Journal of Orthopaedic Surgery and Research最新文献

{"title":"A novel rat model of lumbar disc herniation induced by puncture: accurate positioning and controllable degree of herniation.","authors":"Ming Yang, Jiangling Zhou, Qiandong Yang, Bo Yu, Juan Cai, Tianyong Hou","doi":"10.1186/s13018-025-05710-6","DOIUrl":"10.1186/s13018-025-05710-6","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation (LDH) is the serious stage of intervertebral disc degeneration (IDD), and the location and degree of intervertebral disc herniation are closely related to clinical symptoms and signs. However, there is currently no low-cost, high-benefit animal model to support in vivo research on LDH.</p><p><strong>Method: </strong>Expose the rat's lumbar 5/6 intervertebral disc through the space between the psoas major and erector spine muscles, and then use different lengths of puncture needles to control the degree of herniation and different puncture angles to push the nucleus pulposus tissue backwards to the different position. Observe the protrusion of intervertebral discs through MRI. Von Frey mechanical pain test and BBB score were used to evaluate the behavior of LDH rats. H&E and SF staining were used to observe the morphological changes after intervertebral disc herniation. Immunofluorescence was used to analyze the expression of Aggrecan (ACAN), IL-1β, TNF-α, and CD31 in intervertebral disc tissue.</p><p><strong>Results: </strong>LDH rat exhibit varying degrees of motor and sensory dysfunction. The nucleus pulposus tissue in the center of the intervertebral disc undergoes degenerative changes, with a decrease in the content of nucleus pulposus cells and proteoglycans, an increase in the expression of inflammatory factors in the protruding tissue, and neovascularization.</p><p><strong>Conclusion: </strong>We have successfully constructed rat models of different types of intervertebral disc herniation, including disc degeneration, bulging, central herniation, and lateral herniation, using the method of puncture of intervertebral discs. This animal model is consistent with the characteristics of LDH in terms of behavior, imaging, and histopathology.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"309"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700675","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":"Therapeutic interventions of platelet-rich plasma versus corticosteroid injections for lumbar radicular pain: a systematic review and meta-analysis.","authors":"Xinan Wang, Ying Zhang","doi":"10.1186/s13018-025-05725-z","DOIUrl":"10.1186/s13018-025-05725-z","url":null,"abstract":"<p><strong>Objective: </strong>Although epidural corticosteroid injections (ESIs) provide short-term relief for lumbar radicular pain caused by disc herniation, concerns remain regarding their long-term efficacy and complications. Platelet-rich plasma (PRP), with its dual anti-inflammatory and regenerative properties, is a promising alternative, but the comparative evidence between the two treatments remains inconclusive.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library, with a cutoff date of January 10, 2025. The primary outcomes were the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. The risk of bias in the included studies was assessed using Cochrane ROB and ROBINS-I. The primary outcome measures were analyzed by evaluating standardized mean differences (SMDs).</p><p><strong>Results: </strong>A total of seven studies (four randomized controlled trials and three prospective studies) were included in the meta-analysis, comprising 416 patients. The results indicated that corticosteroids significantly reduced ODI scores at the initial follow-up (4 weeks) (SMD = 0.48, 95% CI: 0.20 to 0.75, p = 0.0008, I² = 15%), with no significant differences observed in VAS and ODI scores between the two groups at other time points. The complication rates for the PRP and corticosteroid groups were reported, with no severe adverse events reported.</p><p><strong>Conclusions: </strong>Compared to PRP, corticosteroid injections showed significant early functional improvements in patients. Although no significant differences in pain and functional improvements were observed between the PRP and corticosteroid groups at other follow-up time points, future studies are needed to assess the efficacy and safety of PRP versus corticosteroid injections in treating lumbar radicular pain by standardizing PRP preparation, extending follow-up durations, and increasing sample sizes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"306"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700731","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":"Electroacupuncture attenuates intervertebral disc degeneration by upregulating aquaporins via the cAMP/PKA pathway.","authors":"Min Wang, Jia-Bao Huang, Jing Zou, Guo-Fu Huang","doi":"10.1186/s13018-025-05729-9","DOIUrl":"10.1186/s13018-025-05729-9","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration (IVDD) is characterized by a decrease in extracellular matrix (ECM) and water loss, which is a major cause of low back pain (LBP). Electroacupuncture (EA) has long been used to relieve LBP in IVDD. To investigate whether EA can upregulate aquaporins (AQPs) in IVDD via the cAMP/PKA pathway in a rabbit model of disc degeneration.</p><p><strong>Methods: </strong>A homemade loading device was adapted to trigger a disc degeneration model. After 28 days, EA treatment was performed. Magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and diffusion tensor imaging (DTI) were performed to evaluate AQP content and water diffusion. AQP protein expression in the slices was observed by Western blot and immunofluorescence (IF) staining. The pathology of the intervertebral discs was determined by staining. cAMP and PKA levels were examined using ELISA, and the expression of AQP genes as well as the cAMP/PKA pathway and its related molecules were examined using quantitative reverse transcription-PCR (qRT-PCR) and Western blot analysis.</p><p><strong>Results: </strong>The EA intervention reduced MRI Pfirrmann scores, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) values. EA can upregulate the expression of AQP1 and AQP3, thereby improving the pathological morphology of the nucleus pulposus (NP) and the cartilage endplate of the intervertebral disc. cAMP and PKA levels were significantly increased after EA intervention in rabbits with IVDD. EA intervention can partially improve the expression of related molecules in the cAMP/PKA pathway, but H-89 reverses the effect of EA.</p><p><strong>Conclusion: </strong>EA can attenuate intervertebral disc degeneration by regulating AQP expression, a process that may be mediated by the cAMP/PKA pathway.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"310"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700713","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 screw hole inserts for the unused screw holes on the strength of a plate.","authors":"Onur Basci, Selahaddin Aydemir, Ahmet Emrah Acan, Onur Gursan, Bora Uzun, Mehmet Erduran","doi":"10.1186/s13018-025-05686-3","DOIUrl":"10.1186/s13018-025-05686-3","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to determine if the use of specially designed screw hole inserts in empty locking screw holes improves the strength and failure characteristics of locking plates.</p><p><strong>Methods: </strong>Forty-two 7-hole locking LC/DCP plates were mounted on cylindric UHMW Polyethylene blocks with a 1-cm gap between blocks, simulating a fracture with comminution and bone loss. 21 plates had a screw hole insert placed in the center hole (centered over the simulated fracture), while 21 of the plates remained empty in the center hole. The plate-block constructs were placed in a mechanical testing machine and subjected to loading conditions. The axial, bending, and torsional stiffness and displacements needed for the failure of each plate-block construct were calculated. The statistical analysis was performed using the Mann-Whitney U test for independent variables.</p><p><strong>Results: </strong>All plates were then loaded to failure. There were significant differences in the axial load to failure (p = 0.017), bending load to failure (p < 0.01), and bending displacements (p < 0.01) of the test groups favoring the screw hole insert group as higher mechanical strength.</p><p><strong>Discussion/conclusion: </strong>In conclusion, the study demonstrates that the addition of the specially designed locking screw hole insert does significantly change the strength of the locking LC/DCP plates and might be suggested in the clinical application.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"312"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700718","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":"Bone marrow mesenchymal stem cell exosomes improve fracture union via remodeling metabolism in nonunion rat model.","authors":"Cheng Li, Ming Chen, Lijun Guo, Dadong Yu, Zhonghai Xu, Bin Chen, Zhijian Xiao","doi":"10.1186/s13018-025-05721-3","DOIUrl":"10.1186/s13018-025-05721-3","url":null,"abstract":"<p><strong>Background: </strong>Nonunion of fractures is a major unsolved problem in clinical treatment and prognosis of orthopedics. Bone marrow mesenchymal stem cell (BMSC) exosomes have been proven to be involved in mediating tissue and bone regeneration in a variety of diseases. However, the role of BMSC exosomes in fracture nonunion is unclear.</p><p><strong>Methods: </strong>BMSC exosomes were injected into a rat model of nonunion fracture, and the fracture-healing site was detected by micro-CT and the serum metabolites were analyzed by LC-MS/MS.</p><p><strong>Results: </strong>The results showed that the exosomes could be successfully isolated from rat BMSCs cultured in an exosome-free medium. Compared with the model group, the fracture site of the exosome-treated rats were healing obviously. Compared with the PBS group, there were 158 up-regulated differential abundance metabolites (DAMs) and 79 down-regulated DAMs in the BMSC-exo group. The DAMs were enriched in 'Th1 and Th2 cell differentiation', 'ErbB signaling pathway', 'PPAR signaling pathway' and 'HIF-1 signaling pathway' that were related to the function of cell proliferation and differentiation. DAMs-PE in HIF-1 signaling pathway were the major metabolite to promote fracture healing.</p><p><strong>Conclusions: </strong>Our study reveals the mechanism by which BMSC-exosome improves the fracture healing process through metabolic reprogramming and provides a reference for the treatment of fracture nonunion.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"308"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700692","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":"Deformity angular distance ratio independently predicts intraoperative neuromonitoring alerts in spinal deformity correction.","authors":"Jiajun Ni, Xinhu Guo, Zhuoran Sun, Chunwei Zhao, Zhongqiang Chen, Yan Zeng","doi":"10.1186/s13018-025-05693-4","DOIUrl":"10.1186/s13018-025-05693-4","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative neuromonitoring (IONM) alerts are critical concerns for surgeons performing spinal deformity corrective surgeries, as they indicate a heighteded risk of postoperative neurological deficits. Previous studies have demonstrated that patients with large Cobb angle or elevated deformity angular ratio (DAR) are at an increased risk of IONM alerts. However, spinal curves with similar Cobb angles and DARs may exhibit significantly different risks of IONM alerts during surgery. Current methods for evaluating spinal deformity fail to comprehensively and accurately reflect its severity. The purpose of this study was to investigate whether the deformity angular distance ratio (DADR) serves as an independent predictor of IONM alerts during corrective surgery for spinal deformity.</p><p><strong>Methods: </strong>This study analyzed a consecutive series of 404 patients undergoing corrective surgery at a single academic center. Preoperative radiographs were used to calculate the DAR and DADR. Twelve clinically relevant candidate variables were selected for univariable analysis. Multivariable logistic regression analysis was then conducted to identify independent predictors of IONM alerts.</p><p><strong>Results: </strong>The incidence of IONM alerts in this cohort was 25.2%. Univariable analysis identified several factors potentially associated with IONM alerts, including older age, type-III spinal cord morphology, location of apex, etiological diagnosis, preoperative sagittal Cobb angle, sagittal DAR, sagittal DADR, coronal DADR, total DAR, total DADR, three-column osteotomy, and preoperative neurological deficits. Multivariable analysis revealed that an apex location at C7-T4, preoperative neurological deficits, sagittal DADR, and total DADR were independent predictors of IONM alerts.</p><p><strong>Conclusions: </strong>Among patients undergoing corrective surgeries for spinal deformities, the DADR is a robust measure of spinal deformity severity and is strongly correlated with the risk of IONM alerts. Compared to other deformity parameters, DADR is an independent predictor of IONM alerts. Additional independent predictors include the location of the apex and the presence of preoperative neurological deficits.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"305"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700709","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":"Comparable clinical outcome with greater thickness and lesser re-tear rate following allogenous dermal scaffold augmentation for large to massive rotator cuff tears: a retrospective case-controlled study.","authors":"Hyunseong Kang, Seung Jin Yoo, Joseph Yang, Kyung Ryeol Lee, Sungwook Choi","doi":"10.1186/s13018-025-05696-1","DOIUrl":"10.1186/s13018-025-05696-1","url":null,"abstract":"<p><strong>Background: </strong>Allogenous dermal scaffold augmentation enhances partial rotator cuff repairs by providing structural support and a biologic scaffold that promotes tissue regeneration, reduces mechanical strain, and compensates for poor tendon quality in large to massive rotator cuff tears. This approach helps lower the risk of retear and improves functional recovery.</p><p><strong>Methods: </strong>This study included 55 patients with large to massive rotator cuff tears, divided into two groups. Group A (28 patients) underwent arthroscopic partial repair, while Group B (27 patients) received allogenous dermal scaffold graft augmentation following partial repair to reinforce the repair and resurface the uncovered tendon footprint. Clinical assessments, including the University of California-Los Angeles score, Constant-Murley score, and visual analogue scale, were conducted preoperatively, at 3, 6, and 12 months postoperatively, and annually thereafter. Radiologic evaluations, including magnetic resonance imaging and ultrasonography, were performed preoperatively and postoperatively to assess tendon integrity.</p><p><strong>Results: </strong>The mean follow-up period was 40 months for Group A and 36 months for Group B. Clinical functional scores significantly improved in both groups at the final follow-up. Postoperative radiologic assessment showed 9 retears in Group A and 4 in Group B (p < 0.05), respectively, with significantly greater postoperative tendon thickness in Group B compared to Group A (p-value < 0.05). Additionally, acromiohumeral distance improved significantly in both groups, from 7 mm to 9 mm in Group A and from 7 mm to 11 mm in Group B, with Group B demonstrating superior improvement (p < 0.01).</p><p><strong>Conclusion: </strong>This study suggests that allogenous dermal scaffold graft augmentation, in addition to partial repair, enhances tendon thickness and acromiohumeral distance. Furthermore, it results in lower retear rates compared to partial repair alone.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"304"},"PeriodicalIF":2.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676589","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":"Fatty infiltration predicts retear and functional impairment following rotator cuff repair: systematic review and meta-analysis.","authors":"Hao-Tian Wu, Qiang Liu, Jian-Hao Lin","doi":"10.1186/s13018-025-05702-6","DOIUrl":"10.1186/s13018-025-05702-6","url":null,"abstract":"<p><strong>Introduction: </strong>Fatty infiltration (FI) in rotator cuff (RC) is detected in many patients with complete RC tears. But there remains controversy on the prognostic effects of FI in RC tears, especially for patients with moderate and severe FI. This study aims to systematically review the relationship between the severity of preoperative FI and risk of retear, and the association between preoperative FI and functional outcomes.</p><p><strong>Materials and methods: </strong>We searched PubMed, Embase and Web of Science for studies on association between preoperative FI and retear or functional outcomes following complete RC repair. FI was assessed using Goutallier classification and global fatty degeneration index (GFDI). Meta-analysis was performed to determine odds ratios (ORs) for retear among patients with mild (grade 0-1), moderate (grade 2) and severe (grade 3-4) FI in RC tears. We delivered qualitative synthesis on association between FI and functional outcomes.</p><p><strong>Results: </strong>Eighteen studies with 1997 patients were included in the systematic review and ten studies were included in the meta-analysis. Patients with GFDI ≤ 1 had lower retear odds (OR = 0.08, 95%CI 0.02-0.29, p < 0.01). Moderate FI in supraspinatus muscle (SSP) was associated with higher retear odds compared with mild FI (OR = 1.95, 95%CI 1.09-3.48, p = 0.02) and severe FI was associated with more retear compared with moderate FI (OR = 3.37, 95%CI 1.08-10.53, p = 0.04). Similar effects were observed in FI in infraspinatus muscle (ISP) (moderate vs. mild: OR = 2.22, 95%CI 1.07-4.62, p = 0.03; severe vs. moderate: OR = 2.06, 95%CI 1.02-4.16, p = 0.04). The severity of FI in subscapularis muscle and teres minor muscle was not observed to be associated with the retear rates. In functional outcomes, lower grade of FI in GFDI was associated with better prognosis. FI in single muscles failed to present prognostic effects on functional outcomes.</p><p><strong>Conclusions: </strong>The severity of FI in SSP and ISP showed effects on retear following complete RC repair. The GFDI was a compatible predictor for risk of anatomic and functional impairment.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"303"},"PeriodicalIF":2.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676604","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":"Soft tissue swelling on anterior posterior radiograph predicts subsequent displacement of song 2 lateral humeral condyle fractures.","authors":"Peng Huang, Tian Xia, Dahui Wang, Jun Song, Chunhui Cai, Bo Ning","doi":"10.1186/s13018-025-05708-0","DOIUrl":"10.1186/s13018-025-05708-0","url":null,"abstract":"<p><strong>Introduction: </strong>According to the Song classification, the treatment of Song 2 lateral humeral condyle fracture (LHCF) is controversial because the stability of the fracture is difficult to determine. The aim of this study is to investigate whether the swelling of soft tissue on lateral side of elbow could be used as a predictor of the stability of Song 2 fractures.</p><p><strong>Materials and methods: </strong>A retrospective study of children diagnosed with LHCF admitted to our hospital from January 2017 to March 2023. Fractures were classified by Song classification. Age at onset, laterality, sex, initial treatment and follow-up times were collected. The Swelling value was measured on AP radiograph at two time point of fracture was diagnosed (swelling value 1) and healed (swelling value 2). The Song 2 fractures who underwent conservative treatment at initial were divided into 2 groups according to whether occur subsequent displacement or not: (1) displacement group, (2) nondisplaced group.</p><p><strong>Results: </strong>A total of 255 patients were enrolled. Swelling value 1 increased with the severity of Song type, and Song 2 significantly smaller than Song 4 and Song 5 (P = 0.002 and 0.000, respectively). Among the 50 Song 2 patients who underwent initial conservative treatment, 28% (14/50) patients occurred subsequent displacement. The swelling value 1 was significantly higher in displacement group than nondisplaced group (54.4%±2.4% vs. 50.3%±3.0%, P = 0.001), and the mean timing of late displacement was 3.9 days (1 to 8). Binary logistic regression analysis showed that swelling value 1 had significant difference (P = 0.003), and a cutoff value of 53.0% of swelling value 1 for subsequent displacement in Song 2 type fracture.</p><p><strong>Conclusions: </strong>The swelling value correlates with Song type and exhibits an increasing trend, potentially reflecting the integrity of the cartilage hinge indirectly, and it can be a reliable predictor of subsequent displacement for Song 2 fractures.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"301"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670262","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 miR-519d-3p and BMP2: potential early diagnostic markers and their mechanism in delayed fracture healing.","authors":"Jing Xiang, Lina Huang, Chuangye Qu, Weibing Bao, Wenqi Wang, Xiaozhong Zhu, Yong Deng","doi":"10.1186/s13018-025-05695-2","DOIUrl":"10.1186/s13018-025-05695-2","url":null,"abstract":"<p><strong>Background: </strong>Delayed fracture healing (DFH) affects patients' quality of life, and there are limitations in diagnosis by CT scan. The purpose of the study is to evaluate the potential and mechanism of clinical application of miRNAs in DFH for early diagnosis and intervention.</p><p><strong>Methods: </strong>Serum samples were obtained from delayed and normal fracture healing patients and the levels of miR-519d-3p and BMP2 were measured by RT-qPCR, and the value of both in the diagnosis of DFH was assessed by ROC curve. Cell viability and apoptosis were monitored using CCK8 kit and flow cytometry, respectively, and mRNA expression of osteogenesis and apoptosis-related genes were detected by RT-qPCR. The molecular interactions were verified using luciferase reporter gene system and RIP technique.</p><p><strong>Results: </strong>Up-regulation of miR-519d-3p expression and down-regulation of BMP2 in the serum of fracture patients four weeks after surgery can be used as an early warning marker of DFH and a risk factor for poor fracture healing. Further studies showed that overexpression of miR-519d-3p markedly inhibited the expression of RUNX2, OCN and ALP and prevented osteoblast differentiation. Meanwhile, it inhibited cell viability, promoted apoptosis, upregulated Bax and Cleaved-caspase-3 mRNA expression, and downregulated Bcl-2 expression. BMP2, targeted by miR-519d-3p, enhanced osteogenesis and reversed the inhibitory of action miR-519d-3p.</p><p><strong>Conclusions: </strong>Serum miR-519d-3p and BMP2 can be used as early diagnostic markers for DFH. miR-519d-3p inhibited osteogenesis by targeting BMP2, which may slow down fracture healing.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"302"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670257","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}