Paige M Lind, Michael L Pearl, Katharine E Alter, Euan A Forrest, Frances T Sheehan
{"title":"Humeral Development Throughout the Arc of Childhood-A 3D MRI Study.","authors":"Paige M Lind, Michael L Pearl, Katharine E Alter, Euan A Forrest, Frances T Sheehan","doi":"10.1002/jor.26081","DOIUrl":"https://doi.org/10.1002/jor.26081","url":null,"abstract":"<p><p>A quantitative understanding of humeral morphology through the arc of pediatric development is crucial in optimizing the treatment of pediatric shoulder-related orthopedic disorders and athletic overuse injuries. However, data regarding modern normative humeral development are not available. Thus, the aim of this study is to derive biomechanically relevant humeral size and shape measures from a pediatric cohort spanning infancy to adulthood (age 0.6-18.8 years, n = 52). Three-dimensional models were generated by segmenting axial MR images from typically developing, dominant-side humeri. Quadratic regression defined the relationship between each parameter and age. In a sub-cohort, we compared humeral morphological parameters between dominant and nondominant humeri from the same child. Children exhibited a pattern of steady growth, anteversion, and declination throughout development that gradually tapered off toward adulthood. Size measurements had the strongest regressions with age (head diameter: R<sup>2</sup> = 0.908; humeral length: R<sup>2</sup> = 0.960; epicondylar width: R<sup>2</sup> = 0.889, p < 0.001). Version was more variable and less strongly related to age (R<sup>2</sup> = 0.238, p < 0.001), whereas inclination demonstrated the weakest relationship with age (R<sup>2</sup> = 0.128, p < 0.05). The shallow curve fits indicated that there is not a single age where adult values were attained. In the sub-cohort analysis, the data from the right and left limbs were no different and correlated, supporting the use of the contralateral limb as a comparator when unilateral pathology is present, if the contralateral parameters fall within the normative range. Our data set provides a unique asset for pediatric clinical interventional planning as it provides the only current in vivo humeral development measures throughout the arc of childhood.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kayla D Seymore, Shawn L Hanlon, Ryan T Pohlig, Dawn M Elliott, Karin Grävare Silbernagel
{"title":"Relationship Between Structure and Age in Healthy Achilles Tendons.","authors":"Kayla D Seymore, Shawn L Hanlon, Ryan T Pohlig, Dawn M Elliott, Karin Grävare Silbernagel","doi":"10.1002/jor.26080","DOIUrl":"https://doi.org/10.1002/jor.26080","url":null,"abstract":"<p><p>Age is an important factor to consider with Achilles tendon injury, as variability in tendon structure during developmental growth and aging influence lower limb function and mobility. However, the overlap in structural alterations with aging and Achilles tendon injury makes it unclear which structural changes are related to age separate from tendon pathology. The objective of this study was to determine the relationship between structure and age in healthy Achilles tendons. Healthy Achilles tendons from 389 children and adults (8-79 years) were included in this retrospective analysis. Achilles tendon morphology was assessed via B-mode ultrasound of Achilles tendon length, cross-sectional area (CSA), and thickness. Mechanical properties of Achilles tendon shear modulus and viscosity were assessed via continuous shear wave elastography. The relationship between Achilles tendon structure and age was determined using General Linear Models and White's test of heteroscedasticity (to assess for unequal variance across the age span), controlling for sex, weight, and physical activity level. Healthy free Achilles tendon length (p = 0.002), thickness (p < 0.001), CSA (p < 0.001), and viscosity (p = 0.009) increased with age, supporting age-related changes in tendon structure that may limit its capacity to store and transfer energy in older adults. Full Achilles tendon length and CSA varied across the age span (p < 0.05), suggesting the Achilles tendon undergoes natural aging processes seen with most musculoskeletal tissue. Normative data on Achilles tendon structure with age will contribute to our understanding and interpretation of Achilles tendon injury pathogenesis; aiding in the design of injury prevention and treatment strategies.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Issei Shinohara, Mayu Morita, Simon Kwoon-Ho Chow, Masatoshi Murayama, Yosuke Sususki, Qi Gao, Stuart B Goodman
{"title":"Pathophysiology of the Effects of Oxidative Stress on the Skeletal System.","authors":"Issei Shinohara, Mayu Morita, Simon Kwoon-Ho Chow, Masatoshi Murayama, Yosuke Sususki, Qi Gao, Stuart B Goodman","doi":"10.1002/jor.26075","DOIUrl":"https://doi.org/10.1002/jor.26075","url":null,"abstract":"<p><p>Reactive oxygen species (ROS) are molecules that are generated primarily during energy production in cells. ROS are involved in critical biological functions such as signal transduction; when the production of ROS is imbalanced, excessive ROS causes oxidative stress, and subsequent cellular damage. Oxidative stress is linked to numerous pathological disorders in major organs including the skeletal system. In an aging society, understanding the role of ROS in skeletal health is critical to developing preventative and therapeutic interventions. Oxidative stress causes defects in cellular differentiation, apoptosis, mitochondrial dysfunction, and inflammation. The effects of oxidative stress on the skeletal system have been implicated in the development of osteoporosis, knee osteoarthritis, and osteonecrosis by inhibiting bone remodeling, increasing osteoclast activity, and decreasing osteoblast function. ROS are also involved in many signaling pathways that regulate immune defense, cell proliferation, and inflammation. This underscores the importance of maintaining a balance between ROS and antioxidants to prevent oxidative stress and related diseases. Targeting ROS and oxidative stress mechanisms may offer new treatments for diseases affecting the skeletal system and other organs, potentially improving health outcomes, and extending healthy lifespans. This review highlights the significant impact of oxidative stress on skeletal health and explores potential preventative and therapeutic strategies to mitigate the adverse effects of ROS.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brett D Steineman, Kalle L Chastain, Sean C Letendre, Joshua Leadem, Kathryn Colone, Manuela Montes de Oca, Lila Pender, Madison Lang, Erin R Leatherman, Erin Argentieri, Amanda Wach, Matthew F Koff, Scott A Rodeo, Amy L Lerner, Suzanne A Maher
{"title":"In Pursuit of Quantifying Patient Knee Contact Mechanics: Finite Element Model Validation of Cadaveric Knees in Axially Loaded MRI Scans.","authors":"Brett D Steineman, Kalle L Chastain, Sean C Letendre, Joshua Leadem, Kathryn Colone, Manuela Montes de Oca, Lila Pender, Madison Lang, Erin R Leatherman, Erin Argentieri, Amanda Wach, Matthew F Koff, Scott A Rodeo, Amy L Lerner, Suzanne A Maher","doi":"10.1002/jor.26077","DOIUrl":"https://doi.org/10.1002/jor.26077","url":null,"abstract":"<p><p>Our long-term objective is to quantify patient-specific changes in contact mechanics after partial meniscectomy (PM) using knee-specific finite element (FE) models created from clinical MR scans under axial load. Before creating patient-specific models, a validation of our workflow and processes is required. The objective of this study was to validate knee-specific FE models of tibiofemoral joint contact mechanics by comparison to direct measurements of contact by electronic pressure sensors. We hypothesized that knee-specific FE model data would fall within direct measurements of the contact area and pressure values from sensors, but that detected differences in outcomes would be smaller than differences reported after PM. The workflow consisted of performing MRIs on five cadaveric knees using a patient-based loading system adapted to cadaveric knees where loaded and unloaded scans were acquired with and without a sensor in place, segmenting images to develop FE models, running those models with statistical approaches to model material property variation and comparing the model outputs to the outputs quantified physically by sensors. Overall, 53% of outcomes (32/60) from the FE models fell within the ranges of those directly measured. Of the values that fell outside, differences were lower than those identified from a literature review of the mechanical effects of partial meniscectomies, especially when meniscectomies were 30% or 60% of the meniscus volume. FE models developed using this workflow may be helpful in assessing or anticipating changes in joint force redistribution following partial meniscectomies in patients.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In Vitro Characterization and In Vivo Performance of Vancomycin-Loaded PLGA Microspheres Prepared by Using Microfluidics for the Management of Orthopedic Infections.","authors":"Dinesh Dhamecha, Mehmet D Asik, Cecilia Nepple, Yingfang Fan, Amita Sekar, Keita Fujino, Fawaz Malick, Madeline McCanne, Ebru Oral, Orhun Muratoglu","doi":"10.1002/jor.26070","DOIUrl":"https://doi.org/10.1002/jor.26070","url":null,"abstract":"<p><p>Periprosthetic joint infection (PJI) is a severe complication of total joint arthroplasty (TJA), leading to high rates of revision surgeries, long-term morbidity, and mortality. Conventional antibiotic treatments often suffer from limited bioavailability and systemic toxicity. This study explores a novel approach using vancomycin-loaded poly(lactic-co-glycolic) acid (PLGA) microparticles (VMP) formulated via a microfluidic double emulsion method for controlled, localized drug delivery for managing PJI. The PLGA microparticles were synthesized to achieve high loading capacity and sustained vancomycin release, aiming to maintain therapeutic intra-articular concentrations. In vitro characterization demonstrated optimal loading capacity (up to 28% w/w), morphology with a homogeneous particle size distribution (49-65 µm), and sustained release profiles over 8 weeks. In vivo efficacy was evaluated using a rat joint infection model, showing significant reductions in bacterial viability and enhanced bone healing compared to controls. Weight-bearing recovery assessments showed that VMP-treated rats regained functionality significantly earlier than controls (p < 0.05). Radiographic, histological, and immunofluorescent analyses confirmed reduced inflammation and improved bone integrity with VMP treatment. These findings suggest that microfluidic-synthesized PLGA microparticles provide a promising strategy for localized, controlled release of antibiotics, potentially helping the management of PJI and improving postsurgical outcomes. Future research should explore the long-term effects and scalability of clinical applications. This study lays the foundation for advancing controlled release systems in orthopedic postoperative care.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kosar Safari, Borja Rodriguez Vila, David M Pierce
{"title":"Automated Detection of Microcracks Within Second Harmonic Generation Images of Cartilage Using Deep Learning.","authors":"Kosar Safari, Borja Rodriguez Vila, David M Pierce","doi":"10.1002/jor.26071","DOIUrl":"https://doi.org/10.1002/jor.26071","url":null,"abstract":"<p><p>Articular cartilage, essential for smooth joint movement, can sustain micrometer-scale microcracks in its collagen network from low-energy impacts previously considered non-injurious. These microcracks may propagate under cyclic loading, impairing cartilage function and potentially initiating osteoarthritis (OA). Detecting and analyzing microcracks is crucial for understanding early cartilage damage but traditionally relies on manual analyses of second harmonic generation (SHG) images, which are labor-intensive, limit scalability, and delay insights. To address these challenges, we established and validated a YOLOv8-based deep learning model to automate the detection, segmentation, and quantification of cartilage microcracks from SHG images. Data augmentation during training improved model robustness, while evaluation metrics, including precision, recall, and F1-score, confirmed high accuracy and reliability, achieving a true positive rate of 95%. Our model consistently outperformed human annotators, demonstrating superior accuracy, repeatability, all while reducing labor demands. Error analyses indicated precise predictions for microcrack length and width, with moderate variability in estimations of orientation. Our results demonstrate the transformative potential of deep learning in cartilage research, enabling large-scale studies, accelerating analyses, and providing insights into soft tissue damage and engineered material mechanics. Expanding our data set to include diverse anatomical regions and disease stages will further enhance performance and generalization of our YOLOv8-based model. By automating microcrack detection, this study advances understanding of microdamage in cartilage and potential mechanisms of progression of OA. Our publicly available model and data set empower researchers to develop personalized therapies and preventive strategies, ultimately advancing joint health and preserving quality of life.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcus G Pandy, Hans A Gray, Padma N Ganapam, Adam G Culvenor, Kay M Crossley, Shanyuanye Guan
{"title":"A High-Riding Patella Is a Feature of Knee Joint Motion During Gait After ACL Reconstruction.","authors":"Marcus G Pandy, Hans A Gray, Padma N Ganapam, Adam G Culvenor, Kay M Crossley, Shanyuanye Guan","doi":"10.1002/jor.26062","DOIUrl":"https://doi.org/10.1002/jor.26062","url":null,"abstract":"<p><p>Accurate measurements of knee joint motion during gait after anterior cruciate ligament reconstruction (ACLR), especially for the patellofemoral joint, are sparse. The aim of this study was to measure six-degree-of-freedom (6-DOF) patellofemoral and tibiofemoral motion in ACLR and uninjured contralateral knees during gait, and to compare these results to healthy (control) knees. Biplane fluoroscopy was used to measure 6-DOF patellofemoral and tibiofemoral motion in 15 ACLR participants (26.3 ± 3.9 years) for complete cycles of level walking and downhill walking, and the results were compared to data for 10 healthy individuals (29.8 ± 6.1 years). Mean patellar superior translation, anterior translation, and flexion over the gait cycle were respectively 4.4-5.6 mm greater, 5.4-6.3 mm greater, and 3.7°-7.0° less in the ACLR and contralateral knees compared to controls across both activities (p < 0.021). Articular contact was 7.6 mm higher on the femoral trochlea in the ACLR and contralateral knees compared to controls. The patellar tendon was 8.9 mm longer (p < 0.001) in the ACLR and contralateral knees compared to controls. Among ACLR participants, 14 out of 30 knees (47%) had an Insall-Salvati ratio ≥ 1.20, indicating patella alta. Mean tibial external rotation and anterior translation over the gait cycle were respectively 3.4°-3.8° greater and 2.6-3.0 mm greater in the ACLR knee compared to controls across both activities (p < 0.025). A high-riding patella in both knees of the ACLR participants was due to a longer patellar tendon. A change in the load-bearing areas of the femoral trochlea may contribute to the high rate of patellofemoral osteoarthritis seen after ACLR.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Classification of Kinematic Coupling Patterns Between Lower Limb Joints During Running.","authors":"Shiori Hiratsuka, Tomoya Takabayashi, Takahiro Watanabe, Takanori Kikumoto, Masayoshi Kubo","doi":"10.1002/jor.26074","DOIUrl":"https://doi.org/10.1002/jor.26074","url":null,"abstract":"<p><p>Abnormal foot alignment such flatfoot is involved in running injuries. The mechanism by which flatfoot is susceptible to running injuries has not yet been established. The purpose of this study was to classify kinematic coupling patterns by hierarchical clustering, adding individuals with flatfoot and motion in the transverse plane involved in running injuries, and to identify the factors that determine the clusters classified. Twenty-four young healthy adults were divided and classified into normal and flat foot groups of 12 participants each, using the foot posture index. The task involved treadmill running. Cross-correlation coefficients between the ankle and knee joints and between the knee and hip joint were used to evaluate kinematic coupling in the sagittal, frontal, and transverse planes during the stance phase. Hierarchical clustering was used to classify kinematic coupling patterns using the cross-correlation coefficient as an input variable. After cluster classification, joint angles during the stance phase and static standing were compared between clusters. Hierarchical clustering classified kinematic coupling patterns between lower limb joints into two clusters, mainly the kinematic coupling on the frontal plane. However, clusters were not classified by foot alignment. Significant differences in knee varus/valgus, hip adduction/abduction, and internal/external rotation angles during the stance phase were observed between clusters. Foot alignment was not involved in the cluster analysis in this study. Further detailed evaluation of foot alignment is required.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Halloum, Maria Tirta, Søren Kold, Shima Gholinezhad, Jan Duedal Rölfing, John Rasmussen, Ahmed A Abood, Ole Rahbek
{"title":"The Effect of Rotational Guided Growth With Flexible Tethers on the Distal Femoral Bone: An Experimental Study in a Porcine Model.","authors":"Ahmed Halloum, Maria Tirta, Søren Kold, Shima Gholinezhad, Jan Duedal Rölfing, John Rasmussen, Ahmed A Abood, Ole Rahbek","doi":"10.1002/jor.26073","DOIUrl":"https://doi.org/10.1002/jor.26073","url":null,"abstract":"<p><p>New and innovative surgical techniques, using a flexible tether to correct rotational deformities of the growing femur have recently emerged, but are lacking radiographic validation of desired rotation and adverse effects in the frontal and sagittal planes. We, therefore, investigated this new technique in an established large animal model. Eight skeletally immature pigs were included in the study in a paired (left vs. right leg) design. Mean (range) observation time was 83 days (77-90). CT-scans and X-rays were performed immediately after insertion of the tethers and again at euthanasia after 12 weeks. From the CT-scans, 3D-models of the left and right femora were generated and analyzed for intended external rotation and unintended effects in other planes and bone morphology. One pig was excluded due to surgical site infection. Average change in rotation between the operated and non-operated femora was 7.2° (CI: 5.9-8.6) external rotation. We also found unintended valgus deformity in the coronal plane (7.8° (CI: 3.9-12.0) and unintended extension in the sagittal plane (3.9° (CI: -1.8 to 8.7). Unintended changes to the joint morphology were also observed. Rotation by guided growth was achieved with this surgical technique, confirmed by radiological measurements. Clinical Significance. While this large animal study has shown that this new surgical technique reliably corrected rotational deformities by guided growth, it has also revealed adverse effects that need further investigation before clinical use.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mitochondrial Dysfunction of the Subsynovial Connective Tissue in Patients With Carpal Tunnel Syndrome.","authors":"Shuya Tanaka, Yutaka Mifune, Atsuyuki Inui, Kohei Yamaura, Takahiro Furukawa, Tatsuo Kato, Masaya Kusunose, Tomoyuki Matsumoto, Takehiko Matsushita, Ryosuke Kuroda","doi":"10.1002/jor.26064","DOIUrl":"https://doi.org/10.1002/jor.26064","url":null,"abstract":"<p><p>In idiopathic carpal tunnel syndrome (CTS), fibrosis and thickening of the subsynovial connective tissue (SSCT) increase pressure within the carpal tunnel, resulting in median nerve entrapment. Mitochondrial dysfunction in tissues reportedly leads to senescent cell accumulation and various diseases through reduced adenosine triphosphate (ATP) and excessive reactive oxygen species (ROS) production; however, no reports have linked this to CTS. Therefore, this study aimed to evaluate mitochondrial function in SSCTs of patients with CTS. This study investigated SSCTs obtained during carpal tunnel release surgery in patients with CTS (CTS group) and those obtained during tendon transfer or tendon rupture surgery in patients without CTS (control group) from April 2021 to March 2023 at our hospital. Outcome measures included superoxide dismutase (SOD) activity, gene expression levels, immunofluorescence staining, ATP production assays, and transmission electron microscopy (TEM). p values were calculated using the Mann-Whitney U test. The CTS and control groups included 10 and 5 patients (mean age, 67.8 ± 9.57 and 65.4 ± 9.75 years), respectively. The CTS group exhibited decreased SOD activity (p = 0.026), increased gene expression of mitochondrial biosynthetic factors, and decreased mitochondrial ATP production (p = 0.027). The CTS group showed increased mitochondrial ROS production (p = 0.038) on immunofluorescence and larger mitochondrial area (p = 0.030) and fewer mitochondrial cristae (p = 0.045) on TEM. Multiple mitochondrial function assays suggested mitochondrial dysfunction of SSCTs in the CTS group. STATEMENT OF CLINICAL SIGNIFICANCE: This research provided important information on the histological changes in the subsynovial connective tissue within the carpal tunnel in carpal tunnel syndrome.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}