Bone & Joint ResearchPub Date : 2025-02-20DOI: 10.1302/2046-3758.142.BJR-2024-0086.R2
Nike Walter, Thomas Loew, Thilo Hinterberger, Melvin Mohokum, Volker Alt, Markus Rupp
{"title":"Mental health implications of fracture-related infections : a longitudinal quality of life study.","authors":"Nike Walter, Thomas Loew, Thilo Hinterberger, Melvin Mohokum, Volker Alt, Markus Rupp","doi":"10.1302/2046-3758.142.BJR-2024-0086.R2","DOIUrl":"10.1302/2046-3758.142.BJR-2024-0086.R2","url":null,"abstract":"<p><strong>Aims: </strong>Fracture-related infections (FRIs) are a major concern for patients and healthcare systems, yet their impact on mental health has been largely overlooked. This study aimed to assess the longitudinal impact of FRI on patients' quality of life.</p><p><strong>Methods: </strong>A prospective study was conducted at a level 1 trauma centre between January 2020 and December 2022. In total, 56 patients participated, with quality of life assessed at five timepoints: one week preoperatively, and one, three, six, and 12 months postoperatively. Statistical analysis was performed using repeated measures analysis of variance (ANOVA) with adjusted post-hoc analysis.</p><p><strong>Results: </strong>The preoperative Physical Component Summary score on the 36-Item Short-Form Health Survey questionnaire (SF-36) was 26.71, increasing to 30.40 at one month, remaining stable at three months. A modest increase was observed at six months (32.45, p = 0.003), but it decreased to 29.72 at 12 months. The preoperative Mental Component Summary score (SF-36) was 46.48, decreasing to 39.89 at one month (p = 0.027) and to 36.03 at three months (p ≤ 0.001). However, it improved at six (42.74) and 12 months (44.05). Positive changes were seen in EuroQol five-dimension questionnaire (EQ-5D) subdimensions, such as mobility, self-care, usual activities, and pain/discomfort, while anxiety/depression scores decreased over time. The EQ-5D visual analogue scale (VAS) score increased to 62.79 at six months (p ≤ 0.001) and decreased to 58.2 at 12 months (p = 0.011).</p><p><strong>Conclusion: </strong>FRIs substantially affect mental health and quality of life, particularly during the initial three months of treatment. This study emphasizes the importance of addressing psychological aspects early in FRI management, advocating for holistic care encompassing both physical and psychological aspects of treatment.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 2","pages":"136-142"},"PeriodicalIF":4.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456918","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":"eIF5A downregulated by mechanical overloading delays chondrocyte senescence and osteoarthritis by regulating the CREBBP-mediated Notch pathway.","authors":"Jialuo Huang, Jianrong Zheng, Jianbin Yin, Rengui Lin, Junfeng Wu, Hao-Ran Xu, Jinjian Zhu, Haiyan Zhang, Guiqing Wang, Daozhang Cai","doi":"10.1302/2046-3758.142.BJR-2024-0288.R1","DOIUrl":"10.1302/2046-3758.142.BJR-2024-0288.R1","url":null,"abstract":"<p><strong>Aims: </strong>To examine how eukaryotic translation initiation factor 5A (eIF5A) regulates osteoarthritis (OA) during mechanical overload and the specific mechanism.</p><p><strong>Methods: </strong>Histological experiments used human bone samples and C57BL/6J mice knee samples. All cell experiments were performed using mice primary chondrocytes. Messenger RNA (mRNA) sequencing was performed on chondrocytes treated with 20% cyclic tensile strain for 24 hours. Western blot (WB) and quantitative polymerase chain reaction were employed to detect relevant indicators of cartilage function in chondrocytes. We created the destabilization of the medial meniscus (DMM) model and the mechanical overload-induced OA model and injected with overexpressing eIF5A adenovirus (eIF5A-ADV). Cartilage degeneration was evaluated using Safranin O/Fast Green staining. Relative protein levels were ascertained by immunohistochemistry (IHC) and immunofluorescence (IF) staining.</p><p><strong>Results: </strong>After OA initiation, eIF5A caused an upregulation of type II collagen (COL2) and a downregulation of matrix metalloproteinase 13 (MMP13), P16, and P21, which postponed the aggravation of OA. Further sequencing and experimental findings revealed that eIF5A knockdown accelerated the progression of OA by boosting the expression of histone acetyltransferase cyclic-adenosine monophosphate response element binding protein (CREB)-binding protein (CREBBP) to mediate activation of the Notch pathway.</p><p><strong>Conclusion: </strong>Our findings identified a crucial functional mechanism for the onset of OA, and suggest that intra-articular eIF5A injections might be a useful therapeutic strategy for OA treatment.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 2","pages":"124-135"},"PeriodicalIF":4.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456898","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}
Bone & Joint ResearchPub Date : 2025-02-18DOI: 10.1302/2046-3758.142.BJR-2023-0409.R2
Jinpeng Wang, Lianfeng Shan, Jing Hang, Hongyang Li, Yan Meng, Wenhai Cao, Chunjian Gu, Jinna Dai, Lin Tao
{"title":"Development and validation of a novel prediction model for osteoporosis : from serotonin to fat-soluble vitamins.","authors":"Jinpeng Wang, Lianfeng Shan, Jing Hang, Hongyang Li, Yan Meng, Wenhai Cao, Chunjian Gu, Jinna Dai, Lin Tao","doi":"10.1302/2046-3758.142.BJR-2023-0409.R2","DOIUrl":"10.1302/2046-3758.142.BJR-2023-0409.R2","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to develop and validate a novel prediction model for osteoporosis based on serotonin, fat-soluble vitamins, and bone turnover markers to improve prediction accuracy of osteoporosis.</p><p><strong>Methods: </strong>Postmenopausal women aged 55 to 65 years were recruited and divided into three groups based on DXA (normal, osteopenia, and osteoporosis). A total of 109 participants were included in this study and split into healthy (39/109, 35.8%), osteopenia (35/109, 32.1%), and osteoporosis groups (35/109, 32.1%). Serum concentrations of serotonin, fat-soluble vitamins, and bone turnover markers of participants were measured. Stepwise discriminant analysis was performed to identify efficient predictors for osteoporosis. The prediction model was developed based on Bayes and Fisher's discriminant functions, and validated via leave-one-out cross-validation. Normal and empirical volume under the receiver operating characteristic (ROC) surface (VUS) tests were used to evaluate predictive effects of variables in the prediction model.</p><p><strong>Results: </strong>Significant variables including oestrogen (E2), total procollagen type 1 amino-terminal propeptide (TP1NP), parathyroid hormone (PTH), BMI, vitamin K, serotonin, osteocalcin (OSTEOC), vitamin A, and vitamin D3 were used for the development of the prediction model. The training accuracy for normal, osteopenia, and osteoporosis is 74.4% (29/39), 80.0% (28/35), and 85.7% (30/35), respectively, while the total training accuracy is 79.8% (87/109). The internal validation showed excellent performance with 72.5% testing accuracy (72/109). Among these variables, serotonin and vitamin K exert important roles in the prediction of osteoporosis.</p><p><strong>Conclusion: </strong>We successfully developed and validated a novel prediction model for osteoporosis based on serum concentrations of serotonin, fat-soluble vitamins, and bone turnover markers. In addition, interactive communication between serotonin and fat-soluble vitamins was observed to be critical for bone health in this study.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 2","pages":"111-123"},"PeriodicalIF":4.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439535","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":"Melatonin alleviates senile osteoporosis by regulating autophagy and enhancing fracture healing in aged mice.","authors":"Denghui Zhang, Tianer Zhu, Jingyao Bai, Chunchun Chen, Junru Wen, Yi Zhou, Xiaoxu Guan","doi":"10.1302/2046-3758.142.BJR-2024-0112.R2","DOIUrl":"10.1302/2046-3758.142.BJR-2024-0112.R2","url":null,"abstract":"<p><strong>Aims: </strong>In our previous research, we have found that melatonin (MEL) affects the osteoporotic process. By balancing bone remoulding, autophagy is involved in age-related bone loss. However, as a regulator of autophagy, whether MEL influences senile osteoporosis via regulating autophagy remains unclear.</p><p><strong>Methods: </strong>Cellular, radiological, and histopathological evaluations were performed on 36 16-month-old male C57BL6/L mice or aged bone marrow-derived mesenchymal stem cells. A MEL-gelatin methacrylamide system was constructed to aid osteoporotic fracture healing.</p><p><strong>Results: </strong>In this study, we found that bone loss, low level of MEL, and decreased autophagy coexisted in aged C57BL6/L mice. A physiological (low, 10 nM but not 100 nM) concentration of MEL restored bone loss, transformed the cytokine framework, and increased the autophagic level in aged mice, whereas inhibition of autophagy unfavourably reduced the positive effects of MEL on bone mass. The autophagy-conducted increased osteogenic lineage commitment and extracellular matrix mineralization, but not matrix synthesis of aged bone marrow-derived mesenchymal stem cells, was responsible for MEL anabolic effects on bone. <i>PIK3C-AKT-MTOR</i> signal was tested to be a main pathway that is involved in MEL-induced autophagy.</p><p><strong>Conclusion: </strong>Our data suggest that the application of MEL can restore degenerative osteogenesis of aged bone marrow-derived mesenchymal stem cells, and has the potential to regain bone mass in aged mice through activating autophagy via the <i>PIK3C-AKT-MTOR</i> pathway. MEL therefore may serve as a potential clinical therapy to treat senile osteoporosis.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 2","pages":"97-110"},"PeriodicalIF":4.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254909","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}
Bone & Joint ResearchPub Date : 2025-02-06DOI: 10.1302/2046-3758.142.BJR-2024-0313.R1
Warran Wignadasan, Andreas Fontalis, Mohammed Shaeir, Fares S Haddad
{"title":"Beyond the surface: anterior cruciate ligament assessment in knee osteoarthritis.","authors":"Warran Wignadasan, Andreas Fontalis, Mohammed Shaeir, Fares S Haddad","doi":"10.1302/2046-3758.142.BJR-2024-0313.R1","DOIUrl":"10.1302/2046-3758.142.BJR-2024-0313.R1","url":null,"abstract":"","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 2","pages":"93-96"},"PeriodicalIF":4.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254905","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}
Bone & Joint ResearchPub Date : 2025-02-04DOI: 10.1302/2046-3758.142.BJR-2024-0033.R2
Barend J Spanninga, Thomáy-Claire A Hoelen, Scott Johnson, Boyle Cheng, Taco J Blokhuis, Paul C Willems, Jacobus J C Arts
{"title":"Clinical efficacy and safety of P-15 peptide enhanced bone graft substitute in surgical bone regenerative procedures in adult maxillofacial, spine, and trauma patients : a systematic literature review.","authors":"Barend J Spanninga, Thomáy-Claire A Hoelen, Scott Johnson, Boyle Cheng, Taco J Blokhuis, Paul C Willems, Jacobus J C Arts","doi":"10.1302/2046-3758.142.BJR-2024-0033.R2","DOIUrl":"10.1302/2046-3758.142.BJR-2024-0033.R2","url":null,"abstract":"<p><strong>Aims: </strong>Autologous bone graft (ABG) is considered the 'gold standard' among graft materials for bone regeneration. However, complications including limited availability, donor site morbidity, and deterioration of regenerative capacity over time have been reported. P-15 is a synthetic peptide that mimics the cell binding domain of Type-I collagen. This peptide stimulates new bone formation by enhancing osteogenic cell attachment, proliferation, and differentiation. The objective of this study was to conduct a systematic literature review to determine the clinical efficacy and safety of P-15 peptide in bone regeneration throughout the skeletal system.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library were searched for relevant articles on 13 May 2023. The systematic review was reported according to the PRISMA guidelines. Two reviewers independently screened and assessed the identified articles. Quality assessment was conducted using the methodological index for non-randomized studies and the risk of bias assessment tool for randomized controlled trials.</p><p><strong>Results: </strong>After screening, 28 articles were included and grouped by surgical indication, e.g. maxillofacial procedures (n = 18), spine (n = 9), and trauma (n = 1). Published results showed that P-15 peptide was effective in spinal fusion (n = 7) and maxillofacial (n = 11), with very few clinically relevant adverse events related to P-15 peptide.</p><p><strong>Conclusion: </strong>This systematic literature review concluded that moderate- (risk of bias, some concern: 50%) to high-quality (risk of bias, low: 46%) clinical evidence exists showing equivalent safety and efficacy in bone regeneration using a P-15 peptide enhanced bone graft substitute compared to ABG. P-15 peptide is safe and effective, resulting in rapid bone formation with a low probability of minor complications.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 2","pages":"77-92"},"PeriodicalIF":4.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122058","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}
Bone & Joint ResearchPub Date : 2025-02-01DOI: 10.1302/2046-3758.142.BJR-2024-0172.R2
Martin Tripon, Matthieu Lalevee, Floris van Rooij, Chinyelum Agu, Mo Saffarini, Philippe Beaudet
{"title":"Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus.","authors":"Martin Tripon, Matthieu Lalevee, Floris van Rooij, Chinyelum Agu, Mo Saffarini, Philippe Beaudet","doi":"10.1302/2046-3758.142.BJR-2024-0172.R2","DOIUrl":"10.1302/2046-3758.142.BJR-2024-0172.R2","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate how fore- and midfoot coronal plane alignment differs in feet with hallux valgus (HV), using 3DCT when measured in standard weightbearing (SWB) versus sesamoid view (SV) position, and to determine whether first metatarsophalangeal (MTP) dorsiflexion affects the relationship between the first metatarsal (M1) head and the sesamoid bones.</p><p><strong>Methods: </strong>A consecutive series of 34 feet that underwent 3DCT in SWB and SV positions for symptomatic HV was assessed, of which four feet were excluded for distorted or incomplete images. Two foot and ankle clinicians independently digitized a series of points, and measured a series of angles according to a pre-defined protocol. Measurements include navicular pronation angle, M1 head (Saltzman angle), and metatarsosesamoid rotation angle (MSRA).</p><p><strong>Results: </strong>The mean age of the 30 patients was 57.5 years (SD 13.4). The mean navicular pronation angle was significantly smaller in the SV position (9.6° (SD 4.4°)) compared to the SWB position (16.4° (SD 5.8°); p < 0.001). There was a difference in MSRA between the SWB and SV positions, revealing an increase in MSRA in 22 patients, while there was a decrease in eight patients. In patients where the MSRA increased, the mean Saltzman angle was 2.5° (SD 5.7°) lower in the SV position versus the SWB position, while in patients where MSRA decreased, the mean Saltzman angle was 3.4° (SD 3.6°) greater in the SV position versus the SWB position.</p><p><strong>Conclusion: </strong>MTP dorsiflexion causes supination of the navicular, while other first ray parameters remain unchanged, and has a greater influence on the M1 head coronal alignment than on the sesamoids. MTP dorsiflexion induces axial rotations of M1, which vary in direction and magnitude from one patient to another.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 2","pages":"69-76"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073530","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}
Bone & Joint ResearchPub Date : 2025-01-27DOI: 10.1302/2046-3758.141.BJR-2024-0081.R1
Ruth Pelleg-Kallevag, Sarah Borgel, Einat Kedar, Nathan Peled, Hila May
{"title":"Changes in the shape of the lumbar curve during growth : a geometric morphometric approach.","authors":"Ruth Pelleg-Kallevag, Sarah Borgel, Einat Kedar, Nathan Peled, Hila May","doi":"10.1302/2046-3758.141.BJR-2024-0081.R1","DOIUrl":"10.1302/2046-3758.141.BJR-2024-0081.R1","url":null,"abstract":"<p><strong>Aims: </strong>The development of lumbar lordosis has been traditionally examined using angular measurements of the spine to reflect its shape. While studies agree regarding the increase in the angles during growth, the growth rate is understudied, and sexual dimorphism is debated. In this study, we used a novel method to estimate the shape of the lumbar curve (LC) using the landmark-based geometric morphometric method to explore changes in LC during growth, examine the effect of size and sex on LC shape, and examine the associations between angular measurements and shape.</p><p><strong>Methods: </strong>The study population included 258 children aged between 0 and 20 years (divided into five age groups) who underwent a CT scan between the years 2009 and 2019. The landmark-based geometric morphometric method was used to capture the LC shape in a sagittal view. Additionally, the lordosis was measured via Cobb and sacral slope angles. Multivariate and univariate statistical analyses were carried out to examine differences in shape between males and females and between the age groups.</p><p><strong>Results: </strong>The overall shape of the LC overlapped between males and females in most age groups, except for the nine- to 12-year age group. However, size did not affect LC shape. LC shape changed significantly during growth from straight to curved, reaching its mature shape earlier in females. This corresponded with the results obtained by the lordosis and sacral slope angles. A significant positive correlation was found between the LC shape and angles, although the angles demonstrated poor distinction between age groups, as opposed to the LC shape.</p><p><strong>Conclusion: </strong>New insights into LC shape development were achieved using the geometrical morphometric method. The LC shape was sex-independent in most age groups. However, the LC reached its mature shape earlier in females than males. The method and data of this study are beneficial for future studies examining aetiological factors for spinal pathologies and maldevelopment.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 1","pages":"58-68"},"PeriodicalIF":4.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045150","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}
Bone & Joint ResearchPub Date : 2025-01-24DOI: 10.1302/2046-3758.141.BJR-2024-0134.R1
M Abdulhadi Alagha, Justin Cobb, Alexander D Liddle, Henrik Malchau, Ola Rolfson, Maziar Mohaddes
{"title":"Prediction of implant failure risk due to periprosthetic femoral fracture after primary elective total hip arthroplasty : a simplified and validated model based on 154,519 total hip arthroplasties from the Swedish Arthroplasty Register.","authors":"M Abdulhadi Alagha, Justin Cobb, Alexander D Liddle, Henrik Malchau, Ola Rolfson, Maziar Mohaddes","doi":"10.1302/2046-3758.141.BJR-2024-0134.R1","DOIUrl":"10.1302/2046-3758.141.BJR-2024-0134.R1","url":null,"abstract":"<p><strong>Aims: </strong>While cementless fixation offers potential advantages over cemented fixation, such as a shorter operating time, concerns linger over its higher cost and increased risk of periprosthetic fractures. If the risk of fracture can be forecasted, it would aid the shared decision-making process related to cementless stems. Our study aimed to develop and validate predictive models of periprosthetic femoral fracture (PPFF) necessitating revision and reoperation after elective total hip arthroplasty (THA).</p><p><strong>Methods: </strong>We included 154,519 primary elective THAs from the Swedish Arthroplasty Register (SAR), encompassing 21 patient-, surgical-, and implant-specific features, for model derivation and validation in predicting 30-day, 60-day, 90-day, and one-year revision and reoperation due to PPFF. Model performance was tested using the area under the curve (AUC), and feature importance was identified in the best-performing algorithm.</p><p><strong>Results: </strong>The Lasso regression excelled in predicting 30-day revisions (area under the receiver operating characteristic curve (AUC) = 0.85), while the Gradient Boosting Machine (GBM) model outperformed other models by a slight margin for all remaining endpoints (AUC range: 0.79 to 0.86). Predictive factors for revision and reoperation were identified, with patient features such as increasing age, higher American Society of Anesthesiologists grade (> III), and World Health Organization obesity classes II to III associated with elevated risks. A preoperative diagnosis of idiopathic necrosis increased revision risk. Concerning implant design, factors such as cementless femoral fixation, reverse-hybrid fixation, hip resurfacing, and small (< 35 mm) or large (> 52 mm) femoral heads increased both revision and reoperation risks.</p><p><strong>Conclusion: </strong>This is the first study to develop machine-learning models to forecast the risk of PPFF necessitating secondary surgery. Future studies are required to externally validate our algorithm and assess its applicability in clinical practice.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 1","pages":"46-57"},"PeriodicalIF":4.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027821","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}