Background: Wearable sensor technologies are emerging as promising tools to monitor orthopedic rehabilitation. This narrative review synthesizes recent evidence on wearable sensor applications across major orthopedic conditions. Materials and Methods: Relevant studies were identified through a literature search of PubMed, MEDLINE, and Google Scholar. Search terms included combinations of “wearable sensors,” “orthopedic rehabilitation,” “inertial measurement units,” “tele-rehabilitation,” “remote monitoring,” and “postoperative recovery.” Results: Studies demonstrate these technologies can accurately quantify kinematics, such as joint angles and gait metrics, and detect functional deficits that inform rehabilitation progress. Sensor-assisted rehabilitation has shown potential to improve mobility, strength, and patient adherence in selected studies and may achieve outcomes comparable to traditional therapy in certain contexts. Additionally, wearable technologies may improve exercise compliance and provide real-time feedback that could support rehabilitation performance and help clinicians monitoring factors associated with rein-jury risk. Conclusion: Although early evidence supports the feasibility and potential benefits of wearable technologies in orthopedic rehabilitation, further large-scale studies are needed to determine their long-term clinical impact and cost effectiveness.
Background: Second metacarpal index (2MCI) is a quick and simple calculation obtained from hand or wrist radiographs that can be used to screen for osteoporosis and target high-risk patients. In this study, we investigate the relationship between the 2MCI and hip bone mineral density. Materials and Methods: We conducted a retrospective review of 1,080 patients aged 18 to 100 years who received a dual-energy x-ray absorptiometry (DEXA) scan between January 1, 2004, and March 1, 2024, and had a hand or wrist radiograph within 1 year of their scan. Patients were excluded if the second metacarpal could not clearly be seen on radiographs or if there was no mention of the femoral neck T-score. Multivariable logistic regression and Pearson correlation analyses were performed. Results: A total of 1,028 patients were included. Pearson correlation analysis demonstrated a moderate correlation between 2MCI and femoral neck T-score (R = .40, P < .001). Stratification by age, sex, and days between scans demonstrated a minor modifier effect. The mean time between hand radiographs and DEXA scans was 134 days ± 107 days. The mean 2MCI was 0.56 ± 0.11 (range, 0.21–0.94). The mean femoral neck T-score was −1.6 ± 1.1 (range, −4.9 to 3.2). The area under the curve, sensitivity, and specificity of 2MCI for osteoporosis with a threshold value of 0.57 were 0.833, 82.2%, and 72.4%, respectively. Conclusion: Using the 2MCI offers a straightforward approach for osteoporosis screening, requiring minimal time and no complex calculations. Although DEXA scans remain the gold standard for diagnosing osteoporosis, this measurement may help orthopedic surgeons identify patients who should be referred for further assessment.
Background: This study compared outcomes of bicondylar tibial plateau fractures treated with staged versus acute definitive fixation. Materials and Methods: A multicenter retrospective review at 3 academic level 1 trauma centers included adult patients treated surgically for bicondylar tibial plateau fractures, grouped by treatment strategy: staged fixation (external fixation followed by open reduction internal fixation [ORIF]) or acute ORIF within ≤72 hours, comparing quality of reduction and complications, including unplanned return to the operating room. Results: A total of 96 patients were treated with staged ORIF (group 1) and 74 with acute ORIF ≤72 hours (group 2). Length of stay was longer ( P = .011) and incidence of complication higher in group 1 (31% vs 14%; P = .013). Wound dehiscence and drainage were significantly higher in group 1; concomitant compartment syndrome and wound vacuum-assisted closure were also highest in this group. There were no differences in AO/OTA classification across groups ( P = .13); however, more complex fractures were associated with infection ( P = .026) and longer delays to definitive surgery ( P = .046). Quality of reduction was similar between groups. Patients in group 2 were less frequently treated definitively with >1 plate (16% vs 84%; P < .001). Those treated with >1 plate had higher incidence of any complication (14% vs 44%; P < .001). On backwards logistic regression, patients treated with early definitive fixation were 65% less likely to have any complication ( P = .022). Any complication, osteoporosis, and cerebrovascular disease significantly increased risk of unplanned return to the operating room. Conclusion: Early definitive ORIF is safe for select bicondylar tibial plateau fractures.
Background: Methamphetamine use in orthopedic trauma carries an indeterminate risk, with prior studies suggesting increased rates of deep vein thrombosis and elevated mortality. Upper extremity fractures (UEFs) have distinct mechanisms of injury and operative risk. This study evaluates outcomes following operative management of UEFs in patients with and without documented methamphetamine use. Materials and Methods: A retrospective chart review was conducted of adults undergoing surgical fixation of UEFs (distal radius/ulna to clavicle; phalangeal, metacarpal, and carpal fractures were excluded) from January 2022 to March 2025. Outcomes included urinary tract infection, deep vein thrombosis, pulmonary embolism, myocardial infarction, pneumonia, emergency department (ED) visits, readmission, surgical site infection, hardware removal, and mortality. A post hoc subgroup analysis of isolated UEFs was performed. Results: There were 426 patients meeting study criteria: 40 with methamphetamine use, and 386 without. Methamphetamine users were more likely to experience polytrauma (27.5% vs 10.9%, P = .003), higher-energy injuries (75.0% vs 53.6%, P = .003), interpersonal violence, such as altercations (22.5% vs 5.7%, P < .001), and ED visits within 30 days (20.0% vs 9.1%, P = .047). No other estimable postoperative outcome differed significantly. For isolated UEFs, methamphetamine users had shorter follow-up (85.9 vs 116.3 days, P = .022). Conclusion: Methamphetamine use was associated with higher-energy injury mechanisms and increased health care use, namely ED visits. No other estimable perioperative complication differed significantly, and no deaths occurred. Operative management should not be withheld solely because of methamphetamine use; targeted case management may reduce postoperative use.
Background: Knee osteoarthritis (KOA) is a prevalent, disabling degenerative joint disorder featuring progressive articular cartilage loss, persistent chronic pain, and compromised knee mobility. This work aimed to characterize the expression pattern of mechanosensitive ion channels PIEZO1/2 in KOA and explore their potential regulatory roles, as well as preliminarily evaluate whether non-selective PIEZO inhibitor GsMTx4 could slow KOA–related pathological changes. Materials and Methods: Cartilage tissues and matched clinical data were collected from 54 KOA patients undergoing knee arthroplasty, and 20 trauma patients with intact cartilage served as controls. Correlations between PIEZO1/2 abundance, clinical pain severity, and radiographic grades were analyzed. A rat posttraumatic KOA model was established via anterior cruciate ligament, medial collateral ligament, and partial medial meniscus resection, followed by weekly intra-articular GsMTx4 injection for 8 weeks. Pain behaviors and cartilage histology were assessed. Transcriptomic profiling and bioinformatic analysis were carried out, and core differentially expressed genes were further verified via immunohistochemistry. Results: PIEZO1/2 expression was markedly increased in KOA cartilage, and their upregulation showed positive correlations with aggravated pain and higher Kellgren-Lawrence grades. In animal assays, GsMTx4 treatment appeared to alleviate hyperalgesia, attenuate chondrocyte apoptosis and cartilage damage, and partially rescue KOA–associated fibrotic remodeling, lipid metabolic imbalance, and inflammatory dysregulation. Conclusion: Aberrant PIEZO1/2 upregulation and activation may be linked to chondrocyte apoptosis, cartilage degeneration, and pain hypersensitivity in KOA. Blocking PIEZO channels with GsMTx4 might mitigate pathological joint remodeling, suggesting PIEZO channels could represent potential therapeutic targets for KOA intervention.
