Journal of Orthopaedic Surgery and Research最新文献

{"title":"A novel external fixation for treating tibial fractures: a finite element and biomechanical study.","authors":"Shen Liu, Xiangdang Liang, Songyang Liu, Zhanshe Guo, Xing Wei, Yonghui Liang","doi":"10.1186/s13018-025-05681-8","DOIUrl":"10.1186/s13018-025-05681-8","url":null,"abstract":"<p><strong>Objective: </strong>Design a new type of external fixation device that is small in size, high in strength, and capable of achieving the mechanical requirements for fracture healing. Verify the rationality and effectiveness of the device in treating tibial fractures through finite element analysis and biomechanical comparative tests.</p><p><strong>Methods: </strong>Finite element simulation was performed on the new external fixation device to treat fractures, to verify whether the mechanical properties of the device meet the requirements of fracture healing. A fracture gap model was created using Sawbones to simulate midshaft tibial comminuted fractures. The experiment was divided into four groups, testing the mechanical characteristics of the new external fixation (NEF), locking compression plate (LCP), the unilateral external fixation (UEF), and the externalized locking compression plate (E-LCP). The axial compression, torsion, fatigue and ultimate load tests were performed separately. Data were collected and statistical analysis was performed to verify whether there were statistical differences between the four groups.</p><p><strong>Results: </strong>The finite element analysis of NEF demonstrated that the fracture end was displaced by 0.512 mm under 700 N loading, and the maximum stress value of the device was 189 MPa, which met the mechanical requirements. Axial compression tests showed that LCP (2108.596 N/mm) had the highest stiffness, and NEF (519.489 N/mm) had higher stiffness than both UEF (327.153 N/mm) and E-LCP (316.763 N/mm) (p < 0.05), but no significant difference between UEF and E-LCP (p = 0.313). There was a significant difference in mean torsional stiffness among UEF (1.412 N·m/deg), NEF (1.398 N·m/deg), LCP (1.128 N·m/deg), and E-LCP (0.838 N·m/deg). No structural failures occurred during fatigue testing spanning 108,000 cycles. In ultimate load tests, NEF withstood the highest load, followed sequentially by LCP, UEF, and E-LCP. Significant differences were found between the groups (p < 0.05), with frame bending and secondary bone fractures noted in post-test evaluations.</p><p><strong>Conclusions: </strong>The NEF for tibial fractures is well-designed to meet the fracture healing requirements. It has certain advantages in comparison with other fixation methods and can be used as a new method for the treatment of tibial fractures.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"319"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730559","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":"Effect of miR-654-3p targeting EMP1 on osteoblast activity and differentiation in delayed fracture healing.","authors":"Shantao Wang, Mingwei Wang, Shengliang Sun, Xinsheng Liu, Danzhi Li","doi":"10.1186/s13018-025-05736-w","DOIUrl":"https://doi.org/10.1186/s13018-025-05736-w","url":null,"abstract":"<p><strong>Background: </strong>Delayed fracture healing (DFH) is a common postoperative complication in fracture patients, and a validated serum marker may aid in the clinical management and improve the prognosis of fracture patients. In this study, we investigated the diagnostic role and potential regulatory mechanisms of miR-654-3p in DFH.</p><p><strong>Methods: </strong>73 patients with DFH and 75 patients with normal fracture healing (NFH) were included. Expression of miR-654-3p and EMP1 and several mRNA markers of osteogenic differentiation were evaluated by RT-qPCR. The diagnostic value of miR-654-3p and EMP1 alone and in combination was assessed using ROC curves. Cell proliferation capacity was assessed by CCK-8 and apoptosis rate by flow cytometry. DLR experiments demonstrated the targeting relationship between miR-654-3p and EMP1.</p><p><strong>Results: </strong>Levels of miR-654-3p were found to be significantly lower in DFH compared to NFH. Following cell differentiation treatment, miR-654-3p levels increased and EMP1 levels decreased. Furthermore, a negative correlation was identified between miR-654-3p and EMP1 target binding and expression levels. The combination of miR-654-3p and EMP1 holds significant diagnostic value for DFH. miR-654-3p high expression can inhibit EMP1 levels, which promotes cell proliferation, increases osteoblast activity and levels of differentiation markers, and decreases the rate of apoptosis.</p><p><strong>Conclusion: </strong>miR-654-3p and EMP1 are aberrantly expressed in DFH, and both have high diagnostic value for DFH. miR-654-3p is involved in the proliferation, differentiation, and apoptotic activities of osteoblasts by regulating the level of EMP1, thus affecting the progression of DFH.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"322"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743111","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":"Cup positioning relative to the acetabular rim planned with three-dimensional computed tomography improves precision in total hip arthroplasty: a randomized controlled trial.","authors":"Anuwat Pongkunakorn, Napon Wongkamthong, Rukthanin Ruktrakul","doi":"10.1186/s13018-025-05704-4","DOIUrl":"10.1186/s13018-025-05704-4","url":null,"abstract":"<p><strong>Background: </strong>Accurate acetabular cup positioning is essential for successful total hip arthroplasty (THA) outcomes. The conventional mechanical alignment guide (MAG) method provides moderate accuracy. We developed a novel technique for cup positioning that utilizes preoperative three-dimensional computed tomography (3D-CT) planning based on the native acetabular rim's relative position and compared cup orientation between this method and the MAG technique.</p><p><strong>Methods: </strong>A randomized controlled trial with 120 patients undergoing primary THA via the posterolateral approach targeted cup positions of 40° radiographic inclination (RI) and 20° radiographic anteversion (RA). The control group (n = 40) used a MAG for cup placement, while the study group (n = 80) utilized preoperative 3D-CT to measure native RI, calculate RA, and determine the cup overhang distance (COD). The cup inclination was positioned relative to the superior rim point and the transverse acetabular notch. The cup anteversion was adjusted to achieve overhang at the posterior or anterior rim point according to the planned COD. Postoperative RI and RA were assessed using tilt-adjusted plain radiographs and CT scans. The percentages of cups positioned within 5° of the target position (RI/RA of 40°/20° ± 5°), and within the Grammatopoulos aiming zone (RI/RA of 40°/20° ± 10°) were compared between the two groups.</p><p><strong>Results: </strong>The mean RI was 41.7° ± 5.4° (range, 33°-59°) in the control group and 39.9° ± 3.2° (range, 33.8°-45.5°) in the study group (p = 0.019). The mean RA was 19.5° ± 7.6° (range, 3°-33°) in the control group and 20.2° ± 3.3° (range, 12.9°-28.3°) in the study group (p = 0.356). Cup alignment within 5° of the target was achieved in 86.2% (69 hips) of the study group and 32.5% (13 hips) of the control group (p < 0.001). The study group had a significantly higher percentage of cups within Grammatopoulos aiming zone (100% vs. 77.5%, p < 0.001).</p><p><strong>Conclusions: </strong>3D-CT-guided cup positioning relative to the acetabular rim can enhance the precision of cup placement in THA to achieve alignment within 5° of the target position.</p><p><strong>Trial registration: </strong>Thai Clinical Trials Registry (TCTR 20201220001). Registered on 20 December 2020. Prospectively registered.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"318"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720011","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 proximal femoral universal nail system (PFUN): a novel intramedullary nail for treating complex proximal femoral fractures and its biomechanical comparison with the proximal femoral nail anti-rotation (PFNA).","authors":"Fang Zhou, Jixing Fan, Yang Lv","doi":"10.1186/s13018-025-05724-0","DOIUrl":"10.1186/s13018-025-05724-0","url":null,"abstract":"<p><strong>Aims: </strong>The loss of medial and lateral wall support were the main risk factors of implant failure for proximal femoral fractures. A novel intramedullary nail, called proximal femoral universal nail system (PFUN), was proposed by our team to reconstruct the medial wall and lateral wall integrity and the biomechanical performance was evaluated in this study.</p><p><strong>Methods: </strong>The synthetic femora were assigned to three groups randomly according to three different proximal femoral fracture types. For each group, the PFUN or PFNA were implanted separately and divided into PFUN subgroup and PFNA subgroup. Biomechanical tests were separately conducted in the axial compression test, torsional test, and fatigue test in sequence. The finite element analysis (FEA) was conducted by ANSYS 14.5 and we analyzed the von Mises stress distribution and the model displacement of two implant models in three different fracture types.</p><p><strong>Results: </strong>For proximal femoral fractures with intact medial wall and lateral wall, our biomechanical results showed that the PFUN had a similar biomechanical property with the PFNA. Furthermore, the biomechanical results showed that the PFUN had a larger axial stiffness, higher torsional strength, and a similar failure load when compared with the PFNA for proximal femoral fracture with medial wall fracture. For proximal femoral fractures with broken medial wall and lateral wall, a larger axial stiffness, higher average torque and higher failure load were found in the PFUN when compared with the PFNA. The FEA results showed that the PFUN model had a higher stress concentration compared with the PFNA model, and the total displacement of the PFNA model increased by 11.63% when compared with the PFUN model in the proximal femoral fracture with broken medial wall and lateral wall.</p><p><strong>Conclusion: </strong>Our results showed that PFUN had better biomechanical performance than PFNA, especially for complex proximal femoral fractures with medial wall fracture and lateral wall fracture, indicating that the PFUN had great potential as a new fixation strategy in future clinical applications.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"317"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720055","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":"Gradual restoration of gait following unicompartmental knee arthroplasty: a prospective study.","authors":"Ming Zhang, Haoyue Wang, Yu Zhang, Haochong Zhang, Quanlei Zhang, Xiaoran Zu, Wei Chai, Xiang Li","doi":"10.1186/s13018-025-05662-x","DOIUrl":"10.1186/s13018-025-05662-x","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the gait characteristics and clinical outcomes following Unicompartmental Knee Arthroplasty (UKA) to provide scientific evidence for optimizing postoperative rehabilitation and patient management.</p><p><strong>Methods: </strong>Between December 2022 and November 2023, 34 patients with unilateral medial compartment knee osteoarthritis (KOA) underwent UKA. Preoperative and postoperative videos of patients in standing, walking (side view), squatting, and supine knee-bending positions were captured using smartphones. Gait parameters including gait cycle, swing time, swing phase, stance time, stance phase, double support time, walking speed, step time, cadence, step length, stride length, stride width, active knee flexion angle, and maximum hip and knee flexion angles during squatting were analyzed using the MediaPipe framework for human pose estimation.</p><p><strong>Results: </strong>Postoperative WOMAC scores were significantly lower than preoperative scores (P < 0.001), while postoperative KSS scores were significantly higher than preoperative scores (P < 0.001).Compared to preoperatively, postoperative affected-side gait speed, step length, step width, and active knee flexion angle all increased (P < 0.05). Additionally, postoperative gait cycle time and double-limb support time were reduced compared to preoperative values (P < 0.05). Among the 17 patients who could perform squats preoperatively and postoperatively, the maximum knee flexion angle and hip flexion angle in the squat position increased from preoperative values of (96.41 ± 20.65)° and (113.77 ± 22.56)° to postoperative values of (110.15 ± 20.79)° and (124.84 ± 21.13)°.</p><p><strong>Conclusions: </strong>UKA significantly enhances knee joint kinematics, facilitating the transition from basic to advanced functional activities.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"315"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720037","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":"Impact of unilateral periacetabular osteotomy on bony birth canal in female hip dysplasia patients with gynecoid and anthropoid type pelvis: a pelvic three-dimensional computed tomography measurement using maximum- inscribed-sphere method.","authors":"Yanjun Wang, Hui Cheng, Dianzhong Luo, Zhendong Zhang, Hong Zhang","doi":"10.1186/s13018-025-05718-y","DOIUrl":"10.1186/s13018-025-05718-y","url":null,"abstract":"<p><strong>Background: </strong>To explore the application of a new three-dimensional computed tomography measurement (maximum-inscribed-sphere method) in female DDH (developmental dysplasia of the hip) patients with gynecoid and anthropoid type pelvis on measuring the bony birth canal before and after unilateral PAO (periacetabular osteotomy).</p><p><strong>Methods: </strong>A total of 19 female DDH patients of childbearing age were included in this study. The pelvis types were classified as gynecoid (11 patients) and anthropoid (8 patients). The maximum-inscribed-sphere method was applied to measure the bony birth canal. The lateral central edge angle (LCE), the anterior central edge angle (ACE), the Tönnis angle, and the distance between the femoral head and Koher's line were measured.</p><p><strong>Results: </strong>For the gynecoid type, the narrowest part of the bony birth canal before and after the surgery occurred both at the 21st layer of bilateral ischial spines and the 4th sacrum (107.39 mm ± 4.33 mm; 106.27 mm ± 4.76 mm). In anthropoid patients, the narrowest part of the bony birth canal was found at the 21st layer before surgery (105.89 mm ± 6.58 mm), and the 19th layer after surgery (103.48 mm ± 7.36 mm). The most significant narrowing was found at the 8th layer (4.25 mm ± 3.51 mm p < 0.05) in those with gynecoid type pelvis, and at the 9th layer (5.8 mm ± 3.15 mm p < 0.001) in those with anthropoid type pelvis after PAO. There was no statistical significant difference between acetabular dysplasia and bony birth canal in the two type groups before surgery. For the anthropoid type, the increment of LCE angle and the narrowing of bony birth canal from the 13th to 19th layer after PAO was also more significant. As the impact of unilateral PAO on the gynecoid type pelvis was caused by a decreased distance between the femoral head and Kohler's line, resulting in the narrowing of bony birth canal between the 1st and 12th layer.</p><p><strong>Conclusions: </strong>Unilateral PAO did not affect the narrowest part of the bony birth canal in either pelvis type but caused mild narrowing above the ischial spine, with notable effects in the anthropoid group. In gynecoid pelvis patients, it led to narrowing through changes in the relation between the femoral head and Kohler's line.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"314"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710346","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 effect of preoperative ultrasound localization on the incidence of infrapatellar branch of the saphenous nerve injury after hamstring tendon harvesting.","authors":"Tianli Du, Jianfeng Chen, Chao Yan, Hongzhi Fang, Zhenghui Shang","doi":"10.1186/s13018-025-05689-0","DOIUrl":"10.1186/s13018-025-05689-0","url":null,"abstract":"<p><strong>Background: </strong>The potential of ultrasound-guided labelling of the inferior patellar branch of the saphenous nerve (IPBSN) to reduce IPBSN injury during anterior cruciate ligament reconstruction (ACLR) has not been explored. The primary objective of this retrospective cohort analysis was to assess whether intraoperative hamstring tendon harvesting avoiding the marked IPBSN would be effective in reducing the incidence of postoperative skin sensory disturbances and the mean area of sensory disturbances.</p><p><strong>Methods and analysis: </strong>A retrospective cohort study involving 60 patients who underwent autograft ACLR at Yichang Central People's Hospital from October 2020 to October 2024 was conducted. Patients were divided into two groups on the basis of the use of preoperative ultrasound localization of the IPBSN, including the nonultrasound localization group (control group) and the ultrasound localization group (experimental group), with 30 patients in each group. The control group underwent standard ACLR with a diagonal incision for hamstring tendon harvesting, whereas the experimental group underwent preoperative ultrasound-guided localization of the IPBSN to avoid the nerve during incision. The primary outcome measures include the incidence of skin sensory disturbances and the average sensory disturbance area. The secondary outcomes include the Lysholm score and VAS score at the 6-month postoperative follow-up.</p><p><strong>Results: </strong>The incidence of skin sensory disturbances in the experimental group was lower than that in the control group, and the average area of sensory disturbance was smaller in the experimental group (P < 0.05). At the 6-month postoperative follow-up, no statistically significant differences in the Lysholm knee scores or visual analogue scale (VAS) pain scores were noted between the two groups (P > 0.05).</p><p><strong>Conclusion: </strong>Preoperative ultrasound-guided localization of the IPBSN can reduce the risk of nerve injury during ACLR. The ultrasound-guided approach leads to a lower incidence of sensory disturbances and a smaller average area of sensory disturbance. IPBSN injury was not related to anterior knee pain or knee ROM limitations. Patients can choose whether to use ultrasound localization before surgery according to their needs. The study protocol adhered to strict standards of ethical conduct and patient safety. The results of this trial are expected to provide valuable insights into the prevention of injury to the IPBSN during hamstring tendon harvesting.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"316"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720045","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":"METTL3-mediated m6A modification of circSTAT6 modulates miR-188-3p/Beclin1 axis to promote osteogenic differentiation of mesenchymal stem cells.","authors":"Yue Luo, Yubo Shi, Yanqing Wu, Hui Cao","doi":"10.1186/s13018-025-05720-4","DOIUrl":"10.1186/s13018-025-05720-4","url":null,"abstract":"<p><strong>Background: </strong>The role of N6-methyladenosine (m6A)-modified circRNAs in disease progression is of great significance. However, the specific impact of m6A modification of circSTAT6 on osteoporosis (OP) is still uncertain.</p><p><strong>Methods: </strong>The qRT-PCR was employed to assess the levels of METTL3, circSTAT6, miR-188-3p, and Beclin1. To investigate the interaction between miR-188-3p and circSTAT6 or Beclin, a dual-luciferase reporter assay was performed. To evaluate osteogenic differentiation in bone marrow mesenchymal stem cell (BMSC), western blot analysis was conducted to evaluate the protein expression of osteogenic markers, including ALP, OPN, and Runx2. In addition, alizarin red and alkaline phosphatase (ALP) staining assays were employed to assess osteogenesis.</p><p><strong>Results: </strong>The findings revealed that the downregulation of circSTAT6 was observed in OP. On the other hand, the overexpression of circSTAT6 was found to enhance the osteogenic differentiation of BMSC. In addition, the involvement of METTL3 in mediating m6A methylation of circSTAT6 was identified, which ultimately promoted osteogenesis. Furthermore, circSTAT6 functioned as an miR-188-3p sponge to regulate the expression of Beclin1. Further study revealed that the osteogenic-enhancing effect caused by circSTAT6 overexpression was counteracted by introducing a miR-188-3p mimic. Similarly, the osteogenic-promoting impact of the miR-188-3p inhibitor was reversed by suppressing Beclin1 expression.</p><p><strong>Conclusions: </strong>The present study revealed, for the first time, that METTL3-mediated m6A modification of circSTAT6 regulated the miR-188-3p/Beclin1 axis to promote the osteogenic differentiation of BMSC. These findings offer a potential therapeutic target for the treatment of OP.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"313"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710347","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":"Arthroscopic adhesiolysis in elderly patients with post-traumatic frozen shoulder.","authors":"Zhusha Wang, Yulong Shi, Xu Yang, Qubo Ni, Kai Tie","doi":"10.1186/s13018-025-05734-y","DOIUrl":"10.1186/s13018-025-05734-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the current study is to investigate the efficacy and risk factors associated with arthroscopic adhesiolysis in treating elderly traumatic frozen shoulder.</p><p><strong>Methods: </strong>One hundred and two elderly patients with post-traumatic frozen shoulder treated at our Hospital were selected. The patients were randomly divided into a study group and a control group, with 51 cases in each group. The study group was treated with arthroscopic adhesiolysis, and the control group received physical therapy combined with joint manipulation.</p><p><strong>Results: </strong>The operation time and intraoperative blood loss of the study group were (54.98 ± 5.94) min and (53.28 ± 4.93) ml, respectively. The Visual Analogue Scale (VAS) (0.87 ± 0.12, P = 0.021), Present Pain Intensity (PPI) (0.76 ± 0.07, P = 0.016), and Pain Rating Index (PRI) (5.32 ± 0.32, P < 0.001) scores were lower in the study group than the control group at 3 months post-treatment. Moreover, no significant differences were seen in terms of pain relief, daily living activities, shoulder joint function, and muscle strength between the two groups before the treatment; however, at 3 months post-treatment, the study group demonstrated better outcomes in these dimensions compared to the control group (all P ≤ 0.021), with notably improved shoulder joint mobility (all P < 0.001).</p><p><strong>Conclusion: </strong>Arthroscopic adhesiolysis exerts beneficial outcomes for elderly patients with post-traumatic frozen shoulder. Age and fat infiltration are identified as risk factors influencing the efficacy of arthroscopic adhesiolysis in this patient population.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"311"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700688","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":"Comparation of tumor-free margin or intralesional spondylectomy for chondrosarcoma in mobile spine: a retrospective study of surgery management, complications and prognosis.","authors":"Fangzhi Liu, Ben Wang, Xiaoguang Liu, Fengliang Wu, Hua Zhou, Lei Dang, Yan Li, Yanchao Tang, Xiao Liu, Panpan Hu, Zihe Li, Feng Wei, Zhongjun Liu","doi":"10.1186/s13018-025-05712-4","DOIUrl":"10.1186/s13018-025-05712-4","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objectives: </strong>Chondrosarcoma of mobile spine is a rare aggressive malignant tumor and postsurgical local recurrence rates remain high. En bloc resection is currently the preferred treatment. Resection that achieves tumor-free margin removal of the tumor may enable more complete removal of tumor tissue but significantly increases the complexity and risk of surgery and results in more postoperative complications. We sought to compare surgical outcomes, complications, and prognoses between patients who underwent en bloc resection with and without intralesional removal of the tumor.</p><p><strong>Methods: </strong>We reviewed 56 patients with spinal chondrosarcoma who underwent en bloc tumor resection and reconstructive surgery at our center between 2000 and 2024 with a minimum postoperative follow-up of 1 year. We collected and analyzed data regarding surgical procedures, complication characteristics, and local tumor control and recurrence.</p><p><strong>Results: </strong>We included 56 patients. Of these, 36 patients underwent the first surgery, and 20 experienced recurrences. All patients underwent en bloc tumor resection; 36 and 20 underwent intralesional and tumor-free margin resections, respectively. We recorded 83 complications; the incidence and the number of major complications were significantly higher in the tumor-free margin surgery group. Thirty patients experienced tumor recurrence and 26 patients died. Tumor-free margin en bloc resection and conventional-type chondrosarcoma were predictive factors for reduced long-term postoperative recurrence and mortality risk.</p><p><strong>Conclusions: </strong>Tumor-free margin resection carries higher risks and is associated with a greater number of perioperative complications, but reduces the risk of local tumor recurrence and prolongs recurrence-free survival and overall survival, providing patients with better prognoses.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"307"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700695","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}