MUSCULOSKELETAL SURGERY最新文献

{"title":"Osteonecrosis as a manifestation of Long-COVID Syndrome: a systematic review.","authors":"P Za, G F Papalia, P Gregori, S Vasta, R Papalia","doi":"10.1007/s12306-024-00854-w","DOIUrl":"10.1007/s12306-024-00854-w","url":null,"abstract":"<p><p>Purpose SARS-CoV-2 is an RNA virus responsible for COVID-19 pandemic. Some authors described the set of persistent symptoms COVID-related as \"Long-COVID Syndrome.\" Several cases of post-COVID-19 osteonecrosis (ON) are described. Our primary aim was to study the hypothetical correlation between SARS-CoV-2 infection and ON; our secondary aim was to understand if ON can be considered part of Long-COVID. Materials and methods We performed a systematic review following the Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) guidelines. Because COVID-19 is a recently described disease, we included all levels of evidence studies. We excluded studies lacking specification regarding the use of corticosteroids (CCS) and studies not related to COVID-19. The variables extracted were age, sex, risk factors, affected joints, signs and symptoms, magnetic resonance imaging (MRI) and X-ray features, histology, treatment of COVID-19, dose and duration of treatment with CCS, treatment of ON, follow-up, and treatment outcome. Results A total of 13 studies were included, involving 95 patients and 159 joints. Time between the diagnosis of COVID-19 and the onset of symptoms related to ON was 16 weeks on average. Time between the onset of symptoms and the MRI was 6 weeks. An average of 926.4 mg of prednisolone equivalent per patient were administered. On average, CCS were administered for 20.6 days. Conclusions Patients with a history of COVID-19 infection developed osteonecrosis prematurely and with a lower dose of CCS than usually reported in the literature. Symptoms of osteonecrosis occur within the interval of the period described as Long-COVID. Surgeons should not underestimate the persistence of arthralgia when a history of SARS-CoV-2 infection and use of CCS is reported.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860333","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":"Long-term follow-up of adolescent idiopathic scoliosis surgery with Harrington instrumentations: a systematic review and meta-analysis.","authors":"F Barile, A Ruffilli, M Morandi Guaitoli, G Viroli, M Ialuna, M Manzetti, T Cerasoli, E Artioli, M Traversari, A Mazzotti, C Faldini","doi":"10.1007/s12306-024-00836-y","DOIUrl":"10.1007/s12306-024-00836-y","url":null,"abstract":"<p><strong>Purpose: </strong>In the 1960s, Harrington instrumentation (HRI) revolutionized the surgical treatment of adolescent idiopathic scoliosis (AIS). Despite the transition to more innovative techniques, concerns regarding its impact on sagittal alignment, associations with low back pain, and correction loss have consistently persisted. The aim of this meta-analysis is precisely to evaluate the clinical and radiological outcomes, as well as the complications of patients treated with HRI over an extended follow-up period. A systematic search of articles about AIS patients who underwent HRI and reported long-term outcomes (> 10 years) was conducted on electronic databases according to PRISMA guidelines. Data regarding radiographic and clinical outcomes were extracted and meta-analyses were performed. Eleven studies comprising 644 patients were included. The mean follow-up ranged from 10.8 to 51.7 years. Radiographic analysis revealed a decrease in the main curve Cobb angle from 60.6° to 38.3°, with a correction loss of - 9.49° between postoperative and last follow-up. Concerning sagittal parameters, preoperative thoracic kyphosis was 19.65° at last follow-up, and preoperative lumbar lordosis was 42.94°. Additional spine surgeries were required in 42% of patients. Clinical outcomes varied among studies, but overall, HRI patients showed comparable quality of life and function to controls, although a higher incidence of low back pain was reported. Patients who underwent HRI exhibited suboptimal correction of rib deformity and a flattened sagittal spinal alignment. However, they generally displayed favourable long-term functional outcomes. Despite the implant's tendency to reduce lumbar curvature, patients achieved good clinical outcomes and functional scores comparable to age-matched individuals, suggesting that disability is not an inevitable consequence of lumbar flattening.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"17-31"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162041","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":"Conservative versus surgical treatment for displaced olecranon fractures in the elderly: a retrospective study and a review of the literature.","authors":"V Luppi, D Regis, T Maluta, A Sandri, A Trivellato, A Mirabile, B Magnan","doi":"10.1007/s12306-024-00853-x","DOIUrl":"10.1007/s12306-024-00853-x","url":null,"abstract":"<p><strong>Background: </strong>Surgery is the gold standard treatment of displaced olecranon fracture, but it presents a high rate of complications, especially in the elderly, including wound breakdown and fixation failure. Conservative treatment of these fractures has recently been proposed with good functional outcomes. The aim of this retrospective study was to compare the functional results and level of satisfaction of displaced olecranon fractures which were managed surgically or conservatively in geriatric patients. The rate of implant removal and reoperation in the surgical group were also calculated.</p><p><strong>Materials and methods: </strong>Sixteen and eleven patients aged ≥ 75 years (mean 83 and 86.2, respectively) with isolated Mayo IIA or IIB olecranon fracture were surgically and conservatively treated, respectively. All but 1 were females. Due to coronavirus pandemic, they were contacted by phone to validated clinical scores (QuickDASH, PREE and VAS), which were used to assess the outcome.</p><p><strong>Results: </strong>At an average follow-up of 26.5 months in the conservative group and 53.1 in the surgical group (range 4-82), the mean Quick DASH was 11.67 and 11.2, respectively, while the mean PREE was 11.36 and 12.67, respectively. There was no significant difference in functional outcomes between the two groups, and all patients were satisfied. Seven complications occurred in the surgical cohort (33.3%), requiring reoperation in 4 cases (19%).</p><p><strong>Conclusions: </strong>Displaced olecranon fractures can successfully be treated conservatively in low-demand geriatric patients with good functional results and high satisfaction rate.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860332","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":"No difference in clinical outcomes when retaining or sacrificing the posterior cruciate ligament in medial congruent total knee replacement. A retrospective study.","authors":"B C M Foong, W C Lee, S K M Khoo, R Kunnasegaran","doi":"10.1007/s12306-024-00866-6","DOIUrl":"10.1007/s12306-024-00866-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to evaluate the effect of retaining or sacrificing the posterior cruciate ligament (PCL) in patients who undergo primary total knee replacement (TKR) with the medial congruent (MC) implant.</p><p><strong>Methods: </strong>This retrospective study looks at patients who underwent TKR with the MC implant. Comparison was made between the group with the PCL sacrificed (MC-PCLS) and the group with the PCL retained (MC-PCLR). Range of motion (ROM), Oxford knee score (OKS), Knee society knee score (KS-KS) and Knee society function score (KS-FS) were recorded.</p><p><strong>Results: </strong>The study identified 76 patients. 50 in the MC-PCLS group and 26 in the MC-PCLR group. Both groups had similar patient demographics. Three months postoperatively, OKS and KS-KS had significant improvement. However, there was significant improvement in KS-FS score in the MC-PCLS group but not the MC-PCLR group (MC-PCLR: 33 ± 17, p = 0.07; MC-PCLS: 19 ± 24, p = 0.01). Twelve months postoperatively, the OKS continued to improve significantly for both groups, while the KS-FS and KS-KS scores appeared to stagnate. The ROM continued to improve significantly for the MC-PCLR group but not the MC-PCLS group (MC-PCLR: 7 ± 9, p = 0.03; MC-PCLS: 4 ± 9, p = 0.30). Both groups were similar in ROM, OKS and KSS scores at both the 3 and 12 month post-operative period.</p><p><strong>Conclusion: </strong>There is no difference in post-operative outcomes with the PCL retained or sacrificed. As such, surgeons can consider routinely sacrificing the PCL for easier balancing of the knee and shorter surgical time.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133268","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":"Multicenter survey about leg length discrepancy and total hip arthroplasty: postoperative management.","authors":"D Stimolo, S Lo Giudice, F Matassi, M Innocenti, R Civinini, F Boniforti","doi":"10.1007/s12306-024-00855-9","DOIUrl":"10.1007/s12306-024-00855-9","url":null,"abstract":"<p><strong>Background: </strong>We created a Multicenter Survey for Italian orthopedics surgeons on how they approach leg length discrepancy when dealing with primary total hip arthroplasty. Aim of the study was to show how surgeons manage LLD and follow literature recommendations during clinical practice.</p><p><strong>Methods: </strong>The Survey was composed of 25 questions divided in 4 sections: surgeon's profile, preoperative and intraoperative evaluation, postoperative management. In this paper, we report the absolute and relative frequencies of answers to section on \"postoperative management.\" Then, regarding the treatment of residual LLD, we reported whether trauma surgeons and experts in replacement surgery had higher odds ratios for providing \"literature-based\" answers compared to orthopedics physicians.</p><p><strong>Results: </strong>Only four questions received more than 70% agreement on one of the answers. The OR for giving the \"literature-based\" answer, taking OP as the reference group was 1.57 for TR and 1.72 for RS for 10 mm LLD at first follow-up (FU) and 1.23 TR and 1.32 RS when 20 mm. When 10 mm LLD at 3 months FU the OR was 0.88 TR and 1.15 RS. The OR for treatment of LLD after the first examination of a new patient was 2.16 TR and 1.85 RS.</p><p><strong>Conclusions: </strong>LLD is a debated topic with no definitive recommendations. Many decisions still depend on tradition. Treatment of LLD during clinical practice often differs from literature recommendations.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of potential genes associated with metastasis in osteosarcoma: an integrated bioinformatics analysis.","authors":"I G E Wiratnaya, M D Ismail, F Hasan","doi":"10.1007/s12306-025-00891-z","DOIUrl":"https://doi.org/10.1007/s12306-025-00891-z","url":null,"abstract":"<p><p>This study aims to identify the potential genes, pathways, and tumor immune microenvironment that might be involved in the metastasis process of osteosarcoma (OS). The GEO2R tool was deployed to screen two datasets obtained from the Gene Expression Omnibus (GEO) database (GSE87624 and GSE85537). Integrated bioinformatic analyses were then performed to investigate Gene Ontology, potential pathways, protein-protein network interaction, core hub genes, genetic alterations, and immune cell infiltration. The hub gene expression levels were validated utilizing another dataset (GSE14329) and patient prognosis was validated using the GDC-TARGET OS dataset. Our analysis identified 263 differentially expressed genes (DEGs), predominantly associated with the PI3K-AKT signaling pathway. Analysis using Cytoscape based on DEGs revealed five validated core hub genes including COL6A1, MMP2, POSTN, TAGLN, and THY1. Additionally, TAGLN and THY1 have a significant association (P = 0.008) (P = 0.03) with unfavorable outcomes in osteosarcoma patients. This study unveiled that TAGLN and THY1 were associated with metastasis and poor prognosis in OS.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502631","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":"Outcome of total knee arthroplasty in patients with Blount disease or Blount-like deformity: a systematic review.","authors":"I Akkawi, H Zmerly, M Draghetti, L Felli","doi":"10.1007/s12306-025-00893-x","DOIUrl":"https://doi.org/10.1007/s12306-025-00893-x","url":null,"abstract":"<p><p>Blount disease is a genetic disorder affecting the proximal tibial bone, resulting in a complex deformity of the knee. In the absence of timely treatment, the likelihood of developing degenerative arthritis increases. A total knee arthroplasty (TKA) is the conventional treatment for adult patients with Blount disease or Blount-like deformity with advanced degenerative changes. The aim of this systematic review is to evaluate the results of TKA in this particular cohort of patients. The present systematic review comprised a total of 5 articles. The 5 evaluated studies included data from 9 patients who undergone 12 TKAs. The patients were assessed throughout an average follow-up duration of 4 years. In all, there were three revisions of the prosthetic components. All studies achieved successful clinical scores at the last follow-up. A thorough exploration of PubMed, Embase, and Web of Science was conducted to identify research that documented the results of TKA in patients diagnosed with Blount disease or Blount-like deformity. TKA in patients with Blount disease or Blount-like deformities is intricate and demanding. Constrained implants can effectively mitigate the possible problem of persistent instability. Notwithstanding the unfavorable circumstances, TKA in this cohort of patients appears to yield satisfactory outcomes during the short- to medium-term period of observation. Other study is necessary to establish the enduring outcomes of TKA in this particular cohort of patients.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476770","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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","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":"Outcome of hemiarthroplasty to total hip arthroplasty conversion: a systematic review.","authors":"S Ansari, T Gupta, J Pranav, K Gupta, B S Raja, A Biswas, R B Kalia","doi":"10.1007/s12306-025-00895-9","DOIUrl":"https://doi.org/10.1007/s12306-025-00895-9","url":null,"abstract":"<p><strong>Purpose: </strong>A systematic review of the literature was performed in order to synthesize the available data on the outcome of conversion total hip arthroplasty after failed hemiarthroplasty keeping in mind the higher complication rates of conversion as compared to a primary total hip arthroplasty.</p><p><strong>Methods: </strong>Comprehensive search of literature was performed for the systematic review through online databases-PubMed, EMBASE, Scopus, and the Cochrane database. The abstracts were identified first by the above-mentioned search methods and were assessed for eligibility based on strict criteria. 15 studies regarding conversion hemiarthroplasty were finally included for the study.</p><p><strong>Results: </strong>The 15 studies evaluating 3432 hips revealed that the main indication for conversion to arthroplasty was pain in the groin or thigh symptomatically and acetabular erosion with well-fixed femoral stem (455 cases; 13.25%) radiologically. Majority of the cases were revised in a single stage (292 cases) as compared to 25 cases revised in 2-stage surgery mostly owing to infection. The mean pre-conversion Harris Hip Score (HHS) improved from 45.74 to 84.03 in the post-conversion time. Majority of the conversions constituted cemented fixation for the femoral component and uncemented fixation for the acetabular component. Mean survivorship was found to be 97.21% at 5-6 years. The conversions were most commonly complicated by prosthetic joint infection most commonly which was managed by long-term antibiotics and/or debridement with or without exchange of implants.</p><p><strong>Conclusion: </strong>The conversion group had consistently higher odds of prosthetic joint dislocation, prosthetic joint infection, periprosthetic fracture, aseptic loosening and revision both at 1- and 2-year follow-ups. It was also noteworthy that the odds of developing these complications increased significantly from 1-year follow-up to the 2 years follow-up.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468593","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":"Artificial intelligence in orthopedic research assistance: a resident's perspective.","authors":"Rubén Dario Arias Perez, Ricardo Londoño Garcia","doi":"10.1007/s12306-025-00894-w","DOIUrl":"https://doi.org/10.1007/s12306-025-00894-w","url":null,"abstract":"<p><p>Artificial intelligence (AI) is transforming orthopedic research by optimizing academic workflows, improving evidence synthesis, and expanding access to advanced data analysis tools. Generative AI models such as ChatGPT and GPT-4, alongside specialized platforms such as Consensus and SciSpace, empower researchers to refine search queries, enhance literature reviews, synthesize documents, and conduct advanced statistical analyses. These technologies enable the interpretation of large datasets, saving time and boosting efficiency. For orthopedic residents, AI is particularly impactful, revolutionizing their education and fostering greater independence in research. This review explores the key applications of AI as a research assistant in orthopedics, as well as its ethical considerations and challenges.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441146","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}