European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Does a Suprascapular Nerve block reduce chronic shoulder pain at 3 months compared to standard non-operative care? A systematic review.","authors":"Sean David Scattergood, Abdul Hassan, Mark Williams","doi":"10.1007/s00590-025-04287-4","DOIUrl":"https://doi.org/10.1007/s00590-025-04287-4","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic shoulder pain affects 2.4-30% of adults at any given time because of a wide variety of underlying pathologies. Treatment of chronic shoulder pain should attempt to address the underlying cause, if possible, either through surgical or non-surgical means. Routine non-operative care involves analgesia, physiotherapy and perhaps injection of corticosteroid at the appropriate site. A suprascapular nerve block (SSNB) is a minimally invasive, low-risk procedure which offers analgesia for patients. This review evaluates the effectiveness of SSNB in reducing shoulder pain at a 3-month follow-up, in comparison to standard non-operative care.</p><p><strong>Methods: </strong>A literature search was conducted across Medline, Embase, Cochrane, ISRCTN and clinicaltrial.gov databases from inception to November 2024. Ninety publications were screened by abstract followed by full text, by the authors against inclusion criteria, and risk of bias was assessed using the RoB 2 tool.</p><p><strong>Results: </strong>Five randomised studies were included for analysis, presenting a heterogeneous mix of intervention, study populations and outcome measures. The two studies performing SSNB with local anaesthetic (LA) and corticosteroid found a significant reduction in pain at 3 months. In contrast, compared to studies using LA alone did not demonstrate the same level of efficacy.</p><p><strong>Conclusion: </strong>Suprascapular nerve block is an effective analgesic option for chronic shoulder pain, which can be offered to patients as part of a shared decision-making approach. While studies suggest efficacy of combined LA and corticosteroid, limitations such as heterogeneity, variability in result reporting and short follow-up periods reduce the strength of the evidence.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"162"},"PeriodicalIF":1.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013452","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":"Posterior approaches for articular distal humeral fractures.","authors":"Federico Martinelli, Clelia Rota, Domenico Rodà, Martina Coppola, Andrea Celli","doi":"10.1007/s00590-025-04280-x","DOIUrl":"https://doi.org/10.1007/s00590-025-04280-x","url":null,"abstract":"<p><p>Approaching the elbow joint posteriorly is the most used method to visualize closed fractures of the distal humerus in adults. Treatment can span from open reduction and internal fixation to elbow hemiarthroplasty and total elbow arthroplasty. Different approaches were developed in the necessity of balancing an adequate visualization with minimizing complications and these surgical exposures can be divided into four main categories: paratricipital, triceps reflecting, triceps splitting and olecranon osteotomy. In this article are described the positive and negative features of the principal posterior elbow approaches and their best clinical uses for the treatment of distal humerus complete articular fractures classified according to AO/OTA classification 13C.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"161"},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fix and replace for acetabular fractures: a decade of outcomes.","authors":"Samuel Walters, Matthew Hague, Eamonn Coveney, Simon Smith, Paul Gillespie, Adrian Day, Ross Coomber","doi":"10.1007/s00590-025-04281-w","DOIUrl":"https://doi.org/10.1007/s00590-025-04281-w","url":null,"abstract":"<p><strong>Background: </strong>Fix and replace is the combination of fixation and hip arthroplasty for the treatment of acetabular fractures. This technique is typically performed for elderly patients with complex fracture patterns, whereby fixation alone may not achieve a satisfactory result or allow early unrestricted weightbearing.</p><p><strong>Methods: </strong>This was a retrospective observational study of patients with acetabular fractures treated with fix and replace, identified from a locally maintained, prospectively collected database. Imaging and case notes were reviewed for patient and injury characteristics and outcomes.</p><p><strong>Results: </strong>Between 2014 and 2024, 92 consecutive cases (91 patients) were identified with a median age of 78 years. Operations performed with a single approach had a significantly lower mean anaesthetic time and intra-operative blood loss than dual approach (4.4 h vs 5.0 h, p = 0.043; 500 ml vs 800 ml, p = 0.036). There were 3 revisions for infection (3.3%) and 5 dislocations (5.4%), one of which was revised, with the other four treated successfully with manipulation only. Mortality rates were 12.5%, 30.9%, and 50% at 1, 3, and 5 years, respectively. Increasing age, dependent pre-operative mobility status, and increasing Charlson Comorbidity Index were all associated with all-time mortality risk (p < 0.001, p < 0.001, and p = 0.002, respectively).</p><p><strong>Conclusion: </strong>This is the largest series of its kind to date, providing additional information about typical patient and injury characteristics and expected outcomes. Due to the benefits of single rather than dual approach, this should be considered where possible using percutaneous techniques and acetabular component augmentation where required, to minimise operative time and blood loss.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"160"},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BicepBrace biceps tendon augmentation improves outcomes one year following surgery.","authors":"Theodore Joaquin, Christopher Bellaire, Gregory Perraut, Evan Argintar","doi":"10.1007/s00590-025-04285-6","DOIUrl":"https://doi.org/10.1007/s00590-025-04285-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study emphasizes the clinical utility of our newly published \"BicepBrace\" technique by comparing its preliminary outcomes with standard treatment within the short term follow-up of 12 months following massive rotator cuff repair surgery.</p><p><strong>Methods: </strong>A retrospective chart review of all the rotator cuff repairs by E.H.A. over a two year span was completed under institutional review board approval. Inclusion criteria included all adult patients who received primary massive rotator cuff repair within the time frame of June 15, 2021 and June 15, 2023. Exclusion criteria included non-massive rotator cuff repair, revision surgery, or rotator cuff repairs that were paired with total shoulder arthroplasty. These massive rotator cuff repairs were then evaluated for clinical failure necessitating revision surgery within 12 months of original repair. Statistical analyses were performed using t tests and chi square tests.</p><p><strong>Results: </strong>In total, 102 rotator cuff repairs were identified within the study timeframe. In total, 24 of these cases met criteria to be labeled as massive tears. In total, 13 of these massive tears were treated by standard technique and 11 of them were treated with our BicepBrace biceps tendon transfer technique. In total, 4 of the patients in the standard technique group were deemed clinical failures necessitating revision surgery (failure rate of 30.8%). Only one of the BicepBrace patients were deemed clinical failures (failure rate of 9.1%).</p><p><strong>Conclusion: </strong>In the setting of a massive rotator cuff tear, the BicepBrace technique-utilizing the long head of the biceps tendon for superior cuff augmentation-may enhance the survivability of the repair within one year of surgery. This relatively new approach offers a promising alternative to standard techniques, particularly for certain patient populations.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"159"},"PeriodicalIF":1.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonoperative versus operative management of pediatric type 1 open fractures.","authors":"Kevin Schauer, Dylan Lis, Ellen Lutnick, Lauren Harte, M Nadir Haider, Jeremy Doak","doi":"10.1007/s00590-025-04277-6","DOIUrl":"https://doi.org/10.1007/s00590-025-04277-6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare outcomes, including complications and admission status of pediatric type I open fractures treated operatively versus nonoperatively, and to expand on a previously published analysis regarding the efficacy and safety of nonoperative treatment of pediatric type I open fractures by this group.</p><p><strong>Methods: </strong>Retrospective chart review via ICD-9 and ICD-10 codes correlated with type 1 open fractures of long bones at our Level 1 Children's Hospital from 2000 to 2020. Nonoperative management included IV antibiotics and closed reduction and immobilization under sedation. Operative management included formal I&D and ORIF. Demographics, antibiotic administration, hospitalization, and complications were compared using independent t test, and chi-squared or fisher exact test. Radiographic healing was analyzed.</p><p><strong>Results: </strong>Ninety patients met inclusion criteria [52 nonoperative (NO), 38 operative (OR)] (Table 1). Patients were treated predominately with cefazolin (NO 85.7%, OR 71.4%). Nonoperative patients were more frequently given oral antibiotics (NO 82.7%, OR 44.7%, p value 0.004). Those treated operatively were more frequently admitted (71.1% vs. 25%, p < 0.001). There were three deep infections in the operative cohort requiring repeat operative I&D (p 0.110) (Table 2). There were more incisional infections (7.9% vs. 1.9%), nonunion (2.6% vs. 0%), and ED visits/readmissions (10.5% vs. 3.8%) in the operative cohort. Loss of reduction was more common in the nonoperative cohort (9.6% vs. 5.2%), and refracture/peri-implant fracture in the operative (10.5% vs. 0%). Comparison of overall complications favored the nonoperative group (p = 0.037, Table 3).</p><p><strong>Conclusions: </strong>Nonoperative management is a safe and effective treatment of pediatric type I open fractures, including decreased hospital admission and elimination of anesthesia risks.</p><p><strong>Level iii evidence: </strong>Retrospective comparative study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"158"},"PeriodicalIF":1.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D virtual surgical planning of fractures in hip arthrodesis: a systematic review, case series and recommendations for treatment.","authors":"Raul G Plomp, Kaj Ten Duis, Anne M L Meesters, Frank F A IJpma","doi":"10.1007/s00590-025-04283-8","DOIUrl":"https://doi.org/10.1007/s00590-025-04283-8","url":null,"abstract":"<p><strong>Purpose: </strong>Fractures through an arthrodesed hip are rare and challenging. The aim of the study is (1) to explore whether 3D-planned percutaneous screw fixation of fractures in hip arthrodesis is a viable minimally invasive surgical option for geriatric patients and (2) to standardize surgical treatment by providing a comprehensive overview of the literature and propose a treatment algorithm.</p><p><strong>Methods: </strong>We presented a case series of patients with an acute fracture in a previous hip arthrodesis treated in a level 1 trauma centre in 2024. Furthermore, we conducted a systematic review on fractures in hip arthrodesis from 1970 to 2023.</p><p><strong>Results: </strong>We presented three cases treated for a fracture in an arthrodesed hip. Two patients with a proximal/medial fracture to the acetabulum were operated with 3D-planned percutaneous cannulated screws, and one patient with an intertrochanteric fracture was operated with a DHS system. The systematic review resulted in an overview of 16 case series on fractures in hip arthrodesis treated with various surgical techniques, each with its pros and cons; cannulated screws, DHS system, intramedullary nailing and plate osteosynthesis.</p><p><strong>Conclusion: </strong>Acute fractures in arthrodesed hips in fragile geriatric patients can be treated minimally invasively with 3D-planned percutaneous screw fixation. This technique is most suitable for femoral neck fracture types. Alternative surgical techniques include DHS, intramedullary nailing, plate osteosynthesis or conversion to total hip arthroplasty, for which a treatment algorithm is provided.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"157"},"PeriodicalIF":1.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046717","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":"National and regional trend over time in the prevalence of osteonecrosis of the femoral head among military draft-eligible males in South Korea: an analysis of a nationwide database from 2013 to 2022.","authors":"Hong Jin Kim, Pil Whan Yoon, Jae Youn Yoon, Hyun Woog Lee, Sung Min Park, Dong-Hoon Lee, Jun-Ki Moon","doi":"10.1007/s00590-025-04278-5","DOIUrl":"https://doi.org/10.1007/s00590-025-04278-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prevalence of ONFH among the military draft-eligible male population in South Korea between 2013 and 2022.</p><p><strong>Methods: </strong>A total of 3,166,669 individuals were examined at regional Military Manpower Administration offices for 10 years. In a study using a retrospective analysis of prospectively collected data, the prevalence of ONFH per 100,000 individuals, along with the 95% confidence interval (CI), was measured among military draft-eligible Korean males. The Mann-Kendall trend test was performed to assess the correlation of the ONFH prevalence with several potentially related factors.</p><p><strong>Results: </strong>The mean annual prevalence of ONFH was 13.04 (95% CI: 9.06-17.01), indicating a rare entity. The prevalence was nearly consistent (Tau = - 0.2; p = 0.484), with the highest in 2018 (21.54; 95% CI: 16.42-26.66) and the lowest in 2020 (10.99; 95% CI: 7.12-14.85). Unilateral ONFH had a higher proportion than bilateral ONFH. There was a significant correlation between the prevalence of ONFH and the rate of risk alcohol consumption (Tau = 0.644, p = 0.009).</p><p><strong>Conclusion: </strong>The prevalence of ONFH in military draft-eligible males was low, with nearly consistent trends between 2013 and 2022. Unilateral ONFH was relatively high compared to bilateral cases, highlighting distinctive characteristics in the military draft-eligible male population.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"156"},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical evaluation of arthroscopic decompression of spinoglenoid notch cyst through a single posterior portal.","authors":"Yi Zhang, Youliang Shen, Dewei Kou, Jinli Chen, Tengbo Yu, Chao Qi","doi":"10.1007/s00590-025-04208-5","DOIUrl":"https://doi.org/10.1007/s00590-025-04208-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to describe and evaluate the arthroscopic technique for decompressing spinoglenoid notch cyst (SGNC) using a single posterior working portal.</p><p><strong>Methods: </strong>From January 2010 to March 2022, 20 patients with SGNC who were available for a minimum of 2 years of follow-up were included. All surgical procedures involved suprascapular nerve (SSN) decompression via a posterior portal. Preoperative and postoperative assessments included the visual analog scale (VAS), Constant-Murley Shoulder Score (CS), American Shoulder and Elbow Surgeon (ASES) score, magnetic resonance image (MRI) and electromyogram (EMG). MRI and EMG were performed at 6 months postoperatively.</p><p><strong>Results: </strong>All 20 patients were included in this study. The mean follow-up period was 32.5 ± 11.71 months. The VAS improved from 4.50 ± 3.11 to 1.50 ± 0.50 (P < .001), the mean CS improved from 40.80 ± 14.89 to 88.30 ± 7.51 (P < .001), and the mean ASES score improved from 50.51 ± 10.62 to 87.80 ± 6.95 (P < .001) at the last follow-up. Postoperative MRI and EMG at 6 months revealed complete symptomatic remission in all 20 cases. Patient satisfaction with the surgery was good to excellent in 19 patients.</p><p><strong>Conclusion: </strong>Arthroscopic decompression of the SGNC through a single posterior working portal is a simple, straightforward and effective technique that ensures visualization while preventing potential damage to the SSN.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"153"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does capsulotomy in closed reduction of garden type 3 femoral neck fractures decrease incidence of avascular necrosis? A randomized controlled trial.","authors":"Mohamed Salama Hamdy, Ahmed O Sabry, Mahmoud Abdelazim, Rana Ali Ahmed, Ahmed Morrah, Alaa Eldin Mohy Eldin, Mohamed Ghanem","doi":"10.1007/s00590-025-04264-x","DOIUrl":"https://doi.org/10.1007/s00590-025-04264-x","url":null,"abstract":"<p><strong>Background: </strong>Femoral neck fractures, pose significant risks of AVN and non-union. Recent studies suggest that adding capsulotomy to CRIF could reduce complications by alleviating intracapsular pressure and enhancing femoral head vascularity. This study aims to assess the efficacy of capsulotomy combined with CRIF in reducing the incidence of AVN and non-union in Garden III femoral neck fractures compared to CRIF alone.</p><p><strong>Methods: </strong>Participants aged 18-55 with Garden III femoral neck fractures were randomly assigned to either the CRIF-only group or the CRIF with capsulotomy group. Outcomes included rates of AVN and non-union, assessed at 3 and 6 months postoperatively. Functional outcomes were measured using the Harris Hip Score (HHS).</p><p><strong>Results: </strong>67 patients were included, with 32 in the capsulotomy group and 35 in the CRIF-only group. The capsulotomy group demonstrated significantly lower rates of AVN (6.25% vs. 11.4%) and non-union (0% vs. 5.7%) compared to the CRIF-only group. Additionally, the capsulotomy group achieved a significantly higher mean HHS at 3 months, indicating improved functional outcomes.</p><p><strong>Conclusion: </strong>Adding capsulotomy to CRIF in the management of Garden III femoral neck fractures may reduce complications, specifically AVN and non-union, and enhance functional recovery. The combination of randomization and blinding methods in this study underscores the reliability of these findings, supporting capsulotomy as a potentially beneficial adjunct to CRIF in specific fracture patterns.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"155"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of the therapeutic effects of mesenchymal stem cells and exosomes on cartilage regeneration: exploring their synergistic potential with hyaluronic acid for treating articular cartilage defects.","authors":"Gökhan Meriç, Olcay Eren, Aylin Yaba, Burak Çağrı Aksu, Koray Başdelioğlu, Utku Ateş","doi":"10.1007/s00590-025-04284-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04284-7","url":null,"abstract":"<p><strong>Purpose: </strong>Articular cartilage exhibits a low regenerative capacity and limited potential for self-renewal. Recent research has demonstrated that exosomes and mesenchymal stem cells (MSCs) significantly enhance cartilage repair by promoting cellular proliferation, increasing extracellular matrix synthesis, and modulating the immune response. Additionally, hyaluronic acid (HA), a critical component of synovial fluid, plays a key role in facilitating cell migration. This study aims to compare the regenerative effects of Wharton's jelly-derived MSCs, MSC-derived exosomes, and their combination with hyaluronic acid in the treatment of cartilage defects. Additionally, we seek to evaluate the impact of hyaluronic acid when combined with MSCs and exosomes through histological analysis in a rat model.</p><p><strong>Methods: </strong>In this study, full-thickness cartilage defects were created in the trochlear grooves of both distal femurs in 48 adult rats. The knees were randomly assigned to six groups: Group I: Control-saline, Group II: Wharton's jelly mesenchymal stem cells (MSCs), Group III: Wharton's jelly MSC-derived exosomes (Exo), Group IV: Hyaluronic acid (HA), Group V: MSC and HA combination, and Group VI: Exo and HA combination. Each rat received a total of three intra-articular injections at weekly intervals, beginning two weeks post-surgery. Four weeks following the final injection, all rats were euthanized, and their femurs were dissected for analysis. All groups were assessed macroscopically using the International Cartilage Repair Society (ICRS) scoring system, following histological staining with hematoxylin-eosin (HE) and toluidine blue, and immunohistochemical staining with type II collagen antibodies. The quality of the repaired cartilage was subsequently evaluated according to the ICRS histological grading system by an independent, blinded observer.</p><p><strong>Results: </strong>Macroscopic evaluations indicated that the ICRS scores of the MSC group (8.2 ± 0.7) were significantly higher (P < 0.05) than those of the control group (4.3 ± 0.7). The cartilage defects in the MSC group showed substantial repair, displaying the most effective cartilage regeneration among all groups. Furthermore, comparison between groups revealed that both the MSC and Exo groups demonstrated a higher rate of defect depth repair, a smaller demarcation border, and a smoother cartilage surface.</p><p><strong>Conclusions: </strong>This study demonstrates that exosomes are as effective as stem cell therapies in promoting cartilage repair, suggesting that exosomes may serve as a viable alternative to cell-based therapies for cartilage damage. However, the addition of hyaluronic acid to stem cells and exosomes showed no significant enhancement in cartilage repair. Our findings highlight a potentially effective therapeutic strategy for the treatment of osteochondral cartilage defects.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"154"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}