Journal of Orthopaedic Surgery and Research最新文献

{"title":"Impact of cloud-based follow-up exercise prescription on knee function and quality of life in homebound patients post-total knee arthroplasty: a randomized controlled trial.","authors":"Weiqiang Chen, Xianglan Qin, Haoze Yang, Zhen Tan, Pei Liu","doi":"10.1186/s13018-025-06187-z","DOIUrl":"https://doi.org/10.1186/s13018-025-06187-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the impact of a cloud-based follow-up exercise prescription on knee function and quality of life in patients undergoing home-based rehabilitation following total knee arthroplasty (TKA), thereby informing the application of telemedicine in post-TKA home rehabilitation.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted from February 2023 to January 2024. Patients were divided into a control group and an intervention group according to a random number table. Both groups performed rehabilitation exercises based on exercise prescriptions. After discharge, the control group received follow-up via conventional methods, while the intervention group was monitored using a cloud-based follow-up system. Independent samples t-tests were employed to compare the two patient cohorts with respect to knee function, quality of life, adherence to rehabilitation exercises, and total follow-up costs.</p><p><strong>Results: </strong>Of the 164 patients initially enrolled, 151 completed the 12-week follow-up and functional exercises: 75 in the control group and 76 in the intervention group. At 2 and 4 weeks post-surgery, the intervention group demonstrated superior knee function and adherence to rehabilitation exercises compared to the control group (all P < 0.05). At 4 weeks post-surgery, the intervention group also exhibited a higher quality of life (P < 0.05). At 12 weeks post-surgery, no significant differences were observed between the two groups in knee function, quality of life, or adherence to rehabilitation exercises. The total follow-up cost for the intervention group was lower than that of the control group (p < 0.05).</p><p><strong>Conclusions: </strong>Cloud-based follow-up exercise prescriptions can improve knee function and quality of life in home-based patients in the early stages (within 4 weeks) of rehabilitation exercises after TKA, which is of clinical significance.</p><p><strong>Trial registration: </strong>ChiCTR2200067031, registered 23 December 2022, https://www.chictr.org.cn/bin/project/edit?pid=185737 .</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"809"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957945","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":"Shear wave elastography for noninvasive assessment of intracompartmental pressure in tibial plateau fractures: a cross-sectional study.","authors":"Heng Zhang, Luqi Li, Huiyang Jia, Haofei Wang, Qi Dong, Jialiang Guo, Zhiyong Hou","doi":"10.1186/s13018-025-06241-w","DOIUrl":"https://doi.org/10.1186/s13018-025-06241-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the utility of shear wave elastography (SWE) as a noninvasive diagnostic tool for assessing anterior compartment intracompartmental pressure (ICP) in patients with tibial plateau fractures, facilitating early detection of high compartment pressure (HCP) to mitigate acute compartment syndrome (ACS) risks.</p><p><strong>Methods: </strong>In this cross-sectional study conducted from January 2024 to March 2025 at a tertiary hospital in China, 170 patients aged 18-65 years with tibial plateau fractures diagnosed within 48 h were enrolled. Demographic data, injury mechanisms, Schatzker classification, and laboratory parameters were collected. shear wave velocity (SWV) was measured via SWE on both injured and contralateral anterior compartment muscles, alongside invasive ICP monitoring. Statistical analyses encompassed Spearman's correlations, stepwise logistic regression for a multivariate model incorporating SWV, age, and fracture type, and receiver operating characteristic (ROC) curves for diagnostic performance.</p><p><strong>Results: </strong>Among participants (57.1% male, median age 45 years), 44 exhibited HCP (ICP ≥ 30 mmHg). Injury-side SWV and SWV differential showed strong positive correlations with ICP (ρ = 0.704 and 0.535, respectively; both P < 0.001). Significant SWV disparities were observed between HCP and non-HCP groups (P < 0.001). The multivariate model yielded an AUC of 0.880, with 93.2% sensitivity and 71.4% specificity, demonstrating consistent performance across gender subgroups. Adjusted odds ratios highlighted injury-side SWV (aOR 5.99) and Schatzker Ⅳ-Ⅵ fractures (aOR 4.14) as key predictors.</p><p><strong>Conclusion: </strong>Our study results indicate that SWE can reliably and noninvasively detect HCP in tibial plateau fractures, providing superior diagnostic accuracy and clinical applicability.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"807"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958016","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":"Instrument-assisted soft tissue mobilization and percussion massage therapy in cervical disc herniation: a randomized controlled study.","authors":"Burak Menek, Emre Dansuk, Sema Gorguluer","doi":"10.1186/s13018-025-06238-5","DOIUrl":"https://doi.org/10.1186/s13018-025-06238-5","url":null,"abstract":"<p><strong>Background: </strong>Cervical disc herniation (CDH) is a common musculoskeletal disorder characterized by chronic neck pain, impaired proprioception, kinesiophobia, and functional limitations, often requiring multimodal conservative care. Myofascial techniques, including Instrument-Assisted Soft Tissue Mobilization (IASTM) and percussion massage therapy (PMT), have emerged as supportive physiotherapy interventions. This randomized controlled trial compared the effects of IASTM and PMT on pain, disability, kinesiophobia, and proprioceptive function in individuals with CDH.</p><p><strong>Methods: </strong>In this double-blinded RCT, 57 participants with CDH were randomly allocated to Conventional Therapy (CT), CT + PMT, or CT + IASTM (n = 19 each). Interventions were delivered three times per week for 3 weeks. PMT was applied with a percussion massage device (33-40 Hz) for 3 min to each target muscle group (trapezius, levator scapulae, cervical paravertebral) using longitudinal strokes. IASTM used stainless-steel tools on trapezius, splenius, and suboccipital muscles, with sweep and fan techniques at 30°-60°, for 9 min per session. Primary outcomes were pain (VAS) and disability (NDI); secondary outcomes included kinesiophobia (TSK) and joint position sense (JPS). Between-group differences were analyzed using ANCOVA with baseline values as covariates.</p><p><strong>Results: </strong>All groups showed significant within-group improvements across all outcomes (p < 0.001). Compared to CT, both PMT and IASTM produced greater improvements in pain, kinesiophobia, and JPS (p < 0.001). VAS-rest reductions were - 4.00 ± 0.89 (d = 4.49) for IASTM, - 3.38 ± 1.95 (d = 1.74) for PMT, and - 2.13 ± 1.49 (d = 1.43) for CT. VAS-activity decreased by - 4.89 ± 1.44 (d = 3.41) for IASTM and - 3.89 ± 1.84 (d = 2.11) for PMT. NDI improved by - 11.47 ± 4.23 (d = 2.71) in IASTM, - 12.11 ± 6.86 (d = 1.76) in PMT, and - 6.63 ± 5.47 (d = 1.21) in CT, all exceeding the MCID threshold of 7.5 points. JPS-flexion improved by - 3.80 ± 1.61 (d = 2.36) in IASTM, - 3.67 ± 1.34 (d = 2.73) in PMT, and - 1.09 ± 0.84 (d = 1.29) in CT. Similar patterns occurred for extension, right rotation, and left rotation. Overall, IASTM and PMT yielded comparable improvements, suggesting similar clinical efficacy.</p><p><strong>Conclusions: </strong>IASTM and PMT provide added benefits over conventional therapy alone in managing CDH, especially in reducing pain and kinesiophobia and enhancing proprioception. Both can be effectively integrated into conservative rehabilitation programs targeting sensorimotor deficits in CDH.</p><p><strong>Trial registration: </strong>Prospectively registered in the ClinicalTrials.gov registry (NCT06903000) on 24/03/2025.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"801"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957954","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 a single intra-articular injection of mesenchymal stem cells for knee osteoarthritis: a dose-focused meta-analysis of randomized controlled trials.","authors":"Rizki Rahmadian, Zikril Ariliusra, Kevin Rizki Agung Kusuma, Hirowati Ali, Benni Raymond, Riki Meksiko","doi":"10.1186/s13018-025-06190-4","DOIUrl":"10.1186/s13018-025-06190-4","url":null,"abstract":"<p><strong>Background: </strong>Intra-articular injection of mesenchymal stem cells (MSCs) has emerged as a promising therapy for knee osteoarthritis (OA). However, uncertainty remains regarding the optimal cell dose for maximizing clinical benefit. This systematic review and meta-analysis aimed to evaluate the efficacy of MSC injections for knee OA and investigate the relationship between cell dose and treatment outcome.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed and Scopus for randomized controlled trials (RCTs) published between 2015 and 2025. Eligible studies were RCTs that used intra-articular MSC injections for knee OA, and WOMAC scores were reported at baseline and 12-month follow-up. Standardized mean differences (SMDs) were pooled using a random-effects model. Subgroup analysis and meta-regression were performed to evaluate the effect of MSC dose on treatment outcomes.</p><p><strong>Results: </strong>Eight treatment arms from six RCTs involving 300 patients were included. The pooled SMD in the WOMAC score at 12 months was -1.35 (95% CI: -1.97 to -0.74), indicating a moderate to large treatment effect. MSC doses of ≤ 25 million cells were associated with statistically significant improvement, while higher doses did not demonstrate additional benefit. Meta-regression confirmed no significant dose-response relationship. Heterogeneity was moderate (I2 = 49.8%).</p><p><strong>Conclusion: </strong>Intra-articular MSC therapy significantly improves clinical outcomes in knee OA at 12 months, with lower doses (≤ 25 million cells) appearing to be both effective and potentially more efficient. These findings support dose optimization as a critical consideration in advancing MSC therapy.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"812"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957758","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":"Ultrasound-assisted minimally invasive repair of acute Achilles tendon rupture with a shuttling needle.","authors":"Chaonan Wang, Yajing Lin, Lina Ye, Zhanghuan Chi, Zhongliang Su","doi":"10.1186/s13018-025-06239-4","DOIUrl":"https://doi.org/10.1186/s13018-025-06239-4","url":null,"abstract":"<p><strong>Background: </strong>The optimal management of acute Achilles tendon ruptures remains controversial. Open surgical repair (OSR) carries high complication rates, while minimally invasive techniques reduce risks but pose concerns regarding sural nerve injury. This study evaluates the clinical outcomes of ultrasound-assisted minimally invasive repair (MIR) using a double-ended shuttling needle.</p><p><strong>Methods: </strong>A retrospective cohort of 41 patients (2017-2022) was analyzed: 19 underwent OSR (8-10 cm midline incision, Krackow suture), and 22 received MIR (2 cm incision, ultrasound-guided Bunnell suture with shuttling needle). Operative time, scar length, American Orthopaedic Foot & Ankle Society (AOFAS) score, Achilles Tendon Rupture Score (ATRS), calf circumference, and complications were compared. Statistical analyses included independent t-tests, Mann-Whitney U tests, and chi-square tests (α = 0.05).</p><p><strong>Results: </strong>MIR demonstrated significantly shorter operative time (18.8 ± 3.0 min vs. 55.2 ± 6.5 min; p = 0.010) and smaller scars (2.02 ± 0.39 cm vs. 10.2 ± 1.9 cm; p = 0.005) versus OSR. No significant functional differences existed at 12 months (AOFAS: 90.2 ± 4.3 vs. 88.6 ± 3.8, p = 0.558; ATRS: 90.9 ± 3.3 vs. 89.7 ± 2.6, p = 0.601). Zero complications occurred with MIR, whereas the OSR had 1 superficial infection, 3 sural nerve injuries, and 2 cases of scar adhesion. MIR patients initiated controlled training at 3 months, showing superior trends in activity resumption.</p><p><strong>Conclusion: </strong>Ultrasound-assisted MIR reduces operative time by 69.9%, minimizes scarring by 80.2%, and eliminates nerve injury risks while achieving functional parity with OSR. Long-term biomechanical performance and resource accessibility warrant further investigation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"813"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958033","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 sagittal alignment changes in the spine-pelvis joint in sitting and standing positions after long- or short-segment fixation to the pelvis for lumbar degenerative diseases.","authors":"Yue Ma, ChunGuo Wang, Han Yu, Benzhang Tao, Chao Gao, Gan Gao, Chao Xue","doi":"10.1186/s13018-025-06199-9","DOIUrl":"https://doi.org/10.1186/s13018-025-06199-9","url":null,"abstract":"<p><strong>Background: </strong>The spine, pelvis, and joints maintain sagittal balance, which is often disrupted in lumbar degenerative diseases. While preoperative changes in sagittal alignment are well studied, postoperative adaptations, particularly following spinal fixation extending to the pelvis, are less understood. Therefore, the present study aimed to examine sagittal changes in the spine, pelvis, and joints in sitting and standing positions after short- or long-segment posterior spinal fixation extending to the pelvis.</p><p><strong>Methods: </strong>This cross-sectional study analyzed patients who underwent long- or short-segment instrumented fusion to the pelvis for lumbar degenerative disease at our hospital from June 2018 to October 2019. Patients were grouped based on the number of internal fixation segments, both short and long. Sagittal parameters were measured in standing and sitting positions and matched for sex, gender, height, weight, and other related parameters. Statistical analysis was performed using t-tests and Mann-Whitney U tests.</p><p><strong>Results: </strong>A total of 98 patients were included, of whom 55 were included in the long-segmengroup (31 men, 24 women; mean age of 63.1 ± 8.5 years). In the long-segment group, no significant changes were observed between standing and sitting positions (P > 0.05). In the short-segment group, significant changes were observed in the sacral vertical axis, pelvic tilt, sacral slope, thoracic kyphosis, lumbar lordosis, T1 pelvic angle, T1 spinopelvic inclination, acetabular tilt, and pelvic-femoral angle between the two positions (P < 0.05). The difference in pelvic femoral angle changes between the groups was also significant (P < 0.05).</p><p><strong>Conclusions: </strong>In the short-segment group, transitioning from standing to sitting leads to greater sagittal changes, including decreased lumbar lordosis and forward trunk lean, with smaller hip joints than in the long-segment internal fixation group.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"803"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958061","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":"Ginkgolide B modulates the gut-bone axis to ameliorate bone loss in ovariectomized mice.","authors":"Ning Wang, Han Yang, Xue Tong, Tong Xu, Jiamin Zhao, Yi-Kai Li","doi":"10.1186/s13018-025-06215-y","DOIUrl":"https://doi.org/10.1186/s13018-025-06215-y","url":null,"abstract":"<p><strong>Scope: </strong>Estrogen deficiency post-menopause is a key driver of bone loss and is often associated with disruption of the gut-bone axis. This study explored the therapeutic potential of Ginkgolide B (GB), a natural bioactive compound from Ginkgo biloba, in estrogen deficiency-induced bone loss using ovariectomized (OVX) mice.​.</p><p><strong>Methods: </strong>Female SPF C57BL/6J mice were randomly divided into sham-operated (Sham), OVX, and OVX+GB groups. Osteoporosis was induced by bilateral ovariectomy, and GB was administered via oral gavage for 8 weeks. Evaluations included serum biochemical markers, bone microstructure (micro-CT, histomorphometry), intestinal barrier function (histology, immunohistochemistry, and Western blot), immune cell populations (flow cytometry), and gut microbiota composition (16S rRNA gene sequencing).</p><p><strong>Results: </strong>GB treatment significantly mitigated bone loss in OVX mice, as confirmed by micro-CT, histological, and biochemical tests. GB enhanced intestinal barrier integrity by upregulating tight junction proteins and reducing pro-inflammatory markers. Flow cytometry showed that GB restored the balance of T helper 17 (Th17) and regulatory T (Treg) cells in the mesenteric lymph node and spleen, suggesting immune regulation. Additionally, GB modulated gut microbiota composition, increasing beneficial taxa like Lactobacillaceae and Prevotellaceae. Correlation analysis indicated significant associations between microbial taxa and serum markers and bone metabolism, highlighting the role of gut microbiota in GB's therapeutic effects on osteoporosis.</p><p><strong>Conclusion: </strong>GB is a promising natural bioactive compound for modulating bone health through the gut-bone axis, warranting further research to clarify underlying mechanisms.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"804"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957913","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":"Correction: Validation of the Turkish version of the knee osteoarthritis outcome score-child questionnaire.","authors":"Ahmet Onur Akpolat, Onur Gultekin, Halil Ibrahim Arikan, Ahmet Eren Sen, Bekir Eray Kılınc","doi":"10.1186/s13018-025-06251-8","DOIUrl":"https://doi.org/10.1186/s13018-025-06251-8","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"811"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957730","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 outcomes and mortality after multi-limb amputations following the 2023 Türkiye earthquake: a two-year follow-up study from a level I trauma center.","authors":"Nihat Yiğit, İbrahim Alper Yavuz, Tahsin Aydın, Şahan Güven, Ceyhun Çağlar, İbrahim Bozkurt, Özgür Doğan, Enver Kılıç, Ahmet Özgür Yıldırım","doi":"10.1186/s13018-025-06231-y","DOIUrl":"https://doi.org/10.1186/s13018-025-06231-y","url":null,"abstract":"<p><strong>Background: </strong>Multi-limb amputations are extremely rare and devastating injuries, particularly in the context of civilian disasters. The 2023 Türkiye earthquake resulted in a significant number of complex traumatic injuries, including multiple limb amputations. This study aims to investigate early mortality, surgical complications, and functional outcomes at two-year follow-up in civilian patients who underwent two or more limb amputations following the disaster.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 22 patients who sustained multiple limb amputations after the earthquake. Demographic data, amputation levels, surgical interventions, complications, and outcomes at two-year follow-up were recorded. The primary outcomes were mortality, the number and type of reoperations, and functional recovery at two years.</p><p><strong>Results: </strong>Among the cohort, two-limb amputations were performed in 17 patients, three-limb amputations in 4 patients, and four-limb amputation in 1 patient. Twenty patients required at least one additional surgical procedure during hospitalization, most commonly surgical debridement for soft tissue infection. Eight patients died, of whom five had undergone amputation of three or more limbs. Sepsis was the leading cause of death. Follow-up data at two years were available for 14 survivors. Of these, only 3 patients were able to ambulate independently using prosthetic devices. Phantom limb pain was reported in 6 patients, and all received medical management. The average hospital stay exceeded 80 days in patients with bilateral amputations.</p><p><strong>Conclusions: </strong>This study presents one of the largest case series of multi-limb amputees following a civilian earthquake. The findings highlight the high rate of reoperation, substantial mortality, and limited functional recovery at two-year follow-up in this population. Early multidisciplinary rehabilitation strategies should be prioritized to improve outcomes in future mass-casualty settings.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"802"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957900","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 management for osteoporotic vertebral compression fractures: a network meta-analysis.","authors":"Yan Li, Xianghong Wang, Jianfeng Sun, Maozhen Ma","doi":"10.1186/s13018-025-06233-w","DOIUrl":"10.1186/s13018-025-06233-w","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of osteoporotic vertebral compression fractures (OVCFs) remains controversial. This network meta‑analysis (NMA) evaluated the relative efficacy and safety of third‑generation percutaneous vertebral augmentation (TVA), percutaneous kyphoplasty (PKP), percutaneous vertebroplasty (PVP), and non‑surgical management (NSM) in OVCFs.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted from inception to February 1, 2025, to identify clinical trials comparing ≥ 2 of these interventions. Primary outcomes included pain intensity (Visual Analog Scale [VAS]), functional disability (Oswestry Disability Index [ODI]), quality of life (EQ‑5D), and anterior vertebral body height (AVB). Adverse events, including adjacent vertebral fracture (AVF) and bone cement leakage (BCL), were also assessed.</p><p><strong>Results: </strong>Forty‑six studies (23 RCTs and 23 comparative cohort studies; n = 5,660) were included. Both TVA and PKP yielded greater VAS reductions than NSM at short‑term (≤ 6 months; MD - 1.28 and - 1.37; 95% CI - 1.62 to - 0.93 and - 1.82 to - 0.92) and long‑term (> 6 months; MD - 0.86 and - 0.69; 95% CI - 1.22 to - 0.50 and - 1.20 to - 0.19) follow‑up. TVA outperformed NSM in ODI improvement at short‑term (MD - 6.84; 95% CI - 9.84 to - 3.84) and long‑term (MD - 9.14; 95% CI - 14.64 to - 3.65); PKP surpassed NSM short‑term (MD - 5.59; 95% CI - 9.32 to - 1.86) but was inferior to TVA long‑term (MD 8.34; 95% CI 2.62 to 14.06). Surgical interventions uniformly outperformed NSM in quality‑of‑life gains. TVA and PKP achieved greater AVB restoration than NSM, whereas PVP carried a higher BCL risk compared to TVA and PKP. NSM was associated with the lowest probability of AVF (90.2%).</p><p><strong>Conclusions: </strong>Although PKP offers the greatest long‑term preservation of AVB, third‑generation TVA appears superior to PVP, PKP, and NSM in improving pain, functional disability, quality of life, and safety in OVCF patients. High‑quality randomized trials with extended follow‑up are required to confirm these findings.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"810"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957974","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}