Journal of Orthopaedic Surgery and Research最新文献

{"title":"Risk factors and prognosis analysis of dysphagia after occipitocervical fusion surgery: a retrospective study of 43 cases.","authors":"Yufan Chen, Weihong Xu","doi":"10.1186/s13018-025-05516-6","DOIUrl":"10.1186/s13018-025-05516-6","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the risk factors for developing dysphagia after occipitocervical fusion (OCF) and investigate possible mechanisms and prognosis.</p><p><strong>Methods: </strong>The case data of 43 patients who underwent OCF were retrospectively reviewed. Patients were divided into group A (dysphagia group) and group B (non-dysphagia group) based on Bazaz scoring criteria. Baseline data and imaging parameters were collected: O-C2 angle, C2-7 angle, pharyngeal inlet angle (PIA), posterior occipital cervical angle (POCA), O-EA angle, Oc-Ax angle, Atlas-dens interval, C2-7 sagittal vertical axis (SVA), T1 slope, narrowest oropharyngeal airway space (nPAS), and thickness of the prevertebral soft tissue. Potential risk factors were identified via one-way intergroup comparisons and included in multivariable logistic regression analysis. Pearson or Spearman correlation analysis was performed to assess associations between dnPAS% and each parameter and inter-parameter correlations. Predictors were selected to plot receiver operating characteristic (ROC) curves for diagnostic evaluation. Prognosis was analyzed using the Kaplan-Meier method and curvilinear regression.</p><p><strong>Results: </strong>Dysphagia occurred in 17 of 43 patients (39.53%). By the final follow-up (≥ 12 months), 11 patients (25.58%) had residual symptoms. Baseline factors, including dyspnea (P = 0.028), operative segment (P = 0.021), operative time (P = 0.006), anesthesia time (P = 0.025), solitude (P = 0.019), and satisfaction (P < 0.001), differed significantly between groups. Imaging parameters dO-C2a (P < 0.001), dPOCA (P < 0.001), PoPIA (P = 0.036), dPIA (P < 0.001), dOc-Axa (P = 0.001), dC2-7 SVA (P = 0.040), PonPAS (P = 0.004), dnPAS (P = 0.005), and dnPAS% (P < 0.001) were also significantly different. Multivariable regression analysis identified dPIA (OR = 0.870, P = 0.008) as an independent protective factor. ROC analysis showed dPIA had good diagnostic value (AUC = 0.855) with a cutoff of -8°. Prognostic analysis indicated rapid recovery was possible by 3 months postoperatively, with full recovery achieved in ~ 30% of patients by 1 year, after which recovery plateaued.</p><p><strong>Conclusion: </strong>Postoperative dysphagia after OCF appears to result from multiple factors involving both \"static + dynamic\" elements. dPIA is a reliable predictor, with patients having a dPIA >-8° being less likely to develop dysphagia. However, only ~ 30% of patients achieve full recovery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"89"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028854","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":"Biomechanical insights through finite element analysis of Bennett fracture fixation: a comparative study of four surgical techniques.","authors":"Numan Mercan, Ebubekir Eravşar, Selim Safalı, Levent Uğur, Ali Özdemir","doi":"10.1186/s13018-025-05481-0","DOIUrl":"10.1186/s13018-025-05481-0","url":null,"abstract":"<p><strong>Background and objectives: </strong>Bennett fractures are intra-articular fractures of the first metacarpal, typically resulting from axial loading. The optimal surgical method for fixation remains a topic of ongoing debate. This study aims to evaluate and compare the biomechanical properties of different fixation techniques.</p><p><strong>Materials and methods: </strong>Four fixation models were analyzed: the Lag Screw (LS) model, the Plate-screw (PS) model, and two K-wire models (Kw1 and Kw2). The biomechanical stability of each model was assessed by measuring the total displacement at the fracture line and the maximum von Mises stresses (MvMs) on the fixation materials.</p><p><strong>Results: </strong>Measurements revealed that the LS model exhibited the highest total displacement of 2,184 mm, while the PS model showed the least displacement at 0,069 mm. Among the K-wire models, Kw1 had a total displacement of 0,408 mm, while Kw2 displayed 0,146 mm. Notably, the MvMs values at the fracture line were highest in the LS model (623,95 MPa for the large fragment surface) and lowest in the Kw2 model (16,237 MPa). The PS model demonstrated the lowest stresses on the fixation materials, highlighting its biomechanical advantage. Furthermore, the assessment of joint-level displacement indicated that the Kw1 model had the greatest displacement (0,156 mm), while the PS model maintained remarkable stability, recording a stable 0 mm displacement.</p><p><strong>Conclusion: </strong>The PS model demonstrated superior biomechanical stability, making it the most suitable fixation method among those studied. While the Kw2 model showed promising results with low total displacement values, further studies are necessary to establish its clinical efficacy.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"90"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029029","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":"Efficacy and safety of long fusion versus short fusion in degenerative scoliosis: a systematic review and meta-analysis.","authors":"Bin Zheng, Qiang Zhou, Xuanwen Liu, Zhe Qiang","doi":"10.1186/s13018-025-05466-z","DOIUrl":"10.1186/s13018-025-05466-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy and safety of long fusion versus short fusion in patients with degenerative scoliosis.</p><p><strong>Methods: </strong>Databases were systematically searched up to June 2024. The authors applied Review Manager 5.4 to manage the data and perform the analysis.</p><p><strong>Results: </strong>After the selection of 611 studies from electronic databases, 13 studies were eligible for inclusion. These 13 studies included 1261 patients: 534 patients underwent long fusion, and 727 underwent short fusion. At baseline, the Cobb angle, coronal imbalance, and sagittal imbalance were greater in the long fusion group. There was no difference in the VAS back, Cobb angle, ODI, hospital stay, revision surgery, adjacent segment degeneration, sacral slope, pelvic tilt, Cobb angle, lumbar lordosis, coronal balance, or sagittal balance at the final follow-up. The surgery time, complication rates, and amount of blood loss were greater in the long fusion group.</p><p><strong>Conclusions: </strong>Long fusion leads to superior radiographic improvement, particularly in reducing the Cobb angle and reconstructing coronal and sagittal balance. The long fusion group was inferior in terms of increased surgical time, more blood loss, and higher postoperative complication rates. At the final follow-up, there was no difference in the clinical or radiographic outcomes between the long and short groups. For patients with a large coronal Cobb angle and significant coronal or sagittal imbalance, long fusion surgery should be performed. On the other hand, for patients whose milder deformities and clinical symptoms are the main concern, short fusion surgery is recommended.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"91"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028300","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":"Activation of osteoblast ferroptosis by risperidone accelerates bone loss in mice models of schizophrenia.","authors":"Hongyan Fan, Zaihong Yang, Lan Pang, Peifan Li, Changrong Duan, Guangyuan Xia, Lei Zheng","doi":"10.1186/s13018-025-05520-w","DOIUrl":"10.1186/s13018-025-05520-w","url":null,"abstract":"<p><strong>Background: </strong>Ferroptosis is an iron-dependent regulatory cell death, which plays an essential role in bone loss. This study investigated whether the mechanism of risperidone (RIS)-induced bone loss is related to ferroptosis.</p><p><strong>Methods: </strong>The schizophrenia mice were induced by administering MK-801. Subsequently, RIS were injected, or ferroptosis inhibitor Ferrostatin-1 (Fer-1) co-injected for 8 weeks. Bone loss of schizophrenia mice were assessed using microCT, H&E staining, ALP staining, ARS staining and WB, respectively. Ferroptosis of schizophrenia mice were detected by Iron Colorimetric Assay Kit and WB, respectively. In addition, ALP staining, ARS staining, and WB were performed to reveal the role of RIS in osteogenic differentiation of MC3T3-E1 and BMSCs cells.</p><p><strong>Results: </strong>RIS treatment facilitates bone loss in schizophrenia mice and inhibit osteogenic differentiation of MC3T3-E1 and BMSCs cells. Moreover, up-regulated ferroptosis was found in vivo and in vitro after RIS treatment. Interesting, the bone loss and inhibition of osteogenic differentiation induced by RIS in schizophrenia mice were reversed by ferroptosis inhibitor Fer-1.</p><p><strong>Conclusion: </strong>Ferroptosis induced by RIS aggravates the bone loss of schizophrenia mice via inhibiting osteogenic differentiation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"83"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029027","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":"Satisfied with the worst health outcomes or unsatisfied with the best: explaining the divergence between good patient-reported outcomes and low satisfaction and vice versa among knee arthroplasty patients - a retrospective cohort study.","authors":"Lukas Schöner, Viktoria Steinbeck, Reinhard Busse, Carlos J Marques","doi":"10.1186/s13018-025-05507-7","DOIUrl":"10.1186/s13018-025-05507-7","url":null,"abstract":"<p><strong>Objectives: </strong>Total knee arthroplasty (TKA) is an effective treatment for patients with end-stage knee osteoarthritis but some patients exhibit a discrepancy between patient-reported outcomes (PROs) and patient satisfaction (PS). This study aims to identify predictors for patients reporting unfavorable PROs but high PS and vice versa.</p><p><strong>Materials and methods: </strong>This retrospective cohort study categorized patients from nine German hospitals into four groups based on (i) whether they achieved a minimal clinically important difference (MCID) in knee functionality, measured with a joint-specific PRO from admission to 12-month post-surgery; and (ii) whether they were satisfied at 12 months post-surgery. The groups were (A) Satisfied Achievers (satisfied, MCID reached), (B) Dissatisfied Achievers (not satisfied, MCID reached), (C) Satisfied Non-Achievers (satisfied, MCID not reached) and (D) Dissatisfied Non-Achievers (not satisfied, MCID not reached). Exploratory analyses were performed to understand differences between the four groups using chi-squared tests and ANOVA. Multinomial logistic regression models were conducted to identify predictors for the allocation of patients in groups.</p><p><strong>Results: </strong>A total of 1546 knee arthroplasty patients with a mean age of 65.9 years, 54.1% female, were included. 1146 (74.1%) patients were Satisfied Achievers, 131 (8.5%) were Dissatisfied Achievers, 141 (9.1%) were Satisfied Non-Achievers, and 128 (8.3%) Dissatisfied Non-Achievers. The results showed that higher improvements in health-related quality of life, pain and fatigue symptoms significantly decreased the likelihood of being a Dissatisfied Achiever and a Satisfied Non-Achiever. Comorbidities of blood circulation, chronic back pain or diabetes increased the likelihood of being a Dissatisfied Achiever, while depression decreased the likelihood of being a Satisfied Non-Achiever.</p><p><strong>Conclusion: </strong>Addressing individual health concerns, e.g. through expectation management, and assessing alternative treatment options might improve satisfaction in line with functional improvements. A closer evaluation at which physical impairment level surgery is beneficial could help to improve the care of Satisfied Non-Achievers.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"88"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028857","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":"Autophagy activation alleviates annulus fibrosus degeneration via the miR-2355-5p/mTOR pathway.","authors":"Zilin Yu, Chunyang Fan, Yubo Mao, Xiexing Wu, Haiqing Mao","doi":"10.1186/s13018-025-05492-x","DOIUrl":"10.1186/s13018-025-05492-x","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration disease (IVDD) is a major cause of disability and reduced work productivity worldwide. Annulus fibrosus degeneration is a key contributor to IVDD, yet its mechanisms remain poorly understood. Autophagy, a vital process for cellular homeostasis, involves the lysosomal degradation of cytoplasmic proteins and organelles. This study aimed to investigate the role of autophagy in IVDD using a hydrogen peroxide (H₂O₂)-induced model of rat annulus fibrosus cells (AFCs).</p><p><strong>Methods: </strong>AFCs were exposed to H₂O₂ to model oxidative stress-induced degeneration. Protein expression levels of collagen I, collagen II, MMP3, and MMP13 were quantified. GEO database analysis identified alterations in miR-2355-5p expression, and its regulatory role on the mTOR pathway and autophagy was assessed. Statistical tests were used to evaluate changes in protein expression and pathway activation.</p><p><strong>Results: </strong>H₂O₂ exposure reduced collagen I and collagen II expression to approximately 50% of baseline levels, while MMP3 and MMP13 expression increased twofold. Activation of autophagy restored collagen I and II expression and decreased MMP3 and MMP13 levels. GEO analysis revealed significant alterations in miR-2355-5p expression, confirming its role in regulating the mTOR pathway and autophagy.</p><p><strong>Conclusions: </strong>Autophagy, mediated by the miR-2355-5p/mTOR pathway, plays a protective role in AFCs degeneration. These findings suggest a potential therapeutic target for mitigating IVDD progression.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"86"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029028","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":"Effect of early rehabilitation on hospital stay and postoperative complications in elderly hip fracture patients: a prospective cohort study.","authors":"Wen Tang, Yiqi Wang, Yulian He, Bo Liu, Runzhi Yuan, Yanhui Zhou, Huayong Huang","doi":"10.1186/s13018-024-05354-y","DOIUrl":"10.1186/s13018-024-05354-y","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures in the elderly are a major global public health concern, with incidence projected to rise as populations age. Rehabilitation is critical to recovery after hip fracture surgery, but the ideal timing for initiation remains uncertain. While early rehabilitation, within 48 h post-surgery, is associated with better outcomes, its specific impact on hospital stay duration and postoperative complications is not yet conclusively established.</p><p><strong>Aim: </strong>This study aims to evaluate the effects of initiating rehabilitation within 48 h after hip fracture surgery on hospital length of stay and postoperative complications, compared to rehabilitation started one-week post-surgery in elderly patients. It is hypothesized that early rehabilitation will significantly reduce hospital stays and decrease the rate of postoperative complications.</p><p><strong>Methods: </strong>In this prospective cohort study, patients aged 65 and older are divided into early rehabilitation (within 48 h) and delayed rehabilitation (after one week) groups. Data will be collected using electronic medical records (EMR), standardized clinical tools (Barthel Index, Timed Up and Go), and patient-reported outcome measures (SF-36, EQ-5D). Statistical analyses will include t-tests and chi-square tests for outcome comparison, with multiple regression adjusting for potential confounders such as age, gender, and comorbidities.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"84"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029030","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":"Optimising patient engagement for assessing total joint arthroplasty outcomes - a randomised controlled trial.","authors":"Wyatt Tyndall, Nebojsa Kuljic, Michael Thatcher, Michaela Nickol, Johannes M van der Merwe","doi":"10.1186/s13018-025-05493-w","DOIUrl":"10.1186/s13018-025-05493-w","url":null,"abstract":"<p><strong>Introduction: </strong>Patient satisfaction is a critical outcome in total joint arthroplasty (TJA), yet assessing it effectively remains a challenge due to limitations in patient-reported outcome measures (PROMS). While these measures are commonly gathered in clinical settings, additional contact through mail or phone is often needed, and low response rates can affect the validity and reliability of collected data. To improve response rates, this study evaluated various methods of incentivizing patient participation in a randomized trial format, focusing on postal questionnaires.</p><p><strong>Patients and methods: </strong>The study investigated three methods to improve response rates: including a gift card with the questionnaire, promising a gift card upon questionnaire completion, and offering no incentive. It also examined whether different monetary values and the inclusion of the surgeon's name on materials impacted response rates. We tried to determine factors that could improve follow up telephone response rates in the group of patients that failed to return their questionnaires.</p><p><strong>Results: </strong>Higher response rates were observed with monetary incentives (P = 0.056), larger amounts of money offered (P = 0.3839) for filling out the questionnaire, and if the surgeon's details were on the cover letter or questionnaire (P = 0.632). There was no correlation between age and sex and participation. We did find a statistically significant difference in total participation and poorer total knee arthroplasty outcomes scores (P < 0.001).</p><p><strong>Conclusion: </strong>Our study supports findings from prior research indicating that monetary incentives and personalized materials can improve response rates, although in this cohort, results were modest. Follow-up calls further boosted response rates, suggesting that multi-modal engagement may be beneficial. Although the response improvements were limited and lacked statistical significance, the study highlights the importance of refining strategies to ensure reliable PROMS data, which is vital for understanding patient outcomes in TJA. Future studies might consider demographic factors and other outreach methods to enhance PROMs data collection.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"82"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028851","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 analysis of bioinformatics, mendelian randomization, and experimental validation reveals novel diagnostic and therapeutic targets for osteoarthritis: progesterone as a potential therapeutic agent.","authors":"Ziyu Weng, Chenzhong Wang, Bo Liu, Yi Yang, Yueqi Zhang, Chi Zhang","doi":"10.1186/s13018-025-05459-y","DOIUrl":"10.1186/s13018-025-05459-y","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA), characterized by progressive degeneration of cartilage and reactive proliferation of subchondral bone, stands as a prevalent condition in orthopedic clinics. However, the precise mechanisms underlying OA pathogenesis remain inadequately explored.</p><p><strong>Methods: </strong>In this study, Random Forest (RF), Least Absolute Shrinkage and Selection Operator (LASSO), and Support Vector Machine-Recursive Feature Elimination (SVM-RFE) machine learning techniques were employed to identify hub genes. Based on these hub genes, an Artificial Neural Network (ANN) diagnostic model was constructed. The Drug Signatures Database (DSigDB) was utilized to screen small-molecule drugs targeting these hub genes, and molecular docking analyses and molecular dynamics simulations were employed to explore and validate the binding interactions between proteins and small-molecule drugs. Expression changes of the hub genes under inflammatory conditions were validated through in vitro experiments, including RT-qPCR and Western blotting, and the therapeutic effects of the identified small-molecule drug on chondrocytes under inflammatory conditions were further verified in vitro. Lastly, Mendelian randomization analysis was conducted to examine the causal association between progesterone levels and various OA phenotypes.</p><p><strong>Results: </strong>In this study, we identified three hub genes: interleukin 1 receptor-associated kinase 3 (IRAK3), integrin subunit beta-like 1 (ITGBL1), and Ras homolog family member U (RHOU). An Artificial Neural Network (ANN) diagnostic model constructed based on these hub genes demonstrated excellent performance in both training and validation phases. Screening with the Drug Signatures Database (DSigDB) identified progesterone as a small-molecule drug targeting these key proteins. Molecular docking analysis using AutoDock Vina revealed that progesterone exhibited binding energies of ≤ -7 kcal/mol with each of the key proteins, indicating strong binding affinity. Furthermore, molecular dynamics simulations validated the stability and strength of these interactions. RT-qPCR and Western blotting confirmed the downregulation of the hub genes in IL-1β-treated chondrocytes. Western blotting also demonstrated the potential therapeutic effects of progesterone on IL-1β-treated chondrocytes. Finally, Mendelian randomization analysis established a significant association between progesterone levels and multiple OA phenotypes.</p><p><strong>Conclusion: </strong>In our study, IRAK3, ITGBL1, and RHOU were identified as potential novel diagnostic and therapeutic targets for OA. Progesterone was preliminarily validated as a small-molecule drug with potential effects on OA. Further research is crucial to elucidate the pathogenesis of OA and the specific therapeutic mechanisms involved.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"85"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028902","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":"Current developments in robotic assistance technology for total knee arthroplasty: a comprehensive overview.","authors":"Hongli Zhang, Xing-An Jiang, Bing-Chen Jin, Hong-Hao Zhang, Jun-Bo Liang","doi":"10.1186/s13018-025-05490-z","DOIUrl":"10.1186/s13018-025-05490-z","url":null,"abstract":"<p><p>Knee arthritis is a common degenerative joint disease, usually with joint swelling, chronic pain, and dysfunction as the main clinical manifestations. At present, the conservative treatment for knee arthritis is mostly using anti-inflammatory and analgesic drugs, but the effect is mostly temporary, and can not prevent its progress and surgery is usually the last treatment method. Total knee arthroplasty, also known as TKA, is one of the most effective treatments for osteoarthritis of the knee that has progressed to the end stage. The inevitable human factor in conventional total knee arthroplasty (TKA) frequently results in poor positioning of the prosthesis during the reconstruction of the lower limb's biomechanical axis. This can lead to severe postoperative pain, accelerated wear of the prosthesis, early loosening, and other problems in the affected knee, which has always been a primary concern for orthopaedic surgeons. Over the course of the past few years, China has gradually begun to develop joint robots. The idea is to plan the surgical plan based on the anatomical structure of the affected limb before the operation, and then to use a mechanical arm and a visual system to assist in the implantation of the prosthesis while the operation is being performed. The treatment costs of robot-assisted technology, on the other hand, vary greatly, and there is still a relatively small amount of high-quality evidence on clinical efficacy. This is because the field of robotic-assisted technology is a relatively new one that has gradually developed over the past few years. In order to provide a fundamental reference for the application value of new treatment methods for advanced knee osteoarthritis, it is necessary to conduct an analysis of the current status of the application of joint robots, as well as the technical advantages and disadvantages that they bring.This narrative study delineates the historical context and current clinical application of robots in knee replacement surgery. An examination of the advantages and disadvantages of RATKA in comparison to TKA offers insights on the prospective application value of the technology.Clinical trial number: Not applicable.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"80"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023751","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}