Journal of Orthopaedic Surgery and Research最新文献

{"title":"Cemented versus cementless cup fixation in total hip arthroplasty for proximal femoral fractures: analysis of revision and mortality rates from the German arthroplasty registry (EPRD).","authors":"Clemens Roitzsch, Cecilia Rogmark, Yinan Wu, Alexander Grimberg, Jörg Lützner, Anne Postler","doi":"10.1186/s13018-025-06281-2","DOIUrl":"https://doi.org/10.1186/s13018-025-06281-2","url":null,"abstract":"<p><strong>Background: </strong>The management of femoral neck fractures (FNF) in elderly patients depends on comorbidities, pre-fracture mobility, any hip joint disease, and life expectancy, with treatment typically involving either hemiarthroplasty (HA) or total hip arthroplasty (THA). While cemented femoral stem fixation is standard, there is no clear consensus regarding cemented versus cementless cup fixation in THA. This study aimed to compare revision and mortality rates between THA, divided into cemented and cementless cup fixation, and HA, following FNF.</p><p><strong>Methods: </strong>Data from the German Arthroplasty Registry (EPRD) were analyzed, including all patients with fracture-related THA or HA and available follow-up. A total of 34,501 patients undergoing THA (27,757 cementless, 6,744 cemented cups) and 72,022 patients with HA were included. 5-year revision and mortality rates were compared.</p><p><strong>Results: </strong>The 5-year revision rate was the lowest in the HA group (4.1%), followed by cemented cup THA (5.0%), and cementless cup THA (6.8%; p < 0.001). Dislocation, infection, and periprosthetic fracture were the leading causes of revision. The 5-year mortality rate was the lowest in cementless cup THA patients (23%), 43% in cemented cup THA patients and highest in HA patients (54%). Cementless fixation was associated with a higher revision risk (HR 1.28, 95% CI 1.14-1.44), while HA was associated with increased mortality (HR 1.26, 95% CI 1.22-1.31).</p><p><strong>Conclusion: </strong>Cemented cup fixation in THA after FNF is associated with lower revision rates but higher mortality compared to cementless fixation. In patients with limited life expectancy, HA remains the preferred option.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"873"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251621","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":"Heterotopic ossifications in revision reverse shoulder arthroplasty and their impact on long-term outcomes.","authors":"Raphael Trefzer, Michel Leisner, Mustafa Hariri, Johannes Weishorn, Paul Mick, Matthias Bülhoff","doi":"10.1186/s13018-025-06312-y","DOIUrl":"https://doi.org/10.1186/s13018-025-06312-y","url":null,"abstract":"<p><strong>Background: </strong>Heterotopic ossifications (HO) are frequently observed after joint replacement surgery and may impair joint mobility and clinical outcomes. The incidence and clinical relevance of HO in revision reverse shoulder arthroplasty (RSA) remain unclear. The purpose of this study was to investigate the (1) incidence of HO and (2) the influence of HO on long-term clinical outcomes in a selected patient cohort who underwent revision RSA.</p><p><strong>Methods: </strong>We retrospectively identified patients who underwent revision RSA with a minimum follow-up of 5 years. A total of 37 patients (20 female; mean age, 66 years) were examined after a mean follow-up of 10 years. Clinical outcomes included the Constant-Murley Score (CMS) and its age- and sex-adjusted form (aCMS). HO were evaluated on radiographs by two independent raters and graded using a modified Brooker classification. Inter-rater agreement was calculated using Cohen's Kappa. Statistical comparison of means was conducted using student's t-test for normally distributed data. Chi square tests were used to assess the incidence between groups. Spearman's Rho was calculated to investigate correlations between HO grades and clinical outcome.</p><p><strong>Results: </strong>HO were observed in 28 of 37 patients (75%). Inter-rater agreement was substantial (Cohen's Kappa = 0.63). The mean aCMS at 10 years was 70.7%; 62% of patients (23/37) reached the patient-acceptable symptomatic state (PASS, defined as aCMS > 61%). HO incidence did not differ between one-stage and two-stage revisions (77% vs. 74%). Higher HO grades were negatively correlated with CMS (r = - 0.412; p = 0.013). Patients with HO grade ≥ 2 had significantly lower aCMS values (61.5% vs. 81.6%; p = 0.03) and were less likely to reach the PASS (40% vs. 88%; p = 0.0003).</p><p><strong>Conclusion: </strong>HO show a high incidence in revision RSA and are clinically relevant as they are associated with inferior long-term clinical outcomes in grade 2 or higher. Future studies should emphasize on preventive strategies in patients undergoing revision RSA.</p><p><strong>Level of evidence iii: </strong>Therapeutic study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"871"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251344","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":"Cross-cultural adaptation and validation of the 12-item short forms of the knee injury and osteoarthritis outcome score (KOOS-12) to Persian language.","authors":"Fereshteh Kazemi Pakdel, Ahmad Kazemi Pakdel, Ali Asghar Norasteh","doi":"10.1186/s13018-025-06301-1","DOIUrl":"https://doi.org/10.1186/s13018-025-06301-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to translate, culturally adapt, and validate the 12-item short form of the knee injury and osteoarthritis outcome score (KOOS-12) for use in the Persian language.</p><p><strong>Methods: </strong>This study employed a cross-sectional design involving 105 participants with moderate to severe knee osteoarthritis (OA). The Persian version of the KOOS-12 was administered to assess its test-retest reliability, internal consistency, and construct validity. Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC), with values above 0.75 indicating excellent reliability. Internal consistency was assessed using Cronbach's alpha, where values between 0.70 and 0.90 indicate good to excellent consistency. Construct validity was examined through Pearson correlation coefficients, comparing KOOS-12 scores with established measures such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), cincinnati knee rating system (CKRS), Oxford knee score (OKS), and knee society knee scoring system (KSS). Additionally, the standard error of measurement (SEM) and minimal detectable change (MDC) were calculated to provide insights into the measurement's precision and responsiveness, with SEM calculated as SD × √(1-R) and MDC as 1.96 × √2 × SEM.</p><p><strong>Results: </strong>The Persian version of the KOOS-12 was administered to assess its construct validity, test-retest reliability, and internal consistency. Construct validity was evaluated through Pearson correlation coefficients, revealing strong correlations with the KOOS (r = 0.81), moderate correlation with the CKRS (r = 0.56), and strong negative correlation with the WOMAC (r = - 0.77), along with strong correlations with the OKS (r = 0.71) and the KSS (r = 0.73). Test-retest reliability was assessed using the ICC, with values above 0.75 indicating excellent reliability. Internal consistency was measured using Cronbach's alpha, where values between 0.70 and 0.90 indicate good to excellent consistency.</p><p><strong>Conclusion: </strong>The analysis of the Persian KOOS-12 questionnaire confirms its excellent reliability, validity, and suitability for clinical use, supported by excellent internal consistency and excellent test-retest reliability. These findings underscore the importance of culturally adapted instruments and indicate the need for future research to evaluate the KOOS-12's responsiveness to clinical changes over time.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"882"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251174","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":"Delayed fixation of neglected acetabular fractures: clinical challenges and mid-term outcomes of a prospective case series.","authors":"Mahmoud Fahmy, Hazem Abdelazeem, Ahmed Hazem Abdelazeem, Mostafa Ahmed Shawky","doi":"10.1186/s13018-025-06298-7","DOIUrl":"https://doi.org/10.1186/s13018-025-06298-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Neglected acetabular fractures, defined as those not addressed surgically within three weeks of injury, pose significant technical and prognostic challenges due to chronic displacement, malunion, and soft tissue contracture. This study aimed to evaluate radiological and functional outcomes of open reduction and internal fixation (ORIF) in a large prospective cohort managed at a tertiary trauma center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between 2009 and 2019, patients aged 14 years and older with displaced, neglected acetabular fractures (&gt; 3 weeks post-injury) were enrolled at a high-volume Level I pelvic trauma center. Exclusion criteria included pathological fractures, fresh fractures, unreconstructable articular surfaces, and patients who did not complete the minimum follow-up period. Of the total cohort, 94 patients underwent ORIF and were analyzed. Preoperative evaluation included CT imaging, and fractures were classified using the Letournel-Judet system. Radiological reduction quality was graded by Matta's criteria, and functional recovery was assessed using the modified Merle d'Aubigné-Postel score. Secondary outcomes included complication rates and conversion to THA. For subgroup analysis, patients were stratified into early-late presenters (3-5 weeks) and very-late presenters (&gt; 5 weeks). Statistical analysis employed chi-square tests for categorical variables, Student's t-test or Mann-Whitney U test for continuous variables, and multivariate logistic regression to identify predictors of outcome, with significance set at p &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 94 patients analyzed, anatomical reduction (≤ 1 mm displacement) was achieved in 59.6%, with imperfect and poor reductions in 26.6% and 13.8%, respectively. Quality of reduction (β = 0.44, p &lt; 0.001) and surgical delay (β = - 0.32, p = 0.006) independently predicted functional outcome, while fracture type and femoral head condition were not significant.On subgroup comparison, early-late presenters (3-5 weeks) showed a trend toward better outcomes compared with very-late presenters (&gt; 5 weeks), although differences did not reach statistical significance. Major complications included heterotopic ossification (12.8%), post-traumatic arthritis (14.9%), avascular necrosis (9.6%), and conversion to THA during follow-up (10.6%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study represents one of the largest prospective series on neglected acetabular fractures with midterm follow-up. Despite delayed presentation, ORIF achieved satisfactory anatomical and functional results in most cases. Early surgical intervention within the neglected window was associated with superior outcomes, while subgroup analysis highlighted a gradual adverse effect of increasing delay. These findings underscore the importance of individualized surgical strategies, meticulous planning, and experienced surgical execution in optimizing results for this challenging patient populatio","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"872"},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251340","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":"Reply to Sun et al.: Methodological clarifications regarding \"Ultratape and sutures combination versus conventional sutures in arthroscopic rotator cuff repair: a 6-month retrospective matched cohort study\".","authors":"Ala' Hawa, James Bilbrough, Christyon Hayek, Mina Shenouda, George A C Murrell","doi":"10.1186/s13018-025-06198-w","DOIUrl":"10.1186/s13018-025-06198-w","url":null,"abstract":"<p><p>We thank Sun et al. for their interest in our article, \"UltraTape and Sutures Combination Versus Conventional Sutures in Arthroscopic Rotator Cuff Repair: A 6-Month Retrospective Matched Cohort Study\", and for their constructive comments. Their concerns regarding temporal bias and methodology merit clarification. Here, we detail our study design and efforts to minimize bias, and discuss the interpretation and clinical value of real-world, retrospective cohort data in the context of new surgical technologies.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"867"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199718","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":"Morphometric analysis of safe working zones for minimally invasive lateral extrapleural/retroperitoneal approach via transdiaphragmatic and transpsoas to the thoracolumbar and lumbar spine.","authors":"Zhengming Lv, Jian Tong, Haijun Li, Yongxin Ren","doi":"10.1186/s13018-025-06219-8","DOIUrl":"10.1186/s13018-025-06219-8","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"869"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199682","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":"KDM6B promotes ferroptosis in rheumatoid arthritis fibroblast-like synoviocytes via the miR-128-3p/SLC7A11 axis through H3K27me3 modification.","authors":"Bin Wang, Song Gao, Zongwei Liu, Yan Cong, Chuansheng Wu","doi":"10.1186/s13018-025-06277-y","DOIUrl":"10.1186/s13018-025-06277-y","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic inflammatory joint disease, primarily driven by fibroblast-like synoviocytes (FLSs) that trigger synovial inflammation and joint destruction. This study explores the mechanisms of KDM6B in ferroptosis in RA-FLSs, providing a theoretical basis for the treatment of RA.</p><p><strong>Methods: </strong>RA-FLSs were isolated from RA synovial tissue samples. si-KDM6B was transfected into RA-FLSs, followed by the detection of KDM6B and miR-128-3p using qRT-PCR and Western blot. Cell viability was assessed using the CCK-8 assay. The levels of ROS, GSH, MDA, and Fe²⁺ were evaluated, and the expression of GPX4, SLC7A11, and ACSL4 was measured. The enrichment of KDM6B and H3K27me3 on the miR-128-3p promoter was detected by ChIP. The binding relationship between miR-128-3p and SLC7A11 was validated by dual-luciferase reporter assay. Combined experiments were designed to validate the mechanism.</p><p><strong>Results: </strong>KDM6B was highly expressed in RA tissues and RA-FLSs. Inhibition of KDM6B increased cell viability, elevated ROS, MDA, and Fe²⁺, decreased GSH, reduced GPX4 and SLC7A11, and increased ACSL4. KDM6B and H3K27me3 were enriched on the miR-128-3p promoter. Inhibition of KDM6B increased H3K27me3 enrichment and suppressed miR-128-3p expression. miR-128-3p targeted and inhibited SLC7A11 expression. miR-128-3p overexpression or SLC7A11 inhibition partially reversed the inhibitory effect of KDM6B inhibition on ferroptosis in RA-FLSs.</p><p><strong>Conclusion: </strong>KDM6B promotes ferroptosis in RA-FLSs via the miR-128-3p/SLC7A11 axis through the removal of histone H3K27me3 modification.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"862"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191997","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":"Physical therapy versus conventional treatment for grade I and II acute ankle sprains: trial sequential analysis and meta-analysis.","authors":"Changsen Yang, Weilu Gao, Zhengfeng Jia, Jiantao Li, Miaotian Tang","doi":"10.1186/s13018-025-06272-3","DOIUrl":"10.1186/s13018-025-06272-3","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis evaluated the effectiveness of physiotherapy compared with conventional therapies for grade I and II acute ankle sprains.</p><p><strong>Methods: </strong>Randomized controlled trials were identified through a comprehensive search of PubMed, Embase, and Web of Science databases. Eligibility criteria were defined using the PICOS framework. Analyses included forest plot analysis, subgroup analysis, sensitivity analysis, publication bias analysis, and Trial Sequential Analysis (TSA) using Review Manager (version 5.4), StataMP 17, and TSA 0.9.5.10 beta software.</p><p><strong>Results: </strong>Ten RCTs involving 565 participants met the inclusion criteria. The physical therapy group had significantly lower post-treatment visual analog scale (VAS) scores for pain compared to the conventional treatment group (weighted mean difference [WMD] = -0.46, 95% CI = -0.90 to -0.01, P = 0.04). On subgroup analysis, VAS scores at rest were also significantly lower in the physical therapy group compared to the conventional treatment group (WMD = -0.34, 95% CI = -0.67 to -0.01, P = 0.04).</p><p><strong>Conclusions: </strong>Physical therapy may offer superior pain relief compared with conventional treatment for grade I and II acute ankle sprains. Further high-quality, adequately powered RCTs are warranted to obtain more robust evidence.</p><p><strong>Level of evidence: </strong>level 1.</p><p><strong>Registration: </strong>CRD42025640304.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"861"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192029","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 pipeline to morph finite element models of the lumbar spine for generation of customised spinal cages.","authors":"Yihang Yu, Dale L Robinson, David C Ackland, Peter Vee Sin Lee","doi":"10.1186/s13018-025-06248-3","DOIUrl":"10.1186/s13018-025-06248-3","url":null,"abstract":"<p><strong>Background: </strong>Lumbar interbody fusion with spinal cages is an established treatment for degenerative disc disease, however, generic cages comprising standardised shapes and sizes still encounter complications such as cage migration and subsidence. Incorporating biomechanical analysis and implant customisation for pre-operative planning provides the possibility to optimise cage positioning and its 3D geometry, such that cage loading is optimised to reduce the chance of post-operative complications. However, current customisation processes involve considerable resources to develop personalised finite element models for evaluating bespoke cage designs. Therefore, this study aimed to build an automated pipeline to generate personalised lumbar FE model with a customised spinal cage.</p><p><strong>Methods: </strong>A template lumbar FE model was established based on an average-sized healthy male, whose surface mesh was non-rigidly aligned to a training set of 46 lumbar spines. Then, a statistical shape model was built to predict the shape of new spines by changing the weightings of parameters inside, which facilitate the generation of personalised FE model. Once the spine mesh was fitted to the new subject, a customised cage was created by extruding a 2D cage template in the axial direction then trimming it via a Boolean function with the adjacent endplates. After adjustment of cage parameters, the cage model could be added to the FE model to replace one disc component. The range of motions and facet joint forces in typical lumbar rotations were extracted from the results of FE analyses.</p><p><strong>Results: </strong>The predicted ROM and facet joint force for corresponding intact lumbar models compared well with or approached to the range of published data, while the cage insertion significantly reduced the ROM of lumbar spine in all directions (all p[Formula: see text]0.02). Also, the lateral cage position affected the ROM of the whole spine and resulted in larger fracture volume on the vertebrae based on the analysis on a specific subject.</p><p><strong>Conclusions: </strong>The pipeline can generate personalised lumbar FE models and customised spinal cages with predictive outputs. Its automatic process reduced the effort expenditure involved in FE model development and cage design, making it viable for application in fusion surgery planning and spinal cage customisation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"864"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192032","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 short-term clinical effects of accelerated rehabilitation following open surgery for acute Achilles tendon rupture based on ultrasonography monitoring: a retrospective cohort study.","authors":"Yuan Cao, Shan Gao, Bo Zhao, Xiuzhi Li, Xiaoyu Norman Pan, Yang Lv, Fang Zhou","doi":"10.1186/s13018-025-06282-1","DOIUrl":"10.1186/s13018-025-06282-1","url":null,"abstract":"<p><strong>Background: </strong>Individualized rehabilitation after acute Achilles tendon rupture (AATR) repair is important. The aim of this study was to evaluate and compare the short-term clinical effects of different rehabilitation processes following open surgery for AATR based on ultrasonography (US) monitoring.</p><p><strong>Methods: </strong>This retrospective cohort study included 80 patients (mean age, 32.0 ± 4.4 years) who underwent open surgery for AATR repair between March 2022 and May 2023. The patients were categorised into two groups (ultrasound-guided rehabilitation group, UR, and conventional rehabilitation group, CR) according to whether postoperative rehabilitation relied on US monitoring. All patients received the same suture technique and immobilisation duration; they were clinically examined at 2, 4, 6, 8, 10, 12, 14, and 16 weeks postoperatively, with a final follow-up at a mean of 18.8 months. The primary outcome was the recovery time for the one-leg heel-rise height (OHRH). Secondary outcomes included the time required to return to range of motion(ROM) and light exercise (LE), the clinical function scores, and complications. Data regarding the surgical duration, the visual analogue scale (VAS) score for pain, the Achilles tendon Total Rupture Score (ATRS), and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score were also collected.</p><p><strong>Results: </strong>The recovery times for OHRH (11.6 ± 2.1 vs. 12.1 ± 1.4) and LE (17.2 ± 1.7 vs. 18.3 ± 2.2) were significantly shorter in group UR than in group CR (P < 0.05). The VAS scores decreased over time, reaching 0 in both groups by 10 weeks. ATRS and the AOFAS Ankle-Hindfoot scale score increased across both groups over time, showing significant between-group differences from 4 to 14 weeks(36.2 ± 9.7 vs. 28.4 ± 5.7; 61.0 ± 12.3 vs. 52.2 ± 6.8; 76.1 ± 9.7 vs. 69.7 ± 5.1; 87.2 ± 8.4 vs. 82.1 ± 4.6; 93.8 ± 5.8 vs. 91.6 ± 4.0; 96.7 ± 2.8 vs. 96.1 ± 2.0; P < 0.05) and 4 to 8 weeks (67.6 ± 7.9 vs. 60.1 ± 4.8; 77.8 ± 11.7 vs. 68.9 ± 7.4; 94.9 ± 9.8 vs. 92.9 ± 7.9; P < 0.05). The mean scores were better in group UR than in group CR. Three re-ruptures (3.8%) were observed, and all complications were resolved at the last follow-up, with no significant between-group differences.</p><p><strong>Conclusions: </strong>Rehabilitation under ultrasonography monitoring may be a promising strategy to optimize early functional recovery after AATR repair for young people with high demands for sports.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"865"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192071","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}