Bone & Joint Research最新文献

{"title":"Metal artifact reduction sequence MRI in hip periprosthetic joint infection management : a noninvasive reference for infection control before two-stage reimplantation.","authors":"Zhenyuan Lin, Lan Lin, Mingzhong Liu, Chaofan Zhang, Wenming Zhang, Yang Chen, Chaoyang Wu, Zida Huang, Zhenpeng Guan, Xinyu Fang","doi":"10.1302/2046-3758.159.BJR-2025-0586.R1","DOIUrl":"10.1302/2046-3758.159.BJR-2025-0586.R1","url":null,"abstract":"<p><strong>Aims: </strong>There is currently no validated noninvasive method to determine infection control prior to prosthesis reimplantation during the two-stage revision process for hip periprosthetic joint infections (PJI) after total hip arthroplasty (THA). This prospective study investigates whether metal artifact reduction sequence (MARS) MRI can serve as a diagnostic reference for infection control before second-stage revision surgery by analyzing artifact-reduced MRIs in patients with hip PJI prior to reimplantation.</p><p><strong>Methods: </strong>Patients with hip PJI after THA who entered the two-stage revision process between January 2019 and January 2024 were prospectively and consecutively enrolled. Based on the Musculoskeletal Infection Society (MSIS) criteria, 23 patients achieved infection control after the interval period (prior to reimplantation), and 11 experienced infection recurrence after spacer implantation (prior to repeat debridement). All patients underwent MARS MRI prior to both first-stage surgery and second-stage reimplantation. Data collected included patient demographics (sex, age), ESR, CRP, intraoperative pathology, culture results, and MARS MRIs. Two imaging specialists reviewed the MARS MRIs obtained prior to the first-stage surgery and prior to the second-stage reimplantation, evaluating regression of prior infectious lesions, emergence of new lesions, and overall infection control. Their assessments were then compared with intraoperative pathology and culture-confirmed infection status.</p><p><strong>Results: </strong>MARS MRI revealed significantly more frequent findings of bone oedema, soft-tissue oedema, and joint effusion in patients with recurrent infection compared to those with controlled infection after spacer implantation (p = 0.002). The imaging specialists' evaluations were in complete agreement with the clinical findings confirmed by pathology and cultures.</p><p><strong>Conclusion: </strong>Evaluating the difference in MARS MRIs between the first-stage and second-stage preoperative periods, and focusing on oedema signals in the bone and soft tissues surrounding the prosthesis, provides a useful noninvasive indicator for determining infection control prior to two-stage reimplantation.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 9","pages":"1101-1110"},"PeriodicalIF":5.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser scanning registration for knee arthroplasty.","authors":"Thomas Warren, Ulani Hayter Otaola, Brett Robertson, Riaz Khan, Sam Withers, Hari Goonatillake, Benjamin Hewitt, Tomasz Kozak, Sajan Kuriakose, Tareq Batanony, Jon Greenwald, Morteza Meftah","doi":"10.1302/2046-3758.159.BJR-2025-0617.R2","DOIUrl":"10.1302/2046-3758.159.BJR-2025-0617.R2","url":null,"abstract":"<p><strong>Aims: </strong>Accurate registration of anatomy is fundamental to robotic and computer-assisted surgery; however, conventional methods rely on manual data acquisition performed by the surgeon using a tracked probe that is slow and affected by operator variability. Limitations of manual methods have hindered wider adoption of surgical navigation despite its benefits for alignment accuracy, particularly in orthopaedic applications. This study evaluates a laser surface scanning system, LumaScan, against standard intraoperative probe-based registration with a controlled phantom knee model.</p><p><strong>Methods: </strong>Surgeons performed repeated probe-based data acquisition for registration, while LumaScan executed operator-initiated scans mounted to a robotic arm. The accuracy of each modality was assessed using root mean square (RMS) error relative to a CT-derived reference model, alongside evaluations of repeatability and acquisition time.</p><p><strong>Results: </strong>LumaScan achieved a RMS error of 0.07 mm (SD 0.02), compared to probe-based methods, which resulted in a RMS error of 0.34 mm (SD 0.36). Acquisition time was reduced from 112 seconds (SD 75.8) manually to 6.38 seconds (SD 0.03) for LumaScan (p < 0.001), with probe-based timing increasing three times from the fastest to the slowest participant despite a fixed protocol. The errors of the femur and tibia achieved by LumaScan had a > 70% reduction compared to manual surface acquisition, with these results being statistically significant (p < 0.001). The results demonstrate that robotic laser scanning can significantly improve speed, accuracy, and precision over manual methods. Minimizing operator influence and standardizing registration has the potential to reduce error sources that persist in clinical workflows, subsequently accelerating the integration of navigation and robotics into routine orthopaedic procedures.</p><p><strong>Conclusion: </strong>LumaScan enables faster, more accurate, and more precise anatomical registration than manual methods.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 9","pages":"1092-1100"},"PeriodicalIF":5.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite element analysis in foot and ankle arthrodesis.","authors":"Jitendra Mangwani, Hengshuo Zhang, Simin Li","doi":"10.1302/2046-3758.159.BJR-2026-0041.R1","DOIUrl":"10.1302/2046-3758.159.BJR-2026-0041.R1","url":null,"abstract":"","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 9","pages":"1088-1091"},"PeriodicalIF":5.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical comparison of mini-plate and screw fixation in minimally invasive distal metatarsal osteotomy for hallux valgus : a finite element and cadaveric study.","authors":"Ya-Han Chan, Yan-Yu Chen, Keen-Wai Chong, Chia-Hung Chu, Hsuan-Wen Wang, Shao-Fu Huang, Chun-Li Lin","doi":"10.1302/2046-3758.159.BJR-2026-0011.R1","DOIUrl":"10.1302/2046-3758.159.BJR-2026-0011.R1","url":null,"abstract":"<p><strong>Aims: </strong>To biomechanically compare the stability of mini-plate and dual-screw fixation following minimally invasive distal metatarsal osteotomy for hallux valgus, with an emphasis on early-stage stability under clinically relevant loading conditions.</p><p><strong>Methods: </strong>Three fixation configurations were evaluated: mini-plate fixation with two (PS2) or three (PS3) locking screws and dual-screw fixation (DS). Finite element analysis (FEA) was performed to quantify displacement and stress distribution under controlled bending and torsional loading, providing insight into internal load transfer mechanisms not accessible experimentally. Fresh-frozen human cadaveric specimens then underwent distal chevron metatarsal osteotomy and fixation according to each configuration (n = 3 per group). Cyclic and static bending tests were performed to simulate early postoperative weightbearing, and displacement responses were recorded. FE predictions were compared with experimental displacement trends.</p><p><strong>Results: </strong>Under bending loads, both FEA and cadaveric testing consistently demonstrated that PS3 exhibited the smallest displacement, followed by PS2, with DS showing the greatest instability. FE analysis further revealed that mini-plate fixation reduced bone stress at the osteotomy site but increased implant stress, whereas DS showed higher bone stress concentration. Under torsional loading, FE results indicated lower displacement but higher bone stress in DS. Cadaveric cyclic tests confirmed the superior stability of PS3, showing the least displacement accumulation over 1,000 cycles (p < 0.05). In static testing, PS3 achieved the highest failure load (~423 N), followed by PS2 (~248 N), while DS showed the lowest (~205 N).</p><p><strong>Conclusion: </strong>Mini-plate fixation, particularly PS3, provides superior resistance to bending-induced micromotion compared with DS, with consistent agreement between FE predictions and experimental findings. FEA further elucidated internal stress distribution, highlighting increased bone stress concentrations in DS. Overall, mini-plate fixation offers a more stable and clinically reliable construct for maintaining correction during early postoperative weightbearing.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 9","pages":"1074-1087"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of the cytokine profile of platelet-rich plasma when combined in vitro with low versus high molecular weight hyaluronic acid.","authors":"David J Ellenbogen, Simarjeet Puri, Rishi Chatterji, Joseph Seta, Adam Miller, Ian Al'khafaji, Therese Bou-Akl, Paula Pawlitz, David C Markel","doi":"10.1302/2046-3758.158.BJR-2025-0500.R2","DOIUrl":"10.1302/2046-3758.158.BJR-2025-0500.R2","url":null,"abstract":"<p><strong>Aims: </strong>Platelet-rich plasma (PRP) and hyaluronic acid (HA) are nonoperative treatments for osteoarthritis (OA) of large joints. Clinically, some endorse the use of both methods together for a theoretical synergistic effect therapeutically, with limited evidence. This study aimed to evaluate whether the molecular weight of HA influences the cytokines released from PRP in vitro.</p><p><strong>Methods: </strong>Leucocyte-rich PRP was prepared from venous blood of ten healthy males (aged 18 to 35 years). Three groups were tested: PRP + phosphate-buffered saline (PBS, control), PRP + low molecular weight HA (LMWHA, and PRP + high molecular weight HA (HMWHA). Samples were incubated at 37°C, and the concentrations of insulin-like growth factor binding protein 1 (IGFBP1), interleukin-1β (IL-1β), interleukin-1 receptor antagonist (IL-1RA), IL-6, IL-10, platelet-derived growth factor subunit B (PDGF-BB), transforming growth factor-β (TGF-β1), and tumour necrosis factor-alpha (TNF-α) were measured at two hours (Day 0) and 72 hours (Day 3). Data were analyzed using repeated measures analysis of variance (p < 0.05). A Bonferroni test was performed as a post hoc analysis.</p><p><strong>Results: </strong>PDGF-BB decreased significantly (p < 0.001) from Day 0 to 3 across all groups. This was more pronounced in the presence of HA, regardless of molecular weight. IL-1β rose significantly in HA-treated groups only (p = 0.009). No significant intergroup differences emerged for IGFBP1, IL-6, TGF-β1, or TNF-α at either timepoint. There was a significant increase in both IL-1RA (p = 0.016), and IL-10 (p < 0.001) concentration from Day 0 to 3. There were no significant differences in IL-1RA or IL-10 between the control, LMWHA, and HMWHA groups at Day 0 or 3.</p><p><strong>Conclusion: </strong>The molecular weight of HA did not improve the cytokine profile of PRP in vitro, suggesting that both LMWHA and HMWHA formulations may be comparable when used in combination with PRP, at least in males.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 8","pages":"1067-1073"},"PeriodicalIF":5.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148807947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial-laden PerOssal beads display in vitro inhibition and killing of extensively drug-resistant Gram-negative bacteria associated with conflict wounds in Ukraine.","authors":"Henry Adam Claireaux, Edward J A Douglas, Scott J C Pallett, Luke S P Moore, Matthew K O'Shea, Olena V Moshynets, Julian R Jones, Arul Ramasamy, Andrew M Edwards","doi":"10.1302/2046-3758.158.BJR-2026-0211.R1","DOIUrl":"https://doi.org/10.1302/2046-3758.158.BJR-2026-0211.R1","url":null,"abstract":"<p><strong>Aims: </strong>Open fractures sustained in contemporary conflict are associated with high-energy transfer, contamination with resistant bacteria, and delays to surgical care, resulting in high rates of infection. Similar conditions occur in civilian disasters, where crush injuries and overwhelmed healthcare systems prolong the interval to surgical wound excision. Prophylactic systemic antimicrobial regimens may be ineffective due to antimicrobial resistance or limited bioavailability in bone and joint tissues. Local antimicrobial delivery can provide higher drug concentrations within the wound, which may be sufficient to overcome resistance. This route is established in bone and joint infection, although evidence in conflict trauma is lacking. We evaluated the in vitro activity of antimicrobial-laden PerOssal hydroxyapatite and calcium sulphate beads.</p><p><strong>Methods: </strong>Bacterial isolates from Ukraine isolated from contaminated traumatic wounds were tested, including extensively drug-resistant (XDR) <i>Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa</i>, and <i>Escherichia coli</i>. The antimicrobial effects of antimicrobial-laden PerOssal beads were assessed by zone-of-inhibition testing and time-kill analysis.</p><p><strong>Results: </strong>All Gram-negative isolates from Ukraine were resistant to gentamicin, tobramycin, co-amoxiclav, cefazolin, and ciprofloxacin, with minimum inhibitory concentrations (MICs) exceeding European Committee on Animicrobial Susceptibility Testing (EUCAST) breakpoints. PerOssal beads laden with gentamicin, tobramycin, or cefazolin were weakly growth inhibitory. However, gentamicin-rifampicin in combination achieved consistent broad-spectrum bacterial inhibition and killing, while co-amoxiclav-loaded beads inhibited the growth of all bacterial strains.</p><p><strong>Conclusion: </strong>Antimicrobial-laden PerOssal hydroxyapatite and calcium sulphate beads displayed in vitro inhibition and killing of XDR Gram-negative bacteria associated with contaminated traumatic wounds. Early local antimicrobial delivery may reduce infection risk following heavily contaminated open fractures, particularly when surgical wound excision is delayed. This may be relevant to both modern conflict and civilian disaster settings. Further work is required to determine the effectiveness of this approach in vivo.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 8","pages":"1055-1066"},"PeriodicalIF":5.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting AHNAK ameliorates osteonecrosis of the femoral head and affects adipogenic pathways involving Smad/PPARγ.","authors":"Mei-Feng Chen, Chih-Chien Hu, Yi-Min Hsiao, Pei-Heng Jiang, Yung-Heng Hsu, Chia-Yun Wu, Steve W N Ueng, Yuhan Chang","doi":"10.1302/2046-3758.158.BJR-2025-0304.R2","DOIUrl":"https://doi.org/10.1302/2046-3758.158.BJR-2025-0304.R2","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the role of AHNAK in patients with osteonecrosis of the femoral head (ONFH) and its association with bone adipogenesis. Non-traumatic ONFH, primarily driven by steroid use and alcohol consumption, results in an imbalance between osteogenesis and adipogenesis. Understanding the function of AHNAK under ischaemic stress may help identify novel therapeutic targets for ONFH.</p><p><strong>Methods: </strong>Bone tissues from 19 ONFH patients and 15 control patients were analyzed using proteomics, enzyme-linked immunosorbent assay (ELISA), and immunofluorescence (IF). A steroid-induced ONFH mouse model and an ischaemia-mimicking in vitro model using MC3T3-E1 preosteoblasts were employed to examine AHNAK expression and function. AHNAK knockdown was performed using short hairpin RNA (shRNA) to assess its regulatory effects on adipogenic markers and Smad/PPARγ/C/EBPα signalling.</p><p><strong>Results: </strong>AHNAK expression was significantly upregulated in bone tissues of ONFH patients and in femoral heads of steroid-induced ONFH mice. This was accompanied by reduced osteocyte numbers and increased adipogenesis, as indicated by elevated perilipin 1 (PLIN1) expression. In vitro, ischaemic stress induced AHNAK and PLIN1 expression, whereas AHNAK knockdown reversed these effects and suppressed Smad1/5 phosphorylation and PPARγ activation. C/EBPα expression remained unchanged, suggesting a selective role of AHNAK in modulating the Smad/PPARγ axis during adipogenesis.</p><p><strong>Conclusion: </strong>AHNAK is a critical mediator of ischaemia-induced adipogenesis in ONFH through activation of the Smad/PPARγ signalling pathway, promoting the differentiation of preosteoblasts into adipocytes. Targeting AHNAK may offer a novel therapeutic strategy to reduce bone loss and marrow fat accumulation in ONFH, particularly in cases associated with steroids or metabolic dysfunction. Further studies are warranted to validate AHNAK as a clinical target.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 8","pages":"1042-1054"},"PeriodicalIF":5.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vivo quantification of polyethylene wear in total ankle arthroplasty : a longitudinal study using weightbearing CT.","authors":"Francois Lintz, Alessio Bernasconi, Wolfram Grün, Enrico Pozzessere, Emily Luo, Pierre-Henri Vermorel, Albert Anastasio, Mark Easley, Kristian Buedts, Cesar de Cesar Netto","doi":"10.1302/2046-3758.158.BJR-2026-0005.R2","DOIUrl":"https://doi.org/10.1302/2046-3758.158.BJR-2026-0005.R2","url":null,"abstract":"<p><strong>Aims: </strong>In vivo assessment of polyethylene (PE) wear in total ankle arthroplasty (TAA) relies on approximation using 2D metal interspace height (2D-MIH) loss on weightbearing radiographs. Weightbearing CT (WBCT), combined with distance mapping, may improve quantification of PE wear over time using 3D metal interspace volume (3D-MIV) loss. This study aimed to assess 3D-MIV with successive WBCT scans. We hypothesized that WBCT based 3D-MIV would enable longitudinal quantification of PE wear and identify predictors.</p><p><strong>Methods: </strong>This retrospective study included 29 ankles from 28 TAA patients (16 men, mean age 57.9 years (SD 10.5), BMI 26.3 kg/m² (SD 4.1)) who had WBCT scans at minimum two-year intervals. Patients aged below 18 years, and those with trauma or surgical procedures affecting ankle alignment between scans, were excluded. Demographic data, implant types, and clinical outcomes were extracted. 3D-MIV was measured after segmentation of individual bones and prosthetic components. Annualized approximated wear rates were calculated. Correlations and multivariate regression analyses were used to identify predictors.</p><p><strong>Results: </strong>Mean follow-up between scans was 58.7 months (SD 17.9). Mean 3D-MIV decreased from 3.92 mL (SD 1.17) initially to 3.86 mL (SD 1.11) (p = 0.015). Yearly 3D-MIV loss was -11.34 mm³/year (SD 19.62). Correlations existed between 3D-MIV loss and coronal plane rotation (ρ = -0.58, p < 0.001), mediolateral translation (ρ = -0.52, p = 0.004, superoinferior translation (ρ = 0.56, p = 0.002) and BMI ≥ 27 kg/m² (p = 0.037). Multivariate regression identified coronal plane alignment (<i>β</i> = -3.66, 95% CI -7.31 to -0.01), p = 0.049) and mediolateral translation (<i>β</i> = -9.97, 95% CI -18.48 to -1.45), p = 0.024) as predictors of 3D-MIV loss.</p><p><strong>Conclusion: </strong>Using a WBCT-based approach, this study enabled longitudinal in vivo quantification of PE wear in TAA. Wear rates (~11.3 mm³/year) aligned with prior estimates, and the method correctly identified anticipated predictors of increased wear.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 8","pages":"1033-1041"},"PeriodicalIF":5.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piezo1 drives fibroblast activation in epidural fibrotic remodelling via the ET-1/HIF-1α pathway.","authors":"Yue Huang, Zeyuan Song, Xiaojie Mei, Youpeng Zhao, Tao Zhu, Mohan Shi, Jinpeng Sun, Mingshun Zhang, Tao Wu, Jun Liu","doi":"10.1302/2046-3758.158.BJR-2025-0662.R1","DOIUrl":"10.1302/2046-3758.158.BJR-2025-0662.R1","url":null,"abstract":"<p><strong>Aims: </strong>Epidural fibrosis is a major cause of failed back surgery syndrome following laminectomy. While previous studies have focused primarily on the early phases of scar formation, fibrotic remodelling remains poorly understood. This study aimed to investigate the interaction between collagen accumulation and fibroblasts during the remodelling phase of epidural fibrosis.</p><p><strong>Methods: </strong>In this study, a 3D collagen encapsulation model was used to simulate mechanical stress. Fibrotic and mechanosensitive pathway-related molecules were analyzed to assess fibroblast activation, and specific pharmacological inhibitors were applied to verify the proposed mechanism. Additionally, a mouse laminectomy model was used to evaluate the therapeutic effect of Piezo1 blockade on epidural fibrosis.</p><p><strong>Results: </strong>We found that collagen fibres encapsulate fibroblasts during the stage of scar remodelling. In vitro, collagen may activate the transforming growth factor beta-1 (TGF-β1)/Smad3 pathway in fibroblasts, which is mediated by the Piezo1 and hypoxia-inducible factor 1-alpha (HIF-1α) signalling pathways. This process establishes a positive feedback loop between collagen accumulation and fibroblast activation. Furthermore, we demonstrated that Piezo1-mediated activation of HIF-1α occurs through calcium ion influx and stabilization of endothelin-1 (ET-1). More importantly, blocking the activation of Piezo1 attenuated fibrosis progression in a mouse model of laminectomy.</p><p><strong>Conclusion: </strong>These results highlight the critical role of the Piezo1/ET-1/HIF-1α pathway in epidural fibrotic remodelling. Targeting Piezo1 may offer a promising therapeutic strategy for alleviating epidural fibrosis and improving outcomes after spinal surgery.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 8","pages":"1017-1032"},"PeriodicalIF":5.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel diagnostic technology rapidly detects the presence of infection and defines antimicrobial sensitivities in organisms typical for joint infection.","authors":"Isabelle L Cochrane, Roselline Gabriella Gunarto, Frank Alexander Schildberg, Dieter Christian Wirtz, Robert J H Hammond, Phillip J Walmsley","doi":"10.1302/2046-3758.158.BJR-2025-0581.R1","DOIUrl":"https://doi.org/10.1302/2046-3758.158.BJR-2025-0581.R1","url":null,"abstract":"<p><strong>Aims: </strong>Infective arthritis is rare, but serious. Timely treatment with appropriate antimicrobial therapy is potentially life- and limb-saving, but our ability to deliver this is limited by current laboratory practices, which confer a delay of several days before antimicrobial sensitivities are available. We propose a novel diagnostic modality, the Scattered Light Integrating Collector (SLIC), which monitors bacterial growth in real time, allowing a diagnosis of infection to be made in minutes, and antimicrobial sensitivities to be delivered in under an hour.</p><p><strong>Methods: </strong>We collated data previously collected on SLIC relating to laboratory strains of <i>Staphylococcus aureus 25923</i> and <i>methicillin-resistant S. aureus</i> (MRSA) <i>29213</i>. Liquid cultures of the two organisms, with varying dilutions of target antibiotics, were compared in SLIC against positive (no antibiotic) and negative (no bacteria) controls. Three key measurements were derived: time to positivity (TTP - the timepoint at which significant bacterial growth was confirmed), time to sensitivities (TTS - the timepoint of statistically significant growth inhibition conferred by antibiotics vs the positive control), and IC50 (50% growth suppression relative to control).</p><p><strong>Results: </strong>TTP for <i>S. aureus</i> and MRSA was two minutes and 2.2 minutes, respectively. <i>S. aureus</i> was sensitive to gentamicin, with a minimum TTS of one minute, and IC50 achieved in under 19 minutes for all doses. Similarly, <i>S. aureus</i> susceptibility to vancomycin was established, with a minimum TTS of three minutes, and IC50 achieved in under 55 minutes for all but the lowest dose. MRSA was sensitive to rifampicin, with IC50 achieved in 16.5 minutes. Despite all tested antibiotics achieving TTS in under 30 minutes, only rifampicin achieved the criterion IC50 to declare susceptibility.</p><p><strong>Conclusion: </strong>SLIC rapidly determines the presence of infection and characterizes antimicrobial susceptibilities in organisms typical for joint infection.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"15 8","pages":"1005-1016"},"PeriodicalIF":5.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}