Journal of Orthopaedic Science最新文献

{"title":"Factors influencing the achievement of early surgery in proximal femoral fractures under a Japanese incentive policy","authors":"Yutoku Yamada ,&nbsp;Toshiaki Kotani ,&nbsp;Shunji Kishida ,&nbsp;Yosuke Ogata ,&nbsp;Shun Okuwaki ,&nbsp;Shuhei Ohyama ,&nbsp;Shuhei Iwata ,&nbsp;Yasushi Iijima ,&nbsp;Shohei Ise ,&nbsp;Tsuyoshi Sakuma ,&nbsp;Keisuke Ueno ,&nbsp;Daisuke Kajiwara ,&nbsp;Risa Moriyasu ,&nbsp;Takako Nakajima ,&nbsp;Shohei Minami ,&nbsp;Eiko Hashimoto ,&nbsp;Nobuyasu Ochiai ,&nbsp;Seiji Ohtori","doi":"10.1016/j.jos.2024.08.001","DOIUrl":"10.1016/j.jos.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Proximal femoral fractures in geriatric patients are a major challenge in orthopedics, often leading to major functional impairment. Early surgical intervention is crucial for improving patient recovery and overall health outcomes. Thus, Japan's Ministry of Health, Labour and Welfare initiated a reimbursement policy in April 2022 to encourage early surgery for these fractures in patients aged ≥75 years. This study investigated the impact of this policy on early surgery rates in Japan and identified factors influencing the timing of surgical interventions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of patients who underwent surgery for proximal femoral fractures at our institution between April 2022 and March 2023. Patients were categorized into two groups based on the timing of surgery relative to the injury: ≤48 h and &gt;48 h. Demographic and clinical data, including age, sex, fracture type, and various health- and admission-related factors, were assessed.</div></div><div><h3>Results</h3><div>Of the 192 patients, 152 were included in the study. Among them, 38% underwent early surgery (≤48 h), and 15% of the patients arrived more than 48 h post-injury. Significant differences were found in admission routes and residence types between the groups. The ≤48 h group had shorter intervals from injury to admission and surgery than the &gt;48 h group. Factors such as the admission process, day of the week, and C-reactive protein levels significantly influenced the timing of surgery.</div></div><div><h3>Conclusions</h3><div>After introducing incentives for early surgery in Japan, 38% of patients with proximal femoral fractures underwent surgery within 48 h of injury. Factors contributing to patients not receiving early surgery included transport from another hospital, weekend hospitalization, and elevated CRP levels. These findings suggest that achieving surgery within 48 h of injury is challenging through hospital efforts alone, and the time criteria might be more appropriate if changed to “admission to surgery.”</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 518-522"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080632","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":"PNI is useful for predicting the prognosis of patients with soft tissue sarcoma: A retrospective study","authors":"Keiju Saito ,&nbsp;Yusuke Kawabata ,&nbsp;Ikuma Kato ,&nbsp;Satoru Shinoda ,&nbsp;Kenta Hayashida ,&nbsp;Shintaro Fujita ,&nbsp;Tomotaka Yoshida ,&nbsp;Hyonmin Choe ,&nbsp;Masanobu Takeyama ,&nbsp;Yutaka Inaba","doi":"10.1016/j.jos.2024.08.005","DOIUrl":"10.1016/j.jos.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>It is known that preoperative Prognostic Nutritional Index (PNI) is useful in predicting prognosis in gastrointestinal diseases and that preoperative improvement of nutritional status improves prognosis. However, there have been few large-scale reports examining the prognostic value of PNI in soft tissue sarcomas. Therefore, the aim of this study is to investigate whether the PNI can be useful for predicting overall survival in soft tissue sarcoma.</div></div><div><h3>Methods</h3><div>Between January 2006 and March 2022 at our hospital, 111 patients with pathologically diagnosed soft tissue sarcoma were included, retrospectively. Several nutritional or inflammatory biomarkers such as PNI were calculated from the pretreatment blood sample results. The patients were classified into two groups (low and high groups) based on the median value of each parameter. Overall survival was analyzed by the Kaplan‒Meier method and log-rank test. Univariate and multivariate analyses using the Cox proportional hazards model were used to investigate prognostic factors for overall survival.</div></div><div><h3>Results</h3><div>The median overall survival was 24.3 months (mean 37.3 months), and the high PNI group had a significantly longer overall survival than the low PNI group (p &lt; 0.0001). PNI was the most significant univariate factor for overall survival among other nutritional and inflammatory parameters (HR: 5.64, 95% CI: 2.26–14.12, p = 0.0002). The multivariate proportional hazards model was built using variables with prognostic potential as suggested by previous analysis with respect to patient characteristics and PNI. As potential confounding factors, we included PNI, stage, age, and tumor location. PNI was also an independent prognostic factor in multivariate analysis (HR: 7.02, CI: 2.52–19.40, p = 0.0002).</div></div><div><h3>Conclusion</h3><div>PNI is a useful prognostic factor among various parameters for overall survival in patients with soft tissue sarcoma.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 535-541"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256967","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 the increase in the number of total hip arthroplasties in Japan due to an aging society?","authors":"Maho Tsuchiya ,&nbsp;Kensuke Fukushima ,&nbsp;Yoshihisa Ohashi ,&nbsp;Noritaka Mamorita ,&nbsp;Hiroki Saito ,&nbsp;Kentaro Uchida ,&nbsp;Katsufumi Uchiyama ,&nbsp;Naonobu Takahira ,&nbsp;Masashi Takaso","doi":"10.1016/j.jos.2024.06.008","DOIUrl":"10.1016/j.jos.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><div>The number of total hip arthroplasty<span> (THA) is increasing globally, including Japan. The Japanese Orthopaedic Association has been conducting a registry of joint replacement surgery, but there may be a gap between the reported numbers of THA in the registry and the actual number. This study aimed to investigate the exact number of THA and assess the trends in Japan using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).</span></div></div><div><h3>Methods</h3><div>We downloaded data from 2014 to 2019 from the NDB Open Data. Data on primary THA were extracted, and we calculated the annual number and number for each 10-year age group and sex. We also compared the number and trends between elderly and non-elderly groups.</div></div><div><h3>Results</h3><div>During the study period, number of THAs increased by approximately 20,000, showing a continuous upward trend. The highest number of THAs were performed on patients in their 60s, except for the years 2014 and 2019. Comparison of the numbers in 2014 and 2019 by age group showed an increase in the number in patients in their 90s (by 2.05 times). There were significantly a greater number of elderly patients (P &lt; 0.001). The number of THAs performed was higher in women than in men (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The number of THAs in Japan increased substantially from 2014 to 2019, despite a decrease in population. Significantly higher number of THAs were performed on elderly patients in Japan, which might be due to an aging society. The NDB data is highly valuable for epidemiological research in Japan, as it might enable the early detection of issues occurring during THA, facilitating their prompt integration into daily clinical practice.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 451-455"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492363","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":"Proprioceptive and clinical outcomes of anterior cruciate ligament reconstruction with remnant tissue preservation technique: A comparison according to the preserved tissue length","authors":"Hasan Bombacı ,&nbsp;Buğra Başalan ,&nbsp;Özgül Öztürk ,&nbsp;Onur Aydoğdu ,&nbsp;Muhammet Karaaslan ,&nbsp;Zübeyir Sarı","doi":"10.1016/j.jos.2024.07.009","DOIUrl":"10.1016/j.jos.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>No consensus is obtained regarding the effects of remnant-preserving ACL reconstruction on long-term clinical and proprioceptive outcomes. This study aimed to compare proprioceptive and clinical outcomes of the knee joint after ACL reconstruction with two different lengths of preserved remnant tissue.</div></div><div><h3>Methods</h3><div>This study included 61 patients who underwent single-bundle ACL reconstruction with remnant preservation method using hamstring autograft, divided into two groups according to the length of the remnant tissue. Group ≤33% included subjects with equal and less than 1/3 of the remnant preserved (n = 30) and group &gt;33% included subjects with more than 1/3 of the remnant preserved (n = 31). Proprioception was evaluated at 20°, 50°, and 70° knee angles. Clinical outcome measures included Tegner activity scale, Lysholm knee score, single-leg-hop test, and muscle strength of quadriceps femoris and hamstring muscles which was evaluated using Biodex dynamometer. Anterior laxity was determined with a KT2000 arthrometer. A statistical comparison of the assessments was performed.</div></div><div><h3>Results</h3><div>The mean follow-up time after surgery were 28.33 and 33.67 months for group ≤33% and &gt;33%, respectively. No significant differences were detected for Lysholm and Tegner scores between the groups (p &gt; 0.05). Additionally, proprioception and muscle strength values displayed similarity between the groups (p &gt; 0.05). The length of the remnant tissue did not affect post-operative knee stability (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Patients who underwent remnant-preserving ACL reconstruction obtained similar proprioceptive function, muscle strength, anterior stability, and clinical results regardless of the amount of preserved tissue length at short-term assessment.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 486-491"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917004","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":"Association between smoking and duration of regional anesthesia – A propensity score matching study","authors":"Yuichiro Machiyama ,&nbsp;Takahisa Ogawa ,&nbsp;Tomoji Matsuo ,&nbsp;Jacqueline Sim ,&nbsp;Jun Takeda ,&nbsp;So Kameda ,&nbsp;Itaru Morohashi ,&nbsp;Ryo Onuma ,&nbsp;Toshitaka Yoshii ,&nbsp;Atsushi Okawa ,&nbsp;Muneaki Ishijima","doi":"10.1016/j.jos.2024.06.012","DOIUrl":"10.1016/j.jos.2024.06.012","url":null,"abstract":"<div><h3>Background</h3><div><span>Previous studies have shown shorter duration of general anesthesia in smokers but it is unclear in </span>regional anesthesia among smokers. We investigated the association between smoking status and the duration of regional anesthesia.</div></div><div><h3>Methods</h3><div>A total of 77 patients with a mean age of 47.3 years who underwent lower extremity orthopaedic surgery under regional anesthesia between January 2021 and June 2022 were enrolled. Sixteen patients were smokers and 57 patients were non-smokers. Propensity score matching<span> was performed to balance patient characteristics. Our primary outcome was the time to onset of motor or sensory blockade and the duration required for full recovery of motor or sensory function.</span></div></div><div><h3>Results</h3><div>The time to sensory loss was 43.4 (SD 35.9) minutes in the smoking group and 39.6 (SD 31.7) minutes in the non-smoking group (p = 0.69), and the time to motor blockade was 37.0 (SD 28.4) minutes in the smoking group and 30.1 (SD 24.1) minutes in the non-smoking group (p = 0.35). The time for recovery of sensory function was 1146.7 (SD 197.8) minutes in the smoking group and 1024.6 (SD 177.9) minutes in the non-smoking group (p = 0.024). The time to recovery of motor function was 978.3 (SD 220.5) minutes in the smoking group and 1090.9 (SD 222.8) minutes in the non-smoking group (p = 0.08). The duration of sensory effect was significantly longer in the smoking group than in the non-smoking group.</div></div><div><h3>Conclusions</h3><div>We found no significant association in the onset of regional anesthesia, but the duration of sensory blockade was significantly longer in the smoking group than in the non-smoking group. Hence, attention should be paid to the risks of the insensate limb in smokers due to prolonged sensory blockade as compared to non-smokers, rather than be concerned about delays in the onset of anesthesia.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 560-564"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603722","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 a standard (GPT-4o) and reasoning-enhanced (o1 pro) large language model on complex clinical questions from the Japanese orthopaedic board examination","authors":"Joe Hasei ,&nbsp;Ryuichi Nakahara ,&nbsp;Koichi Takeuchi ,&nbsp;Aki Yoshida ,&nbsp;Takuto Itano ,&nbsp;Tomohiro Fujiwara ,&nbsp;Eiji Nakata ,&nbsp;Toshiyuki Kunisada ,&nbsp;Toshifumi Ozaki","doi":"10.1016/j.jos.2025.03.005","DOIUrl":"10.1016/j.jos.2025.03.005","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 565-568"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772556","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 causal association between serum vitamin D levels and intervertebral disc degeneration: A mendelian randomization study","authors":"Libangxi Liu ,&nbsp;Chao Sun ,&nbsp;Biwang Huang ,&nbsp;Dongdong Zhao ,&nbsp;Chengjie Xiong ,&nbsp;Feng Xu ,&nbsp;Tanjun Wei","doi":"10.1016/j.jos.2024.07.001","DOIUrl":"10.1016/j.jos.2024.07.001","url":null,"abstract":"<div><h3>Objectives</h3><div><span><span>Intervertebral disc degeneration (IDD) is a prevalent </span>musculoskeletal disorder with substantial implications for disability and healthcare expenditures. The role of serum </span>vitamin D<span> (25-Hydroxyvitamin D, 25(OH)D) levels in the pathogenesis of various musculoskeletal conditions has been explored in prior observational studies, suggesting a potential association. While previous observational studies have suggested an association between the two conditions, it might confound the effect of 25(OH)D on IDD. This Mendelian randomization (MR) study seeks to elucidate the causal relationship between 25(OH)D and IDD.</span></div></div><div><h3>Methods</h3><div><span>We performed a MR analysis using summary-level data from genome-wide association studies (GWAS) of 25(OH)D (sample size = 441,291 European) and IDD (sample size = 336,439 (cases = 41,669, controls = 294,770) European). Single nucleotide polymorphisms (SNPs) significantly associated with 25(OH)D (p &lt; 5 × 10</span>⁻⁸<span>) were selected as instrumental variables. The associations between genetically predicted 25(OH)D and IDD were estimated using the inverse-variance weighted (IVW) method, with sensitivity analyses employing the weighted median, MR-Egger, and MR-PRESSO approaches to assess the robustness of the findings.</span></div></div><div><h3>Results</h3><div>In the primary IVW analysis, genetically predicted 25(OH)D was unrelated associated with IDD (odds ratio (OR) = 0.9671, 95% confidence interval (CI): 0.8956–1.0444, p = 0.39). The results remained consistent across the sensitivity analyses, and no significant directional pleiotropy was detected (MR-Egger intercept: p = 0.64).</div></div><div><h3>Conclusions</h3><div>This study found no obvious evidence that 25(OH)D is causally associated with IDD risks. We call for larger sample size studies to further unravel the potential causal relationship and the exact mechanism.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 433-439"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734454","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":"Does total hip arthroplasty in elderly patients with femoral neck fractures reduce complications? A Japanese DPC study","authors":"Yu Mori ,&nbsp;Kunio Tarasawa ,&nbsp;Hidetatsu Tanaka ,&nbsp;Naoko Mori ,&nbsp;Kiyohide Fushimi ,&nbsp;Kenji Fujimori ,&nbsp;Toshimi Aizawa","doi":"10.1016/j.jos.2024.06.011","DOIUrl":"10.1016/j.jos.2024.06.011","url":null,"abstract":"<div><h3>Background</h3><div>The global increase in femoral neck fractures due to aging and osteoporosis is a major clinical challenge. The debate on the optimal surgical intervention for femoral neck fractures remains unresolved. This large-scale study explores femoral neck fractures among the elderly, focusing on the comparative outcomes of Total Hip Arthroplasty (THA) versus Bipolar Hemiarthroplasty (BHA) in Japanese patients.</div></div><div><h3>Methods</h3><div>Using the Japanese National Administrative Diagnosis Procedure Combination (DPC) database, we studied cases of femoral neck fracture from April 2016 to March 2023, and after propensity score matching by age, sex, and comorbidities, we examined the association between THA, complications, and clinical outcomes, and the usefulness of THA for elderly patients with femoral neck fracture.</div></div><div><h3>Results</h3><div>One-to-one propensity score matching identified 7741 pairs of THA and BHA cases. There was no difference in length of stay between the THA and BHA groups. Significantly more blood transfusions were required in the THA group. There was no significant difference in mortality between the THA and BHA groups, but there was a reduced risk of pneumonia in the THA group, with a ratio of 0.547 (95% CI: 0.418–0.715). On the other hand, the THA group had a higher risk of pulmonary embolism, with a ratio of 1.607 (95% CI: 1.379–1.874). The THA group shows improved discharge rates directly home from the facility where the operation was performed, with a ratio of 1.798 (95% CI: 1.675–1.929).</div></div><div><h3>Conclusion</h3><div>The findings of this research indicate that THA is more effective than BHA in enabling elderly Japanese patients with femoral neck fractures to be discharged directly home and in preventing pneumonia, despite concerns about pulmonary embolism. These findings suggest that THA may improve functional prognosis in elderly patients with femoral neck fractures, although there is a trade-off with an increased risk of pulmonary embolism.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 3","pages":"Pages 507-512"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492362","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 look back at lumbar spinal stenosis cases in older adults during the COVID-19 pandemic.","authors":"Yuki Akaike, Soya Kawabata, Takehiro Michikawa, Takaya Imai, Hiroki Takeda, Kei Ito, Sota Nagai, Daiki Ikeda, Shinjiro Kaneko, Nobuyuki Fujita","doi":"10.1016/j.jos.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.jos.2025.04.007","url":null,"abstract":"<p><strong>Background: </strong>The management of elective surgeries during the COVID-19 pandemic was controversial, and the impact on lumbar spinal stenosis (LSS) surgery outcomes remains unclear. This study aimed to retrospectively analyze older adults who underwent LSS surgery during the pandemic and compare cases from its early and late phases.</p><p><strong>Methods: </strong>Medical records of patients aged 65 and older who underwent LSS surgery between April 2020 and April 2023 were reviewed. The Zurich Claudication Questionnaire and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were administered preoperatively and at 6 months and 1 year postoperatively.</p><p><strong>Results: </strong>The period from April 2020 to September 2021 was classified as the early phase, while October 2021 to April 2023 was classified as the late phase. This study evaluated a total of 267 older patients with LSS, with 138 undergoing surgery during the early phase and 129 during the late phase. There was one case of COVID-19 infection during hospitalization in the early phase and none in the late phase. Significant differences were found between the early and late phases in the distribution of American Society of Anesthesiologists physical status (ASA) and frequency of degenerative lumbar scoliosis (DLS). When the association between the COVID-19 pandemic phase and effective case of surgery treatment on JOABPEQ was examined, the multivariable adjusted relative risks of effective case in social life domain for the late-stage group were 0.7 (95 % CI = 0.5-0.9) at both 6 months and 1 year postoperatively using the early-phase group as the reference. No significant differences were found in the other four domains at either 6 months or 1 year postoperatively.</p><p><strong>Conclusions: </strong>Poorer social life outcomes in the late-phase patients with LSS surgery may be attributed to worse preoperative ASA scores and changes in social life during different pandemic phases.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020700","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":"Morphological characteristics of the flexor hallucis longus groove and tendon quality in patients with hallux rigidus: A CT-based study.","authors":"Dan Moriwaki, Tomoyuki Nakasa, Yasunari Ikuta, Shingo Kawabata, Satoru Sakurai, Saori Ishibashi, Munekazu Kanemitsu, Nobuo Adachi","doi":"10.1016/j.jos.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.jos.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>The etiology of hallux rigidus is still unknown and elucidating targeted factors to prevent hallux rigidus or improve treatment outcomes is essential. An association between flexor hallucis longus (FHL) tendon tightness and hallux rigidus development has been suspected; however, the characteristics of the FHL tendon in the hallux rigidus remain unclear. This study aimed to explore the quality of the FHL tendon and the morphological characteristics of the FHL tendon groove at the talus and sustentaculum tali in the pathogenesis of hallux rigidus.</p><p><strong>Methods: </strong>Twenty-one feet with hallux rigidus and 15 feet without hallux rigidus were retrospectively reviewed. The ratio of the FHL tendon groove depth to the FHL tendon anteroposterior diameter (groove/tendon ratio), Hounsfield unit (HU) values of the cancellous bone below the FHL tendon groove to those of the navicular (groove HU ratio) were measured using computed tomography at the talus and sustentaculum tali. The ratio of HU values inside the FHL tendon to those inside the tibialis anterior tendon (tendon HU ratio) were measured at the FHL tendon groove of the talus, that of the sustentaculum tali, and below the sesamoids.</p><p><strong>Results: </strong>The depth of the FHL tendon groove, groove/tendon ratio, and groove HU ratio were significantly larger in the hallux rigidus group; the FHL tendons of the hallux rigidus group were deeply fitted into the FHL groove than those of the control group. The tendon HU ratio was significantly smaller in the hallux rigidus group.</p><p><strong>Conclusions: </strong>The FHL tendon in the hallux rigidus can be more constrained at the FHL groove of the talus and sustentaculum tali, and its quality can change compared to that in healthy feet. Tightness of the FHL tendon should be considered when treating hallux rigidus.</p><p><strong>Level of evidence: </strong>Ⅲ.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016655","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}