Journal of Orthopaedic Science最新文献

{"title":"Predicting anterior cruciate ligament degeneration using magnetic resonance imaging: Insights from histological evaluation","authors":"Shuji Toyono ,&nbsp;Akemi Suzuki ,&nbsp;Yoshihiro Wanezaki ,&nbsp;Daiichiro Takahara ,&nbsp;Rintaro Ohe ,&nbsp;Shigenobu Fukushima ,&nbsp;Mitsuru Futakuchi ,&nbsp;Michiaki Takagi","doi":"10.1016/j.jos.2024.04.009","DOIUrl":"10.1016/j.jos.2024.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Mucoid degeneration of the anterior cruciate ligament<span><span> is a pathological condition that may impair knee mechanics and contribute to the symptomatology of </span>osteoarthritis<span>. This study aimed to evaluate whether preoperative magnetic resonance imaging can predict anterior cruciate ligament degeneration, specifically mucoid degeneration, and to elucidate the histopathological characteristics of mucoid degeneration in knee osteoarthritis patients.</span></span></div></div><div><h3>Methods</h3><div><span><span>We evaluated a total of 95 knees of osteoarthritis patients (23 males, 72 females; mean age: 72.7 ± 7.5) scheduled for </span>total knee arthroplasty<span>. The relationship between preoperative magnetic resonance imaging findings and the histopathological evidence of anterior cruciate ligament mucoid degeneration was examined. Immunohistochemical analysis was employed for collagen types (COL-I, COL-II), chondrogenesis (SOX9), and </span></span>vascularity (CD31).</div></div><div><h3>Results</h3><div><span>High signal intensity on magnetic resonance imaging showed a positive correlation with Alcian Blue staining areas (rs = 0.59, p &lt; 0.01) and the swelling index (rs = 0.62, p &lt; 0.01), indicating advanced mucoid degeneration. The </span>absence<span><span> of synovial lining around the anterior cruciate ligament was associated with more severe degeneration. In the histological evaluations, advanced degeneration was characterized by an increase in chondroid </span>metaplasia<span> and collagen disorientation. The Alcian Blue<span> and SOX9<span> correlation was positive (rs = 0.69, p &lt; 0.01), but negative with COL-I (rs = −0.38, p = 0.03) and vascularity (CD31) (rs = −0.60, p &lt; 0.01).</span></span></span></span></div></div><div><h3>Conclusions</h3><div>Preoperative magnetic resonance imaging is an effective tool in assessing the severity of anterior cruciate ligament degeneration; it influences surgical decisions. High signal intensity on magnetic resonance images denotes advanced mucoid degeneration. The absence of synovial lining around the anterior cruciate ligament is associated with more severe degeneration and may accelerate degenerative changes. Chondroid metaplasia and collagen disorientation mark advanced degeneration. Magnetic resonance imaging can be used to gauge the degree of anterior cruciate ligament degeneration in osteoarthritis.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 325-332"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074496","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":"Joint-preserving effect and patient-reported outcomes of transtrochanteric curved varus osteotomy for osteonecrosis of the femoral head","authors":"Yusuke Ayabe,&nbsp;Goro Motomura,&nbsp;Satoshi Ikemura,&nbsp;Ryosuke Yamaguchi,&nbsp;Takeshi Utsunomiya,&nbsp;Noriko Yamamoto,&nbsp;Hidenao Tanaka,&nbsp;Satoshi Hamai,&nbsp;Shinya Kawahara,&nbsp;Yasuharu Nakashima","doi":"10.1016/j.jos.2024.03.010","DOIUrl":"10.1016/j.jos.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><div>This study assessed the hip survival rate and patient-reported outcome measures (PROMs) of transtrochanteric curved varus osteotomy<span> (CVO) for osteonecrosis of the femoral head (ONFH) compared with those of conservative management.</span></div></div><div><h3>Methods</h3><div>The CVO group comprised 32 consecutive patients (39 hips) who underwent CVO for ONFH between 2000 and 2011. The conservative group consisted of 36 consecutive patients (37 hips) who were managed conservatively for at least 1 year after collapse and who had ONFH classified by the Japanese Investigation Committee of Health and Welfare as type B or C1, for which CVO is indicated. Kaplan–Meier analysis of hip survival used any ONFH-related therapeutic surgery as the endpoint. PROMs were evaluated for all patients with surviving hips and radiographs available at the latest follow-up.</div></div><div><h3>Result</h3><div>The 10-year hip survival rate in the CVO group was 86.7%, which was significantly higher than the 51.0% 5-year survival rate in the conservative group (p &lt; 0.0001). The Oxford Hip Score and UCLA Activity Score were significantly better in the CVO group without joint space narrowing than in the conservative group, with no significant differences between the CVO group with joint space narrowing and the conservative group.</div></div><div><h3>Conclusion</h3><div>CVO could preserve hip joints more effectively than conservative follow-up after collapse, although the presence of joint space narrowing could reduce satisfaction levels even in patients with long-term hip survival.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 313-319"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787994","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":"Action protocol of medical staff for airway obstruction after anterior cervical spine surgery: A systematic review of case reports","authors":"Kentaro Yamada ,&nbsp;Toshitaka Yoshii ,&nbsp;Takashi Hirai ,&nbsp;Atsushi Kudo ,&nbsp;Nobuyuki Nosaka ,&nbsp;Satoru Egawa ,&nbsp;Yu Matsukura ,&nbsp;Hiroyuki Inose ,&nbsp;Atsushi Okawa","doi":"10.1016/j.jos.2024.03.011","DOIUrl":"10.1016/j.jos.2024.03.011","url":null,"abstract":"<div><h3>Background</h3><div><span>Postoperative airway obstruction after anterior cervical spine surgery (ACSS) can be a fatal complication. Occasionally, it rapidly progresses to complete obstruction. There are no established standardized protocols on how medical staff should assess for signs and symptoms, seek help, or facilitate airway management after ACSS to prevent unfavorable events. This study aimed to primarily describe a systematic approach by assessing the signs and treatment outcomes of airway compromise in patients who underwent ACSS. Further, it recommended an action protocol after </span>extubation for medical staff according to patients’ symptoms to prevent unfavorable outcomes.</div></div><div><h3>Methods</h3><div><span>An extensive literature search was performed on PubMed, Web of Science, and the Cochrane Library to identify case reports, case series, and cohort studies restricted to English and published between January 1990 and March 2023. We included cases that described the signs, symptoms, and treatment of airway obstruction after ACSS. Meanwhile, cases involving complications of other known causes, cases of trauma or occipital-cervical fixation, or those using </span>bone morphogenetic protein were excluded.</div></div><div><h3>Results</h3><div>Twenty cases from 17 studies were obtained, and their study quality was acceptable. Four patients died, and two presented with hypoxic ischemic encephalopathy. Further, five of six patients had fatal complications that initially developed within 7 h after surgery. Then, 9 (69%) of 13 patients with evidence of hematoma (69%) showed initial symptoms within 12 h after surgery. Finally, 9 of 11 patients with early-stage symptoms had favorable outcomes, and patients who developed late-stage symptoms commonly had unfavorable outcomes.</div></div><div><h3>Conclusion</h3><div>The early identification of signs and symptoms and immediate treatment are important, particularly within 12 h postoperatively. We suggest a novel action protocol for medical staff according to symptom urgency, which includes the measurement of neck circumference using a string for evaluating neck swelling.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 259-266"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789674","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":"Diaphyseal forearm fracture management in adolescent patients from 2011 to 2020: A multicenter study of surgery and regional anesthesia trends","authors":"Yoshihiko Kimura ,&nbsp;Yuta Asami ,&nbsp;Katsuhiro Tokutake ,&nbsp;Yasuhiko Takegami ,&nbsp;Kazuma Oshima ,&nbsp;Noriko Ishihara ,&nbsp;Shiro Imagama","doi":"10.1016/j.jos.2024.03.009","DOIUrl":"10.1016/j.jos.2024.03.009","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Diaphyseal forearm fractures<span> are common traumatic injuries among children. There has been much debate on the use of intramedullary nailing (IMN) or </span></span>plate fixation<span><span> in the adolescent population (10–16 years of age). Furthermore, as ultrasound technology has advanced, the safety and efficacy of ultrasound-guided axillary </span>brachial plexus block for children has dramatically improved. Therefore, anesthesia options for adolescent patients have increased in recent years. This study aimed to investigate recent surgical and </span></span>regional anesthesia trends of diaphyseal forearm fractures in patients 10 to 16 years of age in Japan through a multicenter epidemiological survey from 2011 to 2020.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter study included 226 pediatric patients with diaphyseal forearm fracture aged 10–16 years treated from January 2011 to December 2020. We divided the patients into four groups according to the period in which they were treated: early (2011–2013), middle (2014–2016), late (2017–2019), and COVID-19 (2020). Information from medical records was used to investigate the number of surgeries, types of anesthesia administered, and internal fixation methods used for diaphyseal forearm fracture in adolescent patients during each period.</div></div><div><h3>Results</h3><div>The number of surgeries was generally constant in each period but decreased during the COVID-19 period. In the early, middle, late, and COVID-19 periods, the percentages of surgeries performed under regional anesthesia were 67.7, 85.5, 87.0, and 100% respectively (p = 0.003). During the same periods, the percentages of patients receiving IMN were 41.5, 49.3, 58.0, and 66.7%, respectively (p = 0.033).</div></div><div><h3>Conclusion</h3><div>The use of IMN and regional anesthesia to treat diaphyseal forearm fracture in patients 10 to 16 years of age steadily increased during the study period from 2011 to 2020. These results indicate that regional anesthesia is safe, effective, and well-tolerated by adolescent patients. The treatment strategy for diaphyseal forearm fractures in adolescents using regional anesthesia in combination with IMN worked well and was effective during COVID-19. Our evidence suggests this trend will continue. We anticipate that our findings can be extrapolated for upper extremity fractures in adolescent patients beyond the Tokai region of Japan where the study was based.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 385-389"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793807","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 bone density on the drill-hole diameter made by a cannulated drill bit in cancellous bone","authors":"Utomo Andi Pangnguriseng ,&nbsp;Shinji Imade ,&nbsp;Satoshi Furuya ,&nbsp;Koichiro Nakazawa ,&nbsp;Kazuma Shiraishi ,&nbsp;Masaya Sato ,&nbsp;Toshihiko Kawamura ,&nbsp;Yuji Uchio","doi":"10.1016/j.jos.2024.04.001","DOIUrl":"10.1016/j.jos.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><div>When a pilot hole is made prior to a screw's insertion into bone, the same drill bit is used irrespective of the bone quality. However, osteoporotic bone is fragile and this may affect the hole diameter, which is of particular concern in cancellous bone<span>. In this study, the relationship between bone density and drill-hole diameter was investigated assuming a pre-drilling process in screw-only osteosynthesis<span> in the metaphysis<span> and epiphysis.</span></span></span></div></div><div><h3>Methods</h3><div><span>Two types of drill bit (triple-flute [T] and quadruple-flute [Q]) with different shapes and diameters were prepared: type T bits with 3.5 mm and 4.4 mm diameters, and type Q bits with 3.5 mm and 4.2 mm diameters. Drilling was performed manually in simulated bones with four densities: 5, 10, 15, and 20 pounds per cubic foot. We measured the hole diameters with a coordinate measuring machine and analyzed the relationship between the drill-hole diameters and the densities of the simulated bones. We then compared the screw pull-out </span>strength between the two 3.5-diameter drill bits.</div></div><div><h3>Results</h3><div>In all cases, the diameters of the drill holes were larger than those of the drill bits. The relationship between the drill-hole diameters and the bone densities was a negative linear correlation. Enlarging the hole diameter decreased the screw pull-out strength.</div></div><div><h3>Conclusions</h3><div>For cannulated drill bits of 3.5, 4.2 and 4.4 mm diameter, the diameter of the drill hole in cancellous bone obtained by the manual drilling technique tends to be larger in low-density (e.g., osteoporotic) compared to high-density (e.g., healthy) bone.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 405-412"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792997","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":"Research promotes advancements in the field of orthopaedic surgery","authors":"Norimasa Iwasaki","doi":"10.1016/j.jos.2024.12.001","DOIUrl":"10.1016/j.jos.2024.12.001","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Page 258"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846832","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":"Toxic effects of local anesthetics on rat fibroblasts: An in-vitro study","authors":"Keegan M. Hones ,&nbsp;Kevin A. Hao ,&nbsp;Jonathan O. Wright ,&nbsp;Thomas W. Wright ,&nbsp;Jeffrey Hartzell ,&nbsp;David A. Myara ,&nbsp;Padraic P. Levings ,&nbsp;Brian Badman ,&nbsp;Steven C. Ghivizzani ,&nbsp;Rachael S. Watson Levings","doi":"10.1016/j.jos.2024.04.003","DOIUrl":"10.1016/j.jos.2024.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Infusion catheters facilitate a controlled infusion of local anesthetic (LA) for pain control after surgery. However, their potential effects on healing fibroblasts are unspecified.</div></div><div><h3>Methods</h3><div><span>Rat synovial fibroblasts were cultured in 12-well plates. Dilutions were prepared in a solution containing reduced-serum media and 0.9% sodium chloride in 1:1 concentration. Each well was treated with 500 μl of the appropriate LA dilution or normal saline for 15- or 30-min. LA dilutions included: 0.5% ropivacaine<span> HCl, 0.2% ropivacaine HCl, 1% lidocaine HCl and epinephrine 1:100,000, 1% lidocaine HCl, 0.5% </span></span>bupivacaine<span> HCl and epinephrine 1:200,000, and 0.5% bupivacaine HCl. This was replicated three times. Dilution of each LA whereby 50% of the cells were unviable (Lethal dose 50 [LD50]) was analyzed.</span></div></div><div><h3>Results</h3><div>LD50 was reached for lidocaine and bupivacaine, but not ropivacaine. Lidocaine 1% with epinephrine is toxic at 30-min at 1/4 and 1/2 sample dilutions. Bupivacaine 0.5% was found to be toxic at 30-min at 1/2 sample dilution. Bupivacaine 0.5% with epinephrine was found to be toxic at 15- and 30-min at 1/4 sample dilution. Lidocaine 1% was found to be toxic at 15- and 30-min at 1/2 sample dilution. Ropivacaine 0.2% and 0.5% remained below LD50 at all time-points and concentrations, with 0.2% demonstrating the least cell death.</div></div><div><h3>Conclusions</h3><div>Though pain pumps are generally efficacious, LAs may inhibit fibroblasts, including perineural fibroblast and endoneurial fibroblast-like cells, which may contribute to persistent nerve deficits, delayed neurogenic pain, and negatively impact healing. Should a continuous infusion be used, our data supports ropivacaine 0.2%.</div></div><div><h3>Level of evidence</h3><div>Basic Science Study; Animal model.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 397-404"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789764","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 central sensitization and multisite pain in the general population: A cross-sectional analysis of The Wakayama Health Promotion Study.","authors":"Shingo Inoue, Hiroshi Hashizume, Shizumasa Murata, Hiroyuki Oka, Takuhei Kozaki, Kunihiko Minakata, Ryo Taiji, Masatoshi Teraguchi, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Kanae Mure, Yukihiro Nakagawa, Nobuyuki Miyai, Hiroshi Yamada","doi":"10.1016/j.jos.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jos.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Central sensitization (CS), which is characterized by amplified nociceptive processing within the central nervous system, is a key mechanism underlying chronic pain disorders. Chronic pain is a significant global health issue; however, the relationship between CS and pain distribution in the general population remains unclear. This study aimed to investigate the association between CS and the number of locations of body pain in a representative sample of the general population.</p><p><strong>Methods: </strong>This cross-sectional study included 739 participants (340 men, 399 women) from the Wakayama Health Promotion Study. CS was assessed using the Japanese version of the Central Sensitization Inventory (CSI-J), with scores of ≥30 indicating CS. Participants reported pain at 13 locations. Statistical analyses, including chi-square tests, Student's t-tests, and multiple regression analyses, were performed to determine the associations between Central Sensitization Inventory (CSI) scores and pain locations.</p><p><strong>Results: </strong>Among the participants, 9.5 % were diagnosed with CS. Females had significantly higher CSI scores than males. Lower back pain (20.6 %) and shoulder pain (15.0 %) were most common in men, whereas shoulder pain (20.6 %), knee pain (20.1 %), and lower back pain (19.5 %) were most common in women. Multivariate analysis revealed that sex, headache, neck pain, shoulder pain, arm pain, lower back pain, hip pain, thigh pain, and knee pain were significantly associated with CSI scores. Participants with ≥3 locations were 14.4 times more likely to have CS.</p><p><strong>Conclusions: </strong>This study highlights the significant prevalence of CS in the general population, with a higher prevalence in females. Specific locations of pain, particularly those close to the trunk, are strongly associated with CS. These findings underscore the importance of assessing CS in individuals with multisite pain for targeted management and treatment strategies.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537310","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 magnetic resonance imaging of lateral meniscus extrusion likely indicates posterior root tear in anterior cruciate ligament-injured knees.","authors":"Yusuke Yanatori, Yasushi Takata, Kazuki Asai, Mitsuhiro Kimura, Rikuto Yoshimizu, Tomoyuki Kanayama, Yoshihiro Ishida, Junsuke Nakase","doi":"10.1016/j.jos.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.jos.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>A lateral meniscal posterior root tear (LMPRT) is a known complication of anterior cruciate ligament (ACL) injury. Complete repair of meniscal posterior root tears is essential for preventing degenerative changes in the knee that may result from meniscal extrusion and rotational instability. This study aimed to assess the relationship between LMPRT morphology and preoperative lateral meniscal extrusion (LME) and to determine the cutoff value for complete LMPRT based on preoperative LME measurements.</p><p><strong>Methods: </strong>We retrospectively analyzed 403 patients who underwent ACL reconstruction at our hospital between 2011 and 2021. The study finally included 35 patients with LMPRT and 20 with an intact lateral meniscus (LM) as controls. Based on the arthroscopic findings during ACL reconstruction, the 35 patients were divided into two groups: partial (type 1) and complete (types 2-5) LMPRT, in accordance with the LaPrade Classification. The degree of LME was measured using magnetic resonance imaging (MRI).</p><p><strong>Results: </strong>The partial LMPRT group comprised 17 knees (10 male and 7 female patients), and the complete LMPRT group comprised 18 knees (9 male and 9 female patients). MRI revealed notably greater preoperative LME measurements in cases of complete LMPRT than in cases of both partial LMPRT and intact LM. Receiver operating curve analysis established the optimal cutoff threshold of 2.2 mm for a preoperative LME, with a sensitivity of 78 % and specificity of 71 % for predicting complete LMPRT.</p><p><strong>Conclusions: </strong>The findings of this study indicate a higher degree of LME in complete LMPRT than in partial LMPRT in knees with ACL injury. Additionally, in patients with ACL injuries, a preoperative MRI measurement of LME ≥2.2 mm suggests a greater likelihood of complete LMPRT.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523815","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 comparison of modified sinus tarsi approach and L-shaped approach in open reduction and internal fixation for Sanders typeIII-IV intra-articular calcaneal fractures: Complications, security, effectiveness analysis.","authors":"Yang Bin, Zhang Xingguo, Li Hua, Wang Decheng","doi":"10.1016/j.jos.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.jos.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>L-shaped incision is the most widely used approach for treating calcaneal fracture; however, it has been associated with various complications, such as wound infection, skin edge necrosis, postoperative fracture malunion, and traumatic arthritis. Accordingly, this surgical approach should be re-examined. This study aimed to investigate the clinical effect and safety of the modified sinus tarsi approach in open reduction and internal fixation for Sanders type III-IV calcaneal fractures and compare it with the traditional L-shaped approach.</p><p><strong>Methods: </strong>This retrospective study enrolled 72 patients with unilateral closed Sanders type III-IV calcaneal fractures treated with a modified sinus tarsi approach (38 patients) and L-shaped approach (34 patients) from May 2018 to June 2020. Postoperative complications and changes in calcaneal Böhler angle, Gissane angle, and Varus angle were observed and compared between the two groups before and 3 days, and 12 months after the operation. At 12 months after the operation, the Maryland foot function score, AOFAS score, and VAS score were used to evaluate the recovery of foot function in both groups.</p><p><strong>Results: </strong>The modified tarsal sinus approach group had significantly shorter incision healing time (9.8 ± 1.9 d) and operation time (75.53 ± 21.12 min), as well as fewer wound-healing complications (2.6 %) compared to the L-shaped approach group (P < 0.05). There were no significant differences in the Böhler, Gissane, and Varus angles between the two groups after the operation. At 12 months after the operation, no significant differences were observed in Maryland, AOFAS, and VAS scores.</p><p><strong>Conclusion: </strong>The modified sinus tarsi and L-shaped approaches had similar clinical effects in the treatment of Sanders type III-IV calcaneal fractures. However, the treatment of modified sinus tarsi approaches in open reduction and internal fixation for Sanders type III-IV calcaneal fractures implies small incision, low degree of soft tissue injury, and low wound-healing complications, thus resulting in an effective minimally invasive treatment for Sanders type III-IV calcaneal fractures.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523814","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}