Orthopedics最新文献

{"title":"Rates of Revision for Progressive Deformity and Contralateral Slipped Capital Femoral Epiphysis Using a Partially Threaded Cannulated Screw: A Retrospective Review.","authors":"Ryan L Siller, Kaley F Haney, Alice K Lee, Kelly D Carmichael","doi":"10.3928/01477447-20250217-02","DOIUrl":"10.3928/01477447-20250217-02","url":null,"abstract":"<p><strong>Background: </strong>Slipped capital femoral epiphysis (SCFE) is a problem affecting the pediatric population, with high rates of re-slip and contralateral pinnings. The purpose of this study was to identify both rates of recurrence and contralateral slips after in situ pinning of stable and unstable SCFE.</p><p><strong>Materials and methods: </strong>Pediatric patients who underwent in situ and revision pinning of SCFE from January 2000 to December 2022 were reviewed for subsequent procedures, including contralateral pinning and revision procedures. All hips were pinned in situ using a technique consisting of a single, cannulated, 6.5-mm partially threaded screw. Association with age and sex were prioritized and compared with previous literature. Data analysis was performed using <i>t</i> tests and chi-square tests. Statistical significance was set at <i>P</i>>.05.</p><p><strong>Results: </strong>Eighty-eight patients were selected for review, with a total of 124 native hips pinned and 7 revision hips (5.6% revised for progression of deformity). Twelve contralateral hips underwent sequential pinning for contralateral slip (24.0% of all unilateral procedures performed). Seventy-four percent of patients were male. The mean age at initial slip for patients who did not undergo a subsequent procedure was 13.0±1.5 years, compared with 10.8±1.6 years for contralateral slips and 11.5±1.5 years for revision hips (<i>P</i><.001).</p><p><strong>Conclusion: </strong>The rates of revision and contralateral slip were comparable to and slightly lower than those reported in the current literature. The complication rate for this procedure is low. This study demonstrates a safe and an efficient technique for management of SCFE. [<i>Orthopedics</i>. 2025;48(2):e100-e104.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e100-e104"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tapered, Fluted, Titanium Stems in Revision Total Hip Arthroplasty.","authors":"Bradford P Zitsch, Jay J Byrd, Brandt Buckner, Beau S Konigsberg, Curtis W Hartman","doi":"10.3928/01477447-20250217-01","DOIUrl":"10.3928/01477447-20250217-01","url":null,"abstract":"<p><strong>Background: </strong>Establishing stable femoral component fixation in revision total hip arthroplasty (rTHA) remains challenging. Early monobloc tapered, fluted, titanium (TFT) designs were complicated by high rates of subsidence, while modular designs were complicated by taper corrosion and junctional fractures. Newer generation monobloc stems have been designed to minimize subsidence. Therefore, the aim of this study was to present the clinical and radio-graphic results of the most recent modular and monobloc TFT designs.</p><p><strong>Materials and methods: </strong>Patients undergoing rTHA in which TFT femoral stems were used, whether modular or monobloc, were included in this retrospective review. Included stems had the same design characteristics and were from the same manufacturer. The only difference was neck modularity. Radiographic analysis for stem subsidence was performed. Clinical outcomes including Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and re-revisions were collected. We examined survivorship for the endpoints of subsidence or re-revision for any reason.</p><p><strong>Results: </strong>Ninety-four (66 monobloc, 28 modular) hips met inclusion criteria, with a median follow-up of 25.9 months. Mean stem subsidence was 1.9±0.2 mm in the modular group and 2.1±0.3 mm in the monobloc group (<i>P</i>=.56), with 90 of 94 (95%) stems subsiding less than 5 mm. Twelve hips (13%) required re-revision with no difference in survival between the groups. HHS and WOMAC scores significantly improved from preoperative to last recorded follow-up in both groups (<i>P</i>≤.01).</p><p><strong>Conclusion: </strong>Advances in implant design including spline geometry and more aggressive tapers in monobloc TFT femoral components offer encouraging clinical outcomes with an overall low risk of clinically significant subsidence. [<i>Orthopedics</i>. 2025;48(2):79-86.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"79-86"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerometer-Assisted Physical Activity Outcomes During the First Year of Recovery After Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Pilot Study.","authors":"Tim Dwyer, Erin Gordey, Prabjit Ajrawat, Darius L Lameire, John Theodoropoulos, Darrell Ogilvie-Harris, Guy Faulkner, Catherine Sabiston, Jaskarndip Chahal","doi":"10.3928/01477447-20250123-02","DOIUrl":"10.3928/01477447-20250123-02","url":null,"abstract":"<p><strong>Background: </strong>Wearable activity-measurement devices are increasingly popular among the public, but there is little information regarding their use among patients undergoing sports medicine procedures. The purpose of this study was to compare accelerometer-measured data with traditional patient-reported measures and to determine the trajectory of physical activity from before surgery to 1 year after anterior cruciate ligament reconstruction.</p><p><strong>Materials and methods: </strong>Adult patients undergoing primary anterior cruciate ligament reconstruction were enrolled in this prospective cohort pilot study. The Tegner activity scale, Marx activity scale, International Physical Activity Questionnaire Short Form (IPAQ-SF), Knee injury and Osteoarthritis Outcome Score (KOOS), and EuroQoL-5D were administered preoperatively and 3, 6, and 12 months postoperatively. At these intervals, each patient was asked to wear an accelerometer for 7 consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA min/wk), metabolic equivalents of physical activity, and average daily steps were calculated from the accelerometer output and correlated with patient-reported measures.</p><p><strong>Results: </strong>Twenty-eight patients were included in this study. Of the 28 patients, 20 remained, and at the 12-month analysis, 18 patients were analyzed. There were significant improvements in Tegner activity scale score, KOOS symptoms, sports/recreation, and quality of life subscales, and IPAQSF MVPA min/wk at final follow-up. All accelerometer-based outcomes had improvements at 3, 6, and 12 months.</p><p><strong>Conclusion: </strong>The accelerometer may be a useful tool for understanding patients' activity levels at different time points during their recovery and for providing tangible targets for patients to achieve at least an average recovery. [<i>Orthopedics</i>. 2025;48(2):e62-e68.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e62-e68"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difference in Postoperative Outcomes and Satisfaction Between Men and Women After Total Knee Arthroplasty.","authors":"Seung Hoon Lee, Jae Hoon Ryoo, Hee Dong Lee, Yun Seong Choi","doi":"10.3928/01477447-20250228-01","DOIUrl":"10.3928/01477447-20250228-01","url":null,"abstract":"<p><strong>Background: </strong>This study was conducted to determine the difference in clinical outcomes and satisfaction between men and women after total knee arthroplasty (TKA) and whether the relationship between postoperative outcomes and satisfaction differs between the 2 groups after TKA.</p><p><strong>Materials and methods: </strong>This retrospective study included 324 patients who underwent TKA. The participants were divided by sex as follows: male (n=130) and female (n=194). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Society Score (KSS), and satisfaction score and their correlation coefficients at 1 and 2 years after TKA were compared between the groups.</p><p><strong>Results: </strong>The satisfaction scores of the male and female patients were 27.1 and 22.7, respectively (<i>P</i><.001), 1 year after TKA and 29.7 and 29.2, respectively (<i>P</i>=.575), 2 years after TKA. No significant differences in the WOMAC score or KSS were observed between the 2 groups. The correlation coefficients between the satisfaction score and WOMAC score or KSS (function scores) were higher for women than for men 1 and 2 years after TKA (1-year WOMAC score: men, -0.682; women, -0.724; 1-year KSS function score: men, 0.500; women, 0.795) (2-year WOMAC score: men, -0.536; women, -0.778; 2-year KSS function score: men, 0.444; women, 0.702).</p><p><strong>Conclusion: </strong>The early postoperative satisfaction of female patients was lower than that of male patients but eventually improved to the satisfaction level of male patients, and the association between outcomes and satisfaction within 2 years after TKA was higher for female patients than for male patients. [<i>Orthopedics</i>. 2025;48(2):121-127.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"48 2","pages":"121-127"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of an Extensible Trial Neck in Total Hip Arthroplasty.","authors":"Takashi Suzuki, Kei Kojima, Shunsuke Aoki, Tatsuya Kubomura, Keinosuke Ryu","doi":"10.3928/01477447-20250204-02","DOIUrl":"10.3928/01477447-20250204-02","url":null,"abstract":"<p><strong>Background: </strong>Maintaining appropriate soft tissue tension is essential in total hip arthroplasty (THA). Surgeons generally achieve this by altering the neck length. However, experimenting with different neck lengths is time-consuming, as it requires repeated hip dislocations. To address this, we have used a new extensible trial neck device that allows for easy adjustment of neck length during surgery. This device can help surgeons avoid the need for repeated hip dislocations to determine the correct neck size. The objective of this research was to investigate whether this device could help shorten operative times and decrease surgical invasion for patients.</p><p><strong>Materials and methods: </strong>Patients undergoing THA were randomly separated into two groups. The first group used the extensible trial neck during trial reduction after the stem and cup were placed (group M), while the second group used a conventional trial neck (group C). Operative time, blood loss, number of additional dislocations needed during the operation, and C-reactive protein (CRP) and creatine phosphokinase (CPK) levels after the operation were compared.</p><p><strong>Results: </strong>Operative time was significantly shorter and the number of additional dislocations required to choose the final neck size was significantly lower in group M compared with group C. No significant difference in blood loss was observed. CRP and CPK levels days 3 and 7 after surgery decreased in group M compared with group C.</p><p><strong>Conclusion: </strong>The extensible trial neck was useful for THA by greatly reducing operative time and stress on the patient. [<i>Orthopedics</i>. 2025;48(2):e88-e93.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e88-e93"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Costs After Lumbar Fusion and Disk Replacement for Diskogenic Pain.","authors":"Darren Z Nin, Ya-Wen Chen, David H Kim, Ruijia Niu, Hannah Travers, David C Chang, Raymond W Hwang","doi":"10.3928/01477447-20250123-01","DOIUrl":"10.3928/01477447-20250123-01","url":null,"abstract":"<p><strong>Background: </strong>Lumbar fusion is the most common surgical intervention for chronic or severe low back pain. However, lumbar disk replacement (LDR) may be appropriate for certain patients. The objective of this study was to describe the postoperative management costs associated with both lumbar fusion and LDR in the 2-year period after surgery.</p><p><strong>Materials and methods: </strong>An observational cohort study was conducted using the Merative MarketScan databases. Patients who underwent lumbar fusion or LDR between January 1, 2017, and December 31, 2017, were identified and included in the study. The primary outcome was the cost of payments for physical therapy, pain medication, injections, and bladder management in the 2-year period after surgery.</p><p><strong>Results: </strong>A total of 1660 patients (mean age, 50.1±10.6 years; lumbar fusion, 99%; LDR, 1%) were included in the study. The mean total cost of postoperative interventions identified was $2832±$5461 per patient, with no differences found between patients for identified interventions. The mean 30-day episode-of-care cost was $65,777±$40,869 and was similar (<i>P</i>=.894) between the two groups of patients. The main driver of cost was physical therapy for both groups of patients (lumbar fusion, 53.7%; LDR, 64.9%).</p><p><strong>Conclusion: </strong>Patients who underwent lumbar fusion and LDR had similar postoperative management costs. The shorter recovery periods associated with LDR may not necessarily translate into reduced long-term health care expenditure. [<i>Orthopedics</i>. 2025;48(2):117-120.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"117-120"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Evolution of ChatGPT as an Information Resource in Shoulder and Elbow Surgery.","authors":"Benjamin Nieves-Lopez, Alexandra R Bechtle, Jennifer Traverse, Christopher Klifto, Bradley S Schoch, Keith T Aziz","doi":"10.3928/01477447-20250123-03","DOIUrl":"10.3928/01477447-20250123-03","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the performance and evolution of Chat Generative Pre-Trained Transformer (ChatGPT; OpenAI) as a resource for shoulder and elbow surgery information by assessing its accuracy on the American Academy of Orthopaedic Surgeons shoulder-elbow self-assessment questions. We hypothesized that both ChatGPT models would demonstrate proficiency and that there would be significant improvement with progressive iterations.</p><p><strong>Materials and methods: </strong>A total of 200 questions were selected from the 2019 and 2021 American Academy of Orthopaedic Surgeons shoulder-elbow self-assessment questions. ChatGPT 3.5 and 4 were used to evaluate all questions. Questions with non-text data were excluded (114 questions). Remaining questions were input into ChatGPT and categorized as follows: anatomy, arthroplasty, basic science, instability, miscellaneous, nonoperative, and trauma. ChatGPT's performances were quantified and compared across categories with chi-square tests. The continuing medical education credit threshold of 50% was used to determine proficiency. Statistical significance was set at <i>P</i><.05.</p><p><strong>Results: </strong>ChatGPT 3.5 and 4 answered 52.3% and 73.3% of the questions correctly, respectively (<i>P</i>=.003). ChatGPT 3.5 performed significantly better in the instability category (<i>P</i>=.037). ChatGPT 4's performance did not significantly differ across categories (<i>P</i>=.841). ChatGPT 4 performed significantly better than ChatGPT 3.5 in all categories except instability and miscellaneous.</p><p><strong>Conclusion: </strong>ChatGPT 3.5 and 4 exceeded the proficiency threshold. ChatGPT 4 performed better than ChatGPT 3.5, showing an increased capability to correctly answer shoulder and elbow-focused questions. Further refinement of ChatGPT's training may improve its performance and utility as a resource. Currently, ChatGPT remains unable to answer questions at a high enough accuracy to replace clinical decision-making. [<i>Orthopedics</i>. 2025;48(2):e69-e74.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e69-e74"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Delayed Surgery After Distal Radius Fracture: A Large National Database Study.","authors":"Philip P Ratnasamy, Omar Allam, Alexander J Kammien, Peter Y Joo, Xuan Luo, Jonathan N Grauer","doi":"10.3928/01477447-20250204-01","DOIUrl":"10.3928/01477447-20250204-01","url":null,"abstract":"<p><strong>Background: </strong>Surgical timing after distal radius fracture may impact patient outcome. This retrospective study assessed the timing of surgery after distal radius fracture and predictors of delayed surgery.</p><p><strong>Materials and methods: </strong>Patients who had distal radius fractures were identified from the PearlDiver M161Ortho dataset. Those who went on to have surgery in the subsequent 52 weeks were identified, with immediate surgery designated as occurring in weeks 0 to 2 after fracture and delayed surgery designated as occurring in weeks 3 to 52 after fracture. Demographics of patients with immediate and delayed surgery, including age, sex, comorbidity burden (measured by Elixhauser Comorbidity Index [ECI]), region of the country where surgery was performed, insurance (commercial, Medicare, Medicaid), and smoking status (non-smoker, cannabis, tobacco, both), were assessed and compared by multivariate analyses.</p><p><strong>Results: </strong>A total of 90,570 patients undergoing surgery for distal radius fractures were identified, of whom immediate surgery was performed for 76,683 (88.0%) and delayed surgery was performed for 10,887 (12.0%). Independent predictors of delayed surgery included non-clinical factors (Medicaid [vs commercial insurance]: odds ratio [OR], 1.62, <i>P</i><.0001; and region [vs Midwest]: West, OR, 1.39, <i>P</i><.0001; Northeast, OR, 1.37, <i>P</i>=.0115; and South, OR, 1.21, <i>P</i>=.0001) as well as clinical factors (smoking tobacco [vs non-smoker]: OR, 1.31, <i>P</i><.0001; and increased ECI: OR, 1.14 per 2-point increase, <i>P</i><.0001).</p><p><strong>Conclusion: </strong>In a large cohort of patients, 12% of distal radius fracture surgeries occurred outside the 2-week window. These cases were predicted by non-clinical and clinical factors that deserve attention to limit the delay of such surgeries. [<i>Orthopedics</i>. 2025;48(2):e75-e80.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e75-e80"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Early Return to Driving in a Contemporary Arthroplasty Population.","authors":"Eric J Wilson, Nicholas R Olson, Nancy L Parks, Michael E Seem, P Henry Ho, C Anderson Engh","doi":"10.3928/01477447-20250206-01","DOIUrl":"10.3928/01477447-20250206-01","url":null,"abstract":"<p><strong>Background: </strong>As arthroplasty techniques become more advanced, patients recover more rapidly. Is this same trend observed with patients' ability to drive after hip and knee replacement? The purpose of this study was to evaluate the impact of various factors on patients' ability to drive within 4 weeks after primary hip or knee arthroplasty to better counsel patients on their return to driving postoperatively.</p><p><strong>Materials and methods: </strong>This retrospective cohort study investigated 1146 patients who underwent primary joint arthroplasty. These patients were surveyed 3 to 4 weeks after surgery, and 851 patients were included in the analysis. Univariate and multivariate analyses were performed to determine which factors were associated with return to driving.</p><p><strong>Results: </strong>Among the patients, 47.0% (n=382) returned to driving within 4 weeks of their procedure, with a mean postoperative time of 16.0±6.3 days. Factors significantly correlated with an early return to driving based on univariate analysis included younger age at surgery, lower body mass index, male sex, prior daily driving, same-day discharge, higher scores on patient-reported outcome measures, left-sided procedure, unicompartmental knee arthroplasty (UKA), no walking aids, and no use of narcotic pain medication. Multivariate Cox regression analysis revealed that male sex (hazard ratio [HR], 2.19), same-day discharge (HR, 1.86), prior daily driving (HR, 1.81), left-sided surgery (HR, 1.62), and type of procedure (UKA: HR, 1.65; total hip arthroplasty by the direct anterior approach: HR, 1.50) were associated with early return to driving.</p><p><strong>Conclusion: </strong>Many patient, surgical, and rehabilitation factors can impact the ability of primary arthroplasty patients to return to driving within 4 weeks of surgery. This large cohort incorporating current surgical techniques can support surgeons to better counsel patients on their expected return to driving. [<i>Orthopedics</i>. 2025;48(2):e94-e99.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e94-e99"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Leukotriene Receptor Blockers Improve Tendon-Bone Interface Healing in a Rat Model of Acute Rotator Cuff Tear.","authors":"Jong Pil Yoon, Sung-Jin Park, Dong-Hyun Kim, Yoon Seong Choi, Hyun Joo Lee, Jun-Young Kim, Seok Won Chung","doi":"10.3928/01477447-20250218-01","DOIUrl":"10.3928/01477447-20250218-01","url":null,"abstract":"<p><strong>Background: </strong>Excessive expression of proinflammatory cytokines after rotator cuff (RC) surgery impairs the quality of tendon-bone interface (TBI) healing. There is evidence that the asthma drug montelukast (MS) inhibits the expression of proinflammatory cytokines. This study was conducted to verify the effect of MS administration on TBI healing after RC repair.</p><p><strong>Materials and methods: </strong>Thirteen rats in the MS group were intraperitoneally administered 10 mg/kg of the drug daily for 2 weeks after RC surgery, and 13 rats in the control group were administered only 0.9% saline. The healing effect of the TBI was assessed through histologic and biomechanical analysis 4 weeks after tendon repair.</p><p><strong>Results: </strong>In the MS group, the expression of interleukin-1 beta (IL-1β; <i>P</i><.01) and interleukin 6 (IL-6; <i>P</i><.01) was significantly reduced compared with the control group. In the evaluation of supraspinatus fatty infiltration, the MS group showed significant inhibition of fatty infiltration compared with the control group (<i>P</i><.001). Histologic analysis showed that the MS group had significant improvements in collagen density (<i>P</i>=.035) and alignment (<i>P</i>=.011). Biomechanical analysis after systemic administration of MS showed an increase in the cross-sectional area (<i>P</i><.001) and elongation (<i>P</i><.01) of the TBI.</p><p><strong>Conclusion: </strong>The use of MS improved tendon elasticity through suppressing fatty infiltration and improving TBI collagen density and arrangement. The mechanism is down-regulation of IL-1β and IL-6. These results strongly support the use of MS as an anti-inflammatory agent that does not impair tendon healing. [<i>Orthopedics.</i> 2025;48(2):e105-e112.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e105-e112"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}