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Optimizing bone marrow harvesting sites for enhanced mesenchymal stem cell yield and efficacy in knee osteoarthritis treatment

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World Journal of Methodology 2025年第2期15卷 92-107页

作者： Arulkumar Nallakumarasamy Sandeep Shrivastava Ravi Velamoor Rangarajan Naveen Jeyaraman Avinash Gandi Devadas Swaminathan Ramasubramanian Madhan Jeyaraman Department of orthopaedics Datta Meghe Institute of Higher Education and ResearchWardha 442004MaharashtraIndia Department of Regenerative medicine Mother Cell Regenerative CentreTiruchirappalli 620017Tamil NaduIndia Department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia Department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia

Knee osteoarthritis(OA)is a debilitating condition with limited long-term treatment *** therapeutic potential of mesenchymal stem cells(MSCs),particularly those derived from bone marrow aspirate concentrate,has garnered attention for cartilage repair in *** the iliac crest is the traditional site for bone marrow harvesting(BMH),associated morbidity has prompted the exploration of alternative sites such as the proximal tibia,distal femur,and proximal *** paper reviews the impact of different harvesting sites on mesenchymal stem cell(MSC)yield,viability,and regenerative potential,emphasizing their relevance in knee OA *** iliac crest consistently offers the highest MSC yield,but alternative sites within the surgical field of knee procedures offer comparable MSC characteristics with reduced *** integration of harvesting techniques into existing knee surgeries,such as total knee arthroplasty,provides a less invasive approach while maintaining thera-peutic ***,variability in MSC yield from these alternative sites underscores the need for further research to standardize techniques and optimize clinical *** directions include large-scale comparative studies,advanced characterization of MSCs,and the development of personalized harvesting ***,the findings suggest that optimizing the site of BMH can significantly influence the quality of MSC-based therapies for knee OA,enhancing their clinical utility and patient outcomes.

关键词： Knee Osteoarthritis Mesenchymal stem cells Bone marrow harvest Regenerative medicine

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Visualizing medicine:The case for implementing graphical abstracts in clinical reporting

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World Journal of Methodology 2025年第2期15卷 1-8页

作者： Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Arulkumar Nallakumarasamy Department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia Department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia Department of orthopaedics Jawaharlal Institute of Postgraduate Medical Education and Research–KaraikalPuducherry 609602India

Graphical abstracts(GAs)are emerging as a pivotal tool in medical literature,enhancing the dissemination and comprehension of complex clinical data through visual *** editorial highlights the significant advantages of GAs,including improved clarity,increased reader engagement,and enhanced visibility of research *** transforming intricate scientific data into accessible visual formats,these abstracts facilitate quick and effective knowledge transfer,crucial in clinical decision-making and patient ***,challenges such as potential data misrepresentation due to oversimplification,the skill gap in graphic design among researchers,and the lack of standardized creation guidelines pose barriers to their widespread ***,while software such as Adobe Illustrator,BioRender,and Canva are commonly employed to create these visuals,not all researchers may be proficient in their *** address these issues,we recommend that academic journals establish clear guidelines and provide necessary design training to *** proactive approach will ensure the creation of high-quality GAs,promote their standardization,and expand their use in clinical reporting,ultimately benefiting the medical community and improving healthcare outcomes.

关键词： Graphical abstracts Clinical data dissemination Visual communication Research impact Academic publishing

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Malpractice or masterful practice?Navigating vicarious liability in healthcare

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World Journal of Clinical Cases 2025年第2期13卷 10-13页

作者： Satvik N Pai Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Department of orthopaedics PES University Institute of Medical Sciences and ResearchBengaluru 560100KarnatakaIndia Department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia Department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia

In the intricate landscape of healthcare,vicarious liability looms large,shaping the responsibilities and actions of healthcare practitioners and administrators *** by a poignant scenario of a medication error,this article navigates the complexities of vicarious liability in *** explains the legal basis and ramifications of this theory,emphasizing its importance in fostering responsibility,protecting patient welfare,and easing access to *** paper explores the practical effects of vicarious responsibility on day-to-day operations,leadership practices,and decision-making processes via the eyes of senior consultants,junior doctors,and hospital *** comprehensive insights and real-world examples,it underscores the imperative of fostering a culture of accountability,communication,and quality care to navigate the intricate web of liabilities inherent in modern healthcare.

关键词： Vicarious liability Healthcare Responsibility Litigation Patient welfare

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Navigating the ethical terrain:Off-label and experimental treatments in medical case reports

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World Journal of Methodology 2025年第1期15卷 1-5页

作者： Madhan Jeyaraman Naveen Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077India Department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002India

This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and *** emphasizes the balance between innovation and evidence-based medicine,highlighting the critical role of case reports in disseminating clinical experiences and advancing medical *** discussion delves into the ethical framework guiding case reporting,including principles of patient autonomy,informed consent,non-maleficence,beneficence,justice,and *** such as negative outcome reporting,commercial interests,and the balance between innovation and caution are *** for ethical vigilance,the development of comprehensive guidelines,and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific *** article concludes by underscoring the importance of a collaborative effort among clinicians,researchers,ethicists,and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.

关键词： Ethical considerations Patient autonomy Informed consent Non-maleficence Beneficence Transparency Evidence-based medicine

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Voices that matter:The impact of patient-reported outcome measures on clinical decision-making

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World Journal of Methodology 2025年第2期15卷 54-61页

作者： Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Sathish Muthu Department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennaiTN 600077India Department of Research Methods Orthopaedic Research GroupCoimbatoreTN 641045India Department of orthopaedics Government Medical CollegeOmandurar Government EstateChennaiTN 600002India Department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatoreTN 641021India Department of orthopaedics Government Medical CollegeKarurTN 639004India

The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific *** encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of *** integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments *** deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment ***,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health ***,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and *** these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of *** paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.

关键词： Patient-reported outcome measures Clinical decision-making Patient-centered care Healthcare technology Data management Policy development

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Neuromuscular trunk activation patterns in back pain patients during one-handed lifting

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World Journal of Orthopedics 2017年第2期8卷 142-148页

作者： Juliane Mueller Tilman Engel Stephan Kopinski Frank Mayer Steffen Mueller University Outpatient Clinic Sports Medicine and Sports OrthopaedicsUniversity of Potsdam

AIM To analyze neuromuscular activity patterns of the trunk in healthy controls(H) and back pain patients(BPP) during one-handed lifting of light to heavy loads. METHODS After assessment of back pain(graded chronic pain scale according to von Korff) all subjects(n = 43) performed a warm-up(treadmill walking). Next, subjects were instructed to lift 3 × a 20 kg weight placed in front of them(with both hand) onto a table(height: 0.75 m). Subsequently, all subjects lifted with one hand(left-side, 3 repetitions) a weight of 1 kg(light), 10 kg(middle) and 20 kg(heavy) in random order from the ground up onto the table left of them. Trunk muscle activity was assessed with a 12-lead EMG(6 ventral/6 dorsal muscles; 4000 Hz). EMG-RMS(%) was averaged over the 3 repetitions and analyzed for the whole one-handed lifting cycle, then normalized to RMS of the two-handed lifting. Additionally, the mean(normalized) EMG-RMS of four trunk areas [right/left ventral area(VR/VL); right/left dorsal area(DR/DL)] was calculated. Data were analyzed descriptively(mean ± SD) followed by student's t-test comparing H and BPP(α = 0.05). With respect to the unequal distribution of subjects in H and BPP, a matched-group analysis was conducted. Seven healthy controls were gender- and age-matched(group H_(matched)) to the 7 BPP. In addition, task failure was calculated and compared between H/H_(matched) vs BPP using χ~2. RESULTS Seven subjects(3m/4f; 32 ± 7 years; 171 ± 7 cm; 65 ± 11 kg) were assigned to BPP(pain grade ≥ 2) and 36(13m/23f; 28 ± 8 years; 174 ± 10 cm; 71 ± 12 kg) to H(pain grade ≤ 1). H and BPP did not differ significantly in anthropometrics(P > 0.05). All subjects were able to lift the light and middle loads, but 57% of BPP and 22% of H were not able to lift the heavy load(all women). χ~2 analysis revealed statistically significant differences in task failure between H vs BPP(P = 0.03). EMG-RMS ranged from 33% ± 10%/30% ± 9%(DL, 1 kg) to 356% ± 148%/283% ± 80%(VR, 20 kg) in H/BPP with n

关键词： Lifting Core Trunk EMG MISPEX

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Beyond statistical significance:Embracing minimal clinically important difference for better patient care

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World Journal of Methodology 2025年第1期15卷 33-41页

作者： Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Sathish Muthu Department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia Department of Research Methods Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia Department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Department of orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia

The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's *** comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and *** discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based ***,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical *** for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global *** steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.

关键词： Minimal clinically important difference Patient-centered care Clinical relevance Global health

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Tracking the in vivo spatio-temporal patterns of neovascularization via NIR-II fluorescence imaging

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Nano Research 2020年第11期13卷 3123-3129页

作者： Mo Chen Sijia Feng Yimeng Yang Yunxia Li Jian Zhang Shiyi Chen Jun Chen institute of sports medicine of Fudan University Department of Orthopaedic Sports MedicineHuashan HospitalFudan UniversityShanghai200041China

The in vivo spatio-temporal patterns of neovascularization are still poorly understood because it is limited to multi-scale techniques from the cellular level to living animal *** to deep tissue-penetration and zero autofluorescence background,the second near-infrared(NIR-II,1,000–1,700 nm)fluorescence imaging recently shows promise in breaking through this dilemma by dynamically tracking the pathophysiological process of neovascularization in ***,NIR-II fluorescence imaging was recruited for monitoring blood vessels in order to visualize the vascular injury and quantitively assess neovascularization in mouse models of acute skeleton muscle contusion and hindlimb *** temporal analysis of real-time NIR-II fluorescence intensity demonstrated that the blood flow perfusion of ischemia area was able to rapidly restore to 96%of pre-ischemic state within one ***,the spatial analysis revealed that the lower and outer quadrants of ischemia area in the mouse model of hindlimb ischemia always had relatively high blood flow perfusion compared with other quadrants during three weeks post-ischemia,and even exceeded pre-ischemic quantity at 21 days *** conclusion,this in vivo imaging technique has significant potential utility for studying the spatio-temporal patterns of neovascularization in vivo.

关键词： bioimaging second near-infrared(NIR-II)fluorescence nanoprobes spatio-temporal neovascularization

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Advances in the Application of Three-dimensional Printing for the Clinical Treatment of Osteoarticular Defects

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Current Medical Science 2022年第3期42卷 467-473页

作者： Xiao-ze FAN Ming-ze DU Chen JIAO Qin-wei GUO Dong JIANG Department of sports medicine Peking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key laboratory of Sports InjuriesBeijing 100191China|

As a promising manufacturing technology,three-dimensional(3D)printing technology is widely used in the medical *** the treatment of osteoarticular defects,the emergence of 3D printing technology provides a new option for the reconstruction of functional articular *** present,3D printing technology has been used in clinical applications such as models,patient-specific instruments(PSIs),and customized implants to treat joint defects caused by trauma,sports injury,and *** review summarizes the application status of 3D printing technology in the treatment of osteoarticular defects and discusses its advantages,disadvantages,and possible future research strategies.

关键词： 3D printing osteoarticular defect models PSI custom-made implant

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Bone marrow edema in a postpartum female following ankle sprain: a case report

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World Journal of Emergency medicine 2024年第4期15卷 325-327页

作者： Peng Zhang Junjie Zhang Peng Chen Jianjing Lin Jiang Guo Weixuan Liu Zhiwen Luo Qing Wang Xintao Zhang Department of sports medicine Peking University Shenzhen HospitalShenzhen 518000China Department of sports medicine Huashan HospitalFudan UniversityShanghai 200040China Department of orthopaedics Kunshan Hospital of Traditional Chinese MedicineKunshan 215300China

Bone marrow edema(BME)is characterized by an accumulation of interstitial fluid within the bone marrow,the cancellous,hematopoietic compartment within bones.[1]BME is divided into two principal categories:idiopathic or primary BME,with an unknown etiology,and secondary BME,which occurs as a result of an identifiable underlying pathology.[2]Although the prevalence of BME is not limited to specific demographic parameters,it shows a predilection for males or individuals assigned male at birth,predominantly aged between the ages of 30 and 60 years,especially in cases of bone marrow edema syndrome(BMES),a rare idiopathic variant.[3]The etiological spectrum of BME is diverse,including oncological entities(such as acute myeloid leukemia and osteosarcoma),degenerative diseases(such as osteoarthritis),infectious processes(osteomyelitis),ischemic conditions(avascular necrosis),metabolic dysfunctions(osteoporosis),inflammatory disorders(rheumatoid arthritis),and traumatic injuries(such as stress fractures).[1,2]Clinically,BME primarily manifests as localized pain,often accompanied by joint effusion and warmth near the affected *** protocols typically include physical examination,serological assays,bone marrow biopsies,dual-energy X-ray absorptiometry(DEXA)scans,magnetic resonance imaging(MRI),and ultrasonography,with computed tomography(CT)scans and radiographs being less effective.

关键词： edema injuries female

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