Orthopedic Research and Reviews最新文献

{"title":"Biportal Endoscopic Interlaminar Resection of Lumbar Facet Cyst: A Technical Note.","authors":"Asrafi Rizki Gatam, Luthfi Gatam, Ajiantoro Ajiantoro, Omar Luthfi, Phedy Phedy, Harmantya Mahadhipta, Syafrudin Husin, Ilham Suryo Wibowo Antono, Erwin Ardian Noor, Karina Sylvana Gani, Mitchel Mitchel, Erica Kholinne","doi":"10.2147/ORR.S534359","DOIUrl":"10.2147/ORR.S534359","url":null,"abstract":"<p><strong>Introduction: </strong>Facet cysts are degenerative lesions near the facet joints, often seen in older adults with lumbar or radicular pain. They can compress nerves and cause significant morbidity. Treatment options range from conservative care to surgery. This article outlines the Biportal Endoscopic Spine Surgery (BESS) technique using interlaminar ipsilateral or contralateral approaches for symptom relief.</p><p><strong>Methods: </strong>This paper outlines the surgical techniques of Biportal Endoscopic Spine Surgery (BESS), utilizing both ipsilateral and contralateral interlaminar approaches. The choice of approach was determined by the location and characteristics of the synovial cyst. It details the surgical process, including portal placement, visualization, trajectory differences between approaches, and steps for cyst removal.</p><p><strong>Results: </strong>Biportal endoscopic spine surgery is a safe and effective minimally invasive treatment for symptomatic lumbar facet cysts, especially in elderly patients. The contralateral approach offers better visualization, improved dural dissection, and greater facet joint preservation, making it ideal for medial or adherent cysts. It also reduces nerve root manipulation and postoperative instability. In contrast, the ipsilateral approach is more suitable for lateral cysts.</p><p><strong>Conclusion: </strong>The choice between contralateral and ipsilateral approaches in biportal endoscopic facet cyst removal depends on cyst location and anatomical considerations. The contralateral approach is better suited for medial or adherent cysts, offering improved access with less facet disruption. Meanwhile, the ipsilateral approach provides a direct path for lateral cysts but may require more nerve manipulation and facet joint resection. A personalized surgical strategy is essential to optimize access, ensure nerve safety, and maintain spinal stability.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"373-380"},"PeriodicalIF":2.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874394","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":"Preoperative Spino Cranial Angle Predicts Adjacent Segment Degeneration After Single-Level Anterior Cervical Discectomy and Fusion.","authors":"Yong Li, Peiyan Cheng, Xiaolei Zhang, Cai Cheng","doi":"10.2147/ORR.S533548","DOIUrl":"10.2147/ORR.S533548","url":null,"abstract":"<p><strong>Background: </strong>Adjacent segment degeneration (ASD) is a common complication after anterior cervical decompression and fusion (ACDF). The spino cranial angle (SCA), a novel sagittal parameter reflecting head-to-cervical alignment, may be associated with ASD, yet its predictive value remains unclear.</p><p><strong>Methods: </strong>A total of 98 patients who underwent single-level ACDF with at least 24 months of follow-up were retrospectively analyzed. Radiographic evaluations were conducted preoperatively and at 3, 6, 12, and 24 months postoperatively. Patients were classified into ASD and non-ASD groups based on established radiographic criteria. Pre- and postoperative cervical sagittal parameters, including SCA, T1 slope (T1s), sagittal segmental alignment (SSA), sagittal alignment of the cervical spine (SACS), and C2-C7 sagittal vertical axis (cSVA) were measured. Clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score, Neck Disability Index (NDI), and Visual Analog Scale (VAS) scores. Multivariate logistic regression and Receiver operating characteristic (ROC) curve analysis were performed to identify independent predictors of ASD.</p><p><strong>Results: </strong>ASD occurred in 36 patients (36.7%). Preoperative SCA was significantly larger in the ASD group compared to the non-ASD group (86.7° ± 7.4° vs 80.5° ± 6.9°, p < 0.001), while T1s and SSA were significantly smaller (p = 0.015 and p = 0.001, respectively). Multivariate analysis identified preoperative SCA as the only independent risk factor for ASD (OR = 1.279, 95% CI: 1.010-1.619, p = 0.041). Patients with SCA > 84.2° showed a significantly higher incidence of ASD (55.8% vs 21.4%, p < 0.001). ROC analysis demonstrated that SCA had good predictive value for ASD development. No significant differences were observed in JOA, NDI, or VAS scores between the two groups at final follow-up.</p><p><strong>Conclusion: </strong>Preoperative SCA is a significant predictor of ASD, and may be considered in preoperative risk assessment.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"361-371"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775918","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 and Validation of Key Genes Related to Lipophagy in Osteoporosis.","authors":"Yixin Hu, Mingliang Zuo, Yu Wu, Yu Yang, Xiaobing Shi, Qian Zhang, Ji Wu, Runqi Xie, Yu Bi, Bo Lin, Chou Mo","doi":"10.2147/ORR.S518036","DOIUrl":"10.2147/ORR.S518036","url":null,"abstract":"<p><strong>Background: </strong>Lipid droplet autophagy (lipophagy) is the breakdown and recycling of lipids within cells via autophagy. Some research suggests that enhancing lipophagy could have potential benefits for bone health. This study aimed to determine the key genes linked to lipophagy in osteoporosis (OP) and provided a reference for the treatment of OP.</p><p><strong>Methods: </strong>The study analyzed OP-related datasets (GSE56815, GSE62402) and lipophagy-related genes (LRGs). Candidate genes associated with lipophagocytosis were identified through differential expression (DE) analysis and weighted gene co-expression network analysis (WGCNA). The minimum absolute contraction selection operator (LASSO), support vector machine recursive feature elimination (SVM-RFE) and Boruta algorithm are used to identify candidate genes for OP-related feature genes, and the expression of key genes is analyzed. In addition, we constructed a nomogram to predict the incidence of OP patients. Subsequently, multiple bioinformatics tools were used to reveal the associations between key genes and OP. Finally, quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression levels of key genes.</p><p><strong>Results: </strong>Eight signature genes were identified by machine learning. Only EIF3K and SHMT2 had consistent, significantly different expression trends between OP and control in GSE56815 and GSE62402, being up-regulated in OP. Thus, they were recognized as lipophagy-related key genes. Enrichment analysis showed that EIF3K is related to \"Mitochondrial cell assembly\", etc., and SHMT2 to \"Arf-3 pathway\", etc. Both genes negatively linked to activated dendritic cells and mast cells. In regulatory networks, hsa-let-7 family miRNAs were upstream of these genes. Clindamycin and SCHEMBL14520730 targeted them. SHMT2 and EIF3K expression trends matched bioinformatic results.</p><p><strong>Conclusion: </strong>This study identified lipophagy-related key genes (EI<i>F</i>3K and <i>SHMT2</i>) in OP, which contributed to the early diagnosis and clinical treatment of OP.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"341-359"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732585","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":"Enhancing Bone Repair with β-TCP-Based Composite Scaffolds: A Review of Design Strategies and Biological Mechanisms.","authors":"Xuewen Ni, Jing Feng, Mengxue Liang, Fangzheng Zhou, Yuanjie Xia, Zijie Dong, Qingyu Xue, Zehao Li, Feifei Pu, Ping Xia","doi":"10.2147/ORR.S525959","DOIUrl":"10.2147/ORR.S525959","url":null,"abstract":"<p><p>It is reported that there are approximately 2.2 million bone graft procedures every year due to injuries, bone tumors, marginal bone defects, and aging of the population. However, the scarcity of natural donors and graft rejection make it difficult to adequately fulfill clinical demands for bone repair. While β-tricalcium phosphate (β-TCP) is a key material in bone tissue engineering, it remains insufficient for treating large bone defects. Therefore, researchers have started investigating the combination of β-TCP with other biomaterials to achieve improved clinical outcomes. Such composite scaffolds possess excellent biocompatibility and effectively provide structural support to promote cell adhesion, proliferation, and differentiation-thereby accelerating new bone tissue formation. This review examines β-tcp-based composite scaffolds for bone regeneration, analyzing design innovations and biological mechanisms, and bone repair principles-with a focus on cellular dynamics and microenvironmental regulation. The discussion valuates β-TCP's osteoconductive properties while addressing its clinical limitations in mechanical strength and degradation control. Additionally, it systematically elucidates the specific application of β-TCP-based composite scaffolds in bone repair. These include osteoinductive, osteogenic, osteoconductive and inflammatory regulation. Moreover, clinical translation progress is discussed, highlighting applications in craniomaxillofacial reconstruction and osteonecrosis management. Finally, we summarize that β-TCP composite scaffolds face challenges including poor mechanical strength, asynchronous degradation-regeneration, and manufacturing limitations. Future directions should focus on developing synchronously degradable materials and intelligent scaffolds via 4D printing and AI-optimized designs, and clinical translation systems to achieve precise bone regeneration.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"313-340"},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675354","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":"Combination Hyaluronic Acid and Multipotent Stromal Cells Fails to Improve Rat Knee OA Outcomes Compared to Cells Alone.","authors":"Kennedy Michele Davis, Megan Hamilton, Donald Muathe, Aldyn Wildey, Stephen Harrington, Douglas C Bittel, Michael Filla, Lisa Stehno-Bittel","doi":"10.2147/ORR.S525292","DOIUrl":"10.2147/ORR.S525292","url":null,"abstract":"<p><strong>Introduction: </strong>Multipotent Stromal Cells (MSCs) are utilized as therapeutic agents for addressing musculoskeletal conditions, including knee osteoarthritis (OA). However, major challenges in the clinical application include maintenance of the cells in the joint capsule. Hyaluronic acid (HA) is endogenous in synovial joints and commercially available as a joint lubricant. We tested the hypothesis that delivery of MSCs in HA into an OA rat knee model could improve outcomes.</p><p><strong>Methods: </strong>Rat bone marrow MSCs were suspended in a commercially available HA paste, and cell viability measured with live/dead stains. Biomarkers for MSC chondrogenesis and osteogenesis were monitored with PCR. MSCs with or without HA were injected into the knees of OA rats and histology conducted 6 weeks later.</p><p><strong>Results: </strong>Suspending MSC in HA resulted in a slight reduction in viability. The gene expression profile showed an increase in MSC biomarkers for cells in HA with a decrease in osteogenic markers. Four groups of treatment (vehicle, MSCs alone, HA alone, MSCs + HA) were injected into the knees of osteoarthritic rats. Pain scores, collected weekly, showed no difference between the groups. Immunohistochemistry for inflammatory markers illustrated no obvious differences between groups. Proteoglycans, indicative of cartilage, showed a loss in the vehicle group and modest signs of cartilage with MSCs alone, but when mixed with the HA, any benefit was lost. OARSI Histological Scoring completed by 2 independent technicians concluded no improvement in joint integrity with the addition of HA.</p><p><strong>Conclusion: </strong>A commercially available HA failed to enhance joint regeneration compared to MSCs alone.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"299-312"},"PeriodicalIF":1.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643121","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":"Clinical Insights on Transforaminal Lumbar Interbody Fusion (TLIF) Implantations Following Spinal Fusion Surgery: Enhancing and Monitoring Bone Health in Patients.","authors":"Francesco Puglia, Marcello Ferraro, Valentina Longhi, Enrico Gallazzi, Giovanni Andrea La Maida","doi":"10.2147/ORR.S364680","DOIUrl":"10.2147/ORR.S364680","url":null,"abstract":"<p><p>Spinal degenerative diseases are major contributors to chronic back pain and disability. Transforaminal lumbar interbody fusion (TLIF) is a widely used surgical approach to address these conditions by achieving vertebral fusion. The success of TLIF is significantly influenced by bone health, particularly bone mineral density (BMD), as low BMD increases risks of complications such as cage subsidence and pseudarthrosis. This systematic review evaluated factors predictive of TLIF outcomes, focusing on BMD, bone graft materials, and postoperative bone health monitoring. A comprehensive literature search was conducted according to PRISMA modalities, and ten studies met the inclusion criteria. This review emphasizes the importance of preoperative BMD assessment and tailored surgical strategies in optimizing TLIF outcomes. Future research should focus on defining BMD thresholds, developing innovative graft materials, and long-term studies to improve surgical success in TLIF procedures.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"281-288"},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626887","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":"Correlation Analysis of Serum G-Protein-Coupled Receptor 4 and Biglycan Levels with the Severity of Intervertebral Disc Degeneration.","authors":"Bingjie Gao, Yizhi Cui, Yexiao Qin, Chuncheng Qu, Jiaqi Zhao, Xiaoning Li","doi":"10.2147/ORR.S525337","DOIUrl":"10.2147/ORR.S525337","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between serum levels of G protein-coupled receptor 4 (GPR4) and Biglycan (BGN) with the severity of Intervertebral Disc Degeneration (IVDD).</p><p><strong>Methods: </strong>A total of 162 patients with IVDD treated at our hospital from August 2023 to August 2024 were included. The general information of patients was retrospectively collected. MRI was used to assess IVDD severity using the Pfirrmann grading system. Serum GPR4 and BGN levels were measured by enzyme-linked immunosorbent assay (ELISA). Multiple linear regression analysis was performed to identify risk factors for IVDD severity. <i>Spearman</i>'s and <i>Pearson</i>'s correlation analyses were used to evaluate the relationships between serum GPR4, BGN, and IVDD severity. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of serum GPR4 and BGN in IVDD.</p><p><strong>Results: </strong>Significant differences in age and the proportion of diabetic patients as well as serum GPR4 and BGN were found among different Pfirrmann grades (<i>P</i><0.05). Serum GPR4 levels increased but BGN levels decreased with higher Pfirrmann grades (<i>P</i><0.05). Multiple linear regression analysis showed that age and serum GPR4 and BGN levels were risk factors for IVDD severity (<i>P</i><0.05). The results of the correlation analysis showed that serum GPR4 and age were positively correlated with the severity of IVDD (<i>r</i>=0.651, <i>r</i>=0.488, <i>P</i><0.001), while BGN was negatively correlated with the severity of IVDD (<i>r</i>=-0.591, <i>P</i><0.001). The results of <i>Spearman</i> correlation analysis showed a negative correlation between serum GPR4 and BGN (<i>P</i><0.05). ROC curve analysis revealed that the AUC values for the diagnosis of IVDD using serum GPR4 alone, BGN alone, and the combination of GPR4 and BGN were 0.918, 0.811, and 0.919, respectively (<i>P</i><0.05). Moreover, the combination of GPR4 and BGN demonstrated higher sensitivity and specificity compared to either marker alone.</p><p><strong>Conclusions: </strong>Serum GPR4 and BGN levels are identified as effective diagnostic indicators for IVDD, with serum GPR4 positively correlated but BGN negatively correlated with the severity of IVDD.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"289-297"},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626888","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":"Functional Outcomes of Minimally Invasive Percutaneous Surgical Correction of Late-Presenting Severely Deformed Foot in a Patient with Myelomeningocele.","authors":"Suliman Abdullah Shurbaji, Abdulaziz Ahmed Abdulaziz, Obaidallah Buraykan Alsuwat, Saleh Mohammad Abu Adas, Khalid Ayidh Alotaibi, Ali Mohammed Alahmari","doi":"10.2147/ORR.S504536","DOIUrl":"10.2147/ORR.S504536","url":null,"abstract":"<p><strong>Background: </strong>Congenital talipes equinovarus (CTEV), continues to rank among the most common congenital musculoskeletal deformities. The management of CTEV, particularly when it is part of a syndromic presentation or associated with conditions such as myelomeningocele (MMC), presents a significant challenge due to the deformity's tendency to be stiffer and more complex. Most children with CTEV may require surgical intervention. The current case report highlights the functional outcome of minimally invasive percutaneous surgical correction in a late-presenting, rigid, and severe foot deformity in an MMC patient, aiming to have accepted residual deformity that gave better function with less surgical complication.</p><p><strong>Methods: </strong>A case involving an eight-year-old girl having a deformity in her left foot secondary to low lumbar level MMC was referred for management. The Pirani score total was 6, signifying a severe deformity according to received initial assessments. Upon review of treatment alternatives, minimally invasive percutaneous surgical correction was performed consisting of percutaneous plantar fascia release followed by Achilles tendon lengthening and flexor digitorum tenotomy. We followed up with the patient for one year for wound healing and functional outcomes. An early weight bearing in cast was achieved 1 week with walker frame. Removal of cast and application of custom walker orthosis for walking on the 6th week post-operation. Following up to one year, she is a walker, and residual deformity of the foot did not affect her mobilization.</p><p><strong>Results: </strong>As of the one-year follow-up, she is self-ambulatory, thanks to her custom walking orthosis. Residual deformity did not affect her functional outcome. We recommend further follow-up, and future surgery may be necessary if her deformity worsens.</p><p><strong>Conclusion: </strong>The functional outcome, the social and economic status of the family, and the psychological impact on the patient significantly influence the selection of the most suitable method.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"275-280"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541666","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":"Clinical Outcomes of Methotrexate Usage in Postoperative Arthroplasty Patients: An Evidence Based Review.","authors":"Jason Koppert, David Heikoop, Brent A Lanting","doi":"10.2147/ORR.S524513","DOIUrl":"10.2147/ORR.S524513","url":null,"abstract":"<p><p>Patient dissatisfaction after joint arthroplasty remains common. Synovitis is known to contribute to patient dissatisfaction in patients with osteoarthritis. Methotrexate (MTX) is commonly used to prevent joint deterioration in rheumatoid arthritis, however it is much less common in the treatment of osteoarthritic patients. This review explores the effect of MTX on surgical outcomes in the general arthroplasty patient population. While most of the papers reviewed include patients with rheumatoid arthritis, we also review papers that include patients with osteoarthritis and juvenile idiopathic arthritis. Publications were queried in PUBMED and OVID MEDLINE using the following terms: arthroplasty, joint replacement, methotrexate, DMARDs, osteoarthritis, rheumatoid arthritis, arthritis. After applying exclusion criteria, we identified 12 publications for this review. Our results showed no significant increase in revisions or long-term infections were reported in patients taking MTX. One study reported detriment to nerve function with postoperative MTX use. All other studies reported no difference in post-operative pain or function scores. One study investigating the effect of MTX on mobility in rheumatoid arthritis patients following arthroplasty showed improvement in function in patients taking MTX. Thus, based on this review, perioperative MTX use does not appear to worsen arthroplasty outcomes. This review should suffice as a building block for further investigations and trials into MTX's utility for arthroplasty patients.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"269-274"},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554084","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":"Weight-Bearing Monitoring Devices in Lower Extremity Fractures: A Scoping Review.","authors":"Jackson Robinson, Alice Wei Ting Wang, David J Stockton","doi":"10.2147/ORR.S521013","DOIUrl":"10.2147/ORR.S521013","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedic surgeons commonly prescribe weight-bearing parameters for their patients for a variety of reasons. Weight-bearing may be limited in order to control the healing environment, but advancing a patient's weight-bearing status is preferably done as quickly as possible to maximize functional recovery. However, it is entirely unclear to what extent these prescriptions are followed in practice. The purpose of this scoping review is to identify and compare non-invasive devices used for the measurement of weight-bearing following lower extremity fractures.</p><p><strong>Methods: </strong>Database searches of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were completed to identify relevant studies. Titles were screened for relevance, and abstracts were screened against the eligibility criteria. We identified studies that investigated the use of external force, pedal pressure, or activity monitoring devices used in adults after lower extremity fractures and excluded studies involving compartment pressure measurement.</p><p><strong>Findings: </strong>Sixty-two studies met the inclusion criteria. About 39% of studies used an insole-type device, which could be worn in a shoe or integrated into a removable boot. Other device types included step count or activity monitors (52%), force plates (18%), pressure film (2%) and external pedobarography systems (27%).</p><p><strong>Interpretation: </strong>We found that different monitors offered varying types of measurements and are suitable for a variety of applications. Therefore, selecting the ideal device depends on the metric of interest. Further high-quality prospective studies utilizing device monitoring are needed to validate the theory that early weight-bearing is beneficial and safe for patients with lower extremity fractures.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"257-267"},"PeriodicalIF":1.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497585","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}