Journal of Orthopaedic Surgery and Research最新文献

{"title":"Clinical efficacy and complications of 10 surgical interventions for cervical ossification of the posterior longitudinal ligament: an updated systematic review and network meta-analysis.","authors":"Xiao Chen, Yuanhe Fan, Jie Chen, Hongliang Tu","doi":"10.1186/s13018-025-05878-x","DOIUrl":"10.1186/s13018-025-05878-x","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical techniques for cervical ossification of the posterior longitudinal ligament (OPLL) remain controversial due to insufficient high-level evidence. We investigated the following surgical approaches for cervical OPLL: anterior decompression and fusion (ADF), anterior cervical corpectomy and fusion (ACCF), anterior controllable antedisplacement fusion (ACAF), anterior cervical discectomy and fusion (ACDF), posterior decompression with instrumented fusion (PDIF), posterior decompression and fusion (PDF), laminectomy (LC), laminoplasty (LP), laminectomy with fusion (LF), and vertebral body sliding osteotomy (VBSO).</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Ovid, the Cochrane Library, and Web of Science from database inception through October 30, 2024. Our search identified both randomized and non-randomized controlled trials compar ing the following surgical interventions: ACDF, ADF, ACCF, ACAF, PDIF, PDF, LC, LP, LF, and VBSO. The extracted data were subjected to network meta-analysis. Our analysis included the following outcome measures: Patient demographic characteristics, Japanese Orthopaedic Association (JOA) scores, JOA improvement rates, overall complication rates, excellent/good recovery rates, cervical lordosis characteristics, Visual Analog Scale (VAS) scores, Neck Disability Index (NDI) scores, surgical duration and intraoperative blood loss.</p><p><strong>Results: </strong>In our analysis of 50 studies involving 8705 patients, ACAF demonstrated the most significant improvements in JOA scores, cervical lordosis, VAS scores, and NDI scores. ADF showed the greatest increase in JOA improvement rate, while VBSO had the highest rate of excellent and good postoperative recovery. ACDF was associated with the fewest total complications and the shortest surgical duration. Finally, LC resulted in the lowest intraoperative blood loss.</p><p><strong>Conclusion: </strong>This studies demonstrate that ACAF significantly improves JOA scores and cervical lordosis while reducing VAS and NDI scores. Additionally, it achieves higher postoperative JOA improvement rates and excellent/good recovery rates, with fewer total complications and reduced intraoperative blood loss. Based on these findings, ACAF can be one of the preferred options for clinicians treating cervical OPLL, but it requires high surgical experience and strict indication selection. Additionally, the surgical team need to develop the best surgical plan based on imaging features and patient functional needs.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"576"},"PeriodicalIF":2.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248374","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":"Clinical outcomes of standard primary vs. primary rotating hinge total knee arthroplasty: a retrospective matched-pair analysis.","authors":"Samuel F Schaible, Sophie C Eberlein, Raymond Schaefer, Frank M Klenke, Andreas Hecker","doi":"10.1186/s13018-025-05961-3","DOIUrl":"10.1186/s13018-025-05961-3","url":null,"abstract":"<p><strong>Background: </strong>In complex primary cases- marked by significant ligamentous instability, extensive bone loss, or severe deformities- standard total knee arthroplasty (TKA) may be insufficient. Rotating-hinge (RH) TKA offers a higher-constraint alternative. We retrospectively compared the clinical outcomes of primary RH TKA with those of standard primary (SP) TKA.</p><p><strong>Methods: </strong>Nineteen patients per group were matched for age, sex, and follow-up (SP: 68.8 ± 6.8 years; RH: 68.2 ± 8.1 years; 11 females each). Patients with < 2 years of follow-up were excluded. Outcomes included stability, range of motion (ROM), radiographic loosening, leg alignment, and the following scores: Hospital for Special Surgery (HSS), Knee Society Score (KSS), Oxford Knee Score (OKS), EuroQol-5 Dimension-3 Level (EQ-5D-3 L), and Visual Analogue Scale (VAS).</p><p><strong>Results: </strong>At follow-up (SP: 34 ± 7 months; RH: 32 ± 6 months, p = 0.346), medio-lateral instability was present in 26% of SP knees and absent in RH knees (p = 0.023). RH TKA had higher ROM by a mean 9° (126 ± 12° vs. 117 ± 9°; mean Δ = 9°, 95% CI 1.7-16.3°, Cohen d = 0.86; p = 0.012). No cases of antero-posterior instability, radiographic loosening, or axis malalignment occurred. Group differences were non-significant for HSS (89 ± 8 vs. 87 ± 19, p = 0.564), KSS (85 ± 14 vs. 87 ± 26, p = 0.790), OKS (17 ± 7 vs. 22 ± 11, p = 0.118), EQ-5D-3 L index (0.694 ± 0.314 vs. 0.781 ± 0.265, p = 0.364), and VAS (78 ± 27 vs. 77 ± 17, p = 0.886).</p><p><strong>Conclusion: </strong>Primary RH TKA is a viable alternative to standard TKA in selected cases, demonstrating significantly less medio-lateral instability (0% in RH vs. 26% in SP, p = 0.023) and greater range of motion (126 ± 12° in RH vs. 117 ± 9° in SP, p = 0.012) in this cohort.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"575"},"PeriodicalIF":2.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248375","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":"Lateral position posterior surgery followed by supine position anterior surgery in a single stage (LP-A) for the treatment of cervical spinal cord anterior severe dynamic compression in short-term.","authors":"Qiang Zhang, Shunqiang Sun, Jinkai Liu, Zequn Zhang, Yuan Xue","doi":"10.1186/s13018-025-05976-w","DOIUrl":"10.1186/s13018-025-05976-w","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"574"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248376","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":"Stairway to heaven via the highway to hell: a qualitative study on patients' experience of knee joint replacement surgery.","authors":"Anna Cronström, Thérése Jönsson, Gunilla Limbäck, Marcus Ljung, Caroline Ståhl, Elin Östlind","doi":"10.1186/s13018-025-05989-5","DOIUrl":"10.1186/s13018-025-05989-5","url":null,"abstract":"<p><strong>Background: </strong>Knee replacement (KR) is the most common osteoarthritis (OA) related surgery. Studies suggest that there are major international and national disparities in pre-operative information, support and access to rehabilitation which have a substantial impact on patients' perceived outcomes of the KR. The aim of this qualitative study was to explore experiences and perceptions of the care pathway in patients who have undergone KR and subsequent rehabilitation in Sweden.</p><p><strong>Methods: </strong>Four focus group discussions were performed including in total 25 patients (16 women), median age 67.5 (range) (46-81 years), 1 to 15 months after KR. The discussion recordings were transcribed verbatim and were analysed qualitatively using content analysis with an inductive approach.</p><p><strong>Results: </strong>The analysis resulted in four categories: (1) The crooked road towards surgery, (2) Needing support throughout the whole journey, (3) Feelings of psychological distress and (4) A balancing act towards a new life. A lack of pre-operative information regarding expected pain, need of support and mental well-being were described. Although the journey was sometimes tough, patients' expectations were, however, often fulfilled and they were in general satisfied with the decision to undergo surgery.</p><p><strong>Conclusions: </strong>Some of the challenges identified in this study may be alleviated by sufficient pre-operative information covering realistic expectations on surgery outcomes and mental aspects as well as emphatic and holistic support by healthcare providers. The result of this study will aid in the development and implementation of a national clinical practice guideline to ensure patient-centered care throughout the KR care pathway.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"570"},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234391","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":"Response to: \"Letter to the editor regarding osteonecrosis of the femoral head in post-COVID-19 patients: a retrospective comparative study\".","authors":"Jichang Seong, Abduaziz Babakulov, Saodat Asilova, Babamukhamedova Shakhnoza, Makhmudova Nodira, Akbarjon Mirzayev","doi":"10.1186/s13018-025-05930-w","DOIUrl":"10.1186/s13018-025-05930-w","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"572"},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234390","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":"Letter to the editor regarding \"osteonecrosis of the femoral head in post-COVID-19 patients: a retrospective comparative study\".","authors":"Xin Liu, Yunzhuan Luo, Dingchang He, Zujian Xu","doi":"10.1186/s13018-025-05871-4","DOIUrl":"10.1186/s13018-025-05871-4","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"573"},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234389","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":"Sympathetic cholinergic nerve fibres promote BMSC differentiation into osteoblasts via NRTN secretion: a potential treatment for osteoporosis.","authors":"Yuechun Chen, Zhenyu Zhang, Huibo Ti, Junjie Wu, Feng-Lai Yuan, Xia Li","doi":"10.1186/s13018-025-05944-4","DOIUrl":"10.1186/s13018-025-05944-4","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"571"},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234392","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":"Clinical outcomes of modified Mitchell's osteotomy and shortening oblique osteotomy for forefoot deformities with hallux valgus due to rheumatoid arthritis: A retrospective analysis.","authors":"Nariaki Hao, Naoki Kondo, Rika Kakutani, Eiji Kinoshita, Hiroyuki Kawashima","doi":"10.1186/s13018-025-05965-z","DOIUrl":"10.1186/s13018-025-05965-z","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis (RA) is a systemic autoimmune disease that primarily affects the synovial membrane, leading to progressive joint destruction. Among RA-related deformities, forefoot deformities are particularly common, causing severe pain, gait disturbances, and a significant decline in patient quality of life. Typical forefoot deformities observed in patients with RA include hallux valgus (HV), hammer toe deformities, and plantar callosities, all of which require appropriate therapeutic intervention. We aimed to evaluate the clinical outcomes of modified Mitchell's osteotomy with shortening oblique osteotomy (SOO) for forefoot deformities in patients with RA.</p><p><strong>Methods: </strong>Twenty-four patients (31 feet) underwent surgery between 2005 and 2023. The cohort included 22 women (29 feet) and two men (2 feet) with a mean age of 59 ± 12 years and disease duration of 20.3 ± 8.7 years. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) RA Foot and Ankle Scale and radiographic evaluations.</p><p><strong>Results: </strong>At a mean follow-up of 10.1 years, the JSSF scale score improved significantly from 57.9 to 77.1 points; HV angle (HVA) significantly improved from 31.7° to 17.1°; and the 1st to 5th intermetatarsal angles (M1M5A) significantly improved from 29.3° to 20.6°. The 28 joint-Disease activity score with erythrocyte sedimentation rate significantly improved from 2.75 to 2.20. Complications included recurrence of callosities in six feet (16.1%), metatarsal phalangeal joint subluxation in 13 feet (8.4%), appearance of HV deformity in 10 feet (32.3%), and infections in two feet (6.5%). No non-union was observed.</p><p><strong>Conclusions: </strong>Modified Mitchell's osteotomy with SOO significantly reduced pain and improved walking ability in patients with RA. The procedure also achieved a remarkable degree of radiographic correction, particularly a reduction in HVA and M1M5A, contributing to improved forefoot alignment. These findings suggest that the procedure provides clear benefits. Careful attention should be paid to potential postoperative complications such as the appearance of HV deformity and infection.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"564"},"PeriodicalIF":2.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216120","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 cement distribution patterns in vertebral augmentation for osteoporotic vertebral compression fractures: a systematic review.","authors":"Kangjia Yang, Xingyu Zhu, Xiaopeng Sun, Hang Shi, Lixuan Sun, Hua Ding","doi":"10.1186/s13018-025-05868-z","DOIUrl":"10.1186/s13018-025-05868-z","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic vertebral compression fractures (OVCFs) are common in osteoporosis patients. Vertebral augmentation procedures like percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used, but the impact of bone cement distribution patterns on treatment efficacy remains unclear, and there is a lack of unified classification criteria.</p><p><strong>Methods: </strong>A systematic search was conducted in multiple databases, including PubMed, Web of Science, EMBASE, and CENTRAL until September 30, 2024. Studies on OVCF patients who underwent vertebral augmentation, described cement distribution patterns, and provided clinical data were included. Data extraction and quality assessment were performed following PRISMA guidelines.</p><p><strong>Results: </strong>After screening 408 papers, 21 studies with 3997 patients were included. Morphological classifications showed that a diffuse spongy distribution pattern was associated with better clinical outcomes. Directional classifications indicated that bilateral and even cement distribution led to better vertebral height restoration and pain relief. Sufficient cement distribution was crucial for treatment success, and cement contact with both upper and lower endplates reduced refracture risk.</p><p><strong>Conclusions: </strong>Cement distribution patterns significantly affect OVCF treatment efficacy. Current classifications lack standardization, necessitating objective assessment tools and large-scale studies to optimize surgical techniques and patient outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"568"},"PeriodicalIF":2.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225762","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":"Reverse shoulder arthroplasty versus locking plate fixation for proximal humeral fracture dislocations in elderly patients: study protocol for a randomized controlled trial.","authors":"Yijie Chai, Haochen Jiang, Haoning He, Longxiang Shen, Yunfeng Chen, Qiuke Wang","doi":"10.1186/s13018-025-05982-y","DOIUrl":"10.1186/s13018-025-05982-y","url":null,"abstract":"<p><strong>Background: </strong>Proximal humeral fractures are common injuries in the elderly population, with their incidence expected to rise due to increased life expectancy. A small subset of these fractures may be associated with dislocating forces that can result in shoulder dislocation concurrent with the fracture. For the elderly patients, proximal humeral fracture dislocation can be treated by open reduction and internal locking plate (LP) fixation or reverse shoulder arthroplasty (RSA). By now, no high-quality trials have compared the two.</p><p><strong>Methods: </strong>This study is a prospective, single-center, superiority randomized controlled trial (RCT) comparing RSA and LP fixation in elderly patients (aged 65 to 85 years) with a proximal humeral fracture dislocation. Eligible participants will be randomly assigned to either the RSA or LP group (1:1 ratio). Postoperative follow-up will be conducted at 1 day (in the ward), 1 month, 3 months, 6 months, 12 months, and 24 months after surgery. Primary outcome is the Constant-Murley Score at 1-year postoperatively. Secondary outcomes include short version of Disabilities of the Arm Shoulder and Hand questionnaire score, American Shoulder and Elbow Surgeons score, Visual Analog Scale score, EuroQol-5 Dimension score, range of motion, strength and postoperative complications.</p><p><strong>Discussion: </strong>This trial is the first RCT comparing RSA with LP fixation for proximal humeral fracture dislocations in elderly patients. The results of this study will provide high-quality evidence to guide clinical practice.</p><p><strong>Trial registration: </strong>China Clinical Trials Registry No. ChiCTR2400088249.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"565"},"PeriodicalIF":2.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216124","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}