Journal of orthopaedics最新文献

{"title":"Smart implantable devices are associated with reduced 90-day acute care utilization and cost following total knee arthroplasty","authors":"Kris Hanby ,&nbsp;Jeffrey Yergler ,&nbsp;Patrick Aubin ,&nbsp;Mouhanad M. El Othmani ,&nbsp;Edward Stolarski ,&nbsp;Steven Lyons","doi":"10.1016/j.jor.2025.12.054","DOIUrl":"10.1016/j.jor.2025.12.054","url":null,"abstract":"<div><h3>Background</h3><div>Remote monitoring has been correlated to reduced acute care usage (emergency department (ED)) in cardiovascular, diabetes and COVID domains. Correspondingly, the use of smart implantable devices (SID) in total knee arthroplasty (TKA) may lead to reduced acute care usage in orthopedics.</div></div><div><h3>Methods</h3><div>Retrospective claims data from a nationally representative, third-party claims aggregator were analyzed for ED and hospital admission incidence and cumulative 90-day costs. Patients who received an SID were identified and matched 1:2 with patients who received a traditional knee prosthesis. A subgroup of patients with complete longitudinal claims data for days 91–365 were analyzed for cost comparisons. Chi-squared tests were used to compare acute care incidence and Wilcoxon rank sum tests were used to compare costs.</div></div><div><h3>Results</h3><div>The analysis included 1621 patients with SID knees (1709 TKAs) and 3041 patients (3418 TKAs) implanted with traditional knees. Cumulative incidence of ED visit (SID: 11.4 %; control: 15.6 %), hospital admission (SID: 6.0 %; control: 8.8 %), or any acute care (ED or hospital admission) (SID: 14.1 %; control: 19.2 %) was significantly lower in the SID group (p &lt; 0.05). Median total cost of all healthcare services from the day after surgery to day 90 was significantly lower in the SID group ($3747) than the controls ($5629), representing 61 % of the cost of control patients. SID patients also had lower costs during day 91–365 ($5322 and $8,454, respectively).</div></div><div><h3>Conclusion</h3><div>Use of SIDs in primary TKA was associated with fewer ED visits and hospital admissions, as well as lower 90-day total healthcare costs. These cost reductions reflect both a lower incidence of unplanned care and lower costs per patient. These findings support the potential of implant-derived recovery data to enhance care coordination, align postoperative management with patient expectations, increase patient confidence in their health status and reduce the burden of post-TKA acute care.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 289-295"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal fixation versus hemiarthroplasty for valgus impacted femoral neck fractures: Results from an institutional ortho-geriatric hip fracture registry","authors":"Brian Rui Kye Chee,&nbsp;Emrick Sen Hui Quah,&nbsp;Daniel Xing Fu Hap","doi":"10.1016/j.jor.2025.12.058","DOIUrl":"10.1016/j.jor.2025.12.058","url":null,"abstract":"<div><h3>Purpose</h3><div>The ideal surgical treatment type for valgus impacted Garden I (AO 31B1.1) femoral neck fractures (FNFs) remains controversial. The primary aim of this study was to compare functional outcomes, mortality and reoperation rates between valgus impacted FNF patients treated with internal fixation (IF) or hemiarthroplasty (HA). The secondary outcomes studied were length of acute hospital stay, and postoperative medical complications.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed in a single level I trauma center. All patients aged 60 years and above who were treated surgically for valgus impacted Garden I (AO 31B1.1) femoral neck fractures between January 2014 and December 2021 were included. Case matching based on gender, age, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI) score and MBI score was performed.</div></div><div><h3>Results</h3><div>208 patients (IF n = 104, HA n = 104) were included in the final study group. The IF group showed better mobility at six months compared to the HA group (31.4 % independent without aid vs 17.1 %, p-value = 0.047). However, at 12 months, this difference was no longer present (39.8 % independent without aid vs 34.4 %, p-value = 0.915). The HA group had higher rates of acute urinary retention compared to the IF group (37.5 % vs 24.0 %, p = 0.049). There was no statistically significant difference in MBI scores, reoperation rate, mortality rate, or length of hospital stay between the two groups.</div></div><div><h3>Conclusions</h3><div>Internal fixation showed better mobility at the 6 month mark and lower postoperative urinary retention rates, with similar reoperation and mortality rates compared to hemiarthroplasty in the treatment of valgus-impacted femoral neck fractures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 1-5"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of surgeon workload using the NASA-TLX during the early introduction of robot-assisted total knee arthroplasty","authors":"Tatsuya Kubo ,&nbsp;Tsuneari Takahashi ,&nbsp;Yuji Kaneda ,&nbsp;Kohei Watanabe ,&nbsp;Shoichi Shinohara ,&nbsp;Takahiro Higashi ,&nbsp;Katsushi Takeshita","doi":"10.1016/j.jor.2025.12.055","DOIUrl":"10.1016/j.jor.2025.12.055","url":null,"abstract":"<div><h3>Background</h3><div>Robot-assisted total knee arthroplasty (RA-TKA) improves accuracy, but surgeon workload during early adoption is poorly studied. We quantified workload using the NASA Task Load Index (NASA-TLX) and examined its relation to operative efficiency.</div></div><div><h3>Methods</h3><div>Fifty consecutive RA-TKA procedures were performed by one surgeon. After each case, workload was assessed with the NASA-TLX. Outcomes were changes in NASA-TLX scores, operative time learning curves, and perioperative safety. Analyses included segmented regression, CUSUM, and correlation tests.</div></div><div><h3>Results</h3><div>Fifty knees (mean age 73 years, BMI 27) were included. Mean operative time was 97 min. Four complications occurred within 30 days, with no system failures. NASA-TLX scores declined significantly with case number (ρ = −0.54, p &lt; 0.001), stabilizing after ∼8 cases. Operative time showed a breakpoint at 9 cases. Subscales improved earlier for mental demand, effort, temporal demand, and frustration, while performance stabilized later (∼19 cases). NASA-TLX correlated with operative time (r = 0.62, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Surgeon workload and operative efficiency improved in parallel, stabilizing after the first 8–10 RA-TKA cases. NASA-TLX is a practical tool for monitoring workload during robotic adoption and may guide training strategies in medium-volume institutions.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 394-399"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient acceptable symptom state (PASS) thresholds for the Hip disability and Osteoarthritis Outcome Score (HOOS) after total hip arthroplasty","authors":"Junji Nishimoto ,&nbsp;Rikumi Kurahashi ,&nbsp;Kotaro Tamari ,&nbsp;Ryo Tanaka","doi":"10.1016/j.jor.2025.12.056","DOIUrl":"10.1016/j.jor.2025.12.056","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is an effective treatment for hip osteoarthritis (OA). The patient acceptable symptom state (PASS) provides meaningful thresholds for patient-reported outcomes. However, short-term PASS after THA remains underexplored, despite its importance in identifying early recovery status, guiding timely postoperative interventions, and supporting patient expectations during the critical early rehabilitation phase. This study aimed to determine short-term PASS thresholds for each Hip disability and Osteoarthritis Outcome Score (HOOS) subscale.</div></div><div><h3>Methods</h3><div>This multicenter prospective cohort study evaluated 150 patients with hip OA who underwent primary unilateral THA. PASS thresholds for the HOOS subscales—symptoms, pain, activities of daily living (ADL), sport and recreation (SR), and quality of life (QOL)—were calculated at 3 and 6 months after THA using both the 25th percentile method and receiver operating characteristic (ROC) analysis, anchored to the Global Rating of Change scale.</div></div><div><h3>Results</h3><div>At 3 months post-THA, the PASS thresholds (percentile/ROC) were: symptoms 60.0/47.5, pain 70.0/56.3, ADL 60.3/72.8, SR 37.5/28.1, and QOL 37.5/28.1. At 6 months post-THA, the PASS thresholds (percentile/ROC) were: symptoms 70.0/52.5, pain 82.5/72.5, ADL 77.9/72.8, SR 37.5/37.0, and QOL 62.5/46.9.</div></div><div><h3>Conclusions</h3><div>This study provides preliminary short-term PASS thresholds for the HOOS subscales after THA in patients with hip OA. These early benchmarks may assist clinicians in identifying patients who appear to be experiencing suboptimal recovery as early as 3 months post-THA, potentially enabling timely postoperative support. Short-term PASS thresholds may offer helpful indicators of expected early recovery and support shared decision-making during follow-up. While these findings suggest potential clinical practice value, further studies with larger and more diverse populations are needed to enhance generalizability and confirm applicability.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 33-38"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From fracture to function: return-to-sport after acetabular fractures","authors":"Anna L. Schiltenwolf ,&nbsp;Tina Histing ,&nbsp;Florian Laux ,&nbsp;Markus A. Kueper ,&nbsp;Stefan Doebele ,&nbsp;Steven C. Herath","doi":"10.1016/j.jor.2025.12.053","DOIUrl":"10.1016/j.jor.2025.12.053","url":null,"abstract":"<div><h3>Background and aim of the study</h3><div>Acetabular fractures can affect young, athletically active patients. This study aimed to describe the previously unexplored interaction between injury severity, return to sport, and subjective attitude towards sport.</div></div><div><h3>Material and methods</h3><div>Twenty-two patients with acetabular fracture treated at a Level I Trauma Center between Jan. 2009–Dec. 2020 were retrospectively included. Patients received a postal questionnaire assessing activity level and sporting activity before trauma (PRE) and after trauma (POST). The median follow-up was 145 (IQR 75.5–166) months. Patients also reported whether the injury altered their subjective attitude towards exercise.</div></div><div><h3>Results</h3><div>Participants were divided into two subgroups according to ISS: ISS &lt;16 = ‘no polytrauma’ (n = 8) and ISS ≥16 = ‘polytrauma’ (n = 14). The mean highest UCLA Activity Score decreased more in the ‘no polytrauma’ subgroup (−39.7 %) than in the ‘polytrauma’ subgroup (−23.4 %). The POST sports break lasted over five times longer in the ‘polytrauma’ subgroup, who more often underwent longer inpatient rehabilitation. In the ‘no polytrauma’ subgroup, 50 % (3/6) of previously active athletes returned to sport, whereas all PRE active patients in the ‘polytrauma’ subgroup returned (10/10). POST sport level was lower in the ‘no polytrauma’ subgroup (0 % club sports (0/8), 37.5 % occasional (3/8); 0 % high-impact (0/8), 37.5 % low-impact (3/8)) compared with the ‘polytrauma’ subgroup (21.4 % club sports (3/14), 50 % occasional (7/14); 35.7 % high-impact (5/14), 35.7 % low-impact (3/8)). A negative change in the subjective attitude towards exercise occurred in 12.5 % (1/8) of ‘no polytrauma’ patients and 42.9 % (6/14) of ‘polytrauma’ patients.</div></div><div><h3>Conclusion</h3><div>Sporting activity was reduced after acetabular fracture. Although ‘polytrauma’ participants reported more negative shifts in exercise attitude, they demonstrated higher return-to-sport rates compared with ‘non-polytrauma’ participants. Potentially the longer sport interruption and inpatient rehabilitation may facilitate more effective reintegration. Further studies with larger study groups are warranted.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 11-16"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic treatment of post-traumatic knee chondral defects using microfractures and the Autologous Collagen-Induced Chondrogenesis (ACIC™) technique: a retrospective observational cohort study","authors":"Giacomo Galanzino ,&nbsp;Ilaria Morelli ,&nbsp;Alessandro Ivone ,&nbsp;Edoardo Bianchi Visconti ,&nbsp;Domenico Iovinella ,&nbsp;Roberto Edoardo Vanelli","doi":"10.1016/j.jor.2025.12.051","DOIUrl":"10.1016/j.jor.2025.12.051","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate return to sport and one-year clinical outcomes in young athletes with focal grade III–IV knee chondral lesions treated arthroscopically using the Autologous Collagen-Induced Chondrogenesis (ACIC™) technique, which combines microfractures with an atelocollagen scaffold stabilized by fibrin glue.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on all consecutive patients undergoing arthroscopic microfractures with ACIC™. Inclusion criteria comprised monofocal ICRS III–IV knee chondral defects ≥1 cm², young sports-active patients, and a minimum follow-up of one year. Patients with malalignment &gt;5°, knee instability, inflammatory disease, BMI ≥30, or kissing lesions were excluded. Pain and function were assessed after injury and one year postoperatively. Sport level (Tegner Activity Scale) was compared before injury and at one year postoperatively.</div></div><div><h3>Results</h3><div>Four patients met the inclusion criteria. Lesions were located on the femoral condyle (n = 3) or tibial plateau (n = 1), with a mean defect area of 1.8 ± 1 cm². Three patients returned to their pre-injury level of sport at one year. No significant difference was observed between pre-injury and postoperative Tegner scores. Significant improvements were found in VAS pain (p = 0.004) and IKDC functional scores (p = 0.0009) after surgery. All patients reported to be highly satisfied with the surgery.</div></div><div><h3>Conclusions</h3><div>Arthroscopic ACIC™ demonstrated significant pain reduction, improved knee function, and a high rate of return to pre-injury sport level at one-year follow-up in young athletes with focal high-grade knee chondral lesions. Larger studies with long-term follow-up are needed to confirm durability and characterize cartilage repair quality.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 6-10"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cost of PRP: Disparities in orthobiologic utilization","authors":"Ellen Lutnick,&nbsp;Eoin Devoy,&nbsp;Nicholas Frappa,&nbsp;Joseph Barbarino,&nbsp;Robert Ablove","doi":"10.1016/j.jor.2025.12.047","DOIUrl":"10.1016/j.jor.2025.12.047","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to assess cost and access to orthobiologic injection via platelet rich plasma (PRP).</div></div><div><h3>Methods</h3><div>Retrospective review at one academic affiliated orthopedic practice identified PRP injections for musculoskeletal indications in adult patients between January 1, 2010 and January 1, 2025 via CPT code. Cost of injection per patient category including race, sex, and anatomic location of the injection was analyzed, and US census data utilized to determine correlations between injection utilization and social determinants of health (SDoH) via ZIP code. Comparisons were performed via Wilcoxon rank-sum test or Kruskal–Wallis test. Injection counts aggregated at the ZIP code level were linked to publicly available ZIP-level SDoH variables. Analyses using per-capita injection rates were performed. P &lt; 0.05 was significant. Analyses were performed using R version 4.5.0.</div></div><div><h3>Results</h3><div>Of 727 PRP injections analyzed (57.4 % male, age of 53.0 ± 18.2 years, BMI 28.2 ± 5.5 kg/m²), patient race was predominantly White (87.2 %), followed by Black/African American (8.0 %). The mean charge was $574 ± 362. Males incurred higher charges than females ($598 vs $541; p = 0.001); charges did not differ by race (p = 0.64). Injection utilization demonstrated a strong socioeconomic gradient. The highest-income quartile (mean income ∼$115k) accounted for 40.7 % of injections; the lowest-income quartile (mean ∼$46k) accounted for only 13.6 % (χ²(3) = 114.7, p &lt; 0.001). Education level correlated positively with injection counts; uninsured rate correlated negatively. Injection distribution across income quartiles remained highly unequal after adjusting for population share (χ²(3) = 81.2, p &lt; 0.001). The uninsured rate was the only independent predictor of per-capita injection volume (IRR = 0.90, 95 % CI 0.85–0.95, p &lt; 0.001): each 1 % increase in uninsured residents was associated with a ∼10 % decrease in utilization.</div></div><div><h3>Conclusion</h3><div>PRP injections are disproportionately utilized by older, white, and insured patients from higher-income communities. Given the lack of universal insurance coverage and high out-of-pocket costs, these treatments remain inaccessible for many uninsured and lower-income patients.</div></div><div><h3>Level of evidence</h3><div>Level III; retrospective cohort study.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 370-373"},"PeriodicalIF":1.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis based on the web of science database: advances and research trends in the application of umbilical cord mesenchymal stem cells in bone repair","authors":"Xiang Zhao ,&nbsp;Zhiquan Liang ,&nbsp;Hangang Hong ,&nbsp;Kai Zhang ,&nbsp;Wenyuan Xiang ,&nbsp;Rui Fang","doi":"10.1016/j.jor.2025.12.020","DOIUrl":"10.1016/j.jor.2025.12.020","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis is a multifactorial degenerative joint disease characterized by articular cartilage destruction, synovitis, subchondral sclerosis or cystic degeneration, marginal osteophytes, and formation of bony encumbrances, with cartilage damage representing a common pathological process; Umbilical Cord-Derived Mesenchymal Stem Cells (UMSCs) have been widely investigated for bone repair and regeneration due to their differentiation into osteoblasts and chondrocytes, yet there remains a need for bibliometric analyses of literature on the role of UMSCs in bone repair.</div></div><div><h3>Methods</h3><div>We conducted a bibliometric analysis of 411 articles indexed in the Web of Science Core Collection from inception to 31 July 2024, employing bibliometric tools including VOSviewer, CiteSpace, and Bibliometrics to assess publication trends, country and institutional contributions, authorship, journals, and keyword clustering, with descriptive statistics applied to quantify publication counts and average citations.</div></div><div><h3>Results</h3><div>The overall publication trend in this field is increasing, with China contributing the largest number of publications (n = 134) and an average citation of 29.30; the most prolific author is Guo from the Chinese PLA General Hospital (15 publications, avg. cit. 49.27), followed by Ha (Samsung Medical Center/Sungkyunkwan University) and Park (Samsung Medical Center/Sungkyunkwan University); Stem Cells International is the leading journal with 19 articles and an average citation of 38.47; keyword clustering revealed eight major themes: high tibial osteotomy, regenerative medicine, xenogeneic approaches, osteogenic differentiation, scaffold, expression, mechanical properties, proteomics, and autologous chondrocyte implantation, indicating the principal research directions and interrelationships in UMSC-related bone repair.</div></div><div><h3>Conclusions</h3><div>This bibliometric analysis delineates the productive landscape and dominant themes in UMSC research for bone repair within osteoarthritis, highlighting China as a major contributor, key institutions and authors, and the central role of regenerative strategies, scaffolds, and differentiation processes; the identified hotspots and cluster structure offer guidance for future investigators to target gaps, refine research questions, and design studies advancing UMSC applications in bone repair and osteoarthritis treatment.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 157-173"},"PeriodicalIF":1.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research hotspots and frontier trends of articular cartilage regeneration and repair technology in knee osteoarthritis: A bibliometric study and visual analysis","authors":"Jiaojiao Wu ,&nbsp;Yixin Chen ,&nbsp;Honghai Zhou ,&nbsp;Shaoting Su ,&nbsp;Hua Lu ,&nbsp;Jiali Yang ,&nbsp;Zhaomeng Hou","doi":"10.1016/j.jor.2025.12.028","DOIUrl":"10.1016/j.jor.2025.12.028","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to systematically explore the research hotspots and emerging trends in articular cartilage regeneration and repair within the context of KOA through bibliometric and visualization analysis, thereby providing valuable references for future research and clinical practice.</div></div><div><h3>Methods</h3><div>This study systematically reviewed and aggregated research literature from the past two decades concerning the application of articular cartilage regeneration and repair technologies in KOA, as indexed in the Web of Science Core Collection (WoSCC) database. Employing bibliometric methods, we conducted a statistical analysis of these publications and utilized visualization tools to construct scientific knowledge maps, thereby providing a clear depiction of the research framework and developmental trends within this field.</div></div><div><h3>Results</h3><div>An analysis of 682 publications revealed a steep, two-decade rise in both annual output and citations. The United States dominates production, with the University of California System contributing the largest share. Koh YG emerged as the most prolific and highly cited author. <em>Osteoarthritis Cartilage</em> leads journals in article count and citations, reflecting its outsized influence. Orthopedics predominates by frequency, whereas Biochemistry Molecular Biology exhibits the highest betweenness centrality, bridging disparate research strands. Current focal points include stem cells, platelet-rich plasma, intraarticular injection, hyaluronic acid, inflammation, regenerative medicine, cartilage regeneration, extracellular vesicles, exosomes, tissue engineering, management, and efficacy, collectively delineating the field's leading edge and prospective trajectory.</div></div><div><h3>Conclusions</h3><div>A well-defined research framework for articular cartilage regenerative repair has emerged within KOA therapy and offers substantial translational potential. Continued advances in the directed differentiation of stem cells, optimization of tissue-engineered scaffolds, and gene-editing-mediated modulation are expected to position this technology as a central component of precision KOA management.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 324-339"},"PeriodicalIF":1.5,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do patients outlive their shoulder prosthesis?","authors":"Tarek Haj Shehadeh,&nbsp;Adam Elsayed,&nbsp;Gary Updegrove,&nbsp;Nathan Lanham","doi":"10.1016/j.jor.2025.12.044","DOIUrl":"10.1016/j.jor.2025.12.044","url":null,"abstract":"<div><h3>Purpose</h3><div>Total shoulder arthroplasty (TSA) is projected to exponentially increase in the near future. Despite having excellent long-term survivorship, revision surgery remains a key metric in the implant's success. With an increasingly aging population, it is key to understand the relative incidence of death compared to revision surgery to better guide patients counseling and surgical decision-making. In this study, we aim to compare the rates of revision surgery and mortality following TSA in patients aged &lt;65 and ≥ 65.</div></div><div><h3>Methods</h3><div>We queried the TriNetX database for patients undergoing TSA. Patients were grouped into two cohorts depending on age at surgery (&lt;65 and ≥ 65), and were followed up for 10 years after surgery. Incidence of death and revision surgery were compared between the two cohorts. Significance was set for p &lt; 0.05.</div></div><div><h3>Results</h3><div>135,021 patients were initially included in this study. 106,777 patients formed the cohort aged ≥65 compared to 28,244 patients in the cohort aged &lt;65. The cumulative incidence of mortality was 22.9 % while that of revision was 6.1 % for the ≥65 cohort, while the cumulative incidence of mortality was 7.0 % and revision was 9.4 % for the &lt;65 cohort. The old cohort had significantly lower odds of revision compared to the younger cohort (3.2 % vs 3.5 %, OR = 0.911, p = 0.011), however had significantly higher odds of mortality compared to the young cohort (7.2 % vs 1.9 %, OR = 4.021, p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>Patients younger than 65 years had a higher risk of revision surgery but a lower risk of mortality compared to those older than 65 years. Younger patients appear more likely to require revision during their lifetime, whereas older patients are more likely to outlive their implants. These findings underscore distinct risk profiles across age groups and can guide individualized counseling and surgical planning.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"73 ","pages":"Pages 321-323"},"PeriodicalIF":1.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}