-07046-1","url":null,"abstract":"<p><strong>Background: </strong>Ponticulus posticus (POPO) may distort C1 surface landmarks for C1 pedicle screw (CPS) placement, raising concern for vertebral artery compromise (VAC). We aimed to establish a CTA-based workflow to identify POPO anatomies potentially suitable for CPS placement.</p><p><strong>Methods: </strong>This single-center retrospective CTA simulation study included 141 subjects: 46 bilateral POPO, 65 unilateral POPO, and 30 pure non-POPO patients. CPS trajectories were primarily simulated using PedicleScrewSimulator. D1 and D2 were analyzed as supra-arch and infra-arch localization variables. Ten morphometric parameters were measured; key safety metrics included D3 and D5. Simulated CPS feasibility and VAC were evaluated for 2.5-, 3.0-, 3.5-, and 4.0-mm screws. A side was considered geometrically feasible when D5 ≥ screw radius (r), D6/2 ≥ r, and D7/2 ≥ r. Simulated VAC was defined as violation of D5 or D7/2 clearance. Outcomes were analyzed using patient-clustered generalized estimating equations.</p><p><strong>Results: </strong>D1 and the D1-D2 shift differed markedly among groups (p < 0.001). D5 was smaller in bilateral POPO (2.93 ± 0.99 mm vs. 3.44 ± 1.14 mm vs. 3.81 ± 1.13 mm; p < 0.001). D3 did not differ significantly (p = 0.211). At 3.5 mm, overall simulated feasibility was 96.0%. Actual POPO sides showed 93.5% simulated feasibility and 6.5% simulated VAC, versus 99.2% and 0.8% in regular sides. In actual POPO sides, increasing diameter from 2.5 to 4.0 mm reduced simulated feasibility from 98.7% to 85.6% and increased VAC from 1.3% to 14.4%. The exploratory D3/D5 rule (D3 ≥ 3.4 mm and D5 ≥ 2.0 mm) achieved 88.4% sensitivity, 100% specificity, and 100% positive predictive value for avoiding simulated 3.5-mm VAC. Reliability for the four remeasured variables ranged from 0.702 to 0.799.</p><p><strong>Conclusions: </strong>CTA-based D3 and D5 thresholds can identify POPO anatomies potentially suitable for CPS placement, but simulation results reflect planning feasibility rather than validated operative safety. The D3 ≥ 3.4 mm and D5 ≥ 2.0 mm rule may serve as a conservative rule-in screening tool, pending clinical validation. POPO should not automatically preclude consideration of CPS but should trigger side-specific CTA analysis and conservative screw-diameter selection.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302247","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":"Which vertebral levels provide practical HU-based assessment for osteoporosis screening? A comparative analysis from T1 to S2.","authors":"Ze Zhou, Yan-Xiang Hou, Xin-Yu Dong, Jia-Qi Wang, Lu-Ping Zhou, Yu Chen, Pei-Lin Jin, Hua-Qing Zhang, Chong-Yu Jia, Liang Kang, Hui-Ya Ma, Cai-Liang Shen, Ren-Jie Zhang","doi":"10.1186/s13018-026-06952-8","DOIUrl":"10.1186/s13018-026-06952-8","url":null,"abstract":"<p><strong>Objective: </strong>To identify practical vertebral HU measurement strategies for opportunistic bone mineral density (BMD) screening using routine CT.</p><p><strong>Methods: </strong>Seven anatomical segmental combinations were defined: upper thoracic (T1-T4, UT), mid-thoracic (T5-T8, MT), lower thoracic (T9-T12, LT), thoracolumbar (T11-L2, TL), upper lumbar (L1-L2, UL), lower lumbar (L3-L5, LL), and sacral (S1-S2, SA). Correlations between HU and DEXA-derived T-score were analyzed for both single vertebrae and multi-segment combinations, using the full-segment average (T1-S2, TS) as reference. Stepwise linear regression across 19 vertebrae generated an exploratory combination (EC) model. ROC analysis and age-sex subgroup analyses were performed.</p><p><strong>Results: </strong>A total of 300 patients were enrolled (150 males, 150 females; mean age 54.94 ± 14.39 years). Both single- and multi-segment measurements correlated positively with T-score. TS showed the strongest correlation (r = 0.799) and highest predictive performance (AUC = 0.914). Among single vertebrae, T5 showed the strongest correlation (r = 0.785). Among anatomical combinations, TL showed one of the strongest correlations (r = 0.787) and favorable predictive performance (AUC = 0.912). Subgroup analyses showed stable TL performance across sex groups, whereas the strongest correlation and predictive performance were observed in the 51-60-year age subgroup.</p><p><strong>Conclusion: </strong>Both single- and multi-segment HU measurements were effective for BMD assessment. The TL segment represents a practical HU-based assessment approach for opportunistic osteoporosis screening on routine CT, with stable predictive performance and practical clinical value.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308411","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":"Optimizing instrument selection during core decompression for osteonecrosis of the femoral head: a 3D analysis.","authors":"Reza Bergemann, Ryan Mullan, Alexandra Massey, Steven Tommasini, Daniel Wiznia","doi":"10.1186/s13018-026-07057-y","DOIUrl":"10.1186/s13018-026-07057-y","url":null,"abstract":"<p><strong>Background: </strong>Core decompression is the leading surgical treatment for pre-collapse osteonecrosis of the femoral head (ONFH). There are many different instruments that are used during core decompression, ranging from drill bits to expandable reamers, yet there is limited guidance regarding how to select the appropriate instrument for an individual patient's unique anatomy. We sought to examine how lesion characteristics affect instrument performance. To quantitatively compare instruments' efficacy at removing necrotic bone while preserving healthy bone, we developed an in-silico metric called the resection fraction, defined as the volume of necrotic bone resected divided by the total volume of bone (healthy and necrotic) resected. We hypothesize the optimal instrument will vary with lesion size and type (ARCO 2021).</p><p><strong>Methods: </strong>CT-based 3D models of 100 femurs with ONFH were created from a retrospective database of patients who underwent 3D guided computer navigated core decompression at our institution. Using these models, core decompression procedures were simulated with six different instruments. 3D volumetric analysis was used to determine the volumes of necrotic and healthy bone resected, and the resection fraction was calculated. Statistical analysis was performed to compare instrument performance across all lesions, as well as by lesion size and type.</p><p><strong>Results: </strong>A total of 100 hips from 75 unique patients with ONFH were modeled and each hip's core decompression procedure was simulated with six different instruments. All three expandable reamers had higher resection fractions compared to straight instruments (drill bits). For small volume lesions, the small expandable reamer had the highest resection fractions. The medium expandable reamer had the highest resection fractions for larger lesions. The large expandable reamer had lower resection fractions across all sizes.</p><p><strong>Conclusions: </strong>Compared to straight instruments, expandable reamers had the highest resection fractions. To maximize resection fraction, surgeons should personalize instrument choice to patient anatomy; small expandable reamers should be used for smaller lesions, while medium-sized reamers should be used for larger lesions. The largest expandable reamer performed worse than either the small or medium reamer for almost all lesions. Further work is needed to validate the in-silico resection fraction metric with clinical outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel classification system based on the lateral view of 3D-CT for predicting the reducibility of intertrochanteric fractures: a retrospective study.","authors":"Shiyun Qian, Yong Zhu, Kaihu Li, Zhangyuan Lin, Haitao Long, Ruibo Zhao, Buhua Sun, Shushan Zhao, Liang Cheng","doi":"10.1186/s13018-026-07044-3","DOIUrl":"10.1186/s13018-026-07044-3","url":null,"abstract":"<p><strong>Objective: </strong>Current classifications for intertrochanteric fractures poorly predict the difficulty of achieving closed reduction. This study aimed to develop and validate a novel classification system based on the lateral view of three-dimensional computed tomography (3D-CT) to preoperatively assess reducibility.</p><p><strong>Methods: </strong>We retrospectively reviewed 609 patients with intertrochanteric fractures. After screening, 318 cases (117 AO/OTA 31-A1 and 201 AO/OTA 31-A2) were included. Based on preoperative 3D-CT, fracture morphology was categorized as flexed, neutral, or extended types. The intraoperative outcome of closed reduction was used to define fractures as reducible or irreducible.</p><p><strong>Results: </strong>Among the 318 fractures, 174 (54.7%) were reducible and 144 (45.3%) were irreducible. The reducible group included 105 flexed, 21 neutral, and 48 extended types. The irreducible group comprised 90 flexed-type and 54 extended-type fractures. Irreducible flexed-type and extended-type fractures were further subdivided into 3 distinct subtypes each, based on characteristic radiological features.</p><p><strong>Conclusion: </strong>The proposed classification system, which integrates the AO/OTA framework with 3D-CT morphology, effectively identifies fractures at high risk for irreducible closed reduction. This system can help surgeons avoid futile reduction attempts and guide the choice of an appropriate reduction strategy.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302119","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":"Total hip replacement after gunshot hip injuries: a severity-based clinical framework-a single-centre experience.","authors":"Mohamed Abo-Elsoud, Mostafa Ahmed Shawky, Mahmoud Fahmy","doi":"10.1186/s13018-026-07037-2","DOIUrl":"10.1186/s13018-026-07037-2","url":null,"abstract":"<p><strong>Purpose: </strong>Gunshot hip injuries present major reconstructive challenges due to contamination, retained projectiles, soft-tissue compromise, and variable bone loss. Total hip replacement (THR) in this setting carries increased risks of infection, instability, and technical failure. This study evaluated the clinical and radiological outcomes of THR following gunshot hip trauma using a structured, severity-based subclassification to inform reconstructive strategy.</p><p><strong>Methods: </strong>Thirty patients with gunshot hip injuries underwent surgical debridement followed by THR, performed as single-stage or staged procedures according to injury severity, contamination, and systemic condition. Injuries were categorized into three groups: structurally benign injuries; severe or neglected injuries with major bone or soft-tissue compromise; and complex abdominopelvic traversing injuries with visceral involvement. Reconstruction predominantly used cementless acetabular components, with selective use of long femoral stems, revision cups, dual-mobility designs, and bone grafts or porous metal augments. Clinical outcomes were assessed using the Harris Hip Score (HHS) and WOMAC index, and radiological evaluation focused on component stability and graft incorporation.</p><p><strong>Results: </strong>A total of 30 patients were included: 11 in Group I (structurally benign injuries), 10 in Group II (severe or neglected injuries), and 9 in Group III (complex abdominopelvic traversing injuries). At a mean follow-up of 46 ± 10 (24-72) months, the mean Harris Hip Score (HHS) was 84 ± 10 and the mean WOMAC score was 19 ± 7. Operative complexity and blood loss increased with injury severity. Two-stage THR was required in 27% of Group I, 60% of Group II, and 100% of Group III. Radiographs demonstrated stable component fixation in all hips, with complete graft or augment incorporation within 6-12 months. Postoperative complications occurred in five patients, predominantly in higher-severity groups. Functional outcomes were inversely related to injury severity.</p><p><strong>Conclusions: </strong>THR after gunshot hip injury achieved satisfactory mid-term functional and radiological outcomes in this single-center cohort. Staged reconstruction and advanced implant strategies appear beneficial in managing complex and contaminated injuries. These findings are descriptive and intended to inform clinical decision-making; further studies are required for external validation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13307706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301718","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":"Double mini-locking plates for unstable Danis-Weber B distal fibular fractures: superior functional outcomes and lower implant removal rates.","authors":"Xiao Wang, Fei Xiao, Zhongsheng Wei, Yongchang Chen, Haibo Xu, Lin Wei, Guoqing Zheng","doi":"10.1186/s13018-026-07034-5","DOIUrl":"10.1186/s13018-026-07034-5","url":null,"abstract":"<p><strong>Background: </strong>Unstable Danis-Weber B distal fibular fractures require anatomical reduction. However, conventional lateral locking plates (LLP) are frequently associated with soft-tissue irritation, high implant removal rates, and limitations in rotational stability. This study aimed to evaluate whether a low-profile double mini-locking plates (DMLP) provides superior clinical outcomes compared to LLP.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 120 patients with unstable Danis-Weber B fractures treated between 2016 and 2020. Patients were divided into DMLP and LLP groups according to the fixation method employed. Associated posterior and medial malleolar fractures were treated as needed. Outcome measures included time to radiographic union, AOFAS ankle-hindfoot scores, complications, and implant removal rates over 36 months.</p><p><strong>Results: </strong>The DMLP group achieved significantly faster radiographic union than the LLP group (12.35 vs. 13.48 weeks, p = 0.032). Functionally, patients treated with DMLP demonstrated significantly higher AOFAS ankle-hindfoot scores from 3 months post-operatively through the final follow-up (p < 0.05). Although the DMLP technique required a longer operative time (p < 0.001), the overall complication rate was significantly lower (5.0% vs. 15.0%, p = 0.049). Notably, implant removal was performed significantly less frequently in the DMLP group (41.7%) than in the LLP group (65.0%) (p = 0.009).</p><p><strong>Conclusions: </strong>DMLP showed accelerated union and superior functional recovery compared to LLP. Although the operative time was longer, the technique appeared to be associated with fewer soft-tissue complications and a lower rate of secondary implant removal. DMLP may serve as a viable alternative for unstable fractures, though prospective studies are needed to confirm these findings.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301530","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":"Platelet-rich plasma facilitates earlier functional recovery and return to sport in traumatic meniscal repair: a retrospective cohort study.","authors":"Tian Lei, Yujia Zou, Yan Zhao, Qin Guo, Shangqing Zhang, Zhaopu Jing, Jidong Song, Bocheng Xiang, Wenlong Qiao, Haiping Zhao, Lihong Fan","doi":"10.1186/s13018-026-07008-7","DOIUrl":"10.1186/s13018-026-07008-7","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical efficacy of arthroscopic repair combined with platelet-rich plasma (PRP) injection for traumatic meniscal tears.</p><p><strong>Methods: </strong>A retrospective cohort study included patients who underwent arthroscopic repair for traumatic meniscal tears between January 2023 and August 2024. Clinical outcomes were evaluated preoperatively and at 6 and 12 months postoperatively using the International Knee Documentation Committee (IKDC) score, Tegner activity scale (Tegner scale), and visual analogue scale (VAS). MRI healing rate, return to sport (RTS) outcomes, and postoperative satisfaction were evaluated. Subgroup analyses were conducted for patients with preoperative bone marrow edema (BME).</p><p><strong>Results: </strong>A total of 96 patients were included (48 per group), with comparable baseline characteristics. At 6 months, the PRP group demonstrated significantly greater improvements in IKDC score, Tegner scale and VAS than the surgery-alone group (p < 0.001, p = 0.036, and p < 0.001, respectively), with differences exceeding the minimal clinically important differences (MCIDs). MRI healing rate was higher in the PRP group (p = 0.014). By 12 months, improvements in IKDC score and VAS remained superior in the PRP group though differences no longer exceeded MCIDs. Tegner scale and MRI healing rates were comparable (p = 0.265 and 0.088, respectively). The PRP group achieved superior RTS outcomes. Satisfaction (≥ satisfied) was high in both groups (95.8% vs. 89.6%). In the PRP group, postoperative IKDC scores did not differ significantly between patients with and without BME, whereas in the surgery-alone group, scores were significantly lower in those with BME.</p><p><strong>Conclusions: </strong>PRP augmentation for traumatic meniscal repair may provide clinically improvements at 6 months postoperatively, including better IKDC score, Tegner scale, and VAS, a higher meniscal healing rate, and facilitate earlier RTS. However, these benefits diminished by 12 months, with functional differences falling below the MCID and no sustained difference in healing rate. Patients with preoperative BME may derive greater functional benefit from adjunctive PRP treatment.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301611","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":"Outcomes of cannulated screw fixation for nondisplaced femoral neck fractures in patients older than 80 years: a retrospective cohort study.","authors":"Sara Wahab-Zuriarrain, Angelica Millan-Billi, Javier Arenas-Romera, Mireia Gómez-Masdeu, Ion Carrera, Álvaro Toro-Aguilera, Julio De Caso-Rodríguez","doi":"10.1186/s13018-026-07025-6","DOIUrl":"10.1186/s13018-026-07025-6","url":null,"abstract":"<p><strong>Background: </strong>The optimal management of nondisplaced femoral neck fractures in very elderly patients remains controversial. Although hip arthroplasty is frequently advocated, internal fixation with cannulated screws may represent a less invasive alternative in carefully selected patients.</p><p><strong>Methods: </strong>A retrospective single-centre cohort study was conducted including patients aged 80 years or older with nondisplaced femoral neck fractures treated with cannulated screw fixation between 2010 and 2019. Primary outcomes were fixation failure and conversion to hip arthroplasty. Secondary outcomes included reoperation rate, radiographic fracture collapse, ambulatory status, weight-bearing protocol, and radiographic measurements related to screw positioning.</p><p><strong>Results: </strong>A total of 170 patients were included, with a mean age of 86.9 years. Fixation failure occurred in 17 patients (10%). Reoperation for any cause was required in 15 patients (8.8%), and conversion to hip hemiarthroplasty was performed in 6 patients (3.5%). Radiographic fracture collapse was observed in 46 patients (30%), although only 7 patients (15.2%) required reoperation. Immediate full weight-bearing was not associated with increased fixation failure or fracture collapse and was associated with improved ambulatory status at 6 months. Greater femoral head occupancy on lateral radiographs was associated with fracture collapse, whereas tip-apex distance was not.</p><p><strong>Conclusions: </strong>In carefully selected patients older than 80 years with nondisplaced femoral neck fractures, cannulated screw fixation was associated with low rates of fixation failure and conversion to hip arthroplasty. Immediate full weight-bearing did not increase complication rates and was associated with improved early mobility, supporting a less invasive treatment strategy in this super-aged population.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295506","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}