Journal of Orthopaedic Surgery and Research最新文献

{"title":"Contradictory links between lipid levels and bone health: atherogenic index of plasma and bone microarchitecture.","authors":"Bo Xu, Guo-Liang Ma, Xin Chen, Bo-Wen Yang, Dian Zhang, Xiao-Kuan Qin, Tai-Wei Lou, Wei-Li Duan, Le Yu, Min-Shan Feng, He Yin, Xu Wei, Li-Guo Zhu","doi":"10.1186/s13018-025-05460-5","DOIUrl":"10.1186/s13018-025-05460-5","url":null,"abstract":"<p><strong>Purpose: </strong>Lipids increase osteoporosis and fracture risk, yet research on Atherogenic Index of Plasma (AIP), bone mineral density declines (BMD), and trabecular bone score (TBS) is limited. This study examined the relationships between AIP, TBS, and BMD in American adults using the National Health and Nutrition Examination Survey (NHANES) data, including the effect of obesity.</p><p><strong>Methods: </strong>Based on data from 3,162 Americans, multivariable logistic regression and a generalized additive model (GAM) were used to analyze AIP, BMD, and TBS. Mediation studies assessed the impact of obesity (BMI) on these relationships. A threshold effect study identified turning points.</p><p><strong>Results: </strong>The average participant age was 47.5 ± 17 years. AIP showed no correlation with BMD after BMI adjustment but was significantly associated with lumbar spine and femoral neck BMD without BMI adjustment. AIP negatively correlated with TBS even after adjusting for covariates. The relationship between AIP and TBS was L-shaped, with a turning point at -0.17. BMI mediated the AIP-BMD relationship by 122.01-131.49% (P < 0.05).</p><p><strong>Conclusions: </strong>This study found AIP levels associated with decreased TBS and increased BMD, influenced by obesity. AIP may be a valuable tool in evaluating bone metabolism, indicating high BMD but poor TBS, warranting further exploration.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"34"},"PeriodicalIF":2.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965534","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":"Diagnostic efficacy of dual-energy CT virtual non-calcium technique in the diagnosis of bone marrow edema of sacroiliac joints in ankylosing spondylitis.","authors":"Hongyue Lu, Zhi Li, Ziheng Liang, Yuqi Liu","doi":"10.1186/s13018-024-05341-3","DOIUrl":"10.1186/s13018-024-05341-3","url":null,"abstract":"<p><strong>Objective: </strong>In-depth investigation of the diagnostic performance of dual-energy CT (DECT) virtual non-calcium (VNCa) technique for sacroiliac joint bone marrow edema (BME) in patients with ankylosing spondylitis(AS).</p><p><strong>Methods: </strong>A total of 42 patients with AS)who underwent sacroiliac joint MRI and DECT scans on the same day at our Rheumatology and Immunology Department between August 2022 and June 2023 were selected. Using MRI as the reference standard, the presence of BME on the iliac and sacral surfaces was evaluated, resulting in the categorization of patients into BME-positive and BME-negative groups. Subsequently, the DECT scan data was processed using the \"Bone Marrow\" algorithm to generate VNCa color-coded images of the bone marrow. The diagnostic performance of DECT in detecting BME was assessed through visual qualitative evaluation and objective quantitative analysis.</p><p><strong>Results: </strong>Visual qualitative assessment analysis showed good agreement between the results of BME analysis on virtual non-calcium images and MRI images by both physicians (Kappa > 0.61). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of visual qualitative assessment for BME by Physicians A and B were as follows: iliac facet [(92.5%, 88.6%, 88.1%, 92.9%, 90.5%), (90.0%, 90.9%, 90.0%, 90.9%, 90.5%)], sacral facet [(88.4%, 87.8%, 88.4%, 87.8%, 88.1%), (90.7%, 85.3%, 86.7%, 89.7%, 88.1%)].In terms of objective quantitative analysis, the CT values of the edematous areas on the iliac and sacral surfaces were (-41.4 ± 15.9) Hu and (-38.8 ± 19.7) Hu, respectively, while the CT values of normal bone marrow areas were (-79.6 ± 18.2) Hu and (-72.8 ± 14.8) Hu, respectively. The CT values of the edematous areas were higher than those of the non-edematous areas. Based on the receiver operating characteristic curve analysis, the area under the curve for the iliac and sacral surfaces were 0.90 and 0.89, respectively. The optimal CT cutoff values were - 57.4 Hu and - 56.8 Hu, with corresponding sensitivities of 92.5% and 86.4% and specificities of 90.7% and 87.8%.</p><p><strong>Conclusion: </strong>The DECT VNCa technique has a high diagnostic efficacy in the diagnosis of BME in the sacroiliac joints in ankylosing spondylitis in terms of visual qualitative assessment and objective quantitative analysis.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"28"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950465","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":"circ_0075048 silencing regulates LCP1 to improve IL-1β-induced chondrocyte injury by binding with miR-663b.","authors":"Pin Zhang, Ru Pei, Quanhu Shen","doi":"10.1186/s13018-025-05449-0","DOIUrl":"10.1186/s13018-025-05449-0","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a common type of degenerative arthropathy. Previous studies have demonstrated that circular RNAs (circRNAs) are involved in the progression of OA. This study aimed to investigate the role and associated mechanism of circ_0075048 in OA.</p><p><strong>Methods: </strong>The expression of circ_0075048 was analyzed based on the Gene Expression Omnibus dataset GSE178724. Human chondrocytes were stimulated with IL-1β to establish an in vitro OA model. Bioinformatic analysis was performed to identify target genes of circ_0075048. The expression of circ_0075048, miR-663b, and LCP1 was detected by quantitative reverse transcription-polymerase chain reaction. The cell viability and apoptosis of C28/I2 cells were determined using Cell Counting Kit-8 assay and flow cytometry. Protein expression was detected using western blotting.</p><p><strong>Results: </strong>The expression of circ_0075048 was up-regulated in IL-1β-induced chondrocytes. circ_0075048 silencing promoted the viability of and inhibited the apoptosis of and extracellular matrix (ECM) production of chondrocytes. circ_0075048 was found to be a sponge of miR-663b and LCP1 was found to be a target of miR-663b. circ_0075048 silencing increased miR-663b expression but decreased LCP1 expression levels in chondrocytes. An miR-663b inhibitor eliminated the protective effect of a circ_0075048 small interfering RNA (siRNA) on chondrocytes. However, an LCP1 siRNA abolished the effect of the miR-663b inhibitor on chondrocytes.</p><p><strong>Conclusion: </strong>circ_0075048 silencing inhibited the apoptosis of and ECM degradation in IL-1β-induced chondrocytes by regulating miR-663b/LCP1 axis.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"24"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950462","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":"Dynamic biomechanical effects of medial meniscus tears on the knee joint: a finite element analysis.","authors":"Zuming Mao, Qiang Yang, Xiangyu Meng, Dong Jiang, Feng Zhao","doi":"10.1186/s13018-024-05401-8","DOIUrl":"10.1186/s13018-024-05401-8","url":null,"abstract":"<p><strong>Background: </strong>Meniscus tears can change the biomechanical environment of the knee joint and might accelerate the development of osteoarthritis. The aim of this study was to investigate the dynamic biomechanical effects of different medial meniscus tear positions and tear gaps on the knee during walking.</p><p><strong>Methods: </strong>Seven finite element models of the knee joint were constructed, including the intact medial meniscus (IMM), radial stable tears in the anterior, middle, and posterior one-third regions of the medial meniscus (RSTA, RSTM, RSTP), and the corresponding unstable tears (RUTA, RUTM, RUTP). The seven models applied a 1000 N axial static load and a human walking load, as defined by the ISO14243-1 standard.</p><p><strong>Results: </strong>Compared with the results under static loading, the axial load ratio of the medial and lateral compartments was redistributed (ranging from 0.7:1 to 2.9:1). The stress concentration was in the middle and posterior portions of the lateral compartment, not in the anterior and middle portions of the medial compartment under dynamic analysis. Compared with that of the IMM, the maximum von Mises stress on the medial meniscus increased by approximately 24.68-57.14% in the RUTA, RUTM, and RSTM models, with a greater difference observed in the hoop stress on both sides of the radial tear. The peak radial tear gap appeared at GC6 and GC44, and the tear gap remained at a high level from GC30-GC60.</p><p><strong>Conclusions: </strong>Radial tears should be considered for repair, and reinforced sutures should be placed on the anterior or middle regions of the meniscus. Greater attention should be given to the dynamic biomechanical effects on the knee joint during preoperative diagnosis and postoperative rehabilitation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"26"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950466","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 effect of mesenchymal stem cell-derived exosome therapy for periodontal regeneration: a systematic review and meta-analysis of preclinical trials.","authors":"Liping Zhou, Wenjia Cai, Yuhan Zhang, Wenjie Zhong, Ping He, Jingsong Ren, Xiang Gao","doi":"10.1186/s13018-024-05403-6","DOIUrl":"10.1186/s13018-024-05403-6","url":null,"abstract":"<p><strong>Background: </strong>To assess the therapeutic effects of mesenchymal stem cell (MSC)-derived exosome therapy on periodontal regeneration and identify treatment factors associated with enhanced periodontal regeneration in recent preclinical studies.</p><p><strong>Methods: </strong>Searches were conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases until October 10, 2024. A risk of bias (ROB) assessment was performed using the SYRCLE tool. Osteogenic-related parameters were used as the primary outcome measures.</p><p><strong>Results: </strong>In total, 1360 articles were identified, of which 17 preclinical studies were based on MSC-derived exosome therapy, and they demonstrated a beneficial effect on BV/TV (SMD = 13.99; 95% Cl = 10.50, 17.48; p < 0.00001), CEJ-ABC (SMD = -0.22; 95% Cl = -0.31, -0.13; p < 0.00001), BMD (SMD = 0.29; 95% Cl = 0.14, 0.45; p = 0.0002), and Tp.Sp (SMD = -0.08; 95% Cl= -0.15, -0.02; p = 0.02) compared with the control group. However, no significant differences were observed in Tp.Th (SMD = 0.03; 95% CI = 0.00, 0.07; p = 0.09) between the exosome-treated group and control group. Additionally, subgroup analysis indicated that preconditioned exosomes (p = 0.03) significantly improved BV/TV. In contrast, there were no significant differences in the enhancement of BV/TV with respect to the application method (p = 0.29), application frequency (p = 0.10), treatment duration (p = 0.15), or source of MSCs (p = 0.31).</p><p><strong>Conclusions: </strong>MSC-derived exosomes show great promise for enhancing the quality of periodontal regeneration. However, more standardized and robust trials are needed to reduce heterogeneity and bias across studies and to confirm the therapeutic parameters associated with the enhancement of periodontal regeneration by MSC-derived exosomes.</p><p><strong>Registration: </strong>CRD42024546236.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"27"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950407","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":"Integrated bioinformatics analysis and experimental validation of exosome-related gene signature in steroid-induced osteonecrosis of the femoral head.","authors":"Renqun Mao, Wen Bi, Mengyue Yang, Lei Qin, Wenqing Li","doi":"10.1186/s13018-025-05456-1","DOIUrl":"10.1186/s13018-025-05456-1","url":null,"abstract":"<p><strong>Background: </strong>Steroid-induced osteonecrosis of the femoral head (SIONFH) is a universal hip articular disease and is very hard to perceive at an early stage. The understanding of the pathogenesis of SIONFH is still limited, and the identification of efficient diagnostic biomarkers is insufficient. This research aims to recognize and validate the latent exosome-related molecular signature in SIONFH diagnosis by employing bioinformatics to investigate exosome-related mechanisms in SIONFH.</p><p><strong>Method: </strong>The GSE123568 and GSE74089 datasets were employed to conduct differentially expressed genes (DEGs) analysis, and the GSE123568 dataset was subjected to perform weighted genes co-expression network analysis (WGCNA). The exosome-related genes (ERGs) were retrieved from the GeneCards database. We identified differentially expressed exosome-related genes (DEERGs) between healthy controls (HC) and SIONFH patients, and a consensus clustering analysis was then implemented to group the SIONFH patients. The CIBERSORT was implemented to calculate the immune cell infiltration. Gene Set Variation Analysis (GSVA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) were conducted to investigate latent enriched pathways. In addition, machine-learning algorithms were applied to refine the DEERGs. Ultimately, we verified the diagnostic significance and expression of the hub genes using the SIONFH datasets and performing quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis.</p><p><strong>Results: </strong>This study identified twenty DEERGs from the peripheral serum and hip articular cartilage samples of SIONFH patients and HC. Two SIONFH subtypes related to ERGs were identified, and distinctions in pathways and immune cell infiltration patterns were compared. SIONFH's high-risk subpopulation exhibited enriched immune-related pathways and high immune cell infiltration, such as M0 macrophages, resting mast cells, and neutrophils. Three machine-learning algorithms then determined LCP1, PNP, UBE2V1, and ZFP36 as four exosome-related hub genes (ERHGs). Compared to HC samples, these ERHGs showed excellent diagnostic efficiency (overall AUC for ERHGs is in the range of 0.923 to 0.970 in GSE123568) in SIONFH samples. LCP1, PNP, UBE2V1, and ZFP36 expressions were validated in the GSE123568 and GSE74089 datasets and finally detected in peripheral serum samples with accordant expression by RT-qPCR.</p><p><strong>Conclusion: </strong>Twenty potential exosome-related genes involved in SIONFH were identified through bioinformatics analysis. LCP1, PNP, UBE2V1, and ZFP36 might become candidate biomarkers and therapeutic targets because they have an intimate relationship with exosomes. These findings shed light on the exosome-related acquaintance of SIONFH and might contribute to the diagnosis and prognosis of SIONFH.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"29"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950469","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 sintering of osteoporotic vertebral fractures on the sagittal lumbar profile and degenerative changes.","authors":"Christoph Beyersdorf, Max Prost, Melanie Elisabeth Röckner, Uwe Martin Maus, Cornelius Jacobs, Max Joseph Scheyerer","doi":"10.1186/s13018-025-05454-3","DOIUrl":"10.1186/s13018-025-05454-3","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis, a skeletal disorder affecting nearly 20% of the global population, poses a significant health concern, with osteoporotic vertebral body fractures (VBF) representing a common clinical manifestation. The impact of osteoporotic sintering fractures in the thoracolumbar spine on the sagittal lumbar profile is incompletely understood and may lead to the onset of clinical symptoms in previously asymptomatic patients.</p><p><strong>Methods: </strong>This retrospective single-center study analyzed data from patients presenting with osteoporotic spine fractures between 2017 and 2022. Patient selection involved stringent inclusion and exclusion criteria, focusing on radiologically documented osteoporotic sintering fractures in the thoracolumbar junction (TH11-L2). Clinical parameters were recorded and analyzed, alongside lateral-view radiographic assessments utilizing the IDS 7-PACS^®-System (Sectra, Linköping, Sweden). Measurements included total lumbar lordosis, lordosis caudal to the fracture, kyphosis of the fractured vertebra, and sacral slope. Statistical analysis was conducted using SPSS 27 (IBM, Armonk, USA).</p><p><strong>Results: </strong>Thirty patients (73.3% female, 26.7% male) met the inclusion criteria, with an average age of 82.4 years. Analysis revealed a significant increase in kyphosis of the fractured vertebra in the thoracolumbar spine (p < 0.0001) following further sintering of osteoporotic VBF with increased lordosis caudal to the fracture (p < 0.0001). Total lumbar lordosis remained unchanged, alongside sacral slope measurements (p = 0.612 and p = 0.863, respectively).</p><p><strong>Conclusion: </strong>Progressive sintering of osteoporotic fractures in the thoracolumbar junction accentuates lordosis in underlying segments, potentially exacerbating degenerative changes and symptomatic manifestations. Thus, prioritizing interventions aimed at preventing progressive sintering and restoring sagittal balance is paramount in optimizing treatment outcomes for affected individuals.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"23"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11716212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950402","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":"Correction: Correlation and diagnostic performance of metal ions in patients with pseudotumor after MoM hip arthroplasty: a systematic review and meta-analysis.","authors":"He-Xi Li, Qing-Yi Zhang, Ning Sheng, Hui-Qi Xie","doi":"10.1186/s13018-024-05359-7","DOIUrl":"10.1186/s13018-024-05359-7","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"22"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950464","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":"Combining an internal tension relieving technique with anterior cruciate ligament reconstruction (ACLR) reduces graft failure rate and improves functional outcomes: a systematic review and meta-analysis.","authors":"Yixin Wen, Wei Huang, Minghui Li, Yong Jiang, Yibo Tong, Hongjun Mei, Junfeng Tan","doi":"10.1186/s13018-025-05451-6","DOIUrl":"10.1186/s13018-025-05451-6","url":null,"abstract":"<p><strong>Purpose: </strong>Graft rupture is a significant cause of graft failure in anterior cruciate ligament reconstruction (ACLR). To address this issue, clinicians have combined the internal tension relieving technique (ITRT) with ACLR to improve graft stiffness, aiming to reduce the risk of graft failure. The purpose of this study is to compare the graft failure rates and clinical functional outcomes between ITRT-assisted ACLR and conventional ACLR.</p><p><strong>Methods: </strong>Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search was conducted in databases including Ovid, PubMed, Web of Science, Embase, Cochrane Library, Wanfang Data, CNKI, and VIP Medical Database for clinical controlled trials comparing the ITRT combined with ACLR to conventional ACLR. The search period spanned from the establishment of the databases to September 2024. Studies meeting the inclusion and exclusion criteria were selected, with two independent reviewers conducting literature screening, quality assessment, and data extraction. Data analysis was performed using RevMan 5.4 software. The evaluated outcomes included graft failure rate, Lysholm Knee Scoring Scale, Tegner activity score, Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, Visual Analog Scale (VAS) score, Single Assessment Numeric Evaluation (SANE), return to sport (RTS) rate, and knee joint laxity.</p><p><strong>Results: </strong>A total of 11 studies were included in the final analysis, with 1,339 patients (592 patients with ITRT-assisted ACLR and 747 patients with conventional ACLR). The combined analysis results indicated that, compared to conventional ACLR, ITRT-assisted ACLR showed significant advantages in reducing graft failure rates (RR = 0.44; 95% CI: 0.23, 0.83; P = 0.01), increasing return-to-sport rates (MD = 1.75; 95% CI: 1.05, 2.91; P = 0.03), and improving knee scores (including KOOS score and Tegner activity score) (all P values < 0.05). However, no significant differences were observed between the two approaches in terms of Lysholm knee score, VAS score, IKDC score, and knee joint laxity.</p><p><strong>Conclusions: </strong>This meta-analysis highlighted the significance and superiority of combining ITRT with ACLR compared to conventional ACLR, particularly in reducing graft failure rate and improving knee function outcomes. The ITRT-assisted ACLR procedure may represent the optimal approach for minimizing graft failure. However, given the limitations of short-term follow-up and reliance on retrospective studies, more randomized controlled trials and longer follow-up periods are needed to further evaluate the long-term graft failure rates and functional outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"19"},"PeriodicalIF":2.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950463","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":"Mid-term outcomes of the modified Dunn procedure for slipped capital femoral epiphysis: results from a north African pediatric hip unit.","authors":"Mohammad Kamal Abdelnasser, Ahmed Abdelazim Hassan, Mohammed Ibrahim, Abdelkhalek Hafez Ibrahim, Nariman Abol Oyoun","doi":"10.1186/s13018-024-05369-5","DOIUrl":"https://doi.org/10.1186/s13018-024-05369-5","url":null,"abstract":"<p><strong>Background: </strong>Slipped Capital Femoral Epiphysis (SCFE) is a prevalent pediatric orthopedic condition. Treatment options range from in situ pinning to various osteotomies, with the Modified Dunn procedure gaining significant attention over the past two decades. However, the suitability of this procedure for different SCFE subtypes and the risk of avascular necrosis (AVN), particularly in moderate and severe cases, remains controversial. This study aims to report the midterm clinical and radiographic outcomes of the Modified Dunn procedure in treating SCFE, emphasizing the factors contributing to AVN development.</p><p><strong>Patients and methods: </strong>We conducted a prospective case series between 2014 and 2022, enrolling patients with moderate and severe SCFE who were treated using the Modified Dunn procedure by a single experienced hip surgeon. Patients were followed up clinically and radiologically for a minimum of two years.</p><p><strong>Results: </strong>Thirty-six patients (29 males, 7 females) with moderate and severe SCFE were included, with an average age of 14 years and a mean follow-up of 49.28 months (range: 24-118 months). Statistically significant improvements were observed in clinical and radiographic parameters at the final follow-up compared to pre-operative data. Five patients developed AVN, though no specific risk factor reached statistical significance regarding AVN development. While most AVN cases occurred early in the learning curve, this trend was not statistically significant.</p><p><strong>Conclusion: </strong>Modified Dunn is a safe and effective option for treating moderate to severe SCFE, offering superior femoral head realignment and patient-reported outcomes. When performed by experienced surgeons, it results in acceptable complication rates, including AVN.</p><p><strong>Level of evidence: </strong>Level IV Prospective Case series.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"14"},"PeriodicalIF":2.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950390","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}