Exclusive Papers Collection of Editorial Board Members and Invited Scholars in Osteology

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration and quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of the NewClip narrow locking plate system with early weight-bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with the NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation. Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and a final follow-up at twelve months revealed complete osseous healing without complications. Conclusions: The use of this type of plate in treating isolated fibular fractures with early weight-bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes, warranting further investigation with larger cohorts. Full article

Background: Exosomes, nanoscale extracellular vesicles, play a crucial role in tissue physiology and regeneration. This study uses infometric techniques to explore the structure of exosome-based tissue and bone regeneration research. Methods: We applied BERTopic, an advanced topic modeling algorithm, to a comprehensive corpus of the scientific literature on exosomes and tissue regeneration, identifying key themes such as stem cell studies, tissue healing, and regenerative applications, with orthopedics and dentistry emerging as dominant subfields. To further investigate the ‘ideoscape’, i.e., the conceptual landscape that maps how ideas, methods, and themes are interconnected across the field, we extracted significant concepts from abstracts using GPT 3.5 turbo and created knowledge graphs. Results: Our analysis revealed rapid growth in the field of dental stem cell regeneration, which has outpaced other bone regeneration topics by twofold. This analysis highlighted central themes such as periodontal stem cells and their cellular processes—proliferation, migration, and differentiation—along with their clinical applications. Our approach provided a clear visualization of the field’s intellectual structure, showing how emerging topics are interconnected. Our findings offer a comprehensive view of the evolving trends in exosome-based bone regeneration, revealing not only the most active research areas but also gaps and opportunities for further investigation. Conclusions: This study exemplifies the utility of combining topic modeling with knowledge graph creation to map research trends, offering a flexible and largely automated tool for researchers to explore the vast bodies of literature and guide future research directions. Full article

Background: The treatment of patients affected by recurrent anterior shoulder instability has received more attention in the last ten years, focusing on the management of bone loss, which is crucial in predicting postoperative recurrence risk. Recently, various bone grafting techniques and different fixation methods have been developed to preserve native anatomy and reduce complications. Nowadays, glenoid bone reconstruction is usually carried out via the Latarjet procedure or free bone block technique. While the Latarjet procedure has traditionally been considered the best option, the bone block has been demonstrated to be a successful procedure. Even though the indication to perform a free bone block or a Latarjet procedure may be given preoperatively, in cases where the choice between the two procedures is unclear, the decision can be made intraoperatively, given the possibility to switch from one to another. This technical note aims to outline our techniques for the arthroscopic Latarjet procedure and the arthroscopic free bone block, as well as discuss the indications, benefits and downsides of each procedure. Technical tips and tricks are provided. Methods: A step-by-step thorough description of bone block and Latarjet procedures is provided, as well as a comparison of advantages and disadvantages of each technique and tips to avoid complications. Respective indications are discussed. Results: Both the procedures have benefits and downsides. The arthroscopic Latarjet procedure is the most effective in addressing anterior shoulder instability, but is more elaborate, has a shallow learning curve and can have a high complication rate. The bone block technique is an anatomic procedure with a shorter learning curve but has fewer indications. Conclusion: The Latarjet is currently considered the gold standard for glenoid bone grafting. The bone block technique can allegedly be seen as being “in the middle” of the soft tissue repair and Latarjet procedures. Many factors should be considered when choosing the right surgical technique, and treatment plans must be customized for each patient. More studies with long-term follow-up are needed to evaluate the efficacy of arthroscopic bone grafting procedures in various subtypes of patients based on bipolar bone loss assessment and individual risk factors. Full article