Journal of Orthopaedic Surgery and Research最新文献

{"title":"Clinical efficacy and learning curve of percutaneous endoscopic cervical discectomy for symptomatic cervical spondylotic radiculopathy.","authors":"Xiao Sun, Lijuan Zhan, Zhongxin Tang, Mingkui Shen, Haijun Ma, Jun Tan","doi":"10.1186/s13018-025-05530-8","DOIUrl":"10.1186/s13018-025-05530-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the clinical efficacy and learning curve of percutaneous endoscopic cervical discectomy (PECD) in treating patients with symptomatic cervical spondylotic radiculopathy (CSR).</p><p><strong>Methods: </strong>A total of 105 patients with single-segment symptomatic CSR treated between January 2020 and January 2022 were retrospectively analyzed and divided into PECD and ACDF groups based on the surgical approach. Patient demographics, operation time, estimated intraoperative blood loss, complications, postoperative hospital stay, total hospitalization cost, neck dysfunction index (NDI), arm and neck visual analog scale (VAS) scores were compared and analyzed. The learning curve of the PECD group was assessed using cumulative sum (CUSUM) analysis.</p><p><strong>Results: </strong>There was no statistically significant difference in baseline data between the two groups (P > 0.05). The PECD group had shorter operative time, smaller incision length, less estimated intraoperative bleeding, lower total hospitalization costs, and shorter postoperative hospital stays compared to the ACDF group (P < 0.05). Postoperative NDI, arm VAS, and neck VAS scores improved significantly in both groups compared to preoperative values (P < 0.05). However, no significant difference was found between the two groups during the same period (P > 0.05). There were also no significant differences between the PECD and ACDF groups in the number of intraoperative fluoroscopies, complications, or surgical success rates (P > 0.05). As more cases accumulated, a trend toward shorter operative times was observed in the PECD group. When grouped according to the learning curve, with the 23rd case as the cutoff point, there was no significant difference in clinical outcomes between the learning phase and proficient phase groups (P > 0.05).</p><p><strong>Conclusions: </strong>PECD is a safe and effective procedure for treating single-segment CSR, offering clinical outcomes comparable to ACDF. PECD has a notable learning curve, requiring beginners to perform 23 cases to reach proficiency. However, longer operative times do not negatively impact preclinical outcomes.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"138"},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256010","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 prevalence and risk factors for peripheral nerve injury following arthroplasty: a systematic review and meta-analysis.","authors":"Jianchun Qiu, Xiaohong Liao, Ruiming Deng","doi":"10.1186/s13018-024-05394-4","DOIUrl":"10.1186/s13018-024-05394-4","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence and identify the risk factors for peripheral nerve injury (PNI) following arthroplasty through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were searched for observational studies investigating the prevalence and risk factors for PNI following arthroplasty. Prevalence data for PNI following arthroplasty were extracted and pooled using a random-effects model, with results presented as pooled prevalence with 95% CI. ORs and 95% CIs for identified risk factors were calculated. Subgroup analyses were conducted based on age, study type, sample size, arthroplasty site, region, and others. Publication bias was assessed using funnel plots and Egger's test, and sensitivity analyses were performed.</p><p><strong>Results: </strong>After screening, a total of 21 studies were included in the meta-analysis. The pooled prevalence of PNI was 0.7% (95% CI: 0.006-0.009) with significant heterogeneity (I² = 99%). The prevalence of PNI following arthroplasty was found to be more likely as a result of several identified factors, including spinal conditions (ORs = 2.269, 95% CI 1.625-3.170), postoperative anemia (ORs = 1.370, 95% CI 1.149-1.633), mechanical complications (ORs = 1.791, 95% CI 1.118-2.868) and hypothyroidism (ORs = 1.189, 95% CI 1.054-1.341).</p><p><strong>Conclusions: </strong>The pooled prevalence of PNI was approximately 0.7%. Furthermore, we identified potential risk factors for PNI following arthroplasty, including spinal conditions, postoperative anemia, mechanical complications, and hypothyroidism. Our findings emphasize the importance of recognizing these risk factors in the perioperative management of arthroplasty patients.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"137"},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256041","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":"Ginkgetin delays the progression of osteoarthritis by inhibiting the NF-κB and MAPK signaling pathways.","authors":"Liang Zhu, Yanchi Bi, Ting Liang, Po Zhang, Xiao Xiao, Tengbo Yu","doi":"10.1186/s13018-025-05525-5","DOIUrl":"10.1186/s13018-025-05525-5","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is considered an advancing chronic degenerative joint disease, leading to severe physical functional impairment of patients. Its development is closely related to increased inflammation and oxidative stress within the joint. Ginkgetin (GK), a natural non-toxic chemical, has proven anti-inflammatory, antioxidant, anti-tumor, and neuroprotective effects.</p><p><strong>Methods: </strong>First, this study utilizes network pharmacology to explore the intrinsic connection between GK and OA. In vitro, SW1353 human cartilage cells were stimulated with Tert-butyl hydrogen peroxide (TBHP), and different GK concentrations were pre-treated to evaluate its protective effects. GK's anti-inflammatory and antioxidative effects were comprehensively assessed via MTT assay, western blot, cell immunofluorescence, ELISA, and transcriptome sequencing. Potential underlying mechanisms were also explored. In vivo, OA was induced in rats via anterior cruciate ligament transection (ACLT), and GK's impact on cartilage protection was further assessed via histological analysis and western blot.</p><p><strong>Results: </strong>Network pharmacology has revealed that GK regulates OA via several key pathways, especially NF-κB, HIF-1, PI3K-AKT, and substances like reactive oxygen species. In vitro experiments showed GK effectively reverses oxidative stress damage from TBHP, inhibits inflammatory factor release, and protects Extracellular matrix (ECM) from degradation. These functions may be achieved via the NF-κB and MAPK signaling pathways. In vivo experiments showed GK significantly reduced proteoglycan loss from ACLT and inhibited matrix metalloproteinase 13 (MMP13) and ADAMTS5 (A disintegrin and metalloproteinase with thrombospondin motifs 5) production, effectively preventing cartilage degeneration in rats.</p><p><strong>Conclusion: </strong>These findings suggest that GK has potential as a therapeutic agent for OA, offering new strategies and directions for OA treatment.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"139"},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256016","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":"Analysis of the short-term effect of three different level pedicle screws in the treatment of thoracolumbar type A fractures.","authors":"Alimujiang Yusufu, Abudula Abulaiti, Abuduwupuer Haibier, Junyi Ma, Yuan Ma","doi":"10.1186/s13018-025-05509-5","DOIUrl":"10.1186/s13018-025-05509-5","url":null,"abstract":"<p><strong>Objective: </strong>The effects of three short-segment vertebral fixation methods-short-segment fixation (4s group), short-segment fixation across the injured vertebra (6s group), and long-segment fixation (8s group)-on the surgical efficacy of patients with type A thoracolumbar fractures were compared to identify the optimal fixation method.</p><p><strong>Methods: </strong>Data from 277 patients who underwent posterior pedicle screw fixation for thoracolumbar fractures between September 2018 and January 2023 were retrospectively analyzed. Surgery-related indicators, laboratory parameters, clinical functional measures (VAS and ODI), and postoperative imaging findings were compared among the three groups.</p><p><strong>Results: </strong>Baseline data showed no significant differences among the three groups. The operation time in the 4s group (75.352 ± 15.458 min) and intraoperative blood loss (188.65 ± 42.728 ml) were significantly lower compared to the 8s group (operation time: 108.243 ± 19.529 min; intraoperative blood loss: 209.93 ± 50.542 ml), with statistically significant differences (p < 0.05). Postoperative hematocrit (33.277 ± 4.639) and albumin levels (34.971 ± 4.116) in the 6s group were significantly higher than those in the 8s group (hematocrit: 31.820 ± 4.323; albumin: 33.170 ± 3.553), with p < 0.05. Other outcome indicators did not show statistically significant differences (p > 0.05).</p><p><strong>Conclusion: </strong>Short-segment fixation across the injured vertebra (6s) provides results comparable to short-segment fixation (4s) while causing less trauma. Furthermore, the 6s method demonstrates similar efficacy to long-segment fixation (8s) in maintaining long-term deformity correction. These findings offer valuable insights for clinicians in selecting surgical fixation methods, optimizing treatment strategies, and improving patient outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"133"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189472","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":"Effectiveness and safety of percutaneous endoscopic debridement and drainage for spinal infections: a systematic review and meta-analysis.","authors":"Guozhong Zhou, Xiaorong Liu, Zhi Liang, Xuesong Chen, Chao Song","doi":"10.1186/s13018-025-05540-6","DOIUrl":"10.1186/s13018-025-05540-6","url":null,"abstract":"<p><strong>Background: </strong>Spinal infections (SI) typically manifest with and pose a growing medical challenge. However, current evidence for treating SI is limited and inconclusive. Our aim was to assess the effectiveness and safety of percutaneous endoscopic disc decompression (PEDD) for SI.</p><p><strong>Methods: </strong>On 20 October 2023, we searched the EMBASE, PubMed, Cochrane Library, China Biology Medicine Disc, China National Knowledge Infrastructure, and Wanfang databases for eligible studies. Cohort studies on SI treated with PEDD, reporting relevant effectiveness or safety outcomes. We assessed study quality using a modified Newcastle-Ottawa Scale and conducted a random-effects meta-analysis to calculate pooled results.</p><p><strong>Results: </strong>Overall, 36 studies involving 925 patients were included. Erythrocyte sedimentation rate levels decreased significantly at 1-week postoperatively compared with preoperative levels (mean difference [MD] = - 13.48 [95% CI - 15.65 to - 11.31]) and continued to decrease over 3 months. Similarly, the c-reactive protein (CRP), visual analogue scale, and oswestry disability index scores significantly reduced postoperatively. The rates of excellent or good MacNab classification were 92.6% (95% CI 84.1-98.1%). Microbiological diagnostics revealed a 71.7% (95% CI 65.5-77.6%) positive rate in tissue cultures, surpassing blood cultures (odds ratio [OR] 2.72 [95% CI 1.01-7.30]). The rates of complication, reoperation, and mortality were 4.1% (95% CI 1.5-8.0%), 8.6% (95% CI 4.3-14.3%), and 1.7% (95% CI 0.4-4.1%), respectively. Subgroup analyses demonstrated a significantly lower reoperation rate in the group that discontinued antibiotics based on a normal CRP than in the fixed-duration group (2.7% [95% CI 0.3-7.7%] vs 20.1% [95% CI 14.5-26.3%], p = 0.0002). Conversely, ambulation 1 day postoperatively was associated with a higher reoperation rate than ambulation within 5-14 days (16.2% [95% CI 9.3-24.6%] vs 1.1% [95% CI 0.0-6.0%], p = 0.0060).</p><p><strong>Conclusion: </strong>Our meta-analysis suggests that PEDD is a potentially effective and safe intervention for SI. Optimizing antibiotic discontinuation and postoperative care strategies may contribute to reducing reoperation rate. However, these findings require further validation from controlled studies.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"135"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189483","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":"Risk factors for venous thromboembolism after hip arthroscopy: a systematic review and meta-analysis.","authors":"Haoxuan Li, Huan Zhang, Shengjie Zhou, Chaowei Hu, Yiyuan Guan, Ri Jin","doi":"10.1186/s13018-025-05536-2","DOIUrl":"10.1186/s13018-025-05536-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative venous thromboembolism (VTE) following hip arthroscopy is associated with increased hospital readmissions and significant medical costs. However, the risk factors for postoperative VTE after hip arthroscopy remain a topic of debate. In this study, we aimed to quantitatively and comprehensively identify risk factors for postoperative VTE after hip arthroscopy, providing evidence for the development of clinical prevention strategies.</p><p><strong>Methods: </strong>A systematic search was conducted using PubMed, Embase, Web of Science, Scopus, and the Cochrane Library databases from their inception to December 10, 2024. The search was limited to English-language articles that evaluated risk factors for postoperative VTE after hip arthroscopy. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relationship between various risk factors and the incidence of postoperative VTE after hip arthroscopy. This protocol was registered with PROSPERO (registration number: CRD42024601636).</p><p><strong>Results: </strong>Five studies, encompassing 71,815 patients who underwent hip arthroscopy, were included in the meta-analysis. The analysis identified obesity (OR: 1.41, 95% CI: 1.23-1.61), smoking (OR: 1.23, 95% CI: 1.04-1.45), and age > 45 years (OR: 1.49, 95% CI: 1.03-2.15) as significant risk factors for postoperative VTE.</p><p><strong>Conclusion: </strong>Obesity, smoking, and age > 45 years are found to be significant risk factors for postoperative VTE after hip arthroscopy.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"134"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189402","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":"Analysis of the efficacy of multidisciplinary integration based on 3D reconstruction technology for the treatment of gout stone.","authors":"Shizhe Zhou, Zengxiao Zhang, Tian Liu, Yijun Xu, Yuehai Pan, Ying Chen","doi":"10.1186/s13018-025-05506-8","DOIUrl":"10.1186/s13018-025-05506-8","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the efficacy of multidisciplinary fusion therapy based on 3D reconstruction technology for the treatment of gouty stone by comparing the efficacy of multidisciplinary fusion therapy with pharmacologic therapy.</p><p><strong>Methods: </strong>This study is a cohort study.Patients who underwent gout stone surgery at the Affiliated Hospital of Qingdao University from November 2020 to November 2022 were included in this study, totaling 85 to form the MDT surgery group, and matched among gout stone patients in the outpatient clinic during the same period to form the medication group. Patients in the 2 groups were followed up for 6 months to compare baseline and follow-up data.</p><p><strong>Results: </strong>Both groups experienced a decrease in uric acid levels and an increase in SF-36 scores during follow-up. After adjusting for confounders, multifactorial logistic regression showed that the uric acid attainment rate of patients in the MDT surgery group was 4.011 times higher than that of the drug group (OR: 4.011, 95% CI: 1.595, 10.086, P = 0.003); the proportion of patients with an increase in SF-36 in the MDT surgery group was 4.976 times higher than that of the drug group (OR: 4.976, 95% CI: 2.243, 11.040, P < 0.001); the proportion of patients treated with high-dose medication in the MDT surgery group was 1.8% of that of patients in the drug group (OR: 0.018, 95% CI: 0.002, 0.148, P < 0.001); and the proportion of patients in the MDT surgery group who developed frequent gout was 2.8% of that in the drug group (OR: 0.028 95% CI: 0.003, 0.2398, P = 0.001). the proportion of patients in the MDT surgery group who developed abnormal liver function was 0.317 times higher than that in the drug group (OR: 0.317, 95% CI: 0.121, 0.831, P = 0.019).</p><p><strong>Conclusion: </strong>The multidisciplinary integration of 3D reconstructive techniques for gout stone treatment resulted in an increase in uric acid compliance, a decrease in the frequency of gout and the appearance of liver impairment; and a greater benefit in terms of improvement in the quality of life of the patients after treatment.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"132"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189466","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":"Pelnac^® artificial dermis assisted by vacuum sealing drainage for treatment of severe avulsion injuries of the fingers.","authors":"Zhenmu Lv, Yujie Wang, Jingliang Chen, Qingfu Zhang, Haitao Zhao","doi":"10.1186/s13018-025-05547-z","DOIUrl":"10.1186/s13018-025-05547-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the outcomes of Pelnac assisted by vacuum sealing drainage in managing severe avulsion injuries of the fingers.</p><p><strong>Methods: </strong>This prospective study was conducted from May 2017 to September 2023, involving 12 consecutive patients with severe avulsion injuries of the fingers. Patients underwent single-stage or two-stage procedures employing Pelnac assisted by vacuum sealing drainage (VSD) for the management of severe avulsion injuries of the fingers. Post-operative follow-up was routinely scheduled, and aesthetic and functional outcomes, sensory recovery, complications were recorded.</p><p><strong>Results: </strong>Twelve patients were included in the analysis, consisting of 9 males and 3 females, with a mean age of 30.6 ± 11.0 years. All patients presented with severe damage to tendons and deep tissues, as well as varying degrees of bone exposure and injury, with average defect area of 36.9 cm² (range, 11 to 180 cm²). At the final follow-up (mean, 14 months; range, 12 to 29 months), the average score on the Fingertip Injuries Outcome Score (FIOS) was 14.3 (SD 3.9, range 10 to 22), with 6 patients achieving excellent result, 4 classified as good and 2 as fair. Patients reported an average satisfaction score of 74.0 (SD 11.6; range 51 to 94) regarding the aesthetic appearance. The average score on the Vancouver Scar Scale score was 2.3 (SD 2.1, range 1.0 to 7.4). Ten patients reported normal or near-normal sensation, while 2 patients experienced slight sensory loss. The average score on the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was 13.2 (SD 8.5, range 0 to 47). No infections or hematomas were reported during hospitalization or after discharge.</p><p><strong>Conclusion: </strong>Pelnac, assisted by VSD, proved to be an effective approach for managing severe avulsion injuries of the fingers. This approach can be considered as a viable alternative for addressing severe injuries or complex wound conditions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"136"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189433","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":"Cervical pedicle screw fixation with the Tianji orthopedic surgical robot.","authors":"Hao Shen, Jinlong Zhou, Lipeng Yu","doi":"10.1186/s13018-024-05325-3","DOIUrl":"10.1186/s13018-024-05325-3","url":null,"abstract":"<p><strong>Objective: </strong>To compare the accuracy and safety of implanting cervical pedicle screws (CPS) between orthopedic surgical robot-assisted technique and traditional fluoroscopy-assisted free-hand technique.</p><p><strong>Methods: </strong>Retrospective analysis of 95 patients treated with posterior cervical spinal surgery using either Tianji orthopedic surgical robot-assisted or traditional fluoroscopy-assisted free-hand pedicle screw implantation technology from March 2021 to March 2024, including 44 cases in the orthopedic surgical robot group and 51 cases in the traditional fluoroscopy group.</p><p><strong>Results: </strong>Compared with the traditional fluoroscopy group, the orthopedic surgical robot group had better accuracy in screw implantation that is, a higher acceptable rate of screws (p = 0.0083). In addition, compared with the traditional fluoroscopy group, postoperative hospital stay was shorter in the orthopedic surgical robot group (p = 0.0447), but operation duration was longer (p = 0.0038). There was no significant difference in intraoperative blood loss between groups (p = 0.0872). There were 2 cases of cerebrospinal fluid leakage and 1 case of decreased left handgrip strength in the traditional fluoroscopy group, while only 1 case of cerebrospinal fluid leakage occurred in the orthopedic surgical robot group.</p><p><strong>Conclusions: </strong>In this retrospective study, the accuracy of spine surgery with CPS implantation assisted by orthopedic surgical robot is often superior to that of spine surgery using traditional fluoroscopy-guided CPS implantation technique, while maintaining comparable safety.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"131"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189480","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 alphanumeric classification system for ankle fractures: clinical applications and evaluation.","authors":"Cemil Aktan, Ozkan Kose","doi":"10.1186/s13018-025-05539-z","DOIUrl":"10.1186/s13018-025-05539-z","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to introduce and evaluate the Descriptive Ankle Fracture Classification (DAFC) system, a novel alphanumeric method for categorizing ankle fractures and fracture dislocations, and to assess its reliability and prognostic value compared to traditional classification systems (AO/OTA, Weber, and Lauge-Hansen).</p><p><strong>Materials and methods: </strong>A retrospective review was conducted on 90 patients who underwent surgical treatment for ankle fractures. Four observers of varying experience levels classified the fractures using the DAFC, AO/OTA, Weber, and Lauge-Hansen classification systems. Interobserver and intraobserver reliability were evaluated using Fleiss' Kappa coefficient. Functional outcomes were assessed with the American Orthopaedic Foot & Ankle Society (AOFAS) and Olerud Molander Ankle Score (OMAS) systems, and comparisons were made across classification systems to determine prognostic value.</p><p><strong>Results: </strong>The DAFC system demonstrated superior interobserver reliability, particularly for medial malleolus fractures (Kappa = 0.935-0.954) and syndesmotic injuries (Kappa = 0.873-0.891), compared to the other systems. Intraobserver reliability was consistently high across all categories in the DAFC system, with Kappa values ranging from 0.967 to 1.000. Functional outcomes revealed significant associations with the DAFC classification: patients with complete dislocation (D2) had significantly lower AOFAS and OMAS scores than those without dislocation (D0) (P = 0.011), and those with larger posterior malleolus fractures (P2) had poorer OMAS scores (P = 0.014). No statistically significant differences in AOFAS or OMAS scores were observed across AO/OTA, Weber, or Lauge-Hansen classifications.</p><p><strong>Conclusions: </strong>The DAFC system offers a reliable and comprehensive framework for ankle fracture classification, with the added benefit of prognostic insights, particularly regarding dislocation and posterior malleolus involvement. Its high interobserver and intraobserver reliability, even among observers with varying experience, suggests that the DAFC system is valuable for clinical use. Future research should focus on validating these findings in larger cohorts and assessing the DAFC system's impact on long-term patient outcomes.</p><p><strong>Level of evidence: </strong>Level IV, Retrospective cohort.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"130"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123053","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}