Joint diseases and related surgery最新文献

{"title":"Second metacarpal cortical percentage and psoas muscle index in predicting loss of reduction after non-operative treatment of distal radius fractures in adult women.","authors":"Elyesa Ergen, Emre Öztürk, Ender Gümüşoğlu, Zeynel Mert Asfuroğlu","doi":"10.52312/jdrs.2026.2970","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2970","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate whether second metacarpal cortical percentage (2MCP) and psoas muscle index (PMI) were associated with loss of reduction after closed reduction and cast immobilization.</p><p><strong>Patients and methods: </strong>A total of 91 adult female patients with distal radius fractures (DRFs) treated with closed reduction and cast immobilization between January 2014 and June 2025 were retrospectively analyzed. Patients with standardized serial radiographs and lumbar computed tomography (CT) performed within ± 3 months of injury were included. Clinical characteristics, AO/OTA fracture type, Lafontaine instability criteria, lumbar CT densitometry T-scores, 2MCP, and PMI were evaluated. Loss of reduction was defined radiographically during follow-up. Multivariate logistic regression was performed using predefined cut-off values, and receiver operating characteristic (ROC) curve analysis was used to explore cut-off values for 2MCP and PMI.</p><p><strong>Results: </strong>The mean age was 63.0 ± 8.2 (range, 44 to 84) years. Loss of reduction occurred in 23 patients (25.3%). In group comparisons, AO/OTA Type C fracture pattern, Lafontaine instability, CT densitometry-defined osteoporosis, 2MCP-defined osteoporosis, and low PMI were more frequent among patients with loss of reduction. In the multivariate analysis, 2MCP-defined osteoporosis was independently associated with loss of reduction (adjusted OR = 7.22; 95% CI: 1.16-45.06; p = 0.034). Low PMI was also independently associated with loss of reduction (adjusted OR = 25.52; 95% CI: 5.33-122.14; p < 0.001). The ROC curve analysis identified cut-off values of 48% for 2MCP and 3.65 for PMI.</p><p><strong>Conclusion: </strong>Our study results showed that 2MCP-defined osteoporosis and low PMI were independently associated with loss of reduction after non-operative treatment of DRFs in female patients. These imaging-based parameters may support exploratory risk stratification.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"811-821"},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654892","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 proximal fibular osteotomy on tibiofibular and medial knee loads in severe varus: A finite element study.","authors":"Oğuzhan Pekince, Ahmet Yıldırım","doi":"10.52312/jdrs.2026.2965","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2965","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the biomechanical effects of proximal fibular osteotomy (PFO) on tibiofemoral and proximal tibiofibular load transfer under simulated neutral and varus alignment conditions using a lower-extremity finite element analysis (FEA) model.</p><p><strong>Materials and methods: </strong>A patient-specific three-dimensional FEA model of the lower extremity was developed from computed tomography and magnetic resonance imaging data of a healthy volunteer. Neutral, 3° varus, and 5° varus alignments were simulated before and after PFO under a simplified physiological axial load of 900 N. Tibiofemoral compartment forces, proximal tibiofibular joint (PTFJ) force, distal tibiotalar reaction force, and peak von Mises stresses within the cartilage-meniscus complex were evaluated.</p><p><strong>Results: </strong>Proximal fibular osteotomy markedly reduced PTFJ force across all alignment conditions. Under neutral alignment, PTFJ force decreased from 122.94 N to 21.84 N, while distal tibiotalar reaction force increased from 787.55 N to 897.89 N, indicating redistribution of load through distal pathways. Tibiofemoral compartment forces changed minimally. Under 5° varus alignment, medial tibiofemoral force decreased only from 608.45 N to 603.78 N following PFO. Peak medial meniscal and cartilage stresses increased with varus alignment and remained largely unchanged after osteotomy.</p><p><strong>Conclusion: </strong>In this single-subject static FEA model, PFO substantially reduced proximal tibiofibular loading, but produced only limited changes in tibiofemoral load distribution under simulated varus alignment. Within the present model, load redistribution occurred predominantly through distal load-transfer pathways rather than substantial unloading of the medial tibiofemoral compartment. These findings suggest that the biomechanical effect of PFO may primarily involve alteration of fibular load transmission rather than meaningful reduction of medial knee loading.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"800-810"},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655201","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":"Shoulder stiffness following distal radius open reduction and internal fixation: Natural course and effect of structured postoperative exercise.","authors":"Joonha Lee, Yohan Lee, Donghyun Lee, Yeongcheol Shin, SeongJu Choi","doi":"10.52312/jdrs.2026.2737","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2737","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the effect of a structured postoperative shoulder exercise program on shoulder range of motion (ROM) recovery and the development of postoperative shoulder stiffness following surgical fixation of distal radius fractures (DRFs).</p><p><strong>Patients and methods: </strong>This non-randomized, time-based cohort study included a total of 64 patients who underwent volar plate fixation of DRF between October 2022 and March 2023. Patients were allocated into two groups based on calendar periods and basic demographic factors were evaluated. Group 1 (exercise group, n = 33) was educated on pre-designed shoulder exercise to prevent shoulder stiffness after surgical treatment. Group 2 (control group, n = 31) was instructed to use their shoulders freely without an arm sling. Shoulder ROM and Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) scores were evaluated and compared at postoperative Weeks 2, 4, 8, 12, and 24. Shoulder stiffness was defined as passive ROM restricted by 30° or more compared to the contralateral side (or difference of two or more Constant-Murley scores in internal rotation) in two or more planes of movement.</p><p><strong>Results: </strong>Of the patients, 12 were male and 52 were female with a mean age of 65.7 ± 8.9 (range, 42 to 85) years. The mean follow-up was 6.8 ± 1.6 months. Shoulder ROM markedly decreased between postoperative Weeks 2 and 4, but continuously improved until the final follow-up in both groups. A transient improvement in internal rotation at postoperative Weeks 4 and 8 was observed in Group 1 compared to Group 2. No significant difference in internal rotation was observed at the other time points. At the final follow-up, 7.8% of all patients continued to experience shoulder stiffness.</p><p><strong>Conclusion: </strong>Structured shoulder exercise may facilitate earlier recovery of shoulder internal rotation after volar plate fixation of DRFs. However, this advantage can be transient and cannot be maintained beyond eight weeks postoperatively, suggesting that shoulder ROM often recovers spontaneously even in the absence of a routine rehabilitation protocol. Furthermore, secondary shoulder stiffness following DRF fixation peaks at approximately four weeks after surgery and subsequently resolves more rapidly than the typical natural history of primary frozen shoulder. These findings indicate that structured shoulder exercises may provide short-term benefits in postoperative recovery, while the long-term clinical significance of routine shoulder rehabilitation remains uncertain.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"658-666"},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655195","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":"A comparative analysis of arthroscopy-assisted minimally invasive percutaneous plate osteosynthesis versus open reduction and internal fixation for tibial plateau fractures.","authors":"Bing Yan, Jian Zhang, Wang Yao, Yu-Jie Li","doi":"10.52312/jdrs.2026.2921","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2921","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate whether arthroscopy-assisted minimally invasive percutaneous plate osteosynthesis (MIPPO) provided more favorable early functional recovery and reduced surgical trauma compared to traditional open reduction and internal fixation (ORIF).</p><p><strong>Patients and methods: </strong>A total of 84 patients with Schatzker type I-IV tibial plateau fractures treated between January 2021 and January 2024 were retrospectively analyzed. The MIPPO group (n = 41) underwent arthroscopy-assisted reduction plus MIPPO, while the ORIF group (n = 43) received conventional ORIF. Allocation was chronological, with ORIF predominant in the first two years and MIPPO in the latter two years. Operative parameters, postoperative drainage, radiographic outcomes (Rasmussen radiological score), functional recovery (Hospital for Special Surgery [HSS] score), range of motion (ROM), fracture healing time, hospital stay, and complications were compared.</p><p><strong>Results: </strong>Of a total of 84 patients, 28 were male and 56 were female of 49.4 ± 9.0 (range, 27 to 69) years. The arthroscopy-assisted MIPPO group had significantly longer operative time (96.0 ± 18.2 vs. 84.0 ± 13.9 min, p = 0.001) but shorter incision length (3.9 ± 0.7 vs. 6.2 ± 0.9 cm, p < 0.001), less intraoperative blood loss (56.5 ± 9.6 vs. 72.6 ± 10.1 mL, p < 0.001), and lower postoperative drainage volume (47.1 ± 7.5 vs. 59.0 ± 7.0 mL, p < 0.001) than the ORIF group. The arthroscopy-assisted MIPPO group also achieved higher Rasmussen radiological scores (15.4 ± 1.4 vs. 14.0 ± 1.6, p < 0.001) and better HSS scores at one, three, and six months postoperatively (all p < 0.001). At six months postoperatively, the MIPPO group also demonstrated significantly improved knee ROM (118.5° ± 8.2° vs. 107.3° ± 9.1°, p < 0.001), a difference exceeding the clinically meaningful threshold for activities of daily living. However, no significant differences were found in hospital stay (p = 0.051), fracture healing time (11.4 ± 1.3 vs. 11.1 ± 1.3 weeks, p = 0.340), or the excellent-and-good rate of HSS score at final follow-up (95.1% vs. 97.7%, p = 0.746). Complication rates were similar between the groups (p = 1.000).</p><p><strong>Conclusion: </strong>For Schatzker type I-IV tibial plateau fractures, arthroscopy-assisted MIPPO provides more favorable early functional recovery and radiological reduction quality compared to conventional ORIF, with less surgical trauma and comparable early functional recovery and similar complication rates during follow-up. Although operative time is longer, this minimally invasive approach is a safe and effective option for managing these complex fractures. Its principal advantage is accelerated early recovery, particularly in knee ROM, enabling patients to reach clinically meaningful thresholds for activities of daily living sooner.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"667-676"},"PeriodicalIF":2.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655043","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":"Juxta-epiphyseal fractures at the base of the proximal phalanx of the finger in pediatric patients.","authors":"Burak Kuşcu, Kaan Gürbüz","doi":"10.52312/jdrs.2026.2698","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2698","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the mid-term clinical and functional outcomes of juxta-epiphyseal fractures of the proximal phalanx in pediatric patients.</p><p><strong>Patients and methods: </strong>Between July 2013 and December 2023, a total of 23 pediatric patients treated for juxta-epiphyseal fractures of the proximal phalanx were retrospectively analyzed. Functional outcomes were assessed using four subtests of the Jebsen-Taylor Hand Function Test. To compare the Jebsen-Taylor Hand Function Test, a control group of healthy children (n = 23) from the outpatient clinic was formed. Patients were treated either with closed reduction and splinting or with closed reduction followed by Kirschner wire (K-wire) fixation according to fracture displacement and stability. Radiographs were evaluated for residual deformity and malunion using Campbell's lines.</p><p><strong>Results: </strong>Of a total of 23 patients, 13 were male and 10 were female with a mean age of 7.24 ± 2.21 (range, 6 to 13) years. The fifth digit was the most commonly affected (n = 14), followed by the fourth (n = 5), middle (n = 2), and thumb (n = 2). In 15 patients, the injury occurred on the non-dominant hand. No malunions were detected. One patient demonstrated a pseudo-claw deformity. Hand function tests revealed statistically significant delays in patients with dominant-hand injuries compared to healthy controls (p < 0.05). Seven patients reported a change in hand dominance after injury.</p><p><strong>Conclusion: </strong>Our study results suggest that appropriate reduction techniques, including closed or K-wire-assisted fixation, offer favorable outcomes with minimal complications. However, functional impairment can be more notable, when the dominant hand is involved. Taken together, these findings emphasize the need for early intervention, close follow-up, and consideration of hand dominance during recovery planning.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"705-713"},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655136","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":"Endobronchial pulmonary metastasis in malignant tenosynovial giant cell tumor: A rare cause of central airway obstruction.","authors":"Ipek Çalık, Canberk Canayakın, Şule Kevser Dursun, Nur Büyükpınarbaşılı, Mehmet Akif Özgül","doi":"10.52312/jdrs.2026.2787","DOIUrl":"10.52312/jdrs.2026.2787","url":null,"abstract":"<p><p>Tenosynovial giant cell tumor (TGCT) is a rare mesenchymal neoplasm arising from the synovium, tendon sheath, or bursa. Although the localized and diffuse forms of TGCT are typically considered benign, malignant TGCT characterized by marked histologic atypia and increased mitotic activity may exhibit aggressive clinical behavior. Pulmonary metastasis from malignant TGCT is rare and, in previously reported cases, pulmonary involvement has predominantly been described as parenchymal nodules or pleural lesions. In this article, we describe a rare case of endobronchial pulmonary metastasis occurring approximately 72 months after the initial diagnosis of malignant TGCT originating from the tendon sheath of the knee.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"882-885"},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655215","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 greater sciatic notch-based transcolumnar magic screw trajectory in the acetabulum: An anatomical guide.","authors":"Pelin İsmailoğlu, Cengiz Kazdal, Emrehan Uysal, Alp Bayramoğlu","doi":"10.52312/jdrs.2026.2857","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2857","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to define the greater sciatic notch (GSN)-based transcolumnar \"magic screw\" corridor in the acetabulum and to assess its morphometric characteristics and anatomical feasibility according to quadrilateral plate (QP) morphology.</p><p><strong>Materials and methods: </strong>Between November 2025 and January 2026, three-dimensional morphometric analysis was performed on pelvic CT reconstructions of 90 adults (180 acetabulae) with intact pelvic bones and no evidence of hip or pelvic pathology. Using Mimics, pelvic models were reconstructed and a virtual 6.5-mm cannulated screw was advanced from the midpoint of the GSN toward the anterior column along a transcolumnar intraosseous trajectory. Bilateral trajectory length, angulation, and QP thickness were recorded. Differences by sex and side, age associations, and anatomical feasibility (\"easy\" versus \"hard\") were analyzed based on anatomical corridor constraints.</p><p><strong>Results: </strong>Of the patients included in the study, 42 were male and 48 were female with a mean age of 49.88 ± 17.18 (range, 19 to 86) years. The defined GSN-based transcolumnar screw corridor was anatomically feasible in 94.44% of cases. Mean posterior acetabular screw length was 74.16 ± 7.49 mm right and 73.21 ± 6.90 mm left. Mean GSN entry segment length was 22.95 ± 4.14 mm right and 23.48 ± 4.34 mm left. Mean acetabular screw angles were 125.86° ± 6.05° right and 124.26° ± 5.24° left, with a small but significant right-left difference (p = 0.004). The QP morphology demonstrated substantial variability: mean maximum thickness was 14.87 ± 2.75 mm right and 14.77 ± 2.82 mm left, while minimum thickness was 3.46 ± 1.37 mm right and 3.48 ± 1.32 mm left. Men had significantly greater superior and posterior acetabular screw lengths and markedly thicker QP parameters compared with women (all p ≤ 0.027), with large effect sizes for QP thickness (d > 1.0).</p><p><strong>Conclusion: </strong>A GSN-based transcolumnar magic screw corridor appears anatomically feasible in most adult pelves and provides a quantifiable intraosseous trajectory reaching both acetabular columns. Quadrilateral plate thickness emerges as the main anatomical limiting factor, particularly in female pelves and in cases categorized as corridor-constrained.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"731-746"},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655125","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":"Investigating the efficacy of acupoint acupuncture combined with rehabilitation training in knee osteoarthritis treatment: A prospective comparative study informed by systematic acupoint analysis.","authors":"Yan Li, Jiabei Yu, Yuhong Liu, Lin Zhu, Yafang Zhang, Ming Jin, Chunhua Wu, Songyu Li, Lanlan Fu, Linlin Zheng, Shunan Xu, Yan Jin","doi":"10.52312/jdrs.2026.2205","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2205","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aims to investigate the clinical effect of acupuncture combined with rehabilitation training in the treatment of knee osteoarthritis (KOA) under unified acupoint intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;In this prospective, comparative study informed by systematic acupoint analysis, the literature related to acupuncture for KOA treatment was retrieved from public databases and the core acupoints were analyzed using the Traditional Chinese Medicine Inheritance Calculation System (TCMICS) software. Eighty-four patients were selected as the participants, and the clinical effect (total efficacy rate), Numeric Rating Scale (NRS) for pain score, American Knee Society Score (AKSS) for knee joint function and the self-care ability score for daily living activities were used to evaluate the treatment effect. The curative effect index was calculated using the AKSS scores.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After analyzing the core acupoints, we selected the Dubi, Zusanli, Yanglingquan, Xuehai, Neixiyan and Liang Qiu acupoints for the acupuncture treatment. The patients were divided into a control group (n = 42 patients undergoing rehabilitation training) and an intervention group (n = 42 patients undergoing acupuncture combined with rehabilitation training). The control group consisted of 15 male and 27 female, with a mean age of 62.90 ± 11.531 (range, 40 to 78) years. The mean course of the disease was 4.07 ± 1.841 years. The intervention group consisted of 16 male and 26 female, with a mean age of 63.95 ± 10.613 (range, 41 to 79) years and a mean disease course of 4.76 ± 2.328 years. There was no significant difference between the groups before treatment (p &gt; 0.05). After acupuncture treatment, the 92.85% total efficacy rate (n = 39) was significantly higher than the 73.80% (n = 31) in the control group. The mean AKSS of the control and intervention groups were 64.17 ± 11.148 and 66.67 ± 17.795, respectively, and the mean knee joint articulation scores were 57.40 ± 8.925 and 54.10 ± 10.150 in the two groups, respectively. Following treatment, the scores of knee joint function and knee joint articulation in the intervention group were higher than those in the control group (p &lt; 0.05). For AKSS, the mean difference of the control group was 6.030, and the proportion of patients who reached the improvement of minimum clinically significant difference (MCID) standard was 80.95%. The mean difference of the intervention group was 10.98, and the proportion of patients who reached MCID was 100%. Following treatment, the self-care ability score in the intervention group were higher than those in the control group (p &lt; 0.05). For modified Barthel Index (MBI), the mean difference of the control group and intervention group were 6.446 and 6.225, all accounting for 100%. The mean NRS scores were significantly decreased from 5.19 ± 1.042 to 1.93 ± 0.640 after one month of acupuncture treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Con","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"614-625"},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655182","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":"Ten-year follow-up of functional and biomechanical outcomes after open double-Tajima repair for acute Achilles tendon rupture in non-competitive adults.","authors":"Ahmet Aybar, Kemal Gökkuş, Abdullah Şükün, Canan Gönen Aydın, Erdem Özden, Celal Bozkurt","doi":"10.52312/jdrs.2026.2866","DOIUrl":"https://doi.org/10.52312/jdrs.2026.2866","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the clinical and objective biomechanical outcomes at a minimum 10-year follow-up following open double-Tajima repair combined with a structured functional loading protocol.</p><p><strong>Patients and methods: </strong>Between January 2011 and December 2014, a total of 47 consecutive non-competitive adults (Tegner Activity Scale ≤ 4) with acute unilateral Achilles tendon rupture treated with open double-Tajima repair and an eight-week functional loading protocol were included in this retrospective cohort study. The primary outcome was the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Secondary outcomes included isokinetic dynamometry (peak torque at 30°/s and total work at 120°/s for plantar flexion and dorsiflexion), joint position sense, and ankle/calf circumference. Between-limb comparisons were performed.</p><p><strong>Results: </strong>Of the patients, 35 were male and 12 were female with a mean age at the time of surgery of 36.7 ± 6.6 (range, 22 to 55) years. The mean follow-up was 132.4 ± 13.5 (range, 120 to 168) months. The rupture involved the dominant limb in 29 patients (61.7%) and the non-dominant limb in 18 patients (38.3%). The primary outcome (AOFAS score) showed no statistically significant between-limb difference: the median score was 91.0 (IQR, 91.0 to 93.0) on the operated limb versus 93.0 (IQR, 91.0 to 93.0) on the contralateral limb (median difference: 0.00 points; 95% confidence interval [CI]: -1.00 to 1.00; p = 0.92). No statistically significant between-limb differences were detected across the secondary outcomes, including peak torque at 30°/s, total work at 120°/s, joint position sense, and ankle/calf circumference (p ≥ 0.09 for all). The complication rate was 4.3% (2/47): one partial rerupture managed conservatively and one superficial wound infection treated with oral antibiotics. No complete reruptures were observed.</p><p><strong>Conclusion: </strong>Open double-Tajima repair combined with a structured functional loading protocol seems to be associated with clinically acceptable long-term outcomes in this cohort of non-competitive adults. However, given the retrospective, single-cohort design without an independent comparison group or formal equivalence framework, these findings should be interpreted as descriptive long-term observations.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"756-767"},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655129","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 efficacy of conventional rehabilitation, balance acupuncture combined with conventional rehabilitation and additional unconscious proprioception training for chronic ankle instability: A randomized-controlled clinical study.","authors":"Na Liu, Mi Wang, Qing Meng, Mingyu Wang, Kai Shang, Ying-Li Bi, Xiaowei Jiang, Jin Li, Jiaojiao Chen, Shiming Feng, Hongwei Zhai","doi":"10.52312/jdrs.2026.2311","DOIUrl":"10.52312/jdrs.2026.2311","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to compare the efficacy of conventional rehabilitation alone, conventional rehabilitation combined with balance acupuncture (BA) and conventional rehabilitation plus BA and unconscious proprioception training in chronic ankle instability (CAI) patients.</p><p><strong>Patients and methods: </strong>This single-center, parallel-group, assessor-blinded randomized-controlled trial included a total of 120 CAI patients between October 2022 and October 2024. The patients were randomly assigned to control (n = 40), BA (n = 40), and combination therapy (CT, (n = 40) groups. All groups received six weeks of intervention (6 days/week): the control group received conventional rehabilitation, the BA group received conventional rehabilitation + BA and the CT group received conventional rehabilitation + BA + unconscious proprioception training. Unconscious proprioception training was defined as dual-task training using the MOTOmed system with cognitive distraction to shift focus away from conscious movement control. Assessments were conducted before and after treatment using a three-dimensional gait analysis system, a balance function testing and training system, and the Star Excursion Balance Test (SEBT).</p><p><strong>Results: </strong>There was no statistically significant difference in age and sex among the groups (p > 0.05). In addition, disease duration and number of previous sprains were comparable among the groups (p > 0.05). Following the six-week intervention, all three groups showed significant improvements in gait parameters, balance function and SEBT scores compared to baseline (p < 0.05). The CT group exhibited significantly greater improvements in gait speed, cadence, movement length, movement ellipse area and SEBT scores than the BA group (p < 0.05), whereas the BA group outperformed the control group in all outcome measures (p < 0.05). No adverse reactions were reported in any group.</p><p><strong>Conclusion: </strong>The integration of BA and unconscious proprioception training may offer additional benefits for improving gait and balance in CAI patients compared to conventional rehabilitation plus BA or conventional rehabilitation alone. Based on these preliminary findings, the combined approach shows potential clinical value for targeted populations with CAI.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 3","pages":"637-648"},"PeriodicalIF":2.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655147","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}