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Journal articleGill SS, Prashar A, Kamath AG, et al., 2026, , Indian Journal of Radiology and Imaging, Vol: 36, Pages: 151-166, ISSN: 0971-3026
IntroductionSince the 2000s, artificial intelligence (AI) publications in medicine have surged, particularly in orthopaedics and radiology. A key area is the diagnosis of anterior cruciate ligament (ACL) tears, where AI enhances detection and treatment strategies. This study aims to perform a bibliometric analysis of AI in ACL tear diagnosis, identifying pivotal studies to guide future research and clinical priorities.Materials and MethodsA bibliometric analysis was conducted using the Web of Science database. The top-50 articles were ranked by citation count and analyzed for basic characteristics and research focus. Trends in diagnostic advancements and AI model utilization were also assessed.ResultsThe most cited articles, published between 2017 and 2024, peaked in 2021 (n = 13). Citation counts ranged from 7 to 401 (median: 8.5 ± 7.0). China (n = 14) and the United States (n = 13) emerged as the leading contributors. The vast majority (90%) of models were based on convolutional neural networks (CNNs), with 80% undergoing internal validation. Only 5% of the included models utilized a radiomic framework.ConclusionThis bibliometric analysis examines the growing role of AI in ACL tear diagnosis, with a marked increase in research output from 2017 to 2024. Key barriers to the adoption of AI models include algorithmic bias, data privacy, explainability, cost-effectiveness, and interoperability. The underrepresentation of radiomic-based models, despite their diagnostic potential, highlights an avenue for future research. Advancing explainable AI, strengthening validation, and establishing standardized reporting guidelines will be essential to ensure clinical integration to improve patient outcomes.KeywordsACL - AI - anterior cruciate ligament - artificial intelligenceData Availability StatementAll relevant data supporting the findings of this study can be accessed within the Supplementary Digital Content att
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Journal articleMestriner MB, Reynolds A, Barrosso BG, et al., 2026, , Am J Sports Med, Vol: 54, Pages: 1027-1034
BACKGROUND: The rectus femoris (RF) tendon may be an option for combined anterior cruciate ligament (ACL) and anterolateral (AL) reconstruction utilizing a double-stranded (DRF) tendon for the ACL and a single-stranded tendon (SRF) for AL reinforcement; however, biomechanical data remain limited. PURPOSE/HYPOTHESIS: This study aimed to biomechanically assess the DRF for ACL reconstruction using a patellar tendon (PT) graft and the SRF for AL reconstruction using an iliotibial band (ITB) graft. The hypothesis was that the biomechanical properties of the DRF graft would not differ from those of the PT graft, and the SRF graft would not differ from the ITB graft. STUDY DESIGN: Controlled laboratory study. METHOD: Eight fresh-frozen human knees were used: 2 male and 6 female, with a mean age of 49 years (range, 36-64 years). Each knee produced 4 grafts: DRF, SRF, PT, and ITB. Each graft was mounted in a materials test machine. The cross-sectional area was measured using alginate molding. After 10 preconditioning cycles to 250 N, each specimen was extended to failure at 100 mm/min. The Friedman test assessed differences between the 4 graft types using matched samples. The Dunn multiple-comparison test was used to examine differences among graft types. RESULTS: The ultimate strengths (N) of the grafts were as follows: DRF, 1978 ± 338; SRF, 1445 ± 584; PT, 1824 ± 557; ITB, 819 ± 268 (DRF and PT >ITB; P < .01). The elastic moduli (MPa) were as follows: DRF, 272 ± 59; SRF, 617 ± 153; PT, 318 ± 90; ITB, 631 ±4 31 (DRF and PT<SRF; P < .05). The ultimate tensile stresses (MPa) were as follows: DRF, 51 ± 12; SRF, 89 ± 28; PT, 62 ± 19; ITB, 56 ± 24 (SRF > DRF; P < .05). CONCLUSION: As hypothesized, the DRF graft exhibits mechanical properties that do not differ from those of the PT graft. Likewise, the SRF graft showed biomechanical properties that do not differ from those of the
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Journal articleWang E, Alexander C, Strutton P, 2026, , Scientific Reports, ISSN: 2045-2322
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Journal articleGreenfield S, Samarth G, McGregor A, et al., 2026, , Journal of Vascular Surgery, Vol: 83, Pages: 879-894, ISSN: 0741-5214
Objective:Partial foot amputations (PFA) serve as a limb-preserving alternative to major amputations in diabetic patients with advanced foot disease. This systematic review aimed to analyse clinical outcomes, including major and minor re-amputation rates, wound healing, re-ulceration, and mortality following PFA in diabetic adults.Data Sources and Review Methods:A comprehensive search of MEDLINE and Embase databases was conducted following PRISMA guidelines. Studies reporting on diabetic patients undergoing PFA for dysvascular or infective causes were selected. Out of 2437 screened abstracts, 46 studies met the inclusion criteria, representing 32,496 patients. Data extraction was performed using Covidence, and study quality was assessed using the ROBINS-I Tool.Results:Major amputation rates following PFA ranged from 0%-10% for digit and metatarsal amputations, 8%-54% for transmetatarsal amputation (TMA), and 11%-44% for midfoot amputations. The random effects model estimated a major amputation rate of 23% (95% CI 15%-30%), with high heterogeneity (I²=90%). Minor re-amputation rates varied from 12%-33%, notably high after 1st metatarsal amputation. One-year all-cause mortality was 16% (95% CI 10%-22%), with wide variability across studies. Delayed wound healing and high re-ulceration rates were common, particularly following TMA, with re-ulceration rates reaching up to 69%.Conclusion:PFA in diabetic patients carries significant risks of re-amputation, delayed healing, and limb loss. Clinicians should ensure that these risks are communicated during shared decision-making with patients. Standardisation of post-operative care, including multidisciplinary approaches involving orthotists and structured rehabilitation protocols, could help improve outcomes. Further research is needed to explore optimised care strategies and long-term functional outcomes following PFA.
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Journal articleMullington CJ, Iacona GMV, Rolph AR, et al., 2026, , Br J Anaesth, Vol: 136, Pages: 1066-1067
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Journal articleGarner AJ, Dandridge OW, Cobb JP, 2026, , Bone Joint Res, Vol: 15, Pages: 148-156, ISSN: 2046-3758
AIMS: Lateral unicompartmental arthroplasty (UKA-L) is a bone- and cruciate-preserving procedure in the treatment of isolated lateral compartment gonarthrosis, but relatively little is known of its associated gait characteristics and patient-reported outcomes. METHODS: A total of 20 individuals, at a mean 35 months (SD 37) post UKA-L, were measured on an instrumented treadmill. They were compared to age-, sex-, and BMI-matched healthy controls (n = 22) and individuals with unilateral total knee arthroplasty (TKA, n = 28) mean 44 months (SD 46) post-surgery (p = 0.382). Top walking speed, temporospatial parameters, and vertical ground reaction forces of gait were analyzed. Oxford Knee Scores (OKS) and EuroQol five-dimension questionnaire (EQ-5D) scores were compared. RESULTS: The UKA-L group walked at a mean speed of 7.0 km/hour (SD 0.6), which was 0.2 km/hour (3%) slower than the healthy control group (7.2 km/hour (SD 0.7); p = 0.681) but 26% faster than the TKA group (5.5 km/hour (SD 0.7), p < 0.001). UKA-L displayed nearer normal vertical ground reaction forces throughout the stance phase. TKA demonstrated significantly reduced maximum weight acceptance, increased mid-stance, and reduced push-off forces compared to healthy and UKA-L subjects (all p < 0.05). UKA-L recorded similar step and stride lengths to healthy controls, and were 12% and 10% longer than TKA, respectively (p < 0.05). UKA-L was associated with a mean OKS of 44 (SD 3) compared to 36 (SD 6) for TKA (p < 0.001), and mean EQ-5D of 0.90 (SD 0.09) vs 0.78 (SD 0.14) for TKA (p = 0.003). CONCLUSION: UKA-L restores healthy gait characteristics at top walking speeds. Compared to TKA, faster walking speeds, nearer-normal vertical ground reaction forces, longer stride lengths, and a more consistent gait pattern demonstrate the importance of functional cruciate ligaments to gait. UKA-L is associated with high patient satisfaction and good quality of life in the treatment of isolated lateral compar
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Journal articleHussein Hakami H, Sgambato BG, Banger MS, et al., 2026, , Sci Rep, Vol: 16
Upper-limb amputation often leads to compensatory trunk and shoulder movements, increasing the risk of secondary musculoskeletal complications. This issue is exacerbated by the limited wrist functionality in current prosthetic systems, which restrict natural movement patterns during daily activities. Here, we investigate how limitations in the degrees of freedom (DoF) of the prosthetic wrist influence compensatory upper body motion during functionally relevant tasks. Three transradial amputees, experienced in the use of both body-powered and myoelectric prostheses, were fitted with custom sockets and a prosthetic hand controlled via a 32-channel A-mode ultrasound interface. Eight able-bodied participants served as controls. All participants performed three standardized tasks-drinking, lightbulb insertion, and the Clothespin Relocation Test-while trunk and shoulder kinematics and kinetics were recorded using motion capture and surface electromyography. The results demonstrated task-dependent compensation, with the Clothespin Relocation Test eliciting the greatest trunk flexion and bilateral shoulder involvement. Distinct adaptive patterns emerged between dominant and non-dominant sides, with increased reliance on proximal joints as wrist DoFs were restricted. The findings highlight the need for prosthetic designs and rehabilitation strategies that are tailored to specific tasks and user movement patterns. Quantifying compensatory motion provides a foundation for developing user-centered control systems that enhance function and reduce long-term musculoskeletal strain.
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Journal articleSingh Gill S, Jones GG, Cobb J, et al., 2026, , Bioengineering, Vol: 13, ISSN: 2306-5354
Knee osteoarthritis (OA) affects around 37% of U.S. adults over 60, with over 25% expe-rience depressive symptoms (DSs), linked to worse pain and outcomes. Yet their impact on analgesic use and recovery remains unclear. This study aimed to assess if DSs influ-ence analgesic use and functional outcomes in knee OA. Using data from the Osteoar-thritis Initiative (n = 3680), we used a Machine Learning (ML)- based Gradient Boosting Machine (GBM) model to perform propensity score matching, matching pa-tients with knee OA and DSs (n = 487) to those without DSs (n = 487). Outcomes at baseline, 1 and 2 years included analgesic use, function (WOMAC), quality of life (KOOS-QoL), and physical health (SF-12 PCS). Regression and timepoint models com-pared follow-up with baseline. DSs alone were not associated with greater opioid use up to Year 2 (OR = 0.89, 95% CI: 0.45–1.73; p = 0.73). Among patients with DSs, SF-12 PCS improvement was less likely at Year 1, while decline was more likely up to Year 2. DSs in OA were linked to poorer physical health, but often greater functional gains than those in OA without DSs, and with no difference in opioid use. These findings highlight the need for multidisciplinary strategies, addressing both pain and psychosocial well-being.
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Journal articleDronkers EAC, Clunie GM, Iacovidou A, et al., 2026, , The Laryngoscope, Vol: 136, Pages: 243-250, ISSN: 0023-852X
ObjectiveFull-thickness resection and skin grafting of the laryngotracheal junction, the “Maddern Procedure,” can be used to treat patients with recalcitrant laryngotracheal stenosis. We report the long-term surgical outcomes of this procedure.MethodsA consecutive series of 27 females with idiopathic, iatrogenic, or vasculitic subglottic stenosis who underwent the Maddern procedure between 2012 and 2023 were retrospectively reviewed. Airway outcome was assessed using the Modified Medical Research Council Dyspnea (mMRC) Scale. Secondary outcomes included voice, swallowing, mucus management, complications, and the need for subsequent airway surgery.ResultsMost patients had idiopathic subglottic stenosis (n = 20, 74.1%), followed by vasculitic (n = 4, 14.8%) and intubation-related (n = 3, 11.1%) etiologies. Patients had an average of 7.3 (SD 3.4) endoscopic procedures before undergoing the Maddern procedure. Mean pre-Maddern inter-treatment interval was 7.5 months (SD 3.4). The median follow-up was 6.6 years (interquartile range 0.75–11.3). The mMRC dyspnea scale improved from 2.7 (SD 0.73) to 0.52 (SD 0.85). The five-year recurrence-free rate was 63%. It differed between etiologies, ranging from 83% for idiopathic stenosis to 67% for intubation-related and 0% for vasculitis-related stenoses. During the first 4 years after Maddern, 67% of patients reported daily cough and the need to use nebulizers regularly.ConclusionThe Maddern procedure is an effective and durable option for patients with idiopathic subglottic stenosis. Careful screening of patients with presumed idiopathic subglottic stenosis for possible underlying auto-immune conditions remains important when considering patients for this procedure.Level of EvidenceLevel 4.
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Journal articleBoughton O, Green C, Haider Rizvi SZ, et al., 2026, , Techniques in Orthopaedics, Vol: Publish Ahead of Print, ISSN: 0885-9698
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Journal articleKaria M, Behforootan S, Stoy L, et al., 2026, , Advances in Orthopedics, Vol: 2026, ISSN: 2090-3464
Background: Bone mechanical properties, including strength and stiffness, influence intraoperative fracture risk and implant stability in hip arthroplasty. Surgeons frequently utilize radiographic metrics to evaluate bone quality and inform surgical strategies. This study investigates the correlation between radiographic bone metrics and mechanical properties of the femoral neck.Methods: Femoral neck cortical bone samples from 23 patients undergoing elective hip arthroplasty were subjected to mechanical compression testing to measure elastic modulus and ultimate strength. Density was also measured. Radiographic metrics, including cortical thickness index, canal flare index, canal-bone ratio, and canal-calcar ratio, were determined from preoperative radiographs. The correlations between these metrics and bone mechanical properties were analysed using linear regression, with intra- and inter-observer reliability assessed.Results: Analysis included 19 of the 23 participants. Whilst cortical thickness index measurements demonstrated a weak positive correlation with bone density (R2 = 0.291; p = 0.013) and ultimate strength (R2 = 0.279; p = 0.015), canal-bone ratio showed a weak negative correlation with both factors (R2 = 0.291; p = 0.013 and R2 = 0.279; p = 0.015, respectively). Both cortical thickness index and canal-bone ratio demonstrated excellent inter and intra-observer reliability. Neither canal flare index nor canal-calcar ratio correlated with any mechanical properties, and none of the radiographic metrics correlated with elastic modulus.Conclusions: Cortical thickness index and canal-bone ratio correlate weakly with bone strength and density, but not with elastic modulus. Given their limited utility, radiographs should be used with caution in surgical decision-making regarding impaction force and implant fixation strategy.
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Journal articleMusbahi O, Pouris K, Hadjixenophontos S, et al., 2025, , World Journal of Methodology, Vol: 15, ISSN: 2222-0682
Background:Relieving pain is central to the early management of knee osteoarthritis, with a plethora of pharmacological agents licensed for this purpose. Intra-articular corticosteroid injections are a widely used option, albeit with variable efficacy. Aim:To develop a machine learning model that predicts which patients will benefit from corticosteroid injections.Methods:Data from two prospective cohort studies (OAI and MOST) was combined. The primary outcome was patient-reported pain score following corticosteroid injection, assessed using the WOMAC pain scale, with significant change defined using Minimally Clinically Important Difference and Meaningful Within Person Change. A machine learning algorithm was developed, utilising Linear Discriminant Analysis, to predict symptomatic improvement, and examine the association between pain scores and patient factors by calculating the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and F2 score.Results:A total of 330 patients were included, with a mean age of 63.4 (SD: 8.3). The mean WOMAC pain score was 5.2 (SD: 4.1), with only 25.5% of patients achieving significant improvement in pain following corticosteroid injection. The machine learning model generated an accuracy of 67.8% (95 CI: 64.6% – 70.9%), F1 score of 30.8%, and an AUC score of 0.60. Conclusion:The model demonstrated feasibility to assist clinicians with decision-making in patient selection for corticosteroid injections. Further studies are required to improve the model prior to testing in clinical settings.
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Journal articleBladt F, Varaeva YR, Retter GJ, et al., 2025, , Journal of Dance Medicine and Science, Vol: 29, Pages: 200-210, ISSN: 1089-313X
Introduction: Elite ballet is one of the most demanding physical activities for the skeleton, making dancers susceptible to bone stress injuries. This pilot study compared bone remodeling in professional female ballet dancers from the Royal Ballet Company with controls from 海角社区. Methods: The study included dancers (n = 5, median age 29 ± 16 years) and controls (n = 6, median age 24 ± 8.5 years). The main outcome measure was bone turnover, assessed by measuring the ratio of resorption (NTX) and formation (P1NP) markers in urine and serum. Estrogen metabolism was evaluated through 2OH/16OH metabolite ratios. Both markers were measured using ELISA kits. Diet was tracked using 72-hour diaries, and weekly exercise hours were recorded through 2-week diaries and cross referenced with training logs. Results: Results showed significantly higher bone resorption to formation ratio (NTX/P1NP) in dancers versus controls (P < .050), and elevated estrogen metabolite ratios (2OH/16OH) (P < .010). These findings occurred despite similar dietary profiles between groups including fat (P = .874) carbohydrate (P = .501) and protein (P = .099). Dancers showed significantly higher weekly exercise hours (46.50 ± 38.75 vs 14.75 ± 11.75 hours/week, P < .001) and lower BMI (18.36 ± 1.35 vs 20.77 ± 3.66, P = .020). Conclusions: The pilot data suggest elite ballet dancers may exhibit an imbalance in bone remodeling with high resorption and low formation relative to controls. This imbalance in bone turnover markers could serve as a screening tool for identifying dancers at increased risk of bone stress injuries. The NTX/P1NP ratio could potentially offer a low-cost, non-invasive approach to identify
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Journal articleBradshaw FE, Gompels BD, Mainwaring E, et al., 2025, , Knee, Vol: 57, Pages: 444-454
AIMS: Anterior cruciate ligament (ACL) injuries disproportionately affect female athletes, with a two-to eightfold increased risk compared to males. Using a modified Delphi approach, this study aimed to identify and prioritise key research questions regarding ACL injury prevention, diagnosis, treatment, rehabilitation, and care delivery in the female population. METHODS: A modified priority setting exercise (Delphi) was conducted with the Women's ACL Orthopaedic Steering Group, the British Orthopaedic Association (BOA), and the British Association for Surgery of the Knee (BASK). Two rounds of online surveys were distributed via Qualtrics between June and November 2024, followed by an in-person workshop on 14th November 2024. The initial poll collected research questions from patients, carers, and healthcare professionals. A systematic literature review was categorised into questions based on existing evidence. The second survey prioritised 50 questions, with the top 30 discussed at the final workshop, where the top ten research priorities were determined through structured discussion and consensus-building. RESULTS: A total of 166 questions were submitted, of which 116 were deemed relevant. Following the literature review, 50 questions were included in the second survey. The final workshop, attended by 14 participants, identified ten key research priorities, focusing on sex-specific rehabilitation, injury prevention strategies, and psychological recovery. CONCLUSION: This study presents a consensus-driven research agenda to address critical gaps in managing female ACL injuries. These ten priorities will guide future research, enhance clinical outcomes, and promote gender-specific strategies for ACL injury prevention and rehabilitation.
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Journal articleAlagha MA, Cobb J, Liddle A, et al., 2025, , Bone & Joint Open, Vol: 6, Pages: 1504-1514, ISSN: 2633-1462
AimsPain and poor health-related quality of life measures serve as the primary indication for primary elective total hip arthroplasty (THA). It remains challenging to predict whether THA delivers the patient-anticipated improvements. Our study aimed to develop and validate statistical and machine learning prediction models of one-year clinical improvement in patient-reported outcome measures (PROMs) after elective THA.MethodsWe included 82,526 patients with primary elective THAs from the Swedish Arthroplasty Register (SAR) for forecasting one-year improvements in the EuroQol five-dimension questionnaire (EQ-5D) index, EQ-visual analogue scale (VAS), and combined EQ-5D/EQ-VAS scores. Two minimal clinically important difference (MCID) thresholds were applied for the EQ-5D index score based on the approaches of standardized response mean (SRM) of 0.196 and capacity of benefit (CoB) of 0.428. MCID cutoff for the EQ-VAS was set to 7.81. A total of 21 features were used to feed the models. To avoid estimates bias, we eliminated missing data. Model performance was tested using the area under the receiver operating characteristic curve (AUC), and importance of features was identified in the best performing algorithm.ResultsApplying the SRM MCID, approximately two-thirds of patients reported one-year improvements in EQ-5D index (66.3%) and EQ-VAS (69.1%). The improvement rate decreased to 51.7% when we combined improvements in both outcomes. A higher CoB cut-off for EQ-5D index yielded lower rates (~40% for the EQ-5D index and 31.3% for the combined measure). The gradient boosting machine (GBM) consistently outperformed other models by a narrow margin in predicting significant clinical improvements in one-year PROMs and achieved a good to excellent binary discriminative power (AUC range 0.80% to 0.97%). Preoperative PROMs, EQ-5D index, EQ-VAS, and Charnley Hip Score, along with age, collectively contributed to over 80% of the algorithmic power in the ensemble GBM model.Concl
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Journal articleHolthof SR, Nejima S, Rock M, et al., 2025, , Knee Surgery, Sports Traumatology, Arthroscopy, Vol: 33, Pages: 3896-3905, ISSN: 0942-2056
Purpose:This study implemented a novel robotic test method to quantify the effect of three distinct total knee arthroplasty (TKA) designs on knee kinematics and stability. It was hypothesised that the implant geometries would affect stability and rollback, with differences between the native and replaced knees, as well as between implant designs.Methods:Eight fresh-frozen cadaveric knees were tested across the arc of flexion-extension under 710 N compressive load, combined with either no anterior-posterior (AP) tibial force, 90 N anterior or 90 N posterior drawer force using a robotic actuator. The same testing protocol was used post-TKA using three distinct implant designs (gradually reducing femoral condylar radius medially stabilised, multi-radius medially conforming and single-radius symmetrical), matched to the same bone cuts. Laxity and rollback were analysed using statistical parametric mapping and implant designs were compared to the intact knee and each other.Results:No significant differences in AP laxity were found between the intact knee (4.7 ± 0.7 mm), gradually reducing radius (6.3 ± 1.3 mm) and multi-radius designs (5.7 ± 1.1 mm). The single-radius implant showed significantly larger average AP laxity envelope (11.6 ± 2.3 mm) than the intact knee, the multi-radius design and the gradually reducing radius design and was more variable between knees. The rollback among the intact knee and TKAs were not significantly different: gradual radius 81% of native, multi-radius 85% and single-radius 90%.Conclusions:Significant differences of AP laxity were found between the pre- and post TKA knee and between implant designs. Rollback did not differ significantly. Implanted knee behaviour also showed differences of sensitivity to cadaveric specimen and implantation variation among the prosthesis designs.Clinical relevance:Instability
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Journal articleIacona GMV, Rolph AR, Manteigas HFM, et al., 2025, , BRITISH JOURNAL OF ANAESTHESIA, Vol: 135, Pages: 1231-1239, ISSN: 0007-0912
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Journal articleSch眉tze R, Liew B, Caneiro JP, et al., 2025, , Behaviour Research and Therapy, Vol: 193, ISSN: 0005-7967
Chronic low back pain (CLBP) is an urgent global health priority given its high prevalence and impact as the leading cause of disability. While several efficacious treatments exist, most have modest effects. Improving outcomes requires a better understanding of treatment mechanisms to enable optimisation. This study explored the mechanisms of cognitive functional therapy (CFT), a biopsychosocial intervention with large, durable effects for adults with disabling CLBP. A longitudinal mediation analysis was performed on data from the RESTORE multisite clinical trial comparing CFT (n = 327) to usual care (n = 165). Mediators (self-efficacy, fear, catastrophising, and pain intensity) were specified based on behavioural theories underlying CFT and previous research. The joint mediation of treatment effects on disability (Roland Morris Disability Questionnaire) and pain intensity (numerical rating scale), were examined using a counterfactual framework for mediation analysis. As hypothesised, earlier changes in self-efficacy, fear, catastrophising, and pain intensity mediated improvements in disability at the end of treatment and at 12-month follow-up, explaining up to 61 % of the effect. Similarly, self-efficacy, fear, and catastrophising mediated the effect of CFT on pain intensity, explaining up to 62 % of the effect. Results are consistent with previous CLBP mediation research highlighting self-efficacy, fear, and catastrophising as likely common mechanisms among effective biopsychosocial treatments. CFT demonstrates large, durable, and clinically important effects on these mechanisms. Findings shed light for clinicians and researchers on how CFT works, although the role of other mechanisms such as movement changes requires further exploration, along with research analysing how different treatment components activate these mechanisms.
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Journal articleBoughton OR, Mann S, O'Toole P, 2025, , JBJS Case Connect, Vol: 15
CASE: This case report, with 3 years of follow-up, describes a 9-year-old boy who suffered sequential Delbet type IV proximal femoral fractures. Three months postoperatively he had a unilateral slipped capital femoral epiphysis and had to undergo further surgery to address this. CONCLUSION: Proximal femur fractures are rare in childhood, and a slipped capital femoral epiphysis after fixation of a Delbet type 4 fracture has only been described once before in the literature. This case report highlights underlying risk factors of subsequent slipped capital femoral epiphysis after a Delbet type IV proximal femoral fracture and emphasizes the importance of careful follow-up.
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Journal articlePonniah HS, Montin E, Namireddy S, et al., 2025, , Bone and Joint Research, Vol: 14, Pages: 832-838
Femoroacetabular impingement (FAI) is caused by abnormal contact between the femur and acetabulum, resulting in pain, limited motion, and early osteoarthritis. Existing imaging techniques for diagnosing FAI face considerable challenges. Radiomics involves the quantitative extraction and analysis of imaging features using advanced algorithms, often combined with machine learning (ML), to enhance diagnostic and prognostic precision. When integrated with ML, radiomics can identify patterns beyond conventional imaging measurements, potentially enabling automated, precise, and reproducible assessment of hip morphology and pathology. Early studies demonstrate its potential to differentiate between normal, symptomatic, and asymptomatic cam-type hips. However, challenges persist, including the standardization of imaging protocols, feature selection, access to large datasets, and the explainability of models. This review summarizes the state of the art in radiomics for FAI and highlights its future applications.
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