BMC Musculoskeletal Disorders最新文献

{"title":"High prevalence of vertebral fractures associated with apnea-hypopnea index in patients with recent diagnosis of obstructive sleep apnea.","authors":"Yanling Liu, Fengying Zhang, Yuanyuan Hong, Yingfeng Tang, Ping Zhang, Jiaoli Zou","doi":"10.1186/s12891-025-09157-y","DOIUrl":"10.1186/s12891-025-09157-y","url":null,"abstract":"","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"881"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197842","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":"Measurement of the sustentaculum tali range and biomechanical screw analysis based on the space shape of the calcaneal trabeculae.","authors":"Yong Zhang, Qiuyan Weng, Yan-Ru Zhang, Jianming Chen, Yunfeng Yang","doi":"10.1186/s12891-025-09120-x","DOIUrl":"10.1186/s12891-025-09120-x","url":null,"abstract":"<p><strong>Background: </strong>The sustentaculum tali (ST) plays an important role in the surgical treatment of calcaneal fracture. However, there is a lack of relevant literature report on the true extent of the distance process. The introduction of the 'space shape of the trabeculae within the calcaneus allowed the ST range to be defined with reference to the trabecula topographic trend. Here, we investigated the biomechanical properties of two common ST screws after implantation by applying the finite element method (FEM).</p><p><strong>Methods: </strong>Dicom imaging data of the calcaneus ST was obtained by computed tomography (CT)scanning techniques and a spatial three-dimensional (3D) coordinate system was established to measure the extent of the ST. The continuation range was identified according to the trend of the trabecula bone and then superimposed to form a new ST range. Next, by structural design and FEM, we performed biomechanical tests on the two type of ST screws: the 'pressure type (transverse group)' test for vertical fracture lines and the 'tension type (oblique group) of the center' test.</p><p><strong>Results: </strong>Based on space shape of the trabeculae within the calcaneus, the spatial extent of the ST was redefined. According to FEM calculations, the load bearing capacity of the transverse group was better than that of the oblique group by 15.15% when the screws were implanted in the peak area. Furthermore, the load bearing capacity of the oblique group was better than that of the transverse group by 14.13% and 5.59% when the screws were implanted in the lumbar and valley regions.</p><p><strong>Conclusions: </strong>Based on the space shape of the trabeculae within the calcaneus, the range of the ST is expanded. The best mechanical properties of two different screws were implanted in the peak area. The load-bearing capacity gradually reduced when implanted in the lumbar and valley regions. However, the waist area and valley area can still meet the requirements for structural strength and stability, and also provide a good fixation effect.</p><p><strong>Level of evidence: </strong>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"873"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198086","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":"Body composition, bone mineral density, and functional impairment in axial spondyloarthritis: a 36-month longitudinal study.","authors":"Chiara Ceolin, Sara Bindoli, Giacomo Cozzi, Benedetta di Marzio, Mariagrazia Lorenzin, Marina De Rui, Paolo Sfriso, Andrea Doria, Giuseppe Sergi, Roberta Ramonda","doi":"10.1186/s12891-025-09088-8","DOIUrl":"10.1186/s12891-025-09088-8","url":null,"abstract":"<p><strong>Background: </strong>Axial spondyloarthritis (ax-SpA) is a chronic inflammatory disease affecting the axial skeleton, peripheral joints, And entheses, often leading to pain, stiffness, And extra-articular complications. Its impact on muscle and bone health has gained attention, as chronic inflammation, reduced physical activity, sedentary behaviour, and glucocorticoid therapy, may alter body composition, particularly lean mass and adipose tissue distribution. This study explores the association between disease activity, body composition, and bone parameters in ax-SpA patients over a 36-month period.</p><p><strong>Methods: </strong>This longitudinal study was conducted at Padua University Hospital (Italy). The following data was collected at baseline And 36 months: medical history, phospho-calcium metabolism, anthropometric measurements, handgrip strength (using hand dynamometer), sit-to-stand test, and Dual-Energy X-ray Absorptiometry assessments. Patients completed Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Health Assessment Questionnaire (HAQ). Correlations between questionnaire scores and clinical variables were analysed, and changes from baseline to follow-up were assessed using paired comparisons.</p><p><strong>Results: </strong>Twenty participants (10 ax-SpA, 10 matched controls) were enrolled. At baseline, no significant differences in bone and body composition were found between groups. In ax-SpA patients, BASFI correlated with BMI (r = 0.800, p < 0.01), fat percentage (r = 0.808, p < 0.01), and fat mass index (r = 0.903, p < 0.01), while BASDAI correlated with sit-to-stand performance (r = 0.677, p < 0.05) and fat percentage (r = 0.700, p < 0.05). After 36 months, significant improvements were observed in sit-to-stand scores [from 17.37 (7.47) to 11.98 (3.81), p = 0.02] and femoral neck BMD [from 0.89 (0.13) to 1.02 (0.14), p = 0.01]. Sit-to-stand improvements correlated with BASFI (r = 0.78, p < 0.01), and ASMMI changes correlated with HAQ (r = 0.92, p < 0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that greater muscle mass and physical performance are associated with lower disease activity and improved quality of life in ax-SpA patients. These associations support integrating pharmacologic treatment with structured exercise, although causal inferences cannot be drawn from this observational design. Further studies are needed to clarify the directionality and underlying mechanisms.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"878"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198452","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 effects of mechanical stimulation on the morphology and function of spinal ligament cells.","authors":"Tao Tang, Fuan Wang, Xizhe Liu, Shaoyu Liu, Zhiyu Zhou, Lin Chen","doi":"10.1186/s12891-025-09142-5","DOIUrl":"10.1186/s12891-025-09142-5","url":null,"abstract":"<p><strong>Background: </strong>It has been shown that mechanical signaling in the cellular microenvironment is crucial for control at the cellular and tissue levels, affecting human growth and the prevalence of disease. Ligament cells from individuals with posterior longitudinal ligament ossification (OPLL) have been found to respond to external mechanical stimulation. However, the response of mechanical stimulation to OPLL ligament cells is unclear. This study aims to comprehensively assess the effects of mechanical stimulation on the proliferation, viability, shape and function of OPLL ligament cells.</p><p><strong>Methods: </strong>Eleven OPLL and 11 non-OPLL patient-derived Ligament cells were selected for this study. cells of test groups were exposed to 10% uniaxial cyclic stretch at frequency of 0.5 Hz for 3 h to 48 h. Calcein-AM/PI/Hoechst33342 assay was used to detect the activity of ligament cells. The CCK8 test was used to investigate the effect of stretch on cell proliferation. The level expression of pro-inflammatory factors was detected by using RT-qPCR. Cytoskeleton staining was used to evaluate changes in cytoskeleton morphology.</p><p><strong>Results: </strong>The proportion of Live cells was not substantially different from the control group after stretch for 12 and 24 h. After 6 and 12 h of cyclic stretch, there was no discernible difference in the rate of cell proliferation; however, after 24 h and 48 h, the cell proliferation rate increased by 27% and 52%, respectively. Apart from the mRNA expression of IL-8 and GROa was 1.41 times and 1.43 times higher than that of the control group in 9-hour groups, and RANTES mRNA expression was 1.38 times higher than that of the control group in 6-hour groups, there was also no appreciable difference in the expression levels of inflammatory factors such as IL1β, TNFα and PF4. The Ligament cells became elongated and were rearranged after 12- and 24-hours' uniaxial stretch.</p><p><strong>Conclusions: </strong>Cyclic stretch encourages OPLL ligament cell proliferation and alteration of the cytoskeleton structure, but it has no effect on the inflammatory response or cell activity, which provides a new insight into the pathophysiology of OPLL.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"864"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198307","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":"Combining radiomics of X-rays with patient functional rating scales for predicting satisfaction after radial fracture fixation: a multimodal machine learning predictive model.","authors":"Changsen Yang, Zhengfeng Jia, Weilu Gao, Cheng Xu, Licheng Zhang, Jiantao Li","doi":"10.1186/s12891-025-09160-3","DOIUrl":"10.1186/s12891-025-09160-3","url":null,"abstract":"<p><strong>Background: </strong>Patient satisfaction after one year of distal radius fracture fixation is influenced by various aspects such as the surgical approach, the patient's physical functioning, and psychological factors. Hence, a multimodal machine learning prediction model combining traditional rating scales and postoperative X-ray images of patients was developed to predict patient satisfaction one year after surgery for personalized clinical treatment.</p><p><strong>Methods: </strong>In this study, we reviewed 385 patients who underwent internal fixation with a palmar plate or external fixation bracket fixation in 2018-2020. After one year of postoperative follow-up, 169 patients completed the patient wrist evaluation (PRWE), EuroQol5D (EQ-5D), and forgotten joint score-12 (FJS-12) questionnaires and were subjected to X-ray capture. The region of interest (ROI) of postoperative X-rays was outlined using 3D Slicer, and the training and test sets were divided based on the satisfaction of the patients. Python was used to extract 848 image features, and random forest embedding was used to reduce feature dimensionality. Also, a machine learning model combining the patient's functional rating scale with the downscaled X-ray-related image features was built, followed by hyperparameter debugging using the grid search method during the modeling process. The stability of the Radiomics and Integrated models was first verified using the five-fold cross-validation method, and then receiver operating characteristic curves, calibration curves, and decision curve analysis were used to evaluate the performance of the model on the training and test sets.</p><p><strong>Results: </strong>The feature dimensionality reduction yielded 16 imaging features. The accuracy of the two models was 0.831, 0.784 and 0.966, 0.804 on the training and test sets, respectively. The area under the curve (AUC) values for the Radiomics and Integrated model were 0.937, 0.673 and 0.997, 0.823 for the training and test sets, respectively. The calibration curves and decision curve analysis (DCA) of the Integrated model for the training and test sets had a more accurate prediction probability and clinical significance than the Radiomics model.</p><p><strong>Conclusions: </strong>A multimodal machine learning predictive model combining imaging and patient functional rating scales demonstrated optimal predictive performance for one-year postoperative satisfaction in patients with radial fractures, providing a basis for personalized postoperative patient management.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"879"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for increased postoperative drainage in patients undergoing spinal fusion surgery: a retrospective study.","authors":"Yongxing Li, Xia Liang, Haoquan Huang, Wenqi Wu, Meihua Lin, Chenxi Liu, Yanni Fu","doi":"10.1186/s12891-025-09080-2","DOIUrl":"10.1186/s12891-025-09080-2","url":null,"abstract":"<p><strong>Background: </strong>The adverse events and complications caused by blood loss after spinal surgery have attracted increasing amounts of attention. This retrospective study aimed to identify risk factors for postoperative bleeding and develop predictive models.</p><p><strong>Methods: </strong>This was a retrospective analysis of patients who underwent spinal fusion surgery between November 2018 and December 2019. Preoperative data were collected, and LASSO regression and multifactor regression analyses were performed to identify risk factors for increased postoperative blood loss. Using the obtained risk factors, a nomogram model was established. The nomogram was evaluated based on the concordance index (C-index), receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curve analysis.</p><p><strong>Results: </strong>A total of 434 patients who underwent spinal surgery were included in the study. LASSO regression analysis and multivariate logistic regression analysis revealed that age, cardiovascular disease status, fusion level, use of neuromuscular blockers, peak pressure of mechanical ventilation, and intraoperative blood loss were related to the amount of postoperative drainage. Based on these six risk factors, we developed a nomogram with a C-index of 0.807. The areas under the curve (AUCs) in the training group and the verification group were 0.8155 and 0.7529, respectively, indicating that the established model had good predictive performance. There was good agreement in the calibration curve, and the clinical decision curve showed a significant net benefit after the intervention.</p><p><strong>Conclusions: </strong>We developed a nomogram model through retrospective analysis, enabling clinicians to predict the likelihood of postoperative blood loss based on risk factors. The risk factors for increased drainage volume after spinal fusion surgery include age, cardiovascular disease status, fusion level, use of neuromuscular blockers, peak pressure of mechanical ventilation, and intraoperative blood loss.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"866"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198278","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":"Study of the extent of surgical osteotomy in Cierny-Mader stages III and IV chronic osteomyelitis.","authors":"Xu Wang, Fei Liu, Zhi-Meng Zhang, Dao-Tong Yuan, Wen-Peng Xie, Yong-Kui Zhang","doi":"10.1186/s12891-025-09121-w","DOIUrl":"10.1186/s12891-025-09121-w","url":null,"abstract":"<p><strong>Purpose: </strong>To determine an optimal osteotomy criterion for patients with Cierny-Mader stages III and IV chronic osteomyelitis.</p><p><strong>Methods: </strong>Seventy patients with Cierny-Mader stages III and IV chronic osteomyelitis admitted to the Department of Orthopedics of a Class III Grade A Hospital from January 2018 to March 2022 were selected for retrospective analysis and study. The following patient data were collected: gender, age, site of infection, bacterial culture results, internal fixation status, bone defect length, BMI, history of diabetes mellitus, smoking history, and history of preoperative antibiotic use. The patients were treated with sensitive antibiotics after surgery, followed up regularly, and venous blood C-reactive protein (CRP), sedimentation (ESR), white blood cells (WBC) and muscle strength (MTT scale), joint mobility (neutral 0° method), and bony healing time were measured to observe the recurrence rate of osteomyelitis and to assess the recovery of limb function according to the Enneking scale.</p><p><strong>Results: </strong>Among the 70 patients, 20 cases were guided by X-ray, 30 cases by MRI, and 20 cases by SPECT. All patients underwent thorough debridement under the guidance of imaging modalities followed by external fixation. All cases were followed up and with a mean follow-up time of (12.2 ± 3.2) months. The recurrence rate of 35% in patients with X-ray as a guide was significantly higher than that of patients with MRI as a guide (10%) and SPECT as a guide (5%), and the difference between the three groups was statistically significant (P < 0.05).</p><p><strong>Conclusion: </strong>For patients with osteomyelitis without metal internal fixation, the osteotomy surgical technique with MRI to guide the expansion of 0.5 cm distally and proximally, or with SPECT imaging to guide the surgical procedure in the area with 30-40% of the radioactive count contour (isocontour, ISO) had the advantages of low recurrence rate and good recovery of limb function, and the differences were not statistically significant. For patients with osteomyelitis with metal internal fixation, the osteotomy surgical technique with SPECT to guide the surgical procedure had the advantages of low recurrence rate and good recovery of limb function. In patients with osteomyelitis with metal internal fixation, SPECT was used as a guide to determine the extent of the osteomyelitis lesion, and osteotomy in the area with 30-40% of ISO was more effective than MRI.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"877"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198346","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":"Upper trapezius muscle stiffness among musicians with and without playing-related musculoskeletal disorders: a cross-sectional study.","authors":"Cinzia Cruder, Pia Schönhofer, Alessandro Schneebeli, Stefano Vercelli, Marco Barbero","doi":"10.1186/s12891-025-09057-1","DOIUrl":"10.1186/s12891-025-09057-1","url":null,"abstract":"<p><strong>Background: </strong>Increased muscle stiffness (MS) in the upper trapezius (UT) has been shown to be correlated with pain in some populations, but knowledge regarding altered MS in musicians affected by playing-related musculoskeletal disorders (PRMDs) remains limited. The primary aim of this study was to investigate whether MS is altered in musicians with PRMDs. A further aim was to explore the associations between MS and musicians' features.</p><p><strong>Methods: </strong>A total of 60 musicians from the Conservatory of Southern Switzerland and the Orchestra della Svizzera italiana participated in the study. The assessment procedure included a self-report questionnaire on background and lifestyle, practice habits, PRMD characteristics (i.e., presence, intensity, location, and extent), physical activity and perceived health, along with a bilateral evaluation of MS in the UT using the MyotonPRO (Muomeetria, Tallinn, Estonia).</p><p><strong>Results: </strong>Of the 60 participants, 28 musicians (47%) reported ongoing PRMDs, with higher pain prevalence in the UT, especially on the left side. MS in the UT did not differ significantly between musicians with and without PRMDs. However, significant differences were observed in preparatory exercises (𝑍 = -2.1, p < 0.05) and rest breaks during practice sessions (𝑍 = -2.8, p < 0.01). Furthermore, positive correlations were identified between MS and perceived effort (ρ = 0.6, p < 0.01), playing-related disability (ρ = 0.5, p < 0.01), and physical activity level (ρ = 0.4, p < 0.01). Conversely, a negative correlation was found between MS and the physical component of perceived health (ρ= -0.7; p < 0.01).</p><p><strong>Conclusions: </strong>Although no statistically significant difference was found in MS between the PRMD and non-PRMD groups, significant associations between MS and musician-related features were detected. Future research should prioritise collaborative longitudinal studies between musical and scientific communities, with the aim of monitoring musicians over time and developing a deeper understanding of the relationships between specific musical practices, individual characteristics, and MS.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"870"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198359","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 effect of an empowerment program on pain control and self-efficacy in patients undergoing total knee arthroplasty in Iran: a quasi-experimental study.","authors":"Akram Ghahramanian, Nazila Mirmaroofi, Mohammad Asghari-Jafarabadi, Mozhgan Behshid, Faranak Jabbarzadeh Tabrizi, Tonia Onyeka, Jafar Ganjpour","doi":"10.1186/s12891-025-09150-5","DOIUrl":"10.1186/s12891-025-09150-5","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis significantly limits mobility and increases pain in patients. Pain self-efficacy, a crucial psychological construct, is essential for optimal recovery outcomes. This study,grounded in Bandura's self-efficacy theory and Linton's cognitive-behavioral model, evaluated the effectiveness of an empowerment program on pain intensity indices and self-efficacy in patients undergoing total knee arthroplasty.</p><p><strong>Methods: </strong>A quasi-experimental design was employed. Ninety-eight patients were recruited via convenience sampling and randomly assigned to intervention (n=49) or control (n=49) groups. The intervention group received six structured sessions (one preoperative, five postoperative) including education on pain management, coping strategies, and goal setting, in addition to routine care. Pain intensity was assessed using the Short McGill Pain Questionnaire (SF-MPQ), Present Pain Intensity (PPI) index, and Visual Analogue Scale (VAS), while Pain self-efficacy was measured with the Pain Self-Efficacy Questionnaire (PSEQ). Evaluations were conducted at baseline (preoperatively) and six weeks postoperatively. Demographic (age, sex, education), medical (BMI), and theory-related variables were collected. Analysis of covariance, adjusting for confounders, was used to compare outcomes, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>Among 98 participants (predominantly women; mean age 62.72 years, mean BMI 29.77, limited formal education), no significant baseline differences existed between groups. Post-intervention, the intervention group demonstrated significantly greater pain reduction: sensory-affective pain (MD = 1.8, 95% CI [-3.86 to -0.96], p = 0.015), Present Pain Intensity (0.62, [-1.04 to -0.18], p = 0.023), and Visual Analogue Scale scores (1.57, [-2.12 to -1.01], p < 0.001). Pain self-efficacy increased significantly (9.81, [0.71 to 1.24], p < 0.001). Analysis of covariance confirmed intervention effectiveness after adjusting for confounding variables.</p><p><strong>Conclusions: </strong>The empowerment program proved effective as an interactive, applicable, and non-invasive approach for enhancing pain management and self-efficacy in total knee arthroplasty patients.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"875"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198343","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":"Comparison of parallel and orthogonal plating techniques and the predictive role of Hounsfield unit values in AO/OTA type 13-C distal humerus fractures in patients over 50.","authors":"Muhammed Bilal Kurk, Kutalmis Albayrak, Murat Onder, Mert Demirci, Baris Ozkul, Osman Orman","doi":"10.1186/s12891-025-09042-8","DOIUrl":"10.1186/s12891-025-09042-8","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aimed to compare the clinical outcomes of parallel and orthogonal plating in the surgical treatment of AO/OTA type 13-C distal humerus fractures in patients over 50 years of age and to evaluate the predictive role of local bone quality, measured using Hounsfield Unit (HU), on these outcomes.</p><p><strong>Methods: </strong>In this retrospective study, 80 patients over the age of 50 who underwent surgery for AO/OTA type 13-C distal humerus fractures between 2012 and 2022 were analyzed. Patients were categorized into two groups according to the plating technique: parallel(n = 33) or orthogonal(n = 47). Functional and radiological outcomes were compared, including elbow range of motion, Mayo Elbow Performance Score (MEPS), QuickDASH, time to union, complication and reoperation rates, and presence of post-traumatic osteoarthritis. Bone quality was stratified based on HU measurements obtained from preoperative CT scans, specifically from the largest intact slice of the capitellum and trochlea in the sagittal view and from the axial slice just above the proximal fracture line, using a threshold value of 124.5 HU corresponding to the median HU value of the patient cohort. MEPS and QuickDASH were evaluated at the 12-month postoperative follow-up.</p><p><strong>Results: </strong>Orthogonal plating was associated with longer union times (p < 0.001), higher complication rates (p = 0.008), and greater incidence of post-traumatic arthrosis (p = 0.027) compared to parallel plating. Subgroup analysis revealed that in patients with HU ≤ 124.5, orthogonal plating was linked to significantly increased nonunion risk (p = 0.03) and longer union times (p < 0.001), whereas parallel plating yielded more consistent results regardless of bone quality. Nonunion was significantly higher in the HU ≤ 124.5 subgroup (p = 0.031), and particularly more frequent in orthogonal plating within this group (p = 0.04).</p><p><strong>Conclusion: </strong>While both plating techniques provided comparable functional outcomes, orthogonal plating was associated with higher complication and nonunion rates, especially in patients with poor bone quality. This may be attributed to the reduced mechanical stability of orthogonal constructs in osteoporotic bone, which may compromise fixation strength and lead to higher failure rates. HU assessment from routine CT scans may aid in preoperative decision-making to optimize surgical outcomes.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"883"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198455","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}