Background Lacrosse research spans orthopedic injury, concussion, prevention, and sports science. This study characterized publication, citation, and collaboration patterns in a search-defined literature. Methods Web of Science records exported on July 22, 2026, were analyzed. Of 458 unique retrieved records, 24 clearly out-of-scope records were excluded. The primary corpus required lacrosse in the title, abstract, or author keywords, yielding 388 records. A broader 434-record corpus included additional records linked only through Keywords Plus. Indicators were recalculated from the full-record export. Results The primary corpus spanned 1987–2026, contained 141 source-title labels, and accumulated 14,987 citations (mean, 38.63; h-index, 61). Of the records, 235 (60.6%) were dated 2017–2026; 2026 was incomplete. American Journal of Sports Medicine and Journal of Athletic Training each contributed 44 records. Sport Sciences and Orthopedics were assigned to 275 (70.9%) and 120 (30.9%) records, respectively. An explicit USA address label occurred in 343 records (88.4%). Injury, concussion, and epidemiology were the most frequent normalized keywords. The broader sensitivity analysis retained concussion and epidemiology among its leading terms. Conclusions This literature connects lacrosse injury research with broader sports medicine and is concentrated in US-affiliated publications. Concussion and epidemiology are prominent, but bibliometric patterns do not establish clinical evidence quality or quantify treatment-related research gaps.
Tranexamic acid (TXA) is used to reduce perioperative bleeding in fracture surgery, but the preferred administration route and its effects on fracture healing remain uncertain. This narrative review examines intravenous, topical, and combined TXA in adult femoral and tibial fracture surgery, emphasizing direct route comparisons and the distinction between blood conservation and patient-centered outcomes. Publications identified in an initial Elicit-assisted evidence report were selectively checked against primary sources, supplemented by targeted source searches. No meta-analysis or formal risk-of-bias assessment was performed. Randomized trials generally support reductions in calculated blood loss with intravenous TXA, although transfusion benefits are not uniform. Topical TXA improves selected blood-conservation outcomes, while direct comparisons with intravenous administration yield procedure-dependent results. Adding local TXA to intravenous treatment reduced calculated blood loss in a tibial nailing trial, but observational hip-fracture studies do not establish a consistent advantage for combined administration. Studies generally did not detect increased thromboembolic events; limited sample sizes and selected populations preclude firm conclusions about uncommon harms or comparative safety. Fracture-union evidence is sparse and does not establish that TXA accelerates healing or that one route is preferable for this purpose. TXA is a useful blood-conservation adjunct in selected femoral and tibial fracture procedures, but current evidence does not support a universal ranking of administration routes. Procedure-specific randomized comparisons with standardized transfusion criteria and longer-term union and functional outcomes are needed.
Background Medial pivot total knee arthroplasty (TKA) has been developed to better reproduce native knee kinematics and improve patient satisfaction compared with conventional implant designs. This study evaluated the short- and mid-term clinical, functional, radiographic, and survivorship outcomes of the 5C® MEDic medial pivot knee system following primary TKA. Methods A retrospective cohort study included 419 primary TKAs performed in 372 patients between 2022 and 2025, with a minimum follow-up of 12 months. Clinical outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS-12), Oxford Knee Score (OKS), Forgotten Joint Score (FJS-12), visual analogue scale (VAS) satisfaction, and range of motion. Radiographic evaluation included hip–knee–ankle angle, arithmetic HKA, joint line obliquity, lateral distal femoral angle, medial proximal tibial angle, and Coronal Plane Alignment of the Knee (CPAK) classification. Implant survivorship was assessed using Kaplan–Meier analysis. Results Significant improvements were observed in all patient-reported outcome measures at 1 year . Mean OKS improved from 20.8 preoperatively to 41.2, while KOOS subscales demonstrated substantial gains in pain, symptoms, function, sports, and quality of life. Knee flexion increased from 111.1° to 123.2°, and extension improved from −5.6° to −0.7°. Kaplan–Meier survivorship was 99.8% at 1 year. One acute periprosthetic joint infection was successfully treated with debridement, antibiotics, and implant retention, and one patient developed deep venous thrombosis. No cases of aseptic loosening, instability, mechanical failure, or periprosthetic fracture were observed. Conclusions The 5C® MEDic medial pivot knee system demonstrated excellent early clinical, functional, and radiographic outcomes, high patient satisfaction, a low complication rate, and excellent short- and mid- term survivorship following primary TKA.
Background While conservative management often improves lumbar disc herniation (LDH) symptoms and promotes spontaneous resorption over time, the clinical value of extracorporeal shock wave therapy (ESWT) in accelerating this process remains underexplored. Observation We present a 36-year-old female with an acute, massive right-sided L5/S1 disc prolapse. Following a staged conservative regimen and the subsequent introduction of ESWT combined with acupuncture. Lastly her radicular pain and numbness almost completely resolved. Lessons Staged conservative intervention is highly effective for prolapsed LDH. The timely application of ESWT provides a novel, non-invasive strategy that promotes neovascularization and immune phagocytosis, strongly supporting the conservative management of massive disc herniations.
Purpose Enhanced recovery after surgery (ERAS) pathways are increasingly used in arthroplasty and spine surgery, but the structure of the orthopaedic literature remains incompletely characterized. This study mapped publication growth, contributors, collaboration, citation influence, and research themes. Methods Web of Science Core Collection records were retrieved with a title-based search and exported on June 15, 2026. Reproducibility screening of 655 exported records excluded 347 stemming-related false positives in which “ERAS” matched the word “era” and 13 enhanced-recovery records that were trauma-related but not orthopaedic, leaving 295 eligible publications. Publication patterns, co-authorship, keyword co-occurrence, and reference co-citation were analyzed. Results The 295 publications spanned 2012-2026; 242 (82.0%) were published from 2020 onward, and annual output peaked at 53 in 2025. China contributed to 129 records (43.7%), the United States to 59 (20.0%), and England to 16 (5.4%). Sichuan University was the leading standardized organization (12 publications). Major themes centered on total knee and hip arthroplasty, length of stay, complications, perioperative care, pain, and spine surgery. Conclusion Orthopaedic ERAS research has grown rapidly and continued to increase through 2025, but output remains geographically concentrated. The literature is mature around clinical efficacy and perioperative outcomes; implementation, dissemination, and broader international representation are important priorities.
