Journal of Orthopaedic Science最新文献

{"title":"Addressing severe spinal deformities associated with neurofibromatosis type 1: Surgical strategies and outcomes.","authors":"Shogo Hashimoto, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Toshiki Okubo, Masahiro Ozaki, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1016/j.jos.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>Surgical strategies for spinal deformities associated with neurofibromatosis type 1(NF-1) have been still controversial due to the wide variety of pathologies, particularly, for deformities with severe dystrophic changes in pediatric patients remained challenging with high complication and reoperation rates. The purpose of this study was to validate our surgical strategies by evaluating clinical and radiographical outcomes.</p><p><strong>Methods: </strong>We retrospectively evaluated 22 cases who underwent correction surgeries for spinal deformities in our institute. The investigations included patient background, presence of dystrophic changes and paravertebral tumors, surgical procedure, number of surgeries, complications and reoperation, and radiographical parameters including Cobb angle and T1-S1 length.</p><p><strong>Results: </strong>The mean age at the first surgery was 11.6 ± 5.5 years. The mean follows up period was 84.3 ± 50.2 months. Of the 22 cases, 4 cases had cervical kyphosis and 18 cases had deformity in thoracic and/or lumbar spine. Dystrophic changes of spine were observed in all 4 cases with cervical kyphosis and 15 cases with spinal deformity in thoracic and/or lumbar spine. All cases with cervical kyphosis underwent posteroanterior fusion following halo gravity traction preoperatively. The mean local kyphosis of cervical spine improved from 83.7 ± 5.9° to 16.9 ± 2.4° after surgery and 19.4 ± 2.5° at final follow up, and 2 cases required unplanned surgery due to pseudarthrosis. In cases of deformity in thoracic and/or lumbar spine, 11 cases underwent posteroanterior fusion, 4 cases underwent only posterior fusion, and 3 cases underwent conventional growing-rod, of which 4 cases underwent halo gravity traction before correction surgery. The mean Cobb angle of scoliosis in thoracic and/or lumbar spine improved from 73.2 ± 16.9° to 30.9 ± 15.8° after surgery and 29.5 ± 13.3° at final follow up, and that of T1-S1 growth increased from 338.3 ± 13.3 mm to 406.3 ± 8.9 mm at final follow up. Four cases required unplanned surgery due to pseudarthrosis (n = 2) or progression of deformity (n = 2).</p><p><strong>Conclusion: </strong>The fundamental of surgical treatment for NF-1-related spinal deformity is extensive rigid spinal fusion by adequate bone grafting. Even if these surgeries are performed, in some cases additional surgery could be necessary due to progression of deformity.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958436","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, Hiroaki Shima, Masatoshi Takashima","doi":"10.1016/j.jos.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.jos.2025.08.001","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 > 0.1 for all comparisons).</p><p><strong>Results: </strong>Preoperative HVA and IMA in the two groups were significantly improved postoperatively (P < 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 < 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 < 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 > 0.1 for all comparisons). None of the feet had nonunion, infection, or breakage of hardware in both groups.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-25","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, Naomi Kobayashi, Yuta Hieda, Masashi Simoda, Hiroyuki Ike, Ken Kumagai, Yutaka Inaba","doi":"10.1016/j.jos.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.008","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 Staphylococcus epidermidis. However, the JI Panel successfully identified Candida species, a pathogen often undetected by conventional methods.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","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":"Effects of proprioceptive neuromuscular facilitation therapy combined with orthotic insole intervention on lower limb function improvement in children with foot drop and inversion deformity.","authors":"Hong Cheng, Xiaobing Chou, Xiaoli Hou, Xinyue Wang, Yan Zhou, Yuxin Mao, Xuan Zhou","doi":"10.1016/j.jos.2025.06.012","DOIUrl":"10.1016/j.jos.2025.06.012","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether combining proprioceptive neuromuscular facilitation (PNF) therapy with customized orthotic insoles leads to greater improvements in gait parameters, ankle range of motion, and lower-limb function than either intervention alone in pediatric foot drop and inversion deformity.</p><p><strong>Methods: </strong>Ninety-seven children (aged 5-14 years) with foot drop and inversion deformity were randomized into three groups: (1) PNF plus insole, (2) insole only, and (3) PNF only. All interventions lasted 12 weeks. Gait parameters, the Gross Motor Function Measure (GMFM), ankle range of motion, muscle strength, and functional balance were assessed at baseline, immediately post-intervention, and at 1- and 3-month follow-ups.</p><p><strong>Results: </strong>Children receiving the combined PNF plus insole intervention demonstrated significantly greater increases in gait velocity (18.5 % vs. 9.2 % and 8.7 % for insole-only and PNF-only groups, respectively) and higher improvements in GMFM scores (12-point increase vs. 6 and 5 points). Ankle dorsiflexion improved by a mean of 6.1° in the combined group (p < 0.05). Approximately 85 % of these gains were maintained at the 1-month follow-up, which exceeded the modest regression observed in the single-intervention groups.</p><p><strong>Conclusion: </strong>Combining PNF therapy with customized orthotic insoles offers superior and more durable improvements in gait and lower-limb function compared to single interventions, suggesting a more effective rehabilitative strategy for pediatric patients with foot drop and inversion deformity.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883087","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":"Expression of small leucine-rich proteoglycans in the medial meniscus posterior horn associated with medial meniscus posterior root tear.","authors":"Takaaki Hiranaka, Takayuki Furumatsu, Aki Yoshida, Yuki Okazaki, Masanori Tamura, Koki Kawada, Yusuke Yokoyama, Toshifumi Ozaki","doi":"10.1016/j.jos.2025.07.011","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.011","url":null,"abstract":"<p><strong>Background: </strong>Small leucine-rich proteoglycans (SLRPs) play a regulatory role in collagen fibril growth and organization. Medial meniscus posterior root tear (MMPRT) causes the loss of medial meniscus (MM) function and the rapid degradation of the articular joint. In this study, we aimed to evaluate the expression levels of SLRPs in the MM posterior horn in relation to MMPRT.</p><p><strong>Methods: </strong>MM tissue samples were obtained from patients with MMPRT (mean age: 72.6, n = 5) and control patients with bone and soft tissue tumors (mean age: 69.8, n = 5), all of whom underwent knee arthroplasty. Patients with MMPRT who underwent surgery within three months of the injury were included. Quantitative real-time PCR was performed to evaluate the expression levels of transforming growth factor-β1 (TGFB1) and SLRPs in the cultured MM posterior horn cells. Additionally, expression of TGF-β1 and SLRPs proteins was analyzed using immunohistochemical staining and quantified using image analysis.</p><p><strong>Results: </strong>Quantitative real-time PCR analysis revealed that the expression levels of SLRPs were higher in the MMPRT group than in the control group. Significantly elevated expression levels of TGFB1 (3.2-fold), lumican (4.2-fold), and fibromodulin (3.8-fold) were observed in the MMPRT group compared to those in the control group. Similarly, immunohistochemistry revealed more TGF-β1-, lumican-, and fibromodulin-positive cells in the MMPRT group compared to those in the control group.</p><p><strong>Conclusions: </strong>This study is the first to demonstrate elevated expression of SLRPs, especially lumican and fibromodulin, in menisci of patients with MMPRT, suggesting that these proteins could serve as potential biomarkers or therapeutic targets for MMPRT treatment.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859297","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 different types of prosthetic feet in patients with unilateral transtibial amputation; patient perspective.","authors":"Gizem Kılınç Kamacı, Şahide Eda Artuç, Hatice Ceylan, Elif Tekin, Onur Kanlıoğlu, Merve Örücü Atar, Yasin Demir, Koray Aydemir","doi":"10.1016/j.jos.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.007","url":null,"abstract":"<p><strong>Objectives: </strong>Prosthetic feet are designed to fulfil the function of the ankle-foot part. It is an important part of lower extremity prostheses. Although there are many different types of prosthetic feet, it is difficult to determine the most suitable prosthetic foot for each amputee. The aim of this study was to determine the experiences of patients with unilateral transtibial amputation (TTA) regarding different types of prosthetic feet [non-articulating ankle (NAA), articulating hydraulic ankle (AHA) or microprocessor-controlled foot (MPC)].</p><p><strong>Methods: </strong>Seventeen patients with unilateral traumatic TTA who had experience with all three prosthetic foot types were included. Patients were asked to rate 14 features of the different types of prosthetic feet they had used using a numeric rating scale.</p><p><strong>Results: </strong>There were statistically significant differences between the prosthetic feet in walking on flat roads, walking on uneven roads, walking fast, running, descending and ascending stairs, descending and ascending ramps, using with different shoes, using at home, maintenance need, and general satisfaction (p < 0.001, p < 0.001, p < 0.001, p:0.005, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p:0.042, p < 0.001, respectively). No statistically significant difference was found in the frequency of malfunction and weight of prosthetic foot types (p:0.929, p:0.114, respectively).</p><p><strong>Conclusions: </strong>From the patient perspective, MPC was better than AHA and NAA in most activities of daily living and general satisfaction. AHA was better than NAA in these activities. There was no difference in the frequency of malfunction and the weight of the prosthetic foot.</p><p><strong>Clinicaltrial: </strong>Registry name: Comparison of Different Types of Prosthetic Feet; Patient Perspective, Registry number: NCT05691998.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855656","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":"Characteristics of hernia reduction and signal intensity changes on magnetic resonance images after condoliase therapy for lumbar disc herniation.","authors":"Kazuhiro Fujimoto, Hidenori Suzuki, Norihiro Nishida, Masahiro Funaba, Yusuke Ichihara, Issei Tanaka, Yasuaki Imajo, Manabu Yamamoto, Takashi Sakai","doi":"10.1016/j.jos.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.010","url":null,"abstract":"<p><strong>Background: </strong>Few studies have investigated factors associated with lumbar disc herniation (LDH) reduction and signal intensity changes after condoliase therapy. The aim of study is to investigate pre- and post-injection factors for hernia reduction and signal intensity changes on magnetic resonance images (MRI) after condoliase therapy in cases of LDH.</p><p><strong>Methods: </strong>This retrospective, double-center study examined patients with unilateral leg pain caused by LDH who received condoliase therapy between August 2018 and July 2024. Patients were divided into three groups based on post-MRI: Group R: Hernia reduction; Group C: No hernia reduction and a signal intensity change; Group N: No hernia reduction or signal intensity change. Sex, age, the body mass index, duration of symptoms, herniation level, neurological and radiographic findings, the visual analog scale (VAS) score for leg pain, and the Oswestry disability index were examined in the three groups.</p><p><strong>Results: </strong>Subjects included 128 males and 84 females with a mean age of 50.6 years, mean BMI of 23.2, and mean duration of symptoms of 5.6 months. The duration of symptoms was shorter in group R than in group N (p = 0.02). Surgery after condoliase therapy was more frequent and improvements in VAS were fewer in group N than in the other two groups (both p < 0.01). The high intensity zone (HIZ) of hernia was more frequent in group R than in the other two groups (p < 0.01).</p><p><strong>Conclusions: </strong>The present study revealed that patients with hernia reduction had a shorter duration of symptoms, more frequent HIZ of herniation, and pain relief early after condoliase therapy. Furthermore, approximately 50 % of cases without hernia reduction showed signal intensity changes within the herniation. These cases also had a shorter duration of symptoms and achieved pain relief after condoliase therapy.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847137","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 of knee extension deficit and lumbar kyphosis with functional impairments in patients with knee osteoarthritis: The Nagahama study.","authors":"Sayaka Okada, Masashi Taniguchi, Tome Ikezoe, Tadao Tsuboyama, Hiromu Ito, Shuichi Matsuda, Fumihiko Matsuda, Tsukasa Kamitani, Noriaki Ichihashi","doi":"10.1016/j.jos.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>The knee extension deficit is known to occur with an increase in lumbar kyphosis. This study aimed to determine the association of knee extension deficit and lumbar kyphosis with knee symptoms and functional activities in patients with Knee Osteoarthritis (KOA).</p><p><strong>Methods: </strong>Four hundred forty-eight participants aged 60 or over with radiographic KOA, all local community residents, were included in the analysis. The Knee Scoring System (KSS) was used to assess the functional abilities and symptoms. The knee extension angle was measured using a goniometer, and the lumbar spine angle was measured using Spinal Mouse, which is a noninvasive skin surface device. The associations between KSS symptoms or function scores with the presence or absence of knee extension deficit and lumbar kyphosis was evaluated using the multiple regression analysis. Another multiple regression analysis was conducted to clarify the effect of the coexisting knee extension deficit and lumbar kyphosis on KSS scores.</p><p><strong>Results: </strong>The presence of knee extension deficit (β = -2.67; 95 % confidence interval [95 % CI]: -5.08, -0.27; p = 0.03) and lumbar kyphosis (β = -6.15; 95 % CI: -9.44, -2.86; p < 0.01) were associated with the KSS function score. Furthermore, the coexisting knee extension deficit and lumbar kyphosis significantly decreased the KSS function score (β = -10.24; 95 % CI: -15.1, -5.37; p < 0.01). However, the interaction between knee extension deficit and lumbar kyphosis was not statistically significant (p = 0.25). The KSS symptom score was not associated with knee extension deficit or lumbar kyphosis in either analysis.</p><p><strong>Conclusions: </strong>Our findings indicate that the coexisting knee extension deficit and lumbar kyphosis are an adverse clinical indicator associated with functional impairments in patients with KOA.</p><p><strong>Study design: </strong>Retrospective clinical study.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812191","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 utility of apparent diffusion coefficient maps for evaluating chemotherapy response and prognosis in osteosarcoma.","authors":"Hiroshi Koike, Yoshihiro Nishida, Hiroshi Urakawa, Kunihiro Ikuta, Tomohisa Sakai, Kan Ito, Shiro Imagama","doi":"10.1016/j.jos.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.006","url":null,"abstract":"<p><strong>Background: </strong>Assessing the response to neoadjuvant chemotherapy is crucial for determining surgical treatment strategies and optimizing personalized postoperative care in osteosarcoma patients. The apparent diffusion coefficient, derived from diffusion-weighted imaging, reflects tumor aggressiveness; however, its role in evaluating neoadjuvant chemotherapy response remains unclear. This study aimed to evaluate the utility of apparent diffusion coefficient maps in assessing chemotherapy-induced necrosis and prognosis in osteosarcoma.</p><p><strong>Methods: </strong>Twenty osteosarcoma patients referred to our hospital between 2007 and 2020, for whom apparent diffusion coefficient maps were available, were included. The association between apparent diffusion coefficient values, tumor necrosis rate, and prognosis was analyzed.</p><p><strong>Results: </strong>The study cohort consisted of 14 males and six females, with a median age of 16 years (range, 7-37). Tumor locations included the femur (12 patients), tibia (5), humerus (2), and scapula (1). Significant correlations were found between changes in mean apparent diffusion coefficient values pre- and post-neoadjuvant chemotherapy and tumor necrosis rate (r = 0.61, p < 0.01). Post-chemotherapy mean and minimum apparent diffusion coefficient values were significantly associated with overall survival (p = 0.04 for both).</p><p><strong>Conclusions: </strong>This study demonstrates a strong correlation between chemotherapy effectiveness and apparent diffusion coefficient values in osteosarcoma. Future clinical efforts should focus on integrating apparent diffusion coefficient values into treatment strategies to improve patient outcomes.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799411","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":"Preoperative sonography facilitates minimally invasive costal graft harvesting for reconstruction of advanced capitellar osteochondritis dissecans.","authors":"Tetsuya Takenaga, Sho Yamauchi, Jumpei Inoue, Tomoya Ono, Satoshi Takeuchi, Keishi Takaba, Yohei Kawaguchi, Masahiro Nozaki, Hiroaki Fukushima, Hideki Murakami, Masahito Yoshida","doi":"10.1016/j.jos.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.005","url":null,"abstract":"<p><strong>Background: </strong>Costal osteochondral autograft transplantation is a promising surgical option for lateral capitellar osteochondral dissecans. However, this approach is limited by the difficulty in identifying the costal osteochondral junction (COCJ) in patients with a well-developed pectoralis major or excessive subcutaneous fat. Moreover, the cross-section of the costal cartilage usually remains unknown until the graft is harvested, which often leads surgeons to make long skin incisions. This study investigated the accuracy of sonography in identifying the COCJ and predicting the cross-sectional size of the costal cartilage.</p><p><strong>Methods: </strong>Two orthopedic surgeons performed sonographic assessment to identify 15 COCJs in Thiel-embalmed cadavers. They measured the long and short axes of the cross-section of 20 costal cartilages 10 mm away from the COCJ. After sonographic assessment, costal grafts were harvested to measure the distance between the sonographically marked and actual COCJ. The long and short axes of the costal cartilage 10 mm from the COCJ were manually measured.</p><p><strong>Results: </strong>The mean distance between the sonographically marked and actual COCJ was 0.1 ± 0.4 and 0.7 ± 0.9 mm in Testers A and B, which were significantly smaller in Tester A with more experience in musculoskeletal sonography (p < 0.05). Pearson correlation coefficients showed significant, strong, and positive correlations between sonographic and manual measurements of costal graft size in both testers (for long axis, 0.79 in Tester A and 0.88 in Tester B, for short axis, 0.75 in Tester A and 0.73 in Tester B, p < 0.001 for all correlations).</p><p><strong>Conclusions: </strong>Our findings indicate the accuracy of sonography in assessing the COCJ and cross-sectional size of the costal cartilage. Preoperative sonography could provide help surgeons determine the number of costal grafts to be harvested in advance and minimize skin incisions during graft harvesting.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789423","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}