Tazio Maleitzke

Introduction: Reported rates of loss of reduction in nonoperatively treated distal radius fractures (DRF) range from 17 to 71%. Thus, realistic biomechanical models are warranted to test novel immobilization devices that prevent loss of reduction in nonoperative fracture management. Currently available human cadaveric specimen models have several limitations: (i) disrupted soft tissue integrity, (ii) difficulty in replicating complex fracture patterns, and (iii) high technical demands and costs. Therefore, the aim of this study was to establish a feasible and accessible method for inducing DRFs, that accurately reflects in-vivo biomechanical fracture conditions in tissue-intact cadaveric specimens, suitable for testing of novel immobilization devices. Materials and methods: Fifteen upper extremity cadaveric specimens were included. Specimens were prepared as full‑length forearm models. Using a repurposed strength training tower as a vertical drop tower, fractures were induced by proximally administering 120–135 J impacts. CT scans were performed pre- and post-fracture induction. All fractures were classified according to the AO/OTA classification. Results: DRFs were successfully induced in all 15 specimens. A single 120 J impact produced a DRF in 11 out of 15 cases (73%). A second impact was administered in 4 out of 15 specimens (27%). Eleven of the 15 induced DRFs (73%) were classified as AO/OTA type C fractures, most commonly 2R3C3.2. Concomitant distal ulnar fractures were present in 6 cases, concomitant carpal fractures in 9 specimens. The overall cost of the setup amounted to 947 €. Conclusions: This study presents a feasible, cost-effective method to induce DRFs in tissue-intact, full-length human cadaveric forearm specimens. The setup consistently produces DRFs, predominantly AO/OTA type C, which can, with certain limitations, be utilized for biomechanical testing of immobilization devices, while also being uited for surgical and anatomical education.

In this multinational and multireader study, a radiography-based artificial intelligence tool for fracture detection showed robust performance and conferred the greatest benefits to less experienced readers.

Despite the growing burden of osteoarthritis (OA), effective disease‐modifying treatments remain limited. Hyaluronic acid, platelet‐rich plasma, and hydrogels are in clinical use, but their efficacy beyond placebo is debated. Cell‐based therapies are continuously investigated for their disease‐modifying potential. Stromal vascular fraction (SVF), a minimally processed and clinically accessible cell product, has shown therapeutic potential, but remains poorly characterized in respect to its pro‐regenerative cell types and molecular signaling. To determine whether CD31 ⁺ cell enrichment enhances the regenerative efficacy of SVF, a comparative efficacy study was conducted using the Dunkin Hartley guinea pig model of spontaneous OA. Spatial proteomics reveals that both treatments modulate cartilage extracellular matrix (ECM) composition, reducing fibronectin and COL1A1 levels, with CD31 ⁺ SVF showing more pronounced effects. Both therapies attenuate cartilage fibrosis, increase aggrecan, suppress MMP‐13, and reduce TNF‐α and MCP‐1 expression. Compared to SVF, CD31 ⁺ SVF shows greater and more consistent improvements in subchondral and trabecular bone integrity. These findings demonstrate that CD31 ⁺ enrichment enhances the therapeutic potential of SVF, likely through more consistent modulation of ECM remodeling and osteochondral integrity. Our results provide a preclinical rationale for the testing of CD31 ⁺ ‐enriched SVF as a biologically refined cell therapy approach for OA, with potential disease modifying properties.

Background: Proximal femur fractures in adolescents are rare and usually occur following high-energy trauma. When such injuries result from minimal trauma, they demand careful evaluation of skeletal integrity. This case highlights how social withdrawal, prolonged immobilization, and malnutrition can lead to reversible bone fragility and an unusual fracture pattern in a young patient. Case presentation: A 14-year-old boy of Danish ethnicity with no prior somatic disease sustained an intertrochanteric femur fracture after falling from a floor bed of approximately one meter. For the preceding two years, he had been socially withdrawn and largely bedridden. Profound malnutrition, vitamin D deficiency, secondary hyperparathyroidism, and markedly reduced bone quality were evident. Intraoperative findings confirmed cortical thinning and brittle bone structure inconsistent with chronological age. The patient was treated with surgical fracture fixation using a pediatric dynamic hip screw in combination with vitamin D and calcium supplementation, calorie-dense nutrition, physiotherapy, and social support. The fracture healed, and over eight months he regained mobility, caught up on body weight and growth, and improved in developmental parameters. Conclusions: Low-energy hip fractures in adolescents are rare but may indicate reversible bone fragility from unloading and malnutrition; early multidisciplinary interventions are warranted.

Case: A 30-year-old woman sustained a complex open pelvic ring injury with urogenital and rectal injuries and a severe Morel-Lavallée lesion after getting stuck between a train platform and an arriving train. Orthopaedic trauma management included extensive debridements, temporary internal and external fixation, staged plate osteosynthesis, and negative-pressure wound therapy. Progressive soft-tissue necrosis due to mucormycosis necessitated a hemipelvectomy. At the 1-year follow-up, the patient had returned to independent living. Conclusion: Complex open peripelvic injuries, complicated by mucormycosis infection and subsequent hemipelvectomy, have a high risk of mortality. We outline multidisciplinary surgical and antimicrobial strategies potentially effective in similar scenarios.

Genicular artery embolization with rapidly resorbable gelatin-based microspheres was safe and associated with sustained pain reduction and functional improvement in patients with knee osteoarthritis at 12 months.

BACKGROUND: Total hip arthroplasty (THA) is one of the most frequently performed surgeries worldwide. Approximately 1% to 10% of patients experience one or multiple dislocations of their THA, a painful condition requiring urgent treatment. In Denmark, the usual treatment is closed reduction, typically performed in the operating theater under general anesthesia. However, logistical and clinical challenges can delay treatment in an often frail, elderly population. This study investigated whether time to reduction and type of anesthetics were associated with post-reduction length of stay (LOS) and complications in patients with THA dislocation. We hypothesized that longer time to reduction would be associated with increased post-reduction LOS and complications. METHODS: This retrospective observational cohort study included adults (≥18 years) with a first-time THA dislocation who underwent closed reduction in the operating theater, from 1 January 2017 to 31 January 2025 in the Capital and Zealand Regions of Denmark. Data were extracted from the Electronic Health Record “Sundhedsplatformen.” The primary outcome was post-reduction LOS, assessed using linear regression adjusted for predefined confounders. Secondary outcomes were 90-day all-cause mortality, delirium, readmission, intensive care unit admission, infections, acute kidney injury, and cardiovascular complications. RESULTS: A total of 3494 reductions were included; 86.7% were performed within 12 hours of admission. Increasing time to reduction was associated with longer post-reduction LOS. In the reference group (P < .001), 197 hours at 18–24 hours (95% CI 146–249; P < .001), and 137 hours beyond 24 hours (95% CI 119–154; P < .001). Post-reduction LOS beyond 24 hours was also statistically significantly associated with increased mortality, delirium, and infection. CONCLUSIONS: Most patients underwent closed reduction within 12 hours, without increased risk of complications. Reductions exceeding 12 hours of waiting time were associated with longer post-reduction LOS, even when adjusting for known confounders. Further delays were associated with increased odds of mortality, delirium, and infections. Whether these associations were driven by system delays or patient-related factors remains unclear.

Aims: Salmon calcitonin (CT) has been shown to have antiresorptive and chondroprotective effects, and several clinical trials have reported beneficial effects of salmon CT treatment in patients with knee osteoarthritis (OA). The objective of the present study is to investigate the role of endogenous CT-mediated signalling in OA. Methods: Calcitonin receptor (CTR)-deficient mice and wild-type (WT) littermate controls were subjected to experimental post-traumatic OA (ptOA) by anterior cruciate ligament transection (ACLT). Radiological and histomorphometric outcome measurements in WT and CTR -deficient mice with ACLT were performed at early (4 weeks) and late (8 weeks) stages after ptOA induction. Expression of CTR on messenger RNA (mRNA) and protein level in sham and ACLT knees of WT mice were measured by gene expression analysis and immunofluorescence, respectively. Results: In WT mice, Calcr mRNA was progressively induced in ptOA knees, and CTR protein was abundantly expressed in articular cartilage and subchondral bone (SB) in diseased joints. CTR ^-/- mice displayed decreased osteophyte formation compared to WT mice, while cartilage deterioration, pathological SB alterations, and synovial inflammation were not affected by CTR deficiency. In line with this, bone resorption, cartilage, and inflammatory markers were unaltered between WT and CTR -deficient mice, while bone formation parameters were increased only in WT ptOA knees on gene expression level four weeks after surgery. Conclusion: Although CTR is highly expressed in articular cartilage and SB and promotes osteophyte formation, endogenous CTR signalling does not affect cartilage degeneration and SB pathologies in murine ptOA. Cite this article: Bone Joint Res 2026;15(2):190–203.

Background/Objectives: Genicular artery embolization (GAE) is an emerging, minimally invasive treatment for symptomatic osteoarthritis. This study assesses global online search trends for GAE compared with traditional knee replacement using Google Trends data. Methods: This retrospective observational study analyzed global search trends for osteoarthritis treatments using the publicly accessible Google Trends platform. Monthly relative search volumes (RSV; scaled 0–100) for English-language queries were retrieved from January 2018 to December 2024. Three emerging minimally invasive terms (“genicular artery embolization”, “knee embolization”, “interventional radiology”), and three traditional surgical terms (“knee arthroplasty”, “knee replacement”, “total knee replacement”) were included. Temporal trends were evaluated using linear and non-linear regression models, with model fit evaluated using coefficients of determination (R²), ANOVA, and accuracy measures. Statistical significance was defined as p < 0.05. Results: GAE-related terms demonstrated significant growth over time. “Genicular artery embolization” increased by 0.9% per month (R² = 0.795, p < 0.001), and “knee embolization” increased at 0.9% per month (R² = 0.627, p < 0.001) in a linear model. Traditional terms showed slower growth rates of 0.13–0.23% per month (R² = 0.159–0.271). Exponential and quadratic models confirmed these patterns. Mean RSV values over the study period were higher for traditional procedures (e.g., “total knee replacement”: 83.13) than for GAE-related terms (e.g., “genicular artery embolization”: 22.5). Conclusions: Global online interest in GAE-related terms is increasing at a substantially faster rate than interest in traditional knee replacement. Rapidly growing search interest highlights the need for accurate and accessible online patient education regarding emerging treatments.