Indian Journal of Orthopaedics最新文献

{"title":"Efficacy and Safety of Tamsulosin in the Prevention of Postoperative Urinary Retention in Hip Fractures (TamPOUR-Hip Trial): A Randomized, Double-Blind Placebo-Controlled Study.","authors":"Sujit Kumar Tripathy, Paulson Varghese, Shahnawaz Khan, Ranjan Kumar Patel, Deepak Neradi, Mantu Jain","doi":"10.1007/s43465-026-01876-1","DOIUrl":"https://doi.org/10.1007/s43465-026-01876-1","url":null,"abstract":"<p><strong>Background: </strong>Postoperative urinary retention (POUR) is a common problem after hip fracture surgery in the elderly patients, leading to increased morbidity, catheterization, and prolonged hospitalization. Tamsulosin, an α1-adrenergic antagonist, may reduce POUR by decreasing bladder outlet resistance. This study evaluated the efficacy and safety of perioperative tamsulosin in preventing POUR in hip fracture patients.</p><p><strong>Methods: </strong>In this prospective, randomized, double-blind, placebo-controlled trial, 120 patients undergoing hip fracture surgery under spinal anaesthesia were allocated to receive either tamsulosin (0.4 mg daily) or placebo from admission until the second postoperative day. Foley catheter was removed on postoperative day one, and POUR was defined as post-void residual urine > 200 mL at six hours of catheter removal. Primary outcome was incidence of POUR; secondary outcomes included indwelling re-catheterization rates, urinary tract infections (UTIs), and adverse events.</p><p><strong>Results: </strong>POUR was observed in 16.7% of patients in the tamsulosin group compared with 33.3% in the placebo group. Tamsulosin significantly reduced the pre-void bladder volume (311.3 ± 174.5 mL vs. 402.9 ± 198.4 mL; <i>p</i> = 0.008) and post-void residual urine volume (median 20 mL vs. 53.5 mL; <i>p</i> < 0.001). Re-catheterization was less frequent with tamsulosin (8.3% vs. 21.7%), though not statistically significant. Multivariate logistic regression analysis identified female sex, longer surgical duration, and blood loss as independent risk factors for POUR, while tamsulosin use was not found to be preventive. Adverse events, including dizziness and postural hypotension, were mild and self-limiting.</p><p><strong>Conclusion: </strong>Perioperative tamsulosin was safe and improved bladder emptying, but did not significantly reduce the incidence of POUR in elderly patients undergoing hip fracture surgery. Larger multicentric studies are needed to further clarify its role in this population.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2740-2748"},"PeriodicalIF":1.3,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181711","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":"Radiological and Clinical Effects of Exercise Intervention Therapy on Adolescent Idiopathic Scoliosis: A Meta-analysis.","authors":"Yuxin Zhang, Jiulong Song, Yuxin Fang, Jiexin Gu, Jian Fu","doi":"10.1007/s43465-026-01861-8","DOIUrl":"https://doi.org/10.1007/s43465-026-01861-8","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the radiological and clinical efficacy of exercise intervention therapy in improving Cobb angle, axial trunk rotation (ATR), axial vertebral rotation (AVR), and quality of life in adolescents with adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>Literature was retrieved from databases including CNKI, Wanfang, VIP, Web of Science, and PubMed, and screened according to inclusion criteria. Methodological quality was assessed using Cochrane Risk of Bias Tool. This is a meta-analysis based on a systematic review. RevMan 5.4 software was employed to calculate pooled effect sizes for Cobb angle, ATR, AVR, and the Scoliosis Research Society-22 (SRS-22) quality of life questionnaire. This systematic review was registered at the International Prospective Register of Systematic Reviews.</p><p><strong>Results: </strong>Ten randomized controlled trials (RCTs) were included. Analysis revealed that compared with conventional interventions, exercise therapy significantly reduced Cobb angle [Standardized Mean Difference (SMD) =  -  1.80, 95% Confidence Interval (CI) (- 2.61, - 0.98), <i>P</i> < 0.05], significantly reduced ATR [SMD = - 1.55, 95% CI (- 2.31, - 0.80), <i>P</i> < 0.05], and significantly enhanced quality of life [SMD = 1.35, 95% CI(0.72,1.98), <i>P</i> < 0.05]. However, the pooled results for improving AVR did not show statistical significance [SMD = - 0.09, 95% CI(- 1.14, 0.96), <i>P</i> > 0.05].</p><p><strong>Conclusion: </strong>Exercise intervention therapy significantly improves radiological parameters including Cobb angle and ATR, effectively improves physical function in AIS patients, and also significantly enhances their quality of life.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2634-2646"},"PeriodicalIF":1.3,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181531","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":"Progressive Pseudorheumatoid Dysplasia Presenting with Cauda Equina Compression: A Case Report.","authors":"Praveenkumar Udayakumar, Pasupathy Palaniappan, Deep Sharma, Deepak Amalnath","doi":"10.1007/s43465-026-01864-5","DOIUrl":"https://doi.org/10.1007/s43465-026-01864-5","url":null,"abstract":"<p><p><b>Background</b> Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive skeletal dysplasia frequently misdiagnosed as juvenile idiopathic arthritis because of overlapping clinical features.  <b>Case presentation</b> We report a 21-year-old man who presented with bilateral leg pain and acute progressive lower-limb weakness associated with gait disturbance. Clinical examination revealed asymmetric motor weakness, absent knee and ankle reflexes, and preserved bowel and bladder function. Radiographs demonstrated generalized platyspondyly, scoliosis, and epiphyseal enlargement of long bones. Magnetic resonance imaging revealed a right paracentral L1-L2 disc extrusion causing severe central canal stenosis with compression and displacement of cauda equina nerve roots. Laboratory investigations were negative for inflammatory markers. Whole-exome sequencing identified a homozygous missense variant c.1010G  A (p.Cys337Tyr) in the CCN6 gene, confirming the diagnosis of PPD. The patient underwent posterior decompressive laminectomy with stabilization, resulting in complete neurological recovery at six weeks. <b>Conclusion</b> This case highlights the rarity of acute cauda equina syndrome in PPD and emphasizes the importance of early recognition and appropriate surgical management.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2706-2713"},"PeriodicalIF":1.3,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181548","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":"Morphometric Analysis of the Acetabular Anterior Column for Retrograde Screw Fixation: A Comparative CT Study.","authors":"Günbay Noyan Dirlik, Serkan Aydın, Taha Alperen Özçelik, Abdulkadir Toker, Merve Türkegün Şengül, Ahmet Aslan","doi":"10.1007/s43465-026-01873-4","DOIUrl":"https://doi.org/10.1007/s43465-026-01873-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to define the morphological characteristics of the acetabular anterior column to facilitate safe and efficient intramedullary fixation and to compare these parameters across different populations.</p><p><strong>Methods: </strong>Pelvic computed tomography (CT) scans of 82 adult patients (42 Turkish and 40 Russian; males and females, aged 18-92 years) were retrospectively analyzed. Measurements included the minimum corridor diameter, maximum corridor length, and craniocaudal (sagittal) and mediolateral (horizontal) angles of the anterior column. Comparisons were made according to ethnicity, age, and sex.</p><p><strong>Results: </strong>Among 82 patients (51.2% Turkish, 48.8% Russian), no significant age difference was found between the groups (p = 0.126). In the Turkish population, the mean maximum corridor length was 123.6 ± 8.09 mm, and the mean minimum diameter was 12.1 ± 2.08 mm; in the Russian population, these values were 125.8 ± 9.21 mm and 11.5 ± 2.52 mm, respectively (p = 0.247 and p = 0.241, respectively). No significant interethnic differences were found in morphological features. Subgroup analysis revealed that Turkish males had a significantly greater mean minimum diameter (12.33 ± 2.04 mm) than Russian males (10.69 ± 1.85 mm) (p = 0.019). Within both ethnicities, males had a significantly greater maximum corridor length than females.</p><p><strong>Conclusion: </strong>Intramedullary fixation of anterior column acetabular fractures requires precise morphometric understanding. This study provides normative morphometric data for Turkish and Russian populations, offering guidance for implant design, surgical planning, and future comparative research.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01873-4.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2810-2821"},"PeriodicalIF":1.3,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181402","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":"The Relationship Between Static Plantar Pressure Distribution, Lower Extremity Isokinetic Muscle Strength, and Body Composition in Elite Badminton Players.","authors":"Aydan Orscelik, Buse Ataoglu, Zeynel Duman, Gökhan Büyüklüoğlu, Duran Akbaş","doi":"10.1007/s43465-026-01845-8","DOIUrl":"10.1007/s43465-026-01845-8","url":null,"abstract":"<p><strong>Background: </strong>Badminton is characterized by rapid multidirectional movements and repetitive unilateral loading, which may influence plantar pressure distribution, lower-extremity muscle strength, and body composition. The use of static plantar pressure assessment provides a practical and accessible method to characterize loading patterns although it does not capture dynamic sport-specific movements. This study aimed to evaluate these parameters and examine their interrelationships in elite badminton athletes.</p><p><strong>Methods: </strong>This retrospective study included 31 elite badminton athletes (14 females, 17 males). Static plantar pressure distribution was assessed using pedobarography, isokinetic knee strength was measured at 60 and 180°/s using a dynamometer, and body composition was evaluated via multi-frequency bioimpedance analysis. Hamstring-quadriceps ratios (H/Q), bilateral strength asymmetries (calculated as absolute inter-limb differences), and plantar pressure variables were calculated. Group comparisons were performed using Mann-Whitney U tests, associations were assessed using Spearman correlation with Benjamini-Hochberg correction, and exploratory multiple linear regression analysis was conducted to identify potential predictors of performance outcomes.</p><p><strong>Results: </strong>Model-based estimates of muscle mass demonstrated strong correlations with isokinetic peak torque at both angular velocities (<i>ρ</i> = 0.847-0.918, all FDR-adjusted <i>p</i> < 0.001) and were identified as a consistent predictor knee flexor and extensor strength (<i>β</i> = 0.52-0.64, <i>R</i> ² = 56-65%). Male athletes showed significantly greater forefoot loading and higher torque production compared with females (<i>p</i> < 0.05). Anthropometric variables did not significantly predict plantar pressure distribution or strength asymmetry. Although mean H/Q ratios were within normative ranges, their interpretation should be approached cautiously, and substantial inter-individual variability in asymmetry was observed.</p><p><strong>Conclusion: </strong>Model-derived muscle mass appears to be an important correlate of isokinetic knee strength in elite badminton athletes, whereas plantar loading patterns and strength asymmetries appear to be influenced by neuromuscular and biomechanical factors beyond body morphology. Given the observational design, these findings should be interpreted cautiously. Multidimensional assessment may support individualized performance optimization and inform, rather than directly predict, injury-risk management.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"2075-2085"},"PeriodicalIF":1.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678386","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":"Pack-Size-Dependent Effects of Bone Cement Use in Unicompartmental Knee Arthroplasty: A Prospective Randomized Trial.","authors":"Zhenbao Lu, Qingshan Xu, Yuhua Feng, Yebao Xu, Xu Wang, Qijin Wang","doi":"10.1007/s43465-026-01849-4","DOIUrl":"https://doi.org/10.1007/s43465-026-01849-4","url":null,"abstract":"<p><strong>Purpose: </strong>Excess bone cement is often discarded in unicompartmental knee arthroplasty (UKA), increasing costs and potentially cement-related complications. Although cement inefficiency is recognized in total knee arthroplasty (TKA), no prospective randomized trial has assessed the effect of cement pack size in UKA. We compared 20-g and 40-g cement packs for cement utilization, radiographic fixation, and 1-year outcomes.</p><p><strong>Methods: </strong>In this prospective single-center randomized trial (from September 1, 2022 to June 30, 2024), patients undergoing medial UKA were allocated to 40-g (<i>n</i> = 98) or 20-g (<i>n</i> = 100) cement packs. Outcomes included cement used, wastage rate, penetration depth, radiolucent lines, extrusion, and 1-year implant survival. Groups were compared using appropriate parametric or nonparametric tests, and survival was analyzed using the Kaplan-Meier method with the log-rank test.</p><p><strong>Results: </strong>Cement used was similar (≈8.1 g; <i>P</i> = 0.173), but the 40-g group had a higher wastage rate than the 20-g group (85.76% vs. 71.49%; <i>P</i> < 0.001). Cement penetration (≈1.5 mm femur, ≈2.5 mm tibia), radiolucent lines (≈18-20%), and extrusion (≈12-18%) were comparable. One patient in the 40-g group developed infection requiring debridement, antibiotics, and implant retention (DAIR). One-year implant survival was 100% in the 20-g group and 99.0% in the 40-g group (<i>P</i> > 0.3).</p><p><strong>Conclusions: </strong>In UKA without substantial bone defects, a 20-g cement allocation strategy reduces cement waste while maintaining comparable short-term radiographic fixation and clinical outcomes to a 40-g strategy. Under institutional pricing assumptions, smaller packs were associated with estimated cement acquisition cost savings, so 20-g allocation may be considered in routine UKA when substantial defects are absent.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2347-2355"},"PeriodicalIF":1.3,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108728","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":"Diagnostic Dilemmas in Periprosthetic Joint Infection: Validating the 2018 MSIS Criteria in an Australian Healthcare Context.","authors":"Dimitrios Nikos, Kim Pham, Arjun Fadia, James Sires, Andrew P Kurmis","doi":"10.1007/s43465-026-01843-w","DOIUrl":"https://doi.org/10.1007/s43465-026-01843-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Periprosthetic joint infection (PJI) is a serious complication of joint arthroplasty, requiring accurate diagnosis to guide effective management. The 2018 Musculoskeletal Infection Society (MSIS) criteria provide a structured framework for PJI diagnosis, integrating clinical, serological, microbiological, and histopathological data. Although these criteria perform well in North American studies, their utility in the Australian healthcare setting-where access to specialised preoperative tests may be limited-remains uncertain. This study, therefore, evaluated the diagnostic accuracy of the 2018 MSIS criteria in an Australian cohort and examined whether incorporating routinely available local biomarkers could improve preoperative assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review was performed on 133 patients with suspected PJI within the Northern Adelaide Local Health Network (Adelaide, SA, Australia) from 2019 to 2024. Cases were evaluated using the 2018 MSIS minor and major diagnostic criteria, with intraoperative findings serving as the gold standard reference. Diagnostic performance was assessed using multinomial and ordinal logistic regression, sensitivity, specificity, and receiver-operating characteristic analysis. Exploratory biomarkers-albumin, white cell count (WCC), and polymorphonuclear cell percentage (PMN%)-were also examined due to their availability and established associations with infection severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Intraoperative MSIS criteria demonstrated strong diagnostic accuracy (AUC = 0.82), whereas preoperative criteria showed poor alignment with the gold standard (AUC = 0.48). Complete preoperative MSIS datasets-requiring ESR, CRP, synovial WCC, PMN%, and α-defensin-were available in fewer than 10 cases (&lt; 8%), reflecting widespread data incompleteness. High rates of missing laboratory values, particularly ESR (available in only 5.3% of cases) and synovial PMN% (available in 22.6%), substantially limited the reliability of preoperative scoring. In contrast, routine biomarkers such as WCC (AUC = 0.57), PMN% (AUC = 0.57), and albumin (AUC = 0.38)-each available in nearly 100% of patients-showed limited standalone accuracy but may provide pragmatic supplementary clinical information when interpreted alongside the MSIS framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Intraoperative MSIS criteria demonstrated strong diagnostic performance in this cohort, although this may be influenced by selection bias given the inclusion of only surgically managed cases. Preoperative diagnostic performance appeared limited and was likely influenced by incomplete laboratory testing rather than reflecting intrinsic limitations of the MSIS criteria. These findings highlight the challenges of applying the full MSIS preoperative framework in routine Australian practice. Improved compliance with recommended preoperative investigations and better resource allocation may enhance diagnostic ","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2356-2367"},"PeriodicalIF":1.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108947","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":"Independent Association Between Lumbar Intervertebral Disc Degeneration and Fatty Degeneration of Paravertebral Muscles.","authors":"Ki Tae Park, Changkyun Jeong, Jin Kwang Lee, Hun Kyu Shin, Ji Hyun Ahn, Jai Hyung Park","doi":"10.1007/s43465-026-01840-z","DOIUrl":"https://doi.org/10.1007/s43465-026-01840-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the associations between degeneration of the lumbar intervertebral disc and degeneration of paravertebral muscles.</p><p><strong>Methods: </strong>735 adults who underwent a comprehensive health check-up from March 2012 to February 2018 were analyzed with a self-diagnosis questionnaire and T2-weighted magnetic resonance imaging of L4-5 intervertebral disc and paravertebral muscles. For degeneration of the intervertebral disc, basic information of subjects such as age, sex, and variables of smart questionnaire data including history of osteoporosis and shift work were evaluated. The association between the degeneration of the lumbar intervertebral disc and fatty degeneration of paravertebral muscles was analyzed.</p><p><strong>Results: </strong>The odds ratio for having degeneration of paravertebral muscles was 4.67 (95% CI 3.31-6.59) for the group with severe fatty degeneration of the multifidus and 3.87 (95% CI 2.80-5.36) for the group with severe fatty degeneration of the erector spinae muscle, showing significant associations of degeneration of paravertebral muscles with severe fatty degeneration of the multifidus and the erector spinae muscle (both <i>p</i> < 0.001). Even after adjusting for age, sex, osteoporosis, and shift work as confounding variables, the odds ratios to having degeneration of paravertebral muscles were 3.75 (95% CI 2.56-5.49) and 3.31 (95% CI 2.30-4.77), respectively, for the two groups, showing significant associations (both <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Fatty degeneration of paravertebral muscles was significantly associated with degenerative changes of intervertebral discs in the lumbar spine, even considering age, sex, osteoporosis, and shift work.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01840-z.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2663-2671"},"PeriodicalIF":1.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181296","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":"Efficacy Assessment of Intraoperative Traction Table Readjustment Combined with Percutaneous Cerclage Wiring and Long Intramedullary Nail for Unstable Femoral Subtrochanteric Fractures.","authors":"Liang Zhou, Gang-Xiang Wang","doi":"10.1007/s43465-026-01847-6","DOIUrl":"https://doi.org/10.1007/s43465-026-01847-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and clinical efficacy of intraoperative traction table readjustment combined with percutaneous cerclage wiring and long intramedullary nailing in the treatment of femoral subtrochanteric fractures.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 28 patients with femoral subtrochanteric fractures who were treated using traction table readjustment combined with percutaneous cerclage wiring and long intramedullary nails between February 2019 and January 2025.</p><p><strong>Results: </strong>All 28 patients completed follow-up, with durations ranging from 6 to 16 months (mean 8.5 months). Fracture union was achieved in 27 patients (union rate 96.4%), with a mean healing time of 5.6 months (range 3.5-12 months). One patient developed nonunion at 8 months postoperatively and achieved union after bone grafting and supplementary plate fixation. Another patient experienced wire slippage during surgery, but the fracture still healed successfully. Based on the modified Harris Hip Score, functional outcomes were graded as excellent in 19 cases, good in 5 cases, and fair in 4 cases, with 85.7% of patients achieving excellent or good hip function.</p><p><strong>Conclusion: </strong>Traction table readjustment combined with percutaneous cerclage wiring and long intramedullary nail could be considered as one of several treatment options for unstable femoral subtrochanteric fractures.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2787-2794"},"PeriodicalIF":1.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181661","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":"Restricted Kinematic Alignment Total Knee Arthroplasty Using CT-Based Patient-Specific Jigs: An Observational Feasibility Study from an Indian Cohort.","authors":"BoobathiRaja Rs, Bharath Loganathan, Sivamurugan S","doi":"10.1007/s43465-026-01844-9","DOIUrl":"https://doi.org/10.1007/s43465-026-01844-9","url":null,"abstract":"<p><strong>Background: </strong>Restricted kinematic alignment (rKA) aims to restore patient-specific knee anatomy within defined safety boundaries during total knee arthroplasty (TKA). Evidence regarding the feasibility of rKA using indigenously developed patient-specific instrumentation (PSI) in the Indian population remains limited.</p><p><strong>Methods: </strong>This single-center, single-surgeon prospective observational study included consecutive patients aged ≥ 50 years with primary osteoarthritis undergoing rKA-TKA using an indigenously developed CT-based patient-specific jig system (PERFIT-R) between January 2022 and January 2024. Valgus knees were excluded as the system was initially developed for varus morphology, limiting generalizability. CT-based preoperative planning was used to guide component positioning within restricted kinematic alignment boundaries. Functional outcomes were assessed preoperatively and at 6, 12, and 18 months postoperatively using WOMAC, Oxford Knee Score (OKS), Knee Society Score (KSS), SF-12, EQ-5D, and Forgotten Joint Score (FJS). Agreement between planned and achieved bone resections was assessed intraoperatively using caliper measurements as an indicator of execution consistency. Complications were recorded prospectively.</p><p><strong>Results: </strong>A total of 246 patients were included in the study cohort, with follow-up ranging from 6 to 18 months. The mean age was 64 ± 8.9 years, and 13.8% were male. Statistically significant improvements were observed in WOMAC, OKS, KSS, SF-12 Physical Component Score, and EQ-5D across follow-up (<i>p</i> < 0.05). The magnitude of improvement exceeded commonly reported minimal clinically important difference (MCID) thresholds; however, these findings should be interpreted cautiously as MCID values were derived from external populations and were not validated in this cohort. The Forgotten Joint Score remained relatively stable during follow-up. Planned bone resections were generally within ± 1 mm of intended values, suggesting intraoperative execution consistency rather than radiographic alignment accuracy. The overall complication rate was 2.0%, with no revision procedures during the follow-up period.</p><p><strong>Conclusion: </strong>CT-based patient-specific instrumentation-guided restricted kinematic alignment TKA appears feasible in a selected cohort, with consistent intraoperative execution and favorable early functional outcome trends. However, in the absence of a control group, standardized radiographic validation, and long-term follow-up, these findings should be interpreted as preliminary and hypothesis-generating. Further comparative studies with objective alignment assessment and extended follow-up are required before definitive conclusions regarding clinical effectiveness and generalizability can be established.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2330-2339"},"PeriodicalIF":1.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108996","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}