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Anxiety and depression as risk factors for postoperative complications and pain in lumbar spine surgery: A national database study 焦虑和抑郁是腰椎手术术后并发症和疼痛的风险因素:国家数据库研究
IF 1.6 4区 医学 Pub Date : 2024-09-18 DOI: 10.1177/10225536241280190
Ruimin Wu, Pengcheng Gao, Shuxia Liu, Qinfeng Yang, Jian Wang, Fangguo Liang, Yuhang Chen, Lin Yang
Objective: To investigate the potential association between anxiety and depression and surgical outcomes in patients undergoing LSS. By analyzing data from the Nationwide Inpatient Sample (NIS) database, we aim to identify whether anxiety and depression serve as predictors for postoperative complications and pain-related symptoms. Methods: A retrospective analysis was conducted via the NIS database. Those undergoing LSS from 2010 to 2019 were divided into four groups: those with a diagnosis of anxiety, depression, both depression and anxiety, and neither depression nor anxiety. The chi-squared test, rank sum test, the Student-Newman-Keuls, least significant difference, and Bonferroni tests were used to identify differences between these groups. Logistic regression analysis was utilized to determine if anxiety and depression were predictors for postoperative complications and pain-related symptoms. Results: From 2010 to 2019, 832,099 patients undergoing LSS were identified. Patients with either anxiety or depression were associated with heavier economic burdens ($85,375, $76,840, $88,542 in the anxiety, depression, and comorbid group, respectively, p < 0.001) and prolonged hospital stay ( p < 0.001). They were identified to experience higher risks of various complications especially thrombophilia (OR = 1.82, and 1.55 in the anxiety and the depression group, respectively, p < 0.01). Multiple pain-related symptoms, but face reduced risks of inpatient mortality (OR = 0.71, 0.75, and 0.63 in the anxiety, depression, and comorbid group, respectively, p < 0.01). Conclusions: The overall morbidities of depression and anxiety were relatively high. Psychiatric comorbidities were closely correlated with the negative outcomes after LSS. The psychological health of patients receiving LSS requires necessary attention to ensure pain control and prevent complications postoperatively.
目的研究焦虑和抑郁与 LSS 患者手术结果之间的潜在关联。通过分析全国住院患者样本(NIS)数据库中的数据,我们旨在确定焦虑和抑郁是否是术后并发症和疼痛相关症状的预测因素。研究方法通过 NIS 数据库进行回顾性分析。将 2010 年至 2019 年期间接受 LSS 的患者分为四组:诊断为焦虑、抑郁、抑郁和焦虑以及既无抑郁也无焦虑的患者。采用卡方检验、秩和检验、Student-Newman-Keuls 检验、最小显著性差异检验和 Bonferroni 检验来确定这些组间的差异。利用逻辑回归分析确定焦虑和抑郁是否是术后并发症和疼痛相关症状的预测因素。结果:从 2010 年到 2019 年,共有 832,099 名患者接受了 LSS 手术。焦虑或抑郁患者的经济负担更重(焦虑组、抑郁组和合并组分别为 85,375 美元、76,840 美元和 88,542 美元,p < 0.001),住院时间更长(p < 0.001)。研究还发现,他们出现各种并发症的风险较高,尤其是血栓性疾病(焦虑组和抑郁组的 OR 值分别为 1.82 和 1.55,p <0.01)。多种疼痛相关症状,但住院死亡率风险降低(焦虑组、抑郁组和合并症组的 OR 值分别为 0.71、0.75 和 0.63,p <0.01)。结论抑郁和焦虑的总体发病率相对较高。精神病合并症与 LSS 后的不良后果密切相关。为确保疼痛控制和预防术后并发症,LSS 患者的心理健康需要得到必要的关注。
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引用次数: 0
Imaging evaluation of extraarticular posterior loose bodies in varus ankle osteoarthritis 曲踝骨关节炎患者关节外后松动体的影像学评估
IF 1.6 4区 医学 Pub Date : 2024-09-14 DOI: 10.1177/10225536241284507
Tae Hun Song, Jun Young Choi, Jin Soo Suh, Yu Min Suh, Kyung Ah Chun
Purpose: Multiple loose bodies (LBs) are often found in patients with varus ankle osteoarthritis (OA). This study aimed to investigate the characteristics of extra-articular posterior ankle LBs in patients with varus ankle OA. We also sought to determine whether there were variations in the characteristics of LBs according to the degree of ankle OA. Methods: We retrospectively reviewed 50 patients who had appeared posterior extraarticular LBs on preoperative ankle imaging among the patients who underwent operative treatment for varus ankle OA from March 2011 to February 2023. We categorized the entire patient cohort into four groups according to the degree of ankle arthritis (Takakura stage II, IIIA, IIIB, and IV). Size, number, and location of LBs were evaluated using preoperative computed tomography and magnetic resonance imaging. Results: 142 LBs were identified (mean size: 11.5 mm); 76.8% were located within the flexor hallucis longus (FHL) tendon sheath, 20.4% in the posterior recess, and 2.8% in the flexor digitorum longus tendon sheath. Average LB size was significantly larger in Takakura stage IIIB and IV patients ( p < .05), and the LB number was significantly lower in stage II patients ( p = .013). Conclusion: Extra-articular posterior LBs in varus ankle OA are predominantly located within the FHL tendon sheath and were larger in Takakura stages IIIB and IV patients.Level of Evidence: Level III. Retrospective comparative study.
目的:在踝关节屈曲性骨关节炎(OA)患者中经常会发现多个松动体(LBs)。本研究旨在调查踝关节OA曲张患者关节外后踝松动体的特征。我们还试图确定 LBs 的特征是否随踝关节 OA 的程度而变化。研究方法我们回顾性研究了 2011 年 3 月至 2023 年 2 月期间因踝关节 OA 屈曲接受手术治疗的患者中,术前踝关节成像显示出现后方关节外 LB 的 50 名患者。我们根据踝关节炎的程度(高仓健 II 期、IIIA 期、IIIB 期和 IV 期)将所有患者分为四组。术前使用计算机断层扫描和磁共振成像对枸橼酸钙的大小、数量和位置进行了评估。结果共发现 142 个 LB(平均大小:11.5 毫米);76.8% 位于拇长屈肌腱鞘内,20.4% 位于后凹处,2.8% 位于拇长屈肌腱鞘内。高仓IIIB期和IV期患者的平均枸橼酸瘤大小明显增大(p <.05),II期患者的枸橼酸瘤数量明显减少(p = .013)。结论外翻性踝关节 OA 的关节外后 LB 主要位于 FHL 腱鞘内,在高仓 IIIB 期和 IV 期患者中更大:证据等级:III级。回顾性比较研究。
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引用次数: 0
Comparison of Cemented and Cementless Fixation in Total Knee Arthroplasty: A Meta-Analysis and Systematic Review of RCTs. 全膝关节置换术中的有骨水泥固定与无骨水泥固定的比较:对研究性临床试验的元分析和系统回顾。
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241267270
Zirui Liu, Lei Wen, Libo Zhou, Zhongcheng Liu, Yi Chen, Bin Geng, Yayi Xia

Objective: This study aimed to compare infection, aseptic loosening, revision, operation time, function scores, and the radiographic radiolucent line (RLL) between cementless and cemented fixation in total knee arthroplasty (TKA).

Methods: Articles reporting the outcomes of cemented and cementless TKA were searched in Medline, EMBASE, Web of Science, and the Cochrane Library. The search was conducted from articles published from January 1996 to May 2024. Odds Ratios (OR) and confidence intervals (CI) were used to measure the results. Cochrane Collaboration's Review Manager software was used to perform the meta-analysis.

Results: Sixteen randomized controlled trials containing 2358 participants were included in this meta-analysis. Pooled data found that, in TKA, there were no significant differences between cemented fixation and cementless fixation for a prosthesis in infection, aseptic loosening and revision. The subgroup analysis and sensitivity analysis results of the knee society score (KSS) showed a significant difference favoring cementless fixation in a follow-up of less than 5 years (MD = -2.30, 95%CI -3.85 -0.74, p = .001) while favoring cemented fixation in a follow-up over 5 years (MD = 2.79, 95%CI 0.95 4.63, p = .003). The operation time of cementless was less than that of cemented (MD = 12.03, 95%CI 8.30 15.77, p < .00001). No significant difference was detected in knee society function score, Western Ontario and McMaster Universities osteoarthritis index, and RLL. There was no heterogeneity across studies (p > .1), and most studies have a low risk of bias.

Conclusions: Within a follow-up period of less than 5 years, cementless TKA had better KSS, while over 5 years, KSS was better in cemented TKA, and cementless TKA required less operation time.

目的:本研究旨在比较全膝关节置换术(TKA)中无骨水泥固定和有骨水泥固定的感染、无菌性松动、翻修、手术时间、功能评分和放射线透亮线(RLL):在 Medline、EMBASE、Web of Science 和 Cochrane 图书馆中检索了报告有骨水泥和无骨水泥 TKA 结果的文章。搜索范围为 1996 年 1 月至 2024 年 5 月期间发表的文章。研究结果采用比值比(OR)和置信区间(CI)进行测量。使用 Cochrane Collaboration 的 Review Manager 软件进行荟萃分析:本次荟萃分析共纳入了 16 项随机对照试验,共有 2358 人参与。汇总数据发现,在TKA中,有骨水泥固定和无骨水泥固定假体在感染、无菌性松动和翻修方面没有显著差异。膝关节社会评分(KSS)的亚组分析和敏感性分析结果显示,在随访不到5年的情况下,无骨水泥固定的优势明显(MD = -2.30,95%CI -3.85-0.74,p = .001),而在随访超过5年的情况下,有骨水泥固定的优势明显(MD = 2.79,95%CI 0.95-4.63,p = .003)。无骨水泥固定的手术时间少于有骨水泥固定(MD = 12.03,95%CI 8.30 15.77,p < .00001)。在膝关节社会功能评分、西安大略和麦克马斯特大学骨关节炎指数以及RLL方面未发现明显差异。各研究之间不存在异质性(P > .1),大多数研究的偏倚风险较低:在不到5年的随访期内,无骨水泥TKA的KSS更好,而在5年以上的随访期内,有骨水泥TKA的KSS更好,而且无骨水泥TKA所需的手术时间更短。
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引用次数: 0
Does high body mass index affect short-term clinical and radiologic outcomes in robotic-assisted total knee arthroplasty? 高体重指数是否会影响机器人辅助全膝关节置换术的短期临床和放射学结果?
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241276158
MingYang Li, Han Zhang, HaoXiang Zhu, YongTao Zhang

Background: The purpose of this study was to determine whether high BMI affect short-term clinical and radiologic outcomes of robotic-assisted total knee arthroplasty (TKA) by comparing the clinical outcomes, radiologic outcomes and complications between high BMI and normal patients.

Methods: We retrospectively compared the short-term clinical and radiological outcomes of 424 knees (408 patients). The patients were divided into four groups: BMI < 24.9 kg/m2 (normal); BMI between 25.0 and 29.9 kg/m2 (overweight); BMI between 30.0 and 34.9 kg/m2 (obese class I) and BMI between 35.0 and 39.9 kg/m2 (obese class II). Clinical and radiologic outcomes were evaluated.

Results: There was no significant difference in radiologic outcomes between those groups (p > .05). Furthermore, there was no significant difference in operation time, drainage volume, fall in hemoglobin, post-operative CRP and complications, including periprosthetic fracture and periprosthetic joint infection (PJI), between those groups.

Conclusion: High BMI does not affect short-term clinical and radiologic outcomes in robot-assisted TKA.

背景:本研究旨在通过比较高体重指数患者和正常患者的临床结果、放射学结果和并发症,确定高体重指数是否会影响机器人辅助全膝关节置换术(TKA)的短期临床和放射学结果:我们回顾性比较了 424 个膝关节(408 名患者)的短期临床和放射学结果。患者分为四组:体重指数小于 24.9 kg/m2(正常);体重指数介于 25.0 至 29.9 kg/m2(超重);体重指数介于 30.0 至 34.9 kg/m2(肥胖 I 级);体重指数介于 35.0 至 39.9 kg/m2(肥胖 II 级)。对临床和放射学结果进行了评估:结果:两组患者的放射学结果无明显差异(P > .05)。此外,两组在手术时间、引流量、血红蛋白下降、术后 CRP 和并发症(包括假体周围骨折和假体周围关节感染 (PJI))方面也无明显差异:结论:高体重指数不会影响机器人辅助 TKA 的短期临床和放射学结果。
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引用次数: 0
Preoperative abaloparatide plus zoledronate treatment accelerates femoral bone healing in rats following osteotomy. 术前阿巴拉帕肽加唑来膦酸钠治疗可加速大鼠截骨后的股骨头愈合。
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241293486
Takashi Kataoka, Yuta Tsubouchi, Ryota Takase, Takefumi Otsu, Tatsuya Iwasaki, Masashi Kataoka, Nobuhiro Kaku

Purpose: We investigated the potential efficacy of abaloparatide (Abalo) and zoledronate (ZA) combination therapy for accelerating femoral union in a rat osteotomy model. Methods: Nine-week-old male Sprague-Dawley rats were randomly divided into four groups (n = 14 per group): control, abaloparatide (Abalo, 30 μg/kg via subcutaneous injection [s.c.] 5 times per week for 6 weeks), zoledronate (ZA; 0.1 mg/kg via s.c., single dose), and Abalo + ZA. Rats were then subjected to unilateral osteotomy of the femoral shaft, followed by osteosynthesis with intramedullary nailing to establish bone healing models. At 2 and 4 weeks after osteotomy, both femurs were removed from seven rats per group for soft X-ray imaging to evaluate bone union and microcomputed tomography (micro-CT) for bone morphometric evaluation. Blood samples were collected from all rats every 2 week starting 6 weeks pre- to 4 weeks postosteotomy. Toluidine blue staining was used for histopathological evaluation of the undecalcified specimens. Results: Soft X-ray imaging revealed accelerated callus formation, callus maturation, and fracture line closure in Abalo and Abalo + ZA groups compared to ZA and control groups. Micro-CT demonstrated greater cortical bone and trabecular bone to total volume ratios in contralateral (left) femurs of the Abalo + ZA group compared to the Abalo group. Both trabecular and cortical bone mineral densities were also greater in contralateral femurs of the Abalo + ZA group compared to Abalo and ZA groups. Conclusion: These findings suggest substantial additive or synergistic efficacy of abaloparatide plus zoledronate combination therapy for accelerating bone healing following osteotomy and for maintaining normal bone health.

目的:我们研究了阿巴拉帕肽(Abaloparatide,Abalo)和唑来膦酸钠(zoledronate,ZA)联合疗法在大鼠截骨模型中加速股骨结合的潜在疗效。研究方法将九周大的雄性 Sprague-Dawley 大鼠随机分为四组(每组 n = 14):对照组、阿巴拉帕肽(Abaloparatide,30 μg/kg 经皮下注射 [s.c.],每周 5 次,共 6 周)组、唑来膦酸钠(ZA,0.1 mg/kg 经皮下注射,单剂量)组和阿巴拉帕肽 + ZA 组。然后对大鼠进行单侧股骨干截骨,再用髓内钉进行骨合成,以建立骨愈合模型。截骨后 2 周和 4 周,每组取出 7 只大鼠的股骨,进行软 X 射线成像以评估骨结合情况,并进行微计算机断层扫描(micro-CT)以评估骨形态。从截骨前 6 周到截骨后 4 周,每 2 周采集一次所有大鼠的血液样本。甲苯胺蓝染色用于对未钙化标本进行组织病理学评估。结果软X射线成像显示,与ZA组和对照组相比,Abalo组和Abalo + ZA组的胼胝形成、胼胝成熟和骨折线闭合速度更快。显微 CT 显示,与 Abalo 组相比,Abalo + ZA 组对侧(左侧)股骨的皮质骨和骨小梁占总体积的比例更大。与阿巴洛组和ZA组相比,阿巴洛+ZA组对侧股骨的骨小梁和皮质骨矿物质密度也更高。结论:这些研究结果表明,阿巴拉帕肽+唑来膦酸钠联合疗法在加速截骨术后骨愈合和维持正常骨骼健康方面具有显著的相加或协同疗效。
{"title":"Preoperative abaloparatide plus zoledronate treatment accelerates femoral bone healing in rats following osteotomy.","authors":"Takashi Kataoka, Yuta Tsubouchi, Ryota Takase, Takefumi Otsu, Tatsuya Iwasaki, Masashi Kataoka, Nobuhiro Kaku","doi":"10.1177/10225536241293486","DOIUrl":"https://doi.org/10.1177/10225536241293486","url":null,"abstract":"<p><p><b>Purpose:</b> We investigated the potential efficacy of abaloparatide (Abalo) and zoledronate (ZA) combination therapy for accelerating femoral union in a rat osteotomy model. <b>Methods:</b> Nine-week-old male Sprague-Dawley rats were randomly divided into four groups (<i>n</i> = 14 per group): control, abaloparatide (Abalo, 30 μg/kg via subcutaneous injection [s.c.] 5 times per week for 6 weeks), zoledronate (ZA; 0.1 mg/kg via s.c., single dose), and Abalo + ZA. Rats were then subjected to unilateral osteotomy of the femoral shaft, followed by osteosynthesis with intramedullary nailing to establish bone healing models. At 2 and 4 weeks after osteotomy, both femurs were removed from seven rats per group for soft X-ray imaging to evaluate bone union and microcomputed tomography (micro-CT) for bone morphometric evaluation. Blood samples were collected from all rats every 2 week starting 6 weeks pre- to 4 weeks postosteotomy. Toluidine blue staining was used for histopathological evaluation of the undecalcified specimens. <b>Results:</b> Soft X-ray imaging revealed accelerated callus formation, callus maturation, and fracture line closure in Abalo and Abalo + ZA groups compared to ZA and control groups. Micro-CT demonstrated greater cortical bone and trabecular bone to total volume ratios in contralateral (left) femurs of the Abalo + ZA group compared to the Abalo group. Both trabecular and cortical bone mineral densities were also greater in contralateral femurs of the Abalo + ZA group compared to Abalo and ZA groups. <b>Conclusion:</b> These findings suggest substantial additive or synergistic efficacy of abaloparatide plus zoledronate combination therapy for accelerating bone healing following osteotomy and for maintaining normal bone health.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241293486"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Letter to the editor regarding the article "knocking-down long non-coding RNA LINC01094 prohibits chondrocyte apoptosis via regulating microRNA-577/metal-regulatory transcription factor 1 axis". 致编辑的信,内容涉及文章 "敲除长非编码 RNA LINC01094 通过调节 microRNA-577/ 金属调节转录因子 1 轴阻止软骨细胞凋亡"。
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241288281
Xiaohua Jiang, Guowu Chen
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引用次数: 0
A randomized controlled trial comparing carbazochrome sodium sulfonate and tranexamic acid in reducing blood loss and inflammatory response after simultaneous bilateral total hip arthroplasty. 一项随机对照试验,比较卡巴克酸钠磺酸盐和氨甲环酸在同时进行双侧全髋关节置换术后减少失血和炎症反应的效果。
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241293544
Guangtao Han, Lijun Cai, Qin Wang, Qianhao Li, Pengde Kang

Purpose: A drug known as carbazochrome sodium sulfonate (CSS) can reduce blood loss. But, it is not known how it can prevent the development of hemostatic and inflammatory conditions in patients who undergo bilateral simultaneous total hip arthroplasty (SBTHA). This study will analyze the safety and effectiveness of combining this drug with SBTHA.

Methods: The study was conducted on 100 patients who underwent SBTHA with simultaneous total hip replacement. They were split into two groups: group B received TXA with CSS, group A received TXA with no CSS. The main observation of the study was the total blood loss, which is the most common indication of blood loss. Other secondary indicators of the study included hidden blood loss, postoperative blood transfusion rate, level of inflammatory reactants, hip function, pain score, venous thromboembolism (VTE) and the incidence of adverse events.

Results: Group B had significantly lower TBL and HBL compared to Group A. Group B showed significant improvement in inflammatory biomarker levels, blood transfusion rate when compared to Group A (p < .05). No thromboembolic complications occurred in either group. There were no significant differences between the two groups in terms of postoperative swelling rate, intraoperative blood loss, visual analog scale pain score, platelet count, discharge motion and average length of stay.

Conclusions: As a hemostatic agent, CSS combined with TXA can reduce postoperative blood loss in patients undergoing SBTHA, and is more effective than TXA alone in terms of blood loss and inflammation, and does not increase the incidence of thromboembolic complications.

目的:一种名为卡巴肼磺酸钠(CSS)的药物可以减少失血量。但它如何防止双侧同时全髋关节置换术(SBTHA)患者出现止血和炎症情况尚不清楚。本研究将分析将该药物与 SBTHA 结合使用的安全性和有效性:研究对象为 100 名接受 SBTHA 和同期全髋关节置换术的患者。他们被分为两组:B 组接受含 CSS 的 TXA,A 组接受不含 CSS 的 TXA。研究的主要观察指标是总失血量,这是最常见的失血指标。其他次要指标包括隐性失血、术后输血率、炎症反应物水平、髋关节功能、疼痛评分、静脉血栓栓塞(VTE)和不良事件的发生率:与 A 组相比,B 组的 TBL 和 HBL 明显降低;与 A 组相比,B 组的炎症生物标志物水平和输血率明显改善(P < .05)。两组均未发生血栓栓塞并发症。两组在术后肿胀率、术中失血量、视觉模拟量表疼痛评分、血小板计数、出院动作和平均住院时间方面无明显差异:作为一种止血剂,CSS 联合 TXA 可以减少 SBTHA 患者的术后失血量,在减少失血和炎症方面比单独使用 TXA 更有效,并且不会增加血栓栓塞并发症的发生率。
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引用次数: 0
Comparative analysis of changes in spinal dimensions following different correction methods in adult spinal deformity surgery. 成人脊柱畸形手术中不同矫正方法后脊柱尺寸变化的比较分析。
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241289313
Hoai Tp Dinh, Hiroki Ushirozako, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe, Tomohiro Yamada, Koichiro Ide, Kenta Kurosu, Yukihiro Matsuyama

Background: Adult spinal deformity (ASD) surgery has gained popularity, with significant improvements in patient-reported outcomes. Posterior lumbar interbody fusion with multiple grade II osteotomies (PLIF + MOs) and lateral lumbar interbody fusion (LLIF) have been utilized to correct ASD; however, no studies have compared these methods with regard to the pre- and postoperative changes in length and volume of the spinal canal. This study aimed to investigate the 3-dimensional changes in the anterior vertical column length (AVCL), spinal canal length (SCL), and spinal canal volume (SCV) in patients with ASD after surgery, employing LLIF and PLIF + MOs. Methods: This retrospective study examined 44 patients with ASD who underwent surgery between 2010 and 2021 using two corrective surgical methods, LLIF and PLIF + MOs. Radiographic parameters and clinical outcomes were assessed, and three-dimensional models were created from computed tomography images to analyze changes in AVCL, SCL, and SCV. Results: We compared the effects of LLIF and PLIF + MOs on spinal canal dimensions during ASD surgery. LLIF demonstrated an increase in lumbar segment (L1-S1) AVCL and whole spine (T1-S1) SCL by 6.5 ± 8.0 mm and 13.8 ± 7.6 mm, respectively, compared with PLIF + MOs. However, PLIF + MOs exhibited a reduction in the lengths of the lumbar segment AVCL. Postoperative differences were significant for AVCL (L1-S1), SCL fusion level, and first-standing lumbar lordosis between the groups (p < 0.0001, 0.002, and 0.016, respectively). LLIF significantly increased the SCV at the fusion level and whole spine T1-S1 by 14.5% and 10.6%, respectively, outperforming PLIF + MOs. Despite changes in dimensions, the postoperative Oswestry disability index scores showed no significant difference between the two groups. Conclusions: Our study suggests that LLIF can increase spinal canal space, lumbar lordosis, and anterior column length in the lumbar spinal segment. Knowledge of these variations may be critical for enhancing surgical outcomes and preventing neurological complications.

背景:成人脊柱畸形(ASD)手术越来越受欢迎,患者报告的疗效有了显著改善。后腰椎椎体间融合术加多处二级截骨(PLIF + MOs)和侧腰椎椎体间融合术(LLIF)已被用于矫正脊柱畸形;然而,还没有研究对这些方法术前和术后椎管长度和容积的变化进行比较。本研究旨在探讨采用 LLIF 和 PLIF + MOs 的 ASD 患者术后前垂直柱长度(AVCL)、椎管长度(SCL)和椎管容积(SCV)的三维变化。方法:这项回顾性研究对 2010 年至 2021 年间接受手术的 44 例 ASD 患者进行了检查,采用了两种矫正手术方法:LLIF 和 PLIF + MOs。对放射学参数和临床结果进行了评估,并通过计算机断层扫描图像创建了三维模型,以分析AVCL、SCL和SCV的变化。结果:我们比较了 LLIF 和 PLIF + MO 对 ASD 手术中椎管尺寸的影响。与 PLIF + MOs 相比,LLIF 显示腰椎段(L1-S1)AVCL 和整个脊柱(T1-S1)SCL 分别增加了 6.5 ± 8.0 毫米和 13.8 ± 7.6 毫米。然而,PLIF + MOs 的腰椎节段 AVCL 长度有所减少。术后各组间的AVCL(L1-S1)、SCL融合水平和初立腰椎前凸差异显著(P分别<0.0001、0.002和0.016)。LLIF 使融合水平和整个脊柱 T1-S1 的 SCV 分别增加了 14.5% 和 10.6%,明显优于 PLIF + MOs。尽管尺寸发生了变化,但两组患者术后的 Oswestry 残疾指数评分并无明显差异。结论:我们的研究表明,LLIF 可以增加腰椎段的椎管空间、腰椎前凸和前柱长度。了解这些变化对于提高手术效果和预防神经系统并发症至关重要。
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引用次数: 0
Elevation and distraction of the Tibial periosteum in the management of chronic ischemic lower limb diseases. 在治疗慢性缺血性下肢疾病时抬高和牵引胫骨骨膜。
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241295483
Meng Gan, Xiqin Xia, Yi You, Wei Xu, Xinyu Peng, Jinjun Xu, Wengao Wu, Yinkui Tang, Qiong Chen, Yun Wu, Naxin Zeng

Objective: This study investigates the effectiveness of tibia periosteum distraction (TPD) applied to the tibial periosteum, an innovative approach grounded in Ilizarov's tension-stress theory, for the treatment of ischemic diabetic foot and vasculitic foot conditions.

Methods: A retrospective analysis was conducted on 33 patients (36 limbs) who underwent TPD between June 2019 and May 2022. The study comprised 21 males (23 limbs) and 12 females (13 limbs), aged 41 to 80 years (mean age: 63.4 years). Diabetic foot accounted for 27 cases, thromboangiitis obliterans for 2 cases, and arterial occlusive disease for 4 cases. The distribution of affected limbs included 15 left feet and 21 right feet. Periosteum traction commenced on the third postoperative day at a rate of approximately 0.75 mm/day, adjusted biweekly. The traction device was removed after two weeks. Evaluation included capillary refill and wound healing assessment, along with pre- and postoperative analysis of foot skin temperature, ankle-brachial index (ABI), visual analogue scale (VAS) pain scores, and peripheral blood oxygen saturation. CT angiography (CTA) was utilized to assess vascular conditions in both lower limbs.

Results: All 33 patients were successfully followed up for a duration ranging from 4 to 24 weeks (mean: 11.03 weeks). VAS pain scores significantly decreased from preoperative (5.09 ± 1.70, range: 2-8) to postoperative two weeks (2.24 ± 0.90, range: 1-4) (t = 9.44, p < .001). Oxygen saturation levels increased from 83.88% ± 11.82% (range: 58%-97%) preoperatively to 91.36% ± 5.69% (range: 76%-98%) at two weeks postoperatively (t = -4.21, p < .001). Foot skin temperature also showed a significant increase (t = -3.98, p < .001). Capillary refill test at two weeks postoperatively demonstrated notable improvement. CTA revealed evident neovascularization in the operated limbs compared to preoperative conditions. Wound improvement was significant in all 33 patients within two months postoperatively.

Conclusion: TPD emerges as a promising technique for chronic ischemic lower limb diseases, demonstrating favorable preliminary outcomes in wound healing promotion and amputation rate reduction. Nevertheless, large-scale randomized controlled trials are essential to further validate its efficacy.

研究目的本研究探讨了应用胫骨骨膜牵张术(TPD)治疗缺血性糖尿病足和血管炎性足部疾病的有效性:对 2019 年 6 月至 2022 年 5 月期间接受 TPD 的 33 名患者(36 条肢体)进行了回顾性分析。研究对象包括 21 名男性(23 个肢体)和 12 名女性(13 个肢体),年龄在 41 岁至 80 岁之间(平均年龄:63.4 岁)。糖尿病足患者 27 例,血栓闭塞性脉管炎患者 2 例,动脉闭塞性疾病患者 4 例。受影响肢体的分布情况为左足 15 例,右足 21 例。骨膜牵引从术后第三天开始,速度约为每天 0.75 毫米,每两周调整一次。两周后拆除牵引装置。评估包括毛细血管再充盈和伤口愈合评估,以及术前和术后的足部皮肤温度、踝肱指数(ABI)、视觉模拟量表(VAS)疼痛评分和外周血氧饱和度分析。CT 血管造影术(CTA)用于评估双下肢血管状况:所有 33 名患者均成功接受了 4 至 24 周(平均 11.03 周)的随访。VAS 疼痛评分从术前(5.09 ± 1.70,范围:2-8)明显降低至术后两周(2.24 ± 0.90,范围:1-4)(t = 9.44,p < .001)。血氧饱和度从术前的 83.88% ± 11.82%(范围:58%-97%)升至术后两周的 91.36% ± 5.69%(范围:76%-98%)(t = -4.21,p < .001)。足部皮肤温度也有明显升高(t = -3.98,p < .001)。术后两周的毛细血管再充盈测试显示病情明显好转。与术前相比,CTA 显示手术肢体有明显的新生血管。术后两个月内,所有 33 名患者的伤口均有明显改善:TPD是一种治疗慢性下肢缺血性疾病的有前途的技术,在促进伤口愈合和降低截肢率方面显示出良好的初步效果。尽管如此,大规模的随机对照试验对进一步验证其疗效至关重要。
{"title":"Elevation and distraction of the Tibial periosteum in the management of chronic ischemic lower limb diseases.","authors":"Meng Gan, Xiqin Xia, Yi You, Wei Xu, Xinyu Peng, Jinjun Xu, Wengao Wu, Yinkui Tang, Qiong Chen, Yun Wu, Naxin Zeng","doi":"10.1177/10225536241295483","DOIUrl":"https://doi.org/10.1177/10225536241295483","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the effectiveness of tibia periosteum distraction (TPD) applied to the tibial periosteum, an innovative approach grounded in Ilizarov's tension-stress theory, for the treatment of ischemic diabetic foot and vasculitic foot conditions.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 33 patients (36 limbs) who underwent TPD between June 2019 and May 2022. The study comprised 21 males (23 limbs) and 12 females (13 limbs), aged 41 to 80 years (mean age: 63.4 years). Diabetic foot accounted for 27 cases, thromboangiitis obliterans for 2 cases, and arterial occlusive disease for 4 cases. The distribution of affected limbs included 15 left feet and 21 right feet. Periosteum traction commenced on the third postoperative day at a rate of approximately 0.75 mm/day, adjusted biweekly. The traction device was removed after two weeks. Evaluation included capillary refill and wound healing assessment, along with pre- and postoperative analysis of foot skin temperature, ankle-brachial index (ABI), visual analogue scale (VAS) pain scores, and peripheral blood oxygen saturation. CT angiography (CTA) was utilized to assess vascular conditions in both lower limbs.</p><p><strong>Results: </strong>All 33 patients were successfully followed up for a duration ranging from 4 to 24 weeks (mean: 11.03 weeks). VAS pain scores significantly decreased from preoperative (5.09 ± 1.70, range: 2-8) to postoperative two weeks (2.24 ± 0.90, range: 1-4) (t = 9.44, <i>p</i> < .001). Oxygen saturation levels increased from 83.88% ± 11.82% (range: 58%-97%) preoperatively to 91.36% ± 5.69% (range: 76%-98%) at two weeks postoperatively (t = -4.21, <i>p</i> < .001). Foot skin temperature also showed a significant increase (t = -3.98, <i>p</i> < .001). Capillary refill test at two weeks postoperatively demonstrated notable improvement. CTA revealed evident neovascularization in the operated limbs compared to preoperative conditions. Wound improvement was significant in all 33 patients within two months postoperatively.</p><p><strong>Conclusion: </strong>TPD emerges as a promising technique for chronic ischemic lower limb diseases, demonstrating favorable preliminary outcomes in wound healing promotion and amputation rate reduction. Nevertheless, large-scale randomized controlled trials are essential to further validate its efficacy.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241295483"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Evaluation of the results of closed kinetic chain exercises applied in the conservative treatment of patellofemoral pain syndrome by means of shear wave elastography: A randomized controlled trial. 通过剪切波弹性成像技术评估髌骨股骨痛综合征保守治疗中封闭式运动链练习的效果:随机对照试验。
IF 1.6 4区 医学 Pub Date : 2024-09-01 DOI: 10.1177/10225536241280384
Yigit Kultur, Emir Harbiyeli, Huseyin Botanlioglu, Mahmut K Ozsahin, Sude Ozturhalli, Onder Aydingoz, Mehmet R Erginer

Purpose: Non-selective closed kinetic chain exercises (NSKCE) and or selective closed kinetic chain exercises (SCKCE) has been shown to increase Vastus medialis obliquus (VMO) muscle power in patellofemoral pain syndrome (PFPS). However, the superiority of the exercises to each other has not been shown. This study aimed to evaluating the effects of different exercises on the stiffness of the VMO and vastus lateralis (VL) muscles, pain management, functional scores, and thigh circumferences.

Methods: One hundred 60 knees of 80 patients followed up in our outpatient clinic between December 2016 and February 2018 were included in the study. Patients were divided into two groups as 40 patients with single-sided PFPS (20 male and 20 female patients) and 40 healthy controls (20 male and 20 female patients). The patients in each group were divided into subgroups according to NSCKCE or SCKCE. VMO and VL muscles were measured by shear wave elastography (SWE) before and after a 6-weeks therapy.

Results: There was a significant decrease in Visual Analog Scale (VAS) score while a significant increase was found in Lysholm Knee Scale (LKS), however, no statistically difference was found between the two exercise groups in PFPS patients. The effect of both exercises on pain and functional improvement was similar.

Conclusion: Decrease in VAS scores, increase in LKS scores, increase in thigh circumference measurements, and increase in the stiffness of VMO and VL muscles were observed in both groups who received SCKCE and NSCKCE on PFPS patients.

Trial registration: Study registered at ClinicalTrials.gov (registration number: NCT05427357).

Design: Randomized controlled trial.

目的:研究表明,非选择性闭合运动链练习(NSKCE)和或选择性闭合运动链练习(SCKCE)可增强髌骨股骨痛综合征(PFPS)患者的内侧斜方肌(VMO)肌力。然而,这些练习之间的优劣尚未得到证实。本研究旨在评估不同运动对 VMO 和阔筋膜(VL)肌肉僵硬度、疼痛控制、功能评分和大腿围度的影响:研究纳入了 2016 年 12 月至 2018 年 2 月期间在我院门诊随访的 80 名患者的 160 个膝关节。患者分为两组,即 40 名单侧 PFPS 患者(男性 20 名,女性 20 名)和 40 名健康对照组(男性 20 名,女性 20 名)。每组患者根据 NSCKCE 或 SCKCE 分成若干亚组。在为期 6 周的治疗前后,用剪切波弹性成像(SWE)测量了 VMO 和 VL 肌肉:结果:PFPS 患者的视觉模拟量表(VAS)评分明显降低,而 Lysholm 膝关节量表(LKS)评分明显提高,但两种运动组之间没有统计学差异。两种运动对疼痛和功能改善的效果相似:结论:在接受 SCKCE 和 NSCKCE 锻炼的两组 PFPS 患者中,均观察到 VAS 评分下降、LKS 评分上升、大腿围测量值增加以及 VMO 和 VL 肌肉僵硬度增加:研究已在 ClinicalTrials.gov 注册(注册号:NCT05427357):设计:随机对照试验。
{"title":"Evaluation of the results of closed kinetic chain exercises applied in the conservative treatment of patellofemoral pain syndrome by means of shear wave elastography: A randomized controlled trial.","authors":"Yigit Kultur, Emir Harbiyeli, Huseyin Botanlioglu, Mahmut K Ozsahin, Sude Ozturhalli, Onder Aydingoz, Mehmet R Erginer","doi":"10.1177/10225536241280384","DOIUrl":"10.1177/10225536241280384","url":null,"abstract":"<p><strong>Purpose: </strong>Non-selective closed kinetic chain exercises (NSKCE) and or selective closed kinetic chain exercises (SCKCE) has been shown to increase Vastus medialis obliquus (VMO) muscle power in patellofemoral pain syndrome (PFPS). However, the superiority of the exercises to each other has not been shown. This study aimed to evaluating the effects of different exercises on the stiffness of the VMO and vastus lateralis (VL) muscles, pain management, functional scores, and thigh circumferences.</p><p><strong>Methods: </strong>One hundred 60 knees of 80 patients followed up in our outpatient clinic between December 2016 and February 2018 were included in the study. Patients were divided into two groups as 40 patients with single-sided PFPS (20 male and 20 female patients) and 40 healthy controls (20 male and 20 female patients). The patients in each group were divided into subgroups according to NSCKCE or SCKCE. VMO and VL muscles were measured by shear wave elastography (SWE) before and after a 6-weeks therapy.</p><p><strong>Results: </strong>There was a significant decrease in Visual Analog Scale (VAS) score while a significant increase was found in Lysholm Knee Scale (LKS), however, no statistically difference was found between the two exercise groups in PFPS patients. The effect of both exercises on pain and functional improvement was similar.</p><p><strong>Conclusion: </strong>Decrease in VAS scores, increase in LKS scores, increase in thigh circumference measurements, and increase in the stiffness of VMO and VL muscles were observed in both groups who received SCKCE and NSCKCE on PFPS patients.</p><p><strong>Trial registration: </strong>Study registered at ClinicalTrials.gov (registration number: NCT05427357).</p><p><strong>Design: </strong>Randomized controlled trial.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"32 3","pages":"10225536241280384"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Journal of Orthopaedic Surgery
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