Bone and Arthrosurgery Science

The Depth of the Lateral Femoral Notch Sign: Its Significance in Acute Anterior Cruciate Ligament Tears with Concomitant Posterior Root Tears of the Lateral Meniscus

Jiqun Shi — 2026-03-11

Background: Anterior cruciate ligament (ACL) tears are frequently accompanied by lateral meniscus posterior root tears (LMPRT), which worsen prognosis. The lateral femoral notch sign (LFNS), a radiographic depression on the lateral femoral condyle, has been linked to ACL injury, yet its association with LMPRT and post-operative function remains unclear. This study examined whether LFNS depth predicts LMPRT and influences short-term functional outcomes after ACL reconstruction. Purpose: To investigate the relationship between the LFNS and functional outcomes in patients with acute ACL tears undergoing surgery and to explore the potential of LFNS as a predictive sign for ACL injuries combined with LMPRT. Methods: A total of 89 patients with ACL tears were enrolled in this retrospective pilot study between December 2020 and December 2023. All enrolled patients were divided into two groups based on LMPRT: the ACL group (ACL tear alone) and the LMPRT group (ACL tear combined with concomitant LMPRT). In addition to demographic data, the following parameters were compared: the incidence and depth of LFNS, functional results (Lysholm score) at 6 and 12 months, VAS score, and ROM before and after surgery. A logistic regression model was used to identify potential risk factors for ACL injury with concurrent LMPRT. Results: Among the 89 enrolled patients, 64 patients (71.9%) were in the ACL group, whereas 25 patients (28.1%) were in the LMPRT group. LMPRT was found to be correlated with the depth of LFNS (P < 0.001), and logistic regression analysis demonstrated that age, depth of LFNS, and LMPRT were correlated with the 12-month functional results (P = 0.001, P = 0.035, P = 0.010). The 12-month functional results were better in the LMPRT group (P < 0.001); however, no significant difference was found in the 6-month functional results between the ACL group and the LMPRT group (P = 0.272). The ROM in the ACL group was 118.44 ± 10.35 at 12 months post-operatively (P = 0.031), which was significantly greater than that in the LMPRT group (113.20 ± 9.45). However, no significant differences were observed at any other time points. Conclusion: LFNS may be a potential indicator of the LMPRT in patients with ACL tears. LFNS had an impact on the 12-month functional results in the LMPRT group but not on the 6-month functional results. Age, depth of LFNS, and LMPRT are risk factors for 12-month functional results.

Clinical Observation on the Analgesic Effect of Motor Acupuncture in the Acute Phase of Lumbar Disc Herniation

Xiaochun Hu — 2026-03-12

Objective: To investigate the efficacy of motor acupuncture in patients with lumbar disc herniation (LDH) during the acute phase. Methods: This was a controlled study involving 98 patients with acute LDH admitted to the Traditional Chinese Medicine Hospital of Changji Hui Autonomous Prefecture from November 2023 to June 2024. The patients were divided into two groups using the envelope method. The control group received conventional acupuncture treatment, while the observation group received conventional acupuncture combined with motor acupuncture. After one week of continuous treatment, the pain symptoms, lumbar spine function, and overall treatment efficacy were compared between the two groups. Results: After one week of treatment, the observation group had lower pain symptom scores compared to the control group (P < 0.05) and higher lumbar spine function scores (P < 0.05). The overall treatment efficacy rate in the observation group was 97.96%, which was significantly higher than 85.71% in the control group (P < 0.05). Conclusion: Conventional acupuncture combined with motor acupuncture is effective in treating LDH, providing ideal analgesic effects during the acute phase and significantly improving lumbar spine function.

Comparison of the Incidence of Postoperative Complications and Upper Limb Function Scores Between Minimally Invasive Percutaneous Plate Osteosynthesis and Traditional Open Reduction and Internal Fixation in Treating Middle and Lower Humeral Shaft Fracture

Aixiang Pan — 2026-03-11

Objective: To analyze the therapeutic effects of minimally invasive percutaneous plate osteosynthesis (MIPPO) and traditional open reduction and internal fixation (ORIF) for humeral shaft fractures (middle and lower segments). Methods: A total of 38 patients with humeral shaft fractures (middle and lower segments) admitted to the hospital from May 2022 to May 2025 were selected and evenly divided into two groups using a random number table. The experimental group received MIPPO treatment, while the reference group received ORIF treatment. The postoperative complication rates, upper limb function scores, and perioperative indicators were compared between the two groups. Results: The experimental group had a lower postoperative complication rate, higher upper limb function scores at one month postoperatively, and superior perioperative indicators compared to the reference group (P < 0.05). Conclusion: MIPPO treatment for patients with humeral shaft fractures (middle and lower segments) results in fewer postoperative complications than ORIF, with superior upper limb functional recovery and postoperative rehabilitation quality, demonstrating significant surgical advantages.

Gouty Arthritis Patients’ Health Economic Disease Burden and Healthcare Resource Consumption

Fujie Xu — 2026-03-11

Objective: To investigate the health economic burden of disease and healthcare resource utilization among patients with gouty arthritis. Methods: Medical records of patients with gouty arthritis documented in the Langchao database from January 1, 2020, to December 31, 2024, were selected. Descriptive analysis and statistical tests were conducted on healthcare resource consumption, types of medications used, and corresponding recurrence and new-onset disease events during patients’ visits. For between-group comparisons of normally distributed continuous variables, t-tests or analysis of variance (ANOVA) were employed; for non-normally distributed continuous variables, Wilcoxon rank-sum tests or Kruskal-Wallis H tests were used; for categorical variables, Pearson’s χ² tests or Fisher’s exact tests were applied. Results: This study included 96,199 patients with gouty arthritis, with a mean age of 50.49 years, of whom 68.65% were male. Patients used nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and glucocorticoids a total of 1,089,800 times, with NSAIDs accounting for 57.32%, colchicine for 1.38%, and glucocorticoids for 41.30%. From 2020 to 2024, patients had 4,440,466 outpatient visits (annual average of 12.65 visits) and 85,078 hospitalizations (annual average of 0.55 admissions). Hospitalized patients had an average length of stay of 8.73 days per admission, with an average of 10.27 laboratory tests and 1.74 examinations per hospitalization, substantially higher than for outpatients. In terms of expenditures for patients with gouty arthritis, hospitalized patients incurred higher laboratory test costs (253.26 yuan/person/year) and examination costs (472.53 yuan/person/year) compared to outpatients (laboratory tests: 137.00 yuan/person/year; examinations: 257.47 yuan/person/year), suggesting greater disease complexity and resource consumption. In the one-year follow-up after acute gout flares, recurrence rates differed across the three medication groups: the glucocorticoid group had an average of 3.28 recurrences, the colchicine group 2.82, and the NSAIDs group the lowest at 2.21. For new-onset adverse events, no significant differences were observed among the groups in gastrointestinal ulcers (P = 0.236) or bleeding (P = 0.069). However, significant differences existed in hepatic dysfunction (P = 0.033), renal impairment (P < 0.001), and cardiovascular/cerebrovascular events (P < 0.001). The glucocorticoid group exhibited the highest rates, with 2.72% for hepatic dysfunction, 5.90% for renal impairment, and 18.45% for cardiovascular/cerebrovascular events. Conclusion: Based on real-world electronic medical record data from the Langchao database (2020–2024), this study systematically evaluated the health economic burden and healthcare resource utilization of patients with gouty arthritis. The findings indicate a generally high level of healthcare resource consumption in real-world settings, particularly the substantial burden from laboratory tests and examinations among inpatients. Hospitalized patients incurred higher laboratory and examination costs than outpatients, suggesting greater disease severity, higher diagnostic and therapeutic complexity, and increased resource consumption. Regarding medication use, NSAIDs were the most frequently used agents and were associated with lower recurrence rates, although their potential adverse effects on renal function and cardiovascular risk warrant attention. The glucocorticoid group showed the highest recurrence rates and adverse event incidence, indicating that these agents should be used cautiously, particularly in patients with hepatic or renal dysfunction or elevated cardiovascular risk. Individualized medication management and monitoring should be strengthened to reduce recurrence frequency and adverse events, thereby alleviating disease burden and optimizing healthcare resource utilization. Clinicians are advised to comprehensively consider drug efficacy, recurrence risk, adverse events, and resource consumption when developing individualized treatment plans to achieve cost-effectiveness optimization and provide a scientific basis for healthcare policy formulation.

Clinical Study on the Treatment of Lumbar Disc Herniation with Electroacupuncture Combined with Heat-Sensitive Moxibustion

Zhihong Zhang — 2026-03-12

Objective: To investigate the clinical efficacy of adjacent-needling electroacupuncture combined with heat-sensitive moxibustion in the treatment of lumbar disc herniation (LDH), as well as its impact on pain relief, improvement of lumbar function, and levels of inflammatory factors. Methods: A total of 120 LDH patients who sought treatment at our hospital from January 2023 to December 2024 were selected and randomly divided into two groups using the envelope method. The two groups received different treatment modalities: the adjacent-needling electroacupuncture plus heat-sensitive moxibustion group (observation group, 60 cases) and the conventional acupuncture group (control group, 60 cases). Both groups underwent treatment for two courses. Changes in the Visual Analogue Scale (VAS) for pain, the Japanese Orthopaedic Association (JOA) score for lumbar function, the straight leg raise (SLR) angle, and serum inflammatory factors IL-6 and TNF-α were compared between the two groups before and after treatment. Results: After two courses of treatment, both groups showed improvements in pain and functional indicators compared to before treatment (P < 0.05), but the observation group demonstrated more significant improvements. Compared to the control group, the observation group had a more pronounced decrease in VAS scores, a greater increase in JOA functional scores, and a more substantial improvement in the SLR angle (all P < 0.05). Both groups exhibited a marked decrease in serum IL-6 and TNF-α levels, but the reduction in the observation group was significantly greater than that in the control group (P < 0.05). After treatment, the total effective rate in the observation group was 93.33%, while in the control group it was 78.33%, with the observation group demonstrating a significantly higher overall effectiveness (P < 0.05). Conclusion: Electroacupuncture combined with heat-sensitive moxibustion can significantly alleviate pain and improve lumbar function in patients with LDH, offering advantages such as ease of operation and reliable efficacy, making it suitable for clinical promotion.

Current Application Status and Development Trends of Minimally Invasive Techniques in the Treatment of Spinal Fractures

Yanxiao Liu — 2026-03-12

Spinal fractures are a common orthopedic injury, with thoracolumbar fractures being the most prevalent. These fractures are often accompanied by nerve damage, severely impacting patients’ lives, health, and quality of life. In recent years, minimally invasive techniques have gradually replaced traditional open surgery as the mainstream approach for treating spinal fractures, owing to their advantages of minimal trauma, rapid recovery, and fewer complications. This article reviews the current clinical application status of mainstream minimally invasive procedures, including percutaneous vertebroplasty, percutaneous pedicle screw fixation, and percutaneous endoscopic lumbar discectomy. It analyzes the indications, advantages, and limitations of each technique. Furthermore, by integrating digital and intelligent technologies, it explores the future development trends of minimally invasive techniques in the treatment of spinal fractures, providing references for optimizing clinical treatment plans and technological innovation.

Percutaneous Minimally Invasive Partial Resection of Vertebral Lesions Combined with Decompression and Percutaneous Vertebroplasty Injection for Thoracolumbar Metastatic Tumors

Yufei Wang — 2026-03-11

Objective: To explore the clinical efficacy and safety of percutaneous minimally invasive partial resection of vertebral lesions combined with decompression and percutaneous vertebroplasty (PVP) in the treatment of thoracolumbar metastatic tumors. Methods: The clinical data of 54 patients with thoracolumbar metastatic tumors who underwent percutaneous minimally invasive partial resection of vertebral lesions combined with decompression and PVP injection in our hospital from January 2020 to June 2024 were analyzed retrospectively. All patients received local anesthesia. There were 27 males and 27 females, including 31 cases of thoracic vertebral metastases, 18 cases of lumbar vertebral metastases, and 5 cases of thoracolumbar vertebral metastases. The Visual Analog Scale (VAS) score for pain and Oswestry Disability Index (ODI) before surgery and 1 week after surgery were compared. Meanwhile, the operation time, intraoperative blood loss, bone cement leakage, and other complications were recorded. Results: All patients successfully completed the operation. The operation time was 45–90 (67.89 ± 11.96) minutes, and the intraoperative blood loss was 30–100 (60.19 ± 20.16) mL. All patients were followed up for 3–12 months, with an average of 7.8 months. Except for 5 patients who experienced bone cement leakage, all other patients had their lesions healed smoothly, with no intraspinal leakage or other complications. The preoperative VAS score was 6–9 (7.69 ± 1.03) points, and the ODI was 51–79% (74.70 ± 7.64)%. One week after surgery, the VAS score was 1–3 (2.07 ± 0.70) points, which was significantly improved compared with that before surgery (P < 0.05). One week after surgery, the ODI was 24–41% (31.93 ± 4.43)%, which was also significantly improved compared with that before surgery (P < 0.05). Conclusion: Percutaneous minimally invasive partial resection of vertebral lesions combined with decompression and PVP injection in the treatment of thoracolumbar metastatic tumors has the advantages of minimal invasiveness, effective relief of cancer-related pain, restoration of vertebral stability, and few complications, which is conducive to improving the quality of life of patients.

Analysis of the Impact of Double-Row Suture Bridge Technique under Shoulder Arthroscopy on Postoperative Recovery and Shoulder Joint Function in the Treatment of Rotator Cuff Injuries

Bing Yin — 2026-03-12

Objective: To analyze the therapeutic effect of the double-row suture bridge technique under shoulder arthroscopy in treating rotator cuff injuries and its impact on postoperative shoulder joint functional rehabilitation. Methods: A retrospective analysis was conducted on the clinical treatment outcomes of 76 patients with traumatic rotator cuff injuries who underwent surgical treatment from 2024 to 2025. Patients who received single-row anchor suture fixation were designated as the control group (37 cases), while those who received the double-row suture bridge technique under shoulder arthroscopy during the same period were designated as the bridge group (39 cases). The ASES and Constant-Murley scores, as well as shoulder joint range of motion, were compared between the two groups before surgery and at 3 and 6 months postoperatively. Results: In the bridge group, the ASES score at 6 months postoperatively, as well as the shoulder joint forward flexion and abduction range of motion at 3 and 6 months postoperatively, were higher than those before surgery and in the control group during the same period, with statistically significant differences (P < 0.05). Conclusion: Compared to single-row anchor suture fixation, the double-row suture bridge technique under shoulder arthroscopy offers definite advantages in improving postoperative shoulder joint function and range of motion in patients with traumatic rotator cuff injuries, meeting the treatment needs of relevant patients.