Orthopaedic Surgery骨科手术
Orthopaedic Surgery(英文缩写 ORTHOP SURG),ISSN 1757-7853,eISSN 1757-7861,中文译名:骨科手术 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 2.279 | Q3 |
| 2022 | 2.100 | Q3 |
| 2023 | 1.800 | Q2 |
| 2024 | 2.100 | Q2 |
| 2025 | 2.500 | Q2 |
Orthopaedic Surgery 最新收录文献
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1. Clinical Outcomes of an Improved Arthroscopic Suture-Bridge Technique Assisted by a "5 O'clock" Portal for Acute Bony Bankart Lesions.
PMID:DOI:日期:2026-10-01Bony Bankart lesion is a primary cause of traumatic shoulder instability. Although the arthroscopic suture bridge technique has been applied clinically, its operative complexity remains a challenge. This study aimed to evaluate the mid-term clinical and radiological efficacy of a modified suture bridge technique combined with anchor insertion through a "5 o'clock" accessory portal for treating acute bony Bankart lesions. This study retrospectively analyzed 36 patients with acute bony Bankart lesions who underwent the modified surgical treatment between January 2019 and February 2023. All patients were followed up for at least 2 years. Preoperative and final follow-up assessments included VAS, Constant-Murley, ASES, UCLA, and Rowe scores, as well as shoulder range of motion (ROM). Statistical analysis was performed using paired t-tests to compare preoperative and postoperative clinical scores and ROM. Fracture reduction and healing were assessed via CT 3D reconstruction at 6 months postoperatively. The mean follow-up period was 28.8 months. At the final follow-up, all clinical functional scores and ROM showed significant improvement compared to the preoperative status (p < 0.001). CT 3D reconstruction at 6 months postoperatively showed successful reduction of the fracture fragment in all patients. The mean glenoid bone loss decreased from 18.2% ± 6.5% preoperatively to 2.5% ± 1.5% at follow-up (p < 0.001). The fracture healing rate was 97.2%. Eighty percent of patients successfully returned to a pre-injury or higher level of sport. The redislocation rate was 2.8%, and the total complication rate was 5.6%. The modified suture-bridge technique using a "5 o'clock" accessory portal is a reliable and reproducible method for treating acute bony Bankart lesions. This approach achieves anatomical fracture reduction and yields excellent mid-term clinical and radiological outcomes with a low risk of complications.
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2. Development and Validation of Daping Orthopedics Operative Risk Scoring System for Geriatric Hip Fracture (DOORS-GHF) for Predicting Postoperative Outcomes in Geriatric Hip Fracture Patients: A Multicenter Retrospective Comparative Study.
PMID:DOI:日期:2026-09-27With China's accelerating population aging, geriatric hip fractures pose a growing clinical challenge. High comorbidity burden and diminished physiological reserve drive elevated postoperative complication and mortality risks in this population. However, most existing systems were developed decades ago, incompatible with modern perioperative advances, and are not tailored for geriatric hip fracture patients, resulting in unsatisfactory predictive specificity. To fill this gap, we developed the Daping Orthopedics Operative Risk Scoring System for Geriatric Hip Fracture (DOORS-GHF) and evaluated its predictive accuracy and clinical utility. We collected 4417 geriatric patients with hip fractures who underwent operative treatment at multicenter hospitals between 2012 and 2025. A total of 1599 patients were finally enrolled in this study. Of these, 1199 cases were included for the development of the scoring system. Using binary logistic regression with preoperative physiological score (PS) and operative severity score (OS) as independent variables, we constructed the DOORS-GHF model to predict 30-day postoperative complications and mortality. The remaining 400 cases formed the external validation cohort, in which we compared DOORS-GHF against the Daping Orthopedic Operative Risk Scoring System for Senile Patient version 3.0 (DORSSSP v3.0) and the Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) using AUC, sensitivity, specificity, Hosmer-Lemeshow calibration, Brier score, and decision curve analysis (DCA). The DOORS-GHF predictive equations were ln[R/(1 - R)] = -5.089 - 0.114 × OS + 0.226 × PS (complications) and ln[Z/(1 - Z)] = -10.308 + 0.655 × OS + 0.201 × PS (mortality). In the validation cohort (n = 400), 30-day mortality was 2.0% (8/400) and complication rate was 6.5% (26/400). DOORS-GHF outperformed both comparators across all metrics. For complication prediction, it achieved the highest AUC (0.878), acceptable calibration (HL χ = 11.887, p = 0.156), and the lowest Brier score (0.0489). For mortality prediction, it achieved the highest AUC (0.968), good calibration (HL χ = 6.259, p = 0.510), and the lowest Brier score (0.0140). DCA confirmed the broadest clinical net benefit for DOORS-GHF across threshold ranges of 0-0.65 (complications) and 0-0.40 (mortality). DOORS-GHF demonstrated superior discrimination, calibration, accuracy, and clinical utility over DORSSSP v3.0 and P-POSSUM in geriatric hip fracture patients. As a precise and practical system for assessing the risk of 30-day postoperative complications and mortality, it holds strong potential to improve perioperative decision-making and patient counseling in this vulnerable population.
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3. Staged Lateral Lumbar Interbody Fusion Targeting Driver and Compensatory Structural Segments for Adult Degenerative Scoliosis: A Novel Strategy and Early Outcomes.
PMID:DOI:日期:2026-09-25Traditional treatments for adult degenerative scoliosis (ADS) often rely on highly morbid long-segment fusions. While lateral lumbar interbody fusion (LLIF) provides a minimally invasive alternative, consensus on precise surgical targets is lacking. We propose a novel strategy targeting "driver" and "compensatory structural" segments to optimize surgical outcomes. A retrospective review of 104 ADS patients (2023-2024) compared this targeted LLIF strategy (n = 64) to traditional posterior surgery (n = 40). The LLIF approach utilized staged procedures focusing exclusively on segments driving the primary deformity and rigid compensatory segments. We evaluated radiographic parameters and clinical outcomes (VAS, ODI, EQ-5D). The LLIF group achieved significant deformity correction, with the coronal major Cobb angle decreasing from 24.73° to 10.76°, alongside marked improvements in sagittal alignment. Patients exhibited progressive self-correction of coronal balance over the 1-year follow-up. Clinical scores (VAS, ODI, EQ-5D) improved significantly. Compared to the traditional group, targeted LLIF resulted in significantly shorter operative times and less blood loss, with comparable overall complication rates (16.0% vs. 20.0%), although traditional surgery achieved superior immediate radiographic correction. Targeting driver and compensatory structural segments via LLIF is an effective, minimally invasive strategy for ADS. It offers substantial deformity correction, symptom relief, and progressive postoperative self-correction while significantly reducing surgical trauma compared to traditional long-segment fusions.
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4. Effect of Keeping Caspar Retractor During Prestige LP Cervical Disc Implantation on Intra- and Postoperative Outcomes.
PMID:DOI:日期:2026-09-24Implantation of the Prestige LP prosthesis requires substantial endplate modification and insertion forces, yet the manufacturer's guide recommends relaxing or completely removing the Caspar retractor before implantation, which we observed to cause vertebral instability during endplate preparation and prosthesis insertion. This study aimed to evaluate the effect of retaining the Caspar retractor during Prestige LP cervical disc implantation. A total of 55 patients who underwent cervical disc arthroplasty (CDA) between January and December 2025 were retrospectively reviewed. The retractor group maintained the retractor during endplate preparation and prosthesis implantation, while the no-retractor group removed it after discectomy. Clinical outcomes and radiographic parameters were assessed preoperatively, intraoperatively, and at 1 week, 3 months, and 6 months postoperatively. Statistical analyses were performed using two-way repeated-measures ANOVA, paired and independent t-tests, Mann-Whitney U test, and Chi-square test. Clinical outcomes were similar in both groups. The retractor group demonstrated superior intraoperative stability with reduced functional spinal unit (FSU) Cobb angle fluctuations (p = 0.001), fewer fluoroscopy exposures (p = 0.044), and shorter prosthesis implantation times (p = 0.017). The retractor group received significantly larger prostheses (p < 0.001). Postoperatively, the retractor group exhibited greater FSU height, disc height, and larger interfacet distance (all p < 0.005) but these differences diminished by 6 months. The retractor group also showed smaller bone-implant interface gap (p = 0.003) at 1 week, and more segmental range of motion (p < 0.008) and FSU height loss (p = 0.002) at 6 months. Subsidence and heterotopic ossification rates were comparable between groups. During Prestige LP implantation in CDA, retaining the Caspar retractor enhanced intraoperative stability, improved prosthesis placement accuracy, and reduced fluoroscopy use, achieving comparable clinical outcomes. While associated with greater FSU height loss at 6 months, it did not increase complications, supporting its viability as a standard technical modification for Prestige LP implantation.
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5. Postoperative Sleep Disturbance and Functional Recovery Following Hip Fracture Surgery: A 13-Month Prospective Longitudinal Cohort Study.
PMID:DOI:日期:2026-09-21Sleep disturbances are common after hip fracture surgery and may adversely affect postoperative recovery. However, the longitudinal course of sleep quality and its relationship with functional recovery remain poorly understood. This study aimed to characterize postoperative changes in sleep quality and examine their association with functional outcomes in patients with hip fractures. A total of 323 patients with hip fractures and no preoperative sleep disturbance were enrolled and followed for up to 13 months. Sleep quality and functional status were assessed at each postoperative visit with the Pittsburgh Sleep Quality Index (PSQI) and Barthel Index (BI). Temporal changes were characterized, and the association between PSQI and BI was evaluated using correlation analysis and adjusted linear mixed-effects models. A clinically specified Firth penalized logistic regression model was also performed to identify risk factors for postoperative sleep disturbance (PSD). A total of 1521 follow-up observations were included. The proportion of patients with PSD decreased from 88.2% at 1 month to 27.8% at 13 months after surgery, with the highest burden observed at 1 month (mean PSQI score, 7.72). Over time, PSQI scores decreased significantly (β = -0.151, 95% CI -0.188 to -0.114, p < 0.001), whereas BI scores increased (β = 3.041, 95% CI 2.701 to 3.380, p < 0.001). Higher PSQI scores were associated with lower BI scores (r = -0.182, p < 0.001), and this association remained significant after multivariable adjustment (β = -0.014, 95% CI -0.023 to -0.005, p = 0.002). Postoperative PSQI scores improved significantly across all subgroups over time (all p < 0.001). A significant follow-up month × sex interaction (β = 0.11, p = 0.013) indicated slower sleep recovery in males than females, whereas fracture type and surgical procedure did not significantly modify the longitudinal PSQI trajectories. A clinically prespecified Firth penalized logistic regression model showed that a higher preoperative ACCI score was independently associated with PSD at 1 month (adjusted OR = 1.226, 95% CI 1.005-1.495, p = 0.044). PSD was common after hip fracture surgery and gradually improved over time, although recovery was slower in male patients. PSD was independently associated with worse functional status during follow-up, although residual psychological confounding cannot be excluded, while a higher preoperative comorbidity burden may increase the risk of PSD. Sleep disturbance is a readily screenable and potentially modifiable factor, supporting routine sleep screening during postoperative rehabilitation and further evaluation of targeted sleep interventions.
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6. Iliosacral Screw Fixation for Treating Sacral Fractures: A Modified Pedicle-Guided Fixation Technique in Prone Position.
PMID:DOI:日期:2026-09-21Sacral fractures are posterior pelvic ring injuries which mechanisms range from high-energy trauma to low-energy falls in osteoporotic patients. In surgical treatment, percutaneous approaches have demonstrated significant shorter operation time and less soft tissue damage. In this study, we present a method of iliosacral (SI) screw insertion in prone position, with modified pedicle-guided technique. The present study is a retrospective case series of 22 patients for SI screw fixation from February 2019 to September 2023 under our method. Surgical technique was described in detail with images. Perioperative clinical parameters were analyzed. Activity status, complications, data of 10-point visual analogue scale (VAS) for pain and further functional outcomes using the Majeed Pelvic Score (MPS) were recorded. In addition, computed tomography (CT) was routinely performed at 6 months postsurgery to inspect the quality of screws position. Excellence rate of screw position was 97% upon CT. Two patients had screws partially contacting the cortical bone but not violating sacral foramen, and no neurological symptoms were noted. All screws were secure from possible iatrogenic nerve injuries. VAS scores improved significantly over time and most patients recorded excellent functional recovery. One untoward complication occurred involving unexpected cement extravasation after sacroplasty. No associated neurologic compromise, or clinical evidence of venous emboli thrombosis was reported. Our method aims at reducing operation time and radiation exposure to surgeons as conventional two-dimensional fluoroscopy was enough to identify safe insertion corridors in SI screw placement. Performing SI fixation in prone position is also advantageous when dealing with obese patients and concomitant spinal injuries.
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7. Inter-Session Repeatability of a Smartphone-Based Markerless System to Measure Segment Length and Lower-Limb Kinematics in Patients With End-Stage Knee Osteoarthritis.
PMID:DOI:日期:2026-09-17While kinematic analysis is crucial to characterize multi-planar functional deficits in end-stage knee osteoarthritis (OA), traditional laboratories impose severe physical burdens on patients. In-field markerless systems like OpenCap offer an accessible alternative, yet their repeatability in this population remains underexplored. The objective of this study was to assess the inter-session repeatability of OpenCap for quantifying segment lengths and lower-limb kinematics during gait and sit-to-stand tasks in end-stage knee osteoarthritis (OA) patients. Twenty-three patients with end-stage knee OA scheduled for total knee arthroplasty performed gait and sit-to-stand tasks while wearing street clothes across two visits. Segment lengths obtained from static calibration were compared between sessions, while waveform repeatability of lower-limb joint angles was assessed using root mean square deviation (RMSD) and intraclass correlation coefficient (ICC). Additionally, the standard error of measurement (SEM) and minimal detectable change (MDC) were calculated for discrete kinematic parameters. The segment lengths exhibited moderate to excellent repeatability between sessions (mean ICC: 0.79). Measurement bias was generally minimal (< 0.5 cm, except for the upper arm), with the overall 95% limits of agreement ranging from -4.51 to 3.98 cm. For gait, the average RMSD and ICC values were 4.0° (SD: 0.9) and 0.82 (SD: 0.07), respectively, whereas for the sit-to-stand task, these values were 5.2° (SD: 1.1) and 0.69 (SD: 0.08), respectively. The average SEM and MDC values for gait were 2.9° and 8.0°, and for sit-to-stand, 3.0° and 8.4°, respectively. OpenCap demonstrates moderate to good inter-session repeatability for static anatomical measurements and gait kinematics in patients with end-stage knee OA, showing promise as a low-burden clinical assessment tool. However, the higher variability observed during the sit-to-stand task necessitates cautious, task-specific interpretation, underscoring the need for further improvements before expanding its use across broader functional assessments.
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8. Artificial Intelligence-Driven Precision Bisphosphonate Therapy in Osteoporosis: Mechanisms, Clinical Applications, Risks, and Future Directions.
PMID:DOI:日期:2026-09-17Bisphosphonates remain the pharmacological standard of care for osteoporosis; however, their clinical efficacy is limited by significant diagnostic gaps, heterogeneous therapeutic responses, and persistent concerns regarding long-term safety, including medication-related osteonecrosis of the jaw (MRONJ) and atypical femoral fractures (AFF). To address these limitations, a structured comprehensive search of the Web of Science Core Collection, Scopus, and PubMed (January 2005-December 2025) was conducted to evaluate the intersection of bisphosphonate pharmacotherapy and computational medicine. The integration of artificial intelligence (AI) facilitates a methodological transition from empirical prescription to precision medicine across critical clinical domains. (1) Screening and Diagnosis: AI-driven opportunistic screening utilizes routine computed tomography (CT) scans to automate asymptomatic vertebral fracture detection and assess bone quality via radiomics. (2) Treatment Stratification: Machine learning algorithms enable the prediction of individual bone mineral density (BMD) responses and optimize alternative or sequential therapies, facilitating precise patient selection for potent agents like zoledronic acid. (3) Safety Monitoring: Predictive models integrating clinical and imaging data allow for the pre-emptive risk stratification of adverse events, shifting management from passive surveillance to active prevention. (4) Smart Delivery Systems: Furthermore, computational modeling accelerates the design of stimuli-responsive nanocarriers to improve bone targeting and reduce systemic toxicity. Despite current challenges regarding algorithmic interpretability and multi-center validation, incorporating emerging technologies-such as large language models (LLMs) for clinical triage and the integration of systemic metabolic networks (e.g., the gut-bone axis)-suggests a promising trend toward a data-informed, risk-adjusted, and biologically targeted precision ecosystem in osteoporosis management.
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9. Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures: A Retrospective Comparative Study of a Negative Pressure-Guided Technique.
PMID:DOI:日期:2026-09-17To conduct a preliminary evaluation of the feasibility, safety, and radiographic characteristics of a negative pressure-guided percutaneous vertebroplasty (PVP) technique. The primary focus of this study is on the distribution of bone cement and perioperative hemodynamic changes, with the overarching aim of mitigating the common perioperative risks associated with conventional PVP. In this retrospective comparative study, patients with vertebral compression fractures underwent either conventional percutaneous vertebroplasty (Normal PVP) or negative pressure-guided percutaneous vertebroplasty (Guided PVP). In the Normal PVP group, bone cement was injected via bilateral pedicles. In the Guided PVP group, cement was injected through a unilateral pedicle while negative pressure suction was applied through the contralateral pedicle. The following parameters were assessed: injected cement volume, perioperative vital signs, anterior vertebral height, local kyphosis angle, visual analogue scale (VAS), Oswestry Disability Index (ODI), and postoperative adverse events. A total of 60 patients were included, with 30 patients in each group. The negative pressure-guided technique was associated with a more homogeneous bone cement distribution, with a distribution index of 1.10 ± 0.12 in the Guided PVP group compared with 0.94 ± 0.18 in the Normal PVP group (p < 0.001). Smaller perioperative fluctuations in mean arterial pressure were observed in the Guided PVP group at 6 s, 3 min, and 5 min after cement injection (p < 0.05). At 3 months postoperatively, anterior vertebral height preservation was greater in the Guided PVP group than in the Normal PVP group (p = 0.017). Both groups demonstrated significant pain relief and functional improvement, with no statistically significant differences between groups. Negative pressure-guided PVP appears to be a feasible and safe technique that may promote more favorable bone cement distribution and attenuate perioperative hemodynamic fluctuations. However, given the retrospective design and limited sample size, these findings should be interpreted as exploratory, and further prospective studies are warranted to clarify its clinical advantages.
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10. Comparative Efficacy of Bone Defect Filler Strategies Following Lesion Debridement for Osteonecrosis of the Femoral Head: A Systematic Review and Network Meta-Analysis.
10. 股骨头坏死病灶清创后骨缺损填充策略的疗效比较：一项系统综述和网状Meta分析PMID:DOI:日期:2026-09-17This study aimed to systematically review and compare the clinical and radiographic outcomes of different bone defect filler materials following lesion debridement for osteonecrosis of the femoral head (ONFH). Existing evidence on filler materials relies heavily on isolated pairwise comparisons, leaving the optimal reconstruction strategy undefined. Therefore, the current network meta-analysis integrates multiple treatments and diverse clinical endpoints to determine the most effective reconstructive option. With increasing recognition of the importance of intraosseous structural reconstruction, this study sought to provide evidence-based guidance for filler selection in hip-preserving treatment. PubMed, MEDLINE, Embase, the Cochrane Library, Web of Science, and Scopus were searched from inception to March 2026. Comparative clinical studies evaluating two or more bone defect filler materials after lesion debridement for ONFH were included. Evidence was synthesized using a Bayesian random-effects network meta-analysis. Methodological quality and risk of bias were assessed using the Cochrane Risk of Bias Tool 2.0 for randomized controlled trials (RCTs) and a modified Newcastle-Ottawa Scale for non-randomized comparative trials (NCTs). After screening 2046 records, 18 eligible studies were included, comprising 10 RCTs and 8 NCTs, with a total of 1176 patients and 1284 hips. Fourteen filler strategies were analyzed, including without graft, allograft, tantalum rods, iliac autograft, artificial bone, fibular autograft, vascularized iliac autograft, vascularized fibular autograft, artificial bone combined with iliac autograft, tantalum rods combined with autograft or allograft, other autografts, other autografts combined with vascularized greater trochanter graft, iliac autograft with screw fixation, and vascularized iliac autograft with screw fixation. Tantalum rods combined with bone graft showed relative advantages in functional recovery and pain relief, as assessed by the Harris Hip Score and Visual Analogue Scale. However, tantalum rods alone were associated with a higher rate of conversion to total hip arthroplasty. Allograft ranked favorably for early functional recovery and necrosis stage maintenance, although no significant differences were observed among interventions for necrosis stage maintenance. Iliac autograft with screw fixation ranked first in preventing radiographic progression. However, without significant pairwise differences, this ranking remains inconclusive. Considering postoperative functional recovery, pain relief, and disease progression after lesion debridement, tantalum rods combined with bone graft may provide advantages in early outcomes, but the long-term failure risk of tantalum rods alone should be carefully considered. Allograft and iliac autograft with screw fixation showed favorable profiles in specific outcome domains and may represent balanced options in selected patients. Further high-quality studies with longer follow-up are needed to validate the long-term efficacy of different filler strategies.