Journal of Orthopaedic Science最新文献

{"title":"Inflammatory biomarkers predict Cutibacterium acnes detection at the portal area during arthroscopic shoulder surgery","authors":"Kazuya Uehara ,&nbsp;Kiminori Yukata ,&nbsp;Takashi Imagama ,&nbsp;Shunya Tsuji ,&nbsp;Yosuke Yamashita ,&nbsp;Kenzo Fujii ,&nbsp;Atsushi Mihara ,&nbsp;Ryuta Iwanaga ,&nbsp;Tetsuya Seto ,&nbsp;Masataka Asagiri ,&nbsp;Hiroshi Fujii ,&nbsp;Takashi Sakai","doi":"10.1016/j.jos.2025.08.003","DOIUrl":"10.1016/j.jos.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div><em>Cutibacterium acnes</em> (<em>C. acnes</em>), 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 <em>C. acnes</em> at the portal of arthroscopic shoulder surgery.</div></div><div><h3>Methods</h3><div>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 <em>C. acnes</em>. Preoperative inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR), were evaluated in relation to bacterial detection.</div></div><div><h3>Results</h3><div><em>C. acnes</em> 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 <em>C. acnes</em> cultures. Receiver operating characteristic (ROC) curve analysis identified optimal threshold values of 1.73 for NLR and 0.17 for MLR in predicting <em>C. acnes</em> detection.</div></div><div><h3>Conclusion</h3><div>Elevated preoperative NLR and MLR are associated with the intraoperative detection of <em>C. acnes</em> at the arthroscopic portal site. These readily available biomarkers may help identify patients at increased risk for bacterial contamination, informing preoperative prophylactic protocols.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 353-357"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","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}

{"title":"Diagnostic accuracy of preoperative imaging and intraoperative pathology in intradural spinal tumors and their impact on reoperation rate","authors":"Shogo Hashimoto,&nbsp;Narihito Nagoshi,&nbsp;Toshiki Okubo,&nbsp;Masahiro Ozaki,&nbsp;Takahito Iga,&nbsp;Kazuki Takeda,&nbsp;Satoshi Suzuki,&nbsp;Morio Matsumoto,&nbsp;Masaya Nakamura,&nbsp;Kota Watanabe","doi":"10.1016/j.jos.2025.09.008","DOIUrl":"10.1016/j.jos.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Accurate preoperative imaging and intraoperative pathological diagnosis are critical for managing intradural spinal tumors (IDST). This study aimed to assess the diagnostic accuracy of these methods and their impact on reoperation rates.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 1383 patients who underwent primary surgical treatment for IDST at a single institution between 2001 and 2022. Preoperative imaging diagnoses were established by spine surgeons and radiologists, while intraoperative pathological assessments were performed using frozen sections with hematoxylin and eosin staining in 929 cases. Final pathological diagnoses were confirmed through immunohistochemistry and genetic analysis. A diagnosis was defined as correct when the final pathology matched either of the two preoperative imaging diagnoses or the intraoperative frozen-section diagnosis. A discrepancy was recorded when the final pathology differed from both. Discrepancy assessments were determined retrospectively from medical records and pathology reports by a single investigator. The accuracy of preoperative imaging and intraoperative pathological diagnoses was compared with final pathology, and reoperation rates were analyzed.</div></div><div><h3>Results</h3><div>The accuracy of preoperative imaging diagnosis was 94.2 %, while that of intraoperative pathological diagnosis was 93.6 %. In subgroup analyses of patients with intraoperative pathology, reoperation was more frequent in cases with inaccurate preoperative imaging compared with accurate imaging (7.7 % vs 2.2 %; P &lt; 0.05). Similarly, intraoperative pathological discrepancies were associated with higher reoperation rates compared with concordant cases (10.2 % vs 2.1 %; P &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>This study demonstrated that both preoperative imaging and intraoperative pathology achieved high diagnostic accuracy in IDST, generally exceeding 90 %. Subgroup analyses suggested that discrepancies in preoperative imaging as well as in intraoperative pathology may be associated with an increased risk of reoperation. These findings indicate that both reliable preoperative imaging and precise intraoperative evaluation could be important for guiding surgical management, while challenges remain in diagnosing rare and histologically diverse tumors.</div></div><div><h3>Level of evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 313-318"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313108","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":"Locomotive syndrome severity and physical frailty progression in community-dwelling older adults: A 1-year longitudinal study from the DETECt-L study","authors":"Naoki Deguchi ,&nbsp;Junji Nishimoto ,&nbsp;Kazuaki Hamada ,&nbsp;Tomoyuki Akita ,&nbsp;Ryo Tanaka","doi":"10.1016/j.jos.2025.09.004","DOIUrl":"10.1016/j.jos.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is a geriatric syndrome that increases susceptibility to adverse health outcomes, including falls, disability, and mortality. Locomotive syndrome (LS), characterized by declining mobility, is a known predictor of poor health outcomes in older adults. However, the longitudinal relationship between LS severity and physical frailty progression in community-dwelling populations remains unclear.</div></div><div><h3>Methods</h3><div>This 1-year prospective cohort study included 252 community-dwelling older adults who were non-frailty at baseline. LS severity at baseline was classified into three categories—non-LS, LS Stage 1, and LS Stage 2 or 3—based on a standardized assessment. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria, with physical frailty progression after 1 year defined as a transition from robust to pre-frailty or frailty, or from pre-frailty to frailty, over 1 year. Binary logistic regression analyses examined the association between LS severity at baseline and physical frailty progression at 1 year, adjusting for confounders such as age, sex, body mass index, pain, fall history, Timed Up and Go test, single -leg standing time, and baseline frailty status.</div></div><div><h3>Results</h3><div>The median participant age was 74 years (range, 65–89 years; women, 85.3 %). Among the participants, LS Stage 1 was the most common (53.6 %), while 21.7 % were at LS Stage 2 or 3. After 1 year, 16.9 % of participants exhibited physical frailty progression (from baseline to 1 year), 70.9 % remained stable, and 12.2 % showed improvement. Compared with the non-LS group, those with LS Stage 2 or 3 had a significantly greater risk of physical frailty progression (adjusted odds ratio [aOR], 4.89; 95 % CI, 1.18–20.3). LS Stage 1 was not significantly associated with physical frailty progression.</div></div><div><h3>Conclusions</h3><div>While advanced LS (Stage 2 or 3) significantly predicts frailty progression, our findings pinpoint LS Stage 1 as the crucial window for preventive action. At this early stage, a subclinical increase in risk manifests as a twofold rise in the rate of worsening frailty. Effective prevention strategies must therefore be initiated at LS Stage 1 to alter the trajectory away from functional decline.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 492-498"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308576","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 ,&nbsp;Takayuki Furumatsu ,&nbsp;Aki Yoshida ,&nbsp;Yuki Okazaki ,&nbsp;Masanori Tamura ,&nbsp;Koki Kawada ,&nbsp;Yusuke Yokoyama ,&nbsp;Toshifumi Ozaki","doi":"10.1016/j.jos.2025.07.011","DOIUrl":"10.1016/j.jos.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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 (<em>TGFB1</em><em>)</em> 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.</div></div><div><h3>Results</h3><div>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 <em>TGFB1</em> (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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 426-432"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","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":"Radiographic evaluation of cervical spondylosis using an elemental grading system in a population-based cohort study of a Japanese mountain village","authors":"Junichi Yamada ,&nbsp;Koji Akeda ,&nbsp;Norihiko Takegami ,&nbsp;Koki Kawaguchi ,&nbsp;Takahiro Hasegawa ,&nbsp;Tatsuhiko Fujiwara ,&nbsp;Akinobu Nishimura ,&nbsp;Akihiro Sudo ,&nbsp;Masahiro Hasegawa","doi":"10.1016/j.jos.2025.08.008","DOIUrl":"10.1016/j.jos.2025.08.008","url":null,"abstract":"<div><h3>Background</h3><div>Cervical spine radiography is a common screening tool for cervical spondylosis with radiographic features, including osteophytes, disc height narrowing, vertebral sclerosis, and spondylolisthesis. The Kellgren–Lawrence classification is widely used for evaluating musculoskeletal radiographs, including spinal radiographs; however, evaluating the individual radiographic features of spondylosis is challenging with this classification. This study aimed to develop an elemental grading system for evaluating cervical spine radiographs and the extent of cervical spondylosis.</div></div><div><h3>Methods</h3><div>In total, 320 participants from a typical Japanese mountain village were included in this study. From the lateral cervical spine radiographs from C2/C3 to C6/C7, radiographic features related to cervical spondylosis were separately graded as 0, 1, or 2 according to the severity of degeneration. The sum of the grades of each radiographic feature at each intervertebral level was designated the intervertebral grade. The average grades of each radiographic feature (osteophytes, disc height narrowing, vertebral sclerosis, and spondylolisthesis), intervertebral grade, and Kellgren–Lawrence classification of the whole cervical spine were defined as ‘wOP,’ ‘wDHN,’ ‘wVS,’ ‘wSL,’ ‘wIG’ and ‘wKL,’ respectively.</div></div><div><h3>Results</h3><div>This elemental grading system showed good inter- and intraobserver reliability, similar to the Kellgren–Lawrence classification. The distribution of grades 1 and 2 in osteophytes, disc height narrowing, and vertebral sclerosis was observed most frequently at the C5/C6 level, followed by the C4/C5 and C6/C7 levels, whereas a significantly higher spondylolisthesis grade than expected was found at C4/C5. Participants with neck pain showed significantly higher wVS (P &lt; 0.05) than those without neck pain, whereas wOP, wDHN, wSL, wIG, and wKL showed no significant differences.</div></div><div><h3>Conclusions</h3><div>We developed a grading system for radiographic cervical spondylosis with high reliability and a simple design, which will contribute to future epidemiological studies in evaluating the extent of degenerative changes on cervical radiographs.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 298-304"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008365","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":"Arthroscopic lateral ankle ligament repair for chronic lateral ankle instability in dancers","authors":"So Minokawa ,&nbsp;Ichiro Yoshimura ,&nbsp;Kazuki Kanazawa ,&nbsp;Tomonobu Hagio ,&nbsp;Tetsuro Ishimatsu ,&nbsp;Yuki Sugino ,&nbsp;Yozo Shibata ,&nbsp;Teruaki Izaki ,&nbsp;Takuaki Yamamoto","doi":"10.1016/j.jos.2025.09.003","DOIUrl":"10.1016/j.jos.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Foot and ankle injuries are common among dancers. Full plantar flexion places stress on the lateral aspect of the ankle, increasing the risk of ankle sprains. Arthroscopic lateral ankle ligament repair has shown favorable clinical outcomes in elite athletes with chronic lateral ankle instability (CLAI); however, its effectiveness in dancers remains unclear. This study was performed to evaluate the clinical outcomes and efficacy of arthroscopic lateral ankle ligament repair for CLAI in dancers.</div></div><div><h3>Methods</h3><div>From July 2015 to March 2021, arthroscopic lateral ankle ligament repair was performed on seven ankles of seven female dancers. The patients’ mean age at surgery was 21.4 years, and the mean follow-up duration was 17.3 months. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) scale and patient satisfaction with the surgical outcome.</div></div><div><h3>Results</h3><div>The mean JSSF scale score significantly improved from 75.4 ± 6.6 points preoperatively to 95.3 ± 5.4 points at the final follow-up (<em>p</em> &lt; 0.05). Six feet were rated as excellent and one as fair.</div></div><div><h3>Conclusions</h3><div>These findings suggest that arthroscopic lateral ankle ligament repair is an effective surgical treatment for CLAI in dancers.</div></div><div><h3>Level of evidence</h3><div>Level IV, case series.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 387-391"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280712","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 ,&nbsp;Hidenori Suzuki ,&nbsp;Norihiro Nishida ,&nbsp;Masahiro Funaba ,&nbsp;Yusuke Ichihara ,&nbsp;Issei Tanaka ,&nbsp;Yasuaki Imajo ,&nbsp;Manabu Yamamoto ,&nbsp;Takashi Sakai","doi":"10.1016/j.jos.2025.07.010","DOIUrl":"10.1016/j.jos.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 &lt; 0.01). The high intensity zone (HIZ) of hernia was more frequent in group R than in the other two groups (p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 284-289"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","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":"Comparison of clinical features between patients with bone and soft tissue angiosarcomas","authors":"Yuta Kamo ,&nbsp;Masatake Matsuoka ,&nbsp;Tomohiro Onodera ,&nbsp;Koji Iwasaki ,&nbsp;Dai Sato ,&nbsp;Taku Ebata ,&nbsp;Yoshiaki Hosokawa ,&nbsp;Eiji Kondo ,&nbsp;Norimasa Iwasaki","doi":"10.1016/j.jos.2025.08.009","DOIUrl":"10.1016/j.jos.2025.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Angiosarcoma is a rare and aggressive malignancy arising from vascular endothelial cells, with distinct subtypes originating in bone (AS-B) and soft tissue (AS-ST). While these subtypes share pathological similarities, differences in clinical outcomes remain unclear due to limited data. This study aimed to compare the clinical features, treatment strategies, and survival outcomes between AS-B and AS-ST using the Surveillance, Epidemiology, and End Results (SEER) database.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using the SEER database from 2000 to 2020. A total of 3600 angiosarcoma cases were included, with 114 AS-B and 3486 AS-ST cases. Patient demographics, tumor characteristics, and treatment modalities were analyzed. Cancer-specific survival (CSS) and overall survival (OS) were assessed using Kaplan-Meier analysis, and risk factors were evaluated through Cox proportional hazards modeling.</div></div><div><h3>Results</h3><div>AS-B patients were predominantly male, with higher rates of extremity tumors and distant metastases compared to AS-ST. The 5-year CSS was 34.4 % and OS was 15.0 % for AS-B, compared to 38.3 % CSS and 26.0 % OS for AS-ST, with no significant differences after Cox proportional hazards modeling. Metastases were associated with poorer survival in AS-B, while surgical intervention and chemotherapy improved both CSS and OS. Similar trends were observed in AS-ST, with tumor grade, metastases, and treatment modalities influencing survival.</div></div><div><h3>Conclusion</h3><div>This population-based study highlights the distinct clinical features of AS-B and AS-ST. It also demonstrates comparable survival outcomes between the two groups. Although survival was similar between AS-B and AS-ST, their distinct clinical characteristics suggest the need for site-specific therapeutic considerations. Given the retrospective design, observed treatment effects should be interpreted as associations rather than causal relationships.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 466-472"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008320","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":"Thromboembolic risks after knee arthroplasty in patients with severe obesity: A large-scale analysis using Japanese medical claims data","authors":"Yu Mori ,&nbsp;Kunio Tarasawa ,&nbsp;Hidetatsu Tanaka ,&nbsp;Masayuki Kamimura ,&nbsp;Naoko Mori ,&nbsp;Kiyohide Fushimi ,&nbsp;Toshimi Aizawa ,&nbsp;Kenji Fujimori","doi":"10.1016/j.jos.2025.08.007","DOIUrl":"10.1016/j.jos.2025.08.007","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is associated with an increased risk of complications after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA), particularly in Western populations. However, the effect of severe obesity (body mass index [BMI] ≥ 35 kg/m²) on postoperative complications in Japanese patients remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using Japan's Diagnosis Procedure Combination (DPC) database, including patients who underwent TKA or UKA between April 2016 and March 2023. Patients were classified into severely obese (BMI ≥35 kg/m²) and non-severely obese (BMI &lt;35 kg/m²) groups. After 1:1 propensity score matching for age, sex, comorbidities, surgical method, and Charlson Comorbidity Index, postoperative complications were compared using chi-square tests and multivariate logistic regression analyses.</div></div><div><h3>Results</h3><div>A total of 7832 matched pairs were analyzed. The incidence of deep vein thrombosis (odds ratio [OR], 1.16; 95 % confidence interval [CI], 1.03–1.29; p = 0.011) and pulmonary embolism (OR, 1.79; 95 % CI, 1.03–3.10; p = 0.037) was significantly higher in the severely obese group. Simultaneous bilateral surgery was also an independent risk factor for venous thromboembolism (VTE). No significant differences were observed in surgical site infection, length of hospital stay, or transfusion volume between the two groups.</div></div><div><h3>Conclusions</h3><div>Severe obesity and simultaneous bilateral surgery are independent risk factors for VTE following knee arthroplasty in Japanese patients. These findings highlight the need for careful perioperative management in this high-risk population.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 414-419"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008318","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":"Prospective observational study of daily upper-limbs activities following arthroscopic rotator cuff repair using triaxial accelerometers: Recovery process and relationship with preoperative clinical parameters","authors":"Toshiyuki Fukushima ,&nbsp;Yoshihiro Nakamura ,&nbsp;Hiroshi Kurumadani ,&nbsp;Shota Date ,&nbsp;Masako Tominaga ,&nbsp;Toru Sunagawa","doi":"10.1016/j.jos.2025.08.011","DOIUrl":"10.1016/j.jos.2025.08.011","url":null,"abstract":"<div><h3>Background</h3><div>Following arthroscopic rotator cuff repair (ARCR), upper-limb movement must be restricted during the early postoperative phase. However, the postoperative recovery process of daily upper-limb use and its relationship with preoperative parameters remain unclear. We investigated the postoperative recovery process of the operated limb use following ARCR quantitatively using triaxial accelerometers and examined its relationship with preoperative parameters.</div></div><div><h3>Methods</h3><div>We evaluated bilateral upper-limb use in daily activities using triaxial accelerometers in 21 patients who underwent ARCR. Measurements were performed immediately before the surgery and at 2, 3, 6, and 12 months postoperatively. Twenty healthy adults served as the controls. Additionally, correlations with preoperative clinical scores, active range of motion, muscle strength, and pain were investigated.</div></div><div><h3>Results</h3><div>The frequency of upper-limb use showed no significant differences between the operated and non-operated limbs from the preoperative to 12 months postoperatively. The intensity of upper-limb use in the operated limb was significantly lower than that in the non-operated limb and controls at the preoperative, 2 and 3months. These differences were resolved 6 months postoperatively. Regarding preoperative parameters, postoperative intensity particularly correlated with shoulder flexion and muscle strength.</div></div><div><h3>Conclusion</h3><div>Following ARCR, the intensity of upper-limb use should be increased progressively, as additional time may be needed for intensity recovery. Furthermore, maintaining preoperative shoulder flexion may promote postoperative daily upper-limb activities. These findings suggest that clinicians may consider monitoring the intensity of upper-limb use in daily living following ARCR and maintaining shoulder flexion through preoperative rehabilitation.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 335-342"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092008","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}