Orthopedic Research and Reviews最新文献

{"title":"Titanium versus Biodegradable Implants for Fracture Fixation: A Retrospective Comparative Study.","authors":"Wajid Ullah, Aierbanjiang Shali, Alimujiang Abulaiti, Cheng Erlin, Aihemaitijiang Yusufu","doi":"10.2147/ORR.S585068","DOIUrl":"10.2147/ORR.S585068","url":null,"abstract":"<p><strong>Background: </strong>Titanium alloy implants are widely used in fracture fixation due to their excellent mechanical stability, but they often require secondary surgeries for removal. In contrast, biodegradable implants eliminate the need for removal, yet concerns regarding their mechanical strength in load-bearing bones remain. This study evaluates the clinical trade-off between mechanical rigidity and the burden of secondary surgery by comparing titanium versus biodegradable implants in limb and pelvic fractures.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 73 patients treated between November 2021 and August 2024. Patients were divided into the titanium group (n = 40, primarily diaphyseal fractures) and the biodegradable group (n = 33, primarily metaphyseal/peri-articular fractures). Outcomes including implant palpability and reoperation rates were assessed. A stratified analysis compared outcomes in weight-bearing versus non-weight-bearing fractures.</p><p><strong>Results: </strong>The mean age of patients was 42.6 ± 16.03 years. Titanium implants were associated with significantly higher rates of plate palpability (18/40, 45.0% vs 3/33, 9.1%; OR 8.18, 95% CI 2.14-31.3; <i>P</i> = 0.001) and secondary surgery (14/40, 35.0% vs 3/33, 9.1%; OR 5.38, 95% CI 1.39-20.8; <i>P</i> = 0.012) compared to biodegradable implants. Elective removal due to discomfort occurred in 17.5% (7/40) of titanium patients but was eliminated (0%) in the biodegradable group (<i>P</i> = 0.014). In the weight-bearing subgroup, biodegradable implants significantly reduced palpability (11.1% vs 53.3%, OR 9.14) without increasing complication-driven reoperations. However, three cases (9.1%) of refracture occurred in the biodegradable group compared to zero in the titanium group (<i>P</i> = 0.088).</p><p><strong>Conclusion: </strong>In this cohort, biodegradable implants were associated with a reduction in implant palpability and elective removal surgery for metaphyseal and peri-articular fractures. However, due to lower mechanical strength, titanium remains the preferred choice for diaphyseal fractures requiring high mechanical stability. These findings are limited by the retrospective design and heterogeneity of fracture sites.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"585068"},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723384","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":"Brucella Infection of the Sternoclavicular Joint with Innovative Localized Drug Delivery: A Case Report and Review of the Literature.","authors":"Xianshuai Kou, Xiao Pan, Yi Zhang, Binfeng He, Zaichun You, Guifu Ma","doi":"10.2147/ORR.S567349","DOIUrl":"10.2147/ORR.S567349","url":null,"abstract":"<p><strong>Background: </strong>Brucellosis is typically associated with complications involving the osteoarticular, cardiovascular, and central nervous systems. However, septic arthritis of the sternoclavicular joint (SCJ) represents an isolated and exceptionally rare clinical entity. We report a case of Brucella-induced SCJ abscess successfully managed via the localized implantation of doxycycline-loaded calcium sulfate. This targeted drug delivery system offers a robust therapeutic strategy for controlling focal infections in atypical anatomical locations.</p><p><strong>Case presentation: </strong>A 47-year-old woman presented with intermittent fever and a progressively enlarging clavicular mass. Physical examination revealed distinct, tender swelling over the right SCJ. The patient's symptoms were refractory to prior antimicrobial therapy with cefuroxime sodium. Computed tomography (CT) demonstrated localized soft tissue swelling and osteolytic destruction at the SCJ. Magnetic resonance imaging (MRI) further characterized the pathology, revealing cortical erosion, marrow edema, and abscess formation. Serological testing confirmed the diagnosis by demonstrating a Brucella antibody titer of 1:400. The patient underwent surgical intervention. Intraoperative exploration exposed significant yellowish-white purulent exudate covering the joint surface. Following extensive debridement, doxycycline-loaded calcium sulfate beads were implanted into the residual cavity, and a drainage catheter was placed. Postoperatively, she received intravenous cephalosporins for two weeks, followed by oral doxycycline and rifampin. At the three-month follow-up, inflammatory markers-including ESR, CRP, and IL-6-had normalized. Long-term monitoring confirmed complete recovery without recurrence.</p><p><strong>Conclusion: </strong>Managing infections at atypical sites often necessitates the adaptation of standard therapeutic protocols. This case illustrates that novel modalities, specifically localized antibiotic delivery systems using calcium sulfate, can effectively treat complex infections where systemic therapy alone may be insufficient. By ensuring sustained local antibiotic release, this strategy expands the therapeutic armamentarium available for clinicians addressing rare, site-specific presentations of pathogens such as Brucella.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"567349"},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13023395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574885","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":"Research Advances on the Mechanism and Diagnosis of Bone Bridging in Ankylosing Spondylitis.","authors":"Minghao Wang, Zhiqiang Liang","doi":"10.2147/ORR.S592297","DOIUrl":"10.2147/ORR.S592297","url":null,"abstract":"<p><p>Ankylosing spondylitis (AS) is a chronic immune-mediated inflammatory disease characterized by progressive pathological new bone formation and bone bridging, ultimately leading to spinal ankylosis and functional disability. Bone bridging is a hallmark structural manifestation of AS, yet its underlying mechanisms and optimal diagnostic strategies remain incompletely understood. This review summarizes recent advances in the genetic, immunological, and molecular drivers of bone bridging in AS. We highlight HLA-B27-associated endoplasmic reticulum stress, dysregulated inflammatory cytokines (e.g. interleukin-17 and tumor necrosis factor-α), and aberrant activation of osteogenic signaling pathways, including Wnt/β-catenin, RANK/RANKL/OPG, and bone morphogenetic protein signaling. Collectively, these interconnected processes disturb the balance between inflammation and bone remodeling, promoting ectopic ossification at entheseal and spinal sites. In parallel, we review progress in imaging-based assessment, emphasizing low-dose computed tomography, MRI-based synthetic CT, and artificial intelligence-driven radiomics for sensitive detection and quantitative evaluation of early structural changes beyond conventional radiography. Clinically, integrating mechanistic insights with advanced imaging and radiomics may enable earlier detection, risk stratification, and precision monitoring of structural progression in AS. Overall, this review provides an integrated framework to support the development of earlier diagnostic strategies and precision-targeted interventions aimed at mitigating irreversible spinal ankylosis.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"592297"},"PeriodicalIF":2.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499627","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":"Patellar Instability: A Narrative Review with an Integrated Treatment Algorithm.","authors":"Joseph Mouawad, Joeffroy Otayek, Youssef Jamaleddine, Theodore Kaypekian, Mohamad Omar Youssef Honeine, Alfred Khoury","doi":"10.2147/ORR.S583399","DOIUrl":"10.2147/ORR.S583399","url":null,"abstract":"<p><strong>Background: </strong>Patellar instability is a multifactorial condition characterized by episodic dislocation or subluxation of the patella, often affecting young and athletic populations. Patients present with patellar apprehension, swelling, and fear of having another episode. It results from a complex interplay between anatomical abnormalities, soft tissue dysfunction, and biomechanical imbalances.</p><p><strong>Objective: </strong>This narrative review aims to provide a structured, up-to-date synthesis of the current understanding of patellar instability, from pathoanatomy and diagnostic evaluation to non-operative and operative management strategies, including specific considerations in skeletally immature patients.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted across major orthopedic databases and reference texts, focusing on key anatomical risk factors, diagnostic modalities, classification systems, and evidence-based treatment algorithms. Emphasis was placed on integrating recent findings with classical concepts such as Dejour's classification and the role of medial patellofemoral ligament reconstruction.</p><p><strong>Results: </strong>The management of patellar instability requires accurate identification of contributing factors such as trochlear dysplasia, elevated TT-TG distance, patella alta, and patellar tilt. First-time dislocators without predisposing factors may benefit from conservative management, while recurrent or anatomically predisposed cases often require individualized surgical correction. Procedures such as MPFL reconstruction, tibial tubercle osteotomy, and trochleoplasty have shown favorable outcomes when tailored to the patient's anatomy. In skeletally immature individuals, physeal-sparing techniques and guided growth are preferred to avoid iatrogenic growth disturbances.</p><p><strong>Conclusion: </strong>A patient-specific, \"à la carte\" surgical approach grounded in detailed radiographic and clinical assessment yields the best outcomes in patellar instability. Integration of anatomical, biomechanical, and developmental considerations is essential for optimal treatment selection and long-term patellofemoral joint preservation.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"583399"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474366","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 Dual-Mobility versus Fixed-Bearing Primary Total Hip Arthroplasty in Ankylosing Spondylitis Patients with Hip Involvement: A Retrospective Cohort Study.","authors":"Ahmad Abdallah Iessa Obeid, Yan Zhang, Xin-Hua Cai, Shuai Liu, Jun-Feng Lu, Ke Bi, Xue-Jian Liu, Talha Waseem, Yi-Le Jiang, Wadee Abdullah Al-Shehari, Shuo Geng","doi":"10.2147/ORR.S574795","DOIUrl":"10.2147/ORR.S574795","url":null,"abstract":"<p><strong>Purpose: </strong>Hip involvement in ankylosing spondylitis (AS) can progress to bony or fibrous fusion, causing severe pain and disability. Total hip arthroplasty (THA) offers major benefits, but instability and implant choice remain key challenges. This study compared dual-mobility (DM) and fixed-bearing (FB) implants in AS patients with hip fusion.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 51 patients with AS and hip fusion who underwent primary THA between 2019 and 2023. Patients received either DM or FB implants. Functional outcomes (The Short Form 12 Health Survey (SF-12), Harris Hip Score (HHS), Oxford Hip Score (OHS)), disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and radiographic parameters were assessed preoperatively and postoperatively.</p><p><strong>Results: </strong>Both DM and FB implants improved mobility, pain, and quality of life. DM implants provided significantly better functional outcomes at 3 and 6 months (all p < 0.01). BASDAI scores improved in both groups, with no long-term difference. Patients with bony fusion achieved greater functional gains, while those with fibrous fusion reported more symptom relief. No dislocations or major complications were observed within the follow-up period.</p><p><strong>Conclusion: </strong>THA proves to be an effective approach for managing hip fusion in patients with ankylosing spondylitis. While both implant types enhanced clinical outcomes, DM implants were associated with quicker recovery and better early functional results, suggesting an advantage for their use in this challenging patient population.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"574795"},"PeriodicalIF":2.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468288","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":"Research Progress on the Evaluation and Clinical Value of Negative Surgical Margins in Osteosarcoma.","authors":"Man Sun, XiangHong Meng, Zhi Wang","doi":"10.2147/ORR.S564231","DOIUrl":"10.2147/ORR.S564231","url":null,"abstract":"<p><p>Achieving negative surgical margins is a critical objective in osteosarcoma management, directly linked to reduced local recurrence and improved survival. This review comprehensively examines the evaluation techniques and clinical significance of these margins. We discuss the ongoing debate surrounding the optimal margin width and the impact of neoadjuvant chemotherapy on this standard. The application of conventional imaging (X-ray, CT, MRI) and advanced technologies (radiomics, fluorescence imaging, robot-assisted surgery) for margin assessment is analyzed. Furthermore, we explore treatment strategies to secure negative margins. By synthesizing current evidence, this article aims to guide clinicians in margin selection and highlights future directions for improving oncological outcomes.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"564231"},"PeriodicalIF":2.0,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390596","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":"Elevated Length of Stay and Cost of Orthopedic Hospitalization are Associated with Urban Setting, Non-Trauma Diagnosis, and Medicare Enrollment.","authors":"Angel G A Prempeh, Olorunferanmi Oni, Allison Tenfelde","doi":"10.2147/ORR.S579574","DOIUrl":"10.2147/ORR.S579574","url":null,"abstract":"<p><strong>Purpose: </strong>Disparities in orthopedic care delivery across hospital settings and payer types may significantly correlate with length of stay (LOS), cost burden, and care efficiency. This study quantifies the associations between geographic location, case acuity, insurance status and resource utilization in Michigan.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using 2018-2020 discharge records from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for Michigan. Orthopedic-related hospitalizations were identified and stratified by hospital location (urban vs rural), injury mechanism (trauma vs non-trauma), and primary payer (Medicare, Medicaid, private, other, uninsured). Outcomes included LOS, per-discharge cost, aggregate hospital-level expenditures, and population-adjusted discharge rates. Statistical comparisons were performed using two-sample t-tests and ANOVA. Independent associations were evaluated via mixed-effects regression models with hospital-level random intercepts.</p><p><strong>Results: </strong>Among 334,756 orthopedic discharges, urban facilities recorded longer average LOS (4.57 vs 4.09 days; P<0.001) and higher mean aggregate costs per hospital ($8.70M vs $1.74M; P<0.001) than rural counterparts. Non-traumatic cases were associated with greater per-stay costs ($19,645 vs $16,630; P<0.001). Uninsured patients experienced the longest LOS (4.70 days), followed by Medicare (4.35 days), Medicaid (3.89 days), private (3.72 days), and other (3.06 days; all P<0.001). Medicare accounted for the largest hospital-level expenditure ($3.28M mean; P<0.001). Mixed-effects models confirmed urban setting, non-trauma diagnosis, and Medicare enrollment as independent factors associated with elevated LOS and cost (P<0.001).</p><p><strong>Conclusion: </strong>Orthopedic care patterns demonstrate distinct variations linked to structural, clinical, and financial factors. These findings highlight disparities that may inform future discussions on reimbursement policies and rural capacity planning.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"579574"},"PeriodicalIF":2.0,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356070","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":"O-Arm CT-Guided Intercostal Nerve Radiofrequency Ablation for Refractory Tietze's Syndrome: A Case Report.","authors":"Tamerlan Shokanov, Talgat Anashev, Ibragim Sakhanov, Yerdar Shaukhin","doi":"10.2147/ORR.S574131","DOIUrl":"10.2147/ORR.S574131","url":null,"abstract":"<p><strong>Background: </strong>Tietze's syndrome is a rare inflammatory condition of the anterior chest wall that may cause chronic localized pain resistant to conservative treatment. Surgical cartilage resection often provides only temporary relief, and recurrence of pain presents a significant therapeutic challenge.</p><p><strong>Case presentation: </strong>We report the case of a 49-year-old female with recurrent anterior chest wall pain due to refractory Tietze's syndrome following two costal cartilage resections. Despite corticosteroid injections and physiotherapy, pain persisted with a VAS score of 7-8/10. Considering multiple treatment failures, O-arm CT-guided radiofrequency ablation (RFA) of the intercostal nerves at the 2nd-3rd ribs was performed. The procedure allowed precise cannula placement under 3D visualization and correction of intrathoracic misplacement detected on intraoperative O-arm CT (not evident on conventional fluoroscopy). After final lesioning at 80 °C for 90s, the patient experienced complete pain relief (VAS 0-1/10), restored respiratory comfort, and full functional recovery without complications.</p><p><strong>Conclusion: </strong>O-arm CT guidance enables accurate targeting and improved safety during intercostal nerve RFA in anatomically complex anterior chest wall regions. This technique represents a promising minimally invasive option for refractory Tietze's syndrome when surgery and conservative therapy fail.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"574131"},"PeriodicalIF":2.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326215","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":"Perioperative Bleeding Risk and Associated Factors in End-Stage Kidney Disease Patients Undergoing Intertrochanteric Fracture Surgery: Implications for Management.","authors":"Yijun Wang, Hua Gao, Guoqiang Xu, Baojun Wang, Zhenyu Liu, Xiaodong Bai, Ji Ma, Jiatian Wang, Wentao Chen, Gang Wang","doi":"10.2147/ORR.S515632","DOIUrl":"10.2147/ORR.S515632","url":null,"abstract":"<p><strong>Background: </strong>End-stage renal disease (ESRD) patients undergoing intertrochanteric fracture surgery face complex coagulation challenges. This study aimed to identify risk factors for coagulation dysfunction in ESRD patients during the perioperative period of intertrochanteric fracture surgery.</p><p><strong>Methods: </strong>This retrospective study included 127 patients who underwent surgical treatment for intertrochanteric femoral fractures between January 2019 and June 2023, of whom 33 had end-stage renal disease (ESRD) and were receiving maintenance dialysis. Propensity score matching was performed at a 1:1 ratio based on age, gender, BMI (body mass index), fracture classification, anesthesia type, and APACHE II score, yielding 33 matched non-ESRD controls. Perioperative data, including coagulation parameters, biochemical indices, and clinical outcomes, were collected. Multivariable regression analysis was conducted to identify risk factors associated with coagulation dysfunction.</p><p><strong>Results: </strong>The dialysis group showed significantly different coagulation profiles compared to controls, particularly in platelet count (71.6 ± 21.3 vs 159.1 ± 35.7×10⁹/L, <i>P</i> = 0.003) and blood loss (609.9 ± 89.2 vs 559.3 ± 55.5 mL, <i>P</i> = 0.007). Regression analysis revealed that blood loss in the dialysis group was primarily influenced by platelet count (<i>P</i> < 0.001) and anticoagulant dose (<i>P</i> < 0.001), while in the control group it was mainly affected by surgery duration (<i>P</i> < 0.001). Although mean surgery duration did not differ significantly between groups, its relationship with blood loss varied markedly between ESRD and non-ESRD patients. The dialysis group experienced more complications, with most bleeding events occurring 5-7 days postoperatively when platelet counts reached their nadir.</p><p><strong>Conclusion: </strong>ESRD patients face increased bleeding risk during intertrochanteric fracture surgery, primarily associated with platelet count and anticoagulant use. The critical period for bleeding complications occurs 5-7 days postoperatively, suggesting the need for careful platelet monitoring and individualized anticoagulation protocols during this timeframe.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"515632"},"PeriodicalIF":2.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308611","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":"Stress Fracture Along with Transient Osteoporosis in a 72-Year-Old Female with Hip Pain: A Case Report.","authors":"Khalil Kargar Shooraki, Arash Aris, Masih Rikhtehgar","doi":"10.2147/ORR.S571126","DOIUrl":"10.2147/ORR.S571126","url":null,"abstract":"<p><strong>Purpose: </strong>Transient hip osteoporosis (THO) is a rare, self-limiting condition characterized by acute hip pain and bone marrow edema. Although typically benign, THO may coexist with or predispose to femoral neck stress fractures, creating critical diagnostic and therapeutic challenges. We report a case of concurrent THO and femoral neck stress fracture in an elderly patient and discuss implications for management.</p><p><strong>Patients and methods: </strong>A 72-year-old female presented with an eight-month history of persistent right hip pain. Initial radiographs suggested synovial chondromatosis; however, symptoms persisted despite conservative treatment. Repeat radiographs demonstrated subtle sclerotic change and a cortical fracture line at the medial/inferior femoral neck. MRI revealed mild-to-moderate joint effusion and diffuse bone marrow edema involving the femoral head and neck consistent with THO, along with a linear low-signal fracture line consistent with an established femoral neck stress fracture. The patient was initially managed with protected weight-bearing and analgesics.</p><p><strong>Results: </strong>Symptoms persisted after conservative management, and prophylactic fixation with proximal femoral nail antirotation (PFNA) was performed. The patient experienced complete pain resolution by four months. At 18-month follow-up, radiographs demonstrated healing of the stress fracture with full return to weight-bearing.</p><p><strong>Conclusion: </strong>Diffuse marrow edema suggestive of THO does not exclude a clinically meaningful femoral neck stress fracture, particularly in older adults with persistent atraumatic hip pain. Early MRI and close follow-up are essential for detecting occult fractures, guiding weight-bearing recommendations, and preventing progression to displacement.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"571126"},"PeriodicalIF":2.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284704","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}