Bone and Arthrosurgery Science

Epidemiological Investigation of Spinal Scoliosis in Children and Adolescents in Liangqing District, Nanning City

Han Deng — 2026-04-08

Objective: To investigate the epidemiological characteristics of scoliosis among primary and secondary school students in Liangqing District, Nanning City, and provide data support and prevention strategies for offline screening of scoliosis in children and adolescents in Nanning City. Methods: A total of 2,421 students from 6 primary and secondary schools in Liangqing District, Nanning City were randomly selected for scoliosis screening and questionnaire survey. Results: A total of 2,421 students were screened, including 1,294 males and 1,127 females. The positive detection rate of scoliosis was 18.4%. The detection rates of scoliosis in male and female students were 19.1% and 17.6% respectively, with no statistically significant difference. The positive rates of scoliosis in children and adolescents of different school levels were: general high school > junior high school > primary school, with statistically significant differences. Among different school levels, the positive detection rates of scoliosis in male and female students: the detection rate of female students in junior high school was the highest at 25.1%, while the detection rate of male students in general high school was the highest at 26.3%, with statistically significant differences. Conclusion: The positive rate of scoliosis among children and adolescents in this area is relatively high. Educational institutions should strengthen the publicity and education of spinal health knowledge.

A Case of Congenital Cranial Vascular Foramen Misdiagnosed as a Fracture: A Forensic Clinical Analysis

Fuqiu Mo — 2026-05-14

Congenital cranial vascular foramina may mimic fractures on imaging, potentially leading to errors in forensic injury severity assessment. This article reports the case of a 42-year-old male who sustained a blunt force head trauma. Multiple computed tomography scans initially revealed a linear hypodense shadow in the left temporal bone, diagnosed as a skull fracture and subsequently assessed as Minor Injury Grade II. Upon forensic re-evaluation, a longitudinal comparison with pre-injury imaging was conducted. Detailed analysis utilizing three-dimensional reconstruction technology demonstrated that the radiological finding was present prior to the injury. Furthermore, post-injury follow-up scans showed no morphological change or callus formation, characteristics consistent with a congenital vascular foramen rather than an acute fracture. Consequently, the injury severity was revised to Slight Injury. This case underscores the critical importance in forensic clinical practice of obtaining detailed medical history, systematically reviewing pre-injury imaging, and employing advanced image post-processing techniques for differential diagnosis. Such an approach helps prevent misdiagnosis due to anatomical variants, ensuring the objectivity and accuracy of injury severity assessment and upholding judicial integrity.

Study on the Clinical Efficacy of Spinal Endoscopy in the Treatment of Lumbar Spinal Stenosis

Yongbo Xie — 2026-05-14

Objective: To investigate the clinical efficacy of spinal endoscopy in the treatment of lumbar spinal stenosis. Methods: Eighty patients with lumbar spinal stenosis treated in our hospital from January 2024 to June 2025 were selected and randomly divided into two groups using a random number table. Patients treated with traditional open laminectomy were assigned to the control group, while those treated with spinal endoscopic decompression were assigned to the observation group. Clinical indicators were compared between the two groups. Results: Compared with the control group, the observation group demonstrated a higher rate of excellent and good treatment outcomes after treatment, shorter operation time, earlier postoperative ambulation, shorter hospital stay, less intraoperative blood loss, higher Japanese Orthopaedic Association scores, and lower Visual Analog Scale and Oswestry Disability Index scores (P < 0.05). The overall complication rate was lower in the observation group than in the control group (P < 0.05). Conclusion: Spinal endoscopy for the treatment of lumbar spinal stenosis offers advantages such as minimal surgical trauma, less intraoperative bleeding, rapid postoperative recovery, and fewer complications. It effectively improves lumbar spine function, alleviates pain, and enhances clinical efficacy, making it worthy of clinical promotion and application.

A Post-Hoc Analysis of the 48-Week Data from Study 301 of Firsekibart for Acute Gouty Arthritis: Evaluation of Number of Doses and Switching-to-Firsekibart Efficacy

Yu Xue — 2026-05-14

Objective: This post-hoc analysis aimed to evaluate the number of Firsekibart administrations over 48 weeks in patients with acute gout and the efficacy of switching to Firsekibart treatment during the open-label period in patients who had recurrent flare recurrence on compound betamethasone. Methods: We performed a post-hoc analysis on the 48-week treatment data from the 301 study (a multicenter, randomized, double-blind, active-controlled Phase III clinical trial) of Firsekibart for acute gout. A total of 312 patients with acute gout were randomized to receive either Firsekibart 200 mg subcutaneously or compound betamethasone 7 mg intramuscularly during the 24-week double-blind period, followed by a 24-week open-label period. After the initial dose, patients could receive additional doses upon gout flare; those with an inadequate response could receive oral prednisone as rescue therapy. During the open-label period, patients in the betamethasone group who experienced gout flares could switch to Firsekibart treatment. Differences in the number of doses between the two groups over 48 weeks, differences in the number of doses before and after switching to Firsekibart treatment in the betamethasone group, and the proportion of patients experiencing at least one gout flare after switching were analyzed. Results: Over 48 weeks, the median number of doses in the Firsekibart group was 1.0 (Q1, Q3: 1.0, 2.0), which was significantly lower than that in the compound betamethasone group (2.0 [1.0, 3.0]), P < 0.0001. For patients who switched from compound betamethasone to Firsekibart treatment, the median number of doses after switching was 1.0 (1.0, 1.0), markedly lower than the 2.0 (1.0, 3.0) before switching (P < 0.0001). During the open-label period, 69 patients (44.2%) in the betamethasone group switched to Firsekibart treatment, of whom only 2 (2.9%) experienced a gout flare. This recurrence rate was significantly lower than that observed during the double-blind period while receiving compound betamethasone (2.9% vs. 82.6%, P < 0.001). Conclusion: The median annual number of doses of Firsekibart for treating acute gout flares is one dose per year. For patients with inadequate response to corticosteroid therapy, Firsekibart demonstrates favorable efficacy and dosing convenience in controlling gout flares, representing a valuable new option for long-term gout management.

Traditional Chinese Medicine Regulates Th17/Treg Balance to Improve Osteoporosis: A Review of Bone Immunomodulation Mechanisms and Therapeutic Prospects

Zhiyuan Zhu — 2026-05-14

Osteoporosis (OP) is a metabolic bone disease characterized by reduced bone mass and destruction of bone microstructure, posing a serious threat to the health of the elderly population. Studies in osteoimmunology have revealed that an imbalance between Th17 cells and regulatory T cells (Treg) is a core immunopathological mechanism underlying OP: overactivation of Th17 cells promotes osteoclast differentiation and accelerates bone resorption, while impaired Treg function weakens bone protection, ultimately leading to disrupted bone metabolism. Traditional Chinese medicine (TCM), with its advantages in multi-target and holistic regulation, shows broad application prospects in restoring Th17/Treg balance and reshaping the bone immune microenvironment. This article systematically reviews the molecular mechanisms by which TCM compounds (e.g., Yishen Juanbi Pills, Jintiange Capsules) and active components (e.g., icariin, astragaloside IV) regulate T cell differentiation, with a focus on the involvement of signaling pathways such as NF-κB and Wnt/β-catenin, as well as the gut microbiota–short-chain fatty acids axis in mediating immune regulation. In addition, it summarizes preclinical and clinical research evidence supporting the use of TCM in treating OP. In response to current challenges, including insufficient target analysis and a lack of high-quality clinical evidence, this paper proposes that future efforts should integrate cutting-edge approaches such as multi-omics technologies, nano-delivery systems, and artificial intelligence to systematically elucidate the molecular network through which TCM regulates bone immunity. Such advances will facilitate the transition of TCM from experience-based to evidence-based medicine, providing safer and more effective immune-targeted therapeutic strategies for the prevention and management of OP.

Clinical Observation on the Efficacy of Minimally Invasive Treatment for Comminuted Fractures of Long Bones Using Adjustable Carbon Fiber Three-Dimensional External Fixator-Assisted Closed Reduction and Internal Fixation

Tuo Jia — 2026-05-14

Objective: To observe the clinical efficacy of minimally invasive treatment for comminuted fractures of long bones using adjustable carbon fiber three-dimensional external fixator-assisted closed reduction and internal fixation, providing practical evidence for clinical treatment. Methods: Ninety patients with comminuted fractures of long bones admitted to the orthopedics department of our hospital from January 2024 to January 2026 were selected as the study subjects. They were randomly divided into an observation group and a control group using a random number table method, each with 45 patients. The control group underwent traditional open reduction and internal fixation, while the observation group underwent minimally invasive treatment using adjustable carbon fiber three-dimensional external fixator-assisted closed reduction and internal fixation. Surgical-related indicators (operative time, intraoperative blood loss, hospital stay), fracture healing status (fracture healing time, excellent and good rate of fracture healing), postoperative complications, and limb function recovery before and after treatment were compared between the two groups. Results: The observation group had significantly lower operative time, intraoperative blood loss, hospital stay, healing time, and complication rate compared to the control group (all P < 0.05). The excellent and good rate of fracture healing in the observation group was significantly higher than that in the control group (P = 0.013 < 0.05). At 3 and 6 months after treatment, the Johner-Wruhs scores of both groups were significantly higher than those before treatment, and the scores in the observation group were significantly higher than those in the control group (all P < 0.001). Conclusion: Minimally invasive treatment for comminuted fractures of long bones using adjustable carbon fiber three-dimensional external fixator-assisted closed reduction and internal fixation offers advantages such as minimal surgical trauma, less intraoperative bleeding, rapid postoperative recovery, good fracture healing, and fewer complications. It effectively promotes limb function recovery in patients, demonstrating definite clinical efficacy and warranting widespread application.

Single-Row Versus Double-Row Rotator Cuff Repair: A Systematic Review and Meta-Analysis of Structural Integrity and Functional Outcomes

Delger — 2026-05-14

Background: Double-row rotator cuff repair is often used to improve tendon healing. However, its effect on clinical outcomes is still not clearly established. Methods: A systematic review and meta-analysis was performed following PRISMA guidelines. This study compared single-row and double-row repair. Structural integrity and functional outcomes were evaluated. Structural failure was defined as any non-intact repair, including both partial- and full-thickness defects. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Eight comparative studies were included. Six contributed to structural analysis, and six reported functional outcomes. Among these, four were included in the quantitative synthesis for functional results. Structural failure occurred in 42.7% of shoulders after single-row repair and 26.4% after double-row repair. This corresponds to an absolute reduction of about 16%, which is significant in practice. Double-row repair reduced the risk of structural failure (OR 0.47, 95% CI 0.29 to 0.75; I² = 0%). In contrast, postoperative Constant scores were similar between groups (MD −0.08, 95% CI −3.98 to 3.82; I² = 0%). Conclusion: Double-row repair improves structural integrity. But it does not seem to improve functional outcomes, at least within the current sample size. This indicates that structural healing and clinical recovery may not fully align.

Effects of Grape Seed Extract on NF-κB Expression in Synoviocytes of Mice with Rheumatoid Arthritis

Fan Li — 2026-05-14

Objective: To investigate the effects of grape seed extract (GSE) on NF-κB expression and inflammatory injury in synoviocytes of mice with rheumatoid arthritis (RA), so as to provide experimental evidence for the natural drug therapy of RA. Methods: RA mouse model was established by collagen induction. The mice were randomly divided into a normal control group, a model group, and low-/medium-/high-dose GSE groups, and received intragastric intervention for 48 hours. Synoviocytes were isolated and cultured in vitro. The mRNA and protein expressions of NF-κB/p65 were detected by qRT-PCR and Western blot, respectively. The secretion levels of TNF-α, IL-6, and IL-1β were detected by ELISA, and the pathological changes of synovial tissue were observed by HE staining. Results: Compared with the model group, the expression of NF-κB/p65 in each GSE dose group decreased in a dose-dependent manner (P < 0.05 or P < 0.01). The expression and secretion of downstream inflammatory factors were significantly down-regulated, and the pathological injury of synovial tissue was significantly improved, with the most significant effect in the high-dose group. Conclusion: GSE can inhibit the NF-κB signaling pathway, down-regulate the release of inflammatory factors, and alleviate synovial inflammation and pathological injury in RA mice. It is expected to be a potential natural drug for the treatment of RA.

Comparison of the Clinical Effect of Collagenase Lysis with Different Administration Routes in Treating Lumbar Disc Herniation

Junhong Liu — 2026-05-14

Objective: To observe and discuss the clinical effect of collagenase lysis in the treatment of lumbar disc herniation through different administration routes. Methods: Sixty patients with lumbar disc herniation admitted to Liuzhou People’s Hospital from February 2023 to February 2024 were selected, including 31 males and 29 females. They were divided into A and B groups according to the random number table method. Group A was injected through sacral hiatus route combined with intervertebral foramen safety triangle route (n = 30), and Group B was injected only through sacral hiatus route (n = 30). The VAS score, ODI index, and the efficacy of Macnab were observed before operation, 3 days, 1 month, and 3 months after operation, and the results were summarized and compared. Results: Compared with Group B (only through the sacral hiatus route), the VAS score, ODI index, and the efficacy evaluation of Macnab in Group A (through the sacral hiatus route combined with the intervertebral foramen safety triangle route) were significantly better, and the differences were statistically significant (P < 0.05). Conclusion: Multi-path collagenase lysis is more effective than single-path collagenase lysis.

Observation on the Therapeutic Effect of Core Stability Training of Lumbar and Back Muscles Combined with Dynamic Joint Mobilization on Patients with Sacroiliac Joint Dysfunction

Huiqian Yan — 2026-05-14

Objective: To explore the clinical efficacy of core stability training of the lumbodorsal muscles combined with dynamic joint mobilization in patients with sacroiliac joint dysfunction. Methods: From October 2023 to December 2025, 38 patients with sacroiliac joint dysfunction were randomly divided into a training group (n = 13), a treatment group (n = 12), and a combined intervention group (n = 13). The training group received core stability training of the lumbodorsal muscles, the treatment group received Mulligan’s technique, and the combined intervention group first received core stability training of the lumbodorsal muscles followed by Mulligan’s technique. Before treatment and after six weeks of treatment, evaluations were conducted using the Numeric Pain Rating Scale (NPRS), the Oswestry Disability Index (ODI score), lumbar range of motion (ROM), and pressure pain threshold (PPT). Results: After six weeks of treatment, both the treatment group and the combined intervention group showed a decrease in NPRS scores compared to before intervention (P < 0.05). All three groups showed a decrease in ODI scores compared to before intervention (P < 0.05), with the combined intervention group having lower NPRS scores than the training group (P < 0.05) and lower lumbar extension ROM than the treatment group (P < 0.05). Conclusion: Core stability training of the lumbodorsal muscles combined with dynamic joint mobilization can effectively alleviate pain and improve dysfunction in patients with sacroiliac joint dysfunction, demonstrating good clinical application value.

Research Progress on Subchondral Bone Lesions in Knee Osteoarthritis

Yunlong Li — 2026-05-14

This article reviews the research on subchondral bone lesions in knee osteoarthritis. Subchondral bone is closely related to articular cartilage in terms of embryonic development and anatomical structure, and the two form bone-cartilage units. These units interact and crosstalk with each other in biomechanics and molecular biology. Subchondral bone lesions include various pathological forms. There are certain research prospects for the prevention and treatment of knee osteoarthritis targeting the subchondral bone.