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      Comparison between bioabsorbable magnesium and titanium compression screws for hallux valgus treated with distal metatarsal osteotomies: A meta-analysis

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          Abstract

          Objectives

          In this review, we discuss the efficacy and safety of biodegradable magnesium screws compared to titanium screws in the treatment of hallux valgus (HV) in patients undergoing distal metatarsal osteotomy (DMO).

          Materials and methods

          Eligible scientific articles published prior to October 2022 were retrieved from the PubMed, Springer, ScienceDirect, and Cochrane Library databases. The terms used for searching included “hallux valgus”, “distal metatarsal osteotomies”, and “bioabsorbable magnesium screw” which were limited in the title or abstract through the text. The title and abstract were checked one by one to exclude the non-related studies. For primary identified studies and relevant systematic reviews, the full texts were accessed and browsed to finally include the eligible studies. No restriction was set on publication language and publication status.

          Results

          Two randomized-controlled trials (RCTs) and three non-RCTs that met the inclusion criteria were included. There was no significant difference in the American Orthopaedic Foot and Ankle Society (AOFAS) score, postoperative HV angle (HVA), intermetatarsal angle (IMA), Visual Analog Scale (VAS) score, soft tissue irritation, implant fracture, reoperation, and infection rates between two groups.

          Conclusion

          Bioabsorbable magnesium compression screws show comparable clinical or radiological results to titanium compression screws in the treatment of HV in patients undergoing DMO.

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          Most cited references21

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          Methodological index for non-randomized studies (minors): development and validation of a new instrument.

          Because of specific methodological difficulties in conducting randomized trials, surgical research remains dependent predominantly on observational or non-randomized studies. Few validated instruments are available to determine the methodological quality of such studies either from the reader's perspective or for the purpose of meta-analysis. The aim of the present study was to develop and validate such an instrument. After an initial conceptualization phase of a methodological index for non-randomized studies (MINORS), a list of 12 potential items was sent to 100 experts from different surgical specialties for evaluation and was also assessed by 10 clinical methodologists. Subsequent testing involved the assessment of inter-reviewer agreement, test-retest reliability at 2 months, internal consistency reliability and external validity. The final version of MINORS contained 12 items, the first eight being specifically for non-comparative studies. Reliability was established on the basis of good inter-reviewer agreement, high test-retest reliability by the kappa-coefficient and good internal consistency by a high Cronbach's alpha-coefficient. External validity was established in terms of the ability of MINORS to identify excellent trials. MINORS is a valid instrument designed to assess the methodological quality of non-randomized surgical studies, whether comparative or non-comparative. The next step will be to determine its external validity when used in a large number of studies and to compare it with other existing instruments.
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            Biodegradable magnesium-based screw clinically equivalent to titanium screw in hallux valgus surgery: short term results of the first prospective, randomized, controlled clinical pilot study

            Purpose Nondegradable steel-and titanium-based implants are commonly used in orthopedic surgery. Although they provide maximal stability, they are also associated with interference on imaging modalities, may induce stress shielding, and additional explantation procedures may be necessary. Alternatively, degradable polymer implants are mechanically weaker and induce foreign body reactions. Degradable magnesium-based stents are currently being investigated in clinical trials for use in cardiovascular medicine. The magnesium alloy MgYREZr demonstrates good biocompatibility and osteoconductive properties. The aim of this prospective, randomized, clinical pilot trial was to determine if magnesium-based MgYREZr screws are equivalent to standard titanium screws for fixation during chevron osteotomy in patients with a mild hallux valgus. Methods Patients (n=26) were randomly assigned to undergo osteosynthesis using either titanium or degradable magnesium-based implants of the same design. The 6 month follow-up period included clinical, laboratory, and radiographic assessments. Results No significant differences were found in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) score for hallux, visual analog scale for pain assessment, or range of motion (ROM) of the first metatarsophalangeal joint (MTPJ). No foreign body reactions, osteolysis, or systemic inflammatory reactions were detected. The groups were not significantly different in terms of radiographic or laboratory results. Conclusion The radiographic and clinical results of this prospective controlled study demonstrate that degradable magnesium-based screws are equivalent to titanium screws for the treatment of mild hallux valgus deformities.
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              Which articles do the editors prefer to publish?

              O. Atik (2022)
              The editors prefer publishing original scientific research article with valuable data in all academic journals, since readers prefer reading something original and important.[1,2] Manuscripts may be rejected without peer review by the Editor-in-Chief, if they do not comply with the Instructions to Authors, in case of an ethical issue or plagiarism, and if they are beyond the scope of the journal. The title of the article should be concise, brief but comprehensive. It should provoke the readers to read the full text. The title should accurately reflect the outcome of the study.[3] It should also be the research question or the answer of it. The abstract must summarize the manuscript. No discrepancies between the abstract and the article must be. Keywords must be concordant with the National Library of Medicine (NLM) Medical Subject Headings (MeSH) vocabulary terms, and three to six keywords should be listed.[4] The study must be based on the review of the relevant literature in the Introduction section. The objective of the study must be clearly defined. A hypothesis or a research question must exist.[1,2] The authors must have Informed Consent and Ethical Committee Approval (date and number) in the Patients/Materials and Methods section. The methods should explain the steps taken to produce the results. It should contain adequate details for other researchers to replicate the study.[1,2] The results must be presented in logical sequence in the text, tables, and illustrations. Data in the text should not be repeated in the tables or illustrations. Avoid repeating yourself.[5] In the Discussion section, start emphasizing the new and the most important finding(s) of the study. Relate the observations to other relevant studies. Finally, present limitations and conclusion short and clear enough.[6] The format of the references and abbreviated title of the journal must be according to the style used by the PubMed/MEDLINE with year, volume, and inclusive page numbers. Recent references must be preferred. Illustrations and figures must be original, professionally drawn, and photographed. Finally, the authors must check the following list to reduce the possibility of rejection.[7] • Has the manuscript adhered to all the author instructions? • Does the manuscript add something to the existing literature? • Is the title reflective of the content of the manuscript? • Does the abstract convey the key message clearly? • Is the purpose, research question/hypothesis clearly stated in the Introduction? • Is the methodology detailed? • Are the statistics in a clear and detailed manner presented? • Are the results explicitly presented? • Is the Discussion relevant to the manuscript’s core theme? • Are the strengths and limitations addressed? • Are the conclusions clearly supported by the data?
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                Author and article information

                Journal
                Jt Dis Relat Surg
                Jt Dis Relat Surg
                Joint Diseases and Related Surgery
                Bayçınar Medical Publishing
                2687-4784
                2687-4792
                August 2023
                12 May 2023
                : 34
                : 2
                : 289-297
                Affiliations
                [1 ] Department of Orthopedics, Tianjin Hospital, Tianjin, China
                [2 ] Department of Traumatic Orthopedics, Tianjin Hospital, Tianjin, China
                [3 ] Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
                Author notes
                Zhi-jun Li, MD. Department of Orthopedics, Tianjin Medical University General Hospital, 300052 Tianjin, China. zyyhanson@ 123456163.com .
                Author information
                http://orcid.org/0000-0002-6786-9259
                http://orcid.org/0000-0001-7960-2861
                http://orcid.org/0000-0003-4622-6358
                http://orcid.org/0000-0003-1373-6837
                Article
                10.52312/jdrs.2023.1026
                10367175
                37462631
                42e33a27-375d-488a-aa0d-186b2f80f9a3
                Copyright © 2023, Turkish Joint Diseases Foundation

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 12 January 2023
                : 29 March 2023
                Categories
                Original Article

                biodegradable screws,hallux valgus,meta-analysis,osteotomy.

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