首页 > 最新文献

International Orthopaedics最新文献

英文 中文
A new anatomical locking plate for scapular neck fractures: a finite element analysis and retrospective clinical study.
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-11 DOI: 10.1007/s00264-026-06738-x
Kaiwen Yang, Xiaoqi Tan, Feifan Xiang, Yunkang Yang

Background: Scapular neck fractures, typically caused by high-energy trauma, often require surgical fixation. Conventional reconstruction plates (RPs) are limited by poor anatomical conformity and extended operative times. We developed a novel scapular neck anatomical locking compression plate (SNALCP) and assessed its biomechanical stability and clinical performance.

Methods: Finite element analysis (FEA) was used to compare the biomechanical behaviour of SNALCP and RP in Miller type IIA/B fractures, simulating forward flexion (FF), abduction (AB), internal rotation (IR), and external rotation (ER). Clinically, 40 patients treated between January 2021 and August 2023 were enrolled: RP group (n = 22) and SNALCP group (n = 18). Operative time, blood loss, Visual Analog Scale (VAS) pain scores, healing time, complications, and Constant-Murley scores were evaluated.

Results: SNALCP demonstrated lower stress and displacement than RP across all loading conditions. For type IIA fractures, AB and FF stresses were 10.133 < 19.223 and 36.698 < 65.761 MPa; for type IIB, AB 63.089 < 97.578, FF 74.346 < 137.110, IR 379.290 < 540.640, and ER 1982.300 < 2253.100 MPa. Clinically, SNALCP yielded shorter surgical times (97.7 ± 19.3 min), less blood loss (152.6 ± 58.5 mL), faster healing (7.6 ± 1.4 weeks), and superior VAS and Constant-Murley scores (all p < 0.05). Only three cases of transient shoulder stiffness were observed.

Conclusion: SNALCP provides superior biomechanical stability and improved functional outcomes compared with RP. Larger, multicenter studies are warranted to validate these findings.

{"title":"A new anatomical locking plate for scapular neck fractures: a finite element analysis and retrospective clinical study.","authors":"Kaiwen Yang, Xiaoqi Tan, Feifan Xiang, Yunkang Yang","doi":"10.1007/s00264-026-06738-x","DOIUrl":"https://doi.org/10.1007/s00264-026-06738-x","url":null,"abstract":"<p><strong>Background: </strong>Scapular neck fractures, typically caused by high-energy trauma, often require surgical fixation. Conventional reconstruction plates (RPs) are limited by poor anatomical conformity and extended operative times. We developed a novel scapular neck anatomical locking compression plate (SNALCP) and assessed its biomechanical stability and clinical performance.</p><p><strong>Methods: </strong>Finite element analysis (FEA) was used to compare the biomechanical behaviour of SNALCP and RP in Miller type IIA/B fractures, simulating forward flexion (FF), abduction (AB), internal rotation (IR), and external rotation (ER). Clinically, 40 patients treated between January 2021 and August 2023 were enrolled: RP group (n = 22) and SNALCP group (n = 18). Operative time, blood loss, Visual Analog Scale (VAS) pain scores, healing time, complications, and Constant-Murley scores were evaluated.</p><p><strong>Results: </strong>SNALCP demonstrated lower stress and displacement than RP across all loading conditions. For type IIA fractures, AB and FF stresses were 10.133 < 19.223 and 36.698 < 65.761 MPa; for type IIB, AB 63.089 < 97.578, FF 74.346 < 137.110, IR 379.290 < 540.640, and ER 1982.300 < 2253.100 MPa. Clinically, SNALCP yielded shorter surgical times (97.7 ± 19.3 min), less blood loss (152.6 ± 58.5 mL), faster healing (7.6 ± 1.4 weeks), and superior VAS and Constant-Murley scores (all p < 0.05). Only three cases of transient shoulder stiffness were observed.</p><p><strong>Conclusion: </strong>SNALCP provides superior biomechanical stability and improved functional outcomes compared with RP. Larger, multicenter studies are warranted to validate these findings.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Smoking increases the risk of early postoperative infection after elective total hip arthroplasty: Evidence from a Nationwide Japanese database.
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-11 DOI: 10.1007/s00264-026-06747-w
Hidetatsu Tanaka, Kunio Tarasawa, Yu Mori, Hideki Fukuchi, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori

Purpose: Smoking is a potentially modifiable risk factor for adverse outcomes after total hip arthroplasty (THA), but evidence on early postoperative complications in Asian populations remains limited. This study examined the association between smoking and early postoperative complications after elective THA using a nationwide inpatient database in Japan.

Methods: This retrospective cohort study analysed data from the Japanese Diagnosis Procedure Combination (DPC) database between December 2011 and March 2023. Patients undergoing elective primary THA for osteoarthritis, osteonecrosis of the femoral head, or rheumatoid arthritis were included. Smoking status was identified using administrative codes. One-to-one propensity score matching was used to balance baseline characteristics between smokers and non-smokers. Primary outcomes were early postoperative surgical complications, medical complications, and in-hospital mortality. Dose-dependent effects were assessed using the Brinkman Index, with heavy smoking defined as ≥ 600.

Results: After propensity score matching, 52,551 patients were included in each group. Smoking was associated with a higher risk of postoperative infection (odds ratio [OR] 1.31; 95% confidence interval [CI] 1.15-1.49; p < 0.001) and a lower likelihood of blood transfusion (OR 0.83; 95% CI 0.80-0.85; p < 0.001). No significant associations were observed with dislocation, periprosthetic fracture, wound dehiscence, reoperation, major medical complications, or in-hospital mortality. Heavy smoking (Brinkman Index ≥ 600) was not associated with postoperative complications.

Conclusions: Smoking was associated with an increased risk of early postoperative infection following elective THA, but not with other major complications or in-hospital mortality. Smoking cessation should be considered an important component of perioperative optimisation.

{"title":"Smoking increases the risk of early postoperative infection after elective total hip arthroplasty: Evidence from a Nationwide Japanese database.","authors":"Hidetatsu Tanaka, Kunio Tarasawa, Yu Mori, Hideki Fukuchi, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori","doi":"10.1007/s00264-026-06747-w","DOIUrl":"https://doi.org/10.1007/s00264-026-06747-w","url":null,"abstract":"<p><strong>Purpose: </strong>Smoking is a potentially modifiable risk factor for adverse outcomes after total hip arthroplasty (THA), but evidence on early postoperative complications in Asian populations remains limited. This study examined the association between smoking and early postoperative complications after elective THA using a nationwide inpatient database in Japan.</p><p><strong>Methods: </strong>This retrospective cohort study analysed data from the Japanese Diagnosis Procedure Combination (DPC) database between December 2011 and March 2023. Patients undergoing elective primary THA for osteoarthritis, osteonecrosis of the femoral head, or rheumatoid arthritis were included. Smoking status was identified using administrative codes. One-to-one propensity score matching was used to balance baseline characteristics between smokers and non-smokers. Primary outcomes were early postoperative surgical complications, medical complications, and in-hospital mortality. Dose-dependent effects were assessed using the Brinkman Index, with heavy smoking defined as ≥ 600.</p><p><strong>Results: </strong>After propensity score matching, 52,551 patients were included in each group. Smoking was associated with a higher risk of postoperative infection (odds ratio [OR] 1.31; 95% confidence interval [CI] 1.15-1.49; p < 0.001) and a lower likelihood of blood transfusion (OR 0.83; 95% CI 0.80-0.85; p < 0.001). No significant associations were observed with dislocation, periprosthetic fracture, wound dehiscence, reoperation, major medical complications, or in-hospital mortality. Heavy smoking (Brinkman Index ≥ 600) was not associated with postoperative complications.</p><p><strong>Conclusions: </strong>Smoking was associated with an increased risk of early postoperative infection following elective THA, but not with other major complications or in-hospital mortality. Smoking cessation should be considered an important component of perioperative optimisation.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and radiological outcomes of Inlay versus Onlay humeral stems in reverse shoulder arthroplasty with a 145° neck shaft angle: a multicentre retrospective study with a minimum follow-up of three years, an analysis from the registry of the shoulder friends institute. 颈轴角为145°的反向肩关节置换术中置入与置入肩关节干的临床和放射学结果:一项至少随访三年的多中心回顾性研究,来自肩友协会的注册分析。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-09 DOI: 10.1007/s00264-026-06742-1
Charlotte Audebert, Thomas Boissinot, Stéphane Audebert, Nicolas Bonnevialle, Yves Lefebvre, Christophe Charousset

Background: While the original Paul Grammont Inlay design had a 155° neck-shaft angle (NSA), developments in humeral stem designs have led to the emergence of the Onlay design with a more vertical angle. The purpose of the study is to compare three year clinical and radiological outcomes of two humeral stem designs, namely Inlay versus Onlay designs, with a 145° NSA and identical glenoid component.

Methods: In this multicentric retrospective study, 227 patients (141 Inlay versus 86 Onlay) that underwent primary reverse shoulder arthroplasty (RSA) between March 2019 and April 2020, were reviewed at a minimum follow-up of three years. Clinical evaluation included pain on visual analogue scale (VAS), active range of motion, subjective shoulder value (SSV), and Constant score. Radiological assessment included in situ stem inclination, cortical contact bone remodelling, and scapular notching.

Results: The two groups were comparable in terms of age, sex, diagnosis, and follow-up (mean follow-up, 3.3 ± 0.5 years). No significant differences were found for pain on VAS, SSV or Constant score. The Onlay group had significantly greater external rotation with 90° of abduction (ISA-Inlay, 52.2 ± 24.2; versus ISA-Onlay, 59.2 ± 25; p = 0.037), more valgus alignment (ISA-Inlay, -0.573; versus ISA-Onlay, -5.55; p < 0.001), and a higher rate of cortical contact (ISA-Inlay, 9%; versus ISA-Onlay, 39%; p < 0.001). No significant differences were found in terms of bone remodelling around the stem and scapular notching.

Conclusion: At a follow up of three years, both humeral stem designs resulted in comparable clinical and radiological outcomes, while the Onlay design seemed to improve external rotation without increasing the risk of bony complications. The choice of stem design should be motivated by patient specific functional needs and surgeon experience. However, the conclusions of the present study are limited to mid-term follow-up.

背景:虽然最初的Paul Grammont嵌套设计具有155°颈轴角(NSA),但肱骨杆设计的发展导致了具有更垂直角度的嵌套设计的出现。该研究的目的是比较两种肱骨干设计的三年临床和放射学结果,即内嵌式和内嵌式设计,具有145°NSA和相同的肩关节组件。方法:在这项多中心回顾性研究中,在2019年3月至2020年4月期间,227例(141例Inlay对86例Onlay)接受了初级反向肩关节置换术(RSA),随访时间至少为3年。临床评估包括疼痛视觉模拟量表(VAS)、活动范围、主观肩值(SSV)和常数评分。放射学评估包括原位骨倾斜、皮质接触骨重塑和肩胛骨切迹。结果:两组患者在年龄、性别、诊断、随访等方面具有可比性(平均随访3.3±0.5年)。疼痛在VAS、SSV和Constant评分上无显著差异。外展90°时,Onlay组的外旋能力显著增强(ISA-Inlay, 52.2±24.2;与ISA-Onlay, 59.2±25;p = 0.037),外翻对齐能力显著增强(ISA-Inlay, -0.573;与ISA-Onlay, -5.55; p)。结论:在三年的随访中,两种肱骨杆设计的临床和放射学结果相当,而Onlay设计似乎改善了外旋,但没有增加骨并发症的风险。干细胞设计的选择应根据患者的具体功能需求和外科医生的经验。然而,本研究的结论仅限于中期随访。
{"title":"Clinical and radiological outcomes of Inlay versus Onlay humeral stems in reverse shoulder arthroplasty with a 145° neck shaft angle: a multicentre retrospective study with a minimum follow-up of three years, an analysis from the registry of the shoulder friends institute.","authors":"Charlotte Audebert, Thomas Boissinot, Stéphane Audebert, Nicolas Bonnevialle, Yves Lefebvre, Christophe Charousset","doi":"10.1007/s00264-026-06742-1","DOIUrl":"https://doi.org/10.1007/s00264-026-06742-1","url":null,"abstract":"<p><strong>Background: </strong>While the original Paul Grammont Inlay design had a 155° neck-shaft angle (NSA), developments in humeral stem designs have led to the emergence of the Onlay design with a more vertical angle. The purpose of the study is to compare three year clinical and radiological outcomes of two humeral stem designs, namely Inlay versus Onlay designs, with a 145° NSA and identical glenoid component.</p><p><strong>Methods: </strong>In this multicentric retrospective study, 227 patients (141 Inlay versus 86 Onlay) that underwent primary reverse shoulder arthroplasty (RSA) between March 2019 and April 2020, were reviewed at a minimum follow-up of three years. Clinical evaluation included pain on visual analogue scale (VAS), active range of motion, subjective shoulder value (SSV), and Constant score. Radiological assessment included in situ stem inclination, cortical contact bone remodelling, and scapular notching.</p><p><strong>Results: </strong>The two groups were comparable in terms of age, sex, diagnosis, and follow-up (mean follow-up, 3.3 ± 0.5 years). No significant differences were found for pain on VAS, SSV or Constant score. The Onlay group had significantly greater external rotation with 90° of abduction (ISA-Inlay, 52.2 ± 24.2; versus ISA-Onlay, 59.2 ± 25; p = 0.037), more valgus alignment (ISA-Inlay, -0.573; versus ISA-Onlay, -5.55; p < 0.001), and a higher rate of cortical contact (ISA-Inlay, 9%; versus ISA-Onlay, 39%; p < 0.001). No significant differences were found in terms of bone remodelling around the stem and scapular notching.</p><p><strong>Conclusion: </strong>At a follow up of three years, both humeral stem designs resulted in comparable clinical and radiological outcomes, while the Onlay design seemed to improve external rotation without increasing the risk of bony complications. The choice of stem design should be motivated by patient specific functional needs and surgeon experience. However, the conclusions of the present study are limited to mid-term follow-up.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The education of the orthopaedic surgeon's hand with the tool. 矫形外科医生的手与工具的教育。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-07 DOI: 10.1007/s00264-026-06749-8
Philippe Hernigou, Andreas F Mavrogenis, Marius M Scarlat
{"title":"The education of the orthopaedic surgeon's hand with the tool.","authors":"Philippe Hernigou, Andreas F Mavrogenis, Marius M Scarlat","doi":"10.1007/s00264-026-06749-8","DOIUrl":"https://doi.org/10.1007/s00264-026-06749-8","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Customized positioning of the glenoid component in reverse shoulder arthroplasty: a new computer aided design methodology. 逆向肩关节置换术中关节盂假体的定制定位:一种新的计算机辅助设计方法。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-07 DOI: 10.1007/s00264-026-06748-9
Antonino Cirello, Tommaso Ingrassia, Giuseppe Rovere, Lorenzo Nalbone, Lawrence Camarda, Igor Agostino Mirulla, Vincenzo Nigrelli, Vito Ricotta, Micol Tantillo

Purpose: Reverse Shoulder Arthroplasty (RSA) is widely used to treat shoulder joint pathologies. However, this procedure may result in reduced range of motion (ROM), scapular notching, and prosthetic instability. These complications vary among patients, highlighting the need for individualized preoperative planning. This study introduces a novel parametric methodology to determine optimal glenoid component positioning by evaluating ROM, instability ratio, and the percentage of bone resected.

Method: The proposed approach was applied to four patient models treated with two prosthetic designs. The methodology consists of four steps within a patient-specific parametric tool: 3D anatomical reconstruction, virtual surgical planning, biomechanical and geometric evaluation, and identification of optimal configurations. Fifteen glenoid component orientations were generated by varying tilt angles. The best configurations were identified based on ROM and instability assessments, while bone resection volume was calculated as an additional parameter.

Results: Maximum values of abduction-adduction, internal rotation, and external rotation were 87.23°, 90°, and 70.59°, respectively, although not achieved in a single configuration. Instability ratios ranged from 0.23 to 0.62. Bone resection varied between 0.4% and 5.5%, depending on the configuration.

Conclusions: This methodology provides a patient-specific framework to support preoperative planning in RSA. By combining ROM analysis, instability assessment, and bone preservation, the approach enables the identification of glenoid component orientations that improve mobility while minimizing instability risk and surgical invasiveness.

目的:逆行肩关节置换术(RSA)被广泛应用于肩关节病变的治疗。然而,该手术可能导致活动范围缩小、肩胛骨切迹和假体不稳定。这些并发症因患者而异,突出了个体化术前计划的必要性。本研究引入了一种新的参数方法,通过评估ROM、不稳定性比率和骨切除百分比来确定最佳的盂骨假体定位。方法:将所提出的方法应用于四种不同义肢设计的患者模型。该方法由患者特定参数工具中的四个步骤组成:三维解剖重建,虚拟手术计划,生物力学和几何评估,以及最佳配置的识别。通过不同的倾斜角度产生15个关节组件方向。根据ROM和不稳定性评估确定最佳配置,同时计算骨切除体积作为附加参数。结果:内展-内收、内旋和外旋的最大值分别为87.23°、90°和70.59°,尽管在单一构型下不能实现。失稳比为0.23 ~ 0.62。骨切除在0.4%到5.5%之间,取决于结构。结论:该方法为支持RSA术前计划提供了一个患者特异性的框架。通过结合ROM分析、不稳定评估和骨保存,该方法能够识别关节盂组件的方向,从而提高活动能力,同时最大限度地降低不稳定风险和手术侵入性。
{"title":"Customized positioning of the glenoid component in reverse shoulder arthroplasty: a new computer aided design methodology.","authors":"Antonino Cirello, Tommaso Ingrassia, Giuseppe Rovere, Lorenzo Nalbone, Lawrence Camarda, Igor Agostino Mirulla, Vincenzo Nigrelli, Vito Ricotta, Micol Tantillo","doi":"10.1007/s00264-026-06748-9","DOIUrl":"https://doi.org/10.1007/s00264-026-06748-9","url":null,"abstract":"<p><strong>Purpose: </strong>Reverse Shoulder Arthroplasty (RSA) is widely used to treat shoulder joint pathologies. However, this procedure may result in reduced range of motion (ROM), scapular notching, and prosthetic instability. These complications vary among patients, highlighting the need for individualized preoperative planning. This study introduces a novel parametric methodology to determine optimal glenoid component positioning by evaluating ROM, instability ratio, and the percentage of bone resected.</p><p><strong>Method: </strong>The proposed approach was applied to four patient models treated with two prosthetic designs. The methodology consists of four steps within a patient-specific parametric tool: 3D anatomical reconstruction, virtual surgical planning, biomechanical and geometric evaluation, and identification of optimal configurations. Fifteen glenoid component orientations were generated by varying tilt angles. The best configurations were identified based on ROM and instability assessments, while bone resection volume was calculated as an additional parameter.</p><p><strong>Results: </strong>Maximum values of abduction-adduction, internal rotation, and external rotation were 87.23°, 90°, and 70.59°, respectively, although not achieved in a single configuration. Instability ratios ranged from 0.23 to 0.62. Bone resection varied between 0.4% and 5.5%, depending on the configuration.</p><p><strong>Conclusions: </strong>This methodology provides a patient-specific framework to support preoperative planning in RSA. By combining ROM analysis, instability assessment, and bone preservation, the approach enables the identification of glenoid component orientations that improve mobility while minimizing instability risk and surgical invasiveness.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology of hospitalization and surgical therapy in degenerative cervical myelopathy: A Nationwide discharge-based twenty year analysis. 退行性颈椎病住院和手术治疗的流行病学:一项基于全国出院的20年分析。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-07 DOI: 10.1007/s00264-026-06740-3
Yazan Noufal, Marcus Richter, Philipp Hartung, Felix Schmitz, Philipp Drees, Yama Afghanyar, Martin Naisan

Introduction: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Despite its clinical importance, nationwide data on long-term hospitalization and surgical management trends in Germany remain scarce.

Methods: A retrospective analysis was conducted using the German Federal Statistical Office's hospital discharge database covering all inpatient cases with the primary diagnosis of DCM (ICD-10-GM code M50.0) from 2005 to 2024. Annual case numbers, age and sex distributions, and surgical procedures were analyzed descriptively. Hospitalization rates per 100,000 inhabitants were calculated using mid-year population data.

Results: Between 2005 and 2024, approximately 70,000 hospital discharges with a primary diagnosis of DCM were recorded in Germany. Annual hospitalizations increased from 2,477 cases in 2005 to a peak of 4,076 cases in 2015, followed by a decline to 3,037 cases in 2024. Corresponding hospitalization rates rose from 3.0 to 4.96 per 100,000 inhabitants before decreasing to 3.7 per 100,000 in 2024. Segmented Poisson regression demonstrated a significant increase until 2015 followed by a significant decline thereafter. Age-specific analyses demonstrated a stable predominance of middle-aged and older adults, with consistently highest hospitalization volumes in patients aged 50-70 years. After age standardization to the 2015 reference population, the temporal pattern remained largely unchanged, indicating that observed trends were not solely attributable to population ageing. Mean length of hospital stay decreased steadily over time. Anterior surgical approaches accounted for the majority of procedures throughout the study period, while the proportion of surgically treated cases per hospitalization increased over time.

Conclusions: This nationwide, discharge-based analysis demonstrates substantial temporal changes in hospitalizations and surgical treatment patterns for DCM in Germany over the past two decades. Hospitalization volumes increased until approximately 2015 and declined thereafter, a pattern that persisted after age standardization. DCM predominantly affected patients aged 50-70 years throughout the study period, without a pronounced shift toward progressively older age groups. The increasing ratio of surgical procedures to hospitalizations suggests more selective inpatient admissions focusing on operative management. These findings provide a descriptive reference for long-term hospitalization and surgical trends in DCM.

简介:退行性颈椎病(DCM)是成人脊髓功能障碍的最常见原因。尽管它具有临床重要性,但关于德国长期住院和手术管理趋势的全国性数据仍然很少。方法:回顾性分析2005 - 2024年德国联邦统计局医院出院数据库中所有首发诊断为DCM (ICD-10-GM代码M50.0)的住院病例。对年度病例数、年龄和性别分布以及手术方式进行描述性分析。每10万居民的住院率是使用年中人口数据计算的。结果:2005年至2024年间,德国约有70,000名初步诊断为DCM的出院患者。年住院人数从2005年的2477例增加到2015年的峰值4076例,随后在2024年下降到3037例。相应的住院率从每10万居民3.0人上升到4.96人,然后在2024年下降到每10万居民3.7人。分段泊松回归在2015年之前呈显著上升趋势,之后呈显著下降趋势。年龄特异性分析表明,稳定的优势是中老年人,50-70岁患者的住院人数一直最高。对2015年参考人口进行年龄标准化后,时间格局基本保持不变,表明观察到的趋势并非完全归因于人口老龄化。平均住院时间随着时间的推移而稳步下降。在整个研究期间,前路手术入路占大多数手术,而每次住院手术治疗病例的比例随着时间的推移而增加。结论:这项全国性的、以出院为基础的分析表明,在过去二十年中,德国DCM的住院和手术治疗模式发生了实质性的时间变化。住院人数一直增加到大约2015年,此后下降,这一模式在年龄标准化后持续存在。在整个研究期间,DCM主要影响50-70岁的患者,没有向逐渐变老的年龄组明显转变。外科手术与住院比例的增加表明,住院患者更注重手术管理。这些发现为DCM的长期住院和手术趋势提供了描述性参考。
{"title":"Epidemiology of hospitalization and surgical therapy in degenerative cervical myelopathy: A Nationwide discharge-based twenty year analysis.","authors":"Yazan Noufal, Marcus Richter, Philipp Hartung, Felix Schmitz, Philipp Drees, Yama Afghanyar, Martin Naisan","doi":"10.1007/s00264-026-06740-3","DOIUrl":"https://doi.org/10.1007/s00264-026-06740-3","url":null,"abstract":"<p><strong>Introduction: </strong>Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Despite its clinical importance, nationwide data on long-term hospitalization and surgical management trends in Germany remain scarce.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the German Federal Statistical Office's hospital discharge database covering all inpatient cases with the primary diagnosis of DCM (ICD-10-GM code M50.0) from 2005 to 2024. Annual case numbers, age and sex distributions, and surgical procedures were analyzed descriptively. Hospitalization rates per 100,000 inhabitants were calculated using mid-year population data.</p><p><strong>Results: </strong>Between 2005 and 2024, approximately 70,000 hospital discharges with a primary diagnosis of DCM were recorded in Germany. Annual hospitalizations increased from 2,477 cases in 2005 to a peak of 4,076 cases in 2015, followed by a decline to 3,037 cases in 2024. Corresponding hospitalization rates rose from 3.0 to 4.96 per 100,000 inhabitants before decreasing to 3.7 per 100,000 in 2024. Segmented Poisson regression demonstrated a significant increase until 2015 followed by a significant decline thereafter. Age-specific analyses demonstrated a stable predominance of middle-aged and older adults, with consistently highest hospitalization volumes in patients aged 50-70 years. After age standardization to the 2015 reference population, the temporal pattern remained largely unchanged, indicating that observed trends were not solely attributable to population ageing. Mean length of hospital stay decreased steadily over time. Anterior surgical approaches accounted for the majority of procedures throughout the study period, while the proportion of surgically treated cases per hospitalization increased over time.</p><p><strong>Conclusions: </strong>This nationwide, discharge-based analysis demonstrates substantial temporal changes in hospitalizations and surgical treatment patterns for DCM in Germany over the past two decades. Hospitalization volumes increased until approximately 2015 and declined thereafter, a pattern that persisted after age standardization. DCM predominantly affected patients aged 50-70 years throughout the study period, without a pronounced shift toward progressively older age groups. The increasing ratio of surgical procedures to hospitalizations suggests more selective inpatient admissions focusing on operative management. These findings provide a descriptive reference for long-term hospitalization and surgical trends in DCM.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open arthrolysis is rarely performed in the management of stiffness after total knee arthroplasty. 开放关节松解术很少用于全膝关节置换术后僵硬的治疗。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-02 DOI: 10.1007/s00264-026-06743-0
Rémi Garrigue, Renaud Siboni, Ainu Verdini, Cécile Batailler, Bruno Miletic, Matthieu Elhinger

Purpose: Postoperative stiffness is a common and incapacitating complication after total knee arthroplasty (TKA), significantly impacting functional outcomes. Open arthrolysis remains a less-studied surgical option. The objective of this study was to assess the use and outcomes of open arthrolysis in post-TKA stiffness management. We hypothesised that open arthrolysis is the least frequently used technique.

Methods: This was a retrospective multicentre study conducted as part of the 2024 SOFCOT symposium on post-TKA stiffness management, including 13 centres in France. Patients who underwent open arthrolysis for post-TKA stiffness between 2015 and 2019 were included. Demographic, radiographic, and clinical data were collected, and functional outcomes were evaluated using KOOS, Oxford, and JFS-12 scores preoperatively and postoperatively. Range of motion (ROM) was assessed and compared across different treatment modalities.

Results: Among 490 patients treated for post-TKA stiffness, 12 (2.4%) underwent open arthrolysis. The mean follow-up duration was seven years. Open arthrolysis patients were treated later than those undergoing manipulation under anaesthesia (28.1 vs. 7.2 months, p = 0.001) and later than arthroscopic arthrolysis patients without statistical difference (9.9 months, p = 0.216). Mean ROM improved by 27° postoperatively but remained lower than in other treatment groups (74° vs. 98°, p = 0.011). More than 90% of open arthrolysis patients reported dissatisfaction, compared to 26% for other techniques (p < 0.001).

Conclusion: Open arthrolysis is rarely performed for post-TKA stiffness with higher patient dissatisfaction rates than other treatment modalities. These findings suggest that open arthrolysis may have a limited role in post-TKA stiffness management.

目的:术后僵硬是全膝关节置换术(TKA)后常见的致残并发症,显著影响功能预后。开放关节松解术仍然是一种研究较少的手术选择。本研究的目的是评估开放关节松解术在tka后僵硬管理中的应用和结果。我们假设开放关节松解术是最不常用的技术。方法:这是一项回顾性多中心研究,作为2024年SOFCOT后tka僵硬管理研讨会的一部分,包括法国的13个中心。纳入了2015年至2019年期间因tka后僵硬接受开放关节松解术的患者。收集人口统计学、放射学和临床数据,术前和术后使用oos、Oxford和JFS-12评分评估功能结局。评估和比较不同治疗方式的活动范围(ROM)。结果:490例tka后僵硬患者中,12例(2.4%)行开放关节松解术。平均随访时间为7年。开放关节松解术患者比麻醉下操作关节松解术患者治疗时间晚(28.1个月比7.2个月,p = 0.001),比关节镜下关节松解术患者治疗时间晚(9.9个月,p = 0.216),差异无统计学意义。术后平均ROM改善27°,但仍低于其他治疗组(74°对98°,p = 0.011)。超过90%的开放式关节松解术患者报告不满意,而其他技术的患者报告不满意率为26% (p结论:开放式关节松解术很少用于tka后僵硬患者,患者不满意率高于其他治疗方式。这些发现表明开放关节松解术在tka后僵硬管理中的作用有限。
{"title":"Open arthrolysis is rarely performed in the management of stiffness after total knee arthroplasty.","authors":"Rémi Garrigue, Renaud Siboni, Ainu Verdini, Cécile Batailler, Bruno Miletic, Matthieu Elhinger","doi":"10.1007/s00264-026-06743-0","DOIUrl":"https://doi.org/10.1007/s00264-026-06743-0","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative stiffness is a common and incapacitating complication after total knee arthroplasty (TKA), significantly impacting functional outcomes. Open arthrolysis remains a less-studied surgical option. The objective of this study was to assess the use and outcomes of open arthrolysis in post-TKA stiffness management. We hypothesised that open arthrolysis is the least frequently used technique.</p><p><strong>Methods: </strong>This was a retrospective multicentre study conducted as part of the 2024 SOFCOT symposium on post-TKA stiffness management, including 13 centres in France. Patients who underwent open arthrolysis for post-TKA stiffness between 2015 and 2019 were included. Demographic, radiographic, and clinical data were collected, and functional outcomes were evaluated using KOOS, Oxford, and JFS-12 scores preoperatively and postoperatively. Range of motion (ROM) was assessed and compared across different treatment modalities.</p><p><strong>Results: </strong>Among 490 patients treated for post-TKA stiffness, 12 (2.4%) underwent open arthrolysis. The mean follow-up duration was seven years. Open arthrolysis patients were treated later than those undergoing manipulation under anaesthesia (28.1 vs. 7.2 months, p = 0.001) and later than arthroscopic arthrolysis patients without statistical difference (9.9 months, p = 0.216). Mean ROM improved by 27° postoperatively but remained lower than in other treatment groups (74° vs. 98°, p = 0.011). More than 90% of open arthrolysis patients reported dissatisfaction, compared to 26% for other techniques (p < 0.001).</p><p><strong>Conclusion: </strong>Open arthrolysis is rarely performed for post-TKA stiffness with higher patient dissatisfaction rates than other treatment modalities. These findings suggest that open arthrolysis may have a limited role in post-TKA stiffness management.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of an enhanced recovery after surgery program on total hip and knee arthroplasty in a university hospital: a two-cohort study. 一所大学医院全髋关节置换术术后增强恢复方案的效果:一项双队列研究。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-02-02 DOI: 10.1007/s00264-026-06744-z
Eric Albrecht, Alexandre Koninckx, Corey Kull, Marcio Oliveira, Valérie Addor, Jean-Benoit Rossel, Julien Wegrzyn

Background: Enhanced Recovery After Surgery (ERAS®) is a coordinated, evidence-based program delivered through a multidisciplinary team, which objective is to improve outcomes and patient satisfaction, while minimizing complications. The objective of this two-cohort study is to evaluate the clinical impact of an ERAS program on elective primary hip (THA) and knee (TKA) arthroplasties with regards to hospital length of stay, during the first 12 months after implementation.

Methods: We compared a retrospective pre-ERAS with a prospective ERAS cohort. Key aspects of this program included preoperative education, minimal fasting, standardised, anaesthetic and surgical techniques, multimodal analgesia, and early mobilization. The primary outcome was hospital length of stay. Other outcomes included rest, dynamic pain scores, and rates of complications.

Results: From December 1st, 2021 to November 30th, 2022, data from 267 patients (138 THA, 129 TKA) were compared with data from 258 patients (128 THA, 130 TKA) collected between December 1st, 2022, and November 30th, 2023, who underwent the ERAS® program (total: 525 patients). The mean hospital length of stay for THA patients before ERAS® was 5.5 ± 2.9 days versus 4.5 ± 2.0 days after ERAS® implementation (p = 0.002). For TKA patients, it was 6.6 ± 3.1 days before vs 5.6 ± 1.9 days after ERAS® implementation (p = 0.001). Rest, dynamic pain scores, and rates of complications were similar between groups except for pneumonia in patients undergoing TKA.

Conclusion: The implementation of an ERAS® program for hip and knee arthroplasty led to a reduced hospital length of stay, below the Swiss national average, without impacting pain outcomes and rates of complications.

背景:ERAS®(Enhanced Recovery After Surgery)是一个协调的、以证据为基础的项目,由一个多学科团队提供,其目标是改善结果和患者满意度,同时最大限度地减少并发症。这项双队列研究的目的是评估ERAS项目对选择性原发性髋关节(THA)和膝关节(TKA)关节置换术实施后最初12个月住院时间的临床影响。方法:我们比较了回顾性ERAS前期和前瞻性ERAS队列。该计划的关键方面包括术前教育、最低限度禁食、标准化麻醉和手术技术、多模式镇痛和早期活动。主要观察指标为住院时间。其他结果包括休息、动态疼痛评分和并发症发生率。结果:从2021年12月1日至2022年11月30日,将267例患者(138例THA, 129例TKA)的数据与2022年12月1日至2023年11月30日收集的258例患者(128例THA, 130例TKA)的数据进行比较,这些患者接受了ERAS®项目(总数:525例)。ERAS®前THA患者的平均住院时间为5.5±2.9天,而ERAS®实施后为4.5±2.0天(p = 0.002)。对于TKA患者,ERAS实施前为6.6±3.1天,实施后为5.6±1.9天(p = 0.001)。除TKA患者的肺炎外,各组间休息、动态疼痛评分和并发症发生率相似。结论:ERAS®髋关节和膝关节置换术的实施缩短了住院时间,低于瑞士全国平均水平,且不影响疼痛结局和并发症发生率。
{"title":"Effect of an enhanced recovery after surgery program on total hip and knee arthroplasty in a university hospital: a two-cohort study.","authors":"Eric Albrecht, Alexandre Koninckx, Corey Kull, Marcio Oliveira, Valérie Addor, Jean-Benoit Rossel, Julien Wegrzyn","doi":"10.1007/s00264-026-06744-z","DOIUrl":"https://doi.org/10.1007/s00264-026-06744-z","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS®) is a coordinated, evidence-based program delivered through a multidisciplinary team, which objective is to improve outcomes and patient satisfaction, while minimizing complications. The objective of this two-cohort study is to evaluate the clinical impact of an ERAS program on elective primary hip (THA) and knee (TKA) arthroplasties with regards to hospital length of stay, during the first 12 months after implementation.</p><p><strong>Methods: </strong>We compared a retrospective pre-ERAS with a prospective ERAS cohort. Key aspects of this program included preoperative education, minimal fasting, standardised, anaesthetic and surgical techniques, multimodal analgesia, and early mobilization. The primary outcome was hospital length of stay. Other outcomes included rest, dynamic pain scores, and rates of complications.</p><p><strong>Results: </strong>From December 1st, 2021 to November 30th, 2022, data from 267 patients (138 THA, 129 TKA) were compared with data from 258 patients (128 THA, 130 TKA) collected between December 1st, 2022, and November 30th, 2023, who underwent the ERAS® program (total: 525 patients). The mean hospital length of stay for THA patients before ERAS® was 5.5 ± 2.9 days versus 4.5 ± 2.0 days after ERAS® implementation (p = 0.002). For TKA patients, it was 6.6 ± 3.1 days before vs 5.6 ± 1.9 days after ERAS® implementation (p = 0.001). Rest, dynamic pain scores, and rates of complications were similar between groups except for pneumonia in patients undergoing TKA.</p><p><strong>Conclusion: </strong>The implementation of an ERAS® program for hip and knee arthroplasty led to a reduced hospital length of stay, below the Swiss national average, without impacting pain outcomes and rates of complications.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment outcomes of periprosthetic joint infections of the elbow: a retrospective cohort study from a single referral centre. 肘关节假体周围感染的治疗结果:来自单一转诊中心的回顾性队列研究。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-01-25 DOI: 10.1007/s00264-026-06736-z
Matej Mazura, Michal Benes, David Veigl, Rastislav Hromadka, Stanislav Jr Popelka, Vladislav Bartak

Purpose: Periprosthetic joint infection (PJI) is a potentially devastating complication following total elbow arthroplasty. In this retrospective study, we aimed to review our cohort of patients to assess the treatment success rates of elbow PJI using different treatment methods and to report on the additional treatment approach for failed cases.

Methods: The study included 26 patients who underwent revision surgery for elbow PJI between 2007 and 2023. Patients were enrolled if they possessed a minimum follow-up of two years. Success of different treatment strategies, including debridement, antibiotics, and implant retention (DAIR) with or without modular component exchange, and two-stage revision was evaluated, as well as the fate of patients who experienced initial treatment failure.

Results: At a mean follow-up of 140.5 ± 74.5 months, only 11 patients (42.3%) were successfully treated after a single revision. The overall infection-free survival rates were 65.4% at one year, 50.0% at two years, and 45.8% at five years. DAIR without component exchange had the lowest success (23.1%), while DAIR with modular component exchange and two-stage revision showed the highest (60.0% and 62.5%, respectively). Failed cases (57.7%) required a mean of 2.1 additional procedures to achieve infection control.

Conclusion: Treatment of elbow PJI remains especially challenging due to an overall high treatment failure. While two-stage exchange appears to be the most effective treatment modality, DAIR with modular component exchange shows promising outcomes in well-fixed prostheses. DAIR without modular components exchange yields poor infection control rates and should be omitted.

目的:假体周围关节感染(PJI)是全肘关节置换术后潜在的破坏性并发症。在这项回顾性研究中,我们旨在回顾我们的患者队列,以评估不同治疗方法对肘关节PJI的治疗成功率,并报告失败病例的额外治疗方法。方法:该研究包括2007年至2023年间接受肘关节PJI翻修手术的26例患者。如果患者至少有两年的随访,他们就会被纳入。不同的治疗策略,包括清创、抗生素和种植体保留(DAIR),有或没有模块组件交换,两阶段翻修,以及经历初始治疗失败的患者的命运进行了评估。结果:在平均140.5±74.5个月的随访中,只有11例(42.3%)患者在单次翻修后成功治疗。总体无感染生存率为1年65.4%,2年50.0%,5年45.8%。没有组件交换的DAIR成功率最低(23.1%),而模块化组件交换和两阶段修订的DAIR成功率最高(分别为60.0%和62.5%)。失败病例(57.7%)平均需要2.1次额外手术才能实现感染控制。结论:由于整体治疗失败率高,肘关节PJI的治疗仍然特别具有挑战性。虽然两阶段交换似乎是最有效的治疗方式,但具有模块化组件交换的DAIR在固定良好的假体中显示出有希望的结果。没有模块组件交换的DAIR产生较差的感染控制率,应省略。
{"title":"Treatment outcomes of periprosthetic joint infections of the elbow: a retrospective cohort study from a single referral centre.","authors":"Matej Mazura, Michal Benes, David Veigl, Rastislav Hromadka, Stanislav Jr Popelka, Vladislav Bartak","doi":"10.1007/s00264-026-06736-z","DOIUrl":"https://doi.org/10.1007/s00264-026-06736-z","url":null,"abstract":"<p><strong>Purpose: </strong>Periprosthetic joint infection (PJI) is a potentially devastating complication following total elbow arthroplasty. In this retrospective study, we aimed to review our cohort of patients to assess the treatment success rates of elbow PJI using different treatment methods and to report on the additional treatment approach for failed cases.</p><p><strong>Methods: </strong>The study included 26 patients who underwent revision surgery for elbow PJI between 2007 and 2023. Patients were enrolled if they possessed a minimum follow-up of two years. Success of different treatment strategies, including debridement, antibiotics, and implant retention (DAIR) with or without modular component exchange, and two-stage revision was evaluated, as well as the fate of patients who experienced initial treatment failure.</p><p><strong>Results: </strong>At a mean follow-up of 140.5 ± 74.5 months, only 11 patients (42.3%) were successfully treated after a single revision. The overall infection-free survival rates were 65.4% at one year, 50.0% at two years, and 45.8% at five years. DAIR without component exchange had the lowest success (23.1%), while DAIR with modular component exchange and two-stage revision showed the highest (60.0% and 62.5%, respectively). Failed cases (57.7%) required a mean of 2.1 additional procedures to achieve infection control.</p><p><strong>Conclusion: </strong>Treatment of elbow PJI remains especially challenging due to an overall high treatment failure. While two-stage exchange appears to be the most effective treatment modality, DAIR with modular component exchange shows promising outcomes in well-fixed prostheses. DAIR without modular components exchange yields poor infection control rates and should be omitted.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Molecular background behind lateral elbow pain reduction with Leukocyte-Rich and Leukocyte-Poor Platelet-Rich Plasma-randomized control trial and single-cell platelet analysis. 富白细胞和贫白细胞富血小板血浆减轻侧肘疼痛的分子背景:随机对照试验和单细胞血小板分析。
IF 2.6 3区 医学 Q2 ORTHOPEDICS Pub Date : 2026-01-24 DOI: 10.1007/s00264-025-06719-6
Joanna Wałecka, Paweł Bąkowski, Marta Jokiel, Rafał Trąbka, Monika Chaszczewska-Markowska, Daniel Ghete, Dorota Gurda-Woźna, Agnieszka Fedoruk-Wyszomirska, Przemyslaw Lubiatowski, Eliza Wyszko, Agata Tyczewska, Kamilla Bąkowska-Żywicka

Purpose: Degeneration at the common extensor origin leads to lateral elbow pain and reduced quality of life. We conducted a double-blind, randomized, placebo-controlled trial involving 71 patients treated with leukocyte-poor PRP (LP-PRP), leukocyte-rich PRP (LR-PRP), or saline.

Methods: PRP content was analyzed using flow cytometry, confocal microscopy, and holotomography. Clinical outcomes (Visual Analogue Scale, Oxford Elbow Score) were assessed at baseline and at three, six, 12, 24, and 55 weeks.

Results: LR-PRP contained 3.8 × more leukocytes and 2.7 × fewer platelets than LP-PRP. Imaging revealed distinct platelet morphology and activation patterns between PRP types. The LP-PRP group showed significantly greater pain reduction at six weeks and improved elbow function from three to six weeks onward.

Conclusion: LP-PRP produced superior and longer-lasting clinical outcomes compared to LR-PRP and saline.

Clinicaltrials: GOV: NCT06854666 (retrospectively registered on 2025-01-13).

目的:伸肌总起点的退变导致肘关节外侧疼痛和生活质量下降。我们进行了一项双盲、随机、安慰剂对照试验,共有71例患者接受了低白细胞PRP (LP-PRP)、高白细胞PRP (LR-PRP)或生理盐水治疗。方法:采用流式细胞术、共聚焦显微镜和全息层析术分析PRP含量。临床结果(视觉模拟量表,牛津肘评分)在基线和3、6、12、24和55周进行评估。结果:LR-PRP白细胞比LP-PRP多3.8倍,血小板比LP-PRP少2.7倍。成像显示不同PRP类型的血小板形态和活化模式不同。LP-PRP组在6周时疼痛明显减轻,3 - 6周后肘关节功能得到改善。结论:与LR-PRP和生理盐水相比,LP-PRP具有更优越和更持久的临床效果。临床试验:GOV: NCT06854666(回顾性注册日期为2025-01-13)。
{"title":"Molecular background behind lateral elbow pain reduction with Leukocyte-Rich and Leukocyte-Poor Platelet-Rich Plasma-randomized control trial and single-cell platelet analysis.","authors":"Joanna Wałecka, Paweł Bąkowski, Marta Jokiel, Rafał Trąbka, Monika Chaszczewska-Markowska, Daniel Ghete, Dorota Gurda-Woźna, Agnieszka Fedoruk-Wyszomirska, Przemyslaw Lubiatowski, Eliza Wyszko, Agata Tyczewska, Kamilla Bąkowska-Żywicka","doi":"10.1007/s00264-025-06719-6","DOIUrl":"https://doi.org/10.1007/s00264-025-06719-6","url":null,"abstract":"<p><strong>Purpose: </strong>Degeneration at the common extensor origin leads to lateral elbow pain and reduced quality of life. We conducted a double-blind, randomized, placebo-controlled trial involving 71 patients treated with leukocyte-poor PRP (LP-PRP), leukocyte-rich PRP (LR-PRP), or saline.</p><p><strong>Methods: </strong>PRP content was analyzed using flow cytometry, confocal microscopy, and holotomography. Clinical outcomes (Visual Analogue Scale, Oxford Elbow Score) were assessed at baseline and at three, six, 12, 24, and 55 weeks.</p><p><strong>Results: </strong>LR-PRP contained 3.8 × more leukocytes and 2.7 × fewer platelets than LP-PRP. Imaging revealed distinct platelet morphology and activation patterns between PRP types. The LP-PRP group showed significantly greater pain reduction at six weeks and improved elbow function from three to six weeks onward.</p><p><strong>Conclusion: </strong>LP-PRP produced superior and longer-lasting clinical outcomes compared to LR-PRP and saline.</p><p><strong>Clinicaltrials: </strong>GOV: NCT06854666 (retrospectively registered on 2025-01-13).</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Orthopaedics
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1