Orthopaedic Surgery最新文献

{"title":"Comparison of Patellar Tracking Following Kinematic Alignment Versus Mechanical Alignment Total Knee Arthroplasty via the Mini-Subvastus Approach.","authors":"Bochen Sun, Yiyang Xu, Guiguan Wang, Long Chen, Fenqi Luo, Guoyu Yu, Yuan Lin, Jie Xu","doi":"10.1111/os.70016","DOIUrl":"https://doi.org/10.1111/os.70016","url":null,"abstract":"<p><strong>Objectives: </strong>Different alignment strategies (kinematic alignment [KA] versus mechanical alignment [MA]) during total knee arthroplasty (TKA) significantly influence postoperative patellar tracking. This study aimed to compare radiological parameters of patellar tracking and clinical outcomes between KA-TKA and MA-TKA via the mini-subvastus approach.</p><p><strong>Methods: </strong>This prospective randomized controlled study included 234 patients who underwent KA-TKA and MA-TKA from January 2022 to October 2023. The preoperative and postoperative patellar tilt, lateral patellar shift, knee society score (KSS), oxford knee score (OKS), and intraoperative patellar lateral retinacular release (LRR) rate were measured. In addition, radiological parameters and clinical outcomes were compared between the LRR and non-LRR groups. Independent samples t test and chi-square test were used to compare the differences between groups.</p><p><strong>Results: </strong>Two-hundred and thirty-four patients were followed up for 12 months post-TKA. No significant differences were observed between the two groups in terms of the demographics and pre- or post-operative radiological parameters of patellar tracking (p > 0.05). The postoperative KSS and OKS were significantly higher in the KA group than in the MA group (p < 0.05). The LRR rate was 6.7% (8/120) in the KA group and 25.4% (29/114) in the MA group, and the difference was statistically significant (x² = 15.476, p < 0.001). The preoperative patella tilt and lateral patellar shift were greater in the LRR group (p < 0.001) and the postoperative OKS was lower (p < 0.05).</p><p><strong>Conclusions: </strong>KA-TKA via the mini-subvastus approach can achieve both good patellar tracking and clinical outcomes. Avoiding muscle damage and refraining from excessive soft tissue release are crucial to improving postoperative patient comfort. In our opinion, KA-TKA via the mini-subvastus approach may be a more suitable surgical option.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586428","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":"Posterolateral Tibial Plateau Fractures in Adult Anterior Cruciate Ligament Avulsion Effect on Postoperative Knee Function.","authors":"Bin Feng, Jian Peng, Weizhi Ren, Zhenghui Hu, Jiawei Ouyang, Wei Xu","doi":"10.1111/os.70015","DOIUrl":"https://doi.org/10.1111/os.70015","url":null,"abstract":"<p><strong>Background: </strong>The impact of posterior lateral tibial plateau fractures (PLTPFs) on knee joint stability after anterior cruciate ligament (ACL) reconstruction has garnered widespread attention. However, limited literature exists on the co-occurrence of ACL tibial avulsion fractures (ACLAFs) and PLTPFs. The objective of this study is to investigate the prevalence of PLTPFs in adult ACLAF patients and assess the impact of concurrent PLTPFs on postoperative knee function.</p><p><strong>Methods: </strong>This retrospective study analyzed adults, who underwent arthroscopic surgery for ACLAF at our institution between January 2016 and January 2022. Demographic and preoperative/postoperative imaging data were collected, focusing on meniscus and ligament injuries, Segond fractures, PLTPFs, and tibial plateau slope. Patients were grouped into isolated ACLAF (I-ACLAF) and ACLAF with concurrent PLTPFs (ACLAF-PLTPF). The ACLAF-PLTPF group was further divided into Group A (PLTPFs not exceeding the anterior edge of the lateral meniscus posterior horn) and Group B (PLTPFs exceeding this edge). Clinical outcomes were evaluated using International Knee Documentation Committee and Tegner scores. The study also examined the morphology of PLTPFs and their specific affected areas. Statistical analysis was performed using the Mann-Whitney U tests for continuous variables and Fisher's exact tests for categorical variables.</p><p><strong>Results: </strong>The study included 62 patients with a mean follow-up of 41 ± 17 months. Among these, 71.0% (44/62) patients with ACLAF also had PLTPFs. The ACLAF-PLTPF group showed a significantly steeper lateral tibial plateau slope than the I-ACLAF group (10.86° ± 5.47° vs. 7.17° ± 3.68°, p = 0.011). Segond fractures were present in 22.7% of the ACLAF-PLTPF group, compared to none in the I-ACLAF group (p = 0.027). IKDC and Tegner scores were lower in the ACLAF-PLTPF group (80.7 ± 5.2 and 4, respectively) than in the I-ACLAF group (87.4 ± 6.4 and 4.5, respectively), with statistical significance (p < 0.001 and p = 0.008, respectively). Older age correlated with a greater extent of concurrent PLTPFs (p = 0.038). Additionally, Patients in Group B exhibited a significantly higher incidence of meniscal injury (22.2% vs. 53.8%, p = 0.036) and poorer postoperative knee joint function compared to those in Group A (IKDC 82.3 ± 2.8 vs. 78.5 ± 5.6, p = 0.013). More extensive PLTPFs were linked to increased fracture collapse and a higher rate of lateral meniscus injuries.</p><p><strong>Conclusion: </strong>PLTPFs demonstrated a high prevalence in adults with ACLAF. Additionally, the ACLAF-PLTPF cohort frequently showed reduced postoperative knee function. Simultaneous management of severe concomitant PLTPFs may improve long-term outcomes in patients with ACLAF.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586432","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":"Comparative Study of Trans-Axillary Approach and Delto-Pectoral Approach to the Treatment of Ideberg Types I and II Scapular Glenoid Fractures.","authors":"Xu Zhang, Zhen Jiang, Feng-Long Chu, Dai-Liang Jia, Xiu-Guo Han, Xiao-Yan Li, Yi-Feng Zhao, Hai-Bin Wang, Bin Wu","doi":"10.1111/os.70012","DOIUrl":"https://doi.org/10.1111/os.70012","url":null,"abstract":"<p><strong>Objective: </strong>Clinically, simple glenoid fractures are less prevalent, and surgical treatment of anterior glenoid fractures is often based on the classic anterior approach (delto-pectoral approach), while there are few reports on the efficacy of the trans-axillary approach. The objective of this study is to explore the clinical efficacy of both approaches in the treatment of Ideberg Types I and II scapular glenoid fractures.</p><p><strong>Methods: </strong>The trans-axillary approach is the surgical method of exposing a glenoid fracture along the anterior edge of the latissimus dorsi muscle through an axillary incision. In terms of the Ideberg classification of scapular glenoid fractures, 36 patients with Ideberg Types I and II scapular glenoid fractures were retrospectively analyzed. There were 22 males and 14 females, and 9 cases of traffic injuries, 6 cases of high fall injuries (> 1 m), 18 cases of fall injuries (≤ 1 m), and 3 cases of strain injuries. Meanwhile, there were 29 cases of Type Ia, 2 cases of Type Ib, and 5 cases of Type II. Based on the surgical approach, the patients were divided into the trans-axillary approach group (21 cases) and the delto-pectoral approach group (15 cases). The following data were collected: general information including age, gender, and body mass index; hospitalization time, operation time, bleeding volume; disability of the arm, shoulder, and hand (Quick DASH [QDASH]); and patient satisfaction. Comparisons between the groups were made using the t test for two independent samples.</p><p><strong>Results: </strong>Operative time was significantly shorter in the trans-axillary approach group than in the delto-pectoral approach group (t = 6.39, p < 0.05). Constant-Murley score was significantly higher in the trans-axillary approach group than in the delto-pectoral approach group (t = 4.96, p < 0.05). QDASH score was lower in the trans-axillary approach group than in the delto-pectoral approach group (t = 2.66, p < 0.05). Patient satisfaction was higher in the trans-axillary approach group than in the delto-pectoral approach group (t = 4.5, p < 0.05). All fractures healed by the final follow-up.</p><p><strong>Conclusion: </strong>Trans-axillary approach to the treatment of scapular glenoid fractures is less traumatic and less painful, associated with good recovery of shoulder joint function and high patient satisfaction, and more advantageous compared with the delto-pectoral approach.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537637","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":"High Simulation Training System for Spinal Full-Endoscopic Surgery, Based on the Combination of VR/AR and Magneto-Optical Navigation Technology.","authors":"Tianqi Fan, Lin Shi, Xuan Peng, Menghao Wu, Lingjia Yu, Bin Zhu","doi":"10.1111/os.70008","DOIUrl":"https://doi.org/10.1111/os.70008","url":null,"abstract":"<p><strong>Objective: </strong>Spinal full-endoscopic surgery is a challenging technique with a steep learning curve, limited by inadequate training models and the shortcomings of cadaver-based training. To address this, we propose a high-simulation training system using VR/AR and magneto-optical navigation technology to enhance skill development and reduce the learning curve.</p><p><strong>Methods: </strong>A new simulation training system for spinal full-endoscopic surgery was established, which was conducted by using the data of Chinese Digital Human with medical image parameters for the three-dimensional (3D) reconstruction, as well as integrating the technical advantages of VR/AR, 3D printing, and magneto-optical navigation technology.</p><p><strong>Results: </strong>Based on the original dataset of Chinese digital humans and clinical medical imaging processing, the data model was obtained and then the 3D printing engineering model was created. The simulation perspective filming technology, joint process shaping and cutting technology, and tube placement technology have been constructed, based on the combination of VR/AR under optical navigation. Based on electromagnetic tracking, a microscopic anatomical simulation using preorder optical navigation has been designed. Finally, a physical simulation model based on the clinical reality of flocculent behavior was constructed. As a simulator for spinal endoscopic surgery training, it was tested during an advanced endoscopic training course. Moreover, 17 out of 20 novices (85%) met the surgical standards by the end of the final simulation training session.</p><p><strong>Conclusion: </strong>We present a high simulation training system based on the combination of VR/AR and magneto-optical navigation for spinal full-endoscopic surgery. The model may be used by surgeons starting with spinal endoscopy and should be considered a comparable and sufficiently realistic tool to train key operation steps to reduce the learning curve.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537653","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":"Clinical Study on the Effects of Total Hip Arthroplasty Assisted by Virtual Planning Combined With Intraoperative Navigation Templates.","authors":"Haotian Zhu, Jiayi Wu, Kai Cheng, Han Yan, Junjun Liang, Yunjin Long, Shaoxing Fan, Yadi Zhang, Huanwen Ding","doi":"10.1111/os.14335","DOIUrl":"10.1111/os.14335","url":null,"abstract":"<p><strong>Objectives: </strong>Although total hip arthroplasty (THA) effectively alleviates pain and restores joint function in the end-stage hip disease, challenges remain in achieving precise osteotomy and minimizing subjective dependency on prosthesis positioning. This study aims to evaluate the efficacy and safety of preoperative virtual planning and navigation templates compared to conventional techniques, providing new methods to enhance the precision and personalization of THA.</p><p><strong>Methods: </strong>During the period from 2022 to 2023, we conducted a retrospective case-control study on 74 patients who underwent THA surgery at our hospital, based on the inclusion and exclusion criteria. The study included 42 patients in the traditional method group, who underwent preoperative planning and surgical procedures according to traditional methods; and 32 patients in the digital assistance group, who used computer-assisted virtual preoperative planning and three-dimensional printed personalized navigation templates to assist in the surgery. The main parameters of the two groups were compared, including surgical time, blood loss, postoperative femoral anteversion, neck-shaft angle, anatomical-mechanical femoral axis angle (aMFA), leg length discrepancy (LLD), and the angle of hip prosthesis placement. The Harris hip score was recorded both preoperatively and at the final follow-up to assess the accuracy of the prosthesis placement and the prognosis of the patients.</p><p><strong>Results: </strong>There were no significant differences in femoral anteversion, neck-shaft angle, aMFA, or LLD between the two groups. However, the digital group showed smaller deviations between the planned and actual acetabular prosthesis angles compared to the conventional group, with shorter operative times and reduced blood loss. Follow-up Harris hip scores were significantly higher in the digital group (p < 0.05).</p><p><strong>Conclusions: </strong>Digital technology enhances the accuracy and reproducibility of prosthesis placement in THA, reduces operative time and blood loss, and shows a promising potential for broader application.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"831-840"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Internal Fixation Methods for Sanders Type II and III Calcaneal Fractures: A 5-Year Retrospective Study and Finite Element Analysis.","authors":"Dewei Kong, Zhen Yang, Xinbin Fan, Ming Wu, Chao Song, Yan Zhang","doi":"10.1111/os.14359","DOIUrl":"10.1111/os.14359","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Soft tissue defects and postoperative wound healing complications related to calcaneus fractures may result in significant morbidity. The aim of this study was to investigate whether percutaneous minimally invasive screw internal fixation (PMISIF) can change this situation in the treatment of calcaneal fractures, and aimed to explore the mechanical effects of different internal fixation methods on Sanders type III calcaneal fractures through finite element analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective analysis focused on 83 patients with Sanders II and III calcaneal fractures from March 2017 to March 2022. Among them, 32 patients underwent PMISIF, 24 patients underwent tarsal sinus incision plate internal fixation (TSIPIF), and 27 patients underwent extended lateral incision plate internal fixation (ELIPIF). The present study aimed to compare various parameters, including the perioperative hospital stay, intraoperative blood loss, operative time, postoperative drainage volume, incidence of postoperative wound complications, and Gissane angle and Bohler angle data before surgery, after surgery, and at the last follow-up, among the three treatment groups. Additionally, three different finite element models were created to simulate Sanders III calcaneal fractures treated with PMISIF, TSIPIF, and ELIPIF. The models were subjected to longitudinal stresses of 350 and 700 N, and the displacement and stress distribution were analyzed to compare the stability of each model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with ELIPIF and TSIPIF, PMISIF has several advantages, including shorter operative times, smaller incisions, shorter hospital stays, and lower incidences of postoperative complications. At the 12-month time point after the operation, the percentages of patients with excellent and good American Orthopedic Foot and Ankle Society (AOFAS) functional scores were 96.9%, 91.7%, and 96.2%, respectively, for the three methods, demonstrating similar outcomes. Intraoperative blood loss in the PMISIF group was comparable to that in the TSIPIF group and lower than that in the ELIPIF group. There were no significant differences in the Gissane or Bohler angles among the three groups before or after the operation. However, the differences in the Gissane and Bohler angles after the operation within each group were statistically significant compared with those before the operation. Finite element analysis revealed that stress in all three internal fixation models was primarily concentrated on the subtalar articular surface, whereas displacement was mainly observed on the medial side of the subtalar articular surface. The peak stress and displacement of bone fragments and implants in the PMISIF model were lower than those in both the TSIPIF and ELIPIF models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PMISIF can achieve excellent and good rates comparable to those of TSIPIF and ELIPIF. Additionally, this approach offers the ad","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"909-921"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Percutaneous Kyphoplasty the Better Choice for Treatment of Stage III Kümmell's Disease Without Neurological Symptoms? A Retrospective Study of Two Invasive Procedures.","authors":"Yijie Liu, Tangyiheng Chen, Haoyun Yu, Xiaohui Zhou, Runjia Hua, Yudong Wang, Qiang Wei, Yong Gu, Genglei Chu","doi":"10.1111/os.14313","DOIUrl":"10.1111/os.14313","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis.</p><p><strong>Objective: </strong>Kümmell's disease is an uncommon and complicated spinal condition first described in 1891. Treatment of this disease must be individualized according to the stage of disease and the experience and preference of the surgeon. Nevertheless, the surgical option in Stage III Kümmell's disease without neurological deficits remains controversial. The purpose of this study is to determine whether PKP or pedicle subtraction osteotomy (PSO) combined with long-segment fixation (LSF) is more effective in treating Kümmell's disease at Stage III without neurological impairments.</p><p><strong>Methods: </strong>Between January 2017 and June 2020, 89 patients were treated with PKP or PSO + LSF. The outcomes, including operative time, blood loss, Oswestry Disability Indexes (ODIs), heights of fractured vertebrae, visual analog scale (VAS) scores, and kyphosis Cobb angles, were measured at the follow-up time for the PKP group and PSO + LSF group. Fisher's exact test or chi-square test for number and percentage data was employed to compare statistical analyses between two groups.</p><p><strong>Results: </strong>Forty-six patients underwent PKP and 43 patients who treated by PSO + LSF. Postoperative measurements showed substantial improvements in kyphosis Cobb angle and vertebral height in the PKP group compared to preoperative measurements. Operating time, estimated blood loss, and duration of stay were all reduced in the PKP group compared to the PSO + LSF group. The PSO + LSF group had better correction of a kyphotic Cobb angle than the PKP group. Short-term monitoring showed that the PKP group had fewer ODI and VAS scores than the PSO + LSF group. In addition, no significant neurological symptoms were found after operation in both groups. The complication rates of PKP and PSO + LSF groups were 10.87% and 9.30%, respectively.</p><p><strong>Conclusions: </strong>Kümmell's disease in Stage III without neurological symptoms responded to both PKP and PSO + LSF as safe and efficient treatments. Despite limited correction of kyphotic Cobb angle, PKP patients had better early clinical outcomes, increased fractured vertebral height, decreased blood loss, and less surgical trauma compared with the PSO + LSF group.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"724-732"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Progress and Hot Topics in Telerehabilitation for Hip or Knee Arthroplasty.","authors":"Liqiong Wang, Liming Zhang, Chengqi He","doi":"10.1111/os.14347","DOIUrl":"10.1111/os.14347","url":null,"abstract":"<p><strong>Objective: </strong>Many publications on telerehabilitation for hip or knee arthroplasty have been published in recent years. However, no specific studies have attempted to characterize research hotspots, global research collaborations, or trends related to telerehabilitation after hip or knee arthroplasty. Therefore, the aim of this bibliometric analysis was to provide an overview of the current status of research and map the research landscape on telerehabilitation for joint replacement to understand current trends, identify research gaps, and guide future research directions.</p><p><strong>Methods: </strong>The Web of Science Core Collection and PubMed were comprehensively searched to identify all relevant English-language documents published from 2003 to June 7, 2024. Data from these published studies were then cleaned and structured. CiteSpace and VOSviewer were used to conduct the bibliometric visualization and comparative analysis of countries, institutions, journals, authors, references, and keywords. Then, the map illustrating the research hotspots and knowledge structure was plotted based on the analysis results.</p><p><strong>Results: </strong>A total of 229 records were obtained, and the number of articles published has increased steadily over the investigated period. The largest increase was observed in 2022. With the highest number of publications and centrality, the United States was the most influential country. The University of Sherbrooke was the most productive institution. Author Boissy P. ranked first in terms of the number of publications, while Tousignant M. ranked highest in cited authors, with 7 publications and 65 citations. The Journal of Arthroplasty published the greatest number of articles, with 29 publications. The most popular keywords from 2018 to 2023 were \"home telerehabilitation,\" \"older adults,\" and \"physical therapy\". In terms of the strongest citation burst, the top five keywords were associated with \"total knee arthroplasty,\" \"in home tele rehabilitation,\" \"physical activity,\" \"motion,\" and \"range.\" The frontier keywords were \"patient satisfaction,\" \"mobile application,\" \"self-efficacy,\" \"fear avoidance model,\" \"home assessment tool,\" and \"cost benefit analysis.\"</p><p><strong>Conclusions: </strong>The current status and trends in telerehabilitation for hip or knee arthroplasty are presented. A major concern at present is physical therapy for home telerehabilitation in the elderly. In the future, mobile app-based telerehabilitation programs for arthroplasty will continue to be encouraged, and some outcomes, such as \"patient satisfaction,\" \"self-efficacy,\" and \"cost benefit analysis,\" are expected to receive more attention. Our work will serve as a valuable resource, providing fundamental references and a directional guide for future research.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"677-693"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observation of the Clinical Efficacy of Self-Modified Skin-Stretching Device in the Treatment of Soft-Tissue Defects of the Heel: A Retrospective Single-Arm Cohort Study.","authors":"Shibo Liu, Yong Wang, Aqin Peng, Yanlong Zhang","doi":"10.1111/os.14340","DOIUrl":"10.1111/os.14340","url":null,"abstract":"<p><strong>Objective: </strong>Due to the poor skin mobility of the heel, there are few reports on the efficacy and safety of skin-stretching devices in the treatment of soft-tissue defects of the heel. Redesigning the claws of the stretching devices may be one of the solutions to the problem. This study was designed to investigate the clinical effect of self-modified skin-stretching device in the treatment of soft-tissue defects in the heel.</p><p><strong>Methods: </strong>From December 2017 to March 2022, 23 patients with heel soft-tissue defects were enrolled. There were 15 males and 8 females, with a mean age of 50 years (range, 28-73 years). Defect size, time of wound closure, duration of stretching time, and complications were documented. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate functional outcomes, and pain was assessed by the visual analog scale (VAS) at the last follow-up. Statistical analysis was performed using t-tests and Mann-Whitney U test.</p><p><strong>Results: </strong>The mean follow-up time was 14.2 months. Primary wound closure was performed in 6 patients and delayed wound closure in 17 patients. The average time of wound closure was 14.3 days, and the average duration of stretching time was 23.5 days. Complications were observed in 9 patients. Finally, all wounds were healed. At the last follow-up, the average AOFAS score was 86.7, with 9 excellent, 13 good, and 1 fair results. The mean VAS score was 2.6.</p><p><strong>Conclusions: </strong>Self-modified skin-stretching device is another option for treating heel soft-tissue defects. The technique can achieve good appearance and function with a low price and easy to install.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"858-868"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curve Behavior of Distal Segments After Posterior-Only Hemivertebra Resection for Congenital Cervicothoracic Scoliosis.","authors":"Yang Li, Zezhang Zhu, Wanyou Liu, Saihu Mao, Zhen Liu, Xu Sun, Yong Qiu, Benlong Shi","doi":"10.1111/os.14341","DOIUrl":"10.1111/os.14341","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective and consecutive study.</p><p><strong>Objective: </strong>To demonstrate the curve evolution of distal non-structural compensatory curves in patients with congenital cervicothoracic hemivertebra (CTH) scoliosis undergoing posterior-only hemivertebra resection and to propose the possible mechanisms of this specific phenomenon.</p><p><strong>Summary of background data: </strong>Though the spinal alignment could be well corrected via posterior hemivertebra resection in CTH patients, the high prevalence of distal curve progression was remarkable. However, the curve behavior of distal non-structural compensatory curves and its possible mechanisms were unclear.</p><p><strong>Methods: </strong>This study retrospectively reviewed a consecutive series of CTH patients undergoing posterior-only hemivertebra resection with a minimum 24 months follow-up. The parameters measured in coronal plane included local scoliosis, clavicle angle, head shift, and the Cobb angle of distal unfused segments. The distal curve was considered as an emerging scoliosis (ES) if with more than 20° progression and the apex of distal curve no less than 2 levels away from the lower instrumented vertebra.</p><p><strong>Results: </strong>A total of 51 CTH patients with a mean age of 8.5 ± 3.8 years at surgery and a mean 38.0 ± 5.3 months follow-up were recruited. The correction of local scoliosis and clavicle angle was statistically significant (p < 0.05 for all). The distal compensatory curve was 11.8 ± 5.3° before surgery and 6.5° ± 4.1° after surgery (p < 0.001), which was slightly increased to 11.6° ± 10.9° (p = 0.002) at the latest follow-up. During follow-up, the increase of distal compensatory curve was significantly correlated with the change in clavicle angle (r = 0.49, p = 0.038). The ES was observed in 10 patients (19.6%) with an average value of 28.0 ± 2.1° at diagnosis, including 7 patients within 6 months and 3 patients after 5 years postoperatively. The mean value of ES was 31.9° ± 3.1° at the latest follow-up, while no patients required revision surgery. The ES was classified into compensatory and idiopathic types according to the typical curve behaviors. The compensatory ES usually presented within 6 months after operation and was responsible for further reconstruction of head and shoulder balance. While the idiopathic ES occurred at adolescent which may be related to the rapid body growth.</p><p><strong>Conclusions: </strong>Distal compensatory curve had a tendency toward slight progression during follow-up in CTH patients with posterior hemivertebra resection surgery. The prevalence of emerging scoliosis was 19.6% and the typical compensatory and idiopathic curve behavior were firstly proposed. Close and longitudinal follow-up was thus highly recommended for CTH patients with posterior HV resection surgery.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"869-875"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}