Clinics in Orthopedic Surgery最新文献

{"title":"Radiologic Outcomes of Plantar Plate Repair through a Plantar Approach for the Dislocated Metatarsophalangeal Joint of the Lesser Toe.","authors":"Chang Hyun Doh, Sunghoo Kim, Young-Rak Choi, Ho Seong Lee","doi":"10.4055/cios24046","DOIUrl":"https://doi.org/10.4055/cios24046","url":null,"abstract":"<p><strong>Background: </strong>A torn plantar plate (PP) is important pathologic anatomy related to a dislocated or subluxated metatarsophalangeal joint (MTPJ). Traditionally, a torn PP was treated with Weil osteotomy through a dorsal approach. However, because of the limited visualization of the dorsal approach, PP repair through a plantar approach has been proposed as a new technique. This study aimed to radiologically evaluate the outcome of PP repair through the plantar approach using an improved MTPJ overlap distance (MOD) on an anteroposterior view and the degree of subluxation on an oblique view. We also aimed to investigate the potential factors affecting the recurrence of MTPJ instability.</p><p><strong>Methods: </strong>In this study, we included 31 patients who had a subluxated or dislocated MTPJ of the second or third toe and underwent surgical PP repair. PP repair was performed via a plantar approach after shortening metatarsal (MT) osteotomy with a dorsal approach for longer MT bone. We assessed the severity of MTPJ subluxation by measuring the MOD and subluxation subtype on radiographs. Radiologic recurrence was defined as an increase in MOD or change from subluxation type A to subluxation type B. The relationship of recurrence with clinical and radiologic factors was evaluated by comparing the recurred group against the non-recurred group.</p><p><strong>Results: </strong>Shortening MT osteotomy was performed in 26 of 31 cases (84%). Repeated measures analysis of variance comparing preoperation, pin removal, and the latest follow-up MOD values revealed the effectiveness of PP repair through the plantar approach (<i>p</i> < 0.001). The MOD did not significantly change after pin removal and the latest follow-up (<i>p</i> = 0.130), indicating that reduction was well maintained. None of the clinical and radiologic factors were significantly related to recurrence. However, 3 of 12 rheumatoid arthritis (RA) feet (25%) recurred and 3 of 5 recurred cases (60%) were RA feet. This result suggests that RA indicated a tendency for recurrence.</p><p><strong>Conclusions: </strong>PP repair through the plantar approach has the advantage of excellent visualization of a torn PP and direct repair. We, therefore, recommend using the plantar approach for PP repair of the MTPJ.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"1001-1009"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773480","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 In-Shoe Pedobarographic Variables between 2 Orthoses during Toe and Heel Gaits.","authors":"Min Gyu Kyung, Hyun Seok Seo, Young Sik Yoon, Dae-Yoo Kim, Seung Min Lee, Dong Yeon Lee","doi":"10.4055/cios24106","DOIUrl":"https://doi.org/10.4055/cios24106","url":null,"abstract":"<p><strong>Background: </strong>The choice of an appropriate type of orthosis depends on the patient's specific condition and needs. Different types of orthoses can affect plantar pressure distribution during certain gait patterns. Toe and heel gaits are common patterns of gait assigned for optimal recovery in patients with foot or ankle injuries. This study aimed to evaluate differences in plantar pressure between postoperative shoes and walker boots during toe and heel gaits in healthy individuals.</p><p><strong>Methods: </strong>A total of 30 healthy individuals with a mean age of 21.7 ± 1.2 years were included in this study. Two types of gaits, toe and heel, were performed while wearing each orthosis on the right side of the foot. A standardized running shoe was worn on the left side of the foot. Plantar pressure variables including contact area, peak pressure, and maximum force were collected using the Pedar-X in-shoe pressure measuring system.</p><p><strong>Results: </strong>During toe gait, while both orthoses demonstrated similar offloading in the hindfoot areas, walker boots were superior in reducing the peak pressure (first toe, <i>p</i> = 0.003; second to fifth toes, <i>p</i> < 0.001) and contact area (first toe, <i>p</i> = 0.003; second to fifth toes, <i>p</i> = 0.003) in the forefoot areas. During heel gait, both orthoses demonstrated similar offloading in the toe areas; however, the walker boots were superior in reducing the peak pressure in the lateral hindfoot (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The results of our study can serve as a guideline for orthopedic physicians in prescribing an appropriate type of orthosis during specific types of gait for patients following foot and ankle injury and postoperative recovery.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"987-993"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773771","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":"Central Bone Mineral Density Is Not a Useful Tool to Predict Bone Strength of the Distal Femur for Cementless Total Knee Arthroplasty.","authors":"Dongwhan Suh, Dai-Soon Kwak, Yong Deok Kim, Seokjae Park, Nicole Cho, In Jun Koh","doi":"10.4055/cios24096","DOIUrl":"https://doi.org/10.4055/cios24096","url":null,"abstract":"<p><strong>Backgroud: </strong>The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee.</p><p><strong>Methods: </strong>This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed.</p><p><strong>Results: </strong>Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R² = 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA.</p><p><strong>Conclusions: </strong>Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"917-924"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773722","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":"Computed Tomography Versus Simple Radiography for Detecting and Classifying Heterotopic Ossification after Reverse Shoulder Arthroplasty.","authors":"Tae Kang Lim, Yun Sun Choi, Gu Min Jeong, Dong Kyun Kim, Myung-Sun Kim","doi":"10.4055/cios24071","DOIUrl":"https://doi.org/10.4055/cios24071","url":null,"abstract":"<p><strong>Backgroud: </strong>Heterotopic ossification (HO) is difficult to characterize and classify on simple radiographs. Therefore, we attempted to evaluate intraobserver and interobserver reliability of simple radiography and computed tomography (CT) for detecting and classifying HO after reverse shoulder arthroplasty (RSA). It was hypothesized that CT would provide more reliable results than simple radiography.</p><p><strong>Methods: </strong>This retrospective study reviewed 30 patients who underwent RSA performed by a single surgeon. Patients were included if they had both postoperative simple radiographs and CT images taken immediately after surgery and at 1 year after surgery and if they had completed clinical assessment at least 1 year after surgery. We first evaluated the intraobserver and interobserver reliability for the detection of the presence of HO and Modified Brooker's classification both on simple radiographs and CT scans with the use of Kappa statistics. Then, we analyzed the correlation of HO observed in simple radiographs and CT scans with clinical outcomes. All radiographic evaluations were performed by 2 independent reviewers in random orders with 3 weeks of intervals.</p><p><strong>Results: </strong>The intraobserver reliability outcomes of both reviewers in simple radiography and CT were almost perfect or perfect for the detection of HO and classification. However, CT images improved the interobserver reliability for the detection of HO (kappa value for simple radiographs [K_XR] = 0.6018 and kappa value for CT [K_CT] = 0.8316) and classification (K_XR = 0.5300 and K_CT = 0.6964). At a mean follow-up of 25 months (range, 12-54 months), clinical scores were not significantly different according to the presence of HO based on simple radiographs. However, when CT images were used, the University of California, Los Angeles score and physical component score of short-form 36-item health survey were significantly lower in patients with HO than in patients without HO (27.0 vs. 30.4, <i>p</i> = 0.045 and 57.6 vs. 70.7, <i>p</i> = 0.034, respectively).</p><p><strong>Conclusions: </strong>Both simple radiography and CT provided excellent intraobserver reliability for detecting and classifying HO after RSA. Compared to simple radiography, CT tended to improve interobserver reliability and defined the presence and severity of HO more clearly.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"962-970"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773782","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 Robot-Assisted Surgery on Clinical Outcomes in Patients with Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebral Augmentation: a Meta-Analysis and a Validation Cohort.","authors":"Haibo Li, Juan Zou, Jianlin Yu","doi":"10.4055/cios24086","DOIUrl":"10.4055/cios24086","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to investigate the impact of robot-assisted surgery (RA) on the risk of new vertebral compression fracture (NVCF) and bone cement leakage in patients with osteoporotic vertebral compression fractures (OVCF) after percutaneous vertebral augmentation (PVA), including percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP).</p><p><strong>Methods: </strong>A meta-analysis was performed to evaluate the clinical outcomes and adverse effects of RA-PVA versus fluoroscopy-assisted (FA)-PVA in patients with OVCF. A validation cohort of 385 patients who underwent PVP or PKP was retrospectively analyzed. In addition, we attempted to create well-calibrated nomograms to estimate the risk of NVCF and bone cement leakage.</p><p><strong>Results: </strong>The meta-analysis revealed that the incidence of NVCF and bone cement leakage was significantly lower in RA-PVA than in FA-PVA. The validation cohort confirmed that RA-PVA provided better results than FA-PVA in terms of NVCF and bone cement leakage.</p><p><strong>Conclusions: </strong>The meta-analysis and the validation cohort suggest that RA reduced the risk of NVCF and bone cement leakage in patients with OVCF after PVA. The nomograms are accurate and easy-to-implement methods for clinicians to estimate the risk of NVCF and bone cement leakage after PVA.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"948-961"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773710","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":"<i>Cutibacterium acnes</i> in Shoulder Surgery: Is It a Significant Risk Factor for Postoperative Infection?","authors":"Jong Pil Yoon, Kang-San Lee, Sung-Jin Park, Dong-Hyun Kim, Junsung Kim, Yoon Seong Choi, Hyun Joo Lee, Seok Won Chung","doi":"10.4055/cios23371","DOIUrl":"10.4055/cios23371","url":null,"abstract":"<p><p><i>Cutibacterium acnes</i>, a commensal, lipophilic, anaerobic Gram-positive bacterium, is well known for its potential to cause infections, particularly in the field of orthopedics, notably in the shoulder. However, its indolent strain nature presents challenges in the diagnosis of the bacterium using clinical, laboratory, and culture-based methods. There are controversies surrounding its actual threat as an infection-causing agent, leading to an incomplete consensus on treatment strategies after the infection. Furthermore, research is ongoing to explore preventive procedures before the onset of infection. This review aimed to comprehensively explore the diagnosis and treatment of <i>C. acnes</i> and determine whether it is a risk factor for shoulder joint infections.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"845-853"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773649","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":"Evolution and Hotspots in Bilateral Total Joint Arthroplasty Research: A Bibliometric Analysis.","authors":"Maroun Aoun, Ralph Chalhoub, Fong H Nham, Eliana Kassis, Mohammad Daher, Mouhanad M El-Othmani","doi":"10.4055/cios24114","DOIUrl":"10.4055/cios24114","url":null,"abstract":"<p><strong>Background: </strong>Total joint arthroplasty (TJA) is a potent treatment for degenerative joint disorders. Bilateral total joint arthroplasty (BTJA) encompasses both bilateral total knee arthroplasty (BTKA) and bilateral total hip arthroplasty (BTHA). Both BTKA and BTHA can be performed as either a simultaneous procedure or a staged procedure. The goal of this study was to investigate trends in BTJA research, including pertinent authors, journals, countries, and papers. We also evaluated frequent keywords and topics to predict potential future study fields.</p><p><strong>Methods: </strong>Articles published between 1982 and 2022 were retrieved from the Web of Science Core Collection of Clarivate Analytics. The search query included \"hip\" OR \"knee\" (Topic) AND \"arthroplasty\" OR \"replacement\" (Topic) AND \"bilateral\" OR \"simultaneous\" (Topic) AND 1992-2022 (Year published) AND Article (Document type). Metrics were imported for further analysis with Bibliometrix and VOSviewer.</p><p><strong>Results: </strong>A total of 736 articles associated with BTJA were retrieved, originating from 44 countries with the United States being the biggest contributor. Top institutions were Cornell University and Ewha Womans University. Kim YH was the most productive and impactful author. <i>The Journal of Arthroplasty</i> had the highest impact and the greatest number of articles and citations. Williams Russo had the most cited article. Co-occurrence visualizations highlighted predominant topics in the literature.</p><p><strong>Conclusions: </strong>Since 1982, there has been a growing interest in BTJA research. The United States institutions have been the primary providers in global scholarly production. This bibliometric analysis identified previous, present, and emergent tendencies in BTJA with the goal of forecasting new potential hotspots.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"880-889"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773716","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":"Outcomes of Surgical Treatment of Acetabular Fractures with a Minimum of 1-Year Follow-up.","authors":"Hyun-Chul Shon, Eic-Ju Lim, Jae-Young Yang, Chan-Hong Min","doi":"10.4055/cios23359","DOIUrl":"https://doi.org/10.4055/cios23359","url":null,"abstract":"<p><strong>Backgroud: </strong>Acetabular fractures are rare and challenging to treat, and the surgeon's learning curve for managing these fractures is steep. The incidence of acetabular fractures is low, making it difficult to conduct single-surgeon, single-center studies. Therefore, multi-surgeon and multi-center studies may produce inconsistent outcomes compared to those of single-surgeon, single-center studies. According to the authors' literature investigation, single-surgeon, single-center, large-scale studies on this topic are lacking. Thus, this study investigated the radiological and functional outcomes and prognostic factors in patients with displaced acetabular fractures treated by a single surgeon at a single center and followed up for at least 1 year.</p><p><strong>Methods: </strong>This retrospective study was conducted on 149 patients treated for acetabular fractures at Chungbuk national university hospital between January 2005 and December 2021. Demographic data, time to surgery, and complications were collected using medical records. The Judet and Letournel classification was confirmed using preoperative radiographs, and Matta's quality of reduction was confirmed using immediate postoperative radiographs. At the latest outpatient follow-up, Matta's radiological outcome grading and the modified Postel Merle d'Aubigné score were confirmed as radiological and functional outcomes, respectively.</p><p><strong>Results: </strong>The radiological outcome was excellent or good in 131 patients (87.9%) and fair or poor in 18 (12.1%) and influenced by age (<i>p</i> = 0.009), quality of reduction (<i>p</i> < 0.001), and the Judet and Letournel classification (<i>p</i> = 0.025). Functional outcome was excellent or good in 121 patients (81.2%) and fair or poor in 28 (18.8%); this was influenced by the quality of reduction (<i>p</i> < 0.001) and the Judet and Letournel classification (<i>p</i> = 0.030).</p><p><strong>Conclusions: </strong>Our radiological and functional outcomes of acetabular fractures were comparable with those of other single-surgeon, single-center studies regarding the follow-up period. Poor prognostic factors for radiological outcomes included age > 65 years, associated patterns, and poor quality of reduction. Associated patterns and poor quality of reduction were factors associated with poor functional outcomes.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"871-879"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773468","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":"Risk factors for Implant Failure in Thoracolumbar Fractures Treated with Posterior Long-Segment Instrumentation.","authors":"Han-Dong Lee, Nam-Su Chung, Je-Yoon Lee, Hee-Woong Chung","doi":"10.4055/cios23387","DOIUrl":"https://doi.org/10.4055/cios23387","url":null,"abstract":"<p><strong>Background: </strong>Posterior long-segment instrumentation (PLSI) enables the stable repair of thoracolumbar fractures (TLFx) and is thus widely used. However, patients with highly unstable fractures may experience implant failure and related complications (e.g., pain and kyphosis) despite PLSI. Few studies have considered the implant failure rate and risk factors associated with PLSI for TLFx.</p><p><strong>Methods: </strong>This study reviewed 162 consecutive patients with TLFx who underwent PLSI and completed > 1 year of follow-up between April 2011 and December 2019. Implant failure was defined as rod breakage, cap dislodgement, or screw breakage. Risk factors for implant failure were evaluated by multivariate regression analysis that included demographic, injury-related, and surgical factors.</p><p><strong>Results: </strong>There were 15 cases (9.3%) of implant failure at the final follow-up (mean, 28.0 ± 18.0 months). Current smoker at the time of injury, fracture level, load sharing score, and anterior compression ratio (ACR) significantly differed between the implant failure and control groups (all <i>p</i> < 0.05). Multivariate logistic regression identified current smoker at the time of injury (adjusted odds ratio [aOR], 5.924; 95% CI, 1.405-24.988), mid to low lumbar fracture (aOR, 15.977; 95% CI, 4.064-62.810), and ACR (aOR, 1.061; 95% CI, 1.009-1.115) as predictors of implant failure.</p><p><strong>Conclusions: </strong>This study demonstrated a high implant failure rate in patients with TLFx treated with PLSI. Smoking at the time of injury, mid to low lumbar fracture, and higher ACR were identified as significant risk factors for implant failure. These findings can help guide treatment decisions and improve patient outcomes in TLFx surgery.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"863-870"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773487","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":"Augmentation with Bone Marrow Aspirate Harvested from the Iliac Crest for Horizontal or Radial Meniscal Tears Yields Favorable Healing Rates in Magnetic Resonance Imaging and Clinical Outcomes.","authors":"Byung Sun Choi, Juneseok Won, Hyuk-Soo Han","doi":"10.4055/cios23213","DOIUrl":"https://doi.org/10.4055/cios23213","url":null,"abstract":"<p><strong>Background: </strong>As the importance of meniscus in joint function becomes more apparent, there is a growing interest in meniscus repair techniques. Notably, biological augmentation methods have shown promising results for meniscus healing, despite their challenges in practical implementation. The purpose of this study was to evaluate meniscus healing and clinical outcomes of meniscus repair with bone marrow aspirate for horizontal or radial tears.</p><p><strong>Methods: </strong>This study retrospectively reviewed patients who underwent arthroscopic meniscal repair with bone marrow aspirate from the iliac crest. A total of 30 patients with horizontal or radial meniscus tears confirmed by magnetic resonance imaging (MRI) were included, excluding those with insufficient data or concurrent surgeries. Patient demographic characteristics, operative data, and clinical outcomes including pain numeric rating scale, International Knee Documentation Committee score, Lysholm score, and Tegner activity scale were evaluated. For radiographic evaluation, knee x-rays, preoperative MRIs, and postoperative 3-month MRIs were evaluated.</p><p><strong>Results: </strong>Thirty patients (15 women and 15 men) with a mean age of 46.8 ± 15.2 years were followed up for a mean of 25.1 ± 3.4 months. Of these patients, 22 (73%) had horizontal meniscal tears, while 8 (27%) had radial tears. Clinical outcomes were significantly improved over the time from the initial to 2 years after surgery. Meniscus healing was 60% on MRI at 3 months after surgery. There was no correlation between changes in clinical scores and healing rate. Furthermore, there was no statistically significant difference in the healing rate or changes in clinical scores according to tear patterns. Retears were observed in 2 patients, who were non-compliant with rehabilitation and were managed conservatively.</p><p><strong>Conclusions: </strong>Augmentation with bone marrow aspirate harvested from the iliac crest for meniscal repair of horizontal or radial tears yields favorable healing rates in MRI and clinical outcomes, highlighting its potential for addressing challenging meniscal repair.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":"16 6","pages":"897-905"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773718","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}