Journal of Orthopaedic Science最新文献

{"title":"Etiology and clinical trends in hip osteoarthritis in Japan: Insights from a multicenter cross-sectional study.","authors":"Taishi Sato, Ryosuke Yamaguchi, Takeshi Utsunomiya, Yutaka Inaba, Hiroyuki Ike, Koichi Kinoshita, Kenichiro Doi, Tsutomu Kawano, Kyohei Shiomoto, Toshihiko Hara, Kazuhiko Sonoda, Ayumi Kaneuji, Eiji Takahashi, Tomohiro Shimizu, Daisuke Takahashi, Yusuke Kohno, Tamon Kabata, Daisuke Inoue, Shuichi Matsuda, Koji Goto, Taro Mawatari, Shoji Baba, Michiaki Takagi, Juji Ito, Yasuharu Nakashima","doi":"10.1016/j.jos.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.006","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological characteristics of Hip osteoarthritis (OA) continue to change due to population aging and emerging disease concepts, such as femoroacetabular impingement (FAI) and subchondral insufficiency fracture of the femoral head (SIF). This study aimed to analyze the current etiologies of hip OA in Japan and identify characteristics associated with each etiology.</p><p><strong>Methods: </strong>A multicenter cross-sectional study was conducted in 2022 at 12 major Japanese hospitals, including 1197 patients (1515 hips) newly diagnosed with hip OA. Etiologies were classified into nine categories based on patient background and imaging findings: hip dysplasia, primary OA, FAI, SIF, rapidly destructive coxopathy (RDC), trauma, Legg-Calvé-Perthes disease (LCPD), slipped capital femoral epiphysis (SCFE), and skeletal dysplasia.</p><p><strong>Results: </strong>The etiologies included hip dysplasia (74.4 %), primary OA (13.4 %), FAI (4.8 %), SIF (3.4 %), RDC (1.3 %), trauma (1.3 %), LCPD (0.9 %), SCFE (0.1 %), and skeletal dysplasia (0.1 %). Patients in their 70s comprised the largest group, with a predominance of female patients across all ages. The proportion of hip dysplasia decreased in the elderly patients, whereas primary OA and SIF increased. Hip dysplasia was more common in female than male (78.2 % vs. 55.2 %), whereas FAI was more frequent in male (17.9 % vs. 2.2 %). The Japanese Orthopaedic Association hip scores were highest for FAI and lowest for SIF. Kellgren-Lawrence (KL) grade ≥3 was more common in primary OA (82.0 %) and hip dysplasia (76.7 %) than in FAI (57.7 %) and SIF (66.7 %).</p><p><strong>Conclusions: </strong>Hip dysplasia remains the predominant cause of hip OA in Japan. Age-specific analyses revealed that FAI was more common in younger patients, while primary OA and SIF were prevalent in older patients. Patients with hip dysplasia and primary OA often presented with advanced KL grades, while SIF was associated with the poorest clinical scores. These findings may inform diagnostic and treatment approaches based on predominant etiologies.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528504","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":"Lumbar apophyseal ring fracture: Prevalence and relationship with spina bifida occulta.","authors":"Saori Soeda, Masatoshi Morimoto, Kosuke Sugiura, Kosaku Higashino, Shunsuke Tamaki, Keisuke Nishidono, Kiyoshi Yagi, Kazuya Kishima, Hiroaki Manabe, Koichi Sairyo","doi":"10.1016/j.jos.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.009","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prevalence of apophyseal ring fracture and its association with spina bifida occulta (SBO).</p><p><strong>Methods: </strong>A total of 973 patients (mean age 62 years [range 21-90]) with abdominal and pelvic computed tomography scans available were retrospectively evaluated. The prevalence of apophyseal ring fracture and of SBO and the association between these two entities were evaluated.</p><p><strong>Results: </strong>The prevalence of apophyseal ring fracture was 3.8 % (n = 22) in men and 2.8 % (n = 11) in women; the difference was not statistically significant (p = 0.53). The incidence was highest at L5 in both men (58.3 %, n = 14) and women (38.5 %, n = 5). SBO was found in 92 patients (9.5 %), who comprised 75 men (12.9 %) and 17 women (4.4 %). The prevalence of SBO was 2.95-fold higher in men than in women (p < 0.0001). Apophyseal ring fracture was 2.6 times more frequent in patients who had SBO than in those who did not (7.6 % vs 3.0 %, p = 0.019).</p><p><strong>Conclusions: </strong>This study identified the lower lumbar levels as the anatomical locations where apophyseal ring fracture was more likely to occur, particularly involving the anterior portion of the cephalad endplate at L3 and L4 and the posterior portion of the cephalad endplate at S1. This finding will be helpful for understanding the site of origin of apophyseal ring fractures, which can be easily overlooked. In addition, apophyseal ring fractures were more frequent in the presence of SBO, which may contribute to understanding their etiology.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512092","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":"Minimum 10-year outcomes of a curved anatomic femoral stem designed for the Japanese femora including dysplastic hips in total hip arthroplasty.","authors":"Sachiyuki Tsukada, Naoyuki Hirasawa, Masayoshi Saito, Masahiro Nishino, Takuya Kusakabe, Hiroyuki Ogawa","doi":"10.1016/j.jos.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.013","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the minimum 10-year outcomes of total hip arthroplasty (THA) using the CentPillar-TMZF, a curved anatomic stem developed based on anatomical data from Japanese patients including those with hip dysplasia.</p><p><strong>Methods: </strong>Among 331 consecutive THA procedures, the CentPillar-TMZF was implanted in 80 primary THAs (24 %) following standardized selection criteria based on preoperative CT data. X-rays taken at the 10-year follow-up were assessed to evaluate stem fixation and the degree of stress shielding. Kaplan-Meier survivorship was calculated, with revision for any reason as the endpoint.</p><p><strong>Results: </strong>Seventy-three of the 80 hips (91 %) were followed for 10 years or until revision surgery. In all hips followed more than 10 years, stem fixation was classified as bone-ingrown stable with first- or second-degree stress shielding. The survivorship rate, with revision as the endpoint, was 98 % (95 % CI 90 %-99 %) at 10 years. Before the 10-year follow-up, one patient required revision due to a periprosthetic fracture, and another required revision for dislocation.</p><p><strong>Conclusion: </strong>In THA using CentPillar-TMZF, no aseptic loosening was observed until postoperative 10 years in patients whose femoral medullary canal shape was preoperatively determined to be compatible based on CT evaluation.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506052","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":"Treatment trends and outcomes of pyogenic vertebral osteomyelitis in Japan, 2015-2023: A descriptive epidemiological study.","authors":"Takaki Yoshiyama, Toshiki Fukasawa, Soichiro Masuda, Bungo Otsuki, Koichi Murata, Takayoshi Shimizu, Takashi Sono, Shintaro Honda, Koichiro Shima, Masaki Sakamoto, Ryohei Saito, Shuichi Matsuda, Koji Kawakami","doi":"10.1016/j.jos.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.003","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic vertebral osteomyelitis (PVO) is a rare but serious disease that presents diagnostic and therapeutic challenges. Although recent studies provide limited insights into its management trends, data on antibiotic regimens and surgical procedures remain scarce. This study aimed to assess real-world treatment trends for PVO in Japan.</p><p><strong>Methods: </strong>We conducted a descriptive study using a hospital administrative database from 2015 to 2023. We included 1524 adult patients hospitalized for PVO in 50 hospitals that continuously contributed data during this period. We assessed antibiotic regimens (duration, trends in specific agents, and combination therapy), surgical procedures, and in-hospital mortality. We used the Cochran-Armitage trend test to evaluate annual changes, and examined factors associated with in-hospital mortality using univariable modified Poisson regression.</p><p><strong>Results: </strong>The median duration of antibiotic therapy was 54 days. Although the proportion of patients receiving cefazolin (slightly over half) remained unchanged, there was a marked increase in the use of broad-spectrum antibiotics such as ceftriaxone, vancomycin, and piperacillin-tazobactam. During the oral phase, minocycline (33.5 %) and levofloxacin (24.8 %) were the most commonly prescribed. Approximately 30 % of patients received combination therapy, and this proportion did not change substantially over time. Surgical interventions increased during the study period, primarily because of rising posterior fixation procedures. In-hospital mortality was 5.2 %. Older age, heart failure, hemodialysis, and a higher Charlson Comorbidity Index were strongly associated with increased in-hospital mortality.</p><p><strong>Conclusions: </strong>Our findings suggest that the treatment duration of PVO tended to be longer than guideline recommendations, whereas the selection of oral agents was consistent with them. The growing trend in posterior fixation surgeries may reflect the adoption of minimally invasive techniques such as percutaneous pedicle screw fixation. Older patients with heart and kidney failure require particular caution in treatment.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497391","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":"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}