Journal of Orthopaedic Surgery and Research最新文献

{"title":"Effects of obturator and femoral nerve blocks on pain and kinematic gait parameters in patients undergoing unicompartmental knee arthroplasty: a retrospective cohort study.","authors":"Tianxiang Yang, Yunpeng Hei, Xueqi Liu, Jun Li, He Shang, Tao Ma, Desheng Chen","doi":"10.1186/s13018-025-06278-x","DOIUrl":"10.1186/s13018-025-06278-x","url":null,"abstract":"<p><strong>Background: </strong>Postoperative data indicate that 15-30% of patients undergoing unicompartmental knee arthroplasty (UKA) experience moderate-to-severe pain during the early recovery period, impeding rehabilitation. Due to the complex innervation in the knee, continuous femoral nerve block (FNB) is often administered but provides incomplete analgesia. Although the analgesic effects of nerve blocks are well studied, less is understood about their effects on postoperative rehabilitation and gait kinematics. Thus, in this study, we aimed to investigate the impact of ultrasound-guided obturator nerve block (ONB) combined with FNB on gait kinematics in patients undergoing UKA. This is the first study to quantify the biomechanical benefits of ONB combined with FNB in patients undergoing UKA by gait analysis.</p><p><strong>Methods: </strong>Patients undergoing UKA and admitted to the Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region between March 2024 and December 2024 were retrospectively enrolled. The patients were allocated based on their postoperative nerve block procedure into the FNB or FNB + ONB group, with 30 cases in each group. The FNB group underwent ultrasound-guided, single-shot FNB with catheterization, whereas the FNB + ONB group underwent additional ipsilateral ONB. Patient demographics, preoperative and postoperative visual analog scale (VAS) scores (at rest and during 30° knee flexion), adverse events, kinematic gait parameters, Knee Society Score, and range of motion were recorded.</p><p><strong>Results: </strong>No intergroup differences were observed in the preoperative VAS scores (P > 0.05). Both groups showed improved postoperative VAS scores (P < 0.05) with comparable resting VAS scores (P > 0.05). The FNB + ONB group demonstrated significantly lower activity-associated VAS scores than did the FNB group (P < 0.05). Analgesic rescue needs and adverse event rates showed no intergroup differences (P > 0.05). The FNB + ONB group exhibited superior postoperative Knee Society Scores, greater range of motion, and reduced kinematic gait abnormalities compared with the FNB group (all, P < 0.05).</p><p><strong>Conclusion: </strong>ONB combined with FNB provides superior postoperative analgesia compared with FNB alone in patients undergoing UKA, particularly during activity, thereby facilitating early rehabilitation and mitigating postoperative gait disturbances.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"845"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176059","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":"Serum methylmalonic acid levels predict multisite bone mineral density decline in patients with suspected mitochondrial dysfunction.","authors":"Tengbo Pei, Yutian Lei, Yingfang Gao, Xiaowei Hao, Peixuan Wu, Yufang Gao, Qiang Liu","doi":"10.1186/s13018-025-06246-5","DOIUrl":"10.1186/s13018-025-06246-5","url":null,"abstract":"<p><p>This study leverages NHANES data to examine the relationship between methylmalonic acid (MMA), a marker of mitochondrial dysfunction, and bone mineral density (BMD). Multivariable linear regression reveals a negative correlation between log10-transformed MMA(Log10 MMA) levels and BMD, along with nonlinear dose-response relationships. Elevated MMA levels are associated with lower BMD, suggesting a negative impact on bone health and highlighting the importance of metabolic regulation in osteoporosis prevention and areas for further research.</p><p><strong>Methods: </strong>Using NHANES data, multivariable linear regression analyzed the association between log10-transformed MMA levels and BMD, considering covariates like age, race and education. MEC weights were applied to adjust for the complex survey design, and weighted restricted cubic spline (RCS) analyses were used to visualiz the dose - response relationships.</p><p><strong>Results: </strong>The study included 19,393 participants. Log10 MMA levels showed negative associations with BMD across skeletal sites (P < 0.0001 in final models), and nonlinear relationships were identified through restricted cubic spline analysis (P < 0.05). Stratified analyses confirmed consistent associations without significant interactions.</p><p><strong>Conclusion: </strong>Elevated MMA levels, indicative of mitochondrial dysfunction, are significantly associated with lower BMD at multiple skeletal sites. This suggests that mitochondrial metabolic disturbances may compromise bone health, highlighting the importance of metabolic regulation in osteoporosis prevention and management, and emphasizing the need for further research into the mechanisms and treatments.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"842"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176096","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":"Associations between flexibility, stretching habits, and spine injuries in professional golfers: a nationwide, cross-sectional study.","authors":"Hong Jin Kim, Hyung Rae Lee, Seung Woo Suh, Dong-Gune Chang, Jae Hyuk Yang","doi":"10.1186/s13018-025-06268-z","DOIUrl":"10.1186/s13018-025-06268-z","url":null,"abstract":"<p><strong>Background: </strong>Although pre-training stretching and the inherent flexibility of an athlete are generally regarded as beneficial for injury prevention, limited evidence exists on the association between flexibility, stretching habits, and spine injuries in professional golfers. This study aimed to evaluate the association between flexibility and spinal injuries among professional golfers in South Korea.</p><p><strong>Methods: </strong>A nationwide cross-sectional study was conducted to assess spine injuries among professional active golfers in South Korea. Data on cervical (C)-spine and thoracolumbar/lumbar (T/L)-spine injury experiences, pre-injury golf-related habits, and flexibility measures containing the floor touch test, shoulder reach test, and thumb-to-forearm test were collected. Post-injury modifications in stretching, warming-up, and swing motion were also assessed. Multivariate logistic regression analysis was used to analyze the risks of golf-related spinal injuries.</p><p><strong>Results: </strong>Of the 439 participants, 33.7% reported the experience of spinal injuries, with 15.5% experiencing C-spine injuries and 21.9% reporting T/L-spine injuries. For the flexibility measures, the shoulder reach test showed significant differentiation between injured and non-injured golfers (P = 0.010), with a \"fair\" grade being associated with a lower risk of T/L-spine injuries (OR, 0.29; 95% CI, 0.14-0.62). However, the floor touch test did not show a significant distinction (P = 0.274). Among golfers with the experience of T/L-spine injury, performance was significantly associated with modifications in warming-up (P = 0.002) and swing motion (P = 0.033).</p><p><strong>Conclusion: </strong>This study found that a fair grade of flexibility in the shoulder reach test was associated with a significantly lower risk of T/L-spine injuries. Additionally, modifications in warming-up and swing motion after T/L-spine injuries were significantly associated with the performance of professional golfers.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"848"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175472","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":"Comparing the predictive value of CT-derived hounsfield units and MRI-derived bone quality scores for cage subsidence following spinal fusion: a systematic review and meta-analysis.","authors":"Omar Lubbad, Akram Hagos, Wajeeh Ullah Mahmood, Suzanne Murphy, Nektarios K Mazarakis","doi":"10.1186/s13018-025-06226-9","DOIUrl":"10.1186/s13018-025-06226-9","url":null,"abstract":"<p><strong>Background: </strong>Cage subsidence is the most common hardware-related complication of spinal fusion, often associated with suboptimal outcomes. Poor vertebral bone quality has repeatedly been suggested as a key risk factor. Therefore, we aim to evaluate and compare the predictive value of indirect bone quality metrics, Hounsfield units and vertebral bone quality (VBQ) scores, for cage subsidence following spinal fusion.</p><p><strong>Methods: </strong>Standard medical databases were searched to identify studies comparing HU or VBQ scores between patients with and without subsidence. Standard mean differences (SMD), diagnostic odds ratios (DOR), sensitivity, specificity, and area under the curve (AUC) were pooled. Meta-regression was performed to assess the influence of covariates.</p><p><strong>Results: </strong>A total of 28 studies with 3,729 patients were included. Patients with subsidence had significantly lower HU (SMD: -1.22; 95% CI: [-1.5, -0.95], Z = 8.82, P < 0.001) and higher VBQ scores (SMD: 1.14; 95% CI: [0.91, 1.37], P < 0.001). Pooled diagnostic performance was high for both HU (AUC: 0.88, DOR: 19.3) and VBQ (AUC: 0.84, DOR: 14.8). Sensitivity and specificity were comparable and exceeded 79% for both metrics. Meta-regression identified no significant effect modifiers in multivariate models.</p><p><strong>Conclusion: </strong>Both HU and VBQ scores demonstrate strong and comparable diagnostic accuracy for predicting cage subsidence. While HU seemed to exhibit slight superiority, VBQ provides a radiation-free, cost-effective alternative with comparable performance. Incorporating these metrics into preoperative planning may improve risk stratification and guide surgical planning in spinal fusion.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"840"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175774","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":"Design of novel plate for fixation of anterior pelvic ring injury: a digital anatomy study and finite element analysis.","authors":"Kequan Yu, Shichang Gao, Min Wu","doi":"10.1186/s13018-025-06280-3","DOIUrl":"10.1186/s13018-025-06280-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To develop a novel internal fixation system for anterior pelvic ring injuries and to compare the biomechanical stability of this novel anatomical plate with conventional fixation devices in the management of Tile B1-type pelvic fractures using finite element analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 200 pelvic thin-slice CT datasets were collected from healthy adults, comprising 100 male and 100 female subjects. The three-dimensional (3D) pelvic models were reconstructed using Mimics software. The following measurements were obtained: inter-pubic tubercle distance (ITD), inter-obturator foramen inner border distance (IOFIBD), superior-inferior distance of pubic symphysis (SIDPS), pubis superior ramus length from mid-external pubic tubercle to lateral obturator margin (PSR-LOTM), pubic symphysis gap (PSG), pubic symphysis upper plane-superior ramus angle (SPS-SRA), pubic symphysis-coronal plane angle (PS-CPA), maximum superior-inferior diameter of pubic superior ramus (SID-PSR), and anterior-posterior diameter of pubic superior ramus (APD-PSR). Standard pelvis models were selected and imported into SolidWorks software to design two novel plates. Finally, a Tile B1 pelvic finite element model was established and fixed using two novel plates, a single superior pubic symphysis plate, and a combination of anterior and superior pubic symphysis plates. A load of 500 N was applied to the model in three directions (cranial-caudal, anterior-posterior, and lateral-medial), and the stiffness was determined based on the maximum displacements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The ITD was 48.93 ± 5.51 mm in males and 54.45 ± 5.15 mm in females; the IOFIBD was 46.67 ± 4.02 mm in males and 55.17 ± 4.46 mm in females; the SIDPS was 39.77 ± 4.12 mm in males and 36.76 ± 4.21 mm in females; the PSR-LOTM was 35.87 ± 4.04 mm in males and 37.62 ± 5.31 mm in females; the SPS-SRA was 135.67 ± 4.83° in males and 137.53 ± 4.46° in females; and the ITD + PSR-LOTM was 120.68 ± 10.66 mm in males and 124.70 ± 11.93 mm in females. Significant differences were observed between males and females for all these measurements (P &lt; 0.05). These values were used as reference criteria for selecting standard pelvis models. The ITD + PSR-LOTM data were sorted in ascending order, and the medians of the 0-33%, 33-66%, and 66-100% intervals were used as references for selecting standard pelvis models. Based on the selected standard pelvis models, two designs and six length specifications (110, 115, 120, 125, 130, and 135 mm) of anatomical plates were developed. In the finite element analysis, the maximum displacements of the pelvis under three loading modes (cranial-caudal, anterior-posterior, and lateral-medial) were as follows: for Type A plate fixation, 0.357 mm, 0.192 mm, and 1.018 mm, respectively; for Type B plate fixation, 0.362 mm, 0.505 mm, and 1.133 mm, respectively; for single pubic symphysis superior plate fixation, 0.386 mm, 0.965 mm, and ","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"853"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of direct anterior approach versus conventional surgical approaches in total hip arthroplasty: a systematic review and meta-analysis of randomized clinical trials.","authors":"Run Liu, Yaheng Zhao, Zhiming Yu, Changcheng Liu, Qi Sun, Xinyu Nan","doi":"10.1186/s13018-025-06227-8","DOIUrl":"10.1186/s13018-025-06227-8","url":null,"abstract":"<p><strong>Background: </strong>Conventional approaches (CA) include the posterior approach (PA) and the lateral approach (LA). Although the direct anterior approach (DAA) and CA possess distinct advantages and limitations in clinical treatment outcomes, the existing literature provides conflicting descriptions. Therefore, this study conducted a systematic literature review and meta-analysis based on randomized clinical trials (RCTs) to compare the clinical outcomes of DAA and CA in total hip replacement (THR).</p><p><strong>Methods: </strong>Up to May 2025, we executed a comprehensive literature search to compare RCTs of DAA and CA in THA. We assessed Surgical parameters, functional scores, and postoperative complications. Pooled statistical analysis was employed to quantify the therapeutic outcomes by comparing DAA and CA, with CA as the control group, using data extracted from the included RCTs. We used the Review Manager 5.4 software for assessing publication bias and data analysis, and I² (based on the DerSimonian-Laird method) to assess the heterogeneity among studies. We used the random-effects model for the pooled analysis.</p><p><strong>Results: </strong>This study included 17 eligible RCTs comprising 1,575 patients, of which 4 were Level I evidence and 13 were Level II evidence. The meta-analysis revealed that DAA prolonged the operative time (random-effects model, mean difference [MD] = 14.5 min, 95% confidence interval [CI] 9.14 to 19.86, p < 0.01), resulted in lower posteroperative day 1 pain scores (random-effects model MD = -0.79, 95% CI -1.00 to -0.59, p < 0.01), demonstrated superior early functional outcomes (Harris Hip Score at 1 month postoperatively, random-effects model, MD = 3.41, 95% CI 0.29 to 6.53, p = 0.03), and was linked to an increased risk of postoperative nerve injury (relative risk [RR] = 7.37, 95% CI 2.52 to 21.51, p < 0.01). No comparable outcomes were found between DAA and CA methods in intraoperative blood loss, VAS score at 1 month postoperatively, Harris score after 3 months, and other complications (intraoperative fracture, intraoperative greater trochanter fracture, dislocation, infection, wound complications, thrombosis, etc.)..</p><p><strong>Conclusion: </strong>Compared with CA, DAA reduced early postoperative pain levels and yielded superior early hip joint function. However, DAA was linked to longer operative durations and an elevated risk of nerve injury.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"837"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175605","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":"Complication profile and risk patterns following elective implant removal in pediatric fractures: a 10-year retrospective analysis.","authors":"Taner Alıç, Seniye Burcu Torumtay Alıç, Soner Gürel, Abdulrahim Dündar, Deniz İpek, Murat Çalbiyik","doi":"10.1186/s13018-025-06264-3","DOIUrl":"10.1186/s13018-025-06264-3","url":null,"abstract":"<p><strong>Background: </strong>There is no clear consensus regarding the optimal timing and necessity of implant removal (IR) following fracture healing in children. Although generally recommended between 1 and 12 months after osteosynthesis, IR carries risks such as refracture, infection, and neurovascular injury. This study aimed to evaluate the indications for IR, the timing of removal, and the complications observed during and after implant extraction in pediatric patients.</p><p><strong>Methods: </strong>This retrospective study included 115 pediatric patients (mean age: 10.8 years, range: 2-17) who underwent IR following fracture treatment. Data on implant retention duration, type of implant, indication for removal, and post-removal complications were recorded and analyzed.</p><p><strong>Results: </strong>IR was most commonly performed in asymptomatic cases upon parental request (90.4%), particularly for forearm fractures. Titanium elastic nails and plate-screw systems were the most frequently removed implants. Post-removal complications included refracture (4.3%), infection (1.7%), incomplete removal (1.7%), radial nerve neuropraxia (0.9%), and wound problems (0.9%). Refractures occurred within 5 to 18 days postoperatively, with the forearm being the most frequently affected region (7.5% of forearm IR cases). No statistically significant association was found between implant type, retention duration, and the occurrence of refracture (p > 0.05). These findings underscore the importance of patient-specific planning and postoperative protective strategies, especially for forearm IR.</p><p><strong>Conclusion: </strong>Implant removal in pediatric patients is generally safe; however, the risk of early refracture, especially in the forearm, highlights the need for short-term activity restrictions and splint immobilization post-removal. Surgeons should clearly communicate the risks and timing of IR with families during the decision-making process.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"836"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical study of percutaneous Kirschner wire fixation in pediatric supracondylar humeral fractures with medial column impaction: surgical technique and outcomes.","authors":"Liang Yuan, Cheng Zhou, Saiwen Chen, Ran Gu, Yudong Lin","doi":"10.1186/s13018-025-06275-0","DOIUrl":"10.1186/s13018-025-06275-0","url":null,"abstract":"<p><strong>Background: </strong>This study aims to introduce a surgical technique using percutaneous Kirschner wire fixation for pediatric supracondylar humeral fractures with medial column impaction.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 46 patients diagnosed with supracondylar humeral fractures with medial column impaction who underwent treatment at a children's hospital, from January 2022 to January 2024. Among these patients, 20 received percutaneous K-wire fixation, while 26 underwent conservative treatment. Fracture healing time and complications were recorded. The carrying angle (CA) and Baumann angle (BA) of the affected elbow joint were assessed preoperatively, immediately after surgery, and at 3 months postoperatively. Elbow range of motion was measured and compared at the final follow-up. Additionally, elbow function was evaluated using Mayo Elbow Performance Score (MEPS).</p><p><strong>Results: </strong>All 46 patients completed follow-up, with durations ranging from 4 to 10 months. Fracture healing times were similar between the two groups, averaging 27.60 ± 1.85 days in surgical group and 27.85 ± 2.33 days in conservative treatment group. Postoperative complication rates were 5% and 7.7%, respectively. No statistically significant difference in the preoperative BA (P > 0.05). However, significant differences were observed in terms of immediate postoperative BA, BA at 3-month follow-up, and CA at 3-month follow-up(P < 0.05). At the final follow-up, elbow joint range of motion was similar( P > 0.01). However, MEPS demonstrated significantly better functional outcomes in the surgical group ( P < 0.05).</p><p><strong>Conclusion: </strong>Percutaneous Kirschner wire fixation is effective in treating this distinctive fracture subtype, providing superior radiographic alignment and comparable cosmetic outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"839"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176090","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 size and density of muscle and subcutaneous adipose tissue are independently associated with the risk of mortality in older women with different hip fracture types.","authors":"Yangtong Li, Rui Jiang, Haoyan Yu, Yihang Hu, Yuehua Li, Jing Lu","doi":"10.1186/s13018-025-06269-y","DOIUrl":"10.1186/s13018-025-06269-y","url":null,"abstract":"<p><strong>Aims: </strong>To investigate whether the size and density of proximal femur muscle and surrounding subcutaneous adipose tissue (SAT) are associated with the risk of mortality in older women with different hip fractures (HF) types, as well as to assess how this association changes over time following the fracture.</p><p><strong>Methods: </strong>CT images and data from 378 female patients with low-energy acute HF were retrospectively collected between January 2020 and July 2022, with an average follow-up of four years. The cross-sectional area and density of the gluteal muscle around the hip, thigh muscle, and adjacent SAT were measured. Cox proportional hazard models were used to assess mortality risk adjusted for covariates in different HF types.</p><p><strong>Results: </strong>At the end of the follow-up period, 58 had died, and 320 had survived. The mean age at death for non-surviving patients (84.5 ± 7.9 years) was significantly higher than that of surviving patients (72.1 ± 10.6 years). In the femoral neck fracture (FNF) group, the size and density of the gluteus medius and minimus muscles (G.Med/MinM), as well as thigh muscle density, were negatively associated with mortality (P < 0.05). In the intertrochanteric fracture (ITF) group, the mid-thigh SAT (MSAT) area and density were negatively and positively correlated with mortality, respectively. Gluteal muscle size was inversely associated with mortality at one year and beyond following a HF. The MSAT area was inversely associated with mortality within 2 years after HF, while the MSAT density was positively correlated with mortality during the 1-2 years following the fracture.</p><p><strong>Conclusions: </strong>In different HF groups, the size and density of proximal femur muscles and surrounding SAT demonstrated varying associations with post-fracture mortality in older women, independent of age, BMI, and clinical risk scores.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"834"},"PeriodicalIF":2.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149565","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":"Neuregulin 4 inhibits synovial macrophage pro-inflammatory polarization via ErbB4/Stat5b/NF-κB signaling to alleviate osteoarthritis progression.","authors":"Daoliang Jiang, Xiaoli Xu, Wenjing Yang, Mengjia Tang, Yuping Zhang, Lingfeng Shi, Jiongyu Hu","doi":"10.1186/s13018-025-06259-0","DOIUrl":"10.1186/s13018-025-06259-0","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a chronic inflammatory disease characterized by synovial inflammation and cartilage degradation. Synovial macrophages, as a key driver of OA progression, during all stages of OA and induced to produce inflammatory cytokines that aggravate the degradation of cartilage. Here, we demonstrate that neuregulin-4 (Nrg4) deficiency exacerbates synovial pro-inflammatory macrophage transformation and articular cartilage abrasion in a mouse model of OA. Conversely, Nrg4 re-expression significantly reduces pro-inflammatory macrophage accumulation and synovial inflammation, thereby attenuating OA progression. Mechanistically, Nrg4 activates the ErbB4/Stat5b signaling pathway, which subsequently suppresses NF-κB activation, leading to reduced pro-inflammatory macrophage transformation and pro-inflammatory cytokine production. In vitro experiments further confirm that Nrg4 directly inhibits macrophage infiltration. These findings reveal a novel role for Nrg4 in modulating synovial macrophage transformation through the ErbB4/Stat5b/NF-κB axis, offering a potential therapeutic strategy for OA by targeting synovial inflammation. This study also expands our understanding of OA protection beyond chondrocyte protection, emphasizing its role in regulating the synovial microenvironment and cartilage homeostasis in OA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"835"},"PeriodicalIF":2.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149562","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}