BMC Musculoskeletal Disorders最新文献

{"title":"Why is it worth carefully assessing the way hemiplegic sitting and standing up?","authors":"Agnieszka Wareńczak-Pawlicka, Przemysław Lisiński","doi":"10.1186/s12891-025-08833-3","DOIUrl":"10.1186/s12891-025-08833-3","url":null,"abstract":"<p><strong>Background: </strong>Sitting up and rising are basic daily activities that can become seriously impaired due to a stroke. This dysfunction can be a reason for limiting the ability to perform other daily activities. The aim of the study was to conduct functional and kinematic estimation of abnormalities of sitting down and getting up in people after a stroke.</p><p><strong>Methods: </strong>Twenty-nine patients after stroke (mean age: 52.9 ± 7.8) and 29 healthy volunteers (mean age: 50.9 ± 7.4) were included in this study. The wireless sensors and functional tests, such as the 30-s Chair Stand Test (30CST) and The Five Times Sit-to-Stand Test (FTSST), were used to assess functionally and kinematically of the movement of getting up and sitting down. The force platform was used to assess the symmetry index (SI).</p><p><strong>Results: </strong>A significantly higher mean square error (MSE) was observed in the paretic limb compared to the control limb (p = 0.037) during sitting on a chair. A lower average angular velocity of the knee joint of the paretic limb compared to the non-paretic limb (p = 0.027) was observed while getting up from a chair. Stroke survivors needed more time to perform the FTSST test (p < 0.001) and performed fewer repetitions of getting up and sitting down in the 30CST test (p < 0.001) than healthy volunteers. Compared to the control group, more significant limb load asymmetry in the standing position was observed in the study group (p < 0.001).</p><p><strong>Conclusions: </strong>The differences detected between stroke patients with hemiparesis and healthy individuals in the results of kinematic and functional tests allow for the direction of lower limb therapy in patients in the early period of post-stroke rehabilitation.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"563"},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233195","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":"Effect of heel height on lower limb biomechanics during stair descent in young women: a laboratory study.","authors":"Yue Wang, Xiaoqin Yan, Gang Ma, Wei Sun, Hailong Xu, Jiangna Wang","doi":"10.1186/s12891-025-08826-2","DOIUrl":"10.1186/s12891-025-08826-2","url":null,"abstract":"<p><strong>Background: </strong>Stair descent in high heels is risky for young women. Existing studies have focused on level walking, but research on stair descent biomechanics with different heel heights is limited. This study aimed to investigate the effects of heel heights on the biomechanical parameters of the lower limbs, joint stiffness and work pattern in young women during stair descent.</p><p><strong>Methods: </strong>Twenty-five young women walked downstairs wearing high heels heights (1 cm, 3 cm, 5 cm, and 7 cm). Kinematic and kinetic data of the lower limb joints were synchronously collected using the Vicon infrared motion capture system and AMTI force plates.</p><p><strong>Results: </strong>The ankle stiffness decreased at 3 cm (P = 0.035), 5 cm (P < 0.001) and 7 cm (P < 0.001), compared with a heel height of 1 cm. The ankle joint net work significantly decreased at 7 cm compared with 1 cm (P = 0.017) and 3 cm (P = 0.003). The work contribution of the ankle joint significantly decreased at 7 cm compared with 1 cm (P = 0.017) and 3 cm (P = 0.003).</p><p><strong>Conclusion: </strong>Young women wearing 7 cm heels significantly affected ankle biomechanics during stair descent, reducing ankle net work, work contribution, and stiffness. Therefore, it is recommended that young women prioritize footwear with heel heights below 7 cm during stair descent.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"556"},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214964","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 role of high knee range of motion at discharge on functional outcome after total knee arthroplasty: a retrospective cohort study.","authors":"Jimin Ma, Yakun Zhu, Zhen Dong, Ziming Guo, Rui Song, Wendan Cheng","doi":"10.1186/s12891-025-08802-w","DOIUrl":"10.1186/s12891-025-08802-w","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to investigate the impact of high knee range of motion at discharge on functional outcome after total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>We conducted a retrospective study of 136 patients with primary osteoarthritis who were treated between January 2022 and June 2023. Patients were classified according to the type of rehabilitation program: high range of motion (HROM) group or control group. In the HROM group, patients underwent high-intensity rehabilitation, especially without restricting the range of motion (ROM) following knee surgery. In the control group, patients received routine rehabilitation, with the affected knee achieving approximately 90 degrees of flexion at discharge. Patients' data related to postoperative knee ROM, Hospital for Special Surgery (HSS) score, visual analogue scale (VAS) score, transfusion rate, wound complications, thrombus of lower limb, and usage of analgesic drugs were recorded to assess the influence of ROM at discharge on clinical outcomes.</p><p><strong>Results: </strong>The HROM group had a higher knee ROM compared to the control group at discharge (P < 0.001). There were no significant differences between the HROM group and the control group in the basic demographic information, hospital stay and operation time (P > 0.05). HSS scores and knee ROM in the HROM group were significantly higher than those in the control group 1 and 2 months after surgery (P < 0.001). There were no significant differences in VAS at 1, 2 and 7 days after surgery between the two groups. The usage of analgesic drugs, wound complications, thrombus of lower limb, and transfusion rates were similar between the two groups (P > 0.05).</p><p><strong>Conclusions: </strong>High knee ROM at discharge achieved through high-intensity rehabilitation is an effective and simple way to improve early knee mobility and function. The routine application of this protocol did not increase the incidence of wound complications.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"555"},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214983","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":"Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population.","authors":"Jou-Hua Wang, Shu-Hsin Yao, Ting-Ming Wang, Chii-Jeng Lin, Chang-Hao Lin, Chun-Ho Chen","doi":"10.1186/s12891-025-08740-7","DOIUrl":"10.1186/s12891-025-08740-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the effectiveness of integrating Graf method into the universal neonatal screening program for detecting developmental dysplasia of the hip (DDH) in Taiwanese population.</p><p><strong>Methods: </strong>A total of 4,667 neonates screened between May 2014 and November 2019 were enrolled in this study. Hip ultrasound scans were performed three days after birth, and hips were classified based on their morphology and stability. The incidence rates of early diagnosis, late diagnosis, and surgical interventions for DDH were assessed. Risk factors and treatment measures for DDH were documented.</p><p><strong>Results: </strong>During the initial examination, 95.95% of hips were classified as Graf type I, while a small proportion were classified as types IIa, IIc (stable/unstable), or III. By the second examination at 4 weeks, all type IIa hips had matured to type I. A total of 35 hips (0.37%) were diagnosed with DDH and treated with a Pavlik harness before 12 weeks, resulting in an early diagnosis rate of 0.37%, with no cases of late diagnosis reported. The incidence of DDH-related surgeries was 0.04%. Multivariable logistic regression identified female sex (OR = 2.41, 95% CI: 1.05-5.52, p = 0.038) and breech presentation (OR = 6.54, 95% CI: 2.22-19.32, p < 0.001) as significant risk factors for DDH.</p><p><strong>Conclusion: </strong>Universal neonatal ultrasound screening using the Graf method is simple and beneficial in the early detection and intervention of DDH. Additionally, it significantly reduces the rates of late diagnosis and the need for surgical intervention.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"551"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214910","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":"Effectiveness of stationary cycling with electromyographic biofeedback on neuromuscular control and function in individuals with knee osteoarthritis: a feasibility study.","authors":"Chia-Ming Chang, Huynh Chung, Horng-Chaung Hsu, Li-Tzu Chen, Ruei-Yi Lin, Hsiu-Chen Lin","doi":"10.1186/s12891-025-08794-7","DOIUrl":"10.1186/s12891-025-08794-7","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effects of stationary cycling with electromyographic (EMG) biofeedback on neuromuscular control and function in individuals with knee osteoarthritis (OA).</p><p><strong>Methods: </strong>Fourteen knee OA patients were randomized into two groups: cycling with EMG biofeedback of the vastus medialis (EBF group) and cycling without biofeedback (Cycling group). Both groups underwent a six-week cycling program, 30 min per session, twice a week. Outcomes were measured at baseline and post-training. Knee pain and function were assessed using the Visual Analog Scale and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Quadriceps strength and endurance were evaluated with an isokinetic machine, and muscle activation was recorded using a wireless EMG system. A two-way mixed-model analysis of variance (ANOVA) was used to assess the differences between sides and groups. For outcomes that were not normally distributed, the non-parametric Mann-Whitney U test was performed.</p><p><strong>Results: </strong>Both groups showed improvements in knee pain and function, with no significant differences between groups. Muscle strength remained largely unchanged, but the endurance was improved on the contralateral side (p = 0.038, η² = 0.312). Larger muscle activations were observed at various time points during the 30-minute cycling test in the EBF group with significant increases in muscle recruitment in the vastus medialis (p = < 0.001 ~ 0.042, η² = 0.482 ~ 0.996), rectus femoris (p = 0.003 ~ 0.040, η² = 0.493 ~ 0.859) and vastus lateralis (p = 0.002 ~ 0.036, η² = 0.534 ~ 0.875).</p><p><strong>Conclusions: </strong>A six-week cycling program can alleviate pain and enhance knee function. EMG biofeedback of the vastus medialis significantly changed the neuromuscular control in the rectus femoris and vastus lateralis during cycling. Therefore, this study demonstrated that stationary cycling combined with electromyographic biofeedback training can enhance neuromuscular control of the quadriceps and potentially improve functional performance in patients with OA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT03484910 (registered at March 31st, 2018).</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"547"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214911","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":"Single versus double tendon transfer for improving shoulder function in brachial plexus birth palsy: a meta-analysis of comparative studies.","authors":"Ahmed O Sabry, Mohamed K A Genedy, Yara Kassem, Marwa El-Difrawy, Reem Shalata, Maziad Hennidi, Farah A R Salama, Badr Ali Mohammed Badr, Mohamed Abdel-Wahed","doi":"10.1186/s12891-025-08803-9","DOIUrl":"10.1186/s12891-025-08803-9","url":null,"abstract":"<p><strong>Background: </strong>Obstetric brachial plexus palsy (OBPP) may result in lifelong shoulder dysfunction despite nerve repair surgery. Tendon transfer has emerged as a surgical option to restore external rotation and abduction in OBPP sequelae. Single and double tendon transfer techniques have been developed, but the optimal approach remains debated. This meta-analysis is the first to compare the range of motion outcomes and complications, particularly loss of midline function (LOM), between the two techniques in managing OBPP sequelae.</p><p><strong>Methods: </strong>On January 2025, systematic literature search was performed in five databases (PubMed, Cochrane Library, Embase, Scopus and Web of Science), to identify studies comparing single and double tendon transfer in children with OBPP. Eligible studies underwent quality assessment via MINORS criteria and a meta-analysis using RevMan was conducted to compare the functional outcomes and complications.</p><p><strong>Results: </strong>Five retrospective studies encompassing 189 patients were analyzed. The pooled mean difference (MD) in the total modified Mallet score between groups was statistically insignificant (MD = 0.09; 95% CI= -0.68 to 0.85;p > 0.05). Analyses for the sub-scores revealed no differences across all sub-scores. However, for Latissimus Dorsi (LD) single transfers, Abdel-Ghani et al. reported 7.7-fold greater odds of LOM (OR = 0.13; 95% CI = 0.04-0.42;p < 0.05), whereas the pooled LOM of Teres Major (TM) single transfers were not significantly different (OR = 0.40; 95% CI = 0.11-1.47;p > 0.05).</p><p><strong>Conclusion: </strong>In conclusion, our meta-analysis suggests that both single and double tendon transfers achieve comparable functional outcomes. However, the data suggests that LD single tendon transfer potentially lowers rate of LOM, though further research is needed to confirm this finding.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"554"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214982","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":"Physical examination tests in the acute phase of shoulder injuries with negative radiographs: a diagnostic accuracy study.","authors":"Martine Enger, Malte Schmidt, Lars Nordsletten, Stefan Moosmayer, Are Hugo Pripp, Knut Melhuus, Jens Ivar Brox","doi":"10.1186/s12891-025-08754-1","DOIUrl":"10.1186/s12891-025-08754-1","url":null,"abstract":"<p><strong>Background: </strong>Rotator cuff tears may easily be missed in patients with acute shoulder trauma. The evidence in support of shoulder physical examination tests has been considered insufficient in reviews and meta-analyses. The purpose of this study was to explore whether physical examination tests can effectively predict or rule out acute full-thickness rotator cuff tears in soft tissue shoulder injuries in emergency departments and primary health care.</p><p><strong>Methods: </strong>In a combined primary care walk-in clinic and secondary care orthopaedic emergency department, 120 consecutive patients aged ≥ 40 years with acute shoulder injury without fracture on plain x-rays were enrolled prospectively at the first follow-up within three weeks of the injury. Thirteen physical examination tests and ultrasound screening as reference standard, were performed blinded to each other.</p><p><strong>Results: </strong>The median age was 55 years, 51% were female. The prevalence of the target condition rotator cuff full-thickness tear and/or occult fracture of the insertion was 38% (n = 46; 38 tears and 8 occult avulsion fractures). Almost all tears involved the supraspinatus tendon (n = 36). The highest test accuracy was observed for the inability to abduct above 90°, resisted abduction pain and external rotation strength. The sensitivity, specificity and diagnostic odds ratio of the inability to abduct the arm above 90 ° was 84% (95% CI 69-93), 71% (95% CI 59-82) and 12.9 (95% CI 4.8-34.2), respectively, and 66% (51-80), 86% (77-93) and 12.4 (5.0-30.8) for external rotation strength assessed by the small finger test. Combining the inability to abduct above 90° and weakness in external rotation improved the sensitivity to above 90% and the diagnostic odds ratio to above 22, but specificity decreased.</p><p><strong>Conclusions: </strong>The present study suggests that two simple tests, the inability to abduct above 90° and weakness in external rotation may effectively predict full-thickness tears of the supra- and infraspinatus and/or occult fracture at their insertion in the acute phase of soft tissue shoulder injuries. The test combination may be useful for selecting patients for advanced imaging and for diagnostic purposes when such imaging is not available.</p><p><strong>Trial registration: </strong>The Norwegian Regional Ethics Committee South East (2015/195) on 24th March 2015, and retrospectively registered on ClinicalTrials.gov (NCT02644564) on 31st December 2015.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"546"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214915","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":"Rare case of systemic lupus with manifestation of FS Jaccoud arthropathy: a case report and literature review.","authors":"Shao-Yu Wang, Si-Peng Wang, Liang Kang, Zhi-Hui Pang","doi":"10.1186/s12891-025-08696-8","DOIUrl":"10.1186/s12891-025-08696-8","url":null,"abstract":"<p><strong>Background: </strong>François-Sigismond Jaccoud arthropathy (FSJA) is a rare, secondary joint disease characterised by joint deformities without bone erosions, with a \"reducible\" pattern. Substantial knowledge exists in this area; however, the pathogenesis of FSJA remains indefinite, and clear diagnostic criteria are lacking. Moreover, preventive measures and specialised treatment interventions for the development of FSJA are needed. Thus, in this novel report, we present the case of a 24-year-old male patient with secondary FSJA, characterised by a prolonged disease course, early atypical symptoms, and an unclear primary systemic lupus erythematosus (SLE) diagnosis. Our objective was to provide further guidance regarding the pathogenesis, diagnosis, and treatment of FSJA secondary to SLE.</p><p><strong>Case presentation: </strong>The patient presented with a 9-year medical history of polyarthralgia. Furthermore, a generalised rash of the lower limbs and hand deformities manifested over a 6-month duration, with symptoms worsening over a week. Physical examination revealed butterfly-shaped facial erythema, hand deformities, and arthralgia. Radiography revealed joint deformities without bone erosions. Laboratory findings indicated proteinuria, positive antinuclear antibodies, and decreased levels of complement components 3 and 4. Based on the 2019 European League Against Rheumatism/American College of Rheumatology classification criteria, the diagnoses of lupus nephritis (LN) and FSJA, secondary to SLE were made. The patient's SLE LN and joint symptoms improved after a year of intravenous belimumab infusion; in addition to oral methylprednisolone, hydroxychloroquine, and mycophenolate mofetil. Additionally, his hand deformities did not considerably worsen.</p><p><strong>Conclusions: </strong>FSJA secondary to SLE is rare; nonetheless, further attention and studies regarding this condition are required. Clinically, the differential diagnosis of FSJA should routinely be performed to avoid a misdiagnosis. The manifestation of early joint symptoms without joint deformation requires regular examinations of the joints, in patients with SLE. The early diagnosis and prompt management of FSJA will thus be ensured, reducing the impact on their quality of life.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"544"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214916","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":"Hydroxyapatite/collagen composite graft for anterior cervical discectomy and fusion: a comparison with Iliac crest bone graft.","authors":"Yu Matsukura, Takashi Hirai, Motonori Hashimoto, Kentaro Sakaeda, Kenichiro Sakai, Ichiro Torigoe, Kentaro Yamada, Masaki Tomori, Kyohei Sakaki, Shingo Morishita, Satoru Egawa, Hiroaki Onuma, Jun Hashimoto, Kurando Utagawa, Takuya Takahashi, Yoshiyasu Arai, Toshitaka Yoshii","doi":"10.1186/s12891-025-08782-x","DOIUrl":"10.1186/s12891-025-08782-x","url":null,"abstract":"<p><strong>Background: </strong>The iliac crest bone graft (ICBG) has been traditionally used as the gold standard for anterior cervical discectomy and fusion (ACDF). However, the complication rate associated with harvesting the tricortical ICBG is significantly high. Thus, this study aimed to investigate the efficacy of the hydroxyapatite/collagen (HAp/Col) composite graft combined with an intervertebral cage in ACDF.</p><p><strong>Methods: </strong>This was a retrospective study investigated 49 consecutive patients who underwent one- or two-level ACDF using the HAp/Col composite graft combined with an intervertebral cage at two institutions from March 2016 to January 2019. Clinical and radiological evaluations were performed before the surgeries and during the postoperative follow-up. Further, the outcomes of ACDF using the HAp/Col composite graft combined with the cage were compared with those of the tricortical ICBG without the cage.</p><p><strong>Results: </strong>The Japanese Orthopaedic Association (JOA) scores of the HAp/Col and ICBG groups at 2 years postoperatively improved significantly compared with those preoperatively. The two groups did not significantly differ in terms of the recovery rate based on the JOA scores at 2 years postoperatively. The fusion rates in the HAp/Col group (one-level, 95.7%; two-level, 92.0%) were comparable to those in ICBG group (one-level, 100%; two-level, 88.9%) at 2 years postoperatively. The surgical time was significantly shorter in the HAp/Col group (one-level, 113.2 min; two-level, 157.5 min) than in the ICBG group (one-level, 161.0 min; 2-level, 223.3 min) for both one- and two-level fusions. Intraoperative blood loss was significantly lower in the HAp/Col group than in the ICBG group in two-level fusion (HAp/Col, 34.1 g; ICBG, 215.4 g).</p><p><strong>Conclusions: </strong>The HAp/Col composite graft with an intervertebral cage could be a safe and effective alternative scaffold to the conventional autologous iliac tricortical grafts in ACDF.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"552"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214913","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":"Icariin-loaded composite scaffold promotes osteogenic differentiation and bone regeneration.","authors":"Dong-Sheng Jin, Zhang-Hong Zhao, Shi-Qiang Ruan, Wen-Liang Huang, Ren-Yuan Tian, Yu Wan, Jiang Deng","doi":"10.1186/s12891-025-08824-4","DOIUrl":"10.1186/s12891-025-08824-4","url":null,"abstract":"<p><strong>Background: </strong>Bone defects remain a significant challenge in orthopedics, and traditional treatments often face limitations. Icariin (ICA) has been shown to promote osteogenic differentiation and angiogenesis, which may benefit bone repair.</p><p><strong>Methods: </strong>ICA-loaded microspheres were prepared using an evaporation method with a co-solvent system. The encapsulation efficiency, drug loading, and release characteristics were evaluated. Silk fibroin/chitosan/nano-hydroxyapatite (SF/CS/nHA) composite scaffolds incorporated with ICA microspheres were fabricated using vacuum freeze-drying. Bone marrow mesenchymal stem cells (BMSCs) were cultured on these scaffolds in vitro. Scanning electron microscopy (SEM) was used to observe the morphology of microspheres and scaffolds, as well as cell adhesion. In vitro assessments of BMSC morphology, proliferation, and migration on different scaffolds were conducted using CCK-8 assays, live/dead staining, and scratch tests. Osteogenic differentiation was evaluated by alkaline phosphatase staining, Alizarin Red staining, immunofluorescence, RT-qPCR, and Western blotting. A rabbit radial critical-size bone defect model was established in vivo, and SF/CS/nHA-ICA composite scaffolds were implanted at the defect sites. Bone repair effects were assessed by CT imaging, hematoxylin-eosin (H&E) staining, and Masson's trichrome staining. Osteogenic and angiogenic protein expression levels were further analyzed by immunohistochemistry and Western blot.</p><p><strong>Results: </strong>In vitro experiments demonstrated that the SF/CS/nHA-ICA group had superior BMSC adhesion, cell morphology, proliferation, and osteogenic differentiation compared to other groups (P < 0.05). In vivo, evaluations indicated that the addition of ICA significantly enhanced bone regeneration and vascularization at the defect sites compared to control and other experimental groups. Western blot and immunohistochemical analyses confirmed significant upregulation of osteogenic and angiogenic proteins (type I collagen, runt-related transcription factor 2, osteocalcin, vascular endothelial growth factor) in the SF/CS/nHA-BMSCs-ICA group.</p><p><strong>Conclusion: </strong>ICA-loaded scaffolds effectively promote bone regeneration and repair of bone defects, offering a potential strategy for the treatment of bone defects.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"548"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214914","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}