https://www.organscigroup.us/journals/open-journal-of-orthopedics-and-rheumatology A Peertechz Open Access Journal en-us 06 Jan, 2026 https://www.organscigroup.us/articles/OJOR-11-156.php Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by synovial inflammation and joint destruction, with Cyclooxygenase-2 (COX-2) significantly contributing to its pathogenesis. Traditional management includes NSAIDs and COX-2 inhibitors, which pose gastrointestinal and cardiovascular risks. Azadirachta indica (neem), known for its anti-inflammatory properties, was studied for its antioxidant activity, mineral content, and potential COX-2 inhibitors, emphasizing its relevance to RA treatment. Fresh leaves of neem were extracted using n-butanol and evaluated for total phenolic content (TPC), total flavonoid content (TFC), and ferric reducing antioxidant power (FRAP) using standard protocols. Mineral content was determined by atomic absorption spectroscopy, and bioactive compounds were identified using high-performance liquid chromatography (HPLC). Identified phytochemicals were subjected to in silico analyses against human COX-2. The fraction exhibited high TPC and TFC and demonstrated strong FRAP activity. HPLC analysis identified seven polyphenolic compounds, and mineral analysis revealed the presence of essential macro- and microelements, all within FAO/WHO permissible limits. E-pharmacophore screening, molecular docking, ADMET predictions, and AutoQSAR analysis identified ferulic acid as a promising COX-2 inhibitor, with ferulic acid showing the strongest binding affinity (−6.899 kcal/mol) and favorable MM-GBSA binding free energy (−34.71 kcal/mol). This study demonstrates that Azadirachta indica leaf possesses significant antioxidant activity, a beneficial mineral profile, and bioactive compounds with promising COX-2 inhibitory potential. Ferulic acid stands out for its strong binding affinity, pharmacokinetic properties, and safety profile. The combined in vitro and in silico results highlight neem’s potential as a natural anti-inflammatory agent for RA, necessitating further in vivo and clinical validation. 18 Dec, 2025 https://www.organscigroup.us/articles/OJOR-10-155.php The forecasting model underpinning future adoption of phase-specific, DNA-informed physiotherapy protocols employs a hybrid methodological framework, integrating population-level epidemiological data, genomic biobank insights, and contemporary clinical adoption trends. Key assumptions include: - The routine clinical utility of DNA-based prognostic profiling for musculoskeletal disorders by 2030, facilitated by declining costs and expanded biorepository access. - Accelerated adoption of digital health and AI-powered rehabilitation technologies, following a sigmoidal (logistic) growth curve, sensitive to sociodemographic and policy variables. - Stratified patient management anchored both in genomic risk and longitudinal function, enabling precision technology deployment and tailored rehabilitation intensity. 30 Sep, 2025 https://www.organscigroup.us/articles/OJOR-10-154.php Introduction: Myositis ossificans (MO) is a form of heterotopic ossification that develops within muscles or soft tissues, usually after trauma. It is a benign tumor-like lesion commonly seen in young adults and adolescents, and rarely in children. MO can be classified into two forms: myositis ossificans progressiva (genetic) and myositis ossificans traumatica (acquired). Its exact pathophysiology remains unclear, though trauma is a major contributing factor. Case Presentation: We present a case of a 6-year-old girl who developed MO in her right elbow following a minor trauma caused by a tractor injury. Initial imaging diagnosed a non-displaced supracondylar humerus fracture and she was managed with immobilization. Despite this, she developed persistent pain and stiffness, followed by physiotherapy which worsened her condition. A soft-tissue mass appeared with limited elbow mobility. Radiographic imaging revealed a calcified mass consistent with heterotopic ossification. Due to limited resources and parental refusal, further imaging like MRI was not performed. Conservative management with NSAIDs and rest led to notable improvement over 4 weeks. Discussion: MO is characterized by zonal ossification and typically follows trauma or inappropriate rehabilitation. It commonly affects large skeletal muscles like the quadriceps and brachialis. Diagnosis is often clinical and radiological, with CT being the gold standard. In resource-limited settings, radiography remains a practical alternative. Conclusion: This case underscores the importance of considering MO in cases of post-traumatic stiffness and pain, particularly in children. Conservative treatment can be effective, and physiotherapy should be cautiously approached. 22 Aug, 2025 https://www.organscigroup.us/articles/OJOR-10-153.php Introduction: Tibial plateau fractures account for 5–8% of lower limb fractures and 1% of fractures in adults. Materials and methods: This was a prospective, single-center, descriptive, continuous study conducted over an 18-month period, from September 15, 2022, to March 15, 2024, in the Orthopedics and Traumatology Department of CHNDJ. We studied the therapeutic and evolutionary aspects of surgical treatment for tibial plateau fractures. Results: The time to treatment was 2 to 6 days in 56.2% of our patients. The anterolateral approach was used in 74% of cases. Lateral screw plates were used in 53.1% of our patients, and external fixators combined with screws in 15.6% of patients. The average length of hospital stay was 4.6 days, ranging from 1 to 54 days. The average time to bone union was 12 weeks, ranging from 8 to 16 weeks. Our anatomical results were very good or good in 79.2% of cases, and the overall functional results were very good or good in 95.8% of cases. We recorded 15.8% infection, 5.3% skin necrosis, 10.5% knee stiffness, 5.3% malunion, 15.8% gonarthrosis, and 15.8% proximal tibial necrosis. Conclusion: Tibial plateau fractures are clearly on the rise in our societies with the advent of motorized two-wheeled vehicles as a means of public transportation. 24 Jul, 2025 https://www.organscigroup.us/articles/OJOR-10-152.php Rheumatoid Arthritis (RA) is a chronic autoimmune disorder characterized by persistent joint inflammation, pain, and progressive disability. While conventional pharmacological treatments remain the cornerstone of RA management, growing interest in alternative and complementary therapies has drawn attention to the medicinal potential of natural compounds such as ginger (Zingiber officinale). This review investigates the therapeutic role of ginger in alleviating RA-related symptoms, with a particular focus on its anti-inflammatory and immunomodulatory mechanisms. Bioactive constituents such as gingerols and shogaols have demonstrated the ability to inhibit pro-inflammatory cytokines and oxidative stress pathways implicated in RA pathogenesis. Clinical and preclinical studies provide preliminary evidence supporting ginger's efficacy and safety. This paper highlights current findings and outlines future directions for integrating ginger as a complementary therapeutic option in RA management. 10 Jul, 2025 https://www.organscigroup.us/articles/OJOR-10-151.php Introduction: Fibromyalgia is considered to be a multifactorial idiopathic disease with a strong psychological impact, and no structured protocol is currently able to organize the clinical investigation of the patient, outside of the patient's history, without incurring diagnostic errors. Objective: The effectiveness of the "Perrotta Fibromyalgia Protocol" (PF-p) is under discussion for the functional diagnosis of patients with fibromyalgia. Materials and methods: A population sample was selected for the pilot study, which was administered a clinical interview based on narrative-anamnestic and documentary evidence, including key inflammatory indices and Section A of the Perrotta Integrative Clinical Interviews (PICI-3TA), investigating dysfunctional personality traits. Blood investigations needed to complete the individual profile were then performed. Finally, blood indices were repeated after 6 months to evaluate the effectiveness of the protocol used (PF-p). Results: Preliminary results of clinical interviews and clinical data would suggest that the diagnostic framing might be contaminated by diagnostic errors, partly due to the framing of all clinical symptoms stated by the patients in the selected population sample (n = 48, M = 36.9, SD = 12.6). Blood results confirm the organic inflammatory state. The use of the PF-p, 6 months after the first instrumental verification, shows a marked and significant alleviation of symptoms in 72.9% of cases (35/48) and complete resolution in 27.1% of cases (13/48). Conclusions: Fibromyalgia could be considered a polysymptomatic condition (and not an independent disorder or disease) resulting from an active systemic inflammatory state capable of interfering with normal organic functioning, capable of altering one or more biological functions. 04 Feb, 2025 https://www.organscigroup.us/articles/OJOR-10-150.php Metatarsal fractures are a common type of injury to the foot and can result in chronic pain and disability if the fracture site fails to fuse after a series of bone fusion procedures with or without instrumentation, resulting in pseudarthrosis, which may ultimately require amputation. A 58-year-old male patient without any known risk factors presented with pseudarthrosis and chronic pain in the right foot after 4 failed bone fusion procedures on the first metatarsal bone where amputation was considered. The Hyper-Crosslinked Carbohydrate Polymer (HCCP) was injected with autologous bone marrow into the site of non-union without reduction or instrumentation in an outpatient setting. The patient showed a dramatic improvement over the course of 12 weeks and a radiographic fusion along with a 90% improvement in the pain scale. Forefoot and midfoot fractures and injuries associated with a high degree of pseudarthrosis may require a better predictor and appropriate fusion procedure before amputation is considered. 16 Apr, 2024 https://www.organscigroup.us/articles/OJOR-9-149.php Introduction: Exosomes, nanosized vesicles derived from various cellular sources, hold immense potential in modulating physiological processes and promoting tissue repair. Exosomes derived from amniotic fluid show significant promise in regenerative medicine and tissue repair. To our knowledge, there are no reported cases of reduction of chronic pain due to bone- and cartilage degeneration reported after exosome treatment. Case presentation: Three male patients, all with chronic pain and reduced physical function due to bone- or cartilage degeneration all showed a remarkable reduction in pain and increase in function after one single injection of amniotic-derived exosomes. Conclusion: These cases raise the hypothesis that amniotic-derived exosomes may be an effective intervention in the treatment of degenerative bone- and cartilage diseases. Especially in combination with other regenerative medicine interventions. Further research is required to test this theory. 02 May, 2023 https://www.organscigroup.us/articles/OJOR-8-148.php Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder, and the incidence in children is increasing year by year. The modern medical field lacks long-acting drugs for the treatment of ADHD and there is an urgent need to investigate new therapeutic drugs or complementary and alternative therapies. Recent studies have found that Traditional Chinese Medicine (TCM) has the advantages of individualization, precise efficacy and minimal side effects in improving attention deficit hyperactivity disorder. This paper reviews the progress of Chinese medicine in the treatment of ADHD in terms of its understanding of the etiology and pathogenesis of ADHD, treatment according to pattern identification and Chinese medicinal preparations. 24 Feb, 2023 https://www.organscigroup.us/articles/OJOR-8-147.php Antisynthetase Syndrome (ASS) is a rare chronic autoimmune disorder, associated with interstitial lung diseases (the most important feature), such as Dermatomyositis (DM) and Polymyositis (PM). The cause of ASS is unknown. The hallmark of ASS is the presence of serum autoantibodies directed against aminoacyl-tRNA synthetases (anti-ARS involved in protein synthesis). Anti -Jo1 is the most common (20% - 30%); anti-PL12 is present in 2% - 5% of SAS, associated with Interstitial Lung Disease (ILD) in 90%, mainly as Non-Specific Interstitial Pneumonia (NSIP). Autoimmune hepatitis is related to rheumatological diseases (2.7% - 20% in systemic lupus erythematosus, 6% - 47% in primary Sjögren’s syndrome), however, is rare in patients with inflammatory myopathies, and there is no previous reported association with SAS. A literature search was carried out using the PubMed and EMBASE databases in English and Spanish. Our case, a 62-year-old woman who developed polyarthritis, with progressive dyspnea, facial and lower limb edema, proximal muscle weakness, and Raynaud’s phenomenon; high-resolution chest CT, showing pulmonary interstitial disease, consistent with Nonspecific Interstitial Pneumonia (NSIP). She had elevated transaminases and a prolonged prothrombin time, with positive anti-nuclear and anti-smooth muscle antibodies, and was made a diagnosis with autoimmune hepatitis type 1 (HAI). According to this presentation and reports of the literature review, anti-PL12 patients are characteristically associated with a severe phenotype of lung inflammation, that does not necessarily require myositis manifestation. To our knowledge, there is not any case of the antisynthetase syndrome and autoimmune hepatitis reported previously in the literature. 18 Jan, 2023 https://www.organscigroup.us/articles/OJOR-8-146.php Introduction: Carpal Tunnel Syndrome (CTS) is the most common and best well-known cause of peripheral nerve compression. To date, none of the studies have determined the optimal combination of pyrimidine nucleotides and electrical stimulation (ES) in CTS patients. The objective of the study was to evaluate the effectiveness of a novel product containing uridine and cytidine monophosphate (Nucleo CMP Forte™) in combination with ES for the treatment of CTS. Methods: This open-label, randomized, controlled study involved 60 patients with CTS at the Azerbaijan Medical University (Baku, Azerbaijan) and Research Institute of Medical Rehabilitation between 2017 and 2021 years. Patients were randomized to receive the exploratory treatment (Nucleo CMP Forte™ and ES) or single ES treatment for ten days. The combination treatment included two stages: Nucleo CMP Forte™ and ES for ten days (stage one), and Nucleo CMP Forte™ as monotherapy (stage two) for ten days. Results: In the exploratory group, the complete restoration of pain sensitivity was achieved by 17.1% of patients and the narrowing of the existing zone of hypesthesia by 74.3%. Positive Tinel test was revealed in 52.4% of patients after the first and 76.2% after the second stage in the exploratory group, versus 43.8% in the control group. Mean values in the Boston Carpal Tunnel Questionnaire significantly decreased in both groups. Conclusion: Nucleo CMP Forte™ in combination with ES contributes to a more pronounced regression of patients' complaints, clinical manifestations, severity, and neurophysiological indicators in mild-to-moderate CTS. 20 Sep, 2022 https://www.organscigroup.us/articles/OJOR-7-145.php For over four centuries the posture was under very different points of view. The theory of centralized Aerobic-Anaerobic Energy Balance Compensation (CAAEBC) gives an additional angle of consideration, associated with the concept of brachiocephalic arterial blood flow access to the rhomboid fossa. This helps to understand the requirements of the set of physical exercises, that will be able to keep the posture training simultaneously with the healthcare. 02 May, 2022 https://www.organscigroup.us/articles/OJOR-7-144.php Chondrosarcoma is the most common primary malignant bone tumor after myeloma and osteosarcoma, ranking third. It may be in second place in terms of frequency after osteosarcoma if we consider myeloma as a tumor of bone marrow cells rather than a bone tumor because it is a hematopoietic derivation [1]. 30 Apr, 2022 https://www.organscigroup.us/articles/OJOR-7-143.php Chondrosarcoma is a malignant tumor occupying the 2nd position in terms of frequency, all ages combined, after osteosarcoma [1]. Epidemiological data extracted from cancer registries in Europe indicate an annual incidence of ~0.1/100,000 inhabitants [2]. 23 Feb, 2022 https://www.organscigroup.us/articles/OJOR-7-142.php Osteoporosis is a skeletal disorder characterized by compromised bone strength resulting in an increased risk of fracture [1]. Bone Mineral Density (BMD) is responsible for 60-90% of the strength of bone [1] and the current standard of assessment is by Dual-energy X-Ray Absorptiometry (DXA). DXA generates T-scores of the lumbar spine, femoral neck, or hip by calculating the difference between the individual’s BMD and the population mean, divided by the standard deviation of the reference population. The World Health Organisation (WHO) classifies osteoporosis at a T-score of or below -2.5. 23 Sep, 2021 https://www.organscigroup.us/articles/OJOR-6-141.php The World Health Organization (WHO) declared, on January 30, 2020, that the outbreak of the disease caused by the new Coronavirus (COVID-19) constitutes a Public Health Emergency of International Importance - the highest level of alert of the Organization, as provided for in the International Health Regulations. On March 11, 2020, COVID-19 was characterized by the WHO as a pandemic and since then the world has been going through an unprecedented period. The pandemic is interfering with all aspects of everyday life, especially in the area of ​​health. Surgical practice was directly affected by the suspension of elective procedures and the prioritization of urgent and emergency surgeries as a way to free up beds for patients infected with the disease. New coronavirus. The script for resumption of elective surgery after this COVID-19 pandemic must be progressive and cautious. Elective surgery should be performed in COVID-free facilities and the hospital stay should be as short as possible. For safety reasons, patients considered for surgery should be carefully selected according to status/exposure to COVID-19 infection, age, ASA physical status/risk factor classification system, socio-professional status and surgical indication. Therefore, in this study, we will demonstrate the positive impact on surgical resumption using a rapid recovery protocol combined with a minimally invasive technique (AMIS) for total hip arthroplasty during the period of worldwide pandemic for SARS-CoV-2. 08 Sep, 2021 https://www.organscigroup.us/articles/OJOR-6-140.php Hip osteoarthritis (OA) is the most frequent and common among all degenerative joint disorders and affecting huge number of individuals. Older females and low income people are more likely to develop Hip OA. A cross sectional survey was conducted in different hospitals of Karachi & Quetta, Pakistan from July to September 2019. A self-constructed proforma was used among all 392 already diagnosed patients to collect the data and Spss version 23 was used to analyze the data. In demographic Characterstics the age, gender and household income were significantly associated with Hip OA (p&lt;0.05). The study concluded that the people who were older, belongs to female gender and with low house hold income were found physically restrictive due to the hip OA. Older females and people with low income should be prioritized for the treatment of hip OA in order to reduce the restrictiveness from their activities of daily life and to enhance their physical functional capacity. 16 Jul, 2021 https://www.organscigroup.us/articles/OJOR-6-139.php Delayed healing of stress fractures constitutes a significant clinical problem causing pain and disability for the patients affected. The vast majority heal after immobilization of the extremity affected, but a certain small number of patients display delayed union despite standard treatment, resulting in prolonged disability and usually end up needing orthopedic procedures to get symptomatic relief. All stress fractures exhibit Bone Marrow Edema or Bone Marrow Lesions (BMLs) with and without fracture lines on MRI, and in cases of delayed union these lesions persist. Thus, it is conceivable that BML formation might contribute to non-union. Previous studies on transient osteoporosis and osteoarthritis have demonstrated that bisphosphonates can reduce BMLs. We therefore wanted to test, whether treatment with IV. Bisphosphonates could promote healing of such fractures. In this study we report our clinical experience and the results obtained after treating 8 patients exhibiting delayed healing an off label protocol using two Zoledronic acid infusions (given 3 months apart). Seven female and one male patient (aged 30-72) were enrolled. All had signs of non-union for more than 12 months (defined as continued pain, disability and persistent BMLs on MRI). Pain was monitored using VAS (1-10) and MRI was performed in six of the patients at baseline, 3, 6 and 12 months after the first infusion. All patients received Ca (0.5-1 g Ca per day) and vitamin D supplementation (800-1000 IE per day). All patients experienced clinical healing with significant reduction of pain at the fracture site and improvement of ambulation within 1-3 months after the first infusion. 4 patients experienced further reducgtion of pain after the second infusion. At 6 months, ambulatory functions were completely restored in all patients and a highly significant reduction of VAS scores from an average of 7.3 before treatment to 1.1 at 6 months and 0,9 at 12 months (P&lt;0,0001) could be demonstrated. The alleviation of pain was accompanied by reduction or total resolution of BMLs on MRI. Except for 2 cases of flu-like symptoms after the first infusion, no adverse effects were recorded. In conclusion, In conclusion, 2 infusions of zoledronic acid (5 mg) given 3 months apart, may emerge as a possible treatment modality of stress fractures in the foot showing delayed union, and could potentially reduce the need for more extensive surgical intervention in such complicated cases. This small observational pilot study needs to be corroborated in a larger randomized, controlled trial. 01 Jul, 2021 https://www.organscigroup.us/articles/OJOR-6-138.php Background: The modernization of arthroplasty has paved the way for the resurgence of ultrasound-guided regional analgesia (RA) techniques. The evolution of newer RA techniques aids in reducing postoperative pain considerably as well as facilitates early ambulation and discharge. “Dual Subsartorial Block (DSB)” is recently described as a novel procedure-specific, motor-sparing, and opioid-sparing RA technique for total knee arthroplasty (TKA) surgery. This review article highlights the innervations covered by DSB based on the anatomical considerations and its suitability for providing analgesic coverage in TKA with medial approaches. Methodology: We describe anatomical considerations based on the available literature about the anatomy related to the femoral triangle, adductor canal, and subsartorial region. The technical consideration of the DSB is based on our observations of the ongoing study on patients undergoing TKA with medial approaches. However, other details of the study are not part of this article. Results: After studying the anatomical and technical aspects of the DSB, it is possible to cover almost all procedure-specific innervations of TKA surgeries with the DSB. Our observations and statistical analysis found DSB as a procedure-specific, motor-sparing, and opioid-sparing RA technique. Discussion: We describe the complex anatomy of the femoral triangle and adductor canal block along with sonoanatomical variations of various subsartorial regions. We also elaborate on the technical details, analgesic coverage, and possible complications of DSB. 02 Jun, 2021 https://www.organscigroup.us/articles/OJOR-6-137.php Hallux Abductus Valgus (HAV) is a pathology that affects the first metatarsophalangeal joint, in which there is a medial displacement of the metatarsal and a lateral deviation of the hallux, causing joint dysfunction and disability in the patient. There are two types of treatments for this condition (conservative and surgical), and both require an exhaustive biomechanical assessment, since biomechanics are the main cause of this deformity. The main objective of the article is the development of a biomechanical examination and assessment algorithm to be carried out systematically in patients with HAV. 17 May, 2021 https://www.organscigroup.us/articles/OJOR-6-136.php Fracture neck of femur is a common event in elderly people in India. Total Hip Arthroplasty (THA) has established as the better choice of surgical intervention. There are two major surgical approaches for performing a total hip replacement 1) the posterior approach 2) the anterior approach. The posterior approach to total hip replacement is the most used method and allows the surgeon excellent visibility of the joint, more precise placement of implants and is minimally invasive. In India, cemented modular hemiarthroplasty is being promoted using a cost-effective Indian implant that has confirmed distinct advantage. While the common cause of Femur neck fractures are falls in bathrooms or slipper floors. We are reporting a case of Femur neck fracture, after alighting from a bus. Due to the inaccessibility of THA in rural India, patient had to be shifted to the state Hqs. The course of surgery, hospital stay and outcome of Left side Total Hip Replacement (THR) therapy in an elderly male with known comorbidities is being narrated. The patient had the shortest hospital stay of 5 days, was stable throughout the surgery, postoperative period, despite being diabetic and hypertensive and was back doing his normal activities within 6 months. 17 May, 2021 https://www.organscigroup.us/articles/OJOR-6-135.php Objective: To demonstrate the benefits and complications of the single posterior approach through bilateral costotransversectomy in the treatment of neoplastic disease of the thoracic spine. Methods: Twelve consecutive patients with thoracic spine tumors, who underwent single posterior approach with bilateral costotransversectomies were reviewed. Through posterior extrapleural access, total vertebrectomy and reconstruction were performed. In reconstruction, a cage was used anteriorly, and a pedicular screw fixation was used posteriorly. The minimum follow-up was sixteen months. The parameters analyzed were pain, neurological and functional capacity, survival time, fixation stability, and complications. Results: All patients had improvement in their pain or in their functional capability. Among those with a preoperative neurological deficit, 71.4% showed improvement of at least one degree at postoperative evaluation. There was no functional or neurological decline in any patient. The observed complications were: one adult respiratory stress syndrome, one excessive bleeding, one pneumothorax, one infection and one local recurrence. All but one of these complications was reversed with appropriate treatment. Conclusion: The posterolateral approach through costotransversectomy was safe and secure method for the resection and reconstruction of thoracic vertebrae affected by neoplastic disease. 10 Apr, 2021 https://www.organscigroup.us/articles/OJOR-6-134.php The clavicle is the most frequently fractured bone in humans. General anesthesia with or without Regional Anesthesia (RA) is most frequently used for clavicle surgeries due to its complex innervation. Many RA techniques, alone or in combination, have been used for clavicle surgeries. These include interscalene block, cervical plexus (superficial and deep) blocks, SCUT (supraclavicular nerve + selective upper trunk) block, and pectoral nerve blocks (PEC I and PEC II). The clavipectoral fascial plane block is also a safe and simple option and replaces most other RA techniques due to its lack of side effects like phrenic nerve palsy or motor block of the upper limb. We present a comprehensive review of anatomy and RA techniques of clavicle surgeries. This review will help readers understand the functional anatomy and nature of clavicle fractures, and apply an algorithmic approach to procedure-specific blocks for complexly innervated structures like clavicle. 17 Mar, 2021 https://www.organscigroup.us/articles/OJOR-6-133.php Introduction: Osteoporosis is characterized by a loss of bone mass along with alterations in its structure, with subsequent increase in bone fragility and susceptibility to fractures, ultimately reinforcing the importance of its prevention by the reduction of the risk of falling. In this paper we propose to analyze the functional progression of a patient, integrated in a multidisciplinary program (TOMBO-Therapeutic Occupational Multidisciplinary approach to the Benefit of Osteoporosis), after an osteoporotic fracture. Methods: Retrospective descriptive case-study of the first patient included in the TOMBO program. Data were gathered for Time Up and Go Test (TUGT), Sit to Stand in 30 secs. (SS-30), 10m Walking Test (10m-WT), Barthel Index (BI) and Morse Scale (MS) in 3 different moments: baseline (ward, at discharge: M0), 2 and 6-months after surgery (multidisciplinary appointments: MD2, MD6). Results: TUGT- M0: no capability; MD2: 18,8 secs.; MD6: 8 seg. SS-30 - M0: no capability; MD2: 9 stands; MD6: 10 stands. 10m-WT - M0: 30 secs.; MD2: 13 secs.; MD6: 8 secs. BI - M0: 60; MD2, 80; MD6: 100. MS - M0: 85, MD2: 50; MD6: 15. Conclusion: This case-study revealed us that the first patient admitted to this innovative multidisciplinary approach improved some functional parameters (level of dependency and risk of falling) as shown by its favorable progression on the tests and scales applied. 02 Feb, 2021 https://www.organscigroup.us/articles/OJOR-6-132.php The occurrence of hematoma and bruise formation, accounting for the majority of donation-related complications in the arm, rarely results in Complex Regional Pain Syndrome (CRPS). We report a 24-year-old man who presented with CRPS on his right upper limb two months later due to hematoma and bruising formation just after a blood donation following with immediate performance of strenuous exercise in the upper limbs. Triple phase bone scan, one of the bone scintigraphic studies, revealed positive findings and was compatible with the symptoms of CRPS, e.g. hyperalgesia, swelling and discoloration. The potentially disabling condition, however, ended up with a thankfully benign outcome because of our early finding and proper treatment that included three-day oral prednisolone and two-week physiotherapy and occupational rehabilitation. To our knowledge, CRPS produced by donation-related complications with subsequent hematoma and bruise due to vigorous exercise is rare. CRPS should be taken into consideration in a blood donor who demonstrated allodynia because of performing heavy exercise immediately after blood donation. 04 Jan, 2021 https://www.organscigroup.us/articles/OJOR-6-131.php A significant number of papers relatively to the investigation made on Anterior Cruciate Ligament (ACL) Reconstruction (ACLR) has been published in orthopaedic related journals. Finite Element (FE) Analysis (FEA) has been used to predict the performance of biomechanical-biomedical systems as well as the effect of clinical factors on the ACLR success. This research tool presents some advantages relatively to experimental studies in assessing stresses and strains in soft tissues of the knee joint. By interpreting correctly FE results, it is possible to extrapolate them to clinical situations. This article reviews papers published from 2016 until nowadays on FEA for ACLR studies searched in Google Scholar, Medline and PubMed databases. Only studies that addressed surgery techniques, type and size of grafts, tunnel geometry and orientation, and fixation devices are reviewed and presented. 29 Dec, 2020 https://www.organscigroup.us/articles/OJOR-5-130.php Objectives: To evaluate the clinical efficacy of Qingre Jiedu Quyu Decoction in the treatment of Systemic Lupus Erythematosus (SLE) and its effect on NLRP3 inflammatory bodies. Methods: From January 2017 to December 2019, 74 patients with SLE were randomly divided into control group and observation group. The patients in the control group were given routine treatment(prednisone combined with immunosuppressive (hydroxychloroquine)). The patients in the observation group were treated with Qingre Jiedu Quyu Decoction on the basis of routine western medicine. The differences of related indexes and the changes of NLRP3 inflammatory bodies between the two groups before and after treatment were compared. Results: The total effective rate was 94.59% in the observation group and 75.67% in the control group, there was significant difference between the two groups (P < 0> 0.05). Conclusions: Qingre Jiedu Quyu Decoction had certain clinical effect in the treatment of SLE. After treatment, the index of NLRP3,IL-1 β and IL-18 in peripheral blood of the observation group decreased more obviously than that of the control group (P &lt; 0.05). Fund project: Funded by the National Natural Science Foundation of China in 2018-2018-40-0561; Young backbone talents training project of Traditional Chinese medicine in Jiangxi Province ;The molecular mechanism of nanorealgar in the treatment of SLE was explored from the B cell autophagy pathway which mediated by cAMP-Rap2B-PLCε-IP3R/Ca2+. 28 Dec, 2020 https://www.organscigroup.us/articles/OJOR-5-129.php Chitosan is of great interest in regenerative medicine because of its plentiful properties, like biocompatibility, biodegradability and non-toxicity. The objective of the present study was histopathological and biomechanical survey on effect of methoxatin loaded chitosan conduit on Deep Digital Flexor Tendon (DDFT) healing in rabbit models. Eighteen healthy male white New Zealand rabbits were randomized into three groups of six animals each. In CONTROL group the DDF tenotomy was performed and the sumps were sutured. In CTN (chitosan) group the DDF tenotomy was performed and the sumps were sutured and CTN conduit was wrapped around the damaged area. In CTN/METHO (chitosan/methoxatin) group the procedure was the same as CTN group as well as local administration of 100 µL methoxatin (100 µg/Rabbit) into the CTN conduit. The histopathological assessments including inflammation, angiogenesis and collagen fibers arrangement, and biomechanical assessments were performed after 8 weeks. Histopathological observations showed that the conduit was absorbed and adhesion around the tendon was deceased in CTN and CTN/METHO groups. There were no noticeable signs of infection and tissue reaction in the granulation tissue in CTN/METHO group compared to other groups (P&lt;0.05). Local administration of methoxatin in combination with chitosan conduit could accelerate deep digital flexor tendon healing via decrease in adhesion around the tendon with no signs of excessive tissue reaction or infection in rabbits. 07 Sep, 2020 https://www.organscigroup.us/articles/OJOR-5-127.php Sjögren’s syndrome is an autoimmune disease characterized by exocrine glands lymphocytic infiltration. However, some manifestations can happen outside the secretory glands affecting multiple organs. We report a 63-year-old man without previous history of any rheumatologic disease and negative arthralgias, mucosal or ocular dryness, in which findings of chest CT scan were consistent with interstitial lung disease prompting further diagnostic workup. Given the serological results, Sjögren's syndrome was highly suspicious in our diagnosis for which a lip biopsy was performed revealing the etiology of our patient's interstitial lung changes. To our knowledge, respiratory symptoms are rarely the initial presentation of this disease, heightening a more thorough workup for a patient with interstitial lung disease with an unclear clinical association requiring a biopsy. 07 Sep, 2020 https://www.organscigroup.us/articles/OJOR-5-126.php Systemic Lupus Erythematosus (SLE) is a chronic, inflammatory, autoimmune, multisystem connective tissue disease characterized by various autoantibodies to nuclear and cytoplasmic antigens and commonly affects the joints and a variety of organs due to an over activation of the body's immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. The presence of antinuclear antibodies (ANA) in serum is generally considered a decisive diagnostic sign of SLE. However, a small subset of SLE patients who had the typical clinical features of SLE was reported to show persistently negative ANA tests. Our report describes a 24-yr-old female who presented with the clinical manifestations of SLE such as malar rash, photosensitivity, arthritis, oral ulcer and proteinuria. The serum autoantibodies were all negative except anti ribosomal P. She was also positive for lupus anti-coagulant. She was treated with oral prednisolone, hydroxychloroquine with topical tacrolimus and improved significantly. Three months after, repeat ANA and anti-ds DNA showed persistent negativity but lupus anti-coagulant remained positive. This case suggests that ANA may not be required in the pathogenesis of SLE. 03 Sep, 2020 https://www.organscigroup.us/articles/OJOR-5-125.php Background: Wnt signaling pathways are taking a part in regulation of cell fate decisions in normal and cancerous cells. In some cancer types, a transition from canonical to non-canonical Wnt signaling pathways was identified, a phenomenon, that in return led to increase proliferation, invasiveness and metastasis. Methods: In the current in vitro study we investigated the influence of MSCs, co-cultured in direct and indirect contact with OS cells, on the role of Wnt signaling pathways and tumor aggressiveness. Sub-populations were separated using Boyden chambers. Gene expression profiles were determined by qPCR. Results: The results revealed that interactions with MSCs increased migration and invasion capacities along with OS proliferation. Moreover, canonical Wnt signaling activity was low in OS, and co-culture with MSC. However, MSCs did not trigger a switch between the canonical to the no-canonical Wnt pathways. In addition, a more aggressive OS sub-population tend to undergo a transition towards the non-canonical pathway. Moreover, this aggressive subtype presented cancer stem-cells like characteristic. Conclusions: We submit that the progression in OS aggressiveness is attributed to a transition in Wnt signaling from canonical to non-canonical pathways, although MSCs are likely to take a part during the tumor progression, in the case of OS, they did not affect the Wnt switch. These complex tumor promoting interactions may be found in the natural and tumorigenic bone microenvironment. A better understanding of the molecular signaling mechanisms involved in the tumor development and metastasis may contribute to development of new cancer therapies. 27 Jun, 2020 https://www.organscigroup.us/articles/OJOR-5-124.php The authors discuss an interesting case of a Pacinian corpuscle neuroma in the finger of a young woman who presented with severe digital pain. The clinical signs were very prominent. The patient had complete pain relief following excision of the tumor. Pacinian corpuscle neuromas are rare, with only about few cases reported in the literature. The histology, presenting features and associated conditions are discussed in detail. In addition to a neuroma or glomus tumor, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of digital or palmar pain of unknown etiology. 22 Jun, 2020 https://www.organscigroup.us/articles/OJOR-5-123.php Low Back Pain (LBP) is a major cause of morbidity with significant economic impact through loss of work (15% in the United Kingdom). Additionally, there is the cost of health care and social support for the affected individual and their family. It is estimated that more than half the population (49%-70%) will experience significant LBP during their lives. Point prevalence from 12% to 30% is reported in western countries [1,2]. 04 Jun, 2020 https://www.organscigroup.us/articles/OJOR-5-121.php Treatment of trans-scaphoid perilunate injuries of the wrist presents a clinical challenge for patients and the treating hand surgeon. In the past, traditional treatment consisted of combined volar and dorsal approaches, repair of all of the involved ligaments, screw fixation of the scaphoid fracture, and immobilization until the scaphoid is radiographically united. We describe a volar approach that allows for decompression of the carpal tunnel, repair of the rent in the Space of Poirier, and direct internal fixation of the scaphoid fracture with a staple (scaple) that allows for early range of motion. We have used this approach in 18 patients at a Level 1 Trauma Center with satisfactory clinical outcomes. 27 May, 2020 https://www.organscigroup.us/articles/OJOR-5-120.php The operative treatment of the unstable cavovarus foot is a multi-level procedure and comprises of a combination of osteotomies and soft tissue procedures. 28 Jan, 2020 https://www.organscigroup.us/articles/OJOR-5-119.php Tibia is exposed to frequent injury there by being the most commonly fractured long bone. Because one third of tibial surface is subcutaneous throughout the most of its length and it also has a precarious blood supply than other bones, which are enclosed by bulky muscles. The presence of the hinge joints at the knee and ankle allow to no adjustment of the rotatory deformity after fracture requiring during correction of reduction [1]. 31 Dec, 2019 https://www.organscigroup.us/articles/OJOR-4-118.php Background and purpose: Early-Onset Scoliosis (EOS) treatment aim to improve natural history and the child’s quality of life. Magnetically Controlled Growing-Rods (MCGRs) represented a major evolution in distraction-based management of EOS by eliminating the surgical elongations. The technique can be used until cessation of growth and consequently it overlaps with primary Permanent Deformity Surgery (PDS). Patient reported outcomes of growth instrumentation compared to PDS is an interesting but uninvestigated subject. 12 Mar, 2019 https://www.organscigroup.us/articles/OJOR-4-117.php Introduction: Post-operative analgesia is an important part of Total Knee Arthroplasty (TKA) to facilitate early mobilization and patient satisfaction. We investigated the effect of periarticular infiltration of the joint with levobupivacaine local anesthetic (LA) on the requirement of analgesics in the first 24 hours period post operatively. Methods: 28 patients who underwent TKA were analysed retrospectively. They were divided into two groups of 14 each; who did and did not receive the LA infiltration respectively. Analgesic requirement was assessed in terms of the amount of paracetamol, morphine, diclofenac, oxynorm and tramadol administered in 24hrs post operatively. Visual analogue scale was used to record the subjective pain intensity. 04 Oct, 2018 https://www.organscigroup.us/articles/OJOR-3-116.php Social comparisons, although often subconscious, contribute to defining who we are. We constantly compare ourselves to new acquaintances, neighbors, friends (often through social media), professional colleagues, and people in the media. Comparison allows us to identify ourselves: our self image, intellectual and physical abilities, and financial and social standing. 03 May, 2018 https://www.organscigroup.us/articles/OJOR-3-115.php Background: Management of calcaneal fractures has always been in controversy. Many treatment techniques have been described. In this prospective study, we studied the functional outcome of surgically treated intra-articular calcaneal fracture. Aim of study: To study the functional outcomes and complication in the surgically managed calcaneal fracture. 27 Feb, 2018 https://www.organscigroup.us/articles/OJOR-3-114.php Background: Management of large and massive rotator cuff tears remains controversial. Such tears are often irreparable, and results of treatment are unpredictable. This study documents the current practice of orthopaedic surgeons in the British Elbow and Shoulder Society. 31 Jan, 2018 https://www.organscigroup.us/articles/OJOR-3-113.php Fractures that occur against the background of osteoporosis represent a global medical and social problem. In elderly people, 90% of hip fractures, as international studies have shown, 24 Nov, 2017 https://www.organscigroup.us/articles/OJOR-2-112.php Objectives: To describe the pattern of clavicle fractures and to evaluate the results of surgical treatment for clavicle fractures. 11 Oct, 2017 https://www.organscigroup.us/articles/OJOR-2-111.php Congenital pseudarthrosis of the clavicle is a rare clinical entity. The literature reports to date only 200 clinical cases in the world. 12 Sep, 2017 https://www.organscigroup.us/articles/OJOR-2-110.php Familial Mediterranean Fever (FMF) is an autoinfl ammatory disease caused by mutations in the MEFV gene and characterized by recurrent fever, polyserositis and arthritis. It is transmitted in an autosomal recessive pattern. 07 Sep, 2017 https://www.organscigroup.us/articles/OJOR-2-109.php Shoulder dislocations are the most common joint dislocations, and only 2% of these are seen as posterior shoulder dislocations. The fl oating elbow was fi rst described in children, after that shown in adults. Floating elbow cases are very rare, and usually seen with high-energy trauma. Classical defi nition is the coexistence of the humeral diaphyseal and forearm fracture, but there are other defi nitions as well. 29 May, 2017 https://www.organscigroup.us/articles/OJOR-2-108.php Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome is a genetic disorder caused by mutation in the Proteoglyacn PRG4 gene on chromosome 1. The syndrome is characterized by congenital or early onset camptodactyly and childhood-onset of non-infl ammatory arthropathy, coxa vara deformity, or other dysplasia associated with progressive hip disease and non-infl ammatory pericardial effusion. 27 Mar, 2017 https://www.organscigroup.us/articles/OJOR-2-107.php Muscle atrophy is the loss of muscles bulk; it can be a partial or complete wasting away of muscle. Herein, we describe a 56-year-old man with diffuse large B-cell lymphoma underwent F-18 FDG PET for postchemotherapy evaluation. 06 Feb, 2017 https://www.organscigroup.us/articles/OJOR-2-106.php Purpose: An update of the technical nuances of microsurgical - endoscopic assisted approaches to the craniocervical junction (transnasal, transoral and transcervical) if provided from the literature in order to better contribute to identify the best strategy. 30 Dec, 2016 https://www.organscigroup.us/articles/OJOR-1-105.php Introduction: Scaphoid fractures evolves in 10% of cases to nonunion. Untreated, it progresses to arthrosis of the wrist that may compromise the function of the hand. The recently described vascularized bone grafts have helped to expand the armamentarium of management of scaphoid nonunion. 06 Dec, 2016 https://www.organscigroup.us/articles/OJOR-1-104.php We report the protocol of a prospective observational study on surgical and conservative therapies for painful thumb carpometacarpal (CMC) osteoarthritis. 18 Jun, 2016 https://www.organscigroup.us/articles/OJOR-1-103.php Innovation remains a major key to advance research and to develop new techniques. It is an essential need to speed up the valorization of scientific discovery in concrete and rapid implementation for the benefit of patients. Innovation involves collaboration between multidisciplinary researchers because it should enable knowledge transfer in both directions. 21 Apr, 2016 https://www.organscigroup.us/articles/OJOR-1-102.php Objective: This manuscript reports the outcomes of medial meniscectomy (MM) surgery on cartilage and cortical bone strength and the reaction of cartilage and bone to intensive treatment with antiresorptive (zoledronate) and anabolic bone (PTH) therapies. 10 Jan, 2016 https://www.organscigroup.us/articles/OJOR-1-101.php Surgical treatment is indicated for displaced and unstable distal radius fractures. Kapandji percutaneous pin fixation technique is widely practiced on account of its efficiency and relative reproducibility.