Orthopedic Reviews最新文献

{"title":"Arthroscopic Double-Row Repair of ALPSA Lesions: Prospective Outcomes at 2 and 5 Years Abstract.","authors":"Ahmed Abdelsattar Ali Ismail, Ahmed Samir El Kalyoby, Walid Reda Mohammed, Khaled Abdelsalam Shohayeb, Mohamed Refaat Waly","doi":"10.52965/001c.171211","DOIUrl":"10.52965/001c.171211","url":null,"abstract":"<p><strong>Background: </strong>Anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions represent a variant of anterior shoulder instability and are associated with higher recurrence rates after arthroscopic stabilization compared with classic Bankart lesions.</p><p><strong>Hypothesis: </strong>Arthroscopic double-row capsulolabral repair would result in favorable clinical and functional outcomes in patients with ALPSA lesions.</p><p><strong>Study design: </strong>Case series.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Methods: </strong>A prospective case series was conducted on 50 patients with traumatic anterior shoulder dislocation and confirmed ALPSA lesions. Preoperative assessment included history, clinical examination, and functional scoring with the Instability Severity Index Score (ISIS), Constant Shoulder Score (CSS), and Rowe Score. All patients underwent arthroscopic double-row repair using a single medial anchor and three lateral anchors. A trans-subscapularis portal used to obtain an end-on trajectory for medial anchor placement. 48 Patients were followed clinically for 2 years, and remote follow-up at 5 years was conducted for 44 patients using a culturally adapted and validated translated version of the Simple Shoulder Test (SST).</p><p><strong>Results: </strong>Constant Shoulder Score increased from a preoperative mean of 59.2 to 94.92 at 2 years (P<.001). External rotation in adduction decreased initially after surgery but recovered to a mean of 52.2° by 2 years. Forty-seven patients (97.9%) resumed their previous activity level, and no redislocations occurred. At 5 years, 44 patients completed SST follow-up, with scores ranging from 9 to 12 (mean 11.36), confirming good mid-term outcomes and no recurrent dislocations.</p><p><strong>Conclusion: </strong>Arthroscopic double-row repair of ALPSA lesions resulted in good functional recovery, high return-to-activity rates, and no redislocations at both 2- and 5-year follow-up. This technique needs to be compared with single row repair of ALPSA lesion.</p><p><strong>Clinical relevance: </strong>This study provides prospective outcome data for assessment the arthroscopic double-row repair technique as a treatment option for ALPSA lesions in patients with anterior shoulder instability.</p><p><strong>What is known about this subject: </strong>ALPSA lesions are associated with higher failure rates after arthroscopic stabilization compared with Bankart lesions, and restoration of the native capsulolabral anatomy is technically challenging.</p><p><strong>What this study adds to existing knowledge: </strong>This study provides prospective mid-term clinical outcome data following arthroscopic double-row repair for ALPSA lesions, demonstrating favorable results in a selected low-risk population.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171211"},"PeriodicalIF":1.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216594","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":"ARTHROSCOPIC REPAIR OF A LARGE ROTATOR CUFF TEAR USING THE SUTURE BRIDGE TECHNIQUE AUGMENTED WITH PLATELET-RICH FIBRIN: A CASE REPORT.","authors":"Manh Khanh Nguyen, Van Hai Do","doi":"10.52965/001c.170936","DOIUrl":"10.52965/001c.170936","url":null,"abstract":"<p><strong>Objective: </strong>To describe the arthroscopic double-row suture bridge technique for the treatment of large rotator cuff tears augmented with platelet-rich fibrin (PRF).</p><p><strong>Background: </strong>Large rotator cuff tears are associated with a high retear rate because of poor tendon quality and extensive tissue defects. Platelet-rich fibrin (PRF) provides a stable fibrin scaffold enriched with multiple growth factors, including transforming growth factor-beta 1 (TGF-β1), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), insulin-like growth factor (IGF), and epidermal growth factor (EGF). These biological mediators have been shown in animal studies to accelerate tendon-to-bone healing.</p><p><strong>Surgical technique: </strong>This case report presents the step-by-step surgical technique, including autologous platelet-rich fibrin (PRF) preparation, arthroscopic evaluation of intra-articular pathology, preparation of the tendon-to-bone footprint, anchor placement, application of PRF at the tendon-bone interface, and rotator cuff repair using the suture bridge technique.</p><p><strong>Clinical significance: </strong>The addition of PRF during arthroscopic repair of large rotator cuff tears may provide a favorable biological environment, promote early angiogenesis, and enhance tendon-to-bone healing during the early postoperative period.</p><p><strong>Disclaimer: </strong>This research was funded by the Vietnam National University, Hanoi, under research project No. QG.24.109.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"170936"},"PeriodicalIF":1.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216573","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":"Physical Rehabilitation for Postpartum Perineal Morbidity After Episiotomy and Childbirth-Related Perineal Trauma: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Ayesha Alnashwan, Yasmin Mibrad Alenezi, Hala Mesbah Alruwaili, Waad Alshamrani, Sadeem Talal S Alanazi, Thana Ali Alqarni, Renad Hamed Alazwari, Khalid Abdulbaqi Alghareeb, Shahad Enad E Alenezi, Fatimah Farhan S Alanazi, Alruwaili Noor Abdullah B, Raniyah Inad B Alanazi, Abdulrhman A Almazrou, Abdulelah F Alshehri","doi":"10.52965/001c.171902","DOIUrl":"https://doi.org/10.52965/001c.171902","url":null,"abstract":"<p><strong>Background: </strong>Postpartum perineal trauma commonly causes pain and delayed maternal recovery, yet randomized evidence supporting rehabilitation interventions remains fragmented.</p><p><strong>Objective: </strong>To compare the effectiveness of physical and electrophysical rehabilitation modalities for postpartum perineal pain, wound healing, and oedema following episiotomy or childbirth-related perineal trauma.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted in accordance with PRISMA 2020. PubMed/MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov, and ICTRP were searched from inception to April 7, 2026. Randomized controlled trials evaluating rehabilitation modalities were included. Random-effects meta-analysis was performed where appropriate, and methodological quality was assessed using the Cochrane Risk of Bias 2 tool.</p><p><strong>Results: </strong>Nine randomized controlled trials were included, seven of which contributed to quantitative synthesis. TENS significantly reduced short-term postpartum perineal pain compared with control (SMD -1.19, 95% CI -1.83 to -0.55). LLLT showed no significant benefit (SMD -0.16, 95% CI -0.52 to 0.19), while therapeutic ultrasound demonstrated no significant reduction in persistent pain. Narrative evidence indicated favorable effects of cooling interventions on oedema, immediate pain relief, and maternal satisfaction. Two studies were judged at low risk of bias, five had some concerns, and two were at high risk of bias.</p><p><strong>Conclusions: </strong>This review provides the first comparative synthesis of randomized evidence evaluating physical and electrophysical rehabilitation modalities for postpartum perineal morbidity. The strongest evidence currently supports TENS for short-term pain relief, whereas cooling interventions appear beneficial for local symptom management. Larger, rigorously designed randomized trials are required to establish evidence-based rehabilitation strategies for postpartum perineal recovery.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171902"},"PeriodicalIF":1.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167602","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":"Platelet-Rich Plasma Injections for Refractory Greater Trochanteric Bursitis: A Three-Patient Case Series.","authors":"Jamal Hasoon, Preethash Sundar, Omar Viswanath, Christopher L Robinson, Alan D Kaye, Alaa Abd-Elsayed, Ivan Urits","doi":"10.52965/001c.171752","DOIUrl":"https://doi.org/10.52965/001c.171752","url":null,"abstract":"<p><strong>Background: </strong>Greater trochanteric bursitis is a common cause of lateral hip pain and is frequently considered within the broader clinical spectrum of greater trochanteric pain syndrome. Initial treatment commonly includes activity modification, physical therapy, a home exercise program, nonsteroidal anti-inflammatory drugs, and other nonopioid medications. Corticosteroid injections may provide meaningful relief, although their duration of benefit can be limited. Platelet-rich plasma is an autologous biologic injectate that can be considered as an alternative treatment for greater trochanteric pain syndrome.</p><p><strong>Case presentation: </strong>We present three patients with clinically diagnosed greater trochanteric bursitis who underwent fluoroscopically guided platelet-rich plasma injections after failing conservative treatment options. The first patient was a woman in her 50s with left greater trochanteric bursitis who had failed physical therapy, a home exercise program, nonsteroidal anti-inflammatory drugs, and muscle relaxants. Two previous corticosteroid injections provided approximately two months and three weeks of relief, respectively. Following a platelet-rich plasma injection into the left greater trochanteric bursa, she reported 50% sustained pain relief at three-month follow-up. The second patient was a woman in her 40s with bilateral greater trochanteric bursitis who had failed physical therapy, a home exercise program, nonsteroidal anti-inflammatory drugs, and duloxetine. A previous corticosteroid injection provided only one week of relief. Following bilateral fluoroscopically guided platelet-rich plasma injections, she reported 70% sustained pain relief at six-week follow-up. The third patient was a man in his 50s with left greater trochanteric bursitis diagnosed clinically and supported by magnetic resonance imaging. He had failed physical therapy, a home exercise program, and nonsteroidal anti-inflammatory drugs and was not interested in corticosteroid injections. An initial platelet-rich plasma injection provided 25% improvement at four-week follow-up. A second injection was performed two weeks later, after which he reported 85% sustained pain relief at three-month follow-up. No complications were reported in any patient.</p><p><strong>Conclusion: </strong>Fluoroscopically guided platelet-rich plasma injections were associated with clinically meaningful pain improvement in three patients with refractory greater trochanteric bursitis. Two patients experienced moderate improvement after a single treatment, while one patient demonstrated a substantially greater response following a second injection. These cases suggest that platelet-rich plasma may be considered in carefully selected patients who have experienced limited benefit from corticosteroid injections or wish to avoid corticosteroid exposure.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171752"},"PeriodicalIF":1.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169152","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":"Safe Harbors to the Federal Anti-Kickback Statute in Orthopedics: A Rapid Review.","authors":"Theodore Couris, Parker Lehmann, Paul Cappiello, Matthew Michelberger, Christopher Fang","doi":"10.52965/001c.171754","DOIUrl":"https://doi.org/10.52965/001c.171754","url":null,"abstract":"<p><strong>Introduction: </strong>Orthopedic surgery relies on complex collaborations across ambulatory surgery centers (ASCs), device industries, and value based care models. However, a lack of specialty-specific guidance leaves orthopedic surgeons vulnerable to Federal Anti-Kickback Statute (AKS) violations. This review maps how legal safe harbors apply directly to modern orthopedic business arrangements.</p><p><strong>Objective: </strong>The purpose of this review is to summarize the federal Anti-Kickback Statute safe harbors most relevant to orthopedic practice, clarify how they apply to common orthopedic business arrangements, identify high-risk arrangements in orthopedic practice, and to demonstrate practical compliance strategies.</p><p><strong>Methods: </strong>A rapid review of PubMed, PMC, and Google Scholar was conducted from inception to October 29, 2025. This search was supplemented with official federal materials, Office of Inspector General (OIG) advisory opinions, and Department of Justice (DOJ) enforcement actions to synthesize a narrative compliance framework for orthopedic practice.</p><p><strong>Results: </strong>Out of 123 screened records, 17 sources were used to explore the AKS in terms of orthopedic practice. 18 additional sources were included to supplement this analysis. This study identified gray zones in orthopedics: consulting agreements, royalty arrangements, ASC investment terms, and industry funded travel. High-risk arrangements are often targeted by regulators when compensation is high, as demonstrated by recent multi-million dollar DOJ settlements.</p><p><strong>Conclusion: </strong>AKS safe harbors provide vital protection but demand meticulous, ongoing documentation of compliance. As value-based care expands, orthopedic surgeons must ensure that modern, integrated business models are structured strictly around clinical justification and independent medical judgment, actively insulating patient care from personal financial incentives.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171754"},"PeriodicalIF":1.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168742","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 Responses to Cocaine-Positive Urine Drug Screens in Patients Receiving Chronic Opioid Therapy: A Four-Patient Case Series.","authors":"Jamal Hasoon, Jenna Chuan, Omar Viswanath, Ivan Urits","doi":"10.52965/001c.171215","DOIUrl":"10.52965/001c.171215","url":null,"abstract":"<p><strong>Background: </strong>Urine drug screening (UDS) is commonly incorporated into the monitoring of patients receiving chronic opioid therapy for noncancer pain. Detection of an illicit substance such as cocaine creates a challenging clinical situation because continuation of full µ-opioid agonist therapy may carry increased risk, while abrupt or reflexive discontinuation may also have unintended consequences. There is limited literature describing how clinicians modify chronic opioid therapy following cocaine-positive UDS results.</p><p><strong>Case series: </strong>We describe four patients receiving chronic opioid therapy who were found to have cocaine-positive UDS results. Two patients receiving hydrocodone/acetaminophen were gradually weaned from opioid therapy and opioids were subsequently discontinued. A third patient receiving hydrocodone/acetaminophen was transitioned to buprenorphine/naloxone 2 mg twice daily as an alternative to continued full agonist opioid therapy. A fourth patient with a history of substance misuse and prior spine surgery was offered transition to buprenorphine/naloxone but declined and elected not to continue care with the practice.</p><p><strong>Conclusion: </strong>Cocaine-positive UDS results may substantially alter chronic opioid prescribing. Management may include increased monitoring, gradual discontinuation of full agonist opioids, or consideration of buprenorphine-based therapy in appropriately selected patients. These cases emphasize the importance of individualized risk assessment rather than a uniform response to an unexpected UDS result.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171215"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081806","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":"Artificial Intelligence in Orthopedics: Global Research Trends and Emerging Applications.","authors":"Lillian Bosh, Pranay Gadikota, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.171220","DOIUrl":"10.52965/001c.171220","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has rapidly expanded across orthopedics, with applications spanning imaging analysis, preoperative planning, implant selection, outcome prediction, rehabilitation, and related clinical workflows. Despite rapid growth in the literature, the global research landscape remains incompletely characterized.</p><p><strong>Objectives: </strong>To characterize global research trends in AI applications in orthopedics, including publication growth, disciplinary distribution, authorship, journal patterns, geographic output, and thematic evolution.</p><p><strong>Methods: </strong>The Web of Science Core Collection was searched for publications indexed from 1997 through June 16, 2026 using terms related to artificial intelligence and orthopedics. A total of 2,351 records were analyzed. VOSviewer was used for co-authorship, keyword co-occurrence, and co-citation network mapping.</p><p><strong>Results: </strong>Publication output increased sharply after 2016, with 97.9% of publications appearing from 2017 through the partial 2026 period. Output reached 636 publications in 2025. Computer Science, Interdisciplinary Applications (36.7%) and Health Care Sciences & Services (22.2%) were the leading Web of Science categories, whereas Orthopedics (4.2%) and Surgery (4.3%) represented smaller shares. Chen Y was the most prolific author with 30 publications (1.3%), and no single journal accounted for more than 1.8% of publications. Japan (33.1%) and South Korea (18.3%) led national output. Keyword mapping demonstrated three co-dominant hubs centered on artificial intelligence, machine learning, and deep learning, while co-citation analysis identified foundational clusters rooted largely in computer science methodology.</p><p><strong>Conclusion: </strong>AI research in orthopedics has expanded rapidly and is increasingly interdisciplinary. The literature is broadly distributed across authors and journals, with no single dominant research group or publication venue. Emerging areas include large language models.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171220"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081803","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":"Robotic-Assisted Total Knee Arthroplasty in HIV-Positive Patients: Precision Surgery for a Changing Epidemic.","authors":"Innocent Senyolo, Nnenna Elebo, Dyllan B Geldenhuys, Winnie Mukiibi, Nkhodiseni Sikhauli, Jurek Rafal Tomasz Pietrzak","doi":"10.52965/001c.165230","DOIUrl":"10.52965/001c.165230","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis(OA) and Human Immunodeficiency Virus(HIV) infection are two major global health burdens increasingly intersecting in orthopaedic practice. The global HIV-positive population is aging due to effective antiretroviral therapy, leading to a grwoing number of patients presenting with end-stage knee osteoarthritis requiring total knee arthroplasty(TKA). Conventional TKA, while successful in the general population, remains vulnerable to aseptic loosening and periprosthetic joint infection(PJI); complications that may be accelerated in immunocompromised hosts with altered bone biology. Simultaneously, robotic-assisted TKA (RA-TKA) is transforming knee arthroplasty by improving implant alignment, reproducibility and soft-tissue protection. However, no studies have directly evaluated outcomes of RA-TKA in HIV-positive patients.</p><p><strong>Aims of the review: </strong>This narrative review synthesises current data on OA prevalnece, HIV pathophysiology, TKA outcomes, and robotic technology to examine how precision arthroplasty may alleviate or exacerbate risks in this unique and growing population.</p><p><strong>Key findings: </strong>This review highlights an aging HIV-positive population with increasing demand for TKA, due to improved management. HIV-positive patients show mixed short- and long-term TKA outcomes. RA-TKA enhances precision but may increase surgical time, infection risk, pin-site sepsis and osteoporotic bone-related fractures. Mitigation of these potential adverse events is essential and surgeons should follow guidelines to reduce risks.</p><p><strong>Conclusion: </strong>The increasing subpopulation of people living with HIV and requiring TKA needs to be addressed. Strategies to combat complications that are prone to this group need to be highlighted. Advances in treatment strategies have enabled us to address this intersection between HIV and TKA.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165230"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081226","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":"Mapping the Global Research Landscape of 3D Printing in Orthopedics.","authors":"Zahra Machlab, Sofia Haddadin, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.171222","DOIUrl":"10.52965/001c.171222","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) printing has expanded from prototyping and anatomic modeling to patient-specific guides, implants, and tissue-engineering applications across orthopedic subspecialties.</p><p><strong>Objective: </strong>To characterize the global publication landscape of 3D printing in orthopedics, including geographic and institutional contributions, collaboration patterns, publication growth, and evolving research themes.</p><p><strong>Methods: </strong>Web of Science Core Collection was searched on June 16, 2026 using terms for 3D printing/additive manufacturing combined with orthopedic terms. Articles and reviews were included. Bibliographic records were analyzed descriptively, and VOSviewer was used for author co-authorship and keyword co-occurrence mapping. Association-strength normalization was used for network visualization; the keyword overlay map applied a minimum occurrence threshold of 42.</p><p><strong>Results: </strong>The search identified 3,070 publications spanning 1965-2026. China contributed 968 publications (31.6%) and the United States 531 (17.3%). Shanghai Jiao Tong University was the most productive institution with 88 publications, followed by Peking University (66) and the Chinese Academy of Sciences (65). Publication output accelerated markedly after 2013-2014; 91.7% of records were published during 2017-2026, although 2026 data were incomplete. In the author network, Changchun Zhou had the highest total link strength (116), followed by Yujiang Fan (94) and Lei Wang (68). The most frequent keywords were \"3d printing\" (1,010 occurrences), \"additive manufacturing\" (738), and \"mechanical-properties\" (558).</p><p><strong>Conclusion: </strong>Orthopedic 3D-printing research has expanded rapidly and is geographically concentrated, with strong representation from Chinese institutions. The literature connects orthopedic surgery with biomaterials, engineering, and patient-specific technologies. Future work should emphasize reproducible bibliometric methods and clinical studies addressing durability, effectiveness, cost, and implementation of 3D-printed orthopedic technologies.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171222"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081768","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":"Cardiac Adaptations in Endurance Athletes: A Bibliometric Analysis of Exercise‑Induced Physiologic Remodeling.","authors":"Elena Lorenzi, Ethan Nichols, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.171224","DOIUrl":"10.52965/001c.171224","url":null,"abstract":"<p><strong>Background: </strong>Endurance exercise induces cardiovascular adaptations known as exercise-induced physiologic remodeling of the athlete's heart, including sinus bradycardia, chamber enlargement, enhanced vagal tone, and atrial and ventricular remodeling. These changes are generally physiologic, but concern remains about their association with arrhythmias and long-term outcomes. This study aimed to characterize the research landscape, identify influential contributors, and explore emerging themes in this field.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science Core Collection database. Publications were retrieved from inception through June 11, 2026, yielding 754 results. Annual trends, leading countries, institutions, collaboration networks, and keyword co-occurrence were analyzed using VOSviewer and organized using Microsoft Excel.</p><p><strong>Results: </strong>Publication output grew steadily from the 1990s and plateaued from the mid-2010s onward, without a sharp inflection point. The United States (146) and Italy (126) led national output, followed by England (87) and Australia (77); 36 countries met the network threshold. Institutional output was distributed, led by Liverpool John Moores University, Harvard University, and KU Leuven, while citation strength clustered around Belgian and Italian hubs. Exercise, echocardiography, athlete's heart, and endurance emerged as dominant keywords. Top-cited works date largely to 1994-2002, with citations accumulating over decades.</p><p><strong>Conclusions: </strong>This field has grown through incremental refinement of a stable question rather than a single catalyst, with a distributed evidence base. Influential work treats athlete's hearts as benign by default, while emerging themes suggest growing attention toward identifying which athletes deviate toward pathologic remodeling. Cross-hub collaboration is needed to resolve whether an athlete's heart is one phenomenon or several.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171224"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081767","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}