BMC Musculoskeletal Disorders最新文献

Objective: To compare perioperative outcomes and early functional recovery between AI-robotic and conventional total knee arthroplasty (TKA).

Methods: We retrospectively analyzed data from 88 patients who underwent primary unilateral TKA for knee osteoarthritis between April 2024 and December 2024. The AI-robotic group (n = 44) received AI-assisted preoperative planning and robot-assisted TKA, while the traditional group (n = 44) underwent conventional 2D templating and manual TKA. Key metrics included preoperative prosthesis prediction accuracy, intraoperative and postoperative blood loss, osteotomy time, postoperative radiographic alignment, and functional scores.

Results: The AI-robotic group showed significantly higher prosthesis prediction accuracy (femoral: 79.5% vs. 52.3%, P = 0.023; tibial: 84.1% vs. 61.4%, P = 0.042), shorter osteotomy time (15.24 ± 4.71 vs. 18.43 ± 4.76 min, P = 0.002), reduced intraoperative blood loss (197.41 ± 78.41 vs. 234.35 ± 74.53 mL, P = 0.026), and lower 72-hour total blood loss (1022.96 ± 226.14 vs. 1118.71 ± 193.30 mL, P = 0.036). Postoperative lateral femoral component (LFC) angles were superior in the AI-robotic group (5.87 ± 2.18° vs. 6.91 ± 2.10°, P = 0.025). At 6 weeks, the AI-robotic group had better VAS pain scores (2.27 ± 1.12 vs. 2.84 ± 1.22, P = 0.029) and HSS scores (61.57 ± 4.40 vs. 59.59 ± 3.80, P = 0.027).

Conclusion: AI-assisted preoperative planning with robotic TKA improves prosthesis sizing accuracy, reduces perioperative blood loss and 72 h total blood loss, and enhances early functional outcomes compared to conventional methods. These findings support AI-robotic integration as a precision solution for TKA, particularly in complex cases.

Background and objective: Resistance training is the cornerstone of sarcopenia management. However, whether combining it with amino acid-based supplementation, including essential amino acids, branched-chain amino acids, leucine, and derivatives such as HMB, provides additional benefits remains unclear.

Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials until February 2025. Meta- and subgroup analyses were performed using a random-effects model. The Cochrane ROB2 tool and GRADE framework were used to assess the risk of bias and evidence certainty.

Results: We included nine randomized controlled trials involving 496 participants with sarcopenia. Evidence rated as low to very low certainty indicated that, compared with resistance training alone, combined amino acid supplementation and resistance training significantly improved handgrip strength (SMD = 0.69, 95% CI: 0.04 to 1.35), gait speed (SMD = 0.64, 95% CI: 0.02 to 1.25), Short Physical Performance Battery scores (SMD = 1.69, 95% CI: 0.81 to 2.57), and Five Times Sit-to-Stand Test performance (SMD = -1.42, 95% CI: -2.68 to -0.16). No significant effects were observed for skeletal muscle mass index or appendicular skeletal muscle mass. Subgroup analyses showed that baseline protein intake, intervention setting, amino acid supplement type, resistance-training frequency, and whether the supplement contained co-nutrients were significant effect modifiers.

Conclusion: Resistance training combined with amino acid supplementation may improve muscle strength and physical function in older adults with sarcopenia, although effects on muscle mass remain limited. Responsiveness to the intervention may vary by baseline protein intake, training frequency, setting, type of amino acid supplementation, and whether the supplement includes co-nutrients, all of which should be considered when designing sarcopenia management strategies.

Background: The 2023 armed conflict in Sudan disrupted higher education and forced a sudden shift to remote learning. This transition altered students' physical habits, posture, and daily routines, potentially increasing the risk of musculoskeletal disorders (MSDs). Evidence regarding the musculoskeletal impact of such disruption among medical students in conflict-affected contexts remains scarce.

Objective: To assess the prevalence, patterns, and predictors of musculoskeletal symptoms among Sudanese medical students engaged in remote learning during the 2023-2024 conflict.

Method: We conducted a cross-sectional study between May and August 2024 among 421 medical students who were engaged in remote learning during the conflict across more than 15 Sudanese universities. Participants completed a validated online questionnaire adapted from a Greek study.Data collected included demographics, remote learning habits, posture, and musculoskeletal complaints. Paired data were analyzed using McNemar's chi-squared test and paired t-tests, while group comparisons were conducted using the Kruskal-Wallis test and Pearson's chi-square test. Results are reported with 95% confidence intervals (CI).

Results: Participants' mean age was 22.3 ± 2.3 years; 71% were female. Physical inactivity increased from 25% (95% CI [21%, 30%]) before the conflict to 45% (95% CI [41%, 50%]) during it (p < 0.001). Daily musculoskeletal pain prevalence rose from 23% (95% CI [19%, 27%]) to 32% (95% CI [27%, 37%]) (p < 0.001), and mean pain intensity increased from 3.4 ± 2.0 (95% CI [3.2, 3.6]) to 4.4 ± 2.2 (95% CI [4.2, 4.6]). Prolonged screen exposure (>6 hours/day) was significantly associated with higher pain frequency (P-value = 0.020).

Conclusions: MSDs were highly prevalent among Sudanese medical students during conflict-related remote learning. Female gender, poor ergonomic posture, and extended screen time were major associated factors. The findings emphasize the need for ergonomic awareness programs, structured physical activity, and improved learning setups in conflict and low-resource settings.

Background: Patient-reported outcome measures (PROMs) are increasingly used to assess treatment effectiveness in various domains from the patients' perspective. This systematic review aimed to identify what PROMs have been used in hip fracture clinical trials, whether they are used as the primary outcome, whether validity evidence is referenced and how their use has changed over time.

Methods: Studies obtained from PubMed, Embase, and Web of Science published between 01/01/2010 and 29/09/2025 were assessed. Eligible studies were controlled trials on hip fracture interventions in adult populations published in English. We checked the reference for validity evidence of PROMs used in included studies. Characteristics of each study were extracted, and PROMs usage was summarised by year of publication.

Results: A total of 28 different PROMs were used in 189 trials, with each covering different outcome domains. The most used PROMs were Harris hip score, EuroQoL-5D and pain visual analogue scale. A predominant proportion of studies (n = 162, 85.7%) utilised at least one PROMs, including 65 studies used multiple PROMs. There is an increasing trend of PROMs usage in trials and the number of papers using a PROM as a primary outcome over time. However, 95 studies did not reference any validity evidence for PROMs used.

Conclusion: The frequent usage of PROMs in trials, and often as a primary outcome, suggests patient perspective is valued when evaluating hip fracture intervention. However, the lack of a single PROM covering all outcome domains necessitates using more than one PROMs in the included trials. A more comprehensive PROM or a core set of PROMs that measures all patient-related outcomes would achieve a holistic assessment and the ability to make direct comparisons between different interventions.