Journal of Orthopaedic Surgery and Research最新文献

Objectives: Foot postural alignment is linked to changes in gait patterns. This review aimed to compare spatiotemporal and kinematic parameters of the lower extremities in individuals with and without flexible flatfoot.

Methods: Under PRISMA guidelines, a systematic review and meta-analysis were conducted by searching PubMed, Scopus, Web of Science, and Google Scholar databases for original and peer-reviewed articles with selected keywords from inception to November 2024. The quality of the included studies was assessed using the Joanna Briggs Institute checklist. Statistical analysis was conducted with Comprehensive Meta-Analysis software version 3. To evaluate data heterogeneity, the Q-test and I² statistic were applied. Egger's test was used to assess publication bias.

Results: After searching the mentioned databases, 5309 articles were found. Finally, sixteen articles were included in the current review. A significant difference was found between the two groups in ankle inversion (effect size; 0.291, 95% CI = 0.053_0.053, P = 0.017), eversion (effect size; -0.568, 95% CI= -0.784_-0.352, P = 0.001), and hip flexion (effect size; -0.348, 95% CI= -0.576_-0.120, P = 0.003). Also, stride length (effect size; 0.658, 95% CI = 0.184_1.133, P = 0.007) and gait speed (effect size; 0.447, 95% CI = 0.120_0.774, P = 0.007) significantly differed between the two groups.

Conclusion: This study indicated that subjects with flatfoot exhibited alterations in the inversion, eversion, hip flexion, stride length, and walking speed compared to neutral foot participants and demonstrated a distinct gait pattern throughout the entire gait cycle. Health specialists are advised to consider these findings when prescribing prevention and rehabilitation programs for musculoskeletal deformities in individuals with flexible flatfoot.

Objective: To investigate the risk factors for Type II respiratory failure associated with severe scoliosis in patients under 40 years of age.

Methods: Patients with severe scoliosis and pulmonary impairment treated in our hospital from January 2020 to December 2022 were recorded. We evaluated the spinal parameters in standing full spine X-rays, including the main thoracic curve, thoracic kyphosis, apical vertebrae, and distance between T1-T12. We also assessed the patient's pulmonary function test (PFT), including forced vital capacity (FVC) and the percentage of measured FVC values to predicted values (FVC%).

Results: The study included 64 patients with severe and rigid scoliosis accompanied by severe pulmonary impairment. They were divided into two groups: Group 1 comprised 22 patients with Type II respiratory failure, and Group 2 comprised the remaining 42 patients without respiratory failure. The average age of onset for the two groups was 2.3 ± 2.9 years and 4.0 ± 4.5 years, respectively. The range of the apical vertebrae in Group 1 was from T6 to T11, and the range in Group 2 was the same. There was no significant difference in the main curve and kyphosis angle between the two groups. The average T1-T12 distances for the two groups were 130.3 ± 32.7 mm and 148.2 ± 37.6 mm, respectively. The PFT results indicated that all patients had severe pulmonary function impairment. Multivariate logistic regression analysis revealed that a T1-T12 distance of less than 100 mm was an independent risk factor for Type II respiratory failure.

Conclusions: If not treated properly, early onset scoliosis would have a severe impact on pulmonary function. The T1-T12 distance was a risk factor for Type II respiratory failure associated with severe scoliosis in patients under 40 years old.

Background: There is no consensus as to the best technique for percutaneous trigger finger release.

Methods: This assessor-blinded study compared three ultrasound-guided percutaneous trigger finger release techniques using a needle (N), a needle-knife (NK), and a specially designed knife (K). Three physicians simulated A1 pulley release surgery on 56 fingers of 14 fresh-frozen hand cadaver body donors. Both the physicians and the fingers included were randomly selected.

Results: The results of repeated-measures ANOVA revealed significantly longer cuts for the NK and K techniques, than for the N technique, both absolute (mean ± SD) (NK = 5.55 ± 3.07 mm, K = 6.29 ± 4.07 mm, and N = 2.02 ± 3.46 mm; N vs. NK p = 0.015, N vs. K p = 0.002, and NK vs. K p = 1.000), and cut percentage in relation to the total pulley length (NK = 51.61 ± 28.34%, K = 54.63 ± 33.72% and N = 18.24 ± 31.09%; N vs. NK p = 0.008, N vs. K p = 0.003, and NK vs. K p = 1.000). No neurovascular bundle injuries were found upon dissection. The overall complication rate was 11%, with no significant differences among the three techniques. Only one major tendon injury occurred in the NK group.

Conclusions: In this cadaveric study, the NK and K techniques were more effective at releasing the A1 pulley than the N technique. All three techniques have emerged as equally safe.

Purpose: This study explores the relationship among lower limb dynamic balance, lower limb strength, explosive power, agility, and sports injuries in male volleyball players.

Method: The study involved thirty-one male volleyball athletes assessed for lower limb dynamic balance using the Y Balance Test Kit™. Muscle strength in the hip, knee, and ankle was measured using the Isomed 2000 isokinetic dynamometer. Power performance was evaluated through squat jump, countermovement (CMJ) jump, and drop jump tests using the Kistler force platform. Agility measurements were conducted using timing gates and a stopwatch.

Results: Our findings revealed a significant correlation between interlimb asymmetry in the anterior reach of the Y balance test and non-contact injuries (r = 0.597, P < 0.01). Additionally, there were significant correlations between the Y balance test and lower limb strength (r = 0.356 to 0.715, P < 0.05), vertical jumping performance (r = 0.357 to 0.672, P < 0.05), and agility (r = -0.379 to -0.702, P < 0.05).

Conclusion: Based on these findings, It is recommended that interlimb asymmetry in the anterior reach direction of the Y Balance Test be considered as one of the indicators for potential non-contact lower limb injuries among elite male volleyball players. The lower limb muscle strength of the hip, knee, and ankle joints and power and agility are associated with lower limb dynamic balance capabilities. Additionally, dynamic balance may contribute to overall physical performance. Targeted strength training for unilateral muscles and incorporating various explosive exercise modes may support athletic performance and reduce the risk of sports-related injuries.

Background: Managing large soft-tissue defects in the distal lower extremities remains challenging for orthopedic surgeons, particularly in elderly patients with comorbidities. This study evaluates the clinical outcomes of the reverse sural flap (RSF) for reconstructing soft-tissue defects in the distal leg, heel, foot, and ankle.

Methods: This prospective study was performed on 52 cases aged from 18 to 60 years old, with either post-traumatic or post-surgical soft tissue defects situated between the distal third leg and the mid-metatarsals of the foot and underwent RSF surgery.

Results: The mean hospital stay was 8.4 (± 3.24) days. All patients experienced the healing of their soft tissue coverage. During the follow-up, ten patients had complications: Ankle stiffness occurred in 2 (3.85%) patients, marginal necrosis in 2 (3.85%) patients, superficial infection occurred in 2 (3.85%) and delayed healing in 4 (7.69%) patients.

Conclusion: The RSF is a reliable and practical option for reconstructing significant and distal soft tissue defects in the lower extremities, with acceptable complication rates and surgical durations. Complications were found in 10 cases in the form of ankle stiffness occurring in 2 (3.85%) patients; marginal necrosis occurred in 2 (3.85%), superficial infection occurred in 2 (3.85%) patients managed with dressing, debridement, delayed healing occurred in 4 (7.69%) patients and. The hospital stay's mean value (± SD) was 8.4 (± 3.24) days.

Objectives: Nerve growth factor (NGF) is a key mediator in osteoarthritis pain signaling. Clinical studies revealed that anti-NGF antibodies are often accompanied by progressively worsening cartilage degeneration, although they exhibit significant analgesic effects. However, the relationship between NGF expression and cartilage destruction remains unclear. Our study aimed to investigate the effects of NGF on chondrocytes and to elucidate the underlying mechanisms involved.

Methods: The ATDC5 cells were induced to differentiate into chondrocytes and stimulated with NGF at different concentrations (0.5-10 ng/mL). The cell counting kit-8 assay (CCK-8) was used to measure the effects of NGF on chondrocyte proliferation. Chondrocytes were subsequently stimulated with varying doses of NGF to identify the expression levels of the extracellular matrix. Chondrocytes were pretreated with GNF5837 (a tropomyosin receptor kinase A inhibitor) or LY294002 (a phosphoinositide 3-kinase inhibitor) before exposure to 5 ng/mL NGF to analyze associated signaling pathways. Western blotting and immunofluorescence staining were employed to analyze expression of related proteins.

Results: Alcian blue, toluidine blue staining, and type II collagen immunofluorescence staining demonstrated that ATDC5 cells differentiated into functional chondrocytes after 14 days of chondrogenic induction. The CCK-8 assay confirmed that cell proliferation was unaffected. NGF (0.5-5 ng/mL) was found to enhance chondrocyte matrix synthesis in a dose-dependent fashion, particularly in the expression of aggrecan, type II collagen, Sox9, and through the activation of the PI3K/AKT signaling pathway. The highest promoting effects were exhibited at 5 ng/mL of NGF. Further analysis indicated that GNF5837 (TRKA inhibitor) or LY294002 (PI3K inhibitor) could reverse the protective effects of NGF on chondrocyte matrix synthesis.

Conclusion: Our study identified a potentially beneficial role of NGF at concentrations of 0.5-5 ng/mL in chondrocytes, enhancing extracellular matrix synthesis, with significant involvement of the PI3K/AKT signaling pathway in this process.

Objective: To compare clinical efficacy and quality of life (QoL) outcomes between minimally invasive surgery and conservative treatment for type II fragility fractures of the pelvis (FFP II).

Methods: A total of 150 patients with FFP II, treated at our hospital from January 2019 to December 2022, were included in this study. The mean follow-up period was 22 ± 5 months. Patients were divided into two groups: 68 were assigned to the minimally invasive surgery group and 82 to the conservative treatment group. Clinical outcomes were assessed using the Majeed questionnaire and the self-reported Short Musculoskeletal Function Assessment. Health-related quality of life was evaluated with the Short-Form 36 Health Survey and World Health Organization Quality of Life Brief Version questionnaires.

Results: There were no significant differences in basic information (gender/cause of injury/comorbidities/Rommens classification/osteoporosis status) or clinical outcomes between the two groups on the basis of the Majeed and Short Musculoskeletal Function Assessment questionnaire scores at the final follow-up. However, the minimally invasive surgery group showed a significant improvement in QoL compared with the conservative treatment group (including on the Short-Form 36 Health Survey and World Health Organization Quality of Life Brief Version; P < 0.01).

Conclusion: Minimally invasive surgery and conservative treatment achieve similar clinical outcomes in patients with FFP II fractures. However, minimally invasive surgery significantly enhances the health-related QoL of these patients.

Objective: The relationship between dietary fiber intake and osteoarthritis (OA) remains unclear. This cross-sectional study, using data from the National Health and Nutrition Examination Survey (NHANES), aimed to examine the association between dietary fiber intake and OA.

Methods: A cross-sectional analysis was conducted using NHANES data from 1999 to 2018 to assess the association between dietary fiber intake and OA. Univariate and multivariate weighted logistic regression models, along with restricted cubic spline (RCS) curves, were used to evaluate the relationship.

Results: A total of 30,620 participants were included in this study, of whom 1,864 were diagnosed with OA, yielding a prevalence of 5.74%. Multivariate weighted logistic regression revealed a consistent inverse association between dietary fiber intake and OA (OR = 0.99, 95% CI: 0.97-0.99, P = 0.018). When dietary fiber was treated as a categorical variable, the highest quartile of intake (Q4) was associated with a 27% lower risk of OA compared to the lowest quartile (Q1) (OR = 0.73, 95% CI: 0.58-0.92, P = 0.007). The RCS analysis indicated a non-linear association between dietary fiber intake and OA risk (non-linear P = 0.013). The threshold effect interval suggested that dietary fiber intake in the range of 14.4-26.7 g was associated with a reduced risk of OA, while intake above this level did not provide significant additional protection.

Conclusion: The findings demonstrate a negative linear association between dietary fiber intake and OA risk. Increasing dietary fiber consumption may reduce the risk of OA, offering potential strategies for its prevention and management. Further studies are needed to confirm these findings.