World Journal of Orthopedics最新文献

{"title":"Return to work and resumption of driving after anterior minimally invasive total hip arthroplasty.","authors":"Hisatoshi Ishikura, Yuji Masuyama, Sho Fujita, Takeyuki Tanaka, Sakae Tanaka, Toru Nishiwaki","doi":"10.5312/wjo.v16.i2.103817","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.103817","url":null,"abstract":"<p><strong>Background: </strong>Return to work (RTW) and resumption of driving (ROD) are critical factors that influence postoperative quality of life in patients undergoing total hip arthroplasty (THA). However, few studies have focused on the minimally invasive (MIS) approach and its effect on these outcomes.</p><p><strong>Aim: </strong>To investigate RTW and ROD's timelines and influencing factors following anterior MIS-THA.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 124 patients who underwent anterior MIS-THA. Data on the demographics, occupational physical demands, and RTW/ROD timelines were also collected. Clinical outcomes were measured using standardised scoring systems. Statistical analyses were performed to evaluate the differences between the groups based on employment status and physical workload.</p><p><strong>Results: </strong>Among employed patients, the RTW rate was 94.7%, with an average return time of five weeks. The average ROD time was 3.5 weeks across all patients. Despite similar postoperative clinical scores, RTW time was significantly influenced by occupations' physical workload, with heavier physical demands associated with delayed RTW.</p><p><strong>Conclusion: </strong>Anterior MIS-THA facilitates early RTW and ROD, particularly in occupations with lower physical demands. These findings highlight the importance of considering occupational and physical workload in postoperative care planning to optimize recovery outcomes.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"103817"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544107","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":"Some artificial intelligence tools may currently be useful in orthopedic surgery and traumatology.","authors":"Emerito Carlos Rodriguez-Merchan","doi":"10.5312/wjo.v16.i2.102252","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.102252","url":null,"abstract":"<p><p>Artificial intelligence (AI) can help in diagnosing fractures and demonstrating effusions, dislocations, and focal bone lesions in both adult and pediatric aged individuals and also aid in early tumor discovery (bone osteosarcoma) and in robot-assisted surgery. A recent AI model [Mask R-CNN (region-based convolutional neural network)] has shown to be dependable for detecting surgical target zones in pediatric hip and periarticular infections, offering a more convenient and quicker alternative to conventional methods. It can help inexperienced physicians in pre-treatment evaluations, diminishing the risk of missed diagnosis and misdiagnosis. AI has some very interesting applications in orthopedic surgery, which orthopedic surgeons should be aware of and if possible use. Although some interesting advances have been made recently on AI in orthopedic surgery, its usefulness in clinical practice is still very limited. Ethical concerns, such as transparency in AI decision-making, data privacy, and the potential loss of human intuition cannot be forgotten. Besides, it is paramount to explore how to gain trust from both healthcare professionals and patients in the utilization of AI.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"102252"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544121","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":"Hidden dangers of pelvic fracture: A meta-analysis on urinary tract injury incidence and risk factors.","authors":"Gonzalo Mariscal, Ali Dway, Carlos Barrios","doi":"10.5312/wjo.v16.i2.102483","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.102483","url":null,"abstract":"<p><strong>Background: </strong>Pelvic fractures are often associated with significant morbidity, including injuries to the urinary tract. Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management. This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.</p><p><strong>Aim: </strong>To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, Scopus, and the Cochrane Library was conducted without date restrictions. Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included. Data extracted included demographics, injury mechanism, pelvic fracture type, urinary tract injury incidence, mortality, and discharge disposition. Review Manager 5.4 was used for data analysis.</p><p><strong>Results: </strong>Ten studies comprising 22700 patients were included. The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88% (95%CI: 6.20%-7.55%). Vehicle, motorcycle, and pedestrian accidents were identified as risk factors for urinary tract injury, with relative risks (RR) of 1.08 (95%CI: 1.06-1.11), 1.89 (95%CI: 1.78-2.00), and 1.53 (95%CI: 1.20-1.95), respectively. Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury [odds ratio (OR) 1.94, 95%CI: 1.09-3.44 and OR 5.53, 95%CI: 4.67-6.54, respectively)]. Patients without urinary tract injury were more likely to be discharged home (RR 0.79, 95%CI: 0.67-0.92). Mortality was higher in patients with urinary tract injury (OR 1.92, 95%CI: 1.77-2.09).</p><p><strong>Conclusion: </strong>Urinary tract injury occurs in nearly 7% of patients with pelvic fractures. Motorcycle accidents, pubic fractures, and pelvic ring disruptions are significant risk factors. Urinary tract injury following pelvic fracture is associated with increased mortality.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"102483"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544034","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":"Individual and population differences affect the pain management in acute musculoskeletal injury.","authors":"Yu Deng, Qi-Long Jiang","doi":"10.5312/wjo.v16.i2.100745","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.100745","url":null,"abstract":"<p><p>In this editorial, we comment on the article published in a recent issue of the <i>World Journal of Orthopedics</i>. Although substantial literature regarding pain management of acute musculoskeletal injury has been published over the last three decades, there is still a lack of evidence-based protocol for individual and population disparities. This systematic review gives us a comprehensive view of the evidence-based use of opioid <i>vs</i> opioid-free analgesia. Nevertheless, there is still a need for further investigation at a high level regarding this topic.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"100745"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544038","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":"Novel association between chronic obstructive pulmonary disease and osteoporosis: A prospective cross-sectional study.","authors":"Rong Gao, Jian-Kang Zeng, Kai Yang, Ping Wang, Sheng Zhou","doi":"10.5312/wjo.v16.i2.102101","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.102101","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition often associated with a high incidence of osteoporosis. Studies indicate that patients with COPD present with a significant decrease in bone mineral density (BMD), potentially related to inflammation and corticosteroid use.</p><p><strong>Aim: </strong>To investigate the relationship between BMD and lung function, mainly the forced expiratory volume in the forced expiratory volume in 1 second (FEV1)/ forced vital capacity percentage (FVC%), in patients with COPD using quantitative computed tomography (QCT).</p><p><strong>Methods: </strong>This prospective cross-sectional study included 85 patients with COPD treated at Gansu Provincial People's Hospital. Exposure variables included lung function parameter (FEV1/FVC%), age, sex, body mass index, smoking status, tea-drinking habits, and physical activity. BMD was measured using QCT. Linear regression and generalized additive models were employed to analyze the relationship between exposure variables and BMD.</p><p><strong>Results: </strong>Linear regression analysis revealed a significant positive relationship between BMD and FEV1/FVC% (<i>β</i> = 0.1, 95% confidence interval [CI]: 0.1-0.1; <i>P</i> < 0.0001). Non-linear analysis identified a unique BMD breakpoint of 128.08 mg/cm³. Before the breakpoint, BMD was significantly positively correlated with FEV1/FVC% (<i>β</i> = 0.245; <i>P</i> = 0.0019); while after the breakpoint, the relationship was negative and showed no statistical significance (<i>β</i> = -0.136; <i>P</i> = 0.0753). This finding underscores the critical role of BMD in COPD management and highlights the importance of individualized clinical interventions in improvement of lung function and overall health status in patients.</p><p><strong>Conclusion: </strong>There is a complex non-linear relationship between BMD and lung function in patients with COPD, highlighting the importance of monitoring change in bone density during the management of COPD.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"102101"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544042","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":"Periprosthetic fractures of the tibial shaft following long-stemmed total knee arthroplasty: A case report.","authors":"Maciej Kocon, Dariusz Grzelecki","doi":"10.5312/wjo.v16.i2.98674","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.98674","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic fractures of the tibia are uncommon complications after total knee arthroplasty (TKA). Therefore, there is still clinical debate regarding the appropriate treatment method. This study presents the case of a patient with two successive periprosthetic fractures of the tibial shaft treated with revision TKA (rTKA) and intramedullary fixation.</p><p><strong>Case summary: </strong>A 65-year-old woman was treated for tibial shaft pseudarthrosis after a periprosthetic fracture. The patient underwent rTKA with a tibial component exchange to a long-stemmed implant. At her 1.5-year follow-up visit, partial asymptomatic bone union was noted with no prosthesis loosening. The patient achieved 0° to 120° range of motion and a stable knee, and reported high satisfaction. Improvements were observed in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) from 74 to 17, and in the knee society scores (KSS) from 56 to 91 (clinical) and 10 to 80 (functional). After 2.5 years, the patient sustained a second fracture below the original site due to low-energy trauma. The rTKA with intramedullary stabilization was performed. One year later, WOMAC and clinical and functional KSS were 15, 81, and 80, respectively. Despite tibial shortening and lower limb inequality, the patient remains very satisfied and does not experience any issues with daily activities nor weight-bearing.</p><p><strong>Conclusion: </strong>There is little consensus in the literature on the management of tibial shaft periprosthetic fractures. Intramedullary stabilization may yield excellent outcomes, but individual case discussion is necessary for rTKA indications.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"98674"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544065","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":"Effectiveness of sub-acromial injections in rotator cuff injuries: A systematic review and meta-analysis.","authors":"Luana Tossolini Goulart, Fabio Teruo Matsunaga, Joao Carlos Belloti, Nicola Archetti Netto, Thays Sellan Paim, Marcel Jun Sugawara Tamaoki","doi":"10.5312/wjo.v16.i2.102856","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.102856","url":null,"abstract":"<p><strong>Background: </strong>Sub-acromial injections are a therapeutic option for rotator cuff injuries; however, evidence regarding the most effective drug in this context is unclear, which needs to be investigated.</p><p><strong>Aim: </strong>To evaluate the effectiveness of various sub-acromial injections for rotator cuff injuries.</p><p><strong>Methods: </strong>We conducted a systematic review and pair-wise and network meta-analyses of randomized clinical trials (RCTs) comparing sub-acromial injections for rotator cuff injuries. The interventions evaluated were hyaluronic acid (HA), platelet-rich plasma (PRP), prolotherapy, and corticosteroids. The outcomes of interest were pain and functional improvement, which were evaluated with standardized scores. The Risk of Bias 2 tool and the Grading of Recommendations, Assessment, Development and Evaluation methodology were used to assess data quality.</p><p><strong>Results: </strong>Twenty RCTs, comprising 1479 participants, were included. In the short term, HA achieved the best outcomes [pain mean difference (MD) = -1.48, 95% confidence interval (CI) -2.37 to -0.59; function MD = 10.18, 95%CI: 4.96-15.41]. In the medium term, HA, PRP, HA + PRP, and corticosteroids were not superior to placebo in improving pain. Based on function, HA + PRP was superior to placebo, corticosteroids, and PRP (MD = 26.72; 95%CI: 8.02-45.41). In the long term, HA, PRP, and corticosteroids were not superior to placebo in reducing pain. However, based on function, HA + PRP, PRP, and HA were superior to placebo, and HA + PRP had the best result (MD = 36.64; 95%CI: 31.66-33.62).</p><p><strong>Conclusion: </strong>HA provides satisfactory short-term results, while HA with PRP demonstrates functional improvement in the medium and long terms. However, no intervention maintained the pain-relief effect on > 3-month follow-up.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"102856"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544028","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":"Atlantoaxial dislocation with vertebral artery anomaly: A case report.","authors":"Ruo-Hui Tang, Jin Yin, Zhao-Wen Zhou","doi":"10.5312/wjo.v16.i2.104095","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.104095","url":null,"abstract":"<p><strong>Background: </strong>Surgical intervention is a critical treatment approach for symptomatic atlantoaxial dislocation. However, vertebral artery injury remains a significant challenge during such procedures. We present a case of successful treatment of atlantoaxial dislocation with concurrent vertebral artery injury using interlaminar screw technology, and review the relevant literature.</p><p><strong>Case summary: </strong>A 69-year-old female patient, with no history of trauma, was diagnosed with atlantoaxial dislocation based on X-ray, computed tomography (CT), and magnetic resonance imaging. Preoperative CT angiography (CTA) revealed vertebral artery developmental anomalies, and she underwent posterior cervical surgery. Postoperative follow-up showed improvement in the patient's clinical symptoms such as unstable walking and dizziness, as well as functional scores compared to pre-surgery. Intraoperative vertebral artery injury was successfully managed, and postoperative CTA review revealed no complications related to vascular damage.</p><p><strong>Conclusion: </strong>Thorough preoperative evaluation, such as CTA imaging, and the surgeon's expertise in various spinal screw placement techniques are crucial for improving the success rate of atlantoaxial dislocation surgeries.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"104095"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543846","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":"Percutaneous transforaminal endoscopic treatment of gas-containing pseudocyst compressing the L5 nerve root: A case report.","authors":"Zhen-Xian Jiang, Ji-Bin Ren, Yu-Cai Li, Lei Chen","doi":"10.5312/wjo.v16.i2.103416","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.103416","url":null,"abstract":"<p><strong>Background: </strong>Gas-containing pseudocysts rarely cause of lumbar radiculopathy. This report describes successful treatment of a gas-containing pseudocyst using percutaneous transforaminal endoscopy.</p><p><strong>Case summary: </strong>A 48-year-old man presented with severe pain and numbness in his right leg, which worsened upon walking or weight bearing. Computed tomography and magnetic resonance imaging revealed a gas-containing cyst compressing the left L5 nerve root at the L4-5 level. The pseudocyst was successfully removed using a percutaneous transforaminal endoscopic discectomy. Vivid and clear endoscopic imaging of the pseudocysts was performed intraoperatively. The patient experienced immediate pain relief and was discharged one day after the operation. The patient returned to work. Moreover, numbness in the right leg returned to normal within 6 months. At the one-year follow-up, there was no symptoms recurrence.</p><p><strong>Conclusion: </strong>Transforaminal endoscopy offers excellent surgical visualization and facilitates meticulous operative manipulation, making it a minimally invasive approach for treating gas-containing pseudocysts in the intervertebral foramen.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"103416"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544049","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":"Discussion of the public interest in arthroscopy based on the Baidu index and its implications for nursing care.","authors":"Jia-Li Deng, Kai Yang, Shuai Zhang, Bin Wang, Li Zhang, Xia Zhao","doi":"10.5312/wjo.v16.i2.101895","DOIUrl":"https://doi.org/10.5312/wjo.v16.i2.101895","url":null,"abstract":"<p><strong>Background: </strong>Despite the widespread application of big data in topic analysis, the public's attention and nursing requirements for arthroscopy remain inadequate.</p><p><strong>Aim: </strong>To understand netizens' concerns and spatial distributions regarding arthroscopy and to provide customized nursing strategies.</p><p><strong>Methods: </strong>The Baidu index was employed to gather and analyze the search index, demand graph, keyword popularity, and regional distribution data for the keywords \"arthroscopy,\" \"knee arthroscopy,\" and \"arthroscopy surgery\" from 2018 to 2023.</p><p><strong>Results: </strong>A total of 254692 items of information were searched for these keywords, with 59.86% from mobile terminals. Netizens' interest in arthroscopy showed a fluctuating pattern, which was consistent with fluctuations in the elasticity coefficient, and was primarily concentrated in the provinces of Guangdong, Jiangsu, and Shandong.</p><p><strong>Conclusion: </strong>The Baidu index provides new avenues for exploring public demand for arthroscopy. Nursing personnel can utilize these data to develop more precise health education plans and guidance, enhancing the quality and satisfaction of patient care.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 2","pages":"101895"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544021","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}