Journal of orthopaedics最新文献

{"title":"Mid-term outcomes of the Latarjet procedure for shoulder instability: A retrospective study of 187 shoulders with an eight-year follow-up","authors":"Asghar Elmi,&nbsp;Aran Nikpay,&nbsp;Sharareh Mirzazadeh Maryan,&nbsp;Alireza Rouhani","doi":"10.1016/j.jor.2026.01.006","DOIUrl":"10.1016/j.jor.2026.01.006","url":null,"abstract":"<div><h3>Purpose</h3><div>While the Latarjet procedure is a recognized intervention for glenohumeral instability, mid-term outcomes data, particularly regarding recurrence and complication rates, remain uncharacterized within the specified national context. This study aimed to retrospectively evaluate the mid-term clinical and functional results of the open Latarjet procedure for the management of recurrent anterior shoulder instability.</div></div><div><h3>Methods</h3><div>A retrospective, descriptive cohort study was conducted on patients undergoing the open Latarjet procedure for shoulder instability between 2009 and 2017 at a single academic medical center. A total of 186 patients (187 shoulders) were included via census sampling. Primary outcome measures included postoperative pain assessed via a Visual Analog Scale (VAS) and functional stability evaluated using the Rowe and Duplay-Walch scoring systems. Radiographic assessment for osteoarthritis and documentation of complications were performed.</div></div><div><h3>Results</h3><div>The mean follow-up period was [If available, insert mean ± SD years]. The mean postoperative Duplay-Walch score was 84 ± 19.4. A statistically significant improvement was observed in the mean Rowe score, from 13.9 ± 19 preoperatively to 93.6 ± 14 postoperatively (P &lt; 0.001). The rate of recurrent dislocation was 3.2 % (n = 6). Postoperative complications included the development of grade I osteoarthritis in 9.6 % (n = 18) and grade II in 2.1 % (n = 4) of shoulders, and musculocutaneous nerve neuropraxia in 1.1 % (n = 2) of cases. No instances of axillary nerve injury were recorded.</div></div><div><h3>Conclusion</h3><div>The findings indicate that the open Latarjet procedure is an effective and reliable intervention for recurrent anterior shoulder instability, providing excellent mid-term stability with a low recurrence rate. The procedure was associated with predictable complication profiles, including a low risk of nerve injury and progressive glenohumeral arthritis, with minimal functional restriction in external rotation.</div></div><div><h3>Level of evidence</h3><div>Level IV (Therapeutic Study, Case Series).</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 220-225"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023304","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":"Interobserver reliability of the AO/OTA and Luo three-column classification systems for tibial plateau fractures and their impact on surgical approach selection","authors":"Maximilian Appel ,&nbsp;Axel Jubel ,&nbsp;Moritz Antoni","doi":"10.1016/j.jor.2026.01.013","DOIUrl":"10.1016/j.jor.2026.01.013","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to compare the interobserver reliability of the traditional two-dimensional AO/OTA classification with the more recent three-dimensional Luo three-column classification for tibial plateau fractures. Furthermore, it evaluates the impact of both systems on the surgical approach selection, particularly examining Luo et al.'s hypothesis that the three-column classification encourages increased consideration of the posterior column during preoperative planning. However, this hypothesis has not been evaluated yet, leaving a research gap regarding its influence in practice on surgical approach selection.</div></div><div><h3>Methods</h3><div>Fifteen cases of tibial plateau fractures were retrospectively analyzed by nine trauma surgeons using radiographs and CT scans. Fractures were classified according to the AO/OTA and Luo classifications, and preferred surgical approaches for definitive fixation were determined. Interobserver reliability was assessed using Fleiss' kappa and interpreted according to the categorical rating by Landis and Koch. Additionally, a chi-square test was performed to evaluate statistical significance in the surgical approach selection.</div></div><div><h3>Results</h3><div>Both classification systems showed overall substantial reliability (k_AO = 0.63; k_Luo = 0.67). The difference in agreement for surgical approach groups between the two classifications was 0.11 (k_{AO_approach} = 0.37; k_{Luo_approach} = 0.48). The posterior approach group was not selected significantly more often using the Luo three-column classification compared to the AO/OTA classification (p = 0.543).</div></div><div><h3>Conclusion</h3><div>No significant difference in interobserver reliability or in the choice of surgical approach was observed between the AO/OTA and Luo classifications.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 234-238"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023381","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":"Arthroscopic treatment of post-traumatic knee chondral defects using microfractures and the Autologous Collagen-Induced Chondrogenesis (ACIC™) technique: a retrospective observational cohort study","authors":"Giacomo Galanzino ,&nbsp;Ilaria Morelli ,&nbsp;Alessandro Ivone ,&nbsp;Edoardo Bianchi Visconti ,&nbsp;Domenico Iovinella ,&nbsp;Roberto Edoardo Vanelli","doi":"10.1016/j.jor.2025.12.051","DOIUrl":"10.1016/j.jor.2025.12.051","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate return to sport and one-year clinical outcomes in young athletes with focal grade III–IV knee chondral lesions treated arthroscopically using the Autologous Collagen-Induced Chondrogenesis (ACIC™) technique, which combines microfractures with an atelocollagen scaffold stabilized by fibrin glue.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on all consecutive patients undergoing arthroscopic microfractures with ACIC™. Inclusion criteria comprised monofocal ICRS III–IV knee chondral defects ≥1 cm², young sports-active patients, and a minimum follow-up of one year. Patients with malalignment &gt;5°, knee instability, inflammatory disease, BMI ≥30, or kissing lesions were excluded. Pain and function were assessed after injury and one year postoperatively. Sport level (Tegner Activity Scale) was compared before injury and at one year postoperatively.</div></div><div><h3>Results</h3><div>Four patients met the inclusion criteria. Lesions were located on the femoral condyle (n = 3) or tibial plateau (n = 1), with a mean defect area of 1.8 ± 1 cm². Three patients returned to their pre-injury level of sport at one year. No significant difference was observed between pre-injury and postoperative Tegner scores. Significant improvements were found in VAS pain (p = 0.004) and IKDC functional scores (p = 0.0009) after surgery. All patients reported to be highly satisfied with the surgery.</div></div><div><h3>Conclusions</h3><div>Arthroscopic ACIC™ demonstrated significant pain reduction, improved knee function, and a high rate of return to pre-injury sport level at one-year follow-up in young athletes with focal high-grade knee chondral lesions. Larger studies with long-term follow-up are needed to confirm durability and characterize cartilage repair quality.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 6-10"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839441","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 single-stage cartilage treatments in the knee: A systematic review and meta-analysis of osteochondral autograft transfer surgery (OATS) and minced cartilage repair (MCR) techniques","authors":"Jason Jia Shyan Ong ,&nbsp;Christopher Busby ,&nbsp;Francisco Barbosa ,&nbsp;Thomas Kurien ,&nbsp;Jimmy Wui Guan Ng","doi":"10.1016/j.jor.2025.12.052","DOIUrl":"10.1016/j.jor.2025.12.052","url":null,"abstract":"<div><h3>Background</h3><div>Focal chondral lesions of the knee remain challenging to treat. Although small defects may respond to conservative management, moderate-sized lesions often require surgical intervention. Single-stage cartilage restoration procedures—osteochondral autograft transfer (OATS) and minced cartilage repair (MCR)—are gaining popularity due to lower morbidity, faster rehabilitation, and reduced cost compared with two-stage techniques. However, comparative evidence between these options is limited. This systematic review evaluates current literature and compares clinical and radiologic outcomes of OATS and MCR.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, studies were included if they reported clinical outcomes of OATS or MCR for moderate-sized chondral knee lesions, enrolled ≥10 patients, and had ≥12 months of follow-up. Clinical outcomes were extracted using International Knee Documentation Committee (IKDC) and Visual Analog Scale (VAS) scores, and radiologic outcomes using Magnetic Resonance Imaging Score and Classification System (MOCART) scoring.</div></div><div><h3>Results</h3><div>19 studies (14 OATS, 5 MCR) comprising 736 patients (OATS n = 524; MCR n = 212) met inclusion criteria. No direct comparative trials were identified. Patients undergoing OATS (mean age 38.7 ± 12.8 years) demonstrated greater improvements in IKDC (40.49) and VAS scores (−4.27) than those treated with MCR (mean age 31.7 ± 6.8 years; IKDC 30.9; VAS –3.7). Mean defect sizes were similar (OATS 3.36 ± 1.80 cm²; MCR 3.39 ± 0.72 cm²). Twelve-month MOCART scores were comparable between groups (OATS 62.7; MCR 65). Longer follow-up in OATS studies (54.2 vs 32.9 months) may partially account for superior clinical outcomes.</div></div><div><h3>Conclusion</h3><div>Both OATS and MCR yield favourable results for focal chondral knee lesions. Current evidence suggests greater clinical improvement with OATS, although radiologic findings appear similar in the short term. High-quality, long-term comparative studies are needed to clarify the relative durability and efficacy of these single-stage techniques.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 61-72"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882551","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":"Unveiling CDKN1A and RELA: Machine learning-driven aging biomarkers for precision diagnosis and therapy in knee osteoarthritis","authors":"Zehao Hu ,&nbsp;Zixuan Xu ,&nbsp;Tao Xiao ,&nbsp;Qiuxuan Huang ,&nbsp;Zenan Wu","doi":"10.1016/j.jor.2025.11.045","DOIUrl":"10.1016/j.jor.2025.11.045","url":null,"abstract":"<div><h3>Background</h3><div>Knee Osteoarthritis (KOA) is a degenerative joint disease marked by progressive cartilage deterioration, closely tied to cellular senescence. Despite advances in understanding KOA mechanisms, systematically identifying aging-related biomarkers remains challenging.</div></div><div><h3>Methods</h3><div>KOA gene expression datasets (GSE12021, GSE169077) were sourced from the GEO database, and aging-related genes from GenAge and CellAge databases. Differentially expressed aging-related genes (ARDEGs) were identified using the limma package. Functional enrichment involved Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA). Core biomarkers were screened via LASSO regression, SVM-RFE, and Random Forest, with cross-tabulation using Venn software. Immune cell infiltration correlations were assessed using CIBERSORT and Pearson analysis. Single-cell RNA sequencing (GSE176308) was analyzed with Seurat and UMAP. Molecular docking with AutoDockTools evaluated curcumin interactions, and microRNA-mRNA networks were built using STRING and Cytoscape. In vivo validation in a mouse KOA model (DMM-induced) confirmed gene expression via qRT-PCR and Western blotting.</div></div><div><h3>Results</h3><div>Integration of KOA datasets identified 543 (GSE12021) and 1909 (GSE169077) differentially expressed genes (DEGs), intersecting with 517 aging-related genes to yield 90 ARDEGs. Enrichment linked ARDEGs to senescence, metabolism, and signaling. Machine learning pinpointed CDKN1A and RELA as core biomarkers. Single-gene GSEA tied CDKN1A to sphingolipid/glucose metabolism and RELA to FGF/CXCR4 pathways. CIBERSORT revealed correlations with immune cells (CDKN1A: Tregs/NK cells; RELA: plasma cells/M1 macrophages). Single-cell analysis showed high expression in progenitor chondrocytes. Molecular docking confirmed curcumin binding, and microRNA-mRNA networks predicted upstream regulators. Multi-dataset validation supported CDKN1A's diagnostic robustness, with RELA showing cohort-specific significance. Experimental validation confirmed downregulated CDKN1A and RELA in KOA synovial tissue.</div></div><div><h3>Conclusion</h3><div>Integrated transcriptomic and machine learning analyses identified CDKN1A and RELA as downregulated biomarkers in KOA, validated experimentally. CDKN1A deficiency impairs cell cycle regulation, and RELA disruption affects NF-κB-mediated inflammation, driving cartilage degeneration. Their immune-metabolic correlations and curcumin affinity highlight their potential as diagnostic and therapeutic targets for precision KOA intervention.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 340-352"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837322","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":"Cost analysis for patients with adult spinal deformity by surgical approach and technique: A systematic review of the literature","authors":"Omkar S. Anaspure ,&nbsp;Anthony N. Baumann ,&nbsp;Dalton McGlamery ,&nbsp;Jessica Vitrano ,&nbsp;Grayson Talaski ,&nbsp;Nicholas I. Chiaramonti ,&nbsp;Keegan T. Conry ,&nbsp;Gordon Preston ,&nbsp;Jacob C. Hoffmann","doi":"10.1016/j.jor.2025.12.059","DOIUrl":"10.1016/j.jor.2025.12.059","url":null,"abstract":"<div><h3>Introduction</h3><div>Adult spinal deformity (ASD) correction approaches span transforaminal lumbar interbody fusion (TLIF) and posterior‐only (PO) fusion, with more complex options emerging such as combined anterior-posterior (AP) constructs, lateral lumbar interbody fusion (LLIF), and multilevel osteotomies. Given the substantially variable hospital costs associated with these diverse strategies, this systematic review quantifies and compares their economic impact to inform value‐based decision‐making in ASD surgery.</div></div><div><h3>Methods</h3><div>We conducted a PROSPERO-registered systematic review and meta-analysis (CRD42025644391) of comparative studies to evaluate cost differences for various surgical interventions for ASD patients. We queried PubMed, CINAHL, MEDLINE, and Web of Science from inception through January 28th, 2025.</div></div><div><h3>Results</h3><div>Six observational studies of moderate quality (n = 7297; operative patients n = 7,095, 97.23 %) with a mean age 47.0 ± 5.3 years were included. Approaches included PO, LLIF, TLIF and combined AP. Osteotomies included grade 2 osteotomy and three-column osteotomies (3CO). One study found LLIF to have higher index hospitalization costs compared to TLIF ($65,937 vs. $50,945; p &lt; 0.01) and higher 2-year cumulative costs ($70,847 vs. $53,657; p &lt; 0.01), driven by increased OR expenses. Two studies found AP fusion to incur substantially higher index hospitalization costs compared to PO (range $84,329-$103,275 for AP vs. $58,789-$64,281 for PO; p ≤ 0.001), maintaining a significant cost gap at 2 years ($89,824 vs. $73,904; p = 0.011). However, the findings for quality-adjusted life years (QALY) were heterogenous for AP vs PO approaches. Osteotomy added an estimated $21,000 at 2 years, with 3-column osteotomy (3CO) having higher 90-day and 1-year costs than posterior-column osteotomy, but with higher complication and readmission rates. One study found that over 2 years, LLIF trended toward the lowest cost-per-QALY ($463,798) vs. grade-2 ($509,370) vs. 3CO ($518,406), with no significant differences.</div></div><div><h3>Conclusion</h3><div>Complex ASD procedures observed higher index and two-year costs than TLIF or PO approaches, with cost-per-QALY ratios showing no clear benefit for higher-cost techniques. These findings are limited by heterogenous cost definitions and sparse utility data, warranting cautious interpretation and underscore the need for prospective, standardized cost-effectiveness studies with extended follow-up.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 374-380"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837455","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":"Serological risk factors associated with arthroplasty complications","authors":"Mars Zhao ,&nbsp;Janan Ashique ,&nbsp;Cole Elaschuk ,&nbsp;Nathan Oster ,&nbsp;Mikayla Rudniski ,&nbsp;Jenna England ,&nbsp;Mason Beaulieu ,&nbsp;Davidson Fadare ,&nbsp;Johannes van der Merwe","doi":"10.1016/j.jor.2025.12.002","DOIUrl":"10.1016/j.jor.2025.12.002","url":null,"abstract":"<div><h3>Intro</h3><div>Post-operative complications can have a devastating impact on patients' quality of life. Peri-operative bloodwork is often routinely conducted and may predict post-operative complications. The purpose of this study is to understand if pre- or post-operative serology is associated with post-operative complications arising from hip and knee arthroplasty.</div></div><div><h3>Methods</h3><div>A retrospective chart review of 383 participants with post-operative total hip and knee arthroplasty complications was conducted. One hundred and forty-one participants with post-operative complications were included and compared to a control group of 120 participants. Patient, surgical, and pre- and post-operative serological data were collected. L2-regularized logistic regression was utilized to assess whether identified factors independently predicted post-operative complications.</div></div><div><h3>Results</h3><div>The complications group had higher age, male sex, presence of osteoporosis, Charlson Comorbidity Index and bilateral arthroplasties compared to the control group (p &lt; 0.05). Pre-operatively, the complications group had a lower hemoglobin value (p = 0.027; OR = 0.64) and higher Basophil Count (p = 0.012, OR = 2.23) and Monocyte–Lymphocyte ratio (p = 0.003, OR = 2.23), higher rates of undergoing a general anesthetic (p = 0.019, OR = 0.43) and psychiatric illness (p = 0.001, OR = 3.07). Post-operatively, the complications group had lower WBC (p = 0.040, OR = 0.55) and Neutrophil counts (p = 0.001, OR = 0.45), increased Eosinophil count (p = 0.018, OR = 2.36), increased age (p = 0.034, OR = 2.06) and BMI (p = 0.049, OR = 1.74), having postoperative anticoagulation other than ASA (p = 0.000, OR = 3.99).</div></div><div><h3>Conclusion</h3><div>We identified multiple peri-operative patient, surgical, and serological risk factors for developing post-operative complications following hip and knee arthroplasty. These markers could be prioritized for monitoring high-risk patients for possible intervention.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 128-136"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787581","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 the effects of gap filling and tuberosity union for stability in open-wedge distal tuberosity tibial osteotomy","authors":"Hiroya Akase,&nbsp;Nobuhiro Kaku,&nbsp;Kensei Tanaka,&nbsp;Masashi Hirakawa","doi":"10.1016/j.jor.2025.12.041","DOIUrl":"10.1016/j.jor.2025.12.041","url":null,"abstract":"<div><h3>Background</h3><div>Open-wedge distal tuberosity tibial osteotomy is a joint-preserving surgical procedure that minimally affects the patellofemoral joint. Although it is considered less stable than other osteotomy procedures, few studies have evaluated its stability. Therefore, here, we categorized cases according to the state of bone union and performed a finite-element stability analysis.</div></div><div><h3>Methods</h3><div>Computed tomography (CT) data from a patient (63-year-old female) scheduled for osteotomy at our hospital were analyzed. We created a model with 10 patterns by dividing the progression of gap filling into five stages (0 %, 25 %, 50 %, 75 %, and 100 %) and further subdividing them into two groups based on the presence or absence of descending cut union. The maximum von Mises stress and displacement of the osteotomy site were calculated using specialized software.</div></div><div><h3>Results</h3><div>The maximum Mises stress decreased by approximately 90 % at 50 % gap filling compared with baseline (0 %), regardless of whether the descending cut had healed. Conversely, under gap filling conditions of 0 % and 25 %, the tibial tuberosity fused, resulting in a 66.7 % reduction in maximum von Mises stress under the 0 % condition and a 66.2 % reduction under the 25 % condition. Similarly, displacement decreased by 87.9 % under the 0 % condition and by 65.1 % under the 25 % condition owing to descending-cut union.</div></div><div><h3>Conclusion</h3><div>When gap filling reached 50 %, both maximum stress and displacement decreased significantly compared with baseline, regardless of whether the descending cut had fused. Furthermore, there was a significant difference in stability depending on whether the descending cut had fused, particularly when gap filling was insufficient. Therefore, in cases where descending cut healing is not achieved, it may be recommended to wait until gap filling reaches close to 50 % before removing the implants; moreover, when considering removal at approximately 25 %, it may be necessary to use tuberosity bone healing as a criterion in the decision.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 278-282"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787584","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":"Initial safety outcomes of adipose-derived mesenchymal stem cell for rotator cuff tear: A 3-year pilot trial","authors":"Parisa Nejati ,&nbsp;Nahid Masoumi Shahre Babak ,&nbsp;Amir Sobhani Eraghi ,&nbsp;Lida Nejati ,&nbsp;Kimia Didehvar ,&nbsp;Ali Mazaherinezhad ,&nbsp;Nahid Nafisi ,&nbsp;Naser Amini ,&nbsp;Mohammad Taghi Joghataei","doi":"10.1016/j.jor.2025.12.025","DOIUrl":"10.1016/j.jor.2025.12.025","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff injuries are the underlying cause of shoulder pain in 65–70 % of the patients over the age of 50. A novel therapeutic approach is stem cell therapy, which promises to heal. This study represents one of the first long-term safety evaluations of autologous adipose-derived mesenchymal stem cells (MSCs) in human subjects with total rotator cuff tear, with a specific focus on potential adverse effects.</div></div><div><h3>Methods</h3><div>This study was designed as a pilot safety phase within a broader clinical trial framework. Ten patients with full-thickness rotator cuff tears were enrolled. Autologous mesenchymal stem cells (MSCs), derived from adipose tissue, were injected directly into the torn tendons under ultrasound guidance. Patients were monitored over a 36-month period to assess safety outcomes. These included complete blood count (CBC), inflammatory markers—erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)—radiological imaging (X-ray and MRI), pain assessment via visual analog scale (VAS), and functional status through validated questionnaires.</div></div><div><h3>Results</h3><div>No systemic or local adverse events were reported during the 36-month follow-up, indicating a favorable safety profile. The CBC parameters after three years compared to the baseline measurement: hemoglobin [mean = 13.92 (SD = 1.32) vs. 13.85 (1.34)], red blood cells [mean = 4.97 (SD = 0.31) vs. 5.11 (0.31)], white blood cells [mean = 6.05 (SD = 2.06) vs. 6.01 (1.70)], platelets [mean = 248.8 (SD = 2.76) vs. 246.9 (2.50)]. The inflammatory markers were also within the normal range as following: ESR [mean = 7 (SD = 1.22) vs. 6.4 (2.48)] and CRP [mean = 0.2 (SD = 0.70) vs. 0.3 (SD = 0.89)]. Pain intensity and functional status improved compared to baseline: VAS [3.6 (SD = 1.17) vs 8.5 (1.93)], WORC [34.17 (SD = 3.31) vs 47.53 (SD = 2.56)], DASH [32.95 (SD = 2.45) vs 50.71 (SD = 4.34)].The shoulder X-ray and MRI did not show any significant pathology in the soft or bony tissues of the shoulder joint over the follow-ups.</div></div><div><h3>Conclusion</h3><div>Injection of autologous MSCs derived from adipose tissue is safe in treating total rotator cuff tear. These findings support the initiation of larger-scale trials to further investigate the therapeutic potential and efficacy of MSCs in tendon regeneration.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 206-212"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787601","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":"Do patients outlive their shoulder prosthesis?","authors":"Tarek Haj Shehadeh,&nbsp;Adam Elsayed,&nbsp;Gary Updegrove,&nbsp;Nathan Lanham","doi":"10.1016/j.jor.2025.12.044","DOIUrl":"10.1016/j.jor.2025.12.044","url":null,"abstract":"<div><h3>Purpose</h3><div>Total shoulder arthroplasty (TSA) is projected to exponentially increase in the near future. Despite having excellent long-term survivorship, revision surgery remains a key metric in the implant's success. With an increasingly aging population, it is key to understand the relative incidence of death compared to revision surgery to better guide patients counseling and surgical decision-making. In this study, we aim to compare the rates of revision surgery and mortality following TSA in patients aged &lt;65 and ≥ 65.</div></div><div><h3>Methods</h3><div>We queried the TriNetX database for patients undergoing TSA. Patients were grouped into two cohorts depending on age at surgery (&lt;65 and ≥ 65), and were followed up for 10 years after surgery. Incidence of death and revision surgery were compared between the two cohorts. Significance was set for p &lt; 0.05.</div></div><div><h3>Results</h3><div>135,021 patients were initially included in this study. 106,777 patients formed the cohort aged ≥65 compared to 28,244 patients in the cohort aged &lt;65. The cumulative incidence of mortality was 22.9 % while that of revision was 6.1 % for the ≥65 cohort, while the cumulative incidence of mortality was 7.0 % and revision was 9.4 % for the &lt;65 cohort. The old cohort had significantly lower odds of revision compared to the younger cohort (3.2 % vs 3.5 %, OR = 0.911, p = 0.011), however had significantly higher odds of mortality compared to the young cohort (7.2 % vs 1.9 %, OR = 4.021, p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>Patients younger than 65 years had a higher risk of revision surgery but a lower risk of mortality compared to those older than 65 years. Younger patients appear more likely to require revision during their lifetime, whereas older patients are more likely to outlive their implants. These findings underscore distinct risk profiles across age groups and can guide individualized counseling and surgical planning.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 321-323"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787694","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}