Hypertrophic scars and keloids are fibroproliferative disorders arising from aberrant wound healing, often leading to aesthetic disfigurement, functional impairment, and psychosocial burden. Intralesional therapies remain a mainstay of treatment, yet the comparative efficacy and recurrence profiles of different agents have not been definitively established. We conducted a systematic search of PubMed (National Institutes of Health, Bethesda, MD), Cochrane Library (Wiley, Hoboken, NJ), US National Institutes of Health Ongoing Trials Register, EMBASE (Elsevier, Amsterdam, the Netherlands), and Google Scholar (Alphabet, Inc., Mountain View, CA) from inception through May 2025, restricted to English-language publications, to identify randomized controlled trials comparing 2 or more intralesional treatments for hypertrophic scars or keloids. Twenty-four eligible trials were included in a frequentist random-effects network meta-analysis integrating direct and indirect comparisons. Pooled estimates demonstrated that triamcinolone acetonide combined with 5-fluorouracil (TAC + 5-FU) achieved the most consistent improvements in treatment efficacy and recurrence control. Botulinum toxin A (BTA) ranked highest in treatment response but did not significantly reduce recurrence risk. Verapamil was associated with significantly lower efficacy compared with TAC, whereas bleomycin and 5-FU monotherapies provided intermediate outcomes without statistical superiority. Overall, TAC + 5-FU offered the most favorable balance between efficacy and recurrence reduction, whereas BTA showed strong response efficacy. These findings provide a comprehensive synthesis of intralesional therapies for hypertrophic scars and keloids, support the consideration of combination regimens in scar management, and underscore the need for further well-designed head-to-head trials with standardized endpoints to refine individualized treatment strategies. Level of Evidence: 3 (Therapeutic)

Non-traumatic osteonecrosis of the femoral head (ONFH) is a multifactorial disorder in which genetic susceptibility is thought to play an important role, yet the contribution of many candidate genes remains unclear. The catenin beta-1 (CTNNB1) gene encodes β-catenin, a key regulator of the Wnt/β-catenin signaling pathway involved in bone homeostasis and vascular regulation, and may therefore influence susceptibility to non-traumatic ONFH. In this case–control study, genotype data from China Medical University Hospital were analyzed to evaluate the association between CTNNB1 polymorphisms and the risk of ONFH. A total of 609 patients with ONFH and 2436 age- and sex-matched controls were included. Fourteen CTNNB1 single-nucleotide polymorphisms (SNPs) with a minor allele frequency greater than 5% were selected and analyzed using logistic regression under multiple genetic models, with Hardy–Weinberg equilibrium assessed in controls. Two SNPs, rs3774370 and rs11564478, showed significant differences in allele frequencies between cases and controls, with lower minor allele frequencies observed in the ONFH group. Both variants were associated with a reduced risk of ONFH, and these associations remained significant under dominant genetic models. These findings suggest that specific CTNNB1 polymorphisms may confer a protective effect against non-traumatic ONFH and provide further insight into the genetic architecture of this disease.

INPLASY202570010 Comparative Efficacy and Recurrence Risk of Intralesional Therapies for Hypertrophic Scars and Keloids: A Network Meta-Analysis Keywords: keloid; hypertrophic scar; intralesional i…