International Orthopaedics最新文献

{"title":"Letter to the Editor regarding the article: \"Proximal versus distal tenotomy of the Iliopsoas tendon in the surgical treatment of developmental dysplasia of the hip: a randomized clinical trial\".","authors":"Yunjie Song, Limin Wei","doi":"10.1007/s00264-025-06516-1","DOIUrl":"https://doi.org/10.1007/s00264-025-06516-1","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative anaemia and one year mortality risk in older patients undergoing femoral neck fracture surgery: an observational study.","authors":"Pei-Pei Li, Ziruo Zhang, Jing Hu, Hong Zhi, Ping Xie, Xin Jiao, Dan Chen, Lian Wen","doi":"10.1007/s00264-025-06521-4","DOIUrl":"https://doi.org/10.1007/s00264-025-06521-4","url":null,"abstract":"<p><strong>Purpose: </strong>This research was designed to explore the incidence of anaemia before surgery and the rate of mortality one year after surgery for femoral neck fractures in older adults. It also investigated whether anaemia prior to surgery influences the likelihood of mortality within one year after the procedure.</p><p><strong>Methods: </strong>A retrospective cohort analysis was undertaken at Honghui Hospital, a tertiary academic medical institution affiliated with Xi'an Jiaotong University in China. This investigation included elderly individuals who underwent surgery for femoral neck fractures within the year spanning from January to December 2021. The research team gathered data encompassing demographic details, levels of haemoglobin prior to surgery, existing comorbid conditions, and mortality statistics after one year.</p><p><strong>Results: </strong>In this retrospective study, 994 patients were analyzed, with 84 reported fatalities. The incidence of anaemia in this group was 71.1%, affecting 707 individuals. Of these, 486 (48.8%) had mild anaemia, and 221 (22.2%) exhibited moderate to severe anaemia. Independent factors correlating with heightened one-year mortality risk included operative blood transfusions (odds ratio [OR] = 1.8, p = 0.0327), coronary artery disease presence (OR = 1.85, p = 0.0077), and moderate to severe anaemia (OR = 3.18, p = 0.0006). In contrast, higher body mass index (OR = 0.8, p < 0.0001) and red blood cell count (OR = 0.6, p = 0.0253) were linked to reduced one-year mortality risk. Multivariate logistic regression analyses underscored the independent association of moderate to severe anaemia with increased one-year mortality risk, with varying ORs across models: non-adjusted OR at 3.18 (p = 0.0006), Adjust I model OR at 3.08 (p = 0.0191), and Adjust II model OR at 2.96 (p = 0.0278).</p><p><strong>Conclusion: </strong>At Honghui Hospital, affiliated with Xi'an Jiaotong University in China, anemia has been identified as a common condition among elderly patients undergoing surgery for femoral neck fractures, and it significantly contributes to an elevated risk of mortality within one year post-surgery. It is advisable to implement interventions aimed at managing anaemia before surgery, which should include setting haemoglobin thresholds that are not specific to any gender for its diagnosis.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor on \"Is synovectomy still of benefit today in total knee arthroplasty with rheumatoid arthritis\".","authors":"Xianfa Zhang, Jing Wang","doi":"10.1007/s00264-025-06524-1","DOIUrl":"https://doi.org/10.1007/s00264-025-06524-1","url":null,"abstract":"<p><p>We study Hernigou P's paper \"Is synovectomy still of benefit today in total knee arthroplasty with rheumatoid arthritis?\" It highlights the need for further research and progress in this field. Future studies should address limitations like small sample sizes, inadequate patient stratification, lack of quantifiable metrics for synovectomy extent, and limited early postoperative analyses to provide stronger evidence for clinical practice.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor concerning nerve entrapment syndromes in overhead athletes: adding atmosphere with ultrasound.","authors":"Hilmi Berkan Abacıoğlu, Levent Özçakar","doi":"10.1007/s00264-025-06522-3","DOIUrl":"https://doi.org/10.1007/s00264-025-06522-3","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum five years outcomes of modular dual mobility in primary total hip arthroplasty: a systematic review.","authors":"Marco Minelli, Elizaveta Kon, Alessio D'Addona, Marco Rosolani, Berardo Di Matteo, Federico Della Rocca","doi":"10.1007/s00264-025-06507-2","DOIUrl":"https://doi.org/10.1007/s00264-025-06507-2","url":null,"abstract":"<p><strong>Background: </strong>Modular dual mobility (MDM) cups are constituted by a cobalt-chromium (CoCr) liner inserted into a standard acetabular shell, allowing for intra-operative decision and supplementary screw fixation of the acetabular component. MDM could face mechanical issues and biological issues, with the associated risk of elevated blood metal ions levels and adverse local tissue reactions (ALTRs).</p><p><strong>Materials and methods: </strong>A systematic review of the literature on minimum five years outcomes of modular dual mobility in primary total hip arthroplasty (THA) was performed on PubMed, Cochrane, and Google Scholar databases, in adherence with PRISMA guidelines. Risk of bias in each study was assessed through the JBI checklist for case series.</p><p><strong>Results: </strong>A total of 381 primary THAs with MDM acetabular cup were performed. At minimum five years follow-up, mean revision rate was 2.3% and implant survivorship was 98.2%. No MDM acetabular construct was revised specifically due to liner mechanical failure, neck-rim impingement, or ALTRs. No intraprosthetic dislocation or iliopsoas tendinitis was observed. No cases of THA dislocation were reported. Mean serum metal ion levels were observed to be within laboratory reference ranges. Greater-than-normal values of serum Co were observed in 9.4% of cases, while greater-than-normal values of serum Cr were observed in 1.6% of patients.</p><p><strong>Conclusions: </strong>The main finding of this systematic review is that modular dual mobility acetabular construct appears to be a safe and effective option for primary THA at minimum five years follow-up. Longer follow-up time is needed in order to investigate modular dual mobility long-term survivorship, revision and complication rates, clinical and radiological outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for predicting ischaemic muscle sequelae after revascularization in patients with traumatic femoral-popliteal artery injuries: a retrospective cohort study.","authors":"Huiyang Jia, Heng Zhang, Lin Jin, Haofei Wang, Qi Dong, Wei Chen, Yingze Zhang, Lin Liu, Zhiyong Hou","doi":"10.1007/s00264-025-06470-y","DOIUrl":"https://doi.org/10.1007/s00264-025-06470-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the incidence and associated risk factors of ischaemic muscle sequelae in patients with traumatic femoropopliteal artery injuries following revascularization, as well as to develop a nomogram to predict the risk of ischaemic muscle sequelae.</p><p><strong>Methods: </strong>Data from patients with acute traumatic femoropopliteal artery injuries between January 2008 and December 2022 were collected. All patients with successful limb salvage were divided into two groups based on the occurrence of ischaemic muscle sequelae: the ischemic muscle sequelae group (IG) and the non-ischaemic muscle sequelae group (NG). Univariate and multivariate logistic regression analyses were used to identify potential predictive factors associated with ischaemic muscle sequelae. A predictive nomogram was constructed and internally validated.</p><p><strong>Results: </strong>Among the 102 patients, 30 cases (29.41%) developed ischaemic muscle sequelae. Independent predictors of ischaemic muscle sequelae were identified as crush injury, HCT, and CKMB. A nomogram was constructed based on these three parameters. The area under the receiver operating characteristic (ROC) curve of the predictive model was 0.894, indicating excellent discrimination. The calibration curve demonstrated a high degree of consistency between the predicted probabilities and the observed outcomes. Additionally, the decision curve analysis (DCA) showed that the nomogram model had good predictive capability.</p><p><strong>Conclusions: </strong>Our study demonstrated that crush injury, HCT, and CKMB were independent predictors of ischaemic muscle sequelae in patients with acute traumatic femoropopliteal artery injuries following revascularization. The nomogram integrating clinical factors and blood markers can assist physicians in conveniently predicting the risk of ischaemic muscle sequelae in patients.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedures under tourniquet in sickle cell disease: safety evaluated in two hundred and thirty three sickle-cell disease anaemia adult patients in comparison with outcomes in five hundred and seventy four sickle cell anaemia patients with procedures without tourniquet.","authors":"Philippe Hernigou","doi":"10.1007/s00264-025-06510-7","DOIUrl":"https://doi.org/10.1007/s00264-025-06510-7","url":null,"abstract":"<p><strong>Purpose: </strong>There is a lack of data evaluating the impact of tourniquet versus no tourniquet surgery in patients with sickle cell disease (SCD).</p><p><strong>Methods: </strong>The records of 233 sickle cell patients who underwent orthopaedic surgery with a tourniquet between 1978 and 2018 were retrospectively reviewed. This study group (233 patients) was compared to a control group of 574 SCD patients followed by the same surgical team in the same hospital undergoing the same procedures in the same period between 1978 and 2018 but without a tourniquet. Outcomes assessed skin complications, thrombophlebitis, bone necrosis, muscle necrosis or abnormal muscle function, peripheral nerve impairment, elevated blood pressure, post-operative sickle cell crises, and blood loss under a tourniquet.</p><p><strong>Results: </strong>The pneumatic tourniquet was primarily applied proximally in both lower and upper limbs. The median tourniquet duration was 65 minutes, with most procedures lasting between 30 and 90 minutes . Postoperative medical complications occurred in both groups, with no significant difference in hospital stay (6.7 vs. 7.1 days). Painful sickling crises affected 86 patients, with a lower prevalence in transfused patients (p = 0.04). Blood loss was significantly lower in the tourniquet group during knee surgeries (438 ml vs. 731 ml, p = 0.031), resulting in fewer transfusions. Skin complications did not affect wound healing. The 90-day incidence of venous thromboembolism (VTE) was 0.4%, with no significant difference between groups. Muscle biopsies showed no necrosis immediately post-surgery, but some necrosis appeared after 12 weeks in the tourniquet group. New bone osteonecrosis cases and infection rates were similar between groups.</p><p><strong>Conclusion: </strong>this study provides valuable insights into the use of tourniquets in sickle cell disease.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index matters: morbid obese patients have different microorganism profiles in the setting of periprosthetic hip joint infections.","authors":"Maximilian Budin, Nemandra A Sandiford, Thorsten Gehrke, Mustafa Citak","doi":"10.1007/s00264-025-06513-4","DOIUrl":"https://doi.org/10.1007/s00264-025-06513-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the relationship between BMI and microorganism profiles, with a particular focus on gut microorganisms in patients with PJI following total hip arthroplasty (THA). It also explored comorbidities, that may contribute to these variations.</p><p><strong>Methods: </strong>This study included all patients treated at our institution for a PJI of a THA between 1996 and 2021. Patients were categorized into four distinct BMI groups: <30; 30-34.9; 35-39.9; ≥ 40. Bivariate and logistic regression analysis were conducted, with presentation of odds ratio (OR) and 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 3645 hip PJI cases were recruited for the final analysis. Patients with a BMI ≥ 40 had approximately a ten fold higher risk for Streptococcus dysgalactiae (p < 0.001; OR = 9.92; 95% CI 3.87-25.44) and a seven fold higher risk for Proteus mirabilis (p < 0.001; OR = 7.43; 95% CI 3.13-17.67) and Klebsiella pneumoniae (p < 0.001; OR = 6.9; 95% CI 2.47-19.31). Furthermore, polymicrobial infections (p < 0.001; OR = 2.17; 95% CI 1.50-3.15) were found to be significantly more prevalent in patients with a BMI ≥ 40.</p><p><strong>Conclusion: </strong>Obese patients (BMI ≥ 30) displayed a distinct microorganism profile in hip PJIs, mainly dominated by Firmicutes and Proteobacteria. Comorbidities such as diabetes, hypertension, and hyperlipidaemia may contribute to a leaky gut syndrome, increasing PJI risk caused by gut microorganisms. Optimizing comorbidities may help reduce the risk of hip PJI. Further research is needed to clarify the relationship between obesity, gut microbiome alterations and hip PJI development.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of high-dose dexamethasone on postoperative opioid consumption and perioperative glycaemia in fast-track primary hip arthroplasty: a retrospective cohort study.","authors":"Rosario Josefina Fabian-Quillama, Tomás Cuñat, Yocelin Saavedra, Elisabet Ripoll-Romero, Nuria Martin, Jenaro Ángel Fernández-Valencia, Montserrat Tió","doi":"10.1007/s00264-025-06430-6","DOIUrl":"https://doi.org/10.1007/s00264-025-06430-6","url":null,"abstract":"<p><strong>Background and purpose: </strong>Standard recommendations for fast-track hip arthroplasty suggest using 8-10 mg of dexamethasone to reduce opioid consumption, with potential benefits of higher doses but scarce data on glycaemic control and complications. This study compares the effects of higher doses versus the standard doses on postoperative opioid consumption, and secondarily, numerical pain scale, glycaemic control, hospital length of stay and postoperative complications.</p><p><strong>Methods: </strong>Retrospective cohort study of patients scheduled for FAST-TRACK primary hip arthroplasty between 2016 and 2021. Propensity score-matched analyses compared the standard dose group (4-8 mg) versus the high-dose group (16-24 mg).</p><p><strong>Results: </strong>168 patients were included (56 with 4-8 mg, 112 with 16-24 mg). After one-to-one propensity score matching, 52 patients were included in the standard group and 52 in the high-dose group. After matching, the median [IQR] opioid consumption in the low-dose group was 10 [0-12] and in the high-dose group was 0 [0-10], with a 95% CI of -1 to 0 (p = 0.016). In the matched group, there was a median difference of 8 mg/dL (95% CI, -2 to 7, P < 0.05) in the immediate postoperative glycaemia, of 17 mg/dl (95% CI, -2 to 14, P < 0.05) in glycaemia at 24 h and of -1 day (95% CI, -1 to 0, P < 0.05) in hospital stay. No differences in the numerical pain scale and postoperative complications were found.</p><p><strong>Conclusion: </strong>High-dose dexamethasone slightly increased perioperative glycaemia while reducing opioid consumption and shortening hospital length of stay.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous pelvic ring fracture reduction using an external fixator: a technical trick and case series.","authors":"Guillaume David, Nicholas J Tucker, Clement Marc, Vincent Steiger, Louis Rony, Cyril Mauffrey","doi":"10.1007/s00264-025-06509-0","DOIUrl":"https://doi.org/10.1007/s00264-025-06509-0","url":null,"abstract":"<p><strong>Purpose: </strong>Pelvic ring and acetabular fractures pose significant morbidity and mortality risks due to substantial haemorrhage and internal organ injury. Many percutaneous reduction techniques involve manipulating the injured side while stabilizing the uninjured side, often requiring specific or costly equipment. This article presents a technique for creating a pelvic reduction frame using a standard external fixator.</p><p><strong>Method: </strong>We included surgical pelvic ring fractures between 2018 and 2022. Pelvic reduction was achieved using an external fixator (Hoffmann III, Stryker Corporation, Kalamazoo, Michigan, USA). Reduction quality was assessed according to the technique described by Lefaivre et al., based on the following criteria: mean asymmetry (mm), mean deformity index (mm), and mean maximum horizontal or vertical displacement (mm).</p><p><strong>Results: </strong>15 patients (10 men, 5 women, mean age 35 years) underwent surgical treatment for pelvic fractures using an external fixator and percutaneous fixation. Mean operative time was 130 min (range, 80-276). Postoperative imaging showed a mean maximum displacement of 5.4 mm and a mean asymmetry of 3.7 mm, with excellent or good reductions in 11 cases.</p><p><strong>Conclusion: </strong>This system uses widely available equipment and enables the benefits of percutaneous techniques, but surgical expertise remains the key to success.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}