Journal of orthopaedics最新文献

{"title":"Assessing the statistical fragility of randomized controlled trials in hip and knee arthroplasty: A methodological review","authors":"Imad Kashir ,&nbsp;Emmanuel Olaonipekun ,&nbsp;Jananey Rajagopalan ,&nbsp;Moin Khan ,&nbsp;Anthony Adili ,&nbsp;Lawrence Mbuagbaw ,&nbsp;Kim Madden","doi":"10.1016/j.jor.2025.05.065","DOIUrl":"10.1016/j.jor.2025.05.065","url":null,"abstract":"<div><h3>Introduction</h3><div>Randomized controlled trials (RCTs) are considered the gold standard in evidence-based medicine, providing high-quality evidence for the effectiveness of interventions in healthcare. However, the quality of RCTs can vary substantially. One aspect of methodological quality that has recently garnered interest is the fragility index (FI) which is a metric indicating how many event changes would lead to a change the significance of a study's results. Surgical RCTs, especially in orthopedic fields like hip and knee arthroplasty, have been shown to have high fragility, raising concerns about their reliability. This methodological study aims to describe the statistical fragility of RCTs in hip and knee arthroplasty over the past decade, with a secondary objective of determining the study characteristics associated with fragility.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of Medline and Embase databases for RCTs published between 2012 and 2022, focusing on hip and knee arthroplasty. Trials were included if they had a 1:1 parallel design and reported at least one statistically significant outcome. FI were calculated for both dichotomous and continuous outcomes using established methods. We extracted data such as sample size, study characteristics, and statistical measures. Multivariable regression was used to explore relationships between FI and study characteristics such as sample size, intervention type, and region.</div></div><div><h3>Results</h3><div>From 16,214 records, 140 studies met the inclusion criteria. The median FI for dichotomous outcomes was 2, interquartile range (IQR) = 4, while the median continuous FI (CFI) was 8.85 (IQR 14.4), indicating higher robustness for continuous outcomes. No significant associations were found between FI and variables like region, year of publication, or sample size.</div></div><div><h3>Conclusions</h3><div>Hip and knee arthroplasty trials often exhibit statistical fragility, particularly those reporting dichotomous outcomes. These fragile findings suggest the need for more robust RCT designs in orthopedic research. Incorporating FI into sample size calculations could improve trial stability and ensure more reliable outcomes that better inform clinical guidelines and patient care.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 216-221"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of anterior controllable antedisplacement and fusion (ACAF) on cervical lordosis and sagittal alignment in OPLL: A comparative radiographic analysis","authors":"Shunmin Wang ,&nbsp;Dong Liu ,&nbsp;Jincui Li ,&nbsp;Jingchuan Sun ,&nbsp;Tiefeng Li ,&nbsp;Jiangang Shi","doi":"10.1016/j.jor.2025.05.044","DOIUrl":"10.1016/j.jor.2025.05.044","url":null,"abstract":"<div><h3>Purpose</h3><div>The conventional anterior method for addressing multi-segmental severe ossification of cervical posterior longitudinal ligament (OPLL) is challenging and carries significant risks. Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of cervical OPLL. This study aims to assess the enhancement and preservation of cervical lordosis and sagittal alignment following ACAF for patients with multi-segmental severe cervical OPLL.</div></div><div><h3>Methods</h3><div>A total of 69 patients with multi-segmental severe cervical OPLL were enrolled, of whom 44 patients underwent ACAF, and 25 underwent traditional anterior cervical corpectomy and fusion (ACCF). Preoperative, postoperative, and the final follow-up radiographs were utilized to evaluate improvements in cervical lordosis and sagittal alignment among patients. The following parameters were measured: C0–2 lordosis, C2–7 lordosis, segmental coriander, C2–7 sagittal vertical axis (SVA), T1 slope, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and Japanese Orthopedic Association (JOA) scores. Subgroup analyses were conducted for 21 patients undergoing single-level ACAF and 23 patients undergoing ACAF more than two levels. Additionally, outcomes for patients treated with single-level ACAF were compared with those who received single-level ACCF.</div></div><div><h3>Results</h3><div>At the final following-up, patients receiving ACAF had improved C0-2 lordosis, C2-7 lordosis, segmental coriander and C2-7 SVA (all p values &lt; 0.05). The C2-7 lordosis of patients from the ACAF group more than two levels was much better than those with single level. Although the improved segmental coriander postoperatively decreased at the final follow-up, the final segmental coriander of the patients in single-level ACAF group was much better than those in two or more level ACAF.</div></div><div><h3>Conclusion</h3><div>ACAF showed better therapeutic effects on the enhancement and preservation of cervical lordosis and sagittal alignment in patients with multi-segmental cervical OPLL.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 158-165"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal analysis of radiological parameters after monosegmental lumbar instrumentation and posterior lumbar interbody fusion (PLIF) compared with transforaminal lumbar interbody fusion (TLIF)","authors":"Hassan Awan Malik ,&nbsp;Andreas Kiebler ,&nbsp;Julia Müller ,&nbsp;Thomas Caffard ,&nbsp;Timo Zippelius ,&nbsp;Luis Ferraris ,&nbsp;Heiko Reichel ,&nbsp;Balkan Cakir ,&nbsp;Tugrul Kocak","doi":"10.1016/j.jor.2025.06.002","DOIUrl":"10.1016/j.jor.2025.06.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Restoring the sagittal balance of the spine has gained significant importance. Still there is little data objectifying the influence of a monosegmental fusion or the implants used.</div><div>This is a comparative study that directly contrasts PLIF and TLIF regarding their impact on sagittal balance. In this study 53 patients who received a monosegmental lumbar fusion were followed up.</div></div><div><h3>Methods</h3><div>53 patients (37 women, 16 men, average age 57.4 years) who received a monosegmental spondylodesis were followed up with an average time of 15.1 months.</div><div>To objectify the potential postoperative changes radiographs were made to measure the index segments lordosis as well as the lumbar lordosis overall. A further subdivision was made according to the operated functional spinal segment treated and cage used.</div></div><div><h3>Results</h3><div>Overall no significant changes in total or segmental lordosis were found. Statistically significant changes were measurable on immediately postoperative radiographs and declined in time, while lumbar lordosis decreased, segmental lordosis increased. Segmental lordosis was consistent. Comparing patients operated in PLIF and TLIF technique the overall lordosis showed the same patterns. Segmental lordosis was increased postoperatively (p = 0.0162). Followed by a significant loss (p = 0.0405). The TM 500 PLIF Cage showed a significantly improved lumbar lordosis over the course compared with postoperative values, but not in comparison to the preoperative values.</div></div><div><h3>Conclusion</h3><div>We were unable to find significant difference of the sagittal profile after a monosegmental instrumentation and fusion in the lumbar spine. However, the PLIF procedure seems to be superior with regards of lordosis restoration. The L4/5 segment also seems to have a greater potential for correction the L5/S1 segment in the long term.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 162-171"},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite element analysis of femoral stress and deformation during progressive squat postures","authors":"Ankit Saxena ,&nbsp;Rahul S. Mulik ,&nbsp;Santhosh Kumar Dubba ,&nbsp;Roopsandeep Bammidi","doi":"10.1016/j.jor.2025.06.004","DOIUrl":"10.1016/j.jor.2025.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the mechanical behavior of the human femur under body weight during progressive squatting using finite element analysis.</div></div><div><h3>Methods</h3><div>A static simulation was conducted to evaluate load distribution, deformation, and stress patterns in the femur across various squatting postures, defined by increasing knee flexion angles.</div></div><div><h3>Results</h3><div>The femoral head exhibited the highest deformation, with a maximum value of 18.167 mm at 90° of knee flexion. Minor deformation was also noted in the greater trochanter region. The distal femur consistently experienced the greatest stress, with the stress concentration shifting circumferentially depending on posture. In standing, knee-bend, chair, and pre-squat positions, the stress was primarily located at the anterior distal femur, while in the deep squat posture, it shifted to the posterior region. Among all positions, the pre-squat posture generated the highest stress magnitudes.</div></div><div><h3>Conclusion</h3><div>The findings provide detailed insight into femoral biomechanics during squatting and may support improved orthopaedic assessment, injury prevention strategies, and rehabilitation protocols.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 222-228"},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can bioactive glass replace bone grafts after curettage of benign bone Tumors? A systematic review and meta-analysis of randomized controlled trials","authors":"Rodrigo Arruda Conde ,&nbsp;André Richard Silva Oliveira Filho ,&nbsp;Elcio Machinski ,&nbsp;Vinícius Furtado da Cruz ,&nbsp;Marian Andrei Melinte ,&nbsp;Bruno Butturi Varone ,&nbsp;Olavo Pires de Camargo ,&nbsp;Camilo Partezani Helito ,&nbsp;Daniel Peixoto Leal","doi":"10.1016/j.jor.2025.05.061","DOIUrl":"10.1016/j.jor.2025.05.061","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Curettage followed by autografts or allografts has been the preferred method for treating benign bone tumors. However, the development of synthetic substances, such as bioactive glass (BAG), has prompted interest in the medical community. This meta-analysis of randomized controlled trial (RCTs) aimed to compare the adverse event rates between BAG and autograft or allograft following curettage for benign bone tumors.</div></div><div><h3>Methods</h3><div>We searched PubMed, EMBASE, and Cochrane Central for RCTs comparing BAG versus autograft or allograft after curettage for benign bone tumors. The primary endpoint was tumor recurrence. Secondary endpoints included rates of overall complications, mild complications, and reoperations. Risk ratios (RRs) with 95 % CIs were pooled across trials.</div></div><div><h3>Results</h3><div>Four RCTs encompassing 156 patients were included, with 80 (51.3 %) receiving BAG. The most common lesions were enchondromas (24.4 %) and aneurysmal bone cysts (21.8 %). Recurrence rates were comparable between the BAG group (18.7 %) and the bone grafts (21.0 %) group (RR 0.91; 95 % CI 0.52 to 1.61; p = 0.75; I²: 0 %). Reoperation (RR 1.53; 95 % CI 0.64 to 3.66; p = 0.34; I² = 0 %), overall complications (RR 0.72; 95 % CI 0.46 to 1.13; p = 0.15; I² = 0 %), and mild complications (RR 0.54; 95 % CI 0.16 to 1.86; p = 0.33; I² = 21 %) were also comparable. Longer follow-up subanalysis showed analogous results.</div></div><div><h3>Conclusions</h3><div>BAG appears as effective as autografts or allografts regarding recurrence, reoperation, and complication rates after curettage of benign bone tumors. Larger RCTs with more standardized approaches are needed for validation.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 208-215"},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing minimum two-year follow-up PROMIS scores after total shoulder arthroplasty: Is there a difference between 1- and 2-year outcomes?","authors":"Mahdi Mazeh,&nbsp;Joshua Castle,&nbsp;Alexander Jurayj,&nbsp;Chimdindu Obinero,&nbsp;Kai Zhu,&nbsp;Johnny Kasto,&nbsp;Michael Gaudiani,&nbsp;Stephanie Muh,&nbsp;Jared M. Mahylis","doi":"10.1016/j.jor.2025.06.001","DOIUrl":"10.1016/j.jor.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Historically 2-year outcomes have served as a standard to evaluate functional improvement after shoulder arthroplasty. However, recent studies suggest that legacy patient-reported outcomes often plateau at 1 year. Evaluation of newer patient-reported outcomes, such as Patient-Reported Outcomes Measurement Information System scores, has yet to be performed. This study aimed to assess differences in PROMIS Upper Extremity function and PROMIS Pain Interference between 1 and 2 years after primary shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>We retrospectively identified 199 patients from a single-center, multi-surgeon database who underwent primary anatomic and reverse total shoulder arthroplasty from 2017 to 2022 and had 1-year and 2-year PROMIS scores. Forty-six of these patients had 1- and 2-year follow-up where clinical outcomes were measured. Patients undergoing revision surgeries, hemiarthroplasty, and those lacking both 1-year and 2-year PROMIS scores were excluded. Statistical analysis was done using non-parametric analysis tests such as the Mann-Whitney <em>U</em> Test.</div></div><div><h3>Results</h3><div>In the overall cohort of 199 patients, no statistically significant difference was observed in PROMIS Upper Extremity scores between the 1-year (mean: 39.06 ± 8.5) and 2-year (mean: 38.26 ± 8.3) postoperative time points (p = 0.22). PROMIS Pain Interference scores showed a statistically significant increase from 55.25 ± 6.7 at 1 year to 56.74 ± 7.1 at 2 years (p = 0.01), but this change did not meet the minimal clinically important difference threshold. An analysis of patients with clinical follow-up revealed no significant differences in PROMIS Upper Extremity or PROMIS Pain Interference scores (p &gt; 0.05). Additionally, no statistically significant differences were found in other clinical outcomes, including visual analog scale pain scores (1-year: 1.15 ± 0.9, 2-year: 1.48 ± 1.1, p = 0.51), range of motion, and strength measurements between the 1- and 2-year follow-ups (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Patients undergoing total shoulder arthroplasty demonstrate no significant differences in PROMIS scores between 1-year and 2-year follow-up, suggesting that patients likely reach their maximal benefit of PROMIS scores at the 1-year follow-up timepoint.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 172-175"},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of hospital size on postoperative outcomes, length of stay, and costs following single-level cervical disc arthroplasty","authors":"Paul G. Mastrokostas ,&nbsp;Leonidas E. Mastrokostas ,&nbsp;Jason M. Dayan ,&nbsp;Luke B. Schwartz ,&nbsp;Joseph Razi ,&nbsp;Ahmed K. Emara ,&nbsp;Ahmed Saleh ,&nbsp;Jad Bou Monsef ,&nbsp;Afshin E. Razi ,&nbsp;Mitchell K. Ng","doi":"10.1016/j.jor.2025.05.066","DOIUrl":"10.1016/j.jor.2025.05.066","url":null,"abstract":"<div><h3>Background</h3><div>Hospital size has been shown to influence resource availability, staffing, and patient care quality. This study aims to evaluate the impact of hospital size on postoperative outcomes such as length of stay (LOS), total costs, complications, and non-routine discharge rates in patients undergoing single-level CDA.</div></div><div><h3>Methods</h3><div>The National Inpatient Sample (NIS) was queried to identify 14,315 weighted cases of patients who underwent single-level CDA between 2016 and 2020. Patients undergoing single-level CDA were stratified by hospital size (small, medium, large). Chi-square and ANOVA tests were used to compare demographic variables and outcomes across hospital sizes. Ridge regression was employed to analyze the relationship between perioperative complications and non-routine discharge across hospital sizes. Statistical significance was set at the 0.05 level.</div></div><div><h3>Results</h3><div>Patients treated in smaller hospitals were younger than those in medium and large hospitals (46.9 vs. 48.4 and 48.0 years, <em>P</em> = 0.036). LOS was shorter in small hospitals compared to medium and large-sized hospitals (1.30 vs. 1.45 vs. 1.45 days, <em>P</em> = 0.048). Medium hospitals had a higher rate of non-routine discharges (9.3 %) compared to small (5.3 %) and large hospitals (6.2 %, <em>P</em> = 0.004). Cardiovascular complications were predictive of non-routine discharge in large hospitals (OR = 2.31, <em>P</em> = 0.048), while surgical complications were significant in medium hospitals (OR = 2.00, <em>P</em> = 0.010).</div></div><div><h3>Conclusion</h3><div>Medium hospitals demonstrated longer LOS and higher non-routine discharge rates, likely due to resource limitations. Enhancing staffing and care coordination may improve outcomes across hospital settings.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 150-154"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors and treatment outcomes of malignant peripheral nerve sheath tumors (MPNST) of the extremities: A tertiary cancer institutional analysis","authors":"Abhijeet Ashok Salunke,&nbsp;Sanjay Singh,&nbsp;Tarun Barnalla,&nbsp;Nandlal Bharwani,&nbsp;Dhruv Patel,&nbsp;Keval Patel,&nbsp;Vikas Warikoo,&nbsp;Mohit Sharma,&nbsp;Ketul Puj,&nbsp;Shashank Pandya","doi":"10.1016/j.jor.2025.05.054","DOIUrl":"10.1016/j.jor.2025.05.054","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Malignant peripheral nerve sheath tumor (MPNST) is an uncommon and aggressive ectomesenchymal soft tissue sarcoma that usually originates from peripheral nerves or pre-existing neurofibromas. These tumors are recognised for their high metastatic risk and challenging cases to treat. The purpose of this study was to analyse the factors impacting patient prognosis and treatment options by analysing treatment results and prognostic factors in patients with MPNST of the extremities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This retrospective longitudinal study included 53 patients with histologically and immunohistochemically confirmed MPNST of the extremities, treated at a tertiary care cancer centre from 2011 to 2018. Data were collected on demographics, clinical presentation, treatment modalities (surgery, radiotherapy, chemotherapy, palliative care), and follow-up. Follow-up included physical exams, imaging, and CECT thorax at 3–6 month intervals for two years, then biannually for three more years.Variables assessed for prognostic impact included age, sex, NF1 status, tumor grade, size, location, margin status, metastasis at diagnosis, and treatment intent. Disease-free survival (DFS) was measured from the date of surgery, and overall survival (OS) from the date of diagnosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 53 patients with MPNST of the extremities, 52.83 % were over 45 years of age, and 63 % were male and 37 % were females. Most tumors (86.79 %) were sporadic, with NF1-associated tumors accounting for 13.20 %. Primary disease was more common (66.03 %) than recurrent (33.96 %). High-grade tumors were predominant, with 24.52 % classified as Grade 2 and 45.28 % as Grade 3. Metastatic disease was present in 20.75 % of cases. Tumor size was variable, with the largest proportion (32 %) in the 5–10 cm range. Curative treatment was administered to 67.92 % of patients, while 32.07 % received palliative care. Adjuvant radiotherapy was given to 35.64 % of patients, and chemotherapy (doxorubicin + ifosfamide) was administered to those with metastases. The overall survival rate was 58.46 %. Tumor grade (G2, G3), metastatic presentation, and intent of treatment were significantly associated with survival outcomes. NF1 status did not significantly impact overall survival, though NF1-positive patients benefited significantly from adjuvant radiation. Tumor grade was a strong predictor of survival, with Grade 3 tumors showing poorer outcomes than Grades 1 and 2.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our current study focuses on the predictive importance of treatment intent, tumor grade, and metastatic manifestation in patients with malignant peripheral nerve sheath tumors (MPNST) of the extremities. While variables such as age, gender, tumor size, surgical margin status, and NF1 status exhibited varying correlations, the most accurate predictors of survival were tumor biology, namely histological grade and meta","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 196-201"},"PeriodicalIF":1.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling endochondral ossification: Effects of mechanical loading and bone shape","authors":"Cristian Rodrigo Bustamante-Porras ,&nbsp;Kalenia Marquez-Florez ,&nbsp;Carlos Alberto Duque-Daza ,&nbsp;Diego Alexander Garzón-Alvarado","doi":"10.1016/j.jor.2025.05.034","DOIUrl":"10.1016/j.jor.2025.05.034","url":null,"abstract":"<div><h3>Background</h3><div>The influence of mechanical and biochemical factors has been extensively studied through the development of mathematical, computational and experimental research, offering insights into bone development and the complex interplay of contributing factors. This knowledge has potential applications in multiple areas of medical science. However, existing models lack flexibility in simulating diverse geometric and loading conditions. This study proposes the development of a model to address these limitations.</div></div><div><h3>Methods</h3><div>A computational approach employing parametric geometry and loading conditions was applied, accounting for the effects of stress on epiphyseal growth. Finite element analyses were conducted iteratively to predict potential sites of secondary ossification based on stress distribution. Three distinct scenarios with varying geometry and loading conditions were evaluated, revealing differences in the presence, number, and spatial distribution of secondary ossification centers (SOCs).</div></div><div><h3>Findings</h3><div>The variation in the onset of SOCs across different configurations and parameter adjustments was analyzed. The model predicts a shift in SOC location influenced by cartilage concavity and width; the formation of two ossification centers in concave heads subjected to dual loading; reduced surface ossification contributing to articular cartilage; and a decrease in the ossification index (OI) with increased volume.</div></div><div><h3>Conclusions</h3><div>The model emulates the formation of anatomically distinct human joints, though some certain outputs based on non-biological geometries were excluded. Moreover, the model focuses solely on mechanical and geometrical influences, while other aspects of mechanobiology should be incorporated in future work. Nevertheless, the model effectively captures the formation of various human joints and provides a foundation for future studies and diverse applications in medical research, particularly in bone growth disorders.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 197-218"},"PeriodicalIF":1.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical stimulation in 2D: A potent accelerator of matrix mineralization in ATDC5 chondrogenic cells","authors":"Diego Quexada-Rodríguez ,&nbsp;Taha Messelmani ,&nbsp;Rachid Jellali ,&nbsp;Anne Le Goff ,&nbsp;Marie-Christine Ho Ba Tho ,&nbsp;Diego Garzón-Alvarado ,&nbsp;Olfa Trabelsi","doi":"10.1016/j.jor.2025.05.058","DOIUrl":"10.1016/j.jor.2025.05.058","url":null,"abstract":"<div><h3>Background</h3><div>Matrix mineralization is a key process in endochondral ossification and cartilage maturation. While optimized biochemical protocols using ATDC5 chondrogenic cells have shortened mineralization timelines, the role of mechanical stimulation in enhancing this process remains underexplored. This study investigates whether dynamic mechanical stimulation in 2D monolayer cultures can accelerate mineralization and influence extracellular matrix (ECM) composition.</div></div><div><h3>Methods</h3><div>ATDC5 cells were cultured on PDMS membranes coated with collagen and subjected to cyclic tensile strain (12 % at 0.05 Hz for 1 h/day) using a uniaxial bioreactor over 5 days. The culture protocol included supplementation with β-glycerophosphate and ascorbic acid. Mineralization and ECM production were assessed at days 7, 17, and 23 using Alizarin Red and Alcian Blue staining. SEM/EDX confirmed calcium-phosphate deposition. A phenomenological finite element model was developed to correlate mechanical stimuli with hypertrophy using the osteogenic index.</div></div><div><h3>Results</h3><div>Mechanical stimulation led to a 32 % increase in Alizarin Red staining compared to controls (P &lt; 0.001), indicating faster mineralization. GAG production was reduced under mechanical loading (P &lt; 0.05), consistent with early mineralization. SEM/EDX confirmed more uniform mineral deposition in stimulated samples. Morphologically, stimulated cells aligned along the loading axis and displayed a nearly 10-fold increase in hypertrophic cell area. The numerical model showed elevated osteogenic index values and stress peaks in the chondrocyte membrane under mechanical loading.</div></div><div><h3>Conclusions</h3><div>Dynamic tensile stimulation in 2D culture significantly accelerates ECM mineralization in ATDC5 cells. This effect appears to be mediated through enhanced chondrocyte hypertrophy and alignment of ECM components. The combined use of mechanical and biochemical cues provides a promising strategy for optimizing in vitro models of endochondral ossification and developing tissue engineering therapies.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 173-182"},"PeriodicalIF":1.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}