Journal of Orthopaedic Surgery and Research最新文献

{"title":"The utility of robotic-assisted surgery in total knee arthroplasty for moderate and severe valgus deformities: a case series.","authors":"Charles Poh Thean Ang, Kunalan Ganthel, Jade Pei Yuik Ho, Khanchana Devi, Juliet Kar Yan Cheong","doi":"10.1186/s13018-024-05443-y","DOIUrl":"10.1186/s13018-024-05443-y","url":null,"abstract":"<p><strong>Background: </strong>Achieving soft tissue balance is challenging in valgus arthritic knee because of a combination of anomalies in the soft tissues and bones. It has been stipulated that contemporary robotic systems are more precise than traditional instrumentation. Its advantage lies in the soft tissue algorithms. Presently, there is paucity of information on the use of robotic-assisted TKA in addressing moderate and severe valgus deformities. The aim of this series is to demonstrate the utility of robotic-assisted surgery in TKA for arthritic knees with moderate and severe valgus deformities, including accuracy, soft tissue releases performed and level of constraint required.</p><p><strong>Methods: </strong>This is a single surgeon series of 14 cases of moderate and severe valgus osteoarthritic knees who underwent robotic-assisted TKA, utilizing the robotic surgical assistant ROSA^® System.</p><p><strong>Results: </strong>All patients were restored to within 3° of the planned alignment. 8 patients were implanted with cruciate retaining implants, 2 had ultracongruent implants, 3 had posterior stabilized implants, and 1 had a constrained posterior stabilized implant. No patients required release of the popliteus tendon or origin of the lateral collateral ligament. No perioperative complications were encountered in all cases. All patients reported an improvement in the Forgotten Joint Score of > 10.8 at 1year follow up with a 100% satisfaction rate.</p><p><strong>Conclusion: </strong>In this case series, the utilization of robotic assisted the surgeon to achieve a final limb alignment to within 3° of the planned alignment with minimal use of constrained prostheses and good patient-reported outcomes in moderate and severe valgus deformities.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"145"},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370768","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":"External validation and revision of the Lafontaine criteria for unstable distal radius fractures: a retrospective study.","authors":"Pornpanit Dissaneewate, Phatklao Thanavirun, Yanin Tangjaroenpaisan, Kantapon Dissaneewate","doi":"10.1186/s13018-025-05558-w","DOIUrl":"10.1186/s13018-025-05558-w","url":null,"abstract":"<p><strong>Background: </strong>The Lafontaine criteria are the most commonly cited criteria for predicting unstable distal radius fractures. However, formal validation of the performance of these criteria remains limited. Therefore, we aimed to evaluate the Lafontaine criteria as a diagnostic prediction rule for distal radius fractures, assess the inter-rater reliability and predictive ability of various parameters for distal radius instability, and develop new criteria for fracture instability using reliable and highly predictive factors.</p><p><strong>Methods: </strong>This retrospective study included 274 adult patients with acute distal radius fractures treated with closed reduction and immobilisation between January 2019 and December 2022. Patients who underwent immediate surgery, were lost to follow-up before 4 weeks, or had unacceptable alignment after reduction were excluded. The Lafontaine criteria were validated using the area under the receiver operating characteristic curve (AUROC). Criteria with an AUROC > 0.7 were considered acceptable. The criteria were updated using risk factors with stronger associations in the multivariable logistic regression analysis, and the inter-rater reliability of potential predictors was evaluated.</p><p><strong>Results: </strong>The median age of the patients was 63 years; 78% were female. Redisplacement occurred in 39% of the cases. The AUROC for the Lafontaine criteria was 0.65 (95% confidence interval [CI] 0.57-0.74). Multivariable logistic regression showed that age 56-74 years (odds ratio [OR] 3.92, 95% CI 1.82-9.16, p < 0.001) age > 74 years (OR 6.34, 95% CI 2.66-16.2, p < 0.001), associated ulna fracture (OR 1.61, 95% CI 0.92-2.84, p = 0.10), and initial radial shortening > 3 mm (OR 5.78, 95% CI 3.11-11.2, p < 0.001) were the strongest predictive factors of fracture instability. These predictors demonstrated substantial inter-rater reliability, making them suitable for clinical use. Updating the model with these risk factors resulted in an AUROC of 0.74 (95% CI 0.66-0.82).</p><p><strong>Conclusions: </strong>The performance of the Lafontaine criteria in discriminating unstable distal radius fractures was unacceptable in our study cohort. The updated criteria using age group (< 56 years, 56-74 years, and > 74 years), associated ulnar fractures, and initial radial shortening > 3 mm was found to have moderate discrimination; however, further research is warranted to improve the prediction and measurement reliability of fracture instability.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"146"},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of long-term ankle joint function after one-stage and staged microsurgical repair of open achilles tendon defects.","authors":"Jianjie Mao, Yang Xiang, Hui Chu, GenYang Jin, Guangyan Su, Chang Zeng Liu, Feng Zhu","doi":"10.1186/s13018-025-05548-y","DOIUrl":"10.1186/s13018-025-05548-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To explore the differences in long-term ankle joint function between one-stage and staged microsurgical repair of open Achilles tendon defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis of the surgical treatment and follow-up data of 147 patients with open Achilles tendon defects from January 2007 to September 2023 was conducted. Patients were divided into a one-stage reconstruction group (n = 81) and a staged reconstruction group (n = 66) on the basis of whether one-stage microsurgical repair was used. In the one-stage reconstruction group, 43 patients underwent vascular anastomosed fascia lata free anterolateral thigh perforator flap transplantation for repair, and 38 patients underwent descending genicular artery free flap transplantation with the adductor magnus tendon. In the staged reconstruction group, the sural neurovascular flap was used to repair the soft tissue defect in the heel area in the first stage. In the second stage, 31 patients underwent flexor hallucis longus tendon transfer, and 35 patients underwent peroneus longus muscle tendon transfer with the lateral calcaneal artery. Observations included evaluation of the continuity and healing of the Achilles tendon via colour Doppler ultrasound 3 months postoperatively and assessment of ankle joint function 2 years postoperatively using the American Orthopedic Foot and Ankle Society ankle-hindfoot score (AOFAS) and the Achilles tendon total rupture score (ATRS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three months after surgery, colour Doppler ultrasound revealed good continuity of the Achilles tendon in all patients, with slight thickening and irregular fibre orientation. Two years after surgery, the ATRS and AOFAS scores of the one-stage reconstruction group were superior to those of the staged group (P&lt;sub&gt;ATRS&lt;/sub&gt; &lt; 0.05, P&lt;sub&gt;AOFAS&lt;/sub&gt; &lt; 0.05). Among the one-stage reconstruction group, patients who underwent descending genicular artery-free flap transplantation with the adductor magnus tendon presented better performance in walking on uneven surfaces, fast stair climbing, abnormal gait, plantar flexion and dorsiflexion, and inversion and eversion than did those who underwent vascular anastomosed fascia lata free anterolateral thigh perforator flap transplantation, although there was no overall functional difference (P&lt;sub&gt;AOFAS&lt;/sub&gt; = 0.792; P&lt;sub&gt;ATRS&lt;/sub&gt; &lt; 0.001). In the staged repair group, patients who underwent peroneus longus muscle tendon transfer with the lateral calcaneal artery in the second stage had better postoperative follow-up ankle joint function than did those who underwent flexor hallucis longus tendon transfer (P&lt;sub&gt;AOFAS&lt;/sub&gt; &lt; 0.001; P&lt;sub&gt;ATRS&lt;/sub&gt; &lt; 0.001). Preoperative injury classification of the heel region (P &lt; 0.001), size of the defect area in the heel region (P&lt;sub&gt;AOFAS&lt;/sub&gt; &lt; 0.001, R&lt;sub&gt;AOFAS&lt;/sub&gt; = -0.397; P&lt;sub&gt;ATRS&lt;/sub&gt; &lt; 0.001, R&lt;sub&gt;ATRS&lt;/sub&gt; = -0.436), and length of the Achilles tendon de","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"149"},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370667","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":"Efficacy and safety of sequential therapy for primary osteoporosis with bone formation promoters followed by bone resorption inhibitors: a meta-analysis.","authors":"Yuxin Liu, Xin Liu, Yuefeng Wu, Tao Luo","doi":"10.1186/s13018-025-05545-1","DOIUrl":"10.1186/s13018-025-05545-1","url":null,"abstract":"<p><strong>Objective: </strong>Through this study we aimed to present the latest and most comprehensive pooled analysis, providing an updated evaluation of the efficacy and safety of sequential therapy for primary osteoporosis, using bone formation promoters followed by bone resorption inhibitors.</p><p><strong>Methods: </strong>PubMed, the Cochrane Library, Web of Science, and Embase databases were retrieved to identify pertinent studies. Randomized controlled trials (RCTs) on the sequential therapy of primary osteoporosis with bone formation promoters followed by bone resorption inhibitors were included. Data from clinical studies that met the eligibility criteria were extracted, and quality assessment and meta-analysis were performed using RevMan v5.4 and Stata v15.0. Sensitivity and subgroup analyses were performed to find the source of heterogeneity and discover more findings.</p><p><strong>Results: </strong>A total of 10 eligible articles involving 14,510 patients (7171 in the intervention group versus 7339 in the comparator group) were included for the evidence synthesis. The baseline characteristics of the two groups were similar. Pooled analysis showed that the intervention group (bone formation promoters followed by bone resorption inhibitors) increased BMD at the spine (SMD:1.64; 95% CI: 0.97, 2.31; P < 0.00001; I² = 99%), femoral neck (SMD: 0.57; 95% CI: 0.16, 0.99; P = 0.007; I² = 96%), and total hip (SMD: 0.82; 95% CI: 0.16, 1.48; P = 0.02; I² = 97%) compared with the comparator group (monotherapy or combination therapy using two drugs)for postmenopausal osteoporosis patient; however, there was no statistically significant difference observed in the increase of BMD at the 1/3 distal radius comparing the intervention group and comparator group (SMD: -0.25; 95% CI: -1.49, 0.99; P = 0.069; I² = 92%). The incidence of new fractures was reduced in the intervention group relative to the comparator group (RR: 0.60; 95% CI: 0.43, 0.82; P = 0.001; I² = 75%). The incidence of adverse events differed statistically between the two groups (RR: 0.85; 95% CI: 0.76, 0.95; P = 0.004; I² = 97%), but the difference in adverse event incidence was not statistically significant among subgroups within the intervention and comparator groups. The intervention group had a superiority of Clinical efficacy.</p><p><strong>Conclusion: </strong>Among patients with primary osteoporosis, sequential therapy with bone formation promoters followed by bone resorption inhibitors substantially increased BMD at sites such as the spine, femoral neck, and total hip while concurrently mitigating fracture risks. However, benefits regarding BMD at the 1/3 distal radius and the incidence of adverse events have not yet been established.</p><p><strong>Study registration: </strong>Registered on PROSPERO (ID: CRD42023437188).</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"147"},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370634","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":"Does protruding headless cannulated screw reduce fixation stability in tension band wiring technique for patella fractures? a biomechanical study.","authors":"Mehmet Maden, Omer Berkay Bayraktar, Tayfun Bacaksiz, Ihsan Akan, Bora Uzun, Cemal Kazimoglu","doi":"10.1186/s13018-025-05567-9","DOIUrl":"10.1186/s13018-025-05567-9","url":null,"abstract":"<p><strong>Background: </strong>The selection of an implant is a critical factor in the surgical treatment of patella fractures due to the risk of various complications, such as non-union, implant failure, and irritation. The present study evaluated and compared the biomechanical strength of headless cannulated screws about screw length using the tension band wiring technique.</p><p><strong>Methods: </strong>Forty-eight sawbone patellas with transverse fractures were divided into three fixation groups based on the screw length used in tension band wiring. Overall, three different fixation groups were determined: Group 1 (recessed headless cannulated screw fixation), Group 2 (full-length headless cannulated screw fixation), and Group 3 (protruding headless cannulated screw fixation). A setup was used to simulate a knee with a flexion angle of 60 degrees. Specimens underwent biomechanical testing under axial traction (static test) and cyclic loading (dynamic test). Displacements at 300 Newtons (N), loads at 2 millimetres (mm) displacement, and failure loads were documented for each sample in the static test. In the dynamic test protocol, 10,000 repetitive cycles were performed under physiological load between 100 and 300 N, and final displacements were recorded.</p><p><strong>Results: </strong>There were significant differences in the loads achieved at 2 mm displacement levels, and Group 3 demonstrated lower force values compared to other constructs in the static test (P = 0.003). All groups revealed similar displacements at 300 N and failure load values under axial traction. In the dynamic test, Group 3 had significantly higher fracture displacement under cyclic loading compared to the other specimens (P = 0.006).</p><p><strong>Conclusions: </strong>This study found headless cannulated screws for transverse patella fracture fixation provide sufficient stability; however, protruding headless screws reduce the fixation strength. Recessed or full-length screws may improve stability and bony healing, potentially preventing complications in patella fractures.</p><p><strong>Level of evidence: </strong>Biomechanical study N/A.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"148"},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370611","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":"Is it beneficial to use lateral protective crossing K-wires during medial open wedge high tibial osteotomy? A retrospective comparative study.","authors":"Hossam Fathi Mahmoud, Ahmed Hatem Farhan, Ahmed Mohamed Abdelwahab, Ahmed Mohamed Elshaer, Mahmoud Abdo Mahmoud, Fahmy Samir Fahmy","doi":"10.1186/s13018-025-05524-6","DOIUrl":"10.1186/s13018-025-05524-6","url":null,"abstract":"<p><strong>Background: </strong>An iatrogenic lateral hinge fracture is a common intraoperative problem that may occur during medial open wedge high tibial osteotomy (MOWHTO). This study aims to assess the significance of using additional crossing lateral K-wires and their advantage in protecting the lateral hinge during MOWHTO procedures.</p><p><strong>Methods: </strong>The data of patients fulfilling the inclusion criteria who underwent MOWHTO between May 2021 and August 2022 were retrospectively evaluated. One group had additional lateral hinge crossing K-wires (+ MOWHTO group), while the other did not (-MOWHTO group). Both groups were assessed for rate of intraoperative lateral hinge fractures, knee injury and osteoarthritis outcome score - 12 (KOOS-12), medial proximal tibial angle (MPTA), time of union, and time to return to work. The outcomes were compared using the independent T-test for continuous variables and the Fisher Exact test for nominal variables. A p-value of < 0.05 was considered statistically significant for both tests.</p><p><strong>Results: </strong>The study included forty-eight patients; twenty-four in each treatment group. The mean follow-up durations were 30.5 ± 3.6 months for + MOWHTO and 31.6 ± 3.2 months for -MOWHTO (p = 0.26). There was no statistically significant difference regarding mean age, sex, KOOS-12, MPTA, and time of surgery between both groups. The + MOWHTO group had a faster time of union (p = 0.001), an earlier return to work (p = 0.002), and a lower rate of intraoperative lateral hinge fractures (p = 0.04).</p><p><strong>Conclusion: </strong>This study demonstrated that using additional crossing lateral K-wires during MOWHTO had a beneficial effect on reducing the rate of iatrogenic lateral hinge fractures, with a faster time of union, and an early return to work. The KOOS-12, MPTA, and mean operative time did not reveal significant differences between treatment groups.</p><p><strong>Level of evidence: </strong>retrospective cohort comparative study; level III.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"142"},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256020","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 reliability of talonavicular uncoverage to indicate forefoot abduction in progressive collapsing foot deformity: a finite element analysis.","authors":"Yulin Wei, Hua Liu, Can Xu","doi":"10.1186/s13018-025-05478-9","DOIUrl":"10.1186/s13018-025-05478-9","url":null,"abstract":"<p><strong>Background: </strong>Progressive Collapsing Foot Deformity (PCFD) presents various deformities. While medializing displacement calcaneal osteotomy (MDCO) and lateral column lengthening (LCL) are commonly employed as corrective surgeries, their impact on foot structure and functionality necessitates detailed biomechanical analysis. The objective of this study is to analyze the reliability of using talonavicular uncoverage percentage (TUP) as a metric for assessing the degree of forefoot abduction.</p><p><strong>Methods: </strong>Seven subject-specific flatfoot models were constructed based on previous study. Finite element analysis was conducted to simulate stress distribution and contact characteristics in PCFD. Models were categorized based on TUP values, and MDCO was performed to analyze stress changes in the medial longitudinal arch and contact characteristics of subtalar joint.</p><p><strong>Results: </strong>The study revealed discrepancies in TUP measurements between plain radiographs and three-dimensional models. Comparative analysis of the seven models showed that TUP exceeding 40% showed varied stress responses. A newly introduced parameter, the distance from the center of the head of the second metatarsal to the talar body axis (DSMT), demonstrated potential as a more dependable indicator. Models with DSMT below 20 mm experienced a remarkable reduction in ligamentous stress and notable change in region of stress concentration on the subtalar joint surface after MDCO, while those above 20 mm showed no noteworthy change.</p><p><strong>Conclusion: </strong>The study suggests that TUP may not be a reliable indicator for LCL surgery in PCFD, highlighting the need for improved assessment parameters. DSMT shows promise as a more dependable indicator, warranting further research to validate its efficacy. Enhanced indicators will facilitate better surgical planning in PCFD corrective procedures.</p><p><strong>Clinical relevance: </strong>Accurate assessment of flatfoot deformities is crucial for developing effective treatments. DSMT , which utilizes the talar body axis as a reference, is not affected by anatomical variations in the talar head body angle, rendering it more reliable for assessment of forefoot abduc tion. Improved indicators will contribute to better surgical decision making and patient outcomes in PCFD.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"143"},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365132","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":"Plastic deformation of anterior cruciate ligament: listen to the patient, do not just rely on imaging.","authors":"Sérgio Rocha Piedade, Daniel Miranda Ferreira, Carlos Górios, Nicola Maffulli","doi":"10.1186/s13018-025-05527-3","DOIUrl":"10.1186/s13018-025-05527-3","url":null,"abstract":"<p><strong>Purpose: </strong>Diagnosing plastic deformation of the anterior cruciate ligament (ACL) is challenging: patients may not report knee instability, and MRI may not confirm the lesion, delaying adequate treatment. This study analyzed clinical findings and complaints in patients with a confirmed diagnosis of plastic deformation of the ACL.</p><p><strong>Methods: </strong>Data on complaints, physical, imaging and arthroscopic assessment, and subjective evaluation of 15 patients with undiagnosed or delayed ACL insufficiency from plastic deformation of the ACL (Group 1) and 30 patients who underwent an ACL reconstruction following complete tear of the ACL diagnosed clinically and at imaging (Group 2) were compared and analyzed.</p><p><strong>Results: </strong>A knee effusion was reported in both study groups, occurring within the first 4 h after the index knee injury, and it was statistically more significant in the complete ACL tear group. All patients reported low values (zero, one, and two) on a scale from zero to 10 in their confidence in performing high-intensity pivoting sports and physical activities. All patients reported that they did not feel comfortable in performing changing direction pivoting on their injured knee.</p><p><strong>Conclusion: </strong>Plastic deformation of the ACL may not be clearly manifest clinically and on MRI, and physical exam may present subtle findings that do not allow to fully assess the function of the injured ligament. Therefore, surgeons should listen to the patient, not just rely on imaging, taking into account the patient's report of how the knee is working and their complaints as they remain the leading guide for decision-making.</p><p><strong>Level of evidence iv: </strong>Diagnostic studies - Investigating a diagnostic test.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"144"},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365061","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":"Jingui Shenqi Wan alleviates bone loss induced by primary osteoporosis by inhibiting osteoblast pyroptosis.","authors":"Yuwangxuan Qian, Yihe Yu, Fan Yang, Qixing Liang, Dan Xu, Jiaxiang Chen, Xueqin Hu","doi":"10.1186/s13018-025-05542-4","DOIUrl":"10.1186/s13018-025-05542-4","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study was to elucidate the underlying pharmacological mechanisms by which Jingui Shenqi Wan (JGSQW) alleviates postmenopausal osteoporosis (PMOP). Through a systematic investigation, we sought to identify the specific molecular pathways through which JGSQW modulates the progression of PMOP, thereby providing a scientific basis for its clinical application.</p><p><strong>Methods: </strong>We established an ovariectomized (OVX) mouse model to simulate estrogen deficiency-induced PMOP. Initially, micro-CT imaging and Alcian blue hematoxylin/orange G (ABH/OG) staining were employed to assess the effects of JGSQW on bone microarchitecture and bone mass preservation. Immunohistochemistry (IHC) was then utilized to evaluate the expression of osteogenic markers, including Osterix (OSX), Runx2, and Osteopontin (OPN). Additionally, Tartrate - Resistant Acid Phosphatase (TRAP) staining was performed to visualize and quantify osteoclasts. We further investigated the potential role of JGSQW in modulating the pyroptosis pathway.</p><p><strong>Results: </strong>JGSQW effectively alleviates the destruction of bone microstructure and the loss of bone mass caused by estrogen deficiency, an effect that appears to be mediated by promoting osteogenesis. Additionally, JGSQW significantly downregulates the expression of GSDMD in osteoblasts and mitigates the abnormal release of inflammatory factors, thereby maintaining the normal functional activities of osteoblasts.</p><p><strong>Conclusion: </strong>JGSQW may effectively mitigate the progression of estrogen deficiency-induced PMOP by inhibiting the dysregulated activation of osteoblast pyroptosis.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"141"},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256038","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":"Is surgery superior for distal ulna fractures? a comprehensive systematic review and meta-analysis.","authors":"Zakaria Chabihi, Brahim Demnati, Mohamed Moussadiq, Tariq Aalil, Yassine Fath El Khir, El Mehdi Boumediane, Mohamed Amine Benhima, Imad Abkari","doi":"10.1186/s13018-024-05438-9","DOIUrl":"10.1186/s13018-024-05438-9","url":null,"abstract":"<p><strong>Background: </strong>The management of distal ulna fractures remains a subject of considerable debate within orthopedic practice. This systematic review and meta-analysis aims to evaluate the efficacy of surgical versus non-surgical management strategies for distal ulna fractures and their impact on functional outcomes.</p><p><strong>Methods: </strong>This study followed PRISMA guidelines and involved a systematic search of databases like PubMed, Scopus, and Web of Science for relevant studies published in English up to December 2023. The search included keywords such as \"ulnar styloid fracture\", \"non-surgical management\", \"surgical management\", and \"treatment outcomes\". Studies were selected based on predefined inclusion and exclusion criteria, and data were extracted on patient demographics, fracture characteristics, treatment details, functional outcomes, patient-reported outcomes, complications, and follow-up duration. The methodological quality of included studies was assessed using the GRADE system. The meta-analysis used standardized mean differences for continuous outcomes and log odds ratios for dichotomous outcomes.</p><p><strong>Results: </strong>The initial search yielded 1253 studies, which were narrowed down to 12 studies suitable for review after removing duplicates and irrelevant articles. These studies included a total of 709 patients, with 422 receiving non-surgical management and 287 undergoing surgical treatment. The results showed no significant differences in grip strength, DASH score, or VAS score between surgical and non-surgical management. However, a higher union rate was observed with surgical management.</p><p><strong>Limitations: </strong>The moderate quality of the included studies and the moderate to high heterogeneity among them are noted as limitations, indicating a need for more standardized research methodologies in this area.</p><p><strong>Conclusions: </strong>While surgical management may offer a higher union rate, the choice of treatment should be individualized, balancing the potential benefits against the risks of surgery, as ORIF implants are typically associated with higher ulnar-sided pain rates and limited ulnar deviation due to implant prominence. Future research should focus on standardizing study designs to improve the quality of evidence in the management of distal ulna fractures.</p><p><strong>Level of evidence i: </strong>Evidence from a meta-analysis and systematic review from all relevant studies.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"140"},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256034","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}