bims-ricfun Biomed News
on Rehabilitation ICF
Issue of 2026–03–15
68 papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica
  1. Mechanics in Motion: Dynamic Ultrasonography Identifies Osteophyte-Induced Gracilis Impingement.
  2. The hidden architecture of back pain: ultrasound-based lumbar multifidus pennation angle analysis - a cross-sectional pilot study.
  3. Laying the foundation for an instrument to assess environmental factors in people with chronic pulmonary diseases: mapping the content of the Craig Hospital Inventory of Environmental Factors (CHIEF) to ICF core sets.
  4. Practical tips for paediatricians: It hurts, swells and changes color, maybe its complex regional pain syndrome-Tips for early diagnosis and treatment.
  5. Postoperative Functional Recovery After Carpal Tunnel Release: A Narrative Review on Exercise-Based Rehabilitation.
  6. Nerve Ultrasound for the Diagnosis of Tarsal Tunnel Syndrome: Findings in 26 Clinically and Electrophysiologically Confirmed Feet.
  7. Postoperative Immobilization After Foveal Triangular Fibrocartilage Complex Repair: A Systematic Review and Meta-Analysis of Comparative Studies.
  8. The Inlet Cross-Sectional Area: The Most Reliable Ultrasound Parameter for the Diagnosis of Carpal Tunnel Syndrome.
  9. Platelet-Rich Plasma in Acute Muscle Injuries: An Umbrella Review and Meta-analysis of Return to Sport and Reinjury Outcomes.
  10. Can a Clinician Accurately Diagnose Iliopsoas Tendinitis on a Physical Examination?
  11. Virtual reality in pulmonary rehabilitation: A systematic review of clinical outcomes in COPD and post-COVID conditions.
  12. Identification and preservation of the Berrettini branch in ultrasound-guided carpal tunnel release.
  13. Functional and radiological outcomes of the all-dorsal technique for scapholunate ligament reconstruction.
  14. Refractory Chronic Knee Pain After Total Knee Replacement Successfully Treated With L4 Dorsal Root Ganglion Pulsed Radiofrequency.
  15. Clinical value of 3D-FIESTA-C sequence in evaluating the arcuate ligament of the elbow joint: a retrospective study.
  16. Rehabilitation and outcomes following revision total hip replacement: patients' experiences, optimised rehabilitation interventions and opioid use (PhD Academy Award).
  17. Comparative effectiveness of amitriptyline vs duloxetine in the treatment of chronic low back pain: An observational study.
  18. MRI-Based Quantitative Assessment of Calcific Tendinopathy: Imaging Predictors and Thresholds for Rotator Cuff Tear Detection.
  19. Arthroscopic debridement with microfragmented adipose tissue for wrist and hand chondral lesions in professional athletes.
  20. Crucial anatomic ensemble of the lateral knee: the 'W' configuration.
  21. Chronic Obstructive Pulmonary Disease and Overtraining Syndrome: A Narrative Review.
  22. Intracapsular injection of triple-drug solution in the treatment of early and mid-stage knee osteoarthritis.
  23. Ultrasound-guided platelet-rich plasma versus corticosteroid injection for supraspinatus tendinopathy: a randomized comparative study.
  24. Pisotriquetral arthrodesis for the management of chronic pisotriquetral fracture-dislocation: a case report.
  25. The epidemiology of cubital tunnel syndrome: a UK Biobank case-control study.
  26. Prevention of postoperative shoulder stiffness after Rotator Cuff Repair through a structured self-rehabilitation protocol.
  27. CT-guided sacroiliac joint injection for chronic sacroiliitis: outcomes and predictors in a retrospective cohort study.
  28. Considering mental function for successful total knee arthroplasty in older people.
  29. Mediating effect of catastrophising in correlation between pain and disability amongst patients with carpal tunnel syndrome.
  30. Shear Wave Elastography Assessment of Achilles Tendon Stiffness in Asymptomatic Patients with Psoriatic Arthritis.
  31. Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane reviews: Summary of a Cochrane review.
  32. The Role of Electrolytes in Muscle Pain Syndromes: A Systematic Review and Meta-Analysis With Implications for Temporomandibular Disorder.
  33. Anterior Knee Pain and Excessive External Tibial Torsion in Female Patients: Rationale and Outcomes of Rotational Tibial Osteotomy.
  34. Systematic Review: Preclinical and Clinical Evidence on MSC Efficacy and Mechanism of Action in Neuropathic Pain Reduction.
  35. Efficacy and Safety of Intra-Articular Therapies for Temporomandibular Disorders: A Systematic Review and Meta-Analysis.
  36. Osteonecrosis and stress-related subchondral injuries in the elite athlete: a review on etiology, clinical signs, and management.
  37. Ultrasonographic Assessment of the Diaphragm and the Effects of Smoking on Respiratory Function in Individuals Attending a Smoking Cessation Center.
  38. Does Spine Pathology Influence Hip Arthroscopy Outcomes? A Systematic Review and Meta-analysis.
  39. Association between frailty status and pain, balance, and quality of life in patients with lumbar spinal stenosis.
  40. Returning to Work and Cost-Effectiveness After Lumbar Facet Cryodenervation Among Patients with Chronic Low Back Pain.
  41. Effectiveness, Safety, and Patient Satisfaction of Laparoscopic Uterosacral Nerve Ablation in Terms of Pain Relief in Women with Chronic Pelvic Pain.
  42. Functional outcomes and reoperation rates following conversion of failed anatomic and reverse shoulder arthroplasty to hemiarthroplasty: A systematic review.
  43. Advancing chronic low back pain management: Insights from amitriptyline and duloxetine comparison.
  44. Steroid Injections for Arthropathy, Tendinopathy and Myopathy in the Pediatric Population: A Systematic Review.
  45. Association of Vitamin D Status with Radiographic Changes in Knee Osteoarthritis Patients.
  46. Ultrasound-guided intra-articular steroid injection or ultrasound-guided suprascapular notch steroid injection for frozen shoulder? A sequential comparative study with a 1-year follow-up.
  47. Radiofrequency ablation of the superior cluneal nerves to treat chronic low back pain: a description of a novel technique.
  48. Preoperative Electrophysiological Findings Predicting Surgical Outcomes in Tarsal Tunnel Syndrome.
  49. Use of Autologous Platelet-rich Plasma as a Biological Adjunct in Distal Humerus Non-union: A Case Report.
  50. Radiologic Insights: Diagnosing Lumbosacral Transitional Vertebrae. Systematic Review of the Literature.
  51. Editorial: Advancements in injury rehabilitation and return-to-sport practices.
  52. The effects of physiotherapy on neck pain with associated symptoms, ıncludıng cervicogenic dizziness and tinnitus: a systematic review.
  53. Hoffa's Fat Pad Ganglion Cyst Causing Infrapatellar Impingement in a Collegiate Athlete: A Report of a Rare Case.
  54. Effects of hip strengthening on postural control and muscle strength in individuals with chronic ankle instability: A systematic review and meta-analysis of randomized controlled trials.
  55. Effect of Prebiotic Supplementation With and Without Physiotherapy on Pain and Pain Sensitivity in People with Knee Osteoarthritis.
  56. Ultrasound Guided Radiofrequency Ablation of Suprascapular Nerve for Shoulder Pain: A Novel Technique Description.
  57. TRANSCRANIAL DIRECT CURRENT STIMULATION IS EFFECTIVE FOR PAIN RELIEF OF INDIVIDUALS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN: A DOUBLE-BLIND RANDOMIZED CLINICAL TRIAL.
  58. Comparative Efficacy of Surgical Versus Nonsurgical Management for Acute Achilles Tendon Rupture in a Novel Mouse Model.
  59. The Infrapatellar Fat Pad in Osteoarthritis: From Pathophysiology to a Novel Therapeutic Target.
  60. Evaluating the construct validity of five concern for falling outcome measures and the concern for falling framework in people with lower limb loss using the International Classification of Functioning, Disability and Health framework.
  61. Changes in human multifidus muscle size with aging and short-term disuse.
  62. Core stability in women with and without chronic pelvic pain.
  63. Botulinum Toxin Injection to Treat Bruxism in a Child: A Case Report and Technique Description.
  64. Effectiveness of elastic resistance training in frail older adults on muscle strength and functionality levels: A systematic review.
  65. Prospective, non-inferiority, multicenter, randomized, single-blind clinical trial comparing cooled radiofrequency ablation to standard radiofrequency ablation to manage chronic facetogenic lumbar back pain.
  66. Effectiveness of drug interventions to prevent delirium after surgery for older adults: systematic review and network meta-analysis of randomised controlled trials.
  67. Weight-bearing computed tomography in knee pathologies: current evidence and future perspectives.
  68. Symptomatic Tendon Sheath Ganglion at the Insertion of the Popliteus Tendon Treated With Local Cortisone Injection.
  1. Am J Phys Med Rehabil. 2026 Mar 10.
    Mechanics in Motion: Dynamic Ultrasonography Identifies Osteophyte-Induced Gracilis Impingement.
    Berkay Yalçınkaya, Ahmet Furkan Çolak, Hilmi Berkan Abacıoğlu, Alp Çetin.
      
    Keywords:  Dynamic Imaging; Knee; Osteoarthritis; Sono-Palpation; Ultrasound
    DOI:  https://doi.org/10.1097/PHM.0000000000002982
  2. BMC Musculoskelet Disord. 2026 Mar 11.
    The hidden architecture of back pain: ultrasound-based lumbar multifidus pennation angle analysis - a cross-sectional pilot study.
    Nagma Sheenam, Nitesh Manohar Gonnade, Ravi Gaur, T K Abins, Arindam Ghosh, Rejuwan Hussain.
      
    Keywords:  Lumbar multifidus, pennation angle, chronic low back pain, muscle architecture; Muscle thickness; Paraspinal muscles; Ultrasound imaging
    DOI:  https://doi.org/10.1186/s12891-026-09604-4
  3. Disabil Rehabil. 2026 Mar 11. 1-12
    Laying the foundation for an instrument to assess environmental factors in people with chronic pulmonary diseases: mapping the content of the Craig Hospital Inventory of Environmental Factors (CHIEF) to ICF core sets.
    Larissa Tatiane Costa, Giovanna Camargo Mello, Wallace Pereira Silva, Junior Francisco Da Silva, Luciana Maria Malosa Sampaio, Soraia Micaela Silva.
       PURPOSE: To map the concepts assessed by Craig Hospital Inventory of Environmental Factors (CHIEF) to International Classification of Functioning, Disability, and Health (ICF) and to ICF core sets related to pulmonary diseases.
    METHODS: Two professionals with adequate taxonomic knowledge of the ICF performed the initial linking, following standardized and updated linking rules. The same professionals subsequently linked the CHIEF items to the ICF core sets for post-acute cardiopulmonary diseases, obstructive pulmonary diseases, and interstitial pulmonary diseases to map CHIEF's alignment with the key concepts encompassed in chronic pulmonary diseases.
    RESULTS: CHIEF covered 25 categories across all ICF environmental domains. Several relevant categories for individuals with chronic respiratory conditions were not included, such as: e110 Products or substances for personal consumption, e120 Products and technology for personal indoor and outdoor mobility and transportation, e245 Time-related changes, e2450 Day/night cycles, e260 Air quality, e320 Friends, e340 Personal care providers, e355 Health professionals, e420 Individual attitudes of friends, and e450 Individual attitudes of health professionals.
    CONCLUSION: Although the CHIEF aligns with the ICF, important gaps were identified in air quality, health professional support, assistive products, and social support domains, indicating the need for adaptation.
    Keywords:  Environmental factors; ICF Core Sets; ICF linking rules; International Classification of Functioning, Disability and Health (ICF); Pulmonary rehabilitation
    DOI:  https://doi.org/10.1080/09638288.2026.2642539
  4. Paediatr Child Health. 2026 Mar;31(2): 84-86
    Practical tips for paediatricians: It hurts, swells and changes color, maybe its complex regional pain syndrome-Tips for early diagnosis and treatment.
    Krista Baerg.
      
    Keywords:  Adolescent; Child; Chronic primary pain; Complex regional pain syndrome; Nociplastic pain; Pain management
    DOI:  https://doi.org/10.1093/pch/pxaf093
  5. Cureus. 2026 Feb;18(2): e103195
    Postoperative Functional Recovery After Carpal Tunnel Release: A Narrative Review on Exercise-Based Rehabilitation.
    Evangelos E Tzanis, Sophia Syngouna, Evangelos Sakellariou, John Vlamis.
      Carpal tunnel release is a commonly performed surgical procedure that effectively alleviates compressive symptoms in patients with carpal tunnel syndrome. However, postoperative recovery of hand function, including grip strength, pinch strength, and coordinated hand use, varies considerably among individuals. This variability indicates that functional recovery is influenced by factors beyond the surgical intervention itself. This narrative review synthesizes the existing literature on postoperative functional recovery following carpal tunnel release, with emphasis on functional outcomes, rehabilitation strategies, and exercise-based interventions. Surgical decompression consistently improves sensory symptoms; however, restoration of hand strength and overall functional performance is frequently delayed and heterogeneous. Although early mobilization is generally considered safe, it does not adequately address persistent deficits in strength, coordination, or endurance. Exercise-based rehabilitation approaches-including nerve and tendon gliding exercises and progressive strengthening-are biologically plausible and potentially relevant to postoperative recovery, yet the existing literature is characterized by variability in study design, intervention protocols, and outcome assessment. Postoperative recovery following carpal tunnel release represents a multifactorial process. Exercise-based rehabilitation is a promising but insufficiently studied modifiable component of postoperative care. Well-designed prospective studies are required to clarify its role in optimizing functional recovery after carpal tunnel surgery.
    Keywords:  carpal tunnel release; carpal tunnel syndrome; exercise-based rehabilitation; grip strength; postoperative rehabilitation
    DOI:  https://doi.org/10.7759/cureus.103195
  6. J Clin Med. 2026 Feb 24. pii: 1699. [Epub ahead of print]15(5):
    Nerve Ultrasound for the Diagnosis of Tarsal Tunnel Syndrome: Findings in 26 Clinically and Electrophysiologically Confirmed Feet.
    Ben-Ole Holtz, Mihai Ceanga, Andrea Behnert, Raphaela Marquardt, Christian Geis, Hubertus Axer.
      Background/Objectives: Posterior tarsal tunnel syndrome is a compressive neuropathy of the tibial nerve at the level of the ankle within the tarsal tunnel. However, there is no established gold standard for the diagnosis of tarsal tunnel syndrome to date. High-resolution ultrasound could add important value in this setting. But up to date, to the best of our knowledge, only six clinical studies have investigated the use of ultrasound for the diagnosis of tarsal tunnel syndrome, with partially conflicting results. Most authors identify nerve swelling at the level of anatomical compression as the key ultrasonographic criterion, whereas at least one study and some expert opinions instead emphasize nerve compression at the site of entrapment. Methods: We performed a retrospective observational study of high-resolution ultrasound of the tibial nerve in patients with typical clinical and electrophysiological characteristics of tarsal tunnel syndrome. Results: A cohort of 26 feet with clinically and electrophysiologically confirmed tarsal tunnel syndrome was collected. Nerve ultrasound demonstrated a moderate sensitivity of 65% for the detection of abnormalities of the tibial nerve when applying the commonly used cut-off of 11.8 mm2 for the tibial nerve at the level of the tarsal tunnel entry or within the tarsal tunnel. In all but one of the cases classified as pathological on ultrasound, an increase in tibial nerve CSA in the tarsal tunnel was observed compared with the CSA measured 5-10 cm proximal to the tarsal tunnel entry (by a factor of 1.6 ± 0.53). A secondary cause was found in only 12% of the cases. But this study also suggests that ultrasound may remain unremarkable in approximately one third of patients with tarsal tunnel syndrome. Conclusions: Establishing the diagnosis of tarsal tunnel syndrome remains challenging. Our study supports the hypothesis proposed in previous publications that tarsal tunnel syndrome appears to be an exception among compression neuropathies on ultrasound: sonography demonstrates nerve swelling not proximal to the site of compression, but at the level of the anatomical compression. Further prospective data would be of substantial clinical relevance.
    Keywords:  nerve conduction studies; nerve ultrasound; tarsal tunnel syndrome
    DOI:  https://doi.org/10.3390/jcm15051699
  7. J Hand Surg Am. 2026 Mar 11. pii: S0363-5023(26)00143-7. [Epub ahead of print]
    Postoperative Immobilization After Foveal Triangular Fibrocartilage Complex Repair: A Systematic Review and Meta-Analysis of Comparative Studies.
    Jun-Ku Lee, Tien-Ching Lee, Sujung Lee, Hyunsun Lim, Eric Chang, Meewon Olivia Park, Jeffrey Yao.
       PURPOSE: Foveal tears of the triangular fibrocartilage complex (TFCC) are a major cause of distal radioulnar joint instability and often require surgical repair to restore forearm function. Although foveal repair is increasingly performed, postoperative immobilization protocols remain variable and poorly standardized. This systematic review and meta-analysis evaluated the effects of different immobilization methods and durations on clinical outcomes after TFCC foveal repair.
    METHODS: Comparative clinical studies assessing postoperative immobilization after TFCC foveal repair were identified through a systematic review of MEDLINE, EMBASE, Web of Science, and the Cochrane Library. Outcomes included pain (visual analog scale), Disabilities of the Arm, Shoulder and Hand scores, wrist range of motion, grip strength, and complications. For quantitative analysis, studies were grouped according to immobilization method: elbow-restricted immobilization versus forearm-restricted immobilization permitting elbow motion. Studies evaluating immobilization duration or timing of motion initiation were analyzed descriptively.
    RESULTS: Five comparative studies (288 patients) met the inclusion criteria; four evaluated immobilization methods, and 2 assessed immobilization duration or initiation of forearm rotation. Three studies were included in the meta-analysis. No significant differences were found between elbow-restricted and forearm-restricted immobilization in final pain visual analog scale (mean difference [MD] -0.34; 95% CI, -0.91 to 0.24), Disabilities of the Arm, Shoulder and Hand scores (MD -1.67; 95% CI, -6.71 to 3.38), grip strength (MD +0.38%; 95% CI, -9.69 to 10.45), or wrist range of motion, and complication rates were similarly low across groups. Studies investigating immobilization duration demonstrated that restricting pronation and supination for approximately 4-6 weeks yielded better pain relief and functional recovery than immediate rotation, without causing persistent elbow stiffness.
    CONCLUSIONS: Based on currently available comparative studies, postoperative immobilization after TFCC foveal repair may benefit more from restricting forearm rotation than from restricting elbow motion. Additional restriction of elbow flexion and extension has not shown a consistent advantage in reported outcomes, whereas delaying forearm pronation and supination for up to 6 weeks may help protect the repair while still permitting early functional recovery. Further studies are needed to establish standardized guidelines.
    TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
    Keywords:  Distal radioulnar joint instability; Forearm rotation; Foveal repair; Postoperative immobilization; Triangular fibrocartilage complex
    DOI:  https://doi.org/10.1016/j.jhsa.2026.01.029
  8. Am J Phys Med Rehabil. 2026 Jan 13.
    The Inlet Cross-Sectional Area: The Most Reliable Ultrasound Parameter for the Diagnosis of Carpal Tunnel Syndrome.
    Zahra Soleimani-Shishavan, Bina Eftekharsadat, Raha Markazi-Movaghar, Mehran Mohammadzadeh, Arash Babaei-Ghazani, Sanam Dolati, Fatemeh Jahanjoo.
       OBJECTIVE: Despite emerging interest in dynamic parameters like the ratio of median nerve-to-hamate distance (RMHD) for diagnosing carpal tunnel syndrome (CTS)-particularly in selected populations such as hemodialysis patients-this study evaluates whether the inlet cross-sectional area (CSA-I) retains diagnostic superiority in a general CTS population.
    DESIGN: In this case-control study, 88 participants (44 CTS patients, 44 healthy controls) were recruited from a tertiary referral university hospital between November 2024 and March 2025. High-resolution ultrasonography measured median nerve parameters.
    MAIN OUTCOME MEASURES: Diagnostic accuracy (AUC, sensitivity, specificity) of CSA-I vs. Outlet cross-sectional area (CSA-O), anteroposterior diameters (AP-I/O), flattening ratio at the outlet (FR-O), and RMHD during rest/grip.
    RESULTS: CSA-I demonstrated exceptional diagnostic accuracy (AUC = 0.93). At a cutoff of >9.5 mm2, CSA-I yielded 86% sensitivity and 84% specificity. CSA-O showed lower accuracy (AUC = 0.88) and novel dynamic parameters such as RMHD performed poorly in this general population (AUC ≈ 0.50).
    CONCLUSION: CSA-I remains the most reliable sonographic parameter for diagnosing CTS in the general population. A CSA-I value >9.5 mm2 is recommended for routine clinical practice. Dynamic measures may retain value in specific subgroups but do not replace CSA-I for general CTS evaluation.
    Keywords:  Carpal Tunnel Syndrome; Diagnostic Accuracy; Median Nerve; Ultrasonography
    DOI:  https://doi.org/10.1097/PHM.0000000000002930
  9. Orthop J Sports Med. 2026 Mar;14(3): 23259671251399907
    Platelet-Rich Plasma in Acute Muscle Injuries: An Umbrella Review and Meta-analysis of Return to Sport and Reinjury Outcomes.
    Eiki Nicholas Kobayashi, Jan Willem Cerf Sprey, Pedro Baches Jorge.
       Background: Platelet-rich plasma (PRP) is frequently used in sports medicine to treat muscle injuries; however, the clinical evidence remains inconsistent and fragmented.
    Purpose: To assess whether PRP therapy improves clinical outcomes, particularly return to sport (RTS) and reinjury rate, compared with conventional treatments for acute muscle injuries.
    Study Design: Systematic review and meta-analysis; Level of evidence, 2.
    Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic search of PubMed, Embase, BVS, and Scopus was conducted through April 2025 for systematic reviews, with or without meta-analysis, to evaluate PRP for acute muscle injuries in athletes. A total of 1464 manuscripts were identified through the initial search. Main outcomes included RTS, reinjury rate, pain, and complications. Methodological quality was assessed using the Risk of Bias in Systematic Reviews (ROBIS) tool, and the certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Meta-analyses were performed using random-effects models with Hartung-Knapp-Sidik-Jonkman adjustments.
    Results: Eight systematic reviews were included. PRP significantly reduced reinjury risk compared with controls (risk ratio, 0.84 [95% CI, 0.76 to 0.92]; I2 = 0%), with high-certainty evidence. A reduction in RTS time favored PRP (mean difference, -4.43 days [95% CI, -9.28 to 0.42); however, it did not reach statistical significance (low-certainty evidence). Narrative synthesis suggested inconsistent short-term pain relief and low complication rates, but evidence certainty was rated very low to low due to methodological and reporting limitations.
    Conclusion: Our review study demonstrated that PRP may reduce muscular reinjury rates and potentially accelerate RTS, although benefits on pain and safety remain uncertain. Current evidence supports the selective use of PRP in sports settings; however, standardization in protocols and outcomes is needed. These findings may assist clinicians in individualizing treatment strategies involving PRP for acute muscle injuries, particularly in high-performance athletes at risk of recurrence.Registration: CRD42021279300.
    Keywords:  complications; muscle injuries; pain; platelet-rich plasma; reinjury; return to sport
    DOI:  https://doi.org/10.1177/23259671251399907
  10. Am J Sports Med. 2026 Mar 13. 3635465261428681
    Can a Clinician Accurately Diagnose Iliopsoas Tendinitis on a Physical Examination?
    Thomas Johnstone, Kinsley Pierre, Eugene Roh, Michael Fredericson, Marc R Safran.
       BACKGROUND: Iliopsoas (IP) tendinitis is an underrecognized but important cause of anterior hip pain in active patients. Some studies have reported that a physical examination (PE) has limited reliability in making a diagnosis of IP tendinitis. Differentiating anterior hip pain due to IP tendinitis from intra-articular sources is critical to appropriately and expediently treat patients.
    HYPOTHESIS/PURPOSE: PE techniques can detect IP tendinitis, and we sought to quantify the diagnostic utility of these techniques using responses to an ultrasound-guided anesthetic injection as the reference standard.
    STUDY DESIGN: Cohort study; Level of evidence, 3.
    METHODS: Charts from a single surgeon's practice were reviewed. Patients with suspected IP tendinitis who received an ultrasound-guided IP bursa injection were included. A pain reduction ≥50% immediately or at first follow-up defined the positive reference standard. Recorded PE variables were absolute and relative seated hip flexion (SHF) weakness, pain with SHF, and absolute and relative tenderness to palpation (TTP) of the IP tendon. Radiographs were systematically reviewed for relevant parameters and concomitant abnormalities, and magnetic resonance imaging (MRI) scans obtained within 12 months of the diagnosis were examined for changes consistent with IP tendinitis. Diagnostic accuracy statistics were calculated.
    RESULTS: A total of 135 injections in 105 patients (mean age, 41.2 ± 15.4 years; 74.8% female) had follow-up; 77.8% had true positive results. Absolute SHF weakness showed 96.2% sensitivity and a 77.1% positive predictive value (PPV). Relative SHF weakness yielded 82.2% sensitivity, 24.1% specificity, and a 79.0% PPV. Pain with SHF demonstrated 76.1% sensitivity and a 76.9% PPV. Absolute TTP reached 92.6% sensitivity and a 74.6% PPV, whereas relative TTP showed 86.6% sensitivity, 18.5% specificity, and a 76.3% PPV. MRI abnormalities were present in 18.1% of scanned hips, producing 19.2% sensitivity and 85.0% specificity.
    CONCLUSION: Weakness or pain during SHF and direct TTP of the IP tendon were highly sensitive and predictive for IP tendinitis, whereas MRI was poorly sensitive and should be considered for ruling out other sources of hip pain. Ultrasound-guided injections may be helpful both diagnostically and therapeutically. A focused PE can allow for a rapid, accurate diagnosis.
    Keywords:  hip pain; iliopsoas tendinitis; physical examination; sports medicine
    DOI:  https://doi.org/10.1177/03635465261428681
  11. Physiol Int. 2026 Mar 13. pii: 2060.2026.00811. [Epub ahead of print]
    Virtual reality in pulmonary rehabilitation: A systematic review of clinical outcomes in COPD and post-COVID conditions.
    Jaekyung Lee, Fernanda Büchner Strachman, Gabriella Szendrő, Mónika Fekete, János Tamás Varga.
       Background: Chronic obstructive pulmonary disease (COPD) and post-COVID syndrome cause persistent dyspnea and exercise intolerance. Traditional pulmonary rehabilitation (PR) improves outcomes. Virtual reality (VR)-based PR has been proposed as an engaging alternative. We systematically reviewed randomized trials of VR-based PR programs to evaluate its efficacy and feasibility.
    Methods: Following PRISMA guidelines, we searched PubMed, Web of Science, CENTRAL and Google Scholar (2014-Feb 2025) for RCTs comparing VR-assisted PR versus standard PR in patients with COPD or post-COVID conditions. Based on the selection criteria nine trials (primary search total n = 552; 488 COPD and 64 post-COVID patients) were included. Six domains were considered: lung function, exercise capacity (6MWT, STST), dyspnea, quality of life, mental health, and cognitive function.
    Results: Across nine RCTs (n = 552), VR-based pulmonary rehabilitation resulted improvements in exercise capacity in all studies, with several reporting greater gains in VR groups. A long-duration trial showed meaningful FEV1 improvement with VR, while shorter trials showed limited changes. Dyspnea and functional scores improved in both groups without consistent between-group differences. VR tended to yield greater reductions in anxiety and depression scores, and one trial showed better cognitive function in post-intervention. Quality-of-life outcomes improved in both groups.
    Conclusion: VR-based PR was feasible and produced functional gains at least equal to those of traditional PR. VR's capacity for remote supervised training and gamification holds promise to improve access and adherence. However, evidence is limited by small, short-term trials. Larger, longer RCTs are needed to confirm these benefits, optimize VR protocols, and evaluate cost-effectiveness.
    Keywords:  COPD; exercise tolerance; post-COVID; pulmonary rehabilitation; virtual reality
    DOI:  https://doi.org/10.1556/2060.2026.00811
  12. J Hand Surg Eur Vol. 2026 Mar 12. 17531934261428976
    Identification and preservation of the Berrettini branch in ultrasound-guided carpal tunnel release.
    Georgia Antoniou, Frédéric Schuind, Fabian Moungondo.
      The Berrettini branch is at risk of iatrogenic injury during carpal tunnel surgery. We describe a systematic ultrasound method to visualize this branch, ensuring its preservation during ultrasound-guided percutaneous release.
    Keywords:  Berrettini branch; Sono-Instruments®; carpal tunnel release; minimally invasive surgery; nerve preservation; ultrasound-guided surgery
    DOI:  https://doi.org/10.1177/17531934261428976
  13. J Hand Surg Eur Vol. 2026 Mar 11. 17531934261428319
    Functional and radiological outcomes of the all-dorsal technique for scapholunate ligament reconstruction.
    Cam Tu Nguyen, Ayla A Hohenstein, Justus Osterloh, Horst Zajonc, Steffen U Eisenhardt, Nico Leibig.
       INTRODUCTION: Scapholunate instability is a common and challenging wrist pathology with no universally accepted surgical solution. The all-dorsal scapholunate reconstruction technique restores the dorsal ligament with an extensor carpi radialis brevis tendon autograft. The aim of this study was to assess outcomes in patients with a chronic scapholunate ligament rupture.
    METHODS: We retrospectively analysed 31 patients. Outcomes were assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) score and a visual analogue scale score for pain. Clinical examination included wrist range of motion and grip strength. The radiological parameters measured were scapholunate (SL) angle and gap. Follow-up averaged 39 months (range 12-84) for all outcomes.
    RESULTS: Postoperatively median pain scores improved from 5 to 2 and disability scores from 58 to 48, although changes were not statistically significant. Median wrist extension at final follow-up measured 50° (IQR 42.5 to 70) and flexion 45° (IQR 39 to 60). Radiographically, there was persistent carpal malalignment with a median SL angle of 66° (IQR 58 to 73), a static SL gap of 3 mm (IQR 2.2 to 4) and a dynamic SL gap of 4.8 mm (IQR 3.3 to 5.4). Median grip strength improved from 28 kg (IQR 20 to 40) preoperatively to 29 kg (20-37) postoperatively. Five patients required salvage procedures owing to progressive symptomatic osteoarthritis. Complications included complex regional pain syndrome (n = 3), transient nerve symptoms (n = 2), anchor-site osteolysis (n = 13) and isolated scaphocapitate joint osteoarthritis (n = 5).
    CONCLUSION: The relative simplicity and preservation of wrist function with the all-dorsal reconstruction technique justify its continued use, despite high complication and revision incidences.
    LEVEL OF EVIDENCE: Level IV.
    Keywords:  All-dorsal technique; carpal instability; complications; functional outcomes; radiological results; reconstruction; scapholunate ligament
    DOI:  https://doi.org/10.1177/17531934261428319
  14. Cureus. 2026 Feb;18(2): e102951
    Refractory Chronic Knee Pain After Total Knee Replacement Successfully Treated With L4 Dorsal Root Ganglion Pulsed Radiofrequency.
    Mohamad Omar, Benan M AlShehhi, Salah Al Ali.
      Persistent pain following total knee replacement (TKR) remains a significant clinical problem and may lead to long-term functional impairment despite technically successful surgery. The underlying mechanisms are often multifactorial and may include neuropathic and referred pain components. We report the case of a 71-year-old woman with severe bilateral knee pain persisting after bilateral TKR, refractory to pharmacologic therapy, physiotherapy, genicular nerve interventions, and peripheral nerve blocks. Ongoing neuropathic features and failure of peripheral treatments raised suspicion of a spinal pain source. A diagnostic left L4 selective nerve root block produced marked but temporary pain relief, supporting a radicular pain component. Subsequent therapeutic pulsed radiofrequency (PRF) of the left L4 dorsal root ganglion (DRG) resulted in sustained pain reduction exceeding 70%, functional improvement, and discontinuation of analgesic medications. This case emphasizes the importance of considering spinal pain generators in refractory post-TKR pain and suggests DRG-targeted PRF as a potential treatment option in appropriately selected patients.
    Keywords:  chronic knee pain; chronic lumbar radiculopathy; dorsal root ganglion; genicular nerve; l4 nerve root; neuropathic pain; postoperative pain; pulsed radiofrequency treatment; total knee replacement (tkr)
    DOI:  https://doi.org/10.7759/cureus.102951
  15. BMC Med Imaging. 2026 Mar 09.
    Clinical value of 3D-FIESTA-C sequence in evaluating the arcuate ligament of the elbow joint: a retrospective study.
    Yi Cao, Zhen He, Kaihui Zhang, Lin Guo.
      
    Keywords:  Arcuate ligament; Cubital tunnel syndrome; Magnetic resonance imaging; Ulnar nerve
    DOI:  https://doi.org/10.1186/s12880-026-02267-6
  16. Br J Sports Med. 2026 Mar 10. pii: bjsports-2026-111665. [Epub ahead of print]
    Rehabilitation and outcomes following revision total hip replacement: patients' experiences, optimised rehabilitation interventions and opioid use (PhD Academy Award).
    Martin Gade Stisen.
      
    Keywords:  Exercise; Hip; Orthopedics; Randomized Controlled Trial; Rehabilitation
    DOI:  https://doi.org/10.1136/bjsports-2026-111665
  17. World J Methodol. 2026 Mar 20. 16(1): 107203
    Comparative effectiveness of amitriptyline vs duloxetine in the treatment of chronic low back pain: An observational study.
    Nityananda Sardar, Raktim Swarnakar, Soumyadipta Ghosh, Pankaj Kumar Mandal.
       BACKGROUND: Chronic nonspecific low back pain is defined as pain that persists for greater than 12 weeks and mainly occurs in the lower back with no evidence of associated underlying serious conditions [like malignancy, inflammation (like ankylosing spondylitis) or infection, vertebral fracture, etc.].
    AIM: To compare the efficacy and safety of amitriptyline with duloxetine in treating chronic low back pain (CLBP).
    METHODS: The present study was a two-arm observational study conducted over 18 months in a tertiary rehabilitation setting. A total of 254 patients were included in the study.
    RESULTS: The mean age was significantly higher in the amitriptyline group (34.78 ± 8.22 years) compared with the duloxetine group (29.98 ± 7.28 years, P < 0.0001). Baseline visual analog scale (VAS) scores were also significantly different between groups (amitriptyline: 7.92 ± 0.56; duloxetine: 8.46 ± 0.79; P < 0.0001). Within-group analysis showed a significant reduction in VAS scores over time in both groups (P < 0.001). At 12 weeks the duloxetine group showed significantly lower VAS scores (0.92 ± 0.78) compared with the amitriptyline group (1.87 ± 1.71; P < 0.0001). Analysis of variance, adjusting for age and baseline VAS, confirmed a significant group effect on pain reduction at 12 weeks (P < 0.001), favoring duloxetine. Side effects were generally mild. The most common in the amitriptyline group were dry mouth (17.3%) and drowsiness (7.9%) while in the duloxetine group, dry mouth (15.7%) and constipation (2.4%) were most reported.
    CONCLUSION: Amitriptyline and duloxetine effectively treat CLBP; however, considering side effects and more sustained pain relief, duloxetine appears to be the better option. Nonetheless, treatment choice should consider individual patient profiles.
    Keywords:  Amitriptyline; Chronic low back pain; Duloxetine; Neuropathic pain; Pain
    DOI:  https://doi.org/10.5662/wjm.v16.i1.107203
  18. J Comput Assist Tomogr. 2026 Mar 11.
    MRI-Based Quantitative Assessment of Calcific Tendinopathy: Imaging Predictors and Thresholds for Rotator Cuff Tear Detection.
    Safiye Sanem Dereli Bulut, Berfin Akcayoz.
       OBJECTIVE: To quantitatively evaluate MRI-derived morphologic and bursal parameters in patients with calcific tendinopathy (CaT) of the shoulder and to determine imaging thresholds predictive of rotator cuff (RC) tears.
    MATERIALS AND METHODS: In this retrospective, single-center study, 112 patients with calcific tendinopathy who met the inclusion criteria were included (January 2020 to April 2025). Patients with CaT confirmed by radiography or computed tomography were included. Exclusion criteria were prior shoulder surgery, incomplete MRI sequences, severe motion artifacts, or calcifications outside the RC tendons. MRI features recorded included tendon involvement, calcification morphology (solitary or multifocal), maximum deposit size, bursal thickness, and presence of bursitis. RC tear presence and severity were assessed in 3 planes on fluid-sensitive sequences. Receiver operating characteristic (ROC) analysis determined optimal thresholds for tear prediction.
    RESULTS: Of 134 eligible patients, 112 met inclusion criteria (84 females, 28 males; mean age: 50.3±10.5 y). RC tears were identified in 42.9% of cases. Multifocal morphology was more frequent in patients with tears (79.2% vs. 25.0%, P<0.001). Mean deposit size was greater in the tear group (10.2±3.5 vs. 8.5±2.6 mm, P=0.004); ROC analysis identified a ≥9 mm cutoff (AUC=0.62). Bursal thickness was significantly higher in the tear group (5.1±2.1 vs. 2.8±1.9 mm, P<0.001), with a ≥5 mm threshold demonstrating good predictive value (AUC=0.81). Bursitis was more prevalent in tear cases (97.9% vs. 62.5%, P<0.001).
    CONCLUSION: MRI-derived multifocal calcification morphology, deposit size ≥9 mm, and bursal thickness ≥5 mm are significant predictors of RC tears in CaT. Quantitative assessment of these parameters can enhance MRI interpretation and may guide early management decisions.
    Keywords:  ROC analysis; bursal thickness; calcific tendinopathy; morphologic predictors; rotator cuff tear; shoulder MRI
    DOI:  https://doi.org/10.1097/RCT.0000000000001861
  19. Hand Surg Rehabil. 2026 Mar 07. pii: S2468-1229(26)00073-3. [Epub ahead of print] 102636
    Arthroscopic debridement with microfragmented adipose tissue for wrist and hand chondral lesions in professional athletes.
    F Raggini, M D M Lombardo, V Salini, L Pegoli.
       BACKGROUND: Focal chondral lesions of the wrist and hand are an underrecognized source of pain and functional limitation in athletes. Their management remains challenging due to the limited healing capacity of hyaline cartilage, the biomechanical demands of small joints, and the lack of standardized treatment algorithms. Arthroscopy allows accurate diagnosis and targeted treatment with minimal morbidity, while biologic augmentation using autologous adipose-derived products has emerged as a potential adjunct to improve clinical outcomes.
    OBJECTIVE: To evaluate the clinical outcomes of arthroscopic debridement combined with intra- and peri-articular injection of autologous microfragmented adipose tissue in professional athletes affected by focal chondral lesions of the wrist and hand.
    PATIENTS AND METHODS: This prospective single-center case series included six professional athletes (5 men, 1 woman; mean age 26.3 years) treated between June 2020 and April 2022. A total of nine joints were addressed (3 radiocarpal and 6 metacarpophalangeal). All patients underwent standardized wrist or hand arthroscopy followed by intra- and peri-articular injection of autologous microfragmented adipose tissue processed using a closed mechanical system. Chondral lesions were graded according to the International Cartilage Repair Society classification. Clinical outcomes included pain (visual analog scale, VAS), upper-limb function (QuickDASH), and joint range of motion (ROM), assessed preoperatively and during follow-up. Nonparametric statistical analysis was performed.
    RESULTS: At a mean follow-up of 17.5 ± 8.2 months (range, 8-30 months), all patients demonstrated clinically meaningful improvement in pain, function, and joint mobility. Mean VAS scores decreased from 7.2 to 1.5, and QuickDASH scores improved from 36.9 to 8.2. Joint ROM increased across all planes. All athletes returned to their pre-injury competitive level, and activities of daily living were fully resumed within a mean of 4.8 months. No procedure-related complications or reoperations were observed.
    CONCLUSION: Arthroscopic debridement combined with autologous microfragmented adipose tissue injection appears to be a safe and feasible joint-preserving option for the management of focal chondral lesions of the wrist and hand in professional athletes. The observed clinical improvements represent a preliminary signal of benefit and support further investigation in larger comparative studies.
    Keywords:  adipose-derived mesenchymal stem cells; athletes; cartilage injury.; hand chondropathy; microfragmented adipose tissue; wrist arthroscopy
    DOI:  https://doi.org/10.1016/j.hansur.2026.102636
  20. Clin Radiol. 2026 Feb 13. pii: S0009-9260(26)00064-4. [Epub ahead of print]96 107288
    Crucial anatomic ensemble of the lateral knee: the 'W' configuration.
    S Saran, D Sanghvi, D K Singh.
       AIM: To review the normal anatomy, imaging appearance, and associated pathologies of the 'W' configuration of the knee-formed by the biceps femoris tendon, fibular collateral ligament (FCL), anterolateral ligament (ALL), and iliotibial band (ITB)-and to highlight its value as an anatomical and imaging landmark in assessing lateral knee instability.
    MATERIALS AND METHODS: A structured review of the posterolateral and anterolateral corners of the knee was performed, focusing on the 'W' configuration. Emphasis was placed on magnetic resonance imaging (MRI) assessment, particularly coronal and sagittal planes, to evaluate normal anatomical features and detect structural disruptions.
    RESULTS: The posterolateral and anterolateral corners form a complex stabilising framework, with the 'W' configuration serving as a key anatomical and imaging landmark. MRI is the primary diagnostic modality for visualising this configuration. Disruption of the 'W' pattern commonly indicates injury, including biceps femoris tendon tears, FCL ruptures, ALL injuries, ITB syndrome, and ITB ruptures, frequently associated with cruciate ligament tears. Isolated injuries are uncommon, with most cases involving multiligamentous trauma.
    CONCLUSION: Recognition of the 'W' configuration improves diagnostic accuracy in evaluating lateral knee injuries. While mild injuries may be managed conservatively, high-grade tears-particularly those involving the posterolateral corner or causing rotational instability-often require surgical repair. Understanding this anatomical framework supports appropriate treatment planning and optimises patient outcomes in lateral knee instability.
    DOI:  https://doi.org/10.1016/j.crad.2026.107288
  21. Cureus. 2026 Mar;18(3): e105016
    Chronic Obstructive Pulmonary Disease and Overtraining Syndrome: A Narrative Review.
    Bruno Bordoni, Enricomaria Mattia, Bruno Morabito.
      Chronic obstructive pulmonary disease (COPD) is a condition that inevitably leads to airflow limitation. COPD is among the leading causes of increased mortality and morbidity worldwide. A non-invasive and non-pharmacological approach is rehabilitation training, where the patient follows an active program to stimulate the limb and respiratory muscles. Training involves a constant increase in workloads throughout the rehabilitation process. A fundamental concept absent from the literature is that of including training sessions with reduced loads and periods of "unloading" intensity within the rehabilitation program. Without adequate recovery and rest between sessions, the patient may lack the resources necessary to tackle a subsequent demanding rehabilitation session. This situation could lead to the onset of overtraining syndrome (OTS), where the patient experiences an unexplained decline in performance. The article reviews the muscular adaptation of COPD patients and the planned rehabilitation and emphasizes the concept that clinicians should structure the rehabilitation training program not in a linear fashion (constantly increasing loads), but in a wave-like fashion (scheduling some sessions with decreased loads). This organization could benefit the patient's performance, reducing the risk of OTS.
    Keywords:  american thoracic society; copd; diaphragm; european respiratory society; fev1; inspiratory muscle training; maximal inspiratory pressure; overtraining syndrome; rehabilitation training
    DOI:  https://doi.org/10.7759/cureus.105016
  22. Front Surg. 2026 ;13 1756840
    Intracapsular injection of triple-drug solution in the treatment of early and mid-stage knee osteoarthritis.
    Fulin Li, Tingyou Ning, Yingrong Mo, Xiao Huang, Wenhui Liu, Dong Yin.
       Objective: The objective of this study was to evaluate the efficacy and safety of intra-articular injection of the "triple injection" in the treatment of early and middle-stage knee osteoarthritis (KOA).
    Materials and methods: A total of 120 patients with unilateral KOA, recruited from October 2021 to December 2023, were randomly divided into two groups with 60 cases in each group. The control group received intra-articular injection of 2 mL sodium hyaluronate once a week for 5 consecutive weeks. The experimental group received intra-articular "triple injection" (0.3 mL betamethasone + 0.7 mL lidocaine + 2 mL sodium hyaluronate) in the first week, followed by intra-articular injection of 2 mL sodium hyaluronate once a week for 4 consecutive weeks. The clinical efficacy was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), Hospital for Special Surgery (HSS) knee score, and flexion range of motion (ROM) before treatment, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after treatment.
    Results: Comparisons of WOMAC scores, VAS scores, HSS scores, and ROM before treatment revealed no statistically significant differences between the two groups (all P > 0.05). In contrast, statistically significant differences in WOMAC scores, VAS scores, HSS scores, and ROM between the two groups were observed at different time points after treatment (all P < 0.05). Additionally, the comparison of overall efficacy in K-L grade III patients between the two groups showed a statistically significant difference (P < 0.05), and no complications were observed in any of the patients.
    Conclusion: Intra-articular injection of sodium hyaluronate and the "triple injection" are both effective therapeutic modalities for the early and mid-stage of KOA. Compared with sodium hyaluronate, the "triple injection" can more effectively relieve pain and improve knee joint function.
    Clinical trial registration: Identifier ChiCTR2100048131 with a registration date of 04/07/2021.
    Keywords:  KOA; betamethasone; function; hyaluronic acid sodium; triple injection
    DOI:  https://doi.org/10.3389/fsurg.2026.1756840
  23. BMC Musculoskelet Disord. 2026 Mar 09.
    Ultrasound-guided platelet-rich plasma versus corticosteroid injection for supraspinatus tendinopathy: a randomized comparative study.
    Douquan Huang, Yingfeng Ning, Xingfa Yao, Xianhua Luo, Mingjian Wang, Shiqian Zhou, Tieliang Tian, Yanli Lin.
      
    Keywords:  Clinical efficacy; Local injection; Platelet-rich plasma(PRP); Supraspinatus tendinopathy
    DOI:  https://doi.org/10.1186/s12891-026-09679-z
  24. Int J Surg Case Rep. 2026 Jan;138(1): 42-47
    Pisotriquetral arthrodesis for the management of chronic pisotriquetral fracture-dislocation: a case report.
    Thomas Nicolaï, Alice Abs, Lucas Audiffret, Jean-Baptiste de Villeneuve Bargemon.
       Introduction and importance: Isolated dislocation of the pisotriquetral joint is a rare and often overlooked condition, with diagnosis frequently delayed because of nonspecific clinical symptoms and inconclusive initial imaging.
    Case presentation: We report the case of a young, active patient with chronic distal dislocation of the pisiform bone, associated with an initially undiagnosed articular fracture of the triquetrum. Clinically, the patient reported pain rated at 4/10 during wrist flexion, which was slightly limited (76°), while extension and pronation remained preserved. His grip strength was measured at 23 kg on the painful side compared to 35 kg on the opposite side. The patient was treated with pisotriquetral arthrodesis with favorable functional outcomes with no loss of range of motion or pain. Arthrodesis was performed through an open ulnar approach, with careful protection of the dorsal sensory branch of the ulnar nerve. After joint surface preparation and temporary K-wire fixation, stabilization was achieved using a 2.5-mm Autofix® screw without bone graft, followed by 6 weeks of immobilization and progressive rehabilitation. At the 18-month follow-up, the patient showed no functional limitations, with full range of motion and complete resolution of wrist pain. His grip strength was measured at 33 kg during the assessment. This work has been reported in line with the SCARE criteria.
    Clinical discussion: Although rarely reported in the literature (only two cases and never in traumatic situation), pisotriquetral arthrodesis offers a valuable alternative to pisiformectomy, particularly in young patients or those with high functional demands. Our case appears unique in several respects: it involved a young, active patient with a triquetral joint fracture associated with distal and medial dislocation of the pisiform bone, treated several months after the initial trauma.
    Conclusion: This case highlights the need for an appropriate treatment strategy in managing pisotriquetral instability, reinforcing the potential role of arthrodesis in selected indications.
    Keywords:  arthrodesis; carpal; case report; chronic dislocation; pisotriquetral
    DOI:  https://doi.org/10.1097/RC9.0000000000000016
  25. J Hand Surg Eur Vol. 2026 Mar 11. 17531934261426700
    The epidemiology of cubital tunnel syndrome: a UK Biobank case-control study.
    Maria Lucey, Frederik Heymann Lassen, Dominic Furniss, Akira Wiberg.
       INTRODUCTION: Cubital tunnel syndrome is the second most prevalent upper limb compression neuropathy. Limitations in non-operative and surgical treatment warrant an adjunctive preventative approach targeting modifiable risk factors. However, risk factors are poorly characterized given methodologic shortcomings in previous studies.
    METHODS: In this case-control study in the UK Biobank (1971 cases, 398,639 controls), multivariable logistic regression with extensive covariate correction was conducted to assess the association between cubital tunnel syndrome and sex, age, ethnicity, socioeconomic deprivation, smoking status, alcohol intake, height, body mass index, plasma lipids, HbA1c, diabetes, hypertension, carpal tunnel syndrome, osteoarthritis, rheumatoid arthritis, hypothyroidism and gastroesophageal reflux disease.
    RESULTS: Cubital tunnel syndrome was significantly associated with several modifiable risk factors: smoking status (odds ratio 2.08, 95% CI: 1.83-2.37), diabetes with microvascular complications (OR 1.80, 95% CI: 1.40-2.30), hypertension (OR 1.37, 95% CI: 1.24-1.52) and raised body mass index (OR 1.13, 95% CI: 1.08-1.19). Male sex (OR 1.77, 95% CI: 1.54-2.04) and age (OR 0.981, 95% CI: 0.975-0.986) were non-modifiable risk factors. Several comorbidities were associated with cubital tunnel syndrome: carpal tunnel syndrome (OR 11.7, 95% CI: 10.6-12.9), osteoarthritis (OR 2.12, 95% CI: 1.92-2.34), rheumatoid arthritis (OR 1.72, 95% CI: 1.42-2.07), and gastroesophageal reflux disease (OR 1.66, 95% CI: 1.50-1.83). Cubital tunnel syndrome had a weak association with socioeconomic deprivation and no association with ethnicity, height, alcohol intake, plasma lipids, HbA1c and hypothyroidism.
    CONCLUSION: Cubital tunnel syndrome is robustly associated with several modifiable risk factors that may be targeted in primary and secondary prevention.
    LEVEL OF EVIDENCE: III.
    Keywords:  Biobank; cubital tunnel syndrome; epidemiology; modifiable; primary prevention; risk factors; secondary prevention
    DOI:  https://doi.org/10.1177/17531934261426700
  26. Orthop Traumatol Surg Res. 2026 Mar 11. pii: S1877-0568(26)00070-8. [Epub ahead of print] 104649
    Prevention of postoperative shoulder stiffness after Rotator Cuff Repair through a structured self-rehabilitation protocol.
    François Saade, Jean-Pierre Liotard, Florent Borel, Gabriel Franger, Laurent Nové-Josserand, Lionel Neyton, Philippe Collotte, Gilles Walch, Arnaud Godenèche.
       INTRODUCTION: Postoperative shoulder stiffness is a frequent complication after arthroscopic rotator cuff repair (RCR) and may delay early recovery. The influence of preoperative mobility, rehabilitation strategy, and immobilization position on postoperative stiffness and functional outcomes remains debated.
    HYPOTHESIS: Preoperative limitation of shoulder mobility and early postoperative stiffness influence mid-term functional recovery, and supervised self-rehabilitation may reduce early stiffness compared with classical physiotherapy.
    METHODS: A retrospective cohort of 362 patients undergoing arthroscopic RCR was analyzed. Shoulder stiffness was defined as passive forward flexion <120 ° combined with passive external rotation <30 °. In addition, a relative analysis based on forward flexion loss ≥10 ° compared with the contralateral shoulder was performed. Patients were evaluated at 1, 6, and 12 months using range of motion, Constant score, and Subjective Shoulder Value (SSV). Rehabilitation type and immobilization position were recorded.
    RESULTS: Preoperative limitation ≥10 ° was observed in 139 patients (38%). It was significantly associated with increased postoperative stiffness at 1 and 6 months (p < 0.05), but not with differences in Constant score or SSV at 6 or 12 months. Persistent stiffness at 6 months was associated with inferior Constant score and SSV at 12 months (p < 0.01). Patients who followed supervised self-rehabilitation demonstrated lower stiffness rates at 1 month and better functional classification at 6 months compared with those receiving active physiotherapy (p < 0.0002). Immobilization at 20 ° of abduction was associated with higher early stiffness compared with 60 ° (p = 0.022).
    CONCLUSION: In conclusion, preoperative limitation predicts early postoperative stiffness but does not compromise mid-term functional outcomes after arthroscopic rotator cuff repair. Persistent stiffness at six months is associated with inferior one-year results. Patients who followed supervised self-rehabilitation according to the Liotard protocol experienced less early postoperative stiffness and better short-term functional classification than those who received additional active physiotherapy. Structured, patient-controlled rehabilitation appears to support functional recovery while respecting tendon protection principles.
    LEVEL OF EVIDENCE: IV.
    Keywords:  arthroscopic cuff repair; arthroscopic repair; postoperative rehabilitation; quick dash; rehabilitation following shoulder arthroscopy; rotator cuff tear
    DOI:  https://doi.org/10.1016/j.otsr.2026.104649
  27. Radiol Med. 2026 Mar 11.
    CT-guided sacroiliac joint injection for chronic sacroiliitis: outcomes and predictors in a retrospective cohort study.
    Mostafa Farouk Balbaa, Antonio Barile, Mohamed Mahmoud El Shafei, Hoda Mohammed Aly Abdel Naby, Anna Maria Ierardi, Mohamed Ragab Nouh, Tarek El Sakka, Pierpaolo Biondetti, Francesco Arrigoni, Gianpaolo Carrafiello, Mamdouh Ahmed Zidan.
       PURPOSE: To evaluate the safety, technical success, and clinical outcomes of CT-guided sacroiliac joint (SIJ) injections in patients with chronic sacroiliitis and to assess the impact of disease etiology, age, and body mass index (BMI) on therapeutic response.
    MATERIALS AND METHODS: This retrospective study included 80 patients with clinically and radiologically confirmed sacroiliitis who underwent CT-guided intra-articular SIJ injection between February 2020 and May 2022. Pain and disability were assessed using the Numerical Rating Scale (NRS) and the Oswestry Disability Index (ODI) at baseline and at 1-week, 1-month, and 6-month follow-up intervals. Patients were stratified by etiology (inflammatory vs degenerative), age, and BMI.
    RESULTS: All procedures were technically successful and complication-free. Mean NRS scores improved from 6.86 ± 1.20 at baseline to 2.26 ± 0.78 at 6 months (p < 0.001). ODI scores decreased from 37.28 ± 9.84 to 5.68 ± 2.49 (p < 0.001). Greater ODI improvement was observed in inflammatory cases compared to degenerative ones (p < 0.05), though both subgroups showed significant clinical benefit. Age and BMI did not significantly affect outcomes.
    CONCLUSION: CT-guided SIJ injection is a safe and effective intervention for sacroiliitis, yielding sustained pain relief and functional improvement across both inflammatory and degenerative etiologies, independent of age and BMI.
    Keywords:  CT-guided injection; Functional outcome; Low back pain; Pain management; Sacroiliac joint; Sacroiliitis
    DOI:  https://doi.org/10.1007/s11547-026-02191-3
  28. World J Methodol. 2026 Mar 20. 16(1): 107921
    Considering mental function for successful total knee arthroplasty in older people.
    Takahiko Nagamine.
      Many older individuals suffer from chronic knee joint pain due to osteoarthritis, a degenerative joint disease. Total knee arthroplasty (TKA), also known as total knee replacement, is a surgical procedure designed to replace a damaged knee joint with artificial implants. TKA can significantly reduce or eliminate this pain. However, depression or cognitive decline may affect the therapeutic outcome of TKA in older individuals. When performing TKA in older people, it is necessary to screen for and address mental function.
    Keywords:  Cognitive function; Depression; Older people; Osteoarthritis; Total knee arthroplasty
    DOI:  https://doi.org/10.5662/wjm.v16.i1.107921
  29. Scand J Pain. 2026 Jan 01. 26(1):
    Mediating effect of catastrophising in correlation between pain and disability amongst patients with carpal tunnel syndrome.
    Veikko Sainio, Mikhail Saltychev, Annika Miikkulainen, Hanna-Stiina Taskinen.
       OBJECTIVES: To examine the mediating role of catastrophizing in the relationship between pain and disability among patients with carpal tunnel syndrome (CTS).
    METHODS: Cross-sectional register of 141 patients with CTS. Pain Catastrophizing Scale (PCS) was used. Mediation analysis was used to assess the indirect effect of pain catastrophizing on pain-related disability.
    RESULTS: The average age was 54.0 (SD 16.1) years and 89 (63 %) were women. For the total PCS score, the indirect effect was responsible for 31 % (95 % CI 15 %-47 %) to 33 % (95 % CI 15 %-52 %). The highest proportion was observed in the helplessness domain, 37 % (95 % CI 19 %-55 %). The lowest effect of 11 % (95 % CI 0 %-23 %) was seen for the magnification domain.
    CONCLUSIONS: The mediating effect of catastrophizing was responsible for over 30 % of the total effect seen in correlation between pain and disability experienced by patients with CTS. While the effect of magnification sub-score was borderline and could probably be ignored in clinical context, domain of helplessness reached the effect size of almost 40 %. The results suggest that catastrophizing should be considered when treating or rehabilitating people with CTS. Catastrophizing may play a significant role in the development of pain-related disability.
    Keywords:  chronic pain; disability; mediation; pain catastrophizing level; upper extremity pain
    DOI:  https://doi.org/10.1515/sjpain-2025-0055
  30. Diagnostics (Basel). 2026 Mar 02. pii: 742. [Epub ahead of print]16(5):
    Shear Wave Elastography Assessment of Achilles Tendon Stiffness in Asymptomatic Patients with Psoriatic Arthritis.
    Veysel Burulday, Nurullah Dag, Aysun Gunduz Uslu, Servet Yolbas.
      Objectives: We aimed to evaluate Achilles tendon stiffness characteristics in asymptomatic patients with psoriatic arthritis (PsA) using shear wave elastography (SWE). Methods: In this prospective case-control study, 34 asymptomatic PsA patients and 34 age- and sex-matched healthy controls underwent bilateral Achilles tendon evaluation with grayscale ultrasonography and SWE. Tendon thickness was measured 3 cm proximal to the calcaneal insertion. Shear-wave velocity (m/s) and Young's modulus (kPa) were obtained under standardized acquisition conditions, including five-star motion stability and ≥90% reliability. Results: Achilles tendon morphology and thickness did not differ between PsA patients and controls (p > 0.05). In contrast, SWE demonstrated higher tendon stiffness in the PsA group. Mean shear-wave velocity was significantly greater in PsA patients for both the left (4.89 ± 2.52 m/s vs. 3.23 ± 0.41 m/s; p < 0.001) and right tendons (4.88 ± 1.94 m/s vs. 3.12 ± 0.30 m/s; p < 0.001), with corresponding increases in Young's modulus (all p < 0.001). SWE demonstrated good group discrimination, with shear-wave velocity achieving AUC values of up to 0.90 in differentiating PsA patients from healthy controls. Conclusions: SWE may reflect biomechanical tendon alterations in PsA, even in the absence of clinical symptoms, and may serve as a complementary imaging tool in the assessment of tendon involvement.
    Keywords:  achilles tendon; psoriatic arthritis; shear wave elastography; tendon stiffness; ultrasonography
    DOI:  https://doi.org/10.3390/diagnostics16050742
  31. Explore (NY). 2026 Mar 03. pii: S1550-8307(26)00053-4. [Epub ahead of print]22(3): 103366
    Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane reviews: Summary of a Cochrane review.
    Esra Abdalla, L Susan Wieland.
      
    DOI:  https://doi.org/10.1016/j.explore.2026.103366
  32. Int Dent J. 2026 Mar 10. pii: S0020-6539(26)00084-5. [Epub ahead of print]76(3): 109488
    The Role of Electrolytes in Muscle Pain Syndromes: A Systematic Review and Meta-Analysis With Implications for Temporomandibular Disorder.
    Shankargouda Patil, Andrea Falkowski, Venkata Suresh Venkataiah, Shilpa Bhandi, Frank W Licari, Amey G Patil.
       BACKGROUND: Temporomandibular disorders (TMDs) are a major cause of chronic orofacial pain, with myalgia of the masticatory muscles being central to symptom burden. Electrolyte modulation, particularly magnesium, may influence neuromuscular excitability and nociceptor sensitization, but no systematic review has synthesized the evidence for muscle pain syndromes or its relevance to TMD.
    OBJECTIVES: To evaluate the efficacy of electrolyte supplementation (magnesium, sodium, calcium, and potassium) in reducing muscle cramps and myalgia, and to explore the biological plausibility and potential extrapolation to TMD-related myofascial pain.
    METHODS: This systematic review followed PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251120631). PubMed/MEDLINE, Embase, and Cochrane CENTRAL were searched from January 1995 to August 2025. Randomized or quasi-randomized trials of electrolyte supplementation for cramps or myalgia were eligible. Data extraction and risk-of-bias assessment (RoB 2 tool) were performed independently by 2 reviewers. Meta-analyses used random-effects models in R (v4.4.3) and Python (v3.11).
    RESULTS: Thirteen trials were included. Magnesium was most frequently studied (10 RCTs). In pregnancy-associated cramps (4 trials, N≈364), magnesium significantly reduced cramp frequency compared with placebo (pooled RR 1.35, 95% CI: 1.05-1.74, P = .02). In nocturnal or persistent leg cramps in adults (4 trials, N≈396), no significant effect was found (MD -0.42 cramps/week, 95% CI: -1.15 to 0.31, P = .26). Intravenous magnesium showed no benefit in older adults, but a perioperative trial demonstrated reduced fasciculations and postoperative myalgia. Sodium-based solutions reduced cramp susceptibility in exercise and cirrhosis, while calcium and potassium lacked supportive evidence. Risk of bias was generally low to moderate.
    CONCLUSION: Magnesium supplementation benefits pregnancy-related cramps but shows inconsistent effects in other populations. Sodium-based interventions are context-specific, and calcium and potassium remain unsupported. Magnesium is the most plausible candidate for translation to TMD myalgia, warranting targeted clinical trials.
    Keywords:  Electrolyte supplementation; Magnesium; Myalgia; Potassium; Sodium; Temporomandibular disorders (TMD)
    DOI:  https://doi.org/10.1016/j.identj.2026.109488
  33. J Clin Med. 2026 Mar 06. pii: 2015. [Epub ahead of print]15(5):
    Anterior Knee Pain and Excessive External Tibial Torsion in Female Patients: Rationale and Outcomes of Rotational Tibial Osteotomy.
    Vicente Sanchis-Alfonso, Jesus Castellano-Curado, Erik Montesinos-Berry, Santiago Ferrer-Piquer, Robert A Teitge.
      Excessive external tibial torsion (ETT) is a recognized cause of anterior knee pain (AKP). In patients with excessive ETT, placing the foot forward during gait causes the knee joint to point inward, increasing the Q-angle and the lateral quadriceps vector. In appropriately selected cases, internal rotational tibial osteotomy is a reliable treatment option for symptomatic excessive ETT, yielding favorable outcomes with minimal complications. Nevertheless, no universally accepted torsion threshold exists to guide surgical decision-making, and evidence remains limited regarding the optimal anatomic level for performing the osteotomy.
    Keywords:  anterior knee pain; excessive external tibial torsion; patellofemoral pain; rotational tibial osteotomy
    DOI:  https://doi.org/10.3390/jcm15052015
  34. Int J Mol Sci. 2026 Mar 05. pii: 2397. [Epub ahead of print]27(5):
    Systematic Review: Preclinical and Clinical Evidence on MSC Efficacy and Mechanism of Action in Neuropathic Pain Reduction.
    Zahrina Haziqah Harun, Min Hwei Ng, Nor Hazla Mohamed Haflah, Htwe Ohnmar, Yogeswaran Lokanathan, Zhe Kang Law, Amaramalar Selvi Naicker, Soon Yong Thow, Shalimar Abdullah.
      Nerve injury often results in neuropathic pain, marked by spontaneous pain, hyperalgesia, and allodynia. Current treatments have moderate efficacy and have side effects, prompting interest in alternative approaches. Mesenchymal stem cell (MSC) therapy has shown promise in preclinical studies for reducing neuropathic pain and inflammation. However, the precise mechanisms underlying MSC-mediated pain reduction remain unclear. Investigating these mechanisms is crucial for optimizing MSC-based therapies for neuropathic pain. This article provides a brief overview of the MSC administration, animal models of neuropathic pain, and treatment regimens used in 25 preclinical studies, focusing on the potential mechanisms of action underlying the neuropathic pain-reducing effect of MSCs. Importantly, 23 out of the 25 studies demonstrated a reduction in neuropathic pain following MSC therapy, despite differences in MSC sources and treatment regimens. Neuropathic pain relief was associated with decreased inflammation, suggesting that MSCs may act through immune modulation. However, the resolution of inflammation does not always correlate with complete neuropathic pain relief, indicating the involvement of additional mechanisms.
    Keywords:  cell therapy; immunomodulation; inflammation; mesenchymal stem cells; neuropathic pain
    DOI:  https://doi.org/10.3390/ijms27052397
  35. Oral Dis. 2026 Mar 12.
    Efficacy and Safety of Intra-Articular Therapies for Temporomandibular Disorders: A Systematic Review and Meta-Analysis.
    Mateus Gaya Dos Santos, Wellington Luiz de Oliveira da Rosa, Cristian Sbardelotto, Júlia Silva Gomes de Araújo, Camila da Silva Rodrigues, Noéli Boscato.
       OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the most effective minimally invasive intra-articular procedure for reducing pain and improving maximum mouth opening (MMO) in individuals diagnosed with painful articular TMD, specifically TMJ osteoarthritis and/or internal derangement.
    MATERIALS AND METHODS: Only randomized clinical trials (RCTs) assessing the efficacy of minimally invasive procedures, such as arthrocentesis and intra-articular injection (IAI), were included. The meta-analysis included seven studies with a 6-month follow-up, while 23 studies with different follow-up periods were evaluated qualitatively.
    RESULTS: The meta-analysis showed that IAI with tenoxicam was the most effective procedure for pain reduction, with the highest [7.44 mean difference (MD); 6.28-8.60 confidence interval (CI)], followed by opioids (5.93; 5.03-6.83), the combination of hyaluronic acid (HA) with platelet-rich plasma (PRP) (5.10; 4.52-5.68), and PRP alone (4.99; 3.13-6.85). For improvement in MMO, tenoxicam had the highest MD (+11.50 mm; 15.47-7.53), followed by PRP (+10.46 mm; 14.89-6.02) and the HA-PRP combination (+10.10 mm; 11.89-8.31).
    CONCLUSIONS: Tenoxicam showed promising results for pain reduction and improvement in MMO, although the evidence remains limited, followed by opioids and the combination of HA and PRP with arthrocentesis. Further high-quality studies are needed to confirm their clinical applicability.
    Keywords:  adverse events; arthrocentesis; intra‐articular; temporomandibular disorder; temporomandibular joint
    DOI:  https://doi.org/10.1111/odi.70284
  36. Skeletal Radiol. 2026 Mar 13.
    Osteonecrosis and stress-related subchondral injuries in the elite athlete: a review on etiology, clinical signs, and management.
    Pieter D'Hooghe, Victor Klincke, Matthias Peiffer, Arne Burssens, James Calder.
      This review examines osteonecrosis (ON) in elite athletes, encompassing bone infarcts (BI) in the medullary canal of the metaphysis or diaphysis and epiphyseal subchondral avascular necrosis (AVN), which is more likely to lead to joint collapse. Unlike in the general population where systemic disease and trauma are primary causes, chronic repetitive microtrauma and stress-related injury are significant contributors in athletes. This review therefore distinguishes between primary ON and secondary ON, which develops on a background of stress or insufficiency fractures, relevant in this population. This review also highlights the paradigm shift in the understanding of "spontaneous osteonecrosis of the knee" (SONK), now recognized as a subchondral insufficiency fracture with secondary ON on the continuum of stress-related injuries rather than as an idiopathic, isolated event. The role of corticosteroids is analyzed, distinguishing the well-established risk from systemic use from the more controversial, incompletely defined link to local intra-articular injections, noting the contraindication of injections in certain pathologies like sesamoid AVN. Finally, this review emphasizes the crucial role of MRI for early detection and staging of ON in elite athletes and the importance of tailored management strategies, which begin with conservative measures but may necessitate career-altering surgical interventions in advanced stages. The prognosis for return to sport is often guarded, underscoring the need for a holistic approach that addresses both biomechanical loading patterns and systemic risk factors.
    Keywords:  Athlete; Avascular necrosis; Bone infarct; MRI; Osteonecrosis; SONK
    DOI:  https://doi.org/10.1007/s00256-026-05180-9
  37. J Clin Med. 2026 Mar 04. pii: 1950. [Epub ahead of print]15(5):
    Ultrasonographic Assessment of the Diaphragm and the Effects of Smoking on Respiratory Function in Individuals Attending a Smoking Cessation Center.
    Ahmet Utus, Semiramis Ozyilmaz, Turgay Karatas, Nurullah Dag, Gurkan Ural, Ipek Balikci Cicek, Murat Kılıc.
      Background: Smoking adversely affects pulmonary function and systemic health; however, its impact on diaphragm muscle morphology and its relationship with functional capacity and psychosocial outcomes in individuals without clinically diagnosed respiratory disease remain unclear. This study aimed to evaluate diaphragm muscle thickness in smokers and to investigate its associations with pulmonary function, functional capacity, sleep quality, and depression. Methods: This cross-sectional observational study included 20 smokers and 20 age-matched never-smokers. Pulmonary function was assessed using spirometry. Functional capacity was evaluated with the 6-Minute Walk Test (6 MWT) and the 30 s sit-to-stand test (30 s STST). Sleep quality and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI). Inspiratory and expiratory diaphragm muscle thicknesses were measured by ultrasonography. Between-group comparisons and correlation analyses were performed. Results: Smokers exhibited significant impairments in all assessed parameters except expiratory diaphragm thickness compared with controls (p < 0.05). Large to very large effect sizes were observed for FEV1, FEF25-75%, functional capacity, and inspiratory diaphragm thickness. Inspiratory diaphragm thickness showed moderate to strong positive correlations with pulmonary function parameters and a very strong positive correlation with functional capacity, while strong negative correlations were observed with sleep quality and depression (p < 0.05). Smoking duration was strongly associated with poorer functional and psychosocial outcomes. Conclusions: Smoking is associated with early and multidimensional impairments in diaphragm muscle morphology, pulmonary function, functional capacity, and psychosocial status, even in individuals without overt respiratory disease. Reduced inspiratory diaphragm thickness may represent an early and clinically meaningful marker of smoking-related respiratory muscle dysfunction.
    Keywords:  diaphragm muscle; pulmonary function; six-minute walk test; smoking; ultrasonography
    DOI:  https://doi.org/10.3390/jcm15051950
  38. Am J Sports Med. 2026 Mar 13. 3635465261426561
    Does Spine Pathology Influence Hip Arthroscopy Outcomes? A Systematic Review and Meta-analysis.
    Napatpong Thamrongskulsiri, Logan D Moews, Jacob T Morgan, Felipe Casanova, Tomas F Vega, Gabriel Octavio Pérez Lloveras, Jorge Chahla.
       BACKGROUND: Hip arthroscopy is increasingly used for femoroacetabular impingement, but outcomes may be influenced by coexisting spine pathology due to altered spinopelvic mechanics. Understanding this relationship is critical for patient counseling and surgical planning.
    PURPOSE: To systematically review and meta-analyze the effect of preexisting spine pathology on patient-reported outcomes, revision hip arthroscopy, and conversion to arthroplasty after hip arthroscopy.
    STUDY DESIGN: Systematic review and meta-analysis; Level of evidence, 3.
    METHODS: A comprehensive literature search of PubMed, Ovid MEDLINE, and Scopus through July 2025 identified studies comparing hip arthroscopy outcomes between patients with and without spine pathology. Inclusion criteria were comparative studies reporting patient-reported outcomes or postoperative complications. Data extraction included demographic characteristics, type of spine pathology, surgical details, and outcomes. The Modified Coleman Methodology Score (MCMS) assessed study quality. Pooled mean difference (MD) and odds ratio (OR) with 95% CI were calculated using random- or fixed-effects models depending on heterogeneity.
    RESULTS: Fourteen studies (4462 hips) were included, with 948 patients having spine pathology. Meta-analysis demonstrated statistically significantly inferior outcomes in the spine pathology group for the modified Harris Hip Score (MD, -6.71; P = .001), Hip Outcome Score-Activities of Daily Living (MD, -6.13; P = .004), Hip Outcome Score-Sports Subscale (MD, -10.45; P = .0002), Non-Arthritic Hip Score (MD, -7.16; P = .04), and International Hip Outcome Tool (MD, -9.17; P = .04) but not for visual analog scale scores for pain (P = .28). Patients with spine pathology also had higher rates of revision hip arthroscopy (OR, 2.56; P = .04) and conversion to arthroplasty (OR, 1.46; P = .01).
    CONCLUSION: Patients with preexisting spinal pathology had statistically significantly worse patient-reported outcomes after hip arthroscopy compared with patients without spinal pathology as well as higher rates of revision arthroscopy and conversion to arthroplasty.
    Keywords:  femoroacetabular impingement; hip arthroscopy; lumbar spine; outcome; spinopelvic
    DOI:  https://doi.org/10.1177/03635465261426561
  39. Turk J Med Sci. 2026 ;56(1): 246-255
    Association between frailty status and pain, balance, and quality of life in patients with lumbar spinal stenosis.
    Musa Güneş, Aydın Sinan Apaydin.
       Background/aim: Frailty is a clinical syndrome that affects individuals physically and psychosocially. However, the association between lumbar spinal stenosis (LSS) and frailty remains unclear. This study aimed to compare pain, balance, disability, fear of falling, and quality of life between patients with LSS with and without frailty.
    Materials and methods: This cross-sectional study included 43 frail and 48 nonfrail patients with LSS according to the frailty criteria of Fried et al. Pain intensity (numeric rating scale [NRS]), static balance (single leg stance test [SLST]), dynamic balance (Timed Up and Go test [TUG]), disability (Oswestry Disability Index [ODI]), fear of falling (Falls Efficacy Scale-International [FES-I]), and quality of life (Short form-36 [SF-36]) were assessed.
    Results: Frailty was observed in 47.3% of patients, and baseline characteristics were similar between the groups (p > 0.05). NRS scores for low back and leg pain, ODI and FES-I scores, and TUG test durations were significantly higher in frail patients with LSS than in nonfrail patients (p < 0.05). SLST durations and SF-36 subscale scores were significantly lower in frail patients with LSS (p < 0.05). TUG duration (p = 0.001, OR = 1.482), physical activity level (p = 0.007, OR = 0.999), and the SF-36 vitality subscale (p = 0.031, OR = 0.968) were significantly associated with frailty in the logistic regression model (p < 0.001).
    Conclusion: Frail patients with LSS experience greater pain intensity, balance disorders, disability, fear of falling, and poorer quality of life. Moreover, reduced mobility, lower physical activity levels, and decreased vitality are associated with a higher likelihood of frailty in patients with LSS. Therefore, early assessment of frailty in patients with LSS and the implementation of personalized rehabilitation approaches may help mitigate its negative impact.
    Keywords:  Lumbar spinal stenosis; balance; disability; frailty; pain; quality of life
    DOI:  https://doi.org/10.55730/1300-0144.6158
  40. J Clin Med. 2026 Feb 27. pii: 1825. [Epub ahead of print]15(5):
    Returning to Work and Cost-Effectiveness After Lumbar Facet Cryodenervation Among Patients with Chronic Low Back Pain.
    Michał Krakowiak, Julia Stelmach, Jarosław Dzierżanowski, Tomasz Borusiński, Piotr Zieliński.
      Background/Objectives: Low back pain (LBP) is a leading cause of disability and work absenteeism worldwide. Lumbar facet joint degeneration is a common source of chronic LBP, and when conservative treatment fails, interventional procedures may be indicated. Cryodenervation is a minimally invasive option that remains less extensively studied. This study aims to evaluate clinical outcomes, cost-utility, and return-to-work rates following lumbar facet joint cryodenervation. Methods: A retrospective study included 42 professionally active patients treated with lumbar facet joint cryoablation between 2020 and 2022 at a tertiary neurosurgical center. All patients had facet-mediated LBP confirmed by a positive diagnostic medial branch block. Pain (VAS), disability (ODI), and work status were assessed before and after treatment. ODI scores were converted to SF-6D utilities to estimate quality-adjusted life years (QALYs). Cost data were obtained from institutional records. Results: Mean ODI improved from 48.5 ± 12.8 to 36.6 ± 17.8, and mean VAS from 7.0 ± 1.7 to 3.8 ± 2.0. Mean SF-6D increased from 0.53 to 0.59, corresponding to a gain of 0.0103 QALYs over four months (annualized 0.0309). The mean procedure cost was 1905 PLN, resulting in approximately 185,000 PLN per QALY, which is within the national cost-effectiveness threshold. Overall, 58.5% of patients returned to work, with the highest rate in those aged 30-39 years (83.3%). Conclusions: Lumbar facet cryoablation provides meaningful pain relief and functional improvement at a favorable cost-effectiveness profile. Younger patients show higher return-to-work rates. Larger prospective studies are required to confirm these findings.
    Keywords:  occupational disability; work incapacity; work reintegration; workplace productivity
    DOI:  https://doi.org/10.3390/jcm15051825
  41. Gynecol Minim Invasive Ther. 2026 Jan-Mar;15(1):15(1): 14-21
    Effectiveness, Safety, and Patient Satisfaction of Laparoscopic Uterosacral Nerve Ablation in Terms of Pain Relief in Women with Chronic Pelvic Pain.
    Lena Steinkasserer, Jens Hachenberg, Delnaz Fard, Elna Kuehnle, Peter Hillemanns, Lars Brodowski.
       Objectives: Chronic pelvic pain (CPP) is defined as intermittent or constant pain in the lower abdomen or pelvis for a duration of 6 months that is not exclusively associated with menstruation or sexual intercourse. Laparoscopic ablation of the nerve plexuses and ganglia in the uterosacral ligaments (laparoscopic uterosacral nerve ablation [LUNA]) is a viable treatment option. LUNA, if proven effective, may be a significant treatment amendment as an alternative to surgical therapy. The purpose of our study is to evaluate the efficacy, safety, and patient satisfaction in LUNA in terms of pain relief in women with CPP in whom diagnostic laparoscopy failed to demonstrate an anatomical correlation.
    Materials and Methods: In this retrospective observational study, we examined pseudonymized data of women who underwent laparoscopy for chronic pelvic. If there was a pathological correlation for the CPP, LUNA was performed and patients were asked to participated in a postsurgical questionnaire. They were asked about effectiveness, outcome, and satisfaction after LUNA.
    Results: The average age of the study population was 25.8 years. All women were premenopausal. When performing LUNA, postoperative pain tolerance improved significantly (P = 0.004). Statistically, the use of painkillers was more frequent before surgery than after (P = 0.015 and P = 0.031). There was a positive trend when asked about social isolation, sexual activity, self-confidence, disgruntlement, and ability to work.
    Conclusion: In our retrospective study, we were able to show a decrease of pain frequency and pain insensitivity for women with CPP who underwent LUNA. Further prospective randomized, double-blind studies are needed to test if LUNA as a surgical technique is an appropriate treatment option for CPP.
    Keywords:  Chronic pelvic pain; Minimally Invasive Therapy; laparoscopic uterosacral nerve ablation; life quality
    DOI:  https://doi.org/10.4103/gmit.gmit_62_24
  42. Shoulder Elbow. 2026 Mar 09. 17585732261425148
    Functional outcomes and reoperation rates following conversion of failed anatomic and reverse shoulder arthroplasty to hemiarthroplasty: A systematic review.
    Mohammed Tayyem, William White, Andrew Richards, Steven Corbett, Ashley Simpson.
       Background: Conversion to hemiarthroplasty is occasionally performed as a salvage option in patients with failed total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA) when further revision to RSA is not feasible. This Systematic review and meta-analysis aims to evaluate the functional and clinical outcomes and complication rates of revision to shoulder hemiarthroplasty.
    Methods: A systematic review was conducted according to PRISMA guidelines, with searches performed in PubMed, Embase, and Cochrane databases up to January 2024. Studies reporting functional outcomes, pain scores, range of motion, complication rates, or revision rates following conversion of failed TSA or RSA to hemiarthroplasty, with ≥24 months follow up, were included.
    Results: Thirteen studies comprising 211 patients met inclusion criteria. Pain scores improved significantly postoperatively (mean difference 2.57 points on a 10-point scale, p < 0.0001). Functional scores increased by a mean of 16.83 points (on a 100-point scale, p = 0.01). Overall patient satisfaction was reported in seven studies, with 58% of patients satisfied. The reoperation rate was 16.1%.
    Conclusion: Hemiarthroplasty offers a viable salvage option for failed TSA or RSA in patients unsuitable for complex revision surgery. While functional gains are modest and range of motion improvement is limited, pain relief and preservation of bone stock support its role in selected revision scenarios.
    Keywords:  functional outcomes and complications; revision shoulder arthroplasty; shoulder hemiarthroplasty
    DOI:  https://doi.org/10.1177/17585732261425148
  43. World J Methodol. 2026 Mar 20. 16(1): 113191
    Advancing chronic low back pain management: Insights from amitriptyline and duloxetine comparison.
    Shree Rath.
      Chronic low back pain (CLBP) is a leading cause of disability worldwide, yet optimal pharmacological management remains debated. This letter to the editor appraises the observational study by Sardar et al, which compared amitriptyline and duloxetine in a tertiary rehabilitation setting. The study, involving 254 patients, demonstrated that amitriptyline provided rapid early pain relief, while duloxetine offered more sustained pain reduction at 12 weeks with fewer anticholinergic and sedative side effects. These findings are consistent with existing evidence supporting duloxetine's efficacy and tolerability in chronic pain management. Although the absence of a placebo group limits causal inference, the study underscores the importance of individualized treatment strategies. We recommend further randomized controlled trials to validate these findings and strengthen evidence-based guidelines for CLBP management.
    Keywords:  Amitriptyline; Chronic low back pain; Duloxetine; Sedatives; Visual analog scale
    DOI:  https://doi.org/10.5662/wjm.v16.i1.113191
  44. Pain Med. 2026 Mar 14. pii: pnag036. [Epub ahead of print]
    Steroid Injections for Arthropathy, Tendinopathy and Myopathy in the Pediatric Population: A Systematic Review.
    David S Jevotovsky, Andres Gronda, Gabrielle Avancena, Anish Rana, Brandon Burg, Chun Maung, Salman Hirani, Salvador Portugal, Tracy Espiritu McKay.
       OBJECTIVE: To assess the effectiveness and safety of corticosteroid injections (CSI) for pediatric patients with non-rheumatologic peripheral musculoskeletal pain conditions.
    DESIGN: Systematic review.
    METHODS: A comprehensive search of PubMed, Embase, Web of Science, and Cochrane Central was performed through August 2024 in alignment with PRISMA 2020 guidelines. Eligible studies included pediatric patients receiving CSI for peripheral musculoskeletal pain unrelated to rheumatologic disease. Primary outcomes were pain relief and functional improvement; secondary outcomes consisted of safety and adverse events. MASTER and GRADE scales evaluated risk of bias and certainty of evidence.
    RESULTS: 1,061 studies were identified, six of which met inclusion criteria, encompassing 267 pediatric patients. Interventions targeted hip pain related to dislocation or femoroacetabular impingement (n = 4 studies), sacroiliac pain (n = 1), and acute anterior cruciate ligament tears (n = 1). Across most studies, CSI provided short-term pain relief and functional improvement, with post-injection follow-up ranging from 5 days to 5 years. However, the randomized controlled trial in ACL tear patients found no significant difference between CSI and saline placebo. Rare adverse events were reported, including localized swelling, pain flare, and one transient sciatic nerve block post-SI joint injection. There were no long-term complications reported. Evidence certainty was rated "very low" due to small sample sizes, heterogeneity, and risk of bias.
    CONCLUSIONS: CSI may provide temporary pain relief for select pediatric peripheral musculoskeletal conditions, albeit with limited and low quality supporting evidence. Despite current data suggesting a favorable short-term safety profile, longer-term effects and standardized dosing guidelines are insufficient. Larger, higher-quality trials with more varied pediatric pathologies are required in order to elucidate the role of CSI in non-rheumatologic pediatric pain management.
    DOI:  https://doi.org/10.1093/pm/pnag036
  45. Cureus. 2026 Feb;18(2): e103235
    Association of Vitamin D Status with Radiographic Changes in Knee Osteoarthritis Patients.
    Shamim Farhad, Mohammad Muhibbur Rahman, Shahina Sarker, A B M Mehedi, Md Obaidul Alam, Fatima Tuz Zahra, Mohammed Emran.
       BACKGROUND: Knee osteoarthritis (KOA) is a common degenerative joint disease and a major cause of pain and disability among older adults. Vitamin D plays an important role in musculoskeletal function, yet its association with radiographic severity of KOA remains unclear, particularly in South Asian populations where deficiency is widespread. This study aimed to assess the relationship between serum vitamin D levels and radiographic KOA among patients attending a tertiary care center in Bangladesh.
    METHODS: A cross-sectional analytical study was conducted at the Department of Physical Medicine and Rehabilitation at Bangladesh Medical University (BMU), Dhaka, Bangladesh. Patients aged ≥50 years presenting with knee pain were screened, and 90 individuals fulfilling the American College of Rheumatology (ACR) criteria for primary KOA were enrolled through purposive sampling. Weight-bearing anteroposterior and lateral knee radiographs were obtained and graded using the Kellgren-Lawrence (K-L) classification. Serum 25-hydroxyvitamin D levels were measured using the Abbott Architect chemiluminescent microparticle immunoassay (CMIA) assay (Abbott Laboratories, Abbott Park, IL, USA). Vitamin D status was categorized as deficient (<20 ng/mL), insufficient (21-29 ng/mL), or sufficient (30-100 ng/mL). Statistical analyses included chi-square tests, ANOVA, and multivariate logistic regression.
    RESULTS: The mean age of participants was 63.2 ± 6.7 years, and 56.7% were female. Overweight (35%) and obesity (23.6%) were common. Vitamin D deficiency was present in 51.1% of patients, and insufficiency in 18.9%. Radiographically, K-L grade 2 (32.2%) and grade 3 (31.2%) were the most frequent findings. Gender was significantly associated with vitamin D status (p = 0.026), and hypocalcemia was more prevalent among vitamin D-deficient individuals (p = 0.028). However, vitamin D status, vitamin D concentration, age, BMI, and disease duration showed no independent association with radiographic osteoarthritis (OA) severity in multivariate analysis.
    CONCLUSIONS: Vitamin D deficiency was highly prevalent in this cohort; however, serum vitamin D levels did not independently predict radiographic severity of KOA. These findings suggest that mechanical and age-related factors may influence structural joint degeneration more strongly than vitamin D status alone. We need larger, multicenter longitudinal studies to elucidate the clinical significance of vitamin D in the progression of KOA in Bangladesh.
    Keywords:  kellgren-lawrence grading system; knee osteoarthritis; radiographic severity; serum vitamin d; vitamin d deficiency
    DOI:  https://doi.org/10.7759/cureus.103235
  46. Eur J Orthop Surg Traumatol. 2026 Mar 09. pii: 130. [Epub ahead of print]36(1):
    Ultrasound-guided intra-articular steroid injection or ultrasound-guided suprascapular notch steroid injection for frozen shoulder? A sequential comparative study with a 1-year follow-up.
    Dipit Sahu, Himanshu S Choudhary, Neha Gaikwad, Sonam Gupta.
      
    Keywords:  Adhesive capsulitis; Frozen shoulder; Intra-articular injection; Steroid injection; Suprascapular notch; Ultrasound injection
    DOI:  https://doi.org/10.1007/s00590-026-04715-z
  47. Ann Palliat Med. 2026 Mar 05. pii: apm-25-111. [Epub ahead of print]
    Radiofrequency ablation of the superior cluneal nerves to treat chronic low back pain: a description of a novel technique.
    Alaa Abd-Elsayed, Madelyn Reilly, Geovany Riad.
      Superior cluneal nerve (SCN) entrapment is an often-overlooked cause of chronic axial low back and gluteal pain. Recent cadaveric findings demonstrate that the SCN originates from T11-L5 with variable branching across the posterior iliac crest. This technical report describes a method for treating low back and gluteal pain using fluoroscopy-guided radiofrequency ablation (RFA) for SCN pain and summarizes the relevant anatomical sites. For the RFA procedure, under a combination of fluoroscopic and ultrasound-guided imaging, an 18-22-gauge cannula is advanced to the osseoaponeurotic orifice 6-8 cm lateral to the midline. Sensory stimulation is utilized to confirm pain reproduction, while motor testing verifies the absence of distal activation. RFA is performed at 80 °C for 90 seconds, and additional lesions are added as needed due to anatomical variability. With minimal complications, peer-reviewed studies show significant but preliminary pain reduction and improved function after SCN-targeted RFA. Accuracy in probe placement, achieved through the use of fluoroscopic and ultrasound-guided imaging and stimulation testing, enhances both reproducibility and safety. SCN-targeted RFA offers a minimally invasive treatment for patients with refractory axial low back pain. Moderate-quality evidence suggests a therapeutic benefit, although current data are obtained from observational studies. Detailed attention to anatomic variability and technique is crucial for achieving consistent outcomes and ensuring patient safety.
    Keywords:  Radiofrequency ablation (RFA); chronic pain; fluoroscopic guidance; superior cluneal nerves (SCNs)
    DOI:  https://doi.org/10.21037/apm-25-111
  48. Neurol Med Chir (Tokyo). 2026 Mar 12.
    Preoperative Electrophysiological Findings Predicting Surgical Outcomes in Tarsal Tunnel Syndrome.
    Eiko Sunami, Satoshi Ikeda, Takao Kitamura, Taku Yoneyama, Arito Yozu, Qing Li, Yoichiro Aoyagi.
      Tarsal tunnel syndrome is an entrapment neuropathy caused by the compression of the tibial nerve and its terminal branches in the tarsal tunnel. Electrophysiological examinations are often used to diagnose tarsal tunnel syndrome. Surgical decompression of the tibial nerve is performed in patients who are resistant to conservative treatment. However, the preoperative electrophysiological findings that predict surgical outcomes remain unknown. This study aimed to clarify the preoperative electrophysiological findings that predict the surgical outcomes of tarsal tunnel syndrome. We reviewed 28 feet of 23 patients who underwent preoperative electrophysiological examinations between November 2021 and October 2024, were diagnosed with tarsal tunnel syndrome, and subsequently underwent surgery. Electrophysiological examinations included nerve conduction study and needle electromyography. We reviewed patient characteristics and electrophysiological findings prior to surgery. Sensory plantar symptoms, such as numbness and pain, were evaluated using the Numerical Rating Scale before and after surgery. Patients were divided into the improvement and non-improvement groups based on the Numerical Rating Scale improvement rate after surgery. A comparative analysis of patient characteristics and preoperative electrophysiological findings was performed between the improvement and non-improvement groups. In a motor nerve conduction study of the tibial nerve, the amplitude of the compound motor action potential evoked by stimulation at the ankle was significantly lower in the non-improvement group than in the improvement group. In tarsal tunnel syndrome, a low compound motor action potential amplitude of the tibial nerve on preoperative motor nerve conduction study may indicate poor symptomatic improvement after surgery. Electrophysiological examinations may be useful for predicting the surgical outcomes of tarsal tunnel syndrome.
    Keywords:  electrophysiological examination; nerve conduction study; surgical outcome; tarsal tunnel syndrome; tibial nerve
    DOI:  https://doi.org/10.2176/jns-nmc.2025-0323
  49. J Orthop Case Rep. 2026 Mar;16(3): 132-138
    Use of Autologous Platelet-rich Plasma as a Biological Adjunct in Distal Humerus Non-union: A Case Report.
    Mainak Roy, Anirudh Dwajan, Jitendra Kumar, Bishnu Prasad Patro, Kumar Asutosh, Amber Agarwal.
       Introduction: Distal humerus fractures are uncommon injuries with a known risk of non-union despite surgical fixation. Revision surgery with bone grafting remains standard, but some patients may decline reoperation or may be unfit for surgery. Platelet-rich plasma (PRP), an autologous biological product rich in growth factors, may enhance healing in selected cases.
    Case Report: A woman in her 30s developed an aseptic non-union of the distal humerus 6 months after internal fixation for a complex fracture. As she declined revision surgery, she was managed non-surgically with autologous PRP injections. Seven injections were administered over 4 consecutive days using anatomical landmarks. Pain progressively reduced, function improved, and radiographs demonstrated bridging callus and cortical continuity by 6 months.
    Conclusion: In stable fixation with aseptic atrophic non-union, PRP may act as a minimally invasive biological adjunct to support bone healing. Careful patient selection and monitoring are essential for success.
    Keywords:  Distal humerus; Non-union; biological therapy; bone healing; orthobiologics; platelet-rich plasma
    DOI:  https://doi.org/10.13107/jocr.2026.v16.i03.6916
  50. Pain Pract. 2026 Mar;26(3): e70138
    Radiologic Insights: Diagnosing Lumbosacral Transitional Vertebrae. Systematic Review of the Literature.
    Pedro Andrade-Andrade, Juan Carlos Acevedo-González.
       INTRODUCTION: The lumbosacral transitional vertebra (LSTV) has been studied since 1876, with Castellvi developing a classification in 1984 based on its anatomy and laterality. It often goes unnoticed, or its diagnosis is limited to a lumbar spine X-ray for confirmation. This has led to LSTV being underdiagnosed or even ignored. Our aim is to describe and evaluate radiological diagnostic techniques for LSTV and propose a diagnostic methodology to reduce errors in vertebral level identification, useful for percutaneous procedures and/or biomechanical measurement analysis.
    MATERIALS AND METHODS: A systematic literature review was conducted. The search terms included: "Castellvi," "Lumbosacral Transitional Vertebra," "Radiology." Logical connectors such as "and" and "or" were applied. The following databases were reviewed: Scopus, PubMed, Ovid, ScienceDirect, EBSCO, and Nature. The timeframe was limited from 2004 to December 2024. Inclusion and exclusion criteria were applied. A total of 419 articles were identified. The "Rayyan" program was used to compile information, and "PRISMA," "STROBE," and "CONSORT" were used to facilitate the analysis process.
    RESULTS: Forty-eight articles were included and analyzed (10 CT, 4 PET-CT, 2 bone scans, 9 MRI, 6 X-rays, 4 EOS, and 13 mixed). The most common findings highlighted CT as the gold standard for diagnosing LSTV, with spinopelvic parameters correlating with LSTV. Radiography is effective for vertebral numbering. MRI studies utilize anatomical landmarks to identify vertebral levels and LSTV, although they are less sensitive. EOS is also used for vertebral level identification.
    CONCLUSIONS: Our proposed diagnostic methodology for LSTV includes: first, using plain AP radiography for cranial-to-caudal vertebral numbering and evaluating morphological anomalies. Second, if LSTV is suspected, performing CT as the gold standard for diagnosis due to its high sensitivity and specificity, and measuring spinopelvic parameters to correlate with LSTV. Third, using MRI in special cases. Fourth, conducting a morphological analysis and using Jenkins' classification for LSTV categorization.
    Keywords:  Castellvi classification; low back pain; lumbosacral transitional vertebra; radiology; spine; systematic review
    DOI:  https://doi.org/10.1111/papr.70138
  51. Front Sports Act Living. 2026 ;8 1795108
    Editorial: Advancements in injury rehabilitation and return-to-sport practices.
    Anna Christakou, Konstantinos Fousekis, Maria Constantinou.
      
    Keywords:  editorial; prevention; readiness; return-to-play; sport
    DOI:  https://doi.org/10.3389/fspor.2026.1795108
  52. BMC Musculoskelet Disord. 2026 Mar 09.
    The effects of physiotherapy on neck pain with associated symptoms, ıncludıng cervicogenic dizziness and tinnitus: a systematic review.
    Kübra Canlı, Indra De Greef, Eveline Van Looveren, Mira Meeus, Barbara Cagnie, Kayleigh De Meulemeester.
      
    Keywords:  Exercise therapy; Musculoskeletal manipulations; Physical therapy modalities; Rehabilitation; Sham treatment
    DOI:  https://doi.org/10.1186/s12891-026-09664-6
  53. Cureus. 2026 Feb;18(2): e103216
    Hoffa's Fat Pad Ganglion Cyst Causing Infrapatellar Impingement in a Collegiate Athlete: A Report of a Rare Case.
    Justin Prusinski, Angela Cavanna.
      Ganglion cysts are benign, fluid-filled lesions most frequently arising from the wrist and hand, while occurrence within Hoffa's (infrapatellar) fat pad of the knee is rare. When present in the knee, these cysts may lead to localized irritation, mechanical infrapatellar impingement, restricted range of motion, and anterior knee pain. We present the case of a 19-year-old collegiate basketball player with chronic anterior right knee pain without any prior history of trauma, unresponsive to initial conservative management. Initial clinical evaluation suggested patellofemoral pain syndrome; however, advanced imaging via MRI and musculoskeletal ultrasound revealed a ganglion cyst impinging on Hoffa's fat pad and abutting the posterior patellar tendon. Given persistent functional impairment despite conservative therapy, arthroscopic excision was performed. Postoperatively, the patient achieved complete resolution of symptoms and successfully returned to competitive athletic activity without limitation. This case demonstrates the value of early imaging and consideration of intra-articular ganglion cysts in the differential diagnosis of anterior knee pain in young athletes. Early recognition through appropriate imaging is essential for optimizing functional outcomes in young athletes.
    Keywords:  hoffa’s fat pad; knee ganglion cyst; mri; musculoskeletal ultrasound; surgical excision
    DOI:  https://doi.org/10.7759/cureus.103216
  54. Complement Ther Med. 2026 Mar 11. pii: S0965-2299(26)00041-5. [Epub ahead of print] 103358
    Effects of hip strengthening on postural control and muscle strength in individuals with chronic ankle instability: A systematic review and meta-analysis of randomized controlled trials.
    Peng Chen, Xikai Lin, Huiwu Zuo, Junfan Ye, Lin Wang.
       BACKGROUND: Despite encouraging findings, research on the therapeutic efficacy of hip strengthening in individuals with chronic ankle instability (CAI) continues to yield conflicting results.
    PURPOSE: This study aims to systematically evaluate the effects of hip strengthening on postural control and muscle strength in individuals with CAI.
    METHODS: A comprehensive search of five databases was conducted from inception to November 6, 2025 following the guidelines defined by the PRISMA statement. We conducted a meta-analysis using a random-effects model via the metafor package in R software. Subgroup analysis was performed based on comparison types.
    RESULTS: Nine randomized controlled trials were included. Hip strengthening significantly improved the posteromedial distance (SMD=0.60, 95% CI: 0.22-0.97) and posterolateral distance (SMD=0.55, 95% CI: 0.15-0.96) in the Star excursion balance test (SEBT), Cumberland ankle instability tool scores (MD=1.54, 95% CI: 0.86-2.24), and hip abductor muscle strength (SMD=0.72, 95% CI: 0.17-1.26). Subgroup analysis results demonstrated that combining hip strengthening with ankle rehabilitation significantly improved SEBT distances, whereas isolated hip strengthening showed no superior effect to either the blank control group or ankle rehabilitation training alone.
    CONCLUSION: Hip strengthening improves postural control and muscle strength in individuals with CAI. Notably, the application of hip strengthening combined with ankle rehabilitation training is beneficial for postural control, whereas standalone hip strengthening yields no additional benefits. However, these findings should be interpreted with caution due to the limited number of studies, small sample sizes, and low quality of the evidence.
    Keywords:  Chronic ankle instability; Hip strengthening; Meta-analysis; Muscle strength; Postural control
    DOI:  https://doi.org/10.1016/j.ctim.2026.103358
  55. Nutrients. 2026 Feb 24. pii: 714. [Epub ahead of print]18(5):
    Effect of Prebiotic Supplementation With and Without Physiotherapy on Pain and Pain Sensitivity in People with Knee Osteoarthritis.
    Afroditi Kouraki, Susan Franks, Amrita Vijay, Thomas Kurien, Moira A Taylor, Stephanie L Smith, Benjamin Smith, Anthony Kelly, Ana M Valdes.
      Background: Emerging evidence links the gut microbiome to chronic pain processing. Inulin, a prebiotic fibre, modulates the gut microbiome, while physiotherapy-supported exercise (PSE) improves pain and function. We evaluated the effects of inulin supplementation with and without PSE on knee osteoarthritis (OA) pain. Methods: In a 2 × 2 factorial RCT, 117 community-dwelling adults with knee OA received 6 weeks of: (A) 20 g/day inulin, (B) digital PSE (Joint Academy™), (C) inulin +PSE, or (D) 10 g/day maltodextrin. Primary outcome: pain (Numerical Rating Scale). Secondary: 30 s sit-to-stand (30-CST), timed up and go (TUG), grip strength, and quantitative sensory testing. Serum short-chain fatty acids (SCFAs) and glucagon-like peptide-1 (GLP-1) were measured. The study was not powered to detect synergistic interaction. Results: A total of 117 participants (58.1% female; mean ± SD age = 67.5 ± 9.4 years; BMI = 29.5 ± 5.3 kg/m2; NRS = 3.96 ± 2.67) completed the trial. Pain improved with inulin (baseline-adjusted between-group mean difference (Δ) = -1.11 [95%CI -2.18, -0.04], p = 0.045) and PSE (Δ = -1.55 [95%CI -2.52, -0.58], p = 0.002) compared to placebo, with no synergistic effect. PSE improved TUG (p = 0.02) and 30-CST (p = 0.0004), while inulin improved grip strength (p = 0.002), pressure pain thresholds (p = 0.009) and temporal summation (p = 0.025) compared to placebo and had significantly lower dropout rates (3.6%) compared with PSE (21% p < 0.01). Only inulin increased SCFA butyrate (p = 0.0248) and GLP-1 (p = 0.0109), and higher GLP-1 was associated with improved grip strength, suggesting a gut-muscle link. Conclusions: Inulin and PSE each produced meaningful pain reductions. Only inulin improved pain sensitivity and grip strength, the latter paralleled by increased GLP-1, and had much higher rates of retention compared to PSE.
    Keywords:  2 × 2 factorial design; fibre; glucagon-like peptide-1; inulin; knee osteoarthritis; pain; physiotherapy-supported exercise; prebiotic supplements; short-chain fatty acids
    DOI:  https://doi.org/10.3390/nu18050714
  56. Curr Pain Headache Rep. 2026 Mar 13. pii: 33. [Epub ahead of print]30(1):
    Ultrasound Guided Radiofrequency Ablation of Suprascapular Nerve for Shoulder Pain: A Novel Technique Description.
    Alaa Abd-Elsayed, Muhammed Zahid Şahin, Nina Hashimoto.
      
    DOI:  https://doi.org/10.1007/s11916-026-01469-5
  57. Arch Phys Med Rehabil. 2026 Mar 07. pii: S0003-9993(26)00565-4. [Epub ahead of print]
    TRANSCRANIAL DIRECT CURRENT STIMULATION IS EFFECTIVE FOR PAIN RELIEF OF INDIVIDUALS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN: A DOUBLE-BLIND RANDOMIZED CLINICAL TRIAL.
    Ricardo Vinicius Silva de Souza, Mikhail Santos Cerqueira, Ingrid Martins de França, Yasmim Sousa de Lima, Amanda Silva Saldanha, Felipe Viana Gama, Bianca Mirelle Ferreira de Souza, Vinicius Augusto Magalhães Silveira, Wouber Hérickson de Brito Vieira.
       OBJECTIVE: To assess the efficacy of transcranial direct current stimulation (tDCS) for pain relief and disability reduction in individuals with non-specific chronic low back pain (NSCLBP).
    DESIGN: Randomized, double-blind, controlled trial with participants allocated to active tDCS (n = 20) or sham tDCS (n = 17) groups.
    SETTING: University laboratory.
    PARTICIPANTS: 37 individuals aged 18 to 60 years with NSCLBP.
    INTERVENTION: Participants received ten 20-minute sessions of tDCS (2 mA), administered twice weekly for five weeks, targeting the left dorsolateral prefrontal cortex.
    OUTCOME MEASURES: Pain intensity (Visual Analog Scale), pressure pain threshold (PPT, algometry), and disability (Roland-Morris Disability Questionnaire [RMDQ], Oswestry Disability Index [ODI], and sit-to-stand test) were assessed 1 week before the first intervention session and 1 week after completion of the tenth session. Data were analyzed using two-way repeated-measures ANOVA (time × group), followed by Tukey's post hoc test (when appropriate). Significance was set at p < 0.05.
    RESULTS: The active tDCS group showed a significant reduction in pain compared with sham (sham: 4.70 ± 2.59 to 3.66 ± 2.55; active: 5.40 ± 1.64 to 2.02 ± 1.72; p = 0.026). No significant differences were found between groups for PPT (L5R, p = 0.427; L5L, p = 0.843; L3R, p = 0.649; and L3L, p = 0.788), ODI (p = 0.113), RMDQ (p = 0.285), or sit-to-stand performance (p = 0.726). Both showed similar trends for secondary outcomes (minor improvements), but without significant between-group differences.
    CONCLUSION: tDCS applied to the dorsolateral prefrontal cortex produced a small but significant pain reduction in individuals with NSCLBP; however, it did not significantly affect pain threshold or disability levels. These findings suggest that, while tDCS helps modulate perceived pain, its isolated use may not improve functional disability. Further studies with larger sample sizes, varied stimulation parameters, and combined interventions are needed to clarify the potential role of tDCS in managing NSCLBP.
    Keywords:  Transcranial electrical stimulation; analgesia; chronic low back pain; musculoskeletal pain
    DOI:  https://doi.org/10.1016/j.apmr.2026.02.484
  58. J Bone Joint Surg Am. 2026 Mar 12.
    Comparative Efficacy of Surgical Versus Nonsurgical Management for Acute Achilles Tendon Rupture in a Novel Mouse Model.
    Keyu Wei, Xiang-Hua Deng, Yuexi Mou, Ting Wang, Xianding Sun, Mao Nie.
       BACKGROUND: Acute Achilles tendon rupture is a common and serious injury in sports medicine. Clinical studies demonstrate that both surgical and nonsurgical interventions can achieve satisfactory outcomes; however, considerable debate exists regarding the optimal treatment modality for this injury. Currently, most animal experimental studies on acute Achilles tendon rupture lack clinical relevance due to inadequate fixation of the ankle joint.
    METHODS: This study involved 162 male C57BL/6 mice and 30 Scx-CreERT2; Rosa26-tdTomato transgenic mice. The injury+repair groups underwent Achilles tenotomy followed by Kessler suture repair, while the injury+no repair groups underwent tenotomy alone. Ankle joints were immobilized at 160° (plantar flexion) or 90° (neutral alignment). Samples were collected at 2 and 4 weeks post-injury for biomechanical, histological, and quantitative real-time PCR (qPCR) analyses, including tracing of Scx+ tendon progenitor stem cells.
    RESULTS: Biomechanical analysis was performed 2 and 4 weeks post-injury. At 2 weeks, the injury+repair group immobilized at a maximum plantar flexion angle of 160° showed significantly higher failure force and stiffness compared with the injury+no repair+160° group. However, there was no significant difference between the groups at 4 weeks (p > 0.05). The failure force in each 160° group was significantly higher than in the corresponding 90° group (p < 0.0001). Histological analysis indicated better collagen fiber alignment and higher expression of collagen type I alpha 1 (COL1A1) in the injury+repair groups. qPCR revealed generally higher expression of tendon repair-related genes (Scx, Tnmd, Tgfb1) in the injury+repair groups, while inflammatory factors (Il1b, Il6) were higher in the injury+no repair+90° group. Scx+ tendon progenitor stem cell tracing showed the greatest percentage in the injury+repair+160° group.
    CONCLUSIONS: Both surgical and nonsurgical treatments for acute Achilles tendon rupture achieved satisfactory tendon healing results when the ankle joint was maintained in maximum plantar flexion. However, surgical treatment yielded superior histological tendon repair.
    CLINICAL RELEVANCE: The results suggest that clinical trials may show immobilization in maximum plantar flexion following surgery to be optimal for tendon healing.
    DOI:  https://doi.org/10.2106/JBJS.25.01211
  59. Int J Mol Sci. 2026 Mar 03. pii: 2369. [Epub ahead of print]27(5):
    The Infrapatellar Fat Pad in Osteoarthritis: From Pathophysiology to a Novel Therapeutic Target.
    Qianshuo Wang, Dingge Liu, Fan Hu, Langran Wang, Zhihua Zhang, Yuhao Yan, Xin Zhang.
      Osteoarthritis (OA) is a prevalent degenerative joint disease which affects millions of patients across the globe. The infrapatellar fat pad (IPFP) harbors diverse cell types with intricate intercellular interactions. Its mesenchymal stem cells (MSCs) and extracellular vesicles (EVs) possess significant biological functions and hold promising applications in regenerative medicine. IPFP exhibits active secretory capacity, releasing adipokines including leptin and adiponectin, along with various cytokines. Furthermore, it contains a rich neural network playing a crucial role in knee pain perception and sensation. Moreover, IPFP and synovium can be considered an integrated unit, exhibiting interactions both with each other and with cartilage. In imaging applications, IPFP is gaining widespread attention as an emerging biomarker. In clinical practice, the decision to resect or preserve IPFP remains a controversial topic. This article will review the latest research regarding the mechanism of IPFP in OA, and discuss its clinical applications, providing a theoretical basis for the prevention and treatment of OA.
    Keywords:  cartilage; infrapatellar fat pad; mesenchymal stem cells; osteoarthritis; synovium
    DOI:  https://doi.org/10.3390/ijms27052369
  60. Disabil Rehabil. 2026 Mar 11. 1-13
    Evaluating the construct validity of five concern for falling outcome measures and the concern for falling framework in people with lower limb loss using the International Classification of Functioning, Disability and Health framework.
    Kristin Nugent, Leslee Ward, Ricardo Viana, Michael W Payne, Janelle Unger, Susan W Hunter.
       PURPOSE: To evaluate construct validity of five concern for falling (CFF) outcome measures: 1) Locomotor Capability Index (LCI); 2) Prosthetic Limb Users Survey-Mobility (PLUS-M); 3) Consequences of Falling (COF) Scale; 4) Perceived Ability to Manage a Fall (PAMF) Scale; and 5) Perceived Control Over Falling (PCOF) Scale in people with lower limb loss (PWLLL).
    METHODS: Two coders independently linked ICF codes to measures using established linking rules. Consensus was achieved through discussion and consultation with an additional author. Inter-rater reliability was assessed using Cohen's kappa. ICF codes were compared with established CFF construct codes using descriptive statistics, and codes from limb loss-specific measures (PLUS-M, LCI) were compared against concepts identified in generic measures (COF, PAMF, PCOF).
    RESULTS: Inter-rater reliability ranged from moderate to very good (kappa values = 0.52-0.91, p < 0.001); values could not be calculated for the PCOF due to limited items. Forty-seven items were linked; the most common codes were d4602 (n = 11) ('Moving around outside the home/buildings') and d4551 (n = 9) ('Climbing/going up/down steps/hills'), concentrated within the Activities and Participation ICF component.
    CONCLUSION: While the ICF offers a standardized framework, greater specificity for limb loss-related mobility demands may enhance its clinical utility for PWLLL.
    Keywords:  Amputation; concern for falling; falls; outcome measure; prosthesis
    DOI:  https://doi.org/10.1080/09638288.2026.2639926
  61. Exp Gerontol. 2026 Mar 07. pii: S0531-5565(26)00068-9. [Epub ahead of print]217 113090
    Changes in human multifidus muscle size with aging and short-term disuse.
    Fabio Sarto, Elena Monti, Sara Tagliaferri, Bostjan Simunič, Marco Salvi, Tereza Jandova, Martino V Franchi, Rado Pišot, Marcello Maggio, Marco V Narici.
      Lumbar multifidus (MF) muscle plays a key role in spinal stability, yet its adaptations to aging and disuse, which become increasingly prevalent with advancing age, remain unclear. We conducted two studies to investigate age- and inactivity-induced changes in MF size. In Study 1, we assessed 32 young adults (50% females) and 75 older adults (67% females), categorized as non-sarcopenic (NS) or probable sarcopenic (PS) based on EWGSOP2 criteria. In Study 2, we examined early MF responses to 10-day horizontal bed rest in 10 young males. MF cross-sectional area (CSA) and side-to-side asymmetry were measured using ultrasound imaging and compared with the vastus lateralis (VL) CSA. In Study 1, MF CSA was negatively associated with age (p < 0.0001) and probable sarcopenia, being lower in PS compared to NS (p = 0.012). MF showed larger effect sizes than VL [Y vs NS: MF g = 1.62, VL g = 1.35; Y vs PS: MF g = 2.48, VL g = 1.35]. MF asymmetry was greater in PS compared to Y (p = 0.003). In Study 2, bed rest induced early reductions in MF CSA (detectable by day 4, p = 0.047) without increasing asymmetry. In conclusion, the MF was smaller in older populations and decreased following short-term disuse, while greater asymmetry was observed only with aging. These findings suggest that the MF is a highly plastic muscle in response to aging and disuse and that its assessment may serve as a potential hallmark of muscle maladaptation in clinical and experimental settings.
    Keywords:  Bed rest; Muscle atrophy; Paraspinal muscles; Physical inactivity; Sarcopenia; Ultrasound imaging; Unloading
    DOI:  https://doi.org/10.1016/j.exger.2026.113090
  62. PM R. 2026 Mar 13.
    Core stability in women with and without chronic pelvic pain.
    Hannah V Chatwin, Abhilasha Kumar, Michael Wesolowski, Laura Glaser, Colleen M Fitzgerald, Stacey Bennis.
       BACKGROUND: Physical activity (PA) and core stability levels are unknown for women with musculoskeletal chronic pelvic pain (CPP) compared to healthy women. At this time, there is no validated treatment method aimed specifically at CPP.
    OBJECTIVE: To elucidate the PA habits and core stability of women with and without CPP. We hypothesized that aerobic and resistance PA (aPA, rPA) and core stability would differ significantly.
    DESIGN: Prospective, cross-sectional study. Wilcoxon rank sum tests, simple and multiple linear regressions, and Pearson chi-square test were used for analysis.
    SETTING: Primary and specialty care outpatient physical medicine and rehabilitation, female pelvic medicine and reconstructive surgery, and gynecology clinics associated with a large tertiary center.
    PATIENTS: We recruited 91 women aged 18-70 years with and without CPP (defined by American College of Obstetricians and Gynecologists).
    INTERVENTIONS: Not applicable.
    MAIN OUTCOME MEASURES: Physical activity, core stability scores.
    RESULTS: Women with CPP demonstrated lower overall core stability (p = .04). Having CPP predicted a 2-point decrease in overall core score (p < .01). Women with CPP demonstrated significantly worse scores for the supine bridge (p < .01) and prone bridge (p = .03). There were no significant differences in aPA or rPA between women with and without CPP. Pelvic floor muscle strength did not have a significant effect on core scores in women with CPP before or after adjusting for age, parity, and body mass index.
    CONCLUSIONS: This study reports a novel finding that women with CPP had significantly reduced core scores (suggestive of weaker core stability) but similar levels of physical activity (aPA and rPA) compared to women without CPP. Future directions will include larger, multicenter, randomized controlled trials to investigate the association between pelvic floor muscles and core stability as well as therapeutic interventions to include specific exercises targeted at improving overall core stability in women with CPP.
    DOI:  https://doi.org/10.1002/pmrj.70103
  63. Cureus. 2026 Feb;18(2): e103108
    Botulinum Toxin Injection to Treat Bruxism in a Child: A Case Report and Technique Description.
    Franco Ignáccio Mallaguti, José Geraldo Malaguti, Otacilio de Paula Rodrigues Júnior.
      Managing sleep bruxism (SB) in children remains a clinical challenge due to the limited evidence-based treatment options for muscle hyperactivity in this population. This case report describes the successful use of botulinum toxin type A (BTX-A) in managing SB in an otherwise healthy eight-year-old girl. The patient received 10 units of BTX-A in each masseter muscle, administered at two points per side using anatomical landmarks and muscle palpation to guide injection. Symptom resolution was reported as early as the day after treatment, with effects lasting approximately two months and no adverse reactions observed. This is the first known report of BTX-A being used to treat bruxism in a healthy pediatric patient. The findings suggest that botulinum toxin may be a safe and effective alternative for managing muscle hyperactivity in children. Further research is needed to establish optimal dosing protocols and long-term safety.
    Keywords:  botulinum toxin; bruxism; orofacial pain; pediatric dentistry; temporomandibular disorders
    DOI:  https://doi.org/10.7759/cureus.103108
  64. Rehabilitacion (Madr). 2026 Mar 10. pii: S0048-7120(26)00003-4. [Epub ahead of print]60(1): 100961
    Effectiveness of elastic resistance training in frail older adults on muscle strength and functionality levels: A systematic review.
    A Puelles-Diaz, N Bousellet-Laflor, S Pizarro-Torres, J Grau-Riveros, J González-Aroca.
       INTRODUCTION: Frailty in older adults is a clinical syndrome that significantly affects independence and quality of life. Resistance training with elastic bands has been proposed as a low-cost intervention to improve physical function in this population.
    OBJECTIVE: To evaluate the best available evidence on the effectiveness of elastic band training in frail older adults for improving muscle strength, physical performance, and overall functionality.
    METHODS: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD42024582352). Four randomized controlled trials were included, comprising 148 frail participants aged 65 years or older. The interventions lasted between 12 and 28 weeks and included exercises with elastic bands, with or without nutritional education. The outcomes assessed included functionality, frailty status, muscle strength, physical fitness, cognition, quality of life, and endurance.
    RESULTS: Significant improvements were observed in functionality, handgrip strength, and lower-limb strength, particularly in programs with progressive intensity and longer duration. Combined interventions (exercise plus nutritional education) showed a greater impact in reducing frailty levels. However, no significant changes were observed in autonomy. The risk of bias was high in three studies, mainly due to insufficient reporting of randomization procedures and missing outcome data.
    CONCLUSIONS: Elastic band training appears to be a safe, affordable, and feasible intervention to improve physical outcomes in frail older adults. These findings support its implementation in community and institutional settings, although further research with long-term follow-up and improved methodological quality is needed.
    Keywords:  Aged; Bandas elásticas; Elastic bands; Entrenamiento de resistencia; Fragilidad; Frailty; Personas mayores; Resistance training
    DOI:  https://doi.org/10.1016/j.rh.2026.100961
  65. Reg Anesth Pain Med. 2026 Mar 13. pii: rapm-2025-107299. [Epub ahead of print]
    Prospective, non-inferiority, multicenter, randomized, single-blind clinical trial comparing cooled radiofrequency ablation to standard radiofrequency ablation to manage chronic facetogenic lumbar back pain.
    David A Provenzano, Sean Li, Timothy A Deer, Leonardo Kapural, Fred K Khalouf, Francesco Vetri, Keith M Zora, Maged N Guirguis, Zachary L McCormick.
       BACKGROUND: Low back pain is a leading cause of disability. Up to 45% of lumbar spine pain may be facetogenic. Both standard radiofrequency ablation (SRFA) and cooled radiofrequency ablation (CRFA) have been deployed to treat facetogenic pain.
    METHODS: Patients with lumbar facetogenic back pain, identified by two positive medial branch blocks (MBBs), were randomized to treatment with CRFA or SRFA. The primary endpoint was the proportion of subjects whose back pain decreased by ≥50% on the Numeric Rating Scale (NRS (usual): patient's level of pain over the past 7 days) at 6 months, with subjects followed through 12 months. Secondary endpoints included changes in SF-36 (36-Item Short Form Health Survey) Physical Functioning (PF), Oswestry Disability Index (ODI), Global Perceived Effect scale (GPE), and EQ-5D-5L index (EuroQol's Health-Related Quality of Life Score using 5 levels over 5 dimensions).Enrollment (target 188) ended early after 18 months due to funding reallocation and strict Medicare criterion requiring ≥80% pain relief from dual MBBs.
    RESULTS: 74 patients (37 CRFA, 37 SRFA) were randomized, treated, and included in the intention-to-treat analysis. 61 patients (27 CRFA, 34 SRFA) completed the 6-month primary endpoint visit. Both CRFA and SRFA provided robust, statistically significant and clinically relevant reductions in NRS pain scores from baseline at every time point (p≤0.0001). CRFA met the predefined non-inferiority criterion relative to SRFA (p=0.0069), with a high proportion of both groups achieving ≥50% pain relief at the primary endpoint-74.1% with CRFA and 64.7% with SRFA. Although CRFA showed numerically greater reductions in NRS pain scores from baseline (-4.3 vs -3.4), both treatments exceeded the minimal clinically important difference threshold. No statistically significant differences in NRS scores were observed between groups at any time point, likely due to the premature termination of the study (only 52% enrolled). Both groups also showed significant and comparable improvements in NRS, EQ-5D-5L, ODI, SF-36 (PF), and GPE at 6 and 12 months.
    CONCLUSION: Despite the smaller than intended sample size, due to early termination by the sponsor, this study demonstrated that with appropriate patient selection and proper procedural technique, both CRFA and SRFA can relieve chronic facetogenic low back pain, improve disability, function, and quality of life for 6-12 months.
    TRIAL REGISTRATION NUMBER: NCT04803149.
    Keywords:  Back Pain; CHRONIC PAIN; Nerve Block; Orthopedic Procedures; Pain Management
    DOI:  https://doi.org/10.1136/rapm-2025-107299
  66. BMJ. 2026 Mar 13. 392 s496
    Effectiveness of drug interventions to prevent delirium after surgery for older adults: systematic review and network meta-analysis of randomised controlled trials.
      
    DOI:  https://doi.org/10.1136/bmj.s496
  67. Front Surg. 2026 ;13 1769099
    Weight-bearing computed tomography in knee pathologies: current evidence and future perspectives.
    Andre Giardino Moreira da Silva, Renata Vidal Leão, Carlos Felipe Teixeira Lobo, Enzo Tunala Mendonça, Camilo Partezani Helito.
      Weight-bearing computed tomography (WBCT) provides three-dimensional (3D), high-resolution imaging with patients in either a unipodal or bipodal stance, allowing visualization of dynamic joint alterations that might be missed in conventional radiographs or in non-weight-bearing exams, such as conventional computed tomography (CT) or magnetic resonance imaging (MRI) scans. Multiple lines of research are exploring its application for the evaluation of knee osteoarthritis, knee ligamentous instability, malalignment syndromes, patellofemoral disorders, and postoperative assessment following total knee arthroplasty. Despite its growing clinical utility, the development of standardized imaging protocols, broader accessibility, and integration with advanced image-analysis tools remain important areas for further progress. This review summarizes the current evidence supporting the clinical applications of WBCT in knee assessment and discusses future directions aimed at optimizing its role in personalized musculoskeletal care.
    Keywords:  anterior cruciate ligament; knee alignment; knee osteoarthritis; knee pathology; patellofemoral; total knee arthroplasty; weight-bearing CT
    DOI:  https://doi.org/10.3389/fsurg.2026.1769099
  68. Case Rep Orthop. 2026 ;2026 6686698
    Symptomatic Tendon Sheath Ganglion at the Insertion of the Popliteus Tendon Treated With Local Cortisone Injection.
    Monika Reden, Jules-Nikolaus Rippke, George-Mihai Avram, Elias Ammann, Laszlo Toth, Matthias Koch, Randa Elsheikh, Michael Hirschman, Natalie Mengis.
      Popliteus tendon sheath ganglia represent a rare and frequently overlooked cause of persistent lateral knee pain. This case report describes a patient with chronic symptoms unresponsive to conservative treatment, in whom advanced imaging revealed a ganglion at the lateral insertion of the popliteus tendon. Ultrasound-guided corticosteroid injection resulted in complete resolution of symptoms. The case highlights the importance of thorough differential diagnosis using advanced imaging and supports the effectiveness of targeted, minimally invasive interventions. Informed consent for publication was obtained.
    DOI:  https://doi.org/10.1155/cro/6686698
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