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Purpose: The purpose of this study was to investigate the effects of acute ischemic preconditioning (IPC) on tennis skill and physical exercise performance, as well as to explore whether 7-day repeated IPC (RIPC) accelerated fatigue recovery after a simulated tennis match. Methods: Twenty-nine male tennis-specific current students were randomly allocated into 1 of 2 groups: SHAM (n = 14, 3 × 5 min at 20 mm Hg) and IPC (n = 15, 3 × 5 min at 220 mm Hg). Participants in both groups engaged in acute IPC and RIPC interventions. After the first acute IPC intervention, assessments were conducted to evaluate tennis-specific skills and overall physical exercise capacity. Following completion of chronic RIPC interventions, all participants competed in a simulated tennis match specifically designed to induce fatigue. To evaluate recovery from this induced fatigue, physical exercise capacity tests were conducted at 24 and 48 hours postmatch, allowing for an assessment of the participants' recovery capabilities over time. Results: After the first acute intervention, notable differences were observed between the IPC and SHAM groups in their performance on the repeated-sprint ability test. Specifically, the total times recorded were significantly shorter in the IPC group compared with the SHAM group (IPC: 109.05 [2.70] vs SHAM: 114.57 [7.45] s, P =.012), and this trend was also reflected in their best times (IPC: 4.20 [0.18] s vs SHAM: 4.39 [0.30] s, P =.042), indicating an immediate benefit of the IPC intervention on sprint performance. After a 7-day RIPC intervention, significant changes were noted in the SHAM group's performance metrics postmatch. There was an increase (P <.001) in fatigue index from 22% (8%) to 30% (9%) during repeated-sprint ability test and a decrease in serve speed from 120.2 (17.5) to 106.7 (13.0) km/h (P =.002) and knee peek torque from 196.0 (49.0) to 162.7 (39) N (extension, 60°/s, P <.001) in the SHAM group 24 hours postmatch, relative to the IPC group. Moreover, compared with the SHAM group, the IPC group showed a lower rate of perceived exertion during the match (P <.001) and a decrease in visual analog scale score (P =.026) 24 hours postmatch, suggesting enhanced recovery and reduced perception of pain relative to the SHAM group. Conclusion: IPC could serve as a strategy to generate an ergogenic effect and recovery during training and competition. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of a single infrapositioned ankylosed tooth or implant-supported restoration on smile esthetics. Materials and Methods: A series of 48 digitally modified images that simulated varying degrees of infraposition (from 0.25 to 2.0 mm, with a step of 0.25 mm) were created for each maxillary anterior tooth by altering the full-portrait image of a smiling man, adjusted to show medium and high smile lines. For the model with the high smile line, a series of 24 digitally modified images were created that simulated the infraposition of a single anterior tooth with a restored incisal edge. Smile esthetics for each of the images were evaluated by 160 participants (80 dentists and 80 laypersons), and a visual analog scale (VAS) was implemented. Results: For the images with the high smile line, an infraposition of ≥ 0.25 mm in the central incisor region and ≥ 0.5 mm in the region of the lateral incisor or the canine had a negative effect on the perceived smile esthetics for both the dentists and the laypersons. Regarding the medium smile line, an infraposition of ≥ 0.5 mm in the central and lateral incisor region had a negative effect on the perceived smile esthetics for both groups of observers. In the canine area, an infraposition of ≥ 0.5 mm for the dentists and ≥ 0.75 mm for the laypersons also had a negative impact on the smile esthetics. Conclusions: Even a minor infraposition of a single maxillary anterior ankylosed tooth or implant-supported restoration can reduce the perceived attractiveness of the smile. Infraposition in the canine site can be better tolerated in a medium smile line compared to a high smile line. In patients with a high smile line, prosthetic intervention is needed to restore the incisal edge of an infrapositioned tooth without harmonizing the gingival contour; this can be beneficial for the lateral incisor but ineffective for the central incisor and unfavorable for the canine. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare patient satisfaction levels in edentulous patients treated with different configurations of implant-supported prostheses as well as previous prosthesis experiences before implant treatment. Materials and Methods: A study population of 142 patients was identified and separated into four treatment groups: group 1 comprised 43 patients treated with an implant-supported overdenture in the mandible and conventional complete denture in the maxilla; group 2 comprised 32 patients treated with implant-supported overdentures in the maxilla and mandible; group 3 comprised 26 patients treated with an implant-supported overdenture in the mandible and a fixed prosthesis in the maxilla; and group 4 comprised 41 patients treated with implant-supported maxillomandibular fixed restorations. Questionnaires asking about masticatory performance, pronunciation, comfort, and social ability were used to evaluate treatment outcomes. Results: The patients in group 4 were significantly more satisfied regarding masticatory performance than other treatment modalities. Visual analog scale (VAS) scores for comfort and social ability were similar in groups 3 and 4 and significantly higher than those in groups 1 and 2. The patients who used a conventional removable prosthesis before implant treatment were more satisfied with their implant-supported prosthesis regarding social ability (P = .03). Conclusions: The treatment design of an implant-supported fixed prosthesis in the maxilla and implant overdenture in the mandible provided a comparable level of satisfaction with maxillomandibular fixed prosthesis for edentulous patients. This combination served as a practical solution especially for patients with mandibular atrophy who would require extensive surgeries to support maxillomandibular fixed prostheses. In the maxilla, patient satisfaction with an implant-supported overdenture was not superior to that with a conventional prosthesis. Note that previous removable prosthesis experience may influence social comfort for patients. [ABSTRACT FROM AUTHOR]

The introduction of a new collagen substitute, which will potentially reduce the invasiveness of techniques by avoiding the need for a second surgical site (ie, the donor site), needs to be evaluated in relation to the surgical procedure that could benefit the most by utilizing such a matrix. This study compared the clinical outcomes following treatment of RT1 multiple adjacent gingival recessions (MAGRs) using the modified coronally advanced tunnel (MCAT) technique or the multiple coronally advanced flap (MCAF) in conjunction with a new volume-stable xenogeneic collagen matrix (VXCM). Secondarily, the study evaluated whether patients report a preference between the two surgical techniques in terms of discomfort. A total of 20 patients requiring treatment of MAGRs were randomly assigned to one of the two treatment groups: MCAF+VCMX (Group A) or MCAT+VCMX (Group B). The following measurements were recorded at baseline (before surgery) and at 6 and 12 months: gingival recession depth (REC), probing pocket depth (PD), keratinized tissue width (KTW), and gingival thickness (GT). Postoperative pain and discomfort were recorded using a visual analog scale (VAS) at 1 week. The primary outcome variable was mean root coverage (mRC), and secondary outcomes were complete root coverage (CRC), changes in KTW and GT, patient discomfort and satisfaction, and duration of surgery. Healing was uneventful in both groups. At 12 months, both treatments resulted in statistically significant improvements in REC and GT compared to baseline (P < .05). The mRC was 79.95% ± 29.92% in the MCAF group and 64.74% ± 40.5% in the MCAT group (P = .124). CRC was seen in 65.6% of MCAF-treated sites and 52% of MCAT-treated sites (P = .181). Similar clinical results should be expected when MAGRs are treated with MCAF or MCAT, with the adjunct of VCMX. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was 2-fold: (1) to examine the relationships between psychophysiological responses and locomotor demands with variations in technical performance during 2v2 and 4v4 conditioned games and (2) to compare psychophysiological and locomotor responses among players exhibiting higher and lower technical performance levels during the conditioned games. Methods: Twenty-four male youth soccer players (16.3 ± 0.8 y old) participating at the trained/developmental level underwent monitoring for psychophysiological responses (including heart rate, rating of perceived exertion, and visual analog scale), locomotor demands (such as distance covered), and technical performance variables (including successful and unsuccessful passes and shots, as well as lost balls) across 2v2 and 4v4 formats. These formats were applied 4 times within a single session and were replicated twice over 2 weeks. Results: Large correlations between the number of lost balls per minute and mean heart rate were found in both the 2v2 and 4v4 games (r =.586 and r =.665, respectively). Successful shots were inversely and largely correlated with mean heart rate (r = −.518) in 4v4 games. The number of interceptions per minute was inversely and significantly correlated with the visual analog scale in 2v2 and 4v4 games (r = −.455 and r = −.710, respectively). The frequency of lost balls was significantly higher among players who attained a higher mean heart rate (2v2: +42.9%, P =.031, d = −0.965; 4v4: +57.1%, P <.001, d = −2.072). Conclusions: Coaches should be aware that highly psychophysiologically demanding scenarios may significantly impair technical performance. Therefore, prioritizing technical performance by deliberately adjusting the intensity should be considered. [ABSTRACT FROM AUTHOR]

This study assessed the effects of buccal contour augmentation for periodontally compromised teeth with horizontal bone loss. A total of 30 subjects were divided into Group A or Group B (n = 15 subjects per group). Group A received open-flap debridement (OFD) with buccal contour augmentation using deproteinized bovine bone mineral (DBBM), jointly referred to as contour augmentation for periodontal defects (CAPD; test group). Group B received only OFD (control group). Bleeding on probing (BOP), clinical attachment level (CAL), probing depth (PD), gingival recession (GR), keratinized mucosa width (WKM), keratinized mucosa thickness (TKM), and labial cortical plate thickness were compared at baseline and 1 year. BOP, CAL, PD, and GR did not show significant differences. TKM increased by 1.76 mm for Group A but decreased by 1 mm for Group B. WKM increased from 2.86 ± 0.4 mm to 3.6 ± 0.71 mm (P < .001) and from 2.93 ± 0.32 mm to 3 ± 0.7 mm (P = 0.5) for Groups A and B, respectively, which showed statistical significance. Labial cortical plate thickness increased from 0.94 ± 0.3 mm to 1.95 ± 0.54 mm (P < .001) for Group A but decreased from 0.87 ± 0.45 mm to 0.68 ± 0.31 mm for Group B. Visual analog scale scores for pain perception showed no difference between the two groups. CAPD for periodontally compromised teeth improves WKM and TKM. Long-term analyses are needed to determine its benefits in daily clinical practice. [ABSTRACT FROM AUTHOR]

Gingival recession treatment is one of the major clinical challenges in periodontics, and various surgical techniques have been proposed to correct it. Most of these techniques are suitable for isolated recession sites and involve harvesting an autogenous tissue graft, which increases patient morbidity and might result in inferior esthetics due to incision design. This study assessed the benefit of adding platelet-rich fibrin (PRF) to the vestibular incision subperiosteal tunneling approach (VISTA) in treating multiple gingival recession compared to using VISTA alone. A total of 41 teeth with Miller Class I and II defects were randomized in a split-mouth design. Multiple clinical parameters were tested, including the change in gingival thickness over time, keratinized tissue width, and gingival phenotype (using the transparency of a periodontal probe). Patient-centered outcomes were also assessed via visual analog scale. Multiple Miller Class I and II recessions in the maxilla can be effectively treated with VISTA. However, when used in conjunction with PRF, no significant differences were detected in any parameter. VISTA has been shown to be associated with a low level of postsurgical pain for patients and can be used for patients with high esthetic demands. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the impact of injectable plateletrich fibrin (iPRF) and concentrated growth factor on postoperative pain, edema, trismus, and quality of life in impacted mandibular third molar surgery. The primary aim of this study was to minimize common sequelae following third molar surgery by using iPRF and concentrated growth factor. The secondary objective was to compare the postoperative effects of these products. Method and materials: This study represents a single-center, randomized prospective clinical trial conducted at the Ordu University Faculty of Dentistry. It involved patients who underwent third molar surgery for various reasons between July and October 2022. The predictor variables were the use of concentrated growth factor and i-PRF. They were categorized as concentrated growth factor, i-PRF, and control groups. The outcome variables include pain levels and analgesic consumption measured on a visual analog scale, distances between predetermined anatomical points, maximum mouth opening capacity, and data from the postoperative symptom severity (PoSSe) scale. Some statistical tests were performed with a 95% confidence interval, which was considered significant. Results: Total analgesic use was notably lower in the concentrated growth factor group (P = .044). Concentrated growth factor and iPRF outperformed the control group in all edema measurements by postoperative day 7 (tragus–pogonion, lateral canthus–angulus, tragus–commissura; P < .05). Concentrated growth factor significantly reduced trismus on days 2 and 7. Quality of life was notably higher in the concentrated growth factor group than in the control group (P = .026), although iPRF group differences were not significant. Conclusion: The results indicate that concentrated growth factor has a limited impact on postoperative pain, but significantly reduces edema, trismus, and enhances quality of life. The iPRF group experienced positive effects on pain, edema, and trismus, although the statistically significant differences observed with concentrated growth factor highlight its potential for use instead of iPRF after third molar surgery. An increased sample size is essential for more comprehensive results [ABSTRACT FROM AUTHOR]

Context: Wheelchair Power Soccer (WPS) is the only team sport that allows the participation of people with severe physical disabilities who require the daily use of motorized wheelchairs. These individuals may live with chronic pain due to the characteristics of the disabilities and treatments, interfering with their health and limiting their participation in sports. Objectives: To investigate the prevalence of musculoskeletal pain and its relationship with mood in WPS players and to analyze the incidence of traumatic injuries during a championship. Methods: A prospective, longitudinal study was carried out on 30 WPS athletes (93.33% male) with a mean (SD) (range) age of 22.37 (9.79) (47) years. Data collection was performed during a South American WPS Championship lasting 3 days, with: investigation of the presence of musculoskeletal pain and mood through a questionnaire; investigation of the occurrence of traumatic injuries through match observation; and confirmation of the occurrence of traumatic injuries through access to medical department records. Results: About 30% (n = 9/30) of the sample presented some pain on the day of evaluation, with an intensity of 5.67 (3.35) (10) points on the visual analog scale. The most common regions of pain were the lower back (13.3%, n = 4/30), thoracic (10%; n = 3/30), and cervical (10%; n = 3/30) areas of the spine. A total of 46.7% (n = 14/30) reported pain in the month before data collection but of less intensity (2.56 [4] [10] points), the most common regions being the lower limbs (20%; n = 6/30) and cervical spine (20%; n = 6/30). Among the between-group comparisons (ie, participants with pain vs without pain), no relationship was observed between mood state and pain. No traumatic injuries were identified during the competition. Conclusion: The presence of musculoskeletal pain was common in WPS players, but it was not related to mood. As no traumatic injuries were observed during the championship, this modality seems to be safe for people with physical disabilities in general. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the long-term predictability of simplifying mandibular overdenture treatment using single-stage surgery and immediate prosthetic loading of a single implant to provide a more affordable treatment option. Materials and Methods: A total of 29 patients with a mean age of 68 years with problematic mandibular dentures were treated. A single implant (Brånemark System Mklll TiUnite, Nobel Biocare) was placed into the mandibular midline for primary stability. A ball attachment was placed, and the retentive cap was incorporated into the existing denture. The patients were recalled at 3 and 12 months and at 3, 5, 10, and 15 years. Clinical assessments, radiographs, and resonance frequency analysis were recorded. All complications, failures, maintenance, and reasons for failure to follow-up were noted. Visual analog scale (VAS) questionnaires were used to record patient satisfaction (ANOVA; P < .05). Results: One implant did not achieve sufficient primary stability to be immediately loaded and was treated with a two-stage delayed loading protocol. Of the 28 patients receiving immediately loaded implants, 14 patients were available for follow-up at 15 years. Implant survival remained at 100% throughout the study. Patient satisfaction was high, with a significant increase in all comfort and functional parameters (P values ranged from < .001 to .07) throughout the 15-year period. Conclusions: These 15-year results indicate that immediate loading of a single oxidized surface implant used to retain a mucosa-borne overdenture is a safe, reliable, and cost-effective treatment with high levels of patient satisfaction long term. [ABSTRACT FROM AUTHOR]

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. Design: A parallel, single-blinded, randomized controlled trial. Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes. [ABSTRACT FROM AUTHOR]

Purpose: To assess the pain, swelling, infection, and alteration in sensation following the flapless placement of zygomatic implants guided by dynamic navigation. Materials and Methods: A randomized controlled trial was conducted on 20 patients. In group 1, the placement of the zygomatic implants was carried out without reflecting a mucoperiosteal flap (flapless). In group 2, a mucoperiosteal flap was raised (flapped). Two zygomatic implants were placed in each patient (one on each side) under local anesthesia, guided by dynamic navigation. Postoperative evaluations included pain (using the visual analogue scale [VAS]), swelling (using standard measurements), maxillary sinus infection, and alteration of sensation (using mechanical stimuli, thermal threshold detection, and a two-point discrimination test). The assessments were carried out at 2 days, 1 week, and then 1, 2, and 3 months postoperatively. Results: In group 1, all implants except for one were successfully osseointegrated. Immediate postoperative pain and swelling were both significantly greater in group 2 (P < .01). No alteration in sensation was detected in any case in the two groups. There were a total of three cases of chronic sinusitis: one in group 1 and two in group 2. Conclusions: The flapless placement of zygomatic implants guided by dynamic navigation and under local anesthesia improves postoperative recovery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate two pharmacologic antibiotic prophylaxis regimens and a control group of immunocompetent patients undergoing two-stage dental implant placement in a triple-blind randomized controlled clinical trial. Materials and Methods: From a group of 61 immunocompetent patients, 21 were randomly allocated into group 1 (G1) without antibiotic prophylaxis (control), 20 in group 2 (G2) with preoperative antibiotic prophylaxis (1 g amoxicillin 1 hour before the procedure), and 20 in group 3 (G3) with preoperative (1 g amoxicillin) and postoperative (500 mg every 8 hours for 5 days) antibiotic prophylaxis. Pain was assessed with the visual analog scale (VAS) and by considering the number of painkillers patients used. Infection was identified via the presence of pus and fistula. Patients were evaluated after 7, 14, 30, and 120 days. Implant failure (defined as mobility upon the application of manual torque) was evaluated after 120 days during the second surgical stage. Results: At the 7-day follow-up, pain intensity was less severe in the patients who had received antibiotics, with the G3 patients experiencing the least pain (P < .05). Infection was present in groups G1 (2 cases) and G3 (2 cases), but there was no statistically significant intergroup difference. Two implants failed, one in G1 and the other in G3. Conclusions: Based on the results of the present study, although the use of antibiotics reduced pain in the immediate postoperative period, it did not reduce infection rates and implant failure in immunocompetent patients. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of menstrual-cycle (MC) phase on measures of recovery status, that is, resting heart rate, perceived sleep quality, and physical and mental readiness to train, among female endurance athletes. Methods: Daily data were recorded during 1 to 4 MCs (ie, duration ≥21 and ≤35 d, ovulatory, luteal phase ≥10 d) of 41 trained-to-elite-level female endurance athletes (mean [SD]: age 27 [8] y, weekly training: 9 [3] h). Resting heart rate was assessed daily using a standardized protocol, while perceived sleep quality and physical and mental readiness to train were assessed using a visual analog scale (1–10). Four MC phases (early follicular phase [EFP], late follicular phase, ovulatory phase, and midluteal phase [MLP]) were determined using the calendar-based counting method and urinary ovulation-prediction test. Data were analyzed using linear mixed-effects models. Results: Resting heart rate was significantly higher in MLP (1.7 beats·min−1, P =.006) compared with EFP without significant differences between the other MC phases. Perceived sleep quality was impaired in MLP compared with late follicular phase (−0.3, P =.035). Physical readiness to train was lower both in ovulatory phase (−0.6, P =.015) and MLP (−0.5, P =.026) compared with EFP. Mental readiness to train did not show any significant differences between MC phases (P >.05). Conclusions: Although significant, the findings had negligible to small effect sizes, indicating that MC phase is likely not the main determinant of changes in measures of recovery status but, rather, one of the many possible stressors. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the alveolar sealing performance between free gingival graft (FGG) and porcine collagen membrane (MS) and qualitatively assess patient-centered outcomes via a visual analog scale. Method and materials: Eighteen patients were randomly divided into control (FGG) and test (MS) groups. After extraction, all the alveoli were filled with bovine bone grafts (small granules) and sealed. Follow-up was during the immediate postoperative period and after 3, 7, 15, 30, 60, 90, and 120 days. After 180 days, before implant placement, tissue samples were obtained for histologic analysis. The epithelial tissues were morphometrically measured for each sample. Qualitative information on the patient's perception of the treatment was collected after 7 days. Results: A faster healing was observed for the MS group. After 60 days, all the sites from the MS were partially healed, in contrast with only five from the FGG. The histologic results after 120 days showed for the FGG group a predominant acute inflammatory process, whereas chronic processes were observed for the MSgroup. The mean epithelial heights found for the FGG and MS were 535.69 pm and 495.33 pm, respectively (P = .54). The intragroup analysis showed significant variance among the data (P<.001) for both groups. The qualitative result showed statistically more significative comfort for the MS group (P < .05). Conclusion: Within the limitations of the study, both techniques effectively promote alveolar sealing. However, the visual analog scale result was superior and more signiffcant for the MS group, with faster wound healing and lower discomfort. [ABSTRACT FROM AUTHOR]

BackgroundChronic pain has long been a major health burden that has been addressed through numerous forms of pharmacological and nonpharmacological treatment. One of the tenets of modern medicine is to minimize risk while providing efficacy. Further, because of its noninvasive nature, virtual reality (VR) provides an attractive platform for potentially developing novel therapeutic modalities.ObjectiveThe purpose of this study was to determine the feasibility of a novel VR-based digital therapy for the treatment of chronic pain.MethodsAn open-label study assessed the feasibility of using virtual embodiment in VR to treat chronic pain. In total, 24 patients with chronic pain were recruited from local pain clinics and completed 8 sessions of a novel digital therapeutic that combines virtual embodiment with graded motor imagery to deliver functional rehabilitation exercises over the course of 4 weeks. Pain intensity as measured by a visual analog scale before and after each virtual embodiment training session was used as the primary outcome measure. Additionally, a battery of patient-reported pain questionnaires (Fear-Avoidance Beliefs Questionnaire, Oswestry Low Back Pain Disability Questionnaire, Pain Catastrophizing Scale, and Patient Health Questionnaire) were administered before and after 8 sessions of virtual embodiment training as exploratory outcome measures to assess if the measures are appropriate and warrant a larger randomized controlled trial.ResultsA 2-way ANOVA on session × pre- versus postvirtual embodiment training revealed that individual virtual embodiment training sessions significantly reduced the intensity of pain as measured by the visual analog scale (P

Purpose.: Plantar fasciitis is the most frequent cause of heel pain. Custom-made plantar supports are a common treatment solution, while the application of kinesiology tape (KT) can be an effective measure to alleviate pain. The objective was to evaluate the effects of KT on the pain of patients with plantar fasciitis. Methods.: Randomized controlled trial including participants with plantar fasciitis. There was an experimental group (n = 17), whose participants underwent a KT treatment, and a control (sham tape) group (n = 17). The pain, measured with a visual analog scale (VAS), was the primary outcome and was assessed daily until the fifth day of wearing the tape and 24 h after removing it. Inferential statistics looked for time, group, and time per group differences with CI at 95%. Results.: The greatest between-group VAS difference was 3.5 points, and occurred at the 2-day follow-up assessment. Then, pain differences decreased over time until the last assessment point. Statistically significant time, group, and time*group differences were found with p < 0.001. Conclusion.: This study supports that KT is effective in reducing pain in the short term in patients with plantar fasciitis, and more effective than a sham intervention with tape. IMPLICATIONS FOR REHABILITATION: Kinesiology tape (KT) reduces pain in patients with plantar fasciitis. Pain is reduced from the first day and the tape can be worn up to five days. KT is an effective solution prior to the application of orthopaedic treatment. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effectiveness of wrist orthoses in reducing pain in individuals with carpal tunnel syndrome. Materials and methods: The searches were carried out in the CINAHL, Cochrane Library, EMBASE, Regional Portal of the Virtual Health Library, PubMed, Scopus, and Web of Science databases on 18 February 2021, and updated on 16 February 2023. Four independent evaluators performed the steps for inclusion of studies following the recommendations of the PRISMA and methods of the Cochrane Handbook for systematic review. Results: Three randomized clinical trials, two quasi-randomized clinical trials and one cohort study met the inclusion criteria. The visual analogue scale and numeric analog scale were used as a tool to assess pain outcome. The treatment period ranged from 2 weeks to 3 months. The period of use varied between nighttime only, and nighttime plus daytime. Most orthoses promoted a statistically significant reduction in intensity pain at night, at rest or during activities. Only one study carried out follow-up after the end of treatment and showed that pain reduction was maintained up to 6 months after treatment. Conclusions: The findings suggest that the isolated use of orthoses were effective in reducing pain in individuals with carpal tunnel syndrome. IMPLICATIONS FOR REHABILITATION: Orthoses are effective in reducing pain in individuals with carpal tunnel syndrome. Orthoses can be used nighttime or nighttime plus daytime according to the necessity. Prefabricated orthosis may represent lower cost and greater accessibility. Pain reduction can be maintained up to 6 months after the end of treatment. [ABSTRACT FROM AUTHOR]

This randomized controlled study aims to investigate the effect of acupressure on pain and postpartum comfort following a cesarean section. The study was conducted with 60 women who underwent cesarean delivery. The participants were randomly assigned to either the intervention or control group. In the intervention group, acupressure was applied to the LI4, SP6, and P6 points for 15 minutes at the 2nd and 4th hours after the cesarean section. In the control group, acupressure was not applied and only routine nursing care was given. Data was collected using a personal information form, Visual Analog Scale (VAS), and Postpartum Comfort Questionnaire (PCQ). Acupressure application was applied to the intervention group at the 2nd and 4th hour after cesarean section. All data collection forms were filled out by women in the intervention group before starting acupressure application at 2 hours after cesarean section. VAS was filled out again after acupressure application at 2 hours. VAS was filled out before and after acupressure application at 4 hours after cesarean section. PSQ was filled out in both groups before discharge. In the study, the intervention group’s 2nd (3.03 ± 1.24, p < .001) and 4th (4.06 ± 1.22, p < .001) hour posttest VAS scores were lower and PCQ posttest scores (140.6 ± 9.01, p < .001) were higher than the control group. The results indicate that acupressure intervention applied to points LI4, SP6, and P6 was a useful nonpharmacological treatment for postpartum pain and comfort for the study group. [ABSTRACT FROM AUTHOR]

Study Design. Multicenter, prospective registry study. Objective. To clarify minimal clinically important differences (MCIDs) for surgical interventions for spinal metastases, thereby enhancing patient care by integrating quality of life assessments with clinical outcomes. Background. Despite its proven usefulness in degenerative spinal diseases and deformities, the MCID remains unexplored regarding surgery for spinal metastases. Patients and Methods. This study included 171 (out of 413) patients from the multicenter "Prospective Registration Study on Surgery for Metastatic Spinal Tumors" by the Japan Association of Spine Surgeons. These were evaluated preoperatively and at 6 months postoperatively using the Face Scale, EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), including the Visual Analog Scale, and performance status. The MCIDs were calculated using an anchor-based method, classifying participants into the improved, unchanged, and deteriorated groups based on the Face Scale scores. Focusing on the improved and unchanged groups, the change in the EQ-5D-5L values from before to after treatment was analyzed, and the cutof f value with the highest sensitivity and specificity was determined as the MCID through receiver operating characteristic curve analysis. The validity of the MCIDs was evaluated using a distribution-based calculation method for patient-reported outcomes. Results. The improved, unchanged, and deteriorated groups comprised 121, 28, and 22 participants, respectively. The anchor-based MCIDs for the EQ-5D-5L index, EQ-Visual Analog Scale, and domains of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression were 0.21, 15.50, 1.50, 0.50, 0.50, 0.50, and 0.50, respectively; the corresponding distribution-based MCIDs were 0.17, 15, 99, 0.77, 0.80, 0.78, 0.60, and 0.70, respectively. Conclusion. We identified MCIDs for surgical treatment of spinal metastases, providing benchmarks for future clinical research. By retrospectively examining whether the MCIDs are achieved, factors favoring their achievement and risks affecting them can be explored. This could aid in decisions on surgical candidacy and patient counseling. Level of Evidence. II. [ABSTRACT FROM AUTHOR]

Background: The management of anterior colliculus fractures in combination with deltoid ligament injuries is a topic of debate, and there is a need to improve surgical outcomes. The purpose of the present study was to describe the application of a modified double-row suture bridge technique and evaluate its early clinical outcomes in the management of anterior colliculus fracture combined with deltoid ligament injury. Methods: From 2020 to 2022, 12 patients with anterior colliculus fracture combined with deltoid ligament injury were treated using a modified double-row suture bridge technique. For clinical outcome evaluation, objective data are presented through clinical examination findings; radiographic assessments, including X-rays and computed tomography (CT); and follow-up analysis utilizing American Orthopaedic Foot & Ankle Society ankle‒hindfoot (AOFAS) scores, Olerud Molander Ankle Scores (OMAS), and visual analogue scale (VAS) scores. Preoperative and follow-up scores were compared with Student's t test. (p <.05). Results: The mean age of the patients was 52.67 ± 9.42 years (range: 39–74). The mean duration of follow-up was 14.42 ± 1.51 months (range: 12–17). At the final follow-up, the mean AOFAS score (P < 0.001) improved to 91.50 ± 2.65 points (range: 87–96), the mean OMAS (P < 0.001) improved to 77.08 ± 3.97 points (range: 70–85), and the mean VAS score (P < 0.001) improved to 0.25 ± 0.45 points (range: 0–1). Nine patients achieved excellent outcomes, and three achieved good outcomes according to the AOFAS score. Follow-up imaging evaluation indicated satisfactory alignment of the fracture and complete healing. Clinical examination suggested good mobility of the ankle. At the last follow-up, ankle dorsiflexion mobility was 14–18 degrees, plantar flexion mobility was 42–45 degrees, inversion mobility was 27–32 degrees, and eversion mobility was 22–25 degrees. Conclusions: The modified double-row suture bridge technique is effective for achieving anatomic reduction of anterior colliculus fractures, and the technique also provides substantial benefit to the injured deltoid ligament. With this technique, the clinical outcomes can be significant and encouraging, indicating a new stage in its application and development. [ABSTRACT FROM AUTHOR]

Objective: Cold hypersensitivity in the hands and feet(CHHF) is a common condition that reduces the quality of life and causes daily discomfort. The current treatments are primarily pharmacological. This study aimed to expand treatment options by comparing the efficacy of electroacupuncture (EA) and acupuncture (AC) with that of no treatment (control). Methods: A three-group randomized controlled trial was conducted with 72 women diagnosed with cold hypersensitivity in the hands and feet, as confirmed by subjective symptoms and objective temperature differences. Participants were randomly assigned to the EA, AC, or control groups. Outcome measures included hand and feet visual analog scale (VAS) scores, temperature changes measured using a non-contact thermometer, and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores assessed at pretreatment (T0), posttreatment (T1), and follow-up (T2). Repeated measures ANOVA and 2-way mixed-model ANOVA were used to evaluate group, time, and interaction effects. Results: Both the EA and AC groups showed significant improvements in hand and feet VAS and WHOQOL-BREF scores compared with those of the control group posttreatment (T1). Notably, the EA group demonstrated sustained benefits at follow-up (T2), with significant reductions in feet VAS scores and positive changes in several WHOQOL-BREF domains. Interaction effects between group and time were observed, indicating that the changes in the EA and AC groups were meaningfully different form those in the control group. The control group also exhibited a statistically significant reduction in the VAS scores at follow-up (T2), likely due to the natural variability of cold extremity symptoms and psychological factors. Conclusion: This study demonstrated that EA and AC are effective in alleviating the symptoms of CHHF and enhancing the quality of life compared to no treatment. EA showed long-lasting effects than those of AC, suggesting its potential to regulate the autonomic nervous system. These findings provide a foundation for expanding non-pharmacological treatment options for CHHF and offer clinical guidance on the use of EA and AC. [ABSTRACT FROM AUTHOR]

Dizziness following mild traumatic brain injury (mTBI), or concussion, is common and can encompass multiple sensations reflecting diverse aetiologies. This exploratory study investigated the types of dizzy sensations experienced, their evolution, and relationship with other post-concussion symptoms. Thirty New Zealanders (24 female) aged 49 ± 16 years who experienced dizziness or imbalance following their injury completed the Dizziness Handicap Inventory, Visual Vertigo Analogue Scale, and the Hospital Anxiety and Depression Scale. Additional custom questionnaires probed subjective experiences of dizziness and balance, headaches, and difficulties with auditory processing and vision. Just over half the participants (56.7%) experienced a single mTBI. The median time interval since the injury was 16 months (IQR = 24 months). Participants usually reported multiple dizzy symptoms which developed within a week of the injury, although delays of up to six months were reported. Most participants (70%) felt their symptoms improved over time, while lack of improvement was associated with a history of multiple mTBI (P = 0.020). Moderate to strong correlations between questionnaire scores representing dizziness handicap, visual vertigo severity, and auditory processing difficulties (P < 0.001) suggest that dizziness and sensory impairment following mTBI are multi-modal and likely to benefit from holistic, multidisciplinary treatment. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of the titanium mesh on flail chest and bone healing from clinical and animal experiments. Methods: Clinical experiment: 24 patients with flail chests in our hospital from January 2020 to January 2023 were prospectively selected and divided into control and titanium mesh groups according to different treatment plans and basic data‐matching principles, with 12 cases in each group. The control group was treated with conservative external fixation, and the titanium mesh group was treated with titanium mesh fixation. The clinical efficacy index, visual analog scale and blood gas indexes and hemodynamic indexes of the two groups of patients were recorded. Chest CT and pulmonary function and life quality were examined after operation. Animal experiment: The flail chest sheep were treated conservatively with a titanium mesh, and the expression of bone‐healing‐related proteins was detected. Results: The mechanical ventilation time, drain indwelling time, ICU observation time, and hospital time in the titanium mesh group were significantly shorter than those in the control group (p < 0.05). The PaO2, CVP, FVC, FEV1, MVV, and life quality of the titanium mesh group were significantly better than those of the control group after operation, and the visual analog scale, PaCO2, CI, ELWI, and the proportions of atelectasis, thoracocyllosis, and consolidation tardive after operation were significantly lower than those of the control group (p < 0.05). The expressions of BMP2, IGF‐1, VEGF, and PDGFD in the rib tissue of titanium mesh sheep were higher than those of control sheep at 4 weeks after operation (p < 0.05). Conclusion: Titanium mesh is a safe and effective treatment for flail chest, which can improve pain, blood gas, hemodynamic indexes, and pulmonary function and promote fracture healing. [ABSTRACT FROM AUTHOR]

Objectives Patients and Methods Results Conclusion To investigate patient tolerability and safety (using urinary tract infection (UTI) as a proxy measure) following EndoSheath‐assisted flexible cystoscopy (eFC). EndoSheaths are single‐use, disposable sheaths used in FC. They reduce cystoscope turnaround times as complicated, time‐consuming and costly sterilisation is no longer necessary. This reduces patient waiting times as cystoscope idle time, the most common rate limiting step, is reduced.All adult patients undergoing eFC over a 26‐month period at a single institution were evaluated prospectively. Post‐eFC, participants rated discomfort on a visual analogue scale (discomfort 1 = none, 2–4 = mild, 5–7 = moderate, 8–10 = severe). The diagnosis of UTI was broad and based on any one of patient self‐report, positive urine culture or antibiotic prescription within 30 days of eFC. Data were analysed using chi‐squared testing (P < 0.05, two‐tailed).Of the 1091 eFCs analysed, 33.2% and 48.2% of were ranked as causing no or mild discomfort, respectively, with just 3.1% ranked severe. Discomfort was greater in younger participants but similar between sexes. Overall, post‐eFC UTI incidence was 13.3%, with rates higher in females (18.1%) than males (11.2%). Participants aged ≥65 years reported a higher UTI rate (15.4%) than those aged <65 years (8.8%). No participants developed urosepsis.This large, prospective, unselected, real‐world study reports that eFC is well tolerated. UTI was higher in females than males, and in those aged ≥65 years, in line with other studies using the same broad based diagnostic criteria for UTI. The conclusion is that eFC is both well tolerated and safe. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Plain Language Summary Pexidartinib is effective in patients with tenosynovial giant cell tumor (TGCT) for whom surgery is not feasible. Durability of response after discontinuation of pexidartinib and the safety and efficacy of restarting pexidartinib have not been previously recorded. This phase 4 study was designed to mimic the real‐world experience with pexidartinib to evaluate the effects of discontinuation of and retreatment with pexidartinib in patients with TGCT who previously benefited from the drug.This was a global, multicenter, phase 4 study that enrolled patients with TGCT who were experiencing clinical benefit from pexidartinib in one of four prior phase 1 or phase 3 studies investigating pexidartinib in the disease. Patients could choose to continue pexidartinib at the same dose (the treatment‐continuation cohort) or discontinue treatment with the option to restart pexidartinib (the treatment‐free/retreatment cohort). Tumor progression determined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, patient‐reported outcomes (the Patient‐Reported Outcomes Measurement Information System–Physical Function [PROMIS‐PF] questionnaire and the EuroQol 5‐dimension, 5‐level [EQ‐5D‐5L] visual analog scale), and safety were assessed every 3 months. The primary end point was the proportion of patients in the treatment‐free/retreatment cohort who remained treatment‐free at month 12 and 24; this did not depend on disease progression.Thirty‐two patients were enrolled: 21 chose to enter the treatment‐continuation cohort, and 11 entered the treatment‐free/retreatment cohort. During the treatment‐free period, six of 11 (54.5%) patients in the treatment‐free/retreatment cohort had progressive disease (PD) according to RECIST, version 1.1, whereas no patient in the treatment‐continuation cohort had disease progression. Over the 24‐month study, three of 11 (27.3%) patients in the treatment‐free/retreatment cohort restarted treatment because of RECIST version 1.1 PD, symptomatic progression, or both (n = 1 each). The probability of remaining treatment‐free in the treatment‐free/retreatment cohort was 73% (95% confidence interval, 37%–90%). In the treatment‐free/retreatment cohort, the median progression‐free survival of the treatment‐free period was 22.8 months (95% confidence interval, 1.6 months to not estimable). By 6 months of retreatment, all retreated patients achieved new disease stabilization with no new safety concerns; two patients had clinically significant improvements in PROMIS‐PF and EQ‐5D‐5L visual analog scale scores. The mean PROMIS‐PF and EQ‐5D‐5L scores remained stable throughout the study. There was no hepatotoxicity and no new safety signal in either cohort.In this small phase 4 study designed to evaluate outcomes in patients who stopped and restarted pexidartinib, 54.5% of patients who discontinued pexidartinib showed PD, with a median progression‐free survival of 22.8 months. Each of the three patients who restarted pexidartinib stopped progressing, and some reported a new gain in physical function. No PD was detected in patients who remained on treatment, and the safety profile did not indicate long‐term hepatotoxicity or any new safety concerns. Pexidartinib is a medication for people with tenosynovial giant cell tumor (TGCT) for whom surgery is not recommended. This study examined what happens when patients stop taking pexidartinib (after it has helped them) to see whether it is safe and effective to restart if needed. Thirty‐two patients were followed for 2 years: 21 chose to continue pexidartinib and did not experience disease progression, while 11 chose to stop pexidartinib; 54.5% of them had disease progression within 2 years. Three patients who stopped pexidartinib restarted treatment after their tumor size increased or their symptoms worsened. Restarting pexidartinib was safe and effective in these patients. Pexidartinib is a medication for people with tenosynovial giant cell tumor (TGCT) for whom surgery is not recommended.This study examined what happens when patients stop taking pexidartinib (after it has helped them) to see whether it is safe and effective to restart if needed.Thirty‐two patients were followed for 2 years: 21 chose to continue pexidartinib and did not experience disease progression, while 11 chose to stop pexidartinib; 54.5% of them had disease progression within 2 years.Three patients who stopped pexidartinib restarted treatment after their tumor size increased or their symptoms worsened.Restarting pexidartinib was safe and effective in these patients. [ABSTRACT FROM AUTHOR]

Background: Robotic-assisted surgery has emerged as an innovative approach widely adopted in the field of orthopedics. However, its application specifically for managing atlantoaxial dislocation with a high-riding vertebral artery (AAD-HVA) remains underreported in the existing literature. Objective: To compare the perioperative outcomes of robotic-assisted (RA) and fluoroscopic-guided free-hand (FH) techniques for atlantoaxial dislocation in combination with a high-riding vertebral artery (AAD-HVA). Study design: This was a retrospective study. Setting: This research was performed at a single department of spine surgery. Methods: Data from patients who underwent atlantoaxial internal fixation between July 2018 and January 2022 at our hospital were retrospectively analyzed. Among the cases, 14 were performed using free-hand (FH) techniques and 11 utilized robotic-assisted (RA) techniques. Data collected included case notes, imaging records, and follow-up data. The reliability of screw placement was evaluated based on the Gertzbein and Robbins scores, while treatment outcomes were assessed using the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS), neck disability index (NDI), and postoperative complication rate. Results: Baseline patient characteristics were comparable between the FH and RA groups. The mean blood loss was markedly lower in the RA group (157.3 ± 49.7 ml) compared to the FH group (290.0 ± 110.3 ml) (p = 0.03). Although the average operative time was slightly higher in FH group than in RA group, this disparity did not achieve statistical significance (p = 0.7588). Moreover, the radiation exposure dose was remarkably higher in FH group (32.7 ± 4.4 mGy) than in RA group (23.0 ± 3.2 mGy) (p < 0.0001). The percentage of clinically acceptable screw placement was slightly lower in FH group (87.5%) than in RA group (97.8%), but the observed variance was not statistically meaningful (p = 0.3669). Furthermore, the differences in JOA, VAS, and NDI scores between the FH and RA groups were not statistically significant. Additionally, no obvious differences were found in clinical outcomes or complications related to screw implantation between the two groups. Limitations: This study has inherent limitations as it was retrospective in nature and conducted at a single center. Conclusion: Robotic-assisted surgery for AAD-HVA patients offers a minimally invasive approach, reduced bleeding and lower radiation exposure compared with traditional free-hand surgery. [ABSTRACT FROM AUTHOR]

Objective: This study was aimed to explore the mid-term efficacy of non-contact orthopedic robot navigation in the treatment of lumbar spondylolisthesis. Methods: The clinical data of young and middle-aged patients with lumbar spondylolisthesis were retrospectively analyzed and divided into an observation group and a control group according to surgical methods. The observation group was treated with minimally invasive transforaminal interbody fusion (MIS-TLIF) combined with orthopedic robot-navigated percutaneous pedicle screw fixation; while the control group underwent traditional posterior lumbar interbody fusion (PLIF). Perioperative indicators, waist and leg pain Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI), and complications were compared between groups. Results: A total of 32 patients with lumbar spondylolisthesis were included in this study, with the average age of 50.3 ± 2.7 years old. There were 17 patients in the observation group and 15 patients in the control group. Although the new surgical technique for the observation group may require longer operative time, it showed significant advantages in reducing intraoperative bleeding, postoperative drainage, and shortening hospital stay. These benefits might result in faster recovery for patients, reduced risk of complications, and improved overall quality of life. The new technology was also significantly better compared to the traditional method in terms of VAS scores and ODI at 1 week, 1 month, 3 months, and 6 months post-surgery. These results provided patients with better treatment options and potentially a faster path to recovery. One case with infectious incision in the observation group and one case with intraspinal hematoma formation in the control group were observed. However, there was no statistical difference in the complication rates between the two groups (P > 0.05). Conclusion: The non-contact orthopedic robot navigation for the treatment of lumbar spondylolisthesis was demonstrated to be minimally invasive, precise, and stable surgical method. It is a treatment option worth considering for suitable patients. [ABSTRACT FROM AUTHOR]

This study aims to evaluate and compare the short-term efficacies of high-intensity laser therapy (HILT) and ESWT(focused) on pain, sensitivity, handgrip strength and functions, in the treatment of lateral epicondylitis (LE). Fourty seven patients (age range, 18 to 65 years) with unilateral elbow pain were randomized into two groups. HILT group (n = 24) and ESWT group(n = 23). The HILT and ESWT were administered three times a week for three weeks, and each treatment was combined with exercises. All paticipant in both of two groups were evaluated with ultrasonography for common extansor tendon thickness. A visual analog scale (VAS), quick Disabilities of the Arm, Shoulder, and Hand (QDASH), hand grip strength test were used to evaluate the patients before, one and six weeks after treatment. There were significant improvement in VAS, hand grip strength, QuickDASH scores and CET thickness before and after treatment in both group(p < 0,05). But there were no significant differences between the groups pre-treatment, at the 1st week, and 6th week after treatment (p > 0.05). Only hand grip strength was smilar to the pretreatment outcomes in HILT group. Both treatment methods were found to be effective and safe in the short-term treatment of LE. Consequently, these non-invasive, effective and safe techniques can be successfully used in the treatment of common pathology of the elbow. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion To investigate the association between soluble adhesion molecules (sE‐cadherin, sE‐selectin, sICAM‐1, sVCAM‐1) in serum and peritoneal fluid and pelvic pain in infertile women with endometriosis.This observational study included 86 infertile women undergoing diagnostic laparoscopy, 43 of whom were diagnosed with endometriosis. Pain intensity was evaluated using the visual analog scale (VAS). Levels of soluble adhesion molecules in serum and peritoneal fluid were quantified using ELISA. Statistical analysis included the Mann–Whitney U test for group comparisons, Spearman's rank correlation for associations with VAS scores, and receiver operating characteristic (ROC) curve analysis for diagnostic performance.Serum sE‐selectin levels were significantly higher in women with pelvic pain (P = 0.022) and correlated with VAS scores (r = 0.271, P = 0.012). Peritoneal sE‐selectin and sICAM‐1 levels were elevated in women with pelvic pain (P = 0.044 and P = 0.029, respectively) and showed positive correlations with VAS scores (r = 0.246, P = 0.022 and r = 0.310, P = 0.004, respectively). Comparing endometriosis and control groups, peritoneal sE‐selectin and sICAM‐1 levels were significantly higher in endometriosis cases with pelvic pain (P = 0.003 and P < 0.001, respectively). ROC analysis revealed the potential diagnostic value of serum sE‐selectin (AUC = 0.698, P = 0.002), serum sICAM‐1 (AUC = 0.721, P < 0.001), and serum sVCAM‐1 (AUC = 0.750, P < 0.001) in distinguishing endometriosis from non‐endometriosis cases.Elevated levels of sE‐selectin and sICAM‐1 in serum and peritoneal fluid are associated with pelvic pain in women with endometriosis, suggesting their role in pain pathogenesis and potential as biomarkers for pain severity and disease diagnosis. Further research is warranted to explore the underlying mechanisms and validate these findings in larger cohorts. [ABSTRACT FROM AUTHOR]

Background: Intervertebral disc (IVD) degeneration (IVDD) is one of the main causes of low back pain. One of the most important features of IVDD is the loss of extracellular matrix (ECM) with its structural components. Cartilage intermediate layer proteins (CILPs), minor glycoproteins residing in ECM, have been found to be increased in IVD as degeneration and aging progresses. The aim of the present study was to evaluate the expression of CILP-2 in the IVD of patients with lumbar radiculopathy. Methods: The IVD samples were collected from 25 patients during spinal surgery (interlaminectomy, herniated disc removal). The control IVD samples were obtained from nine patients who underwent lateral corpectomies in the thoracic region. CILP-2 expression was detected by immunohistochemistry. The patients were divided into two groups – aged under or over 50 years. A standardized clinical examination with assessment of radicular signs and deficits was performed. Subjective disability and pain were assessed using the visual analogue scale and Oswestry Disability Index (ODI). The pre-operative MRI was graded for the degree of IVD degeneration by Pfirrmann grading system. IVD samples obtained during operations were subjected to the standardized histopathological analysis applying modified Boos classification. The data were analysed by t-test, Mann-Whitney U-test, and Spearman correlation test. Results: Both histopathology scores and Pfirrmann grades did not differ between patients' groups. Also, no correlations were found between histopathology and Pfirrmann grades, neither were any differences seen when correlating both grades to ODI, back pain or leg pain scores. CILP-2 staining was noted in all studied samples, notably strong staining was seen around large cell clusters. However, no differences in CILP-2 staining were seen between the age groups of patients. No correlations were found between CILP-2 staining and Pfirrmann grades. Grading of CILP-2 immunostaining in nine control patient samples resulted in significantly lower values. The difference is statistically significant (P = 0.002) compared to CILP-2 staining scores of all 25 patients' samples. Conclusion: In this study, we detected increased CILP-2 expression in the human IVD as compared to the control group patients. CILP-2 can be a possible IVDD marker; however, as knowledge about the role of CILP-2 is limited, further studies are required. [ABSTRACT FROM AUTHOR]

Background: Complex Regional Pain Syndrome type 1 (CRPS-1) is severely debilitating and painful disease that is difficult to treat. Objective: The objective was to evaluate the long-term residual disability of patients with CRPS-1 following parenteral neridronate treatment. Design: This is real-life retrospective observational study. Methods: Patients affected by CRPS-1 of the upper limb were treated with neridronate infusions (400 mg over 10 days) between February 2017 and December 2021 for whom clinical and demographic information was collected. From November 2022, patients treated ⩾1 year previously were recalled for clinical evaluation. A dedicated instrument (DASH questionnaire, Disabilities of the Arm, Shoulder and Hand) was employed to assess residual disability. Multivariate logistic regression analysis was used to investigate predictors of disability. Results: Forty-nine patients aged 61.1 ± 11.5 years and 73.5% female with CRPS-1 of the upper limb were included. Disease duration before treatment was 9.9 ± 8.0 weeks, and the mean length of follow-up was 4 years (47.7 ± 22.0 months). The disease had fully resolved in 46 patients (93.9%) for whom the diagnostic criteria were no longer recognized. According to the DASH score, 38 patients (77.6%) resulted free of functional limitations, whereas 11 patients (22.4%) were still suffering from disability. The DASH score was positively correlated with residual visual analogue scale (VAS; Spearman's Rho = 0.61; P <.001). Predictors of residual disability were younger age (odds ratio [OR]: 0.77, 95% CI: 0.63-0.93; P =.012) and delay between disease onset and treatment (OR: 1.45, 95% CI: 1.13-1.96; P =.004). Conclusions: In this real-life study, neridronate parenteral treatment provided a full recovery of CRPS-1 in over 3 quarters of patients, provided they are treated early. [ABSTRACT FROM AUTHOR]

Background: Calcaneal fractures are the most common type of tarsal fractures. The sustentaculum tali (ST) offers anatomical stability in calcaneal fractures, and recently, ST screws have been widely used in their treatment. This study aimed to investigate the clinical efficacy and value of ST screw fixation via a modified sinus tarsi approach (MSTA) for treating displaced intraarticular calcaneal fractures (DIACFs). Methods: This study enrolled 64 patients (64 feet): 32 patients in the calcaneal locking plate combined with the ST screw group (CLP-STS Group) and 32 patients in the simple calcaneal locking plate internal fixation group (CLP Group). The minimum follow-up duration was 18 months. Ankle function was evaluated using VAS, AOFAS, and Short Form-36 scores. Imaging evaluation included the Böhler angle, Gissane angle, length, height, and width of the calcaneus, and the Böhler angle in both groups 1 year after surgery. Results: Functional evaluation revealed that postoperative AOFAS and VAS scores in the CLP-STS Group were significantly better than those in the CLP Group. After surgery, the Böhler angle, Gissane angle, and length, height, and width of the calcaneus were significantly corrected compared to the preoperative values; however, the difference in these indicators between the two groups was not significant. Nevertheless, at the 1-year postoperative follow-up, the calcaneal Böhler angle loss in the CLP-STS Group was significantly better than that in the CLP Group. Conclusion: Compared to simple calcaneal locking plate internal fixation, combining the plate with the additionally free ST screw can resolve the limited intraoperative exposure of MSTA, reduce postoperative foot pain in patients, and improve clinical efficacy. [ABSTRACT FROM AUTHOR]

Purpose: Pain following arthroscopic knee surgery remains a controversial clinical problem. Intra-articular (IA) glucocorticoid injections have demonstrated the potential to provide better analgesia in some orthopedic surgeries; however, due to the lack of studies, its role in knee arthroscopies remain unclear. This systematic review aimed to evaluate the efficacy and safety of intra-articular glucocorticoids after arthroscopic knee surgery. Methods: A systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline, with literature search performed on Medline, Embase, and the Cochrane Library. This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42024509749). Inclusion criteria included randomized controlled trials published in English comparing IA glucocorticoid to placebo in patients undergoing knee arthroscopy. Risk of bias for all included studies was assessed using the Cochrane Collaboration's risk of bias tool. Clinical outcomes compared were pain score: visual analogue scale (VAS) or International Knee Documentation Committee (IKDC), time to first analgesia requirement, analgesia consumption, range of motion (ROM), patient satisfaction, and complications. Results: A total of 7 studies (3 and 4 with evidence level I and II, respectively) involving 309 patients were included. All studies showed that IA glucocorticoids significantly decreased subjective pain scores. Three studies showed significantly longer duration to first postoperative analgesia use, while 6 showed significantly reduced postoperative analgesic administration with IA glucocorticoid use. Two studies showed significantly increased patient satisfaction with IA glucocorticoid (P = 0.001 and P = 0.01, respectively). No studies showed significant differences in complications such as nausea, vomiting, bradycardia, hypotension, or procedure-related adverse effects between the groups. Conclusion: Current available randomized controlled trials suggest that IA glucocorticoids can significantly reduce postoperative pain, delay, and minimize postoperative analgesia use, and improve patient satisfaction. No postoperative complications or adverse events were reported, reflecting its safety as a postoperative analgesic modality. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of the flexion angle of a femoral prosthesis on the postoperative clinical outcome of patients with knee osteoarthritis who are undergoing unicompartmental knee arthroplasty. Methods: Patients were divided into three groups according to the flexion angle of the femoral prosthesis following unicompartmental knee arthroplasty. Group A comprised patients with a flexion angle of the femur prosthesis of less than 5°, Group B included those with a flexion angle of 5° to 10°, and Group C consisted of patients with a flexion angle of the femur prosthesis greater than 10°. The basic clinical data, visual analog scale (VAS) score, Hospital for Special Surgery (HSS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and knee range of motion (ROM) were subjected to statistical analysis and comparison between the groups. Results: No significant differences were observed in the basic data of the patients in each group. The ROM and VAS scores for the knee in the first month following unicompartmental knee arthroplasty in groups B and C were significantly greater than those in group A. The HSS scores for the knee joint in Group B indicated superior outcomes in the initial postoperative month and the third postoperative month, as evidenced by the WOMAC scores, which demonstrated a statistically significant difference between Group B and the other two groups within the six-month postoperative period. Conclusion: The short-term recovery of patients in Group B was the fastest. These results provide a new reference for the installation of femoral prostheses in unicompartmental knee arthroplasty. [ABSTRACT FROM AUTHOR]

This retrospective study evaluated the clinical effectiveness of endoscopic interlaminar decompression for lumbar spinal stenosis in 40 patients treated from February 2020 to January 2022. The procedure was successful in all cases, with only one dural sac injury reported and no other complications. Postoperative Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores improved significantly (P<0.05), and the modified Macnab criteria showed an 87.5% rate of excellent and good outcomes at follow-up. No patients required revision surgery. Overall, the endoscopic interlaminar approach proved to be effective, safe, and supported early recovery. [ABSTRACT FROM AUTHOR]

Background: Bioceramic-based root canal sealers are increasingly important in root canal treatment because of their biocompatible properties. This study aimed to evaluate postobturation pain incidence and intensity after root canal obturation with NeoSealer Flo, MTA-Bioseal, and GuttaFlow bioseal calcium silicate-based sealers and AH Plus epoxy resin-based sealer in patients with asymptomatic irreversible pulpitis or necrotic pulp with chronic apical periodontitis. Methods: A total of 120 participants with single-rooted teeth were included and randomly divided into four groups according to the root canal sealer used (n = 30). The patients were subsequently categorised based on the pulp vitality (vital or nonvital) in each group (n = 15) and all teeth were obturated in a single-visit. The postobturation pain scores were recorded on a visual analogue scale (VAS) at 6 h, 24 h, 48 h, 72 h, 7 d and 30 d. Moreover, analgesic intake was also noted at 24 h and 48 h. The Mann–Whitney U test, Kruskal‒Wallis H test, Friedman test, and Spearman's correlation test were used, and a p value < 0.05 was considered significant. Results: VAS scores were highest for the 6 h > 24 h > 48 h ≈ 72 h ≈ 7 d ≈ 30 d time intervals for both pulp status in each root canal sealer. A significant decrease in the VAS score was observed for all sealers from 6 h to 48 h (p 0.05). Nonvital cases had lower VAS scores at all time intervals. Analgesic intake was greater in the first 24 h (p < 0.05) in vital cases (p < 0.05) and also in females than males. Conclusion: The level of pain experienced after obturation was similar in patients with different pulp status for all the root canal sealers. Analgesic intake was greater in vital cases and females within 24 h. Trial registration: ClinicalTrial.gov, NCT06515756, record date: 2024-07-17, retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Chronic non-specific low back pain (CNSLBP) is prevalent among firefighters and may negatively affect their job performance. Alterations in the thoracolumbar fascia (TLF) structure are associated with CNSLBP. Percussive massage therapy (PT) has demonstrated potential in modifying fascial properties and alleviating pain. However, its effects on TLF structure in CNSLBP patients have not been thoroughly investigated. This study evaluates the effects of 6 weeks of PT on TLF echo intensity, thickness, pain, and disability in firefighters with CNSLBP, utilizing ultrasound imaging as a primary assessment tool. Methods: This six-week randomized controlled trial involved 38 firefighters with CNSLBP. Participants were randomly assigned 1:1 to either the PT group (receiving PT and core stability exercise) or the control group (receiving only core stability exercise). TLF echo intensity and thickness were measured using ultrasound imaging, and disability was assessed using the Roland-Morris Disability Questionnaire (RMQ) at baseline and post-intervention. Pain was measured using the Visual Analog Scale (VAS) at baseline, immediately after the first intervention, three weeks post-intervention, and post-intervention. Paired t-tests were conducted to analyze within-group changes in RMQ and ultrasound data, while ANCOVA was used to assess between-group differences, and repeated measures ANOVA for VAS scores. Results: Participants in the PT and control groups were aged 26.6±4.1 and 23.6±1.7 years, respectively, with BMI of 23.1±1.8 and 21.8±1.2 kg/m². The PT group showed significant reductions in bilateral TLF echo intensity post-intervention (left side: mean difference -6.4, 95% CI -9.7 to -3.1, p < 0.001, effect size 0.67; right side: mean difference -7.6, 95% CI -11.8 to -3.3, p < 0.01, effect size 0.60). Changes in TLF thickness were not statistically significant (p > 0.05). The PT group demonstrated significantly lower VAS scores than the control group (mean difference - 0.626, 95% CI -1.087 to -0.165, p = 0.009, effect size 0.63). RMQ scores decreased by -1.3 (95% CI -2.1 to -0.4, p < 0.01, effect size 0.5). Conclusion: Six weeks of percussive massage therapy significantly reduced thoracolumbar fascia echo intensity, alleviated pain, and improved functional disability in firefighters with chronic non-specific low back pain, but was not effective in altering fascia thickness. Percussive massage therapy emerges as an effective and safe strategy for managing chronic non-specific low back pain in firefighters. Trial registration: Retrospectively registered in Thai Clinical Trials Registry (TCTR20221223001) on December 22, 2022. [ABSTRACT FROM AUTHOR]

Background: Oral Health-Related Quality of Life (OHRQoL) is a term that encompasses conditions such as oral health status, living conditions, and function. OHQoL can change with the varying health conditions of the same individual. Many patients cannot afford implants or have anatomical limitations and therefore use traditional removable dentures. There are comparatively few studies investigating OHRQoL and denture satisfaction that include the patients' sociodemographic data, denture satisfaction and related questions. Aim: This study aimed to investigate OHRQoL and patients' satisfaction with three types of dentures: upper and lower complete dentures, upper and lower partial dentures, and upper complete lower partial dentures. Methods: The study was conducted between January 2022 and June 2023, with 150 patients using removable dentures. Patients' age, gender, education level, place of residence, smoking status, reasons for tooth loss and visiting the clinic, type of denture and the duration of denture use were recorded. Oral Health Impact Profile (OHIP-14) and patient satisfaction with dentures as measured on a Visual Analog Scale (VAS) were used to assess patients' satisfactions with OHRQoL and dentures respectively. Descriptive statistics, the Shapiro-Wilk normality test, the Mann-Whitney non‐parametric test and the Kruskal-Wallis test were used. Results: Statistically significant differences were found between gender, prosthetic type, usage duration and OHIP and VAS scores (p < 0.05). Women's OHIP scores were higher than men's, patients using complete dentures had higher scores than those using partial dentures in both jaws, those using dentures for less than 1 year had higher scores than those that had used them for more than 1 year. The analysis revealed no statistically significant differences in OHIP and VAS scores based on age, education level, and place of residence (p > 0.05). Conclusions: Patients may find it easier to adapt to removable partial dentures compared to complete dentures. Therefore, in prosthetic planning, dentists should prioritize preserving existing teeth. Regardless of the type of prosthesis, patients adapt to their prostheses over time, leading to increased satisfaction with prolonged use. Since individuals do not have a habit of visiting the dentist when there is no known problem, dentists should encourage patients to attend regular dental check-ups. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine the mental health of patients with lumbar disc herniation with radiculopathy (LDHR) and to evaluate the effects of percutaneous transforaminal endoscopic discectomy (PTED) on their mental well-being. Method: This study included 114 LDHR patients who received PTED in the Spinal Orthopedics Department of Zhongshan Hospital of Traditional Chinese Medicine between May 2022 and May 2023. The study population was stratified into two groups according to the presence of preoperative anxiety and depression: Group A comprised patients with such symptoms, and Group B included the remainder. Patients were assessed using the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale for Pain (VAS), and the Oswestry Disability Index (ODI) at preoperative and final follow-up visits. Evaluations were performed using the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale, and the Oswestry Disability Index (ODI) at the time of preoperation and during the last follow-up. Results: Among the 114 LDHR patients who obtained complete follow-up, fifty-four had anxiety/depression symptoms before surgery, which accounted for a incidence of 47%. Both Group A and Group B patients showed significant improvement in all evaluation indicators after PTED, but the overall prognosis of Group A was worse than that of Group B. Conclusion: PTED can effectively improve patients' pain, functional activities and mental health, which has a positive impact on patients' quality of life, and there is a significant correlation between patients' preoperative mental health and prognosis. [ABSTRACT FROM AUTHOR]

Background: The benefits of low-pressure laparoscopic cholecystectomy (LPLC) in patients with cardiopulmonary comorbidities remain unclear. This study aimed to explore the feasibility and pulmonary effects of LPLC in patients with cardiopulmonary comorbidities. Methods: This was a multicenter, parallel, double-blind, randomized controlled trial. Eligible patients included patients with cardiac or pulmonary comorbidities, who were randomly assigned (1:1) to undergo LPLC (10 mmHg) or standard-pressure laparoscopic cholecystectomy (SPLC) (14 mmHg). The primary outcome was postoperative partial pressure of carbon dioxide (CO2). Surgical safety variables, patient recovery, pulmonary function parameters, and surgeon comfort were also compared between groups. Results: This study enrolled 144 participants, with 124 participants extracted for the final analysis (62 in LPLC and 62 in SPLC group, respectively). The median postoperative PaCO2 was similar in the LPLC (43.3 mmHg) and SPLC (43.0 mmHg) groups (p = 0.988). Pulmonary parameters including postoperative pH, PaCO2, HCO3, and lactate levels were similar between the two groups. Postoperative base excess was significantly higher in the LPLC group (− 0.6 mmol/L [− 6.9 ~ 7.5] vs. −1.9 mmol/L [− 6.6 ~ 5.4]; p = 0.031). There was no between-group difference regarding intraabdominal operative time, rate of intraoperative bile spillage, blood loss, surgeon comfort during surgery, and conversion rate. Moreover, postoperative major complication rates, the median time to the first flatus, postoperative hospital stay, or mean postoperative visual analog scale score for pain were similar in both groups. Conclusions: This study found no reduction of partial pressure of CO2 with LPLC compared with SPLC for patients with cardiopulmonary comorbidities. LPLC with a pneumoperitoneum pressure of 10 mmHg may be safe and feasible for these patients when performed by experienced surgeons, although it does not improve pulmonary parameters. Registration: The trial is retrospectively registered at ClinicalTrials.gov (NCT04670952) on December 17, 2020. [ABSTRACT FROM AUTHOR]

Background: This study investigated clinicopathological factors associated with the visibility of early gastric cancer and the efficacy of linked color imaging. Methods: Patients with early gastric cancer who underwent endoscopic treatment between April 2021 and July 2022 were enrolled. All cases underwent white light imaging and linked color imaging. Three experts evaluated lesion visibility using a visual analog scale. A mean score ≥3 on white light imaging was defined as "good visibility", and <3 as "poor visibility". We extracted patient information and endoscopic and pathological data for the lesion and background mucosa, analyzed factors associated with the visibility of early gastric cancer, and compared visibility between white light imaging and linked color imaging. Results: Ninety-seven lesions were analyzed, with good visibility in 49 and poor visibility in 48. Multivariate analysis revealed small lesion size (odds ratio 1.89) and presence of endoscopic intestinal metaplasia (odds ratio 0.49) as significantly associated with the poor visibility of early gastric cancer. Mean visibility score was significantly higher for linked color imaging (P<0.001). Mean score for linked color imaging was significantly higher in the poor visibility group (P<0.001), but not significantly different in the good visibility group (P = 0.292). Mean score was significantly higher with linked color imaging in cases with endoscopic intestinal metaplasia (P = 0.0496) and lesions <20 mm in diameter (<10 mm, P = 0.002; 10–20 mm, P = 0.004). Conclusions: Lesion size and endoscopic intestinal metaplasia are associated with the visibility of early gastric cancer in white light imaging. Linked color imaging improves visibility of gastric cancer with these factors. [ABSTRACT FROM AUTHOR]

Objective: To explore whether anterior transposition of the ulnar nerve is necessary in patients with post-traumatic elbow stiffness. Method: This was a retrospective study of 177 patients with post-traumatic elbow stiffness treated at Shandong Provincial Hospital from 1 January 2012 to 31 October 2022. Sixty-one patients presented with ulnar nerve symptoms, and 116 patients had no nerve symptoms. Outcomes between patients with and without symptoms were compared using a range of clinical measures, namely range of motion (ROM), ulnar nerve symptoms, and various standardized scoring systems, namely, the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS), improved Broberg and Morrey Score (BMS), Quick disabilities of the Arm, Shoulder, and Hand (DASH) score, Oxford Elbow Score (OES), and Amadio score. Results: Open elbow release surgery significantly improved elbow joint function in patients with post-traumatic elbow stiffness, regardless of the presence of ulnar nerve symptoms. Patients with ulnar nerve symptoms showed significant improvement after anterior transposition compared with in situ release. For patients without ulnar nerve symptoms, there was no significant difference in outcomes between the two types of ulnar nerve surgery. Conclusion: Anterior transposition of the ulnar nerve is preferable for patients with ulnar nerve symptoms, while the choice between anterior transposition and in situ release can be individualized for patients without symptoms, based on intraoperative findings. [ABSTRACT FROM AUTHOR]

Background: This study seeks to elucidate the expressions of lncRNA TSIX in Osteoarthritis (OA) and to explore its mechanisms in regulating OA progression. Methods: RT-qPCR was employed to analyze the expression of TSIX in OA patients classified by Kellgren-Lawrence (K-L) grades. Receiver operator characteristic (ROC) was conducted to evaluate the diagnostic value of TSIX. Correlation between TSIX levels and clinical scores such as Lysholm and visual analogue scale (VAS) score was evaluated using Pearson method. IL-1β-induced SW1353 cells served as an in vitro model. The cell function were assessed by flow cytometry and cell counting kit-8 (CCK-8) assay. The relationship between TSIX and miR-320a was verified by luciferase reporting system, while bioinformatics approaches were utilized to predict the downstream target genes of miR-320a. Results: The findings revealed that TSIX level in OA patients was elevated compared to that of the control group, with a notable progressive increase in TSIX expression correlated with higher K-L grades. In OA patients, the Lysholm score showed a negative correlation with TSIX expression, while the VAS score displayed a positive correlation with TSIX levels. Cell studies demonstrated that inhibition of TSIX enhanced cell viability and mitigated IL-1β-induced apoptosis by targeting miR-320a, in addition to promoting Aggrecan and Collagen II secretion. Luciferase reporter assay further validated the targeting interaction among TSIX, miR-320a, and PTEN. Conclusions: This study demonstrated an increased expression of TSIX in OA patients. It suggests that TSIX may play a role in chondrocyte dysfunction during OA by modulating the miR-320a/PTEN axis. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Currently, traditional UBE surgery, which is based on arthroscope, has been increasingly employed for complex lumbar degenerative diseases. However, this approach is associated with complications such as intraoperative dural sac tears, nerve root injuries, and postoperative epidural hematomas. In response to these challenges, we propose a novel technique utilizing uniaxial spinal endoscope to replace arthroscope—Unilateral Bi/Multi‐Portal Endoscopy (UME). This new method has successfully treated complex lumbar disc herniation and spinal stenosis, resulting in improved postoperative outcomes and a reduction in complications. Based on the previous findings, we utilized uniaxial spinal endoscopy as the primary operating method, with the assistance of multi‐portal endoscopic techniques (UME‐TLIF), to perform transforaminal lumbar interbody fusion. The feasibility and preliminary clinical results have been presented in this paper.A total of 18 patients (8 men and 10 women, aged 52.6 ± 15.29 years) diagnosed with lumbar degenerative diseases, such as giant lumbar disc herniation, severe lumbar spinal stenosis, or lumbar spondylolisthesis, were included in this study from January 2022 to March 2023. Various parameters including operation time, ambulatory time, intraoperative fluoroscopy times, hospitalization days, and complications were recorded during the perioperative period. Clinically relevant symptoms were evaluated and documented 1, 3, 6, and 12 months postoperatively. Visual analogue scale (VAS) scores for lower back pain and leg pain, as well as the Oswestry disability index (ODI), were measured. The extent of lumbar interbody fusion was assessed using lumbar X‐ray and CT scans at the 12‐months follow‐up. MRI was performed to assess the degree of nerve decompression in patients at the same time points. The paired t‐test or Wilcoxon signed‐rank test were used as statistical methods.The single‐segment UME‐TLIF procedure had an average operation time of 211 ± 53.3 min, and the average number of X‐rays taken during the operation was 11.78 ± 5.32. Patients were able to walk and perform functional exercises approximately 35.11 ± 8.41 h post‐surgery, and the average duration of hospital stay was 8.5 ± 2.27 days. The VAS and ODI values at each time point post‐surgery were significantly lower than the respective pre‐surgery values (p < 0.05). Two patients developed postoperative sensory disturbances which significantly improved with conservative treatment. Furthermore, a follow‐up CT scan conducted 12 months post‐surgery showed 100% fusion rate of the surgical segments in all patients.UME‐TLIF is an endoscopy‐assisted fusion procedure that minimizes muscle damage in patients and allows early rehabilitation. This technique broadens the surgical applications of uniaxial spinal endoscope as a surgical tool, particularly benefitingpatients diagnosed with severe lumbar disc herniation and lumbar instability. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion Study Design Level of Evidence Previous studies have reported on the outcomes of autologous chondrocyte implantation (ACI) versus matrix‐induced ACI (MACI) and microfracture. Specific clinical outcomes of ACI, MACI, osteochondral autograft transplantation (OAT) and osteochondral allograft (OCA) have not been well studied. The purpose of this systematic review and meta‐analysis was to analyze the outcomes of these regenerative surgical techniques with an emphasis on comparing their effectiveness using the International Knee Documentation Committee (IKDC) subjective score, the Lysholm Knee Scoring Scale, the Tegner Activity Scale and the Visual Analogue Scale (VAS) score for the surgical treatment of tibiofemoral joint cartilage defects.An electronic search of MEDLINE, Embase and Cochrane Library was performed to identify studies that reported clinical outcomes for ACI, MACI, OAT and OCA procedures. The literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and only studies involving cartilage defects in the tibiofemoral joint were included. Outcomes were measured with the IKDC evaluation, Lysholm Knee Scoring Scale, Tegner Activity Scale and the VAS. Outcomes were compared to the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). The methodological quality of the included studies was analyzed by the Methodological Index for Nonrandomized Studies and the Jadad scale.Forty‐seven studies were included representing a total of 1993 patients with a mean follow‐up time of 57.2 ± 40.3 months (range: 4.0–160.0 months). The location of cartilage defects was reported in 46 studies, with a total of 1922 cartilage defects. There were 1277 medial femoral condyle cartilage defects, 488 lateral femoral condyle cartilage defects, 139 unspecified femoral condyle cartilage defects and 18 tibial plateau cartilage defects. All four procedures reported significant improvements in the Lysholm, IKDC, Tegner and VAS scores with no significant differences between them. The OAT technique surpassed the PASS threshold for the IKDC score while all four techniques surpassed the PASS threshold for Tegner and Lysholm scores. Additionally, all procedures met the MCID for each clinical outcome.This systematic review and meta‐analysis indicate that ACI, MACI, OAT and OCA all result in significant improvements in knee function and pain for cartilage defects of the tibiofemoral joint. When selecting a procedure, patient and cartilage defect characteristics should be assessed to determine the best technique for each individual patient.Systematic review and meta‐analysis.Level III. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic cholecystectomy is a popular abdominal surgery and the most common problem for patients undergoing laparoscopic cholecystectomy is the postoperative pain, and associated side effects due to opioids use for pain management and multimodal analgesia is suggested to reduce postoperative pain and need for postoperative opioids. This controlled clinical trial compares the effects of multimodal analgesia and pregabalin as unimodal analgesia on postoperative pain management, postoperative opioids consumption, and reduction of opioids accompanied adverse effects in patients undergoing laparoscopic cholecystectomy where large multicenter studies evaluating specific analgesic combinations are lacking. Method: This comparison randomized controlled trial between multimodal analgesia approach and pregabalin as unimodal analgesia included 95 laparoscopic cholecystectomy patients that were randomly allocated to three groups using a simple randomization method where multimodal and pregabalin groups included 30 patients in each and the drugs was administered orally one hour before the incision and control group included 35 patients that did not receive any preoperative analgesia. Multimodal analgesic therapy included acetaminophen 1 g, pregabalin 150 mg and celecoxib 400 mg while pregabalin group received pregabalin 150 mg only. Results: Multimodal group showed a significantly lower need for total opioid analgesics mean ± SD (1.33 ± 1.918) as compared to the control group mean ± SD (3.31 ± 2.784) with p-value 0.014. Pregabalin and multimodal groups showed significantly lower postoperative visual analogue scale used for pain assessment mean ± SD (3.50 ± 2.543) and mean ± SD (3.70 ± 2.231), respectively, compared to the control group mean ± SD (5.89 ± 2.857) with p-value 0.001. Conclusion: Multimodal analgesia reduced postoperative opioids consumption more than pregabalin alone when used preoperatively in laparoscopic cholecystectomy and consequently reduced opioids associated adverse effects, but they have the same efficacy in reducing postoperative pain, so pregabalin can be used alone preoperatively in patients with contraindications for using some analgesics included in multimodal analgesia protocol. The study was registered retrospectively in clinical trials; Trial registration ID: NCT05547659. [ABSTRACT FROM AUTHOR]

Introduction: ACL tears are the most common injuries in kabaddi, an inherently violent high pivoting and high-velocity direct contact sport. Combined ACL and MCL injuries and combined ACL and ALL injuries have been better understood but there is a lacuna of literature on these combined injuries in kabaddi players and no literature on combined AMRI and ALRI injuries. The present prospective cohort study aims to assess knee outcomes and return to sport for these injuries in elite kabaddi players. Methods: A prospective cohort of 26 elite kabaddi players with clinical and MRI findings of ACL and MCL high-grade partial or complete tears were recruited. After ACL reconstruction and MCL repair, the resultant pivot shift was assessed against the now intact medial pillar and those with high-grade or explosive pivot were addressed using a modified deep Lemaire lateral extra-articular tenodesis. Pain scores (VAS) and knee outcomes (IKDC and Lysholm scores) were assessed pre-operatively and at regular intervals until 1-year follow-up. Return to sport and complications were also assessed. Results: There was significant improvement in pain and knee scores throughout the study period, with most patients achieving full scores by six months duration. Return to sport was 96% and return to sport at pre-injury level was 77%. Complication rate of the combined triple procedure was low (< 5%), with most complications being minor. Conclusion: The triple procedure of ACL reconstruction, MCL repair and Lateral extraarticular tenodesis successfully addressed the combined AMRI and ALRI in elite kabaddi players with a high rate of return to sport, excellent knee outcomes and low complication rate. [ABSTRACT FROM AUTHOR]

Introduction: Our understanding of antero-lateral rotatory instability (ALRI) has evolved considerably, with a shift towards a combined procedure of ACL reconstruction and lateral extra-articular procedure (LEAP) to reduce ALRI and decrease graft re-rupture rates. Despite mounting evidence for the same in high-pivot and high-contact athletes in the West, there is a paucity of data for regional sports such as kabbadi. To the authors best knowledge, this is the first such study to track the outcomes of the combined procedure (ACLR and LEAP) in kabbadi players. Methods: Ethics approval was obtained from the institutional ethics review committee. A total of 93 consecutive kabbadi players with ALRI were recruited for undergoing the combined procedure of ACLR with lateral extra-articular tenodesis. Demographical variables (age and gender) and functional outcome scores (IKDC, Lysholm, VAS, AOFAS, and FADI) were recorded pre-operatively and followed up at 6 week, 3 month, 6 month and 1 year post-surgery. In addition, complications (pain, stiffness, residual laxity, re-rupture, and infection) and return to sport were recorded. Results: All 93 patients completed the prospective cohort study with no drop-outs. The mean age of the study population was 22.4 ± 2.7 years and 84% were males. VAS, IKDC and Lysholm scores showed significant improvement at each time frame during the study period and significant improvement at end of the study period versus baseline. AOFAS and FADI scores showed no significant difference between baseline and end of study period. There was no significant difference with respect to age and gender for knee (IKDC and Lysholm) or ankle (AOFAS and FADI) scores. Return to sport was achieved in 99% of study participants with return to pre-injury level was 86%. Re-rupture rate was low (n = 2 patients) and the majority of complications related to the LET (either a complaint of swelling or shape change phenomenon). Conclusion: The present study shows that ACLR with LET provides a safe and effective option for treating kabbadi players engaged in an inherently high-pivot and high-contact sport. Knee outcomes (VAS, IKDC and Lysholm scores) showed substantial improvement versus baseline with a high degree of return to sport at pre-injury level and low re-rupture rate. [ABSTRACT FROM AUTHOR]