Journal of Orthopaedic Science最新文献

{"title":"Potential involvement of family structure in locomotive recovery following surgery in older patients with lumbar spinal stenosis.","authors":"Koutaro Kageshima, Soya Kawabata, Takehiro Michikawa, Yuki Akaike, Sota Nagai, Takaya Imai, Hiroki Takeda, Kei Ito, Daiki Ikeda, Shinjiro Kaneko, Nobuyuki Fujita","doi":"10.1016/j.jos.2025.05.010","DOIUrl":"10.1016/j.jos.2025.05.010","url":null,"abstract":"<p><strong>Background: </strong>Surgical outcomes for lumbar spinal stenosis (LSS) are generally favorable, even in older adults, and they effectively address locomotive syndrome. In older patients with LSS, support from family members during the postoperative recovery period is expected to be helpful, but the extent to which family structure influences surgical outcomes for LSS remains unclear. Herein, this study aimed to investigate the involvement of family structure in surgical outcomes for older patients with LSS.</p><p><strong>Methods: </strong>This retrospective study included 350 consecutive patients aged ≥65 years who underwent LSS surgery between April 2020 and December 2023. Patients were categorized by family structure into the M (living with multiple family members) or S group (living with few or no family members). Postoperative outcomes were assessed using patient-reported outcomes, including the Roland-Morris Disability Questionnaire (RDQ), Geriatric Locomotive Function Scale (GLFS-25), and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.</p><p><strong>Results: </strong>The M group consisted of 102 participants, while the S group comprised 248 participants. Preoperatively, there were no significant differences in the scores of all patient-reported outcomes between the groups. However, even after adjusting for baseline characteristics that significantly differed between the groups, the RDQ (p = 0.018) and GLFS-25 scores (p = 0.030) were significantly better in the M group than in the S group at 1 year postoperatively. Furthermore, the proportion of patients with postoperative improvement in the locomotive syndrome stage was significantly higher in the M group than in the S group at both 6 months (p = 0.027) and 1 year (p = 0.002) postoperatively.</p><p><strong>Conclusions: </strong>Family structure significantly affected postoperative outcomes in older adults with LSS, particularly concerning locomotive syndrome recovery. These findings highlight the potential value of involving families in healthcare planning, while recognizing that the availability and quality of support may vary across households.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified arthroscopic-assisted reduction and internal fixation for treatment of Ideberg type III scapular glenoid fracture associated with acromioclavicular joint injury.","authors":"Tongtong Li, Xuelei Wei, Guoyun Bu, Jianan Li, Haobo Jia, Jie Zhao, Chen Chen, Zengliang Wang","doi":"10.1016/j.jos.2025.05.011","DOIUrl":"10.1016/j.jos.2025.05.011","url":null,"abstract":"<p><strong>Objective: </strong>Ideberg type III scapular glenoid fracture associated with acromioclavicular joint injury is rare, as well as its therapeutic experience. The purpose of this study was to evaluate the effectiveness of modified arthroscopic-assisted treatment, and introduce our experience and surgical techniques.</p><p><strong>Method: </strong>We retrospectively reviewed 11 patients with Ideberg type III scapular glenoid fracture associated with acromioclavicular joint injury. 6 males and 5 females were included with a mean of age 52.6 years. After the acromioclavicular joint was treated with clavicular hook plate, Ideberg type III scapular glenoid fracture experienced modified arthroscopic-assisted reduction and fixation, in which the 1:00 o'clock position of the glenoid was utilized as the starting point for screws to fix in multiple directions.</p><p><strong>Results: </strong>The cases were followed up for 12-35 months, with an average of 18 months. The mean healing time of fracture was 3.4 months. The postoperative range of motion of the shoulders was well maintained. There were no complications of shoulder stiffness and muscle atrophy in the cases. The mean Constant score, UCLA score and ASES score were 95.1 points (range, 88-100 points), 34 points (range, 32-35 points) and 95.8 points (range, 90-100 points) respectively. The average VAS pain score was 0.4.</p><p><strong>Conclusions: </strong>For patients with Ideberg type III scapular glenoid fracture associated with acromioclavicular joint injury, the modified arthroscopic-assisted reduction and internal fixation is a minimally invasive and effective treatment. The 1:00 o'clock position of the glenoid could be utilized as a safe starting point for screws to fix in multiple directions.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors influencing the occurrence of drug-induced renal dysfunction during continuous local antibiotic perfusion therapy.","authors":"Yuki Fujihara, Kazuki Uchibori, Yuya Yoshimoto, Hideyuki Ota, Hiroaki Kumagai, Yuki Chiba","doi":"10.1016/j.jos.2025.05.007","DOIUrl":"10.1016/j.jos.2025.05.007","url":null,"abstract":"<p><strong>Background: </strong>To manage bone and soft tissue infection, continuous local antibiotics perfusion (CLAP) therapy, in which gentamicin is injected directly into the site of infection to control the infection, has been developed. However, gentamicin is nephrotoxic, and CLAP is often associated with complications, including acute kidney injury. Thus, in this study, we aimed to investigate the frequency of complications and the factors influencing their occurrence.</p><p><strong>Methods: </strong>Overall, 82 patients who underwent CLAP in our hospital between January 2020 and September 2023 were included in this study. We defined the occurrence of renal dysfunction within 1 month after CLAP as the primary outcome and evaluated the following factors: history of diabetes and liver dysfunction, site of injury, initial open wound, skin defect, hemodynamic compromise, concomitant antibiotics, type of treated tissue, purpose of treatment, drainage method, duration of CLAP, and total amount of the gentamicin dose. To identify prognostic factors, we performed a logistic regression analysis.</p><p><strong>Results: </strong>The mean follow-up was 10.3 months. Of the 82 patients, 50 were cured, 12 reached infection prevention, 14 had recurrent infection, three had their affected limb amputated, two did not achieve infection prevention, and one died. Side effects of treatment included decreased renal function in 13 cases and drug eruption in 1 case. Logistic regression analysis showed that age (Odds ratio: 1.07; 95 % Confidence interval [CI]: 1.01-1.13) and duration of CLAP (Odds ratio: 1.06; 95 % CI: 1.01-1.12) were significant prognostic factors for the occurrence of renal function decline.</p><p><strong>Conclusions: </strong>This study shows that renal function deterioration due to gentamicin used during CLAP is relatively common. Consideration should be given to shortening the duration of CLAP in older adult patients. Considering pharmacokinetics, a variable concentration regimen of gentamicin may be more effective and less nephrotoxic than continuous administration of a fixed concentration.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new nomogram for predicting the postoperative venous thromboembolism in patients with spinal metastasis undergoing operation: A retrospective study.","authors":"Hui Li, Xiang Tong, Xiao Long, Yihe Hu, Bin Chen","doi":"10.1016/j.jos.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.jos.2025.04.006","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a severe clinical illness. Cancer patients exhibit a VTE risk substantially increased, ranging from four to seven times that of non-cancer patients. Our study aimed to ascertain the occurrence and risk determinants of VTE in spinal metastasis patients undergoing operation, as well as to formulate a predictive model.</p><p><strong>Methods: </strong>Examining 166 cancer patients treated surgically for spinal metastases and 100 non-cancer patients treated surgically for spinal diseases between 2022 and 2025 at our institution in this study. Data on patient characteristics and clinical parameters were collected for comparison between VTE and non-VTE cases in cancer populations to identify risk factors. Subsequently, an independent risk factor-driven nomogram was constructed, and its predictive performance was assessed.</p><p><strong>Results: </strong>The authors identified 166 cancer patients, 43 (27.20 %) were diagnosed with a DVT postoperatively, 2 (1.20 %) were diagnosed with PE. Among the 100 non-cancer patients, only 2 (2 %) were diagnosed with DVT postoperatively. In the multivariate logistic regression model, nine independent risk factors for VTE in cancer patients were identified. These included preoperative albumin level (OR = 0.889, 95 % CI 0.823-0.962, P = 0.003) and one-day postoperatively (OR = 1.261, 95 % CI 1.062-1.498, P = 0.008), the preoperative D-dimer level (OR = 1, 95 % CI 1.00-1.00, P = 0.032) and three-day postoperatively (OR = 1, 95 % CI 1.00-1.001, P = 0.005), the PLT level one-day postoperatively (OR = 1.016, 95 % CI 1.005-1.027, P = 0.004) and three-day postoperatively (OR = 0.989, 95 % CI 0.980-0.999, P = 0.023), the preoperative hemoglobin level (OR = 1.050, 95 % CI 1.001-1.102, P = 0.044) and one-day postoperatively (OR = 0.901, 95 % CI 0.833-0.974, P = 0.009), the fibrinogen level three-day postoperatively (OR = 2.011, 95 % CI 1.125-3.595, P = 0.018). The constructed Nomogram model exhibited high accuracy in predicting VTE in spinal metastasis patients undergoing operation, with external validation confirming its predictive performance. Based on the receiver operating characteristic (ROC) curves, the nomogram showed the areas under the curves (AUCs) of the model were 0.819.</p><p><strong>Conclusion: </strong>Following oncological spine surgery, this study confirmed the relevance of nine biomarkers in predicting VTE in cancer patients. The model devised by our team exhibits significant potential to support clinicians in clinical decision-making and patient risk assessment. Validating these biomarkers is crucial for future research.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slight graft laxity five months after anterior cruciate ligament reconstruction can be a risk factor for graft injury within two years in young patients.","authors":"Takaki Sanada, Hiroshi Iwaso","doi":"10.1016/j.jos.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Young and highly active athletes are at high risk of second anterior cruciate ligament injuries. The high frequency of second injuries after anterior cruciate ligament reconstruction among the young population is influenced by various factors, such as sex, age, return-to-play time, and graft selection.</p><p><strong>Methods: </strong>Between 2014 and 2019, 108 primary anterior cruciate ligament reconstructions under 20 years, involving 48 knees using a hamstring tendon autograft and 60 knees using a bone-patellar tendon autograft, were performed by a single surgeon. The incidence and risk factors affecting postoperative graft injury within two years after surgery were compared with those of non-graft injury knees. After univariate analysis, multivariate logistic regression analysis was performed to investigate the independent predictive factors.</p><p><strong>Results: </strong>Graft rupture occurred in 11.1 % (12/108) of cases. Univariate analysis indicated that postoperative glide-grade Lachman and the pivot shift test, and tibial anterior translation with a mean of 2.7 mm at 5 months post-surgery were sustained in the graft injury group compared with the non-graft injury group with a mean of 1.2 mm. Logistic regression analysis identified that an excessive instrumental anterior tibial translation at 5 months (odds ratio = 2.67; 95 % confidence intervals = 1.45-4.91; p = 0.0016) increased the risk of graft injury. Graft selection or quadriceps and hamstring muscle strength did not influence graft injury.</p><p><strong>Conclusion: </strong>In young patients, postoperative residual anterior tibial translation after ACL reconstruction is a risk factor for graft injury, even if the amount of graft laxity is small. Graft selection or muscle strength did not affect graft injury.</p><p><strong>Level of evidence: </strong>Level Ⅳ.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of skeletal muscle metabolism during walking in symptomatic and asymptomatic patients with osteoarthritis of the knee joint using positron emission tomography.","authors":"Yusuke Yanatori, Takeshi Oshima, Yasushi Takata, Junichi Taki, Takuya Sengoku, Goro Sakurai, Seigo Kinuya, Satoru Demura, Junsuke Nakase","doi":"10.1016/j.jos.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.001","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate skeletal muscle metabolism during walking in symptomatic and asymptomatic patients with knee osteoarthritis using positron emission tomography-computed tomography with 18F-fluorodeoxyglucose. We hypothesized that quadriceps muscle metabolism during walking would vary between the groups.</p><p><strong>Methods: </strong>Twenty-two participants (11 males and 11 females) with knee osteoarthritis (Kellgren-Lawrence grade 2) were divided into symptomatic and asymptomatic groups. The participants performed two 10-min walks on a treadmill, received an intravenous injection of 18F-fluorodeoxyglucose between sets, and underwent positron emission tomography-computed tomography. Regions of interest were manually segmented into 35 skeletal muscles from the pelvis to the foot. The standardized uptake value was calculated to quantitatively examine 18F-fluorodeoxyglucose uptake by muscle tissue.</p><p><strong>Results: </strong>The mean standardized uptake values of the hip abductor and external rotator muscles were lower in the symptomatic group than in the asymptomatic group and displayed a medium effect size (gluteus medius, P = 0.281; d = 0.482; gluteus minimus, P = 0.079; d = 0.793; piriformis, P = 0.184; d = 0.622). Although the vastus medialis demonstrated a medium effect size (P = 0.191; d = 0.597), the rectus femoris (P = 0.454; d = 0.299), vastus lateralis (P = 0.303; d = 0.392), and vastus intermedius (P = 0.300; d = 0.434) demonstrated no significant differences and only small effect sizes. Therefore, no overall difference in quadriceps muscle metabolism was observed between the groups.</p><p><strong>Conclusion: </strong>A trend towards lower hip abductor and external rotator muscle metabolism was observed in patients with symptomatic knee osteoarthritis, suggesting that muscle metabolism may be associated with knee symptoms.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional dependency of sex differences in height-adjusted knee cartilage thickness in KL0 knees using 3D-MRI.","authors":"Ichiro Sekiya, Hisako Katano, Hideyuki Koga, Noriya Okanouchi, Jun Masumoto, Nobutake Ozeki","doi":"10.1016/j.jos.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.jos.2025.04.014","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of knee osteoarthritis (OA) is higher in females than in males, possibly due to cartilage characteristics. However, studies examining sex differences in normal knee cartilage thickness, particularly those that adjust for height and regional variation, remain limited. This study examined sex differences in cartilage thickness across six regions of Kellgren-Lawrence grade 0 (KL0) knees, using sex, height, and age as explanatory variables.</p><p><strong>Methods: </strong>KLO knees in the Kanagawa Knee Study (n = 573) were analyzed using automated KL-grading software. Cartilage thickness was quantified using automated three-dimensional magnetic resonance imaging (3D-MRI) in six regions: the medial femur (MF), medial tibia (MT), lateral femur (LF), trochlear femur (TrF), lateral tibia (LT), and patella (P). Multiple regression analysis was performed using sex, height, and age as explanatory variables. Uncorrected cartilage thickness was compared among regions for each sex using one-way analysis of variance (ANOVA). Statistical significance was set at P < 0.05.</p><p><strong>Results: </strong>The study included 306 KL0 knees (138 females, 168 males), with females being younger and shorter than males. After height adjustment, females showed significantly thinner cartilage in the MF, MT, LF, and TrF regions, while the LT and P regions showed no sex differences. All regions showed positive correlations between cartilage thickness and height. In both sexes, the P region had the thickest cartilage, followed by LT.</p><p><strong>Conclusions: </strong>Sex differences in cartilage thickness showed regional dependency in KL0 knees. While most regions showed thinner cartilage in females after height adjustment, the LT and P regions, characterized by greater cartilage thickness, showed no sex differences.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of potentially inappropriate medication on surgical outcomes in older patients with lumbar spinal stenosis.","authors":"Yuki Akaike, Takehiro Michikawa, Takao Tobe, Risa Tobe, Soya Kawabata, Sota Nagai, Hiroki Takeda, Takaya Imai, Shinjiro Kaneko, Morio Matsumoto, Masaya Nakamura, Shigeki Yamada, Nobuyuki Fujita","doi":"10.1016/j.jos.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.005","url":null,"abstract":"<p><strong>Background: </strong>The administration of potentially inappropriate medications (PIMs) as well as polypharmacy in older individuals has become a medical and socioeconomic issue. Meanwhile, given that lumbar spinal stenosis (LSS) is one of the most prevalent musculoskeletal conditions, significantly affecting mobility in older adults and becoming increasingly common in aging societies, its management in this population has emerged as a critical concern. We aimed to elucidate the prevalence of PIMs among older LSS patients and identify those potentially impacting surgical outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed 296 consecutive patients aged 65 years or older who underwent LSS surgery. Based on available guidelines, 19 medication categories were considered PIMs. Pre- and postoperative health-related quality of life was assessed using the Roland-Morris Disability Questionnaire and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.</p><p><strong>Results: </strong>The most frequently prescribed PIMs included hypnotics, steroids, antithrombotic drugs, antidiabetic drugs, laxatives, and nonsteroidal anti-inflammatory drugs in older LSS patients. Among these medications, antithrombotic drugs showed a significant association with surgical outcomes. When the subjects were divided into antithrombotic drug users (n = 57) and non-users (n = 239), no significant difference in the incidence of postoperative complications was observed between the two groups. However, 1 year after surgery, users had significantly worse walking ability than did nonusers (adjusted p value = 0.028), despite no significant differences before and 6 months after surgery. Furthermore, nonusers showed significant improvement in walking ability (p < 0.001) and social life scores (p = 0.014) from 6 months to 1 year after surgery, whereas users exhibited no significant improvements during this period.</p><p><strong>Conclusions: </strong>Among the PIMs, hypnotics, steroids, antithrombotic drugs, laxatives, antidiabetic drugs, and nonsteroidal anti-inflammatory drugs were commonly used by older LSS patients. Older LSS patients taking antithrombotic drugs are unlikely to have good surgical outcomes.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of stem alignment on femoral mechanical stress using simulation models of cemented total hip arthroplasty: A finite element study.","authors":"Fumito Kobayashi, Kenichi Oe, Daisuke Suzuki, Shohei Sogawa, Arata Kanaizumi, Takanori Saito","doi":"10.1016/j.jos.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.jos.2025.04.015","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effects of cemented stem alignment on the femoral mechanical stress in total hip arthroplasty (THA) simulation models using finite element analysis (FEA) and verified whether only the commonly used von Mises equivalent stress was sufficient for evaluating mechanical stress.</p><p><strong>Methods: </strong>We performed 20 consecutive THAs using collarless, polished, tapered, and cemented stems for the Dorr classification type B of osteoarthritis in March 2022. Simulation models were created using three-dimensional imaging software using postoperative computed tomography data. Under malalignment conditions, the rate of mechanical stress change for each Gruen zone was calculated using FEA. Mechanical stress was classified into von Mises equivalent, maximum principal, and minimum principal stresses.</p><p><strong>Results: </strong>In the anterolateral view, the rates of change in all mechanical stresses showed no significant difference between the neutral and malalignment positions. In the lateral view, however, the rates of change in the maximum principal stress at zone 12 and the minimum principal stress at zones 9 and 10 significantly differed between the neutral and flexed positions. Stress mapping revealed that the maximum principal stresses tended to be high in zones 2 and 3, whereas the minimum principal stresses tended to be high in zones 5 and 6. The locations and magnitudes of stress concentrations varied depending on the stress type-von Mises equivalent, maximum principal, or minimum principal stress.</p><p><strong>Conclusion: </strong>FEA showed that the flexion in cemented stems increases the maximum and minimum principal stresses and should therefore be avoided. Additionally, evaluating only the von Mises equivalent stress is insufficient for fully assessing the mechanical stress acting on the femur.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a relationship between Buford complex and glenoid version?","authors":"Haluk Yaka, Mustafa Özer, Hasan Rüzgar, Yahaya Baako, Ulunay Kanatli","doi":"10.1016/j.jos.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.002","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the relationship between the arthroscopically demonstrated Buford complex (BC) and scapular morphology in patients with anterior shoulder instability (ASI) and rotator cuff tears (RCT). We hypothesized that there may be a relationship between BC and scapular morphology.</p><p><strong>Material and methods: </strong>1947 consecutive shoulder arthroscopy cases performed between 2015 and 2023 were retrospectively evaluated. 17 BC with ASI, 25 RCT with BC, 50 with RCT control group, 50 with ASI control group, and 60 with general control group were included in the study. Critical shoulder angle (CSA) on true anterior posterior radiographs, glenoid version (GV) and glenoid inclination (GI) values on magnetic resonance imaging were compared in all groups.</p><p><strong>Results: </strong>The mean GV in the RCT with BC group was significantly lower than in the RCT control group (P < 0.001, -1º±3.3º vs 7.7º± 5.7º) and in the ASI with BC group than in the ASI control group (p < 0.001, -1.9º± 3.6º vs 3.35º± 4.8º). The mean GV in all patients with BC was significantly lower than the sum of the RCT, ASI control groups, and the general control group(P < 0.001,P < 0.001), with no difference between the groups in terms of GI and CSA.</p><p><strong>Conclusion: </strong>In patients with RCT and ASI, the glenoid was more antevert in patients with the arthroscopically demonstrated BC. The BC may be a compensatory variation that develops against the tendency of the humeral head to shift anteriorly due to a reduced GV, and when the BC is diagnosed, it should be kept in mind that a more antevert glenoid may be encountered.</p><p><strong>Level of evidence: </strong>Level III retrospective comparative study.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}