Journal of Orthopaedic Science最新文献

{"title":"Prospective observational study of daily upper-limbs activities following arthroscopic rotator cuff repair using triaxial accelerometers: Recovery process and relationship with preoperative clinical parameters.","authors":"Toshiyuki Fukushima, Yoshihiro Nakamura, Hiroshi Kurumadani, Shota Date, Masako Tominaga, Toru Sunagawa","doi":"10.1016/j.jos.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.011","url":null,"abstract":"<p><strong>Background: </strong>Following arthroscopic rotator cuff repair (ARCR), upper-limb movement must be restricted during the early postoperative phase. However, the postoperative recovery process of daily upper-limb use and its relationship with preoperative parameters remain unclear. We investigated the postoperative recovery process of the operated limb use following ARCR quantitatively using triaxial accelerometers and examined its relationship with preoperative parameters.</p><p><strong>Methods: </strong>We evaluated bilateral upper-limb use in daily activities using triaxial accelerometers in 21 patients who underwent ARCR. Measurements were performed immediately before the surgery and at 2, 3, 6, and 12 months postoperatively. Twenty healthy adults served as the controls. Additionally, correlations with preoperative clinical scores, active range of motion, muscle strength, and pain were investigated.</p><p><strong>Results: </strong>The frequency of upper-limb use showed no significant differences between the operated and non-operated limbs from the preoperative to 12 months postoperatively. The intensity of upper-limb use in the operated limb was significantly lower than that in the non-operated limb and controls at the preoperative, 2 and 3months. These differences were resolved 6 months postoperatively. Regarding preoperative parameters, postoperative intensity particularly correlated with shoulder flexion and muscle strength.</p><p><strong>Conclusion: </strong>Following ARCR, the intensity of upper-limb use should be increased progressively, as additional time may be needed for intensity recovery. Furthermore, maintaining preoperative shoulder flexion may promote postoperative daily upper-limb activities. These findings suggest that clinicians may consider monitoring the intensity of upper-limb use in daily living following ARCR and maintaining shoulder flexion through preoperative rehabilitation.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092008","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":"Translation, cultural adaptation, validity, and reliability of the Japanese version of the constant score: A cross-sectional study.","authors":"Daisuke Uritani, Yuuka Yasuura, Kinako Sasaki, Nobuya Harada, Christopher R Constant","doi":"10.1016/j.jos.2025.08.012","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.012","url":null,"abstract":"<p><strong>Background: </strong>The Constant Score (CS) is one of the most widely used shoulder function assessment instruments. However, a culturally and linguistically adapted Japanese version has not yet been established. This study aimed to translate and culturally adapt CS into Japanese (CS-J) and evaluate its reliability and validity.</p><p><strong>Methods: </strong>The CS was translated into Japanese following internationally accepted cross-cultural adaptation guidelines. Psychometric properties of the CS-J were evaluated in 64 patients with shoulder dysfunction. Internal consistency was assessed using Cronbach's alpha. Test-retest reliability was examined using intraclass correlation coefficients (ICC). Construct validity was confirmed by exploratory factor analysis (EFA), and concurrent validity was tested against SPADI, QuickDASH, and SF-12 scores.</p><p><strong>Results: </strong>The CS-J demonstrated excellent internal consistency (Cronbach's alpha = 0.91) and test-retest reliability (ICC = 0.91). The EFA revealed a two-factor structure corresponding to the subjective and objective components of the CS. Significant correlations were found between CS-J and SPADI (r = -0.82), QuickDASH (r = -0.82), SF-12 Physical Component Summary (r = 0.72), and Mental Component Summary (r = 0.52) scores, supporting concurrent validity.</p><p><strong>Conclusions: </strong>The CS-J has acceptable reliability and validity, making it a useful tool for evaluating shoulder function in Japanese patients. The standardized adaptation of the CS-J enables more accurate clinical assessments and facilitates international research collaboration.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086408","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 characteristics of femoroacetabular impingement among Japanese patients: A nationwide epidemiological study.","authors":"Kensuke Fukushima, Tetsuya Jinno, Ryohei Takada, Takuma Yamasaki, Hideki Fujii, Naomi Kobayashi, Toshikazu Kubo, Hajime Sugiyama, Nobuhiko Sugano","doi":"10.1016/j.jos.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.014","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement (FAI) causes hip pain and osteoarthritis (OA). However, its prevalence and characteristics in the Japanese population remain unclear. Therefore, this large-scale nationwide epidemiological study aimed to determine the current aetiologies of hip disorders in Japan, focusing on the prevalence and clinical features of primary FAI.</p><p><strong>Methods: </strong>A total of 2402 patients presenting with groin pain were prospectively enrolled from 16 hip-specialised institutions across Japan. Diagnoses were based on standardised clinical and radiographic evaluations, including the Japanese Hip Society criteria for primary FAI. Centralised radiographic assessment was also conducted using dedicated measurement software.</p><p><strong>Results: </strong>Secondary OA due to hip dysplasia was the most common diagnosis (52.9 %), followed by primary OA (16.8 %), osteonecrosis of the femoral head (8.5 %), and primary FAI (6.2 %). Patients with FAI were predominantly younger males. Cam-type FAI was the most frequently identified FAI subtype. Centralised radiographic assessment revealed discrepancies compared with institutional diagnoses, in which 12.8 % of patients initially diagnosed with FAI showed signs of advanced OA, the percentage of hips with a lateral center-edge angle <25° was higher in the centralised measurements (13.8 % vs. 6.4 %; P < 0.001), and the percentage of hips with an alpha angle ≥55° was reduced (40.3 % vs. 67.7 %; P = 0.0393).</p><p><strong>Conclusion: </strong>This nationwide study identified secondary OA due to hip dysplasia as the most common (52.9 %), with primary FAI identified in 6.2 % of cases, predominantly affecting younger males with cam-type morphology. Standardised radiographic assessment revealed an underdiagnosis of hip dysplasia and OA and a potential overdiagnosis of cam-type FAI, emphasising the need for accurate diagnosis to guide appropriate treatment decisions.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075502","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 preoperative albumin level associated with wound complications after oncologic surgery for spinal metastases? An ACS-NSQIP analysis.","authors":"Ali Haider Bangash, Victoria Cao, Rose Fluss, Sertac Kirnaz, Saikiran G Murthy, Yaroslav Gelfand, Reza Yassari, Rafael De la Garza Ramos","doi":"10.1016/j.jos.2025.08.010","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.010","url":null,"abstract":"<p><strong>Background: </strong>Wound complications following metastatic spine tumor surgery (MSTS) can significantly impact patient recovery and delay adjuvant therapy. While nutritional status has been implicated in surgical outcomes, the specific relationship between preoperative albumin levels and wound complications after MSTS remains incompletely understood. We investigated the association between preoperative albumin levels and wound complications following MSTS.</p><p><strong>Methods: </strong>We analyzed the data of 2195 patients who underwent MSTS from the American College of Surgeons National Surgical Quality Improvement Program database (2018-2023). The primary endpoint was a composite of wound complications (dehiscence, superficial/deep incisional infections, organ/space surgical site infections) within 30 days. The secondary endpoint was reoperation due to wound complications. Univariable and multivariable logistic regression analyses assessed associations between patient/operative characteristics and outcomes, with albumin level evaluated both: continuously and categorically.</p><p><strong>Results: </strong>Wound complications occurred in 4 % (88/2195) of patients, with 22 % (19/88) requiring reoperation. Complications were observed in 3 % of normoalbuminemic patients, 5 % with mild hypoalbuminemia, and 8 % with severe hypoalbuminemia. Multivariable analysis controlling for chronic steroid use, operative time, perioperative transfusion, and posterior instrumentation revealed that each 1 g/dL increase in preoperative albumin was independently associated with 31 % lower odds of wound complications (OR 0.68 [95 % CI 0.49-0.95]; p = 0.026). Severe hypoalbuminemia (<2.5 g/dL) more than doubled complication risk compared to normal levels (OR 2.15 [95 % CI 1.01-4.56]; p = 0.045). Preoperative albumin level was not significantly associated with reoperation due to wound complications.</p><p><strong>Conclusions: </strong>These findings suggest the potential value of albumin as a modifiable risk factor in preoperative assessment for candidates of MSTS. Future prospective studies should validate these findings and investigate whether nutritional optimization targeting albumin levels can reduce complications in this vulnerable patient population.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058605","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":"Comparative analysis of Birmingham hip resurfacing: Minimum 2-year follow-up clinical outcomes in obese vs. non-obese populations.","authors":"Roger Quesada-Jimenez, Elizabeth G Walsh, Ady H Kahana-Rojkind, Benjamin D Kuhns, Andrew R Schab, Benjamin G Domb","doi":"10.1016/j.jos.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.012","url":null,"abstract":"<p><strong>Background and objective: </strong>With obese individuals experiencing osteoarthritis (OA) at early stages of life, hip resurfacing (HR) has emerged as an alternative to arthroplasty. The purpose is to conduct a short-term analysis on patients with obesity who underwent primary HR for OA compared to a benchmark control group of non-obese patients.</p><p><strong>Materials and methods: </strong>Patients with a body mass index (BMI) ≥ 30 kg/m2 who underwent HR from 2010 to 2021 were eligible for inclusion. Included patients had pre-operative and minimum 2-year follow-up for the Modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score Joint Replacement Score (HOOS-JR), Forgotten Joint Score (FJS), Visual Analog Scale for Pain (VAS), and patient satisfaction or reached an endpoint revision surgery during the study time frame. Patients were propensity matched in a 1:1 ratio based on approach, age, and follow-up time. Clinically relevant outcome thresholds, sports participation, acetabular cup placement, complications, and conversions to total hip arthroplasty (THA) were included in the analysis.</p><p><strong>Results: </strong>Seventy patients were included. Obese patients displayed significant improvements across all patient reported outcomes (PROs) and high patient satisfaction at short-term follow-up that was comparable to the non-obese group. Both groups also showed a similar return to sport and acetabular cup placement and met clinically relevant thresholds at similar rates. The obese group, specifically patients with a BMI>35, exhibited higher complication and revision surgery rate.</p><p><strong>Conclusions: </strong>HR in patients with obesity showed significant short-term improvements, allowing a high percentage of patients to return to sports. These results were equivalent to a benchmark control group of non-obese patients. Additionally, obese patients tended to have an increased risk of complications than non-obese patients, with a higher rate of conversion to THA. Level of EvidenceLevel of Evidence III.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033552","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 Hounsfield units for preoperative bone mineral density assessment in intertrochanteric femoral fractures.","authors":"Shuichi Eto, Shunji Imanishi, Wataru Komuta, Yosuke Oba, Nobumichi Hidaka","doi":"10.1016/j.jos.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.005","url":null,"abstract":"<p><strong>Background: </strong>Hounsfield units (HU) on computed tomography (CT) are strongly correlated with bone mineral density (BMD) and may aid in osteoporosis screening. However, there is no standardized method for assessing bone density in displaced femoral head fractures. This study aimed to measure HU values in the femoral head using preoperative post-fracture CT images of patients with intertrochanteric femoral fractures and investigate whether it correlated with BMD measured by dual-energy X-ray absorptiometry (DXA).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed post-fracture CT images of intertrochanteric fractures (n = 52). Hounsfield units were measured in the axial, coronal, and sagittal planes using the femoral neck axis as a reference. Severe osteoporosis was defined as <60 % of the young adult mean (YAM) (T-score <-3.3). We evaluated the correlations between HU and DXA-derived BMD, along with reliability (intraclass correlation coefficient [ICC]), measurement bias (Bland-Altman analysis), and diagnostic performance (receiver operating characteristic [ROC]).</p><p><strong>Results: </strong>HU values demonstrated strong associations with BMD across all planes, with the highest correlations observed in the axial and coronal planes. ICC values exceeded 0.9, indicating excellent reliability. Bland-Altman analysis revealed no proportional bias but a fixed bias in the sagittal plane, whereas the narrowest limits of agreement were observed in the axial plane. Based on the ROC analysis, an axial HU cutoff of 151.5 identified severe osteoporosis (sensitivity, 0.756; specificity, 0.783).</p><p><strong>Conclusions: </strong>Axial HU measurements were most reliable for assessing the bone quality. This cutoff value may help identify severe osteoporosis and determine eligibility for cement augmentation. However, further validation is needed.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033613","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 related factors of early-phase diffuse idiopathic skeletal hyperostosis in a community-dwelling population - A cross-sectional observational study.","authors":"Kairo Wada, Kanichiro Wada, Takaaki Nakano, Tetsushi Oyama, Gentaro Kumagai, Yohshiro Nitobe, Kotaro Aburakawa, Noriyuki Chiba, Yasuyuki Ishibashi","doi":"10.1016/j.jos.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.009","url":null,"abstract":"<p><strong>Background: </strong>The concept of early-phase diffuse idiopathic skeletal hyperostosis (EDISH) was recently introduced and its prevalence at the thoracic spine level was revealed. Some cases of EDISH progress to diffuse idiopathic skeletal hyperostosis (DISH) in association with being overweight. The prevalence and distribution of EDISH in the whole spine and related factors are unclear. The purpose of this study is to identify the prevalence and ossification patterns of EDISH, termed EDISH, as well as factors associated with the severity of ossification in a community-dwelling Japanese population.</p><p><strong>Methods: </strong>A cohort study based on an observational health check-up project. The study included 524 participants (215 men and 309 women) from a community health checkup in 2021. Each participant underwent lateral whole spine radiography for evaluation of intervertebral ossification and was allocated into one of three groups accordingly: no DISH (NDISH), EDISH, and DISH. We recorded the body composition and laboratory data. Factors associated with ossification were investigated using multivariable regression analysis.</p><p><strong>Results: </strong>The prevalence of EDISH was 5.5 % overall (10.2 % in men and 2.3 % in women). The prevalence of DISH was 7.4 %, and the prevalence was significantly higher in men (P < .001). The center and lower end of ossification were most observed at the lower thoracic level. Age was significantly higher in the EDISH and DISH groups than in the NDISH group. Multivariable analysis revealed that the severity of ossification was associated with the percentage of body fat, insulin-like growth factor-1, adiponectin, and high-density lipoprotein-cholesterol.</p><p><strong>Conclusion: </strong>The overall prevalence of EDISH and DISH was 5.5 % and 7.4 %, respectively, and the prevalence of both conditions was higher in men. Our analysis suggests that the center of ossification was the lower thoracic level, with gradual development. Lipid metabolism may be associated with ossification.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015695","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 randomized controlled trial comparing the outcomes of the modified Stoppa and ilioinguinal approaches in the surgical treatment of acetabular fractures.","authors":"Ajay Sharma, Laxman Choudhary, Akshant Chandel, Satyendra Kumar, Amandeep Bains","doi":"10.1016/j.jos.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.006","url":null,"abstract":"<p><strong>Background: </strong>The Stoppa approach was modified to manage fractures of the anterior column as an alternative to the ilioinguinal approach to reduce complications. A debate persists regarding the superiority of one approach over the other. Therefore, in the present study we performed a randomized controlled trial (RCT) to investigate the following hypotheses: (1) Whether the modified Stoppa approach leads to reduced blood loss, (2) Whether the functional and radiological outcomes with the modified Stoppa approach are superior to those with the ilioinguinal approach, and (3) Whether the complication rates differ between the two approaches.</p><p><strong>Methods: </strong>A total of 92 patients were initially enrolled in the study. After applying exclusion criteria and obtaining informed consent, 60 patients with acetabular fractures were randomly allocated into two groups and underwent internal fixation at our tertiary care hospital using either the ilioinguinal approach or the modified Stoppa approach. Bleeding and surgical time was evaluated intraoperatively. Post-operative evaluation of wound drainage and neurovascular status was done. Post-operative radiographs reduction assessment of reduction was done as per Matta scoring and clinically Merle D'Aubigne score was compared at 12 months. All data were statistically analyzed with non-parametric tests by using SPSS 20.0 software.</p><p><strong>Results: </strong>Among the studied population, 48.3 % cases (21.6 % and 26.7 % with ilioinguinal and modified Stoppa approach, respectively) of all patients exhibited excellent radiological outcomes. Additionally, 33.3 % (15 % with the ilioinguinal approach and 18.3 % with the modified Stoppa approach) achieved an excellent clinical score based on the Merle D'Aubigne criteria at 12 months. However, no significant difference was found between two approaches. Both the approaches offer adequate exposure however; quadrilateral surface is directly visualised with the modified Stoppa approach. Considering two significant findings, i.e., reduced intra-operative blood loss and shorter surgical duration was associated with the modified Stoppa approach.</p><p><strong>Conclusion: </strong>Notably, in the context of the ongoing debate between proponents of these two approaches, our study presents a valuable contribution. Overall, the modified Stoppa approach is a better choice in treating anterior acetabular fractures.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008379","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":"Epidemiology and risk factors of hallux valgus in Japanese population: HAPPI study.","authors":"Masatake Matsuoka, Yasutaka Murahashi, Seiji Kimura, Tomohiro Onodera, Atsushi Teramoto, Akinobu Nishimura, Hideaki Nagamoto, Yuka Kimura, Ken Innami, Ryosuke Nakagawa, Takumi Matsumoto, Kentaro Amaha, Kenichiro Takeshima, Hiroyuki Seki, Masafumi Horie, Ryo Matsunaga, Hirokazu Okada, Myongsu Ha, Masanori Taki, Kuniji Ohara, Noriyuki Kanzaki, Yoshiyuki Takakura, Makoto Hirao, Shigeto Nakazora, Tomoyuki Nakasa, Kenta Saiga, Shinji Imade, Hirofumi Tanaka, Koji Noguchi, Shunsuke Nakamura, Chinatsu Azuma, Yuki Shiko, Yohei Kawasaki, Satoshi Yamaguchi","doi":"10.1016/j.jos.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.004","url":null,"abstract":"<p><strong>Introduction: </strong>Hallux valgus (HV) is a common foot deformity characterized by lateral deviation of the great toe. Despite known associations with gender, age, and footwear, the prevalence of HV and its associated risk factors in Japan remain unclear. We conducted the first-ever prospective population-based cohort study (HAPPI study) in Japan to elucidate the prevalence of HV and identify its associated risk factors.</p><p><strong>Methods: </strong>HAPPI study is a prospective, population-based cohort conducted in Japan from 2020 to 2023. A total of 1499 participants aged 20 and older were included across seven geographic regions in this analysis. HV was objectively assessed using self-photographs, with a hallux valgus angle ≥15° defining the condition. Demographic, clinical, and footwear-related data were collected via questionnaires. Logistic regression analysis identified risk factors, calculating odds ratio (OR) and 95 % confidence interval (CI).</p><p><strong>Results: </strong>The prevalence of HV was 23.5 %, with higher rates in women (31.6 %) than men (13.3 %). Age-specific prevalence rates among women increased from 20.0 % in their 20s to 48.0 % in those aged 80 years or older. Bilateral HV was observed in 12.4 % of participants (5.7 % in men, 17.7 % in women), while unilateral HV was observed in 11.1 % (7.5 % in men, 13.9 % in women). Logistic regression identified significant risk factors, including female gender (OR: 3.2, 95 % CI: 2.4-4.4) and age ≥60 years. High-heeled shoe use in the 20s (OR: 3.3, 95 % CI: 1.2-9.5) and very narrow toe-box shapes (OR: 2.5, 95 % CI: 0.98-6.5) were associated with HV.</p><p><strong>Conclusion: </strong>HAPPI study demonstrated that HV is prevalent in Japan, affecting nearly one in four individuals, with significantly higher rates in women and older adults. Early footwear choices, particularly the use of high-heeled and very narrow toe-box shoes, were strongly associated with HV.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008345","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":"Radiographic evaluation of cervical spondylosis using an elemental grading system in a population-based cohort study of a Japanese mountain village.","authors":"Junichi Yamada, Koji Akeda, Norihiko Takegami, Koki Kawaguchi, Takahiro Hasegawa, Tatsuhiko Fujiwara, Akinobu Nishimura, Akihiro Sudo, Masahiro Hasegawa","doi":"10.1016/j.jos.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.008","url":null,"abstract":"<p><strong>Background: </strong>Cervical spine radiography is a common screening tool for cervical spondylosis with radiographic features, including osteophytes, disc height narrowing, vertebral sclerosis, and spondylolisthesis. The Kellgren-Lawrence classification is widely used for evaluating musculoskeletal radiographs, including spinal radiographs; however, evaluating the individual radiographic features of spondylosis is challenging with this classification. This study aimed to develop an elemental grading system for evaluating cervical spine radiographs and the extent of cervical spondylosis.</p><p><strong>Methods: </strong>In total, 320 participants from a typical Japanese mountain village were included in this study. From the lateral cervical spine radiographs from C2/C3 to C6/C7, radiographic features related to cervical spondylosis were separately graded as 0, 1, or 2 according to the severity of degeneration. The sum of the grades of each radiographic feature at each intervertebral level was designated the intervertebral grade. The average grades of each radiographic feature (osteophytes, disc height narrowing, vertebral sclerosis, and spondylolisthesis), intervertebral grade, and Kellgren-Lawrence classification of the whole cervical spine were defined as 'wOP,' 'wDHN,' 'wVS,' 'wSL,' 'wIG' and 'wKL,' respectively.</p><p><strong>Results: </strong>This elemental grading system showed good inter- and intraobserver reliability, similar to the Kellgren-Lawrence classification. The distribution of grades 1 and 2 in osteophytes, disc height narrowing, and vertebral sclerosis was observed most frequently at the C5/C6 level, followed by the C4/C5 and C6/C7 levels, whereas a significantly higher spondylolisthesis grade than expected was found at C4/C5. Participants with neck pain showed significantly higher wVS (P < 0.05) than those without neck pain, whereas wOP, wDHN, wSL, wIG, and wKL showed no significant differences.</p><p><strong>Conclusions: </strong>We developed a grading system for radiographic cervical spondylosis with high reliability and a simple design, which will contribute to future epidemiological studies in evaluating the extent of degenerative changes on cervical radiographs.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008365","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}