Bone and Arthrosurgery Science

Abnormal Brain Connectivity Networks in Patients with Knee Osteoarthritis: A Resting-state Functional MRI Study

Huajuan Yang — 2025-08-19

Background: Resting-state functional connectivity (FC) has been nominated as an effective method for elucidating the neural mechanisms underlying chronic pain. To date, whole-brain FC alterations in chronic knee osteoarthritis (KOA) remain largely unknown. Purpose: To investigate the functional connectivity patterns across the entire brain in patients with knee osteoarthritis (KOA) using resting-state functional magnetic resonance imaging (rs-fMRI). Methods: The current rs-fMRI analysis included 56 well-characterized KOA patients and 20 healthy controls (HCs), with data obtained from OpenNeuro. To identify aberrant topological organization in the brains of KOA patients, the study employed a graph theoretical approach. Additionally, the independent component analysis was conducted to characterize both intra-network and inter-network brain connectivity in these individuals. Results: Both the KOA cohort and healthy control cohort exhibited small-world characteristics in brain functional networks. Additionally, compared to HCs, KOA patients showed altered global properties, specifically characterized by reduced global efficiency and increased assortativity. At the nodal level, the KOA patients exhibited decreased degree centrality and betweenness centrality in the right thalamus. Furthermore, independent component analysis indicated abnormal FC within the anterior default mode network (DMN) and salience network (SN) in this patient cohort. The inter-network interactions did not show intergroup differences after multiple-test correction. Conclusion: The widespread functional abnormalities observed from a whole-brain network perspective in subjects with KOA pain may provide more comprehensive insights and reinforce the grasp of the neural mechanisms underpinning KOA.

Analysis of Morphological Characteristics of Modic Changes in the Lumbar Spine Based on MRI Imaging Omics and Their Association with Low Back Pain

Tuanmao Guo — 2025-08-29

Objective: To analyse the MRI imaging characteristics, morphological features, and association with low back pain in different types of Modic changes (MC) of the lumbar spine. Features in different types of Modic changes (MC) in the lumbar spine and their association with low back pain. Methods: A retrospective analysis was conducted on the clinical data of 124 patients who underwent lumbar MRI examinations and were diagnosed with Modic changes between March 2024 and February 2025 at a certain hospital. Prospective collection of imaging and clinical data was conducted on 30 patients with different types of lumbar Modic changes and low back pain scores during the same period. Pyradiomics was used to extract MRI morphological and radiomics features in Modic changes, followed by Kruskal-Wallis test, Dunn’s test, Mann-Whitney U test, correlation analysis, LASSO regression screening, and validation of differential features. A classification model was constructed using the support vector machine (SVM) algorithm, and heatmap analysis was performed to investigate the correlation between MRI morphological and radiomics features and low back pain scores. Results: Among 154 patients without low back pain, 34 were Modic Type I, 62 were Type II, and 58 patients with Modic Type III. A total of 7 morphological features and 19 radiomics features showed significant differences in mean values among the three Modic groups (P < 0.05). A Modic classification model based on the differential features was constructed using SVM, with an accuracy rate of 98%. In the correlation analysis, ODI scores were positively correlated with the long-to-short axis ratio and surface area-to-volume ratio of morphological features, and negatively correlated with sphericity and flatness (P < 0.05). Additionally, it was positively correlated with the radiomics feature FS_lbp_3D_m1_glszm_ZoneEntropy (r = 0.380, p < 0.05) and negatively correlated with T1_lbp_3D_m2_glszm_SmallAreaLowGrayLevelEmphasis (r = -0.423, p < 0.05) and FS_wavelet_LLH_firstorder_90thPercentile (r = -0.376, p < 0.05). Conclusion: Morphological and radiomics features differ among different subtypes of Modic changes (MC). An automatic classification model constructed based on these differential features demonstrates high accuracy, and key features are significantly associated with the low back pain functional disability index.

The Effect of Psychological Intervention and Exercise Rehabilitation on the Improvement of Patients’ Confidence in Osteoporosis Rehabilitation

Haoxuan Ning — 2025-08-29

The integration of psychological intervention and sports rehabilitation in osteoporosis rehabilitation aims to enhance patients’ confidence in recovery through the synergistic effects of psychological regulation and functional training. Psychological interventions aim to strengthen self-efficacy, alleviate negative emotions, and stimulate the desire for rehabilitation. Sports rehabilitation improves bone metabolism, strengthens physical function, and enhances the overall rehabilitation experience. Through a multidisciplinary collaboration mechanism and personalized intervention approaches, this approach systematically improves rehabilitation compliance and self-management skills, significantly reduces the risk of falls and re-fractures, creates a supportive rehabilitation environment, promotes the internalization of health beliefs, and provides strong support for long-term rehabilitation outcomes.

Effect Analysis of Muscle Strength Training in Sports Rehabilitation for Patients with Knee Joint Injuries

Xinyu Wang — 2025-08-29

In this study, the theoretical relationship between knee joint injury and muscle strength training is explored, and the biomechanical changes caused by injury, the role of muscle on joint stability, and the physiological basis of training are clarified. The implementation strategies of personalized training programs based on injury type and stage, scientific training intensity control, and coordinated use of diversified training types are explained. Multi-dimensional evaluation is conducted from the aspects of joint function recovery, muscle strength and morphological recovery, and improvement of knee joint biomechanical properties, providing theoretical and practical references for muscle strength training in knee joint injury rehabilitation.

Investigation of the Causes of Inflammatory Reaction after Arthroscopic Anterior Cruciate Ligament Reconstruction

Lifeng Wang — 2025-08-29

Objective: To analyze the data of local inflammatory storm after anterior cruciate ligament reconstruction under knee arthroscopy, and to understand the causes and countermeasures. Methods: A retrospective analysis was performed on 135 patients who underwent anterior cruciate ligament reconstruction in the Third Surgical Group of the Department of Orthopedics, the 988th Hospital of the Joint Logistics Support Force from September 2020 to September 2023. The gender, age, injury time, operation time, blood loss, postoperative anticoagulant drug application time, drainage tube application, and other items were collected. The causes of postoperative local inflammatory storm in patients were obtained by binary logistic regression analysis. Results: There were no significant differences in gender, age, injury time, operation time, and blood loss (P > 0.05), but there were significant differences in the placement of drainage tubes and the initiation time of anticoagulant drugs (P < 0.05). Early application of anticoagulants for one day increased the risk of local inflammatory storm after arthroscopic anterior cruciate ligament reconstruction by 0.305 times, and the occurrence of inflammatory reaction without a drainage tube was 5.994 times higher than that with a drainage tube. Conclusions: Premature use of anticoagulant drugs and inadequate drainage may be the main causes of local inflammatory storm in these patients.

Clinical Study on the Treatment of Delayed Union After Long Bone Fracture Surgery with Platelet- Rich Plasma and Intramedullary Nail Dynamization

Yalun Li — 2025-08-29

Background: The purpose of this study was to investigate the clinical effect of platelet-rich plasma (PRP) combined with intramedullary nailing in the treatment of delayed union after long bone fracture surgery. Methods: To retrospectively analyze the clinical data of 60 patients with delayed healing of long bone fractures treated in the Department of Orthopaedics of the Fourth Affiliated Hospital of Guangzhou Medical University in 2023 from January 2021 to December 2021, patients were randomly divided into a combined treatment group (30 cases) and a control group (30 cases). PRP combined with intramedullary nail dynamic therapy was used for combined treatment, while only intramedullary nail dynamic therapy was used for the control group. Results: Bone healing was achieved in 28 patients in the combination group (93.3%), and the mean bone healing time was 4.2 ± 1.1 months. The former group was significantly better than the control group (76.7%, 6.5 ± 1.4 months) (p < 0.05). At the last follow-up, the recovery rate of limb function was 90.0% in the combined treatment group and 70.0% in the control group, and the former had an advantage in this aspect (p < 0.05). No disability or death occurred during follow-up in either group. Conclusion: PRP combined with intramedullary nailing has a significant clinical effect on delayed union after long bone fracture surgery, which can effectively promote fracture healing and improve patient prognosis.

Extrapedicular vs Transpedicular Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta-analysis

Fan Wu — 2025-08-29

Background: Osteoporotic Vertebral Compression Fractures (OVCFs) are one of the most common health problems in the elderly population. Percutaneous kyphoplasty is a minimally invasive technique that has gained widespread recognition. Transpedicular and extrapedicular are two approaches for kyphoplasty. But over the last decade, the safety and effectiveness of two approaches have remained unclear, and there is still a lack of evaluation of their therapeutic effects. Objectives: To assess the efficacy and safety of the two approaches as a treatment for patients with OVCF. Methods: The study searched CENTRAL, MEDLINE, EMBASE, Chinese Biological Medicine Database, VIP Journals Database, Wan-fang database, CNKI and Chinese Evidence-Based Medicine Database from their inception to December 2020 in both English and Chinese. The study searched Chinese-language journals and conference proceedings. Randomised-controlled trials that compared any form of the transpedicular approach to any form of the extrapedicular approach control intervention in the treatment of osteoporotic vertebral compression fracture patients were included. Two review authors (Wu and Huang) independently determined the studies to be included in the review based on inclusion and exclusion criteria and the extracted data were analysed by RevMan 5.3, and the level of evidence was assessed by the GRADE system. Results: Six randomised controlled trials with a total sample size of 395 patients were included; all of them were from Asian countries. Meta-analysis showed that the extrapedicular approach kyphoplasty is superior to the transpedicular approach kyphoplasty for less radiology exposure time, less cement volume, and a lower leakage rate. But there is no difference between the extrapedicular approach kyphoplasty and the transpedicular approach kyphoplasty with postoperative VAS scores and ODI scores. Conclusion: Based on the evidence of 6 RCTs, the effectiveness of extrapedicular kyphoplasty for the treatment of osteoporotic vertebral compression fracture patients is suggestive. Extrapedicular kyphoplasty has less radiology exposure time, cement volume and a lower leakage rate than transpedicular kyphoplasty, and there is no significant difference in VAS and ODI after surgery. With the methodological quality and the small number of the included studies taken into consideration, furthermore high quality and large-scale randomized controlled trials are needed.

Synthesis of the Best Evidence for Perioperative Pain Administration in Patients Having Total Hip Prostheses

Sunjuan Dong — 2025-08-29

Objective: A methodical compendium of the best evidence on the management of pain in the Perioperative phase in patients undergoing total hip arthroplasty to offer evidence-based support for practice in the clinic. Methods: In the 6S pyramid model, we looked for guidelines, clinical decisions, expert consensus, evidence summaries, recommended practices, and systematic reviews of perioperative pain management in total hip arthroplasty patients in domestic and international guideline websites, websites of professional associations, and both English and Chinese data banks from December 16, 2014, to December 16, 2024, to obtain detailed statistics on perioperative patient pain monitoring and management in total hip joint arthroplasty patients, and to check the results of these results from the following sources. Literature quality assessment, evidence extraction, and summarization were done independently by 2 researchers. Literature quality assessment, evidence extraction, and summarization were done independently by 2 researchers. Results: A total of 20 papers were included, including 2 clinical decisions, 8 guidelines, 6 expert consensus, 3 Meta-analyses, and 1 randomized controlled trial. Forty pieces of evidence were summarized in six areas: preoperative preparation, principles of analgesic regimen development, choice of anesthesia, pharmacological analgesic modalities, nonpharmacological analgesic modalities, and post-discharge pain management. Conclusion: Perioperative pain management for THA patients is necessary, and healthcare professionals can refer to the summarized evidence to improve patients’ perioperative pain, increase their postoperative exercise compliance, and accelerate the postoperative recovery process.

Prevention of Ocular Complications in Spine Surgery Patients in the Prone Position

Yang Liu — 2025-08-29

Objective: To investigate the causes and preventive methods for blindness after spine surgery in the prone position. Methods: A retrospective analysis was conducted on the data of three patients who developed blindness after prone-position spinal surgery. Results: One patient died. Two patients were followed up 5 to 6 months after discharge, with no recovery of vision. Both patients remained blind in both eyes. Conclusion: Postoperative blindness in patients undergoing prone-position spine surgery is rare and difficult to treat once it occurs. Early recognition and prevention are essential to avoid this catastrophic complication.

Research on Serum Biomarkers in Knee Joint Diseases of the Elderly

Jikui Guan — 2025-09-04

Background: Knee osteoarthritis (KOA) is characterized by chronic degeneration or wear of the articular cartilage, cartilage degeneration, fragmentation, and hardening, as well as bone spur formation and synovial inflammation. Over time, these changes occur slowly, and bone wear becomes more severe. This in turn causes pain, stiffness and swelling. It has an impact on normal work and life. To understand the mechanism and monitoring index of cartilage injury in the elderly population and prevent osteoarthritis. The purpose of this study was to compare the changes of serum cytokine biomarker levels in elderly patients with knee injury and osteoarthritis, and explore the correlation with the severity of lesions, which is conducive to early diagnosis and prevention of knee diseases. Objective: To investigate the differences in serum concentrations of matrix metalloproteinase-3 (MMP-3) and cartilage oligomeric matrix protein (COMP) in elderly patients with osteoarthritis, knee fracture or ligament injury. Methods: A total of 36 elderly KOA patients who underwent knee replacement in our hospital from July 2021 to May 2023 were selected as the observation group, and 36 elderly patients with knee fractures, patellar fractures, ligament or meniscus injuries who were treated during the same period were selected as the control group for the study. The age, gender, weight and other data of the patients were compared. The anteroposterior and lateral radiographs of the knee joints were examined for the first time, and the Kellgren and Lawrence (KL) score was used to compare the severity of KOA. The levels of serum MMP-3 and COMP in the two groups of patients were tested by enzyme-linked immunosorbent assay, and the changes and sensitivity of the two biomarkers in elderly knee diseases were compared and analyzed. Results: (1) Among the 72 knee joints included in the study, 36 cases were assigned to each group. No significant differences were observed in gender, age, or weight between the two groups (P > 0.05). (2) The concentrations of serum MMP-3 and COMP in the observation group were significantly higher than those in the control group. Conclusion:The elevated levels of COMP and MMP-3 in patients with knee osteoarthritis (KOA) suggest a potential correlation with disease progression, as their concentrations increased with worsening severity. These biomarkers may hold significant value for early detection, diagnosis, and prevention of KOA in elderly populations, warranting further investigation.