Acta orthopaedica Belgica最新文献

Outcomes of hemicortical resection and reconstruction with liquid nitrogen-treated autograft for high-grade sarcomas: A retrospective case series. 高级别肉瘤半皮质切除术和液氮自体移植物重建的结果：回顾性病例系列。

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15249

F A Janjua, H U Arshad, M Osama, I Rafi

{"title":"Outcomes of hemicortical resection and reconstruction with liquid nitrogen-treated autograft for high-grade sarcomas: A retrospective case series.","authors":"F A Janjua, H U Arshad, M Osama, I Rafi","doi":"10.52628/92.2.15249","DOIUrl":"https://doi.org/10.52628/92.2.15249","url":null,"abstract":"Hemicortical resection (HCR) is a limb salvage option for eccentrically located bone sarcomas that allows preservation of native bone stock and nearby joint anatomy. Evidence on outcomes in high-grade extremity sarcomas remains limited. We performed a retrospective case series of consecutive patients undergoing HCR for high-grade primary malignant bone tumors of the extremities. Collected variables included demographics, tumor type and location, systemic therapy, local radiotherapy, radiographic union, time to union, complications, local recurrence, distant metastasis, survival status, and last follow-up. Five patients were included (mean age 14.2 years; 3/5 female). Diagnoses were Ewing sarcoma (n = 3) and osteosarcoma (n = 2). Sites were distal femur (n = 2), proximal tibia (n = 1), distal tibia (n = 1), and tibial shaft (n = 1). One patient received local radiotherapy. Union was achieved in all cases. Median time to union was 8.2 months (mean 11.1; range 4.4-18.9). Median follow-up was 20.8 months (mean 19.3; range 11.7-23.4). Complications included one infection treated with antibiotics and one late implant exposure requiring debridement and flap coverage. No local recurrences, distant metastases, or deaths were observed at last follow-up. In this small series, HCR with biological reconstruction achieved universal union and a low early complication rate. No local recurrence, distant metastasis, or death was observed during the available follow-up; however, oncologic safety cannot be inferred from this limited cohort, and larger studies with longer follow-up are required. INTRODUCTION tumor-bearing autograft devitalized by methods such as liquid nitrogen (LN), pasteurization, irradiation, 5-7 Limb salvage surgery has become the standard of care or ethanol . Among these, LN-treated autograft is for most localized high-grade extremity sarcomas widely used because it delivers rapid, deep cytocidal when wide margins are achievable and function can temperatures while p.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Reduced Serum Klotho Levels in Disuse-Induced Skeletal Muscle Atrophy: An Experimental Study Related to Orthopedic Immobilization. 废用性骨骼肌萎缩患者血清Klotho水平降低：与骨科固定相关的实验研究。

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15471

S Key, Ö Esmez, A Agar, O S Tanyeri, G Arkali, S Çeribaşi, A Yüce

{"title":"Reduced Serum Klotho Levels in Disuse-Induced Skeletal Muscle Atrophy: An Experimental Study Related to Orthopedic Immobilization.","authors":"S Key, Ö Esmez, A Agar, O S Tanyeri, G Arkali, S Çeribaşi, A Yüce","doi":"10.52628/92.2.15471","DOIUrl":"https://doi.org/10.52628/92.2.15471","url":null,"abstract":"Klotho is an anti-aging protein involved in phosphate homeostasis, oxidative stress regulation, and tissue regeneration. Although circulating Klotho levels decline with chronological aging, its response to acute disuse- induced skeletal muscle alterations remains unclear. In this experimental study, sixteen male Wistar rats (3 months old) were randomly assigned to a control group (n = 8) or an intermittent hindlimb unloading group (3 h/day for 15 consecutive days) (n = 8). Skeletal muscle morphology was evaluated in the extensor digitorum longus (EDL) and soleus muscles using hematoxylin-eosin staining, and muscle fiber cross-sectional area (CSA) was quantified with ImageJ software. Interstitial connective tissue changes were qualitatively assessed using Masson's trichrome staining, and serum Klotho concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Intermittent unloading induced histological features consistent with early disuse-associated muscle remodeling in both EDL and soleus muscles, accompanied by a modest reduction in muscle fiber CSA compared with controls. Serum Klotho levels were significantly lower in the unloading group (7.44 ± 0.54 vs 8.21 ± 0.81, p = 0.045), and a moderate positive correlation was observed between circulating Klotho concentrations and mean muscle fiber CSA (r = 0.58, p = 0.02). Mild interstitial connective tissue expansion was qualitatively noted in the soleus muscle following unloading. These findings suggest that short-term intermittent hindlimb unloading in young adult rats is associated with reduced circulating Klotho levels and mild skeletal muscle remodeling. Serum Klotho may represent a candidate biomarker of early disuse-associated muscle alterations; however, further studies are required to confirm its clinical applicability. These results may have potential implications for orthopedic conditions characterized by immobilization, including fracture treatment, casting, and postoperative rehabilitation.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Association between Kinematic Patterns and Patient-Reported Outcome Measures in Revision Total Knee Arthroplasty. 全膝关节置换术中运动学模式与患者报告的预后指标之间的关系。

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15398

L Stroobant, H Vermue, A VAN DE Cotte, N Arnout, S VAN Onsem, S A Banks, J Victor, A Chevalier

{"title":"Association between Kinematic Patterns and Patient-Reported Outcome Measures in Revision Total Knee Arthroplasty.","authors":"L Stroobant, H Vermue, A VAN DE Cotte, N Arnout, S VAN Onsem, S A Banks, J Victor, A Chevalier","doi":"10.52628/92.2.15398","DOIUrl":"https://doi.org/10.52628/92.2.15398","url":null,"abstract":"Introduction: While knee kinematics are well-documented in primary TKA, less is understood regarding revision TKA (rTKA), where altered soft tissue conditions may influence kinematics. This study aimed to investigate the relationship between kinematic parameters, specifically anteroposterior (AP) translation and post-cam engagement, and patient-reported outcome measures (PROMs) in rTKA patients.Materials and methods: Thirty patients who underwent rTKA between 2022 and 2024 were assessed at a minimum six-month follow-up. Tibiofemoral kinematics, measured as femoral AP translation relative to the tibia, were evaluated during open-chain flexion-extension (FE) and closed-chain exercises (sit-to-stand (STS) and a lunge) using fluoroscopy. Two clusters, categorized by higher and lower PROMs, were compared for AP translation and post-cam engagement.Results: In the medial compartment, the low-PROMs group exhibited a more anterior femoral position compared to the high-PROMs group, with statistical significance observed during mid-flexion of the STS (50.87% (SD, 4.04) vs. 47.57% (SD, 2.75); p = 0.043) and FE exercise (51.97% (SD, 3.83) vs. 48.55% (SD, 3.62); p = 0.037). No significant differences were found in the lateral compartment. Post-cam engagement did not differ between the groups in either open- or closed-chain exercises.Conclusions: Poorer PROM scores were associated with a more anterior femoral position in the medial compartment during mid-flexion of STS and FE exercises. Further research is needed to explore the relationship between kinematic variations and PROMs in rTKA patients.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Custom 3D Implant for Hemiarthroplasty of the Third Metacarpal in a Giant Cell Tumor of bone: Functional Outcomes and Hand Stability. 骨巨细胞肿瘤第三掌骨半关节置换术的定制3D植入物：功能结果和手部稳定性。

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15376

M Roelen, S Noens, R Nolet, Y Safi, L Taihi, T Schubert

{"title":"Custom 3D Implant for Hemiarthroplasty of the Third Metacarpal in a Giant Cell Tumor of bone: Functional Outcomes and Hand Stability.","authors":"M Roelen, S Noens, R Nolet, Y Safi, L Taihi, T Schubert","doi":"10.52628/92.2.15376","DOIUrl":"10.52628/92.2.15376","url":null,"abstract":"Giant cell tumor (GCT) of the hand is a rare benign but locally aggressive bone tumor with high recurrence rates. It is commonly treated by curettage with cementation or bone grafting. However, reconstruction after en bloc resection of metacarpal GCT remains challenging, particularly in young patients. Conventional options such as allografts or standard prostheses are associated with notable complications and functional limitations. Custom- made 3D-printed implants have recently emerged as a potential alternative, although current evidence is limited. We report the case of a 19-year-old woman with a recurrent GCT of the third metacarpal following initial curettage and cementation. After neoadjuvant denosumab therapy, an en bloc resection of the third metacarpal was performed. Reconstruction was achieved using a patient-specific 3D-printed titanium hemiarthroplasty featuring an intramedullary stem, screw fixation, porous surfaces for osseointegration, and dedicated structures for ligament reinsertion to ensure hand stability. Early postoperative mobilization was allowed. At mid-term follow-up, the patient demonstrated excellent functional recovery, high total active motion, minimal pain, and no complications, implant instability, or tumor recurrence. Custom-made metacarpal hemiarthroplasty appears particularly suitable for reconstruction of central rays, where transverse stability is supported by adjacent structures. This case supports patient-specific 3D-printed hemiarthroplasty as a promising reconstructive option, providing favorable early functional outcomes while preserving joint biomechanics. Further studies are needed to assess long-term durability.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Rehabilitation after Total Hip & Total Knee Arthroplasty with Smartphone Applications: a Scoping Exercise using a Systematic Review of Current Applications and Patient Survey. 智能手机应用于全髋关节和全膝关节置换术后的康复：使用当前应用和患者调查的系统回顾进行范围界定。

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15600

G Drury, A Sidhu, A O Al-Naseem, F Rayan, S Konan

{"title":"Rehabilitation after Total Hip & Total Knee Arthroplasty with Smartphone Applications: a Scoping Exercise using a Systematic Review of Current Applications and Patient Survey.","authors":"G Drury, A Sidhu, A O Al-Naseem, F Rayan, S Konan","doi":"10.52628/92.2.15600","DOIUrl":"10.52628/92.2.15600","url":null,"abstract":"This study aims to assess the quality, user friendliness of current smartphone applications (\"apps\") available for total hip (THR) and total knee (TKR) arthroplasty patients and identifies patient preferences regarding the content of an ideal rehabilitation app. ® ® The Google Play and Apple app stores were systematically searched. The Mobile App Rating Scale (MARS) and the Systematic Usability Scale (SUS) were used for the assessment of apps. A questionnaire was designed and used in a post op orthopaedic clinic at a large tertiary center. 102 patients (52 TKR and 50 THR) completed the questionnaire. Nine apps were included in the systematic review. On MARS assessment, the mean overall score was 3.55/5. The highest and lowest mean scores were seen in the functionality (3.86/5) and aesthetics (3.44/5) subscales respectively. The mean overall SUS score was 75.3/100 (Grade B) with a range of 51.25 - 95. Both scales suggested moderate levels of quality and user friendliness of currently available apps, but with significant variation between apps. Patient preferences are not currently ideally matched by available apps.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

How does the use of smartphones affect cervical region structures? 使用智能手机如何影响颈椎区域结构？

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.11100

D Cankurtaran, Z A Yigman, F B Uz, E Umay

{"title":"How does the use of smartphones affect cervical region structures?","authors":"D Cankurtaran, Z A Yigman, F B Uz, E Umay","doi":"10.52628/92.2.11100","DOIUrl":"https://doi.org/10.52628/92.2.11100","url":null,"abstract":"Postural changes occurring during prolonged smartphone usage may be associated with impaired proprioception, altered musculoskeletal dynamics, and structural alterations in the cervical region. This study aimed to investigate the association between smartphone addictive use and cervical paraspinal muscles morphology and vertebral degeneration in patients with chronic neck pain (NP). This study included 119 patients with chronic NP. The cross-sectional areas (CSA) of the paraspinal muscles were quantified from magnetic resonance imaging (MRI) slices using the software program ImageJ 1.53. The relationship between the Smartphone Addiction Scale-Short Version (SAS-SV) and cervical paraspinal CSAs as well as cervical intervertebral disc degeneration was analyzed. A weak positive correlation was observed between SAS-SV scores and degeneration at C2-C3, C3-C4, C4-C5, C5-C6, and C6-C7 (p<0.05). Conversely, a weak negative correlation existed between SAS-SV and the CSAs of the sternocleidomastoid (SCM), trapezius, scalene muscles (anterior, middle, posterior), multifidus, multifidus+semispinalis, levator scapulae muscles and the posterolateral, lateral, and anterior muscle groups (p<0.05). Prolonged smartphone use may be associated with subtle reductions in cervical paraspinal muscle CSA and increased disc degeneration; however, these associations remain modest and should be interpreted cautiously. Given the prevalence of smartphones in contemporary lifestyles, individuals with neck pain may benefit from limiting continuous device use and incorporating postural breaks. Patients may also benefit from appropriately designed exercise programs aimed at improving cervical stability, reducing pain, and preserving paraspinal muscle integrity and function.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Study on Catalpol inhibiting PI3K/AKT/NF-кB Signaling Pathway in the Treatment of OA through Anti-senescence of Chondrocytes. 梓醇抑制PI3K/AKT/NF-кB信号通路通过软骨细胞抗衰老治疗骨性关节炎的研究

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15277

Yongbiao Meng, Jianhua Yuan, Shenghua Wu, F U Qin, Fenyan Bi

{"title":"Study on Catalpol inhibiting PI3K/AKT/NF-кB Signaling Pathway in the Treatment of OA through Anti-senescence of Chondrocytes.","authors":"Yongbiao Meng, Jianhua Yuan, Shenghua Wu, F U Qin, Fenyan Bi","doi":"10.52628/92.2.15277","DOIUrl":"https://doi.org/10.52628/92.2.15277","url":null,"abstract":"The study aimed to explore the therapeutic effect of catalpol on articular chondrocyte senescence and osteoarthritis through cell experiments, and to explore the role of NF-κB and its upstream and downstream pathways in the therapeutic process. Rat primary chondrocytes were isolated. catalpol was added to evaluate cytotoxicity and cell viability, and the optimal catalpol concentration was determined accordingly. IL-1β was added to simulate OA inflammation, establish a cellular senescence model and detect senescence-associated β-galactosidase activity. The proportion of senescent cells, cell cycle distribution, and ROS levels in each group were measured and compared. Western blotting was used to detect the expression of Type II collagen, ADAMTS-5, MMP-13, IL-6, p16, p21, PI3K, p-PI3K, AKT, p-AKT, p65, and p-p65 proteins. After catalpol treatment, the proportion of positive chondrocytes decreased, the proportion of chondrocytes in G0-G1 phase decreased significantly, and the ROS levels of chondrocytes in the inflammatory rat model decreased significantly. IL-1β significantly elevated the expression of IL-6, p16, and p21. However, this effect of IL-1β was inhibited by catalpol. catalpol could significantly inhibit the expression of MMP-13, IL-6, ADAMTS-5, p16, and p21, significantly increased the expression of type II collagen, and significantly inhibited the activation of PI3K/AKT and NF-κB signaling pathways. Catalpol attenuated chondrocyte senescence in an IL-1β-induced in vitro OA model, suppressed PI3K/AKT/NF-κB signaling, and decreased SASP expression. These in vitro findings suggest a potential mechanistic basis for the anti-senescence effects of catalpol on chondrocytes, which requires further validation in animal models and clinical studies before any therapeutic conclusions can be drawn.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

CircHMGB2 Acts as a Molecular Decoy for IGF2BP1 to Promote Cisplatin Resistance via Grb10/Akt Signaling in Chondrosarcoma. CircHMGB2作为IGF2BP1的分子诱饵，通过Grb10/Akt信号传导促进软骨肉瘤顺铂耐药

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.14037

Y I Zhu, Hui Song, Shengyang DU, Weijun Zhang, Lei Cao

{"title":"CircHMGB2 Acts as a Molecular Decoy for IGF2BP1 to Promote Cisplatin Resistance via Grb10/Akt Signaling in Chondrosarcoma.","authors":"Y I Zhu, Hui Song, Shengyang DU, Weijun Zhang, Lei Cao","doi":"10.52628/92.2.14037","DOIUrl":"https://doi.org/10.52628/92.2.14037","url":null,"abstract":"Chondrosarcoma is a common bone sarcoma in adults with limited therapeutic options due to frequent chemoresistance. Cisplatin (CDDP) is a key chemotherapeutic agent, but resistance often develops. This study investigated the role and mechanism of circular RNA HMGB2 (circHMGB2) in cisplatin resistance of chondrosarcoma. Clinically, circHMGB2 was upregulated in chondrosarcoma tumors and associated with cisplatin resistance and poor patient survival. Functionally, exogenous overexpression of circHMGB2 elevated cisplatin resistance in chondrosarcoma cells (SW1353, OUMS-27) in vitro, while its silencing re-sensitized resistant cells. Mechanistically, circHMGB2 did not function as a miRNA sponge but acted as a competitive molecular decoy for the RNA-binding protein IGF2BP1. We demonstrated that circHMGB2 directly binds IGF2BP1, competitively impairing IGF2BP1's binding to and stabilization of Grb10 mRNA, leading to its destabilization and subsequent downregulation of Grb10 protein. This suppression of Grb10, a known negative regulator of the PI3K/Akt pathway, resulted in constitutive Akt phosphorylation, driving resistance. Crucially, co-overexpression of IGF2BP1 rescued circHMGB2-induced Grb10 downregulation, Akt activation, and cisplatin resistance, validating the decoy mechanism. Furthermore, in a cisplatin-resistant xenograft model, silencing circHMGB2 synergized with cisplatin to significantly inhibit tumor growth, improve host survival, and upregulate intratumoral Grb10 while suppressing Akt phosphorylation. Our results delineate a novel circHMGB2/IGF2BP1/Grb10/Akt axis that drives cisplatin resistance in chondrosarcoma. Targeting circHMGB2 could therefore serve as a promising therapeutic strategy to overcome chemoresistance and enhance treatment efficacy.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Multifactorial retrospective analysis of pathological fracture risk and treatment strategies in unicameral bone cysts. 单侧骨囊肿病理性骨折风险及治疗策略的多因素回顾性分析。

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15416

Y S Durak, B Karabak, S Toy, K Tuncer

{"title":"Multifactorial retrospective analysis of pathological fracture risk and treatment strategies in unicameral bone cysts.","authors":"Y S Durak, B Karabak, S Toy, K Tuncer","doi":"10.52628/92.2.15416","DOIUrl":"https://doi.org/10.52628/92.2.15416","url":null,"abstract":"Unicameral bone cysts (UBCs) are benign fluid-filled bone lesions that primarily affect children and adolescents and carry a clinically relevant risk of pathological fracture. This study explored radiological and clinical variables associated with fracture and recurrence in a histologically confirmed retrospective cohort. Seventy-two patients with histologically confirmed UBCs treated between 2010 and 2021 were retrospectively analysed. Median follow-up was 38 months (range 24-132). Primary outcomes were pathological fracture and radiological recurrence. Because only eight fractures were observed, multivariable analyses were treated as exploratory. Pathological fractures occurred in 8/72 patients (11.1%). Fracture rates were 0/46 (0%), 2/20 (10%) and 6/6 (100%) for Capanna stages 1, 2 and 3, respectively (p < 0.001). Latent cysts had a higher fracture rate than active cysts (21.4% vs 4.5%; p = 0.049). Recurrence occurred in 7/71 evaluable patients (9.9%), exclusively in the interventional group (7/23, 30.4% vs 0/48; p < 0.001). In this retrospective, histologically selected cohort, higher Capanna stage, younger age, latent activity and diaphyseal localisation were associated with fracture risk. Given the limited number of fracture events, the mixed paediatric-adult population and the selection bias inherent to histological inclusion, these findings are best interpreted as exploratory and hypothesis-generating. Overall, they may be more compatible with structured, individualised risk assessment than with a prescriptive Capanna-guided treatment algorithm.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Inter- and intra-observer reliability of cobb angle measurement between orthopaedic residents and spine specialists. 骨科住院医师和脊柱专家之间cobb角测量的观察者间和观察者内的可靠性。

IF 0.7 4区医学

Acta orthopaedica Belgica Pub Date : 2026-08-05 DOI: 10.52628/92.2.15167

A I Al Alawi, S Al Kalbani, A M Al Barwani, R S Al Weshahi

{"title":"Inter- and intra-observer reliability of cobb angle measurement between orthopaedic residents and spine specialists.","authors":"A I Al Alawi, S Al Kalbani, A M Al Barwani, R S Al Weshahi","doi":"10.52628/92.2.15167","DOIUrl":"https://doi.org/10.52628/92.2.15167","url":null,"abstract":"Cobb angle measurement is essential for diagnosing and monitoring scoliosis; however, its accuracy varies with observer experience. In many healthcare systems, including Oman, initial measurements are commonly performed by residents and influence referral urgency, follow-up intervals, and bracing decisions, where even small inaccuracies may alter clinical pathways. This study evaluated the inter- and intra-observer reliability of Cobb angle measurement among orthopaedic residents and spine specialists. A prospective comparative reliability study was conducted including 18 OMSB orthopaedic residents (PGY2-5) and five spine specialists. Each participant measured Cobb angles on five standardised standing scoliosis radiographs on two occasions, four weeks apart. Inter- and intra-observer reliability were assessed using the intraclass correlation coefficient (ICC) with a two-way random-effects, single-measurement, absolute-agreement model [ICC(2,1)], and Bland-Altman plots were used to assess intra-observer reproducibility. Mean Cobb angles ranged from 45° to 56°. Inter-observer reliability was poor among residents (ICC = -0.219; 95% CI -1.41 to 0.485) and remained low among specialists (ICC = 0.120; 95% CI -2.28 to 0.898). Intra-observer variation averaged approximately 5°, with a Bland-Altman mean bias close to zero and limits of agreement of ±5%. Negative ICC values indicated that between-observer variability exceeded within- observer consistency. Residents demonstrated markedly poorer inter-observer reliability compared to specialists, highlighting the impact of clinical experience on accurate end-vertebra selection and angle measurement. Targeted training modules and structured exposure during residency may improve measurement consistency, referral accuracy, and overall scoliosis management pathways.","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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