HIP International最新文献

{"title":"Can't stop the slide: factors associated with lag screw slide following cephalomedullary nail fixation of intertrochanteric hip fractures.","authors":"Christopher J Pettit, Carolyn Herbosa, Nina D Fisher, Abhishek Ganta, Steven Rivero, Nirmal C Tejwani, Philipp Leucht, Sanjit Konda, Kenneth A Egol","doi":"10.1177/11207000261426459","DOIUrl":"10.1177/11207000261426459","url":null,"abstract":"<p><strong>Objective: </strong>To examine factors associated with lag screw slide following fixation of intertrochanteric hip fractures with 1 type of cephalomedullary nail.</p><p><strong>Methods: </strong>Retrospective review of patients operatively treated for intertrochanteric hip fractures (OTA/AO 31A1 and 31A2) with a single cephalomedullary nail (CMN) at a single academic medical centre between November 2014 and November 2023. CMN lag screw was placed in \"dynamic\" mode to allow for controlled collapse, or screw \"slide.\" Screw slide was defined as the difference in lateral prominence of the lag screw at latest follow up compared to its initial position. Patients were grouped based on the amount of screw slide (<5 mm, 5-15 mm, >15 mm) and correlation analysis was performed.</p><p><strong>Results: </strong>614 intertrochanteric hip fracture patients were identified (mean age 80.76 years; 72.3% female) with mean 6.2 months follow-up. Mean amount of slide was 3.77 ± 4.79 mm. 66.3% of patients had <5 mm of slide, while 31.3% had 5-15 mm and 2.4% had >15 mm. Univariate analysis demonstrated that slide >15 mm was associated with increased patient BMI (<i>p</i> = <0.001), use of some anti-osteoporotic medications (<i>p</i> = 0.021) and more than 5 mm of immediate postoperative prominence (<i>p</i> = 0.016). Although not statistically significant, patients with >15 mm of slide were only taking vitamin D and calcium whereas those with <15 mm slide more often took bisphosphonates, denosumab and teriparatide (<i>p</i> = 0.163). Multivariate regression demonstrated that only BMI (OR 1.14, 95% CI, 1.04-1.24; <i>p</i> = 0.002) was associated with >15 mm screw slide.</p><p><strong>Conclusions: </strong>Excessive lag screw slide (>15 mm) was associated with higher patient BMI. Patients with higher BMIs should be monitored to identify excessive slide. Surgeons should attempt to keep the lag screw as close to the lateral cortex as possible. While the use of anti-osteoporotic therapy was associated with more slide, this was almost exclusively seen in patients only prescribed vitamin D and calcium.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"652-660"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally-invasive re-stabilisation of loosened hip implants using percutaneous periprosthetic cement injections: a feasible option to reduce pain in frail patients.","authors":"Kiki Q de Smidt, Shaho Hasan, Perla J Marang-van de Mheen, Demien Broekhuis, Rob Ghh Nelissen","doi":"10.1177/11207000251415370","DOIUrl":"10.1177/11207000251415370","url":null,"abstract":"<p><strong>Introduction: </strong>Loosening of hip implants causes severe pain and disability. Revision surgery, the standard treatment, carries high risks, especially for frail patients. Therefore, a less-invasive treatment option is needed for patients with incapacitating pain. We evaluated the safety and efficacy of percutaneous periprosthetic cement injection (PPCI) to restabilise loosened hip implants.</p><p><strong>Methods: </strong>All patients treated with PPCIs of hip implants between 2004 and 2020 were retrospectively included (median follow-up 24 months, IQR 11-51). Cement was injected in the periprosthetic space of the loosened hip implant under fluoroscopy. Patient characteristics and the Charlson Comorbidity Index (CCI) were measured. Pain reduction was measured by the Harris Hip pain-subscore and adverse events were recorded.</p><p><strong>Results: </strong>34 patients were included (mean age 83 years, median CCI 6 points). 10 patients had a second PPCI after 12 months (median, IQR 7-27). 2 patients needed revision surgery. 30 patients had pain reduction and 4 had no pain reduction. Adverse events included femoral fissure during needle placement (<i>n</i> = 1) and progressive migration of a loosened acetabular cup (despite the cement injection; <i>n</i> = 2).</p><p><strong>Conclusions: </strong>PPCIs for loosened hip implants is feasible in frail patients with pain reduction in the majority of patients and has limited adverse events.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"567-574"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480563","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":"Influence of bone quality on femoral stress distribution after cemented stem insertion: an experimental thermoelastic stress analysis.","authors":"Shota Yasunaga, Ryunosuke Watanabe, Tomofumi Nishino, Tomohiro Yoshizawa, Fumi Hirose, Koshiro Shimasaki, Hajime Mishima, Yoshihisa Harada","doi":"10.1177/11207000261420734","DOIUrl":"10.1177/11207000261420734","url":null,"abstract":"<p><strong>Purpose: </strong>With an ageing population, the number of total hip arthroplasty (THA) performed in osteoporotic patients is increasing. Cemented stems are often chosen for osteoporotic bone owing to their lower fracture risk. However, how bone quality influences stress distribution after cemented stem insertion remains unclear. This study compared femoral stress distribution between normal and osteoporotic femora using thermoelastic stress analysis (TSA).</p><p><strong>Materials and methods: </strong>6 composite femora were used: 3 normal adult male models (#3403) and 3 osteoporotic models (#3503). C-stem AMT cemented stems were implanted with a standardised technique. TSA was conducted before and after stem insertion under physiological loading (normal: 100-1900 N; osteoporotic: 100-1000 N). Stress distribution was analysed by Gruen zones and compared using linear mixed models.</p><p><strong>Results: </strong>In the normal models, stress uniformly decreased after stem insertion with a distal shift of peak stress. In the osteoporotic models, proximal stress decreased markedly, while distal stress (zones 4L, 4M) increased, demonstrating a more pronounced distal shift.</p><p><strong>Conclusions: </strong>Bone quality strongly affects load transfer after cemented stem insertion. Osteoporotic bone demonstrated proximal stress loss and distal concentration, possibly underlying atypical periprosthetic femoral fractures. TSA provides useful insights for implant design and surgical planning in osteoporotic THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"541-549"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480487","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":"Initial stability and bone response at 6 months post-operation in the Avenir complete stem: a comparative study by femoral canal shape.","authors":"Musashi Ima, Tamon Kabata, Daisuke Inoue, Yu Yanagi, Takahiro Iyobe, Naoya Fujimaru, Satoru Demura","doi":"10.1177/11207000251410505","DOIUrl":"10.1177/11207000251410505","url":null,"abstract":"<p><strong>Objective: </strong>To compare the initial postoperative fixation and bone response at 6 months among different femoral canal morphologies in patients implanted with a specific fully hydroxyapatite-coated femoral stem.</p><p><strong>Methods: </strong>This study included 95 hip joints of patients who underwent primary total hip arthroplasty between 19 October 2020 and 20 October 2023 (17 male and 78 female). Femoral canal shapes were categorised into Dorr types A, B, and C using the canal flare index.</p><p><strong>Results: </strong>Dorr types A, B, and C were observed in 17, 76, and 25 cases, respectively, and averaged -0.17 ± 1.99°, 0.71 ± 2.24°, and 1.57 ± 1.25°, respectively in the coronal plane, indicating a trend toward varus insertion. The medullary cavity occupancy rate was highest in Dorr type C (17.6 ± 9.81%). The bone contact rates were higher in Zones 3 and 7 for Dorr type C than for types A and B. At 6 months, spot welds indicative of fixation appeared in all cases, with Dorr type A showing an absence of spot welds in Zones 1 and 7, suggesting a risk of distal fixation.</p><p><strong>Conclusions: </strong>Although the implant generally provides satisfactory fixation, the risk of malalignment and distal fixation associated with specific femoral canal morphologies should be carefully considered.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"558-566"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the place for non-operative management of neck of femur fractures: analysis of the Australia and New Zealand Hip Fracture Registry (ANZHFR).","authors":"Carla Davies, Lara Harvey, Rebecca Mitchell, Mitchell Sarkies, Pierre Navarre, Christopher Wall","doi":"10.1177/11207000251408435","DOIUrl":"10.1177/11207000251408435","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures cause significant morbidity and mortality worldwide, a burden expected to rise with population ageing. Operative management remains the mainstay of treatment; however, a small number of patients receive non-operative treatment. The Australian and New Zealand Hip Fracture Registry (ANZHFR) began recording reasons for non-operative management in 2021. The study aimed to identify factors influencing the decision for non-operative management, compare outcomes between operative and non-operative treatment and compare palliative patients who died ⩽30 days to those who survived >30 days.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using ANZHFR data between 01 January 2021 and 31 December 2022, including patients aged ⩾50 years with a hip fracture. Patients were categorised as: operative or non-operative, the latter sub-categorised; palliative, not clinically indicated, or other. Demographic, clinical and fracture characteristics, length of stay, discharge destination and mortality at 30, 120 and 365 days were compared. A sub-analysis of the palliative group compared those who survived >30 days with those who died ⩽30 days.</p><p><strong>Results: </strong>Of 31,423 hip fracture patients, 30,734 (97.8%) underwent surgery, and 689 (2.2%) were managed non-operatively (438 palliative, 127 surgery not clinically indicated, 124 other). Palliative patients were older, frailer, less mobile, more likely to live in residential aged care, and to have dementia. Men and patients treated in Tasmania were more likely to receive palliative care. Non-displaced valgus impacted fractures were more common among the not clinically indicated group. 30-day mortality was highest in the palliated group (87.2%) and lowest in the operative group (7.3%). Age was the only factor associated with survival >30 days among palliated patients.</p><p><strong>Conclusions: </strong>This is the first registry-based analysis of non-operative hip fracture management by reason. It identified distinct demographic, clinical and geographical patterns that influenced non-operative care. The palliative cohort had the highest mortality; however, a small proportion of patients survived.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"627-636"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can native offset be restored in total hip arthroplasty? A contralateral-based evaluation from the FP-UCBM Hip Study group.","authors":"Biagio Zampogna, Andrea Zampoli, Augusto Ferrini, Francesco Rosario Parisi, Giancarlo Giurazza, Giovanni Zagaria, Riccardo Vitale, Alessandro Del Monaco, Ferruccio Vorini, Alice Laudisio, Rocco Papalia","doi":"10.1177/11207000261437301","DOIUrl":"10.1177/11207000261437301","url":null,"abstract":"<p><strong>Background: </strong>Accurate restoration of coronal-plane biomechanics after total hip arthroplasty (THA) needs assessment of the 2 aspects: global offset (GO) and leg-length discrepancy (LLD). The SGL index (sum of the leg-length discrepancy and the difference in global femoral offset) combines ΔGO and LLD into a single measure, which could provide a more complete evaluation than single-parameter measures. The study evaluates SGL for coronal restoration following THA, followed by GO restoration (±5 mm) and its femoral versus acetabular contribution.</p><p><strong>Methods: </strong>This retrospective analysis included 256 hips that underwent unilateral THA with standardised AP pelvic radiographs. Preoperative and postoperative measurements included femoral (FO), acetabular (AO), and GO, as well as LLD and SGL. The contralateral healthy hip was used as a reference, and accuracy was defined to be within ±5 mm.</p><p><strong>Results: </strong>SGL restoration (⩽5 mm) was achieved in 64.5% of hips; compared with non-restored cases, SGL-restored hips had higher postoperative FO (40.0 ± 5.5 vs. 38.5 ± 6.0 mm; <i>t</i>-test <i>p</i> = 0.050; Mann-Whitney <i>p</i> = 0.062), while AO did not differ. Preoperative offsets were similar. The contralateral (healthy) GO was higher in the non-restored group (71.1±7.7 vs. 68.9 ± 6.8 mm; <i>t</i>-test <i>p</i> = 0.024; Mann-Whitney <i>p</i> = 0.011).</p><p><strong>Conclusions: </strong>SGL is a valid parameter for determining coronal-plane restoration following THA. Among single measures, femoral offset (FO) is the most sensitive indicator of global offset restoration.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"522-528"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"15-year experience with tapered fluted modular titanium stems in revision hip arthroplasty and complex femoral reconstruction: a long-term survivorship analysis in a tertiary care centre.","authors":"José Antonio Guerrero-Serrano, Alejandro Oliver-Grosso, Claudia Ortega-Romero, José María García-López, José Alberto Moreno-Beamud, Emilio Delgado-Díaz","doi":"10.1177/11207000261427712","DOIUrl":"10.1177/11207000261427712","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past 2decades, tapered fluted modular titanium stems have gained wide acceptance due to their intraoperative versatility and encouraging early- to mid-term outcomes. This study aims to analyse the clinical and radiographic outcomes, complications, and survivorship of tapered fluted modular titanium stems in revision THA and complex femoral reconstruction with long-term follow-up.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted on patients who underwent revision hip surgery or complex reconstruction using a non-cemented modular tapered fluted stem at a single institution between 2009 and 2016. A total of 47 patients (48 hips) were included. Clinical evaluation was performed using the Harris Hip Score (HHS). Radiographic parameters were used to assess implant stability, osteointegration, subsidence, and stress shielding. Complications were recorded, and implant survivorship was analysed using the Kaplan-Meier method.</p><p><strong>Results: </strong>The mean age was 70 (range 37-95) years, with a mean follow-up of 9 (range 6-15) years. All patients showed functional and pain improvement after surgery, with an average increase of 38 points in the HHS (<i>p</i> < 0.001). Distal osteointegration was observed in 96% of cases, with a significant subsidence rate (>5 mm) of 4%. Stress shielding was present in 8% of cases. A total of 6 reoperations were recorded: 3 (6%) due to recurrent dislocation, 2 (4%) due to septic loosening, and 1 (2%) due to aseptic loosening. Overall implant survivorship was 87.5% for any reoperation, 91.7% for any stem revision, and 100% for stem revision due to mechanical failure of the femoral component.</p><p><strong>Conclusions: </strong>The modular tapered fluted stem proved to be a reliable and durable option in revision total hip arthroplasty and complex femoral reconstruction, with high rates of osteointegration and long-term stability. Its design allows for effective distal fixation and bone reconstruction in patients with severe femoral defects.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"582-593"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidised zirconium heads show a lower linear wear rate than 28-mm metal heads against XLPE: a retrospective analysis.","authors":"Amit Atrey, Zoe Thompson, Veronica Pentland, Richard McCalden, Kevin Gargan, Douglas Naudie, James P Waddell, Graeme Hoite, Amir Khoshbin","doi":"10.1177/11207000251412753","DOIUrl":"10.1177/11207000251412753","url":null,"abstract":"<p><strong>Aims: </strong>The use of highly cross-linked polyethylene (XLPE) on the acetabulum has undoubtedly improved the wear rates and hence survivorship of total hip arthroplasty (THA). However, the importance of head tribology is not known. Oxidised zirconium (OxZr) was introduced to offer the lower wear rates of ceramic but the strength of metal. Whether OxZr heads have any purported benefits in terms of lowering wear is not known. This study therefore aims to compare wear rates of XLPE against metal and OxZr heads over a 10-year period.</p><p><strong>Methods: </strong>A previous study has suggested we need a minimum 95 cases to show a statistically significant difference. Thus, in this 10-year retrospective analysis we included 95 subjects with a primary THA with a 28-mm OxZr and 131 patients with a 28-mm cobalt-chrome (CoCr) head, both against XLPE liners.Linear and volumetric wear rate comparisons were performed using a validated 2-dimensional stereoisometric analysis by an independent centre.</p><p><strong>Results: </strong>There were no significant differences for any of the patient demographics between the 2 groups, with >60% women in both groups and normally distributed age. Cup inclination angle was also comparable between the 2 groups.While there was no difference in volumetric wear rates (<i>p</i> = 0.7377), the annual linear wear rate for OxZr was 0.030 mm (95% CI, 0.024-0.036) compared with 0.046 mm (95% CI, 0.038-0.054) for CoCr, a statistically significant difference (<i>p</i> = 0.0002)Conclusions:The widespread use of XLPE has revolutionised THA. This study is the first to show a statistically significantly lower wear rate with the use of OxZr. Whether this is enough to justify the cost differential and whether it translates to better implant survivorship is still to be determined. But if wear limiting wear rates is associated with decreasing revision rates, the use of ceramicised metal may be of clinical benefit.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"602-608"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283449","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":"Prognostic factors predicting outcomes after total hip arthroplasty for femoral neck fractures; a multicentre retrospective cohort-study.","authors":"Eelco A P van Leent, Frederik Okke Lambers Heerspink, Stan C J Vos, Rutger G Zuurmond, Karel J du Pré, Matthijs P Somford, Esther R C Janssen","doi":"10.1177/11207000261439050","DOIUrl":"10.1177/11207000261439050","url":null,"abstract":"<p><strong>Objectives: </strong>Fractures of the femoral neck (FFN) are a significant public health problem in an ageing population. Treatment options for FFN include head-sparing procedures with internal fixation, although there is a risk of conversion to total hip arthroplasty (cTHA) if internal fixation fails. Primary total hip arthroplasty (pTHA) is recommended for vital elderly patients with fully displaced FFN and/or with preexisting osteoarthritis. This study aims to identify prognostic factors that predict the risk of postoperative complications and revision for THA in patients with a FFN using a prediction model.</p><p><strong>Methods: </strong>A multicentre retrospective cohort study was conducted in 5 hospitals in the Netherlands. Patients receiving a primary or conversion THA after FFN from 2006 until 2022 were included in the study. Multivariate regression analysis was used to develop a prediction model to identify predictive factors for risk of postoperative complications and revision.</p><p><strong>Results: </strong>In total, 747 patients with THA after FFN were included. 18% of the population developed one or more major complications and 6.6% had a revision after THA within 4.6 years. From the multivariate regression analysis, we found male gender (odds ratio [OR] 2.1 (95% confidence interval (CI) 1.3-3.4)) was the only predictor for postoperative major complications. Male gender (OR 2.2; 95% CI, 1.0-4.7), ASA III classification (OR 7.4; 95% CI, 1.5-36.0) and cementless stem fixation (OR 2.4; 95% CI, 1.1-5.2) were predictive for revision.</p><p><strong>Conclusions: </strong>Male gender is associated with a higher risk of major complication and revision in THA after FFN. ASA III and cementless stem fixation are associated with a higher risk of revision of THA after FFN.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"637-645"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The uncoached athlete: reframing performance and longevity in the surgical profession.","authors":"Rachel Neylan, Michael C Wyatt","doi":"10.1177/11207000261449189","DOIUrl":"10.1177/11207000261449189","url":null,"abstract":"<p><p>The demands of competing in the Olympic games is remarkably similar to that of surgeon in theatre. Both require sustained precision, high cognitive load, emotional regulation, physical endurance, and the weight of outcomes that matter profoundly.Other high-performance domains, such as elite sport, aviation, and the military, have long recognised that peak execution comes from deliberate investment in human performance science: training body and mind, integrating recovery, applying technology, and employing coaching and human performance strategy to optimise outcomes. Athletes systematically invest in programmed and periodised conditioning, physiological monitoring, recovery, nutrition, and psychological resilience. Their success depends on the integration of physiology, psychology, and environment.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"508-510"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}