BMC Musculoskeletal Disorders最新文献

{"title":"Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population.","authors":"Li Li, Rui Huang, Xiang Gao, Zhenxing Li, Yuanyuan Lin, Hanle Zhang, Yilun Jiang, Pei Fan","doi":"10.1186/s12891-025-08389-2","DOIUrl":"10.1186/s12891-025-08389-2","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is common in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and varies in different regional and ethnic. However, it is unclear whether the prevalence of osteoporosis and osteopenia in these patients is different from that in the general population. This study aims to investigate the prevalence of osteoporosis and osteopenia in both populations to help exploring the relationship between the osteoporosis and osteoarthritis, and to explore whether knee function and radiological assessments of KOA are associated with osteoporosis.</p><p><strong>Methods: </strong>In total, 249 patients diagnosed with KOA awaiting TKA were investigated in this cross-sectional study. The mean age was 70.9 ± 6.4 years. Bone mineral density (BMD) and T scores at the hip and lumbar spine were used to assess bone status using dual X-ray absorptiometry. A matched cohort from 2448 individuals in the Health Examination Center of our hospital was set as controls by matching sex, age (± 3.0 years) and BMI (± 1.0). The Kellgren-Lawrence grades (K-L grades), mechanical femorotibial angle (mFTA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and range of motion (ROM) of the knee were measured to evaluate radiological assessments and knee function in patients awaiting TKA and used to explore the association between KOA and BMD or T score. Prevalence of osteoporosis and osteopenia were investigated in the two cohorts, and inferential statistical analyses were undertaken. The chi-squared test or Fisher's exact test was used for categorical variables while comparisons of scores were examined by ANOVA with/without Bonferroni correction or the Kruskal‒Wallis test.</p><p><strong>Results: </strong>The prevalence of osteoporosis and osteopenia in patients awaiting TKA was 30.5% (76/249) and 44.2% (110/249), respectively. In the matched cohort, 72/249 (28.9%) had osteoporosis, while 98/249 (39.4%) had osteopenia. There was no significant difference in the prevalence of osteoporosis or osteopenia between the two groups (χ2 = 2.603, P = 0.272). mFTA was significantly correlated with BMD and T score (P < 0.05), while no correlation was found between K-L grade, ROM or WOMAC and BMD or T score (P > 0.05).</p><p><strong>Conclusions: </strong>The prevalence of osteoporosis in patients awaiting TKA was similar to that in the general population. BMD and T score were not correlated with WOMAC score or K-L grade but were correlated with mFTA.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"217"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540301","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":"The well-being of people with anterior cruciate ligament rupture-related post-traumatic osteoarthritis in Aotearoa New Zealand.","authors":"Daniel O'Brien, Martin Rabey, Duncan Reid, Richard Ellis, Tammi Wilson Uluinayau, Jackie L Whittaker","doi":"10.1186/s12891-025-08421-5","DOIUrl":"10.1186/s12891-025-08421-5","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) ruptures are a potent risk factor for post-traumatic knee osteoarthritis (PTOA). Annually, in Aotearoa New Zealand, approximately 2,500 people under the age of 30 undergo ACL reconstruction surgery. Due to the young age of injury and surgery, many develop osteoarthritis before age 50 and have a higher likelihood of requiring total knee replacement compared to the general population. This study aimed to gain insight into the medium- to long-term impacts of ACL rupture on people's well-being in Aotearoa New Zealand, by exploring their lived experiences five or more years post-injury.</p><p><strong>Method: </strong>In this Interpretive Description observational study, we conducted semi-structured interviews with people who had ruptured their ACL and had or were at risk of developing PTOA. Analysis was conducted guided by Braun and Clarke's Reflexive Thematic Analysis.</p><p><strong>Findings: </strong>Twelve people (7 women, median age 49.5 [25-62] years) were interviewed. Three themes were generated from the data: 1) Nobody Ever Told Me…, 2) The Post-Rehabilitation Void, and 3) The Elephant in the Room: The Psychosocial Impact. Participants commonly described fear, grief and long-term psychological impacts, and most reported wanting to know more about the long-term management of their knees.</p><p><strong>Conclusion and impact: </strong>The study highlights opportunities to provide better long-term support and management, improve outcomes, and reduce the burden on these individuals. ACL injury can profoundly impact people's lives in the long term. Better education, support services, and consideration of psychosocial factors are needed. Addressing identified barriers could reduce the individual and socioeconomic burden of PTOA for New Zealanders. Future research involving stakeholders must establish acceptable long-term management programmes tailored to ensure they meet the population's needs and address the unique socioeconomic context and ethnic disparities in Aotearoa New Zealand.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"216"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536632","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":"Surgical outcomes of Hemivertebra Resection with Mono-Segment Fusion in Children under 10 years with congenital scoliosis: a retrospective study stratified by the Crankshaft Phenomenon.","authors":"Zhiming Peng, You Du, Haoran Zhang, Bingtai Han, Shengru Wang, Jianguo Zhang","doi":"10.1186/s12891-025-08375-8","DOIUrl":"10.1186/s12891-025-08375-8","url":null,"abstract":"<p><strong>Background: </strong>Congenital early-onset scoliosis (CEOS), particularly due to hemivertebra, presents significant challenges in spinal deformity correction. The standard surgical approach, hemivertebra resection combined with short-segment fusion, can be complicated by the crankshaft phenomenon, a progressive deformity that may develop postoperatively. This study aims to evaluate the long-term surgical outcomes of single-stage posterior hemivertebra resection with mono-segment fusion in CEOS, stratified by the presence or absence of the crankshaft phenomenon.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 31 CEOS patients who underwent single-stage posterior hemivertebra resection and mono-segment fusion between 2003 and 2019. Patients were grouped based on the presence (n = 9) or absence (n = 22) of the crankshaft phenomenon. Clinical and radiographic outcomes, including main curve correction, compensatory curves, apical vertebral translation (AVT), coronal balance (CB), and sagittal balance (SB), were assessed at preoperative, immediate postoperative, and latest follow-up points. Statistical analyses were performed using SPSS and R software.</p><p><strong>Results: </strong>The cohort showed significant deformity correction with an initial main curve angle reduction from 29.76° to 7.34° (76% correction rate), though some loss of correction was observed at the last follow-up (12.28°). The group with the crankshaft phenomenon exhibited a significantly lower initial correction rate (62%) compared to the non-crankshaft group (82%), with a higher rate of curve progression at follow-up (25.02° vs. 7.06°). Compensatory curves, AVT, and CB showed differences between groups, with those having the crankshaft phenomenon demonstrating worse outcomes. However, no significant differences were found in sagittal parameters (segmental kyphosis, thoracic kyphosis, and lumbar lordosis) between the two groups.</p><p><strong>Conclusions: </strong>The study demonstrates that single-stage posterior hemivertebra resection with mono-segment fusion is effective in correcting deformities in CEOS patients. However, the presence of the crankshaft phenomenon is associated with a poorer long-term surgical outcome, including higher rates of curve progression and worse compensatory curve management. These findings highlight the importance of identifying the crankshaft phenomenon as a potential factor influencing the prognosis of surgical correction in CEOS.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"210"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531201","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 dynamic neuromuscular stabilization training on the core muscle contractility and standing postural control in patients with chronic low back pain: a randomized controlled trial.","authors":"Huanjie Huang, Haoyu Xie, Guifang Zhang, Wenwu Xiao, Le Ge, Songbin Chen, Yangkang Zeng, Chuhuai Wang, Hai Li","doi":"10.1186/s12891-025-08417-1","DOIUrl":"10.1186/s12891-025-08417-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with chronic low back pain (CLBP) usually demonstrate poor postural control due to impaired core muscle function. Dynamic neuromuscular stabilization (DNS) is based on developmental kinesiology principles, utilizing infant motor patterns to treat motor disorders. DNS has been shown to improve postural control in cerebral palsy patients by activating core muscle. However, whether the DNS approach is superior for enhancing core muscle contractility and postural control in CLBP patients still remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to compare the effects of DNS training and conventional core exercises on core muscle contractility and standing postural control in CLBP patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixty CLBP patients were randomly assigned to a DNS group or a control group. Participants in the DNS group received DNS training, while those in the control group completed conventional core exercises. Both groups completed 12 sessions over 4 weeks (3 sessions/week, 50 min/session). Pre- and post-intervention evaluations included diagnostic musculoskeletal ultrasound to assess the change rate of core muscles (transversus abdominis (TrA), lumbar multifidus, and diaphragm), a balance assessment system to evaluate postural control performance (center of pressure displacement (COP)), and clinical questionnaires (Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RDQ)) for pain intensity and disability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After 4 weeks, comparisons between both groups revealed significant statistical differences in the interaction effects of time*group. These differences were observed in the change rates of the left and right TrA (F&lt;sub&gt;1,58&lt;/sub&gt;=4.820 and 3.964, p = 0.032 and 0.041), diaphragm change rate (F&lt;sub&gt;1,58&lt;/sub&gt;=11.945, p = 0.001), as well as COP velocity (F&lt;sub&gt;1,58&lt;/sub&gt;=5.283, p = 0.025), variability (F&lt;sub&gt;1,58&lt;/sub&gt;=13.189, p = 0.001) in the anterior-posterior (AP) direction, COP path length (F&lt;sub&gt;1,58&lt;/sub&gt;=6.395, p = 0.014), and COP area (F&lt;sub&gt;1,58&lt;/sub&gt;=5.038, p = 0.029) in the eye-closed condition. DNS participants showed significantly greater muscle change rates and reduced COP (p &lt; 0.05). The scores of VAS (F&lt;sub&gt;1,58&lt;/sub&gt;=173.929, p = 0.001), ODI (F&lt;sub&gt;1,58&lt;/sub&gt;=60.871, p = 0.001), and RDQ (F&lt;sub&gt;1,58&lt;/sub&gt;=60.015, p = 0.001) decreased significantly over time, although no group differences were found between both groups (p &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;DNS is superior to conventional core exercises in enhancing core muscle contractility and standing postural control in CLBP patients, showing potential to reduce pain and improve disability. Its mechanism may involve the enhancement of proprioceptive feedback, particularly when visual feedback is blocked.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;This study was registered in the Chinese Clinical Trial Registry (ChiCTR) wit","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"213"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536631","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":"Wrist joint tuberculosis masquerading as traumatic arthritis sequalae.","authors":"Han-Zheng Li, Jun Zhang, Liang Ma, Hai-Feng Jia, Jia-Cheng Li, Gang Li","doi":"10.1186/s12891-025-08400-w","DOIUrl":"10.1186/s12891-025-08400-w","url":null,"abstract":"<p><strong>Background: </strong>Wrist joint tuberculosis(WJ-TB)is a rare manifestation of osteoarticular tuberculosis(OAT).Delayed diagnosis is common and often leads to postponed treatment, resulting in complications such as joint stiffness and persistent pain in the affected limb.</p><p><strong>Case presentation: </strong>A 50-year-old man presented with symptoms in the wrist joint suggestive of WJ-TB.Initially, he was diagnosed with traumatic arthritis.However, following a series of diagnostic tests, the final diagnosis of tuberculous arthritis was confirmed.The patient underwent effective treatment, which led to a marked improvement in his condition.</p><p><strong>Conclusions: </strong>WJ-TB is a treatable condition.Early diagnosis and prompt treatment are essential to prevent joint destruction and maintain function in patients with OAT.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"211"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531210","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":"Triple-incision treatment of the posterior condylar triad in the lateral prone position.","authors":"Hongfei Qi, Zhong Li, Bo Wu, Chengcheng Zhang, Yu Cui, Yao Lu, Ming Li","doi":"10.1186/s12891-024-08138-x","DOIUrl":"10.1186/s12891-024-08138-x","url":null,"abstract":"<p><strong>Background: </strong>Posterior tibial plateau bicondylar fracture combined with anterior cruciate ligament injury, also known as the \"Posterior Condylar Triad\", is a regular combination injury. The traditional surgical strategy involves first fixing the posterior condyle in the prone position and then treating the anterior cruciate ligament avulsion injury after the patient turns over. This surgical strategy is cumbersome, requires multiple surgical preparations, prolongs the surgical time, and increases the patient's risk. Our centre proposed one lateral prone position with three incisions to treat the \"Posterior Condylar Triad\".</p><p><strong>Methods: </strong>This was a retrospective analysis of the clinical data of 11 \"Posterior Condylar Triad\" patients who underwent surgical treatment at our centre from February 2017 to August 2020. Using a unified surgical strategy, the patient rotates the limb in a lateral prone position. The posterior condyle fracture of the tibial plateau is treated through a posterior medial incision and posterior lateral Frosch approach. Finally, anterior cruciate ligament avulsion fracture is treated through a small incision on the medial side of the patella. All patients were encouraged to perform functional exercises of the knee joint early after surgery. The postoperative complications (deep vein thrombosis, poor wound healing, deep infection, internal fixation failure and fracture reduction loss) and knee joint function (knee joint range of motion, Lysholm score and SF36 scale) of the patients were recorded 1 year after surgery.</p><p><strong>Results: </strong>All patients' fractures healed smoothly, with an average fracture healing time of 17.0 weeks, ranging from 12 to 22 weeks. There were 2 patients with deep vein thrombosis (DVT) after the operation. One patient experienced wound fat liquefaction, and no patients reported serious complications, such as loss of fracture reduction, failure of internal fixation, or deep infection. One year after surgery, the average range of motion (ROM) of the affected limb's knee joint was 3.6-120.5°, the average Lysholm score was 86.7, ranging from 61 to 100, and the average SF36 score was 76.96, with a range of 52.45-94.75.</p><p><strong>Conclusion: </strong>The \"Posterior Condylar Triad\" is a serious injury, and our proposed surgical strategy can simplify the surgical process, avoid large-scale changes in patient position during surgery, shorten surgical time, and reduce the risk of surgical anaesthesia, enabling patients to achieve good clinical prognosis.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"215"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536636","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":"Significant correlations of upregulated MPO expression with cytokine imbalance in ankylosing spondylitis patients and the inhibitory effect mediated by mesenchymal stem cells.","authors":"Shubei Liu, Chunjuan Yang, Donghua Xu, Bingjie Gu, Minning Shen","doi":"10.1186/s12891-025-08458-6","DOIUrl":"10.1186/s12891-025-08458-6","url":null,"abstract":"<p><strong>Background: </strong>Little is known regarding both the role of myeloperoxidase (MPO) and the impact of mesenchymal stem cells (MSCs) on inflammatory and immune responses in ankylosing spondylitis (AS). This study is aimed to explore the role of MPO and the regulatory effect of umbilical cord-derived MSCs on MPO expression in monocytes in AS.</p><p><strong>Methods: </strong>MPO mRNA expression in the peripheral blood mononuclear cells (PBMCs) was detected by Real-time PCR. Cytokines including IL-2, IFN-γ, IL-17 A, IL-4, IL-10, IL-6 and TNF-α were determined by flow cytometry. A co-culture system was established by culturing THP-1 cells with MSCs at a ratio of 5:1.</p><p><strong>Results: </strong>Increased mRNA expression of MPO was observed in PBMCs of AS patients compared to healthy controls (P < 0.05). The mRNA expression of MPO was positively associated with C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) (P < 0.05) in AS. Besides, the levels of IL-2, IL-10, IFN-γ, IL-17 A, IL-4, IL-6, TNF-α in plasma were notably increased in AS (P < 0.05). Positive correlations between MPO expression and IL-2, IFN -γ, IL-4, TNF-α as well as IL-6 were demonstrated in AS (P < 0.05). Furthermore, MSCs remarkably suppressed the mRNA expression of MPO along with the secretion of IL-17 A and TNF-α, but promoted IL-10 generation in monocytes.</p><p><strong>Conclusion: </strong>MPO expression is significantly upregulated and correlates with cytokine imbalance in AS. It may serve as a valuable immunotherapeutic target for AS. MSCs can significantly inhibit monocyte-mediated inflammatory response potentially by downregulating MPO in monocytes.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"212"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531198","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":"Trajectories of physical, mental health and health satisfaction before and after arthritis diagnosis: a UK population-based study.","authors":"Amy E Taylor, Claryn S J Kung, Feifei Bu, Daisy Fancourt, Andrew Steptoe","doi":"10.1186/s12891-025-08444-y","DOIUrl":"10.1186/s12891-025-08444-y","url":null,"abstract":"<p><strong>Background: </strong>Few longitudinal studies have explored changes in physical and mental health in individuals prior to and after arthritis diagnosis. This is important for understanding timing of diagnosis in relation to symptoms and their broader health impacts.</p><p><strong>Methods: </strong>Adults (≥ 16 years) reporting new diagnoses of arthritis between 2010 and 2023 in the UK Household Longitudinal Study (UKHLS) were included in the study (N = 5,258), along with a 1:1 matched sample of arthritis-free individuals. Trajectories of physical health (assessed using the SF-12 physical component summary), mental health (General Health Questionnaire (GHQ-12)) and satisfaction with health were constructed from 8 years prior to 8 years after diagnosis using growth curve models with linear splines. Difference in difference analysis was used to test whether changes in health measures following diagnosis were attributable to arthritis diagnosis.</p><p><strong>Results: </strong>Physical health decreased from 8 years prior to diagnosis, but began to show a steeper decline from 4 years before diagnosis. There was a small recovery in the year following diagnosis, followed by a continued decline from 4 years post diagnosis. Mental health worsened at 2 years prior to diagnosis and then remained relatively stable. Health satisfaction also decreased around 2 years prior to diagnosis, showing a gradual increase in the 3 years following diagnosis and then remaining stable. Patterns of change were similar by sex, neighbourhood deprivation and living situation. There was some evidence that changes in mental health and health satisfaction were larger and occurred earlier in individuals diagnosed at younger ages (16-49 year olds). Difference in difference models showed consistent findings, with deteriorations across all three outcomes in the arthritis group relative to their matched controls.</p><p><strong>Conclusions: </strong>Detectable changes in physical and mental health several years prior to diagnosis suggest the need to improve pathways to diagnosis. Persistence of worse mental health, particularly amongst younger people, highlights the importance of considering both physical and mental health in the years following diagnosis.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"214"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536634","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":"Age diversity among older surgically treated patients with lumbar spinal stenosis: a retrospective comparative study of early and late older adults.","authors":"Ken Takase, Soya Kawabata, Takehiro Michikawa, Yuki Akaike, Takao Tobe, Risa Tobe, Sota Nagai, Takaya Imai, Hiroki Takeda, Shinjiro Kaneko, Shigeki Yamada, Nobuyuki Fujita","doi":"10.1186/s12891-025-08456-8","DOIUrl":"10.1186/s12891-025-08456-8","url":null,"abstract":"<p><strong>Background: </strong>At present, the threshold defining older adults is 65 years, and this classification has been widely accepted globally. However, with the extension of both life expectancy and healthy life expectancy, there is a need to reconsider this age-based definition. This study compared the characteristics and surgical outcomes of older patients with lumbar spinal stenosis (LSS) between the early and late stages to clarify age diversity in this population.</p><p><strong>Methods: </strong>Data collected from consecutive patients aged ≥ 65 years who underwent LSS surgery were retrospectively reviewed. All participants completed the Zurich Claudication Questionnaire, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and 25-Question Geriatric Locomotive Function Scale preoperatively as well as 6 and 12 months postoperatively. Frailty was evaluated using the 11-point modified frailty index. Polypharmacy was defined as the concomitant use of at least six drugs.</p><p><strong>Results: </strong>In total, 311 older patients with LSS were enrolled. Among them, 136 patients younger than 75 were categorized into the E group, and 175 patients aged 75 and older were categorized into the L group. Baseline characteristics, including frailty and polypharmacy, significantly differed between the groups. The frequency of effective case of surgical treatment on JOABPEQ was significantly lower for walking ability in the L group. At 1 year after surgery, the incidence of non-improvement in locomotive syndrome stages was higher in the L group than in the E group (relative risk = 1.38, 95% confidence interval [CI] = 1.08-1.78). In addition, when the L group was further divided into three subgroups based on age, the relative risk was 1.32 (95% CI = 0.99-1.76) for patients aged 75 to < 80, 1.42 (95% CI = 1.07-1.88) for those aged 80 to < 85 years, and 1.68 (95% CI = 1.16-2.45) for those aged ≥ 85.</p><p><strong>Conclusions: </strong>Significant differences were observed in baseline characteristics and postoperative improvement of walking ability and locomotive syndrome based on age among older patients with LSS. Our findings underscore the significant age diversity among older adults, highlighting the necessity of considering each patient in a more nuanced age-specific manner rather than adopting a one-size-fits-all approach.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"209"},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531186","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":"Does preoperative muscle biopsy predict the outcome of lower extremity amputation in diabetic patients? a prospective observational study.","authors":"Ihsan Akan, Tayfun Bacaksiz, Mehmet Maden, Arzu Avci, Mahmut Tuncez, Cemal Kazimoglu","doi":"10.1186/s12891-025-08448-8","DOIUrl":"10.1186/s12891-025-08448-8","url":null,"abstract":"<p><strong>Background: </strong>Determining the most appropriate level of amputation in patients with diabetes mellitus has not been well established. The purpose of this study is to determine whether muscle biopsy reveals predictive information about the success rate of patients undergoing diabetic major lower limb amputation.</p><p><strong>Methods: </strong>A prospective observational study was conducted among diabetic patients who underwent below-knee amputation. Skin-subcutaneous and muscle biopsy samples were obtained during the operation from 62 patients who undergo major limb amputation. Depending on the complications after surgery, patients were assigned into three groups: Group 1 consisted of patients with adequate wound healing without any complications; Group 2 included patients with prolonged wound healing requiring additional interventions like debridement; and Group 3 consisted of patients who underwent reamputation at a more proximal level. Biopsy samples of the groups were compared regarding degenerative cells, inflammatory cells, and the presence of infection.</p><p><strong>Results: </strong>There was a significant difference between Groups 1 and 3 regarding the presence of abscess formation and infection (p < 001). Comparison of Groups 1 and 3 revealed significant differences regarding inflammatory cell count, respectively (p < 001). According to the results of the ROC analysis performed for histopathologic cellular evaluation, 15% for inflammatory cell ratio in muscle samples and 25% for degenerative cell ratio both in muscle and skin samples were determined as cut-off values.</p><p><strong>Conclusions: </strong>The presence of increased degenerative cell count and infection in muscle biopsy areassociated with higher rates of reoperation. The present study revealed that preoperative muscle biopsy has predictive value in patients undergoing major limb amputation.</p><p><strong>Level of evidence: </strong>Level II, Prospective observational study.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"208"},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531187","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}