Journal of Orthopaedic Science最新文献

{"title":"Effectiveness of ultra-early balloon kyphoplasty at one year after osteoporotic vertebral fracture.","authors":"Masatoshi Teraguchi, Yukihiro Nakagawa, Tomohiro Nakatani, Masakazu Minetama, Yoshio Enyo, Takahiro Maeda, Ryo Taiji, Takahide Sasaki, Yoshio Yamamoto, Masafumi Nakagawa, Hiroshi Yamada","doi":"10.1016/j.jos.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.005","url":null,"abstract":"<p><strong>Introduction: </strong>Balloon kyphoplasty (BKP) for osteoporotic vertebral fracture (OVF) has been reported to maintain quality of life (QOL). This study aimed to investigate the effectiveness of ultra-early BKP performed within two weeks of injury (ultra-early group) to cases after two to four weeks post-injury (early group) and over four weeks (conventional group), assessing radiographic assessment such as subsequent fracture etc, questionarre such as QOL and back pain-related activities of daily living (ADL) one year after surgery.</p><p><strong>Methods: </strong>Ninety cases of OVF treated with BKP (23 males, 67 females, average age 78.0 years) were included. Radiographic assessments were examined and QOL parameters (SF-36 and EQ-5D-5L) and back pain-related ADL (ODI score) were assessed using self-administered questionnaires before and one year after surgery. Analysis of Variance (ANOVA) was used to compare changes in evaluation parameters among 3 groups. When significant differences were detected, post-hoc multiple comparisons were performed using the Steel-Dwass test.</p><p><strong>Results: </strong>The mean follow-up duration was 16.6 months. The ultra-early group consisted of 29 cases (10 males, 19 females, average age 77.0 years), the early group consisted of 39 (6 males, 33 females, average age 79.3 years), while the conventional group consisted of 22 cases (7 males, 15 females, average age 80.0 years). There was no significant difference in the preoperative score of SF-36, EQ-5D-5L, and ODI score. At the 1 year follow up, presence of subsequent fracture was significantly difference among 3 groups (3.4 % vs. 10.3 % vs. 31.8 %) (ANOVA, p < 0.05). Moreover, subsequent Steel-Dwass multiple comparisons also revealed that ultra-early group showed significantly less subsequent fracture compared to the conventional group (p < 0.05). Furthermore, Significant differences were observed in the changes of bodily pain in SF-36, EQ-5D-5L and ODI among 3 groups (ANOVA, p < 0.05). Steel-Dwass multiple comparisons also revealed that ultra-early group showed significantly greater improvement in EQ-5D-5L compared to the early group and conventional group (p < 0.05). ODI scores in ultra-early group also showed greater recover compared to the conventional group (p < 0.005).</p><p><strong>Conclusions: </strong>Ultra early BKP within two weeks of OVF demonstrates effectiveness for less complication such as subsequent fracture, QOL and back pain-related ADL one year post-surgery, enabling early return to society.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750908","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":"Mechanical studies for the rotational stability of a cemented stem in cases with stem anteversion adjustment in the cement mantle.","authors":"Ariha Goshi, Yu Takeda, Takuya Nakai, Shigeo Fukunishi","doi":"10.1016/j.jos.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.006","url":null,"abstract":"<p><strong>Introduction: </strong>The cemented stem can accommodate various shapes of femurs and is a stable stem with long-term results. Additionally, the cemented stem is a highly versatile stem that can be used to adjust stem anteversion in patients with variable femoral anteversion. On the other hand, rotating a stem with increasing cement viscosity may result in reduced postoperative rotational stability.</p><p><strong>Materials and methods: </strong>Rotational stability was compared using two different cementing techniques via in vitro models. Six stems in Group S (Static) were inserted and fixed until the cement was completely hardened. Six stems in Group R (Rotation) were inserted and then rotated 15° before the cement had fully cured. After the cement had completely set, a static rotation testing was performed in which the stem was rotated at a rate of 1°/sec to 20° while a vertical load of 600 N was applied. For the dynamic testing, a vertical load of 600 N and 10,000 cycles of repetitive rotation were applied at 10° around the stem axis at 0.1 Hz. After 10,000 cycles, maximum torque was compared between Groups S and R.</p><p><strong>Results: </strong>In both groups, the torque value increased proportionally to the rotation angle. There were no significant differences in resistance to static rotation between Groups S and R (P = 0.599). In the dynamic testing, there was no significant difference between Groups S and R in both minimum torque and maximum torque in any of the cycles. There were no differences in the rotational torque between Groups S and R at 10,000 cycles (P = 0.693).</p><p><strong>Conclusions: </strong>The rotational stability of the cemented stems did not decrease in vitro when stem version control was performed up to 15° before the cement had completely hardened.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739848","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":"Validation of the Japanese version of the scoliosis research society-30 questionnaire for adult patients with spinal deformity.","authors":"Hideyuki Arima, Yu Yamato, Yosuke Shibata, Hiroki Oba, Jun Takahashi, Kei Watanabe, Ryo Sugawara, Katsushi Takeshita, Yasuhisa Arai, Tomoyuki Asada, Satoru Demura, Toru Doi, Akira Matsumura, Satoshi Suzuki, Shinji Takahashi, Takumi Takeuchi, Haruki Ueda, Naobumi Hosogane","doi":"10.1016/j.jos.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>The Scoliosis Research Society-30 (SRS-30) is a questionnaire that was originally developed from the SRS-22r questionnaire and is used to evaluate adolescent idiopathic scoliosis (AIS). It comprises two sections, with Section 1 containing 22 items related to the SRS-22r questionnaire and 1 item regarding self-image and Section 2 containing 7 items specifically related to postoperative status. The SRS-30 has been also found useful in evaluating spinal disorders or deformity in adults. However, the Japanese version of the SRS-30 (Japanese SRS-30) has been validated for adolescent idiopathic scoliosis, but not for adult spinal deformity (ASD). This study aimed to assess the internal consistency and external validity of the Japanese SRS-30 for ASD.</p><p><strong>Methods: </strong>Of the 30 questions on the SRS-30, 8 questions added from the SRS-22r were translated and back-translated to create the Japanese SRS-30. The Japanese SRS-30 was used to survey patients with ASD who underwent corrective fusion surgery within 1 postoperative year. The internal consistency of the responses was evaluated using Cronbach α coefficient. Additionally, we performed Spearman correlation analysis of the Oswestry Disability Index (ODI) and SRS-22r with the Japanese SRS-30.</p><p><strong>Results: </strong>We included 120 patients (20 males and 100 females; mean age at surgery, 53.3 years). The mean preoperative Cobb angle, sagittal vertical axis, and pelvic incidence minus lumbar lordosis were 36.9°, 81.8 mm, and 24.0°, respectively. The Cronbach α coefficient for the overall SRS-30 was 0.941, indicating high internal consistency. Moreover, the coefficients for each domain were as follows: function/activity, 0.864; pain, 0.783; self-image/appearance, 0.858; mental health, 0.916; and satisfaction, 0.763. The total SRS-30 score was significantly correlated with the total SRS-22r score (r = 0.966, P < 0.001) and ODI (r = -0.752, P < 0.001). The SRS-30 domains showed strong correlations with the corresponding SRS-22r domains, with the r values ranging from 0.878 to 1.000 (all P < 0.001 except mental health).</p><p><strong>Conclusions: </strong>The Japanese SRS-30 demonstrated good internal and external validity. The Japanese SRS-30 can be used to assess health-related quality of life in patients with ASD.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729611","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":"Radiological features of the carpometacarpal joint in hamate body fracture on anteroposterior hand X-ray image.","authors":"Yusuke Kubo, Kazuhiko Sonoda, Takahiro Ushijima, Tatsuhiko Miura, Toshihiko Hara","doi":"10.1016/j.jos.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>Hamate body fractures are rare and can be overlooked due to the diagnostic difficulty on X-ray. We focused on the carpometacarpal joint space width (CMC-JSW) and examined the features of this fracture on versatile anteroposterior hand X-ray images, initially taken for hand trauma cases.</p><p><strong>Methods: </strong>Ten patients (nine males and one female; mean age, 34 years) diagnosed with a hamate body fracture on CT in our facility between January 2013 and October 2023 were included in this study. The fracture types were dorsal type in six cases and shear type in four cases. The 4th and 5th CMC-JSWs were measured on anteroposterior hand radiography and CT sagittal sections. If the metacarpal and hamate bones appeared to overlap due to depression, the width was expressed as a negative value (overlap sign). CMC-JSWs were compared between the types or unaffected sides using the Mann-Whitney U test. The correlation with X-ray and CT measurements was analyzed using the Spearman test.</p><p><strong>Results: </strong>The average CMC-JSWs (IV: -0.52 mm, V: -1.33 mm) in hamate body fractures on X-ray were minus and these values were significantly lower than unaffected side (IV: 1.51 mm, V: 1.48 mm) (p < 0.05, p < 0.001). CMC-JSW (IV: -1.64 mm) and CMC-JSW (V: -2.70 mm) of dorsal type were significantly lower than shear type (IV: 1.17 mm, V: 0.72 mm) (p < 0.05). CMC-JSW values on X-ray were positively correlated with those on CT (IV: ρ = 0.796, V: ρ = 0927).</p><p><strong>Conclusions: </strong>Decreased CMC-JSW, correlated with CT sagittal sections, and \"overlap sign\" on anteroposterior hand X-ray were possible radiological characteristics of hamate body fracture. Care should be taken to avoid overlooking shear-type fractures because of subtle CMC-JSW decreases.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695615","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":"Prevalence and associated factors for primary osteoarthritis of the thumb carpometacarpal joint in the general elderly population: A cohort survey randomly sampled from a basic resident registry of a small rural town in Japan.","authors":"Itsuo Joko, Hiroyuki Kato, Masanori Hayashi, Shota Ikegami, Yo Kitamura, Hiroko Iwakawa, Kentaro Nakayama, Kazutaka Uemura, Shigeharu Uchiyama, Jun Takahashi","doi":"10.1016/j.jos.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.012","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis of the thumb carpometacarpal joint often presents pain and affects activity of daily life. There is no consensus regarding prevalence of primary radiographic osteoarthritis and symptomatic osteoarthritis of the thumb carpometacarpal joint, and their associated factors are not well investigated. The purpose of this study is to evaluate the prevalence and associated factors of primary radiographic and symptomatic osteoarthritis of the thumb carpometacarpal joint in a resident cohort.</p><p><strong>Methods: </strong>A total of 1297 residents aged 50 to 89 were randomly sampled from a small rural town in Japan, and their demographic data and questionnaire regarding lifestyle and job were obtained. All participants underwent posteroanterior radiographs of the bilateral hands. Participants with thumb carpometacarpal joint radiographic osteoarthritis were diagnosed if one of their thumb carpometacarpal joints was Kellgren-Lawrence grade 2, 3, or 4. Symptomatic osteoarthritis was diagnosed by tenderness or positive motion pain at the thumb base. Associated factors for the thumb carpometacarpal joint radiographic osteoarthritis were statistically analyzed.</p><p><strong>Results: </strong>A total of 646 thumbs with 323 participants (153 male and 170 female) were investigated. The mean age was 69.1 (range 50-89) years, The prevalence of thumb carpometacarpal joint radiographic osteoarthritis was 17.3 % (13.7 % males and 20.6 % females) and that of thumb carpometacarpal joint symptomatic osteoarthritis was 3.1 %. Associated factors for thumb carpometacarpal joint radiographic osteoarthritis were presence of finger joint radiographic osteoarthritis in the ipsilateral hand, increasing age, and female in order of degree of relevance. Dominant hand, body mass index, smoking history, heavy manual or agriculture work, use of vibrating tools, racket or bat sports, or scaphotapeziotrapezoidal joint radiographic osteoarthritis were not associated factors for thumb carpometacarpal joint radiographic osteoarthritis.</p><p><strong>Conclusions: </strong>The prevalence of thumb carpometacarpal joint primary radiographic osteoarthritis in general Japanese elderly aged 50-89 years was 17.3 %, most of carpometacarpal joint radiographic osteoarthritis was asymptomatic.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695563","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":"Minimal clinically important difference in the Japanese Orthopedic Association Score and shoulder 36 after arthroscopic rotator cuff repair in a Japanese population: A retrospective cohort study.","authors":"Daisuke Yoshimura, Jun Kawamata, Shoji Fukuta, Yuka Shimasaki, Daisuke Kita, Koichi Sairyo","doi":"10.1016/j.jos.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.004","url":null,"abstract":"<p><strong>Background: </strong>In Japan, the Japanese Orthopedic Association (JOA) score is widely used as a clinician-reported outcome after shoulder surgery. However, Shoulder36 is positioned as a general patient-reported outcome measure. This study aimed to determine the correlations between the JOA score and scores in the domains of the Shoulder36 and their minimal clinically important differences (MCIDs) and cutoff values for the patient-acceptable symptom state (PASS) after unilateral arthroscopic rotator cuff repair (ARCR).</p><p><strong>Methods: </strong>We evaluated 145 patients using the JOA score and Shoulder36 before and 1 year after surgery. The MCID and PASS cutoff values were determined by patients' responses to the following anchor item: A, none (\"no good at all\"); B, poor (\"some effect but unsatisfactory\"); C, good (\"satisfactory effect with occasional episodes of pain or stiffness\"); D, excellent (\"ideal response, virtually pain-free\"). The correlations between the JOA score and the domains of the Shoulder36 were statistically calculated. The border between B and C was defined as the threshold for PASS.</p><p><strong>Results: </strong>There were significant correlations between the JOA score and the Shoulder36 domains. The responses to the anchor item were as follows: A (n = 0), B (n = 21), C (n = 76), and D (n = 48). The MCID for the JOA score was 19.5 points and the MCIDs for Shoulder36 were 0.5 points for pain, 0.667 for range of motion, 0.67 for muscle strength, 0.3 for general health, 0.571 for activities of daily living, and 1.0 for sports ability. The PASS cutoff value was 89.0 points for the JOA score and 3.8 points for pain, 3.667 for range of motion, 3.0 for muscle strength, 3.7 for general health, 3.7 for activities of daily living, and 3.0 for sports ability in the Shoulder36.</p><p><strong>Conclusions: </strong>The MCID and cutoff PASS values for the JOA score and Shoulder36 identified in this study will help to determine the effectiveness of multidisciplinary management after ARCR.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693159","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":"Clinical characteristics and results after conservative treatment or interfascicular neurolysis of 100 limbs with spontaneous anterior interosseous nerve palsy: A prospective Japanese multicenter study.","authors":"Kensuke Ochi, Yasuhito Tajiri, Shigeru Kurimoto, Yo Kitamura, Toshiyuki Tsuruta, Shota Ikegami, Kazuo Ikeda, Hiroshi Satake, Masao Nishiwaki, Yuki Hara, Naoki Kato, Rikuo Shinomiya, Ryusuke Osada, Kenichi Tazaki, Masato Okazaki, Takao Omura, Yuichiro Matsui, Hiroshi Yasunaga, Masatoshi Amako, Hiroyuki Tanaka, Yuka Kobayashi, Seietsu Senma, Shingo Nobuta, Shinichi Yamamoto, Shigeharu Uchiyama, Hiroko Narisawa, Kaoru Tada, Yasushi Morisawa, Yukio Horiuchi, Hiroyuki Kato","doi":"10.1016/j.jos.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.009","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous anterior interosseous nerve (AIN) palsy is characterized by the sudden onset of upper limb pain followed by weakness of muscles mainly innervated by the AIN. Although this palsy is conventionally treated conservatively, interfascicular neurolysis to release hourglass-like fascicular constrictions has been recommended. The present study aimed to establish the clinical characteristics and treatment strategy for this condition.</p><p><strong>Methods: </strong>One hundred limbs with spontaneous AIN palsy from 24 Japanese institutions were treated either conservatively or with interfascicular neurolysis according to the patient's intention. Patients were followed periodically from 3 months to either recovery or ≥36 months after onset. Limbs recovering to manual muscle testing grade 4 or better in both the flexor pollicis longus and flexor digitorum profundus of the index finger were rated as Good recovery, with all other results classified as Poor recovery. We performed logistic regression analysis to determine the independent factors associated with Good recovery.</p><p><strong>Results: </strong>Good recovery was achieved in 39 of 49 limbs treated conservatively and 44 of 51 limbs by interfascicular neurolysis. All 26 limbs with conservative treatment displaying ≥1 grade of manual muscle testing improvement within 6 months after onset achieved Good recovery. All 23 limbs with Group I palsy, in which weakness was recognized only in muscles innervated by the AIN, obtained Good recovery with interfascicular neurolysis regardless of when it was performed. In the 59 limbs with no recovery at 6 months by conservative treatment, Good recovery was achieved in 30 of 36 limbs by subsequent interfascicular neurolysis and 13 of 23 limbs continuing conservative treatment. In these 59 limbs, interfascicular neurolysis and Group I palsy were significantly associated with Good recovery.</p><p><strong>Conclusions: </strong>Conservative treatment is recommended within 6 months following symptom onset, after which time interfascicular neurolysis is advisable for cases of no improvement.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693158","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":"Platelet-rich plasma in the treatment of delayed union and nonunion fractures: An umbrella meta-analysis.","authors":"Jinqiang Zhu, Dunhu Han, Yuanyuan Sun, Chunzeng Zhao","doi":"10.1016/j.jos.2024.10.015","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.015","url":null,"abstract":"<p><strong>Background: </strong>Long bone fractures may exhibit nonunion/delayed union and the precise mechanism underlying this devastating condition remain unknown. More recently, a series of meta-analyses have examined the effect of local administration of platelet-rich plasma (PRP) in patients suffering from nonunion/delayed union fractures; however, the conclusions of available meta-analyses have remained debatable. This umbrella meta-analysis was performed to synthesize and recalculate available evidence to assess the certainty of the effect of PRP on nonunion/delayed union fractures.</p><p><strong>Methods: </strong>Relevant meta-analyses and individual studies investigating the effect of PRP therapy on nonunion/delayed union fractures were obtained through a systematic search in PubMed, Web of Knowledge, and Scopus up to November 2023. Meta-analyses were re-conducted for healing rate and healing time using a random effects model. The methodology quality of the included meta-analyses and the quality of evidence was assessed using the AMSTAR2 and GRADE criteria, respectively.</p><p><strong>Results: </strong>A total of 5 meta-analyses with 13 individual studies, comprising 1362 patients, were included. The analysis revealed a significant improvement in both healing rate (relative risk (RR) = 1.30, 95%CI: 1.06 to 1.60) and healing time (mean difference (MD): -1.25, 95 % CI: -2.09 to -0.42) of nonunion/delayed union fractures. However, when individual studies were pooled, PRP was not effective in increasing the healing rate, while it was effective in reducing healing time (MD = -2.15, 95 % CI = -3.17 to -1.13). PRP therapy had no significant effect on pain improvement and the Excellent/Good Posttreatment Limb Function. The risk of the adverse side effects was not significant.</p><p><strong>Conclusion: </strong>This umbrella meta-analysis revealed that PRP may reduce healing time in patients with nonunion/delayed union fractures, with no potential side effects. This finding is needed to be confirmed by further studies.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687070","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":"What is the appropriate revascularisation approach in traumatic popliteal artery injury?","authors":"Yuta Izawa, Kentaro Futamura, Masahiro Nishida, Masayuki Hasegawa, Takafumi Suzuki, Kanako Tsuihiji, Yoshihiko Tsuchida","doi":"10.1016/j.jos.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.jos.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Popliteal artery injury (PAI) is sometimes accompanied by proximal tibial fracture or knee dislocation. We hypothesized that revascularisation approach should be selected depending on the associated injury. The purpose of this study is to propose revascularisation approach that does not interfere with definitive surgery.</p><p><strong>Methods: </strong>Patients with PAI who were treated between 2013 and 2023 were included. Associated injuries, revascularisation approach, and skin incision for the definitive surgery were investigated. We investigated whether varus-valgus instability remained as an outcome.</p><p><strong>Results: </strong>21 limbs with PAI were included. There were 6 cases with proximal tibial fracture. Medial incision was used in 2 cases and crank shaped incision in 4 cases. In 4 cases of crank shaped incision, osteosynthesis was performed through a crank shaped incision. There were 8 cases with knee dislocation. Medial incision was used in 1 case, S shaped incision in 4 cases, and crank shaped incision in 3 cases. In cases of S shaped incision, extra-articular ligament was repaired through independent incisions. In three cases of crank shaped incision, it was not possible to repair extra-articular ligament because of interfere with the initial incision. As a result, knee joint instability remained. There were 7 cases without proximal tibial fracture or knee dislocation. Medial incision was used in 1 case, S shaped incision in 3 cases, and crank shaped incision in 3 cases. There was no interference between the incisions for revascularisation and for definitive surgery.</p><p><strong>Conclusion: </strong>For PAI, revascularisation approaches should be selected depending on the associated injury.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682174","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":"Analysis of cancer multigene panel testing for osteosarcoma in pediatric and adults using the center for cancer genomics and advanced therapeutics database in Japan.","authors":"Yoshiyuki Suehara, Rina Kitada, Satoshi Kamio, Koichi Ogura, Shintaro Iwata, Eisuke Kobayashi, Akira Kawai, Shinji Khosaka","doi":"10.1016/j.jos.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.jos.2024.10.016","url":null,"abstract":"<p><strong>Background: </strong>Osteosarcoma (OS) is the most common primary malignant bone tumor. Despite advances in multimodal chemotherapy, prognosis for metastatic or recurrent OS remains poor. Next-generation sequencing (NGS) can uncover new therapeutic options by identifying potentially targetable alterations. This study analyzed NGS data from the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database in Japan, comparing findings with the Memorial Sloan-Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) data from the United States.</p><p><strong>Methods: </strong>We sequenced tumor and/or germline DNA from 223 high-grade OS samples using the FoundationOne® CDx or OncoGuideTM NCC Oncopanel System, and the FoundationOne® Liquid CDx for multigene panel testing (2019-2023). Genomic alterations were interpreted using the Cancer Knowledge Database (CKDB), with potentially actionable genetic events categorized into A-F levels.</p><p><strong>Results: </strong>Analysis of 223 high-grade OS samples revealed 1684 somatic mutations in 167 genes and 1114 copy number alterations in 89 genes. Potentially actionable alterations were identified in 94 patients (42.2 %) at CKDB Levels A-C. These included 2 cases with NTRK fusions (0.9 %; Level A), one case with TMB-high (0.4 %; Level A), 3 with ERBB amplifications (1.3 %; Level B), and 88 cases (39.5 %) with alterations such as CDK4 amplification, PTEN deletion/mutation, and others (Level C). Co-occurring amplifications of KIT, KDR, and PDGFRA at the 4q12 locus were found in 8 cases (3.6 %), while VEGFA and CCND3 co-amplifications at the 6p12-21 locus were seen in 33 cases (14.8 %). These gene amplifications, also reported in US studies, are targetable by multi-kinase inhibitors, although the C-CAT cohort's profiles differed from US cohorts like MSK-IMPACT.</p><p><strong>Conclusions: </strong>Precision medicine for rare tumors still poses challenges. In this Japanese cohort, 42.2 % of high-grade OSs had potentially actionable alterations per CKDB. Concurrent gene amplifications of KIT, KDR, and PDGFRA at 4q12, and VEGFA and CCND3 at 6p12-21, might offer promising therapeutic options for patients with recurrent/metastatic OS resistant to conventional chemotherapy.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676024","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}