Journal of orthopaedics and sports medicine最新文献

{"title":"Psychological Treatment in the Management of Pain following Musculoskeletal Injury.","authors":"Andre Aabedi, Vera Wang, Marcel P Fraix, Devendra K Agrawal","doi":"10.26502/josm.511500191","DOIUrl":"https://doi.org/10.26502/josm.511500191","url":null,"abstract":"<p><p>Musculoskeletal injuries are a leading cause of pain and disability, with many patients developing chronic pain. While traditional management focuses on physical treatments, psychological interventions have emerged as a complementary approach. This study examines the role of psychological treatments in pain management after musculoskeletal injury, their efficacy, and their integration with existing treatment strategies. A review of literature, including systematic reviews and meta-analyses, was conducted to assess the effectiveness of psychological treatments such as cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and pain neuroscience education (PNE). Studies on the impact of psychological distress on pain perception, circulating inflammatory biomarkers, and neuromuscular exercises were analyzed. Research indicates that psychological elements, particularly pain catastrophizing, anxiety, and depression, play crucial roles in determining both pain intensity and disability levels. Short-term improvements in pain intensity, functional capacity, and psychological well-being have been documented with CBT, MBSR, and PNE interventions. The integration of psychological approaches with physiotherapy demonstrates enhanced patient outcomes. Biological markers of inflammation, specifically CRP and IL-6, show potential as indicators of pain severity and treatment effectiveness. Notably, neuromuscular exercises have shown pain-reducing effects comparable to pharmaceutical interventions, though long-term efficacy data for psychological treatments remains variable. The integration of psychological interventions represents a significant advancement in musculoskeletal pain management, particularly in addressing the mental and emotional dimensions of pain experience. While current research supports their immediate benefits, additional investigation is necessary to determine long-term effectiveness and refine treatment approaches. Future research should emphasize individualized treatment protocols, technological integration, and robust longitudinal studies to maximize therapeutic outcomes.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"7 1","pages":"162-168"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Strategies in the Prevention and Management of Infection in Open Fractures.","authors":"Laura Roberts, Mohamed Radwan Ahmed, Devendra K Agrawal","doi":"10.26502/josm.511500198","DOIUrl":"10.26502/josm.511500198","url":null,"abstract":"<p><p>Open fractures are complex injuries that significantly increase the risk of infection and complications such as delayed healing, nonunion, and chronic osteomyelitis. Infections rates remain high, particularly in severe cases involving extensive soft tissue damage and contamination. This is due to a variety of factors involving the patient, environment and bacteria. This article critically reviewed the classification, common pathogens, and complications associated with open fractures, emphasizing the challenges posed by biofilms, antibiotic resistance, and host factors such as diabetes and immunosuppression. Current management strategies, including early antibiotic administration, surgical debridement, and wound care, are examined alongside emerging therapies such as continuous local antibiotic perfusion, antibiotic-coated implants, bacteriophage therapy, and bioelectric dressings. These approaches show promise in reducing infection rates, enhancing patient outcomes, and addressing the limitations of traditional treatments. However, there are gaps in understanding their long-term efficacy, especially in high-risk populations. Future research should focus on personalized protocols, combination therapies, and clinical trials to reduce the burden of infection-related complications in open fracture management.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"7 2","pages":"218-229"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical interventions in Severe Osteoarthritis: Pros and Cons.","authors":"Andre Aabedi, Marcel P Fraix, Devendra K Agrawal","doi":"10.26502/josm.511500192","DOIUrl":"10.26502/josm.511500192","url":null,"abstract":"<p><p>Severe osteoarthritis (OA) is a debilitating condition that often necessitates surgical intervention when conservative treatments fail. We carefully reviewed the literature on the pros and cons of surgical options for severe OA, focusing on total joint arthroplasty (TJA) and other surgical techniques. Total joint arthroplasty, including total knee arthroplasty (TKA) and total hip arthroplasty (THA), is the most established surgical option for severe OA, providing significant pain relief, functional restoration, and improved quality of life. The American College of Rheumatology and the American Association of Hip and Knee Surgeons recommend proceeding to TJA without delay in patients with symptomatic moderate-to-severe OA unresponsive to nonoperative therapy. Osteotomies and cartilage repair procedures are less commonly performed and have limited evidence supporting their long-term efficacy in reducing OA progression. Arthroscopic interventions, such as lavage and debridement, do not alter disease progression and are not recommended for routine treatment of OA. While TJA is highly effective, it is associated with risks such as postoperative complications, revisions, and reoperations. The cost-effectiveness of TJA is well-documented, making it a favorable option for managing end stage OA. However, patient selection is crucial, and factors such as age, comorbidities, and obesity must be considered to optimize outcomes. Total joint arthroplasty remains the gold standard for surgical management of severe OA, offering substantial benefits in pain relief and functional improvement. Other surgical options, such as osteotomies and arthroscopy, have limited roles and should be considered based on individual patient factors and disease severity. Evidence-based guidelines support the timely use of TJA to enhance patient outcomes and quality of life.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"7 1","pages":"169-178"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors, Incidence, and Management of Re-Injury following Repair of Shoulder Rotator Cuff.","authors":"David Parvizi, Ramtin Sahafi, Timothy Pisarski, Sugeeth Kandikattu, Manas Aavula, Devendra K Agrawal","doi":"10.26502/josm.511500193","DOIUrl":"https://doi.org/10.26502/josm.511500193","url":null,"abstract":"<p><p>Rotator cuff tears are among the most common musculoskeletal injuries worldwide, often requiring surgical intervention to restore shoulder function. Despite improvements in surgical techniques, rotator cuff re-injury remains a significant challenge, influenced by a combination of patient-related and procedural factors. The incidence of re-injury after surgery ranges from 15% to 21%, varying based on the severity of the initial injury and adherence to rehabilitation. In this article, we critically examine the risk factors, incidence, and management strategies associated with rotator cuff re-injury. Key risk factors include advanced age, larger tear size, poor tissue quality, high activity levels, and comorbid conditions like diabetes and hyperlipidemia. Age-related degenerative changes, muscle atrophy, and fatty infiltration impair tendon healing, increasing the risk of re-injury. Emerging geometric classifications of rotator cuff tears (Types 1-4) provide valuable insights into prognosis and guide surgical approaches. Management strategies for re-injury include both conservative approaches, such as physical therapy and activity modification, and surgical revisions, including tendon transfers and superior capsular reconstruction. Novel interventions like biological scaffolds, mesenchymal stem cell therapy, and machine learning-driven rehabilitation protocols are being explored to enhance tendon healing and reduce re-injury rates. However, gaps remain in understanding the biological mechanisms of tendon repair and optimizing personalized treatment strategies. Future research should focus on integrating biomolecular insights with clinical practice to improve outcomes and reduce the burden of rotator cuff re-injury.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"7 1","pages":"179-185"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Approaches for the Treatment of Spinal Disorders: A Comprehensive Review.","authors":"Edgmin Rostomian, Kevin Ghookas, Alexander Postajian, Kevin B Vartanian, Vedi Hatamian, Marcel P Fraix, Devendra K Agrawal","doi":"10.26502/josm.511500190","DOIUrl":"https://doi.org/10.26502/josm.511500190","url":null,"abstract":"<p><p>This comprehensive review explores the latest advancements in the management of spinal disorders, including minimally invasive surgical techniques, treatment of complex deformities, disc replacement technologies, and non-surgical approaches. The review highlights the potential of innovations such as robotic-assisted surgeries, regenerative medicine, and artificial intelligence to enhance precision, reduce recovery times, and improve patient outcomes. It also discusses the integration of wearable technologies and personalized medicine in tailoring treatments. Challenges such as high costs, accessibility issues, and limited long-term data are critically analyzed, alongside gaps in research, including a lack of diversity in study populations and insufficient economic evaluations. Future directions emphasize the need for multidisciplinary collaboration to develop durable, accessible, and personalized solutions to address the global burden of spinal disorders.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"7 1","pages":"144-161"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Osteoarthritis Research: Insights from Rodent Models and Emerging Trends.","authors":"Resmi Rajalekshmi, Devendra K Agrawal","doi":"10.26502/josm.511500187","DOIUrl":"https://doi.org/10.26502/josm.511500187","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a degenerative joint disease that affects millions of individuals worldwide, causing pain, disability, and a significant burden on public health. Preclinical research using animal models is essential to our understanding of the underlying pathogenesis of OA and developing therapeutic strategies. Rodent models, in particular, have become indispensable in studying OA due to their ability to mimic various features of human disease. This review provides an overview of commonly used rodent models of OA, including surgical induction (e.g., destabilization of the medial meniscus and anterior cruciate ligament transection), chemical induction (e.g., monoiodoacetate-induced cartilage degeneration), and genetically modified models. Additionally, age-related OA models that naturally develop OA-like symptoms in aged rodents are also discussed. Despite their utility, rodent models face limitations in fully recapitulating the complexity of human OA. Emerging trends in OA research, including the use of 3D imaging for joint analysis, molecular profiling for deeper insights into disease mechanisms, and advancements in biomarkers for early detection and treatment, are highlighted. These innovations provide new opportunities to refine existing models and enhance the translation of findings to clinical therapies. This critical review provides comprehensive information for researchers working in OA and related fields, promoting a better understanding of the available rodent models and their applications in OA research.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"7 1","pages":"110-128"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Artificial Intelligence and its Subsets in Various Stages of Knee Arthroplasty from Pre-op to Post-op: An Overview.","authors":"Jacqueline B Anderson Enni, Devendra K Agrawal","doi":"10.26502/josm.511500185","DOIUrl":"10.26502/josm.511500185","url":null,"abstract":"<p><p>Osteoarthritis is a complex and painful condition marked by joint destruction and remodeling, often resulting from overuse, aging, or genetic predisposition. Surgical arthroplasty is a widely used treatment to replace degenerated joints, relieve pain, and restore function, often caused by osteoarthritis. Artificial intelligence, including its subsets such as machine learning and deep learning, has emerged as a tool to enhance knee arthroplasty by improving diagnostic accuracy, surgical efficiency and patient outcomes. This article addresses the diverse applications of artificial intelligence across the preoperative, perioperative, and postoperative stages of knee arthroplasty, categorizing studies by their focus on patient education, surgical assistance, and outcome assessment.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"7 1","pages":"96-102"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energizing Healing with Electromagnetic Field Therapy in Musculoskeletal Disorders.","authors":"Resmi Rajalekshmi, Devendra K Agrawal","doi":"10.26502/josm.511500147","DOIUrl":"10.26502/josm.511500147","url":null,"abstract":"<p><p>There is mounting evidence to suggest that exogenous electromagnetic fields (EMF) may play a significant role in various biological processes that are crucial to therapeutic interventions. EMFs have been identified as a non-invasive, safe, and effective therapy that appears to have no apparent side effects. Numerous studies have demonstrated that pulsed EMFs (PEMFs) have the potential to become a stand-alone or adjunctive treatment modality for managing musculoskeletal disorders. However, several questions remain unresolved. Before their widespread clinical application, further research from well-designed, high-quality studies is required to standardize treatment parameters and determine the optimal protocol for healthcare decision-making. This article provides a comprehensive overview of the impact of musculoskeletal diseases on overall well-being, the limitations of conventional treatments, and the need to explore alternative therapeutic modalities such as electromagnetic field (EMF) therapy. EMF therapy uses low-frequency electromagnetic waves to stimulate tissue repair, reduce inflammation, and modulate pain signals, making it a safe and convenient alternative to conventional treatments. The article also discusses the historical perspective of EMF therapy in medicine. The article highlights the potential of EMF therapy as a personalized and comprehensive care option for musculoskeletal diseases, either alone or in conjunction with other therapies. It emphasizes the imperative for further research in this field and presents a compelling case for the use of EMF therapy in managing musculoskeletal diseases. Overall, the available findings on the underlying cellular and molecular biology support the use of EMF therapy as a viable option for the management of musculoskeletal disorders and stresses the need for continued research in this area.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"6 2","pages":"89-106"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation and Fatty Infiltration Correlates with Rotator Cuff Muscle Atrophy in Hypercholesterolemic Yucatan Microswine.","authors":"Hoangvi Le, Vikrant Rai, Devendra K Agrawal","doi":"10.26502/josm.511500161","DOIUrl":"10.26502/josm.511500161","url":null,"abstract":"<p><p>Rotator cuff injuries are the most common injuries among active and training astronauts. According to the CDC, 1 in 4 adults in the U.S. experience rotator cuff injuries, particularly affecting the supraspinatus muscle. Hypercholesterolemia, a condition characterized by high levels of LDL cholesterol, is prevalent in approximately 2 in 5 adults in the US and is a risk factor for worsened outcomes in shoulder inflammation and rotator cuff injury repairs. Chronic inflammation, a prolonged low-grade inflammatory state, can arise from conditions like hypercholesterolemia and contribute to muscle atrophy. Skeletal muscle atrophy can be caused by factors such as disuse, aging, malnutrition, and microgravity, and currently lacks approved drug therapies. Thus, gaining a comprehensive understanding of the associations between hypercholesterolemia, chronic inflammation, and skeletal muscle atrophy is imperative for developing effective strategies to manage this condition. We conducted an animal study in Yucatan miniswine to investigate the impact of a high-cholesterol diet on rotator cuff muscle. The results suggested the presence of chronic inflammation in rotator cuff muscle hypercholesterolemic swine, associated with elevated pro-inflammatory cytokines and intramuscular adipocytes, and skeletal muscle atrophy. The results also revealed upregulation of the FOXO3/TRIM63/Titin axis in a hyperlipidemic state. These findings open new perspectives for developing better treatment strategies by targeting the FOXO3/TRIM63/Titin axis to manage rotator cuff muscle atrophy in the context of hypercholesterolemia.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"6 3","pages":"198-213"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopedic Dermatopathies: Skin Manifestations in Orthopedic Conditions.","authors":"Tony Eskandar, Fihr Chaudhary, Devendra K Agrawal","doi":"10.26502/josm.511500157","DOIUrl":"https://doi.org/10.26502/josm.511500157","url":null,"abstract":"<p><p>Orthopedic diseases often present with dermatological symptoms that require prompt identification for appropriate treatment. Understanding these dermatologic presentations is crucial for accurate diagnosis and effective management. This article critically reviewed the dermatological manifestations observed in general and regional pathologies, followed by treatment-related manifestations. An extensive literature search was performed and limited to manifestations in orthopedic disease, excluding those pertaining to infection or syndromes. Case reports and case series documenting unusual and rare dermatologic presentations of orthopedic conditions were examined, providing novel perspectives on both prevalent and uncommon illnesses. The identified pathologies are discussed in detail, including their clinical features and diagnosis, while treatment approach varies depending on the severity of the condition, ranging from self-care to surgical intervention. The findings emphasize the need for interdisciplinary collaboration and highlight the importance of careful diagnosis and appropriate management to eliminate unnecessary approaches and ensure optimal outcomes for patients with orthopedic diseases and dermatologic symptoms.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"6 3","pages":"171-183"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}