Medical sciences (Basel, Switzerland)最新文献

{"title":"Preoperative Coagulation Markers and Clinical Predictors of Transfusion Requirement in Patients Undergoing Total Knee or Hip Arthroplasty: A Single-Center Retrospective Study.","authors":"Wojciech Konarski","doi":"10.3390/medsci13030135","DOIUrl":"https://doi.org/10.3390/medsci13030135","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are widely performed procedures often associated with significant blood loss, leading to the need for allogeneic blood transfusion. Transfusions carry inherent risks and increase healthcare costs, making the identification of transfusion predictors crucial. This study aimed to assess preoperative predictors associated with transfusion requirement in patients undergoing THA or TKA. <b>Methods:</b> This single-center, retrospective analysis included 742 patients who underwent primary TKA or THA between 2016 and 2023. Preoperative variables such as hemoglobin, red blood cell count (RBC), INR, APTT, and use of tranexamic acid (TXA) were collected. Univariable and multivariable logistic regression analyses were conducted to identify independent predictors of transfusion. <b>Results:</b> Transfusions were required in 12.0% of patients. Multivariable analysis revealed that lower preoperative HGB and RBC levels, absence of TXA use, higher INR, and undergoing THA (versus TKA) were independently associated with increased transfusion risk. INR was not significant in univariable analysis but reached significance in the adjusted model. The final multivariable model demonstrated good predictive performance, with an area under the ROC curve (AUC) of 0.79. <b>Conclusions:</b> Lower hemoglobin and RBC levels, elevated INR, absence of TXA use, and THA surgery were independent predictors of transfusion. These findings may guide the use of routine preoperative hematologic and coagulation assessments to guide perioperative management and reduce transfusion rates in joint arthroplasty.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981468","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":"Effect of <i>Spirulina platensis</i> Versus Simvastatin on the Skeletal Muscles of Experimentally Induced Dyslipidemia: A Multitarget Approach to Muscle Ultrastructural and Cytomolecular Modulation.","authors":"Mai E Abdelhady, Khaled H Elmosalamy, Asmaa A A Kattaia, Mai A Samak","doi":"10.3390/medsci13030137","DOIUrl":"https://doi.org/10.3390/medsci13030137","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dyslipidemia is a prevalent metabolic disorder closely linked to cardiovascular complications and muscular pathologies, often managed using statins such as simvastatin. However, statin-induced myopathy remains a significant treatment-limiting side effect, necessitating the exploration of safe, natural alternatives. <i>Spirulina platensis</i>, a phytochemical-rich marine-derived cyanobacterium, has emerged as a promising bioactive nutraceutical with potent antioxidant and anti-inflammatory properties. This study evaluated the comparative effects of <i>Spirulina platensis</i> and simvastatin in attenuating dyslipidemia-induced skeletal muscle injury in adult male albino rats.</p><p><strong>Methods: </strong>Forty animals were allocated to the control and high-fat diet (HFD) groups. After 4 weeks, the dyslipidemic rats were subdivided into untreated, simvastatin-treated, and <i>Spirulina platensis</i>-treated subgroups. Serum lipid profile, creatine kinase (CK), and malondialdehyde (MDA) levels were assessed. Histological, ultrastructural, and immunohistochemical analyses were conducted to assess muscle fiber integrity and expression of TGF-β1 and Bcl2.</p><p><strong>Results: </strong><i>Spirulina platensis</i> significantly improved lipid parameters, reduced CK and MDA levels, preserved muscle histoarchitecture, and downregulated fibrotic (↓TGF-β1) and apoptotic (↑Bcl2) responses compared to the dyslipidemic and simvastatin-treated groups. Our results proved that <i>Spirulina platensis</i> ameliorates the effects of statin-associated myopathy while exerting lipid-lowering, cytoprotective, and antifibrotic effects.</p><p><strong>Conclusion: </strong>These molecular and ultrastructural benefits position <i>Spirulina platensis</i> as a promising, natural alternative to statins for managing dyslipidemia and preventing statin-induced myopathy. Future translational and clinical studies are warranted to further validate its efficacy and safety, supporting its broader application in metabolic and muscle-related disorders.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981444","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":"Psychometric Properties of the Greek Version of the Pediatric Assessment Scale for Severe Feeding Problems (PASS-FP).","authors":"Andri Papaleontiou, Louiza Voniati, Vassiliki Siafaka, Alexandros Gryparis, Rafaella Georgiou, Dionysios Tafiadis","doi":"10.3390/medsci13030133","DOIUrl":"https://doi.org/10.3390/medsci13030133","url":null,"abstract":"<p><p><b>Background/Objective:</b> Pediatric feeding problems are becoming more widespread. They represent a synthesis of social, behavioral, and biological issues. Inevitably, the multifaceted nature of these problems has to be evaluated through one multidimensional tool. The Pediatric Assessment Scale for Severe Feeding Problems is designed to assess these complex issues and represents the first attempt to associate these factors into a single multidimensional measure. The aim of this study is to translate and culturally adapt the Pediatric Assessment Scale for Severe Feeding Problems into Greek and to assess its psychometric properties for use among a Greek Cypriot pediatric sample. <b>Methods:</b> This study involved 142 parents of children with symptoms of feeding problems. It included parents of children who were oral-fed (<i>n</i> = 65), partially oral-fed with supplementation (<i>n</i> = 62), and tube-fed (<i>n</i> = 15). The sample of parents was recruited from mainstream and special education schools in Cyprus and were asked to complete a Greek-translated version of the PASS-FP. <b>Results:</b> The PASS-FP-Gr demonstrated excellent psychometric properties. Internal consistency was good, and test-retest reliability showed a perfect Spearman's rank correlation with high significance. The tool exhibited strong discriminatory ability, with statistically significant differences in median scores across the three feeding groups. <b>Conclusions:</b> The PASS-FP appears sensitive to the Greek Cypriot population and presents satisfactory psychometric features. It demonstrated excellent discriminatory ability, as evidenced by the participants' consistent response patterns.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981459","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":"Cardiotoxicity in Breast Cancer Therapy: Risks, Mechanisms, and Prevention Strategies.","authors":"Annisa Eka Fitrianti, Nadea Olyvia Wardani, Astri Astuti, Kusnandar Anggadiredja, Lia Amalia, Risani Andalasia Putri, Zulfan Zazuli","doi":"10.3390/medsci13030130","DOIUrl":"https://doi.org/10.3390/medsci13030130","url":null,"abstract":"<p><p>Breast cancer is the most prevalent cancer in women. Anthracyclines are commonly used as the first line of treatment, often combined with other agents, including trastuzumab. Despite their efficacy, both drugs pose a risk of cardiotoxicity, which may impair patients' quality of life (QoL) and hinder treatment persistence. Anthracycline-induced cardiotoxicity is dose-dependent and generally irreversible, whereas trastuzumab is associated with potentially reversible cardiac dysfunction. This review discusses the risk factors and biological mechanisms underlying chemotherapy-induced cardiotoxicity in breast cancer and explores effective strategies for prevention and treatment. It has been demonstrated that several cardioprotective strategies, such as treatments with angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), beta-blockers, and dexrazoxane, can help lessen cardiotoxic effects. A better understanding of cardioprotective strategies may help optimize cancer treatment without compromising cardiovascular function.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981410","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":"Phenotypic and Spatial Characterization of Tumor-Associated Macrophages in Non-Metastatic Seminoma: Association with Local Tumor Progression.","authors":"Grigory Demyashkin, Vladimir Shchekin, Dmitriy Belokopytov, Tatyana Borovaya, Ivan Zaborsky, Kadir Safiullin, Oleg Karyakin, Alexey Krasheninnikov, Nikolay Vorobyev, Petr Shegay, Andrei Kaprin","doi":"10.3390/medsci13030129","DOIUrl":"https://doi.org/10.3390/medsci13030129","url":null,"abstract":"<p><p><b>Background:</b> Seminoma is the most common subtype of testicular germ cell tumors in young men; however, the contribution of tumor-associated macrophages (TAMs) to disease progression remains insufficiently understood. This study aimed to quantitatively and phenotypically characterize CD68⁺ and CD163⁺ TAMs in non-metastatic seminomas (pT1N0M0 and pT2N0M0). <b>Methods</b>: This retrospective, multicenter, cohort, observational, analytical study was conducted from 1 January 2015 to 1 January 2025 at two branches of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation: the A. Tsyb Medical Radiological Research Center and the P. Hertsen Moscow Oncology Research Institute. Archived paraffin-embedded tumor samples from 96 patients and 21 samples of normal testicular tissue were analyzed using immunohistochemistry and digital morphometric analysis with QuPath software to assess macrophage density and spatial distribution. <b>Results</b>: Compared to normal testicular tissue, seminomas demonstrated more than a 10-fold increase in CD68⁺ TAMs and over a 100-fold increase in CD163⁺ TAMs. CD68⁺ cells predominantly localized to peripheral tumor regions, while CD163⁺ cells formed diffuse clusters in central tumor zones and around peripheral vessels. No statistically significant differences in CD68⁺ cell density were found between pT1 and pT2 stages. However, pT2 tumors showed a trend toward higher CD163⁺ TAMs density, suggesting increased M2 polarization with advancing tumor stage. <b>Conclusions</b>: These findings highlight the spatial and phenotypic heterogeneity of TAMs in seminoma and indicate a shift toward an immunosuppressive tumor microenvironment during local progression. Future studies should assess macrophage polarization and progression-free survival to evaluate their potential as prognostic biomarkers and therapeutic targets in seminoma.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981426","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":"Optimizing Recovery in Cardiac Surgery: A Narrative Review of Enhanced Recovery After Surgery Protocols and Clinical Outcomes.","authors":"Arzina Jaffer, Kayleigh Yang, Alisha Ebrahim, Amy N Brown, Ryaan El-Andari, Aleksander Dokollari, Alex J Gregory, Corey Adams, William D T Kent, Ali Fatehi Hassanabad","doi":"10.3390/medsci13030128","DOIUrl":"https://doi.org/10.3390/medsci13030128","url":null,"abstract":"<p><p>Enhanced Recovery After Surgery (ERAS) is an evidence-based, holistic perioperative recovery protocol intended to improve patient outcomes and decrease postoperative complication rates. While ERAS protocols were first introduced in 1997, specific guidelines for cardiac surgery were not established until 2019. Although the core principles of ERAS remain constant across surgical disciplines, ERAS guidelines for cardiac surgery have remained relatively understudied, likely due to the unique complexities posed by cardiac procedures. Within this comprehensive narrative review, we aimed to explore the current guidelines and evidence for ERAS in both cardiac and non-cardiac surgeries. In non-cardiac surgeries, ERAS has been shown to improve various outcomes, including ICU length of stay, patient satisfaction, and pain management. ERAS for cardiac surgery has also shown encouraging results, including shorter ICU and hospital stays, reduced postoperative opioid use, and faster recovery times. However, there is limited consensus across studies, particularly regarding its impact on morbidity and mortality, with mixed results reported. Furthermore, the limited data on the efficacy of ERAS in minimally invasive cardiac surgeries makes it difficult to establish well-supported guidelines for these procedures. Despite its limitations, the overall outcomes of ERAS for cardiac surgery remain promising. As our understanding and application of ERAS in cardiac surgery continue to evolve, these protocols have the potential to redefine cardiac surgical care standards.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981232","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":"Hyperemesis in Pregnancy: Complications and Treatment.","authors":"Angeliki Gerede, Sofoklis Stavros, Efthalia Moustakli, Anastasios Potiris, Ilias Orgianelis, Athanasios Zikopoulos, Peter Drakakis, Ekaterini Domali, Makarios Eleutheriades, Nikolaos Nikolettos","doi":"10.3390/medsci13030132","DOIUrl":"https://doi.org/10.3390/medsci13030132","url":null,"abstract":"<p><strong>Background: </strong>Hyperemesis gravidarum (HG) is the leading cause of hospitalization during early pregnancy, affecting approximately 0.3-3% of pregnancies. It represents the most severe end of the nausea and vomiting in pregnancy (NVP) spectrum and is associated with substantial maternal morbidity and potential adverse fetal outcomes. Despite extensive research, the exact pathophysiology remains poorly understood, and optimal management strategies continue to be debated.</p><p><strong>Methods: </strong>This narrative review synthesizes current evidence on the complications and treatment approaches for HG. A literature search was conducted in PubMed, Scopus, and Medline up to October 2024 using predefined keywords. Eligible sources included observational studies, cohort studies, descriptive studies, and case reports. Systematic reviews, meta-analyses, and non-English articles were excluded.</p><p><strong>Results: </strong>HG is associated with a broad spectrum of complications, including dehydration, electrolyte imbalances, Wernicke's encephalopathy, cardiac arrhythmias, thromboembolism, and adverse pregnancy outcomes such as fetal growth restriction and preterm birth. Pharmacological treatments-most notably doxylamine-pyridoxine (the only FDA-approved therapy), ondansetron, metoclopramide, and corticosteroids-have demonstrated varying efficacy and safety profiles. Non-pharmacological interventions such as acupressure, dietary adjustments, psychotherapy, and hypnosis have also been studied, although evidence remains limited.</p><p><strong>Conclusions: </strong>HG requires a comprehensive and individualized management approach. While doxylamine-pyridoxine remains the cornerstone of therapy, other pharmacologic and supportive measures may offer additional benefit. Continued research is essential to clarify the underlying mechanisms, improve therapeutic efficacy, and develop evidence-based guidelines that integrate both medical and psychosocial care for affected women.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981540","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":"Left Atrial Mechanics and Remodeling in Paroxysmal Atrial Fibrillation: Introducing the EASE Score for Pre-Ablation Risk Prediction.","authors":"Fulvio Cacciapuoti, Ilaria Caso, Rossella Gottilla, Fabio Minicucci, Mario Volpicelli, Pio Caso","doi":"10.3390/medsci13030131","DOIUrl":"https://doi.org/10.3390/medsci13030131","url":null,"abstract":"<p><p><b>Background:</b> Paroxysmal atrial fibrillation (PAF) is a common arrhythmia often treated with catheter ablation, particularly pulmonary vein isolation (PVI). However, recurrence remains frequent and is often linked to unrecognized structural and functional remodeling of the left atrium. <b>Methods:</b> We introduce the Echocardiographic Atrial Strain and conduction Evaluation (EASE) score as a theoretical, noninvasive model to stratify recurrence risk in patients undergoing catheter ablation for PAF. The score is based on the hypothesis that integrated echocardiographic parameters can reflect the extent of atrial remodeling relevant to ablation outcomes. <b>Results:</b> The EASE score combines six echocardiographic metrics-left atrial reservoir strain (LASr), atrial conduction time (PA-TDI), left atrial volume index (LAVI), stiffness index (E/e'/LASr), E/e' ratio, and contractile strain (LASct)-each representing structural, electrical, or mechanical remodeling. The total score ranges from 0 to 12, stratifying patients into low, intermediate, and high-risk categories for arrhythmia recurrence. Preliminary retrospective data suggest a significant association between higher EASE scores and increased recurrence rates following ablation. <b>Conclusions:</b> The EASE score offers a biologically plausible, multidimensional framework for noninvasive risk prediction in PAF ablation. Prospective studies are warranted to validate its clinical utility and refine its structure.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981180","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":"Breathwork for Chronic Stress and Mental Health: Does Choosing a Specific Technique Matter?","authors":"Adam Siebieszuk, Adam Filip Płoński, Marcin Baranowski","doi":"10.3390/medsci13030127","DOIUrl":"https://doi.org/10.3390/medsci13030127","url":null,"abstract":"<p><p>Modern society faces a growing prevalence of mental disorders, with stress emerging as a critical factor affecting mental well-being. In recent years, breathwork has gained public and scientific recognition as a promising approach for enhancing psychological health. Despite the rapid growth in research, the field remains fragmented due to the diversity of breathing techniques. Moreover, recent findings have challenged several foundational concepts traditionally believed to underlie the therapeutic effects of breathwork. This review offers a comprehensive overview and comparison of the most widely practiced breathing techniques, with a focus on addressing key theoretical issues. We examine the primary psychophysiological pathways and mechanisms of breathwork, highlighting its influence on the nervous system as central to its effectiveness. We critically evaluate the role of breathing variables, including pace, ratio, breathing route, attention, and the use of biofeedback, in promoting the long-term neurobiological changes that have been associated with improved mental health. We argue that most breathwork techniques share core neurophysiological mechanisms that benefit well-being, regardless of the theoretical differences between specific techniques. Accumulating evidence suggests breathwork may serve as both a preventive and adjunctive therapy for chronic stress, anxiety, and depression, given its potential to target key risk factors and produce clinically relevant outcomes. Contemporary breathwork research, however, is limited by inconsistent study quality and methodological heterogeneity. By synthesizing current evidence and identifying critical knowledge gaps, this review aims to guide future research and advance understanding of breathwork's therapeutic potential.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981424","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":"Over 10% of Surgically Treated High-Energy Pelvic Fractures Are Associated with Undiagnosed Ligamentous Knee Injuries: An Epidemiologic Study in Italy's Largest Trauma Center.","authors":"Simone Giusti, Vittorio Alfonsi, Edoardo De Fenu, Claudia Franco, Stefano Cacciatore, Francesco Liuzza, Ezio Adriani","doi":"10.3390/medsci13030124","DOIUrl":"https://doi.org/10.3390/medsci13030124","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prevalence of undiagnosed ligamentous knee injuries in patients surgically treated for high-energy pelvic ring or acetabular fractures and propose a mechanism to diagnose these briefly post-hospital discharge.</p><p><strong>Methods: </strong>A retrospective case series (level of evidence IV) was conducted at Italy's largest trauma center. Medical records from 2018 to 2023 were reviewed to identify patients who underwent surgical treatment for pelvic or acetabular fractures. Eligible patients were contacted for a structured telephone interview, which included a questionnaire on knee symptoms and the International Knee Documentation Committee (IKDC) score. Associations between demographic factors, trauma mechanism, and knee outcomes were statistically analyzed.</p><p><strong>Results: </strong>Fifty-nine patients (mean age 55 years, 72.9% male) were enrolled. Undiagnosed knee ligament injuries were present in 11.9%, with an additional 8.5% reporting persistent knee symptoms. The average time to diagnosis was 6.4 months post-discharge. Patients involved in road traffic accidents showed a significantly higher incidence of knee injuries (34.8%) compared to those who fell from a height (3.9%) (<i>p</i> = 0.049). Patients who had undergone ligament reconstruction had significantly lower IKDC scores (62.0 ± 8.2) than non-surgical cases (82.4 ± 12.1, <i>p</i> = 0.0002). No association was found with age or sex.</p><p><strong>Conclusions: </strong>Ligamentous knee injuries are frequently overlooked in the acute management of high-energy pelvic fractures, particularly in road traffic accidents. A systematic knee assessment before discharge or early outpatient imaging should be considered to improve detection and outcomes.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981384","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}