Journal of Joint Surgery and Research最新文献

{"title":"Robotic-assisted total hip arthroplasty","authors":"Faraz A. Asim ,&nbsp;K. Keely Boyle ,&nbsp;Antonia F. Chen","doi":"10.1016/j.jjoisr.2025.12.006","DOIUrl":"10.1016/j.jjoisr.2025.12.006","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the review was to outline the evolution of navigation and robotic-assisted systems in total hip arthroplasty (THA), describe major classification schemes and current platforms, and summarize evidence on their clinical performance and limitations.</div></div><div><h3>Methods</h3><div>This review traces the development of computer-assisted and robotic-assisted technologies in THA, highlights key system classifications and representative platforms, and synthesizes published data on accuracy, outcomes, and workflow considerations.</div></div><div><h3>Results</h3><div>Navigation and robotic-assisted systems were developed to reduce variability in component placement through pre-operative planning, intra-operative guidance, and real-time feedback. Evidence demonstrates that robotic-assisted THA improves the accuracy of component orientation and limb length restoration compared with manual techniques, while long-term functional outcomes and cost effectiveness remain similar.</div></div><div><h3>Conclusions</h3><div>Robotic-assisted THA provides measurable improvements in technical accuracy and reproducibility. However, further prospective studies with robust methodology are needed to clarify its long-term clinical and economic value.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"4 1","pages":"Pages 81-86"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of post-operative kneeling ability in patients with varus knee osteoarthritis: unicompartmental knee arthroplasty versus open-wedge high tibial osteotomy","authors":"Umito Kuwashima,&nbsp;Masafumi Itoh,&nbsp;Junya Itou,&nbsp;Ken Okazaki","doi":"10.1016/j.jjoisr.2025.09.002","DOIUrl":"10.1016/j.jjoisr.2025.09.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared post-operative kneeling abilities following unicompartmental knee arthroplasty (UKA) and open-wedge high tibial osteotomy (OWHTO) for varus knee osteoarthritis.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 127 knees that underwent UKA and 100 knees that underwent OWHTO between 2018 and 2022. Clinical data, including Knee injury and Osteoarthritis Outcome Score (KOOS) and the University of California, Los Angeles (UCLA) activity score, were collected pre-operatively and at a minimum 12 month follow-up. Kneeling ability was defined using the KOOS Sp5 subscore. Factors influencing post-operative kneeling, including age, pre- and post-operative knee flexion angle, pre-operative UCLA activity score, degree of osteoarthritis, femorotibial angle, pre-operative kneeling ability, and surgical procedure, were evaluated using multiple linear regression analysis.</div></div><div><h3>Results</h3><div>OWHTO demonstrated significantly better post-operative kneeling ability than UKA. Pre-operative kneeling ability and surgical procedure statistically significantly influenced post-operative outcomes (regression coefficient −0.50, 95% confidence interval −0.003–0.99; <em>p</em> ​= ​0.049).</div></div><div><h3>Conclusions</h3><div>OWHTO was significantly associated with better Sp5 scores and improved post-operative kneeling ability, emphasizing the importance of choosing the appropriate surgical technique for better post-operative kneeling ability.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 201-206"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total hip arthroplasty in very young patients aged under 21 years: A 25 year literature review (2000–2025)","authors":"Philippe Hernigou ,&nbsp;Michel Dagher ,&nbsp;Yasuhiro Homma ,&nbsp;Charles Henri Flouzat Lachaniette","doi":"10.1016/j.jjoisr.2025.11.001","DOIUrl":"10.1016/j.jjoisr.2025.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Total hip arthroplasty (THA) in very young patients (aged &lt;21 years) remains rare and challenging due to concerns about implant longevity and lifetime revision risk. Historically avoided, its use has increased over the past two decades thanks to advances in materials, fixation, and surgical techniques.</div></div><div><h3>Methods</h3><div>A systematic review of PubMed/MEDLINE (2000–2025) identified 10 studies reporting outcomes of primary THA in patients aged 10–21 years, representing 3106 hips. Data on indications, implant design, fixation, bearing surfaces, complications, and functional outcomes were extracted and analyzed.</div></div><div><h3>Results</h3><div>The mean patient age at surgery was 17.7 years, with a mean follow-up of 7.7 years. The main indications were avascular necrosis (35%) and dysplastic osteoarthritis (33%). Uncemented fixation predominated (82%). A clear temporal shift in bearing use was observed: ceramic-on-polyethylene increased from 5% to 65% between 2000 and 2021, while metal-on-metal declined from 30% to 2%. The overall revision rate was 8.3%, with loosening (53%) and wear (12%) as leading causes. Five to ten year survivorship averaged 91.7%, comparable with adult benchmarks.</div></div><div><h3>Conclusions</h3><div>Over the past 25 years, THA in very young patients has shown encouraging outcomes, with substantial functional gains and improved implant survival. Although lifetime revision risk remains, modern uncemented implants with advanced bearings appear durable in carefully selected cases. Continued long-term surveillance and registry-based studies are needed to refine implant selection and optimize management of early-onset hip disease.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 239-243"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One year longitudinal changes in clinical outcomes after total knee arthroplasty: Implications for early dissatisfaction","authors":"Shunsuke Utsumi ,&nbsp;Takehiko Sugita ,&nbsp;Naohisa Miyatake ,&nbsp;Akira Sasaki ,&nbsp;Seiya Miyamoto ,&nbsp;Ikuo Maeda ,&nbsp;Takashi Aki ,&nbsp;Masayuki Kamimura ,&nbsp;Toshimi Aizawa","doi":"10.1016/j.jjoisr.2025.08.002","DOIUrl":"10.1016/j.jjoisr.2025.08.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Some patients experience anxiety or dissatisfaction shortly after total knee arthroplasty (TKA) regarding pain relief and the resumption of normal activities. The aim of this study was to clarify the longitudinal changes in clinical outcomes up to 12 months after TKA.</div></div><div><h3>Methods</h3><div>This study included 230 Japanese patients (39 males and 191 females) who underwent TKA for varus knee osteoarthritis by the same surgical team using the same implant. Clinical evaluations were performed pre-operatively and at 3, 6, and 12 months after TKA. The following patient reported outcome measures were used: Japanese Knee Osteoarthritis Measure (JKOM); visual analog scale for pain; and patient satisfaction. The Knee Society Score, Timed Up and Go test score, and range of motion were also evaluated.</div></div><div><h3>Results</h3><div>The evaluated scores showed statistically significant improvements at all three post-operative evaluation points compared with pre-operation, except for knee flexion angle. Improvements in almost all evaluated clinical outcomes persisted up to 12 months. Among the 60 unsatisfied patients at 3 months, 31 were satisfied while 29 remained unsatisfied at 12 months. Multivariable logistic regression analysis revealed that the pain and stiffness subscale of the JKOM and flexion contracture influenced satisfaction at 12 months.</div></div><div><h3>Conclusions</h3><div>Almost all clinical outcomes improved by 12 months after TKA. These findings can be used to encourage patients who are concerned about their outcomes shortly after this procedure. The pain and stiffness subscale of the JKOM and flexion contracture influenced satisfaction at 12 months.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 182-187"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of telephone administration of the HOOS-JR and KOOS-JR joint replacement specific patient reported outcomes measures","authors":"Henry Somerby ,&nbsp;Allina Nocon ,&nbsp;Ananya Alleyne ,&nbsp;David Mayman ,&nbsp;Thomas Sculco ,&nbsp;Stephen Lyman","doi":"10.1016/j.jjoisr.2025.08.004","DOIUrl":"10.1016/j.jjoisr.2025.08.004","url":null,"abstract":"<div><h3>Purpose</h3><div>The Hip Disability and Osteoarthritis Outcome Score – Joint Replacement (HOOS-JR) and the Knee Injury and Osteoarthritis Outcome Score – Joint Replacement (KOOS-JR) are validated, short-form versions of the HOOS and KOOS patient reported outcome measures (PROMs) that are used to assess “joint health.” Developed in response to the Centers for Medicare &amp; Medicare's (CMS) pay-for-performance policy, HOOS-JR and KOOS-JR evaluate patients before in-office visits. New mandatory CMS reporting requirements raise challenges for collecting PROMs. Telephone administration of PROMs may reduce reliability issues and increase collection rates. This study aimed to evaluate the reliability of telephone-administered HOOS-JR and KOOS-JR compared with in-person administration. It was hypothesized that telephone administration of PROMs will be a reliable modality for collection.</div></div><div><h3>Methods</h3><div>Phone interviews were conducted for new patients seeking care for hip- or knee-related disabilities (66 hips, 66 knees). Patients answered demographic questions and either the HOOS-JR or KOOS-JR. At their in-office visit, patients completed the same PROM via self-administration. To reduce recall bias, a minimum of 7 days between phone interview and self-administration was ensured. Test–retest reliability, using an intraclass correlation coefficient (ICC), was calculated.</div></div><div><h3>Results</h3><div>The overall cohort had a mean age of 65 ​± ​10.7 years and was primarily female (60.6%) having less than a postgraduate degree (63.6%). The HOOS-JR telephone interview showed good reliability compared with self-administration [ICC 0.80, 95% confidence interval (CI) 0.70–0.87], while KOOS-JR showed moderate agreement (ICC 0.70, 95% CI 0.55–0.81). Patients preferred to self-administer HOOS-JR or KOOS-JR (78.0%). Within self-administration, patients preferred email administration (65%), followed by paper (25%), and tablet (10%).</div></div><div><h3>Conclusion</h3><div>Telephone administration of HOOS-JR and KOOS-JR is a reliable alternative to self-administration. Incorporating phone interviews into clinical practice may enhance care delivery and increase required PROM capture rates.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 188-193"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on robotic versus manual total hip arthroplasty: A nationwide social media sentiment analysis from 2015 to 2024","authors":"Taylor D. Ottesen ,&nbsp;Cameron J. Sabet ,&nbsp;Jonathan R. Franco ,&nbsp;Britney Shaw ,&nbsp;Abhishek Das ,&nbsp;Jason Wang ,&nbsp;Antonia F. Chen","doi":"10.1016/j.jjoisr.2025.08.003","DOIUrl":"10.1016/j.jjoisr.2025.08.003","url":null,"abstract":"<div><h3>Purpose</h3><div>As robotic-assisted surgery grows in popularity, including for total hip arthroplasty (THA), patient perceptions of robotic versus manual techniques have not been extensively studied. This research aimed to compare patient perspectives on robotic and manual THA by analyzing comments from social media platforms and health forums.</div></div><div><h3>Methods</h3><div>A total of 885 comments from self-reported patients were collected from Instagram, Facebook, X (formerly Twitter), Quora, Reddit, and WebMD between 2015 and 2024. Of these, 211 comments referenced robotic THA and 674 mentioned manual THA. Sentiment analysis was conducted using VADER, a natural language processing tool known for handling nuanced language, including sarcasm and social media-specific text. Word clouds and thematic analysis were generated to visualize common themes.</div></div><div><h3>Results</h3><div>The most frequently discussed themes for robotic surgery included surgical experience (50%), pain management (43%), and physical therapy (30%). For manual surgery, pain management (43%), surgical experience (35%), and physical therapy (25%) were the most common themes. Sentiment analysis showed predominantly positive scores for robotic surgery, peaking between 0.25 and 0.50, while manual surgery scores were more neutral, peaking at 0–0.25. Permutation testing with comprehensive weighting confirmed a statistically significant difference favoring robotic surgery (<em>p</em> ​= ​0.0000), and bootstrap resampling demonstrated robustness of the findings with a mean difference of 0.3837.</div></div><div><h3>Conclusions</h3><div>Social media and forum comments suggest that robotic THA results in more positive patient feedback compared with manual THA, with significant differences in sentiment and thematic content. Importantly, while statistically significant, these sentiment differences may not always translate to clinically meaningful disparities.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 214-222"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical outcomes between high tibial osteotomy and total knee arthroplasty in early elderly patients with severe osteoarthritis","authors":"Kodai Hamaoka ,&nbsp;Shinichiro Okimura ,&nbsp;Kazushi Horita ,&nbsp;Yasutoshi Ikeda ,&nbsp;Yohei Okada ,&nbsp;Tomoaki Kamiya ,&nbsp;Atsushi Teramoto","doi":"10.1016/j.jjoisr.2025.08.001","DOIUrl":"10.1016/j.jjoisr.2025.08.001","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to compare the clinical outcomes of high tibial osteotomy (HTO) and total knee arthroplasty (TKA) in early elderly patients with severe knee osteoarthritis (OA).</div></div><div><h3>Methods</h3><div>This retrospective study included patients aged 65–74 years with Kellgren–Lawrence grade 4 medial knee OA who underwent either HTO or TKA. All patients had a minimum post-operative follow-up of 2 years. Propensity score matching was performed to balance baseline characteristics between the groups. Clinical outcomes were evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS), along with the achievement rates of minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) for each KOOS subscale at final follow-up. Statistical comparisons were made using the unpaired <em>t</em>-test, paired <em>t</em>-test, and Fisher's exact test, with statistical significance set at <em>p</em> ​&lt; ​0.05.</div></div><div><h3>Results</h3><div>A total of 27 matched pairs were analyzed. Pre-operatively, there were no statistically significant differences in KOOS subscale scores between the groups. At the final follow-up, KOOS symptoms and pain scores, as well as the MCID achievement rate for KOOS symptoms, were statistically significantly better in the TKA group than in the HTO group. PASS achievement rates did not differ statistically significantly between the groups.</div></div><div><h3>Conclusion</h3><div>At a mean follow-up of 60.8 months, TKA resulted in better KOOS symptoms and pain scores and higher MCID achievement rate for KOOS symptoms than HTO. These findings suggest that TKA may offer more favorable outcomes than HTO for early elderly patients with severe medial knee OA.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 177-181"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on hip surgery in Japan: An analysis using National Database Open Data","authors":"Maho Tsuchiya ,&nbsp;Kensuke Fukushima ,&nbsp;Yoshihisa Ohashi ,&nbsp;Noritaka Mamorita ,&nbsp;Yoji Toyomura ,&nbsp;Akira Norisugi ,&nbsp;Kentaro Uchida ,&nbsp;Naonobu Takahira ,&nbsp;Masashi Takaso","doi":"10.1016/j.jjoisr.2025.09.004","DOIUrl":"10.1016/j.jjoisr.2025.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>The coronavirus disease 2019 (COVID-19) pandemic significantly disrupted surgical services worldwide. This study aimed to assess the pandemic's impact on hip surgeries in Japan using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).</div></div><div><h3>Methods</h3><div>Five types of hip surgery were analyzed, including total hip arthroplasty (THA), pelvic osteotomy, femoral osteotomy, hip arthroscopic synovectomy, and hip arthroscopic labral repair, based on NDB Open Data from 2014 to 2022. Annual procedure counts were examined, and percentage changes were calculated for 2019–2020, 2020–2022, and 2019–2022. Poisson regression was used to evaluate temporal trends.</div></div><div><h3>Results</h3><div>The total number of hip surgeries declined in 2020 compared with 2019 but rebounded by 2021 and exceeded pre-pandemic levels in 2022. During the observation period, THA and arthroscopic labral repair showed significant upward trends (<em>p</em> ​&lt; ​0.0001 and <em>p</em> ​= ​0.0033, respectively), while pelvic osteotomy, femoral osteotomy, and arthroscopic synovectomy declined (<em>p</em> ​&lt; ​0.0001 for all). THA was the least affected by the pandemic. Arthroscopic labral repair showed the greatest post-pandemic growth, whereas pelvic osteotomy showed a persistent decline, remaining below pre-pandemic levels in 2022.</div></div><div><h3>Conclusions</h3><div>THA and arthroscopic labral repair recovered and increased during the later phase of the COVID-19 pandemic, while pelvic and femoral osteotomy experienced a decline and have not recovered. Although the trends might be temporary rather than sustained, the pandemic may have significantly impacted the strategy for hip disorders in Japan. Ongoing monitoring of these trends over the long term is warranted.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 223-226"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of deep vein thrombosis and post-operative delirium following total knee arthroplasty compared with unicompartmental knee arthroplasty in patients aged 80 years and older: A nationwide Japanese medical claims-based propensity score-matched study","authors":"Yu Mori ,&nbsp;Kunio Tarasawa ,&nbsp;Hidetatsu Tanaka ,&nbsp;Masayuki Kamimura ,&nbsp;Naoko Mori ,&nbsp;Kiyohide Fushimi ,&nbsp;Toshimi Aizawa ,&nbsp;Kenji Fujimori","doi":"10.1016/j.jjoisr.2025.10.002","DOIUrl":"10.1016/j.jjoisr.2025.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>As life expectancy increases, the number of elderly patients undergoing knee arthroplasty continues to rise. Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are both viable options, yet comparative data on post-operative risks in very elderly patients are limited. The aim of this study was to compare in-hospital post-operative complications between TKA and UKA in patients aged ≥80 years using a large-scale Japanese nationwide database derived from Diagnosis Procedure Combination (DPC)-participating acute care hospitals.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the DPC database from 2016 to 2023. Patients aged ≥80 years undergoing TKA or UKA were identified. Propensity score matching (1:1) was used to balance baseline characteristics, including age, sex, body mass index, Charlson comorbidity index, anesthesia type, and simultaneous bilateral surgery. Outcomes included deep vein thrombosis (DVT), cognitive dysfunction, pneumonia, cerebrovascular events, surgical site infection, in-hospital mortality, length of stay, discharge disposition, and blood transfusion volume.</div></div><div><h3>Results</h3><div>After matching, 7782 TKA and 7782 UKA patients were analyzed. TKA was associated with higher rates of DVT [9.0% <em>vs.</em> 6.0%; odds ratio 1.56; <em>p</em> ​&lt; ​0.0001] and post-operative delirium (1.6% <em>vs.</em> 0.7%; odds ratio 2.31; <em>p</em> ​&lt; ​0.0001). Additionally, surgical site infections were more frequent and transfusion volumes were greater in TKA. UKA patients had shorter hospital stays and higher rates of discharge to home (75.3% <em>vs.</em> 65.4%).</div></div><div><h3>Conclusions</h3><div>In patients aged ≥80 years, TKA was associated with higher risks of DVT and cognitive dysfunction compared with UKA. Given the observational design, causal inference is limited. UKA may be a safer option in appropriately selected patients.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 244-250"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm outcomes of total hip arthroplasty with a cementless tapered wedge stem designed for Japanese patients","authors":"Yusuke Fujimoto ,&nbsp;Daichi Arima ,&nbsp;Toshiro Ijuin ,&nbsp;Tomohiro Iuchi ,&nbsp;Hirotaka Kawakami ,&nbsp;Shunsuke Nakamura ,&nbsp;Naohiro Uezono ,&nbsp;Noboru Taniguchi","doi":"10.1016/j.jjoisr.2025.09.005","DOIUrl":"10.1016/j.jjoisr.2025.09.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Cementless tapered wedge stems are widely used in total hip arthroplasty (THA) based on their reliable initial fixation and favorable long-term outcomes. However, the mid-to long-term outcomes of the J-Taper cementless tapered wedge stem designed for Japanese patients remain unclear. This study aimed to evaluate its midterm clinical and radiographic results.</div></div><div><h3>Methods</h3><div>A total of 125 hips (106 patients) that underwent primary THA with the J-Taper stem between 2013 and 2018 and were assessed during a minimum 5 year follow-up were retrospectively reviewed. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) hip score and the JOA Hip Disease Evaluation Questionnaire (JHEQ). Radiographic evaluations included stem alignment, subsidence, cortical hypertrophy, stress shielding, and radiolucent lines.</div></div><div><h3>Results</h3><div>The JOA and JHEQ scores improved statistically significantly from pre-operatively to final follow-up (both <em>p</em> ​&lt; ​0.001). The stem survival rate was 100%, with no cases of clinically significant subsidence (≥2 ​mm) or radiolucent lines (≥2 ​mm). However, stress shielding (Engh grade ≥2) was observed in 38 hips (30.4%) and was statistically significantly associated with longer follow-up (<em>p</em> ​= ​0.027), but did not adversely affect clinical outcomes. Binomial logistic regression confirmed that follow-up duration was a statistically significant risk factor for stress shielding (odds ratio 1.03, 95% confidence interval 1.01–1.05; <em>p</em> ​= ​0.010).</div></div><div><h3>Conclusions</h3><div>The J-Taper stem demonstrated favorable midterm clinical and radiographic outcomes, including excellent implant survival and significant functional improvement. However, radiographic stress shielding was frequently observed and progressed over time, suggesting a risk of delayed complications and underscoring the need for longer-term follow-up.</div></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"3 4","pages":"Pages 227-232"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}