中国修复重建外科杂志最新文献

{"title":"[Effectiveness of arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous tendon graft for irreparable massive rotator cuff tears].","authors":"Kai Huang, Xuancheng Zhang, Guoming Xie, Huixiang Wang, Kang Han, Caiqi Xu, Jinzhong Zhao, Xiaoqiao Huangfu","doi":"10.7507/1002-1892.202605054","DOIUrl":"10.7507/1002-1892.202605054","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate effectiveness of arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous tendon graft in treatment of irreparable massive rotator cuff tears (IMRCT).</p><p><strong>Methods: </strong>A retrospective case series study was conducted on 32 patients with IMRCT treated between July 2022 and December 2023. All patients underwent arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous peroneus longus tendon graft. There were 11 males and 21 females, aged 49-76 years (mean, 65 years). The clinical symptoms were joint pain accompanied by limited mobility and abduction weakness. The duration of preoperative symptoms ranged from 3 to 24 months (mean, 9 months). Pain was assessed using the visual analogue scale (VAS) score, and shoulder function was evaluated using the modified University of California at Los Angeles (UCLA) score and the Constant-Murley score before operation and at 3, 6, 12 months after operation. MRI was performed during follow-up to assess graft integrity. Complications were recorded.</p><p><strong>Results: </strong>The operation time ranged from 75 to 130 minutes, with a mean of 90 minutes. All incisions healed by first intention, and no significant complication or adverse reaction was observed. All patients were followed up 12-24 months (mean, 16.5 months). All postoperative scores improved significantly when compared with preoperative values ( <i>P</i><0.05). Pain and function continued to improve over time; no significant difference was observed in the modified UCLA scores among 6 months, 12 months, and last follow-up, nor in any scores between 12 months and last follow-up ( <i>P</i>>0.05); all other pairwise comparisons showed significant differences ( <i>P</i><0.05). At last follow-up, shoulder function was rated as excellent in 12 cases, good in 18 cases, and poor in 2 cases according to the modified UCLA scoring system, yielding an excellent-to-good rate of 93.8%. MRI follow-up demonstrated intact reconstructed rotator cuff structures in 29 patients, with a healing rate of 90.6% (29/32).</p><p><strong>Conclusion: </strong>Arthroscopic grid-pattern dynamic rotator cuff reconstruction using autologous tendon graft is effective for IMRCT, significantly alleviating pain, improving shoulder range of motion, and restoring both functional and structural integrity, without major complication or adverse reaction.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1548-1554"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224965","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":"[Classification and Ilizarov reconstruction strategies for post-infectious calcaneal bone defects].","authors":"Xinglei Cheng, Lei Zhang, Li Li, Shaohua Chen, Qiyuan Wang, Ke Zhao, Yueliang Zhu, Meng Li","doi":"10.7507/1002-1892.202607125","DOIUrl":"10.7507/1002-1892.202607125","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To retrospectively analyze the clinical data of patients with post-infectious calcaneal bone defects from multiple centers and to propose a clinical classification system and corresponding reconstruction strategies for calcaneal bone defects following infection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed on 94 patients with post-infectious calcaneal bone defects treated at five hospitals between January 2017 and June 2025. The study population consisted of 61 males and 33 females, with a mean age of 36.5 years (range, 15-65 years). There were 67 cases of open calcaneal fractures and 27 cases of closed calcaneal fracture. The infections were located at the calcaneus alone in 71 cases, both the calcaneus and talus in 20 cases, and the calcaneus, talus, and tibia in 3 cases. The disease duration was 7-68 months (mean, 42.7 months). A staged treatment protocol was adopted. The first stage involved radical debridement and implantation of antibiotic-loaded bone cement for bone defect management. After infection control, secondary reconstruction was performed according to the extent of calcaneal bone loss and the condition of adjacent bones surrounding the calcaneus. The recurrent infection, repeat debridement, amputation or limb salvage, duration of external fixation, occurrence of abnormal bone transport trajectories, pin tract infections, displacement, and the need for repeat corrective or fusion surgeries were recorded. Functional outcomes at last follow-up were evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Based on the integrity of the major weight-bearing cortical framework of the calcaneus after debridement, the proportion of calcaneal bone loss, hindfoot deformity, subtalar joint involvement, and the condition of adjacent bones, the bone defects were classified into four types with eight subtypes. Among the 94 patients, there were 28 cases of type Ⅰ, 16 cases of type ⅡA, 5 cases of type ⅡB, 13 cases of type ⅢA, 9 cases of type ⅢB, 9 cases of type ⅣA, 11 cases of type ⅣB, and 3 cases of type ⅣC. All patients were followed up 12-63 months (mean, 25.6 months). One patient (type ⅣC) underwent amputation because of intolerance to bone transport. Seven patients experienced recurrent infection; infection was controlled after debridement in 5 patients, whereas 2 (type ⅢB and type ⅣB) eventually underwent amputation. Ultimately, 91 limb-salvage patients completed the second-stage treatment and were included in the outcome assessment at last follow-up. The duration of external fixation ranged from 6 to 13 months (mean, 7.7 months). Three patients developed abnormal bone transport trajectories, which were corrected after adjustment of the external fixator. Seven patients developed pin tract infections, which healed after local treatment and oral antibiotics. Two patients experienced 1-2 mm displacement after screw fixatio","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1533-1540"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225023","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":"[Impact of preoperative therapeutic antibiotic use on pathogen detection rate in single-stage revision of chronic periprosthetic joint infection].","authors":"Hong Cheng, Chenchen Zou, Ruofan Chen, Wenbo Li, Guochang Bai, Ye Yang, Baijian Wu, Zida Huang, Wenming Zhang","doi":"10.7507/1002-1892.202605009","DOIUrl":"10.7507/1002-1892.202605009","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the impact of intravenous administration of therapeutic antibiotics prior to skin incision on the intraoperative pathogen detection rate and clinical outcomes in single-stage revision for chronic periprosthetic joint infection (PJI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on the clinical data of 65 patients with chronic PJI who met the selection criteria and underwent single-stage revision between January 2020 and June 2025. Based on the timing of antibiotic administration, the patients were divided into a preoperative antibiotic group (Pre-Abx group, &lt;i&gt;n&lt;/i&gt;=31, intravenous infusion started 60-120 minutes before skin incision) and an intraoperative antibiotic group (Intra-Abx group, &lt;i&gt;n&lt;/i&gt;=34, administration started after the removal of the infected prosthesis and thorough debridement). Intraoperative joint fluid, periprosthetic tissue, and prosthesis sonication fluid were collected. The overall pathogen detection rate, culture-positive rates of various specimen types, and pathogen distribution were compared between the two groups. According to the Musculoskeletal Infection Society (MSIS) criteria, the proportions of patients meeting the major criteria, minor criteria, and those with culture-negative PJI were analyzed. Subgroup analyses were performed based on the antibiotic regimen (broad-spectrum or pathogen-specific antibiotics) and administration timing (Pre-Abx or Intra-Abx group) to compare the intraoperative culture-positive rates. Clinical outcomes, including infection control rate, length of hospital stay, reoperation rate, and postoperative complications, were also analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The overall pathogen detection rate for all patients was 81.54% (53/65). Coagulase-negative staphylococci were the most common pathogens (26.15%), followed by &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (16.92%) and methicillin-resistant &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (MRSA, 15.38%). There was no significant difference between the two groups in pathogen distribution, overall detection rate (80.65% &lt;i&gt;vs.&lt;/i&gt; 82.06%), and culture-positive rates of various specimen types (joint fluid, periprosthetic tissue, and sonication fluid) ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). When classified by MSIS criteria, the proportions of patients meeting the major criteria, minor criteria, and those with culture-negative PJI also showed no significant difference between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). Subgroup analyses revealed that regardless of whether a broad-spectrum or pathogen-specific antibiotic regimen was used, the timing of administration did not affect the pathogen detection rate ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). Furthermore, under the same administration timing, different types of antibiotics had no significant effect on the detection rate ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). All patients were followed up 12-45 months with a mean duration of 22.69 months. The overall infection control rate was 83.08% (54/65), with 87.10% and 79.41% i","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1576-1582"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224963","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":"[Comparative efficacy of internal versus external BTLP technique with locking plates in treating large-segment infectious bone defects of tibia].","authors":"Shiyu Xiao, Xiaohua Wang, Shulin Wang, Zhao Xie","doi":"10.7507/1002-1892.202604017","DOIUrl":"10.7507/1002-1892.202604017","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare effectiveness of internal versus external bone transport with locking plate (BTLP) technique in treating large-segment infectious bone defects of tibia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 131 cases of large-segment infectious bone defects of tibia, who were admitted between July 2018 and October 2024 and met the selective criteria. All patients underwent primary debridement followed by antibiotic-containing bone cement filling, with secondary repair employing locking plates combined with external frame technology after infection control. Patients were allocated into an internal fixation group ( &lt;i&gt;n&lt;/i&gt;=45) and an external fixation group ( &lt;i&gt;n&lt;/i&gt;=86) based on the secondary fixation method: the internal fixation group utilized locking plates for maintaining alignment and stability, whereas the external fixation group combined locking plate fixation with external frames for reduction. No significant difference was observed between groups regarding age, gender, number of previous surgeries, proportion of patients with a history of smoking, type of bone infection, length of bone defect, and preoperative C-reactive protein level and erythrocyte sedimentation rate ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). But there was a significant difference in preoperative white blood cell counting ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Clinical outcomes were recorded and compared between groups, including the re-debridement rates after the first-stage operation, the bone defect healing rates and healing time after the second-stage operation, the visual analogue scale (VAS) score for pain and external fixation index during bone transport, the infection recurrence rates during follow-up, Paley joint motion score, and occurrence of complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients completed treatment and were followed up 12-62 months (mean, 20.5 months). The re-debridement rate was significantly higher in the internal fixation group than in the external fixation group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). There was no significant difference in VAS scores, incidence of skin redness and swelling, or external fixation index between two groups during bone transport ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). The internal fixation group had significantly shorter duration of pin tract exudation and lower joint restriction rate compared to the external fixation group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Bone defects healed successfully in 122 cases (93.13%), with no significant difference in healing rates between groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05), but the internal fixation group required significantly longer healing time than the external fixation group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). During follow-up, the infection recurrence rate was significantly higher in the internal fixation group than in the external fixation group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). At last follow-up, the excellent and good rate of Paley joint motion score in the internal fixation group were significantly higher than those in the external fixation group ( &lt;i","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1502-1508"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224977","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":"[Application of Ilizarov soft-tissue distraction technique in chronic limb wounds following popliteal artery injury].","authors":"Haichao Wang, Guangkai Zhu, Hui Liu, Yueliang Zhu","doi":"10.7507/1002-1892.202608021","DOIUrl":"10.7507/1002-1892.202608021","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effectiveness of Ilizarov soft-tissue distraction combined with debridement and dressing changes in the treatment of chronic limb wounds after popliteal artery injury.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 24 patients with chronic limb wounds after popliteal artery injury who were admitted between January 2023 and June 2025 and met the selection criteria. There were 15 males and 9 females, aged 24-79 years (mean, 52.6 years). Causes of injury included traffic accident injury in 16 cases, mechanical injury in 6 cases, and fall from height in 2 cases. The time from injury to revascularization ranged from 4 to 16 hours (mean, 9.6 hours). There were 29 wounds in total, with wound sizes ranging from 3 cm×2 cm to 12 cm×9 cm. Among them, 18 wounds in 16 patients were persistent chronic wounds after injury, and 11 wounds in 8 patients were recurrent muscle liquefaction wounds after healing of the limb soft tissue. Wound reconstruction was performed sequentially using debridement, continuous dressing changes, Ilizarov soft-tissue distraction, and other methods. The external fixation configuration for soft-tissue distraction was individually assembled according to wound location and morphology. Wound healing, limb salvage rate, complications, and limb functional recovery were observed.</p><p><strong>Results: </strong>Of the 29 wounds in 24 patients, 28 ultimately healed, with a healing rate of 96.6%. Limb salvage was successful in 23 patients, with a limb salvage rate of 95.8%; 1 patient underwent amputation due to severe ischemic necrosis of the limb caused by thrombosis, with an amputation rate of 4.2%. All patients were followed up 12-29 months (mean, 24.1 months); 17 had more than 2 years of follow-up. The Hospital for Special Surgery (HSS) score was 58-85 (mean, 72.4); Lower Extremity Functional Scale (LEFS) score was 32-68 (mean, 58.6). Twenty-two patients recovered two-point discrimination (range, 10-40 mm), and 2 patients recovered protective sensation.</p><p><strong>Conclusion: </strong>Ilizarov soft-tissue distraction technique combined with debridement and dressing changes can effectively promote the healing of chronic limb wounds after popliteal artery injury, improve the limb salvage rate and limb function, representing a feasible treatment strategy.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1541-1547"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225020","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":"[Interpretation of the 2026 Asia-Pacific Expert Consensus on Robotic-assisted Hip and Knee Arthroplasty: From precise execution to individualized decision-making].","authors":"Yue Song, Hongbin Xie, Jiafeng Yi, Hao Li, Zhuo Zhang, Shaokui Nan, Wei Chai","doi":"10.7507/1002-1892.202609030","DOIUrl":"10.7507/1002-1892.202609030","url":null,"abstract":"<p><p>In 2026, the Arthroplasty Society in Asia (ASIA) published the Asia-Pacific Expert Consensus on Robotic-assisted Hip and Knee Arthroplasty, comprising 18 consensus statements. The corresponding author of this article participated in the whole process of consensus formulation. This article interprets the main recommendations according to total knee arthroplasty (TKA), total hip arthroplasty (THA), and unicompartmental knee arthroplasty (UKA). For TKA, robotic assistance improves the accuracy of bone resection, implant positioning, and alignment, and provides quantitative support for individualized alignment and pre-resection soft-tissue balancing; however, optimal alignment and balancing targets and their long-term clinical benefits remain uncertain. For THA, robotic assistance improves acetabular cup positioning and reconstruction of limb length and offset. Current evidence does not indicate an increased risk of infection, but reductions in dislocation or revision have not been demonstrated, and functional planning requires further validation. For UKA, robotic assistance reduces technical variation, and some clinical studies and registry data suggest possible improvements in functional outcomes and revision risk, although interpretation is influenced by patient selection and platform differences. Safe implementation also depends on structured training, the ability to troubleshoot and convert safely when necessary, and platform-specific long-term registries. Future studies should clarify which patients are most likely to benefit, what reconstruction targets should be selected, and whether technical precision translates into durable clinical value.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1474-1479"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224980","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":"[Biological characteristics of urine-derived stem cells during <i>in vitro</i> expansion].","authors":"Yuzhen Xiao, Yizhou Huang","doi":"10.7507/1002-1892.202605078","DOIUrl":"10.7507/1002-1892.202605078","url":null,"abstract":"<p><strong>Objective: </strong>To explore the biological characteristics of urine-derived stem cells (USCs) during <i>in vitro</i> expansion to provide a reference for seed cell selection.</p><p><strong>Methods: </strong>USCs were isolated from fresh midstream urine samples from healthy volunteers by using the centrifugation combined with adherent cultivation method, followed by continuous passaging at a 1∶3 ratio. The morphological changes of cells were observed under inverted microscopy and analyzed using Image J software. After osteogenic and chondrogenic induction and identification of cells at passage 3 (P3), the biological characteristics of cells at different passages (P3, P5, and P7) were compared. Cell proliferation, cell cycle, senescence, and apoptosis were assessed via cell counting kit 8 assays, flow cytometry, β-galactosidase staining, and Annexin Ⅴ-fluorescein isothiocyanate/propidium iodide staining. RT-PCR was used to detect the expression of stemness genes (Nanog, Oct4, c-Myc, and Sox2). Tube formation assays were conducted to evaluate the <i>in vitro</i> tube-forming ability of cells at different passages.</p><p><strong>Results: </strong>After osteogenic and chondrogenic induction, USCs were positive for alkaline phosphatase‌, Alizarin red, and Alcian blue staining, respectively. During expansion, the morphology of USCs gradually shifted from rice-grain-like to spindle-shaped, with increasing trends in long diameter, short diameter, area, and aspect ratio ( <i>P</i><0.05). Surface antigen expression was similar across passages. The proliferation capacity declined with increasing passages, and the proportions of S and G ₂/M phases decreased. The proportion of senescent cells gradually increased ( <i>P</i><0.05), but the proportion of apoptotic cells showed no significant change ( <i>P</i>>0.05). Compared to USCs at P3, the expression of Oct4 was significantly lower in USCs at P7 ( <i>P</i><0.05), whereas no significant difference was found in the expression of other stemness genes among different passages ( <i>P</i>>0.05). Tube formation assays demonstrated that USCs at P3 and P5 exhibited superior <i>in vitro</i> tube-forming ability compared to cells at P7 ( <i>P</i><0.05). When co-cultured with human umbilical vein endothelial cells (HUVECs), USCs at P3 showed higher total tube length than the HUVECs only group ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>During <i>in vitro</i> expansion, USCs was accompanied by cell enlargement, reduced proliferation, and accumulation of senescence. Compared to USCs at P7, those at P3 and P5 retained better proliferative status and <i>in vitro</i> tube formation ability.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1591-1599"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225018","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":"[<i>L-</i>lactylation regulatory network in orthopedic degenerative diseases].","authors":"Jianlin Shen, Yiting Xu, Jialin Yang, Miao Xu, Xuan Lin, Xiaoning Lin, Yue Lai, Yunfeng Rui, Huan Liu","doi":"10.7507/1002-1892.202601143","DOIUrl":"10.7507/1002-1892.202601143","url":null,"abstract":"<p><strong>Objective: </strong>To explore the therapeutic potential of <i>L</i>-lactylation in degenerative disc disease, arthritis, muscle degeneration, exercise metabolism, and osteoporosis.</p><p><strong>Methods: </strong>Literatures about <i>L-</i>lactylation in metabolic regulation, inflammatory response, and bone homeostasis at home and abroad in recent years were extensively reviewed. Emphasis was placed on analyzing the molecular regulatory networks of <i>L-</i>lactylation and its related clinical therapeutic potential in intervertebral disc degenerative diseases, arthritis, muscle degeneration and exercise metabolism, and osteoporosis.</p><p><strong>Results: </strong><i>L-</i>lactylation reprograms metabolic flux by modifying key enzymes, and regulates chromatin dynamics through histone/non-histone modifications, thereby modulating macrophage polarization, osteoclast-osteoblast balance, and extracellular matrix remodeling. In intervertebral disc degeneration, tumor necrosis factor α activates glycolytic enzymes to promote <i>L-</i>lactylation, while glutamine supplementation reduces <i>L-</i>lactylation levels and activates the adenosine monophosphate-activated protein kinase catalytic subunit α pathway; hypoxia inducible factor 1α promotes the extracellular transport of <i>L-</i>lactylation by upregulating monocarboxylate transporter 4. In osteoarthritis, lactate dehydrogenase A (LDHA) overexpression leads to elevated histone <i>L-</i>lactylation levels, which in turn upregulates the transcriptional activity of triosephosphate isomerase 1 and accelerates cartilage degradation. In rheumatoid arthritis, artemisinin induces <i>L-</i>lactylation of pyruvate kinase M2 and inhibits the proliferation and migration of fibroblast-like synoviocytes. In tendinopathy, <i>L-</i>lactylation exerts regulatory effects in the aspects of extracellular matrix, immunity, nerves and blood vessels. In osteoporosis, <i>L-</i>lactylation affects osteogenic differentiation and bone resorption through regulatory axes such as Forkhead box F1, crystallin alpha B/ferritin heavy chain 1, and JunB, and interventions including LDHA regulation and scopolamine administration can promote osteogenic differentiation.</p><p><strong>Conclusion: </strong><i>L-</i>lactylation plays a dual regulatory role in orthopedic degenerative diseases, and its spatiotemporal dynamics and tissue specificity provide new opportunities for precise treatment. Although target specificity and clinical validation still face challenges, targeting <i>L-</i>lactylation modification is expected to become a new direction for disease-modifying therapy of orthopedic degenerative diseases.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1623-1634"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225022","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":"[Anterior cruciate ligament reconstruction with double-bundle artificial ligament based on four-dimensional impingement free mechanism: a comparative study with single-bundle reconstruction].","authors":"Sheng Li, Kaijia Yang, Weida Zhuang, Wei Lu","doi":"10.7507/1002-1892.202603058","DOIUrl":"10.7507/1002-1892.202603058","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the surgical method of anterior cruciate ligament (ACL) reconstruction with double-bundle artificial ligaments based on four-dimensional impingement free mechanism, and to compare its short-term effectiveness with traditional single-bundle reconstruction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed on the clinical data of 45 patients with complete ACL rupture who met the selection criteria and were treated between October 2022 and October 2025. Based on anatomical measurement results and surgical technique selection, patients were divided into a single-bundle reconstruction group (29 cases, receiving traditional over-the-top isometric single-bundle reconstruction) and a double-bundle reconstruction group [16 cases, receiving four-dimensional impingement free ACL double-bundle reconstruction (over-the-top anteromedial bundle+low posterolateral bundle)]. Baseline data-including age, injured side, cause of injury, concomitant meniscus injury, and preoperative Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner score-showed no significant difference between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05); however, the difference in gender distribution between the two groups was significant ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Operation time, complications, knee range of motion, and the results of the Lachman test, anterior drawer test, and pivot-shift test were recorded. Knee function was evaluated using the Lysholm, IKDC, and Tegner scores preoperatively and at last follow-up, and the proportion of patients returning to pre-injury sports activity levels was calculated. Postoperative three-dimensional CT was performed to evaluate bone tunnel placement and graft-to-tunnel congruence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Operations were successfully completed in both groups, with the operation time in the double-bundle reconstruction group being significantly longer than that in the single-bundle reconstruction group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). All patients were followed up 6-13 months, with an average of 8.5 months. Patients in both groups resumed immediate postoperative knee range of motion reached 0°-135°, and normal independent walking at 2 weeks postoperatively. At last follow-up, the Lachman test and anterior drawer test were negative in all patients; the pivot-shift test was negative in all cases in the double-bundle reconstruction group, whereas 3 cases (all grade Ⅰ) were positive in the single-bundle reconstruction group, with no significant difference in the positive rate of the pivot-shift test between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). At last follow-up, the proportion of patients returning to pre-injury sports activity levels was significantly higher in the double-bundle reconstruction group than in the single-bundle reconstruction group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Both the IKDC and Tegner scores showed significant improvement compared with preoperative values in the two groups ( &lt;i&gt;P&lt;/i&gt;&lt;0.05), wh","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1555-1562"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224948","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":"[Staged comprehensive limb reconstruction strategy and effectiveness analysis for severe open lower leg injury].","authors":"Lijun Yin, Zhijun Du, Weifeng Duan, Jiquan Liu, Zhiwei Zhao, Mingwu Zhou, Xiaofeng Li, Xinjiang Liu, Jingwei Zhang, Huijun Fan, Yongyao Lin, Yangyang Wen","doi":"10.7507/1002-1892.202605068","DOIUrl":"10.7507/1002-1892.202605068","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effectiveness and safety of a staged comprehensive limb reconstruction strategy for severe open lower leg injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed on clinical data of 10 patients with severe open lower leg injury accompanied by large segmental bone defects, extensive soft tissue destruction and neurovascular injuries treated between October 2020 and February 2025. There were 8 males and 2 females with an average age of 50.1 years (range, 18-65 years). The causes of injuries included traffic accident in 6 cases, falling from height in 1 case, and machine crush in 3 cases. The injuries were classified as Gustilo type ⅢB in 6 cases and type ⅢC in 7 cases. The size of tissue defect ranged from 7 cm×3 cm to 18 cm×15 cm. The interval between injury and admission ranged from 2 to 8 hours (mean, 4.6 hours). All patients received a three-stage sequential reconstruction protocol. In the emergency early stage, thorough debridement, neurovascular anastomosis, temporary external fixation combined with vacuum sealing drainage (VSD) were performed to rapidly control injury, restore limb perfusion, and stabilize the extremity. In the intermediate stage, precise debridement was conducted to manage wound infection, and soft tissue coverage was achieved via skin grafting and flap transplantation. In the final stage, Ilizarov circular external fixator was applied to implement bone transport, bone grafting, limb lengthening, as well as release and correction of foot and ankle deformities. Individualized rehabilitation training was administered to restore limb function. Perioperative complications, bone healing parameters, and limb length recovery were recorded. The Paley bone healing and functional scoring system was adopted to evaluate overall outcomes at last follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 10 patients successfully completed the staged treatment and were followed up. The follow-up time ranged from 13.1 to 37.0 months (mean, 20.6 months). Among the 10 patients, 9 patients achieved bone union after bone transport; 1 patient attained bone union following autologous iliac crest bone grafting. The duration of bone transport was 1.3-5.2 months (mean, 2.6 months). Three patients developed pin tract infections, which resolved after routine dressing change and symptomatic management. The time of bone union were 6.1-32.8 months (mean, 15.0 months). At last follow-up, the Paley evaluation showed excellent results in 7 cases, good in 2 cases, and fair in 1 case. All patients regained the ability of independent walking and weight-bearing of the affected limb. The residual limb shortening ranged from 0.4 to 1.8 cm, with a mean of 0.9 cm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The staged comprehensive limb reconstruction strategy for severe open lower leg injury enables sequential revascularization, soft tissue repair, bone defect reconstruction, and limb deformity correction. It ca","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 10","pages":"1524-1532"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225108","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}