Journal of Orthopaedic Surgery and Research最新文献

{"title":"Application of intraoperative neurophysiological monitoring in unilateral biportal endoscopic lumbar spine surgery.","authors":"Tian-Yu Bai, Hai Meng, Ji-Sheng Lin, Zi-Han Fan, Qi Fei","doi":"10.1186/s13018-025-05738-8","DOIUrl":"10.1186/s13018-025-05738-8","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the value of intraoperative neurophysiological monitoring (IONM) in unilateral biportal endoscopic (UBE) lumbar spine surgery.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 127 patients who underwent UBE lumbar spine surgery at Xicheng Branch of Beijing Friendship Hospital from January 2024 to September 2024. Patients were divided into two groups: the observation group (IONM, 64 cases) and the control group (no IONM, 63 cases). Changes of monitoring indicators included somatosensory evoked potentials (SEP), motor evoked potentials (MEP), and free electromyography (freeEMG) were recorded. Age, sex, body mass index, surgery length, surgical levels, surgery time, intraoperative fluid volume, post anesthesia care unit time, time to first ambulation, length of hospital stay, leg visual analog scale (VAS), preoperative and postoperative fall scores, activities of daily living, and postoperative complication of two groups were collected and compared.</p><p><strong>Results: </strong>In the observation group, 40 cases (62.5%) showed freeEMG stimulation. 10 cases (15.6%) had a significant decrease in MEP amplitudes, with 9 cases showing a decline in MEP amplitudes immediately following freeEMG stimulation. No significant changes in SEP. The postoperative 24-hour leg VAS in the observation group was 1.8 ± 0.4, which was significantly lower than the 2.1 ± 0.2 in the control group (p < 0.001). No significant differences were found between the two groups in terms of surgical time and other data (p > 0.05).</p><p><strong>Conclusion: </strong>IONM provides timely information of neurological function in UBE lumbar spine surgery, reduces the invasiveness of intraoperative procedures, and reduce early postoperative leg pain.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"334"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764199","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":"Comparison of three surgical methods for displaced posterior cruciate ligament tibial insertion avulsion fractures: a retrospective study.","authors":"Gengao Wen, Congliang Chen, Song Wang, Zhuping Jiang, Shuo Feng, Wei Zheng","doi":"10.1186/s13018-025-05703-5","DOIUrl":"10.1186/s13018-025-05703-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the clinical outcomes of three surgical methods, three types of arthroscopic suture fixation, suspension fixation with EndoButton, and open screw fixation, in the treatment of displaced posterior cruciate ligament tibial insertion avulsion fractures.</p><p><strong>Methods: </strong>A retrospective analysis of the clinical data of 104 patients with posterior cruciate ligament avulsion fractures between 2010 and 2023 was performed. The patients were divided into three groups according to the surgical approach used: suture fixation in Group A (24 patients), suspension fixation with EndoButton in Group B (37 patients), and hollow screw fixation in Group C (43 patients). The Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner activity score, and postoperative imaging findings of all patients were collected. The final follow-up data were used to compare the differences among the three groups.</p><p><strong>Results: </strong>There was no statistically significant difference in the general information of the three groups of patients. Among the 104 patients, the mean postoperative Lysholm score was 92.9 (CI, 91.0-94.8) in Group A, 93.4 (CI, 92.3-94.6) in Group B, and 93.5 (CI, 92.6-94.4) in Group C. Postoperative IKDC subjective assessment of knee function was considered normal or near normal in more than 95% of the patients in all three groups. More than 93% of the patients in all three groups did not have severe abnormalities in knee range of motion. The mean postoperative Tegner activity score was 6.7 (CI, 6.3-7.1) in Group A, 7.0 (CI, 6.7-7.3) in Group B, and 6.9 (CI, 6.6-7.1) in Group C. Imaging at 3 months after surgery revealed bone healing, and no serious postoperative complications were found in any of the three groups.</p><p><strong>Conclusion: </strong>All three treatments yielded good clinical results and imaging healing. In particular, arthroscopic suspension fixation with EndoButton is recommended as the preferred treatment because of its low invasiveness, good mechanical properties and low complication rate.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"333"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764202","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":"Does halofuginone influence regeneration after peripheral nerve injury?","authors":"Muzaffer Çaydere, Ömer Şahin","doi":"10.1186/s13018-025-05758-4","DOIUrl":"10.1186/s13018-025-05758-4","url":null,"abstract":"<p><strong>Background: </strong>Halofuginone is an antiprotozoal drug with antifibrotic and anti-inflammatory properties. The aim of our study was to determine the effects of halofuginone on nerve recovery in sciatic nerve injury and compare it with steroid treatment.</p><p><strong>Methods: </strong>The left sciatic nerves of Sham subjects were exposed without intervention. The nerves of trauma animals were transected and sutured. In the methylprednisolone group and in the trauma group, after nerve transection and repair, 1 mg/kg methylprednisolone per day was administered intraperitoneally for seven days; in the halofuginone group and in the trauma group, after nerve transection and repair, 0.2 mg/kg halofuginone per day was administered orally by gavage for seven days. The rats were functionally evaluated at 4 and 8 weeks through walking path analysis. Pathological-morphometric, immunostaining-quantitative, and muscle weight measurements were performed at 8 weeks.</p><p><strong>Results: </strong>Compared with the trauma group, the methylprednisolone and the halofuginone groups had better functional outcomes (p < 0.001). Statistically significant difference was found in comparisons of the pathological and immunostaining results of the methylprednisolone and halofuginone groups (Respectively, nerve diameter (p = 0.007) and edema (P = 0.009)).</p><p><strong>Conclusion: </strong>Halofuginone positively contributed to recovery after sciatic nerve injury.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"331"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764206","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":"Virtual and augmented reality for anxiety reduction in orthopedic patients and providers: a systematic review.","authors":"Negarsadat Namazi, Yashar Khani, Amirhossein Salmannezhad, Mohammad Behdadfard, Ehsan Safaee, Mohammad Nouroozi, Amir Mehrvar","doi":"10.1186/s13018-025-05690-7","DOIUrl":"10.1186/s13018-025-05690-7","url":null,"abstract":"<p><strong>Background: </strong>Anxiety impacts patients and healthcare providers during orthopedic procedures, yet virtual reality (VR) and augmented reality (AR) effectiveness remains inconsistently reported, lacking systematic synthesis in this setting. This review addresses this gap.</p><p><strong>Methods: </strong>Per PRISMA guidelines (PROSPERO: CRD42024553394), we searched PubMed, Scopus, Web of Science, and Embase in March 2024 for studies on VR/AR/mixed reality (MR) interventions for anxiety in orthopedic procedures. Data were narratively synthesized; bias assessed via RoB-2 and ROBINS-I.</p><p><strong>Results: </strong>Twenty-four studies (16 RCTs, 8 cohort, n = 1714) showed VR (22 studies) and AR (2 studies) significantly reduced anxiety across procedure phases, notably in pediatrics. Healthcare providers (HCPs) reported lower anxiety and higher confidence with VR. Satisfaction rose, anesthetic use dropped, though inconsistent tools and methods limited comparisons.</p><p><strong>Conclusion: </strong>VR/AR reduce pediatric anxiety in orthopedics, with less conclusive adult/HCP benefits. Clinicians could adopt preoperative VR. Research needs standardized tools and adult-focused RCTs.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"327"},"PeriodicalIF":2.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753172","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":"Correction: Evaluation and testing of polymethylmetacrylic (PMMA) bone cements with admixed Amphotericin B.","authors":"Florian A Frank, Barbara Krampitz, Julia Steiner, Rainer Strathausen, Mario Morgenstern, Martin Clauss, Klaus-Dieter Kühn","doi":"10.1186/s13018-025-05643-0","DOIUrl":"https://doi.org/10.1186/s13018-025-05643-0","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"325"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743108","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":"MiR-103-3p regulates chondrocyte autophagy, apoptosis, and ECM degradation through the PI3K/Akt/mTOR pathway by targeting CPEB3.","authors":"Jun Li, Farui Sun, Yuanjin Zhang, Xian Pan, Bo Li, Guofu Zhang, Qian Zhou","doi":"10.1186/s13018-025-05719-x","DOIUrl":"https://doi.org/10.1186/s13018-025-05719-x","url":null,"abstract":"<p><strong>Background: </strong>Chondrocyte apoptosis is associated with the severity of cartilage destruction and matrix degeneration in the progression of osteoarthritis. Increasing evidence indicates that autophagy has a significant cytoprotective effect against chondrocyte apoptosis. Here, we investigated the role of microRNA-103-3p (miR-103-3p) in regulating chondrocyte function and elucidated the underlying mechanism.</p><p><strong>Methods: </strong>MiR-103-3p expression in interleukin-1β (IL-1β)-stimulated chondrocytes was evaluated using RT-qPCR. The targets of miR-103-3p predicted by online databases were verified using biotin-based pulldown assay and luciferase reporter assay. IL-1β stimulated-chondrocytes were transfected with miR-103-3p inhibitor along with siRNA targeting cytoplasmic polyadenylation element-binding protein3 (siCPEB3), the autophagy inhibitor 3-MA, or the PI3K agonist 740 Y-P. Chondrocyte proliferation was evaluated using cell counting kit-8. Apoptosis was detected by flow cytometry. The levels of apoptosis-, extracellular matrix (ECM)-, autophagy-, and the PI3K/Akt/mTOR pathway-related proteins in chondrocytes were detected using immunoblotting or immunofluorescence.</p><p><strong>Results: </strong>We found that IL-1β stimulation upregulated miR-103-3p and downregulated CPEB3 in mouse chondrocytes. Inhibiting miR-103-3p reduced IL-1β-induced apoptosis and ECM macromolecule degradation while enhancing autophagy in chondrocytes. MiR-103-3p targeted CPEB3, and its downregulation rescued the expression of level in IL-1β stimulated-chondrocytes. MiR-103-3p downregulation inhibited the PI3K/Akt/mTOR pathway in IL-1β stimulated-chondrocytes by upregulating CPEB3. 3-MA, 740 Y-P, or CPEB3 knockdown counteracted the effect of miR-103-3p downregulation on chondrocyte apoptosis, ECM macromolecule degradation, and autophagy.</p><p><strong>Conclusion: </strong>Overall, inhibition of miR-103-3p reduces IL-1β-induced apoptosis and ECM macromolecule degradation in chondrocytes by enhancing autophagy through the CPEB3/PI3K/Akt/mTOR pathway.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"324"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743116","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 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":"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":"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}