Journal of Orthopaedic Surgery and Research最新文献

{"title":"The role of quadriceps strength and quadriceps-focused rehabilitation following medial meniscus posterior root repair: a systematic review.","authors":"Wenqiang Zhao, Qiuyue Liu, Guolei Ren, Jie Xu, Changxu Han","doi":"10.1186/s13018-026-06877-2","DOIUrl":"https://doi.org/10.1186/s13018-026-06877-2","url":null,"abstract":"<p><strong>Background: </strong>Medial meniscus posterior root tear (MMPRT) can lead to biomechanical disruption of the medial compartment and accelerate the progression of osteoarthritis. Although surgical repair may improve pain and functional outcomes, postoperative rehabilitation is also considered important for recovery. The quadriceps plays a central role in knee joint stability, load distribution, and functional recovery, yet its role in rehabilitation following MMPR repair remains unclear. This study aimed to systematically summarize the available evidence regarding quadriceps strength and quadriceps-focused rehabilitation following MMPR repair.</p><p><strong>Methods: </strong>Databases including PubMed, Embase, the Cochrane Library, Web of Science, Scopus, PEDro, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched from inception to June 2025. Studies were included if they involved patients who underwent medial meniscal posterior root (MMPR) repair and received quadriceps-focused rehabilitation. Methodological quality was assessed using the MINORS tool. Because of substantial heterogeneity in reported outcomes, only qualitative synthesis was performed. This study was registered with PROSPERO (CRD420251145452).</p><p><strong>Results: </strong>Three studies involving 93 patients were included. All patients underwent transtibial pull-out repair and were followed for 1 year. Weaker preoperative quadriceps strength was associated with greater postoperative medial meniscal extrusion (MME) and progression of medial joint space narrowing (MJS). Protocols emphasizing quadriceps-focused rehabilitation, including isometric exercises, straight-leg raises, resistance training, and neuromuscular electrical stimulation, were generally associated with improved muscle strength, better functional scores (IKDC, KOOS, and Lysholm), and faster Timed Up and Go (TUG) recovery. In addition, groups with greater quadriceps strength or more quadriceps-focused rehabilitation tended to show less progression of MME and MJS on imaging. All studies had a MINORS score of 11, indicating acceptable clarity of study aims and follow-up, but limitations in prospective design and sample size estimation.</p><p><strong>Conclusion: </strong>Quadriceps-focused rehabilitation may play an important role in recovery following MMPR repair. Greater quadriceps strength was associated with better muscle strength, functional outcomes, and potentially more favorable structural findings. However, the current evidence is limited and mainly based on retrospective studies, so these findings should be interpreted cautiously. Further high-quality, multicenter prospective studies are needed to clarify the optimal role and components of quadriceps-focused rehabilitation after MMPR repair.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MIPO versus ORIF with long proximal humerus locking plate for metadiaphyseal proximal humeral fracture.","authors":"Tahsin Aydın, Fatih İnci, Murat Bozbek, Furkan Türk, İbrahim Alper Yavuz, Yakup Kahve, Özdamar Fuad Öken","doi":"10.1186/s13018-026-06866-5","DOIUrl":"https://doi.org/10.1186/s13018-026-06866-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare ORIF (open reduction internal fixation) and MIPO (minimal invasive plate osteosynthesis) using long PHLP (proximal humerus locking plate) in treating metadiaphyseal proximal humeral fractures regarding time to union, complications, and clinical outcomes.</p><p><strong>Methods: </strong>This retrospective study was conducted at a single-center Level 1 trauma facility. The study population consisted of patients who underwent long PHLP fixation for metadiaphyseal proximal humeral fractures and completed a minimum follow-up of 1 year. Patients with additional injuries in the same extremity, those treated with implants other than long PHLP, or those managed with surgical techniques other than MIPO or ORIF were excluded. The cohort was divided into two groups: MIPO (32 patients) and ORIF (29 patients). The groups were compared with respect to demographic characteristics (age, sex, mechanism of trauma), radiological outcomes (time to union), and clinical outcomes, including the Disabilities of the Arm, Shoulder and Hand (DASH) score, Constant-Murley score, and complication rates.</p><p><strong>Results: </strong>The mean age was 54.96 (SD 17.1, range 24-85) in the MIPO group and 54.55 (SD 15.03, range 22-84) in the ORIF group. The MIPO group (n = 32) had a significantly shorter mean time to union than the ORIF group (n = 29) [13.8 ± 3.0 vs. 17.3 ± 5.1 weeks; p = 0.003]. At 1 year, DASH scores were lower in the MIPO group [8.6 ± 7.1 vs. 12.8 ± 8.8; p = 0.044]. Constant-Murley scores showed no significant difference between groups [87.8 ± 6.2 vs. 84.5 ± 9.0; p = 0.094]. In the MIPO group, 1 (3.1%) patient had radial nerve impairment and 1 (3.1%) patient had subacromial impingement; in the ORIF group, 1 (3.4%) patient had radial nerve impairment and 2 (6.9%) patients had nonunion.</p><p><strong>Conclusion: </strong>In metadiaphyseal proximal humeral fractures, minimally invasive plate osteosynthesis using a long proximal humeral locking plate was associated with a shorter radiographic time to union than open reduction and internal fixation, although this finding should be interpreted in the context of the different radiographic union criteria applied in the two groups.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes and contributing factors in pediatric radial neck fracture.","authors":"Rak Jun Kim, Woo Sub Kim, Moon Seok Park, Ki Hyuk Sung","doi":"10.1186/s13018-026-06875-4","DOIUrl":"https://doi.org/10.1186/s13018-026-06875-4","url":null,"abstract":"<p><strong>Background: </strong>Few studies have investigated the contributing factors for pediatric radial neck fractures. This study aimed to analyze the radiographic and clinical factors that influence the treatment outcomes in pediatric radial neck fracture.</p><p><strong>Methods: </strong>This retrospective study included the 112 pediatric patients with radial neck fracture. On elbow radiographs, angulation, displacement, and carrying angle were measured, and fractures were classified using the modified Judet classification. Clinical outcomes were assessed using the Flynn criteria based on the elbow ROM and carrying angle. Univariable and multivariable Firth logistic regression analysis was used to assess the risk factors for unsatisfactory clinical outcome.</p><p><strong>Results: </strong>According to the Flynn criteria, 99 (88.4%) and 13 (11.6%) patients had satisfactory (excellent or good) and unsatisfactory (fair or poor) outcomes, respectively. There were statistically significant differences in the initial displacement and follow-up duration between the two groups (p = 0.002 and 0.025, respectively). Multivariable Firth logistic regression analysis showed that initial displacement was the only independent risk factor for unsatisfactory clinical outcomes after pediatric RNF (odds ratio = 1.448, p = 0.002). The cutoff value of displacement for predicting unsatisfactory clinical outcomes was 72% with a 53.9% of sensitivity and an 87.9% of specificity.</p><p><strong>Conclusions: </strong>This study showed that greater initial displacement was associated with an increased risk of unsatisfactory clinical outcomes in pediatric radial neck fractures. The exploratory 72% displacement threshold may help identify higher-risk patients; however, further validation is required before clinical application.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between MRI template and tumor resection for safety margin: a retrospective study.","authors":"Abdulrahman Bobseit, Raed Qeretli, Mohammed Alsalman, Ali Alassiri, Abdullah Alanazi, Ziad Aljaafri, Luai Almarzouq, Jumanah Altwalah, Wazzan Aljuhani","doi":"10.1186/s13018-026-06845-w","DOIUrl":"https://doi.org/10.1186/s13018-026-06845-w","url":null,"abstract":"<p><strong>Background: </strong>Bone tumor surgery necessitates precise assessment of resection margins to optimize patient outcomes. Magnetic resonance imaging (MRI) modalities offer valuable preoperative insights, but their correlation with anatomopathological findings remains largely underexplored.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 47 patients with long bone sarcomas eligible for resection surgery. Preoperative MRI scans, including T1, T2, and contrast sequences, were analyzed, and corresponding histopathological evaluations were performed postoperatively. Data analysis was conducted on SAS 9.4 using summary statistics and t-tests for comparison.</p><p><strong>Results: </strong>Mean differences in tumor measurements between preoperative MRI and histopathological assessment were measured. The observed disparities were 2.04 cm for T1, 1.92 cm for T2, and 1.55 cm for contrast sequences, with no significant variations detected between MRI modalities. Similarly, when MRI modalities were compared among themselves for tumor measurements, no significant difference was found. Most of the observed differences between MRI modalities and histopathology were < = 2 cm.</p><p><strong>Conclusion: </strong>The present study highlighted the importance of optimizing MRI utilization and surgical planning protocols to enhance the accuracy of bone tumor surgery. By addressing the challenges associated with margin analysis and integrating MRI findings with histopathological evaluations, it is possible to improve patient outcomes and advance the field of orthopedic oncology.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed reality-assisted navigation versus conventional manual positioning for anterior cruciate ligament reconstruction using 3D-printed knee models: a controlled experimental study.","authors":"Binyang Meng, Zi Zhang, Wenhe Li, Baoting Li, Yichen Wang, Hao Pang, Zhilin Yue, Rui Wang, Qi Wang, Jiangang Cao","doi":"10.1186/s13018-026-06904-2","DOIUrl":"https://doi.org/10.1186/s13018-026-06904-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of mixed reality (MR)-assisted navigation compared with conventional manual positioning on operative time and tunnel positioning accuracy during anterior cruciate ligament reconstruction (ACLR) using 3D-printed knee models. In particular, this study aimed to determine whether MR navigation can reduce the accuracy gap between senior and junior surgeons.</p><p><strong>Methods: </strong>Computed tomography (CT) data from 20 patients with anterior cruciate ligament injury were randomly selected to generate standardized 3D-printed knee models. One senior surgeon and one junior surgeon independently performed femoral and tibial tunnel drilling using either MR-assisted navigation (N) or conventional manual positioning (C). Based on surgeon experience (H/L) and positioning technique (N/C), four groups were established: HN, HC, LN, and LC (n = 5 per group). Operative time was recorded from the initiation of tunnel positioning to completion of tunnel drilling. Postoperative three-dimensional CT scans were used to measure the actual tunnel locations. The absolute percentage deviation between the actual and ideal tunnel coordinates (|Δ%|) was calculated using the Bernard quadrant method for femoral tunnels and the Staubli-Rauschning method for tibial tunnels. Two-way analysis of variance (ANOVA) was used to evaluate the main effects and interaction effects, followed by Fisher's least significant difference (LSD) post hoc comparisons.</p><p><strong>Results: </strong>In the tibial mediolateral (ML) direction, both positioning technique and surgeon experience demonstrated significant main effects, with a significant interaction effect (P < 0.001). MR navigation significantly reduced positioning errors in junior surgeons, bringing their accuracy close to that of senior surgeons. In the tibial anteroposterior (AP) direction, the main effect of navigation was significant (P = 0.009), whereas the interaction effect was not significant. In the femoral D direction, positioning accuracy was primarily influenced by surgeon experience (P = 0.011), whereas only a trend toward improvement was observed in the femoral H direction. Operative time analysis demonstrated a significant interaction effect (P < 0.001): MR navigation significantly prolonged operative time in senior surgeons but did not significantly increase operative time in junior surgeons.</p><p><strong>Conclusion: </strong>MR-assisted navigation significantly improves femoral and tibial tunnel positioning accuracy, particularly in the tibial ML direction, and partially reduces the accuracy gap between senior and junior surgeons. Importantly, the improvement in accuracy among junior surgeons was not accompanied by an increase in operative time. These findings suggest that MR navigation may serve as a valuable educational and training tool; however, further clinical studies are required to validate its long-term clinical effectiveness.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of 3D-printed artificial vertebral bodies for spinal tumor resection and reconstruction: a systematic review and meta-analysis.","authors":"Qiaojuan Wang, Jiyao Chen, Shutao Zheng, Jun Ma","doi":"10.1186/s13018-026-06788-2","DOIUrl":"https://doi.org/10.1186/s13018-026-06788-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of 3D printed artificial vertebral body in spinal reconstruction after total en bloc spondylectomy (TES) for spinal tumors.</p><p><strong>Methods: </strong>We searched PubMed, Embase, ScienceDirect, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database, and Wei Pu Database by computer to collect controlled clinical studies on the efficacy and safety of 3D printed artificial vertebral body and titanium mesh cages (TMCs) in the treatment of spinal tumors after total en bloc spondylectomy (TES) from database establishment to February 2024.</p><p><strong>Results: </strong>A total of 10 cohort studies and 2 randomized controlled study with a total of 489 patients were included in this study, including 234 patients in the 3D group and 255 patients in the TMC group. The 3D group had lower intraoperative blood loss than the TMC group [mean difference (MD) = - 1.47, 95% CI (- 2.38, -0.55), P = 0.002] and operation time was shorter than that of the TMC group [MD = -0.65, 95% CI (- 1.23, - 0.07), P = 0.03]. Early postoperative JOA scores improved more significantly in the TMC group [MD = 0.50, 95% CI (0.18, 0.82), P = 0.002].</p><p><strong>Conclusion: </strong>The 3D printing group demonstrated advantages in early postoperative pain relief (VAS) and spinal sequence maintenance (loss of Cobb angle), while there were no statistically significant differences between the two groups in Frankel grading and neurological improvement rates. Notably, the traditional titanium mesh group showed more significant improvements in early postoperative JOA scores.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and management of spinal fractures in patients with ankylosing spondylitis: a retrospective cohort study.","authors":"Xin Zhao, Mingwang Jia, Chenning Ding, Shan Xiao, Xiguang Sang","doi":"10.1186/s13018-026-06871-8","DOIUrl":"https://doi.org/10.1186/s13018-026-06871-8","url":null,"abstract":"<p><strong>Background: </strong>Patients with ankylosing spondylitis (AS) are prone to spinal fractures with unique characteristics. This retrospective cohort study aimed to characterize the demographic and clinical features of spinal fractures in AS patients; analyze fracture patterns, including anatomical distribution, morphology, and association with spinal cord injury (SCI); and evaluate surgical approaches and their associated complications.</p><p><strong>Methods: </strong>From January 1, 2017, to December 31, 2022, AS patients admitted with spinal fractures were enrolled. Demographic details, fracture characteristics, surgical interventions, and postoperative complications were systematically collected and retrospectively reviewed. Neurological status was graded using the ASIA Impairment Scale.</p><p><strong>Results: </strong>In total, 43 patients were identified over 46 admissions (mean age 55.1 ± 11.9 years, 87% male). Cervical spine fractures were most prevalent (34.8%), and fractures spanning multiple spinal regions were observed in 11 cases (23.9%). SCI was documented in 16 cases (34.8%), with 56.3% classified as ASIA A. Patients with SCI had significantly higher rates of in-hospital complications than those without SCI (62.5% vs. 10.0%, p = 0.001). Respiratory complications were most common (26.8% of all complications). Instrumentation failure requiring revision occurred in 4.9% of surgically treated patients; both cases involved failure of the anterior fixation-one after anterior‑only and the other after combined anterior‑posterior cervical surgery.</p><p><strong>Conclusions: </strong>AS patients are at high risk for spinal fractures and associated SCI, particularly in the cervical spine. The higher rate of postoperative complications in patients with SCI highlights the critical need for enhanced perioperative monitoring. The potential risk of instrumentation failure with anterior fixation warrants further investigation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased lateral posterior tibial slope and greater tibiofemoral rotation are associated with a higher risk of lateral meniscal tears in anterior cruciate ligament injuries.","authors":"Rongxin Huang, Shulin Li, Zijie Zhou, Laipeng Yan, Faqiang Tang, Huiling Guo","doi":"10.1186/s13018-026-06873-6","DOIUrl":"https://doi.org/10.1186/s13018-026-06873-6","url":null,"abstract":"<p><strong>Background: </strong>Lateral meniscal (LM) tears are common in anterior cruciate ligament (ACL)-injured knees but may be underestimated on preoperative magnetic resonance imaging. Structural imaging parameters reflecting knee morphology and alignment may help identify patients at increased risk of LM injury. This study examined whether medial posterior tibial slope (MPTS), lateral posterior tibial slope (LPTS), and tibiofemoral rotation angle (TFA) are associated with LM tears in ACL injuries.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated clinical records and preoperative magnetic resonance imaging (MRI) scans of patients undergoing primary ACL reconstruction. MPTS, LPTS, TFA, and delta angle were measured on standardized MRI, and LM status was confirmed arthroscopically. Multivariable logistic regression analysis identified independent associations. Restricted cubic spline (RCS) analysis assessed nonlinear dose-response patterns, and receiver operating characteristic (ROC) curves with DeLong testing quantified incremental predictive performance.</p><p><strong>Results: </strong>A total of 215 patients were included (100 with and 115 without LM tears). Patients with tears demonstrated greater LPTS (5.9 ± 3.9° vs 4.5 ± 3.4°, p = 0.005) and TFA (2.3 ± 4.7° vs 1.0 ± 3.1°, p = 0.015), while MPTS and delta angle did not differ. After adjustment, LPTS (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.03-1.21; p = 0.007), MPTS (OR, 2.48; 95% CI, 1.24-5.07; p = 0.011), and TFA (OR, 1.10; 95% CI, 1.02-1.18; p = 0.014) remained independently associated with LM tears. RCS analysis revealed a nonlinear, right-shifted U-shaped association between TFA and tear risk (P-nonlinearity < 0.001), with risk increasing at extreme rotational values, particularly increasing internal tibial rotation. ROC analysis showed modest improvements in discrimination with LPTS (area under the curve [AUC], 0.600 to 0.665; p = 0.041) and TFA tertiles (AUC, 0.600 to 0.674; p = 0.040); however, overall discrimination remained limited and these findings should be interpreted cautiously without external validation.</p><p><strong>Conclusion: </strong>Steeper lateral posterior tibial slope and greater tibiofemoral rotation were independent risk factors for LM tears in anterior cruciate ligament injuries. Tibiofemoral rotation showed a nonlinear increase in risk, driven mainly by excessive internal rotation. These parameters may provide additional context for preoperative risk stratification.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter to the editor.","authors":"Tingwei Zhao, Kaibo Zhang, Jian Li, Weili Fu","doi":"10.1186/s13018-026-06757-9","DOIUrl":"10.1186/s13018-026-06757-9","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774282","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":"Comparative analysis of different mobility aids in the early accelerated rehabilitation phase following acute achilles tendon repair surgery: a prospective cohort study.","authors":"Zhuoqi Wei, Zengzhen Cui, Yuan Cao, Xiuzhi Li, Yuliang Fu, Liangyu Bai, Yang Lv","doi":"10.1186/s13018-026-06881-6","DOIUrl":"https://doi.org/10.1186/s13018-026-06881-6","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to evaluate and compare the safety, efficacy, and cost-effectiveness of different mobility aids during the early rehabilitation phase following surgical repair of acute Achilles tendon rupture (AATR).</p><p><strong>Methods: </strong>This prospective cohort study included 198 patients who underwent surgical repair for AATR between April 2023 and February 2025, with 171 males (86.4%) and a mean age of 36.4 years. Based on the mobility aid used weeks 3-6 postoperatively, participants were categorized into four groups: Wheelchair (n = 43), Knee Scooter (n = 41), Axillary Crutches (n = 78), and Leg Support (LS) Walker (n = 36). Patients were scheduled for assessments at 2, 4, 6, 12, and 24 weeks, with an additional telephone follow-up conducted approximately one year after surgery. Primary outcomes included the rate of unplanned Emergency Department (ED) visits, the affected-to-unaffected (A: U) calf circumference ratio, and expected rehabilitation costs. Secondary outcomes encompassed the Visual Analog Scale, the Achilles Tendon Total Rupture Score, the American Orthopedic Foot & Ankle Society Ankle-Hindfoot Score, and time to key recovery milestones, including single-leg heel raise to 50% of contralateral side, return to light exercise, return to work, and return to pre-injury exercise. Continuous variables were analyzed using one-way ANOVA or Kruskal-Wallis test, and categorical variables using chi-square or Fisher's exact test, while linear mixed-effects models were employed for longitudinal outcomes.</p><p><strong>Results: </strong>During the early rehabilitation phase (Weeks 3-6), unplanned ED visit rates differed significantly among the four groups (p = 0.032), with the Axillary Crutches showing significantly higher odds than the Wheelchair (OR = 8.24, 95% CI 1.16-58.53, p = 0.040). A significant difference in the A: U ratio was observed among the four groups at 6 weeks postoperatively (p = 0.037), and post-hoc comparisons showed significant differences for LS Walker vs. Wheelchair (p < 0.001), Axillary Crutches vs. Wheelchair (p = 0.002), and LS Walker vs. Knee Scooter (p = 0.038). The LS Walker and Axillary Crutches also demonstrated superior performance in VAS, ATRS, and AOFAS scores from Week 4 to Week 12, and achieved key recovery milestones significantly earlier (p < 0.001). Economic analysis revealed the lower direct treatment costs in the Axillary Crutches (477 RMB) and Knee Scooter (539 RMB), followed by the Wheelchair (664 RMB) and LS Walker (1126 RMB) (p < 0.001).</p><p><strong>Conclusions: </strong>LS Walker demonstrated superior efficacy in preserving muscle and accelerating functional recovery, while Knee Scooter offered a favorable profile for fall prevention and cost-effectiveness.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT04663542), registered on 22 September 2020.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774301","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}