Introduction Considering the response burden of the full version of the HOOS scale, researchers developed a more concise HOOS-12 scale. Although the HOOS-12 has been verified to have good reliability, validity and responsiveness in most Western-country studies, it still needs further evaluation in other non-English populations. Therefore, our aim is to assess the content validity, internal consistency, structural validity, test-retest reliability, responsiveness, floor effect and ceiling effect of the Chinese version of HOOS-12 in the patient population whose native language is Chinese. The goal is to provide a high-quality evaluation tool for the global Chinese-using hip joint patient population, promote cross-cultural and cross-regional hip joint research, and ensure the comparability of the data. Method Patients with chronic hip diseases scheduled for total hip arthroplasty were included in the study. Content validity was evaluated using expert review to assess item relevance. CFA was employed to validate the construct validity of the CHOO-12. Convergent and discriminant validity of the CHOOS-12 were assessed using the SF-36, OHS, and WOMAC scales as reference instruments. The first HOOS-12 scores were used to evaluate content validity, internal consistency, and structural validity. The second set of scores was utilized to assess test-retest reliability and ceiling/floor effects. The third set of scores was applied to evaluate responsiveness. Result The CHOOS-12 demonstrated good content validity. No ceiling or floor effects were observed for the CHOOS-12 total scale or its pain, function, and quality of life subscales. The internal consistency among items was high for both the overall CHOOS-12 and all its subscales. CFA indicated satisfactory performance for the pain dimension, though the unidimensionality of the function and quality of life dimensions was challenged. The CHOOS-12 scale exhibited good convergent and discriminant validity. With overall ES and SRM values of 2.08 and 2.42 respectively, the CHOOS-12 also demonstrated good responsiveness Conclusion CHOOS-12 demonstrated good reliability and validity in this study. In terms of construct validity, the pain subscale performed well, although the unidimensionality of the PF and QOL subscales was challenged, the core items still had measurement potential. Future research needs to conduct further validation in larger and more diverse samples

Chondrosarcoma (CS) is the second most common bone sarcoma with a cartilage matrix. Angiogenesis and integrated stress response (ISR) exert a vital influence on the development of CS. This research aimed to conduct a comprehensive analysis to pinpoint angiogenesis and ISR-related potential biomarkers in CS and to elucidate their potential molecular mechanisms. CS data were from GEO. Potential biomarkers were identified and confirmed using differential expression analysis, WGCNA, and expression assessment. Moreover, enrichment analysis was employed to examine relevant pathways. Molecular regulatory network, compound prediction, and molecular docking analyses further explored the key regulatory roles of potential biomarkers in CS. GSE184118 was used to determine key cells and perform pseudo-time and cell communication analyses. Finally, RT-qPCR was used to confirm potential biomarker expression levels. Overall, three potential biomarkers (HSPA8, LMNA and SERPINH1) were determined, and their expression trends were consistent across the GSE30835 and GSE22855 datasets. Potential biomarkers were significantly enriched in the pathways like “medicus variant mutation caused aberrant HTT to 26S proteasome mediated protein degradation” in CS. Moreover, 9 transcription factors (TFs) (like STAT1), 69 key microRNAs (miRNAs) (like hsa-miR-361-3p), and 78 long non-coding RNAs (lncRNAs) (like NEAT1) were found to have relationships with potential biomarkers, and potential biomarkers had stable binding affinity with adenosine diphosphate (ADP) and lonafarnib. Moreover, pseudo-time analysis demonstrated a notable correlation between potential biomarkers’ expression and differentiation status of key cells (stromal cells (excluding leucocytes)), and cell communication revealed the strong interactions between stromal cells and chondroid clusters 1. Importantly, RT-qPCR confirmed higher expression of HSPA8, LMNA and SERPINH1 in CS patients. The findings suggested that HSPA8, LMNA and SERPINH1 might offer novel insights for the development of targeted therapies for CS associated with angiogenesis and ISR.

This finite element analysis study biomechanically evaluated the cup-on-cup technique against jumbo cup and trabecular metal augment (TA) in Paprosky IIIB acetabular defects to assess its application value. The biomechanical feasibility and clinical potential of the cup-on-cup technique were evaluated. A pelvic model was developed from CT scans, and the Paprosky IIIB acetabular defect was created. Simulations of the four techniques were performed, analyzing von Mises stress and displacement under static loading. Among the four types of surgical techniques, there was almost no difference in cortical bone stress when standing, walking, or jogging. Under the four types of surgical techniques, the peak stresses of cancellous bone were 0.355, 2.921, 1.054, and 1.123 MPa during standing, respectively; the peak stresses were 2.136, 3.257, 2.721, and 2.684 MPa during walking, respectively; and the peak stresses were 4.989, 6.387, 4.862, and 4.747 MPa during jogging, respectively. The stress on the acetabular cup was still highest after the jumbo cup, with values of 9.02, 36.64, and 83.49 MPa at 210, 2100, and 4200 N, respectively. There is no difference in acetabular cup stress between cup-on-cup surgery and hip revision with TA. When standing, the stress on the lateral cup after cup-on-cup surgery was minimal, while the stress on the lateral cup after cup-on-cup surgery was greater during walking and jogging. After the cup-on-cup technique, the displacement of the acetabular cup during standing, walking, and jogging is 0.0426 mm, 0.3769 mm, and 0.7053 mm, and the displacement of the lateral cup during standing, walking, and jogging is 0.0365 mm, 0.3278 mm, and 0.6157 mm. Among the four hip revision surgeries, only the cup-on-cup technique had the smallest displacement and maintained good immediate postoperative stability. In summary, these findings not only reveal the differences in mechanical behavior and potential advantages and disadvantages of different techniques. At the same time, it also demonstrated that the cup-on-cup technology provides a promising solution for Paprosky IIIB acetabular defects while protecting the host bone and enhancing biomechanical stability.

The avascular and alymphatic nature of articular cartilage severely limits its intrinsic repair capacity. Even when spontaneous healing occurs, it inevitably culminates in fibrocartilage formation, which lacks the biomechanical functionality of native hyaline cartilage. Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic candidate owing to their regenerative potential. However, direct intra-articular transplantation exposes MSCs to a hostile microenvironment characterized by excessive reactive oxygen species and pro-inflammatory cytokines, leading to extensive apoptosis and substantially compromised therapeutic efficacy. Cell-derived decellularized extracellular matrix (dE) has been shown to enhance chondrogenic potential, yet it fails to suppress hypertrophic differentiation during chondrogenic induction, a major hurdle in cartilage engineering. To overcome this bottleneck, we integrated ascorbic acid (AA) with dE preconditioning. Notably, concurrent dE and AA combination synergistically enhanced antioxidant capacity during expansion, while significantly attenuating hypertrophic markers and matrix catabolism (MMP13, IL-1β) during chondrogenic induction. Mechanistically, this strategy sustained TGF-β receptor I expression alongside endogenous TGF-β1 ligand downregulation, optimizing canonical signaling without pathological overactivation. Strikingly, antecedent AA priming reversed these benefits, compromising chondrogenic potential and exacerbating hypertrophy during chondrogenic induction, underscoring a stringent temporal dependency. Collectively, this biomaterial-guided preconditioning strategy generates chondroprogenitors with reduced hypertrophic markers and improved hyaline phenotype in vitro, warranting further preclinical in vivo investigation.

[This corrects the article DOI: 10.3389/fcell.2025.1539308.].

Glenoid bone defect is one major contributor to anterior shoulder instability. Numerous procedures have been developed for anterior glenoid reconstruction, such as the Eden-Hybinette procedure and the Latarjet-Bristow procedure, as well as various techniques for graft fixation, including screw, endobutton, and anchor fixation. However, these methods can be instrumentally and technically complex. This Technical Note introduces a arthroscopic technique using double-row suture anchors and parallel double-pulley to fix iliac crest bone grafts for anterior glenoid reconstruction, which enables convenient and quick fixation of the bone graft without requirement of any specialized instruments or consumables.

To explore the therapeutic effect of using Fast Fix suture device combined with suture hook technique by arthroscopy to all-inside suture the tear of the lateral meniscus within the popliteal hiatus area. Seventy-two patients with the tear of the lateral meniscus within the popliteal hiatus area were selected and divided into three groups: a Combined Group (n = 24) treated with Fast Fix and suture hook, a Fast-Fix Group (n = 24), and a Suture Hook Group (n = 24). All patients had longitudinal tears located in the red and red-white zone. All patients received arthroscopic all-inside suture in the red and red-white zones of the meniscus with no complex tears or defects. Knee function was evaluated preoperatively and postoperatively using the Lysholm score and knee flexion-extension range of motion (ROM). MRI images were collected at least six months post-operation to assess meniscus healing. Follow-up was conducted at 3, 6, and 12 months, with no major complications such as infection or secondary trauma, and good patient compliance. At 6 months and 12 months post-operation, the patients in the Combined Group showed significant improvements in both Lysholm scores and ROM (P < 0.05), demonstrating the positive therapeutic effects of the combined treatment. The Lysholm score increased from 53.71 ± 11.37 points preoperatively to 70.63 ± 8.47 points at 6 months (P < 0.05) and 81.04 ± 13.08 points at 12 months (P < 0.05). The ROM improved from 103.58° ± 10.75° preoperatively to 123° ± 9.15° at 6 months (P < 0.05) and 125.13° ± 7.49° at 12 months (P < 0.05). MRI results confirmed good healing of the meniscus after more than six months, further supporting the effectiveness of the procedure. Compared with the other two surgical technique, the combined technique yielded significantly better functional recovery and structural healing than either technique alone (P < 0.05). The combination of the Fast Fix meniscus suturing device and suture hook technology provides a safe, stable, and effective method for the arthroscopic repair of lateral meniscus tears. This technique demonstrates significant clinical benefits in terms of knee function recovery, meniscus healing, and patient satisfaction. We recommend wider clinical adoption of this combined technique for improved outcomes in meniscus repair.

Chronic hip joint disease has a high prevalence in China, and the primary scale currently used to assess functional recovery after total hip arthroplasty (THA) is the Hip disability and Osteoarthritis Outcome Score - Physical Function Short-form (HOOS-PS). Therefore, our objective was to translate the HOOS-PS scale into Simplified Chinese and evaluate its reliability, validity, and responsiveness in THA patients. First, we followed the widely accepted cross-cultural translation process to translate the original HOOS-PS into the Chinese version of HOOS-PS (CHOOS-PS). Then, we recruited patients with chronic hip joint disease who were scheduled to undergo THA to complete the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Oxford Hip Score (OHS), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and CHOOS-PS scales. Subsequently, we calculated the standardized response mean (SRM), effect size (ES), Spearman correlation coefficient (rs), standard error of measurement (SEM), intraclass correlation coefficient (ICC), Cronbach’s alpha coefficient, and confirmatory factor analysis (CFA) based on the scale scores. Ultimately, 142, 138, and 109 patients completed the scale assessments at three stages. The results showed that CHOOS-PS has excellent test-retest reliability (ICC = 0.848–0.919) and good internal consistency (Cronbach’s alpha = 0.892). The CHOOS-PS questionnaire demonstrated excellent correlation with the OHS scale (rs = 0.874), good correlation with all three subscales of the WOMAC (rs = 0.638–0.764), moderate to good correlation with the physical dimensions of the SF-36 (rs = 0.424–0.693), and poor to fair correlation with the mental dimensions of the SF-36 (rs = 0.165–0.319). The CFA results showed a good fit (root mean square error of approximation (RMSEA) = 0.050, the comparative fit index (CFI) = 0.995, and the Tucher-Lewis Index (TLI) value = 0.991). These results indicate that the HOOS-PS scale has good construct validity. Additionally, CHOOS-PS showed good responsiveness (ES = 1.93, SRM = 1.88). The CHOOS-PS scale is a reliable tool for evaluating the functional outcomes of Chinese patients with chronic hip joint disease after THA.

Knee septic arthritis caused by Stenotrophomonas maltophilia (S. maltophilia) was very rare in immunocompetent group but was observed in a series of post-arthroscopy patients in our hospital. This study aimed to report the clinical course and treatments of the infections and the investigation of the incidents. One patient who underwent knee arthroscopy exhibited serious knee septic arthritis 17 days postoperatively. Later, three more similar patients were also suspected of knee infection. Investigation was initiated by interviews with personnel and reviews of medical records. All instruments associated with arthroscopy were subsequently sampled and tested. While no abnormalities were revealed in medical personnel and records, positive culture of S. maltophilia was found on one arthroscope, used in all four infected patients. No violations were found in sterilization processes. The contaminated arthroscope was proven loss of airtightness subsequently. For infection treatment, double or triple therapy of levofloxacin, sulfamethoxazole-trimethoprim, and minocycline was administered, with additional debridement performed in one patient. By retrospective survey, another three patients were suspected of infection out of the total 19 patients who underwent knee arthroscopy in last 4 weeks. After intervention, all involved patients recovered. Although S. maltophilia is a rare cause of knee septic arthritis, it can still occur and even lead to nosocomial outbreaks through instrument-related transmission. Sulfamethoxazole-trimethoprim, levofloxacin, and minocycline remain the treatment of choice, despite the rising global resistance rates. Although hydrogen peroxide gas plasma sterilization serves as a fast and effective method for instrument sterilization in arthroscopy, maintaining good arthroscope condition and airtightness ensures success, which warrants periodic checks.

Osteoporosis represents a major global health challenge with increasing prevalence and substantial healthcare burden. Current diagnostic approaches relying primarily on bone mineral density measurements have limitations for early disease detection and understanding pathophysiological mechanisms. We conducted comprehensive metabolomic analysis of osteoporotic cancellous bone to identify potential metabolic features and explore disease mechanisms. Hip cancellous bone samples from 18 osteoporotic patients and 18 age-matched non-osteoporotic controls were analyzed using dual-platform gas/liquid chromatography-mass spectrometry. Multivariate analysis combined with machine learning approaches identified metabolic patterns distinguishing osteoporotic from non-osteoporotic bone. Untargeted metabolomics of osteoporotic cancellous bone revealed widespread metabolic alterations. Key findings included significant reductions in amino acids (phenylalanine, glutamate, aspartate, lysine, arginine, serine, cystine), polyamines (spermidine), TCA intermediates (citrate, succinate), and purine nucleosides (adenosine, inosine, guanosine, inosine-2′-phosphate), together with decreased phospholipid precursors (phosphorylcholine, choline). In contrast, metabolites such as allantoic acid and inorganic sulfate were elevated. Pathway enrichment implicated amino acid, purine, energy, one-carbon, and phospholipid metabolism, converging on impaired osteoblast function, enhanced osteoclast activity, and oxidative stress. Statistically, inosine-2′-phosphate (AUC = 0.951) Allantoic acid (log2FC: 3.14785) and phenylalanine (log2FC: − 5.3884) showed strong discriminatory potential. This study provides the first comprehensive metabolomic profile of human osteoporotic cancellous bone, highlighting a network of metabolic disturbances that underlie dysregulated bone remodeling. These findings identify amino acid, purine, and phospholipid pathways as potential mechanistic drivers and therapeutic targets in osteoporosis. Metabolites with strong statistical significance warrant further validation and translational investigation.

ObjectiveHyperuricemia is a common metabolic disorder linked to systemic inflammation; however, its impact on perioperative hematological and inflammatory markers in patients residing in high-altitude regions who have undergone anterior cruciate ligament reconstruction remains unclear. We hypothesized that hyperuricemia is associated with a heightened perioperative inflammatory response.MethodsThis retrospective, cross-sectional study included 83 long-term high-altitude (≥2500 m) residents who underwent anterior cruciate ligament reconstruction between 2019 and 2025. Patients were divided into hyperuricemia (n = 40) and normouricemia (n = 43) groups based on their serum uric acid levels. Inclusion criteria included isolated anterior cruciate ligament injury, complete perioperative laboratory records, and confirmed preoperative hyperuricemia based on serum uric acid levels. Exclusion criteria included systemic inflammatory disease and incomplete data. Perioperative hematological and inflammatory parameters-including platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio-were compared using t-tests and chi-square tests.ResultsPreoperatively, the hyperuricemia group had lower neutrophil-to-lymphocyte ratio (1.17 ± 0.92 vs. 1.91 ± 0.82, p < 0.001) and platelet-to-lymphocyte ratio (101.6 ± 28.4 vs. 116.4 ± 31.9, p = 0.028) but higher lymphocyte count (2.21 ± 0.56 vs. 1.91 ± 0.47, p = 0.009) than the normouricemia group. Postoperatively, compared with the normouricemia group, the hyperuricemia group showed elevated white blood cell count (10.82 ± 2.90 vs. 8.23 ± 2.55, p < 0.001), neutrophil count (7.98 ± 2.88 vs. 5.55 ± 2.23, p < 0.001), and lymphocyte count (2.63 ± 2.36 vs. 1.75 ± 0.52, p = 0.023) but lower platelet-to-lymphocyte ratio.ConclusionHyperuricemia is associated with altered perioperative hematological profiles and amplified inflammatory responses in patients residing in high-altitude regions who have undergone anterior cruciate ligament reconstruction, underscoring the need for targeted perioperative monitoring.

Quantitative CT (QCT) is a method of measuring bone mineral density (BMD) of human based on a CT machine,calibrated by QCT body model and analyzed by professional software.Compared with dual-energy X-ray absorptiometry,QCT can not only assess the cortical and cancellous BMD but also exclude the influences of osteophytes and aortic/vascular calcification,thus being capable of accurately reflecting patients' bone mass.In recent years,increasing studies on QCT and osteoporosis (OP) have been carried out,and the application of QCT in the diagnosis of OP,evaluation of vertebral bone conditions,prediction of fracture risks,and assessment of anti-OP treatment is garnering increasing attention from researchers at home and abroad.This article reviews the research progress in this field,aiming to provide a reference for the research on QCT in the diagnosis and treatment of OP.

Background:This study aimed to investigate the graft isometry of anatomical single-bundle anterior cruciate ligament (ACL) reconstruction using a novel method. Methods:Seventy-three patients (mean age, 28.4 ± 9.5 years, 71 men and 2 women) underwent unilateral ACL reconstruction using hamstring autografts and an anteromedial drilling technique. Femoral tunnels were positioned in the high portion of the anteromedial bundle insertion; tibial tunnels were positioned at the center of the ACL tibial footprint. Graft laxity was evaluated using a new method based on Endobutton flip. Two knots were tied on the pulling sutures of the Endobutton, and the distance changes between the knots during flipping were measured, which represented the extent of flipping and the graft laxity. Measurements were conducted at 0°, 30°, 60°, 90°, and 120° of knee flexion, respectively. The patterns of graft laxity and their association with femoral tunnel positions were analyzed. Results:The grafts were taut at knee extension but exhibited laxity during knee flexion in nearly all patients. Three patterns of graft laxity were observed: pattern 1, constant laxity throughout flexion (n = 39); pattern 2, lax at mid flexion, and taut again at high flexion (n = 11); and pattern 3, gradually increasing laxity with knee flexion (n = 15). Compared to pattern 1, the femoral tunnels were significantly higher and shallower in pattern 2 and significantly lower and deeper in pattern 3. Conclusions:Positioning a graft in the high portion of the anteromedial bundle insertion on the femoral side does not achieve absolute isometry, but exhibits laxity changes similar to the overall pattern presented by the native ACL during the range of knee motion. Minor variations in the positions of femoral tunnels are associated with distinct patterns of graft laxity. Tensioning and fixation of the ACL graft at knee extension are suggested.

IntroductionOsteoarthritis (OA) remains a significant clinical challenge, necessitating improved strategies for cartilage repair. Stem cells and scaffolds have crucial roles in tissue repair and regeneration. In this study, we comprehensively investigated the proliferation and differentiation potential of infrapatellar fat pad stem cells (IFPSCs), synovium-derived stem cells (SDSCs), and bone marrow stem cells (BMSCs) from unpretreated knee joints in young rabbits, and after decellularized extracellular matrix (dECM) deposition by stem cell pretreatment in vitro.MethodsWe also examined adhesion and differentiation effects of poly-L-lactic acid (PLLA) and poly-D, L-lactic acid (PDLLA) scaffolds after inoculation with the three stem cell types. We conducted osteogenic, adipogenic, and chondrogenic induction studies using three unpretreated stem cell groups, nine stem cell groups cross-preconditioned with different dECM types, and six stem cell groups cultured on nanofiber PLLA and PDLLA scaffolds. Staining and PCR analyses were then performed.ResultsIn vitro studies indicated that without pretreatment, IFPSCs exhibited the highest proliferation capacity, followed by SDSCs, while BMSCs had the lowest proliferation rate. After cross-pretreatment with dECMs from different sources, IFPSCs pretreated with IECM (decellularized extracellular matrix deposited by IFPSCs) showed the greatest proliferation. BMSCs displayed the highest osteogenic potential, while SDSCs and IFPSCs showed greater chondrogenic potential. No significant differences were observed in adipogenic potential among the three groups. BMSCs exhibited reduced osteogenic potential after pretreatment with all three dECMs, whereas IFPSCs and SDSCs showed enhanced osteogenic potential following SECM and IECM pretreatment, respectively. Additionally, all 3 cell types showed reduced lipogenic potential after pretreatment with the three dECM types. For chondrogenesis, BECM pretreatment were suitable for enhancing the chondrogenic potential of all 3 cell types. Furthermore, BMSCs and IFPSCs exhibited better adhesion and survival than SDSCs on electrospun scaffolds, which mimicked dECM structures. Besides, BMSCs and IFPSCs are more suitable for PLLA to promote osteogenic, adipogenic, and chondrogenic differentiation, whereas SDSCs are better suited for PDLLA.DiscussionOverall, it is anticipated that IFPSCs can be expanded with BECM pretreatment in vitro, and when combined with degradable nanofiber PLLA scaffolds in vivo, will facilitate better OA repair.

BACKGROUND:To understand the current status and influencing factors of kinesiophobia in patients after anterior cruciate ligament reconstruction (ACLR), and to provide references for the refined management of kinesiophobia patients by medical workers. METHODS:Guided by the scoping methodology, the Web of Science, Cochrane Library, PubMed, Embase, EBSCO, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang, and China Biomedical Literature were searched from database inception until May 31, 2025. The included literature was integrated and analyzed. RESULTS:A total of 16 articles were included in the study, involving 1725 patients. The incidence of kinesiophobia in patients after ACLR was relatively high, ranging from 33.33% to 92%. The influencing factors could be summarized into 3 themes, including general condition factors (gender, age, body mass index, family income, employment status, education level, and sleep quality), disease characteristics and treatment factors (postoperative time, timing of surgery after injury, number of injuries, function of the injured knee, pain intensity, muscle activity, and biomechanical indicators), and social psychological factors (pain catastrophizing, psychological state, and self-perceived or self-efficacy scores). CONCLUSION:Kinesiophobia is highly prevalent among patients after ACLR, with complex influencing factors. Assessment tools vary between domestic and international studies, and current research remains limited. Future studies should explore the causal relationships between kinesiophobia and its influencing factors, and develop targeted interventions to reduce its incidence, enabling patients to return to sports and society prompt.

OBJECTIVE:To evaluate the feasibility and accuracy of virtual preoperative planning and 3D-printed templates for pre-contoured plates for the treatment of posterior wall fractures of the acetabulum. METHODS:A retrospective analysis of 29 patients with posterior acetabular wall fractures treated between August 2017 and March 2021 were divided into 2 groups based on whether to use preoperative virtual planning and 3D printed template. In 3D-printing group, there were 14 patients, including 10 males and 4 females； aged from 21 to 53 years old；CT-based virtual surgical planning was done using Mimics and 3-Matic software and 3D-printed templates for pre-contoured plates were adopted. In conventional group, there were 15 patients, including 10 males and 5 females；aged from 19 to 55 years old；conventional method of intra-operative contouring to adapt the plate to the fracture region was adopted. Blood loss, surgical time, radiographic quality of reduction, and hip function were compared between groups. RESULTS:The difference in operation time and intraoperative blood loss was significant（P<0.05）. Twenty-three patients were followed up from 12 to 30 months, and the fractures in both groups healed with a healing time of 3 to 6 months. At the last follow-up, the Merle d'Aubign-Postel score of the 3D printed group was lower than that of the conventional group（P<0.05）, with no significant differences in walking ability, hip mobility and total score（P>0.05）. In 3D printing group, 6 cases were excellent, 5 cases were good, 3 cases were fair；in conventional group, 5 cases were excellent, 5 cases were good, 4 cases were fair, 1 case was worse；no significant difference between two groups（P>0.05）. CONCLUSION:Virtual preoperative planning and 3D-printed templates for pre-contoured plates can reduce operative time and the blood loss of surgery, improve the quality of reduction. This method is efficient, accurate and reliable to treat acetabular posterior wall fractures.

The ankle joint, which connects the lower limbs and the sole of the foot, is prone to sprain during walking and sports, which leads to ankle arthritis. Supratroleolar osteotomy is an ankle preserving operation for the treatment of ankle arthritis, in which the osteotomy is an important fixing and supporting part. In order to avoid stress shielding effect as much as possible, the osteotomy block is designed as a porous structure. In this study, the osteotomy block was designed based on three-period minimal surface, and the designed structure was manufactured by 3D printing. The mechanical properties of different structures were studied by mechanical test and finite element simulation. In mechanical tests, the Gyroid structure showed a progressive failure mechanism from bottom to bottom, while the Diamond structure showed a shear failure zone at 45° Angle, which was not conducive to energy absorption and was more prone to brittle fracture than the Gyroid structure. Therefore, the Gyroid structure is valuable for further research in the development of porous osteotomy.

To investigate the anatomical features of the femoral tunnel in anatomical and isometric single-bundle ACL reconstruction. Thirty-two 3-dimensional knee models were reconstructed based on CT scan (average age: 26.5 ± 6.7 years, 18 males and 14 females, 17 left and 15 right). Multiple anatomical landmarks were identified. Virtual femoral tunnels were created at the deep and high portion of ACL footprint, close to the lateral intercondylar ridge to achieve best anatomy and isometry, simulating an anteromedial portal reconstruction. Anatomical features of the femoral tunnels were analyzed. The position of the femoral tunnel was quantified by the distance to anatomical landmarks and using quadrant methods. The spatial angles, length and outer opening of the femoral tunnels were also evaluated. Acceptable tunnels were created in all models. The center of femoral tunnel was slightly higher than the apex of deep cartilage, near the deep one-third point across the shallow-deep dimension of the lateral femoral condyle. Using the quadrant method, the tunnel was located at 28.4

Objective:The risk factors of PJK (proximal junctional kyphosis) related to AIS (adolescent idiopathic scoliosis) are inconsistent due to heterogeneity in study design, diagnostic criteria, and population. Therefore, the meta-analysis was conducted to investigate the factors affecting PJK after posterior spinal fusion for AIS patients. Methods:We implemented a systematic search to obtain potential literature relevant to PJK in AIS surgery. Then, a meta-analysis was performed to assess the incidence of PJK and its risk factors. Results:We retrieved 542 articles, and 24 articles were included. The PJK incidence was 17.67%. The use of hooks at UIV (upper instrumented vertebrae) (p = 0.001) could prevent PJK. Before surgery, the larger TK (thoracic kyphosis) (p < 0.001), GTK (global thoracic kyphosis) (p < 0.001), and LL (lumbar lordosis) (p < 0.001) were presented in the PJK group. Immediately post-operatively, in the PJK group, the following parameters were higher: TK (p = 0.001), GTK (p < 0.001), LL (p = 0.04), PJA (proximal junctional angle) (p < 0.001), and PJA-RCA (rod contouring angle) (p = 0.001). At the final follow-up, the following parameters were higher in the PJK group: TK (p < 0.001), GTK (p < 0.001), LL (P < 0.001), and PJA (P < 0.001). Sub-group analysis detected that before surgery, the following parameters were larger in the PJK group: TK (p < 0.001), LL (p = 0.005), and PJA (p = 0.03) in Lenke type 5 AIS patients. Immediately post-operatively, in the PJK group, the following parameters were higher: TK (p < 0.001), LL (p = 0.005), and PJA (p < 0.001). At the final follow-up, the following parameters were higher in the PJK group: TK (p < 0.001), LL (p < 0.001), and PJA (p < 0.001). Conclusion:The individuals with larger preoperative TK were more susceptible to PJK, and PJA was mainly influenced by the adjacent segments rather than the whole sagittal alignment. Using hooks or claws at UIV should prevent PJK.