Journal of orthopaedics最新文献

{"title":"Matching lines to designs: A novel radiographic index for shorter femoral stems in total hip arthroplasty","authors":"Catalina Baez ,&nbsp;Blane Kelly ,&nbsp;Sunny Trivedi ,&nbsp;Jeff Dela Cruz ,&nbsp;Justin Deen ,&nbsp;Chancellor F. Gray ,&nbsp;Hernan Prieto ,&nbsp;Luis Pulido ,&nbsp;MaryBeth Horodyski ,&nbsp;Hari Parvataneni","doi":"10.1016/j.jor.2025.03.036","DOIUrl":"10.1016/j.jor.2025.03.036","url":null,"abstract":"<div><h3>Introduction</h3><div>Matching stem design and femoral morphology to balance stability and osseointegration with complication risk is critical in total hip arthroplasty (THA). Several historical radiographic measurements have assisted surgeons in selecting the best stem design for a patient. As these measurements were developed for longer stems (&gt;150 mm) they have less utility for shorter stems (&lt;120 mm). This study evaluated a set of new radiographic measurements tailored to shorter stems and the relative radiographic performance of several medial-to-lateral (ML) and metaphyseal-filling (MF) stems.</div></div><div><h3>Methods</h3><div>Retrospective cohort study on all elective primary THAs between January 2011 and August 2020 at a single institution. Patients received a short metaphyseal-engaging stem and a minimum six-month follow-up with standardized radiographs. Six radiographic indices were created based on validated reference points. Postoperative radiographs were evaluated for stable fixation by bone ingrowth and lucent zones.</div></div><div><h3>Results</h3><div>There were 748 cases, with a mean age of 63 (±12.2) years. Radiolucencies were evident in 13.6 % of stems. Metaphyseal-filling stems had a lower incidence of radiolucencies than ML stems (9.1 vs 19.3 %, <strong><em>p &lt; 0.001</em></strong>). A Metaphyseal Flair Index (MFI) below 0.6 and a Lesser Cortical Index (LCI) above 0.3 significantly predicted higher rates of radiolucency (<strong><em>p &lt; 0.001</em></strong>). Patients with an LCI of 0.3 or higher had a 93 % probability of developing radiolucencies when using ML stems (<strong><em>p &lt; 0.001</em></strong>).</div></div><div><h3>Conclusion</h3><div>Two indices (MFI and LCI) predicted areas of osseointegration in modern short femoral stems. Metaphyseal-filling stems have lower radiolucency rates than ML stems. Due to the higher probability of radiolucencies, surgeons should consider avoiding ML stems in patients with LCI values above 0.3.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 39-47"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683262","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":"Underestimated incidence of acute lateral hinge fractures in medial opening wedge high tibial osteotomy: The role of MRI in early detection","authors":"Woon-Hwa Jung ,&nbsp;Minish Raghunath Katkar ,&nbsp;Min-Seok Seo ,&nbsp;Dong-Hyun Kim ,&nbsp;Ryohei Takeuchi","doi":"10.1016/j.jor.2025.03.026","DOIUrl":"10.1016/j.jor.2025.03.026","url":null,"abstract":"<div><h3>Objective</h3><div>1) Investigate the incidence of lateral-hinge fractures after medial opening wedge high tibial osteotomy using MRI postoperatively alongside radiographs. 2) Determine the number of missed acute lateral-hinge fractures and distinguish them from true delayed fractures 3)Evaluate the complications associated with these fractures.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 250 knees from 227 patients who underwent medial opening-wedge high tibial osteotomy. Radiological evaluation was performed using radiographs, CT scans, and MRI. Patients were categorized into four groups: (1) Acute Lateral-hinge fractures, (2) missed Lateral-hinge fractures, (3) delayed Lateral-hinge fractures and (4) no fractures.</div></div><div><h3>Results</h3><div>MRI detected lateral hinge fractures (LHF) in 59.6 % of cases, nearly doubling the detection rate of radiographs and CT scans (33.2 %), revealing a significant underestimation of LHF in MOWHTO. Additionally, 73.49 % of presumed delayed fractures were actually missed acute fractures, with a true delayed fracture incidence of only 1.6 %. The fracture groups had a longer healing time and were associated with a loss of correction.</div></div><div><h3>Conclusion</h3><div>The incidence of lateral-hinge fractures after medial opening-wedge high tibial osteotomy is significantly underestimated, with most occurring intra-operatively but often missed on postoperative radiographs and misclassified as delayed fractures. MRI, highly sensitive for early detection and prevention of misclassification, helps optimize rehabilitation strategies and improve patient outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 117-123"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686899","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":"Pain worsens peripartum after hip arthroscopy for femoroacetabular impingement and may not return to pre-pregnancy improvement","authors":"Allison M. Morgan,&nbsp;Dhruv S. Shankar,&nbsp;Andrew S. Bi,&nbsp;Zachary I. Li,&nbsp;Jairo Triana,&nbsp;Thomas Youm","doi":"10.1016/j.jor.2025.03.008","DOIUrl":"10.1016/j.jor.2025.03.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess hip symptomatology during the perioperative and peripregnancy periods and postoperative outcomes among reproductive age females undergoing arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) and pregnancy complications in females after hip arthroscopy.</div></div><div><h3>Methods</h3><div>Females aged 18–44 years who underwent hip arthroscopy for the treatment of FAIS with a single surgeon were included in the study. Postoperatively, patients were surveyed regarding obstetric history, hip symptomology, and post-surgery pregnancy experiences. Subjects were classified as nulligravid (Group 1), pregnant at least once before hip surgery but never again following surgery (Group 2), or pregnant at least once following hip surgery (Group 3). Hip pain intensity was reported on a 10-point Visual Analog Scale (VAS) and hip function was reported using the modified Harris Hip Score (mHHS). Patients self-reported pregnancy outcomes and complications.</div></div><div><h3>Results</h3><div>85 patients were enrolled with a mean age of 32.3 ± 6.5 years at the time of surgery. Mean follow-up time was 51.9 ± 34.5 months. There were 39 subjects in Group 1 (45.9 %), 20 in Group 2 (23.5 %), and 26 in Group 3 (30.6 %). There were no significant inter-group differences in mHHS preoperatively or at final follow-up (p = 0.95). Group 3 subjects reported that both postoperative and post-pregnancy VAS remained significantly lower than the preoperative baseline (p &lt; 0.001). 69.2 % and 73.1 % report worsened hip pain during the third trimester and postpartum, respectively. 57.9 % reported that their hip pain returned to the pre-pregnancy baseline by time of survey completion.</div></div><div><h3>Conclusion</h3><div>Females of reproductive age with FAIS can expect clinical improvements relative to their baseline after hip arthroscopy regardless of pregnancy timing relative to surgical intervention. A majority of patients who become pregnant post-arthroscopy experience a peripartum recurrence of their symptoms. Most but not all of these patients return to the level of maximal improvement they had initially experienced postoperatively.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 119-125"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724692","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":"Evaluating barbed sutures: A porcine biomechanical comparison of Z-plasty and turndown flap according to Silfverskiöld","authors":"Henry V. Bürger ,&nbsp;Jahnke Alexander ,&nbsp;Harz Torben ,&nbsp;Carlos A. Fonseca-Ulloa ,&nbsp;Markus Rickert ,&nbsp;Dirk Stolz","doi":"10.1016/j.jor.2025.03.003","DOIUrl":"10.1016/j.jor.2025.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>It is not possible to add an infinite amount of suture material to tendon plasties and repairs in vivo. Each additional knot can reduce the tensile strength by up to 50 %. Therefore, barbed sutures, as a knotless suturing system, should be investigated as a potential alternative to traditional sutures to minimize knot-related weakening.</div></div><div><h3>Material and methods</h3><div>Superficial porcine flexors were randomized into five groups. A non-contact measurement was utilized. The Z-plasty and the turndown flap according to Silfverskiöld were used. The Stratafix barbed knotless suture was compared to regular smooth polydioxanone. The biomechanical protocol included a creep test, a cyclic test, and a tear-off test.</div></div><div><h3>Results</h3><div>The Z-plasty with Stratafix showed significantly improved maximum force compared to the Z-plasty with Polydioxanon (PDS 108.5 ± 22.2N, Stratafix 142.3 ± 23.5N, p &lt; .01). The Z-plasty was significantly superior to the turndown flap in maximum Force (turndownflap with Stratafix 52.4 ± 14.6N, Z-plasty with Stratafix 108.5 ± 22.2N, p &lt; .001).</div></div><div><h3>Conclusion</h3><div>The Stratafix barbed suture can significantly improve the Z-plasty in maximum tension by up to 32 % when compared to regular PDS. To formulate a more precise indication, biological factors must be further investigated.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 30-36"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriately planned resection depth can impact outcomes after robotic total knee arthroplasty","authors":"Jayson Zadzilka ,&nbsp;Bernard Stulberg ,&nbsp;Brian Davis","doi":"10.1016/j.jor.2025.03.004","DOIUrl":"10.1016/j.jor.2025.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>There are many factors to consider while planning and executing a successful total knee arthroplasty. One of these, the amount of bony resection, is determined in part based on the patients’ anatomy and preoperative deformity. Utilizing intraoperative technology such as robotics allows for resection to be done accurately. Therefore, the goal of this study was to investigate the relationship between tibial &amp; femoral resection depths and postoperative outcomes. Additionally, a quantitative method for preoperatively determining the level of resection depth needed was developed.</div></div><div><h3>Methods</h3><div>A de-identified dataset containing 107 robotic total knee arthroplasty cases was reviewed. Preoperative demographics, preoperative planning details, and sub-scale scores from the Knee Society Scoring System were reviewed. Analysis was performed to find significant associations with the sub-scale scores. Additionally, multiple regression models were developed to predict resection depth values.</div></div><div><h3>Results</h3><div>Associations were found between femoral resection depth and Satisfaction &amp; Function scores three months postoperatively. Additionally, Satisfaction and Function were 6 % and 16 % higher respectively when the native alignment strategy was used rather than mechanical alignment of the lower limb. Three-month Function scores were also 6 % higher for males than females. The models to predict resection depth included alignment strategy, preoperative knee deformity, and gender as the significant contributors.</div></div><div><h3>Conclusion</h3><div>Tibial and femoral resection depth can influence postoperative outcomes. Therefore, it is important to understand what factors contribute to the determination of how much bone should be resected. With that information, patient-specific preoperative plans can be developed with the intent of optimizing postoperative outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 42-46"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal fibular osteotomy definitively ameliorates medial compartment knee osteoarthritis: A finite element analysis","authors":"Quan Sun ,&nbsp;Kaiwei Zhang ,&nbsp;Di Yang ,&nbsp;Yang Liu ,&nbsp;Yuankun Xu ,&nbsp;Shuguang Zheng","doi":"10.1016/j.jor.2025.03.005","DOIUrl":"10.1016/j.jor.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study was designed to explore the biomechanical impacts of the proximal fibular osteotomy (PFO) on medial compartment knee osteoarthritis (KOA). Furthermore, this study utilized finite element analysis (FEA) to examine the biomechanical impacts of PFO on medial compartment KOA both pre- and post-surgery.</div></div><div><h3>Methods</h3><div>Fifteen individuals with medial compartment KOA were selected randomly. Three-dimensional reconstruction software, coupled with FEA software, was employed to model PFO, allowing observation of changes in stress distribution, peak stress, and contact area of articular cartilage in femoral cartilage, tibial plateau cartilage, and meniscus before and after PFO.</div></div><div><h3>Results</h3><div>After PFO, significant changes in peak stress and stress distribution in the knee joint (KJ) were observed. The stress distribution shifts notably from the medial side to the lateral side. A significant reduction in peak values was observed in the medial femoral cartilage (changing from 1.91 ± 0.44 to 1.40 ± 0.14), medial meniscus (2.89 ± 0.72 to 2.05 ± 0.49), and medial tibial plateau cartilage (2.25 ± 0.65 to 1.60 ± 0.38). On the contrary, an increase in these metrics was recorded in the lateral femoral cartilage (changing from 1.10 ± 0.32 to 1.59 ± 0.30), lateral meniscus (1.82 ± 0.58 to 2.49 ± 0.60), and lateral tibial plateau cartilage (0.95 ± 0.21 to 1.40 ± 0.26). In addition, the stress distribution area of articular cartilage was reduced significantly in the medial dimension (346.25 ± 55.66 to 267.05 ± 51.05) and increased in the lateral dimension (219.35 ± 38.89 to 333.25 ± 29.90).</div></div><div><h3>Conclusion</h3><div>PFO demonstrates effectiveness in alleviating stress within the medial compartment of the KJ, presenting a straightforward and efficacious approach for managing medial compartment KOA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 47-52"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628132","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":"Corrigendum to “Comparison of rerupture rates after operative and nonoperative management of Achilles tendon rupture in older populations: Systematic review and meta-analysis” [J Orthopaedic 52 (2024) 112–118]","authors":"Daniel Acevedo ,&nbsp;Jose R. Garcia ,&nbsp;Rajvarun S. Grewal ,&nbsp;Ashish Vankara ,&nbsp;Christopher J. Murdock ,&nbsp;Patrick C. Hardigan ,&nbsp;Amiethab A. Aiyer","doi":"10.1016/j.jor.2025.03.002","DOIUrl":"10.1016/j.jor.2025.03.002","url":null,"abstract":"","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 37-41"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and complications of three-column osteotomy in treating adult spinal deformity in elderly patients: A retrospective analysis","authors":"Ved A. Vengsarkar ,&nbsp;Jialun Chi ,&nbsp;Kate S. Woods ,&nbsp;Hanzhi Yang ,&nbsp;Zhichang Zhang ,&nbsp;Yi Zhang ,&nbsp;Jesse Wang ,&nbsp;Lawal Labaran ,&nbsp;Xudong Li","doi":"10.1016/j.jor.2025.03.001","DOIUrl":"10.1016/j.jor.2025.03.001","url":null,"abstract":"<div><h3>Aims &amp; objectives</h3><div>Sagittal imbalance linked to adult spinal deformity negatively affects quality of life and can be treated with 3CO techniques. While effective, these methods are invasive and can lead to high complications. Since 2010, a more patient-focused approach has grown in popularity, but its effects on elderly patients remain unclear. This retrospective study aimed to investigate the trend of three-column osteotomy (3CO) utilization in posterior long-segment fusion among different age groups. We also sought to determine the safety profile of 3CO by analyzing postoperative complications in the elderly population.</div></div><div><h3>Materials &amp; methods</h3><div>The study assessed postoperative complications and long-term outcomes for elderly patients aged 70 and above who underwent 3CO as part of a posterior spinal instrumented fusion from 2010 to 2020 using multivariable logistic regression. A total of 2091 patients were identified for analysis.</div></div><div><h3>Results</h3><div>The Mann-Kendall trend test revealed a significant downward trend in 3CO interventions after 2017. Elderly patients demonstrated higher rates of medical complications compared to younger cohorts but had lower rates of surgical complications and reoperations. This pattern persisted even after adjusting for baseline comorbidity profiles. At the five-year mark, elderly patients (ages 70–84) exhibited reoperation rates similar to the middle-aged group (ages 55–69) but notably lower than those in patients younger than 55 years.</div></div><div><h3>Conclusion</h3><div>Aside from an increased risk of medical complications following 3CO, older patients were not at an increased risk of surgical complications, including pseudarthrosis, proximal junctional failure, and reoperation.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 23-29"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579464","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":"Admission to rehab increases risk of postoperative venous thromboembolism and bleeding after operative fixation of femoral neck fractures","authors":"Hannah I. Travers ,&nbsp;Gloria S. Coden ,&nbsp;Samantha Simon ,&nbsp;Mikhail Kuznetsov ,&nbsp;Eric L. Smith ,&nbsp;Rushad Patell ,&nbsp;Brian L. Hollenbeck","doi":"10.1016/j.jor.2025.01.032","DOIUrl":"10.1016/j.jor.2025.01.032","url":null,"abstract":"<div><h3>Aims &amp; objectives</h3><div>The risk of postoperative venous thromboembolism (VTE) and bleeding after operative management of femoral neck fractures (FNF) is well established. It is common for FNF patients to be discharged to rehabilitation facilities, despite higher complication rates. It was hypothesized that discharge to rehabilitation after operative fixation of FNF was associated with increased risk of VTE and bleeding.</div></div><div><h3>Materials &amp; methods</h3><div>Retrospective review of 7483 patients who sustained FNF and underwent operative treatment between 1/1/2019-12/31/2021 was conducted using a commercial claims database. The primary outcome was VTE and bleeding post-discharge within 30 days of surgery. Risk factors for VTE and bleeding were evaluated by logistic regression analysis.</div></div><div><h3>Results</h3><div>The cumulative incidence was 3.77 % (95 % confidence interval (CI) = 3.33–4.21) for VTE and 4.01 % (CI = 3.56–4.46) for bleeding. There were 56.7 % of patients who were discharged to rehabilitation. Multivariable analysis demonstrated hereditary hypercoagulable diagnosis (odds ratio (OR) = 2.86, CI = 1.33–6.16), discharge to rehabilitation (OR = 2.08, CI = 1.47–2.92), discharge to another location (OR = 1.94, CI = 1.15–3.27), and length of stay (LOS) ≥5 days (OR = 1.69, CI = 1.15–2.50) increased risk for postoperative VTE. Variables that increased risk of bleeding included discharge to rehabilitation (OR = 2.20, CI = 1.55–3.12), discharge to other (OR = 1.92, CI = 1.12–3.27), and chronic anticoagulation (OR = 1.58, CI = 1.19–2.10). Analysis of patients prescribed thromboprophylactic medications demonstrated cumulative incidence of VTE 3.46 % (CI = 2.24–4.68) and 4.47 % (CI = 3.09–5.85) for bleeding at 30 days.</div></div><div><h3>Conclusion</h3><div>In patients with FNF, discharge to inpatient rehabilitation was associated with increased risk of postoperative VTE and bleeding. LOS ≥5 days was also associated with increased VTE risk, demonstrating the importance of timely hospital discharge.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 114-120"},"PeriodicalIF":1.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436591","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":"A therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery: A study of early and mid-term follow-up","authors":"Jinkun Guo ,&nbsp;Meng Que ,&nbsp;Jinyan Guo ,&nbsp;ZhongFan Liu ,&nbsp;Yan-Jun Che","doi":"10.1016/j.jor.2025.02.006","DOIUrl":"10.1016/j.jor.2025.02.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To perform therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery in terms of early and mid-term follow up.</div></div><div><h3>Methods</h3><div>From December 2021 to April 2023, a total of 40 patients with rotator cuff injury were enrolled and randomly assigned to two groups with equal number of patients, and all patients received shoulder arthroscopic surgery before receiving either tranexamic acid or normal saline managements. Patients in the experimental group, group A, treated with 2g tranexamic acid (diluted with normal saline to 20ml) via intra-articular injection, while patients in the control group (group B) received 20ml normal saline management. The whole process was conducted in accordance with randomized double-blind controlled trials. Clinical outcomes were assessed preoperatively and postoperatively via American Shoulder and Elbow Surgeons (ASES) score, a UCLA shoulder rating, a CONSTANT score, and visual analog scale (VAS). Early and mid-term follow-up were performed at 1 week, 1 month, 3 months, and 6 months after surgery.</div></div><div><h3>Results</h3><div>The ASES score and CONSTANT score at 1 month, 3 months and 6 months after operation in the tranexamic acid group were higher than those in the normal saline group (p &lt; 0.05). Meanwhile, the UCLA score at 3 months and 6 months after operation in the tranexamic acid group was higher than that in the normal saline group (p &lt; 0.05). In addition, the muscle strength score and external rotation value at 6 months after operation in the tranexamic acid group and normal saline group were higher than those in the normal saline group (p &lt; 0.05). There was no significant difference in the VAS score between the two groups at each observation cut-off point (p &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Injection of tranexamic acid after rotator cuff repair surgery plays an positive role on the recovery of patients muscle strength and tone as well as shoulder flexibility. Therapeutic assessment demonstrates the favorable clinic efficacy either early or mid-term follow-up.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 177-182"},"PeriodicalIF":1.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436396","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}