bims-ricfun Biomed News
on Rehabilitation ICF
Issue of 2026–02–01
58 papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica
  1. Advanced Ultrasonographic Insights into Neglected/Occult Achilles Tendon Rupture in Rheumatoid Arthritis.
  2. Subdeltoid Bursitis Following a Transient Ischemic Attack.
  3. A comparative study of the efficacy of single and double centrifuged platelet-rich plasma and placebo (normal saline injection) on pain, ROM, and physical function of patients with knee osteoarthritis: a double-blinded controlled randomized trial with a six-month follow-up.
  4. Muscle Thickness and Function of Transversus Abdominis and Gluteus Medius in Individuals with Chronic Non-Specific Low Back Pain.
  5. Ultrasound-Based Knee Osteoarthritis Severity Assessment and Its Association With Kellgren-Lawrence Grading.
  6. Musculoskeletal Injections in Dancers: Therapeutic Approaches for Injury Recovery and Performance Optimization.
  7. Complex regional pain syndrome should be aggressively treated as soon as it is diagnosed.
  8. Clinical Outcomes of Intra-Articular Ozone Injections in Hip Osteoarthritis: A Retrospective Study Comparing Different Injection Frequencies.
  9. Return to sport following Lisfranc injuries in elite athletes-2024 international foot and ankle sports consensus and systematic review.
  10. Proximal Row Carpectomy Versus Open Reduction and Internal Fixation in Late-Presenting Perilunate Dislocations.
  11. MRI scans of the lumbar spine in lower back pain-why are we missing the elephant in the room?
  12. Knee Osteoarthritis.
  13. Pectoralis Minor Tenotomy in the Treatment of Painful Shoulder Syndromes associated with Scapular Dyskinesis.
  14. Electrophysiological analysis of distal, proximal, and dual compression of the median nerve.
  15. The Effects of 24 Weeks Sensorimotor Training on Balance, Physical Function, and Pain in Women with Knee Osteoarthritis.
  16. Narrative Review and Clinical Recommendations for Sportsman's Hernia and Athletic Pubalgia Based on 30 Years of Expert Experience.
  17. Pulsed Electromagnetic Field Therapy for Mild-to-Moderate Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial.
  18. Rehabilitative Ultrasound Imaging as Visual Biofeedback in Pelvic Floor Dysfunction: A Narrative Review.
  19. End-to-side anterior interosseous nerve transfer augmentation of ulnar nerve function in moderate and severe cubital tunnel syndrome; a randomised controlled trial protocol.
  20. Does central sensitization affect responses to genicular radiofrequency and intra-articular injection in elderly knee osteoarthritis patients?
  21. Radial Extracorporeal Shock Wave Therapy Versus Multimodal Physical Therapy in Non-Traumatic (Degenerative) Rotator Cuff Tendinopathy with Partial Supraspinatus Tear: A Randomized Controlled Trial.
  22. Isolated pectoralis minor tear at the costal origin: a case-based review of the literature.
  23. Rebuilding life after heart valve surgery: The VALCAR(E)_QoL study on rehabilitation and quality of life.
  24. Correction to "New Zealand Survey of the Diagnosis and Treatment Experiences of People With Upper Limb Complex Regional Pain Syndrome".
  25. Outcomes of Non-operatively Managed Achilles Tendon Rupture: A Retrospective, Single-Centre Study.
  26. Thickening of Dorsal Foot Nerves: A Frequent Sonographic Finding in Asymptomatic Volunteers, Potentially Leading to False Positive Results.
  27. Top 10 Technical Tips and Tricks for Safe Sciatic Nerve Management During Posterior Hip Endoscopy.
  28. Central and Peripheral Sensitization in Temporomandibular Disorders: Proposed Mechanisms of Botulinum Toxin Therapy.
  29. Bringing Rehabilitation Home: A Policy and Practice Perspective on COPD Management.
  30. Suprascapular nerve entrapment syndrome caused by a spinoglenoid notch cyst with a concomitant giant lipoma: a case report.
  31. Boutonniere Deformity of the Proximal Interphalangeal Joint in a Young, Active Female Patient: A Nonstandard Surgical Procedure.
  32. Anabolic medications for rehabilitation after hip fracture in older people.
  33. Sports injury: biomechanical approach to interpretation of knee MRI.
  34. Case Report: Prosthetic revision due to aseptic loosening following total knee arthroplasty: a clinical management and pathological mechanism investigation.
  35. Meta-analysis of comparative effects of mobile app-based digital rehabilitation versus traditional rehabilitation after total knee arthroplasty.
  36. Comparison of ultrasound- and fluoroscopy-guided intra-articular corticosteroid injections for hip osteoarthritis.
  37. Morphology of the scapholunate joint, lunate, and capitate in dorsal wrist ganglion: An MRI case-control study.
  38. Enhancing Carpal Tunnel Syndrome Diagnosis: The Combined Use of CTS-6 and Ultrasound Measured Median Nerve CSA.
  39. Irreducible Anterior Shoulder Dislocation Caused by Soft Tissue Interposition: A Comprehensive Review.
  40. Comparing perspectives from experts and individuals with lived experience in the Global North versus the Global South: ICF core sets for deafblindness.
  41. Effects of Pulmonary Rehabilitation on Dyspnea, Quality of Life and Cognitive Function in COPD: A Systematic Review.
  42. Therapeutic potential of a supine straight-leg thrust in managing knee joint dysfunction in knee osteoarthritis: A biomechanical study.
  43. A Nerve Injury After Total Hip Arthroplasty from Etiology to Treatment: A Narrative Review.
  44. Biomechanics of medial meniscus tears in the context of pain: a finite element analysis.
  45. Adipose-derived Cell Therapies versus Non-Active Controls for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
  46. Frozen Shoulder: Diagnosis and Treatment of Adhesive Capsulitis.
  47. The underdiagnosed issue in anterior hip painful conditions: A myofascial perspective to the sartorius muscle and dry needling protocol.
  48. Engineered GO-Based Hydrogels for Controlled Hyaluronic Acid Release in Knee Osteoarthritis Treatment.
  49. Late Dislocation Following Normal Multiplanar Dynamic Ultrasonography for Developmental Dysplasia of the Hip: A Case Report.
  50. Assessing the Effectiveness of Tranexamic Acid in Hip Fracture Management: A Systematic Review.
  51. Association Between Radiological Stenosis Level and Patient-Reported Outcomes in Patients with Lumbar Spinal Stenosis: A Cross-Sectional Study.
  52. A systematic review of the use of corticosteroid injections with and without local anaesthetic for trigger finger.
  53. Case Report: Focused shockwave therapy (fESWT) in thumb carpometacarpal joint osteoarthritis: a single case study.
  54. Investigating the effectiveness of stretching interventions on post-traumatic elbow stiffness: a systematic review.
  55. The Effects of Virtual Immersive Gaming to Optimize Recovery (VIGOR) in Low Back Pain: A Phase II Randomized Controlled Trial.
  56. Predictive value of ultrasound elastography for functional outcomes after orthognathic surgery.
  57. Kinesiology Taping in Grade I-II Meniscus Injuries: A Randomized, Placebo-Controlled Pilot Trial.
  58. Predictors of Shoulder Pathology in Rheumatoid Arthritis: A Cross-Sectional Study.
  1. Am J Phys Med Rehabil. 2025 Dec 24.
    Advanced Ultrasonographic Insights into Neglected/Occult Achilles Tendon Rupture in Rheumatoid Arthritis.
    Hilmi Berkan Abacıoğlu, Alp Çetin.
      
    Keywords:  Bursitis; foot; inflammation; pain; ultrasound
    DOI:  https://doi.org/10.1097/PHM.0000000000002929
  2. Am J Phys Med Rehabil. 2025 Dec 29.
    Subdeltoid Bursitis Following a Transient Ischemic Attack.
    Hilmi Berkan Abacıoğlu, Ahmet Furkan Çolak, Mustafa Cihad Güneş, Berkay Yalçınkaya, Murat Kara.
      
    Keywords:  Ultrasound; hemiparesis; rehabilitation; rotator cuff; shoulder
    DOI:  https://doi.org/10.1097/PHM.0000000000002926
  3. Adv Rheumatol. 2026 Jan 27.
    A comparative study of the efficacy of single and double centrifuged platelet-rich plasma and placebo (normal saline injection) on pain, ROM, and physical function of patients with knee osteoarthritis: a double-blinded controlled randomized trial with a six-month follow-up.
    Paniz Jahani, Hooman Angoorani, Azar Moezy, Marzieh Fazlinejad, Ali Mazaherinezhad.
      
    Keywords:  Double-centrifuged; Knee osteoarthritis; Platelet-rich plasma; Single-centrifuged
    DOI:  https://doi.org/10.1186/s42358-026-00518-2
  4. J Clin Med. 2026 Jan 14. pii: 666. [Epub ahead of print]15(2):
    Muscle Thickness and Function of Transversus Abdominis and Gluteus Medius in Individuals with Chronic Non-Specific Low Back Pain.
    Thanawat Yodthee, Patraporn Sitilertpisan, Aatit Paungmali, Sompong Sriburee, Samatchai Chamnongkich, Amornthep Jankaew, Ranida Quiggins, Cheng-Feng Lin.
      Background: Non-specific low back pain (NSLBP) is associated with altered neuromuscular control of the lumbopelvic-hip complex (LPHC). However, the functional behavior of the transversus abdominis (TrA) and gluteus medius (GM) during upright postural tasks, with and without the abdominal drawing-in maneuver (ADIM), remains unclear. This study aimed to compare TrA and GM activation between individuals with NSLBP and asymptomatic controls during standing and single-leg stance using rehabilitation ultrasound imaging (RUSI). Methods: Thirty-two participants (16 with NSLBP and 16 asymptomatic controls) underwent RUSI assessment under four task conditions: standing and single-leg stance, with and without ADIM. Muscle function was quantified using thickness change derived from ultrasound measurements. A two-way mixed-model analysis of variance with Bonferroni-adjusted post hoc comparisons was performed. Results: Significant group × condition interactions were identified for TrA activation (p < 0.05). Individuals with NSLBP demonstrated reduced TrA activation during standing with ADIM and reduced GM activation during single-leg stance compared with asymptomatic controls. The effect sizes were moderate to large for TrA activation and small to moderate for GM activation. Conclusions: These findings suggest task-specific differences in neuromuscular activation patterns in individuals with NSLBP. Ultrasound-derived thickness change measures obtained during functional, weight-bearing tasks may provide clinically relevant information to support motor control rehabilitation strategies.
    Keywords:  gluteus medius; low back pain; motor control; transversus abdominis; ultrasound imaging
    DOI:  https://doi.org/10.3390/jcm15020666
  5. ScientificWorldJournal. 2026 ;2026 2248441
    Ultrasound-Based Knee Osteoarthritis Severity Assessment and Its Association With Kellgren-Lawrence Grading.
    Rita Vivera Pane, Handayani, Aisyah, Nurhasyimah Hisamud-Din, Aufar Zimamuz Zaman Al Hajiri, Alif Noeriyanto Rahman.
       Background: Kellgren-Lawrence (KL) grading is a conventional radiography (CR)-based system commonly used to assess osteoarthritis (OA). Knee OA is characterized by damage to the femoral cartilage (FC); however, CR cannot directly visualize cartilage integrity. Ultrasound (US) may be superior in detecting FC damage. This study is aimed at evaluating the US-based knee OA severity assessment and analyze its association with KL grading.
    Methods: This was an analytical observational study with a cross-sectional design which included knee OA patients. All participants underwent knee US scanning by two independent raters. The severity of knee OA was assessed based on three parameters: the contour of the femoral cartilage, the presence of osteophytes, and meniscus protrusion. The results were accumulated and interpreted into grades from 0 to 4. Association between US-based knee OA assessment and KL grading was analyzed statistically.
    Results: A total of 112 knee OA patients were included in this study. The average age of participants was 61.4 years, with a higher female prevalence. Grade 3 was the most frequently recorded in both US and KL grades. The US interpretation from both raters showed a perfect agreement based on weighted kappa analysis (κ = 1.00). A chi-square test showed a significant association between the US and KL grade (p < 0.001), with a very strong association based on the Cramér's V test of 0.742 (95% CI: 0.599-0.824).
    Conclusion: This study demonstrates the US-based knee OA severity assessment and was associated with KL grade.
    Keywords:  Kellgren–Lawrence grading; cartilage damage; conventional radiography; knee osteoarthritis; knee osteoarthritis ultrasound grading
    DOI:  https://doi.org/10.1155/tswj/2248441
  6. J Dance Med Sci. 2026 Jan 27. 1089313X261417199
    Musculoskeletal Injections in Dancers: Therapeutic Approaches for Injury Recovery and Performance Optimization.
    Rosa M Pasculli, Dana L Sheng, Kathleen L Davenport, Courtney N Gleason.
      Background: Dancers are uniquely susceptible to musculoskeletal injuries due to the repetitive, high-impact, and technical demands of their art form. When conservative measures are insufficient or expedited recovery is needed, injection therapy may be considered as part of a comprehensive treatment plan. Purpose: This narrative review provides a high-level overview of musculoskeletal injections relevant to dancers. As many dancers receive education and initial guidance from non-physician professionals, this review is designed to support these providers by summarizing common injection options, the conditions for which they are most appropriate, and dancer-specific considerations. Methods: A comprehensive literature search of PubMed, MEDLINE, and Google Scholar was conducted through March 2025. Peer-reviewed studies, systematic reviews, and case reports were analyzed qualitatively. Injections in this review are organized by clinical indication rather than preference, reflecting how decisions are made in practice. Selecting an injection requires consideration of multiple contextual factors, including the dancer's diagnosis, performance schedule, symptom chronicity, therapeutic goals, and comorbid medical issues. Results: Five main categories of injections were identified: (1) fluid aspiration, (2) corticosteroid injections, (3) regenerative medicine, (4) peripheral nerve hydrodissections, and (5) spine injections. Image guidance with ultrasound and/or fluoroscopy enhances accuracy and safety across injection types. Corticosteroid injections offer potent anti-inflammatory effects and rapid symptom relief. Regenerative medicine injections (hyaluronic acid, prolotherapy, platelet-rich plasma [PRP], and mesenchymal stromal cell-based therapies), aim to enhance tissue healing and may be beneficial for chronic tendinopathies and mild to moderate osteoarthritis. Peripheral nerve hydrodissection provides a minimally invasive approach for nerve entrapment syndromes, and spinal injections may be indicated for persistent axial or radicular pain. Post-injection care and return-to-dance protocols should be individualized based on the injectate, anatomical target, and performance goals. Conclusion: Musculoskeletal injections can be a valuable tool in a dancer's treatment plan alongside multidisciplinary care for successful return to dance.
    Keywords:  corticosteroid; dance medicine; musculoskeletal injections; platelet-rich plasma (PRP); regenerative medicine
    DOI:  https://doi.org/10.1177/1089313X261417199
  7. Agri. 2026 Jan;38(1): 52-55
    Complex regional pain syndrome should be aggressively treated as soon as it is diagnosed.
    Burak Ekici, Mustafa Turgut Yıldızgören.
      Complex regional pain syndrome is a chronic pain condition characterized by regional pain without a dermatomal distribution. The primary goal of treatment is to alleviate pain and restore function in the affected limb. Multimodal therapeutic methods are adopted, including stellate ganglion block, with favorable outcomes such as pain score reduction and increased mobility in affected patients. This case presentation aims to describe the importance of early stellate ganglion block in the management of CRPS.
    DOI:  https://doi.org/10.14744/agri.2023.90699
  8. J Clin Med. 2026 Jan 16. pii: 744. [Epub ahead of print]15(2):
    Clinical Outcomes of Intra-Articular Ozone Injections in Hip Osteoarthritis: A Retrospective Study Comparing Different Injection Frequencies.
    Burcu Ozalp, Argun Pire, Meltem Uyar, Can Eyigor.
      Background: This retrospective study evaluated the association between the number of intra-articular ozone injection sessions and clinical outcomes in patients with hip osteoarthritis (OA). Methods: Data from 54 patients (65 hips) with Tönnis grade 1-2 hip OA treated at a tertiary algology clinic between 2022 and 2024 were analyzed. Patients were categorized into three groups based on the number of ozone sessions received (1, 2, or 3). Pain and functional status were assessed using the Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index at baseline and at 4, 12, and 24 weeks post-procedure.Results: All groups demonstrated significant improvements in VAS and WOMAC scores compared to baseline (p < 0.001). Although the three-session group showed more pronounced numerical improvements in both early and late follow-ups, intergroup differences did not consistently reach statistical significance across all time points.Conclusions: Intra-articular ozone application is associated with favorable clinical trends in pain reduction and functional recovery. Our findings suggest that a three-session regimen may provide more pronounced clinical improvement compared to fewer sessions. These findings warrant validation through rigorous, randomized controlled trials.
    Keywords:  WOMAC; hip osteoarthritis; injection frequency; intra-articular injection; medical ozone; ozone therapy; pain management
    DOI:  https://doi.org/10.3390/jcm15020744
  9. Knee Surg Sports Traumatol Arthrosc. 2026 Jan 26.
    Return to sport following Lisfranc injuries in elite athletes-2024 international foot and ankle sports consensus and systematic review.
    IFASC Committee
       PURPOSE: Lisfranc injuries, also referred to as tarsometatarsal joint injuries, are relatively uncommon within the general population and can possess profound clinical implications, especially for elite athletes. Existing follow-up and return to sport (RTS) protocols remain poorly defined and variable based on surgeon preference or institutional protocols. The purpose of this study was to both perform a systematic review and determine if consensus on postoperative protocols and RTS timelines could be reached among an expert panel of orthopaedic foot and ankle surgeons who manage Lisfranc injuries in the elite athlete.
    METHODS: The systematic review evaluated the post-operative management of sports-related Lisfranc injuries. A consensus process was then conducted using a modified Delphi technique with four rounds of questionnaires. General consensus was defined as 75%-85% agreement, strong consensus as 86%-99% agreement and unanimous consensus as 100% agreement.
    RESULTS: The systematic review found patients with ligament Lisfranc injuries were permitted to begin weightbearing at an average of 3.5 weeks. The mean time for these athletes to RTS was 8.9 months. Those with bony Lisfranc injuries were allowed to partially weightbear at 4.5 weeks, on average. Bony Lisfranc injuries treated with open reduction and internal fixation (ORIF) allowed the athlete to RTSs at a median of 8 weeks (range 3-12 weeks). There are nine consensus statements presented that illustrate the expected follow-up and RTS milestones. There was unanimous agreement that the athlete can expect to return to their sport 4-6 months postoperatively and athletes with unstable ligament injuries can expect to return to full weightbearing 8-12 weeks postoperatively.
    CONCLUSIONS: This study integrates expert consensus and systematic review findings to establish evidence-based guidelines for returning athletes to sport following Lisfranc injuries. Consensus and literature findings aligned, indicating that most athletes progress to full weightbearing by 8-12 weeks and RTS within 4-6 months postoperatively. Over 90% of athletes successfully resumed play, underscoring the effectiveness of structured, phase-based rehabilitation. These data provide a standardised framework to guide clinicians in optimising recovery and ensuring a safe, efficient RTS.
    LEVEL OF EVIDENCE: Level V.
    Keywords:  athlete; follow‐up; lisfranc; return to sport; tarsometatarsal
    DOI:  https://doi.org/10.1002/ksa.70285
  10. Hand Surg Rehabil. 2026 Jan 23. pii: S2468-1229(26)00020-4. [Epub ahead of print] 102585
    Proximal Row Carpectomy Versus Open Reduction and Internal Fixation in Late-Presenting Perilunate Dislocations.
    Francesco Smeraglia, Andrea Poggetti, Francesca Crisci, Carlotta Faccenda, Giovanni Balato, Teresa Benigno.
       PURPOSE: Perilunate dislocations and fracture-dislocations are severe wrist injuries, frequently caused by high-energy trauma, that can lead to long-term complications if not promptly addressed. While early open reduction and internal fixation (ORIF) is the standard treatment for acute injuries, the optimal management of late presentations remains controversial. This study aims to compare the clinical outcomes of proximal row carpectomy (PRC) with those of ORIF in patients with late-presenting perilunate injuries.
    METHODS: This retrospective comparative study analyzed data from three hand trauma centers in Italy. Patients with perilunate injuries presenting more than four weeks post-injury were included and treated with either PRC or ORIF. Clinical outcomes, including Disability of the Arm, Shoulder and Hand (DASH) questionnaire scores, pain scores according to a Visual Analog Scale (VAS), wrist range of motion, and grip strength, were assessed pre-operatively and at 3, 6, and 12 months post-operatively. Patient allocation was non-randomized and based on surgeon judgment and intra-operative findings RESULTS: Twenty-seven patients were included (11 PRC, 16 ORIF). Both procedures resulted in significant improvements in pain and function. At 3 months, PRC showed lower disability and pain scores compared with ORIF (DASH 34.1 vs 43.1; VAS 2.18 vs 3.06). At 12 months, outcomes were comparable, with greater wrist flexion after PRC (49.1 ° vs 44.1 °) and greater grip strength after ORIF (28.1 vs 23.6 kg).
    CONCLUSION: In late-presenting perilunate injuries, PRC is a viable surgical option, offering faster early recovery and comparable long-term outcomes to ORIF. While ORIF may provide superior grip strength, PRC is advantageous for early pain relief and flexion recovery.
    Keywords:  Proximal row carpectomy; carpal instability; chronic wrist injury; open reduction internal fixation; perilunate dislocation
    DOI:  https://doi.org/10.1016/j.hansur.2026.102585
  11. J Surg Case Rep. 2026 Jan;2026(1): rjaf1120
    MRI scans of the lumbar spine in lower back pain-why are we missing the elephant in the room?
    Mansha Bhiryani, George Ampat.
      Lower back pain (LBP) is a leading cause of disability worldwide and a major contributor to healthcare costs. Diagnosing non-specific mechanical LBP remains difficult and often relies on exclusion. Current magnetic resonance imaging (MRI) reports typically emphasize disc degeneration, an age-related and often asymptomatic finding, while overlooking more clinically relevant factors like the state of the muscle. Fat infiltration and muscle wasting seen on MRI scans are common in LBP patients and are potentially reversible with targeted exercise rehabilitation. In a recent case, MRI revealed significant fat infiltration and muscle atrophy, yet the report focused solely on disc changes, missing the elephant in the room: the correctable muscular dysfunction. Since exercise is the cornerstone of LBP management, ignoring modifiable muscle health while highlighting irreversible and non-pathological age-related changes limits targeted treatment guidance. Routine reporting of muscle condition could lead to more precise rehabilitation and improved patient outcomes.
    Keywords:  lower back pain; magnetic resonance imaging; multifidus; paraspinal muscles; radiology
    DOI:  https://doi.org/10.1093/jscr/rjaf1120
  12. Orthop Nurs. 2026 Jan-Feb 01;45(1):45(1): E5
    Knee Osteoarthritis.
      
    DOI:  https://doi.org/10.1097/NOR.0000000000001199
  13. J Shoulder Elbow Surg. 2026 Jan 23. pii: S1058-2746(26)00033-9. [Epub ahead of print]
    Pectoralis Minor Tenotomy in the Treatment of Painful Shoulder Syndromes associated with Scapular Dyskinesis.
    Philippe Collin, Laurent Baverel, Donald Tedah, Céline Daniel, Alexandre Lädermann.
       BACKGROUND: Scapular dyskinesis is an alteration in scapular position and movement that disrupts glenohumeral kinematics. Among its causes, pectoralis minor retraction induces scapular protraction and internal rotation, altering shoulder biomechanics. Often asymptomatic, scapular dyskinesis may also cause pain and reduced joint mobility, compromising function. Initial management relies on targeted rehabilitation, which generally ensures recovery. However, when conservative treatment fails, surgery may be considered. This study evaluates the clinical outcomes of arthroscopic pectoralis minor tenotomy in patients with painful shoulder and scapular dyskinesis due to pectoralis minor retraction.
    METHODS: A retrospective monocentric study included patients operated on between 2020 and 2024 for painful shoulder syndrome associated with scapular dyskinesis secondary to excessive pectoralis minor tension. Patients undergoing concomitant or subsequent surgery on the same shoulder were excluded. We conducted a longitudinal intra-subject study comparing pre- and postoperative outcomes. Patients were assessed preoperatively and at their last follow-up for active range of motion, pain (VAS), Constant score, and Simple Shoulder Value (SSV). Complications were recorded.
    RESULTS: Thirty-seven patients met the entry criteria and were enrolled in the study with a mean follow-up 19.9 months (range, 6 to 44). All patients were women (mean age 43.8), with 49% reporting trauma and 57% practicing sports. Among the 37 patients, information on preoperative corticosteroid injections was missing for 2 patients. Of the remaining 35, 34 (97%) received at least one injection. Functional scores and pain improved significantly postoperatively. The Constant score increased from 55.3 to 73.27 (p < 0.001), the VAS decreased from 7.51 to 2.62 (p < 0.001), and the SSV rose from 46.75 to 74.73 (p < 0.001). Active elevation improved significantly from 128.38 degrees to 143.9 degrees (p = 0.013), while external and internal rotations showed no significant difference. Four cases of adhesive capsulitis were reported; three resolved with rehabilitation, while one patient retained stiffness in elevation at last follow-up.
    CONCLUSION: When conservative treatment fails, arthroscopic tenotomy is an effective surgical option for patients with painful shoulder and scapular dyskinesis due to pectoralis minor contracture. This study demonstrates significant improvement in functional scores, pain, and anterior elevation range, while external and internal rotations remain unchanged. However, randomized studies with longer follow-up are needed to confirm result durability.
    Keywords:  Arthroscopic tenotomy; Functional outcomes; Retraction; Scapular dyskinesis; Shoulder biomechanics; Shoulder pain
    DOI:  https://doi.org/10.1016/j.jse.2025.12.012
  14. IBRO Neurosci Rep. 2025 Dec;19 205-209
    Electrophysiological analysis of distal, proximal, and dual compression of the median nerve.
    Qiongfang Zhang, Yongfeng Liu, Jinhuan Zhang, Yirong Chen, Xingxian Huang, Haibo Yu.
       Objective: Both distal and proximal compression of the median nerve can lead to hand numbness inpatients.This study aimed to dissect the electrophysiological characteristics of median nerve motor fibers inpatients with carpal tunnel syndrome (CTS) caused by distal median nerve compression, C8 - T1 nerve root - type cervical spondylosis (CRS) resulting from proximal median nerve compression, and double - compression syndrome (DCS) with CTS combined with C8 - T1 CRS, so as to verify the double - nerve compression theory, provide evidence-based basis for clinical treatment.
    Methods: Retrospective analysis of 30 subjects per group (CTS, CRS, DCS, controls) from a neurophysiological database. Parameters included distal motor latency (DML1-wrist, DML2-elbow), compound muscle action potential (CMAP1, CMAP2), wrist-elbow motor conduction velocity (MCV), and F-wave latency.
    Results: For each indicator, both the CTS group and the DCS group showed statistically significant differences from the normal group. When comparing between the CTS group and the DCS group, there were no statistically significant differences in all data indicators. When comparing the CRS group with the normal group, there were no statistically significant differences in DML1 and DML2, but there were statistically significant differences in the shortest latency of the F wave and the motor conduction velocity (MCV).
    Conclusion: Double compression does not cause more severe damage to the nerve compared with simple distal compression. Distal compression of the median nerve causes more severe damage to the peripheral nerve than proximal compression. For patients with double compression syndrome, clinical treatment should prioritize the treatment of the distal compression site.
    Keywords:  Carpal tunnel syndrome; Cervical spondylosis with radiculopathy; Double compression syndrome; Electroneurophsiological; Median nerve motor branch
    DOI:  https://doi.org/10.1016/j.ibneur.2025.06.010
  15. Sports (Basel). 2026 Jan 16. pii: 43. [Epub ahead of print]14(1):
    The Effects of 24 Weeks Sensorimotor Training on Balance, Physical Function, and Pain in Women with Knee Osteoarthritis.
    Caterina Mauri, Charles James Steward, Attilio Parisi, Mathew Hill, Sara Severoni, Claudia Cerulli, Elisa Grazioli.
       BACKGROUND: Osteoarthritis (OA) is a common degenerative joint disease that often leads to impaired postural control, pain, and reduced physical function. Exercise is considered a first-line treatment, with sensorimotor training being an effective approach for managing OA. However, the optimal method of sensorimotor training for individuals with OA has not yet been established. Thus, the aim of this study was to compare the effects of a 24-week Gyrokinesis method (GK) versus Pilates (PL) intervention on balance control, function, pain and kinesiophobia in women with knee OA.
    METHODS: Twenty women (aged 60 ± 7 years) with grade 2 or 3 knee OA were assigned to either GK (n = 12) or PL (n = 8). Both groups trained twice weekly for 24 weeks. Pre- and post-intervention assessments included postural sway parameters (RMS, velocity, frequency), physical function tests (e.g., TUG, Sit-to-Stand), flexibility, pain (Brief Pain Inventory), kinesiophobia (Tampa Scale), and quality of life (SF-36).
    RESULTS: GK resulted in significantly greater improvements than PL in postural sway mean velocity AP right (GK -53.85% vs. PL -20.17%), AP left (GK -43.48% vs. PL +13.45%), and ML left (GK -40.18% vs. PL +37.95), pain reduction (GK -82.5% vs. PL -33.3%), and physical function (Sit-to-Stand: GK +75.9% vs. PL +3.7%; TUG: GK -16.4% vs. PL -13.8%; Step Test right: GK +34.2% vs. PL +19.9%; Step Test left: GK +41.4% vs. PL +18.1%) (all, p < 0.05). No significant between-group differences were observed for kinesiophobia or SF-36 scores (both, p > 0.05).
    CONCLUSIONS: Gyrokinesis method may be more effective than Pilates in enhancing balance, reducing pain, and improving physical function in women with knee OA. These findings support the use of the Gyrokinesis method in rehabilitation programs for individuals with OA.
    Keywords:  Rheumatic diseases; exercise; functional abilities; pain; postural sway; quality of life
    DOI:  https://doi.org/10.3390/sports14010043
  16. J Abdom Wall Surg. 2025 ;4 15394
    Narrative Review and Clinical Recommendations for Sportsman's Hernia and Athletic Pubalgia Based on 30 Years of Expert Experience.
    Moshe Dudai, Hannu Paajanen.
       Purpose: Sportsman's Hernia and Athletic Pubalgia (SH/AP) typically develop as a result of muscle imbalance and continuous sports-related microtrauma to the groin area. The injury progresses through two phases: initially, SH is localized in the groin soft tissues, while in the advanced stage, AP extends the injury to the pubic bone. Despite increasing clinical recognition of SH/AP, high-quality, large-scale studies remain limited. As a result, extensive clinical experience may help inform understanding and managing the different phases of the injury. This narrative review aims to stream the authors' expertise-based on approximately 30 years of hands-on experience in diagnosing, treating, and endoscopically managing SH/AP-into a scientific literature and real-world clinical practice.
    Methods: An extensive literature review was conducted to present the current knowledge of diagnostic tests, imaging, endoscopic surgery and rehabilitation treatment of SH/AP. Where appropriate, clinical observations drawn from over three decades of surgical experience with SH/AP patients are used to contextualize the evidence.
    Results: MRI is a primary imaging tool for suspected SH/AP, particularly in advanced cases or when nerve involvement is suspected but multiple imaging findings may also be present in asymptomatic athletes. Clinical history and physical examination remain crucial in making the diagnosis of SH/AP, guiding imaging decisions as auxiliary test. Surgical treatment of SH/AP is may be indicated after 2-3 months of failed conservative treatment. The totally extraperitoneal (TEP) without or with release of inguinal ligament (TEP-RRT) approaches have been described in the literature with favorable outcomes. Postoperative rehabilitation plays a critical role in functional recovery.
    Conclusion: Physical examination and endoscopic surgery remain most effective in SH/AP according literature and authors experience, followed by dedicated controlled athletics muscles rehabilitation program.
    Keywords:  TEP repair; athletic pubalgia; groin nerve entrapment; laparoscopic treatment; sportsman’s hernia
    DOI:  https://doi.org/10.3389/jaws.2025.15394
  17. J Cachexia Sarcopenia Muscle. 2026 Feb;17(1): e70199
    Pulsed Electromagnetic Field Therapy for Mild-to-Moderate Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial.
    Kenney Ki Lee Lau, Abbey Ssu Chi Chen, Christine Hoi Yan Fu, Jonathan Patrick Ng, Michael Tim Yun Ong, Patrick Shu Hang Yung, Pauline Po Yee Lui.
       BACKGROUND: Current treatments for knee osteoarthritis (OA) offer limited functional and structural improvements. Compared to age- and gender-matched controls, patients with knee OA show a higher prevalence of muscle weakness, which negatively affects their ability to exercise-a key factor in enhancing physical mobility and delaying disease progression. Pulsed electromagnetic field (PEMF) therapy shows promise in promoting myogenesis and chondrogenesis in pre-clinical studies. However, its effects on muscle strength and size, cartilage deterioration and overall physical function in knee OA patients remain unclear. This randomized placebo-controlled trial aimed to evaluate the impact of PEMF therapy on knee muscle power, lean muscle mass, femoral cartilage thickness, minimum joint space width (mJSW), lower limb physical functions and knee-specific patient-reported outcome (PRO) in patients with refractory mild-to-moderate knee OA.
    METHODS: Sixty refractory knee OA patients, aged 50 and older, with a pain score of 4 or higher were randomized to receive either PEMF or SHAM treatment for 30 min, 3 times a week over 8 weeks. Outcome measures, including muscle strength, lean muscle mass, cartilage thickness, mJSW, mobility and PRO were assessed at baseline, immediate post-intervention and 6- and 12-month post-intervention.
    RESULTS: Significant interactions were observed between PEMF therapy and time for both knee extension peak torque (p < 0.001) and knee flexion peak torque (p = 0.007). Post hoc analysis revealed that PEMF significantly increased extension peak torque compared to the SHAM group at 6-month post-intervention (p = 0.042). The PEMF group showed a 72% increase in knee extensor strength after 6 months from baseline, whereas the SHAM group only saw a 25% increase (p = 0.003). However, no significant difference in knee flexion peak torque was detected between the PEMF and SHAM treatments in the post hoc analysis. Nonetheless, the knee flexor strength in the PEMF group increased by 72% at 6 months from baseline, whereas the SHAM group showed only a 24% rise (p = 0.022). Additionally, there were no differences between the PEMF and SHAM groups in lean muscle mass, cartilage thickness, mJSW, the 6-m walk time and the number of repetitions of chair standing in 30 s and WOMAC (all p > 0.05).
    CONCLUSIONS: An 8-week course of PEMF therapy significantly improved the knee extension strength in refractory patients with mild to moderate knee OA at 6-month post-intervention, suggesting its potential to address extensor weakness in this high-risk population. However, it did not significantly enhance knee flexion strength, lean muscle mass, cartilage thickness, mJSW, lower limb physical functions or PRO up to 12-month post-intervention. Further research is needed to identify treatment regimens that may promote structural and functional outcomes in knee OA patients.
    TRIAL REGISTRATION: ClinicalTrials.gov: NCT05442697.
    Keywords:  degenerative knee arthritis; electromagnetic fields; knee arthroses; knee osteoarthritis; knee osteoarthrosis; pulsed electromagnetic field therapy
    DOI:  https://doi.org/10.1002/jcsm.70199
  18. Tomography. 2026 Jan 15. pii: 10. [Epub ahead of print]12(1):
    Rehabilitative Ultrasound Imaging as Visual Biofeedback in Pelvic Floor Dysfunction: A Narrative Review.
    Dana Sandra Daniel, Mila Goldenberg, Leonid Kalichman.
      Background: Pelvic floor dysfunction, more prevalent in women but affecting both genders, impairs sphincter control and sexual health, and causes pelvic pain. Pelvic floor muscle (PFM) training is the first-line treatment for urinary incontinence, supported by robust evidence. Rehabilitative ultrasound imaging (RUSI) serves as a visual biofeedback tool, providing real-time imaging to enhance PFM training, motor learning, and treatment adherence. Aim: This narrative review evaluates the role and efficacy of RUSI in pelvic floor rehabilitation. Method: A comprehensive search of PubMed, Cochrane, and MEDLINE was conducted using keywords related to pelvic floor rehabilitation, ultrasound, and biofeedback, limited to English-language publications up to July 2025. Systematic reviews, meta-analyses, and clinical trials were prioritized. Results: Transperineal and transabdominal ultrasound improve PFM function across diverse populations. In post-prostatectomy men, transperineal ultrasound-guided training enhanced PFM contraction and reduced urinary leakage. In postpartum women with pelvic girdle pain, transabdominal ultrasound-guided biofeedback combined with exercises decreased pain and improved function. Ultrasound-guided pelvic floor muscle contraction demonstrated superior performance compared to verbal instruction. Notably, 57% of participants who were unable to contract the pelvic floor muscles with verbal cues achieved a correct contraction with ultrasound biofeedback, and this approach also resulted in more sustained improvements in PFM strength. Compared to other biofeedback modalities, RUSI demonstrated outcomes that are comparable to or superior to those of alternative methods. However, evidence is limited by a lack of standardized protocols and randomized controlled trials comparing RUSI with other modalities. Conclusions: RUSI is an effective visual biofeedback tool that enhances outcomes of PFM training in pelvic floor rehabilitation. It supports clinical decision-making and patient engagement, particularly in cases where traditional assessments are challenging. Further research, including the development of standardized protocols and comparative trials, is necessary to optimize the clinical integration of this method and confirm its superiority over other biofeedback methods.
    Keywords:  pelvic floor dysfunction; pelvic floor muscle training; physical therapy; rehabilitative ultrasound imaging; visual biofeedback
    DOI:  https://doi.org/10.3390/tomography12010010
  19. BMC Surg. 2026 Jan 26.
    End-to-side anterior interosseous nerve transfer augmentation of ulnar nerve function in moderate and severe cubital tunnel syndrome; a randomised controlled trial protocol.
    Abdus S Burahee, Samuel George, Tahseen Chaudhry, Paul Malone, Suzanne Beale, Christopher McGhee, Liron S Duraku, J Michiel Zuidam, Dominic M Power.
       BACKGROUND: The anterior interosseous nerve (AIN) end-to-side (ETS) nerve transfer is a relatively recent treatment innovation in managing cubital tunnel syndrome (CuTS). Potential benefits must be balanced against the risks associated with the adoption of an innovative technique, evaluating procedure-specific risks, and considering additional costs in the safe delivery of care. The ETS technique has been proposed as a method of improving intrinsic muscle function in the hand in the setting of ulnar nerve compression at the elbow. The technique is controversial with emerging evidence from retrospective cohort and single-arm interventional studies to support its use. However, there is persisting uncertainty regarding the relative contributions of the decompression, collateral sprouting from intact terminal axons, and neo-innervation from the ETS transfer to any functional recovery. Given this lack of equipoise regarding the efficacy of ETS nerve transfers, a randomised controlled trial is proposed to assess recruitment, protocol compliance, subject retention, and define the sample size for a future multicentre study.
    METHODS: This randomised controlled trial (RCT) protocol defines a prospective, single centre study of 20 patients randomised to ulnar nerve decompression with or without ETS nerve transfer, with participant blinding to treatment allocation. Anticipated follow up period is up to 24 months.
    DISCUSSION: Data from this study will be used to calculate the sample size for a future multicentre RCT evaluating SETs transfer in CuTS. It would also inform on the willingness of clinicians to randomise their patient given the current uncertainty surrounding this technique and the retention rates anticipated. Should the RCT demonstrate significant functional benefits of combining ETS nerve transfer with decompression, it could shift clinical practice toward using this dual approach, especially in patients with moderate or severe ulnar neuropathy. The findings would likely influence treatment algorithms, optimising patient outcomes, and could also spur further studies into ETS applications in peripheral nerve injuries.
    PRIMARY TRIAL REGISTRY: ISRCTN ID Number: ISRCTN18379703, Date of Registration: 14th May 2024.
    Keywords:  Anterior interosseous nerve; Cubital tunnel syndrome; Nerve transfer; Randomised controlled trial.; Supercharge end to side (SETS); Ulnar nerve
    DOI:  https://doi.org/10.1186/s12893-025-03432-4
  20. Agri. 2026 Jan;38(1): 29-37
    Does central sensitization affect responses to genicular radiofrequency and intra-articular injection in elderly knee osteoarthritis patients?
    Ahmet Başarı, Ayşe Seda Eren Zeydoğlu.
       OBJECTIVES: This study aimed to evaluate the effect of central sensitization level on treatment response in individuals older than 65 years who underwent genicular nerve radiofrequency and intra-articular injection treatments for knee osteoarthritis (OA).
    METHODS: In this retrospective cohort study, 37 patients were divided into two groups according to the Central Sensitization Inventory (CSI) score (CSI<40 and CSI≥40). All patients underwent genicular nerve radiofrequency ablation and intra-articular injection. Pain (NRS), functionality (WOMAC), walking capacity (6MWT), sleep quality (PSQI), and satisfaction levels were evaluated at baseline and at 1 and 3 months following the procedure. Variance and regression analyses were used for statistical evaluation.
    RESULTS: Significant clinical improvements were observed in all patient groups for the evaluated parameters (p<0.001). However, variance analysis for pain (F=22.566, p<0.001), function (F=15.283, p<0.001), sleep quality (t=-3.87, p<0.001), and walking capacity (F=13.301, p=0.001) showed lower scores in the CSI≥40 group compared with the CSI<40 group. Regression analysis confirmed lower responses in CSI≥40 patients: pain (β=-2.1; 95% CI: -3.1 to -1.1; p<0.001), function (β=-4.6; 95% CI: -7.2 to -2.0; p=0.001), walking (β=-24.6; 95% CI: -40.7 to -2.8; p=0.026), and sleep (β=-1.9; 95% CI: -2.9 to -0.9; p=0.001).
    CONCLUSION: The presence of central sensitization significantly limits the clinical response to genicular radiofrequency ablation and intra-articular injection treatments in older patients with OA. Routine use of screening tools such as CSI in treatment planning may guide more effective and personalized approaches.
    DOI:  https://doi.org/10.14744/agri.2025.54679
  21. J Clin Med. 2026 Jan 07. pii: 471. [Epub ahead of print]15(2):
    Radial Extracorporeal Shock Wave Therapy Versus Multimodal Physical Therapy in Non-Traumatic (Degenerative) Rotator Cuff Tendinopathy with Partial Supraspinatus Tear: A Randomized Controlled Trial.
    Zheng Wang, Lan Tang, Ni Wang, Lihua Huang, Christoph Schmitz, Jun Zhou, Yingjie Zhao, Kang Chen, Yanhong Ma.
      Background/Objectives: Non-traumatic (degenerative) rotator cuff tendinopathy with partial supraspinatus tear (NT-RCTT) is a common source of shoulder pain and disability. Comparative evidence between radial extracorporeal shock wave therapy (rESWT) and multimodal physical therapy modalities (PTMs) remains scarce. Methods: In this single-center randomized controlled trial, 60 adults with MRI-confirmed NT-RCTT were assigned (1:1) to rESWT (one session weekly for six weeks; 2000 impulses per session, 2 bar air pressure, positive energy flux density 0.08 mJ/mm2; 8 impulses per second) or a multimodal PTM program (interferential current, shortwave diathermy and magnetothermal therapy; five sessions weekly for six weeks). All participants performed standardized home exercises. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) total score; secondary outcomes included pain (visual analog scale, VAS), satisfaction, range of motion (ROM), supraspinatus tendon (ST) thickness and acromiohumeral distance (AHD). Assessments were conducted at baseline, and at week 6 (W6) and week 12 (W12) post-baseline. Results: Both interventions significantly improved all outcomes, but rESWT produced greater and faster effects. Mean ASES total scores increased by 31 ± 5 points with rESWT versus 26 ± 6 with PTMs (p < 0.05). VAS pain decreased from 5.2 ± 0.7 to 1.0 ± 0.7 with rESWT and from 5.2 ± 0.8 to 1.7 ± 0.8 with PTMs (p < 0.01). rESWT achieved higher satisfaction and larger gains in abduction, flexion and external rotation. Ultrasound showed reduced ST thickness and increased AHD after rESWT but not after PTMs. No serious adverse events occurred. Conclusions: rESWT yielded superior pain relief, functional recovery and tendon remodeling compared with a multimodal PTM program, with markedly lower treatment time and excellent tolerability.
    Keywords:  partial supraspinatus tear; physical therapy modalities; rESWT; radial extracorporeal shock wave therapy; randomized controlled trial; rehabilitation; rotator cuff tendinopathy; shoulder pain; supraspinatus tendon
    DOI:  https://doi.org/10.3390/jcm15020471
  22. BMC Musculoskelet Disord. 2026 Jan 26.
    Isolated pectoralis minor tear at the costal origin: a case-based review of the literature.
    Nezih Ziroglu, Ali Can Koluman.
       BACKGROUND: Isolated tears of the pectoralis minor (PMi) are rare and often misdiagnosed as pectoralis major or costochondral injuries. Since the first report in 2004, only eleven cases have been described in the English-language literature, all involving the myotendinous junction or coracoid insertion. A tear at the costal origin has not previously been reported.
    CASE PRESENTATION: A 46-year-old male developed acute anterior chest pain after pulling a heavy hospital bed. Physical examination revealed focal tenderness over the third to fifth ribs and pain with resisted internal rotation. Magnetic resonance imaging demonstrated a partial tear of the pectoralis minor at its costal origin with associated rib bone marrow edema, while the coracoid insertion and pectoralis major were intact. The patient was treated nonoperatively with analgesics and a structured physiotherapy program emphasizing scapular stabilization, resulting in complete symptom resolution within six weeks.
    LITERATURE REVIEW: A structured search of PubMed and Scopus identified eleven previously reported cases of isolated PMi tear published between 2004 and 2021. Most injuries occurred in contact or overhead athletes and involved the myotendinous or insertional region. All cases were managed conservatively with favorable clinical outcomes.
    CONCLUSION: This case represents the first documented costal origin tear of the pectoralis minor, associated with rib bone marrow edema following a low-energy, non-sporting mechanism. The findings expand the anatomical spectrum of PMi injuries and highlight the importance of considering this diagnosis in patients with anterior chest wall pain and an intact pectoralis major. MRI is essential for accurate localization of the lesion and exclusion of concomitant injury. Conservative management remains an effective treatment strategy.
    Keywords:  Anterior chest wall pain; Case report; Costal origin; MRI; Muscle tear; Pectoralis minor; Scapular stabilizers
    DOI:  https://doi.org/10.1186/s12891-025-09454-6
  23. MethodsX. 2026 Jun;16 103781
    Rebuilding life after heart valve surgery: The VALCAR(E)_QoL study on rehabilitation and quality of life.
    Piergiuseppe Liuzzi, Camilla Elena Magi, Paolo Iovino, Ercole Vellone, Andrea Mannini, Claudio Macchi, Biagio Nicolosi, Mariachiara Figura, Francesco Limonti, Duccio Frangi, Hamilton Dollaku.
      The VALCAR(E)_QoL study is a prospective, mixed-methods observational investigation designed to characterize the rehabilitation process and determinants of health-related quality of life in patients undergoing cardiac valve surgery. Conducted at the IRCCS Fondazione Don Carlo Gnocchi in Florence (Italy), the study integrates quantitative and qualitative approaches to capture the multidimensional nature of recovery within the International Classification of Functioning, Disability and Health (ICF) framework. Consecutive patients admitted for inpatient cardiac rehabilitation after valve surgery will be assessed at four time points: pre-surgery (T0), rehabilitation admission (T1), discharge (T2), and six-month follow-up (T3). Data collection includes clinical, functional, and psychosocial indicators, as well as patient-reported outcomes such as the Kansas City Cardiomyopathy Questionnaire (primary outcome), SF-12 Health Survey, and standardized measures of anxiety, depression, stress, self-care, and sleep quality. Qualitative interviews at discharge complement quantitative findings by exploring patients' emotional experiences, perceived barriers, and facilitators of recovery. All data are collected in pseudonymized form through a secure REDCap database and analyzed using multivariate and thematic techniques. This protocol adheres to the STROBE guidelines to ensure methodological transparency and reproducibility. By integrating objective measures and subjective experiences, the VALCAR(E)_QoL study aims to identify clinical and psychosocial predictors of successful rehabilitation and to provide evidence for patient-centered, multidisciplinary models of post-surgical care for individuals recovering from heart valve surgery.
    Keywords:  Cardiac rehabilitation; Functional capacity; Health-related quality of life; International Classification of Functioning, Disability and Health (ICF); Patient-reported outcomes; Post-surgical recovery; Predictors of rehabilitation outcomes; Psychosocial recovery; Self-care and self-efficacy
    DOI:  https://doi.org/10.1016/j.mex.2025.103781
  24. Pain Pract. 2026 Feb;26(2): e70118
    Correction to "New Zealand Survey of the Diagnosis and Treatment Experiences of People With Upper Limb Complex Regional Pain Syndrome".
      
    DOI:  https://doi.org/10.1111/papr.70118
  25. Cureus. 2025 Dec;17(12): e100235
    Outcomes of Non-operatively Managed Achilles Tendon Rupture: A Retrospective, Single-Centre Study.
    Adam Daneshyar, Sajid Ali, Mohanraj Venkatesan, Omar Mostafa, Anam Jawaid, Qutub Qadri, Kowshik Jain.
      Introduction Achilles tendon ruptures can be managed surgically or conservatively. Due to the increased risk of post-operative complications, non-surgical management is often preferred. Evidence suggests that non-operative approaches can achieve outcomes comparable to surgical repair. One such approach is the Leicester Achilles Management Protocol (LAMP), which involves immobilisation in a VACOped boot for eight weeks. Patient outcomes following non-operative management are commonly assessed using the Achilles Tendon Total Rupture Score (ATRS). In this retrospective study, it is hypothesised that patients managed with the LAMP protocol will report favourable outcomes as measured by the ATRS. Methodology This retrospective cohort study analysed patients who presented and were managed for Achilles tendon rupture at a district general hospital in the West Midlands, UK, between January 2022 and October 2024. Patients aged 18 years and above with confirmed Achilles tendon injuries (International Classification of Diseases, Tenth Revision (ICD-10) code: S86.0), managed through fracture or elective clinics, were included in the analysis. Data obtained from electronic health records included demographics, comorbidities, management duration, time to rehabilitation, and patient-reported outcomes using the ATRS. ATRS data were collected via telephone interviews conducted by local clinicians and analysed descriptively using frequencies, means, and ranges. Results A total of 53 patients were initially screened for inclusion. Eight patients were excluded following clinic reassessment due to misdiagnosis (no rupture or posterior tibial rupture) or death. Of the remaining 45 patients contacted by telephone, 16 did not respond after two attempts, and one declined participation. The final study cohort comprised 28 patients. The analysis showed that patients were mainly male, with an average age of 52.1 years (range: 29-82). Patient-reported outcome measures showed the mean ATRS was 67.1 (range: 26-100), reflecting a wide variation in self-reported recovery. Conclusion Despite a lower ATRS compared to previous studies with non-operative management, this retrospective study showed that LAMP provides satisfactory functional recovery whilst avoiding operative and post-operative complications.
    Keywords:  achilles rupture; achilles tendon; achilles tendon (at); achilles tendon injury; achilles tendon rehabilitation; conservative management of achilles tendon
    DOI:  https://doi.org/10.7759/cureus.100235
  26. Diagnostics (Basel). 2026 Jan 17. pii: 303. [Epub ahead of print]16(2):
    Thickening of Dorsal Foot Nerves: A Frequent Sonographic Finding in Asymptomatic Volunteers, Potentially Leading to False Positive Results.
    Veronika Vetchy, Tobias Rossmann, Paata Pruidze, Wolfgang Grisold, Wolfgang J Weninger, Stefan Meng.
      Objectives: Compression neuropathies such as Anterior Tarsal Tunnel Syndrome are usually associated with focal thickening at the compression site. This study aimed to determine the frequency and location of thickenings of dorsal foot nerves in asymptomatic, healthy volunteers. We hypothesized that focal nerve thickening of dorsal foot nerves is a frequent finding in asymptomatic individuals and occurs at anatomically plausible locations, potentially limiting the specificity of ultrasound in the diagnosis of anterior tarsal tunnel syndrome. Materials and Methods: In this prospective study, the nerves at the dorsal foot were examined with ultrasound in 60 volunteers without clinical signs of neuropathy. Cross-sectional area (CSA) changes along the nerve course were assessed, their anatomical location recorded, and demographic data collected. Results: Focal deep peroneal nerve (DPN) thickening was observed in 45% of participants, with a median CSA of 2.14 mm2 (range: 0.84-5.16) and median length of 3.98 mm (range: 1.46-9.95). The most frequent site was the first tarsometatarsal joint (41%). Thickening occurred across all age groups. Superficial peroneal nerve (SPN) thickening was found in 13.3% of participants, primarily affecting the intermediate branch, with a median CSA of 1.82 mm2 and length of 3.02 mm. No thickening was observed in the sural nerve (SN). A strong correlation was found between CSA and length of DPN thickening (r = 0.67, p < 0.001). Conclusions: Asymptomatic, focal thickening of dorsal foot nerves, particularly the DPN, is a frequent sonographic finding in healthy volunteers. These findings highlight the potential for false-positive ultrasound results and the necessity of correlating imaging findings with clinical examination when evaluating for anterior tarsal tunnel syndrome and similar neuropathies.
    Keywords:  anterior tarsal tunnel syndrome; asymptomatic thickening; deep peroneal nerve; nerve thickening; nerve ultrasound
    DOI:  https://doi.org/10.3390/diagnostics16020303
  27. Video J Sports Med. 2026 Jan-Feb;6(1):6(1): 26350254251359672
    Top 10 Technical Tips and Tricks for Safe Sciatic Nerve Management During Posterior Hip Endoscopy.
    Andrew S Bi, Jesus E Cervantes, Eric Y Hu, Shane J Nho.
       Background: A thorough understanding of posterior hip anatomy is essential for safe and effective posterior hip endoscopy. The sciatic nerve runs laterally to the ischium and hamstring origin. While sciatic nerve injury during proximal hamstring repair is uncommon, the increasing use of endoscopic techniques has led to a rise in iatrogenic injuries. This highlights the need for a structured approach to identifying and protecting the sciatic nerve.
    Indications: Surgical intervention is indicated for complete proximal avulsions involving all 3 hamstring tendons, partial avulsions involving ≥2 tendons and >2 cm of retraction, and partial avulsions that fail to improve after 6 months of conservative management.
    Technique Description: There are various safeguards to safely manage the sciatic nerve during posterior hip endoscopy. Proper patient positioning and portal creation are essential steps to minimize sciatic nerve risk. Utilization of prone positioning with strategic padding allows slight hip extension, knee flexion, and hip abduction. In turn, this will relax the nerve and increase the ischiofemoral space. Creation of the subgluteal space is critical, with meticulous resection of the subgluteal bursa to expose the proximal hamstring tendon and surrounding anatomy. A fascial veil consistently separates the tendon from the sciatic nerve and can be partially resected for nerve visualization. Tear exposure is achieved through a longitudinal split between the semimembranosus and conjoint tendon, which also serves as access for ischioplasty. The remaining tendon provides natural protection, while fluoroscopy guides safe bony resection and helps assess ischial width.
    Results: Endoscopic proximal hamstring repair is an effective approach leading to significant improvement in pain and function. Among endoscopic hamstring repairs, complications-such as persistent peri-incisional numbness and postoperative neuropathy-have each been reported in approximately 8% of cases. This highlights the importance of proper sciatic protection.
    Discussion/Conclusion: Endoscopic proximal hamstring repair and ischioplasty serve as effective, minimally invasive options for proximal hamstring pathology with careful attention to sciatic nerve safety. A thorough understanding of posterior hip anatomy, strategic patient positioning, precise portal placement, and deliberate dissection techniques is critical for minimizing iatrogenic nerve injury.
    Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
    Keywords:  endoscopy; ischioplasty; nerve protection; proximal hamstring repair; sciatic nerve
    DOI:  https://doi.org/10.1177/26350254251359672
  28. Toxins (Basel). 2026 Jan 06. pii: 28. [Epub ahead of print]18(1):
    Central and Peripheral Sensitization in Temporomandibular Disorders: Proposed Mechanisms of Botulinum Toxin Therapy.
    Basit Ali Chaudhry, Christopher L Robinson, Edoardo Caronna, Freda Dodd-Glover, Amrittej Singh Virk, Mario Fernando Prieto Peres, Hope L O'Brien, Marcela Romero-Reyes, Sait Ashina.
      Temporomandibular disorders (TMDs) are common musculoskeletal chronic orofacial pain conditions involving peripheral and central sensitization within trigeminal nociceptive pathways, manifesting as mechanical allodynia and functional impairment. Botulinum toxin type A (BoNT-A) has been explored as a treatment targeting both muscle hyperactivity and nociceptive modulation. Preclinical and clinical evidence demonstrate that BoNT-A reduces peripheral neurotransmitter release, neurogenic inflammation, and central neuronal excitability, leading to attenuation of mechanical allodynia in TMD models and patients. Clinical trials show modest and variable analgesic effects, with patients displaying sensory sensitization appearing to respond more favorably, though methodological heterogeneity limits definitive conclusions. Safety concerns related to muscle weakening, changes in bone density, and structural changes underscore the need for standardized protocols optimizing dosing and monitoring, in addition to prospective studies. These findings suggest that BoNT-A may serve as an adjunctive, mechanism-based therapy within multimodal TMD management. Future research should focus on standardized sensory phenotyping and trial design to clarify BoNT-A's role in modulating central sensitization and improving patient outcomes.
    Keywords:  BoNT-A; TMD; allodynia; botulinum toxin therapy; central sensitization; temporomandibular disorders; trigeminal nociceptive system
    DOI:  https://doi.org/10.3390/toxins18010028
  29. Rambam Maimonides Med J. 2026 Jan 28. 17(1):
    Bringing Rehabilitation Home: A Policy and Practice Perspective on COPD Management.
    Abins Thozhuthinkal Kasim, Ravi Gaur, Nitesh Manohar Gonnade, Nagma Sheenam.
      
    DOI:  https://doi.org/10.5041/RMMJ.10567
  30. Front Surg. 2025 ;12 1737191
    Suprascapular nerve entrapment syndrome caused by a spinoglenoid notch cyst with a concomitant giant lipoma: a case report.
    Zaichao Ma, Mengxue Guan, Maimaitiyibubaji Abudukadier, Xiaoping Han, Tao Huang, Zengqiang Yang, Biao Li, Yong Cui.
       Background: Suprascapular nerve entrapment is a cause of shoulder pain and dysfunction, often complicated by symptomatic overlap with other shoulder pathologies. Entrapment most commonly occurs at two anatomical constrictions: the suprascapular notch and the spinoglenoid notch. Compression of the nerve's inferior branch at the spinoglenoid notch by a paralabral cyst, leading to isolated infraspinatus weakness and atrophy, is a relatively common pattern. Diagnosis relies on a detailed physical examination, multimodal imaging evaluation including MRI and ultrasound, and confirmation by electromyography. For patients who do not respond to conservative management or who have definitive space-occupying compression, surgical decompression is an effective treatment option.
    Case presentation: This is the case of a 27-year-old man presenting with progressive right shoulder weakness and pain over just one month, already demonstrating isolated infraspinatus atrophy. Imaging revealed the etiology to be a paralabral cyst that, notably, occupied both the suprascapular and spinoglenoid notches, creating a "double-crush" compression on the suprascapular nerve. This case clearly illustrates how a strategically located space-occupying lesion can lead to rapid and characteristic neurologic deficit, even within a short clinical course.
    Conclusion: This case clearly illustrates the classic presentation of an isolated spinoglenoid notch cyst causing suprascapular nerve compression, underscoring that this diagnosis must be considered in patients with isolated external rotation weakness even without a clear traumatic etiology, and highlighting that early recognition and systematic evaluation are key to successful management and neurological recovery.
    Keywords:  cyst; fatty lump; nerve; spinoglenoid notch; suprascapular nerve entrapment
    DOI:  https://doi.org/10.3389/fsurg.2025.1737191
  31. Cureus. 2025 Dec;17(12): e100032
    Boutonniere Deformity of the Proximal Interphalangeal Joint in a Young, Active Female Patient: A Nonstandard Surgical Procedure.
    Jakub Florek, Oles Petrovych, Filip Georgiew, Patryk Kawa, Sebastian Janowiec.
      One of the key elements of post-traumatic osteoarthritis treatment is not only pain relief but also the return of joint function close to pre-injury levels. This is particularly important for young and physically active individuals. Unfortunately, the ability to return to satisfactory proximal intraphalangeal joint mobility after surgical treatment is often limited. This article describes the treatment of a young, active female patient who, several years ago, suffered a proximal interphalangeal (PIP) joint injury in her fifth finger following a fall from a height. Initially, the patient was treated at another hospital using open reduction internal fixation and stabilization with two Kirschner wires. A complication of this treatment was a "boutonniere" finger deformity with stiffening of the phalanx in the position of flexion contracture of 80° and the presence of finger pain with a numerical rating scale (NRS) score of 6. X-ray examination revealed initial degenerative changes in the joint surface of the proximal phalanx. The patient was classified for joint replacement using a cementless CapFlex hemiarthroplasty. A follow-up examination was performed after six months, which revealed an unsatisfactory clinical outcome because the total range of motion was 10° (extension deficit: 80°; flexion range: 90°) and the boutonniere deformity was still present. Pain intensity was 0 on the NRS scale. Due to the patient's active lifestyle, a joint decision was made to qualify the patient for revision surgery using a 3S ORTHO semiconstrained prosthesis. A follow-up examination performed eight weeks after the surgery showed correction of the butenoid deformity, improvement of the flexion range of motion to 50°, with limitation of the active extension movement (extension deficit reached 15°). Pain intensity was rated 0 on the NRS scale. After the follow-up examination, the patient was referred for additional specialized physiotherapy treatments, including post-isometric muscle relaxation, manipulation exercises, and whirlpool massage, to further improve the range of motion and dexterity of the treated hand. Additional physiotherapy treatments resulted in further improvement in range of motion and functional efficiency. Arthroplasty of the PIP joint using a cementless CapFlex hemiarthroplasty corrected the boutonniere deformity. At follow-up, a significant degree of flexion contracture developed. Revision surgery involving implantation of a 3S ORTHO prosthesis improved the flexion range of motion. The extension range of motion did not return to normal. According to the patient, the regained hand function met her expectations and allowed her to return to her previously performed activities. These results reflect the early follow-up period.
    Keywords:  boutonniere; deformity; degenerative disease; flexion contracture; hand; pip; proximal interphalangeal joint; surgical treatment
    DOI:  https://doi.org/10.7759/cureus.100032
  32. Cochrane Database Syst Rev. 2026 Jan 30. 1 CD016226
    Anabolic medications for rehabilitation after hip fracture in older people.
    Christopher Deacon, Christopher Busby, Katie E Rollins, Ian Cameron, Paul Greenhaff, Benjamin J Ollivere.
       OBJECTIVES: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the relative benefits and harms of anabolic medications after hip fracture in older people.
    DOI:  https://doi.org/10.1002/14651858.CD016226
  33. Skeletal Radiol. 2026 Jan 24.
    Sports injury: biomechanical approach to interpretation of knee MRI.
    Ronald W Mercer, Zachary E Stewart, F Joseph Simeone, J Rafael Terneira Vicentini, Rene Balza, William E Palmer.
      Sports-related knee injuries are common and clinically consequential. Interpreting MR imaging through a biomechanical lens links injury patterns to the forces that produced them, improving the detection of subtle but prognostically important lesions. Characteristic osseous findings-contusions, subchondral/osteochondral fractures, and avulsions-act as "maps" of force vectors that distinguish compression from distraction mechanisms. In anterior cruciate ligament (ACL) trauma, bone bruise locations have kinematic associations (i.e., valgus-flexion-external rotation vs varus-flexion-internal rotation) and enable a targeted search for injuries involving functionally related structures, such as the menisci. The medial meniscus functions as a secondary stabilizer to anterior tibial translation. Therefore, peripheral vertical longitudinal tears and meniscocapsular ramp lesions are frequent companions of ACL rupture and may be overlooked without a mechanism-based approach. The lateral meniscus is vulnerable to radial/posterior root and peripheral capsular injuries during translational and compressive loading of the lateral compartment. Posterolateral corner structures resist varus and external rotation forces; unrecognized PLC injury compromises cruciate reconstruction and perpetuates rotatory instability. This review synthesizes biomechanical principles to provide a practical, pathophysiological framework for MRI interpretation and reporting. Applying this approach enhances diagnostic accuracy, guides surgical decision-making, and supports better outcomes for athletes with acute knee trauma. KEY POINTS: • Biomechanical principles provide a systematic framework for interpreting knee MRI after sports trauma, improving diagnostic accuracy and detection of subtle lesions. • Characteristic injury patterns on MRI often reveal the underlying traumatic mechanism, directing targeted evaluation of osseous structures, ligaments, tendons, and menisci. • Subtle injuries such as Segond fracture, ramp lesion, or posterolateral corner disruption may be overlooked without a mechanism-based interpretive approach.
    Keywords:  ACL; Biomechanics; Instability; Knee Injury; MRI; Mechanism
    DOI:  https://doi.org/10.1007/s00256-026-05126-1
  34. Front Surg. 2025 ;12 1710878
    Case Report: Prosthetic revision due to aseptic loosening following total knee arthroplasty: a clinical management and pathological mechanism investigation.
    Jun Li, He Shang, Tao Ma, Tianxiang Yang, Yi Wang, Xueqi Liu, Xing He, Yumei Ding, Jinpeng Liang, Yinbin Wang, Desheng Chen.
       Background: Total joint arthroplasty is an effective treatment for end-stage joint diseases, with approximately 1.5 million procedures performed globally annually and a 25%-30% annual growth rate in China. However, 10%-15% of patients develop prosthetic loosening or subsidence within 15-20 years postoperatively, predominantly due to aseptic loosening (incidence >10%) caused by wear particle-induced aseptic inflammatory osteolysis. The role of autophagy in this pathogenesis remains incompletely understood.
    Methods: A 61-year-old female patient developed aseptic loosening 11 months after left total knee arthroplasty. Comprehensive management included preoperative screening (including synovial cell count, differential, and alpha-defensin detection), revision surgery (debridement of necrotic/inflammatory tissue/residual cement and implantation of a new prosthesis with vancomycin-impregnated cement), synovial HE staining, quantitative immunohistochemistry (IHC; Ki67, CD3, CD20, CD68, P62, LC3II, and Beclin1), and postoperative rehabilitation.
    Results: Postoperatively, pain was relieved: the patient ambulated with crutches at 3 days, achieved 90° knee flexion at 1 week, and full pain-free weight-bearing (110° flexion) at 2 months. Postoperative infection markers (C-reactive protein and erythrocyte sedimentation rate) were temporarily elevated due to surgical trauma and returned to normal during follow-up. Imaging showed a stable prosthesis without infection or recurrent loosening. Synovial HE staining revealed extensive inflammatory infiltration; quantitative IHC showed high expression of inflammatory markers and low expression of autophagy-related markers. Clinical outcomes were favorable with validated patient-reported outcome measures (Knee injury and Osteoarthritis Outcome Score: 85 points; Western Ontario and McMaster Universities Osteoarthritis Index score: 20 points) at 6 months post-revision.
    Conclusion: The integrated protocol effectively treated aseptic loosening. Wear particle-induced chronic synovitis and altered autophagy-related marker expression may be involved in the pathogenesis, providing preliminary clinical and pathological evidence for further research.
    Keywords:  aseptic loosening; autophagy dysregulation; immunohistochemistry; synovial inflammation; total knee arthroplasty revision
    DOI:  https://doi.org/10.3389/fsurg.2025.1710878
  35. Front Physiol. 2025 ;16 1737373
    Meta-analysis of comparative effects of mobile app-based digital rehabilitation versus traditional rehabilitation after total knee arthroplasty.
    Liang Ma, Jia-Qiang Liu, Kun Yu, Mei-Yun Tan.
       Objective: The purpose of this study is to compare the effect of digital rehabilitation based on mobile app and traditional rehabilitation program after total knee arthroplasty.
    Methods: The following electronic databases were systematically searched to identify eligible trials: PubMed, EMBASE, Web of Science, the Cochrane Library, Scopus, and CINAHL. The searches were conducted from database inception to 1 December 2025. According to the inclusion and exclusion criteria, literature screening, data extraction and evaluation of its methodological quality were carried out. RevMan5.4 software was used to conduct heterogeneity test and meta-analysis of the included studies, and Cochrane systematic review tool was used to evaluate the literature publication bias. The main outcomes were visual analogue scale (VAS) of pain, "standing walking" timing test, knee function score (KSS), knee range of motion (ROM), and 10-m Walk Test.
    Results: This meta-analysis included 8 studies involving a total of 694 patients. Compared with traditional rehabilitation, the app-based group showed significantly lower pain scores, as assessed by the Visual Analogue Scale (VAS), with a positive mean difference favoring the app-based group (MD = 1.03, 95% CI 0.30 to 1.75; I2 = 0%; P = 0.006). Performance-based functional outcomes favored the app-based group, with significant improvements observed in the Timed Up and Go test (MD = -1.75, 95% CI -2.55 to -0.94; I2 = 19%; P < 0.0001) and the 10-m Walk Test (SMD = 0.47, 95% CI 0.05 to 0.88; I2 = 0%; P = 0.03). Knee range of motion (ROM) was also significantly greater in the app-based rehabilitation group (MD = 6.46°, 95% CI 2.92 to 10.00; I2 = 53%; P = 0.0004). No significant difference was observed in the Knee Society Score (KSS) between groups (P > 0.05). The overall risk of bias among the included studies was moderate, primarily due to unclear allocation concealment and lack of blinding.
    Conclusion: Compared with traditional rehabilitation, mobile app-based digital rehabilitation after total knee arthroplasty was associated with improved pain relief and better performance-based functional outcomes, as well as greater early gains in knee range of motion. No significant difference was observed in composite knee function scores. Given the low to moderate certainty of evidence, app-based rehabilitation may be considered as an adjunct or alternative rehabilitation strategy for selected patients, while further high-quality randomized controlled trials are needed to confirm long-term effectiveness.
    Keywords:  digital rehabilitation; meta-analysis; mobile apps; total knee arthroplasty; traditional rehabilitation
    DOI:  https://doi.org/10.3389/fphys.2025.1737373
  36. Agri. 2026 Jan;38(1): 1-10
    Comparison of ultrasound- and fluoroscopy-guided intra-articular corticosteroid injections for hip osteoarthritis.
    Yılmaz Karaduman, Arzu Muz, Emine Yüksel, Seydi Gündoğan, İsmail Eren Durmuş, Suna Akın Takmaz.
       OBJECTIVES: This study aimed to evaluate the effectiveness of ultrasound (US)-guided and fluoroscopy (FL)-guided intra-articular steroid injections on pain and hip function. The study focused on patients with hip osteoarthritis (coxarthrosis) who were refractory to medical treatment.
    METHODS: In this retrospective study, 61 patients with stage ≥2 coxarthrosis and VAS ≥4 were evaluated. Patients received either US-guided (Group U) or FL-guided (Group F) corticosteroid injections. Visual analog scale (VAS), Harris Hip Score (HHS), and analgesic use were assessed at 1 week and at 1, 3, and 6 months post-treatment. Analgesic use was evaluated based on the number of days with analgesic consumption and was interpreted as increased, decreased, or unchanged compared to baseline.
    RESULTS: Both treatment methods provided significant improvements in VAS and HHS scores at all follow-up points across osteoarthritis stages (p<0.05). However, no statistically significant difference was found between the groups in terms of pain scores, functional outcomes, or analgesic use. While marked improvements were observed in stage 2 patients, the clinical effectiveness of the injections decreased as the disease stage progressed.
    CONCLUSION: Both US-guided and FL-guided steroid injections resulted in significant pain reduction and improved functionality in patients with osteoarthritis. No clear superiority was observed between the two techniques. Treatment was most effective in patients at earlier stages of the disease, with efficacy declining as the disease advanced. Additionally, US is a safer imaging modality compared to FL, as it does not involve exposure to ionizing radiation.
    DOI:  https://doi.org/10.14744/agri.2025.58966
  37. J Orthop Surg (Hong Kong). 2026 Jan-Apr;34(1):34(1): 10225536261421345
    Morphology of the scapholunate joint, lunate, and capitate in dorsal wrist ganglion: An MRI case-control study.
    Zeynel Mert Asfuroğlu, Ahmet Ülker, İdris Demirtaş, Atilla Arık.
      BackgroundDorsal wrist ganglia (DWGs) are common, yet the contribution of carpal morphology to their formation is underexplored. We investigated whether scapholunate joint, lunate, and capitate morphology differ between DWG wrists and controls.MethodsRetrospective MRI case-control study of adults aged 18-60 years, comprising 70 DWG wrists and 70 controls. Categorical variables were lunate type (medial hamatolunate facet present or absent), scapholunate joint morphology (parallel, inverted-Y, point-like parallel), and capitate head shape (flat, round, V-shaped). Quantitative measures included capitate-triquetral distance, mid-joint scapholunate gap, and medial hamatolunate facet length, recorded only when a facet was present.ResultsInterobserver agreement was generally good across both categorical and quantitative measures (categorical κ range: 0.50-0.88; quantitative ICC range: 0.72-0.95). Capitate morphology differed between groups: round heads were more frequent in DWG (71.4%) than in controls (44.3%) (p < 0.05). The scapholunate gap was larger in DWG (mean 1.8 mm) than in controls (1.5 mm) (p < 0.05). No between-group differences were observed for lunate type (Type II: 51.4% vs 38.6%; p = 0.107), scapholunate joint type (p = 0.787), capitate-triquetral distance (p = 0.223), or medial hamatolunate facet length (p = 0.395).ConclusionDWG wrists more often exhibit a round capitate head and a larger scapholunate gap than matched controls, whereas lunate type, scapholunate joint configuration, capitate-triquetral distance, and medial hamatolunate facet length are similar. Capitate head shape may be associated with DWG; however, given the lower agreement for this parameter, this finding should be considered exploratory and requires further validation before any recommendation for routine reporting can be made. The scapholunate gap can be considered supportive context alongside clinical findings. Prospective multicenter studies with multiplanar/loaded MRI or arthroscopic correlation are warranted.
    Keywords:  MRI; capitate morphology; dorsal wrist ganglion; lunate type; scapholunate joint; wrist
    DOI:  https://doi.org/10.1177/10225536261421345
  38. Hand (N Y). 2026 Jan 25. 15589447251411545
    Enhancing Carpal Tunnel Syndrome Diagnosis: The Combined Use of CTS-6 and Ultrasound Measured Median Nerve CSA.
    Rachel Hyzny, Stacia Ruse, Michael Niemann, Christopher Gonzalez, Jenna Dvorsky, John Fowler.
       BACKGROUND: While clinical examination for carpal tunnel syndrome (CTS) is the first-line diagnostic method, its accuracy can vary, particularly among clinicians without specialized training. The CTS-6 questionnaire and ultrasound measurement of the median nerve's cross-sectional area (CSA) are two widely studied diagnostic methods. Combining these tools may provide a more reliable and standardized approach to CTS diagnosis.
    METHODS: A review was conducted of patients aged 18 years or older screened for CTS from June 2023 to Sept 2023. We combined scores using the formula (CTS-6 score + 2 × CSA) based on a previous study by Kimura et al. We then used the Index of Union and positive likelihood ratio (PLR) to analyze the optimal cutoff values for the combined score.
    RESULTS: A total of 142 hands were analyzed. The combined score had the highest sensitivity, while the CTS-6 alone had the highest specificity. The accuracy of the combined score with a cutoff value of 31.25 was equal to that of the CTS-6 score alone. Per the Index of Union, the optimized cutoff for the combined score was 27.68. Maximizing the PLR, the combined score cutoff was found to be 34.08.
    CONCLUSIONS: Combining the CTS-6 and median nerve CSA offers the most accurate method for diagnosing CTS. A lower cutoff value (27.68 vs. 31.25) improved the sensitivity of the combined score, demonstrating a strong diagnostic performance for CTS as a screening tool. Alternatively, using the PLR-optimized cutoff (34.08), this becomes a highly specific confirmatory test.
    Keywords:  anatomy; basic science; diagnosis; evaluation; hand; nerve; nerve compression; research & health outcomes; specialty; surgery
    DOI:  https://doi.org/10.1177/15589447251411545
  39. Cureus. 2025 Dec;17(12): e100246
    Irreducible Anterior Shoulder Dislocation Caused by Soft Tissue Interposition: A Comprehensive Review.
    Ahmed Mohamed, Nabil Elmaleh, Usman Fuad, Adham Elsayed, Ahmed Genena, Marwa Harb, Jumanah Darwish, Ahmed Nagi.
      Anterior shoulder dislocation is the most common type of joint dislocation encountered in clinical practice, with the vast majority being successfully managed using closed reduction techniques. However, in rare instances, anatomical obstacles prevent successful closed reduction, necessitating open surgical intervention. Irreducible anterior shoulder dislocations caused by soft tissue interposition represent a challenging clinical entity that requires prompt recognition and appropriate management. This comprehensive review examines the pathophysiology, clinical presentation, diagnostic approaches, and treatment strategies for irreducible anterior shoulder dislocations secondary to soft tissue interposition, with an emphasis on recent literature from 2008 to 2025. The most commonly interposed structures include the long head of the biceps tendon (LHBT), the subscapularis tendon, other rotator cuff components, and, rarely, peripheral nerves. Understanding the mechanisms of irreducibility, recognizing clinical red flags, and implementing appropriate imaging protocols are essential for optimal patient outcomes. The deltopectoral approach remains the standard surgical access, with external rotation maneuvers facilitating the delivery of interposed subscapularis tissue. MRI provides superior soft tissue characterization compared to CT when plain radiographs fail to demonstrate obvious bony pathology. Outcomes are generally favorable when early recognition is coupled with appropriate surgical intervention and structured rehabilitation, although complications, including nerve injury and residual functional deficits, can occur.
    Keywords:  anterior dislocation; biceps tendon; glenohumeral joint; irreducible shoulder dislocation; soft tissue interposition; subscapularis
    DOI:  https://doi.org/10.7759/cureus.100246
  40. Popul Health Metr. 2026 Jan 25.
    Comparing perspectives from experts and individuals with lived experience in the Global North versus the Global South: ICF core sets for deafblindness.
    Walter Wittich, Shirley Dumassais, Maya Saini, Xin Yi Li, Sarah Granberg.
       BACKGROUND: Achieving equitable global health frameworks requires the intentional integration of diverse voices-both professional and lived-from across the high-resourced Global North (GN) and low-resourced South (GS). It is, however, rare that Core Set development using the International Classification of Functioning, Disability and Health (ICF) has equal data representation from both regions. Using the data from the development of Core Sets on deafblindness, we explored a unique opportunity, given the geographic distribution of data sources. We compared ICF category frequencies from the GN and GS across body structure, body function, activities and participation, and environmental factors.
    METHODS: We divided the data from an expert survey (n = 105) and from interviews with deafblind individuals (n = 72) by country of origin into GN and GS using the Brandt Line, representing all six regions of the WHO (28 countries). Using the ICF coding system to identify perceived categories of functioning, aggregated frequencies of unique ICF categories were compared across ICF components and chapters using chi-square statistics.
    RESULTS: Survey data showed no significant geographic differences across activities and participation or environmental factors; however, qualitative interviews revealed significant deviations. For activities and participation, GN emphasized d9205 (socializing) and d940 (human rights), while GS highlighted d760 (family relationships). For environmental factors, GN focused on e5800 (health services) and e298 (environmental adaptations), whereas GS emphasized e5550 (associations), e310 (family), and e325 (community supports). Within the GN, survey and interview data also differed. Surveys emphasized e310, e315 and e320 (supports), while interviews highlighted e410, e425, e450, and e455 (attitudes). For activities and participation, d660 (assisting others) was more frequent in interviews. The GS showed significant within-region differences for e4 (attitudes), d9 (community, social and civic life) and d2 (general tasks and demands).
    CONCLUSIONS: Findings highlight the regional variations in activities and participation among individuals with deafblindness as they reflect differences in environmental factors. Rooted in cultural and resource differences, geographic region itself constitutes a key environmental factor. Expert perspectives may underrepresent differences in lived environmental realities of individuals with deafblindness. Future Core Set development will benefit from including more diverse sources.
    Keywords:  Data equity; Global North; Global South; ICF Core Set
    DOI:  https://doi.org/10.1186/s12963-026-00453-w
  41. J Clin Med. 2026 Jan 14. pii: 670. [Epub ahead of print]15(2):
    Effects of Pulmonary Rehabilitation on Dyspnea, Quality of Life and Cognitive Function in COPD: A Systematic Review.
    Alessandro Vatrella, Angelantonio Maglio, Maria Pia Di Palo, Elisa Anna Contursi, Angelo Francesco Buscetto, Noemi Cafà, Marina Garofano, Rosaria Del Sorbo, Placido Bramanti, Colomba Pessolano, Andrea Marino, Mariaconsiglia Calabrese, Alessia Bramanti.
      Background/Objectives: Chronic Obstructive Pulmonary Disease (COPD) is frequently associated with dyspnea, impaired health-related quality of life (HRQoL), and cognitive dysfunction. Although pulmonary rehabilitation (PR) is considered a core therapeutic strategy, its specific effects on cognitive function, dyspnea, and dysphonia remain unclear. This systematic review aimed to evaluate the impact of PR and respiratory or cognitive-focused rehabilitative interventions on dyspnea, quality of life, cognitive performance, and voice outcomes in adults with COPD. Methods: This review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251131325). A systematic search of PubMed, Scopus and Web of Science identified studies published between 2010 and 21 August 2025. Eligible designs included randomized and non-randomized controlled studies, cohort, and mixed-method studies involving adults with COPD undergoing rehabilitative interventions targeting dyspnea, cognition, dysphonia, or swallowing. Outcomes included cognitive measures, dyspnea scales, voice parameters, and HRQoL indices. Results: Twelve studies (n ≈ 810 participants) met inclusion criteria. Most PR and exercise-based programs showed improvements in global cognition and executive functions, particularly when combined with cognitive training or high-intensity exercise modalities. Dyspnea improved consistently following short- to medium-term PR or respiratory muscle training, whereas low-frequency long-term programs yielded limited benefit. HRQoL improved across structured PR programs, especially in multidimensional interventions. Only one study assessed dysphonia, reporting transient improvements in maximum phonation time following inspiratory muscle training. No included study evaluated dysphagia-related outcomes. Conclusions: PR and respiratory muscle training can enhance cognition, dyspnea, and HRQoL in COPD, although evidence for dysphonia remains scarce and dysphagia is entirely unaddressed. Future high-quality trials should adopt standardized outcome measures, include long-term follow-up, and integrate voice and swallowing assessments within PR pathways.
    Keywords:  Chronic Obstructive Pulmonary Disease; cognitive function; dysphonia; dyspnea; exercise training; pulmonary rehabilitation; quality of life; rehabilitation outcomes; respiratory muscle training; speech-language therapy
    DOI:  https://doi.org/10.3390/jcm15020670
  42. J Biomech. 2026 Jan 22. pii: S0021-9290(26)00037-0. [Epub ahead of print]197 113183
    Therapeutic potential of a supine straight-leg thrust in managing knee joint dysfunction in knee osteoarthritis: A biomechanical study.
    Xiaolong Zeng, Shiyang Chen, Qingyang Kang, Wenjia Zhou, Zhilin Ge, Ruotong Liao, Xin Zhang, Shunying Huang, Guoyi Su, Fangzheng Lin, Yongjin Li, Dingkun Lin.
      Rehabilitation of knee osteoarthritis is often constrained by limited understanding of muscle activation patterns and active joint mobilization mechanisms. The supine straight-leg thrust (SST) exercise, previously introduced by our team, has shown promising clinical effects, yet its neuromuscular and kinematic mechanisms remain unclear. This study aims to investigate quadriceps-hamstring activation and knee joint kinematics during SST using synchronized surface electromyography and three-dimensional motion capture, and to compare its biomechanical effects with walking, squatting, and supine air cycling (SAC). Fifteen healthy adults performed walking, squatting, SST, and SAC exercises. Surface electromyography data of the quadriceps and hamstrings, and three-dimensional kinematic data of the tibiofemoral and patellofemoral joints were collected. Comparisons were made across tasks to evaluate muscle activation levels and multi-planar joint range of motion. SST elicited significantly greater activation of the rectus femoris, vastus medialis, and vastus lateralis compared to walking (P < 0.05), with levels comparable to squatting. SST also produced significantly larger ranges of motion in both tibiofemoral and patellofemoral joints than walking and squatting (P < 0.05). Compared to SAC, SST resulted in higher thigh muscle activation and more favorable joint mobility (P < 0.05). SST effectively activates key quadriceps muscles and enhances multi-planar knee joint mobility, outperforming walking, squatting, and SAC. These findings support the biomechanical rationale for SST as a targeted exercise for addressing joint dysfunction in knee osteoarthritis rehabilitation.
    Keywords:  Exercise therapy; Knee joint kinematics; Knee osteoarthritis; Quadriceps-hamstring activation; Supine straight-leg thrust
    DOI:  https://doi.org/10.1016/j.jbiomech.2026.113183
  43. J Clin Med. 2026 Jan 10. pii: 563. [Epub ahead of print]15(2):
    A Nerve Injury After Total Hip Arthroplasty from Etiology to Treatment: A Narrative Review.
    Alberto Di Martino, Matteo Brunello, Isabella Giannini, Manuele Morandi Guaitoli, Chiara Di Censo, Federico Pilla, Cesare Faldini.
      Total hip arthroplasty (THA) is a widely performed procedure that significantly enhances patients' quality of life. However, nerve injury remains a concerning complication, with an incidence ranging from 0.6% to 3.7%, depending on patient and surgical variables. This narrative review provides a comprehensive overview of nerve injuries associated with THA, focusing on etiology, risk factors, clinical manifestations, prevention, and treatment strategies. The most affected nerves include the sciatic, femoral, lateral femoral cutaneous (LFCN), superior gluteal, and obturator nerves. Anatomical factors such as developmental hip dysplasia (DDH), limb length discrepancy, and aberrant nerve courses, along with patient-specific conditions like female sex, obesity, and pre-existing spinal disorders, increase the risk of nerve damage. Surgical complexity, revision procedures, and surgeon experience also influence injury likelihood. Clinical manifestations range from sensory disturbances to motor deficits including foot drop, Trendelenburg gait, or impaired knee extension, depending on the nerve involved. Diagnosis is primarily clinical, supported by electrophysiological studies and imaging when needed. Prevention hinges on careful preoperative planning, appropriate surgical approach selection, meticulous intraoperative technique, and attention to limb positioning. Treatment is typically conservative, involving pain control, physical therapy, and neurostimulation. In refractory or severe cases, interventions such as nerve decompression, repair, or tendon transfer may be considered. Pharmacological agents including vitamin B12, tacrolimus, and melatonin show potential in promoting nerve regeneration. Although most nerve injuries resolve spontaneously or with conservative measures, some cases may result in long-term deficits. Understanding the mechanisms, risk factors, and management strategies is essential to mitigating complications and optimizing functional outcomes in patients undergoing THA.
    Keywords:  bikini; femoral nerve; nerve injury; sciatic nerve; surgical approach; total hip arthroplasty
    DOI:  https://doi.org/10.3390/jcm15020563
  44. Front Bioeng Biotechnol. 2025 ;13 1693500
    Biomechanics of medial meniscus tears in the context of pain: a finite element analysis.
    Karol Daszkiewicz, Piotr Łuczkiewicz.
       Introduction: Meniscal tears represent the most common knee pathology and may be associated with pain. Meniscal pain is caused by direct mechanical stimulation of nociceptors located in the outer, vascular part of the meniscus. Due to difficulties in selecting the optimal surgical treatment, the aim of the study was to analyze the influence of meniscal tears on the stress state in the context of meniscal pain.
    Methods: Radial, oblique, longitudinal and horizontal tears involving up to 90% of the width of the medial meniscus were modelled using the finite element method. Two types of knee joint loading were simulated: the stance phase of the gait cycle and external tibial rotation combined with compression.
    Results: The highest Tresca equivalent stresses were obtained for the radial tear of the posterior horn. The largest increase in mean shear stress (187%) on the outer surface of the meniscus, relative to the intact meniscus model, was observed for the oblique tear. Neither complete nor partial horizontal tears were associated with changes in shear stress in the innervated part of the meniscus.
    Discussion: Increased shear stresses in the innervated part of the meniscus, which may result in pain, were obtained in radial and oblique meniscal tears models. In the longitudinal tear model, instability of the inner part of the meniscus and increased shear stress were observed in the central part of the meniscus and at both ends of the tear.
    Keywords:  finite element; knee; medial meniscus; meniscal tear; nociceptors; pain
    DOI:  https://doi.org/10.3389/fbioe.2025.1693500
  45. Am J Phys Med Rehabil. 2025 Nov 28.
    Adipose-derived Cell Therapies versus Non-Active Controls for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
    Antonio Madrazo-Ibarra, Daniel de la Huerta-Meza, Jose M Gutierrez Naranjo, Vijay B Vad.
       OBJECTIVE: To compare adipose-derived cell therapies (ADCTs) versus non-active controls in treating knee osteoarthritis.
    DESIGN: This systematic review and meta-analysis included randomized controlled trials (RCTs) comparing ADCTs with placebo or no treatment in patients with knee osteoarthritis. Two reviewers extracted study, patient, and intervention data, as well as patient-reported outcomes. Random-effects meta-analyses were performed for outcomes reported in at least three studies. The primary outcome was pain improvement at six months, with secondary outcomes including function, quality of life, and adverse events.
    RESULTS: Eight RCTs (585 patients) were included. ADCTs showed superior pain improvement versus controls at six months, with WOMAC Pain (MD -1.75, 95% CI -2.62 to -0.88) and KOOS Pain (MD 7.95, 95% CI 0.98 to 14.93) achieving statistical significance. Functional outcomes also improved significantly, while quality of life favored ADCT but did not reach significance. No serious adverse events occurred, although two patients reported severe events after ADCT.
    CONCLUSIONS: At six months, ADCTs provided greater pain relief and functional improvement than non-active controls, though no benefit was observed for quality-of-life. Severe adverse events were uncommon, but additional studies are needed for long-term efficacy and safety.
    Keywords:  Adipose-derived cell therapy; Knee; Meta-analysis; Osteoarthritis
    DOI:  https://doi.org/10.1097/PHM.0000000000002908
  46. Am J Med. 2026 Jan 23. pii: S0002-9343(26)00055-0. [Epub ahead of print]
    Frozen Shoulder: Diagnosis and Treatment of Adhesive Capsulitis.
    Feyza Achilova, Mohammad Daher, Joseph E Nassar, Alan H Daniels, Joseph A Abboud.
      Adhesive capsulitis, commonly referred to as frozen shoulder, is a frequent cause of shoulder pain and stiffness in middle-aged adults and is associated with substantial functional limitation. Although traditionally considered a self-limited condition, growing evidence suggests that many patients experience prolonged symptoms and incomplete recovery. Diagnosis is primarily clinical, based on characteristic history and examination findings demonstrating global restriction of passive glenohumeral motion, with imaging reserved for exclusion of alternative pathology. Management is predominantly nonoperative and should be individualized according to disease stage, symptom severity, and patient comorbidities. Corticosteroid injection and physical therapy provide meaningful benefit in appropriately selected patients, while surgical intervention is reserved for refractory cases. This review summarizes the current understanding of the epidemiology, clinical presentation, diagnostic approach, and evidence-based management of adhesive capsulitis, emphasizing practical considerations to guide patient-centered care.
    Keywords:  Adhesive capsulitis; Diagnosis; Frozen shoulder; Physical Therapy; Shoulder stiffness
    DOI:  https://doi.org/10.1016/j.amjmed.2026.01.021
  47. Agri. 2026 Jan;38(1): 59-60
    The underdiagnosed issue in anterior hip painful conditions: A myofascial perspective to the sartorius muscle and dry needling protocol.
    Sema Nur Mutlu Ekici, Fatih Bağcıer.
      
    DOI:  https://doi.org/10.14744/agri.2023.98512
  48. Polymers (Basel). 2026 Jan 06. pii: 152. [Epub ahead of print]18(2):
    Engineered GO-Based Hydrogels for Controlled Hyaluronic Acid Release in Knee Osteoarthritis Treatment.
    Roya Binaymotlagh, Damiano Petrilli, Laura Chronopoulou, Giorgio Mandato, Francesca Sciandra, Andrea Brancaccio, Marisa Colone, Annarita Stringaro, Leonardo Giaccari, Francesco Amato, Andrea Giacomo Marrani, Silvia Franco, Roberta Angelini, Cleofe Palocci.
      Osteoarthritis (OA) is a prevalent chronic pain syndrome and a leading cause of disability worldwide, characterized by progressive deterioration of articular cartilage. This degradation leads to pain, swelling, inflammation, and eventual stiffness as the cartilage wears down, causing bone-on-bone friction. Current medical treatments primarily aim at pain relief; however, many interventions, especially invasive or surgical ones, carry risks of adverse outcomes. Consequently, intra-articular (IA) therapy, particularly hyaluronic acid (HA) injections, is widely adopted as a conservative treatment option. HA plays a crucial role in maintaining joint homeostasis by supporting proteoglycan synthesis and scaffolding, restoring optimal HA concentrations in synovial fluid, and providing chondroprotective and anti-inflammatory effects. In recent years, hydrogels composed of natural and synthetic materials have emerged as promising candidates for OA treatment. Our research focuses on the biosynthesis and characterization of novel hydrogel composites combining short peptide hydrogelators with aminated graphene oxide (a-GO) nanosheets functionalized with HA (a-GO-HA@Hgel). These a-GO-HA@Hgel nanocomposites are designed to facilitate the controlled release of HA into the extracellular matrix, aiming to promote cartilage regeneration and mitigate inflammation. The strategy is to exploit the oxygen-containing functional groups of GO nanosheets to enable covalent coupling or physical adsorption of HA molecules through various chemical approaches. The resulting a-GO-HA are incorporated within hydrogel matrices to achieve sustained and controlled HA release. We study the influence of a-GO-HA on the native hydrogel structure and its viscoelastic properties, which are critical for mimicking the mechanical environment of native cartilage tissue. Through this multidisciplinary approach combining advanced materials science and cellular biology, this work aims to develop innovative nanocomposite hydrogels capable of delivering HA in a controlled manner, enhancing cartilage repair and providing a potential therapeutic strategy for OA management.
    Keywords:  bioconjugate; graphene oxide; hyaluronic acid; osteoarthritis; peptide hydrogels
    DOI:  https://doi.org/10.3390/polym18020152
  49. JBJS Case Connect. 2026 Jan 01. 16(1):
    Late Dislocation Following Normal Multiplanar Dynamic Ultrasonography for Developmental Dysplasia of the Hip: A Case Report.
    Karen Jiang, Brent Weatherhead, John Norgrove Penny.
       CASE: We describe a case of late dislocation of the hip in a male infant at the age of 5 months after a normal screening ultrasound study using multiplanar static and dynamic images at the age of 6 weeks. The patient was treated with adductor tenotomy, closed reduction, and spica casting, and followed to the age of 7 years with normal hip stability.
    CONCLUSION: This case demonstrates that despite evidence of both static and dynamic stability on ultrasonography earlier in life, late developmental hip dislocation can occur.
    Keywords:  developmental hip dysplasia; dynamic ultrasound; hip dislocation; late dislocation; screening ultrasound
    DOI:  https://doi.org/e25.00527
  50. Cureus. 2025 Dec;17(12): e100360
    Assessing the Effectiveness of Tranexamic Acid in Hip Fracture Management: A Systematic Review.
    Mushtaq Ahmed, Mahnoor Qureshi, Mohammad M Khan, Irfan Ullah.
      Hip fractures often lead to significant blood loss and transfusion requirements in the older population. Tranexamic acid (TXA) is used to control bleeding, but its optimal dose, timing, and broader clinical benefits remain unclear. A systematic search of PubMed, ScienceDirect, the Cochrane Library, Ovid-EMBASE, and EBSCOhost was performed for studies published between 2019 and 2024. Eligible studies included adults with traumatic hip fractures (intra- or extracapsular) treated with TXA. In total, 14 studies met the inclusion criteria, including randomised controlled trials, cohort studies, and meta-analyses. Findings were synthesised narratively due to heterogeneity in interventions and outcomes. TXA consistently reduced intraoperative and postoperative blood loss and lowered transfusion needs, with reductions up to 46% compared with controls. Across various dosing strategies, i.e., preoperative, divided doses, or topical, no significant increase in thromboembolic complications was reported. Limited but favourable evidence suggested improvements in pain, functional recovery, and hospital stay. Benefits appeared more pronounced in extracapsular fractures, where hidden blood loss is typically greater. TXA is a safe and effective adjunct in hip fracture surgery, significantly reducing blood loss and transfusion requirements without increasing the risk of thromboembolism. Standardised dosing protocols are needed, and further research should focus on long-term recovery and tailoring treatment to the type of fracture and patient characteristics.
    Keywords:  blood transfusion need; dosage regimen; patient-centred outcome; tranexemic acid; traumatic hip fracture
    DOI:  https://doi.org/10.7759/cureus.100360
  51. Medicina (Kaunas). 2025 Dec 23. pii: 29. [Epub ahead of print]62(1):
    Association Between Radiological Stenosis Level and Patient-Reported Outcomes in Patients with Lumbar Spinal Stenosis: A Cross-Sectional Study.
    Selda Çiftci İnceoğlu, Aylin Ayyıldız, Bora Şahin, Sefa Özcan, Alperen İnceoğlu, Hakan Ayyıldız, Banu Kuran.
      Background and Objectives: The aim of this study was to evaluate the relationship between low back pain questionnaires and radiological stenosis severity in patients with lumbar spinal stenosis (LSS). Materials and Methods: Patients aged 50 years and over who presented with complaints of low back pain and were diagnosed or not diagnosed with LSS by magnetic resonance imaging (MRI) were included in the study. Demographic data, physical examination findings, and walking distance were recorded. Pain severity was assessed using the Visual Analog Scale (VAS), and patients completed the Oswestry Disability Index (ODI), the Istanbul Low Back Pain Disability Index (ILBPDI), and the Swiss Spinal Stenosis Questionnaire (SSS-Q). Results: A total of 120 patients with LSS (n = 56) and without LSS (n = 64) were included in the study. No significant differences were found between the groups in terms of demographic variables (p > 0.05). Neurogenic claudication and lumbar extension limitation were higher in the LSS group (p = 0.033 and p = 0.008, respectively), and walking distance was significantly shorter compared to the group without LSS (p = 0.024). There were significant differences between the VAS, ODI, ILBPDI, and SSS-Q scores between the two groups (p < 0.05). A strong positive correlation exists between the radiological severity of LSS and SSS-Q (p < 0.001, r = 0.707). Additionally, ROC analysis revealed that the SSS-Q had a significantly higher diagnostic value for LSS compared to the ODI and ILBPDI (p < 0.001). For the SSS-Q, likelihood ratios indicated limited diagnostic relevance (PLR 4.04 [95% CI: 2.45-6.67]; NLR 0.22 [95% CI: 0.13-0.44]). Conclusions: SSS-Q, ODI, and ILBPDI scores vary significantly between patients with and without LSS. Although the SSS-Q correlates most strongly with radiological LSS severity, its diagnostic utility appeared of minor importance, as likelihood ratios indicated limited discriminative ability.
    Keywords:  cross-sectional study; lumbar spinal stenosis; patient-reported outcomes; radiology
    DOI:  https://doi.org/10.3390/medicina62010029
  52. Acta Chir Plast. 2025 ;67(3): 203-209
    A systematic review of the use of corticosteroid injections with and without local anaesthetic for trigger finger.
    G J Hourston, K R Quinn, J Chan, A Mckee.
       BACKGROUND: Trigger finger causes pain, catching, and locking of the finger, with corticosteroid injection being the first-line treatment. Injections with local anaesthetic may reduce immediate pain, but it has been suggested that added volume worsens pain. This systematic review aimed to evaluate studies investigating pain following corticosteroid injection for trigger finger, with or without local anaesthetic. Evaluation of the topic: We performed a prospectively registered systematic review (PROSPERO ID: CRD42024502361) following PRISMA guidelines. We searched PubMed, Cochrane Library, and Embase database for randomised trials or prospective cohort studies investigating pain following injection with corticosteroid with or without local anaesthetic. Patient demographic data, injection details and outcomes including visual analogue scale (VAS) pain scores were collected and summarised. Two articles including 98 patients (135 injections) were included. One article compared steroid injection with local anaesthetic and adrenaline to steroid injection with placebo (0.9% saline), and found that omitting local anaesthetic had a lower immediate VAS pain score (2.0 vs. 3.5; P &lt; 0.01) however all injections contained the same volume. The second study measured VAS pain scores at multiple time points, and a recollection score for patients injected with either corticosteroid alone (1mL), corticosteroid and 1% xylocaine (2 mL), or corticosteroid and 0.9% saline (2 mL). VAS pain scores were similar in the steroid alone and steroid and local anaesthetic group at 1 minute post-injection and highest in the steroid and saline group. The local anaesthetic group had the lowest pain score 10 minutes post-injection. Meta-analysis of outcomes in these heterogeneously reported studies was not possible.
    CONCLUSION: Corticosteroid injection for trigger finger varies considerably and outcomes are reported inconsistently. The evidence suggests that the addition of local anaesthetic may increase immediate pain due to volume effect or lowered pH but reduce early post-injection pain. Further well-designed randomised studies are needed to guide treatment decisions.
    Keywords:  corticosteroid injection; local anaesthetic; trigger finger
    DOI:  https://doi.org/10.48095/ccachp2025203
  53. Front Rehabil Sci. 2025 ;6 1716305
    Case Report: Focused shockwave therapy (fESWT) in thumb carpometacarpal joint osteoarthritis: a single case study.
    Timmy Gustafsson, Sofia Ryman Augustsson.
       Background: Several studies have demonstrated the efficacy of shock wave therapy in managing OA-related pain and improving joint function but evidence specific to thumb CMC joint OA remains limited. Therefore, the aim of this study was to evaluate the effectiveness of fESWT in reducing pain and improving function as well as to assess the safety and tolerability of this intervention, providing insight into its potential role as a non-invasive and long-term alternative for patients unresponsive to conventional therapies or seeking to avoid surgery.
    Methods: A 64-year-old woman with radiographically confirmed bilateral CMC OA and persistent symptoms unresponsive to prior conservative treatments received three weekly fESWT sessions. Energy flux density was individually adjusted per session based on tolerance. Outcome measures included the QuickDASH questionnaire and grip strength testing, assessed at baseline, 2-, 8-, 26-, and 52-weeks post-intervention.
    Results: Treatment was well tolerated with no adverse events. QuickDASH scores improved from 20.5 at baseline to 2.3 at 52 weeks, indicating an improvement in pain and functional disability. Grip strength increased by 29.5% in the right hand and 17.4% in the left hand over the same period. Subjectively, the patient reported pain relief, functional improvement, and sustained benefit at one-year follow-up.
    Conclusions: This case demonstrates the potential of individualized fESWT as a safe and effective intervention for thumb CMC OA, with improvements in pain and function lasting up to 12 months. These findings support further investigation of fESWT in larger controlled studies and highlight the importance of individualized dosing strategies in clinical practice.
    Keywords:  CMC joint; ICD-10 M.18; QuickDASH; grip strength; musculoskeletal pain; physiotherapy
    DOI:  https://doi.org/10.3389/fresc.2025.1716305
  54. JSES Int. 2025 Nov;9(6): 2146-2155
    Investigating the effectiveness of stretching interventions on post-traumatic elbow stiffness: a systematic review.
    Georgina Wistow, Meredith Newman, Erin Hannink, Karen L Barker.
       Background: Post-traumatic elbow stiffness is a significant complication following traumatic elbow injury, with incidence up to 56%. A loss of 50% of elbow range-of-movement represents a total loss of 80% of upper limb function, a challenge for both patients and clinicians. There are no established guidelines for the physiotherapy management of elbow stiffness following traumatic injury. Understanding the best treatment for nonarthritic elbow stiffness and most effective rehabilitation for prevention of stiffness following trauma or surgery are two of the top 10 James Lind Alliance priorities for elbow conditions. The study investigates the effectiveness of clinical stretching interventions, either via hold-relax manual techniques or bracing, on post-traumatic elbow stiffness in previously healthy elbow joints.
    Methods: A systematic search of five databases was performed until July 2024. Search terms related to the condition and interventions were used, without limits on date, language, or design. Adults aged ≥18 years with post-traumatic elbow stiffness, investigating any clinical stretch intervention, were eligible. Chronic or overuse elbow injuries and studies assessing alternative conservative interventions were excluded. Outcomes studied were elbow range-of-movement, function, and pain. Two reviewers screened articles and independently rated the evidence using the Cochrane Risk of Bias and Joanna Briggs Institute critical appraisal tools. Data were extracted, tabulated, and narratively synthesized.
    Results: Nine studies were included, involving a total 312 participants. Three small randomized controlled trials investigated manual stretches using hold-relax stretch-reflex techniques in early post-traumatic elbow stiffness, with no adverse events reported. One randomized controlled trial and five retrospective case series studies investigated brace interventions in persistent post-traumatic elbow stiffness. Clinically important improvements were reported in elbow flexion and extension range-of-movement following both intervention types (hold-relax and bracing). Bracing interventions had more adverse events. Insufficient information was available regarding adherence to protocols. Heterogeneity and incomplete reporting prevented meta-analysis.
    Conclusion: Hold-relax interventions may be used for early post-traumatic elbow stiffness, with weaker evidence supporting bracing in persistent elbow stiffness. Limitations included the study risk of bias and number of participants, with larger, multicenter studies warranted to confirm and quantify the effect size.
    Keywords:  Brace; Post-traumatic elbow stiffness; Splinting; Stretch; Stretching; Systematic review
    DOI:  https://doi.org/10.1016/j.jseint.2025.06.015
  55. Healthcare (Basel). 2026 Jan 06. pii: 142. [Epub ahead of print]14(2):
    The Effects of Virtual Immersive Gaming to Optimize Recovery (VIGOR) in Low Back Pain: A Phase II Randomized Controlled Trial.
    Susanne M van der Veen, Alexander Stamenkovic, Christopher R France, Amanda Robinson, Roy Sabo, Forough Abtahi, James S Thomas.
      Background: Chronic low back pain (cLBP) with kinesiophobia is difficult to treat, and traditional graded activity approaches often show limited adherence and short-term effects. Virtual reality (VR) may enhance treatment engagement by providing immersive game-based environments that encourage therapeutic movement. This randomized controlled trial aimed to examine the effects of VR interventions designed to promote lumbar spine flexion in individuals with cLBP and elevated movement-related fear. Methods: Participants were randomized to one of two nine-week VR game conditions that differed only in the amount of lumbar flexion required. Primary outcomes were changes in pain intensity and disability from baseline to one-week post-treatment. Secondary analyses examined lumbar flexion and expectations of pain/harm as potential mediators. Follow-up assessments were conducted at multiple time points through 48 weeks to assess maintenance of treatment gains. Results: Both VR groups showed significant and clinically meaningful reductions in pain and disability at post-treatment. Improvements were maintained throughout the 48-week follow-up period. Depression symptoms continued to improve during follow-up. Expectations of pain and harm decreased significantly during treatment and remained reduced, whereas objective lumbar flexion did not change appreciably over time. Mediator analyses indicated that improved expectations of pain/harm, rather than increased lumbar flexion, were more closely associated with treatment response. Conclusions: Immersive VR gaming produced sustained reductions in pain, disability, and movement-related fear in individuals with cLBP and kinesiophobia. Findings suggest that VR may enhance rehabilitation outcomes by modifying maladaptive expectations rather than altering lumbar motion. VR-based interventions represent a promising and engaging approach for long-term cLBP management.
    Keywords:  clinical trial; kinesiophobia; low back pain; virtual reality
    DOI:  https://doi.org/10.3390/healthcare14020142
  56. Br J Oral Maxillofac Surg. 2025 Dec 30. pii: S0266-4356(25)00930-1. [Epub ahead of print]
    Predictive value of ultrasound elastography for functional outcomes after orthognathic surgery.
    Yutaka Sasajima, Kazuhiro Ooi, Takako Terakami, Kosuke Ueki, Rei Jokaji, Hirokazu Okita, Yusuke Nakade, Shuichi Kawashiri.
      This study aimed to evaluate the utility of ultrasound elastography for assessing postoperative recovery of the masseter muscle, and its potential role in predicting functional outcomes in patients undergoing orthognathic surgery. Fifteen patients with dentofacial deformities (30 masseter muscles) underwent ultrasound strain elastography at rest, during mouth opening, and during clenching, at four time points: preoperatively, and at seven days, one month, and three months postoperatively. Strain values (SVs), cross-sectional muscle area, and maximal mouth opening (MMO) were measured. Statistical analyses included Friedman and Wilcoxon signed-rank tests, with correlations assessed using Pearson's or Spearman's coefficients, as appropriate. SVs significantly decreased at seven days postoperatively and recovered to baseline by one month, remaining stable at three months. The cross-sectional area increased significantly at seven days and one month in the rest and mouth opening conditions, returning to baseline at three months, while no significant changes were observed during clenching. Significant positive correlations were observed between SVs and muscle area at rest and during mouth opening. In addition, higher preoperative SVs were associated with greater postoperative improvement in MMO. Ultrasound elastography provides objective, non-invasive information on postoperative changes in the masseter muscle. This modality may serve as a useful tool for predicting functional recovery after orthognathic surgery in patients with dentofacial deformities.
    Keywords:  Dentofacial deformities; Functional recovery; Masseter muscle; Orthognathic surgery; Ultrasound elastography; Ultrasoundelastography
    DOI:  https://doi.org/10.1016/j.bjoms.2025.12.007
  57. Medicina (Kaunas). 2026 Jan 02. pii: 97. [Epub ahead of print]62(1):
    Kinesiology Taping in Grade I-II Meniscus Injuries: A Randomized, Placebo-Controlled Pilot Trial.
    Eren Arabacı, Kübra Okuyucu, Fatih Erbahçeci.
      Background and Objectives: Meniscus injuries, particularly Grade I and II, are common knee injuries that can affect pain, joint function and quality of life, but the effectiveness of non-invasive treatments like Kinesiology taping (KT) in this population remains limited. This pilot randomized controlled trial aimed to explore the short-term effects of KT on pain, fear of movement, muscle strength, proprioceptive force sense, joint range of motion, joint position sense and quality of life in individuals with Grade I/II meniscus injuries. Materials and Methods: 26 participants diagnosed with Grade I-II meniscus injury were randomly assigned to two groups: the experimental group was applied 'Y shaped' kinesiology taping on quadriceps femoris muscle, based on facilitation technique with 25-50% tension. The control (placebo) group was applied a tape without tension, perpendicular to the quadriceps femoris muscle. Outcomes were evaluated before and 48-72 h after taping. Results: Between-group analysis demonstrated a significant improvement in joint position sense at 60° flexion with eyes closed in KT group compared with placebo (p = 0.002). Additionally, the KT group showed significantly greater improvements in the physical function (p = 0.006) and energy (p = 0.013) subdomains of the SF-36 quality of life scale. No significant between-group differences were observed for pain, fear of movement, muscle strength, proprioceptive force sense, or joint range of motion. Conclusions: In this pilot study, KT showed acute benefits in proprioception and quality of life in grade I-II meniscus injuries, but no advantage over placebo taping for pain, fear of movement, joint range of motion or muscle strength. Given the exploratory nature and limited sample size, these findings should be interpreted cautiously. Larger trials should confirm these results and determine the role of KT within multimodal rehabilitation programs.
    Keywords:  kinesiology taping; meniscus injury; pain; quality of life
    DOI:  https://doi.org/10.3390/medicina62010097
  58. Cureus. 2025 Dec;17(12): e100215
    Predictors of Shoulder Pathology in Rheumatoid Arthritis: A Cross-Sectional Study.
    Raj Kumar, Ganesh Kumar, Abhinav Singh, Md Jawed Akhtar.
       BACKGROUND: Shoulder pain is a frequent but under‑recognized manifestation of rheumatoid arthritis (RA), contributing substantially to disability and impaired quality of life. High‑resolution musculoskeletal ultrasound (HRUS) offers sensitive detection of structural abnormalities, while the Shoulder Pain and Disability Index (SPADI) provides patient‑reported assessment of pain and function. However, the clinical and laboratory predictors of shoulder pathology and disability in RA remain incompletely defined.
    METHODS: In this cross‑sectional study, 105 RA patients presenting with shoulder pain were enrolled. All participants underwent HRUS evaluation of the affected shoulder(s) and completed the SPADI questionnaire. Baseline demographic and laboratory parameters were recorded. Binary logistic regression was used to identify predictors of abnormal HRUS findings and seropositivity, while linear regression analyses examined associations with SPADI total (SPADI‑T), pain (SPADI‑P), and disability (SPADI‑D) scores.
    RESULTS: Abnormal HRUS findings were present in 69 patients (65.7%). Logistic regression identified lower Hb (p=0.006, OR=0.01) and higher platelet (PLT) count (p=0.016, OR=1.16) as significant predictors of abnormal HRUS findings, with erythrocyte sedimentation rate (ESR) (p=0.010) and vitamin D deficiency (p=0.050) approaching significance. Higher ESR was also correlated with higher CRP. Linear regression demonstrated that longer disease duration, lower Hb, higher PLT count, elevated random blood sugar, and higher thyroid-stimulating hormone were predictors of worse SPADI‑T scores (R²=54.4%).
    CONCLUSION: Shoulder pathology in RA is multifactorial, with anemia, thrombocytosis, systemic inflammation, metabolic derangements, and vitamin D deficiency contributing to pain and disability. HRUS abnormalities are strongly linked to hematologic and metabolic markers, while functional impairment is influenced by both inflammatory and endocrine factors.
    Keywords:  disability; hemoglobin; high-resolution musculoskeletal ultrasound; platelets; rheumatoid arthritis; seropositivity; shoulder pain; spadi; vitamin d
    DOI:  https://doi.org/10.7759/cureus.100215
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