Journal of Orthopaedic Surgery and Research最新文献

{"title":"A development of machine learning models to preoperatively predict insufficient clinical improvement after total knee arthroplasty.","authors":"Geunwu Gimm, Byoungjun Jeon, Sung Eun Kim, Byeong Soo Kim, Hyuk-Soo Han, Sungwan Kim","doi":"10.1186/s13018-025-06206-z","DOIUrl":"https://doi.org/10.1186/s13018-025-06206-z","url":null,"abstract":"<p><strong>Background: </strong>Identifying patients unlikely to achieve meaningful improvement following total knee arthroplasty (TKA) supports more effective shared decision-making (SDM). This study aimed to develop and validate machine learning (ML) models that preoperatively predict insufficient clinical improvement one year after TKA using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscales and total scores, and to assess the important predictive variables.</p><p><strong>Methods: </strong>A retrospective analysis was performed on consecutive primary TKA patients from 2004 to 2022 at a single tertiary hospital was conducted. Insufficient clinical improvement was defined as not achieving the minimal clinically important difference (MCID) for each WOMAC subscale and total. Candidate preoperative variables included demographics, comorbidities, knee range of motion, radiologic variables, and WOMAC scores. A variety of ML models were evaluated using performance metrics for calibration and discrimination, as well as decision curve analysis and Shapley additive explanations.</p><p><strong>Results: </strong>Among the 3,810 TKAs included, the ExtraTrees model performed best for WOMAC pain, stiffness, function, and total scores, achieving AUCs of 0.92, 0.90, 0.87, and 0.89; recall rates of 0.79, 0.86, 0.70, and 0.83; and Brier scores of 0.09, 0.10, 0.11, and 0.06, respectively, along with demonstrating good calibration curves and net clinical benefit. Shapley additive explanations identified better preoperative WOMAC scores, osteoporosis, diabetes mellitus, older age, malignancy, and coronary artery disease as important predictors of insufficient clinical improvement.</p><p><strong>Conclusions: </strong>The ML models demonstrated good performance in preoperatively predicting insufficient clinical improvement at 1 year after TKA based on WOMAC. These models have the potential to enhance SDM and perioperative patient management by preoperatively identifying approximately 70% to over 80% of patients likely to experience insufficient clinical improvement, with a specificity of about 80%, and by providing explanations regarding associated factors.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"778"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957992","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":"AI-assisted 3D versus conventional 2D preoperative planning in total hip arthroplasty for Crowe type II-IV high hip dislocation: a two-year retrospective study.","authors":"Zhenbao Lu, Cuihua Yuan, Qingshan Xu, Yuhua Feng, Qiujin Xia, Xiaolu Wang, Jianfu Zhu, Jinqing Wu, Tihui Wang, Jiliang Chen, Xu Wang, Qijin Wang","doi":"10.1186/s13018-025-06208-x","DOIUrl":"https://doi.org/10.1186/s13018-025-06208-x","url":null,"abstract":"<p><strong>Background: </strong>With the growing complexity of total hip arthroplasty (THA) for high hip dislocation (HHD), artificial intelligence (AI)-assisted three-dimensional (3D) preoperative planning has emerged as a promising tool to enhance surgical accuracy. This study compared clinical outcomes of AI-assisted 3D versus conventional two-dimensional (2D) X-ray preoperative planning in such cases.</p><p><strong>Methods: </strong>A retrospective cohort of 92 patients with Crowe type II-IV HHD who underwent THA between May 2020 and January 2023 was analyzed. Patients received either AI-assisted 3D preoperative planning (n = 49) or 2D X-ray preoperative planning (n = 43). The primary outcome was the accuracy of implant size prediction. Secondary outcomes included operative time, blood loss, leg length discrepancy (LLD), implant positioning, functional scores (Harris Hip Score [HHS], WOMAC, VAS), complications, and implant survival at 24 months.</p><p><strong>Results: </strong>At 24 months, both groups demonstrated significant improvements in functional outcomes. Compared to the 2D X-ray group, the AI-3D group showed higher accuracy in implant size prediction (acetabular cup: 59.18% vs. 30.23%; femoral stem: 65.31% vs. 41.86%; both p < 0.05), a greater proportion of cups placed within the Lewinnek and Callanan safe zones (p < 0.05), shorter operative time, reduced intraoperative blood loss, and more effective correction of leg length discrepancy (all p < 0.05). No significant differences were observed in HHS, WOMAC, or VAS scores between groups at 24 months (all p > 0.05). Implant survivorship was also comparable (100% vs. 97.7%; p = 0.283), with one revision noted in the 2D X-ray group.</p><p><strong>Conclusion: </strong>AI-assisted 3D preoperative planning improves prosthesis selection accuracy, implant positioning, and perioperative outcomes in Crowe type II-IV HHD THA, although 2-year functional and survival outcomes were comparable to 2D X-ray preoperative planning. Considering the higher cost, radiation exposure, and workflow complexity, its broader application warrants further investigation, particularly in identifying patients who may benefit most.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"777"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958030","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 influence of hand position on scapular kinematics in push-ups: comparing athletes with chronic shoulder pain and healthy controls.","authors":"Sajjad Abdollahi, Rahman Sheikhhoseini, Mohammad Salsali, Hashem Piri, Julie A Hides","doi":"10.1186/s13018-025-06212-1","DOIUrl":"https://doi.org/10.1186/s13018-025-06212-1","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"776"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958035","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":"Reduced opioids after total joint replacement surgery (REPAIRS): a pilot randomized controlled trial.","authors":"Zhiwei Yang","doi":"10.1186/s13018-025-06193-1","DOIUrl":"https://doi.org/10.1186/s13018-025-06193-1","url":null,"abstract":"<p><strong>Background: </strong>Opioid analgesics are commonly used for controlling pain after total knee or hip replacement. However, it is unclear how much opioid should be prescribed at discharge after total hip and knee replacement surgery to optimize pain management but minimise adverse events. To determine the acceptability and feasibility of a trial comparing a reduced and standard opioid regimen following discharge from total knee or hip replacement.</p><p><strong>Methods: </strong>This pilot randomized controlled trial recruited participants from the pre-admission clinic of a metropolitan hospital in Sydney. All participants received a non-opioid regimen of naproxen 500 mg 12 hourly for 7 days, and paracetamol 1000 mg 6 hourly daily for 14 days. Participants were randomly allocated to the 'standard' group (oxycodone 5 mg taken as needed, maximum recommended frequency of 4 hourly, 20 tablets dispensed) or the 'reduced' group (received half the amount of oxycodone, taken half as frequently) at hospital discharge. Primary outcomes were screening to recruitment rate, percentage completing follow-ups, and acceptability of the trial procedures. Acceptability was measured quantitatively at weeks 1 and 2 post-discharge and qualitatively by interview at 6 weeks post-discharge. Adverse events were collected up to 6-weeks post-discharge.</p><p><strong>Results: </strong>In four months, we screened 254 people, of which 72 were eligible and 53 were recruited (recruitment rate = 21%). 93% participants completed all their follow up surveys. Participants scored the trial intervention between neutral and acceptable (3.6/5 for both groups and weeks). 39 interviews were conducted where both clinicians and patients reported strong support for the pilot trial design. Few adverse events occurred across both groups, the most common being constipation.</p><p><strong>Conclusions: </strong>This pilot trial indicated that a full-scale trial would be feasible and acceptable. Such a trial could provide evidence of comparative effectiveness for the reduced opioid regimen in this population.</p><p><strong>Trial registration: </strong>The trial was pre-registered in Australian New Zealand Clinical Trials Registry (ACTRN12623001070628).</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"774"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957947","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":"Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial.","authors":"Dunbing Huang, Wei Song, Yang Liu, Xiaohua Ke, Zhenhua Wu","doi":"10.1186/s13018-025-06194-0","DOIUrl":"https://doi.org/10.1186/s13018-025-06194-0","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of a 12-week isokinetic eccentric training program on postural control and ankle muscle strength in individuals with functional ankle instability (FAI).</p><p><strong>Methods: </strong>In this randomized controlled trial, 42 participants with unilateral FAI were randomly assigned to either an experimental group (n = 21), receiving isokinetic eccentric training, or a control group (n = 21), receiving isokinetic concentric training. Both groups trained three times per week for 12 weeks. One participant from each group dropped out during the intervention, resulting in 20 participants per group included in the final analysis. Primary outcomes included static and dynamic postural control assessed using the Pro-Kin 254P platform. Secondary outcomes were ankle dorsiflexion and eversion strength, as well as dorsiflexion/plantarflexion (D/P) and eversion/inversion (E/I) torque ratios measured with a Biodex System 4 Pro^® dynamometer at 60°/s and 180°/s. Between-group comparisons and effect sizes (Cohen's d) with 95% confidence intervals (CI) were reported.</p><p><strong>Results: </strong>After 12 weeks, the experimental group demonstrated significantly greater improvements in postural control and ankle strength outcomes compared to the control group (p < 0.01). For dynamic postural control, the total offset index decreased by 23.8% in the eccentric group, showed a significant improvement with a very large effect size (Cohen's d = 2.06, 95% CI [1.29, 2.82], p < 0.001). Static postural control, measured by sway area, was reduced by 17.3% (Cohen's d = 0.81, 95% CI [0.16, 1.45], p = 0.015), while sway length did not reach statistical significance (Cohen's d = 0.55, 95% CI [-0.08, 1.18], p = 0.090). Regarding ankle strength, dorsiflexion relative peak torque (RPT) at 60°/s increased by 30.7% in the eccentric group (Cohen's d = - 0.79, 95% CI [-1.44, - 0.15], p = 0.016), while eversion RPT at 180°/s improved by 75.7% (Cohen's d = - 1.13, 95% CI [-1.79, - 0.46], p = 0.001). The D/P torque ratio at 180°/s exhibited a very large between-group difference (Cohen's d = - 2.18, 95% CI [-2.96, - 1.39], p < 0.001), and the E/I torque ratio at 60°/s demonstrated an extremely large effect size (Cohen's d = - 4.50, 95% CI [-5.67, - 3.34], p < 0.001).</p><p><strong>Conclusion: </strong>Isokinetic eccentric training significantly enhances postural stability and ankle muscle strength in patients with FAI. These improvements in torque symmetry and balance support the inclusion of eccentric training as an effective rehabilitation strategy to reduce reinjury risk and restore neuromuscular function.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"775"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957895","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":"Burden of screening and treatment of bone health markers amongst elderly patients with proximal femur fractures.","authors":"Alexander Yunke, Antonio Farinhas, Zachary Tamweber, Alexandra Wadhwani, Ellen Lutnick","doi":"10.1186/s13018-025-06202-3","DOIUrl":"10.1186/s13018-025-06202-3","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to quantify changes in the burden of screening for osteoporosis and vitamin D deficiency (VDD) amongst elderly patients treated with proximal femur fracture repair (PFFR).</p><p><strong>Methods: </strong>Data collection and analysis was performed via the TriNetX HCO group network titled Research. Patients aged 65 and older who underwent PFFR were included based on CPT codes. Rates of preexisting diagnoses of VDD and/or osteoporosis, and first-time diagnoses of VDD or osteoporosis at 1 month, 6 months, and 1 year following PFFR between 2004 and 2024 were explored. Patient demographics and comorbidity data were compared across patient cohorts using chi-square tests for categorical variables, independent samples t-tests for continuous variables. Standardized differences were used to calculate the effect size.</p><p><strong>Results: </strong>PFFRs registered in TriNetX have increased from 2004 to 2024 (Table 1). Those patients who underwent PFFR without prior history of VDD and/or osteoporosis ranged from 74.60% in 2004 to 49.83% in 2024. Conversely, patients with a prior history of documented VDD and/or osteoporosis ranged from 25.4% in 2004 to 50.1% in 2024. The percent risk of a first-time diagnosis of osteoporosis at 1 month, 6 months, and 1 year in the overall cohort were 3.7%, 8.6%, and 10.3%, respectively. The percent risk of a first-time diagnosis of VDD at 1 month, 6 months, and 1 year in the overall cohort were 2.1%, 4.4%, and 5.6%, respectively.</p><p><strong>Conclusion: </strong>The burden of screening for markers of bone health and subsequent treatment in at risk patients has increased over time. Rates of first-time diagnoses of osteoporosis or VDD after PFFR represent a current treatment burden of approximately 10% and 5% of this population at 1 year, respectively. This number may underrepresent the true burden of disease, highlighting the necessity of screening protocols targeting this population.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"772"},"PeriodicalIF":2.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883043","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 diagnostic and therapeutic potential of miR-3149 in osteoporotic fractures through SMAD4.","authors":"Guanwei Xu, Zhichao Yang, Sibao Zeng, Yongqi Dong, Lina Huang","doi":"10.1186/s13018-025-06182-4","DOIUrl":"10.1186/s13018-025-06182-4","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic fractures (OPF) are one of the most common bone diseases in aging societies. MiR-3149 is a short non-coding RNA, its expression level, therapeutic effects, and mechanisms in OPF remain unclear.</p><p><strong>Purpose: </strong>This study aims to explore the impact of miR-3149 on OPF progression and uncover its mechanism for influencing OPF progression via SMAD4.</p><p><strong>Methods: </strong>In this study, we first used reverse transcription-quantitative polymerase chain reaction (RT-qPCR) to detect miR-3149 expression levels in the serum of OPF patients. Then, we assessed miR-3149's diagnostic value for OPF via ROC curve analysis. Using cell counting kit-8 (CCK-8) assays, flow cytometry, and RT-qPCR, we explored miR-3149's effects on cell proliferation, apoptosis, and the expression of key factors RANK and NFATc1. Furthermore, we examined SMAD4 expression in RAW264.7 cells and conducted a dual-luciferase reporter assay to confirm the interaction between miR-3149 and SMAD4. Finally, we analyzed how miR-3149 regulates SMAD4 expression and investigated the effects of miR-3149-mediated SMAD4 regulation on cell function.</p><p><strong>Results: </strong>This study reveals that miR-3149 is markedly upregulated in the OPF group, effectively differentiating the control and case groups. MiR-3149 knockdown suppressed RAW264.7 cell proliferation and osteoclastic differentiation, while inducing apoptosis. Notably, SMAD4, a downstream target gene of miR-3149, was low-expressed in RANKL-induced RAW264.7 cells, and exhibits specific binding with miR-3149. Co-transfection with pcDNA-SMAD4 reversed the effects of mimic-miR on RAW264.7 cell proliferation, apoptosis, and osteoclastic induction.</p><p><strong>Conclusions: </strong>Down-regulating miR-3149 inhibited the osteoclastic generation ability of RAW264.7 by up-regulating SMAD4 expression.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"773"},"PeriodicalIF":2.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883045","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 new individually designed 3D printing guide plate-assisted internal fixator (INFIX) surgery for the treatment of pelvic fractures.","authors":"Kaidong Wu, Xiaoyu Bai, Shuwei Li","doi":"10.1186/s13018-025-06125-z","DOIUrl":"10.1186/s13018-025-06125-z","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"770"},"PeriodicalIF":2.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883042","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":"Sensory integration and spinal structure in AIS: is there a functional-structural association?","authors":"Dan Wang, Raymond Tsang, Qing Li, Feng Chen, Rajkumar Krishnan Vasanthi, Vinosh Kumar Purushothaman, Song Wang","doi":"10.1186/s13018-025-06172-6","DOIUrl":"10.1186/s13018-025-06172-6","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"771"},"PeriodicalIF":2.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883044","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":"Meridian-Sinew Release Therapy as an adjunctive treatment for gouty arthritis: a systematic review and meta-analysis.","authors":"Xia Zhou, Shulei Peng, Lang Hu, Song Wei, Zhihuang Chen","doi":"10.1186/s13018-025-06123-1","DOIUrl":"10.1186/s13018-025-06123-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the efficacy and safety of Meridian-Sinew Release Therapy (MSRT) combined with conventional Western medicine (MSRTW) in the treatment of gouty arthritis (GA) and to provide scientific evidence for clinical practice.</p><p><strong>Methods: </strong>A comprehensive search of both Chinese and English literature databases was conducted to identify randomized controlled trials (RCTs) that met the inclusion criteria. The study compared MSRTW to Western medicine treatment (WM) alone. The primary outcome was changes in serum uric acid levels (SUA), and secondary outcomes included Visual Analog Scale (VAS) pain scores, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Additionally, the safety and incidence of adverse events were analyzed.</p><p><strong>Results: </strong>A total of 6 RCTs involving 376 participants were included. Meta-analysis demonstrated that the MSRTW group was significantly more effective than the WM group in reducing SUA levels (MD = -99.94, P < 0.001), relieving pain (VAS score: MD = -1.50, P < 0.001), and improving ESR and CRP levels. Additionally, fewer adverse events were reported in the MSRTW group, indicating good safety. Sensitivity analyses confirmed the robustness of the results. Subgroup analyses suggested that treatment duration, gender, and the use of urate-lowering therapy or colchicine may be potential sources of heterogeneity.</p><p><strong>Conclusion: </strong>MSRT, as an adjunct therapy, may offer clinical benefits in managing gouty arthritis by reducing urate deposition, relieving inflammation, and improving joint function with good safety. However, due to the limited sample size and variability among studies, further high-quality, multi-center trials are needed to confirm its long-term efficacy and underlying mechanisms.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"769"},"PeriodicalIF":2.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873649","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}