Frontiers in Surgery最新文献

{"title":"Unexplained intraoperative cardiac tamponade during thoracoscopic lobectomy: a case report.","authors":"Wenyu Zhang, Ruixu Yan, Xiujie Lu, Junchao Liu","doi":"10.3389/fsurg.2026.1936557","DOIUrl":"10.3389/fsurg.2026.1936557","url":null,"abstract":"<p><strong>Background: </strong>Cardiac tamponade is a life-threatening emergency characterized by reduced cardiac output and circulatory failure. It most commonly occurs during cardiac surgery, interventional cardiology procedures, pericardiocentesis, or central venous catheterization, as well as in the setting of acute myocardial infarction or aortic dissection. To the best of our knowledge, cardiac tamponade during video-assisted thoracoscopic surgery (VATS) lobectomy has not been reported and may has an insidious presentation, making diagnosis challenging in the absence of obvious pericardial injury.</p><p><strong>Case presentation: </strong>We report a case of unexplained intraoperative cardiac tamponade in a 74-year-old man undergoing VATS left upper lobectomy. During hilar vessel dissection, the blood pressure decreased to 82/65mmHg. The heart rate increased to 95 beats/min, requiring norepinephrine infusion (0.2-0.3 μg·kg⁻¹·min⁻¹) to maintain blood pressure. However, no bleeding was evident in the surgical field, hemoglobin and lactate levels remained stable, and oxygenation and airway pressures were unchanged. After considering and excluding major differential diagnoses, including tension pneumothorax, hypovolemic shock, and pulmonary embolism, intraoperative point-of-care transthoracic echocardiography (TTE) was performed and revealed pericardial effusion with echocardiographic features of cardiac tamponade. Creation of a pericardial window with drainage of approximately 200 mL of bloody fluid. Immediately, blood pressure rose to 170/90 mmHg and heart rate decreased to 82 beats per minute. No definitive source of bleeding was identified during the operation. On postoperative day1, the patient developed paroxysmal atrial fibrillation, which resolved after treatment with amiodarone. Serial TTE on postoperative days 1, 2, and 6 showed no significant abnormalities. The chest tube was removed on postoperative day 6, and the patient was discharged the following day.</p><p><strong>Conclusion: </strong>During VATS lobectomy, intraoperative hypotension that cannot be explained by blood loss or changes in ventilation parameters, particularly when accompanied by a narrowed pulse pressure, should prompt consideration of occult cardiac tamponade. Early point-of-care ultrasonography and timely pericardial drainage are essential for rapid diagnosis and hemodynamic stabilization.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1936557"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Giant congenital hydronephrosis presenting as massive retroperitoneal cystic lesion with literature review.","authors":"Wen Yan, Mengmeng Xiao, Ming Yi Li, Yin Li Zhang, Ying Chao Qin","doi":"10.3389/fsurg.2026.1763193","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1763193","url":null,"abstract":"<p><p>Giant retroperitoneal cystic lesions encompass multiple differential diagnoses including renal cysts, lymphangiomas and congenital hydronephrosis. Congenital giant hydronephrosis is extremely rare in adult patients, with limited clinical data to guide preoperative differentiation and surgical management. We report a unique case of a 60-year-old male with a 10-year history of progressive giant left retroperitoneal cystic mass, accompanied by left abdominal distending pain. Preoperative contrast-enhanced ultrasound and CT demonstrated severe left hydronephrosis with markedly atrophic renal cortex. Complete surgical resection of the cystic lesion was performed under laparotomy. Cyst fluid creatinine and postoperative histopathology confirmed the diagnosis of congenital giant hydronephrosis. The patient recovered uneventfully without complications during regular follow-up. We further review published literature to summarize clinical manifestations, multimodal imaging differentiation, surgical indications and long-term prognosis of adult giant congenital hydronephrosis, aiming to provide practical references for clinicians to distinguish retroperitoneal cystic masses and optimize surgical decision-making.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1763193"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Advancements in understanding nasal airflow and improved success of intranasal surgery.","authors":"Johan Hellgren, Sverre Steinsvåg","doi":"10.3389/fsurg.2026.1963390","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1963390","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1963390"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular retrieval of bone cement entrapped in an inferior vena cava filter after percutaneous vertebroplasty: a case report.","authors":"Guangxu Wan, Jingwei Yan, Qichen Liang, Ziteng Zhang, Ziqiang Sun, Peng Liu","doi":"10.3389/fsurg.2026.1913450","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1913450","url":null,"abstract":"<p><p>Percutaneous vertebroplasty (PVP) is widely used to treat osteoporotic vertebral compression fractures, however, bone cement leakage may enter the venous system and cause potentially serious embolic complications. Entrapment of migrated bone cement within an inferior vena cava filter (IVCF) is rare and may pose substantial technical challenges during filter retrieval. We report the case of a 67-year-old woman with bilateral deep vein thrombosis who underwent placement of a Denali retrievable IVCF after thrombus progression while receiving a nonstandard initial rivaroxaban regimen selected because of concern about bleeding risk. She subsequently underwent PVP for osteoporotic thoracolumbar compression fractures and returned 5 months after filter placement for elective retrieval. Pre-retrieval ultrasonography showed a patent inferior vena cava (IVC) but did not identify the intrafilter abnormality. Intraoperative inferior vena cavography revealed an obvious filling defect within the IVCF. A radiopaque shadow on fluoroscopy and retrospective review of prior PVP images suggested an impacted bone cement foreign body. Conventional retrieval through the right internal jugular vein failed. After reassessment of the procedural risks and discussion with the patient and her family, a 22F large-bore sheath was introduced through the femoral vein, and a temporary protective IVCF was deployed in the infrarenal IVC, caudal to the renal vein ostia and cephalad to the mobilized Denali filter-cement complex. The Denali retrievable IVCF and entrapped bone cement were retrieved <i>en bloc</i> through femoral venous access, and the protective filter was subsequently removed using the LOOP technique. The patient remained hemodynamically stable and had no fever, chest tightness, dyspnea, or abdominal pain. Follow-up computed tomography showed no hematoma, IVC stenosis, or IVC occlusion, and she was discharged in stable condition. This case highlights that, in patients with a history of PVP and an indwelling IVCF, intrafilter bone cement entrapment should be considered before planned filter retrieval. Careful review of previous fluoroscopic or interventional images, preoperative abdominal radiography followed by selective IVC CT venography (CTV) when radiopaque material is suspected, routine intraoperative cavography, preparation of large-bore sheaths and protective filters, and readiness for open surgical conversion may improve procedural safety.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1913450"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and surgical outcomes of sodium fluorescein-guided pediatric brain tumor surgery: a retrospective before-and-after single-center cohort study.","authors":"Christian Ott, Alexander Hebeler, Tommaso Araceli, Barbara Greiner, Katharina Rosengarth, Martin Proescholdt, Nils-Ole Schmidt, Sebastian Siller","doi":"10.3389/fsurg.2026.1875948","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1875948","url":null,"abstract":"<p><strong>Purpose: </strong>Sodium fluorescein (SF) used with a YELLOW 560-nm filter may improve intraoperative visualization of contrast-enhancing brain tumors, but pediatric evidence remains limited. We assessed the feasibility, safety, and surgical outcomes of SF-guided resection in a single-center pediatric cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed pediatric brain tumor resections performed between 2015 and 2023 using a before-and-after design based on the institutional introduction of SF. SF-guided procedures were compared with historical white-light controls. Inclusion required a contrast-enhancing intracranial tumor considered amenable to gross total resection (GTR). SF was administered intravenously at 2 mg/kg. The primary endpoint was radiographically confirmed GTR within 72 h; operative duration, postoperative course, complications, and follow-up outcomes were secondary exploratory endpoints. Exploratory multivariable logistic regression for GTR included SF use, age, sex, and supra- vs. infratentorial location. Operative duration was compared using a two-sided Mann-Whitney <i>U</i>-test.</p><p><strong>Results: </strong>Among 60 procedures in 50 patients, 32 were performed with SF and 28 without SF. GTR was achieved in 93.8% of SF-guided and 71.4% of non-SF procedures (absolute difference, 22.4 percentage points; Fisher's exact <i>p</i> = 0.035). In exploratory multivariable analysis, SF use was associated with GTR (adjusted odds ratio 5.890, 95% confidence interval 1.091-31.080; <i>p</i> = 0.039). In an unadjusted exploratory analysis, operative duration was lower with SF [median 191.5 min (IQR 148.25-264.25) vs. 249.5 min (IQR 184.00-306.75); <i>U</i> = 303, <i>p</i> = 0.032]. No SF-related adverse reactions occurred. Fluorescence was documented in 20/32 SF-guided procedures and was positive in 17/20 of those cases.</p><p><strong>Conclusion: </strong>Low-dose SF was safe and feasible and was associated with higher GTR rates and lower operative duration. However, the historical-control design, limited number of non-GTR outcomes, heterogeneous tumors, baseline differences, unequal follow-up, and residual confounding preclude causal or long-term oncological conclusions. Prospective validation is required.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1875948"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical spinal epidural lipomatosis: diagnostic strategy and treatment with AUSS technique-A case report.","authors":"Ke Deng, Leilei Wu, Long Peng, Quan Yuan, Changhua Peng, Xiao Yang, Chuan He, Xiaolin Li, Chaoju Zhang","doi":"10.3389/fsurg.2026.1980348","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1980348","url":null,"abstract":"<p><p>Spinal epidural lipomatosis (SEL) often presents with atypical symptoms, leading to misdiagnosis and delayed treatment, which significantly affects patients' quality of life. The optimal treatment for SEL remains controversial. We report a case of SEL in a patient whose sole symptom was perianal pain-a presentation not previously documented in the literature. We summarize the clinical data and the use of arthroscopic-assisted uniportal spinal surgery (AUSS) for treatment, offering a novel approach for managing symptomatic SEL.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1980348"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of concurrent repair of occult contralateral inguinal hernias during TAPP: a retrospective cohort study.","authors":"Hanxia Hao, Lijia Liu, Yao Wang, Simeng Chen, Yuan Li","doi":"10.3389/fsurg.2026.1963908","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1963908","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the clinical efficacy and surgical safety of intraoperative exploration and immediate repair of occult inguinal hernia (OIH) during transabdominal preperitoneal (TAPP) repair.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 238 adult patients who underwent TAPP at Jiangsu Provincial People's Hospital (The First Affiliated Hospital with Nanjing Medical University) from May 2023 to May 2024. Based on preoperative diagnosis and intraoperative exploration findings, patients were divided into three groups: the unilateral group (without OIH, <i>n</i> = 173), the OIH group (intraoperatively explored and repaired, <i>n</i> = 32), and the preoperative bilateral group (<i>n</i> = 33). Operative time, total hospitalization costs, and the incidence of postoperative complications (including pain, seroma, urinary retention, and recurrence) were compared among the three groups.</p><p><strong>Results: </strong>Among patients preoperatively diagnosed with unilateral hernia, the intraoperative exploration rate of OIH was 15.61% (32/205). Indirect inguinal hernia was the predominant type of OIH (71.88%). The operative time in the OIH group (112.03 ± 37.61 min) was significantly longer than that in the unilateral group (<i>P</i> < 0.001), but showed no statistically significant difference compared with the preoperative bilateral group (<i>P</i> = 0.258). Total hospitalization costs in the OIH group (17119.57 ± 1958.58 CNY) were significantly higher than in the unilateral group (<i>P</i> < 0.001), but slightly lower than in the preoperative bilateral group (<i>P</i> = 0.010). Postoperative complication analysis revealed that the incidence of acute pain in the OIH group (31.25%) was significantly higher than in the unilateral group (<i>P</i> = 0.008). However, no statistically significant difference was observed when compared with the preoperative bilateral group (<i>P</i> = 0.221). No statistically significant differences were observed among the three groups in the incidence of other complications, such as seroma, urinary retention, and hernia recurrence.</p><p><strong>Conclusions: </strong>Routine intraoperative exploration during TAPP effectively identifies occult inguinal hernias. Concurrent laparoscopic repair of an incidentally detected OIH appears technically feasible and exhibits a favorable safety profile, without an obvious increase in major short-term postoperative complications compared with standard unilateral or bilateral repairs. These findings support concurrent repair as a feasible and safe intraoperative choice when an OIH was encountered.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1963908"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A large iliopsoas abscess due to migration of ureteral stent: a case report.","authors":"Haipeng Sun, Xiande Cao, Yongtao Su, Siyuan Liu","doi":"10.3389/fsurg.2026.1975183","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1975183","url":null,"abstract":"<p><strong>Background: </strong>Iliopsoas abscess (IPA) is a rare but potentially life-threatening condition. Due to its nonspecific clinical presentation and low incidence, IPA often leads to diagnostic delays and suboptimal initial management. Secondary IPA originating from urinary tract complications is extremely rare, and IPA induced by ureteral stent migration appears to be exceptionally uncommon. Fungal IPA caused by <i>Candida tropicalis</i> is also a scarcely reported clinical entity, especially in immunocompromised patients with long-term rheumatoid arthritis (RA).</p><p><strong>Case presentation: </strong>We report a 63-year-old woman with a history of rheumatoid arthritis (RA) and prior colon cancer surgery that involved partial ureteral resection and ureteral stent implantation 6 months ago. The patient later developed IPA, which was successfully managed with dual ultrasound-guided percutaneous drainage, ureteral stent exchange, and systemic antimicrobial therapy. Cultures of the drained abscess and urine both yielded <i>C. tropicalis</i>; the drainage-fluid creatinine (5,334 μmol/L) was consistent with urine, suggesting that the IPA likely originated from infected urine leaking from the ureteral anastomosis due to migration of the ureteral stent. The patient was eventually discharged without further complications.</p><p><strong>Conclusion: </strong>Ultrasound-guided percutaneous drainage is a safe and effective treatment modality for IPA. This case highlights that ureteral stent migration, though typically managed uneventfully, may precipitate severe septic sequelae including IPA, particularly in immunocompromised patients.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1975183"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term clinical experience with a 3-step combined technique for involutional lower eyelid entropion and ectropion based on common pathophysiologic mechanisms.","authors":"A Pasteris, M Rodio, S Rampazzo, F Ziani, E Trignano, C Rubino","doi":"10.3389/fsurg.2026.1892004","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1892004","url":null,"abstract":"<p><strong>Background: </strong>Involutional lower eyelid malpositions, including ectropion and entropion, are common age-related conditions resulting from horizontal eyelid laxity, imbalance between the anterior and posterior lamellae, and orbicularis oculi muscle dysfunction. Although numerous surgical techniques have been described, no single approach has proven universally superior. At our institution, two previously described condition-specific 3-step procedures are used to address the specific pathophysiologic mechanisms underlying involutional ectropion and entropion.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients treated between 2012 and 2025 using condition-specific 3-step surgical techniques. For involutional ectropion, the procedure combined lower eyelid skin release, lateral eyelid shortening through a base-up full-thickness triangular resection, and transposition of a laterally based upper eyelid myocutaneous flap. For involutional entropion, the technique consisted of partial orbicularis oculi muscle myectomy, lateral eyelid shortening through a base-down triangular resection, and excision of a lower eyelid skin strip. Functional and aesthetic outcomes, postoperative complications, and recurrence rates were evaluated throughout follow-up.</p><p><strong>Results: </strong>Forty-five patients (57 eyelids) underwent ectropion correction, with a mean follow-up of 22 months. The overall success rate was 94.7%, with one case of undercorrection and two late recurrences, all successfully managed with secondary procedures. Complications were minimal and limited to one early wound dehiscence. Thirty-five patients (40 eyelids) underwent entropion correction, with a median follow-up of 12 months. No recurrences were observed, while one case of undercorrection and one early wound dehiscence were reported.</p><p><strong>Conclusions: </strong>Involutional ectropion and entropion share a common pathophysiologic substrate characterized by horizontal eyelid laxity, lamellar imbalance, and orbicularis oculi dysfunction. Despite technical differences, both procedures are based on the same reconstructive principles: restoration of horizontal eyelid tension, rebalancing of the anterior and posterior lamellae, and normalization of orbicularis muscle forces. The favorable long-term outcomes and low recurrence rates observed in both groups support a pathophysiology-driven, vector-based reconstructive approach for the management of involutional lower eyelid malpositions.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1892004"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical outcomes between mobile- and fixed-bearing unicompartmental knee arthroplasty for medial compartment osteoarthritis: a retrospective study.","authors":"Hongze Chen, Xiaodong Zheng, Shaobin Zhu, Longyu Shan, Jixin Chen, Lei Wan, Feng Ye","doi":"10.3389/fsurg.2026.1746302","DOIUrl":"10.3389/fsurg.2026.1746302","url":null,"abstract":"<p><strong>Background: </strong>Unicompartmental knee arthroplasty (UKA) is an established treatment for isolated medial compartment osteoarthritis (MCOA). The optimal choice between mobile-bearing (MB) and fixed-bearing (FB) designs remains debated, particularly in Asian populations where treatment costs and insurance policies influence surgical decisions.</p><p><strong>Objective: </strong>To compare short-term clinical and radiographic outcomes between MB and FB UKA and to evaluate potential implications for healthcare resource allocation.</p><p><strong>Methods: </strong>Sixty-four patients who underwent medial UKA between January 2022 and October 2024 were retrospectively analyzed (MB: <i>n</i> = 32; FB: <i>n</i> = 32). All surgeries were performed by a single senior surgeon using standardized protocols. Pain (Visual Analogue Scale, VAS), function (Hospital for Special Surgery [HSS] and American Knee Society Score [KSS]), radiographic alignment (femorotibial angle, FTA; tibial slope angle, STA), and range of motion (ROM) were assessed preoperatively and at 3 months postoperatively. Statistical significance was set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Both groups achieved significant improvements in VAS, HSS, and KSS scores (all <i>P</i> < 0.001), with no intergroup differences. MB showed greater correction in FTA (-3.27° vs. -2.70°, <i>P</i> < 0.05) and larger ROM gains in flexion and extension compared with FB (<i>P</i> < 0.05). No infections, loosening, or bearing dislocations occurred.</p><p><strong>Conclusions: </strong>MB and FB UKA provide comparable short-term pain relief and functional improvement. MB may offer greater alignment correction and range of motion, whereas FB was associated with lower hospitalization cost in this cohort and may therefore have a potential economic advantage. Prosthesis selection should consider both clinical performance and economic factors to optimize patient outcomes and resource utilization.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1746302"},"PeriodicalIF":1.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}