Indian Journal of Orthopaedics最新文献

{"title":"Denosumab Injection Combined with Intramedullary Nail Fixation for Osteoporotic Fractures.","authors":"Weichu Cai, Changfan Li, Shuoxin Chen, Yijia Gao","doi":"10.1007/s43465-026-01770-w","DOIUrl":"https://doi.org/10.1007/s43465-026-01770-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical efficacy of denosumab injection combined with intramedullary nail fixation for osteoporotic femoral intertrochanteric fractures.</p><p><strong>Methods: </strong>A total of 106 patients diagnosed with osteoporotic femoral intertrochanteric fractures, classified according to the Evans-Jensen system, who were admitted to The First Affiliated Hospital of Guangzhou University of Chinese Medicine between May 2019 and May 2024. All patients underwent internal fixation using the proximal femoral nail antirotation (PFNA) system. The study group received denosumab injections within 1 week postoperatively, and both groups were administered conventional osteoporosis treatment following surgery. The baseline data (age, sex, cause of injury, and Evans-Jensen classification), operation time, intraoperative blood loss, length of hospital stay, fracture healing time, <i>T</i> value of hip bone density, and postoperative complications were compared between these two groups. The VAS score and HHS was evaluated 1 year after surgery.</p><p><strong>Results: </strong>All 106 patients were followed up for at least 1 year. There was no significant difference in operation time, intraoperative blood loss, hospital stays, fracture healing time, and HHS between the two groups (<i>P</i> > 0.05). The incidence of postoperative complications, <i>T</i> value of hip bone density, and VAS score in the study group was significantly lower than that in the control group, and the difference between the groups was statistically significant (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>In summary, the integrative therapeutic protocol combining denosumab administration with proximal femoral nail antirotation (PFNA) fixation demonstrates marked efficacy in enhancing femoral neck bone mineral density and reducing fracture-related limb pain among elderly patients with osteoporotic intertrochanteric fractures. This evidence-based dual-intervention strategy not only optimizes fracture healing outcomes, but also represents a valuable clinical approach for comprehensive postoperative rehabilitation in this vulnerable patient population.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2582-2587"},"PeriodicalIF":1.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108985","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":"Does Cartilage Protein Distribution Vary Across Anatomical Regions of the Femur and Tibia in Osteoarthritic Knees? Insights from Proteomic Analysis.","authors":"Dhanasekaran Soundarrajan, Sharon Michael Nayagam, Divya Arunachalam, Narmatha Devi, Chitra Thangavel, Shanmuganathan Rajasekaran","doi":"10.1007/s43465-026-01774-6","DOIUrl":"https://doi.org/10.1007/s43465-026-01774-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to elucidate the difference in the protein distribution between anatomical regions of the femur and tibia in osteoarthritic knees in macroscopically uninvolved areas.</p><p><strong>Methods: </strong>Proteomic analysis was performed on cartilage tissues isolated from femoral and tibial macroscopically uninvolved areas of the knees during total knee arthroplasty. Six samples were collected in each group. The proteomic analyses comprised extraction of soluble proteins from cartilage, separation of the protein mixtures followed by in-solution digestion, extracts were subjected to precipitation and subsequent tandem mass spectrometry analysis in conjunction with a database search for protein identification and semi-quantitation. Differential analysis was carried out using metaboanalyst software.</p><p><strong>Results: </strong>A total of 967 and 869 proteins were identified in femoral and tibial condyles, respectively. Based on stringent parameters (≥ 5 PSM, one unique peptide, 100% sample positivity), 183 common proteins were identified, of which four proteins showed significant differential expression (<i>p</i> < 0.05, fold change ≥ 1.5). Three proteins were downregulated in the femoral condyle: transthyretin (fold change: 3.04, log2FC: - 0.627 [95% CI - 1.12 to - 0.13], <i>p</i> = 0.0004), apolipoprotein A1 (fold change: 1.66, log2FC: - 0.58 [95% CI - 1.03 to - 0.13], <i>p</i> = 0.007), and alpha-2-macroglobulin (fold change: 1.7, log2FC: - 1.118 [95% CI - 2.35 to 0.11], <i>p</i> = 0.045). One protein, transketolase, was upregulated (fold change: 1.6, log2FC: 0.776 [95% CI 0.12-1.43], <i>p</i> = 0.01). Unique proteins of the femoral condyle were enriched in pathways crucial for chondrocyte metabolism and cartilage homeostasis. Tibial condyle proteins were enriched in complement and coagulation cascades (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Proteomic analysis identified subtle yet meaningful differences in protein expression between the femoral and tibial condyles of osteoarthritic knees. The differences in biological process enrichment highlight the unique functional roles and regulatory mechanisms of the femoral and tibial condyles in controlling OA progression.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 6","pages":"1412-1421"},"PeriodicalIF":1.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204818","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":"Functional Outcome of Single Bundle ACL Reconstruction with Superficial Quadriceps Tendon Graft in an Indian Cohort: A 3-Year Study.","authors":"Rajeev Raman, Sunit Hazra, Udeepto Lodh, Debayan Sinha Roy","doi":"10.1007/s43465-026-01750-0","DOIUrl":"10.1007/s43465-026-01750-0","url":null,"abstract":"<p><strong>Background: </strong>There are only a few studies on the functional outcome of anterior cruciate ligament reconstruction using quadriceps tendon (QT) autograft. The available evidence highlights many advantages of this technique. The graft is thicker and stronger with less donor site morbidity and there is much less kneeling pain as compared to patellar tendon grafts. It is very versatile and allows harvesting as an all-soft tissue or bone-tendon graft, thereby making it suitable for various groups of patients and various surgical techniques.</p><p><strong>Objectives: </strong>To evaluate the functional outcome associated with anterior cruciate ligament reconstruction using quadriceps tendon autograft.</p><p><strong>Methods: </strong>A prospective study was conducted over a period of 3 years in a Tertiary Care Orthopedics department. The study included male and female patients aged between 20 and 50 years with symptomatic isolated ACL tears and a BMI below 40 kg/m². Patients were excluded if they had associated meniscal, cartilage, or posterior cruciate ligament injuries, bilateral or multiple knee ligament injuries, ipsilateral ankle injuries, prior knee or ankle surgery, osteoarthritic changes, active infection or restricted knee motion, or fractures involving the knee. These patients underwent ACLR with QT autograft. Functional outcomes were assessed with standardized scoring systems (Lysholm Knee Score, Subjective IKDC, Tegner Activity Scale) pre-operatively, at 1 and 3 years post-operatively.</p><p><strong>Results: </strong>The study included 50 patients with ACL injuries, most of whom were aged between 20 and 30 years and predominantly male. Nearly half of them had a healthy BMI, with the remainder being overweight or obese. Injuries were commonly caused by road traffic accidents and sports activities, and the right knee was more frequently affected. Following ACL reconstruction with a quadriceps tendon autograft, significant improvement in clinical outcomes was observed. Most of the patients experienced no post-operative complications, while a small number developed superficial infection, anterior knee pain, or knee stiffness.</p><p><strong>Conclusion: </strong>Even though the use of QT for ACL reconstruction has become popular in recent times, only a few surgeons are using it as the preferred primary graft option. Several clinical studies have shown that ACL reconstruction using the quadriceps tendon autograft offers comparable, and, in some cases, superior functional outcomes to hamstring and patellar tendon grafts. In our study, ACLR using QT autograft provided satisfactory clinical results and functional outcomes with relatively low rates of complications. Given its consistent results and adaptability for both primary and revision procedures, the quadriceps tendon autograft should be considered as a preferred graft choice for ACL reconstruction surgeries.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"570-577"},"PeriodicalIF":1.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573784","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":"Ligamentous and Soft-Tissue Injury Patterns in Hyperextension Tibial Plateau Fractures: An MRI-Based Analysis of Varus and Valgus Subtypes.","authors":"Xiaodong Xie, Lihua Ma, Yu Zhang, Peng Chen, Lingbin Wang, Heng Xu","doi":"10.1007/s43465-026-01759-5","DOIUrl":"https://doi.org/10.1007/s43465-026-01759-5","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the incidence, characteristics, and patterns of associated ligamentous and soft-tissue injuries in hyperextension tibial plateau fractures (HTPFs) using magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>We retrospectively analyzed data from 48 patients diagnosed with HTPFs at our hospital between January 2019 and October 2025. Patients with complete radiographic, computed tomography (CT), and magnetic resonance imaging (MRI) data were included. MRI was utilized to evaluate injuries to menisci, collateral ligaments, cruciate ligaments, the posterolateral corner (PLC), popliteus tendon/muscle, and the patellar ligament. Statistical analyses included Chi-square and Fisher's exact tests, with significance set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Among the 48 patients included in the analysis (26 men and 22 women; mean age, 51.3 ± 13.7 years), associated soft-tissue injuries were identified in 43 patients (89.6%). Anterior cruciate ligament (ACL) injuries (60%) and posterolateral corner (PLC) injuries (75%) were the most frequently observed. Patients were categorized into two groups: Group 1, hyperextension-varus fractures (<i>n</i> = 18), and Group 2, hyperextension-valgus fractures (<i>n</i> = 27). Hyperextension-varus fractures demonstrated a significantly higher incidence of fibular head avulsion fractures compared with hyperextension-valgus fractures (56% vs. 4%, <i>P</i> = 0.01). No statistically significant differences were observed between the two groups with respect to other ligamentous injuries. Given the relatively small sample size of the present study, these results should be interpreted with caution.</p><p><strong>Conclusion: </strong>HTPFs frequently involve concomitant ligamentous and soft-tissue injuries, particularly affecting the ACL and PLC. Fibular head avulsion fractures were notably prevalent in hyperextension-varus fracture subtypes. Comprehensive preoperative imaging, including MRI, is critical for accurate diagnosis, surgical planning, and optimizing functional outcomes.</p><p><strong>Level of evidence: </strong>Diagnostic level Ⅲ.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2431-2438"},"PeriodicalIF":1.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109069","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":"Extracorporeal Shock Wave Therapy Combined with Subtalar Arthroereisis and Medial Column Stabilisation in the Treatment of PCFD: A Retrospective Study.","authors":"Guanglong Zeng, Qingxiang Xie, Haiquan Mai, Liu Zhang, Boyuan Su","doi":"10.1007/s43465-026-01756-8","DOIUrl":"10.1007/s43465-026-01756-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Both the stability of the subtalar joint and the support of the medial column serve as crucial stabilising structures in progressive collapsing foot deformity (PCFD). Effective restoration of these stabilising components-often involving gastrocnemius or Achilles tendon recession-is essential for the treatment of PCFD. Therefore, this study aims to evaluate the clinical outcomes of extracorporeal shock wave therapy (ESWT) combined with subtalar arthroereisis and medial column stabilisation for PCFD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixty-eight patients (68 feet) with PCFD treated at our hospital between February 2023 and April 2024 were retrospectively analysed. The patients were divided into two groups based on treatment regimen: the intervention group (IG, &lt;i&gt;n&lt;/i&gt; = 36), which received ESWT combined with subtalar arthroereisis (HyProCure) and medial column stabilisation [hereinafter referred to as 'dual stabilisation procedures (DSP)'], and the control group (CG, &lt;i&gt;n&lt;/i&gt; = 32), which underwent DSP alone. The groups underwent preoperative and postoperative assessments of clinical function and imaging parameters. Clinical function assessments included the Visual Analogue Scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and Tegner activity scale score. Conversely, imaging assessments encompassed weight-bearing anteroposterior talo-first metatarsal angle (T1-MT), talonavicular coverage angle (TNCA), lateral calcaneal pitch angle (pitch angle), lateral talo-first metatarsal angle (Meary's angle), calcaneal valgus angle (CVA), and elastic modulus of the Achilles tendon or gastrocnemius muscle. Complications, including flatfoot recurrence, internal fixation implant rejection, and wound infection, were also documented.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Postoperative follow-up lasted at least 12 months, with a mean duration of (13.66 ± 1.65) months. At the last follow-up, analyses revealed that both groups exhibited significant improvements in weight-bearing X-ray parameters (T1-MT, TNCA, pitch angle, Meary's angle and CVA) compared with their preoperative values (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The intervention group demonstrated superior outcomes for CVA and elastic modulus of the Achilles tendon and gastrocnemius muscle compared to the control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Postoperatively, in both groups, the AOFAS and Tegner activity scores were higher than the preoperative values within the same group, whereas the VAS scores were lower relative to the preoperative measurements. Notably, the intervention group showed higher AOFAS and Tegner activity scores than the control group at 2 and 6 months postoperatively and at the last follow-up (&lt;i&gt;P&lt;/i&gt; &lt; 0.05) and a lower VAS score at 2 months postoperatively (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). During follow-up, 59 patients (86.76%) from both groups met the criteria for returning to athletic activity. The intervention group achieved a shorter time to return to athl","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"2042-2053"},"PeriodicalIF":1.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678604","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":"Frailty Is a Predictor of Inpatient Mortality and Unplanned ICU Admission Following Early Fixation of Intertrochanteric Fractures.","authors":"Victor Koltenyuk, Jared Sasaki, Nithin Gupta, Zachary Chanmin, Ruby G Patel, Taylor Manes, Jack W Weick","doi":"10.1007/s43465-026-01751-z","DOIUrl":"10.1007/s43465-026-01751-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to examine the role of frailty in predicting inpatient mortality following early surgical fixation of intertrochanteric (IT) fractures.</p><p><strong>Methods: </strong>The ACS-TQIP (2017-21) database was queried for patients with intertrochanteric fractures undergoing surgical fixation within 48 h. Frailty status was determined using the 5-item modified frailty index (mFI-5) (0 = nonfrail, 1 = prefrail, and, 2 = frail, and > 2 = severely frail). The primary end point was inpatient mortality. Secondary end points were unplanned ICU admission and thromboembolic events (DVT or PE). Significance was considered a <i>p</i>-value < 0.05.</p><p><strong>Results: </strong>Frailty, as determined by the mFI-5, was a significant predictor of inpatient mortality and unplanned ICU admissions. Frail and severely frail patients had higher odds of mortality (OR: 2.00 and 3.58, respectively) and ICU admission (OR: 1.66, 3.09, 3.83, respectively). When compared with nonoperative management in frail (OR: 0.561) and severely frail (OR: 0.665) patients, surgical intervention within 48 h significantly reduced the risk of mortality.</p><p><strong>Conclusion: </strong>Increasing frailty status, as measured by the mFI-5, has increased odds for unplanned ICU admission and inpatient mortality following surgery within 48 h for IT fractures. Although operative management is required in these patients, these results suggest frailty may be used to preoperatively identify patients at high risk for adverse events. Future studies may seek to identify modifiable factors in the preoperative period to improve outcomes in frail patients.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-026-01751-z.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 5","pages":"1237-1243"},"PeriodicalIF":1.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137905","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":"Effect of Needle Type and Concomitant Pathologies on the Efficacy of Corticosteroid Injection in Subacromial Impingement Syndrome.","authors":"Evren Er, Hüsne Nur Bayrak, Zerrin Kasap, İlker Fatih Sari","doi":"10.1007/s43465-026-01722-4","DOIUrl":"10.1007/s43465-026-01722-4","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effect of needle type and concomitant pathologies on the efficacy of subacromial corticosteroid injection in patients with subacromial impingement syndrome.</p><p><strong>Methods: </strong>Forty patients diagnosed with subacromial impingement syndrome were retrospectively analyzed and divided into two groups: Group I (27-gauge/50 mm needle) and Group II (21-gauge/33 mm needle). Painless range of motion (ROM), NRS, SPADI, and DASH scores were assessed pre- and post-injection. MRI was used to determine whether the needle reached the supraspinatus tendon level. The presence of concomitant pathologies was recorded.</p><p><strong>Results: </strong>Both groups showed statistically significant improvements in painless flexion, abduction, and internal rotation ROM, as well as in NRS, SPADI, and DASH scores (<i>p</i> < 0.05). A significant improvement in painless external rotation ROM was observed only in Group II (<i>p</i>  < 0.001). Painless flexion ROM improved more than abduction ROM only in patients without long head of biceps brachii tendinopathy (<i>p</i>  = 0.032). Pre-injection painless abduction ROM was more limited than painless flexion ROM in patients with acromioclavicular joint degeneration (<i>p</i>  = 0.041).</p><p><strong>Conclusions: </strong>Needle type did not significantly alter treatment efficacy except in external rotation ROM. The long head of biceps brachii tendinopathy may partially benefit from subacromial corticosteroid injection, although the effect appears to be limited. Subacromial corticosteroid injection may offer therapeutic value in patients with acromioclavicular joint degeneration. Individualized needle selection and recognition of concomitant pathologies may optimize clinical outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"1941-1948"},"PeriodicalIF":1.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678578","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 Outcome of Adding Middle Trapezius Transfer to Anterior Latissimus Dorsi and Teres Major Transfer in Anterosuperior Irreparable Rotator Cuff Tears with Narrow Acromiohumeral Distance: A Comparative Study.","authors":"Chang Hee Baek, Chaemoon Lim, Jung Gon Kim, Bo Taek Kim, Seung Jin Kim","doi":"10.1007/s43465-025-01680-3","DOIUrl":"10.1007/s43465-025-01680-3","url":null,"abstract":"<p><strong>Objective: </strong>Anterosuperior irreparable rotator cuff tears (ASIRCTs), involving the supraspinatus and subscapularis, cause severe dysfunction. Combined anterior latissimus dorsi and teres major (aLDTM) tendon transfer restores transverse plane force coupling; however, superior stability may not be maintained when the preoperative acromiohumeral distance (AHD) is narrow. This study compared aLDTM tendon transfer alone versus aLDTM tendon transfer with arthroscopy-assisted middle trapezius transfer (aMTT).</p><p><strong>Methods: </strong>We retrospectively reviewed 49 patients with ASIRCTs and preoperative AHD ≤ 6 mm who underwent aLDTM tendon transfer between 2020 and 2023. Group A (<i>n</i> = 28) received aLDTM tendon transfer alone, and Group M (<i>n</i> = 21) received aLDTM tendon transfer with aMTT. Clinical outcomes at postoperatively 2 years included shoulder pain, patient-reported outcome measures (PROMs), active range of motion (aROM) and aROM strength. Radiologic outcomes included AHD, Hamada grade and transferred tendon integrity. The differences between the two groups exceeding the minimum clinically important difference (MCID) were considered clinically relevant.</p><p><strong>Results: </strong>Both groups showed significant improvements in shoulder pain, PROMs, aROM, and aROM strength. However, Constant scores (66.0 ± 11.8 vs 75.4 ± 6.9, <i>p</i> = 0.011), forward elevation (FE) (144.6 ± 24.9˚ vs 161.0 ± 9.4˚, <i>p</i> = 0.010), abduction (118.9 ± 26.5˚ vs 137.1 ± 16.2˚, <i>p</i> = 0.014), FE strength (24.4 ± 4.5N vs 28.4 ± 3.9N, <i>p</i> = 0.006) and ABD strength (22.6 ± 6.3N vs 26.9 ± 2.3N, <i>p</i> = 0.009) of group M were significantly higher than that of group A. Moreover, all surpassing MCID thresholds. Postoperative AHD was also greater in Group M (6.9 ± 1.1 mm vs 10.0 ± 3.4 mm, <i>p</i> < 0.001). Operative time (47.9 ± 4.0 min vs 96.8 ± 5.4 min, <i>p</i> < 0.001) and hospital day (7.9 ± 1.2 days vs 8.7 ± 0.9days, <i>p</i> = 0.008) were significantly shorter in Group A.</p><p><strong>Conclusions: </strong>In ASIRCTs with preoperative AHD ≤ 6 mm, both procedures improved function and radiology, but the addition of aMTT provided superior recovery of AHD, overhead motion, and strength. Augmenting an aLDTM tendon transfer with an aMTT may represent an effective strategy for optimizing outcomes in this challenging population.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"1931-1940"},"PeriodicalIF":1.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678573","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":"Recurrence Risk and Functional Outcomes of Total Knee Arthroplasty in Tuberculous Arthritis: A Systematic Review and Meta-Analysis.","authors":"Anil Regmi, Surakshya Baral, Abdus Sami, Vijay Kumar Jain, Karthikeyan P Iyengar, Ranusha Ganapathy","doi":"10.1007/s43465-026-01763-9","DOIUrl":"https://doi.org/10.1007/s43465-026-01763-9","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal tuberculosis (TB) of the knee presents major reconstructive challenges due to joint destruction, ankylosis, and deformity. While total knee arthroplasty (TKA) is a proven solution for end-stage arthritis, its use in TB-affected knees raises concerns of recurrence, perioperative complications, and prosthesis survival. This review aims to evaluate functional outcomes and recurrence rates following knee arthroplasty in tuberculosis and assess the impact of ATT duration and surgical strategy.</p><p><strong>Methods: </strong>A systematic search following PRISMA guideline (PROSPERO: CRD420251158365) was performed on PubMed, Embase, and Scopus on 10 June 2025. Continuous outcomes were pooled using random-effects meta-analysis (SMD, 95% CI), and dichotomous outcomes were analyzed using a random-effects model with Freeman-Tukey transformation. Heterogeneity was assessed with I², and subgroup differences were evaluated using Chi-square tests; P < 0.05 was considered significant.</p><p><strong>Results: </strong>Across 10 studies including 234 knees, postoperative outcomes improved significantly. KSS Knee scores increased from 35.3 to 83.5 (SMD - 3.59, 95% CI - 4.61 to - 2.58, P < 0.05), KSS Function from 32.7 to 84.2 (SMD - 3.99, 95% CI - 6.19 to - 1.79), and HSS from 37.0 to 85.9 (SMD - 6.75, 95% CI - 10.71 to - 2.78). Overall recurrence was 9%, with higher rates seen with preoperative ATT < 3 months and postoperative ATT < 12 months. Single-stage procedures had a slightly higher recurrence rate than two-stage procedures, though not statistically significant.</p><p><strong>Conclusion: </strong>Knee arthroplasty in tuberculosis significantly improves functional outcomes, and adequate pre and postoperative ATT reduces recurrence. Both single and two-stage procedures are effective when combined with optimal medical therapy.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-026-01763-9.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 6","pages":"1308-1322"},"PeriodicalIF":1.1,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204608","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":"Guest Editorial-Special Issue on Global Collaboration in Arthroscopy and Sports Medicine.","authors":"Sivaraman Arumugam, Thomas Werner Patt","doi":"10.1007/s43465-026-01697-2","DOIUrl":"10.1007/s43465-026-01697-2","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"529-530"},"PeriodicalIF":1.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573802","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}