Journal of Orthopaedic Surgery and Research最新文献

{"title":"ILOBONE: A phase I/IIa randomized controlled trial to assess the safety and feasibility of local iloprost therapy for enhancing proximal humerus fracture healing- a pilot study design.","authors":"Hisham Elazaly, Ioanna Maria Dimitriou, Tazio Maleitzke, Michael Dahne, Vera Jaecker, Sven Maerdian, Sascha Tafelski, Torsten Diekhoff, Tobias Lindner, Doruk Akgün, Anna-Maria Mielke, Alp Paksoy, Dominik Adl Amini, Elisa Marie Planatscher, Vincent Leopold, Susana González-Khatib, Paul Christoph Köhli, Marcel Niemann, Alexander Hildebrandt, Stephan Oehme, Yannick Palmowski, Melissa Paraskevaidis, Lukas Schönnagel, Sebastian Benedict Braun, Matthias Pumberger, Sebastian Hardt, Sigmar Stricker, Levent Akyüz, Gerald Grütz, Stefan Schaller, Luis Lauterbach, Maximilian Volcksdorff, Lukas Mödl, Martin Textor, Melanie Ort, Simon Reinke, Ulrich Stöckle, Carsten Perka, Georg N Duda, Katharina Schmidt-Bleek, Sven Geissler, Tobias Winkler","doi":"10.1186/s13018-025-05865-2","DOIUrl":"10.1186/s13018-025-05865-2","url":null,"abstract":"<p><strong>Background: </strong>Proximal humerus fractures (PHFs) are the third most common fractures in elderly patients. Over 70% of PHFs in patients aged over 60 are displaced fractures, often necessitating surgical treatment. However, osteosynthesis is associated with a high rate of complications, highlighting the urgent need for additional therapeutic approaches to enhance bone healing and prevent osteonecrosis. This study evaluates the safety, feasibility and potential efficacy of local prostacyclin (iloprost) to improve bone healing in patients with PHFs.</p><p><strong>Methods: </strong>Thirty eligible patients will be randomized into one of three groups at a 1:1:1 ratio. All patients will receive angular stable locking plate fixation. Two treatment groups will receive an additional single dose of local iloprost through a 24-hour infusion postoperatively (group 1: low dose; group 2: high dose), while the control group will only receive the osteosynthesis. Patients will be monitored for 52 weeks. The primary endpoint is safety, with secondary endpoints including the preservation of the screw tip apex distance as an indicator of fracture healing, head shaft angle, necrosis rate, and patient-related outcome measures.</p><p><strong>Discussion: </strong>The Ilobone study aims to provide data on the potential for biological augmentation of osteosynthesis procedures in PHFs, prone to healing challenges and complications.</p><p><strong>Trial registration: </strong>The trial is registered with ClinicalTrial.gov (NCT04543682), registered 02 Sep. 2020, https://clinicaltrials.gov/show/NCT04543682 and the German Clinical Trials Registry (DRKS00027081), registered 10 Nov. 2021 https://drks.de/search/de/trial/DRKS00027081 .</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"498"},"PeriodicalIF":2.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127894","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 of ultrasound-guided capsular hydrodilatation for refractory post-trauma finger joint stiffness in adult patients.","authors":"Xin Ju Hou, Ying Jing Ng, Qing Ying Yu, Xing Zhen Lin, Ray P S Han","doi":"10.1186/s13018-025-05893-y","DOIUrl":"10.1186/s13018-025-05893-y","url":null,"abstract":"<p><strong>Background: </strong>Finger joint stiffness is a common post-treatment complication in patients with upper limb fractures that lowers their quality of life. Physiotherapy is the standard of care for functional restoration in patients with finger joint stiffness. However, in adult patients, physiotherapy alone is not always sufficient to restore joint function. In this study, we report the efficacy of ultrasound-guided capsular hydrodilatation in adult patients with post-trauma finger joint stiffness that did not improve after ≥ 2 weeks of conventional physiotherapy.</p><p><strong>Methods: </strong>This prospective study included adult patients who developed finger joint stiffness after conservative treatment with plaster of Paris or open reduction and internal fixation for upper limb injuries between March 2023 and June 2024. All patients underwent ultrasound-guided hydrostatic separation of the finger joint capsules followed by conventional finger joint exercises. The outcomes of treatment were evaluated two weeks post-treatment.</p><p><strong>Results: </strong>A total of 15 patients with an average age of 58.13 ± 17.64 years were included in this study. The mean pain score decreased from 6.4 ± 1.06 cm to 1.93 ± 0.70 cm respectively (p < 0.0001) at baseline and 2 weeks post-treatment. The median joint swelling score decreased from 2 at baseline to 0 at 2 weeks post-treatment (p < 0.0001). The active ranges of motion increased by 51 ± 4.48 degrees, 18.27 ± 4.62 degrees, and 29.73 ± 4.79 degrees for the MCP, PIP, and DIP joints, respectively. Similarly, the passive ranges of motion increased by 43.4 ± 4.72, 13.27 ± 5.73 degrees, and 26.73 ± 4.83 degrees for the MCP, PIP, and DIP joints, respectively.</p><p><strong>Conclusion: </strong>Ultrasound-guided capsular hydrodilatation in combination with conventional finger joint exercises is an effective intervention for post-trauma finger joint stiffness that is refractory to conventional physiotherapy in adult patients. It is a relatively simple and minimally invasive procedure that can rapidly reduce pain, and swelling, and restore finger joint function.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"494"},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110999","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 effect of lactate dehydrogenase B and its mediated histone lactylation on chondrocyte ferroptosis during osteoarthritis.","authors":"Yang Zhang, Chen-Yu Zhao, Zheng Zhou, Cheng-Cun Li, Qiang Wang","doi":"10.1186/s13018-025-05894-x","DOIUrl":"10.1186/s13018-025-05894-x","url":null,"abstract":"<p><strong>Background: </strong>Histone lactylation is a novel epigenetic regulator that is reported to participate in gene expression. Ferroptosis is an oxidative form of cell death and chondrocyte ferroptosis crucially impacts the development of osteoarthritis (OA). The study aimed at investigating the effect of lactate dehydrogenase B (LDHB) and its mediated histone lactylation on chondrocyte ferroptosis during OA.</p><p><strong>Methods: </strong>Our study focused on the establishment of in vivo mouse model and in vitro interleukin-1β (IL-1β)-induced chondrocytes model and administrated LDHB knockdown (siLDHB). Histopathological assessment of cartilage was conducted via HE staining, while serum levels of cartilage oligomeric matrix protein (COMP) and crosslinked C-telopeptides of type II collagen (CTX-II) were quantified using ELISA to evaluate OA severity. The matrix degradation was further examined by expression of Collagen II and Aggrecan. Levels of total iron, ferrous iron (Fe2+), and lipid reactive oxygen species (ROS) were considered measurements of ferroptosis. Assessment of cell viability and proliferation relied on cell counting kit 8 (CCK-8) together with colony formation assay. Western blotting assay served for detecting the relative expression of proteins and protein lactylation. The epigenetic regulation of ACSL4 by LDHB was determined by chromatin immunoprecipitation (ChIP) and luciferase reporter gene assay.</p><p><strong>Results: </strong>OA mice presented remarkably elevated protein level of LDHB and H3K18 lactylation in the cartilage versus the sham group. Knockdown of LDHB downregulated the levels of COMP and CTX-II, as well as alleviated chondrocyte ferroptosis in vitro and in vivo. Results from ChIP and luciferase reporter gene assay demonstrated direct histone lactylation of ACSL promoter, and knockdown of LDHB and treatment with LDH inhibitor reduced histone lactylation and expression of ACSL4. ACSL4 overexpression could reverse the impact of LDHB depletion on chondrocyte proliferation and ferroptosis.</p><p><strong>Conclusion: </strong>LDHB promotes ACSL4 by histone lactylation to induce chondrocyte ferroptosis, which further contributes to OA development. The findings in the study assist in understanding the modulating mechanism of LDHB-mediated lactylation against chondrocyte ferroptosis in OA progression.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"493"},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic imaging confusion in infectious spondylitis.","authors":"Zhihao Xu, Weijian Zhu, Sirui Zhou, Zhiying Yang, Liqiao Xiang, Jinming Zhang, Kangshou Liu","doi":"10.1186/s13018-025-05781-5","DOIUrl":"10.1186/s13018-025-05781-5","url":null,"abstract":"<p><strong>Background: </strong>Infectious spondylitis is a rare but increasingly recognized condition involving infectious lesions of the spine. It can affect patients of all ages and is typically caused by bacterial, fungal, or other pathogens. The infection commonly targets the vertebral bodies and intervertebral discs. Early symptoms of infectious spondylitis are often nonspecific, making it challenging to differentiate from other spinal disorders such as tumors, degenerative diseases, or other types of infections. As the condition can progress rapidly, early diagnosis and intervention are crucial to improving patient outcomes.</p><p><strong>Main body: </strong>Imaging plays a critical role in the early diagnosis of infectious spondylitis. Magnetic resonance imaging is considered the gold standard due to its superior ability to visualize soft tissue structures and assess the extent of infection. CT imaging and nuclear medicine scans also provide valuable information in certain clinical scenarios, particularly for evaluating bony involvement and detecting occult infection. However, imaging findings in infectious spondylitis can overlap with those of other spinal conditions, making differential diagnosis essential for accurate identification. This study explores the advantages and limitations of different imaging modalities in diagnosing infectious spondylitis, focusing on their ability to suggest the possible etiology, determine the severity of the disease, and guide treatment decisions. Additionally, the relationship between imaging characteristics and clinical symptoms is examined to offer clinicians a systematic approach to improve diagnostic accuracy.</p><p><strong>Conclusion: </strong>Early and accurate diagnosis of infectious spondylitis is critical for preventing long-term complications. Imaging techniques, especially MRI, are invaluable tools for clinicians in identifying this condition, assessing its extent, and guiding treatment. Improved understanding of the imaging features associated with infectious spondylitis is essential for more accurate diagnosis and treatment planning.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"496"},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119876","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":"Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head.","authors":"Baoxiang Zhao, Qin Sun, Zhiqun Wang, Zhi Feng, Shiying Wang","doi":"10.1186/s13018-025-05897-8","DOIUrl":"10.1186/s13018-025-05897-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the role of serum β C-terminal telopeptide of type 1 collagen (β-CTx) and N-terminal mid-fragment of osteocalcin (N-MID) concentration in non-traumatic osteonecrosis of the femoral head (NONFH).</p><p><strong>Materials and methods: </strong>In this retrospective case-control study, serum β-CTx and N-MID levels were measured in 64 NONFH patients and 64 healthy controls. Propensity score matching (PSM) was used to balance the baseline characteristics of the two groups. The study was conducted at Linyi People's Hospital between January 2023 and February 2024. The primary outcomes included the differences in serum β-CTx and N-MID levels between the two groups, their correlations with clinical parameters, and their diagnostic performance for NONFH.</p><p><strong>Results: </strong>The serum concentration of β-CTx and N-MID was significantly higher in NONFH patients compared to healthy controls (β-CTx: 0.70 ± 0.30 ng/ml vs. 0.36 ± 0.16 ng/ml, P < 0.001; N-MID: 21.35 ± 8.24 ng/ml vs. 13.27 ± 3.87 ng/ml, P < 0.001). No significant differences were observed in serum β-CTx and N-MID levels among different etiological subgroups or ARCO stages. Pearson analysis revealed a positive correlation between serum β-CTx and N-MID levels, as well as β-CTx and pain duration. The ROC curve analysis showed that β-CTx had an AUC of 0.876 (95% CI 0.815-0.938) with a cut-off value of 0.505 ng/ml, sensitivity of 90.63%, and specificity of 76.56%. N-MID had an AUC of 0.860 (95% CI 0.797-0.924) with a cut-off value of 17.050 ng/ml, sensitivity of 84.38%, and specificity of 78.13%.</p><p><strong>Conclusion: </strong>Serum β-CTx and N-MID levels are significantly elevated in patients with NONFH and may serve as potential biomarkers for the diagnosis of NONFH. Further studies with larger sample sizes are needed to validate these findings and explore their clinical applications.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"495"},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119877","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 mechanism by which UCHL3 alleviates diabetic foot ulcers: FOXM1/NLRP3 inflammasome-mediated angiogenesis and endothelial cell pyroptosis.","authors":"Xincheng Liao, Zhengying Jiang, Zhonghua Fu, Guanghua Guo","doi":"10.1186/s13018-025-05914-w","DOIUrl":"10.1186/s13018-025-05914-w","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the role of ubiquitin C-terminal hydrolase L3 (UCHL3) in regulating endothelial cell (EC) pyroptosis and angiogenesis in diabetic foot ulcers (DFUs), with a focus on FOXM1 and NLRP3 inflammasomes.</p><p><strong>Methods: </strong>Differentially expressed genes in DFUs were identified using the GSE134431 dataset and cross-referenced with vascular formation-related factors from GeneCard and deubiquitinases from the UbiNet 2.0 database. A rat DFU model was used to evaluate wound healing, with or without UCHL3 overexpression and FOXM1 knockdown. Histological analysis and immunohistochemistry were employed to assess tissue morphology and the expression of CD31, eNOS, UCHL3, and FOXM1. In vitro, high glucose-induced human umbilical vein ECs (HUVECs) were transfected with UCHL3 overexpression and FOXM1 knockdown constructs. Cell viability, migration, and angiogenesis were assessed.</p><p><strong>Results: </strong>UCHL3 expression was significantly reduced in DFU tissues. UCHL3 overexpression promoted wound healing in a rat model, while FOXM1 knockdown impaired wound healing and vascular formation. In HUVECs, UCHL3 overexpression enhanced cell viability, migration, and angiogenesis, accompanied by reduced NLRP3 and N-GSDMD levels. FOXM1 knockdown reversed these effects, but treatment with the NLRP3 inhibitor, MCC950, alleviated this damage.</p><p><strong>Conclusion: </strong>UCHL3 enhances FOXM1 deubiquitination, inhibits NLRP3 inflammasome activation, and reduces EC pyroptosis, thereby contributing to DFU healing. UCHL3 and FOXM1 are potential therapeutic targets for DFU.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"488"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111073","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":"Functional outcome and cost effectiveness of patellar resurfacing and non-resurfacing in total knee arthroplasty: systematic review and meta-analysis.","authors":"Muhammad Andry Usman, Henry Yurianto, Nur Rahmansyah, St Fatimah Zahrah Anwar","doi":"10.1186/s13018-025-05892-z","DOIUrl":"10.1186/s13018-025-05892-z","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is rising globally, with patellar management impacting outcomes. Resurfacing reduces pain and revision rates but poses complications, while non-resurfacing lowers costs but risks persistent pain. This study updates previous meta-analyses by comparing the functional and economic outcomes of both approaches.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines. Studies comparing patellar resurfacing and non-resurfacing in TKA with functional outcomes in adults were included. Five databases were searched until February 6, 2024. Two authors independently extracted data and assessed risk of bias. Any disagreements were resolved by a third author. Statistical analysis used a random-effects model, reporting mean differences (MD) and odds ratios (OR) with 95% CI. Sensitivity and subgroup analyses were performed to assess heterogeneity and reliability.</p><p><strong>Results: </strong>A total of 49 studies (34 RCTs, 15 observational) were included from 963 screened records. Analysis of 22 studies found no significant difference in Knee Society Score (KSS) function between resurfacing and non-resurfacing (MD 2.03; 95% CI 0.58-3.48; p = 0.59, I² = 53%). Resurfacing significantly reduced anterior knee pain (OR 0.61; 95% CI 0.42-0.87; p = 0.007, I² = 70%). However, no significant differences were observed in pain scale, range of motion (ROM), or Oxford Knee Score. Three studies assessed economic outcomes using Incremental Net Benefit (INB) and Incremental Cost-Effectiveness Ratio (ICER) showed no significant cost-effectiveness.</p><p><strong>Conclusions: </strong>Patellar resurfacing in TKA significantly reduces anterior knee pain but shows no advantage in KSS function, pain scale, Oxford Knee Score, ROM, or cost-effectiveness. Surgical decisions should be individualized to optimize patient outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"492"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111074","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":"Meta-analysis on effects of lymphatic drainage techniques in the management of carpal tunnel syndrome.","authors":"Sina Shahshenas, Hossein Yarmohammadi, Masood Soltanipur, Zahra Sheikhi","doi":"10.1186/s13018-025-05887-w","DOIUrl":"10.1186/s13018-025-05887-w","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome (CTS) is a common neuropathy caused by median nerve compression, leading to pain, numbness, and functional impairment. While surgical decompression remains the definitive treatment for severe cases, non-surgical approaches are often utilized for symptom management. Lymphatic drainage techniques, including manual lymphatic drainage (MLD) and Kinesio taping, have been proposed as potential therapies for CTS by reducing edema and nerve compression. However, their efficacy remains uncertain. This study aimed to evaluate the effects of lymphatic drainage techniques on symptom severity, functional outcomes, nerve conduction parameters, and pain relief in patients with CTS.</p><p><strong>Methods: </strong>This meta-analysis was conducted following PRISMA guidelines. A comprehensive search of PubMed, Scopus, and Web of Science databases was performed up to February 2025. Studies assessing the effects of lymphatic drainage techniques (MLD, Kinesio taping, or compression therapy) on CTS-related outcomes were included. Two meta-analytical approaches were used: (1) between-group differences comparing intervention and control groups and (2) within-group changes pre- and post-intervention. Primary outcomes included the Boston Symptom Severity Scale (BSSS), Boston Functional Status Scale (BFSS), Visual Analog Scale (VAS), median nerve cross-sectional area (CSA), hand grip strength, and nerve conduction studies.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria, with a total of 479 participants. The between-group meta-analysis revealed significant pain reduction (VAS: SMD = -0.31, 95% CI: -0.51 to -0.12, p < 0.05) and improvements in CSA (SMD = 0.39, 95% CI: 0.10 to 0.68, p < 0.05). Median nerve motor and sensory velocities also improved significantly (p < 0.05). However, BSSS and BFSS did not show significant differences between groups. The within-group analysis demonstrated significant improvements in symptom severity (BSSS: MD = -10.80, 95% CI: -14.73 to -6.78, p < 0.05) and functional status (BFSS: MD = -6.44, 95% CI: -8.78 to -4.09, p < 0.05). The subgroup analysis showed that treatment benefits were sustained over time, with no significant differences between short-term and long-term follow-ups.</p><p><strong>Conclusions: </strong>Lymphatic drainage techniques offer a promising non-invasive approach for CTS, decreasing pain, reducing edema, and enhancing nerve conduction. While intra-group improvements were notable, limited between-group differences were observed.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"491"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111076","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 subdermal needle and surface adhesive electrodes for intraoperative neuromonitoring during spine surgeries.","authors":"Weiwei Xia, Dekui Song, Han Fu, Ting Lei, Kaifeng Wang, Yan Zeng","doi":"10.1186/s13018-025-05907-9","DOIUrl":"10.1186/s13018-025-05907-9","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to further compare subdermal needle electrodes (NE) and surface adhesive electrodes (SE) during intraoperative neuromonitoring (IONM) in spine surgeries.</p><p><strong>Methods: </strong>We analyzed data from forty consecutive patients undergoing spine surgery. The data mainly included impedance, Root Mean Square (RMS), Tc-MEP and free-run EMG characteristics of NE versus SE with (left foot) and without (right foot) conductive paste (CP) during IONM.</p><p><strong>Results: </strong>Results indicated that SE with CP exhibited significantly lower impedance than SE without CP and higher impedance than NE. The RMS of free-run EMG recorded by SE were found to be higher than the NE, but no significant differences were found between SE with CP and SE without CP. Furthermore, NE yielded higher MEP amplitudes and superior signal-to-noise ratios (SNR) than SE. The ratios of MEP amplitude and SNR recorded by SE to NE were not significantly different between the left and right foot. The success rate for MEP induction was significantly higher with NE than SE.</p><p><strong>Conclusion: </strong>This research advocates for prioritizing NE in IONM during spine surgeries due to their favorable performance characteristics.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"490"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110983","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":"Knee morphology and patella malalignment in neglected developmental dysplasia of the hip: a systematic review and meta-analysis.","authors":"Daofeng Wang, Jianzhong Sun, Yang Liu, Zhengjie Tang, Hui Zhang","doi":"10.1186/s13018-025-05877-y","DOIUrl":"10.1186/s13018-025-05877-y","url":null,"abstract":"<p><strong>Purpose: </strong>To quantitatively analyze the structural changes of the knee in patients with neglected developmental dysplasia of the hip (DDH).</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library databases were searched to identify studies comparing the morphological parameters of the knee between DDH patients and healthy individuals. Data on rotational and mechanical parameters of the lower limb, rate of occasional anterior knee pain (AKP), and knee morphological parameters, were extracted. Review Manager and R statistic software were used to perform the statistical analysis.</p><p><strong>Results: </strong>Nine studies with a total of 790 legs in 521 neglected DDH patients and 431 legs in 303 health subjects were included. Patients were predominantly female (88.3%). The Crowe classification is most commonly used to assess the severity of DDH. The total incidence of occasional AKP ranged from 8.6 to 20.6%, with an overall pooled rate of 14.4% (95%CI = 9.8-19.8%). In patients with neglected DDH, significant increases (P < 0.0001) were observed in femoral anteversion (weighted mean: 39.1° vs. 17.7°), knee torsion (weighted mean: 9.0° vs. 1.6°), and the vertical dimension of the medial femoral condyle (weighted mean: 13.8 mm vs. 11.6 mm), along with a significant decrease in the lateral distal femoral angle (weighted mean: 82.1° vs. 84.8°), which can lead to torsion deformity of the lower limb and valgus inclination of the distal femoral articular surface. Compared with the intact subjects, DDH knees demonstrated an increased sulcus angle (weighted mean: 144.9° vs. 137.5°; P < 0.0001), decreased trochlear depth (weighted mean: 3.1 mm vs. 4.5 mm; P < 0.0001), increased lateral shift of the patella (5.1 mm vs. 3.8 mm, P = 0.06), and increased patellar tilt angle (weighted mean: 18.2° vs. 13.2°; P < 0.0001). These findings were associated with developmental dysplasia of femoral trochlear and patellar instability.</p><p><strong>Conclusion: </strong>Developmental dysplasia of the hip leads to patellar malalignment and developmental changes in the bony anatomy of the knee joint, including the development of a valgus deformity of the lower extremity and trochlear dysplasia. These findings may be associated with patellar instability.</p><p><strong>Level of evidence: </strong>III, systematic review.</p><p><strong>Registration: </strong>This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42025640292).</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"489"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111075","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}