Journal of Orthopaedic Case Reports最新文献

{"title":"Intraoperative Discovery of Incorrect Femoral Component Packaging during Bilateral Total Knee Arthroplasty: A Near-Miss Case Report.","authors":"Tsuneari Takahashi, Takumi Matsumoto","doi":"10.13107/jocr.2026.v16.i10.8240","DOIUrl":"10.13107/jocr.2026.v16.i10.8240","url":null,"abstract":"<p><strong>Introduction: </strong>Incorrect implant delivery during total knee arthroplasty (TKA) is rare but represents a potential patient safety risk. Implant discrepancies may remain undetected until intraoperative opening despite correct external labeling.</p><p><strong>Case report: </strong>A 76-year-old woman with bilateral varus knee osteoarthritis underwent simultaneous bilateral TKA using a medial pivot system planned with computed tomography-based patient-specific instrumentation. Cementless fixation was intended for both knees. The left knee was implanted uneventfully. During right TKA, a femoral component with correct external labeling was opened; however, the implant inside was a cemented component, one size larger than planned, and intended for the contralateral side. An appropriately sized backup component was available, allowing completion of surgery without interruption. At 1 year, range of motion improved from -5°-110° to 0°-120° on the left and from -10°-114° to 0°-125° on the right. Pain on the visual analog scale improved from 67 to 0, and the Western Ontario and McMaster Universities Osteoarthritis Index score improved from 56.1 to 90.6.</p><p><strong>Conclusion: </strong>This intraoperative implant packaging discrepancy represents a near-miss event. Even with correct external labeling and meticulous pre-operative planning, implant mismatch may occur. Intraoperative verification and immediate availability of appropriate backup implants are essential to prevent patient harm.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"215-218"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136883","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":"Arthrokinematic and Magnetic Resonance Imaging-Based Outcomes of Customized Lateral Wedge Insoles in Medial Compartment Knee Osteoarthritis: Six-Month Interim Findings of a Prospective Cohort Study.","authors":"Sundip Hemant Charmode, Nikesh Shah, Abhishek Kumar Mishra, Prateek Sihag, Simmi Mehra, Piyush Solanki, Nisarg Raval","doi":"10.13107/jocr.2026.v16.i10.8346","DOIUrl":"10.13107/jocr.2026.v16.i10.8346","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Knee osteoarthritis (OA) is a leading musculoskeletal disorder with a prevalence of 22-39% in India, representing approximately one-third of 500 million individuals affected globally. The epidemiological burden increased 2.66-fold from 23.46 million (1990) to 62.35 million (2019). Mechanical axis deviation drives OA progression; finite element analysis (FEA) provides a non-invasive tool to evaluate tissue-level biomechanical changes. Prospective Indian OA cohort studies combining arthrokinematic and magnetic resonance imaging (MRI)-based outcomes are lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A non-randomized prospective cohort study - carrying inherent risk of selection bias, confounding by indication, and baseline imbalance - was conducted at AIIMS Rajkot in collaboration with the Saurashtra University after acquiring ethical approval (IEC: AIIMS/RAJKOT/6th IEC/FB/02) and CTRI registration (CTRI/2025/02/081105). Fifty-five knees in 45 patients (male knees n = 19, female knees n = 36; mean age 58.3 ± 10.3 years; body mass index [BMI] 28.2 ± 5.3 kg/m2) with knee OA and mechanical axis deviation were enrolled; and allocation to the customized lateral wedge insole group (n = 28) or to conventional conservative management (n = 27) was made by the treating orthopaedic surgeon on the basis of mechanical axis deviation severity, without randomization or allocation concealment. Osteokinematic parameters were assessed by calibrated goniometry at 3-month intervals; MRI osteoligamentous metrics (joint space width [JSW], meniscal thickness) were obtained at baseline, 6 and 18months. This article presents the observations collected at the end of the 1st project year, namely the 6-month MRI follow-up and four 3-monthly biomechanical assessment outcomes. 22 out of 55 participants (40.0%) attended the 6-month MRI assessment and two 3-monthly biomechanical analyses, thereby constituting the complete-case analysis set (11 study group, 11 control group). No imputation was performed, and outcome assessment was not blinded. No validated patient-reported outcome measure was collected. Paired/unpaired t-tests and two-way repeated-measures analysis of variance with Bonferroni correction (Statistical Package for the Social Sciences v16.0; α = 0.05); analyses were unadjusted for confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 55 enrolled knees, 22 (40.0%) were successfully followed up at the 6-month assessment, representing substantial attrition of 60.0% (n = 33), and all outcomes below refer to this analysis set (n = 22). Knee flexion increased (+4.4°; P = 0.02) and external rotation showed the greatest gain (+5.64°; P &lt; 0.01); medial JSW widened (+0.40 mm; P &lt; 0.01) and medial meniscus thickness increased (+0.16 mm; P = 0.05). Internal rotation (+1.56°; P = 0.06) and extension (+1.56°; P = 0.08) did not reach significance levels. In exploratory, non-prespecified sex-stratified analyses (male knees n = 10, female knees n","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"580-598"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136901","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":"Thromboprophylaxis in Non-operative Lower-Limb Immobilization: Risk Stratification Identifies Whom to Spare, Not Whom to Treat - A Narrative Review.","authors":"Emmanuel Belardo Del Rio, Derick Rodríguez-Reyes, Edwin L Acevedo-Soto, Gabriel Gonzalez-Diaz, Hiram E Luigi-Martinez, Rafael Señeriz-Ortiz","doi":"10.13107/jocr.2026.v16.i10.8280","DOIUrl":"10.13107/jocr.2026.v16.i10.8280","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Temporary lower-limb immobilization after injury is an established risk factor for venous thromboembolism (VTE), yet recommendations for non-operatively managed patients remain discordant. Secondary literature in this field commonly asserts that pharmacological prophylaxis, while unnecessary as a routine, is effective in patients identified as high risk. The aims of this review were to (i) determine whether that assertion is supported by primary randomized evidence, and (ii) define what validated risk assessment models can and cannot currently be used to justify.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Narrative review prepared in accordance with the Scale for the Assessment of Narrative Review Articles and published guidance on narrative review methodology; the full search string and eligibility criteria are reported in Material and Methods. PubMed/MEDLINE was searched to June 2026 for randomized trials, systematic reviews and network meta-analyses, prospective multicenter cohorts, risk model derivation and validation studies, and guidelines addressing VTE prophylaxis in temporary lower-limb immobilization. Every source was checked against its own stated conclusions. A claim of treatment efficacy in a defined population was accepted only where supported by a randomized comparison against no prophylaxis within that population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In unselected patients, the Prevention of Thrombosis after Lower Leg Plaster Cast (POT-CAST) trial found no reduction in symptomatic VTE with low-molecular-weight heparin (1.4% vs. 1.8%; relative risk 0.8, 95% confidence interval [CI] 0.3-1.7). Meta-analyses do demonstrate reductions in asymptomatic and composite endpoints, but the older trials contributing to them used mandatory screening, and network meta-regression identified no treatment effect modifier other than the agent used. The validation and subgroup analysis of POT-CAST found no risk category in which prophylaxis was effective, despite confirming markedly elevated absolute risk in some strata, including 8.5% (95% CI 3.7-16.1) after Achilles tendon rupture. CASTING confirmed prospectively that anticoagulation can be withheld below a thrombosis risk prediction for patients with cast immobilization TRiP(cast) score of seven, with symptomatic VTE of 0.7% (95% CI 0.3-1.4), but every patient above the threshold was treated, so the trial cannot estimate efficacy in that group; in the TILLIRI cohort, 846 anticoagulated patients scoring below seven sustained no symptomatic VTE. Elevated baseline risk and treatment benefit are therefore separate constructs requiring separate evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Current evidence establishes risk stratification as an instrument for de-escalation rather than escalation, since roughly three-quarters of immobilized patients can be identified as low risk and safely left untreated. In the high-risk minority, prophylaxis remains reasonable and permitt","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"320-329"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137230","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":"Letter to the Editor: Comparative Efficacy of Intra-Articular Growth Factor Concentrate and Platelet-Rich Plasma Injections in Knee Osteoarthritis: An Evaluation of Clinical, Radiological, and Biomarker Outcomes.","authors":"Ashim Gupta, Gaurav Kant Sharma, Karun Jain, Madhan Jeyaraman","doi":"10.13107/jocr.2026.v16.i10.8362","DOIUrl":"10.13107/jocr.2026.v16.i10.8362","url":null,"abstract":"","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"645-647"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137060","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":"Humeral Fractures in Metabolically Compromised Bone: Outcomes of Structural Strut Onlay Allograft with Open Reduction and Internal Fixation - A Case Series of Three Patients.","authors":"Mohamed Nagy, Saud N Aldanyowi, Paul Erdman, Neil Ashwood","doi":"10.13107/jocr.2026.v16.i10.8230","DOIUrl":"10.13107/jocr.2026.v16.i10.8230","url":null,"abstract":"<p><strong>Introduction: </strong>Humeral fractures arising in bone of poor structural quality - whether secondary to osteoporosis-related non-union or primary metabolic bone disease such as osteogenesis imperfecta (OI) - present a significant surgical challenge. Achieving reliable fixation in deficient cortical bone requires augmentation strategies beyond standard plating. Structural strut onlay allograft, applied in conjunction with open reduction and internal fixation (ORIF), has been reported to address both the mechanical and biological shortfalls of fixation in such cases.</p><p><strong>Case report: </strong>We report three patients managed with ORIF augmented by structural strut allograft for humeral fractures in metabolically compromised bone. The first two cases involve elderly women with osteoporosis presenting with established humeral shaft non-unions - one hypertrophic, one atrophic - both treated using locking plate constructs with cortical onlay allograft. The third case is a 78-year-old woman with known OI who sustained an acute distal third humerus fracture with associated sensory radial nerve palsy, managed with an elastic intramedullary (titanium elastic nail) nail supplemented by an allograft bone strut. In all three cases, the fixation construct was radiologically satisfactory, and early clinical outcomes were encouraging.</p><p><strong>Conclusion: </strong>Structural strut allograft augmentation is a versatile adjunct to ORIF for humeral fractures in bone of compromised quality. The technique can be adapted to different fracture configurations, bone pathologies, and fixation implants. These cases support its use across the spectrum of humeral fractures in metabolically deficient bone and highlight the importance of tailoring implant strategy to the underlying bone biology.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"186-192"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136935","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":"Tibial Plateau Fracture in a Patient with Fibular Hemimelia: A Case Report.","authors":"L Warnau, S Koulischer, V Bobu, S Y Maatou","doi":"10.13107/jocr.2026.v16.i10.8228","DOIUrl":"10.13107/jocr.2026.v16.i10.8228","url":null,"abstract":"<p><strong>Introduction: </strong>Fibular hemimelia (FH) is the most common congenital longitudinal deficiency of the lower limb, characterized by partial or complete fibular absence and associated musculoskeletal abnormalities. Its coexistence with a traumatic tibial plateau fracture has not been previously reported in the literature. We present the first reported case of a comminuted bicondylar tibial plateau fracture occurring in a patient with complete congenital fibular absence and describe the specific anatomical and technical challenges encountered during surgical management.</p><p><strong>Case report: </strong>A 37-year-old Portuguese man with congenital right-sided FH (Achterman and Kalamchi type II) sustained a comminuted Schatzker V tibial plateau fracture following a fall from an electric scooter. Staged management consisted of temporary external fixation followed by dual-plate open reduction and internal fixation. The congenitally altered proximal tibial geometry necessitated the use of a contralateral implant, as the standard ipsilateral plate did not conform adequately. Post-operative recovery was complicated by delayed union of the posteromedial fragment, complex regional pain syndrome, and a complete rupture of the anterior cruciate ligament of indeterminate origin. At 4 years of follow-up, the patient had persistent knee stiffness with flexion limited to 100°, early post-traumatic gonarthrosis, and ambulated with a single crutch.</p><p><strong>Conclusion: </strong>Congenital fibular absence alters proximal tibial anatomy and neurovascular landmarks, complicating fracture fixation and requiring individualized surgical planning. However, the guarded long-term outcome and multiple confounding factors in this single case indicate that these anatomical observations should inform surgical vigilance rather than be generalized as a management protocol.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"180-185"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137220","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":"Late Diagnosis of Femoral Shaft Perforation During Total Hip Arthroplasty: Case Report.","authors":"Yakup Yıldırım, Kemal Gokkus, Waziri Juma Msangı","doi":"10.13107/jocr.2026.v16.i10.8242","DOIUrl":"10.13107/jocr.2026.v16.i10.8242","url":null,"abstract":"<p><strong>Introduction: </strong>Femoral shaft fractures are recognized complications of total hip arthroplasty (THA); however, femoral cortical perforation is a rare entity and is most often diagnosed intraoperatively or in the early post-operative period. Delayed diagnosis is uncommon and may result in serious complications. This report presents a case of femoral shaft perforation diagnosed 15 days after primary THA and highlights the importance of two-view radiographic evaluation.</p><p><strong>Case report: </strong>A 68-year-old woman presented to our outpatient clinic for routine suture removal 15 days after primary right THA performed at another institution for osteoarthritis. Postoperatively, she complained of a painful bulging mass on the posteromedial aspect of the thigh. Despite persistent symptoms, she had been evaluated twice by orthopedic surgeons, and anteroposterior (AP) radiographs were repeatedly interpreted as normal. She was able to ambulate with full weight-bearing using a walker. Physical examination revealed a tender posterior thigh mass and pain with passive hip motion. Laboratory studies were unremarkable. Repeat AP radiographs showed no obvious abnormality; however, a lateral radiograph demonstrated catastrophic posteromedial perforation of the femoral shaft with protrusion of the femoral stem just below the lesser trochanter, tenting the skin. Revision surgery was recommended, but the patient chose to return to her primary surgeon.</p><p><strong>Conclusion: </strong>This case demonstrates that femoral cortical perforation after THA may be overlooked despite patient ambulation and normal AP radiographs. Persistent or atypical post-operative thigh pain should prompt thorough evaluation, including lateral radiographs. Routine use of two-view imaging is essential to avoid delayed diagnosis of this rare but potentially serious complication.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"219-222"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137071","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":"Arthroscopic Posterior Cruciate Ligament Tibial Spine Avulsion Fixation Using a Suture Pull-Through Single-Tunnel Technique.","authors":"Parth Jayeshkumar Patel, Harshlaxen Ashvinsinh Rajpardhi, Lomesh Pravinbhai Modi, Krishna Himmatbhai Goti, Naushil Nileshkumar Gandhi, Hayati Bharatbhai Visani","doi":"10.13107/jocr.2026.v16.i10.8302","DOIUrl":"10.13107/jocr.2026.v16.i10.8302","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior cruciate ligament (PCL) tibial avulsion fractures are uncommon intra-articular injuries that may cause persistent posterior instability, loss of motion, and functional impairment if displaced fractures are not anatomically reduced. Arthroscopic suture pull-through fixation offers stable transosseous fixation while avoiding complications associated with screw fixation.</p><p><strong>Aim: </strong>The aim of this study was to evaluate the functional and radiological outcomes of arthroscopic PCL tibial avulsion fixation using a suture pull-through single-tunnel technique.</p><p><strong>Materials and methods: </strong>A prospective, single-center observational study without a control group was conducted in the Department of Orthopedics, N.D. Desai Medical College, from May 2026 to July 2026. Twenty-four patients with displaced isolated PCL tibial avulsion fractures underwent arthroscopic single-tunnel suture pull-through fixation. Lysholm scores and radiological union were assessed at 6 weeks, 3 months, and 6 months; no instrumented posterior laxity testing or additional validated patient-reported outcome measure was available.</p><p><strong>Results: </strong>The cohort included 24 patients with a mean age of 28 years (range 18-60 years). The mean Lysholm score improved from 41.6 ± 3.2 preoperatively to 81.2 ± 5.6 at 6 weeks, 90.7 ± 3.5 at 3 months, and 94.9 ± 2.3 at 6 months (Friedman P < 0.001). All fractures were recorded as united by 3 months on follow-up radiographs, and 22 patients (approximately 92%) reported return to their pre-injury activity level within 4-6 months. One patient developed a mild extension lag that improved with physiotherapy. No non-union, fixation failure, or revision surgery was observed during the 6-month follow-up; however, objective posterior translation was not measured.</p><p><strong>Conclusion: </strong>In this small single-center observational cohort, arthroscopic single-tunnel suture pull-through fixation was feasible and was associated with radiographic union and favorable short-term Lysholm score improvement. Because there was no comparator group, objective posterior stability testing, or long-term follow-up, these findings should not be interpreted as evidence of superiority or equivalence to other fixation techniques.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"408-414"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136876","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":"Platelet-Rich Plasma as an Adjunct to Rehabilitation for Partial Rotator Cuff Tears in Recreational Athletes: A Comparative Study.","authors":"Ayyappan V Nair, Shishir Mysore, Aravind Rajan, Harikanth Reddy, M Priyamvada, Prince Shanavas Khan","doi":"10.13107/jocr.2026.v16.i10.8352","DOIUrl":"10.13107/jocr.2026.v16.i10.8352","url":null,"abstract":"<p><strong>Introduction: </strong>The role of platelet-rich plasma (PRP) in the treatment of partial rotator cuff tears (RCTs) in young recreational athletes remains controversial. Our study aimed to investigate the efficacy and return-to-sports (RTS) rates of two commonly prescribed treatment options for partial RCTs in young recreational athletes.</p><p><strong>Materials and methods: </strong>Sixty-one young recreational athletes with partial RCT were assigned based on patient preference to two groups: Physical therapy (PT) group (28 patients) receiving a standardized rehabilitation program and PRP with PT group (33 patients) receiving ultrasound-guided PRP injection at the site of the tear along with the same rehabilitation program. Functional outcomes such as the American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, Hand (DASH) score, Constant-Murley score, and Visual Analog Scale (VAS) score were assessed at baseline and after 6 months.</p><p><strong>Results: </strong>At 6 months, the PRP with PT group demonstrated significantly greater improvements in functional outcomes compared to the PT group. Adjusted Constant-Murley (89.4 vs. 79.5; P < 0.001) and ASES scores (83.7 vs. 75.2; P < 0.001) were higher in the PRP with PT group, while QuickDASH scores (48.8 vs. 24.5; P < 0.001) showed a steeper adjusted decline, indicating superior recovery of shoulder function in the PRP with PT group. However, after adjusting for baseline, VAS scores did not differ significantly between groups. RTS rates were 50% in the PRP with PT group versus 20% in the PT group (P < 0.05).</p><p><strong>Conclusion: </strong>Autologous PRP injection among recreational athletes with partial RCTs is an effective tool to be used as an adjunct to rehabilitation owing to its effect on improving shoulder function, reducing disability, and allowing greater rates of RTS.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"611-618"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136920","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":"Efficacy of Transforaminal Nerve Root Block for Lumbar Disc Herniation.","authors":"Vipin Kumar Mishra, Jeetesh Gawande, Saumya Mishra","doi":"10.13107/jocr.2026.v16.i10.8350","DOIUrl":"10.13107/jocr.2026.v16.i10.8350","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar disc herniation is a common cause of monoradicular pain, often managed conservatively. For patients unresponsive to non-operative measures, transforaminal selective nerve root block (SNRB) offers a minimally invasive alternative aimed at reducing inflammation and pain.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the efficacy of SNRB in patients with monoradicular pain due to lumbar disc herniation and to assess its role in reducing surgical intervention rates.</p><p><strong>Materials and methods: </strong>A prospective study was conducted on 120 patients with acute (<6 weeks) unilateral radicular pain and magnetic resonance imaging-confirmed single-level disc herniation. Under fluoroscopic guidance, 2 mL methylprednisolone acetate and 5 mL lignocaine were injected at the affected root. Pain relief was assessed using the visual analogue scale (VAS) at 2 weeks and 6 months. Patients with persistent symptoms were offered a repeat block or microdiscectomy.</p><p><strong>Results: </strong>At 2 weeks, 60 patients (Group 1) achieved good pain relief (VAS < 3), 40 had partial relief (Group 2), and 20 had poor relief (Group 3). At 6 months, 36 of Group 1 maintained satisfactory relief, while 24 experienced recurrence (15 required a repeat block, 9 underwent surgery). In Group 2, 20 improved with conservative care, eight required a repeat block, and 12 underwent surgery. In Group 3, 12 underwent surgery and eight received a repeat block, of which two maintained relief. Early VAS response predicted long-term outcomes and guided further management.</p><p><strong>Conclusion: </strong>SNRB is an effective, safe, and minimally invasive option for lumbar disc herniation-related radicular pain, providing meaningful pain relief and delaying or reducing the need for surgery.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"606-610"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136786","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}