Journal of Orthopaedic Surgery and Research最新文献

{"title":"Analyses of proximal adjacent segment degeneration and prognostic factors after lumbar fusion surgery: study based on proximal facet joint angle.","authors":"Feng Qin, Weiqiang Fan, Lili Ren, Qi Chen, Xiaoxiao Chen, Wenjun Liu","doi":"10.1186/s13018-025-05835-8","DOIUrl":"https://doi.org/10.1186/s13018-025-05835-8","url":null,"abstract":"<p><strong>Objective: </strong>Lumbar fusion surgery is a common procedure for treating various degenerative spinal conditions. However, the incidence of proximal adjacent segment degeneration (PASD) remains a concern. This study aimed to investigate the effect of proximal facet joint angle (FJA) on PASD and then identify factors that influence prognosis after lumbar fusion surgery.</p><p><strong>Methods: </strong>In this retrospective study, the cases of 192 patients who underwent lumbar fusion surgery between January 2020 and June 2022 were analysed. Patients were classified in accordance with their baseline proximal FJA into the high (≥ 40°) and low (< 40°) FJA groups. Prognosis was evaluated during the last follow-up by using clinical, imaging and functional recovery criteria. PASD was assessed using Weishaupt criteria, and imaging parameters were measured on postoperative computed tomography (CT) reconstructions. Statistical analyses, including univariate and multivariate logistic regression, were performed to identify prognostic factors. Receiver operating characteristic (ROC) curves were used to assess predictive value.</p><p><strong>Results: </strong>The high FJA group exhibited significantly higher rates of PASD compared with the low FJA group (P < 0.001). No significant differences were observed in sex, age, body mass index (BMI) or follow-up duration between the two groups. Poor prognosis was associated with higher BMI, larger FJA and wider facet joint diameter. Logistic regression analysis identified BMI (odds ratio [OR] = 1.801, P = 0.001), FJA (OR = 6.320, P < 0.001) and facet joint sagittal (OR = 1.888, P < 0.001) and coronal (OR = 1.462, P < 0.001) diameters as independent predictors of poor prognosis. A smaller screw inclination angle was associated with better outcomes (OR = 0.907, P = 0.017). Joint ROC analysis underscored the significant predictive power of these factors (area under the curve = 0.881).</p><p><strong>Conclusion: </strong>This study demonstrates that a larger proximal FJA is associated with increased PASD. It also identifies several prognostic factors that influence outcomes after lumbar fusion surgery. Patients with higher BMI, larger FJA and wider sagittal and coronal diameters are at increased risk for poor prognosis. These findings highlight the importance of comprehensive preoperative assessments to optimise surgical planning and improve outcomes in lumbar fusion surgery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"446"},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996883","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":"Ejiao as a preventive agent for osteoporosis - a scoping review of current evidence.","authors":"Yuanzhong Wang, Guiju Chen, Xia Ji, Sok Kuan Wong, Sophia Ogechi Ekeuku, Kok-Yong Chin","doi":"10.1186/s13018-025-05759-3","DOIUrl":"https://doi.org/10.1186/s13018-025-05759-3","url":null,"abstract":"<p><p>Ejiao, a traditional Chinese medicinal product derived from donkey's hide, has long been used to promote blood formation and treat various ailments. Recently, growing pharmacological evidence has suggested that Ejiao and its formulations may also possess bone-protecting properties, making it a potential candidate for preventing and treating osteoporosis. This scoping review aims to summarise the current scientific evidence on the anti-osteoporosis potential of Ejiao and its formulations in osteoporosis prevention. A comprehensive literature search was conducted using PubMed, Web of Science, Scopus, and China National Knowledge Infrastructure up to October 2024. Primary studies published in English or Mandarin, regardless of study design, that investigated the effects of Ejiao on bone in vivo or bone cells in vitro were included. A total of 22 studies were included, comprising five studies on Ejiao alone and 17 studies on Ejiao-based formulations. The findings indicated that Ejiao alone enhanced osteoblast differentiation by increasing alkaline phosphatase synthesis and reducing bone remodelling markers in ovariectomised rats. However, its direct effect on bone mineralisation and density remains uncertain due to the absence of an exogenous mineral source. In contrast, Ejiao-based formulations, such as calcium-Ejiao oral liquid and Donkey-hide glue reinforcing bone oral solution, demonstrated more pronounced bone-protective effects, including improving bone density, enhancing bone repair, and supporting vitamin D metabolism in both animal models and clinical studies. These findings suggest that while Ejiao alone may promote osteoblast activity, its role in osteoporosis management may be more effective when combined with essential minerals. Further long-term studies and human clinical trials are needed to clarify its therapeutic potential and underlying molecular mechanisms.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"445"},"PeriodicalIF":2.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014387","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":"Focusing on spinal stenosis: emerging discoveries concerning Alendronate-induced risks and genetic drug targets.","authors":"Nan Yang, Jingkai Di, Xiang Han, Wei Zhang, Xinliang Cui, Haoyu Feng","doi":"10.1186/s13018-025-05854-5","DOIUrl":"https://doi.org/10.1186/s13018-025-05854-5","url":null,"abstract":"<p><strong>Background: </strong>Spinal stenosis is a common disease in clinical practice, and drug use is one of its potential predisposing factors. Alendronate, a widely used clinical drug for osteoporosis treatment, has the potential to trigger spinal stenosis. Based on the real world, this study aims to deeply investigate the association between spinal stenosis and alendronate, and to explore novel drug targets against spinal stenosis at the genetic level.</p><p><strong>Methods: </strong>Alendronate patient data from the FDA Adverse Event Reporting System (FAERS) from Q1 2004 to Q4 2024 were included in the study, and four pharmacovigilance analytic methods and Bonferroni corrected P-values were applied to the baseline data, and subgroups of data were analyzed. Complementarily, Weibull distribution were applied to further parse the data. Meanwhile, in order to explore therapeutic targets against spinal stenosis, Mendelian randomization analyses were carried out based on eQTLGen consortium data as well as genome-wide association study (GWAS) data from two large independent cohorts. Subsequently, the medicinal value of the identified drug targets was verified by drug prediction and molecular docking techniques.</p><p><strong>Results: </strong>Pharmacovigilance analysis showed a strong positive signal between alendronate and spinal stenosis, especially in females and older patients. Fourteen significant drug targets were identified. Their medicinal value was verified by drug prediction and molecular docking, obtaining four protein-drug docking model structures.</p><p><strong>Conclusions: </strong>This study reveals an alendronate-spinal stenosis association, offering insights for clinical prevention. It also identifies new genetic drug targets, opening new treatment pathways for spinal stenosis.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"444"},"PeriodicalIF":2.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998929","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":"Obacunone acts as a histone deacetylase 1 inhibitor to limit p38MAPK signaling and alleviate osteoarthritis progression.","authors":"Yong Gao, Ke Wang, Chao Shi, Yang Gao, De-Qian Kong","doi":"10.1186/s13018-025-05804-1","DOIUrl":"https://doi.org/10.1186/s13018-025-05804-1","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is an age-related progressive degenerative disorder characterized by cartilage extracellular matrix degradation and inflammation. In this study, we explored the function and mechanism of action of obacunone (OB) in inhibiting OA progression.</p><p><strong>Methods: </strong>The degradation of articular cartilage and its severity were examined using Safranin O-fast green and hematoxylin and eosin (HE) staining. Chondrocyte survival was evaluated using a cell counting kit-8 assay. In addition, qRT-PCR, western blot analysis, immunohistochemical staining, and enzyme-linked immunosorbent assay were performed to evaluate the effects of OB on cartilage injury.</p><p><strong>Results: </strong>OB mitigated cartilage lesions in rats with anterior cruciate ligament transaction-induced OA. The protein expression of collagen II was increased and the protein expression of ADAM metallopeptidase with thrombospondin type 1 motif 5 (ADAMTS-5), matrix metalloproteinase (MMP)-13, and RUNX family transcription factor 2 (RUNX2) was reduced in the articular cartilage of OB-treated rats. Moreover, OB exhibited anti-inflammatory activities by reducing the serum levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-1β, and IL-18. In IL-1β-stimulated primary chondrocytes, OB dose-dependently elevated the expression of collagen II, and decreased the expression of ADAMTS-5, MMP-13, RUNX2 and inflammatory cytokines. Histone deacetylase 1 (HDAC1) was identified as a predicted OB target. OB inhibited HDAC1 expression to limit the activation of p38MAPK signaling. The transfection of chondrocytes with HDAC1 or p38MAPK overexpression plasmids reversed the chondroprotective effects of OB.</p><p><strong>Conclusion: </strong>OB mitigated OA progression by binding to HDAC1 and inhibiting p38MAPK signaling, indicating that OB may be a promising drug for the treatment of OA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"441"},"PeriodicalIF":2.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014951","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":"\"Anatomic patella design versus medialized dome design in the modern posterior stabilized (ATTUNE) total knee arthroplasty: a systematic review and meta-analysis\".","authors":"Sina Hajiaghajani, Omid Bahrami, Mohammadhossein Hefzosseheh, Maryam Alaei, Amir Mehrvar, Mohammad Poursalehian","doi":"10.1186/s13018-025-05858-1","DOIUrl":"https://doi.org/10.1186/s13018-025-05858-1","url":null,"abstract":"<p><strong>Background: </strong>Patellar component design in total knee arthroplasty (TKA) can influence patellofemoral kinematics and clinical outcomes. The medialized dome design (MDD) aligns the patella apex more medially, while the anatomic patella design (APD) aims to replicate the native patella's shape and tracking. Although biomechanical studies suggest potential benefits of APD, clinical evidence remains inconclusive.</p><p><strong>Methods: </strong>A systematic review and meta-analysis following PRISMA guidelines was conducted to compare the clinical outcomes of MDD and APD in a modern posterior-stabilized TKA (ATTUNE system). We searched PubMed, Scopus, Embase, and Web of Science on January 10, 2025, without language or date restrictions. Eligible studies included randomized controlled trials (RCTs) and comparative cohort designs evaluating patient-reported outcome measures (PROMs), revisions, complications, range of motion (ROM), and radiologic measures of patellar stability. Risk of bias was assessed using RoB-2 for RCTs and ROBINS-I for cohort studies. Pooled effect sizes were calculated using Hedges's g and random-effects modeling.</p><p><strong>Results: </strong>Seven studies, including three RCTs and four cohort studies, with a total of 1,069 patients and 1,113 knees (507 APD vs. 606 MDD), were included. The meta-analysis demonstrated no significant difference in PROMs (Hedges's g = 0.09; 95% CI [-0.04 to 0.22]; P = 0.17) or ROM (Hedges's g = 0.02; 95% CI [-0.21 to 0.26]; P = 0.83) between APD and MDD. While revision rates and complications were higher for APD, the differences were not statistically significant compared to MDD (14 vs 9). Radiographic measures showed inconsistencies and did not definitively favor either design.</p><p><strong>Conclusions: </strong>Current evidence suggests that APD offers no clear clinical advantage over MDD in the ATTUNE posterior-stabilized TKA. Both designs yield broadly comparable PROMs and knee function outcomes. Larger RCTs with extended follow-up are warranted to clarify the safety of APD.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"442"},"PeriodicalIF":2.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019004","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":"Omeprazole exacerbates intervertebral disc degeneration through Caspase-3 mediated apoptosis of nucleus pulposus cells: a Mendelian randomization, network toxicology, and in vitro experimental study.","authors":"Yuchao Jia, Haifan Zhao, Shengbo Huang, Baoshan Xu","doi":"10.1186/s13018-025-05863-4","DOIUrl":"https://doi.org/10.1186/s13018-025-05863-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the causal correlation and toxicological mechanisms of omeprazole in intervertebral disc degeneration (IVDD), alongside a particular emphasis on Caspase-3 (CASP3) mediated apoptosis of nucleus pulposus cells (NPCs).</p><p><strong>Methods: </strong>Mendelian randomization (MR): GWAS data was employed to assess causal associations between proton pump inhibitors (PPIs) and IVDD. Network toxicology: Shared omeprazole-IVDD targets were identified using STRING, SwissTargetPrediction, and GeneCards databases. Functional enrichment analysis: Biological pathways were explored by employing Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Molecular docking: Omeprazole-CASP3 binding affinity was assessed by employing AutoDock Vina. Experimental validation: Rat NPCs were subjected to CCK-8 assay viability, flow cytometry apoptosis, Western blot, and immunofluorescence.</p><p><strong>Results: </strong>MR analysis suggested omeprazole substantially augmented IVDD risk (OR = 1.058, 95% CI = 1.004-1.115, P = 0.034), with no association observed for esomeprazole or lansoprazole. Network toxicology identified 11 overlapping targets, with CASP3 as the hub gene. Molecular docking revealed strong omeprazole-CASP3 binding (free energy: - 6.725 kcal/mol) via hydrogen bonds, π-π stacking, and π-S interactions. Enrichment analysis highlighted the response to reactive oxygen species, caveolae, endopeptidase activity, and IL-17 signaling pathway as key pathways. As revealed by in vitro experiments, omeprazole dose-dependently lessened NPCs viability (300 µM) and heightened apoptosis (28.99% apoptosis rate). Western blot showed significant upregulation of Cleaved-CASP3/pro-CASP3 ratios (P < 0.001), and immunofluorescence demonstrated CASP3 nuclear translocation in omeprazole-treated NPCs.</p><p><strong>Conclusions: </strong>This study found that taking omeprazole may exacerbate IVDD, and its potential mechanism is through CASP3 leading to apoptosis of NPCs. These findings advocate cautious long-term omeprazole use in clinical practice and suggest alternative PPIs.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"443"},"PeriodicalIF":2.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012446","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":"Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis.","authors":"Yashar Khani, Ali Salmani, Mohammad Elahi, Iman Elahi Vahed, Elias Sadooghi Rad, Alireza Bahrami Samani, Shaghayegh Karami, Mohammad Nouroozi, Amir Mehrvar","doi":"10.1186/s13018-025-05847-4","DOIUrl":"https://doi.org/10.1186/s13018-025-05847-4","url":null,"abstract":"<p><strong>Purpose: </strong>Osteoarthritis (OA) affects weight-bearing joints, such as hips and knees, and its prevalence is rising due to factors like obesity and aging. Muscle atrophy, exacerbated by aging and surgery, increases the risk of joint instability and falls. Orthopedic surgeons explore dietary interventions to counteract these effects, with protein supplementation (PS) showing promise. This systematic review and meta-analysis assessed the effectiveness of PS in arthroplasty patients, comparing findings with sports medicine and sarcopenia literature.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus, and Embase (February 2025) for protein and amino acid supplementation studies in total knee or hip arthroplasty (TKA and THA) patients. The quality assessment used the Cochrane risk of bias and the Newcastle-Ottawa Scale. Meta-analysis calculated effect sizes for muscle atrophy and strength outcomes.</p><p><strong>Results: </strong>Nineteen studies (903 patients) evaluated oral or intravenous protein/amino acid supplementation over a mean follow-up of 55.2 days. Essential amino acids (EAA) significantly reduced muscle atrophy in quadriceps femoris muscle mass (SMD: 0.69; 95% CI: 0.44 to 0.95) and hamstring muscle mass (SMD: 1.04; 95% CI: 0.52 to 1.55). However, effects on intramuscular adipose tissue (IMAT) and muscle thickness (MT) were inconsistent. Muscle strength outcomes varied, with no significant effect on quadriceps muscle strength (QMS) or handgrip strength (HGS). Intravenous amino acid infusion improved muscle protein synthesis and reduced perioperative blood loss.</p><p><strong>Conclusions: </strong>Protein and amino acid supplementation can reduce muscle atrophy in hip or knee arthroplasty patients. While effects on muscle strength and function are mixed, intravenous supplementation offers benefits. Further standardized research is needed to confirm these findings.</p><p><strong>Trial registration: </strong>PROSPERO registration code (CRD42024555899).</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"439"},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997940","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":"Simulation and analysis of non-navigational errors in robot-assisted pedicle Kirschner wire placement surgery.","authors":"Yongkang Yang, Yishi Jia, Chang Liu, Liang Li, Boyao Wang","doi":"10.1186/s13018-025-05790-4","DOIUrl":"https://doi.org/10.1186/s13018-025-05790-4","url":null,"abstract":"<p><strong>Background: </strong>Surgical errors of orthopedics robotic are influenced by a multitude of factors. This study aims to investigate the impact of non-navigational errors on the accuracy of pedicle screw placement in orthopedic surgery.</p><p><strong>Methods: </strong>Initially, a robot-assisted Kirschner wire (K-wire) placement simulation system was constructed, comprising a universal arm, wide-angle cameras, microscope cameras, and a vertebral base. Utilizing this system, we conducted a systematic analysis of the effects of four factors on non-navigational errors: operator habits, guide-to-bone surface distance, robotic arm stiffness, and vertebral fixation stiffness.We investigated two distinct operator habits: Habit 1 involves first positioning the K-wire against the bone surface through the guide and then inserting it using a bone drill; Habit 2 involves clamping the K-wire onto the bone drill and then inserting it together. Based on the control variable method, we designed precision measurement experiments for K-wire placement under different factors, forming 26 variable combinations to investigate the K-wire placement errors under each factor and their proportions in the overall error.</p><p><strong>Results: </strong>A total of 933 K-wire placements were performed in this study. The average deviation under Habit 2 conditions was 0.51 mm, compared to 0.13 mm under Habit 1 conditions; the average deviation was 0.36 mm when the guide-to-bone surface distance was 5 cm, and 0.28 mm when the distance was 1 cm; the average deviation was 0.36 mm under the 600 mm robotic arm condition, and 0.24 mm under the 500 mm robotic arm condition; the average deviation was 0.37 mm in the Plaster-Fixed Vertebra Group, and 0.85 mm in the Silicone-Fixed Vertebra Group.</p><p><strong>Conclusions: </strong>Operator habits and vertebral fixation stiffness are the primary factors influencing non-navigational errors, while guide-to-bone surface distance and robotic arm stiffness are secondary factors. This study recommends adopting Habit 1 in clinical surgeries, minimizing the guide-to-bone surface distance, and enhancing the stiffness of the robotic arm and vertebral fixation to reduce non-navigational errors and improve the accuracy of robot-assisted pedicle screw placement.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"440"},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004467","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":"Enhanced rehabilitation for unstable pelvic tile C fractures: integrating mechanotherapy and early intervention.","authors":"Khan Akhtar Ali, LingXiao He, Weikai Zhang, Chengyan Xia, Hui Huang, Hui Huang Emails","doi":"10.1186/s13018-025-05833-w","DOIUrl":"https://doi.org/10.1186/s13018-025-05833-w","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to enhance the rehabilitation process for patients with unstable pelvic Tile C fractures resulting from polytrauma by integrating mechanotherapy using the Hocoma Lokomat robotic device with conventional rehabilitation methods. The goal was to improve functional recovery outcomes and minimize pain levels following surgical intervention.</p><p><strong>Methods: </strong>A total of 74 participants, aged 21 to 65 years, with severe unstable pelvic Tile C fractures were enrolled at Tongji Hospital's Department of Rehabilitation from 2022 to 2024. They were randomly divided into two groups: Group A (34 patients) received comprehensive rehabilitation including mechanotherapy with the Hocoma Lokomat, while Group B (40 patients) underwent only conventional therapeutic exercises. Functional outcomes were assessed using the Majeed pelvic score, and pain were monitored over time.</p><p><strong>Results: </strong>Group A demonstrated significantly better pelvic function scores compared to Group B throughout the rehabilitation period(91.53 ± 4.10vs. 88.17 ± 5.15). Additionally, at the six-month follow-up, Group A showed superior pain control benefits attributed to mechanotherapy(2.09 ± 1.10vs2.29 ± 1.12).</p><p><strong>Conclusion: </strong>Integrating the Hocoma Lokomat into rehab for unstable pelvic Tile C fractures improves function and pain control versus conventional care. The study supports robotic-assisted therapy's benefits for polytrauma patients, advocating innovative rehab approaches.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"438"},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029847","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":"Targeted anterior expansion of the cervical facet joints achieves indirect foraminal decompression and reduces spondylolisthesis via a posterior approach: a cadaveric study.","authors":"Amro Al-Habib, Sami AlEissa, Ayman Al-Jazaeri","doi":"10.1186/s13018-025-05851-8","DOIUrl":"https://doi.org/10.1186/s13018-025-05851-8","url":null,"abstract":"<p><strong>Background: </strong>In this cadaveric study, we aimed to assess the effects of distraction at the anterior end of the cervical facet joints (CFJ), achieved via a posterior cervical approach (PCA), on intervertebral neural foraminal height (IVFH) and segmental alignment. A novel cervical expandable facet implant (CeLFI) was used to facilitate anterior expansion within the CFJ.</p><p><strong>Methods: </strong>This study was conducted in three time periods (2018, 2019, and 2024). The CeLFI was primarily placed at the CSPL levels or at the non-fused C3-7 levels if no CSPL was present. Pre- and post-implantation outcomes were assessed using cervical spine radiography and computed tomography (CT) scan. Changes in facet joint space (FJS) height, IVFH, interspinous distance (ISD), intervertebral disc height (IVDH), and cervical alignment were assessed.</p><p><strong>Results: </strong>CeLFI insertion (n = 12) resulted in an increase in the mean IVFH (+ 1.5 mm left; + 2 mm right, both p < 0.001), FJS height (+ 2.41 mm left; 2.53 mm right, both p < 0.001), ISD (+ 2.83 mm, p = 0.003), and posterior IVDH (+ 1.16 mm p = 0.001). In the cadavers with CSPL (n = 9), a segmental reduction was observed, which remained stable in flexion-extension radiographs. Two cadavers also showed unbuckling of the posterior interspinous ligaments on post-insertion CT. No significant changes in overall cervical alignment were observed after CeLFI insertion.</p><p><strong>Conclusions: </strong>Indirect cervical intervertebral foraminal decompression and reduction of cervical segmental spondylolisthesis were achieved via a PCA with targeted distraction at the anterior end of the CFJ. This novel concept is promising but requires further clinical studies to evaluate its benefit for patients with degenerative cervical spine disease.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"437"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021798","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}