Journal of Orthopaedic Surgery and Research最新文献

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.

Background: Steroid-induced osteonecrosis of the femoral head (SONFH) is a challenging and debilitating orthopedic condition with a rising incidence in recent years. Shuanghe Decoction (SHD), a traditional Chinese medicine formula, has shown significant efficacy in treating SONFH, though its underlying mechanisms remain unclear.

Purpose: This study aims to elucidate the therapeutic effects and potential mechanisms of SHD on SONFH through in vivo experiments, combined with network pharmacology, metabolomics, and gut microbiota analysis.

Materials and methods: Forty male Sprague-Dawley rats (300 ± 20 g) were randomly assigned to four groups: Control, Model, SHD-L, and SHD-H, with 10 rats each. SONFH was induced in all groups except the Control group using lipopolysaccharide and methylprednisolone. The SHD-L and SHD-H groups were treated with Shuanghe decoction at doses of 4.86 g/kg/day and 9.72 g/kg/day, respectively, for eight weeks. Bone morphology, pathological changes, and osteogenic factors were evaluated using Micro-CT, histological staining, and immunohistochemistry. Network pharmacology, metabolomics, and gut microbiota analyses were conducted to explore SHD's mechanisms.

Results: SHD improved bone morphology and increased osteogenic factor expression (RUNX2, OCN, COL-I). Network pharmacology indicated that metabolic pathways play a key role in SHD's therapeutic effects. Metabolomic analysis identified 14 differential metabolites, including 21-hydroxypregnenolone and tyramine, which were restored to normal levels by SHD. Gut microbiota analysis revealed that SHD modulated bacterial abundance, particularly Verrucomicrobia, Allobaculum, and Burkholderiales. A comprehensive network identified two key metabolites (tyramine, 21-hydroxypregnenolone), seven targets (CYP19A1, CYP1A2, CYP1B1, CYP2C9, CYP3A4, MIF, and HSD11B1), two metabolic pathways (tyrosine metabolism, steroid hormone biosynthesis), and four bacterial taxa (Jeotgalicoccus, Clostridium, Corynebacterium, rc4-4) as central to SHD against SONFH.

Conclusion: SHD alleviates SONFH by reshaping gut microbiota, reversing metabolic imbalances, and enhancing osteogenesis. Our findings provide novel insights into the pharmacological mechanisms of SHD, laying a foundation for its clinical application in treating SONFH.

Background: Chronic Achilles tendon injuries, commonly resulting from inadequate management of acute incidents, significantly reduce patients' quality of life. Current treatments, including conservative, surgical, and regenerative approaches, often yield suboptimal results. This study investigated the therapeutic effectiveness of a chitosan/β-glycerophosphate/collagen (C/GP/Co) hydrogel combined with bone marrow mesenchymal stem cells (MSCs) for chronic Achilles tendon injury in a rat model.

Material & methods: A temperature-sensitive injectable C/GP/Co hydrogel was synthesized and combined with MSCs to treat a chronic Achilles tendon injury in Sprague-Dawley rats. The rats were divided into four groups receiving saline (model), C/GP/Co hydrogel, C/GP/Co/MSCs hydrogel, or normal control. After 6 weeks, morphological, biomechanical, and molecular assessments were conducted, including histology, Western blot analysis for protein expression, and the evaluation of the Akt/GSK-3β signaling pathway.

Results: The C/GP/Co/MSCs hydrogel significantly enhanced tendon healing compared to the model and C/GP/Co groups, as evidenced by improved collagen fiber organization and an increased type I/III collagen ratio on histological analysis. Western blot results revealed activation of the Akt/GSK-3β pathway by the C/GP/Co/MSCs hydrogel, leading to enhanced tendon cell proliferation and reduced apoptosis, demonstrated by a decreased Bax/Bcl-2 ratio and Caspase-3 expression. Downregulation of inflammation markers CD206 and CD163 was significant. Biomechanical testing indicated that the C/GP/Co/MSCs hydrogel restored tendon tensile strength closer to normal levels.

Conclusions: The C/GP/Co/MSCs hydrogel establishes a supportive microenvironment for MSC function, aiding tendon healing through the Akt/GSK-3β pathway. Its dual role in inflammation and apoptosis reduction, while enhancing biomechanical properties, demonstrates its potential as an innovative treatment for persistent Achilles tendon ailments. Future research endeavors should comprehensively explore the molecular pathways and assess their clinical applicability.

Background: Autologous osteochondral transplantation (AOT) combined with biological agents is an advanced technique for treating osteochondral lesions. Therefore, this study aimed to explore the effect of combining platelet-rich plasma (PRP) treatment with AOT on postoperative functional and magnetic resonance imaging (MRI) outcomes in patients with osteochondral lesions of the talus (OLTs) accompanied by chronic lateral ankle instability (CLAI).

Methods: This retrospective study had a minimum follow-up period of 1 year. Thiry-nine patients with CLAI who underwent AOT between 2019 and 2023 were included in this study. Of these, 21 and 18 received AOT combined with PRP treatment (AOT + PRP group) and AOT alone (AOT-alone group), respectively. Preoperative and postoperative follow-up assessments were performed using the visual analog scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS), and foot and ankle ability measure-sport scale (FAAM-sport scale). The final follow-up MRI was evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 ankle scoring system.

Results: Both groups showed a significant reduction in VAS scores and significant improvements in AOFAS and FAAM-sport scale scores at the final follow-up compared with the preoperative values. No significant differences were observed in the final follow-up VAS, AOFAS, FAAM-sport scale, and MOCART 2.0 ankle scores between the groups. However, significant between-group differences were found at postoperative months 1 (P < 0.001) and 3 (P = 0.031) for VAS scores and at postoperative month 3 for FAAM-sport scale scores (P = 0.005). The AOT + PRP group showed significantly better final follow-up scores for the "surface of the repair tissue" on the MOCART 2.0 ankle score system than the AOT-alone group (P = 0.029).

Conclusions: PRP did not result in significantly superior outcomes when used as an adjunct to AOT compared to AOT alone in the setting of concomitant OLTs and CLAI.

Cisplatin is a potent and efficacious anticancer medication. In pediatric cancer, the height of the growth plate's proliferating layer is known to be reduced by cisplatin, but researchers have not yet determined the specific mechanism behind this phenomenon. Lectin-like oxidized low-density lipoprotein receptor-1 is known to be involved in the development of osteoarthritis and atherosclerosis. The equilibrium of cartilage is regulated by LOX-1, but the function of LOX-1 in cisplatin-induced chondrocyte impairment remains unknown. Positive regulation of LOX-1 leads to increased cellular oxidative stress and cell damage. Research has shown that blocking of LOX-1 can reduce the chondrocyte damage and oxidative stress in cells induced by oxidized LDL treatment. However, the role of LOX-1 in cisplatin-mediated chondrocyte damage is still unclear. This study found that cisplatin increased ROS concentration and p38, ERK phosphorylation. Cisplatin activated NF-κB in chondrocytes. In addition, LOX-1 small interfering RNA transfection mitigated cisplatin-induced apoptosis in TC28a2 cells. Phosphorylated extracellular signal-regulated kinase and p38 were dose-dependently increased by administration of cisplatin. Silencing LOX-1 or MAPK inhibition reduces cisplatin-caused apoptosis. The findings suggest that cisplatin-induced growth plate dysfunction operates through the LOX-1/p38/NF-κB signaling pathway.