Acta orthopaedica Belgica最新文献

{"title":"Masquelet Technique Combined with Platelet-Rich Plasma for Large Infectious Bone Defects: A Narrative Review.","authors":"Zhipeng Yang, Huanhuan Sun, Zewen Qiao","doi":"10.52628/91.4.14862","DOIUrl":"10.52628/91.4.14862","url":null,"abstract":"<p><p>Large segmental infected bone defects represent a serious complication frequently encountered following high-energy trauma, bone tumor resection, and osteomyelitis surgery, presenting substantial challenges in orthopedic management. Current clinical approaches such as autologous bone grafting, allogeneic bone grafting, the Ilizarov technique, and artificial bone substitutes each come with inherent limitations. In recent years, the Masquelet technique (induced membrane technique) has become increasingly refined in clinical practice. This method works by establishing a bioactive local microenvironment that serves as both a physical barrier and maintains a stable repair space, effectively enhancing the regenerative healing of bone defects. Concurrently, platelet-rich plasma (PRP), a biological therapeutic material abundant in various growth factors, has shown significant potential in stimulating angiogenesis and accelerating bone tissue repair, gaining widespread clinical adoption, particularly in orthopedic applications. This article presents a narrative review based on a structured literature search, aimed at synthesizing current evidence on the combined application of the Masquelet technique and platelet-rich plasma (PRP) in the treatment of large segmental infected bone defects.Through a narrative review of existing literature, it summarizes current evidence suggesting that the combination may offer synergistic benefits, highlights reported clinical observations and preclinical findings aims to inform clinical decision-making in orthopaedic practice, and identifies key areas for future investigation, providing a basis for further research into this combined approach.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 4","pages":"419-428"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607699","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}

{"title":"Acta Orthopaedica Belgica: Entering the Digital Era.","authors":"Frank Plasschaert","doi":"10.52628/91.4.14221","DOIUrl":"https://doi.org/10.52628/91.4.14221","url":null,"abstract":"","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 4","pages":"399"},"PeriodicalIF":0.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607454","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}

{"title":"Experimental Research on Role of Traction Tension Affecting Wound Healing during Skin Traction Technique Performed on Pigs Specimen as Animal Models.","authors":"M I Nadaph, C Meng, X Wu","doi":"10.52628/91.4.14965","DOIUrl":"10.52628/91.4.14965","url":null,"abstract":"<p><p>Objective is to investigate the role of traction tension on wound healing during skin traction experiment performed on pigs as animal models. The experimental group comprises sixteen pigs with traction tension while sixteen pigs in control group without traction tension. All healthy specimen were procured from the Experimental Animal Center of Zhengzhou University. All methods were performed in accordance with relevant guidelines of Ethics Committee of the First Affiliated Hospital of Zhengzhou University. The wound of 5-10 cm x 10 cm size was made surgically on back of pigs. Wound healing has been analyzed based on traction tension and histological staining method. Traction tension applied during skin traction technique on pig models are 1kg, 2kg, 3kg, 4kg and 5kg to analyze the wound healing speed. Data were evaluated by SPSS software. Elevated rates of skin marginal necrosis were observed under traction tension of 4 kg and 5 kg, whereas a traction tension of 3 kg is appeared to expedite wound healing. Minimal collagen fiber disruption was seen under 3Kg, whereas substantial degradation was noted under traction exceeding 3Kg. Furthermore, the applications of traction tension correlated with a discernible reduction in postoperative complications compare to specimen without traction. The magnitude of traction tension significantly modulates the wound healing speed. Pig models subjected to traction exhibited a lower incidence of complications such as necrosis, infection, inflammation, and skin scar compared to without traction.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 4","pages":"523-530"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607708","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}

{"title":"The effect of teriparatide on fracture union in rats with chronic kidney disease.","authors":"E Ajdin, H Can Olke, E Tuba Canpolat, A Purbager, S Beyaz","doi":"10.52628/91.4.13776","DOIUrl":"10.52628/91.4.13776","url":null,"abstract":"<p><p>This study aims to examine the effect of teriparatide on fracture healing in a rat model with chronic kidney disease (CKD). A total of 32 adult, male Sprague-Dawley rats were randomly assigned to four groups: Group I (control group, teriparatide -), Group II (CKD +, teriparatide -), Group III (control group, teriparatide +) and Group IV (CKD +, teriparatide +) (n=8 each). To create CKD model, 5/6 nephrectomy was performed in the CKD groups. A proof of CKD in the CKD model was ascertained through BUN and creatinine levels in blood samples. Osteotomy of the femur was performed on all rats at the same time. Fractures were fixed using a K-wire. Eight rats from the control group (Group III) and 8 rats from the CKD group (Group IV) received a daily doses of 20 µg/kg/day teriparatide. Plain radiographic imaging was performed at 4th week. Rats were then sacrificed at the 8th week, and right femurs were removed for histological evaluation. For radiographical analysis, outcome measures such as Allen scoring, callus thickness, and Rust scoring were obtained. The results of radiological analysis showed that teriparatide had no effect on the callus thickness of the control group, while the callus thickness was the least in Group II (p=0.041). There was no significant difference in the pathological fusion analysis between the groups. While teriparatide has been shown to increase callus thickness, it does not exert a significant influence on the process of fracture union, neither enhancing nor inhibiting it.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 4","pages":"531-537"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607681","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}

{"title":"The Clinical Efficacy of Traditional Chinese Medicine Topical Therapy Combined with Sodium Hyaluronate Intra-articular Injection in the Treatment of Patellar Chondromalacia: a systematic review and meta-analysis.","authors":"Huwei Bian, Chonghao Gu, Cheng Qian, Tao Jiang","doi":"10.52628/91.4.13257","DOIUrl":"10.52628/91.4.13257","url":null,"abstract":"<p><strong>Background: </strong>Chondromalacia patellae (CMP) is a cartilaginous degeneration of patellofemoral joint caused by a variety of reasons. Recent studies have shown that the incidence of patellomalacia is getting higher and higher. Our meta-analysis is used to illustrate the clinical effect of external treatment of traditional Chinese medicine combined with joint cavity injection of sodium hyaluronate in the treatment of patellomalacia.</p><p><strong>Methods: </strong>Literature searches were carried out in various databases, such as PubMed, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, and Weipu, with the search timeline extending from the inception of each database until April 2024. Two investigators independently conducted literature screening, data extraction, and quality assessment of the included studies. Review Manager 5.4 software was used to perform a meta-analysis, which evaluated changes in the clinical efficacy rate, visual analogue scale (VAS) scores, and time of symptom onset before and after treatment.</p><p><strong>Results: </strong>The study included a total of 11 randomized controlled trials (RCTs) involving 1,279 patients. The meta- analysis results indicated that compared to the standalone injection of sodium hyaluronate, the combination of TCM topical therapy significantly enhanced the clinical efficacy rate in treating CMP [RR=1.17, 95% CI=[1.12,1.22], P<0.00001]. Furthermore, the addition of TCM topical therapy lowered the VAS score in patients with CMP five weeks post-treatment compared to the control group. In comparison to the standalone injection of sodium hyaluronate, the combination of TCM topical therapy showed a quicker onset, thus reducing patients' pain [RR=-7.44, 95% CI=(-9.86,-5.01), P<0.00001].</p><p><strong>Conclusion: </strong>The combination of TCM topical therapy and sodium hyaluronate intra-articular injection demonstrated superior clinical efficacy over the sole intra-articular injection of sodium hyaluronate. This combination effectively mitigated pain in patients and had a faster onset.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 4","pages":"439-446"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607661","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}

{"title":"Giant, High-Grade Chondrosarcoma of The Hand: A Rare Case with Exceptional Tumor Size and Review of The Literature.","authors":"O A Yildiz, U Eyupoglu, A S Dogruyol, M Memisoglu, M S Engin","doi":"10.52628/91.4.14017","DOIUrl":"10.52628/91.4.14017","url":null,"abstract":"<p><p>Chondrosarcoma is a malignant tumor originating from cartilage-producing cells. Although rare in the hand, it is the most common primary malignant bone tumor in this location. We present a case of high-grade chondrosarcoma of the first metacarpal bone in an 85-year-old female, who presented with pain and severe limitation of hand function. Imaging studies initially suggested a giant cell bone tumor, and a tru-cut biopsy did not confirm chondrosarcoma. During the preoperative period, the tumor enlarged from approximately 10x9 cm to 15x11 cm, ultimately necessitating amputation as the treatment of choice. Histopathological evaluation revealed grade 2-3 chondrosarcoma. According to the existing literature, a hand chondrosarcoma of this size has not been previously documented. Hand chondrosarcomas, unlike those in other regions, rarely metastasize; however, despite their low metastatic potential, they may still lead to substantial morbidity. When wide resection and amputation are performed, as in our case, the risk of local recurrence is significantly reduced.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 4","pages":"563-566"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607639","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}

{"title":"The Effect of Fasciotomy Timing on Limb Vitality and Functionality in Kahramanmaras/Turkey Earthquake.","authors":"O Kilinc, F Gunaydin, B Sakarya, I Demirtas, B Aslan","doi":"10.52628/91.4.14579","DOIUrl":"10.52628/91.4.14579","url":null,"abstract":"<p><p>The earthquakes in Kahramanmaras, Turkey, on February 6, 2023, caused many crush injuries complicated by acute compartment syndrome (ACS). This study assessed how fasciotomy timing (rubble-to-fasciotomy time, RFT) affects survival, limb viability, and functional outcomes.We retrospectively analyzed 145 patients (mean age: 29.2 ± 17.5 years) with crush injuries and ACS who underwent fasciotomy. RFT was grouped as 0-24, 25-48, 49-72, 73-96, and >97 hours. Outcomes were classified as full minor deficits, major deficits, amputation and death. Patients with full recovery or minor deficits were considered to have \"good outcome,\" while those with major deficits or amputation were labeled \"poor outcome.\"Full recovery was observed in 35 patients (24.1%), whereas 110 patients (75.9%) experienced complications. The mean RFT was significantly shorter in the good outcome group (25.1 ± 10.9 hours) compared with the poor outcome group (47.1 ± 23.4 hours, p < 0.05). No patients achieved full recovery when fasciotomy was performed after 48 hours. hyperbaric oxygen therapy(HBOT) use was associated with higher rates of good outcomes (p = 0.006), whereas dialysis requirement was associated with poorer outcomes (p = 0.009). Logistic regression analysis demonstrated that HBOT and dialysis remained statistically significant variables associated with functional outcomes (HBOT: p = 0.012; dialysis: p = 0.010). Fasciotomy within 24 hours is essential for functional recovery in ACS. Delays beyond 24 hours resulted in worsening outcomes, with no full recovery after 48 hours. Early surgical intervention in disaster settings is crucial to preserve limb function and viability.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 4","pages":"495-502"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607629","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}

{"title":"Long term follow-up of semi-constrained total elbow arthroplasty: a single centre retrospective analysis.","authors":"W Eerens, J Brouwers, M VAN Nuffel, I Degreef","doi":"10.52628/91.3.14023","DOIUrl":"10.52628/91.3.14023","url":null,"abstract":"<p><p>Total elbow arthroplasty (TEA) is an effective treatment for end-stage elbow arthritis and fractures, with semi- constrained designs demonstrating superior outcomes in stability and implant longevity. However, long-term survival and clinical performance data remain limited. This single-center retrospective study analyzed 122 patients who underwent semi-constrained TEA between 2003 and 2019. The cohort included 94 Coonrad-Morrey, 17 Nexel, and 11 Latitude prostheses. Clinical outcomes were assessed using Visual Analogue Scale (VAS) for pain and satisfaction, Disabilities of the Arm, Shoulder and Hand (DASH), and Mayo Elbow Performance Score (MEPS). Radiographic evaluations identified aseptic loosening and periprosthetic fractures. Kaplan-Meier survival analysis was performed to determine implant longevity. Mean follow-up durations varied across implant designs, with the Coonrad-Morrey group averaging 7.4 years. The 5-, 10-, and 15-year survival rates were 96%, 92%, and 70% for Coonrad-Morrey, 100% and 82% for Latitude (at 5 and 10 years), and 78% for Nexel at 5 years. Complication rates differed among prostheses, with Nexel showing the highest rate (41.2%), followed by Latitude (36.3%) and Coonrad-Morrey (20.6%). Functional outcomes were comparable across groups, with mean DASH scores of 33.3 (Coonrad-Morrey), 32.2 (Latitude), and 22.3 (Nexel), and mean MEPS scores of 88.7, 93.7, and 90.6, respectively.Semi-constrained TEA provides reliable pain relief, functional restoration, and implant survival, with variations in outcomes among different prosthetic designs. The Coonrad-Morrey prosthesis exhibited the highest long-term survival, while Nexel demonstrated higher early complication rates. Further longitudinal studies are needed to optimize implant design and patient selection to enhance long-term TEA performance.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 3","pages":"347-355"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324453","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}

{"title":"X-linked hypophosphatemic rickets: a rare case report.","authors":"L Yuan, W Chen, G Li, Y Xu, G Zhang, G Zhou, S Diao, H Zhong","doi":"10.52628/91.3.13791","DOIUrl":"10.52628/91.3.13791","url":null,"abstract":"<p><p>X-linked hypophosphatemic rickets (XLHR) is a rare hereditary disease. To date, the diagnosis and treatment of XLHR is still in dilemma due to a lack of cases. In the consensus recommendations for the XLHR proposed in Belgium, next-generation sequencing (NGS) is recommended in several genetic centers for PHEX and other skeletal dysplasia genes. We reported our experiences on the diagnosis and treatment of XLHR. A 17-year-old boy with a body height of 1.3 meters presented to our department with a compound deformity of lower limbs. He showed a visual analogue scale (VAS) of 3, short form 36 questionnaire (SF-36) of 90 scores, and health assessment questionnaire (HAQ) of 23. Laboratory examinations showed increased serum alkaline phosphatase levels (369 U/L) and decreased blood phosphorus levels (0.58 mmol/L). The whole exome sequencing (WES) showed mutation of PHEX gene (NM_000444.6: exon18: c.1853T>G: p.M618R) in the patient and his mother. The patient was finally diagnosed with XLHR. The patient received Ilizarov technique combined with multi-segment osteotomy to correct lower limb deformity. Finally, the patient was able to walk independently and take care of himself without any complications. This may provide a reference for the diagnosis and treatment of XLHR.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 3","pages":"357-364"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324410","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}

{"title":"Comprehensive investigation into the endothelium in Legg-Calvé-Perthes with clinical, molecular, and histopathological examinations reveals arteriolar wall thickening and proliferative synovitis: A preliminary report.","authors":"B Göker, K Kosemehmetoglu, G Yilmaz, M Ayvaz, M C Aksoy","doi":"10.52628/91.3.12985","DOIUrl":"10.52628/91.3.12985","url":null,"abstract":"<p><strong>Background and study aims: </strong>The exact cause of spontaneously healing idiopathic osteonecrosis in the Legg-Calvé-Perthes disease (LCPD) is still unknown. Although it is postulated that thrombotic processes that occur as a result of genetic, epigenetic and environmental factors are at the forefront, the root cause cannot be fully elucidated. The aim of this study is to investigate underlying endothelial inflammation as a trigger of these pathophysiological mechanisms leading to LCPD.</p><p><strong>Materials: </strong>The levels of ICAM-1 and E-selectin in the local blood vessels around the femoral neck and peripheral veins of seven surgically treated LCPD patients and similar age controls were compared. These were reviewed together with the clinical and histopathological findings of the LCPD patients.</p><p><strong>Results: </strong>There were no statistically significant differences between each group's ICAM-1 and E-selectin levels in the femoral neck region or the peripheral vessels (p>0.05). Histopathological examination revealed arterioles with thickened walls and luminal obliteration. Chronic synovitis with plasma cell and lymphocyte infiltration of different severity was detected in more than half of the patients. Proliferative synovitis with papillary proliferations was seen in two patients. The patients who had these histological findings also had endothelial marker levels above the cohort mean.</p><p><strong>Conclusions: </strong>In summary, this study provided a comprehensive examination of LCPD patients. We observed arteriolar involvement and proliferative synovitis in multiple patients in the group.</p><p><strong>Clinical relevance: </strong>This study provides important information about the pathophysiological basis of LCPD by combining clinical, molecular, and histopathological data. It is a comprehensive study in an uncommon population of surgically treated LCPD patients and similar age controls. To our knowledge, the findings of proliferative synovitis and arteriolar wall thickening have not been previously reported in the LCPD literature.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"91 3","pages":"365-374"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324402","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}