Close association has been established between obstructive sleep apnea (OSA) and adolescent idiopathic scoliosis (AIS), with PSQ being employed as a screening method for OSA. A cross-sectional study was conducted among patients aged from 10 to 16 years who presented to a scoliosis outpatient clinic. Patient demographics, radiological assessments, and PSQ scores were gathered. A total of 299 patients were included in the study, with 28.7% males and 71.2% females. The average Cobb angle was 6.20°. PSQ scores revealed a prevalence of 33.4% for significant obstructive sleep apnea. Patients diagnosed with AIS exhibited a prevalence of 32.9% with positive PSQ results. Among those undergoing adenoid and/or tonsil surgery, 27% had positive PSQ scores. Factors such as genetics, abnormal biomechanical forces, environmental factors including melatonin, and intermittent hypoxia were explored for their potential contribution to AIS etiology. The aim of the study is to underscore the importance of early detection and intervention in OSA cases and highlights the effectiveness of the PSQ, as a screening tool in identifying sleep disorders. The findings underscore the complex relationship between OSA and AIS, and moreover any spinal curvature is in relation with OSA.

This study evaluates the effects of exenatide (EXE), a glucagon-like peptide-1 (GLP-1) receptor agonist, on bone healing in rats using a single radius cortical defect model and histopathological, biochemical, and in silico methods. Forty-two male Sprague–Dawley rats, excluding controls, were divided into 7 groups after receiving a standard radius defect. The serum levels of total protein (TP), calcium (Ca2+), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (OC), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each specimen were measured. Radius samples were examined histopathologically using hematoxylin and eosin (H&E) and Masson’s trichrome staining. Molecular docking analyses were used to assess EXE interactions with the GLP-1 receptor and osteogenic transcription factors. Statistical significance was set at p < 0.05. Changes in the selected serum markers were observed in the blood samples obtained from the specimens; however, these changes may not have been due to EXE administration. No significant negative effect on bone healing was observed in the groups that received subcutaneous EXE after the bone defect was created. By contrast, it was observed that for the treatment group that received EXE for 7 consecutive days before the bone defect was created on Day 7, bone healing progressed more slowly than in the groups treated with saline. Regarding the binding of EXE to the other target receptors, root mean square deviation (RMSD) values were low, bruised surface area (BSA) was high, and electrostatic interactions were strong, indicating that the ligand (i.e., EXE) binds to the selected receptor surfaces. Although the data obtained from the in vitro analyses in this study were verified using molecular docking, it should be noted that its design is preclinical. Given the widespread clinical use of GLP-1 receptor agonists in the management of type 2 diabetes mellitus (T2DM), our research findings may have translational relevance. Although derived from an experimental animal model, these results suggest that GLP-1 agonists such as EXE can exert additional effects on bone healing and inflammatory processes, thus warranting further studies, including controlled clinical investigations, to elucidate the potential implications for patient care.

Background/Objectives: Specialized pro-resolving lipid mediators (SPMs), such as Resolvin E1 (RvE1) and Resolvin D1 (RvD1), play a critical role in the resolution phase of inflammation. However, their relevance to tendon pathology and tissue-specific degeneration in rotator cuff tears remains unclear. This study aimed to investigate the relation between serum RvE1 and RvD1 levels and the morphological severity of tendon retraction and muscle fatty degeneration in patients with full-thickness rotator cuff tears. Methods: A total of 70 participants were included: 35 patients with full-thickness rotator cuff tears determined by magnetic resonance imaging (MRI) and 35 healthy controls. Tendon retraction and muscle fatty degeneration were graded using Patte and Goutallier classifications, respectively. Serum RvE1 and RvD1 levels were measured using enzyme-linked immunosorbent assay (ELISA). Group comparisons were performed using Welch’s t-test, and correlations were analyzed with Spearman’s coefficient. Results: RvE1 and RvD1 levels were significantly lower in patients compared to controls (p < 0.001). RvE1 showed a moderate positive correlation with Patte score (ρ = 0.37, p = 0.027), while no significant correlation was observed with Goutallier classification (ρ = 0.19, p = 0.27). RvD1 levels demonstrated no significant relationship with either morphological parameter. Conclusions: These findings suggest that decreased serum RvE1 levels are associated with the severity of tendon retraction but not with muscle fatty degeneration. Therefore, RvE1 may serve as a potential biochemical biomarker reflecting tendon damage severity and the impaired resolution of inflammation in rotator cuff tears.

Objective: This study delves into the implications of adenoidectomy for scoliosis progression, investigating the intricate nexus of hypoxia, spinal curvature, and surgical intervention. With adenoidectomy being a common procedure for addressing pediatric sleep-disordered breathing, this research study explores its potential impact on spinal health. Patients and Methods: Employing a retrospective cohort design, this study gathered data from patients who underwent adenoidectomy, including those with scoliosis, between January 2017 and March 2023. Initial and follow-up evaluations involved clinical and radiological assessments, notably measuring the Cobb angle to quantify spinal curvature. Results: This study enrolled 218 patients under 10 years old. Among them, 18 exhibited Cobb angles of 10° or more, with a mean Cobb angle of 12.8°. In the follow-up evaluation, 83% of patients with initial Cobb angles of 10° or more were reached out to, along with 84.6% of those with Cobb angles below 10°. The postoperative follow-up revealed a notable decrease in Cobb angles for most patients, particularly those with an initial Cobb angle exceeding 10°. Conclusions: This study underscores the potential connection between adenoidectomy, hypoxia, and scoliosis regression, highlighting the importance of early intervention for scoliosis management. Despite certain limitations, this investigation lays the foundation for future research involving larger patient cohorts and multifaceted analyses. The observed interactions between airway function, hypoxia, and spinal health open avenues for refining clinical strategies in scoliosis treatment.

Background: Hallux valgus (HV) is a complex forefoot deformity influenced by interactions between osseous alignment, ligamentous restraint, and muscle–tendon forces. While the biomechanical role of ligament laxity and bone geometry has been extensively investigated, the contribution of tibialis anterior (TA) tendon insertion variability to medial column mechanics remains insufficiently understood. Materials and Methods: A patient-specific finite element model of the foot was developed from high-resolution computed tomography data. Five anatomically documented TA distal insertion configurations were modeled, representing different distributions of attachment to the medial cuneiform and first metatarsal base. All simulations were performed under identical boundary and loading conditions representative of the stance phase of gait. Global (full-foot) and local (first bone and first metatarsal) mechanical responses were quantified using total deformation, equivalent von Mises stress, and strain distributions. Results: Marked differences in mechanical behavior were observed across TA insertion types. The metatarsal-dominant configuration (Type 3) demonstrated the highest global and local deformation values (global deformation: 1.0928 mm; first bone deformation: 1.0928 mm) and elevated strain distributions, whereas the medial-dominant configuration (Type 2) showed minimal deformation (global: 0.0727 mm; first bone: 0.0350 mm) but the highest global equivalent von Mises stress (5.7698 MPa). The single-band insertion to the medial cuneiform (Type 5) produced the greatest localized stress in the first bone region (3.8634 MPa). Representative strain maps revealed distinct spatial redistribution patterns within the medial column associated with TA insertion geometry. Conclusions: This patient-specific finite element analysis indicated that distal TA insertion variability alone can substantially modify deformation, stress, and strain patterns within the medial column. These findings suggested that TA insertion anatomy may act as a biomechanical modulator of first-ray mechanics and should be considered in future studies investigating hallux valgus pathomechanics and personalized treatment strategies.

Aims: Fluoroscopy is widely used in orthopedic surgery but raises concerns regarding radiation exposure. This study aimed to compare radiation exposure between pulsed and continuous fluoroscopy modes during PFN-A (proximal femoral nail - antirotation) fixation of pertrochanteric femoral fractures.Methods: In this retrospective cohort study, 102 patients treated with PFN-A for AO/OTA (Arbeitsgemeinschaft für osteosynthesefragen Foundation/Orthopedic Trauma Association) type 31A1.2 and 31A1.3 pertrochanteric fractures at a single institution between January 2024 and January 2025 were included.Results: No significant differences were observed between groups in terms of fluoroscopy time, total radiation dose, DAP (dose-area product), or number of exposures. However, radiation exposure per image was significantly lower in the pulsed fluoroscopy group, as demonstrated by both dose per image (p = 0.001, r = 0.32) and DAP per image (p = 0.002, r = 0.29). In adjusted analyses, fluoroscopy mode remained a significant predictor of radiation exposure per image (F = 9.07, p = 0.003). Image quality was considered subjectively adequate based on intraoperative assessment, with no clinically relevant difference between the groups. Radiation exposure was also normalized per image. Statistical analyses were performed using the Mann–Whitney U test and ANCOVA.Conclusion: Pulsed fluoroscopy does not significantly reduce total radiation parameters but is associated with lower radiation exposure per image during PFN-A fixation of pertrochanteric fractures. These findings indicate a reduction in radiation exposure per image without significant differences in total radiation parameters.