SICOT-J最新文献

{"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":2.4,"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":"Lateral parapatellar approach versus transpatellar splitting approach in intramedullary nailing of diaphyseal tibia fractures, a prospective randomized controlled study.","authors":"Amr Amal Amin, El Zaher Hassan El Zaher, Youssef Mohamed Abd-El Salam Wafa, Ahmed Mohamed Khaled El Ghazawy, Amr Mohamed Nagy","doi":"10.1051/sicotj/2026042","DOIUrl":"10.1051/sicotj/2026042","url":null,"abstract":"<p><strong>Background: </strong>Anterior knee pain (AKP) is a frequent complaint after tibial intramedullary nailing (IMN), and the choice of entry approach may contribute to its occurrence. This trial compared the lateral parapatellar semi-extended (LPP) approach versus the midline transpatellar splitting (MLTP) approach for IMN of closed diaphyseal tibial fractures, focusing on AKP and knee function.</p><p><strong>Methods: </strong>In this single-blinded randomized controlled trial, 50 adults with acute closed AO/OTA 42 tibial shaft fractures were allocated 1:1 to IMN performed through either the LPP or MLTP approach. Follow-up assessments were performed at 3 and 6 months after surgery. Primary outcomes were AKP during weight-bearing, quantified using a visual analog scale (VAS), and knee function measured by the Lysholm Knee Score.</p><p><strong>Results: </strong>LPP achieved higher Lysholm scores at 3 months (82.36 ± 5.2 vs. 75.76 ± 6.1; P < 0.001) and 6 months (87.32 ± 4.8 vs. 84.20 ± 5.4; P = 0.024), indicating superior early functional recovery. VAS AKP was lower with LPP at 3 months (2.40 ± 0.9 vs. 3.60 ± 1.2; P = 0.001), but similar by 6 months (1.80 ± 0.7 vs. 1.96 ± 0.8; P = 0.122), suggesting the benefit is mainly early. Operative time favored LPP (62.1 ± 8.7 vs. 68.4 ± 10.2 min; P = 0.02) with fewer fluoroscopy shots (29.2 ± 5.4 vs. 38.5 ± 6.1; P < 0.001). All fractures united; time to union was comparable (16.8 ± 2.4 vs. 16.2 ± 2.1 weeks; P = 0.41). Complications were minor in both groups.</p><p><strong>Conclusions: </strong>LPP semi-extended tibial IMN was associated with lower early AKP, better early knee function, and improved operative efficiency without compromising union during 6-month follow-up. A Longer follow-up is required to determine whether anterior knee pain and functional outcomes converge over time.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"39"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266536","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 external fixation and dorsal mini-plate fixation for a distal radius fracture with an overlying volar burn.","authors":"Takahiro Yamazaki, Yusuke Matsuura, Seiji Ohtori, Takane Suzuki","doi":"10.1051/sicotj/2026074","DOIUrl":"10.1051/sicotj/2026074","url":null,"abstract":"<p><p>Burns combined with fractures are uncommon and become particularly challenging when the burn overlies the surgical corridor. We report a 51-year-old woman with an intra-articular distal radius fracture and an overlying deep volar ulnar wrist burn (deep partial-thickness to full-thickness) after jumping from a second floor during a house fire. A spanning external fixator was applied through unburned skin on the day of injury while the burn was managed conservatively by plastic surgeons. Ten days later, definitive fixation was performed through an intact dorsal approach with articular reduction, bone substitute filling, and fragment-specific fixation using two low-profile 2.0-mm dorsal mini-plates; the extensor retinaculum was interposed at closure to reduce tendon irritation. Although intraoperative stress testing after plating showed no gross instability, the spanning fixator was retained for 4 weeks because construct rigidity was a concern and volar splinting would interfere with burn dressing care. At 14 months after injury (3 months after plate removal), the patient had good wrist motion, 80.3% grip strength versus the contralateral side, PRWE 16.5, and QuickDASH 20.5, without infection or pin-tract problems. Staged stabilization that avoids burned skin and uses a dorsal safe corridor may be a feasible option in selected patients while facilitating ongoing burn management.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"59"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128734","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":"Hemiepiphysiodesis with tension band plate in idiopathic genu valgum: Insights on indications, outcomes, and follow-up from a systematic review and meta-analysis of more than 600 cases.","authors":"Luca Bianco Prevot, Francesco Natoli, Domenico Curci, Eleonora Caboni, Laura Mangiavini, Fabio Verdoni","doi":"10.1051/sicotj/2026047","DOIUrl":"10.1051/sicotj/2026047","url":null,"abstract":"<p><strong>Aims: </strong>Hemiepiphysiodesis with tension band plates is widely used for the correction of idiopathic genu valgum in skeletally immature patients. Although widely adopted, considerable heterogeneity persists regarding indications, timing of intervention, and radiographic outcome assessment, limiting the development of standardized clinical pathways.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Studies reporting radiographic and clinical outcomes of hemiepiphysiodesis with tension band plates in idiopathic genu valgum were included. The study evaluates mechanical axis deviation (MAD), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA), indication for surgery, timing of implant removal, complications, and follow-up interval. The risk of bias and quality of evidence were assessed using Cochrane guidelines.</p><p><strong>Results: </strong>A total of 11 studies, including more than 600 treated knees, were analyzed. Hemiepiphysiodesis resulted in significant improvement in coronal plane alignment. MAD improved by a pooled mean difference of 12.4 mm (p = 0.002). mLDFA shoed a mean correction of 5.2° (p = 0.004), while MPTA improved by 3.6° (p = 0.01). The overall complication rate was low (6.8%), mainly related to transient implant-site irritation and mild rebound growth, with no permanent physeal damage reported.</p><p><strong>Conclusions: </strong>Hemiepiphysiodesis with tension band plates provides safe, predictable, and clinically meaningful correction of idiopathic genu valgum in skeletally immature patients, supporting its role as a first-line surgical option and highlighting the importance of standardized radiographic monitoring and follow-up strategies to optimize timing of implant removal and minimize the risk of over- or under-correction.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"62"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138666","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":2.4,"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":"Total calcanectomy in chronic osteomyelitis of calcaneus: A case report.","authors":"Kumar Shantanu Anand, Rakhee Anand, Gyan Ranjan","doi":"10.1051/sicotj/2026064","DOIUrl":"https://doi.org/10.1051/sicotj/2026064","url":null,"abstract":"<p><p>Chronic osteomyelitis of the calcaneus, although uncommon, is associated with substantial morbidity and remains one of the most challenging forms of chronic osteomyelitis to treat, causing significant patient morbidity. The condition is rather refractory to various treatment modalities and sometimes may necessitate below-knee amputation for complete eradication of infection. Total calcanectomy, in such a scenario, can be a limb salvage (foot salvage) procedure in carefully selected patients. Here we report a case of Cierny-Mader stage IV chronic osteomyelitis of the calcaneus treated by means of total calcanectomy and application of antibiotic (vancomycin and gentamicin) impregnated beads of synthetic absorbable calcium sulfate powder (STIMULAN, Biocomposites, UK), with a follow-up period of 6 years and 2 months - complete eradication of infection while preserving the weight-bearing functions of foot, has been successfully achieved. To our knowledge, this is among the first few reported cases of total calcanectomy combined with application of synthetic absorbable antibiotic-loaded calcium sulphate (STIMULAN) beads for chronic diffuse calcaneal osteomyelitis.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"70"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185271","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":"Saphenous nerve injury in ACL reconstruction: higher risk with dual hamstring harvest - an observational study.","authors":"Khayas Omer Kunheen, Vishnu Subramaniyan, Raju Karuppal, Sibin Surendran, Jijulal Cu, Ramesh Govindharaaju","doi":"10.1051/sicotj/2026051","DOIUrl":"10.1051/sicotj/2026051","url":null,"abstract":"<p><strong>Introduction: </strong>Injury to the saphenous nerve or its branches is one of the most common complications of Arthroscopic ACL reconstruction surgery. Among the various iatrogenic reasons for this injury, nerve injury during the passage of the tendon stripper (due to the anatomical proximity of the nerve to the tendons) has been reported already. This study compares the incidence of the saphenous nerve injury following isolated semitendinosus graft harvest versus combined semitendinosus and gracilis harvest during Arthroscopic ACL reconstruction.</p><p><strong>Methods: </strong>A prospective observational study of 120 patients, who had undergone arthroscopic ACL reconstruction with semitendinosus graft alone (60 patients) and semitendinosus + gracilis graft (60 patients) from April 2020 to September 2023 was conducted. A follow-up regarding the presence of sensory changes in the saphenous nerve distribution was done at six months.</p><p><strong>Results: </strong>28.3% (17/60) of patients in the semitendinosus group (group A) had sustained sensory disturbances compared to 53.3% (32/60) of patients in the semitendinosus + gracilis group (group B). This difference was found to be statistically significant. However, the nerve injury did not interfere with the daily activities of the majority of patients.</p><p><strong>Conclusions: </strong>The saphenous nerve is at a higher risk of injury during double hamstring graft harvesting. Surgeons may avoid resorting to double hamstring harvest whenever possible. Tripled or quadrupled semitendinosus is a viable option in most situations. Techniques like All inside ACLR with shorter graft lengths are worth considering in this context.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"72"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196778","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":"Palmar plating for displaced metacarpal neck fractures: A new technique.","authors":"Ahmed Naeem Atiyya, Moheeb Gadullah, Hamdy E Alnaggar, Khaled Nabil Youssef, Ahmed Gamal Nouh, Ahmed Morsi","doi":"10.1051/sicotj/2026037","DOIUrl":"10.1051/sicotj/2026037","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate fixation of metacarpal neck fractures using miniplates applied via a palmar approach as an alternative to conventional dorsal plating, which carries a higher complication rate.</p><p><strong>Methods: </strong>A prospective case series of 34 patients with acute unstable metacarpal neck fractures treated with palmar miniplating from 2018 to 2022.</p><p><strong>Results: </strong>The mean follow-up was 25.79 months (range, 22-36 months). All fractures united in a mean of 5.4 weeks. Grip strength averaged 96% ± 4.01%, and ROM averaged 93% ± 4.25% compared to the contralateral hand. Minor complications occurred in 11.76% of cases.</p><p><strong>Conclusion: </strong>In the short term, palmar miniplates for unstable metacarpal neck fractures result in excellent radiological and functional outcomes with minimal complications.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"75"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196585","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":"Risk-stratified association between dilute povidone-iodine lavage and SSI/PJI after primary total hip arthroplasty.","authors":"Daisuke Inoue, Tamon Kabata, Yu Yanagi, Musashi Ima, Takahiro Iyobe, Naoya Fujimaru, Keisuke Sano, Rin Maeda, Taisuke Yamamoto, Satoru Demura","doi":"10.1051/sicotj/2026054","DOIUrl":"10.1051/sicotj/2026054","url":null,"abstract":"<p><strong>Introduction: </strong>Unresolved issue remains regarding which patient populations benefit from diluted povidone-iodine (PI) irrigation for preventing surgical-site infection (SSI)/periprosthetic joint infection (PJI) after primary total hip arthroplasty (THA). We aimed to clarify the clinical effect of diluted PI lavage on SSI/PJI incidence in risk-stratified patients undergoing primary THA.</p><p><strong>Methods: </strong>This retrospective, single-center study included 1,128 patients with primary THA for osteoarthritis. We classified all enrolled patients into three groups according to the American Society of Anesthesiologists Physical Status (ASA-PS) 1, 2, and 3 groups. We compared the incidence rate of SSI/PJI between two subgroups in each group: patients who received diluted PI and those who did not. Odds ratios (ORs) for SSI/PJI were estimated for PI irrigation.</p><p><strong>Results: </strong>Eleven infections occurred overall (0.9%): five superficial SSIs (0.4%) and six early PJIs (0.5%). No infections occurred among patients in the ASA-PS 1 group. In the ASA-PS 2 group, eight SSI/PJI events were observed (0.8%), and in ASA-PS 3, three SSI/PJI events occurred (3.3%). In the ASA-PS 2 group, PI use was associated with a lower infection rate (P = 0.04), whereas no significant difference was detected in ASA-PS 3 (P = 0.55). OR revealed that diluted PI caused a significant reduction in SSI/PJI (OR, 0.23; P = 0.03) in the ASA-PS 2 group.</p><p><strong>Discussion: </strong>In this cohort, dilute PI lavage was associated with fewer SSI/PJI events among patients with ASA-PS class 2 who underwent primary THA; however, a clear benefit was not demonstrated in patients with ASA-PS class 3. Additional intraoperative measures may be required for higher-risk patients, such as those with ASA-PS class 3.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"12 ","pages":"73"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196712","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}