BMC Musculoskeletal Disorders最新文献

{"title":"Short term efficacy of subtalar arthroscopy combined with medial calcaneal-talar joint distraction in minimally invasive treatment of diabetic patients with calcaneal fractures: a retrospective study.","authors":"Xiaoyu Dai, Kejie Wang, Chenyang Xu, Kai Ding, Yige Zhang, Wenge Ding","doi":"10.1186/s12891-024-07960-7","DOIUrl":"10.1186/s12891-024-07960-7","url":null,"abstract":"<p><strong>Background: </strong>The surgical treatment and management of postoperative soft tissue complications in diabetic patients with displaced calcaneal fractures are still controversial. We aimed to evaluate the short-term efficacy of percutaneous minimally invasive screw fixation in treatment of diabetic patients with Sanders II and III calcaneal fractures under subtalar arthroscopy assisted by preoperative musculoskeletal ultrasonic locating lateral calcaneal branch (LCB) of the sural nerve and calcaneal-talar joint distraction device.</p><p><strong>Methods: </strong>The clinical data of 52 diabetic patients diagnosed with Sanders II or III calcaneal fractures from March 2016 to August 2020 were followed up and analyzed. There were 23 patients of type II and 29 patients of type III, 34 males and 18 females, with a mean age of 61.7 ± 14.5 years (range: 45-72 years). Preoperative musculoskeletal ultrasonography was routinely examined to locate LCB of the sural nerve. During surgery, we performed arthroscopic percutaneous prying reduction screw fixation assisted by medial calcaneal-talar joint distraction. Incision healing, local skin paraesthesia and other conditions were observed regularly at 3 days, 6, 12 months, and the last follow-up after surgery. Also, we measured the length, width, height, Böhler angle, and Gissane angle of the calcaneus on lateral and axial x-rays. Visual analogue pain scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score and Maryland score were used to evaluate the efficacy.</p><p><strong>Results: </strong>52 patients were followed up for 23.7 ± 3.2 months (range: 20-28 months) without incision-related complications. Calcaneal radiographic parameters (length, width, height, Böhler/Gissane angle) were improved after surgery, and the differences were all statistically significant (P<0.05). There was no difference between calcaneal radiographic parameters at 6,12 months and the last follow-up compared with 3 days after surgery without significant loss in overall morphology (P>0.05). Postoperative VAS, AOFAS scores, and Maryland scores were significantly improved compared with those before surgery (P<0.05).</p><p><strong>Conclusions: </strong>Preoperative ultrasonic locating LCB of the sural nerve and arthroscopic percutaneous minimally invasive screw fixation of Sanders II and III calcaneal fractures with the assistance of calcaneal-talar joint distraction have good short-term efficacy and clinical feasibility in diabetic patients.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495242","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 affecting cervical spondylotic myelopathy complicated with traumatic central cord syndrome and the efficacy of different treatment options.","authors":"Yongwei Sun, Ping Li, Xin Jin, Kai Guan, Hongjun Huo","doi":"10.1186/s12891-024-07918-9","DOIUrl":"10.1186/s12891-024-07918-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze the influencing factors and treatment options of cervical spondylotic myelopathy (CSM) complicated with traumatic central cord syndrome (TCCS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 243 patients with CSM admitted to our hospital from January 2021 to September 2022 were retrospectively analyzed, and then divided into the control group (n = 152) and the observation group (n = 91) according to the presence or absence of concurrent TCCS. The clinical data and imaging data of the two groups were compared, and multivariate logistic regression was used to analyze the influencing factors of CSM complicated with TCCS. Patients in the observation group were further divided into the zero notch anterior cervical interbody fusion device (Zero-P) group (n = 45) and the cervical spine locking plate (CSLP) group (n = 46) according to the treatment mode, and the perioperative indexes of the two groups were compared. The treatment effects were evaluated by the American Spinal Injury Association (ASIA) and the Japanese Orthopedic Association (JOA) before surgery, 1 week after surgery and 6 months after surgery. The height of intervertebral space and the cervical lordosis angle were measured.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Multivariate logistic regression analysis showed that the injury mechanism (hyperextension injury), hand muscle weakness, cervical instability, age, degree of cervical spinal stenosis, degree of cervical spinal cord compression, and changes in intramedullary high signal were the risk factors, while the type of compression (soft), ASIA score and JOA score were the protective factor for CSM complicated with TCCS (P &lt; 0.05). Patients in Zero-P group had much shorter operation time and hospitalization time than these in CSLP group (P &lt; 0.05). The cervical lordosis angle and intervertebral space height at 1 week and 6 months after operation in the two groups were both largely higher than these before operation, and the cervical lordosis angle and intervertebral space height in the Zero-P group were significantly higher than these in the CSLP group one week after surgery (P &lt; 0.05). The ASIA score and JOA score were obviously increased in the two groups 1 week and 6 months after surgery, and the ASIA score and JOA score in the Zero-P group were significantly higher than these in the CSLP group at 1 week after surgery (P &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The mechanism of TCCS in CSM is still controversial, which it is generally believed to be caused by cervical hyperextension injury. The clinical symptoms are diverse, and the treatment methods are also different. This study shows that the mechanism of injury, type of compression, hand muscle weakness, cervical instability, age, cervical stenosis compression, and intramedullary high signal changes are all risk factors for CSM complicated with TCCS. Early identification of risk factors and targeted interventions can effectively reduce the complicate","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495239","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":"Comprehensive classification and its value of capitellar cartilage injury concomitant with radial head fracture.","authors":"Huanxiang Bao, Guoyou Zou, Zhengchun Cao, Haifeng Li, Xiaofei Shen","doi":"10.1186/s12891-024-07851-x","DOIUrl":"10.1186/s12891-024-07851-x","url":null,"abstract":"<p><strong>Background: </strong>There are defects in the existing classification of capitellar cartilage injury (CCI) concomitant with radial head fracture (RHF). This study aimed to introduce a comprehensive classification of CCI and to analyze its surgical guidance value.</p><p><strong>Methods: </strong>According to the affected site and severity, CCI was classified into four types: Type I - partial-thickness loss of articular cartilage, Type II - full-thickness loss of articular cartilage, Type III - full-thickness loss of articular cartilage with subchondral bone loss, Type IV - full-thickness loss of articular cartilage with thin cortex loss on the border of the capitellum; Different types suggest different surgical methods. Between January 2017 and January 2023, this comprehensive CCI classification was applied in 31 operated patients with CCI concomitant with RHF. The ranges of motion (ROM), Mayo Elbow Performance Index (MEPI) score, Hospital for Special Surgery (HSS) score and visual analog scale (VAS) for pain, were used to evaluate the functional recovery of the affected limb.</p><p><strong>Results: </strong>Mason Type I-IV RHF accounted for 6.45%, 38.71%, 48.39%, and 6.45%, respectively. Type I-IV CCI accounted for 12.90%, 35.48%, 45.16% and 6.45%, respectively. There was no relationship between the CCI and RHF types (p > 0.05). At the end of the follow-up period of 11-26 months with an average of 16 months, the elbow flexion and extension ROM recovered to (147.39 ± 9.84)°, forearm rotation ROM recovered to (168.74 ± 11.70)°, MEPI score recovered to (89.19 ± 4.17), HSS score recovered to (88.74 ± 4.62), VAS score recovered to (0.50 ± 0.57), indicating significant differences compared to preoperative measurements (p < 0.05). According to the MEPI and HSS scores, the excellent and good rate of functional recovery was 100%.</p><p><strong>Conclusion: </strong>Different types of CCI differ not only in pathology but also in treatment methods. Surgical strategy according to the comprehensive CCI classification introduced in this paper may lead to a satisfactory outcome.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495208","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 cervical traction on cervicogenic headache in patients with cervical radiculopathy: a preliminary randomized controlled trial.","authors":"Anis Jellad, Amine Kalai, Amr Chaabeni, Cyrine Ben Nasrallah, Atef Ben Nsir, Mahbouba Jguirim, Asma Belguith Sriha, Zohra Ben Salah Frih, Mohamed Hedi Bedoui","doi":"10.1186/s12891-024-07930-z","DOIUrl":"10.1186/s12891-024-07930-z","url":null,"abstract":"<p><strong>Background: </strong>Cervical radiculopathy (CR) is a common condition, often associated with cervicogenic headache (CGH), a secondary headache arising from cervical spine disorders. Mechanical intermittent cervical traction (MICT) is frequently prescribed to treat CR symptoms. The purpose of the study was to make a preliminary estimate of efficacy of adding MICT to conventional rehabilitation on CGH in patients with cervical radiculopathy.</p><p><strong>Methods: </strong>A total of 36 CR patients with CGH were randomly allocated to 3 equally sized groups (A, B and C). The treatment consisted of twelve sessions of conventional rehabilitation (4 weeks) combined with MICT (2 kg for group A, 8 kg for group B and 12 kg for group C). Primary outcomes were CGH intensity (visual analog scale) and frequency (days per week). Secondary outcomes were radicular pain intensity (visual analog scale), cervical range of motion (cervical range of motion instrument), proprioception (cervical range of motion instrument) and muscle strength (MicroFET2 dynamometer), handgrip strength (handheld dynamometer), function (Neck Disability Index), kinesiophobia (Tampa Scale for KInesiophobia), anxiety and depression (Hospital Anxiety and Depresion questionnaire), and quality of life (World Health Organization Quality of Life). Patients were assessed at baseline, one, three and six months after the beginning of treatment. The post hoc Dunn testing was used to determine which traction load had the better effect on CGH symptoms.</p><p><strong>Results: </strong>At one, three and six months follow-ups, Group C exhibited the highest improvement in CGH intensity and frequency compared to the other groups (p = 0.021 and p = 0.023; p = 0.012 and p = 0.01; p = 0.005 and p = 0.005). Both groups C and B showed a significant improvement in radicular pain compared to group A at one month follow-up (p = 0.05).The improvement in group C was significantly better in terms of function (p = 0.049) and anxiety (p = 0.011) at three months and quality of life at six months (Psychological p = 0.046 and Environment p = 0.006).</p><p><strong>Conclusions: </strong>The blend of conventional rehabilitation alongside 12 kg MICT seems to be efficacious in diminishing both the intensity and frequency of CGH in patients with CR. These advantages appear to last for up to six months following the treatment period, potentially leading to decreased CGH severity and occurrence rates, heightened functionality, reduced anxiety levels, and an overall enhancement in quality of life. These findings are preliminary and require confirmation in larger trials.</p><p><strong>Trial registration: </strong>The study protocol was retrospectively registered at the Pan African Clinical Trial Registry (PACTR202401838955948). Date of registration is 16/01/2024.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495219","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":"Direct repair of the chronic ochronotic Achilles tendon rupture: a case report.","authors":"Takuji Yokoe, Makoto Nagasawa, Takuya Tajima, Nami Yamaguchi, Tomomi Ota, Yudai Morita, Etsuo Chosa","doi":"10.1186/s12891-024-07973-2","DOIUrl":"10.1186/s12891-024-07973-2","url":null,"abstract":"<p><strong>Background: </strong>Alkaptonuria (AKU) is a rare hereditary disease. Ochronotic arthropathy, tendinopathy, and osteopenia/osteoporosis are generally musculoskeletal manifestations in patients with AKU. Because of the ochronotic tendinopathy and osteopenia, the surgical strategy for chronic ochronotic Achilles tendon rupture may be challenging. No studies have reported the surgical treatment of chronic Achilles tendon rupture in patients with AKU.</p><p><strong>Case presentation: </strong>We report a case of AKU that required surgical treatment for chronic Achilles tendon rupture. A 60-year-old woman was referred to our department for the assessment of left hindfoot pain that persisted for more than nine months after an ankle sprain. Three years prior to the first presentation to our hospital, she was diagnosed with AKU due to pigmented hip cartilage at the time of total hip arthroplasty. The patient was diagnosed as chronic Achilles tendon rupture based on the results of physical examination and magnetic resonance imaging (MRI). The MRI showed enlarged scar tissue of the Achilles tendon with an intrasubstance high signal intensity. We performed resection of the central part of the scar tissue (total length, 24 mm) followed by direct repair using the proximal and distal stumps of the scar tissue. The MRI at 12months after surgery showed continuity of the repaired Achilles tendon. At 18 months after surgery, the Achilles Tendon Total Rupture Score improved from 22 points preoperatively to 84 points postoperatively. The foot and ankle outcome score also improved.</p><p><strong>Conclusions: </strong>We reported a case of AKU with chronic Achilles tendon rupture in which direct repair using scar tissue between the tendon stumps was effective. Careful selection of the surgical procedure for the treatment of chronic ochronotic Achilles tendon rupture is recommended because of concomitant ochronotic tendinopathy and osteopenia/osteoporosis.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495210","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":"Combination of different local anesthetic adjunct for supraclavicular brachial plexus block after arthroscopic shoulder surgery: a prospective randomized controlled trial.","authors":"Jiangping Wu, Guizhen Chen, Xiaolin Quan, Han Shu, Guangyou Duan, Bin Shu, Ting Wang, He Huang, Yuanjing Chen, Mao Nie","doi":"10.1186/s12891-024-07982-1","DOIUrl":"10.1186/s12891-024-07982-1","url":null,"abstract":"<p><strong>Background: </strong>Acute pain is a major concern after arthroscopic shoulder surgery, supraclavicular brachial plexus blockade has shown favorable postoperative analgesic effects. However, its duration of analgesia does not meet clinical needs. We aimed to explore whether the combination of different local anesthetic adjunct can prolong the analgesic duration of supraclavicular brachial plexus block for arthroscopic shoulder surgery.</p><p><strong>Methods: </strong>In this prospective randomized controlled trial, we allocated 80 patients into four groups: Group DMD (dexamethasone 10 mg + ropivacaine 100 mg + dexmedetomidine 50 µg + magnesium sulfate 250 mg), Group DM (ropivacaine 100 mg + dexmedetomidine 50 µg + magnesium sulfate 250 mg), Group M (ropivacaine 100 mg + magnesium sulfate 250 mg) and Group D (ropivacaine 100 mg + dexmedetomidine 50 µg). The primary outcome was the time to first request for analgesia. Secondary outcome measures included cumulative opioid consumption at 6, 12, 18, 24, and 48 h postoperatively, VAS scores at 6, 12, 18, 24, and 48 h postoperatively and so on.</p><p><strong>Results: </strong>The time to first request for analgesia in Group DMD was significantly longer than Group DM (P = 0.011) and Group M (P = 0.003). The cumulative opioid consumption at 18 h postoperatively in Group DMD was significantly lower than in Group DM (P = 0.002) and Group M (P = 0.007). The cumulative opioid consumption at 24 h postoperatively in Group DMD was significantly lower than in Group DM (P = 0.016). The VAS score at 6 h postoperatively in Group DMD was significantly lower than in Group DM and Group M. The VAS score at 12 h postoperatively in Group DMD was significantly lower than in Group M. For American Shoulder and Elbow Surgeons Score, Group DMD had a better score than Group DM and Group D.</p><p><strong>Conclusions: </strong>The analgesic efficacy of supraclavicular brachial plexus blockade combined with dexamethasone, magnesium sulfate, and dexmedetomidine is significantly superior to the combination of magnesium sulfate and dexmedetomidine, and significantly superior to the use of magnesium sulfate alone.</p><p><strong>Trial registration: </strong>This trial was registered in Chinese Clinical Trial Registry. (ChiCTR2200061181, Date of registration: June 15, 2022, http://www.chictr.org.cn ).</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495204","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":"Decreased volume of rectus femoris and iliocapsularis in patients with femoroacetabular impingement syndrome after primary hip arthroscopy.","authors":"Yichuan Zhu, Rongge Liu, Yuang Hao, Beibei Tao, Rui Sun, Guanying Gao, Yan Xu","doi":"10.1186/s12891-024-07965-2","DOIUrl":"10.1186/s12891-024-07965-2","url":null,"abstract":"<p><strong>Purpose: </strong>(1) to investigate the consecutive changes in hip muscle volume in patients with femoroacetabular impingement syndrome (FAIS) during the initial postoperative period, and (2) to determine the potential effect of the early changes in hip muscle volume on clinical outcomes.</p><p><strong>Methods: </strong>Data between March 2021 and March 2022 was reviewed. Patients diagnosed with FAIS based on clinical symptoms and radiographic findings, and undergoing hip arthroscopic treatment were included. Exclusion criteria were incomplete MRI data, prior history of hip surgery, and concomitant hip conditions including hip osteoarthritis with a Tönnis grade > 1, avascular necrosis, Legg-Calvé-Perthes disease, osteoid osteoma, synovial chondromatosis, pigmented villonodular synovitis, and developmental dysplasia of the hip (DDH). MRI was performed preoperatively and 3, 6, 12-month postoperatively. Cross-sectional area (CSA) of hip muscles including rectus femoris (RF), iliocapsularis (IC), iliopsoas (IP), gluteus medius/minimus complex (G-med/min), and gluteus maximus (G-max) were collected on MRI. The CSA was corrected by body surface area (BSA). Preoperative and a minimum of 2-year postoperative patient-reported outcome (PRO) scores including Visual Analog pain Scale (VAS), modified Harris Hip Score (mHHS), and international Hip Outcome Tool, 12-component form (iHOT-12) were collected. A multivariate linear regression model was built to determine the influence of the potential factors on postoperative PROs.</p><p><strong>Results: </strong>A total of 76 patients were included in the study. Compared to the preoperative level, decreased volume of RF and G-max, and increased IC/RF ratio were observed at postoperative 3 months (all with P < .05). Both G-med/min and G-max presented decreased volume at postoperative 6 months (all with P < .05). G-med/min presented decreased volume (P = .001) at postoperative 12 months. Changes in RF at postoperative 3 months and 12 months were positively related to improvement of iHOT-12 (Beta = 0.371, P = .012 and Beta = 0.330, P = .026, respectively). Changes in IC at postoperative 6-month was positively related to improvement of mHHS (Beta = 0.367, P = .027) and iHOT-12 (Beta = 0.315, P = .044).</p><p><strong>Conclusion: </strong>During the initial first year following arthroscopic treatment for FAIS, decreased volume of the RF and gluteal muscles was observed. Early changes in volume of RF and IC were positively correlated to the improvement of minimum 2-year PROs.</p><p><strong>Level of evidence: </strong>Level IV; case series.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495209","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":"How does the position of the pelvis and femur influence the selection of prosthesis size during 2D preoperative planning for total hip arthroplasty?","authors":"Junzhe Wu, Chaohui Lin, Xunrong Zhuang, Lijiang He, Jiawei Wang, Xinzhe Zhou, Nanjie Xu, Huating Xie, Hanzhang Lv, Hui Ye, Rongmou Zhang","doi":"10.1186/s12891-024-07955-4","DOIUrl":"10.1186/s12891-024-07955-4","url":null,"abstract":"<p><strong>Purpose: </strong>Total Hip Arthroplasty (THA) is the primary treatment for hip diseases today. Nevertheless, total hip arthroplasty has its challenges, and one of these challenges is the potential for incorrect execution of the preoperative planning process. Such errors can lead to complications such as loosening and instability of the prosthesis and leg length discrepancy. In this study, we used human phantoms to investigate the influence of pelvic and femoral factors on prosthesis size selection in the preoperative planning of total hip arthroplasty and to provide a reference standard for clinical imaging in preoperative planning of total hip arthroplasty.</p><p><strong>Methods: </strong>In this experiment, we utilised a custom-made experimental device that enabled us to manipulate the movement of the pelvis and femur in various directions. The device also incorporated sensors to control the angle of movement. By obtaining X-rays from different positions and angles, we were able to determine the size of the prosthesis based on the 2D preoperative planning generated by the mediCAD software.</p><p><strong>Results: </strong>When the pelvis was in a nonneutral position, the size of the acetabular cup varied within a range of three sizes. Similarly, when the femur was in a nonneutral position, the size of the femoral stem varied within a range of two sizes. The movement of the pelvis and femur in the coronal plane, relative to the neutral position, did not impact the selection of the prosthesis size. However, the motion of the pelvis and femur in the sagittal and transverse planes had a notable effect.</p><p><strong>Conclusion: </strong>The selection of the prosthesis size for preoperative planning can be significantly influenced by specific positions of the pelvis and femur. It is crucial for the radiographer to ensure that the pelvis and femur maintain a standard neutral position, particularly in the sagittal and transverse planes, during the image acquisition process.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495225","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":"Outcomes of orthopaedic surgery in Ehlers-Danlos syndromes: a scoping review.","authors":"Jane R Schubart, Susan E Mills, Scott A Rodeo, Clair A Francomano","doi":"10.1186/s12891-024-07937-6","DOIUrl":"10.1186/s12891-024-07937-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with Ehlers-Danlos syndromes (EDS) often experience high rates of joint subluxations and dislocations, and associated pain that may require surgical interventions. Orthopaedic surgical management is challenging in this population, and patients will often undergo multiple unsuccessful surgeries. Outcomes data specific to patients with EDS are sparse in the orthopaedic surgery literature. We conducted a scoping review to evaluate the evidence and outcomes for orthopaedic surgery specifically for the EDS population.</p><p><strong>Methods: </strong>PubMed MEDLINE, Embase, The Cochrane Library, Cochrane Controlled Register of Trials (CENTRAL), CINHL, and Scopus from their inception to February 28, 2024 for all studies that reported outcomes for orthopaedic surgery in patients with EDS. Two reviewers independently determined study eligibility, rated study quality, and extracted data. Methodology followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The studies in this scoping review include Level III (retrospective cohort and case control) and Level IV (case series) evidence.</p><p><strong>Results: </strong>The literature search yielded a total of 71 citations published between 1990 and 2023. All were primary studies. 38 were single case studies, 14 were case series, and 19 were retrospective cohort studies. No randomized clinical studies or systematic reviews were identified. Overall, the reported findings for the various anatomical sites and procedures indicated that surgery outcomes were inconsistent. Our review highlights the need for future research to determine whether currently established surgical approaches for various orthopaedic conditions offer long-term clinical benefit in patients with EDS. This is clearly a challenging diagnosis, and more rigorous clinical studies are required to identify optimal treatment approaches.</p><p><strong>Conclusions: </strong>Our review found little evidence-based research to guide optimal surgical treatment in EDS. Established surgical techniques that have been shown to be successful in the wider orthopaedic population should be studied to determine their efficacy in the EDS population.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495238","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":"Combined effect of artificial cervical disc replacement and facet tropism on the index-level facet joints: a finite element study.","authors":"Jing Li, Yuxiao Deng, Junqi Zhang, Beiyu Wang, Kangkang Huang, Hao Liu, Xin Rong","doi":"10.1186/s12891-024-07895-z","DOIUrl":"10.1186/s12891-024-07895-z","url":null,"abstract":"<p><strong>Background: </strong>Artificial Cervical Disc Replacement (ACDR) is an effective treatment for cervical degenerative disc diseases. However, clinical information regarding the facet joint alterations after ACDR was limited. Facet tropism is common in the sub-axial cervical spine. Our previous research indicated that facet tropism could lead to increased pressure on the cervical facet joints. This study aimed to assess the impact of facet tropism on the facet contact force and facet capsule stress after ACDR.</p><p><strong>Methods: </strong>A C2-T1 cervical finite element model was constructed from computed tomography (CT) scans of a 28-year-old male volunteer. Symmetrical, moderate asymmetrical (7 degrees tropism), and severe asymmetrical (14 degrees tropism) models were created at the C5/C6 level by altering the facet orientation at the C5-C6 level. The C5/C6 ACDR was simulated in the intact, moderate asymmetrical and severe asymmetrical models. A 75-N follower load with 1.0-Nm moments was applied to the top of C2 vertebra in the models to simulate flexion, extension, lateral bending, and axial rotation with the T1 vertebra fixed. The range of motions (ROMs) under all moments, facet contact forces (FCFs) and facet capsule strains were tested.</p><p><strong>Results: </strong>In the asymmetrical model, the right FCFs considerably increased under flexion, extension, right bending, left rotation, especially under right bending the right sided FCF of the severe asymmetrical model was about 5.44 times of the neutral position, and 3.14 times of the symmetrical model. and concentrated on the cephalad part of the facets. The facet capsule stresses on both sides remarkably increased under extension, lateral bending and right rotation. In the moderate and severe asymmetrical models, the capsule strain was greater on both sides of each position than in the symmetric model.</p><p><strong>Conclusions: </strong>The face tropism increased facet contact force and facet capsule strain after ACDR, especially under extension, lateral bending, and rotation, and also could result in abnormal stress distribution on the facet joint surface and facet joint capsule. The results suggest that face tropism might be a risk factor for post-operative facet joint degeneration progression after ACDR. Facet tropism may be noteworthy when ACDR is considered as a surgical option.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495205","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}