Journal of Orthopaedic Surgery and Research最新文献

{"title":"Impact of titanium mesh cage slotting width on anterior cervical corpectomy and fusion for compression cervical spondylosis with MRI T2WI hyperintensity: a one-year follow-up study.","authors":"Rongguo Yu, Xiurong Yuan, Kangkang Huang, Tingkui Wu, Hong Wang, Chen Ding, Beiyu Wang, Hao Liu","doi":"10.1186/s13018-024-05339-x","DOIUrl":"10.1186/s13018-024-05339-x","url":null,"abstract":"<p><strong>Background: </strong>Anterior cervical corpectomy and fusion (ACCF) is a standard surgical procedure for cervical spondylosis with spinal cord compression (CSWSCC), especially in patients with intensity on T2-weighted imaging high signal (T2WIHS). The titanium mesh cage (TMC) utilized in this procedure is essential in stabilizing the spine; however, the optimal slotting width of the TMC remains unclear.</p><p><strong>Objective: </strong>This study aimed to investigate the impact of TMC slotting width on the clinical and radiological outcomes of ACCF in patients with spinal cord compression type cervical spondylosis with intensity on T2WIHS (CST2WIHS).</p><p><strong>Methods: </strong>We retrospectively analyzed 69 patients who underwent single-level ACCF between December 2010 and October 2021. The patients were divided into narrower (< 2 mm) and wider (> 2 mm) groups based on the slotting width of the TMC. The Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores were used to assess clinical outcomes. Radiological outcomes included cervical lordosis (CL), functional spinal unit (FSU) height, transverse decompression range (TDR), spinal canal area (SCA), TMC alignment, and subsidence and fusion rates.</p><p><strong>Results: </strong>Patients in both groups exhibited significant postoperative improvement in NDI and JOA scores (P < 0.05). Radiologically, patients in the wider slotting group exhibited better decompression, evidenced by a larger TDR (P < 0.01) and smaller postoperative SCA (P < 0.01) than the narrow group. Regarding CL, FSU height, TMC alignment, subsidence, or fusion rates, the groups did not differ significantly. Although statistically non-significant, patients in the wider group exhibited a trend towards improvement in spinal cord signal intensity than those in the narrower group.</p><p><strong>Conclusion: </strong>The study demonstrated that a wider TMC slotting width offers superior decompression and may improve postoperative spinal cord signal; it does not compromise spinal stability or fusion outcomes. These findings indicate that slotting width should be carefully considered in ACCF procedures to optimize decompression and spinal cord recovery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"896"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909810","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 and alternative treatment method for moderate diabetic foot ulcer: tibial periosteal distraction.","authors":"Yusong Yuan, Xiaofang Ding, Hao Lu, Ying Chen, Hailin Xu","doi":"10.1186/s13018-024-05375-7","DOIUrl":"10.1186/s13018-024-05375-7","url":null,"abstract":"<p><strong>Objective: </strong>Researchers have proposed a novel surgical treatment for moderate diabetic foot ulcer: tibial periosteal distraction (TPD) which could improve affected limb microcirculation. We aimed to describe the method and therapeutic effects of this technique.</p><p><strong>Methods: </strong>We provided a technical guide to perform TPD surgery for the treatment of moderate diabetic foot ulcer of who had been treated in our department. The demographic information had been collected at the time of their admission. The patients were followed up at 3, 6, and 12 months after the operation with the ulcer area, skin temperature of the medial malleolus, transcutaneous oxygen pressure of the medial malleolus, ankle brachial index, dorsalis pedis artery pulsation, 12 item short form survey quality of life scale score, and visual analogue scale.</p><p><strong>Results: </strong>A total of 35 patients with type 2 diabetes were included in this study, including 19 males and 16 females, with an average age of 62.49 ± 10.34 years and a maximum age of 87 years. The ulcers of all patients were cured, and the average healing time of ulcers was 8.09 ± 2.28 weeks, with no associated complications. The microcirculation indexes of the affected foot were significantly improved (p < 0.05). Three cases showed new vessels regeneration in the affected limbs according to their computed tomography angiography (CTA) results.</p><p><strong>Conclusion: </strong>TPD surgery technique is a simple procedure that significantly increases the efficacy and reduces the complications of moderate diabetic foot ulcer patients, which could accelerate the formation of collateral circulation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"889"},"PeriodicalIF":2.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902849","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 bone defect mapping analysis of true acetabulum in Crowe type IV hip dysplasia.","authors":"Yuhui Yang, Duanyong Chen, Bichun Zhang, Qingtian Li, Linyong Hu, Yuanchen Ma, Qiujian Zheng","doi":"10.1186/s13018-024-05389-1","DOIUrl":"10.1186/s13018-024-05389-1","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of this study was to quantitatively analysis the acetabular morphological feature and 2D/3D coverage of the Crowe IV DDH hip, dividing into subgroups by the false acetabulum. The secondary aim was to propose a 3D bone mapping to determine acetabular bone defect analysis from the perspective of the implanted simulation.</p><p><strong>Methods: </strong>A total of 53 Crowe IV hips (27 hips without the false acetabulum in IVa group and 26 hips in IVb group) and 40 normal hips met the inclusion criteria and were retrospectively evaluated. Firstly, the anatomical size and volume of the acetabulum were measured quantitatively. Secondly, through the simulated implantation, morphological assessments of the true acetabulum included Cup-CE, Cup-Sharp, acetabular anteversion angle, and thickness of the medial wall. Last, Acetabular sector angles (ASAs) and the component coverage ratio were measured to provide coverage indices. Further, 3D bone mapping visualization was applied to determine the uncovered component portion distribution.</p><p><strong>Results: </strong>The anatomic shape and volume of the acetabular triangle were significantly smaller in Crowe IV hips. At the level of the acetabular component center, IVb acetabula were found to be more anteverted and abductive, with smaller Cup-CE and larger Cup-Sharp angles. The coverage sector angles in Crowe IVa hips were larger in the anterosuperior and superior direction, while smaller in the posterosuperior and posterior direction, with no subgroup difference in total component coverage. Both 3D bone mapping and correlation analysis reveal that posterosuperior and posterior bone stock is highly associated with the component coverage.</p><p><strong>Conclusion: </strong>With the presence of the false acetabulum, there existed acetabular anteversion and segmental coverage distinctions between subgroups. During the acetabular reconstruction, management of posterosuperior and posterior bone stock was important for ideal component coverage.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"888"},"PeriodicalIF":2.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903051","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-468-3p suppresses osteogenic differentiation of BMSCs by targeting Runx2 and inhibits bone formation.","authors":"Tao Fang, Ranxi Zhang, Feng Song, Xueru Chu, Qin Fu, Qianqian Wu","doi":"10.1186/s13018-024-05410-7","DOIUrl":"10.1186/s13018-024-05410-7","url":null,"abstract":"<p><p>An improved understanding of the molecular actions underpinning bone marrow mesenchymal stem cell (BMSC) differentiation could highlight new therapeutics for osteoporosis (OP). Current evidence indicates that microRNAs (miRNAs) exert critical roles in many biological systems, including osteoblast differentiation. In this study, we examined miR-468-3p effects on osteogenic differentiation (OD). Distinct miR-468-3p reductions were identified during OD. MiR-468-3p also suppressed BMSC OD in gain- and loss-of-function assays, while it negatively regulated Runx2 as shown by molecular, protein, and bioinformatics approaches. When Runx2 was inhibited by small-interfering RNA (siRNA), the inhibitory effects of miR-468-3p toward BMSC osteogenesis were considerably reversed. Also, silenced miR-468-3p in ovariectomized (OVX) and sham mice augmented bone mass (BM) and bone formation (BF) and improved trabecular (Tb) microarchitecture. Therefore, miR-468-3p is a novel Runx2 regulator with key physiological action in BF and OD.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"887"},"PeriodicalIF":2.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903047","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":"Early therapeutic efficacy of condoliase chemonucleolysis for lumbar disc herniation.","authors":"Kazuyoshi Kobayashi, Koji Sato, Yoshinori Morita","doi":"10.1186/s13018-024-05405-4","DOIUrl":"10.1186/s13018-024-05405-4","url":null,"abstract":"<p><strong>Background: </strong>Low back pain is often caused by lumbar disc herniation (LDH). Treatment of LDH is possible using chemonucleolysis of the nucleus pulposus with condoliase injection. However, onset of the therapeutic effect varies among patients, with improvement from an early stage to 3 months post-injection. This study was performed to identify the characteristics of early responders to condoliase therapy.</p><p><strong>Methods: </strong>A retrospective cohort study was performed in 371 consecutive patients (259 males, 112 females; age, 49.9 ± 18.7 years; follow-up period, 13.1 ± 7.4 months) treated with condoliase injection for LDH between August 2018 and January 2024. Chemonucleolysis was performed with 1 mL of condoliase (1.25 U/mL) injected into the intervertebral nucleus pulposus. Clinical assessments were made before injection and 1 day, and 1, 4 and 12 weeks post-injection. Pain was measured on a visual analogue scale. Herniation parameters were evaluated on axial MRI. The herniated disc volume was measured on plain lumbar radiography. Demographic and clinical data were taken from medical charts. Multivariate logistic regression analysis was used to identify factors with independent relationships with treatment efficacy.</p><p><strong>Results: </strong>Improvement of leg pain from baseline by ≥ 50% occurred in 21% of cases within one day after condoliase treatment. Patients with this improvement at 1 week post-injection were defined as early responders (n = 142, 38.3%). In multivariate analysis, age < 40 years (p = 0.022, odds ratio (OR): 1.71, 95% confidence interval (CI): 1.12-4.35), Pfirrmann Grade II or III at baseline (p = 0.032, OR: 1.86, 95% CI: 1.17-5.41), and a high intensity MRI signal in the herniation (p = 0.041, OR: 1.87, 95% CI: 1.06-5.27) were significantly associated with early improvement. No patients had anaphylactic shock or neurologic sequelae.</p><p><strong>Conclusions: </strong>This study confirms the safety and efficacy of chemonucleolysis with condoliase for treating patients with painful LDH. Age, high-intensity MRI signals, and baseline Pfirrmann grade were significant factors associated with early improvement.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"890"},"PeriodicalIF":2.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903033","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":"Meta-analysis of minimally invasive transforaminal lumbar interbody fusion versus oblique lumbar interbody fusion for treating lumbar degenerative diseases.","authors":"Dun Liu, Xinyu Huang, Chongyang Zhang, Qin Wang, Hua Jiang","doi":"10.1186/s13018-024-05422-3","DOIUrl":"10.1186/s13018-024-05422-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to perform a meta-analysis that integrates multiple literature sources to evaluate the clinical efficacy of oblique lumbar interbody fusion (OLIF) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for treating lumbar degenerative diseases (LDD).</p><p><strong>Methods: </strong>A systematic search was conducted across various databases, including CNKI, VIP, WANFANG DATA, SinoMed, PubMed, Cochrane Library, Embase, and Web of Science, for clinical comparative studies on OLIF and MIS-TLIF for treating LDD, covering the time frame from the inception of the databases to September 2024. Following PRISMA guidelines, studies were screened, assessed, and data were extracted rigorously. Indicators extracted included operative time, intraoperative blood loss, hospital stay, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), disc height (DH), segmental lordotic angle (SLA), lumbar lordosis angle (LLA), postoperative JOA scores, patient satisfaction, complication rates, and fusion rates. Meta-analysis was performed using Review Manager 5.4 software.</p><p><strong>Results: </strong>A total of 24 studies were included, comprising 11 randomized controlled trials and 13 retrospective cohort studies. The total population consisted of 1785 patients, with 898 in the OLIF group and 887 in the MIS-TLIF group. The meta-analysis indicated that, compared to the MIS-TLIF group, the OLIF group exhibited significantly lower intraoperative blood loss, shorter hospital stays, improved postoperative DH, shorter operative time, reduced postoperative VAS scores, lower postoperative ODI scores, and improved postoperative SLA and LLA. No significant differences were observed between the groups in postoperative JOA scores, fusion rates, complication rates, or patient satisfaction. The OLIF group exhibited advantages such as lower blood loss, shorter hospital stays, higher postoperative fusion rates, and improved recovery of disc and foraminal heights.</p><p><strong>Conclusion: </strong>Compared to MIS-TLIF, OLIF is associated with a shorter operative time and less intraoperative blood loss, potentially leading to better relief of leg pain, restoration of DH, and prevention of subsidence. These findings offer valuable insights for clinical practice.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"891"},"PeriodicalIF":2.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906873","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":"Current understanding of articular cartilage lesions in femoroacetabular impingement syndrome.","authors":"Zhi Li, Jiangwei Yu, Peitong An, Weiguo Zhang, Kang Tian","doi":"10.1186/s13018-024-05322-6","DOIUrl":"10.1186/s13018-024-05322-6","url":null,"abstract":"<p><p>The concept of femoroacetabular impingement syndrome (FAIS) has received much attention over the past 20 years. Currently, it is believed that FAIS can lead to intra-articular pathologies such as labral tears and articular cartilage lesions, resulting in clinical symptoms and subsequent poor clinical outcomes. FAIS-related articular cartilage lesions are common but unique, and their natural course always leads to early osteoarthritis of the hip. However, despite these cartilage lesions having gradually gained considerable attention, limited consensus has been reached on key aspects, such as diagnosis, mechanisms, classification, and management strategies, which limits clinical and research advances. Hence, an intensive comprehensive overview based on the existing evidence is necessary. The purpose of this review was to introduce the general consensus, controversial issues, and recent advances in FAIS-related articular cartilage lesions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"886"},"PeriodicalIF":2.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903034","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":"Two-stage surgery with oblique lateral interbody fusion and posterior fixation in degenerative scoliosis with lumbosacral curve-driven degenerative lumbar scoliosis: a feasible option to prevent postoperative coronal decompensation.","authors":"Zuoran Fan, Qingyang Huang, Weiguo Zhu, Wei Wang, Xiangyu Li, Yu Wang, Dongfan Wang, Tao Hu, Xiaolong Chen, Shibao Lu","doi":"10.1186/s13018-024-05368-6","DOIUrl":"10.1186/s13018-024-05368-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to introduce a two-stage surgical procedure, namely oblique lateral interbody fusion (OLIF), for spinal disorders treatment. Furthermore, clinical outcomes and imaging results are analyzed between OLIF with posterior fixation and posterior lumbar interbody fusion (PLIF) with fixation for lumbosacral curve-driven degenerative lumbar scoliosis (DLS).</p><p><strong>Methods: </strong>146 patients with type 2 DLS who underwent OLIF or PLIF between January 2019 and November 2023 were included. Spinal and pelvic parameters were measured using X-ray imaging before and after surgery. Clinical symptoms were assessed using Oswestry Disability Index (ODI) and visual analog scale (VAS). Operation time, intraoperative blood loss, surgical fixation segments, drainage tube indwelling time, and drainage volume were recorded.</p><p><strong>Results: </strong>70 patients underwent OLIF and 76 underwent PLIF. Preoperative and postoperative clinical symptoms remain the same (p > 0.05). OLIF group exhibited significantly less intraoperative blood loss, fewer fixation segments, shorter drainage tube retention time, and reduced drainage volume (p < 0.01). Additionally, improvements in coronal parameters, including coronal balance distance, were more pronounced in OLIF group with less potential postoperative coronal imbalance (p < 0.05).</p><p><strong>Conclusion: </strong>For type 2 DLS, two-stage surgery of OLIF with posterior fixation represents a more efficient surgical approach, reducing surgical fusion segments, causing less trauma and bleeding, and effectively avoiding postoperative coronal plane decompensation than traditional posterior surgery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"880"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895457","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":"Is perioperative use of a combination of pregabalin and naproxen superior to naproxen only in reducing pain in ankle fractures? A prospective, randomized, multicenter study.","authors":"Gi Won Choi, Kwang Hwan Park, Yeo Kwon Yoon, Jin Woo Lee, Dong Woo Shim","doi":"10.1186/s13018-024-05321-7","DOIUrl":"10.1186/s13018-024-05321-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the analgesic efficacy, adverse effects, and long-term functional outcomes of perioperative naproxen alone versus naproxen with pregabalin for treating pain in ankle fractures.</p><p><strong>Methods: </strong>This study included 70 patients who underwent operative fixation of rotatory ankle fractures. Group A received naproxen 500 mg only, and Group B received naproxen 500 mg with pregabalin 75 mg 2-hour before surgery and 12 hourly for 14 days thereafter. The minimal clinically important difference of the visual analog scale (VAS) for pain was set at 1.8 out of 10. VAS for pain, opioid consumption, and any adverse effects were recorded for 3 days postoperatively. VAS for pain was checked at 2- and 6-weeks and 3- and 6-months, and functional outcomes were measured at 3- and 6-months postoperatively.</p><p><strong>Results: </strong>Sixty-three patients (33 and 30 in groups A and B, respectively) completed the 6-month follow-up. Demographic data were similar between groups. VAS for pain did not significantly differ between the groups at any timepoint up to 6 months (P ≥ 0.520), with 95% confidence intervals consistently within 1.8. No significant differences were observed between groups in opioid consumption and functional outcomes (P ≥ 0.211). In group B, dizziness at 48-hour and somnolence at 72-hour were significantly predominant (P ≤ 0.05).</p><p><strong>Conclusion: </strong>Our study demonstrated comparable pain reduction between two groups following operative fixation of rotatory ankle fractures. However, side effects, including dizziness and somnolence, were predominant in Group B between 48 and 72 h.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"882"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895450","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":"Efficacy of telerehabilitation for total knee arthroplasty: a meta-analysis based on randomized controlled trials combined with a bibliometric study.","authors":"Xu Liu, Guang Yang, Wenqing Xie, Wenhao Lu, Gaoming Liu, Wenfeng Xiao, Yusheng Li","doi":"10.1186/s13018-024-05381-9","DOIUrl":"10.1186/s13018-024-05381-9","url":null,"abstract":"<p><strong>Background: </strong>Physical therapy (PT) is widely employed in osteoarthritis (OA). This study aimed to explore the research development of PT for OA and to identify the emerging treatment, and verify its efficacy.</p><p><strong>Materials and methods: </strong>The Web of Science Core Collection was used to conduct the bibliometric analysis. Furthermore, a meta-analysis based on randomized controlled trials (RCTs) was performed to evaluate the identified treatment's efficacy.</p><p><strong>Results: </strong>A total of 3,142 articles were retrieved from the Web of Science Core Collection, and the annual publication volume shows an exponential growth trend (R² = 0.9515). Keyword analysis demonstrated that telerehabilitation (TELE) in total knee arthroplasty (TKA) has become a hotspot since 2020. To assess the effectiveness of TELE, we conducted a meta-analysis of 25 RCTs including 4402 patients. In the total analysis, the TELE group exhibited superior outcomes compared to the traditional face-to-face (FTF) rehabilitation group in terms of pain (standardized mean differences [SMD]: - 0.15, 95% CI - 0.27 to - 0.04, P = 0.01), passive flexion (MD: 2.60, 95% CI 0.77 to 4.44, P = 0.005), quadriceps muscle strength (SMD: 0.32, 95% CI 0.04 to 0.61, P = 0.03), and cost (SMD: - 0.50, 95% CI - 0.88 to - 0.12, P = 0.009). The subgroup analysis also demonstrated that the fixed equipment-assisted telerehabilitation (FEAT) group and the mobile device-assisted telerehabilitation (MDAT) group were superior to the FTF group. Moreover, patients in the FEAT group exhibited better prognoses than those in the MDAT group. No significant differences in the other measured outcome were observed.</p><p><strong>Conclusion: </strong>Telerehabilitation proved to be more effective than traditional FTF rehabilitation in patients who underwent TKA. Further research is warranted to compare the different TELE interventions to establish the best protocols and timing for interventions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"874"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895220","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}