Efort Open Reviews最新文献

Current trends in the treatment of focal cartilage lesions: a comprehensive review.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-04-01 DOI: 10.1530/EOR-2024-0083

Halah Kutaish, Arnaud Klopfenstein, Susan Nasif Obeid Adorisio, Philippe M Tscholl, Sandro Fucentese

{"title":"Current trends in the treatment of focal cartilage lesions: a comprehensive review.","authors":"Halah Kutaish, Arnaud Klopfenstein, Susan Nasif Obeid Adorisio, Philippe M Tscholl, Sandro Fucentese","doi":"10.1530/EOR-2024-0083","DOIUrl":"10.1530/EOR-2024-0083","url":null,"abstract":"Focal cartilage lesions refer to localized damage or defects in the cartilage covering joint surfaces, often resulting from trauma, wear and tear or underlying joint conditions. These lesions can lead to pain, impaired joint function and, if left untreated, may contribute to the development of degenerative joint diseases. Challenges in treatment of focal cartilage lesion are mainly due to limited intrinsic healing capacity, difficulty in early detection of lesions and variability in symptoms make timely intervention tricky. Conservative treatments varies from addressing symptoms using physical therapy, corticosteroid injections and viscosupplementation, to regenerative attempts such as in platelet-rich plasma and mesenchymal stem cells therapy. These modalities provide a limited duration of improvement and are commonly used to delay more aggressive treatment. Traditional surgery options are mainly summed up by microfractures (MFX) for smaller lesions, osteochondral autograft transfer, osteochondral allograft transfer (OCA) and autologous matrix-induced chondrogenesis for moderate-to-large lesions. Cellular approaches encompass autologous chondrocyte implantation (ACI), which involve targeted transplantation of chondrocytes. Current research is concentrating on cell-based surgical approaches utilizing advanced biomaterials for both scaffold and scaffold-free implants. While gene therapy and tissue engineering approaches aim to optimize chondrocyte proliferation and differentiation for improved quality of the transplanted biomaterial and patient's outcomes.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 4","pages":"203-212"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validity and reliability of inertial measurement units on gait, static balance and functional mobility performance among community-dwelling older adults: a systematic review and meta-analysis.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-04-01 DOI: 10.1530/EOR-2024-0088

Lulu Yin, Xin Xu, Ruiyan Wang, Feifei Li, Yushan Wang, Lin Wang

{"title":"Validity and reliability of inertial measurement units on gait, static balance and functional mobility performance among community-dwelling older adults: a systematic review and meta-analysis.","authors":"Lulu Yin, Xin Xu, Ruiyan Wang, Feifei Li, Yushan Wang, Lin Wang","doi":"10.1530/EOR-2024-0088","DOIUrl":"10.1530/EOR-2024-0088","url":null,"abstract":"Purpose: This systematic review and meta-analysis investigated validity and test-retest reliability of inertial measurement units (IMUs) in gait metrics, static balance and functional mobility performance in community-dwelling older adults.Methods: Spatiotemporal/biomechanical outcomes were meta-analyzed using intraclass correlation coefficients (ICCs) or Pearson correlation coefficients (r) for validity and reliability, respectively.Results: In our systematic review of 56 articles and meta-analysis of 38 articles, the included studies varied in quality from low-to-moderate. During validity analysis, IMU-derived metrics, including walking speed, cadence, step/stride time, step time variability, step/stride length and duration of sit-to-stand (STS) test/timed up, and go test (TUGT) exhibited excellent (ICCs) or good-to-excellent (r values) agreement with gold standards. In terms of reliability, excellent test-retest consistency was found for walking speed, cadence, step/stride time, stance/swing time, step/stride length during gait, individual STS duration, TUGT duration and walking speed during the 6-min walk test.Conclusions: Due to consistently high levels of validity and reliability, the present study supported the use of IMUs for measuring gait spatiotemporal outcomes. However, caution was advised when applying spatiotemporal variability and symmetry metrics. In addition, characterized by moderate-to-good validity and reliability, current review provides evidence of a neutral nature regarding the utilization of IMUs for static balance and functional mobility performance.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 4","pages":"172-185"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of smoking on meniscus surgery: a systematic review.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-04-01 DOI: 10.1530/EOR-24-0097

Jan Zabrzyński, Jakub Pękala, Maria Zabrzyńska, Przemysław Pękala, Łukasz Łapaj, Robert F LaPrade

{"title":"The impact of smoking on meniscus surgery: a systematic review.","authors":"Jan Zabrzyński, Jakub Pękala, Maria Zabrzyńska, Przemysław Pękala, Łukasz Łapaj, Robert F LaPrade","doi":"10.1530/EOR-24-0097","DOIUrl":"10.1530/EOR-24-0097","url":null,"abstract":"Purpose: To provide a comprehensive, systematic review on the relationship and effects of smoking on clinical outcomes after meniscus surgery.Methods: The following combination of keywords was entered into the electronic search engines: meniscus, meniscus repairs, meniscectomy, meniscal tear, meniscus excision AND (smoke OR smoking OR nicotine OR tobacco). The year of the study, country, type of study, number of subjects, medial/lateral/both menisci, body mass index, smoking status, mean age, gender, follow-up, type/pattern of injury, surgical implications and clinical outcomes were recorded.Results: A total of 23 studies published in 2013-2024 were included in the analysis. In ten studies, the meniscus injury was associated with an anterior cruciate ligament (ACL) tear. In four studies, the effect of smoking on meniscal allograft transplantation (MAT) was investigated. The neutral effect of smoking on meniscus surgery was revealed in nine studies, and only one of them focused on isolated meniscus pathology and surgery. The negative effect of smoking on meniscus surgery was shown in ten papers, with four papers focused on isolated meniscus tears and six papers presenting data with concurrent ACL reconstructions.Conclusions: This systematic review found that the results regarding the impact of smoking on meniscus repair outcomes were conflicting. Nevertheless, MAT and meniscus repair performed in the presence of concurrent ligamentous injury, both being demanding surgical procedures, require reduction of factors that may contribute to failure. Therefore, cessation of smoking in patients undergoing these procedures is highly advised.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 4","pages":"193-202"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cortisol stress response after musculoskeletal surgery: a narrative review.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-04-01 DOI: 10.1530/EOR-2024-0126

Maximilian M Menger, Tina Histing, Matthias W Laschke, Sabrina Ehnert, Tim Viergutz, Johann Fontana

{"title":"Cortisol stress response after musculoskeletal surgery: a narrative review.","authors":"Maximilian M Menger, Tina Histing, Matthias W Laschke, Sabrina Ehnert, Tim Viergutz, Johann Fontana","doi":"10.1530/EOR-2024-0126","DOIUrl":"10.1530/EOR-2024-0126","url":null,"abstract":"Trauma induced by surgery stimulates a neuroendocrine stress response, substantially increasing cortisol levels in the post-surgical setting. This has substantial effects on metabolism, water and electrolyte balance as well as on the cardiovascular, nervous and immune systems. While there are valid data on cortisol level courses in a variety of specific pathologies, such as septic shock, acute respiratory distress syndrome, bacterial meningitis, cardiac arrest, community-acquired pneumonia and influenza, there is a persisting lack of data on the cortisol stress response after musculoskeletal surgery. The present review provides an overview of the current state of research regarding trauma-induced cortisol response after musculoskeletal interventions, including both elective orthopedic surgery and trauma surgery. Trauma induced by musculoskeletal surgery triggers a cortisol response, which varies significantly depending on the type of surgery and its invasiveness. Notably, elective orthopedic procedures demonstrate a smaller range of cortisol levels compared to musculoskeletal trauma and surgery. In the future, high-quality prospective trials need to analyze the factors that may modulate the adequate adrenal response to stress, such as preoperative long-term treatments with glucocorticoids, as well as the potential impact of low cortisol levels and perioperative cortisol substitution therapy on pain management, blood requirements, catecholamine dependency, delirium and mortality after musculoskeletal surgery.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 4","pages":"186-192"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurogenic bladder pathophysiology, assessment and management after lumbar diseases.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-24-0087

Jiayu Hao, Jian Jiang, Qiaoyue Han, Kui Wang, Yuefeng Sun, Hong Wang

{"title":"Neurogenic bladder pathophysiology, assessment and management after lumbar diseases.","authors":"Jiayu Hao, Jian Jiang, Qiaoyue Han, Kui Wang, Yuefeng Sun, Hong Wang","doi":"10.1530/EOR-24-0087","DOIUrl":"10.1530/EOR-24-0087","url":null,"abstract":"Neurogenic bladder (NB) is a group of bladder and/or urethral dysfunctions caused by neurological lesions, commonly seen in patients with lumbar spine diseases, manifesting as urinary storage and voiding dysfunction, significantly affecting patients' quality of life. Degenerative changes or trauma to the lumbar spine can lead to narrowing of the dural sac, compressing the sacral nerve roots, cauda equina or blood vessels, causing bladder dysfunction and leading to NB. Diagnostic methods for NB include history taking, physical examination and noninvasive and invasive tests, such as urodynamic testing and cystoscopy. The treatment goals for NB are to protect upper urinary tract function, restore or partially restore lower urinary tract function, improve urinary control, reduce residual urine volume, prevent urinary tract infections and improve patients' quality of life. Treatment methods include conservative treatment, pharmacological treatment, catheterization, neuromodulation and surgical treatment, which should be sequentially administered based on the patient's specific condition.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 3","pages":"156-165"},"PeriodicalIF":4.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical vs conservative: what is the best treatment of acute Rockwood III acromioclavicular joint dislocation? A systematic review and meta-analysis.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-2024-0077

Luca Bianco Prevot, Riccardo Accetta, Stefania Fozzato, Philipp Moroder, Giuseppe Basile

{"title":"Surgical vs conservative: what is the best treatment of acute Rockwood III acromioclavicular joint dislocation? A systematic review and meta-analysis.","authors":"Luca Bianco Prevot, Riccardo Accetta, Stefania Fozzato, Philipp Moroder, Giuseppe Basile","doi":"10.1530/EOR-2024-0077","DOIUrl":"10.1530/EOR-2024-0077","url":null,"abstract":"Purpose: No literature consensus was found about the best treatment of acute Rockwood type III acromioclavicular joint (ACJ) dislocation. In particular, the advantages and disadvantages between conservative treatment and surgery are not sufficiently quantified in the current literature.Methods: A systematic literature search was conducted using PubMed, Web of Science and Embase in March 2024. We selected studies comparing surgical and conservative treatment in acute Rockwood III ACJ dislocations. The two treatment methods were compared in terms of Constant score; Disabilities of the Arm, Shoulder, and Hand (DASH); American Shoulder and Elbow Surgeons (ASES) score; Acromioclavicular Joint Instability Score (ACJIS); subjective shoulder value (SSV); radiographical findings; reported complications; and return to sports activity. The risk of bias and quality of evidence were assessed using Cochrane guidelines.Results: A total of 1844 articles were evaluated, and ten were included in the study for a total of 397 patients. The results of the meta-analysis showed no significant differences between the two groups in terms of Constant score (P = 0.31), DASH (P = 0.52), ASES (P = 0.66) and SSV (P = 0.21), while it highlighted a statistically significant difference in terms of ACJIS (P = 0.00) and acromioclavicular (P = 0.00) and coracoclavicular distance (P = 0.00).Conclusion: The results showed no significant differences in terms of patient-reported or objective functional outcomes between the two treatment groups. Nonetheless, it highlights a difference in terms of radiographical outcomes and type of complications. While surgical intervention is able to improve joint reduction, it adds the risk for surgical complications.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 3","pages":"141-150"},"PeriodicalIF":4.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of pediatric femoral neck fractures from classification to surgery: a review of indications based on anatomic and radiographic features of the proximal femur.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 DOI: 10.1530/EOR-2024-0129

WenTao Wang, Federico Canavese, Zhu Xiong, ShengPing Tang, ShunYou Chen, ShengHua He

{"title":"Management of pediatric femoral neck fractures from classification to surgery: a review of indications based on anatomic and radiographic features of the proximal femur.","authors":"WenTao Wang, Federico Canavese, Zhu Xiong, ShengPing Tang, ShunYou Chen, ShengHua He","doi":"10.1530/EOR-2024-0129","DOIUrl":"10.1530/EOR-2024-0129","url":null,"abstract":"This review focuses on the anatomic and radiographic characteristics of the pediatric proximal femur and the advantages and disadvantages of different protocols for the management of pediatric femoral neck fractures (PFNFs) in terms of fracture classification, reduction methods, reduction quality and fixation methods, with the goal of proposing an optimal treatment protocol for PFNFs to reduce the incidence of postoperative complications. The anatomic and radiographic characteristics of the pediatric proximal femur, including the presence of an active growth plate, an immature femoral calcar, greater trabecular density and plasticity and a relatively immature blood supply are very different from those of the adult proximal femur. Treatment protocols for PFNFs must differ from those for adult femoral neck fractures. PFNFs with posterior translation, and those with comminuted medial-posterior columns, are associated with a higher postoperative complication rate. This review suggests that the degree of damage to the nutrient vessels along the posterior femoral neck and the stability of the medial-posterior column of the femoral neck should be well assessed in patients with PFNFs for both classification and treatment purposes. Anatomic reduction through an anterior approach, placement of a small number of implants in the mid-inferior part of the femoral neck and additional external support are effective in reducing postoperative complications in patients with PFNFs.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 3","pages":"125-140"},"PeriodicalIF":4.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pre-operative management of fracture blisters: a systematic review.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-2024-0074

Ishtar Redman, Kapil Sugand, Aashtad Daruwalla, Andrew Clark

{"title":"Pre-operative management of fracture blisters: a systematic review.","authors":"Ishtar Redman, Kapil Sugand, Aashtad Daruwalla, Andrew Clark","doi":"10.1530/EOR-2024-0074","DOIUrl":"10.1530/EOR-2024-0074","url":null,"abstract":"Purpose: The pre-operative management of fracture blisters is an area of uncertainty within trauma and orthopaedic surgeries. Management strategies vary significantly between and within orthopaedic departments across the United Kingdom. The purpose of this systematic review was to comprehensively appraise and synthesize the existing literature pertaining to this topic, highlighting current practices and areas for ongoing research.Methods: Extensive electronic literature searches were performed on PubMed/MEDLINE (January 1946-May 2024), Embase (January 1974-May 2024) and Cochrane library (January 1933-May 2024) databases. The search terms were as follows: (fracture blister OR bone blister*) AND (dress* OR drain* OR aspirat* OR deroof* OR manage*). These keywords were searched in the subject headings, in title and in abstract.Results: The results of the search methodology revealed five articles, which represented the best evidence to the clinical question. These papers reported on rates of wound healing and post-operative infection, time to surgical readiness and treatment costs, following varying treatment modalities in 1162 patients. The authors, publication dates, countries, patient groups, study outcomes and results of these papers are tabulated in Supplementary Table 1.Conclusion: Fracture blisters pose a significant challenge in clinical practice, leading to delays in surgery, suboptimal surgical approaches and complications in wound healing post-operatively. Currently, there is no consensus describing the optimal management of these blisters. This review challenges the conventional belief that fracture blisters are sterile, highlighting that the application of topical agents to the deroofed blister bed may expedite surgical readiness.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 3","pages":"166-171"},"PeriodicalIF":4.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unilateral biportal endoscopy: review and detailed surgical approach to extraforaminal approach.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI: 10.1530/EOR-24-0137

João Pedro Gomes Reis, Eduardo Moreira Pinto, Artur Teixeira, Ricardo Frada, Diogo Rodrigues, Raquel Cunha, António Miranda

引用次数: 0

Ochronotic arthropathy: skeletal manifestations and orthopaedic treatment.

IF 4.3 2区医学

Efort Open Reviews Pub Date : 2025-02-03 Print Date: 2025-02-01 DOI: 10.1530/EOR-2023-0112

Khaled Hamed Salem, Alyaa Diaa Elmoghazy

{"title":"Ochronotic arthropathy: skeletal manifestations and orthopaedic treatment.","authors":"Khaled Hamed Salem, Alyaa Diaa Elmoghazy","doi":"10.1530/EOR-2023-0112","DOIUrl":"10.1530/EOR-2023-0112","url":null,"abstract":"Alkaptonuria is an extremely rare disorder of tyrosine metabolism caused by an autosomal recessive enzymatic deficiency of homogentisic acid (HGA) oxidase, causing its accumulation in collagenous structures, especially in hyaline cartilage. It is characterized by a triad of homogentisic aciduria, bluish-black discoloration of connective tissues (ochronosis) and arthropathy of the spine and large weight-bearing joints. Several clinical manifestations were described including coronary and valvular calcification, aortic stenosis, limited chest expansion, and renal, urethral and prostate calculi as well as ocular and cutaneous pigmentation. Skeletal affection usually presents as spondylotic changes of the spine. The knee is the most common peripheral joint to be involved. Enthesopathy or tendon ruptures may occur, and reduced bone density is not unusual. A low-protein diet and ascorbic acid may reduce HGA levels. Nitisinone can safely and effectively reduce HGA production and urinary excretion. In severe ochronotic arthropathy, joint arthroplasty can offer reliable pain relief and excellent functional outcomes. Cementless fixation is successful in young patients.","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"75-81"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0