Journal of Orthopaedic Surgery and Research最新文献

{"title":"Experimental study of radial extracorporeal shock wave therapy for periprosthetic osteolysis induced by wear particles.","authors":"Fengnian Zhao, Yufei Chen, Ao Dong, Keguan Song","doi":"10.1186/s13018-025-05661-y","DOIUrl":"10.1186/s13018-025-05661-y","url":null,"abstract":"<p><p>Radial Extracorporeal Shock Wave Therapy (rESWT) is applied as a conservative treatment modality in orthopedics, yet its effectiveness in addressing aseptic loosening of cementless joint prostheses remains unclear. Through animal experimentation, we have revealed that in a titanium particle-induced osteolysis rat model, rESWT intervention significantly increased periprosthetic bone density compared to untreated controls, concurrently reducing osteolytic lesion area and lowering serum IL-1β levels. Histological analyses demonstrated a relative decrease in osteoclast counts within the treatment group versus non-treated controls. These findings indicate that rESWT, through mechanisms involving anti-inflammatory actions and suppression of osteoclastogenesis, may serve as a non-invasive therapeutic strategy for preventing and managing periprosthetic bone loss, demonstrating clinical potential to delay or eliminate the necessity for revision surgeries.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"282"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625185","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":"Global trends and hotspots of neuromodulation in spinal cord injury: a study based on bibliometric analysis.","authors":"Shutao Gao, Yukun Hu, Shizhe Li, Wei Li, Weibin Sheng","doi":"10.1186/s13018-025-05674-7","DOIUrl":"10.1186/s13018-025-05674-7","url":null,"abstract":"<p><strong>Objective: </strong>Spinal cord injury (SCI) is a debilitating condition that can result in permanent disability. Neuromodulation is a promising technology that has gained popularity as a treatment for SCI. This study aims to analyze the published literature to investigate the global trends and hotspots in research on neuromodulation in the context of SCI.</p><p><strong>Methods: </strong>All relevant publications on the topic of neuromodulation in SCI from January 1, 2005, to September 17, 2024, were acquired from the Web of Science Core Collection database. Bibliometric analysis was performed to evaluate the publication distribution by country, institution, author, and journal, as well as keyword, using CiteSpace, VOSviewer, and Scimago Graphica software.</p><p><strong>Results: </strong>Overall, 3,211 publications were eligible for inclusion in the analysis. The publication number in 2005 and 2024 were 77 and 222, respectively. A steady increasing trend in the publication number over the past two decades was observed. The Unites States published 1544 articles with 52,521 citations, ranking first regarding publication number and total citations. Case Western Reserve University was the most productive institution that published 181 papers. All of the highly productive institutions were located in the United States, Canada, and Australia. The University of California Los Angeles harvested 6626 total citations and 81.8 average citations, ranking first among the productive institutions. Gorgey AS published 60 articles and ranked first regarding total publication number. Edgerton VR harvested 4333 citations and ranked first among the authors for total citations. The analysis of high-yielding journals suggested that Journal of Spinal Cord Medicine was the most productive journal with 133 publications. Spinal Cord yielded 4200 citations and ranked first among the journals for total citations. The keyword analysis identified \"functional electrical stimulation\" and \"spinal cord stimulation\" as research hotspots.</p><p><strong>Conclusion: </strong>This study delineates the current knowledge landscape and research trends on the topic of neuromodulation in SCI. The findings highlight the growing interest in this field and underscore the significance of neuromodulation in SCI research.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"275"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625186","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":"Mogroside V enhances bone marrow mesenchymal stem cells osteogenesis under hyperglycemic conditions through upregulating miR-10b-5p and PI3K/Akt signaling.","authors":"Dongni Lan, Kongmei Li, Zhimao Ye, Yicai Luo, Cuiping Li, Hao Li","doi":"10.1186/s13018-025-05684-5","DOIUrl":"10.1186/s13018-025-05684-5","url":null,"abstract":"<p><strong>Background: </strong>Mogroside V (MV) is a triterpene glucoside that reportedly exhibits an array of antitumor, anti-inflammatory, hypolipidemic, and hypoglycemic properties. In prior studies, our group determined that MV was able to readily enhance osteogenic bone marrow mesenchymal stem cells (BMSCs) differentiation under high-glucose conditions through mechanisms potentially associated with miR-10b-5p and PI3K/Akt signaling activity. The precise molecular basis for these effects, however, remains to be fully elucidated.</p><p><strong>Objective: </strong>This study aims to explore the potential mechanisms by which MV regulates the osteogenic differentiation of BMSCs under hyperglycemic conditions.</p><p><strong>Methods: </strong>Femoral and tibial BMSCs were isolated from control and diabetic C57BL/6J mice. qRT-PCR was used to quantify miR-10b-5p levels. Putative miR-10b-5p target genes were predicted through bioinformatics assays and validated in a luciferase reporter assay system. miR-10b-5p expression was inhibited with an antagomiR-10b-5p construct, while PI3K/Akt pathway signaling was inhibited with LY294002. Western blotting was used to detect PI3K/Akt pathway and target gene protein levels, while Alizarin red staining was used to detect calcium nodule deposition by BMSCs.</p><p><strong>Results: </strong>miR-10b-5p upregulation was noted in BMSCs exposed to hyperglycemic conditions. HOXD10 was identified as a cell differentiation-related miR-10b-5p target gene in bioinformatics analyses, and the targeting relationship between the two was confirmed in a luciferase reporter assay. MV treatment elicited significantly higher levels of miR-10b-5p expression, PI3K phosphorylation, and calcium deposition, while antagomiR-10b-5p or LY294002 treatment reversed these changes, and the opposite trends were observed with respect to HOXD10 protein levels.</p><p><strong>Conclusion: </strong>MV favors BMSCs osteogenic differentiation under high-glucose conditions through the upregulation of miR-10b-5p and the activation of PI3K/Akt signaling.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"278"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625189","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":"miR-374-5p inhibits osteogenesis by targeting PTEN/PI3K/AKT signaling pathway.","authors":"Guangning Long, Fen Liu, Hongmeng Cheng, Jun Guo, Pei Wang, Yunfei Luo, Zhihua Li, Fei Tong","doi":"10.1186/s13018-025-05670-x","DOIUrl":"10.1186/s13018-025-05670-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the effects of miR-374-5p on osteogenesis in rat osteoblasts, validate its target on PTEN, and explore its role in the PTEN/PI3K/AKT signaling pathway during osteoblast differentiation.</p><p><strong>Methods: </strong>We transfected 293T cells with miR-374-5p mimics and inhibitors, followed by Western blot and qRT-PCR analyses to assess protein and mRNA expression levels. A dual-luciferase assay was performed to confirm direct targeting. Markers of osteoblast function, such as Runx2, OSX, and OCN, were examined in osteoblasts from rats by qRT-PCR and Western blot. Additionally, we developed a lentiviral vector to overexpress miR-374-5p, which successfully infected rat osteoblast progenitors. Bone formation was subsequently assessed using Alizarin Red staining and ALP activity assays. Finally, rescue experiments were conducted to validate the involvement of the miR-374-5p/PTEN/PI3K/AKT signaling pathway.</p><p><strong>Results: </strong>Our results demonstrate that miR-374-5p significantly downregulates both the protein and mRNA levels of its target gene PTEN, as confirmed by dual luciferase assays. qRT-PCR and Western blot analyses revealed that osteoblastic markers-including Runx2, OSX, and OCN-were markedly reduced in the miR-374-5p mimic group, whereas an opposite trend was observed in the inhibitor group. In vitro, overexpression of miR-374-5p suppressed osteoblast differentiation, as evidenced by decreased calcium nodule formation and reduced ALP activity compared to controls. Furthermore, co-transfection of miR-374-5p mimics with the PI3K/AKT pathway inhibitor LY294002 in osteoblasts led to significantly lower expression of PI3K/AKT pathway-related genes, and notably, the inhibitory effect of miR-374-5p on osteoblast differentiation was reversed by LY294002 treatment.</p><p><strong>Conclusion: </strong>Our findings indicate that miR-374-5p inhibits osteogenesis in rat osteoblasts by targeting PTEN and modulating the PI3K/AKT signaling pathway.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"283"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633791","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":"Research on the biomechanical characteristics of the tibiofemoral joint before and after kinematic alignment unicompartmental knee arthroplasty.","authors":"Chong Li, Mengyu Chen, XiangYing Wang, SongHua Yan, Kuan Zhang, Ji Zhou Zeng","doi":"10.1186/s13018-025-05659-6","DOIUrl":"10.1186/s13018-025-05659-6","url":null,"abstract":"<p><strong>Background: </strong>Kinematic alignment (KA) unicompartmental knee arthroplasty (UKA), which has not been widely adopted in clinical practice, aims to implant a more personalized and physiologically compatible mobile-bearing UKA prosthesis for the treatment of advanced single compartment knee osteoarthritis. KA UKA is anticipated to enhance patient satisfaction and decrease the revision rate following UKA. However, its quantified biomechanical indicators remain unclear. The purpose of this study is to reveal the biomechanical characteristics of the tibiofemoral joint in normal and KA UKA knees, and to evaluate the biomechanical effect.</p><p><strong>Methods: </strong>In this study, six cadaveric knee joint specimens were utilized for biomechanical testing before (normal cadaveric knee joint specimen ) and after KA UKA. The knee joint specimens were subjected to an axial load of 1000 N, and the biomechanical parameters were assessed at flexion angles ranging from 0° to 120° in 10° increments.</p><p><strong>Results: </strong>The root mean square (RMS) values of the tibiofemoral contact area, mean contact pressure, and peak contact pressure during knee flexion were 529 mm², 1.8 MPa, and 4.5 MPa in normal knees, respectively. After KA UKA, these values changed to 449 mm², 2.0 MPa, and 9.8 MPa, respectively. Additionally, the RMS value of the external rotation of the femur relative to the tibia in the tibiofemoral joint was 9.9° in normal knees, while the posterior translations of the center of the femoral condyle, the medial femoral condyle, and the lateral femoral condyle were 18.4 mm, 11.5 mm, and 25.4 mm respectively. After KA UKA, these values changed to 8.6°, 19.3 mm, 12.9 mm, and 25.9 mm respectively.</p><p><strong>Conclusion: </strong>At the same flexion angle, the increase in peak contact pressure in the medial compartment after KA UKA is the most significant compared with the normal knees. However, the kinematic characteristics do not change significantly after KA UKA. These findings are beneficial for understanding the possible postoperative complications and good functional effects of KA UKA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"277"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625132","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":"Robot-assisted total knee arthroplasty is more precise than conventional total knee arthroplasty in restoring knee, but not ankle alignment: a retrospective study based on imaging data.","authors":"Hongxu Li, Haoyang Liu, Yu Zhou, Bailiang Wang, Jinhui Ma","doi":"10.1186/s13018-025-05678-3","DOIUrl":"10.1186/s13018-025-05678-3","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis often leads to varus deformity, disrupting lower limb alignment and potentially causing ankle osteoarthritis. While total knee arthroplasty (TKA) can correct knee alignment and improve ankle alignment, the impact of different alignment strategies on the ankle remains unclear. This study investigates whether robot-assisted functional alignment (RA-FA) offers advantages over conventional mechanical alignment (CM-MA) in correcting ankle alignment, addressing the paucity of evidence on the impact of alignment strategies on distal joint biomechanics.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on radiographic data from 202 patients with primary knee osteoarthritis who underwent TKA. Patients were divided into two groups based on the surgical approach: CM-MA group and RA-FA group, with 101 patients in each group. Using preoperative and postoperative full-length lower limb X-rays, multiple coronal radiographic parameters of the knee and ankle joints were measured. The correlation between knee and ankle alignments was assessed. Patients were further subgrouped based on the type of knee varus deformity, and differences in alignment correction between CM-MA and RA-FA within these subgroups were analyzed.</p><p><strong>Results: </strong>Preoperatively, there were no significant differences in radiographic parameters of the knee and ankle between the two groups. Postoperatively, the RA-FA group showed superior correction in HKA and mLDFA compared to the CM-MA group. However, no statistically significant differences were observed between the two groups regarding ankle alignment correction. Subgroup analysis revealed that RA-FA was more effective in correcting knee alignment in specific subgroups. Nevertheless, even in these subgroups, RA-FA did not demonstrate a significant advantage over CM-MA in correcting ankle alignment.</p><p><strong>Conclusion: </strong>This study highlights the close relationship between knee and ankle alignments and confirms that TKA can improve ankle alignment. While RA-FA allows for more precise adjustments in femoral osteotomy and implant positioning, it does not significantly improve ankle alignment compared to CM-MA. Future studies should investigate the long-term effects of TKA on ankle alignment and evaluate whether other alignment strategies or different types of prostheses may influence the prognosis of the ankle or more distal joints such as the subtalar joint.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"281"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625134","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":"Exploring the dynamics of stability and lumbar proprioception in hypermobility syndrome: a comparative and mediation analysis.","authors":"Mohammad A ALMohiza, Ravi Shankar Reddy","doi":"10.1186/s13018-025-05683-6","DOIUrl":"10.1186/s13018-025-05683-6","url":null,"abstract":"<p><strong>Background: </strong>HMS is characterized by excessive joint mobility, presenting various physical and psychological challenges. Understanding the interplay between these factors is essential for effective HMS management. This study aimed to examine differences in Limits of Stability (LOS) and lumbar proprioception between Hypermobility Syndrome (HMS) and control groups, explore correlations between LOS and proprioception errors, and understand the mediation effects of Kinesiophobia and fatigue on proprioception in HMS individuals.</p><p><strong>Methods: </strong>In this cross-sectional study, 72 HMS patients and 72 control participants were assessed. LOS was evaluated using a computerized Iso-free stabilometric force platform, lumbar proprioception was measured with digital inclinometers, and Kinesiophobia was quantified using the Tampa Scale of Kinesiophobia (TSK). Fatigue was assessed through standardized fatigue scales. Pearson correlation and mediation analyses were employed for statistical examination.</p><p><strong>Results: </strong>Individuals with HMS showed significantly lower LOS (mean differences ranging from 7.79 to 37.69%) and higher lumbar proprioception errors (mean differences from - 1.09° to -2.88°) compared to the control group. Moderate negative correlations between LOS and proprioception errors were observed (r values from - 0.45 to -0.60). Mediation analysis revealed significant roles of Kinesiophobia (indirect coefficient = -0.14, p = 0.049) and fatigue (indirect coefficient = -0.135, p = 0.047) in the relationship between LOS and proprioception.</p><p><strong>Conclusion: </strong>This study highlights significant balance and proprioception deficits in HMS individuals, with substantial mediation effects of psychological and physical factors. These findings emphasize the need for an integrated approach in HMS management, combining physical therapy with psychological interventions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"285"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633627","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 effectiveness of kinesiotaping in treating chronic lateral epicondylitis: a randomized, sham-controlled, single-blind study.","authors":"Halil Ekrem Akkurt, Ramazan Yilmaz, Fatma Sümeyye Suna, Savaş Karpuz, Halim Yilmaz","doi":"10.1186/s13018-025-05658-7","DOIUrl":"10.1186/s13018-025-05658-7","url":null,"abstract":"<p><strong>Objectives: </strong>Kinesiotaping (KT), with its non-restrictive nature, is a preferred treatment option, yet there remains insufficient evidence regarding its effectiveness in managing lateral epicondylitis (LE). This study aims to investigate the efficacy of KT on pain intensity, functional status, and quality of life in patients with chronic LE.</p><p><strong>Methods: </strong>Between February and August 2024, 42 patients (17 females, 25 males; mean age: 44.5 ± 9.1 years; range: 27-61) with chronic LE were included in this single-blind, parallel-group randomized controlled trial (RCT). Patients were randomized into either the KT or sham-controlled group. Kinesiotaping and sham-taping were applied six times over three weeks. Both groups received recommendations for activity modification and a home-based stretching and strengthening exercise program. Outcome measures were the visual analog scale (VAS) pain score; the Patient-Rated Forearm Evaluation Questionnaire (PRFEQ); grip strength; Disabilities of Arm, Shoulder, and Hand (DASH); quality of life in Short Form-36 (SF-36), and the Roles and Maudsley patient satisfaction score. The participants were assessed before treatment, at the end of treatment (week three), and four weeks after the end of treatment (week seven).</p><p><strong>Results: </strong>Both groups showed improvements from the baseline in all outcome parameters. At the third and seventh week follow-up, KT was superior to sham-taping in all outcome measures, except for two SF-36 subscales, with effect sizes further supporting the clinical relevance of these findings by indicating meaningful differences in favor of KT.</p><p><strong>Conclusions: </strong>The results of the present study suggest that KT using the epidermis, dermis, fascia (EDF), and muscle inhibition technique effectively reduces pain, improves disability and quality of life, and achieves high patient satisfaction levels without any adverse effects in LE.</p><p><strong>Clinicaltrials: </strong>gov identifer: NCT06611709.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"274"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625139","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":"miR-138-5p inhibits healing of femoral fracture osteogenesis in rats by modulating osteoblast differentiation via SIRT1/FOXO1 axis.","authors":"Guangming Dai, Wei Jiang, Bo Feng, Lan Zhang","doi":"10.1186/s13018-025-05667-6","DOIUrl":"10.1186/s13018-025-05667-6","url":null,"abstract":"<p><strong>Background: </strong>MicroRNAs have a crucial part to play in maintaining bone formation, signaling, and repair. This research explored the involvement miR-138-5p in modulating osteoblast differentiation in femoral fractures model.</p><p><strong>Methods: </strong>The role of mir-138-5p in the healing process of femoral fractures in rats was assessed through micro computed tomography (CT) imaging. After that, qPCR was employed to identify the cellular mRNA expression levels of miR-138-5p, SIRT1, and FoxO1 in either the callus or MC3T3-E1. Next, the protein expression level of Runx2, OPN, OCN and ALP was determined by western blot or ELISA. A dual-luciferase reporter gene assay was implemented to examine the target of miR-138-5p. The quantity of mineralized nodules was measured by means of alizarin red staining.</p><p><strong>Results: </strong>The miR-138-5p inhibitor promotes the mending of femoral fractures. When it is knocked down, the osteogenic differentiation is promoted, which may be caused by the enhanced activity of ALP and the elevation of the expression of Runx2, OPN and OCN. Meanwhile, an increase in the expression of mir-138-5p impairs the biosynthesis of SIRT1 and FoxO1. When SIRT1 and FoxO1 were downregulated with shRNA, the effect caused by the mir-138-5p inhibitor could be reversed.</p><p><strong>Conclusion: </strong>Our studies uncovered that the overexpressed miR-138-5p might have an inhibitory role in femoral fractures healing by inactivating SIRT1/FOXO1 axis.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"280"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625188","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 accuracy of blood C-reactive protein and erythrocyte sedimentation rate in periprosthetic joint infections - A 10-year analysis of 1510 revision hip and knee arthroplasties from a single orthopaedic center.","authors":"Dariusz Grzelecki, Maciej Kocon, Rafał Mazur, Aleksandra Grajek, Jacek Kowalczewski","doi":"10.1186/s13018-025-05531-7","DOIUrl":"10.1186/s13018-025-05531-7","url":null,"abstract":"<p><strong>Background: </strong>Despite the availability of many highly accurate biomarkers and novel criteria, serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are still the basis for diagnosing periprosthetic joint infection (PJI). This study aims to analyze the influence of different demographical and clinical factors on the cut-off values and accuracy of CRP and ESR in diagnosing chronic PJI.</p><p><strong>Methods: </strong>A total number of 4757 patients (with ICD-10 codes T84.0 and T84.5) operated on between January 2014 to December 2023 in a single orthopaedic center were screened in terms of the inclusion and exclusion criteria. Finally, 1510 patients (1032 aseptic revisions and 478 periprosthetic joint infections [PJI]) were included in the analysis. The best cut-off values, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for both CRP and ESR for all cohort and for subgroups divided depending on the demographical (gender, joint and BMI) and clinical factors (prosthesis fixation, specific diagnostic criteria, and virulence of the bacteria) were calculated.</p><p><strong>Results: </strong>For all cohort, the best cut-off value for CRP was 9.6 mg/L with an area under the curve (AUC) of 0.93 and for ESR was 29 mm/h with the AUC of 0.891. For CRP the sensitivity was higher (84.9%) than for ESR (75.1%), with the same values of specificity (90.5% and 90.8%, respectively). According to the specific subgroups, for CRP higher sensitivity was observed for males (89.6%) than for females (82.6%) if lower thresholds were used. Similarly, when the higher cut-off value for CRP was applied, better specificity for high-virulent (94.8%) than for low-virulent pathogens (88.9%) was observed. For ESR, superior sensitivity values were observed if a fistula was observed, for lower BMI thresholds and for infections caused by high-virulent pathogens. Higher optimal threshold and better specificity were observed for knees than for hips, without the appearance of fistula, when minor criteria were used and infection was caused by high-virulent pathogens.</p><p><strong>Conclusions: </strong>Our study indicates better sensitivity for CRP than ESR and similar specificity values for diagnosing chronic PJI. If results oscillate close to 10 mg/L for CRP and between 25 and 30 mm/h for ESR we propose to use different cut-off values depending on the demographic and/or clinical factors to increase diagnostic accuracy.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"276"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625136","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}