Aims: Osteosarcopenia, the coexistence of osteoporosis and sarcopenia, is increasingly recognized as a key geriatric syndrome associated with frailty, falls, fractures, disability, and mortality. We aimed to map worldwide publication trends and thematic evolution in osteosarcopenia research.Methods: We performed a bibliometric analysis of Web of Science Core Collection publications from 2001 to October 2025, restricted to English-language open-access articles with a geriatric and musculoskeletal focus. Analyses included annual scientific production, source and country productivity, keyword co occurrence, thematic mapping, thematic evolution, and multiple correspondence analysis (MCA). Results: A total of 1,514 articles were identified, with a marked growth in publications after 2017. The most productive countries were China, the United States, and Japan. Core themes centered on sarcopenia, osteoporosis, bone mineral density, and muscle, while thematic analyses highlighted both clinical epidemiological domains and emerging mechanistic topics. MCA suggested a dual-axis conceptual structure linking clinical foundations with biological mechanisms. Conclusion: Osteosarcopenia research has expanded rapidly since 2017 and evolved into a multidisciplinary domain. These findings support the need to integrate osteosarcopenia into geriatric risk stratification and preventive strategies.

This study aimed to evaluate the association between AO/OTA subclassification and treatment selection in intertrochanteric femur fractures and to determine how closely real-world clinical decisions align with classification-based recommendations. A retrospective analysis was performed on 474 patients treated for intertrochanteric femur fractures between 2015 and 2020. Fractures were subclassified according to AO/OTA 31-A classification using standard radiographs. Chi-square tests with Cramer's V were used to assess the relationship between fracture groups and treatment modalities. Multinomial logistic regression evaluated predictors of treatment choice, while guideline adherence was analyzed using binary logistic regression. A p value < 0.05 was considered statistically significant. PFN was the most frequently applied treatment (74.1%), followed by conservative management (13.5%) and DHS (5.7%). Treatment distribution differed significantly among AO/OTA groups (χ² = 40.408, p < 0.001; Cramer's V = 0.206). AO/OTA group independently predicted treatment selection (p = 0.002), whereas age (p = 0.179) and sex (p = 0.579) did not independently predict treatment selection. The regression model explained 8-10% of treatment variance (Nagelkerke R² = 0.097). Guideline adherence was 79.3%, with no independent predictors of non-adherence. Additionally, the 95% confidence intervals for regression coefficients crossed 1 for all variables (age: 0.947-1.016; sex: 0.570-1.483; AO group: 0.592-1.199), confirming that none independently predicted adherence. Conservative treatment was relatively frequent due to the cohort's advanced age and comorbidity burden. Revision surgery occurred in 3.8% of cases. Although AO/OTA subclassification significantly influences treatment choice, fracture morphology alone is insufficient for determining management. PFN remains preferred across fracture types, while non-operative care is suitable for high-risk patients. Future models should integrate frailty, bone quality, and functional status.

This retrospective comparative study evaluated the effect of tranexamic acid (TXA) on perioperative transfusion requirements and clinically documented thromboembolic events in patients undergoing proximal femoral tumor resection and megaprosthetic reconstruction for metastatic bone disease. A total of 32 patients who underwent proximal femoral tumor resection and megaprosthetic reconstruction between 2019 and 2026 were included. The patients were divided according to perioperative TXA administration (TXA group, n = 15; control group, n = 17). TXA was administered intravenously at 10 to 15 mg/kg prior to skin incision. Primary outcomes included transfusion requirements and the number of transfused erythrocyte units. The secondary outcomes included perioperative hemoglobin change, length of hospital stay, postoperative complications, and mortality. Perioperative blood transfusion was required in 60.0% and 82.4% of the patients in the TXA and control groups, respectively ( P = .243). The transfusion requirement was numerically lower in the TXA group, corresponding to an absolute difference of 22.4 percentage points (relative risk, 0.73). The mean number of transfused units was similar between groups (1.27 ± 1.22 vs 1.35 ± 0.99, P = .829). Hospital stay was numerically shorter in the TXA group (9.53 ± 4.73 vs 13.94 ± 10.52 days, P = .202). No clinically documented symptomatic thromboembolic events were observed in either group of patients. In this small retrospective cohort, TXA use was associated with a numerically lower perioperative transfusion requirement, although the difference was not statistically significant. These findings should be considered exploratory and hypothesis-generating and require confirmation in larger, adequately powered prospective studies.

Proximal femur fractures are associated with high mortality in older adults, and accurate prognostic assessment is clinically important. The Albumin–

Aim: Diabetic foot is a disease associated with severe morbidity, mortality, and significant socioeconomic problems. Numerous risk factors influence revision amputations in diabetic feet; however, the literature does not reach a consensus on this matter. This study aims to analyze the significant factors affecting revision surgery in patients who have undergone major lower extremity amputations due to diabetes. Materials and Methods: This retrospective study was conducted at a university hospital in İzmir between April 10, 2023, and October 12, 2023. A total of 276 patients who underwent surgical operation due to diabetic foot between 2010 and 2022 were included in the study. The study evaluated the impact of demographic characteristics and various parameters, including a history of peripheral angiography or peripheral bypass, the surgical specialty performing the operation, hemoglobin, platelet count, hemoglobin A1c, albumin, sedimentation rate, C-reactive protein, sodium and potassium levels, lymphocyte-to-neutrophil ratio, blood transfusion requirements, and the Charlson Comorbidity Index, recorded at admission and discharge, on the need for revision surgery. Results: The patients were divided into two groups: those who underwent revision amputation (96) and those who did not (180). The revision amputation rate among all patients was determined to be 35%. The risk of revision amputation can be predicted by the admission and discharge albumin levels, as well as the admission and discharge potassium levels. In addition to high admission albumin levels and low discharge potassium levels, high admission potassium levels may also contribute to the adverse outcomes of revision surgery. Conclusions: In this study, it was found that albumin levels, which are considered important for wound healing in many sources, were not a determining factor for revision amputation as previously thought. Additionally, the regulation of potassium levels, which can be affected by various metabolic diseases, may have a significant impact on the revision surgery that becomes necessary after amputation.