Journal of Orthopaedic Science最新文献

{"title":"Humero-ulnar external fixation of pediatric supracondylar humeral fractures using an adult wrist external fixator.","authors":"Takeshi Ogawa, Sho Iwabuchi, Ryosuke Tsutsumi, Fumihiko Eto, Akira Ikumi, Yuichi Yoshii","doi":"10.1016/j.jos.2026.02.014","DOIUrl":"https://doi.org/10.1016/j.jos.2026.02.014","url":null,"abstract":"<p><strong>Background: </strong>Although cross-pinning is widely used to treat pediatric supracondylar humeral fractures, it involves risks of nerve injury, malunion, and compartment syndrome. In this two-center retrospective observational study, we compared the outcomes of humero-ulnar external fixation using an adult wrist fixator with those of conventional pinning for pediatric supracondylar humeral fractures. Given the technical complexity of Slongo lateral external fixation, we evaluated a simpler joint-spanning external fixation method.</p><p><strong>Methods: </strong>This study enrolled 37 children: 19 treated with pinning between 2010 and 2017, and 18 treated with external fixation from 2018 onwards at two hospitals. All patients were followed up for at least 12 months. Clinical outcomes were assessed using Flynn's criteria. The Baumann, tilting, and carrying angles were measured.</p><p><strong>Results: </strong>Patient backgrounds were comparable between the two groups. External fixation required a significantly longer surgical time (mean 65.3 vs. 38.9 min for pinning); however, postoperative immobilization with a plaster cast was not required. Radiographic parameters were similar between the groups; however, the pinning group demonstrated greater discrepancies in Baumann and tilting angles than the unaffected side. Flynn outcomes were good or excellent in 53 % of pinning cases and 61 % of external fixation cases. Varus deformities were slightly less frequent in patients who underwent external fixation. Complications included pin-site infections (four pinning, one external fixation) and transient preoperative nerve palsy in both groups, which were resolved spontaneously. No new nerve injuries or compartment syndrome occurred.</p><p><strong>Conclusion: </strong>Humeral-ulnar EF provides safe and stable fixation with favorable outcomes and may therefore be a useful option for pediatric supracondylar humeral fractures, particularly in severely displaced cases.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369526","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":"Impact of symptom duration on the effectiveness of intradiscal condoliase injection for lumbar disc herniation: A multicenter retrospective study.","authors":"Kota Watanabe, Yohei Takahashi, Takehiro Michikawa, Takuya Takahashi, Tomohiro Banno, Kyohei Sakaki, Yoshiyasu Arai, Yuichi Takano, Yawara Eguchi, Yuki Taniguchi, Satoshi Maki, Yasuchika Aoki, Shunichi Fujii, Kentaro Sakaeda, Yu Matsukura, Tsutomu Akazawa, Akihito Minamide, Hidetoshi Nojiri, Kenichiro Sakai, Satoshi Kato, Koji Tamai, Hidekazu Suzuki, Masayuki Miyagi, Toshitaka Yoshii, Hiroshi Yamada, Takashi Kaito, Yutaka Hiraizumi, Masatsune Yamagata, Masaya Nakamura, Naobumi Hosogane, Seiji Ohtori, Takashi Hirai","doi":"10.1016/j.jos.2026.02.009","DOIUrl":"https://doi.org/10.1016/j.jos.2026.02.009","url":null,"abstract":"<p><strong>Background: </strong>Intradiscal condoliase injection has become a minimally invasive therapeutic option for lumbar disc herniation (LDH) in Japan. However, the influence of symptom duration on its clinical and radiological effectiveness has not been fully established.</p><p><strong>Methods: </strong>This multicenter retrospective study included 228 patients treated with either intradiscal condoliase injection (CD group, n = 180) or microendoscopic discectomy (MED group, n = 48) across nine academic institutions. Patients were stratified into four groups by symptom duration: ≤2 months, 3-5 months, 6-11 months, and ≥12 months. Clinical outcomes included changes in Numerical Rating Scale (NRS) scores for back and leg pain, responder rate (≥50 % leg pain reduction), and MRI-based disc resorption rate. Statistical analyses were adjusted for age, sex, and herniation level.</p><p><strong>Results: </strong>In the CD group, longer symptom duration was associated with reduced treatment effectiveness. At 3-6 months, duration-dependent differences were modest; adjusted improvement showed no significant trend, while only the back pain responder rate decreased with longer duration (p for trend = 0.04). At 12 months, leg pain improvement showed a non-significant downward trend (p for trend = 0.11), whereas the responder rate declined from 84.6 % to 62.5 % (p for trend = 0.03), and the resorption rate dropped from 42.3 % ± 23.5 %-23.9 % ± 24.3 % (p for trend <0.01). In contrast, the MED group showed consistent outcomes regardless of symptom duration. Pfirrmann grades did not differ significantly across groups.</p><p><strong>Conclusion: </strong>Longer symptom duration was associated with reduced clinical and radiologic response to intradiscal condoliase injection, with duration-dependent effects becoming more evident at 12 months than at 3-6 months. Early intervention-ideally within 6-12 months of symptom onset-may maximize therapeutic benefit. These findings support a time-sensitive approach to chemonucleolytic treatment for LDH.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes and prognosis of osteosarcoma in patients aged 9 years or younger: A study using the nationwide bone tumor registry in Japan.","authors":"Kensaku Yamaga, Keiichi Akahori, Mari Osaki, Akira Kawai, Hideki Nagashima","doi":"10.1016/j.jos.2026.02.007","DOIUrl":"https://doi.org/10.1016/j.jos.2026.02.007","url":null,"abstract":"<p><strong>Background: </strong>Osteosarcoma is a representative malignant bone tumor that typically occurs in adolescents, with a peak incidence in teenagers. However, osteosarcoma is rare in children younger than 10 years, and its clinical features and prognosis remain unclear.</p><p><strong>Methods: </strong>Using data from the nationwide Bone Tumor Registry in Japan, we retrospectively analyzed patients aged ≤19 years diagnosed with osteosarcoma between 2006 and 2019. We compared the clinicopathological characteristics and outcomes between patients aged ≤9 years (group P) and those aged 10-19 years (group A).</p><p><strong>Results: </strong>A total of 1035 patients were included in the study (group P, n = 121; group A, n = 914). The 5-year overall survival (OS) was 73.0 % in group P and 70.7 % in group A (p = 0.84). Among the non-metastatic extremity cases, the 5-year OS rate was 74.5 % in group P and 80.3 % in group A, with no significant difference. The event-free survival rates in surgically treated non-metastatic extremity cases were 60.3 % and 62.4 % in groups P and A, respectively. Amputation was significantly more frequent in group P (18.4 % vs. 7.9 %; p = 0.001).</p><p><strong>Conclusion: </strong>Osteosarcoma in children ≤9 years accounts for approximately 10 % of cases in patients ≤19 years and demonstrates clinical characteristics and prognosis similar to those of adolescents. However, amputations are more frequently performed in younger children, highlighting the need for prosthetic and reconstructive options tailored for this age group.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369532","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 relationship of central sensitization with disability, pain catastrophizing, depression, and sleep quality in patients with lumbar spinal stenosis.","authors":"Musa Güneş, Aydın Sinan Apaydın","doi":"10.1016/j.jos.2026.02.013","DOIUrl":"https://doi.org/10.1016/j.jos.2026.02.013","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pain in lumbar spinal stenosis (LSS) may play an important role in developing central sensitization (CS) symptoms. However, the relationship between CS severity and clinical parameters in LSS is unclear. This study aimed to compare pain intensity, pressure pain threshold (PPT), disability, pain catastrophizing, depression, and sleep quality across CS severity in LSS patients and to examine their relationships.</p><p><strong>Methods: </strong>This cross-sectional study included 81 patients with LSS. Patients were divided into two groups according to Central Sensitization Inventory (CSI) scores: high CSI and low CSI. Pain intensity (Numeric Rating Scale (NRS)), PPT, disability (Oswestry Disability Index (ODI)), pain catastrophizing (Pain Catastrophizing Scale (PCS)), depression (Center for Epidemiologic Studies Depression Scale (CES-D)), and sleep quality (Pittsburgh Sleep Quality Index (PSQI)) were assessed.</p><p><strong>Results: </strong>Patients with LSS with high CSI had statistically significantly higher NRS, ODI, PCS, CES-D, and PSQI scores (p < 0.05) and lower PPT (p = 0.010) values than those with low CSI. ODI (OR = 1.069) and PSQI (OR = 1.545) scores increase the risk of high CSI (p < 0.001). In addition, increases in ODI (B = 0.215), CES-D (B = 0.316), and PSQI (B = 1.563) scores and decreases in PPT (B = -2.033) are significant predictors of CSI score (p < 0.001).</p><p><strong>Conclusions: </strong>LSS patients with high CSI have more pain, disability, pain catastrophizing, and depression, lower PPT, and worse sleep quality. Furthermore, decreased PPT, increased disability and depression, and worse sleep quality were associated with increased CSI score. Therefore, to effectively manage LSS, increased CS severity and its relationship to psychosocial factors that influence patients' pain experience should be assessed.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365348","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":"Older adult residents in disaster public housing had lower muscle function and mobility compared to non-residents: A cross-sectional study.","authors":"Takashi Yamashita, Gaku Kato, Yuta Kosuge, Taisei Fujino, Takeshi Ohkubo, Hiroaki Seto, Eisuke Ochi","doi":"10.1016/j.jos.2026.01.011","DOIUrl":"https://doi.org/10.1016/j.jos.2026.01.011","url":null,"abstract":"<p><strong>Background: </strong>Older adults who experienced post-disaster relocation are at risk of reduced muscle function and mobility due to changes in living environments. This study aimed to compare muscle morphology and physical function between older adults residing in disaster public housing (DPH) and those living in their own homes (Control: CON) in Kesennuma City, following relocation processes after the 2011 Great East Japan Earthquake.</p><p><strong>Methods: </strong>Fifty-two older participants were recruited from three wards of Kesennuma City and divided into DPH (n = 18; age: 78.8 ± 7.2 y, height: 153.0 ± 9.6 cm, weight: 56.0 ± 11.8 kg, BMI: 23.8 ± 3.9 kg/m²) and CON (n = 34; age: 75.0 ± 6.6y, height: 153.2 ± 6.8 cm, weight: 54.4 ± 7.6 kg, BMI: 23.2 ± 2.7 kg/m²) groups based on the survey results. The measurement variables were blood pressure, heart rate, muscle cross-sectional area, muscle thickness, echo intensity, handgrip strength, maximal voluntary contraction (MVC), rate of force development (RFD; 0-50 ms, 0-100 ms, 0-150 ms, 0-200 ms, 0-250 ms, 0-300 ms) of knee extension, and locomotive syndrome risk test (comprising the two-step test, stand-up test, and 25-Question Geriatric Locomotive Function Scale).</p><p><strong>Results: </strong>The MVC was significantly lower in the DPH group (p = 0.043). The RFD was significantly lower in the DPH group at each time point (p < 0.05). In addition, the two-step test was significantly lower in the DPH group (p < 0.001). The other variables did not show significant differences between the groups.</p><p><strong>Conclusions: </strong>Residents in DPH were associated with decreased muscle strength and mobility, suggesting that post-disaster relocation environments may contribute to the decline of physical function and performance.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355473","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":"Epidemiological trends in periprosthetic hip and knee fractures in older adults in Japan, 2019-2023: A descriptive study.","authors":"Takaki Yoshiyama, Toshiki Fukasawa, Soichiro Masuda, Shuichi Matsuda, Koji Kawakami","doi":"10.1016/j.jos.2026.02.005","DOIUrl":"https://doi.org/10.1016/j.jos.2026.02.005","url":null,"abstract":"<p><strong>Background: </strong>Japan is one of the world's most aged societies, and the number of joint replacements is increasing. However, studies investigating the recent incidence and treatment patterns of periprosthetic hip and knee fractures (PF) in Japan remain limited. This study aimed to clarify recent trends in case counts and treatment patterns of PFs among Japanese adults aged ≥65 years.</p><p><strong>Methods: </strong>We conducted a descriptive study using a hospital administrative database provided by JMDC Inc. from 2019 to 2023. We included 2767 patients aged ≥65 years hospitalized for PF in 239 hospitals that continuously contributed data during this period. We assessed annual PF case counts, treatment patterns (open reduction and internal fixation [ORIF], revision arthroplasty, implant removal, conservative treatment), time to surgery, resource use (length of stay, hospitalization cost), and in-hospital mortality. Trends were tested using the Cochran-Armitage trend test, linear regression, and multinomial logistic regression.</p><p><strong>Results: </strong>From 2019 to 2023, PF hospitalizations increased steadily from 1.45 to 1.98 annual cases per hospital. Periprosthetic hip fracture rose steadily each year, climbing 40.2 % over the same 5-year period. Women comprised 85.3 % of cases. Surgical intervention occurred in 53.2 % of patients (ORIF, 45.1 %; revision arthroplasty, 7.6 %; implant removal, 0.5 %), with no clear change in procedure choice over time (ORIF, P = 0.79; arthroplasty, P = 0.89). Mean time to surgery was 5.4 days, mean length of hospital stay was 43.7 days, mean hospitalization cost was $12,888, and in-hospital mortality was 1.6 %, without showing no clear trend change.</p><p><strong>Conclusions: </strong>From 2019 to 2023, PF case in older Japanese adults increased gradually each year, whereas surgical procedures, time to surgery, length of hospital stay, hospitalization costs, and in-hospital mortality showed no clear trend changes. These descriptive data may be useful for understanding recent epidemiological trends in PFs.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355409","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 outcomes of proximal clavicle fractures: A retrospective cohort study from a single Japanese institution","authors":"Shoichiro Hamada ,&nbsp;Mikio Nakajima ,&nbsp;Sumire Suzuki ,&nbsp;Takuma Sasaki ,&nbsp;Richard H. Kaszynski ,&nbsp;Makoto Hodohara ,&nbsp;Kenichi Kawano ,&nbsp;Yasuhito Tajiri","doi":"10.1016/j.jos.2025.07.002","DOIUrl":"10.1016/j.jos.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Clavicle fractures are common injuries, with proximal clavicle fractures being relatively rare. Previous studies have suggested that proximal clavicle fractures are often associated with high-energy trauma and carry a high risk of complications. However, no studies have comprehensively described their clinical characteristics and severity in Japan. This study aimed to evaluate the clinical characteristics of proximal clavicle fractures and their association with injury severity compared to non-proximal clavicle fractures in Japan.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted at a single community hospital. Patients diagnosed with acute clavicle fractures between April 2013 and March 2023 were included, excluding those presenting with cardiac arrest on arrival or more than 7 days post-injury. Patients were categorized into the proximal group (Robinson classification type 1) and the control group (other types). Data on age, sex, injury mechanism, fracture type, and concomitant injuries were analyzed. The association between fracture type and severity, defined as AIS ≥3 or ISS ≥16, was assessed using multivariate logistic regression.</div></div><div><h3>Results</h3><div>A total of 361 patients (proximal group 30 vs. control group 331) were included. Patients in the proximal group were significantly older and had a higher proportion of injuries resulting from falls from standing height compared to the control group. There were no significant differences between the groups in the prevalence of severe concomitant injuries (AIS ≥3; 30 % vs. 19 %), major trauma (ISS ≥16; 10 % vs. 11.8 %), or in-hospital mortality. Logistic regression analysis revealed no significant association between proximal clavicle fractures and severe outcomes.</div></div><div><h3>Conclusions</h3><div>This study focused on acute clavicle fractures tipically encountered in routine orthopediac practice in Japan. Proximal clavicle fractures were more common in older adults and were frequently caused by low-energy falls. Proximal clavicle fractures were not significantly associated with severe concomitant injuries or trauma.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 433-437"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707895","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":"Patient-reported and radiologic outcomes of arthrodesis of the first metatarsophalangeal joint for severe hallux valgus in elderly patients compared with proximal supination metatarsal osteotomy","authors":"Ryuzo Okuda ,&nbsp;Hiroaki Shima ,&nbsp;Masatoshi Takashima","doi":"10.1016/j.jos.2025.08.001","DOIUrl":"10.1016/j.jos.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>There is no study regarding the difference in outcomes between arthrodesis of the first metatarsophalangeal joint (1-MTPj) and a metatarsal osteotomy for hallux valgus (HV). This study aimed to retrospectively examine the radiological parameters and patient-reported outcomes of arthrodesis of the 1-MTPj compared with a proximal supination osteotomy for severe HV in elderly patients.</div></div><div><h3>Methods</h3><div>The series consisted of 15 feet treated with arthrodesis of 1-MTPj (AD group) and 15 feet treated with a proximal supination osteotomy (MO group). Radiographic parameters, the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) score, and a visual analog scale pain score (VAS-PS) were analyzed preoperatively and at a minimum follow-up of 12 months with a median of 22 months. Patients in the two groups were matched by age, gender, BMI, the duration of follow-up, preoperative HV angle (HVA), and preoperative intermetatarsal angle (IMA) between the two groups (P &gt; 0.1 for all comparisons).</div></div><div><h3>Results</h3><div>Preoperative HVA and IMA in the two groups were significantly improved postoperatively (P &lt; 0.001 for both groups). There was no significant difference in postoperative HVA between the two groups, although postoperative IMA in the AD group was significantly greater than that in the MO group (P &lt; 0.001; P = 0.178). All preoperative subscale scores of the SAFE-Q except the subscale for social functioning in the MO group significantly improved in the two groups postoperatively (P &lt; 0.01). No significant differences in all postoperative subscale scores of the SAFE-Q except the subscale score for social functioning (P = 0.003) and postoperative VAS-PS were observed between the AD and MO groups (P &gt; 0.1 for all comparisons). None of the feet had nonunion, infection, or breakage of hardware in both groups.</div></div><div><h3>Conclusions</h3><div>Arthrodesis of the 1-MTPj is a viable procedure for elderly patients in whom correction of severe HV deformity seems to be difficult with joint-preserving procedures for HV.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 372-379"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958470","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":"Automated multiplex PCR of BioFire joint infection panel enables rapid pathogen identification in periprosthetic joint infection excluding coagulase-negative Staphylococci","authors":"Hyonmin Choe ,&nbsp;Naomi Kobayashi ,&nbsp;Yuta Hieda ,&nbsp;Masashi Simoda ,&nbsp;Hiroyuki Ike ,&nbsp;Ken Kumagai ,&nbsp;Yutaka Inaba","doi":"10.1016/j.jos.2025.07.008","DOIUrl":"10.1016/j.jos.2025.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Periprosthetic joint infection (PJI) is a serious complication requiring rapid diagnosis for effective treatment. The BIOFIRE® Joint Infection (JI) Panel, a fully automated multiplex PCR system, enables the identification of 31 organisms and 8 antimicrobial resistance (AMR) genes within 1 h, offering a promising diagnostic method. However, its diagnostic performance, particularly in Asian populations, remains underexplored.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 60 cases of suspected PJI between 2022 and 2023. Synovial fluid samples were evaluated using the JI Panel and microbiological culture, with PJI diagnoses based on the International Consensus Meeting 2018 criteria. Diagnostic accuracy, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), was assessed by comparing JI Panel results with microbiological culture findings or PJI diagnosis.</div></div><div><h3>Results</h3><div>Among 60 cases, 33 were diagnosed with PJI. The JI Panel demonstrated a sensitivity of 45.5 % and a specificity of 100 % for detecting PJI, while microbiological culture showed a sensitivity of 63.6 % and specificity of 100 %. Combined use of the JI Panel and culture improved diagnostic sensitivity to 69.7 %. Notably, the JI Panel identified pathogens in two culture-negative PJI cases. Limitations of the JI Panel included its inability to detect coagulase-negative staphylococci (CNS), such as <em>Staphylococcus epidermidis</em>. However, the JI Panel successfully identified <em>Candida</em> species, a pathogen often undetected by conventional methods.</div></div><div><h3>Discussion</h3><div>The JI Panel facilitates rapid and accurate diagnosis of PJI with high specificity. Although limited by its low sensitivity for CNS-associated infections, the ability to rapidly identify causative organisms and detect fungal pathogens supports its clinical utility. Implementation of the JI Panel in diagnostic laboratories may expedite diagnosis, reduce unnecessary antibiotic use, and alleviate the burden of multidrug-resistant infections.</div></div><div><h3>Conclusion</h3><div>The BIOFIRE® JI Panel offers a highly specific, fully automated method for the rapid diagnosis of PJI. Its adoption in clinical practice may enhance diagnostic accuracy, particularly for culture-negative cases, although improvements in detecting CNS pathogens are necessary.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 486-491"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958472","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":"Enhanced mechanical properties of a novel unsintered hydroxyapatite/poly l-lactic acid (u-HA/PLLA) screw with a reverse buttress thread design","authors":"Takuya Wakatsuki ,&nbsp;Shinji Imade ,&nbsp;Satoshi Furuya ,&nbsp;Hiroshi Morii ,&nbsp;Daishiro Oka ,&nbsp;Koichiro Nakazawa ,&nbsp;Kazuma Shiraishi ,&nbsp;Takuya Manako ,&nbsp;Masaya Sato ,&nbsp;Yuji Uchio","doi":"10.1016/j.jos.2025.08.013","DOIUrl":"10.1016/j.jos.2025.08.013","url":null,"abstract":"<div><h3>Background</h3><div>Although bioabsorbable screws offer various advantages, they also have the clinical drawback of low inherent strength. We developed a novel u-HA/PLLA screw with an innovative shape that maintains the screw function while increasing its strength. The aim of this study was to assess the mechanical properties of this novel screw in comparison to the conventional type.</div></div><div><h3>Methods</h3><div>Both the novel and conventional screws had a major diameter of 4.5 mm and a pitch of 1.6 mm. The conventional type had a minor diameter of 3.5 mm (with thread depth of 0.5 mm) and utilized a buttress thread design. In contrast, the novel screw had a minor diameter of 3.7 mm (with thread depth of 0.4 mm) and a reverse buttress thread. Three-point bending, shear, and torsion tests were performed to compare the screw strengths (n = 10). In addition, to compare their pullout strengths, the screws were inserted into two types of simulated bone, one mimicking osteoporotic bone and the other healthy bone (n = 10 replicates for each condition).</div></div><div><h3>Results</h3><div>The novel screw exhibited 33 % higher three-point bending strength (p &lt; 0.001), 23 % higher shear strength (p &lt; 0.001), and 24 % higher torsion strength (p &lt; 0.001) than the conventional screw. The fourth parameter of mechanical strength, pullout strength, was not significantly different between the screw types, regardless of the bone conditions.</div></div><div><h3>Conclusion</h3><div>The novel u-HA/PLLA screw demonstrated superior mechanical strength while maintaining comparable pullout strength versus the conventional type.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 450-455"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292509","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}