World Journal of Orthopedics最新文献

{"title":"Insights of cartilage imaging in cartilage regeneration.","authors":"Madhan Jeyaraman, Naveen Jeyaraman, Arulkumar Nallakumarasamy, Swaminathan Ramasubramanian, Sathish Muthu","doi":"10.5312/wjo.v16.i7.106416","DOIUrl":"10.5312/wjo.v16.i7.106416","url":null,"abstract":"<p><p>Cartilage, as a specialized connective tissue, underpins joint mobility and mechanical load distribution while exhibiting inherently limited self-repair capabilities. This comprehensive review redefines the current landscape of cartilage imaging by exploring conventional and advanced modalities used to assess both the structural and biochemical attributes of cartilage. Whereas conventional radiography and ultrasound offer rudimentary, indirect assessments, cutting-edge techniques - including magnetic resonance imaging (MRI)-based sequences such as T2 mapping, delayed gadolinium-enhanced MRI of cartilage, and sodium MRI - enable early detection of molecular alterations in the cartilage matrix. In addition, hybrid approaches like positron emission tomography-MRI are emerging to provide integrative molecular and structural insights. This article critically appraises imaging strategies in the context of regenerative interventions, highlighting technical innovations, persistent challenges, and future directions to facilitate improved diagnostic accuracy and therapeutic monitoring.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"106416"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692029","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":"Surgical techniques and outcomes of difficult total hip replacements: A challenge in a low-income country.","authors":"Herijaona Manasse, Thomas Daoulas, Amboara S Rohimpitiavana, Gaëtan Duval Solofomalala, Frederic Dubrana, Henri Jean-Claude Razafimahandry","doi":"10.5312/wjo.v16.i7.105111","DOIUrl":"10.5312/wjo.v16.i7.105111","url":null,"abstract":"<p><strong>Background: </strong>Difficult total hip replacements (THRs) are hip arthroplasties performed on patients with compromised or severely altered bone or soft tissue. Difficult THR indications are common in low-income countries, where access to care is often delayed. In these contexts, patients generally consult us with severe impairments that require significant technical adaptations, as well as adaptation to available resources and local conditions.</p><p><strong>Aim: </strong>To describe the results and difficulties encountered following difficult THR in the study center.</p><p><strong>Methods: </strong>This bi-centric retrospective study was conducted over a 10-year period (2013-2023) and included 50 patients operated on for difficult THR. The mean age of the patients was 37.8 years. Surgical difficulties were recorded from operative reports, and the strategies employed to overcome these difficulties were analyzed, taking into account the types of implants used.</p><p><strong>Results: </strong>At last follow-up, functional results were considered good to excellent according to the Postel-Merle d'Aubigné score, with significant improvement after surgery (<i>P</i> < 0.005). Mean operative time was 177 minutes (range: 90-290 minutes), with a mean blood loss of 568 mL (range: 200-900 mL). The short-term and medium-term post-operative complication rate was 6%.</p><p><strong>Conclusion: </strong>Even in difficult conditions, THR can produce favorable results through careful planning, adaptation of techniques and targeted approaches to overcoming challenges.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"105111"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692035","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":"Effect of total knee arthroplasty on the spinopelvic parameters: A systemic review and metanalysis.","authors":"Mantu Jain, Deb Kumar Pal, Rabi Narayan Sahu, Bikash Ranjan Meher, Binod Kumar Patro, Sujit Kumar Tripathy","doi":"10.5312/wjo.v16.i7.107869","DOIUrl":"10.5312/wjo.v16.i7.107869","url":null,"abstract":"<p><strong>Background: </strong>Sagittal spinopelvic alignment (SSA) is essential for preserving a stable and effective upright posture and locomotion. Although alterations in the SSA are recognised to induce compensatory modifications in the pelvis, hips, and knees, the inverse relationship concerning knee pathology undergoing total knee arthroplasty (TKA) has been examined by a limited number of studies, yielding inconclusive results.</p><p><strong>Aim: </strong>To generate evidence of the effect of TKA on the SSA from existing literature.</p><p><strong>Methods: </strong>Databases like PubMed, EMBASE, and Scopus were used to identify articles related to the \"knee spine syndrome\" phenomenon using a combination of subject terms and keywords such as \"spinopelvic parameters\", \"sagittal spinal balance\", and \"total knee arthroplasty\" were used with appropriate Boolean operators. Studies measuring the SSA following TKA were included, and research was conducted as per preferred reporting items for systematic review and meta-analysis guidelines.</p><p><strong>Results: </strong>A total of 475 participants had undergone TKA, and six studies measuring SSA were analysed. Following TKA, pelvic tilt was the only parameter that showed significant changes, while lumbar lordosis (LL), pelvic incidence, and sacral slope were non-significant, as evident from the forest plots.</p><p><strong>Conclusion: </strong>The body's sagittal alignment is a complex balance between pelvic, spine, and lower extremity parameters. TKA, while having the potential to correct the flexion contracture, can also correct it. Still, the primary SSA for spinal pathology, <i>i.e.</i>, LL, may not be corrected in patients with co-existent spinal degenerative disease.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"107869"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692027","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":"miR-365 promotes HOXA9-mediated differentiation of mesenchymal stem cells to nucleus pulposus cells by interacting with HIF-1α.","authors":"Zhong-Zheng Zhi, Tao Liu, Jian Kang, Fu-Chao Zhou, Xiao-Dong Liu, Zhi-Min He","doi":"10.5312/wjo.v16.i7.107045","DOIUrl":"10.5312/wjo.v16.i7.107045","url":null,"abstract":"<p><strong>Background: </strong>Degenerative disc disease (DDD) is characterized by the loss of nucleus pulposus cells (NPCs). Inducing differentiation of bone marrow mesenchymal stem cells (MSCs) into NPCs has emerged as a novel therapeutic strategy for DDD. However, the efficiency of MSC differentiation and the underlying mechanisms remain to be fully elucidated.</p><p><strong>Aim: </strong>To investigate the role and mechanism of miR-365 in promoting the differentiation of MSCs into NPCs for DDD treatment.</p><p><strong>Methods: </strong><i>In vitro</i>, the effects of miR-365 on MSC proliferation, apoptosis, and differentiation were assessed by cell counting kit-8 assay, flow cytometry, and quantitative real-time polymerase chain reaction (qRT-PCR). <i>In vivo</i>, the expression levels of miR-365, HIF-1α, Sox9, Kdm6a<i>,</i> and HOXA9 in the spinal cord of rats with spinal cord injury were determined by qRT-PCR and Western blot.</p><p><strong>Results: </strong><i>In vitro</i>, miR-365 significantly promoted MSC proliferation and inhibited MSC apoptosis. The expression levels of glycosaminoglycans, proteoglycan, and type 2 collagen were significantly increased with miR-365 ectopic expression. <i>In vivo</i>, the expression levels of miR-365, HIF-1α, Sox9, and Kdm6a were significantly increased, whereas HOXA9 was remarkably decreased. Mechanically, miR-365 inhibited HOXA9 expression by directly binding to its 3' untranslated region. HOXA9 could inhibit HIF-1α expression by binding to the <i>Hif-1α</i> promoter, thereby affecting the expression levels of <i>Sox9</i> and <i>Kdm6a</i>. Moreover, HOXA9 knockdown significantly reversed the differentiation of MSCs into NPCs induced by miR-365.</p><p><strong>Conclusion: </strong>miR-365 promotes HOXA9-mediated differentiation of MSCs into NPCs by interacting with HIF-1α and may serve as a potential target for DDD treatment.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"107045"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692032","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":"Minimally invasive plate osteosynthesis for distal radius fractures using a 3-point positioning technique.","authors":"You-You Ye, Zhao-Qing Shen, Chun-Ling Wu, Yan-Bin Lin","doi":"10.5312/wjo.v16.i7.107913","DOIUrl":"10.5312/wjo.v16.i7.107913","url":null,"abstract":"<p><strong>Background: </strong>The volar approach with plate fixation is the gold standard for treating distal radius fractures, often requiring incision of the pronator quadratus (PQ) muscle. Preserving the PQ during surgery may facilitate early postoperative recovery. However, conventional minimally invasive plate osteosynthesis (MIPO) techniques frequently necessitate multiple (3-4) intraoperative fluoroscopic adjustments to achieve optimal plate positioning, which can inadvertently damage the PQ muscle. Based on our clinical observations, we developed a novel 3-point positioning technique to minimize PQ injury while ensuring accurate plate placement. Preliminary results demonstrate promising early clinical outcomes.</p><p><strong>Aim: </strong>To retrospectively analyze distal radius fractures treated using the 3-point positioning-assisted MIPO technique with preservation of the PQ.</p><p><strong>Methods: </strong>The 3-point positioning technique was applied: The Kirschner wire was inserted after fluoroscopy and was correctly adjusted the position of the plate above the PQ. With the aid of Kirschner wires positioning the PQ stripping was performed only once, and the plate then placed in a correct and satisfactory position. Operation time, incision length, wrist pain score, upper extremity function disabilities of the arm, shoulder and hand (DASH) score, wrist Gartland-Werley score, wrist grip strength, and range of motion were among the quantitative variables recorded. Qualitative variables including AO fracture classification, intraoperative and postoperative complications were evaluated.</p><p><strong>Results: </strong>At a mean follow-up of 6.9 ± 0.8 months, the mean scar length was 25.4 ± 1.5 mm, the pain score was 0.7 ± 0.6, the DASH score for the upper limb was 4.7 ± 1.3, and the Gartland-Werley score for wrist function was 4.1 ± 1.1 at the last follow-up. Mean flexion was 97.3%, extension was 97.0%, pronation was 98.9%, supination was 98.9%, and grip strength was 86.6% compared to contralateral values. No unfavorable intraoperative or postoperative complications occurred.</p><p><strong>Conclusion: </strong>The 3-point positioning technique may reduce the damage to the PQ muscle and is a safe and effective method for MIPO for distal radius fractures.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"107913"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692030","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":"Broader perspective on the role of peroneus longus tendon in ligament reconstruction.","authors":"Murat Yuncu","doi":"10.5312/wjo.v16.i7.107957","DOIUrl":"10.5312/wjo.v16.i7.107957","url":null,"abstract":"<p><p>This article offers additional clinical and biomechanical insights into using the peroneus longus tendon (PLT) autograft in posterior cruciate ligament reconstruction. While recent studies report favorable knee outcomes, concerns remain regarding donor site morbidity. The PLT plays a key role in foot biomechanics, and its harvesting may lead to subtle changes, as suggested by imaging and pedobarographic studies. Tendon regeneration may limit long-term morbidity, but further studies are needed. We recommend that future research include gait analysis, long-term follow-up, and insights from anterior cruciate ligament literature.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"107957"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692014","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":"Defensive antibacterial coating in orthopaedic surgery: Current evidence and future direction.","authors":"Richard Henry Randall Roberts, Charles Gamble, Ibrahim Malek","doi":"10.5312/wjo.v16.i7.107575","DOIUrl":"10.5312/wjo.v16.i7.107575","url":null,"abstract":"<p><p>Periprosthetic joint infections contribute significantly to patient morbidity, prolonged hospital stays, and escalating healthcare costs. Defensive antibacterial coating (DAC^®) hydrogel has emerged as a promising strategy to combat these infections. It forms a biodegradable barrier that reduces bacterial adhesion and can deliver local antibiotics, thereby addressing a key mechanism in biofilm formation. Early clinical evidence suggests that DAC^® effectively lowers infection recurrence in revision hip and knee arthroplasties, with additional benefits in trauma procedures and soft tissue repairs. Moreover, it has demonstrated compatibility with existing implants and surgical techniques, while potentially reducing overall antibiotic use and hospital stays. Despite these encouraging findings, data for its use in primary arthroplasty remains limited, underscoring the need for large-scale, high-quality studies. Future research is poised to refine DAC^®'s antimicrobial efficacy through novel antibiotic combinations, personalised delivery systems, and broader applications beyond lower limb procedures. As the prevalence of comorbidities continues to rise, DAC^® represents a valuable addition to multifaceted infection control protocols, potentially transforming orthopaedic care by enhancing patient outcomes and mitigating the economic and clinical burden of implant-related infections.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"107575"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692017","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":"Functional outcomes of radial head arthroplasty in Mason type III and IV fractures.","authors":"Shikhar Bindal, Harshaan Singh Pooni, Rajnish Garg, Deepak Jain","doi":"10.5312/wjo.v16.i6.106871","DOIUrl":"10.5312/wjo.v16.i6.106871","url":null,"abstract":"<p><strong>Background: </strong>Radial head fractures constitute approximately one-third of all elbow fractures, significantly impacting the young and active population. While open reduction and internal fixation is the preferred treatment for displaced fractures, its high complication rate in comminuted fractures has led to the increasing use of radial head arthroplasty (RHA). RHA provides improved functional outcomes with fewer complications, yet its long-term efficacy remains a topic of debate.</p><p><strong>Aim: </strong>To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.</p><p><strong>Methods: </strong>A prospective and retrospective hospital-based study was conducted at Dayanand Medical College and Hospital, Ludhiana over 32 months (January 2021-August 2023). A total of 26 patients with Mason type III and IV fractures were included, with six retrospective and 20 prospective cases. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS), elbow range of motion, pain <i>via</i> Visual Analog Scale, and activities of daily living at immediate postoperative, three-month, and six-month follow-ups.</p><p><strong>Results: </strong>MEPS at 6 months follow up for 4 cases (15.38%) had good scores, and 22 cases (84.62%) had excellent scores, with a mean ± SD of 97.31 ± 6.67. Comparisons showed significant improvement from immediate post-operative to 3 months (<i>P</i> < 0.0001), from immediate post-operative to 6 months (<i>P</i> < 0.0001), and between 3 months and 6 months (<i>P</i> < 0.0001). None of the patients had elbow instability after radial head replacement and 22 cases (84.62%) had no complications, while 3 cases (11.54%) had a stiff elbow, and 1 case (3.85%) had heterotopic ossification.</p><p><strong>Conclusion: </strong>RHA is an effective treatment for comminuted radial head fractures, providing stable elbow function with minimal complications.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 6","pages":"106871"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477336","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":"Thoracic anterior controllable antedisplacement fusion for thoracic ossification of the posterior longitudinal ligament: A case report.","authors":"Xing-Yu Jin, Hua-Zheng Wang, Kai Yang, Yu Bao, Ye Wang, Xing-Lei Ben, Hai-Yan Sun","doi":"10.5312/wjo.v16.i6.107753","DOIUrl":"10.5312/wjo.v16.i6.107753","url":null,"abstract":"<p><strong>Background: </strong>Thoracic ossification of the posterior longitudinal ligament (T-OPLL) is caused by the ossified posterior longitudinal ligament occupying space in the spinal canal, which causes compression of the thoracic spinal cord. Surgical treatment is difficult, risky and complicated; thus, clinical treatment is difficult at present.</p><p><strong>Case summary: </strong>A case of severe multi-segmental T-OPLL treated with thoracic anterior controllable antedisplacement fusion (TACAF) is reported, including the surgical procedures and analysis of the clinical data. The modified-Japanese Orthopaedic Association score in this patient was 4 before surgery, and it was raised to 9 after the operation. The symptoms of spinal canal compression were subsequently relieved. Three months after surgery, digital radiography showed good healing and recovery of limb sensory function.</p><p><strong>Conclusion: </strong>This case report suggests that TACAF is feasible for the treatment of long-segment T-OPLL, and has the advantages of low risk and reduced trauma. However, this operation still needs to be verified by clinical research with a larger sample size.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 6","pages":"107753"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477343","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":"Top ten causes of non-arthritic hip pain: A comprehensive review.","authors":"Ping-Yen Yeo, Ayyadarshan Kasivishvanaath, Luis Pérez-Carro, Jegathesan T","doi":"10.5312/wjo.v16.i6.107397","DOIUrl":"10.5312/wjo.v16.i6.107397","url":null,"abstract":"<p><p>Hip pain in young patients is a common complaint that can pose diagnostic challenges. Clinical evaluation of hip pain requires strong foundational knowledge of relevant anatomy, careful history-taking, focused physical examination, and appropriate imaging techniques. Rapid advancements in hip arthroscopy techniques over the past decade has made it an essential tool in assessing and managing hip pain. This article aims to provide an evidence-based update on ten common causes of non-arthritic hip pain. These causes are categorized into three groups based on predominant symptom location to facilitate the readers' understanding and enhance evaluation of hip pain in the clinical setting. Each condition is discussed with an overview of relevant anatomy, clinical features and evaluation methods, as well as management strategies, emphasizing arthroscopic techniques where applicable.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 6","pages":"107397"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477344","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}