Journal of Orthopaedic Surgery and Research最新文献

{"title":"Low-dose erythropoietin in anemic arthroplasty patients within contemporary patient blood management pathways.","authors":"Hervé Hourlier, Guillaume Fricault, Peter Fennema","doi":"10.1186/s13018-026-06857-6","DOIUrl":"https://doi.org/10.1186/s13018-026-06857-6","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anemia remains a major determinant of transfusion risk in total joint arthroplasty (TJA), even within contemporary patient blood management (PBM) pathways. Although erythropoietin (EPO) increases preoperative hemoglobin (Hb) levels, its role in modern low-transfusion arthroplasty practice remains debated. This study evaluated the real-world effectiveness of a selective, low-dose preoperative EPO protocol in anemic patients undergoing TJA within a comprehensive PBM program.</p><p><strong>Methods: </strong>We retrospectively analyzed 2462 primary TJA procedures performed between 2013 and 2024 and identified 188 patients with baseline Hb < 12 g/dL. Of these, 80 received low-dose EPO and 108 served as controls. The EPO regimen consisted of two weekly subcutaneous injections of 20,000 IU administered preoperatively, combined with oral iron supplementation. All patients were managed under a standardized PBM protocol. The primary outcome was the bleeding index at postoperative day 7 (BI-7), defined as the sum of Hb decline between admission and postoperative day 7 and the number of transfused red-blood-cell units.</p><p><strong>Results: </strong>Patients receiving EPO had lower baseline Hb levels than controls (10.9 vs. 11.5 g/dL). EPO treatment increased preoperative Hb by a mean of 1.3 g/dL and resulted in higher Hb levels at hospital admission, postoperative day 1, and postoperative day 7. No blood transfusions were administered during the observation period. BI-7 values were low and comparable between groups (2.1 vs. 2.3; p = 0.30). No thromboembolic events were observed.</p><p><strong>Conclusions: </strong>Within a contemporary PBM framework, selective low-dose preoperative EPO safely optimized perioperative Hb levels and was associated with a transfusion-free perioperative course despite higher baseline hematologic risk. These findings suggest that modern low-transfusion PBM strategies can be effectively extended to selected anemic arthroplasty patients by improving preoperative Hb reserve.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Abnormal patellar loading may lead to femoral trochlear dysplasia: an experimental study of patellar hypermobility and patellar dislocation in growing rats.","authors":"Shiyu Tang, Weifeng Li, Shengjie Wang, Fei Wang","doi":"10.1186/s13018-026-06839-8","DOIUrl":"10.1186/s13018-026-06839-8","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698388","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 and complications of the indirect modified arthroscopic posterior transseptal approach at a minimum 2-year follow-up.","authors":"Christian Arras, Georg Gaentzsch, Karl-Heinz Frosch, Markus T Berninger, Selina Loose, Alexander Korthaus, Matthias Krause, Jannik Frings","doi":"10.1186/s13018-026-06861-w","DOIUrl":"10.1186/s13018-026-06861-w","url":null,"abstract":"<p><strong>Background: </strong>The arthroscopic posterior transseptal approach (TSA) allows improved visualization of the posterior compartment of the knee joint. However, it can be associated with increased risks particularly regarding potential injury to the neurovascular bundle or postoperative scarring, which may contribute to extension deficits of the knee joint. We hypothesized that the modified TSA does not increase the risk of postoperative extension deficit or neurovascular complications while providing safe access to the posterior compartment.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed prospectively collected data from patients who underwent arthroscopic knee surgery via TSA between 01/2018 and 02/2024. The primary outcome measure was the occurrence of perioperative complications. The secondary outcome measures were postoperative complications, postoperative range of motion compared with the contralateral (control) knee, and functional outcomes measured by the subjective International Knee Documentation Committee (IKDC) score and Tegner score.</p><p><strong>Results: </strong>A total of 82 patients were eligible for the study. No perioperative complications were observed. 48 patients (10 females, 38 males; mean age, 37.8 ± 13.5 years) completed follow-up and were available for secondary outcome analysis at a mean follow-up of 45.9 ± 20.7 months. Indications for the TSA included posterior and/or posterolateral knee instability (n = 36), chronic knee dislocation (n = 8), posterior compartment synovectomy for tenosynovial giant cell tumors (n = 2), posterior meniscal pathology (n = 3), and posterior cruciate ligament cysts (n = 2). Patient-reported outcomes were good (IKDC 77.9 ± 17.4; Tegner 4.5 ± 1.7). There were no relevant side-to-side (SSD) differences in knee extension (mean SSD = 0.39, p = 0.098).</p><p><strong>Conclusions: </strong>The indirect posterior transseptal approach is a safe arthroscopic technique that can be associated with moderate clinical outcomes depending on the underlying pathology. The modified TSA appears to be safe when performed by experienced surgeons and was not associated with neurovascular complications in this cohort.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690813","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":"Arthrodesis for post-traumatic ankle osteoarthritis leads to a reduced function of the affected limb with changes in gait and pedobarography: a retrospective cross-sectional study.","authors":"Alexis Brinkemper, Thomas Rosteius, Charlotte Cibura, Lukas Karla, Thomas A Schildhauer, Christiane Kruppa","doi":"10.1186/s13018-026-06842-z","DOIUrl":"10.1186/s13018-026-06842-z","url":null,"abstract":"<p><strong>Background: </strong>Ankle arthrodesis is an established procedure for end-stage ankle osteoarthritis. Besides the known limited functionality, gait and foot arch changes are accompanying pathologies, which are little investigated. The aim of the present study was to determine the influence of ankle arthrodesis on gait, pedobaropraphy and functional outcome.</p><p><strong>Methods: </strong>Thirtyfive patients with unilateral ankle joint fusion after post-traumatic osteoarthritis and a mean follow-up of 60.8 months (SD 18.5, range 32-92) were included. Primary outcome were a 3-D gait analysis including pedobarography. American Orthopaedic Foot and Ankle Society (AOFAS) Score, douleur neuropathique (DN4), EQ-5D-3 L, numeric pain rating scale (NRS), Olerud-Molander Ankle Score (OMAS), painDETECT, short form 36 (SF-36), short musculoskeletal function assessment-German version (SMFA-D) and a clinical examination were secondary outcomes.</p><p><strong>Results: </strong>The AOFAS scores showed predominantly fair or poor results (Rearfoot: 48.6% fair, 34.3% poor; Midfoot 42.9% fair, 25.7% poor), while the SMFA tended to reflect mild dysfunction (bother index 31.7, functional index 27.5). Pain-related questionnaires showed a low incidence of pain (DN4 4.1, NRS 2.2, painDETECT 11.6). Kinematic changes were only marginally observed, while the spatio-temporal parameters showed relevant asymmetries between the fused and healthy side. The pedobarography revealed, in addition to other differences, a reduced maximum contact area on the arthrodesis side compared to the healthy side.</p><p><strong>Conclusions: </strong>Arthrodesis of the ankle joint results in significant limitation of daily activities with reduced function of the affected limb. The impact of ankle arthrodesis go well beyond the loss of extension and flexion, with changes in spatial and temporal movement, weight bearing profile and contact surface. However, results of pain questionnaires show a good result with regard to the main goal of the arthrodesis, the elimination of pain.</p><p><strong>Trial registration: </strong>DRKS, DRKS00033495. Registered 14 March 2024, https://www.drks.de/DRKS00033495 .</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699117","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 application of large language models in orthopedic postgraduate education: potentials, challenges, and future prospects.","authors":"Ke Ren, Qianlin Weng, Qiu Chen, Hui Li, Dongxing Xie, Chao Zeng, Jie Wei, Guanghua Lei, Yilun Wang","doi":"10.1186/s13018-026-06844-x","DOIUrl":"https://doi.org/10.1186/s13018-026-06844-x","url":null,"abstract":"<p><p>With the widespread integration of artificial intelligence (AI), orthopedics postgraduate education is transitioning into the intelligent era. Large language models (LLMs), which leverage deep learning and natural language processing (NLP), have profoundly influenced orthopedic postgraduate education through their sophisticated capabilities in coherent comprehension, contextual response and content generation. These models encompass both general-purpose tools (e.g., ChatGPT) and specialized orthopedic applications (e.g., DocOA, BioinspiredLLM, MechGPT, DrSR, and AmbossGPT). They can offer interdisciplinary research training, targeted academic guidance, real-time resource access, interactive case exercise and immersive simulation practice in orthopedics. Most models exhibited promising performance: for instance, ChatGPT-4 achieved a 61.2% accuracy on the Orthopedic In-Training Examination (OITE) comparable to orthopedic residents, while DocOA significantly outperformed ChatGPT-4 with more than 142% improvement in orthopedic benchmark evaluations. The LLMs' capabilities could promote a personalized, interactive, and adaptive transformation of orthopedic postgraduate education. However, the application of LLMs faces significant challenges such as over-reliance, delayed updates and inconsistent outputs, sparking ongoing controversy in the medical education. Moving forward, establishing a comprehensive human-AI collaborative framework is imperative to optimize the application of LLMs in orthopedic postgraduate education. This holistic framework integrates learner-centered perspectives, multidimensional governance, phased implementation strategies, and geographic diversity. Together, adopting this innovative human-AI approach will strengthen the cultivation of high-level orthopedic talents for orthopedic postgraduate education.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does reconstructing superficial branch of radial nerve defect with a split homolateral graft prevent painful neuromas?","authors":"Yingliang Liu, Xiahan Liu, Xu Zhang, Jingming Xie, Zhi Zhao, Yanjun Liu, Gang Li, Yingsong Wang","doi":"10.1186/s13018-026-06862-9","DOIUrl":"https://doi.org/10.1186/s13018-026-06862-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the efficiency of reconstructing the superficial branch of the radial nerve using a split homolateral graft to prevent painful neuromas.</p><p><strong>Methods: </strong>From January 2019 to October 2022, 32 patients (32 forearms) with traumatic defects of the superficial branch of the radial nerve were treated using a split homolateral graft. The assessments included pain, two-point discrimination, and patient satisfaction. For comparison, another 35 patients (35 forearms) who did not undergo nerve repair were reviewed.</p><p><strong>Results: </strong>The mean age of the nerve repair group was 36 years (range, 18-52 years). The mean defect length was 42 ± 18 mm. The mean follow-up period was 28.5 ± 4.7 months. The mean age of the non-nerve repair group was 35 years (range, 19-54 years). The mean defect length was 45 ± 22 mm. The mean follow-up period was 27.7 ± 5.8 months. There were no significant differences in patient age (P > 0.05), defect length (P > 0.05), and follow-up period (P > 0.05). At the final follow-up, the pain scales at the injury site for the two groups were 0 ± 1 cm vs 5 ± 4 cm (P < 0.05) based on the 10-cm visual analog scale. Sensation on the dorsum of the thumb were 4.8 ± 1.5 mm for the injured hand, 4.2 ± 1.4 mm for the opposite hand, and 9.3 ± 1.6 for the non-nerve repair hand (P < 0.05). Sensation on the first web were 5.2 ± 1.5 mm for the injured hand, 4.7 ± 1.2 mm for the opposite hand, and 8.9 ± 2.6 mm for the non-verve repair hand, (P < 0.05). Based on the Short Assessment of Patient Satisfaction, patient satisfaction of the nerve repair group and non-nerve repair group were 22.3 ± 3.5 and 18.6 ± 4.7, respectively (P < 0.05).</p><p><strong>Conclusions: </strong>Traumatic defects of the superficial branch of the radial nerve can be reconstructed using a split homolateral graft. Most sensations can be restored without causing morbidity. The surgery may reduce the incidence of painful neuroma formation.</p><p><strong>Level of evidence: </strong>Therapeutic study, Level IVa.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-derived CT morphometric phenotypes predict survival, functional decline, and surgical morbidity following curative-intent surgical sarcoma resection.","authors":"Julian Kylies, Elias Brauneck, Dominik Bannier, Tobias Dust, Alonja Reiter, Anna Duprée, Jana Striefler, Karl-Heinz Frosch, Matthias Priemel","doi":"10.1186/s13018-026-06851-y","DOIUrl":"10.1186/s13018-026-06851-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Outcomes after curative-intent sarcoma surgery vary substantially and are incompletely explained by tumor-centered factors alone. Although CT-based body composition metrics provide objective host-related information, most sarcoma studies rely on isolated parameters or binary sarcopenia definitions. AI-driven analytical approaches offer the opportunity to integrate multidimensional morphometric data into data-driven phenotypes that may better capture clinically relevant heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort study, our institutional sarcoma database (n = 2667) was screened to identify patients with osteosarcoma, myxofibrosarcoma, liposarcoma, or chondrosarcoma who underwent curative-intent surgical resection and had a preoperative CT including mid-L3 vertebral level for morphometric analysis (final cohort n = 234). Skeletal muscle index (SMI), skeletal muscle density (SMD), and visceral adipose tissue area (VAT) were quantified from a single axial mid-L3 slice. Unsupervised k-means clustering of standardized SMI, SMD, and VAT identified AI-derived morphometric phenotypes. Outcomes included overall survival (OS), ECOG performance status at follow-up, surgical site infection (SSI requiring surgical revision), and length of hospital stay (LOS). Multivariable regression models evaluated independent associations between phenotypes and outcomes, adjusting for relevant clinical covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Clustering identified four phenotypes: muscle-preserved (n = 88), myosteatotic (n = 62), sarcopenic (n = 56), and cachexia-like (n = 28). Morphometric profiles differed markedly: muscle-preserved (SMI 47.8 ± 6.3 cm&lt;sup&gt;2&lt;/sup&gt;/m&lt;sup&gt;2&lt;/sup&gt;; SMD 41.6 ± 6.4 HU; VAT 118 ± 56 cm&lt;sup&gt;2&lt;/sup&gt;), myosteatotic (SMI 42.1 ± 5.9; SMD 28.9 ± 5.3; VAT 142 ± 62), sarcopenic (SMI 35.6 ± 4.8; SMD 34.0 ± 5.6; VAT 96 ± 48), and cachexia-like (SMI 31.2 ± 4.4; SMD 26.4 ± 4.9; VAT 64 ± 35). Median OS differed significantly across phenotypes (155 vs. 32 vs. 64 vs. 19 months; p &lt; 0.0001). Postoperative functional status also worsened stepwise (median ECOG at follow-up: 1 ± 0.5 vs. 2.5 ± 1 vs. 3 ± 1 vs. 3 ± 0.5; p &lt; 0.0001). In multivariable Cox regression, cachexia-like (HR 3.28, 95% CI 2.01-5.36; p &lt; 0.001) and sarcopenic phenotypes (HR 1.89, 95% CI 1.26-2.83; p = 0.002) independently predicted mortality, whereas conventional sarcopenia did not. SSI rates increased across phenotypes (6.8% to 21.4%; p = 0.042), cachexia-like (HR 3.21, 95% CI 1.69-6.10; p &lt; 0.001) and sarcopenic phenotypes (HR 2.08, 95% CI 1.17-3.70; p = 0.012) were independently associated with SSI. LOS was independently prolonged in sarcopenic (+ 3.4 days, p = 0.002) and cachexia-like patients (+ 6.2 days, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;AI-derived CT morphometric phenotypes obtained from routine preoperative imaging identify distinct host profiles in sarcoma patients and independently predict survival, posto","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690741","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 significance and regulatory mechanism of miR-4284 in lumbar intervertebral disc degeneration.","authors":"Fang Pei, Qing Chen, Zhengtian Gao, Yingnuo Hou, Fanlei Kong, Shibin Hou, Ting Li","doi":"10.1186/s13018-026-06841-0","DOIUrl":"https://doi.org/10.1186/s13018-026-06841-0","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc degeneration (LDD) is one of the main causes of low back pain. This study investigates the role of miR-4284 and its target, CYCS, in LDD pathogenesis.</p><p><strong>Methods: </strong>Serum levels of miR-4284 and CYCS were measured in 121 LDD patients and 79 healthy controls. The clinical diagnostic and predictive value of miR-4284 was evaluated using ROC curve analysis and logistic regression. Stimulated human nucleus pulposus (NP) cells with LPS and transfected with miR-4284 mimic/inhibitor or CYCS overexpression vector. Cell viability, inflammatory factors (IL-1β, TNF-α), and oxidative stress markers (MDA, T-AOC) were assessed. A luciferase reporter assay confirmed targeting. Western blot analysis was performed to detect the expression of apoptosis-related proteins (Bax, Bcl-2) and mitochondrial function-related proteins (PGC-1α, SOD2).</p><p><strong>Results: </strong>In LDD patients, serum miR-4284 expression was significantly downregulated (P < 0.001) and exhibited good diagnostic value (AUC = 0.831). miR-4284 might serve as a protective factor for LDD (OR = 0.100), showing negative correlations with Pfirrmann grading, ODI, and VAS scores (P < 0.001). Luciferase assays confirmed that CYCS was a direct target of miR-4284. In LPS-stimulated NP cells, miR-4284 overexpression alleviated inflammation and oxidative stress while enhancing cell viability. Concurrently, overexpression of CYCS not only completely reversed the protective effects mediated by miR-4284 but also exacerbated cellular apoptosis and mitochondrial dysfunction, thereby synergistically promoting the pathological progression of LDD.</p><p><strong>Conclusion: </strong>miR-4284 is significantly decreased in LDD and may serve as a protective biomarker. By targeting CYCS, it alleviates inflammation and oxidative stress, inhibits apoptosis, and mitigates mitochondrial dysfunction in NP cells, thereby potentially delaying LDD progression.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"circ_0044235 exacerbates neuroinflammation and apoptosis following spinal cord injury by targeting miR-338-5p.","authors":"Mianlong Lin, Lina Huang, Bin Zhang, Yue Wang, Xingyu Zhu, Wencong Zen","doi":"10.1186/s13018-026-06832-1","DOIUrl":"https://doi.org/10.1186/s13018-026-06832-1","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) triggers a cascade of secondary damages, including neuroinflammation and apoptosis, which critically impede neurological recovery. This study aims to investigate the function of circ_0044235 in this pathological process.</p><p><strong>Methods: </strong>In this study, an in vitro injury model was established by stimulating PC-12 cells with lipopolysaccharide (LPS), and an in vivo SCI model was prepared by the rat T9-10 percussion method. The recovery of motor function in rats was evaluated by BBB score. RT-qPCR was used to determine the levels of circ_0044235, miR-338-5p, and mRNA. Cell viability and apoptosis were detected by MTT and flow cytometry. ELISA was used to determine the levels of inflammatory factors. The interaction between circ_0044235 and miR-338-5p was verified by dual-luciferase reporter gene and RNA pull-down.</p><p><strong>Result: </strong>LPS treatment up-regulated circ_0044235 expression and exacerbated PC-12 cell injury in a concentration-dependent manner. Silencing circ_0044235 improved cell viability, suppressed apoptosis, and reduced inflammatory factor release. Mechanistically, circ_0044235 directly bound to and negatively regulated miR-338-5p, with rescue experiments confirming its pro-injury role via miR-338-5p sponging. In vivo, knockdown of circ_0044235 promoted motor function recovery and reduced inflammation; these effects were reversed by a miR-338-5p antagomir. LRP1 was further identified as a direct downstream target of miR-338-5p.</p><p><strong>Conclusion: </strong>circ_0044235 functions as a key pro-injury factor in SCI. It directly targets and adsorbs miR-338-5p, thereby exacerbating the neuroinflammatory response and the process of apoptosis, and ultimately hindering the recovery of neural function.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition of miR-224-5p promotes osteogenesis in dental pulp stem cells by targeting the PTEN/PI3K/AKT axis.","authors":"Zhihong Ke, Fan Yang, Ningkai Huang, Hongbing Lv","doi":"10.1186/s13018-026-06853-w","DOIUrl":"https://doi.org/10.1186/s13018-026-06853-w","url":null,"abstract":"<p><strong>Background: </strong>MiR-224-5p has been proven to play an important role in regulating cell differentiation. This study aimed to clarify the regulatory role and mechanism of miR-224-5p in the osteogenic differentiation of human dental pulp stem cells (hDPSCs), thereby laying a theoretical foundation for subsequent jaw defect repair.</p><p><strong>Methods: </strong>Human dental pulp stem cells (hDPSCs) were isolated, cultured, and sorted from healthy dental pulp tissues. We performed integrated bioinformatics analysis to screen and identify the potential targets and pathways of miR-224-5p involved in the osteogenic induction of hDPSCs. Subsequently, in vitro experiments were conducted. Plasmid transfection was used to regulate the overexpression and knockdown of miR-224-5p in hDPSCs, and the expression of osteogenesis-related proteins was detected. Furthermore, luciferase reporter assays and Western blot assays were used to confirm the direct targets of miR-224-5p, and rescue experiments were performed to verify the underlying mechanism.</p><p><strong>Results: </strong>The results demonstrated that overexpression of miR-224-5p inhibited the osteogenic differentiation of DPSCs, as reflected by the significantly decreased expression of osteogenic markers (OCN, Runx2, and ALP). In contrast, inhibition of miR-224-5p promoted the osteogenic differentiation of DPSCs. Bioinformatics analysis and dual-luciferase reporter gene assays indicated that miR-224-5p specifically targets the 3' untranslated region of the PTEN gene. Rescue experiments further confirmed that miR-224-5p regulates this process by modulating the PTEN/PI3K/AKT pathway.</p><p><strong>Conclusions: </strong>Inhibition of miR-224-5p promotes osteogenesis in DPSCs by targeting the PTEN/PI3K/AKT signaling axis. These findings provide reliable evidence for the fabrication of three-dimensional tissue-engineered structures and further repair of maxillofacial bone defects.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}