BMC Musculoskeletal Disorders最新文献

{"title":"Musculoskeletal characteristics of the lower limbs of students at a vocational ballet institution - retrospective analysis of cross-sectional data.","authors":"Tobias Almasi, Elisabeth Exner-Grave, Daniela Ohlendorf, David A Groneberg, Eileen M Wanke","doi":"10.1186/s12891-025-08692-y","DOIUrl":"https://doi.org/10.1186/s12891-025-08692-y","url":null,"abstract":"<p><strong>Background: </strong>The existing literature on pre-professional ballet students mostly reports on injury patterns, eating disorders, hormonal paramenters or other singular items whereas an overall description of anthropometric and orthopedic values of this particular study population can rarely be found. The aim of the present article was to anthropometrically and orthopedically describe the lower extremity of the typical vocational ballet student, establish a database and enable future comparisons.</p><p><strong>Methods: </strong>In this study, n = 606 students (414 female, 192 male) of a governmental institution for vocational ballet in Germany, between the ages of 5 and 22 (Mean ±SD: 13.9 ±3.5) were examined by an experienced orthopedist and dance physician.</p><p><strong>Results: </strong>The average passive external rotation of the hip (ER) was 60° (±7.5) and 43.5° (±11.3) for the internal rotation (IR). The calculated range of motion (ROM) was 103.3° (±10.4). The mean tibial torsion (TT) was 22.4° (±6.3). The average calculated turnout (ER + TT) was 83.3° (±9.9) per leg. The passive dorsiflexion (DF) of the ankle was 23.6° (±4.7) and 70.1° (±7.5) for plantarflexion (PF). 52.5% of the examinees showed a splay foot. The passive DF of the metatarsophalangeal (MTP) joint was 88.9° (±6.3) and 62.3° (±5.2) for PF. The Pearson's correlation coefficient for age was r =.237/0.302 (right/left) with hip ER, r= -.634/0.537 (right/left) with hip IR, r =.11 (both sides) with ankle PF and r = -.0.253/-0.264 (right/left) with MTP joint DF of the big toe.</p><p><strong>Conclusions: </strong>The typical vocational ballet student of our study showed a large ROM for hip ER, ankle PF and MTP joint DF of the big toe. Students were more flexible than examinees of previous studies and often achieved ballet-specific ideal values. Hence, it is very likely that a ballet-specific selection favours the generally large ROMs found in the present study. The data collected over the long period of twenty years can be seen as a limitation of the present study, as students selected at the beginning of that period might be very different to selected students at the end it. Furthermore, this study measured passive joint range of motion only.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"444"},"PeriodicalIF":2.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral patellar tilting can also result in cartilage lesions of tibial plateau - the characteristic features of excessive lateral pressure syndrome: a retrospective study of 141 cases.","authors":"Li Minghao, Liu Qiang, Cui Guoqing","doi":"10.1186/s12891-025-08686-w","DOIUrl":"https://doi.org/10.1186/s12891-025-08686-w","url":null,"abstract":"<p><strong>Background: </strong>To comprehensively summarize the characteristics of cartilage and other knee joint lesions associated with excessive lateral pressure syndrome (ELPS).</p><p><strong>Methods: </strong>Patients diagnosed with ELPS and admitted to our department between October 1, 2015, and September 30, 2023 were retrospectively included in this study. Prior to undergoing arthroscopic examination and surgery, all included patients underwent knee MRI evaluation. The lesion regions and corresponding lesion grading of each knee joint were meticulously documented, and the concordance between imaging and arthroscopic evaluation was quantified. All patients were categorized based on age and gender, and further comparison of each group was made.</p><p><strong>Results: </strong>There were 82 male participants and 59 female participants included. No significant differences in age or side distribution were observed. Regarding gender comparison, there were no statistically significant differences in imaging observations (P = 0.940) and arthroscopic examinations (P = 0.237). There were no significant differences observed in radiographic incidences among all three groups divided by age, while during arthroscopic examination, a significantly higher incidence was found in over 50 group compared to both those under 20 and those aged between 20 and 50. The incidence of Graded that both radiographic evaluation and arthroscopic observation demonstrated a significantly higher incidence in the > 50 years old group compared to the other two groups.</p><p><strong>Conclusions: </strong>In addition to patellofemoral joint cartilage lesions, excessive lateral pressure syndrome (ELPS) of the patella can also cause cartilage lesions in the central region of the medial tibial plateau and posterior region of the lateral tibial plateau. These specific sites of lesion are not influenced by gender or age. The incidence of full-thickness cartilage defects gradually increases with age.</p><p><strong>Trial registration: </strong>The Ethics Committee of the Third Hospital of Peking University approved this study. (No.: IRB00006761-M2021002) LEVEL OF EVIDENCE: IV Case series.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"443"},"PeriodicalIF":2.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low back pain among the working-age population: from the global burden of disease study 2021.","authors":"Yao-Kan Zhang, Jia-Xuan Wang, Yi-Zhou Ge, Ze-Bin Wang, Feng Chang","doi":"10.1186/s12891-025-08704-x","DOIUrl":"https://doi.org/10.1186/s12891-025-08704-x","url":null,"abstract":"<p><strong>Background: </strong>The burden of low back pain in the global working-age population (WAP) is substantial and exhibits unique characteristics. This study aimed to evaluate global, regional, and national trends in low back pain prevalence among the WAP over a 32-year period.</p><p><strong>Methods: </strong>We utilized data from the 2021 Global Burden of Disease (GBD) study to evaluate the global impact of low back pain in the WAP from 1990 to 2021. A secondary analysis focused on temporal trends and a decomposition analysis of low back pain.</p><p><strong>Results: </strong>From 1990 to 2021, there was a continuous decrease in the rate of low back pain among the global WAP. The age-standardized incidence rate (ASIR) decreased from 4,111 (95% uncertainty interval [UI]: 2,682-5,619) to 3,676 (95% UI: 2,563-5,021), with an annual average percentage change (AAPC) of -0.36. The age-standardized prevalence rate (ASPR) decreased from 9,731 (95% UI: 7,061-12,970) to 8,632 (95% UI: 6,296-11,517), with an AAPC of -0.39. The age-standardized disability-adjusted life years (DALYs) rate (ASDR) decreased from 1,108 (95% UI: 686-1,650) to 982 (95% UI: 608-1,460), with an AAPC of -0.39. However, the number of low back pain cases in the global WAP continued to increase. Regions with a middle Socio-demographic Index (SDI), South Asia, China, and India carried a heavier burden of low back pain in the WAP. The burden was also greater among females, with the gender gap continuing to widen. Decomposition analysis revealed that population growth and population aging were the predominant driving factors.</p><p><strong>Conclusions: </strong>Despite the overall reduction in the ASIR, ASPR, and ASDR of low back pain among WAP, it remained a leading cause of disability worldwide. More attention needs to be paid to the low back pain burden among WAP in middle-SDI regions, countries with a large population base, and females. Significant gender and regional disparities persist within WAP, highlighting the necessity for targeted preventive and therapeutic interventions to alleviate the burden of low back pain and reduce the risks of disability.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"441"},"PeriodicalIF":2.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for post-traumatic osteoarthritis and subsequent total hip arthroplasty in patients with acetabular fractures.","authors":"Hung Yen Chen, Yao Hung Tsai","doi":"10.1186/s12891-025-08690-0","DOIUrl":"https://doi.org/10.1186/s12891-025-08690-0","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic osteoarthritis (PTOA) often develops after acetabular fractures, leading to a need for total hip arthroplasty (THA). This study aimed to identify the risk factors associated with PTOA and subsequent THA among patients with acetabular fractures treated with open reduction and internal fixation (ORIF).</p><p><strong>Methods: </strong>The records of patients with closed acetabular fractures treated at a tertiary care medical center in Taiwan from 2002 to 2019 were retrospectively reviewed. Eligibility criteria were patients who underwent ORIF with a minimum follow-up of 2 years. The primary outcomes were occurrence of PTOA and subsequent THA. Multivariate logistic regression was employed to identify significant factors associated with PTOA and THA.</p><p><strong>Results: </strong>A total of 54 patients were included, with a mean age of 41.4 years and 76% were male (n = 41). PTOA occurred in 28 patients (52%), and 13 patients (24%) required THA. Advanced age (adjusted odds ratio [aOR] = 1.05, 95% confidence interval [CI]: 1.00-1.10, p = 0.035) and a both column fracture (aOR = 12.80, 95% CI: 2.21-74.16, p = 0.004) were significant predictors of PTOA. Time to ORIF (aOR = 1.36, 95% CI: 1.06-1.75, p = 0.018) and unsatisfactory Matta criteria (aOR = 7.62, 95% CI: 1.30-44.58, p = 0.024) were significant predictors for subsequent THA.</p><p><strong>Conclusion: </strong>Age and fracture pattern are independent predictors of PTOA, while time to ORIF and Matta criteria are predictive of the need for THA. Early timing of ORIF could decrease the likelihood of subsequent THA, underscoring the importance of prompt surgical intervention in clinical decision-making to optimize patient outcomes. Further research is needed to refine preoperative risk stratification and clinical management strategies for patients with acetabular fractures.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"440"},"PeriodicalIF":2.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dislocation incidence and risk factors following direct anterior primary total hip arthroplasty: a consecutive, single-surgeon cohort.","authors":"Peyman Mirghaderi, Mohammad-Taha Pahlevan-Fallahy, Hesan Rezaee, Alireza Moharrami, Hadi Ravanbod, Mohammad Hossein Pourgharib-Shahi, Seyed Mohammad Javad Mortazavi","doi":"10.1186/s12891-025-08683-z","DOIUrl":"https://doi.org/10.1186/s12891-025-08683-z","url":null,"abstract":"<p><strong>Backgrounds: </strong>Dislocation is one of the debilitating complications of total hip arthroplasty. It is a common reason for revision surgery after THA, along with other complications such as infection and instability. This study determined the incidence and risk factors of dislocation after primary total hip arthroplasty using the direct anterior approach.</p><p><strong>Methods: </strong>Retrospective Data from patients who underwent primary THA from 2013 to 2020 was analyzed. Anteversion and inclination angles were extracted from their imaging studies, and demographic data were also recorded from their medical records. Data were analyzed using SPSS version 26.</p><p><strong>Results: </strong>One thousand two hundred four cases of THA were reviewed in our study. 31 (2.57%) dislocations happened after a minimum follow-up of five years. Our study showed that DDH diagnosis as the underlying condition, using Wagner Cone and Wagner SL stem, cup size smaller than 52, head size smaller than 34, anteversion and inclination angle outside the Lewinnek safe zone can be risk factors for dislocation. Primary OA and Fitmore stem acted as protective factors for dislocation.</p><p><strong>Conclusion: </strong>In the DA approach, the underlying disease, properties of the prosthesis used such as cup and head size, stem type, and anteversion and inclination angles can be the potential risk factors for dislocation.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"442"},"PeriodicalIF":2.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with high hidden blood loss in patients undergoing primary total knee arthroplasty for osteoarthritis: a cross-sectional retrospective study of 1444 patients.","authors":"Tao Deng, Yongjian Liang, Chi Xu, Libo Hao, Jun Fu, Jiying Chen","doi":"10.1186/s12891-025-08698-6","DOIUrl":"https://doi.org/10.1186/s12891-025-08698-6","url":null,"abstract":"<p><strong>Purpose: </strong>Total knee arthroplasty (TKA) can cause significant hidden blood loss after surgery, and transfusion or erythropoietin (EPO) treatment may be required. This study aimed to identify the factors associated with blood loss in patients undergoing TKA for osteoarthritis (OA).</p><p><strong>Methods: </strong>We retrospectively enrolled 1444 OA patients undergoing primary TKA from January 2022 to June 2024. The patients were divided into two groups according to the grade of hidden blood loss. To identify the key influencing factors, we conducted a logistic regression analysis.</p><p><strong>Results: </strong>This study analyzed 1,444 primary arthroplasty cases, identifying 236 patients with high hidden blood loss (HHBL). Coronary artery disease (CAD) was significantly more prevalent in the HHBL group (15.3% vs. 9.4%, p = 0.006). Preoperative EPO use was higher in the low hidden blood loss (LHBL) group (21.9% vs. 9.3%, p < 0.001). Significant preoperative lab differences included hemoglobin, hematocrit, and platelet count. Surgical factors associated with HHBL included left knee TKA, conventional mechanical TKA (CMTKA), longer operation times, and intraoperative blood loss (IBL) > 20%. Postoperatively, the HHBL group had significantly more transfusions and longer hospital stays. Logistic regression identified CAD, platelet count, left knee surgery, CMTKA, operation time, and preoperative EPO use as significant factors influencing HHBL. These findings highlight the need for targeted strategies to manage blood loss in knee arthroplasty patients.</p><p><strong>Conclusions: </strong>This study identifies several factors associated with high hidden blood loss in patients undergoing TKA for osteoarthritis. CAD, CMTKA, prolonged operation time, left-sided surgery, lower preoperative platelet count, and lack of preoperative erythropoietin (EPO) use were significantly linked to HHBL. While these associations highlight potential targets for intervention, further prospective studies are needed to confirm causality.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"439"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of PRP injection combined with intersecting femoral head decompression versus combined with multiple core decompression in the treatment of avascular necrosis of femoral head-a single-center retrospective cohort study.","authors":"Lei Sun, Ziyao Xu, Zhongyuan Zhang, Jinwei Zhao, Mengshuai Sun, Guangling Gao, Fang Gao, Hongjiang Jiang, Changjun Ju","doi":"10.1186/s12891-025-08679-9","DOIUrl":"https://doi.org/10.1186/s12891-025-08679-9","url":null,"abstract":"<p><strong>Background: </strong>Avascular necrosis of femoral head (ANFH) is a localized destruction of the femoral head caused by a variety of complex reasons, which eventually progresses to collapse of the femoral head and loss of joint function. Platelet-rich plasma(PRP), an autologous platelet concentrate rich in growth factors, has been widely used in the treatment of ANFH because of its ability to promote osteogenesis. PRP injection is often combined with multiple surgical approaches to treat ANFH. The objective of this study is to evaluate the effect of PRP injection combined with intersecting femoral head decompression versus combined with multiple core decompression (MCD) in the treatment of ANFH.</p><p><strong>Methods: </strong>A retrospective cohort analysis comparing two surgical interventions was conducted between January 2020 and December 2020. Specifically, 25 patients with ARCO stage II non-traumatic ANFH received PRP injection combined with intersecting femoral head decompression, while another 25 patients underwent PRP injection plus MCD. Postoperative functional outcomes were assessed using the Harris Hip Score (HHS) and Visual Analogue Scale (VAS), while radiographic progression was evaluated through standardized X-ray and computed tomography (CT) imaging protocols. Functional and radiographic results were compared between the two groups.</p><p><strong>Results: </strong>All patients were followed up without occurrence of complications such as infection and thrombosis. The mean follow-up time was 29.7 ± 3.4 months. HHS of patients treated by intersecting femoral head decompression at 12 months and 24 months postoperatively (78.7 ± 4.1 and 79.8 ± 5.0) were significantly higher than those of patients treated by MCD (75.9 ± 5.4 and 76.6 ± 5.1) (P < 0.05). VAS of patients treated by intersecting femoral head decompression at 12 months and 24 months postoperatively (2.7 ± 0.8 and 2.6 ± 0.8) were significantly lower than those of patients treated by MCD (3.3 ± 0.8 and 3.1 ± 0.8) (P < 0.05).. HHS and VAS were improved postoperatively in both groups (P < 0.05). According to radiographic changes, the proportion of patients with aggravation of necrosis in patients treated by intersecting femoral head decompression (12%) was lower than that (24%) in patients treated by MCD at 24 months postoperatively (P > 0.05), but the difference is not significant.</p><p><strong>Conclusion: </strong>Unlike conventional core decompression, PRP can penetrate slowly into the cancellous bone of the femoral head through drilled pores in patients treated by intersecting femoral head decompression, thus extending duration of action of PRP. Compared with PRP injection combined with MCD, PRP injection combined with intersecting femoral head decompression had better functional and radiographic outcomes in our study.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"438"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior treatment of ankylosing spinal diseases with thoracolumbar fractures: a network meta-analysis.","authors":"Jiaxiao Shi, Bo Yang, Chaochao Zhang, Wei Guo, Fujiang Cao, Fangfang Wang","doi":"10.1186/s12891-025-08700-1","DOIUrl":"https://doi.org/10.1186/s12891-025-08700-1","url":null,"abstract":"<p><strong>Objective: </strong>The implementation of diverse surgical techniques plays a crucial role in managing ankylosing spinal diseases (ASDs), serving as invaluable tools. Presently, posterior surgery stands out as the predominant approach owing to its familiarity with anatomical structures; however, it comprises various methodologies that require a thorough comprehension for their suitable application. Henceforth, we performed a network meta-analysis to assess and prioritize the efficacy and safety of surgical interventions for ASDs.</p><p><strong>Methods: </strong>The databases PubMed, EMBASE, Cochrane Library, and CNKI (China National Knowledge Infrastructure) were systematically searched for both randomized and non-randomized studies. No restrictions were placed on the initial time periods or languages of the searches. Patients with thoracolumbar fractures accompanied by ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis were included in this study. RevMan 5.4 and Stata 14.2 software programs were utilized for assessing literature quality and conducting data analysis.</p><p><strong>Results: </strong>A total of 20 trials involving 1116 patients with ASDs were included, encompassing 4 posterior approaches. Network meta-analysis revealed that Percutaneous puncture demonstrated favorable outcomes in terms of surgical duration, intraoperative blood loss, postoperative bed rest time, and hospital stay. Both percutaneous internal fixation and 3D assisted fixation exhibited alternating advantages in postoperative functional recovery.</p><p><strong>Conclusions: </strong>Based on the available evidence, it is evident that percutaneous instrumentation offers clear advantages over other forms of instrumentation. However, the quality of some studies is suboptimal and further high-quality randomized controlled trials are necessary to provide additional verification.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"436"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplemental nucleus pulposus allograft in patients with lumbar discogenic pain: results of a prospective feasibility study.","authors":"Douglas P Beall, Timothy T Davis, Kasra Amirdelfan, Ramana K Naidu, Michael J DePalma, Shrif Costandi, Edward S Yoon, Jacob W Fleming, Jon E Block, Nagy Mekhail","doi":"10.1186/s12891-025-08701-0","DOIUrl":"https://doi.org/10.1186/s12891-025-08701-0","url":null,"abstract":"<p><strong>Background: </strong>Degeneration of the intervertebral disc is a significant source of chronic axial low back pain. Direct supplementation of degenerated nucleus pulposis (NP) tissue with intradiscally delivered allogeneic NP represents an opportunity to bridge the treatment gap between failed conservative care and spine surgery for patients with lumbar discogenic pain.</p><p><strong>Methods: </strong>Prospective, single-arm clinical study conducted at 6 sites in the US. The primary objective was to determine the magnitude of improvement in back pain severity and back function in patients with chronic lumbar discogenic pain at 12 months after a single intradiscal supplementation procedure using a commercially available NP allograft at up to two vertebral levels identified on magnetic resonance imaging. Back pain severity was evaluated using an 11-point numeric rating scale (NRS) and back function using the Oswestry Disability Index (ODI). Minimal clinically important difference (MCID) and substantial clinical benefit (SCB) were set at ≥ 30% and ≥ 50% over baseline, respectively. The patient acceptable symptom state (PASS) threshold for pain severity was ≤ 3.</p><p><strong>Results: </strong>Twenty-eight participants with a mean age of 44 ± 13 yrs. were enrolled and 22 provided 12-month outcomes. The average overall improvement in back pain severity was 43% through 12 months (p < 0.001). Approximately 64% (14 of 22) achieved the MCID in back pain at 12 months, with 55% (12 of 22) realizing SCB. Almost 60% (13 of 22) reported a 12-month back pain severity score of ≤ 3. The corresponding average decrease in ODI values was 50% (p < 0.001) with approximately 59% (13 of 22) of study participants achieving the MCID. At baseline approximately 82% (23 of 28) of participants reported severe or crippled back impairment compared to 18% (4 of 22) at 12 months (p < 0.001).</p><p><strong>Conclusion: </strong>The results of this study provide additional evidence that supplementation of the degenerated intervertebral disc with intradiscally delivered allogeneic NP is associated with clinically significant pain palliation and functional improvement.</p><p><strong>Trial registration: </strong>This trial was prospectively registered at ClinicalTrials.gov on December 30, 2021 (NCT05201287).</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"437"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effects of two calcaneal lengthening osteotomies (Hintermann vs. Evans) in stage II adult-acquired flatfoot.","authors":"Cheng Hao, Zi Li, Chenyu Xu, Yaping Ye, Jingjing Zhao, Wei Xie, Zhenhua Fang","doi":"10.1186/s12891-025-08678-w","DOIUrl":"https://doi.org/10.1186/s12891-025-08678-w","url":null,"abstract":"<p><strong>Background: </strong>Stage II adult-acquired flatfoot (AAF) could be effectively treated by Hintermann (H) and Evans (E) lateral column lengthening (LCL) calcaneal osteotomies. This retrospective cohort study was aimed to compare the post-surgical outcome of this two osteotomies used in Chinese patients.</p><p><strong>Methods: </strong>Of 114 eligible patients (149 feet) with Stage II AAF admitted from October 2018 to October 2022, 92 feet treated by Hintermann osteotomy and 57 feet treated by Evans osteotomy were observed in 2-year follow-up. Pre-surgical and post-surgical radiographic parameters, clinic scores and degenerative changes of related joints were collected and analyzed.</p><p><strong>Result: </strong>Pitch angle, Meary's angle, Naviculocuboidal (NC) overlap (%), Medial arch sagittal (MAS) angle, Talocalcaneal (TC) angle, Talonavicular (TN) coverage angle, Talus-second metatarsal (T-2MT) angle were significantly corrected by both H-LCL and E-LCL osteotomies (P <.05). The clinic scores of AOFAS (American Orthopaedic Foot & Ankle Society) score, SF-36 (Short-Form 36-item Health Survey), Pain-NRS (Numerical Rating Scale), and UCLA (University of California at Los Angeles activity score) after surgery showed significant improvement for the patient in both groups. Comparing between the two groups, no significant differences were found regarding to radiographic parameters, clinic scores or degenerative changes. However, degenerative changes of calcaneocuboidal (CC) joint were found in 6 cases (6.5%) in H-LCL group and 17 cases (29.8%) in E-LCL group. Degenerative changes of subtalar joint were found in 6 cases (6.5%) in H-LCL group and 17 cases (24.6%) in E-LCL group. One case developed complication of osteotomy nonunion, and one case underwent secondary arthrodesis in E-LCL group.</p><p><strong>Conclusion: </strong>Both H-LCL and E-LCL osteotomies give rise to an outstanding radiographic correction and a significant enhancement of clinic scores in flatfoot deformity. Compared to E-LCL, H-LCL tends to protect the subtalar joint for Chinese patients.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"434"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}