Journal of Orthopaedic Science最新文献_第5页

Prospective observational study of daily upper-limbs activities following arthroscopic rotator cuff repair using triaxial accelerometers: Recovery process and relationship with preoperative clinical parameters 应用三轴加速度计进行关节镜下肩袖修复术后上肢日常活动的前瞻性观察研究：恢复过程及其与术前临床参数的关系

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-09-18 DOI: 10.1016/j.jos.2025.08.011

Toshiyuki Fukushima , Yoshihiro Nakamura , Hiroshi Kurumadani , Shota Date , Masako Tominaga , Toru Sunagawa

Background

Following arthroscopic rotator cuff repair (ARCR), upper-limb movement must be restricted during the early postoperative phase. However, the postoperative recovery process of daily upper-limb use and its relationship with preoperative parameters remain unclear. We investigated the postoperative recovery process of the operated limb use following ARCR quantitatively using triaxial accelerometers and examined its relationship with preoperative parameters.

Methods

We evaluated bilateral upper-limb use in daily activities using triaxial accelerometers in 21 patients who underwent ARCR. Measurements were performed immediately before the surgery and at 2, 3, 6, and 12 months postoperatively. Twenty healthy adults served as the controls. Additionally, correlations with preoperative clinical scores, active range of motion, muscle strength, and pain were investigated.

Results

The frequency of upper-limb use showed no significant differences between the operated and non-operated limbs from the preoperative to 12 months postoperatively. The intensity of upper-limb use in the operated limb was significantly lower than that in the non-operated limb and controls at the preoperative, 2 and 3months. These differences were resolved 6 months postoperatively. Regarding preoperative parameters, postoperative intensity particularly correlated with shoulder flexion and muscle strength.

Conclusion

Following ARCR, the intensity of upper-limb use should be increased progressively, as additional time may be needed for intensity recovery. Furthermore, maintaining preoperative shoulder flexion may promote postoperative daily upper-limb activities. These findings suggest that clinicians may consider monitoring the intensity of upper-limb use in daily living following ARCR and maintaining shoulder flexion through preoperative rehabilitation.

背景：关节镜下肩袖修复（ARCR）术后早期必须限制上肢活动。然而，术后上肢日常使用的恢复过程及其与术前参数的关系尚不清楚。我们使用三轴加速度计定量研究ARCR术后肢体使用的恢复过程，并研究其与术前参数的关系。方法：我们使用三轴加速度计评估21例ARCR患者的双侧上肢在日常活动中的使用情况。在手术前和术后2、3、6、12个月进行测量。20名健康成人作为对照。此外，研究了术前临床评分、活动范围、肌肉力量和疼痛的相关性。结果：术前至术后12个月，手术肢体与未手术肢体上肢使用频率差异无统计学意义。术前、2、3个月手术肢体上肢使用强度明显低于非手术肢体和对照组。这些差异在术后6个月消除。术前参数中，术后强度主要与肩关节屈曲和肌力相关。结论：在ARCR后，上肢使用强度应逐步增加，因为强度恢复可能需要额外的时间。此外，保持术前肩关节屈曲可以促进术后日常上肢活动。这些发现表明，临床医生可以考虑在ARCR术后监测上肢的日常使用强度，并通过术前康复来维持肩关节屈曲。

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引用次数: 0

Relationship between lifestyle differences and sarcopenia, muscle mass in patients with rheumatoid arthritis: Comparison of metropolitan and country areas 生活方式差异与类风湿关节炎患者肌肉减少症和肌肉质量的关系：都市和乡村地区的比较

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-07-21 DOI: 10.1016/j.jos.2025.07.003

Masahiro Tada , Chika Yoshimura , Yoshinari Matsumoto , Koji Mandai

Objectives

Differences in living environments and lifestyle affect physical activity and the sarcopenia rate in rheumatoid arthritis (RA) patients. This study aimed to investigate the effects of differences in living environment and lifestyle by area of residence on the prevalence rate of sarcopenia, physical activity, and body composition in RA patients.

Methods

Patients were divided into metropolitan (n = 77) and country (n = 67) groups by area of residence. Both groups were age- and sex-matched. Body composition was evaluated by a body composition analyzer, and the prevalence of sarcopenia was compared. Physical activity was assessed using the international physical activity questionnaire. Questions regarding means of commuting to hospital, family structure, and occupation type were asked to evaluate living environment and lifestyle. Associations between sarcopenia and lifestyle were investigated by univariate and multivariate analyses.

Results

There was no significant difference in the prevalence of sarcopenia between the metropolitan (26.0 %) and country (34.3 %) groups. Muscle mass was significantly higher in the metropolitan group (34.6 kg) than in the country group (32.9 kg; p = 0.026). Transportation physical activity was significantly higher in the metropolitan group (693 METs⋅Min/Week) than in the country group (0 METs⋅Min/Week; p < 0.001). Multivariate logistic regression analysis, adjusted for age, disease duration, DAS28-ESR,mHAQ, and glucocorticoid usage, identified only unemployment as an independent factor associated with sarcopenia (OR: 3.40, 95%CI: 1.10–10.4, p = 0.032).

Conclusions

RA patients living in metropolitan areas had significantly higher muscle mass than those living in the countryside. However, there was no significant difference in the prevalence of sarcopenia. Unemployment was identified as an independent factor associated with sarcopenia.

目的：生活环境和生活方式的差异影响类风湿关节炎（RA）患者的身体活动和肌肉减少率。本研究旨在探讨居住地区生活环境和生活方式的差异对类风湿关节炎患者肌肉减少症患病率、体力活动和身体成分的影响。方法：按居住地区分为城市组（77例）和乡村组（67例）。两组都是年龄和性别匹配的。用体成分分析仪评估体成分，并比较肌肉减少症的患病率。使用国际身体活动问卷对身体活动进行评估。通过询问到医院的通勤方式、家庭结构和职业类型等问题来评估生活环境和生活方式。通过单因素和多因素分析研究了肌肉减少症和生活方式之间的关系。结果：都市组（26.0%）和乡村组（34.3%）的肌肉减少症患病率无显著差异。都市组的肌肉质量（34.6 kg）明显高于乡村组（32.9 kg）；P = 0.026)。都市组的交通体力活动（693 METs·Min/Week）显著高于乡村组（0 METs·Min/Week）；P < 0.001)。多因素logistic回归分析，调整了年龄、病程、DAS28-ESR、mHAQ和糖皮质激素的使用，确定失业是与肌肉减少症相关的独立因素（OR: 3.40, 95%CI: 1.10-10.4, p = 0.032）。结论：大城市RA患者肌肉质量明显高于农村RA患者。然而，在肌肉减少症的患病率方面没有显著差异。失业被确定为与肌肉减少症相关的独立因素。

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引用次数: 0

The utility of apparent diffusion coefficient maps for evaluating chemotherapy response and prognosis in osteosarcoma 表观扩散系数图在评估骨肉瘤化疗反应和预后中的应用。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-08-07 DOI: 10.1016/j.jos.2025.07.006

Hiroshi Koike , Yoshihiro Nishida , Hiroshi Urakawa , Kunihiro Ikuta , Tomohisa Sakai , Kan Ito , Shiro Imagama

Background

Assessing the response to neoadjuvant chemotherapy is crucial for determining surgical treatment strategies and optimizing personalized postoperative care in osteosarcoma patients. The apparent diffusion coefficient, derived from diffusion-weighted imaging, reflects tumor aggressiveness; however, its role in evaluating neoadjuvant chemotherapy response remains unclear. This study aimed to evaluate the utility of apparent diffusion coefficient maps in assessing chemotherapy-induced necrosis and prognosis in osteosarcoma.

Methods

Twenty osteosarcoma patients referred to our hospital between 2007 and 2020, for whom apparent diffusion coefficient maps were available, were included. The association between apparent diffusion coefficient values, tumor necrosis rate, and prognosis was analyzed.

Results

The study cohort consisted of 14 males and six females, with a median age of 16 years (range, 7–37). Tumor locations included the femur (12 patients), tibia (5), humerus (2), and scapula (1). Significant correlations were found between changes in mean apparent diffusion coefficient values pre- and post-neoadjuvant chemotherapy and tumor necrosis rate (r = 0.61, p < 0.01). Post-chemotherapy mean and minimum apparent diffusion coefficient values were significantly associated with overall survival (p = 0.04 for both).

Conclusions

This study demonstrates a strong correlation between chemotherapy effectiveness and apparent diffusion coefficient values in osteosarcoma. Future clinical efforts should focus on integrating apparent diffusion coefficient values into treatment strategies to improve patient outcomes.

背景：评估对新辅助化疗的反应对于骨肉瘤患者确定手术治疗策略和优化个性化术后护理至关重要。由扩散加权成像得出的表观扩散系数反映肿瘤的侵袭性；然而，它在评估新辅助化疗反应中的作用尚不清楚。本研究旨在评估表观扩散系数图在评估化疗诱导的骨肉瘤坏死和预后方面的效用。方法：选取2007年至2020年在我院就诊的20例骨肉瘤患者，并对其进行表观扩散系数图分析。分析表观扩散系数值、肿瘤坏死率与预后的关系。结果：研究队列包括14名男性和6名女性，中位年龄为16岁（范围7-37岁）。肿瘤部位包括股骨（12例）、胫骨（5例）、肱骨（2例）和肩胛骨（1例）。新辅助化疗前后平均表观扩散系数值变化与肿瘤坏死率有显著相关性（r = 0.61, p < 0.01）。化疗后平均和最小表观扩散系数值与总生存率显著相关（p = 0.04）。结论：本研究表明骨肉瘤的化疗效果与表观扩散系数值有很强的相关性。未来的临床工作应侧重于将表观扩散系数值整合到治疗策略中，以改善患者的预后。

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引用次数: 0

Diagnostic accuracy of preoperative magnetic resonance arthrography for detecting midsubstance capsular tears: Irregular outline sign 术前磁共振关节造影检测中囊撕裂的诊断准确性：不规则轮廓征象。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-10-09 DOI: 10.1016/j.jos.2025.09.002

Kei Matsunaga , Satoshi Miyake , Terufumi Shibata , Shunsuke Kobayashi , Naofumi Hata , Masahiko Sakai , Teruaki Izaki , Yozo Shibata , Takuaki Yamamoto

Background

Traumatic anterior shoulder instability is caused by functional and structural failure of the inferior glenohumeral ligament–labrum complex. One such cause is midsubstance capsular tear, which is a rare condition with a prevalence of 1.5 %–4.0 %. It is crucial to obtain accurate preoperative imaging of a midsubstance capsular tear because of the high skill level required for surgical treatment. However, reproducible and reliable radiological features for the diagnosis of midsubstance capsular tear have not been identified, and although the distorted shape of the magnetic resonance arthrography is reportedly a sign of midsubstance capsular tear, its reproducibility and reliability have not been adequately demonstrated. The present study investigated the diagnostic accuracy of the Irregular Outline (IO) sign on magnetic resonance arthrography for diagnosing midsubstance capsular tear.

Methods

This retrospective study included 204 shoulders with traumatic anterior shoulder instability after excluding patients with previous surgeries, fractures, or poor-quality magnetic resonance arthrography images. Two examiners evaluated the magnetic resonance arthrography images for the IO sign, and the presence of midsubstance capsular tear was confirmed via arthroscopic records.

Results

Midsubstance capsular tear was identified in 12 of 204 shoulders (5.9 %). The IO sign demonstrated high diagnostic accuracy with a sensitivity of 85.4 %, specificity of 94.9 %, positive predictive value of 51.8 %, and negative predictive value of 99.1 %. The inter-rater and intra-rater reliabilities were high, with kappa coefficients above 0.8.

Conclusion

The IO sign on magnetic resonance arthrography is a reliable indicator with high sensitivity and specificity for diagnosing midsubstance capsular tear. The accurate preoperative diagnosis of a midsubstance capsular tear can assist in planning appropriate surgical interventions, especially for shoulder surgeons with less experience. Further studies are needed to confirm these findings in larger populations and with standardized imaging equipment.

背景：外伤性肩关节前部不稳定是由下盂肱韧带-唇状复合体的功能和结构失效引起的。其中一个原因是中囊撕裂，这是一种罕见的情况，患病率为1.5% - 4.0%。由于手术治疗需要很高的技术水平，因此获得准确的中囊撕裂术前成像至关重要。然而，诊断中囊撕裂的可重复和可靠的放射学特征尚未确定，尽管据报道，磁共振关节成像的扭曲形状是中囊撕裂的标志，但其可重复性和可靠性尚未得到充分证明。本研究探讨了不规则轮廓（IO）征象在磁共振关节造影诊断中囊撕裂的准确性。方法：本回顾性研究纳入204例外伤性肩前路不稳患者，排除既往手术、骨折或磁共振关节造影图像质量差的患者。两名检查人员评估了磁共振关节成像图像的IO征象，并通过关节镜记录确认了中间物质囊撕裂的存在。结果：204例肩部中膜撕裂12例（5.9%）。IO征象诊断准确率高，敏感性85.4%，特异性94.9%，阳性预测值51.8%，阴性预测值99.1%。评价者间和评价者内信度较高，kappa系数均在0.8以上。结论：关节磁共振成像IO征象是诊断中囊撕裂的可靠指标，具有较高的敏感性和特异性。中囊撕裂的准确术前诊断有助于制定适当的手术干预措施，特别是对于经验不足的肩关节外科医生。需要进一步的研究来证实这些发现在更大的人群和标准化的成像设备。

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引用次数: 0

Preoperative undernutrition in older people with adult spinal deformities is associated with worse postoperative sagittal vertical axis 老年成人脊柱畸形患者术前营养不良与术后矢状垂直轴恶化相关。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-07-28 DOI: 10.1016/j.jos.2025.07.001

Jun Ouchida , Hiroaki Nakashima , Sadayuki Ito , Naoki Segi , Tokumi Kanemura , Tetsuya Ohara , Taichi Tsuji , Ryuichi Shinjo , Ippei Yamauchi , Yukihito Ode , Shiro Imagama

Background

The impact of preoperative nutritional status on postoperative clinical outcomes in older adults undergoing surgery for adult spinal deformity (ASD) remains unclear. This study aimed to investigate the association between preoperative nutritional status and postoperative clinical and radiological outcomes in patients undergoing surgery for ASD.

Methods

A total of 117 patients (mean age: 73.3 ± 5.4 years; 77 women) who underwent fusion of ≥3 vertebrae for ASD were retrospectively enrolled from a multicenter database. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) scale, which is based on serum albumin, total lymphocyte count, and total cholesterol levels, with scores ranging from 0 to 10. Patients were classified into two groups according to their nutritional status: the undernutrition (UN) group (CONUT score ≥2) and the normal nutrition (N) group (CONUT score 0–1). Multivariate regression analysis was performed to identify independent predictors of postoperative sagittal alignment deterioration.

Results

The N group included 67 patients, while the UN group included 50 patients. At 2 years postoperatively, the UN group exhibited a significantly greater sagittal vertical axis (SVA) (56.5 ± 47.5 mm vs. 44.2 ± 40.2 mm, P = 0.007) and a smaller spino-femoral angle (SFA) (194.4 ± 19.3° vs. 202.6 ± 19.2°, P = 0.029) compared to the N group. Multivariate analysis revealed that preoperative undernutrition was an independent predictor of postoperative SVA deterioration.

Conclusions

Preoperative undernutrition was associated with increased SVA and decreased SFA at 2 years postoperatively in older patients undergoing surgery for ASD. These findings suggest that preoperative nutritional status may influence postoperative outcomes in this population, highlighting the importance of nutritional screening and intervention prior to surgery.

背景：术前营养状况对接受成人脊柱畸形（ASD）手术的老年人术后临床结果的影响尚不清楚。本研究旨在探讨ASD手术患者术前营养状况与术后临床和放射预后之间的关系。方法：117例患者(平均年龄73.3±5.4岁；我们从多中心数据库中回顾性纳入了接受≥3个椎体融合术治疗ASD的77名女性。采用控制营养状态量表（CONUT）评估营养状况，该量表基于血清白蛋白、总淋巴细胞计数和总胆固醇水平，评分范围从0到10。根据患者的营养状况分为两组：营养不良（UN）组（CONUT评分≥2）和营养正常(N)组（CONUT评分0-1）。进行多变量回归分析以确定术后矢状位线恶化的独立预测因素。结果：N组67例，UN组50例。术后2年，UN组矢状垂直轴（SVA）明显大于N组（56.5±47.5 mm vs. 44.2±40.2 mm, P = 0.007），脊柱-股骨角（SFA）明显小于N组（194.4±19.3°vs. 202.6±19.2°，P = 0.029）。多因素分析显示术前营养不良是术后SVA恶化的独立预测因素。结论：在接受ASD手术的老年患者中，术前营养不良与术后2年SVA升高和SFA降低相关。这些发现表明，术前营养状况可能影响该人群的术后结果，强调了术前营养筛查和干预的重要性。

{"title":"Preoperative undernutrition in older people with adult spinal deformities is associated with worse postoperative sagittal vertical axis","authors":"Jun Ouchida , Hiroaki Nakashima , Sadayuki Ito , Naoki Segi , Tokumi Kanemura , Tetsuya Ohara , Taichi Tsuji , Ryuichi Shinjo , Ippei Yamauchi , Yukihito Ode , Shiro Imagama","doi":"10.1016/j.jos.2025.07.001","DOIUrl":"10.1016/j.jos.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>The impact of preoperative nutritional status on postoperative clinical outcomes in older adults undergoing surgery for adult spinal deformity (ASD) remains unclear. This study aimed to investigate the association between preoperative nutritional status and postoperative clinical and radiological outcomes in patients undergoing surgery for ASD.</div></div><div><h3>Methods</h3><div>A total of 117 patients (mean age: 73.3 ± 5.4 years; 77 women) who underwent fusion of ≥3 vertebrae for ASD were retrospectively enrolled from a multicenter database. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) scale, which is based on serum albumin, total lymphocyte count, and total cholesterol levels, with scores ranging from 0 to 10. Patients were classified into two groups according to their nutritional status: the undernutrition (UN) group (CONUT score ≥2) and the normal nutrition (N) group (CONUT score 0–1). Multivariate regression analysis was performed to identify independent predictors of postoperative sagittal alignment deterioration.</div></div><div><h3>Results</h3><div>The N group included 67 patients, while the UN group included 50 patients. At 2 years postoperatively, the UN group exhibited a significantly greater sagittal vertical axis (SVA) (56.5 ± 47.5 mm vs. 44.2 ± 40.2 mm, P = 0.007) and a smaller spino-femoral angle (SFA) (194.4 ± 19.3° vs. 202.6 ± 19.2°, P = 0.029) compared to the N group. Multivariate analysis revealed that preoperative undernutrition was an independent predictor of postoperative SVA deterioration.</div></div><div><h3>Conclusions</h3><div>Preoperative undernutrition was associated with increased SVA and decreased SFA at 2 years postoperatively in older patients undergoing surgery for ASD. These findings suggest that preoperative nutritional status may influence postoperative outcomes in this population, highlighting the importance of nutritional screening and intervention prior to surgery.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 277-283"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731915","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}

引用次数: 0

Comparison of different types of prosthetic feet in patients with unilateral transtibial amputation; patient perspective 不同类型假足在单侧经胫骨截肢患者中的应用比较病人的视角。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-08-14 DOI: 10.1016/j.jos.2025.07.007

Gizem Kılınç Kamacı, Şahide Eda Artuç, Hatice Ceylan, Elif Tekin, Onur Kanlıoğlu, Merve Örücü Atar, Yasin Demir, Koray Aydemir

Objectives

Prosthetic feet are designed to fulfil the function of the ankle-foot part. It is an important part of lower extremity prostheses. Although there are many different types of prosthetic feet, it is difficult to determine the most suitable prosthetic foot for each amputee.

The aim of this study was to determine the experiences of patients with unilateral transtibial amputation (TTA) regarding different types of prosthetic feet [non-articulating ankle (NAA), articulating hydraulic ankle (AHA) or microprocessor-controlled foot (MPC)].

Methods

Seventeen patients with unilateral traumatic TTA who had experience with all three prosthetic foot types were included. Patients were asked to rate 14 features of the different types of prosthetic feet they had used using a numeric rating scale.

Results

There were statistically significant differences between the prosthetic feet in walking on flat roads, walking on uneven roads, walking fast, running, descending and ascending stairs, descending and ascending ramps, using with different shoes, using at home, maintenance need, and general satisfaction (p < 0.001, p < 0.001, p < 0.001, p:0.005, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p:0.042, p < 0.001, respectively). No statistically significant difference was found in the frequency of malfunction and weight of prosthetic foot types (p:0.929, p:0.114, respectively).

Conclusions

From the patient perspective, MPC was better than AHA and NAA in most activities of daily living and general satisfaction. AHA was better than NAA in these activities. There was no difference in the frequency of malfunction and the weight of the prosthetic foot.

Clinicaltrial

Registry name: Comparison of Different Types of Prosthetic Feet; Patient Perspective, Registry number: NCT05691998.

目的：设计假肢足来完成踝关节-足部的功能。它是下肢假体的重要组成部分。虽然有许多不同类型的假肢脚，但很难确定最适合每个截肢者的假肢脚。本研究的目的是确定单侧经胫骨截肢（TTA）患者对不同类型假肢足[非关节踝关节（NAA），关节液压踝关节（AHA）或微处理器控制足（MPC）]的体验。方法：选取17例曾使用过三种假肢足的单侧创伤性TTA患者作为研究对象。患者被要求使用数字评分量表对他们使用过的不同类型的假脚的14个特征进行评分。结果:有统计上显著的差异假脚在走在平坦的道路,走在凹凸不平的道路,走快,运行,下行和上行楼梯,下行和上行坡道,使用不同的鞋子,在家使用,维护需要,总体满意度(p < 0.001, p < 0.001, p < 0.001, p: 0.005, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p: 0.042, p < 0.001,分别)。假足类型的故障频率和重量差异无统计学意义（p:0.929, p:0.114）。结论：从患者的角度来看，MPC在大多数日常生活活动和总体满意度方面优于AHA和NAA。AHA在这些活动中优于NAA。在故障频率和假肢脚的重量方面没有差异。临床试验：注册名称：不同类型假肢足的比较；患者视角，注册号：NCT05691998。

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引用次数: 0

Association of knee extension deficit and lumbar kyphosis with functional impairments in patients with knee osteoarthritis: The Nagahama study 膝骨关节炎患者的膝关节伸展缺陷和腰椎后凸与功能损伤的关联：Nagahama研究。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-08-08 DOI: 10.1016/j.jos.2025.07.004

Sayaka Okada , Masashi Taniguchi , Tome Ikezoe , Tadao Tsuboyama , Hiromu Ito , Shuichi Matsuda , Fumihiko Matsuda , Tsukasa Kamitani , Noriaki Ichihashi

Background

The knee extension deficit is known to occur with an increase in lumbar kyphosis. This study aimed to determine the association of knee extension deficit and lumbar kyphosis with knee symptoms and functional activities in patients with Knee Osteoarthritis (KOA).

Methods

Four hundred forty-eight participants aged 60 or over with radiographic KOA, all local community residents, were included in the analysis. The Knee Scoring System (KSS) was used to assess the functional abilities and symptoms. The knee extension angle was measured using a goniometer, and the lumbar spine angle was measured using Spinal Mouse, which is a noninvasive skin surface device. The associations between KSS symptoms or function scores with the presence or absence of knee extension deficit and lumbar kyphosis was evaluated using the multiple regression analysis. Another multiple regression analysis was conducted to clarify the effect of the coexisting knee extension deficit and lumbar kyphosis on KSS scores.

Results

The presence of knee extension deficit (β = −2.67; 95 % confidence interval [95 % CI]: −5.08, −0.27; p = 0.03) and lumbar kyphosis (β = −6.15; 95 % CI: −9.44, −2.86; p < 0.01) were associated with the KSS function score. Furthermore, the coexisting knee extension deficit and lumbar kyphosis significantly decreased the KSS function score (β = −10.24; 95 % CI: −15.1, −5.37; p < 0.01). However, the interaction between knee extension deficit and lumbar kyphosis was not statistically significant (p = 0.25). The KSS symptom score was not associated with knee extension deficit or lumbar kyphosis in either analysis.

Conclusions

Our findings indicate that the coexisting knee extension deficit and lumbar kyphosis are an adverse clinical indicator associated with functional impairments in patients with KOA.

Study design

Retrospective clinical study.

背景：众所周知，膝关节伸展不足会随着腰椎后凸的增加而发生。本研究旨在确定膝骨关节炎（KOA）患者的膝关节伸展缺陷和腰椎后凸与膝关节症状和功能活动的关系。方法：选取448名60岁及以上胸片KOA患者，均为当地社区居民。膝关节评分系统（KSS）用于评估功能能力和症状。膝关节伸角测量采用测角仪，腰椎角度测量采用Spinal Mouse，这是一种无创皮肤表面装置。使用多元回归分析评估KSS症状或功能评分与是否存在膝关节伸展缺陷和腰椎后凸之间的关系。另一项多元回归分析用于阐明膝关节伸展缺陷和腰椎后凸共存对KSS评分的影响。结果：膝关节伸展缺损(β = -2.67；95%置信区间[95% CI]: -5.08, -0.27；P = 0.03)和腰椎后凸(β = -6.15；95% ci: -9.44, -2.86；p < 0.01)与KSS功能评分相关。此外，同时存在的膝关节伸展缺陷和腰椎后凸显著降低了KSS功能评分(β = -10.24；95% ci: -15.1, -5.37；P < 0.01)。然而，膝关节伸展缺陷与腰椎后凸之间的相互作用无统计学意义（p = 0.25）。在两种分析中，KSS症状评分与膝关节伸展缺陷或腰椎后凸无关。结论：我们的研究结果表明，并存的膝关节伸展缺陷和腰椎后凸是与KOA患者功能损伤相关的不良临床指标。研究设计：回顾性临床研究。

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引用次数: 0

Prevalence and related factors of early-phase diffuse idiopathic skeletal hyperostosis in a community-dwelling population – A cross-sectional observational study 社区居民早期弥漫性特发性骨骼增生的患病率及相关因素——一项横断面观察研究。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-09-06 DOI: 10.1016/j.jos.2025.07.009

Kairo Wada, Kanichiro Wada, Takaaki Nakano, Tetsushi Oyama, Gentaro Kumagai, Yohshiro Nitobe, Kotaro Aburakawa, Noriyuki Chiba, Yasuyuki Ishibashi

Background

The concept of early-phase diffuse idiopathic skeletal hyperostosis (EDISH) was recently introduced and its prevalence at the thoracic spine level was revealed. Some cases of EDISH progress to diffuse idiopathic skeletal hyperostosis (DISH) in association with being overweight. The prevalence and distribution of EDISH in the whole spine and related factors are unclear. The purpose of this study is to identify the prevalence and ossification patterns of EDISH, termed EDISH, as well as factors associated with the severity of ossification in a community-dwelling Japanese population.

Methods

A cohort study based on an observational health check-up project. The study included 524 participants (215 men and 309 women) from a community health checkup in 2021. Each participant underwent lateral whole spine radiography for evaluation of intervertebral ossification and was allocated into one of three groups accordingly: no DISH (NDISH), EDISH, and DISH. We recorded the body composition and laboratory data. Factors associated with ossification were investigated using multivariable regression analysis.

Results

The prevalence of EDISH was 5.5 % overall (10.2 % in men and 2.3 % in women). The prevalence of DISH was 7.4 %, and the prevalence was significantly higher in men (P < .001). The center and lower end of ossification were most observed at the lower thoracic level. Age was significantly higher in the EDISH and DISH groups than in the NDISH group. Multivariable analysis revealed that the severity of ossification was associated with the percentage of body fat, insulin-like growth factor-1, adiponectin, and high-density lipoprotein-cholesterol.

Conclusion

The overall prevalence of EDISH and DISH was 5.5 % and 7.4 %, respectively, and the prevalence of both conditions was higher in men. Our analysis suggests that the center of ossification was the lower thoracic level, with gradual development. Lipid metabolism may be associated with ossification.

背景：早期弥漫性特发性骨骼肥厚症（edesh）的概念最近被提出，其在胸椎水平的患病率被揭示。一些病例的EDISH进展为弥漫性特发性骨骼肥厚症（DISH）与超重有关。EDISH在全脊柱的患病率、分布及相关因素尚不清楚。本研究的目的是确定日本社区居民中EDISH的患病率和骨化模式，以及与骨化严重程度相关的因素。方法：基于观察性健康体检项目的队列研究。该研究包括524名参与者（215名男性和309名女性），他们来自2021年的社区健康检查。每位参与者均接受侧位全脊柱x线摄影以评估椎间骨化情况，并据此分为三组：无DISH （NDISH）、eddish和DISH。我们记录了身体成分和实验室数据。采用多变量回归分析探讨与骨化相关的因素。结果：EDISH的总体患病率为5.5%（男性10.2%，女性2.3%）。DISH患病率为7.4%，男性患病率明显高于男性（P < 0.001）。骨化的中心和下端多见于胸椎下部。EDISH组和DISH组的年龄明显高于NDISH组。多变量分析显示，骨化的严重程度与体脂百分比、胰岛素样生长因子-1、脂联素和高密度脂蛋白-胆固醇有关。结论：EDISH和DISH的总患病率分别为5.5%和7.4%，男性患病率较高。我们的分析表明骨化的中心在胸椎下部，骨化是逐渐发展的。脂质代谢可能与骨化有关。

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引用次数: 0

Prevalence and characteristics of femoroacetabular impingement among Japanese patients: A nationwide epidemiological study 日本患者股骨髋臼撞击的患病率和特征：一项全国性的流行病学研究。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-09-15 DOI: 10.1016/j.jos.2025.08.014

Kensuke Fukushima , Tetsuya Jinno , Ryohei Takada , Takuma Yamasaki , Hideki Fujii , Naomi Kobayashi , Toshikazu Kubo , Hajime Sugiyama , Nobuhiko Sugano

Background

Femoroacetabular impingement (FAI) causes hip pain and osteoarthritis (OA). However, its prevalence and characteristics in the Japanese population remain unclear. Therefore, this large-scale nationwide epidemiological study aimed to determine the current aetiologies of hip disorders in Japan, focusing on the prevalence and clinical features of primary FAI.

Methods

A total of 2402 patients presenting with groin pain were prospectively enrolled from 16 hip-specialised institutions across Japan. Diagnoses were based on standardised clinical and radiographic evaluations, including the Japanese Hip Society criteria for primary FAI. Centralised radiographic assessment was also conducted using dedicated measurement software.

Results

Secondary OA due to hip dysplasia was the most common diagnosis (52.9 %), followed by primary OA (16.8 %), osteonecrosis of the femoral head (8.5 %), and primary FAI (6.2 %). Patients with FAI were predominantly younger males. Cam-type FAI was the most frequently identified FAI subtype. Centralised radiographic assessment revealed discrepancies compared with institutional diagnoses, in which 12.8 % of patients initially diagnosed with FAI showed signs of advanced OA, the percentage of hips with a lateral center-edge angle <25° was higher in the centralised measurements (13.8 % vs. 6.4 %; P < 0.001), and the percentage of hips with an alpha angle ≥55° was reduced (40.3 % vs. 67.7 %; P = 0.0393).

Conclusion

This nationwide study identified secondary OA due to hip dysplasia as the most common (52.9 %), with primary FAI identified in 6.2 % of cases, predominantly affecting younger males with cam-type morphology. Standardised radiographic assessment revealed an underdiagnosis of hip dysplasia and OA and a potential overdiagnosis of cam-type FAI, emphasising the need for accurate diagnosis to guide appropriate treatment decisions.

背景：股髋臼撞击（FAI）引起髋关节疼痛和骨关节炎（OA）。然而，其在日本人口中的流行程度和特征尚不清楚。因此，这项大规模的全国性流行病学研究旨在确定日本髋关节疾病的当前病因，重点关注原发性FAI的患病率和临床特征。方法：从日本16个髋关节专科机构前瞻性纳入2402例腹股沟疼痛患者。诊断基于标准化的临床和放射学评估，包括日本髋关节协会对原发性FAI的标准。亦使用专用的测量软件进行集中的放射评估。结果：髋关节发育不良引起的继发性骨关节炎是最常见的诊断（52.9%），其次是原发性骨关节炎（16.8%）、股骨头坏死（8.5%）和原发性FAI（6.2%）。FAI患者以年轻男性为主。cam型FAI是最常见的FAI亚型。结论：这项全国性的研究发现，由于髋关节发育不良导致的继发性OA最为常见（52.9%），原发性FAI在6.2%的病例中被确诊，主要影响具有凸轮型形态的年轻男性。标准化的影像学评估显示髋关节发育不良和OA的诊断不足，cam型FAI的潜在过度诊断，强调需要准确的诊断来指导适当的治疗决策。

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引用次数: 0

Translation, cultural adaptation, validity, and reliability of the Japanese version of the constant score: A cross-sectional study 日文恒分的翻译、文化适应、效度与信度：一项横断面研究。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2026-03-01 Epub Date: 2025-09-17 DOI: 10.1016/j.jos.2025.08.012

Daisuke Uritani , Yuuka Yasuura , Kinako Sasaki , Nobuya Harada , Christopher R. Constant

Background

The Constant Score (CS) is one of the most widely used shoulder function assessment instruments. However, a culturally and linguistically adapted Japanese version has not yet been established. This study aimed to translate and culturally adapt CS into Japanese (CS-J) and evaluate its reliability and validity.

Methods

The CS was translated into Japanese following internationally accepted cross-cultural adaptation guidelines. Psychometric properties of the CS-J were evaluated in 64 patients with shoulder dysfunction. Internal consistency was assessed using Cronbach's alpha. Test–retest reliability was examined using intraclass correlation coefficients (ICC). Construct validity was confirmed by exploratory factor analysis (EFA), and concurrent validity was tested against SPADI, QuickDASH, and SF-12 scores.

Results

The CS-J demonstrated excellent internal consistency (Cronbach's alpha = 0.91) and test–retest reliability (ICC = 0.91). The EFA revealed a two-factor structure corresponding to the subjective and objective components of the CS. Significant correlations were found between CS-J and SPADI (r = −0.82), QuickDASH (r = −0.82), SF-12 Physical Component Summary (r = 0.72), and Mental Component Summary (r = 0.52) scores, supporting concurrent validity.

Conclusions

The CS-J has acceptable reliability and validity, making it a useful tool for evaluating shoulder function in Japanese patients. The standardized adaptation of the CS-J enables more accurate clinical assessments and facilitates international research collaboration.

背景：恒积分（CS）是目前应用最广泛的肩功能评估工具之一。然而，在文化和语言上改编的日文版本尚未建立。本研究旨在将中文翻译成日语并进行文化改编，并评估其信度和效度。方法：按照国际通行的跨文化适应指南，将CS翻译成日文。对64例肩部功能障碍患者的CS-J心理测量特性进行了评估。内部一致性采用Cronbach’s alpha评价。用类内相关系数（ICC）检验重测信度。采用探索性因子分析（EFA）验证结构效度，并采用SPADI、QuickDASH和SF-12测试并发效度。结果：CS-J具有良好的内部一致性（Cronbach’s alpha = 0.91）和重测信度（ICC = 0.91）。EFA揭示了一个双因素结构，对应于CS的主观和客观成分。CS-J与SPADI （r = -0.82）、QuickDASH （r = -0.82）、SF-12 Physical Component Summary （r = 0.72）、Mental Component Summary （r = 0.52）得分呈显著相关，支持并发效度。结论：CS-J具有可接受的信度和效度，是评价日本患者肩关节功能的有效工具。CS-J的标准化调整使临床评估更加准确，并促进了国际研究合作。

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引用次数: 0