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Operative management of osteochondral lesions of the talus: 2024 recommendations of the working group 'clinical tissue regeneration' of the German Society of Orthopedics and Traumatology (DGOU). 距骨骨软骨损伤的手术治疗:德国矫形与创伤学会(DGOU)"临床组织再生 "工作组的 2024 年建议。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-05 DOI: 10.1530/EOR-23-0075
Markus Walther, Oliver Gottschalk, Matthias Aurich

The working group 'Clinical Tissue Regeneration' of the German Society of Orthopedics and Traumatology (DGOU) issues this paper with updating its guidelines. Literature was analyzed regarding different topics relevant to osteochondral lesions of the talus (OLT) treatment. This process concluded with a statement for each topic reflecting the best scientific evidence available with a grade of recommendation. All group members rated the statements to identify possible gaps between literature and current clinical practice. Fixation of a vital bony fragment should be considered in large fragments. In children with open physis, retrograde drilling seems to work better than in adults, but even there, the revision rate reaches 50%. The literature supports debridement with bone marrow stimulation (BMS) in lesions smaller than 1.0 cm² without bony defect. The additional use of a scaffold can be recommended in lesions larger than 1.0 cm². For other scaffolds besides AMIC®/Chondro-Gide®, there is only limited evidence. Systematic reviews report good to excellent clinical results in 87% of the patients after osteochondral transplantation (OCT), but donor site morbidity is of concern, reaching 16.9%. There is no evidence of any additional benefit from autologous chondrocyte implantation (ACI). Minced cartilage lacks any supporting data. Metallic resurfacing of OLT can only be recommended as a second-line treatment. A medial malleolar osteotomy has a minor effect on the clinical outcome compared to the many other factors influencing the clinical result.

德国矫形与创伤学会(DGOU)"临床组织再生 "工作组发布了这份更新指南的文件。我们分析了与距骨骨软骨损伤(OLT)治疗相关的不同主题的文献。在此过程中,每个主题都有一份声明,反映了现有的最佳科学证据,并给出了推荐等级。所有小组成员对声明进行评分,以确定文献与当前临床实践之间可能存在的差距。对于大块骨质碎片,应考虑固定重要的骨质碎片。对于有开放性髋臼的儿童,逆行钻孔的效果似乎比成人好,但即便如此,翻修率仍高达50%。文献支持对小于 1.0 平方厘米且无骨缺损的病变进行清创,同时进行骨髓刺激(BMS)。对于大于 1.0 平方厘米的病变,建议额外使用支架。关于 AMIC®/Chondro-Gide® 之外的其他支架,目前只有有限的证据。系统性综述报告显示,87%的患者在接受骨软骨移植(OCT)后取得了良好至卓越的临床效果,但供体部位的发病率令人担忧,达到16.9%。没有证据表明自体软骨细胞移植(ACI)能带来额外的益处。碎软骨缺乏任何支持性数据。OLT的金属重铺只能作为二线治疗推荐使用。与影响临床结果的许多其他因素相比,内侧踝骨截骨术对临床结果的影响较小。
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引用次数: 0
Treatment of unilateral cervical facet fractures without evidence of dislocation or subluxation: a narrative review and proposed treatment algorithm. 无脱位或半脱位证据的单侧颈椎面骨骨折的治疗:叙述性综述和建议的治疗算法。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-05 DOI: 10.1530/EOR-23-0161
Juan Ignacio Cirillo, Guillermo A Ricciardi, Facundo Lisandro Alvarez Lemos, Alfredo Guiroy, Ratko Yurac, Klaus Schnake

Isolated cervical spine facet fractures are often overlooked. The primary imaging modality for diagnosing these injuries is a computed tomography scan. Treatment of unilateral cervical facet fractures without evidence of dislocation or subluxation remains controversial. The available evidence regarding treatment options for these fractures is of low quality. Risk factors associated with the failure of nonoperative treatment are: comminution of the articular mass or facet joint, acute radiculopathy, high body mass index, listhesis exceeding 2 mm, fragmental diastasis, acute disc injury, and bilateral fractures or fractures that adversely affect 40% of the intact lateral mass height or have an absolute height of 1 cm.

孤立性颈椎面骨骨折经常被忽视。诊断这些损伤的主要成像方式是计算机断层扫描。对于无脱位或半脱位证据的单侧颈椎面骨骨折的治疗仍存在争议。有关这些骨折治疗方案的现有证据质量不高。与非手术治疗失败相关的风险因素包括:关节肿块或面关节粉碎、急性根性神经病、体重指数高、畸形超过2毫米、骨折片松弛、急性椎间盘损伤、双侧骨折或骨折对完整侧块高度的40%造成不利影响或绝对高度达到1厘米。
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引用次数: 0
What factors are associated with osteoarthritis after cementation for benign aggressive bone tumor of the knee joint: a systematic review and meta-analysis. 膝关节良性侵袭性骨肿瘤骨水泥术后骨关节炎与哪些因素有关:系统回顾和荟萃分析。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-05 DOI: 10.1530/EOR-23-0189
Serkan Bayram, Ahmet Salduz, Ahmet Müçteba Yıldırım, Korhan Özkan, Levent Eralp, Harzem Özger

Background: The current systematic review aimed to answer the following questions: (i) Does extended curettage combined with the PMMA technique for the treatment of aggressive bone tumors around the knee led to the development of knee osteoarthritis? (ii) What factors are associated with osteoarthritis after bone cementation around the knee joint?

Methods: This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All electronic searches were performed on November 20, 2022, by a single researcher who evaluated the full texts of potentially eligible studies to determine inclusion. In these patients, the presence of osteoarthritis secondary to the surgical procedure was investigated. Data extracted included study type, characteristics of participants, sample size, gender, tumor site (femur or tibia), secondary osteoarthritis, tumor volume, distance from the joint cartilage, reoperation, follow-up time, Campanacci grade, and pathological fracture.

Results: In total, 11 studies comprising 204 patients were evaluated, and it was found that 61 (30%) patients developed knee osteoarthritis due to extensive curettage and bone cement application for benign aggressive tumor treatment. According to the results obtained based the random effects model with the 11 studies included in the meta-analysis, the mean odds ratio of development knee OA with the 95% CI was calculated as -2.77 (-3.711, -1.83), which was statistically significant (z = -5.79; P < 0.000).

Conclusion: The association of distance between the tumor and joint cartilage and development of osteoarthritis was not shown in this meta-analysis.

Level of evidence: Level IV prognostic study.

背景:本系统综述旨在回答以下问题:(i) 延长刮治术结合PMMA技术治疗膝关节周围侵袭性骨肿瘤是否会导致膝关节骨关节炎的发生?(ii) 膝关节周围骨水泥术后骨关节炎与哪些因素有关?本研究根据《系统综述和荟萃分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)指南进行。所有电子检索均于2022年11月20日进行,由一名研究人员对可能符合条件的研究进行全文评估,以确定是否纳入。在这些患者中,调查了是否存在继发于外科手术的骨关节炎。提取的数据包括研究类型、参与者特征、样本大小、性别、肿瘤部位(股骨或胫骨)、继发性骨关节炎、肿瘤体积、与关节软骨的距离、再次手术、随访时间、Campanacci分级和病理骨折:共对11项研究的204名患者进行了评估,结果发现,61名(30%)患者因良性侵袭性肿瘤治疗中的大面积刮除和骨水泥应用而导致膝关节骨关节炎。根据纳入荟萃分析的 11 项研究的随机效应模型得出的结果,计算出患膝关节 OA 的平均几率比(95% CI)为-2.77(-3.711,-1.83),具有统计学意义(z = -5.79;P <0.000):结论:该荟萃分析未显示肿瘤与关节软骨之间的距离与骨关节炎的发生有关:IV级预后研究。
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引用次数: 0
Influence of patients' preoperative expectations on postoperative outcomes after total knee or hip arthroplasty: a systematic review. 患者术前期望对全膝关节或髋关节置换术后效果的影响:系统性综述。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-02-01 DOI: 10.1530/EOR-23-0087
Yvet Mooiweer, Lina Roling, Margaret Vugrin, Lena Ansmann, Martin Stevens, Gesine H Seeber

Purpose: The association between preoperative expectations and treatment outcomes in total hip arthroplasty (THA) or total knee arthroplasty (TKA) is still unclear. Therefore the aim is to examine the association between preoperative outcome expectations, process expectations, and self-efficacy, and the postoperative outcomes overall outcome, pain, function, stiffness, satisfaction, and quality of life following THA/TKA.

Methods: A systematic review with narrative synthesis was conducted. PubMed, EMBASE, PsycINFO, CINAHL and Cochrane Library were searched from inception to October 17, 2022. Included were prospective longitudinal cohort studies published in English, German, or Dutch, with an adult population undergoing THA/TKA, and including at least one measure of preoperative expectations and the postoperative outcomes mentioned earlier. Two independent reviewers screened the retrieved articles for eligibility, a third solved disagreements. Risk of bias (RoB) was assessed using the QUIPS tool.

Results: Of the 50 included studies, 38 had high RoB and 12 moderate RoB. Unadjusted results suggest a positive association between preoperative outcome expectations and overall outcome in the medium and long term, and between self-efficacy and change in 'overall outcome' in the long term. Adjusted results suggest positive associations between outcome expectations and function and between self-efficacy and overall outcome in the medium term, and for outcome expectations with pain and change in pain, respectively, and self-efficacy and stiffness in the long term.

Conclusions: Preoperative expectations show a possible positive association with specific outcome measures, such as pain or function. For future research, it is advised to link matching specific expectations with specific outcomes.

目的:全髋关节置换术(THA)或全膝关节置换术(TKA)的术前期望与治疗结果之间的关系尚不清楚。因此,本文旨在研究术前结果预期、过程预期和自我效能与 THA/TKA 术后总体结果、疼痛、功能、僵硬度、满意度和生活质量之间的关系:方法:采用叙事综合法进行系统综述。检索了从开始到 2022 年 10 月 17 日的 PubMed、EMBASE、PsycINFO、CINAHL 和 Cochrane Library。所纳入的是以英语、德语或荷兰语发表的前瞻性纵向队列研究,研究对象为接受 THA/TKA 手术的成人,至少包括一项术前预期和上述术后结果的测量指标。两位独立审稿人对检索到的文章进行了资格筛选,第三位审稿人解决了分歧。采用 QUIPS 工具评估偏倚风险(RoB):结果:在纳入的 50 项研究中,38 项研究的偏倚风险较高,12 项研究的偏倚风险中等。未经调整的结果表明,术前结果预期与中长期总体结果之间以及自我效能与长期 "总体结果 "变化之间存在正相关。调整后的结果表明,在中期,结果预期与功能、自我效能与总体结果之间存在正相关,在长期,结果预期分别与疼痛和疼痛变化、自我效能与僵硬程度存在正相关:结论:术前期望可能与疼痛或功能等特定结果指标呈正相关。结论:术前期望与疼痛或功能等特定结果指标之间可能存在正相关,建议今后的研究将特定期望与特定结果联系起来。
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引用次数: 0
Superficial acral fibromyxoma: insights from case management and comprehensive literature review. 浅表性肩峰纤维瘤:病例管理和综合文献综述的启示。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-02-01 DOI: 10.1530/eor-23-0151
Han Ling Tan, Tunku Sara Ahmad, C Sankara Kumar, Yohan Khirusman Adnan, Lai Meng Looi, Jayaletchumi Gunasagaran
Superficial acral fibromyxoma, also known as digital fibromyxoma, is a slow-growing, benign, solitary soft tissue tumor. First described in 2001 by Fetsch et al., it is a condition that often occurs in middle-aged individuals. However, it has also been reported across a wide range of ages, ranging from 4 to 86 years, with males more commonly reported. The condition often presents as solitary soft tissue swelling over the periungual or subungual. We present the management experience of the rare presentation of this rare tumor and a detailed review of the past literature on this condition. Detailed management of the condition has been described, along with the outcome after 2 years of follow-up and treatment experience. Our detailed analysis shows that 2 years is the shortest duration of follow-up to rule out recurrence. Hence, most of the cases reported earlier had given the false sense of the recurrence rate of the tumor, which could lead to undertreatment of the condition. The purpose of this article is to allow the readers to understand better the tumor's characteristics with bone involvement and the tumor's diagnostic strategies and treatment options.
浅表暗疮纤维瘤又称数字纤维瘤,是一种生长缓慢、良性的单发软组织肿瘤。Fetsch 等人于 2001 年首次描述了这种疾病,它通常发生在中年人身上。但也有报道称,该病的年龄跨度很大,从 4 岁到 86 岁不等,男性更常见。这种疾病通常表现为真皮周围或真皮下的单发软组织肿胀。我们介绍了这种罕见肿瘤的罕见表现的治疗经验,并详细回顾了过去有关该病症的文献。我们介绍了详细的处理方法,以及 2 年随访后的结果和治疗经验。我们的详细分析显示,2 年是排除复发的最短随访时间。因此,之前报道的大多数病例都误认为肿瘤的复发率很高,从而导致治疗不当。本文旨在让读者更好地了解肿瘤累及骨骼的特点,以及肿瘤的诊断策略和治疗方案。
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引用次数: 0
Letter to the editor: 'The history of the development of the regular straight stem in hip arthroplasty'. 致编辑的信:"髋关节置换术中常规直柄的发展史"。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-02-01 DOI: 10.1530/EOR-23-0171
Guido Grappiolo, Edoardo Guazzoni, Francesco Manlio Gambaro, Mattia Loppini
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引用次数: 0
Reply to the Letter to the editor from Grappiolo G et al. to the article 'The History of the development of the regular straight stem in hip arthroplasty'. 回复 Grappiolo G 等人写给编辑的信,回复 "髋关节置换术中常规直柄的发展历史 "一文。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-02-01 DOI: 10.1530/EOR-23-0177
Hanna Wellauer, Roman Heuberger, Emanuel Gautier, Moritz Tannast, Hubert Steinke, Peter Wahl
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引用次数: 0
Correction of rotational deformities in long bones using guided growth: a scoping review. 利用引导生长法矫正长骨旋转畸形:范围综述。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-02-01 DOI: 10.1530/eor-23-0149
Ahmed Halloum, Søren Kold, Jan Duedal Rölfing, Ahmed A Abood, Ole Rahbek
The objective of this scoping review was to describe the extent and type of evidence of using guided growth to correct rotational deformities of long bones in children.
本次范围界定审查的目的是描述使用引导生长法矫正儿童长骨旋转畸形的程度和证据类型。
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引用次数: 0
Systematic literature review of in vivo rat femoral defect models using biomaterials to improve the induced membrane technique: a comprehensive analysis. 使用生物材料改进诱导膜技术的体内大鼠股骨缺损模型的系统文献综述:综合分析。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-02-01 DOI: 10.1530/EOR-23-0055
Marc Saab, Cédric Zobrist, Nicolas Blanchemain, Bernard Martel, Feng Chai

Purpose: The aim of this study was to conduct a systematic literature review analyzing the results of in vivo rat femoral defect models using biomaterials for improving the induced membrane technique (IMT).

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, Embase, and Web of Science databases were searched. Inclusion criteria were studies reporting results of the IMT in in vivo rat femoral critical-sized defect models using a biomaterial possibly combined with molecules. Methodologic quality was assessed with the Animal Research: Reporting In Vivo Experiments guidelines.

Results: Twenty studies met the inclusion criteria. Femoral stabilization with plate and screws was the most frequent. Histologic, biomechanical, and/or radiologic analyses were performed. In two-stage strategies, the PMMA spacer could be associated with bioactive molecules to enhance IM growth factor expression and improve bone formation. Modulating the roughness of spacers could increase IM thickness and accelerate its formation. In one-stage strategies, human tissue-derived membranes combined with bone grafting achieved bone formation comparable to a standard IMT. All calcium phosphate grafts seemed to require a functionalization with growth factors or bone marrow mononuclear cells to improve outcomes compared with non-functionalized grafts.

Conclusion: This systematic review described the main parameters of the in vivo rat femoral defect models using biomaterials to improve the induced membrane technique. Although the studies included had several methodological limitations that may limit the scope of these conclusions, one- and two-stage strategies reported promising results with biomaterials to improve the IMT.

目的:本研究旨在进行系统性文献综述,分析使用生物材料改善诱导膜技术(IMT)的体内大鼠股骨缺损模型的结果:根据《系统综述和元分析首选报告项目》指南,在 PubMed、Embase 和 Web of Science 数据库中进行了检索。纳入标准是报告在体内大鼠股骨临界大小缺损模型中使用可能与分子相结合的生物材料进行 IMT 的结果的研究。方法学质量根据《动物研究:结果:结果:20 项研究符合纳入标准。使用钢板和螺钉稳定股骨的研究最多。研究进行了组织学、生物力学和/或放射学分析。在两阶段策略中,PMMA 垫片可与生物活性分子结合,以增强 IM 生长因子的表达并改善骨形成。调节垫片的粗糙度可增加 IM 厚度并加速其形成。在单阶段策略中,人体组织衍生膜结合骨移植可实现与标准 IMT 相当的骨形成。与未功能化的移植物相比,所有磷酸钙移植物似乎都需要使用生长因子或骨髓单核细胞进行功能化,以提高疗效:本系统综述描述了使用生物材料改善诱导膜技术的体内大鼠股骨缺损模型的主要参数。尽管所纳入的研究在方法上存在一些局限性,可能会限制这些结论的范围,但一阶段和两阶段策略报告了使用生物材料改善IMT的良好结果。
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引用次数: 0
Effectiveness of functional or biomechanical bandages with athletic taping and kinesiotaping in subjects with chronic ankle instability: a systematic review and meta-analysis. 功能性绷带或生物力学绷带、运动绑带和运动塑形对慢性踝关节不稳定患者的疗效:系统回顾和荟萃分析。
IF 3.4 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-02-01 DOI: 10.1530/eor-23-0129
Gema Chamorro-Moriana, Veronica Perez-Cabezas, Marisa Benitez-Lugo
The aim of the study was to analyze the effects of functional or biomechanical bandages, whether elastic or inelastic, in Chronic Ankle Instability (CAI).
这项研究旨在分析功能性或生物力学绷带(弹性或非弹性绷带)对慢性踝关节不稳定(CAI)的影响。
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引用次数: 0
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Efort Open Reviews
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