Journal of orthopaedics最新文献

{"title":"Characteristics and trends of fireworks-related hand injuries and treatment at a Level I trauma center","authors":"Jonathan Weinerman ,&nbsp;Alina Syros ,&nbsp;Nikhil Patel ,&nbsp;Jacob Mesenger ,&nbsp;Dylan Luxenburg ,&nbsp;Arya Minaie ,&nbsp;Max Baron ,&nbsp;Helen G. Hui-Chou","doi":"10.1016/j.jor.2025.08.012","DOIUrl":"10.1016/j.jor.2025.08.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Firework-related injuries can have devastating consequences, often resulting in permanent damage or amputation, with incidence rising in recent years. This study characterizes firework-related hand injuries treated at a Level 1 Trauma Center over a 10-year period, analyzing demographics, injury patterns, outcomes, and trends.</div></div><div><h3>Methods</h3><div>The medical records of patients treated at a Level I trauma center for firework-related hand injuries between January 2013 and January 2023 were retrospectively reviewed. Variables analyzed included patient demographics, injury characteristics, hospital course, treatment details, and socioeconomic factors.</div></div><div><h3>Results</h3><div>The study included 33 male and 2 female patients aged 9–74 years (mean age 31 years). Injuries occurred in 88.6 % of cases due to patients holding fireworks, often in their dominant hand (42.9 %). Fractures occurred in 77.1 % of cases, traumatic amputations in 34.3 %, vascular injuries in 45.7 %, and nerve injuries in 48.6 %. Surgery was required in 82.9 % of patients, with irrigation and debridement (74.3 %) and revision amputation (60 %) being the most common procedures. The average length of hospitalization was 4.64 days, and many patients resided in lower-income areas, with 62.8 % from zip codes reporting an annual household income below $60,000.</div></div><div><h3>Conclusion</h3><div>Firework-related hand injuries impose significant physical and socioeconomic burdens, with most patients requiring surgery for fractures, suffering vascular or nerve damage, or undergoing traumatic or surgical amputation. Young adult males from lower-income, socially vulnerable areas were most affected. Future prevention efforts should focus on public health and legislative initiatives to reduce these injuries.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IV.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 271-277"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809741","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":"Deep learning-based anomaly detection in orthopedic medical imaging: A systematic literature review","authors":"Nabila Ounasser ,&nbsp;Maryem Rhanoui ,&nbsp;Mounia Mikram ,&nbsp;Bouchra EL Asri","doi":"10.1016/j.jor.2025.07.015","DOIUrl":"10.1016/j.jor.2025.07.015","url":null,"abstract":"<div><div>In recent years, deep learning (DL) has revolutionized medical imaging, offering notable promise in orthopedic diagnostics. This systematic review explores how DL, particularly Convolutional Neural Networks (CNNs) and Generative Adversarial Networks (GANs), are applied to detect and analyze orthopedic anomalies such as fractures, spinal deformities, and foot deformities. We reviewed 63 peer-reviewed studies published between 2017 and 2025, analyzing their methodologies, datasets, performance metrics, and clinical relevance. The findings reveal significant advancements in fracture classification and vertebral labeling, though challenges persist for subtle anomalies and less-represented deformities. Despite encouraging results, limitations include small sample sizes, lack of external validation especially for rare pathologies. We conclude by identifying research gaps and proposing future directions for developing robust, clinically integrated DL tools to enhance diagnostic accuracy, data diversity, and anomaly detection in complex orthopedic scenarios.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 329-345"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886099","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":"Global trends and hotspots related to complications following total knee arthroplasty","authors":"Keerthi Eraniyan ,&nbsp;Nofel Iftikhar ,&nbsp;Latha Ganti","doi":"10.1016/j.jor.2025.08.005","DOIUrl":"10.1016/j.jor.2025.08.005","url":null,"abstract":"<div><div>This bibliometric analysis aims to assess the global research landscape on the topic of complications of knee arthroplasty. Understanding the research being done on knee arthroplasty can help identify prominent areas in the field.</div><div>Over the past two decades, knee arthroplasty has become one of the most common surgical procedures done to treat knee osteoarthritis. While it is used widely, many patients experience severe complications after surgery and often have to undergo revision surgery. This bibliometric analysis seeks to provide researchers with an up-to-date, relevant analysis and visualization of key authors and contributors, institutions, and trends in countries.</div><div>The following search query was used to find literature on the topic: query = knee arthroplasty (Topic) AND complications (Topic). The search yielded a total of 10,000 articles, which served as the main dataset for further analysis. VOSviewer was utilized to perform co-authorship, institutional, and country analyses. Annual publication trends were visualized through bar graphs generated using metadata from the database.</div><div>The United States and China were prominent countries in the field of complications after knee arthroplasty. Prominent institutions included The Hospital for Special Surgery, Thomas Jefferson University, Cleveland Clinic, and Mayo Clinic. A prominent contributing author was Michael Mont, who is also from the United States, showing the country's dominance in this field.</div><div>This analysis highlights the distribution of countries and institutions in knee arthroplasty research in the growing field of complications post-surgery, and these findings offer valuable insights into areas of improvement, and it demonstrates how the field is growing.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 215-219"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840938","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":"Hotspot analysis and frontier exploration of biomechanical research on knee osteoarthritis: a bibliometric study and visualization analysis","authors":"Zhangjie Xu ,&nbsp;Xiaoli Chen ,&nbsp;Jiaojiao Wu ,&nbsp;Yixin Chen ,&nbsp;Zhaomeng Hou","doi":"10.1016/j.jor.2025.08.004","DOIUrl":"10.1016/j.jor.2025.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study employs bibliometric and visualization analysis to systematically investigate research hotspots and emerging trends in the biomechanics of knee osteoarthritis (KOA).</div></div><div><h3>Methods</h3><div>This study utilizes the Web of Science Core Collection (WoSCC) as the data source, employing a keyword-based search strategy to retrieve literature on the biomechanics of KOA published over the past two decades. Bibliometric analyses are conducted using tools such as CiteSpace and VOSviewer.</div></div><div><h3>Results</h3><div>A total of 1932 articles were included in the analysis. Research outputs from the United States have been particularly prominent, setting a benchmark for the global academic community. Institutions such as the University of Melbourne and Stanford University have exhibited notable academic leadership. Professors Bennell KL and Andriacchi TP, identified as highly productive authors, have been frequently cited. Journals including Gait Posture and Osteoarthr Cartilage have served as key platforms for knowledge dissemination and academic dialogue. Current research foci are centered on keywords such as total knee arthroplasty, outcomes, injury, baseline, exercise, meniscus, MRI, risk, and knee adduction moment (KAM). These themes reflect contemporary research activity and suggest emerging frontiers. As biomechanical investigations deepen, the pathogenesis of KOA is anticipated to be more fully understood, offering a robust scientific foundation for clinical practice.</div></div><div><h3>Conclusions</h3><div>This study employs bibliometrics and visualization analysis to conduct a comprehensive examination of hotspot issues and frontier trends in the biomechanics of KOA, offering researchers a structured understanding of research trajectories and trend insights.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 288-304"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827615","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":"Glucagon-like Peptide-1 receptor agonist use is not associated with increased reoperation risk following rotator cuff repair","authors":"Spencer T. Rasmussen ,&nbsp;Asif M. Ilyas","doi":"10.1016/j.jor.2025.08.016","DOIUrl":"10.1016/j.jor.2025.08.016","url":null,"abstract":"<div><h3>Objectives</h3><div>The use of glucagon-like peptide-1 (GLP-1) receptor agonists is increasingly common among orthopaedic patients, often prescribed for type 2 diabetes mellitus and obesity, which are frequent comorbidities. Recent studies have explored the effects of GLP-1's on postoperative outcomes in orthopaedic procedures. This study evaluates the impact of GLP-1 on re-operation risk following rotator cuff repair (RCR).</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis of patients aged 18 and older from 2014 to 2024 was conducted using the TriNetX US collaborative network. Patients with documented RCR and no prior GLP-1 use were included in the control group. Those taking semaglutide, dulaglutide, or liraglutide for at least 3 months before RCR comprised the GLP-1 group. After comparing baseline characteristics, cohorts were matched based on selected covariates. Outcomes were compared using risk ratios (RR) with 95 % confidence intervals (CI). A subgroup analysis by GLP-1 indication (type 2 diabetes or weight loss) was performed.</div></div><div><h3>Results</h3><div>Propensity score matching yielded well-balanced cohorts of 5306 patients. Subgroup analysis included 781 patients per group. At 3, 6, and 12 months post-RCR, the control group showed no difference in reoperation risk. In a sub-analysis of the GLP-1 group, those receiving it for diabetes, compared to obesity, showed an increased risk of adhesive capsulitis at 3 months (RR = 2.20, 95 % CI [1.05–4.62], P = 0.0321).</div></div><div><h3>Conclusion</h3><div>The use of GLP-1 was not associated with a higher reoperation risk after RCR, suggesting that these medications can safely be taken leading up to RCR. However, increased short-term risks in diabetes patients highlight the need for individualized care and further study of GLP-1 effects on orthopaedic outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 235-240"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861325","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":"Postoperative complications, length of stay, and discharge disposition following single-level anterior lumbar interbody fusion in elderly and octogenarian patients","authors":"Paul G. Mastrokostas ,&nbsp;Leonidas E. Mastrokostas ,&nbsp;Aaron B. Lavi ,&nbsp;Abigail Razi ,&nbsp;John K. Houten ,&nbsp;Ahmed Saleh ,&nbsp;Jad Bou Monsef ,&nbsp;Afshin E. Razi ,&nbsp;Mitchell K. Ng","doi":"10.1016/j.jor.2025.08.002","DOIUrl":"10.1016/j.jor.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Anterior lumbar interbody fusion (ALIF) has become a widely accepted treatment for degenerative lumbar spine pathologies, with increasing prevalence due to its effectiveness in restoring lumbar lordosis and improving spinal balance. This study aims to evaluate postoperative complications, length of stay (LOS), and discharge disposition following ALIF across different age groups.</div></div><div><h3>Methods</h3><div>A total of 92,800 weighted cases of patients aged 50 and older underwent single-level ALIF in the National Inpatient Sample (NIS) from 2016 to 2020. Patients were stratified into age cohorts (50–64, 65–79, 80+). Exclusions were made for non-elective cases and missing data on key variables. Primary outcomes included postoperative complications (anemia, DVT, myocardial infarction, stroke, acute kidney injury, sepsis, anesthesia-related complications), LOS, and discharge disposition. Statistical comparisons between age groups were conducted using chi-square tests with a Bonferroni correction. Significance was set at <em>P</em> &lt; 0.005.</div></div><div><h3>Results</h3><div>The study identified significant variations in outcomes across age groups. The mean age differed significantly (<em>P</em> &lt; 0.001). Older patients had higher rates of comorbidities and complications, with acute post-hemorrhagic anemia being most prevalent in the 65–79 group (16.78 %) and sepsis more common in the 80+ group (0.90 %). The LOS increased with age (<em>P</em> &lt; 0.001), and total admission charges were highest in the 65–79 age group (<em>P</em> = 0.004). Routine discharge rates decreased significantly with age, while non-routine discharges increased (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Age significantly influences postoperative outcomes following ALIF. Patients aged 65 and older are at increased risk for various complications, longer hospital stays, and non-routine discharges. These findings highlight the need for tailored perioperative care and robust discharge planning to improve outcomes for elderly patients undergoing ALIF. As with all retrospective database studies, this analysis is limited by potential coding inaccuracies and the absence of granular clinical details within the NIS.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 311-316"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827617","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":"Array pin placement in robotic-assisted total hip arthroplasty: Optimal trajectory to avoid neurovascular injury","authors":"Jessyka Desrosiers ,&nbsp;Aneesh V. Samineni ,&nbsp;Sarai G. Ramirez ,&nbsp;Juan D. Lopez ,&nbsp;David S. Constantinescu ,&nbsp;Victor H. Hernandez ,&nbsp;Jean Jose","doi":"10.1016/j.jor.2025.07.031","DOIUrl":"10.1016/j.jor.2025.07.031","url":null,"abstract":"<div><h3>Background</h3><div>Array pin placement into the pelvis is a necessary step for robotic-assisted total hip arthroplasty (RATHA). Despite the increase in RATHA being performed, there is limited literature investigating safe zones and pin trajectory to avoid neurovascular injury.</div></div><div><h3>Methods</h3><div>This study utilized lower extremity magnetic resonance images of nine patients. The trajectory of three array pins placed at caudal angles of 35, 45, and 55 were recreated, and each pin was divided into four equidistant zones. For each pin, the distance was determined from each zone to nearby neurovascular structures: lateral femoral cutaneous nerve (LFCN), internal iliac artery (IIA), superior gluteal artery (SGA), superior gluteal nerve (SGN).</div></div><div><h3>Results</h3><div>Pin 3 placed at a caudal angle of 35° was the furthest distance away from the IIA compared to pins 1 and 2 (p = 0.005). Pin 1 placed at a caudal angle of 55° was the furthest distance away from the SGA (p = 0.009) and SGN (p = 0.012) and was associated with the most distal portion of the pin being in bone compared to other caudal angles (p = 0.002). There were no statistically significant differences in distances from pins to neurovascular structures based on gender.</div></div><div><h3>Conclusion</h3><div>Pin placement is a required step for RATHA, and the results of this study show that caudal angle trajectory is important for placement of specific array pins to ensure the distal aspect is in bone as well as far away from important neurovascular structures to avoid injury.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 278-282"},"PeriodicalIF":1.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809742","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":"Significant functional improvements and radiographic stability following fully cemented total hip arthroplasty in elderly patients: A 2-year prospective study","authors":"Carlo Marega ,&nbsp;Domenico De Mauro ,&nbsp;Daniele Lamberti ,&nbsp;Giuseppe Rovere ,&nbsp;Francesco Bosco ,&nbsp;Luca Marega","doi":"10.1016/j.jor.2025.07.027","DOIUrl":"10.1016/j.jor.2025.07.027","url":null,"abstract":"<div><h3>Purpose</h3><div>Using fully cemented total hip arthroplasty (THA), involving both a cemented cup and stem, remains uncommon in several countries. This study aimed to evaluate the clinical and radiographic outcomes of fully cemented primary THA in an elderly population.</div></div><div><h3>Methods</h3><div>This prospective, single-center, longitudinal cohort study enrolled patients in THA. Clinical assessments included the Harris Hip Score (HHS), the Timed Up-and-Go (TUG) test, and the Hip Disability and Osteoarthritis Outcome Score (HOOS). Radiographic evaluation was performed using anteroposterior and lateral X-rays to assess implant positioning and stability.</div></div><div><h3>Results</h3><div>Forty patients completed the 2-year follow-up (FU), with a mean age of 79.0 ± 6.0 years. Clinical outcomes demonstrated significant improvements at 2-year FU: the mean HHS increased from 42 ± 15 preoperatively to 93 ± 9; TUG improved from 24 ± 25 s preoperatively to 8 ± 3 s; and HOOS improved from 35 ± 14 preoperatively to 84 ± 17. No intraoperative complications or implant-related adverse events were reported during the 2-year follow-up.</div></div><div><h3>Conclusion</h3><div>This study highlights substantial improvements in functional outcomes, patient satisfaction, and radiographic evidence of good implant stability at 2-year follow-up. These findings support fully cemented THA as a safe and effective treatment option for elderly patients.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 287-293"},"PeriodicalIF":1.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771550","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":"Clinical outcomes of arthroscopic Bankart repair versus Latarjet repair for shoulder instability: A systematic review and meta-analysis","authors":"Wei Lun Lui ,&nbsp;Hemant Sharma","doi":"10.1016/j.jor.2025.07.023","DOIUrl":"10.1016/j.jor.2025.07.023","url":null,"abstract":"<div><div>Determining the optimal surgical approach for recurrent anterior shoulder instability remains contentious, often guided more by clinician familiarity than comparative data. This meta-analysis assessed outcomes of arthroscopic Bankart repair versus the Latarjet procedure. A thorough search of CINAHL, MEDLINE, and Scopus (up to June 2022) was performed. For continuous outcomes such as operative time and Rowe scores, mean differences (MDs) were calculated, while categorical variables like recurrence and complications were summarized as risk ratios (RRs) with 95 % confidence intervals (CIs). From five eligible cohort studies involving 3145 patients, Bankart repair was associated with elevated redislocation (RR = 3.74, CI: 1.94–7.22) and recurrence risks (RR = 3.09, CI: 1.96–4.87). Conversely, it had a lower infection rate (RR = 0.14, CI: 0.05–0.42) and yielded reduced Rowe scores (MD = −7.94, CI: −13.00 to −2.87). Revision and hematoma incidence showed no meaningful differences. These findings suggest that while Latarjet offers improved stability and function, Bankart repair is linked to fewer infections. Both methods were similar in terms of revision and hematoma outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 294-301"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779284","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":"Relationship between RAR and the risk of osteoarthritis: a comprehensive analysis based on NHANES data (1999–2018)","authors":"Qifan Chen ,&nbsp;Jiaxing Zeng ,&nbsp;Hanhua Wu ,&nbsp;Bufan Li ,&nbsp;Yu-Nan Man ,&nbsp;LuYang Zhong ,&nbsp;Mao-Lin He ,&nbsp;Shuizhong Cen","doi":"10.1016/j.jor.2025.07.028","DOIUrl":"10.1016/j.jor.2025.07.028","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis (OA) is a prevalent disease characterized by the progressive loss of articular cartilage and chronic inflammation, contributing to an increasing epidemiological burden. While several risk factors have been identified, there remains a significant lack of reliable biomarkers for assessing OA risk. This study aims to investigate the association between the red blood cell distribution width to albumin ratio (RAR) and OA risk, as well as to evaluate its potential utility as a biomarker for OA risk assessment.</div></div><div><h3>Methods</h3><div>We utilized data from the National Health and Nutrition Examination Survey (NHANES) to include a total of 35,902 participants, among whom 4,285 were diagnosed with OA. A weighted logistic regression model was employed to assess the association between different quartiles of RAR and OA risk, adjusting for relevant confounding factors. Additionally, we applied a restricted cubic spline (RCS) model to explore the non-linear dose-response relationship between RAR and OA risk, and conducted subgroup analyses to further elucidate this association.</div></div><div><h3>Results</h3><div>RAR was significantly and positively associated with the risk of OA, with an odds ratio of 1.91 (95 % CI: 1.58–2.31, P = 5.31 × 10−10) for the highest quartile (Q4) in the weighted multivariate logistic regression model. This indicates a marked increase in OA risk with rising RAR levels. Furthermore, the relationship between RAR and OA was non-linear, and the effects of RAR exhibited significant heterogeneity across different populations.</div></div><div><h3>Conclusion</h3><div>The level of RAR is positively correlated with OA risk, suggesting its potential as a biomarker for OA risk assessment. However, since causality cannot be established, further prospective or longitudinal studies are necessary to validate its clinical relevance.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 262-269"},"PeriodicalIF":1.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749258","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}