Orthopedic Reviews最新文献

{"title":"Trends and Hotspots in Psoriasis-Related Musculoskeletal Research.","authors":"Aniysa Joseph, Sofia Haddadin, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.169734","DOIUrl":"10.52965/001c.169734","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic inflammatory disease with systemic manifestations, including psoriatic arthritis (PsA), that can lead to significant musculoskeletal complications and reduced quality of life. This bibliometric analysis aims to characterize trends and research hotspots in the scientific literature pertaining to psoriasis, PsA, and musculoskeletal involvement by examining leading countries, authors, institutions, publication trends, and keyword co-occurrence patterns.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science Core Collection. A focused literature search was performed on June 16, 2026, using the title-based search query TI=(psoriasis AND (\"psoriatic arthritis\" OR enthesitis OR dactylitis OR spondylitis)) AND DT=(Article OR Review). VOSviewer was used to analyze keyword co-occurrence and generate network visualizations, while Microsoft Excel was used to evaluate publication trends and the leading countries, authors, and institutions.</p><p><strong>Results: </strong>A total of 1,263 publications published between 1968 and 2026 were identified, with 97.0% written in English. More than 35.7% of all publications were published between 2021 and 2025, demonstrating continued growth in the field. The United States accounted for the highest proportion of publications, the University of Toronto was the leading institution, and keyword co-occurrence analysis identified psoriasis, psoriatic arthritis, biologics, therapy, management, and quality of life as major research themes.</p><p><strong>Conclusion: </strong>Research on psoriasis-related musculoskeletal involvement has continued to expand, with increasing emphasis on disease management and treatment strategies. The findings highlight evolving research hotspots in psoriatic arthritis and related musculoskeletal manifestations while also demonstrating geographic concentration of the literature. Future research should encourage greater international collaboration and broader geographic representation to further improve the understanding of psoriatic musculoskeletal disease.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169734"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040337","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":"Concussion and Head Injuries in Soccer: Research Trends, Knowledge Structure, and Emerging Themes.","authors":"Sriram Muppala, Pranay Gadikiota, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.169729","DOIUrl":"10.52965/001c.169729","url":null,"abstract":"<p><strong>Introduction: </strong>Soccer is the world's most widely played sport and exposes athletes to a distinctive combination of acute concussion risk and repetitive head-impact exposure. Player-to-player contact, aerial challenges, falls, and purposeful heading all contribute to the spectrum of head impacts encountered in the sport. Although the literature has expanded substantially, its development, disciplinary structure, geographic distribution, and evolving research priorities have not been comprehensively characterized. This study maps the research landscape of concussion and head injury in soccer and identifies major contributors, knowledge clusters, and emerging themes.</p><p><strong>Methods: </strong>A bibliometric analysis was performed using the Web of Science Core Collection. The search combined soccer/football title terms with concussion, traumatic brain injury, and head-impact topic terms and retrieved 2,134 publications. Publication year, citation counts, Web of Science categories, source journals, authors, institutions, countries, cited references, and keywords were analyzed. VOSviewer was used to construct co-authorship, institutional, country, co-citation, and keyword networks.</p><p><strong>Results: </strong>Publication output increased from fewer than 30 papers annually during most of 2002-2011 to a peak of 198 publications in 2020, with output remaining substantially above early-period levels thereafter. The 10 most-cited papers accounted for approximately 13.8% of citations in the retrieved corpus. Sports Sciences was the leading Web of Science category, and the Journal of Neurotrauma was the most productive source journal. Network analyses demonstrated distinct collaborative and thematic clusters spanning biomechanics, concussion assessment, neuroimaging, repetitive head impacts, and neurodegeneration. The United States occupied the most central position in country collaboration networks, while several soccer-dominant nations were comparatively peripheral.</p><p><strong>Conclusion: </strong>Research on concussion and head injury associated with soccer has expanded markedly and has become increasingly multidisciplinary. However, the present dataset also reveals an important methodological and interpretive issue: because the search included the unqualified title term \"football,\" some American-football literature entered the corpus. Thus, the prominence of American-football papers should not be interpreted solely as evidence that soccer research is derived from American football; it also reflects search-term overlap. Within this limitation, the networks identify persistent gaps in soccer-specific research, particularly sex-specific evidence, youth education, international representation, and validation of objective measures of cumulative head-impact exposure.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169729"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040256","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":"Public Awareness and Perceptions Toward Cosmetic Stature Lengthening: A Cross-Sectional Survey Study.","authors":"Hamza M Alrabai, Abdullah Addar, Rakan Abdulkarim A AlEtebi, Taher Mohammed A Mufti, Nawaf Madallah M AlEnazi, Mohammed Yousef A AlAli, Hussain Mustafa H Reda, Rayan Yousef M AlShammari, Hamad Mohamad AlJamea, Bassam Mugbel A AlAnazi, Ali Mohammed AlJeshi","doi":"10.52965/001c.169772","DOIUrl":"10.52965/001c.169772","url":null,"abstract":"<p><strong>Background: </strong>Cosmetic stature-lengthening surgery is a topic of growing conversation, but there is limited information regarding its awareness, attitudes, and determinants of willingness. Questions/Purpose: To evaluate public awareness, ethical perceptions, and willingness toward cosmetic stature lengthening, and to identify associated demographic, psychosocial, and decision-making factors influencing acceptance and interest.</p><p><strong>Methodology: </strong>The survey was of cross-sectional nature and used 255 respondents. Sociodemographic, anthropometric, risk-taking scores and history of previous cosmetic procedures were measured. Chi-square and Mann Whitney U tests were done to analyze associations with willingness to have surgery.</p><p><strong>Results: </strong>The median age was 27 years (IQR 23-41) and median height 167 cm (IQR 160-175). The rate of awareness on height-lengthening surgery was good (73.3%), although just one-third (31.4) of them had ever thought of visiting a cosmetic surgeon, and 9.8% had ever undergone cosmetic surgery. There were no notable correlations between the readiness to have surgery with sociodemographic factors, perceived height, previous cosmetic history, and risk-taking scores. It was also found that occupational constraints, in particular, the necessity to have a longer duration without an opportunity to work, were also strongly correlated with decreased willingness (p = 0.019).</p><p><strong>Conclusion: </strong>Although the knowledge of cosmetic stature-lengthening surgery is considerable, the readiness to obtain the surgery is low and independent of demographic or anthropometric variables to a great extent. Occupational barriers are practical constraints that are very important in decision-making.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"169772"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040297","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":"Swimming-related shoulder injuries: A Bibliometric Analysis of Global Research Trends.","authors":"Aarya Ali, Samuel Andrade, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.167319","DOIUrl":"10.52965/001c.167319","url":null,"abstract":"<p><strong>Introduction: </strong>Competitive swimming has grown substantially worldwide, bringing increased attention to the prevalence of overuse injuries among athletes. One of the most common conditions, swimmer's shoulder, is closely associated with orthopedic pathologies including rotator cuff tendinopathy, labral injury, and scapular dyskinesis, resulting from the repetitive overhead motion required in swimming. Despite growing clinical and research interest in these injuries, the global landscape and evolution of scientific research on swimming-related shoulder injuries have not yet been investigated.</p><p><strong>Methods: </strong>Using Web of Science, a total of 542 publications concerning shoulder disorders in swimmers between 1965 and 2026 were analyzed to investigate key factors, contributors, and overall research trends. VOSviewer was also used during this process to assess co-authorship networks, journal distribution, and collaboration patterns. Lastly, Microsoft Excel was used to evaluate publication trends over time, citation patterns, language distribution, and geographic contributions.</p><p><strong>Results: </strong>Publication and citation output increased substantially over time, with particularly rapid growth starting from the 2010s. A geographical examination found that the United States accounted for the highest proportion of publications, followed by England, Australia, Canada, and Brazil. The most prolific publication sources included Journal of Sport Rehabilitation, Journal of Athletic Training, American Journal of Sports Medicine, British Journal of Sports Medicine, and International Journal of Sports Physical Therapy. Lastly, author and affiliation patterns suggested that research output is concentrated among a limited number of institutions and collaborative networks.</p><p><strong>Conclusion: </strong>The steady increase of research on swimmer's shoulder reflects a growing awareness of shoulder overuse injuries as a significant issue in sports medicine. Much of this work comes from English publications, high-income countries, and various author and institution networks. This shows improvements in understanding injury mechanisms and management. Additionally, the high number of studies in sports medicine, rehabilitation, and orthopedic journals emphasizes the clinical focus of this field and provides a future avenue for research. However, gaps still exist in global representation, language diversity, and the application of findings into prevention and rehabilitation strategies. Further efforts should emphasize international collaboration and clinically applicable research to enhance long-term swimmer health.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"167319"},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881083","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":"Proximal Humerus Fractures - A Contemporary Narrative Review of Management Strategies.","authors":"Umair Baig, Basel Balbisi, Reece Patel, Daoud Makki","doi":"10.52965/001c.168220","DOIUrl":"10.52965/001c.168220","url":null,"abstract":"<p><p>Proximal humerus fractures are a heterogeneous group of injuries with increasing incidence, particularly among older adults. Management remains controversial and is influenced by fracture morphology, patient characteristics, functional demands and evolving surgical options. Traditional classification systems, including Neer and AO/OTA, assist treatment planning but have limited reproducibility and predictive value. This contemporary narrative review integrates current evidence with expert clinical insight to provide a pragmatic framework for managing adult proximal humerus fractures. PubMed, Embase and the Cochrane Library were searched for studies published between 2000 and 2025, including randomised controlled trials, systematic reviews, meta-analyses and key cohort studies addressing operative and non-operative treatment. Undisplaced fractures are generally managed non-operatively with good outcomes. Fracture-dislocations and completely displaced humeral shaft injuries are biomechanically unstable and usually require early surgery. Most other fractures lie within a clinical grey zone in which treatment can be individualised according to age, fracture pattern, bone quality and functional demand. Younger patients with reconstructable fractures may benefit from early fixation, whereas some complex, non-reconstructable injuries can still achieve acceptable outcomes with conservative treatment. In elderly patients, early arthroplasty may be indicated for fractures extending into the proximal shaft, with delayed intervention suitable in selected cases. Advances in imaging, implant design and artificial intelligence may further improve patient-specific decision-making.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"168220"},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881169","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":"Factors Affecting Transfusion Rate for Patients After Hip Fracture.","authors":"Fouad Qupti, Mahmod Hasan, Fadi Khalil Hanna, Habib Shehadeh, Mokbil Shalah, Mohammad Ghadir","doi":"10.52965/001c.167323","DOIUrl":"10.52965/001c.167323","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures are a common indication for red blood cell transfusion among elderly patients. Blood transfusion may be clinically necessary, yet it carries risks and should be anticipated according to patient and surgical characteristics.</p><p><strong>Objective: </strong>This retrospective study aimed to identify clinical and perioperative factors associated with the need for blood transfusion among patients hospitalized with hip fracture.</p><p><strong>Methods: </strong>The study included 150 patients with hip fracture treated at the Orthopedic Department of Bnei Zion Medical Center between April 2014 and June 2015. The transfusion group included 100 patients who received blood transfusions, and the control group included 50 surgically treated patients who did not require transfusion. Group comparisons were performed using t tests, chi-square tests, Fisher exact tests, and multivariable logistic regression.</p><p><strong>Results: </strong>Transfused patients were older than non-transfused controls (84.5 ± 7.4 vs 80.2 ± 8.1 years; P = 0.002). Age above 90 years (34% vs 14%; P = 0.030), subtrochanteric fracture (20% vs 6%; P = 0.031), aspirin use (41% vs 18%; P = 0.006), surgery duration exceeding 90 minutes (33% vs 8%; P = 0.0079), and B+ blood type (26% vs 6%; P = 0.041) were significantly associated with transfusion in univariate analysis. In multivariable logistic regression, age above 90 years (OR, 2.64; 95% CI, 1.08-6.45; P = 0.033), subtrochanteric fracture (OR, 3.21; 95% CI, 1.01-10.18; P = 0.048), and surgery duration exceeding 90 minutes (OR, 4.87; 95% CI, 1.62-14.63; P = 0.005) remained significant predictors.</p><p><strong>Conclusions: </strong>Among elderly patients with hip fracture, advanced age, subtrochanteric fracture, and prolonged surgical duration were the main independent predictors of blood transfusion. Aspirin use and B+ blood type were significant in univariate analysis but should be interpreted cautiously. Recognition of high-risk profiles may improve perioperative planning, blood bank preparation, and patient management.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"167323"},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881148","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":"Adolescent patellofemoral pain syndrome: reappraisal of pathophysiology and implications for clinical management.","authors":"Thierry Conrozier, Anne Lohse","doi":"10.52965/001c.166796","DOIUrl":"10.52965/001c.166796","url":null,"abstract":"<p><strong>Background: </strong>Adolescent patellofemoral pain syndrome (APFS) is the most common cause of knee pain in this population. Despite its high prevalence, it remains frequently underestimated and is often considered a benign and self-limiting condition. However, persistent symptoms, significant psychosocial burden, and limited long-term efficacy of conventional treatments challenge this traditional view and call for an updated understanding of its underlying mechanisms and management.</p><p><strong>Main body: </strong>This narrative review is based on a structured literature search conducted in PubMed and Google Scholar, with studies selected according to predefined relevance criteria. APFS typically develops around puberty and predominantly affects physically active adolescents, particularly females. Clinical presentation is characterized by activity-related anterior knee pain and pain during prolonged sitting. Diagnosis remains primarily clinical, although it should incorporate assessment of biomechanical, functional, and psychosocial factors. While standard imaging is usually unremarkable, advanced magnetic resonance imaging techniques have revealed early structural and biochemical cartilage alterations. Current evidence supports a multifactorial model of pain involving both peripheral nociceptive sources and central sensitization mechanisms, further supported by neuroimaging studies. Psychosocial factors, including kinesiophobia, reduced participation in physical activity, and impaired quality of life, play a key role in symptom persistence. Standard management based on education, load management, and rehabilitation yields suboptimal outcomes in a substantial proportion of adolescents. Emerging approaches include psychologically informed interventions, digital adherence strategies, and adjunctive therapies such as intra-articular hyaluronic acid.</p><p><strong>Conclusion: </strong>APFS should no longer be regarded as a benign condition. A shift toward earlier, multimodal, and individualized management is warranted, integrating physical, psychological, and educational components. Improved understanding of central pain mechanisms and the development of adjunctive therapeutic strategies may contribute to better outcomes and prevention of chronicity.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166796"},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881159","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":"Selective Distribution of Flexor Hallucis Longus-Derived Slips at the Knot of Henry and Fifth Toe Functional Independence: A Narrative Review.","authors":"Seiichi Niikura, Yoichi Toyoshima, Haruka Emori, Yuichiro Okazaki, Hirotaka Kato, Mayuko Noda, Yoshifumi Kudo","doi":"10.52965/001c.167321","DOIUrl":"10.52965/001c.167321","url":null,"abstract":"<p><p>The tendon interconnection between the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) at the knot of Henry has important anatomical and clinical implications, particularly in tendon transfer surgery. Although previous anatomical studies have consistently shown that FHL-derived slips are distributed mainly to the second through fourth toes, the reason for their minimal contribution to the fifth toe remains unclear. This narrative review examined anatomical and functional studies identified through PubMed and Google Scholar, focusing on the FHL-FDL interconnection, toe-specific tendon distribution, and the role of the quadratus plantae (QP). Six major anatomical studies were identified. Across studies, FHL-derived slips consistently supplied the second and third toes and occasionally the fourth toe, whereas direct contribution to the fifth toe was absent or extremely rare (<1%). Anatomical evidence also demonstrated close integration of the QP with the lateral digital flexor system. Biomechanical findings suggest that the FHL primarily supports medial forefoot propulsion, whereas the lateral column, including the fifth toe, is more closely associated with balance and stabilization through the FDL-QP complex. Together, these findings support the concept of functional differentiation within the long digital flexor system. The selective distribution of FHL-derived slips appears to represent a consistent anatomical pattern rather than random variation, with the fifth toe functioning as a relatively independent unit associated with the FDL-QP complex. This concept may provide a useful framework for interpreting checkrein deformity and for planning tendon-level surgical procedures.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"167321"},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881111","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":"Neuromuscular Electrical Stimulation for Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials Evaluating Pain, Disability, Muscle Strength, and Functional Performance.","authors":"Waleed O Samarkandi, Hassan E Mesri, Faisal Khalid M Alqahtani, Rayan N Alanazi, Saud Turki M Alqahtani, Mohammed M Tarabishi, Abdullah M A Khattab, Abdelrahman N Barakat, Thekra S Alabdah, Saad Shafi Al-Ghamdi, Sara Adil Alqazanli, Abdalrazaq S Jamous, Yazn AlQabbani, Abdulrhman A Almazrou, Abdulelah F Alshehri","doi":"10.52965/001c.168252","DOIUrl":"10.52965/001c.168252","url":null,"abstract":"<p><strong>Background: </strong>Neuromuscular electrical stimulation (NMES) is widely used in the rehabilitation of knee osteoarthritis (KOA) to improve quadriceps activation and counteract arthrogenic muscle inhibition. However, randomized controlled trials (RCTs) have reported inconsistent findings, and the overall clinical effectiveness of NMES across key patient outcomes remains uncertain.</p><p><strong>Objective: </strong>To evaluate the effects of NMES, administered alone or in combination with exercise, on pain, self-reported disability, quadriceps muscle strength, and functional performance in adults with KOA, and to explore whether treatment effects differ according to comparator intervention.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of RCTs was conducted according to PRISMA 2020. PubMed/MEDLINE, Embase, Scopus, Web of Science, and CENTRAL were searched from inception to April 20, 2026. Random-effects meta-analyses were performed using restricted maximum likelihood estimation. Prespecified subgroup and sensitivity analyses were undertaken, and risk of bias was assessed using the Cochrane RoB 2 tool.</p><p><strong>Results: </strong>Eight unique RCTs (10 publications) were included. Overall, NMES did not significantly improve pain, self-reported disability, quadriceps strength, or six-minute walk distance compared with pooled comparator interventions. A significant improvement was observed for Timed Up and Go performance, although this estimate was largely driven by a single trial. Prespecified subgroup analyses demonstrated that treatment effects differed according to comparator intervention. NMES combined with exercise resulted in greater pain reduction than exercise alone, whereas no consistent advantage was observed when NMES was compared with alternative conservative interventions. Most trials were judged to have low risk of bias or some concerns.</p><p><strong>Conclusions: </strong>NMES does not appear to provide consistent clinical benefits across all rehabilitation settings for KOA. Rather, its effectiveness depends on the therapeutic context in which it is delivered, with the greatest benefit observed when used as an adjunct to structured exercise rather than as a stand-alone intervention. Larger, methodologically rigorous RCTs using standardized stimulation protocols are required to define the patients most likely to benefit.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"168252"},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881162","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 Evolving Research Landscape of Stress Fracture Risk Factors in Athletes.","authors":"Dharish Kalaisenthil, Pranay Gadikota, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.167315","DOIUrl":"10.52965/001c.167315","url":null,"abstract":"<p><strong>Introduction: </strong>Stress fractures are repetitive overuse injuries in which loading exceeds the bone's threshold to repair damage, thus being prevalent among active people like athletes and soldiers.</p><p><strong>Methods: </strong>The present bibliometric analysis of 2,365 papers from the Web of Science Core Collection published between 1974 and 2026 aimed at discovering emerging research trends, highly cited authors, and core themes discussed in the scientific literature on the risk factors associated with stress fractures.</p><p><strong>Results: </strong>A considerable increase in publication numbers was observed, with one sharp peak recorded between 2016 and 2021 that correlated with the heightened interest in the topics related to the Female Athlete Triad and RED-S. Using co-author and keyword analysis, it was possible to outline six main research clusters covering such topics as epidemiology, female athlete physiology, biomechanics and loading in the military setting, stress fractures in the spinal area, foot-related stress injuries, and radiographic examination methods.</p><p><strong>Discussion: </strong>The results suggested the evolution of approaches to stress fractures, shifting from mechanical and orthopedic perspectives to a multi-layered one that considered hormonal, dietary, and energy-availability aspects.</p><p><strong>Conclusion: </strong>Inconsistencies in terminology used to refer to stress fractures were found to be an additional barrier to conducting systematic reviews.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"167315"},"PeriodicalIF":1.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831279","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}