Aims: Rapid identification of the causative microorganisms of osteoarticular infections is essential for successful treatment. BIOFIRE® FilmArray® Joint Infection Panel (JI panel), a fully automated multiplex PCR panel, can rapidly detect pathogens and antimicrobial resistance genes in the synovial joints in patients with acute osteoarticular infections. Accordingly, this study aimed to evaluate the diagnostic method of the JI panel in patients with osteoarticular infections.
Methods: Synovial fluid samples were collected from patients with suspected osteoarticular infections. Fifty-five samples from 49 patients were analysed. The JI panel results were compared with those obtained using conventional culture methods.
Results: The sensitivities of the JI panel and culture for detecting microorganisms were 55 and 61 %, respectively, while the specificities were both 100 %. For patients with osteoarticular infections (n = 23) and positive culture or JI panel, the agreement rate between the JI panel and culture was 65 %. In five samples (22 %), the culture was positive, but the JI panel was negative. In three of the five JI panel-negative specimens (13 %), the bacteria identified in the culture were not included in the panel design. Three culture-negative specimens were JI panel-positive. Significantly higher sensitivity (70 % vs. 55 %; P = 0.008) was observed with the combined JI panel and culture than with the JI panel alone.
Conclusion: The JI panel is a useful technique to identify causative bacteria rapidly and automatically, but the combination of the JI panel and culture methods is recommended because some pathogens are not included in the JI panel.
Level of evidence: Diagnostic level III.
目的：快速鉴定骨关节感染的致病微生物对成功治疗至关重要。BIOFIRE®FilmArray®关节感染面板（JI Panel）是一种全自动多重PCR检测面板，可快速检测急性骨关节感染患者滑膜关节内的病原体和抗菌耐药基因。因此，本研究旨在评价JI面板对骨关节感染患者的诊断方法。方法：采集疑似骨关节感染患者的滑液标本。分析了49例患者的55个样本。将JI面板结果与常规培养方法获得的结果进行比较。结果：JI平板和培养物检测微生物的灵敏度分别为55%和61%，特异性均为100%。对于骨关节感染患者（n = 23），培养或JI面板阳性，JI面板与培养的符合率为65%。在5个样本（22%）中，培养呈阳性，但JI面板呈阴性。在5个JI阴性标本中，有3个（13%）在培养中发现的细菌未包括在样本设计中。3例培养阴性标本为JI面板阳性。与单独使用JI面板相比，联合使用JI面板和培养的灵敏度明显更高（70% vs 55%; P = 0.008）。结论：冀菌法是一种快速、自动鉴定病原菌的技术，但由于冀菌法中不包括某些病原菌，建议将冀菌法与培养法结合使用。证据等级：诊断级III。
{"title":"Evaluation of a fully automated multiplex PCR panel for the microbiological diagnosis of joint infections.","authors":"Narumi Ueda, Yasushi Nakamori, Kazuyuki Okuda, Hirokazu Iida, Tetsuro Sugiura, Takanori Saito","doi":"10.1016/j.jos.2025.12.004","DOIUrl":"https://doi.org/10.1016/j.jos.2025.12.004","url":null,"abstract":"<p><strong>Aims: </strong>Rapid identification of the causative microorganisms of osteoarticular infections is essential for successful treatment. BIOFIRE® FilmArray® Joint Infection Panel (JI panel), a fully automated multiplex PCR panel, can rapidly detect pathogens and antimicrobial resistance genes in the synovial joints in patients with acute osteoarticular infections. Accordingly, this study aimed to evaluate the diagnostic method of the JI panel in patients with osteoarticular infections.</p><p><strong>Methods: </strong>Synovial fluid samples were collected from patients with suspected osteoarticular infections. Fifty-five samples from 49 patients were analysed. The JI panel results were compared with those obtained using conventional culture methods.</p><p><strong>Results: </strong>The sensitivities of the JI panel and culture for detecting microorganisms were 55 and 61 %, respectively, while the specificities were both 100 %. For patients with osteoarticular infections (n = 23) and positive culture or JI panel, the agreement rate between the JI panel and culture was 65 %. In five samples (22 %), the culture was positive, but the JI panel was negative. In three of the five JI panel-negative specimens (13 %), the bacteria identified in the culture were not included in the panel design. Three culture-negative specimens were JI panel-positive. Significantly higher sensitivity (70 % vs. 55 %; P = 0.008) was observed with the combined JI panel and culture than with the JI panel alone.</p><p><strong>Conclusion: </strong>The JI panel is a useful technique to identify causative bacteria rapidly and automatically, but the combination of the JI panel and culture methods is recommended because some pathogens are not included in the JI panel.</p><p><strong>Level of evidence: </strong>Diagnostic level III.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917889","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}
Condoliase is a chemonucleolytic agent approved in Japan for the treatment of lumbar disc herniation (LDH). There had been no follow-up evaluation of its long-term effects on discs covering a period exceeding 10 years.
Methods
The present study evaluated the 10-year post-dose outcomes of patients treated with condoliase during the phase III trial in terms of neurological results, Oswestry Disability Index (ODI), X-ray findings (disc height, posterior intervertebral angle, vertebral body translation), and magnetic resonance image findings (Modic classification, Pfirrmann grade).
Results
Among the 82 patients treated with condoliase during the phase III trial, 37 (45.1 %) were available for the 10-year post-dose follow-up in the present study. At 10 years post-dose, low back pain and leg pain were observed in 15 (40.5 %) and 6 (16.2 %) of 37 patients, and the number of patients with positive straight leg raise test, hypesthesia, muscle weakness, and deep tendon hyporeflexia were 1 (2.7 %), 2 (5.4 %), 0 (0 %), and 8 (21.6 %), respectively; mean ODI was 8.6, with 32/37 (86.5 %) patients having ODI of 0 %–20 %; 8 (21.6 %) patients had disc height decreased by ≥ 30 %; 1 patient had posterior intervertebral angle of ≥5° and 1 had vertebral body translation of ≥3 mm. Although 5 patients (13.5 %) underwent lumbar surgery after receiving condoliase, no patient underwent surgery for spinal instability. In the Modic classification, the number of patients with “Type 0,” “Type 1,” and “Type 3” decreased, while those with “Type 2” increased compared to evaluations conducted at 1-year post-dose. For Pfirrmann grade, the number of patients with “Grade IV” decreased and those with “Grade V″ increased from 1 to 10 years post-dose.
Conclusions
No significant imaging findings necessitating surgery were observed, suggesting that chemonucleolysis with condoliase remains a safe and effective treatment option for LDH over the long term.
{"title":"A clinical study of ten-year prognosis in patients with lumbar disc herniation treated with condoliase in a phase III trial","authors":"Yukihiro Matsuyama , Tomohiro Banno , Hideaki Imabayashi , Tetsuro Takatsu , Fumihiro Oha , Takashi Tsuji , Tetsuya Watanabe , Masaki Tatsumura , Kyohei Sakaki , Yoji Ogura , Yoshihisa Suzuki , Tetsuya Ohara , Tadashi Komatsubara , Takahiko Hyakumachi , Masahiro Hoshino , Yoshio Sakuma , Kozo Chino , Kei Ando , Kiyotaka Yamada , Ippei Watanabe , Kazuhiro Chiba","doi":"10.1016/j.jos.2025.05.006","DOIUrl":"10.1016/j.jos.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Condoliase is a chemonucleolytic agent approved in Japan for the treatment of lumbar disc herniation (LDH). There had been no follow-up evaluation of its long-term effects on discs covering a period exceeding 10 years.</div></div><div><h3>Methods</h3><div>The present study evaluated the 10-year post-dose outcomes of patients treated with condoliase during the phase III trial in terms of neurological results, Oswestry Disability Index (ODI), X-ray findings (disc height, posterior intervertebral angle, vertebral body translation), and magnetic resonance image findings (Modic classification, Pfirrmann grade).</div></div><div><h3>Results</h3><div>Among the 82 patients treated with condoliase during the phase III trial, 37 (45.1 %) were available for the 10-year post-dose follow-up in the present study. At 10 years post-dose, low back pain and leg pain were observed in 15 (40.5 %) and 6 (16.2 %) of 37 patients, and the number of patients with positive straight leg raise test, hypesthesia, muscle weakness, and deep tendon hyporeflexia were 1 (2.7 %), 2 (5.4 %), 0 (0 %), and 8 (21.6 %), respectively; mean ODI was 8.6, with 32/37 (86.5 %) patients having ODI of 0 %–20 %; 8 (21.6 %) patients had disc height decreased by ≥ 30 %; 1 patient had posterior intervertebral angle of ≥5° and 1 had vertebral body translation of ≥3 mm. Although 5 patients (13.5 %) underwent lumbar surgery after receiving condoliase, no patient underwent surgery for spinal instability. In the Modic classification, the number of patients with “Type 0,” “Type 1,” and “Type 3” decreased, while those with “Type 2” increased compared to evaluations conducted at 1-year post-dose. For Pfirrmann grade, the number of patients with “Grade IV” decreased and those with “Grade V″ increased from 1 to 10 years post-dose.</div></div><div><h3>Conclusions</h3><div>No significant imaging findings necessitating surgery were observed, suggesting that chemonucleolysis with condoliase remains a safe and effective treatment option for LDH over the long term.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 69-75"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642791","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}
Patient satisfaction is an essential metric for evaluating treatment outcomes for LSS, both for patients and for their primary physicians. However, the Zurich Claudication Questionnaire (ZCQ) is the only representative patient-reported outcome measure that evaluates satisfaction. To develop a model using machine learning to predict postoperative satisfaction among older patients with lumbar spinal stenosis (LSS) based on preoperative and postoperative scores of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ).
Methods
The training dataset was composed of time-course data of ZCQ and JOABPEQ scores from patients aged ≥65 years who underwent LSS surgery at a university hospital. The validation dataset included data from patients with LSS treated at a private orthopedic clinic. A linear support vector machine classifier was trained to predict achievement of a “Satisfied” state from preoperative and postoperative JOABPEQ scores. Internal validation was carried out via leave-one-out cross-validation, and external validation using a separate dataset to assess the accuracy, sensitivity, specificity, F1 score, and area under the receiver operating characteristics curve (AUROC). Variable importance was analyzed using model class reliance.
Results
A total of 232 and 66 individuals were included in the training and validation datasets, respectively. The machine-learning model exhibited an accuracy of 0.72, sensitivity of 0.75, specificity of 0.69, and AUROC of 0.82. Psychological disorder and walking ability were identified through permutation importance analysis as key factors for satisfaction. External validation on an independent dataset demonstrated comparable accuracy (0.76), sensitivity (0.83), and AUROC (0.75), although the specificity decreased (0.42).
Conclusions
The machine learning model presented here can predict the postoperative satisfaction score on the ZCQ from preoperative and postoperative JOABPEQ scores, highlighting its potential for broader application in clinical settings.
{"title":"Development of a machine-learning model for patient satisfaction prediction in lumbar spinal stenosis surgery: A multicenter study with ZCQ and JOABPEQ scores","authors":"Soya Kawabata , Gen Miura , Yuki Akaike , Sota Nagai , Kurenai Hachiya , Takaya Imai , Hiroki Takeda , Atsushi Yoshioka , Shinjiro Kaneko , Yudo Hachiya , Nobuyuki Fujita , Takayuki Kannon , Junichiro Yoshimoto","doi":"10.1016/j.jos.2025.06.014","DOIUrl":"10.1016/j.jos.2025.06.014","url":null,"abstract":"<div><h3>Background</h3><div>Patient satisfaction is an essential metric for evaluating treatment outcomes for LSS, both for patients and for their primary physicians. However, the Zurich Claudication Questionnaire (ZCQ) is the only representative patient-reported outcome measure that evaluates satisfaction. To develop a model using machine learning to predict postoperative satisfaction among older patients with lumbar spinal stenosis (LSS) based on preoperative and postoperative scores of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ).</div></div><div><h3>Methods</h3><div>The training dataset was composed of time-course data of ZCQ and JOABPEQ scores from patients aged ≥65 years who underwent LSS surgery at a university hospital. The validation dataset included data from patients with LSS treated at a private orthopedic clinic. A linear support vector machine classifier was trained to predict achievement of a “Satisfied” state from preoperative and postoperative JOABPEQ scores. Internal validation was carried out via leave-one-out cross-validation, and external validation using a separate dataset to assess the accuracy, sensitivity, specificity, F1 score, and area under the receiver operating characteristics curve (AUROC). Variable importance was analyzed using model class reliance.</div></div><div><h3>Results</h3><div>A total of 232 and 66 individuals were included in the training and validation datasets, respectively. The machine-learning model exhibited an accuracy of 0.72, sensitivity of 0.75, specificity of 0.69, and AUROC of 0.82. Psychological disorder and walking ability were identified through permutation importance analysis as key factors for satisfaction. External validation on an independent dataset demonstrated comparable accuracy (0.76), sensitivity (0.83), and AUROC (0.75), although the specificity decreased (0.42).</div></div><div><h3>Conclusions</h3><div>The machine learning model presented here can predict the postoperative satisfaction score on the ZCQ from preoperative and postoperative JOABPEQ scores, highlighting its potential for broader application in clinical settings.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 96-101"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553844","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}
Cervical spondylotic myelopathy (CSM) is a degenerative condition caused by spinal cord compression, leading to significant neurological impairments. While decompression surgery is the gold standard for treating CSM, recovery is often incomplete, prompting the need for adjunct therapies. Erythropoietin (EPO), widely used for anemia treatment, has shown beneficial effects on the nervous system. This study evaluates the combined effects of decompression surgery and EPO administration in a rat model of compressive myelopathy.
Methods
We developed a rat model of compressive myelopathy using a gradually expanding polymer sheet at C4–C5 levels. Rats were divided into three groups: Control (sham surgery, weekly saline injections), Decompression (decompression surgery, weekly saline injections), and Decompression + EPO (decompression surgery, weekly EPO injections). Motor function, myelination, and axonal integrity were evaluated over eight weeks using Basso, Beattie, and Bresnahan (BBB) scores, grid runway tests, and histological analyses.
Results
The decompression + EPO group exhibited significantly better motor function, with higher BBB scores and fewer hindlimb drops in grid runway tests compared to the Control group. Histological analyses revealed enhanced myelination in the corticospinal tract, as shown by Luxol Fast Blue (LFB) staining and myelin basic protein (MBP) staining, along with increased axonal growth marked by growth-associated protein 43 (GAP-43) expression.
Conclusion
Combining decompression surgery with EPO administration significantly improved motor recovery and promoted spinal cord myelination in a rat model of compressive myelopathy. These findings suggest EPO as a promising adjunct to surgical treatment in CSM, warranting further clinical investigation.
脊髓型颈椎病（CSM）是一种由脊髓压迫引起的退行性疾病，导致严重的神经损伤。虽然减压手术是治疗脊髓型颈椎病的金标准，但恢复往往不完全，这促使需要辅助治疗。促红细胞生成素（EPO）广泛用于贫血治疗，对神经系统有良好的作用。本研究评估减压手术和EPO给药对压缩性脊髓病大鼠模型的联合作用。方法：我们在C4-C5水平使用逐渐扩大的聚合物片建立了大鼠压缩性脊髓病模型。将大鼠分为对照组（假手术，每周生理盐水注射）、减压组（减压手术，每周生理盐水注射）和减压+ EPO组（减压手术，每周EPO注射）。运动功能、髓鞘形成和轴突完整性在8周内通过Basso、Beattie和Bresnahan （BBB）评分、网格跑道测试和组织学分析进行评估。结果：与对照组相比，减压+ EPO组表现出更好的运动功能，BBB评分更高，后肢在网格跑道测试中的下降更少。组织学分析显示皮质脊髓束髓鞘形成增强，Luxol Fast Blue （LFB）染色和髓鞘碱性蛋白（MBP）染色显示，同时生长相关蛋白43 （GAP-43）表达的轴突生长增加。结论：减压手术联合EPO治疗可显著改善压缩性脊髓病大鼠的运动恢复，促进脊髓髓鞘形成。这些发现表明EPO作为CSM手术治疗的一种有希望的辅助手段，值得进一步的临床研究。
{"title":"Effects of decompression surgery and erythropoietin combination on a rat model of compressive myelopathy","authors":"Yuki Shiratani, Takeo Furuya, Yuki Nagashima, Yasunori Toki, Masataka Miura, Sho Okimatsu, Juntaro Maruyama, Kyota Kitagawa, Takaki Inoue, Atsushi Yunde, Satoshi Maki, Seiji Ohtori","doi":"10.1016/j.jos.2025.06.013","DOIUrl":"10.1016/j.jos.2025.06.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Cervical spondylotic myelopathy (CSM) is a degenerative condition caused by spinal cord compression, leading to significant neurological impairments. While decompression surgery is the gold standard for treating CSM, recovery is often incomplete, prompting the need for adjunct therapies. Erythropoietin (EPO), widely used for anemia treatment, has shown beneficial effects on the nervous system. This study evaluates the combined effects of decompression surgery and EPO administration in a rat model of compressive myelopathy.</div></div><div><h3>Methods</h3><div>We developed a rat model of compressive myelopathy using a gradually expanding polymer sheet at C4–C5 levels. Rats were divided into three groups: Control (sham surgery, weekly saline injections), Decompression (decompression surgery, weekly saline injections), and Decompression + EPO (decompression surgery, weekly EPO injections). Motor function, myelination, and axonal integrity were evaluated over eight weeks using Basso, Beattie, and Bresnahan (BBB) scores, grid runway tests, and histological analyses.</div></div><div><h3>Results</h3><div>The decompression + EPO group exhibited significantly better motor function, with higher BBB scores and fewer hindlimb drops in grid runway tests compared to the Control group. Histological analyses revealed enhanced myelination in the corticospinal tract, as shown by Luxol Fast Blue (LFB) staining and myelin basic protein (MBP) staining, along with increased axonal growth marked by growth-associated protein 43 (GAP-43) expression.</div></div><div><h3>Conclusion</h3><div>Combining decompression surgery with EPO administration significantly improved motor recovery and promoted spinal cord myelination in a rat model of compressive myelopathy. These findings suggest EPO as a promising adjunct to surgical treatment in CSM, warranting further clinical investigation.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 109-118"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600844","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}
Pub Date : 2026-01-01DOI: 10.1016/j.jos.2025.06.005
Fuchao Wang , Shixia Chen , Yan Zhang , Yue Shen , Yuqi Wang , Xi Zhang
Objective
We endeavor to investigate the incidence and treatment of acute traumatic patellar dislocation (PD) in conjunction with various knee joint injuries in children.
Methods
A retrospective analysis was conducted on 137 patients diagnosed with acute traumatic PD and associated periarticular injuries. Patient imaging examinations, medical histories, and treatment records were collected and analyzed to assess the occurrence of PD in combination with injuries to the surrounding knee joint tissues, and to explore effective treatment strategies.
Results
Among the patients studied: 1 had a quadriceps injury, 6 had peripheral ligament injuries, 31 had avulsion fractures of the medial border of the patella, 7 had fractures of the lateral femoral condyle, 2 had fractures of the medial femoral condyle,5 had tibial tubercle fractures, 43 had cartilage injuries. Several patients presented with multiple injuries. In cases where only medial patellofemoral ligament (MPFL) injury occurred: 13 patients underwent MPFL reconstruction, none of whom experienced re-dislocation post-surgery. 29 patients underwent non-surgical treatment, with 12 experiencing at least one re-dislocation afterward. Overall: 92 patients received non-surgical treatment, with 30 patients experiencing re-dislocation post-surgery, resulting in a re-dislocation rate of 32.61 %. 45 patients underwent surgical treatment, with only 1 patient experiencing re-dislocation post-surgery, yielding a recurrence rate of 2.22 %.
Conclusion
Traumatic PD in children often involves significant soft tissue and bone damage. Surgical intervention is particularly beneficial when combined with extensor mechanism injuries, cartilage damage, or large fractures, as it effectively reduces the recurrence rate of postoperative dislocations.
{"title":"Acute traumatic patellar dislocation with periarticular injuries in children: A retrospective study of 137 patients","authors":"Fuchao Wang , Shixia Chen , Yan Zhang , Yue Shen , Yuqi Wang , Xi Zhang","doi":"10.1016/j.jos.2025.06.005","DOIUrl":"10.1016/j.jos.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>We endeavor to investigate the incidence and treatment of acute traumatic patellar dislocation (PD) in conjunction with various knee joint injuries in children.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 137 patients diagnosed with acute traumatic PD and associated periarticular injuries. Patient imaging examinations, medical histories, and treatment records were collected and analyzed to assess the occurrence of PD in combination with injuries to the surrounding knee joint tissues, and to explore effective treatment strategies.</div></div><div><h3>Results</h3><div>Among the patients studied: 1 had a quadriceps injury, 6 had peripheral ligament injuries, 31 had avulsion fractures of the medial border of the patella, 7 had fractures of the lateral femoral condyle, 2 had fractures of the medial femoral condyle,5 had tibial tubercle fractures, 43 had cartilage injuries. Several patients presented with multiple injuries. In cases where only medial patellofemoral ligament (MPFL) injury occurred: 13 patients underwent MPFL reconstruction, none of whom experienced re-dislocation post-surgery. 29 patients underwent non-surgical treatment, with 12 experiencing at least one re-dislocation afterward. Overall: 92 patients received non-surgical treatment, with 30 patients experiencing re-dislocation post-surgery, resulting in a re-dislocation rate of 32.61 %. 45 patients underwent surgical treatment, with only 1 patient experiencing re-dislocation post-surgery, yielding a recurrence rate of 2.22 %.</div></div><div><h3>Conclusion</h3><div>Traumatic PD in children often involves significant soft tissue and bone damage. Surgical intervention is particularly beneficial when combined with extensor mechanism injuries, cartilage damage, or large fractures, as it effectively reduces the recurrence rate of postoperative dislocations.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 255-261"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540601","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}
Patients with clear cell renal cell carcinoma (ccRCC) have a higher incidence of bone metastasis; however, the availability of immune checkpoint inhibitors (ICIs) is expected to improve their overall survival (OS). Hence, accurate data on the prognosis and survival of patients with bone metastases are necessary to recommend appropriate treatments. Therefore, we investigated the prognosis and prognostic factors of patients with ccRCC bone metastasis in the era of ICIs.
Methods
This retrospective cohort study included 33 patients with ccRCC who were treated for bone metastases between 2016 and 2022. We evaluated the association between OS and clinical parameters, including serum biochemical concentrations, and blood cell count, using Kaplan–Meier curves and Cox proportional hazards models.
Results
The median OS was 28 months (95 % confidence interval (CI): 8 months - not censored), and the 1-year survival rate was 64 %. Twenty-one patients were treated with ICIs after bone metastasis diagnosis. The multivariate analysis revealed that the use of ICIs after bone metastasis diagnosis was a good prognostic factor (hazard ratio, 0.32; 95 % CI: 0.11–0.89, p = 0.029). Patients in the Katagiri score 5–7 points group using ICIs had a significantly longer survival (p = 0.012) but similar OS compared to the 2–4 points group (p = 0.34).
Conclusions
ICI use after the diagnosis of bone metastasis may be a favorable prognostic factor in patients with bone metastases due to ccRCC. The predictive power of the current scoring system could underestimate the prognoses in patients with ccRCC and bone metastasis not treated with ICIs, highlighting the need for a better predictive scoring system in the era of ICIs.
{"title":"Prognostic factors in patients with bone metastasis of renal cell carcinoma in the era of immune checkpoint inhibitors","authors":"Yuki Ishibashi , Hiroshi Kobayashi , Koichi Okajima , Takahiro Oki , Yusuke Tsuda , Yusuke Shinoda , Ryoko Sawada , Sakae Tanaka","doi":"10.1016/j.jos.2025.06.008","DOIUrl":"10.1016/j.jos.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Patients with clear cell renal cell carcinoma (ccRCC) have a higher incidence of bone metastasis; however, the availability of immune checkpoint inhibitors (ICIs) is expected to improve their overall survival (OS). Hence, accurate data on the prognosis and survival of patients with bone metastases are necessary to recommend appropriate treatments. Therefore, we investigated the prognosis and prognostic factors of patients with ccRCC bone metastasis in the era of ICIs.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 33 patients with ccRCC who were treated for bone metastases between 2016 and 2022. We evaluated the association between OS and clinical parameters, including serum biochemical concentrations, and blood cell count, using Kaplan–Meier curves and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>The median OS was 28 months (95 % confidence interval (CI): 8 months - not censored), and the 1-year survival rate was 64 %. Twenty-one patients were treated with ICIs after bone metastasis diagnosis. The multivariate analysis revealed that the use of ICIs after bone metastasis diagnosis was a good prognostic factor (hazard ratio, 0.32; 95 % CI: 0.11–0.89, p = 0.029). Patients in the Katagiri score 5–7 points group using ICIs had a significantly longer survival (p = 0.012) but similar OS compared to the 2–4 points group (p = 0.34).</div></div><div><h3>Conclusions</h3><div>ICI use after the diagnosis of bone metastasis may be a favorable prognostic factor in patients with bone metastases due to ccRCC. The predictive power of the current scoring system could underestimate the prognoses in patients with ccRCC and bone metastasis not treated with ICIs, highlighting the need for a better predictive scoring system in the era of ICIs.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 262-267"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560428","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}
Epidemiological characteristics of Hip osteoarthritis (OA) continue to change due to population aging and emerging disease concepts, such as femoroacetabular impingement (FAI) and subchondral insufficiency fracture of the femoral head (SIF). This study aimed to analyze the current etiologies of hip OA in Japan and identify characteristics associated with each etiology.
Methods
A multicenter cross-sectional study was conducted in 2022 at 12 major Japanese hospitals, including 1197 patients (1515 hips) newly diagnosed with hip OA. Etiologies were classified into nine categories based on patient background and imaging findings: hip dysplasia, primary OA, FAI, SIF, rapidly destructive coxopathy (RDC), trauma, Legg-Calvé-Perthes disease (LCPD), slipped capital femoral epiphysis (SCFE), and skeletal dysplasia.
Results
The etiologies included hip dysplasia (74.4 %), primary OA (13.4 %), FAI (4.8 %), SIF (3.4 %), RDC (1.3 %), trauma (1.3 %), LCPD (0.9 %), SCFE (0.1 %), and skeletal dysplasia (0.1 %). Patients in their 70s comprised the largest group, with a predominance of female patients across all ages. The proportion of hip dysplasia decreased in the elderly patients, whereas primary OA and SIF increased. Hip dysplasia was more common in female than male (78.2 % vs. 55.2 %), whereas FAI was more frequent in male (17.9 % vs. 2.2 %). The Japanese Orthopaedic Association hip scores were highest for FAI and lowest for SIF. Kellgren-Lawrence (KL) grade ≥3 was more common in primary OA (82.0 %) and hip dysplasia (76.7 %) than in FAI (57.7 %) and SIF (66.7 %).
Conclusions
Hip dysplasia remains the predominant cause of hip OA in Japan. Age-specific analyses revealed that FAI was more common in younger patients, while primary OA and SIF were prevalent in older patients. Patients with hip dysplasia and primary OA often presented with advanced KL grades, while SIF was associated with the poorest clinical scores. These findings may inform diagnostic and treatment approaches based on predominant etiologies.
{"title":"Etiology and clinical trends in hip osteoarthritis in Japan: Insights from a multicenter cross-sectional study","authors":"Taishi Sato , Ryosuke Yamaguchi , Takeshi Utsunomiya , Yutaka Inaba , Hiroyuki Ike , Koichi Kinoshita , Kenichiro Doi , Tsutomu Kawano , Kyohei Shiomoto , Toshihiko Hara , Kazuhiko Sonoda , Ayumi Kaneuji , Eiji Takahashi , Tomohiro Shimizu , Daisuke Takahashi , Yusuke Kohno , Tamon Kabata , Daisuke Inoue , Shuichi Matsuda , Koji Goto , Yasuharu Nakashima","doi":"10.1016/j.jos.2025.06.006","DOIUrl":"10.1016/j.jos.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Epidemiological characteristics of Hip osteoarthritis (OA) continue to change due to population aging and emerging disease concepts, such as femoroacetabular impingement (FAI) and subchondral insufficiency fracture of the femoral head (SIF). This study aimed to analyze the current etiologies of hip OA in Japan and identify characteristics associated with each etiology.</div></div><div><h3>Methods</h3><div>A multicenter cross-sectional study was conducted in 2022 at 12 major Japanese hospitals, including 1197 patients (1515 hips) newly diagnosed with hip OA. Etiologies were classified into nine categories based on patient background and imaging findings: hip dysplasia, primary OA, FAI, SIF, rapidly destructive coxopathy (RDC), trauma, Legg-Calvé-Perthes disease (LCPD), slipped capital femoral epiphysis (SCFE), and skeletal dysplasia.</div></div><div><h3>Results</h3><div>The etiologies included hip dysplasia (74.4 %), primary OA (13.4 %), FAI (4.8 %), SIF (3.4 %), RDC (1.3 %), trauma (1.3 %), LCPD (0.9 %), SCFE (0.1 %), and skeletal dysplasia (0.1 %). Patients in their 70s comprised the largest group, with a predominance of female patients across all ages. The proportion of hip dysplasia decreased in the elderly patients, whereas primary OA and SIF increased. Hip dysplasia was more common in female than male (78.2 % vs. 55.2 %), whereas FAI was more frequent in male (17.9 % vs. 2.2 %). The Japanese Orthopaedic Association hip scores were highest for FAI and lowest for SIF. Kellgren-Lawrence (KL) grade ≥3 was more common in primary OA (82.0 %) and hip dysplasia (76.7 %) than in FAI (57.7 %) and SIF (66.7 %).</div></div><div><h3>Conclusions</h3><div>Hip dysplasia remains the predominant cause of hip OA in Japan. Age-specific analyses revealed that FAI was more common in younger patients, while primary OA and SIF were prevalent in older patients. Patients with hip dysplasia and primary OA often presented with advanced KL grades, while SIF was associated with the poorest clinical scores. These findings may inform diagnostic and treatment approaches based on predominant etiologies.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 187-193"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528504","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}
Pub Date : 2026-01-01DOI: 10.1016/j.jos.2025.05.008
Tsunemasa Kita , Taro Funamoto , Haruki Mori , Hiroshi Ikejiri , Takuya Tajima , Etsuo Chosa , Naosuke Kamei
Background
A medical fee incentive based on a 48-h target time for hip fracture surgery has been implemented in Japan since 2022. This study aimed to evaluate the clinical outcomes of early surgery within 48 h after hip fracture.
Methods
This study was a retrospective, single-center study. Patients >60 years of age who underwent hip fracture surgery between 2021 and 2022 were eligible. They were divided into 2 groups: 2021 (before implementation of the system) and 2022 (after implementation of the system). The primary outcome was the surgical waiting time after injury. The secondary outcomes were clinical outcomes such as postoperative complication rate, mortality rate at 1 and 6 months after surgery, and length of stay in our institution. To assess the influence of early surgery on these outcomes, an additional analysis was performed in 2 groups: the early group (surgery within 48 h) and the delayed group (surgery beyond 48 h).
Results
In total, 365 patients were included in this study. The surgical waiting time was significantly shortened after the implementation of the system (64.5 h in 2021 vs. 42.8 h in 2022, p < 0.001). There were significant differences between the 2021 and 2022 groups in the complication rate (17 % vs. 9 %, p = 0.03) and length of hospital stay (15 days vs. 13 days, p < 0.001). A multivariate analysis between the early and delayed group showed that early surgery was associated with a lower complication rate and shorter length of stay (p < 0.05).
Conclusion
Efforts to perform early surgery within 48 h of injury following the new reimbursement scheme have contributed to improved clinical outcomes, including lower complication rates and shorter hospital stay in our institution.
{"title":"Early surgery within 48 h for post-injury hip fractures improved clinical outcomes","authors":"Tsunemasa Kita , Taro Funamoto , Haruki Mori , Hiroshi Ikejiri , Takuya Tajima , Etsuo Chosa , Naosuke Kamei","doi":"10.1016/j.jos.2025.05.008","DOIUrl":"10.1016/j.jos.2025.05.008","url":null,"abstract":"<div><h3>Background</h3><div>A medical fee incentive based on a 48-h target time for hip fracture surgery has been implemented in Japan since 2022. This study aimed to evaluate the clinical outcomes of early surgery within 48 h after hip fracture.</div></div><div><h3>Methods</h3><div>This study was a retrospective, single-center study. Patients >60 years of age who underwent hip fracture surgery between 2021 and 2022 were eligible. They were divided into 2 groups: 2021 (before implementation of the system) and 2022 (after implementation of the system). The primary outcome was the surgical waiting time after injury. The secondary outcomes were clinical outcomes such as postoperative complication rate, mortality rate at 1 and 6 months after surgery, and length of stay in our institution. To assess the influence of early surgery on these outcomes, an additional analysis was performed in 2 groups: the early group (surgery within 48 h) and the delayed group (surgery beyond 48 h).</div></div><div><h3>Results</h3><div>In total, 365 patients were included in this study. The surgical waiting time was significantly shortened after the implementation of the system (64.5 h in 2021 vs. 42.8 h in 2022, p < 0.001). There were significant differences between the 2021 and 2022 groups in the complication rate (17 % vs. 9 %, p = 0.03) and length of hospital stay (15 days vs. 13 days, p < 0.001). A multivariate analysis between the early and delayed group showed that early surgery was associated with a lower complication rate and shorter length of stay (p < 0.05).</div></div><div><h3>Conclusion</h3><div>Efforts to perform early surgery within 48 h of injury following the new reimbursement scheme have contributed to improved clinical outcomes, including lower complication rates and shorter hospital stay in our institution.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 219-225"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564923","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}
Pub Date : 2026-01-01DOI: 10.1016/j.jos.2025.06.011
Mehmet Fevzi Cakmak , Serkan Bayram , Levent Horoz , Hicabi Sezgin , Burak Akan
Background
This study aimed to compare the clinical and radiological outcomes of patients who underwent autograft application following standard transverse osteotomy supported by two cobalt-chrome cables with those who did not use autografts to support the osteotomy line in Crowe type IV Developmental Dysplasia of the Hip (DDH).
Methods
Sixty-nine patients (78 hips) with Crowe type IV DDH underwent a transverse subtrochanteric shortening osteotomy. In Group 1, 42 hips had their osteotomy site supported with an autograft harvested from the shortening osteotomy. Conversely, Group 2 consisted of 36 hips in which graft application was not performed, and fixation of the osteotomy site was solely achieved by employing the femoral stem. Clinical outcome measures included limb length discrepancy, pain (visual analog score), and functional Harris Hip Score (HHS). For radiological evaluation, bone healing of the femoral osteotomy site was assessed using the radiographic union score for tibial (mRUST) classification, and stabilization of components was evaluated according to the Engh classification.
Results
There were no significant differences in age, body mass index, follow-up duration, preoperative and postoperative LLD, VAS score, and HHS values. No statistically significant difference was identified between the Engh classification. Significant differences between the groups were detected in the mRUST classification (p = 0.020). The mean value of the group not utilizing autograft (11,89 ± 1,83) was higher than that of the group using autografts (10,95 ± 1,59). There was no statistically significant relationship between complications between the groups (p = 0.981).
Conclusion
Performing of THA in Crowe type IV DDH, the press-fit application of the femoral component, without additional implantation or grafting, have shown comparable and satisfactory outcomes.
{"title":"Intercalary autograft not mandatory for shortening in total hip arthroplasty: A retrospective study","authors":"Mehmet Fevzi Cakmak , Serkan Bayram , Levent Horoz , Hicabi Sezgin , Burak Akan","doi":"10.1016/j.jos.2025.06.011","DOIUrl":"10.1016/j.jos.2025.06.011","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to compare the clinical and radiological outcomes of patients who underwent autograft application following standard transverse osteotomy supported by two cobalt-chrome cables with those who did not use autografts to support the osteotomy line in Crowe type IV Developmental Dysplasia of the Hip (DDH).</div></div><div><h3>Methods</h3><div>Sixty-nine patients (78 hips) with Crowe type IV DDH underwent a transverse subtrochanteric shortening osteotomy. In Group 1, 42 hips had their osteotomy site supported with an autograft harvested from the shortening osteotomy. Conversely, Group 2 consisted of 36 hips in which graft application was not performed, and fixation of the osteotomy site was solely achieved by employing the femoral stem. Clinical outcome measures included limb length discrepancy, pain (visual analog score), and functional <strong>Harris Hip Score (HHS).</strong> For radiological evaluation, bone healing of the femoral osteotomy site was assessed using <strong>the radiographic union score for tibial (mRUST)</strong> classification, and stabilization of components was evaluated according to the Engh classification.</div></div><div><h3>Results</h3><div>There were no significant differences in age, body mass index, follow-up duration, preoperative and postoperative LLD, VAS score, and HHS values. No statistically significant difference was identified between the Engh classification. Significant differences between the groups were detected in the mRUST classification (p = 0.020). The mean value of the group not utilizing autograft (11,89 ± 1,83) was higher than that of the group using autografts (10,95 ± 1,59). There was no statistically significant relationship between complications between the groups (p = 0.981).</div></div><div><h3>Conclusion</h3><div>Performing of THA in Crowe type IV DDH, the press-fit application of the femoral component, without additional implantation or grafting, have shown comparable and satisfactory outcomes.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 170-176"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649805","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号