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Microfractures, autologous matrix-induced chondrogenesis, osteochondral autograft transplantation and autologous chondrocyte implantation for knee chondral defects: a systematic review and network meta-analysis of randomized controlled trials. 微骨折、自体基质诱导软骨生成、骨软骨自体移植物移植和自体软骨细胞植入治疗膝关节软骨缺损:随机对照试验的系统综述和网络荟萃分析。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0089
Silvia Valisena, Benjamin Azogui, Rémy S Nizard, Philippe M Tscholl, Etienne Cavaignac, Pierre-Alban Bouché, Didier Hannouche
{"title":"Microfractures, autologous matrix-induced chondrogenesis, osteochondral autograft transplantation and autologous chondrocyte implantation for knee chondral defects: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Silvia Valisena, Benjamin Azogui, Rémy S Nizard, Philippe M Tscholl, Etienne Cavaignac, Pierre-Alban Bouché, Didier Hannouche","doi":"10.1530/EOR-23-0089","DOIUrl":"10.1530/EOR-23-0089","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the publication of several randomized controlled trials (RCTs), it is not clear which technique for the treatment of focal chondral and osteochondral defects of the knee grants the best clinical outcome. The aim of this network meta-analysis (NMA) was to compare the efficacy and safety of microfractures (MF), autologous chondrocyte implantation (ACI), autologous matrix-induced chondrogenesis (AMIC), osteochondral autograft transplantation (OCT) at short (< 1 year), intermediate (1-5 years) and long-term (> 5 years).</p><p><strong>Methods: </strong>We carried out an NMA with Bayesian random-effect model, according to PRISMA guidelines. The search was performed in MEDLINE, EMBASE, Web of Science, CENTRAL, CINAHL, SPORTDiscus, clinicaltrials.gov, WHO ICTRP, from inception to November 2022. The eligibilities were randomized controlled trials on patients with knee chondral and osteochondral defects, undergoing microfractures, OCT, AMIC, ACI, without restrictions for prior or concomitant surgery on ligaments, menisci or limb alignment, prior surgery for fixation or ablation of osteochondritis dissecans fragments, and prior cartilage procedures as microfractures, drilling, abrasion, or debridement.</p><p><strong>Results: </strong>Nineteen RCTs were included. No difference among treatments was shown in the pooled comparison of patient reported outcome measures (PROMs) at any timepoint. Safety data were not available for all trials due to the heterogeneity of reporting, but chondrospheres seemed to have lower failure and reoperation rates.</p><p><strong>Conclusion: </strong>This NMA showed no difference for PROMs with any technique. The lower failure and reoperation rates with chondrospheres must be interpreted with caution since adverse event data was heterogenous among trials. The standardization of the efficacy and safety outcome measures for future trials on knee cartilage repair and regeneration is necessary.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"785-795"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861268","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
An update on the role of ferroptosis in the pathogenesis of osteoporosis. 铁蛋白沉积症在骨质疏松症发病机制中的最新作用。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0148
Xinhui Wu, Xiaoxin Fang, Feng Lu, Qiong Chen, Junjian Liu, Longpo Zheng
{"title":"An update on the role of ferroptosis in the pathogenesis of osteoporosis.","authors":"Xinhui Wu, Xiaoxin Fang, Feng Lu, Qiong Chen, Junjian Liu, Longpo Zheng","doi":"10.1530/EOR-23-0148","DOIUrl":"10.1530/EOR-23-0148","url":null,"abstract":"<p><p>Ferroptosis is a novel form of programmed cell death, distinguished from apoptosis, autophagy, and programmed necrosis and has received much attention since it was defined in 2012. Ferroptotic cells physiologically exhibit iron metabolism dysregulation, oxidative stress, and lipid peroxidation. Morphologically, they show plasma membrane disruption, cytoplasmic swelling, and mitochondrial condensation. Osteoporosis is taken more and more seriously as the proportion of the aging population continues to increase globally. Interestingly, ferroptosis has been demonstrated to be involved in the development and progression of osteoporosis in many extant studies. The review summarizes iron metabolism, lipid peroxidation, and the different regulatory signals in ferroptosis. Changes in signaling mechanisms within osteoblasts, osteoclasts, and osteocytes after ferroptosis occur are explained here. Studies showed ferroptosis play an important role in different osteoporosis models (diabetes osteoporosis, postmenopausal osteoporosis, glucocorticoid-induced osteoporosis). Inhibitors and EC (Exos) targeting ferroptosis could ameliorate bone loss in osteoporotic mice by protecting cells against lipid peroxidation. Shortly, we hope that more effective and appropriate clinical therapy means will be utilized in the treatment of osteoporosis.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"712-722"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861262","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
Efficacy and safety of topical tranexamic acid in spinal surgery: a systematic review and meta-analysis. 局部氨甲环酸在脊柱手术中的疗效和安全性:系统综述和荟萃分析。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0199
Hua Luo, Xuelei Zhang, Chengxin Xie, Luxia Wu, Guoping Cai, Yu Ren
{"title":"Efficacy and safety of topical tranexamic acid in spinal surgery: a systematic review and meta-analysis.","authors":"Hua Luo, Xuelei Zhang, Chengxin Xie, Luxia Wu, Guoping Cai, Yu Ren","doi":"10.1530/EOR-23-0199","DOIUrl":"10.1530/EOR-23-0199","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the effects of topical tranexamic acid (tTXA) in spinal surgery to provide reliable clinical evidence for its usefulness.</p><p><strong>Methods: </strong>The PubMed, EMBASE, Medline, and Cochrane Central Register of Controlled Trials databases were comprehensively searched to identify randomized controlled trials and non-randomized controlled trials evaluating the effect of tTXA on blood loss during spine surgery. The observation indexes were intraoperative blood loss, total blood loss, output and duration of postoperative drainage, postoperative hematological variables, length of postoperative hospital stay, blood transfusion rate, and complication rate.</p><p><strong>Results: </strong>A total of 21 studies involving 1774 patients were included. Our results showed that the use of tTXA during spinal surgery significantly reduced the total blood loss, postoperative drainage volume, postoperative transfusion rate, duration of postoperative drainage, and postoperative hospital stay, and increased the serum hemoglobin concentration, thereby providing better clinical outcomes for surgical patients. However, tTXA had no effect on intraoperative blood loss and associated complications.</p><p><strong>Conclusion: </strong>On the basis of the available evidence, the present results provide strong clinical evidence of the clinical value of tTXA in spinal surgery and provide an important reference for future research and clinical decision-making.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"796-805"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861264","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
Leg length discrepancy after total hip arthroplasty performed by direct anterior approach: a systematic review comparing surgical approaches and strategies for prevention. 通过直接前路进行全髋关节置换术后的腿长差异:比较手术方法和预防策略的系统综述。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0116
Leonardo Tassinari, Alberto Di Martino, Matteo Brunello, Valentino Rossomando, Francesco Traina, Cesare Faldini
{"title":"Leg length discrepancy after total hip arthroplasty performed by direct anterior approach: a systematic review comparing surgical approaches and strategies for prevention.","authors":"Leonardo Tassinari, Alberto Di Martino, Matteo Brunello, Valentino Rossomando, Francesco Traina, Cesare Faldini","doi":"10.1530/EOR-23-0116","DOIUrl":"10.1530/EOR-23-0116","url":null,"abstract":"<p><strong>Purpose: </strong>Leg length discrepancy (LLD) is a common complication following total hip arthroplasty (THA). The direct anterior approach (DAA) for THA is gaining popularity due to its advantages, but there is limited research on the incidence and size of LLD. This systematic review aims to explore the differences in LLD between DAA and other approaches, as well as the techniques to control LLD in DAA.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted to identify relevant studies comparing THA by DAA with other surgical approaches and investigating methods to control LLD in DAA, following PRISMA guidelines and a priori registration on PROSPERO (CRD42023412644). The quality of the included studies was assessed. Data on preoperative and postoperative LLD and other relevant outcomes were extracted and analyzed descriptively.</p><p><strong>Results: </strong>In total, 29 studies were included in this systematic review. The majority (86%) were classified as level IV evidence. Comparisons between DAA and posterior approach (PA) or anterolateral approach (ALA) showed DAA had lower rates of LLD >10 mm compared to PA and ALA. Different pre- and intra-operative techniques were evaluated, but no consensus on the best method for preventing LLD in DAA was reached.</p><p><strong>Conclusion: </strong>DAA shows comparable or superior results in the prevention of LLD compared to other surgical approaches. Supine patient placement, direct leg measurement, and the use of IF contribute to these outcomes. Intraoperative fluoroscopy with a grid and preoperative planning offers a good option, especially for training purposes, but its role in preventing LLD by experienced DAA surgeons needs further investigation.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"733-744"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861265","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
Metal-on-metal hip resurfacing arthroplasty: is it safe and reliable? A synopsis of the past, the present, and the future of HRA. 金属对金属髋关节置换术:它安全可靠吗?HRA的过去、现在和未来简介。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0099
Feng Xie, Shuya Sheng, Jeya Palan, Hemant G Pandit
{"title":"Metal-on-metal hip resurfacing arthroplasty: is it safe and reliable? A synopsis of the past, the present, and the future of HRA.","authors":"Feng Xie, Shuya Sheng, Jeya Palan, Hemant G Pandit","doi":"10.1530/EOR-23-0099","DOIUrl":"10.1530/EOR-23-0099","url":null,"abstract":"<p><p>This paper discusses the existing literature in the field of metal-on-metal (MoM) hip resurfacing arthroplasty (HRA), the background (why was it developed), the past (what was the evidence leading to its rise and fall in clinical use), the present situation (why a potential resurgence), and the future directions for potential improvements. All literature relevant to MoM HRA was reviewed and summarized to provide a comprehensive summary. Furthermore, a detailed literature search was performed on PubMeD, MEDLINE, and Google Scholar to identify all clinical studies reporting a minimum 10 years of outcomes for modern MoM HRA devices from February 2018 to February 2023. In addition, joint registry data over the same time period, available in the public domain, was examined to extract related information on MoM HRA. Metal ions are present in almost all types of hip replacement; on the whole, however, the risk of revision for resurfacing due to metal-related pathologies is very low, but higher than in other types of bearings. There are studies that show that some brands of MoM resurfacing prostheses have achieved excellent clinical outcomes in long-term follow-up studies and are still in use although less commonly than in early 2000s. Use of alternative bearing surfaces has demonstrated excellent results in the short-term and a very critical long-term follow-up of these cases still will help establish their place in the hip arthroplasty world. HRA deserves a permanent place in the armamentarium of orthopedic surgeons and in the hand of experienced surgeons.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"751-761"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861266","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
Do we need another screw? Sacroiliac screw fixation in open-book pelvic ring injuries (APC type II). 我们还需要另一颗螺钉吗?开卷骨盆环损伤(APC II 型)中的骶髂螺钉固定。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0173
Martin C Jordan, Konrad F Fuchs, Steven C Herath, Joachim Windolf, Rainer H Meffert, Anne Neubert
{"title":"Do we need another screw? Sacroiliac screw fixation in open-book pelvic ring injuries (APC type II).","authors":"Martin C Jordan, Konrad F Fuchs, Steven C Herath, Joachim Windolf, Rainer H Meffert, Anne Neubert","doi":"10.1530/EOR-23-0173","DOIUrl":"10.1530/EOR-23-0173","url":null,"abstract":"<p><strong>Purpose: </strong>To compare anterior plate fixation (SP fixation) both alone and in combination with an additional posterior sacroiliac screw (SP+SIS fixation) as a treatment for pelvic ring injuries with widening of the pubic symphysis and disruption to the anterior sacroiliac ligaments.</p><p><strong>Methods: </strong>To find studies with pelvic ring injuries (APC II; B2.3d) and SP or SP+SIS fixation, a systematic literature review was conducted by searching four databases. A protocol was published a priori at Open Science Framework (https://doi.org/10.17605/OSF.IO/3YHAV). Exclusion criteria included perineal injuries, chronic instability of the symphysis, complete sacroiliac separation, and pediatric patients (age <18 years). Primary outcomes of interest were defined as implant failure, health-related quality of life, and revision rate.</p><p><strong>Results: </strong>Altogether, 1861 studies were screened, and 40 studies qualified for full-text analysis. In total, 14 studies (two surveys, six biomechanical studies, and six retrospective clinical studies) were included. The surveys revealed that surgeons who had more recently begun practicing were more likely to use posterior fixation (SP+ISS). The biomechanical studies were heterogenous and did not yield a uniform pattern. In clinical studies, 117 patients (45%) received SP fixation, and 142 patients (55%) received SP+SIS fixation. Complications occurred in 31 SP patients (30%) and in five SP+SIS patients (3.5%).</p><p><strong>Conclusion: </strong>A high risk of bias was uncovered, and reporting was found to be incomplete. SP+SIS may have the potential to improve outcomes, but the evidence remains too inconclusive to draw reliable recommendations.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"827-836"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861263","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
Prevalence and related factors for neck pain in military personnel: a systematic review. 军人颈部疼痛的发病率和相关因素:系统综述。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0150
Le Tang, Yong-Hui Zhang, Shu-Hao Du, Xue-Qiang Wang
{"title":"Prevalence and related factors for neck pain in military personnel: a systematic review.","authors":"Le Tang, Yong-Hui Zhang, Shu-Hao Du, Xue-Qiang Wang","doi":"10.1530/EOR-23-0150","DOIUrl":"10.1530/EOR-23-0150","url":null,"abstract":"<p><strong>Purpose: </strong>In the military, neck pain is second to low back pain among musculoskeletal disorders. However, the prevalence and related factors of neck pain in military personnel have not been systematically investigated, which may lead to the lack of neck pain prevention and the generation of additional medical expenses, posing challenges to medical care. This review aimed to obtain the prevalence and related factors for neck pain in military personnel in an attempt to provide directions for prevention and intervention.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases in December 2021. Two researchers independently screened studies according to eligibility criteria and assessed study quality.</p><p><strong>Results: </strong>We screened titles and abstracts of 503 articles, and 17 articles met the inclusion criteria. Sixteen articles received moderate to high-quality evaluations. Neck pain is common in the military, with 1-year prevalence as high as 83% and lifetime prevalence as high as 78%. Old age (OR = 5.0), poor neck mobility (OR = 3.61), shoulder pain (OR = 4.9), low back pain (OR = 2.3), high-G pilots (OR = 1.6), longer flight time (OR = 2.53), type of aircraft (OR = 3.93), and use of helmets and night vision systems (OR = 1.9) may be associated with the prevalence of neck pain.</p><p><strong>Conclusion: </strong>Neck pain is highly prevalent in military personnel and exhibits a substantial lifetime prevalence rate. The high prevalence rate of neck pain in the military is related to many individual-related factors and work-related factors. The in-depth assessment and prevention of specific factors is an important direction of future research.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"806-816"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861327","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
Methods for three-dimensional characterization of the acetabulum prior to pelvic reorientation osteotomy: a scoping review. 骨盆重新定向截骨术前髋臼三维特征描述方法:范围综述。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-22-0126
Xavier du Cluzel de Remaurin, Nejib Khouri, Samuel Georges, Laurent Gajny, Claudio Vergari, Alina Badina
{"title":"Methods for three-dimensional characterization of the acetabulum prior to pelvic reorientation osteotomy: a scoping review.","authors":"Xavier du Cluzel de Remaurin, Nejib Khouri, Samuel Georges, Laurent Gajny, Claudio Vergari, Alina Badina","doi":"10.1530/EOR-22-0126","DOIUrl":"10.1530/EOR-22-0126","url":null,"abstract":"<p><p>Periacetabular osteotomy is the gold standard treatment for acetabular dysplasia. The great variability of acetabular dysplasia requires a personalized preoperative planning improved by 3D reconstruction and computer-assisted surgery. To plan the displacement of the acetabular fragment by a pelvic osteotomy, it is necessary to define a reference plane and a method to characterize 3D acetabular orientation. A scoping review was performed on PubMed to search for articles with a method to characterize the acetabulum of native hips in a 3D reference frame. Ninety-eight articles out of 3815 reports were included. Three reproducible reference planes were identified: the anterior pelvic plane, the Standardization and Terminology Committee plane used in gait analysis, and the sacral base plane. The different methods for 3D analysis of the acetabulum were divided in four groups: global orientation, triplanar measurements, segmentation, and surface coverage of the femoral head. Two methods were found appropriate for reorientation osteotomies: the global orientation by a vector method and the triplanar method. The global orientation method relies on the creation of a vector from the acetabular rim, from the acetabular surface or from successive planes. Normalization of the global acetabular vector would correct acetabular dysplasia by a single alignment maneuver on an ideal vector. The triplanar method, based on angle measurements at the center of the femoral head, would involve correction of anomalies by considering axial, frontal, and sagittal planes. Although not directly fit for reorientation, the two others would help to candidate patients and verify both planning and postoperative result.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"762-772"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861267","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
Molecular genetics of Dupuytren's contracture. 杜普伊特伦挛缩症的分子遗传学。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0056
Shankar Aissvarya, King-Hwa Ling, Manohar Arumugam, Karuppiah Thilakavathy
{"title":"Molecular genetics of Dupuytren's contracture.","authors":"Shankar Aissvarya, King-Hwa Ling, Manohar Arumugam, Karuppiah Thilakavathy","doi":"10.1530/EOR-23-0056","DOIUrl":"10.1530/EOR-23-0056","url":null,"abstract":"<p><p>Dupuytren's contracture (DC) is a fibroproliferative disorder of the palmar fascia characterised by the digits' flexion contractures and is associated with abnormal build-up of type III collagen. The prevalence of the disease is reported to be highest among Northern European descendants. However, the disease is widespread globally with varying prevalence. DC is a multifactorial disease, having both genetic and environmental factors contributing to the causality of the disease. Over the years, various studies have been conducted to understand the molecular mechanism and genetic aspects of DC but there is a lack of reports on the variants found in the exonic regions. Most reports are backdated making it necessary to re-evaluate the variants to further understand the genetic aetiology of DC. In this review, we first highlight the genetic aspects and previous genetic studies on DC. The report is followed by a discussion on the molecular pathways suggested to be associated with DC and a summary of the genetic variants in the exonic regions found in DC and their connections with the molecular pathways. A total of nine variants were reported originating from six genes comprising three pathways. Most variants reported are involved in the Wnt signalling pathway. Moreover, all variants identified are in European/Caucasian subjects and the variants found in the exonic regions are missense variants. A comparison of these findings with variants from populations of other regions can be conducted to identify the variants with the most occurrence to act as biomarkers or therapeutic targets for DC.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"723-732"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861326","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
Redisplacement rate after bony hip reconstructive surgery in nonambulatory patients with cerebral palsy: a systematic review and meta-analysis. 不行动的脑瘫患者骨性髋关节重建手术后的再置换率:系统回顾和荟萃分析。
IF 4.3 2区 医学
Efort Open Reviews Pub Date : 2024-08-01 DOI: 10.1530/EOR-23-0043
Heide Delbrück, Yannik Gehlen, Frank Hildebrand, Reinald Brunner
{"title":"Redisplacement rate after bony hip reconstructive surgery in nonambulatory patients with cerebral palsy: a systematic review and meta-analysis.","authors":"Heide Delbrück, Yannik Gehlen, Frank Hildebrand, Reinald Brunner","doi":"10.1530/EOR-23-0043","DOIUrl":"10.1530/EOR-23-0043","url":null,"abstract":"<p><strong>Purpose: </strong>Up to 90% of nonambulatory patients with cerebral palsy (CP) experience hip displacement during their lifetime. Reconstructive surgery is recommended. Redisplacement rate is an outcome parameter.</p><p><strong>Methods: </strong>In a systematic literature review (MEDLINE, Embase and CENTRAL databases) until January 2023 we searched for reports with redisplacement rates after bony hip reconstructive surgery in nonambulatory patients. Quantitative data synthesis, subgroup analysis and meta-regression with moderators were carried out.</p><p><strong>Results: </strong>The pooled mean redisplacement rate was 16% (95% CI: 12-21%) with a prediction interval of 3-51% (Q: 149; df: 32; P < 0.001; I2: 78%; τ2: 0.67 and τ: 0.82) in 28 studies (1540 hips). Varus derotation osteotomy (VDRO) alone showed a higher redisplacement rate than VDRO + pelvic osteotomy (30% vs 12%, P < .0001). Mean age in the VDRO-alone subgroup was 7.1 years and in the combined group 9.5 years (P = .004). In meta-regression, lower redisplacement rates were observed with higher preoperative migration index (MI) (correlation coefficient: -0.0279; P = .0137), where comprehensive surgery was performed. Variance in true effects are explained by type of bone surgery (57%), preoperative MI (11%), age (5%) and MI for definition of failure (20%). No significant reduction in the redisplacement rate could be observed over the mid-years of studies (1977-2015).</p><p><strong>Conclusion: </strong>Our pooled data support the more extensive surgical approach in patients with high preoperative MI and emphasize the superiority of combined surgery. Studies should report a coordinated set of parameters and outcome classifications according to internationally accepted gradings to reduce redisplacement in future.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 8","pages":"773-784"},"PeriodicalIF":4.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861328","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}
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