SICOT-J最新文献

{"title":"Cybersecurity is imperative in robotic arthroplasty.","authors":"Vaibhav Bagaria, Raju Vaishya, Abhishek Vaish, Sébastien Lustig","doi":"10.1051/sicotj/2026019","DOIUrl":"10.1051/sicotj/2026019","url":null,"abstract":"<p><p>Robotic platforms have revolutionized arthroplasty through precision and patient-specific planning, yet introduce cyber-physical vulnerabilities in interconnected surgical ecosystems. Recent incidents, including the 2026 cyber-attack, highlight operational risks despite low direct intraoperative threats. Proactive cybersecurity, via FDA-aligned secure design, institutional audits, and surgeon vigilance, is imperative to safeguard patient safety and trust in precision orthopedics.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"E3"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844204","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":"Midcarpal tenodeses versus partial arthrodeses for stage II SLAC/SNAC wrists: Long-term outcomes from a single-surgeon comparative series.","authors":"Spyridon Maris, Emmanouil Apergis, Alexandros Apostolopoulos, Dimitra Melissaridou, Panagiotis Koulouvaris, Panayiotis J Papagelopoulos, Olga Savvidou","doi":"10.1051/sicotj/2025069","DOIUrl":"10.1051/sicotj/2025069","url":null,"abstract":"<p><strong>Background: </strong>Stage II scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) are commonly treated with partial arthrodeses or motion-preserving techniques such as midcarpal tenodeses. Comparative evidence with long-term follow-up remains limited.</p><p><strong>Purpose: </strong>To compare long-term clinical and functional outcomes of midcarpal tenodeses and partial arthrodeses in patients with stage II SLAC/SNAC, by evaluating grip strength, range of motion, patient-reported outcomes, and reoperation rates.</p><p><strong>Methods: </strong>A retrospective review was performed on 21 patients operated by a single surgeon with a mean follow-up of 103 months. Nine underwent midcarpal tenodeses (FCR or ECRB based), and twelve underwent partial arthrodeses (four-corner fusion or capitolunate fusion). Outcomes included grip strength, range of motion, radiographs, and PROMs (VAS, DASH, PRWE, Mayo Wrist Score).</p><p><strong>Results: </strong>Both procedures produced comparable long-term outcomes. Mean postoperative grip strength was 27.9 kg (~75% of the contralateral side). PROMs were similar between groups (DASH 12.1, PRWE 15.5). Importantly, no complications, non-unions, or conversions to salvage arthrodesis occurred in either group during long-term follow-up.</p><p><strong>Conclusion: </strong>Midcarpal tenodeses and partial arthrodeses yield similarly durable outcomes in stage II SLAC/SNAC wrists. Tenodeses preserve motion and are suitable for patients with preserved cartilage, whereas partial arthrodeses offer predictable stability when midcarpal degeneration is present. Treatment should be individualized according to cartilage status, functional demands, and patient expectations.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"9"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272541","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":"Direction of screw insertion for internal fixation plate in distal femoral osteotomy: Evaluation using axial computer tomography imaging.","authors":"Fumiyoshi Kawashima, Ryuichi Nakamura, Akira Okano, Kaori Matsumoto, Jun Oike, Koji Kanzaki","doi":"10.1051/sicotj/2025066","DOIUrl":"10.1051/sicotj/2025066","url":null,"abstract":"<p><strong>Purpose: </strong>In distal femoral osteotomy (DFO), using longer distal screws in fixation plates may improve stability. This study examined the insertion direction of three distal screws at the horizontal cross-section to determine if posterior angulation enables deeper placement.</p><p><strong>Methods: </strong>Forty-seven varus knees that underwent DFO were included (medial closed-wedge DFO [MCWDFO], 30 knees; lateral closed-wedge DFO [LCWDFO], 17 knees). Postoperative plain CT images were obtained from a plane parallel to the three distal screws, with the most distal screw designated as A, the anterior of the second distal row as B, and the posterior of the second distal row as C. For each case, a curve passing through the center of the bony cortex on the cross-section parallel to each screw and over its entire length was drawn, and the curve and the lower edge of the screw were projected onto a graph. The maximum angle at which the lower edge of each screw touches the intercondylar region without interfering with the intercondylar region was designated as (AnA), (AnB), and (AnC) for A-, B-, and C-screws, respectively. The angle between the line connecting the insertion points of the B- and C-screws on the plate and the tangent line to the medial and lateral bony cortex was designated as (AnP).</p><p><strong>Results: </strong>In the MCWDFO group, the mean values for each parameter were AnA, 10.9 ± 5.4; AnB, 27.0 ± 4.2; AnC, 9.2 ± 3.4; and AnP, -2.6 ± 6.9. In the LCWDFO group, the mean values for each parameter were AnA, 18.2 ± 6.9; AnB, 30.4 ± 7.1; AnC, 16.1 ± 7.2; AnP, -0.2 ± 6.1°.</p><p><strong>Conclusions: </strong>The medial surface is inclined compared to the epicondylar axis and posterior condyle, usually resulting in plate positioning that is parallel to the placement surface. The optimal screw insertion from the anterior to posterior was generally achieved; however, there was still room for posterior angulation margins of 9-11° for A- and C-screws and approximately 27° for the B-screw. In contrast, the lateral surface is flatter with less inclination, causing anterior plate placement and wider posterior angulation - approximately 16-18° for A- and C-screws and 30° for the B-screw - allowing a greater range of posterior swing than the medial side.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"3"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067721","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":"A systematic review of radiological outcomes and implant positioning in robotic-assisted functionally aligned robotic total knee arthroplasty.","authors":"Vasileios Giovanoulis, Angelo V Vasiliadis, Eleftherios Tsiridis, Luca Andriollo, Pietro Gregori, Konstantinos Dretakis, Christos Koutserimpas, Sébastien Lustig","doi":"10.1051/sicotj/2025068","DOIUrl":"10.1051/sicotj/2025068","url":null,"abstract":"<p><strong>Introduction: </strong>Functional alignment (FA) or functional knee positioning is a patient-specific strategy for total knee arthroplasty (TKA) that utilizes robotics to balance coronal, sagittal, and axial planes while preserving joint-line orientation and soft-tissue tension within predefined guardrails. Although early clinical outcomes are encouraging, the radiographic profile and workflow consistency of robotic FA have not been clearly synthesized.</p><p><strong>Methods: </strong>In accordance with PRISMA guidelines, English-language studies of primary robotic FA-TKA with ≥2-year follow-up were searched. Eligible designs included RCTs, prospective/retrospective cohorts, and large case series (≥50 patients). Information on pre- and postoperative coronal alignment [hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA)], component positioning (femoral valgus/rotation/flexion; tibial varus/rotation/slope), and explicit FA workflow boundaries (guardrails) was extracted.</p><p><strong>Results: </strong>Twenty-one cohorts (5,360 knees) reported at least one radiographic or workflow endpoint. Preoperatively, the predominant deformity was varus. Postoperatively, limb alignment converged near neutral: HKA clustered around 178-179.5°, with LDFA ~89-91° and MPTA ~87-89°. Component positions were tightly distributed within FA targets: femoral valgus ≈ 0.5-1.5°, tibial varus ≈ ~3°, femoral flexion ~6-9°, and tibial slope ~0-3°; tibial rotation was overwhelmingly referenced to Akagi's line, and femoral rotation to the TEA in most series. Reported guardrails showed strong convergence: typical workflows included femoral valgus -3° to +6°, tibial varus 0-6°, tibial slope 0-3°, and femoral ER ~3-6° to TEA. Across cohorts, achieved radiographs closely tracked these limits, indicating high adherence and reproducibility. Most observational studies had a moderate risk of bias; the lone RCT was low risk.</p><p><strong>Discussion: </strong>Robotic FA-TKA delivers a radiographic profile with slight femoral valgus and modest tibial varus, while keeping components within narrow, pre-specified guardrails.</p><p><strong>Level of evidence: </strong>Level III, systematic review and meta-analysis.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"4"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067655","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":"No dislocation rate gap between single and two-stage revisions with a cementless Dual Mobility Cup.","authors":"Justine Bidard, Nory Elhadjene, Nicolas Zadel, Thomas Neri, Frédéric Farizon, Bertrand Boyer","doi":"10.1051/sicotj/2025033","DOIUrl":"10.1051/sicotj/2025033","url":null,"abstract":"<p><strong>Introduction: </strong>A major complication of hip arthroplasty is dislocation. In revision, the rate of dislocation is even higher, especially among patients with hip prosthetic joint infection treated with two-stage surgery. The utility of a dual-mobility cup (DMC) in revision was already demonstrated but with a relatively low level of confidence due to the lack of direct comparison with other surgical techniques. We hypothesized that the dislocation rate for patients undergoing cementless DMC total hip arthroplasty (THA) would be similar between single and two-stage revisions.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective, and case-control study from January 2011 through December 2020. During this period, 220 patients underwent a revision of their total hip arthroplasty. Among these, 40 patients experienced THA two-stage revision. This group constituted the cases in this case-control study. Each of the 40 cases was matched with 2 controls, single-stage surgery, on age, sex, and Paprosky grade, and we defined the groups according to primary endpoint: dislocation rate.</p><p><strong>Results: </strong>There was no significant difference in dislocation rate between two-stage and single-stage revisions (7.5% vs 3.8%, p = 0.40). In univariate analysis, auto-inflammatory disease and immunosuppressive agent use were risk factors for dislocation. There was no significant difference in dislocation-free survival (log-rank test, p = 0.40) or re-revision (log-rank test, p = 0.92) between single-stage and two-stage revision THA. At the end of follow-up, the mortality rate did not differ between the two groups. No chronic instability was noted at the last follow-up (80.4 ± 38.5 months) in both groups.</p><p><strong>Conclusion: </strong>The dislocation rate was similar between single and two-stage revision THA using DMC. Further studies are warranted to highlight the potential benefits of DMC in preventing dislocation in two-stage revision THA.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"11"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366474","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 driving higher opioid use after total hip arthroplasty: Insights from a large-scale, tertiary centre analysis.","authors":"Andreas Fontalis, Shannon Tse, Mads K Hansen, Adam T Yasen, Crystallynn S The, Isabella Catrina Haddad, Warran Wignadasan, Ricci Plastow, Fares S Haddad","doi":"10.1051/sicotj/2025064","DOIUrl":"10.1051/sicotj/2025064","url":null,"abstract":"<p><strong>Introduction: </strong>Effective postoperative pain management is imperative in total hip arthroplasty (THA) to enable early mobilization and accelerate recovery pathways. This study investigated the patterns of inpatient opioid consumption following THA and identified the factors associated with increased opioid usage.</p><p><strong>Methods: </strong>In this large-scale, single-institution study, we analyzed data from 1,867 primary THAs between April 2019 and July 2023. We collected data on demographics, length of stay (LOS), type of anaesthesia, Post Anaesthesia Care Unit (PACU) admissions, 30-day readmissions, total opioid consumption (MME; morphine milligram equivalents), implant fixation techniques, surgical characteristics and pre- and postoperative haemoglobin (Hb) levels. Factors associated with increased opioid consumption (patients in the ≥ 75th percentile of inpatient opioid consumption; MME ≥ 211.9 mg) were identified through univariate and multivariate logistic regression models.</p><p><strong>Results: </strong>The cohort included 1150 women (61.6%) and 717 men (38.4%). The median inpatient opioid use was 88 mg (IQR = 39.3-211.9). In the univariate model, significant predictors included age, American Society of Anaesthesiologists (ASA) score, manual THA technique, general anaesthesia, pre- and postoperative Hb levels, need for PACU admission and year of surgery. After adjusting for baseline demographics in the hierarchical multivariate logistic regression model, significant predictors of higher opioid utilization were age (OR 0.989 [95% CI 0.981-0.997], p = 0.01), general anaesthesia (OR 2.386 [95% CI 1.865-3.054], p < 0.001), PACU admission (OR 2.098 [95% CI 1.310-3.358], p = 0.002), ASA score (OR 1.492 [95% CI 1.193-1.866], p < 0.001), postoperative Hb levels (OR 0.981 [95% CI 0.970-0.992], p < 0.001), and year of surgery (OR 0.638 [95% CI 0.579-0.703], p < 0.001) indicating that later years were associated with lower odds of high opioid consumption).</p><p><strong>Discussion: </strong>Younger age, higher ASA scores, lower postoperative haemoglobin, the need for PACU admission and general anaesthesia were significantly associated with increased opioid consumption following THA. Recognizing these factors can facilitate the development of tailored postoperative pain management protocols, enabling targeted interventions that minimize opioid reliance while enhancing recovery.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"6"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114570","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":"Osteonecrosis in sickle cell disease: Contemporary orthopaedic practice and outcomes across African healthcare settings.","authors":"Emmanuel Olusola Oladeji, Oluwatobi Olayode, Abdulahi Zubair, Vernon Ipomai, Oluwafemi Olayinka, Patrick Okonkwo, Onyeka Omerenma, Gregory Okhifun, Oghofori Obakponovwe","doi":"10.1051/sicotj/2026008","DOIUrl":"10.1051/sicotj/2026008","url":null,"abstract":"<p><strong>Background: </strong>Osteonecrosis is a disabling complication of sickle cell disease (SCD), with a disproportionate burden in Africa, where healthcare resources are limited. Despite this, the region remains underrepresented in the literature on SCD-related osteonecrosis. This scoping review synthesises current evidence on the epidemiology, management practices, and outcomes of SCD-related osteonecrosis in African healthcare settings.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, we systematically searched MEDLINE, Embase, Web of Science, Google Scholar, and African Journals Online through February 2025. Eligible studies reported clinical features, management, or outcomes of osteonecrosis in SCD patients in Africa. Data on demographics, staging, imaging, treatment modalities, and outcomes were narratively synthesised.</p><p><strong>Results: </strong>Thirty-two studies involving 779 patients met the inclusion criteria. Most were small, descriptive case series. Patients typically presented late: 85% at Ficat stage III-IV, with delays exceeding 20 years in some cases. The femoral head was affected in 98% of cases. Diagnosis relied almost exclusively on radiographs, with MRI reported in only 6% of studies. Conservative management, mainly traction and immobilisation, showed benefit in paediatric early-stage cases but was largely ineffective in adults. Joint-preserving surgeries were rarely reported but included core decompression and vascularised grafting with variable success. Arthroplasty predominated, yielding functional improvement but was technically demanding and prone to complications, particularly in SS genotype patients.</p><p><strong>Conclusion: </strong>Late presentation, diagnostic limitations, and reliance on salvage arthroplasty mark SCD-related osteonecrosis in Africa. Strengthening early detection, expanding capacity for joint-preserving interventions, and generating robust regionally relevant evidence are critical to improving outcomes in this high-burden, resource-constrained setting.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"13"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13059667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634818","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":"Corrigendum to: Historically, did Cemented Thompson perform better than uncemented Austin Moore hemiarthroplasty for femoral neck fractures? A meta-analysis of available evidence.","authors":"Mohamed S A Shehata, Ahmed Abdelal, Sami Salahia, Hussien Ahmed, Muhammad Shawqi, Ahmed Elsehili, Mahmoud Morsi, Ahmed M Afifi, Nardeen Kader, Florian Grubhofer, Asser Sallam, Mohamed Imam","doi":"10.1051/sicotj/2026013","DOIUrl":"10.1051/sicotj/2026013","url":null,"abstract":"","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"16"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692859","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":"Implant survival and factors associated with failure of cemented custom-made distal femoral megaprostheses after tumor resection.","authors":"Vasileios Apostolopoulos, Michal Mahdal, Marián Kubíček, Lukáš Pazourek, Petr Boháč, Luboš Nachtnebl, Tomáš Tomáš","doi":"10.1051/sicotj/2026020","DOIUrl":"10.1051/sicotj/2026020","url":null,"abstract":"<p><strong>Background: </strong>Distal femoral megaprosthetic reconstruction is a standard limb-salvage procedure after tumor resection. This study aimed to evaluate implant survival and associated factors, the incidence of mechanical failure, and functional outcomes following reconstruction with cemented custom-made distal femoral megaprostheses.</p><p><strong>Methods: </strong>Fifty-seven patients who underwent distal femoral tumor resection followed by reconstruction with a cemented custom-made distal femoral megaprosthesis between 2010 and 2024 were retrospectively analyzed. Implant survival was evaluated using Kaplan-Meier analysis, and associations with outcomes were assessed using Cox proportional hazards and Fine-Gray competing-risk regression models. The analyzed risk factors included age, sex, resection length, stem diameter, fixation length, and functional score. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) score.</p><p><strong>Results: </strong>Implant survival remained above 60% at the latest follow-up, with survival rates of 100% at 12 months, 93.5% at 24 months, and 72.9% at 60 months. No clinical or implant-related geometric variables were significantly associated with implant survival. The cumulative incidence of mechanical failure was 7% at 48 months and approximately 15% at the latest follow-up, with no association between mechanical failure and resection length, stem diameter, or fixation length. Functional outcomes were favorable, with a mean MSTS score of 21.6 ± 3.9.</p><p><strong>Conclusion: </strong>Cemented custom-made distal femoral megaprostheses demonstrated satisfactory mid- to long-term survival following tumor resection. In this cohort, none of the evaluated variables were significantly associated with implant survival. The incidence of mechanical failure remained relatively low, and geometric implant parameters were not significantly associated with mechanical failure. Functional outcomes were favorable, with most patients achieving good or excellent MSTS scores.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"20"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785084","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":"Acupuncture vs usual care for chronic low back pain: a systematic review and meta-analysis of immediate and intermediate effects.","authors":"Spyridon Sotiropoulos, Eleftherios Kalafatis, Evaggelos Michalakakos, Andreas Mavrogenis, George Georgoudis","doi":"10.1051/sicotj/2025061","DOIUrl":"10.1051/sicotj/2025061","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic low back pain (CLBP) is a leading global cause of disability. Acupuncture is increasingly integrated into its management, yet its standalone effectiveness compared to usual care remains uncertain. This review aimed to assess the immediate (≤2 weeks) and intermediate (2 weeks-6 months) effects of acupuncture versus usual care on pain and disability in adults with CLBP.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials was conducted, searching MEDLINE, CENTRAL, Scopus, and PEDro through November 2024. Eligible studies compared acupuncture (body, electroacupuncture, scalp) to usual care (physiotherapy, education, medication, and exercise) in adults with CLBP. Outcomes included pain and disability at immediate and intermediate follow-up. Data were pooled using a random-effects model. Risk of bias was assessed with the PEDro scale, and GRADE was used to evaluate evidence certainty. Sensitivity and subgroup analyses were conducted to explore clinical and methodological heterogeneity and test the reliability of findings.</p><p><strong>Results: </strong>A total of 2.956 records were identified, and 8 RCTs (n = 1,123 participants) were included in this study. Acupuncture significantly reduced pain at both immediate (SMD = -0.73, 95% CI -1.04 to -0.42) and intermediate (SMD = -1.13, 95% CI -1.82 to -0.43) timepoints. Disability also improved at both follow-ups (immediate: SMD = -0.49, 95% CI -0.68 to -0.30 and intermediate: SMD = -0.79, 95% CI -1.18 to -0.41). Sensitivity analyses confirmed effect robustness, especially in electroacupuncture subgroups. Certainty of evidence ranged from low to very low due to risk of bias, inconsistency, and suspected publication bias.</p><p><strong>Discussion: </strong>Acupuncture appears more effective than usual care for reducing pain and disability in adults with CLBP, but the certainty of evidence is low, warranting cautious interpretation.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"7"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114583","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}