Journal of Orthopaedic Surgery and Research最新文献

{"title":"Distal tubercle osteotomy in medial opening-wedge high tibial osteotomy is superior in rotational alignment changes compared to proximal tubercle osteotomy: a propensity score-matched analysis.","authors":"Hong Yeol Yang, Youzhen Zheng, Sung Ju Kang, Gyung Hwan Bae, Jong Keun Seon","doi":"10.1186/s13018-025-06256-3","DOIUrl":"10.1186/s13018-025-06256-3","url":null,"abstract":"<p><strong>Background: </strong>Rotational alignment changes following high tibial osteotomy (HTO) can alter patellofemoral joint biomechanics, potentially leading to adverse clinical outcomes. This study aimed to compare rotational alignment changes and clinical outcomes between two different types of biplanar medial opening-wedge HTO: proximal tubercle osteotomy (PT-HTO) and distal tubercle osteotomy (DT-HTO).</p><p><strong>Methods: </strong>A total of 178 patients who underwent medial opening-wedge HTO for medial compartment osteoarthritis between January 2020 and March 2023, with a minimum follow-up of two years, were retrospectively identified. Patients were stratified into two groups based on the direction of the second-plane osteotomy: PT-HTO (n = 136) and DT-HTO (n = 42). Propensity score matching was performed based on age, sex, body mass index, preoperative Kellgren-Lawrence grade, preoperative mechanical hip-knee-ankle angle, and correction angle, yielding 42 matched patients in each group. Radiological assessments were conducted using preoperative and postoperative lower extremity computed tomography scans. The primary outcome measure was the change in rotational alignment (tibial torsion angle, knee rotation angle, and knee-ankle rotation angle). Secondary outcomes included the tibial tuberosity-trochlear groove (TT-TG) distance and clinical outcomes assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Kujala score.</p><p><strong>Results: </strong>The mean tibial torsion angle significantly decreased in both groups compared to preoperative values, with reductions of - 3.8° in the PT-HTO group and - 1.4° in the DT-HTO group, with a marginally significant difference between the groups (p = 0.062). The knee rotation angle exhibited a greater reduction following PT-HTO than DT-HTO (- 2.4° vs. -1.4°; p = 0.046), indicating increased external rotation of the proximal fragment after PT-HTO. The TT-TG distance increased in the PT-HTO group but was preserved in the DT-HTO group, with a significant difference in mean change between the groups (2.1 mm vs. -0.2 mm; p < 0.001). Patellar height significantly decreased in the PT-HTO group, as reflected by reductions in the Blackburne-Peel ratio (- 0.14; p = 0.001) and Caton-Deschamps index (- 0.16; p < 0.001), whereas the DT-HTO group maintained preoperative patellar height. At a mean follow-up of 31.2 months, the DT-HTO group showed significantly better postoperative clinical outcomes, with higher KOOS pain scores (82.6 vs. 74.0; p = 0.030) and Kujala scores (72.3 vs. 65.7; p = 0.028) compared to the PT-HTO group.</p><p><strong>Conclusions: </strong>DT-HTO resulted in reduced rotational alignment changes and superior patellofemoral joint alignment compared to PT-HTO, leading to improved clinical outcomes.</p><p><strong>Level of evidence: </strong>Retrospective comparative study; Level III.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"833"},"PeriodicalIF":2.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149588","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":"Comprehensive profiling of immune cell infiltration and biomarker identification in intervertebral disc degeneration.","authors":"Yuanhao Wang, Bingtao Hu, Lijun Tian, Guowang Li, Baoshan Xu","doi":"10.1186/s13018-025-06250-9","DOIUrl":"10.1186/s13018-025-06250-9","url":null,"abstract":"<p><p>Intervertebral disc (IVD) homeostasis and function depend on the immunological privilege status, while immune cell infiltration constitutes a pivotal pathological driver of intervertebral disc degeneration (IDD). Nevertheless, the immune infiltration landscape and associated molecular targets in IDD remain elusive. We therefore integrated bioinformatic analysis of public datasets and single-cell RNA-sequencing analysis (scRNA-seq) data, flow cytometric (FACS) and experimental validation to delineate immune infiltration dynamics and identify therapeutic targets. CIBERSORT deconvolution analysis revealed significant increases in follicular helper T cells (p < 0.05) and M2 macrophages (p < 0.05) in IDD, with M1 macrophages demonstrating an upward trend. WGCNA showed that the blue module was associated with M1 macrophages infiltration (positive correlation 0.87, P < 0.001), among which VAMP8, JUN and others were mainly enriched in macrophage activation and myeloid leukocyte activation. FACS quantification established postoperative day 14 as the peak of leukocyte infiltration in rat IVDs following puncture. scRNA-seq resolved seven cellular subsets within degenerated rat IVDs: annulus fibrosus cells, smooth muscle cells, fibroblasts, macrophages, monocytes, vascular endothelial cells, and nucleus pulposus (NP) cells, with pronounced expression of Jun and Vamp8. Western blotting confirmed upregulated VAMP8 and JUN expression in TNF-α-stimulated (50 ng/ml, 24 h) NP cells. Immunohistochemistry further demonstrated elevated VAMP8 and JUN levels during rat IDD progression. This work identifies post-puncture day 14 as the critical window for peak immune infiltration in rat IVDs, and reveals VAMP8 and JUN are macrophage-associated regulators of IDD pathogenesis, thereby revealing promising targets for immunomodulatory interventions against disc degeneration.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"829"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137804","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-148a-3p regulates the fracture healing process by targeting MAFB.","authors":"Yongheng Li, Shuwei Yang, Ganggang Wang, Yingxuan Huang","doi":"10.1186/s13018-025-06223-y","DOIUrl":"10.1186/s13018-025-06223-y","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic vertebral fracture (OVF) is an extremely common fragile fracture in the elderly population.</p><p><strong>Aims: </strong>To explore the expression changes, clinical significance and mechanism of action of miR-148a-3p in the postoperative healing process of patients with OVF.</p><p><strong>Methods: </strong>185 OVF patients who received percutaneous vertebroplasty (PVP) treatment were selected as the research subjects. RT-qPCR was used to detect the expression levels of miR-148a-3p and genes. ROC curve analysis was applied to evaluate the relationship between miR-148a-3p and postoperative healing, as well as its diagnostic value for delayed healing. In vitro, miR-148a-3p overexpression and knockdown cell models were established to investigate its potential mechanism in fracture healing.</p><p><strong>Results: </strong>Serum miR-148a-3p expression in OVF patients was significantly higher than in healthy controls, and it gradually decreased over time after surgery. The expression of miR-148a-3p in the delayed healing group is significantly higher than that in the healing group, and it showed potential diagnostic value for delayed healing (AUC = 0.859). In addition, miR-148a-3p is an independent risk factor for delayed healing. In cell experiments, during the process of osteogenic induction, expression of miR-148a-3p decreased, while the expression of osteogenic markers increased. Mechanistically, miR-148a-3p directly targeted and inhibited MAFB expression; its upregulation suppressed cell proliferation and osteogenic marker expression, and these inhibitory effects were reversed by MAFB overexpression.</p><p><strong>Conclusions: </strong>miR-148a-3p inhibits osteoblast proliferation and differentiation by targeting and suppressing MAFB, participates in the post-OVF healing process.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"826"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137845","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":"Femoral head infarction: a case-control study of a rare complication.","authors":"Guanying Gao, Rongge Liu, Yichuan Zhu, Jiayang Liu, Jianquan Wang, Yan Xu","doi":"10.1186/s13018-025-06243-8","DOIUrl":"10.1186/s13018-025-06243-8","url":null,"abstract":"<p><strong>Background: </strong>To determine the prevalence of the femoral head infarction (FHI) following hip arthroscopy, explore potential contributing factors, and assess its influence on clinical outcomes.</p><p><strong>Methods: </strong>We evaluated consecutive patients who underwent hip arthroscopy in our hospital between May 2014 and May 2023 retrospectively. Patients underwent MRI at least one year after surgery. FHI was identified as large scale edema signal at the junction of the femoral head and neck in postoperative MRI. FHI were matched in a 1:3 cohort to the normal group based on sex, age, and body mass index (BMI). Preoperative patient-reported outcomes (PROs) and PROs at least one year after surgery were obtained.</p><p><strong>Results: </strong>A total of 372 patients were finally included in this study. In the MRI follow-up, it was discovered that ten patients (2.7%) had FHI. Patients in FHI group had significantly lower BMI than patients without FHI (P = 0.008). Patients in the FHI group did not show significant improvements in postoperative mHHS, iHOT-12, or VAS scores (P > 0.05). Patients in the FHI group demonstrated significantly lower postoperative mHHS and iHOT-12 scores, along with higher VAS scores (P < 0.05). In the FHI group, only 3 patients (30%) surpassed the MCID and achieved the PASS for mHHS, while no patients surpassed the MCID or achieved the PASS for iHOT-12. The proportion of patients who achieved the MCID or the PASS in the normal group was significantly higher than that in the FHI group (P < 0.05).</p><p><strong>Conclusion: </strong>Our study demonstrated that FHI could be a rare complication following hip arthroscopy. Patients with lower BMI are at a higher risk of developing postoperative FHI. The clinical outcomes for patients with FHI are poor, with no significant improvement in patient-reported outcomes observed.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"828"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137813","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":"Analysis of miR-151a-3p as a biomarker of osteoarthritis and its clinical value.","authors":"Xuchen Liu, Min Zhou, Dejian Yang, Lihua Gong, Xiong Chen, Zhiwei Zeng, Yingxuan Huang","doi":"10.1186/s13018-025-06228-7","DOIUrl":"10.1186/s13018-025-06228-7","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic strategies that focus on chondrocyte protection and matrix repair may represent a key direction for delaying the progression of osteoarthritis (OA).</p><p><strong>Aim: </strong>To evaluate miR-151a-3p as a biomarker for the diagnosis of OA and its potential mechanism of action.</p><p><strong>Materials and methods: </strong>RT-qPCR was used to determine miR-151a-3p and SOX9 expression levels in OA patients and lipopolysaccharide-induced OA (LPS-OA) cell model. The receiver operating characteristic (ROC) curve was used to analyze the clinical value of miR-151a-3p in the diagnosis of OA. A cell function experiment was conducted to investigate the impact of miR-151a-3p on cell viability and apoptosis levels in the LPS-induced OA cell model. Genecards and starBase were used to screen the target genes of miR-151a-3p. The dual luciferase reporter assay was used to verify the interaction between miR-151a-3p and SOX9.</p><p><strong>Results: </strong>The expression of miR-151a-3p was up-regulated in synovial fluid of OA patients and LPS-OA cell model. The ROC curve analysis and logistic regression analysis demonstrated that miR-151a-3p could be a potential biomarker for the diagnosis of OA and exhibited significant diagnostic value. Genecards and starBase databases screened 6 potential targets of miR-151a-3p. Dual luciferase reporter assay demonstrated that miR-151a-3p targeted SOX9. Cell function experiments demonstrated that suppressed miR-151a-3p can upregulate SOX9 expression, thereby enhancing LPS-OA cell activity, reducing apoptosis, and increasing extracellular matrix (ECM) production.</p><p><strong>Conclusion: </strong>MiR-151a-3p could be a biomarker for the diagnosis of OA and has high diagnostic value.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"832"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137885","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":"Optimal timing of bone marrow aspiration concentrate injection for tendon-bone healing in a chronic rat rotator cuff tear model.","authors":"Congyang Wang, Hao Zeng, Qiang Shi, Hua Jiang","doi":"10.1186/s13018-025-06253-6","DOIUrl":"10.1186/s13018-025-06253-6","url":null,"abstract":"<p><strong>Background: </strong>The Bone marrow aspirate concentrate (BMAC) injection is a beneficial therapy for bone-tendon interface (BTI) regeneration following rotator cuff (RC) repair. However, the optimal timing for BMAC injection remains undetermined. Injection at different timepoints may influence BTI regeneration.</p><p><strong>Methods: </strong>After concentrating bone marrow (BM) to obtain BMAC, the viability of cells, nucleated cell content, platelet count, stem cell number, and concentration of growth factors in both BM and BMAC were comparatively evaluated. Supraspinatus tendon tears were induced at the greater tuberosity in 152 Wistar rats. Three weeks after the tear induction, the rats following RC repair surgery were then randomly divided into four groups based on the timing of BMAC injection: PBS injected immediately during RC repair (PBS group), BMAC injected immediately (P0-BMAC group), on postoperative day 7 (P7-BMAC group), or day 14 (P14-BMAC group). Eight weeks after RC repair, the supraspinatus tendon-proximal humerus complexes were harvested for evaluating BTI regeneration using micro-CT, histological and biomechanical testing. Additionally, at the day 0, 3, 10, 17 after RC repair, the specimens were harvested for evaluating the inflammation and oxidative stress.</p><p><strong>Results: </strong>Cell viability in the BMAC exceeded 90%. The BMAC contained higher concentrations of platelets, nucleated cells, stem cells, TGFβ1, and IGF1 compared to BM. In vivo results demonstrated that the BMAC injection on postoperative day 7 had a more pronounced effect on BTI regeneration compared to other timepoints. Micro-CT analysis revealed that the new bone in the P7-BMAC group formed and remodelled significantly better than in the P14-BMAC, P0-BMAC, or PBS groups. Histologically, the P7-BMAC group exhibited a significantly higher rate of fibrocartilage regeneration at the RC healing site compared to the P14-BMAC, P0-BMAC, or PBS groups. Biomechanically, the P7-BMAC group showed significantly higher failure load and stiffness compared to the P14-BMAC, P0-BMAC, or PBS groups. Moreover, the P7-BMAC group showed significantly inhibiting inflammation and decreasing oxidative stress in the ST-proximal humerus complexes as compared with the other groups.</p><p><strong>Conclusions: </strong>BMAC injected at 7 days postoperatively is an optimal timing of the BMAC Injection for BTI regeneration in a chronic rat RCT model.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"830"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137825","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":"USP28 participates in high glucose-mediated endothelial dysfunction via deubiquitinating SIRT1 protein in diabetic foot ulcers.","authors":"Qiong Liu, Jin Zhang, Jichang Bai, Kuanzhi Liu","doi":"10.1186/s13018-025-06244-7","DOIUrl":"10.1186/s13018-025-06244-7","url":null,"abstract":"<p><strong>Background: </strong>Silent information regulator sirtuin 1 (SIRT1) protects and improves diabetic wound healing, but SIRT1 undergoes ubiquitination degradation in various cellular environments. The research aims to reveal a mechanism related to SIRT1 deubiquitination to attenuate HG-induced injury in human umbilical vein endothelial cells (HUVECs).</p><p><strong>Methods: </strong>HUVECs treated with high glucose (HG) were utilized to simulate hyperglycemic conditions in vitro. Cell viability, proliferation, apoptosis, invasion, and angiogenesis were determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide, 5-ethynyl-2'-deoxyuridine, flow cytometry, transwell, and tube formation assays, respectively. Ferroptosis was analyzed by analyzing Fe²⁺ levels, reactive oxygen species production, and glutathione activity. Endoplasmic reticulum stress (ERS) was evaluated by detecting CHOP and GRP78 protein levels. The interaction between SIRT1 and ubiquitin-specific peptidase 28 (USP28) was determined by co-immunoprecipitation analysis and ubiquitination assays.</p><p><strong>Results: </strong>Serum SIRT1 mRNA levels were lower in patients with DFUs. SIRT1 overexpression impaired HG-induced injury, ERS, and ferroptosis in HUVECs. USP28 deubiquitinates and stabilizes SIRT1 protein. USP28 overexpression eased HG-induced injury, ERS, and ferroptosis in HUVECs, but the USP28 inhibitor AZ1 counteracted the function of USP28 overexpression. Furthermore, both SIRT1 knockdown and the SIRT1 inhibitor EX-527 undercut USP28 overexpression-mediated protective effect on HUVEC injury, ERS, and ferroptosis under HG stimulation. Additionally, USP28 regulated the NRF2/HO-1 pathway by deubiquitinating SIRT1 in HG-stimulated HUVECs.</p><p><strong>Conclusion: </strong>USP28 weakens HG-mediated endothelial dysfunction via activating the NRF2/HO-1 pathway through stabilizing SIRT1 protein, indicating that targeting USP28 is the direction for developing clinical strategies for diabetic wound healing.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"831"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137856","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":"Percutaneous ultrasound-guided repair of Achilles tendon rupture: a cadaveric study and preliminary clinical report.","authors":"Alvaro Iborra, Manuel Villanueva, Daniel Ferro, Jose Palacios, Nicola Maffulli","doi":"10.1186/s13018-025-06098-z","DOIUrl":"10.1186/s13018-025-06098-z","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"825"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137883","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 clinical outcomes of joint-preserving endoprosthesis reconstruction for primary sarcomas about the knee.","authors":"Zhuoyu Li, Weifeng Liu, Xiaohui Niu, Chunyan Jiang, Qing Zhang","doi":"10.1186/s13018-025-06252-7","DOIUrl":"10.1186/s13018-025-06252-7","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the clinical outcomes of joint-preserving endoprosthesis reconstruction for primary sarcomas about the knee.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 45 patients (21 males, 24 females) who underwent joint-preserving endoprosthesis reconstruction (JPER) for bone tumours about the knee between January 2009 and January 2023. The average age was 23.9 ± 15.1 years (range, 7-66 years) and the most common pathological type was osteosarcoma (34), followed by Ewing's sarcoma (5), adamantinoma (3), spindle cell sarcoma (2), and undifferentiated pleomorphic sarcoma (UPS, 1). There were 35 cases of tumors located in the femur and 10 cases located in the tibia. The oncological outcomes included local control, metastasis, progression-free survival, and overall survival. The functional outcomes were evaluated by the Musculoskeletal Tumour Society Score (MSTS-93).</p><p><strong>Results: </strong>45 patients were included in this retrospective study, and no patient were lost in the follow-up. The mean follow-up time was 105.3 ± 44.6 months (range, 15-183 months). Five patients (11.1%) died in the last follow-up. Four patients had local recurrences, and the mean interval between the index procedure to local recurrence was 25.5 months (range, 4-36 months). The 5-year and 10-year overall survival rate was 91.2% (95% CI 82.5%-99.9%) and 86.2% (95% CI 74.3%-98.1%), respectively. The 5-year and 10-year progression-free survival rate was 85.5% (95% CI 74.9%-96.1%) and 81.5% (95% CI 69.3%-93.7%), respectively. The average MSTS-93 score was 93% (range, 70-100%). The overall survivorship of the JPER was 84.4% (38/45) at an average of 8.7 years follow-up. Failure mechanisms included 4 infections (57%), 2 local tumour progression (29%), and one structural failure (14%) according to Henderson classification.</p><p><strong>Conclusions: </strong>The joint-preserving endoprosthesis reconstruction (JPER) is a reliable technique to reconstruct massive bone defects after primary sarcoma resection about the knee with acceptable oncological outcomes, function, and satisfaction.</p><p><strong>Level of evidence: </strong>Level IV therapeutic study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"827"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137850","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":"Comparison of 2D and 3D fluoroscopy for intraoperative detection of intra-articular incongruities in distal radius fractures.","authors":"Fenna Brunken, Benno Bullert, Paul A Grützner, Sven Y Vetter, Nils Beisemann","doi":"10.1186/s13018-025-06284-z","DOIUrl":"10.1186/s13018-025-06284-z","url":null,"abstract":"<p><strong>Background: </strong>Insufficient reduction of intra-articular fractures can lead to posttraumatic arthritis. An accurate intraoperative assessment of the articular surface is essential to guide surgical decision-making. This study aims to compare the sensitivity of 2D and 3D fluoroscopy for detecting intra-articular gaps and step-offs in distal radius fractures.</p><p><strong>Methods: </strong>Intra-articular distal radius fractures were induced in 6 cadaveric forearms and intra-articular incongruities (gap/step-off) of 0, 1 and 2 mm were created using 3D-printed repositioning guides. Images were acquired by 2D and 3D fluoroscopy for each step and evaluated by 3 blinded observers. Sensitivity and specificity for the detection of intra-articular incongruities were analyzed. Additionally, the inter-rater agreement for the decision to perform revision surgery and dose area product (DAP) were evaluated.</p><p><strong>Results: </strong>The overall sensitivity of 3D fluoroscopy for the detection of intra-articular incongruities was 90.28% compared to 55.56% for 2D fluoroscopy. Sensitivities for the detection of 2 mm incongruities were higher than for 1 mm especially in 2D fluoroscopy (1 mm: 38.89%; 2 mm: 74.72%). In 41.67% of cases with 1 mm incongruities where no revision was deemed necessary in 2D fluoroscopy, 3D imaging prompted a change in decision to perform revision. The dose area product was significantly higher for 3D fluoroscopy (41.87 cGycm²) compared to 2D fluoroscopy (3.13 cGycm²) (p < 0.0001).</p><p><strong>Conclusion: </strong>The results suggest that 3D fluoroscopy can facilitate the detection of intra-articular incongruities in distal radius fractures and may prompt intra-operative revisions. Further clinical studies are needed to determine the effect on surgical outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"824"},"PeriodicalIF":2.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131138","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}