new orthopaedic research topics

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Orthopaedics articles from across Nature Portfolio

Orthopaedics is a medical specialty concerned with the prevention and treatment of disorders of the musculoskeletal system by use of surgical and non-surgical methods.

Latest Research and Reviews

Histological and immunohistochemical analyses of articular cartilage during onset and progression of pre- and early-stage osteoarthritis in a rodent model

• Ikufumi Takahashi
• Keisuke Takeda
• Masahiro Hoso

Effects of static exercises on hip muscle fatigue and knee wobble assessed by surface electromyography and inertial measurement unit data

• Olivia L. Dyer
• Mark A. Seeley
• Benjamin B. Wheatley

Finite element study on the micromechanics of cement-augmented proximal femoral nail anti-rotation (PFNA) for intertrochanteric fracture treatment

• Liqin Zheng

Impact of specialized fatigue and backhand smash on the ankle biomechanics of female badminton players

• Zhanyang He

Electrocardiographic abnormalities in patients with microtia

• Xiaoying Tian

Comparative analysis of the quality of life regarding patients who underwent hip replacement in public versus private hospitals in Hungary

• Luca Fanni Kajos
• Bálint Molics

News and Comment

Long-lived biomaterials

The design of implantable biomaterials with lasting function is rooted in biomolecular and cellular principles.

Joint implants: An elution solution

An optimized drug-eluting polymer for the surface of articulating artificial joints may make them infection-free.

• Noreen J. Hickok

Neuronal origin of osteogenic effects of magnesium

• David Holmes

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Page 1 of 102

Comparison of minimally invasive transforaminal lumbar interbody fusion and midline lumbar interbody fusion in patients with spondylolisthesis

This study aimed to compare surgical outcomes, clinical outcomes, and complications between minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and midline lumbar interbody fusion (MIDLIF) in ...

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Correction: A risk prediction model for postoperative recovery of closed calcaneal fracture: a retrospective study

The original article was published in Journal of Orthopaedic Surgery and Research 2020 15 :100

The varying clinical effectiveness of single, three and five intraarticular injections of platelet-rich plasma in knee osteoarthritis

To investigate the variations in clinical effectiveness among patients diagnosed with knee osteoarthritis who underwent intra-articular administration of platelet-rich plasma using single, triple, or quintuple...

Total knee arthroplasty following lateral closing-wedge high tibial osteotomy versus primary total knee arthroplasty: a propensity score matching study

The disparity in patient-reported outcomes between total knee arthroplasty (TKA) following high tibial osteotomy (HTO) and primary TKA has yet to be fully comprehended. This study aims to compare the patient-r...

Comparison of the forearm rotation restriction capacities of four upper-extremity immobilization methods: there is no difference between single and double sugar tong splinting

The aim of this study was to compare the effects of four different immobilization methods [single sugar tong splint (SSTS), double sugar tong splint (DSTS), short arm cast (SAC), and long arm cast (LAC)] commo...

Evaluating lumbar disc degeneration by MRI quantitative metabolic indicators: the perspective of factor analysis

This study aimed to investigate an early diagnostic method for lumbar disc degeneration (LDD) and improve its diagnostic accuracy.

Effects of various load magnitudes on ACL: an in vitro study using adolescent porcine stifle joints

The escalating incidence of anterior cruciate ligament (ACL) injuries, particularly among adolescents, is a pressing concern. The study of ACL biomechanics in this demographic presents challenges due to the sc...

Demonstrating the effectiveness of intra-articular prolotherapy combined with peri-articular perineural injection in knee osteoarthritis: a randomized controlled trial

This study aimed to compare the efficacy of intra-articular prolotherapy (IG) combined with peri-articular perineural injection (PG) in the management of knee osteoarthritis (KOA).

Precise execution of personalized surgical planning using three-dimensional printed guide template in severe and complex adult spinal deformity patients requiring three-column osteotomy: a retrospective, comparative matched-cohort study

The surgical treatment of severe and complex adult spinal deformity (ASD) commonly required three-column osteotomy (3-CO), which was technically demanding with high risk of neurological deficit. Personalized t...

Factors influencing the posterior cruciate ligament buckling phenomenon—a multiple linear regression analysis of bony and soft tissue structures of the knee joint

To determine whether posterior cruciate ligament (PCL) buckling (angular change) is associated with anterior cruciate ligament (ACL) status (intact or ruptured), meniscal bone angle (MBA), anterior tibial tran...

Randomised controlled trial of tourniquet associated pain generated in lower limb after exsanguination by Esmarch bandage versus limb elevation

Tourniquets are common adjuncts in the operating theatre but can be associated with post-operative pain. This study was designed to compare what effect pre-tourniquet Esmarch bandage exsanguination has on pain...

Correction: Impact of preoperative anemia on patients undergoing total joint replacement of lower extremity: a systematic review and meta-analysis

Effectiveness and safety of polyacrylamide hydrogel injection for knee osteoarthritis: results from a 12-month follow up of an open-label study.

There are few effective osteoarthritis (OA) therapies. A novel injectable polyacrylamide hydrogel (iPAAG) previously demonstrated efficacy and safety up to week 26 in an open-label study of knee OA. Here we re...

Three-dimensional printed custom-made modular talus prosthesis in patients with talus malignant tumor resection

Talar malignant tumor is extremely rare. Currently, there are several alternative management options for talus malignant tumor including below-knee amputation, tibio-calcaneal arthrodesis, and homogenous bone ...

Comparative effectiveness of low-level laser therapy versus muscle energy technique among diabetic patients with frozen shoulder: a study protocol for a parallel group randomised controlled trial

Diabetes mellitus is one of the fastest-growing health challenges of the twenty-first century with multifactorial impact including high rates of morbidity and mortality as well as increased healthcare costs. I...

Intelligent robot-assisted fracture reduction system for the treatment of unstable pelvic fractures

Precise and minimally invasive closed reduction is the premise of minimally invasive internal fixation. This paper aims to explore the safety and efficacy of a robot-assisted fracture reduction system (RAFR) i...

Preoperative handgrip strength can predict early postoperative shoulder function in patients undergoing arthroscopic rotator cuff repair

Rotator cuff tears (RCTs) are a common musculoskeletal disorder, and arthroscopic rotator cuff repair (ARCR) is widely performed for tendon repair. Handgrip strength correlates with rotator cuff function; howe...

Efficacy of PE-PLIF with a novel ULBD approach for lumbar degeneration diseases: a large-channel endoscopic retrospective study

This study aims to assess the effectiveness of Percutaneous Endoscopic Posterior Lumbar Interbody Fusion (PE-PLIF) combined with a novel Unilateral Laminotomy for Bilateral Decompression (ULBD) approach using ...

Critical distance of the sacroiliac joint for open reduction using screw fixation for traumatic sacroiliac joint diastasis: a retrospective study

Osteosynthesis for sacroiliac joint (SIJ) diastasis using an iliosacral screw (ISS) and a trans-iliac-trans-sacral screw (TITSS) can be performed using a closed or an open method. However, no clear indication ...

Combined with the first dorsal (plantar) metatarsal artery pedicle free bilobed flap with a cell scaffold for the repair of a mid-distal adjacent finger defect: a retrospective study

Assessing the clinical effectiveness of combining with the first dorsal (plantar) metatarsal artery pedicle free bilobed flap with a cell scaffold to repair mid-distal defects in adjacent fingers.

Different radius of curvature at the talus trochlea from northern Chinese population measured using 3D model

To analyze the curvature characteristics of the talus trochlea in people from northern China in different sex and age groups.

Research progress in the pathogenesis of hormone-induced femoral head necrosis based on microvessels: a systematic review

Hormonal necrosis of the femoral head is caused by long-term use of glucocorticoids and other causes of abnormal bone metabolism, lipid metabolism imbalance and blood microcirculation disorders in the femoral ...

Investigating the impact of cartilaginous endplate herniation on recovery from percutaneous endoscopic lumbar discectomy

This study aimed to evaluate the influence of herniation of cartilaginous endplates on postoperative pain and functional recovery in patients undergoing percutaneous endoscopic lumbar discectomy (PELD) for lum...

Outcomes of surgical treatment of patellar instability in children with Down syndrome

patellar instability is a relatively frequent musculoskeletal disorder in children with Down syndrome (DS). However, such a condition has seldom been studied in the literature, even less its surgical treatment...

Positive buttress reduction in femoral neck fractures: a literature review

Femoral neck fractures (FNFs) in young adults are usually caused by high-energy trauma, and their treatment remains a challenging issue for orthopedic surgeons. The quality of reduction is considered an import...

Clinical effect of full endoscopic lumbar annulus fibrosus suture

The aim of this study was to investigate the clinical efficacy of full endoscopic lumbar annulus fibrosus suture in the treatment of single-segment lumbar disc herniation (LDH).

Upregulation of circ_0076684 in osteosarcoma facilitates malignant processes by mediating miRNAs/CUX1

Circular RNAs (circRNAs) are a newly appreciated type of endogenous noncoding RNAs that play vital roles in the development of various human cancers, including osteosarcoma (OS). In this study, we investigated...

A Novel growth guidance system for early onset scoliosis: a preliminary in vitro study

The purpose of the study was to describe a novel growth guidance system, which can avoid metal debris and reduce the sliding friction forces, and test the durability and glidability of the system by in vitro t...

Biomechanical and clinical outcomes of 3D-printed versus modular hemipelvic prostheses for limb-salvage reconstruction following periacetabular tumor resection: a mid-term retrospective cohort study

Debates persist over optimal pelvic girdle reconstruction after acetabular tumor resection, with surgeons grappling between modular and 3D-printed hemipelvic endoprostheses. We hypothesize superior outcomes wi...

CircPRKD3/miR-6783-3p responds to mechanical force to facilitate the osteogenesis of stretched periodontal ligament stem cells

The mechanotransduction mechanisms by which cells regulate tissue remodeling are not fully deciphered. Circular RNAs (circRNAs) are crucial to various physiological processes, including cell cycle, differentia...

Cross-cultural adaptation, reliability, validity and responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ-Sp) in Spain

The Michigan Hand Outcomes Questionnaire (MHQ) is a self-report tool widely recognized for measuring the health status of patients with hand and wrist problems from a multidimensional perspective . The aim of this...

The extracts of osteoblast developed from adipose-derived stem cell and its role in osteogenesis

Cell-based therapy has become an achievable choice in regenerative medicines, particularly for musculoskeletal disorders. Adipose-derived stem cells (ASCs) are an outstanding resource because of their ability ...

One-hole split endoscope versus unilateral biportal endoscopy for lumbar spinal stenosis: a retrospective propensity score study

The one-hole split endoscopy (OSE) was first proposed and clinically applied in China in 2019. The aim of this study was to compare the clinical efficacy of one-hole split endoscopy (OSE) and unilateral biport...

Robotic-assisted plate fixation of the anterior acetabulum - clinical description of a new technique

We present a detailed procedure for the robotic-assisted plate osteosynthesis of an anterior acetabular fracture. The purpose of this work was to describe a robotic-assisted minimally invasive technique as a p...

Risk factors for poor outcomes in patients with acute lower leg compartment syndrome: a retrospective study of 103 cases

The primary aim of this study was to investigate the risk factors associated with poor outcomes following acute compartment syndrome (ACS) of lower leg. The secondary objective was to determine if delayed fasc...

Relationship between lipid metabolism, coagulation and other blood indices and etiology and staging of non-traumatic femoral head necrosis: a multivariate logistic regression-based analysis

To analyze the relationship between lipid metabolism, coagulation function, and bone metabolism and the contributing factor and staging of non-traumatic femoral head necrosis, and to further investigate the fa...

Relationship between sarcopenia and fatty liver in middle-aged and elderly patients with type 2 diabetes mellitus

In this study, we investigated the relationship between sarcopenia and fatty liver in middle-aged and elderly patients diagnosed with type 2 diabetes mellitus (T2DM) to provide a theoretical foundation for the...

Impact of preoperative anemia on patients undergoing total joint replacement of lower extremity: a systematic review and meta-analysis

Preoperative anemia increases postoperative morbidity, mortality, and the risk of allogeneic transfusion. However, the incidence of preoperative anemia in patients undergoing total hip arthroplasty and total k...

Predictors of success of pharmacological management in patients with chronic lower back pain: systematic review

Conservative management is recommended as the first therapeutic step in chronic low back pain (LBP), but there is no available evidence regarding the possible effect of patients’ baseline characteristics on th...

Evaluation of the consistency of the MRI- based AI segmentation cartilage model using the natural tibial plateau cartilage

The study aims to evaluate the accuracy of an MRI-based artificial intelligence (AI) segmentation cartilage model by comparing it to the natural tibial plateau cartilage.

Robot-assisted anterior cruciate ligament reconstruction based on three-dimensional images

Background  Tunnel placement is a key step in anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the accuracy of bone tunnel drilling in arthroscopic ACL reconstruction assi...

Preoperative MRI-based endplate quality: a novel tool for predicting cage subsidence after anterior cervical spine surgery

The objective of this study was to examine the predictive value of a newly developed MRI-based Endplate Bone Quality (EBQ) in relation to the development of cage subsidence following anterior cervical discecto...

KLF5 promotes the ossification process of ligamentum flavum by transcriptionally activating CX43

Ossification of ligamentum flavum (OLF) is a prevalent degenerative spinal disease, typically causing severe neurological dysfunction. Kruppel-like factor 5 (KLF5) plays an essential role in the regulation of ...

Exosomes derived from M2 macrophages prevent steroid-induced osteonecrosis of the femoral head by modulating inflammation, promoting bone formation and inhibiting bone resorption

Inflammatory reactions are involved in the development of steroid-induced osteonecrosis of the femoral head(ONFH). Studies have explored the therapeutic efficacy of inhibiting inflammatory reactions in steroid...

Meta-analysis of the efficacy and safety of OLIF and TLIF in the treatment of degenerative lumbar spondylolisthesis

To systematically evaluate the difference in clinical efficacy between two surgical approaches, oblique lateral approach and intervertebral foraminal approach, in the treatment of degenerative lumbar spondylol...

Circ_0044235 regulates the development of osteoarthritis by the modulation of miR-375/PIK3R3 axis

Circular RNAs (circRNAs) play an important role in osteoarthritis (OA). However, the role of circRNA in OA is still unclear. Here, we explored the role and mechanism of circ_0044235 in OA.

Percutaneous kyphoplasty with or without posterior pedicle screw fixation for the management of severe osteoporotic vertebral compression fractures with nonunion

To assess the radiographic outcomes, clinical outcomes and complications of percutaneous kyphoplasty (PKP) with and without posterior pedicle screw fixation (PPSF) in the treatment of severe osteoporotic verte...

MiR-98-5p plays suppressive effects on IL-1β-induced chondrocyte injury associated with osteoarthritis by targeting CASP3

This study aims to explore how miR-98-5p affects osteoarthritis, focusing on its role in chondrocyte inflammation, apoptosis, and extracellular matrix (ECM) degradation.

Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis

Our study aimed to assess the effectiveness of the simplified S1 vertebral bone quality (VBQ) score in predicting the incidence of proximal junctional kyphosis (PJK) after surgery for degenerative lumbar scoli...

More anterior bone loss in middle vertebra after contiguous two-segment cervical disc arthroplasty

Contiguous two-segment cervical disc arthroplasty (CDA) is safe and effective, while post-operative radiographic change is poorly understood. We aimed to clarify the morphological change of the three vertebral...

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2022 Citation Impact 2.6 - 2-year Impact Factor 3.0 - 5-year Impact Factor 1.251 - SNIP (Source Normalized Impact per Paper) 0.744 - SJR (SCImago Journal Rank)

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Journal of Orthopaedic Surgery and Research

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Official Journal of the Italian Society of Orthopaedics and Traumatology

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Page 1 of 17

Metal-backed or all-poly tibial components: which are better for medial unicompartmental knee arthroplasty? A propensity-score-matching retrospective study at the 5-year follow-up

This retrospective medium-term follow-up study compares the outcomes of medial fixed-bearing unicompartmental knee arthroplasty (mUKA) using a cemented metal-backed (MB) or an all-polyethylene (AP) tibial comp...

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Unravelling variations: an examination of entry point selection in proximal femoral cephalomedullary nailing

The exact positioning of the cephalomedullary (CM) nail entry point for managing femoral fractures remains debatable, with significant implications for fracture reduction and postoperative complications. This ...

Autogenous structural bone graft reconstruction of ≥ 10-mm-deep uncontained medial proximal tibial defects in primary total knee arthroplasty

Management of uncontained medial proximal tibial defects during primary total knee arthroplasty (TKA) can be challenging, especially for defects ≥ 10 mm in depth. This study sought to assess the outcomes of au...

Polytherapy versus monotherapy in the treatment of tibial non-unions: a retrospective study

Treating tibial non-unions efficiently presents a challenge for orthopaedic trauma surgeons. The established gold standard involves implanting autologous bone graft with adequate fixation, but the addition of ...

Lateralising reverse shoulder arthroplasty using bony increased offset (BIO-RSA) or increasing glenoid component diameter: comparison of clinical, radiographic and patient reported outcomes in a matched cohort

This study aims to compare the range of motion (ROM) of reverse shoulder arthroplasty lateralised by bony increased offset (BIO-RSA) using a standard 38-mm (mm) component to regular reverse shoulder arthroplas...

Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery

The objective of this study is to investigate the risk of revision surgery when delaying anterior cruciate ligament reconstruction (ACLR) past 3 months or 6 months after injury.

Functional and oncological outcomes of patients with proximal humerus osteosarcoma managed by limb salvage

Osteosarcoma is the most common primary bone malignancy in skeletally immature patients. The proximal humerus is the third most common site of osteosarcoma. The literature shows a paucity of published data con...

Capacitive biophysical stimulation improves the healing of vertebral fragility fractures: a prospective multicentre randomized controlled trial

Capacitively coupling electric fields (CCEF) is a method of non-invasive biophysical stimulation that enhances fracture repair and spinal fusion. This multicentre randomized controlled trial aimed to further e...

Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

The purpose of this systematic review is to examine the outcomes, complications, and potential advantages of using anatomical interlocking intramedullary nails (IMN) in the treatment of radius and ulnar shaft ...

Evaluation of time to reimplantation as a risk factor in two-stage revision with static spacers for periprosthetic knee joint infection

We investigated the time to reimplantation (TTR) during two-stage revision using static spacers with regard to treatment success and function in patients with chronic periprosthetic joint infection (PJI) of th...

TikTok content as a source of health education regarding epicondylitis: a content analysis

This study aimed to assess the validity and informational value of TikTok content about epicondylitis. The hypothesis tested herein was that TikTok video content would not provide adequate and valid information.

Optimizing periprosthetic fracture management and in-hospital outcome: insights from the PIPPAS multicentric study of 1387 cases in Spain

The incidence of all periprosthetic fractures (PPF), which require complex surgical treatment associated with high morbidity and mortality, is predicted to increase. The evolving surgical management has create...

Unexpected early loosening of rectangular straight femoral Zweymüller stems with an alumina-reduced surface after total hip arthroplasty—a prospective, double-blind, randomized controlled trial

Alumina particles from the grit blasting of Ti-alloy stems are suspected to contribute to aseptic loosening. An alumina-reduced stem surface was hypothesized to improve osseointegration and show comparable sho...

Three-dimensional printed models can reduce costs and surgical time for complex proximal humeral fractures: preoperative planning, patient satisfaction, and improved resident skills

Proximal humeral fractures (PHFs) are still controversial with regards to treatment and are difficult to classify. The study’s objective is to show that preoperative planning performed while handling a three-d...

Reverse shoulder arthroplasty with a 155° neck-shaft angle inlay implant design without reattachment of the subscapularis tendon results in satisfactory functional internal rotation and no instability: a cohort study

The aim of this study was to use the Activities of Daily Living which require Internal Rotation (ADLIR) questionnaire to assess the functional internal rotation in patients who had undergone reverse shoulder a...

Direct anterior approach with conventional instruments versus robotic posterolateral approach in elective total hip replacement for primary osteoarthritis: a case–control study

The purpose of this study is to compare peri-operative and short-term outcomes in patients who underwent elective total hip replacement (THA) for primary osteoarthritis (OA) with direct anterior approach (DAA)...

The effect of cellular nuclear function alteration on the pathogenesis of shoulder adhesive capsulitis: an immunohistochemical study on lamin A/C expression

The network of intermediate filament proteins underlying the inner nuclear membrane forms the nuclear lamina. Lamins have been associated with important cellular functions: DNA replication, chromatin organizat...

All-epiphyseal anterior cruciate ligament reconstruction yields superior sports performances than the trans-epiphyseal technique in skeletally immature patients: a systematic review

Anterior cruciate ligament (ACL) tears in skeletally immature patients are increasingly common. Evidence comparing the outcomes of all-epiphyseal versus trans-epiphyseal ACL reconstruction in skeletally immatu...

Risk factors for early septic failure after two-stage exchange total knee arthroplasty for treatment of periprosthetic joint infection

The cause of early septic failure after two-stage exchange revision total knee arthroplasty (TKA) for chronic periprosthetic joint infection (PJI) and the factors affecting it are not well known. The purpose o...

Suprapatellar tibial fracture nailing is associated with lower rate for acute compartment syndrome and the need for fasciotomy compared with the infrapatellar approach

Intramedullary tibial nailing (IMN) is the gold standard for stabilizing tibial shaft fractures. IMN can be performed through an infra- or suprapatellar approach.

Preoperative antibiotic prophylaxis and the incidence of surgical site infections in elective clean soft tissue surgery of the hand and upper limb: a systematic review and meta-analysis

Surgical site infections (SSI) are the most frequent early complications of hand surgeries. However, the indications still remain uncertain for antibiotic prophylaxis in elective clean soft tissue surgeries of...

High satisfaction rate and range of motion can be expected in frozen shoulder after awake manipulation with brachial plexus block

Adhesive capsulitis (AC) is a disease of the glenohumeral joint that is characterized by pain and both passive and active global stiffness with a slow and insidious onset. The disease can occur spontaneously (...

Validation of Roussouly classification in predicting the occurrence of adjacent segment disease after short-level lumbar fusion surgery

Recent studies demonstrated that restoring sagittal alignment to the original Roussouly type can remarkably reduce complication rates after adult spinal deformity surgery. However, there is still no data provi...

Antithrombotic prophylaxis following total hip arthroplasty: a level I Bayesian network meta-analysis

Several clinical investigations have compared different pharmacologic agents for the prophylaxis of venous thromboembolism (VTE). However, no consensus has been reached. The present investigation compared enox...

Transforaminal lumbar interbody fusion with a tantalum cage: lumbar lordosis redistribution and sacral slope restoration with a modified posterior technique

Transforaminal lumbar interbody fusion (TLIF), a commonly used procedure in spine surgery, has the advantage of a lower incidence of nerve lesions compared to the posterior lumbar interbody fusion (PLIF) techn...

Arthrosis diagnosis and treatment recommendations in clinical practice: an exploratory investigation with the generative AI model GPT-4

The spread of artificial intelligence (AI) has led to transformative advancements in diverse sectors, including healthcare. Specifically, generative writing systems have shown potential in various applications...

Greater medial proximal tibial slope is associated with bone marrow lesions in middle-aged women with early knee osteoarthritis

Bone marrow lesion (BML) is an important magnetic resonance finding (MRI) finding that predicts knee osteoarthritis. The purpose of this study was to investigate the influence of proximal tibial morphology on ...

Reverse shoulder arthroplasty in obstetric brachial plexus injury: our experience with shoulder motion analysis

Obstetric brachial plexus injury (OBPI) is a weakening or paralysis of the upper arm caused by brachial plexus injury followed by a muscle paralysis with severe repercussions on the movement of the shoulder jo...

Clinical effects of different center of rotation reconstructions in total hip arthroplasty after femoral neck fractures: a cohort study including a follow-up analysis on patient’s mobility and daily living ability

The aim of this study is a clinical evaluation of the center of rotation (COR) placement towards a patient’s recovery with respect to daily living ability and mobility. In past experiments based on three-dimen...

Standard views do not suffice in assessing distal scaphoid articular cannulated screw penetration

Articular screw penetration is one of the most common hardware-related problems after scaphoid fracture fixation, occurring in up to two-thirds of patients, in particular into the scaphotrapezotrapezoidal (STT...

Complication rates after proximal femoral nailing: does level of training matter?

Surgical treatment of pertrochanteric fractures is one of the most performed surgeries in orthogeriatrics. Proximal femoral nailing, the most performed procedure, is often used as a training surgery for young ...

Bernese periacetabular osteotomy (PAO): from its local inception to its worldwide adoption

The development of the Bernese periacetabular osteotomy (PAO) is based on a structured approach starting with an analysis of the preexisting procedures to improve the coverage of the femoral head and was follo...

Correct positioning of the calcar screw leads to superior results in proximal humerus fractures treated with carbon-fibre-reinforced polyetheretherketone plate osteosynthesis with polyaxial locking screws

Plate osteosynthesis with implants made of carbon-fibre-reinforced polyetheretherketone (CFR-PEEK) has recently been introduced for the treatment of fractures of the proximal humerus (PHFs). The advantages of ...

LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment

Lateral, All-Round and All-Inside (LARAI) portal is a viewing or working portal for observing and repairing the lesions of the lateral meniscus. However, there are safety concerns about popliteal artery (PA) i...

Functional leg performance 2 years after ACL surgery: a comparison between InternalBrace™-augmented repair versus reconstruction versus healthy controls

While clinical and patient-reported outcomes have been investigated in patients after InternalBrace™-augmented anterior cruciate ligament repair (ACL-IB), less is known regarding restoration of functional perf...

Higher pelvic incidence values are a risk factor for trans-iliac trans-sacral screw malposition in sacroiliac complex fracture treatment

Percutaneous iliosacral (IS) screw fixation and trans-iliac trans-sacral (TITS) screw fixation are clinically effective treatments of posterior pelvic sacroiliac fractures. In order to accurately assess the sa...

Efficacy and safety of modular versus monoblock stems in revision total hip arthroplasty: a systematic review and meta-analysis

Both modular and monoblock tapered fluted titanium (TFT) stems are increasingly being used for revision total hip arthroplasty (rTHA). However, the differences between the two designs in clinical outcomes and ...

National spine surgery registries’ characteristics and aims: globally accepted standards have yet to be met. Results of a scoping review and a complementary survey

Surgery involving implantable devices is widely used to solve several health issues. National registries are essential tools for implantable device surveillance and vigilance. In 2017, the European Union encou...

Anterior debridement combined with autogenous iliac bone graft fusion for the treatment of lower cervical tuberculosis: a multicenter retrospective study

This study aimed to analyze the clinical efficacy of one-stage anterior debridement of lower cervical tuberculosis using iliac crest bone graft fusion and internal fixation.

Italian Orthopaedic and Traumatology Society (SIOT) position statement on the non-surgical management of knee osteoarthritis

Knee osteoarthritis (OA) is a chronic disease associated with a severe impact on quality of life. However, unfortunately, there are no evidence-based guidelines for the non-surgical management of this disease....

Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures

There is no evidence in the current literature about the best treatment option in sacral fracture with or without neurological impairment.

Intramedullary nailing versus cemented plate for treating metastatic pathological fracture of the proximal humerus: a comparison study and literature review

Pathological fracture of the humerus causes severe pain, limited use of the hand, and decreased quality of life. This study aimed to compare the outcomes of intramedullary nailing and locking plate in treating...

Not all questions are created equal: the weight of the Oxford Knee Scores questions in a multicentric validation study

The Oxford Knee Score (OKS) has been designed for patients with knee osteoarthritis and has a widespread use. It has 12 questions, with each question having the same weight for the overall score. Some authors ...

Are the outcomes of single-stage open reduction and Dega osteotomy the same when treating DDH in patients younger than 8 years old? A prospective cohort study

The primary objective was to report our early results after a one-stage procedure [open reduction (OR), Dega pelvic osteotomy (DPO), and femoral osteotomy (FO) when needed] for surgical management of a cohort ...

Carbon-fibre plates for traumatic and (impending) pathological fracture fixation: Where do we stand? A systematic review

Carbon-fibre (CF) plates are increasingly used for fracture fixation. This systematic review evaluated complications associated with CF plate fixation. It also compared outcomes of patients treated with CF pla...

Load-induced increase in muscle activity during 30° abduction in patients with rotator cuff tears and control subjects

Rotator cuff muscles stabilise the glenohumeral joint and contribute to the initial abduction phase with other shoulder muscles. This study aimed to determine if the load-induced increase in shoulder muscle ac...

Combined femoral and tibial component total knee arthroplasty device rotation measurement is reliable and predicts clinical outcome

The optimal total knee arthroplasty (TKA) rotational alignment and how best to obtain and measure it are debatable. The aim was to analyse the reliability of the Berger femoral, three different tibial and four...

New bone formation accelerates during lower limb lengthening and deformity correction in children with Ollier’s disease

Ollier’s disease can cause severe length discrepancy of the lower extremities and deformity in children. Osteotomy and limb lengthening with external fixation can correct the limb deformity. This study evaluat...

Managing early complications in total hip arthroplasty: the safety of immediate revision

Immediate revision refers to a reoperation that involves resetting, draping, and exchanging the implant, after wound closure in total hip arthroplasty. The purpose of this study is to investigate the impact of...

Retrograde drilling for ankle joint osteochondral lesions: a systematic review

Extensive literature exists about the treatment of ankle osteochondral lesions, but there is no specific review of retrograde drilling, despite its common application. Indications for retrograde drilling are s...

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Official Journal of SIOT  Italian Society of Orthopaedics and Traumatology

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2023 Speed 23 days submission to first editorial decision for all manuscripts (Median) 146 days submission to accept (Median)

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Robotic total knee replacement improves outcomes but costs more, finds study

by UT Southwestern Medical Center

Total knee replacements performed with the help of a surgical robot have better outcomes on average than similar surgeries performed manually but can cost significantly more, a new study by UT Southwestern Medical Center researchers shows. The findings, published in Archives of Orthopaedic and Trauma Surgery , could help doctors and patients make more educated decisions on which option is best for each circumstance.

"As the population continues to age, there will be a greater demand for safe and effective total knee replacement surgery, also known as total knee arthroscopy. This study advances the field by outlining differences between these two procedures," said study leader Senthil Sambandam, M.D., Assistant Professor of Orthopaedic Surgery at UT Southwestern.

Total knee arthroplasty (TKA), in which the weight-bearing portions of the knee are completely replaced with prosthetic components, has become increasingly common over the past several decades to treat knee degeneration and relieve pain and disability. Most TKAs are conventional, meaning that surgeons perform them by hand, judging how much bone to remove based on their training and expertise.

A growing number of these surgeries are performed using surgical robots that rely on preoperative imaging or finding anatomical landmarks during surgery to determine where to cut. Using the robot theoretically improves accuracy and safety over conventional techniques; however, some studies have suggested that these improvements are minimal or nonexistent in practice and may not justify the higher cost.

To accurately compare the two approaches, Dr. Sambandam and his colleagues gathered data from the National Inpatient Sample, a publicly available database that contains information from about 7 million hospital stays each year from across the country.

Using diagnostic codes, the researchers identified 541,122 patients who received conventional TKAs and 17,249 who received robotic TKAs between 2016 and 2019. They also collected information related to these procedures, such as the length of hospital stays, complications, costs, and patients' demographic information.

Comparing the data, researchers found that patients who underwent robotic TKA had hospital stays that were nearly a half day shorter. They were also significantly less likely to have a host of complications such as infections, excessive blood loss, fractures, dislocations, or mechanical complications of their prosthetic. However, the robotic TKAs cost an average of about $2,400 more than conventional TKAs.

Most of these findings held true when the researchers made comparisons based on factors such as age, sex, race, tobacco use , diabetes, and obesity. However, in this analysis, the cost of robotic TKA was as much as $15,000 more in some comparisons.

The researchers noted that the higher cost of robotic TKA comes from the increased expense of disposable equipment necessary to perform the procedure and the acquisition of robotic equipment, which typically costs millions of dollars.

However, Dr. Sambandam said robotic TKA may be a more cost-effective option in high-volume hospitals, where savings from reduced complications can help offset the higher costs. Together, he said, the results from this study can help doctors and patients discuss the pros and cons of both procedures and decide which option is best for each patient.

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Orthopedic Surgery

• New directions for orthopedic surgery research

Aug. 06, 2021

Matthew P. Abdel, M.D. , an orthopedic surgeon at Mayo Clinic in Rochester, Minnesota, answers questions about artificial intelligence (AI) and other research goals in Orthopedic Surgery. Dr. Abdel was recently named chair of Mayo Clinic's Orthopedic Surgery Research.

Why is AI a primary focus of Mayo Clinic's orthopedic surgery research?

All of our research priorities are based on the needs of our patients. Our basic science researchers as well as our clinician-investigators are all engaged in research that is directly translatable to clinical practice.

Musculoskeletal innovation goals

Schematic describes Mayo Clinic's goals for musculoskeletal (MSK) innovation.

AI has a strong potential to improve patient care through the development of predictive analytics to guide surgical decision-making. One example is AI analytics to predict whether or not a prosthetic implant is fixed or loose. But the potential applications of AI touch all nine of our Orthopedic Surgery clinical divisions. Our goal is to transform musculoskeletal care through predictive algorithms and AI .

What infrastructure does Mayo Clinic have for building predictive analytics?

In addition to orthopedic surgical subject matter experts, Mayo Clinic has robust data sets for most orthopedic subspecialties. For example, in hip and knee arthroplasty, we have a patient registry that has captured clinical, radiographic, demographic and operative details going back to March 1969. That type of longitudinal data is key to developing the algorithms that drive predictive analytics.

Applying predictive analytics to individual patients requires state-of-the-art imaging. Mayo Clinic also has a long tradition of imaging expertise that will facilitate the development of AI -based applications.

What additional priorities is the research division pursuing?

In addition to AI , our 2030 strategic vision focuses on cartilage regeneration, infection prevention and treatment, fibrosis, arthritis, and orthopedic oncology.

How might research focused on cartilage regeneration benefit patients?

Pharmacological and gene therapies that slow the degeneration of cartilage can help individuals avoid joint replacement surgery. Patients are eager for nonsurgical options. Like AI , cartilage regeneration can impact many of the services we provide, including our upper and lower extremity practices, spine practice, pediatric orthopedics, and sports medicine.

What does Mayo Clinic hope to achieve regarding orthopedic infection research?

One particular issue we hope to clarify is whether bacteriophages play any role in treating periprosthetic joint infections. As described in Clinical Infectious Diseases, Mayo Clinic successfully used phage therapy to treat a 62-year-old man with a history of knee arthroplasty and multiple episodes of prosthetic knee infection — avoiding the need for amputation.

Infections can plague any bone, muscle, ligament, tendon or joint. The prevention and treatment of these orthopedic infections is evolving rapidly, and Mayo Clinic is committed to innovation.

What are Mayo Clinic's goals in fibrosis and arthritis research?

We are working to develop pharmacological modalities that both prevent and treat fibrosis in the musculoskeletal system. Similarly, learning more about the pathogenesis of arthritis, and how we might slow or prevent its development, is key.

All of our research aims ultimately focus around curing musculoskeletal diseases with innovative diagnostics and therapeutics. Moreover, we want to connect patients to optimal care through predictive analytics and advanced registry technologies.

For more information

Cano EJ, et al. Phage therapy for limb-threatening prosthetic knee Klebsiella pneumoniae infection: Case report and in vitro characterization of anti-biofilm activity. Clinical Infectious Diseases. 2021;73:e144.

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Cutting edge topics and advances in orthopaedic research

Edward Schwarz and Jay Lieberman

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The ORS Journals: The Journal of Orthopaedic Research (JOR)

The ORS produces two internationally renowned, peer reviewed musculoskeletal journals, the Journal of Orthopaedic Research (JOR) and the Journal of Orthopaedic Research – Spine (JORS) . These journals offer a comprehensive and multidisciplinary approach to orthopaedic research, ensuring that you stay informed, connected, and contribute to the advancement of this crucial field.

JOR and JORS are committed to publishing high-quality research that undergoes a rigorous peer-review process. Readers can trust the accuracy and reliability of the information presented in these journals.

The Journal of Orthopaedic Research (JOR)

JOR publishes reports on the full spectrum of orthopaedic research, including: life sciences, engineering, translational, and clinical studies.

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Articles on orthopaedic surgery

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Surgery is the default treatment for ACL injuries in Australia. But it’s not the only way

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MaCalus V. Hogan , University of Pittsburgh

3 orthopaedic surgeries that might be doing patients (and their pockets) more harm than good

Giovanni E Ferreira , University of Sydney ; Ian Harris , UNSW Sydney ; Joshua Zadro , University of Sydney , and Mary O'Keeffe , University of Sydney

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‘Engineering’ OA Treatment Lands $31M Research Award

The Advanced Research Projects Agency for Health (ARPA-H) has awarded up to $31 million to researchers at Washington University in St. Louis to support the development of non-surgical osteoarthritis treatment.

The award is part of the Advanced Research Projects Agency for Health’s program for novel innovations for tissue regeneration in osteoarthritis (NITRO). The Advanced Research Projects Agency for Health is part of the U.S. Department of Health and Human Services. In 2022 it was created to enhance the government’s ability to, per the press release, “accelerate biomedical and health solutions.”

The research will be led by Washington University Mildred B. Simon Professor of Orthopaedic Surgery and Shriners Children’s St. Louis Director of Research, Farshid Guilak, Ph.D. Dr. Guilak’s research has focused on advancing therapeutics to prevent or reverse OA progression. The funding will enable a team of scientists to focus on, per the press release, developing “a single-injection treatment that promotes tissue regeneration and restores joints.”

In the press release, Dr. Guilak commented, “Osteoarthritis has one of the greatest disease burdens of any disease in the world. But we have no drugs that can reverse the joint damage it causes.”

Dr. Guilak continued, “This award is a moonshot initiative, funding high-risk projects with the goal of developing a single-injection treatment or even a cure for osteoarthritis. If successful, we could potentially affect the quality of life for millions of people and lessen the economic impact due to the billions of dollars spent treating pain caused by osteoarthritis.”

The project will be driven by a multidisciplinary team focused on developing the single-injection treatment. The team’s investigators will include the following: Christine T.N. Pham, M.D., the Guy and Ella Mae Magness Professor of Medicine and director of the Division of Rheumatology within the university’s Department of Medicine; Hua Pan, Ph.D., an associate professor of medicine; Xiaoxia Cui, Ph.D., an associate professor of genetics; Lori Setton, Ph.D., the Lucy and Stanley Lopata Distinguished Professor and chair of the Department of Biomedical Engineering; and Erik Herzog, Ph.D., the Viktor Hamburger Distinguished Professor in Arts & Sciences in the Department of Biology.

The award will fund a team effort to “develop advanced nanoparticles intended to deliver snippets of genetic code into human joint cells and treat osteoarthritis with a single, yearly joint injection.” In the press release, Dr. Herzog explained, “We are putting knobs on the cells that will allow the body to self-tune drug production according to the severity of the inflammation, degree of mechanical load and the time of day.”

OTW had the opportunity to speak with Dr. Guilak about the award. Dr. Guilak explained that his team “was selected by ARPA-H for funding based on the innovation of our approach to develop a new treatment for osteoarthritis, and the potential to move it to clinical trials within five years.”

Dr. Guilak continued, “The goal of this is study is to reprogram the cells in the knee joint to be ‘smart,’ meaning we will use advanced bioengineering methods to rewire their genes so that they automatically produce biologic drugs to fight pain and inflammation and regenerate the cartilage and bone in the joint that was lost to arthritis.”

“The team is currently testing the ability of these cell reprogramming methods in the lab to show that they produce enough biological drugs on demand, whenever the cells sense inflammation or arthritic changes in the joint.”

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Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

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Orthopaedic Research and Clinical Trials

The Department of Orthopaedic Surgery’s distinguished history is grounded on Johns Hopkins Medicine’s principle that laboratory research and bedside teaching need to coexist in the instruction and practice of medicine. The creation of a formal Research Division and the Center for Musculoskeletal Research in 2009 provided a nexus for basic and translational research related to the musculoskeletal system.

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Training and Enrichment Programs T32 Training Program

A NIH-sponsored T32 training program combines the training of orthopaedic residents and postdoctoral scientists through a unique structure, which requires both research and didactic phases to occur concurrently by teams of trainees.

Clinical Trials

For a complete list of available clinical trials, search the database at the  Johns Hopkins Institute for Clinical and Translational Research . You can search by condition, researcher or doctor’s name.

Experimental Procedure for Children With Knee Cartilage Defects

Summary: A study of MACI in patients aged 10 to 17 years with symptomatic chondral or osteochondral defects of the knee (PEAK). 

Objective: To evaluate an experimental treatment for knee cartilage defects called membrane-induced autologous chondrocyte implantation (MACI).

Principle Investigator: R. Jay Lee, M.D.

Eligibility Criteria: Children age 11-17 with knee cartilage defects

Contact: Gabrielle Richard ( [email protected] )

Learn more about this study.

Integra® Titan™ Modular Shoulder System Generation 2.5 for Primary Shoulder Joint Replacement

Summary: A Post-Market, Prospective, Multi-Center, Open-Label, Single Arm Clinical Evaluation of the Integra TitanTM Modular Shoulder System 2.5 for Primary Shoulder Joint Replacement (IRB00169712).

Objective: To evaluate 2-year implant survivorship in subjects who receive the TSS-2.5 when used for primary shoulder arthroplasty.

Principle Investigator: Umasuthan Srikumaran, M.D., M.P.H., M.B.A.

Eligibility Criteria: Candidate for total shoulder arthroplasty.

Contact: Sanjana Vattigunta ( 443-516-1550  or  [email protected] )

Post-operative Pain Control Following Shoulder Surgery

Summary: A study of MACI in patients aged 10 to 17 years with symptomatic chondral or osteochondral defects of the knee (PEAK). 

Objective: Evaluate overall pain medication consumption following surgical treatment for shoulder pathology

Eligibility Criteria: Opioid-naive adults age 18-90 years old planning to undergo surgical treatment for shoulder pathology with Dr. Uma Srikumaran.

Optimize Low Back Pain

Objective: Improve health care for patients with chronic lower back pain (LBP) and increase the likelihood that patients obtain outcomes that matter most to them.

Principle Investigator: Richard Skolasky, Sc.D.

Eligibility Criteria: Adults age 18 - 64 years old, meets NIH Task Force definition of chronic LBP, had a healthcare visit for LBP in the past 90 days and have moderate levels of pain and disability.

Contact: Tricia Kirkhart ( 410-502-4453  or  [email protected] )

Dysport® (abobotulinumtoxinA) as an Adjunctive Treatment to Bracing in the Management of Adolescent Idiopathic Scoliosis (AIS)

Objective: To evaluate the combined effect of botulinum toxin A (administered as Dysport®) and bracing in children with adolescent idiopathic scoliosis.

Principle Investigator: Paul D. Sponseller, M.D.

Eligibility Criteria: Diagnosed with AIS, 10 to 16-year-old children.

Contact: Vivian Tran and Varun Puvanesarajah ( 410-955-3136  or  [email protected] )

Participants in this study will be compensated.

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Research Labs

Our orthopaedic research division and its faculty members are recognized internationally as leading innovators in musculoskeletal science and training. Our investigators conduct basic, translational and clinical research in topics that represent the great diversity of problems that impact the musculoskeletal system. Focus areas include integrative musculoskeletal biology, stem cells and regenerative medicine, skeletal neurobiology, bone metastasis and clinical outcomes.

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Richard Leroy Skolasky ScD

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Innovation in Spine Surgery

Orthopaedic spine surgeon Khaled Kebaish discusses the latest innovations and research in the spine division at the Johns Hopkins Department of Orthopaedic Surgery.

Recent Publications

Predicting Major Complications and Discharge Disposition After Adult Spinal Deformity Surgery

Surgical Setting in Achilles Tendon Repair: How Does It Relate to Costs and Complications?

Predicting Risk of 30-day Postoperative Morbidity Using the Pathologic Fracture Mortality Index

The Use of Weakly Supervised Machine Learning for Necrosis Assessment in Patients with Osteosarcoma: A Pilot Study

Is Delayed Anterior Cruciate Ligament Reconstruction Associated with a Risk of New Meniscal Tears? Reevaluating a Longstanding Paradigm

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Biomechanics in Orthopaedic Diseases and Surgery

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The mechanical environment of the musculoskeletal system plays a fundamental role in orthopaedic diseases. Understanding the magnitude, pattern, and duration of biomechanical factors and how they impact surgical treatment is an ongoing topic of interest in biomechanics. However, the way forces and stresses ...

Keywords : biomechanics, orthopaedic, treatment, disease progression, osseous tissue, rehabilitation

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Nanotubes, nanoparticles, and antibodies detect tiny amounts of fentanyl

New sensor is six orders of magnitude more sensitive than the next best thing.

A research team at Pitt led by Alexander Star, a chemistry professor in the Kenneth P. Dietrich School of Arts and Sciences, has developed a fentanyl sensor that is six orders of magnitude more sensitive than any electrochemical sensor for the drug reported in the past five years. The portable sensor can also tell the difference between fentanyl and other opioids.

Their work was published in the journal Small .

Fentanyl is a synthetic opioid and one of the main drivers in overdose deaths in the United States, Star said. It's often mixed with other drugs, but because of its potency, it's often present in such small amounts that it can be hard to detect.

Star's sensor uses carbon nanotubes and gold nanoparticles to tell fentanyl apart from other opioids. The key to its groundbreaking sensitivity, however, is the incorporation of fentanyl antibodies. "We're using nature's invention, so to speak," Star said. "That's how we can reach these ultralow levels of detection."

The sensor is a modified version of a COVID-19 sensor developed by Star's research group in 2020. The COVID sensor is itself an adaptation of a THC breath test -- similar to a Breathalyzer, but for marijuana -- he developed in 2019.

At the core of each of these sensors is a chip with carbon nanotubes attached. Each tube is like a tiny wire that's 100,000 times smaller than a human hair and great at conducting electricity. Attached to the nanotubes are gold nanoparticles, each about 43 nanometers tall.

In practice, molecules of fentanyl bound to the nanoparticles, triggering a current that flowed through the nanotubes. Different substances created different currents; using machine learning, the sensor was able to identify a fentanyl molecule. It also had a 91% success rate when it came to telling fentanyl from other opioids, which is helpful when trying to determine if another drug has been tainted with fentanyl.

To reach its unprecedented level of sensitivity, Star and his team took a cue from the COVID sensor and incorporated fentanyl antibodies, attaching them to the nanoparticles. Fentanyl molecules would tightly bind to any antibodies they encountered, changing the current flowing from the antibodies into the nanotubes, signaling the presence of the drug.

The result was a sensor that's more sensitive than any electrochemical fentanyl sensor reported in the past five years. Star's sensors detected fentanyl on the femtomolar scale. That's 10-15 moles per liter. The next closest sensor can detect on the nanomolar scale, which is 10-9 moles per liter.

"Nature developed these selective receptors," Star said. "We adapted them on our platform, the carbon nanotubes."

In addition to its sensitivity, another benefit of Star's sensor is its portability. To detect such small quantities of fentanyl today requires a mass spectrometer -- not a particularly mobile technology. Star's sensor is small enough to be hand-held and inexpensive enough to be practical.

In the future, he anticipates using this technique to develop a sensor array that can detect many kinds of drugs.

This research was supported by the Department of Defense Chemical and Biological Defense program through the Defense Threat Reduction Agency.

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Story Source:

Materials provided by University of Pittsburgh . Original written by Brandie Jefferson. Note: Content may be edited for style and length.

Journal Reference :

• Wenting Shao, Dan C. Sorescu, Zhengru Liu, Alexander Star. Machine Learning Discrimination and Ultrasensitive Detection of Fentanyl Using Gold Nanoparticle‐Decorated Carbon Nanotube‐Based Field‐Effect Transistor Sensors . Small , 2024; DOI: 10.1002/smll.202311835

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