Reports indicate that height significantly impacts bone health, which is a crucial factor in bone mineral density (BMD). The focus of this research was to

Wang Y, et al. Clin Orthop Surg. 2025 Oct;17(5):815-825. https://doi.org/10.4055/cios25087

The albumin-globulin ratio (AGR), which integrates nutritional and inflammatory biomarkers, may reflect skeletal health status; however, its relationship with bone mineral density (BMD) remains inadequately characterized. This cross-sectional analysis utilized data from 10,101 US adults in the National Health and Nutrition Examination Survey 2005 to 2018. Weighted multivariable linear regression was used to evaluate the AGR-BMD associations at the femoral neck and lumbar spine (L1–L4). Generalized additive models identified nonlinearity, with threshold effects quantified by piecewise regression. Subgroup analyses were used to test interactions by sex, race, and comorbidities. After full adjustment, each unit increase in AGR correlated with reduced femoral neck BMD (β = −0.0354 g/cm ² , 95% confidence interval: −0.0464 to −0.0243) and lumbar BMD (β = −0.0245 g/cm ² , 95% confidence interval: −0.0369 to −0.0120). Nonlinear analyses revealed inflection points at AGR = 1.7407 (femoral) and 1.1714 (lumbar), with differential associations below or above thresholds. Women exhibited a 3.1-fold stronger inverse association than men ( P _interaction < .0001). Elevated AGR was independently associated with reduced BMD in adults in the United States, demonstrating nonlinear threshold patterns (1.74 for femoral and 1.17 for lumbar BMD) and pronounced sexual dimorphism. These findings suggest that AGR is a composite biomarker that reflects inflammatory-nutritional pathways that are relevant to skeletal homeostasis.

Pure Posteromedial tibiotalar dislocation unaccompanied by fractures represents an exceptionally rare orthopedic injury, accounting for approximately 0.065% of ankle injuries and 0.46% of ankle dislocations. Such injuries typically result from high-energy trauma, with limited reports involving low-energy mechanisms in athletic activities. This case illustrates the successful management of a closed posterior ankle dislocation in a young student, emphasizing the importance of prompt intervention and structured rehabilitation. A 17-year-old male student sustained a pure posterior tibiotalar dislocation during a recreational basketball game, following a forced inversion and plantarflexion mechanism. Immediate closed reduction was performed under local anesthesia combined with intravenous analgesia, followed by immobilization in a splint and subsequent transition to a controlled ankle motion (CAM) boot. Post-reduction CT confirmed anatomical reduction and excluded occult fracture, while CTA showed no evidence of vascular injury; serial clinical examinations revealed no sensory or motor deficit. At one-year follow-up, the patient achieved a full functional recovery and unrestricted return to academic and physical activities. This case underscores that early closed reduction and phased rehabilitation can yield excellent outcomes in pure posteromedial tibiotalar dislocation, even in adolescent populations. The report highlights the viability of non-operative management for such injuries and contributes to the sparse literature on low-energy mechanisms in young, non-professional athletes.

Diabetes mellitus substantially increases the risk of osteoporosis and fractures, but the mechanisms remain unclear. Dyslipidemia, particularly the role of high-density lipoprotein (HDL), may influence bone mineral density (BMD), yet evidence in diabetic patients is limited. This study aimed to explore the association between HDL and BMD in US adults with diabetes using a nationally representative dataset. We analyzed data from 5 National Health and Nutrition Examination Survey cycles (2005–2018). A total of 5014 diabetic participants with available HDL and dual-energy X-ray absorptiometry (DXA)-measured BMD were included. Weighted multivariable linear regression models, smooth curve fitting, and 2-piecewise linear regression were employed to examine linear and nonlinear associations. Subgroup and sensitivity analyses were also conducted to assess robustness. Among 5014 participants (mean age 40.1 ± 31.2 years; 50.8% male), mean femoral neck and lumbar spine BMD were 0.81 and 1.03 g/cm ² , respectively, with a mean HDL of 48.9 mg/dL. Higher HDL levels were inversely associated with BMD at both the femoral neck (β = −0.0011, 95% CI: −0.0015 to −0.0007) and lumbar spine (β = −0.0012, 95% CI: −0.0018 to −0.0007) after full adjustment. Participants in the highest HDL quartile had significantly lower BMD compared with those in the lowest quartile (femoral neck: −0.0294 g/cm ² ; lumbar spine: −0.0378 g/cm ² ). Smooth curve fitting indicated nonlinear, negative associations. Subgroup analyses revealed stronger inverse associations in men, participants with hypertension, those <60 years at the femoral neck, and those ≥60 years at the lumbar spine. Sensitivity analyses confirmed the robustness of the results. Higher HDL levels were consistently and independently associated with lower BMD in US adults with diabetes. These findings challenge the traditional view of HDL as universally protective, suggesting that in the diabetic context, elevated HDL may exert detrimental effects on bone health. Further longitudinal and mechanistic studies are warranted to clarify causal pathways and guide osteoporosis prevention strategies in this high-risk population.

Shoulder arthroplasty (SA) is an established treatment for advanced shoulder disorders; however, its outcomes can be influenced by various comorbidities, p