Indian Journal of Orthopaedics最新文献

{"title":"Designing of a Distal Humerus Anatomical Biplanar Locking Fixation Plate.","authors":"Anil Kumar Gupta, Varun Singh, Khem Chand Gagal, Sumitra Saini, Amarjeet Meena","doi":"10.1007/s43465-025-01349-x","DOIUrl":"10.1007/s43465-025-01349-x","url":null,"abstract":"<p><strong>Aims: </strong>For anatomical reduction and stable bi-columnar fixation with two separate plates, to allow early joint motion is presently the treatment of choice for distal humerus fractures. Although there is a wide range of implants available for distal humerus fractures but none provides adequate fixation in distal fragment, particularly in very distal and osteoporotic fractures. The present study was conducted to overcome such problems and develop a single pre-contoured locking plate, which can match the anatomy of different sizes of distal humerus, with maximum options of screw placement in distal fragment, preferably in multiple angular planes.</p><p><strong>Methods: </strong>The present study describes about the development of an innovative Y-shape anatomical locking plate for distal humerus fractures, after a detailed morphological study of lower end of humerus in a large number of cadaveric bones. This plate has been designed in such a way to provide wide range of distal fixation options in both coronal as well as sagittal planes.</p><p><strong>Discussion: </strong>The proposed plate is anatomically designed, pre-contoured locking plate construct requiring minimum further molding to match the anatomy of distal humerus in different bone sizes. All the screws are contributing to the stability of the construct. It gives wide range of screw placement options in distal fragment in both coronal and sagittal planes. It allows the surgeon to put long intercondylar screw through the plate both from medial and lateral sides.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 5","pages":"620-626"},"PeriodicalIF":1.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010965","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":"Modified Macroscopic Soft Tissue Injury (Modified MASTI) Classification for Bone and Soft Tissue Integrity in Cruciate Retaining Total Knee Arthroplasty.","authors":"Ravikumar Mukartihal, Rajdeep Das, Sharan Shivaraj Patil, Vikram G K Bhat, S Chandan, Ratnakar Vecham, A V Gurava Reddy, Adarsh Annapareddy","doi":"10.1007/s43465-025-01343-3","DOIUrl":"10.1007/s43465-025-01343-3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to develop a 'modified macroscopic soft tissue injury (MASTI) classification' for cruciate retaining (CR) total knee arthroplasty (TKA), and compare the iatrogenic injury of robotic-arm assisted (RA) TKA and conventional jig-based (CJ) TKA using it.</p><p><strong>Methods: </strong>100 symptomatic knee osteoarthritis patients were chosen of which fifty received RA TKA, whereas fifty received CJ TKA. Posterior cruciate ligament (PCL), soft tissue envelope and bone resection surfaces were assessed during operation and scores allotted for each. The overall score was then graded to form the classification.</p><p><strong>Results: </strong>The classification had a high inter-observer reliability. RA TKA patients had significantly better PCL scores, soft tissue injury scores, bony injury scores, and modified MASTI grades, and had decreased chances and extent of soft tissue release for coronal balancing. Lesser degree of constitutional varus and sagittal plane deformity, and lower BMI have been found to be associated with better soft tissue preservation and better-modified MASTI grades.</p><p><strong>Conclusion: </strong>The 'modified MASTI classification' is a validated and reliable system to serve as a universal tool and platform for recording and grading iatrogenic bone and soft tissue injury during CR TKA. Using this classification, RA TKA is found to be less invasive and inflicts lesser extent of iatrogenic injuries when compared to CJ TKA. This classification can also be used as a parameter for evaluating the outcome of bone and soft tissue injuries and soft tissue releases to short- and long-term functional outcomes of patients, complications and longevity of implants.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-025-01343-3.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 3","pages":"414-425"},"PeriodicalIF":1.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810971","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 Advanced Osteoarthritis Mimic Neuropathic Joint?","authors":"Shubhranshu Shekhar Mohanty, Ashraf Shaikh, Ajinkya Desale, Prashant Kamble, Rudra Prabhu","doi":"10.1007/s43465-025-01347-z","DOIUrl":"10.1007/s43465-025-01347-z","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoarthritis (OA) is a prevalent condition among the elderly and leads to pain and functional limitations. Radiographic imaging often fails to correlate with symptom severity, and advanced OA may exhibit features reminiscent of neuropathic joints. This study explored the clinicopathological and histopathological correlations between advanced OA and neuropathic joints, hypothesizing clinical similarities.</p><p><strong>Methods: </strong>A retrospective study involving 43 patients who underwent total knee arthroplasty for advanced knee OA was conducted from 2016 to 2020. Clinical, radiological, and histopathological evaluations were performed. Advanced OA was defined as an Ahlbach grade IV or above. The functional Knee Society Score (KSS) was used to assess clinical severity, and histopathology was considered \"significant\" if the results were consistent with the neuropathic joint findings. The statistical analyses included univariate and binary logistic regression analyses.</p><p><strong>Results: </strong>The mean age was 57.63 ± 17.13 years, and most patients were females (69.77%). A total of 53.49% of the grading systems yielded histopathological findings resembling those of neuropathic joints. Univariate analysis revealed significant correlations between histopathology and the functional KSS, Ahlbach grade, and NRS score (<i>p</i> < 0.01). Binary logistic regression confirmed that KSS (< 40) and NRS score (< 7) were significant predictors (<i>p</i> < 0.001, Nagelkarke <i>R</i> ^<i>2</i>  = 0.576).</p><p><strong>Conclusion: </strong>Patients with advanced knee OA may exhibit characteristics resembling those of neuropathic joints, particularly individuals with a poorer functional knee. Thorough assessments are crucial for distinguishing between primary OA and neuropathic joint pathology and for carrying out more precise management strategies. This study provides valuable insights into the complex presentation of advanced knee OA and highlights the importance of using more constrained prosthesis and long stem components for potentially better outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 5","pages":"667-672"},"PeriodicalIF":1.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003521","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":"Asymptomatic Rotator Cuff Tears Among the Indian Population: Prevalence, Risk Factors, and Tear Characteristics.","authors":"Jayadev Tankala, Apurve Parameswaran, Vikas Kapildeo Yadav, Madhavi Nori, Krishna Kiran Eachempati, Sunil Apsingi","doi":"10.1007/s43465-025-01346-0","DOIUrl":"10.1007/s43465-025-01346-0","url":null,"abstract":"<p><strong>Background: </strong>Rotator cuff tears (RCTs) are common among the middle-aged and elderly, but frequently remain asymptomatic. The purpose of this study was to evaluate the prevalence of asymptomatic full and partial-thickness RCTs in the Indian population, and to assess their association with potential risk factors for their development.</p><p><strong>Methods: </strong>In all, 284 asymptomatic shoulders in 150 Indian patients (74.6% male, mean age 58.6 ± 9.3 years) over the age of 40 years who presented with non-shoulder-related complaints between March 2018 and March 2019 were studied. Their medical history, and physical and ultrasonographic examination findings were noted. The prevalence and characteristics of RCTs were assessed. The association between RCTs and potential risk factors for their occurrence (increasing age, sex, hand dominance, repetitive overhead activity, and a history of smoking, diabetes mellitus, and thyroid disorders) was assessed.</p><p><strong>Results: </strong>A prevalence of 10.6% (95% CI 7.0%-14.1%), 10.9% (95% CI 7.3%-14.5%), and 21.1% (16.4%-25.9%) was noted for full-thickness RCTs, partial-thickness RCTs, and RCTs overall. Supraspinatus tears were the most common. Partial width and articular side tears were most prevalent among full and partial-thickness RCTs, respectively. Full-thickness tears were more prevalent among the elderly and those with a history of repetitive overhead activity. A statistically significant but clinically negligible deterioration of range of movement and clinical scores was noted among patients with asymptomatic RCTs.</p><p><strong>Conclusion: </strong>Asymptomatic RCTs are common among Indians above the age of 40 years. Future research can investigate the reasons for development of symptoms and disability, and the benefits of early detection of RCTs.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 6","pages":"800-806"},"PeriodicalIF":1.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283764","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":"Proximal Tibia Fractures in Osteoporosis.","authors":"Ravi Sauhta, Dheeraj Makkar","doi":"10.1007/s43465-025-01337-1","DOIUrl":"10.1007/s43465-025-01337-1","url":null,"abstract":"<p><strong>Background: </strong>Tibial plateau fractures are frequently observed in elderly patients, often resulting from low-energy trauma. The treatment of tibial plateau fractures in this population is further complicated by factors such as osteoporosis, osteoarthritis, and other medical comorbidities.</p><p><strong>Objective: </strong>This article provides a comprehensive review of the different treatment strategies for proximal tibial fractures in the elderly. A variety of internal and external fixation techniques, medical management as well as acute arthroplasty, are discussed as potential approaches for achieving optimal reconstruction and functional recovery.</p><p><strong>What is already known: </strong>Existing literature emphasizes that osteoporotic bones, characterized by reduced bone density and compromised structural integrity, pose significant challenges to fracture fixation. These factors often diminish the efficacy of fixation devices in proximal tibial fractures, leading to an increased likelihood of fixation failure.</p><p><strong>Gap in literature: </strong>While the high failure rates associated with osteoporotic bone fixation are wellrecognized, there is a notable lack of comprehensive studies that integrate biomechanical, biological, and technological advancements to improve fixation outcomes, in proximal tibial fractures. This article aims to address this gap by reviewing current diagnostic approaches and exploring innovative strategies involving advanced materials and regenerative technologies designed to enhance fixation success.</p><p><strong>Conclusion: </strong>The management of proximal tibial fractures in the elderly requires a nuanced approach that integrates surgical intervention with medical management. A tailored treatment plan, based on specific fracture characteristics and overall health, is critical to optimizing postoperative functional outcomes. This article emphasizes the importance of a comprehensive, individualized treatment strategy to improve recovery and quality of life for elderly patients suffering from tibial plateau fractures.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 3","pages":"326-345"},"PeriodicalIF":1.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811160","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":"Osteoporotic Distal Femur Fractures: An Overview.","authors":"Vivek Trikha, Arvind Kumar","doi":"10.1007/s43465-025-01345-1","DOIUrl":"10.1007/s43465-025-01345-1","url":null,"abstract":"<p><strong>Background: </strong>Distal femur fractures in geriatric patients present a significant challenge due to age-related factors, including osteoporosis, comorbidities, and diminished functional reserve. These injuries have high morbidity and require nuanced management strategies to optimize outcomes. In the current chapter, we have reviewed the challenges associated with these intricate injuries and the potential solutions for their favorable outcomes.</p><p><strong>Method: </strong>We reviewed the published literature on epidemiology, pathophysiology, clinical presentation, and current treatment modalities for distal femur fractures in the elderly population, with a focus on advances in surgical techniques, rehabilitation strategies, and outcomes.</p><p><strong>Discussion: </strong>Operative treatment remains the mainstay, tailored to fracture patterns, patient comorbidities, and bone quality. Locking plates offer strong fixation in osteoporotic bone, while intramedullary nails, especially the newer generation ones, provide better biomechanical stability for unstable fracture types. Total knee replacement and distal femur replacement is a viable option in severe cases with comminution or poor bone quality.</p><p><strong>Conclusion: </strong>Distal femur fractures in the elderly are complex injuries with high morbidity and mortality. Early surgical intervention, optimized postoperative care, and a focus on addressing osteoporosis are key to improving outcomes and minimizing the long-term impact of these fractures on the vulnerable population. Favorable fracture healing can be achieved with plates, nails and their combinations as long as they are judiciously used.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 3","pages":"311-325"},"PeriodicalIF":1.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811137","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":"Osteosynthesis of Schatzker's Type II and Type III Lateral Tibial Condyle Fracture With or Without Bone Graft-A Clinical and Radiological Prospective Study.","authors":"K Barath, M N Kumar, Sunil Lakshmipura Krishnamurthy","doi":"10.1007/s43465-025-01339-z","DOIUrl":"10.1007/s43465-025-01339-z","url":null,"abstract":"<p><strong>Background: </strong>Tibial plateau fractures can indeed be quite complex, and their management is critical for ensuring optimal outcomes. The management of subchondral cavities following the elevation of depressed plateau fragments is challenging. There are various options to manage the defect, autologous cortico-cancellous bone transfer, bone graft substitutes, and modification of internal fixation techniques in order to minimize the degree of subchondral collapse and articular incongruity.</p><p><strong>Materials and methodology: </strong>A longitudinal prospective study was conducted at our institute. All patients with closed Schatzker type 2 and 3 tibial plateau fractures with articular depression <20 mm were alternatively assigned into two groups, by matching fracture types. Without bone graft, the group underwent treatment in the form of open reduction and plating for lateral condyle fracture. The bone graft group underwent additional bone grafting apart from plating. Each group had 20 patients. Patients were followed at regular intervals of 1 month, 3 months, 6 months, 12 months, and until fracture union.</p><p><strong>Results: </strong>By comparing our results between the two groups, we found that there was no significant difference between groups with and without bone grafting for internal fixation of depressed <20 mm type II and type III tibial plateau fractures. The functional and radiological outcomes, time to union, and complication rates were similar in the two groups, and there was no statistically significant difference between the groups.</p><p><strong>Conclusion: </strong>For osteosynthesis of depressed tibial plateau fractures, Schatzker type 2 and type 3 with depression of <20 mm, internal fixation without bone graft is a viable option. There is no statistically significant difference in functional and radiological outcomes between bone grafting and non bone grafting group.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 5","pages":"627-634"},"PeriodicalIF":1.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012607","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":"Periprosthetic Distal Femoral Fractures: Current Concepts and Management Strategies.","authors":"Dhanasekara Raja Palanisami, Imran Asif, Ramesh Perumal, Velmurugesan Purnaganapathi Sundaram, Dheenadayalan Jayaramaraju","doi":"10.1007/s43465-025-01336-2","DOIUrl":"10.1007/s43465-025-01336-2","url":null,"abstract":"<p><strong>Aim: </strong>Periprosthetic distal femoral fractures present significant challenges in management due to high morbidity and mortality rates. We discuss the treatment options based on fracture pattern, location and status of the prosthesis.</p><p><strong>Methods: </strong>Surgical treatment is favored over nonoperative management to enable early mobilization and prevent complications. The Rorabeck and Taylor classification system for periprosthetic fractures was used to identify the prosthesis status. For stable prosthesis, fixation method was decided based on the location of the fracture from the flange, level of comminution and bone quality.</p><p><strong>Results: </strong>Well-fixed prosthetic components require internal fixation with locking plates either single or double or retrograde intramedullary interlocking nail. A revision knee replacement could be done in patients with loose prosthesis and good bone stock. Distal femoral replacement was required in patients with loose components and poor bone stock along with fracture. Treatment of osteoporosis is an integral part of the management. We have described a surgical algorithm to be followed based on the above protocol.</p><p><strong>Conclusion: </strong>Treatment of periprosthetic fractures after TKA needs a tailored treatment approach based on factors such as bone quality, prosthesis stability, fracture location, and patient-specific considerations. A personalized strategy ensures optimal outcomes by addressing the unique challenges of each case and balancing the need for stability, mobility, and long-term implant survival.The surgical algorithm we have described helps in managing periprosthetic fractures effectively.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1137-1146"},"PeriodicalIF":1.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952308","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":"Partial Cuff Repair in Rotator Cuff Tears: Current Concepts and Clinical Considerations.","authors":"Konstantinos Sidiropoulos, S Samundeeswari, Vasileios Giannatos, Michael Kotsapas, Paolo Arrigoni, Fredy Montoya, Emmanouil Brilakis, David Latz, Christos Koukos","doi":"10.1007/s43465-025-01338-0","DOIUrl":"10.1007/s43465-025-01338-0","url":null,"abstract":"<p><strong>Background: </strong>Partial-thickness rotator cuff tears are a commonly underreported shoulder condition that can lead to pain, functional impairment, and limited range of motion. These tears affect both young, active individuals and the elderly. If left untreated, partial-thickness tears may progress to full-thickness tears over time.</p><p><strong>Classification and diagnosis: </strong>Partial-thickness tears can occur on the bursal side, articular side, or within the tendon itself (intratendinous). The severity of pain and the risk of tear progression depend on the tear's location. Diagnosis often involves physical examination, clinical suspicion, and imaging techniques such as ultrasound, MRI, or diagnostic arthroscopy. Despite these methods, some tears may remain undetected.</p><p><strong>Treatment options: </strong>Conservative management, typically spanning 3 to 6 months, is often recommended for non-athletic patients. Treatment may include Platelet-Rich Plasma (PRP) therapy, corticosteroid injections, prolotherapy, sodium hyaluronate, anaesthetics, atelocollagen, and physiotherapy. If pain and function do not improve adequately, arthroscopic repair is indicated. Repairs may be performed in situ or converted to full-thickness repairs. Operative treatment followed by a structured 6-month rehabilitation protocol generally leads to good to excellent functional outcomes.</p><p><strong>Conclusion: </strong>Early and accurate diagnosis, along with a tailored treatment plan, is essential to prevent the progression of partial-thickness rotator cuff tears to irreparable damage or cuff arthropathy, thereby ensuring optimal patient outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 6","pages":"743-755"},"PeriodicalIF":1.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283784","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":"Structured Exercise Program for Hip Arthroplasty: An Expert Consensus Using the Delphi Technique.","authors":"Valluri Nandini, Chrysolyte Mohanan, Antony Leo Aseer Peter, Artaban Johnson Jeldi, Mohamed Sameer, Soundararajan Kannan","doi":"10.1007/s43465-025-01335-3","DOIUrl":"10.1007/s43465-025-01335-3","url":null,"abstract":"<p><strong>Background: </strong>A structured exercise program following hip arthroplasty for hip fractures is crucial for improving patients' physical function and quality of life. Despite the increasing incidence of hip fractures, there is a dearth of literature on exercise programs for hip arthroplasty performed for fractures. This study aimed to obtain an expert consensus on a structured exercise program for hip arthroplasty patients.</p><p><strong>Methods: </strong>A literature search was performed in electronic databases such as PubMed, Web of Science, PEDro, and Scopus, and evidence was pooled and formulated into items for the protocol. A three-round, online modified Delphi survey was conducted to validate the results of the framed exercise protocol which included national and international physiotherapy experts as panelists.</p><p><strong>Results: </strong>In round 1, 59 items about rehabilitation were mailed to the panelists, and 50 items reached a consensus. Round 2 had 19 items, and 13 items reached a consensus. Consensus was sought on items for which the authors disagreed by sending them for review before the next round. In round three, a model exercise program was framed based on the results of previous rounds and was mailed to the panelists for their feedback. Based on their comments and suggestions, the framework of the structured exercise program was finalized.</p><p><strong>Conclusions: </strong>Based on the results of the Delphi survey, the exercise protocol for hip arthroplasty was framed and validated. The validated exercise program can serve as guidance for physiotherapists in enhancing optimal recovery following hip arthroplasty.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-025-01335-3.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 4","pages":"539-548"},"PeriodicalIF":1.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010035","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}