Orthopaedic Surgery最新文献

{"title":"The Cervical Vertebral Bone Quality Score Is a Novel Reliable Index Reflecting the Condition of Paraspinal Muscles and Predicting Loss of Cervical Lordosis After Open-Door Laminoplasty.","authors":"Junhu Li, Xingxia Long, Linnan Wang, Qiujiang Li, Lei Wang, Yueming Song","doi":"10.1111/os.70028","DOIUrl":"https://doi.org/10.1111/os.70028","url":null,"abstract":"<p><strong>Objective: </strong>Recently, the MRI-based cervical vertebral bone quality (C-VBQ) scoring system has demonstrated accuracy in reflecting cervical bone quality and predicting postoperative complications from cervical spine surgery. Studies have shown that cervical bone quality is closely linked to loss of cervical lordosis (LCL) after open-door laminoplasty. Additionally, research on lumbar VBQ indicates a strong correlation between lumbar VBQ scores and lumbar paraspinal muscle quality. However, the relationship of C-VBQ score to cervical paraspinal muscles and LCL remains unclear. Therefore, this study aimed to explore the relationship between C-VBQ score and cervical paraspinal muscle-related parameters as well as postoperative LCL, in addition to exploring the risk factors associated with LCL.</p><p><strong>Methods: </strong>A total of 101 patients who underwent standard C3-C7 open-door laminoplasty at our institution from 2012 to 2022 were included in this study. The LCL group was defined as loss of cervical lordosis > 5° at 1-year postoperative follow-up. Cervical X-rays were obtained to measure the C2-7 Cobb angle, C2-7 sagittal vertical axis (SVA), T1 slope, and cervical range of motion (ROM). The relative cross-sectional area (RCSA) and degree of fat infiltration (DFF) of the deep cervical extensors, flexors, and all muscles were measured using image J software. Cervical CT Hounsfield unit (HU) and C-VBQ values were measured on preoperative CT and MRI T1-weighted mid-sagittal images, respectively. Then, demographics, cervical sagittal parameters, ROM, paraspinal muscle-related parameters, CT-HU and C-VBQ values were assessed for their correlation with LCL, and multivariate linear analysis was used to determine the risk factors associated with LCL. Finally, the relationship between C-VBQ scores and cervical paraspinal muscle-related parameters was evaluated.</p><p><strong>Results: </strong>A total of 55 (54.45%) patients were included in the LCL group due to loss of cervical lordosis > 5° at 1-year follow-up. LCL was positively correlated to the preoperative T1 slope, Flexion ROM, C2-7 ROM, Flexion/Extension ROM, Flexion muscles DFF, Extension muscles DFF, Average DFF, and C-VBQ scores, while it was negatively correlated to Extension ROM, Extension muscles RCSA, Total RCSA, and CT-HU values. Furthermore, Flexion/Extension ROM, Total RCSA, Average DFF, CT-HU, and C-VBQ values were independent risk factors for LCL. In addition, C-VBQ scores were significantly correlated with RCSA and DFF of Flexion and Extension muscles.</p><p><strong>Conclusions: </strong>This study is the first to find a significant correlation between C-VBQ scores and cervical paraspinal muscle quality. The C-VBQ score is a comprehensive indicator that reflects the quality of the cervical bone and paravertebral muscles, and it is a novel predictor of LCL after open-door laminoplasty.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating Perforations in the Sclerotic Region of the Proximal Tibia During Total Knee Arthroplasty to Enhance Prosthesis Stability.","authors":"Chao Sun, Chunyan Wang, Jintang Li, Chengyan Liu, Zhilin Wei, Zhiguo Bi, Yeran Li, Shuqiang Li","doi":"10.1111/os.70025","DOIUrl":"https://doi.org/10.1111/os.70025","url":null,"abstract":"<p><strong>Objective: </strong>In patients with varus deformity of the knee, the redistribution of the subchondral bone mineral density (BMD) of the tibia leads to sclerotic zones that may cause osteoarthritis. Drilling the sclerotic area of the tibia prior to cementing during total knee arthroplasty is advisable practice. However, the extent of the sclerotic area and the effect of drilling on the tibial component are not well defined. We aimed to quantify the BMD and sclerotic bone distribution of the knee to clarify the effect of drilling on the stability of the prosthesis.</p><p><strong>Methods: </strong>Our retrospective cohort study enrolled a total of 97 patients from December 2018 to December 2019, categorized into drilled and nondrilled groups, with their computed tomography (CT) knee joint images documented. The proximal tibia image was divided into nine regions, the BMD of each region calculated, and CT values compared between the affected and normal sides. We established finite element models to analyze the drilling and stress distribution. The differences in CT values were assessed using the paired t test and Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The mean thickness of sclerotic bone was 7.7 ± 1.4 mm, and the surface area was 441.9 ± 89.4 mm². The CT values of the affected anteromedial, anterolateral, mediomedial, mediolateral, posteromedial, posteromedian, and posterolateral tibial areas were significantly higher than their normal counterparts. Stress concentration around the boreholes in all finite element models is minimal, with stress values ranging from 0.01 to 3.73 MPa, markedly lower than the 13.93 MPa observed in the undrilled model.</p><p><strong>Conclusion: </strong>Abnormal stress in the proximal tibia alters the distribution pattern of BMD, and drilling in the sclerotic area is associated with improved prosthesis stability.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Compartment Knee Osteoarthritis Altered Tibiofemoral Joint Kinematics and Contact Pattern During Daily Weight-Bearing Extension.","authors":"Zheng Jiang, Axiang He, Nan Zheng, Yanjie Mao, Weiming Lin, Xiaoyin Zhang, Han Guo, Yuyan Liu, Tsung-Yuan Tsai, Wanjun Liu","doi":"10.1111/os.70023","DOIUrl":"https://doi.org/10.1111/os.70023","url":null,"abstract":"<p><strong>Objective: </strong>With the advancement of digital orthopedics, the growing prevalence of medial compartment knee osteoarthritis (MCKOA) and the widespread adoption of knee-preserving surgical techniques have heightened new interest in predicting the onset of MCKOA and promoting surgical outcomes. This study was to clarify the differences in kinematics and contact patterns between the MCKOA knee and its native sides during knee extension.</p><p><strong>Methods: </strong>From March 2023 to June 2024, thirty-two patients who suffered from unilateral MCKOA, with their contralateral extremities asymptomatic and intact, were enrolled in this descriptive research. Three-dimensional models were created from computed tomography scans, and all patients performed continuous stair climbing under the surveillance of a dual fluoroscopic imaging system (DFIS) to determine the accurate 6-degrees-of-freedom (6-DOF) of their medial OA knees and the contralateral knees. The volume penetration centers between tibial and femoral cartilage models were defined as contact centers. All measured parameters were tested for significant differences using the Wilcoxon Rank-Sum test.</p><p><strong>Results: </strong>Compared to native knees, the MCKOA tibia showed increased flexion (mean 3.6°) and varus rotation (mean 1.6°), with more posterior (mean 1.4 mm), lateral (mean 1.2 mm) and proximal translations (mean 0.5 mm) relative to the femur during extension (p < 0.05). The tibiofemoral contact patterns on the medial and lateral tibial plateau of the MCKOA knee both shifted more medially (mean 1.4 mm and 1.3 mm, respectively, p < 0.05) than the native side, which was consistent with the lateral translations observed in 6-DOF.</p><p><strong>Conclusion: </strong>Our findings offer valuable insights into the in vivo kinematics of MCKOA knee, its tibiofemoral joint (TFJ) and contact pattern. In MCKOA knees, the tibia exhibited increased flexion and varus rotation, along with more posterior, lateral, and proximal translation relative to the femur compared to the native side during extension. These changes aligned with the more medial shifts in contact patterns of the tibial plateau on the MCKOA side. These findings provide data support for the digital diagnosis and treatment of MCKOA.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Study of Lateral Compression II Screw Path and Entry Parameters Based on Three-Dimensional CT Image Reconstruction Techniques.","authors":"Xingye Du, Yong Liu, Xuefeng Jiang","doi":"10.1111/os.70011","DOIUrl":"https://doi.org/10.1111/os.70011","url":null,"abstract":"<p><strong>Objective: </strong>Lateral compression II (LC-II) fractures, a common type of pelvic injury, often require closed reduction and percutaneous screw fixation due to posterior pelvic ring instability. However, existing methods fail to adequately account for the internal structure of the screw path and lack precise anatomical guidance, increasing surgical risks. This study utilized digital medical software to analyze the LC-II screw path and entry parameters, providing the anatomical references.</p><p><strong>Methods: </strong>This retrospective study enrolled 43 adult patients (21 males and 22 females) who underwent a complete computed tomography (CT) scan examination from February 2017 to February 2019. The digital three-dimensional (3D) pelvic model was reconstructed, and the ideal LC-II screw path was designed by the cross-section method. The primary evaluation parameters included the screw path length (D_AP), maximum diameter (D_max), distances at narrow points (D1 and D2), bone thickness parameters (OW1 and IW1; OW2 and IW2), and screw entry angles (∠α, ∠β, ∠γ).</p><p><strong>Results: </strong>Of 43 patients, 42 successfully completed LC-II screw path construction. Among 21 female patients, 5 (23.8%) could accommodate screws with a maximum diameter of < 6.5 mm. Compared with female patients, male patients exhibited significantly higher D_AP, D_max, D₂, OW₁, IW₁, IW₁/OW₁, and IW₂/OW₂ (p < 0.05). The ∠γ was significantly lower in male patients. Furthermore, digital 3D pelvic model observations revealed that LC-II screws bone entry points in the anterior iliac region were all located posterior to the anterior inferior iliac spine (AIIS). The angles between the LC-II screw and coronal plane were 48.06° in males and 45.10° in females, while the angles between the LC-II screw and sagittal plane were 27.14° and 25.60°, respectively.</p><p><strong>Conclusion: </strong>This study utilized digital medical software to construct the LC-II screw path and analyze sex-based differences, highlighting the importance of individualized preoperative path planning and providing essential anatomical evidence for the precise and safe percutaneous insertion of LC-II screws.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Knee Arthroscopy Be Considered Entirely Safe for Patients Over 50 Years Old With no Risk of Osteonecrosis? Case Series and Literature Review on Post-Artrhoscopy Osteonecrosis of the Knee (PAONK).","authors":"Panagiotis Ntagiopoulos, Georgios Kalinterakis, Pierrenzo Pozzi, Dimitris Fligkos, George Themistocleous, Sotirios Themistokleous, Triantafyllia Dimou, Riccardo Compagnoni, Paolo Ferrua, Pietro Simone Randelli","doi":"10.1111/os.70020","DOIUrl":"https://doi.org/10.1111/os.70020","url":null,"abstract":"<p><strong>Objective: </strong>Although post-arthroscopy osteonecrosis of the knee is well-documented in the literature, its etiology and prognosis remain unclear. The purpose of this study is to present a group of individuals who experienced avascular necrosis following knee arthroscopy, to examine the factors leading to this condition and assess the outcomes of treatment, as well as to perform a literature review on the subject.</p><p><strong>Methods: </strong>We retrospectively studied patients between January 2015 and March 2024 who had developed knee osteonecrosis following a standard arthroscopic procedure for treating meniscal tears. All adult patients with isolated meniscus tears and grade 2 or less chondral lesions were included. Patients with evidence of bone edema on MRI performed 4-6 weeks after the onset of preoperative symptoms were not included in the study. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as an outcome measure. A correlation analysis was performed to explore the degree of association between variables, with significance set at p < 0.05.</p><p><strong>Results: </strong>Eight patients out of 974 arthroscopies met the inclusion criteria. There was one woman and seven men (mean age 57 [range: 51-71]). The lesions noted at arthroscopy included seven medial meniscus tears that were treated with excision and one lateral meniscal tear that was treated with suture repair and still developed osteonecrosis. None of them were traumatic while all patients had early degenerative changes in the compartment of interest.</p><p><strong>Conclusions: </strong>Osteonecrosis should be suspected in older patients experiencing worsening symptoms following knee arthroscopy for degenerative meniscus tears and partial meniscectomy. Increased age, a higher BMI, and a delayed diagnosis appear to be associated with more severe disease progression and the need for operative treatment.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of Wrist Motions During Daily Activities From a Directional Perspective: The Significance of Directions Beyond the Dart-Throwing Motion.","authors":"Qipei Wei, Shijie Jia, Shengfang Zhang, Xiaofeng Qiao, Zhixin Wang, Chang Liu, Shanlin Chen","doi":"10.1111/os.70024","DOIUrl":"https://doi.org/10.1111/os.70024","url":null,"abstract":"<p><strong>Background: </strong>Previous studies on Activities of Daily Living (ADL) suggest that the wrist demonstrates different ranges of motion and frequencies in various directions. However, the specific directional characteristics of wrist activities remain unexplored. This study aims to investigate the directional characteristics of wrist motions during ADL with optical motion capture technology.</p><p><strong>Method: </strong>This is a basic science study. Twenty-six right-handed subjects executed 22 ADLs, with angular wrist positions tracked via retroreflective markers on the dominant limb. The Cartesian coordinate system formed by wrist flexion-extension and radial-ulnar deviation angles was transformed into a polar coordinate system, enabling the directional analysis and the calculation of the directional range of motion (ROM). The directional distribution of trajectory points was analyzed using the Rayleigh test and visualized. The values and trends of directional RoM in 72 directions for both aggregated and individual ADLs were examined. The peaks of ROMs across ADLs were clustered using K-means to identify key directions. Differences in gender and age were analyzed with a two-way ANOVA.</p><p><strong>Result: </strong>The trajectories exhibited a strong directional preference across all ADLs (p < 0.01). In the majority of ADLs, the trajectories favored the ulnar extension direction (19/22) and were distributed along the radial flexion-ulnar extension plane (12/22). ROM was calculated for each of the 72 directions in each ADL. The aggregated ADL analysis provided the directional functional ROM (fROM). Three types of ADLs were identified, each with 1, 2, and 3 peaks in their directional ROM, respectively. Three key directions were identified as clusters of peak ROMs in the ADLs. Comparisons across gender and age groups revealed varying preferences for directional ROM in each group.</p><p><strong>Conclusion: </strong>This study identified three key wrist motion directions essential for daily functions, highlighting the critical role of ulnar extension. Additionally, it demonstrated variations in directional wrist motion preferences across different genders and age groups.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Choice of Hip Arthroplasty: HRA or THA? Revealed by Meta-Analysis.","authors":"Xiao Fan, Yimin Zhou, Tianyu Zhou, Justin P Cobb, Tengbo Yu","doi":"10.1111/os.70019","DOIUrl":"https://doi.org/10.1111/os.70019","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is the gold standard for end-stage hip arthrosis, while hip resurfacing arthroplasty (HRA) is considered a more bone-conserving alternative. This meta-analysis aimed to compare the safety and clinical efficacy of HRA and THA.</p><p><strong>Methods: </strong>The databases of PubMed, EMBASE, Cochrane Library, and CNKI were searched for RCTs comparing HRA and THA in treating hip arthrosis from database initiation to April 2024. Inclusion and exclusion criteria were defined, and data extraction, quality evaluation, and risk bias assessment were performed. A meta-analysis was conducted using appropriate RevManv5.4 and Stata v14.0 software.</p><p><strong>Results: </strong>Twenty RCTs from six countries were included. HRA had a similar revision rate, function scores (WOMAC, HSS, OHS, UCLA activity score, EQ-D, EQ-5D VAS), and blood levels of cobalt and chromium compared to THA. HRA had fewer complications and less blood loss but required more operating time.</p><p><strong>Conclusions: </strong>HRA is a safe and effective alternative to THA, with similar revision and functional outcomes, less blood loss, and is particularly suitable for young male patients with a demand for high-level activities.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors and Experiences Associated With Unscheduled Hospital Readmission After Lateral Lumbar Interbody Fusion: A Case-Controlled Study.","authors":"Wangmi Liu, Feng Zhang, Yiqing Tao, Hao Li, Qixin Chen, Fangcai Li","doi":"10.1111/os.70022","DOIUrl":"https://doi.org/10.1111/os.70022","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the risk factors associated with unscheduled readmission following lateral lumbar interbody fusion (LLIF) is crucial for mitigating the occurrence of these costly events. This study aims to ascertain the incidence and factors of unscheduled hospital readmission subsequent to LLIF.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent LLIF at our institution from March 2016 to February 2023. Instances of unscheduled hospital readmission after LLIF were meticulously recorded, including baseline demographics, characteristics of spine pathology, surgical interventions, duration between two hospitalizations, and hospitalization costs and duration. Reasons for readmission were categorized based on their etiology. A case-control methodology was employed to compare unscheduled hospital readmission patients against planned readmission patients due to staged surgery. Parametric data were analyzed with a two-tailed T-test, nonparametric data with the Wilcoxon rank-sum test, and categorical data with the χ² test.</p><p><strong>Results: </strong>A total of 1521 patients who received LLIF at our institution were included in the study. A total of 59 patients (3.88%) were unscheduled readmitted due to adjacent segment disease (ASD), cage subsidence, the original surgical segments remaining narrow, spondylodiscitis, and pain. 51 patients (3.35%) experienced reoperation, predominantly attributable to ASD. Compared to planned readmission patients, unscheduled readmission patients tended to be younger, had a lower likelihood of having scoliosis, and were more likely to have short-segment surgery and higher initial hospitalization costs. Among unscheduled readmission patients, patients receiving short-segment surgery, as well as those who paid less during the initial hospitalization, demonstrated a higher likelihood of a 90-day readmission rate.</p><p><strong>Conclusion: </strong>Our findings indicated the heightened risks of unscheduled hospital readmission after LLIF. Taking targeted measures against these risk factors is expected to reduce the healthcare burden caused by unplanned readmissions in the future.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Upper Third Subscapularis Tendon Repair Using H-Loop Technique: A Case Series.","authors":"Yi-Tao Yang, Zhuo Wang, Chen-Yang Meng, Xing-Hao Deng, Yi Long, Jing-Yi Hou, Rui Yang","doi":"10.1111/os.70014","DOIUrl":"https://doi.org/10.1111/os.70014","url":null,"abstract":"<p><strong>Objective: </strong>Arthroscopic repair of upper one-third subscapularis tendon tears remains challenging due to suture management difficulties and repair quality limitations. We proposed a simpler knotless technique-the H-Loop technique. This study evaluates its early clinical and imaging outcomes.</p><p><strong>Method: </strong>This is a case series of 38 patients (9 males and 29 females), who underwent arthroscopic H-Loop technique repair for upper one-third subscapularis tendon tears between January 2021 and August 2023. Postoperative assessments include the American Shoulder and Elbow Surgeons (ASES) score, the University of California, Los Angeles (UCLA) shoulder score, the Constant-Murley score, the visual analog scale (VAS), range of motion (ROM) (internal and external rotation), and internal rotation strength. In addition, MRI (30 patients) evaluated fatty infiltration, re-tears, and subscapularis integrity, comparing tendon dimensions and signal-to-signal ratios with a control group of patients with normal subscapularis tendons.</p><p><strong>Result: </strong>Preoperative symptom duration ranged from 3 to 36 months, with an average of 9 months. Follow-up ranged from 12 to 14 months, with an average duration of 12.6 months. No complications were observed in any patient. Postoperative ASES scores increased significantly compared to preoperative scores (55.63 ± 15.85 vs. 88.92 ± 8.24), as did UCLA scores (21.82 ± 4.44 vs. 29.74 ± 3.55) and Constant-Murley scores (69.76 ± 15.30 vs. 86.34 ± 14.48). VAS scores decreased significantly (5.16 ± 1.84 vs. 0.89 ± 0.76). Postoperative ROM showed significant improvement in internal rotation (7.79 ± 2.07 vs. 8.45 ± 1.33) and external rotation (57.63° ± 15.84° vs. 66.58° ± 9.08°) (p < 0.05). Internal rotation strength ratios increased markedly (78.00% ± 15.86% vs. 91.97% ± 6.62%). MRI indicated no re-tears or fatty infiltration in the 30 patients, and compared to the control group, there were no statistically significant differences in the vertical diameter of the subscapularis muscle (62.89 mm ± 9.30 mm vs. 59.41 mm ± 7.55 mm; p = 0.153), transverse diameter of the upper subscapularis muscle (17.82 mm ± 3.79 mm vs. 19.43 mm ± 4.76 mm; p = 0.395), transverse diameter of the lower subscapularis muscle (24.09 mm ± 5.84 mm vs. 25.23 mm ± 5.41 mm; p = 0.870), cross-sectional area of the subscapularis muscle (1338.54 mm² ± 277.26 mm² vs. 1247.94 mm² ± 210.55 mm²; p = 0.098), signal-to-signal ratio of the upper subscapularis muscle (1.18 ± 0.28 vs. 1.24 ± 0.28; p = 0.792), or the signal-to-signal ratio of the lower subscapularis muscle (1.02 ± 0.24 vs. 1.03 ± 0.16; p = 0.128).</p><p><strong>Conclusion: </strong>The arthroscopic H-Loop technique significantly restores function, improves range of motion, and enhances internal rotation strength, maintaining good tendon integrity in the early postoperative period.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic Nervous System in Bone Remodeling: From Mechanisms to Novel Therapies in Orthopedic Diseases.","authors":"Ruihao Xia, Hongjun Peng, Xishan Zhu, Wangdui Suolang, Steve T L Pambayi, Xiao Yang, Yi Zeng, Bin Shen","doi":"10.1111/os.70010","DOIUrl":"https://doi.org/10.1111/os.70010","url":null,"abstract":"<p><p>Recent literature has increasingly demonstrated the significant function of autonomic nerves in regulating physiological and pathological changes associated with the skeletal system. Extensive studies have been conducted to understand the contribution of the autonomic nervous system (ANS) to skeletal metabolic homeostasis and resistance to aseptic inflammation, specifically from the viewpoint of skeletal neurobiology. There have been plenty of studies on how the sympathetic nervous system (SNS) and parasympathetic nervous system (PNS), the two main branches of the ANS, regulate bone remodeling, which is the process of bone formation and resorption. The following studies have revealed critical neurological pathways that induce significant alterations in bone cell biology and uncover the intricate linkages between the ANS and the skeletal system. Furthermore, inspired by the connection between the ANS and bone remodeling, neuromodulation has been utilized as a therapeutic method for patients with orthopedic diseases: by directly influencing the ANS, it is possible to alter the excitability of nerve fibers and the release of neurotransmitters, which can lead to anti-inflammatory and analgesic effects, thereby directly or indirectly impacting bone formation and bone resorption. Our work aims to review the most recent findings on the impact of the ANS on bone remodeling, enhance the current understanding of the interaction between nerves and bones, and explore potential neuromodulation methods that could be used to treat orthopedic conditions, thereby drawing attention to the significant role of the ANS in the skeletal system.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}