Accuracy and deviation risk factors of pedicle screws in AIS surgery using intraoperative CT-based navigation: a retrospective study of 1,082 screws.

Purpose: This study aimed to evaluate the accuracy of pedicle screw placement using intraoperative computed tomography (CT)-based navigation in adolescent idiopathic scoliosis (AIS) surgery and to identify both patient- and screw-level risk factors associated with clinically significant screw deviation.

Methods: A total of 1,082 pedicle screws were placed in 67 consecutive AIS patients using intraoperative CT-guided navigation. Screw placement accuracy was graded according to the Gertzbein and Robbins classification system, with Grade C or D (≥ 2-mm cortical breach) defined as clinically significant deviation.

Total Hip Arthroplasty for Crowe III/IV Hip Dysplasia With Oblique Subtrochanteric Shortening Osteotomy and S-ROM-A Modular Stem: 10-Year Outcomes.

Background: High dislocation due to developmental dysplasia of the hip (DDH), classified as Crowe type III or IV, presents significant challenges in total hip arthroplasty (THA), particularly in preventing nerve complications while restoring leg length.

Aim: This study aimed to evaluate the clinical and radiographic outcomes of primary THA using an S-ROM-A modular stem with oblique subtrochanteric shortening osteotomy in patients with high hip dislocation; to identify the advantages, limitations, and possible countermeasures of this surgical approach.

Patients And Methods: Subjects were 45 hips (37 patients) with high hip dislocation (Crowe III/IV) treated by primary THA using an S-ROM-A stem, with femoral shortening osteotomy performed at our institution.

Two cases of implant removal failure after open reduction and internal fixation using the Prima Hip Screw Side Plate system for femoral neck fracture.

We report two cases of implant removal failure following internal fixation of femoral neck fractures using the Prima Hip Screw Side Plate (PHS-SP) system. Case 1 involved an 80-year-old woman with stripped screw heads, which prevented standard screw removal. The femoral neck was osteotomized, and the screws were severed to allow removal of the plate.

A Safe and Simple Method for Minimally Invasive Harvesting of the Partial-Thickness Quadriceps Tendon-Bone Autograft.

Good long-term postoperative clinical results can be achieved after anterior cruciate ligament reconstruction using the quadriceps tendon (QT) as the graft. Anatomical rectangular tunnel anterior cruciate ligament (ACL) reconstruction is performed using a ribbon-shaped quadriceps tendon with bone (QTB) harvested in partial layers, considering that harvesting the transplanted tendon in all layers, including the joint capsule, may delay recovery from postoperative pain and muscle weakness. However, no consistent method for harvesting the QTB graft tendon has been established.

Innovative Pedicle Screw Insertion with Mixed Reality Technology Improves Insertion Accuracy in Spinal Surgery.

The accuracy of pedicle screw insertion in pediatric scoliosis correction surgery using augmented reality technology in combination with a conventional navigation system was evaluated, and its usefulness was verified. A retrospective study of patients who underwent mixed reality technology-assisted posterior scoliosis correction and fixation was conducted. In total, 361 pedicle screws inserted with a mixed reality technology-assisted navigation system were analyzed; 25 pedicle screws (6.

Anatomical evaluation of the positions of bone tunnels created using a rectangular retro-dilator in revision anterior cruciate ligament reconstruction.

Background: This study used three-dimensional computed tomography (3D-CT) to evaluate the targeted positions of rectangular bone tunnels created using a rectangular retro-dilator (RRD) in revision anterior cruciate ligament (ACL) reconstruction, with the aim of assessing the accuracy of the technique in bone tunnel creation at the target position.

Methods: Participants were 30 patients who underwent revision ACL reconstruction using an RRD. Based on 3D-CT images, the positions of the primary and revision tunnels were qualitatively evaluated according to the Magnussen classification, the quadrant method, and whether they were in the anatomical tibial attachment site of the ACL.

Percutaneous Reduction and Fixation for Traumatic Thoracolumbar Vertebral Fracture Using a Monoaxial Screw System.

Background And Aim: The development of percutaneous pedicle screws (PPSs) has led to the development of minimally invasive spine stabilization (MISt) procedures, which has decreased the invasiveness of spine surgery. Conventionally, PPSs were available as polyaxial screws only, making it technically challenging to perform percutaneous repair of thoracolumbar vertebral fractures with implants. This study aimed to evaluate percutaneous posterior fixation for thoracolumbar vertebral fractures using a monoaxial screw system and determine imaging and clinical outcomes until after implant removal.

Evaluation of the relationship between muscle-tendon preservation and gait analysis in total hip arthroplasty.

Background: For total hip arthroplasty (THA), minimally invasive surgery (MIS) has been reported to enhance early functional recovery. The conjoined tendon-preserving posterior (CPP) approach is a posterior MIS-THA technique designed to minimise muscle-tendon dissection while preserving the piriformis muscle, conjoined tendon, and the joint capsule covered by the conjoined tendon. This approach is expected to facilitate early postoperative functional recovery; however, clinical outcomes remain unreported.

Focal periphyseal edema of the knee in a junior youth tennis player: A case report.

Herein, we report a case of focal periphyseal edema in a 12-year-old female tennis player. The onset of chronic knee pain in adolescents has differential diagnoses, including fatigue fracture, epiphysis (Osgood-Schlatter disease), growth plate injury, Brodie abscess, patella-femoral malalignment, neoplasia, and meniscus tears. In this case, magnetic resonance imaging revealed focal bone marrow edema around the center of the epiphyseal plate of the distal femur.

Cross-organ hierarchy of HLA molecular mismatches in donor-specific antibody development in solid organ transplantations.

Donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) play a crucial role in antibody-mediated rejection, a major barrier to successful organ transplantation. Donor-recipient HLA molecular incompatibility critically influences DSA susceptibility, commonly assessed by analyzing mismatches in the HLA eplet repertoire. This study, including six distinct liver, lung, and kidney transplant cohorts from two centers (978 donor-recipient pairs), explores associations between individual eplet mismatches and DSA development.

Bone formation and bioresorption of silver-doped β-tricalcium phosphate in rabbit bone defects.

Implant-associated infections pose a significant challenge in orthopedic surgery but may be prevented using biomaterials containing antimicrobial agents such as Ag ions. This study examines the effects of Ag doping on bone metabolism following the implantation of β-tricalcium phosphate (β-TCP) doped with 0, 1, 3, and 5 at% Ag with 75% porosity. Additionally, the antimicrobial activity of Ag-doped β-TCP was evaluated against and using shake flask tests, revealing increased antimicrobial activity with higher Ag concentrations.

Impact of Cage Placement on Vertebral Endplate Cyst Formation and Bone Union in Transforaminal Lumbar Interbody Fusion.

Study DesignRetrospective cohort study.ObjectivesTo determine the ideal cage placement position in transforaminal lumbar interbody fusion (TLIF) surgery to prevent vertebral endplate cyst (VEC) formation and improve bone union rates.MethodsThis study retrospectively analyzed 69 patients who underwent TLIF, and 88 intervertebral levels were observed.

Revision Surgery for a Foot With Loss of Correction After Modified Lapidus Procedure: A Case Report.

We report a case of revision surgery for a foot with loss of correction after a modified Lapidus procedure. The patient was a 68-year-old woman, with advanced hallux valgus in both feet. First, a modified Lapidus procedure and Weil osteotomy were performed on the second ray in the left foot, with a good postoperative course.

Long-term course of borderline dysplasia: a 26-year follow-up of nonoperative hips in patients undergoing unilateral acetabular rotational osteotomy.

Aims: We conducted a minimum 20-year follow-up of nonoperated hips that presented with borderline dysplasia (BD), defined as a lateral centre-edge angle (LCEA) of 18° to 25°, in cases of bilateral developmental dysplasia of the hip (DDH) where unilateral rotational acetabular osteotomy (RAO) was performed. The study aimed to identify risk factors for the development of hip osteoarthritis (OA), the timing of OA onset, and hip survival rate in BD. For the timing of OA onset and hip survival rate, we compared cases of BD with cases having LCEA < 18° (definite DDH).

Tendon Tissue Regeneration With Cell Orientation Using an Injectable Alginate-Cell Cross-linked Gel.

Background: Tendons have a limited blood supply and form inferior scar tissue during repair, which increases the risk of reruptures, causes complications, and limits regenerative capacity. Current methods to repair injured tendon tissue use solid scaffolds, which carry the risk of contamination (infections) and require open surgery for transplantation.

Hypothesis: Alginate-cell cross-linked gels, which can be applied by a percutaneous injection and transmit mechanical stress to cells via direct cell interaction, could induce tendon tissue regeneration.

An automated algorithm for quantitative morphometry of thoracic and lumbar vertebral bodies in lateral radiographs.

This exploratory study developed and evaluated an artificial intelligence (AI)-based algorithm for quantitative morphometry to assess vertebral body deformities indicative of fractures. To achieve this, 709 radiographs from 355 cases were utilized for algorithm development and performance evaluation. The proposed algorithm integrates a first-stage AI model to identify the positions of thoracic and lumber vertebral bodies in lateral radiographs and a second-stage AI model to annotate 6 landmarks for calculating vertebral body height ratios (, , and ).

Is it possible to perform reverse sural artery flap on lower limbs where the main trunk of the peroneal artery is interrupted?

As blood flow to the reverse sural artery flap (RSAF) occurs via the peroneal artery, the health of the peroneal artery is generally considered important. In severe limb injuries, the main trunk of the peroneal artery is often disrupted at the fracture site, which brings uncertainty in the use of RSAF. We hypothesized that RSAF could be used even in cases where the main trunk of the peroneal artery is interrupted if retrograde blood flow from the plantar side forms a communication network with the superficial sural artery.

Effect of isavuconazole on the concentration of tacrolimus in a patient with genotype CYP3A5*1/*3: a case report.

Background: Azole antifungals are the standard treatment for pulmonary mycosis, which may develop during long-term immunotherapy for kidney transplant. Isavuconazole (ISCZ) is a cytochrome P450 (CYP) 3 A inhibitor that has a risk of interacting with the immunosuppressive drug tacrolimus (TAC). We report a case of simple pulmonary aspergilloma with renal dysfunction due to increased trough levels of TAC after ISCZ coadministration.

Frailty and osteoporotic fractures represent mutual risks for each other with common physiological backgrounds.

Frailty and osteoporosis are known to exacerbate each other. However, limited research is available on the shared pathophysiological factors contributing to osteoporotic fractures and frailty. This study aims to identify common factors associated with both the current frailty and the occurrence of incident vertebral fractures.

Long-term Outcome of Pediatric Arthroscopic Surgery for Avulsion Fracture of the Ligamentum Teres: A Case Report.

Case: An 8-year-old boy experienced a traffic accident resulting in avulsion fracture of the ligamentum teres, preventing maintenance of hip joint congruity. Hip arthroscopy was performed to remove the teres and bone fragments. Three months postoperatively, he could walk without a cane.

Ankle-Preserving Surgery for Ankle Instability After Triple Arthrodesis: A Case Report.

This report describes a case in which ankle-preserving surgery was performed for secondary ankle instability with good results in a patient with residual deformity after triple arthrodesis. A 42-year-old woman had undergone triple arthrodesis at the age of 16 years to correct a club foot deformity that had caused paralysis of the lower extremities. However, her left ankle instability worsened over time.

Cement-Augmented Versus Conventional Pedicle Screws in Surgical Management of Osteoporotic Vertebral Fractures.

Objective: Cement-augmented pedicle screws (CAPS) are expected to have fewer complications than conventional pedicle screws (PS), including less risk of postoperative screw loosening and loss of correction. However, use of CAPS has been associated with a risk of other complications, such as cement leakage. In this study, we investigated the usefulness of CAPS for osteoporotic vertebral fractures (OVF) by comparing its surgical outcomes with those of PS.

Dysfunction of the Windlass Mechanism Is Associated with Hallux Rigidus: A Case-Control Study.

Background: The cause of hallux rigidus remains controversial. However, it is assumed that dysfunction of the windlass mechanism and metatarsus primus elevatus play a role in the pathology. Three-dimensional (3D) computed tomography (CT) imaging is ideal for analysis of movements of the foot, which involve 3D and rotational motion.

Augmented Reality-Assisted Microsurgery for Severe Thoracic Ossification of the Ligamentum Flavum: A Case Report.

Ossification of the ligamentum flavum (OLF) can lead to dural ossification, significantly increasing the risk of complications, including intraoperative nerve injury. The application of augmented reality (AR) and advanced digital technologies in spine surgery has the potential to reduce these risks. This case report highlights a perioperative nerve injury-free microsurgery using elastic image fusion technology, which integrates preoperative imaging with intraoperative computed tomography for a patient with severe stenotic OLF and dural ossification.

Posterior Fusion With Pedicle Screw Cement Augmentation and Vertebroplasty Using Calcium Phosphate Cement for Osteoporotic Vertebral Fracture: A Case Report.

Osteoporotic vertebral fractures (OVFs) in elderly patients pose challenges due to bone destruction and surgical risks. This case report describes a minimally invasive approach using calcium phosphate cement (CPC) vertebroplasty and short fusion with cement augmentation of pedicle screws (CAPS) in a 91-year-old woman with severe OVF. The patient underwent CPC vertebroplasty at L1 and CAPS fixation at T12-L2, followed by osteoporosis medication.