MUSCULOSKELETAL SURGERY最新文献

{"title":"Early bone graft donor site morbidities; anterior superior iliac crest versus proximal tibia.","authors":"S C Uzodimma, G O Eyichukwu, E C Iyidobi, O Ede, C U Nwadinigwe, H C Ikeabbah, C O Uzuegbunam, U E Anyaehie, R T Ekwunife, K A Okoro, C M Akah","doi":"10.1007/s12306-024-00865-7","DOIUrl":"10.1007/s12306-024-00865-7","url":null,"abstract":"<p><strong>Purpose: </strong>Autogenous bone grafting is a widely used technique in orthopaedic and reconstructive surgeries. The anterior superior iliac crest (AIC) and proximal tibia (PT) are common sources for bone grafts. While, AIC is the gold standard, PT is popular for lower extremity procedures due to its proximity. The research investigates early complications associated with these donor sites in a tertiary orthopaedic centre in Nigeria.</p><p><strong>Methods: </strong>This randomized controlled study was conducted from July 2020 to December 2021. It includes 66 patients randomized into AIC and PT groups. Pain score analysis and the incidence of surgical site infections were compared between both groups.</p><p><strong>Results: </strong>There was no statistical difference in the incidence of surgical site infections (SSI) in both groups. The study also reveals that patients in the AIC group experienced more significant pain in the immediate postoperative period and up to two weeks after surgery, with the severity particularly pronounced on the first postoperative day. (p < 0.001).</p><p><strong>C conclusions: </strong>The PT had less pain severity than the AIC bone graft donor sites. The authors recommend that surgeons consider PT if bone grafting is required.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"207-212"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the continuity of the therapist-patient relationship relevant for the discharge outcome in orthopaedic physical rehabilitation?","authors":"D Platano, R Tedeschi, G Tonini, S Capone, M Morri, A O Magli, D Raffa, M G Benedetti","doi":"10.1007/s12306-024-00860-y","DOIUrl":"10.1007/s12306-024-00860-y","url":null,"abstract":"<p><p>Continuity of care has been linked to patient satisfaction and self-reported outcomes. Following hip fractures in the elderly, rehabilitation aims at restoring patients' mobility and independence at the pre-fracture level and at the earliest possible time. Despite the potential role of physiotherapists' continuity on functional outcomes, this correlation has not yet been studied in an acute orthopaedic setting. Guaranteeing the presence of the same physical therapist on individual patients is challenging from an organizational point of view. An observational retrospective study was conducted on 129 aged patients (84 ± 8 years) who underwent surgery for proximal hip fracture. Indicators of outcomes were ILOA score at discharge, length of stay and achievement of rehabilitation goals as defined by the Individual Rehabilitation Project. The number of physical therapists taking care of patients was monitored during the patient's hospital stay. No correlation was found between the number of physical therapists and functional goals at discharge. The frequent change of physical therapists providing rehabilitation to elderly patients who underwent surgery for hip fragile fracture is not related to functional outcomes.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"195-199"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Returning to running after total knee arthroplasty: a systematic review and a novel multimodal protocol.","authors":"C Faldini, F Traina, V Digennaro, L Berti, A Panciera, D Cecchin, R Ferri, L Benvenuti, L Calbucci","doi":"10.1007/s12306-025-00892-y","DOIUrl":"10.1007/s12306-025-00892-y","url":null,"abstract":"<p><p>Total knee arthroplasty (TKA) is the gold standard for advanced knee osteoarthritis and is increasingly performed on younger, active individuals. While low-impact sports are recommended after TKA, running remains controversial due to concerns about implant loosening. Cemented implants have durability issues at the bone-cement interface, while cementless designs seem to promote better osseointegration. Despite limited research, running after TKA is gaining acceptance. The purpose of this paper is to present a systematic review of the literature and present a novel and specific protocol to guide motivated patients in safely resuming running. We conducted a systematic review of PubMed studies regarding running after TKA and the PRISMA flow diagram shows the inclusion and exclusion criteria adopted. In addition, we present a novel protocol (FAST) specifically designed for TKA patients aiming to return to running which combines surgical techniques, perioperative analgesia, and physical therapy. It has been approved by the Ethics Board, the prospective trial is registered (NCT06383936), and we are currently enrolling participants. After screening according to inclusion and exclusion criteria, six studies were included in the analysis. The FAST protocol combines cementless CR-design implants, minimally invasive surgery, and personalized functional alignment. Local infiltration analgesia reduces pain and enables rehabilitation within 24 h. Rehabilitation progresses with range-of-motion exercises, muscle strengthening, and gradual return to running at 6-8 months. Monitoring activity carefully prevents inflammation, optimizing recovery. Running after TKA, once discouraged, now shows low complication rates. Preoperative fitness and patient-specific factors are key predictors of success. The FAST protocol integrates cementless implants, personalized alignment, and structured rehabilitation. Proper patient selection and communication are essential. Further research is required to validate long-term outcomes.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"145-153"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthogonal versus parallel plating in pediatric distal humeral fractures: a systematic review and meta-analysis.","authors":"R Jonathan, E Kow","doi":"10.1007/s12306-025-00903-y","DOIUrl":"https://doi.org/10.1007/s12306-025-00903-y","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis compared orthogonal and parallel plating techniques for these fractures, focusing on functional recovery, complication rates, and biomechanical stability.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted on January 25, 2025, across PubMed, EMBASE, Europe PMC, and Scopus. Studies involving pediatric patients (aged 0-18 years) with distal humeral fractures treated using orthogonal or parallel plating were included. Eligible studies reported outcomes such as Mayo Elbow Performance Score (MEPS), range of motion (ROM), union time, and non-union rate. Two independent reviewers extracted data, and study quality was assessed using the Cochrane risk of bias (RoB) tool version 2.0. Statistical analyses were performed using a random-effects model in RStudio.</p><p><strong>Results: </strong>From an initial pool of 659 records, five studies (three randomized controlled trials [RCTs] and two cohort studies) met the inclusion criteria. Meta-analyses revealed no significant differences between orthogonal and parallel plating in MEPS (SMD - 0.25, p = 0.07), ROM (SMD - 0.15, p = 0.27), flexion range (SMD - 0.11, p = 0.46), non-union rate (RR 1.01, p = 0.99), union time (RR 1.01, p = 0.99), or surgical duration (SMD 0.06, p = 0.74). However, orthogonal plating showed a statistically significant advantage in extension range (SMD 0.45, p = 0.005). The risk of bias was minimal, and the certainty of evidence was rated as high.</p><p><strong>Conclusions: </strong>Both orthogonal and parallel plating techniques demonstrated comparable efficacy in managing pediatric distal humeral fractures, with no significant differences in most outcomes. Orthogonal plating exhibited a slight advantage in extension range, though its clinical relevance requires further investigation.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing knee diagnostics and treatment: the role of needle arthroscopy.","authors":"R Compagnoni, A Pieroni, G Fedele, Alessio Maione, Filippo Calanna, P Ferrua, P S Randelli","doi":"10.1007/s12306-025-00902-z","DOIUrl":"https://doi.org/10.1007/s12306-025-00902-z","url":null,"abstract":"<p><p>Knee needle arthroscopy (NA) represents a minimally invasive diagnostic and therapeutic approach for managing a variety of knee joint pathologies. This innovative technique, characterized by a thin, flexible, needle-like device, offers a less invasive alternative to conventional arthroscopy (CA), enabling outpatient procedures with reduced postoperative pain, faster recovery, and minimal scarring. This systematic review examines the current applications, diagnostic accuracy, clinical outcomes, and patient benefits of needle arthroscopy. Studies reveal that NA demonstrates comparable diagnostic efficacy to CA and superior accuracy to MRI for intra-articular knee pathology, particularly in meniscal injuries and anterior cruciate ligament assessments. NA facilitates real-time visualization and interventions under local anesthesia, promoting cost-efficiency and patient satisfaction. Despite its advantages, there are challenges such as limited visualization and technical proficiency. While NA emerges as a promising modality in knee diagnostics and treatment, further large-scale clinical trials are essential to validate its long-term efficacy, safety, and broader applications.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary subtalar arthrodesis in displaced intra-articular calcaneal fracture: a systematic review.","authors":"A Giuliani, S Calori, A Singlitico, F Forconi, G Maccauro, R Vitiello","doi":"10.1007/s12306-025-00901-0","DOIUrl":"https://doi.org/10.1007/s12306-025-00901-0","url":null,"abstract":"<p><p>Calcaneus fractures are severe injuries often resulting from traumatic falls or motor vehicle accidents. Surgical treatment through open reduction and internal fixation (ORIF) is considered the standard approach for displaced intra-articular calcaneal fractures (DIACFs), but it is associated with many complications. Our study aimed to review the current literature available on primary subtalar arthrodesis (PSA) as a first-line treatment for DIACFs, mostly Sanders type IV. In this study, we conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The keywords were searched in PubMed, MEDLINE and the Cochrane Library. This review included articles where primary arthrodesis was performed in calcaneal fractures, with or without associated implants. Nine articles were included in the review. The total population comprised 184 patients with 192 calcaneal fractures. The mean age was 44.9 ± 6.9 years old. The mean follow-up period was 30.28 ± 15.29 months when reported. The mean time to surgery was 13.33 ± 7.02 days from injury. All studies reported a good fusion rate (between 94 and 100%) and an average fusion time of 4.05 ± 2.19 months. The mean American Orthopedic Foot & Ankle Society (AOFAS) score was 71.26 ± 8, and the mean Visual Analog Scale (VAS) score for pain was 3.26 ± 0.91. Primary arthrodesis of the subtalar joint for treating DIACFs, mostly Sanders type IV, provides good results due to the avoidance of further procedures, reduced postoperative pain, and a high rate of bony union. However, success heavily depends on factors such as patient comorbidities and addressing hindfoot deformity. Further studies with larger patient populations and more standardized protocols are necessary to draw definitive conclusions about the best management strategies for DIACFs. Systematic review, level III of evidence.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scapular dyskinesis after breast reconstruction surgery for breast cancer: a retrospective clinical analysis on 67 patients.","authors":"L Murena, F Santovito, A de Grazia, G Libretti, G Galeazzi, G B Sidoti, N Renzi, B Trobec, A Buoite Stella, V Ramella, G Papa, G Canton","doi":"10.1007/s12306-025-00904-x","DOIUrl":"https://doi.org/10.1007/s12306-025-00904-x","url":null,"abstract":"<p><strong>Purpose: </strong>Mastectomy and breast reconstruction surgery are often associated with postoperative pain and functional limitation at the ipsilateral shoulder, potentially leading to scapular dyskinesis. However, few studies have determined how the type of surgery and rehabilitation might affect the development of such clinical condition.</p><p><strong>Methods: </strong>A retrospective observational study was performed on a clinical database of females who underwent surgical and adjuvant disease control treatment against breast cancer. Data included in this analysis were: demographics and clinical history, type of surgery and duration of physiotherapy, complications, as well as scapulohumeral rhythm and shoulder soreness evaluated during the orthopedic visit.</p><p><strong>Results: </strong>Based on the inclusion and exclusion criteria, 67 females (age 52 y, range 30-69) entered the statistical analysis. Static dyskinesis was present in 64.2% of the sample at the time of the visit, and it was found present bilaterally in 29.9% of the sample, whereas dynamic dyskinesis was found in 73.1% of the sample at the time of the visit. Longer physiotherapy (> 20 sessions) showed a trend for a lower risk of dynamic dyskinesis (OR 0.228, 95% CI 0.046-1.114, p = 0.072), and compared to the Subpectoral Tissue Expander, Prepectoral Implant-Based Breast Reconstruction presented a reduced risk for dynamic dyskinesis (OR 0.265, 95% CI: 0.074-0.952, p = 0.042).</p><p><strong>Conclusion: </strong>These preliminary findings suggest that some factors, such as the type of surgery and physiotherapy, might influence the development of scapular dyskinesis in females who undergo mastectomy and breast reconstruction.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Co-design of a novel rehabilitation intervention for patients after ankle fracture surgery: establishing healthcare professional consensus.","authors":"C Bretherton, A Al-Saadawi, H Sandhu, J Baird, X Griffin","doi":"10.1007/s12306-025-00898-6","DOIUrl":"https://doi.org/10.1007/s12306-025-00898-6","url":null,"abstract":"","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of titanium elastic nails in open forearm fractures in adults: a feasible alternative.","authors":"B Harna, R Kaushik, S Arya","doi":"10.1007/s12306-025-00900-1","DOIUrl":"https://doi.org/10.1007/s12306-025-00900-1","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional management of forearm fractures involves open reduction and internal fixation (ORIF) using plates and screws after wound healing. However, recent years have seen the emergence of minimally invasive techniques like titanium elastic nailing (TENS) as potential alternatives. This retrospective study evaluates the role of TENS in managing open forearm fractures in adults.</p><p><strong>Methodology: </strong>A retrospective analysis was conducted over 5 years, including 18 adult patients with open forearm fractures without neurovascular or tendon injury, classified as Gustilo Anderson III A and IIIB. Surgical management involved TENS insertion following debridement with patients undergoing general anaesthesia or brachial block. Patients were positioned supine, and reduction was performed under fluoroscopy. TENS nails were inserted into the radius and ulna, with appropriate sizing and positioning. Plastic surgical interventions were performed as necessary.</p><p><strong>Results: </strong>There were satisfactory outcomes in 14 patients, with four patients achieving excellent outcomes at 12-month follow-up. The radiological union was observed in 12 patients, while six required revision surgeries. Deep tissue infection occurred in two patients, managed with debridement and vacuum-assisted closure. No forearm shortening was observed, with average supination and pronation of 70° and 80°, respectively. No evidence of infection was noted at the last follow-up.</p><p><strong>Conclusion: </strong>The study underscores the feasibility of TENS as an alternative to external fixation or ORIF in managing open forearm fractures. TENS provides a viable option, particularly in combined orthopaedic and plastic surgery management, offering satisfactory outcomes and allowing for subsequent plating if needed. Ultimately, treatment decisions should be individualised, weighing various factors to optimise patient care and outcomes.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-design of a novel rehabilitation intervention for patients after ankle fracture surgery: the patient perspective.","authors":"C Bretherton, A Al-Saadawi, H Sandhu, J Baird, X Griffin","doi":"10.1007/s12306-025-00887-9","DOIUrl":"https://doi.org/10.1007/s12306-025-00887-9","url":null,"abstract":"<p><strong>Purpose: </strong>Effective rehabilitation following ankle fracture surgery is essential for optimal recovery and patient satisfaction. However, traditional rehabilitation strategies often lack personalisation, leading to suboptimal outcomes. This study aimed to co-design a rehabilitation package, collaborating directly with patients, to understand their individual needs, using the Behaviour Change Wheel (BCW) framework.</p><p><strong>Methods: </strong>Integrated within the larger weight-bearing in ankle fractures (WAX) trial, this study employed the BCW to understand behaviour, intervention options and content implementation. Nominal Group Technique was used to facilitate a workshop with 10 ankle fracture patients, and subsequent surveys were used to gather and prioritise rehabilitation needs and strategies. Participants were aged between 28 and 69, and nine (90%) were female, with representation from seven different NHS hospital trusts. Two experienced patient representatives facilitated the workshop.</p><p><strong>Results: </strong>Rehabilitation strategies were developed focussing on interventions that included education, training, environmental restructuring, persuasion and enablement, delivered through an app or website. Survey results indicated high patient enthusiasm for structured, accessible rehabilitation support, including instructional videos, live chats with physiotherapists and peer support forums. Patients desired advice on returning to hobbies and life roles, and particularly returning to driving, bathing and work.</p><p><strong>Conclusion: </strong>The BCW framework facilitated the development of a patient-centred rehabilitation package, highlighting the importance of tailored, accessible interventions. Patients expressed strong support for the proposed strategies, suggesting potential for improved rehabilitation outcomes through personalised, digitally delivered support. These components will be used to co-design future rehabilitation interventions.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}