Journal of Orthopaedic Surgery and Research最新文献

{"title":"Effects of pain neuroscience education combined with blood flow restriction training on chronic postoperative pain following total knee arthroplasty: a randomized controlled trial protocol.","authors":"Jipeng Xu, Peijie Sun, Jingfeng Yang, Yani Zhu, Yuanpeng Liao","doi":"10.1186/s13018-026-07146-y","DOIUrl":"10.1186/s13018-026-07146-y","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic postsurgical pain (CPSP) remains a major clinical challenge following total knee arthroplasty (TKA), with psychological maladaptation and persistent neuromuscular dysfunction considered key contributors to ongoing pain and disability. Pain neuroscience education (PNE) may improve maladaptive pain cognitions, whereas blood flow restriction training (BFRT) can enhance muscle function and induce exercise-related hypoalgesia. Although both interventions have shown potential benefits in chronic pain rehabilitation, no randomized controlled trial has investigated the combined efficacy of these two interventions in patients with CPSP after TKA. This study aims to determine whether combined PNE + BFRT produces greater improvements in pain and function in this population.</p><p><strong>Methods and analysis: </strong>This study is a single-blind, four-arm, parallel-group randomized controlled trial. A total of 148 participants will be randomly assigned (1:1:1:1) to the Control, PNE, BFRT, or combined PNE + BFRT group. PNE will be delivered in two structured sessions. BFRT involves a 12-week supervised low-load resistance training program. The primary outcome is the group-by-time interaction effect on KOOS₄ over time. Secondary outcomes include pain intensity (NRS), global perceived effect, pain distribution, psychological measures (HADS, PCS), physical performance (40-m fast-paced walk test, stair climb test, and 30-s chair stand test), and neuromuscular strength. Assessments will be conducted at baseline, post-intervention (12 weeks), and at 12-week, 24-week, and 36-week follow-ups. Data will be analyzed using linear mixed-effects models under the intention-to-treat principle.</p><p><strong>Ethics and dissemination: </strong>Ethics approval has been obtained from the Ethics Committee of the Chengdu Sport University, with permission number CDSUEC2026- 177. This study has been registered with the Chinese Clinical Trial Registry (ChiCTR2600125544). Written informed consent will be obtained from all participants prior to enrollment.</p><p><strong>Trial registration number: </strong>Chinese Clinical Trial Registry ChiCTR2600125544, registered on May 28, 2026.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025191","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":"Correction: circ_0044235 exacerbates neuroinflammation and apoptosis following spinal cord injury by targeting miR-338-5p.","authors":"Mianlong Lin, Lina Huang, Bin Zhang, Yue Wang, Xingyu Zhu, Wencong Zeng","doi":"10.1186/s13018-026-07193-5","DOIUrl":"https://doi.org/10.1186/s13018-026-07193-5","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794465","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":"Correction: Clinical and radiographic outcomes of double-triangle locking compression plate (DT-LCP) versus T-shaped locking compression plate (T-LCP) in medial open-wedge high tibial osteotomy: a follow-up study of over 5 years.","authors":"Yu Jiang, Xiaodong Jia, Haifeng Li, Huiying Zhou, Cui Wang, Liang Zhang, Tianrui Wang, Xia Zhao, Ning Yu, Yingze Zhang, Kuishuai Xu, Jinli Chen","doi":"10.1186/s13018-026-07139-x","DOIUrl":"10.1186/s13018-026-07139-x","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706904","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":"Severe medial tibial plateau fractures: feasibility and functional and radiographic results of an extended approach with medial femoral epicondyle osteotomy.","authors":"Hannah Gablac, Christian Arras, Peter Behrendt, Hendrik Fahlbusch, Clemens Galavics, Michael Hoffmann, Karl-Heinz Frosch, Matthias Krause","doi":"10.1186/s13018-026-07100-y","DOIUrl":"10.1186/s13018-026-07100-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the clinical and radiological outcomes of tibial plateau fractures involving the medial plateau by comparing an extended medial approach with medial femoral epicondyle osteotomy (med ECO) to a conventional approach without epicondyle osteotomy (non-ECO).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at two level one trauma-centers. All fractures of the medial tibial plateau (OA/OTA Type B or C) treated with med ECO were classified according to the AO/OTA and 10-segment classification using pre-operative CT scans. A comparative cohort study was performed against non-ECO patients based on age, sex, body mass index (BMI), injury mechanism, and fracture patterns. The quality of fracture reduction was determined by post-operative CT scans. Functional outcomes and postoperative complications were assessed over a minimum follow-up of 2 years.</p><p><strong>Results: </strong>Twenty-nine patients (mean age: 50.2 ± 10.2 years, mean follow-up 71.65 ± 18.9 months) were analyzed. Both groups consisted of patients with severe tibial plateau fractures, knee dislocations, high-velocity trauma and polytrauma and concomitant injuries requiring an average hospital stay of 24.9 ± 12.4 days. Radiological outcomes showed a medial fracture step > 2 mm in 10 cases (med ECO n = 5, non-ECO n = 5) and a gap > 5 mm in 8 cases (med ECO n = 3, non-ECO n = 5). The mean radiological Rasmussen score was 13.8 ± 2.8 (med ECO 14.1 ± 2.8 vs. non-ECO 13.4 ± 3.0, p > 0.05). The mean Knee Injury and Osteoarthritis Outcome Score (KOOS) was 60.4 ± 16.9 (med ECO 61.3 ± 12.7 vs. non-ECO 59.5 + 16.2, p > 0.05) and the International Knee Documentation Committee score (IKDC score) was 56.6 ± 16.9 (med ECO 58.8 ± 19.0 vs. non-ECO 52.6 ± 14.4, p > 0.05).</p><p><strong>Conclusion: </strong>Both med ECO and non-ECO demonstrated good radiological results. No significant differences were observed in clinical and radiological outcomes during follow-up. However, severe medial tibial plateau fractures are devastating knee injuries, being a challenge to the functional outcome of patients due to multiple concomitant injuries. Thus, medial epicondyle osteotomy should be reserved for specific fractures, considering the added morbidity and invasiveness associated with the procedure.</p><p><strong>Level of evidence: </strong>Retrospective Cohort Study, Level of Evidence = III.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697664","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":"Genotype-dependent miR-499/SOX5 axis regulation and its association with chronic low back pain risk and severity.","authors":"Haixia Feng, Rui Dong, Tingting Liu, Xu Yang, Boyu Song, Zhili Zhang","doi":"10.1186/s13018-026-07138-y","DOIUrl":"10.1186/s13018-026-07138-y","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of chronic low back pain (CLBP) is complex and intricately linked to genetic predisposition. This study aimed to investigate the association between the microRNA-499 (miR-499) rs3746444 genetic polymorphism and CLBP, as well as to elucidate the underlying molecular mechanisms.</p><p><strong>Methods: </strong>A total of 180 patients with CLBP and 180 healthy controls were enrolled in this study. Genotyping of the rs3746444 locus was performed using the TaqMan probe method. The expression of miR-499 and SRY-related HMG-box 5 (SOX5) was quantified by reverse transcription quantitative polymerase chain reaction (RT‑qPCR). RNA immunoprecipitation (RIP) and dual-luciferase reporter gene assays were employed to validate the targeting relationship between miR-499 and SOX5.</p><p><strong>Results: </strong>Genetic model analysis showed that the TC/CC genotypes and the C allele of miR-499 rs3746444 were associated with increased CLBP risk, with a clear genotype‑dose effect. In CLBP patients, miR-499 was upregulated while SOX5 was downregulated. The two molecules were negatively correlated, and SOX5 was validated as a direct target of miR-499. Genotype stratification revealed that the rs3746444 polymorphism was associated with pathology‑dependent regulation of the miR-499/SOX5 axis: mutant genotypes (TC/CC) correlated with miR-499 upregulation and SOX5 downregulation only in CLBP patients, not in healthy controls. Adjusted multivariate logistic regression identified rs3746444 as an independent CLBP risk factor (TC: OR = 1.636, P = 0.037; CC: OR = 3.457, P = 0.002). Additionally, miR-499 showed good diagnostic performance for CLBP and correlated positively with Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores, indicating its potential as a disease activity biomarker.</p><p><strong>Conclusions: </strong>The miR-499 rs3746444 polymorphism was associated with both the risk of developing CLBP and disease severity, suggesting a potential role for context-dependent regulation of the miR-499/SOX5 axis in CLBP pathogenesis, although this mechanistic interpretation requires further functional validation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982898","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":"Multi-parametric quantitative MRI for characterizing of lumbar intervertebral disc high-intensity zones in patients with chronic low back pain.","authors":"Linlin Meng, Xiaojing Liu, Ke Jiang, Ling Huang, Gaochao Ma, Mingming Sheng, Wentao Zhao, Hai Zhong","doi":"10.1186/s13018-026-07129-z","DOIUrl":"10.1186/s13018-026-07129-z","url":null,"abstract":"<p><strong>Background: </strong>A high-intensity zone (HIZ) in the posterior annulus fibrosus is a critical radiological marker frequently associated with discogenic low back pain (LBP) and annular tears. Conventional MRI evaluation is inherently subjective, while quantitative MRI provides objective insights into biochemical changes within the intervertebral disc. Therefore, this cross-sectional study aimed to identify independent factors associated with HIZs and develop an integrated multivariable model combining quantitative parameters and morphological features.</p><p><strong>Methods: </strong>Patients with chronic LBP underwent conventional lumbar MRI and multi-parametric quantitative MRI mapping. Pfirrmann grade, disc level, and structural status (normal, bulging, or herniation) were independently assessed for each intervertebral disc from L1/L2 to L5/S1. Quantitative T1, T2, and proton density (PD) values were measured in the nucleus pulposus, anterior annulus fibrosus, and posterior annulus fibrosus. Univariable and multivariable analyses based on generalized estimating equations (GEE) were performed to identify independent factors associated with HIZ. The model's discriminative performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC) and variable importance analysis.</p><p><strong>Results: </strong>A total of 385 intervertebral discs from 77 patients were evaluated, of which 53 (13.8%) discs were HIZ positive. Disc herniation (OR = 4.39, P = 0.010), lower disc level (L4/L5-L5/S1) (OR = 3.60, P = 0.043), and T2 values in the nucleus pulposus (T2_NP) (OR = 2.46 per 10-ms decrease, P = 0.002) were identified as independent associated factors for HIZ. The integrated multivariable model yielded excellent discrimination (AUC = 0.904, 95% CI 0.871-0.935), which was confirmed by internal validation with 1000 bootstrap resamples (AUC = 0.899, 95% CI 0.889-0.905). T2_NP alone also demonstrated favorable diagnostic efficacy (AUC: 0.832, 95% CI 0.789-0.874, DeLong's test P = 0.008), with a cut-off value of ≤ 60.25 ms. Variable importance analysis showed that T2_NP dominated the model, accounting for 72.3% of the discriminative weight.</p><p><strong>Conclusion: </strong>Disc herniation, lower disc levels, and T2_NP were independent associated factors for HIZs. T2_NP was the predominant quantitative biomarker associated with HIZs in patients with chronic LBP, suggesting that it may reflect underlying biochemical changes more sensitively than macroscopic morphological features.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of self-efficacy and sense of coherence on hand disability during the first year after distal radius fracture surgery-a prospective cohort study.","authors":"S Svärding, C Mellstrand Navarro, O Sköldenberg, M Björk, N Brodin","doi":"10.1186/s13018-026-07114-6","DOIUrl":"10.1186/s13018-026-07114-6","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures are among the most common surgically treated fractures in adults. While many patients recover well after surgery, a substantial number continue to experience pain, stiffness, and limitations in hand function that affect daily life and well-being. These difficulties are not always explained by physical healing alone. Psychological responses such as worry, low motivation, or reduced confidence in recovery are often observed in clinical encounters. Two psychological constructs, sense of coherence and self-efficacy, have been associated with outcomes in musculoskeletal rehabilitation. However, their contribution to recovery after distal radius fracture has not been fully established. This study aimed to explore how sense of coherence and self-efficacy are associated with hand disability during the first year after surgical treatment.</p><p><strong>Methods: </strong>This prospective cohort study included adults (18-74 years) with surgically treated distal radius fractures. Data were collected at cast removal and at three months, six months, and one year post-surgery. Outcome measures included hand disability (DASH), sense of coherence (SOC-13), task-specific self-efficacy, pain, grip strength, and range of motion. Nonparametric statistics were used. Group differences were analyzed with Mann-Whitney U and chi-squared tests. Logistic regression explored associations between psychological factors and disability.</p><p><strong>Results: </strong>74 patients completed the three-month follow-up, and 61 remained at one year. Sense of coherence scores were stable and not associated with disability at any time point. Self-efficacy was generally high. At six months, higher self-efficacy for goal fulfilment was associated with lower disability, but no associations were found at three months or one year. Median DASH scores improved from 12 at three months to 2 at one year. Pain at rest was normalized by one year, while pain during activity remained. Grip strength and volar flexion had not fully recovered at 12 months. Supination, pronation, and radial/ulnar deviation returned to near normal by six months.</p><p><strong>Conclusion: </strong>Neither sense of coherence nor self-efficacy consistently predicted outcomes after a surgically treated distal radius fracture across all time points. However, our exploratory results contribute to the overall understanding of the multifactorial nature of recovery in this patient population.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630722","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":"Three-dimensional subtalar joint space mapping identifies sinus tarsi-predominant structural compromise in early- versus end-stage varus ankle osteoarthritis.","authors":"Nan Mei, Hiroaki Kurokawa, Takuma Miyamoto, Norihiro Tsujimoto, Yinghao Li, Yaokuan Ruan, Fei Chang, Akira Taniguchi, Yasuhito Tanaka, Kawamura Kenji","doi":"10.1186/s13018-026-07116-4","DOIUrl":"https://doi.org/10.1186/s13018-026-07116-4","url":null,"abstract":"<p><strong>Objective: </strong>Subtalar compensation is increasingly recognized in varus ankle osteoarthritis (OA), yet the breakdown of this compensatory mechanism in advanced disease and the regional degenerative signature within the subtalar joint remain poorly characterized. We applied simulated weight-bearing computed tomography (sWBCT)-based three-dimensional (3D) subtalar joint space width (JSW) mapping to quantify regional structural differences between early- and end-stage disease.</p><p><strong>Methods: </strong>Patients with varus ankle OA were stratified by the Takakura-Tanaka classification into early-stage (stage 2) and end-stage (stage 4) groups and underwent bilateral sWBCT. Conventional radiographic and sWBCT-derived alignment parameters were measured. Subtalar bone-to-bone distance mapping was performed and partitioned into four regions of interest (ROIs): the anterior, middle, and posterior articular facets, and the sinus tarsi interosseous region. For each ROI, distance distribution metrics and surface-burden metrics-defined as the proportion of ROI surface with bone-to-bone distance < 3.0, < 2.0, < 1.0, and < 0.5 mm-were extracted. Associations between alignment parameters and JSW indices were assessed using partial Spearman correlations controlling for disease stage.</p><p><strong>Results: </strong>End-stage OA showed a global reduction in subtalar complex JSW and a greater surface burden of severe narrowing than early-stage OA. Between-group separation was most pronounced and consistent in the sinus tarsi compartment: all eight C-SIN metrics differed significantly between stages with uniformly large effect sizes (η² = 0.257-0.562; all linear mixed model [LMM] q ≤ 0.024). After adjustment for disease stage, the tibiotalar angle on sWBCT (TTA-sWBCT) was independently associated with posterior-facet JSW indices (partial |r_p| = 0.44-0.62; all q ≤ 0.036) and with the sinus tarsi severe-narrowing burden (partial |r_p| = 0.49-0.58; all q ≤ 0.027).</p><p><strong>Conclusion: </strong>sWBCT-based 3D distance mapping identified sinus tarsi interosseous-space compromise as the most prominent structural difference between early- and end-stage varus ankle OA, whereas posterior-facet articular JSW was more closely linked to coronal malalignment after adjustment for disease stage.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224246","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 between video-based Pirani Böhm Sinclair score and treatment recommendations in recurrent clubfoot in walking-age children.","authors":"Åsa Thelaus, Salik Kashif, Eva Broström, Alaric Aroojis, Steven Frick, Stephanie Böhm, Josefine Eriksson Naili","doi":"10.1186/s13018-026-07122-6","DOIUrl":"10.1186/s13018-026-07122-6","url":null,"abstract":"<p><strong>Background: </strong>Management of recurrent clubfoot in walking-age children remains inconsistent, with substantial variation in treatment strategies. The role of clinical scoring systems in guiding treatment decisions in this group is unclear. This study investigated whether the video-based Pirani Böhm Sinclair (PBS)-score is associated with treatment recommendations.</p><p><strong>Methods: </strong>Fifty-five children aged 4-15 years (85 clubfeet) were video-documented. Four international paediatric orthopaedic surgeons independently assessed each case using the PBS-score and recommended management.</p><p><strong>Results: </strong>Higher total PBS-scores were significantly associated with lower odds of recommending observation (OR 0.2, p < 0.002). A threshold around PBS-score 10 marked a consistent shift from observation to active intervention. Median PBS-scores were 8 (7-10) for observation and 13 (11-16) for active treatment. Despite this association, there was substantial variability in the type of intervention recommended. Even when specific clinical findings, such as dynamic supination, were consistently identified, this did not uniformly translate into the same surgical decision.</p><p><strong>Conclusion: </strong>While higher PBS-scores are associated with the decision to intervene, considerable variation in treatment choice persists. These findings highlight the lack of consensus in managing recurrent clubfoot and underscore the need for clearer indications and standardized treatment algorithms. Trial registration Clinical trial number NCT06050564, date of registration 2023-09-11.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584587","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 comparative study of distal chevron osteotomy and minimally invasive surgery for surgical correction of hallux valgus deformity.","authors":"Jihyun Hwang, Sukjin Shin, Seung Hun Baek, Sung Jae Kim","doi":"10.1186/s13018-026-07098-3","DOIUrl":"10.1186/s13018-026-07098-3","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus is a common forefoot deformity that significantly impacts patients' functional status and quality of life. This study aims to compare the mid-term clinical and radiographic outcomes of DCMO and MIS in hallux valgus correction.</p><p><strong>Methods: </strong>A retrospective cohort study for 60 patients (34 DCMO, 26 MIS) was analyzed. Clinical outcomes were evaluated using the Manchester-Oxford Foot Questionnaire (MOXFQ) and Foot Function Index (FFI), while radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and sesamoid position were assessed preoperatively and at the final follow-up. Statistical comparisons were performed using t-tests, Mann-Whitney U tests, and chi-square tests, with significance set at p < 0.05.</p><p><strong>Results: </strong>The DCMO group demonstrated superior clinical outcomes, with significantly better MOXFQ pain sub-scale (p < 0.001) and index scores (p = 0.002). However, although the between-group difference in pain-related outcomes was statistically significant, it did not reach the minimal clinically important difference (MCID), indicating that the clinical relevance of this advantage may be limited. The improvement in FFI scores was also significantly greater in the DCMO group (p = 0.022). In contrast, the MIS group exhibited superior radiographic correction, with significantly greater improvements in HVA (p = 0.027), IMA (p = 0.001), and sesamoid displacement (p = 0.001). First metatarsal shortening was more pronounced in the MIS group, showing a trend towards statistical significance (p = 0.050). Postoperative complications were comparable, with recurrence rates of 8.8% (DCMO) and 7.6% (MIS).</p><p><strong>Conclusions: </strong>DCMO showed statistically superior patient-reported outcomes, although its pain-related benefit did not exceed the MCID. MIS achieved greater radiographic correction. Procedure selection should be individualized according to patient-specific factors, radiographic goals, and surgeon expertise. In addition, surgeons transitioning to MIS should be aware of the potential risk of frictional heat-related soft tissue injury and should use meticulous fluoroscopic guidance, controlled instrumentation, and adequate irrigation to minimize this complication.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220238","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}