Orthopedic Research and Reviews最新文献

{"title":"Revascularizing the Lunate: Modern Perspectives on Vascularized Bone Grafting in Kienböck's Disease.","authors":"Rita Saad, Hadi Saada, Johnny Saadeh, Antoine Saber, Christopher Aramouni, Elyssa Kiwan, Wendy Ghanem, Mohamad Badra, Ramzi Moucharafieh","doi":"10.2147/ORR.S619773","DOIUrl":"10.2147/ORR.S619773","url":null,"abstract":"<p><p>Kienböck's disease is a progressive condition characterized by avascular necrosis of the lunate, leading to carpal collapse, chronic pain, and functional impairment if left untreated. Management remains challenging due to variability in disease presentation and the absence of standardized treatment algorithms, particularly regarding surgical options. Among these, vascularized bone grafts (VBGs) have gained increasing attention for their ability to restore blood supply, promote osteogenesis, and preserve carpal architecture. This review provides a comprehensive synthesis of the anatomical basis, indications, surgical techniques, and clinical outcomes of pedicled versus free VBGs in the management of Kienböck's disease. Pedicled grafts, commonly harvested from the distal radius or adjacent carpal structures, maintain their native vascular supply and offer a technically less demanding option with lower morbidity, making them suitable for early to mid-stage disease (Lichtman II-IIIA). In contrast, free vascularized grafts, such as those from the iliac crest or lateral femoral condyle, require microsurgical anastomosis but provide greater structural support and flexibility, particularly in advanced stages or revision cases. Clinical evidence from predominantly retrospective studies suggests that both techniques yield significant improvements in pain, grip strength, and functional outcomes, with variable radiographic progression. However, the literature is limited by small sample sizes, heterogeneity in study design, and lack of direct comparative trials. As a result, no clear consensus exists regarding the superiority of one technique over the other. Current decision-making is largely guided by disease stage, anatomical considerations, and surgical expertise. Further high-quality, prospective comparative studies are needed to establish evidence-based guidelines and optimize treatment strategies for patients with Kienböck's disease.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"619773"},"PeriodicalIF":2.0,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840957","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":"Retrospective Development and Internal Validation of a Diagnostic Model to Identify Secondary Osteoporosis in Community-Dwelling Older Men.","authors":"Yi-You Fang, Liang Zhang, Gang Dong, Liang Peng, Dong Wang, Jiang-Hua Huang, Xian-Xing Wu","doi":"10.2147/ORR.S628918","DOIUrl":"10.2147/ORR.S628918","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a clinical prediction model integrating lumbar spine bone mineral density (LS-BMD) and fall risk assessment for identifying secondary osteoporosis in community-dwelling elderly men.</p><p><strong>Methods: </strong>This retrospective cross-sectional study enrolled men aged 65 years or older from community health centers and geriatric outpatient clinics (June 2023-December 2025). Secondary osteoporosis was defined as T-score ≤ -2.5 at any site (lumbar spine, femoral neck, or total hip) with at least one confirmed major secondary etiology (hypogonadism, glucocorticoid use, vitamin D deficiency, etc). Controls were men with normal BMD or osteopenia without secondary etiology. Participants were randomly assigned to training (70%) and validation (30%) sets. LASSO regression and multivariate logistic regression were used for variable selection and model construction. Bootstrap resampling provided optimism-corrected performance estimates.</p><p><strong>Results: </strong>Among 843 eligible participants (mean age 73.12±5.27 years), 187 (22.18%) were diagnosed with secondary osteoporosis. Six independent predictors were identified: age, LS-BMD T-score, history of fall, testosterone, glucocorticoid use, and vitamin D level. The apparent AUC was 0.846 (95% CI: 0.815-0.878) in the training set and 0.798 (95% CI: 0.741-0.854) in the validation set; the optimism-corrected AUC was 0.731, indicating moderate discrimination. Calibration was satisfactory. Decision curve analysis confirmed clinical net benefit. Of note, three predictors (testosterone, vitamin D, glucocorticoid use) overlap with the diagnostic criteria for secondary osteoporosis, and the AUC values should be interpreted with this caveat in mind.</p><p><strong>Conclusion: </strong>This study developed a preliminary clinical prediction model for identifying secondary osteoporosis in elderly men using internal validation. The model integrates LS-BMD T-score, fall risk, Vitamin D, testosterone, and glucocorticoid use, but external validation is required before clinical application. The overlap between several predictors and the diagnostic criteria represents an important limitation.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"628918"},"PeriodicalIF":2.0,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851280","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":"Acute Knee Flexion Limitation After Sudden Extension: A Clinical Framework Integrating Effusion Decompression and Rotatory Tibial Realignment.","authors":"Herry Herman, Fathurachman Fathurachman","doi":"10.2147/ORR.S621455","DOIUrl":"https://doi.org/10.2147/ORR.S621455","url":null,"abstract":"<p><strong>Background: </strong>Acute inability to flex the knee following a sudden extension event is commonly attributed to structural pathology. However, some patients present with non-mechanical flexion limitation that resolves without invasive intervention, suggesting potentially reversible functional mechanisms.</p><p><strong>Purpose: </strong>To synthesize current concepts and integrate them into a clinically applicable framework that distinguishes effusion-related inhibition from transient alignment-dependent restriction in acute knee flexion limitation.</p><p><strong>Methods: </strong>Narrative review and conceptual synthesis of published literature addressing arthrogenic muscle inhibition, knee effusion, and rotational knee biomechanics, integrated with clinical observations to develop an interpretive framework for bedside assessment.</p><p><strong>Results: </strong>A four-component interpretive framework is described comprising: (1) identification and aspiration of knee effusion to reduce capsular distension; (2) gravity-assisted passive flexion assessment; (3) pain-limited, alignment-facilitated motion involving medial compression, controlled external rotation, posterior translation, and oscillatory flexion; and (4) validation through restoration of symmetric gravity-assisted motion.</p><p><strong>Conclusion: </strong>Acute knee flexion limitation following sudden extension may not always reflect fixed mechanical obstruction. The proposed framework integrates established concepts of arthrogenic muscle inhibition with observations from rotational knee biomechanics to support clinical reasoning in selected cases. As a conceptual and hypothesis-generating model, it has not undergone prospective clinical, imaging, or biomechanical validation, and further investigation is required to determine its validity, safety, reproducibility, and clinical utility.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"621455"},"PeriodicalIF":2.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796275","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":"Effect Of Intraarticular Triamcinolone Hexacetonide versus Betamethasone on Intraocular Pressure: A Prospective Randomized Study.","authors":"Hilal Yağar, Kadir Eren Biçer, Gamze Yıldırım Biçer","doi":"10.2147/ORR.S620422","DOIUrl":"10.2147/ORR.S620422","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroids may cause glaucoma by increasing intraocular pressure (IOP) due to their systemic side effects. Few studies have investigated the effect of intraarticular corticosteroids (IACS) on IOP. This study aimed to evaluate the effects of IACS preparations (betamethasone and triamcinolone hexacetonide) on IOP.</p><p><strong>Methods: </strong>In this single-center randomized study, patients receiving IACS were randomized into two groups: Group 1 received betamethasone (Diprospan^®, betamethasone dipropionate 6.43 mg + betamethasone sodium phosphate 2.63 mg, equivalent to 7.0 mg betamethasone) and Group 2 received triamcinolone hexacetonide (Artropan^®,20 mg triamcinolone hexacetonide). IOP was measured before injection and at 1 week after injection. The change in IOP (ΔIOP) was calculated using the following formula: IOP (after injection) - IOP (before injection).</p><p><strong>Results: </strong>A total of 80 patients and 160 eyes were included in the study, with 40 patients in each group. No significant change was found in ΔIOP in Group 1 (p > 0.05). A statistically significant increase in ΔIOP was observed in both eyes and in the left eye in Group 2; (both eyes: p = 0.002; left eye: p = 0.012; right eye:<i>p</i> = 0.060). ΔIOP was significantly higher in Group 2 than in Group 1 (p = 0.043).</p><p><strong>Conclusion: </strong>Triamcinolone hexacetonide may increase IOP after IACS more than betamethasone; caution is warranted in patients with risk factors for glaucoma.</p><p><strong>Trial registration: </strong>The trial was registered at ClinicalTrials.gov retrospectively (No: NCT07242846, Date: 17.11.2025).</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"620422"},"PeriodicalIF":2.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713288","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":"Intelligent Rehabilitation: Advances in Artificial Intelligence for Musculoskeletal Rehabilitation: A Narrative Review.","authors":"Jiayue Hao, Shibo Sun, Tianxu Dou, Jin Deng, Wen Li, Chicheng Ma, Yejia Zhang, Lutian Yao","doi":"10.2147/ORR.S607912","DOIUrl":"10.2147/ORR.S607912","url":null,"abstract":"<p><p>Musculoskeletal diseases, such as osteoarthritis and joint trauma, significantly impact patient mobility, independence, and quality of life. With the rising demand for effective and accessible rehabilitation strategies, artificial intelligence (AI) has emerged as a powerful tool to support diagnosis, surgical planning, and personalized rehabilitation. This narrative review summarizes recent advances in the application of AI in musculoskeletal disease management, with a particular emphasis on postoperative and conservative rehabilitation. We outline the foundational concepts of AI, including machine learning, deep learning, computer vision, and natural language processing, and discuss their roles in clinical decision-making and recovery monitoring. Furthermore, we examine emerging AI-assisted rehabilitation tools, including mobile applications, robotic exoskeletons, gamified platforms, and markerless motion tracking systems, which collectively enhance treatment precision, patient adherence, and remote care capabilities. Despite promising outcomes, current limitations include insufficient personalization, limited multimodal data integration, and inadequate clinical validation. Future developments should focus on improving model interpretability, integrating real-time biosensing, and optimizing user interface design to support clinically feasible and patient-centered musculoskeletal rehabilitation.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"607912"},"PeriodicalIF":2.0,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562543","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":"Cervical Collar in Adult Trauma: Evidence, Controversies, and Clinical Decision-Making.","authors":"Saied Besharaty, Shahab Sheikhalishahi, Hesameddin Jafarinasab","doi":"10.2147/ORR.S621602","DOIUrl":"10.2147/ORR.S621602","url":null,"abstract":"<p><p>Cervical collars have traditionally been applied routinely in adult trauma to reduce the risk of secondary cervical spinal cord injury. Increasing evidence, however, supports selective spinal motion restriction and earlier collar removal when instability has been adequately excluded. This narrative review evaluates current evidence on collar application, avoidance, clearance, and continued use after confirmed cervical fracture. A structured literature search was conducted across major biomedical databases and guideline sources, with the synthesis guided by the Scale for the Assessment of Narrative Review Articles. In blunt trauma, collar use should be based on clinical risk, examination reliability, mechanism of injury, and phase of care. Routine collaring is generally unsupported in isolated penetrating trauma and may delay time-critical management. In evaluable patients, validated decision rules and high-quality computed tomography (CT) support early clearance when appropriate. In adults with impaired consciousness, collar removal after a negative high-quality CT should be individualized according to neurological findings, clinical context, examination reliability, institutional protocols, and the presence or absence of radio-clinical discrepancy. After fracture confirmation, continued collar use should be individualized according to stability, frailty, treatment goals, and tolerance. Collar-related harms should be incorporated into repeated reassessment. The proposed Four-Domain Trauma Collar Framework organizes these decisions across application, clearance, continuation, and de-escalation but remains a conceptual, unvalidated model.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"621602"},"PeriodicalIF":2.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579552","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":"A Bundled-Payment Program is Associated with Improved Access to Platelet Rich Plasma for Treatment of Osteoarthritis in Women and Non-White Population Groups.","authors":"Alexander Sin, Anant Shukla, Wikien Hung Pinto, Alicia Hymel, Jacquelyn S Pennings, Ruchika Talwar, Lauren Porras","doi":"10.2147/ORR.S607381","DOIUrl":"10.2147/ORR.S607381","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether the implementation of a novel hospital-based bundled-payment program affects access to platelet rich plasma (PRP) injections for the treatment of osteoarthritis (OA) for patients representing different population subgroups.</p><p><strong>Patients and methods: </strong>This was a retrospective observational study, which included patients receiving PRP injections between January 2021 and October 2024, at three outpatient orthopaedic clinics of a single hospital-based institution. Patients were excluded if they did not undergo knee, hip, or shoulder (glenohumeral) PRP injections or had insurance coverage for PRP injections. The main outcome measured was the utilization of the bundled-payment program for PRP injections and treatment failure, defined as need for additional treatment within 9 months.</p><p><strong>Results: </strong>Among 220 patients who received PRP injections, women were more likely to use the bundled-payment program than men (37.76% women vs 18.18% men, p = 0.003). Younger patients more frequently utilized the program (53.26 ± 9.55 years vs 62.02 ± 12.75 years, p < 0.001). Non-white patients were significantly more likely to use the bundled-payment program than white patients (51.61% vs 29.14%, p = 0.014). There were no significant differences in program utilization by ethnicity, DCI, or OA severity. There was no significant difference in odds for requiring additional treatments within 9 months between patients of different racial subgroups.</p><p><strong>Conclusion: </strong>The bundled-payment program was associated with increased access to PRP for non-white patients and women. There was no significant difference between racial subgroups in terms of requiring additional treatments within 9 months after initial PRP treatments.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"607381"},"PeriodicalIF":2.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448539","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":"Does Anteroposterior Cage Position and Screw Orientation Influence Clinical/Radiographic Outcomes and Complications After Oblique Lumbar Interbody Fusion with Lateral Plate Fixation?","authors":"Yachen Li, Xin Shi, Sheng Lu, Jie Liu","doi":"10.2147/ORR.S611380","DOIUrl":"10.2147/ORR.S611380","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the influence of cage anteroposterior position and angulation, as well as plate and screw trajectory, in oblique lumbar interbody fusion with lateral plate fixation, on clinical and radiographic outcomes along with associated perioperative complications.</p><p><strong>Methods: </strong>A total of 47 patients undergoing OLIF-LP surgery were enrolled. Cases were divided into the anterior position group (APG) or the posterior position group (PPG) based on whether the cage was positioned anterior or posterior to the midline. Data were collected preoperatively and at 3 days, 3 months, and 12 months postoperatively. Radiographic parameters measured included LL, FSL, DH, and FH. Implant-related measurements comprised cage-device angle (CDA), superior screw to endplate angle (SSEA), and inferior screw to endplate angle (ISEA). Clinical outcomes included Back-VAS, Leg-VAS, ODI scores, and perioperative complications, to evaluate the impact of cage position on radiographic and clinical outcomes at different time points.</p><p><strong>Results: </strong>No significant differences were found in clinical outcomes between the groups at any point. Radiographically, the APG showed greater improvement in FSL than the PPG (4.37±3.56° vs. 1.75±3.16°, p=0.012). The APG also had greater loss of FH during follow-up (p=0.024). Thigh/inguinal numbness was the most common complication (38.3%), and was more frequent in the PPG. SSEA positively correlated with FSL at final follow-up (r=0.408, p=0.004).</p><p><strong>Conclusion: </strong>When employing a lateral plate for fixation in OLIF, an anteriorly positioned cage yields superior improvement in FSL, whereas posterior placement more effectively maintains FH, albeit with an increased risk of perioperative neurological complications. Moreover, a larger SSEA was positively associated with improvement in long-term FSL.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"611380"},"PeriodicalIF":2.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345984","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":"Digital Health and Smart Technologies in Shoulder Arthroplasty: Emerging Tools and Clinical Implications.","authors":"Asimina Lazaridou, Moritz Kraus, Felix Conrad Oettl, Jan-Philipp Imiolczyk, David A Back, Markus Scheibel","doi":"10.2147/ORR.S605861","DOIUrl":"10.2147/ORR.S605861","url":null,"abstract":"<p><strong>Purpose: </strong>Shoulder arthroplasty has evolved substantially in surgical technique, implant design, and indications. Careful coordination across the patient care pathway remains central to optimizing outcomes. Concurrently, rapid advances in digital health, wearable technologies, smart implants, and intraoperative innovations are being explored across orthopedics, with emerging applications in shoulder arthroplasty.</p><p><strong>Objective: </strong>This narrative review synthesizes current evidence on digital technologies relevant to shoulder arthroplasty, with particular attention to the strength and origin of the available data.</p><p><strong>Patients and methods: </strong>A structured review of recent literature was performed, including primary studies in shoulder arthroplasty as well as relevant evidence extrapolated from hip and knee arthroplasty. Areas examined included CT-based 3D planning, navigation, patient-specific instrumentation, robotics, augmented/mixed reality, mobile health (mHealth) platforms, wearable devices, tele-rehabilitation, sensor-enabled implants, and artificial intelligence (AI).</p><p><strong>Results: </strong>In shoulder arthroplasty, digital planning tools, navigation systems, and patient-specific instrumentation have demonstrated improvements in implant positioning accuracy in selected studies; however, evidence linking these technologies to superior long-term clinical outcomes remains limited. Robotic systems and augmented reality applications are in early investigational phases. Postoperative digital health tools, including tele-rehabilitation and wearable monitoring, have shown non-inferior functional outcomes compared with conventional care in hip and knee arthroplasty, with only preliminary and pilot data currently available in shoulder populations. Sensor-enabled implants and AI-based predictive models represent emerging areas of research, but external validation, workflow integration, and cost-effectiveness analyses remain insufficient.</p><p><strong>Conclusion: </strong>Digital and smart health technologies in shoulder arthroplasty are evolving and largely investigational. While early findings and extrapolated evidence from other arthroplasty domains suggest potential benefits in planning accuracy, patient engagement, and outcome monitoring, robust shoulder-specific clinical validation is limited. Further prospective studies are required before widespread clinical adoption can be recommended. This narrative review synthesizes emerging evidence in this field, which is currently dominated by feasibility studies, technical reports, and early-phase clinical investigations, with limited high-level outcome data specific to shoulder arthroplasty.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"605861"},"PeriodicalIF":2.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308423","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":"Burden and Temporal Trends of Osteoarthritis in Germany from 1990 to 2021, with Projections to 2041: Findings from the Global Burden of Disease Study.","authors":"Mohammad Ali Alshrouf","doi":"10.2147/ORR.S603661","DOIUrl":"10.2147/ORR.S603661","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a leading cause of disability globally, particularly affecting aging populations. This study assessed temporal trends in OA burden in Germany from 1990 to 2021 and projected future burden to 2041.</p><p><strong>Methods: </strong>A secondary analysis of the Global Burden of Disease (GBD) 2021 data was conducted. Metrics analyzed included age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and disability-adjusted life years (DALYs). Temporal trends were assessed using estimated annual percentage change (EAPC) and joinpoint regression. Decomposition analysis was used to examine the main drivers of the increase in incidence. Pearson's correlation assessed temporal co-variation with the Sociodemographic Index (SDI), and ARIMA models projected burden to 2041.</p><p><strong>Results: </strong>Between 1990 and 2021, incident OA cases increased by 36%, prevalent cases by 48%, and DALYs by 49%. Across all three measures, the relative increase was greater in males than in females (incidence: 50% vs 28%; prevalence: 73% vs 36%; DALYs: 74% vs 37%). Despite these steeper relative increases in males, females had higher absolute burden in 2021 for incidence, prevalence, and DALYs (468,653 vs 319,059; 7,571,715 vs 4,696,892; and 272,903 vs 164,888, respectively). Knee OA was the dominant subtype and accounted for the highest incidence and prevalence, exceeding 7.2 million prevalent cases in 2021. Germany's DALY rates exceeded global rates in all age groups except 45-59 years. Decomposition analysis suggested that the increase in incidence was mainly attributable to changes in age structure (23.9%), population growth (6.4%), and epidemiologic change (5.7%). Joinpoint regression identified several significant shifts in temporal trends, with renewed increases after 2010. ASIR, ASPR, and age-standardized DALY rates (ASDaR) showed positive temporal correlations with the SDI. ARIMA projections suggested continued upward trends in ASIR, ASPR, and ASDaR attributed to OA, with projected values by 2041 reaching approximately 580.0 (95% CI: 554.7-605.3), 7309.1 (95% CI: 7110.9-7507.2), and 260.6 (95% CI: 252.3-268.9) per 100,000 persons, respectively.</p><p><strong>Conclusion: </strong>The burden of OA in Germany has increased substantially over the past three decades and is projected to continue rising through 2041. Although the relative increase in incidence was greater in males, the absolute burden remained higher in females. The projected rise in OA burden underscores the need for targeted healthcare planning and resource allocation. National strategies should account for demographic aging to support effective long-term OA management.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"603661"},"PeriodicalIF":2.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252589","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}