Journal of Orthopaedic Surgery and Research最新文献

{"title":"Factors associated with poor hip flexion range of motion after total hip arthroplasty in patients with ankylosing spondylitis: a retrospective study on 538 consecutive hips.","authors":"Liangliang Li, Jun Fu, Chi Xu, Ming Ni, Wei Chai, Libo Hao, Yonggang Zhou, Jiying Chen","doi":"10.1186/s13018-024-05318-2","DOIUrl":"10.1186/s13018-024-05318-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to report the mid-term functional outcomes of total hip arthroplasty (THA) for the treatment of advanced hip involvement in ankylosing spondylitis (AS) and identify the factors associated with poor hip flexion range of motion (ROM) after THA in patients with AS.</p><p><strong>Methods: </strong>We retrospectively investigated the mid-term functional outcomes in 313 AS patients (538 hips) who underwent primary THA from 2012 to 2017, with a mean follow-up of 7 years (range, 4-9 years). Postoperative functional outcomes were assessed by hip flexion ROM, Harris hip score (HHS), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The hips were divided into poor (≤ 90°) and good hip flexion ROM (> 90°) groups based on the degree of hip flexion ROM recorded at the most recent follow-up. We grouped factors related to postoperative hip flexion ROM into three categories: preoperative (or patient-related), intraoperative (or surgery-related), and postoperative factors. Multivariate logistic regression was performed to identify the independent factors associated with postoperative poor hip flexion ROM.</p><p><strong>Results: </strong>The overall flexion-extension ROM improved significantly with a median from 0° (0 ~ 120°) to 100° (30 ~ 130°) after THA (P < 0.001), and the mean HHS increased from 37 to 90 (P < 0.001). There were 102 hips (19%) with a hip flexion ROM of no more than 90°. The poor hip flexion ROM group had significantly lower postoperative HHS and WOMAC than the good hip flexion ROM group (85 ± 6 vs. 91 ± 4, P < 0.001; 63 ± 16 vs. 32 ± 16, P < 0.001). The result of multivariate logistic regression showed that male sex (odds ratio [OR] = 9.42, 95% confidence interval [CI], 1.23 to 72.03), bony ankylosis (OR = 3.02, 95%CI, 1.76 to 5.17), cup anteversion angle (OR = 0.96, 95%CI, 0.93 to 0.98), cup inclination angle (OR = 0.96, 95%CI, 0.93 to 0.99), American Society of Anesthesiologists (ASA) class III (OR = 6.23, 95%CI, 1.83 to 21.70), knee involvement (OR = 7.80, 95%CI, 2.75 to 22.16), and noise (OR = 0.45, 95%CI, 0.25 to 0.81) were independent factors associated with poor hip flexion ROM after THA in patients with AS.</p><p><strong>Conclusion: </strong>Nearly one out of the five hips in patients with AS have a poor hip flexion ROM after THA. Care has to be taken in acetabular component positioning during THA and its effect on the postoperative hip flexion function should be considered in the patients. The optimum treatment strategy is that THA should be performed before ankylosis in patients with AS.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"877"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895238","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":"Identifying an effective Chinese herbal medicine for reducing postoperative hidden bleeding and stabilizing blood volume following intertrochanteric femur fracture: a Bayesian network meta-analysis of randomized controlled trials.","authors":"Xiaowei Wu, Linglan Yan, Tianran Wu, Shaochen Tu, Yanbin Lin","doi":"10.1186/s13018-024-05379-3","DOIUrl":"10.1186/s13018-024-05379-3","url":null,"abstract":"<p><strong>Objective: </strong>Chinese herbal medicine (CHM) is extensively utilized in managing hidden bleeding following an intertrochanteric femur fracture (IFF). Despite its widespread use, the most effective CHM approach for addressing hidden bleeding post-IFF remains unclear. A Bayesian network meta-analysis was conducted to identify a CHM that both effectively reduces hidden bleeding and stabilizes blood volume after IFF.</p><p><strong>Methods: </strong>Comprehensive electronic searches were performed on databases in both Chinese and English, including the Chinese National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform (Wanfang), China Science and Technology Journal Database (VIP), PubMed, Web of Science, and Cochrane Library. All randomized controlled trials (RCTs) employing CHM to address hidden bleeding post-IFF, up to December 31, 2023, were thoroughly reviewed. The analysis utilized Stata17.0 and Review Manager 5.4 software, tailored to the frequentist framework.</p><p><strong>Results: </strong>Thirty-one articles were included, encompassing 17 interventions and 2076 patients. The systematic analysis revealed that: For improving postoperative haemoglobin (HB), the top three interventions were conventional treatment combined with Yiqi Buxue decoction, Yangxue Rougan decoction, and Sanqi powder; For reducing hidden bleeding post-surgery, the leading interventions were conventional treatment combined with Siwu decoction, Yangxue Rougan decoction, and Qitian Keli prescription; For enhancing the Harris score, the top interventions were conventional treatment combined with Bazhen decoction, Danggui Buxue decoction, and Sanqi powder; Descriptive analysis indicated minimal adverse reactions and enhanced safety overall.</p><p><strong>Conclusion: </strong>CHM presents a viable method for treating hidden blood loss after IFF. Yangxue Rougan decoction notably excels in reducing hidden bleeding and stabilizing HB levels, making it a preferred option. Nevertheless, further rigorous RCT studies are essential to compare various CHM treatments to establish the most effective options for clinicians. PROSPERO registration number CRD42023489292.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"876"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895421","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":"Hallux valgus interphalangeus is more common in juvenile-onset hallux valgus than in adult-onset hallux valgus.","authors":"An Seong Chang, Sei Wook Son, Ppuri Park, Hak Jun Kim, Sang Hyeon Hwang, Sang Geon Park, Young Hwan Park","doi":"10.1186/s13018-024-05408-1","DOIUrl":"10.1186/s13018-024-05408-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the prevalence of hallux valgus interphalangeus (HVI) in juvenile-onset hallux valgus and adult-onset hallux valgus and to analyze the correlation between the hallux interphalangeal angle (HIA) and other radiographic parameters in juvenile-onset hallux valgus.</p><p><strong>Methods: </strong>This retrospective study included 640 feet and 320 patients with hallux valgus (160 juvenile-onset and 160 adult-onset cases). Eight radiographic parameters were measured: HIA, hallux valgus angle, intermetatarsal angle, talonavicular coverage angle, anteroposterior talocalcaneal angle, lateral talocalcaneal angle, lateral talo-first metatarsal angle, and calcaneal pitch. The two groups were compared based on the radiographic parameters, and the correlation between the HIA and other radiographic parameters in juvenile-onset valgus was analyzed.</p><p><strong>Results: </strong>The prevalence of HVI in juvenile-onset hallux valgus (63%) was higher than that in adult-onset hallux valgus (28%), and juvenile-onset hallux valgus demonstrated a greater HIA than that displayed by adult-onset hallux valgus (mean ± standard deviation, 12.9 ± 5.7 and 8.3 ± 5.2, respectively). In juvenile-onset valgus, the HIA was negatively correlated with the hallux valgus (r = -0.218, p < 0.001) and intermetatarsal angles (r = -0.143, p = 0.015) and positively correlated with the talonavicular coverage (r = 0.240, p < 0.001) and anteroposterior talocalcaneal angles (r = 0.127, p = 0.008).</p><p><strong>Conclusions: </strong>Juvenile-onset hallux valgus is associated with more HVI than that in adults. Moreover, forefoot abduction deformity is related to the progression of HVI. These findings highlight the need to consider concomitant HVI when juvenile-onset valgus is encountered.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"884"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895362","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":"Biomechanical changes in lumbar intervertebral discs after percutaneous endoscopic transforaminal discectomy surgery at different Body Mass Index (BMI) categories.","authors":"Xiaohai Zhang, Jinghui Lin, Chen Liu, Shuangtao Xue, Mengying Wu, Zongsheng Yin","doi":"10.1186/s13018-024-05319-1","DOIUrl":"10.1186/s13018-024-05319-1","url":null,"abstract":"<p><strong>Objective: </strong>Percutaneous Endoscopic Transforaminal Discectomy (PETD) is recognized as the leading surgical intervention for lumbar disc herniation (LDH). Moreover, Body Mass Index (BMI) has been established as an independent risk factor for disc reherniation post-PETD. Furthermore, there is a lack of studies investigating the biomechanical changes in the disc post-PETD in relation to diverse BMI levels.</p><p><strong>Methods: </strong>A three-dimensional nonlinear finite element model was developed to simulate the L3-S1 lumbar spine, and a surgical model of the lumbar 4/5 right PETD was also constructed. Forces of 392 N (BMI 20.76 kg/m²), 457 N (24.22 kg/m²), 523 N (27.68 kg/m²), 588 N (31.14 kg/m²) and 653 N (34.6 kg/m²) were applied from the superior edge of the L3 vertebrae. The equivalent von Mises stresses and maximum deformation of the L4/5 nucleus pulposus were observed in normal group and PETD surgery group.</p><p><strong>Results: </strong>We established normal and PETD surgery model with different BMIs, contributes to understand the equivalent von Mises stresses and maximum deformation of the L4/5 nucleus pulposus with different BMI. The results indicated that the rise in BMI correlates with heightened equivalent von Mises stresses and maximum deformation within the L4/5 nucleus pulposus in both in normal group and PETD surgery group. Besides, the von Mises stress and maximum deformation of the NP in flexion loading are significantly higher than in other loading conditions under the same BMI condition. These values, alongside the occurrence of high-stress areas, display fluctuations across distinct postures, under the influence of BMI. Furthermore, a discernible accumulation of stress was noted within the compromised regions of the nucleus pulposus.</p><p><strong>Conclusion: </strong>The study suggested that patients who undergone PETD surgery should refrain from engaging in strenuous activities especially flexion during early rehabilitation through finite element analysis. For patients with a high BMI, it is advisable to scientifically reduce weight before and after the surgery in order to maintain appropriate stress on the intervertebral disc.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"875"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894957","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":"Distribution and gender-specific differences of coronal plane alignment of healthy knee.","authors":"Ong-Art Phruetthiphat, Panukorn Pinijprapa, Charoenwat Uthaicharatratsame","doi":"10.1186/s13018-024-05380-w","DOIUrl":"10.1186/s13018-024-05380-w","url":null,"abstract":"<p><strong>Background: </strong>Understanding optimal prosthesis alignment in TKA remains crucial despite ongoing debate. While current research focuses on osteoarthritic knees, a gap exists in characterizing healthy young adult knees in Asians. This study aims to fill this gap by identifying the distribution of CPAK phenotypes in this population, including potential gender variations and individual differences.</p><p><strong>Methods: </strong>A total of 390 knees from 195 young adults aged 20 to 35 years without knee pain who underwent hip-knee-ankle radiography were prospectively collected between February 2024 and March 2024. The average MPTA, LDFA, aHKA, and JLO were measured. The overall CPAK distribution was analyzed to assess gender variations and individual differences. On average, participants were 25.7 years old, 165.7 cm tall, and had a BMI of 23.6 kg/m². LDFA, MPTA, aHKA, and JLO averaged at 86.8°, 87.2°, 0.3°, and 174.0°, respectively.</p><p><strong>Results: </strong>This study demonstrates significant differences in knee alignment between men and women, as measured by the CPAK system. While zone II was the most common overall (43.3%), the distribution of CPAK zones varied by gender, with men exhibiting a higher prevalence of distal apex point alignments (89.9%) and women having a higher prevalence of CPAK zone V (18.3%). Finally, analysis of paired knees revealed a comparable zonal distribution for both genders (approximately 56%).</p><p><strong>Conclusion: </strong>This study examined CPAK distribution in young Asian adults without knee osteoarthritis and identified potential sex-based variations. The findings suggest a predominance of distally pointed CPAK (76.9%) and a possible benefit for slightly varus tibial cuts during TKA in this population for optimal joint alignment. Additionally, gender-specific considerations should be incorporated into knee alignment assessments and treatment planning.</p><p><strong>Level of evidence: </strong>II, A prospective descriptive study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"879"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894994","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 subanesthetic dose of esketamine on early postoperative depression in elderly patients with Sarcopenia.","authors":"Yuru Fang, Guixia Cao, Shiyi Hu, Jing Cheng, Yiqiao Wang","doi":"10.1186/s13018-024-05388-2","DOIUrl":"10.1186/s13018-024-05388-2","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of subanesthetic dose of esketamine on serum inflammatory factor levels and depressive mood in elderly patients with sarcopenia postoperatively.</p><p><strong>Methods: </strong>This study retrospectively included 102 elderly patients who underwent elective total knee arthroplasty from April 2023 to June 2024 with skeletal muscle mass index (SMI) meeting the diagnostic criteria for sarcopenia (male SMI < 42.6 cm²/m², female SMI < 30.6 cm²/m²). They were divided into two groups according to whether esketamine was used: esketamine group (ESK group, n = 51) and control group (CON group, n = 51). The Hamilton Depression Scale (HAMD) scores of the patients in the two groups were completed on preoperative day 1, postoperative day 1 and day 7, and serum ceramide (Cer), NOD-like receptor thermoprotein structural domain-related protein 3 (NLRP3) and interleukin-6 (IL-6) were detected. The length of hospital stay, time to first ambulation and pain VAS scores of 4 h, 8 h and 24 h after surgery were recorded. The incidence of adverse reactions was recorded in the postoperative period of 48 h.</p><p><strong>Results: </strong>There were no significant differences in HAMD scores, Cer, NLRP3 and IL-6 levels between the two groups preoperatively (P > 0.05). Compared with CON group, HAMD score, Cer, NLRP3 and IL-6 levels, and pain VAS scores (postoperative 4 h and 8 h) were significantly decreased in ESK group at postoperative day 1 and day 7 (P < 0.05). In addition, the number of postoperative remedial analgesia and length of hospital stay in the ESK group were significantly shorter than those in the CON group (P < 0.05). HAMD scores and levels of Cer, IL-6 and NLRP3 were higher at postoperative day 1 and day 7 than those preoperatively in both two groups (P < 0.05), and there was no statistically significant difference in the incidence of adverse reactions at postoperative 48 h between the two groups.</p><p><strong>Conclusions: </strong>The subanesthetic dose of esketamine can effectively reduce the serum Cer, NLRP3 and IL-6 levels after knee arthroplasty in elderly patients with sarcopenia, and may improve the patients' depression in the early postoperative period.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"881"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894997","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":"Chronic intermittent hypobaric hypoxia alleviates early-stage posttraumatic osteoarthritis via NF-κB/Nrf2 pathway in mice.","authors":"Guowei Ren, Lindan Geng, Dong Ren, Haowei Hou, Shuangquan Yao, Zhenhua Shi, Pengcheng Wang","doi":"10.1186/s13018-024-05376-6","DOIUrl":"10.1186/s13018-024-05376-6","url":null,"abstract":"<p><strong>Background: </strong>Posttraumatic osteoarthritis (PTOA) is directly associated with early acute articular cartilage injury. Inhibition of cartilage destruction immediately following joint damage can effectively slow or prevent PTOA progression. Therefore, we sought to determine intervention targets and therapeutic strategies in the acute stage of cartilage injury. The benefits of chronic intermittent hypobaric hypoxia (CIHH) extend to various body tissues, but its impact on acute cartilage injury remains unclear. We selected PTOA initiation as the therapeutic window and administered CIHH treatment immediately following cartilage injury initiation to investigate its protective effect on cartilage and molecular mechanism changing with time-varying.</p><p><strong>Methods: </strong>The non-invasive PTOA mouse model was established by applying a single rapid specific impact force to the right knee's tibial plateau, initiating load-induced PTOA development, closely resembling the pathological changes in human diseases. Following loading, we inhibited cartilage destruction by treating mice immediately in a hypobaric chamber with a hypobaric hypoxia mimic at 5000 m altitude. Cohorts of mice subjected to distinct experimental conditions were monitored for 3, 7, 14 or 28 days. Safranin O-Fast Green staining, Immunohistochemistry, immunofluorescence, ELISA, and western blotting were performed to evaluate the therapeutic effects of CIHH on cartilage in vivo. The nuclear translocation of NF-κB p65 and Nrf2 were detected by immunofluorescence.</p><p><strong>Results: </strong>The results showed that inhibiting cartilage destruction using CIHH immediately following acute articular cartilage injury initiation delayed the progression of PTOA, decreased the Mankin score and suppressed the expression of proinflammatory factors, including iNOS, NO, TNF-α, and IL-1β. Meanwhile, immediate CIHH treatment reduced levels of the catabolic enzymes ADAMTS5 and MMP13 in the cartilage matrix, reversed degradation of Collagen II and COMP, and inhibited oxidative stress by decreasing ROS levels. Moreover, CIHH suppressed NF-κB signaling by activating the Nrf2 in vivo studies.</p><p><strong>Conclusion: </strong>Our study demonstrated that immediate CIHH treatment following cartilage injury initiation can attenuate load-induced cartilage damage by activating Nrf2/HO-1 and inhibiting the NF-κB p65 signalling pathways to counteract oxidative stress and inflammatory reactions, enhance the metabolic balance of the cartilage matrix and delay cartilage degeneration. This treatment may represent a potential therapeutic strategy for limiting PTOA progression.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"878"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894979","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":"HyProCure for progressive collapsing foot deformity: is subtalar arthroereisis a good procedure?","authors":"Shaoling Fu, Cheng Wang, Shutao Zhang, Chenglin Wu, Jiazheng Wang, Zhongmin Shi","doi":"10.1186/s13018-024-05406-3","DOIUrl":"10.1186/s13018-024-05406-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the treatment outcomes of subtalar arthroereisis (SA) in progressive collapsing foot deformity (PCFD) patients, to assess the clinical efficacy in PCFD patients after HyProCure removal, and to evaluate safety and effectiveness of SA.</p><p><strong>Methods: </strong>In this retrospective study, 202 cases (213 feet) of PCFD patients treated with SA from June 2015 to December 2022 were selected. General data and surgical information were recorded, and clinical efficacy was evaluated through imaging and clinical indicators. Furthermore, for 36 patients (36 feet) who underwent secondary surgery to remove HyProCure, imaging and clinical evaluation indicators at 1-year post-removal were recorded. Complications were also documented.</p><p><strong>Results: </strong>The main complications were sinus tarsi pain (91.37%), with partial relief or disappearance of symptoms in some patients after conservative treatment. The imaging indicators improved significantly after SA (P < 0.01), and AOFAS score and VAS were significantly improved (P < 0.01), with a 100% excellent rate in patients one year after SA. For patients who removed HyProCure, the imaging indicators exhibited a significant improvement at preoperation and post-SA (P < 0.01), and no statistical difference was observed between post-SA and post-removal (P > 0.05). Regarding clinical indicators, AOFAS score at post-SA was difference compared with preoperation and post-removal separately (P < 0.01). However, the difference in VAS between preoperation and post-SA was not statistically significant (P > 0.05). Notably, there was a significant improvement at post-removal compared with post-SA (P < 0.01).</p><p><strong>Conclusion: </strong>PCFD patients showed significant improvement in imaging and clinical evaluations after SA, with no significant flatfoot recurrence in patients who had HyProCure removed. Therefore, the application of HyProCure in SA can be considered a safe and effective surgical treatment for PCFD patients.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"885"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895372","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":"Minimally invasive surgery versus open surgery for intraspinal tumors: a meta-analysis based on 15 observational studies.","authors":"Chuanhui Xun, Haonan Li, Yukun Hu, Shutao Gao, Jianlin Xu, Yanlong Wang, Ting Wang, Weibin Sheng","doi":"10.1186/s13018-024-05395-3","DOIUrl":"10.1186/s13018-024-05395-3","url":null,"abstract":"<p><strong>Objectives: </strong>This study compared the clinical outcomes of minimally invasive surgery (MIS) and open surgery (OS) for patients with intraspinal tumors.</p><p><strong>Methods: </strong>A systematic search of PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases was conducted to identify relevant studies. Continuous variables, including estimated blood loss, surgery duration, time to mobilization, length of hospitalization, visual analog scale (VAS) score, and incision length, were reported as mean differences (MD) with 95% confidence intervals (95% CIs). Dichotomous variables, such as gross total resection, blood transfusion, cerebrospinal fluid (CSF) leakage, and overall complications, were presented as risk ratios (RR) with 95% CIs. Meta-analyses were performed using RevMan 5.3.</p><p><strong>Results: </strong>Fifteen studies, comprising a total of 943 patients (488 in the MIS group and 455 in the OS group), met the inclusion criteria. The meta-analysis indicated that MIS significantly reduced estimated blood loss (MD = -76.73, 95% CI -102.56 to -50.91, P < 0.01), incision length (MD = -4.09, 95% CI -5.20 to -2.97, P < 0.01), VAS score (MD = -0.79, 95% CI -1.48 to -0.11, P = 0.02), time to mobilization (MD = -4.27, 95% CI -5.12 to -3.43, P < 0.01), length of hospitalization, (MD = -3.94, 95% CI -5.05 to -2.84, P < 0.01), and overall complications (RR = 0.40, 95% CI 0.25 to 0.64, P < 0.01) compared with OS. No significant differences were observed in surgery duration (MD = -28.67, 95% CI -58.58 to 1.23, P = 0.06), gross total resection (RR = 1.00, 95% CI 0.94 to 1.07, P = 0.92), blood transfusion (RR = 0.23, 95% CI 0.05 to 1.04, P = 0.06), or CSF leakage (RR = 0.50, 95% CI 0.24 to 1.04, P = 0.07).</p><p><strong>Conclusion: </strong>Findings from this analysis suggest that MIS offers clinical advantages over OS in reducing blood loss, incision length, pain, time to mobilization, length of hospitalization, and overall complication rates.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"883"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895454","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":"Enhanced diagnostic capabilities of thromboelastography coupled with standard coagulation indices for predicting perioperative thrombosis in older individuals with hip fractures : TEG coupled with standard coagulation indices for predicting thrombosis in hip fractures.","authors":"Huan Yang, Yusong Yuan, Lei Shi, Yurun Yang, Yidan Zhu, Ying Chen","doi":"10.1186/s13018-024-05386-4","DOIUrl":"10.1186/s13018-024-05386-4","url":null,"abstract":"<p><strong>Background: </strong>Deep venous thrombosis of the lower extremity is a common and fatal complication of hip fracture in the elderly. However, there is a lack of targeted laboratory diagnostic methods. Although traditional laboratory indicators can provide some reference, the diagnostic efficiency is relatively limited This study aimed to investigate the diagnostic accuracies of thromboelastography (TEG) combined with traditional coagulation parameters for early diagnosis of newly occurring lower extremity deep vein thrombosis (DVT) in elderly patients with hip fractures.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including seventy-four elderly patients with hip fractures without lower extremity DVT at admission between 2022 and 2023. Disease history, laboratory tests including blood routine, six coagulation parameters at admission, and TEG on the day after the operation were collected using validated methods. Color Doppler ultrasonography of lower extremity venous was performed at admission and discharge to confirm the diagnosis of perioperative new thrombosis. A logistic regression model was used to construct joint diagnostic indexes using traditional parameters, including coagulation parameters and patient histories, combined with TEG indicators, and the receiver operating characteristic (ROC) curve was used to evaluate the discriminatory ability of each single TEG indicator and joint diagnostic indicators for newly occurring thrombosis in elderly patients with hip fracture.</p><p><strong>Results: </strong>The incidence of lower extremity DVT was 33.78%. The average age was 82.0 years, and 7.0% were male. The TEG R values at discharge were 5.8 min and 6.3 min for the DVT and without VTE groups, respectively, showing a significant difference (p = 0.035). D-dimer levels in the DVT group were significantly higher than in the non-VTE group (4.3 vs. 2.9 mg/L, p = 0.029). The multivariate-adjusted model showed significant correlations between newly occurring DVT and TEG indicators, including R values, D-dimer, and BMI, with odd ratio values of 0.43, 1.43, and 1.25, respectively (all p value < 0.05). Among each traditional coagulation parameter and TEG indicators, D-dimer and R-value had the highest diagnostic accuracy (ROC area under the curve, AUC for D-dimer: 67.7%; AUC for R: 67.6%), respectively. For joint indicators, the combination of R + CI + αangle + D-dimer had the highest AUC (0.7475), followed by R + CI + αangle + BMI (0.7123). R + CI + αangle + gender had the lowest AUC (0.5920).</p><p><strong>Conclusion: </strong>TEG demonstrates diagnostic value for newly occurring lower extremity DVT in elderly hip fracture patients. When combined with traditional coagulation parameters and patient histories, its diagnostic value is further enhanced, providing robust support for the establishment of a more comprehensive diagnostic and predictive scoring system for DVT in elderly hip fracture patients.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"870"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884828","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}