Journal of Orthopaedics and Traumatology最新文献

{"title":"Different patterns of neurogenic quadrilateral space syndrome: a case series of undefined posterior shoulder pain.","authors":"Giuseppe Porcellini, Alberto Brigo, Michele Novi, Elisa De Santis, Silvia Di Giacomo, Andrea Giorgini, Gian Mario Micheloni, Rocco Bonfatti, Alessandro Donà, Luigi Tarallo","doi":"10.1186/s10195-024-00813-y","DOIUrl":"10.1186/s10195-024-00813-y","url":null,"abstract":"<p><strong>Background: </strong>Quadrilateral space syndrome is a painful disorder of the shoulder caused by static or dynamic entrapment of the axillary nerve and the posterior humeral circumflex artery. It was first described in 1983; however, it is an uncommon syndrome that initially presents with nonspecific shoulder pain or selective deltoid atrophy, and diagnosis is often delayed owing to its rarity. Young athletes of overhead sports are more commonly affected by this syndrome. Symptoms of quadrilateral space syndrome include silent deltoid atrophy, persistent posterior shoulder pain, paresthesias, and tenderness over the quadrilateral space. Vascular symptoms may involve thrombosis and embolisms of the upper limb. Instrumental tests and imaging are not always conclusive, leading to frequent misdiagnosis of the syndrome.</p><p><strong>Patients and methods: </strong>The aim of this study is to present a case series of four patients diagnosed with neurogenic quadrilateral space syndrome, describe different clinical presentations, and suggest tips for diagnosing this syndrome. All patients underwent a detailed medical history collection, were interviewed about the sports and hobbies they engaged in, and received a comprehensive clinical examination of the neck and shoulder. Patients also underwent diagnostic exams such as magnetic resonance imaging (MRI) and electromyography. An ultrasound-guided injection of local anesthetic was performed into the quadrilateral space.</p><p><strong>Results: </strong>All patients affected by neurogenic quadrilateral space syndrome underwent conservative treatment, which included a rehabilitation program. Only one out of four patients experienced complete resolution of symptoms and did not require surgical decompression.</p><p><strong>Conclusions: </strong>To properly treat this rare syndrome, we propose classifying it as either \"dynamic\" or \"static,\" on the basis of the clinical history, MRI findings, and physical examination. The study includes a rehabilitation program that was effective for one patient, demonstrating that surgical decompression may be avoidable if the cases are promptly diagnosed and classified. Level of evidence IV according to \"The Oxford 2011 Levels of Evidence\".</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"26 1","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923739","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}

{"title":"MRI in the evaluation of plantar plate disease: diagnostic value of the \"stress test\".","authors":"Luca Giuliani, Carlo Ottonello, Alessandra Giuliani, Lucia Bondì, Paolo Ronconi, Valerio Tempesta, Patrizia Pacini, Vito Cantisani","doi":"10.1186/s10195-024-00814-x","DOIUrl":"10.1186/s10195-024-00814-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The plantar plate, also called the plantar ligament, is a fibrocartilaginous structure found in the metatarsophalangeal (MTP) and interphalangeal (IP) joints. Our study aimed to evaluate the role of magnetic resonance imaging (MRI) performed with the patient in the standard position or with joint hyperextension (the \"stress test\", ST) in the study of plantar plate (PP) disease that involves metatarsophalangeal joints.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;All patients underwent forefoot MRI (Atroscan C, Esaote, Genoa, Italy), operating at 0.2 T. All patients first underwent a standard MRI examination (coronal T1 and T2 weighted image (WI) with fat suppression and axial and sagittal T2 WI); the examination was completed by performing a stress test (hyperextension of toes). The ST is an easy task to perform and is not time-consuming (requiring only one additional sagittal fast spin echo (FSE) T2-weighted MRI sequence; repetition time/ echo time (TR/TE): 3200/90 ms) for patients and operators. A 45°-dorsiflexion ST was performed for approximately 2.30 min, the time required to complete the sequence. No further diagnostic investigations were necessary; no patients underwent arthrography or arthro-MRI. The examinations were performed in a double-blind mode by two operators with proven experience in musculoskeletal radiology; no cases of intra-operator discordance were found.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-five patients were recruited into our study over a 2-year period; 15 were positive for metatarsal pain and 10 were controls. Before treatment (surgery), all patients displaying symptoms underwent evaluation. As a result, the imaging features accurately represented the natural and actual conditions of the lesions. Among the symptomatic patients, 11 out of the 15 exhibited a PP tear or dysfunction in both the standard position and the ST. Additionally, two out of the 15 individuals displayed a tear in the ST alone, with no indication of it in the standard position. In contrast, two out of 15 patients showed no evidence of a PP tear in either the standard position or the ST. However, these two patients demonstrated dorsal subluxation during the ST, likely due to micro-instability resulting from PP failure. In the asymptomatic patients, nine out of the 10 individuals were found to be negative for PP dysfunction. Only one out of the 10 patients exhibited dorsal subluxation solely in the ST, indicative of plantar plate dysfunction, but no evidence of a tear in the PP. In the asymptomatic patients, standard MRI provided a specificity of 100% and a high negative predictive value (NPV) (90%), while the latter increased with the ST (specificity and NPV equal to 100%). In symptomatic patients, standard MRI gave a sensitivity of 75% when assessing a PP tear, which increased to 100% with the ST; the sensitivity of standard MRI the evaluation of MF subluxation was 60%, but it reached 100% with the ST.&lt;/p&gt;&lt;p&gt;&lt;strong","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"70"},"PeriodicalIF":3.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883473","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}

{"title":"The ligamentum teres and its role in hip arthroscopy for femoroacetabular impingement: a systematic review.","authors":"Filippo Migliorini, Federico Cocconi, Tommaso Bardazzi, Virginia Masoni, Virginia Gardino, Gennaro Pipino, Nicola Maffulli","doi":"10.1186/s10195-024-00810-1","DOIUrl":"10.1186/s10195-024-00810-1","url":null,"abstract":"<p><strong>Background: </strong>The ligamentum teres (LT) has received attention in patients undergoing hip arthroscopy (HA) for femoroacetabular impingement (FAI). Indeed, a better understanding of the function of the LT and its implications for clinical outcomes in the presence of a torn LT is required. This systematic review analyses the patient-reported outcome measures (PROMs) and the complication rate when an intact or torn LT is encountered during HA for FAI.</p><p><strong>Methods: </strong>Studies that compared patients with an intact to those with a torn LT managed with debridement during hip arthroscopy for FAI were identified from the Web of Science, PubMed, and Embase. The minimum follow-up for inclusion was 24 months. The Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tool was used to assess the risk of bias. Patient characteristics and PROMs were assessed at the baseline and last follow-up.</p><p><strong>Results: </strong>The systematic review identified two studies comprising 611 patients. No statistically significant difference was found in pain, Harris Hip Score, and the activities of daily living and sports subscales of the Hip Outcome Score between patients with an intact LT and those with a torn LT treated with debridement, both of whom underwent HA for FAI.</p><p><strong>Conclusions: </strong>In patients undergoing arthroscopic management for FAI, an intact or torn ligamentum teres managed with debridement does not influence postoperative PROMs. Given the importance of the LT as a structure of the hip joint and the increasing interest in HA for FAI, further standardised studies will be a valuable source for surgeons encountering this pathology.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"68"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865919","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}

{"title":"Current trends in the medial side of the knee: not only medial collateral ligament (MCL).","authors":"Gian Andrea Lucidi, Luca Solaro, Alberto Grassi, Mohammad Ibrahim Alhalalmeh, Stefano Ratti, Lucia Manzoli, Stefano Zaffagnini","doi":"10.1186/s10195-024-00808-9","DOIUrl":"10.1186/s10195-024-00808-9","url":null,"abstract":"<p><p>The medial collateral ligament (MCL) is by far the most commonly injured ligament of the knee. The medial ligament complex covers a broad bony surface on the extraarticular portion of the femur and is highly vascularized, which allows for a high healing potential. For this reason, most MCL complex lesions were treated conservatively in the past. However, recent advancements regarding the MCL anatomy and kinematics highlighted the complex biomechanical behavior of the isolated and combined MCL lesion, and it is now fully appreciated that some MCL lesions warrant surgical treatment. The present review aims to provide the reader with an overview of the new evidence and advancement on the complex anatomy, biomechanics, and treatment of the MCL.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"69"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865917","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}

{"title":"Differences in microorganism profile in periprosthetic joint infections of the hip in patients affected by chronic kidney disease.","authors":"Davide Stimolo, Maximilian Budin, Domenico De Mauro, Eduardo Suero, Thorsten Gehrke, Mustafa Citak","doi":"10.1186/s10195-024-00806-x","DOIUrl":"10.1186/s10195-024-00806-x","url":null,"abstract":"<p><strong>Background: </strong>Patients affected by chronic kidney disease (CKD) are at increased risk of periprosthetic joint infection (PJI) after total hip arthroplasty (THA). This patient population has a higher risk of recurrent infections and hospitalization. The aim of this study is to compare the profile of microorganisms in patients with CKD and PJI of the hip versus controls and to individuate potentially unusual and drug-resistant microorganisms among the causative bacteria.</p><p><strong>Materials and methods: </strong>A total of 4261 patients affected by PJI of the hip were retrospectively studied. Patients affected by CKD in this population were identified and compared with a control group of patients with PJI but without CKD. Data on patient characteristics and comorbidities were collected. The microorganisms responsible for PJI were identified and compared between both groups.</p><p><strong>Results: </strong>The CKD group included 409 patients, 54.3% male, mean age of 73.8 ± 8.9 years, a higher body mass index (BMI) than the general population (29.88 ± 5.90 kg/m²), and higher age-adjusted CCI of 6.15 ± 2.35. Overall, 70 different isolates of microorganisms were identified, including 52 Gram-positive spp., 28 Gram-negative spp., 3 fungi, and 1 mycobacterium. Polymicrobial infections were more common in CKD group than controls (47.9% versus 30.9%; p < 0.0001). Staphylococcus spp. were the most common bacteria in both groups, followed by Gram-negative Enterobacteriaceae and Streptococcus spp. CKD group showed a higher risk of developing infections caused by Staphylococcus aureus (p = 0.003), Gram-negative bacteria, and Candida (p = 0.035).</p><p><strong>Conclusions: </strong>Renal failure exposes patients who undergo THA to PJI caused by microorganisms that are potentially more drug resistant, leading to a higher risk of treatment failure. Knowing in advance the different microorganism profiles could help to plan a different surgical strategy.</p><p><strong>Level of evidence iii: </strong></p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"67"},"PeriodicalIF":3.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865918","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}

{"title":"Efficacy of platelet-rich plasma in meniscal repair surgery: a systematic review of randomized controlled trials.","authors":"Giovanni Sergio Utrilla, Irene Roman Degano, Riccardo D'Ambrosi","doi":"10.1186/s10195-024-00799-7","DOIUrl":"10.1186/s10195-024-00799-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study's primary objective was to evaluate the effectiveness of platelet-rich plasma (PRP) administration for meniscal injuries treated with meniscal repair procedures (sutures), using radiologic measures and clinical scales. The secondary objective was to identify potential bias-inducing elements in the analyzed studies.</p><p><strong>Methods: </strong>In December 2023, a systematic search was conducted in PubMed, Cochrane, Embase, and Scopus for randomized controlled trials. This review compares PRP with placebo. Three studies were finally selected. The risk of bias was assessed using Cochrane's Risk of Bias Tool 2. Radiologic evaluation of meniscal healing was measured with magnetic resonance imaging (MRI) and arthroscopic studies, while clinical evaluation was performed using four scales [Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), International Knee Documentation Committee Subjective Knee Form (IKDC), and Western Ontario and McMaster Universities Index (WOMAC)] and by recording the incidence of complications.</p><p><strong>Results: </strong>The three selected studies included 139 patients; of these, 76 (54.7%) were randomly assigned to the intervention group (PRP injection) and 63 (45.3%) to the control group (placebo). The mean age of the intervention group was 37.4 ± 7.5 years, while the mean age of the control group was 36.5 ± 9.2 years. There were 41 female patients (29.5%). The median follow-up duration was 27.58 ± 17.3 months. MRI evaluation did not show a significant improvement in the PRP group in any of the studies (p-value = 0.41-0.54). However, when assessed by the cumulative evaluation of MRI and arthroscopy, the cumulative failure rate was significantly better in the PRP group (p-value = 0.04-0.048). One study that evaluated isolated arthroscopy also showed significant improvement in the PRP group (p = 0.003). Regarding the VAS scale, no study demonstrated a significant difference, except for one study that showed significant improvement after 6 months and in the difference between the 3rd and 6th months. The KOOS scale yielded conflicting results; one study showed no significant difference, while the other two indicated significant improvement. The IKDC and WOMAC scales were evaluated in two studies, showing opposite results. All included studies reported no complications, and one study indicated no increased risk in the treatment group.</p><p><strong>Conclusions: </strong>The results of this review indicate the necessity for further studies to make a definitive statement about the effectiveness of PRP administration in meniscal repair processes. Level of evidence Systematic review and meta-analysis of articles of level 1.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"63"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855881","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}

{"title":"Efficacy and safety of quadriceps tendon autograft versus bone-patellar tendon-bone and hamstring tendon autografts for anterior cruciate ligament reconstruction: a systematic review and meta-analysis.","authors":"Xiao-Feng Zhang, Pan Liu, Jun-Wu Huang, Yao-Hua He","doi":"10.1186/s10195-024-00801-2","DOIUrl":"10.1186/s10195-024-00801-2","url":null,"abstract":"<p><strong>Background: </strong>Quadriceps tendon (QT), bone-patellar tendon-bone (BPTB), and hamstring tendon (HT) autografts are widely used for anterior cruciate ligament reconstruction (ACLR), but the optimal autograft choice remains controversial. This study assessed the treatment effects of QT versus BPTB and HT autografts for ACLR.</p><p><strong>Methods: </strong>The PubMed, Embase, and Cochrane Library databases were systematically searched for eligible studies published from inception until July 2022. Effect estimates were presented as odds ratios (OR) and weighted mean differences (WMD) with 95% confidence intervals (CI) for categorical and continuous variables, respectively. All pooled analyses were performed using a random-effects model.</p><p><strong>Results: </strong>Twenty-one studies (3 randomized controlled trials [RCTs], 3 prospective studies, and 15 retrospective studies) involving 2964 patients with ACLR were selected for meta-analysis. Compared with the HT autograft, the QT autograft was associated with a reduced risk of graft failure (OR: 0.46; 95% CI: 0.23-0.93; P = 0.031). Compared with the BPTB autograft, the QT autograft was associated with a reduced risk of donor site pain (OR: 0.16; 95% CI: 0.10-0.24; P < 0.001). Moreover, the QT autograft was associated with a lower side-to-side difference than that observed with the HT autograft (WMD: - 0.74; 95% CI: - 1.47 to - 0.01; P = 0.048). Finally, compared with the BPTB autograft, the QT autograft was associated with a reduced risk of moderate-to-severe kneecap symptoms during sports and work activities (OR: 0.14; 95% CI: 0.05-0.37; P < 0.001).</p><p><strong>Conclusions: </strong>The findings of this study suggest that the QT autograft can be defined as a safe and effective alternative choice for ACLR, but its superiority is yet to be proven by RCTs and prospective studies. Level of evidence Level III.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"65"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855750","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}

{"title":"For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review.","authors":"Cesare Faldini, Francesco Traina, Federico Pilla, Claudio D'Agostino, Matteo Brunello, Manuele Morandi Guaitoli, Alberto Di Martino","doi":"10.1186/s10195-024-00812-z","DOIUrl":"10.1186/s10195-024-00812-z","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) has significantly improved the lives of patients with degenerative hip disorders. The direct anterior approach (DAA) is favored for its minimally invasive nature, leading to less postoperative pain and a faster recovery. The bikini incision (BI) approach was developed to enhance aesthetic outcomes while maintaining the clinical and functional benefits of the DAA. Despite its advantages, the BI technique presents challenges, controversies persist regarding its efficacy and safety, and there is no consensus within the medical community about its overall benefits. Incisions aligned with Langer's lines, like the BI, promote better healing and minimal scarring. Studies indicate that BI patients report higher satisfaction with scar appearance and texture compared to traditional DAA patients. However, the BI carries a higher risk of lateral femoral cutaneous nerve (LFCN) injury, although most symptoms resolve within 6 months. For obese patients, the BI is associated with fewer complications, such as infections and delayed healing, compared to the conventional DAA, making it a safe and effective option. BI patients also experience better aesthetic outcomes and functional recovery, with reduced pain and itching. The BI technique in THA represents a significant advancement, offering improved aesthetic and wound-healing outcomes. The shift from the traditional DAA to the BI aligns with patient preferences for scars that are less visible and conspicuous. Despite the steep learning curve and risks, careful patient selection and refined surgical techniques can enhance the BI's benefits. Future research should focus on long-term outcomes and comparative studies to further establish the BI's efficacy and safety. As patient demand for aesthetically favorable surgeries grows, the BI is likely to become a preferred approach in THA.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"66"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855827","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}

{"title":"Postoperative femoral head cartilage injury after hip arthroscopic treatment for femoroacetabular impingement syndrome and labral tear.","authors":"Guanying Gao, Yichuan Zhu, Siqi Zhang, Yingfang Ao, Jianquan Wang, Yan Xu","doi":"10.1186/s10195-024-00811-0","DOIUrl":"10.1186/s10195-024-00811-0","url":null,"abstract":"<p><strong>Background: </strong>Postoperative femoral head cartilage injury (FHCI) is a rare condition that can be observed in a certain proportion of patients undergoing hip arthroscopy. However, the prevalence and associated factors of FHCI, and the effect of this condition on clinical outcomes still remain unknown.</p><p><strong>Patients and methods: </strong>Consecutive patients who were diagnosed with femoroacetabular impingement syndrome (FAIS) and labral tear and underwent hip arthroscopic treatment in our institute between July 2020 and July 2021 were retrospectively evaluated. Supine anteroposterior hip radiographs, cross-table lateral radiographs, magnetic resonance imaging (MRI), and computed tomography (CT) were obtained preoperatively. Postoperative MRI, at least 6 months after arthroscopy, was performed. Postoperative FHCI was evaluated by two surgeons through MRI. Preoperative patient-reported outcomes (PROs) including visual analog scale (VAS) for pain, and modified Harris Hip Score (mHHS) before surgery and at final followup were obtained.</p><p><strong>Results: </strong>A total of 196 patients were included. Postoperative FHCI was identified in 21 (10.7%) patients. The intraobserver reliability of the observer A and B for detecting postoperative FHCI using 3.0-T MRI was high (k = 0.929, and k = 0.947, respectively). The interobserver reliability between the two observers for detecting FHCI using 3.0-T MRI was high (k = 0.919). There was no significant difference in preoperative and postoperative mHHS, VAS, and percentage of patients who surpassed minimal clinically important difference (MCID) and achieved patient acceptable symptom state (PASS) between patients with and without postoperative FHCI (P > 0.05).</p><p><strong>Conclusion: </strong>Although postoperative FHCI was observed in 10.7% of patients, which was associated with larger labrum, this condition did not result in inferior clinical outcomes. Level of evidence IV, retrospective case series. Trial registration The Chinese Clinical Trial Registry approved the registration (ChiCTR2200061166). The date of registration is 2022-06-15.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"64"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856068","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}

{"title":"Biphasic cartilage repair implant versus microfracture in the treatment of focal chondral and osteochondral lesions of the knee: a prospective, multi-center, randomized clinical trial.","authors":"Tzu-Hao Tseng, Chao-Ping Chen, Ching-Chuan Jiang, Pei-Wei Weng, Yi-Sheng Chan, Horng-Chaung Hsu, Hongsen Chiang","doi":"10.1186/s10195-024-00802-1","DOIUrl":"10.1186/s10195-024-00802-1","url":null,"abstract":"<p><strong>Background: </strong>Autologous minced cartilage is a method for cartilage defect repair, and our study focuses on a newly developed biphasic cylindrical osteochondral construct designed for use in human knees. We aimed to compare its clinical effectiveness and safety with microfracture, the commonly utilized reparative treatment for knee chondral or osteochondral defects.</p><p><strong>Materials and methods: </strong>Conducted as a prospective multicenter, randomized controlled, non-inferiority trial across nine hospitals, the study involved 92 patients with International Cartilage Repair Society (ICRS) grade 3 to 4 chondral or osteochondral lesions on femoral condyles. Patients were evenly randomized to receive either the biphasic cartilage-repair implant (BiCRI) or microfracture. Functional outcomes and safety assessments were conducted at postoperative intervals of 6 weeks and 3, 6, and 12 months. Primary and secondary endpoints included International Knee Documentation Committee (IKDC) 2000 Subjective Knee Evaluation Form score improvement, the grade distribution in the IKDC 2000 Knee Examination Form, and various assessments, such as the Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analog scales (VASs) for pain, MRI findings, and arthroscopic findings at 12 months.</p><p><strong>Results: </strong>Out of the initial participants, 47 in the BiCRI group and 45 in the microfracture group completed the follow-up. At 12 months, the mean change in IKDC total score was 25.56 ± 18.48 for BiCRI and 27.51 ± 23.65 for microfracture. The 95% confidence interval (CI) for the score difference (BiCRI minus microfracture) was - 6.95, exceeding the non-inferiority margin of - 12. Secondary endpoints indicated comparable functional outcomes, and arthroscopic findings demonstrated more fully regenerated cartilage in the BiCRI group.</p><p><strong>Conclusion: </strong>Based on the IKDC 2000 Subjective Knee Evaluation Form score, BiCRI proved non-inferior to microfracture at 12 months. Short-term functional outcomes were comparable to those with microfracture, while arthroscopic findings showed more complete cartilage regeneration in the BiCRI group. Consequently, BiCRI emerges as a viable alternative for treating chondral or osteochondral defects.</p><p><strong>Level of evidence: </strong>Level 2, multi-center, randomized clinical trial.</p><p><strong>Trial registration: </strong>Name of the registry: ClinicalTrials.gov.</p><p><strong>Trial registration number: </strong>NCT01477008. Date of registration: 11/14/2011. URL of trial registry record: clinicaltrials.gov/study/NCT01477008.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"62"},"PeriodicalIF":3.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773833","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}