BMC Musculoskeletal Disorders最新文献

{"title":"A novel unilateral extrapedicular approach applied to percutaneous vertebral augmentation to treat thoracic and lumbar Osteoporotic Vertebral Compression Fracture: a retrospective study.","authors":"Bo Yang, Shenghai Wang","doi":"10.1186/s12891-024-07980-3","DOIUrl":"10.1186/s12891-024-07980-3","url":null,"abstract":"<p><strong>Objective: </strong>To design and apply a novel puncture method, named P TO P technique, and to evaluate its efficacy and safety.</p><p><strong>Method: </strong>The data of patients treated with PVA in medical institution from January 2020 to December 2022 were reviewed and analyzed. The degree of pain relief and recovery from daily activities were evaluated using VAS and LAS scores, and radiological parameters were evaluated using local kyphosis angle and excellent cement distribution. Complications such as cement leakage and recurrent vertebral fractures were also recorded.</p><p><strong>Results: </strong>157 patients with thoracolumbar OVCF were successfully treated with novel puncture techniques. All postoperative clinical and radiological parameters significantly decreased in all patients, except for an increase in local kyphosis angle at the last follow-up compared to postoperative. All other above indicators remained statistically significant at the last follow-up compared to postoperative improvement. Except for 2 patients with poor cement distribution, the remaining 155 patients successfully achieved satisfactory results in unilateral puncture and bilateral cement distribution, achieving an excellent rate of 98.73%. In addition, 18 cases (11.46%) of cement leakage occurred during the operation, fortunately none of them were uncomfortable. During the postoperative follow-up period, 4 cases (2.55%) of recurrent fractures occurred. No other serious complications such as neurologic or named vascular injuries occurred.</p><p><strong>Conclusion: </strong>The application of P TO P technology in thoracolumbar OVCF patients is safe and effective. It can not only reduce pain and quickly recover daily activities, but also achieve the perfect effect of unilateral puncture and bilateral cement filling.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543728","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":"Sitting foot: posture dependent changes of volume, edema and perfusion of the foot. A prospective interventional study with 27 volunteers.","authors":"Wolfgang Freund, Peter Wikstroem, Arthur P Wunderlich, Uwe Schuetz, Meinrad Beer","doi":"10.1186/s12891-024-07971-4","DOIUrl":"10.1186/s12891-024-07971-4","url":null,"abstract":"<p><strong>Background: </strong>Sitting is known to be bad for your cardiovascular health. We furthermore hypothesized that sitting posture will reduce perfusion of the foot and increase edema, possibly predisposing to disease like osteochondritis.</p><p><strong>Methods: </strong>We included 27 healthy volunteers and performed MRI measurements including arterial spin labelling (ASL) and intravoxel incoherent motion (IVIM) perfusion as well as short tau inversion recovery (STIR) edema measurement and 3D volumetry. After randomization, the elevation of one foot during the day was used as an intervention.</p><p><strong>Results: </strong>Intra- and interrater variability was 1-6%. ASL perfusion measurement was hindered by artifacts. IVIM perfusion showed no significant changes during supine measurements. Volumetry could demonstrate a highly significant (p = 0.00005) volume increase, while the intervention led to a significant (p = 0.0076) volume decrease during the day. However, the water content in STIR remained unchanged and the normalized (quotient bone/muscle) edema was reduced on the control side (p = 0.006) and increased on the intervention side (p = 0.01).</p><p><strong>Conclusions: </strong>Sitting all day leads to swelling of the healthy foot. Compensation in healthy subjects seems to prevent lasting perfusion changes or edema evolution in the bone despite an increase of muscle signal and volume increase. Thus, the etiology of osteochondritis needs further studies.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543638","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":"Spinal muscle characteristics during three different types of locomotion activities among college students with idiopathic scoliosis.","authors":"Yanyun Gou, Jing Tao, Jia Huang, Meijin Hou, Yifan Sun, Xiang Chen, Xiangbin Wang","doi":"10.1186/s12891-024-07954-5","DOIUrl":"10.1186/s12891-024-07954-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Physical activities such as walking and climbing stairs are pervasive in human daily life. Individuals with scoliosis frequently encounter dysfunction in their muscle recruitment. Multiple studies have corroborated the presence of muscle dysfunction in individuals diagnosed with scoliosis. However, there is currently a noteworthy research gap regarding the exploration of changes in muscle characteristics and disparities from those observed in individuals without scoliosis during everyday activities, specifically stair climbing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to examine the unique patterns of muscle activity during daily life in individuals with scoliosis and distinguish the specific differences between scoliosis patients and the healthy controls. The findings of this study are significantly important for the future accurate assessment of scoliosis and the development of rehabilitation treatment plans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case-control study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Sample size: &lt;/strong&gt;Twenty eight idiopathic scoliosis patients and twenty eight controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;Root Mean Square(RMS), Maximum Voluntary Isometric Contraction(MVIC)%, RMS ratio(RMS convex / RMS concave).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The surface electromyography (sEMG) device used in this study was the Delsys Trigno, with a sampling frequency of 1500 Hz. It recorded the activation level, peak contraction, and average activation level of the erector spinae (at T6, T10, and L3 levels), gluteus maximus, gluteus medius, external oblique, and rectus abdominis muscles during three different types of locomotion for both the 28 individuals with idiopathic scoliosis and the 28 control participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The movement patterns of the idiopathic scoliosis patients significantly differ from those of the normal population during level walking and ascending or descending stairs. In level walking, there is an asymmetry in the activation levels of the T6 and L3 erector spinae muscles, with lower activation on the convex side compared to the concave side. Similarly, during stair ascent, the activation of the T6 and T10 erector spinae muscles is asymmetric, with higher activation on the convex side than the concave side. Moreover, during stair descent, the activation of the T6 erector spinae muscle is asymmetric, with higher activation on the convex side than the concave side.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;During level walking and stair activities, idiopathic scoliosis patients exhibit pronounced abnormal movement patterns that significantly differ from those of the control group. Under different activity conditions such as level walking, ascending and descending stairs, idiopathic scoliosis patients demonstrate abnormal muscle activation in different segments of the spine. It is crucial for clinicians to prioritize the symmetry of muscle activation in the spinal region o","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543639","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":"Correction: Bispherical metal augment improved biomechanical stability in severe acetabular deficiency reconstruction: a comparative finite element analysis.","authors":"Guoyuan Li, Xiaoqi Zhang, Min Chen, Zhengliang Luo, Xiaofeng Ji, Chunang Pan, Hui Li, Xi-Fu Shang","doi":"10.1186/s12891-024-07950-9","DOIUrl":"10.1186/s12891-024-07950-9","url":null,"abstract":"","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543730","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 relationship between ultrasound and electrodiagnostic findings in relation of the severity of carpal tunnel syndrome.","authors":"Seyed Mansoor Rayegani, Rashin Malekmahmoodi, Kianmehr Aalipour, Farshad Nouri","doi":"10.1186/s12891-024-07987-w","DOIUrl":"10.1186/s12891-024-07987-w","url":null,"abstract":"<p><strong>Introduction: </strong>Carpal tunnel syndrome is the most common compression neuropathy. Grading the severity of carpal tunnel syndrome is an important factor in deciding on the type of treatment. This study aims to determine the relationships between the findings of the electrodiagnosis and ultrasonography methods based on the severity of carpal tunnel syndrome.</p><p><strong>Methods: </strong>In this prospective clinical study, 50 patients (96 wrists) who were referred to the Physical Medicine and Rehabilitation Department of the Shohada Tajrish Hospital, Tehran, Iran (from March 2021 to November 2022) were studied. All patients with a history and clinical examination related to CTS underwent electrodiagnosis studies. Based on the results of electrodiagnosis, patients were divided into three groups: mild, moderate, and severe. All eligible patients underwent ultrasound at the cross-section of the wrist (at the level of the pisiform bone, the entrance of the canal) and the middle of the forearm.</p><p><strong>Results: </strong>In this study, the cross-sectional area of the median nerve was measured in 96 wrists of 50 patients with a mean age of 51.78 ± 9.80 years. The mean CSA of the median nerve in the mild, moderate, and severe groups was reported as 0.12 ± 0.03, 0.14 ± 0.02, and 0.21 ± 0.06, respectively. The mean WFR in different groups of CTS was reported as 1.85 ± 0.56, 1.93 ± 0.56, and 2.45 ± 0.49, respectively. A significant relationship between ultrasound findings, including CSA-inlet and WFR, and electrodiagnosis findings was presented (P value < 0.05).</p><p><strong>Conclusion: </strong>Based on our findings, there is a statistically significant relationship between the sonographic findings, including the mean CSA-inlet and WFR, and the severity of CTS based on the electrodiagnosis study. Our findings revealed that as disease severity increases, sonographic parameters also increase significantly.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543642","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":"Unique characteristics of bone union at the infected vertebrae after minimally invasive posterior fixation without bone grafting in thoracolumbar pyogenic spondylitis: a retrospective multicenter cohort study.","authors":"Hisanori Gamada, Toru Funayama, Keigo Nagasawa, Takane Nakagawa, Shun Okuwaki, Kaishi Ogawa, Yosuke Shibao, Katsuya Nagashima, Kengo Fujii, Yosuke Takeuchi, Masaki Tatsumura, Itsuo Shiina, Tsukasa Nakagawa, Masashi Yamazaki, Masao Koda","doi":"10.1186/s12891-024-07993-y","DOIUrl":"10.1186/s12891-024-07993-y","url":null,"abstract":"<p><strong>Background: </strong>The current study aimed to evaluate the bone union rate between infected vertebrae after minimally invasive posterior fixation without bone grafting in thoracolumbar pyogenic spondylitis.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study evaluated 75 patients of posterior fixation for thoracolumbar pyogenic spondylitis that have been recorded at six relevant institutions from January 2016 to December 2022. Data on age, sex, location of infected vertebrae, number of infected disks, comorbidity, Pola classification, number of vertebrae fixed according to surgery, implant failure requiring revision surgery, and distance according to the type of infected vertebrae after surgery were evaluated. Further, their association with postoperative bone union was investigated > 12 months postoperatively.</p><p><strong>Results: </strong>Finally, 40 patients were included in the study. In total, 32 (80%) patients achieved bone union at the infected vertebrae after minimally invasive posterior fixation without bone grafting. The mean duration from surgery to union was 10.7 months. Twenty-six (65%) patients initially achieved bone union at the lateral and/or anterior bridging callus. Patients with multiple-level infected disks (33%, 2/6 patients) had a lower bone union rate than those with a single-level infected disk (88%, 30/34 patients) (p = 0.0095).</p><p><strong>Conclusions: </strong>In 80% of patients, bone union at the infected vertebrae was achieved after minimally invasive posterior fixation without bone grafting in thoracolumbar pyogenic spondylitis. A total of 65% of the patients achieved initial bone union at the lateral and/or anterior bridging callus. Moreover, patients with multiple-level infected disks had a low bone union rate. Hence, the treatment strategy should be cautiously considered.</p><p><strong>Trial registration: </strong>This study was registered retrospectively and all procedures used in this study including the review of patient records were approved by the institutional review board.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543644","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":"Transcutaneous CO₂ application combined with low-intensity pulsed ultrasound accelerates bone fracture healing in rats.","authors":"Kenichi Sawauchi, Tomoaki Fukui, Keisuke Oe, Takahiro Oda, Ryo Yoshikawa, Kyohei Takase, Shota Inoue, Ryota Nishida, Ryosuke Kuroda, Takahiro Niikura","doi":"10.1186/s12891-024-07976-z","DOIUrl":"10.1186/s12891-024-07976-z","url":null,"abstract":"<p><strong>Background: </strong>Low-intensity pulsed ultrasound (LIPUS) is a non-invasive therapy that accelerates fracture healing. As a new treatment method for fracture, we recently reported that the transcutaneous application of CO₂ accelerated fracture healing in association with promoting angiogenesis, blood flow, and endochondral ossification. We hypothesized that transcutaneous CO₂ application, combined with LIPUS, would promote bone fracture healing more than the single treatment with either of them.</p><p><strong>Methods: </strong>Femoral shaft fractures were produced in 12-week-old rats. Animals were randomly divided into four groups: the combination of CO₂ and LIPUS, CO₂, LIPUS, and control groups. As the transcutaneous CO₂ application, the limb was sealed in a CO₂-filled bag after applying hydrogel that promotes CO₂ absorption. Transcutaneous CO₂ application and LIPUS irradiation were performed for 20 min/day, 5 days/week. At weeks 1, 2, 3, and 4 after the fractures, we assessed the fracture healing process using radiography, histology, immunohistochemistry, real-time PCR, and biomechanical assessment.</p><p><strong>Results: </strong>The fracture healing score using radiographs in the combination group was significantly higher than that in the control group at all time points and those in both the LIPUS and CO₂ groups at weeks 1, 2, and 4. The degree of bone fracture healing in the histological assessment was significantly higher in the combination group than that in the control group at weeks 2, 3, and 4. In the immunohistochemical assessment, the vascular densities of CD31- and endomucin-positive microvessels in the combination group were significantly higher than those in the control and LIPUS groups at week 2. In the gene expression assessment, significant upregulation of runt-related transcription factor 2 (Runx2) and vascular endothelial growth factor (VEGF) was detected in the combination group compared to the LIPUS and CO₂ monotherapy groups. In the biomechanical assessment, the ultimate stress was significantly higher in the combination group than in the LIPUS and CO₂ groups.</p><p><strong>Conclusion: </strong>The combination therapy of transcutaneous CO₂ application and LIPUS had a superior effect in promoting fracture healing through the promotion of angiogenesis and osteoblast differentiation compared to monotherapy.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543643","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":"Elastic stable intramedullary nailing in paediatric diaphyseal forearm fractures - a retrospective analysis of 201 cases.","authors":"Katarzyna Kwas, Marcin Mostowy, Klaudia Szatanik, Krzysztof Małecki","doi":"10.1186/s12891-024-07959-0","DOIUrl":"10.1186/s12891-024-07959-0","url":null,"abstract":"<p><strong>Background: </strong>Forearm shaft fractures are common injuries, often caused by falling from a fully-upright position or falling off a bike. They can be treated nonoperatively or surgically with intramedullary nailing or plates. The method of choice for treating pediatric forearm shaft fractures is the application of elastic stable intramedullary nailing (ESIN)|. The aim of the study was to evaluate ESIN in pediatric patients with forearm shaft fractures based on radiological images, and determine the etiology and complication rate associated with the injury.</p><p><strong>Methods: </strong>The study included 201 patients, 30.5% female 69.5% male, aged 1 to 17 years (mean 9.1 years; SD = 3.2), all had been diagnosed with a fracture of the forearm shaft and had been treated surgically with ESIN. In addition, all possessed a complete set of X-ray images and had attended a minimum six-month follow-up examination of the forearm. Axial alignment was evaluated retrospectively in the anatomical (AP) and lateral (LAT) positions. In total, 402 radiographs were examined. Of the injuries, 68% occurred during sports activity and 75% involved both the radius and the ulna.</p><p><strong>Results: </strong>Union was observed in all cases. Mean axial alignment values in AP and LAT X-ray or both the ulna and radius were satisfactory. Axial alignment values were not influenced significantly by age, type of surgery, type of fracture or etiology. Plaster cast application (9.8% of cases) significantly influenced radius axial alignment. The complication rate was 11.4% (n = 23). Significantly more complications were observed in patients receiving open reduction internal fixation (ORIF) (p = 0.0025).</p><p><strong>Conclusion: </strong>The ESIN technique is an effective treatment for forearm diaphyseal fractures in children, with good results regarding reduction and bone healing, indicated by x-ray.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495221","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":"Five states of reduction in OTA/AO A1.3 intertrochanteric fractures of the femur a biomechanical study.","authors":"Shu Li, Yong-Gang Bao, Rong-Hua Tian, Chun-Yang Meng, Hai-Bin Wang, Bin Wu, Xian-Min Bu","doi":"10.1186/s12891-024-07990-1","DOIUrl":"10.1186/s12891-024-07990-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyze the differences in mechanical stability of OTA/AO 31A1.3 intertrochanteric fractures under various reduction conditions.</p><p><strong>Methods: </strong>Twenty standard synbone artificial femur test bones were selected for the OTA/AO 31A1.3 intertrochanteric fracture model. The models were divided into five groups according to their reduction state: positive support, neutral support, negative support, varus fixation, and valgus fixation, with four specimens in each group. All models were fixed using PFNA intramedullary fixation and subjected to static axial compression tests. The subsidence displacement of the proximal femur under different loads and the axial stiffness of the model were measured to verify the mechanical stability of the OTA/AO 31A1.3 intertrochanteric fracture under different reduction conditions.</p><p><strong>Results: </strong>After the static axial compression test, the proximal femoral subsidence displacement in the positive support and neutral support groups was lower than that in the negative support, valgus fixation, and varus fixation groups (p < 0.001). The axial stiffness of the model was highest in the positive support group. Significant differences in subsidence displacement and axial stiffness were found between the groups (p < 0.001). The positive support group demonstrated the best mechanical stability, while the varus fixation group showed the poorest performance.</p><p><strong>Conclusion: </strong>Positive support of the medial cortex can be regarded as the best reduction state for OTA/AO 31A1.3 intertrochanteric fractures, suggesting that this approach should be preferred during surgery to enhance mechanical stability and improve clinical outcomes. Conversely, varus fixation should be avoided due to its inferior stability.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495224","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":"Safety and efficacy of placental mesenchymal stromal cells-derived extracellular vesicles in knee osteoarthritis: a randomized, triple-blind, placebo-controlled clinical trial.","authors":"Najmeh Sadat Bolandnazar, Seyed Ahmad Raeissadat, Hamidreza Haghighatkhah, Seyed Mansoor Rayegani, Rasa Salmani Oshnari, Saeed Heidari Keshel, Mohammad Zahraei, Kianmehr Aalipour, Marzieh Babaee, Amir Zamani, Zahra Besharati Rad, Masoud Soleimani, Farshid Sefat","doi":"10.1186/s12891-024-07979-w","DOIUrl":"10.1186/s12891-024-07979-w","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis causes pain and disability in many people worldwide, for which no definitive treatment has yet been proposed. In this study, we investigated the safety and efficacy of placental mesenchymal stromal cells-derived extracellular vesicles in patients with knee osteoarthritis.</p><p><strong>Methods: </strong>This triple-blind, randomized clinical trial included patients suffering from bilateral knee osteoarthritis with grade 2 or 3. The knees of each patient were randomized to intervention and control. For the intervention knee, 5 cc of placental mesenchymal stromal cells-derived extracellular vesicles were injected, and for the control knee, 5 cc of normal saline was injected. The patients' symptoms were evaluated before the intervention and 2 and 6 months after the intervention using VAS, WOMAC questionnaire, and Lequesne index. MRI was performed before the intervention and 6 months after the intervention to evaluate retropatellar and tibiofemoral cartilage volume, medial and lateral meniscal disintegrity, ACL injury, and effusion-synovitis.</p><p><strong>Results: </strong>62 knees (31 patients) were enrolled in this study. There were 31 knees as intervention and 31 knees as control. Finally, the data of 58 knees (29 patients) were analyzed, including 28 women and 1 man. The mean age of the patients was 55.38 ± 6.07 years. No statistically significant difference was detected between the two groups in clinical outcomes (including VAS, WOMAC, and Lequesne scores) before treatment and 2 and 6 months after treatment. Also, no statistically significant difference was detected between the two groups in MRI findings before treatment and 6 months after treatment. No systemic complications or severe local reactions occurred in the patients.</p><p><strong>Conclusion: </strong>A single intra-articular injection of placental mesenchymal stromal cells-derived extracellular vesicles (5 cc, 7 × 10⁹ particles/cc) is safe, but does not improve clinical symptoms or MRI findings in knee osteoarthritis beyond placebo. The protocol of this study was approved on 11 May 2022 with registration number IRCT20210423051054N1.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495240","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}