Journal of Orthopaedic Surgery and Research最新文献

{"title":"Development of a macrophage polarization-modulating therapeutic agent for osteoarthritis treatment.","authors":"Limin Wu, Xiaotao Cao, Bin Shen","doi":"10.1186/s13018-025-05679-2","DOIUrl":"10.1186/s13018-025-05679-2","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a common chronic degenerative joint disease. Recent studies have emphasized the crucial role of macrophages, particularly tissue-resident macrophages (Tissue-Resident Macrophages, TRMs), in the pathogenesis and progression of OA. Under physiological conditions, TRMs maintain joint homeostasis, but under various stimuli, they can polarize into pro-inflammatory M1 or anti-inflammatory M2 phenotypes. An imbalance in macrophage polarization, favoring the M1 phenotype, leads to sustained inflammation, cartilage degradation, and osteophyte formation, further exacerbating OA symptoms and structural damage. This article reviews the current understanding of macrophage polarization in OA, with a particular emphasis on the mechanisms by which TRMs influence the joint microenvironment. It explores the therapeutic potential of drug molecular platforms aimed at regulating macrophage polarization, shifting the balance from pro-inflammatory M1 to anti-inflammatory M2. The discussion includes various pharmacological agents such as corticosteroids, hyaluronic acid derivatives, monoclonal antibodies, and bioactive molecules like Squid Type II Collagen (SCII) in modulating macrophage function and slowing OA progression. Additionally, the article examines advancements in gene therapy methods targeting macrophages, utilizing nanotechnology-based delivery systems to enhance the specificity and efficiency of macrophage phenotype regulation. Targeting TRMs through sophisticated drug molecular platforms presents a promising strategy for developing novel diagnostic and therapeutic interventions for osteoarthritis.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"279"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625172","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 differences between residual childhood hip dysplasia with previous osteotomy and adolescent-onset hip dysplasia.","authors":"Han-Jin Liu, I-Hsin Chen, Ting-Ming Wang, Chia-Che Lee, Sheng-Chieh Lin, Ken N Kuo, Kuan-Wen Wu","doi":"10.1186/s13018-025-05655-w","DOIUrl":"10.1186/s13018-025-05655-w","url":null,"abstract":"<p><strong>Background: </strong>Hip dysplasia (HD) at skeletal maturity can result from residual developmental dysplasia of the hip (DDH) treated in childhood or from primary adolescent-onset HD (AOHD). This study aims to compare the pathomorphology of these two HD subtypes with that of a normal control group.</p><p><strong>Methods: </strong>This retrospective study reviewed patients who underwent periacetabular osteotomy for symptomatic HD between 2013 and 2020. The study included 27 residual HD patients (32 hips) following a previous pelvic osteotomy and 39 AOHD patients (68 hips), compared to 29 age- and sex-matched healthy individuals. Acetabular morphology was assessed using plain radiographs, measuring the lateral and anterior center-edge angle (LCEA/ACEA), Sharp angle, Tönnis angle (TA), acetabular depth ratio (ADR), acetabular head index (AHI), and head lateralization index (HLI). On 2D axial and frontal CT scans, we measured acetabular version (AV), anterior and posterior acetabular sector angle (AASA/PASA), femoral neck shaft angle (NSA) and femoral anteversion (FAV).</p><p><strong>Results: </strong>Both HD groups presented frontal and sagittal acetabular dysplasia with lower LCEA (p < 0.001), lower ACEA (p < 0.001), and lateral subluxation, indicated by lower AHI (p < 0.001) and higher HLI (p < 0.001). Compared to AOHD, residual HD demonstrated greater lateralization, with a higher HLI (p = 0.028). In the axial plane, both HD groups had similar deficient anterior coverage, with lower AASA (p < 0.001). However, residual HD exhibited poorer posterior coverage, with a lower PASA (p < 0.001) and a lower AV (p = 0.006). NSA did not differ between groups, but residual HD had excessive FAV compared to the other groups (p < 0.001).</p><p><strong>Conclusions: </strong>Although both residual HD and AOHD demonstrated anterior and lateral acetabular deficiencies, residual HD was further characterized by reduced acetabular version, more femoral head lateralization, poorer posterior acetabular support, and excessive FAV.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"271"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615704","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 effects of blood flow restriction training on early muscle strength and mid-term knee function following anterior cruciate ligament reconstruction: a systematic review and meta-analysis.","authors":"Xiaoyan Li, Fajun Xiao, Hongying Ren, Yi Peng, Fang Feng, Qinjian Dong","doi":"10.1186/s13018-025-05673-8","DOIUrl":"10.1186/s13018-025-05673-8","url":null,"abstract":"<p><strong>Objective: </strong>Early restoration of muscle strength and knee joint function after anterior cruciate ligament reconstruction (ACLR) is a critical goal in the rehabilitation process. Blood flow restriction training (BFRT), a low-load training method, has gained attention in musculoskeletal rehabilitation in recent years, but its specific effects in ACLR rehabilitation remain unclear.</p><p><strong>Methods: </strong>Relevant literature up to December 20, 2024, was searched in the PubMed, Embase, Cochrane, and Web of Science databases, and study selection was performed according to PRISMA guidelines. Randomized controlled trials (RCTs) and quasi-RCTs comparing the effects of BFRT and traditional training in ACLR rehabilitation were included. Data on early muscle strength (ACSA and MVIC) and mid-term knee function (IKDC scores and isometric strength of knee extensors) were extracted. The quality of the studies was assessed using the Cochrane risk of bias tool, and statistical analyses were conducted using fixed-effect or random-effect models.</p><p><strong>Results: </strong>A total of 11 studies involving 276 patients were included, with 139 in the BFRT group and 137 in the control group. Meta-analysis showed no significant improvements in quadriceps ACSA (SMD = 0.82, 95% CI: -0.17 to 1.81, p = 0.10) or MVIC (SMD = 0.47, 95% CI: -0.16 to 1.10, p = 0.15) during the early postoperative period (≤ 3 weeks). At mid-term follow-up (8-14 weeks), BFRT significantly improved IKDC scores (SMD = 3.70, 95% CI: 0.20 to 7.21, p = 0.04). No significant differences were observed between the groups in the improvement of isometric strength of knee extensors (SMD = 0.50, 95% CI: -0.62 to 1.63, p = 0.38).</p><p><strong>Conclusions: </strong>BFRT demonstrated limited effectiveness in early muscle strength recovery during ACLR rehabilitation but may have a positive impact on mid-term knee function, particularly in improving IKDC scores. However, due to heterogeneity and potential bias in the included studies, future research should incorporate more high-quality, multicenter RCTs to further validate the mid- to long-term value of BFRT in postoperative rehabilitation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"273"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615708","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":"Safety and feasibility of a smart assistive bone-cement injection system: a cadaveric study.","authors":"Chen Jin, Ming-Liang Ning, Rui-Jun Xu, Xiao-Jian Ye, Hao-Jie Chen, Jiang-Ming Yu","doi":"10.1186/s13018-025-05680-9","DOIUrl":"10.1186/s13018-025-05680-9","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous vertebral augmentation is an effective and commonly surgical treatment for osteoporotic vertebral compression fractures, but the problem of bone cement leakage still cannot be prevented. It has been reported that cement leakage occurs in approximately 20% of vertebroplasty procedures, with symptomatic manifestations reported in 1.6% of cases. Leakage of bone cement into the spinal canal increases the risk for spinal cord compression and nerve injury. The objective of this study was to introduce a smart assistive device specifically designed to facilitate both cement injection control and operator protection.</p><p><strong>Methods: </strong>Two freshly frozen human cadaver specimens were used. The 2 cadaver specimens were divided according to injection method: manual (10 vertebrae, T8-L5); and motorized (10 vertebrae, T8-L5). Fluoroscopy time, cement time, volume injected, and cement distribution were recorded. Postoperative radiography and CT images were used to assess cement distribution in this cadaveric study.</p><p><strong>Results: </strong>The number of times intraoperative X-ray fluoroscopy was used for the manual injection group (6.7 ± 1.5) was significantly greater (P < 0.001) than that for the motorized injection group (4.1 ± 0.9). Mean cement time for the manual injection group (164.3 ± 18.7 s) was significantly greater (P < 0.001) than that for the motorized injection group (72.0 ± 7.2 s). There were no significant differences in the amount of cement injected in the manual vs. motorized injection group (5.2 ± 1.3 mL vs. 5.3 ± 1.0 mL; P = 0.878). Moreover, we found that leakage of cement outside the vertebral body was noted in 4 of 10 injected vertebrae (40%) in the manual injection group, whereas there was no bone cement leakage in the motorized injection group.</p><p><strong>Conclusions: </strong>The system exhibited more precise control of the bone cement injection dosage and better cement distribution compared with traditional manual injection. In addition, the device provided remote activation, reducing the X-ray intake of the surgeon.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"272"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615706","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":"Cable-asisted bone transport versus circular external fixators-asisted bone transport in the management of bone defects of the Tibia: clinical and imaging results.","authors":"Güngör Alibakan, Muharrem Kanar, Raffi Armağan, Yusuf Sülek, Yusuf Altuntaş, Osman Tuğrul Eren","doi":"10.1186/s13018-025-05648-9","DOIUrl":"10.1186/s13018-025-05648-9","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare the efficacy, clinical outcomes, and complications of cable-asisted bone transport (CASt) and circular external fixator-assisted bone transport (CEFt) methods in the management of bone defects of the tibia.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 32 patients who underwent segmental bone transport for tibial bone defects between January 2006 and January 2020 and met the study inclusion criteria. Patients were categorized into two groups: CASt group (n = 16) and CEFt group (n = 16). The primary outcome measures included radiological parameters (External Fixator Index (EFI), Radiological Consolidation Time (RCT), and Radiological Consolidation Index (RCI)), functional independence (Lower Extremity Functional Index, LEFI) and functional outcomes (ASAMI Bone and Functional Scores). Secondary outcomes included pain levels (Visual Analog Scale, VAS), and complication rates (Paley's and Checketts-Otterburn classifications).</p><p><strong>Results: </strong>The CASt method resulted in significantly reduced pain scores during distraction (VAS: 4.81 ± 0.98 vs. 6.75 ± 0.86; p = 0.001). Pin-tract infection rates were significantly lower in the CASt group compared to the CEFt group (50% vs. 93.8%; p = 0.013). There was no significant difference between the groups in radiological (EFI, RCT, RCI) and functional outcomes (ASAMI scores) (p > 0.05).</p><p><strong>Conclusion: </strong>Both CASt and CEFt methods are effective and reliable options in the management of bone defects of the tibia. However, CASt offers advantages such as lower pin-tract infection rates and less pain during distraction, resulting in greater patient comfort and compliance. Given its less invasive nature, CASt may be preferable in patients at higher risk of infection or with a low pain threshold. However, the technical complexity of this method requires experienced surgical application.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"264"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605229","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":"Finite element analysis of retrograde superior ramus screw of pubis for the treament of pelvic anterior ring fracture.","authors":"Gu Meiqi, Xu Zhe, Li Yifei, Xiang Penghui, Wang Zhen, Zhang Rui, Xin Fei, Tang Zhaohui, Yi Chengla","doi":"10.1186/s13018-025-05676-5","DOIUrl":"10.1186/s13018-025-05676-5","url":null,"abstract":"<p><strong>Background: </strong>Retrograde superior ramus screw of pubis (SRSP) is a new kind of pelvic minimally invasive internal fixation apparatus developed by our team. The purpose of this study was to analyze the biomechanical stability of this new minimally invasive pelvic internal fixation device, and to provide this new device with theoretical basis for clinical application.</p><p><strong>Methods: </strong>The Tile C1.3 pelvic fracture model was established. The posterior ring was fixed in the same way with two sacroiliac screws. And the anterior ring was fixed with SRSP, reconstruction plate, minimal invasive subcutaneous internal fixator (INFIX) and hollow screw respectively, to establish the finite element model of fracture-internal fixation. Finite element analysis was used to analyze the deformation and Von Mises(V-M) stress distribution of different kind of fixation under three kinds of stress conditions: vertical self-weight load, anterior-posterior(A-P) compression and lateral compression.</p><p><strong>Results: </strong>Among the four-kind fixation models, all the maximum displacement of fracture site were significantly less than 2 cm, and the maximum V-M stress of internal fixation was lower than the yield stress of titanium metal (1050 MPa). The maximum displacement and V-M stress of total model/internal fixation in INFIX group were higher than those in the others under three stress conditions except for two cases, which were the maximum displacement of total model in SRSP group (0.26266 mm) under A-P compression and the maximum displacement of internal fixation in SRSP group (0.32588 mm) under lateral compression. The values of total model/internal fixation displacement and V-M stress distribution in SRSP group were similar to those of reconstructed plate group and hollow screw group. Furthermore, the stress distribution of SRSP group was more uniform from the stress nephogram.</p><p><strong>Conclusion: </strong>All four kinds of internal fixation can effectively repair Tile C1.3 pelvic fractures. Also fracture-fixation pelvis model were basically restore the normal mechanical conduction path, rebuilding overall stability of the pelvic ring with good static mechanical stability. The stress distribution of fracture-internal fixation model in SRSP group was more uniform. Compared with INFIX group, SRSP group was more advantageous in preventing excessive displacement of the fracture site, loosening and deformation of the internal fixation, etc.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"263"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605157","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":"Serious challenges with bone cement in orthopedic operating rooms: an observational study from Alborz province, Iran.","authors":"Leila Sadati, Rana Abjar, Salman Azarsina, Samaneh Doroudian, Fatemeh Tavakoli","doi":"10.1186/s13018-024-05442-z","DOIUrl":"10.1186/s13018-024-05442-z","url":null,"abstract":"<p><strong>Background: </strong>Alongside the numerous advantages of arthroplasty surgery, the extensive complications associated with bone cement contact remain serious chemical hazards in the operating room. The present study aims to investigate the challenges of using bone cement in orthopedic operating rooms.</p><p><strong>Method: </strong>This is a cross-sectional study conducted from September 2023 to June 2024 with the aim of examining the physical facilities in orthopedic operating rooms and the performance of orthopedic surgical teams in adhering to standards related to the use of bone cement. The performance of 300 personnel working in orthopedic surgical teams in seven operating rooms was assessed. The data collection tools consisted of two checklists, consisting of 15 and 10 items, prepared based on the latest valid international guidelines. The collected data were analyzed using SPSS version 28.</p><p><strong>Results: </strong>Data analysis revealed that 14.2% of the operating rooms were in an unfavorable condition in terms of having facilities and physical amenities for the application of bone cement, while the remaining 85.8% had relatively favorable conditions. Regarding the average adherence to performance standards by surgical team members, 14.3% of participants were in an unfavorable condition, 78% were in a relatively favorable condition, and 7.7% were in a favorable condition.</p><p><strong>Conclusion: </strong>Considering the lack of protective facilities in operating rooms, attention to providing these facilities is essential. Also, based on a deficiency in adherence to some performance standards by surgical team members, training them and giving up-to-date guidelines is recommended.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"262"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605158","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":"Elastic stable intramedullary nails compared to locking compression plates for treating unstable distal ulnar fractures in adults: a prospective comparative study.","authors":"Chaode Cen, Daqing He, Aixin Cao, Yuehua Xie, Chaoran Hu, Yongfei Cao","doi":"10.1186/s13018-025-05646-x","DOIUrl":"10.1186/s13018-025-05646-x","url":null,"abstract":"<p><strong>Background and purpose: </strong>Distal ulna fractures often occur in conjunction with distal radius fractures and other associated injuries. Currently, there are no satisfactory internal fixation systems available for addressing unstable distal ulna fractures, and a definitive consensus on the most effective treatment approach is still lacking. The objective of this research was to evaluate the clinical outcomes of using elastic stable intramedullary nails (ESIN) compared to locking compression plates (LCP) for treating unstable distal ulnar fractures in adults.</p><p><strong>Methods: </strong>In a prospective clinical study, a total of 54 patients (21 females and 33 males; average age 49.3 years, ranging from 30 to 63 years) suffering from unstable or displaced fractures of the distal ulna were randomly allocated to one of two treatment groups between January 2021 and August 2024. Specifically, 26 patients underwent treatment utilizing elastic stable intramedullary nails, whereas 28 patients were managed using locking compression plates. The two groups were evaluated prospectively for perioperative data and functional results.</p><p><strong>Results: </strong>The ESIN group comprised 26 patients, exhibiting a mean age of 48.27 years (with a range of 30 to 62 years), while the LCP group included 28 patients, whose mean age was 50.33 years (ranging from 32 to 63 years). Both groups were comparable regarding gender distribution, side of injury, mechanisms of injury, and classifications of fractures. However, there were significant differences noted in incision length of the ulna, surgical duration, frequency of fluoroscopy, and the rates of excellent and good functional outcomes as measured by the Gartland-Werley scores between the two groups (P < 0.05). Conversely, no significant differences were found concerning the time to union and the duration of immobilization between the two groups (P > 0.05).</p><p><strong>Conclusion: </strong>ESIN offers several advantages, including reduced incision length, lower frequency of fluoroscopy, shorter duration of the surgical procedure, decreased complication rates, and improved Gartland-Werly scores. Therefore, fixation using ESIN serves as an effective alternative for the treatment of distal ulnar fractures in adults. The minimally invasive nature and lower complication rates are defining characteristics of ESIN fixation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"267"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605155","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":"Subtalar joint arthroscopic-assisted reduction and cannulated screw fixation versus open reduction and internal fixation for treating displaced intra-articular calcaneal fractures.","authors":"Hu Yang, Shuo Zhang, Qigang Zhong, Chaoyue Huai, Nan Zhu, Junfeng Zhan","doi":"10.1186/s13018-025-05666-7","DOIUrl":"10.1186/s13018-025-05666-7","url":null,"abstract":"<p><strong>Background: </strong>The treatment of calcaneal fractures is not uniform. This study aimed to compare the functional and imaging results of subtalar joint arthroscopic reduction combined with cannulated screw fixation (SJACF) and the extended lateral approach (ELA) for the treatment of Sanders type II and III displaced intra-articular calcaneal fractures (DIACFs).</p><p><strong>Methods: </strong>From January 2020 to January 2023, 60 patients with calcaneal fractures were treated with SJACF or ELA for foot and ankle surgery at the Second Affiliated Hospital of Anhui Medical University. Changes in calcaneal Böhler's angle, the Gissane angle, and calcaneal length, height, and width were recorded before, after, and at the 1-, 3-, 6-, 12-month, and last follow-up. The preoperative waiting time, operation time, length of hospital stay, and other data of each patient were analyzed. The visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores were used to evaluate clinical effects.</p><p><strong>Results: </strong>All 60 patients were followed up for at least 12 months. There was no statistical difference in baseline data (age, sex, fracture side, mechanism of injury, and classification) between groups (P > 0.05). The preoperative waiting time, length of hospital stay, and intraoperative fluoroscopy times were shorter in the SJACF group than in the ELA group; however, the operative time was greater in the SJACF group (P < 0.05). There were no significant differences in Böhler's angle, the Gissane angle, or calcaneal length, height, or width between the two groups at any time point (P > 0.05). These imaging values were significantly improved after surgery and at the last follow-up (P < 0.05). The VAS scores of the patients in the SJACF group were significantly different from those in the ELA group at the last follow-up (P < 0.05). The final AOFAS score and incidence of postoperative complications were better in the SJACF group; however, the difference was not significant (P > 0.05). Simultaneously, patients were able to return to work and achieve full weight-bearing earlier in the SJACF group (P < 0.05).</p><p><strong>Conclusion: </strong>Both SJACF and ELA improved the clinical outcomes of patients with DIACFs. SJACF reduces surgical wounds and maintains effective reduction and strong internal fixation. It has the advantages of a reduced preoperative waiting time, shortened hospital stay, reduced intraoperative fluoroscopy time, alleviated postoperative pain, and accelerated patient recovery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"270"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615707","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":"MRI underestimates lumbar spinal canal cross-sectional area compared to CT in patients with lumbar spinal stenosis.","authors":"Raphael Lotan, Michael Shaulov, Itzik Lan, Mojahed Sakhnini, Max Zaidman, Oded Hershkovich","doi":"10.1186/s13018-025-05653-y","DOIUrl":"10.1186/s13018-025-05653-y","url":null,"abstract":"<p><strong>Objectives: </strong>Lumbar spinal stenosis (LSS) is a common condition characterized by the narrowing of the spinal canal, often leading to neural compression. Accurate imaging is crucial for diagnosis and surgical planning, with MRI and CT being the primary modalities. While MRI excels in soft tissue visualization, CT is superior for assessing bony structures. This study compares lumbar spinal canal cross-sectional area measurements on MRI and CT in patients undergoing surgery for LSS.</p><p><strong>Methods: </strong>Twenty patients with LSS who underwent lumbar decompression surgery after failed conservative treatment were included. Axial MRI and CT images from L1 to S1 levels were obtained and analyzed using Radiant DICOM Viewer. The spinal canal area was measured and compared between modalities. Statistical analyses assessed the measurement discrepancies, including paired t-tests and Pearson correlations.</p><p><strong>Results: </strong>The mean difference in cross-sectional area between MRI and CT across all levels was 26.5 mm², with MRI consistently underestimating the canal area by 15.3%. The correlation between MRI and CT measurements was high (0.775-0.950), yet significant differences were found (p < 0.001). MRI underestimation was more pronounced in smaller spinal canals, though this trend was not statistically significant. Agreement between MRI-only evaluations and surgical findings was moderate (Cohen's Kappa = 44%, p = 0.035).</p><p><strong>Conclusions: </strong>MRI's underestimation of spinal canal size compared to CT has implications for surgical planning, particularly in severe stenosis. A multimodal MRI and CT approach may improve diagnostic accuracy and surgical outcomes. Future research should involve larger cohorts to elucidate these findings further.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"268"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615705","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}