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What is a useful marker for predicting survival in patients with high-grade soft tissue sarcoma who have non-inflammatory conditions? 什么是预测患有非炎症性疾病的高级别软组织肉瘤患者生存期的有效指标?
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.07.016
Tomoki Nakamura, Kunihiro Asanuma, Tomohito Hagi, Akihiro Sudo

Background

The modified Glasgow prognostic score (mGPS) is a reliable system for identifying patients at high risk of death among patients with soft tissue sarcoma (STS). The scoring systems use a combination of C-reactive protein (CRP) and albumin levels. Although patients with high-grade STS are at risk of metastasis and death, even if their mGPS is 0, the prognostic indicators in these patients are unknown. Therefore, we investigated useful prognostic indicators for survival and the development of metastasis in patients with high-grade STS and an mGPS of 0.

Methods

One hundred and four patients with CRP and albumin levels of <1.0 mg/dl and >3.5 g/dl, respectively, indicating an mGPS of 0, were included. The mean follow-up period was 79 months.

Results

The 5-year disease-specific survival (DSS) rate was 79.2%. Cox proportional analysis showed that tumor size and absolute neutrophil count (ANC) were prognostic variables in multivariate analyses. Patients with higher ANC (ANC>3370/μl) had a worse DSS than those with lower ANC. The 5-year DSS was 74.7% vs. 91.7%, respectively (p = 0.0207). The 5-year metastasis-free survival was 67.2%. Tumor size and ANC remained significant variables for predicting the development of metastasis in the multivariate analysis. Patients with higher ANC had a worse metastasis-free survival than those with lower ANC. The 5-year metastasis-free survival was 59.5% vs. 87.3%, respectively (p = 0.00269).

Conclusions

When patients with high-grade STS have an mGPS of 0, the ANC and tumor size should be carefully evaluated. A higher neutrophil count and larger tumor size may increase the risk of metastasis development.

背景:改良格拉斯哥预后评分(mGPS)是识别软组织肉瘤(STS)高死亡风险患者的可靠系统。该评分系统结合使用了 C 反应蛋白(CRP)和白蛋白水平。虽然高级别 STS 患者即使 mGPS 为 0,也有转移和死亡的风险,但这些患者的预后指标尚不清楚。因此,我们对mGPS为0的高级别STS患者生存和发生转移的有用预后指标进行了研究:方法:纳入 CRP 和白蛋白水平分别为 3.5 g/dl 且 mGPS 为 0 的 104 例患者。平均随访时间为 79 个月:结果:5 年疾病特异性生存率(DSS)为 79.2%。Cox比例分析显示,肿瘤大小和绝对中性粒细胞计数(ANC)是多变量分析中的预后变量。ANC较高的患者(ANC>3370/μl)比ANC较低的患者的DSS更差。5年DSS分别为74.7%和91.7%(P = 0.0207)。5年无转移生存率为67.2%。在多变量分析中,肿瘤大小和ANC仍是预测转移发生的重要变量。ANC较高的患者的无转移生存率低于ANC较低的患者。5年无转移生存率分别为59.5%和87.3%(P = 0.00269):结论:当高级别 STS 患者的 mGPS 为 0 时,应仔细评估 ANC 和肿瘤大小。结论:当高级别 STS 患者的 mGPS 为 0 时,应仔细评估中性粒细胞计数和肿瘤大小,中性粒细胞计数越高、肿瘤越大,转移风险越高。
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引用次数: 0
CircBBS9 accelerates the malignant progression of osteosarcoma through sponging miR-485-3p/HMGB1 axis CircBBS9通过海绵状miR-485-3p/HMGB1轴加速骨肉瘤的恶性进展
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.05.005
Zengliang Zhang, Haotian Wu, Yaozhong Xing, Xiaoli Zhang, Jinzhou Wang, Bingyao Chen

Background

Osteosarcoma (OS) is a leading malignant tumor reported with high mortality and morbidity. Dysexpression of CircBBS9 has been reported to exhibit a critical functional role in various diseases. However, the underlying molecular mechanisms of CircBBS9 in osteosarcoma are poorly characterized.

Methods

The present study aims to investigate the impacts of CircBBS9 on the progression of osteosarcoma.

Results

The findings of the study demonstrated the up-regulated expression of CircBBS9 in osteosarcoma. The Actinomycin D and RNase R treatment experiments confirmed that circBBS9 is indeed a circRNA. In addition, the knockdown of circBBS9 negatively impacted the migration, proliferation and invasion of osteosarcoma cells. Further investigations illustrated that circBBS9 controlled miR-485-3p and miR-485-3p might directly interact with HMGB1. miR-485-3p had a negative regulatory role in HMGB1's gene expression. Through rescue assays, it was verified that CircBBS9 promoted osteosarcoma progression through the miR-485-3p/HMGB1 axis. Finally, circBBS9 knockdown attenuated the in-vivo growth of osteosarcoma.

Conclusions

Conclusively, our study is the first time to examine the possible functional mechanism and regulation roles of CircBBS9 in osteosarcoma. The findings explained that CircBBS9 promoted the malignant osteosarcoma's progression by sponging miR-485-3p/HMGB1 and proposed CircBBS9 as a prognostic biomarker and therapeutic candidate for osteosarcoma patients.

背景:骨肉瘤(Osteosarcoma,OS)是一种死亡率和发病率都很高的主要恶性肿瘤。有报道称,CircBBS9的错误表达在多种疾病中表现出关键的功能性作用。然而,CircBBS9在骨肉瘤中的潜在分子机制尚不清楚:本研究旨在探讨 CircBBS9 对骨肉瘤进展的影响:结果:研究结果表明,CircBBS9在骨肉瘤中表达上调。放线菌素 D 和 RNase R 处理实验证实了 circBBS9 确实是一种 circRNA。此外,敲除 circBBS9 会对骨肉瘤细胞的迁移、增殖和侵袭产生负面影响。进一步的研究表明,circBBS9控制着miR-485-3p,而miR-485-3p可能与HMGB1直接相互作用。通过拯救实验,验证了 CircBBS9 通过 miR-485-3p/HMGB1 轴促进骨肉瘤的进展。最后,circBBS9的敲除抑制了骨肉瘤的体内生长:结论:我们的研究首次探讨了CircBBS9在骨肉瘤中可能的功能机制和调控作用。研究结果表明,CircBBS9通过对miR-485-3p/HMGB1的调控促进了恶性骨肉瘤的发展,并提出CircBBS9可作为骨肉瘤患者的预后生物标志物和候选治疗药物。
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引用次数: 0
Hounsfield Unit values on the subchondral bone are related to clinical outcomes in bone marrow stimulation for osteochondral lesions of the talus 软骨下骨的 Hounsfield 单位值与骨髓刺激治疗距骨软骨损伤的临床效果有关。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.06.002
Shingo Kawabata, Tomoyuki Nakasa, Yasunari Ikuta, Junichi Sumii, Akinori Nekomoto, Nobuo Adachi

Background

Poor clinical outcomes in bone marrow stimulation (BMS) for the osteochondral lesion of the talus (OLT) are caused by subchondral bone deterioration. It is reported that microfracture induces endochondral ossification in the subchondral bone, which may affect the subchondral bone condition after BMS. This study analyzed osteosclerotic patterns of the bed in OLTs on computed tomography (CT) images and the relationship between the subchondral bone condition and clinical outcomes of BMS.

Methods

Sixty-nine ankles in 61 patients with OLT were included. Hounsfield unit (HU) on the bed of OLTs was measured on CT images and the pattern of osteosclerosis or absorption in the bed was analyzed. In these patients, 25 ankles in 24 patients underwent BMS. They were divided into 2 groups according to the presence of bone marrow edema (BME) one year after surgery, and clinical outcomes were compared.

Results

HUs in the anterior region were significantly higher than those of other areas. In patients with BMS, the JSSF scale for BME positive group (88.0 ± 7.7 points) was significantly lower than that for BME negative group (95.0 ± 6.1 points) (p < 0.05) at the final follow-up. On preoperative CT images, HU values of the central region in the BME-positive group were significantly lower than those in the BME-negative group (p < 0.05).

Conclusion

Osteosclerotic changes in the anterior part of the bed were frequently observed, and BMS for the area with low HU values decreased clinical outcomes. BMS should be performed with attention to subchondral bone condition to obtain good clinical outcomes.

Level of evidence

4, case series.

背景:骨髓刺激术(BMS)治疗距骨骨软骨损伤(OLT)的临床疗效不佳是由软骨下骨退化引起的。据报道,微骨折会诱导软骨下骨的内软骨骨化,这可能会影响 BMS 后软骨下骨的状况。本研究分析了计算机断层扫描(CT)图像上 OLT 骨床的骨硬化形态以及软骨下骨状况与 BMS 临床疗效之间的关系:方法:纳入 61 名 OLT 患者的 69 只脚踝。在 CT 图像上测量 OLT 骨床的 Hounsfield 单位(HU),并分析骨床的骨硬化或吸收模式。在这些患者中,24 名患者的 25 只脚踝接受了 BMS 治疗。根据术后一年是否出现骨髓水肿(BME)将他们分为两组,并比较临床结果:结果:前区的 HU 值明显高于其他区域。在 BMS 患者中,BME 阳性组的 JSSF 量表(88.0 ± 7.7 分)明显低于 BME 阴性组(95.0 ± 6.1 分)(P骨床前部经常出现骨硬化改变,对 HU 值较低的区域进行 BMS 会降低临床疗效。进行 BMS 时应注意软骨下骨的状况,以获得良好的临床效果:4,病例系列。
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引用次数: 0
States of contra-lateral rotator cuff – Based on bilateral shoulder ultrasound results of 401 patients 肩袖反外侧的状态 - 基于 401 名患者的双侧肩部超声波检查结果。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.05.007
Tianci Wang , Jialiang Guo , Yaru Mi , Zeng Xiao , Bing Yin , Bo Lu , Heping Deng

Background

For patients with rotator cuff tear (RCT), the contra-lateral shoulders have higher risk of RCT than general population. It has been proved by several previous studies. The focus of this study is to obtain the data of contra-lateral rotator cuff tear in Chinese population, and to find the rules of contra-lateral rotator cuff tear through statistical analysis.

Methods

From March 2016 to January 2020, patients who underwent shoulder arthroscopic surgery were included in the study, we conduct bilateral shoulder ultrasound before surgery, patients information collection include gender, age, occupation and whether received contra-lateral rotator cuff surgery within 1–3 years. The above information was statistically analyzed.

Results

According to the inclusion and exclusion criteria, 401 patients were included. The incidence of contra-lateral rotator cuff tear was 24.3%, 5.58% of them underwent contra-lateral rotator cuff repair surgery within 3 years. The degree of contra-lateral rotator cuff tear was positively correlated with the degree of the primary side; Patients with full-thickness rotator cuff tear were more likely to have contra-lateral rotator cuff tear than patients with partial rotator cuff tear. For patients with supraspinatus tendon tear, the contra-lateral rotator cuff tear risk increases, For patients with subscapularis muscle tear, the contra-lateral rotator cuff tear risk doesn't increases. Contra-lateral rotator cuff tear is related to age, the risk of contra-lateral rotator cuff tear is higher in elderly patients.

Conclusions

The contra-lateral RCT data obtained in our study was 24.3%, significantly lower than that of previous studies. The reasons may include ethnic variation, lifestyle, and proportion of heavy physical labor. The condition of contra-lateral rotator cuff is closely related to affected side rotator cuff tear.

背景:对于肩袖撕裂(RCT)患者而言,反外侧肩部发生 RCT 的风险高于普通人群。之前的一些研究已经证明了这一点。本研究的重点是获取中国人群肩袖反外侧撕裂的数据,并通过统计分析找出肩袖反外侧撕裂的规律:方法:将2016年3月至2020年1月接受肩关节镜手术的患者纳入研究,术前进行双侧肩关节超声检查,患者信息采集包括性别、年龄、职业、1-3年内是否接受过肩袖对侧手术等。对上述信息进行统计学分析:根据纳入和排除标准,共纳入 401 例患者。肩袖外侧撕裂的发生率为 24.3%,其中 5.58% 的患者在 3 年内接受过肩袖外侧修复手术。对侧肩袖撕裂程度与原发侧肩袖撕裂程度呈正相关;全厚肩袖撕裂患者比肩袖部分撕裂患者更容易出现对侧肩袖撕裂。对于冈上肌腱撕裂的患者,肩袖反外侧撕裂的风险会增加;对于肩胛下肌撕裂的患者,肩袖反外侧撕裂的风险不会增加。肩袖外侧撕裂与年龄有关,老年患者肩袖外侧撕裂的风险更高:我们的研究中获得的肩袖对侧撕裂数据为 24.3%,明显低于之前的研究。原因可能包括种族差异、生活方式和重体力劳动的比例。肩袖反外侧的情况与患侧肩袖撕裂密切相关。
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引用次数: 0
Validity and application of Doiguchi's pelvic tilt measurement method 土居骨盆倾斜测量法的有效性和应用。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.06.007
Manabu Tsukamoto , Makoto Kawasaki , Takayuki Nabeshima , Hitoshi Suzuki , Teruaki Fujitani , Ko Chiba , Yuichi Doiguchi , Makoto Osaki , Akinori Sakai

Background

The validity of Doiguchi's pelvic tilt measurement method has not been proven. The objective in our study was to validate the method.

Methods

Our investigation included 73 total hip arthroplasties (THAs) performed using our cup placement procedure from July 2020 to November 2021. Pelvic tilt formed by the pubic symphysis and sacral promontory (PTPS) in supine and lateral positions was calculated by two methods (the Doiguchi method and the digital reconstructed radiograph (DRR) method using a 3D computer templating system) based on the transverse and longitudinal diameters of the pelvic ring measured immediately before THA.

Results

There was a strong/moderate correlation in the values of PTPS between the Doiguchi and DRR methods. However, the value of PTPS calculated by the Doiguchi method was significantly lower than that calculated by DRR, and there was a partially direct match. On the other hand, there was no significant difference in the value of PT change from supine to lateral position between the Doiguchi and DRR methods. The PT changes based on both methods were strongly correlated, and the PT change calculated by the Doiguchi method was almost identical to that calculated by the DRR method.

Conclusions

Doiguchi's pelvic tilt measurement method was validated for the first time. These results demonstrated that the ratio of the transverse and longitudinal diameters of the pelvic ring was an important factor defining the change in pelvic tilt. The slope in the linear function of the Doiguchi method was found to be almost the correct value, although the intercept of the linear function exhibited individual differences.

背景:Doiguchi 骨盆倾斜测量方法的有效性尚未得到证实。我们的研究旨在验证该方法的有效性:我们的调查包括 2020 年 7 月至 2021 年 11 月期间使用我们的髋臼杯置入术进行的 73 例全髋关节置换术(THA)。在仰卧位和侧卧位时,耻骨联合和骶骨突出部(PTPS)形成的骨盆倾斜度通过两种方法计算得出(土渊法和使用三维计算机模板系统的数字重建X光片(DRR)法),计算的依据是在全髋关节置换术前测量的骨盆环的横向和纵向直径:Doiguchi法和DRR法的PTPS值有很强/中等程度的相关性。然而,用土居方法计算出的 PTPS 值明显低于用 DRR 计算出的 PTPS 值,两者有部分直接匹配。另一方面,从仰卧位到侧卧位的 PT 变化值在土居方法和 DRR 方法之间没有显著差异。两种方法计算出的 PT 变化值具有很强的相关性,土居方法计算出的 PT 变化值与 DRR 方法计算出的 PT 变化值几乎完全一致:结论:首次验证了土口骨盆倾斜测量方法。这些结果表明,骨盆环横向和纵向直径的比值是决定骨盆倾斜度变化的重要因素。尽管线性函数的截距表现出个体差异,但发现土居方法线性函数的斜率几乎是正确的值。
{"title":"Validity and application of Doiguchi's pelvic tilt measurement method","authors":"Manabu Tsukamoto ,&nbsp;Makoto Kawasaki ,&nbsp;Takayuki Nabeshima ,&nbsp;Hitoshi Suzuki ,&nbsp;Teruaki Fujitani ,&nbsp;Ko Chiba ,&nbsp;Yuichi Doiguchi ,&nbsp;Makoto Osaki ,&nbsp;Akinori Sakai","doi":"10.1016/j.jos.2023.06.007","DOIUrl":"10.1016/j.jos.2023.06.007","url":null,"abstract":"<div><h3>Background</h3><p>The validity of Doiguchi's pelvic tilt measurement method has not been proven. The objective in our study was to validate the method.</p></div><div><h3>Methods</h3><p><span>Our investigation included 73 total hip arthroplasties (THAs) performed using our cup placement procedure from July 2020 to November 2021. Pelvic tilt formed by the pubic symphysis and sacral promontory (PT</span><sub>PS</sub>) in supine and lateral positions was calculated by two methods (the Doiguchi method and the digital reconstructed radiograph (DRR) method using a 3D computer templating system) based on the transverse and longitudinal diameters of the pelvic ring measured immediately before THA.</p></div><div><h3>Results</h3><p>There was a strong/moderate correlation in the values of PT<sub>PS</sub> between the Doiguchi and DRR methods. However, the value of PT<sub>PS</sub> calculated by the Doiguchi method was significantly lower than that calculated by DRR, and there was a partially direct match. On the other hand, there was no significant difference in the value of PT change from supine to lateral position between the Doiguchi and DRR methods. The PT changes based on both methods were strongly correlated, and the PT change calculated by the Doiguchi method was almost identical to that calculated by the DRR method.</p></div><div><h3>Conclusions</h3><p>Doiguchi's pelvic tilt measurement method was validated for the first time. These results demonstrated that the ratio of the transverse and longitudinal diameters of the pelvic ring was an important factor defining the change in pelvic tilt. The slope in the linear function of the Doiguchi method was found to be almost the correct value, although the intercept of the linear function exhibited individual differences.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746785","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 “ligamentization” process between preserved insertion hamstring tendon autograft and bone-patellar tendon-bone autograft 比较保留插入腘绳肌腱自体移植物和骨-髌腱-骨自体移植物的 "韧带化 "过程。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.06.014
Ravi Gupta , Sandeep Singh , Anil Kapoor , Ashwani Soni , Rohil Mehta , Ravinder Kaur , Gladson David Masih

Background

Ligamentization is a complex process and effect of preservation of hamstring tendon graft insertion on this process is not well studied. Present study was conducted to analyze and compare the ligamentization of semitendinosus gracilis graft with preserved tibial insertion (STGPI) and bone-patellar tendon-bone (BPTB) autografts.

Methods

A total of 50 sportspeople who underwent ACL reconstruction using either BPTB (group A; n = 25) or STGPI (group B; n = 25) autografts were included in the study. Contrast enhanced MRI was done at 8 months and 14 months post-ACL reconstruction to evaluate the ligamentization using Signal noise quotient (SNQ), graft intensity and enhancement index. Clinical outcomes (Lysholm score) and knee laxity were also assessed at 8 months and 14 months.

Results

18/23 (78%) patients in group A and 14/23 (61%) patients in group B had hyperintense graft signal at 8 months (n.s.) and at 14 months, 1/23 patients in group A and none of the patients in group B had hyperintense graft. SNQ at 8 months was 3.6 ± 2 and 3.7 ± 2 in group A and B respectively (n.s.) and at 14 months, SNQ was 2.5 ± 1.5 in group A and 2.4 ± 1.3 in group B (n.s.). Enhancement index at 8 months was 1.5 ± 0.3 and 1.2 ± 0.3 in group A and B respectively (p = 0.0001). Enhancement index at 14 months was 1.21 ± 0.2 in group A and 1.07 ± 0.2 in group B (p = 0.003). Functional outcomes and knee laxity were comparable in both the groups at 8 and 14 months (n.s.).

Conclusion

Both the grafts i.e. BPTB and STGPI are similar in terms of rate and extent of ligamentization. Clinical outcomes and knee laxity are also comparable between two grafts.

背景:结扎是一个复杂的过程,而保留腘绳肌腱移植物插入部对这一过程的影响尚未得到充分研究。本研究旨在分析和比较保留胫骨插入部的半腱肌移植物(STGPI)和骨-髌腱-骨(BPTB)自体移植物的结扎情况:共有 50 名运动员接受了前交叉韧带重建术,他们使用了 BPTB(A 组,n = 25)或 STGPI(B 组,n = 25)自体移植物。在前交叉韧带重建后 8 个月和 14 个月时进行对比增强核磁共振成像,利用信号噪声商(SNQ)、移植物强度和增强指数评估韧带韧化情况。在8个月和14个月时,还对临床结果(Lysholm评分)和膝关节松弛情况进行了评估:结果:8 个月时,18/23(78%)名 A 组患者和 14/23(61%)名 B 组患者出现移植物高密度信号(n.s.);14 个月时,1/23(1/23)名 A 组患者和 0 名 B 组患者出现移植物高密度信号。8 个月时,A 组和 B 组的 SNQ 分别为 3.6 ± 2 和 3.7 ± 2(正常值);14 个月时,A 组的 SNQ 为 2.5 ± 1.5,B 组为 2.4 ± 1.3(正常值)。8 个月时,A 组和 B 组的增强指数分别为 1.5 ± 0.3 和 1.2 ± 0.3(p = 0.0001)。14 个月时,A 组的增强指数为 1.21 ± 0.2,B 组为 1.07 ± 0.2(p = 0.003)。两组在 8 个月和 14 个月时的功能结果和膝关节松弛程度相当(n.s.):结论:BPTB 和 STGPI 两种移植物的结扎率和程度相似。结论:BPTB 和 STGPI 两种移植物的结扎率和结扎程度相似,临床效果和膝关节松弛程度也相当。
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引用次数: 0
Ultrasonography in the evaluation of various factors of developmental dysplasia of the hip in infants: Results from a retrospective study in a large hospital of northwest China 超声波检查评估婴儿髋关节发育不良的各种因素:中国西北地区一家大型医院的回顾性研究结果。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.05.009
Tian-tian Dong , Fang Nie , Lu-lu Yang , Ting Wang

Background

The occurrence and development of developmental dysplasia of the hip (DDH) are related to a variety of factors, which have been reported in the literature, but the literature does not mention factors related to the severity of DDH. The purpose of this study is to analyze the related factors of the occurrence and severity of DDH in combination with the Graf ultrasonic diagnostic classification.

Methods

This study was a monocentric retrospective study describing the factors associated with DDH in a large hospital of northwest China. A total of 3046 infants (6092 hips) within 6 months after birth using the Graf method were admitted to our department between 2014 and 2018. We analyzed data of DDH. After reviewing medical charts and diagnostic examination results, we assessed whether factors such as ethnicity, gender, gestational age, birth weight, diagnosis age, maternal age, mode of delivery, fetal presentation, amniotic fluid volume and birth order, had any effect on development of hip.

Result

① Analysis showed that DDH mostly occurs in female and left hip joint, related to intrauterine fetal presentation, amniotic fluid volume, gestational age, mode of delivery, prenatal weight, and diagnosis age after birth, and the occurrence of DDH is also related to maternal age (All P<0.05). Ethnicity and first born showed have no obvious correlation with DDH incidence (p = 0.718, 0.147, respectively). ② The strongest correlation was found with amniotic fluid, followed by birth weight. ③ The severity of DDH was correlated with ethnicity, births, prenatal weight, gestational age, diagnosis age and maternal age (All P<0.05, respectively). ④ There were significant differences in treatment methods, duration and prognosis among different types of DDH.

Conclusions

The occurrence and development of DDH are related to a variety of factors. Ultrasound examination can provide an early assessment of the hip development status of infants and may play an important role in establishing an early clinical diagnosis treatment and monitoring and prognosis.

背景:髋关节发育不良(DDH)的发生和发展与多种因素有关,文献对此已有报道,但文献并未提及与DDH严重程度有关的因素。本研究的目的是结合格拉夫超声诊断分类法分析DDH发生和严重程度的相关因素:本研究是一项单中心回顾性研究,描述了中国西北地区一家大型医院中与 DDH 相关的因素。2014年至2018年间,我科共收治了3046名出生后6个月内的婴儿(6092髋),采用Graf法进行诊断。我们分析了DDH的数据。在查阅病历和诊断检查结果后,我们评估了种族、性别、胎龄、出生体重、诊断年龄、产妇年龄、分娩方式、胎儿表现、羊水量和出生顺序等因素对髋关节发育是否有影响。结果:①分析表明,DDH 多发生于女性和左髋关节,与宫内胎儿先露、羊水量、胎龄、分娩方式、产前体重和出生后诊断年龄有关,DDH 的发生还与产妇年龄有关(均 P<0.05)。种族和初产妇与 DDH 发生率无明显相关性(P = 0.718,0.147)。与羊水的相关性最强,其次是出生体重。③ DDH 的严重程度与种族、出生人数、产前体重、胎龄、诊断年龄和产妇年龄相关(均分别为 P<0.05)。不同类型的 DDH 在治疗方法、疗程和预后方面存在明显差异:结论:DDH的发生和发展与多种因素有关。结论:DDH的发生和发展与多种因素有关,超声检查可早期评估婴儿髋关节发育状况,对早期临床诊断、治疗、监测和预后判断具有重要作用。
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引用次数: 0
Low back pain, ultrasonographic muscle thickness measurements and biopsychosocial factors at different trimesters of pregnancy 不同孕期的腰痛、超声波肌肉厚度测量和生物心理社会因素。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.07.006
Esra Üzelpasaci , Levent Özçakar , Serap Özgül , Ceren Gürşen , Türkan Akbayrak

Background

Pregnancy-related low back pain is a multifactorial problem and its assosiation with pain intensity and biopsycosocial factors can not be fully explained. This study aimed to determine the psychosocial as well as biological/physical risk factors associated with self-reported low back pain (LBP) intensity during different trimesters of pregnancy.

Methods

This cross-sectional study comprised 107 pregnant women. An introductory information form for physical and medical characteristics, Visual Analog Scale (VAS) for low back pain intensity and Oswestry Disability Index (ODI) for degree of loss of functionality, Short Form-36 (SF-36) for quality of life and Pregnancy Physical Activity Questionnaire (PPAQ) for physical activity were applied. Abdominal muscle thicknesses and diastasis recti were measured by ultrasonography. Univariate regression was used to analyse associations between each plausible independent variable and low back pain intensity.

Results

Mean LBP intensity during 1st, 2nd ve 3rd trimesters were 26.8 ± 20.9, 27.3 ± 19.8, 21.6 ± 20.1 mm, respectively. ODI scores were associated with LBP intensity, explaining 11%, 13% and 26% of LBP severity during the 1st, 2nd ve 3rd trimesters, respectively. Other biological/physical variables like age, body mass index, muscle thickness and diastasis recti were not associated with pain intensity. SF-36 emotional role limitation (coef = −0.03, R2 = 0.20, p = 0.01) in the 3rd trimester and SF-36 pain score in the 1st (coef = −0.04, R2 = 0.12, p = 0.02) and 3rd (coef = −0.05, R2 = 0.26, p = 0.004) trimesters and PPAQ-sedentary was associated during the 2nd trimester (coef = 0.17, R2 = 0.17, p = 0.02) with pain intensity.

Conclusion

ODI scores were associated with LBP intensity in all three trimesters, with SF-36 pain domain in the 1st and 3rd trimesters, with SF-36 emotional role limitation only in the 3rd trimester and with sedentary activity level only in the 2nd trimester. İncreased pain intensity was surprisingly associated with a small number of biopsychosocial factors in all the trimesters. There is need for further large-sample studies.

背景:与妊娠相关的腰背痛是一个多因素的问题,其与疼痛强度和活组织检查社会因素的关系还不能完全解释清楚。本研究旨在确定与妊娠不同孕期自述腰背痛(LBP)强度相关的社会心理以及生物/物理风险因素:这项横断面研究包括 107 名孕妇。方法:这项横断面研究由 107 名孕妇组成,采用了一份介绍身体和医疗特征的信息表、腰背痛强度视觉模拟量表(VAS)和功能丧失程度 Oswestry 残疾指数(ODI)、生活质量简表-36(SF-36)和体力活动调查表(PPAQ)。腹部肌肉厚度和直肠膨出通过超声波进行测量。采用单变量回归法分析每个可能的自变量与腰背痛强度之间的关系:结果:第一、第二和第三孕期的平均腰背痛强度分别为(26.8 ± 20.9)、(27.3 ± 19.8)和(21.6 ± 20.1)毫米。ODI评分与枸杞痛强度相关,分别解释了第一、第二和第三孕期11%、13%和26%的枸杞痛严重程度。其他生物/物理变量,如年龄、体重指数、肌肉厚度和直肠膨出与疼痛强度无关。SF-36情感角色限制(系数=-0.03,R2=0.20,p=0.01)在第 3 个孕期与疼痛强度相关,SF-36 疼痛评分在第 1 个孕期(系数=-0.04,R2=0.12,p=0.02)和第 3 个孕期(系数=-0.05,R2=0.26,p=0.004)与疼痛强度相关,PPAQ-sedentary 在第 2 个孕期与疼痛强度相关(系数=0.17,R2=0.17,p=0.02):结论:ODI 评分在所有三个孕期都与枸杞痛强度相关,在第一和第三个孕期与 SF-36 疼痛域相关,仅在第三个孕期与 SF-36 情感角色限制相关,仅在第二个孕期与久坐活动水平相关。令人惊讶的是,疼痛强度的增加在所有三个孕期都与少数生物心理社会因素有关。有必要进行进一步的大样本研究。
{"title":"Low back pain, ultrasonographic muscle thickness measurements and biopsychosocial factors at different trimesters of pregnancy","authors":"Esra Üzelpasaci ,&nbsp;Levent Özçakar ,&nbsp;Serap Özgül ,&nbsp;Ceren Gürşen ,&nbsp;Türkan Akbayrak","doi":"10.1016/j.jos.2023.07.006","DOIUrl":"10.1016/j.jos.2023.07.006","url":null,"abstract":"<div><h3>Background</h3><p>Pregnancy-related low back pain is a multifactorial problem and its assosiation with pain intensity and biopsycosocial factors can not be fully explained. This study aimed to determine the psychosocial as well as biological/physical risk factors associated with self-reported low back pain (LBP) intensity during different trimesters of pregnancy.</p></div><div><h3>Methods</h3><p><span>This cross-sectional study comprised 107 pregnant women. An introductory information form for physical and medical characteristics, Visual Analog Scale<span> (VAS) for low back pain intensity and Oswestry Disability Index (ODI) for degree of loss of functionality, Short Form-36 (SF-36) for </span></span>quality of life<span> and Pregnancy Physical Activity Questionnaire (PPAQ) for physical activity were applied. Abdominal muscle thicknesses and diastasis recti<span> were measured by ultrasonography. Univariate regression was used to analyse associations between each plausible independent variable and low back pain intensity.</span></span></p></div><div><h3>Results</h3><p>Mean LBP intensity during 1st, 2nd ve 3rd trimesters were 26.8 <span><math><mrow><mo>±</mo></mrow></math></span> 20.9, 27.3 <span><math><mrow><mo>±</mo></mrow></math></span> 19.8, 21.6 <span><math><mrow><mo>±</mo></mrow></math></span><span> 20.1 mm, respectively. ODI scores were associated with LBP intensity, explaining 11%, 13% and 26% of LBP severity during the 1st, 2nd ve 3rd trimesters, respectively. Other biological/physical variables like age, body mass index<span>, muscle thickness and diastasis recti were not associated with pain intensity. SF-36 emotional role limitation (coef = −0.03, R2 = 0.20, p = 0.01) in the 3rd trimester and SF-36 pain score in the 1st (coef = −0.04, R2 = 0.12, p = 0.02) and 3rd (coef = −0.05, R2 = 0.26, p = 0.004) trimesters and PPAQ-sedentary was associated during the 2nd trimester (coef = 0.17, R2 = 0.17, p = 0.02) with pain intensity.</span></span></p></div><div><h3>Conclusion</h3><p>ODI scores were associated with LBP intensity in all three trimesters, with SF-36 pain domain in the 1st and 3rd trimesters, with SF-36 emotional role limitation only in the 3rd trimester and with sedentary activity level only in the 2nd trimester. İncreased pain intensity was surprisingly associated with a small number of biopsychosocial factors in all the trimesters. There is need for further large-sample studies.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9873684","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
Risk factors for lateralization or superiorization of the center of the femoral head in eccentric rotational acetabular osteotomy 偏心旋转髋臼截骨术中股骨头中心侧移或上移的风险因素。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.06.010
Masanori Okamoto , Yasuhiko Takegami , Yusuke Osawa , Hiroki Iida , Hiroto Funahashi , Taisuke Seki , Shiro Imagama

Purpose

This study aimed to clarify the factors that cause the lateralization and superiorization of the femoral head after eccentric rotational acetabular osteotomy (ERAO) by examining the three-dimensional morphology of the osteotomy site using computed tomography (CT).

Methods

This study included 52 patients who underwent ERAO for hip dysplasia. Postoperatively, the center of the femoral head was measured for lateralization and superiorization. We defined the iliac and sciatic osteotomy angles in the coronal and axial CT planes, respectively. The surgical factors for lateralization and superiorization were analysed using multiple logistic regression analysis. We also analysed the relationship between the femoral head relocation and clinical outcomes (as assessed using Japanese Orthopaedic Association (JOA) scores).

Results

Thirty-five patients had hips with lateralized femoral heads, and 25 patients’ femoral heads were superiorized. Logistic regression analysis revealed that a higher osteotomy angle of the ilium in the coronal plane served as a significant predictor of superiorization of the femoral head. Similarly, a larger osteotomy angle of the ischium in the axial plane and the amount of change in the lateral centre edge angle were identified as predictors of lateralization. A weak negative correlation was observed between the amount of lateralization and the JOA score.

Conclusion

Large osteotomy angles in the superior and posterior aspects of the acetabulum carry a risk of superiorization and lateralization of the center of the femoral head. Surgeons should be aware of the need to chisel through the internal plate to achieve the results described in the ERAO theory.

Study design

A single-center, retrospective study.

目的:本研究旨在通过使用计算机断层扫描(CT)检查截骨部位的三维形态,明确导致偏心旋转髋臼截骨术(ERAO)后股骨头外侧化和上移的因素:这项研究包括52名因髋关节发育不良而接受ERAO手术的患者。术后测量了股骨头中心的侧位和上位。我们分别在冠状和轴向 CT 平面上定义了髂骨和坐骨截骨角。我们采用多元逻辑回归分析法对股骨侧移和上移的手术因素进行了分析。我们还分析了股骨头移位与临床结果(使用日本骨科协会(JOA)评分进行评估)之间的关系:结果:35 名患者的髋关节股骨头侧移,25 名患者的股骨头上移。逻辑回归分析显示,髂骨在冠状面上的截骨角度越大,股骨头上移越明显。同样,轴向截骨角度较大的髂骨和外侧中心边缘角的变化量也是预测股骨头偏侧的因素。侧移量与 JOA 评分之间呈弱负相关:结论:髋臼上部和后部的大截骨角度存在股骨头中心上移和侧移的风险。外科医生应意识到需要凿穿内板才能达到ERAO理论中描述的效果:研究设计:单中心回顾性研究。
{"title":"Risk factors for lateralization or superiorization of the center of the femoral head in eccentric rotational acetabular osteotomy","authors":"Masanori Okamoto ,&nbsp;Yasuhiko Takegami ,&nbsp;Yusuke Osawa ,&nbsp;Hiroki Iida ,&nbsp;Hiroto Funahashi ,&nbsp;Taisuke Seki ,&nbsp;Shiro Imagama","doi":"10.1016/j.jos.2023.06.010","DOIUrl":"10.1016/j.jos.2023.06.010","url":null,"abstract":"<div><h3>Purpose</h3><p><span><span>This study aimed to clarify the factors that cause the lateralization and superiorization of the femoral head after eccentric rotational </span>acetabular </span>osteotomy<span> (ERAO) by examining the three-dimensional morphology of the osteotomy site using computed tomography (CT).</span></p></div><div><h3>Methods</h3><p><span>This study included 52 patients who underwent ERAO for hip dysplasia. Postoperatively, the center of the femoral head was measured for lateralization and superiorization. We defined the iliac and sciatic osteotomy angles in the coronal and axial CT planes, respectively. The surgical factors for lateralization and superiorization were analysed using multiple </span>logistic regression analysis. We also analysed the relationship between the femoral head relocation and clinical outcomes (as assessed using Japanese Orthopaedic Association (JOA) scores).</p></div><div><h3>Results</h3><p>Thirty-five patients had hips with lateralized femoral heads, and 25 patients’ femoral heads were superiorized. Logistic regression analysis revealed that a higher osteotomy angle of the ilium in the coronal plane served as a significant predictor of superiorization of the femoral head. Similarly, a larger osteotomy angle of the ischium in the axial plane and the amount of change in the lateral centre edge angle were identified as predictors of lateralization. A weak negative correlation was observed between the amount of lateralization and the JOA score.</p></div><div><h3>Conclusion</h3><p>Large osteotomy angles in the superior and posterior aspects of the acetabulum carry a risk of superiorization and lateralization of the center of the femoral head. Surgeons should be aware of the need to chisel through the internal plate to achieve the results described in the ERAO theory.</p></div><div><h3>Study design</h3><p>A single-center, retrospective study.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132359","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
The correlation of the spinoglenoid ganglion cyst size with the electrophysiological alterations of suprascapular nerve and the rotator cuff muscle power 椎神经节囊肿大小与肩胛上神经电生理改变和肩袖肌力的相关性。
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jos.2023.06.004
Sung-Min Rhee , Vivek Bansal , Ho Yeon Jeong , Young Dae Jeon , Hyeon Jang Jeong , Joo Han Oh

Background

Although various treatment options are available for spinoglenoid cyst, including conservative and surgical methods, there is no standard guideline for its surgical decompression. Thus, the purpose of the study was to correlate the size of the spinoglenoid notch ganglion cyst (GC) as revealed by magnetic resonance imaging (MRI) with electrophysiological alterations, muscle power, and pain severity, and to estimate a cut-off value of cyst size to perform a decompression.

Methods

Between January 2010 and January 2018, the patients with a GC at the spinoglenoid notch diagnosed on MRI, and who had a minimum follow-up of 2 years after the decompression were included. Maximum cyst diameter as measured on MRI was used for comparison. Electromyography (EMG) and nerve conduction velocity (NCV) studies were performed before the surgery. Peak torque deficit (PTD) percentage compared to opposite shoulder was calculated preoperatively and at 1 year after surgery. Pain severity was estimated using visual analogue scale (VAS) preoperatively.

Results

Ten (50%) of 20 patients with GC > 2.2 cm and 1 (5.9%) of 17 patients with GC < 2.2 cm showed EMG/NCV abnormalities (p = 0.019). There was a correlation between the cyst size and the positive EMG/NCV findings (Correlation coefficient (CC) = 0.535, p < 0.001). The preoperative peak torque deficit on the external rotation was correlated with the positive EMG/NCV findings (CC = 0.373, p = 0.021). The PTD was improved significantly at 1 year postoperatively in patients with a GC size >2.2 cm (p = 0.029). The cyst size was not related to the preoperative pain VAS and muscle power.

Conclusions

The spinoglenoid cyst size >2.2 cm, but not pain severity or muscle power, correlates with the positive finding of EMG for compressive suprascapular neuropathy. The GC size >2.2 cm can be a reference to decide the need of decompression surgery.

Level of evidence

IV, case series.

背景:尽管椎弓根神经节囊肿有多种治疗方法,包括保守治疗和手术治疗,但目前还没有手术减压的标准指南。因此,本研究旨在将磁共振成像(MRI)显示的椎管切迹神经节囊肿(GC)大小与电生理改变、肌力和疼痛严重程度相关联,并估算出进行减压手术的囊肿大小临界值:方法:纳入2010年1月至2018年1月期间,经磁共振成像确诊为椎骨切迹GC,且减压术后随访至少2年的患者。核磁共振成像测量的最大囊肿直径用于比较。手术前进行肌电图(EMG)和神经传导速度(NCV)检查。术前和术后一年计算与对侧肩部相比的峰值扭矩不足(PTD)百分比。术前使用视觉模拟量表(VAS)估计疼痛的严重程度:20例患者中有10例(50%)GC大于2.2厘米,17例患者中有1例(5.9%)GC为2.2厘米(P = 0.029)。囊肿大小与术前疼痛VAS和肌肉力量无关:结论:椎管内囊肿大小>2.2 厘米与肌电图对肩胛上神经压迫性病变的阳性发现相关,但与疼痛严重程度或肌肉力量无关。GC大小>2.2厘米可作为决定是否需要减压手术的参考:IV,病例系列。
{"title":"The correlation of the spinoglenoid ganglion cyst size with the electrophysiological alterations of suprascapular nerve and the rotator cuff muscle power","authors":"Sung-Min Rhee ,&nbsp;Vivek Bansal ,&nbsp;Ho Yeon Jeong ,&nbsp;Young Dae Jeon ,&nbsp;Hyeon Jang Jeong ,&nbsp;Joo Han Oh","doi":"10.1016/j.jos.2023.06.004","DOIUrl":"10.1016/j.jos.2023.06.004","url":null,"abstract":"<div><h3>Background</h3><p>Although various treatment options are available for spinoglenoid cyst, including conservative and surgical methods, there is no standard guideline for its surgical decompression. Thus, the purpose of the study was to correlate the size of the spinoglenoid notch ganglion cyst (GC) as revealed by magnetic resonance imaging (MRI) with electrophysiological alterations, muscle power, and pain severity, and to estimate a cut-off value of cyst size to perform a decompression.</p></div><div><h3>Methods</h3><p>Between January 2010 and January 2018, the patients with a GC at the spinoglenoid notch diagnosed on MRI, and who had a minimum follow-up of 2 years after the decompression were included. Maximum cyst diameter as measured on MRI was used for comparison. Electromyography (EMG) and nerve conduction velocity (NCV) studies were performed before the surgery. Peak torque deficit (PTD) percentage compared to opposite shoulder was calculated preoperatively and at 1 year after surgery. Pain severity was estimated using visual analogue scale (VAS) preoperatively.</p></div><div><h3>Results</h3><p>Ten (50%) of 20 patients with GC &gt; 2.2 cm and 1 (5.9%) of 17 patients with GC &lt; 2.2 cm showed EMG/NCV abnormalities (p = 0.019). There was a correlation between the cyst size and the positive EMG/NCV findings (Correlation coefficient (CC) = 0.535, p &lt; 0.001). The preoperative peak torque deficit on the external rotation was correlated with the positive EMG/NCV findings (CC = 0.373, p = 0.021). The PTD was improved significantly at 1 year postoperatively in patients with a GC size &gt;2.2 cm (p = 0.029). The cyst size was not related to the preoperative pain VAS and muscle power.</p></div><div><h3>Conclusions</h3><p>The spinoglenoid cyst size &gt;2.2 cm, but not pain severity or muscle power, correlates with the positive finding of EMG for compressive suprascapular neuropathy. The GC size &gt;2.2 cm can be a reference to decide the need of decompression surgery.</p></div><div><h3>Level of evidence</h3><p>IV, case series.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680251","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
期刊
Journal of Orthopaedic Science
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