To explore the clinical study of 3D printing digital technique assisted with PVP in the treatment of multi-segmental osteoporotic vertebral compression fractures of thoracolumbar vertebrae.

A total of 114 patients with OVCF who were treated in the department of orthopaedics in our hospital from February 2017 to March 2020 were enrolled in the study. Patients of the observation group (n=56) were treated with 3D printing technique and PVP operation, and patients in the control group (n=58) were treated with PVP. The sex, age, course of disease, bone mineral density, bone cement injection volume, fracture site, fracture type, vertebral compression degree and integrity of endplate/posterior wall were compared between the two groups. The puncture location time and fluoroscopy times of patients with different fracture types were recorded. The pain score, function score and imaging index were measured before operation, 1 day and 12 months after operation. The complications such as bone cement leakage and nerve injury were counted during the follow-up period. According to the situation of bone cement leakage, all patients were divided into non-leakage group and leakage group, and the general clinical data of the two groups were compared. the multi-factor Logistic regression models affecting bone cement leakage were established respectively, and the model differentiation was evaluated by ROC, and the internal verification was carried out by the method of Bootstrap repeated sampling.

Compared with those of the control group, the average vertebral body height of the two groups increased significantly at 1 day and 12 months after operation, while the vertebral compression ratio, VAS score, Cobb angle and ODI score decreased significantly, and the VAS score and ODI at 12 months after operation were significantly lower than those at 1 day after operation (P<0.05). 12 months after operation, there was no neurological injury and bedridden-related complications in both groups; bone cement leakage occurred in 5 patients (9.00%) of the observation group and 22 patients (37.93%) of the control group. There was significant difference in bone cement leakage between the two groups (χ²=13.259, P<0.001). The amount of bone cement injected, the degree of vertebral compression, the integrity of endplate/posterior wall and the mode of treatment were the influencing factors of bone cement leakage (P<0.05). The model incorporated into the therapeutic technique has higher predictive value.

3D printing technique combined with PVP can reduce the intraoperative puncture time and fluoroscopy times of OVCF, especially flat and double concave fractures, improve the postoperative VAS and ODI.

To investigate the diagnostic value of dual-energy X-ray absorptiometry (DXA) and lumbar spine CT in the diagnosis of osteoporosis (OP) and its complications, and to evaluate their effectiveness in guiding rehabilitation exercises.

A total of 147 patients with osteoporosis (OP) admitted to our hospital between January 2020 and January 2022 were selected as study subjects, including 64 men and 83 women, with a mean age of (66.49±5.58) years. Based on the presence or absence of osteoporosis complications, the enrolled subjects were divided into a control group (73 patients with uncomplicated OP) and an experimental group (74 patients with OP and complications). Both groups underwent DXA and lumbar spine CT examinations to observe and compare the prevalence of osteoporosis and its complications diagnosed by the two methods. The 74 patients in the experimental group were randomly divided into a DXA-guided group (37 patients) and a CT-guided group (37 patients). Personalized exercise regimens were developed, and participants were followed up for 6 months to assess exercise adherence and efficacy.

① The mean bone mineral density at L₂-L₄, hip T-score, and lowest lumbar T-score in the experimental group were all lower than those in the control group, and the CT value of the L1 vertebra was significantly lower than that in the control group, with statistically significant differences (P<0.05). ② In both the control and experimental groups, the DXA T-scores and mean bone mineral density of the lumbar spine (L₂-L₄) were positively correlated with the CT values of the L₁ vertebra (P<0.001). ③DXA results in the experimental group showed that 59.46%, 22.97%, and 17.57% of patients had mild, moderate, and severe osteoporosis, respectively. Lumbar spine CT results showed that 56.76%, 27.03%, and 16.22% of patients had osteoporosis, osteopenia, and normal bone mass, respectively. The Kappa coefficient between DXA and lumbar spine CT results was 0.721, indicating a high degree of consistency between the two. ④In the experimental group, overall exercise adherence was significantly higher in the CT-guided group than in the DXA-guided group (86.5% vs. 75.7%, P<0.05). ⑤ After 6 months, the CT-guided group showed more pronounced improvements in bone density, with lumbar spine T-scores increasing from -2.33±1.25 to -2.15±1.19, while the DXA-guided group improved from -2.37±1.21 to -2.26±1.18 (P<0.05 for the difference in improvement between groups). ⑥ Pain relief was more pronounced in the CT guidance group, with VAS scores decreasing from 5.72±1.85 to 3.18±1.41, while in the DXA guidance group, scores decreased from 5.81±1.92 to 3.76±1.58 (P<0.05). ⑦ Patient satisfaction was significantly higher in the CT-guided group than in the DXA-guided group (4.35 ± 0.62 vs. 4.08 ± 0.71, P<0.05).

Both DXA and lumbar CT offer high accuracy in the clinical detection of OP and its complications; however, lumbar CT is more suitable for the detection of OP and its complications. Among patients with OP complications, personalized exercise programs based on CT-guided diagnosis were superior to DXA-guided programs in terms of improving adherence, enhancing bone density, and alleviating pain.

To evaluate the clinical efficacy and safety of modular hemipelvic prostheses in elderly patients with periacetabular metastatic tumors.

A retrospective analysis was conducted on 25 patients who underwent reconstruction with a modular hemipelvic prosthesis for bone defects following resection of acetabular metastatic tumors. These patients were treated at Peking University People's Hospital and The First Affiliated Hospital of Ningbo University between March 2018 and March 2024. Data recorded included operative time, intraoperative blood loss, and postoperative complications (infection, tumor progression, prosthesis dislocation, prosthesis fracture) during follow-up. Patient symptoms and functional improvement were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system before and after surgery.

A total of 25 patients were included (8 males, 17 females), with a mean age of 67.64±4.84 years. All surgeries were successfully completed. The mean operative time and intraoperative blood loss were 251.80±44.79 minutes and 1 972.00±709.18 mL, respectively. Perioperative complications included deep vein thrombosis in 2 patient, surgical site infection in 2 patients, and prosthesis dislocation in 1 patient. The mean follow-up duration was 25.40±11.33 months (range: 6-46 months). During follow-up, local tumor recurrence occurred in 3 patients. Four patients died due to progression of their primary disease at postoperative months 6, 8, 14, and 19, respectively. The mean MSTS score at the final follow-up 20.0 (18.5, 25.0) was significantly higher than the preoperative score 7.0 (4.5, 11.0) (P<0.001).

Short-term follow-up confirms that the use of modular hemipelvic prostheses for reconstructing bone defects after resection of periacetabular metastatic tumors in elderly patients demonstrates a high safety profile and enables patients to achieve favorable functional outcomes.

To investigate the protective effects and related molecular mechanisms of quercetin (Que) against oxidative stress, inflammatory response, and mitochondrial dysfunction induced by hydrogen peroxide H₂O₂ osteoarthritis (OA) chondrocytes.

Articular chondrocytes were isolated from neonatal rats and randomly divided into a normal control group, a model group (H₂O₂ induced), and a treatment group (Que intervention). The safe concentration of Que was determined by CCK-8 assay. Cell viability was evaluated using Calcein-AM staining. The levels of intracellular ROS, superoxide anion, NO, and mitochondrial membrane potential were detected by DCFH-DA, DHE, DAF-FM DA, and JC-1 fluorescent probes, respectively. The expression of inflammatory factors and matrix-degrading enzymes was measured by immunofluorescence and RT-qPCR.

Que at 10-40 μg/mL showed no obvious cytotoxicity to chondrocytes. Compared with the model group, 40 μg/mL Que significantly increased cell viability (P<0.05), reduced intracellular levels of ROS, superoxide anion, and NO, and ameliorated the H₂O₂ induced decrease in mitochondrial membrane potential (P<0.05). Meanwhile, Que significantly downregulated the protein expression of MMP-13 and IL-6 as well as the mRNA expression of MMP-3, MMP-13, IL-1β, and IL-6 (P<0.05).

Quercetin attenuates H₂O₂ induced oxidative stress and inflammation in chondrocytes by scavenging reactive oxygen species, inhibiting NO production, and maintaining mitochondrial function. It exerts a protective effect on OA chondrocytes and is expected to be a natural candidate for the treatment of osteoarthritis.

To compare the clinical efficacy of a lumbar traction robot and traditional traction in the treatment of chronic non-specific low back pain (cNSLBP).

A total of 60 patients with cNSLBP admitted to the Third Hospital of Hebei Medical University between January 2023 and December 2024 were enrolled and randomly assigned, using a random number table, to a lumbar traction robot group and a traditional traction group, with 30 patients in each group. Before and after treatment, pain and functional disability were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), and lumbar range of motion (ROM) was measured. In addition, the EQ-5D index, Fear-Avoidance Beliefs Questionnaire (FABQ), and Patient Global Impression of Change (PGIC) were used to evaluate quality of life and psychosocial status.

Before treatment, there were no statistically significant differences in baseline characteristics between the two groups (P>0.05). After 4 weeks of treatment, the lumbar traction robot group showed lower VAS scores, ODI scores, and FABQ total scores than the traditional traction group (all P<0.001). Lumbar flexion, extension, left and right lateral bending ROM, as well as the EQ-5D index, were all higher in the lumbar traction robot group than in the traditional traction group (all P<0.05). The overall response rate was 93.3% in the lumbar traction robot group, higher than 73.3% in the traditional traction group (P=0.038), and the PGIC distribution was also superior in the lumbar traction robot group (P=0.043).

The lumbar traction robot was more effective in relieving pain, improving lumbar range of motion and function, reducing fear-avoidance beliefs, and enhancing quality of life in patients with cNSLBP, and may represent a new rehabilitation option for cNSLBP.

To compare the biomechanical properties of bionic cannulated screws and conventional cannulated screws for the fixation of femoral neck fractures.

Ten fresh-frozen adult femoral specimens were randomly assigned into an experimental group and a control group, with 5 specimens in each group. The experimental group was fixed with bionic cannulated screws, and the control group with conventional cannulated screws. An intact femur fixation model was first established, followed by a Pauwels type Ⅲ femoral neck fracture model in the same specimen. Under an axial load of 600 N, overall displacement, mean strain in the femoral neck region, and regional strain around the fracture line were measured.

In the intact femur fixation model, the overall displacement on both the anterior and posterior sides was significantly greater in the experimental group than in the control group (P<0.05), whereas no significant difference was found in the mean strain of the femoral neck region between the two groups (P>0.05). In the fracture model, no significant differences were observed between the two groups in overall displacement, mean strain, or regional strain (P>0.05).

Bionic cannulated screws fixation for Pauwels type Ⅲ femoral neck fractures can provide initial stability and create a favorable mechanical environment for subsequent osseointegration.

To evaluate the clinical efficacy of extra-articular tendon fixation in patients with anterior cruciate ligament (ACL) injury combined with severe axial shift on postoperative joint function and stability.

Retrospectively, 164 patients with anterior cruciate ligament (ACL) injury complicated with severe pivot shift phenomenon (Grade Ⅲ pivot shift test) admitted to the First Department of Joint Surgery, Tangshan Second Hospital from January 2020 to June 2023 were enrolled in the study, including 104 males and 60 females, aged 20 to 45 years with a mean age of (28.8±5.1) years, having a disease course of 1 to 8 weeks with an average of (4.0±1.4) weeks. Among them, 86 cases suffered from left knee injury and 78 cases from right knee injury, with 67 cases complicated with meniscus injury. The patients were divided into two groups according to the surgical method adopted: the combined group (82 cases) treated with extra-articular tendon fixation combined with ACL reconstruction, and the control group (82 cases) treated with ACL reconstruction alone.

A total of 162 patients were successfully followed up at last, with a follow-up rate of 98.78%. The follow-up period ranged from 22.5 to 25.5 months, with a mean of (24.0±1.5) months. Specifically, 81 patients in the combined group were actually followed up, with a follow-up period of 22.5 to 25.3 months and a mean of (23.9±1.6) months; 81 patients in the simple group were actually followed up, with a follow-up period of 22.6 to 25.5 months and a mean of (24.1±1.4) months. At 6 months and 1 year postoperatively, the negative rates of pivot shift test and Lachman test, Lysholm scores and IKDC scores in the combined group were significantly higher than those in the simple group; at 2 years postoperatively, the excellent and good rate of grafts in the combined group was significantly higher than that in the simple group (P<0.05). The specific values were as follows: at 6 months postoperatively, the negative rate of pivot shift test and Lachman test in the combined group was 93.8% (76/81) and 96.3% (78/81) respectively, with the Lysholm score of (78.5±6.3) points and IKDC score of (76.8±5.7) points; while the corresponding indicators in the simple group were 72.8% (59/81), 76.5% (62/81), (70.2±5.9) points and (68.3±6.2) points respectively. At 1 year postoperatively, the negative rate of pivot shift test and Lachman test in the combined group was 98.8% (80/81) and 100.0% (81/81) respectively, with the Lysholm score of (85.7±4.8) points and IKDC score of (84.2±4.5) points; the corresponding indicators in the simple group were 80.2% (65/81), 83.9% (68/81), (76.3±5.5) points and (73.5±5.9) points respectively. At 2 years postoperatively, the excellent and good rate of grafts (Grade 0-Ⅰ) in the combined group was 97.5% (79/81), which was significantly higher than 81.5% (66/81) in the simple group (P<0.05).

Extra-articular tendon fixation combined with ACL reconstruction can effectively improve postoperative joint stability and function in patients with ACL injury and severe axial displacement, protect the graft, and demonstrate good safety.

Knee osteoarthritis (KOA) is one of the leading causes of disability in the elderly population. With the global rise in aging populations, the prevalence of KOA continues to climb, placing higher and more specific demands on the precision and clinical efficacy of knee replacement surgery. Traditional total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are both effective treatments for end-stage KOA. However, both procedures share limitations such as prosthesis positioning errors, suboptimal soft tissue balance, and highly operator-dependent outcomes. The advent of robotic-assisted technology offers a revolutionary new approach to addressing these challenges. Robotic-assisted total knee arthroplasty (RATKA) and robotic-assisted unicompartmental knee arthroplasty (RAUKA) significantly enhance surgical precision, reproducibility, and standardization through preoperative planning, intraoperative real-time navigation, and robotic arm-assisted manipulation. This paper systematically reviews the technical foundations, research progress, clinical efficacy, and core differences between RATKA and RAUKA. It analyzes challenges encountered in current applications and explores integration trends with cutting-edge technologies like artificial intelligence and personalized prostheses, providing reference for clinical practice and future research.

Adjacent segment degeneration (ASDeg) and adjacent segment disease (ASD) after cervical fusion are the core issues affecting long-term outcomes. The imaging incidence is 16% to 96%, and the incidence of symptomatic ASD is 1.8% to 36%. About 40% require secondary surgery. The core mechanism is that fusion causes an abnormal increase in biomechanical load on adjacent segments (a 73.2% increase in proximal disc pressure during flexion) and accelerates degeneration. Risk factors include multiple dimensions such as preoperative (advanced age, spinal stenosis, multi-level degeneration), intraoperative (multi-level fusion, improper plate positioning) and postoperative (loss of cervical curvature). The diagnosis of ASD requires combining medical history, nerve compression symptoms (neck pain, limb numbness and weakness) and imaging findings (intervertebral space stenosis, osteophytes, spinal canal compression). Treatment needs to be individualized: For mild cases, surgery should be considered for those who fail to respond to non-surgical treatment or have obvious nerve compression. Revision of anterior cervical discectomy and decompression fusion (ACDF) is still the mainstream, but the risk of secondary surgical complications is high; zero-profile fusion cages can significantly reduce the incidence of dysphagia (0% versus 5.2%); posterior laminoplasty is suitable for multi-level spinal cord compression; cervical disc arthroplasty (CDA) preserves range of motion and may delay adjacent segment degeneration. Posterior spinal endoscopic technology (discectomy/spinal canal decompression/nerve root canal decompression) is an emerging treatment direction because it avoids the risk of anterior scarring, has the advantages of minimally invasive, rapid recovery, and little impact on stability. However, more research is needed to verify its long-term efficacy. In the future, it is necessary to strengthen the formulation of evidence-based guidelines and technological innovation to optimize prevention and control strategies.