Journal of Orthopaedic Science最新文献

{"title":"Intercalary autograft not mandatory for shortening in total hip arthroplasty: A retrospective study","authors":"Mehmet Fevzi Cakmak ,&nbsp;Serkan Bayram ,&nbsp;Levent Horoz ,&nbsp;Hicabi Sezgin ,&nbsp;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}

{"title":"Enhanced anatomical accuracy in arthroscopic all-inside lateral ligament repair using ultrasound-guided anchor placement","authors":"Younguk Park,&nbsp;DaeHyun Han,&nbsp;Myungsub Lee,&nbsp;Young Wook Seo","doi":"10.1016/j.jos.2025.06.015","DOIUrl":"10.1016/j.jos.2025.06.015","url":null,"abstract":"<div><h3>Background</h3><div>With significant advancements in arthroscopic surgical techniques, the frequency of arthroscopic lateral ankle ligament repair procedures has increased. However, anchor positioning accuracy remains uncertain, with studies suggesting a higher probability of the anchor being fixed in non-anatomical positions, such as insertion proximal to the fibular obscure tubercle (FOT). Using ultrasound guidance, anchors can be positioned more anatomically. This study aimed to analyze anchor position in arthroscopic all-inside lateral ligament repair using ultrasound.</div></div><div><h3>Methods</h3><div>Thirty-three patients with chronic ankle instability were prospectively enrolled and underwent ultrasound-guided, arthroscopic all-inside lateral ankle ligament repair, termed Arthroscopic Ultrasound-Assisted All-Inside Repair of the Lateral Ankle Ligament (AURA). Postoperative computed tomography (CT) scans were taken to analyze anchor positions, with the FOT as the reference point. Subsequently, the anchor positions were classified as anatomic, sub-anatomic, and nonanatomic based on the relationship between the fibular anterior tubercle and the FOT.</div></div><div><h3>Results</h3><div>The mean distance between anchor position and the fibular obscure tubercle (FOT) was 2.08 mm (range, 0–12 mm). Based on postoperative CT analysis, anchor placements were classified relative to the FOT: 28 of 33 cases (84.8 %) were within 25 % of the fibular length distal to the FOT (anatomic zone), 4 cases (12.2 %) were positioned between 25–50 % (sub-anatomic zone), and 1 case (3.0 %) was beyond 50 % (non-anatomic zone).</div></div><div><h3>Conclusion</h3><div>The ultrasound-assisted technique demonstrated high anatomical accuracy in anchor placement, as confirmed by postoperative 3D-CT evaluation.</div></div><div><h3>Level of Evidence</h3><div>IV, case study.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 177-182"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707896","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}

{"title":"Clinical outcomes of percutaneous intramedullary headless screw fixation with an oblique technique for the treatment of proximal and middle phalanx fractures","authors":"Hiroki Yokoyama ,&nbsp;Kenichi Asano ,&nbsp;Hidemasa Yoneda ,&nbsp;Katsuyuki Iwatsuki ,&nbsp;Marie Mabuchi ,&nbsp;Michiro Yamamoto","doi":"10.1016/j.jos.2025.06.017","DOIUrl":"10.1016/j.jos.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div>Intramedullary headless screw fixation has become significant in the treatment of phalangeal fractures. While intramedullary headless screw fixation is a simple and rigid approach, common techniques for guide wire insertion, including retrograde, antegrade-intra-articular, and <em>trans</em>-articular techniques, damage the articular cartilage and extensor tendon, particularly the central slip. To mitigate these risks, we applied a new method by percutaneously inserting the screw obliquely from the radial or ulnar base of the proximal or middle phalanges. This study aimed to assess the clinical outcomes of intramedullary headless screw fixation using the oblique technique in the treatment of proximal and middle phalangeal fractures.</div></div><div><h3>Methods</h3><div>Between April 2022 and August 2023, we retrospectively collected data on consecutive unstable proximal or middle phalangeal fractures treated with percutaneous intramedullary headless screw fixation using the oblique technique. The clinical outcomes were the active range of motion of each phalangeal joint and the grip strength ratio. Surgical time, fracture union, and complications were also evaluated.</div></div><div><h3>Results</h3><div>Sixteen patients (6 middle and 10 proximal phalanx fractures) were included in this study. The mean operative time was 34.2 min, while the median fracture union time was 7.2 weeks. The mean values of the active range of motion (ROM) of extension and flexion of the proximal interphalangeal joint were -1.3° and 98.5°, respectively, in middle phalanx fractures and -9.2° and 83.7° in proximal phalanx fractures. No complications were observed.</div></div><div><h3>Conclusions</h3><div>This study demonstrated the good clinical outcome of percutaneous intramedullary headless screw fixation using the oblique technique for proximal and middle phalangeal fractures. This simple technique reduces the damage risk to the articular cartilage and extensor tendons.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 119-125"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690612","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}

{"title":"Treatment trends and outcomes of pyogenic vertebral osteomyelitis in Japan, 2015–2023: A descriptive epidemiological study","authors":"Takaki Yoshiyama ,&nbsp;Toshiki Fukasawa ,&nbsp;Soichiro Masuda ,&nbsp;Bungo Otsuki ,&nbsp;Koichi Murata ,&nbsp;Takayoshi Shimizu ,&nbsp;Takashi Sono ,&nbsp;Shintaro Honda ,&nbsp;Koichiro Shima ,&nbsp;Masaki Sakamoto ,&nbsp;Ryohei Saito ,&nbsp;Shuichi Matsuda ,&nbsp;Koji Kawakami","doi":"10.1016/j.jos.2025.06.003","DOIUrl":"10.1016/j.jos.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Pyogenic vertebral osteomyelitis (PVO) is a rare but serious disease that presents diagnostic and therapeutic challenges. Although recent studies provide limited insights into its management trends, data on antibiotic regimens and surgical procedures remain scarce. This study aimed to assess real-world treatment trends for PVO in Japan.</div></div><div><h3>Methods</h3><div>We conducted a descriptive study using a hospital administrative database from 2015 to 2023. We included 1524 adult patients hospitalized for PVO in 50 hospitals that continuously contributed data during this period. We assessed antibiotic regimens (duration, trends in specific agents, and combination therapy), surgical procedures, and in-hospital mortality. We used the Cochran–Armitage trend test to evaluate annual changes, and examined factors associated with in-hospital mortality using univariable modified Poisson regression.</div></div><div><h3>Results</h3><div>The median duration of antibiotic therapy was 54 days. Although the proportion of patients receiving cefazolin (slightly over half) remained unchanged, there was a marked increase in the use of broad-spectrum antibiotics such as ceftriaxone, vancomycin, and piperacillin-tazobactam. During the oral phase, minocycline (33.5 %) and levofloxacin (24.8 %) were the most commonly prescribed. Approximately 30 % of patients received combination therapy, and this proportion did not change substantially over time. Surgical interventions increased during the study period, primarily because of rising posterior fixation procedures. In-hospital mortality was 5.2 %. Older age, heart failure, hemodialysis, and a higher Charlson Comorbidity Index were strongly associated with increased in-hospital mortality.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that the treatment duration of PVO tended to be longer than guideline recommendations, whereas the selection of oral agents was consistent with them. The growing trend in posterior fixation surgeries may reflect the adoption of minimally invasive techniques such as percutaneous pedicle screw fixation. Older patients with heart and kidney failure require particular caution in treatment.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 102-108"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497391","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}

{"title":"Does the upper line of the sacral ala approximate a horizontal line on pelvic radiographs of idiopathic scoliosis?","authors":"Masaki Ikejiri ,&nbsp;Hideki Shigematsu ,&nbsp;Sachiko Kawasaki ,&nbsp;Yuma Suga ,&nbsp;Takahiro Mui ,&nbsp;Yasuhito Tanaka","doi":"10.1016/j.jos.2025.06.009","DOIUrl":"10.1016/j.jos.2025.06.009","url":null,"abstract":"<div><h3>Background</h3><div>Lower instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) corrective surgery is selected using the center sacral vertical line on supine side-bending radiographs. However, a horizontal line reference is not possible on supine radiographs. Therefore, we aimed to determine the pelvic reference line that best reflects the horizontal line, which can be used in determining the LIV on supine side-bending radiograph in patients with AIS.</div></div><div><h3>Methods</h3><div>Patients with AIS (n = 258) were evaluated. On whole-spine standing anteroposterior radiographs, three lines were selected (the upper sacral line [USL], sacroiliac joint line [SIL], and upper iliac line [UIL]) and compared with the horizontal line to investigate tilt angles. Patients were allocated into thoracic (T; n = 90), lumbar (L; n = 61), and double (D; n = 107) curve groups based on thoracic and lumbar Cobb angles.</div></div><div><h3>Results</h3><div>The mean USL; SIL; and UIL tilts were 2.3°, 4.7°, and 3.8°; 1.6°, 2.0°, and 2.0°; and 1.4°, 2.2°, and 1.8° in the T, L, and D groups, respectively. The USL was significantly tilted in all groups, without significant difference between the SIL and UIL tilts. The USL tilted significantly more from the horizontal line in the L and D groups than in the T group; the UIL tilted more in the L group compared with the T group. The SIL tilt was comparable between the groups. The Cobb angle on the thoracolumbar or lumbar curve significantly, albeit weakly, correlated with the USL and UIL tilt.</div></div><div><h3>Conclusions</h3><div>On whole-spine standing anteroposterior radiographs, the USL had the greatest tilt (mean: 3.5°), whereas the SIL had the smallest tilt (mean: 1.8°) without significant variation across scoliosis types. Independent of Cobb angle and scoliosis type, the SIL was the most stable and reliable reference line for horizontal alignment, making it the preferred reference to LIV selection in patients undergoing AIS corrective surgery.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 87-95"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618645","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}

{"title":"Prognostic factors influencing the occurrence of drug-induced renal dysfunction during continuous local antibiotic perfusion therapy","authors":"Yuki Fujihara,&nbsp;Kazuki Uchibori,&nbsp;Yuya Yoshimoto,&nbsp;Hideyuki Ota,&nbsp;Hiroaki Kumagai,&nbsp;Yuki Chiba","doi":"10.1016/j.jos.2025.05.007","DOIUrl":"10.1016/j.jos.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>To manage bone and soft tissue infection, continuous local antibiotics perfusion (CLAP) therapy, in which gentamicin is injected directly into the site of infection to control the infection, has been developed. However, gentamicin is nephrotoxic, and CLAP is often associated with complications, including acute kidney injury. Thus, in this study, we aimed to investigate the frequency of complications and the factors influencing their occurrence.</div></div><div><h3>Methods</h3><div>Overall, 82 patients who underwent CLAP in our hospital between January 2020 and September 2023 were included in this study. We defined the occurrence of renal dysfunction within 1 month after CLAP as the primary outcome and evaluated the following factors: history of diabetes and liver dysfunction, site of injury, initial open wound, skin defect, hemodynamic compromise, concomitant antibiotics, type of treated tissue, purpose of treatment, drainage method, duration of CLAP, and total amount of the gentamicin dose. To identify prognostic factors, we performed a logistic regression analysis.</div></div><div><h3>Results</h3><div>The mean follow-up was 10.3 months. Of the 82 patients, 50 were cured, 12 reached infection prevention, 14 had recurrent infection, three had their affected limb amputated, two did not achieve infection prevention, and one died. Side effects of treatment included decreased renal function in 13 cases and drug eruption in 1 case. Logistic regression analysis showed that age (Odds ratio: 1.07; 95 % Confidence interval [CI]: 1.01–1.13) and duration of CLAP (Odds ratio: 1.06; 95 % CI: 1.01–1.12) were significant prognostic factors for the occurrence of renal function decline.</div></div><div><h3>Conclusions</h3><div>This study shows that renal function deterioration due to gentamicin used during CLAP is relatively common. Consideration should be given to shortening the duration of CLAP in older adult patients. Considering pharmacokinetics, a variable concentration regimen of gentamicin may be more effective and less nephrotoxic than continuous administration of a fixed concentration.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 226-229"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340248","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}

{"title":"Medial meniscus tears in early-stage medial knee osteoarthritis: Prevalence and type in a Japanese cohort","authors":"Ichiro Sekiya ,&nbsp;Hisako Katano ,&nbsp;Hideyuki Koga ,&nbsp;Noriya Okanouchi ,&nbsp;Makoto Tomita ,&nbsp;Jun Masumoto ,&nbsp;Nobutake Ozeki","doi":"10.1016/j.jos.2025.06.010","DOIUrl":"10.1016/j.jos.2025.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Medial meniscus (MM) tears are closely associated with medial knee osteoarthritis (OA); however, their relationship in early-stage OA remains poorly understood. The purpose of this study was to elucidate the prevalence and types of MM tears in relation to age, gender, Kellgren-Lawrence (KL) grade, and MM extrusion among participants in the Kanagawa Knee Study, with the aim of potentially capturing the transition from healthy knees to early-stage medial knee OA.</div></div><div><h3>Methods</h3><div>The study analyzed 469 subjects (227 women, 242 men) aged 30–79 years. MM morphology was classified into six types using 3 T magnetic resonance imaging (3 T MRI): signal, horizontal tear, longitudinal tear, radial tear, complex tear, and root tear. The KL grades were automatically evaluated using KOALA software. The MM extrusion was measured on coronal MRI images.</div></div><div><h3>Results</h3><div>MM tears were present in 18.2 % of the subjects, with complex (7.9 %) and horizontal (7.7 %) tears being the most common. The prevalence of MM tears increased with age, with women in their sixties and seventies showing a significant increase compared to younger age groups. A marked gender difference was observed in patients in their sixties, with women showing a 45 % prevalence of MM tears compared to 19 % in men. The prevalence of MM tears increased with KL grade: 7 % in KL0, 14 % in KL1, 51 % in KL2, and 100 % in KL3–4. The prevalence was significantly higher in knees with MM extrusion ≥3 mm (90 %) than in those with MM extrusion &lt;3 mm (11 %).</div></div><div><h3>Conclusions</h3><div>MM tears become more prevalent with advancing age, higher KL grade, and increased MM extrusion. The risk of MM tears appears to be considerably higher in women in their sixties than in men of the same age group.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 161-169"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564924","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}

{"title":"Potential involvement of family structure in locomotive recovery following surgery in older patients with lumbar spinal stenosis","authors":"Koutaro Kageshima ,&nbsp;Soya Kawabata ,&nbsp;Takehiro Michikawa ,&nbsp;Yuki Akaike ,&nbsp;Sota Nagai ,&nbsp;Takaya Imai ,&nbsp;Hiroki Takeda ,&nbsp;Kei Ito ,&nbsp;Daiki Ikeda ,&nbsp;Shinjiro Kaneko ,&nbsp;Nobuyuki Fujita","doi":"10.1016/j.jos.2025.05.010","DOIUrl":"10.1016/j.jos.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Surgical outcomes for lumbar spinal stenosis (LSS) are generally favorable, even in older adults, and they effectively address locomotive syndrome. In older patients with LSS, support from family members during the postoperative recovery period is expected to be helpful, but the extent to which family structure influences surgical outcomes for LSS remains unclear. Herein, this study aimed to investigate the involvement of family structure in surgical outcomes for older patients with LSS.</div></div><div><h3>Methods</h3><div>This retrospective study included 350 consecutive patients aged ≥65 years who underwent LSS surgery between April 2020 and December 2023. Patients were categorized by family structure into the M (living with multiple family members) or S group (living with few or no family members). Postoperative outcomes were assessed using patient-reported outcomes, including the Roland–Morris Disability Questionnaire (RDQ), Geriatric Locomotive Function Scale (GLFS-25), and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.</div></div><div><h3>Results</h3><div>The M group consisted of 102 participants, while the S group comprised 248 participants. Preoperatively, there were no significant differences in the scores of all patient-reported outcomes between the groups. However, even after adjusting for baseline characteristics that significantly differed between the groups, the RDQ (p = 0.018) and GLFS-25 scores (p = 0.030) were significantly better in the M group than in the S group at 1 year postoperatively. Furthermore, the proportion of patients with postoperative improvement in the locomotive syndrome stage was significantly higher in the M group than in the S group at both 6 months (p = 0.027) and 1 year (p = 0.002) postoperatively.</div></div><div><h3>Conclusions</h3><div>Family structure significantly affected postoperative outcomes in older adults with LSS, particularly concerning locomotive syndrome recovery. These findings highlight the potential value of involving families in healthcare planning, while recognizing that the availability and quality of support may vary across households.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 81-86"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369010","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}

{"title":"Lumbar apophyseal ring fracture: Prevalence and relationship with spina bifida occulta","authors":"Saori Soeda ,&nbsp;Masatoshi Morimoto ,&nbsp;Kosuke Sugiura ,&nbsp;Kosaku Higashino ,&nbsp;Shunsuke Tamaki ,&nbsp;Keisuke Nishidono ,&nbsp;Kiyoshi Yagi ,&nbsp;Kazuya Kishima ,&nbsp;Hiroaki Manabe ,&nbsp;Koichi Sairyo","doi":"10.1016/j.jos.2025.05.009","DOIUrl":"10.1016/j.jos.2025.05.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the prevalence of apophyseal ring fracture and its association with spina bifida occulta (SBO).</div></div><div><h3>Methods</h3><div>A total of 973 patients (mean age 62 years [range 21–90]) with abdominal and pelvic computed tomography scans available were retrospectively evaluated. The prevalence of apophyseal ring fracture and of SBO and the association between these two entities were evaluated.</div></div><div><h3>Results</h3><div>The prevalence of apophyseal ring fracture was 3.8 % (n = 22) in men and 2.8 % (n = 11) in women; the difference was not statistically significant (p = 0.53). The incidence was highest at L5 in both men (58.3 %, n = 14) and women (38.5 %, n = 5). SBO was found in 92 patients (9.5 %), who comprised 75 men (12.9 %) and 17 women (4.4 %). The prevalence of SBO was 2.95-fold higher in men than in women (p &lt; 0.0001). Apophyseal ring fracture was 2.6 times more frequent in patients who had SBO than in those who did not (7.6 % vs 3.0 %, p = 0.019).</div></div><div><h3>Conclusions</h3><div>This study identified the lower lumbar levels as the anatomical locations where apophyseal ring fracture was more likely to occur, particularly involving the anterior portion of the cephalad endplate at L3 and L4 and the posterior portion of the cephalad endplate at S1. This finding will be helpful for understanding the site of origin of apophyseal ring fractures, which can be easily overlooked. In addition, apophyseal ring fractures were more frequent in the presence of SBO, which may contribute to understanding their etiology.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 76-80"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512092","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}

{"title":"Slight graft laxity five months after anterior cruciate ligament reconstruction can be a risk factor for graft injury within two years in young patients","authors":"Takaki Sanada,&nbsp;Hiroshi Iwaso","doi":"10.1016/j.jos.2025.05.003","DOIUrl":"10.1016/j.jos.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Young and highly active athletes are at high risk of second anterior cruciate ligament injuries. The high frequency of second injuries after anterior cruciate ligament reconstruction among the young population is influenced by various factors, such as sex, age, return-to-play time, and graft selection.</div></div><div><h3>Methods</h3><div>Between 2014 and 2019, 108 primary anterior cruciate ligament reconstructions under 20 years, involving 48 knees using a hamstring tendon autograft and 60 knees using a bone-patellar tendon autograft, were performed by a single surgeon. The incidence and risk factors affecting postoperative graft injury within two years after surgery were compared with those of non-graft injury knees. After univariate analysis, multivariate logistic regression analysis was performed to investigate the independent predictive factors.</div></div><div><h3>Results</h3><div>Graft rupture occurred in 11.1 % (12/108) of cases. Univariate analysis indicated that postoperative glide-grade Lachman and the pivot shift test, and tibial anterior translation with a mean of 2.7 mm at 5 months post-surgery were sustained in the graft injury group compared with the non-graft injury group with a mean of 1.2 mm. Logistic regression analysis identified that an excessive instrumental anterior tibial translation at 5 months (odds ratio = 2.67; 95 % confidence intervals = 1.45–4.91; p = 0.0016) increased the risk of graft injury. Graft selection or quadriceps and hamstring muscle strength did not influence graft injury.</div></div><div><h3>Conclusion</h3><div>In young patients, postoperative residual anterior tibial translation after ACL reconstruction is a risk factor for graft injury, even if the amount of graft laxity is small. Graft selection or muscle strength did not affect graft injury.</div></div><div><h3>Level of evidence</h3><div>Level Ⅳ</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 141-146"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248458","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}