SQUARE-IT: a proposed approach to square the identified research problem in the literature with the objectives, the appropriate clinical research question, and the research hypothesis.

The purpose of this article is to design and introduce the SQUARE-IT approach to help scientists and clinicians in research to align important research problems with the objectives, the appropriate clinical research questions to be answered, and the research hypotheses to be investigated in medical and therapeutic specialties. Research ideas can be generated primarily through simple methods such as brainstorming and mind mapping. However, transforming ideas into a valid research question is not as easy as it may seem, as the mere presence of an idea does not guarantee that the researcher has already uncovered existing knowledge on a particular topic or identified the actual research problem.

Activated Cardiac Fibroblasts are a Primary Source High Molecular Weight Hyaluronan Production.

During acute myocardial infarction, the composition of the extracellular matrix changes remarkably. One of the most notable changes in the extracellular matrix is in the accumulation of collagen; however, hyaluronan rivals collagen in its abundance. Yet, the extent to which specific cells and enzymes may contribute to such accumulation has been largely unexplored.

Where does the tether break in vertebral body tethering cases? Clinical insights from revision cases after tether breakage.

Purpose: To evaluate the sites where the tether breaks in vertebral body tethering (VBT) cases.

Methods: Intraoperative evaluation of broken tethers in patients who had anterior revision.

Inclusion Criteria: anterior revision of VBT cases with explantation of the full implant and photo documentation.

Kurarinone Mitigates LPS-Induced Inflammatory Osteolysis by Inhibiting Osteoclastogenesis Through the Reduction of ROS Levels and Suppression of the PI3K/AKT Signaling Pathway.

Inflammatory bone resorption represents a pathological condition marked by an increase in bone loss, commonly associated with chronic inflammatory conditions such as rheumatoid arthritis and periodontitis. Current therapies primarily focus on anti-inflammatory drugs and bisphosphonates; however, these treatments are limited due to side effects, inadequate efficacy, and unpredictable long-term complications. Kurarinone (KR), a bioactive compound isolated from the traditional Chinese herb Sophora flavescens, exhibits a range of biological activities, including anti-inflammatory, anticancer, and cardiovascular protective effects.

Diagnostic Accuracy of Artificial Intelligence for Detection of Rib Fracture on X-ray and Computed Tomography Imaging: A Systematic Review.

Rib pathology is uniquely difficult and time-consuming for radiologists to diagnose. AI can reduce radiologist workload and serve as a tool to improve accurate diagnosis. To date, no reviews have been performed synthesizing identification of rib fracture data on AI and its diagnostic performance on X-ray and CT scans of rib fractures and its comparison to physicians.

Alcohol drinking leads to sex-dependent differentiation of T cells.

Objective: Global per capita alcohol consumption is increasing, posing significant socioeconomic and medical challenges also due to alcohol-related traumatic injuries but also its biological effects. Trauma as a leading cause of death in young adults, is often associated with an increased risk of complications, such as sepsis and multiple organ failure, due to immunological imbalances. Regulatory T cells play a crucial role in maintaining immune homeostasis by regulating the inflammatory response.

Comparison of software-assisted and freehand methods of rotational assessment for diaphyseal tibia fractures.

Objective: Accurate rotational reduction following tibial shaft fracture fixation is absent in up to 36% of cases yet may be critical for lower extremity biomechanics. The objective of this cadaveric study was to compare the results of freehand methods of reduction with software-assisted reduction.

Methods: Four fellowship-trained orthopaedic trauma surgeons attempted rotational correction in a cadaveric model with fluoroscopic assistance (without radiographic visualization of the fracture site) using (1) their method of choice (MoC) and (2) software assistance (SA).

A detoxified TLR4 agonist inhibits tumour growth and lung metastasis of osteosarcoma by promoting CD8+ cytotoxic lymphocyte infiltration.

Background: Osteosarcoma is the most common malignant bone tumour with limited treatment options and poor outcomes in advanced metastatic cases. Current immunotherapies show limited efficacy, highlighting the need for novel therapeutic approaches. Systemic immune activation by Toll-like receptor 4 (TLR4) immunostimulants has shown great promise; however, current TLR4 agonists' toxicity hinders this systemic approach in patients with osteosarcoma.

Platelet-rich plasma does not influence magnetic resonance imaging findings of the gluteus muscles after total hip arthroplasty through the Hardinge approach.

Objective: Total hip arthroplasty through the Hardinge approach damages the hip abductor muscles. MRI can be used to assess adverse postoperative events. In this prospective randomized controlled trial, we evaluated MRI findings and whether platelet-rich plasma affected postoperative healing of the gluteal muscles (gluteus medius and minimus).

[Treatment with TOPS for short femoral stump].

Objective: Treatment with transcutaneous osseointegrated prosthesis systems (TOPS) for short femoral amputation stumps aims to restore independent walking ability after proximal femoral amputation by direct bone-guided prosthesis anchorage. This cannot be safely achieved with conventional socket prostheses due to the mechanically inadequate socket contact surface.

Indications: Treatment of patients with short transfemoral stumps who cannot be mobilized sufficiently with conventional socket prostheses.

ASIC1a mediated nucleus pulposus cells pyroptosis and glycolytic crosstalk as a molecular basis for intervertebral disc degeneration.

Background: One of the etiologic components of degenerative spinal illnesses is intervertebral disc degeneration (IVDD), and the accompanying lower back pain is progressively turning into a significant public health problem. Important pathologic characteristics of IVDD include inflammation and acidic microenvironment, albeit it is unclear how these factors contribute to the disease.

Purpose: To clarify the functions of inflammation and the acidic environment in IVDD, identify the critical connections facilitating glycolytic crosstalk and nucleus pulposus cells (NPCs) pyroptosis, and offer novel approaches to IVDD prevention and therapy.

Deep learning based decision-making and outcome prediction for adolescent idiopathic scoliosis patients with posterior surgery.

With the emergence of numerous classifications, surgical treatment for adolescent idiopathic scoliosis (AIS) can be guided more effectively. However, surgical decision-making and optimal strategies still lack standardization and personalized customization. Our study aims to devise proper deep learning (DL) models that incorporate key factors influencing surgical outcomes on the coronal plane in AIS patients to facilitate surgical decision-making and predict surgical results for AIS patients.

Effect of individual spinal muscle activities on upright posture using a human body finite element model.

The occurrence of diseases characterized by irregular spinal alignment, such as kyphosis, lordosis, scoliosis, and dropped head syndrome (DHS) is increasing, particularly among older adults. DHS is characterized by an excessive forward tilt of the head and neck, causing the head to droop. Although it is believed that muscle activity plays a role in both the onset and treatment of DHS, the underlying mechanisms remain unclear.

Age- and sex-specific incidence rates and future projections for hip fractures in Zimbabwe.

Introduction: Population ageing in Africa is increasing healthcare demands. Hip fractures require multidisciplinary care and are considered an indicator condition for age-related health services. We aimed to estimate current hip fracture incidence in Zimbabwe, compare rates against other regional estimates and estimate future fracture numbers.

Avoiding never events in orthopaedics theatres: a quality improvement project.

Never events in the operating room are a surgeon's nightmare, with an incidence rate of 54%. These events are highly stressful for theatre staff and significantly compromise patient safety. The aim of this project is to avoid never events in trauma and orthopaedic theatres by ensuring that theatre staff adhere to the surgical pause and imaging pause protocols through regular audits.

Recovery Time and Success: A Comparative Study of Robotic and Manual Total Hip Arthroplasty Outcomes.

Background: Despite the growing utilization of robotic-assisted total hip arthroplasty (rTHA), major debate remains regarding its comparative effectiveness in achieving optimal patient outcomes compared to manual total hip arthroplasty (mTHA). This study aimed to compare both the rate and time to achieve minimal clinically important difference (MCID) between rTHA and mTHA.

Methods: We conducted a retrospective analysis comparing 341 rTHAs with a 1:3 propensity score-matched cohort of 1,023 mTHAs performed from 2016 to 2022.

Statin Use is Associated with Decreased Venous Thromboembolism Events Following Total Hip Arthroplasty: A Matched Retrospective Cohort Study.

Background: Despite advances in surgical techniques and postoperative prophylactic protocols, venous thromboembolism (VTE) events remain an important source of morbidity following total hip arthroplasty (THA). Prior research in cardiology and other surgical fields has suggested that statin medications may have a protective effect against VTE. Our study aimed to: 1) Assess if preoperative statin use was associated with decreased rates of VTE following THA, and 2) conduct a subgroup analysis of statin intensity and VTE events.

The Use of Antibiotics Impregnated Bone Cement in Reducing Surgical Site Infections in Spine Surgery: A Systematic Review.

Background And Study Aims: Spine surgeries are one of the most widely accepted method of surgery in orthopaedics. However, one of the most common complications of spine surgeries is surgical site infection (SSI), that associated with various post operative morbidities. The use of antibiotics impregnated bone cement (AIBC) is common in orthopaedics surgeries.

Utilization of smartphone technology and wearable technology following TKA.

Introduction: The widespread adoption of smartphones and wearable technology has introduced innovative approaches in healthcare, particularly in postoperative rehabilitation. These technologies hold significant promise for improving recovery following lower extremity arthroplasty, especially total knee arthroplasty (TKA). Despite growing interest, the evidence on their effectiveness and long-term impact remains variable.

Radiological characteristics of the knee in young patients with medial meniscus horizontal tears.

Introduction: We aimed to assess medial meniscal (MM) healing and horizontal tear (HT) repair in the knees of young patients.

Materials And Methods: We enrolled 37 knees of 35 patients (mean age: 28.0 ± 10.

Prediction of the Serial Alignment Change after Opening-Wedge High Tibial Osteotomy Based on Coronal Plane Alignment of the Knee Using Machine Learning Algorithm.

Categorization of alignment into phenotypes can be useful for predicting and analyzing postoperative alignment changes after opening-wedge high tibial osteotomy (OWHTO). The purposes of this study were (1) to develop a machine learning model for the predicting the Coronal Plane Alignment of the Knee (CPAK) phenotypes of final alignment after OWHTO, and (2) to analyze predictive factors for final alignment phenotypes. Data were retrospectively collected from 163 knees that underwent OWHTO between March 2014 and December 2019.

Zonal Characteristics of Collagen Ultrastructure and Responses to Mechanical Loading in Articular Cartilage.

The biomechanical properties of articular cartilage arise from a complex bioenvironment comprising hierarchically organised collagen networks within the extracellular matrix (ECM) that interact with the proteoglycan-rich interstitial fluid. This network features a depth-dependent fibril organisation across different zones. Understanding how collagen fibrils respond to external loading is key to elucidating the mechanisms behind lesion and managing degenerative conditions like osteoarthritis.

Radiographic Soft Tissue Thickness is not a Risk Factor for Infection after Primary Total Ankle Arthroplasty.

As the incidence of total ankle arthroplasty (TAA) for the management of end-stage arthritis is on the rise, identification of risk factors for periprosthetic joint infection (PJI) is essential. There has been limited research exploring the use of radiographic soft tissue thickness in TAA despite its predictive value in other forms of arthroplasty. This study evaluated the predictive capabilities of radiographic soft-tissue thickness for PJI following TAA.

Patients Undergoing Manipulation under Anesthesia following Primary Total Knee Arthroplasty: Are Their Patient-Reported Outcome Measures Inferior?

Stiffness after total knee arthroplasty (TKA) can lead to decreased function and patient dissatisfaction. Manipulation under anesthesia (MUA) is often performed to improve range of motion (ROM); however, there is no consensus on indications or timing. The purpose of this study was to compare clinical results and patient-reported outcome measures (PROMs) between patients who underwent MUA versus those with an uncomplicated postoperative course following primary TKA.