Journal of orthopaedics最新文献

{"title":"Augmented reality navigation systems vs. conventional techniques in acetabular cup positioning: a systematic review and meta-analysis","authors":"Dimitrios Mouselimis ,&nbsp;Xanthippi Topalidou ,&nbsp;Konstantinos Papadopoulos ,&nbsp;Martin Brucker ,&nbsp;Gábor Molnár ,&nbsp;André R. Zahedi ,&nbsp;Christian Lüring","doi":"10.1016/j.jor.2025.07.005","DOIUrl":"10.1016/j.jor.2025.07.005","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this systematic review and meta-analysis was to evaluate the effectiveness of augmented reality (AR) techniques in acetabular cup positioning during total hip arthroplasty (THA).</div></div><div><h3>Methods</h3><div>The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE databases were systematically searched until December 12, 2024 according to the PRISMA 2020 guidelines for prospective and retrospective studies comparing AR techniques to conventional ones regarding acetabular cup positioning. Anteversion, inclination angles, blood loss, operation time and postoperative complications comprised the outcomes. Bias assessment was performed with the RoB 2 tool for prospective studies and ROBINS-I for retrospective ones.</div></div><div><h3>Results</h3><div>In total, 9 studies were included in the systematic review and 8 in the meta-analysis. The target error according to postoperative radiographs or computer scan for both anteversion and inclination angles was significantly more precise in the 346 THAs of the AR group (Z_inclination = 3.10, <em>P</em>_{<em>inclination</em>} = 0.002, Std. mean difference = −0.52 [95 % CI: 0.85 to −0.19] and Z_anteversion = 2.44, <em>P</em>_{<em>anteversion</em>} = 0.01, Std. mean difference = −0.57 [95 % CI: 1.03 to −0.11]) with a significant substantial heterogeneity (I²_inclination = 79 %, P_inclination&lt;0.0001 and I²_anteversion = 89 %, <em>P</em>_{<em>anteversion</em>} &lt; 0.00001), when compared to the 395 THAs of the conventional group. Regarding blood loss, operation time and postoperative complications, no significant differences were observed. The risk of bias was high among the retrospective studies.</div></div><div><h3>Conclusion</h3><div>The different types of studies, as well as their individual way of assessing the acetabular cup angles are the main limitations of the meta-analysis. The results provide a strong sign of improved acetabular cup positioning with the help of AR systems, while maintaining a favorable safety profile.</div></div><div><h3>Prospero registration number</h3><div>CRD42024609350.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 335-345"},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653865","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":"Application of the LEG NUI score to assess revision success in established distal femur non-unions","authors":"Benedikt J. Braun,&nbsp;Carla Rau,&nbsp;Tanja Maisenbacher,&nbsp;Steven C. Herath,&nbsp;Mika FR. Rollmann,&nbsp;Maximilian M. Menger,&nbsp;Tina Histing,&nbsp;Marie Reumann","doi":"10.1016/j.jor.2025.07.001","DOIUrl":"10.1016/j.jor.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of non-union following distal femur fractures is high. Management of persis-tent non-unions is challenging, often requiring multiple revision surgeries, thereby increasing patient morbidity and socioeconomic burden. Identifying patients at high risk for persistent non-union after revision is therefore crucial. The LEG NUI Score was originally developed to predict the need for early intervention following primary fixation of distal femur fractures. This study aimed to evaluate the LEG NUI Score's ability to predict the need for further revision surgery in a cohort of patients with established distal femur non-union undergoing their index revision procedure.</div></div><div><h3>Patients and methods</h3><div>45 patients with complete clinical data were identified from a non-union database. The LEG NUI Score was calculated for the index revision procedure and assessed in relation to the healing out-come of the revision treatment. Comparative statistics and test characteristics were assessed, as well as a receiver operator characteristic analysis was performed. Only patients with uneventful healing after the first treatment were considered healed for the score calculation. Patients requiring more than one surgery, including second step masquelet were considered non-healers.</div></div><div><h3>Results</h3><div>The union rate (healed non-unions) after the first non-union revision surgery was 55.5 %. 24.4 % of patients had an infected non-union. The average LEG NUI Score in patients with non-union healing was significantly lower than non-healing patients (3.36 ± 1.80 vs. 4.90 ± 1.21; p &lt; 0.05). The AUC in the ROC Analysis was 0.755.</div></div><div><h3>Discussion</h3><div>The LEG NUI Score shows potential applicability in the setting of revision surgery for established distal femur non-unions. Calculating the score may help surgeons identifying patients at in-creased risk for requiring subsequent surgical procedures, thus warranting closer postoperative surveillance. Further validation in larger cohorts is required to fully elucidate its clinical utility in this context.</div></div><div><h3>Level of evidence</h3><div>Level III, Retrospective Cohort Study.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 331-334"},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596035","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":"Biomechanical analysis of retroperitoneal 360° anterior lumbar interbody hybrid stabilization constructs for degenerative conditions: A finite element investigation","authors":"Moustafa Mesbah ,&nbsp;Abdelwahed Barkaoui ,&nbsp;Hakim Chiali ,&nbsp;Mohamed Bendoukha","doi":"10.1016/j.jor.2025.06.034","DOIUrl":"10.1016/j.jor.2025.06.034","url":null,"abstract":"<div><h3>Background</h3><div>Segmental fusion utilizing interbody cages and pedicle screw fixation (PSF) remains the predominant surgical intervention for managing chronic low back pain. However, the biomechanical efficacy of combining anterior interbody cages with hybrid stabilization techniques, particularly in the context of retroperitoneal 360° anterior lumbar interbody fusion (ALIF) is still debated. Hybrid constructs using flexible pedicle-based systems aim to preserve motion and reduce adjacent segment degeneration (ASD), but their biomechanical performance remains insufficiently explored. This study investigates the biomechanical behavior of retroperitoneal ALIF combined with various hybrid stabilization systems for treating disc degeneration, degenerative spondylolisthesis, degenerative scoliosis, or instability.</div></div><div><h3>Methods</h3><div>A validated, non-linear finite element (FE) model of the lumbosacral spine (L2-S1) was developed to simulate and compare the biomechanics of four hybrid stabilization systems combined with interbody cages. The motion of the whole spine was analyzed and the biomechanical environment of the adjacent segments to the operated one was studied. Moreover, the risk of subsidence of the cages was qualitatively evaluated across different configurations.</div></div><div><h3>Results</h3><div>Supplementary fixation at the “topping off” level reduced overall spinal range of motion but led to increased stress at adjacent segments, potentially contributing to adjacent segment disease (ASD) due to the overload. In contrast, interbody cages allowed controlled relative movement, attenuating the impact on adjacent disc health. However, all hybrid systems produced similar contact pressures at the endplates, approaching subsidence risk thresholds.</div></div><div><h3>Conclusions</h3><div>Minimally invasive posterior intervertebral cage insertion, whether combined with hybrid constructs or traditional fusion fixators, significantly influences lumbar biomechanics. Retroperitoneal 360° ALIF combined with hybrid stabilization significantly alters spinal biomechanics. While hybrid systems may offer advantages in preserving motion and reducing adjacent segment stress, they also present a potential compromise in terms of fusion stability and increased risk of cage subsidence. Optimal surgical outcomes will require careful consideration of trade-offs between mobility preservation, long-term stability, and ASD prevention.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 273-285"},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604497","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":"Biomechanical study of myogenic factors in the contracture period of traumatic elbow joint","authors":"Fang Wang ,&nbsp;Yuyang Chen ,&nbsp;Mingxin Li ,&nbsp;Mingze Zhou ,&nbsp;Dalin Jian ,&nbsp;Xuehai Feng ,&nbsp;Yubo Fan","doi":"10.1016/j.jor.2025.07.004","DOIUrl":"10.1016/j.jor.2025.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Elbow contracture is a common complication following elbow trauma. Soft tissue fibrosis is an important cause of exogenous joint contracture. The most effective non-surgical method for preventing and treating elbow contracture is stretching exercise. However, there is currently a lack of understanding of the local mechanical environment of the joint, and difficulties exist in the timing and mode of loading during treatment.</div></div><div><h3>Methods</h3><div>This study established an animal model of elbow contracture and built a mechanical experimental platform to explore its morphological evolution patterns. The range of motion, stiffness changes of the contracted joint caused by myogenic contracture, and the mechanical and morphological changes of the biceps brachii were evaluated at 2, 4, 6, and 8 weeks, respectively.</div></div><div><h3>Results</h3><div>We found that the joint extension stiffness decreased by 24.4 %, 19.8 %, 7.3 %, and 5.3 % compared with the control group at 2, 4, 6, and 8 weeks, respectively. Within 2–6 weeks of elbow contracture, the dynamic stiffness, static stiffness, and viscosity of the muscle all increased with time, and the cross-sectional area of the biceps brachii continued to decrease until it stabilized at 6 weeks, with a reduction of 30 % compared to the control group. Within 2–8 weeks of elbow contracture, the proportion of collagen deposition in the biceps brachii continued to increase. Compared with 2 weeks, the percentage of collagen deposition in the biceps brachii increased by 164.7 % at 8 weeks.</div></div><div><h3>Conclusion</h3><div>During traumatic joint contractures, as the contractures developed over time, myogenic contractures could continue to limit joint range of motion and affect joint stiffness.The changes in muscle mechanical properties during joint contracture could be attributed to changes in muscle cross-sectional area and collagen deposition.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 323-330"},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588037","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":"Conventional mobile-bearing unicompartmental knee arthroplasty effectively achieves personalised alignment: A single surgeon series of 2472 knees","authors":"Arun B. Mullaji,&nbsp;Anand Gupta,&nbsp;Sitaram Chopperla","doi":"10.1016/j.jor.2025.06.029","DOIUrl":"10.1016/j.jor.2025.06.029","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;This study aimed to determine the alignment achieved with a conventional technique of mobile-bearing unicompartmental knee arthroplasty (MB UKA) in a large single-surgeon series. Specifically, it investigated whether MB UKA restores constitutional alignment, correlated preoperative and postoperative alignment, and assessed the reliability of preoperative arithmetic HKA (aHKA) as a predictor of postoperative alignment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;UKA effectively treats anteromedial osteoarthritis, but there is no unanimity regarding optimal postoperative alignment. Personalised alignment, aiming to restore pre-arthritic biomechanics, is gaining prominence. While robotic-assisted UKAs offer precision, a large series reporting conventionally performed mobile-bearing UKA alignment outcomes using full-length radiographs has been lacking.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This retrospective analysis included prospectively collected data from 2472 consecutive cemented Oxford Phase 3 medial UKAs performed by a single surgeon. Patients were divided into two groups: Group 1 (n = 272) had unilateral UKA with an asymptomatic contralateral knee, and Group 2 (n = 2200) comprised bilateral UKAs or unilateral UKAs with an affected contralateral knee. Full-length hip-to-ankle radiographs assessed Hip-Knee-Ankle (HKA) angle, Knee Joint Line Obliquity (KJLO), and Mechanical Axis Deviation (MAD). Arithmetic HKA (aHKA) was also determined.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In Group 1, the mean postoperative HKA angle (175.7°±2.8°) was not significantly different from the contralateral unaffected knee (175.4°±3.2°, p = 0.106). Postoperative HKA was within ±3° of the contralateral limb in 91 % of patients, with a strong positive correlation (r = 0.52, p &lt; 0.001). KJLO was also similar between operated (91.6°±2.6°) and contralateral limbs (90.2°±2.8°), and 86.4 % were within ±3°. MAD distribution postoperatively was similar to the contralateral limb, with 54 % in zone 2, 30 % in zone 1, and 13 % in zone C. In Group 2, the mean preoperative HKA (170.7°±3.86°) significantly improved to postoperative HKA (176.2°±2.8°, p &lt; 0.001). Postoperative MAD demonstrated improved alignment, with shifts from zone 0 towards zones 1 and 2, and a prevalence in zones 2, C, and 1. A strong negative correlation existed between ΔHKA and preoperative HKA (r = −0.695, p &lt; 0.001). Preoperative aHKA showed only a weak correlation with postoperative HKA (r = −0.421, p &lt; 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;This study demonstrates that conventional MB UKA effectively restores alignment close to the native or pre-arthritic state, consistent with personalised alignment principles. Preoperative mean varus of 9&lt;sup&gt;o&lt;/sup&gt; was corrected to approximately 4&lt;sup&gt;o&lt;/sup&gt; varus postoperatively. The strong correlation between postoperative HKA and the contralateral normal limb's HKA, similar KJLO and MAD distribution, support th","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 303-309"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579355","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 and functional outcomes of rehabilitation strategies following arthroscopic repair of chronic isolated peripheral TFCC tears: A scoping review","authors":"Deepthi Paraj,&nbsp;Ashwath M. Acharya,&nbsp;Anil K. Bhat","doi":"10.1016/j.jor.2025.06.028","DOIUrl":"10.1016/j.jor.2025.06.028","url":null,"abstract":"<div><div>This scoping review aims to evaluate the existing literature regarding the types of Triangular Fibrocartilage Complex (TFCC) tears that are amenable to repair, the prevalent rehabilitation protocols, and the documented measurable outcomes across various populations. The review was conducted as per JBI methodology and reported as per PRISMA-ScR guidelines. A total of 35 studies published between 1996 and 2024 were included. Palmer Type 1B was the most frequently operated type of tear. The tears were repaired using various arthroscopic-assisted techniques like capsular repair with polydiaxone sutures(PDS) with or without K-wire fixation, transosseous sutures, and ligament-specific repair. The duration of complete immobilization following repair varied significantly among the elbow, forearm, and wrist joints, with six weeks being the most common immobilization period. Patients on average regained 85 % of grip strength, with 87 % successfully returning to their pre-injury activity levels. The scoping review highlights the variability in rehabilitation practices following TFCC repair and the assessment of outcomes, emphasizing the need for level 1 evidence studies to standardize postoperative protocols.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 310-322"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579354","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":"Effect of diameter reduction by compression on peroneus longus allograft integrity: A biomechanical analysis","authors":"Rafael Calvo Rodriguez ,&nbsp;Waldo Gonzalez Duque ,&nbsp;David Figueroa Poblete ,&nbsp;Minerva Itriago ,&nbsp;Rafael Calvo Mena ,&nbsp;Jorge Isla Villanueva","doi":"10.1016/j.jor.2025.06.036","DOIUrl":"10.1016/j.jor.2025.06.036","url":null,"abstract":"<div><h3>Background</h3><div>There is broad consensus regarding the minimum required graft diameter in anterior cruciate ligament (ACL) reconstruction surgery; a diameter of at least 8 mm is recommended when using hamstring tendon grafts. However, it remains unclear what happens when a larger-diameter graft is compressed to a smaller diameter, and how this alteration may affect the biomechanical properties of the graft. The objectives is determine whether the biomechanical strength of compressed allografts is preserved after reducing their diameter, and whether compression techniques could be considered a viable option for smaller patients such as women and children. Our hypothesis is that a compressed graft may retain similar strength to the original, despite having a reduced diameter.</div></div><div><h3>Methods</h3><div>This was a cadaveric biomechanical case-control study using 30 peroneus longus (PL) tendon allografts. The grafts were divided into three groups: Group 0 (8 mm uncompressed grafts), Group 1 (9 mm uncompressed grafts), and Group 2 (10 mm with a graft tube, compression to 9 mm). Each graft was tested using a Zwick/Roell Z005 tensile testing machine, undergoing cyclic loading between 50 and 250 N at 1 Hz for 1000 cycles, followed by continuous tensile loading to failure. The maximum failure force (Fmax) was recorded for each graft. Statistical analyses were performed using STATA v.18.5.</div></div><div><h3>Results</h3><div>Group 1 (9 mm uncompressed grafts) showed a mean maximum failure force of 1902 N (SD: 432.12; 95 % CI). Group 2 (compressed grafts) showed a mean Fmax of 1608 N (SD: 233.12; 95 % CI), with a statistically significant difference between the two groups (p = 0.037). Group 0 (native 8 mm grafts) showed a mean Fmax of 1341 N (SD: 936.67; 95 % CI). No statistically significant difference was found between Group 0 and Group 2 (p = 0.196).</div></div><div><h3>Conclusions</h3><div>The results indicate that the compressed group had lower resistance compared to the original 9 mm grafts. However, when compared to the smaller-diameter grafts, no significant difference in strength was observed. Nonetheless, the compressed grafts showed a tendency to withstand higher loads than the native 8 mm grafts.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 346-350"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714275","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":"15-year validation of the forgotten joint score after unicompartmental knee arthroplasty: A reliable indicator of long-term patient satisfaction and joint awareness","authors":"R. Radhakrishnan,&nbsp;S. Xu,&nbsp;A.X. Han,&nbsp;X. Liu,&nbsp;M.H. Liow,&nbsp;H.N. Pang,&nbsp;D.K.J. Tay,&nbsp;S.J. Yeo,&nbsp;J.Y. Chen","doi":"10.1016/j.jor.2025.06.018","DOIUrl":"10.1016/j.jor.2025.06.018","url":null,"abstract":"<div><h3>Background</h3><div>Unicompartmental knee arthroplasty (UKA) offers bone- and ligament-preserving treatment for medial compartment osteoarthritis. The Forgotten Joint Score (FJS) is a modern patient-reported outcome measure (PROM) that assesses joint awareness during daily activity—an ideal benchmark for long-term implant success. However, its utility beyond 10 years postoperatively remains insufficiently studied.</div></div><div><h3>Purpose</h3><div>To evaluate long-term clinical outcomes and validate the Forgotten Joint Score (FJS) 15 years following medial fixed-bearing UKA.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 54 patients who underwent medial UKA between 2003 and 2007 at a tertiary academic institution. Functional outcomes (Knee Society Knee Score [KSKS], Knee Society Function Score [KSFS], Oxford Knee Score [OKS], and SF-12 Physical and Mental Component Scores [PCS, MCS]) were assessed preoperatively and at 2, 10, and 15 years postoperatively. At 15 years, patients completed the FJS questionnaire unaided. Internal consistency (Cronbach's α), ceiling effects, Pearson correlations, and logistic regression were performed to assess construct validity and patient-perceived outcomes. Multiple linear regression identified preoperative predictors of FJS.</div></div><div><h3>Results</h3><div>Significant and sustained improvements were observed in KSFS, KSKS, OKS, and PCS up to 15 years postoperatively (p &lt; 0.05). The mean FJS at 15 years was 78.6 (SD 23.1); 94.4 % of patients exceeded the PASS threshold, and 50 % achieved “forgotten joint” status (FJS ≥84.38). Internal consistency was excellent (Cronbach's α = 0.88). FJS showed strong correlations with OKS (r = 0.675, p &lt; 0.001), KSFS (r = 0.470), and PCS (r = 0.340). Logistic regression confirmed FJS as a strong predictor of patient satisfaction (classification accuracy 90.7–92.6 %, p &lt; 0.01). Preoperative KSFS was the only significant predictor of long-term FJS (β = 0.6, p = 0.029).</div></div><div><h3>Conclusion</h3><div>The Forgotten Joint Score is a reliable, internally consistent, and valid long-term outcome measure following medial UKA. Its strong associations with functional scores, patient satisfaction, and preoperative function support its incorporation into long-term clinical outcome assessment and highlight UKA's durability and patient acceptability at 15 years.</div></div><div><h3>Level of evidence</h3><div>III, Retrospective Cohort Study.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 297-302"},"PeriodicalIF":1.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572533","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":"Effect of hyperbaric oxygen therapy (HBO) on osteoblasts of elderly patients on calcification and osteoprotegerin","authors":"Lisa Oezel ,&nbsp;Johannes Schneppendahl ,&nbsp;Jan-Peter Grassmann ,&nbsp;Pia Flender ,&nbsp;Sven Dreyer ,&nbsp;Vera Grotheer","doi":"10.1016/j.jor.2025.06.017","DOIUrl":"10.1016/j.jor.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis stands as one of the most prevalent bone diseases worldwide. This study aims to explore the effects of Hyperbaric Oxygen (HBO) therapy and substances that reduce reactive oxygen species (ROS), such as antioxidants, on osteogenic differentiation and key osteoporosis-related parameters in osteoblasts derived from elderly patients requiring hip arthroplasty.</div></div><div><h3>Methods</h3><div>An in vitro study was conducted using osteoblasts isolated from the femoral heads of 22 patients (78.3 % female) with a mean age of 73 years. Bone mineral density (BMD) was assessed through dual-energy X-ray absorptiometry (DXA), classifying patients into three groups: normal (age-appropriate) BMD (n = 8), osteopenia (n = 6), and osteoporosis (n = 8). Osteogenic differentiation was induced, and HBO therapy was administered over a period of 21 days. Additionally, osteoblasts were treated with catalase. Parameters related to osteogenic differentiation and osteoporosis were evaluated.</div></div><div><h3>Results</h3><div>HBO therapy prompted osteogenic differentiation in all three experimental groups after 21 days, with statistically significant findings (p = 0.0125) in osteoblasts with age-appropriate bone density. Furthermore, the activity of alkaline phosphatase (ALP), an enzyme indicative of bone synthesis, demonstrated significant increases across all groups following HBO treatment (normal BMD and osteoporotic cells: p = 0.04; osteopenic cells: p = 0.006).</div></div><div><h3>Conclusions</h3><div>These findings suggest that HBO therapy holds potential as an adjunctive or investigational treatment for elderly patients to enhance bone density or facilitate bone healing post-fracture, especially in those with normal or osteopenic bone density. This approach could potentially influence clinical practices in the future.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 335-343"},"PeriodicalIF":1.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680618","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":"Hospital-acquired COVID-19 and its effect on length of stay and mortality in orthopedic admissions: A matched cohort study","authors":"Itay Ron ,&nbsp;Ammar Muati ,&nbsp;David Shaked Zari ,&nbsp;Bezalel Peskin ,&nbsp;Nabil Ghrayeb ,&nbsp;Doron Norman ,&nbsp;Jacob Shapira","doi":"10.1016/j.jor.2025.06.031","DOIUrl":"10.1016/j.jor.2025.06.031","url":null,"abstract":"<div><h3>Introduction</h3><div>Hospital-acquired COVID-19 poses a significant threat to orthopedic patients, a population already at risk due to immobility, comorbidities, and extended hospital stays. The combined burden of musculoskeletal injury and SARS-CoV-2 infection may prolong recovery, increase complications, and influence survival. This study aimed to evaluate the impact of nosocomial COVID-19 on hospitalization outcomes in orthopedic patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at a tertiary orthopedic center, analyzing patients hospitalized between 2020 and 2022. COVID-19-positive patients (n = 84) who acquired the infection during admission were matched 1:1 with uninfected controls (n = 84) based on age, gender, and BMI. Data were collected on demographics, comorbidities, hospitalization duration, complications, ICU transfers, and mortality outcomes. Statistical analysis included t-tests, Mann-Whitney U tests, and significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>COVID-19-positive patients experienced significantly longer hospital stays (median 13.9 vs. 4.3 days, p &lt; 0.001) and shorter time to death post-discharge (median 135 vs. 540 days, p = 0.027) compared to controls. Mortality rates were similar between groups (23.8 % vs. 22.6 %, p = 0.86), and ICU admissions occurred only in the COVID-19 group (3.3 %). Baseline characteristics and comorbidity profiles were comparable.</div></div><div><h3>Conclusion</h3><div>Orthopedic patients who contract COVID-19 during hospitalization face a prolonged hospital course and earlier mortality despite similar overall death rates. These findings highlight the importance of infection prevention strategies, including preoperative screening and deferring elective procedures in infected individuals, to mitigate complications associated with immobility, delayed recovery, and systemic decline.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 293-296"},"PeriodicalIF":1.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556664","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}