Journal of Orthopaedic Surgery and Research最新文献

{"title":"The incidence and risk factors of phobic movement disorder after hip fracture internal fixation surgery.","authors":"Liming Xu, Wenjie Chen","doi":"10.1186/s13018-025-05750-y","DOIUrl":"https://doi.org/10.1186/s13018-025-05750-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyze the cumulative incidence and associated risk factors of phobic movement disorder (PMD) after hip fracture internal fixation surgery, with the goal of optimizing postoperative rehabilitation management and improving the quality of life in elderly patients.</p><p><strong>Methods: </strong>A total of 269 patients who underwent hip fracture internal fixation surgery at our hospital from June 2022 to June 2024 were retrospectively included. Clinical data, including age, sex, BMI, underlying diseases, psychological status, postoperative hip joint function, and self-efficacy, were collected. PMD was assessed using the Tampa Scale for Kinesiophobia (TSK), pain acceptance was evaluated using the Chronic Pain Acceptance Questionnaire (CPAQ-8), anxiety and depression status were assessed with the Hospital Anxiety and Depression Scale (HADS), hip joint function was measured using the Harris Hip Score, and self-efficacy was evaluated using the General Self-Efficacy Scale (GSE). Univariate analysis and multivariate binary logistic regression analysis were used to identify independent risk factors for PMD. The variance inflation factor (VIF) was calculated to assess multicollinearity.</p><p><strong>Results: </strong>The cumulative incidence of PMD was 34.9%. Univariate analysis revealed that BMI ≥ 30 kg/m², low pain acceptance, anxiety and depression, poor postoperative hip joint function, and low self-efficacy were significantly associated with PMD (P < 0.001). Multivariate logistic regression analysis further confirmed that BMI ≥ 30 kg/m² (OR = 4.07, 95% CI [2.39, 6.94]), low pain acceptance (OR = 4.67, 95% CI [2.69, 8.10]), anxiety and depression (OR = 4.14, 95% CI [2.44, 7.04]), poor postoperative hip joint function (OR = 10.61, 95% CI [5.67, 19.87]), and low self-efficacy (OR = 4.19, 95% CI [2.44, 7.18]) were independent risk factors for PMD. All VIF values were < 5, indicating no significant multicollinearity.</p><p><strong>Conclusion: </strong>PMD is common after hip fracture internal fixation surgery and is closely associated with high BMI, low pain acceptance, anxiety and depression, poor postoperative hip joint function, and low self-efficacy. The VIF analysis showed no significant multicollinearity, indicating stable results. Comprehensive interventions targeting high-risk factors may help reduce the incidence of PMD and improve postoperative recovery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"323"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743139","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 comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty.","authors":"Hiroki Hijikata, Tomoharu Mochizuki, Keisuku Maeda, Osamu Tanifuji, Go Omori, Noriaki Yamamoto, Hiroyuki Kawashima","doi":"10.1186/s13018-025-05741-z","DOIUrl":"https://doi.org/10.1186/s13018-025-05741-z","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare three-dimensional (3D) and two-dimensional (2D) evaluation of the stress X-rays following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This prospective study analyzed 51 consecutive rTKAs (four males and 44 females, both aged 74 ± 6 years). Postoperative varus/valgus stress X-rays were taken at maximum manual varus/valgus stress during knee extension under anesthesia, and were analyzed three-dimensionally using a 3D-2D image matching technique with 3D bone and component models. The 3D models of the femur and tibia, along with component-bone constructs, were reconstructed from CT data using 3D modeling software. The 2D evaluation of varus/valgus stress X-rays were carried out directly on the stress X-rays. The varus/valgus angle (VV angle) between components, Medial joint opening (MJO) and lateral joint opening (LJO) were assessed under conditions of no stress, valgus stress, and varus stress.</p><p><strong>Results: </strong>The VV angles under no stress, valgus stress, and varus stress in 3D and 2D evaluation were 3.6 ± 1.1 / 3.6 ± 1.1°, -0.6 ± 1.6 / -0.6 ± 1.6°, 7.1 ± 1.9 / 6.8 ± 2.5°, respectively. The MJO in the non-stress condition and under valgus stress in 3D and 2D evaluation were 0.0 ± 0.5 / -1.8 ± 0.8 mm,1.4 ± 1.0 / -0.2 ± 1.4 mm, and the LJO in the non-stress condition and under varus stress in 3D and 2D evaluation were 0.9 ± 1.0 / -0.6 ± 1.0 mm, 3.5 ± 1.9 / 2.1 ± 1.9 mm, respectively.</p><p><strong>Conclusions: </strong>This prospective study revealed that the 3D evaluation of varus/valgus stress X-rays following total knee arthroplasty is equivalent to 2D evaluation in VV angles, whereas different from 2Devaluation in MJO and LJO.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"326"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743132","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":"Appropriate patient selection based on joint line convergence angle minimizes the difference between the mechanical axis in the standing and supine positions after open-wedge high tibial osteotomy and distal tuberosity osteotomy.","authors":"Naosuke Nagata, Takehiko Matsushita, Shu Watanabe, Yuta Nakanishi, Kyohei Nishida, Kanto Nagai, Noriyuki Kanzaki, Yuichi Hoshino, Tomoyuki Matsumoto, Ryosuke Kuroda","doi":"10.1186/s13018-025-05711-5","DOIUrl":"10.1186/s13018-025-05711-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the differences between the mechanical axis (MA) in standing and supine positions in patients who underwent high tibial osteotomy (HTO) or distal tuberosity osteotomy (DTO) based on the surgical indication for the joint line convergence angle (JLCA).</p><p><strong>Methods: </strong>Seventy-one knees of 69 patients with JLCA of < 6° in standing position and a difference of < 3° between the JLCA in the standing and supine positions who had undergone medial open-wedge HTO or DTO were included in this study. The %MA in the standing and supine positions (%MAst and %MAsp, respectively) and JLCA in the standing and supine positions (JLCAst and JLCAsp, respectively) were determined using preoperative and postoperative long-leg-view radiographs. The difference between %MA and JLCA in the standing and supine positions (Δ%MA and ΔJLCA, respectively) was calculated by subtracting the measurement value in the supine position from that in the standing position.</p><p><strong>Results: </strong>The preoperative %MAst, %MAsp, JLCAst, and JLCAsp were 23.8 ± 9.5%, 28.7 ± 8.0%, 2.9 ± 1.4°, and 1.6 ± 1.4° respectively. The preoperative Δ%MA and ΔJLCA were - 4.9 ± 5.9% and 1.3 ± 1.0° respectively. The postoperative %MAst, %MAsp, JLCAst, and JLCAsp were 58.8 ± 6.9%, 59.0 ± 6.2%, 1.7 ± 1.0°, and 1.5 ± 1.1°, respectively. No significant differences were observed between the postoperative %MAst and %MAsp. The postoperative Δ%MA and ΔJLCA were - 0.2 ± 3.0% and 0.3 ± 0.6°, respectively. The postoperative Δ%MA was - 5 to 5% in 68 knees (95.8%).</p><p><strong>Conclusion: </strong>Minimal differences were observed between the Δ%MA after HTO and DTO among patients with preoperative JLCAst of < 6° and ΔJLCA and of < 3°, respectively. Appropriate surgical indications could minimize this difference.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"321"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of preoperative handgrip strength on postoperative outcomes following transforaminal lumbar interbody fusion.","authors":"Duy Nguyen Anh Tran, Yu-Pin Chen, Hui-En Lin, Tan Thanh Nguyen, Hoan Le Nguyen, Yi-Jie Kuo","doi":"10.1186/s13018-025-05717-z","DOIUrl":"10.1186/s13018-025-05717-z","url":null,"abstract":"<p><strong>Background: </strong>With an aging population, the prevalence of lumbar spinal diseases necessitating surgical intervention is increasing. Handgrip strength (HGS) has emerged as a simple measure of muscle function that may correlate with surgical outcomes. However, the role of HGS concerning postoperative recovery following transforaminal lumbar interbody fusion (TLIF) is not well-studied, highlighting a gap in the literature regarding its potential as a prognostic tool.</p><p><strong>Methods: </strong>This prospective observational study included 89 patients who underwent TLIF performed by a single surgeon. Patients were categorized into normal and low HGS groups based on preoperative HGS measurements. Demographics, baseline HGS, and surgical details were recorded, and outcomes were assessed using the JOA, EQ-5D-3L, and Barthel Index at 3, 6, and 12 months postoperatively. Generalized Estimating Equations were used to examine associations between baseline parameters and outcomes over time.</p><p><strong>Results: </strong>All patients were followed for at least one year, except for 15 (15.6%) who were lost to follow-up before the one-year mark. Patients with lower preoperative HGS were associated with significantly poorer postoperative functional outcomes. Specifically, a one-unit decrease in HGS was associated with a 2.551-point decrease in the JOA score (p = 0.008), a 0.142-point decrease in the EQ-5D-3L score (p = 0.007), and a 5.784-point decrease in the Barthel Index (p = 0.036). Additionally, male sex, higher body mass index, and lower Charlson comorbidity index were associated with better postoperative outcomes.</p><p><strong>Conclusions: </strong>Low preoperative handgrip strength is associated with poorer functional, quality of life, and independence outcomes up to 12 months after TLIF surgery. Assessing HGS preoperatively may provide clinicians with valuable information for identifying patients at risk of suboptimal recovery. Future research could explore intervention strategies to improve preoperative muscle function and potentially enhance recovery outcomes for patients undergoing TLIF.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"320"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730564","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 novel external fixation for treating tibial fractures: a finite element and biomechanical study.","authors":"Shen Liu, Xiangdang Liang, Songyang Liu, Zhanshe Guo, Xing Wei, Yonghui Liang","doi":"10.1186/s13018-025-05681-8","DOIUrl":"10.1186/s13018-025-05681-8","url":null,"abstract":"<p><strong>Objective: </strong>Design a new type of external fixation device that is small in size, high in strength, and capable of achieving the mechanical requirements for fracture healing. Verify the rationality and effectiveness of the device in treating tibial fractures through finite element analysis and biomechanical comparative tests.</p><p><strong>Methods: </strong>Finite element simulation was performed on the new external fixation device to treat fractures, to verify whether the mechanical properties of the device meet the requirements of fracture healing. A fracture gap model was created using Sawbones to simulate midshaft tibial comminuted fractures. The experiment was divided into four groups, testing the mechanical characteristics of the new external fixation (NEF), locking compression plate (LCP), the unilateral external fixation (UEF), and the externalized locking compression plate (E-LCP). The axial compression, torsion, fatigue and ultimate load tests were performed separately. Data were collected and statistical analysis was performed to verify whether there were statistical differences between the four groups.</p><p><strong>Results: </strong>The finite element analysis of NEF demonstrated that the fracture end was displaced by 0.512 mm under 700 N loading, and the maximum stress value of the device was 189 MPa, which met the mechanical requirements. Axial compression tests showed that LCP (2108.596 N/mm) had the highest stiffness, and NEF (519.489 N/mm) had higher stiffness than both UEF (327.153 N/mm) and E-LCP (316.763 N/mm) (p < 0.05), but no significant difference between UEF and E-LCP (p = 0.313). There was a significant difference in mean torsional stiffness among UEF (1.412 N·m/deg), NEF (1.398 N·m/deg), LCP (1.128 N·m/deg), and E-LCP (0.838 N·m/deg). No structural failures occurred during fatigue testing spanning 108,000 cycles. In ultimate load tests, NEF withstood the highest load, followed sequentially by LCP, UEF, and E-LCP. Significant differences were found between the groups (p < 0.05), with frame bending and secondary bone fractures noted in post-test evaluations.</p><p><strong>Conclusions: </strong>The NEF for tibial fractures is well-designed to meet the fracture healing requirements. It has certain advantages in comparison with other fixation methods and can be used as a new method for the treatment of tibial fractures.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"319"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730559","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":"Effect of miR-654-3p targeting EMP1 on osteoblast activity and differentiation in delayed fracture healing.","authors":"Shantao Wang, Mingwei Wang, Shengliang Sun, Xinsheng Liu, Danzhi Li","doi":"10.1186/s13018-025-05736-w","DOIUrl":"https://doi.org/10.1186/s13018-025-05736-w","url":null,"abstract":"<p><strong>Background: </strong>Delayed fracture healing (DFH) is a common postoperative complication in fracture patients, and a validated serum marker may aid in the clinical management and improve the prognosis of fracture patients. In this study, we investigated the diagnostic role and potential regulatory mechanisms of miR-654-3p in DFH.</p><p><strong>Methods: </strong>73 patients with DFH and 75 patients with normal fracture healing (NFH) were included. Expression of miR-654-3p and EMP1 and several mRNA markers of osteogenic differentiation were evaluated by RT-qPCR. The diagnostic value of miR-654-3p and EMP1 alone and in combination was assessed using ROC curves. Cell proliferation capacity was assessed by CCK-8 and apoptosis rate by flow cytometry. DLR experiments demonstrated the targeting relationship between miR-654-3p and EMP1.</p><p><strong>Results: </strong>Levels of miR-654-3p were found to be significantly lower in DFH compared to NFH. Following cell differentiation treatment, miR-654-3p levels increased and EMP1 levels decreased. Furthermore, a negative correlation was identified between miR-654-3p and EMP1 target binding and expression levels. The combination of miR-654-3p and EMP1 holds significant diagnostic value for DFH. miR-654-3p high expression can inhibit EMP1 levels, which promotes cell proliferation, increases osteoblast activity and levels of differentiation markers, and decreases the rate of apoptosis.</p><p><strong>Conclusion: </strong>miR-654-3p and EMP1 are aberrantly expressed in DFH, and both have high diagnostic value for DFH. miR-654-3p is involved in the proliferation, differentiation, and apoptotic activities of osteoblasts by regulating the level of EMP1, thus affecting the progression of DFH.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"322"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743111","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":"Cup positioning relative to the acetabular rim planned with three-dimensional computed tomography improves precision in total hip arthroplasty: a randomized controlled trial.","authors":"Anuwat Pongkunakorn, Napon Wongkamthong, Rukthanin Ruktrakul","doi":"10.1186/s13018-025-05704-4","DOIUrl":"10.1186/s13018-025-05704-4","url":null,"abstract":"<p><strong>Background: </strong>Accurate acetabular cup positioning is essential for successful total hip arthroplasty (THA) outcomes. The conventional mechanical alignment guide (MAG) method provides moderate accuracy. We developed a novel technique for cup positioning that utilizes preoperative three-dimensional computed tomography (3D-CT) planning based on the native acetabular rim's relative position and compared cup orientation between this method and the MAG technique.</p><p><strong>Methods: </strong>A randomized controlled trial with 120 patients undergoing primary THA via the posterolateral approach targeted cup positions of 40° radiographic inclination (RI) and 20° radiographic anteversion (RA). The control group (n = 40) used a MAG for cup placement, while the study group (n = 80) utilized preoperative 3D-CT to measure native RI, calculate RA, and determine the cup overhang distance (COD). The cup inclination was positioned relative to the superior rim point and the transverse acetabular notch. The cup anteversion was adjusted to achieve overhang at the posterior or anterior rim point according to the planned COD. Postoperative RI and RA were assessed using tilt-adjusted plain radiographs and CT scans. The percentages of cups positioned within 5° of the target position (RI/RA of 40°/20° ± 5°), and within the Grammatopoulos aiming zone (RI/RA of 40°/20° ± 10°) were compared between the two groups.</p><p><strong>Results: </strong>The mean RI was 41.7° ± 5.4° (range, 33°-59°) in the control group and 39.9° ± 3.2° (range, 33.8°-45.5°) in the study group (p = 0.019). The mean RA was 19.5° ± 7.6° (range, 3°-33°) in the control group and 20.2° ± 3.3° (range, 12.9°-28.3°) in the study group (p = 0.356). Cup alignment within 5° of the target was achieved in 86.2% (69 hips) of the study group and 32.5% (13 hips) of the control group (p < 0.001). The study group had a significantly higher percentage of cups within Grammatopoulos aiming zone (100% vs. 77.5%, p < 0.001).</p><p><strong>Conclusions: </strong>3D-CT-guided cup positioning relative to the acetabular rim can enhance the precision of cup placement in THA to achieve alignment within 5° of the target position.</p><p><strong>Trial registration: </strong>Thai Clinical Trials Registry (TCTR 20201220001). Registered on 20 December 2020. Prospectively registered.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"318"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720011","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 proximal femoral universal nail system (PFUN): a novel intramedullary nail for treating complex proximal femoral fractures and its biomechanical comparison with the proximal femoral nail anti-rotation (PFNA).","authors":"Fang Zhou, Jixing Fan, Yang Lv","doi":"10.1186/s13018-025-05724-0","DOIUrl":"10.1186/s13018-025-05724-0","url":null,"abstract":"<p><strong>Aims: </strong>The loss of medial and lateral wall support were the main risk factors of implant failure for proximal femoral fractures. A novel intramedullary nail, called proximal femoral universal nail system (PFUN), was proposed by our team to reconstruct the medial wall and lateral wall integrity and the biomechanical performance was evaluated in this study.</p><p><strong>Methods: </strong>The synthetic femora were assigned to three groups randomly according to three different proximal femoral fracture types. For each group, the PFUN or PFNA were implanted separately and divided into PFUN subgroup and PFNA subgroup. Biomechanical tests were separately conducted in the axial compression test, torsional test, and fatigue test in sequence. The finite element analysis (FEA) was conducted by ANSYS 14.5 and we analyzed the von Mises stress distribution and the model displacement of two implant models in three different fracture types.</p><p><strong>Results: </strong>For proximal femoral fractures with intact medial wall and lateral wall, our biomechanical results showed that the PFUN had a similar biomechanical property with the PFNA. Furthermore, the biomechanical results showed that the PFUN had a larger axial stiffness, higher torsional strength, and a similar failure load when compared with the PFNA for proximal femoral fracture with medial wall fracture. For proximal femoral fractures with broken medial wall and lateral wall, a larger axial stiffness, higher average torque and higher failure load were found in the PFUN when compared with the PFNA. The FEA results showed that the PFUN model had a higher stress concentration compared with the PFNA model, and the total displacement of the PFNA model increased by 11.63% when compared with the PFUN model in the proximal femoral fracture with broken medial wall and lateral wall.</p><p><strong>Conclusion: </strong>Our results showed that PFUN had better biomechanical performance than PFNA, especially for complex proximal femoral fractures with medial wall fracture and lateral wall fracture, indicating that the PFUN had great potential as a new fixation strategy in future clinical applications.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"317"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720055","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":"Gradual restoration of gait following unicompartmental knee arthroplasty: a prospective study.","authors":"Ming Zhang, Haoyue Wang, Yu Zhang, Haochong Zhang, Quanlei Zhang, Xiaoran Zu, Wei Chai, Xiang Li","doi":"10.1186/s13018-025-05662-x","DOIUrl":"10.1186/s13018-025-05662-x","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the gait characteristics and clinical outcomes following Unicompartmental Knee Arthroplasty (UKA) to provide scientific evidence for optimizing postoperative rehabilitation and patient management.</p><p><strong>Methods: </strong>Between December 2022 and November 2023, 34 patients with unilateral medial compartment knee osteoarthritis (KOA) underwent UKA. Preoperative and postoperative videos of patients in standing, walking (side view), squatting, and supine knee-bending positions were captured using smartphones. Gait parameters including gait cycle, swing time, swing phase, stance time, stance phase, double support time, walking speed, step time, cadence, step length, stride length, stride width, active knee flexion angle, and maximum hip and knee flexion angles during squatting were analyzed using the MediaPipe framework for human pose estimation.</p><p><strong>Results: </strong>Postoperative WOMAC scores were significantly lower than preoperative scores (P < 0.001), while postoperative KSS scores were significantly higher than preoperative scores (P < 0.001).Compared to preoperatively, postoperative affected-side gait speed, step length, step width, and active knee flexion angle all increased (P < 0.05). Additionally, postoperative gait cycle time and double-limb support time were reduced compared to preoperative values (P < 0.05). Among the 17 patients who could perform squats preoperatively and postoperatively, the maximum knee flexion angle and hip flexion angle in the squat position increased from preoperative values of (96.41 ± 20.65)° and (113.77 ± 22.56)° to postoperative values of (110.15 ± 20.79)° and (124.84 ± 21.13)°.</p><p><strong>Conclusions: </strong>UKA significantly enhances knee joint kinematics, facilitating the transition from basic to advanced functional activities.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"315"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720037","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 effect of preoperative ultrasound localization on the incidence of infrapatellar branch of the saphenous nerve injury after hamstring tendon harvesting.","authors":"Tianli Du, Jianfeng Chen, Chao Yan, Hongzhi Fang, Zhenghui Shang","doi":"10.1186/s13018-025-05689-0","DOIUrl":"10.1186/s13018-025-05689-0","url":null,"abstract":"<p><strong>Background: </strong>The potential of ultrasound-guided labelling of the inferior patellar branch of the saphenous nerve (IPBSN) to reduce IPBSN injury during anterior cruciate ligament reconstruction (ACLR) has not been explored. The primary objective of this retrospective cohort analysis was to assess whether intraoperative hamstring tendon harvesting avoiding the marked IPBSN would be effective in reducing the incidence of postoperative skin sensory disturbances and the mean area of sensory disturbances.</p><p><strong>Methods and analysis: </strong>A retrospective cohort study involving 60 patients who underwent autograft ACLR at Yichang Central People's Hospital from October 2020 to October 2024 was conducted. Patients were divided into two groups on the basis of the use of preoperative ultrasound localization of the IPBSN, including the nonultrasound localization group (control group) and the ultrasound localization group (experimental group), with 30 patients in each group. The control group underwent standard ACLR with a diagonal incision for hamstring tendon harvesting, whereas the experimental group underwent preoperative ultrasound-guided localization of the IPBSN to avoid the nerve during incision. The primary outcome measures include the incidence of skin sensory disturbances and the average sensory disturbance area. The secondary outcomes include the Lysholm score and VAS score at the 6-month postoperative follow-up.</p><p><strong>Results: </strong>The incidence of skin sensory disturbances in the experimental group was lower than that in the control group, and the average area of sensory disturbance was smaller in the experimental group (P < 0.05). At the 6-month postoperative follow-up, no statistically significant differences in the Lysholm knee scores or visual analogue scale (VAS) pain scores were noted between the two groups (P > 0.05).</p><p><strong>Conclusion: </strong>Preoperative ultrasound-guided localization of the IPBSN can reduce the risk of nerve injury during ACLR. The ultrasound-guided approach leads to a lower incidence of sensory disturbances and a smaller average area of sensory disturbance. IPBSN injury was not related to anterior knee pain or knee ROM limitations. Patients can choose whether to use ultrasound localization before surgery according to their needs. The study protocol adhered to strict standards of ethical conduct and patient safety. The results of this trial are expected to provide valuable insights into the prevention of injury to the IPBSN during hamstring tendon harvesting.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"316"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720045","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}