Journal of Orthopaedic Surgery and Research最新文献

{"title":"Research on the application effect of arthroscopic access modification in meniscal injury repair.","authors":"Shulin Li, Huayao Sun, Jiahao Zhang, Huiling Guo, Laipeng Yan, Faqiang Tang","doi":"10.1186/s13018-024-05434-z","DOIUrl":"10.1186/s13018-024-05434-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the application value of arthroscopic channel modification in meniscal injury repair.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 100 patients with meniscus injuries treated with knee arthroscopy from December 2022 to December 2023 and divided them into a control group and a modified group according to the application of \"arthroscopic access modification technology\". We compared the operation time, postoperative hospitalization time, VAS score, Lysholm knee function score, postoperative complications, and postoperative images of the patients in these two groups. We compared the operation time, postoperative hospitalization time, pre- and postoperative VAS scores, Lysholm knee function scores, postoperative complications and postoperative imaging indices of the patients in the two groups.</p><p><strong>Results: </strong>All patients successfully underwent surgery and were followed up without intraoperative vascular or nerve injury or postoperative complications such as infection, wound necrosis or thrombosis. The average follow-up time was 16.03 ± 3.69 months; the average operation time and postoperative hospitalization time of the modified group were significantly better than those of the control group were (P < 0.05); the pain and knee function of the two groups significantly improved over time (P < 0.05); and, compared with those of the control group, the modified group could obtain a more satisfactory score at an early stage of the postoperative period (P < 0.05), and the comparison of the intermediate and long-term scores of the two groups was not statistically significant (P > 0.05). There was no statistically significant difference (P > 0.05).</p><p><strong>Conclusion: </strong>The improved arthroscopic access technique can make the entry and exit of instruments into and out of the joint cavity smoother, improve the surgical field of view, significantly shorten the operation time, reduce the occurrence of intraoperative complications, improve the function of patients' knee joints earlier, and increase their satisfaction with the operation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"5"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927270","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":"Dichotomitin promotes osteoblast differentiation and improves osteoporosis by inhibiting oxidative stress.","authors":"Meichun Han, Weibin Du, Lei Zhang, Zhenwei Wang, Shengqiang Fang, Yang Zheng, Renfu Quan","doi":"10.1186/s13018-024-05398-0","DOIUrl":"10.1186/s13018-024-05398-0","url":null,"abstract":"<p><strong>Objective: </strong>Osteoporosis is a systemic disease with high morbidity and significant adverse effects. Increasing evidence supports the close relationship between oxidative stress and osteoporosis, suggesting that treatment with antioxidants may be a viable approach. This study evaluated the antioxidant properties of dichotomitin (DH) and its potential protective effects against osteoporosis.</p><p><strong>Methods: </strong>SD rats were divided into three groups: Sham, OVX, and OVX + DH (5 mg/kg, intraperitoneal injection twice weekly). After three months, blood samples, femurs, and tibiae were collected for analysis. Micro-CT evaluated the femoral, while histological examination assessed tibial tissues. Serum osteogenic biochemical markers were measured. In vitro, osteogenic differentiation was induced with varying concentrations of DH, followed by ALP and ARS staining. RT-qPCR and western blot were used to assess the expression of osteogenesis-related genes and proteins. Additionally, an oxidative stress cell model was established, dividing cells into control, H₂O₂-treated, and H₂O₂ + DH-treated groups. Expression of oxidative stress-related genes and proteins was assessed using real-time quantitative PCR and western blotting.</p><p><strong>Results: </strong>Micro-CT and histological staining revealed decreased and disrupted bone trabeculae in the OVX group, whereas the DH-treated group exhibited enhanced bone trabecular area and structure compared to the OVX group. In vitro studies showed that DH enhanced ALP activity and elevated expression of RUNX2, OPN, OCN, SOD1, and SOD2.</p><p><strong>Conclusion: </strong>DH has the potential to enhance osteoblast differentiation and alleviate osteoporosis through the attenuation of oxidative stress.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"6"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927191","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":"Possible association between Sever's disease and attention deficit hyperactivity disorder. a prospective observational study.","authors":"Nevzat Gonder, Ibrahim Halil Demir, Volkan Özel, Kubra Ilicepinar, Musa Alperen Bilgin","doi":"10.1186/s13018-024-05435-y","DOIUrl":"10.1186/s13018-024-05435-y","url":null,"abstract":"<p><strong>Background: </strong>Sever's disease is among the most common causes of foot pain in childhood.The etiology of Sever's disease is still under debate.The objective of this prospective study is to investigate the relationship between Sever's disease and attention deficit hyperactivity disorder(ADHD).</p><p><strong>Methods: </strong>The study was prospectively conducted for 1 year between 2023-2024.Of 238 children admitted to our clinic with foot pain, 88 children diagnosed with Sever's disease were included in the study.A control group including 90 individuals was employed.Patients diagnosed with Sever's disease in the orthopedics outpatient clinic and healthy control group were evaluated by a pediatric psychiatrist in terms of ADHD based on the DSM-4 diagnostic criteria.</p><p><strong>Results: </strong>Fifty-seven patients were male, and 31 were female.While 45 male patients were diagnosed with ADHD, 12 of them did not have ADHD.While 17 female patients were diagnosed with ADHD, 14 did not have ADHD. ADHD was detected in 12 (13.3%) of 90 patients in the control group, comprising 9 boys and 3 girls. The prevalence of ADHD in the Sever's disease cohort was 62 (70.5%) out of 88, significantly higher than the control group's 12 (13.3%) out of 90 patients (p < 0.01). The high number of the patients diagnosed with ADHD among the Sever's patients who were not engaged in sports was found to be statistically significant(p < 0.01).The diagnosis of ADHD was found to be statistically more significant in boys with Sever's disease compared to girls(p < 0.018).</p><p><strong>Conclusion: </strong>Children with Sever's disease can be the candidates for attention deficit hyperactivity disorder.It is thought that evaluating children, especially male children, diagnosed with calcaneal apophysitis within the framework of attention deficit hyperactivity disorder will be valuable.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"1"},"PeriodicalIF":2.8,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915141","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":"Adipose-derived mesenchymal stem cells combined with platelet-rich plasma are superior options for the treatment of osteoarthritis.","authors":"Weijie He, Jie Zhao, Jiafei Liu, Fangxing Wang, Zhenyu Xu","doi":"10.1186/s13018-024-05396-2","DOIUrl":"10.1186/s13018-024-05396-2","url":null,"abstract":"<p><strong>Background: </strong>There is currently no definitive treatment for osteoarthritis. We examined the therapeutic effects and underlying mechanisms of platelet-rich plasma (PRP) and adipose-derived mesenchymal stem cells (ADSCs), individually or in combination, in a rat model of anterior cruciate ligament-induced degenerative osteoarthritis (OA) of the knee. This study seeks to advance clinical approaches to OA treatment.</p><p><strong>Methods: </strong>Eight- to nine-week-old male Sprague-Dawley (SD) rats were randomly assigned to two groups: (1) a normal control group (Group A) and (2) a model group. The control group received no treatment. The model group underwent treatment and was further subdivided into six groups: Group B (an injury control group), Group C (high-dose ADSCs), Group D (PRP combined with high-dose ADSCs), Group E (low-dose ADSCs), Group F (PRP combined with low-dose ADSCs), and Group G (PRP alone). PRP and/or ADSCs were administered via intra-articular injection on Days 7, 37, and 67 post-surgery. Daily observations recorded activity levels and behavior, while weight changes were monitored weekly. Digital radiography (DR) was conducted on Days 30, 60, and 90 post-surgery to assess joint surface and contour alterations. Histopathological examination and inflammatory factor analysis were performed on cartilage and synovial tissue.</p><p><strong>Results: </strong>No abnormal reactions were observed in any rats, and body weights increased as expected (P > 0.05). Significant differences in knee swelling rates and Wakitani scores were observed between Groups A and B (P < 0.01). Knee swelling rates also differed significantly between Group B and Groups C-G (P < 0.01). Wakitani scores decreased on Days 60 and 90 in Groups C-G. TNF-α and IL-1β expression levels were significantly higher in Group B compared to Group A (P < 0.05). Expression levels of these genes were significantly lower in Groups C-G than in Group B (P < 0.05).</p><p><strong>Conclusions: </strong>Repeated intra-articular injections of PRP and ADSCs alleviated inflammation and pain, promoted tissue repair, and modulated immune responses in rats with surgically induced OA. The combination of PRP and ADSCs demonstrated enhanced therapeutic efficacy, suggesting its potential as a treatment option for OA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"2"},"PeriodicalIF":2.8,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922015","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":"Tuina alleviates the muscle atrophy induced by sciatic nerve injury in rats through regulation of PI3K/Akt signaling.","authors":"Yingqi Zhang, Hanyu Zhang, Jiayue Liu, Jiawei Sun, Yue Xu, Narentuya Shi, Hongzheng Zhang, Jiawang Yan, Jinping Chen, Hourong Wang, Tianyuan Yu","doi":"10.1186/s13018-024-05270-1","DOIUrl":"10.1186/s13018-024-05270-1","url":null,"abstract":"<p><strong>Background: </strong>Tuina is an effective treatment for the decrease of skeletal muscle atrophy after peripheral nerve injury. However, the underlying mechanism of action remains unclear. This study aimed to explore the underlying mechanisms of tuina in rats with sciatic nerve injury (SNI).</p><p><strong>Methods: </strong>We established an SNI rat model. After Tuina intervention, curative effects were evaluated by behavioral assessment, nerve function index, and muscle atrophy index (MAI). Pathological changes were observed by transmission electron microscopy and immunofluorescence. Insulin-like growth factor 1 (IGF-1), forkhead box O (FoxO) and p-FoxO levels were detected using enzyme-linked immunosorbent assay. Western blotting was performed to detect the expression of proteins involved in the PI3K/AKT signaling pathway.</p><p><strong>Result: </strong>Behavioral assessment, nerve function index, and MAI revealed that the tuina had significantly improved muscle atrophy after SNI compared with the SNI model group. Transmission electron microscopy showed that tuina improved muscle ultramicrostructure. CD31 immunofluorescence revealed that tuina improved microcirculation. Furthermore, we observed that tuina differentially regulated the levels of IGF-1, FoxO and p-FoxO, and the protein expression of p-Phosphoinositide 3-kinase (p-PI3K), p-AKT, and vascular endothelial growth factor in the anterior tibial muscle and soleus muscles.</p><p><strong>Conclusion: </strong>Tuina could effectively inhibit skeletal muscle atrophy via the microcirculation pathway in a rat model of SNI by regulating the expression of IGF-1 and FoxO. The underlying mechanism of action may involve the PI3K/Akt signaling pathway.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"892"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906946","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":"Research trends and frontiers in rehabilitation after total knee arthroplasty: based on bibliometric and visualization analysis.","authors":"Runkai Zhao, Haichao Ren, Pengcheng Li, Menglin Fan, Runzhi Zhao, Te Liu, Yan Wang, Quanbo Ji, Guoqiang Zhang","doi":"10.1186/s13018-024-05377-5","DOIUrl":"10.1186/s13018-024-05377-5","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is an effective treatment for end-stage knee osteoarthritis, and postoperative rehabilitation is crucial. However, a comprehensive bibliometric analysis of this area has yet to emerge. This study aims to visualize the research trends in postoperative rehabilitation after TKA through bibliometric analysis and explore current research frontiers and hotspots.</p><p><strong>Methods: </strong>Publications related to postoperative rehabilitation following TKA were identified and extracted from the Web of Science Core Collection (WoSCC) database. CiteSpace and VOSviewer were used for bibliometric and visualization analysis.</p><p><strong>Results: </strong>From January 1, 2000, to December 31, 2022, a total of 1,422 articles on TKA postoperative rehabilitation were identified from the database. The number of publications and citations showed steady growth during this period. The United States was the major contributor in this field, with the University of Colorado being the most active institution domestically. J Arthroplasty ranked first in both publication volume and total citations among all journals. Stevens-Lapsley, JE, and Mizner, RL were the two most influential authors. Reference and keyword analyses suggest that remote or home-based rehabilitation, the development of novel prehabilitation techniques, and pain management hold significant research potential, constituting current research hotspots.</p><p><strong>Conclusion: </strong>This study quantitatively identified and assessed the current research status and trends in perioperative rehabilitation management for TKA through bibliometric and visualization analyses. It provides essential information for scholars in the field of TKA postoperative rehabilitation research, highlighting key research frontiers and trends.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"897"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909822","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 efficacy of platelet-rich plasma in ankle disease: a systematic review and meta-analysis.","authors":"Qixin Ding, Xu Wang, Yurong Liu, Yuefang Li, Di Zhang, Heling Wang, Shenhong Ma, Qiaohua Han, Weisheng Zhuang","doi":"10.1186/s13018-024-05420-5","DOIUrl":"10.1186/s13018-024-05420-5","url":null,"abstract":"<p><strong>Objective: </strong>Ankle osteoarthritis is a debilitating condition that significantly impairs patients' quality of life. Platelet-rich plasma has emerged as a novel cellular therapy in clinical practice. This study evaluates the clinical efficacy of platelet-rich plasma (PRP) after intervention in ankle disorders, so as to provide strong evidence in support of clinical treatment.</p><p><strong>Methods: </strong>A comprehensive and systematic search of PubMed, the Cochrane Library, Embase and web of science databases was performed, and studies that met the requirements according to the inclusion criteria were analyzed using Review Manager and STATA version 14.0. Quality assessment was performed using the Cochrane Collaboration Risk of Bias 2.0 tool. The outcome indicators were the American Orthopaedic Foot and Ankle Society Rating Scale (AOFAS) and Visual Analog Scale (VAS) scores used to evaluate the efficacy of platelet-rich plasma.</p><p><strong>Results: </strong>A total of 10 studies met the inclusion criteria. Regarding the AOFAS score, a meta-analysis that included five randomized controlled trials (each study extracted the score results at the last follow-up time) showed no statistically significant differences between the platelet-rich plasma intervention group and the control group, and there was a great deal of heterogeneity in the results, with subgroup analyses based on disease type. (Mean Difference = 4.14, 95% CI=-0.60-8.87, p = 0.09, I² = 86%). Subgroup analysis showed a more significant effect in patients with talar cartilage injuries (Mean Difference = 8.66, 95%CI = 6.61-10.71, p < 0.00001, I² = 0%). And the treatment effect of PRP remained effective in long-term follow-up (Mean Difference = 7.83, 95% CI = 5.57-10.09, p = 0.46, I² = 0%). For VAS scores, PRP relieved patients' pain (Standardized Mean Difference=-0.62, 95%CI=-1.13-0.10, p = 0.02, I² = 77%) but showed a greater advantage in patients with cartilage injuries of the talus (Standardized Mean Difference=-1.24, 95%CI=-1.68-0.81, p < 0.00001, I² = 0%). Subgroup analyses according to different disease types and different follow-up times showed that PRP had significant efficacy in talar cartilage injuries in both the short and long term. A meta-analysis of single-arm studies showed that PRP was helpful in improving patients' pain before and after the intervention (Standardized Mean Difference = -1.76, 95% CI = -2.85 to -0.67, p = 0.002, I^2 = 87%).However, the high level of heterogeneity may be due to the large differences between the inclusion criteria of the single-arm studies.</p><p><strong>Conclusion: </strong>More clinical studies are needed to further confirm the efficacy of platelet-rich plasma in ankle disorders, and the current study only suggests that platelet-rich plasma may be more effective in talus cartilage injuries than in other types of ankle disorders.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"895"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909843","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":"Morphological and clinical study of lateral malleolus fractures based on fracture mapping: a retrospective study.","authors":"Ruizhi Cai, Shuo Feng, Chuhan Chen, Hao Lu, Hailin Xu","doi":"10.1186/s13018-024-05424-1","DOIUrl":"10.1186/s13018-024-05424-1","url":null,"abstract":"<p><strong>Background: </strong>The traditional classification for lateral malleolus fracture has its limitations. In this study, we introduced a three-dimensional (3D) fracture mapping technique using computed tomography (CT) data to assess fracture line distributions and their impact on patient outcomes, offering a refined classification approach.</p><p><strong>Methods: </strong>Retrospectively, we analysed 97 patients who underwent lateral malleolus fracture surgeries (2014-2019), using CT Digital Imaging and Communications in Medicine data to create 3D models and fracture maps. This methodology refined the Danis-Weber classification and enabled the assessment of fracture severity and syndesmotic stability through clinical scoring.</p><p><strong>Results: </strong>Danis-Weber type B fractures were predominant (83.5%), showing a distinct pattern. Subtypes were identified based on the bone fragments that are clinically associated with increased injury severity but did not significantly affect syndesmotic stability or prognostic scores.</p><p><strong>Conclusion: </strong>The 3D fracture map provides a detailed view of fracture characteristics, enabling precise classification. In type B fractures, bone fragments indicating higher trauma do not predict clinical outcomes, thereby supporting personalised surgical planning.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"894"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909816","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 predictive value of endplate morphology and pedicle screw bone quality score on screw loosening after single-level lumbar spinal fusion surgery.","authors":"Jinxiang Zhan, Qipeng Wei, Weijun Guo, Zihao Liu, Shiji Chen, Qingyan Huang, Dongling Cai","doi":"10.1186/s13018-024-05367-7","DOIUrl":"10.1186/s13018-024-05367-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the predictive value of endplate morphology and pedicle screw bone quality score on screw loosening after single-level lumbar spinal fusion surgery.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 207 patients who underwent single-level lumbar spinal fusion (34 in the screw loosening group and 173 in the non-screw loosening group). Univariate analysis and binary logistic regression model analysis were performed using SPSS 27.0. MedCalc 23 was used to plot the receiver operating characteristic (ROC) curve to evaluate diagnostic efficacy.</p><p><strong>Results: </strong>Through comparative analysis of clinical data, we found statistically significant differences between the two groups in terms of endplate morphology, lumbar CT values, and PBQ scores(P<0.05). The results of the binary logistic regression analysis indicated that endplate morphology (OR = 17.088, 95% CI: 3.886-75.142; p < 0.001) and PBQ score (OR = 3.347, 95% CI: 1.473-7.603; p = 0.004) are independent risk factors for screw loosening after single-level lumbar spinal fusion surgery. The ROC analysis showed that the area under the curve (AUC) for endplate morphology was 0.731 (95% confidence interval [CI]: 0.665-0.790), with the optimal threshold representing irregular endplate morphology (sensitivity: 94.1%, specificity: 52.0%). The AUC for the PBQ score was 0.791 (95% CI: 0.729-0.844), with an optimal threshold of 3.198 (sensitivity: 91.2%, specificity: 61.8%). Furthermore, the predictive model constructed using both endplate morphology and PBQ score had an AUC of 0.870 (95% confidence interval: 0.817-0.913), with a maximum Youden index of 0.668, yielding a diagnostic sensitivity of 88.2% and specificity of 78.6%.</p><p><strong>Conclusion: </strong>Endplate morphology and pedicle screw bone quality score have significant reference value for diagnosing screw loosening after single-level lumbar spinal fusion surgery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"898"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909783","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":"Application of additive manufacturing TaBw01 porous tantalum rod in ARCO stage II osteonecrosis of the femoral head.","authors":"Jingjie Huang, Yifan Jiang, Yang Peng, Lina Hao, Ran Xiong, Tiao Su, Guangxing Chen","doi":"10.1186/s13018-024-05416-1","DOIUrl":"10.1186/s13018-024-05416-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the suitable surgical strategies for applying TaBw01 porous tantalum rod across different stages of osteonecrosis of the femoral head (ONFH).</p><p><strong>Methods: </strong>TaBw01 tantalum rods were fabricated using type FTaY-1 tantalum powder via the foam impregnation-sintering method. Mechanical testing with the Instron 8801 universal testing machine and finite element analysis (FEA) assessed single tantalum rod implantation and impaction bone grafting combined with rod implantation. A total of 86 osteonecrosis of the femoral head (ONFH) patients (94 hips) were treated: the experimental group (45 patients, 50 hips) underwent surgical hip dislocation (SHD) with impaction bone grafting and tantalum rod implantation, while the control group (41 patients, 44 hips) received single rod implantation. Primary failure criteria included femoral head collapse (≥ 2 mm) or total hip arthroplasty. Patient-reported outcomes (PROs), including Harris Hip Score (HHS), Visual Analog Score (VAS), Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), and Hip Outcome Score Sport-Specific Subscale (HOS-SSS), were analyzed based on Minimum Clinically Important Difference (MCID).</p><p><strong>Results: </strong>FEA confirmed stresses below the material's yield and compressive strength. At 3 years, survival rates for ARCO (Association Research Circulation Osseous) stage IIb and IIc were higher in the experimental group (100%, 80.38%) than the control group, while stage IIa survival was 100% in the control group. The experimental group also had higher MCID attainment for HHS, HOS-ADL, and HOS-SSS.</p><p><strong>Conclusions: </strong>Compared with single TaBw01 implantation, impaction bone grafting combined with TaBw01 implantation via SHD demonstrated superior outcomes for ARCO stage IIb and IIc, with a minimum 2-year follow-up. while single TaBw01 implantation may be more suitable for stage IIa. This study emphasizes the importance of combining biological and biomechanical reconstruction in ONFH treatment.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"893"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909749","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}