bims-ricfun Biomed News
on Rehabilitation ICF
Issue of 2026–02–15
fifty-one papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica
  1. Ultrasonograhic Identification of the Entrapment of a Transligamentous Sensory Branch of the Ulnar Nerve.
  2. Nerve Hydrodissection as Treatment for Entrapment Neuropathies: A Literature Review.
  3. Ultrasound-guided management of bilateral Achilles tendon rupture in a patient with ankylosing spondylitis.
  4. High-Resolution Imaging of the Plantar Plate of the Foot: Ultrasound and 3D MR Imaging Evaluation.
  5. Mechanism of Action of Therapeutic Exercise in Rotator Cuff Tendinopathy: What Does Elastography Add?
  6. Delayed Radial Nerve Palsy Following a Low-Impact Mechanical Fall Managed With Early Ultrasound-Guided Hydrodissection: A Case Report.
  7. Sciatic nerve compression as a cause of severe chronic pain after total knee replacement: a case report.
  8. Clinical Outcomes of Biologic Therapies for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Studies With ≥12-Month Follow-up.
  9. Sports Injuries: Traumatic and Overuse Injuries of the Shoulder.
  10. Rebuttal letter for: Intra-articular corticosteroid injections versus platelet-rich plasma as a treatment for cervical facetogenic pain: a randomized clinical trial.
  11. Oblique Muscle Avulsion at the Iliac Crest: A Rare Cause of Abdominal Pain.
  12. Quantitative assessments of ultrasound-based rotator cuff muscle quality.
  13. Preliminary Assessment of Pisotriquetral Joint Kinematics Following Transverse Carpal Ligament Release: A Cadaveric Pilot Study.
  14. Ultrasound of the temporomandibular joint: a pictorial review.
  15. Identifying reliable, valid and feasible outcome measures for adults aged 50 years or older with hip or knee osteoarthritis participating in supervised exercise programs: a scoping review.
  16. Wrist Ligaments Injuries and Instability.
  17. Consensus-based follow-up and treatment registry for GNAO1-associated disorder.
  18. Molecular Indicators of Isometric Exercise Efficacy in Early Rehabilitation of Older Adults After Total Hip Arthroplasty.
  19. Structure and Function of the Achilles Tendon and Plantarflexors 1 Year Following Achilles Tendon Rupture in the United Kingdom: A Cross-Sectional Study.
  20. Analysis of the CTS-6 Questionnaire and Development of a Carpal Tunnel Syndrome Decision Tree.
  21. Pharmacological Agents for Soft Tissue and Articular Injections: From Mechanisms to Clinical Applications.
  22. Spinal Cord Stimulation in Complex Regional Pain Syndrome: A Narrative Review.
  23. Six-week biofeedback gait retraining programme for people with knee osteoarthritis: A randomised controlled trial.
  24. Outcomes of Clinico-radiologically Predetermined Patient-specific Multi-site Steroid Injection in Primary Frozen Shoulder: A Prospective Study.
  25. Dynamic ultrasound motion metrics combined with deep learning for clinical differentiation of subacromial impingement syndrome.
  26. A novel subgrouping approach to low back pain: Exploring differences in lumbar muscle morphology and function - A cross-sectional study.
  27. Effects of virtual walking on neuropathic pain following spinal cord injury: a systematic review.
  28. No Differences in Outcomes Between Operative and Non-Operative Approaches for High-Grade Acromioclavicular Joint Injuries: A Systematic Review and Meta-analysis.
  29. EUROVISCO Recommendations for the Use of Viscosupplementation with Hyaluronic Acid in the Management of Hip Osteoarthritis.
  30. Which factors correlate with muscle strength capacity in people with patellofemoral pain? A systematic review with meta-analysis.
  31. Management of Acute Midsubstance Patella Tendon Rupture: Current Concepts and Clinical Narrative Review.
  32. "Fighter's shoulder" part I: impact on shoulder motion and scapular movement in judo and jiu-jitsu athletes.
  33. Knee osteoarthritis - Current concepts.
  34. Effectiveness of repeated ultrasound-guided suprascapular nerve blocks in hemiplegic shoulder pain: A randomized controlled trial.
  35. Immediate effects of dynamic and Kinesio taping on balance and ground reaction forces in women with patellofemoral pain syndrome.
  36. Pelvic Floor Muscle Training Following Surgery for Pelvic Organ Prolapse: Recommendation from Scientific Literature.
  37. Coccyx pain.
  38. Challenges in Defining Centralized Pain Following Peripheral Nerve Injury.
  39. Ongoing Clinical Challenges in Nerve Surgery (Nerve SPACE 2025).
  40. Ketamine for acute and chronic pain: beyond anaesthesia.
  41. Approach to mallet finger injury: Practical guide for Canadian primary care physicians.
  42. The Role of Musculoskeletal Ultrasound in Detecting Superior Cluneal Nerve Entrapment: Biomechanical Insights in Chronic Low Back Pain-A Pilot Study.
  43. Impairments and outcomes in adults with hip dysplasia (PhD Academy Award).
  44. Platelet-rich plasma in arthroscopic rotator cuff repair: a meta-analysis of biomaterial efficacy and future directions for personalized sports medicine.
  45. The effect of artificial intelligence-assisted pulmonary rehabilitation on exercise capacity: A systematic review and meta-analysis.
  46. Surgical Management of Volar Lip Fractures of the Middle Phalanx: A Case Series on Diverse Techniques and Outcomes, Do Acute and Chronic Presentations Differ in Outcome?
  47. Efficacy of arthroscopic debridement combined with platelet-rich plasma injection for knee osteoarthritis: An updated systematic review and meta-analysis of randomized controlled trials.
  48. Nursing interventions for people with musculoskeletal injuries during physical activity: A scoping review.
  49. A multidimensional evaluation of pain in lipedema.
  50. Reverse End-to-Side Triceps to Axillary Nerve Transfer for Treatment of Axillary Nerve Palsy After Reverse Total Shoulder Arthroplasty.
  51. Reported Minimal Clinically Important Differences for Patient-Reported Outcome Measures in Hand and Upper-Extremity Surgery: A Systematic Review.
  1. Diagnostics (Basel). 2026 Jan 27. pii: 405. [Epub ahead of print]16(3):
    Ultrasonograhic Identification of the Entrapment of a Transligamentous Sensory Branch of the Ulnar Nerve.
    Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar.
      Anatomical variations of the ulnar nerve at the wrist are uncommon and may lead to diagnostic confusion or iatrogenic injury if unrecognized. We present an ultrasound-based identification of a rare transligamentous ulnar nerve sensory branch entrapment in an elderly male with chronic ulnar-sided hand paresthesia. High-resolution ultrasonography revealed an aberrant sensory branch deviating from the ulnar nerve, piercing the palmar carpal ligament, and coursing superficially rather than entering Guyon's canal. Further assessment demonstrated focal nerve flattening within the ligament with proximal enlargement, consistent with entrapment. This case highlights the value of ultrasound in detecting rare peripheral nerve variants and their entrapments. Therefore, it is also noteworthy to extend the sonographic evaluation beyond conventional entrapment sites at the wrist.
    Keywords:  aberrant nerve; ligament; paresthesia; ultrasound; wrist
    DOI:  https://doi.org/10.3390/diagnostics16030405
  2. Cureus. 2026 Jan;18(1): e101039
    Nerve Hydrodissection as Treatment for Entrapment Neuropathies: A Literature Review.
    Szymon Stupnicki, Jakub Tarczykowski, Aleksandra Oparcik, Mikołaj Zakryś, Katarzyna A Zakryś, Mateusz Szot, Natalia Kwaśniewska.
      Entrapment neuropathies are disorders in which peripheral nerves are affected at anatomically restricted sites or at locations where they are vulnerable to external compression. They are prevalent in the general population and may lead to pain, sensory disturbances, and functional impairment. In recent years, nerve hydrodissection has gained attention as a minimally invasive, ultrasound-guided treatment option for entrapment neuropathies. This technique involves the injection of different substances into the perineural space to mechanically separate the nerve from adjacent tissues and potentially reduce compression. The aim of this narrative review was to summarize recent evidence regarding the clinical utility of nerve hydrodissection in the management of entrapment neuropathies in different anatomical regions. The available literature indicates that nerve hydrodissection is associated with meaningful improvements in pain and functional outcomes across a variety of entrapment neuropathies, with the largest body of evidence related to carpal tunnel syndrome. Overall, 5% dextrose in water has emerged as a commonly used injectate with a favorable clinical profile. Nerve hydrodissection appears to be a promising addition to conservative treatment strategies for entrapment neuropathies, particularly in mild to moderate cases. Future studies should focus on entrapment neuropathies other than carpal tunnel syndrome to provide higher-quality and more comprehensive evidence in these conditions.
    Keywords:  hydrodissection; nerve regeneration; perineural injection therapy; peripheral entrapment neuropathy; ultrasound-guided
    DOI:  https://doi.org/10.7759/cureus.101039
  3. Clin Rheumatol. 2026 Feb 12.
    Ultrasound-guided management of bilateral Achilles tendon rupture in a patient with ankylosing spondylitis.
    Berkay Yalçınkaya, Ahmet Furkan Çolak, Alp Çetin.
      
    DOI:  https://doi.org/10.1007/s10067-026-07983-6
  4. Radiol Clin North Am. 2026 Mar;pii: S0033-8389(25)00113-7. [Epub ahead of print]64(2): 241-249
    High-Resolution Imaging of the Plantar Plate of the Foot: Ultrasound and 3D MR Imaging Evaluation.
    Vivek Kalia, Osahon Obanor, Flavio Duarte Silva.
      Plantar plate tears are a significant cause of forefoot pain and functional disability, frequently underdiagnosed due to their nonspecific clinical presentation and overlap with other causes of metatarsalgia. As the primary static stabilizers of the lesser metatarsophalangeal joints, plantar plates are subject to degenerative and traumatic injuries, particularly in specific at-risk populations. Accurate diagnosis necessitates high-resolution imaging modalities, with ultrasound offering a cost-effective, dynamic option, and MR imaging, particularly 3D isotropic sequences, providing superior anatomic detail for precise assessment.
    Keywords:  2D MR imaging; 3D MR imaging; Diagnostic imaging; Forefoot pain; Lesser MTP joint; Metatarsalgia; Plantar plate tear; Ultrasound
    DOI:  https://doi.org/10.1016/j.rcl.2025.10.002
  5. J Clin Med. 2026 Jan 27. pii: 1015. [Epub ahead of print]15(3):
    Mechanism of Action of Therapeutic Exercise in Rotator Cuff Tendinopathy: What Does Elastography Add?
    Irene Pérez-Porta, Claudia de la Fuente-Escudero, Ángel Luis Bueno-Horcajadas, Elia Pérez-Fernández, Fernando García-Pérez, María Velasco-Arribas, Mariano Tomás Flórez-García.
      Background/Objectives: In rotator cuff-related shoulder pain (RCRSP) without associated tendon rupture, therapeutic exercise is one of the main treatment strategies; however, the mechanisms through which it exerts its effects remain poorly understood. The aim of this study was to analyze the role of two potential mechanisms of action: increases in muscle strength and changes in the microarchitecture of the supraspinatus muscle. Methods: This prospective study included 39 patients with RCRSP treated with a strengthening exercise program. Muscle strength was assessed using dynamometry, and supraspinatus muscle stiffness was evaluated using shear wave elastography (SWE) at baseline and after 6 months of exercise. These measurements were correlated with clinical and perceived improvement in the patients. Results: Thirty-seven patients completed follow-up. At 6 months, 67.6% of participants reported being much better or fully recovered, 29.7% reported being somewhat better, and only one patient (2.7%) reported worsening. Overall, the increase in muscle strength was small. In participants reporting marked improvement or full recovery, strength gains were slightly greater, but a significant increase in supraspinatus muscle stiffness was observed. In contrast, participants with mild improvement or worsening showed smaller strength gains and no changes in muscle stiffness. Conclusions: Strength gains following strengthening exercises in RCRSP are small and of limited clinical relevance. In contrast, increased supraspinatus muscle stiffness assessed by SWE was observed after the exercise intervention and may reflect exercise-related adaptations; however, its biological meaning should be interpreted with caution.
    Keywords:  exercise; rotator cuff tendinopathy; shear wave elastography; sonoelastography; stiffness; supraspinatus muscle
    DOI:  https://doi.org/10.3390/jcm15031015
  6. Cureus. 2026 Jan;18(1): e101361
    Delayed Radial Nerve Palsy Following a Low-Impact Mechanical Fall Managed With Early Ultrasound-Guided Hydrodissection: A Case Report.
    Stephanie Marrero Borrero, Jose M Mariani, Miguel F Agrait Gonzalez.
      A 43-year-old male presented to the emergency department due to progressive weakness of the left hand and wrist following blunt trauma to the elbow around three weeks prior to evaluation. He was initially evaluated at the time of injury with radiographs of the elbow and forearm, which were reported to be normal. Due to worsening weakness, he sought care at additional emergency departments and with a neurologist who performed a CT, repeat radiographs, and eventually an MRI of the elbow, all of which revealed no acute findings. At our facility, point-of-care ultrasound evaluation of the elbow demonstrated radial nerve compression just proximal to the joint. Ultrasound-guided hydrodissection of the radial nerve was performed, after which the patient showed improvement in range of motion and strength over the following days. With early initiation of physical therapy, the patient regained full range of motion against gravity within one month and achieved complete recovery within three months. Recognition and prompt management of peripheral nerve compression requires a multidisciplinary approach, involving emergency medicine, physical medicine and rehabilitation, and neurology. Early intervention may help prevent long-term dysfunction and aid in more rapid recovery of compressive neuropathies.
    Keywords:  acute radial nerve palsy; blunt trauma; hydrodissection; olecranon bursitis; pain in elbow; radial nerve injury; wrist drop
    DOI:  https://doi.org/10.7759/cureus.101361
  7. Knee. 2026 Feb 09. pii: S0968-0160(26)00041-4. [Epub ahead of print]60 104363
    Sciatic nerve compression as a cause of severe chronic pain after total knee replacement: a case report.
    Tim Philips, Willem Goethals, Francis De Neve, Pieter-Bastiaan De Keyzer, Jean F Goubau, Michiel Cromheecke.
       BACKGROUND: Persistent pain following total knee replacemnt (TKR) remains a challenging and often multifactorial issue. While common causes include infection, malalignment, or complex regional pain syndrome, less typical origins are easily overlooked. We report a unique case of chronic, disproportionate posterior thigh pain 1 year after TKR, caused by a complete proximal hamstring rupture leading to symptomatic sciatic nerve compression. To our knowledge, this is the first published case describing this specific postoperative complication and its successful surgical management.
    CASE PRESENTATION: A 66-year-old woman presented with severe, unbearable posterior thigh pain that began immediately after left TKR. The pain was continuous, worse at night, and aggravated by sitting, cycling, or stair climbing. Previous surgeons had attributed the symptoms to complex regional pain syndrome. Clinical examination revealed a Popeye-like deformity of the distal hamstring, a positive Tinel's sign, and localized tenderness over the sciatic nerve. Imaging studies demonstrated a complete rupture of the common hamstring tendon, including the semimembranosus, with an 18.5-cm retraction and entrapment of the semitendinosus tendon against the sciatic nerve. Conservative management with ultrasound-guided perineural infiltrations provided only transient relief. Surgical exploration and neurolysis were therefore performed. Intraoperatively, the sciatic nerve was identified, released from adhesions, and decompressed along its bifurcation. The surrounding musculature appeared atrophic and infiltrated with fatty tissue. Postoperatively, the patient experienced immediate and sustained relief, with the pain score improving from 80/100 to 10/100 and complete functional recovery documented within 2 months. There were no neurological or vascular deficits, and the patient reported maximal satisfaction with the surgical outcome.
    CONCLUSIONS: This case highlights an exceptionally rare etiology of chronic pain, which started immediately following TKR: a complete proximal hamstring rupture with secondary sciatic nerve compression. Recognition of this condition requires clinical suspicion when patients present with disproportionate posterior thigh pain unresponsive to standard treatment. Early magnetic resonance imaging is essential for accurate diagnosis. Timely surgical neurolysis can achieve excellent functional outcomes. Increased awareness among orthopedic surgeons and rehabilitation specialists may prevent delayed diagnosis and unnecessary patient suffering.
    Keywords:  Proximal hamstring avulsion; Sciatic nerve compression; Sciatic nerve release; Total knee replacement
    DOI:  https://doi.org/10.1016/j.knee.2026.104363
  8. Mod Rheumatol. 2026 Feb 13. pii: roag010. [Epub ahead of print]
    Clinical Outcomes of Biologic Therapies for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Studies With ≥12-Month Follow-up.
    Tomohiro Oka, Takashi Kitagawa, Takafumi Nasu, Yasuyuki Kurasawa, Hayato Kunihara, Kosuke Suzuki, Norimasa Nakamura.
      This systematic review and meta-analysis aimed to assess the clinical outcomes of biologic therapies, which include platelet-rich plasma and cell-based therapies (e.g., adipose-derived mesenchymal stem cells), on pain, physical function, and disease progression in patients with knee osteoarthritis (OA), focusing on studies with a follow-up of at least 12 months. We searched for randomized controlled trials (RCTs) posted at some stage in January 2000-May 2025. Eligible research protected the ones in adults with Kellgren-Lawrence grades I-III OA who underwent at least 12 months of follow-up. The bias risk was assessed, and the evidence certainty was evaluated. Random-effects models were used for pooled analyses. Fourteen RCTs were included. Compared with control treatments, biologic therapies significantly reduced pain and improved physical function. Potential structural benefits, including cartilage thickness preservation and favourable biochemical changes, were noted. However, substantial heterogeneity in study design and intervention protocols, along with potential publication bias, reduced the certainty of evidence to a very low level. Biologic therapies may be associated with improvements in pain and physical function at ≥12 months of follow-up, with preliminary indications of structural benefit. Nevertheless, high-quality multicenter RCTs with extended follow-up are warranted.
    Keywords:  biologic therapy; evidence certainty; knee osteoarthritis; mesenchymal stem cells; meta-analysis; pain; physical function; platelet-rich plasma; systematic review
    DOI:  https://doi.org/10.1093/mr/roag010
  9. Semin Musculoskelet Radiol. 2026 Feb 11.
    Sports Injuries: Traumatic and Overuse Injuries of the Shoulder.
    Douglas Dunn, Ali Naraghi, Lawrence M White.
      The shoulder joint, one of the most complex and mobile articulations in the human body, is prone to derangement as a result of acute trauma or repetitive microtraumatic injury in athletes. In contact and collision sports, most shoulder injuries are acromioclavicular joint sprains and dislocations, glenohumeral dislocations, and rotator cuff injuries. In overhead and throwing athletes, rotator cuff and labral pathologies are frequent and typically arise as the result of overuse repetitive microtraumatic injuries of the glenohumeral articulation. This review article summarizes the epidemiology, mechanisms of injury, and characteristic imaging findings of common shoulder injuries in athletes, including acromioclavicular joint injuries, rotator cuff tears and avulsions, pediatric epiphyseal and apophyseal injuries, glenohumeral dislocations, repetitive microtraumatic overuse, and other muscular injuries.
    DOI:  https://doi.org/10.1055/a-2771-1174
  10. Reg Anesth Pain Med. 2026 Feb 10. pii: rapm-2026-107656. [Epub ahead of print]
    Rebuttal letter for: Intra-articular corticosteroid injections versus platelet-rich plasma as a treatment for cervical facetogenic pain: a randomized clinical trial.
    David J Allison.
      
    Keywords:  CHRONIC PAIN; CLINICAL PAIN; Pain Management
    DOI:  https://doi.org/10.1136/rapm-2026-107656
  11. Acta Med Port. 2026 Feb 02. 39(2): 161-162
    Oblique Muscle Avulsion at the Iliac Crest: A Rare Cause of Abdominal Pain.
    José Otávio Leal Macedo, Márcio Luí S Duarte.
      
    Keywords:  Abdominal Oblique Muscles/injuries; Abdominal Pain/etiology; Athletic Injuries; Ilium/injuries; Magnetic Resonance Imaging
    DOI:  https://doi.org/10.20344/amp.24205
  12. PM R. 2026 Feb 09.
    Quantitative assessments of ultrasound-based rotator cuff muscle quality.
    Andrew J Nasr, Henry Wang, Michael Khazzam, Nitin B Jain, Yen-Sheng Lin.
       BACKGROUND: Fatty infiltration and muscle atrophy strongly influence clinical outcomes in patients with rotator cuff tears. Emerging quantitative techniques integrated with brightness-mode ultrasound and shear wave elastography (SWE) have been used to evaluate soft tissue morphology and mechanical properties.
    OBJECTIVE: To evaluate integrative B-mode ultrasound and SWE as a potential tool to quantify rotator cuff muscle quality.
    METHODS: Twenty participants (a total of 32 shoulders) with and without rotator cuff tears were included in this study. Shear wave speed (SWS) was measured in SWE-mode and cross-sectional area (CSA) was measured in B-mode with a linear transducer. Muscle strength was measured using a hand-held dynamometer. Psychometric properties were calculated for SWS and CSA under both passive and active conditions.
    RESULTS: The SE of measurement and minimum detectable difference for the SWS of supraspinatus in shoulders with rotator cuff tears were 0.195 and 0.541 m/s, respectively. The SE of measurement and minimum detectable difference for the CSA of supraspinatus in shoulders with rotator cuff tears were 0.265 and 0.733 cm2, respectively. Correlation analysis between passive mean SWS and CSA revealed a strong correlation (r = 0.652, p = .003) for the supraspinatus.
    CONCLUSION: These findings demonstrate a strong positive correlation between SWS and CSA of the supraspinatus in participants with rotator cuff tears but not the infraspinatus or in asymptomatic participants. Assessment of SWS and CSA under passive conditions yields superior psychometric properties compared to active conditions. However, the lack of association between SWS and strength limits the clinical utility of SWE to quantify rotator cuff muscle quality.
    DOI:  https://doi.org/10.1002/pmrj.70097
  13. Cureus. 2026 Jan;18(1): e101067
    Preliminary Assessment of Pisotriquetral Joint Kinematics Following Transverse Carpal Ligament Release: A Cadaveric Pilot Study.
    Raphael Israeli, Chen Steinmetz, Gil Gannot, Amir Oron.
      Introduction Transverse carpal ligament (TCL) release is the standard treatment for carpal tunnel syndrome; however, its potential to alter carpal biomechanics is unclear. Specifically, it has been hypothesized that TCL transection may destabilize the pisotriquetral (PT) joint or unmask latent arthritis. This pilot study investigated the immediate kinematic effects of TCL transection on the PT joint in an embalmed cadaveric model. Methods Six embalmed cadaveric wrists were mounted on a custom stabilization apparatus. Colored markers were affixed to the ulna, pisiform, and fourth metacarpal bones to track the motion vectors. Wrist kinematics were recorded via video analysis before and after complete TCL transection under simulated maximal flexor carpi ulnaris (FCU) contraction. Changes in wrist flexion, extension, and relative PT angle were quantified. Results In this cohort, TCL release did not result in statistically significant changes in kinematic parameters. The mean difference in wrist extension was -2.83° (95% CI: -9.72° to 4.05°; p = 0.34). The mean difference in wrist flexion was -2.84° (95% CI: -10.57° to 4.88°; p = 0.39). The PT angular relationship remained consistent pre- and post-release (mean difference: -0.01°; 95% CI: -2.84° to 2.82°; p = 0.99). Conclusions Within the limitations of a small sample size and embalmed tissue model, complete TCL release did not produce gross kinematic alterations in the PT joint. While these preliminary findings suggest that the intrinsic ligamentous stability of the pisiform is maintained post-release, larger studies utilizing fresh-frozen specimens are required to rule out subtle instability patterns that may contribute to postoperative ulnar-sided wrist pain.
    Keywords:  cadaveric study; carpal tunnel release; pisotriquetral arthritis; pisotriquetral joint; transverse carpal ligament; ulnar-sided wrist pain; wrist biomechanics
    DOI:  https://doi.org/10.7759/cureus.101067
  14. J Stomatol Oral Maxillofac Surg. 2026 Feb 05. pii: S2468-7855(26)00044-3. [Epub ahead of print] 102748
    Ultrasound of the temporomandibular joint: a pictorial review.
    Benoit LE Goff, Manon Darras, Justine Loin, Pierre Corre, Hélio Bertin.
      The temporomandibular joint (TMJ) is a common cause of orofacial pain. Several imaging techniques can be used to aid diagnosis and management of patients. Ultrasound (US) is a non-ionising, inexpensive and widely available technique. This pictorial review aims to demonstrate the US changes associated with various TMJ disorders. Ultrasound examinations should be standardised and include static and dynamic evaluations of the joint. Several abnormalities can be detected in cases of osteoarthritis, inflammatory arthritis, or disc disorders, such as cortical irregularity, effusion, or disc displacement. Ultrasound also enables joint aspiration, intra-articular injection and synovial biopsy with real-time control. This review also discusses the limitations of this imaging modality, with MRI remaining the gold standard for diagnosis in most cases. Nevertheless, ultrasound can still be considered an extension of clinical examination. It provides rapid and cost-effective diagnostic information and serves as a valuable complement to CBCT and MRI within a multimodal TMJ imaging strategy.
    Keywords:  Arthrocentesis; Temporomandibular Joint Disorders; Ultrasonography; arthritis; osteoarthritis
    DOI:  https://doi.org/10.1016/j.jormas.2026.102748
  15. Musculoskelet Sci Pract. 2026 Feb 02. pii: S2468-7812(26)00026-3. [Epub ahead of print]82 103511
    Identifying reliable, valid and feasible outcome measures for adults aged 50 years or older with hip or knee osteoarthritis participating in supervised exercise programs: a scoping review.
    Nikole Watson, Rosmary Martinez Rueda, Hayley Legg, Catherine Boden, Brenna Bath.
       OBJECTIVE: To identify reliable, valid, and feasible outcome measures that could be used to assess outcomes of participating in supervised exercise programs for adults aged 50 years or older with hip or knee osteoarthritis (OA).
    METHODS: A scoping review was conducted in accordance with Joanna Briggs Institute and PRISMA-ScR guidelines. Six databases were searched on July 18, 2024. Eligible studies were systematic, literature, or integrative reviews evaluating at least one psychometric property (reliability, validity, or feasibility) of outcome measures for adults aged ≥50 years with hip or knee OA, including those awaiting or having undergone total joint arthroplasty.
    RESULTS: Sixteen reviews were included, identifying 102 outcome measures (35 self-report, 67 performance-based). Nine reviews used the COSMIN methodology, while others applied alternative or narrative frameworks. Commonly supported measures included the WOMAC, KOOS, HOOS, LEFS, 6-Minute Walk Test, 40-m fast-paced walk, and Timed Up and Go, which showed strong reliability (ICC ≥0.80) and construct validity. Feasibility was discussed narratively in 13 reviews; none used formal criteria. Only three mentioned exercise, and none evaluated measures in supervised programs.
    CONCLUSION: Multiple outcome measures demonstrated acceptable reliability and validity for adults with hip or knee OA, but feasibility data were limited, and no tools were validated in the context of supervised exercise. Consequently, no measure fulfilled all three psychometric criteria for this setting. Future research should include structured feasibility assessments and evaluate measures within exercise-based interventions.
    Keywords:  Clinimetric; Joints; Measurement properties; Outcome assessment; Physiotherapy; Psychometric; Rehabilitation
    DOI:  https://doi.org/10.1016/j.msksp.2026.103511
  16. Radiol Clin North Am. 2026 Mar;pii: S0033-8389(25)00098-3. [Epub ahead of print]64(2): 295-313
    Wrist Ligaments Injuries and Instability.
    Erica Kubascik, Ali Rashidi, Philip K Wong.
      Wrist instability is a challenging topic for radiologists due to the wrist's intricate ligamentous anatomy and complex kinematics. This article provides a comprehensive overview of the intrinsic and extrinsic wrist ligaments, their characteristic imaging appearance, and the pathomechanics and classification systems of carpal instability to enhance radiologists' ability with the diagnosis of wrist ligamentous pathologies. Furthermore, the evolving role of advanced imaging modalities, such as high-resolution MR, kinematic MRI, MR arthrography, 4DCT, CT arthrography, and dynamic imaging techniques for the assessment of the wrist biomechanics and detecting subtle ligamentous injuries were detailed.
    Keywords:  3D MR imaging; 4DCT; Carpal instability; Dynamic MR imaging; Scapholunate ligament; Triangular fibrocartilage complex; Wrist ligaments
    DOI:  https://doi.org/10.1016/j.rcl.2025.09.003
  17. Dev Med Child Neurol. 2026 Feb 13.
    Consensus-based follow-up and treatment registry for GNAO1-associated disorder.
    Larissa R Heideman, Nicole I Wolf, Moritz Thiel, Jolanda H Schieving, Chris De Kruiff, Suzanne van den Bos, Eva Van Heeringen-Broekhuizen, J Jasper Deuring, Annemieke I Buizer, Laura A Van De Pol.
       AIM: To establish consensus-based recommendations on relevant domains of functioning and assessment instruments for an GNAO1-associated disorder follow-up and treatment registry.
    METHOD: This was a mixed-methods study consisting of a systematic literature search, a survey, and a real-time Delphi procedure to achieve consensus on domains and instruments. A panel of experts, including health care professionals and individuals with lived experience, was involved in the survey and Delphi procedure. The International Classification of Functioning, Disability and Health (ICF) was used as a framework for the Delphi query.
    RESULTS: The Delphi procedure consisted of 67 statements, including 19 on domains and 48 on instruments, identified from the survey and systematic search. The international panel consisted of 27 health care professionals and 10 parents. The panel recommended 17 ICF domains and 26 assessment instruments, mainly in the 'Body Structures & Functions' and 'Activities & Participation' components.
    INTERPRETATION: Using consensus-based ICF domains and assessment instruments for a GNAO1 registry is a major step towards harmonization of future international registries, which will facilitate natural history studies and clinical trials.
    Keywords:  Delphi study; GNAO1; ICF framework; Real‐time Delphi procedure; Registry
    DOI:  https://doi.org/10.1111/dmcn.70201
  18. Int J Mol Sci. 2026 Jan 30. pii: 1389. [Epub ahead of print]27(3):
    Molecular Indicators of Isometric Exercise Efficacy in Early Rehabilitation of Older Adults After Total Hip Arthroplasty.
    Elena A Maksimova, Kirill S Krasnov, Anatoly S Senotov, Victor I Shevchenko, Artem M Ermakov, Elizaveta S Zhdanova, Vladimir S Akatov.
      Developing molecular methods for assessing the effectiveness of physical rehabilitation remains a pressing task. Our pilot study aimed to assess the utility of the transcriptome analysis of muscle biopsies in evaluating the efficacy of the isometric exercises (IEs) added to the standard protocol in the early rehabilitation of older patients during the initial two weeks post total hip arthroplasty (THA). Blood concentrations of total leukocytes, neutrophils, IL6, IL8, IL1β, myoglobin, etc. were measured, and transcriptome analysis of rectus femoris biopsies from the operated leg was performed before and after (1 and 12 days) THA in women aged 73-77 years. The additional IEs in the experimental rehabilitation group led to a significant acceleration in the recovery of IL6, IL8, and IL1β blood levels to the normal ranges compared to the control group, as confirmed by a Fisher's exact test for this cytokine combination. The results of Gene Set Enrichment Analysis and Differentially Expressed Gene Analyses for the muscle biopsies point to accelerated resolution of inflammation, along with enhanced activation of genes associated with angiogenesis, lymphangiogenesis, vasodilation, and vasoconstriction in the experimental rehabilitation group compared to the control group. Thus, IL6, IL8, and IL1β blood levels can serve in combination as molecular indicators of the efficacy of early rehabilitation after THA, and transcriptome analysis of the rectus femoris biopsies of the operated leg allows for the revelation of the molecular indicators of regenerative processes in muscle tissue near the surgery area after THA.
    Keywords:  bioinformatics; early rehabilitation; isometric exercises; pro-inflammatory interleukins; total hip arthroplasty; transcriptome
    DOI:  https://doi.org/10.3390/ijms27031389
  19. J Foot Ankle Res. 2026 Mar;19(1): e70134
    Structure and Function of the Achilles Tendon and Plantarflexors 1 Year Following Achilles Tendon Rupture in the United Kingdom: A Cross-Sectional Study.
    Samuel Briggs-Price, Jitendra Mangwani, Alexander Kilcran, Anchal Prasad, Reihaneh Salimian, Seth O'Neill.
       BACKGROUND: Achilles tendon rupture (ATR) is the most common tendon rupture affecting the lower limb. This study investigates Achilles tendon structure, strength and function 1 year or more after ATR.
    METHODS: This cross-sectional study recruited individuals ≥ 12 months post ATR. Structure was assessed using ultrasound tissue characterisation (UTC) including cross-sectional area (CSA), aligned fibrillar structure (AFS), disorganised fibrillar structure (DFS) and echo type percentage. Strength was measured using maximal voluntary isometric contraction (MVIC) plantarflexor testing and the calf raise test. Patient-reported outcomes included the Achilles tendon rupture score (ATRS), EQ-5D-5L and general practice physical activity questionnaire (GPPAQ). Achilles tendon resting angle (ATRA) was used as an indirect measure of tendon elongation. The relationship between outcomes and time since ATR was analysed using linear regression adjusting for age, sex, ethnicity and body mass index (BMI). Between limb comparisons were made using paired t-tests.
    FINDINGS: Sixty participants (mean age 55.2 years and 78.5% male) were assessed at a mean of 6.8 years post ATR. The affected tendon showed a 62% larger cross-sectional area, with 28.7 mm2 (16%) DFS compared to 7.3 mm2 (7%) on the nonaffected side (p < 0.001). Linear regression showed decreasing AFS with time postinjury (p = 0.04); no significant associations were found for CSA or DFS. Significant deficits were observed in plantarflexor strength and function, with MVIC and calf raise work 18% and 40% lower in the affected limb (p < 0.001). ATRA indicated tendon elongation in the affected limb of 6.7° (p < 0.001). Median ATRS was 83, EQ-5D index was 0.95 and VAS was 85; 93% were physically active based on the GPPAQ.
    CONCLUSION: Significant structural and functional deficits persist years after ATR, including increased tendon size, fibre disorganisation, reduced strength and tendon elongation. ATRS scores were consistent with previous nonsurgical immobilisation protocol outcomes in the United Kingdom. Longitudinal studies are needed to understand the trajectory of recovery following ATR.
    Keywords:  Achilles; long term; outcomes; rupture; tendon
    DOI:  https://doi.org/10.1002/jfa2.70134
  20. J Hand Surg Glob Online. 2026 Mar;8(2): 100944
    Analysis of the CTS-6 Questionnaire and Development of a Carpal Tunnel Syndrome Decision Tree.
    Eileen M Colliton, John R Fowler.
       Purpose: Carpal tunnel syndrome (CTS) is a common compressive neuropathy with no gold standard for diagnosis. The CTS-6 questionnaire is a previously validated tool used to determine the likelihood that a patient has CTS; however, numbness and tingling in the median nerve distribution is not a required symptom for a positive test result. The purpose of this study was to re-evaluate the components of the CTS-6 questionnaire to determine if a more succinct carpal tunnel screening tool could be developed.
    Methods: A database of 295 upper extremities who had previously undergone CTS-6 testing were analyzed. All charts were reviewed to determine which patients were offered carpal tunnel release, used as the reference standard for a true positive diagnosis. We split the data into training (80%) and test (20%) sets that were used to develop and validate a decision tree for CTS, respectively. The performance metrics for this decision tree, the CTS-6 questionnaire, and variations of the questionnaire were calculated.
    Results: The CTS-6 had a sensitivity of 76%, specificity of 60%, and overall accuracy of 71%. Variations of the CTS-6 had sensitivity of 72% to 93% and specificity of 37% to 65%, where a higher sensitivity came at the cost of lower specificity. The CTS decision tree had the best performance metrics, with 100% sensitivity, 65% specificity, and 88% overall accuracy.
    Conclusions: A simple CTS decision tree has the potential to be an efficient screening tool to assist in determining which patients may be a good candidate for carpal tunnel release. Further investigation into this screening tool in a larger patient population should be performed to determine its usefulness in a clinical setting.
    Type of study/level of evidence: Diagnostic IV.
    Keywords:  Carpal tunnel; Decision tree; Nerve compression; Questionnaire
    DOI:  https://doi.org/10.1016/j.jhsg.2025.100944
  21. J Clin Med. 2026 Feb 04. pii: 1227. [Epub ahead of print]15(3):
    Pharmacological Agents for Soft Tissue and Articular Injections: From Mechanisms to Clinical Applications.
    Jeries Issa Alghishan, Bogdan Andor.
      Soft tissue and intra-articular injections are common treatments for musculoskeletal disorders, especially chronic tendinopathies and osteoarthritis. In this structured narrative review, receptor-level molecular mechanisms are combined with clinical evidence from various studies for the most common injectable treatments, such as corticosteroids, hyaluronic acid, platelet-rich plasma, and local anesthetics. When combining mechanistic pathways with the results of randomized controlled trials, systematic reviews, and network meta-analyses, clear differences between injectable drugs regarding rapidity of action, duration of action, systemic effects, and safety can be appreciated. Corticosteroids alleviate symptoms rapidly but with only short-term duration. Hyaluronic acid exerts longer-lasting biomechanical and anti-inflammatory effects. Platelet-rich plasma showed the most consistent long-term effect on function and regeneration. Local anesthetics remain useful for diagnostic and interventional purposes but prove harmful to cartilage after excessive administration. A mechanism- and phenotype-based framework for selecting injectables is hereby proposed, wherein treatment could be more individualized and clinical decisions could be optimized in musculoskeletal care.
    Keywords:  corticosteroids; hyaluronic acid; intra-articular injections; local anesthetics; osteoarthritis; platelet-rich plasma; regenerative therapies; soft tissue injections; tendinopathy
    DOI:  https://doi.org/10.3390/jcm15031227
  22. Cureus. 2026 Jan;18(1): e100919
    Spinal Cord Stimulation in Complex Regional Pain Syndrome: A Narrative Review.
    John Salib, Mark Salib, Lisa M Tran, David K Sum.
      Complex regional pain syndrome (CRPS) is a chronic, debilitating pain disorder that primarily affects the limbs and often arises after injury, surgery, or trauma. Spinal cord stimulation (SCS) has emerged as a promising intervention for patients with refractory CRPS, offering targeted modulation of pain pathways in the spinal cord. Evidence suggests that SCS can provide significant pain relief, improve functional outcomes, and enhance quality of life. While generally safe, the therapy carries potential risks, including surgical complications, hardware issues, and infection. Advances in neuromodulation technologies and patient selection strategies continue to refine SCS therapy, highlighting its evolving role within multidisciplinary pain management. This review synthesizes current knowledge on the mechanisms, efficacy, safety, and future directions of SCS in treating CRPS.
    Keywords:  autonomic dysfunction; chronic pain; complex regional pain syndrome (crps); dorsal column stimulation; interdisciplinary rehabilitation; neuromodulation; neuropathic pain; pain management; quality of life; reflex sympathetic dystrophy
    DOI:  https://doi.org/10.7759/cureus.100919
  23. Clin Biomech (Bristol). 2026 Feb 07. pii: S0268-0033(26)00031-8. [Epub ahead of print]134 106776
    Six-week biofeedback gait retraining programme for people with knee osteoarthritis: A randomised controlled trial.
    Yi Wan, Polly McGuigan, James Bilzon, Logan Wade.
       BACKGROUND: Knee osteoarthritis causes pain, can limits mobility and is linked to excessive knee loading. Gait retraining with biofeedback shows promise in reducing knee loading and improving pain and function, but optimal feedback strategies remain unclear. This study compared the effects of different biofeedback-based gait retraining approaches on knee joint loading, pain and functional outcomes.
    METHODS: Fifty individuals with knee osteoarthritis were randomised to gait pattern feedback group, knee moment feedback group, or control group. Participants underwent a six-week programme, with activity knee pain, functional ability and biomechanical assessments conducted at baseline, post-intervention, and one-month follow-up. Data were analysed using linear mixed models under an intention-to-treat approach.
    FINDINGS: All groups improved in functional ability and activity knee pain post-intervention (p < 0.001), with sustained benefits in the intervention groups (p < 0.001). Only the gait pattern group showed a lasting reduction in the 1st peak knee adduction moment during (-7.6%, p = 0.003; maintained at follow-up). No significant change in foot progression angle was observed in any group. Step width increased during stair ascent and sit-to-stand (p ≤ 0.010) and step length decreased during walking (p = 0.021) for all groups, but both changes were transient.
    INTERPRETATION: Gait retraining improves pain and function in individuals with knee OA, but gait pattern feedback uniquely reduces joint loading during walking, supporting the importance of target-specific personalised gait modifications for long-term biomechanical benefit.
    Keywords:  Daily activity; Foot progression angle; Functional ability; Knee adduction moment; Knee pain
    DOI:  https://doi.org/10.1016/j.clinbiomech.2026.106776
  24. J Orthop Case Rep. 2026 Feb;16(2): 290-297
    Outcomes of Clinico-radiologically Predetermined Patient-specific Multi-site Steroid Injection in Primary Frozen Shoulder: A Prospective Study.
    Ayyappan V Nair, Maythilisharan Rambhojun, M S Bharath Bharadhwaj, Shruthi Baburaj, Nizaj Nasimudeen, Prince Shanavas Khan.
       Introduction: Frozen shoulder (FS) is characterized by pain and progressive restriction of motion, with treatment aimed at pain relief, functional improvement, and shortening disease duration. While conservative management is preferred, the best non-surgical modality remains unclear due to heterogeneity in the literature. The current study is to determine the efficacy of patient-specific multi-site landmark-based steroid injection in combination with a standardized physiotherapy protocol followed at our center in the management of Fss.
    Materials and Methods: In this prospective study, 94 patients with primary FS, confirmed via ultrasound and X-ray, received intra-articular and multisite betamethasone injections (8 mg diluted in 8 mL of 2% lignocaine). A total of 5 mL was injected intra-articularly, while the remaining was divided among the areas of tenderness and inflammation pre-determined clinically or radiologically by ultrasound. Injections were performed by a single shoulder surgeon, followed by an 8-week physiotherapy protocol. Patients were assessed at 2, 4, 8- and 12-weeks using range of motion (ROM), Visual Analog Scale (VAS), American Shoulder and Elbow Scoring system (ASES), and Shoulder Pain and Disability Index scores.
    Results: Statistically significant improvements were observed: mean abduction increased from 124° to 173° (P = 0.001), forward flexion from 123° to 174° (P = 0.040), and external rotation from 26° to 55° (P = 0.009). The mean ASES score improved from 28.8 to 92.5 (P = 0.001), VAS decreased from 6.7 to 0.4, and internal rotation improved by 4 vertebral levels.
    Conclusion: The results of our study demonstrate that patient-specific multi-site steroid infiltration significantly reduces pain and improves ROM and clinical outcomes in FS patients.
    Keywords:  Frozen shoulder; adhesive capsulitis; anterior approach; betamethasone; intra-articular steroid injection
    DOI:  https://doi.org/10.13107/jocr.2026.v16.i02.6832
  25. Radiol Med. 2026 Feb 11.
    Dynamic ultrasound motion metrics combined with deep learning for clinical differentiation of subacromial impingement syndrome.
    Yi-Chung Shu, Wen-Hung Ho, Li-Ling Chang, Che-Yu Lin, Lan-Rong Chen, Wei-Ting Wu, Consuelo B Gonzalez-Suarez, Levent Özçakar, Ke-Vin Chang.
       PURPOSE: This prospective study evaluated the diagnostic performance of deep learning models in predicting subacromial impingement syndrome (SIS) during dynamic shoulder ultrasonography, comparing a faster region-based convolutional neural network (Faster R-CNN) with a self-transfer learning CNN (STL-CNN). The utility of integrating a one-dimensional convolutional neural network (1D-CNN) for SIS classification was also examined.
    MATERIALS AND METHODS: Participants underwent shoulder abduction and adduction during ultrasound imaging. Faster R-CNN and STL-CNN were trained to localize anatomical landmarks, and the better-performing model was paired with a 1D-CNN to differentiate SIS. Subacromial motion metrics-including acromiohumeral distance (AHD), horizontal AHD (hAHD), and vertical AHD (vAHD)-were used as classification features.
    RESULTS: Among 59 SIS patients and 59 controls, Faster R-CNN demonstrated significantly lower mean distance errors than STL-CNN for the greater tuberosity (0.1302 cm vs. 0.4835 cm, p = 0.03) and lateral acromion (0.0585 cm vs. 0.2634 cm, p = 0.02). vAHD yielded superior discrimination compared with AHD and hAHD. Using Faster R-CNN-derived trajectories, the 1D-CNN achieved 94% accuracy for vAHD, surpassing results based on ground-truth annotations.
    CONCLUSION: Faster R-CNN enabled more accurate landmark localization than STL-CNN, while vAHD enhanced SIS identification. Combining faster R-CNN with a 1D-CNN demonstrated high diagnostic accuracy, underscoring the potential of deep learning for automated SIS assessment during dynamic ultrasonography. However, the current workflow requires offline video analysis, and future advances should focus on real-time implementation and improved generalizability.
    Keywords:  Artificial intelligence; Convolutional neural network; Machine learning; Shoulder pain; Subacromial impingement; Ultrasonography
    DOI:  https://doi.org/10.1007/s11547-026-02188-y
  26. J Back Musculoskelet Rehabil. 2026 Feb 09. 10538127261416001
    A novel subgrouping approach to low back pain: Exploring differences in lumbar muscle morphology and function - A cross-sectional study.
    Rahmat Adnan, Lieven Danneels, Tine Willems, Sophie Van Oosterwijck, Evy Dhondt, Dorien Goubert, Jessica Van Oosterwijck.
      BackgroundClassifying low back pain (LBP) based solely on symptom duration may be insufficient to explain underlying paraspinal muscle degeneration and dysfunction in recurrent and chronic LBP cases.MethodsFifty-nine females (45 with non-specific low back pain, 14 pain-free controls) were categorized into subgroups using cluster analysis based on personal, pain-related, psychological, and functional characteristics. Lumbar paraspinal muscle structure was assessed using T1-weighted Dixon MRI to measure muscle cross-sectional area (CSA), fat CSA, and muscle fat index (MFI). Muscle function was evaluated using T2-weighted MRI to determine resting T2 values (T2-rest) and T2 shift following muscle activation (T2-shift) at three specific lumbar levels: upper L3 (UL L3), upper L4 (UL L4), and lower L4 (LL L4).ResultsFour new LBP subgroups were identified and compared to HC (healthy control (n = 14), 23.6%): Neutral (NT; n = 5, 8.5%), Personal and Pain Affected (PA; n = 9, 15.3%), Maladaptive cognition affected (MCA; n = 25, 42.4%), and Personal, Pain, Psychological, and Functional Affected (PPFA; n = 6, 10.2%). NT resembled HC indicating healthy lumbar muscle, PA subgroup showed with a higher fat CSA and MFI in paraspinals muscle. PA and MCA exhibited localized muscle hyperactivity. PPFA subgroups remained metabolically inactive.ConclusionsThis novel LBP subgrouping framework revealed distinct patterns of paraspinal muscle fatty infiltration and dysfunction. Fatty infiltration and hyperactivity were linked to BMI, chronicity, and cognitive traits; hypoactivity was found in those with broad psychosocial and functional impairments.
    Keywords:  MRI; cluster analysis; fat infiltration; low back pain; muscle dysfunction; paraspinal muscle
    DOI:  https://doi.org/10.1177/10538127261416001
  27. Neurol Sci. 2026 Feb 13. 47(3): 259
    Effects of virtual walking on neuropathic pain following spinal cord injury: a systematic review.
    Anas R Alashram.
      
    Keywords:  Neuropathic pain; Rehabilitation; Spinal cord injuries; Therapy; Virtual walking
    DOI:  https://doi.org/10.1007/s10072-026-08870-3
  28. Indian J Orthop. 2026 Feb;60(2): 300-310
    No Differences in Outcomes Between Operative and Non-Operative Approaches for High-Grade Acromioclavicular Joint Injuries: A Systematic Review and Meta-analysis.
    Noppanat Poovarodom, Natabhorn Kashemsri Na Ayudhaya, Thanong Sanitwaja, Thun Itthipanichpong, Danaithep Limskul, Thanathep Tanpowpong, Somsak Kuptniratsaikul, Napatpong Thamrongskulsiri.
       Background: This study aimed to compare the clinical outcomes and complications of operative versus non-operative approaches in treating patients with high-grade acromioclavicular (AC) joint injuries.
    Methods: A search was conducted in PubMed, Scopus, and Cochrane databases for studies published between 2007 and 2024. The search focused on studies directly comparing postoperative patient-reported outcomes, radiographic findings, and complications associated with surgical and non-surgical techniques for high-grade AC joint injuries. For dichotomous outcomes, odds ratios (ORs) were calculated, while mean differences (MDs) were computed for continuous outcomes.
    Results: A total of eight studies, encompassing 473 AC joints, were analyzed. The results indicated no statistically significant differences in postoperative clinical outcomes at final follow-up between the operative and non-operative approaches. Specifically, among the seven studies reporting the Constant Score, MD was - 1.38 (95% confidence interval [CI] - 3.14 to 0.38, p = 0.12). For the Disabilities of the Arm, Shoulder, and Hand score, the MD was 1.92 (95% CI - 0.34 to 4.17, p = 0.10), indicating no statistically significant differences. Additional radiographic findings also suggested similar outcomes between the two treatment modalities.
    Conclusion: The analysis revealed comparable clinical outcomes between the two approaches, demonstrating that both strategies can be considered viable options for patient management.
    Keywords:  Acromioclavicular; Dislocation; High-grade; Injury; Non-operative; Operative
    DOI:  https://doi.org/10.1007/s43465-025-01571-7
  29. Cartilage. 2026 Feb 08. 19476035251408602
    EUROVISCO Recommendations for the Use of Viscosupplementation with Hyaluronic Acid in the Management of Hip Osteoarthritis.
    Alberto Migliore, Raghu Raman, Demirhan Diraçoglù, Paulo Cesar Hamdan, Jordi Monfort, Dominique Baron, Mats Brittberg, Belarmino Goncalves, Nicolas Bonin, Xavier Chevalier, Yves Henrotin, Thierry Conrozier.
      BackgroundViscosupplementation (VS) by intra-articular injections of hyaluronic acid (HA) is an increasingly used treatment of hip osteoarthritis (OA). However, there are no clear European recommendations for its use.MethodsTwelve members of the European Viscosupplementation Consensus Group (EUROVISCO), made up of rheumatologists, orthopedic surgeons, and rehabilitation physicians from European countries, were asked to make a therapeutic decision on 23 statements based on an exhaustive analysis of the literature and their clinical experience, using the Delphi method. For each statement, the strength of agreement and the level of consensus were calculated by the chairman of the groupResultsThe expert panel reached unanimous or high consensus, either for or against, on 16 of the proposed statements. The main ones are: Current evidence and the results of observational trials support the use of VS in patients with hip OA who do not require surgery. VS is more effective in cases of mild to moderate hip OA. Hip VS is safe and well tolerated, even with repeated injections. The outcome of VS depends on the viscosupplement used. A standard X-ray must be obtained before deciding on VS. VS must be performed under imaging guidance. A single injection regimen is preferable to repeat injections. VS can be considered for individuals who wish to postpone surgery. Hip replacement surgery should not be performed within 3 months of VS. VS should not be used to treat an osteoarthritis flare. VS is part of a multimodal treatment for hip OA.ConclusionThis set of recommendations is intended to help practitioners make decisions about HA VS in patients with OA.
    Keywords:  EUROVISCO; guidelines; hip; hyaluronic acid; osteoarthritis; recommendations; viscosupplementation
    DOI:  https://doi.org/10.1177/19476035251408602
  30. Knee. 2026 Feb 06. pii: S0968-0160(26)00036-0. [Epub ahead of print]60 104358
    Which factors correlate with muscle strength capacity in people with patellofemoral pain? A systematic review with meta-analysis.
    Guilherme S Nunes, Maitê M Pellenz, Júlia Bianchin Piussi, Bruna Wageck, Luis Ulisses Signori, Matheus Weide Solner, Anna Julia Meireles Dangui.
       BACKGROUND: Individuals with patellofemoral pain (PFP) commonly exhibit muscle weakness; however, the relationship between muscle strength deficits and other factors in this population remains unclear. The present systematic review aimed to identify factors correlated with muscle strength capacity in individuals with PFP.
    METHOD: A systematic search was conducted in Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from their inception to September 2025. Correlational studies that included individuals with PFP and reported quantitative measures of muscle strength correlated with other quantitative variables were eligible for inclusion.
    RESULTS: Out of 9370 records screened, 57 studies met the inclusion criteria, and 37 were included in the meta-analyses. The findings indicated that knee extensor strength is trivially to moderately correlated with functionality, pain, pain duration, and kinesiophobia; knee flexor strength is weakly to moderately correlated with functionality and pain; hip abductor strength is trivially to moderately correlated with function, hip frontal and transverse plane movements; hip extensor strength is weakly correlated with function; hip external rotation strength is weakly correlated with function; hip posterolateral strength is moderately correlated with function; and trunk lateral flexion strength is weakly correlated with knee frontal plane movement.
    CONCLUSION: Despite the generally weak correlations observed, muscle strength capacity in individuals with PFP presents significant associations with key factors such as pain, function, kinesiophobia, and lower limb movement patterns.
    Keywords:  Anterior knee pain; Association; Knee; Muscle weakness
    DOI:  https://doi.org/10.1016/j.knee.2026.104358
  31. JBJS Rev. 2025 Nov 01. 13(11):
    Management of Acute Midsubstance Patella Tendon Rupture: Current Concepts and Clinical Narrative Review.
    Marco T Di Stefano, Michael Young, Michaela Corvi, Domenico Franco, Sebastian Schmidt, Chilan B G Leite, Zylyftar Gorica, Ian Hutchinson.
      » Midsubstance patellar tendon repairs are rare, technically demanding surgeries that are distinct from proximal and distal avulsions due to the challenges of tendon-to-tendon healing and zone of injury tissue quality.» Primary repair using the Krackow suturing technique remains the most widely used method, often combined with patellar and tibial-based fixation.» Protective constructs such as high-strength suture configurations or cerclage wire are employed to share load with the repair site and support healing and function.» Structural and biological augmentations, including autografts, allografts, synthetic ligaments, and collagen scaffolds, are increasingly used to reinforce the injured extensor mechanism, support repair, and enhance healing, particularly in high-risk or complex patients.» Postoperative rehabilitation protocols vary but generally include a period of immobilization in extension followed by progressive flexion, isometric quadriceps activation, and return to normal activity at 9 to 12 months and return to a preinjury level at 12 to 18 months.
    DOI:  https://doi.org/e25.00154
  32. JSES Int. 2026 Mar;10(2): 101416
    "Fighter's shoulder" part I: impact on shoulder motion and scapular movement in judo and jiu-jitsu athletes.
    Wagner Castropil, Juliana Mauad, Giovanna Medina, Breno Schor.
       Background: Martial arts athletes, such as judo and jiu-jitsu, often develop musculature asymmetry due to repetitive movements over the years of practice. Common injuries include strains, sprains, and fractures, with shoulder and upper-arm injuries being particularly prevalent. The objective of this study was to identify potential changes in the shoulder range of motion (ROM) of martial arts athletes and to associate these changes with years of practice, belt graduation, and scapular dyskinesis. The scapular dyskinesis was evaluated and classified according to the Kibler classification.
    Methods: A cross-sectional study including martial arts athletes. The shoulder ROM was evaluated using a goniometer through elevation and internal and external rotation at 0° and 90° of abduction. The analysis was performed on both shoulders. The Kibler classification was used to classify scapular dyskinesis.
    Results: Among 133 belt-ranked combat athletes (54% black belts; mean age 27.8 years), 73% showed scapular dyskinesis (predominantly type I). Years of practice independently predicted reduced dominant-shoulder ROM: anterior elevation -0.320°/year, external rotation at 0° -0.556°/year, and at 90° -0.612°/year (all P < .001). Internal rotation decreased -0.612°/year plus -5.5° in international competitors (P = .030).
    Conclusion: Years of sustained judo/jiu-jitsu practice were associated with progressive loss of dominant-shoulder ROM, with a concurrent trend toward scapular dyskinesis. These time-linked biomechanical and anatomical adaptations suggest a distinct entity named "Fighter's shoulder." Clarifying its causes and chronology through longitudinal studies is essential to guide targeted screening, preventive programming, and sport-specific rehabilitation.
    Keywords:  Athletes; Martial arts; Range of motion, articular; Rotator cuff; Shouder; Shoulder joint
    DOI:  https://doi.org/10.1016/j.jseint.2025.101416
  33. Knee. 2026 Mar;pii: S0968-0160(26)00047-5. [Epub ahead of print]59 104369
    Knee osteoarthritis - Current concepts.
    Oday Al-Dadah, Caroline Hing.
      
    DOI:  https://doi.org/10.1016/j.knee.2026.104369
  34. Medicine (Baltimore). 2026 Feb 13. 105(7): e47547
    Effectiveness of repeated ultrasound-guided suprascapular nerve blocks in hemiplegic shoulder pain: A randomized controlled trial.
    Alper T Dogan, Yasemin Pekin Dogan, Ebru Aytekin, Selman Sogut, Zafer Gokkaya, Murat Tumer, Omur Ercelen, Yavuz Gurkan.
       BACKGROUND: Hemiplegic shoulder pain (HSP) is a common complication after stroke, significantly impairing rehabilitation. While suprascapular nerve block (SSNB) has shown promise in pain management, its long-term efficacy, especially with repeated applications, remains unclear.
    OBJECTIVE: This study aimed to evaluate the effectiveness of ultrasound-guided repeated SSNB in reducing pain, improving range of motion (ROM), and enhancing motor function in patients with HSP.
    METHODS: This double-blind, randomized controlled trial included 42 patients with HSP, allocated to either the SSNB group or the control group in a 1:1 ratio. The SSNB group received ultrasound-guided injections of levobupivacaine and triamcinolone at baseline, 3 weeks, and 6 weeks, while the control group received sham injections. All participants followed a standardized physiotherapy program. Pain was assessed using the visual analog scale, ROM with a goniometer, spasticity with the Ashworth scale, and motor recovery with the Brunnstrom scale. Assessments were conducted at baseline, 1, 4, and 7 weeks.
    RESULTS: Thirty-nine patients completed the study. The SSNB group showed significant reductions in visual analog scale scores at 1, 4, and 7 weeks compared to the control group (P < .05). ROM for abduction and flexion significantly improved in the SSNB group at 7 weeks (P < .05). However, there were no significant differences between groups in Ashworth or Brunnstrom scores at any time point.
    CONCLUSION: Repeated SSNB effectively reduces pain and improves ROM in patients with HSP when combined with physiotherapy. However, it does not significantly impact spasticity or motor function. Further research with longer follow-ups and active comparators is needed to determine its long-term benefits.
    Keywords:  hemiplegic shoulder pain; range of motion; suprascapular nerve block; ultrasound
    DOI:  https://doi.org/10.1097/MD.0000000000047547
  35. Sci Rep. 2026 Feb 12.
    Immediate effects of dynamic and Kinesio taping on balance and ground reaction forces in women with patellofemoral pain syndrome.
    Ali Yalfani, Shirin Rasouli, Masoud Azizian.
      
    Keywords:  Balance; Dynamic taping; Patellofemoral pain syndrome; Postural control; Rehabilitation
    DOI:  https://doi.org/10.1038/s41598-026-39856-y
  36. J Clin Med. 2026 Jan 30. pii: 1116. [Epub ahead of print]15(3):
    Pelvic Floor Muscle Training Following Surgery for Pelvic Organ Prolapse: Recommendation from Scientific Literature.
    Gianfranco Lamberti, Donatella Giraudo, Gianluca Ciardi, John Kenneth Levis.
      Background: POP surgery improves anatomical support and quality of life, but urinary, bowel, sexual, and pain issues are common after surgery. The role of rehabilitation in addressing these problems is recognized, though not yet clearly defined. Objective: This scoping review aims to map the clinical evidence on conservative rehabilitation interventions for urinary, bowel, and sexual dysfunction, and pelvic pain after POP surgery. Methods: In accordance with PRISMA-ScR guidelines, we included randomized controlled trials, cohort studies, observational studies, and systematic reviews relevant to post-surgical rehabilitation options frequently encountered in clinical settings, including pelvic floor muscle training (PFMT), physiotherapy, and multimodal programs. Meta-analysis was not conducted due to clinical and methodological heterogeneity across the studies. Results: PFMT demonstrates beneficial effects on symptom severity and pelvic muscle function in women with POP. Postoperative rehabilitation may improve urinary continence, sexual function, and pelvic pain, although the strength of current evidence remains limited. Many studies prioritize surgical revision over conservative management, and the effectiveness of rehabilitation for persistent or de novo symptoms is not well established. Conclusions: Conservative rehabilitation, especially PFMT, may aid recovery and improve function after POP surgery. More research is needed to define the optimal protocols and to determine how to incorporate them into post-surgical care.
    Keywords:  PFMT; POP; pelvic floor muscle training; pelvic organ prolapse
    DOI:  https://doi.org/10.3390/jcm15031116
  37. Tidsskr Nor Laegeforen. 2026 Feb 10. 146(2):
    Coccyx pain.
    Rainer Günter Knobloch, Ante Matti Kalstad, Vilhjalmur Finsen.
      Coccyx pain, coccydynia, can occur as a result of trauma or childbirth, but the cause can also be unknown. Coccydynia is more common in women, and the symptoms usually subside within a few months. The main symptom is pain when sitting. Alleviation of pain can be achieved by reducing pressure on the coccyx and treatment with corticosteroid injections. Surgery may be appropriate if these measures do not yield improvement. The purpose of this clinical review is to give a comprehensive update on the subject for doctors who encounter these patients.
    DOI:  https://doi.org/10.4045/tidsskr.25.0421
  38. Clin J Pain. 2026 Feb 09.
    Challenges in Defining Centralized Pain Following Peripheral Nerve Injury.
    Antonio Alcántara Montero.
      
    DOI:  https://doi.org/10.1097/AJP.0000000000001365
  39. J Hand Surg Glob Online. 2026 Mar;8(2): 100938
    Ongoing Clinical Challenges in Nerve Surgery (Nerve SPACE 2025).
    Katherine M Gerull, David M Brogan, Harvey Chim, Bryan J Loeffler, Megan M Jack, Robert J Spinner, Macyn M Stonner.
       Where are we?: There have been numerous advances over the last decade in peripheral nerve surgery and rehabilitation following nerve transfers. In particular, advances in nerve allografts, nerve wraps, peripheral nerve sheath tumor treatment, and bionic limb technology have expanded the therapeutic landscape for patients with nerve injuries, tumors, and limb loss. Rehabilitation strategies have improved significantly, largely through advances such as the Donor Activation Focused Rehabilitation Approach. Nerve allografts show promise for short digital nerve gaps, though outcomes for proximal injuries remain controversial. Nerve wraps and connectors are widely available, but their efficacy has been controversial, perhaps due to heterogeneity in materials and limited high-quality research studies. In peripheral nerve sheath tumors, molecular subtyping has improved classification, yet reliable preoperative distinction between benign and malignant tumors remains a challenge. Bionic limb reconstruction has been improved through advances in targeted reinnervation, osseointegration, and myoelectric control, although prosthetic abandonment, phantom limb pain, and high costs remain barriers.
    Where do we need to go?: Future progress requires rigorous empirical evidence to define effective rehabilitation protocols, clarifying the role of allografts versus autografts and determining the clinical utility of nerve wraps and connectors. Improved diagnostic tools are necessary for accurate tumor characterization, and novel systemic therapies are needed for malignant tumors with poor survival outcomes. In bionic limb reconstruction, future advances should integrate intuitive prosthetic control, sensory feedback, and improve pain management while ensuring equitable access to these technologies.
    How do we get there?: Achieving these goals will require multicenter, nonconflicted, randomized clinical trials; the development of standardized outcome measures; and investment in translational research across cellular biology, imaging, and device development. Collaborative interdisciplinary research is critical to developing evidence-based protocols and technologies. Together, these strategies can continue to accelerate our understanding of peripheral nerve injury, disease, and rehabilitation.
    Keywords:  Bionic limb reconstruction; Nerve allograft; Nerve injury rehabilitation; Nerve wraps; Peripheral nerve sheath tumors
    DOI:  https://doi.org/10.1016/j.jhsg.2025.100938
  40. Pain Manag. 2026 Feb 09. 1-11
    Ketamine for acute and chronic pain: beyond anaesthesia.
    Hao G Duong, Tariq G Pulskamp, Daniel J Berlau.
      Ketamine's clinical role has expanded beyond anesthesia into a mechanism-based, non-opioid analgesic used across acute, perioperative, and chronic pain settings. As a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine attenuates central sensitization, modulates opioid tolerance, and enhances descending inhibitory control. At subanaesthetic doses (0.1-0.5 mg/kg), it consistently reduces pain scores and postoperative opioid consumption while maintaining hemodynamic and respiratory stability. In acute and perioperative care, analgesic efficacy is comparable to opioids, though clear superiority has not been demonstrated. In chronic pain, particularly complex regional pain syndrome (CRPS), multi-day infusions provide temporary relief, but durability remains limited. In cancer-related pain, ketamine offers adjuvant benefits for opioid-refractory syndromes with variable outcomes. Short-term adverse effects such as dizziness and mild dysphoria are common, whereas psychomimetic symptoms, hepatobiliary injury, and cystitis restrict prolonged use. Overall, ketamine provides context-dependent, opioid-sparing analgesia with defined but specific clinical utility. Its evolving role in pain management will likely remain targeted, emphasizing patient selection, standardized dosing, and realistic expectations for benefit.
    Keywords:  NMDA receptor; analgesia; cancer pain; complex regional pain syndrome; esketamine; opioid-sparing; perioperative; prehospital
    DOI:  https://doi.org/10.1080/17581869.2026.2627884
  41. Can Fam Physician. 2026 Feb;72(2): 93-97
    Approach to mallet finger injury: Practical guide for Canadian primary care physicians.
    Vincent Dinh, Marisa Market, Kevin Cheung.
       OBJECTIVE: To provide primary care physicians with an evidence-based approach to recognizing and managing mallet finger injuries.
    SOURCES OF INFORMATION: A literature search was conducted in PubMed and Google Scholar using relevant key words and subject headings. Recommendations were categorized based on clinical evidence and expert opinion using a 3-level classification system.
    MAIN MESSAGE: A mallet finger injury commonly occurs after an axial load, resulting in avulsion of the extensor tendon from the distal phalanx. This may occur with or without an avulsion fracture. Diagnosis is made clinically, with x-ray scans used to assess for an associated fracture and joint alignment. Nonsurgical management with continuous splinting for 6 to 8 weeks is the standard of care and achieves excellent outcomes even in cases of delayed presentation. Surgery referral may be considered for avulsion fractures resulting in joint subluxation, open injuries, and failure of conservative management. Untreated mallet finger injuries can lead to chronic swan-neck deformities, which may limit function.
    CONCLUSION: Mallet finger injuries may be easily recognized and managed in the primary care settings, resulting in excellent patient outcomes without the need for specialist referral. This review should equip primary care physicians with confidence in diagnosing a mallet finger injury, initiating appropriate splinting, providing patient education, and recognizing indications for surgical referral.
    DOI:  https://doi.org/10.46747/cfp.720293
  42. Diagnostics (Basel). 2026 Feb 03. pii: 469. [Epub ahead of print]16(3):
    The Role of Musculoskeletal Ultrasound in Detecting Superior Cluneal Nerve Entrapment: Biomechanical Insights in Chronic Low Back Pain-A Pilot Study.
    Giovanni Iudicelli, Francesco Agostini, Alberto Altarocca, Francesco Ioppolo, Marco Narciso, Marco Conti, Andrea Fisicaro, Alessio Savina, Vincenzo Di Nunno, Massimiliano Mangone, Stefano Galletti, Marco Paoloni.
      Background: Superior cluneal nerve (SCN) entrapment is frequently underrecognized as a contributor to chronic Low Back Pain (cLBP) and gluteal pain. Musculoskeletal ultrasound may reveal surrogate markers indicative of a biomechanical entrapment environment. The primary objective was the prevalence of the ultrasound marker triad (Copeman Nod-ules-CN, thoracolumbar fascia-TLF thickening > 3 mm, and iliac enthesophytes. Secondary objectives included mean TLF thickness and its correlation with numeric pain rating scale (NPRS) and Douleur Neuropathique en 4 questions scores (DN4). Methods: In this single-center, cross-sectional observational pilot study, we enrolled 12 patients with cLBP (>12 weeks) localized to the SCN distribution and a healthy control group (12). Ultrasound measurements included TLF thickness in longitudinal and transverse planes, TLF convexity loss, iliac crest enthesophytes, and CN. Statistical analyses comprised Mann-Whitney U test, Fisher exact test, Spearman rank correlation, and multivariate logistic regression. Significance was set at p < 0.05. Results: The ultrasound marker triad (CN, iliac enthesophytes, and TLF thickening > 3 mm) demonstrated high diagnostic specificity: individually, CN were present in 91.7% of patients vs. 8.3% of controls (p < 0.001), iliac enthesophytes in 58.3% vs. 0% (p = 0.005), TLF thickening > 3 mm in 41.7% of patients vs. 0% of controls (p < 0.001)and TLF convexity loss in 100% vs. 75% (p = 0.03). Mean TLF thickness was significantly greater in patients-3.53 ± 0.46 mm longitudinal and 3.42 ± 0.39 mm transverse-compared with controls (2.61 ± 0.28 mm and 2.50 ± 0.32 mm; both p < 0.001). TLF thickness correlated strongly with NPRS (Spearman rho = 0.825; p = 0.001) but not with DN4. Logistic regression demonstrated that the marker triad accounted for 67% of NPRS variance (R2 = 0.67). Conclusions: Ultrasound-detected fascial alterations and enthesopathic changes act as reliable surrogate markers for SCN entrapment and correlate strongly with nociceptive pain severity. The absence of correlation with neuropathic pain scores suggests a predominant fascial-muscular biomechanical mechanism rather than direct nerve damage. Incorporating this non-invasive protocol into clinical practice may enhance diagnostic precision and inform targeted rehabilitative strategies. Future multicenter, prospective studies with larger cohorts are warranted to validate these findings and establish standardized ultrasound criteria.
    Keywords:  Copeman nodules; chronic low back pain; iliac crest enthesophytes; musculoskeletal ultrasound; superior cluneal nerve; thoracolumbar fascia
    DOI:  https://doi.org/10.3390/diagnostics16030469
  43. Br J Sports Med. 2026 Feb 09. pii: bjsports-2025-111208. [Epub ahead of print]
    Impairments and outcomes in adults with hip dysplasia (PhD Academy Award).
    Michael Jm O'Brien.
      
    Keywords:  Hip; Orthopedics; Pelvis; Physical Therapy; Rehabilitation
    DOI:  https://doi.org/10.1136/bjsports-2025-111208
  44. Front Bioeng Biotechnol. 2025 ;13 1665007
    Platelet-rich plasma in arthroscopic rotator cuff repair: a meta-analysis of biomaterial efficacy and future directions for personalized sports medicine.
    Fan Donghua, Lu Wei, Sun Di, Ying Pu, Wang Qiang, Shen Yingchao, Shi Mingfei, Sun Xin.
       Background: Rotator cuff tears represent a prevalent musculoskeletal challenge with high postoperative retear rates despite surgical advances. Platelet-rich plasma (PRP) has emerged as a promising biological adjunct in arthroscopic repair, though clinical evidence remains inconsistent regarding its efficacy in improving structural and functional outcomes.
    Methods: This PRISMA-guided meta-analysis evaluated 13 randomized controlled trials (n = 880 patients) comparing PRP-augmented versus conventional arthroscopic rotator cuff repair. Primary outcomes included retear rates and functional scores (UCLA, Constant, SST, ASES, VAS). Statistical analysis employed fixed/random-effects models with subgroup analyses of PRP formulations and tear characteristics.
    Results: PRP augmentation significantly improved functional outcomes, with mean differences of 1.82 points (95% CI: 1.13-2.51) for UCLA scores, 2.31 points (95% CI: 1.02-3.61) for Constant scores, and 0.43 points (95% CI: 0.11-0.75) for SST scores (all p < 0.01). VAS pain scores decreased by 0.23 points (95% CI: -0.41 to -0.05, p = 0.01). However, retear rates showed no significant reduction (RR = 0.71, 95% CI: 0.48-1.05, p = 0.09). Benefits were most pronounced in medium/large tears treated with leukocyte-poor PRP and double-row repairs (I2 = 0-40% for functional outcomes). Conclusion: While PRP enhances early functional recovery and pain control after rotator cuff repair, its capacity to improve structural integrity remains unproven. Clinical implementation requires standardization of PRP protocols and targeted application in patients with larger tears. Future research should investigate optimized biomaterial formulations and personalized treatment strategies.
    Keywords:  arthroscopy; meta-analysis; platelet-rich plasma; rotator cuff repair; tendon healing
    DOI:  https://doi.org/10.3389/fbioe.2025.1665007
  45. Int J Med Inform. 2026 Feb 05. pii: S1386-5056(26)00076-6. [Epub ahead of print]211 106336
    The effect of artificial intelligence-assisted pulmonary rehabilitation on exercise capacity: A systematic review and meta-analysis.
    Ecran Cinkavuk, Ebru Calik, Naciye Vardar-Yagli.
       INTRODUCTION: Artificial intelligence (AI) technologies are increasingly being integrated into pulmonary rehabilitation (PR) to improve individualization, real-time monitoring, and adherence in individuals with chronic respiratory diseases. However, their clinical impact on exercise capacity remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of AI-supported PR programs compared to usual care in improving exercise capacity and respiratory function in adults with chronic respiratory diseases.
    METHODS: This systematic review and meta-analysis followed PRISMA guidelines and was registered with PROSPERO (ID: CRD420251075622). A comprehensive search was conducted across five electronic databases (PubMed, Web of Science, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and PEDro) from inception to July 2025. Statistical analyses for the meta-analysis were conducted using RevMan 5.4.
    RESULTS: Three eligible RCTs with a total of 456 participants were included. Pooled analysis showed a significant improvement in 6-minute walk distance (6MWD) after AI-assisted PR group compared to control (MD: 22.08 m; 95% CI: 4.96-39.20; p = 0.01). Moderate heterogeneity was observed (I2 = 40%). No meta-analysis was conducted for respiratory function due to insufficient pre-post data. Risk of bias was generally low, though participant blinding was absent in all studies. Methodological quality was good, with a mean PEDro score of 6.0 ± 0.82.
    CONCLUSION: AI-supported PR can significantly improve exercise capacity in individuals with chronic respiratory diseases. Despite promising results, high-quality studies in different pulmonary patient groups are needed to address existing limitations, particularly regarding standardization, cost-effectiveness, and clinical integration of AI-technology.
    Keywords:  Artificial intelligence; Exercise capacity; Pulmonary rehabilitation
    DOI:  https://doi.org/10.1016/j.ijmedinf.2026.106336
  46. J Orthop Case Rep. 2026 Feb;16(2): 282-289
    Surgical Management of Volar Lip Fractures of the Middle Phalanx: A Case Series on Diverse Techniques and Outcomes, Do Acute and Chronic Presentations Differ in Outcome?
    Akshay D Punekar, Santosh D Ghoti, Jaideep Das, Ajit S Rathod, Harsh Jain, Rajath S Shetty.
       Introduction: Volar lip fractures of the middle phalanx are uncommon but potentially debilitating intra-articular injuries, typically resulting from axial loading combined with hyperextension or dorsal dislocation. They frequently involve avulsion of the volar base of the middle phalanx along with the volar plate, compromising joint congruity and stability. The management of such fractures ranges from non-operative care for small stable fragments to open reduction and internal fixation, volar plate repair, hemi-hamate arthroplasty, or dynamic external fixation in unstable or chronic cases.
    Case Series: This series reports five cases of volar lip fractures of the middle phalanx presenting at variable intervals and managed with variable surgical techniques at a tertiary care center which includes: (1) Mini-screw fixation in acute case, (2) mini-screw fixation combined with K-wire stabilization, (3) hemi-hamate arthroplasty, (4) JESS external fixation, (5) mini-screw fixation in a chronic case. Post-operative care included protective splinting for 2-4 weeks, suture removal at 2-3 weeks, and initiation of mobilization with strapping, followed by structured physiotherapy. Comparative analysis revealed that acute cases (Cases 1, 2, and 4) achieved superior outcomes with primary fixation techniques, showing better post-operative proximal interphalangeal joint range of motion, lower Disabilities of the Arm, Shoulder and Hand (DASH) scores, and lower Visual Analog Scale (VAS) pain scores. Chronic cases (Cases 3 and 5) required reconstructive or delayed fixation, yielding restricted motion, higher DASH scores, and higher VAS scores.
    Conclusion: Volar lip fractures of the middle phalanx, though rare, have significant functional implications. Early anatomical reduction and fixation provide the best chance for restoring stability, mobility, and hand function. Chronic or neglected injuries often demand salvage procedures such as hemi-hamate arthroplasty, which can achieve functional but limited outcomes. Our case series highlights that timely surgical intervention and structured rehabilitation are key determinants of optimal recovery.
    Keywords:  Jess external fixator; Volar lip fracture; hemi-hamate arthroplasty; mini-screw fixation; proximal interphalangeal joint
    DOI:  https://doi.org/10.13107/jocr.2026.v16.i02.6830
  47. J Int Med Res. 2026 Feb;54(2): 3000605251404774
    Efficacy of arthroscopic debridement combined with platelet-rich plasma injection for knee osteoarthritis: An updated systematic review and meta-analysis of randomized controlled trials.
    Li Fengzhen, Lu Jinyan, Zhou Honghai, Wu Fengbiao, Xu Zichun, Chen Yulong.
      ObjectiveThis study aimed to provide an updated assessment of the clinical efficacy and safety of arthroscopic debridement combined with platelet-rich plasma injection for the treatment of knee osteoarthritis.MethodsOn 16 August 2025, we systematically searched multiple databases, including the Cochrane Library, Embase, Ovid Medline, PubMed, Web of Science, China Biology Medicine Disc, China National Knowledge Infrastructure, Wanfang, and VIP Chinese Science and Technology Journal Database (VIPC), for randomized controlled trials evaluating the efficacy of arthroscopic debridement combined with platelet-rich plasma injection in the management of knee osteoarthritis. Outcome measures included the following: (a) clinical response rate; (b) visual analog scale score; (c) Lysholm score; (d) Western Ontario and McMaster Universities Osteoarthritis Index score; and (e) adverse reactions. Data were recorded and analyzed using RevMan 5.4 software. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the research protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform (registration number: CRD420251127571).ResultsA total of 17 studies involving 1587 patients were included. Meta-analysis results showed that compared with the control group, the treatment group demonstrated a statistically significant difference in the overall clinical response rate: odds ratio = 5.38; 95% confidence interval: 3.45, 8.38; p < 0.00001. Subgroup analyses based on follow-up duration (3, 6, and 12 months) demonstrated a p value of 1.00 and I² value of 0%. Meta-analysis results for each subgroup were as follows: odds ratio = 5.66; 95% confidence interval: 2.14, 14.94; p = 0.0005 for 3 months; odds ratio = 5.68; 95% confidence interval: 2.87, 11.27; p < 0.00001 for 6 months; and odds ratio = 5.40; 95% confidence interval: 2.44, 11.96; p < 0.0001 for 12 months. The treatment group also exhibited a statistically significant reduction in visual analog scale scores: mean difference = -0.62; 95% confidence interval: -1.03, -0.20; p = 0.004. Lysholm scores increased significantly in the treatment group: mean difference = 5.07; 95% confidence interval: 2.99, 7.14; p < 0.00001. The Western Ontario and McMaster Universities Osteoarthritis Index score indicated statistically significant difference: mean difference = -8.65; 95% confidence interval: -11.13, -6.18; p < 0.00001. Adverse reaction rate demonstrated no statistically significant difference: odds ratio = 0.73; 95% confidence interval: 0.28, 1.89; P = 0.52.ConclusionThe overall clinical response rate of arthroscopic debridement combined with platelet-rich plasma injection for knee osteoarthritis was significantly higher than that of the control group. The visual analog scale scores were lower, indicating effective pain relief in patients with knee osteoarthritis. The Lysholm scores were higher, demonstrating a significant improvement in knee function compared to the control group. The Western Ontario and McMaster Universities Osteoarthritis Index scores were significantly lower than that of the control group, reflecting substantial efficacy of arthroscopic debridement combined with platelet-rich plasma injection in treating knee osteoarthritis by improving pain, stiffness, and functional impairment. The incidence of adverse reactions in the arthroscopic debridement combined with platelet-rich plasma injection group did not differ significantly from that in the control group, indicating that platelet-rich plasma injection does not increase the risk of adverse events.
    Keywords:  Knee osteoarthritis; arthroscopic debridement; meta-analysis; platelet-rich plasma; randomized controlled trials
    DOI:  https://doi.org/10.1177/03000605251404774
  48. Int J Orthop Trauma Nurs. 2026 Jan 24. pii: S1878-1241(26)00003-1. [Epub ahead of print]60 101258
    Nursing interventions for people with musculoskeletal injuries during physical activity: A scoping review.
    J Pinheiro, A Costa, P Pedrosa, C Marques-Vieira.
       INTRODUCTION: Physical inactivity is a major public health concern, with Portugal ranking among the European countries with the lowest levels of regular physical activity. Poorly managed physical activity is associated with a high incidence of musculoskeletal injuries, increasing the need for effective nursing interventions focused on prevention, rehabilitation, and safe return to activity. In orthopedic and trauma care, nurses play a key role in clinical assessment, patient education, functional recovery, and interdisciplinary coordination; however, nursing-specific interventions in this area remain insufficiently mapped.
    OBJECTIVE: To map the scientific literature on nursing interventions for individuals with musculoskeletal injuries related to physical activity.
    METHOD: A scoping review was conducted following the Joanna Briggs Institute methodology, guided by the PCC framework: Population (individuals with musculoskeletal injuries), Concept (nursing interventions), and Context (physical activity). Searches were performed in MEDLINE Ultimate, CINAHL Ultimate, SPORTDiscus, Psychology and Behavioral Sciences Collection, and Scopus, complemented by grey literature. Studies published in English, Portuguese, Spanish, or French were included. Study selection and data extraction were conducted independently by two reviewers, following PRISMA 2021 guidelines.
    RESULTS: 36 studies were included. Most originated from the United States and Europe, and were situated within medicine, physiotherapy, and rehabilitation sciences. Nursing-relevant interventions included comprehensive clinical assessment, pain management, health education, psychosocial support, multidisciplinary rehabilitation coordination, therapeutic exercise guidance, balance and proprioception training, activity modification, and reinjury prevention.
    CONCLUSION: The evidence highlights multiple nursing interventions applicable to musculoskeletal injury rehabilitation of individuals with physical activity, reinforcing the importance of nurses within orthopedic and trauma care.
    Keywords:  Musculoskeletal system; Physical activity; Rehabilitation nursing; Systematic review
    DOI:  https://doi.org/10.1016/j.ijotn.2026.101258
  49. Phlebology. 2026 Feb 13. 2683555261427251
    A multidimensional evaluation of pain in lipedema.
    Elif Sakizli Erdal, Miray Haspolat, Canan Ergin, Ilke Keser.
      ObjectivesThis study aimed to analyze the complex components of pain in lipedema and to evaluate correlations among key pain-related parameters, including intensity, hypersensitivity, catastrophizing, central sensitization, and neuropathic pain.MethodsThis prospective study was conducted between June 2025 and September 2025. Patients aged 18 or older with a diagnosis of lipedema were included. Demographic/clinical characteristics were recorded. Pain intensity, hypersensitivity, pain catastrophizing, central sensitization, and neuropathic pain were assessed using the Numeric Rating Scale (NRS), a 0-3 verbal rating scale, the Pain Catastrophizing Scale, the Central Sensitization Inventory, and the painDETECT questionnaire, respectively.ResultsA total of 85 patients were included in the study. Patients had a median age of 44 years, a median Body Mass Index of 29.24 kg/m2, and most were classified as stage 2 lipedema (50.6%). Pain intensity was moderate, with a median NRS score of 5, while hypersensitivity levels were moderate (41.2%) to high (34.1%) in most patients. Pain catastrophizing, central sensitization, and neuropathic pain were present in 35.1%, 83.5%, and 27.1% of the patients, respectively. Pain intensity was significantly positively correlated with hypersensitivity, pain catastrophizing, central sensitization, and neuropathic pain (p < 0.05). All parameters were significantly correlated with each other (p < 0.05).ConclusionCentral sensitization may be observed in patients with lipedema and is associated with other pain parameters. The findings highlight significant interrelationships among pain intensity, hypersensitivity, pain catastrophizing, and central sensitization. Pain needs to be assessed in detail in patients with lipedema.
    Keywords:  central nervous system sensitization; hypersensitivity; lipedema; pain; pain catastrophizing
    DOI:  https://doi.org/10.1177/02683555261427251
  50. Cureus. 2026 Jan;18(1): e101108
    Reverse End-to-Side Triceps to Axillary Nerve Transfer for Treatment of Axillary Nerve Palsy After Reverse Total Shoulder Arthroplasty.
    Mitchell S Mologne, Michele Christy, Zachary D Randall, Christopher J Dy.
      Nerve injuries are uncommon, yet significant complications following reverse total shoulder arthroplasty (rTSA), with the axillary nerve being most frequently injured. We report a case of a 67-year-old female who developed persistent motor dysfunction and decreased sensation in the axillary distribution following rTSA for a comminuted proximal humerus fracture. Electrodiagnostic studies confirmed right axillary nerve injury with reduced motor unit recruitment. After no improvement in deltoid function at three months following rTSA, we discussed treatment options for the patient, who opted for surgical intervention. Based on intraoperative findings, we performed a reverse end-to-side triceps-to-axillary nerve transfer. Postoperative evaluations over a four-year follow-up revealed substantial improvements in range of motion, strength, and patient-reported outcomes. Ultrasound and magnetic resonance imaging studies obtained at four years post-op demonstrated mild deltoid atrophy and fatty infiltration, despite the excellent clinical result. The triceps-to-axillary nerve transfer has potential as a viable intervention for non-recovering axillary nerve injuries after rTSA.
    Keywords:  axillary nerve injury; axillary nerve transfer; peripheral nerve; reverse end to side nerve transfer; reverse shoulder arthroplasty
    DOI:  https://doi.org/10.7759/cureus.101108
  51. J Hand Surg Glob Online. 2026 Mar;8(2): 100942
    Reported Minimal Clinically Important Differences for Patient-Reported Outcome Measures in Hand and Upper-Extremity Surgery: A Systematic Review.
    Jenna L Dvorsky, Michael R Kann, Christopher Gonzalez, Andrew Gordon, James Kim, Angela Hardi, John Fowler.
       Purpose: In hand and upper-extremity surgery, there are many patient-reported outcome measures (PROMs) used to quantify symptom severity and track patient progress. However, there remains variability and uncertainty regarding the true or most appropriate minimal clinically important difference (MCID) values for each. This systematic review summarized the reported MCIDs for the most commonly used outcome instruments in hand and upper-extremity surgery.
    Methods: The published literature was searched using strategies designed by a medical librarian for the concepts of MCID; the Boston Carpal Tunnel Questionnaire; the Disabilities of the Arm, Shoulder, and Hand Score (DASH); the Michigan Hand Outcomes Questionnaire; carpel tunnel syndrome; and other hand/upper limb disorders with related synonyms. These strategies were executed in Embase, Ovid-Medline All, CINAHL Plus, Scopus, and Web of Science from database inception. Studies retrieved from the database literature search were imported to Endnote. Any duplicate citations were identified and removed. The remaining citations were imported to Covidence screening software for further screening analysis.
    Results: In total, 25 studies published from 1998 to 2025 were included in final data extraction and analysis. Among these, 9 (36.0%) reported the MCID value for BCTQ, 4 (16.0%) reported the MCID value for the MHQ and DASH, and 12 (48.0%) reported the MCID value for the Quick Disabilities of the Arm, Shoulder, and Hand.
    Conclusions: This comprehensive systematic review summarized the reported MCIDs for the Boston Carpal Tunnel Questionnaire, DASH, Quick Disabilities of the Arm, Shoulder, and Hand, and Michigan Hand Questionnaire, all of which are commonly used hand and upper-extremity PROMs. Reported MCIDs for a given PROM can vary not only with the population or diagnosis of patients included but also with the methods used to calculate meaningful change in these patients.
    Clinical relevance: This systematic review reports the MCIDs for common hand and upper-extremity outcome measures, providing surgeons with reference values to interpret patient-reported changes, while also demonstrating variability in MCID based on diagnosis and methodology. This can help distinguish meaningful improvement for different clinical and patient settings in addition to aid design of studies with clinically relevant end points in upper-extremity surgery.
    Keywords:  Hand; Minimal clinically important difference; Systematic review
    DOI:  https://doi.org/10.1016/j.jhsg.2025.100942
This page is being maintained by Thomas Krichel. It was last updated on 2026‒02‒22 at 2:44.