Journal of Orthopaedic Surgery and Research最新文献

{"title":"Reducing femoral peri-implant fracture risk through optimized plate length and screw configuration - a biomechanical study.","authors":"Luise Puls, Lionel Llano, Ivan Zderic, Boyko Gueorguiev, Karl Stoffel","doi":"10.1186/s13018-025-05753-9","DOIUrl":"10.1186/s13018-025-05753-9","url":null,"abstract":"<p><strong>Background: </strong>Locked plating of femur fractures is associated with secondary peri-implant fractures which may be a result of stress concentrations at the proximal plate end region. The aim of this study was to investigate whether the strength of healed femoral bone-locking-compression-plate constructs can be increased by modifying the screw configurations and plate length to minimize the risks of peri-implant femur fractures.</p><p><strong>Methods: </strong>The detached shaft of a variable angle condylar locking compression plate (VA-LCP Condylar Plate; Johnson & Johnson MedTech) was fixed to the proximal two-third of twenty-four intact artificial femurs in four different configurations (n = 6) distinguished by either using a short plate with cortical or locking screws whereby the most proximal screw was inserted in the femoral shaft 50 mm below the lesser trochanter, or using a long plate with either cortical or locking screws whereby the most proximal screw was positioned in the femoral neck. Simulating a situation after fracture healing, constructs were cyclically tested under progressively increased loading until catastrophic failure.</p><p><strong>Results: </strong>Long plates fixed with a cortical screws demonstrated the highest failure load (1091 N ± 142 N) which was significantly higher compared to long plates fixed with locking screws (888 N ± 80 N), short plates fixed with cortical screws (471 N ± 42 N), and short plates fixed with locking screws (450 N ± 19 N). In addition, whereas the locking screw construct with a long plate was associated with a significantly higher failure load compared to both short plate constructs, there were no significant differences between the latter two. The failure modes were predominantly characterized by neck screw pull-out in both long plate constructs and peri-implant bone fractures at the most proximal screw in both constructs with short plates. None of the specimens exhibited a femoral neck fracture.</p><p><strong>Conclusion: </strong>The findings of this study performed on synthetic bones indicate that from a biomechanical perspective long plates that extend into the femoral neck sustained higher failure loads compared to short plates. In addition, long plates fixed with a cortical neck screw further enhanced the construct strength and reduced the risk of peri-implant fractures compared to the use of a locking neck screw. Therefore, this study supports the use of long locking plates combined with use of cortical neck screws, particularly in high-risk patients, such as those with severe osteoporosis.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"340"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788574","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 of multiple autologous apheresis platelet-rich plasma injections for treating knee osteoarthritis and its influencing factors: a retrospective cohort study.","authors":"Jie Yan, Qi Liu, Gang Dai, Chunxi Wu, Nali Song, Bin Zhang, Liu Yang, Chunyan Yao","doi":"10.1186/s13018-025-05756-6","DOIUrl":"10.1186/s13018-025-05756-6","url":null,"abstract":"<p><strong>Background: </strong>The lack of standardized Platelet-Rich Plasma (PRP) protocols for Knee Osteoarthritis (KOA), combined with significant patient variability, leads to inconsistent PRP effectiveness across studies. This study aims to assess the influence of PRP injection frequencies on KOA treatment and explore the role of patient characteristics and PRP properties in the treatment's effectiveness.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted with KOA patients who received three PRP injections (4-week intervals) at a hospital in Chongqing. The Wilcoxon signed-rank test was used to analyze differences in self-reported recovery rates across different treatment time points, with Bonferroni correction applied for significance level adjustment (α). The Mann-Whitney U test, Kruskal-Wallis H test, Spearman correlation analysis, and restricted cubic spline models were used to assess the associations between sex, baseline Kellgren-Lawrence grade, age, PRP red blood cell (RBC) concentration, PRP white blood cell (WBC) concentration, PRP platelet concentration, the multiple of PRP platelet concentration relative to the baseline autologous level (Enrichment-PLT), and self-reported recovery rates.</p><p><strong>Results: </strong>The study included 28 KOA patients. Significant improvement in self-reported recovery rate was observed 4 weeks after the first treatment (median: 30.0%, P < 0.008) and after the second treatment (median: 45.0%, P < 0.008). However, no significant change was noted 4 weeks after the third treatment (median: 55.0%, P = 0.058), and recovery rates at 8, 12, and 24 weeks post-third treatment showed no significant differences compared to 4 weeks (all P > 0.008). Additionally, no correlations were found between sex, baseline Kellgren-Lawrence grade, age, PRP RBC concentration, PRP WBC concentration, PRP platelet concentration, or Enrichment-PLT and self-reported recovery rates.</p><p><strong>Conclusion: </strong>At least two PRP injections are recommended, with effects lasting for at least 24 weeks. Factors such as sex, age, baseline Kellgren-Lawrence grade, and PRP properties (prepared by apheresis) do not significantly affect treatment outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"339"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788572","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":"Coronal plane alignment changes do not affect outcome for total knee implant design with 3 degree varus joint line.","authors":"Joshua Yeuk-Shun Tran, Esther Oi-Ching Chan, Cham-Kit Wong, Gloria Yan-Ting Lam, Tsz-Lung Choi, Rex Wang-Fung Mak, Jonathan Patrick Ng, Kevin Ki-Wai Ho, Patrick Shu-Hang Yung, Michael Tim-Yun Ong","doi":"10.1186/s13018-025-05709-z","DOIUrl":"10.1186/s13018-025-05709-z","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is a widely performed surgical intervention for symptomatic knee osteoarthritis (OA). However, the influence of coronal plane alignment on clinical outcomes remains unclear. This study evaluates whether alterations in the coronal plane alignment of the knee (CPAK) classification, using the same implant system, affect postoperative outcomes in patients undergoing robotic-assisted TKA.</p><p><strong>Methods: </strong>We conducted a retrospective review of 202 patients who underwent primary robotic-assisted TKA between 2019 and 2023 using NAVIO or CORI systems and Journey II implants. Patients were classified based on changes in CPAK classification and functional outcomes assessed using the Knee Society Score (KSS) and Knee Society Function Score (KSFS) at multiple postoperative time points. Statistical analyses compared outcomes between groups with changed and unchanged CPAK.</p><p><strong>Results: </strong>A total of 202 patients were included. Preoperative demographic characteristics were comparable between groups. Functional outcome scores at 6 weeks, 3 months, 6 months, and 12 months postoperatively showed no significant differences between the changed CPAK group and the unchanged CPAK group (p > 0.05 for all comparisons). Subgroup analyses further revealed no statistically significant disparities in functional outcomes based on the type or degree of CPAK changes.</p><p><strong>Conclusion: </strong>Our findings suggest that changes in coronal plane alignment do not adversely affect functional outcomes following robotic-assisted TKA. This implies that alignment strategy may be less critical to patient satisfaction and functional recovery than previously assumed. Implant-induced alignment changes may contribute to comparable clinical outcomes and could be a key factor in patient recovery. Understanding the relationship between CPAK changes and clinical outcomes can inform best practices in knee arthroplasty, ultimately enhancing patient satisfaction and quality of life post-surgery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"338"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788570","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":"Letter to the editor regarding \"effect of buttress plate in herscovici type D vertical medial malleolar fractures and peripheral fractures: a retrospective comparative cohort study\".","authors":"Malik Çelik, Emre Baca","doi":"10.1186/s13018-025-05593-7","DOIUrl":"10.1186/s13018-025-05593-7","url":null,"abstract":"<p><p>In this letter to the editor, we highlight several concerns that may affect the validity of the study results by Luo et al. entitled \"Effect of Buttres plate in Herscovici type D vertical medial malleolar fractures and peripheral fractures: a retrospective comparative cohort study.\" First, we point out a methodological flaw in the selection of treatment groups, as insufficient standardization of criteria potentially led to selection bias. Second, we note that the angle of the screws in vertical fractures differed from the standard recommended in the literature, which may affect the effectiveness of fixation. Studies in the literature have increased the validity of their comparisons by using more reliable screw alignment techniques. They also recommend plate fixation instead of screws for vertical fractures, supporting the idea that plates provide more stable fixation in these cases. The inappropriate placement of screws in the Luo et al. study may therefore bias the results in favor of plate fixation and reduce the validity of the comparison between treatment modalities.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"337"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780230","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":"USP15-modified ADMSCs-Exo alleviates chondrocyte damage and effectively relieved osteoarthritis by inducing M2 polarization of macrophages through deubiquitinating FOXC1.","authors":"Qibin Liang, Qinghe Ding, Liang Zhao, Jingchao Tan, Wei Niu","doi":"10.1186/s13018-025-05742-y","DOIUrl":"10.1186/s13018-025-05742-y","url":null,"abstract":"<p><strong>Background: </strong>The damage to chondrocytes and inflammatory responses are considered the key factors in the pathogenesis of osteoarthritis (OA). Ubiquitin-specific protease 15 (USP15) has been shown to be involved in OA. This study aimed to explore the mechanism of USP15-modified adipose-derived mesenchymal stem cells (ADMSCs) exosome (Exo) in alleviating OA.</p><p><strong>Methods: </strong>ADMSC-Exo with USP15 overexpression was isolated by magnetic beads method, and the Exo marker proteins were identified by western blot assay. M1 and M2 phenotypic markers of THP1-M0 cells were analyzed by flow cytometry. ELISA was used to detect the expression of inflammatory factors in cells. CCK-8, EdU, Transwell, and flow cytometry were used to detect the cell activity, proliferation, apoptosis and migration ability. The interaction between forkhead box C1 (FOXC1) and USP15 was verified by Glutathione-S-transferase (GST) pull-down and Co-immunoprecipitation (Co-IP) experiments. The stability of FOXC1 was measured by cycloheximide (CHX), and its ubiquitination level was analyzed by exogenous ubiquitination assay.</p><p><strong>Results: </strong>The Exos from ADMSCs overexpressing USP15 (oe-USP15/Exos) were successfully isolated. It was confirmed that oe-USP15/Exo inhibited the M1 polarization of THP1-M0 cells caused by lipopolysaccharide (LPS) but induced the M2 polarization and the release of inflammatory inhibitory factors. Meanwhile, the damage of chondrocytes caused by LPS was also prevented by oe-USP15/Exo. Besides, USP15 was validated to exert a deubiquitination effect by binding to FOXC1 and positively regulate FOXC1 expression. And the effects of oe-USP15/Exo were abolished after FOXC1 silencing.</p><p><strong>Conclusion: </strong>USP15-modified ADMSC-derived Exos facilitated M2 polarization of macrophages and improved chondrocyte injury by deubiquitination of FOXC1.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"336"},"PeriodicalIF":2.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772735","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 learning curve for lumbar discectomy in unilateral biportal endoscopic spine surgery using the cumulative summation method.","authors":"Takaki Yoshimizu, Sanshiro Saito, Teruaki Miyake, Tetsutaro Mizuno, Ushio Nosaka, Keisuke Ishii, Mizuki Watanabe, Kanji Sasaki","doi":"10.1186/s13018-025-05763-7","DOIUrl":"10.1186/s13018-025-05763-7","url":null,"abstract":"<p><strong>Background: </strong>Unilateral biportal endoscopy (UBE) is gaining popularity owing to its versatility as a spinal endoscopic procedure. However, the general value of the learning curve for discectomy by UBE is unknown. This retrospective study aimed to determine the learning curve of UBE for lumbar discectomy using a cumulative summation (CUSUM) method. We examined the learning curves of four surgeons at an institution and factors that shortened the learning curves.</p><p><strong>Methods: </strong>The study included 200 patients (mean age 44.2 years) who underwent lumbar discectomy by UBE at our hospital and four male orthopedic surgeons who had performed 50 UBE discectomies. An approximate curve using the CUSUM method was created using the mean operative time for each case as the target. All surgeons had performed lumbar discectomy and over 200 spinal surgeries before inducing UBE. Surgeon A received specialized training in shoulder arthroscopic surgery. The surgical times before and after the curve reached its maximum value were compared; a point of significant difference was defined as case to proficiency.</p><p><strong>Results: </strong>The mean operative times for surgeons A, B, C, and D were 48, 66, 90, and 87 min, respectively. The approximate curves obtained using the CUSUM method had maxima at x = 22, 20, 27, and 13. The operating times of Surgeons A and B showed significant differences before and after the maxima (59 vs. 39 and 75 vs. 60), whereas those of Surgeons C and D did not (96 vs. 84 and 95 vs. 85).</p><p><strong>Conclusions: </strong>UBE is generally considered to have a steep learning curve; in this study, the learning curve differed depending on the surgeon. The surgeon with the best learning curve was trained as an arthroscopic surgeon. Coordination for endoscopic surgery influenced the learning curve compared to the experience with spine surgery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"335"},"PeriodicalIF":2.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772734","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":"One-stage posterior debridement approach combined with autogenous bone grafting and internal fixation for the treatment of adult thoracic or lumbar suppurative spondylitis via the multifidus and longissimus interspaces.","authors":"Yanjiang Guo, Yunbo Yang, Zan Chen, Daxiong Feng, Fei Lei","doi":"10.1186/s13018-025-05735-x","DOIUrl":"10.1186/s13018-025-05735-x","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment of suppurative spondylitis requires focus debridement, spinal stability, and deformity correction. Different approaches face challenges like complex anatomical structures and greater trauma. The aim is to evaluate the clinical efficacy of One-stage debridement approach combined with autogenous bone grafting and internal fixation for the treatment of adult thoracic or lumbar suppurative spondylitis via the multifidus and longissimus interspaces.</p><p><strong>Methods: </strong>From July 2018 to July 2021, 91 patients (65 male, 26 female) with single - level thoracic or lumbar suppurative spondylitis underwent the one-stage posterior procedure. Operative details and hospital stay were recorded. ESR, CRP, and PCT levels were analyzed at specific times. Pain was rated by VAS, Using ODI score to evaluate the improvement of lumbar activity, and neurological function was assessed by ASIA scale. Cobb angles were measured for deformity evaluation. Bony fusion was evaluated by radiography and computed tomography.</p><p><strong>Results: </strong>The mean operative duration was 195.6 ± 15.4 min, blood loss was 575.9 ± 90.1 ml, and hospital stay was 19.9 ± 2.2 days. ESR, CRP, and PCT levels significantly decreased before discharge (ESR: 80.2 ± 14.6 mm/h vs. 30.2 ± 8.9 mm/h, CRP: 58.5 ± 13.6 mg/L vs. 15.1 ± 7.4 mg/L, PCT: 0.8 ± 0.2 ng/ml vs. 0.1 ± 0.1 ng/ml, P < 0.05). All patients had pain relief. VAS scores improved (preoperative 7.7 ± 1.1, before discharge 2.8 ± 0.6, final follow-up 1.3 ± 0.6). The lumbar activity of all patients was significantly improved compared with preoperative(preoperative 41.36 ± 3.20, final follow-up 6.18 ± 1.33). Neurologically impaired patients improved in ASIA grade. The mean preoperative Cobb angle was 19.6 ± 1.6°, reduced to 6.2 ± 1.5° before discharge and 9.4 ± 1.0° at final follow-up. The mean angle correction was 13.4 ± 0.6°, correction rate 68.7% ± 5.4% (P < 0.05), with a final loss angle of 3.2 ± 0.7° and loss rate 24.1% ± 4.8%. All grafts achieved complete fusion.</p><p><strong>Conclusions: </strong>This one-stage posterior approach is effective and feasible for adult single - level thoracic or lumbar suppurative spondylitis, protecting paravertebral muscles and posterior ligament complexes. However, further studies with larger samples and longer follow-up are needed.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"330"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764208","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":"Prevalence and influencing factors of kinesiophobia after total knee arthroplasty: a systematic review and meta-analysis.","authors":"Xingbin Du, Yuanwei Shao, Jian Xue, Jianda Kong","doi":"10.1186/s13018-025-05752-w","DOIUrl":"10.1186/s13018-025-05752-w","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis is a common degenerative disease in the elderly, and total knee arthroplasty is an effective treatment for end-stage knee joint diseases. However, kinesiophobia after surgery can impede patients' rehabilitation and affect the recovery of knee joint function. There are differences in the research on its related influencing factors.</p><p><strong>Objectives: </strong>This meta-analysis examined the prevalence and risk factors of kinesiophobia after TKA.</p><p><strong>Methods: </strong>Pubmed, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Embase, Web of Science on the prevalence and risk factors of kinesiophobia after TKA was searched in science, MEDLINE and other databases. Duplicate literature, low quality literature, literature with inconsistent observation indicators, and literature without full text were excluded. Two independent researchers used Newcastle-Ottawa Scale (NOS) to evaluate the quality of the included literature. After data extraction, Meta-analysis was performed using Stata17.0.</p><p><strong>Results: </strong>A total of 11 articles involving 4039 cases were included in this meta-analysis to assess the prevalence of kinesiophobia after TKA. The overall prevalence was found to be 35% (95% CI: 27-44%). Subgroup analyses revealed varying prevalence rates based on age, education, income, and residence, with the highest prevalence observed in individuals under 65 years and those with lower levels of education and income. Key factors influencing the prevalence of kinesiophobia included pain (OR = 2.313, 95% CI: 1.556-3.07), low social support (OR = 1.681, 95% CI: 1.000-2.361), and negative coping strategies (OR = 1.344, 95% CI: 1.165-1.523).</p><p><strong>Conclusion: </strong>The prevalence of kinesiophobia after TKA is high. There are differences in the prevalence of kinesiophobia among people with different places of residence, different education levels, and different monthly incomes. At the same time, it is affected by many factors such as postoperative pain, low social support, low self-efficacy, negative coping, old age, and low education level.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"332"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764210","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":"Comprehensive validation of a custom three-point bending system for standardized diabetic fracture models in rats.","authors":"Qidong Guo, Weijie Wang, Zheng Guo","doi":"10.1186/s13018-025-05754-8","DOIUrl":"10.1186/s13018-025-05754-8","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) significantly impairs fracture healing, necessitating reliable animal models to study diabetic fracture repair mechanisms and therapeutic interventions. This study aimed to develop and comprehensively validate a standardized three-point bending system for inducing precise, reproducible mid-shaft transverse femoral fractures in rats, addressing existing methodological gaps of insufficient reproducibility and detailed calibration in previous models.</p><p><strong>Methods: </strong>A custom-designed three-point bending fracture induction system was developed using AutoCAD software based on the original principle introduced by Einhorn et al. (1984). After manufacturing and calibration, the system was validated first using 22 cadaveric rat femurs and subsequently applied to live rats (n = 44), including diabetic (streptozotocin-induced, n = 22) and non-diabetic animals (n = 22). Fracture induction reproducibility was assessed through radiographic, histologic and mechanic analysis. Additionally, statistical analysis was conducted using GraphPad Prism 9 software. Coefficients of variation (CV) for fracture-healing parameters (callus diameter, calcification ratio, maximum bending force at re-fracture) were calculated and compared statistically with similar parameters from previously published rat femoral fracture studies.</p><p><strong>Results: </strong>Cadaveric validation confirmed that the optimal blade travel distance, set as half the femoral diameter, consistently produced standardized transverse fractures without comminution. A significant correlation between body weight and femoral diameter (Femoral diameter = 1.0276 ln [Body weight] - 1.349) allowed accurate preoperative determination of optimal blade travel distance. Live animal testing demonstrated consistent fracture patterns, stable intramedullary pin fixation, and no complications during surgical procedures. Statistical analysis revealed significantly lower coefficients of variation for healing parameters in this study compared to previously published models (p < 0.05). Histological analysis indicated the fracture type was transverse. Callus was found around fracture site.</p><p><strong>Conclusion: </strong>Our validated three-point bending system significantly enhances reproducibility, consistency, and methodological rigor in animal fracture research. This standardized model provides an ideal foundation for future preclinical studies investigating diabetic fracture healing mechanisms and potential therapeutic interventions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"328"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764204","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":"Clinical significance of microRNA-328-3p and bone metabolism biomarkers in gout patients with different musculoskeletal ultrasonography imaging.","authors":"Qingqing Song, Lifang Xue, Jie Ren, Xiaoyu Liu, Guilei Li, Congcong Liu, Xin Meng","doi":"10.1186/s13018-025-05691-6","DOIUrl":"10.1186/s13018-025-05691-6","url":null,"abstract":"<p><strong>Aims: </strong>MicroRNA (miRNA) participates in the pathophysiological processes of multiple metabolic diseases, including gout. In gout patients, there is concomitant derangement of bone metabolism. The study aimed to explore the correlation of different ultrasonic manifestations and miR-328-3p levels with bone metabolic markers in gout patients.</p><p><strong>Methods: </strong>A total of 320 gout patients were grouped according to musculoskeletal ultrasound (MSUS) imaging. Serum osteocalcin (BGP), C-terminal telopeptide of type I collagen (CTX-I) and osteopotin (OPN) levels were detected to evaluate bone metabolism. Serum miR-328-3p levels were detected via qRT-PCR. Pearson's correlation analysis was performed to explore the relationships between the variables.</p><p><strong>Results: </strong>Patients with tophi accompanied by bone erosion demonstrated significantly elevated levels of BGP and OPN compared to those with tophi or aggregate of MSU crystals in the absence of bone erosions. Cases with long course of disease exhibited more severe bone destruction. Cases without specific clinical manifestations presented the highest levels of serum miR-328-3p, whereas those with bone erosions demonstrated the lowest values. Significantly negative correlations were also detected for serum miR-328-3p levels with BGP and OPN values in all gout patients.</p><p><strong>Conclusion: </strong>Serum miR-328-3p levels were associated with diverse MSUS manifestations in gout patients. MSUS imaging and miR-328-3p levels are capable of reflecting the joint impairment in gout patients.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"329"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764200","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}