Joint diseases and related surgery最新文献

{"title":"Safety and feasibility of calcium sulfate/hydroxyapatite with zoledronic acid for the augmentation of helical blades in trochanteric fractures: A randomized pilot study.","authors":"Hakan Yolaçan, Deepak Bushan Raina, Lars Lidgren, Magnus Tägil, Šarūnas Tarasevičius, Serkan Güler, Tolga Tolunay, Vetra Markevičiūtė, Erdem Aras Sezgin","doi":"10.52312/jdrs.2026.3017","DOIUrl":"10.52312/jdrs.2026.3017","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the feasibility, safety, and peri-implant bone formation of augmenting a proximal femoral nail (PFN) helical blade with a calcium sulfate/hydroxyapatite (CaS/HA) biomaterial combined with systemic zoledronic acid (ZA).</p><p><strong>Patients and methods: </strong>This single-center, two-arm, parallel-group, randomized-controlled pilot study included a total of 20 patients with osteoporotic trochanteric fractures (TFs) between December 2023 and January 2025. The patients were randomized into a control group receiving standard PFN or an intervention group receiving PFN augmented with CaS/HA biomaterial. All patients received cefazoline and doxycycline for infection prophylaxis. On postoperative Day 7, both groups received a single intravenous infusion of ZA. The primary outcome was the change in bone mineral density (BMD) defined by previously published peri-implant regions-of-interest at one week and six months postoperatively. Secondary outcomes included tip-apex distance (TAD) for assessing blade migration and the Harris Hip Score (HHS) for functional evaluation.</p><p><strong>Results: </strong>Of a total of 20 patients included in the study, 6 were male and 14 were female with a median age of 81 (range, 65 to 90) years. Regarding intervention delivery, all 10 randomly assigned patients received their intended treatment. While 19 of the 20 randomly assigned patients received the intended treatment; one patient died within the first week and did not receive ZA. The required data for clinical analysis (change in peri-implant BMD, TAD, fracture union, and HHS) could only be extracted for five patients in the control group and five patients in the intervention group. There were no intraoperative complications, and no adverse effects related to the CaS/HA biomaterial were reported. Ten patients were included for the outcome analysis. The intervention group demonstrated a more pronounced increase in peri-implant BMD compared to controls. Additionally, TAD changed more in the control group. Functional evaluation revealed that the intervention group demonstrated a slightly greater HHS improvement.</p><p><strong>Conclusion: </strong>Our study results suggest that augmentation using the CaS/HA and ZA is a feasible and safe procedure for patients with osteoporotic TF. Preliminary findings indicate a potential trend toward enhanced peri-implant bone formation in the intervention group.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"863-872"},"PeriodicalIF":2.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654890","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":"Professional experience and reliability of cervical vertebral maturation staging among unfamiliar raters.","authors":"Yiğit Umur Cırdı, Alp Er Tunga Bölükbaşı, Mehmet Oğuz Çolak, Enes Kanay, Danyal Gümüş, Mehmet Demirel, Okan Özkunt, Kerim Sarıyılmaz","doi":"10.52312/jdrs.2026.2784","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2784","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the reliability of cervical vertebral maturation (CVM) staging in determining skeletal maturity in patients with adolescent idiopathic scoliosis (AIS), focusing on the effect of professional experience among orthopedic surgeons.</p><p><strong>Patients and methods: </strong>Between January 2023 and January 2025, this reliability and agreement study included a total of 72 patients aged between nine and 16 years who were diagnosed with AIS. Intra- and inter-rater reliability were analyzed using weighted kappa (κ) statistics with standard errors (SEs) and 95% confidence intervals (CIs). A total of 72 full-spine lateral radiographs were independently assessed by 10 raters with varying levels of orthopedic expertise, including medical students, residents, consultants, and spinal surgeons. None of the raters had prior experience with the CVM classification. Each rater performed CVM staging twice with a four-week interval between assessments.</p><p><strong>Results: </strong>Of the patients, 33 were male and 39 were female with a mean age of 13.07 ± 1.97 (range, 9 to 16) years. Overall intra-rater reliability was substantial (κ = 0.64, SE = 0.032, 95% CI: 0.569-0.714), and overall inter-rater reliability was moderate (κ = 0.52). Although spinal surgeons showed slightly higher intra-rater reliability overall, inter-rater reliability declined between assessments (first assessment κ = 0.61 vs. second assessment κ = 0.34). Consultants exhibited the highest inter-rater agreement (κ = 0.62), whereas residents showed improvement between assessments (κ = 0.40 vs. 0.52); however, no significant difference observed between groups.</p><p><strong>Conclusion: </strong>The reliability of CVM staging for assessing skeletal maturity in AIS patients does not significantly differ across levels of orthopedic expertise. While CVM staging has potential as a radiation-sparing method, the overall moderate agreement, particularly among physicians without prior experience, indicates that reliability is not significantly influenced by professional experience.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"714-722"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654820","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":"Midterm outcomes of complex clubfoot treated with the modified Ponseti method: A comparative study of primary and referred cases.","authors":"Mehmet Ali Dolap, Ahmet Yiğit Kaptan, Turan Bal, Baki Volkan Çetin, Celal Bozkurt, Muhammed Işıkyıldız, Mehmet Akif Altay","doi":"10.52312/jdrs.2026.2959","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2959","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the midterm clinical outcomes of patients with complex clubfoot treated using the Ponseti method and to assess the sustainability of deformity correction over time.</p><p><strong>Patients and methods: </strong>Between January 2016 and January 2021, a total of 38 feet in 26 patients with complex clubfoot treated using the modified Ponseti method were retrospectively analyzed. The patients were divided into two groups: those treated entirely in our institution (study center group) and those referred from external centers after unsuccessful initial treatment (external center group). Clinical severity was assessed using the Pirani score, and ankle dorsiflexion (DF) was measured during follow-up. Functional outcomes were evaluated using the Pirani-Based Score (PBS) and the Oxford Ankle Foot Questionnaire (OxAFQ). Relapse rates, additional procedures, and treatment success were analyzed. Independent predictors of outcomes were identified.</p><p><strong>Results: </strong>Of a total of 26 patients included in the study, 2 were male and 24 were female with a mean age of 6.78 ± 1.29 (range, 5 to 8) years. Of these patients, 14 (53.8%) had unilateral involvement, while 12 (46.2%) had bilateral deformity. The external clinic group presented at a significantly later age than the study center group (p < 0.001), while baseline deformity severity was comparable. Pirani scores and DF measurements improved significantly in both groups, with no intergroup differences during follow-up (p > 0.05). Functional outcomes showed a significant difference in PBS scores, which were higher in the external clinic group (p = 0.045), indicating worse functional performance, while the OxAFQ scores were similar between groups (p = 0.911). Relapse rates were higher in the own clinic group but did not reach statistical significance (p = 0.254). Multivariate analysis revealed that age was the only independent predictor of treatment success (odds ratio [OR] = 2.067, p = 0.019), while referral status was not an independent determinant.</p><p><strong>Conclusion: </strong>The modified Ponseti method provides effective midterm correction in complex clubfoot regardless of referral status. Although referred patients present later and may demonstrate worse functional outcomes, referral source does not independently influence treatment success. Early recognition and appropriate application of modified Ponseti principles remain critical for optimal outcomes.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"873-881"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655213","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 management of tenosynovial giant cell tumors.","authors":"Emin Kursat Bulut, Coskun Ulucakoy, Muzeyyen Burcu Kaplan, Ethem Toptas, Sefik Murat Arikan, Mehmet Serkan Cetin, Ismail Burak Atalay","doi":"10.52312/jdrs.2026.2906","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2906","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the demographic characteristics, anatomical distribution, diagnostic and treatment patterns, postoperative complications, recurrence rates, and recurrence-associated factors in patients diagnosed with tenosynovial giant cell tumors (TGCTs).</p><p><strong>Patients and methods: </strong>A total of 246 patients diagnosed with TGCT and treated between January 2010 and March 2021, were retrospectively analyzed. Pre- and postoperative data of the patients were recorded. Histopathological diagnosis was reviewed, and tumors were classified as localized TGCT and diffuse-type TGCT. Recurrence was defined as the reappearance of a lesion at the same location following an initially complete surgical excision. Survival time was defined as the time elapsed since surgery. Recurrence-free survival was calculated from the date of the surgical procedure to the date of recurrence or the last follow-up.</p><p><strong>Results: </strong>Of a total of 246 patients included in the study, 87 were male and 159 were female with a mean age of 44.3 ± 16.3 (range, 18 to 75) years. The lesions were most commonly located in the hand (62.6%), predominantly at the phalangeal level (89.6%). Foot involvement was mainly at the ankle region (40.8%), while the knee was the third most frequently affected site (15%), with 64.8% of knee lesions being intra-articular. Multiple lesions were observed in 3.3% of patients. Small joints were involved in 63% of cases. Excisional biopsy was the most common diagnostic approach (63.8%), followed by Tru-Cut biopsy (23.2%) and incisional biopsy (8.5%), while macroscopically complete marginal resection was performed in 4.5% of cases. Postoperative complications occurred in 15.4% of patients, including infection, sensory deficits, hematoma, motion restriction, and vascular complications. The median follow-up was 43 months, and recurrence occurred in 15.4% of patients, of whom 76.3% required reoperation.</p><p><strong>Conclusion: </strong>Our study results suggest that TGCT is associated with a notable recurrence rate and postoperative morbidity. Accurate diagnosis, complete surgical excision, and long-term follow-up are essential for optimal management. Recurrence may be associated with factors such as pain at presentation, presence of multiple lesions, delayed treatment, and postoperative infection. Adequate surgical excision with sufficient margins is of utmost importance in reducing the risk of recurrence.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"838-850"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655208","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":"The \"what wrote this?\" era: Artificial intelligence and the shifting paradigms of authorship, credit and originality.","authors":"Muhammed Şakir Çalta, Orkun Büyüksayın, Esra Çetintaş, Erdem Aras Sezgin, O Şahap Atik","doi":"10.52312/jdrs.2026.57934","DOIUrl":"https://doi.org/10.52312/jdrs.2026.57934","url":null,"abstract":"","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"579-580"},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655206","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 efficacy and safety of closed reduction versus in situ internal fixation for valgus-impacted femoral neck fractures: A meta-analysis.","authors":"Duo Shan, Zhong-Bo Deng, Qiang Dong","doi":"10.52312/jdrs.2026.2733","DOIUrl":"10.52312/jdrs.2026.2733","url":null,"abstract":"<p><strong>Objectives: </strong>In this meta-analysis, we discuss the clinical efficacy of closed reduction with in situ fixation for valgus-impacted femoral neck fractures (VIFNFs) by contrasting postoperative functional recovery and complication profiles.</p><p><strong>Materials and methods: </strong>We performed a systematic literature search in PubMed, Embase, Web of Science, the Cochrane Library, and ScienceDirect for publications up to October 2025. The search targeted original studies which directly compared the surgical outcomes of closed reduction and in situ internal fixation for valgus-impacted femoral neck fractures. Search terms included combinations of: valgus-impacted (or valgus impaction), femoral neck fracture, in situ, reduction, and internal fixation. Pooled data were analyzed using mean differences (MD) with 95% confidence intervals (CIs) for continuous outcomes and risk differences (RD) with 95% CIs for dichotomous outcomes.</p><p><strong>Results: </strong>The final analysis included a total of 447 patients extracted from five studies that met the predetermined inclusion criteria. The meta-analysis demonstrated that the closed reduction group exhibited a statistically significant reduction in postoperative femoral neck shortening (FNS) compared with the in situ fixation group (MD: 4.05; 95% CI: 2.68 ~ 5.42; p < 0.00001). For the caput-collum-diaphysis (CCD) angle, the closed reduction group showed a borderline significant improvement relative to the in situ fixation group (MD: 9.79; 95% CI: 0.19 ~ 19.39; p = 0.05). The in situ fixation group was associated with a substantially lower reoperation rate (RD: -0.08; 95% CI: -0.16 ~ -0.01; p = 0.04). No statistically significant intergroup differences were detected for the Harris Hip Score (HHS) (MD: -4.13; 95% CI: -9.37 ~ 1.11; p = 0.12), incidence of femoral head necrosis (RD: -0.05; 95% CI: -0.14 ~ 0.05; p = 0.36), or fixation failure rate (RD: -0.05; 95% CI: -0.17 ~ 0.06; p = 0.37).</p><p><strong>Conclusion: </strong>Closed reduction yields a statistically significant advantage in reducing postoperative FNS and a borderline significant benefit in maintaining the CCD. In contrast, in situ fixation is associated with a lower reoperation rate. The two strategies show comparable outcomes for the HHS, femoral head necrosis incidence, and fixation failure rate. Thus, surgical approach should be individualized based on patient-specific profiles.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"581-891"},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655171","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":"The influence of design factors on the mechanical properties of biodegradable composite plates: A finite element analysis.","authors":"Mustafa Buğra Ayaz, Ali Çağrı Tekin, Süreyya Ergün Bozdağ, Serhat Gürbüz, Mehmet Kürşad Bayraktar, Esra Akdaş Tekin","doi":"10.52312/jdrs.2026.3004","DOIUrl":"https://doi.org/10.52312/jdrs.2026.3004","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the influence of implant design factors on mechanical behavior and to identify lower-profile biocomposite plate configurations with mechanical responses approaching those of a titanium reference construct under selected loading conditions.</p><p><strong>Materials and methods: </strong>In this computational finite element study, three-dimensional implant models were developed, and material properties of polyamide-6/nano-hydroxyapatite and titanium alloy (Ti6Al4V) were assigned. Seven composite plate types were modeled: flat (thicknesses 8, 9, and 10 mm), bellied, curved, enhanced, and hybrid plate. All constructs were mounted on a cylindrical synthetic femoral diaphyseal surrogate and fixed with six screws. Finite element analysis was conducted using ANSYS Mechanical 2022 R2 under axial compression (800 N), distraction (300 N), and torsion (10 Nm). Mechanical responses including maximum deformation, von Mises stress, and strain distribution in bone, plate, and screws were evaluated. Results were evaluated descriptively and comparatively across implant configurations and loading conditions.</p><p><strong>Results: </strong>The titanium construct generally demonstrated the lowest deformation under torsional loading and the lowest plate strain response, whereas selected composite geometries approached or exceeded titanium-like deformation performance under specific loading modes. The hybrid plate showed the lowest deformation under compression, while the thick flat plate provided the lowest deformation among composites under distraction and torsion. The bellied design showed lower torsion-induced deformation and lower plate stress than most other lower-profile composite configurations. The enhanced plate exhibited the lowest plate strain among the composite models under compression and distraction but may pose challenges for soft tissue coverage due to its complex geometry.</p><p><strong>Conclusion: </strong>Optimizing plate geometry can substantially modify the mechanical behavior of biodegradable composite constructs. Hybrid and enhanced designs demonstrated load-mode specific mechanical responses that may inform future biodegradable plate optimization, particularly with further material refinement and experimental validation.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"851-862"},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655162","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":"Early gait recovery following medial open-wedge high tibial osteotomy: A prospective gait analysis study.","authors":"Mehmet Musa Emir, Özgür Selim Uysal, Gurbat Javadov, Sinan Yılmaz, Jihad Hajouj, Umut Öktem, Emre Adıgüzel, Osman Tecimel, Durmuş Ali Öçgüder","doi":"10.52312/jdrs.2026.2776","DOIUrl":"10.52312/jdrs.2026.2776","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the effects of medial openwedge high tibial osteotomy (OWHTO) on gait analysis outcomes in patients with medial compartment osteoarthritis and varus alignment of the knee.</p><p><strong>Patients and methods: </strong>This prospective, observational study included a total of 22 patients who underwent biplanar medial OWHTO between February 2023 and March 2024 were included. Gait analysis was performed preoperatively and at the sixth postoperative month using the DIERS formetric 4D system. Early postoperative (6 months) gait parameters, angular parameters (tibial slope and correction angle), and joint kinematics were evaluated. Patient-reported outcomes were obtained using the Oxford Knee Score (OKS) to assess pain and physical function before and after the procedure.</p><p><strong>Results: </strong>Of a total of 22 patients included in the study, 4 were male and 18 were female with a mean age of 55.41 ± 5.86 (range, 47 to 63) years. Postoperatively, patients' walking speed (0.83 ± 1.12 m/s), step length (0.58 ± 0.73 m), and cadence (82.72 ± 92.05 steps/min) increased significantly (p < 0.001). The tibial slope angle showed a mean increase of 1.93° (p < 0.001). The mean correction angle was 7.53°. The mean knee flexion increased significantly from 35.05° ± 8.74° preoperatively to 52.96° ± 13.21° postoperatively (p < 0.001). Knee extension improved minimally but significantly from -7.55° ± 1.18° to -6.03° ± 0.05° (p = 0.046). Ankle dorsiflexion increased significantly (p < 0.001), whereas changes in plantar flexion were not statistically significant. The OKS score increased significantly from 18.30 preoperatively to 41.50 at the sixth postoperative month (p < 0.001).</p><p><strong>Conclusion: </strong>Medial OWHTO results in early improvements in walking speed, step length, and cadence, as well as enhanced knee flexion kinematics and patient-reported outcomes. These findings indicate that OWHTO is an effective surgical option contributing to the improvement of gait patterns in the early postoperative period.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"768-776"},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655217","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":"Effects of BPC-157 and TB-500 on Achilles tendon healing in rats: A histopathological and biomechanical study.","authors":"Ozancan Biçer, Oktay Adanir, Yiğit Güleryüz, Emin Can Balci, Yaşar Mahsut Dinçel, Mehmet Yağız Yenigün, Cemre Aydin, Büşra Yaprak Bayrak","doi":"10.52312/jdrs.2026.2951","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2951","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aims to evaluate the effects of BPC-157, synthetic thymosin beta-4 (TB-500), and their combination on Achilles tendon healing using biomechanical, histopathological, histochemical, and immunohistochemical analyses in a rat model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Thirty-two male Sprague-Dawley rats, each aged 12 weeks and weighing approximately 330 g, underwent standardized Achilles tendon transection and repair and were randomly assigned to four groups, with eight rats in each group: control, BPC-157 (10 µg/kg/day), TB-500 (60 µg/kg/day), and combined BPC-157 + TB-500 (BPC + TB). Treatments were administered intraperitoneally for four weeks postoperatively. At four weeks, tendons were harvested for biomechanical testing or histological evaluation. Maximum load to failure was assessed biomechanically. Histological and histochemical analyses included hematoxylin-eosin, Masson trichrome, Alcian blue, and Sirius red staining and were evaluated using Bonar and Movin scoring systems. Expression of collagen types I and III was assessed immunohistochemically and semiquantified using H-score analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Biomechanical testing revealed higher maximum load to failure values in the BPC-157 and TB-500 groups compared to controls, reaching statistical significance in the TB-500 group (p &lt; 0.05). Histopathological evaluation demonstrated significantly lower total Bonar scores in the TB-500 group (p = 0.016) and significantly lower total Movin scores in the TB-500 and BPC + TB groups (p = 0.017 and p = 0.040, respectively) relative to controls, indicating improved tendon architecture, collagen alignment, and reduced degenerative changes. The BPC-157 group showed numerically lower scores without reaching statistical significance for total scores. Sirius red birefringence analysis showed increased type I collagen organization and altered type III collagen distribution in treatment groups, particularly in the TB-500 group, suggesting progression toward matrix maturation. Immunohistochemical analysis revealed no significant differences in collagen type I expression among groups, whereas collagen type III expression differed significantly, consistent with histochemical findings. Combined BPC-157 and TB-500 treatment did not confer additional benefits compared to either agent alone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this exploratory rat model study, both BPC-157 and TB-500 were associated with improved histopathological parameters and extracellular matrix organization during early Achilles tendon repair, with TB-500 additionally demonstrating a significant biomechanical advantage at four weeks. The absence of additive effects with combination therapy may reflect convergence on shared downstream pathways; however, this hypothesis requires further experimental confirmation. These preliminary findings indicate that both peptides warrant further investigation as candidate adjuncts to ","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"822-837"},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655184","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":"The impact of reoperation after bipolar hemiarthroplasty for femoral neck fracture: A matched cohort comparison between septic and nonseptic causes.","authors":"Wei-Lin Chang, Cheng-Yang Chang, Jui-Chien Wang, Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Wei-Ming Chen","doi":"10.52312/jdrs.2026.2619","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2619","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to compare the rates of medical complication and mortality following initial bipolar hemiarthroplasty (bHA) and reoperation procedures, as well as between different causes of reoperation (nonseptic vs. septic).</p><p><strong>Patients and methods: </strong>The retrospective study included 118 patients undergoing reoperation after bHA for femoral neck fractures between January 2002 and December 2022. The primary outcomes included in-hospital complications, readmission, and mortality events, while secondary outcomes included length of hospital stay, transfusion rates, and estimated blood loss. These outcomes were compared between each patient's initial bHA and their subsequent reoperation procedure. The two cohorts were matched using propensity scores based on age, sex, and Charlson Comorbidity Index to compare outcomes between nonseptic and septic causes of reoperation.</p><p><strong>Results: </strong>Of the 118 patients, 64 were male and 54 were female. The mean age was 77.8 ± 7.9 years, with a range of 61 to 98 years. The in-hospital complication rate was higher after reoperation than after initial bHA (15.3% vs. 1.7%, p < 0.001). Conversely, the readmission rate was higher after the initial procedure (60.2% vs. 23.7%, p < 0.001), mainly due to surgical complications. Patients undergoing reoperation had longer hospital stays, higher transfusion requirements, and more frequently received general anesthesia compared to the initial procedure (p < 0.05). In the matched cohort, septic group had higher in-hospital complication rates than the nonseptic group (23.5% vs. 3.9%, p = 0.004), while readmission and mortality rates were comparable.</p><p><strong>Conclusion: </strong>Reoperations after bHA carry a higher risk of medical complications. This risk is particularly pronounced in cases related to septic conditions, underscoring the greater impact of reoperation and careful clinical attention.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"626-636"},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655175","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}