World Journal of Orthopedics最新文献

{"title":"Short-term survivorship of antioxidant highly cross-linked polyethylene liners in total hip arthroplasty reported in American Joint Replacement Registry.","authors":"Kirstin Jones, Amber M Muehlmann, Sarah M Melvin, Ebru Oral, Colin T Penrose","doi":"10.5312/wjo.v16.i9.110386","DOIUrl":"10.5312/wjo.v16.i9.110386","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty is a safe and effective procedure. To improve survivorship, ultrahigh molecular weight polyethylene hip liners with antioxidants have been developed. Additive antioxidant was deployed to reduce oxidation and consequential wear, loosening, or osteolysis. A unique manufacturing process was utilized for two such hip liners, the Novation^® and Alteon^® XLE hip liners and this research represents the first large series on this specific material. The study hypothesis was that Novation and Alteon XLE hip liners have similar short-term survivorship as other manufacturers' antioxidant liners according to procedure and outcome data from the American Joint Replacement Registry (AJRR).</p><p><strong>Aim: </strong>To demonstrate similar short-term survivorship of XLE antioxidant hip liners compared to all antioxidant hip liners in AJRR.</p><p><strong>Methods: </strong>Utilizing total hip arthroplasty data from the AJRR, a retrospective review was performed for subjects who underwent implantation of Novation XLE (<i>n</i> = 461), Alteon XLE (<i>n</i> = 989), or any other antioxidant hip liner (termed the aggregate antioxidant group; <i>n</i> = 39964) as of March 31, 2022. Survivorship at three years and revision rates were compared statistically between the Novation group and the aggregate antioxidant group as well as the Alteon group and the aggregate antioxidant group.</p><p><strong>Results: </strong>Survivorship at three years post-surgery was 99.09% for Novation, 97.73% for Alteon, and 97.69% for the aggregate antioxidant group. There were no reports of failure due to wear in either the Novation or Alteon groups. Among the revision categories (fracture, infection, aseptic loosening, instability, mechanical complications, wear, pain, hematoma/wound complications, or other), there were no significant differences identified in either comparison. There were also no significant differences in cumulative percent revision rates up to three years post-surgery for the Novation <i>vs</i> aggregate antioxidant group or the Alteon <i>vs</i> aggregate antioxidant group.</p><p><strong>Conclusion: </strong>Novation and Alteon XLE hip liner revision rate and survivorship are equivalent to other antioxidant hip liners in the short term.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"110386"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114722","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":"Intra-articular treatments for hindfoot osteoarthritis.","authors":"Fernanda Ferreira Gomes, Isnar Moreira de Castro Junior, Joao Antonio Matheus Guimaraes, Isabela de Miranda Rosa, Eduardo B de Sousa, Aline Cordeiro","doi":"10.5312/wjo.v16.i9.109147","DOIUrl":"10.5312/wjo.v16.i9.109147","url":null,"abstract":"<p><p>Hindfoot osteoarthritis (HFOA) leads to pain, impaired function, and reduced quality of life. Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis, particularly in young patients with post-traumatic HFOA. Intra-articular injections of corticosteroids and hyaluronic acid are widely used as alternatives for treating foot and ankle osteoarthritis to provide temporary pain relief and functional improvement. Recently, orthobiologic treatments have gained interest for their potential regenerative effects. This review aims to summarize the current evidence on intra-articular injections for HFOA, highlighting the potential benefits, perspectives, and mechanisms of action of conventional and orthobiologic treatments such as platelet-rich plasma, bone marrow aspirate concentrate, and adipose-derived stem cells.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"109147"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114643","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":"Radial head arthroplasty: A pillar of stability in complex elbow fractures.","authors":"Amr Elshahhat, Mahmoud Almekoud","doi":"10.5312/wjo.v16.i9.110433","DOIUrl":"10.5312/wjo.v16.i9.110433","url":null,"abstract":"<p><p>Radial head (RH) arthroplasty (RHA) has emerged as a critical intervention in the management of complex elbow fractures, particularly Mason type III and IV injuries where the native RH is irreparable. Beyond its role in pain relief and joint congruity, RHA serves as a biomechanical cornerstone for restoring the lateral column and ensuring elbow stability, especially in the presence of associated ligamentous injuries or fracture-dislocations. This editorial synthesizes current evidence on RHA in Mason type III and IV RH fractures, with attention to biomechanical rationale, implant design, and complication trends. Aiming to reaffirm RHA's position as a vital tool in contemporary elbow trauma care, a simplified treatment algorithm is presented to support individualized surgical decision-making.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"110433"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114701","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":"Outcomes of autologous bone grafts <i>vs</i> bone substitutes in tibial plateau fractures: A meta-analysis.","authors":"Ali Saad Alshahrani, Yazan Jumah Alalwani, Nihal Mushabb Alqahtani, Abdullah Shafi D Alanazi, Ahmed Khaled Almarri, Shatha Saud Alqurashi, Deemah Khalid Ghazi, Abdullah Musaaed Alsalamah, Rahaf Hamdan Alruwaili, Ahmed Y Azzam, Fawaz Alanii","doi":"10.5312/wjo.v16.i9.111068","DOIUrl":"10.5312/wjo.v16.i9.111068","url":null,"abstract":"<p><strong>Background: </strong>Tibial plateau fractures often require structural support for metaphyseal defects created during articular reduction. While autologous bone grafting has been utilized as the gold standard, bone substitutes offer advantages including reduced donor site morbidity. Our meta-analysis evaluated the comparative efficacy of these approaches across clinical and operative outcomes.</p><p><strong>Aim: </strong>To conduct a systematic review and meta-analysis of randomized controlled trials comparing autologous bone grafts with bone substitutes for tibial plateau fractures.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials comparing autologous bone grafts with bone substitutes for tibial plateau fractures. Primary outcomes included joint depression, secondary collapse rate, operative time, blood loss, and infection rate. Subgroup analyses were performed by fracture complexity, geographic region, and methodological factors. In addition to that, we also developed a combined outcome score integrating structural, procedural, and complication domains.</p><p><strong>Results: </strong>Seven randomized controlled trials with 424 patients (296 bone substitute, 128 autograft) were included. No significant differences in joint depression or secondary collapse were observed across fracture complexity categories. Geographic variations were evident, with Western studies showing significantly higher risk of secondary collapse with autografts (risk ratio = 1.45, <i>P</i> value = 0.02). Both Western and Asian studies have demonstrated significantly reduced blood loss with bone substitutes (70-90 mL less), while operative time reduction was more significant in the Asian studies (23.65 <i>vs</i> 8.00 minutes, <i>P</i> value = 0.04 for subgroup difference). The combined outcome score (standardized effect size -0.2481) favored bone substitutes, primarily due to procedural advantages.</p><p><strong>Conclusion: </strong>Bone substitutes provide similar structural outcomes to autologous bone grafts while having better procedural advantages in tibial plateau fracture management. These findings support bone substitutes as a viable option across fracture patterns. Future studies should focus on specific bone substitute formulations and cost-effectiveness analyses.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"111068"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114710","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":"Therapeutic potential of traditional Chinese medicine for inflammatory bone diseases: Elucidating molecular mechanisms and insights.","authors":"Jing-Shun Lu, Min Yang, Zeng-Gao Han, Chen-Yu Song, Nurjamal Sarbay, Kai-Yang Wang","doi":"10.5312/wjo.v16.i9.108629","DOIUrl":"10.5312/wjo.v16.i9.108629","url":null,"abstract":"<p><p>Inflammatory bone diseases constitute a category of chronic inflammatory disorders, with the primary pathological characteristic being the impact of chronic inflammation on bone metabolism and remodeling. It leads to pain, spinal joint deformities, and functional impairments. Common clinical types of inflammatory bone diseases include rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis. However, there is a paucity of effective clinical treatments for inflammatory bone diseases, and pharmacological interventions are frequently associated with intolerable side effects. Traditional Chinese medicine (TCM) has a long-standing history and proven efficacy in managing inflammatory bone diseases. In recent years, an increasing number of studies have highlighted the potential of TCM in this context. This article systematically evaluates the application of TCM in treating inflammatory bone diseases, emphasizing the underlying molecular mechanisms of its anti-inflammatory effects. By elucidating the specific targets of TCM in the treatment of rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis, we aim to provide novel insights into the further exploration of TCM's role in clinical application for inflammatory bone diseases.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"108629"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114635","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":"Unilateral biportal endoscopy for minimally invasive spinal fusion: Advancements in biomaterials and clinical outcome optimization.","authors":"Song Fu, Li-Chuan Hou, Xiao-Ling Huang, Wei Zhao, Feng-Ming Wang, Ya-Nan Wang","doi":"10.5312/wjo.v16.i9.108931","DOIUrl":"10.5312/wjo.v16.i9.108931","url":null,"abstract":"<p><p>Lumbar interbody fusion is essential for treating degenerative lumbar diseases. The disadvantages of open surgery have led to the evolution of minimally invasive spine surgery, including endoscopic techniques such as unilateral biportal endoscopy (UBE). Leveraging arthroscopic principles, UBE offers superior visualization and flexibility and expands from decompression to fusion (UBE fusion). However, achieving robust UBE fusion presents challenges, such as suboptimal arthrodesis rates and implant-related complications, requiring more than surgical skill alone. Optimizing UBE fusion critically depends on the effective integration of advanced biomaterials with the surgical technique. This minireview assessed recent advances in UBE, focusing on the development of novel biomaterials, such as functionalized porous, expandable, or double-cage designs, to improve bone regeneration outcomes. These advancements address challenges, like washout of bone graft material and biologics, and utilize growth factors, such as recombinant human bone morphogenetic proteins, while exploring pathway modulation to improve outcomes. We also evaluated clinical optimization strategies involving technical refinements, fluid and hemostasis control, key complication mitigation especially concerning dural tears and hematomas, and technologies such as navigation and robotics. While UBE shows promise particularly for early recovery, its long-term success hinges on these biotechnological advancements. High-quality evidence, especially from randomized controlled trials and long-term studies, is needed to validate integrated strategies and define the optimal role of UBE fusion.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"108931"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114654","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":"Animal models for study on rotator cuff healing.","authors":"Qi-Long Jiang","doi":"10.5312/wjo.v16.i9.110320","DOIUrl":"10.5312/wjo.v16.i9.110320","url":null,"abstract":"<p><p>Rotator cuff tears are highly prevalent, and there is an urgent need to understand their healing mechanisms to improve treatment outcomes for patients. This editorial aims to summarize the roles and limitations of common animal models (including rodents, rabbits, sheep, dogs, and primates) and second-look arthroscopy in rotator cuff healing research. Different animal models offer distinct advantages and disadvantages. For example, rodent models are cost-effective and suitable for genetic studies but have anatomical differences from humans. Rabbit models are favored for their relatively large tendon size and ease of surgical manipulation, yet they still deviate from human shoulder anatomy in some aspects. Larger animals like sheep and dogs have more similar shoulder structures to humans but come with high costs and challenges in maintaining consistent experimental conditions. Second-look arthroscopic studies have provided evidence for the effectiveness of current surgical techniques. Animal models will continue to play a crucial role in further exploring the local microenvironment of the rotator cuff, which is expected to help develop more effective strategies to promote healing.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"110320"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114583","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":"Influence of frailty on postoperative outcomes following primary and revision total hip arthroplasty.","authors":"Qi-Long Jiang","doi":"10.5312/wjo.v16.i9.108400","DOIUrl":"10.5312/wjo.v16.i9.108400","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) effectively treats advanced hip disorders, yet outcomes vary among patients. Frailty has become a crucial factor influencing these results. Several studies explored multiple preoperative factors affecting THA outcomes, highlighting the significance of age, Western Ontario and McMaster Universities Osteoarthritis Index, Center for Epidemiologic Studies Depression Scale, and central sensitization index scores in predicting post-operative recovery, emphasizing comprehensive preoperative assessments. Subsequent research has shown that frailty, measured by tools like the hospital frailty risk score and frailty deficit index, is significantly associated with adverse outcomes such as higher 30-day readmission rates, longer hospital stays, increased costs, and elevated mortality and complication risks in both primary and revision THA. Additionally, frailty related to short-term adverse events but stressed the need for standardized frailty measurement. Currently, there is no unified standard for assessing frailty before THA, which hinders cross-study comparison and evidence-based guideline development. Future research should focus on establishing a universal frailty assessment standard considering physical function, comorbidities, cognitive and psychological status. Prospective studies are also needed to clarify the causal relationship between frailty and long-term THA outcomes and identify modifiable factors for preoperative interventions. Overall, understanding the impact of frailty on THA outcomes is essential for improving patient care and resource utilization, especially in an aging population with a rising prevalence of hip disorders.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"108400"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114645","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":"Deltopectoral <i>vs</i> deltoid split approach for proximal humerus fractures treated with locking plate: Our experience.","authors":"Calogero Cicio, Gianfranco Longo, Vito Pavone, Gianluca Testa, Rocco Ortuso, Giovanni C Salvo, Marco Ganci, Ignazio Prestianni, Alessio Ferrara, Antonio Kory, Alessandro Pietropaolo, Anna M Monachino, Enrica R Cuffaro, Giacomo Papotto","doi":"10.5312/wjo.v16.i9.110859","DOIUrl":"10.5312/wjo.v16.i9.110859","url":null,"abstract":"<p><strong>Background: </strong>Proximal humerus fractures (PHFs) are common, especially in the elderly, and optimal surgical management remains debated. This study compares clinical, functional, and radiographic outcomes of deltoid split (DS) <i>vs</i> deltopectoral (DP) approaches in PHFs treated with locking plates.</p><p><strong>Aim: </strong>To evaluate and compare the clinical, functional, and radiographic outcomes-as well as postoperative complication rates-associated with the DS <i>vs</i> the DP surgical approach in the open reduction and internal fixation (ORIF) of PHFs using locking plate constructs.</p><p><strong>Methods: </strong>A multicenter retrospective study of 120 patients undergoing ORIF for closed Neer type II-IV PHFs between January 2023 and December 2023. Patients were grouped by surgical approach [DS (<i>n</i> = 70), DP (<i>n</i> = 50)]. Outcome measures included Numeric Rating Scale (NRS) for pain, Quick-Disabilities in Arm, Shoulder, and Hand questionnaire (QuickDASH), Constant-Murley score, Short Form Health Survey-12v2, and radiographic alignment. Complication rates were recorded. Statistical significance was defined as <i>P</i> < 0.05.</p><p><strong>Results: </strong>Early outcomes favored the DS group: (1) Lower NRS (3.1 <i>vs</i> 5.9); (2) Higher Constant-Murley (68.2 <i>vs</i> 50.5); and (3) Better QuickDASH (25.4 <i>vs</i> 37.1). Complication rate was lower in the DS group (1.66% <i>vs</i> 5.81%). Radiographic outcomes were comparable. Long-term results were similar between groups.</p><p><strong>Conclusion: </strong>While both approaches yield satisfactory long-term outcomes, the DS approach is associated with faster early recovery and fewer complications, supporting its use in selected cases.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"110859"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114674","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":"Towards comprehensive care in crush syndrome: Expanding the multidisciplinary framework.","authors":"Luca Galassi, Federica Facchinetti","doi":"10.5312/wjo.v16.i9.111218","DOIUrl":"10.5312/wjo.v16.i9.111218","url":null,"abstract":"<p><p>Crush syndrome demands an integrated multidisciplinary approach that spans acute surgical decisions and long-term functional recovery. In response to Khan <i>et al</i>'s recent systematic review, we propose complementary perspectives that address two underrepresented dimensions: Vascular surgical decision-making and psychiatric rehabilitation. We emphasize the use of intraoperative technologies such as indocyanine green fluorescence angiography and compartment pressure monitoring to guide limb salvage strategies and reperfusion management. Additionally, we advocate for the systematic integration of mental health screening and trauma-informed psychiatric care to address the high prevalence of psychological distress in survivors. Embedding these domains into standardized protocols could enhance both short- and long-term outcomes, particularly in high-impact trauma and disaster settings.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 9","pages":"111218"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114670","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}