Search Results (133)

Aims: Coronary heart disease (CHD) associated with rheumatoid arthritis (RA) is a primary driver of mortality in RA patients. In this study, we sought to establish a combined rat model of CHD and RA by integrating cardiac ischemia/reperfusion (I/R), high-fat diet (HFD), and intradermal administration of bovine type II collagen emulsified in complete Freund’s adjuvant. The aim of constructing this model is to investigate and analyze the pathogenesis of RA-induced CHD under the modulation of HFD and cardiac I/R exposure. Methods and Results: Sixty-four male Sprague–Dawley rats were randomly categorized into eight groups (n = 8 per group): control, I/R, HFD, collagen-induced arthritis (CIA), I/R + CIA, HFD + CIA, I/R + HFD, and I/R + HFD + CIA groups (n = 8 per group). We applied Synchrotron radiation-based X-ray micro-computed tomography (micro-CT) to observe the structural changes within the model over time. To further elucidate molecular mechanisms, transcriptome RNA-seq analysis was carried out to identify key signaling pathways, with particular emphasis on the homeostasis of Toll-like receptor 4 (TLR4)/Myd88 signaling in the ischemic myocardium. Furthermore, we conducted in vivo shRNA-mediated knockdown of polymerase I and transcription release factor (PTRF) and evaluated the co-localization of PTRF and TLR4 through immunofluorescence experiments. It is worth mentioning that our rat model of RA-induced (CHD) under a high-fat diet effectively manifested the relevant pathological features that align with the Traditional Chinese Medicine (TCM) definition of “bi” syndrome. The results indicate that the combined stimulation of HFD and CIA significantly elevated cardiac injury markers (CK-MB, LDH, CRP, and c-TNT) and was accompanied by a more severe expansion of the infarct area and increased cardiomyocyte apoptosis compared to the I/R group alone. In addition, the histopathological evaluation revealed significantly aggravated myocardial inflammation and fibrosis deposition, accompanied by extensive areas of tissue damage, further indicating a state of heightened inflammation and severe cardiac degenerative changes. Consistently, myocardial tissues from rats in the I/R + CIA + HFD group exhibited robust activation of the TLR4/MyD88 signaling pathway and a pronounced elevation in the p-JNK/JNK ratio. Moreover, pronounced co-localization between PTRF and TLR4 was evident in small vessels surrounding the infarcted myocardium. Importantly, AAV-mediated knockdown of PTRF attenuated the HFD- and CIA-induced exacerbation of myocardial injury in I/R rats. Conclusions: We successfully established a rat model of CHD with rheumatic syndrome using I/R in combination with RA and HFD. The present findings suggest that the PTRF-related TLR4/MyD88-JNK signaling pathway may act as an important regulatory mechanism underlying myocardial injury aggravated by combined HFD and CIA stimulation. Full article

Osteoarthritis (OA) is a degenerative, age-related joint disease involving bone remodeling and damage to articular cartilage. OA is the most common form of arthritis, causing pain, swelling, stiffness, and reduced mobility. Given the limited efficacy of current therapies, there is growing interest in natural compounds with anti-inflammatory and immunomodulatory properties. Crocus sativus L., known as saffron, contains more than 150 biologically active compounds with proven antioxidant and anti-inflammatory effects, making it a promising candidate for modulating OA-related processes. The aim of the study was to evaluate the effects of saffron extract on immune cell function, osteoclast differentiation, and joint pathology in collagenase-induced osteoarthritis (CIOA) mouse model. OA was induced by intra-articular injection of Collagenase type IA, followed by daily treatment with saffron extract for 30 days. Flow cytometry, apoptosis, Western blot and proliferation assays were performed to analyze the phenotype and activity of bone marrow and synovium cells, as well as histological evaluation of joint tissues. Saffron therapy promoted an anti-inflammatory immune profile, reduced T-cell apoptosis and proliferation, and inhibited osteoclast differentiation. These changes were accompanied by improved histological manifestations of the joints. Overall, the findings suggest that saffron may modulate key inflammatory and cellular mechanisms involved in OA, although further research is needed to confirm its therapeutic relevance in humans. Full article

Background/Objectives: Atlantoaxial posterior fusion has unique characteristics, and it is anticipated that adjacent segment degenerative changes following fusion surgery may present distinctive findings. This study aims to analyze the risk factors for degenerative changes in subaxial levels following the increasingly common atlantoaxial posterior fusion procedure. Methods: A total of 58 patients (19 males, 39 females) who had neutral, flexion, and extension plain lateral radiographs taken and a follow-up record of approximately two years post-surgery were included in the final study cohort. The study analyzed surgical methods, patient demographics, hospitalization-related factors, visual analog scale (VAS) for neck pain, and radiologic parameters. Patients were classified into the radiologic subaxial pathology (RSP) group (n = 34) and the non-RSP group (n = 24) using several radiologic indicators of spinal instability or arthritic changes, and the risk factors for RSP were analyzed. Results: The RSP group showed a significantly higher proportion of females and prevalence of rheumatoid arthritis (RA). At 3 months postoperatively, the C1-7 sagittal vertical axis (SVA) was significantly lower in the RSP group. Multivariate regression analysis using significant variables (p < 0.05) such as sex, RA and 3-month C1-7 SVA showed that RA and 3-month C1-7 SVA were significantly associated with RSP. Among radiologic parameters related to surgery, multivariate analysis identified 3-month C1-7 SVA as the sole risk factor for RSP. To explore its correlation with other radiologic parameters at 3 months postoperatively, linear logistic regression analysis was conducted. Significant positive correlations were observed with the C1-2 Cobb angle. Conclusions: This study identified RA and C1-7 SVA as the most significant risk factors for RSP in atlantoaixal posterior fusion. Full article

Thermosensitive hydrogels have emerged as promising intelligent biomaterials for minimally invasive delivery and targeted therapy. Chitosan/gelatin thermosensitive hydrogels, integrating the biocompatibility, biodegradability, and antibacterial activity of chitosan with the excellent adhesive properties of gelatin, exhibit unique injectability, temperature-responsive gelation, and tunable physicochemical properties. This review systematically summarizes the key performance parameters of chitosan/gelatin thermosensitive hydrogels, including injectability, gelation characteristics (with sol-gel transition tunable between 37 and 42 °C to match diverse species’ body temperatures), mechanical properties, biocompatibility, degradation behavior (tunable from 1 to 8 weeks), drug-loading/release capabilities, and multi-stimuli responsiveness (pH/ROS/enzyme). It focuses on exploring their feasibility and suitability as acupoint embedding materials in Traditional Chinese Veterinary Medicine (TCVM), addressing the technical bottlenecks of traditional acupoint catgut embedding (e.g., unstable degradation, insufficient biocompatibility, and lack of drug-loading capacity). While recent studies have demonstrated the utility of such hydrogels in human disease models (e.g., rheumatoid arthritis and Parkinson’s disease), their translation to veterinary acupoint therapy remains largely unexplored. The prospective application of these hydrogels in treating common animal diseases (e.g., piglet diarrhea, canine degenerative joint disease, and equine laminitis) is, therefore, proposed and analyzed as an illustrative paradigm, emphasizing its integrated “stimulation–drug delivery” function and cross-species adaptability. Additionally, the current challenges (e.g., animal-specific formulation optimization, unclear mechanism of action, and insufficient long-term safety data) and future research directions (e.g., veterinary-specific formulation development, mechanistic exploration, and clinical translation) are highlighted. This review aims to promote the interdisciplinary integration of TCVM and smart biomaterials, provide precision strategies for animal disease treatment, and ultimately contribute to the modernization and standardization of TCVM technologies. Full article

Background/Objectives: Thumb basal joint arthritis is a common degenerative condition often requiring surgery when conservative treatment fails. Dual mobility trapeziometacarpal prostheses are increasingly used, but the optimal anesthetic strategy remains debatable. This study aimed to explore whether WALANT provides intraoperative analgesia and short-term safety comparable to axillary block in dual mobility trapeziometacarpal arthroplasty. Methods: A prospective observational comparative study was carried out on 21 patients (11 WALANT, 10 axillary block) undergoing dual mobility trapeziometacarpal prosthesis for stage II–III in thumb basal joint arthritis according to Eaton–Littler classification at two hospital facilities of ASL Roma 5, from February–December 2025. Patients treated with the WALANT technique were assigned to Group A, whereas those undergoing an axillary block were assigned to Group B. Pain intensity was recorded on a 0–10 visual analogue scale at three stages: during anesthetic administration, during surgery, and 3 h after the procedure. Group A received a field infiltration with 1% mepivacaine combined with epinephrine 1:100,000 and sodium bicarbonate, while Group B underwent an ultrasound-guided brachial plexus block using 0.5–0.7% ropivacaine and a pneumatic tourniquet inflated to 250 mmHg. Results: Pain during anesthesia induction was similar between groups (Group A 3.18 ± 2.89 vs. Group B 2.20 ± 2.37, p = 0.393). Intraoperative pain did not differ significantly (Group A 2.27 ± 1.79 vs. Group B 2.00 ± 2.71, p = 0.898). At 3 h postoperative, Group B showed a trend toward lower pain levels (Group A 4.36 ± 2.54 vs. Group B 3.00 ± 3.08, p = 0.244). No anesthetic failures, no conversion to general anesthesia, and no neurological or ischemic complications occurred in either group. Conclusions: In this prospective observational comparative cohort, WALANT and axillary block provide comparable intraoperative analgesia for dual mobility trapeziometacarpal prosthesis, with comparable safety profiles. WALANT offers advantages in ease of administration, absence of tourniquet-related risks, and potential for intraoperative functional testing. Axillary block provides more prolonged postoperative analgesia in the first 3 h. The choice between techniques should be individualized based on patient-specific factors, anxiety profile, and local expertise. These results should be interpreted as preliminary and hypothesis-generating, given the exploratory design, the small sample size, and the limited statistical power of the study. Full article

Residual valgus instability following ankle fracture fixation presents a reconstructive challenge, especially when medial soft tissue compromise precludes early deltoid ligament repair. Restoring medial stability, together with fibular length and syndesmotic alignment, is crucial for re-establishing joint congruity and preventing progressive deformity or degenerative complications. In this single-patient case report, we describe a novel technique combining the use of an allograft deltoid ligament reconstruction with a Z-lengthening distal fibular osteotomy in a young adult male who developed residual valgus instability after the lateral-only fixation of a Weber C ankle fracture–dislocation. The Z-lengthening osteotomy enabled the controlled, fluoroscopy-guided restoration of fibular length and the correction of syndesmotic malreduction. Concurrently, medial stabilization was achieved with a suspensory-and-aperture fixation allograft construct, providing a tensionable anatomic reconstruction of the deltoid complex. This integrated approach restored the alignment of the medial clear space and syndesmosis, resulting in a pain-free, stable ankle mortise. At the three-year follow-up, the patient maintained a stable reduction with no radiographic signs of post-traumatic arthritis. The technique offers a reproducible, joint-preserving solution that merges mechanical correction with biological reconstruction to restore circumferential ankle stability and facilitate functional rehabilitation after complex ankle fracture fixation. Full article

Objective: The oral cavity is the beginning of the digestive tract and the composition of saliva could indicate immune events in the gut and joints. The objective of this research was to evaluate the diagnostic accuracy of salivary interleukin (IL)-17A for temporomandibular joint (TMJ) internal derangements (IDs) in patients with spondyloarthritis (SpA). Methods: SpA disease activity was assessed using the Bath Ankylosing Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS) and Disease Activity Index for Psoriatic Arthritis (DAPSA). Salivary cytokines were analyzed using enzyme-linked immunosorbent assay. TMJ conditions were evaluated using The Diagnostic Criteria for Temporomandibular Disorder (DC/TMD) protocol. A symptomatic TMJ-ID group with intracapsular arthralgia (n = 64) and asymptomatic TMJ-ID group without intracapsular arthralgia (n = 50), regardless of joint sounds, were compared with controls (healthy TMJs, n = 86). Results: Women were more prevalent and salivary IL-17A concentration was higher in both ID groups than in controls. Salivary IL-17A levels positively correlated with erythrocyte sedimentation rate, anti-streptolysin-O titer, salivary IL-12/23 p40 and matrix metalloproteinase-3 levels, sore and swollen joint counts, BASDAI, chronic TMJ pain and anxiety. IL-17A demonstrated diagnostic accuracy for currently symptomatic (cutoff, 11 pg/mL) and asymptomatic (cutoff, 11.6 pg/mL) TMJ-ID vs. controls. Patients with IL-17A levels above these cutoffs more frequently exhibited disc displacement with reduction and degenerative TMJ disease, higher self-reported spinal pain and higher SpA activity, as assessed by ASDAS, than patients with IL-17A levels ≤ cutoffs. TMJ-related headache and somatization contributed to greater TMJ pain in those with IL-17A > cutoffs, when compared with dichotomous controls. Conclusions: Salivary IL-17A concentration provides an accurate laboratory marker of SpA activity and enables the diagnosis of both currently symptomatic and asymptomatic TMJ-IDs in patients with SpA. Full article

Background: The clinical meaning of hip joint synovial cavity thickness (HJSCT) on ultrasound (US) in juvenile idiopathic arthritis (JIA) without effusion is uncertain. Methods: In this cross-sectional study, we analyzed 369 children (187 JIA; 182 controls) undergoing hip US at a referral center in Kraków, Poland. JIA examinations were performed upon initial referral, early in the care pathway. We excluded patients with hip effusion and pre-existing inflammatory, traumatic or degenerative hip pathology. HJSCT was defined as the distance from the outer capsule margin to the femoral neck cortex. We used a Toshiba Aplio 400 system with a 12 MHz probe to measure and derive mean bilateral HJSCT. Bilateral concordance was assessed. Iterative multivariable linear regression modeling was used to compare groups, adjusting for non-linear age effects (natural splines) and WHO height-for-age z-scores (HAZ). Results: Left–right HJSCT agreement was high (ICC 0.947; mean difference 0.03 mm; 95% limits of agreement −0.64–0.70). In unadjusted analysis, mean (SD) HJSCT was similar in JIA versus controls: 5.83 (1.09) vs. 5.95 (0.99) mm, respectively (p = 0.25). In the final model (adj. R2 0.656), HJSCT was strongly associated with age (non-linear, p < 0.001) but not significantly associated with HAZ (β = 0.04; p = 0.11) or JIA status (β = 0.07; p = 0.30). Predicted HJSCT showed a steep increment in childhood and plateau in adolescence. Conclusions: In children without hip effusion, HJSCT mainly reflects physiological growth and does not differ significantly between early JIA patients and healthy controls. These findings suggest that capsular thickening is not a reliable standalone marker for early disease in the absence of effusion. Full article

Type II collagen is a primary fibrillar component of articular cartilage, and its early degradation is a key biomarker of joint-degenerative disorders such as osteoarthritis, rheumatoid arthritis, gout, etc. Reliable detection at low concentrations remains challenging due to limited assay accessibility, complex analytical procedures, and nonspecific responses in multicomponent biological matrices. This research reports the development of a Molecularly Imprinted Polymer (MIP)–based electrochemical sensor engineered for the selective recognition of type II collagen. A series of monomer formulations were evaluated, and the 1AAM:2VP composition produced a well-defined imprinted layer on screen-printed carbon electrodes, yielding the highest electrochemical sensitivity and linearity. The optimized sensor exhibited strong anodic and cathodic responses proportional to increasing collagen concentrations, with a calibration slope corresponding to an R² value of 0.9394. Minimal signal interference was observed, confirming high molecular selectivity. The limit of detection (LOD) was calculated to be approximately 0.065 µg/mL. These characteristics demonstrate that the proposed MIP sensor provides a low-cost, accessible, and highly selective analytical platform suitable for early-stage cartilage degeneration monitoring. Full article

Osteoarthritis (OA) is the most prevalent form of arthritis and is a major global health burden. OA is a heterogeneous condition with multiple contributing mechanisms that characterize different subtypes and stages of the disease. In this review, we examine the insights gained into the immunological characteristics of OA that have emerged from the increasingly widespread use of checkpoint inhibitors in the immunotherapy of malignancies. We discuss how the conventional view of OA as a degenerative disease is changing in view of the evidence suggesting that OA has an inflammatory component along with the presence in joint tissue of peripherally tolerized autoreactive resident memory T cells, which upon release of their inhibition by immunotherapy mediate immune-related adverse event arthritis (irAE-arthritis). We review clinical trials evaluating the efficacy of immunosuppressive therapies in modifying the course of OA, thereby providing an additional perspective on the presence and nature of the inflammation in OA. In summary, we argue that a shift from the traditional understanding of OA as a mechanical disease to one that incorporates the role of synovial immune cells and mechanisms of self-tolerance is necessary to guide future therapies, including the use of immune checkpoints for patients with OA. Full article

Background: Trapeziometacarpal osteoarthritis (TMC OA) is a prevalent degenerative disorder that causes considerable pain and functional limitations, especially in older individuals, whose ideal treatment is still debated in the literature. Various treatments are described to restore a good functional outcome of the thumb; over the past 50 years, biological arthroplasties have been considered the gold standard for treating advanced stages of TMC OA. However, in the last decade, the use of dual mobility cup prostheses has significantly increased, with numerous studies reporting excellent clinical outcomes. In this case report, we show the results of a patient treated on the left hand with suspension arthroplasty and on his right hand with dual mobility arthroplasty in one-stage surgery. The aim of this case report is to directly compare outcomes between trapeziometacarpal prosthesis and suspension arthroplasty performed simultaneously in the same patient. Case Presentation: The present case reports a 71-year-old male patient with bilateral TMC osteoarthritis, referred to our clinic in May 2024. His medical history included hypertension, hypertriglyceridemia, paroxysmal atrial fibrillation, and benign prostatic hyperplasia. On examination, the right hand showed grade 3 osteoarthritis according to the Eaton–Littler classification, with the trapezium maintaining adequate bone stock, making the patient eligible for trapeziometacarpal prosthesis implantation. Conversely, the left hand demonstrated scaphotrapezoid arthritis with a slight reduction in trapezial bone stock, indicating the need for trapeziectomy followed by suspension arthroplasty. Both procedures were performed during the same surgical session by the same experienced hand surgeon using a lateral approach. On the right side, the trapeziometacarpal joint surfaces were resected and replaced with a dual mobility prosthesis, while on the left side, the trapezium was excised, and suspension arthroplasty was performed using a slip of the flexor carpi radialis (FCR) tendon. Methods: The patient underwent simultaneous treatment with a dual mobility trapeziometacarpal prosthesis on the right hand and trapeziectomy with suspension arthroplasty on the left hand. Clinical outcomes (grip and pinch strength, pain, QuickDASH, satisfaction, and range of motion) were evaluated at 1, 3, 6, and 12 months. Paired comparative statistics were applied with significance set at p < 0.05. Results: At all follow-up intervals (1, 3, 6, and 12 months), the hand treated with a trapeziometacarpal prosthesis demonstrated superior grip and pinch strength compared to the hand treated with trapeziectomy and suspension arthroplasty, with the greatest difference observed at 3 months. At 12 months, grip strength increased from 28 kg to 40 kg in the prosthesis-treated hand and from 25 kg to 33 kg in the suspension arthroplasty hand. Paired comparisons were performed at each follow-up interval up to 12 months, confirming a significant difference for grip strength. Pain levels (VAS, Visual Analogue Scale) decreased progressively in both hands, with a more rapid reduction in the hand treated with a trapeziometacarpal prosthesis, reaching statistical significance. QuickDASH scores indicated an earlier return to daily activities in the hand treated with the prosthesis, although this difference was not statistically significant. Patient satisfaction was consistently higher for the hand treated with a trapeziometacarpal prosthesis, with the patient reporting a ‘very satisfied’ rating at all timepoints. Range of motion recovery, assessed through the Kapandji score and measurements of thumb abduction and extension, also favored the hand treated with the prosthesis, with statistically significant differences for abduction and extension, whereas the hand treated with trapeziectomy and suspension arthroplasty demonstrated more gradual improvement over time. Conclusions: This case highlights the functional efficacy of both surgical approaches—biological arthroplasty and trapeziometacarpal prosthesis—in the treatment of TMC osteoarthritis. Both procedures resulted in a good clinical outcome and high patient satisfaction. However, recovery was noticeably faster in the hand treated with a trapeziometacarpal prosthesis, which is consistent with findings previously reported in the literature. These observations suggest that, while both techniques are valid and effective, trapeziometacarpal prosthetic replacement may offer a quicker return to function in appropriately selected patients. Full article

Oral health represents a complex interplay between local microbial ecology, host immune responses, and systemic physiology. Far from being an isolated entity, the oral cavity is the entry point of the gastrointestinal and respiratory tracts and harbors up to one trillion microorganisms. While commensal species maintain ecological balance, pathogenic bacteria such as Porphyromonas gingivalis drive inflammatory conditions like gingivitis and periodontitis. Studies suggest that as chronic inflammation persists and is manifested through sustained breakdown of periodontal tissues, systemic dissemination of oral pathogens contributes to bacteremia, endothelial dysfunction, and neuroinflammation. As a result, increasing evidence has been found linking these oral pathogens and inflammatory mediators to systemic conditions including Alzheimer’s disease, cardiovascular disease, and arthritis. This narrative review synthesizes current evidence linking oral health to systemic disease while addressing practical strategies to strengthen preventive care. Evidence-based interventions are presented as accessible tools for reducing both oral and systemic inflammatory burden. Importantly, this article emphasizes the public health imperative of bridging mechanistic insights with actionable oral hygiene practices. By promoting evidence-based strategies such as scaling and root planing, dietary sugar reduction, and judicious use of antimicrobial agents, individuals may reduce their risk of chronic inflammatory and degenerative diseases. Future interdisciplinary research is needed to clarify causal mechanisms and optimize preventive frameworks integrating oral-systemic health. Full article

Our understanding of the different developmental origins of osteoclast progenitors and their respective roles during homeostatic bone remodeling at different skeletal sites as well as their roles within bone regeneration and degenerative conditions is evolving. In this narrative review article, we summarize what is known about the developmental origins, anatomical sources, and markers of osteoclast progenitors. We touch on how osteoclast progenitors vary during different disease contexts, including periodontitis, rheumatoid arthritis, and osteoarthritis. In addition, we also characterize osteoclast progenitors that contribute to bone healing and define changes observed with advancing age. In this regard, we offer a critical review of gaps within our understanding and opportunities for future development within the field. Because of their diverse nature under different contexts, identifying and characterizing osteoclast progenitors may help to advance condition-specific therapies. Full article

Background/Objectives: Cardiovascular diseases (CVDs), including valvular heart disease (VHD), remain the leading cause of morbidity and mortality in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Case Presentation: We report a rare case of a woman in her fifth decade of life diagnosed with overlap syndrome (RA and SLE), in whom transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) revealed a degenerative altered bicuspid aortic valve with moderate aortic regurgitation (AR) and preserved left ventricular systolic function. The patient presented with a recent history of continuous, moderate chest discomfort and progressive exertional dyspnea, along with a mild elevation in highly cardioselective enzymes. AR was confirmed as the cause of her symptoms, rather than acute coronary syndrome or heart failure. Conclusions: This case highlights the potential contribution of chronic systemic inflammation in RA/SLE to the pathogenesis of AR, an extra-articular manifestation associated with adverse clinical outcomes. These findings support the routine use of echocadiography in rheumatologic patients as a key strategy for early detection and prevention of life-threatening CV complications. Full article

Introduction: Posterior tibial tendon dysfunction (PTTD) is a progressive degenerative tendinopathy often unresponsive to conservative care, necessitating surgical interventions with significant postoperative risks. Wharton’s jelly (WJ) tissue allograft from the human umbilical cord, with its collagen-rich matrix homologous to tendon tissue, presents a potential alternative intervention. This study aims to report preliminary findings on the safety and efficacy of WJ allografts for the supplementation of degenerated tissue in patients with PTTD. Material and Methods: Twenty-six patients from the observational repository were identified with PTTD (Stages II-IV) and failed at least three months of conservative care. Patients received one or two ultrasound-guided percutaneous applications of the WJ allograft. Outcomes were tracked using the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster University Arthritis Index (WOMAC), and the Quality-of-Life Scale (QOLS) at the initial, 30, 90, and 120-day follow-ups. Results: The cohort was 62% male (n = 16) and 38% female (n = 10), with a mean age predominantly in the 70–89 range. From the initial to final visit (90 days for single applications, 120 days for double applications), the single-application group (n = 22) showed a 48.32% improvement in NPRS and a 22.73% improvement in total WOMAC. The double-application group (n = 8) showed a 50% improvement in NPRS and a 27.86% improvement in total WOMAC. A statistically significant improvement in NPRS was observed in the single-application group (p = 0.042). No adverse events were reported. Discussion: This study provides preliminary evidence that WJ tissue allografts may be a safe and effective minimally invasive application for degeneration of the PTT, which is associated with improvements in pain, function, and quality of life. Key limitations include a lack of a control group and a small cohort size. Conclusions: The positive findings of this study warrant further research through randomized controlled trials to confirm efficacy, establish optimal dosage, and compare WJ to other conservative interventions. Full article