Clinics in Orthopedic Surgery最新文献

{"title":"Correction: The Natural History of Kienböck's Disease Diagnosed at More Than 50 Years of Age.","authors":"Ji Sup Hwang, Bum Jin Shim, Qingyuan Li, Jihyeung Kim, Goo Hyun Baek","doi":"10.4055/cios22022corr","DOIUrl":"10.4055/cios22022corr","url":null,"abstract":"<p><p>[This corrects the article on p. 450 in vol. 14, PMID: 36061838.].</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"358"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"En Bloc Resection of Thoracic and Upper Lumbar Spinal Tumors Using a Novel Rotation-Reversion Technique through Posterior-Only Approach.","authors":"Ming Lu, Changhe Hou, Wei Chen, Zixiong Lei, Shuangwu Dai, Shaohua Du, Qinglin Jin, Dadi Jin, Haomiao Li","doi":"10.4055/cios24377","DOIUrl":"10.4055/cios24377","url":null,"abstract":"<p><strong>Background: </strong>En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy.</p><p><strong>Methods: </strong>Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed.</p><p><strong>Results: </strong>Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6-74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm. The mean operation time and blood loss were 458.5 minutes (range, 220-880 minutes) and 3,146.2 mL (range, 1,000-6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery.</p><p><strong>Conclusions: </strong>The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"346-353"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Subscapularis Function Preserved after the Latarjet Procedure? A Quantitative Analysis Using Positron Emission Tomography.","authors":"Kazuho Aizawa, Nobuyuki Yamamoto, Jun Kawakami, Takayuki Muraki, Shoichi Watanuki, Kotaro Hiraoka, Manabu Tashiro, Toshimi Aizawa, Eiji Itoi","doi":"10.4055/cios24079","DOIUrl":"10.4055/cios24079","url":null,"abstract":"<p><strong>Backgroud: </strong>In the Latarjet procedure, the subscapularis is divided at the superior two-thirds junction. It has been believed that this subscapularis split approach resulted in better internal rotation strength rather than an L-shaped subscapularis tenotomy. However, there are few studies demonstrating the preserved function of the subscapularis after the Latarjet procedure. The aim of the present study was to clarify the subscapularis activity using positron emission tomography (PET) in patients after the Latarjet procedure.</p><p><strong>Methods: </strong>Six men who had undergone the Latarjet procedure were enrolled. The internal rotation exercise with elastic bands was performed with the arm at 0° and 90° of abduction. After the exercises, the patients had an intravenous injection of fluorine 18 fluorodeoxyglucose (¹⁸F FDG). Each PET image was fused to the corresponding computed tomography image to calculate the standardized uptake value (SUV). The internal rotation muscle strength was measured by a dynamometer.</p><p><strong>Results: </strong>At 0° of abduction, the subscapularis SUVs of the involved side were significantly lower than those of the uninvolved side (<i>p</i> = 0.010), although there was no significant difference at 90° of abduction. The SUVs of the involved subscapularis were significantly lower at 0° of abduction than at 90° (<i>p</i> = 0.034). The internal rotation strength of the involved side was 81.1% ± 12.1% of the uninvolved side at 0° of abduction.</p><p><strong>Conclusions: </strong>After the Latarjet procedure with the subscapularis split approach, subscapularis activity was well preserved at 90° of abduction. However, internal rotation strength was reduced by 19%.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"274-282"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia.","authors":"Sung Min Rhee, Soo Young Kim, Cheol Hwan Kim, Kantanavar Radhakrishna, Divyanshu Dutt Dwivedi, Se Yeon Kim, Hyun Joo Ham, Yong Girl Rhee","doi":"10.4055/cios24084","DOIUrl":"10.4055/cios24084","url":null,"abstract":"<p><strong>Backgroud: </strong>This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).</p><p><strong>Methods: </strong>Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65-95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale-revised-98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.</p><p><strong>Results: </strong>Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (<i>p</i> < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (<i>p</i> = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (<i>p</i> = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (Δ) from the preoperative baseline scores to the postoperative values, the ΔDRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (<i>p</i> = 0.014).</p><p><strong>Conclusions: </strong>IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"283-290"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipohemarthrosis of the Hip Joint in Apparently Isolated Greater Trochanter Fractures.","authors":"Hee Joong Kim, Kyungpyo Nam, Jeong Joon Yoo, Hong Seok Kim","doi":"10.4055/cios24358","DOIUrl":"10.4055/cios24358","url":null,"abstract":"<p><strong>Backgroud: </strong>Lipohemarthrosis in the hip joint, a critical indicator for detecting occult femoral neck or acetabular fractures, has not been reported in cases of isolated greater trochanter (IGT) fractures. This study retrospectively reviewed 3-dimensional computed tomography (3D-CT) images of what appeared to be IGT fractures to find out the frequency of lipohemarthrosis and its implication for the necessity of internal fixation.</p><p><strong>Methods: </strong>From October 2004 to December 2019, 90 cases of suspected IGT fractures were evaluated using 3D-CT. After excluding 6 cases due to inadequate follow-up and 8 cases with poor imaging quality caused by metallic implants, 76 cases were included in the final analysis. The cohort consisted of 48 women and 28 men, with a mean age of 77 years (range, 39-97 years). The 3D-CT images were meticulously reviewed to identify lipohemarthrosis in the affected hip joints. Additionally, magnetic resonance (MR) images were available for 13 cases.</p><p><strong>Results: </strong>Sixty-three cases were IGT fractures; no cortical disruption was detected in the intertrochanteric area on CT images. Of these, 56 cases were successfully treated conservatively. Lipohemarthrosis was detected in 5 cases (7.9%), of which 2 were successfully managed with conservative treatment. The remaining 13 cases were classified as incomplete intertrochanteric fractures, with anterior cortical disruption identified in the intertrochanteric area on CT images. Lipohemarthrosis was observed in 3 of these cases (21.3%). In all cases evaluated with MR imaging (10 IGT fractures and 3 incomplete intertrochanteric fractures), varying degrees of intramedullary intertrochanteric extension were observed. Among these, lipohemarthrosis was detected in only 2 cases of IGT fracture, where the intramedullary extension did not cross the midline on mid-coronal images. One case was surgically fixed, but the other case was treated conservatively with success. Notably, 4 cases with intertrochanteric extension crossing the midline did not exhibit lipohemarthrosis.</p><p><strong>Conclusions: </strong>Lipohemarthrosis was more frequently observed in incomplete intertrochanteric fractures than in IGT fractures. However, the presence of lipohemarthrosis alone should not be regarded as an indication for internal fixation.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"223-227"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 3-Dimensional Correction and Clinical Outcomes of Lenke 1A Curves with the Stable Vertebra (SV) or SV-1 Selected as the Lowest Instrumented Vertebra.","authors":"Ismail Emre Ketenci, Hakan Serhat Yanik","doi":"10.4055/cios23228","DOIUrl":"10.4055/cios23228","url":null,"abstract":"<p><strong>Backgroud: </strong>Lowest instrumented vertebra (LIV) selection is controversial in Lenke 1A curves. Alignment of the LIV in coronal, sagittal, and transverse planes is important for correction of overall scoliosis, as well as the alignment of uninstrumented lumbar curve. In this study, we aimed to evaluate the 3-dimensional correction and clinical outcomes of Lenke 1A curves, corrected with rod derotation (RD) maneuver, according to the LIV level.</p><p><strong>Methods: </strong>Prospectively collected data of 46 consecutive idiopathic scoliosis surgery patients with Lenke 1A scoliosis who had been treated with posterior instrumentation and fusion were retrospectively evaluated. Patients were divided into 2 groups according to the LIV level: stable vertebra (SV) group (25 patients) and 1 level proximal to SV (SV-1) group (21 patients). Patients were compared pre- and postoperatively according to radiographic and clinical outcomes. Measured parameters in coronal plane were Cobb angle of thoracic curve, shoulder balance, coronal balance, LIV translation, and LIV tilt; in sagittal plane, thoracic kyphosis, lumbar lordosis, sagittal balance, and distal junctional angle. Transverse plane analysis included rotational measurement of apical vertebra (AV), LIV, and LIV+1 with computerized tomography. Clinical outcomes were evaluated with Scoliosis Research Society (SRS)-22 questionnaire. Surgical times were noted.</p><p><strong>Results: </strong>There were no statistically significant differences between the 2 groups in terms of preoperative radiographic values. In both groups, Cobb angle of thoracic curve, shoulder balance, LIV translation, and LIV tilt improved significantly after the surgery. Postoperatively, AV rotation decreased in both groups significantly. No significant change was observed in rotations of LIV and LIV+1 after the surgery. Clinical outcomes and surgical times were similar between the groups.</p><p><strong>Conclusions: </strong>Selection of the LIV as SV or SV-1 in Lenke 1A patients led to similar results in terms of coronal and sagittal plane reconstruction, as well as AV and LIV rotation. With RD maneuver, an acceptable amount of rotation could be achieved at LIV and LIV+1. Radiologic and functional outcomes were satisfactory in both LIV levels. To save 1 more mobile segment, it seems reasonable to select SV-1 as the LIV if possible in order to obtain a well-aligned LIV in all 3 planes.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"250-257"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Outcomes of Suspension Arthroplasty with Dermal Allograft Interposition after Trapeziectomy: Comparison with Ligament Reconstruction and Interposition Using the Flexor Carpi Radialis Tendon.","authors":"Shin Woo Choi, Joo-Yul Bae, Hyun June Lee, Ha Sung Park, Yun Jae Kim, Jae Kwang Kim","doi":"10.4055/cios24034","DOIUrl":"10.4055/cios24034","url":null,"abstract":"<p><strong>Background: </strong>Trapeziectomy with suspension arthroplasty is a reliable treatment for thumb carpometacarpal (CMC) osteoarthritis. We modified the suture suspension technique to add further support to maintain the arthroplasty space by interposition of the dermal allograft. Our aim was to investigate the surgical outcomes of our technique of suspension arthroplasty with dermal allograft interposition (SADI) compared with those of traditional ligament reconstruction with tendon interposition (LRTI) using a half-sling of the flexor carpi radialis (FCR) tendon.</p><p><strong>Methods: </strong>This retrospective study enrolled 26 patients (29 thumbs) with thumb CMC arthritis who underwent trapeziectomy with traditional LRTI using the FCR tendon (15 thumbs; LRTI group) or SADI (14 thumbs; SADI group) between January 2017 and May 2022. Patient-reported outcomes (visual analog scale; the Disabilities of the Arm, Shoulder and Hand score; and patient-rated wrist evaluation), grip strength, and scaphometacarpal distance were measured at baseline and 3 and 12 months postoperatively. The operation time was checked by reviewing medical records. All measurements were compared between the 2 groups.</p><p><strong>Results: </strong>Between baseline and 12-month postoperative follow-up, all patient-reported outcomes significantly improved in both groups. Patient-reported outcomes, grip strength, and scaphometacarpal distance showed no differences between the 2 groups at all follow-up assessments, except for the scaphometacarpal distance being significantly greater in the SADI group at 3 months postoperatively. The operation time was significantly shorter in the SADI group. No complication was observed in either group.</p><p><strong>Conclusions: </strong>Our modified suture suspension arthroplasty technique using dermal allograft interposition results in markedly shorter surgical times with similar surgical outcomes compared with those of traditional LRTI using the FCR tendon. This procedure appears to be an effective alternative treatment for thumb CMC arthritis.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"317-323"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenge of Trans-Ulnar Basal Coronoid Fracture-Dislocations: A Surgical Strategy Based on the Pattern of Coronoid Fracture.","authors":"Hyoung-Seok Jung, Hyun-Cheul Nam, Min Su Chu, Jae-Sung Lee","doi":"10.4055/cios24169","DOIUrl":"10.4055/cios24169","url":null,"abstract":"<p><strong>Backgroud: </strong>The rarity and complexity of trans-ulnar basal coronoid fracture-dislocations pose significant challenges in treatment. This study aimed to categorize these fractures based on coronoid fracture patterns and propose tailored surgical approaches for each type. Additionally, we evaluated the functional and radiological outcomes among the patients managed using our treatment algorithm.</p><p><strong>Methods: </strong>A total of 19 patients who underwent open reduction and internal fixation for trans-ulnar basal coronoid fracture-dislocations between March 2018 and October 2022 were enrolled in this study. These patients were classified based on the coronoid fracture patterns associated with olecranon fractures: type 1 involved anteromedial facet (AMF) fractures, type 2 encompassed coronoid base and body fractures, and type 3 involved a combination of types 1 and 2. We made a midline longitudinal dorsal incision to facilitate the provisional fixation of the olecranon fragment to the distal metaphysis using a locking plate. Subsequently, we employed the over-the-top (type 1) and Taylor-Scham (type 3) approaches for direct coronoid process fixation with buttress plating. Type 2 fractures were approached via medial fascial exposure from the posterior ulnar cortex or through the olecranon fractures, and subsequently fixed with miniplates and screws. Bony union and joint articulation were assessed via plain radiographs, and functional outcomes were evaluated using range of motion and the Mayo Elbow Performance Score.</p><p><strong>Results: </strong>Among the 19 patients, 3 had type 1 fractures, 14 had type 2 fractures, and 2 had type 3 fractures. All fractures exhibited solid osseous union without subluxation or dislocation. The average flexion and extension arc was 119.47° ± 20.88°, with a mean flexion of 127.37° ± 13.37° and an average flexion contracture of 7.89° ± 10.04°. The average Mayo Elbow Performance Score was 82.63 ± 12.51 points. Qualitatively, patient outcomes were excellent in 5 patients, good in 9, and fair in 5.</p><p><strong>Conclusions: </strong>Most of our patients presented with easily approachable coronoid base and body fractures. However, in AMF fractures of the coronoid process, a direct medial approach is required for buttress plating. We believe our study helps provide useful guidelines for making appropriate decisions in trans-ulnar basal coronoid fracture-dislocations.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"300-307"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Severe Bowing in Bisphosphonate-Related Atypical Femoral Fracture.","authors":"Jung-Wee Park, Young-Kyun Lee, Young-Seung Ko, Seong-Eun Byun, Young-Ho Cho, Kyung-Hoi Koo","doi":"10.4055/cios24103","DOIUrl":"10.4055/cios24103","url":null,"abstract":"<p><strong>Backgroud: </strong>Long-term use of bisphosphonate is a risk factor for atypical femoral fractures (AFFs). Femoral bowing is known to be associated with AFFs. However, whether femoral bowing quickens the occurrence of AFF is unknown. The purpose of this study was to determine whether AFF occurs earlier in patients with severe femoral bowing than in those without severe bowing.</p><p><strong>Methods: </strong>One hundred and sixty-four patients (186 AFFs) from January 2006 to December 2022 were included in this study. According to severity of femoral bowing, patients were divided into 2 groups: severe bowing group (26 femurs) and minimal to moderate bowing group (160 femurs). Age, sex, and completeness and location of AFF were compared between the 2 groups. We compared the time of AFF occurrence after bisphosphonate therapy using cumulative percentage between the 2 groups.</p><p><strong>Results: </strong>Age and sex were similar between the 2 groups, while body mass index (BMI) was lower (22.5 ± 3.0 kg/m² vs. 24.5 ± 3.5 kg/m², <i>p</i> = 0.003) in the severe bowing group. The duration of bisphosphonate use was shorter in the severe bowing group than in the minimal to moderate bowing group (3.3 ± 3.8 years vs. 5.0 ± 4.0 years, <i>p</i> = 0.048). In the severe bowing group, 85% of AFFs were diaphyseal in contrast to the 46% in the minimal to moderate bowing group (<i>p</i> < 0.001). Cumulative percentage plot of AFFs in the severe bowing group was left-shifted compared to the minimal to moderate bowing group.</p><p><strong>Conclusions: </strong>At the time of AFF diagnosis, the severe bowing group exhibited shorter duration of bisphosphonate use, lower BMI, and a higher incidence of diaphyseal location. Shortening the duration of bisphosphonate therapy may be advisable in patients with severe femoral bowing.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"216-222"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study on the Effects of Repeated Subacromial Injections of Parecoxib and Triamcinolone in a Rat Model of Normal Rotator Cuff.","authors":"Jong Pil Yoon, Dong Hyun Kim, Sung-Jin Park, Yoon Seong Choi, Hyun Joo Lee, Seok Won Chung, Kang-San Lee, Jeoung Wook Lee","doi":"10.4055/cios23417","DOIUrl":"10.4055/cios23417","url":null,"abstract":"<p><strong>Backgroud: </strong>This study aimed to investigate changes after repeated subacromial drug injections in a rat model of normal rotator cuff.</p><p><strong>Methods: </strong>Thirty-nine male Sprague-Dawley rats were divided into groups 1 (no injection, n = 3), 2 (parecoxib, n = 18; 6 subgroups, n = 3 each; 0.5 mg/kg), and 3 (triamcinolone, n = 18; 6 subgroups, n = 3 each; 0.3 mg/kg). Groups 2 and 3 received subacromial injections 1-6 times once weekly for 6 weeks. The supraspinatus and infraspinatus tendons and muscles were used for biomechanical and histological evaluation. The subacromial bursa was used to analyze the prostaglandin E2 (PEG2) level.</p><p><strong>Results: </strong>In the biomechanical test, load-to-failure and ultimate stress decreased in groups 2 and 3 with repeated injections and the values were significantly lower in group 3 than in group 1 only at the sixth injection (<i>p</i> = 0.007 and <i>p</i> = 0.008, respectively). On the Bonar score, the cellularity, ground substance, and total score were significantly different among the 3 groups at the fifth and sixth injections (cellularity: <i>p</i> = 0.028 and <i>p</i> = 0.033, ground substance: <i>p</i> = 0.018 and <i>p</i> = 0.006, and total score: <i>p</i> = 0.029 and <i>p</i> = 0.027, respectively). The myocyte cross-sectional area of the infraspinatus muscle showed a significant difference among the 3 groups at the third and fourth injections (<i>p</i> = 0.031 and <i>p</i> = 0.020, respectively). The PEG2 level in the subacromial bursa was significantly different among the 3 groups at the third, fifth, and sixth injections (<i>p</i> = 0.019, <i>p</i> = 0.004, and <i>p</i> = 0.004, respectively).</p><p><strong>Conclusions: </strong>In the rat model of normal rotator cuff, repeated local injections of the cyclooxygenase-2 inhibitor showed fewer negative effects on the biomechanical and histological properties of the normal tendon than triamcinolone.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"17 2","pages":"291-299"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}