World Journal of Orthopedics最新文献

{"title":"Artificial intelligence awareness and perceptions among pediatric orthopedic surgeons: A cross-sectional observational study.","authors":"Ammar K Alomran, Mohammed F Alomar, Ali A Akhdher, Ali R Al Qanber, Ahmad K Albik, Arwa Alumran, Ahmed H Abdulwahab","doi":"10.5312/wjo.v15.i11.1023","DOIUrl":"10.5312/wjo.v15.i11.1023","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is a branch of computer science that allows machines to analyze large datasets, learn from patterns, and perform tasks that would otherwise require human intelligence and supervision. It is an emerging tool in pediatric orthopedic surgery, with various promising applications. An evaluation of the current awareness and perceptions among pediatric orthopedic surgeons is necessary to facilitate AI utilization and highlight possible areas of concern.</p><p><strong>Aim: </strong>To assess the awareness and perceptions of AI among pediatric orthopedic surgeons.</p><p><strong>Methods: </strong>This cross-sectional observational study was conducted using a structured questionnaire designed using QuestionPro online survey software to collect quantitative and qualitative data. One hundred and twenty-eight pediatric orthopedic surgeons affiliated with two groups: Pediatric Orthopedic Chapter of Saudi Orthopedics Association and Middle East Pediatric Orthopedic Society in Gulf Cooperation Council Countries were surveyed.</p><p><strong>Results: </strong>The pediatric orthopedic surgeons surveyed had a low level of familiarity with AI, with more than 60% of respondents rating themselves as being slightly familiar or not at all familiar. The most positively rated aspect of AI applications for pediatric orthopedic surgery was their ability to save time and enhance productivity, with 61.97% agreeing or strongly agreeing, and only 4.23% disagreeing or strongly disagreeing. Our participants also placed a high priority on patient privacy and data security, with over 90% rating them as quite important or highly important. Additional bivariate analyses suggested that physicians with a higher awareness of AI also have a more positive perception.</p><p><strong>Conclusion: </strong>Our study highlights a lack of familiarity among pediatric orthopedic surgeons towards AI, and suggests a need for enhanced education and regulatory frameworks to ensure the safe adoption of AI.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1023-1035"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732420","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":"Gene expression analysis of cytokines and MMPs in melatonin and rhBMP-2 enhanced bone remodeling.","authors":"Marina Ribeiro Paulini, Letícia Ferreira Montarele, Dimitrius Leonardo Pitol, Gisele Giannocco, Bruno Fiorelini Pereira, Daniela Vieira Buchaim, Carlos Henrique Bertoni Reis, Rogério Leone Buchaim, Joao Paulo Mardegan Issa","doi":"10.5312/wjo.v15.i11.1075","DOIUrl":"10.5312/wjo.v15.i11.1075","url":null,"abstract":"<p><strong>Background: </strong>In the medical and dental fields, there is a need for studies of new therapeutic approaches for the treatment of bone defects that cause extensive bone loss. Melatonin may be an important endogenous biological factor for bone remodeling, and growth factors may enhance the repair process.</p><p><strong>Aim: </strong>To evaluate the gene expression of cytokines (IL-1β, IL-6, IL-10 and TNF-α), markers of osteoclastogenesis (RANK, RANKL and OPG) and MMPs (MMP-1, MMP-2, MMP-8 and MMP-13) from the treatment of melatonin associated with an osteogenic membrane and rhBMP-2 on the recovery of a bone injury.</p><p><strong>Methods: </strong>Sixty-four rats were used and divided into 9 experimental groups and were formed according to the treatment carried out in the region of the bone lesion, which varied between the combination of 1, 10 and 100 μmol/L of melatonin. Gene Expression analysis was performed using real time-PCR by reading the concentration of total RNA and reverse transcription.</p><p><strong>Results: </strong>There were differences between groups when compared with clot or scaffold control, and improvement with a higher concentration of melatonin or rhBMP-2. The combination melatonin (1 µg) with 5 μg of rhBMP-2, using the guided bone regeneration technique, demonstrated some effects, albeit mild, on bone repair of critical bone defects.</p><p><strong>Conclusion: </strong>This indicates that the approach for administering these substances needs to be reassessed, with the goal of ensuring their direct application to the affected area. Therefore, future research must be carried out, seeking to produce materials with these ideal characteristics.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1075-1087"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733245","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":"Cardiotoxicity concerns in total joint arthroplasty.","authors":"Chun-Han Cheng, Wen-Rui Hao, Tzu-Hurng Cheng","doi":"10.5312/wjo.v15.i11.1007","DOIUrl":"10.5312/wjo.v15.i11.1007","url":null,"abstract":"<p><p>This editorial examines the cardiotoxic effects of elevated metal concentrations in patients who received total joint arthroplasty, as detailed in the study of Brennan <i>et al.</i> The study findings reveal that elevated cobalt and titanium levels may affect the cardiac structure and function, providing crucial insights for clinical practice and research. This editorial suggests that the close monitoring of metal ion levels in patients undergoing arthroplasty is necessary to reduce cardiovascular risk.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1007-1014"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732657","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":"Ilizarov technique for treatment of a giant aneurysmal bone cyst at the distal femur: A case report.","authors":"Xing-Yu Long, Feng Sun, Tao Wang, Ping Li, Zhong Tian, Xian-Wei Wu","doi":"10.5312/wjo.v15.i11.1088","DOIUrl":"10.5312/wjo.v15.i11.1088","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cyst (ABC) is a benign cystic of unknown etiology, characterized by multiple chambers and a high recurrence rate. Current treatment options include vascular embolization, surgical excision, curettage with cavity filling, sclerosing agent injection into the cavity, radiotherapy, and systemic drug therapy. Among these, surgical excision and curettage are the preferred treatment modalities. However, when the cyst reaches a large size, extensive removal of diseased tissue during surgery can hinder bone healing. In our department, we treated a case of a large ABC at the distal end of the femur in a child using the Ilizarov technique. The tumor was completely excised, and reconstruction was achieved through autologous femoral bone transfer. The follow-up at two years post-surgery indicated good results without tumor recurrence, and the growth and development of the child were essentially unaffected.</p><p><strong>Case summary: </strong>An 11-year-old boy was presented with an accidental fracture of his right leg. Despite having been examined at other hospitals, he had not received treatment. Given the potential for significant bone defects and the difficulty of the surgery, our doctors opted to use the Ilizarov technique to minimize harm to the patient. Upon admission, the patient underwent a needle biopsy and complete tumor resection-the Ilizarov technique assisted in the transport and reconstruction of the autologous femoral bone. Postoperatively, the patient exhibited regular follow-ups, during which bone transport was gradually performed, and the external fixation frame was removed on time. Follow-up X-rays of the right lower limb displayed no tumor recurrence, with a normal appearance. Bone formation at the cutting site was satisfactory, and the union of the bone ends indicated good healing. After two years of follow-up, the patient had essentially returned to normal.</p><p><strong>Conclusion: </strong>We successfully applied the Ilizarov technique to treat ABC, reducing the financial burden of patients and the pain of multiple surgeries. In cases where significant bone defects occur, the Ilizarov technique has demonstrated satisfactory therapeutic outcomes.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1088-1094"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733208","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":"Insights and implications from the study on meniscus reconstruction using tendon autograft.","authors":"Phi Duong Nguyen, Thanh Kien Lam","doi":"10.5312/wjo.v15.i11.1109","DOIUrl":"10.5312/wjo.v15.i11.1109","url":null,"abstract":"<p><p>This letter addresses the recent study by Zhu <i>et al</i> on the predictive factors for coronal and sagittal graft extrusion length following medial meniscus reconstruction using tendon autografts. The study provides valuable insights into the importance of preoperative joint space width and tunnel positioning as predictors of graft extrusion. Specifically, it found strong correlations between preoperative joint space width and medial, posterior, and mean graft extrusion at both 1 week and 8 months post-operation. Additionally, tunnel edge distance at 1 week post-operation correlated with anterior and posterior graft extrusion. These findings offer critical guidance for improving surgical outcomes. However, the letter highlights the need for further research with larger sample sizes and comparative studies involving different graft types to strengthen these findings and broaden their applicability in clinical settings. The study's contributions to understanding meniscus reconstruction using tendon autografts are acknowledged, along with suggestions for future research directions.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1109-1111"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733372","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":"Extracorporeal shock wave therapy in treating ischial non-union following Bernese periacetabular osteotomy: A case report.","authors":"Jun Yan, Jun-Yu Zhu, Fei-Fei Zhao, Jian Xiao, Hao Li, Ming-Xin Wang, Jing Guo, Liang Cui, Geng-Yan Xing","doi":"10.5312/wjo.v15.i10.991","DOIUrl":"https://doi.org/10.5312/wjo.v15.i10.991","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal shock wave therapy (ESWT) is increasingly being recognized as an advantageous alternative for treating non-union due to its efficacy and minimal associated complications. Non-union following Bernese periacetabular osteotomy (PAO) is particularly challenging, with a reported 55% delayed union and 8% non-union. Herein, we highlight a unique case of ischial non-union post-PAO treated successfully with a structured ESWT regimen.</p><p><strong>Case summary: </strong>A 50-year-old patient, diagnosed with left ischial non-union following the PAO, underwent six cycles of ESWT treatment across ten months. Each cycle, spaced four weeks apart, consisted of five consecutive ESWT sessions without anesthesia. Regular X-ray follow-ups showed progressive disappearance of the fracture line and fracture union. The patient ultimately achieved a satisfactory asymptomatic recovery and bone union.</p><p><strong>Conclusion: </strong>The results from this case suggest that this ESWT regimen can be a promising non-invasive treatment strategy for non-union following PAO.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 10","pages":"991-996"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548297","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":"Evidence-based orthobiologic practice: Current evidence review and future directions.","authors":"Madhan Jeyaraman, Naveen Jeyaraman, Swaminathan Ramasubramanian, Sangeetha Balaji, Sathish Muthu","doi":"10.5312/wjo.v15.i10.908","DOIUrl":"https://doi.org/10.5312/wjo.v15.i10.908","url":null,"abstract":"<p><p>The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic. These biologically derived therapies, including platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate, stromal vascular fraction (SVF), and autologous chondrocyte implantation, are gaining traction for their potential to enhance the body's natural healing processes. They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions. Current evidence suggests significant benefits of orthobiologics in treating conditions like osteoarthritis, tendon injuries, and spinal disorders, yet inconsistencies in treatment protocols and outcomes persist. The global market for orthobiologics is projected to grow substantially, driven by advancements in biologic therapies such as adipose-derived stem cells and SVF, and the demand for minimally invasive treatments. Despite their promise, regulatory and ethical challenges, as well as the need for high-quality, standardized research, remain significant obstacles. Future directions in the field include advancements in delivery systems, personalized medicine approaches, and the exploration of novel sources like induced pluripotent stem cells, aiming for more targeted and effective treatments. Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 10","pages":"908-917"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548296","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":"Atypical cervical spondylotic radiculopathy resulting in a hypertensive emergency during cervical extension: A case report and review of literature.","authors":"Hao-Cheng Cui, Zheng-Qi Chang, Shao-Ke Zhao","doi":"10.5312/wjo.v15.i10.981","DOIUrl":"https://doi.org/10.5312/wjo.v15.i10.981","url":null,"abstract":"<p><strong>Background: </strong>Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.</p><p><strong>Case summary: </strong>We here present a 57-year-old woman diagnosed as having cervical spondylotic radiculopathy (CSR) who was scheduled for anterior cervical decompression and fusion. During post-anesthetic positioning, a sudden hypertensive surge was observed when the patient was in a supine position with the neck being slightly extended. This surge was promptly reversed through cervical flexion and head elevation. This event however required an alternate surgical approach for recovery-posterior laminoplasty and endoscopy-assisted nucleus pulposus removal. Following the 6-month outpatient follow-up period, cervical flexion and extension activities substantially improved in the patient without any episodes of increase in acute blood pressure.</p><p><strong>Conclusion: </strong>Maintaining a safe hypotensive posture and performing rapid, thorough decompression surgery may serve as effective interventions for patients presenting symptoms similar to those of CSR accompanied by hypertensive emergencies (HE). This would mitigate the underlying causes of these HEs.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 10","pages":"981-990"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548293","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":"Impact of computed tomography/magnetic resonance imaging registration on rehabilitation after percutaneous endoscopic decompression for lumbar stenosis: Retrospective study.","authors":"Xiao-Bo Guo, Jin-Wei Chen, Jun-Yang Liu, Jiang-Tao Jin","doi":"10.5312/wjo.v15.i10.939","DOIUrl":"https://doi.org/10.5312/wjo.v15.i10.939","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous endoscopic lumbar decompression (PELD) shows promise for lumbar spinal stenosis (LSS) treatment, but its use is limited by the disease's complexity and procedural challenges.</p><p><strong>Aim: </strong>In this study, the effects of preoperative planning and intraoperative guidance with computed tomography (CT)/magnetic resonance imaging (MRI) registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.</p><p><strong>Methods: </strong>This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023. Patients were assigned to preoperative CT/MRI registration and control groups. Data collected included the operative time, length of hospital stay, visual analog scale (VAS) scores for low back and leg pain, and the Japanese Orthopaedic Association (JOA) lumbar spine score. Differences between groups were assessed using Student's <i>t</i> test.</p><p><strong>Results: </strong>Data from 135 patients (71 in the CT/MRI registration group, 64 in the control group) were analyzed. The operative time was significantly shorter in the CT/MRI registration group (<i>P</i> = 0.007). At 2 months postoperatively, both groups showed significant reductions in VAS leg and low back pain scores (all <i>P</i> < 0.001) and improvements in the JOA score (both <i>P</i> < 0.001). No complication or death occurred. Preoperatively, pain and JOA scores were similar between groups (<i>P</i> = 0.830, <i>P</i> = 0.470, and <i>P</i> = 0.287, respectively). At 2 months postoperatively, patients in the CT/MRI registration group reported lower leg and low back pain levels (<i>P</i> < 0.001 and <i>P</i> = 0.001, respectively) and had higher JOA scores (<i>P</i> = 0.004) than did patients in the control group.</p><p><strong>Conclusion: </strong>Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores, demonstrating enhanced effectiveness and safety.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 10","pages":"939-949"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548298","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":"Clinical implications of reconsideration of enthesitis/enthesopathy/enthesial erosion, as tendon attachment-localized avulsions and stress fracture equivalents.","authors":"Bruce M Rothschild","doi":"10.5312/wjo.v15.i10.902","DOIUrl":"https://doi.org/10.5312/wjo.v15.i10.902","url":null,"abstract":"<p><p>Recognizing the mechanical origin of enthesitis/enthesopathy and the avulsion-nature of what had previously been considered erosions, it seems inappropriate to attribute it to stresses related to a person's normal activities. Conversely, sudden or unconditioned repetitive stresses appears the more likely culprit. Studies of enthesial reaction have lacked standardization as to findings present among individuals who appear to be healthy. Clinical evaluation by palpation and manipulation may be as effective as application of radiologic techniques. Recognition of the mechanical nature of the disease, including individuals with inflammatory arthritis suggests prescription of mechanical solutions that reduce stresses across the involved enthesis.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 10","pages":"902-907"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548294","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}