Journal of Orthopaedic Science最新文献

{"title":"Association of cirrhosis severity with outcomes after hip fracture repairs: A propensity-score matched analysis using a large inpatient database","authors":"Osamu Hamada ,&nbsp;Takahiko Tsutsumi ,&nbsp;Ayako Tsunemitsu ,&nbsp;Noriko Sasaki ,&nbsp;Susumu Kunisawa ,&nbsp;Kiyohide Fushimi ,&nbsp;Yuichi Imanaka","doi":"10.1016/j.jos.2025.01.006","DOIUrl":"10.1016/j.jos.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Advanced cirrhosis is associated with increased mortality in certain surgeries, but the impact of cirrhosis severity on outcomes in patients with hip fractures remains unclear.</div></div><div><h3>Methods</h3><div>In a large nationwide administrative database of hospitalized patients, we compared postoperative outcomes in patients with hip fractures across different Child-Pugh classes of cirrhosis in Japan. Using the Japanese Diagnosis Procedure Combination Database, we identified 833,648 eligible patients diagnosed with hip fractures and underwent surgery between July 2010 and March 2021. Three sets of 1:1 propensity-score matching were performed for four groups: non-cirrhosis cases and Child-Pugh classes A, B, and C. We compared in-hospital mortality, length of stay, hospitalization fees, readmission, and complications in non-cirrhosis cases vs. Child-Pugh class A, Child-Pugh class A vs. B, and Child-Pugh class B vs. C.</div></div><div><h3>Results</h3><div>Propensity-score matching created 1065 pairs for non-cirrhosis vs. Child-Pugh class A, 1012 for Child-Pugh class A vs. B, and 489 for Child-Pugh class B vs. C. In-hospital mortality did not differ between non-cirrhosis cases and those with Child-Pugh class A. However, in-hospital mortality was significantly higher in patients with Child-Pugh class B than in those with class A (1.5 % vs. 5.9 %; RD 4.45 %; 95 % CI: 2.79%–6.10 %), and higher in patients with Child-Pugh class C compared with class B (6.3 % vs. 28.4 %; RD 22.09 %; 95 % CI: 17.54%–26.63 %). Patients in more severe Child-Pugh classes had longer hospital stays, higher hospitalization fees, and higher complication rates.</div></div><div><h3>Conclusion</h3><div>Patients with hip fractures and cirrhosis who are at high risk of poor postoperative outcomes could be identified. This study highlights the significantly higher in-hospital mortality observed in patients with Child-Pugh class C cirrhosis undergoing hip fracture surgery compared to those with class B. These findings underscore the need for careful risk-benefit discussions, considering the severity of cirrhosis, surgical risks, and care goals for each patient.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 933-940"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468567","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":"Effect of the suture augmentation on the stability and strength of ulnar collateral ligament reconstruction: The anchor and bone tunnel methods","authors":"Kenta Inagaki,&nbsp;Nobuyasu Ochiai,&nbsp;Eiko Hashimoto,&nbsp;Yu Hiraoka,&nbsp;Fumiya Hattori,&nbsp;Seiji Ohtori","doi":"10.1016/j.jos.2024.10.014","DOIUrl":"10.1016/j.jos.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div><span>The initial fixation strength of the ulnar collateral ligament (UCL) reconstruction is increased by combining a suture augmentation (SA). However, no reports have investigated the stability of UCL reconstruction with SA across multiple elbow flexion angles and the influence of SA on the stability and failure strength of the anchor and bone tunnel methods. This study aimed to compare the displacement against a </span>valgus load at multiple elbow flexion angles of the anchor and bone tunnel methods between with and without SA, and to compare the failure strength between these methods with SA. We hypothesized that the combination of SA reduced the displacement, and the failure strength was comparable between the anchor and Ito methods with SA.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric upper extremities were used. To evaluate the displacement against valgus load, the valgus stability tests at multiple flexion angles were performed for four UCL reconstruction methods: anchor method, anchor with SA, bone tunnel, and bone tunnel with SA. The load-to-failure test was performed to evaluate the failure strength of the anchor and bone tunnel methods with SA. <em>P</em> &lt; 0.05 was considered significant in tests of statistical inference.</div></div><div><h3>Results</h3><div>The displacements of the anchor method with SA at 30°, 60°, and 90° of flexion were significantly smaller than those without SA. Regarding comparing the bone tunnel method with and without SA, a significant difference was observed at only 30° of flexion. There was no significant difference in the failure strength between the anchor and bone tunnel methods with SA.</div></div><div><h3>Conclusion</h3><div>The combination of SA reduced the displacement against a valgus load at multiple flexion angles, and the failure strength was comparable between the anchor and bone tunnel methods with SA. Combining SA may increase the initial fixation strength in both the anchor and bone tunnel methods.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 791-797"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639287","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":"The influence of age, biological sex, anthropometrics, and neck characteristics on external occipital protuberance size","authors":"Caleb Burruss ,&nbsp;Anita Vasavada ,&nbsp;Claire Terhune ,&nbsp;Kaitlin Gallagher","doi":"10.1016/j.jos.2024.10.013","DOIUrl":"10.1016/j.jos.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>40–45 % of the population presents with enlarged external occipital protuberances (EEOPs), which can lead to pain. EEOP occurrence is higher in younger males; however, the reason is debated. We used plane lateral radiographs to investigate how anthropometrics<span>, age, biological sex, head and neck kinematics, and neck strength differ between those with and without an EEOP.</span></div></div><div><h3>Methods</h3><div>Data was compiled across four study samples, which included lateral radiographs taken in a neutral neck posture (n = 102, 50% females). An enlarged EOP was defined as being longer than 10 mm, and this threshold was used to classify participants as having a presence or absence of an EEOP. Statistical analyses were used to compare outcome measures between those with and without an EEOP presence for age, biological sex, skull angle, intervertebral joint angle (C1-C2 through C6-C7), and neck strength (flexion and extension).</div></div><div><h3>Results</h3><div>Twenty-four percent of participants (19 males and five females, <em>p</em> = 00.002 for biological sex differences) presented with an EEOP; only one was over 30 years old. There were no significant main effects on the skull and intervertebral joint angles, participant anthropometrics, or neck strength.</div></div><div><h3>Conclusions</h3><div>This study confirmed that enlarged EOPs are more prevalent in males; however, neck posture and other anthropometrics do not differ with the presence or absence of an EEOP.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 748-754"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622439","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":"The single-leg stand-up test as a simple and effective tool for assessing motor function in children -KID locomo study-","authors":"Yusuke Kido ,&nbsp;Masatoshi Teraguchi ,&nbsp;Kanae Mure ,&nbsp;Takahide Sasaki ,&nbsp;Yoshiki Asai ,&nbsp;Makiko Onishi ,&nbsp;Takashi Shimoe ,&nbsp;Nobuyuki Miyai ,&nbsp;Hiroshi Hashizume ,&nbsp;Hiroshi Yamada","doi":"10.1016/j.jos.2025.01.004","DOIUrl":"10.1016/j.jos.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Early detection of motor function issues in children is crucial for timely interventions and prevention of long-term health problems. We evaluated the effectiveness of the Kodomo Locomo check and the Single-Leg Stand-Up Test (SLSUT) in assessing motor function in children, using the standardized New Physical Fitness Test as a reference measure.</div></div><div><h3>Methods</h3><div>This cross-sectional study involved 871 children (436 boys, 435 girls) aged 6–15 years from rural Japan. Participants underwent the Kodomo Locomo check, the SLSUT, and the New Physical Fitness Test. We analyzed correlations between these assessments using Spearman's rank correlation coefficient and ordinal logistic regression.</div></div><div><h3>Results</h3><div>The Kodomo Locomo check identified 26.4 % of participants as having potential motor function issues, with significant sex differences (33.7 % boys, 19.1 % girls, <em>p</em> &lt; 0.001). The SLSUT demonstrated moderate correlations with New Physical Fitness Test grades (ρ = 0.48 for boys, ρ = 0.46 for girls, <em>p</em> &lt; 0.001), and the Kodomo Locomo check showed weak correlations (ρ = 0.22 for boys, ρ = 0.28 for girls, <em>p</em> &lt; 0.001). Ordinal logistic regression analysis revealed that for every 10 cm increase in SLSUT height, the odds of being in a lower grade category in the New Physical Fitness Test were approximately two times higher for both sexes (OR 2.08, 95 % CI: 1.82–2.38 for boys; OR 2.00, 95 % CI: 1.75–2.27 for girls, <em>p</em> &lt; 0.001 for both).</div></div><div><h3>Conclusions</h3><div>The SLSUT was shown to have a moderate correlation with overall physical fitness, suggesting its potential as a comprehensive tool for assessing motor function in children. The Kodomo Locomo check, while useful in initial screening, had significant sex-based discrepancies in rates of positivity, potentially causing bias in motor function assessments. Both tests are indicated to have potential in complementary roles in pediatric motor function assessment. Further research will seek to establish age- and sex-specific norms for the SLSUT and investigate the longitudinal predictive value.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 954-961"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515938","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":"Comment on Yang et al.: Stress and strain changes of the anterior cruciate ligament at different knee flexion angles: A three-dimensional finite element study","authors":"Ahmad Furqan Anjum,&nbsp;Muhammad Burhan Anjum,&nbsp;Raza ur Rehman Rana","doi":"10.1016/j.jos.2024.12.010","DOIUrl":"10.1016/j.jos.2024.12.010","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 976-978"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528503","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":"Hounsfield unit values are a better predictor than DXA T-score for adjacent vertebral fracture following balloon kyphoplasty","authors":"Koji Matsumoto ,&nbsp;Masahiro Hoshino ,&nbsp;Hirokatsu Sawada ,&nbsp;Sosuke Saito ,&nbsp;Tomohiro Furutya ,&nbsp;Yuya Miyanaga ,&nbsp;Kazuyoshi Nakanishi","doi":"10.1016/j.jos.2025.01.003","DOIUrl":"10.1016/j.jos.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Hounsfield unit values (HU) are known to correlate with dual-energy X-ray absorptiometry (DXA), and they are gaining attention as a new method for assessing Bone mineral density (BMD) that is not affected by the limitations of DXA, such as degeneration, scoliosis<span><span>, and vascular calcification<span>. The purpose of this study was to compare the efficacy of HU and DXA T-scores in predicting adjacent vertebral fractures<span> (AVF) following balloon kyphoplasty (BKP) using the same </span></span></span>computed tomography and DXA at one institution.</span></div></div><div><h3>Methods</h3><div><span>The study included 84 cases (20 males, 64 females, mean age 79.3 ± 6.9) who underwent BKP for osteoporotic vertebral fractures. Cases were divided into two groups based on the presence or </span>absence<span><span> of AVF within 2 months postoperatively. BMD assessment included DXA T-scores (lumbar spine, hip, the lowest), HU of the fractured adjacent vertebra (adjacent-HU) and HU of the L1 vertebra (L1-HU). </span>Logistic regression analysis was performed to identify risk factors for AVF, and the accuracy of AVF prediction was evaluated using the area under the receiver operating characteristics curve (AUC).</span></div></div><div><h3>Results</h3><div>AVF occurred in 23 of the 84 cases (27.4 %) within 2 months postoperatively. In the logistic regression analysis, T-score was not identified as an independent risk factor, but L1-HU was identified as an independent risk factor for AVF (odds ratio: 0.982, P = 0.044∗). The AUC for predicting AVF was 0.515, 0.568, and 0.510 for T-score (lumbar spine, hip, the lowest), and 0.551 for adjacent-HU. The highest AUC was observed for L1-HU at 0.629 (95 % confidence interval 0.495–0.764).</div></div><div><h3>Conclusions</h3><div>In the risk assessment of AVF, L1-HU was a better evaluation method than DXA T-score.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 785-790"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007297","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":"Enhancing gait mechanics: The effectiveness of a novel walking aid","authors":"Yuyu Ishimoto,&nbsp;Satoshi Arita,&nbsp;Hiroshi Yamada","doi":"10.1016/j.jos.2024.12.006","DOIUrl":"10.1016/j.jos.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>A walking support orthosis known as the e-foot®, a rubber orthotic<span> worn from the hip to the forefoot to enhance joint flexibility and movement, has been developed to assist elderly people and individuals with walking impairments. Despite its widespread acceptance and positive reception in some care settings, the precise impact of this device on gait dynamics remains unexplored. This study aims to bridge this gap by comparing the walking speeds of healthy volunteers using the e-foot® against their normal walking speeds. Furthermore, it seeks to elucidate the biomechanical alterations induced by the e-foot® on their gait patterns.</span></div></div><div><h3>Methods</h3><div>In this intervention study, 78 healthy volunteers underwent a 10-m walk test, both with and without the e-foot®, to measure its effect on walking speed. Gait changes were biomechanically compared by analyzing marker positions and accelerations of the lower extremities during the walk tests.</div></div><div><h3>Results</h3><div><span>The e-foot® orthotic device significantly improved walking times for both men and women in the 10-m walk test. Biomechanical testing showed a consistent trend of higher marker positions of the knees, heels, and </span>toes when participants were using the e-foot®. Additionally, marker acceleration during the first half of the swing phase was greater with the e-foot®, indicating a faster gait initiation.</div></div><div><h3>Conclusions</h3><div>The e-foot® increased the walking speed of healthy volunteers. Also, there were changes to knee, heel and toe positions during gait, and comparative increase in acceleration was recorded in these three parts during swinging gait.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 863-867"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950576","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":"Effectiveness of ultra-early balloon kyphoplasty at one year after osteoporotic vertebral fracture","authors":"Masatoshi Teraguchi ,&nbsp;Yukihiro Nakagawa ,&nbsp;Tomohiro Nakatani ,&nbsp;Masakazu Minetama ,&nbsp;Yoshio Enyo ,&nbsp;Takahiro Maeda ,&nbsp;Ryo Taiji ,&nbsp;Takahide Sasaki ,&nbsp;Yoshio Yamamoto ,&nbsp;Masafumi Nakagawa ,&nbsp;Hiroshi Yamada","doi":"10.1016/j.jos.2024.11.005","DOIUrl":"10.1016/j.jos.2024.11.005","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Balloon kyphoplasty (BKP) for osteoporotic </span>vertebral fracture<span> (OVF) has been reported to maintain quality of life<span><span> (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 </span>activities of daily living (ADL) one year after surgery.</span></span></div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 &lt; 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 &lt; 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 &lt; 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 &lt; 0.05). ODI scores in ultra-early group also showed greater recover compared to the conventional group (p &lt; 0.005).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 780-784"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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":"Comparison of dynamic compression plate systems with oblique osteotomy and locking plate fixation versus transverse osteotomy and non-locking plate fixation for ulnar shortening osteotomy","authors":"Yusuke Miyashima ,&nbsp;Takuya Uemura ,&nbsp;Mitsuhiro Okada ,&nbsp;Kosuke Saito ,&nbsp;Hiroaki Nakamura","doi":"10.1016/j.jos.2024.11.007","DOIUrl":"10.1016/j.jos.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Ulnar shortening osteotomy<span> (USO) is a well-established surgical technique for ulnar impaction syndrome and triangular fibrocartilage<span> complex injuries, but complications like delayed union<span> and nonunion are often encountered. Transverse and oblique osteotomy techniques are commonly used, yet direct comparisons using advanced implants are limited. This study aims to compare the clinical and radiological outcomes of USO using the Jplate with a transverse osteotomy device and the APTUS Wrist Ulna Shortening System 2.5 with an oblique osteotomy device.</span></span></span></div></div><div><h3>Methods</h3><div><span>We retrospectively reviewed 37 patients who underwent USO (15 and 22 treated with the Jplate and APTUS systems, respectively) from July 2009 to October 2022. Clinical outcomes were measured using the visual analog scale (VAS), grip strength, range of motion, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and Hand20 scores. Radiological outcomes included time to </span>bone union<span>, delayed union, and nonunion rates. Statistical analyses involved Mann-Whitney and Kruskal-Wallis tests and multivariable linear regression models adjusted for age, sex, and smoking status.</span></div></div><div><h3>Results</h3><div>Time to union was faster in the APTUS group compared to the Jplate group, with a significantly higher delayed union rate in the Jplate group than in the APTUS group. Postoperative pain reduction was significantly greater in the APTUS group compared to the Jplate group. Improvements in Hand20 scores were also significantly higher in the APTUS group compared to the Jplate group. Multivariable regression analyses confirmed that the APTUS system significantly shortened time to union and improved VAS and Hand20 scores.</div></div><div><h3>Conclusions</h3><div>The APTUS system provides superior clinical and radiological outcomes compared to the Jplate, with significant reductions in delayed union rates and postoperative pain and earlier bone healing. This system enables oblique osteotomy and compression of the osteotomy site with a single device, which may have contributed to the observed differences in our study.</div></div><div><h3>Level of evidence</h3><div>Level 4.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 5","pages":"Pages 798-804"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807431","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":"Inflammatory biomarkers predict Cutibacterium acnes detection at the portal area during arthroscopic shoulder surgery.","authors":"Kazuya Uehara, Kiminori Yukata, Takashi Imagama, Shunya Tsuji, Yosuke Yamashita, Kenzo Fujii, Atsushi Mihara, Ryuta Iwanaga, Tetsuya Seto, Masataka Asagiri, Hiroshi Fujii, Takashi Sakai","doi":"10.1016/j.jos.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.003","url":null,"abstract":"<p><strong>Background: </strong>Cutibacterium acnes (C. acnes), a gram-positive bacterium commonly found in the pilosebaceous glands of the shoulder, represents a significant source of infection following shoulder surgery. Identifying patients at higher risk for bacterial contamination prior to surgery could facilitate the implementation of enhanced prophylactic measures. The objective of this study was to identify biomarkers and related factors that predict the detection of C. acnes at the portal of arthroscopic shoulder surgery.</p><p><strong>Methods: </strong>This study included 110 patients undergoing arthroscopic shoulder surgery. Swab cultures were obtained from the arthroscopic portal approximately 1 h post-creation to assess for the presence of C. acnes. Preoperative inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR), were evaluated in relation to bacterial detection.</p><p><strong>Results: </strong>C. acnes was identified in 18.2 % of patients, with all positive cases exclusively observed in male patients. Both NLR and MLR were significantly elevated in patients with positive C. acnes cultures. Receiver operating characteristic (ROC) curve analysis identified optimal threshold values of 1.73 for NLR and 0.17 for MLR in predicting C. acnes detection.</p><p><strong>Conclusion: </strong>Elevated preoperative NLR and MLR are associated with the intraoperative detection of C. acnes at the arthroscopic portal site. These readily available biomarkers may help identify patients at increased risk for bacterial contamination, informing preoperative prophylactic protocols.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958462","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}