Journal of Orthopaedic Science最新文献

{"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}

{"title":"Impact of potentially inappropriate medication on surgical outcomes in older patients with lumbar spinal stenosis","authors":"Yuki Akaike ,&nbsp;Takehiro Michikawa ,&nbsp;Takao Tobe ,&nbsp;Risa Tobe ,&nbsp;Soya Kawabata ,&nbsp;Sota Nagai ,&nbsp;Hiroki Takeda ,&nbsp;Takaya Imai ,&nbsp;Shinjiro Kaneko ,&nbsp;Morio Matsumoto ,&nbsp;Masaya Nakamura ,&nbsp;Shigeki Yamada ,&nbsp;Nobuyuki Fujita","doi":"10.1016/j.jos.2025.05.005","DOIUrl":"10.1016/j.jos.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>The administration of potentially inappropriate medications (PIMs) as well as polypharmacy in older individuals has become a medical and socioeconomic issue. Meanwhile, given that lumbar spinal stenosis (LSS) is one of the most prevalent musculoskeletal conditions, significantly affecting mobility in older adults and becoming increasingly common in aging societies, its management in this population has emerged as a critical concern. We aimed to elucidate the prevalence of PIMs among older LSS patients and identify those potentially impacting surgical outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 296 consecutive patients aged 65 years or older who underwent LSS surgery. Based on available guidelines, 19 medication categories were considered PIMs. Pre- and postoperative health-related quality of life was assessed using the Roland-Morris Disability Questionnaire and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.</div></div><div><h3>Results</h3><div>The most frequently prescribed PIMs included hypnotics, steroids, antithrombotic drugs, antidiabetic drugs, laxatives, and nonsteroidal anti-inflammatory drugs in older LSS patients. Among these medications, antithrombotic drugs showed a significant association with surgical outcomes. When the subjects were divided into antithrombotic drug users (n = 57) and non-users (n = 239), no significant difference in the incidence of postoperative complications was observed between the two groups. However, 1 year after surgery, users had significantly worse walking ability than did nonusers (adjusted p value = 0.028), despite no significant differences before and 6 months after surgery. Furthermore, nonusers showed significant improvement in walking ability (p &lt; 0.001) and social life scores (p = 0.014) from 6 months to 1 year after surgery, whereas users exhibited no significant improvements during this period.</div></div><div><h3>Conclusions</h3><div>Among the PIMs, hypnotics, steroids, antithrombotic drugs, laxatives, antidiabetic drugs, and nonsteroidal anti-inflammatory drugs were commonly used by older LSS patients. Older LSS patients taking antithrombotic drugs are unlikely to have good surgical outcomes.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 63-68"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216203","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":"Effects of proprioceptive neuromuscular facilitation therapy combined with orthotic insole intervention on lower limb function improvement in children with foot drop and inversion deformity","authors":"Hong Cheng ,&nbsp;Xiaobing Chou ,&nbsp;Xiaoli Hou ,&nbsp;Xinyue Wang ,&nbsp;Yan Zhou ,&nbsp;Yuxin Mao ,&nbsp;Xuan Zhou","doi":"10.1016/j.jos.2025.06.012","DOIUrl":"10.1016/j.jos.2025.06.012","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether combining proprioceptive neuromuscular facilitation (PNF) therapy with customized orthotic insoles leads to greater improvements in gait parameters, ankle range of motion, and lower-limb function than either intervention alone in pediatric foot drop and inversion deformity.</div></div><div><h3>Methods</h3><div>Ninety-seven children (aged 5–14 years) with foot drop and inversion deformity were randomized into three groups: (1) PNF plus insole, (2) insole only, and (3) PNF only. All interventions lasted 12 weeks. Gait parameters, the Gross Motor Function Measure (GMFM), ankle range of motion, muscle strength, and functional balance were assessed at baseline, immediately post-intervention, and at 1- and 3-month follow-ups.</div></div><div><h3>Results</h3><div>Children receiving the combined PNF plus insole intervention demonstrated significantly greater increases in gait velocity (18.5 % vs. 9.2 % and 8.7 % for insole-only and PNF-only groups, respectively) and higher improvements in GMFM scores (12-point increase vs. 6 and 5 points). Ankle dorsiflexion improved by a mean of 6.1° in the combined group (p &lt; 0.05). Approximately 85 % of these gains were maintained at the 1-month follow-up, which exceeded the modest regression observed in the single-intervention groups.</div></div><div><h3>Conclusion</h3><div>Combining PNF therapy with customized orthotic insoles offers superior and more durable improvements in gait and lower-limb function compared to single interventions, suggesting a more effective rehabilitative strategy for pediatric patients with foot drop and inversion deformity.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 247-254"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883087","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":"Reply to letter to the Editor by Andreas REHM","authors":"Ryo Fukagawa ,&nbsp;Ichiro Yoshimura ,&nbsp;Tomonobu Hagio ,&nbsp;Tetsuro Ishimatsu ,&nbsp;Yuki Sugino ,&nbsp;Seiya Tomonaga ,&nbsp;Yoshimasa Taniguchi ,&nbsp;Takuaki Yamamoto","doi":"10.1016/j.jos.2025.09.001","DOIUrl":"10.1016/j.jos.2025.09.001","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 270-271"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274984","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":"Minimum 10-year outcomes of a curved anatomic femoral stem designed for the Japanese femora including dysplastic hips in total hip arthroplasty","authors":"Sachiyuki Tsukada,&nbsp;Naoyuki Hirasawa,&nbsp;Masayoshi Saito,&nbsp;Masahiro Nishino,&nbsp;Takuya Kusakabe,&nbsp;Hiroyuki Ogawa","doi":"10.1016/j.jos.2025.05.013","DOIUrl":"10.1016/j.jos.2025.05.013","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the minimum 10-year outcomes of total hip arthroplasty (THA) using the CentPillar-TMZF, a curved anatomic stem developed based on anatomical data from Japanese patients including those with hip dysplasia.</div></div><div><h3>Methods</h3><div>Among 331 consecutive THA procedures, the CentPillar-TMZF was implanted in 80 primary THAs (24 %) following standardized selection criteria based on preoperative CT data. X-rays taken at the 10-year follow-up were assessed to evaluate stem fixation and the degree of stress shielding. Kaplan-Meier survivorship was calculated, with revision for any reason as the endpoint.</div></div><div><h3>Results</h3><div>Seventy-three of the 80 hips (91 %) were followed for 10 years or until revision surgery. In all hips followed more than 10 years, stem fixation was classified as bone-ingrown stable with first- or second-degree stress shielding. The survivorship rate, with revision as the endpoint, was 98 % (95 % CI 90 %–99 %) at 10 years. Before the 10-year follow-up, one patient required revision due to a periprosthetic fracture, and another required revision for dislocation.</div></div><div><h3>Conclusion</h3><div>In THA using CentPillar-TMZF, no aseptic loosening was observed until postoperative 10 years in patients whose femoral medullary canal shape was preoperatively determined to be compatible based on CT evaluation.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 147-153"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506052","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":"Current status of patients with hip fracture in Japan: A nationwide survey","authors":"Kazuhide Inage ,&nbsp;Naoki Kondo ,&nbsp;Satoshi Komatsubara ,&nbsp;Yukio Nakamura ,&nbsp;Nobukazu Okimoto ,&nbsp;Junichi Takada ,&nbsp;Naohisa Miyakoshi ,&nbsp;Takeshi Miyamoto ,&nbsp;Satoshi Mori ,&nbsp;Hiroshi Ozawa ,&nbsp;Satoshi Ikeda","doi":"10.1016/j.jos.2025.05.014","DOIUrl":"10.1016/j.jos.2025.05.014","url":null,"abstract":"<div><h3>Background</h3><div>Although surgical treatment is the standard of care for most hip fractures, the post-fracture management of osteoporosis remains challenging. This study aimed to elucidate the status of osteoporosis treatment, subsequent fracture rates, mortality rates, and changes in residential status and care levels among hip fracture patients in Japan, and to explore strategies for fracture prevention and extension of healthy life expectancy.</div></div><div><h3>Methods</h3><div>This study included patients with hip fractures treated at approximately 3000 orthopaedic facilities nationwide during July 2020. Data was collected via web-based surveys at the time of injury and 6 and 12 months post-injury.</div></div><div><h3>Results</h3><div>A total of 6705 patients were registered from 1309 facilities (mean age: 82.9 ± 0.7 years; 86.4 % were female). The surgery rate was 94.8 %, with 62.1 % undergoing osteosynthesis and 37.9 % receiving hemiarthroplasty or total hip arthroplasty. Osteoporosis treatment rates gradually increased from 23.0 % at the time of injury to 44.8 % at 6 months and 47.3 % at 12 months, although the rates remained suboptimal. Active vitamin D3-based medications were the most commonly used medications, accounting for approximately 60 % of cases. The cumulative 12-month mortality rate was 10.0 %, and the incidence of new fractures was 11.0 %. The main fracture sites were the contralateral proximal femur, vertebral, and proximal humerus. The most common reason for non-treatment was \"patient's decision.” Among patients who were not enrolled in long-term care insurance at the time of injury, 66.1 % had newly obtained care level certification by 12 months after injury. The proportion of patients who returned home among those living at home at the time of injury was 80.7 % at 6 months and 96.8 % at 12 months, respectively.</div></div><div><h3>Conclusions</h3><div>Osteoporosis treatment rates after hip fractures remain low, indicating the need for more proactive intervention, including secondary fracture prevention. This study also highlights the importance of early rehabilitation and continuous support.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 1","pages":"Pages 230-238"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540602","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}