{"title":"Automatic assessment of lower limb deformities using high-resolution X-ray images.","authors":"Reyhaneh Rostamian, Masoud Shariat Panahi, Morad Karimpour, Alireza Almasi Nokiani, Ramin Jafarzadeh Khaledi, Hadi Ghattan Kashani","doi":"10.1186/s12891-025-08784-9","DOIUrl":"https://doi.org/10.1186/s12891-025-08784-9","url":null,"abstract":"<p><strong>Background: </strong>Planning an osteotomy or arthroplasty surgery on a lower limb requires prior classification/identification of its deformities. The detection of skeletal landmarks and the calculation of angles required to identify the deformities are traditionally done manually, with measurement accuracy relying considerably on the experience of the individual doing the measurements. We propose a novel, image pyramid-based approach to skeletal landmark detection.</p><p><strong>Methods: </strong>The proposed approach uses a Convolutional Neural Network (CNN) that receives the raw X-ray image as input and produces the coordinates of the landmarks. The landmark estimations are modified iteratively via the error feedback method to come closer to the target. Our clinically produced full-leg X-Rays dataset is made publically available and used to train and test the network. Angular quantities are calculated based on detected landmarks. Angles are then classified as lower than normal, normal or higher than normal according to predefined ranges for a normal condition.</p><p><strong>Results: </strong>The performance of our approach is evaluated at several levels: landmark coordinates accuracy, angles' measurement accuracy, and classification accuracy. The average absolute error (difference between automatically and manually determined coordinates) for landmarks was 0.79 ± 0.57 mm on test data, and the average absolute error (difference between automatically and manually calculated angles) for angles was 0.45 ± 0.42°.</p><p><strong>Conclusions: </strong>Results from multiple case studies involving high-resolution images show that the proposed approach outperforms previous deep learning-based approaches in terms of accuracy and computational cost. It also enables the automatic detection of the lower limb misalignments in full-leg x-ray images.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"521"},"PeriodicalIF":2.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Potential effect of Irisin on sarcopenia: a systematic review.","authors":"Yixiao Chen, Min Qian, Feng Gao, Guoqing Li, Kangzu Peng, Qingnan Sun, Yifei Sun, Gang Liu, Yufeng Ge, Minghui Yang, Xinbao Wu","doi":"10.1186/s12891-025-08767-w","DOIUrl":"https://doi.org/10.1186/s12891-025-08767-w","url":null,"abstract":"<p><strong>Objective: </strong>Sarcopenia, a progressive musculoskeletal disorder associated with aging, is characterized by the deterioration of muscle mass, strength, and physical performance. This condition significantly increases the risk of debilitating consequences including functional impairment, diminished life quality, and increased mortality. With the progress of aging, it will affect a large number of people in the world and bring many problems. Despite its clinical significance, there are no medicine used to treatment sarcopenia by FDA approval in clinical. This systematic review synthesizes current evidence on the diagnostic and therapeutic potential of irisin-a myokine induced by exercise-in sarcopenia, aiming to address two key questions: (1) Can irisin serve as a reliable biomarker for sarcopenia diagnosis? (2) Does irisin hold promise as a therapeutic agent for sarcopenia management?</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases (Web of Science, PubMed, Cochrane Library, and Embase) to examine the relationship between irisin and sarcopenia. Eligible studies meeting our inclusion criteria underwent rigorous quality assessment.</p><p><strong>Result: </strong>364 studies were identified, of which only 21 met the inclusion criteria-12 involving human studies and 9 involving animal and cell experiments. In human studies, irisin may serve as a potential diagnostic marker for sarcopenia in the elderly and postmenopausal women. In addition, as a myokine of exercise induced, increased circulating levels of irisin may enhanced skeletal muscle mass. Moreover, animal and cellular experiments suggest that increased levels of irisin help improve muscle mass.</p><p><strong>Conclusion: </strong>In conclusion, this review indicates that irisin has potential therapeutic effects for sarcopenia and may become a promising treatment for sarcopenia in the future. However, there is currently a lack of high-quality studies on the use of irisin in treating sarcopenia, and the relevant mechanisms of action are not yet clear. Therefore, more studies are needed to clarify the relationship between irisin and sarcopenia in the future.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"520"},"PeriodicalIF":2.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The efficiency of tactile discrimination training and oculomotor exercises in people with chronic neck pain: a randomized controlled trial.","authors":"Kübra Canlı, Gökhan Demirkıran, Filiz Can","doi":"10.1186/s12891-025-08755-0","DOIUrl":"https://doi.org/10.1186/s12891-025-08755-0","url":null,"abstract":"<p><strong>Background: </strong>Tactile discrimination training (TDT) and oculomotor exercises (OEs) have been widely used somatosensory-based interventions for a wide range of chronic pain conditions. There is, however, little evidence for the effectiveness of these approaches in people with chronic neck pain. This study aimed to determine the superiority of one intervention over another on pain outcomes in people with chronic neck pain.</p><p><strong>Methods: </strong>Fifty seven participants were randomly divided into three groups: TDT, OEs, and a control group who received no intervention. TDT, OEs groups received either TDT or OEs, respectively, three times per week for four weeks. The control group received no intervention. Pain intensity, neck pain-related disability, pressure pain thresholds (PPTs), mechanical pain of temporal summation (mTSP), and conditioned pain modulation were assessed as pain outcomes. Depending on the normality, a repeated measures ANOVA or F1-LD-F1 design was used to analyse the data.</p><p><strong>Results: </strong>A significant group*time interaction and main effects for time were found for pain intensity (p: 0.001, p: 0.001, respectively) and pain-related disability (p < 0.019, p < 0.009; respectively). There was a significant main effect for time for mTSP at the painful side of the neck (p: 0.022). TDT and OEs resulted in a significantly higher improvement in pain intensity (p: 0.005, p < 0.001; respectively) and neck pain-related disability (p: 0.005, p: 0.007; respectively). There was a higher improvement in pain intensity in OEs group compared to TDT group (p: 0.010). A significantly higher improvement in PPT at the painful site after OEs was found (p: 0.038). The control group demonstrated a significantly higher improvement in mTSP in the painful area of the neck (p: 0.048). There were no other significant within- or between-group changes.</p><p><strong>Conclusion: </strong>OEs and TDT are effective somatosensory-based interventions for improving pain intensity and pain-related disability.</p><p><strong>Impact: </strong>This study demonstrated that sensory retraining interventions improves the subjective pain perception.</p><p><strong>Trial registration: </strong>Trial Registration Number: NCT05605132, Date of trial registration: 10/29/2022, Name of trial registry: Neck Pain.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"519"},"PeriodicalIF":2.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical and microbiological profile of spondylodiscitis: a retrospective analysis.","authors":"Ghazaleh Golchoub, Ida Hosseini, Amirali Alamdari, Shabboo Ansari, Farid Javandoust Gharehbagh, Mahboobeh Taheri, Ilad Alavi Darazam","doi":"10.1186/s12891-025-08748-z","DOIUrl":"https://doi.org/10.1186/s12891-025-08748-z","url":null,"abstract":"<p><strong>Background: </strong>Spondylodiscitis is a rare infectious disease with rising incidence in recent years. From 2005 till 2021 the incidence of Spondylodiscitis rose by 104%. Given its potential to cause complications and mortality, it demands greater attention. Epidemiological data and predisposing factors can vary significantly across different geographical regions, suggesting that data from Iran may differ from those in other parts of the world. This study aims to evaluate the demographic, clinical, laboratory, and imaging characteristics of spondylodiscitis patients treated at Loghman Hakim Hospital in Tehran. Additionally, it seeks to analyze the treatment outcomes and complications associated with the disease.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 65 adult patients diagnosed with spondylodiscitis over the past decade (2012-2022). The data collected encompassed demographic characteristics, underlying diseases, clinical presentations, laboratory and radiological findings, microbiological results, treatment approaches, and outcomes.</p><p><strong>Results: </strong>The study included 65 adult patients with a mean age of 55.12 years, showing a slight male predominance (58.5%). Spondylodiscitis was community-acquired in 49.2% of cases and hospital-acquired postoperatively in 50.8%. The lumbosacral spine was the most affected region (47.4%). Staphylococcus aureus was the most frequently isolated microorganism (28.2%), followed by Mycobacterium tuberculosis. Complications included abscess formation in 49.2% of patients and multiorgan failure in 6.2%, resulting in death. Treatment primarily involved antibiotic therapy, with surgical intervention in select cases. Poor outcomes were observed in patients with unidentified microorganisms and those with longer delays in diagnosis.</p><p><strong>Conclusions: </strong>Spondylodiscitis is associated with significant morbidity and a high rate of complications, particularly in cases with delayed diagnosis. Early diagnosis, appropriate antimicrobial therapy, and surgical intervention when necessary are crucial for improving patient outcomes. This study highlights the need for ongoing research to optimize diagnostic pathways and develop long-term management strategies for spondylodiscitis.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"515"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuhu Zhou, Long Yang, Daizhu Yuan, Zhanyu Wu, Shunen Xu, Chuan Ye
{"title":"Optimal parameters and Biomechanical analysis of the lightbulb technique for osteonecrosis of the femoral head: a finite element analysis.","authors":"Yuhu Zhou, Long Yang, Daizhu Yuan, Zhanyu Wu, Shunen Xu, Chuan Ye","doi":"10.1186/s12891-025-08763-0","DOIUrl":"https://doi.org/10.1186/s12891-025-08763-0","url":null,"abstract":"<p><strong>Background: </strong>The lightbulb technique (LBT) is a common surgical procedure for treating peri-collapse osteonecrosis of the femoral head (ONFH). However, the drilling parameters and biomechanics of the technique have not been analyzed. The aim of this study was to optimize the biomechanical stability of the LBT by finite element (FE) analysis to guide intraoperative and postoperative schemes.</p><p><strong>Methods: </strong>FE models were established based on computed tomography images of a healthy adult, including three different degrees of necrotic lesion (60°, 100°, 115°), drilling locations (points C and L) and diameters (1.0 cm, 1.5 cm). The stress of the drilling entrance area, superior and inferior edges of the femoral neck, and bone flap was evaluated under three different loads at 0.5 times body weight (0.5 BW, standing on two feet), 2.75 BW (standing on one foot), and 4 BW (walking with the middle foot on the ground).</p><p><strong>Results: </strong>The stress of the superior and inferior edges of femoral neck, entrance, and bone flap increased as drilling diameter increased. The maximum Von Mises stress of proximal femur does not exceed its yield strength with diameter of 1.0 cm, except for diameter of 1.5 cm. The stress of entrance area and bone flap cortex at point L were higher than those at point C with same diameter. Moreover, the stress of femoral neck and entrance area decreased as the range of lesions increased, except for bone flap cortex. Furthermore, the maximum Von Mises stress of proximal femur did not exceed its yield strength with patients standing on one or both feet and walking process (4BW) with drilling diameter of 1.0 cm at points C or L after surgery, except for diameter of 1.5 cm. Meanwhile, the angles reaching to the coronal plane and transverse plane of weight-bearing area through point L with diameter of 1.0 cm were smaller than those through point C.</p><p><strong>Conclusions: </strong>The optimal parameters of LBT can be selected with a diameter of 1.0 cm at point L. Patients can load partial weight to stimulate the healing of the necrotic area after surgery, but avoid beyond middle foot weight during walking.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"516"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olivier Iryivuze, Anthony Ayotunde Olasinde, Alain Favina, Joshua Muhumuza, Anyanwu Godson Emeka, Ahmed Kiswezi
{"title":"Acute compartment syndrome and its predictors among patients with tibia fracture in Uganda: a multicenter prospective cohort study.","authors":"Olivier Iryivuze, Anthony Ayotunde Olasinde, Alain Favina, Joshua Muhumuza, Anyanwu Godson Emeka, Ahmed Kiswezi","doi":"10.1186/s12891-025-08757-y","DOIUrl":"https://doi.org/10.1186/s12891-025-08757-y","url":null,"abstract":"<p><strong>Introduction: </strong>Acute compartment syndrome (ACS) is a devastating and time-sensitive emergency that increases limb disabilities, amputations, and deaths annually. However, there is a paucity of data on the incidence of ACS in tibia fractures and its predictors in Uganda that can help us save the limb. This study aimed to determine the incidence of ACS in tibia fractures and its predictors in Uganda.</p><p><strong>Methods: </strong>A prospective cohort study was conducted for 6 months at three tertiary hospitals in Uganda where patients with tibia fractures were examined clinically and had their intracompartmental pressure (ICP) measured for ACS using the Whitesides technique, with a 24-hour follow-up after admission and after orthopaedic treatment. All patients were managed as per the ATLS protocol; Data were analyzed using SPSS version 22.</p><p><strong>Results: </strong>The study enrolled 130 study participants with tibia fracture. The majority of participants were males (76.9%). The age group of 18-30 years made up 55.4%. The incidence of ACS was found to be 8.5% (11/130). Among the 11 people with ACS, all had both tibia and fibula fractures, and 8/11 had closed fractures. Smoking (aRR = 2.189, CI = 1.614-7.812, P = 0.049) and swelling of the injured limb (aRR = 3.793, CI = 1.479-9.727, P = 0.008) were the independent predictors of ACS.</p><p><strong>Conclusion: </strong>The incidence of ACS in Uganda was 8.5%. People with a history of cigarette smoking and clinical symptoms of swelling of the limb should be monitored more closely.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"518"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrating bioinformatics and machine learning to identify biomarkers of branched chain amino acid related genes in osteoarthritis.","authors":"Xiao-Zhi ZhaYang, Yan-Xiong Chen, Wen-Da Hua, Zheng-Lin Bai, Yun-Peng Jin, Xing-Wen Zhao, Quan-Fu Liu, Zeng-Dong Meng","doi":"10.1186/s12891-025-08779-6","DOIUrl":"https://doi.org/10.1186/s12891-025-08779-6","url":null,"abstract":"<p><strong>Background: </strong>Branched-chain amino acids (BCAA) metabolism is significantly associated with osteoarthritis (OA), but the specific mechanism of BCAA related genes (BCAA-RGs) in OA is still unclear. Therefore, this research intended to identify potential biomarkers and mechanisms of action of BCAA-RGs in OA tissues.</p><p><strong>Methods: </strong>Differential genes were obtained from the Gene Expression Omnibus (GEO) database and intersections were taken with BCAA-RGs to identify candidate genes. The underlying mechanisms were revealed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Subsequently, by combining three machine learning algorithms to identify genes with highly correlated OA features. In addition, created diagnostic maps and subject Receiver operating characteristic curves (ROCs) to assess the ability of the signature genes to diagnose OA and to predict their possible roles in molecular regulatory network axes and molecular signaling pathways.</p><p><strong>Results: </strong>Eight candidate genes were acquired by intersecting 4,178 DEGs and 14 BCAA-RGs. Subsequently, five candidate biomarkers were obtained, namely SLC3A2, SLC7A5, SLC43A2, SLC43A1, and SLC7A7. Importantly, SLC3A2 and SLC7A5 were validated by validation set and qRT-PCR. Furthermore, the nomogram constructed by SLC3A2 and SLC7A5 exhibited excellent accuracy in predicting the incidence of OA. The enrichment results demonstrated that SLC3A2 and SLC7A5 were significantly enriched in ribosome, insulin signaling pathway, olfactory transduction, etc. Meanwhile, we also found XIST regulated SLC7A5 through hsa-miR-30e-5p, and regulated SLC3A2 through hsa-miR-7-5p.OIP5-AS1 regulated SLC7A5 and SLC3A2 through hsa-miR-7-5p. By the way, 150 drugs were identified, including Acetaminophen and Acrylamide, which exhibited simultaneous targeting of these two biomarkers.</p><p><strong>Conclusion: </strong>Based on bioinformatics, SLC3A2 and SLC7A5 were identified as biomarkers related to BCAA in OA, which may provide a new reference for the treatment and diagnosis of OA patients.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"517"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Blanco-Diaz, Laura Ruiz Palacios, Maria Del Rosario Martinez-Cerón, Borja Perez-Dominguez, Esther Diaz-Mohedo
{"title":"Physiotherapy approaches for coccydynia: evaluating effectiveness and clinical outcomes.","authors":"Maria Blanco-Diaz, Laura Ruiz Palacios, Maria Del Rosario Martinez-Cerón, Borja Perez-Dominguez, Esther Diaz-Mohedo","doi":"10.1186/s12891-025-08744-3","DOIUrl":"https://doi.org/10.1186/s12891-025-08744-3","url":null,"abstract":"<p><strong>Background: </strong>Coccydynia, or tailbone pain, significantly impairs patients' quality of life, affecting daily activities such as sitting and transitioning between positions. It can arise from trauma, childbirth, repetitive strain, or idiopathic causes. Although conservative treatments like physiotherapy are widely employed, their clinical effectiveness remains uncertain due to inconsistent methodologies and varied outcomes reported in the literature.</p><p><strong>Objective: </strong>To evaluate the effectiveness of physiotherapy interventions, in reducing pain and improving functional outcomes in patients with coccydynia.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, PEDro, Scopus, and Web of Science databases, including randomized controlled trials (RCTs) published between 1963 and 2024. The methodological quality was assessed using the PEDro scale and the Cochrane risk-of-bias tool. Inclusion criteria focused on studies evaluating conservative physiotherapy interventions in patients with coccydynia.</p><p><strong>Results: </strong>Nine RCTs comprising 532 participants were included. The Cochrane risk-of-bias assessment indicated a moderate to high risk in several domains, particularly in allocation concealment and blinding. ESWT demonstrated significant reductions in pain and improvements in functional outcomes, with benefits sustained up to six months in some cases. Manual therapy was particularly effective in recent-onset coccydynia, although its efficacy diminished over time. kinesiotaping (KT) improved pain perception but showed limited impact on disability measures. Six studies were rated as moderate to high quality (PEDro scores 6-7), while three were low quality (scores ≤ 4). Despite promising results, heterogeneity in interventions, small sample sizes, and short follow-up periods limited definitive conclusions.</p><p><strong>Conclusion: </strong>Physiotherapy interventions, particularly ESWT, are promising conservative treatment options for coccydynia. However, methodological variability and limited long-term follow-up hinder definitive conclusions. Future research should prioritize standardized protocols, larger sample sizes, and extended follow-up to strengthen the evidence base for clinical recommendations.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"514"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ultra-short stem intercalary prosthetic reconstruction for joint preservation in metaphyseal tumor management: a retrospective review of twenty-five cases.","authors":"Leming Mou, Dayong Liu, Wanping Zhu, Dengxing Lun, Shilong Zhu, Jingyu Zhang, Yancheng Liu, Yongcheng Hu","doi":"10.1186/s12891-025-08780-z","DOIUrl":"https://doi.org/10.1186/s12891-025-08780-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the outcomes, survival, and ASL incidence of ultra-short stem intercalary prosthetic reconstruction for tumors involving the metaphysis of bone.</p><p><strong>Methods: </strong>A retrospective analysis of 25 patients treated at two centers with wide resection for primary or metastatic bone tumors (femur, tibia, humerus) followed by reconstruction using ultra-short stem intercalary prostheses combined extracortical plates. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) and Musculoskeletal Tumor Society (MSTS) score. Survival rates were calculated using the Kaplan-Meier method, and complications were classified according to the Henderson system.</p><p><strong>Results: </strong>The mean follow-up was 20.2 months (range, 3-101 months). The average length of the ultra-short stems was 41.3 ± 9.6 mm. Mean operative time was 164 ± 61.3 min, blood loss averaged 646.4 ± 375.5 ml and the mean defect size was 122 ± 52.1 mm. Postoperative VAS scores were significantly lower than preoperative levels (P < 0.05). The mean MSTS score was 24.2 ± 3.5 (range, 15-29). Kaplan-Meier analysis revealed prosthesis survival rates at 1, 2, 3, and 5 years of 91.7%, compared to patient survival rates of 74.5%, 52.7%, 52.7%, and 52.7%. Postoperative complications occurred in 12% of patients (3/25), including one case of aseptic loosening (ASL), and two patients required reoperation.</p><p><strong>Conclusions: </strong>Ultra-short stem intercalary prostheses with extracortical plates provide a viable, effective option for reconstruction of short bone stumps after tumor resection, offering improved functional outcomes and acceptable prosthesis failure rates.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"513"},"PeriodicalIF":2.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chong Chen, Wenlin Ye, Tao Yu, Xing Cheng, Lutong Wang, Xingchen Zhao, Xiang Long, Jun Ouyang, Yunbing Chang, Xiaoqing Zheng
{"title":"The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study.","authors":"Chong Chen, Wenlin Ye, Tao Yu, Xing Cheng, Lutong Wang, Xingchen Zhao, Xiang Long, Jun Ouyang, Yunbing Chang, Xiaoqing Zheng","doi":"10.1186/s12891-025-08729-2","DOIUrl":"https://doi.org/10.1186/s12891-025-08729-2","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objectives: </strong>This study aims to investigate the relationship between the resection of ossification of the nuchal ligament (ONL), its morphological features, and cervical stability following modified laminoplasty.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of patients diagnosed as degenerative cervical myelopathy (DCM) who underwent modified laminoplasty with muscle-ligament complex (MLC) reconstruction in our hospital between July 2018 and October 2022. Demographic information (e.g., age, gender), cervical sagittal parameters, cervical angular displacement (AD), cervical horizontal displacement (HD), range of motion and patient-reported outcomes were compared between patients with and without ONL.</p><p><strong>Results: </strong>The cervical AD at C4-C5, C5-C6 and cervical HD at C5-6 were significantly higher in ONL (+) group than ONL (-) group before surgery and at the 24-month follow-up time (p < 0.05, all). The AD and HD at C4-C5 and C5-C6 were higher in ONL (+) segments before surgery and at the 24-month follow-up (p < 0.05, all). But the values of AD or HD were lower in ONL (+) segments at 3- or 6-month follow-up (p < 0.05, all). ONL (+) group with two or more consecutive segments demonstrate significantly increased cervical AD and HD at the C4-C5 level after a 24-month follow-up period (p < 0.01, both).</p><p><strong>Conclusion: </strong>Resection of the ONL, particularly involving ≥ 2 cervical segments, is moderately associated with an increased likelihood of cervical instability and abnormal sagittal alignment in long-term follow-up after laminoplasty. Reconstruction of the MLC during laminoplasty may enhance cervical stability in the early follow-up period. For DCM patients with long segmental ONL, more attention should be paid to protecting the MLC structure during posterior cervical surgery.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"511"},"PeriodicalIF":2.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}