Background: Despite the common use of ankle taping as a conservative treatment for chronic ankle instability (CAI), its effects on mechanical instability remain unquantified. This study aimed to use a capacitance-type strain sensor to quantitatively evaluate changes in mechanical instability resulting from several taping methods.
Methods: This crossover study analyzed 30 ankles of individuals with CAI under three taping conditions: athletic taping (AT), ankle kinesio taping (aKT), and lower leg-to-ankle kinesio taping (lKT). The anterior drawer distance (ADD) and ankle range of motion (ROM) were measured before and after each taping method. Participants rated their subjective stability and discomfort. Taping time and cost were also recorded. Statistical significance was set at P < 0.05.
Results: All taping methods significantly reduced the ADD (P < 0.001). AT demonstrated the greatest reduction in ADD and also restricted ankle ROM in all directions compared with both kinesio taping methods (P < 0.001). Inversion was restricted with all taping methods (P < 0.001 to P = 0.016), with lKT providing greater restriction than aKT (P = 0.048). Subjective stability did not significantly differ between the taping methods (P = 0.077). Taping application time was significantly shorter for AT (P < 0.001), while cost was highest for aKT (P = 0.009 to 0.010).
Conclusions: In individuals with CAI, AT provided the greatest improvement in mechanical stability and simultaneously imposed greater restrictions on ankle ROM. Among the KT methods, lKT provided greater inversion restriction than aKT. These findings emphasize the importance of carefully selecting taping methods based on the specific needs of each case.
Level of evidence: Level III, prospective crossover study.
{"title":"Comparative analysis of taping methods for chronic ankle instability: Impacts on ankle stability, range of motion, cost, and application time.","authors":"Seiya Tomonaga, Ichiro Yoshimura, Kazuki Kanazawa, Tomonobu Hagio, Tetsuro Ishimatsu, Yuki Sugino, Ryo Fukagawa, Yoshimasa Taniguchi, Takuaki Yamamoto","doi":"10.1016/j.jos.2026.01.002","DOIUrl":"https://doi.org/10.1016/j.jos.2026.01.002","url":null,"abstract":"<p><strong>Background: </strong>Despite the common use of ankle taping as a conservative treatment for chronic ankle instability (CAI), its effects on mechanical instability remain unquantified. This study aimed to use a capacitance-type strain sensor to quantitatively evaluate changes in mechanical instability resulting from several taping methods.</p><p><strong>Methods: </strong>This crossover study analyzed 30 ankles of individuals with CAI under three taping conditions: athletic taping (AT), ankle kinesio taping (aKT), and lower leg-to-ankle kinesio taping (lKT). The anterior drawer distance (ADD) and ankle range of motion (ROM) were measured before and after each taping method. Participants rated their subjective stability and discomfort. Taping time and cost were also recorded. Statistical significance was set at P < 0.05.</p><p><strong>Results: </strong>All taping methods significantly reduced the ADD (P < 0.001). AT demonstrated the greatest reduction in ADD and also restricted ankle ROM in all directions compared with both kinesio taping methods (P < 0.001). Inversion was restricted with all taping methods (P < 0.001 to P = 0.016), with lKT providing greater restriction than aKT (P = 0.048). Subjective stability did not significantly differ between the taping methods (P = 0.077). Taping application time was significantly shorter for AT (P < 0.001), while cost was highest for aKT (P = 0.009 to 0.010).</p><p><strong>Conclusions: </strong>In individuals with CAI, AT provided the greatest improvement in mechanical stability and simultaneously imposed greater restrictions on ankle ROM. Among the KT methods, lKT provided greater inversion restriction than aKT. These findings emphasize the importance of carefully selecting taping methods based on the specific needs of each case.</p><p><strong>Level of evidence: </strong>Level III, prospective crossover study.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030072","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}
Background: Liposarcoma demonstrates significant biological and clinical heterogeneity across subtypes, yet optimal treatment strategies remain controversial. We evaluated subtype-specific treatment outcomes and hospital volume effects using population-based registry data.
Methods: We conducted a population-based cohort study analyzing 6,678 patients with liposarcoma diagnosed between 2016 and 2019 from the Japanese National Cancer Registry. Subtype-specific clinical characteristics, treatment patterns, and survival outcomes were evaluated using Cox regression and Kaplan-Meier methods. Propensity score matching was performed to assess radiotherapy and chemotherapy effectiveness while controlling for confounding variables.
Results: Well-differentiated liposarcoma was most common (46.2 %), followed by dedifferentiated (27.8 %), myxoid (10.8 %), and pleomorphic (3.2 %) subtypes. Myxoid liposarcomas predominantly affected patients aged <60 years (63.8 %). Multivariate analysis identified male sex (HR 1.264, p = 0.008), older age (HR 3.307, p < 0.001), retroperitoneal location (HR 1.861, p < 0.001), distant disease (HR 6.091, p < 0.001), and treatment at low-volume hospitals (HR 1.381, p = 0.001) as independent poor prognostic factors. Propensity score-matched analysis demonstrated improved survival with radiotherapy in dedifferentiated liposarcomas (3-year survival: 76.5 % vs. 66.1 %, p = 0.022) and with chemotherapy in pleomorphic liposarcomas (3-year survival: 87.5 % vs. 68.8 %, p = 0.038).
Conclusions: Treatment efficacy varies significantly across liposarcoma subtypes, with potential survival benefits of radiotherapy in dedifferentiated subtypes and chemotherapy in pleomorphic subtypes. These findings support subtype-guided treatment approaches and suggest benefits of centralized care for optimal therapy implementation.
{"title":"Subtype-specific characteristics and outcomes of liposarcoma: A population-based study using Japan's National Cancer Registry.","authors":"Hiroya Kondo, Koichi Ogura, Chigusa Morizane, Tomoyuki Satake, Shintaro Iwata, Yu Toda, Shudai Muramatsu, Toshiyuki Takemori, Eisuke Kobayashi, Takahiro Higashi, Akira Kawai","doi":"10.1016/j.jos.2025.12.011","DOIUrl":"https://doi.org/10.1016/j.jos.2025.12.011","url":null,"abstract":"<p><strong>Background: </strong>Liposarcoma demonstrates significant biological and clinical heterogeneity across subtypes, yet optimal treatment strategies remain controversial. We evaluated subtype-specific treatment outcomes and hospital volume effects using population-based registry data.</p><p><strong>Methods: </strong>We conducted a population-based cohort study analyzing 6,678 patients with liposarcoma diagnosed between 2016 and 2019 from the Japanese National Cancer Registry. Subtype-specific clinical characteristics, treatment patterns, and survival outcomes were evaluated using Cox regression and Kaplan-Meier methods. Propensity score matching was performed to assess radiotherapy and chemotherapy effectiveness while controlling for confounding variables.</p><p><strong>Results: </strong>Well-differentiated liposarcoma was most common (46.2 %), followed by dedifferentiated (27.8 %), myxoid (10.8 %), and pleomorphic (3.2 %) subtypes. Myxoid liposarcomas predominantly affected patients aged <60 years (63.8 %). Multivariate analysis identified male sex (HR 1.264, p = 0.008), older age (HR 3.307, p < 0.001), retroperitoneal location (HR 1.861, p < 0.001), distant disease (HR 6.091, p < 0.001), and treatment at low-volume hospitals (HR 1.381, p = 0.001) as independent poor prognostic factors. Propensity score-matched analysis demonstrated improved survival with radiotherapy in dedifferentiated liposarcomas (3-year survival: 76.5 % vs. 66.1 %, p = 0.022) and with chemotherapy in pleomorphic liposarcomas (3-year survival: 87.5 % vs. 68.8 %, p = 0.038).</p><p><strong>Conclusions: </strong>Treatment efficacy varies significantly across liposarcoma subtypes, with potential survival benefits of radiotherapy in dedifferentiated subtypes and chemotherapy in pleomorphic subtypes. These findings support subtype-guided treatment approaches and suggest benefits of centralized care for optimal therapy implementation.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030147","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 : 2026-01-21DOI: 10.1016/j.jos.2026.01.004
Masashi Shimoda, Hyonmin Choe, Yuta Hieda, Koki Abe, Hiroyuki Ike, Hideo Mitsui, Hiroto Kono, Ken Kumagai, Naomi Kobayashi, Yutaka Inaba
Background: Continuous local antibiotic perfusion (CLAP) delivers high-concentration antibiotics locally to achieve the minimal biofilm eradication concentration. Although CLAP has shown efficacy in orthopaedic infections, data on serum gentamicin levels and associated complications remain limited. This study aimed to evaluate serum gentamicin elevation and related adverse events during CLAP, and to identify contributing factors.
Methods: A retrospective review was conducted of 59 patients who underwent CLAP for hip or knee joints between 2019 and 2024, with perioperative serum gentamicin levels measured. Data included laboratory findings, CLAP duration, number of intra-soft tissue perfusion (iSAP) tubes and intra-medullary perfusion (iMAP) pins, gentamicin dose, peak serum gentamicin level, and adverse events.
Results: Serum gentamicin levels exceeded 1.0 μg/mL in 21 patients (36 %). The median day of peak serum gentamicin level was 7 postoperative days (IQR, 3-10), most frequently on postoperative day (POD) 3 and POD 10. Acute kidney injury (AKI) occurred in 7 cases (12 %), with one requiring temporary dialysis. Renal function recovered in all cases after cessation of CLAP. No ototoxicity (cranial nerve VIII toxicity) was observed. A univariate analysis showed that a greater number of iMAP pins, longer CLAP duration, higher gentamicin doses, and abnormal preoperative laboratory values (including lower albumin and hemoglobin, and higher CRP, ESR, creatinine, and neutrophil counts) were associated with elevated serum gentamicin levels.
Conclusion: Elevated serum gentamicin levels occurred in a subset of patients treated with CLAP. Elevated serum gentamicin levels may be associated with both treatment-related factors (iMAP pins, gentamicin dose, and CLAP duration) and host-related factors (lower albumin and hemoglobin, renal function, and systemic inflammation). Considering these risk factors may help adjust dosing strategies and contribute to the safe application of CLAP.
{"title":"Factors associated with elevated serum gentamicin levels in hip and knee joints treated with continuous local antibiotic perfusion: A retrospective cohort study.","authors":"Masashi Shimoda, Hyonmin Choe, Yuta Hieda, Koki Abe, Hiroyuki Ike, Hideo Mitsui, Hiroto Kono, Ken Kumagai, Naomi Kobayashi, Yutaka Inaba","doi":"10.1016/j.jos.2026.01.004","DOIUrl":"https://doi.org/10.1016/j.jos.2026.01.004","url":null,"abstract":"<p><strong>Background: </strong>Continuous local antibiotic perfusion (CLAP) delivers high-concentration antibiotics locally to achieve the minimal biofilm eradication concentration. Although CLAP has shown efficacy in orthopaedic infections, data on serum gentamicin levels and associated complications remain limited. This study aimed to evaluate serum gentamicin elevation and related adverse events during CLAP, and to identify contributing factors.</p><p><strong>Methods: </strong>A retrospective review was conducted of 59 patients who underwent CLAP for hip or knee joints between 2019 and 2024, with perioperative serum gentamicin levels measured. Data included laboratory findings, CLAP duration, number of intra-soft tissue perfusion (iSAP) tubes and intra-medullary perfusion (iMAP) pins, gentamicin dose, peak serum gentamicin level, and adverse events.</p><p><strong>Results: </strong>Serum gentamicin levels exceeded 1.0 μg/mL in 21 patients (36 %). The median day of peak serum gentamicin level was 7 postoperative days (IQR, 3-10), most frequently on postoperative day (POD) 3 and POD 10. Acute kidney injury (AKI) occurred in 7 cases (12 %), with one requiring temporary dialysis. Renal function recovered in all cases after cessation of CLAP. No ototoxicity (cranial nerve VIII toxicity) was observed. A univariate analysis showed that a greater number of iMAP pins, longer CLAP duration, higher gentamicin doses, and abnormal preoperative laboratory values (including lower albumin and hemoglobin, and higher CRP, ESR, creatinine, and neutrophil counts) were associated with elevated serum gentamicin levels.</p><p><strong>Conclusion: </strong>Elevated serum gentamicin levels occurred in a subset of patients treated with CLAP. Elevated serum gentamicin levels may be associated with both treatment-related factors (iMAP pins, gentamicin dose, and CLAP duration) and host-related factors (lower albumin and hemoglobin, renal function, and systemic inflammation). Considering these risk factors may help adjust dosing strategies and contribute to the safe application of CLAP.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029991","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}
Background: The incidence of cancer and related deaths has increased substantially, with bone commonly serving as a metastatic site. Metastatic spinal tumors severely impair quality of life and activities of daily living. Prognostic scoring systems such as the revised Tokuhashi and Tomita scores are widely used in surgical decision-making for these tumors. However, their accuracy for recent cancer cases is unclear due to advances in cancer therapy.
Methods: This multicenter, prospective study by the Japan Association of Spine Surgeons with Ambition analyzed 413 surgical cases for metastatic spinal tumors from October 2018 to March 2021. Of these, 272 cases with complete data were included. The Kaplan-Meier method, log-rank test, and statistical analysis were used to assess the association between survival and prognostic scores.
Results: Both the revised Tokuhashi and Tomita scores significantly stratified patients by survival (P < 0.01). The revised Tokuhashi score accurately predicted survival in 60.3 % of patients, underestimated it in 33.1 %, and overestimated it in 6.6 %. Significant score differences were found among groups with different survival durations. However, differentiating between <6-month and 6-12-month survival periods was difficult.
Conclusions: The revised Tokuhashi and Tomita scores remain valid tools for predicting prognosis in patients undergoing surgery for metastatic spinal tumors. Nonetheless, these systems tend to underestimate survival in recent cases, particularly in short-term prognoses. Updating the scoring criteria may be necessary to reflect advancements in cancer therapy and extended patient survival.
{"title":"Prognostic scoring systems reflect the prognosis of patients with metastatic spinal tumors who underwent spinal surgery in recent cases: JASA multicenter prospective study.","authors":"Masahiro Iinuma, Takeo Furuya, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kosei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takagami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Seiji Ohtori, Hisateru Niki","doi":"10.1016/j.jos.2026.01.003","DOIUrl":"https://doi.org/10.1016/j.jos.2026.01.003","url":null,"abstract":"<p><strong>Background: </strong>The incidence of cancer and related deaths has increased substantially, with bone commonly serving as a metastatic site. Metastatic spinal tumors severely impair quality of life and activities of daily living. Prognostic scoring systems such as the revised Tokuhashi and Tomita scores are widely used in surgical decision-making for these tumors. However, their accuracy for recent cancer cases is unclear due to advances in cancer therapy.</p><p><strong>Methods: </strong>This multicenter, prospective study by the Japan Association of Spine Surgeons with Ambition analyzed 413 surgical cases for metastatic spinal tumors from October 2018 to March 2021. Of these, 272 cases with complete data were included. The Kaplan-Meier method, log-rank test, and statistical analysis were used to assess the association between survival and prognostic scores.</p><p><strong>Results: </strong>Both the revised Tokuhashi and Tomita scores significantly stratified patients by survival (P < 0.01). The revised Tokuhashi score accurately predicted survival in 60.3 % of patients, underestimated it in 33.1 %, and overestimated it in 6.6 %. Significant score differences were found among groups with different survival durations. However, differentiating between <6-month and 6-12-month survival periods was difficult.</p><p><strong>Conclusions: </strong>The revised Tokuhashi and Tomita scores remain valid tools for predicting prognosis in patients undergoing surgery for metastatic spinal tumors. Nonetheless, these systems tend to underestimate survival in recent cases, particularly in short-term prognoses. Updating the scoring criteria may be necessary to reflect advancements in cancer therapy and extended patient survival.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030065","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}
Background: This study aimed to determine whether the association of knee extensor strength symmetry and psychological factors with single-leg hop distance (SLHD) differs according to recovery of knee extensor strength after anterior cruciate ligament (ACL) reconstruction with hamstring autograft.
Methods: Patients who underwent primary ACL reconstruction with knee function test results at 12 months after the surgery were included. Isokinetic knee extensor strength and SLHD were assessed, and the limb symmetry index (LSI) were calculated. Tampa scale for kinesiophobia-11 (TSK-11) score and ACL-Return to Sport after Injury (ACL-RSI) score were measured as psychological factors. The patients were divided into two groups according to the LSI of knee extensor strength: at least 80 % (the High group) or less than 80 % (the Low group). Multivariable liner regression analyses were conducted with the LSI of the SLHD as dependent variable, and the LSI of knee extensor strength and the psychological factors as independent variables for the High and Low groups, respectively.
Results: Of the 251 patients, 163 patients were included in the High group, and 88 patients were included in the Low group. In the High group, the psychological factors were significantly associated with the SLHD, whereas the LSI of knee extensor strength was not associated. Conversely, in the Low group, the LSI of knee extensor strength was significantly associated with SLHD, whereas the psychological factors were not associated.
Conclusion: The association of knee extensor strength symmetry and psychological factors with SLHD differs according to knee extensor strength recovery after ACL reconstruction.
{"title":"Association of knee extensor strength symmetry and psychological factors with single-leg hop performance differs according to recovery of knee extensor strength after anterior cruciate ligament reconstruction with hamstring autograft: A cross-sectional study.","authors":"Yuya Ueda, Takehiko Matsushita, Yohei Shibata, Daisuke Miura, Ryo Goto, Kumiko Ono, Akihiro Kida, Kyohei Nishida, Kanto Nagai, Yuichi Hoshino, Tomoyuki Matsumoto, Yoshitada Sakai, Ryosuke Kuroda","doi":"10.1016/j.jos.2025.12.017","DOIUrl":"https://doi.org/10.1016/j.jos.2025.12.017","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine whether the association of knee extensor strength symmetry and psychological factors with single-leg hop distance (SLHD) differs according to recovery of knee extensor strength after anterior cruciate ligament (ACL) reconstruction with hamstring autograft.</p><p><strong>Methods: </strong>Patients who underwent primary ACL reconstruction with knee function test results at 12 months after the surgery were included. Isokinetic knee extensor strength and SLHD were assessed, and the limb symmetry index (LSI) were calculated. Tampa scale for kinesiophobia-11 (TSK-11) score and ACL-Return to Sport after Injury (ACL-RSI) score were measured as psychological factors. The patients were divided into two groups according to the LSI of knee extensor strength: at least 80 % (the High group) or less than 80 % (the Low group). Multivariable liner regression analyses were conducted with the LSI of the SLHD as dependent variable, and the LSI of knee extensor strength and the psychological factors as independent variables for the High and Low groups, respectively.</p><p><strong>Results: </strong>Of the 251 patients, 163 patients were included in the High group, and 88 patients were included in the Low group. In the High group, the psychological factors were significantly associated with the SLHD, whereas the LSI of knee extensor strength was not associated. Conversely, in the Low group, the LSI of knee extensor strength was significantly associated with SLHD, whereas the psychological factors were not associated.</p><p><strong>Conclusion: </strong>The association of knee extensor strength symmetry and psychological factors with SLHD differs according to knee extensor strength recovery after ACL reconstruction.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030026","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}
Introduction: The relative safety and effectiveness of percutaneous versus open A1 pulley release for trigger finger remain unclear. This systematic review (SR) and meta-analysis (MA) of randomized controlled trials (RCTs) compares these two techniques and evaluates the potential benefits of ultrasound guidance in percutaneous release.
Materials and methods: Following PRISMA guidelines, this SR and MA was conducted of RCTs published up to August 11, 2025. PubMed, Embase, and Cochrane Library were searched to identify studies comparing percutaneous release with open surgery for trigger finger. Outcomes assessed included function, pain, complications, and revision rates at immediate (1 week), short-term (<1 month), mid-term (3 months), and long-term (6 months) follow-up. Subgroup analysis examined ultrasound-guided versus non-ultrasound-guided percutaneous release.
Results: Fourteen RCTs involving 996 patients were included. Percutaneous release demonstrated significantly better outcomes in immediate (mean difference (MD): 24.94, 95 % CI: 11.82-38.06), short-term (MD: 15.08, 95 % CI: 10.25-19.92), and mid-term (MD: 7.27, 95 % CI: 2.36-12.19) Q-DASH scores, as well as time to return to work (MD: 12.82 days, 95 % CI: 10.00-15.63), and duration of postoperative analgesic use (MD: 4.66 days, 95 % CI: 1.77-7.55) (all p < 0.05). No significant differences were observed in long-term outcomes, including DASH scores, grip strength, motion, immediate and mid-term VAS, complications, or revision rates.
Conclusion: Both percutaneous release and open surgery are effective treatments for trigger finger. Percutaneous release provides faster functional recovery, earlier return to daily activities, and reduced analgesic use, while maintaining comparable safety to open surgery.
{"title":"Comparative effectiveness of open versus percutaneous release for trigger fingers: A systematic review and meta-analysis of randomized controlled trials.","authors":"Kuan-Chen Huang, Yu-Ying Chu, Yu-Te Lin, Melanie J Wang, Che-Hsiung Lee","doi":"10.1016/j.jos.2025.12.016","DOIUrl":"https://doi.org/10.1016/j.jos.2025.12.016","url":null,"abstract":"<p><strong>Introduction: </strong>The relative safety and effectiveness of percutaneous versus open A1 pulley release for trigger finger remain unclear. This systematic review (SR) and meta-analysis (MA) of randomized controlled trials (RCTs) compares these two techniques and evaluates the potential benefits of ultrasound guidance in percutaneous release.</p><p><strong>Materials and methods: </strong>Following PRISMA guidelines, this SR and MA was conducted of RCTs published up to August 11, 2025. PubMed, Embase, and Cochrane Library were searched to identify studies comparing percutaneous release with open surgery for trigger finger. Outcomes assessed included function, pain, complications, and revision rates at immediate (1 week), short-term (<1 month), mid-term (3 months), and long-term (6 months) follow-up. Subgroup analysis examined ultrasound-guided versus non-ultrasound-guided percutaneous release.</p><p><strong>Results: </strong>Fourteen RCTs involving 996 patients were included. Percutaneous release demonstrated significantly better outcomes in immediate (mean difference (MD): 24.94, 95 % CI: 11.82-38.06), short-term (MD: 15.08, 95 % CI: 10.25-19.92), and mid-term (MD: 7.27, 95 % CI: 2.36-12.19) Q-DASH scores, as well as time to return to work (MD: 12.82 days, 95 % CI: 10.00-15.63), and duration of postoperative analgesic use (MD: 4.66 days, 95 % CI: 1.77-7.55) (all p < 0.05). No significant differences were observed in long-term outcomes, including DASH scores, grip strength, motion, immediate and mid-term VAS, complications, or revision rates.</p><p><strong>Conclusion: </strong>Both percutaneous release and open surgery are effective treatments for trigger finger. Percutaneous release provides faster functional recovery, earlier return to daily activities, and reduced analgesic use, while maintaining comparable safety to open surgery.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030073","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}
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}
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