Journal of Orthopaedic Surgery and Research最新文献

{"title":"Radiography may not be accurate in assessing acute ankle sprains in children.","authors":"Xiongtao Li, Xiantao Shen, Si Wang, Jie Sun, Zhaoting Liu","doi":"10.1186/s13018-025-05480-1","DOIUrl":"10.1186/s13018-025-05480-1","url":null,"abstract":"<p><strong>Background: </strong>Acute ankle sprains are among the most common injuries in children and are often associated with chondral avulsion fractures and ligament injuries. However, radiography may not be sufficiently accurate for assessing cartilage and ligament injuries in children. The primary purpose of this study was to evaluate the necessity of radiography in the diagnosis of acute ankle sprains in children. The secondary purpose was to assess whether ultrasonography can effectively improve the diagnostic accuracy of acute ankle sprains in children.</p><p><strong>Methods: </strong>We collected medical data from 78 children with acute ankle sprains who underwent both radiological and ultrasound examinations, 59 of whom also had ankle MRI results. The agreement between the radiographic and ultrasonographic findings in these 78 patients was assessed via Cohen's kappa and McNemar tests. Using MRI results as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of radiography and ultrasonography were evaluated for the 59 patients who had MRI results. Cohen's kappa and McNemar's tests were also utilized to assess the reliability of radiography and ultrasonography in comparison to MRI.</p><p><strong>Results: </strong>Among the 78 children with acute ankle sprains, 29 did not show fractures on radiological examination, but fractures were detected via ultrasound examination. Among these 29 fractures, 20 were chondral avulsion fractures of the distal fibula, and 9 were avulsion fractures of the lateral talus process. The agreement between radiography and ultrasonography was fair (Kappa = 0.250), and the difference was statistically significant (P < 0.001). Using MRI as the gold standard, radiography resulted in 17 false-negative cases for lateral ankle fractures, with a sensitivity of only 47%. Ultrasonography produced only one false-negative case, achieving a sensitivity of 97%. Ultrasonography showed substantial agreement with MRI (Kappa = 0.797), whereas radiography showed fair agreement with MRI (Kappa = 0.384).</p><p><strong>Conclusions: </strong>Acute ankle sprains in children frequently result in a high incidence of chondral avulsion fractures. However, radiography may be inadequate for accurately diagnosing these fractures. Reliance on radiography alone may lead to a substantial number of false-negative cases. Compared with radiography, ultrasonography is highly accurate in the diagnosis of chondral avulsion fractures and ligament injuries in children. We believe that ultrasonography, as a noninvasive, radiation-free, and cost-effective dynamic diagnostic method, is particularly suitable for the early diagnosis of acute ankle sprains in children.</p><p><strong>Level of evidence: </strong>Level III; Diagnostic Study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"77"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023756","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":"Mechanism of hyperbaric oxygen therapy downregulating H-type angiogenesis in subchondral bone of knee osteoarthritis through the PHD2/HIF-1α pathway.","authors":"Jianjian Wang, Wen Yu, Yuxin Zhang, Bo Chen, Zhaoxiang Meng","doi":"10.1186/s13018-025-05514-8","DOIUrl":"10.1186/s13018-025-05514-8","url":null,"abstract":"<p><strong>Objective: </strong>To explore the mechanism of hyperbaric oxygen therapy in inhibiting subchondral bone angiogenesis and delaying the progression of osteoarthritis through the PHD2/HIF-1α signaling pathway.</p><p><strong>Methods: </strong>Mice were randomly divided into three groups (control group, osteoarthritis group, and hyperbaric oxygen treatment group). The effect of hyperbaric oxygen therapy on osteoarthritis was evaluated using Micro-CT, Safranin O-Fast Green staining, and detection of osteoarthritis inflammation markers (MMP-13, ADAMTS-5, Col2a1, and Aggrecan). The activation relationship between PHD2 and downstream signaling pathways was investigated through gene knockout and overexpression experiments. Finally, cell scratch assays, tube formation assays, and chondrogenic differentiation experiments were conducted to verify the mechanism of the PHD2/HIF-1α signaling pathway under hyperbaric oxygen stimulation.</p><p><strong>Results: </strong>Hyperbaric oxygen therapy delayed the progression of osteoarthritis in mice. It promoted chondrogenic differentiation of mesenchymal stem cells, inhibited angiogenesis, enhanced PHD2 expression, and suppressed the production of HIF-1α and VEGFA. Silencing/overexpression of PHD2 resulted in increased/decreased production of HIF-1α and VEGFA, respectively.</p><p><strong>Conclusion: </strong>The hyperbaric oxygen environment promotes the expression of PHD2, accelerates the degradation of HIF-1α, and inhibits the production of VEGFA, thereby reducing the generation of type H vessels in subchondral bone.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"79"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023754","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 patellar compression angle: a new, accurate diagnostic angle for lateral patellar compression syndrome.","authors":"Xiaokang Gao, Jinwei Liu, Jingyu Zhang, Zhitao Xie, Chengyue Yu, Yufei Yuan, Leming Mou, Weiguo Xu","doi":"10.1186/s13018-025-05501-z","DOIUrl":"10.1186/s13018-025-05501-z","url":null,"abstract":"<p><strong>Background: </strong>Lateral patellar compression syndrome (LPCS) is a common cause of anterior knee pain. Early diagnosis of LPCS using an accurate radiological examination is, therefore, important. However, the currently used radiological examinations for detecting LPCS are poor diagnostic indicators. Therefore, the aim of this study was to establish a new diagnostic imaging examination for LPCS and evaluate its accuracy in comparison with conventional examinations.</p><p><strong>Methods: </strong>From June 2020 to May 2023, a retrospective analysis was conducted on 72 patients in the LPCS group and 140 patients in the Control group, all of whom underwent axial radiographs of the patella and knee MRI. The patellar compression angle (PCA), Tilting angle (TA), Congruence angle (CA), Grelsamer angle (AG), and Lateral patellofemoral angle (LPA) were used and compared statistically for their accuracy in terms of diagnosing LPCS.</p><p><strong>Results: </strong>The area under the receiver operating characteristic curve (ROC) for the PCA was 0.87, which was the highest among the five examinations. ROC analysis revealed that a smaller PCA, less than 14.7°, was associated with LPCS, with the highest sensitivity (80.6%), specificity (82.9%), accuracy (82.1%), positive predictive value (PPV, 70.7%), negative predictive value (NPV, 89.2%), positive likelihood ratio (PLR, 4.71), and lowest negative likelihood ratio (NLR, 0.23) compared with the other four examinations. The interobserver reproducibility of the PCA was good, with an intraclass correlation coefficients (ICCs) of 0.85.</p><p><strong>Conclusions: </strong>The PCA can detect LPCS with a moderate diagnostic performance and could, therefore, might be a new angle for the diagnosis of LPCS in clinical settings.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"78"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023848","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":"Assessing the effectiveness of the SOLIO Alfa Cure Plus device in treating low back pain: a randomized controlled study.","authors":"Hadari Yotam, Pesah Galia, Goor-Aryeh Itay, Ungar Lior","doi":"10.1186/s13018-024-05441-0","DOIUrl":"10.1186/s13018-024-05441-0","url":null,"abstract":"<p><strong>Background: </strong>Nonspecific low back pain (LBP) has become a significant worldwide public health problem. It is estimated that 84% of people present it at some point in their lives, in which 23% experience its chronic form, negatively affecting their daily lives. Because pain management tool that doesn't require a firm diagnosis, the development of a device, as SOLIO Alfa Cure Plus, that emanates low level laser therapy, radio frequency and heat with the goal of easing chronic back pain was highly expected.</p><p><strong>Methods: </strong>randomized, single blinded, controlled trial.</p><p><strong>Measures: </strong>Numeric Pain Rating Scale (NPRS), the Oswestry Disability Index (ODI) and the Schober's test. Thirty-seven patients completed pain, disability, and lower back flexibility scales. Randomization was obtained by having an equal amount of sham and real devices and distributing them randomly to patients out of a box where the devices were.</p><p><strong>Results: </strong>We observed a larger pain relief in the SOLIO group (42% vs. 23% p = 0.03), and a higher improvement in flexibility (13%) compared to a worsening in the sham group (6.5%; p = 0.04).</p><p><strong>Conclusion: </strong>We concluded that utilizing the SOLIO Alfa Cure Plus device may dramatically reduce back pain and allow patients to experience an improvement in quality of life as a result.</p><p><strong>Trial registration: </strong>The clinical trials registration is 8475-21-SMC.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"76"},"PeriodicalIF":2.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007088","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":"LINC00941 affects the proliferation, apoptosis and differentiation of osteoblasts by regulating the miR-335-5p/KAT7 axis.","authors":"Longjin Liu, Ye Yang, Pengxiao Sun","doi":"10.1186/s13018-025-05469-w","DOIUrl":"10.1186/s13018-025-05469-w","url":null,"abstract":"<p><strong>Background: </strong>Fractures are the prevalent traumatic conditions encountered in orthopedic practices. The rising incidence of fractures has emerged as a pressing global health concern. Although the majority of individuals with fractures experience complete recovery of bone structure and function, approximately 10% of those with fractures exhibit delayed fracture healing (DFH). The objective of this investigation was to explore the function and underlying mechanisms of LINC00941 in the advancement of DFH, as well as its involvement in the regulation of osteoblastic differentiation by regulating the miR-335-5p/KAT7 axis.</p><p><strong>Methods: </strong>The expression levels of LINC00941, miR-335-5p, KAT7 and osteoblast differentiation-related markers were assessed using RT-qPCR. The proliferation of MC3T3-E1 cells was evaluated through the CCK-8 assay, and cell apoptosis was analyzed via flow cytometry. The targeted regulatory relationships between LINC00941 and miR-335-5p, as well as between miR-335-5p and KAT7 were verified by a dual-luciferase reporter gene assay.</p><p><strong>Result: </strong>The expression of LINC00941 was significantly up regulated, while miR-335-5p exhibited a notable downregulation in DFH patients, both of LINC00941 and miR-335-5p have been identified as potential predicted markers for DFH. Furthermore, LINC00941 has been demonstrated to inhibit osteoblast proliferation, promote apoptosis, and suppress osteoblast differentiation through the regulation of the miR-335-5p/KAT7 axis.</p><p><strong>Conclusion: </strong>LINC00941/ miR-335-5p/KAT7 axis may be a therapeutic target for DFH.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"75"},"PeriodicalIF":2.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006777","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":"An alternative fixation for all mild and moderate hallux valgus cases enabling intraoperative readjustment.","authors":"Mesut Uluöz, Mehmet Yiğit Gökmen, Özhan Pazarcı","doi":"10.1186/s13018-024-05413-4","DOIUrl":"10.1186/s13018-024-05413-4","url":null,"abstract":"<p><strong>Background: </strong>The development of a cost-effective and easily applicable fixation method to address all components of hallux valgus (HV) surgery is of great importance to the field. This study aims to assess the clinical efficacy of an  alternative fixation method that combines the advantages aspects of commonly used distal osteotomy techniques and evaluate its level of applicability in the treatment of mild and moderate HV cases.</p><p><strong>Methods: </strong>The retrospectively designed study was conducted at Adana City Training and Research Hospital, Adana, Türkiye. The inclusion criteria were as follows: having undergone distal metatarsal osteotomy, minimum duration of follow-up of twelve months, and the availability of dorsoplantar weight-bearing X-ray images of the foot performed preoperatively and at the follow-up visits. The analysis data included age, gender, Visual Analog Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, the values of the length of the 1st metatarsal, hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), rotation type of the first metatarsal (RTFM), and the position of the tibial sesamoid (TSP).</p><p><strong>Results: </strong>A total of 82 files were available for analysis. The mean age of the patients was 40.5 ± 13.8 (Median = 43) years; 67 (81,7%) were female, and 15 (18.3%) were male. The mean operation duration was 33.2 ± 3.0 min. The mean follow-up period was 22.7 ± 7.0 months. There was a linear relationship between the average age of the patients and the shortness (mm) values (r = 0.466; p < 0.001). The HVA, IMA, DMAA, TSP, and VAS scores were lower in the patients after the operation compared to before values (p < 0.001). The preoperative assessment of RTFM identified 15 cases with an angular type, 38 cases with an intermediate type, and 29 cases with a round type. The postoperative mean AOFAS value was higher than the mean score before the operation (p < 0.001). A dramatic reduction was observed in postoperative IMA and DMAA values (p < 0.001).</p><p><strong>Conclusion: </strong>This study's findings demonstrate the benefits of a new fixation method for treating HV that is applicable to all mild and moderate HV cases. This method enables intraoperative readjustment without compromising the fixation strength and has a short learning curve.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"69"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007085","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":"Deer antler velvet (Cervus elaphus sibiricus) promotes fracture healing via partial BMP2-Smad mediated osteoblast differentiation.","authors":"Ji Hyang Gu, Min-Young Chae, Jeong June Choi, Thanh Chu Duc, Chang Gue Son, Eun-Jung Lee","doi":"10.1186/s13018-024-05426-z","DOIUrl":"10.1186/s13018-024-05426-z","url":null,"abstract":"<p><p>BACKGROUND CERVUS ELAPHUS SIBIRICUS: (CES) has been traditionally used in Korean clinics to promote fracture healing based on its function of tonifying the kidneys and strengthening bones. However, experimental data supporting its efficacy are still insufficient. The aim of this study investigated the bone-union properties of CES in a femoral fracture animal model and its corresponding molecular mechanisms.</p><p><strong>Methods: </strong>Fifty-four C57BL/6 male mice underwent femoral shaft fracture by Bonnarens and Einhorn's method, subsequently receiving a water extract of CES (200 mg/kg/day, daily) for 7 and 14 days. Safranin O staining and immunohistochemistry of the fracture region were conducted against transforming growth factor-β (TGF-β), bone morphogenetic protein 2 (BMP2), and osterix. MG63 cells used to examine the underlying mechanisms of CES focused on BMP2-Smad pathway-related osteogenesis.</p><p><strong>Results: </strong>CES administration led to earlier union of the fractured bones, supported by Safranin O staining of the fracture region, demonstrating significantly increased cartilage formation day on 7 and a rapidly decreased cartilage area due to callus formation day on 14. CES administration also significantly upregulated the expression of TGF-β1 day 7, BMP 2, and osterix day 14 at the fracture site and also up-regulated alkaline phosphatase (ALP) activity, calcium deposition, and the phosphorylation of Smad in MG63 cells.</p><p><strong>Conclusions: </strong>CES promotes fracture healing by promoting osteoblastogenesis via a partial BMP2-Smad pathway.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"70"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007109","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":"Impact of tunnel enlargement on patient-reported outcomes following isolated posterior cruciate ligament reconstruction.","authors":"Kun-Han Lee, Tai-Jung Huang, Hsuan-Hsiao Ma, Kun-Hui Chen, Hsiao-Li Ma, En-Rung Chiang","doi":"10.1186/s13018-024-05445-w","DOIUrl":"10.1186/s13018-024-05445-w","url":null,"abstract":"<p><strong>Background: </strong>Tunnel enlargement (TE) might jeopardize knee function and ligament stability after revision surgery of anterior cruciate ligament reconstruction. To date, only few studies concern TE following posterior cruciate ligament reconstruction (PCLR). This study aims to determine TE after isolated PCLR and its relationship with patient-reported outcomes.</p><p><strong>Methods: </strong>Patients who received primary isolated PCLR were screened. Femoral and tibial tunnel size was measured using an anteroposterior and lateral view of radiographs at least 6 months after surgery. TE is considered significant if the width of the bone tunnel increases by 25% over the drilled size. Patient-reported outcomes were determined using the subjective International Knee Documentation Committee (IKDC) score and the Lysholm score. The association between patient baseline characteristics, patient-reported scores, and the severity of TE was investigated.</p><p><strong>Results: </strong>Fifty-four patients were enrolled. TE was observed in 15 femoral tunnels and in 14 tibial tunnels. The average TE rate is 17.9% for femur and 7.9% for tibia. No correlation between the level of TE and patient-reported outcomes is noted. However, when patients are classified into TE and non-TE group on the basis of 25% of enlargement, those who exhibit femoral TE have a lower postoperative Lysholm score (81.1 ± 13.0 vs. 90.5 ± 12.3, P = 0.031) and those with tibial TE have a lower postoperative IKDC score (76.0 ± 17.4 vs. 87.1 ± 12.1, P = 0.031).</p><p><strong>Conclusions: </strong>The overall incidence of femoral and tibial TE after isolated PCLR is low. However, femoral and tibial TE are correlated with worse patient-reported outcomes in terms of the lower postoperative Lysholm and IKDC scores.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"74"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006774","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":"Expression of MMP1, MMP3, and TIMP1 in intervertebral discs under simulated overload and microgravity conditions.","authors":"Xuanyu Chen, Zhangfu Li, Chao Zheng, Ji Wu, Yong Hai","doi":"10.1186/s13018-025-05508-6","DOIUrl":"10.1186/s13018-025-05508-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate changes in matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase (TIMP) levels in the intervertebral discs of New Zealand white rabbits under simulated overload and microgravity conditions, focusing on the expression of MMP1, MMP3, and TIMP1. The findings aim to provide a theoretical foundation for preventing and delaying lumbar disc degeneration in these environments.</p><p><strong>Methods: </strong>Overload was simulated using an animal centrifuge, and microgravity was mimicked through tail suspension. A randomized single-blind method was applied to divide 120 age- and weight-matched New Zealand white rabbits into six groups: control groups (30 d, 60 d, 90 d) and overload/microgravity groups (30 d, 60 d, 90 d), with 20 rabbits per group. The expression of MMP1, MMP3, and TIMP1 in the lumbar intervertebral discs was measured and analyzed using statistical methods, including chi-square tests and t-tests, across different exposure times.</p><p><strong>Results: </strong>In the experimental groups, MMP1 and MMP3 expression levels were significantly higher than those in the corresponding control groups at all time points (P < 0.01). MMP1 and MMP3 levels progressively increased with longer exposure durations, showing statistically significant differences (P < 0.01). TIMP1 expression was significantly higher in the 30-day and 60-day experimental groups than in the control group (P < 0.01), but decreased in the 90-day group, indicating a late-stage imbalance in the MMP/TIMP1 ratio.</p><p><strong>Conclusion: </strong>Simulated overload and microgravity conditions lead to elevated MMP1, MMP3, and TIMP1 expression in lumbar intervertebral discs, promoting accelerated disc degeneration.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"71"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006835","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":"A prospective randomized controlled trial comparing biphasic cartilage repair implant with microfracture in small chondral lesions of knee: findings at five-year-follow-up.","authors":"Yao-Yi Kuo, Si-Qi Chiu, Wen-Pei Chang, Chih-Yu Chen, Chih-Hwa Chen, Chen-Kun Liaw, Cheng-Aun Tan, Pei-Wei Weng","doi":"10.1186/s13018-024-05392-6","DOIUrl":"10.1186/s13018-024-05392-6","url":null,"abstract":"<p><strong>Background: </strong>Full-thickness cartilage defects have a significant impact on the function of joints in young adults, and the treatment of cartilage defects has been a challenge, as cartilage tissue is an avascular tissue. This study aimed to compare the clinical and radiological outcomes of Biphasic Cartilage Repair Implant (BiCRI) and microfracture treatments for knee cartilage defects.</p><p><strong>Methods: </strong>This randomized controlled clinical trial enrolled patients with symptomatic knee chondral lesions smaller than 3 cm². They were randomized to either the BiCRI (n = 11) or microfracture (n = 10) treatment groups. BiCRI or microfracture surgical procedures were performed on the patients, who were subsequently followed for a period of five years. Primary outcome measures included the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analog Scale (VAS) score, Magnetic Resonance Imaging (MRI) measured cartilage thickness, and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score.</p><p><strong>Results: </strong>21 patients were enrolled, who were subsequently followed for a period of five years. Both BiCRI and microfracture treatments demonstrated significant improvements in IKDC, KOOS and VAS scores, with no significant differences between the two. MRI analysis indicated a significant increase in minimum cartilage thickness with BiCRI treatment (median of difference: 1 mm, P = 0.026)), in contrast to the nonsignificant change in the microfracture group (median of difference: 1 mm, P = 0.102). The MOCART scores revealed a significant increase percentage of isointense signal intensity identical to the adjacent articular cartilage (P = 0.03) in the BiCRI group from the 2-year to the 5-year mark, while the scores remained stable in the microfracture group. Moreover, the BiCRI technique displayed superior performance in graft infill at 5 years (P = 0.008), border integration at 5 years (P = 0.04), surface contour at 2 years (P = 0.04) compared to microfracture.</p><p><strong>Conclusions: </strong>Both BiCRI and microfracture treatments showed significant effectiveness in improving clinical outcomes in patients with small symptomatic articular cartilage defects of the knee, with the BiCRI group demonstrating a superior radiological outcome than microfracture, over a five-year period. However, the sample size of our study is relatively small to reach a definite conclusion, and further studies with larger sample size and longer follow up are recommended. Trial registration The trial was registered on ClinicalTrials.gov under the identifier NCT01477008.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"73"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007083","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}