Comparison of Guided Exercise and Self-Paced Exercise After Lumbar Spine Surgery: A Randomized Controlled Trial.

Background: The efficacy of postoperative exercise rehabilitation after spine surgery is controversial, and a protocol for exercise treatment and detailed outcomes based on functional activity have not yet been established. This study aimed to determine the efficacy of exercise rehabilitation after lumbar spine surgery.

Methods: A prospective, randomized controlled trial was conducted in 40 patients who underwent lumbar spine surgery (20 patients each in the exercise and control groups) for 12 weeks.

Development of an Exercise Rehabilitation Functional Group for Individualized Exercise After Lumbar Spine Surgery.

Individualized exercise therapy is crucial for effective postoperative rehabilitation. However, a widely accepted, standardized framework for measuring individual exercise capabilities after lumbar spine surgery (LSS) is lacking. This study aimed to develop a novel Exercise Rehabilitation Functional Group (ERFG) classification system to enable systematic, individualized rehabilitation after LSS.

A Multicentre, Double-Blind, Randomised, Non-Inferiority Trial of a Novel Single-Injection Intra-Articular HMDA-Cross-Linked Hyaluronate Gel for Knee Osteoarthritis.

: This Phase 3, randomised, double-blind, multicentre trial evaluated the efficacy and safety of a novel hyaluronic acid hydrogel cross-linked with hexamethylenediamine (HMDA-HA) compared to a conventional 1,4-butanediol diglycidyl ether cross-linked HA (BDDE-HA) in patients with mild-to-moderate knee osteoarthritis (OA). : A total of 223 adults (mean age 63.5 years; 167 women) with Kellgren-Lawrence (KL) grade I-III knee OA were randomised 1:1 to receive two intra-articular injections of HMDA-HA or BDDE-HA at baseline and at 24 weeks.

Tibial fixation in anterior cruciate ligament reconstruction using soft-tissue allograft: Cortical suspensory device versus aperture interference screw.

Background: This study aimed to compare clinical outcomes and tibial tunnel widening following anterior cruciate ligament reconstruction (ACLR) using allo-tibialis tendon performed with an all-inside technique (All-inside group) or an aperture fixation technique with a bioabsorbable screw (Aperture fixation group) for tibial side fixation.

Methods: A retrospective analysis of 36 patients between 2012 and 2022 was conducted. Patients who received a single-bundle anatomical ACLR with allo-tibialis tendon using suspensory femoral fixation were divided into two groups according to tibial fixation methods: adjustable suspensory fixative device or aperture fixation technique with a bioabsorbable screw.

Distinct patterns of ligament and meniscal injuries in multiligamentous knee injuries with and without dislocation: a 15-year retrospective study.

Purpose: This study aimed to compare the incidence rates of concomitant injuries, including meniscal and cartilage injuries, between multiligamentous knee injuries (MLKI) with and without dislocation based on our 15-year experience of knee dislocation and MLKI at a level 1 trauma center.

Methods: We retrospectively identified 100 patients (115 knees) with MLKIs and/or dislocations at our trauma center between 2007 and 2021. Magnetic resonance imaging was routinely performed to evaluate the injured structures and extent of injury.

Efficacy and safety of SKCPT in patients with knee osteoarthritis: A multicenter, randomized, double-blinded, active-controlled phase III clinical trial.

Ethnopharmacological Relevance: Osteoarthritis (OA) is the most prevalent type of arthritis worldwide and a leading cause of years lost to pain and disability. Among the current pharmacological treatments for OA, symptomatic slow-acting drugs for OA (SYSADOA) induce pain relief and aim to improve joint function by relieving inflammation while causing fewer gastrointestinal and cardiovascular adverse events than non-steroidal anti-inflammatory drugs (NSAIDs). SKCPT is a herbal SYSADOA formulated from Clematis mandshurica, Trichosanthes kirilowii, and Prunella vulgaris powdered extracts.

Offloading effect in the unoperated contralateral knee after unilateral medial open wedge high tibial osteotomy: A SPECT/CT analysis.

Background: An open wedge high tibial osteotomy (OWHTO) may lead to gait alteration, which change the contact loading in the contralateral knee, while clear evidence about the impact on contralateral knee still lacks. The purpose of the current study was to evaluate the change in scintigraphic uptake using SPECT-CT in the medial compartment of the contralateral knee following OWHTO.

Methods: Contralateral radiographic measurements were performed for patients with medial osteoarthritis and varus malalignment of >5° treated with OWHTO in this retrospective analysis.

Comparison of tibial fracture plate length, placement, and fibular integrity effects on plate integrity through finite element analysis.

Minimally invasive plate osteosynthesis is the most commonly used minimally invasive surgery technique for tibial fractures, possibly involving single or dual plate methods. Herein, we performed a finite element analysis to investigate plate strength according to the plate type, length, and presence of a fibula by constructing a three-dimensional tibia model. A thickness of 20 mm was cut 50 mm distal from the lateral plateau, and the ligaments were created.

Which fixation produces the best outcome for distal femoral fractures? Meta-analysis and systematic review of retrograde nailing versus distal femoral plating in 2432 patients and 33 studies.

Purpose: The distal femur comprises a wide intramedullary cavity and thin cortical bone. Firm internal fixation of comminuted fractures with displacement is challenging. Although many comparative studies have reported retrograde intramedullary nailing (RIN) and distal femoral plating (DFP) as the usual fixation methods for distal femoral fractures, no clear conclusion has been reached.

Stress Effect in the Knee Joint Based on the Fibular Osteotomy Level and Varus Deformity: A Finite Element Analysis Study.

Proximal fibular osteotomy (PFO) was found to relieve pain and improve knee function in patients with medial compartment knee osteoarthritis (OA). Therapy redistributes the load applied from the inside to the outside and alleviates the load applied on the inside through fibula osteotomy. Therefore, the clinical effect of fibular osteotomy using the finite element (FE) method was evaluated to calculate the exact change in stress inside a knee joint with varus deformity.

New Classification for Periprosthetic Distal Femoral Fractures Based on Locked-Plate Fixation Following Total Knee Arthroplasty: A Multicenter Study.

Background: This study aimed to establish a new classification using locked-plate fixation for periprosthetic distal femoral fracture (PDFF) following total knee arthroplasty (TKA) and to determine when dual locked-plate fixation is necessary through defining this classification.

Methods: One-hundred fifteen consecutive PDFFs that underwent operative treatment were reviewed from 2011 to 2019 with minimum 1-year follow-up. Most PDFFs were fixed with single or dual locked-plate fixations using the minimally invasive plate osteosynthesis technique.

Early medial reconstruction combined with severely injured medial collateral ligaments can decrease residual medial laxity in anterior cruciate ligament reconstruction.

Introduction: This study aimed to describe an anatomic medial knee reconstruction technique for combined anterior cruciate ligament (ACL) and grade III medial collateral ligament (MCL) injuries and to assess knee function and stability restoration in patients who underwent primary MCL reconstruction compared with primary repair.

Methods: A total of 105 patients who had undergone anatomic ACL reconstruction between 2008 and 2017 were enrolled in this retrospective study and divided into two groups according to concomitant MCL ruptures. Group A included patients with isolated ACL ruptures without MCL injuries.

Three-column subdivision for isolated posterolateral tibial plateau fractures and perspective surgical approaches.

Background: This study aimed (1) to introduce a computed tomography (CT)-based classification of the posterolateral compartment of the tibial plateau based on the fibula and to propose the individualized surgical approaches for each zone; and (2) to determine the surgical approach based on the classification, that would achieve a safe and effective reduction and could improve postoperative clinical outcomes.

Methods: Eighteen cases of tibia plateau fracture involving the isolated posterolateral compartment in a single institution were retrospectively analyzed. The posterolateral compartment of the tibial plateau was segmented into three zones based on the fibular position and an individualized surgical approach was proposed for each zone.

Clinical Comparison of Medial Patellofemoral Ligament Reconstruction With or Without Tibial Tuberosity Transfer for Recurrent Patellar Instability.

Background: No clear guidelines or widespread consensus has defined a threshold value of tibial tuberosity-trochlear groove (TT-TG) distance for choosing the appropriate surgical procedures when additional tibial tuberosity osteotomy (TTO) should be added to augment medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability.

Purpose: To compare the clinical outcomes between MPFL reconstruction and MPFL reconstruction with TTO for patients who have patellar instability with a TT-TG distance of 15 to 25 mm.

Study Design: Cohort study; Level of evidence, 3.

Clinical outcomes of osteosynthesis of well-fixed periprosthetic proximal tibial fractures (Felix type 2A) after total knee arthroplasty.

Aims: This study aimed to evaluate the clinical and radiologic outcomes of well-fixed periprosthetic tibial fractures after TKA.

Patients And Methods: The medical records of patients who presented with Felix type 2A periprosthetic tibial fractures after TKA between March 2015 and February 2020 were retrospectively obtained from 5 institutions. Data on injury mechanism, fracture pattern including open fractures and Felix classification, and surgical method were recorded.

Triaging deep vein thrombosis using ultrasonography after lower-extremity orthopedic surgery: analysis of a single-center experience.

Purpose: This study aimed to stratify risk factors and vein levels for postoperative deep vein thrombosis (DVT) after lower-extremity orthopedic surgery.

Methods: Ninety-nine patients who underwent Doppler ultrasonography after lower-extremity orthopedic surgery were enrolled. Medical records were reviewed for anesthesia duration, type of surgery, body weight, height, and cardiovascular risk factors (including history of smoking, diabetes mellitus or hypertension, blood pressure, and total cholesterol and high-density lipoprotein [HDL] cholesterol levels), and the DVT treatment.

Relationship of Bone Mineral Density and Knee Osteoarthritis (Kellgren-Lawrence Grade): Fifth Korea National Health and Nutrition Examination Survey.

Background: Osteoarthritis (OA) and osteoporosis (OP) are the 2 most common bone disorders associated with aging. We can simply assume that older patients have a higher incidence of OA and OP with more severity. Although several papers have conducted studies on the relationship between OA and OP, none of them has demonstrated a conclusive link.

Machine-learning algorithm that can improve the diagnostic accuracy of septic arthritis of the knee.

Purpose: Prompt diagnosis and treatment of septic arthritis of the knee is crucial. Nevertheless, the quality of evidence for the diagnosis of septic arthritis is low. In this study, the authors developed a machine learning-based diagnostic algorithm for septic arthritis of the native knee using clinical data in an emergency department and validated its diagnostic accuracy.

Beyond Lipid Signaling: Pleiotropic Effects of Diacylglycerol Kinases in Cellular Signaling.

The diacylglycerol kinase family, which can attenuate diacylglycerol signaling and activate phosphatidic acid signaling, regulates various signaling transductions in the mammalian cells. Studies on the regulation of diacylglycerol and phosphatidic acid levels by various enzymes, the identification and characterization of various diacylglycerol and phosphatidic acid-regulated proteins, and the overlap of different diacylglycerol and phosphatidic acid metabolic and signaling processes have revealed the complex and non-redundant roles of diacylglycerol kinases in regulating multiple biochemical and biological networks. In this review article, we summarized recent progress in the complex and non-redundant roles of diacylglycerol kinases, which is expected to aid in restoring dysregulated biochemical and biological networks in various pathological conditions at the bed side.

Patellar fractures in elderly patients: a multicenter computed tomography-based analysis.

Introduction: This study aimed to demonstrate the characteristics of patellar fractures and evaluate clinical outcomes in elderly patients.

Patients And Methods: Medical records of patients aged ≥ 60 years who presented with patellar fractures were retrospectively reviewed from an institutionally approved multicenter (five institutions) orthopedic database. Patient characteristics and fracture patterns were identified, and the clinical outcomes were investigated.