Orthopedic Reviews最新文献

{"title":"Platelet-Rich Plasma Injections for Refractory Sacroiliac Joint Pain: A Two-Patient Case Series.","authors":"Jamal Hasoon, Christopher L Robinson, Ivan Urits","doi":"10.52965/001c.171213","DOIUrl":"10.52965/001c.171213","url":null,"abstract":"<p><strong>Background: </strong>Sacroiliac joint (SIJ) pain is an important source of chronic axial low back and buttock pain. Initial treatment commonly includes activity modification, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and other nonopioid medications. Interventional treatment options may include corticosteroid injections, radiofrequency ablation, and, in selected refractory cases, SIJ fusion. Platelet-rich plasma (PRP) is an autologous biologic injectate that has been investigated as an alternative treatment for low back pain disorders, although the available literature remains limited and conflicting.</p><p><strong>Case presentation: </strong>We present two patients with refractory SIJ pain who underwent a single PRP injection after failing conservative and interventional treatment options. The first patient was a man in his 50s with persistent SIJ pain despite physical therapy, NSAIDs, and prior corticosteroid injections targeting the SIJ. Following a single PRP injection, he reported approximately 50% sustained pain relief at three-month follow-up. The second patient was a woman in her 50s with persistent SIJ pain despite physical therapy, NSAIDs, muscle relaxants, tramadol, and previous SIJ injections. Radiofrequency ablation was considered but was not covered by her insurance, and she did not wish to proceed with SIJ fusion. Following a single PRP injection, she reported approximately 75% sustained pain relief at four-month follow-up.</p><p><strong>Conclusion: </strong>PRP injection was associated with sustained improvement in pain in two patients with refractory SIJ pain after failure of multiple conventional treatments. These cases provide additional real-world clinical observations supporting further investigation of PRP as a potential nonsurgical option for carefully selected patients with persistent SIJ pain.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171213"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081779","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":"Complement Proteins C1q-C5 as Context‑Dependent Regulators of Osteoblast Function and Fracture Healing: A Systematic Review.","authors":"Patrick R Counts, Tori M Baer, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.171217","DOIUrl":"10.52965/001c.171217","url":null,"abstract":"<p><strong>Background: </strong>Complement proteins (C1q-C5) participate in immune surveillance and inflammation, but their roles in osteoblast biology and fracture healing remain generally undefined. Emerging evidence suggests that complement activation may exert both pro‑regenerative and pro‑inflammatory effects, depending on receptor engagement and physiological context.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines, using a semantic search strategy to identify studies evaluating complement components C1q-C5 in osteoblast function or fracture‑healing outcomes. 20 studies met the inclusion criteria, including rodent fracture models, in vitro osteoblast and osteoclast assays, aging and estrogen‑deficiency models, and receptor‑specific genetic manipulations.</p><p><strong>Results: </strong>Across studies, C3a/C3aR signaling consistently promoted osteoblast differentiation, migration, and early callus organization, while C3 deficiency or C3aR inhibition preserved bone formation in aging and estrogen‑deficiency states. In contrast, C5a/C5aR1 activation induced pro‑inflammatory osteoblast phenotypes, increased osteoclastogenic cytokines, and impaired matrix organization, particularly when complement activity was excessive. C5aR1 blockade had little to no effect in uncomplicated fractures, but restored healing in trauma‑induced systemic inflammation. Receptor‑specific models demonstrated that C5aR1 drives early inflammatory signaling, whereas C5aR2 modulates its resolution.</p><p><strong>Conclusions: </strong>Complement proteins act as contextual regulators of skeletal repair, supporting osteoblast-mediated regeneration under physiologic activation, while impairing healing when over-activated. These findings highlight the therapeutic potential of targeted complement modulation in inflammatory fracture environments and underscore the need for human studies to define translational applications.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171217"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081831","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":"Development and Histopathological Validation of a Novel Unilateral Three-Level Lumbar Artery Ligation Model of Progressive Intervertebral Disc Degeneration.","authors":"Fatih Ugur, Nurtac Sarikas, Irfan Cinar, Kayahan Kayikci, Mehmet Albayrak","doi":"10.52965/001c.171209","DOIUrl":"10.52965/001c.171209","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intervertebral disc degeneration (IVDD) is a major contributor to low back pain and disability worldwide. Increasing evidence suggests that vascular insufficiency plays a critical role in its pathogenesis; however, existing experimental models inadequately reproduce vascular-driven disc degeneration. To develop and histopathologically validate a novel unilateral three-level lumbar artery ligation model capable of inducing progressive vascular insufficiency-related IVDD in rats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fifty-two Sprague-Dawley rats (26 males and 26 females) were randomly assigned to a sham-operated control group or to three experimental groups representing the acute (day 3), subacute (day 15), and chronic (week 8) stages following unilateral ligation of three consecutive lumbar arteries. Intervertebral discs (L4-L5) were analyzed using histopathological staining (Hematoxylin-Eosin and Safranin O/Fast Green). Disc morphology, nucleus pulposus (NP) and annulus fibrosus (AF) integrity, extracellular matrix composition, and disc height parameters were evaluated using a standardized histological scoring system and comprehensive morphometric analyses. Radiological disc height measurements were performed at the chronic stage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Unilateral three-level lumbar artery ligation induced a clear, progressive, and time-dependent pattern of IVDD. Histopathological scores increased significantly from the acute to the chronic phase (p &lt; 0.001), demonstrating gradual disruption of NP and AF architecture, marked loss of proteoglycan content, and progressive structural deterioration. Sex-based analysis revealed no statistically significant differences across time points, although a trend toward higher degeneration scores in females was observed at Week 8. Morphometric evaluation demonstrated region-specific (midline, right, and left) and time-dependent alterations in NP and AF heights (all p &lt; 0.05). Although no significant side-to-side differences were observed during the acute and subacute stages (Day 3 and Week 2; all p &gt; 0.05), NP height showed a trend toward reduction on the ligated side at Week 8 without reaching statistical significance (p = 0.076), whereas AF height was significantly reduced compared with the contralateral side (p = 0.001). Radiological assessments failed to detect significant bilateral differences, emphasizing the superior sensitivity of histopathological and morphometric analyses in identifying early and progressive degenerative changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The proposed unilateral three-level lumbar artery ligation model successfully reproduces the acute, subacute, and chronic stages of IVDD through controlled vascular insufficiency. By avoiding direct mechanical damage to the intervertebral disc, this approach more closely reflects the stepwise pathophysiological evolution of vascular-related IVDD than conventional mechanistically induced models. This model","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"171209"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081739","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 Research Landscape of Osteitis Pubis and Athletic Pubalgia in Soccer.","authors":"Samuel Marya, Ethan Nichols, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.169732","DOIUrl":"10.52965/001c.169732","url":null,"abstract":"<p><strong>Introduction: </strong>Osteitis pubis and athletic pubalgia are important causes of chronic groin pain in soccer players and can lead to reduced performance, recurrent symptoms, and delayed return to play. Although research on these conditions has expanded with advances in sports medicine, imaging, and rehabilitation, the overall research landscape has not been fully evaluated through bibliometric methods.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science Core Collection to evaluate publication trends, research productivity, citation influence, and major research themes related to osteitis pubis and athletic pubalgia in soccer. The search included condition-related terms such as \"osteitis pubis,\" \"pubalgia,\" \"athletic pubalgia,\" \"sports hernia,\" \"groin pain,\" and \"pubic symphysis,\" combined with sport-related terms including \"soccer,\" \"football,\" \"association football,\" and \"footballer.\" A total of 577 articles published between 1984 and 2026 were retrieved. Microsoft Excel was used to organize publication data, while VOSviewer was used to visualize country collaboration, keyword co-occurrence, and co-citation networks.</p><p><strong>Results: </strong>Research activity increased substantially over the study period, with the highest output occurring in recent years. The United States had the most publications, followed by Australia, Denmark, and England. Leading institutions included La Trobe University, Copenhagen University Hospital, the University of Copenhagen, and Aspetar Orthopedic Sports Medicine Hospital. Keyword analysis highlighted groin pain, diagnosis, imaging, rehabilitation, management, risk factors, and return to play.</p><p><strong>Conclusions: </strong>Research on osteitis pubis and athletic pubalgia in soccer has grown greatly over the past several decades. Future studies should focus on prevention, improved diagnosis, long-term outcomes, and stronger institutional collaboration.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169732"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040271","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":"Preliminary One-Year Observational Outcomes After GPS Leukocyte-Rich Platelet-Rich Plasma Injection for Kellgren-Lawrence Grade II and III Knee Osteoarthritis: A Japanese Real-World Case Series.","authors":"Hiroyuki Maeda, Takahiro Maeda, Mutsuhiro Maeda","doi":"10.52965/001c.169123","DOIUrl":"10.52965/001c.169123","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) is used as an orthobiologic injection therapy for knee osteoarthritis (OA), but reported outcomes vary according to PRP formulation, injection protocol, comparator, and patient selection. Real-world data describing the Zimmer Biomet GPS leukocyte-rich PRP system in Japanese clinical practice remain limited.</p><p><strong>Purpose: </strong>To describe 1-year patient-reported outcomes after a single intra-articular GPS leukocyte-rich PRP injection in patients with Kellgren-Lawrence (KL) grade II or III knee OA.</p><p><strong>Methods: </strong>This retrospective single-center case series included patients with symptomatic Kellgren-Lawrence (KL) grade II or III knee osteoarthritis (OA) who underwent GPS leukocyte-rich platelet-rich plasma (PRP) injection. During the study period, 20 patients/knees received an initial GPS L-PRP injection; 5 could not be followed at 1 year and were excluded from the paired 1-year analysis. The final analysis included 15 knees with paired baseline and 1-year numeric rating scale (NRS) pain data. Radiography and magnetic resonance imaging were used to support baseline diagnosis and eligibility; MRI was not analyzed as a longitudinal structural outcome. The primary outcome was change in NRS pain. Secondary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS), Locomo-25, responder status, and adverse events.</p><p><strong>Results: </strong>Of 20 patients/knees treated with an initial GPS L-PRP injection, 5 were lost to 1-year follow-up or had unavailable 1-year outcome data; 15 knees from 5 male and 10 female patients were included in the final paired analysis. NRS pain improved from 4.6 ± 2.4 at baseline to 2.7 ± 2.1 at 1 year (mean change, -1.9 points; 95% CI, -3.4 to -0.4; P = 0.015). KOOS quality of life improved from 30.0 ± 17.1 to 45.4 ± 23.8 (mean change, 15.4 points; 95% CI, 4.8 to 26.0; P = 0.010). Other KOOS domains and Locomo-25 showed numerical improvement but did not reach statistical significance. A ≥30% NRS pain reduction occurred in 7 of 15 knees (46.7%), and pain worsened in 2 of 15 knees (13.3%).</p><p><strong>Conclusions: </strong>In this small uncontrolled retrospective case series, GPS leukocyte-rich PRP injection was associated with improved NRS pain and KOOS quality of life at 1 year. These findings should be interpreted as preliminary observational associations and cannot establish treatment efficacy or safety. Larger prospective controlled studies with standardized PRP characterization are needed.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169123"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040267","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":"The Expanding Multisystem Research Landscape of Hypermobile Ehlers-Danlos Syndrome: An Analysis of Orthopedic, Autonomic, Immunologic, and Neuropsychiatric Comorbidities.","authors":"Sahiti Tanuku, Tori Baer, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.169727","DOIUrl":"10.52965/001c.169727","url":null,"abstract":"<p><strong>Introduction: </strong>Hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD) are increasingly recognized among orthopedic physicians to cause joint instability, frequent dislocation, and chronic musculoskeletal pain. Yet, patients with these disorders frequently have coexisting conditions, such as postural tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), autoimmune and allergic disease, and neuropsychiatric conditions including anxiety, depression, ADHD, and autism. These comorbidities complicate diagnosis and treatment, therefore potentially decreasing the overall quality of care these patients receive. Despite the clinical relevance of comorbidities, the extent of research linking hypermobility disorders to these conditions has not been comprehensively examined.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science Core Collection to identify articles and journals related to the topic. Articles with hEDS and hypermobility spectrum disorder (HSD) as the main topic and addressing at least one of the four comorbidity domains (orthopedic, autonomic, immunologic, or neuropsychiatric) were included without restriction on the type of document. The trend in the year of publication was graphed using the Web of Science Analyze results tool, while the collected bibliographic data was analyzed using VOSviewer to assess the coauthorship network and keyword co-occurrence patterns. Microsoft Excel was also utilized to visualize the articles with the most citations.</p><p><strong>Results: </strong>Between 1967 and June 18, 2026, 1,281 publications were published, with 97.1% in English. About 65.8% of the articles were published within the last ten years, showing the rapid growth of research in this field. The country with the highest number of publications was the United States (482, 37.6%), followed by England (223, 17.4%) and Italy (114, 8.9%). The organization contributing the greatest number of articles in the dataset was the University of London, with 97 articles. Isolated author collaboration networks were observed, featuring small clusters with rare interactions, typically separated by country.</p><p><strong>Conclusion: </strong>Research connecting hEDS and HSD to their orthopedic, autonomic, immunologic, and neuropsychiatric comorbidities has expanded rapidly over the past decade, driven largely by a few geographically isolated research clusters. Despite this growth, the immunologic and mast cell activation literature remains substantially underdeveloped, and collaboration across these research groups remains limited. Future efforts should prioritize cross-disciplinary and cross-national collaboration, with particular attention to expanding research on the immunologic and mast cell activation dimensions of hypermobility disorders.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169727"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040292","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, Radiographic, and Functional Outcomes of Olecranon Fractures Treated With Tension Band Wiring: A Retrospective-Prospective Study.","authors":"Hai Vu Minh, Anh Doan Van, Duc Nguyen Minh, Tu Pham Duc, Bach Pham Xuan, Chau Nguyen Minh, Nam Phan Thanh, Nam Duong Nhu, Giang Doan Truong, Dung Nguyen Van, Tai Nguyen Duc","doi":"10.52965/001c.166439","DOIUrl":"10.52965/001c.166439","url":null,"abstract":"<p><p>To evaluate the clinical, radiographic, and functional outcomes of olecranon fractures treated with tension band wiring and to identify factors associated with postoperative functional recovery and patient satisfaction. # Methods A retrospective-prospective cross-sectional study was conducted on 82 patients with olecranon fractures treated surgically using tension band wiring at Thai Binh General Hospital between January 2023 and December 2025. Patients were followed for a minimum of 6 months after surgery. Clinical characteristics, radiographic outcomes, postoperative complications, elbow function, and patient satisfaction were evaluated using radiographic assessment, Mayo Elbow Performance Score (MEPS), and Oxford Elbow Score (OES). Data were analyzed using SPSS 22.0, and associations between variables were assessed using the Chi-square test. # Results The mean patient age was 46.9 ± 22.6 years, and traffic accidents were the most common cause of injury (56.1%). Most patients achieved complete radiographic reduction (92.7%) and favorable postoperative functional outcomes. Delayed union occurred in 2.4% of patients, while no cases of nonunion, osteomyelitis, myositis ossificans, or osteoarthritis were observed. Higher patient satisfaction was associated with better OES outcomes (p = 0.013). However, rehabilitation practice and MEPS-based elbow mobility were not clearly associated with postoperative OES classification. # Conclusion Tension band wiring provided favorable radiographic and functional outcomes with a low rate of major complications in selected olecranon fractures. Patient satisfaction appeared to be more closely related to patient-reported functional outcomes than clinician-based assessments.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166439"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040306","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":"from treatment to prevention: global evolution of sports injury research in surveillance, rehabilitation, and risk management, 1990-2024.","authors":"Yuming Xu, Jun Peng, Yuting Xu, Nuan Wen","doi":"10.52965/001c.169720","DOIUrl":"10.52965/001c.169720","url":null,"abstract":"<p><strong>Background: </strong>Sports injuries affect clinical care, rehabilitation, athletic participation, and public health. However, the expanding literature has become fragmented across injury surveillance, prevention, rehabilitation, and athlete health.</p><p><strong>Objective: </strong>This bibliometric study examined the long-term evolution of sports injury research from 1990 to 2024 and identified implications for orthopedic and sports medicine practice.</p><p><strong>Methods: </strong>Records on sports injury research were retrieved from the Web of Science Core Collection for 1990-2024. Publication output, collaboration patterns, co-cited references, keyword co-occurrence, and thematic evolution were analyzed with bibliometric mapping tools. The results were interpreted with emphasis on surveillance, prevention, rehabilitation, and risk management.</p><p><strong>Results: </strong>The field showed sustained growth, with a marked shift from treatment-centered descriptions of common injuries toward standardized surveillance, prevention programs, return-to-sport decision-making, workload management, and athlete health. Highly cited work emphasized injury definitions, exposure measurement, epidemiologic reporting, and prevention frameworks. Recent keywords highlighted prevention, rehabilitation, concussion, anterior cruciate ligament injury, overuse injury, and monitoring technologies.</p><p><strong>Conclusion: </strong>Sports injury research has moved from documenting injuries to supporting prevention-oriented and data-informed care. Future work should strengthen standardized surveillance, context-specific prevention, integrated rehabilitation pathways, and translation into training, school sport, and recreational physical activity settings.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169720"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040342","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":"Adverse events with monitored anesthesia care sedation in patients with stroke receiving mechanical thrombectomy.","authors":"Blaze T Borowski, Sang Hyoun Hong, Matthew L Hovancsek, Malika Bhargava, Paul Kang, Sarang S Koushik, Omar Viswanath, Brian G Wilhelmi","doi":"10.52965/001c.168224","DOIUrl":"10.52965/001c.168224","url":null,"abstract":"<p><strong>Background: </strong>Monitored anesthesia care (MAC) sedation for mechanical thrombectomy in stroke patients is considered safe. The association of MAC sedation with respiratory complications is not well studied.</p><p><strong>Objective: </strong>To evaluate adverse events among patients who receive MAC sedation for treatment of acute stroke with thrombectomy.</p><p><strong>Methods: </strong>A retrospective review of adverse events at a single institution between 2020 and 2024 was performed. Univariate and multivariable logistic regression identified clinical covariates associated with the likelihood of adverse outcomes.</p><p><strong>Results: </strong>Among 348 patients treated for stroke with MAC, 310 had no adverse events. Univariate analysis showed patients aged 60-69 years were 3.23 times more likely to have an adverse event than patients <60 years old and >8 times more likely to develop acute respiratory failure. Multivariable analysis indicated smokers were 2.4 times more likely to have an adverse event (odds ratio [OR], 2.41; 95% CI, 1.01-5.72; p = 0.046). Patients aged 60-69 were >3 times as likely to require prolonged ventilation (OR, 3.75; 95% CI, 1.12-12.6; p = 0.03). Patients with comorbidities were also >3 times as likely to require prolonged ventilation (OR, 3.45; 95% CI, 1.49-7.95; p = 0.004). Age, sex, race, body mass index, stroke location, and stroke history were not associated with adverse events, ventilator use, or acute respiratory failure.</p><p><strong>Conclusion: </strong>MAC is a safe method for stroke patients undergoing thrombectomy. Smoking, age 60-69 years, and some comorbidities increased odds of respiratory adverse events, underscoring the importance of preoperative risk stratification.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"168224"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149062938","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":"Global Research Trends in Metatarsal Stress Fractures in Athletes.","authors":"Divya Kalidindi, Pranay Gadikota, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.169724","DOIUrl":"10.52965/001c.169724","url":null,"abstract":"<p><strong>Introduction: </strong>Metatarsal Stress Fractures (MSFs) are commonly occurring overuse injuries for athletes and soldiers. This paper investigated publication patterns, top authors, networks, and themes associated with MSFs.</p><p><strong>Methodology: </strong>Bibliometric analysis of publications on MSFs published during the period from 1970-2026 was carried out using the Web of Science Core Collection. Network and visualization of bibliometric analyses were carried out using VOSviewer.</p><p><strong>Results: </strong>A total of 479 publications were identified. There has been a significant rise in research output following 2011, peaking during 2017-2025 years. Subject categories with highest publication outputs were Orthopedics and Sport Sciences; the most active countries are the United States, England, and Japan; JA Nunley is the most prolific author, whereas Foot & Ankle International is the most popular journal; keywords include Jones' fractures, 5th metatarsal fracture, surgical intervention, and return to play.</p><p><strong>Discussion: </strong>Increase in publication outputs likely reflects rising sports participation levels and advances in sports medicine. Nevertheless, the majority of research is centered around Jones' fractures, surgery, with minimal interest in preventive strategies, metabolism-related risk factors, and minor metatarsal stress fractures.</p><p><strong>Conclusion: </strong>Future research should focus on prevention methods, metabolism, and scientific approaches to returning to sport activities.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169724"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040334","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}